Friday, December 25, 2015

The true meaning...

Christmas eve is always an interesting time at our house.  We eat soup and then get ready for the service.  After everyone is ready and dressed, we take the family picture.  It takes quite a while to get a decent picture and then we leave for church.

Christmas eve at our church is a great night.  I think this is our 24th year of sitting in a pew on Christmas eve.  It is a wonderful family tradition.

Last night, my mind was on my sweet patient that was close...the angels were coming and it was just a matter of when.  I had spent the day getting her family ready for the transition and helping them with the feelings that they were feeling and the ones to come.

We sat in the same place we always sit at church and watch the crowds come in.  The church was beautiful as always and I was feeling hopeful for the new year and tender for this family.  As the service continued and the songs were sung, I couldn't get my mind off of this family...wondering how she was doing, wondering if they were sitting with her holding her hand on this last christmas eve.  After communion, and the end of the service was near, I had decided that if I didn't hear from them, I was going to call them and check in.  The church had begun lighting the candles for the last song and I watched my candle flicker as they dimmed the lights.  I was listening to the multitude sing "Silent Night" and staring at the blue and yellow of my candle and thinking about how life is so difficult  and yet so good in so many ways.  Just as we started the second verse, I felt my pocket vibrate and knew.  I pulled my phone out of my pocket and saw that familiar number.  As the lights were low and the church sung...I walked into the office and called the number to hear what I knew had happened.  Through a voice muffled by tears, I heard the words, "Terry, she's gone."

As always, regardless of how ready you are, it feels like the world has shifted on it's axis and honestly, for this family...it has.

I arrived to find the windows open and the fire roaring.  The snow was gently falling and the peace in the house was deafening.  They were tired, relieved and so proud of how they cared for her and even as we did all the things we do after a person dies, they continued to feel comfort in the love they gave her.  The husband told me of sitting with her and being there holding her hand until she took her last quiet, peaceful breath.  He took comfort in her comfort and peaceful face and she slept and finally left this earth.  

After we had finished, we sat by the fire and talked.  We looked at pictures and they told me stories of this amazing lady.  It's so interesting to listen to the love of a family at this time and the things that meant so much to them and what they are going to miss.

It was after midnight when I finally left and I hugged them so hard that I thought they would break.  I was so proud of how they loved her, cared for her and spent every minute making her comfortable and know that she is and was very loved.  

I drove on the deserted, snow covered roads home with some instrumental Christmas music playing on the radio.  I thought of this week and the journey that I got to be a part of.  I shed a few tears as I thought of the future for this family and the pain that accompanies loss.  Then,  I thought of my family and hoped that they had opened that one present that we do on Christmas eve and that they had a nice time.  

I walked in the kitchen and the lights were on.  Then, I heard , "Mom, is that you?" and saw my boys walking up the stairs from the basement.  "We waited up for you just to make sure you were good, " they said, and sat and talked to me for about an hour.  I went to bed with a peaceful and full heart.  It had been a wonderfully holy and difficult Christmas eve.  It had also been a blessing and honor to be part of such a intimate and special time with this family.  And then, to come home to a family of my own who understands my work, honors it and cares for me.

Life is such a difficult, messy and heartbreaking  journey.  But, it's also such a rich and holy journey with such intense love and loss that it makes you want to cherish every moment there is.

Tonight, I say...love your loves, tell them so, kiss them and feel the softness of the kiss. Then you know that when you can do that, you have felt the true meaning of Christmas...and life. 

Merry Christmas,
We'll tawk tomorrow,
I love you,

Wednesday, December 23, 2015

The eve before the Eve...

Some days this job of mine makes me swallow hard and choke back emotion.  Today was one of those days.  Not because I can't do it anymore but because there are just some stories that hit so close to home that you can put yourself in the shoes of the person instead of staying the safe distance to walk with the family.

My day started with a visit to check on the family and comfort the patient...change the sheets, wash the patient up and make sure the medications are on target.  I spent a nice hour in her room making her comfortable and doing the things I love about nursing.  When I was finished, she had a peaceful look on her face and fell gently to sleep.

I called the family into the living room and made them sit down to talk.  I asked them if they had any questions and they began to ask. They asked the hard questions, and sat and listened to the answers without tears.  Finally, the question that I had been waiting for...why am I not crying anymore even though I know I should be?

That is a question that families will sometimes ask and sometimes they will feel too guilty to ask because they think they should be crying more. 

I asked them the story of the illness and what it was like for the last year while she navigated treatment.  They told me how she was diagnosed and she started the first treatment with good results.  "The tumor shrunk to half it's size" and they were flying high hoping for the best.  They moved on with life and began the new normal of someone living with cancer.  Three months later, the patient went in for a scan and the cancer was back...and the tears came.  They rallied and she had another  round of treatment and that was difficult but they were ready for the fight and stayed in it with her.  Sadly, when the scans were done, they showed a progression of the cancer as well.  The tears came again with the thought that they weren't winning the fight.  She did everything right and when an experimental chemo came along, she jumped in with full faith that this was going to be the thing that gave her more time with her family.  That treatment took a toll on her and it was clear to the family members that it wasn't working...and that's when the tears came at night on the pillows so as to be totally positive during the day.  And now, while we wait for the angels to come, the tears have run dry...and they feel guilty because as they care for her and watch her sleep, they are hollow.  

As they told me the story, my tears flowed...watching the pain of a family losing it's leader, caregiver and the one that kept the family humming.  We talked and talked...about how they are going through this now and feel numb but the tears will come.  I said," Don't go looking for the tears because they will find you" and I believe it.  Sometimes, it is a gift to be focused on the care and to be able to put all the emotion in your back pocket until it comes bursting out after the person has gone.  Sometimes, if you think too much about what you are going through, you wouldn't be able to finish strong.  The family listened intently and I think they heard me.  I also told them that this is "holy" time and that they were doing everything right.  She was clean, comfortable and in her own bed with her family by her side.  I told them to tell her everything they wanted to tell her even if she was told already...and to know she hears them.

When the visit was over, we all turned to the Christmas tree that was up in the living room with only lights on it and talked about Christmas past.  They aren't in the mood for Christmas and I can understand why.   I gave one more speech of the day and I meant it.  Christmas is a time that families gather and celebrate.  Families make it a point to be together and to try to cherish the time together.  That's what this family is doing...and doing it well.  They have been together through this for a year and now, when it would be easy to have someone else care for their loved one because they feel ill equipped, they are all in...loving her all the way out of here by being by her side and caring for her every need.  If that isn't a way to celebrate the love of family and what Christmas is about...nothing is.

So on the eve of Christmas eve, offer a prayer, good intentions or anyway you communicate to the universe for comfort for the folks that have hollow hearts from the pain of losing someone...and maybe, when the tears do come again, they can feel them and know that they did everything right to care for their loved ones and it gives them peace and comfort.

It's been quite a day...
Have a wonderful holiday season, Merry Christmas and Happy New Year!
We'll tawk tomorrow,
I love you all,

Thursday, December 3, 2015

I always thought he'd go first...

Yesterday I spent most of the day with couples.  Couples that have been together for a long time.  It is always a learning experience for me to watch as they negotiate this  time of life.  The time that when we are just "talking", we refer to it as "some day" but never think that the "some day" will come.

As I've written before, losing a partner...maybe the love of your life or a partner in crime is never easy.  Even when you are watching that partner change before your eyes due to treatment or pain or sadness due to the circumstances.  Yeah, I know when we are really close to the end, most folks pray for a quick, peaceful ending but not until the cold, hard reality hits .

I sat on the couch and leaned forward for the questions.  These are a set of questions I ask at every visit.  They become the basis for our  talks and the basis for the persons care.  Today, the questions went fast because the symptoms are under control.  "Hurting anywhere?" "No"..."Are you still taking the same medication dose that we switched you to last week?"  "Yeah"...and "that's taking care of the pain?"  and we go on from there.

My patient is comfortable and doing what she can to make each day it's best.  For some folks, they have to tell the story of treatment and how it went and what she felt during it again and again.  At this visit,  she tells me that she was blindsided by what she went through and was really surprised that the treatment didn't work.  When that conversation comes up, and it frequently does,  it's interesting to hear the caregivers take on it.  Seems to me that when a patient goes to hear the diagnosis and the treatment options, they hear only half of the information...the parts that talk about how this or that treatment is going to work and although there isn't a cure, they have a good chance.  The caregiver, on the other hand, frequently hears that there is no cure and the odds...the numbers that the doctor gives for the treatment chosen, aren't great.  For a lot of couples, it is the dance of love...letting the person make choices and trying to be a cheerleader although they know what they heard.

I notice that my patient got really quiet while the caregiver was telling the "odds" and "cure" story.  I watch her face as he talks of the ICU hospital trips, the symptoms and the loss of control.  After he is done talking about that stuff, I quietly ask her what she was thinking...not demanding an answer but wondering if she wants to talk.  To that question, she replies, " I always thought he'd go first".  A quiet settled on the room and the caregiver agreed after wiping tears from his eyes.  "Yeah" he said," we talked about it and the numbers shake out that the husband outlives the wife and she is left.  That's how we always planned things, money, wills, everything as we got older.  I thought she would be taking care of me."

For me, that is one of those moments when I swallow hard and turn my head.  I don't want them to see me cry because it is such a beautiful moment for a couple to see the deep devotion they have for each other...even if they never thought they had it.  I looked over at my patient and asked, "did you think he was going to take such good care of you" to which she replied, "no."  It wasn't a mean "no" or a "no" that had years of resentment tied to it.  It was a pure, sweet surprise that this man was going to do whatever it takes to make his wife of 45 years comfortable and know that she was loved and cherished.     

I looked across the room at the husband and told him how sometimes spouses cannot do this and  we figure out other ways to care for their loved ones.  He was surprised and said he may need help, but they weren't going anywhere.  They took comfort in being in their home, with the animals and the belongings that they have together over 45 years...the pictures of memories and love shared during their time together.  "I wouldn't have it any other way" he said and looked over at her.  They exchanged that knowing glance of a life weaved together for so many years that is changing. We talked more of the gift of being home and being together and being able to do whatever they want that day.  My patient was taking all of this in and watching her husband as he talked of the upcoming changes and his plans to make things easier for her.  I could see her eyes change to admire his thoughts and caring.  

When I finished and began to say goodbye, I reminded them of how lucky I was to be part of this journey.  I talked of things that happen during this time that are unexpected and comforting even though it is hard to see that.  The patient nodded her head and winked knowing what I meant.  That while time is short, this patient is going to be loved so well and so completely until it is not an option.  Then, this husband will rest in the knowledge that he did everything right to care for his partner of 45 years.  

When my heart gets tired and I wonder why I keep doing this kind of nursing, a day like this happens and makes it crystal clear.  We make plans every day on how things are going to go...and then they don't.  We have to change our plans mid-living and go from there, doing the best we can.  Thankfully, I get to see that every day.

So remember, plan well, hope for the best and when the plans change drastically...just love.

We'll tawk tomorrow,
I love you all,

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 last...in 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 lessen...my 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 something...joy 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 looking....it 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 hard...is 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 all...it'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 place...one 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 love...my 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 me...it 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?  Love...Love...love.  

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 do...love 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,


Sunday, March 29, 2015

Learning to let go...

I just experienced my last spring break vacation with my last child.  He will finish high school in 2 short months and go to college after the summer.   The magical mystery tour of being parent to children at home will be over.  Yeah, I know they will come home but mine, for some reason, leave and do not move back.  They visit and we talk but it is very rare for them to spend more than a couple of weeks at home between gigs.

This year, another mother and I volunteered to be the cooks and "bottle washers" for the Varsity and JV baseball team  for the spring break trip. There were about 22 teenage boys. We were to feed the team, keep them hydrated and make sure they were okay.  In other words, be "Mom" while they were away from theirs.

As I was preparing for the trip, I began to realize what is about to happen.  My son will be leaving the nest in 2 months.  My days will not be based on getting home to make dinner for the family and the house will be empty if Jim is not home.  We are going to have to become a team of him and I because that is what we are going to be.  Might as well not fight it but make the best of the time left.

As we drove to Arizona, we talked and we dreamed and we counted our blessings.  We disagreed about plans and tried to figure out how it all should be.  Then, as time wore on and the miles went by, we rested into a comfortable silence.  We didn't need to talk and just looked at the passing scenery.  I began to think of how things will be when we are alone again.  It wasn't such a sad feeling as it has been in the past.  It was certainly bittersweet as I pondered where all the time has gone.  But then I began to think about all the things we got to do when they were growing up and cherished the memories.

We arrived in Arizona on Sunday night and began our "vacation".  The team arrived around dinner time and I put out 15 pounds of pulled pork that I made along with salads and desserts.  They ate it up and each one thanked me and told me it was good.  I smiled to myself and thought about how I am going to miss that.  The days turned into baseball, taping sore muscles, tending to boys that are not quite as together as they seem and listening to who they are.  They are good boys, negotiating high school and baseball, girls and themselves and who they are and who they wish to be.  They are deep and shallow, clean and dirty...growing and thinking they are all grown up.  It is an amazing transformation that kids negotiate at this time and I got to spend a week watching it. 

They played some good and not so good baseball on beautiful fields.  They played basketball and swam in the pool when they had free time.  They ate and ate and ate and I swear some of them were taller when we left than when they came.  

We did most dinners out on the patio by the grill.  The boys would go through the line and fill their plates and then sit down.  After they got settled, I played waitress...asking them if they needed anything else or brought them a drink or a napkin because they forgot.  It made me feel good.

I have spent a long time fighting change and feeling anxious about it.  But, for some reason, this time,  I am a little better.  Now, don't get me wrong...I will be sobbing when the time comes to say good bye to my boy but for now, I don't want to clutter my brain with worry.  It is coming whether I worry or not.  We have them, they grow up and they leave.  If we are lucky...it is that easy.  Sometimes it's not.

So as usual...I have unsolicited advice.  Life is long and hard and busy...but then it's not.  It slows down.  That's when, for me, the regrets come.  I shoulda stopped and played more, I shoulda held them longer and kissed them more.  I shoulda...and if I knew then what I know now, I  woulda.

This time, as this one gets ready to fly to coop, I am not going to say I shoulda.  I kiss him a lot (more than he wants me to) and I spend any time I can get looking at him and loving him.  I also kiss the other two when they show up...a lot...and I kiss and hug their friends too.  I am not going to miss a second of this time.

I believe we are supposed to love in this lifetime and it will change everything.  I saw it last week with the baseball team.  I loved them, I tended to them and I fed them well...that's how I love and it was great.  

So, life is life and every day, we have a choice on how to respond to it...

I say love...love...love!

We'll tawk tomorrow,
I love you all,

Tuesday, March 17, 2015

A tribute to a co-worker...

Day in and day out, at some time or another, I talk to someone about the end of their life.  I explain the choices, try very hard not to interject what I think and answer questions.  My husband tells me time and time again that I have a "warped' view of life because of it.  I am beginning to think he is right.

Death is such a part of my life, that I wonder how I will do when it comes to me.  I hope I will be calm, level headed and able to handle things...but hell, I'm not that now so why would I think I was going to change?

Like I have said many times before, I get a ring side seat to the worst and the best of life.  I get a gift almost every day to watch families explode apart and come together again and make things work.  Actually, most of the time, I am in awe of the folks I care for the strength they have.

It's a wonderful job but it takes a toll on a nurse.  My compadre...my buddy, the one that  helps me care for this side of town decided she was going to get another job.  She was ready to have time to do the things she loved and not work or be thinking about her work 24/7.  When she called me to tell me, I started to cry and so did she.  I am sad to lose her to another place because her patients loved her dearly and when I covered for her, the visit was all about how awesome of a nurse and a person she is.  I have to admit that I got jealous at times and told them to tell her they liked me better!  

But, I totally understand.  Being a nurse, and even moreso, being a hospice nurse, you have to be all in.  You have to put your heart and soul into the folks you care for because  if it were you...you  would want nothing less.  

That's what my friend, my co-worker, my toe nail cuttin' buddy and my happy hour girl did.  She put her heart, her soul and then some into her patients...until there was nothing left. 

Sometimes, after a particularly difficult situation, there is not enough "comfort" to make it through.  I believe that and I know that even I need to work harder and finding comfort  in other places than what I do now.  I also need to know when to say I need a break so I don't have to leave.  That, though, is easier said than done.

It's funny, as I read this, I could be talking about any nurse that I work with.  We work hard and want only the best for our patients and sometimes it consumes us.  It's easy to spot who is ready to crack and who is doing well.  

But again, it is a choice.  I don't have to do this kind of nursing if it is eating me up inside.  I can make a choice to find something else that will feed my soul.  That's what my buddy is doing.  She is not bitter and not negative...she is real and she is making good decisions for her life and her family.  I admire her so much for that.  The problem is, I am going to miss her...her heart, her smile and her awesome way of going above and beyond to care.  

So, my friend, I will miss you a lot...I will be ready to do happy hour after toe nails, and will tell every nurse that I meet what an awesome nurse I worked with in the last year.  May you paint and cook and raise chickens and love your son and husband and be present in every moment with what you love.  God knows you've made my life better by knowing you!

Take care of yourself, friend and let's get together soon.

We'll tawk tomorrow,
I love you all,

Thursday, February 5, 2015

A life that matters...

I went to a funeral last Sunday.  It was one of those funerals where the church was filled and the family was strong.  They got up and read psalms and readings and said wonderful things about the guy. 

He was a regular guy.  He was the father of 5 kids, husband of a wife of 50 plus years and I think, had it all right.  I mean, probably not all right but mostly.  He loved his wife dearly and daily and it seemed to exude from him.  Not in a loud, talkative, all over her type of love...but a quiet respect, a knowing look and a small smile as he looked her way.  They were a team.  

He was ill for quite a while.  He struggled daily to be and do what he wanted to and he kept the fight on for years.  His kids rallied to help their mom and he remained faithful and kind.  

The funeral was really nice and the readings were great and I began to drift into my "funeral" thoughts...you know, when I die, I will have this song and this pastor and blah, blah, blah.  Then one of his friends and coworkers got up to talk.  He began with the standard fair and then talked about how his life mattered.  

This man did not live a flashy life.  He lived in a small house, he had tons of kids, he did what he could for others...and as I listened...was a lot.  The coworker talked about how every person he came in contact with understood that they were special.  He didn't do it the same way every time but he did it.  He worked in a "group home for boys" and these were the boys that needed a guy like him.  He was in the perfect place. 

I began to think about our relationship and how he made me feel like I was special.  Many years ago, his daughter and I played softball together and he and his wife came to every game.  I had three little kids, and his daughter had two and we were having the time of our lives.  He and his wife would sit right behind home plate and give advice.  As I remember it, every time he was at my game, I would hit a shot out to right field that would turn the fielder around.  I would trundle around the bases and get a triple and sometimes I would make it all the way home.  From then on,  he was my good luck charm.

Fast forward 15 years to a man who was considering Hospice care and by the grace of God, I was in the office.  When I saw his name, I told the girls in the office he was my "good luck charm" and I had to take care of him.  I related the story to them.  

When I arrived to begin my care for him, we talked about the old days and I thanked him for coming to all of my softball games to see me play.  I told him that I used to wait for him to walk up the sidewalk and I knew I was having a great night at the plate.  As we visited, his daughter (who is my dear friend) informed me that he was coming to see her play, not me...and that was that.  I disagreed with her and told her...all these years, I was sure he was coming to cheer me on...sure he wanted to watch you play but he was there for me.  He made me feel like my little old softball game was important to him and he was there to cheer me on!

I spent the next few weeks caring for him and it was a joy to be able to give him a little of the love back that he gave me over the years.  But, even when I was the one offering the care and love, he never let me leave the house without a prayer.  I would pack my nurse bag up and he would say..."we have to have a prayer" and we would hold hands.  Then, true to his form, he would thank God for Me...my skills and having me with him as he was on his journey.  

I left the funeral thinking I want to be like him.  I want to live a life that matters...a life that is remembered well and lived well.  I muttered that to my husband a few times when we were driving home.  Then, I asked, what is a life that matters?  I would imagine to some, it is having an awesome house, great body and handsome husband.  I have 2 out of 3 there and it still doesn't seem to make me content.  So what else makes for a life that matters?  Is it stuff, is it great vacations, more money than time?  Is it a job that you love and great people to work with?  

I think it is all of that at different times in life.  I know that when I had three little ones and they didn't bite or get in trouble at school, I was living a life that matters.  Then I went to Juarez and Nicaragua in the 90's and saw poverty and thought going there and building was what was going to make my life matter.  And, it did...but I couldn't do that every day or every week or even every year.  As I hit the second century of my life...I couldn't figure out what makes my life matter.  I believe end of life care makes my life matter but I always end up getting more love and wisdom than I try to give.  Does that take away from what matters?

I learned on Sunday what makes a life matter...meeting people where they are and letting them know they are special...letting them know that they are special to me and that my life would not be the same if they weren't part of it and...not to use words but use actions and behaviors.  You see, my friend didn't come to every game and tell me that he was there to see me...it was in his smile for me, his words of encouragement and his funny smile when I thanked him for coming to see me play.  He could have said he was there for his girl...but he didn't and it made my softball nights for many years and still makes me warm up inside when I think of him.

Because he did...he lived a life that mattered.  As I sat in that church, I felt the challenge to step it up and get going.  So, Thank you dear friend and know that you are an example of what matters, or living in a way that matters and I am going to make a daily effort  to make my life matter...one special person at a time!

May you rest in peace dear friend!

We'll tawk tomorrow,
I love you all,

Saturday, January 10, 2015

It's better to burn out...then to fade away

It's been a while since I have had the quiet brain to sit down and write my thoughts...but as I sit here, my house is quiet, my coffee is hot and my computer is charged so I am going to give it a try...

The other day, I sat at my computer when my boss walked up.  "How are you?" she asked.  "I'm good,  things are just hard right now with my patients" I replied, hoping that she would walk away and not ask anymore questions.  But, because she is an awesome person that happens to be my boss, she continued..."It seems like you have had your share of hard cases lately, and I can tell you are struggling.  You have to figure out how to back off a little so you don't burn out."   It's funny that she noticed because I have been thinking a lot about how to cope these days.  It's been on my mind for a month or two as I begin this new year.

People have been asking me how I do "it"...deal with one of life's hardest times for families day after day, week after week until they are gone.  It is a great question...how do I do it?  One would think that seeing suffering, dying and sadness becomes common place, that it becomes, as my son told me yesterday, "all in a days work."

Not so much...

There is so much in life that is how you look at it, wouldn't you agree?  It's perspective...

Last week, our community lost a father, son, cop and all around good guy who stopped to help a stranger.  It was cold, it was snowy and it was a situation that he could have just drove on and said, "I'm  off and I have other things to do" but he did not.  So in a split second, without notice, he was gone.  No diagnosis, no planning for the future, no pain medication for symptom control...no time to change relationships if need be...no nothing.  One minute here, the next minute gone and life as it was changed forever. 

I tell this story because usually, in hospice care, it is different.  I can't say that a family and patient that sign up don't have emotions and it is all wine and roses...but there is usually time to do some preparation for the changes to come.  There is planning that is offered, spiritual support if that is what the person and the family needs, explanations of how disease processes progress and time to talk, to fight, to love each other... 

There is always some comfort in caring for the person...be it helping them come to terms with the end of life, or stopping the busy life and sitting and talking.  Many families will pull out the old pictures and recall the wonderful times and maybe not so wonderful times together...they comfort each other and understand the love that they had.  They learn things about each other that they didn't know and see each others hearts.  

I like to think that there is a measure of control that they can have back in the midst of the struggle.  They can choose to struggle or choose to stop the struggle.  Hospice puts those decisions in the hand of the person who has the terminal illness.  It takes it out of the hands of the doctors...

And finally, it allows the patient to be at home...in their favorite chair with the dog or cat on their lap or in their bed with their love next to them.  They can sleep all night or be up all night and it is their choice...and that is a comfort unto itself.

From where I stand, being a hospice nurse is a blessing to me.  Oh yes,  my heart aches daily and I am pushing feelings to different parts of my heart but...I can't imagine doing anything else and Lord knows I've tried.

These thoughts leave me with two questions to ponder.

1.  Isn't living life the the fullest and living on the edge of "burn out" all just how you look at it, your perspective?

2.  When bad things happen to good people, and they do...people become softer, more loving and are ready at a moments notice to help...wouldn't the world be a gentler place if we acted like that most days?

I have no monopoly the "right" way to live or for that matter, die.  I just drive from home to home and family to family and ponder these things...hoping to be what each family needs at the time.  And some days I have the greatest ideas for helping that are epic fails...But, I try and to most people...that's all that matters.

So I'm gonna burn out I guess...continue to try to care for folks with my whole heart and deal with the fall out when I have time.  It's what I would want if the nurse was caring for my loves in my life...

Let's all burn out together from helping each other in this hard world...maybe soften it a little for someone else and each other!

We'll tawk tomorrow,
I love you all,