Sandwiched In

Please pass two whole-grain bread slices. Now that my husband Ed and I are part of the sandwich generation, it’s time for us to crawl between them.

We live in an intergenerational household: he and I and our two sons, Neil (11) and Jared (4), on the upstairs floor of our home, and Ed’s parents, A and D, in the downstairs apartment. Our 23-year-old daughter, Becky, lives in a nearby town with her fiancé. I work full time, in a home office, as a freelance copyeditor. Ed commutes just over an hour each way to his job as a cabinetmaker. A and D help me by taking Neil to his weekly guitar lessons and Jared to his preschool three time a week; this allows me to get in enough billable work hours each week.

A, who’ll turn 70 near the end of May, needs knee-replacement surgery. The degeneration of his knee joint gives him so much pain that he waddles like a penguin. Before he can have the surgery, though, his doctors have required him to undergo a series of tests: blood work, stress tests, and prostate biopsy—the latter because his prostate-specific antigen, or PSA, levels have been astronomically high for years and the docs want to make sure that they won’t be doing surgery on a man with cancer.

Meanwhile, D, who’ll turn 71 in just 9 days, has been having neck pain, making it difficult for her to drive, bend in various ways, and even sleep. Her doctor suspects damage to the discs in her neck or a pinched nerve. She needed to undergo magnetic resonance imaging (MRI) so she could get her condition diagnosed.

Tuesday was Allan’s prostate biopsy. Foreshadowing: The procedure was done at the local VA (Veterans Affairs) hospital.

D drove him home afterward; everything seemed fine. He even dropped Jared off at preschool Wednesday morning.

But not long afterward, he started to shake uncontrollably. D called the hospital and was told to take his temperature. It was 103°F. Time for him to go to the hospital ER; he had an infection. How did we know? The same thing—at the same hospital—happened a few years ago after the same procedure.

D had to drive A to the hospital. I lost work because I had to pick Jared up after preschool was done. But before I could do that, I had to pick Neil up from middle school because otherwise, no one would have been home for him when the school bus dropped him off.

A didn't end up staying at the hospital. He complained so much about how much the hospital would charge him to stay—“Eight hundred dollars they’ll charge me! I don’t have that kind of money!”—that the docs released him AMA (against medical advice) the same day, after pumping him full of antibiotics intravenously.

Yesterday was D’s MRI appointment. Though A was feeling a bit weak, she didn’t want to reschedule, because her neck pain has been going on for a few weeks now. So I took off work again, this time to drive her to the appointment and let A stay home and rest. I brought along Jared, for whom it wasn’t a school day. I knew that the scan would take a while, so I made arrangements for Neil to go to the next-door neighbor's house if I got back home after his bus arrived. Jared was fine the whole 90 minutes; he and I sat in our van, all the windows open and the side doors open to catch the breeze, and played with the Etch A Sketch, read, and talked. (Jared, like his sister before him, is a very easy child.) Meanwhile, I was sitting there thinking that I'll have to work this weekend to make up for all of my lost work time so that I can meet my clients’ deadlines.

We got back home 10 minutes before Neil's bus showed up. Jared and I decided to wait in the front yard for Neil. Meanwhile, D came out of the house to say that she had taken A's temperature, and it was 103! Back to the hospital, this time to stay for a while. But I couldn’t drive him, because I had both boys, and even easy Jared wouldn't last through a 40-minute drive to the VA hospital, getting A admitted, and then another 40-minute drive home. I didn’t think D should drive A because of her neck problems and the muscle relaxant she was given so she wouldn't freak out during the MRI. I called Ed, and he left work early, at 3 p.m., so he could take his father to the hospital. You’ll recall that it takes just over an hour from his job to home.

Poor Ed—and poor A. The VA hospital got A catheterized pretty quickly, but they didn’t start pumping him full of IV antibiotics or officially admit him until his lab test results came back ... at about 8:30 p.m. I did tell you that this is a VA hospital, didn’t I? Ed didn’t want to leave A until he was settled in a room and no longer shaking from fever, and that didn’t happen until almost 10 p.m.! Ed finally had some pizza for dinner just after 10.

At least maybe this whole episode will teach thick-headed A that when the docs say he needs to stay in the hospital, it’s time not to gripe repeatedly about money to every caregiver he sees—and risk alienating them—but to keep quiet, stay still, and recuperate. And if I were him, I for damn sure wouldn’t want to have my knee-replacement surgery done in a VA hospital!

I’m hoping I’ll get to work all day today. But just in case, keep a slice of bread ready for me to crash on. If I don’t need it today, I’ll need it again soon. Taking care of the in-laws as they age is going to fall mostly to me, not because Ed doesn’t want to do it but because I’m here all the time and am self-employed.

Updated 3/31/06, 1:20 p.m.: A nurse in D's doctor's office called to say that the MRI results are in. D has a herniated disk in her neck. The doc hasn't called yet about what the treatment will be, but herniated disks in the neck usually don't require surgery, just hot or cold packs, meds for the pain, a neck brace (which D's already wearing), and physical therapy.

9:15 p.m.: A's doctor says he has prostate cancer. The doc doesn't think the side effects of either external-beam radiation therapy or brachytherapy (also known as seed therapy) are worth it in A's case, so A will be in the hospital a few more days so that he can undergo a radical prostatectomy.

Further update here.



sandwich generation freelancer self-employed in-laws intergenerational prostate cancer herniated disk Veterans Affairs EditorMom