Thursday, October 16, 2008

Mommy Time

Daughter's first call came about 11:30 this morning. Her blood sugar had dropped a little, and she was concerned because there was someone different handling meds today, and she didn't think she would take good care of her. I assured her that she'd be fine, and that she had the same instructions to follow as all the other staff.
The second call came at 12:30. Daughter was in tears. She couldn't tell me what was wrong, she was just stressed and worried. She insisted she needed to see one of her doctors right away. I considered my schedule. I needed to go to town to visit some folks in a nursing home. Tonight I have the second Access class. Daughter had left frustrated this morning, because I had told her she had to apologize to her respite provider tonight. She'd told her that she had vacuumed the stairs Tuesday, and she hadn't. I suspected this was about me "abandoning" her two nights this week, so I decided it would be better to pick her up early if I wanted to go to class tonight. If I didn't deal with her need then, she'd manufacture a crisis to keep me from going to class.
So I did my best to reassure her and help her make it through the rest of the day, but I wasn't surprised when that didn't work. I asked her what she wanted, though I already knew. I told her I'd come get her in about 30 minutes. I stopped and dropped some things off with one of the saints, and then went to the workshop. When she came out, she was no longer crying, but she hugged me (in public--which is usually much too embarrassing). When she hugged me, I could feel her shaking.
She stayed in the car while I went in to the nursing home to visit my people. As we drove home, I asked her if she needed some mommy cuddle time when we got home. She sounded relieved, "Yes!" She still hadn't been able to tell me what's bothering her, but when we got home I looked through the mail, then picked up a book I've been reading, and sat down on the couch. Daughter snuggled in next to me, and Cat claimed my lap (at least Kitten didn't decide she needed to get in on the action.) Daughter quickly fell asleep. I sat with her and read for about an hour, and then she graciously allowed me to leave, though she fell back to sleep on the pillow.
Mommy cuddle time is getting awkward. She's 21 and almost 5 inches taller than I am. Her psychiatrist tells me that emotionally, she's 8 or 9. Now that she's had that time with me, she'll be able to pull it together while I'm gone this evening. It would be nice if I knew the source of her anxiety. There are so many things it could be, from a hormone imbalance that is also contributing to the blood sugar challenges to guilt that she lied to the respite provider to anxiety because her routine has been disrupted by this class I'm taking to anxiety about having another severe low. Whatever the cause, I hope that an hour on the couch with me will be enough to carry her through the evening.

Wednesday, October 15, 2008

Here We Go Again

We have been better organized lately, and it is working well for us. Daughter knows that there is no TV unless her room is done, and she has been keeping it clean, or so it seemed. Today I was doing laundry and needed some more skirt hangers. I went up to her room and opened her closet. There was about a foot of clothing dumped on the floor.



When she got home tonight, I mentioned that her room needed some attention, and told her I'd opened her closet door in search of hangers. She was not happy, but wandered upstairs, knowing it was a battle she couldn't win. She wasn't gone too long before she came back down and plopped herself in the chair in my study. "I need to get out of here now."


I rolled my chair over and put my hands on her knees. I gently explained what had led her to this declaration. "I don't want to clean up my closet. If I had a place of my own, I wouldn't have to listen to her. It's not fair. I'm 21 years old, I should be able to live on my own." I said more, but you get the idea. By the time I was done, she was smiling, though her eyes were still downcast. I reminded her that we have the same goal, equipping her to live independently. I assured her that as soon as she was ready, she could do it. I told her it wasn't going to be today or tomorrow, though.


She said, "One thing I have to learn before I can live on my own is how to do my own laundry." I agreed. I pointed out I didn't want her to have too much piled on her, so when she had kept her room clean for a month, I'd begin teaching her how to do her own laundry. (I've actually gone through it with her before, but she hasn't mastered it yet. She's still working on properly sorting her clothes into the three bag hamper in the bathroom.)


She sat here and moped for a while, and then headed upstairs. She stopped in the hall to jump in frustration once. It reminded me vividly of a time when she was 5 or 6 years old. We were in the family room in the basement of the home we lived in then. I had sent her upstairs for something, and she wasn't happy about it. She dramatically jumped up and down several times at the foot of the stairs. I calmly pointed out that it didn't have much of an impact on the concrete floor, but if she wanted to do it again when she got upstairs, I was sure it would be much more dramatic. She walked up the stairs, glaring at me the whole time. When she got to the top, she very carefully stopped, jumped three times (still glaring at me), and then went off to follow my directions. I waited until she was gone before I laughed.


Tuesday, October 14, 2008

Class


My MS Access class tonight was interesting. The instructor was asked to teach the course a week ago, and yesterday learned that it was going to be on Access 2007, which he has never used. When he got to class, he didn't have the password to get us into the computer. The person who could give us the password was in a meeting, and couldn't be disturbed. They were having a big dinner at the school tonight, and the sound system for it was hooked up to the speaker in our classroom. In 2 1/2 hours, we made it through the first unit, which was supposed to take 30 minutes.


It was all worth it, though. I've already learned some things and picked up some ideas. Even better, of the 5 people in the class, two of us are women in ministry, there to figure out how to better set up our church membership databases. We're going to get together and share ideas. My closest friend in this area moved to another church over a month ago, so I'm delighted by the opportunity to connect with another colleague. If that's all I get out of this class, it will be worth it. Oh, and four of us were probably fairly close in age. I wasn't the oldest person there!


Daughter did well with her respite provider, and was glad to see me when we got home. We successfully reapplied for her Medicaid today.

Back to School


Tonight I'm going back to school. I'm going to be taking a class on Microsoft Access at the local career center. The class runs from 5:30 to 8:00 on 4 evenings over the next 2 weeks. I want to do some work on our membership database at the church. I know we can do more with it, I just don't know how.

I've never taken a class about computers. When I was in seminary 25 years ago, one of my classmates offered an evening seminar on the use of computers in the church. I didn't attend to the seminar, because there was no use for computers in the church. Now, I can't function without one.

I do have some concerns about going back to class. I'm not sure I can sit still for 2 1/2 hours. I wonder if I'll be the oldest person in the class.
Daughter will be with her respite provider tonight. We go into get her Medicaid and the waiver that provides the respite money reauthorized today. It is nice to be able to take an evening class without worrying about what to do with Daughter. I hope that I will be able to do some of these things without her on a more regular basis. It's hard finding a babysitter for a 21 year old, so I am truly blessed to have the waiver that provides the respite.

Monday, October 13, 2008

A Beautiful Fall Day


It has been a beautiful day here. The temperature was up in the 80's, so we opened the windows. We're also in the middle of the harvest, so we had combines and tractors hauling wagons going up and down the street all day. Farm equipment is noisy. It has made conversations and listening to the TV or radio a challenge, to say the least. One of the farmers once apologized for his difficulty hearing, and explained he'd spent too many hours on a combine. I believe it.

For the most part I love living in Tiny Village. There are pieces of it, though, that are less enjoyable. Last week, when the weather first warmed up, one of the farmers spread manure on his field. We couldn't open the windows that day. Then there are the flies. We have a large turkey operation and a large hog operation right outside town.

But there was a beautiful sunrise this morning, and a grand sunset tonight. We have unobstructed views, and I think that those are worth the minor annoyances.

The Election


In the last week, I have had two people who have passed on to me an email insisting that Barack Obama is a Muslim. I thought that this rumor had been put to rest months ago. These individuals have been sincerely frightened about what might happen if Obama wins the election. They refuse to believe anything in the media that contradicts what the email said, because "you can't trust the media-- they're all liberals." I responded to the email I received today. I don't have a problem with people supporting McCain, but please do it on the basis of policy and experience, not false rumors that only serve to sow fear and further divide the country. Friday McCain assured his supporters that they didn't need to fear an Obama presidency, and was booed.

Going into this election, both candidates swore that they would run clean campaigns and not engage in destructive attacks. Both seem to have forgotten that pledge, and it grieves me. As a country we need to learn that it is possible to disagree with someone without them being an enemy. We need to recognize that we can learn and grow when we engage in an open, respectful debate with those who disagree with us. Those who vote differently than we do are not the enemy.
As voters we have a responsibility to look beyond the sound bites to the issues and the candidates positions on them. Both candidates have websites full of information to help in the pursuit of policy positions. Factcheck.org helps sort out when the truth has been stretched. Support your candidates, campaign for your candidates, but do it on the basis of policy and experience, not rumors and fear. Do it with respect for those who disagree with you. Remember, we all want what is best for our country, and working together we can achieve it.

Sunday, October 12, 2008

Another Wonderful Day

A colleague and I sit down together a couple of times a year to plan out worship themes. We don’t have complete sermons, just a theme, sometimes some rough notes, occasionally a hymn that we think will go well with the theme. I print the Scriptures and sermon titles in the newsletter monthly, and the sermon title goes up on the sign out front by Tuesday. This week I did something that I haven’t done too often. After giving the secretary all the hymns and such for the bulletin on Tuesday, I went in on Thursday and changed it all.

In the course of my conversations with the saints this week, it became apparent I needed to address the economic meltdown we’re currently experiencing. So, I threw out all my plans and started over. It went well. They were attentive, and several people thanked me. We closed with the hymn “Great Is Thy Faithfulness,” which fit well with the main message of the sermon. They sang it with great gusto this morning. One woman came up to me after worship and whispered that her daughter has lost her job and home. Her firm was bought out, and the top 5 people in her office were eliminated.

This evening we had youth group at the park. We did some planning on the Thanksgiving dinner they’re going to have with some of our seniors next month. They told us who they wanted to invite, and what they would bring. They’re excited about it. It looks like we’ll be serving about 35 people. I made them volunteer for tasks, and 4 of them agreed to clean up duty. Some of the parents will help, as well. I love these kids. They assured me tonight I wasn’t old, but I loved them even before they told me that. My co-advisor does therapeutic foster care with teenage boys coming out of a residential treatment center. One of her boys is returning home this month, so both he and the one who will be moving in were there tonight. The kids all signed a card for C, and when we closed, they each shared what they would miss about him. They also warmly welcomed B. Once again they made sure our special needs kids were included.

Daughter hasn’t had a low since Tuesday. I suspect part of that is she’s been eating food she hasn’t been testing for and covering with insulin. When caught, she always claims it was “an accident.” She’s yet to convince me of that, though. I still haven’t figured out how one can accidentally go to the refrigerator, open the door, remove food, and consume it. At this point, I’m just grateful for the break from the lows, so I’m not going to worry about it too much.

Saturday, October 11, 2008

Now I Know Why

Today I discovered why we’ve always used glucose tabs for Daughter’s low blood sugars. We can get 50 glucose tabs for $5.49. That’s enough (theoretically) to treat 12 lows. Recently we’ve had to treat lows 3 or 4 times. So it costs about .46 to treat a low, or $1.38 if we have to treat three times. Of course, we have to follow up with a complex carb. Daughter carries packages of crackers with her to eat once her blood sugar has begun to come up. Theoretically, the complex carbs will keep her blood sugar up.

So today, I bought glucose gel and glucose liquid for lows. Enough to treat two lows takes up as much space as enough glucose tabs for 5 lows. Then there’s the cost. The liquid glucose was $2.99 to treat one low. The glucose gel was $3.99 a treatment. If they work, and one treatment will bring her up, they’ll be worth it. If they’re no more effective than glucose tabs, we will quickly be going back to glucose tabs. We also bought cake gel, which was a little less expensive and a little bit smaller, but it still was about 3 times the cost of the tabs.

On a cheerier note, I got gas for $2.92 a gallon this morning. I’m glad the price of something is going down!

Friday, October 10, 2008

Health Care in Rural America

Daughter has 4 doctors, currently based in 3 different cities. The close ones are 22 miles away, one of her specialists is 100 miles away. We have tried to find doctors closer to home, but there are challenges. Daughter is not an easy patient. As Therapist pointed out to me, she’s even abnormal in her abnormalities.

With the severe low blood sugars Daughter has been experiencing and the lack of help her endocrinologist has provided, I am seeking a new endocrinologist for Daughter. The first challenge in finding a specialist where we live is distance. There are two possibilities about 25 miles from here. For various reasons, neither of these two are good choices. The one who is thought of more highly doesn’t have good interpersonal skills, so we’d prefer not to go there if we can avoid it.

There are three more options if I’m willing to go 50 miles. I’m willing to go 50 miles. This brings us to the second challenge: insurance. Two of the three possibilities are out of state, making it less likely that they will accept Daughter’s Medicaid. Medicaid is her secondary insurance; my Blue Cross/Blue Shield is primary. Dr. K (family doctor) has had good luck referring people to the one who is in state and 50 miles from here. I called, and he will take Medicaid. Dr. K has made the referral. We’ll see him on October 29th.

I hope this endocrinologist will be more responsive to Daughter’s needs. It would be nice if I could center all her medical care in one city. I have tried to do that, but distance and insurance pose major challenges. We’d have to go at least 50 miles to do that, and I don’t want to go 50 miles for her family doctor. The other issue is simply that there is a shortage of many specialists in rural America. Finding a good psychiatrist for her has been especially challenging.

There are many advantages to life in Tiny Village, but access to health care is not one of them. I am fortunate that I can rearrange my schedule to carve out half a day (or longer) to take her to an appointment. I hope and pray that this new endocrinologist will be a good match for Daughter and her needs. If I have to, I will take her 100 miles to see the right doctor. My hope is that this time, the right one will just be 50 miles away.

Thursday, October 9, 2008

Good News, Bad News, part 2

I left bright and early this morning to take the continuous glucose monitor to City so that they could figure out how to fix Daughter’s blood sugar problems. I had a call a little while ago from the dietician at the diabetes clinic. The good news is that I have been vindicated. The endo doesn’t want to make any changes in insulin, because over all her blood sugars are good. In other words, I hadn’t messed up her insulin, as the endo accused me of after the night I took her to the emergency room. The other bit of good news is that she had a severe low while she was on the monitor that didn’t respond the way it should have to glucose tablets.

So what is the bad news? We don’t have answers as to cause or cure, or even a plan for further testing. They tried to tell me that I hadn’t given her the right kind of protein for breakfast that day. The low fat sausage she had for breakfast probably had too much fat and not enough protein. I pointed out that she had the same breakfast she has every morning of the week. If the problem were the breakfast, she’d go low other days, too. They wondered if maybe she’d been exercising or had extra activity. The day was just like any other day except that her blood sugar dropped to 35 and didn’t respond well to treatment.

They also thought she had “worn out” the glucose tabs and suggested that I try giving her honey instead. Let me explain why I give her glucose tabs. She can carry them with her in a little tube. They’re very portable. She’ll eat them, but she doesn’t particularly like them, meaning that she isn’t tempted to eat them when she’s not low. There are a number of other things she could use, but she likes those other things, and there is a high probability that when she had a low she would find that she had eaten them all and she wouldn’t have anything to treat the low.

So what did we learn from the monitor? We learned that Daughter has unpredictable, serious lows that don’t respond well to treatment. At least I have been vindicated on that front. What are we doing about it? I’m supposed to experiment to see if honey, glucose gel or cake gel is more effective for her. Why is she having the lows? No idea. Daughter and I seem to be the only ones who are worried about what is causing them. I asked again about the possibility that this related to one of her other medications. Again I was ignored.

Tomorrow morning we go see her family doctor. I hope Dr. K will be a bit more helpful, or will refer us to a different endo. One of my concerns is that each time Daughter has one of these lows, her blood sugar is lower before she recognizes it. I’m concerned that she is developing hypoglycemia unawareness, which can be very dangerous.

Wednesday, October 8, 2008

Happy Anniversary


This afternoon I went to the nursing home for a surprise party for a couple who are celebrating their 65th wedding anniversary. Their son and daughter-in-law live out of state, and set this up after their visit a week and a half ago. This couple is amazing.

Following their marriage, his plane was shot down and was captured by the Germans. He was held in a POW camp for a couple of months. He was fortunate, as by the time he was captured the war was almost over so his captivity was relatively short. That didn’t mean it was easy for C, who was at home with their infant son.

He is a cancer survivor. Several years ago he was going in for more cancer surgery (a different cancer) when his heart stopped on the operating table. I walked into the surgical waiting room as an official came out to tell C that they were doing CPR on her husband. The next day, Easter, they told C that if he D survived, he would probably be severely brain damaged. Well, he survived, and he isn’t brain damaged. He sits in a recliner in the nursing home reading books. I always enjoy my visits with him.

Earlier this year, C decided to move out of their home and join D in the nursing home. They read their books, and when I go in we discuss politics and what’s going on in the world. They are both very content in their life together. They are amazing people, and I was honored to be there today to share in their anniversary celebration.

Tuesday, October 7, 2008

Good News and Bad News

As I was standing in the ICU this morning visiting with a member, my cell phone rang. I checked, and it was Daughter. Since she hadn’t felt good this morning, I decided I’d best answer. Her blood sugar had dropped to 35 (that is very low—one of her lowest). I ascertained that her blood sugar was up and told her I’d call her back when I left the hospital. I finished my visit and considered my schedule for the rest of the day.

I was taking communion to two of our shut-ins this afternoon. One of those visits would take me about 30 miles from Daughter at the workshop. I called her back and told her I would pick her up right after lunch. It was out of the way, but I didn’t want to be 30 miles away if she dropped again. So, I picked her up and dragged her along as an elder and I visited shut-ins. Both women we visited knew her and welcomed her warmly. She’s really good about these visits, and sits quietly and patiently through the conversation. Her blood sugar dropped again a little after 3:00, right after we finished the last visit. This time it only dropped to 50.

The good news is that this low will be seen in the records I turn in to the diabetes clinic on Thursday morning. The bad news is that Daughter had to suffer through it. Fortunately, both of these lows responded relatively quickly to treatment. The frustrating part is that she ate a bunch of bread after the second low, which makes it hard to record the exact carbs and calories on the log we have to turn into the endo. At least she acknowledged what she’d done when I realized that some of the bakery rolls I’d bought for communion were missing. '

One other bit of good news: I found gas in the City for $3.15 a gallon!

Monday, October 6, 2008

Medical Technology


This morning I took Daughter over to the diabetes clinic to be hooked up to a continuous glucose monitor (CGM). For the next 3 days, this little device will record her blood sugars 24 hours a day. It will give a much clearer picture of her ups and downs, and hopefully enable her doctor to figure out her current insulin needs.
Daughter has been hooked up to a CGM several times in the past. It involved having a sensor inserted in her abdomen and a wire running from it to a little box that she had to carry with her. She had special plastic bags to protect the box when she was in the shower. If the lead came loose from the box, numbers would be lost and we’d have to recalibrate the CGM. Several times a day she was required to enter the number from her meter into the box.

Today Daughter became the first person her endo has had connected to a new, much smaller system (see the photo). She won’t have to enter any blood sugar numbers. The sensor is hooked up to a very small transmitter on her abdomen. There are no wires. I’ll take back it and the loaner meter they provided, and the both will be downloaded into a computer and calibrated and analyzed. It will be much easier.

There was a company rep there to do the insertion and get it started. I took advantage of his time there to quiz him about a number of things. The closed loop system (an insulin pump hooked up to the CGM) is probably about 5 years from market in the U.S. (The next best breakthrough and/or cure has been 5 years away since Daughter was diagnosed 8 years ago). People in the clinical trials love it, but they will be introducing it slowly. Later this year it will be introduced in Europe, though all it will do is cut off the basal insulin when the blood sugar goes low.

Insurance companies and Medicaid pay for the pump without too much trouble. Some insurance companies are beginning to cover the CGM, which studies have shown to be very effective in helping achieve better blood sugar control (which reduces complications).

Then I asked him of his opinion of the endocrinologists in the area. I found his input and insight helpful. There is a new adult endo who is aggressive in his treatment of diabetes and is putting lots of patients on the insulin pump. I’m really beginning to believe that Daughter’s problems will best be addressed by going on an insulin pump. It’s more work, but it might be worth the effort.

As frustrated as I get by the fact that the answer is always 5 years away, I must admit that diabetes care has improved tremendously since Daughter’s diagnosis. When we first started this, she had to take the exact same amount of insulin and eat exact same amount of food at the same exact times every day. On Saturdays, we’d get up and get her breakfast and insulin at 7:00 and then go back to bed. Now she doesn’t have to eat to cover insulin peaks, which gives us much more flexibility with regards to food. As I look back on how far we’ve come, I’m grateful, though occasionally impatient as I wait for the next great breakthrough in medical technology that will improve Daughter’s health.

Sunday, October 5, 2008

My Favorite Cuckoo Clock



Daughter doesn’t have a great concept of time. She wants very much to arrive at events early. The result is that if I allow it, she will begin bugging me about leaving two hours before we need to leave. I have learned how to manage this some. For example, if I lay down for a Sunday afternoon nap. I will tell her what time she may wake me up. If I don’t, she’ll come in to report the time every 15 minutes. When we are going someplace, I will tell her what time we need to leave, and what time she can begin bugging me about it. I have found her sitting and staring at the clock waiting for the moment when she can begin to bug me.

I have told her that being her mom is like having my own personal cuckoo clock following me around. When she becomes too obsessed with time, I look at her and say, “Cuckoo, cuckoo,” she will then back down a bit, at least most of the time.

Today we were a little later than usual getting home from church. She had Special Olympics Bowling this afternoon. Normally on bowling Sundays we come home, I sit down for a few minutes, and then we head into town and get lunch before bowling. When I walked in after church today, she was frantic. “We need to leave now and drive through someplace!”

“We have plenty of time. We will go to the Mexican restaurant because I want to sit down and be waited on.”

“But, Mom, I want to get there early so I can be on lane 1!”

“You will be there in plenty of time, and what lane you are on isn’t important.”

We went to the Mexican restaurant. Of course we had plenty of time, and when we finished lunch I thought it was still too early to go to the bowling alley. I decided to get the car washed since the car wash was between the restaurant and bowling. There wasn’t a line, the car was filthy, and it would fill a little bit of time.

Daughter wasn’t thrilled, but she could see that she would still get there early. When the workers started to dry our car, they found that there were still bugs on the windshield, so they told us to go back through. This time, there was a line. I could feel Daughter becoming increasingly anxious beside me. She was staring at the clock in the car. “Remember, that clock runs a few minutes fast, you still have plenty of time.”

“Oh, that’s right, I forgot!”

She pulled out her cell phone and began checking the time on that every 30 seconds. We got through the car wash with fewer bugs, and headed to the bowling alley. By this time I felt like I was sitting next to a keg of dynamite. As we turned the corner towards the bowling alley (still early), she sighed. “Oh, good. There aren’t that many cars there.”

She ended up on lane 6, and had friends bowling all around her. I survived another outing with my favorite Cuckoo clock.

Saturday, October 4, 2008

Providing Opportunities

Yesterday Daughter and I picked up one of her friends and I took them to McDonald’s and a movie. D finished high school in 2004, and is living in one of the supported living homes in Town. She was so nervous at McDonald’s—she had never ordered her own food before! I was amazed. Now Daughter is probably higher functioning than D, but still, I would have thought D would have ordered her own food before.

I let the girls sit at their own table, and I went over to a small table, looking forward to reading while the girls talked. That thought ended when 3 of the men from the workshop entered accompanied by support staff. One, T, is related to some of the saints, so he knows me and has taken a liking to me. As his mother puts it, T is an 8 year old with 40 years of experience. When he saw me, he made a beeline for my table. So, instead of reading my book, I talked to T. His two buddies went over to bug the Daughter and D, but T sat with me and played with his yo-yo.
When I realized how sheltered D was, I decided I’d best go to the movie with them. I think I was the oldest non-grandparent in the theater. The girls had a great time. There were previews for High School Music 3, which opens in 3 weeks. I suspect that I will be back at the theater in 3 weeks for the big event. At least since this is coming out in the theaters, Daughter will only be able to watch it once that weekend. When the last one came out she watched it about 5 times the first weekend.

She told me after we dropped D off how glad she was that she didn’t go to Best Friend’s apartment to hang out with BF and 3 guys. She told me she would have been very uncomfortable there. She is spending less time with BF, and I am very grateful.

Friday, October 3, 2008

A Flash of Brilliance


Daughter has talked about wanting to hang out with friends tonight several times this week. Yesterday she came home and told me Best Friend had invited some of them over to her apartment for supper and movies tonight. It would be two men and two women. Best Friend’s boyfriend, Daughter, and Daughter’s former boyfriend. It was obvious Daughter had some misgivings about this plan, as did I. I won’t even try to list all my concerns, but they were many, to say the least. I suggested Daughter wasn’t real comfortable with this plan, and she agreed. I reminded her she could always say I was the world’s meanest mother and wouldn’t allow her to go. She didn’t like that idea. We went to bed last night with nothing resolved.

This morning Daughter was up with the alarm and listening to her Christian music, which usually means she’s in a great mood and will be pleasant to be around. This morning, though, she was surly, and growling at me for no discernable reason. I asked her what was bothering her, and she said something about the endo. I suspected that was only part the issue. Finally, I said, “You know, I’ve been thinking. What about if instead of hanging at B’s apartment tonight, you and C went to a movie?”

The effect was instantaneous. Her whole demeanor changed and her voice became excited. “There’s a new movie that’s opening tonight and it’s supposed to be really good!” She couldn’t tell me the name, but said it had to do with dogs. I went to the website for the cinema in town, and Beverly Hills Chihuahua is opening tonight. There is a showing at 7:00. She was going to go recruit C to go with her today. C is a woman a little bit older than Daughter and a lot more stable and much safer than the group that will gather at B’s. I haven’t decided what I will do while they’re at the movie, but it will probably be cheaper (and easier) to buy a ticket and go to a movie. I haven’t decided what movie yet, but I’ll figure it out.

Every so often I am able to tell what’s bothering Daughter and offer a suggestion that heads off a major problem. I’m grateful that this morning I had one of those flashes of insight that enabled me to be brilliant.

God Always Wins, But Are We in the Final Inning?

This morning my devotional reading pointed out that God always has the final word, and asked where we were looking for that in our lives. Now the thought resonated with me, and I have often reminded my people that God always wins. I like using the analogy of a game with lots of thrills and a constantly changing score. I point out that it is much less stressful to watch such a game when we know what the final score will be.

The problem I had with today’s question was that we don’t know how long the game will last before God wins. Over the course of my time parenting Daughter, there have been moments of deep despair. I am confident that God called me to be her mother, but there have been times when I have wondered why, times when the situation seemed hopeless. At those times, I have often questioned why I was called to this task. I find comfort in my belief that God didn’t call me to this task for it to end in tragedy. That belief has kept me going through some of the more challenging times.

When I read the question this morning, though, my thoughts weren’t first of Daughter. They were of the current mess we find ourselves in with the economy. I’d like to believe that God’s final word of victory with regard to that is coming soon. I’d like to believe that the rescue plan will fix things, or the people who win the election will have all the answers. I don’t think it’s going to be that easy, though. I think we have a lesson to learn in this mess. I think we are learning about the consequences of greed and living beyond our means. I also think there are many who still don’t get it, who still don’t understand how we got into this mess. Until they understand, I don’t think it will be over. Until they acknowledge (and repent) of their part in this mess, I think the mess will continue. In short, I don’t think the game is anywhere close to being over. I also suspect that our idea of a victory in this particular game may be very different from God’s idea of a victory.

I learned from painful experience that carrying balances on credit cards is not a good idea. I learned the importance of living within my means. I learned that I don’t need all the latest gadgets and a closet full of the latest fashions. I don’t think our country has learned that yet. Until we do, the game continues, and there is suffering ahead. I hope we will come to realize that there aren’t any easy answers, or quick fixes, and that all of us are going to have to make sacrifices if we want the current mess fixed. I know that God has the final word, which is a word of hope, and I think there is more suffering ahead before we are able to hear and recognize that hope, which is going to look very different from the way we’ve lived in the past.

Thursday, October 2, 2008

Medical Rant


Daughter’s blood sugars have been over 200 the last two mornings, and the goal is for them to be under 110. (Some people are never satisfied.) I want to know the why of the erratic readings; endo wants to criticize everything I’m doing. I know I’m not perfect, but I’ve managed this disease fairly well for the last 8 years, so I know that what is going on now is different.


I just got off the phone with the nurse at the diabetes clinic. She’s going to talk to the endo. Endo is only in the clinic once a week. (One of the joys of living in rural America—specialists are hard to come by and often have very limited hours). I’m probably going to have to take her over to the clinic Monday to get hooked up to a continuous glucose monitor for 3 days.


I called and made an appointment with her primary care physician this morning, but PCP’s first available appointment is Friday, October 10. I took it. I want her to help me sort through the issues of the different medications she’s on and whether any of them could be causing these issues. There are two that I’m wondering about. The medications are prescribed by three different doctors, and my experience has been that each one views their treatment as most important and expects the others to adjust. I also want to talk to PCP about switching to an adult endo.


Daughter is on my insurance and has secondary coverage of Medicaid. The Medicaid is supposed to assure Daughter always has access to medical care, but my experience has been that it has been more of a barrier to medical care than a help. The reimbursement rate is so low that most physicians won’t take it even though my insurance (which is very good) is primary. I can’t even take her in on just my insurance and pay the co-pays and such with any provider who accepts Medicaid from anyone. For them to accept money from me would be to commit Medicaid fraud. So the question becomes, would either of the two adult endos within 30 miles of her be willing to see her given that she is on Medicaid? Would either one of them be a good match for Daughter? Both are men which is already a challenge, as Daughter still has problems letting men touch her because of the sexual abuse she suffered prior to her third birthday. She doesn’t like it when current endo, who is a woman, touches her as she’s checking for signs of neuropathy.


I’ve been putting off finding a new endo because I hoped we would be moving. I didn’t want to change and then move and have to change again. However, since it seems that God wants me here for now, I guess we’re going to have to make the change. Daughter currently sees specialists in 3 different cities, from 25 to 100 miles away from here. There are times when her medical needs and appointments take up a great deal of my time and energy. I am grateful that I have flexibility in my schedule and an understanding congregation.

Wednesday, October 1, 2008

Success!

Daughter has called me twice today. She's been so happy and bubbly each time. She had the opportunity to go with a work crew today to clean off-site. She was so excited! She had observed once, but today she actually was filling in for someone and had a responsibility. It will be reflected in her next pay check.

Her blood sugars began to drop this afternoon, but since they start feeding her anytime she's below 100 (we don't treat at home unless she's below 70), she never dropped below 80. Of course, they fed her peanut butter crackers 3 times. The extra 450 calories didn't do much for her diet, but at least she didn't suffer with hypoglycemia. Since she's back up to her regular dose of insulin, I'm pleased she didn't have more difficulties than that.

Running Away in Place

Yesterday evening I made it over to Bible study after missing a couple of weeks because of other responsibilities. We were looking at Jonah, which is a book I have always loved. God tells Jonah to go to Ninevah, and Jonah gets on a boat headed in the opposite direction. He is deeply depressed, and is sleeping through a major storm. The others on the ship wake him up as they seek to determine whose God is punishing one of them on the ship. Jonah acknowledges that it’s his fault, and encourages them to throw him overboard (I find it interesting that he couldn’t even take the initiative to jump in himself). Anyway, they throw him overboard, the storm calms, and Jonah spends 3 days and night in the belly of a great fish. Eventually he prays, the fish vomits him out, and he goes to Ninevah to proclaim God’s judgment. The people of Ninevah repent, and God decides not to destroy the city. Jonah becomes depressed again because God isn’t going to destroy Ninevah, and sits and pouts in the desert. God comes and points out the foolishness of his ways, and Jonah eventually stops pouting.

I recognized myself and some of my recent struggles in the story of Jonah. Off and on since Daughter’s graduation, I have been searching for a call to a different church. I would very much like to be closer to family so I can be more helpful in the care of my parents. I’d also like to get back into a metropolitan area so there would be more opportunities for Daughter. For a while the search was on hold, because after three psychiatric hospitalizations in the summer of 2007, I decided she wasn’t stable enough to handle a move. Since I restarted the search, there haven’t been opportunities available in the area in which I am searching.

As I have been focused on moving, I find I have had less patience with some of the quirks of the people here. They haven’t changed, but my patience has lessened. I finally realized my anger wasn’t at them, but at God. I have not been willing to wrestle with God on these issues. I’ve been praying, but it hasn’t been the kind of deep wrestling I need to do with God. Last night I realized that like Jonah, I’ve been running away. I haven’t jumped on a boat headed away from Tiny Village, but I have been running away from God, just doing it right here in place. This morning I woke up hungry for more intense time with God, and so I spent more time than usual with Scripture and prayer. It’s a beginning. The conversation and struggle need to continue.

I had also seen my work here as being done. A number of major projects have been completed, and I thought it was time for someone else to step in with new ideas and direction. This past weekend, though, pointed out to me that exciting things are still happening, and growth is still taking place. My work here is not complete. I know that at the right time God will call me to the right place. There are times, though, when I wish I knew where I would be going and when it would be happening. For now, though, I rejoice that God is providing me with the new challenges I was seeking right here in Tiny Village.