Father’s Day Is Sometimes Complicated

The holiday has caused such confusion and questioning that for a long time it was easier to ignore it and its significance.

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I never knew how to feel about Father’s Day. 

As a little girl, I probably was obligated to make a card for my father in school. As I grew older and sparred with him verbally, I chose not to celebrate Father’s Day. My father was not the “World’s Best Dad” or “No.1 Dad” — I knew this at a young age. Then as adult, I eventually understood that he knew he had made mistakes as a parent and father, and I had started to meet him for lunch or dinner and share my life with him.

My father was not the “World’s Best Dad” or “No.1 Dad” — I knew this at a young age.

Last year he had another stroke, and I became his caretaker.

And then Sunday was Father’s Day.

It had occurred to me to get him a card, or enlarge a photo that he indicated he liked, or do something to mark the occasion. After all, he is still alive, aware of his surroundings and continues to make progress during therapy.

But making the journey from Orange County to L.A. for his appointments (three or four a week, depending on his therapists’ and acupuncturist’s schedules) is not easy, and the physical and emotional strain is high.

I accompanied him to acupuncture Saturday, and the coward in me thought it might be best to not acknowledge the holiday. If I did, I knew I would start crying, and then I would surely upset him. While I have told him that we both made mistakes and that I would prefer to have him in my life, there are so many little things we have not said.

As it turned out, I was in the area after all on Sunday.

My compromise with myself was to stop in on him at the skilled nursing facility, say hello, ask him how he was doing and let him know I’d be back in two days to accompany him to speech therapy. I told him my visit would be brief because I was on my scooter and wanted to get home before traffic became too heavy and the day became night.

He raised his arm and moved his hand in a way to indicate he felt so-so on this day, and after a few more questions I said goodbye.

The stroke has changed him, especially physically, but even before that, he had been humbled by other strokes and age. He was no longer the commanding and frightening authority figure. He became a man who waned to communicate with his children, although he lacked the tools to do so.  

The stroke has changed him, especially physically, but even before that, he had been humbled by other strokes and age. He was no longer the commanding and frightening authority figure. He became a man who wanted to communicate with his children, although he lacked the tools to do so.

I am certain I am not the only one who feels ambivalence or confusion on this holiday. Even the president of the United States has complicated feelings towards a father he hardly knew. It brought me some comfort to read the article about the trove of letters written by Barack Obama, Sr., preserved, sitting in a box, awaiting the day his son is ready to read them.

Connecting with Connect Four

It was Sunday, and I thought I’d pay my father a visit at the skilled nursing facility. A caretaker who accompanied him to acupuncture the day before said his left arm was very active and that the acupuncturist was working to awaken his throat muscles and improve his ability to swallow.

I was curious if I’d notice a difference in his appearance or demeanor after my 10-day trip to Chicago.

He was awake when I came in, not quite laying down and leaning to his left. He didn’t look very comfortable. Despite knowing how to call for the nurse, he does not use his call button. I snagged two nurses from the hallway and asked that they kindly sit him up.

His most recent stroke was in March 2015, and he has been living at a skilled nursing facility in the Highland Park neighborhood of Los Angeles (northeast of downtown) since last May.

The stroke left him paralyzed on the left side of his body and he cannot yet speak. A few times he’s managed to say a word loud enough for me to hear. He swallows more than before, but it is still not enough and he remains at risk for pneumonia if his saliva goes to his lungs.

It’s not all bad: my father recently moved his left arm, and indicated he’d like to walk. He is aware he must strengthen his upper body, and has been an active participant in physical and occupational therapy since we confirmed he was indeed moving his left arm at will. At a recent occupational therapy visit he sat with zero to minimal support for several minutes. When asked, he nodded that he wanted to try and stand. Assisted, of course.

We reviewed my Chicago photos, which included food, and various buildings around the city that were part of the “L” train tour I created (I have a fascination with architecture and building design) and the gorgeous views from my boyfriend’s family’s cottage near a lake in Hastings, Michigan. The photos also included the murals that dot the area around Chicago’s Columbia College and Wabash Arts Corridor.

I noticed he was very alert and he seemed curious about what I would show him. He was happy to view the photos on my tablet and when we were done, he watched carefully as I closed the tablet and set it aside.

To transition to physical activity, I asked about his right hand and how much he is able to open it. I then asked about his arm, and more questions led to a mini physical therapy session, where he had to touch the top of his head or his left shoulder. A few more minutes of this continued with head, mouth and leg exercises. I reminded him how important it is for him to move, even while he is in bed.

I asked if he wanted to play Connect Four. He did not say no, so I walked over to the closet and pulled out the box. I showed it to him and asked if he remembered playing with his therapist at USC Keck Medical Center. He quickly nodded.

For those of you born after 1974 when the game was first sold, small, round, plastic discs are inserted into a frame and the first person with four discs in a row, either horizontally, vertically or diagonally, wins the game. Think Tic-Tac-Toe, but instead of an “X” or “O”, each person picks a round, colored disc.

Our game features yellow and red discs.

While he cannot speak yet, my father is completely aware of what is going on. His addition and subtraction skills are still intact, although multiplication is giving him problems and he usually has homework that involves reviewing multiplication tables (he’s on the 4’s at the moment).

He also still likes to read. Like my grandfather who had his own printing company in China, my father had his own printing business. He greatly enjoyed or was greatly intrigued by a recent story about meat turning fluorescent blue in China. It was under investigation the last time I checked, but government officials warned people not to eat any blue meat.

I set up the game, and on this day I was red, he was yellow.

I knew I had to pay attention during our game, and I had no intention of letting him win. Now, before you start to feel that I am a cold-hearted daughter, you should keep reading. Yes, I blocked his moves a few times and to my surprise, he got a BIG kick out of blocking me.

I knew I had to pay attention during our game, and I had no intention of letting him win. Now, before you start to feel that I am a cold-hearted daughter, you should keep reading.

You can see from the photo below that I was making my way across diagonally, and his yellow disc stopped me from winning the game.

“Hey, you just blocked me!” I said in surprise. He started laughing and I started laughing. We laughed for a while. Sometimes his laughter is silent, and I only see his mouth open and his body shake. But on this day, I could actually hear noise as he laughed.

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During a game of Connect Four, I attempted to win the game with a horizontal line of four red pieces. My father blocked my move with his yellow disc. We both laughed after I was surprised by his move.

We carried on with our game. At one point I asked if he wanted to continue playing because it didn’t seem anyone was going to win.

He ignored me, so we continued to play.

I thought I might have some luck on the right side of the board, and wasn’t really paying attention to what he was doing.

On his next move, I saw he was more eager than usual to get a disc in to the frame.

I saw where he might be placing it.

“Where are you putting that piece?” I asked, hoping he was not doing what I thought he was doing.

He focused on what he was doing, ignoring me again, and finally dropped the disc in.

I didn’t say anything.

Then he raised his arm again, and motioned to the four yellow discs that appeared horizontally on the frame.

In case I wasn’t paying attention, he was letting me know the obvious: he just won the game.

Then he raised his arm again, and motioned to the four yellow discs that appeared horizontally on the frame. In case I wasn’t paying attention, he was letting me know the obvious: he just won the game.

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My father recently beat me at a game of Connect Four, and made sure to point to the four yellow discs making a horizontal line across the center of the board.

 

 

Do You Want to Talk?

Even before his stroke the words to apologize and explain often eluded him. And now, sitting in a bed, completely dependant on someone else, without the ability to say a word, my once fiercely independent, loud and commanding father has no control of his world.

My sister was in town for the holidays, which meant she was going to visit our father. She had not seen my father since he was hospitalized after his stroke in March.

She wanted someone to go with her. I told her my brothers, who were staying at my mom’s house for Christmas, would be happy to take her.

But she said she wanted someone with experience. A “veteran,” she said. And that veteran was me.

I knew and she knew it would be an emotional visit with my father.

Ours is a complicated relationship, and as he learns to swallow, talk and move his appendages all over again, his triumphs and difficulties seem to carry even more meaning.

We arrived at the nursing facility, and she walked with me from the back of the facility toward his room. His room is near the front of the facility, and his bed is near a window that faces a main street. It’s not a bad view. The passing cars can serve as a distraction and have a rhythm to their flow. There are sufficient trees to add some color and softness to the mix of concrete and asphalt.

I loudly announced my presence, but he seems to hear or sense when someone walks in the room because he had already turned his head to look in my direction as my words made their way out of my mouth.

He saw that my sister was somewhat behind me as I told him he had another guest.

I turn to look at her and move aside so she can have access to his bedside.

My father began to sob as she approached him.

She asked him how he was doing, and I heard her voice crack before I saw the tears well up in her eyes. She hugged him because my sister is a hugger.

She asked him how he was doing, and I heard her voice crack before I saw the tears well up in her eyes. She hugged him because my sister is a hugger.

There was silence.

I wondered what he would say to her if he could speak. Or if he would say anything at all. We were never good at talking about the obvious. And when you add hurt and a complicated past, it gets…complicated.

My sister wiped her tears away, and I told my father it was OK.

I transitioned into my usual routine of sharing the latest family news, current events, etc.

We practiced writing on his whiteboard, but it looked like he was either trying to write his full name in cursive or he was attempting to write Chinese characters. It’s possible he was too emotional to write and could not concentrate. So we practiced just writing the letter “F”, for Frank.

My sister stepped out of the room for a few minutes.

When she returned, my father and I were still working with the board.

I switched gears and asked if he’d like to see some photos.

He nodded, and we started going through the photos on my phone.

I checked the time and my sister and I told him we had to make a mad dash across town to LAX so she could catch a flight home.

Since their emotional greeting he had not looked at her, and the mix of joy, embarrassment and possibly guilt still hung in the air.

My sister asked me if I noticed, and of course I noticed, but I was not surprised.

Since their emotional greeting he had not looked at her, and the mix of joy, embarassment and possibly guilt still hung in the air… Even before his stroke the words to apologize and explain often eluded him. And now, sitting in a bed, completely dependant on someone else, without the ability to say a word, my once fiercely independent, loud and commanding father has no control of his world.

Even before his stroke the words to apologize and explain often eluded him. And now, sitting in a bed, completely dependant on someone else, without the ability to say a word, my once fiercely independent, loud and commanding father has no control of his world.

He has a Chinese calendar in his room now, and I showed him on the calendar that he had a week off before he begins his work with the USC therapists again.

The occupational therapist worked with him on straightening and extending his fingers, and she soon presented him with an opportunity to practice writing.

He immediately began to write his name when the therapist handed him the marker.

The letters appeared shaky, but it was clear enough to make out his name.

She asked if he could write my name, and then she wrote my name on the dry erase board and asked him if he could trace over it.

He looked at the board, studied the words and then wrote my name.

I was sitting across the table from my father and the therapist, fiddling with my phone, when I heard the therapist’s voice rise in delight. She congratulated him on writing my name so clearly. I looked up. I too was delighted. I walked over and snapped a quick photo and congratulated him.

My father started to shake and his face became red. His emotional reaction to writing my name made me emotional as well.

Especially because the word was written so clearly.

 

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My father was able to write my name during an occupational therapy session earlier this month at USC Keck Medical Center. The word in all caps was written by the therapist; he wrote the second “Maria.” He also sees a speech therapist at the outpatient rehab center there. After a stroke in March, he is learning to swallow, move his arms and legs and communicate. 

He continues to make progress with his ability to swallow, and it is not uncommon for him to be able to swallow after he coughs. It is also a littler easier for him to swallow, and he is now swallowing without the assistance of the VitalStim therapy (electrical stimulation for his throat muscles).

The speech therapist also began having him practice talking – mouthing responses in addition to nodding or shaking his head.

I often wonder if he wants to talk. Perhaps it’s easier for him not to since it allows him to continue avoiding the past. Perhaps he does not want to discuss what is happening to his body and his mind.

We came to an agreement that once he began eating, I would take him out to dumplings. I asked him one day if he missed eating and the taste of different foods. If he missed Chinese food. He laughed. Which I think means yes… I have not mustered the courage to ask if we wants to talk. 

We came to an agreement that once he began eating, I would take him out for dumplings. I asked him one day if he missed eating and the taste of different foods. If he missed Chinese food. He laughed. Which I think means yes.

I have not mustered the courage to ask if he wants to talk.

A few times in therapy we leaned in to hear him utter a very low, hoarse response.

Of greater importance is the opening and moving of the mouth, tongue and all the related muscles, the therapist said. Sounds, of course, are great, but she wants him to engage more.

Back at the skilled nursing facility, I practiced what he had done in speech therapy, encouraging my father to “talk” and mouth his responses.

Before leaving, I mentioned when our next appointment was, and asked if that was OK, or “good” with him, in Chinese.

Hao?” I said.

He nodded and opened his mouth.

Hao,” he responded, in a raspy, Darth Vader-like voice.

“I could hear that!” I said. “That’s good – hun hao (very good).”

He began to shake and cry.

These are small steps, but steps nonetheless, I told him.

Hun hao,” I repeated, with tears in my eyes.

Very good indeed.

What a Wednesday – Rehab at USC

So it finally happened.

My father’s evaluations for speech and occupational therapy took place on Dec. 2 at USC’s Keck School of Medicine. My father will be visiting the outpatient rehabilitation center twice a week now.

Since his stroke in March he is unable to speak, although he understands everything going on around him. He cannot move the left side of his body. His right arm and hand are pretty active, but he lacks sufficient hand control to write.

He eats through a tube that connects to his stomach and is not able to swallow consistently. It led to him aspirating and catching pneumonia, and a 10-day hospital stay.

But that led to the discovery of the existence of VitalStim therapy, essentially electrical stimulation on his throat to help the muscles move and contract when swallowing.

Since October, I have pushed the skilled nursing facility to help me get my father to USC’s outpatient rehab center, where VitalStim is offered with speech therapy. The nursing facility does not offer VitalStim.

It only took four weeks for the nursing facility to get all the paperwork to USC.

Getting three pieces of paper to my father’s doctor’s office is apparently a team effort. It involved the social worker, billing manager, marketing manager, me and my sibling, and USC saying something similar to, “I told you, I haven’t received it yet.”

Then, getting the doctor’s signature on those three pieces of paper and making sure they were faxed to USC was the equivalent of walking uphill in a snowstorm, backwards. And barefoot. With your eyes sealed shut.

Then, getting the doctor’s signature on those three pieces of paper and making sure they were faxed to USC was the equivalent of walking uphill in a snowstorm, backwards. And barefoot. With your eyes sealed shut.

Yes, we’ve considered moving him to another skilled nursing facility.

We wonder how that might affect his care at USC and if the transportation to USC would be covered if the new nursing facility is further away. It currently takes less than 20 minutes to get to USC from the nursing facility. When the driver doesn’t get lost, that is.

I think the visits to USC will be a welcome break from the monotony of the nursing facility. It will also allow my father to see what is happening in the outside world.

Since his stroke in March, he has been confined to a bed in a hospital room. Now, at the nursing facility, he alternates from his bed to a wheelchair (with assistance), and watches movies in the main activity room.

A few times a week he is pushed down the long hall to the therapy room, on the opposite side of the facility from his room. There the staff stretches his limbs and has him participate in strengthening exercises.

The Wednesday morning we were scheduled for the evaluations was a chilly one, which in Los Angeles means it was hovering in the upper 40s. But the day began to warm up by the time we arrived at USC.

 

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The fountain on San Pablo Street, outside the buildings where my father is now receiving outpatient therapy on the USC Keck campus.

 

The occupational therapist who will now be working with him is an older woman with curly black hair and glasses, who spoke to my father in Mandarin.

I am not fluent in Mandarin and had to interrupt a few times to ask what was going on, especially when I saw the surprised look on her face each time he’d respond.

She asked my father in Mandarin where he was, and held up a piece of paper with three rows of Chinese characters.

The words were house, hospital, park.

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My father pointed to the second set of characters, indicating he knew he was at a hospital.

 

He looked at the piece of paper, and quickly pointed to the middle row of characters for “hospital.”

The therapist then wrote down several rows of letters in English. She asked my father to spell out his name.

He quickly began to point to each of the letters in his name, Frank, sometimes before she asked.

Another part of her evaluation included three years: 1998, 2008 and 2015. She asked him to tell her what year it was.

He scanned the sheet of paper, and picked the correct year, without hesitation.

It is my custom when I see him to tell him the day and date, and now I show him the calendar on my phone so he can see his appointments.

 

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My father is aware we are still in 2015 after his stroke in March.

 

When she asked if the nursing facility staff respected him and treated him like he knew what was happening, he began to sob and shook his head no.

She became emotional as well.

It became evident through other questions that he would like to read, and because of his interest in writing, the therapist has recommended a dry erase board for him to practice writing.

I asked if he would like to read Chinese newspapers, and he immediately nodded.

When I came by to accompany him to his second speech therapy appointment, I told him I had something for him.

He quickly turned to look at me, saw that I was digging something out of a bag, and his eyes seem to light up when he saw that I was taking out newspapers.

I laid them out in his lap, since he was sitting in his wheelchair, and positioned them so he could see each one.

 

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My father, fidgeting with the newspaper, as he did countless times before the stroke, to get the paper to fold just right.

 

One of the papers was a recommendation from a cousin as his father reads that paper, and I shared this with my father.

He nodded.

I asked if he liked these newspapers.

He nodded.

I said I’d make sure we got him a subscription so he could read them in his room.

He nodded again.

Both papers had the high level of Beijing smog as the main story on the front page, and my father’s eyes darted to the photo of people with surgical masks amid a gray background.

I enjoyed seeing him with the newspaper. It reminded me of the countless times I watched him go through the paper when I was a child. It is likely the reason I gravitated toward journalism. I saw the effect it had on him — he scoffed or laughed, depending on what he was reading.

My grandfather and my father owned their own printing businesses, so it is not surprising he was, and apparently remains, such an avid reader of the news.

The speech therapist has seen my father three times now, and each time, there is some small step forward. I’ve told my father several times that each improvement is significant.

His speech therapist noted the improvements as well. She keeps a tally of the number of swallows, and he has gone from one to five. The next goal is seven swallows.

When I asked my father last week if he wanted to return to USC, he nodded.

You’re welcome USC, for the free advertising. It’s a been a pleasure thus far.