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Showing posts with label preparing for death. Show all posts
Showing posts with label preparing for death. Show all posts

Monday, October 8, 2018

When our Cancer Journey Doesn't End with Happily Ever After...


Just months before mom's pancreatic cancer diagnosis in 2010, a brave, young woman was sitting in a doctor's office receiving the very same diagnosis.

Her name was Dayna.  And she, too, decided to start a CaringBridge site to keep family and friends updated on her progress.

For weeks, months and now years, we have been following the cancer journey of this beautiful soul...

Dayna shared her heart with sweet humor and breath-taking candor... One of her signature sign-offs was to list "3 Things I Loved about Today."  She had a gift for gratitude that simply overflowed, despite the most difficult of circumstances.

On August 13th, 2014, we read her husband's last entry on their CaringBridge site...

"Forget the strong man; this one is about the strongest woman I have ever met.

She was told she had merely a few months left with us and went on to live a few months plus four years.  Later, after 7 different types of grueling treatments, she was again told to get things in order.  Told she likely had a few days, she stretched those few days into months.

Ultimately, cancer picked the year, the month, maybe even the day; but our darling Dayna picked the moment to let go.

Just days before her passing Dayna wanted me to post on Facebook and CaringBridge that she was in the hospital again.  However, after comparing herself to the boy that cried wolf, she asked me not to once again tell everybody that this was "it."  Instead, she said I should "just tell them I am on a teeter-totter."  I promised I would post for her.

My intent was to do so sooner.  Please forgive my tardiness; I was busy loving and enjoying her 24/7 until Friday morning, and busy loving and mourning her since.  As she requested, I will give you a brief account of her last days, but first something to make you smile.

When Dayna asked me to write on her blog she said to write it in my own style, but "be sure not to forget the poo and the pee, you know, the good stuff."  That left me with a bit of a dilemma, as those are not subjects that I am very comfortable talking or even thinking about.  All the same, I will share a moment that I think shall suffice.

Rick, Dayna's hospice nurse came to the house one day not long ago to check up on her and see if we were in need of anything.  As he sat down on the ottoman and began the barrage of questions that are routinely thrown at patients, he asked:  "Dayna, how are your bowels moving?"  Without hesitation and in a sincere tone, Dayna answered: "good, and how are your bowels moving Rick?"  Looking to the ceiling while contemplating, he took a few seconds and then answered Dayna "pretty good.  You know, in all my years on this job, nobody has ever asked me that question before."  "Hmm," she replied with a shrug, "It only seemed polite to ask."

And that was classic Dayna: quick, witty, sincere, caring, funny and controlling the room with that signature smile throughout it all.  A combination that always put a smile on the faces of those who luckily shared time with her.

At 7:50 AM on Friday, Dayna and her smile moved on to a place I like to believe is gentler, kinder and more peaceful (with a lot of dancing).  The Saturday prior she had trouble breathing at home and needed an ambulance to bring her to the U of M hospital.

There she spent a couple days highly sedated and in a breathing mask that enclosed much of her face, completely surrounding her nose and mouth.  She didn't eat and would periodically drink through a straw when we quickly unhooked the mask and pulled it to the side.  Worst of all, she could hardly communicate:  her mind was jumbled from the high dosage of medications to suppress her shortness of breath, and the mask itself, which actually forced air into her lungs, made it difficult to be heard and really frustrated her when she tried to communicate.  She resorted to writing things down.  She persevered, and managed to get all the things she wanted organized and carried out communicated to her girlfriends, family and myself.

A beautiful thing happened halfway through her nearly one week stay:  we found a high flow nasal canula that allowed Dayna to remove the big oxygen mask.  It freed her mouth and allowed her to be heard when she spoke and she began eating.  Like always, I began thinking she was on the mend and we started looking for breathing devices to get her home again.  I even sketched up my own high-flow system to be made at home after the medical supply store told us that there wasn't an at home option.

With her breathing seeming stable and her will to converse with visitors we opted to lower her meds to find a sweet spot where she was lucid as possible without having panic attacks from the shortness of breath.

We found that spot for a couple of days, and she was still hoping to make it back home to her own bed.  However, the disease was still doing its thing and it was eventually realized that going home would no longer be an option.  Bravely, politely, she asked only to be moved to a bigger room where more people could comfortably visit her.  They made it happen.  Happily.  And perhaps with a nudge from wonderful Dr. Lou Emil.

On the transport from one room to the other she had a terrible panic attack that took some time and meds to calm.  It was horrifying to watch and no person should ever have to endure such fright.  This is the true pain that I am happy and grateful that she will never again be faced with.

Thankfully, that evening was nothing short of beautiful.  Friends and family came to visit.  I drove home and brought her back a surprise.  Stella licked every salty inch of Dayna's face and arms, and Dayna smiled and sobbed with tears of joy.

That evening the guests left and my parents took Stella back home.  Dayna's father, George, and I remained.  She asked me to pull up a seat on her right hand side, and her dad sat in the recliner on her left.  We shared some cupcakes the nurse so kindly brought us, and Dayna chatted and chatted, refusing to let either of us go to sleep.  I didn't want to anyway; it was the most lucid she had been since being admitted.

The three of us held hands until around 6:30 AM.  "My two favorite men in the while world," she affectionately said at one point... It was so magical that I should have known it couldn't last.

The fact that she was so lucid probably had much to do with the fact that the infused drugs were losing a bit of their effectiveness, and because of such they were not able to do their job at suppressing her shortness of breath.  She had another breathless panic attack, and ultimately had to be put back in the restrictive full-face mask.  Once again, the horror of her panic attack is hard to put into words.  After some time of quiet thinking, she made it known that she could not face further days of breathless torture.

What happened in that last hour is very personal.

She chose to remove her oxygen mask.

We held her hand and whispered kind words.  And at one point she told her father and myself  "thank you guys.  I know this isn't easy for you."  Thinking of others right till the end.  It was awesome and awful.  And I am so thankful that I was with her through it all.  I am also very thankful that her father was there as well.

In the next hours we made contact with family and friends and a few came to say goodbye.  After breaking the news to one of Dayna's dearest friends, she asked me to whisper a message into Dayna's ear.  I did.  And then I sat back up and just stared towards the window.  Suddenly, something tapped me in the back of the head.  Startled to the bone, I looked around but nobody was near me.  I looked up and down.  Nothing had fallen.  There was some force that bumped my head.  Maybe it was the non-coincidental sign I asked her to give me.  Maybe it was her letting me know I didn't need to whisper to a broken down vessel that no longer confined her.  But it was Dayna.  No maybes in my mind. 

Now to end it with a smile.  Going back to right before they transferred her to her larger room.  She sat at the edge of her bed, excited about hermove, and evidently even more excited about seeing Stella.  It had been five days since she had last had a dose of puppy love.  I carried the second load of belongings to our new room down the hall and walking back into the small room I saw Dayna throwing her hands over her eyes, and holding that smile that seemed to grow by the second.  

"What are you doing, Silly?" I giggled.  "Wait, wait," she said.  "Do you like games?  Let's play a game."  Hands still firmly over eyes and smile big as every she asked, "Who are you?  Do you have hair all over your body?"  (Um...some but not all over)  "Do you like to lick me all over the place?" (Dayna, I think...)  "Is your name Stella Bean!"  She tore her hands from her face and looked around for the dog.  Laughing, I explained to her that I only left for two minutes and the very minute they moved her into her new room, I would quickly go home and get her Stella Bean.  And they did; and I did.  And seeing how ecstatically happy both Stella and Dayna were when they were reunited was pure beauty to behold.  Exactly, I bet, what it is going to be like when Dayna and myself reunite too.  I can't wait.

There was a moment that day, either when being silly about guessing if Stella was visiting or just making the nurse smile like she always did, when Dayna said, "Isn't it fun talking about serious things in a silly way?"  I know she thought it was fun.  That was what made her journal entries such a joy to read for everybody.  I know that all her CaringBridge fans helped her get through the rough times and helped her celebrate when the days were great.  On behalf of Dayna, the strongest person I ever knew, and myself, thank you all for being part of this wonderful Circus.

Three things I love today:

1.  Realizing that I could never again be scared of death, knowing she is waiting for me.

2.  That she left Stella Bean to watch over me for the time being.

3.  The love and support of family and old friends and all the amazing friends and family I gained through Dayna.

I love you Dayna.  Smile down on us today  :)"




Sometimes our cancer journey doesn't end with that Happily Ever After... Sometimes we fight endless battles only to lose the war.  It will never be fair.  Never be right.

Dayna's Story of Love has touched me and stayed with me in ways I could never explain.   Perhaps it was the way her husband shared he could never again be scared of death, knowing she was waiting for him... It is a haunting grief framed in the most beautiful of love stories...

Thank you Dayna for being a beacon of hope on this dark journey.

You have been a Priceless Gift...

Tuesday, May 21, 2013

The Final Chapter... with grace

How do we "do" graceful when we're facing the autumn days in our life?

I'm not sure... There's been much written about handling life's end with grace and dignity, but in the nitty-gritty mess of it all, how do you really "do" graceful?

We are walking that road with Leroy's parents.  It breaks my heart to see their once proud heads stooped, gray and weary...



These days past have been spent back in Illinois.  This time, Leroy's mom... Another fall, dehydration, hospital stays... weak and fatigued.  Strength wrung out, life energy ebbing.

Where do we go from here?

Doctors are advocating a nursing home/rehab unit.  And we accept the necessity... but Leroy's dad isn't "doing" graceful.  He wants to be at home.  With his wife.

And this is where it gets messy...

Millie has been there for Don for 62 years.   She's been a faithful companion, help-meet, loving partner... and major cook and bottle washer to boot.  And now her tired eyes speak truth... she can't do it anymore.  We know.  She knows.  For goodness sake even their pastor knows.  But Don doesn't want to see that... it is so incredibly difficult to accept that our bodies have betrayed us...



And so we talk.  And make meals.  And drive him to the hospital to visit Millie.  And get the wheelchair out of the car for him.  And carry in the portable oxygen.  And pray for strength to return to her frail frame.  And sigh when we leave, knowing that tomorrow we will do it all over again...

And how do you watch a heart break?

How do you do graceful?

In the quiet morning hours, we offer solutions.   Come stay with us.  Let us help.  No, the gray head shakes.  This is home.  Our doctors... are here.  Friends.... are here.  All that is familiar.... is here.

All that is... except Millie.

So we suggest hiring help... with the housekeeping, and the meals, and the bathing, and the lawn care, and, the list is endless...  Don's expression at this suggestion needs no words... we make another pot of coffee and slice into some warm apple pie... the universal remedy when there is no answer...

A niece arrives with sunshine and smiles.  We visit the hospital and make plans, offer another solution that Millie approves of... perhaps the new Assisted Living Facility across town?  And together with our sweet niece, we coax Don into a tour.

And find it totally charming.

And possible.  But for the price tag... It is a private-pay facility and runs high.  Even with their long term care insurance it is out-of-range.
 
And so we headed home.   Defeat weighing heavy... and not very gracefully. 

In the ensuing days, Don digs feet in firm and insists he will stay at home.

Millie's doctors are equally as firm, she must go to nursing home/rehab unit until she regains some strength.

Stale-mate.

If this were a 30 minute sit-com, we'd be arriving at the happy ending by now... But, real life is messy.  And difficult.  And not at all like we planned...

And I have been dragging my feet writing this post because I wanted an answer to the messy, a graceful solution to the dilemma, a roadmap for the difficult.... instead I have been given this... a word. a prayer... from a dear friend, who knows our hearts are hurting right now:

There is hope to be found
in the midst of our pain.
The darkness, the heartbreak,
the sorrow, and the grief
are not permanent.
The Lord's compassion never fails.
He is good to those who hope in Him,
who seek Him,
who wait quietly for Him.
He knows your suffering and
will give you the comfort of His presence.
Walk with Him step-by-step
each day and you will know happiness again.
Life as you knew it has stopped,
don't rush the healing,
the grief will come and go like waves.
Embrace the Lord thru it all,
He will bring you thru it.
 
 
Hope in the midst...
 
Walk with Him, and with Don,
A walk in love and honor and respect...
 
A wait for Grace...
 

Wednesday, December 28, 2011

The Perfect Storm

Mom was diagnosed with Pancreatic Cancer on November 16, 2010.  From the onset we knew she was terminal.  Well, that was the doctor's prognosis.  We believed there was always the Miracle option.  The statistics are grim, but even so, close to 5% of pancreatic cancer patients survive 5 years.  We agreed that would be our Miracle.  Survival.  Living.  Loving.  As long as God deemed fit.

Mom lived 12 months and 3 weeks from the time of her diagnosis. 

Sometime during her fight, she became rather concerned, almost morbidly so, with how this cancer would actually end her life.  I had to remind myself, often, that she's a nurse and with her medical background it was only natural that she would be fixated with the course of the disease.  I am finding out however, that many people who are given a terminal diagnosis wonder the same thing.  Just how exactly is my life going to end?  Will it be painful?  Will I be weak with nausea and vomiting?  Will I know my loved ones right up to the end?  Where will the cancer spread?  How mobile will I be?  Will I be ready for death? What will it be like? Will I know I'm dying?

Morbid questions.  Agreed.  But honest, nonetheless.  Mom even asked her doctor about 3 months ago what he thought about her impending death.  Just how would she die?  Left him speechless for a minute or two, then he quietly looked her in the eye and said, I can answer that.  I held my breath, expecting some horrific description.  A long pause, and then he said, I don't really know... depends on so many variables.

Mom was let down for a day or two.  I think she really wanted to know what to prepare for.  I mean, real specifics.  And there is probably no doctor worth his salt that could predict what mom's last few days would be like.

In our opinion, mom's death was a result of The Perfect Storm.  Not one, not two, but so many events that funneled down together into too few days, laying seige on her precious body.  An assault so detrimental there was no chance of recovery.

Yes, the death certificate says her cause of death was Pancreatic Cancer. 



And I guess that's the truth.   But that's too simple.  What happened to mom's body, the real cause of her death was a culmination of medical crises that simply overwhelmed her weakening reserves.

That Perfect Storm began with the pancreatic cancer.  In treating it, mom fought hard, with radiation and chemotherapy.  The side effects from treatment were brutal on her body.  The chemotherapy continued to knock her blood counts down each cycle.  This last time, the white blood cell count and platelets bottomed out like never before.  With her white blood count so low, her immune system was drastically weakened and she picked up a nasty pneumonia bacteria that infiltrated both lungs in a matter of hours.  And with her platelets so low, that seemingly innocent slip against the coffee table the Saturday after Thanksgiving, caused a horrendous bruise on her hip that turned into a virulent strain of cellulitis within a few days.  The two infections caused a massive strain on mom's body.  Despite 3 potent antibiotics and numerous blood transfusions, her body just couldn't recover.  Her blood glucose began dropping, giving way to heart arrythmias and finally kidney failure.

The Storm lasted 7 days.

Mom now has the answers that her doctors couldn't give her.  I wish she could part the veil just once, and tell us what she experienced as she faced this last walk on her journey.  And then smile once more for us.  My heart is greedy.

I can share what we know.

Was there pain?  Oh yes, there was.  It is one of the hardest memories to endure.  The nurses and doctors increased the morphine almost hourly to keep her comfortable, and I know they succeeded almost completely.  As the doses increased she slept more and more.  It was blissful oblivion, and one of us kept vigil the entire week to make sure she never woke up alone.

Was there nausea? vomiting?  To our everlasting relief, there was none.  As a matter of fact, in the early days of that week, mom's appetite actually returned and she savored desserts with delight.  The last morsel of food that she ate was a brownie delivered by a sweet friend.   So very grateful for these small blessings.

 How mobile was she?  Not very.  The pneumonia made her so weak, and the bruising/cellulitis on her hip was so painful, that moving around wasn't high on her agenda.  As she weakened and the morphine increased, she became bed-bound for the last 4 days.  But she was comfortable there, with a beautiful window view of the sky and front gardens.  The only thing better, would have been to be able to take her home...

Did she know her loved ones up to the end?  An emphatic YES.  Even with the morphine induced slumber, when she woke, she recognized us and spoke specifically, calling us by name.  As death neared, her ability to speak faded, but not the acknowledgement.  She would squeeze our hands and nod her head.  When my brother arrived from Houston, just 18 hours before her death, she smiled in greeting and said, "Oh, you're here."  She sank back into sleep and woke several hours later to smile at him again and say, "I love you."   Yes, she knew us all, right up until the end.  I can't begin to express the myriad of emotions we all experienced.  But the power of her love for each of us kept us connected with her in a way that I will always, always hold close.

Did she know death was near?  I believe she did.  And she was at peace.  We were all a mess, but around her, there was a reverence and acceptance that was unfathomable.  A readiness to lay down this tired body and walk on into the next journey with complete assurance.  We are still all a mess, but the memories we hold of those last days are filled with a calm and a purpose. 

That would be my memory of her passing.  A peacefulness that can't be contained.  It spills over onto our hurting hearts constantly.  I think that would be her message to those following behind.  No matter where the journey has brought you from, the true Miracle is in this passage to where you are going...

That is our miracle.  We can now Hope with Confidence that our paths will cross and join again one day as our journey brings us all to the place of such Peace we can only imagine....