Mental health care gets a pink slip in Dayton

This story better have a happy ending.

Right now, a 45 year old service disabled veteran with mental health problems is not in the VA getting treatment, he’s in Sheriff Phil Plummer’s hell hole of a jail. This is where people with misdemeanor crimes end up dead. This is a country that says collectively that 20 veterans committing suicide a day is a problem we’re committed to stopping, and yet, here is a man, who wasn’t trusted with his own shoelaces last week while confined to a psych ward at Grandview, now behind bars for being mentally ill.

People say blame Ronald Reagan for shifts in policy in mental health care that closed down mental hospitals across the country. You can read about the case that was made for deinstutionalization of the mentally ill in this excellent article in the New York Times from 1994: HOW RELEASE OF MENTAL PATIENTS BEGAN or this article from Salon from 2013: Ronald Reagan’s shameful legacy: Violence, the homeless, mental illness either way, the answer is the same, we traded away a broken attempt at government health care into the hands of big pharma who no doubt lobbied their way into the market for their brand of medicine- take a little pill and everything will be ok, which is fine, if the mentally ill people would only act rationally. Which they don’t.

I could take you on a tangent, to go on a rant how this action by the government created our problems with homelessness, the panhandlers, and the growth of our prison population. We’re good at whitewashing our real problems with new solutions that aren’t, as long as it can sound good coming out of a congressman’s mouth- as a paid puppet of which ever lobbying group stands to benefit. The reality is health care for all is, and should be, a fundamental right, guaranteed by the constitution, just like the 2nd amendment guarantees the right for any and all of us, to own a gun. Oh, the irony. Just remember, in the founding fathers days, a gun was a muzzle loaded musket, and “medicine” wasn’t much more than bloodletting and torture at the hands of a “healer” who was really an imposter- pretending to heal while often having more in common with a butcher. It wasn’t pretty.

Legislating based on current best practices depends on also updating legislation based on current best practices. We, as Americans seem to fail to adapt, and we know what Darwin said about those who fail to adapt (or do we?).

Mental health via community control might work if we really did have a foolproof system of safeguards in place. Regular health and welfare home checks would be a start. Mental illness has lots of indicators of oncoming trouble, changes in sleep patterns, weight loss or gain, compulsive behavior, personal hygiene failures, money problems, issues in the workplace, interpersonal tension. Proper monitoring by a trained professional can help catch a crisis before it becomes a disaster, which is where we are now. Jail is not part of an effective treatment regime.

Backstory

Last spring, before my Dad went in the hospital to die three months later, before I became the soul caretaker of my 89 year old mother with dementia, before I found out that a trusted employee and “friend” was neither, I stepped up to help a friend by agreeing to be his power of attorney, both  durable and statutory. I did this while he was in a state mental facility, where he had been transferred after an arrest while manic. This was nothing new for him, he’d been bouncing from ER to ER for treatment of his psychiatric disability for years- totally unaware that as a veteran, he was entitled to not only care at the VA, but a disability pension. As one of his friends, who had a modicum of experience with VA benefits, and the system, as well as a bully pulpit of this blog and connections to people above my pay grade, it became my mission.

If you’ve been religiously reading this blog, you might remember a post last summer about trials and tribulations with both the SSVF program and the Montgomery County Veterans Service Commission. Despite his 3 year plus service to our country in one of the military academies, some bureaucrat misinterpreted the  definition of veteran on their own, without actually checking the law of the land. We’re still fighting a misunderstanding that a veteran is one who served in the military, combat isn’t the defining experience.

Had I not been dogged about my advocacy, we would have had a homeless veteran, and due to the failure of the system, it’s my name that’s on the lease as responsible for the state of his place, not the program that he was entitled to. I have actual skin in the game on this, something I didn’t think was coming with job description. That lease was signed a year ago June- and had things gone according to plan (which they never do) I might have had to hire a house cleaner to get the deposit back, but am now looking at a glazier, a drywall mechanic, a house cleaner and maybe an exterminator, but that’s the least of it.

In that year, I managed to get his social security restored, put money in a STABLE account, get him a car, a phone, a place to live, his VA claim submitted, his criminal charges dropped (with help from a local attorney, Enrique Rivera, who took the case pro bono), and with help of another friend- kept him employed part time and for the most part, out of trouble.

The trouble started last time, by all accounts, when Social Security dropped his disability payments because he was “making too much money” and so he took extra jobs to make up for the shortfall. Because he had to stay awake, he stopped taking his meds- which make him sleepy, and one thing lead to another with his eventual arrest on the side of I75 in Franklin county, as he was pulled over and manically searching through his car for something. The cop thought he was drunk, and threw in a public indecency charge since he had no belt and his butt made an appearance. He was in the jail for 3 days before we found out he’d been arrested and already transferred to the psych unit.

It took almost 6 months to get his Social Security restored, which came with a big payout of almost $9K. It was as if he’d won the lotto. Unfortunately, having this much money in your account- also is a dis qualifier for receiving disability, so I set up a STABLE account to legally hide the funds. This is one thing I can credit Josh Mandel for doing right- creating a savings vehicle for those with disabilities, so they can have a rainy day fund. Good thing too, because it wasn’t long before those that giveth started asking for it back- saying they miscalculated. They want almost half of it back. Never mind, they can’t even deposit it in the right bank account, after 6 moths of telling them they putting it in his account instead of the payee account.

For almost a year he was golden. He paid his boss off early on a loan for a $1200 Toyota, he paid his phone bill to me each month (adding him to my account saved him money and made it easier to manage), his rent was paid for the first six months by SSVF, and PIPP and HEAP made his utility bills manageable. One could almost say that the safety net was working, as long as I was staying on top of everything. But, alas, when the warning signs started, I as well as his friends and co-workers, didn’t catch his fall from grace until it was almost full blown, which took about 30 days.

The crash

Mental illness is never a single issue problem. You break an arm, you put it in a cast. Your brain breaks, it’s got so many symptoms and compounding issues it’s triage- deal with the life threatening situations first, deal with the other issues over time.

The early warning signs in our case were an increase in drinking and the draining of the measured amounts of money I was entrusting to his personal account. Buying weight loss drugs from unreputable sources via the internet should have been one huge disaster siren of a wake up call. The nights out drinking watching the Stanley Cup with friends (to which I was the designated driver) were also a bad idea- but, we thought things were going pretty well, and if a few beers makes someone happy and feel like one of the boys- well, cheers.

Psychiatric drugs and hydroxycut (or whatever he bought) are a bad idea, as is beer. There’s a reason it’s a four letter word. When he asked for me to deposit $300 into his account (he’d been living off his paychecks, and a few hundred every month for a year) saying he’d given $200 to his son, should have been a red flag. That money was gone in a minute as well. The charges were so often, so small, and all over the map it was insane. He actually asked for help from me and his boss  on Wednesday the 21st. We sat in my conference room and tried to map out a plan. The next morning he texted me asking me to take him to the hospital, with a stop at McD’s on the way there. He’d awoken in a pond of his own piss. We went to Tank’s instead, where his eyes were bigger than his ginormous belly- and he over ordered and couldn’t even eat his pancakes. In one of those strange coincidences, his former Eastway case manager sat at the next table. They talked briefly- and we left with the decision that he was feeling better and would just take his meds and go to work.

When it came to the coming paycheck, instead of letting him put it in his personal account, we thought it better to go into the payee and be rationed out. This infuriated him, and rightfully it should have, but, when you’re manic, everything pisses you off.

That was Friday the 23rds paycheck. That weekend, he managed to make it to a bunch of his favorite watering holes. East Dayton dive bars where everyone knows his name, and smoking is generally permitted although illegal. One of the things that endears him to people is his generosity which increases when manic or drunk. He’s worked for tips for years, and so he always tips well. I could see what was happening by logging into his bank account, which was constantly at zero or overdrawn.

Monday, I called his case manager at Eastway. She’s new and I hadn’t met her yet. She, unlike the old case manager, didn’t know who I was, didn’t have that any idea that I was POA- and now claimed that POA wasn’t enough of a justification to talk to me. She needed me to be a guardian. There were supposedly some forms that she needed me to sign- and she was going to be over in the next few days to do that after I emailed her the PDF copies of the POAs that I keep handy in my dropbox.

Next thing I hear is she has gone to his house, and pink slipped him ( a medical 72 hour hold for evaluation), instead of taking him to the VA as I’d discussed with her, she took him to Grandview. Newsflash- sources tell me that Premier/Miami Valley Hospital no longer accepts psych patients via pink slip, putting additional stain on the already inadequate system.

A friend of his who happened to be there when the case manager and cops showed up, helped keep things calm, and he went willingly. After the door was locked, the friend decided to break in to shut the a/c units off- and instead of going out the way he came in- left the front door unlocked. So now, I had to find the keys. A trip to Grandview that night, I came up empty handed, when the nurses said he didn’t have them. I dropped off my POAs. He didn’t want to talk to me or have a visitor- I got the one finger salute through the safety window.

His car was in a bar parking lot, about a mile from his house. How he got home the night before, I still don’t know. The car had been having problems keeping the battery charged since a welfare driver hit the drivers side outside his work and somehow secrewed up the drivers door just enough that the door ajar light would keep draining the battery that really needed replacing. I had it towed to Carl’s body shop- to get that fixed, the A/C fixed (he had been complaining) and to possibly fix the front bumper since it was held on with duct tape. This was also to keep the car out of his hands until the drunk driving wasn’t going to be an issue.

A trashed kitchen serves as an indication that menal health intervntion might be a good idea

Signs of mental illness. This is his kitchen

By Wednesday night I get a call, an apology and that they had his keys I come get them and  go to the house and get disgusted. Clothes everywhere, trash everywhere, food everywhere. His mattress is standing on edge. The place is worthy of a haz mat suit. I try to find some clothes, put things sort of right, and make sure his only item of real value- a 55″ TV I bought him in a January sale for $300 was still there- in the box (he’d not gotten it out because, well, he’s mentally ill and couldn’t ask for help). I find some clothes, bring them home and wash them- along with everything I’m wearing- as I head directly to my shower, fearing bugs.

The next day, I bring the clothes and “snacks” because, well, a man’s gotta have snacks when he’s locked up. He wants to talk this time. He’s not wearing shoe laces- because- well, they don’t trust him not to kill himself. I talk about transferring to the VA. I’d emailed all the honchos Monday night when I heard he’d been taken to Grandview. I’d talked to the head of social work, who told me to ask their transfer team to coordinate things- the only problem is- Grandview’s people didnt’ want to talk to me either- again saying my POA wasn’t enough- I needed to be his guardian. No one from the VA came out to evaluate him while ill. No one from Eastway was returning my calls. Thursday, just after noon, while I’m talking on the phone to the people at the VA trying to get him to go directly thee- he walks into my office, and sits down. They’d given him bus tokens and sent him on his way.

Yesterday, no shoelaces. Today, bus tokens and a boot out the door. No, he didn’t want to go to the VA. I drive him home. He doesn’t want me to come in. He had confessed the night before that he’d also put a hole in the drywall. I ask if I can arrange for people to come help clean it up, he says he’ll do it himself.

I forgot to mention that when I got the keys, I was also told that he’d been to a bar in Centerville on Sunday night, before he was at the bar where he’d left his car. He’d run up a $35 tab and left his drivers license and debit card there. I should go and get them- and tip at least 20% because he’d done what he did. His tab had one sandwich and beers, shots, well drinks- he was definitely drunk when he left to to the other bar where he had gotten in a fight in the parking lot, smoked some weed and also lost his smart phone that wasn’t even paid off yet.

Friday, we go to look at his car and see if we can find his phone in it. It’s a moving waste basket. No phone. The car also has a new dent on the rear passenger quarter panel that he says he did.  I get him a new SIM card and hand him my parents old flip phone with his number on it. Keeping tabs on him was critical. How else could I find out if he was ready to go to the VA? He’s not going in to work just yet- he’s not ready, and neither are his co-workers, who are all rooting for him.

Friday night- he’s burning through his $20. Saturday night he calls from an Oregon District bar, he’s drunk, he’s a a drunk, he’s happy, and he ran up a $35 tab and left his license and debit card again. I get this message at 12:30 am- and go to get him. He’s not there. I know the bar owner and he can’t find him either- and promised me he’d 86 him from the bar in the future. I pay the tab. Can’t find him. Go home. Next day I go over to his house at 1pm to meet the people who were going to help him clean the place. The plan was to gather all the clothes- go to a laundromat and do them all at once, while others cleaned and organized what was left. But, as I go up the street on the way there- I get a text-

helper: Nevermind David this guy is definitely not interested in any help he’s a little upset that things go the way they do and obviously that’s a conversation you and him need to have but we attempted we had everything ready to do this and not going to go into a situation where it is definitely not wanted on that person’s part sorry
David Esrati: Sorry. I’m here now. I thought you were going to be here at 1
helper: Well I stopped by a few minutes early to see what exactly we were going to need so that we would have everything but he was not open or agreeable to having us do anything

I knock on the door- he comes out screaming at me. He’d taken his beard trimmer and cut a swath from his lower lip straight down to his chin, giving him a wild fu manchu short beard- there was a hunk of green snot above his upper lip- he was shaking, he was mad, he threw things at my minivan, he told me to leave or he was going to punch me- there was already a recliner on the parking pad that he’d thrown out of the house, I got in my vehicle to leave as fast as possible- dialing 911 as I turned out of his alley.

I wanted the police to come and pink slip him again. He’d threatened me- he wasn’t trusted with shoelaces in the last week- what’s the magic phrase “are you a threat to yourself or others”- I thought he’d met all of those conditions. The first cruiser meets me around the corner, an older male cop and short female. They start assessing- and call for the cavalry. In the next ten minutes no less than 10 cops show up- including a few sergeants, and a guy in plain clothes who identifies himself as a hostage negotiator. They mill about. Talk to me, talk to each other. Call in to central. At one point, the pissed off veteran screams down the alley- and throws the recliner for effect- he’s now shirtless- we hear something that sounds like a baseball bat beating the shit out of something twice.

The cops tell me I’m not the guardian. They don’t think they have grounds to violate his constitutional rights. They don’t even go up to talk to him. This is crisis management at half-a-blocks length. I offer to walk up and try to talk to him- so they can observe, to which they tell me I’d be the instigator- and it would be my fault. They say crisis care can pink slip him- I call them, they talk to the cops- they say the cops need to make the call. They drive off.

I call 911 and report their inaction. I tell them specifically, on record, that if anything happens to him in the next 24 hours, I’ll sue them to kingdom come. Sorry, not our problem, we’re the sheriffs bitches, call DPD. I ask to speak to a supervisor- they take my number.

I’m back at the office cleaning my a/c unit. I get a call from one of his co-workers. He’s walking down Wayne Avenue in boots, his underpants and a hockey helmet with “something that looks like a weapon, slung across his back.” I call 911 again- and head that way. I spot him changing on the street corner at Park Drive. The hockey helmet is on the ground, he’s pulling on a shirt, he has a backpack, I’m on the phone to 911 when the supervisor finally calls me back as I start to talk to the first officer that’s shown up. He’s moved around the corner to a parking lot and is talking to his co-worker- I have the hockey helmet in my car. They talk tot he supervisor on my phone, we end the call, the hostage negotiator shows back up- and they start a conversation with the mad man. At one point I step out where he can see me and he immediately starts going ape shit- the cop tells me to step away. I go get the hockey helmet- go back and set it where they can see it and leave.

Final report from the coworker, the cops thought it was ok for him to walk around in his underpants with a hockey helmet- he hadn’t broken the law. A woman can legally walk around topless too. They took him to his bicycle.

Bicycle? What bicycle? He had said he wanted me to get him a bicycle, for exercise. The last one I got him was when he was in the halfway house after the arrest- and it got lost in one of his pink slip visits that time. Turns out, he’d pawned the TV in the box for $200 on Saturday afternoon, and got a bike- and probably some cash to blow before he’d run up the bar tab in the OD.

Monday, I’m calling Eastway and the VA. No one is answering. I’m emailing. I’m worried that he’s going to end up either dead, or in jail again.

You already know he’s in jail. Happened around 10:30 am on Tuesday July 4th. I still can’t find any police reports from any of the encounters. He started with an M-4 and M-5 and a $1000 total bail. By later in the day, it said he had a whole bunch of charges:

bond.

# COURT CASE NUMBER CHARGE DESCRIPTION CHARGE DEGREE CHARGE STATUS JUDGE BAIL TYPE BAIL AMOUNT DISPOSITION DISP DATE NEXT COURT DATE
1 MONT-DMC () MENACING M4 WAITING COURT ACTION *Not Entered* TEN PERCENT 500 *Not Entered* 07/05/17 01:45 PM
2 MONT-DMC () DISORDERLY CONDUCT M4 CHARGE CLEARED *Not Entered* TEN PERCENT 500 RELEASED BY PROSECUTOR 7/5/2017 07/05/17 01:45 PM
3 MONT-DMC () MENACING M4 WAITING COURT ACTION *Not Entered* TEN PERCENT 500 *Not Entered* 07/05/17 01:45 PM
4 MONT-DMC () AGGRAVATED MENACING M1 WAITING COURT ACTION *Not Entered* TEN PERCENT 2500 *Not Entered* 07/05/17 01:45 PM
5 MONT-DMC () AGGRAVATED MENACING M1 WAITING COURT ACTION *Not Entered* TEN PERCENT 2500 *Not Entered* 07/05/17 01:45 PM
1

All of these aren’t crimes, they’re signs of mental illness.

And I, despite being assigned duties of Power of Attorney, am helpless in being able to do anything.

Bailing him out, won’t put him directly in treatment, and frankly, I might be on the receiving end of an ass kicking instead of a thank you.

Yesterday, I called everyone I could to try to get an intervention. No one from the jail staff picked up a call- from the medical people to the director, to the duty sergeant. The Dayton Chief was in meetings, Col. Ecton didn’t call me back. The VA tried to send a person to the jail- a “Veteran Justice Outreach Coordinator” tried to see him, but was thwarted by the shift change, and would be trying again this a.m. No one returned calls from Eastway either. Several hours of my time wasted, all while also dealing with no a/c at home or my rental (I’m looking at $1750 to fix both- and while my tenant had a/c last night- I woke up at 4:30 sweating my rear off- and wanting to share this story of woe).

I had thoughts several times of calling the national veterans health care line. I also thought of sending an email to the head of the VA. In the past, I’ve actually gotten a response from former VA Chief Bob McDonald, but the other Donald fired him.

We’ll see what today brings, but I hold little hope for help for this veteran.

Had things worked out right, I would have thought that the first time I reached out to the VA saying there was a veteran on suicide watch in a local hospital, an action team would have sprung into action to make sure all is done to safeguard that vet.

Why am I still an optimist?

When will America realize jails make lousy psych wards? That health insurance isn’t the same as health care? And, mental health is actually treatable and shouldn’t be considered a stigma, but a measure of society values- in how we treat and take care of those who are less fortunate.

To anyone of you who read all 4310 words of this TL/DR post, thank you. Do me a favor- please leave a comment, even if it’s just one word. America, we have a problem, and it’s crazy to think it’s going to go away by itself. Thank you.

Pray for a veteran.

Act II- update, 3:30 AM Saturday July 8, 2017

Late in the day Thursday, I get a call from the DPD officer who specializes in mental health emergencies. She, and a case worker from Eastway had been called to the veteran’s home early on Tuesday July 4th. He’d broken practically every window in the place- with his bare hands. He’d threatened the neighbors screaming “you go get your weapons, I’ll go get mine” and the place is an even bigger mess. Now, his box spring is sitting outside, one air  conditioner is next to the house- with broken expansion panels. The other A/C unit is in the house- among the squalor.

  • The bathroom
  • The TV- shrine of OTC weight loss
  • Start a fire?
  • Who needs A/C when you break every window?
  • Gumbo for the flies.
  • The kitchen floor.
  • Broken glass- not sure if the bars were bent before.
  • “This” is mental illness?

The cop and social worker go looking for him- and find him half dressed in a nearby park, covered in his own blood. He’s raging. They pink slip him again. The officers get him into a cruiser, where he does the classic crazy “bang your head against the windows” as we’ve seen in the bad behavior reality show “Cops”- of course, new cruisers now have back seats built for this- you can literally hose out the back of the car, and the whole interior is basically ballistic plastic.

They take him to Miami Valley Hospital- to get treated for the bleeding- and to admit. He’s sedated in the ER- and then things get murky, he’s not admitted. Somehow, the hospital thinks he’s good to go and begin to release him. Some officers who had pink slipped him either that day or previously, decide he doesn’t need to be out in public and arrest him and take him to the jail, where he is placed in solitary.

This info, at around 5:30 pm is the first accounting of what happened. I was still unable to pull up the police report online. Got it Friday morning, after I’d gone to the house myself to inspect. The house visit had me feeling queasy. He’d tried to start a fire on the stove top. There was a pan of gumbo on the kitchen floor festering with flies. Ceiling tiles are pulled down. The bathroom is trashed, the sink full of some brackish water. On top of the old analog TV are neatly arranged the OTC weight loss pills that probably contributed to this disaster- they are the only things in the place that seem orderly- as if placed on a shrine for worship.

I go back to the office, wait for my video guy to show up late, and begin working on the paperwork to get guardianship so I can bail him out AND direct him to treatment, since none of the people who’ve been involved in his “treatment plan” seem to have his best interests in mind. I make calls. I’ve pulled almost every person of influence I know into my wheelhouse for help. State Reps, lawyers, my neighbor who used to be the head shrink for crisis care, the PR maven at ADAMHS (our local health and human services admin org). Calls are coming in on two phone lines, but not the ones I need.

We go out and shoot a video- my video guy, who is from a small town in Indiana, can’t quite fathom how this happens. When we get back, he’s warning me to check for bugs, he found one on himself. I go to shower and dress. It’s 11:30 and I still hadn’t had breakfast. The clothes go directly into the wash.

Armed with a stack of papers, I head to the courthouse. Probate is on the second floor- the woman at the desk starts her hands dancing through the papers- I’d put his current case number on all of them- mistake number one. She’s got whiteout tape to fix that. However, I need $50 for the emergency filing and $350 for the full guardianship- which has to be filed at the same time. Here’s another huge stack of papers. I’m going to have to get a background check (but not first thing), bonded, and, btw, you need to have him evaluated by a medical doctor before we can accept the paperwork.

Before I go to Eastway to bow and pray that his doc will sign off on this, I go up to Judge Henderson’s court and talk to his bailiff. She’s compassionate, kind, helpful, but the judge is out until 2- and, frankly, he heard this case on Wednesday and has already entered preliminary charges, it’s unlikely he’ll make any changes to bail or order treatment etc. unless there is a plan in place to manage this mess.

On to Eastway. The skys are darkening, and as I sit in the waiting room to meet his caseworker who wouldn’t talk to me over the last 2 weeks, a security guard walks by saying, “It must be about to rain, DirectTV is out.” Just as the social worker and her boss come out to greet me, the torrential downpour begins. The social worker is wearing dark clip on sunglasses over her prescription glasses, inside. Who is she? Men in Black?

They are very nice. She was out at the house on the 4th, has no clue why MVH dropped the ball. Agree that he doesn’t belong in jail. His Doc isn’t in today, but his old one is. He liked his old doc. I go in to see her, and she’s this sweet woman who says “beautiful” a lot as I describe what I’ve been trying to do to help this veteran over the last year. I had mistakenly filled out the form for the doc in the pile of papers – why not play doctor like on TV? No one else has effectively cared for him. She reads it over, nods, but says, “I can’t sign this because I haven’t seen him lately” and asks me what to do? Me. The amateur social worker/friend/legal beagle wannabe/crisis care interventionalist without a paycheck, me.

I say, you could sign it- knowing from experience and interviewing me and your social worker who saw him Tuesday as reference, or you could (hold for the long shot, pie in the sky request) “go see him in the jail and evaluate him.” She says, well, “I can do that, my incoming patient can see a nurse.”

Damn. I love this woman with her “beautifuls” and her eastern European lilt in her voice. She says to say hi to my neighbor who used to run Crisis Care- and that she missed him. I’m thinking I just hit the lottery. I’ll go back to my office and fill out the half inch of paper, while she evaluates him and by the time she gets done, I’ll be done, run to the courthouse, file and miraculously, the judge will act, and I’ll be able to haul him out on bail and have him taken to the VA for inpatient care.

An hour later, as I finish the paperwork, except for getting the form from his son agreeing that I should be the guardian (I’ve been communicating through his brother, who is also suffering from the same bipolar diagnosis- as is the son), the case managers supervisor calls. “We saw him, he was lucid, he said he didn’t want you to be his guardian, she’s not signing the paper.”

Meltdown. The energy generator that’s been burning in my belly to get him out of the “criminal justice system” (and yes, that expression is either ironic as hell or the best oxymoron since “military intelligence” or “jumbo shrimp”) and into our third world nation mental health care system just got encased in concrete and doused with as much water has fallen from the skys of Dayton this last week.

I failed. The imaginary system failed too. Despite the facts according to the Doctors own caseworker- that he should have been in a psych ward, and that he’s in jail, with restraining orders from his neighbors, and that he’s done enough damage to clean out all the money I’d managed to put away to help him do something like get his own place- psycho boy gets to call the shots, and I’m not the designated hitter.

I could get mad at the doc. I could get mad at myself for not doing the guardianship when he was healthy, but hell, I thought that was what the health care POA was for. No one told me it wouldn’t be enough to manage his treatment when he’s obviously ill.

I talk to my friend, his now former boss, who tells me I’ve done more for him than anyone else- by getting his SS money back, by setting up a STABLE account, and most importantly, getting him into the VA system, but, I’m not the first to give up on him or get blamed for man/boys bad behavior. “Just clean up the mess and let it go” is his advice.

The brother thanks me. He understands my position and plan that’s being formed for me.

First steps: reglaze the windows, get the trash hauled out, get the clothes gathered, laundered and packed. Fix the broken stuff in the apartment- the stove, the ceiling tiles, the miniblinds, the kitchen cabinet drawer that’s in pieces. Put everything in storage, turn in the proverbial key (no one has it right now- or at least is able to get it). Pay the storage bill until his money runs out and turn over POA to someone that feels like being the next punching bag.

A friend who owns a glass shop has a guy coming on Saturday (today), another friend, a veteran, who calls himself a “Debris-ologist” will be there at 9am to start the haz mat removal. His line always makes me laugh, “satisfaction guaranteed or twice your junk back”.

My stomach, which is usually made of iron, is churning and feels like the stuff in a lava lamp. This isn’t what’s best for the veteran, but, I’ve got my 89 year old mother with dementia, a business, employees- that have to come first. There is a long rambling message on my home answering machine from him, thanking me for everything I’ve done for him- and that he didn’t mean anything he said while manic. He left that last week after the first pink slip. Maybe I’ll make it into an MP3 and post it- if I can stand listening to it anytime soon. The words of anyone who is radically bipolar all come with footnotes, that may or may not contradict their actions, or even what they are saying in a span of a voicemail.

I also sent a scathing email to the “team” at the VA, suggesting that their failure to intervene will not go quietly. I referenced this initial post. I told them video was coming. I’ve written the head of the VA- McDonald before, and I’ll write Dr. David Shulkin soon. Congressmen and Senators will be contacted, hell, I’ll even tweet Trump (I’ve already talked to my friend Rob Scott who ran his campaign in Ohio.) This will be someones story to tell to use to dismantle the VA, even though I believe that the care I’ve gotten, that my father got, is as good or better than the Cleveland Clinic (dad used to be seen there as part of Kaiser Permanente in Cleveland). Video added 8 August 2017

If he dies in custody, or anything else happens to him, rest assured, I’ll find an ambulance chaser lawyer and make him wealthy. The documentation- the call to 911 AFTER the cops wouldn’t even talk to him, the steps I took, all make for a very sympathetic jury. Maybe his son will end up owning the Fairgrounds after Premier has to pay for their mistakes. Remember, I wear a nice watch, that I bought with part of the settlement with the city over Mike Turner’s arrest of me while I peacefully protested their attempts to limit public speech at meetings. I wear it, to remind myself, that we always have time for free speech (and because at 36, I still thought that you could give yourself a medal for fighting city hall and “winning”).

There will probably be a third act in this tragedy. Sadly. Stay tuned.

 

 

Senior day care facility shuffle part 2

On April 2nd 2017 I wrote about the closing of one of the Senior day care facilities.

Friday was the last day for the Senior Resource Connection Adult day services facility in Kettering.

Source: Senior day care facility shuts down – Esrati

After surveying the landscape of options, I got mom into the Day Away program at St. Leonard in Centerville. Outstanding staff, facility, and for 2 days a week, my ability to focus 100% on work was restored.

I’d been meaning to write this week that the SRC facility had been taken over by Goodwill Easter Seals and reopened. I learned of this from an employee of SRC. I’d not been contacted by the facility, as a former “client”- nor had I seen anything in the media. But it seemed to me, that just like our tangled mess of local government duplicated services- that we’ve got the same problem in social services, health care, and non-profits.

Today, I got a letter in the mail from CHI Living Communities, the parent of the St. Leonard center. As of Sept 1, 2017, they too will close.

There is a meeting scheduled for families in July where they will explain options.

One thing I do know is that the need for these kinds of facilities is growing, not shrinking, and that if anything, we need more options not less.

Considering much of this is managed through our social services levy and the Area Agency on Aging, I think it would be great to get some kind of community analysis of needs and resources for caring for seniors who are still able to function in their own homes, but benefit from some social interaction as well as caregiver support.

The Narcan® roundabout

In this Wednesday, Sept. 7, 2016 photo released by the East Liverpool Police Department, a young child sits in a vehicle behind his mother and a man, both of whom are unconscious from a drug overdose, in East Liverpool, Ohio. Drug overdoses killed a record 3,050 people in Ohio last year. AP Photo.

In this Wednesday, Sept. 7, 2016 photo released by the East Liverpool Police Department, a young child sits in a vehicle behind his mother and a man, both of whom are unconscious from a drug overdose, in East Liverpool, Ohio. Drug overdoses killed a record 3,050 people in Ohio last year. AP Photo.

A small business I work with has had the Dayton Fire Department stop by almost every other day- because someone OD’d in their parking lot. The other day it was a city employee. The medics revealed that when they looked him up- they found out that he had been treated the day before as well. If a Narcan® revival was a frequent flyer bonus, we’d have people with miles to go to the moon and back.

Current practice is to revive them, offer treatment, which they refuse and let them go right back to using.

That would classify it as insanity- doing the same thing over and over and expecting a different result.
I wrote a post about Narcan, coincidentally, 2 years ago to the day: “Just say no to naloxone” I was chastised in comments. And in the two years, we’ve just seen massive increases in overdose deaths- turning Dayton into the Heroin epidemic epicenter of the nation.
Two friends of mine, who are former journalists (the real kind- no longer employed by the Dayton Daily news) went out on an assignment from a foreign publication to do a story about the heroin problem. Within 30 minutes, they’d taken a photo of a roadside sign offering treatment- and followed a DPD ambulance to an OD victim in a parking lot of the U-haul franchise. Photos, story- the works- easy peasy.
In my last piece I spelled out the societal costs of heroin and overdoses- and they still apply. The drain on resources puts your life in danger- while the paramedics are out dealing with a self-inflicted wound- you might have to wait for a ride while you are having a stroke or heart attack.
Save and release ain’t working.
It’s time to change the way we do things. The first time you qualify for a trip back from death, you are taken to clinic where you are held for four hours, where you have to watch a video explaining the new practices and procedures on Narcan- and given a chance to enroll in a treatment program, offering methadone, Suboxone, Naltrexone, Vivitrol etc.
You are also informed that the next time you need to be revived, you will spend 24 hours in the center. There will be round the clock counseling available, but, you won’t be receiving any medications that aren’t prescribed as part of a doctor supervised program.
Third visit, you’ll spend 3 days in the center. Fourth visit, a full week. Fifth visit, a month. At the end of the month, you will have an option to voluntarily stay in a highly supervised treatment program for up to a year, or walk.
Unfortunately, after the fifth visit, you will no longer be revived by safety personnel. If you are unidentifiable as a five time loser, and are being treated for the sixth time, you will face a mandatory 1 year mental health incarceration. This isn’t in a prison, but a secure treatment facility. There are no options for appeal, or release. If you are identifiable by the medics, treatment will not be administered.
Drivers licenses or state ID’s will be “punched” with each treatment- as reminders and for medical personnel to check.
Right now, we are kidding ourselves if we think we can arrest suppliers and take enough drugs off the street to solve the problem. All the posturing of law enforcement is an insult to our intelligence. Heroin addiction isn’t a criminal problem- it’s a mental health one. Yet it does cause massive increases in crime and threats to public safety.
What we can do is seize all assets of anyone caught with what we would identify as quantities to distribute- and use the proceeds to fund the treatment programs.
Of course, the other option is to stop kidding ourselves, and just start providing addicts with safe, inexpensive heroin and take the profit motive out- and give people who want to stay high permission- no judgements. This has been done in other countries and has cut crime and deaths considerably. There are people who are able to function in society while high- this is nothing new- my paternal grandfather was a PhD MD and a morphine addict his entire adult life.
If you have any better ideas, feel free to leave them in comments.
It’s time to stop the insanity cycle of save and release in Dayton Ohio- it’s not working.

Senior day care facility shuts down

Friday was the last day for the Senior Resource Connection Adult day services facility in Kettering.

I can’t tell you why, or how long it operated, or any of the things I should be able to share. But this video can.

I can tell you it will be missed. Not by my mother- who is soon to be 89, who went 2 days a week. It was always a battle to get her up in the morning and get her dressed to go. But, on those two days, I didn’t have to worry much about her, she was in good hands. The funny thing is, she always came home happy- and had a good time. That’s the horrible part about suffering with dementia.

The drivers were all wonderful and courteous. The facility was clean, well run, and best of all- when I walked around observing- a majority of the guests were engaged. The staff was friendly. There were at least 50 seniors off the streets- and into a positive, social environment. Although I didn’t take advantage of these services, they offered bathing and salon services as well for a very reasonable charge. For a caregiver- this was a much needed break.

One of the things most of us don’t think about, unless we’re dealing with an elderly parent or grandparent, is what kind of safety net is in place to help them cope. Since my father died in August, Mom has been living alone. I’m over at least half a dozen times a day to check on her, but, that’s still not enough. People need to interact- and socialize. Sadly, she no longer asks for books from the library- where she used to go weekly. She no longer turns the TV on- to watch the news- or the old movies that she loved.

Meals on Wheels is an amazing program- but, I still have to do all her grocery shopping, take her to all her appointments, and mange her bills.

But, we’re lucky in Montgomery County- we passed the human services levy- and the Area Agency On Aging has been amazing at helping me navigate the various federal and state programs- and to coordinate care. She’s eligible for a home health aide- who comes 4 days a week- and helps with cleaning, bathing and hopefully- working with her on her physical therapy/exercises. Right now- I’m waiting for a new aide after the last 2 quit.

There are other daycare programs- but, the one that can transport, didn’t impress me on our visit, and the other is “too far away” for her to qualify for transportation. I’m still working on that.

One of the great things about living in Dayton and especially South Park, is the help that I’ve received from friends and neighbors. I’ve had over a half-dozen people voluntarily come to visit with mom, bring her meals, help with watching her when I can’t be around. Our community is filled with amazing people, and for that I’m thankful.

I wish I knew why the center was closing down. I wish someone would see the value in these kinds of programs and step in and re-open it asap.

I shot a video of her at her worst one morning- to be able to show her what she’s like at her worst. I also shot one of her as she came home one day. I asked her how her day was- and she said it was wonderful to be home, that she’d been at “work” and had an amazing day- to which I confused her by telling her that she had been at daycare. “Daycare, that was daycare? I’ll have to think about that.”

We all need to think about it too- because one day, that might be us, who can’t remember, or has a safe place to go to socialize and be engaged.

Nuns kicking teen moms out on the streets

Photo of the home of the Mustard Seed Foundation on Denlinger Road in Dayton- a group home for teen momsApparently, the Sisters of the Precious Blood have lost interest in helping teen moms on a path to self-sufficiency. As of March 31st, 2017, the ten girls who have been living in the converted convent on Denlinger Road will be homeless, as the un-Sisters take back their convent.

Since 2010, the building has been provided at a very reasonable rate to The Mustard Seed Foundation, a group home run by a former foster child who managed to overcome the challenges she faced, and who decided to do something to help young mothers follow in her footsteps to self-sufficiency.

Shondale Dorise (nee Atkinson) suffered through 21 foster homes on her way to becoming a teen mom. She credits her final foster parent as the one that showed her the pathway to success, which she is now sharing with others. In the last 6 years, over a 100 young women have managed to not end up as other victims of the system thanks to their time in the big house on Denlinger.

But, all that is about to an end. Dorise, who is now a nurse, and has built the program, only managed to raise half of the $60K she needed as a down payment on the ideal future home for her young protegees- the former Daybreak facility on Wayne Avenue- in my ‘hood, the South Park Historic District. After losing her place in line, that facility is now going to house young males aging out of foster care.

Finding facilities that are move in ready isn’t that easy and the clock is still ticking.

The Mustard Seed Foundation is kind of unique- the way they fund their services is through the state funding for foster kids- plus providing mental health services paid for by medicaid. It’s this unique combo that seems to make the program work- where others fail. They are the only licensed facility of their type in the state- and accept kids from all over. If anything, they should be growing and expanding- because the need is there.

Instead, they may be going out of business.

What’s interesting to me, a spectator on the world of social service delivery, is that you’d think that this would be a natural extension of the well funded country club for young mothers the next neighborhood over. Over in the midst of the Twin Towers neighborhood, where the struggle is real, is a castle on the hill- The Glenn at St. Josephs– a retreat, a compound, a resort, country club- I don’t know what to call it- for young mothers, heavily backed by the Mathile Family Foundation.

There, young mothers over 18, who have a high-school diploma or GED, can live in a mecca of motherhood as long as they have been drug free for at least 6 months before entering the pearly gates. There, they will be coached, coddled and trained for 2 years, while their kids partake in a private 5 star pre-school, as they get their life together. In fact, many of the Mustard Seed(lings) graduate to The Glenn as part of a natural progression.

Teen pregnancy isn’t going anywhere anytime soon. For the girls in foster care (wards of the state) The Mustard Seed Foundation has been a way to beat the streets. For those who live in dysfunctional homes, where they are following in their mothers footsteps (I was mocked in college for talking about a 22 year old grandmother in my neighborhood- the privileged college kids didn’t think that was even possible, and this was 1986 or so). Dayton Public Schools alone has plenty of young mothers who would do better in a supportive residential environment than where they are now.

That’s why TMSF was probably thinking too small when they were looking at the former Daybreak building- instead of looking for something bigger. If you have any ideas for a new home- you know of a viable facility- be it a former nursing home, group home, hotel, convent, rooming house, please drop me a line so we can try to find a new home for the Mustard Seed Foundation.

If you want to contribute to the cause, they have a donation page set up with Giving Fuel, but, you can save them the service fee by writing a check directly. They are a 501(c)3 and all donations are tax deductible.

I think that at least part of the former Naval Reserve Center on Gettysburg could become the Mustard Seed foundations new home, while the other parts could become a residential home for DPS students needing a temporary secure and safe place to live. Please, share any ideas you may have, the clock is ticking.

A present for all Ohioans starting Jan 1, 2017

Maybe when you read about this in the Dayton Daily news next week, they may give credit to who broke this story for them. Hah.
Yesterday, there was a front page article about the Veterans Service Commission appointment– a full 6 days after I wrote about it and gave you all the documentation.

There was also an article about new laws on the books– but they missed this on- pushed by local state rep Jim Butler:

O.R.C. 5162.80 [Effective 1/1/2017] Good faith estimates for charges and payments.

(A) A provider of medical services licensed, accredited, or certified under Chapter 3721., 3727., 4715., 4725., 4731., 4732., 4734., 4747., 4753., 4755., 4757., or 4779. of the Revised Code shall provide in writing, before products, services, or procedures are provided, a reasonable, good-faith estimate of all of the following for the provider’s non-emergency products, services, or procedures:
(1) The amount the provider will charge the patient or the consumer’s health plan issuer for the product, service, or procedure;
(2) The amount the health plan issuer intends to pay for the product, service, or procedure;
(3) The difference, if any, that the consumer or other party responsible for the consumer’s care would be required to pay to the provider for the product, service, or procedure.

Source: Lawriter – ORC – 5162.80 [Effective 1/1/2017] Good faith estimates for charges and payments.

Imagine this- except in an emergency, hospitals and doctors who have already negotiated different prices with different insurance companies what to charge you for a procedure- will actually have to tell you in advance how much they will bill, how much the insurance will cover- and what you will be stuck with.

This gives you a way to shop for that appendectomy next time- if you can wait a few hours.

It costs nearly $6,000 more, on average, for an appendectomy in Dayton than it costs for the same procedure in Cincinnati, even though the cities are less than a hour’s drive from one another, according to a study released by the nonprofit Health Care Cost Institute.

The 2015 Health Care Cost and Utilization Report found vast disparities in the prices of medical procedures from city-to-city and state-to-state based on actual claims data from some of the nation’s largest health insurers.

While the average cost to have an appendix surgically removed in Dayton is $17,967, you can have the same procedure done in Cincinnati for $12,254, according to the report. Meanwhile, the average cost of an appendectomy in Columbus is $15,290.

Source: Medical costs vary sharply, study says

Of course, the hospital association- a powerful lobby in Columbus, is doing everything possible to stop this law from going into effect.

UPDATE

1pm Christmas day- oops, I missed it- they already filed a lawsuit and have an injunction banning the law from taking effect until Jan 20, 2017

In Dayton Ohio, we’re getting screwed. Between Premier Health and Kettering Health- we have a duopoly working together through their illegal trade association the Greater Dayton Area Health Assoication- GDAHA– to fix prices and drive competition away, while they force every private practice into their pockets.

In a universe, now far far away- this was called racketeering- and monopolization- and the federal government used to prosecute businesses that did this.

The simple solution is to start putting price controls in place on organizations that receive more than 40% of their revenue from federal or state funds- especially ones that claim non-profit status,  limiting payroll with a severe income tax. I’m sorry, running a hospital doesn’t entitle you to $4 million a year when the president of the United States only makes $400K a year.

Of course the first company to go into shock would be CareSource- which is a privatized way of using public dollars to provide health care- which could easily be solved with just expanding medicaid for all/Single Payer – and get on with it. I’ve yet to read a story about an insurance executive (or for that matter- a hospital executive) saving anyone’s life.

Forcing the posting of the true price of any service in the health care industry isn’t new, it’s just new to Ohio. We have laws about car repair quotes, we have laws about the shelf prices in grocery stores, and while having a good faith estimate in advance of care is a great start- what would be even better is requiring actual prices to be 100% posted online- allowing real cost comparisons, as well as stopping the illegal collusion between health care and insurers of creating different prices for the same procedure depending on the deal your insurer has worked out.

Even so- a big thanks to Rep. Butler for forcing at least this first step to health care transparency.

 

Just say no to naloxone

Naloxone, or Narcan® is the antidote for heroin overdose. It puts first responders in a position to “save” junkies from their stupidity. The same junkies who, in many cases, have been taking up inordinate amounts of their resources- causing crimes to feed to their habit.

Some first responders don’t feel comfortable intervening in Darwin’s work. Others, worry about liability, as practicing medicine isn’t what they signed up for. And, in many cases, it’s really a moot point, because many junkies just come back and do it again.

The reality is, our country is schizophrenic about addiction and drug use. While there is a growing base of support for legalized marijuana which was often labeled a “gateway drug”, cigarettes which are said to be more addictive than heroin- are getting carte blanche access to a new nicotine delivery system via vapor/e-cigs. Stats are showing a decline in smoking among teens but a huge uptick in e-cig use.

What’s even funnier- is that persons vaping in the bar, may not even have nicotine fluid in their vape- it may be hash oil- and you’d be none the wiser. Chalk one up for the druggies.

Fentanyl is the “new problem” for junkies. Dealers apparently don’t see the value in return clientele and are cutting their H with Fentanyl- with deadly results. It’s a synthetic opiate- that’s much more powerful and fast acting. It’s a sad day when you need 100% organic labeling on the drug you’re buying to ruin your life- but, that seems to be the case.

Governments can pass laws all they want against drug use, but they won’t stop it anymore than laws against prostitution have worked, or prohibition with alcohol. Drug use is here to stay. What we have to decide is what our real goal is in society? Is it to eliminate people’s escape mechanisms- or to create a huge incarceration industry- or to improve everyone’s quality of life?

Think about it. You may never ingest a single illegal substance. You may not know anyone who does, but you pay for it in so many different ways.

  • The cost of crime to feed the addicts’ habits.
  • The lost hours of productivity as people deal with their loved ones’ addictions.
  • The cost of emergency services to respond to overdoses.
  • The costs of locking people up.
  • The cost of insurance against the actions of addicts- who are more likely to be uninsured motorists involved in accidents, thieves, etc.
  • The cost of health care provided “for free” to these physically debilitated junkies.
  • Costs of maintenance programs that substitute one drug for another at public expense.

Face it- we all pay the costs of a few peoples’ illness.

This isn’t unique to the United States- just our huge emphasis on incarcerating people for being involved with drugs are. We spend billions on a system that doesn’t solve anything. Just like Naloxone- it’s not a cure, just a quick fix- a return back to square one, to start the merry go round again.

Should we just let junkies die? While that sounds harsh- we seem to be in favor of the death penalty too, seeing as we allow it. It’s amazing- the State can’t find the drug combo it wants to use to kill people- with drug companies “refusing to supply it” – while Fentanyl seems to work just fine on the streets.

We need to totally rethink how we want to deal with drug addiction in this country. Suppose we supplied clean kits and provided no questions drug purity testing? Would heroin deaths and the need for Naloxone drop?

Or, if we just legalized the drugs and tried to make sure that the people who want to go through life stoned- can do so without impacting the rest of us? Sometimes I think we’d do better to just wall off a Vegas like compound- where people can go in and do whatever they want- signing waivers to enter- with the only condition is much like the old Vegas ad tagline- “what happens in Vegas, stays in Vegas.” You want to gamble, prostitute, do drugs- go to the compound, let the rest of us get on with our own lives free of your “sins.”

While I believe my body to be a temple- and that ingesting drugs and  alcohol are a defilement, most of the population has no problem with drinking- despite the huge numbers of deaths from drunk driving- and costs associated with lost productivity due to hangovers. Taking drugs is really a crime against yourself in my eyes- and having the government get involved in your personal decisions doesn’t work out most of the time, be it pregnancy, marriage or assisted suicide.

You can make a historical argument for such a place- didn’t the founding fathers declare: “We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness” – and if you think heroin is going to make you happy- who are we to stop you?

When the VA does good

The VA is government-run health care. It’s the largest single health care organization in the United States. The patients they see aren’t like the patients that our private health care system treats- they are different. Many of them have been to hell and back and are already living on borrowed time.

My father, is an 87-year-old Army Veteran with a cornucopia of medical issues. When I was in fourth grade he suffered a heart attack, and doctors gave him less than five years to live. He’d broken up a fight outside a Boston bar in the fifties while driving a cab to put himself through Boston University- and had been stabbed in the back (the VA put him back together then too). He’d had multiple heart surgeries over the years- each one more risky. He has a low grade cancer. He’s diabetic. He’s not what you call an ideal candidate for surgery. In fact, in the pre-op meeting, the anesthesiologist flat out opened with “this surgery will kill you”

That had been the reason they didn’t opt to operate over five years ago when the hernia began. At that time I didn’t challenge the doctor. And neither did my father. He sucked it up and drove on. That’s what old soldiers do. Older people also are less likely to challenge their doctors- it’s just not what they do.

I watched as the hernia grew. And grew. His quality of life kept getting worse. After his first heart attack he started running- jogging as we called it in those days. Running one mile was his first goal- as laid out in the Royal Canadian Mounted Police workout. That was the state of athletic training then. Calisthenics and a run. I remember “running” with him- at a snail’s pace. A 12 minute mile was an amazing accomplishment at first. He kept running- and tracking it on the wall at the JCC on Mayfield Road in Cleveland Heights. He loves to tell people how he ran 3,500 miles. And the cardiologist, who gave him five years to live- died before those five years were up- and they were close in age at the time.

After five years of an ever-growing hernia, he sometimes sat on his special cushion the VA had given him- with a cutout for the distended parts- and just hung his head. I know how uncomfortable it is- having had both a hernia and a varicocele. He never complained.

The turning point was when his pacemaker/defibrillator battery began to near end of life. The doctors all got in a big hurry to operate to replace the battery, device, add leads etc. I said “hold it. You won’t operate on the hernia that’s making him miserable, but have no problem operating on a 10-year-old pacemaker that’s pacing less than 1% of the time and has never defibrillated?” Why is your CYA device more important than everyday life?

I got stern lectures from our GP (we see the same guy) – from cardiology, from pulmonary- all giving all the reasons that one surgery was risky and the other was somehow warranted. The surgeon, luckily saw my point of view and thought she could give it a shot. All the departments that had to sign off, all did so grudgingly and pointed out the things that would make it risky. About two weeks ago, we were on the pre-op consultation rounds and the anesthesiologist flat out said “you’ll die on the table” explaining how his damaged heart’s output wasn’t up to the task of moving the oxygen after surgery.

My father faced a decision. Go on with the ever increasing mass- or risk an almost certain death. We spent the last 2 weeks talking, eating at his favorite places- Smashburger and the Amber Rose. We went over the will, the insurance, the notifications- and today, we headed off to the VA at Oh Dark Thirty for the big day. It was almost 1:30 when the surgeon came out to tell us how it went.

The hole, which is usually the size of a quarter was big enough to fit two hands in. The small intestine had descended instead of the colon. He was suffering from malabsorption in addition- thank to the pieces not being in the right place. They did some innovative anesthesia. When he came to, his first words were “I’m alive.” When I got to see him, he had more color than he’s had in the last year- and his smile was ear to ear (even without most of his teeth).

As Yoda would say, “the will to live is strong with this one.” Others would say, he’s too stubborn to die. My mother, his wife of 60 years, cried tears of joy more than a few times today. I found out on Facebook how many people I’ve touched who were willing to keep him in their thoughts and prayers.

And, this is a story that none of you will read on the front page of the Dayton Daily news- or any other “newspaper” in this country. All you’ll ever hear about the VA is how they made a mistake. As if they don’t make mistakes in every single hospital in the world.

There were other families in the waiting room today. The surgical waiting room is staffed by volunteers- a wonderful woman from Belmont who is a military widow. I didn’t catch her name, but I couldn’t have asked for someone who kept us all smiling through the wait on our loved ones. There was a common bond in that room, not only of those waiting for possibly bad news- but of those who have a common bond of service to this country. There were no strangers in the room. Something that’s pretty common in every VA I’ve ever been in.

The room is stocked and funded by the Disabled American Veterans – who supply free snacks, coffee, tea, water. The TV is donated by Best Buy. The only things missing were wi-fi and cell reception :-) I’ve decided that the bare walls needed some art by veterans on the walls- and have reached out to two Marines I know who are amazing photographers for some prints.

My father isn’t out of the woods yet. There are always post-op complications possible. But, the other families who were waiting, they all got good news too.

But when the VA does good, you won’t read about that anywhere but here. And I am so thankful for the changes that the Director, Glenn Costie has made and the new surgical leadership they have in place.

I urge all veterans in the area, even those in perfect health, to please go out to the Dayton VA and register with them for care. As long as you have a DD 214, and an honorable discharge, they have services available to you.

Thank you for reading. And thank you for supporting our veterans by funding this amazing service.

 

Stop the fat letters

The old putdown “you’re fat and your mother dresses you funny” has sadly become a new nanny state mandate. It’s not enough to endlessly test students academically, we’re now also measuring their waist lines in an endless attempt to turn education into an assembly line process, where all the products conform to someone’s “standard.”

A local teen, whom I’ve known since she was in her momma’s belly, has decided to do something about this absolutely pointless intrusion of schools into personal health matters, by making a documentary exposing this bogus and demeaning practice.

In her own words:

In an effort to address the obesity problem among American youth, lawmakers in over a dozen states passed a controversial mandate forcing schools to perform body mass index, or BMI, tests on their students. What soon followed sparked a heated national debate.

Coined the “Fat Letters” by students, letters were given to overweight kids whose BMI did not fall within a narrowly accepted range; essentially telling children, even as young as kindergarteners, that they are fat.

via THE STUDENT BODY.

It’s one thing for schools to say little Johnny is failing at math, or even in gym, but the idea that BMI is some kind of magic number that is somehow relevant to the process of educational outcomes is a gross overstepping by government. No one sent Chris Christy’s mother a letter saying he’s fat- and that it somehow makes a difference on his performance as governor. Nor, do we have any indication that being overweight makes people stupid. In terms of stupid things our government feels a need to do- shaming children shouldn’t be something we spend a dime on.

I’m pretty sure a better case could be made for teachers having to submit to BMI testing. There is a direct correlation to costs of health care being passed on to taxpayers for fat governmental employees. However, that’s not what was written into law.

Bailey Webber is the daughter of my friend Mike Webber, who makes movies for a living. He’s a local guy with a lot of talent, raising a kid to ask questions and challenge the status quo, and he’s doing a damn fine job of it. Esrati.com readers have read about him and his award-winning documentary “The Elephant in the Living Room”

The movie, “The Student Body” is in production now, and just began a kickstarter to bring it to life as a full length film. If you’ve ever been called fat, maybe you might want to help her finish this film. Pledge to donate $1  (or more) and spread the word- I’m sure there are more than 28,000 of us who have suffered the indignity of being called fat at some point in our life- and would prefer that it’s from a medical professional instead of the state.

How my parathyroid was sucking the life out of me

Back around 1997-98 I had my first bout with kidney stones. I don’t remember if my friend Audra Huelsman drove me to Miami Valley Hospital ER- or was the one that picked me up, but going in I could barely stand up. I remember lying on the gurney tucked into the fetal position. They gave me a shot in my butt- without telling me what it was. 10 minutes later I could dance right out of there. Welcome to my first experience with morphine. Now I knew how guys in WWII stormed machine gun nests despite being shot 5 times.

I started feeling like I had lost my “energy” around 2000. I went to my family doctor, I went to another. I started dating a girl in Cincinnati- who recommended me to a guy who specializes in cholesterol. He found that my triglycerides were at 1200 (normal is under 100) and started me on some meds to put that in check. I felt a little better, but I still didn’t feel like myself.

After eating, I’d often get tired- or feel a wave of depression. I started having reflux, and felt that eating more would help it go down. I’d have a pain in my lower, right side- toward the back. I wondered if it was my gall bladder, appendix or later my adrenal gland. In the last year, my memory seemed to be not as sharp- I found myself hunting for words.

Last September, I went to the hospital again for kidney stones. This time, they weren’t coming out without help. I had surgery to break them up- and a stent put in, and then a second minor procedure to take the stent out. I was sent to an endocrinologist for the first time. He ran tests. Vitamin D was low, calcium was high, PTH- the parathyroid hormone was elevated. He did more tests. 2 biopsies, 2 nuclear scans, multiple ultrasounds. He thought is might be my parathyroid, but wanted to be sure.

I didn’t even know what a parathyroid was, or what it did before that. A friend, Jen Alexander, pointed me to the website of a doctor in Florida who runs an assembly line for removal of parathyroid glands. Reading that site, www.parathyroid.com I learned more than I could ever need to know. There was no need for more tests- it just had to come out.

My grandfather, who was an MD, used to poke at my neck when I was 12 or so- wondering about my thyroid. My grandmother had had hers removed with radiation in 1948- when they were in the first stages of using all the new-found nuclear toys to do new things in medicine. All of my life I’d heard about the thyroid- but never the parathyroid. The parathyroid is actually four small glands that are supposed to be the size of grains of rice that sit on the thyroid- right next to your vocal cords. They are supposed to regulate calcium in your body. When one goes crazy and starts producing too much hormone, the others go dormant. Your body starts sucking the calcium out of your bones- and often times, makes kidney stones. But it also can do all kinds of other things- like be misdiagnosed as fibromyalgia among other things.

David Esrati's neck after parathyroid surgery

On leaving the hospital, the purple was marking the surgery- the scar below is the parathyroid scar.

Then came a few delays in scheduling which were frustrating me no end. Falling asleep while reading, feeling sore and stiff when waking up, all these things were driving me nuts. Never mind the recurrent kidney stones.

Yesterday, around 8:30am I went under the knife at the Cincinnati VA by Dr. David Steward, and got at least 1 oversized parathyroid removed. I have a scar at the base of my neck that follows a fold. The stitches are all internal- and there is a clear glue protective coating on it. It looks like someone tried to garrote me with piano wire- and didn’t finish the job.

My neck and throat were sore as I left the hospital around 1 p.m. They were still sore today- although it’s getting better by the hour. But the way I feel is magical. The haze that hung over me, the feelings of depression and tiredness are gone. I feel a clarity again that I’ve missed for so long, it’s as if I’ve been given a whole new life.

To think that I’ve spent the last 13 years thinking this was just because I was getting old, is a little bit depressing. I’ve always reminded people that doctors are “practicing” medicine – as in they still haven’t got it perfected, but right now- despite being sore, I feel like a gazillion bucks comparatively.

If you’ve had kidney stones, or if you’ve felt like you’ve had a loss in energy, or feel depressed after eating- I highly recommend you do a little research and have your PTH, calcium and vitamin D checked. Apparently, parathyroid disorders often go misdiagnosed for years.