More stuff

I have two pounds to lose in two weeks. I think I’m pretty close.

I won’t be in Seattle next week. No mentoring. I will be tomorrow. And Friday. Applications for Phil time on Friday may be submitted in comments.

Two weeks from tomorrow is the last mentoring day for the school year. After that I will be driving to Seattle even less. I’ll come to any cool kid parties to which I get invited, but otherwise will be staying here more to help mom and to save gas money.

Mom can’t raise her left arm above her head anymore, and she is swiftly losing strength in her hand. I’m guessing she has about a month left of the ability to type. Could be more. Could be less. I’m looking at switches tomorrow. She’ll have to use a switch/scan system, which is going to suck.

Talked to an ambulance/cabulance company today about having someone drive mom to Seattle on the 8th rather than us. She gets uncomfortable in the car fairly quickly. He suggested that it would be jut as comfortable if we rented a top of the line Cadillac with extra soft suspension and 10 point seat adjustment. Mom seemed to like that idea.

I will also start calling around to hire in-home help. Dad finally agreed. Mom can’t even go to the bathroom by herself, since she can’t pull down her pants or pull them back up. And soon enough won’t be able to operate her suction machine or turn pages in a book. He’ll be overwhelmed by all the stuff he has to do. So getting someone else to help out is good. I’ll be there to do some of it, but I have a hard enough time seeing my mom deteriorate as it is.

The periodic decline post

Mom says she’s having a hard time concentrating even at things that really interest her. She’s more or less staying in her easy chair exclusively. She’s using the bipap to assist with her breathing during the day quite frequently now, though she’s trying not to this week because Elaine is visiting.

We have a doctor’s visit on Monday. These have been monthly. I think this will be the last one. After this the doctor will be needing to make a house call (he’s offered), because mom isn’t really up to leaving the house much even now. In a month, unless she’s having a really good day, she’ll be completely wiped out by going in to town.

Social Security won’t be there? Please.

Okay, so one of my pet peeves is people repeating stuff that just isn’t true. I don’t mean rumors that I’m sleeping with Jason’s ex-girlfriends. Hell, that sort of thing is perfectly okay. Tell all sorts of rumors, true or not, about me that you want. No, I mean things like you can’t get ticketed for driving too fast in Montana. Stuff that just isn’t true.

One of the ones that I heard last week was that Social Security will be bankrupt before we retire.

Under reasonable assumptions, it’s just not true. What do I mean by reasonable assumptions? Like we leave the laws around it alone. We could always make Social Security into a dishwasher funding law, but I’m assuming we won’t.

Right now, under the Social Security Trustees projections, Social Security is fully funded through 2041. Under the Congressional Budget Office projections, it’s fully funded through 2046. What does that mean? It means that all planned benefits can be fully paid. Benefits go up faster than inflation, actually. That’s important for what happens after 2041 (or 2046, under slightly more optimistic projections). At that point, benefits can be paid out at 75% of what’s currently planned for those years. 75% of plan at that point is better than if current benefits were indexed to inflation. In other words, retirees after 2041 will be collecting more money, adjusted for inflation, than current beneficiaries.

That’s with no changes whatsoever.

Let’s also point out how far out that actually is. 2041. I will turn 65 in 2035. I will be 71 when Social Security goes bankrupt. 33 years from now. Social Security was in worse shape in 1986 than it will be in 2041, and with a decent change was fixed. 22 years ago. It’s had a surplus since then and we won’t even be dipping into the surplus for another 20 years or so.

This point is so far in the future that if we make really minor changes to the funding (I know, my assumption was no changes, we’re moving on to another part of the argument), like lifting the cap on wage income that is subject to the tax, it will be fully funded forever. Right now if I made 150,000 a year, only the first 90,000 or so would be subject to F.I.C.A. (the tax used to fund Social Security). Poor people pay a higher percentage of income for F.I.C.A. than rich people do.

However, if the economy does as well as it did in the 1970s and 1980s, no changes will be needed. We don’t even need to assume that the economy will be as good as the Clinton years. The economic assumptions in the Social Security Trustees projections assume we won’t do as well as the 1970s. They are extremely conservative (not in the political party sense) assumptions.

To sum up: don’t panic.

Breathing

Mom cannot finish more than 2 or 3 pages without nodding off. It means she is losing breathing function a fair amount and there is a buildup of CO2 in her blood. Since she is already on a bipap machine, the only thing that can really improve it is a trach/ventilator or going on oxygen. She decided against both. I made her promise to ask the hospice nurse about her breathing and oxygen levels.

I am starting to feel like this is her last days. I hope hospice can tell. I need to know if I need to get the family here for their last visits or not. Most have visits scheduled between now and the end of June, but I’d hate for them to get here a week too late.

Anyhow, I’m all sorts of fucked up right now.

Plastic Bags at Sea

Danny Westneat at the Seattle Times writes that plastic bags are a tiny fraction of sea trash.

Although the mayor’s press release on the proposed plastic bag fees notes that plastic bags are particularly harmful to marine life as compared with paper bags, the big push is because the bags take up 4% of our landfill.

In other words, Westneat is building up a nice straw man and then knocking it down. It seems like the Seattle Times really doesn’t like the proposed fees. They’ve charged the fees will hurt the poor, and now this. It won’t hurt the poor. The city will be giving out free re-usable bags. The charge will get people to change their behavior. Because of that, they will not be paying this fee enough to hurt them. People respond to economic incentives. This is a conservative way to address a problem. It uses the market and the laws of supply and demand to achieve a needed end.

So get smarter, Seattle Times.

First hospice

Five+ hour visit. Mostly because my mom can’t get to the point. Also, the nurse was 45 minutes late.

Still, it went well.

If you want to know where I get the gene for being difficult, it’s my mom.

The biggest stumbling block today was the green form, or POLST. I can’t remember what that stands for. My mom has a health care directive. She thought long and hard about what she wants and wrote out two pages of instructions for what to do in case she is incapacitated. She wrote this up last summer. The short version of it is she doesn’t want any intervention to prolong her life if her incapacitation is due to her A.L.S. But if it’s something else, like a heart attack or a tree falls on her, she wants the measures.

The green form asks just a few questions: do you want CPR? do you want no resuscitation, limited measures, or to go all out? do you want anti-biotics? do you want tube feeding?

If hospice has to call emergency personnel, they aren’t going to spend 10 minutes parsing the details of her health care directive. My mom doesn’t like the simple form. Why did I write a health care directive then?

Thing is, if she doesn’t select something on the form, hospice provides the maximum intervention.

Daniel Schorr

Quite frequently I catch Daniel Schorr’s commentaries on N.P.R. when I am driving in the afternoon. I’m not a huge fan of All Things Considered, but it’s better than any other news on the radio so I listen. But invariably turn off the radio midway through Daniel Schorr’s commentary. It’s not that he pisses me off. It’s that his commentaries are so bland and devoid of opinion. What’s the point of having an editorial commentary if the opinion espoused is that N.A.T.O. struggles with finding a purpose since the fall of the Soviet Union? Duh.

Lithium and A.L.S.

There’s been a potential breakthrough in A.L.S. treatment. In Italy, doctors gave a number of A.L.S. patients lithium. The results were dramatic. 30% of the control group died within the study period. None of the lithium patients did. They weren’t cured, or even arrested. But they did slow down the progression quite a bit.

A second U.S. based study is under way.

Since lithium is already approved and on the market for other reasons, it’s available to anyone who can wrangle a prescription from their doctor. So lots of A.L.S. patients are doing so, despite any standardized dosing for A.L.S. Many of these people are participating in an unofficial study.

Mom considered going on lithium because she wants to survive long enough to hold my niece/nephew who is due in September. She’s decided against it though because she thinks she’ll last long enough anyway, and doesn’t want to prolong her life. She’s pretty far along and isn’t to thrilled with the thought of prolonging her life in her current level of A.L.S.

I’d probably go on the lithium if it were me. But then, I’d also have made a point to move to Oregon to take advantage of their assisted suicide law as well.