the big finish

the big finish

Thursday, November 26, 2015

No experience is wasted...

I sat in the comfy chair in the room where her husband is dying.    I mean, he is not imminently dying but has certainly slowed down.  I visit him twice or three times a week and we sit and talk about life, about the good things, the bad things and how things always shake out.

As I care for her husband, this lady cares for me. In the last 6 months, she has been teaching me about marriage and family at every visit.   When I ask the secrets of a long and happy marriage, she is brutally honest and talks about the good times, the hard times, the times when she would have thought that she wasn't going to make it...and then now.  She always ends the conversation with, "And now, knowing what I know, I wouldn't change a thing." 

Yesterday, as I sat in the chair, we talked about the changes coming and what she is doing.  It was a little tearful because, honestly, while a person is ready for their loved on to die...they are not.  She acknowledged that and then offered her wise counsel..."No experiences are wasted".  I asked her what she meant by that phrase and she told me about all of her times in life when she did things she didn't plan to do and how she learned from them.  

Then, we talked of gratitude in the every day, and how she believes that there is something to be thankful for even in the darkest of times.  I talked of how a lot of times, I can be a "glass half empty person" and she had a hard time believing that.  But I can be and because of who I am, for me, the glass can be half empty.  Once again, she urged me to see beyond myself to all the gifts I have.  

As we sat in the room, I asked her husband as he lay quietly with his eyes closed if it was okay to stay and talk, since I thought maybe we were disturbing him as he slept.  He opened his eyes and said he was happy to have us there and to keep talking.  I looked over for a long time and thought about his wife and him.  They have been together for 60 years...caring for each other and sometimes not but always a team in good and bad.  They have grown children and grand-children and are caring for each other as the time clicks away.  

Wow, talk about experiences...

Then today, I visited a patient that does not have very much time left.  Being here for Christmas will be a stretch and because the pain had become unbearable, staying her isn't a priority.  The priority is relief from pain and good time.

Yesterday, I changed all the medications around and wrote them down and made a check off sheet to make sure that the plan was followed to a "T".  Then I hugged the caregiver and prayed silently that this was the answer for comfort.  Because the patient was hoping for the best, a new plan made sense...

Last night, I called to check on the patient and make sure they had no questions and on the phone, she sounded better.  I went to bed last night very hopeful and praying for pain control.

When I arrived today, the feeling in the house was peaceful, and I could tell when I walked in the bedroom that the changes had worked.  She was smiling, ordering her family around and moving her legs effortlessly.  I wanted to cry...from relief and from answered prayers.  I got in the car and sat for a few minutes thanking my God for pain relief and good time for what I know is going to be the last Thanksgiving together.

In the last 5 years, I have watched people have incredible experiences, and many that they would have rather gone without.  Many have to do with caring for a loved one at the end of life in a known situation or one that has been thrust upon them quickly.  The courage and love I experience every day as I walk with these families is amazing and humbling.  I often wonder when it is my time, will I have the capacity to love and care like these folks.

So on this Thanksgiving eve, as I sit on the couch with my pink wine and my cat...waiting for the cheesecake to finish in the oven, I am thankful.  I am thankful for experiences...the ones when I fail to be all I can be for a family and the ones that I can give the patient some relief from the pain and some good time for whatever time is left.  I am thankful for a job that is a calling, a ministry and a job.  I am thankful that when I leave a patient, I can hug them and then kiss them on the cheek and linger to feel the connection that I cherish.  

As my mentor/friend/patient's wife says..."No experience is wasted" and I have to agree.  It's the reaction to the experience and the learning to be thankful even in the darkest of times that we understand the tapestry of this life...and learn to cherish the good times and hopefully grow stronger in the not so good times.

So Happy Thanksgiving...I am thankful for you!!!

May you have good time, peace and comfort with those you love...and when you kiss them on the cheek, linger and feel the gift of warmth and comfort for  today and always...

We'll tawk tomorrow,
I love you all,

Sunday, November 22, 2015

Watching the profound go by...

Yes, I know it's been a while.  I have been dry...dried up and withering...trying to figure out things that are "unfigurable" and 
asking why about things that have no answers.  Needless to say, I have spent a lot of the last three months in my head.  

Let's just say that me being in my head is not a good thing.  I compare, I fret, I wish things were different or wish things were the way they used to be.  In a few words, I stop living in the now....

I must admit, I do not do change well.  I do love a good schedule and I love a good routine.  I am sure when I was younger and busy, I gritched and moaned about how busy I was and how I wish I had some time for myself...some free time.  You can ask anyone you know who knew me then...

So now, I have time.  I mean, I have time to do the things I didn't have time for before.  I can clean my house, get laundry done and be at home.  Now, I wish I was cheering at a band competition or a baseball or soccer game instead of folding the clothes just right.  Funny how that goes, really.

Last week, I had the distinct honor of being knocked off my feet and told to get out of my head while listening to a patient explain her "goals of care".  The goals of care are a fancy way of saying what a patient wants  to do with the time that is left.  It is what means the most to a person's heart when they know they are  near the end.

I sat in the chair by her bed and watched her as she explained what she has been through.  Almost a year ago, it started with a little cough that didn't go away...nagging and nagging for a few months.  She went to the doctor to get antibiotics for the cough and even after that, it was relentless.  Chest x-rays and MRI's and PET scans later, she had the answer.  The big C...Cancer.  It sounded to me that she handled it well, continued to work and  went to chemotherapy for almost a year.  They told her that there wasn't a cure to be had but there was the promise of more time if she did what they told her to do.  So, she did.  

As with most of the people I have the honor of caring for, she had a circle of friends that drove her, cooked for her and cleaned her house when she couldn't do it for one reason or another.  She was uncomfortable with all the help, the love and the concern that she got because it was usually her doing that for her friends.  I told her that I could understand.  I think if we take a minute, we would all rather be the one doing and loving than the one that is fighting for more time.

So here's the rub...what she really wants to be able to do now is so simple.  She wants to straighten up her home, make a nice dinner and sit with her family and enjoy the meal.  She wants the time back that she had a few years ago.   Because she is near the end of her time, and she is so tired,  going to the table takes every ounce of energy,  so she doesn't get to do that much if at all.  As she was telling me this, she teared up.  She just wants a little more time to do what we all used to do when we had kids to tend to and we were mothering.  I listened as she told me how she  used to straighten up the house and put things in their place, figure out dinner for the family and make sure she had all the food in the house.  Then, she would put dinner on and welcome her family home.  Dinner would be ready and she would sit with them, talk with them and clean up after dinner.  

Sounds like a pretty simple routine that went on nightly in that home.  But now, nothing is simple and nothing is easy.  Now  it's hard to get out of bed because she is so tired and when she is really awake, she feels the pain that the cancer causes.  She has to take her pain medication and then she wants to rest because of the fatigue that cancer causes.  Don't get me wrong, she is not complaining as much as remembering how precious those nights were.

I told her I could relate and tears sprang to my eyes.  I too, remember those evenings when I made a favorite dish for dinner and sat with my family and listened to their day. I looked away because  I didn't want her to see my tenderness  I felt that surrounded her realization.

You see, I miss that so much now that it is just Jim and I.  When I am in my head, I wish I had that time back to imprint it in my brain and feel the feelings and smell the smells and remember the looks between the family.  But...and this is the biggest but ever...I can call the family together and make a meal and talk about the old days and feel the new feelings of a family that has time.   This sweet girl cannot.  She can't do it and that is all she wants.  That is a profound loss of control, knowing that you can't do something you want to do and you know your time is running out.

So what is the answer for her?  To make her time with her family as beautiful as she can.  To honor her wishes and give her every medication to keep her comfortable,  give her every moment to be with her family undisturbed...let them be and love each other as much as they can.  

I understand what it is to wish that things were different.  What I cannot comprehend is running out of time to make new memories. To live with the courage to know that every time you look at your husband,  your children that the time is measured and one of these days will be the last time...deep and difficult thoughts.

So, what do we do?  What do I do?  I think it is time to stop wishing things were different, that the kids were little and that I did  a better job.  It is time to live in the now, love in the now and be okay with what is.  

You see, there may be a day, hopefully not soon, that we have a cough that doesn't go away, or a lump in a place it shouldn't be or test that didn't turn out to be clear...and we are in the shoes of my dear patient.  Wanting to be able to do the simple things that show love to our family, our friends ...but are too tired and cannot.  

Profound thoughts for a Sunday night but thoughts that can make the fabric of your life richer...

When we live in the now and understand that we have a life to live and not just watch...when we give ourselves and love each other every day...that's what we are called to do and be.  At least, that is what I believe as I watch life come and go daily.

We'll tawk tomorrow,
I love you all,

Saturday, August 22, 2015

I am an "empty nester"

Wednesday around noon, I became an empty nester.  I took my last child to college.  It is a little more than an hour away and it is a really  nice college.  He will do great there and he started his exit right after graduation in May...really.

All summer, I held on tight and tried to hold him close.  He wanted none of it.  He got a job, he camped, he hiked and he got a life.  He was on his way.

I have no choice now but to figure out what's next.  In my head, Jim and I got married and we began prepping to have a family.  We bought and built a house, got decent jobs and learned how to negotiate differences all in preparation for being parents.  At least, that is how I saw it.  Three years later, along came the the queen, her brother next and then ...the last one.  

We dove in head first and parented.  We sang the songs, we got the mini-van, and we became Mom and Dad.  We even referred to each other as that and still do.  

Now, they are all on their way.  My first is  negotiating adulthood with all of her might, the second one is exploring life with abandon and now my his dorm doing God knows what.  

So back to me...I didn't work on Wednesday, but all of my patients knew that I was taking my last kid to college.  On Thursday, as I showed up to see folks, I was quizzed and comforted.  My patients, who are dealing with illness and end of life stuff took the time to comfort me.  Needless to say, I was humbled.  

Then, at the end of the day, I went to a party for my boss and her husband to be.  The whole office was there and we were celebrating this new union.  Everyone I talked to asked how I was, and if I was doing okay taking my boy.  I finally realized while I talk way too much, I have so much to be thankful for.  These folks don't have to listen and really, they don't have to care.  But they do.  Wow, things like that make my  life so rich... 

It is going to be an adjustment to have more time to do things I want to do.  I mean, I don't even know what I want to do...really.  But, I guess I have time to figure that out.  

So, as I wrap this up, I want to thank all of the folks that asked and listened and comforted me as I negotiate round 3.  This round has the potential to be even better, as rewarding and as holy as the first two round have been. 

Once again, it's about perspective and managing expectations...something I tell my patients all the time.  I guess it's time to take a dose of my own medicine.  

Here's to being an empty nester!  I guess....

We'll tawk tomorrow,
I love you all,

Wednesday, August 12, 2015

When the rubber meets the road...

A lot has happened in the last few weeks and I would love to let you in on it.  I think it helps me to put my thoughts and feelings on paper and I bet these ideas will give you all food for thought.

Where to start is the problem...

My kids came home from summer safe and sound with only missing "things".  My daughter got her belongings stolen in Guatemala but boxes are arriving on my porch daily from Amazon Prime so she is almost up to speed.  Mac showed up on a Thursday night when the town had it's "music in the park" night and it was an honor to hand him a cold one and hold him tight.  My youngest is getting ready to fly the coop and is doing all he can to make it easy on me so I'm not sad when he leaves...(can you hear my voice dripping sarcasm?)

After I sent the two older kids off to the points far away, I spent my summer not thinking about them much.  Or so I thought anyway.  I talked to them and I "facebooked" (verb) whenever I saw the green light on...but I thought I was cool with the whole thing.  Until they arrived on US soil, that is. 

When I saw my Christie Lou coming up the escalator at DIA, my heart lept into my throat and I ran past the ropes.  Then I held her and kissed her face until she told me to get off!  I was glad to see her and have her home.  I could feel my insides relax just slightly as we drove her home and listened to the stories of the summer and her plans to save the world in the future.  

Then, the phone call came from my Mac that he was on 285 in Salida and would love to come to Meyer's Ranch and listen to music with us.  Then he was turning by the Catholic church and I waited...he walked over and I did the same with him but he is taller.  I grabbed him and held him so tight and began to kiss his face until he cried uncle.  I could feel the tension, worry, or whatever I held in my body all summer start to chicks were in the same town and their mamma was happy and peaceful.

I didn't realize that I had been holding my breath (figuratively) all summer until they came home safe and sound...

This summer I also had the privelage of caring for some amazing people and helping them negotiate the end of their life the way they wanted to and the way they lived.  On the flip side, I got to sit in the sh*t with a friend while she kicked cancer's booty.  While I was in the midst of caring for them, it was a little like having my kids in far away places.  I tried not to think about them constantly and how they were doing, but somewhere in my body, I was holding vigil until they were where they were supposed to be...whether that is comfortable and in bed, in heaven with whomever they planned to be with, or done with  treatment and cured!!!

Last Monday morning, one of the patients passed away.  I talked to his wife and she was relieved. When I asked her how she was, she said it was hard to keep from dancing with joy knowing that he was comfortable and on to the next journey while doing the end of this life exactly the way he wanted to.   This guy taught me so much about strength and honor and kindness while having symptoms that were difficult at times.  It was an honor to stand by him.  

He would ask me the hard medical questions about what his body was doing and how long until he was gone.  He asked me to honor his wishes and take care of his wife.  When he was really having a bad day and I kneeled by his bed, he turned to me and smiled when I am sure that was the last thing he wanted to do. 

 When I got the call,  I too was relieved and happy for him.  I sat on the couch and wiped tears of and sadness, but also relief and some peace in my heart.  Similar to how I felt when my kids arrived home.  

 My other patient got a scary diagnosis and endured weeks and weeks of treatment.  She was exhausted most of the time but didn't  show it.   I waited for her to fall apart just because I probably would.  But not her...she remained engaged in life and stronger than I even thought.  She  could have taken to the bed for days but for her, that wasn't an option...she had kids to love and a husband to keep in line!   So today, after almost 7 months, she got her get "done with cancer card" and when she told me I cried...but moreover, the last part of my heart that was holding vigil let go!!!!  Peace on earth again for my buddy and her family...

So what does all of this have to do with rubber meeting the road?  Interesting you should ask...

Because it is my opinion that life is about who we are when no one is is when we are facing the most difficult times of our lives that we really see who we are and what we are made of.  I feel like it is so easy to be holy and authentic when everything in life is proceeeding like we planned.  But are we holy and authentic when we are facing the hardest times in our lives....a cancer diagnosis, a loss of a child, a loss of a spouse?  That's when we really know our strength and abilities and how we teach others to learn their own.

I know kids on adventures is nothing compared to the death of a loved one or a cancer diagnosis but it taught me that I have some work to do.  I have to continue to work on the "holy" and "authentic" and "kindness" actions because it makes the world a better place and makes the people around us better for it.  You see, I'm lucky.  This job that people think is so at times but really it is an example of what life is about.  This summer, I had ring side seat to strength beyond belief, authenticity and what I call holiness as these two folks got through the  most difficult times of their lives...

That is when the rubber meets the road.

We'll tawk tomorrow,
I love you all,

Sunday, July 26, 2015

A week in review...

Tonight, my kids are in three different countries building houses for folks that don't have one.  My oldest is in her last week in Guatemala, my middle guy is in Juarez finishing his summer and my youngest is in the DR building with church.  

That brings me to the sermon I heard on Thursday night at my church when we went to bless the missionaries.  The message was "If not now, when and if not you, then who?"

The message was clear to me and resonated in my soul.  If I am to be someone who lives the life I believe is good and right...I better walk the walk instead of talking the talk.  Lord knows, I can talk.  It's the walk that is hard.

Last week, I had the test.  I had a patient that was difficult to care for and it took everything I had to go to that house.  I was so conflicted in so many ways about the situation, the plan of care and the way it would turn out.  At first, I thought I would just go in and tell them what to do.  I mean, I'm the nurse, right?  I took all the things I would need to just steam roll them into seeing things my way, the "right" way.  I got in there and tried and didn't get anywhere.    As a matter of fact, I just made the situation worse.  Instead of understanding and then trying to be understood, I knew better.  I had the answer for this woman whose husband was dying before her eyes...but I didn't know the history of the family, the issues and the life they led before I showed up.  But, again, I had all the answers.

In the end, doing nothing different except offering kindness and a listening ear, the patient and family got what they wanted...a peaceful, quiet death at home.  

So, as I sat in church on Thursday night and listened to the Pastor speak, I realized that if it's to be me and it's to be now, I need to open my mind and heart and listen first.  I don't need to "know" what everyone should do so that I am content.  It's not about me at's about them and how to help them in their time of need.  Interestingly, that kind of thing is usually not clean, neat and easy but it is what I am called to do.

I am learning that we are who we are, meaning people don't change because they are dying.  Many times, families will assume the person will change to be something different in the last days, that if a person was not affectionate, because they are dying, they will start hugging and kissing.  It doesn't work that way.  I tell families that people die the way they lived.  Our job is to focus on loving them in the best way we know how, without changing who we are. 
"Managing expectations" I say and explain...

So what is the point of all of this?  I learned a big lesson about life this week.  While I know a lot about the end of life and dying, I do not know it all and, it is always better to listen and understand before expecting to be understood and listened to.  It's just the right thing to do and really, it is polite and honorable.  

I was telling someone that I have been a nurse for 30 years and there are still things to learn every day about caring and loving people.  I just need to keep my heart open to learn...

We'll tawk tomorrow,
I love you all,

Tuesday, June 30, 2015

A love story...right or wrong, you make the choice.

It's been a while,  hasn't it?  I have been in a different of indecision and self doubt.  I would begin to write and then stop.  I would wonder who in the world cares what I think...  Lately though, I have been feeling a nudge to write again, to put this short, tumultuous, wonderful life into perspective.  So here goes.  I have decided to redouble my efforts to kids and husband, of course...but also strangers and the unlovable and then write the stories.

I have been watching the feed on facebook and have not commented the supreme court's decision.  Not because I am not happy for the folks that want to get married but because I understand that my opinion is not going to change anyones mind and I do believe that people can think what they want.  They don't need me to tell them they are right or wrong.  

I do have a story though that made me think about love...all kinds and all genders and same genders, and how when a person loves another person...and does the things that are right, to is right.

Sometime last year, I was called in to admit a lady that was dying.  She was older and she was having strokes.  She had been declining for a long time and she had a "caregiver".  I arrived at the house to find two older woman...the one that was to be admitted to hospice care and the "caregiver".  

It didn't take long for me to see the relationship these two women had and the quiet communication and understanding even without the one being able to talk much.  It was clear to me that they were a team, together for what appeared to be many years.  As I asked questions, the wife answered them and explained the medical history of this patient in detail.  She told me her idiosyncracies and her favorite things.  She told me of their daily routine, complete with labels on things so she could remember, and of not leaving the house without her lest she fall, and of making her favorite meals to keep her strength up.

Finally, feeling comfortable enough to ask, I asked her "their" story.  She told me they  met 35ish years ago and had been together ever since.  They took care of each other, bought a house, traveled for vacations, rooted for the Broncos, went to games and then when she got too sick,  they watched them at home.  Their life was one and they were deeply attached and loved each other very much.

As the days went on, the patient's wife took beautiful care of her and made sure her every need was tended to.  She watched as her love was failing, starting to forget who she was and the back and forth banter that they enjoyed over the years.  It was a very difficult time as it is for everyone watching the love of their life fade away.

As the time inched closer, the phone calls  to me became more frequent and difficult.  She did not want her to die and for her, being at home with her, even in the declining state she was in was better than her leaving.  She agonized over the decisions of keeping her at home or trying more life sustaining methods to keep her with us longer.  As with all folks close to death, the patient was fine.  She was "turning inward" and doing the work of leaving this place.  I spent many an hour at the house with the wife at the kitchen table...comforting her, telling her she would be devastated but she would take comfort in how she loved her all these years and off this earth.

Still,  I thought that we were stuck and that she wasn't going to be ready when the time came.  I prayed to God for peace and comfort for this lady and her love as she slowly left us.

A few mornings later, I got a call that she was gone.  Nothing fancy...just quietly left us.  I went to the house to do my work and asked the wife how it all went.  She told me through a veil of tears that she finished caring for her and getting her ready for bed when she noticed her breathing had changed.  She sensed that she was leaving her.   She climbed in bed with her, held her and kissed her face while she took her last breaths...then she relaxed and she was gone.  She held her for a while longer and called me.

As she explained those last minutes of life, I listened and tried to think of a better way to leave this earth.  To have your love close, holding you tight and kissing you gently while your leave this place...all the while telling you what you mean to them.

I was so proud of this wife and told her through my own tears. She had done everything right and I told her so.

After all my work was done, I got in my car and sat.  I asked myself why that "love" is different and should not be allowed by my God.  Why a love that withstood the test of time and difficulties of life was not equal to other loves that I have witnessed.  What makes my love for my husband better than what I had the honor to witness at the end of that life?  For me, it isn't.  I hoped that I would have the courage to climb in bed with Jim when the time comes and tell him what he meant to me and how my life was good with him.  Will I have that courage?  Will I feel that deep, abiding love to do that?  Hopefully, I will but I believe that we all do the best we can at the time.  

So, yes...I guess my opinion is very transparent.  Deep abiding love is love, be it a man or a woman.  So what am I to do with that experience?  

What does that look like?  Being kind, trying not to judge, and being present in the moment with folks.  Am I good at it?  I am sure you know the answer to that. But, I owe that to you and you owe that to me.  And when I stand before my God, I know that I will have done my best.

How about you?

We'll tawk tomorrow.
I love you all,

Thursday, April 9, 2015

Cosmic or profound or holy? C...all of the above.

Today was a day like no other.  I want to say it was profound...

I sat across from a man that had to make a difficult decision.  A life changing decision and a decision that would be something that he thought of often.  We talked for an hour and one half about his choices and then made the decision that made his heart ache but was the right one.  He stood tall and is letting nature take it's course.  It takes a special person to do that and an amazing human being to have the strength to make those kinds of decisions.  I am honored and humbled that I got to sit with him as he decided...

As I left the house, I knew that he was ready for whatever he had to deal with and I got the feeling that I was just where I was supposed to be at the time.    The feeling carried me most of the day until I arrived at a party.

My patient, just diagnosed with a terminal cancer, had planned a birthday party and wanted to have it.  We changed her medication plan to help her deal with the symptoms and I was to "stop" by and make sure we were winning.  We were...

I knocked on the door to find 6  "older" ladies with wine glasses in their hands getting ready to celebrate life.  I looked around and realized that I knew a few from taking care of family members.  I was introduced and revered as "Terry the nurse" that took care of my...  I felt a chill run up my spine as I talked to each one and asked how the family was and what they were doing.  I had made an impact in their lives and they were so happy to see me.  I found that interesting because I always think that no one really wants to see the "hospice nurse" because at the time, things are so tender and sad that it is something to push to the outer aspects of the brain.

But it was a celebration and a time to treasure every second of life in that house.  They joked and visited and loved each other like only 75 year old women could.  I felt so honored to be there and almost stayed to party with them.

But I left, and as I headed to the car, another woman showed up and got out.  She was another one of my widows and it was a short time.  Her husband was very ill and I worked fast and hard to get that family to a place of peace.  She  was so excited to see me and I told her..."You don't want to see me, I was present for such a difficult time in your life"  to which she responded, " I can not repay you and would love to see you again."  I told her that I go by her house most days and if I see her car...I will stop and we can visit.  And, I am sure I will.

I spend my days thinking when I am not on the phone with doctors, patients or my family.  I think about how hard life is, how unfair things can be and how quickly things can change.  I also think about the other side of that...when life is hard, it seems people come out of the woodwork to help, to love, and to make things easier.   As I told this son this morning,  "you are a wonderful son and a reflection of your mothers love...I can only hope my sons can step up and do what you have done for your mother."  Because he did and is and it is not the easy way out.  It is the way of a person with integrity and strength...

I called my husband and apologized for all the things I did to make him feel unloved this week.  Sometimes ( a lot of the time) I take him for granted.

This day was profound, cosmic, holy...all those things... One for the  record books.  I felt like I was exactly where I was supposed to be and do what I am called to folks. 

So, as I finish my week, try to love all these folks exactly where they are...I am thankful for those little signs that keep me going.  I prefer to believe that the holy spirit...the angel on my shoulder...knows that sometimes I need more than can be given by humans and gives me the holy and profound so I know that I got this.  I know that to be true as I mutter things that I never thought of before but come out of my mouth like a song of comfort and peace.  
I also thought of all my friends and how when we are 75, I can only hope that we can be together, remembering the good times, picking at each other and laughing about the times in life that we screwed up.  Just plain loving each other and knowing we did it right.  To see those ladies doing that today made me so happy!

I leave you with thoughts to ponder.  Life is hard, and wonderful and people are difficult but beautiful and loving.  I feel like I get so much more that what I give to familes and people.  I am so lucky to do what I do!

We'll tawk tomorrow,
I love you all,