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7.6.12 You Have 30 Days

There’s nothing like the pressure of the clock. When it was time to take a test, our teachers said we had only “x” minutes, and when the time was up, we had to turn in our papers without delay. Just glancing at our watch while taking tests added more stress. Were we ahead of schedule or behind? Clocks add pressure in the sports arena. How many times do we watch quarterbacks see the play clock run down to two seconds and frantically pressure their centers to snap the ball? The clock adds pressure to golfers. They can’t take their time to swing a golf club or read putts. If they take too long, the golf officials put them on the clock, or they get penalized strokes. The pressure of the clock is stressful. 

There are clocks in the medical world, which I learned in my Dad’s care plan meeting last week. Medicare has a standard of 100 days for senior adults who are in a skilled nursing facility (SNF).  It doesn’t matter what medical condition brought them there. If they are in a SNF to recover from a stroke, they have 100 days. If they were in a car accident and need a SNF, they have 100 days. If they just became a double amputee, they have 100 days. Medicare has set the clock for recovery, and if the patients haven’t recovered by the 100th day, they are no longer covered. They become a private pay patient.  

Dad feels the pressure of the 100-day clock. The physical therapist in Dad’s care plan meeting announced that if he can’t transfer by the 100th day of rehab, he will not be able to return to his assisted living apartment. Dad lost 70 days waiting for his new prosthesis, as he didn’t feel safe trying to transfer with one artificial leg while waiting for his new one. Dad had difficulty embracing the news that he had 30 days left to learn how to transfer with both artificial legs. He said, “I just got my new prosthesis on June 21st! Thirty days sound like a very short time frame. I’m not sure I will be able to do it that quickly.” 

I can’t imagine what Dad is feeling. It feels unfair that a double amputee has to perform rehab as quickly as a stroke victim. But the therapists weren’t as sympathetic. They made it clear that they have helped many double amputees learn how to transfer with just one artificial leg. So the clock is ticking. I told Kendal, the social worker at this meeting, that Dad had VA benefits, so I need to begin pursuing this avenue. Kendal warned me that the VA is not known for providing long term care unless it is connected to his time in the service. My heart sank. Kendal handed me a VA brochure so I could contact the VA attorney to see if there might be other benefits we could pursue. I thanked the ladies for including me in the care plan meeting. I kissed Dad goodbye before heading back to the office. I gave him a pep talk and said, “You have 30 days to show you can transfer yourself. You can do it!” 

As I headed to the car, it struck me that Dad is not the only one who has 30 days. I, too, have 30 days, but my list looks different than his goal to transfer. I need to meet with the VA attorney as quickly as possible. I need to visit with the nursing director at his assisted living apartment. What is the protocol to terminate the rent agreement in case he’s not going back there? If he can’t go back home, then our family needs to deal with moving all of his stuff out, but where? There’s no room at a nursing home facility. How much of his things should we donate versus keep? I have to figure out the financial implications. If he doesn’t qualify for VA benefits, then all of his income could potentially go toward nursing home expenses, which means we’re looking at Medicaid. What about credit card bills? Most importantly, I need to shop for affordable nursing care and do site visits. Whatever facility is best for my Dad will need to have an available bed, preferably a private room, on July 29th. I also need to figure out how to transport him. He doesn’t fit in my car, and if the facility is not in town, then finding transportation may be a problem. I feel the pressure of the clock. 

As I get my track shoes on to race the clock, I am comforted knowing that God already has the facility picked out. He already knows what the financial picture will be. My family is ready to help me get him moved out if necessary. The Lord will help me navigate through the VA system. In the end, God is sovereign, and He is the true caregiver. I look forward to seeing how He leads our family to do what’s in the best interest of my Dad and be financially sound. Please keep the prayers coming. The next 30 days is filled with stress. Dad has 30 days to learn how to transfer, and I have 30 days to find an affordable facility in case he can’t transfer. The Lord will get us to this finish line in a glorious way. He always does. 

Blessings,                                                                                                                                                                                                                                                         Lee Ann

6.27.12 It’s Time to Transfer

     I love taking vacation and unhooking from the normal paces of the real world. The hard part is returning to the office. My goal is to get traction on a normal schedule throughout the week. But I have one more goal for Monday. I need to call Dad’s physical therapist to see how he is progressing since I was gone a week.  

   “Tammy, this is Lee Ann calling on behalf of my Dad. I just got back from vacation, so I wanted to check in with you to see how my Dad’s therapy is going.” 

   “I am glad you called. We discharged your father last week for lack of progress,” Tammy said. 

   “What do you mean ‘lack of progress’?” I asked. “That sounds odd given that this facility is a ‘rehab’ facility.” 

   “What I mean is your Dad is self-limiting.” She continued, “We do physical therapy with many amputees, and we teach many to transfer from their wheelchairs to beds, or toilets, or shower benches with just one leg. When we try to work with your Dad, he just tells us ‘It’s not feasible.’ When we try to push him, he gets angry. In fact, when he told us he could transfer, we asked him to show us, and when he couldn’t, he got very angry with us. The bottom line is when patients don’t want to participate in therapy, we discharge them since there is nothing else we can do.” 

   “So he’s existing in his room, except to go to the dining area for meals, but getting no therapy,” I said. 

   “That’s right,” she said. “We have given him strength exercises for his arms, but he is not really doing much of those either.” 

   “So where do we go from here?” I asked. 

   “Your Dad feels certain that once he gets his second artificial leg, he will be able to transfer, and then we will be able to discharge him back to his assisted living apartment assuming his hypothesis is correct.” 

   “I hope he’s right,” I said. “What kind of timeline will he have to demonstrate that he can transfer once he gets his new leg?” 

   “It is my understanding that your Dad is running out of days according to the Medicare allowance of 100 days,” Tammy offered. “I believe he is going to have about two weeks to accomplish this, or we will be looking at other alternatives.” 

   “That sounds like a short timeframe given that he doesn’t have arm strength to push himself out of his wheelchair,” I said. I decided to change the direction of the conversation to be proactive in case Dad is not able to transfer.

   “I want to be sure that any decisions regarding a transfer to another facility are made not just by my Dad, but also by my uncle, brother and me. We need to make sure that the decision made is not only in the best interest of my Dad, but also financially sound.” 

   “That is no problem, Lee Ann,” Tammy assured me. “I will make sure you’re included in the care plan meetings going forward so you are involved in the decision-making process.” 

   “Thank you, Tammy. I appreciate your time to update me.” 

     This is the conversation I had with the physical therapist on Monday following my vacation. Tammy’s report was very different than what Dad told me when I asked him, “How is your therapy going?” His answer was, “I can do it, it’s just not pretty.” My internal dialogue was “So if you can transfer now, why are you still here?” But I responded, “I am glad to hear that. So when do you think you’ll be discharged?” 

   “I don’t know,” Dad said. “I am starting to feel like a permanent resident here.” 

     I feel sad for him, but I am also not surprised. Dad’s amputation surgery was April 2nd, and no fitting for a new artificial leg could happen until his stump stopped swelling. It was June 14th before he got fitted, and it was June 21st before he finally had a new leg. That is a long time to wait for a prosthesis. And if Dad made up his mind that he couldn’t transfer without two legs, then two and a half months have elapsed without much practice in transferring. Before I left for vacation, I had this premonition that Dad was going to have problems negotiating this critical therapy. It felt like the cards were stacked against him. 

     First, he is heavy. His weight is an obstacle to push himself up. Second, he has lost significant arm strength. Because of his weight, his arms really need to be strong. How does a rehab hospital define strong? If Dad can push himself up in his wheelchair and hold himself up for ten seconds, then that is considered good arm strength. Have you ever tried that? I did just to make sure I could! If you’re not exercising, that can be harder than you think. Third, once he can stand up on his two artificial legs, he needs to show balance and stability, which is very hard after losing a leg. The brain and the leg need to start talking again. Third, he fears falling. Dad can’t picture using his walker and venturing too far from his wheelchair in case he falls. Finally, he fights depression. His level of discouragement influences his decision to not work at building arm strength. 

     When I walk into his room, the therapist has only one goal taped to the wall, “Push yourself up in your wheelchair and hold for 10 seconds. Do this once every 30 minutes.” Dad is struggling to accomplish that one goal. I tried to give him a pep talk. “Dad, your arm strength will come back, but it’s a process. Celebrate pushing yourself up and holding for three seconds. In 30 minutes, try it again, and you may hold yourself up for four seconds. Just keep working at it, and you’ll get there.” 

     My Dad has gambled on the hypothesis that he will be able to do transfer activities with two legs. It is plausible, if he can build up arm strength, that he can do this and go back to his assisted living apartment. I just don’t think it can happen in two weeks. I will see if my hunch is right. I have been asked to attend his Care Plan Meeting tomorrow to discuss Dad’s issues and the roadmap ahead. I have a feeling that it’s time to transfer, but it won’t be back to his apartment. May God’s grace be sufficient for my father to deal with this potential change. May God pour out His wisdom generously on our family as we seek God’s leadership to show us where he should be transferring next. Please keep us in your prayers. 

Blessings,                                                                                                                                                                                                                             Lee Ann

4.29.12 We’ve Got Mail + Video

Do you appreciate when someone writes you? I feel special when I receive a letter because someone took the time to connect with me. I love getting letters. In fact, I save them. 

Saving letters must run in my family. My grandfather, a lieutenant commander in the Navy, was called to duty during World War II, leaving behind a wife and three young boys. He and my grandmother exchanged many letters to keep the family connected. 

When my grandparents passed away, Dad inherited boxes of letters, not only written from Poppa Lee and Gran Jones, but the letters Dad wrote to them. The year Dad downsized his living space, he entrusted these letters to me. I’ve got their letters from 1943 through the 1970s. Can you imagine the family history at my fingertips? Here was my opportunity to learn about the lives of my grandparents, whom I hardly knew. And learning about Dad was a bonus.                                                       

My intentions were good. I’ve had these letters – 3,000 by conservative estimate – for seven years. I started a project of scanning them but stopped after 40 when I discovered my scanner liked having brittle paper for lunch. Then I entertained a goal of reading a letter a day, which was a lovely idea, but it didn’t happen. I talked myself out of it because I wanted to read them in chronological order, which would have meant going through all 3,000 of them. The letters remain unread. 

This undertaking made me think about God and how He intentionally preserved His letters to us. I wonder if we appreciate that God has composed the greatest love letter ever written to mankind. God preserved His letters in the Bible because He wanted to show us how much He loves us. I have learned my legacy as part of God’s family by reading the Bible daily. I am certain that if I were as intentional about reading the letters of my family, I would be enriched with that legacy as well. 

God has a series of letters waiting for us in the Bible. We’ve got mail, and it’s time to read it!

Blessings,                                                                                                                                                                                                                            Lee Ann

4.15.12 Be Anxious for Nothing

Philippians 4:6-8 – “Do not be anxious about anything, but in everything, by prayer and petition, with thanksgiving, present your requests to God.  And the peace of God, which transcends all understanding, will guard your hearts and minds in Christ Jesus.”

     Imagine your doctor telling you he needs to admit you because your leg needs to be elevated to deal with fluid drainage from the ulcers. You head to the hospital in good faith with the premise of managing the leakage. Now imagine your doctor coming in a few days later to look after your wounds and announcing that your arterial circulation has significantly deteriorated and that an amputation is the best option to move forward. When he called me to share the news, he was feeling overwhelmed and scared. Dad was in a difficult position, and I was unsettled about it. Shouldn’t a doctor who has been treating my Dad on a regular basis have a higher level of awareness as to the real condition of Dad’s leg? This didn’t feel right to me. Dad was a captive audience, and he had to make a decision that could potentially place him in a nursing care facility. I asked Dad’s permission to call his physician.

     I was candid with him on the phone. 

     “My Dad understood that he was being hospitalized to elevate his leg and deal with the fluid drainage,” I told him. “He trusted your advice, and now you tell him that his leg needs to be amputated. Can you help me understand what’s going on? Was there more to your conversation with Dad prior to his admission that I didn’t know about?”

      “You are absolutely, one hundred percent correct,” the doctor said. That was the premise.  I had no idea how badly his arterial circulation had deteriorated until I looked at him.” Our family knew this day was coming when Dad would face another amputation. The goal was to save his leg as long as possible. The doctor acknowledged the many treatments Dad had undergone to manage these ulcers and thereby extend Dad’s independence. But the ulcers weren’t healing. He was given two choices. He could undergo an amputation or continue the battle to manage the ulcers.

     Saving the leg means a debridement surgery. This entails scraping away dead tissue in and around his wounds to create a healthy bed of tissue for skin grafts to close the wounds. Dad went that route a year ago. It took a couple of debridement surgeries just to clean out the ulcers and clear away the dead tissue. Then there was the surgery to take skin and graft it to the wounds to close them. This was a viable solution last year because his arterial circulation was very good, but that is not true this year. His arterial circulation deteriorated significantly, which made the debridement/skin graft approach an ineffectual treatment. His only other choice was to amputate.        

     Dad knew in his heart that an amputation was the right decision. Once he consulted with the orthopedic surgeon, Dad agreed to it. Over the weekend I notified family, Dad’s church family, and my Sunday School Class to pray for Dad. Since his surgery was scheduled for Monday, April 2nd, I went to the hospital Sunday evening to pray with him. As I was driving to the hospital, I wondered if Dad would be feeling anxious. Would he be having any doubts about his decision? When I arrived at Dad’s room, the power of prayer was already on display in Dad’s spirit! He was not feeling any anxiety. He was sitting on the edge of his bed exuding a peaceful demeanor. He was nonchalant about the amputation. When I marveled at his calmness, he said, “It’s like I’m ignorant of what’s happening.” That is God honoring the many prayers of His children on behalf of my Dad! But the power of prayer was not the only thing on display.

     God illumined the spiritual maturity of my father during our prayer time. I opened our prayer by asking God to pour out His grace, His mercy, His compassion, His peace, His love, His comfort, His healing, and His encouragement upon my father. I asked the Lord to allow this surgery to be successful. I prayed that the Lord would give Dad a victory in rehab so he could return to his assisted living apartment. I thanked the Lord for what this surgery will mean to Dad. Dad will no longer have nurses in his apartment every other day redressing wounds. There will be no more trips to clinics for lymphatic treatments. He won’t have to take pain medications that dull his memory. He won’t be in and out of hospitals to fight infections with antibiotics. He will feel more independent with more free time. As I finished my prayer, Dad began to pray. He acknowledged that there were just too many blessings to count. He prayed with a spirit of gratitude for all God has done for him. He prayed for those who are spiritually lost. Then he started to pray for me. 

     This is something special that Dad does often. Whenever I am with him and he desires to express appreciation for the things I do for him, he will go beyond a simple “thank you”. He will verbalize his prayer with me present. That evening he recited his favorite, “Lord, thank you for Lee Ann.” he began. “Please reward her generously for all that she does for me.” Now understand I am in a hospital room attempting to minister to him, but instead he is focused on praying God’s blessings over me. I hope I will be spiritually mature enough some day to focus on others instead of myself. His great faith in God’s sovereignty, God’s faithfulness to take care of him, and God’s perfect will for him is a tremendous model for anyone. I kissed him goodnight and knew in my heart that God had “prepped” Dad’s heart with immeasurable peace. 

     The surgeon called me at 8:50 Monday morning to let me know the surgery was a success. The recovery nurse called me at 10 a.m. to let me know he would be back in his room by 11:00. Each call was a confirmation that God was taking care of my father. There is nothing like the power of prayer. I believe God honored the multitude of prayers that went out for my Dad. God hears us when we pray and lovingly responds. Let’s praise God from whom all blessings flow. You can be sure that’s what my Dad is doing. 

Blessings,                                                                                                                                                                                                                            Lee Ann

3.31.12 Is He First?

     Imagine having a favorite restaraunt that you patronize every Sunday. You enjoy the food, the ambiance, the great service, the variety of choices on the menu, and the wait staff who serve you. Envision how the owner of the restaraunt would feel if you just left the restaraunt without paying for your bill week after week. Is your first reaction, “Who would do this?!” That sounds crazy, doesn’t it? Well, this scenario is not happening in restaraunts, but according to Barna’s research I shared in my last post, it is happening in places of worship across America. 

     According to Barna, thirty to fifty percent of active church attenders are patronizing their favorite house of worship, enjoying the fellowship, hearing the Word of God preached well, experiencing a loving atmosphere, appreciating the variety of ministries available to their families and the staff who serve them week after week.  You guessed it.  When the worship experience is over, they walk right out the door without giving anything financially. That’s disconcerting if these attenders are really believers. Barna’s research also reveals that this lack of giving is not exclusive to any one denomination. In fact, the lack of giving feels like an epidemic that has swept many churches across many denominations. How do these attenders justify not giving?               

     There are a multitude of hypotheses. Some attenders may not have a Christian upbringing. They weren’t taught God’s command to give a tenth to their local church. Some may feel their debt keeps them from giving. Others may rationalize they are giving their time and talents in ministry, so giving isn’t required, or optional. Some think their giving to outside organizations satisfies God’s requirement to give. Some may understand they should give ten percent to the local church, but fear or lack of faith in God to provide for the rest of their expenses keep them from giving. Regardless of their rationale, it doesn’t change the fact we have a gross deficiency of giving in the local church. Another fact remains. God feels robbed when we don’t give our tithes according to Malachi 3:8. The Lord accuses the Israelite nation of “turning away from his decrees and having not kept them.” Either we have a bunch of unbelievers who aren’t giving (in which case they’re excused because they don’t know any better), or we have a large swath of believers filling the pews who are either ignorant or ignoring God’s decree while not understanding the blessings of giving.                

     The Lord challenges the Israelites to bring their tithe into the storehouse (the local church). In Mal 3:10 He says, “Test me in this, and see if I will not throw open the floodgates of heaven and pour out so much blessing that you will not have room enough for it.” His decree comes with a reward! But the flipside is also true. The Lord says in Mal 3:9 to the Israelites, “You are under a curse—the whole nation of you—because you are robbing me.” In verse 11 you see what the curse looks like, unless they follow through and honor God with their tithe. It says, “I will prevent pests from devouring your crops, and the vines in your fields will not cast their fruit.” The Lord implies He will not bless their livelihood if they keep withholding the ten percent belonging to the Lord. When I read this passage, I wonder, “What do these attenders not get about the blessings of giving that await them if they would just do it?!” God is just waiting to  “pour out so much blessing that you won’t have room to contain them!”               

     This boggles my mind. Yes, I know this is a reflection of their spiritual condition. But the larger question is, “How do we help them respond to God’s command?” I have heard pastors preach wonderful sermons on the requirement of giving. They work hard to motivate and inspire giving without guilting people, but they still don’t see the change. In the meantime, half the congregation is attending without giving while enjoying the benefits of being connected to a local body of believers. I wish these attenders would connect there is an expectation to give because God has asked them to tithe.                

     Why did I spend so much time on the subject of honoring God with our tithes? There are two reasons. First, if the desire of our heart is to be a generous giver just like God, then our generosity has to start with God.  Give generously to God first, others second. What that means is give God a “thank you” note of 10% of your income wherever you’re actively attending before considering generosity toward others. He deserves that even if He had never asked for it! Everything I write to hopefully inspire a lifestyle of generous giving should never be construed to be in lieu of the tithe. Any living giving I describe should be above and beyond our minimum 10% “thank you” note to God. Thus, as I share my living giving vision, it needs to be understood that the blessings of God will be all over our giving as long as we are not robbing God His tithe.  I know without a doubt my life has been filled with many blessings because I have not short-changed God.                

     Second, I don’t want anyone left behind in becoming a generous giver. So if you don’t tithe, I am getting ready to be your top cheerleader! I will be writing a series of posts for the sole goal of helping you succeed in tithing and bring you on board. One fun way to begin is to start sharing our stories. I bet tithing believers reading this post share my desire to help you experience the blessings God is waiting to pour out on you if you would risk with Him!  

     By way of this post, I am calling upon tithers to help these attenders with your story. When did you begin to tithe, and how did you see God bless you when you obeyed Him?  Perhaps you used to be one of the attenders who struggled to give a tithe. What was your rationale at the time you weren’t giving? What helped you turn the corner to start tithing?  Did your spouse drag you into it, only to discover God’s blessings later? Did you feel a conviction to tithe? Have you ever regretted tithing? 

     I am inviting all tithing believers to pray about sharing your story of how tithing has blessed you. If you feel God is leading you to do so, you may leave a comment through the blog site or email me. Your story can be one sentence, or as long as you want it. Five minutes of your time to type up your story can change the life of attenders who are struggling to honor God with their tithe. It is my prayer that enough of you will share your story so I can publish a separate post of your testimonies. I will be glad to give you anonymity if you request it.  Our stories have power because God is right in the middle of them.  Let’s be an encourager.  May God bless you as you share your story to inspire those who need to take this very important step to be generous to God first, others second.  

Blessings,                                                                                                                                                                                                                            Lee Ann