Baptist Hospital & Medical Center, Little Rock, Arkansas/Medicare/Medical 2016
By – Sheri de Grom

Baptist Hospital and Medical Center, Little Rock, AR

Baptist Hospital and Medical Center, Little Rock, AR


Baptist Hospital, Little Rock, Arkansas sent my husband home to die.

A mere pull on the plug of Tom’s heart generator, a two man lift, a rapid ride in a wheelchair to the front door and we haulted.

We were met, at the exit, by 3 hefty physical therapists who placed my husband in an unfamiliar cradle hold and put him in our car for the ride home to Conway. The speed of Tom’s transfer from the cardiac unit to the outside of the hospital seemed he’d been shot from the dirty laundry chute.

Tom didn’t have the use of his limbs, none of them. He couldn’t sit-up in the wheelchair and the floor RN strapped him in before he was wheeled off the ward!

My Prince Charming had no idea where he was or what was going on and for that I’ll always be grateful. That’s the only thing I’ll ever be thankful for when it comes to Baptist Hospital, Little Rock, Arkansas.


Think back 20 years, would this have happened?

I’ve witnessed much due to Tom being bipolar, but nothing this blatantly hostile. The events of Feb. 10, 2016 exhibit medical care USA 2016. This is where our medical care stands and it can happen to anyone, anywhere.

We didn’t have a rehab to take Tom to that day and I’ll discuss the obstacles in our way in a separate blog. My anger burns and I cannot logically discuss the atrocities imposed upon

My fear and anger swirled in all directions. GET BACK, GO AWAY, LEAVE ME ALONE!

My fear and anger swirled in all directions. GET BACK, GO AWAY, LEAVE ME ALONE!

those requiring high cost medications or that have a mental health illness diagnosis, even if the symptoms have been controlled for well over a decade. Tom has both!

Tom qualified for Home Health due to the severity of his illness. [He was still listed in critical condition and we were going home where I was the primary caregiver]. Just because I knew medical jargon and still carried not only JCAHO (Joint Commission on National Quality Assurance) and Inspector General (IG) credentials. I’m not a Critical Care Team member and that’s what Tom needed 24/7.

I went around our social worker at the hospital (assigned to Tom’s case) and contacted his trauma surgeon. I requested an order for Home Health. He also failed to tell me what our obstacles were in getting Tom into a rehab facility.

Do not assume the social worker assigned to your case cares anything about your loved one or what your own capabilities are. Ours was impossible to reach about possible treatment and/or continuing treatment options. She never seemed to be in her office, never answered her phone directly and when she did return a call, it was often days after I needed the information.

There’s not a doubt in my mind that Tom was discharged from the hospital to die. Discharging him saved hospital resources, made his bed available for another cardiac patient and they no longer had to dispense Tom’s high-priced medications. The hospital had already bled our insurance dry of what they were going to pay with high cost procedures performed back-to-back.

I’ll write more about Home Health in a future blog but over the next few months I learned our social worker at Baptist Health had lied to us about what was available for Tom and we would never have had to undergo the nightmare the week Tom came home.

Other professionals lied by simply omitting what they knew. They understood what was required to admit Tom to a rehab facility and no one, not one person on Tom’s medical team said one word about what the real problem really was. I had to search out this answer for myself by reading the Federal Register and cornering CEO’s of rehab centers when they told me no they would not accept Tom as a patient.

I'm on 1st today the same as I was when Tom was diagnosed with bipolar disorder. Our marriage is based on unconditional love and not about the person on first. We are about loving one another.

I’m on 1st today the same as I was when Tom was diagnosed with bipolar disorder. Our marriage is based on unconditional love and not about the person on first. We are about loving one another.

My former deputy and dear friend, Michael, told me the subject of ageing ill patients came up with his golfing friends on a regular basis. Many are cardiologist docs and they are equally frustrated with Medicare and also freely discuss the practice of discharging patients to home to die. It saves the hospital expenses and if the doctor can make it happen before the weekend, well there’s a good chance the doctor will have an easier weekend as well. There’s not a lot of money to be made in treating dying patients.

These same doctors can enjoy their leisurely 18 holes of golf over the weekend plus spend extra time at the 19th hole while the patient’s family is alone, dealing with the death of their loved one, in the home. This is not a time when you want the doctor on call. We all deserve better than this!

For a doctor to remain in good standing with Medicare they are discouraged from having a patient in the hospital over the weekend.

It wasn’t until about three months later that I learned the social worker had lied to me on several different occasions. I’m not sure she ever shared a single truth.

We arrived home that day of Tom’s discharge and I fell into one of the worst weeks of my life. I met despair at our front door.

This is how it happens. One moment you are surrounded by alarms and buzzers in a cardiac unit and the next you are being wheeled out of the hospital. None of us are immune from this treatment.

Tom came close to dying that week, closer than any man and wife should ever have to go through when they have God and each other at their side. With tears in my eyes, I pray this will never happen to you or anyone you love. I cannot begin to tell you the unimaginable hell that I had yet to face. I will blog about it later but I can only write about this past year in short increments. It’s been an incredibly painful journey with the love of my life. The man I share my life with and wish to do so until death do us part.

Thank you for reading with me. I don’t write of our experiences to cause you needless fear about you or those you love. I want you to be prepared for what’s ahead and know that anyone, regardless of circumstances, could have this happen to them.

I appreciate your time.

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Medical 2016/Research/One Woman’s Opinion
By – Sheri de Grom


From the back of my Medicare statement:


Medicare Difficult To Understand - Getty Photo

Medicare Difficult To Understand – Getty Photo

If you, or someone you’re helping, has questions about a Medicare Summary Notice (MSN), you have the right to get help, and information in your language at no cost. To talk to an interpreter, call 1-800-MEDICARE.

This ruling has become a requirement for all commercial insurance companies and I ask you to imagine the cost to your premium increasing to accommodate this service.

My Opinion: At least 24 languages are offered and include: Vietnamese, Tagalog, Russian, Portuguese, Polish, Korean, Japanese, Italian, Haitian Creole, German, and French to name a few.

If I required medical care in any of the above countries, I would be asked to pay for services rendered. I would not be offered a plan such as Medicare and no one would bother to translate their language to English. Many citizens of the countries named are fluent in English but from my experience these same citizens are selective about when they will use their language skills.

Is MEDICARE broke because we try too hard to be nice to countries whose leaders and/or citizens would just as soon see us dead? Who decided this was a good investment of our tax dollar? Why are we so afraid to stand up for ourselves and say, enough is enough?

From TIME, Oct. 5, 2015:

TIME magazine offered three (3) ways for consumers to get better health care. They based their summary on Leslie D. Michelson’s new book, Patient’s Playbook. The book is listed as one of the top fifteen of 2015 by AARP.

  1. Bond with your doctor. I agree 100% with Mr. Michelson’s assessment that it’s tough to
    Author: Leslie D. Michelson

    Leslie D. Michelson

    make small talk during short visits. But people who have strong relationships with their primary-care physicians tend to be more open about important health details and are likely to get the preventative exams that are right for them.

  2. Get second opinions. In the U.S. alone, diagnostic error contributes to the death or disability of at least 80,000 people a year. It’s important to consult with multiple medical experts before agreeing to surgery and other major treatments.
  3. Don’t be afraid to travel within the United States to major medical centers. Community hospitals offer quality care. But for complex problems, it’s worth considering a major institution; if it accepts your health insurance, the cost will be roughly the same.

From AARP, Dec. 23, 2011 & reprinted Dec. 26, 2015:

An AARP Bulletin discussed five (5) ways you can easily be labeled a difficult patient and have your doctor dislike you:

  1. You don’t arrive on time.
  2. You treat your doctor’s office as your personal assistant.
  3. You don’t admit that you’re not taking your medication.
  4. You diagnose your own medical problem and tell the doctor how to treat it.
  5. You start asking questions just as he/she heads out the door.

From the American Association of Orthopedic Surgeons – Your Access to Health Care Services May Be Threatened:

Severn Sales Laboratory Equipment

Severn Sales Laboratory

There is an effort in Congress to prevent physicians from owning imaging, physical therapy services and pathology services. This doesn’t make sense because it hinders access to quality care. If a patient cannot have these in-house services it will cause scheduling delays, prolonged waits, the need to travel to other offices, etc.

The prohibition of these services could present significant harm to our elderly, disabled, poor and military families. It would not be fair to discriminate against those patients and purposely inconvenience them as they are some of the most vulnerable in society.

My Opinion: I appreciate having all the services mentioned above at the same place as my physicians. It’s an added convenience and a bonus I always look for when considering a new provider.

shinglesFrom The Centers For Disease Control:

  1. 1 in 3 people will get shingles in their lifetime.
  2. If you’ve had chickenpox, the shingles virus is already inside you.
  3. It’s hard to tell when the shingles rash will erupt.
  4. Unlike chickenpox, shingles can be painful and can lead to long-term nerve pain.
  5. Your risk for shingles increases as you get older.

It’s amazing to me just how much information is available along with how much mis-information. We must become informed consumers in selecting our healthcare providers and consider carefully the decisions they make for us. It is a matter of our life and death.

Thank you for reading with me.






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Mental Health/Stigma/One Woman’s Opinion
By – Sheri de Grom


FALL, 2004



We’ll only have peace within when we surrender to ourselves. The worst stigma of all is the individual who’s aware they need help and would benefit from help but refuses to allow themselves to obtain it.

My soul turns in and the world moves, dark and sluggish. Interests once penetrating every part of my being have left me alone. This is a foreign concept. How can I walk away from being victimized by a mental illness?

Globally, one of four will suffer from a mental illness in their lifetime.

We’d moved from our dream retirement home in Brown Summit, North Carolina for greener pastures. The demons in NC were tearing Tom apart and I could not allow that to happen. You may read that blog here and here.

Sitting above the shoreline of Bull Shoals Lake [located a stone’s throw from our back

Life At The Lake

Life At The Lake

door], I marveled at the sweet sounds of the water massaging  the round pebbles and back out again. What peace. What tranquility. Would this be home for us?

It would be wonderful to believe the Arkansas Ozarks is an enchanted place where mental illness, more commonly known as a brain disorder, could tag onto a rainbow, float over the Ozark mountains and move to another place. Unfortunately this never happens.

No one is exempt from brain disorders. One in four homes has someone living there with a mental illness. The crisis presented inside the home includes: stigma, loneliness, hunger, the inability to work and adequate insurance coverage to procure necessary medications. These are just a few of the latest enemies.

To drive away the excruciating pain of the mind and the physical illnesses haunting the body, illegal substances and alcohol are commonly used. These brain disorders are not caused by weakness of character or bad parenting. They are the result of a biochemical disturbance of the brain and no one is immune.

No amount of love or money will save you or me or someone we love from developing a brain disorder. Mental illness is more common than cancer, diabetes, heart disease or arthritis. Comparatively, the success rate for treating heart disease is more successful than the treatment of a mental health diagnosis.

Even though there are thousands of people in the Ozarks with mental illness who are living full and rewarding lives, many are still afraid to ask for help. The stigma of mental illness keeps them from receiving the help that is readily available.

Artisan blowin glass.

Artisan blowin glass.

Unequal insurance coverage, fear of discrimination by friends, families and co-workers and stereotypes of the mentally ill all serve to cloud people’s understanding about the very nature of mental illness.

The fact is that remarkable things begin happening when individuals with mental illness feel it is all right to get treatment: families stay together, kids stay in schools and out of trouble, adults become more productive on the job and health care costs decline.

By changing attitudes and shattering the myths surrounding the illness, we’ll accept that people really do move from mental illness to mental health.

Thank you for reading with me. I always appreciate your time.



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Medicare/Physical Therapy/Medical 2016
By – Sheri de Grom

The Centers for Medicare and Medicaid Services passed a law that’s good for the patient and not the establishment.

The settlement agreement means that there have been changes to the manual that Medicare contractors use to process claims. These claims will no longer be evaluated based on potential for improvement but on the need for skilled care. Skilled care will qualify for Medicare even if the medical record reflects that the patient continues to deteriorate or maintains their current condition.

PHOTO ID 100469476 Stuart Miles/Digital

PHOTO ID 100469476
Stuart Miles/Digital

Facilities are rating an increasing number of patients as needing the highest level of therapy. This level requires 120 minutes of intense therapy daily and documenting this amount for high payment. The reality is that most patients cannot endure the scheduled therapy prescribed to meet those high standards of payment.

Medicare classifies nursing home residents into one of 66 groups depending on the patient’s needs. More than one-third of the groups are for patients who require physical, occupational or speech therapy. Medicare pays more for patients who need the most therapy.

The New York Times reported Oct. 5, 2015 that nursing homes and rehabilitative units bill Medicare for more therapy than patients need.

One of the best kept secrets in nursing homes and rehabilitative care units is that they operate at a profit.

Photo Credit: StauratMills/Free i.d. 100352582/annankhml


‘Profit’ used in conjunction with nursing homes and rehabilitative units is something we don’t hear about. This segment of health care is not eager to open their accounting books for anyone to examine.

The facilities receive more in Medicare payments than it costs the provider to give the patient care, exploiting the billing system while they are attempting more therapy than the patient needs, or can tolerate.

Common sense [obvious to those in the medical profession, caregivers and families of patients everywhere] is that chronically ill patients often require skilled care before returning home from the hospital. These people are too ill to withstand any type of rigorous physical therapy. Physical therapy adds unwarranted pain for this frail population.

Thank you to Birdie Avarialte for posting this photo.

Thank you to Birdie Avarialte for posting this photo to her Pinterest site.


The changes I’ve described above apply to the traditional Medicare program and to private Medicare Advantage plans. They apply to people 65 and older, as well as to people under 65 who qualify for Medicare because of disabilities.

Medicare’s new law, now in place, should circumvent the nightmares families face across the nation. Patients upon discharge from the hospital and too ill to go home no longer must meet the rigorous demands of physical therapy, as in days gone by. They may go to skilled care for recovery [unless your medications are too expensive or you have a mental illness diagnosis]. I’ll be discussing these problems in a separate blog.

Thank you for spending time with me. I sincerely hope the changes in Medicare will enhance your life and the lives of those you love.


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The Dreaded Scale

The Dreaded Scale

Hidden Epidemic/Older Americans/Medical 2016
By – Sheri de Grom


The media reminds us daily of every diet available and agencies report the numbers of how many people are dying from complications of too much food.

At the same time, the CDC, Centers for Disease Control, reports one in two Americans over the age of 70 is at risk for malnutrition. I find this an unacceptable number.

Malnutrition is often thought of as a killer in developing countries. It’s also a problem for the elderly in the United States, according to research published in the May 2016 issue of Annals of Epidemiology.

1 in ever 4 adults is medical deficient in food

1 in every 4 adults is medically deficient in food

These hidden epidemics of malnutrition can jeopardize the health and independence of older adults.

The Alliance on Aging notes several reasons a person might suffer from malnutrition:

  • Older adults living alone or widowed.
  • Social isolation.
  • Have digestive problems related to aging that can stem from certain medications, trouble chewing due to dental issues, problems swallowing or difficulty absorbing nutrients.
  • Loss of Interest In Food Due to Isolation and/or Illness.

    Loss of Interest In Food Due to Isolation and/or Illness.

    Disability limiting mobility.

  • Lack of interest in preparing food, leaving the residence or even planning a menu.
  • Depression.
  • Limited Income.

A number I found not only shocking and appalling reported by the CDC alerted me to the fact that between 2,000 and 3,000 adults over the age of 70 dies in hospitals of malnutrition each year.

I first recognized this problem in 2007 after my hospitalization. I’d had 2 surgeries in 2 days and my meals of Jello-O and Sprite were left on my hospital table. The cover was never removed from the plate and my drink never had the protective covering removed or the straw inserted. Never mind that I couldn’t reach my tray even if everything had been set up for me. I remember someone asking me once if I didn’t like the food, and I replied something to the effect, “I didn’t know, I could never reach it.”

Rarely awake to ask anyone for help, I slept most of the time. When I did wake up, I couldn’t help myself. Two surgeries in 2 days had left me feeling defenseless.

I’ve always referred to that hospitalization as the forced 15-pound weight loss diet! In my early 60’s then I cannot blame anything on Medicare.

After experiencing the same treatment two more times in another hospital, I took notice of meal trays being delivered to other rooms. No help being offered patients, young or old. The covers are no longer being removed from plates. Drink covers are not removed or even placed where patients might reach them. This chore is left to a family member or someone sitting with the patient [if the ill person is fortunate enough to have someone at their side as an advocate].

In 2012 I was hospitalized for several days and weak after a lengthy surgery wherein I lost half my blood. I slept for hours on end. This particular hospital had chefs on staff and I could order anything I wanted from the menu any time of day or night. My biggest problem; I flat didn’t care whether I ate or not. I had no desire for food and no one on my medical team was monitoring my food. I didn’t call for a tray and therefore 3 days went by and I didn’t have anything brought to my room to eat or drink.

When friends dropped by and asked if I would like anything I would ask for a diet coke or bottled water. I knew they would do anything for me; I didn’t want to bother them. [A fatal flaw in my personality].

I was 67 during the above-described hospitalization and other than losing over ½ of my blood, I went home severely anemic and Tom was too ill to care for me. Medicare dismissed me to home without a caregiver or even Home Health. I had no choice but to care for myself when I had an acquired hospital infection, my right arm had suffered severe nerve damage during a 6-hour surgery that was to last 1 ½ hrs at the most. This may sound dramatic to some but this was when I started believing in the Medicare Death Squad. There was no skilled nursing facility that would take me as I was too ill! You may read my blog, Medicare, I Hate You, here.

I’d never thought malnutrition would be an issue for me or Tom and here we are. Tom is anemic and it’s taken me all this time to build my blood supply back to the level it’s supposed to be. I bounce back and forth between being anemic and not. It’s a struggle.

Tom’s hospitalization from January through March, not one hospital delivered a tray to him wherein they removed the cover of his plate, placed drinks where he could reach them and so on . . . that is until I asked them.

Tom was critically ill when admitted to Baptist Hospital in Little Rock, January 2016. I asked all 5 doctors in charge of his care to please order nutrition more appropriate for Tom. He could not eat from a regular menu because he could not swallow. The hospital had the latest results of his swallow test and they knew [if they read their own reports] that Tom could not swallow. The only nutrition available for Tom existed by adding something to one of his various IV drips.  I continued to beg but nothing changed. Tom was a patient at Baptist Health, Little Rock for 10 days and the only nutrition he received was from smoothies I carried into him and fed him one tiny spoonful at a time, once he regained his ability to swallow.

Is it any wonder elderly people die of malnutrition in the hospital? The yearly average is far too high. Nutrition in the elderly receives little attention and as one author remarked, “People get old, they’re expected to pass on and others don’t think much about the cause of it at that point.”

We experienced the exciting pleasure of working with one hospital that ranks above all the rest in Arkansas. I would like to thank River Valley Medical Center and their compassionate staff for having someone beside Tom at every meal. The staff made sure Tom’s meals were liquids and then soft to the point of being unrecognizable. A staff member always noted how much he consumed. His care at River Valley Medical Center reached far beyond exemplary. I’ll discuss the time he spent at this medical center in the near future. He would never have had the admissions to three more hospitals if Baptist Hospital in Little Rock had done their job to begin with.

The Mayo Clinic web site has several articles geared toward the caregiver and how to prevent and detect malnutrition:

  • Observe your loved one’s eating habits.
  • Watch for weight loss.
  • Be alert to other red flags. [poor wound healing, easy bruising and dental difficulties].
  • Know your loved one’s medications.
  • Medicare pays for nutrition counseling, ask the patient’s primary physician to write an order for the patient to consult with a nutritionist.
  • Plan between meal snacks.
  • Make snacks ahead and leave them for your loved one.

Our current status: Tom’s in the hospital, again. We have another doctor added to his team and we’re thrilled he agreed to accept Tom as a patient.

Thank you for taking the time to read with me. I so appreciate your loyalty as I’m still stumbling my way back into blogging. At night when the house is still, I enjoy touching bases with many of you as I read your blogs. Thank you for being there.





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Dreams Floating Away

Dreams Floating Away

Dreams/Caregiving/Medical 2016
by – Sheri de Grom

My dad once told me he could always tell a city girl from a country girl by the way she walked. Dad said the city girl seemed to have more time to enjoy the process of getting where she was going and she wasn’t in a particular hurry to get there.

Then he would grin and say, “Now you country girls seem to always have a raging bull chasing you from place to place in those 3” high heels you wear. It’s a wonder you don’t break your neck.”

Dad after shooting rapids with Tom on Umpquah River, OR A Dream of Dad's Came True

Dad after shooting rapids with Tom on Umpqua River, OR
A Dream of Dad’s Came True

Dad and I often talked about my goals and the things I wanted to do with my life and never once did we talk about any of it being easy to accomplish. He’d had to work hard all his life and he knew I was willing to do the same.

I digress, running through the underground tunnels of the Capitol with documents hanging from the edges of my briefcase. Always another mission, one more legislator to convince, one more signature in support of whatever bill; adrenaline filled my days with purpose.

I often think about my dad and it’s always with love and tenderness. He encouraged me to accomplish every dream I concocted. I’m sure he wondered where some of my ideas came from.

Once upon a time, I told Dad, “Life’s not fair.” It’s not that anyone ever promised me life would be fair but I’d sure like to catch a break here and there as a caregiver to the man I love.

What am I to learn from God, taking away the man I love and leaving me an empty shell of his former self in his place? I love Tom, but how can I carry the load for both of us? I’m exhausted.

As others remind me, FAIR isn’t a word to be found in the Bible but I never went looking for it there. I’ve never believed God would give me more than I could carry.

I’m determined Tom won’t die on my watch but how can I guarantee that? I’m afraid that I’ll turn around and he’ll be gone. The very thought makes me want to run but I can’t imagine running without him at my side, but I would have to carry him.

I watch him sleep with his head covered up and the sheet drawn tight around his body as he hugs the very edge of the bed. What has penetrated his brain and caused him to be so fearful? He cannot verbalize his fears. The strong, determined leader I married has been stolen. But by whom? I don’t understand and I’m beginning to believe I never will.

Bailey’s confused when Tom hides his head. The 29 years we’ve been married, our animals [members of our immediate family] have always known when Tom is in the most   distress].

Bailey doesn't understand when Tom doesn't or can't play.

Bailey doesn’t understand when Tom doesn’t or can’t play.

I’m frustrated and oh so angry at the same time. It’s not Tom’s fault that doctors have made one mistake after another and have ignored symptom after symptom for 30+ years simply because he has a mental health diagnosis of bipolar disorder.

Others ask how I’m getting along and I’m ashamed to tell them the truth. I sound selfish and self-centered. I want to research and continue my work with organizations that support veterans, the elderly, abused civilian military personnel being displaced from their work [especially women once they reach age 50 and are at the pinnacle of their career]. I know how to do these things and I want to do them.

Tom, Bailey and my gardens are my life and that’s not what I had planned at this stage of

Welcome To My Front Door

Welcome To My Front Door

my life. Of course, I wanted all three in my life but I also had plans for so much more.

I thought managing Tom’s mental health care and being his advocate was one of the most difficult challenges I would have in my life. I hadn’t a clue of what was to come. It did set the foundation for what is happening now.

I’ve spoken of reading 50 years of Tom’s medical records while preparing his VA Claim. I wish to share much about this process but in the meantime, it’s one of the most difficult projects I’ve ever taken on. The claim has now been turned in and been told we’ll hear something from the VA in 3 to 6 months.

I read of caregivers and how they dedicate their lives to the person or persons they care for. Then I wonder, am I being too demanding?

My prayer today, “Dear Lord, I humbly submit to you my confused thoughts and ask your help in making me stronger in all aspects of my life. Please let me be more patient and compassionate. The bottom line, it seems – the man I love has disappeared into a tinderbox of chronic illnesses and the only certainty I know is that every day is uncertain. Today, Lord, I ask for perseverance and the ability to do. The toy boxes that represent my life’s interests are in a mess and I’m responsible for that myself. I ask for Your will to be done. In Jesus’ Name, I Pray.

Front Door

Front Door

To my friends – thank you for reading with me.


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Stigma/Mental Health/Medical 2016
By – Sheri de Grom

Notes From My Journal – Conway, AR Dec – 2015

My Grandmother Fromm taught me the importance of keeping a journal when I was 8. She said, “It is never simply a record of daily events. Write with conviction, feel and believe in who you are. It’s okay if others don’t agree.

I remember well that first mental health hospital admission of Tom’s on December 7, 1987. We didn’t know we had other options to gain admission other than the ER.

Those memories of that first admission linger in my heart as if it were yesterday. I first saw the brutality and stigma among not only the general health profession but more tragically, mental health professionals. You may read that blog here.

I reference that first mental health admission of 1987 because I’m infuriated so little has changed since that time. I’m surprised individuals with mental health concerns seek care as often as they do considering how badly they are treated.

I wouldn’t have the proof of this callous, indifferent care continuing 17 years later if I weren’t deeply involved with Tom’s medical records covering the past 30 years.

Why have I spent thousands of hours advocating on behalf of those with mental illness when the health industry continues to turn their backs with indifference on millions who desperately need their help?

I’ve been absent from the blogging world more than I’ve liked due to the responsibilities I have of preparing two case files for Tom and me that will decide our future. We both want to stay in our present home and that will be possible if I’m able to present the specific combination of information the VA requires.

To prepare the cases, I studiously reviewed each page of Tom’s medical records since he retired from the military, along with his complete active duty medical records. Together, the medical records span 50+ years. I wish I could detach my mind from what I’ve read. This is the man I love and what I read is more often than not, barbaric. He wasn’t in an institution nor a patient in any system. He was a full-paying client and no one cared.

In the particular medical record I’m enraged about today, I’d adhered to every regulation required by HIPPA and I still don’t have all the records I requested 3 times from the same hospital. What I do have is a record I specifically stated I didn’t need at this time and it makes me wonder if a copy clerk somewhere wanted to pass the information on or if it was simply a mistake by an outside agency providing the record.

Speaking of the outside agency, forget about your medical information being protected. It’s Not. Investigative research has led me to the conclusion that HIPPA does not protect the patient’s privacy. It does, however, make it almost impossible to obtain a copy of your own medical records and causes far too much work for in-house administrative staff.

You are entitled to a copy of your medical records. I’ve paid as much as $5.00 per page for some of Tom’s copies. The cost of preparing one case file for a VA claim will be a few thousand dollars before I finish. The few thousand dollars will be for each claim and that doesn’t compensate me for my professional time or administrative expenses. It’s no wonder veterans feel they have to hire attorneys to represent them. I understand their frustrations.

I’d requested a copy of all emergency room visits for Tom with the exception of psychiatric and one specific outpatient surgery record from Baxter Regional Medical Center in Mountain Home, AR. It’s the hospital we used the 2 years we lived in the Arkansas Ozarks.

What I received, after all the proper exchanges of HIPPA forms, was the one outpatient surgery record and one ER visit. I specifically asked not to be sent any psych ER records. I didn’t need them. I only needed records about Tom’s many pulmonary related visits. The one ER visit enclosed was for a psych visit and no others.

I hadn’t asked for this outpatient ER medical record but I’m glad I received it.

I stormed around my winter gardens for hours wishing I had weeds to pull or some such thing. I even had a few times when I’m sure I could have uprooted a tree with my bare hands.

The official final record reads: “A 57-year-old white male who presents to the emergency department with worsening shaking presents to the emergency department with worsening shaking hyperventilation, headache, and shortness of breath. He has been diagnosed with bipolar symptoms for approximately 2 months. He is on the bed just shaking the whole bed quivering, sweating. He also complains of leg pain. He has these same symptoms. Apparently, he has been admitted to the sixth floor for this in the past. He is very anxious, hyperventilating, just shaking from head to toe. It is hard to tell if this is intentional shaking or whether he actual does have a tremor.

I talked to Dr. Dollins, who normally takes care of him. The family requests a psych evaluation. He will be admitted to the sixth floor for severe anxiety versus psychosis versus bipolar.” End of Official Record.

Many have argued with me that negative conditions toward the mentally ill could not possibly continue at the rate I’ve witnessed and reported over the years. I had no idea the negative remarks were becoming a part of Tom’s official medical record. It’s critical for all patients and those who love them to join together to ban stigmatizing reporting in all health records.

Remarks such as the ones quoted above are not only erroneous, they are misleading and can cause an insurance company denial of a claim.

The inaccuracies in the record other than grammatical included: the length of time Tom had been diagnosed bipolar. Tom had been a patient in this hospital before and bipolar was a disease listed in his permanent chart. Tom was diagnosed in 1987 and not 2004.

The sixth floor the report refers to is the locked geriatric unit for dementia and Alzheimer’s patients. Baxter Regional Medical Center in Mountain Home, Arkansas did not have a Mental Health Unit. Therefore, all mental health patients were admitted to the geriatric unit.

The geriatric unit is not the ideal place for ANY individual to recover. Mental health patients are fragile and anxious plus the atmosphere alone is distressing.

The closing sentence of the medical report: “It is hard to tell if this is intentional shaking or whether he actual does have a tremor.”

During this same time period Tom was diagnosed with Parkinson’s Disease and the same as Bipolar Disorder, there’s no definitive test to diagnose the ravages to the brain both diseases cause.

The ER doctor reported he’d talked with Tom’s psychiatrist at the time, a Dr. Dollins. I had already spoken with Dr. Dollins and he’d agreed a direct admit for Tom was the best plan. When we’d arrived at the admissions office that dreadful night in 2004, they did not have an admission order on file for Tom and we were left with no choice but to face the dreadful emergency room.

I was so stressed and concerned for Tom that night, I didn’t remember my normal protocol when the hospital staff was telling me what I had to do! I knew I didn’t have to agree to anything. Dr. Dollins had written an order and I wasn’t holding them accountable.

I’d talked with Dr. Dollins earlier that evening and he’d instructed me to take Tom to the hospital where a direct admit order would be waiting for us.

I SHOULD HAVE called Dr. Dollins myself and asked him what happened to the direct admission orders he’d promised. I had the right to demand more. Tom was his regular patient and saw him every week.

Often it’s difficult to remember your own playbook.

Miracles do occur.

As a result of this hospitalization, I knew I had to forget all of my old ideas about using only providers covered by Federal BC/BS. It hit me; I’d been practicing my stigma about all the negatives I’d developed over the years about the VA. It was our one remaining resource. It was time for me to stop being a snob and reach out.

Tom has now, as of today’s date, been with the same psychiatrist at the VA for 11 years and after that first admission when he was taken off all medications, he’s never had another mental health admission. The relationship we have with Tom’s psychiatrist at the Veteran’s Hospital at Fort Roots is one we both treasure. Tom has been free of mental health admissions for 11 years. We’re convinced Dr. Kuo’s treatment is one of the main reasons Tom’s alive today. The 3 of us have a partnership.  We have a great working relationship and if that means we must live in Arkansas and not the Central Coast of California, then so be it.

We’ve made progress in educating the public about mental health but I have grave concerns about healthcare professionals. They continue to allow mentally ill patients to die 25 – 40 years ahead of the general population.

I’m estimating it will take an additional two months for me to complete the VA Claims mentioned earlier. As I read Tom’s medical records, I’m amazed that one man has survived so much.

Thank you for reading with me. I cannot specifically write about what’s going on in Tom’s and my world at present. It’s just too painful. My hours as a caregiver are long; I see the pain in Tom’s eyes and would give most anything to ease the spasms of pain that rack his body daily 24/7.

Our precious Bailey divides his time between being doctor dog and my sidekick. On those days when Tom has an especially difficult time both getting enough air and a problem swallowing, Bailey stays extra close to Tom.

May I impress upon you the importance of acquiring a complete copy of all your medical records [a copy of each doctor visit to include labs, x-ray and other tests]. Additionally you need the interpretation of the labs, x-rays, etc. This information is vital to your welfare. We cannot rely on electronic records. They are crashing faster than they are created and stolen at an even greater speed. Tom’s records alone present far too many problems. It would take a lifetime for me to have the mistakes corrected.

I’ll not stop fighting for equitable care for the mentally ill and I pray you won’t either.

Thank you for reading with me.






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Veterans/Veterans’ Benefits/One Woman’s Opinion
By – Sheri de Grom


My opinion about Veterans with ‘bad paper’ has changed over the years. Having worked in The Office of The Staff Judge Advocate (JAG) for many years [all during times of peace] legal was by the book and shades of gray were rarely allowed to shadow my thoughts.

Varying levels of bad paper discharges exist within the Armed Services:

[1] GENERAL DISCHARGE – For those whose service was generally satisfactory, but who engaged in minor misconduct or received non-judicial punishment.

[2] OTHER-THAN-HONORABLE DISCHARGE – An administrative action for those with behavior problems such as violence or use of illegal drugs.

[3] BAD CONDUCT DISCHARGE – Punishment for a military crime.

[4] DISHONORABLE DISCHARGE – For offenses such as murder or desertion.

Jim Salter with the Associated Press expressed his opinion on December 24, 2015, “There is a small percentage of folks who were court-martialed and convicted, and they have earned their bad paper.”

Exiting the military with a less-than-honorable discharge follows the service member for  the rest of their lives: into the workforce, background checks, social relationships and perhaps most of all it precludes them from getting the benefits other veterans receive upon their discharge.

Never before have we seen combat situations where we’ve deployed our military an excessive number of times. Returning to combat zones requires more than a hug and a pat  on the head. These men and women suffer injuries and anguish in Iraq, Afghanistan and elsewhere. If they’ve turned to drugs and alcohol to relieve their pain, who am I to judge?

Ex-military members who’ve sacrificed so much can’t turn to the Veterans’ Affairs for mental health problems, post-traumatic stress disorder, TBIs or any other injury. Those who want to go to college aren’t eligible for the GI Bill, the jobless get no assistance for career training and the homeless are excluded from vouchers.

The Department of Defense reported that more than 18,000 people left the military last year with ‘bad paper.’ More than 352,000 have been discharged with ‘bad paper’ since 2000.

Studies show those who are less-than-honorably discharged are far more likely to end up in prison than honorably discharged Veterans. They are also more likely to be suicidal and jobs are harder to get because background checks highlight an undesirable military discharge.

We’ve created a population that’s been segregated from the numerous agencies that serve Veterans. In the cases where intervention might have helped the soldier, it’s our responsibility to help, not turn them away. We owe these battle-fatigued Veterans a hand in returning to a civilian life wherein their hopes and dreams might become reality.

What do you think? Have times changed and should we bend the rules for some of the ‘bad paper’ returning after so many deployments or simply see these veterans as individuals who made bad choices?


I’d originally thought I’d continue blogging about Tom’s and my journey through our latest medical nightmare but I’m too close to it on a daily basis. I learn something new about the mystery of Medicare everyday and I’m alarmed by how many see it as the answer to the U.S. healthcare crisis.

I’ll write more about our trip down death’s lane later. I cannot relive all that happened when BAPTIST HEALTH MEDICAL CENTER of LITTLE ROCK discharged Tom to home knowing without a doubt he probably would not survive! BAPTIST HEALTH advertises they provide amazing care for patients. If a hurried trip to death’s door is their definition of ‘AMAZING CARE,’ I can say they exceeded their goal beyond expectation.


Let’s focus on the men and women of the Armed Services, both past and present. Please join me as we not only strive to change legislation for all Medicaire recipients’ but continue the fight for our Veterans and the benefits they rightfully earned.

Thank you for reading with me and I look forward to hearing from you. For those that believe Medicare is the answer for universal healthcare, please consider how long you wish to live.




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Caregiving/Advocacy/Medical 2016
By – Sheri de Grom

Looking back to my last post of Dec 20, 2015 [you may read it here], I had no idea my life would soon become a powder keg.

Many of you have asked if I’ve found the silver heart Tom left me, and unfortunately the answer is no. I know in my heart of hearts, the lost silver heart had to take second place to the beginning of another medical nightmare.

Christmas day I heard Tom using a mallet hammering in his studio. He had trouble standing and I couldn’t imagine what was so important. Sometimes it’s better not to ask Tom why he’s out of bed when there’s every indication he should not be standing without support.

Tom came into my office and handed me a silver heart. He said, “I couldn’t let Christmas pass you by without a silver heart. This heart is from mine to yours.”

Tom took a nasty spill Jan 2, 2016. His upper right forearm fractured in three spirals and broke at 45 degree angles in opposite directions from each other. One break was an inch from his shoulder, the 2nd an inch from the first break, and the 3rd an inch above his right elbow.

Compliments of Google

Compliments of Google

The orthopedic surgeon on call at our local hospital that night was convinced Tom might not survive a surgery to repair his arm due to his multiple life-threatening conditions. He also said there were 2 breaks but there were actually 3, and that they were at 20 degree angles. CATASTROPHIC MISTAKE by the orthopedic surgeon. Tom could have lost his right arm permanently!

Tom’s arm was placed in a compression cast and I was beyond stunned when 2 days later the hospital discharged Tom with a prescription for 30 days Oxycodone, 1 or 2 tablets every 4 hours as needed for pain along with an appointment slip to see the doctor in 30 days.

Medicare refused to issue a wheelchair. Their response to our request was that Tom had broken his arm and not his leg. [Medicare refused to consider that Tom could not walk on the bottom of his feet due to the psoriatic arthritis keeping them an open wound]. HOW DID MEDICARE THINK I WAS GOING TO GET TOM FROM ONE PLACE TO ANOTHER? USING HIS ROLLING WALKER WAS NOW OUT OF THE QUESTION AND HE’D BECOME A MORE SERIOUS FALL RISK.

I brought Tom home and prayed, God’s will be done. I felt myself sinking into a deeper depression. I had to be able to get Tom to his medical appointments but how was I going to make that happen. Medicare put me in a serious situation.

We are fortunate to have exceptional friends of deep faith who have stayed close for the past 10 years. We often share the ups and downs of our lives. Two days after Tom was home from the hospital, a transport wheelchair appeared at our door [fits Tom perfectly and is a gem for Tom to get around in]. I can (with effort) lift it in and out of the trunk.

A quote by Edward Young always comes to mind when I think of Lynn and Bill Garret. To paraphrase, they are indeed “The Wine of Life,” and it’s with thanksgiving to God that I thank them for seeing our need and taking that need and putting it into action. The transport wheelchair is ours to keep. Thank you, Lynn and Bill, seems so little to say when something changes the quality of our daily lives in such a drastic way.

The compression cast placed on Tom’s right arm from the top of his right shoulder and down to his fingertips lasted less than a week before it was too loose to hold Tom’s broken bones in place. The pain medication offered him zero relief.

We visited the orthopedic surgeon’s after-hours clinic for a readjustment of the compression cast within a week of his discharge. Imagine my outrage when on the 2nd visit, I was told, “Take pictures of how we do this. We don’t make money adjusting compression cast.”

I’ve since learned by examining EOBs (Explanation of Payments from insurance companies) that they were paid in excess of $400 for each of the two visits we made lasting less than 15 minutes. For their rudeness and disregard for our need for treatment, I believe they are highly overpaid.

At the time we were at the clinic I wondered if we were being told the truth or was this further evidence of our medical care breaking down further? How could I be expected to take care of the realignment of Tom’s broken bones? I don’t have an x-ray machine at home! I don’t have the medical training

What’s happened to the patient being followed by the physician until a problem resolves? Tom didn’t need yet another chronic diagnosis in the form of a useless arm or one of continuous chronic pain.

The months following Tom’s broken arm have been the toughest yet. My role as a caregiver changed as I met one brick wall after another. However, I’ve learned and I’ve journaled. Much of what I’ve learned has been the result of living in crisis mode day after day. I’ll invite you along my journey in future blogs.

One of the best decisions I made for myself was to get another rescue shih Tzu. I’d asked for an 8 yr old but a 3 yr old flew into my arms the night I visited to meet my possible new rescue. I’m certain now that Bailey knew I was the one that needed rescuing. Each time I went to put him down, right back into my lap he popped

Bailey has been my constant companion these long and horrifying days of not knowing Bailey in Reclinerwhat brick wall would greet me around the next corner.

He’s learning to be a service dog for both Tom and myself as we both have PTSD. When Tom became so sick, Bailey and I lost a lot of ground with our training as Tom came first. We are still using his service dog commands.

I mentioned to Bailey about going to Navy Seal Training and he politely told me, ‘When Pigs Fly!”

Bailey asks for little except to be loved. Most days he divides his time between looking out the window in my office [from my desktop], of course, where he has his own lush blanket, and cuddles and tummy rubs on command.

I’m not sure how I would have made it through the dark days of Jan through March if Bailey hadn’t been at my side. He continues to be a joyous spirit.

Bailey thought New Year’s Eve was the cat’s-meow. Tom wanted flavored water with a sizzle and away we went to find it. Bailey was so excited when 5 Brownie Girls approached and asked if they could have their picture taken with him. Bailey was so-o-o- happy to oblige. After all, what new guy in town meets 5 cute girls on New Year’s Eve that welcome his kisses. His wiggling body and wagging tail encouraged me to get us home to tell Tom of his latest adventures.

As Bailey retold his story, he elected to leave out the part about the Brownie Girls being on a scavenger hunt and that they needed a picture of themselves with a cute dog!

I’m leaving much unsaid here about all that’s happened since I last spoke with you. We’ve had close calls with Tom’s health and never before have I met with such frustration. In mental health quandaries I could always remove Tom from any situation and knew I could keep him safe until I found appropriate care.

The serious medical problems Tom faced included: cardiac, infectious disease, pulmonary, trauma surgeon, endocrinology and more. Tom entered Little Rock Baptist Hospital on January 27th and he’s been home 1 week! Our experience with Baptist Hospital in Little Rock was less than ‘Awesome’ and I’ll be writing more about that in a future blog. I was afraid to move Tom and have him classified as AMA [Against Medical Advice].

What I do know is that the diagnostic overshadowing is the direct cause of the rapid decline of Tom’s body. Our new diagnoses are Histoplasmosis in all 5 chambers of his lungs, COPD brought on by chronic bronchitis and yes, way back Tom smoked for 20 years. [Tom and I have often talked with our friends of the Vietnam era who are dying today from COPD, [brought on by smoking cigarettes]. Daily meal rations, during the Vietnam war, included cigarettes. Then we have the fever of unknown origin that roamed from 101.2 and spiked at 108 for 2 days. His arm had 3 spiral fractures and each was at 45 degree angles going in opposite directions of the other and would never have healed in a compression cast. A trauma surgeon treated Tom a day after he received a new generator and batteries for his pacemaker [they both stopped working while they were in his chest].

Why hadn’t his cardiologist staff scheduled his pacemaker checks at recommended dates? Tom would be dead today if I hadn’t counted the dates and called the cardiologist’s nurse. The pacemaker itself was 100% dead [the batteries] when Tom was admitted to the hospital on the 27th of January. I’ll be talking more about this in a future blog but to add to the tragedy of today’s medicine, we had no idea he had actually been alive because of the back-up generator. Tom would have died at home in a matter of days and we wouldn’t have known why! Tom was off-line before he made it to surgery!

Every available space covered with medical records.

Every available space covered with medical records.

I’ll be discussing some of the horrors of Medicare’s Administrative Rulings as I move forward with blogs this year. Suddenly my own time has become non-existent as my days are spent on the phone arranging care for Tom, reading, indexing and summarizing over 40 years of Tom’s medical records and acquiring all new medical records as Tom’s care continues.


Front Walkway WildflowersI carve out bits of time here and there to enjoy one of my favorite stress relievers. I refuse to take my iPhone to the garden.


I haven’t words for telling all of you just how much I’ve missed communicating with each of you.

My friends, we’ve entered another regulatory age of Medicare. What are your thoughts on this matter?

I’ve spent hours of reading regulatory Federal Registers’ on the matter. It’s not a riveting read but occasionally I unearth a valuable nugget.

As always, I thank you for reading with me. It’s wonderful to be home again.




















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Slice of Life/Caregiving/Unconditional Love
By – Sheri de Grom

I’m desperate. I’ve lost my heart.

I’ve looked everywhere.

Last night in a panic I cleaned everything, and I do mean everything.

At the end table by my favorite chair I shook out magazines, picked up 50 or more Prismacolor Premier Pencils, and placed them in their case where they belonged, sorted reams of research materials I’ve received and not had the time to read. I went through 3 or 4 weeks of mail, picked up my manicure things and still no heart.

Down on my knees I looked under the table and under my chair, behind the table, the windowsill and any number of places nearby, no heart.

I can’t believe it. My heart is still missing and I always find my heart.

Over the years, Tom has been leaving small silver hearts for me all around the house and then he waits for me to find them. Sometimes I’ll find them the next day and it’s never taken me longer than a week.

The silver hearts have never been a once a week deal or even once a month. I never had a clue as to when one might appear and I never knew why with the exception of Tom’s loving me unconditionally.

Silver Heart Running Wild

This time was different–he’d hidden one so long ago, he’d grown worried that I’d tossed it out with the trash. This is the first time he’s ever told me he left a heart and approximately where.

Did my heart go in the big green dumpster? I know it’ll be lonely and still wondering why I haven’t found it like all the others. I cherish each one. They are as important to me as all the gold and diamond jewelry Tom’s designed and made me over the years.

The hearts are unique and I have no idea how many more he’s made. He hasn’t been able to work in his shop for a long time.

As the woman at Tom’s side, I want that heart. It’s something for me to hold onto when the nights are lonely and I wonder how I’m going to keep his breathing going and keep the wounds clean. In years gone by, I often wondered how many times I could bring Tom back to reality after another psychotic break. Today, I pray God will continue to allow me to do whatever it is that I’ve been doing that opens his trachea and allows him to breathe.

Tom continues to fall frequently and I’ve discovered a new way to cope instead of trying to help Tom up immediately. I’ll lay on the floor with him and wrap my body around his. I’ll toss a throw over us for warmth and we often go to sleep. Sometimes when we wake we find we both have the energy to hang onto the furniture and get up one more time.

Tom laughed last week and said, “Isn’t this what we used to do way back when?” I reminded him those memories are as sweet today as they were 30+ years ago.

The laughter presented a gift all it’s own. I can’t remember the last time I’d heard that full throated laughter I’d taken for granted all those years ago.

About my heart–it’s still missing. And, it’s my fault. You see, I’m into pile management and the past few months have been worse than ever.

I’ve been working on a VA appeal for Tom and I to receive help with his care. The paperwork has demanded my attention for 12 to 15 hours a day [yes, I moved back into my workaholic mode] but the decision by the VA will determine how much longer I’ll be able to care for Tom. If we obtain assistance, we should be set to live in our present home until one of us departs this earth.

You might imagine the amount of paperwork I’m talking about when I tell you I’ve had to gather, sort, read and highlight relevant material from his medical records since Nov 1, 1987! That’s a lot of paper and a lot of piles.

The hours I’m working on the VA paperwork seem to consume me alive, heart and all. It’s definitely the reason I haven’t posted a blog since mid-November and the reason I haven’t been around to chat with everyone.

When I do find my heart, it will go on this beveled glass tray Tom made for me wherein he preserved a crochet fancy piece made by my Grandmother Fromm.

Fancy work between beveled Glass

The glass is an exquisite dusky rose with semi-precious stones making up the decorative wire work on each end. This captivating work of art is the perfect place for my hearts.

photo 5b

In the meantime, I wish you and your loved ones the most joyous Christmas ever. May we have Peace on Earth.

I hope to post 2 additional blogs before the end of the year taken from my journal notes of our first Christmas in Washington, D.C. They will close out my 4th year of blogging and relaying to you, my readers, the reality bipolar disorder presents when it arrives at your door.

We no longer worry about bipolar disorder. I watch daily the destruction bipolar disorder contributes to Tom’s pain. It’s the pain of inhabiting his own body wherein there’s no relief. It’s the unforgivable ignorance physicians display when they withhold treatment because an individual has a mental disorder. This is the ultimate stigma determining life and death of those we love.


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