I had to take a break from writing about the trials and tribulations of long distance caregiving. My appreciation to readers who contacted me, fearing the worst. I am thrilled to report that my silence has been due to the fact that my father is doing so well there's been little to write about. The Year 2003 has been very different for my father than 2002 was. He's been staying far away from the medical profession. Last year at about this time he was having surgery to correct mistakes from the previous surgery, and was very close to death.

Well, my dad's ostomy was reversed in November, he survived the operation, fired his 24-hour caregivers after two weeks, and is actually even driving again! At 82, he finally has his life, and his girlfriend, back.

For my new readers, a little background: I was born and raised in Chanute, Kansas. A town very much like Maumee, where I live now, but not attached to any big city. In fact, Chanute is 2.5 hours' drive from any major airport. My dad still lives there, widowed these past 3 years now, and has always avoided doctors like the plague. Turns out he might have had a point.

Now my job, as professional care manager, is to make sure people get the best possible medical care and follow-through. In my dad's case, however, I really think he's one of those anomalies that doesn't fit into the medical profession's patient role. Virtually every single intervention my dad had in 2002 was disastrous, except, thank goodness, for the last one that reversed his ostomy and gave him his bowels back. He's never taken medicine, and always said that medicine affected him badly. So, when the surgeons and internal specialists gave my dad the regular treatment for post-surgical care, his system reacted the opposite way that it should have. His post-op recovery times stretched way beyond the expected 3 to 5 days into 3 to 5 weeks. And even then, we would take him home against medical advice.

Inevitably, as soon as he got home and could control his own medicine, he would start discontinuing certain ones. My sisters and I would freak - "Dad, you HAVE to take your heart regulation pill - you'll have a heart attack!"

"Dad, you HAVE to take your anti-depressant or you'll be too sad to get well!"

"Dad, you HAVE to take your stool softener or your broken bowel will back up and it will kill you!"

Dad would answer, "Oh, okay," and then continue to take what he felt like taking.

And darned if he didn't get better every time he did that.

I started making telephone calls to his physician: "Have you heard of people whose metabolisms are the opposite to most people's and they react badly to medication? Could my dad be one?"

"I don't know."

Many of my clients are of the old-old category. Past 85. Many of my client's physicians and specialists often mimic my father's doctor: "I don't know," they say, honestly, to many of our questions. Our clients' families are dumbstruck: How can a doctor not KNOW? Well, often they don't. They don't know WHY something happens, they just know how to treat the symptoms. This is hard for a family member to hear, and hard for us to explain. People just get old and their systems begin to fail. Not everything can be fixed.

During my last phone conversation with my dad, I admitted defeat: "Well, Daddy, it seems like every time you stop taking something you get better. I tell you what, I'm not going to lecture you any more. You do what you think is best."

"Why, thank you, honey," he said sincerely.

I've written in the past two years about accepting the end of life, about how to communicate with physicians, and how to communicate with your elderly parents, siblings, and spouses. I hope some of it has sunk in. I'd like to continue writing about my trials and tribulations as a long distance caregiver. It's hard being a thousand miles from my dad. It's hard for my clients' families, too. About 60% of my clients have families who are out of state. They go through a lot to make sure that everything is handled as smoothly as possible. We help them by being here, and by looking and listening for those telltale signs that all is not well.

I have a lot of stories to tell about my clients and my own family. With their permission, and yours, I will continue. If there are certain topics you would like me to address, feel free to contact me. Otherwise, I'll go by instinct and serendipity - whatever happens is what I write about generally. It seems to hit home with a lot of you. Thanks for listening.

Debra Sorensen, MSW, LISW, CMC, is a professional care manager and owner of Debra J. Sorensen & Associates Inc., a private geriatric care management company serving Northwest Ohio and Southeast Michigan. She can be reached at 419-367-8835 or e-mail Debra@professionalcareforyou.com.