Monday, May 23, 2016

My Neuro Psychologist says that the majority of brain injury patients fall into depression – after their therapists have given them the go-ahead to return to “normal” life, that they are now free to live their lives without having their weeks plotted out for them and mailed to them on a rotation anymore. Instead of being happy, they are deeply depressed.
“And why’s that?” I recall asking.
Being a shrink, he gave the question back to me: “Why do you think that is?” Because, you know, my answer is more relevant than his facts. How I see it, what I think of it, lends insight into how I would feel.
I imagined it must be because it was easier for them not to have responsibility for their own lives, which were being dictated for them on a daily basis. Now they were on their own, they would fail or succeed by their own merits. Maybe I wasn’t ready to be done myself, maybe after two years I was dependent on them after all.
But today was my last “Family” Meeting at the brain rehabilitation center, and I can tell you right now how I’m going to be feeling in the coming weeks:

A.) Relieved to have my own life back.
B.) Disappointed that for some reason I have been thinking for the past couple of years that when the therapists moved out my life could pick up again right where I left off. No one promised me that, but I’m pretty sure they did promise more than what I’ve got.
C.) Wishing things could have happened differently. Wanting to bargain with somebody somewhere in the past – What if I had been more aggressive about getting the level of therapy I really needed? What if they had gotten me into Occupational Therapy sooner? What if I’d had some kind of case manager who could have helped me to get those things done?
D.) Angry because there are things that I’m always going to struggle with. Angry because I want to be like everyone else and skip the naps and burn the candle at both ends and push my way up to the top of the heap.
E.) Guilty for not being grateful enough for all the things I have, for remembering with every breath that I am alive, and that is all that matters.
F.) Wanting really badly to just forget that the whole thing ever happened, to pretend that I’ve always been here and always been this way, and I’m okay with that, I’m doing fine, I don’t want for anything. The bills are being paid and there is food in the house, I have my bus transportation and my friends here – I don’t need anything more.
G.) Daring to hope. Always at the end of everything bad, down at the bottom of a great big pile of bad, always I’m looking for the hope therein. I think of what a beautiful world this is, what wonderful kids I have, how much I love my family, how much I love Dennis, my friends. How I still have a lot to say in life. I’m not teaching in a classroom, but there’s something shining inside that I have got to share with others, and I can still do that in writing, in painting – in how I love others.

My sister wasn’t able to be at the meeting this time around, but she sent an email that pretty much summed things up: “…My understanding is that this will be the last family meeting at that you are all done treating Heather. Please let me know if Heather's interpretation of the situation is incorrect. I wanted to thank you and your staff for all the hard work you've put into Heather's rehabilitation. It's been a long and interesting process and I've been happy to help as soon as I realized how involved I needed to be. It's been very educational. I also just wanted to make sure that I understand where Heather is and what will be needed for her from here out. There are a lot of skills and steps that Heather has progressed with through the combined efforts of [you, and Heather’s] Tuesday group. Obviously this list isn't exhaustive, but off of the top of my head: · Speech and conversational skills · Information Processing · Memory and scheduling compensational skills · Physical exhaustion management · Surviving relatively independently · Initiating an application for social security · Transportation · Neural fatigue management · Accepting changes to her quality of life (ongoing)
“Obviously Heather could not recover to her full capacity from before the accident, so things that she will continue to struggle with and hopefully improve on include: · Neural fatigue (which leads to greater problems managing even skills that she is typically doing well with) · Information Processing · Problem solving · Sleep hygiene · Medication management · Scheduling and memory compensation · Budgeting · Driving skills
“Things that she is currently unable to do include: · Drive at all other than the 15 minutes from her home to work · Complete more than roughly 4 hours of work a day · Manage a day successfully without a nap in the middle of the day · Complete her masters degree in education · Work in a classroom · Work in a fast-paced position · Work without compensation for her disability
“Questions that I still have include: · Will you provide a therapy wrap up/release statement that details her capabilities? o Heather's understanding was that she could contact your offices whenever she needed a statement for Social Security, housing, food stamp, and other considerations. Is that accurate? What kind of turn around can she expect when she needs something like that? · What happens if she moves, or changes jobs? o Will she need further driving instruction? o Will she need further vocational therapy? o Where can she get further therapy if she moves away from Lansing? o Could she get a referral? I might have more questions that I haven't thought of yet. but this is basically what I would have brought to a family meeting were I able to attend. Once again with sincere thanks...”

Judging by what I understood from the meeting, Thea wasn’t wrong in her assessment of my situation. Origami is signing off. The Vocational Therapist will touch base with me a couple of times within the next couple of months to help with the transition between my old boss and my new boss (There’s actually kind of like a whole committee of bosses, who fortunately are going to be sticking around to help as well). I am by all reports doing well in the quiet, organized atmosphere with the routine schedule (Unless I’m overtired, which is when all bets are off regardless of what I’m doing).

“Heather, we have discussed that you might be able to work a couple of extra hours if you were to have a more repetitive job, but you have expressed concern that you might not be challenged enough by such a job and, frankly, I would have a really hard time with a job like that myself. If you were to change jobs at some point in the future, know that I’m always here for you if you need me. Meanwhile, I’m happy to see that you have finally been contacted by the social security administration regarding your claim, as you will need to be compensated for the work that you are no longer able to do. Although they do usually turn everyone down initially, I think you have a good case with them, given the extremely debilitating effects that neuro fatigue still has on you after two years of recovery.”
The Occupational Therapist then listed things that she feels I am doing well. Since January (when we had our last meeting) and now, I have transitioned into independent housing and am caring for my children relatively well. “And we have a new system in which Heather is keeping her weekly grocery money in envelopes so that she can keep track of her spending and also use the checking account solely for bill paying purposes. So, Heather, how’s that going so far?”

“Um… I lost the envelopes.”
“…and we implemented a new pill reminder system so that she will stop forgetting to take her pills…”
“It’s kind of working – I only missed them twice last week…”
“Well, ANYway, Heather is probably always going to struggle with budgeting, sequencing, organizing, problem-solving when there are sudden changes in her plans or schedule. Rest breaks and time management are always going to be the key to her success in any endeavor. I estimate that we should be done within the next two weeks.”

Why am I so organized at work and not at home? Because I get the great privilege of working first thing in the morning, when my brain is working to its fullest capacity. Also, work has a built-in schedule, tasks that are the same from week to week, and people who worry that things won’t get done, or notice when things don’t get done, and are sure to remind me. In other words, I have the same level of supervision as I did when I lived with Thea and Paul. More. And the bonus is that I actually get paid for doing this stuff, which surprisingly I really enjoy doing. I think it’s because I love people and helping people out, and there are enough creative things to do to keep that side of me satisfied as well.
But I sat at the meeting and marveled at how I could have been just a few classes short of a master’s degree in teaching just a couple of years ago, working full time and considering a job teaching online -- and now I’m weighing the pros and cons of a part time office job over an assembly line job at a factory. With no one but myself foreseeing my ability to do much more in the future.
The medical doctor from the rehab who has been prescribing my treatment told me at the meeting that they are all very proud of how far I’ve progressed, that they would write up a summary of what I have done and what their recommendations will be for my future. She explained that sadly they had not gotten a report back from the driving inspector regarding my future at the wheel yet, but that in the meantime my family should be compensated for helping me go back and forth to pick up Stuart and Lucy for the weekends, and in the future the auto insurance company is still obligated to cover any travel I need to brain-related medical appointments or therapies. The brain rehab will contact me via email when they get further information regarding the driving issue. If I have any further brain-related problems in the future, they are, of course, always there for me... I just have to get a referral from a medical doctor before approaching them.
Now that they are closing shop, it's probably too late for my Neuro Psychologist’s Office to get further therapy for me. He had said that I needed it, and had told me several times that he had sent the recommendation to the new doctor and therapy program he wanted for me (that he felt would be better than what I actually got), but even with his referral and several phone calls on my part, nothing ever came of that in time to be of any use to me. I mean, what are the chances that the auto company, after finding out they are all done paying for my brain treatment, are going to welcome more payments toward an all new therapy program for me? Certainly not after getting the report from the brain rehabilitation folks stating that my therapy is finished and that I am doing the best that I can do now.
That’s it.
It is kind of depressing, isn't it?
I'm not sure anymore if ANY therapy was really ever going to end with any kind of peace or sense of closure -- Maybe I could have gotten OT sooner and would be further along (the neuro psychologist thought so), but regardless I'm still stuck unable to do the things that I used to do, or to live the life I planned and spent thousands in college to achieve. There's no way this was ever going to be a happy conclusion... Except that I do love my current job, still get to paint and to write, and if I can master my fatigue and time management, I now have more time to do those things.

Maybe it was the only way that was ever going to happen, and maybe that's what I can look at as the reason behind it all. I am not one of those people who really believes that everything happens for a reason -- sometimes bad things happen, and they are random, and they will never make any sense. The “reason” isn’t the important thing, but my reaction is. Writing and painting have been my calling since a very young age, and somehow, despite all the distractions and sincere efforts to do other things that seemed more practical at the time, these are what I have left in me that I can still do without any doubt or question.
It’s all still up to me, and always has been.
That’s not depressing at all.

Wednesday, January 6, 2016

The Two Year Mark

I want a t-shirt that says this.
Disturbing Day Yesterday, no doubt about it. First I talked to the car insurance company's claims adjuster, and that conversation was alarming. We discussed how my recovery is going, and I explained that I'm almost done with Vocational Therapy, waiting to get the results of my driver's test, and still struggling with some of the symptoms. (Is it a symptom anymore when it's been two years?)
He asked if the brain injury rehab center  and Doctor Cook had gotten copies of my independent evaluation yet or not because, from his standpoint, they must all agree with it. All he has on file is what Dr Fabiano gave him and, according to Dr Fabiano, I should have been working full time within two months of the date the insurance company received the results of his IME, which TECHNICALLY is in two weeks!
He said he would send a copy of Dr Fabiano's report to Dr Cook for me, and that I should bring a copy to my family meeting for Origami, and that they all have just this one month from receiving these copies of the IME to send their rebuttals.
I happen to know that Dr Cook, at least, has been working hard on mine, but what I think I correctly read between the lines was that the adjuster is actually WORKING WITH me on this a little in that he's provided them an extra cushion of time in which to present him with some evidence to support their diagnosis of me as opposed to Dr Fabiano's.
I don't think he Had to do that.
So I went in to the tri-monthly family meeting at the brain rehab feeling angry with themi and ready to give them a piece of my mind, because Two Months ago my two remaining therapists told me that they had put in a strongly - worded report to the insurance company detailing what treatment I still needed and providing evidence as to why that is. Then after I handed them a copy of my IME, I found out that their report was never sent because Michael, Care Coordinator, had talked it over with their resident doctor and decided that if they sent that report to the insurance company asking for an expensive transition into independence, they might just get my case cancelled completely.
But talking with the adjuster made me mad, because I had told them that it was MY treatment and MY life, and all I wanted was for them to TRY. The worse that could happen is that my insurance would be canceled, and I would have to try to do their jobs for them (which sometimes I feel like I'm doing already) at home for myself. 
When I got to the family meeting and started to tell them what the adjuster told me, their response was, "DID we get your IME? The insurance company  is supposed to send us your IME. This is good, though, because now we can just SAY we only just got it from you today, and then we will still have a month to send our rebuttal." (Finally!) 
When I reminded them that I already gave them those test results two months ago, they didn't deny it. They were far too eager to throw Drew, Doc "Fab," and Dr Cook under the bus over getting things done in a timely fashion. It's frustrating. Thea has reached the conclusion that they're giving me the short end of the stick because I don't have good insurance, but I don't believe that. I think what's happening here is that they don't often get cases like mine and really aren't prepared to handle it. They'll make suggestions and recommendations, but then they keep ending up pulling the rug out from under me when they find out I don't "quite" fit the established criteria for a certain program. For example, they suggested moving me into occupational therapy housing- based independent living arrangement that is a test environment where the Occupational Therapist would monitor me for a year or so to make sure none of my particular issues would hinder my progress. They all agreed I needed it and were supposed to send that report -- And then they found out that the program prioritizes families over individuals when deciding who gets in -- And they chickened out.

Huh. I just remembered that my friend Sam whom I met through the brain rehab was recently moved to the assisted housing -- She lives alone and has no children at all...

That said, here's the brain rehab's current plan:
With Kathie the Vocational Therapist  this week, I'm going to continue following up with the Social Security Office. She doesn't think I can ever work full time again, so something has to be done to pay my bills. The plan was never to live with my sister forever.
One option she mentioned would be to work at the church in the morning, go home for a nap, and then work a second job tutoring or something to supplement my income -- But she wanted to be clear in saying that this is more of a future aspiration for me, as she doesn't think I could do more hours right now, and I can agree because I keep trying to work longer hours just to push myself a little, and the doctor keeps reprimanding me for pushing. Neuro fatigue can NOT be "Pushed" through.
According to what Kathie is putting in her report, if I continue with the job I'm doing right now, I will be done with Vocational Therapy within the next month, because I'm doing great.
If the insurance company insists on transitioning me to full time work as Dr Fabiano suggests, THEN we're looking at another 12 months, and  with almost certain knowledge that I won't be capable of doing it.
Transitioning into Independent Living, the maximum amount of time I would need for continuing OT at the assistant living apartments would take another 12 months, but they've since determined that families are prioritized over individuals, so I won't be able to get in there (not "MIGHT," as it should be). I'm wondering why they ever brought it up in the first place.
Thea thinks they must spend about 75% of their staff meetings training in ways to manipulate clients into choosing the safest path for them as opposed to the best path for the client.
I think they just worry a LOT about getting paid by the insurance company or not, and legitimately struggle between what they think is Right, and what they think is the most cautious approach.
If I get approved for housing through the Housing Commission, they're thinking they could withdraw services in more like only 6 months, because honestly it's more affordable and I could make it on my own once they've gotten me settled in and helped me work out what
my challenges are and have provided coping skills for them.
Meantime, Jessica the Occupational therapist says she'll revisit do-it-myself home therapy exercises for my fine motor coordination because my coordination still isn't up to par, and she's holding off on everything else waiting to get me out of my sister's basement so she can get an accurate measurement of my progress.
She and Thea got off on a tangent about how I get locked into a task or plan and struggle with being flexible. For example: It's pouring rain when I get off work. My sister can't take me home, so I decide to just get some work done until either she CAN, or until I come up with a plan B. I get so engrossed in what I'm working on that it's four o'clock before I even realize it. Jessica is hoping to help me develop the coping skills I need to overcome my mental inflexibility. She was vague as to HOW, but when I see her in my appointment this week, I'll be sure to bring it up. Dr Cook suggested setting a timer for each task, though, and I'm going to experiment with his approach.
While waiting for the Housing Commission's response (which by their word should be next week at the latest), Jessica is going to look into other potential housing with me because she spoke to their transitional housing staff person and discovered that from Eaton County I could take the bus into Wacousta and even Lansing if I needed to, because either they're not as restrictive as Clinton County's public transportation, or they have special rules for a "disability." (Whatever. I don't have to use that word. I can look at it as having some challenges to overcome.)
Michael, Care Coordinator, emailed the TBI Driving Specialist, asking once again for the results of my evaluation. If he hadn't done it right in front of me, I would have gotten snarky and asked him if he really sent it, or was just talking about sending it.
Michael doesn't foresee having more than one final wrap-up meeting with me and my family once Kathie signs off on me, because they don't coordinate those meetings for single-therapy clients who have been declared independent. This makes me really happy, because it's been almost two years now, and I'm getting really tired of feeling as if my fate is completely controlled by therapists and the auto insurance company instead of, oh, I don't know -- Like mySELF and God.
I feel I'm ready for this.
Tonight I talked to Dr Cook and made sure he's aware of the time-line I'm facing in case he could get those test results rolling in any more quickly.
He agreed that the auto insurance adjuster is offering us more time because he would like information with which to help me. If that's the case, I understand it's gotten to be a huge exception to the average claims adjuster.
Dr Cook isn't one to brag, but I'm always happy to do it for him: The first Independent Evaluation I had with Dr Fabiano went about the same as this one, with him twisting my words to fit with what he had predestined to be my test results in the five minutes he spoke to me before his assistant administered the tests so that he could go type his version of the results. Not kidding -- They place bets on who's going to finish first. But THEN Dr Cook sailed in with his rebuttal, and he backed up all of his points with extensive testing data. And from that day, insurance adjuster seems to have realized that I don't fit the mold. (Thea joked to the Origami Team that Dr Cook convinced the man that he was, after all, only a mere claims adjuster, which made them laugh.)
Dr Cook says that Dr Fabiano is attempting to convince the insurance company that I'm not brain injured at all, but rather that I have always been this way, and he said plenty to both Origami AND the Insurance company about what he means by "this" way: He claims that his abbreviated version of the psychological part of testing revealed that I have a dependent personality that is so bad that I would become dependent on any further assistance that the insurance company would allow, even stooping to the point of convincing myself that I'm too brain damaged to do anything for myself.
"Wow," I said. "That's convenient. Now when I tell the insurance company that I don't agree with Dr Fabiano's report because there really are still symptoms that I struggle with daily, he can claim that my protest just proves his point!"
Dr Cook smiled encouragingly at me. With a twinkle in his eye, he said, "Sounds to me, Heather, like you're not the one with the psychosis here."
It feels good to laugh.
"Don't worry about Dr Fabiano," He said. "You focus on healing and using that uniquely designed brain of yours to improve your life just like you're doing right now, and let me send the claims adjuster my rebuttal. As you know, I do the FULL 500 Question psychological report, and what Dr Fabiano claims is pure fiction. There is no sign of any such diagnosis. A woman who fakes illness to get 'taken car of' doesn't insist on choosing the hard job over the assembly line, never leaves her ex husband or go to college, doesn't strive tirelessly to become a full-time teacher for so many years, doesn't have a 3.8 GPA, and doesn't work so hard at therapy, push the limits of what everyone tells her is possible, or aspire to live independently even when she has a loving family who has made it clear to her that she can live with them for as long as she needs to, even if that means for the rest of her life. 

"And your tests will speak for themselves. They will explain once again how you can be such an excellent speaker, beautiful writer, and in general just the charming, witty person that you are and, yes, STILL have a BRAIN INJURY. You called it Swiss Cheese Brain once [I totally stole that term from Quantum Leap]. Well, that's an apt description -- you do. There are parts of your brain that no longer work as they used to. Because it's a diffuse injury, you can be really clever in one area, and still terrible at something very close to it. We're taking about multiple fissures too small and complex for the naked eye to perceive. Add to that the medium to severe damage in that area behind your left ear, and what do we get?"
Me: "Swiss cheese?"
"A woman who could write a better rebuttal than any of the very experienced and professional staff of therapists at the brain rehabilitation center, but who can't make a logical argument when confronted point-blank in person, and doesn't understand the nuances everything that what was said until writing it down later, or discussing it with a sounding board. A woman who can glance at a puzzle and tell me what it is without putting it together,  but who would take weeks or even months to physically sit down and put the pieces together. A woman who can paint a masterpiece in vivid fine detail, but will miss important details when baking a cake from a recipe if there's too much noise in the background. A woman who can write for hours at a time and not hear a thing going on around her, but can't focus on a conversation for more than 15 minutes. People who simply do not understand brain injury are always going to try to tell you that you're faking it or that you're exaggerating, and they will use your symptoms against you to "prove" it -- 'You can spend five hours painting, but you can barely work five hours? You can read and completely tune people out, but a little noise is supposed to mess you up when you're reading a recipe? If you have a brain injury, then how can you go to work, how come you can write like that? Why are you taking naps every day? You're just being lazy.'"

Randy spoke up: "You really gotta learn not to give a shit what people think. You're fine. You're fiiiine! And funny, too!"

"Thanks, Randy --  Dr Cook, you do realize, right, that saying I have like nano fissures in my brain that nobody can see sounds AWFULLY convenient too, don't you?" 

"It may SOUND that way, but your tests SHOW the way. I'll send my rebuttal bullet - pointing your results and how they compare to Dr Fabiano's, and then the test results themselves with a detailed explanation of your neurofatigue and how it affects your capabilities."

Knowledge is Power! Right, guys?!

Paul's response to the Brain Rehab's Family Meeting was, "You're being awfully nice, considering this is your LIFE they're messing with!"

The problem is, once I'm there hearing out their side of the story in person, with their smiling
faces, I fully buy into it. I would need an advocate who could trouble -shoot problems and follow up more aggressively than I seem able to do. PAUL would actually be GOOD at this, if he could make the time. I try really hard to advocate for myself, but I can't be direct about a problem that I'm just not seeing at the time. I have to have time to think about what was said. It's something we were all talking about in TBI Group tonight, how having a brain injury can mean delayed processing. In a detailed conversation with a lot going on under the surface,  I might not always get what you mean at first but, given a few moments afterward, it all comes to me, along with all the nuances I need to read between the lines. I can't tell you how many times I've heard people with TBI describe this very thing. They have a complex conversation with a therapist, doctor, lawyer, or claims adjuster. They don't get mad about what was said until after they've left the office and gotten back into their car. In that moment of quiet, reflection hits with a vengeance. 

The two positive outcomes I get out of all of these discussions about therapy are that, A.) It appears I'm reaching the finish line, and B.) When I get the results of all these things I've got up in the air, then I will finally know for sure what I've got to work with and be able to plan ahead. Granted these two things, I think I can make peace with myself. 

It occurred to me a few nights ago that I'm coming upon the two year mark since my accident -- It just hit me all at once: Although I don't believe in limiting myself within a numerical standard, statistically, after two years, the drastic, most significant improvements in brain functioning have already taken place. From here on out, I can go ahead and expect miracles as I prefer, but to the average observer I will never make as much progress again as I have up to this point. So says the average results, and the hypothetical deadline is in only two months (By which time, for Dr Fabiano's money, I should be working full time again)

Then my freak - out session commences:  But -- Wait! HOLD ON just a MINUTE  here !-- NEVER?! BUT -- but -- I can still only work between four and five hours a day before I'm too tired to think productively anymore! I can't read all the time because my eyes get bloodshot and my head starts feeling squeezed. I still develop headaches and pressure in my skull on a daily basis, I still get clumsy when I'm tired, I still struggle with world-finding issues if overtired, I still have to take a nap every afternoon just to be able to FUNCTION for the rest of the evening, I feel sick and dizzy when I over - do it, I still get overwhelmed in crowds, still get confused if there's too much going on at once, have to be SUPER organized and work from a list, need extra time to get complex jobs done without making mistakes or leaving things out, can't do simple math in my head, can't drive a car with any background noise or in heavy traffic or at night, and I'm still living in my sister's basement. 

THIS CAN'T BE IT!!! 

THIS would mean that the brain rehab is RIGHT when they keep shaking their heads at me and patiently explaining to me that I have a "disability" now, that I can't push my way through things anymore and expect good results -- That I can't work full time anymore unless I want to focus all my attention and all my strength solely on a job, leaving me no energy or intellect with which to even raise my children properly, or do anything else in the shadow of the kind of down time I would require to recover from one simple eight hour shift. I can't teach in a classroom with thirty kids to manage without suffering extreme neuro fatigue, never be able to drive the 2 1/2 hours alone to pick up my kids for weekends unless I plan on taking a nap every couple of hours...
Never?
Of course not!"
But all this blasts my brain and batters my emotions like a gale, like rain pounding against my skull in a thousand simultaneous water tortures, one fearful, negative thought per drop, administered by the thousands at lightening speed --

And then Dennis, who normally tends to be a half-empty sort of a guy most of the time, completely surprises me, takes my hand and simply looks at me until I'm forced to meet his gaze (I have to be looking at you to listen. You must always get my full attention before you start to tell me anything, because I will NOT HEAR you if I'm reading or completing any given task while you're talking. I need to focus only on you, and I will always need to take notes if it is anything that I have to remember). 
Dennis looks me in the eyes, gives my hand a firm squeeze, and he says, "Heather, there isn't anything wrong with being exactly who and how you are RIGHT NOW. Lots of people love you. You are one of the smartest people I know. You are talented, witty, and kind. You are stronger and braver than anyone else I know, and you've got empathy and compassion enough for every single person that you meet, even when most people wouldn't  think that they deserve it, even if it means having to humble yourself a little to do it. You don't work long, but you work hard. You don't think fast, but you think deep, right? You can't work long hours, but you're doing a GREAT job with the time that you've got.
You never thought you'd be able to enjoy reading again, but you do. They didn't think you could do the call center job, but you did. They keep saying you can't do the job you're doing, but you are. And you're not just doing it; you're doing it WELL. And that goes for all sorts of things, more things than you obviously can appreciate.
If you stay just exactly the way you are right in this moment for the rest of your life,  I won't love you even a little bit less than I do right now."

Pause.

Me: "I still MIGHT get better, right?"


"You are absolutely, 100% perfect just the way you are."

"Smart answer."

"The truth? Of course it is."

I may not know for sure what's going to happen with my therapy, my brain or my life, but one thing seems clear: 

This guy's a keeper. 

He just has to wait until I have successfully transitioned back into an independent lifestyle, have finished painting my series and finished becoming the greatest Office Administrator I can possibly be. I'm going to cut him some slack so far as finishing my novel goes, seeing as how I have been writing it on and off for well over twenty years. Some things I can save until later, and the best for last. 

I think that phrase means simply that being last is actually what makes a thing special in the first place, makes it the best.

That's cool, because I was forty before I met Dennis, and unless it's a job or an appointment,  I'm very nearly always late.