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Archive for the ‘health’ Category


christmas 2007

christmas 2007 (Photo credit: paparutzi)

The small condo is loaded to capacity with family members who live scattered down the south-east coast but are now reunited for Christmas.  Their presents are stacked under the tree in an arc that protrudes well into the traffic lane between the living and dining rooms.  There’s no choice but to pass single file around the mound or to step carefully above the lowest packages stacked.  And there is a lot of movement between the two rooms seeing that the food is in one and the TV and seating in the other.

In the crowd are twin babies whose smallest moves transfixes all eyes on them.  There is lots of ahhing and oohing over the infants by relatives who are either meeting them for the first time or have waited weeks for the special occasion.  The family has waited a long time for these babies to be born and they are most definitely the stars of the show.

SantaHatMy husband and I were invited to share the celebration because this family’s patriarch is caregiver to my hospice patient.  I call her my patient because I volunteer my time in her home.  But  I’m not a medical person and she and I have no relationship and have never shared a conversation.  Her brain has been ravaged by Alzheimer’s and her basic functions of breathing, eating and sleeping is what defines her aliveness these days.  She’s confined to a bed and is even blind now.  Nobody knows how much or how little she understands of her world and her family.  She’s been living like this for years, sustained mostly by her husband and through visits by various hospice professionals.  My role is to give her husband time out of the house to do as he pleases.  And we’ve maintained this routine for close to two years.   My relationship is with the husband who, for me, embodies the meaning of “noble” and who ranks close to the top of my “most admired” list of people.

Almost a decade ago his wife received her lethal diagnosis.  He promised to care for her for the rest of her life and never waivers a moment on that pledge even though it renders him housebound  until someone can relieve his vigil for a few precious hours.  He’s lived like this for years and there’s no forecast of how much longer this lifestyle will continue.  He and I visit once a week but the effects of his selflessness lingers with me.

PartyHatChristmasToday he’s decided to have her join the party.  After-all she’s a mother, grandmother and great-grandmother to everyone gathered.  He didn’t like the idea of her languishing in bed while everyone was carrying on.  So into the wheelchair she is placed (with great effort) and rolled into the living room where all the action is taking place.  Her husband plops into the chair next to her, and with his arm around her shoulder, tells her everyone who’s there. He feeds her.  He opens presents for her.  “Shows” them to her.  Tells her how pretty everything is.  And each daughter and grand-daughter come to hug and kiss her, wishing her a Merry Christmas.  One of them brings the babies and touches their fingers to her arms to say hi.  She hadn’t met them, in fact nobody knows if she understood that her grandson’s wife had given birth.  But none of that matters.  They talk to her as though she’s still a vibrant member of the family and its matriarch.

Such love and devotion with nothing given in return.  I’ve never heard the word “burden” uttered.  And there’s nothing about their actions that remotely hints that.

Merry Christmas to that family.  May those among us who are healthy realize it and be grateful for it.

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It’s a good thing I voted early, otherwise I’d be hobbling into the polling station with a very stiff and cranky lower back.  It’s much wiser and safer to be nursing it with some ibuprofen and a heating pad with hopes that it feels better tomorrow.

No barn duty today either although it’s my morning to help with the horses at the Rescue.  Tuesdays come quickly and they’re usually greeted with a healthy back and ambitious attitude to feed, turn out and clean stalls. That’s actually what may have aggravated my back last week during some pretty heavy lifting in some very dirty stalls.

My back has been in great shape for years, thanks to regular exercise and yoga.  But with the cooler weather here and maybe a case of nerves leading up to the election, my back has decided to take control out of my hands and leave it up to fate.

Our bodies have a way of letting us know when it’s time to let go.  To let go of controlling things over which we have no control.

Lesson of the day and I’m listening.  Finally.  It’s our jobs to discern which things we can control, and the wisdom to let go of the others.

What is control, anyway? 

Is it the need to fulfill our expectations? 

To have our lives unfold according to our plans? 

To be right?  

To continue our personal delusions?  

To assume we know best? 

Yes, I think so.

Being a Type A personality, (actually, I like to call myself a recovering Type A), I’ve always needed to control my destiny.  My career put me in constant touch with news and pop culture and my leadership roles allowed me to be the gatekeeper I needed to be.  I had influence over content, budgets, direction, staffs and the masses.

Perfect. 

As my bank account grew with my advancements, so did my sense of personal freedom.  Money has always meant freedom to me, rather than the acquisition of “stuff,” though I accrued that too.  And with that freedom came a sense of control over my destiny.  Oops, there’s that word control again.

If you think my childhood had anything to do with that, you’d be right.  But that’s another subject.  (Or, if you know anything about the Enneagram model, and my type number, you might also realize control issues are in line with that too.)

Anyway, I digress.  Back to control…

These days the issue of control is one that I’m working to live without.  I’ve consciously started to live my life without assuming leadership functions.  Passion may describe a defining personal attribute, but that doesn’t have to lead to controlling an outcome.  A Buddhist tenet is to do what you must and let go of the outcome.  To not be so attached to the activity and its motivation, but, rather to do what’s right and give the rest up to the wind.  What will be, will be.  I’ve done my part, now let it go.

That’s what I think my back has been telling me for a few days now.  I’ve voted, I’ve been an activist for principles that guide me.  Now, just relax and let it be what it will be.

Thank you, back.

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My column from last Sunday’s paper…

A living will is one of those documents you don’t usually think about until circumstances force you to, and then its piercing questions cut straight to the meaning of life.

How hard, and at what price, do you want the medical system to work to keep you alive? Therefore, what does it mean to be alive? This is not light Sunday morning reading, to be sure. For me, the living will took most of a Sunday afternoon to labor through on behalf of my elderly father, whose health just took a turn for the worse.

The first question asked whether he wanted CPR to be administered. He’s always said that if there’s a breath, there’s hope, so I guessed he’d say yes. But now I read that risks of CPR, particularly in the elderly, include broken ribs — one of which could puncture his lung and require mechanical intervention and a chest tube. He could also suffer brain damage because of less oxygen to the brain, and vomiting that might cause pneumonia if it aspirates into his lungs. Really? Call me naive but I had no idea, and, as it turns out, neither did he. In other words, he could be sicker than when he started.

Of course, the alternative is death. So there lies the question: How alive is alive?

Many physicians spend their days saving lives yet would not want heroic intervention for themselves; they well understand that it’s often futile and, worse, imposes suffering on the patient. Dr. Ken Murray writes about quality of life vs. its length in his poignant blog called “How Doctors Die.” (http://bit.ly/LP2d7g)

So many people wind down their lives in an ICU attached to tubes because traumatized family members tell doctors to do everything possible. They’re expecting a chance for the patient to resume a normal life again. Often that doesn’t happen; the patient may live, but not the life they knew. Family doesn’t realize, nor are they usually told, what’s reasonable to expect. And in the process, tens of thousands of dollars are spent every day.

As a hospice volunteer, I witness the process of dying each week. Patients experience their final days receiving compassionate care that minimizes pain and offers emotional, social and spiritual support. It’s usually not death that people fear, but rather pain and social isolation. Facing the end, people realize that it’s relationships that matter and spending time with loved ones takes priority. A book by Dr. Ira Byock summarizes four things he found matter most to a dying person: “Please forgive me. I forgive you. Thank you. I love you.”

Author and philosopher Joseph Campbell says that the real search isn’t for the meaning of life so much as for the experience of being alive. Nobody wants to end their days wishing I had, or hadn’t — we all want to live significantly and feel we’re making contributions of some kind to the planet and each other. We want our lives to have meaning until our last breath.

One of my favorite reads is by Rodney Smith, whose book “Lessons From the Dying” is, despite the title, more about living. During his hospice career Smith gleaned insights about what’s important in life. There are gems throughout this work, but his summary point might be, “It helps to live with the end in sight.” Each day matters, and living it consciously is a choice we’re all empowered to make.

Everyone is going to die. The question is how do we want to live and at what cost?

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We say yes, he insists no.  What’s a child to do?

Right now my 89 year old father is in a rehab unit hoping to re-gain the strength of his body.  His legs don’t work that well anymore, particularly his left leg that’s grown weaker in the 20 years following his stroke.  The same is true of his arms; the right does the lion’s share of work while the left hangs limp at his side.  He desperately wants to return home where he was about a month ago before this current crisis took place.  There he was able to move ever so slowly using his walker and also to perform the daily rituals of living.  Now he can’t get in or out of bed by himself, bathing and dressing himself is impossible and he requires the help of an aid to move even more slowly and unsteadily in his walker for yet shorter distances than before.  And yet he’s convinced himself that he’ll get strong enough to go home and continue life as before.  It doesn’t look promising, though he is improving.

The food there is good; we’ve tasted a bit of all his meals as they’re delivered.  He’s receiving excellent care, has a private room and is in a very cheerful, bright community of people with a similar cultural background as his.  He’s been accepted into their long term care household which is where we want him to live.  He refuses, complaining about the regimented lifestyle and business-like attitude of some of the nurses and aids.  They have schedules to adhere to regardless of whether he agrees.  He likens it to life in the military some 70 years ago and says he wouldn’t wish it on his worst enemy.

We’re in a stalemate.  Once his physical therapy is finished we’ll have to make a decision.  What do we use as our guide?  Our judgement, as his children, about what’s best for him?  Or his emotional insistence on the way he wants to live out the rest of his life?

Based on history, we think that if he goes home he’ll “fire” the aids after a short period of time because he thinks they’re no longer necessary.  It’s happened before.  He hates spending the money; he considers it wasteful.  He wants to die with his money intact “just in case.”  “Just in case” what?  we probe.  “I don’t know” is the answer.  He can’t grasp the idea that NOW is the” just in case” he’s been saving for.

Life at home consists of sitting solitary in a room and watching TV all day.  His only company is my sister when she returns from work and my other sister when she visits.  On many Thursdays he hobbles to his car and drives to meet his buddies for lunch at the nearby deli.  He shouldn’t, but he does.  I doubt he’ll be cleared by a doctor to continue driving.  He’s convinced we’re wrong.  He must keep his car.

When I was a kid I went to hebrew school and took piano lessons because my parents insisted they were beneficial.  I disagreed.  It didn’t matter.  I went and I practiced — for years.  And years.  And years.  Now, as an adult, I’m a richer person for the experiences.

He doesn’t see the analogy.  He sees himself as the parent who knows best.  We disagree.  Who wins?  And at what cost?

What do you say?  What would you do?

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Growing Old


Health

Health (Photo credit: 401K 2012)

It’s a bitch to get old and feeble.  None of us thinks about it while we’re busy with our lives managing careers, family, friends and the daily mundane chores of living.  Nobody anticipates the day when we can no longer take care of ourselves, relegating decisions about our life to others.

That rude awakening landed square between my eyes while now playing the role of parent to my elderly father.  He’s always been a ferociously independent, active man who supported a family of six, sent his kids to college and provided the religious education he considered to be important.  He ran a business and answered to himself about all matters.

As a renegade, my father felt rules were guidelines that he could follow or not.  He could run red lights if he determined there to be no traffic, but God forbid any of his kids do that if he’s a passenger in our cars.  If his customers were tardy on paying him, his bills could wait until cash flow improved.  Any imposed penalty for lateness didn’t apply to him because of his extenuating circumstances.

Now he sits in a wheel chair while his body defies his craving to walk and go and do.  Now he has to listen to us.  And his therapists.  And his doctors.  And eat food they want him to eat and drink liquids that are unappetizing.

Life is incredibly difficult for him these days and at 89 it’s damn near impossible to become a different man, a deferential man.

My heart aches for him and I wonder whether he will be me someday.

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She lies in bed with her feet curled under the sheets, hands gripped in tight fists wrapped around small stuffed bears to prevent her nails from stabbing her palms. She stares into space, now completely blind, with a blank expression.  Her past-time these days is to curl her tongue around her mouth, stick it out and start over again.  She sips water through a straw, is fed baby food with a spoon and her hygiene needs are attended to by others.  She has end-stage Alzheimer’s Disease and as it progresses, she regresses deeper into infancy.  

Amazing how this woman is ending up where she began.  And, as far as doctors know, she’s unaware of the changes in her life.  Eventually her brain will stop remembering how to swallow.

Alzheimer’s Disease is a tragic way to die.  This woman’s progression is now 8 years into diagnosis with her family responsible for her care.  Their lives are on hold and her husband has essentially devoted his to her, rendering him housebound with occasional relief days to steal a few hours out of the house.

“Hi baby” he coos to her when he returns home.  

“How are you?  

Did you have a nap?  

Are you thirsty baby?”  

Blank stare into space.  Tongue rolls around in mouth.  Evidently that response triggers him to reach for the water-glass to give her a quick swig.  And “quick” is the operative word here.  Her sucking impulse is strong and she’s likely to gulp down more than she can process.  A couple coughing and gasping spells is all that’s necessary before that lesson sinks in.

It’s a lonely life relegated to Alzheimer’s families.  They suffer the disease more harshly than the patient because they watch the deterioration of a human being who used to be a vital member of the family.

There is no substitute for the love of an Alzheimer’s caregiver.
–Bob DeMarco

Pat Summitt stepped down today as Head Coach of the Lady Vols.  Less than a year ago she announced a diagnosis of Alzheimer’s Disease.  Fortunately she has plenty of money to pay for round the clock care.  Most people don’t.  But all the money in the world can’t reverse her fate.  Not yet.  

                                                    Maybe someday?

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Pogo

Pogo is thrilled to be back in our neighborhood to explore his old haunts, no longer tethered to a leash.  It’s not necessary at home;  the woods are familiar territory since the days he eked out a life before choosing me as mom.  For a month the little guy was lost, or abandoned, and became quite successful at rooting out small furry ground creatures and bugs.  He considers the wooded neighborhood his backyard and leads the way on our walks announcing every car, person and animal before they barely come within view.  He’s fiercely loyal and protective of me and our bond runs deeper than any other relationship I have.

Not Bow - but looks as beautiful as she was

It’s always been that way with animals and me.  When I was nine my best friend was the collie around the corner, Bow.  She’d wait for me on her front yard and then together we’d crawl into our fort among the bushes and tell each other secrets about our day, some of which made me cry.  I’m convinced she understood my tears, her chin resting on my knee cooing her soft soothing sounds of compassion while she stared sadly into my eyes.  I always felt better afterward.

My life is filled with stories of serendipity involving animals; most of my pets have happened into our family over the years, rarely invited but always welcomed.  I need them for soul survival.  Never had kids.  Must have animals.  Right now we have five cats and Pogo, my first-ever dog.  Somehow this 25 pound feist terrier didn’t cause the typical allergic reactions that plague Rick around dogs and horses.  Go figure; just one more example of serendipity.   Lucky Pogo and very, very lucky me.  We’re inseparable.

There are a lot of life’s lessons to be gleaned from animals if you’re quiet, observant and receptive.  They’re much more authentic than people, in fact, they have no capacity to be otherwise.  They have a smaller pre-frontal cortex, the brain part that allow us to reason and plan.  They don’t manipulate or have ulterior motives.  They teach unconditional love.  Their emotions, pure and concentrated, ooze out of their being – love, fear, anger, hurt, sadness, joy, loneliness – you just look into their eyes to immediately understand their feelings.

Beautiful Madison, our Persian cat

Rudy & Pumpernickel

Pogo & Willey

Scooter

There are few animals I don’t instantly feel attracted to.  They have an uncanny ability to open my heart wide, drawing me into conversation while the owners stand outside our circle disconnected from our secular communion.  The animal and I become immediate friends.  Humans don’t have the same effect on me.  They’re usually armored with defenses, allowing the approved facade to engage in superficial conversation that rarely leads to any true knowledge of one another.  But animals – the more open you are, the more honest and love filled they become.

Horse and Rider

Horse and Rider (Photo credit: Istvan)

I recently read a book by neurosurgeon and horse trainer Dr. Alan Hamilton called “Zen Mind Zen Horse:  The Science and Spirituality of Working With Horses.”  He too recognizes the spiritual magic transpiring between human and animal once you let down your defenses, open to your vulnerability and invite the connection.  Dr. Hamilton harnesses the energy or chi emanating between trainer and horse to non-verbally communicate instructions for the horse to follow.  And this guy’s a scientist.

James Cameron created Avatars to become divine examples of their human counterparts.  Animals serve as my avatars.  Life’s answers can be found during quiet meditation, interaction with nature and communion with animals.  That’s where my joy is born.

And yours?

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