Medical notes from Kyiv. Summer weather.

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Oksana's parents are five and three years younger than me, but they both have geriatric medical issues. Worst is Sasha. He had smoker's leg, a lack of circulation that resulted in gangrene which led to an amputation a couple of months ago. That was on top of kidney problems that had required dialysis, anemia and constriction of the arteries that requires implantation of a stent when his body is up to handling it.

These problems are compounded by breaking a hip when he tried to navigate on crutches before he had had much practice using them. He has been bedridden for a month. Now he has fluid on the lungs. The laundry list of possible causes I find on the Internet includes kidney problems, lack of exercise, smoking and diet. He gave up smoking a couple years ago but the effects linger.

The good news is that doctors still make house calls. We had two of them on Sunday. The first one brought a portable x-ray machine and took a look at his lung.  The second was an internist who read the x-rays to see what to do.

There are two alternatives. He could go to the hospital, with an ill-defined diagnosis for an ill-defined period of time, or stay home and wait it out. If he does get pneumonia they know how to treat that –antibiotics. Pulmonary edema is another story. It happens to old people and you just have to live with it. If it becomes acute they can clean it out, but it will probably come back.

This is a frustrating problem for Oksana and her mother. It is hard to make a decision concerning the life of somebody else in an area in which you have no expertise and the doctors do not provide clear direction. Grandma in particular would worry about being blamed if things turn out badly. She would rather somebody else make the decision, but she has a hard time refraining from second-guessing whoever does it.

I at least know how to make a decision. And I know that it involves taking the blame if I'm wrong. I am awfully glad that my call in keeping the family in Kyiv rather than go into exile in Poland has turned out right. This was an easier decision. There's not much to do, and Sasha is going downhill in any case. Neither our house nor the hospital have air conditioning, but ours is well insulated and stays cooler. Moreover, there is always somebody here to attend to his needs.

Her mother’s inability to make decisions puts a burden on Oksana, who in turn lays the stress on me.  That is mixed relief. I don’t get stressed, and I don’t look stressed. On one hand she’s happy to have somebody to lean on, but on the other hand I think she wishes I would be more worked up.

It helps to have been through this before. My former wife’s father died at about Sasha’s age. He had lived his last four years with us. It was easier in that he had Parkinson’s dementia and could not have been involved in his own treatment if he had wanted to.

That preamble leads me to observe that Sasha is probably in better hands here in Ukraine than he would be in the United States. He would definitely not get house calls from the doctors there, much less at $60 apiece. I doubt he would get better medical advice – the time comes in every life when there’s just nothing more to be done. I handled the Medicare paperwork for my former wife’s father. It represented a considerable expense for no discernible benefit.

Oksana's mother's shoulder bothers her. She is now going daily for some kind of massage treatment. She has to wait in line for a fair while, but it is free under the government medical plan. Socialism probably works as well here is anyplace, but not well enough for me to recommend it. Honest pay for honest work has always struck me as the optimal relationship between the client and the service provider. It amazes me that the underpaid medical staff here treat their patients as well as they do.

One of Sasha’s joys has to be watching his grandchildren run around the house. Both girls are stark naked as often as they can manage, running in and out of the yard. Oksana herself wears a minimum of during the summer. Moreover, to the delight I am sure of every father of children who attend, the comely young women who run the nursery school Zoriana goes to every day are also given to light and loosefitting clothes in the hot weather.

The temperatures have finally become summerlike. The top 3 feet of the lake are pleasantly warm, though you hit a current of cold water beneath if you get vertical in the water. Members of the family find their way to the beach most afternoons.  Oksana takes the girls, Eddie goes with his friend Artem, and I alternate between working out on the exercise bike at home and going down by myself to swim the length of the lake. I have to confess I’m not a good companion to take to the beach. I like to swim and be done with it.

That’s the news from Lake WeBeGone, where the strong man refuses to give in to the heat, the good-looking woman makes absolutely the best of it while not conceding she likes it this hot, and the children are enjoying themselves, though they are not as free as we were when we were kids.

Graham