Isn't life just a 'U-pick" flower garden?

Isn't life just a 'U-pick" flower garden?

Thursday, August 21, 2014

You're not going anywhere anytime soon...

My college friend wrote a blog today that is at the core of what I do and why I do it.  Follow this link and read how a when a person gets tired of fighting, and taking care of everyone else it is a gift to support them as they  "let go".  

Letting go doesn't mean that when they sign the form for hospice, they go quietly into their bedroom, lay down on the bed and die.

Actually, for most people, it means exactly the opposite.  For most patients that sign up for hospice, they want to be able to do what they want and can do without driving to an office, getting stuck with a needle only to find that today is not a good day to get chemo. They go home defeated as if they failed a test only to wait for the next week to go an do it again.  Week after week, while the fight is on, the patient gets tired.

As my friend, Mary, so eloquently put it, Kathleen isn't giving up...she is letting go.  She is finding peace and comfort in what is important...what really matters...her family, friends, animals, her home and her heart and soul.  

I get the honor of seeing this when I show up to a home.   When the battle has been called off because the options are even more difficult, I always sense a feeling of relief from the patient.  They are content to stop being stuck, stop being in the fighting mode and feeling ill constantly.  They are at peace with being at home, with their loves, spending the precious time they have loving and being loved.  If they hurt, we figure out how to help that and if they don't, we support them with the decision and take it a day at a time.  We give them back the control they lost when then diagnosis trampled on them and held them down.  

When I talk about them being in control, I mention that they are now the "boss" and get to call the shots.  If they are hungry for something that was forbidden because of the medication, I tell them to have as much as they like.  Often, a wife will ask if the husband can have a beer or a glass of wine at night.."We used to sit on the deck every night and have a glass of wine after dinner, can we do that now?"  I always respond that they can do whatever that want to and then I wink and tell them they can even sit out on the porch without clothes drinking that wine if the neighbors don't mind!   They always laugh and give each other that look that they have cultivated after many years of togetherness in their story.  

It doesn't seem like such a big deal to a healthy person, but when you have been in the fight of your life and had no control...a glass of wine on the deck like you used to do, is such a comfort to a couple that is counting the time they have together.   "Good time" as I refer to it...when I explain how I can help.  Time that is comfortable, in the place you want to be and with the people you want to be with. That, my friends, is time that is precious.

You see, most folks that have had chemo for many weeks, months and years have gotten used to feeling lousy...tired and weak.  They have fought long and hard and bought time.  I can't say that I wouldn't do that myself.  But, when the options are few and the chemo is tougher, and when the person says enough is enough and stops chemo, I have to say, they usually feel much better.  The nausea goes, the extreme fatigue abates and they can taste food and drink again.  They can live.  If they have pain, they take medication and enough to make it tolerable if not go away.  It's a win-win in a scenario that most folks wish was just a bad dream.

So Kathleen, I wish you plenty of "Good time"...on your porch, with your dear friends and family remembering and feeling how loved and cherished you are and the stellar example for all of us on how to handle life through the good, the bad and the ugly.  There is no right way to "let go"...only your way...

So, as I tell all of my patient's from day one..."I don't think you're going anywhere right now, so what do you want to do?"  

We'll tawk tommorrow,
I love you all,

Saturday, July 26, 2014

Tomorrow is the big day...

Tomorrow morning, bright and early...and I mean early, we will head to the airport and get on a big United Jet headed to Guatemala. Once we get there, we will gather our belongings, the stuff we packed and decided that we couldn't live without for a week, as well as our hammers, work gloves, tool bags, fat pencils and our measuring tapes.  My daughter will meet us at the airport and we will pile into a bus to go to the small town to begin our vacation.

I started doing things like this for vacation in 1999, when my kids were little and I was hanging with the teenagers at church.  They wanted to do something different and I was all in.  My kids couldn't go because the were 7, 5 and Jim stayed home with them.  At that time, what struck me was how hard the work was and how difficult it must have been to live in the conditions that they did.  I came home to my big house and felt terribly guilty.  "Why me and not them...why do I get a big, dry house and they live in cardboard boxes, pallets and bed springs for walls?"  I just got lucky...I guess.

For most of my life after those trips I wondered what I was and am supposed to do.  Am I supposed to sell my house and move to a little one because people don't have houses that are dry in Juarez? Am I supposed to go to nurse practitioner school so I can move down to Nicaragua and take care of a town with my medical knowledge?  Or, do I put my life's work into figuring out water and sanitation for the third world countries?  

In the beginning of my trips, I went to these places thinking they just needed to change.  They needed to do things how we do things in the US with regard to health and they will all be healthier.  In Nicaragua, they need to move their wood burning stoves outside so when they cook, the smoke didn't give the babies asthma.  They need to use birth control and stop having so many babies because they can't afford the ones they have.  In the other countries, they need to stop drinking that filthy water so they don't get sick so much and they feel better.  It was so simple when I started.

Then I went a few more times and grew up a bunch more.  I realized that we are guests in their country, they welcome us and we are there to help.  We are not there to tell them that we have the lock on happiness, health and hygiene and they need to just get going.  It's not so easy to change everything you know and grew up with.

I know in the US, we have a lock on some things.  We have water from our taps that we can drink and we can flush our toilet paper.  We have medication, although sometimes hard to get, and can get it if we really need it.  In other places, if  you or your child needs medicine, you may or may not get it.  But, I would argue that they have a lock on "family."  Generations and generations come to our work site to watch the home being put up...and joking and exuding joy for each other that they are going to have a water tight home.  They carry their babies on them in wraps and those babies don't cry.  They nurse them wherever and whenever that baby is hungry.  Maybe we could both learn from each other.

As I got older, I have come to some pretty deep answers about these things.  I can do what I can do.  I can find a need somewhere, whether it be walking dogs in a dog shelter or flying to a third world country and putting up a house, that I am able to do.  You do what you can do...and maybe a little more.  That's it.   When you get uncomfortable with having so much and watching the suffering around find something and do it.  That's it.  It's sounds so easy, yet is so hard to do it.

So when I land tomorrow in that country, it is not my job to look around and see what "needs" to change and start talking.  My job is to sit back and let them teach me.  If I have been respectful enough to offer advice, and if they want it, sure we will talk but most of the time on these trips, these folks are giving me advice...

Yeah, it's about the house I guess but really it's about the relationships.  It's about being with another human who is very different from you and finding the common ground.  It's about remembering the things we all cherish, such as the love of family and helping provide basic human needs of food, water and shelter. 
It's about basic human connection and being fortunate enough to help another and getting much more than you give in return.  

Oh, and for me...seeing those babies tied to their mommas with big smiles on their faces...that's what it's about for me.  I cannot wait!

We'll tawk tomorrow,
I love you all,

Monday, July 21, 2014

Musings of a hospice nurse...

I attended a death of a patient last week...a younger woman with a quick progression from diagnosis to death.  I say "attended" because that's the fancy hospice term for going to the house, pronouncing the person and calling everyone who needs called.  I always feel like that word is too sterile...too formal.

Anyway, this patient was a fighter and she wasn't going to die.  We did not discuss death, dying or anything to suggest that she was not going to live.  From my perspective, there was no question that she  was going to die and it was coming pretty fast.  But, her plan was to be in the 5% that beat the odds and that was the way I cared for her.  

Then last Monday, as I was caring for her, she sat on the side of the bed and said, "Terry, I think it's time to go."   I shook my head and looked up at her (because of course it seems like when those moments come, I am already on my knees) and she asked me if I understood what she was saying.  I told her I did.  "You are tired of fighting so hard, tired of feeling bad and tired of being in pain.  You're ready to die."   As I was talking, her husband came around the side of the bed and began to tell her it was okay..."I don't want you to go, but I also don't want you to be in so much pain as you have been in the last few days" and then he went on " You are my hero...I've never seen anyone fight as hard as you and if you are's okay to go."  

We settled her into bed, gave her the medication for comfort and walked down the stairs.  We talked about the patient, her strong will, her faith in God and how she had finally come to the place of acceptance.  He wondered if he needed to take her to a hospice facility...or could she stay home?  

I spent the next half hour talking about how he did the hardest care for his wife already.  How she was in pain and he medicated her and how when she needed to be cleaned up, he did that too.  "Now your job" I told him "is to get in bed and hold her and love her until she is gone."

Tuesday came and I called him to check on her.  He said she was awake and talking and that the kids were there and everyone was in the bedroom with her loving her up.  I encouraged him, offered to visit and he declined.  He felt like the family was with him and she was very comfortable...

The Wednesday visit was hard as she had declined more and was less responsive but very comfortable.  It was all it could be in the worst situation possible...losing a wife and mother so quickly and so young.

The call came Thursday that she was "gone".  I arrived at the house to find the family in bed with her, comforting each other and talking about how peaceful she was and how the end was "good."  They were in tears for the loss and tears for the feeling of relief that she was not in pain anymore.  

Oh good Lord, it was so sad.   When I began my job...I put my stethescope to her chest, put my head down and began to choke up...I was so happy that she was out of pain and she was at home with her family, but so sad that she was gone.  I looked up at the family watching me, embarrased that I was so emotional from the beginning and nodded yes.  She indeed had crossed over...was gone...had passed away.  I looked at her face and it was if she had a little smile and asked the family what they thought.  They agreed and took solice in her expression.

I learned a lot from this family and how they handled adversity.  The patient's husband talked about how he was told by so many people that she had to go to a facility and how she had to admit she was dying.  I, at times, felt like it would have been better to talk about it.  He always said no and politely declined.  It wasn't that he didn't know or didn't want to face it...he was honoring her wishes to fight until she decided she didn't want to fight anymore.  He decided that he was not going to have any regrets and so he went about his last days with her that way.  He cared for her with grace and dignity and kindness and love...and when she said she was done, he helped her through that time in the same manner.

The next day, Friday, I walked around in a fog but wanted to celebrate life, so I invited some friends over.  As I sat on my patio sipping wine, I thought about my patient's husband and the heaviness of his heart...and uttered a silent prayer.  Me, I poured myself another glass of wine and listened to the laughing and banter around my table.

Once again, the lesson is...Life is short, hard and wonderful at the same time.  I only hope and pray that I have less regrets and more fond memories and I continue to live.  I wish that for all of you as well!

We'll tawk tomorrow,
I love you all,

Saturday, July 12, 2014

LIfe is hard...

You know what?  Life is so hard!

I told my husband that I was going to delete my facebook because it seemed like everyone was having an awesome time with a perfect life and I was dealing with death, struggle and not looking so good in pictures.

It's interesting because I know I will put up a good picture but one that I have the old lady neck and look like a cow...I forget that picture even though it might have been the best night of my life.  I am so superficial...

Anyway, it has been a week with intensity and sadness and exaustion and goodness and kindness and witnessed strength in the most difficult of situations.  I got to see people much stronger than I life to the fullest.  

I guess I need to take some of my own medicine.  As I used to say when I was a camp nurse... "buck up" and "rub some dirt in'll be fine."

But I have to say...Life is hard...for everyone at one time or another.  I love the t-shirts that talk about life being good...and it is is also hard!

So love the good times with abandon because everyone will have hard times and when that happens...the person you think you are will have the test of a lifetime.

As a husband of one of my dying patients told me this week..." I don't want to have regrets.  I want to care for her and so I don't have to worry that I didn't do a good job...didn't do everything I could do to keep her comfortable and make her know that she is loved."  I told him, " You are doing all that , my are doing an amazing job."

May you have someone on this earth that loves you that this hard life...

We'll tawk tomorrow,
I love you all,

Friday, July 4, 2014

The Dancing Queen...

Being a nurse doesn't usually require much dancing.  As I've said before, I do spend a fair amount of time on my knees but   Yesterday, was different.  I got to dance.  Not only did I get to dance once but I got to dance twice with handsome men. 

I arrived at my patient's house and noticed the front door was open and the light was on in the middle of the day.  I knocked and walked in and noticed that things were in dissarray.  "Helloooo, it's me" I said, "Terry the nurse."  My patient had a scowl on his face and wondered what I was doing there.  He was mad.  I reminded him that I always come on Thursdays to check on him and look at his med minder...and to make sure he was okay.  He still wasn't satisfied.  We spent time talking about what was bothering him, about his sleeping, his aches and pains and if he was eating.  He was doing pretty good but still just mad.  Finally, I asked him to get out of his chair, grabbed him by the waist and began to dance with him around his kitchen.  He quickly took the lead and was stronger and more relaxed than he was since I walked in the door.  "The man is supposed to lead, don't you know that" he told me and laughed.  I kissed him on the cheek and escorted him back to his chair.  I took his vital signs, listened the his heart and lungs and visited for a little bit longer. Instead of being mad, he began to tell me about his  late wife and how they danced all the time and what a good dancer she was.  

I got in the car and laughed...wondering what made me get him out of that chair to dance.  I turned the radio up to one of my favorite songs and headed to my next patient.

This gentleman has a neurological disease that is slowly robbing him of his movement, language and swallow.  I always have to stop a minute and breath before I walk through the door to his room.  Today, I was interrupting him and his wife getting ready to go to the movies.  "I forgot you were coming today" she said "but I am so glad because you can help me get him ready to go."   I told her I would love to because I had only seen him in bed or in the reclining chair.  We got him dressed and prepared for the transfer with the lift but then she asked him if he wanted to try to stand up.  He slowly replied that he did.  Thinking about how she cares for him, I asked her if I could help.  She showed me where to put my legs and said,  "Daddy, put your arms around Terry and stand up and dance." He stood up and wobbled, but slowly I pulled him closer and we danced into the wheelchair.  Before I could gather myself, his wife combed his hair, straightened his clothes and put a little cologne on him.  He looked fantastic, very handsome and smelled awesome.  I told him he smelled better than my husband and he dances better too!   We rolled him to the car and transferred him in, buckled him up and they left for the movies.  

He was my last patient of the day...and I was feeling thankful.  I though about my paperwork, the charting to be done and the time it would take...and then I thought about how I got to dance.  

As hard as it is to do this work, and lately I haven't been as strong as I want to be...I get such special time with people in their homes on their terms.  And some days...I even get to dance!

We'll tawk tomorrow,
I love you all,

Time to write again...

I took a break...a big one from writing.  I wrote, but everything I put on the paper seemed negative and desperate.  I was turning 50, I was taking care of dying people, my son didn't get playing time on the baseball field, my refrigerator is not cold at all and I was behind on my housework.  Other than that, my hair was mostly gray and my face was sliding into my neck! 

I complained and complained to my husband...about all of this...blah, blah, blah...on an on.  I came to a point when I was sick of myself!

My kids came and went for the daughter was home for one day and left for Guatemala for the summer.  My son, the middle child, was home for three weeks and lightened things up but of course, when he left, the hole in my heart opened up even more. Then, my as my 50th birthday crept up, I was almost inconsolable.  I didn't want things to change and I had no control over it.

Then something happened...a lady that I consider a dear friend went through the most difficult time in her life.  She and her husband had to make decisions that were life changing and scary.  It was the big time in life...when the rubber meets the road and you see who you are and who loves you no matter what.  I watched as they manuvered life terrified but strong.  They made plans that they wish they didn't have to, carried on and made it through.  I am sure in the dark of night, they fell apart...but in the light of day, they handled this crisis with a grace that I wish I had.  

As I sat at my 50th happy hour, I held my breath waiting on the news that their son was out of recovery and it all went okay.  When my friend walked in to join the party and said she had heard and he was good, a chill ran up my spine.  He made it, they made it and now it was time to recover and get going on life.  The night was awesome and I felt so loved and special and came to a realization that this is it.  This is the life we are given, gray hair and droopy cheeks and all.  You can either complain and be negative, sit and wallow like I did for a few months or stop the selfishness and get on with this life!

The next Monday, I went to see a woman with pancreatic cancer.  She had some heartburn on New Years eve and started the maze of diagnosis and treatment.  Now, there isn't treatment left and she is doing her best to live knowing she has limited time.  Two months ago, when I walked into her house, I had my shell on, thinking about "poor" me and the broken appliance and the kids being far away.  In some aspects, it made it easier to care for her because I didn't delve into the hard questions and because she didn't really want to, I just was quiet.  I would be in and out of her house in no time.

Two weeks ago, I showed up with new eyes.  I realized that this is it for her and for me.  This is our life and our time left.  She, sadly, has quite a bit less than I probably have...and she knows it.  I took my shell off before I went in and decided that I would try to help her in any way she needed.  When she brushed me off, I would sit quietly a little longer and see if she really wanted me gone or not.  I ended up at her house for an hour and a half...caring for her.  She sat in the chair for a short time and then she was too tired to keep sitting up.  Her husband took her hand gently and led her to the bed and since it was a tall bed, she had to step up.  She didn't have the energy to do that either.  Then, he gently picked her up and cradled her in his arms and placed her in bed.  He shifted her until she was comfortable and covered her up with a soft blanket.  He got her an glass of cold water and gave her a pain pill.  I stood there seeing this couple for the first time with new, unselfish eyes.  They have been together for 26 years and have kids a little older than mine.  They are in their mid-50's.  

As her husband walked me out, I told him what a good man he is and a gentle man and a wonderful caretaker.  I could see the exhaustion around his eyes and his conflict with wanting her to go and wanting her to stay.  We talked about that for some time without answers or right answers anyway.  I just tried to help him understand that this is all normal when you are losing a loved one.  It just is...

I got in the car and counted my blessings.  I, barring getting hit by a beer truck, will be seeing my kids at the end of the summer and will be fighting with my husband and fighting the hands of time on my sliding neck.  I can guarantee that this lady will not.  

So, for me, it's time to get back to writing, to living, to loving and to being aware of others instead of myself.  It's time to love again...with abandon, saying what is on my mind, good or bad, and taking my licks.

So "I'm baaaacccck" and since I'm fifty now, I can assure you, it won't be pretty.  But, it will be.

We'll tawk tomorrow,
I love you all,

Sunday, April 27, 2014

A wonderful day of baseball...

Last Tuesday, my youngest had a baseball game.  He is a varsity player at the high school.  The season hasn't been what everyone wanted it to be...parents and players, but it is almost over.  Needless to say, it's been a tough one in the scheme of baseball seasons.  In the scheme of's an inconvenience and something that is unpleasant.  But in the big pic...(as the cool kids say)...not a big deal.

So Tuesday, I was ramping up to complain and be negative when two of the cutest kids and their momma showed up to watch the "big boys" play baseball.  The baseball team had gone to an elementary school and put on a clinic before the season got going and these little guys had gone to it and convinced their busy mother that they had to come to a game.   Luckily, I know this mom from church and was so happy to see her and spend time with her.  She's one of those "super moms", looks amazing and has the cutest, politest and most pleasant boys.  I am sure she had other things to do but I, with my big 17 year old boy, was humbled that she would bring her guys to see him and the others play.

We sat in the grass and the questions those boys asked took me back to when I had little guys.  "Why is that guy wearing all that stuff?"  "Why is Howie standing on that hill to throw the ball?"  "Why is that guy standing behing the guy who has all that stuff on?" and on and on.  I talked with these two cuties the whole game and their mother let me and I dreamed about being the grandmother to little ones and how precious that must be.

Howie pitched and he did very well.  He is the guy that goes in when the game is out of control and there are loaded bases with no outs and the kid manages to keep the ball down and throw strikes.  But honestly, I was so wrapped up in the sweet boys and the game, that Howie could have totally screwed up and threw belt high strike after strike and I wouldn't have cared. I was so busy looking at those sweeties with their faces covered in lollipop juice and the velco sneakers and the innocent questions about baseball and life. At one point, the little one asked me where my dad was and I had to laugh and ask "you mean my husband?"  He said, "no, the guy you are always with, Mr Jim, your dad?"  As we walked over to Jim, I explained that Mr. Jim was my husband, like his dad was his mom's husband and his father...but it was so freakin' cute and who cares if he got it?  Sometimes, I thought as I explained it to him...Jim acts like my dad and I guess sometimes I act like Jim's mother so I guess he is not that far off.

The game was over and the boys got to visit with Howie and they really wanted to see the catcher but it was a bitter loss and he didn't come out before their mamma took them home.  But, they did get to watch the "big boys" and have a lollipop and I got to have them on my lap and talk about things that really matter.  I got to explain baseball and ask them about their little t-ball team and I got to feel the activity of a couple of busy boys in my lap.  I got to fly them over my head and tell them how fabulous they were and what nice boys they were and how I enjoyed them.  And I did...a lot!  It turned out to be the best baseball game of the year.

I learned last Tuesday a big lesson.  I learned about how some things, while not the way you want them to turn out, are really not a big deal.  I learned that High school baseball is not a big deal and that who you are in adversity and when things go wrong...figuring that out is a big deal.  I also learned that a couple of little boys can make everything right in the world when they are not your own and you can be taken back to when they were.  That time in my life was so hard and so sweet at the same time.  My boys were hard to corral but easy to love and now that they are big boys...I honor that momma and her work and her time that she spends loving these two.  These boys were the cutest guys I have spent time with in a long time and cannot wait to do it again.

In ten years, that mamma will be in my shoes.  She will have big boys, maybe one at college and one in high school.  Probably, she will be wondering where the time has gone because I know she doesn't feel that way now.  Hopefully, she will be sitting at a baseball game and if the season is tough, I hope someone with little boys shows up and returns the favor to her.  To help her see that it is not such a big's just baseball and even though it's intense, it is not life.    

So thank you Sara...for bringing those cute boys to to the game, for giving me a trip back to when I was you (kinda) and to remember how absolutely precious that time was.  You are doing an amazing job with those boys and any time you need a can call me and my dad, Mr. Jim, and Howie and we would love to corral them, play with them, give the blow pops, and velcro their shoes closed.  It would be an honor.


We'll tawk tomorrow,
I love you all,