Monday, I had to go to the inpatient facility where my new son, S, is still. We had his care plan meeting. In this, we discussed his diagnosis, his prognonsis and his treatment plan. The diagnosis is not good, but the prognosis is on par with his sister, E. He doesn't quite grasp that E struggles with similiar cources of her mental health issues, but I do. I then had to comfort this son as he is coming to terms that in addition to being abused, never loved, abandoned, and bounced into an entirely new family now, he is also going to have to accept the reality that his mental struggles are not a temporary situation.
I have no idea what the first adoptive family has tried to teach him. Given that they were trying to abandon him from the moment his psychic fell apart, they couldn't have take him positive and healthy outlooks for his prognosis. I do know they were telling other people (though conveniently not us when they tried to get us to take him) that he was possessed by demons. Well, isn't that just DANDY. Poor kiddo has the unlucky draw of a lifelong mental health condition and they respond from their fundamental nutjob paradigm to tell him this means he is possessed by demons. He's darn lucky that they didn't attempt an exorcist upon the poor boy. They undoubtably convinced him that people are afraid of his struggles and he needed to conceal them until they overwhelmed him and he could not hide them anymore.
Hat number one for this week was a combined hat. I had to be a mental health nurse, which fortunately is one of my absolute favorite hats to wear. I also had to wear my mother's hat, mother of a teenager hat. I'm a pretty good mother to teenagers, I have discovered. I used to think that 1-2 was my all time favorite age range for kids. I was so wrong. I love working with teens. Pre-teens are not my forte, but teens I totally can relate. I started laying the groundwork with this teenager that he is safe, that he is not going to scare us by telling us when he struggles, and that it is our job to help teach him how to be healthy with this diagnosis. I wear my mother's hat a lot. I'm not sure how well I wear it, but my life is often consumed to the point I lose other important hats--like being ME.
After that, I had to switch hats for the afternoon. II had his appointment with the Oncology Orthopedic Surgeon. The first thing out of the doctor's mouth when he entered the room was not to ask the history, was not to reassure us this consult was overkill. The first thing out of his mouth was, "Do you want to keep your toe." II was given two choices. Either he can consent to have the toe removed now. Or, the doctor will do testing, biopsies and, as he put it, he will simply justify to II that it will be necessary to remove the toe. There was no discussion that II could actually keep the toe, ultimately.
The bottom line is that the surgeon doesn't know what the mass in the toe is. He is a soft tissue tumor specialist. It's really not a good thing if the specialist doesn't know what this mass it. He cannot say if it benign or malignant because he's never seen anything like it. The reality of this mutation is that if whatever caused the mutated toe stopped after the toe mutated and the toe remains stable, it is not likely a problem. Once the toe is no longer stable and developing tumors in it, it is only a matter of time before the tumor that mutates in the toe will require the toe be removed. This one is actually far more extensive than we realized. It wraps around the entire base of the toe and travels slightly into the foot. Even removing this one will impair the toe and potentially require removal of the toe anyway. In addition, the more these tumors show up, the more likely they eventually go malignant. The surgeon says there is only a small chance this particular tumor is malignant. However, his preference (and it was a very aggressive sell) is to remove the entire toe and send the entire thing to Pathology and let them figure out what this mass is and whether it requires further treatment.
Obviously, the toe is coming off. The office scheduling department had gone home by the time we were done. They were supposed to call us Tuesday and did not. II attempted to call them and got disconnected. Emotionally, he's just going to wait until after the holiday and call again.
This time, the only hat I wore was wife. Nope, not even close to putting that nursing hat on for this one. This is pure emotion to me. This is my mid-30s husband who is in perfect health and the father of now nine children. I need my partner. I need my husband by my side. My children need their father to be here to raise them. I cannot see beyond the threat to his health and safety and while II grieves the loss of something that has always been an integral part of him, I simply hold animosity to a part of him that threatens the safety of my partner and my family. I also ache for the suffering he is going to have to endure to undergo this amputation and the recovery. I'm a tiny bit worried about the finances. If his company requires him to go on disabaility for the two weeks he will be out of work, that will result in only 70% pay for that paycheck. We'll figure it out, but I'm still nervous.
Yesterday, we were in the first full day of M's quarterly IV antibiotics. For some reason, the home health agency choose to not put one of his antibiotics into gravity balls but instead packaged it as an IV push medication. Hm..... There are three adults in this house, myself, II, and a live-in nanny. How many of those adults know how to do IV push medications? That would be ONE...the one that the state has listed as the nurse supervising the IV medications since this state requires an RN of record to be supervising. Yes, the palliative care agency convinced Hospice to put their agency as the agency of record and formally list one RN/mother as the supervising nurse.
This time, the hat was pure home health nurse. I'm giving M liberal dosing of his Ativan for anxiety (well within the parameters of his palliative prescription by his physicians but far more than I ordinarily provide him) because he is completely freaked out by this course of antibiotics. He nearly died the week before we started the IVs due to a common cold. The oral antibiotics only held the inevitible at bay until we got his IVs started. That means, not only is he very anxious but his health crashed in the day we transitioned from the orals that were barely holding him up and the IVs that will give him approximately two months of better health before he starts to decline again. I could wear my mother's hat on this one, but the honest truth is that M's autism means he cannot handle that. If I show concern and emotions, M will freak out worse. He needs to me to be strictly professional and act like his nurse for this. So, I supposed by deliberately not wearing the mother's hat with him, in a way I am just the same.
Yesterday, I also discovered that the BSN program I am supposed to start this fall has completely messed my coursework and financial aid up. I am calling them tomorrow, but I strongly suspect this cannot be salvaged. I am furious by the behavior of this program. I strongly suspect I am going to miss the fall for this coursework. If I do, I will be looking at other programs entirely. I have two other options, one local and one online, that I believe I can start in the spring. Both will cost more, one of those will stop our ability to return to our home state for two years. However, both programs are more reputable and more likely to assure I actually walk away with my BSN so I can get into my graduate coursework. However, I am disgusted that I will lose another semester due to the incompetence of this program. I will find out the end of this week, but I strongly suspect I cannot save this one, and at the least it will cost me a semester. More likely, this will cost me an entire year in my coursework. To be perfectly honest, if it has cost me a full year, I will likely take the GRE this fall and apply for the RN-MSN program I have my eye on.
So, the ongoing hat that I cannot keep setting down is my student/career hat. This is one part under nursing and another part pure academics. The underlying problem is that the program is not accustomed to a student who holds a Bachelors that is not in Nursing. They have treated me like an Associate graduate from the get-go and have been unwilling or unable to accomodate areas where I have clearly demonstrated their requirements in a manner outside of how they are used to seeing it occur. So, I have a slim chance I can salvage this fall if I can work quickly to get into another school, either for pre-reqs for the other programs that weren't willing to waive them when I looked into them previously, or for another BSN program that might be willing to work with me on missing the appliction deadlines for the fall.
Throughout this week, E has tried to destablize. The reality is there is simply too much stressors hitting her from so many angles right now that she cannot see straight. I've had her into emergency therapy appointments, lots of scripting, lots of walking her back to where she remembers to use her coping skills. Even so, every day is another point of instability as she starts her day and flashpoints of meltdown throughout her day. She's twice been on the edge of violence and thus going to visit her brother by joining him this week. I continue to work with her, but all by herself she can be exhausting. Remembering to make time and energy for her when I cannot get Chicken Little to quiet the cry about the falling sky is exceedingly difficult this week. Thus, nursing, mother, and therapist hats have been utilized with this child this week.
LMB has launched another assault against my father. Interestingly enough, this newest wave began when she was made aware that my father had a fiancee and was planning to get married. He dared to start healing and move away from her influence and she has retaliated by trying to destroy his life, along with the minor children, all over again. She is sueing under the claim that he has not allowed the children to visit her. While he has not encouraged them to visit, he has never actually barred their decision to visit her, honestly. However, they have choosen to not visit her for most of the last two years. The older two children left in the home have legally been awared right of refusal. The oldest just turned 18 and it's a moot point for her anyway. However, the younger two children, while old enough to legally have right of refusal in their state, have never been formally granted such. In their state, it is not an automatic condition from age, but something that must be specifically granted by a judge. When the divorce was finalized, these two children were just under the legal age when a judge could choose to award it. However, when they reached that age, they have acted as if they had the legal right of refusal. Upon the advice of the children's attorney, my father has permitted them to exercise that right.
LMB is now asking not only that Dad be found in contempt of court and sanctioned for parental alientation. However, she is also claiming that based a lack of visitation, the poor grades the children have in school (it takes many, many years to recover from shoddy homeschooling), their poor attendance at school (this is not actually true but she is lying as any good Narcisst will do), and the younger two children royally screwed up with a gang of friends last fall and got into trouble with the law. Upon these claims, she is demanded that custody be reversed and she be given full custody of the children.
LMB is the only person who truly things she has a shot at winning this battle. The old lawyer for the children has fully briefed the new lawyer and is prepared to testify in court to bring the new judge in the new jurisdiction up to speed upon the history of this case. LMB intended to switch jurisdiction by moving and then conceal the history so that a judge would only see the current situation and not grasp that all of the negative things that are visible now are aactually improvements from where this decimated and abused family started once they were legally free from her abause. She wants to use the courts to abuse all of us all over again. The new lawyer for the children has already informed the judge that this is not a case over custody but strictly visitation and that the solution is not to sanction and attack my father but to simply formally award the children the legal right of refusal and give them the right to make their own choices with their lives and relationship with their LMB.
One brother stopped visiting LMB entirely based upon her bizarre and insulting behavior this spring. My brother has scoliosis. First of this year, he had to undergo his second back surgery to prevent the curvature from crushing his organs. He spent over two months between the hospital and hospital homebound school in recovery. While he was in the hospital, this woman kept visiting him. Afterall, she must look like the good mother to the world. Except that while she sat there, she began to whisper disgusting allegations about my father to my brother. She is now alleging that my father has molested all of his daughters and most of his grand-daughters. It's disgusting. It's unfounded. It's a patent lie. It's ironic from a woman who not only turned a blind eye to the molestation of her very young daughters by her own older adopted daughter years ago, but has met the legal defintion of molestation in her own interactions with me for most of my life. My father has never molested any child and there should be an ability for her to face criminal charges for this one. There is no legal recourse except to ignore her. My brother has choosen to have nothing more to do with this woman for this behavior. She's subpeonaed him for this upcoming court case, it will be interesting to see the reaction the judge has when this brother tells the judge why he will no longer speak to LMB and that it has nothing to do with Dad.
Even so, I have had to wear my role of daughter and sister quite a bit this last week. I have to calm down both older and younger siblings. I have to help coordinate children in the home giving Dad space because his stress levels are in overdrive right now. I have to comfort my father when he reviews our testimony and again realizes what he allowed this evil to do and hurt his children right underneath his nose.
The strangest interpretation of my role as daughter is that my father and his fiancee appear to have possible broken up. He admits he cannot seperate this new woman from LMB. He is assigning the fiancee motivation that was LMB's. He is afraid she is trying to control him and make him a kept man. He feel emasculated because he still has no full-time job and this finacee is quite well to do. She loves him. She has supported him and stood through all of this struggle with his healing and LMB. What she cannot tolerate is that he has withdrawn from her entirely and says he doesn't think he wants to be with anyone anymore. Both have sought me out to process and to deal with their hurting hearts. I just mostly listen. There is little else I can do for either of them. If they could weather this attack, I think they would have a great future together. She is heartbroken that she stepped in willingly as mother to his children and grandmother to his grandchildren and she loses not only her heart but the family she always prayed for and never had. I don't know where they go. If he walks away from her, I truly believe he will give up the best thing that ever happened to him. However, I cannot tell him what to do, nor can I ask her to not make a decision until this is over and wait to see if he can get back to the stability and point of healing he had before this newest assault started hitting him.
It's only Wednesday. I have been up, down, and all around this week. I'm afraid I'm not done yet. M's antibiotics are a three week course, and next week we add his summer schooling to it. S is just beginning his journey to mental health. E has been on hers a long time but the unstructured environment is not proving to be a healthy set-up for her stability. My other children require lots of attention and devotion or they will become squeaky wheels, screaming out to me that I am forgetting to give positive attention to those who are not struggling while giving so much attention to those who are struggling. II will face surgery, likely before my birthday in August and I will have to support him through the recovery as well as manage the stress if we face a reduction in his pay for the struggle. I am starting to feel overwhelmed. I am starting to remember that I need to care for ME in all of this chaos. I am re-evaluating the things I had intended to make sure I stay in balance for now. Everytime I hope and pray that life will settle down, it never, ever, ever actually does