Home

Yep. Made it home on August 15. Having exhausted treatment and rehab options, am now taking the hospice at home route. I am basically bed bound, as I cannot sit, stand or walk without assistance and i am very weak overall. not in a lot of pain though so that's good. No appetite so i'm down to around 130lbs. In hospice care there are plenty of people on call and who come around to visit to see how you're doing and make sure you're comfortable. I wrote extensively about hospice at home during Ms.'s mother's final illness in 2009, so those posts are still searchable. The program was newish then and was working out a lot of bugs. it isn't much different now except it seems much smoother and more coordinated. I've met everyone on my care team but one (social worker) and it is a functioning  team including doctor, nurse, home health aide, chaplain and behind the scenes schedulers, coordinators, pharmacists and so forth.

Being home is a big relief. It's been two months in some kind of care/rehab facility so getting home at last is a major treat, Getting used to it is taking time too. The cats. Ms. All these caregivers. The quiet. Every kind of happiness.

There is still a question over what to do about my shoulder. May require surgery but will start with heavy-duty muscle relaxant. At least that blasted cast is off, Yay. 

I have wondered about prognosis. No one has an answer but my own sense, based on the rate of deterioration these last two months is about six weeks/end of September. Maybe a bit longer or shorter. I won't be having tests so symptoms are all that will be tracking my condition, and right now symptoms are pretty stable. We'll see. 

Glad to be home,

A Day and A Night in the ER

 Welp, it's happened again. After waiting longer than I should have, I called the advice nurse about my increasingly uncomfortable condition. She said I needed to be "seen" within the next four hours; I should go to Urgent Care or the ER. Mkay? The nearest Urgent Care run by my HMO was 47 miles away. There is a Primary Care run by another outfit in my little town, and as it happens they take my insurance, so I've been able to go there for immediate care, but not this time. They wouldn't be able to see me for at least 24 hours. Low on staff, high on patients. Mkay? 

So the choice was the Urgent Care way out there. They could see me in a couple of hours.

I got there and was informed they were running behind, but they'd get to me as quickly as they could. It was only about an hour later (c. Noon) when I was called in to the examining room. BP and temp were OK; I was alert, coherent, ambulatory -- with some difficulty. Described symptoms and problems.

"Dude, you need to go to the ER, stat."

Oh fuck. I hate the ER. Nothing but turmoil, stress and strain, lack of care, waiting and waiting and waiting while the place fills up with more and more suffering, disease, madness and pain. What is the point. 

The nearest ER as it happened was another 15 miles or so away, and the Urgent Care said they would call over and let them know I was coming, and they said it would probably be less of a wait there because they would probably have fewer patients.

Mkay. We get to this ER, and truth was there were hardly any patients in the waiting room. Five, maybe six. Most had already been triaged. Some had been seen and were waiting for test results.

It was calm. Very little obvious suffering. Quite a few people came in while I was waiting for triage (c. 30 min). Nearly all were members of one family there to see their relative who was being treated inside. They were allowed in two by two. 

Triage was straightforward, and I was told to wait in the lobby. They'd see me inside as soon as they could. 

More patients came in while I waited. More visitors came to see the one special patient as well as other patients in treatment. Some of those who arrived were in really bad shape. Extreme pain, unable to walk, one couldn't even sit and her wheelchair ride was torture for her. Some appeared to be having strokes or heart attacks. 

And believe it or not, all of those I saw in serious distress were treated promptly and compassionately by the very young staff, none were left to linger unattended. Some were treated directly in the lobby, others were wheeled or ushered into the ER treatment areas, but none were neglected.

This was astonishing. I have never been in an ER where staff did not neglect the patients, ignored their suffering, even disparaged those who sought treatment. I have never been in an ER where prompt treatment of severe conditions was the rule. I have been in ERs where staff had no interest in or consideration of patients waiting, and where patients died while waiting without any care at all. The cynicism and contempt for patients in some ERs I've been in has been off the charts, and it's happened so often, in so many different ERs in California and New Mexico, I took it for granted as just the culture of these places. It's outrageous, but there you are.

This was an entirely different situation altogether. I didn't need immediate treatment, though I would have appreciated the pain medication I eventually received had it been administered while I waited. I got an xray within an hour of arrival, but had to wait to be "seen." My distress was minimal compared to some of the patients who sought care, and everyone who needed immediate care received it compassionately. Those of us who had to wait mostly did so with equanimity; so many others were in much worse shape than we were.

After about 5 hours waiting in the lobby, I was called in to the treatment area and assigned a room where I was introduced to the nurse and CNP who would be treating me. Both were kind and positive. As it turned out, the nursing staff would have a shift change in an hour, but the CNP stayed with me throughout. 

Treatment would take just about 8 hours.  During that time, I received a CT scan, pain medication, Ringer's lactate, anti-nausea and anti-inflammatory medication, and two different treatments for the condition I was there for. Neither was fully effective while I was there, but I was discharged with a prescription for another medication to take if the ER treatments didn't work within the next 6 hours or so.

When I read the after visit summary, I noticed that the CNP had missed a finding on the CT scan -- I had a hernia -- which which was probably a contributory or precipitating cause of the problems that sent me to the ER. Oh. I suspected the hernia, and I pointed out the odd swelling and pain in my groin, but it was not recognized by me or anyone else for what it was at the time. The CNP said it was "gas". And I saw on the CT scan report that there was considerable build up of "gas." But missing a hernia with obvious symptoms (I realized later) was odd. 

The treatments that were administered in the ER did work effectively the next day at home, so that part of the problem was taken care of, thankfully. The hernia has not been addressed yet, though the swelling and pain are not as severe.

It seems to me, I've had this condition before -- a hernia, that is -- and after several weeks, it self-repaired. We'll see. It's not fun, but it's bearable. Primarily it limits my movement. 

What I can say about the overall experience in the ER this time is that it was worlds better than any ER I've been in (for myself or on behalf of others). Even though part of my problem was missed by the staff, or perhaps not missed but dismissed as not that important, I was treated with consideration and respect, was given needed medications and treatment, was tested and imaged to a fare-thee-well, and discharged with explicit instructions and medication prescriptions with orders to return promptly to the ER if none of it worked.

Well, it did work, and I'm grateful.

Now to deal with the hernia... 🤪

The Odd Thanksgiving

We've never been much for the myths of Thanksgiving and the mutual feasting by the Indians and Pilgrims giving thanks for making it through the early famine period of English settlement in Massachusetts.

Over the years of course the truth -- at least partially  -- wills out. We find the myth is a sad and damnable lie, that the relations between the English settlers and most of the native peoples of the land was anything but happy and cooperative, and that massacres were perpetrated with some regularity and glee. The settler were not peaceful, they were religiously intolerant, and their response to resistance by the original peoples was increasingly brutal slaughter.

Since I'm of both English and Irish descent (the German component apparently doesn't  register in my DNA) I've had some interest in the issue of English/Irish relations, including the many times the English and Irish went to battle with one another. In the 17th Century, there was a mass slaughter of Irish by the English under Cromwell, really quite terrible. This took place about 20 or 30 years after the Pilgrim settlements in New England, but Cromwell's practice in Ireland was not particularly different from the mass murder and destruction of Native peoples in Massachusetts and the rest of New England. Patterns were set, and they were maintained throughout the period of Anglo settlement of what became the USA. Mass murder, displacement, and seizure of lands and goods was policy. To an extent it still is.

But I wasn't particularly thinking about that over this year's Thanksgiving holiday. We live in Indian Country, and many of our friends and colleagues are Indians. Ms. Ché is an Indian after all and she's getting her creative writing degree at an Indian art school. We've wrassled with the history for a long time, and in the end we let the past be the past. Indians have their own reasons to mark the harvest season with thanks as they have done in their own way for many thousands of years, but the meaning of the American holiday is quite different for most Indians than many Anglos presume.

No, this year, I was thinking more of the fact that I've survived another year, and this year, at least since May, has been largely pain free. Believe me, I'm grateful for that. Ms. Ché is too. She's been through so much anguish over my condition. There were periods I could barely walk, other times I was in such intense pain and there was nothing she could do about it. This situation actually goes back quite a bit longer than the two or so years I've been diagnosed with RA. It's been tougher for her in some ways than for me.

At any rate, I had the last of four Rituxan infusion treatments this year on the 22 of November; went to the hospital in Albuquerque in the morning, got infused and was released in the early afternoon. I felt OK except I was tired, more tired than I'd been after previous infusions. At least there was no pain.

I had some things I wanted to do while I was in town, but found I was too tired to do it, so I went home. I discussed with Ms Ché that I wasn't really up for a home-prepared feast on Thanksgiving, and asked if she'd like to go out instead. She said, "Why don't we go out this evening? I know just the place." She mentioned a barbecue joint in the Sandia foothills we haven't been to in a couple of years. I said "sure!" and took a nap.

There was an odd chemical smell in the restaurant. I couldn't identify it, but it was noticeable -- except when we were eating, when I didn't notice it at all. When we got home, I felt fine and went to bed at my normal time.

I woke up about 2am. I was nauseous and very dizzy. The room was spinning around me, and I could barely stand up let alone locomote to the bathroom in case I had to expel my stomach contents. By holding on to walls and furniture, I managed to make it, and in the end, nothing came up from my craw.

I sat in the living room for the next couple of hours, head spinning, gorge rising and falling. Went back to bed, slept till about 1pm, and when I got up, I was still dizzy and nauseous, but not as bad.

I told Ms Ché what was going on. She said it might be due to that chemical smell whatever it was, though she said she felt no ill affects. Later, when I could I looked up side effects of Rituxan, and sure enough, dizziness and nausea were among them.

I had not experienced those symptoms after previous infusions. In this case, they seemed to be fading slowly, so I told Ms Ché I would let doctors know I had apparent side effects if they didn't fade by the weekend. I'm scheduled to see the eye doctor and rheumatologist on December 1 anyway.

So Thursday, Thanksgiving Day, was spent in a kind of WTF haze. We did enjoy some home made mac and cheese for Thanksgiving dinner, and we both reflected on what we're grateful for. The list is long and growing.

Of course we're grateful for each other. Every day together is amazing.

This morning, there's a movie on the TeeBee, "Silverado." It was filmed in the Santa Fe/Cochiti/Galisteo area. Galisteo is a few miles north of our place, and the primary location for "Silverado" was on what was then called the Cook Ranch. A western town set was built for the movie, and though it burned down in 1999 when some fireworks used in another movie started a range fire, the movie-town was rebuilt and is still frequently used for filming.

"Silverado" though was the first Big Picture filmed there --other filming location included the Eaves Movie Ranch south of Santa Fe on Highway 14, and at Tent Rocks on the Cochiti Pueblo even farther south of Santa Fe off I-25.

Most of the outdoor scenes feature the views of the mountains and rolling plains toward the west (Jemez Mountains), northeast (Sangre de Cristo Mountains) and south (Ortiz and Sandia Mountains). Practically every outdoor scene features an image we have in our mind's eye, as we pass through the Galisteo Basin, seeing the same views, every time we go to Santa Fe.

This is our home country, and we are extremely grateful to live here. For both of us, it evokes memories -- good memories -- of our more-or-less rural California childhoods. Ranches and farms were all around. Ranch and farm people were and are our family friends. Salt of the earth.

We spent many a year traveling all over the country for work and for pleasure, and we had an extraordinary time of it, but one place and one place only captivated us -- New Mexico. I think we first passed through -- it wasn't even really a visit -- on the way to someplace else (probably St. Louis) in 1983, and we said then, "Someday this will be our home."

And so it is. We can't think of anyplace we'd rather be.

It's full of Indians, and Hispanos and Anglos, sunsets that only happen in other people's imaginations, sunrises that penetrate the soul, challenges and tribulations that you never imagined you'd encounter, let alone get through, and endless spirit-lifting visions, people and experiences. There's no other place like it.

And if you want to see some of what we see practically every day, watch "Silverado" and pay particular attention to the outdoor scenes. Sometimes those sights are dotted with pronghorn antelope, and when they are, we take it as a sign. The antelope, which few people ever see in the West, are more common than deer or coyotes for us. They are our friends, and they, among others, our our spirit animals.

Make no mistake. "Silverado" is a rough story with a lot of violent and unhappy people living violent and unhappy lives -- if they survive. New Mexico is not for everyone, not at all.

The Cook Ranch, Galisteo Basin locations for "Silverado" filming, is no longer the Cook Ranch; it's now called Cerro Pelon ("Bald Hill") after a hill known locally as "The Wave" that's on the 22,000 acre Cerro Pelon Ranch now owned by fashion designer Tom Ford. He's got it listed for sale, if you're interested. Asking price $75 million, including the movie set. the Wave, a contemporary mansion, various outbuildings, a couple of pueblo ruins, and who knows what else. Cowboys negotiable.

The Wave

While all this strikes us as kind of silly, it too is part of our home place.

We're grateful to have a tiny portion of it as our own.

There's much else we are thankful for. Much, much else.

This year's Thanksgiving was a little odd and challenging. But we know where we are. Every day.

A Wells Fargo Horror Story -- and an Update On The Van

Rousseau House in California, plundered by a series of banksters

I came across this story over at Naked Capitalism the other day, then I read that the homeowner had killed himself just days before the scheduled eviction in May. And I read the linked amended complaint.

And I thought "JFC on a merry go round, this is the most outrageous WF horror story yet." Almost beyond belief, and yet given all the other horror stories I've read, it's only unusual in that the homeowners had/have decent legal advice, and that the poor guy was driven to suicide.

Notice that the house above is quite a modest little house, similar to many I've been inside during parts of my working career. That the final refinance in 2007 was for over $350,000 is somewhat shocking, but that's what was still happening to real estate values in California at the time. In fact, I was dealing with a lot of builders, brokers and construction contractors during the boom before the crash, and by 2007, the warning signs were very clear that the crash was about to come, indeed had already come, in some cases that I can't detail here, but people were still refinancing and some were able to take cash out of their homes until well into 2008.

I say $350,000 is somewhat shocking for this house because in a realistic market it wouldn't be worth much over $200,000 if that. It's probably appraised for under that now, though WF ultimately acquired the house for a trustees sale bid of over $400,000.

So the homeowner was being screwed, whether or not there was fraud in the final refinance.

Nevertheless, according to the story, the homeowners were diligent in making mortgage payments. The problem came because they made those payments in person with cashier's checks at a Wachovia branch.

That and grossly false, misleading and predatory lending practices by World/Wachovia.

From the narrative in the amended complaint, the homeowners presented a cashiers check at the bank in April, 2009, in the amount of $1615, the stated mortgage payment amount. The check was handled by an employee who -- apparently -- entered a keystroke wrong during the transaction so that the check was not properly credited to the correct account. The homeowners received a receipt for the check and went on their way.

The next day, the check cleared, but what happened to the money is a mystery. There is also the mysterious claim of a stop payment being ordered on the check, which is simply not something that can happen on a cashiers check.

According to the complaint:

On or about May 5, 2009, while making the monthly payment at the WACHOVIA branch, Plaintiff O. ROUSSEAU the teller confirmed that their account still showed a missing payment for April. At Plaintiff’s request, Branch Manager PERI KERMANI called the corporate office to inquire about the disputed payment. Plaintiff was given a facsimile number to send a written dispute and proof of payment.

Which Plaintiffs (the homeowners) did.

From then on, the situation deteriorated alarmingly. While the homeowners continued to be diligent about making payments until the bank refused to accept them, they were dicked around and lied to by bank personnel constantly throughout a torturous process of trying to rectify the erroneous April "delinquency." They submitted all the documentation necessary to clear the supposed "delinquency" and never once did the bank actually clear it, though they were told it had been taken care of. They were assessed more and more collection fees, NSF fees, a constant tidal wave of fees while they not only tried to straighten out the mess the bank had caused, they were attempting to get their loan modified because of loss of income due to unemployment.

 As has so often been the case, while they were attempting to get the loan modification, the bank was proceeding with foreclosure, which the homeowners tried to get them to stop but were unsuccessful. Meanwhile, even as the bank was refusing to accept offered mortgage payments, they were constantly calling and dunning the homeowners for payment.

As has so often been the case, while attempting to secure a loan modification, the homeowners were repeatedly told that required documents had not been received -- though they had been sent over and over again -- and thus they could not get the modification, and then, apparently, the missing documents would somehow be found and the modification process would supposedly continue only to stop again.

Meanwhile, the foreclosure process churned along, oblivious.

Finally, from what I gather, the homeowners were denied a modification and told to pay up the arrears or get out. By the time they found out how much they had to pay to satisfy the largely bogus debt that was caused by a bank error in the first place, they had one hour to meet a deadline to deliver more than $26,000 demanded to the bank's collection agency in Texas. They had the money, but they couldn't meet the deadline because they couldn't access that much at one time given cash withdrawal restrictions on the account in question.

Wells Fargo acquired the property at a trustees sale purportedly held November 22, 2010, five days after the homeowners were told how much to pay and given a deadline they couldn't meet to satisfy the alleged default. At the time of the court filing, dated January 11, 2011, WF was under temporary injunction from enforcing an unlawful detainer against the Rousseaus. Apparently the injunction was lifted in May of 2012, and the Rousseaus were informed that they would be evicted on May 15, 2012; two days beforehand, when Norman Rousseau was unable to complete repairs on the engine of a motorhome that the couple intended to move into once they were evicted, Mr. Rousseau fatally shot himself.

All because a teller at Wachovia failed to credit the correct account for a payment made in April of 2009 and no one at any of the participating financial institutions and collection agencies between then and the date of Norman Rousseau's suicide had the courage or the brains to recognize that the bank had made a simple -- and not uncommon -- mistake that could have been and should have been easily corrected years before Norman Rousseau took his own life.

That and all the appalling fraud and deceit that went into the Rousseau's final refinance.

And all the lies they were told and the promises that were broken.

And the many tens of thousands of dollars that were being pillaged and looted all along the way.

This is a snapshot of a completely brainless and totally out of control modern banking practice. I'm sure that none of the institutions or people involved on the banking end believe they actually did anything wrong or that they are in any way responsible for the Rousseau's agony and eventually for Norman Rousseau's suicide. They never think that way. They can't. There are no personal relationships at all in these situations. Everything is objectified and scripts and flowcharts rule. "If this, then that." There is no provision for acknowledging or correcting errors, even simple ones such as mis-keying a payment.

As has long been obvious, all of the incentives for banks and mortgage servicers are aligned toward pushing homeowners into foreclosure. Despite ostensible programs to prevent foreclosure, the financial and corporate-bureaucratic incentives are still toward foreclosure. Consequently, millions of people are still losing their homes every year when it is highly likely that foreclosure is actually the least desirable outcome not just for the homeowner but for everyone involved including the banks and servicers who are incentivised to foreclose.

How many of these cases are due to fraud at the outset, errors along the way, and corporate-bureaucratic blindness is anybody's guess, but I am sure the Rousseau's situation is not unique. I've read too many similar stories.

It's one reason I was an advocate long ago for the nationalization of the banks; they are simply too hidebound, blind and dumb to function on behalf of even themselves let alone on behalf of the People in the current financial climate.

They should be run strictly in the public interest for the duration.  But until somebody with clout picks up that cudgel, we'll continue to encounter tragic stories like that of the Rousseaus.

None of this has to happen.

--------------------------------------------------------------------
As for the van, I spent part of the morning in Atwater discussing options with repair folks face to face instead of on the phone. I also drove the van for a short distance, and it was obvious that it wasn't going to make it much farther at all. I got it to the repair shop across the street from where I had left it last Saturday, and when the proprietor saw me drive up and said: "You've got a transmission problem." He explained how he had come to that conclusion when Omar at the first shop had brought the van over for a diagnosis on Monday. I asked about the differential. He said he didn't drive the van, but all the sound he heard when the van was on the lift was coming from the transmission and he thought there was metal on metal (oh yes) requiring a rebuild. I asked him whether he could do it, how soon he could have it ready, and how much he'd charge. He said he most certainly could do it; probably take until until Wednesday of next week, and it would cost X number of dollars (a good deal less than I was anticipating.)  I said, "Let's do it."

The vans that I had been considering as replacements were either sold before I could get to them or they were inappropriate for my needs; as I've said, this red Astro van has been a very good friend on the road for a number of years now. I bought it specifically for the trips back and forth between New Mexico and California, and despite the occasional mechanical problem and infrequent breakdown, it has been a godsend and a jewel. And then I think how lucky I am to be able to write that last sentence at all.

So many Americans don't have the option to just go out and "buy a van" or have it repaired as needed let alone to have a second home in New Mexico to go back and forth to. Those are just a few of the examples of the privileges we have. And when I think about the real struggles so many Americans are facing, struggles that are so far beyond my minor inconveniences (in perspective a broken down van or stalled refinancing are minor inconveniences, yes) I'm humbled.

The Rousseau's story is devastating. That sort of thing is happening to way too many Americans, and there seems to be nothing to thwart the demons of destruction abroad in the land.

Rise up, resist, refuse. It's a start!

Not So Bad-- And Boy Am I Grateful

Fellow named Daniel came out from Public Works yesterday to turn the water on and stick around while I checked for leaks. The stories he told, jeeze. He said that there were broken pipes and flooding all over the place during The Cold, and he was running frantically from house to house turning off water because of busted pipes.

No one right around our place had that problem he said, but it was just crazy for days.

As for our place, when he turned the water on, immediately the meter started going indicating there was a leak or an open faucet somewhere. I checked inside again, and there was no sign at all of leaks in the kitchen or laundry room, no sound of water spraying under the house. When I went to check the bathroom, however, I heard that tell-tale sound, and my heart sunk for a moment. The sound was coming from the toilet, so I checked the tank, and sure enough, the fill valve was split and water was spraying out, even though the tank was full. I turned it off with the valve where the pipe entered the room, and the sound stopped. Went to tell Daniel what I'd found, and said, "Did you turn the water off at the toilet?" I said yeah. "Well, the meter has stopped turning. I think you found the leak."

Really? That simple? "Water isn't running now," he said. "So I think that was probably it."

I just sort of stood there dumbfounded for a minute while he told more tales of what was going on during The Cold. Temps actually got down to -32 he said, and there were at least ten days (rather, nights) with temps at -15 or below. Just brutal. This has never happened in this area before, and even though there was warning it was going to be cold, people weren't prepared for how cold it was going to be. Luckily no one around here lost gas or electricity unlike the unfortunates up north of Santa Fe or down by Alamogordo or Silver City. But pipes were freezing and breaking everywhere. I told him that the previous owner had replaced the house plumbing with PEX; it's not supposed to break in a freeze. But at temperatures that low? Who could say?

What happened was that some of the plastic in fixtures inside the house had split. It wasn't just the fill valve in the toilet. I also found that the spray valve on the kitchen sink had split. We keep the heat on in the house, at a relatively low temperature, 50 degrees or so, when we're not here, but I'm sure it can get colder in the bathroom and kitchen because the heat doesn't circulate all that well. Though our heat is gas fired, it's from a heater in the living room that functions like a big parlor stove. It's warm when you're close to it! But when you get to some of the peripheral rooms, there can be a distinct chill, and I know the pipes -- even the drains -- froze in the kitchen once while I was here and the heat was on. So, what might happen in a Real Cold Snap is anyone's guess.

What did happen may well have saved us a lot of other grief. When the fill valve split in the toilet, the water just ran continuously but safely. It was draining out as fast as it was pouring in. That kept water flowing through all the pipes during The Cold so there was no chance of them freezing. What a wonder.

I'm kind of gobsmacked and very grateful. Simple repairs took part of an afternoon, and that, as they say, was that.

Amazing.