Saturday, July 31, 2010

To Everything Turn, Turn, Turn

My poor Joe isn't feeling well. He has caught a virus and sniffles and snuffles something fierce. At 5:30 this morning was ready for some more ibuprofen. I was awake anyway, so I brought it to him with some juice and tucked him in good, then wandered down here for some precious solitude. I really do love my alone time, which always feels a tad selfish when I think about it. I don't know why I treasure so much being by myself. I think it is because I am always thinking thinking thinking and I really enjoy my thoughts. I am constantly writing and composing in my head and sometimes the activity of the world interrupts that to a degree that is actually imbalancing for me. It is one of the reasons I really enjoy going on my long, long walks. I can turn on my headphones and just think my way around a 4.5 mile course. Which in turn meets a lot of needs in me - solitude, exercise, a continuous thought pattern, sun exposure, a sense of accomplishment. Interestingly, this has nothing at all to do with a desire to not see or be with my family. I love that too and I am loving them constantly. It is just something in my nature, to enjoy silence and peaceful co-existance without a constant need to entertain.

I was reading back this morning over my entries from August 2007. My goodness, how far I have come! It is funny, when you are the one living it, its just life. There is no sense of progression really. Its just on and on we go. Its one of the best reasons I have found for keeping a blog. I can look back and have measurable progress. Here I am, about to start my second semester of nursing school and a happier person. Joe and I are now married (yay!), the boys are in high school and middle school respectively. We have a new home (but have been in it a year already. Can you believe that?). Life is good.

We took a five day trip to Nebraska last week to attend the wedding of my cousin, TJ. He is the youngest of my aunt June, whom I have always been close to. I love my family. I really, really do. The wedding was so fun. Nick and Alex absolutely cracked me up. They were dancing maniacs! Most boys their age are so afraid of looking uncool - not my kids. They danced and danced and danced and when the slow songs came, they took turns coming to get me to dance with them. By the end of the evening, they were spinning me 'round and looking smugly pleased with themselves. I had a new black BCBG dress that had an awesome swingy skirt and I felt gorgeous in it and my strappy sandals, so it was a fun evening to dance the night away to every song. It pays to have so many uncles and male cousins and a truly adoring husband as well as attentive, appreciative sons. I don't have any pictures of the dress or really even of the evening. I was too busy dancing to take any! I'd love to have posted them here. Nick is super tall now and Alex is headed that way.

I have to admit, I would love to move back to Nebraska. It isn't going to happen - the boys let me know in no uncertain terms how they would feel about it, and Mom and Stewart are here in Dallas. But a girl can dream. Omaha is so green and lush, with hills and contour to the land. Every house looks different, unlike here with the cookie cutter neighborhoods. Eh, the neighborhoods here are pretty I guess - all brick homes and people really keep up their landscaping. I just miss the contour to the land, the greenness and having four distinct seasons. This time of year in Dallas is just miserable. Too hot to be outside for month upon month - we have to huddle indoors and pray for relief and pay the power bill. I don't know how the settlers did it before there was air conditioning. I bet everyone was super cranky all the time.

School starts for me on August 23 and we have exams the first week of class. I have started studying (finally) and am looking forward to seeing my classmates again. I am so glad I took a position at the hospital over the summer. It has kept my confidence level fresh. I am turning 40 on September 26th and I am going to have an 80s party here at the house (most likely) to celebrate. I need to get busy planning that and send out save the dates. I am stupidly not happy about turning 40. I am not ready to get old...and looking back on August of 2007, I am actually kind of pleased to feel that way.

Friday, July 30, 2010

A good death

Today my attention was drawn to an article that evokes a very passionate response in me. It embodies all the reasons I want to go into oncology and hospice; it draws attention to some issues that directly impacted our family when Joseph was failing. It is an article in The New Yorker magazine by Dr. Atul Gawande regarding hospice and end of life decision making.

I am almost tripping over myself in my desire to say what I am feeling just now.

We sensed when Joseph was going downhill. His father and I knew things didn't look good. We requested a conversation in which we could address our desires if this should be the end for Joseph, prior to putting him on a ventilator. But that conversation did not happen, despite our inviting it. His physicians were not ready to have that conversation, even when we were. They too were invested in his getting well. And we are grateful for that. I have no critisism for Joseph's doctors or the hospital in which he was treated. But the issue remains - he spent the last four weeks of his life on a ventilator, made immobile by neuromuscular drugs that blocked his neurological impulses because he was so agitated. We live now with the questions of whether that was the right thing to do; whether he was trying to let us know he was done and ready to be done. And we did not get any time to say goodbye. Even though we watched him fade day upon day, we were unprepared for that decision and his death. It seemed to come up very suddenly. The week prior there were words of optimism. Then suddenly there was consensus. The doctors had reached the inevitable conclusion and were finally able to tell us so.

I wish so much his final days had been of better quality. The night before he was placed on the ventilator was probably the hardest night of my life, and yet the most precious. It lives in a golden glow in my memory now and brings me to tears to even think on it...tears of sorrow, gratitude, strength. He could not breathe and he was in pain. Yet he was so accepting of help, of comfort from me and so without fear. As long as I was there to help him, he was strong and brave. He requested pain medication and more oxygen and for me to stay close. I wish now we had more time together like that. He was obviously dying. We struggled toward the miracle, stumbling and uncertain, knowing it was akin to trying to win the lottery in a last desperate attempt. It would have been a kindness for the doctors and nurses to say it was okay if Joseph was done, that the hospital would help us let him go with peace and warmth and honor, that we weren't bad parents for wanting him to call this shot and that we weren't killing him by foregoing the ventilator, that he was going to die anyway. I wish so much his last days had been different. I would love to see better training for medical personnel in starting these conversations and better acceptance across the board that it is honoring the wishes of the individual who is dying that is paramount - and usually those involve a desire to be free from suffering, to be surrounded by loved ones and to be in a peaceful environment, preferably at home, without being a burden to anyone.

Read the article and let it make you think.

My family has been informed - no ICU for me if I am deemed terminal with little hope of long term survival. I don't want that lottery ticket. We all die eventually. I want it on my terms if it comes to that.

Monday, July 19, 2010

Middle of the Night

Oh man. It is one of those up in the middle of the night kind of things, aching, hurting, questioning and guilty. The sadness has been with me a couple of days now after writing Joseph's story out for Heroes For Children. He's an Honored Hero this year for their 5K fundraiser in September and they wanted his story for their website. Joseph's picture is up there as well. All of this makes me very happy, but writing it all down has lead me down some sad, dusty pathways. I can get so tortured wondering what his last moments were like, wishing I had done some things differently before he got sick, regreting things and missing him. Can you belive it still can hit me that fresh, three and a half years later? It has been several days of this aching, right on the fringe of my consciousness. It woke me up in the middle of the night tonight. Is anybody ever a good enough mother in their own eyes? I know I certainly am not and was not.

School starts again at the end of August. It feels like it has been too long and my stomach knots up with uncertainty. I am positive that is simply because I have not really started studying yet. Our schedules came in the mail a couple of weeks ago and contained a big list of homework we have to do prior to the first day of class. I was so happy to see it, but I have not started on it yet and I need to for my own sanity and sense of confidence. My externship over the summer has gone well. I am getting exposed to so many different kinds of patients, so many different kinds of illness. I am learning a lot, the central theme of which is being much more comfortable at the bedside and dealing with a wide range of personalities and needs. Interestingly, I have been hit on at the hospital more than I ever have in my life. Must be something about the scrubs? I am always trepidatious when I have a shift coming up and then always so glad I worked when I get there. I love being in the hospital. I often get floated to floors other than the one I was hired to be on and I have no complaints about that. I figure the more contacts I make and the more I get exposed to, the more likely I am to find work after graduation and the more well-rounded I am going to be in my profession. New graduate nurses across the nation are experiencing very high unemployment. Hospitals just aren't hiring, or if they are, they are specifying they wish at least one to two years experience minimum. The nursing shortage will come back in time, but it certainly isn't here now.

I am back to working out more regularly. I have taken to four-ish mile walks listening to my headphones. I love doing it. It gives me guaranteed alone time to just think and process my life. And I tend to eat better when I have done it. I'd love to shed another 40-50 pounds before I graduate. I am working 12 hour shifts and my legs hurt something fierce once I get home and sit still. It scares me to be honest. I will be royally peturbed (to put it politely) if I have chased this dream too late and I am too old to handle floor nursing. Getting more fit will at least increase my odds of being able to do it.

On a happier note, I am thrilled with how much weight I have lost thus far. I ought to post before and after pics on here. It is dramatic and Joe is always good about reminding me of it. I have fun picking out my clothing now and enjoy going into my closet to select my outfit for the day. So opposite of when I was near 300 pounds and dreaded going out in public.

It is hotter than heck here in Texas right now and getting outside to exercise is tough. I hate hot weather and I hate getting sweaty. Of course, sweat is necessary when working out, but there is a difference between getting sweaty and dripping all stinky and flushed and eyes burning from it running into them. I bought all new work out clothing as both reward and motivator and that helps - the new moisture wicking fabrics are wonderful. I've been wanting to post a punchy blog about getting out nearly naked in public. It is so hot that I have gotten to the point I do not care who I offend - my shirt is coming off when I do these walks. I walk at a brisk pace, around 4 mph and I was getting to where it was hard to see from sweat rolling into my eyes. Misery. It was hard the first time I did it - walked in just my shorts and a sports bra. I mean, let's face it. Out of shape and (nearly) 40 is not exactly pretty. That's a whole lotta jigglin' my friends. But interestingly, it also filled me with a kind of gleeful freedom. It was SO much cooler and more free and felt slightly rebellious. Fat chick takes off clothes in public, thumbs nose at society. The truth is, I am not THAT fat anymore. Playboy isn't banging down my door, but nobody threatened to shoot me while I walked either. Nobody drove by hanging out their car window screeching "Yo yo DoughGirl!" In fact, nobody seemed to pay me much attention at all. How many other things in life do I needlessly overthink to the point of paralyzed, fouled up self esteem? How many other ways do I hide and actually hurt my own quality of life? Something for me to ponder.

Ah, I am just so sad inside, here in the middle of the night. I miss Joseph. I have regrets about the past. I am nervous about school. It has been a cranky, crabby, moody summer. I don't like this lull in my goal chasing. Time to start studying. Between that and the hospital, I am betting I will feel better.

Here's before and afters (or rather, durings, if you will):

This first one was taken on Alexander's Make-A-Wish trip to Disney World. He is swollen from being on steroids. I am swollen from being

This picture is of Me, Joe and Joe's granddaughter, Marisa, this past Christmas.