Captain is Back

Captain is Back.

2 weeks quarantine is over after I 131 stay.
He really looks and acts much better like his old self. We are hopeful he will live a long time and medicine free.

Music appreciation

I stumbled onto Wolfgang's Vault where you can listen to some great concerts.

I thought you would enjoy listening to this concert, one of thousands of incredible performances in the Concert Vault.

nice

Bob Dylan & The Band at Oakland Coliseum Stadium on 02/11/1974

Concert Vault features vintage live concert recordings from the Bill Graham Archives, the King Biscuit Flower Hour and several other legendary music archives, including performances from both famous and almost-forgotten bands.

Concert Vault is brought to you by Wolfgang's Vault, the world's most exceptional collection of rock posters, vintage t-shirts, concert photos, concert tickets, and experiences like this concert.

Sign up and start listening.


wolfgangsvault.com

(meant to post fri. night but the weekend got away from me. we picked, cleaned and canned 25 quarts of green beans (Valentine varierty), 14 bags for swiss chard (bright light variety-pretty) and a couple bags of zuchinni.) mary

Swallows in Monkton are heading south

The swallows are heading south this week like they always do, their internal
clocks and schedule, instinct is always right on. They also feel as we do the strong Atlantic ocean breezes, some of which may help decide how they proceed on their way south. Here is a (slightly rough but fun anyway) video of swallows on the power line out back. There are the parents, first 2010 babies and second brood 2010. They are stout and healthy this year. Nice to see since they did poorly last year. We bid them well on their journey south in between hurricanes and Nor'easters. Rainy darker weather to come. They will be back next spring in time for the first black fly hatch. We have only seen a few bats as opposed to the many many we used to see. Mosquitos thicker and more prevalent. That is partly my explanation for the improved health of the swallows and their broods. Mary

Election Day Vermont...Hey, it's August!

We heard on WDEV radio this morning while in this Tuesday morning fog, Election Day..mumble, snore...Oh yes, something about getting ballots to overseas troops and that's why the legislature changed voting from the traditional September primary.
Oh sure, you could get an absentee ballot like we did. It takes a few more steps in an already packed day.
It did keep me from having to actually go to the polling place and repeat my name for the umteenth time and catch a few visual darts. No thanks, I'll sit here in my kitchen and mark my ballots knowing there are a lot of people on vacation, or not registered, apathetic, unable to cope, too busy feeding their families and paying taxes, or cannot comprehend a primary held in high tourist/vacation/no school in session/crazy busy time. Oh yes, and we have not received our property tax bill yet...would that make a difference in who we vote for?
I am getting used to this remote voting and wonder when we will log on and participate, so that all people with access to a computer or library could join in the political scene.
Those left out in Vermont?
Crazy busy & vacationers & unorganized & apathetic & can't handle one more thing & cognitively impaired/routine people & those that don't get the newspaper anymore & those who cannot get channel 3 anymore & no one to watch the kids & can't take time off & can't afford the gas/time/energy & did I say, don't/can't care and the last but not least the ones who say forget it, I am moving out of state. I believe the troops would not want to be pegged with changing the primary. I believe they would conclude they could get their mail and return by Novemeber. When the turnout doesn't turn out like someone wants, I believe there will be a shift back to a more sensible September primary and instead of having the kids be a conflict/obstruction/issue with voting, let the kids see civics in action after school starts in September. Some days it is hard to keep up with the changes. What if we make it to 80? How will we keep up with election day?

What to wear...

I was wondering what to wear to our friend's annual pig roast today. Cranked up Levon Helm's Tennessee Jed. Fred walked in with a package. It was my Levon Helm Street Team T-shirt. Fashion mystery solved.
I really cannot tell you how a simple shirt can mean so very much. Plus me placing third shows my readers appreciate Levon enough to check out his rigorous show schedule. That encourages me because Levon and his band and support staff are great. Fred found a link to CNN story about Levon and Company

Levon Helm CNN interview

You will see some of the ramble like we have in Levon's barn.
Wore my shirt to the pig roast. Was a beautiful day.
Listened to Dirt Farmer on the way home.

Mary Gerdt, Levon Street Team

Bureaucratica

Dedicated to fellow co-workers, the government employees who suffer working in the system we must have and yet always is a complicated quagmire of opposing political directives incrementally f*ing things up to the point of exhaustion on our part, the bureaucratic gnats who juggle, throw and dodge regulations to the best of their human abilities.

Bureaucratica,
Bureaucratica,

Give me more paper please,

Give me more ink,



Print some more paper

Cure my bureaucratic dis-ease.
My well has run dry,

Criteria recalled,

Print protocols,

Criteria

Recalled.

My life is printer to mailbox,

Phone message to e-mail,

Paper or plastic

None of this rhymes.

I wonder just how,

We can juggle it all,

Then who will pay,
Where will it fall.

For now I am a bureaucrat,

Legislated to be here,

A paper pushing gnat

For another fiscal year.

Write your heart out.

Write your heart out folks, or read others write their hearts out. Start with my blogger friends on my profile. They are the best to me.
I found through a Guy Forsyth song, the name Jack Kerouac and was wondering who he was.
Googling I found this link:

http://www.poetspath.com/transmissions/messages/kerouac.html

Kind of eerie he died before blogging but here we are some of us, stream of consciousness, chronicling life, normal stuff, poems that don't rhyme well enough for some.
One way trip out there.
Gave me something to think about.
Made a marinated tomato salad. Pulled some of the early blight leaves off the tomatoes. Put in the garbage. The rest of vegetation is healthy.
Fred treated them with baking soda and water.
Hope the late blight stays away.
Follow up to perio surgery-doing OK. Plan phase 2 next month. For now back on more regular food.
Captain back to normal again.
Guy's song still playing in my head about Jack...
(from 2 CD live at Antone's-unreal)
"Children of Jack..."
awesome
Mary

Captain is home

The Captain is home
Thanks to the wonderful care at the hospital, all the well wishers and visitors.
He seemed ahead of schedule but he cleared the radioactive I-131 quicker than last time and it was a lower dose. He really looks better this time. More better I should say. He did do better after the first round but was still irritable, yowly, guts irritated, toenails grew thick and quickly. Now a total change. Calmer, a little normal yowly. Stronger. healthier looking.


In summary, we have been pleased with the process as difficult as it has been. Very few cats have to be treated a second time. 1 in 50 for our doctor so far. Most cats normalize their thyroid by the end of the first quarantine.
Many places do not charge for a repeat treatment but our place was more reasonable on the first round than most. In other words, if you pay more, it is because they guarantee and cover the second treatment.
The camera was addictive as the doctor said. This is a very humane treatment over surgery which can lead to other problems,or the toxic drugs and repeated labs that slowly shut down organ function and cause distress.

As we observed him and worried he would be continually frightened, I have to remind myself of what captivity does to a person or other animal. I would watch him sleep or stretch or groom. He would eat, the tech would give him a little pet on the head. He was calmer this time. Maybe saying, oh well, make the best of a bad situation. We did e-mail the hospital asking for more food. Captain is a big eater and gets nervous with an empty plate. They were very nice about keeping him comfortable. So I would recommend this to anyone who needs to treat their hyperthyroid cat. Better check around the house for some stuff to sell first...we do love that cat.

observations...

Captain in captivity.


Surprising he is so docile

Institutionalized we call it.

Take away one’s control and will.

Would we all be so graceful in our cell

Unable to interact/radioactive.

It was reassuring to see him sleeping or napping,
 
Carrying on without me. Still he was thrilled to be home
and scolded me all the way home for taking him to that horrible place.
I gave him every treat, petted him, talked to him and
watched him bat the other cats.
Captain is home.
monkton,vermont

Case Management in Robert Frost Country

This is a story I wrote 5 years ago. It was published in a magazine called, The Case Manager. A friend, editor and hero, Catherine Mullahy helped me immensely and lightly edited for the better I believe.We are still providing choice in Vermont for nursing home care and I hope we do it as well as one can. I got permission to publish this once in my blog, my anthology of writing I hope a legacy to explain who I am, what I did and what I believe. This is my own version. The published version is available at the link below.




Case Management in Robert Frost Country

Official copyrighted version published in The Case Manager Nov/Dec 2006
Link:
http://www.sciencedirect.com/science/journal/10619259


By Mary E. Gerdt 2006


As I began to write what I thought would be a poetic article, I paused to explore

Robert Frost, the man. He is famous in this area for his poetry and his lifestyle of writing

and taking walks in nature. He gave me a goal to work toward.

I envisioned him sitting in his Ripton cabin in need of long term care and out of

money (he was a poet after all). My phone rings. It is a call from a case manager or his

doctor or home health nurse or even from Robert himself. Then I make a few phone calls

and am unable to leave a message. He is out for one of his famous nature hikes. He can't

go as far as he used to and now rides an all terrain scooter of sorts. Finally I get the man

on the phone. He is not sure what I am talking about. Choices for Care? It is a Vermont

Medicaid program for long term care. I lost him. The famous scholar needs me to slow

down and explain. It is a Medicare project. A waiver to the state to provide long term

care in your choice of setting. He is stuck on the word waiver. Nothing rhymes with that

one. I change the subject. So you write poetry? "A little" he replies with a little giggle.

"Silly nurse" he is thinking. Finally we come to agree on a date and time to meet. I will

be doing a clinical assessment. OK he says. He has learned by now I will say things he

has never heard and if he agrees, I will visit and give him more words he does not

understand. Like most people though, he is polite and a little lonely. A visitor would be

nice on a snowy afternoon on the mountain.

Looking into his history, I review what I have of his medical records, home health

OASIS assessment, nursing notes, doctor notes, application. There is very little here.

Diagnoses, medications, generic repetitive statements/care plans.

Nothing about "the man"

I go on the internet. Here is one guy I can search for on the web.

He wasn't born in New England after all. California? His dad took him there and

then died of Tuberculosis. I envisioned young Robbie losing his Dad, hero, his male role

model. And to boot his mother had to support the family. They returned to New England.

I read through all the losses in his life. His children. A three year old, a newborn, one died in

childbirth, a suicide. He lost his precious wife. Only later in life, he holed up here in this

cabin where he could live with nature, write poetry and cry silent and alone when the

cold winds howled.

I had always thought of him as a Vermont native. I myself am not and have been

pestered at times by the multigenerationals. "Flatlander" I have been called. My husband

is a fourth generation Vermonter. He says when we married I assumed his status as a

"real Vermonter". I do not push this to other natives. They would not understand.

So when I read where Robert has been, England, Massachusetts, New Hampshire, I

cannot classify him as a native. But when we assess eligibility residency is simple. You

live here and you have been in the U.S. 5 years, you are a Vermonter.

So I have new feelings about this man when I know where he has been, his losses,

his successes.

Financial eligibility is a quick review. Famous poet. Any assets? Income? No

surprise if I see small numbers. Many arrive at late life with pennies on the dollar. His

taxes must be a bear up here. Flatlanders driving the property values up. What will we do

when we are 80 something? He will still have to do the long forms and submit bank

statements, accounting details for Long Term Care Medicaid eligibility.

I prepare the papers and fill in the forms where I can. I look up my map where the

cabin is. Reminds me of The Legend of Sleepy Hollow. The maple leaves have fallen and

now the road is a swirl of red and yellow and brown. I go up, up, up the hill. What a

place. Views far to the west, The Adirondacks in the distance. The road narrows and

winds. Little bridges creak as I cross them. Funny how this road goes. First this way than

that. Following a deer path perhaps. I keep stopping to check the map.

I think about the program, Choices for Care, a new job for me and 11 other nurses

in Vermont. One for each region. Two for Burlington, the biggest city. We are paving

new ground. We are all enthusiastic about helping Vermonters make the choice between

long term care settings.

The previous Home based Medicaid Waiver was granted by "slots". The funding

depended on legislative action (Robert might call that an oxymoron). Now the Agency of

Human Services of Vermont has gained the status to offer choices to all eligible

Vermonters.

In other words, when a client meets clinical and financial eligibility for Choices

for Care (nursing home eligible/long term Medicaid eligible), they may choose to receive that care in a

traditional nursing home, home based or residential care settings. These clients are often referred to

as "Skilled" or "Intermediate" level of care. They often choose home based when they can.

Robert wants to stay at home.

I arrive at the cabin. My curious side looks at the little details. Indicators of

personality traits. Knick knacks, photos, plaques, awards, pets, glimpses of the life before

old age.

Smells, foods, views out windows. Wishing I could tap into the memories. When

their children were born and died and married and had children. When all the world

bought his poetry and we recited the poem in English class. "Walking through the Woods

on a Snowy Evening…." I want to ask him about his work, his life, his poetry. I found

many of the verses impossible to understand. Others so easy. But would he stoop to

talking to me, a nurse, about poetry. Besides, I only have two hours to get this

assessment done and then get back to the office.

He opens the door. He is shorter than I thought. Famous people usually are.

He is a little shy or maybe wondering why this persistent nurse wants to visit him on a

snowy afternoon.

I notice the lack of female presence. This is a male cabin. His wife has been gone

a long time. "Like yesterday" is how he remembers her. I get a little teary. We both laugh.

I run through the usual routine of questions. Are you able to perform the various

Activities of Daily Living? Any medical issues? Memory/cognition problems? Short term

problems, long term problems, behavior issues, informal supports.

I measure his level of care with the tools we were given and by my own

experiences in acute care, post acute care, long term care, insurance, home care. I think

how my own crooked path has brought me to the man who wrote about the path less

traveled. And how my career in case management has brought a thread through it all.

How when I was laid off in 1996 (nurses were never laid off), my personal devastation

brought me to the most rewarding and exciting less traveled road of case management.

I review the worksheet. He meets criteria for the program.

I fill out certification papers to get him started. We talk about case management

agency choice. Then personal care service choice. Then we discuss personal emergency

services. Companion time. Adult day services. We discuss how if it does not work out for him at home he

could go to a nursing home bed or residential care home if bed available.

We discuss the financial application and how that will be the next step to finish.

His case manager can help him with this.

By the end of our two hours he looked appropriately dazed. The forms, the

signatures, the criteria, protocols. He says he is glad he is the poet and I am the nurse. I

tell him I like to think of myself as both nurse and a writer and poet. Except that my

verses are not so perfect in meter and rhyme. My prose not desired by big publishers and

scholars. I took one college course in literature. I am a slow reader. But I enjoy

expression of ideas, sharing of stories. Hearing a tale from a client is to me the ultimate

sharing of two people in our small world. A poem without framework. A living

impromptu moment of energy remembered only in our minds and so transient.


Robert's on the mountain.

Robert's on the mountain.

He's not coming down

not coming down

not coming down

Robert's on the mountain

Today

He's goin for a walk

Down the less traveled path

Not coming down
Not coming down

Robert's on the mountain

To stay

Robert's goin for a walk

Looking at a bird

Writing his words

Living up there today

Today

Robert's on the mountain

Now going to stay

Writing his poems

Welcoming the new day

Live in the present.

Stay where you are.

Robert's on the mountain

His choice is there.



------------------------------------------------------------------------------------------------------------

Reprint orders: E-mail authorsupport@elsevier.com or phone (toll-free) 888-834-7287; reprint no. YMCM 439



1 Mary E. Gerdt, RN, CCM, is the Choices for Care long-term care clinical coordinator in the Department of Disabilities, Aging and Independent Living for the State of Vermont, Middlebury region.



PII: S1061-9259(06)00374-2


doi:10.1016/j.casemgr.2006.08.010



© 2006 Mosby, Inc. All rights reserved.

Qik Post

Sunny Day Qik Post

No time for extra vowels.

Weeds are fighting 24 hours a day to ensure their comrades death to be avenged.
Weeds live to breed and carry on so future stronger generations will persevere to destroy your will to go on and keep weeding.
I aim to fight back and not be all surprised when a few weeds, noble tall and proud, carry on.
I will respect them as fellow warriors on the world and be content when I next meet their kin.

from a carolyn wonderland song and i am sorry if i can't tell you the name of the song. i know some of the words. "I'll give you a heart like a feather, with your eyes open wide, I will flow like a river to the oceanside, I will quiver like a candle at your bedside late at night...I will wake up all the angels underneath this Milky Light."

That is the song going through my head in battle with weeds today.
Wild West of Monkton, Vermont, Mary Gerdt

Visions

Visions

Visions of a brighter future.

The hope of the hopeless is special indeed.
The wishes of the poorest, a fulfillment of need.
The getting up each day to face the battle ahead.
Harder some days than others until we are dead.

Did you wake up in a dumpster?
Or a box beside a road?
Did you bathe down in the culvert?
Do you carry a heavy load?


Did you watch a vulture watch you
and wonder when and why
Your days are really numbered?
That destiny has died?

We should all envision
A world free from strife,
Hunger and unhappiness,
For the rest of all our life.


2010
by mary e. gerdt,
monkton,vermont

Visit The Captain

I wanted to share The Captain in his captivity.
He got his second dose today and will have to wait in quarantine until radiation levels are safe.
He does seem pretty OK with it and they feed him the canned fancy feast.
You need Mozilla or firefox or something like that.
Just open room 2.
http://www.vvim.com/visit.php
Wish him well.

Mary

Captain Redux

The Captain,
our esteemed lead cat, aka doglike cat, aka recently treated with I-131 cat I wrote about awhile ago,
Had to go back to the lovely cat hospital again.
We really do love these people. They treated him very well and were reasonable and Captain warmed up to them in spite of his overall irritation at being out of his home and hyperthyroid/edgy.
When the Doctor said he had not fully responded, I just was sprachlos, couldn't speak. Fred had heard them say 95% respond with one treatment. I never heard the 5 % part.

That denial thing again.

Plus that panic at the bill for a second treatment. Balanced with Captain needing the life saving treatment.
So I believe it is a test of our love.
Today we put him in the carrier which he really hates now and left him off at the vet hospital and he is having tests again and then will be getting another dose of radiation and quarantine.
Captain is a big cat, had a really big thyroid and he is, well, special. Let's hope he does OK.
My lasered gum is healing nicely and I keep reading good things about LANAP in spite of those costs. When will it be available as a do it yourself kit? Or what is next with this laser light therapy? I believe it is like having the sun shine on sheets how fresh they are. Will we wear little light bulbs in our mouths?
The medical aside reminds me that our health issues predominate our lives quickly.
I have been wanting to give you all this website as my favorite human medicine website
pathguy.com
Plus he has a spattering of other interesting stuff too.
Have a healthy day!
Mary

Solar Flying Cinder

Today's astronomy picture showed

The Sun coughed out an energy burst that took

2 days to travel 93 million miles.

That is 46.5 million mi/day or 1.9 million mi per hour.

Like some flying cinder.

What a narrow life we lead oblivious to eruptions of the sun except that our cell phones and

other communication may get fouled up.

The sun so far away and yet we

feel the warmth. Did you feel the cinder?

Did some particles go straight through you?

Why do we not call the Sun a name?

Periodontal What?

Periodontal disease....
is a silent killer???

Was that what got Grandpa? Cut down by a heart attack at about my age?
Was that what caused Mom's heart attack, and my tooth loss?

So when I was told I would need Gum surgery,
I started my internet searches....
It all sounded weird.

Now, in 2010, they hit the deep pockets of infection, below the gums with a laser tuned to kill the specific bad bacteria. Then they make a sterile blood clot which self dissolves over time and healing. Keep your fingers crossed. I had it done this morning.
Now I wait, take it easy and drink cool fluids, milkshakes, antibiotics, ice packs.
Oh yes, and the visa bill will come and I will say to myself, European vacation? Not this year.
This year I am preventing a heart attack!

We all want to think nothing catches up with us, that we are invincible.
We all do.
I know this having spent so many years working at the bedside of dead and dying people.
A common theme, Why Me? Why Now? What next?

So although I should have seen it coming, my periodontal disease (Ok I own it now), is my disease. Add it to my portfolio.

Now as long as I have to have surgery, why not go to a competent, clean and concerned doctor?
My criteria:

1. One who listens

2. They give you time to talk

3. They don't mess around (this is hard to define)

4. They are recommended by someone you really trust

Now just sit back and relax. Go with the flow.
If you have to have perio surgery,
Try these guys:

http://www.champlainperio.com/

And don't go have a heart attack over a little periodontal disease....
public service announcement brought to you by the travelogue for the universe
i'm mary gerdt and i approve this message...

Perfect weather

This weekend was one we could call perfect weather. 70's, not too humid, breezy, some clouds.
I tried to weed the corn but the weeds fought hard. I did 4 rows and the sunflower row.
Some weeds in the onion patch made me just give up. Otherwise I weeded the onions until I couldn't take the sun anymore.
August first, the swallows are pushing their first born pretty hard now. Second broods are still in the nest and will have to fly in less than a month to points south. The swallows look pretty good. Perhaps that is because we have seen so few bats.
The starlings are flying in formation. The coyotes are howling at night- so eerie.
The great blue heron flies over and lets us admire him on the way. Such a graceful being.
Not many airplanes today. The sky looks more blue.
The Rose of Sharon is blooming.