Fall 2023

Fall 2023

Stuart’s feet have never really healed all the way from 2021 … the diabetic wounds on his feet started around Labor Day 2021, by Nov 1, 2021, he had a picc line to the heart for 6 weeks … see FIC Merry Fucking Christmas Post dated October 2, 2023

We have been fighting to keep them under control ever since … it does not help that Stu has been in and out of at least 12 hospital stays since then … when he is being taken care of for his feet, then his psych problems are not being addressed as much, when he is in the psych ward, his feet get ignored …

When he was in the Fresno system, he went back and forth 3 times between the psych hospital and the medical center … he started in the medical center, then to psych, back to medical, back to psych, back to medical, back to psych … this was due to his feet getting infected in the psych ward because they do not take as good of care of them, just like they did at the VA Hospital 2 East in the FIC MFC post …

The Fresno Psych ward has a pool and they let Stuart swim in the pool several times with his open wounds … wound care 101 = stay out of pools … even I know that, how come they didn’t?

Onboarding the Clozapine proved fruitless … reminder of the process … blood work every week, then you get a 7 day supply (not on the same day), which the pharmacy may or may not have that day … VA Pharmacy is 30 miles and 45 minutes from the house … if they have 50 mg but are out of the 200 mg, then they will not think to use 4x 50mg to make up the 200 mg, so you have to come back the next day to get the 200 mg and skip a dose in the meantime … FOR  6 MONTHS!!! Then it goes to every other week for a while …

I knew in my heart this was a bad plan from the start, but I wanted to see if the Clozapine may work for Stu … we had not tried it before … this cumbersome onboarding was ridiculous, and given Stu’s history of going off the meds at any given moment, I felt it would all be in vane … but it was worth a shot as we have tried all the other medications and Stu refuses to take first generation psychotropics … he is afraid of tardive dyskinesia, the uncontrollable movements that come with some psychotropics, sometimes these effects are permanent … he fear is real but a bit exaggerated as there are ways to prevent that as well …

He has a say in his treatment even though he is out of his mind … crazy right?! It does not make sense to me either, I have a Power of Attorney on him, but it does not give me as much power as you think it does … it goes into effect when he is incapacitated yet in any given hospital, at any given time, that is up for interpretation … the following story will demonstrate … but before I tell you the latest tale, a little more on Clozapine …

The Clozapine was not working that well … he was about 4 months into the treatment which he started in the Fresno Behavioral, Aug- Oct,  … Stu was off, he was not grasping much rationality … when he is more balanced than not, he can be rational and understands basic concepts and functions but he was not firing on most cylinders … he was not able to grasp simple concepts that he normally would get like pulling his draw string tighter so his shorts wouldn’t fall down, he doesn’t know how to fast forward, rewind, pause the TV,  Can’t use his phone properly, doesn’t know what time it is, confused easily … he is confused a lot, but not THIS much!

His driver’s license has been revoked because he did not provide his annual doctor’s note to the DMV that says he is ok to drive because he was in Fresno hospital system, he is actually a good driver when he is balanced, but he cannot remember why he cannot drive, he keeps asking to drive … sorry, no!

Here's a gem for you … a side effect of the Clozapine is that it makes him constipated, so they prescribe a stool softener for him, but he won’t take them because they are another pill he has to take … so he suffers and tells me about all his bowel movements, or lack of them, (Yeah!) I tell him to take the stool softener, but he would rather go off the Clozapine because of the side effect!! Logical? I think not … yet they let him make his own decisions for the meds he wants to take or not take … he has a legal right to be crazy … my POA does not touch this aspect of his care unless he is incapacitated which as long as he can talk, they listen to him and not me …

Other signs of him not being balanced: He could not grasp how serious his foot wounds are … that it could lead to amputation if they do not get better … so he kept running down to the strip to look at pretty girls, spending a bunch of money which is what he does when he is not balanced, but the big thing is here that he is walking on his wounds and they are getting worse, not better …

He also went downtown and was dancing down there in his pink box shirt that is too small for him, it rides up over his belly and he likes wearing his short shorts … he said he was advertising for Pink Box Donuts and that people were photographing him … he may be on YouTube for all I know!

Stuart’s logic as to why his feet are not healing: “When I was a teenager, I blew out my crotch on a motorbike, so I walk differently, so maybe that’s why my toe is red from rubbing the way I walk …” ok …

We have skilled nursing coming in 3 days a week and Kerri, our family’s angel, in another 3 days for wound care,  to take care of dressing his feet 6 days a week … yet he rarely listens to or remembers our instructions that he should take a shower before they came to dress his feet, not after, and then leave the wet bandage on which is worse for the wound …

He kept saying if he sat around the house, he was going to get fatter than he was, so he justified going down to the strip for exercise, fucking up his feet more in the meantime …

He said he did not believe that he was going to lose his feet despite ALL of us telling him how serious this is … yet when we talk about amputation at the doctor’s office he gets pissed and starts yelling that nobody is going to take his feet and that he is angry that the doctor just wants to cut off his feet because it is easier for him to do that than to treat them … Stu is not grasping his own responsibility in his foot care … to stay off them … he cannot grasp that he needs to cooperate in his own treatment to save his feet … he just cannot do it at this time … he cannot do what is necessary to save his own feet, yet they think he is competent to use his own judgement to decide what meds he should take or not take … it is just ridiculous!!

I have seen him have better judgment in the past … but here is the crap shoot … the meds act differently at different times with the chemical make-up of his body which also changes over time, so what worked before, may not work as great today … it is always a moving target … mix in the irrational mind of the user and you have a cocktail for disaster … yet they will listen to him and spend MILLIONS of dollars to keep treating him post actively instead of preemptively with more rational care up front … it honestly makes no sense to me …

So, this is the background leading up to the current insane story that just took place … yes, I promised you a tale and here it is …

Both Kerri & the home health care nurse noticed his right foot was not looking good, red, swollen, emitting charges, she recommended going to the ER (Now called ED these days … just to confuse matters & quite frankly they should have consulted with someone one on those initials before instituting THAT great idea … but they never asked me …) to have it looked at … I was able to get an appointment the next day, Nov 2, with his Podiatrist, Dr. Pekarek, at the VA hospital … he, and his nurse, Adrian, are amazing … Thank God we got in from a canceled appointment …

The Doctor cleans up the wound and determines the infection needs the kind of care a hospital stay requires … infectious disease needs to look at it, MRI, IV antibiotics, monitoring, the osteo myelitis may be back …

I am hesitant because I know this will mess up his psych meds … after all this onboarding crap …

They wheelchair Stu from Podiatry downstairs to the Emergency Department and the processing begins …

I contacted Claudia, his VA caseworker, to let her know what was going on … she can do stuff from inside the VA system that makes life easier for us …

I had to leave for a previous engagement I had planned … I had been at the VA hospital from 10a – 3:30pm … blew my whole day … I took Stuart’s shirt and his special podiatry shoes, wallet and keys as we have had trouble with his personal possessions before … since I’d be picking him up, I could bring clean clothes. If you leave the wallet, they take all the cash and may or may not put it in an account, they are supposed to put it in an account, but as we discovered last time, somehow that did not happen and it was floating around in the VA system and took us jumping through more hoops to get his money back … fun … so I took his stuff with me … theoretically, this sounded like a good idea at the time …

This ER/ED visit was Thursday Nov 2, 2023 …

Over the next 3 days, he is transferred from ER to a room, then to ICU, then back to a room … just in ER alone we spoke to 7 people in a 3.5 hour time span … there is no way to keep up with all the people you need to talk to in order to download them on the current situation … too bad there is not a centralized data base that could alleviate this problem, where all the information is at everyone’s finger tips to understand the situation better instantly without Claudia or myself having to follow Stu around 24/7 in order to apprise every one of the needed steps to ensure his safety and recovery …

You think that him being in the VA hospital, where they should be familiar with his care protocol since he is in the system, that he would get the meds he is presently on distributed to him … NOPE!!! That would be too easy … Stuart refuses to take the Clozapine and they follow his lead …

This is where it gets dicey …

Stu went MIA because he left AMA from the VA hospital (AMA – Against Medical Advise)

He calls me on Sunday night twice and leaves a voice mail … I take Sundays off, it is my day of rest … If I do not take one day away from the world, I am no good to it the rest of the week, Stuart knows this about my schedule, but when he is off his meds all bets are off … I did not answer my phone, I picked up the messages the next day …

He tells me he is leaving the hospital and that he is in his right mind … WTF?! He has no clothes, no shoes, wallet, no keys, no ID, Nothing, no cents or sense!! NO resources whatsoever and they let him leave … he is a danger to himself … a known, repeat offender, psych patient, refusing his meds, on infected feet with no resources, they let him walk out of the hospital … unbelievable …

Back to my point of that when they are taking care of his feet, then they don’t take care of the psych as much … in this case, they did not take care of either!

Oh, I almost forgot to mention that his diabetic numbers were off the chart as well … in the 400s at one point …

I talked to the nurse’s station the next day … they were calling to see how he was doing … I asked them how he left with no clothes?! She said they gave him clothes … what about shoes?! She wasn’t sure if he had shoes or not … so let me get this straight … you let a known psych patient, with infected feet, walk out of the hospital and you are not sure he had shoes or not?!

I went to his condo and unlocked the door in case he came home … I went down there every day and kept calling his phone … no sign of Stu …

He has taken off in the past, but this was different as he had no resources, he has always had resources … he is very resourceful, so I knew he could actually get far, as in leaving the state kind of far, even without resources … 

Claudia can see in the system if he is in jail or if notes pop up that he is in a hospital somewhere … no leads …

I was driving by Henderson Police Department and decided to file a missing person’s report … Officer Giordano was very helpful and by the end of the afternoon, he discovered Stu was in Valley hospital … he didn’t pop up in the VA system because Stu had no ID on him and gave his Medicare info, not his VA info …

Evidently, he had made his way to Fremont Street, found some police officers and told them he needed help. They called an ambulance, and they took him to Valley … this is a new hospital for him … he has not been in Valley that I remember … at least not in the last few years …

One person, who shall remain anonymous, suggested that Stuart can’t just go do what he wants whenever he wants!  Oh yes, he can!  Who is going to stop him?! The system won’t, I can’t … so who?! Who do you suggest will stop him from doing what he wants, when he wants?! Let me know when you figure it all out please …

After several attempts, by both Claudia and I, to reach Stu by phone, I arrive at Valley Hospital … Stuart was saying that he was not able to go home because we did not want him there … not true … Stuart’s mind lying to him …

Stu’s Roommate, Jack, is a screamer, screaming every 5-10 seconds … … Stuart says “I wish there was something they could do for him …” This is Stuart’s sweet spirit  

The floor is sticky … I find out it is because Stu could not find his urinal and peed all over himself, the bed and the floor … this happened in Fresno too, when he was strapped down …

I got Claudia on the phone so she could touch base with Stu …

The doctor arrives 20 minutes after I get there … thank God for small miracles, they have no background on Stu, so I fill her in … Stu is telling her his goal is to get off the meds entirely …

He seemed doped up, but they had given him nothing … he was lethargic, sleepy and slurring his words … I mentioned this was not his normal state … they took his vitals, and he was cold, low blood pressure, his sugars were fine … next thing I know I hear over the loudspeaker …

“Code Sepsis to room 376B” – wait, that’s Stuart! Fuck!

A team of nurses arrive to troubleshoot Stuart … he refuses to take IV fluids because they already blew a vein … not sure which hospital did that … he had been refusing IV treatment since he had been at Valley, pulling out his IV port … they are more bothered by Jack screaming than we are and are trying to get Stu a new room on top of trying to find out why his vitals are all off …

While they are all working on him, I am troubleshooting the phone to see why it doesn’t work … it will ring out, but you cannot hear it ringing in … par for the course …

This is a ‘normal’ Thursday in Stuart’s world … and due to my proximity to Stu, in my world as well …

I eventually leave a go to a meeting to get balanced myself, but end up getting triggered … (FIC post Nov 9)

The next day I get a call from the pretty young nurse that is attending Stu … she said it was fun to see him in different states … the totally slow, speech slurring, falling asleep Stuart and the manic, can’t stop talking Stuart … he looked her straight in the eye and said, “We like you!” Yep, Stu is feeling better alright!

Stuart is ok from the sepsis alert … everything is back to normal, and he got a good night sleep … sleeping through Jack’s screams …

She said that Jack may have been the one screaming yesterday, but now that Stuart is the one who is talking nonstop, and Jack doesn’t seem to mind … they are perfect for each other …

Now he is in the stalker dialing phase … this is where he dials me day and night all day long leaving messages and clogging up my voice mail … when I answer to give him a “hello” and an “I Love You” he begs to come home, he says he is getting released and that he can come home today (which is his Shtick – calling and telling me he is coming home today, which is every day he is in the hospital)  … I am in the middle of work, and he works me from every angle to manipulate to get what he wants … to tiring … he does this to Kerri as well …

I had just finished writing the above thinking now I just have to wait for the end of this story …  I laid down for 15 minutes mentally & emotionally exhausted … I sat up to check my phone as I saw it flash … more insanity … yep, right on schedule … the tale continues …

Valley Hospital Doctor Sehdev is calling to tell me they are releasing him … NOW … can I come and get him? I asked why they had not given me any warning? Oh, we had to get somethings together … BS!  She knew the day before, but did not give any warning so I could plan my day around it … they just expect me to drop all my appointments and plans and come to get him NOW … so unprofessional …

The Nevada Behavioral Health Psych Doctor felt he had no acute psychosis and had coherent thoughts … What?! I had been getting stalker dialed by Stu incessantly and I can promise you he is not coherent nor without psychosis! Where did this guy get his license? I asked that too … I was pissed!

They actually called the guy back in to make another diagnosis to cover their butts … suckers …

Triggered and in shock, I make my way down to Valley to pick him up …

The triggered shock comes from now having to get Stu back home and set up with food, meds, and get him settled, all the while being psycho babbled by Stu with nonsensical word salad. I have him on video talking, making absolutely no sense or even being able to make out what he is saying … It hurts your head to be in that environment … let alone be exposed to it daily …

I knew he was not balanced yet … Stuart can fool people for a minute to get what he wants, he can sound good for a minute, but talk to him for 5 minutes and you will hear and see the psychosis.

I get to Valley and look at Stuart’s feet to assess his diabetic wounds … OMG … they are healed!! What?!! Three years of trying to get them to stay closed and they are closed with only minimal scab … I expressed my wonder at this, and Stuart told me a story … I actually have him on video describing it …

He said, “I was lying in bed with my feet up, and my toes, I felt 60 % light and 40% darkness touched on my right toe and it was like a healing, it was like a fuse, and it healed my toe” He tells that story over and over exactly the same way … I said “it was a miracle”” … he started singing “it’s a miracle, a miracle, a true blue spectacle, a miracle come true …“ I thanked him for the song …

This was a Tuesday and Stu had an appointment with VA Psychiatrist Dr. Racoma Thursday. We wanted to make that appointment … Claudia and I conferred with each other and felt that was a good plan.

He was released from Valley November 14, 2023, with no Clozapine … they had not had him on Clozapine during his stay, after all that effort to onboard that drug .. all to no avail … I even went dumpster diving at one point, as I thought maybe I had accidently thrown out some important instructions about what he was supposed to be taking upon release, but there was no clozapine to be found even on paper … Stuart was refusing that medication.

Stuart was out of it … not being able to work his phone, or TV properly, not able to talk properly, making no sense at all ... I have another video of him rambling unintelligibly the day after he was realeased for Valley ... 

Two days of dealing with Stuart in this manic state, hoping he would not take off again …

Thursday came and we were able to get him to Dr. Racoma. I had to tell Dr. Racoma that we needed a L2K Legal hold him into the VA hospital as Stu was going to hurt himself being in his condo by himself.

I also gave Dr. Racoma the paperwork to fill out for me to become Stuart’s guardian. The POA I have on him is not strong enough to help him in this broken system. They ended up mailing it to Stuart’s home and not to me, I was waiting to hear back from them and finally found the envelope at Stuart’s place two weeks later … I will pursue that in the new year … too much going on right now …

Anyway, Stu goes back to the VA hospital for a couple of weeks to straighten out his psych meds again …

Guess what happens?!  Yep … come and get him … NOW! No warning … why can’t they think ahead that people have lives and jobs?

I had had 15 stalker dialed calls between Sun-Mon from the VA hospital … I thought it was all Stuart’s calls as he does that … evidently the staff was trying to get ahold of me, but they left a message, not one …  and the rumor went around that I was on a cruise … what? Where did that come from? Stuart? Come on … again I feel there is a lack of professionalism here… a voice mail from the staff would have helped all of us figure out what was going on … I cannot answer 15 stalker calls from Stuart, which is a real thing, so I don’t answer, I wait for voice mail to see which calls I need to address … more insanity … He released Nov 28, 2023

I catch a random voicemail that says he left the hospital … What? Panic … again …  but I think it was a phone update and the carrier had replayed an old voice mail from when he left the hospital the first go around … confusing …  I think it was an old voicemail … or Satan messing with me … or both! Fucker …

I believe in Good and Evil … I believe in God & Satan … I believe God wins … so I do my best to stay on God’s side …

Stuart comes home a bit unstable still, but better than before … we hope and pray for the best … a ton of doctor’s appointments ensue, settling him back in, trying to figure out his new meds and if there is anything else that may possibly help him and that he will agree to … counseling? We have tried that road before to no avail, but I think he might be more open to it now … Support groups? Also, a bad experience in the past for him, but he may be willing to try again … we just keep showing up and trying …

This is a never-ending cycle … lots of time and effort that sometimes seems to just be a waste of time … but what am I gonna do?! Just press on … rely on God and His strength to get me through … He will make a way where there seems to be no way … he is a God of miracles … I believe in Him and His ability to make it all work for good in the end … I will rely on that promise in Faith … I will keep fighting the good fight as long as I have breath … God will help us through … I just KNOW it …

Thank you Jesus …