Monthly Archives: October 2009

Medicine 101

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Left brain, right brain, I never remember which side does what. One thing I do know, however, is that I’m not a numbers person. I’d rather write a 50 page paper than add a long column of figures, even if I had a calculator. That’s why keeping track of Nate’s pill bottles and medicine doses is almost more than I can handle. The 8½” X 11” grid Hospice gave me today to write everything down was intended to help but has only screamed, “You can’t!” from its place on the kitchen counter.

The Hospice doctor and the head nurse of our team spent 90 minutes with us today, examining Nate and talking over his current pains and frustrations. The doctor completed his part and was getting ready to leave when I asked him if it was true that marijuana was a legal pain med in Michigan. He answered, as most doctors do, with a detailed explanation. “There are three parts to the answer. The first is the law, and yes, it has become legal to use marijuana in medicating pain in Michigan. The second part is the training of doctors in the proper use of it, and that has widely occurred, too. The third part is the stickler. Who will be the provider?” Good question. Good answer.

The nurse volunteered to stay an extra half hour to tutor me on the meds. My slow responses to her drug-instructions must have triggered anxiety in her as she feared for her patient. She and I lined up all the containers, which included meds we used to use, meds we are currently using and meds we will use in the future. The minute she began referring to the drugs by their real names, I got lost.

Excusing myself to get a thin-tipped indelible marker I said, “You can tell me what and when, and I’ll translate it for myself on the label.”

She chuckled like I was kidding but bravely started in: “Ondansetron is for nausea,” she said, “and he can have up to three pills, 8 hours apart, over 24 hours.” I wrote on the container, “Nausea, 1 at a time, up to 3.”

She continued: “ABHR is a gel you rub on his wrists if the ondansetron isn’t working, and he can have it twice in 24 hours.” So I wrote “Break-through nausea, wrist, twice.”

We handled each vial, packet and tube, she reading the technicalities on the labels and me making them idiot-proof with my marker. I felt much better when we were done, especially after we’d labeled the four different kinds of morphine with their differences, none of which we are yet using. Just reading the word “morphine” on so many pill bottles made me shaky over the great unknown of Nate’s and my medical future together. Nevertheless, we completed our task.

My little pharmacy looks a lot like the leftovers shelf in our refrigerator because I have the meds grouped in Zip Loc Bags, but if there is any hope to keep it all straight, baggies are the answer. In addition to pills for pain, anxiety, sleeping, mood, constipation and swelling, we have a gel for bone pain and another for dry mouth. There are also special mouth washes, lip balms, skin creams and (gulp) suppositories.

As the nurse was leaving, she filled my cupped hands with a pile of bright green, rubber gloves. “You’ll need to wear these when you administer the gels,” she said, “or you’ll be medicating yourself when you apply them on Nate.” Some of those medications were starting to sound pretty good to me. She must have sensed that, because as she left, she gave me a strong hug, and it worked even better than the gels might have.

Tonight my sister Mary, a nurse, came over and pulled me out of my medical quicksand. Sitting on a kitchen stool, she recorded each drug name and its prescribed dose on the paper grid, using nurse-lingo like “M” for midnight and “N” for noon. Just watching her pen fly over the little squares was comforting. She completed the job accurately and thoroughly, relishing the whole process.

God’s tender loving care is in the details. Through the medical perplexities of this day, he made sure all my questions were answered, and he put my mind at ease (both brain sides). He also showed me (again) that if I have to walk through a maze, he’ll keep me from making any wrong turns. Whatever the needs, he’s always got them covered.

“God will generously provide all you need. Then you will always have everything you need and plenty left over to share with others.” (2 Corinthians 9:8, NLT)

Tired

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Last night was lively. Although Nate had his usual medications for pain, nausea and anxiety throughout the day, by evening he was agitated and restless rather than his usual mellow. For a man with stage 4 cancer, he had way too much energy. As bedtime drew closer, I wondered if he would go to sleep. It reminded me of the feeling I got with a newborn, wondering when I put him/her to bed if we’d have an active night or a restful one. New babies are unpredictable. A man with pancreatic cancer is the same.

The rest of the household drifted off to their various beds and their expected sleep. Once Nate was settled, I sat beside him in the dim light of his room and wrote the blog, wondering why he didn’t “clunk” right off to sleep as he so often does. I went to bed at about 1:00 AM, hoping to sleep right through.

By 1:45, I was awakened by Nate checking to see if I was sleeping. I remember the same experience with one of my pre-schoolers tapping me on the shoulder during the night and saying, “Mom, I’m not going to wake you up, but I just have one question…” That, of course, was after he’d woken me up.

I took Nate’s hand and led him back to his hospital bed. He wasn’t tired and wanted my attention. “I’d like a drink of water.” After that, he said, “I’d like a drink of milk.” He seemed to be in toddler mode trying to postpone bed time.

I opened the shade in his room and showed him the night sky. “See?” I said. “It’s night time. Everyone is in bed. You have to sleep, too.” He nodded and obediently got back into bed.

Around 3:00 AM I heard kitchen cabinet doors and water running. Shuffling toward the commotion, I found Nate in the middle of making coffee. “I’m feeling like a cup of coffee,” he said, as if it was the middle of the afternoon. “Want one?”

Taking the decanter out of his hand and pouring the water out, I shut off the lights and said, “Look at the clock. It’s still night time, and we’re both tired.”

Once again he nodded and without resistance took my hand to head back to the bedroom. I wondered how many more episodes we’d have before dawn. This kind of a night goes on forever.

In an hour I heard him again, rummaging through the bathroom cabinet. “I can’t find my comb,” he said, as if he was getting ready for work. “I have so many but can’t find even one.”

Around 5:30, I heard him vomiting in the bathroom and found him struggling to stay standing while hanging onto the towel shelf above the toilet. It was long-distance vomiting, but of course he couldn’t get down on his knees. Soon it was morning, and I got up, walking to Nate’s room to check on him, fully expecting to find his bed empty, but there he was, sleeping soundly with his mouth open and his hands clasped across his chest. Just like a baby who’d been up all night, he needed rest.

Finally, at 2:00 PM, I wondered if he was in a coma or some other distress that was keeping him unconscious. It was difficult to wake him, but he finally roused and sat on the edge of the bed. He looked out the open window shade and said, “Oh. Morning. I can get up.”

“You’re partly right,” I corrected. “You can get up, but its not morning. It’s afternoon.”

Today he slept most of the day in his chair, waving away our attempts to bring him food. The mug of coffee he requested had been reheated four times but was still unsipped at the end of the day, and when he finally crawled into bed, he was completely worn out from doing nothing.

As I tucked him in, I quoted some Scripture, but he was too tired to participate. I sang two hymns, but his eyes were closed, and at the end, barely moving his lips, he whispered, “I’m so tired.”

“Though He cause grief, yet will He have compassion according to the multitude of His mercies. It is of the Lord’s mercies that we are not consumed, because his compassions fail not. They are new every morning: great is thy faithfulness.” (Lamentations 3:32, 22-23)

Sadness and worry

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This morning began with a bang. Actually, I should say a crash. Nate lost his balance in the bathroom while I was still sleeping and went down between the sink cabinet and the tub. The weight of his fall pushed his shower chair up against the tub faucet so hard it severed a pipe joint there. Amazingly, he didn’t hurt himself, except for a slight cut on the top of one foot.

Nelson had been up since well before seven and heard the crash before I did, racing in to help his father. I thought of the many times Nate had helped his children get up after little-kid falls, comforting them and giving them the universal parental encouragement: “Hey, you’re alright!” Usually it was true. Now the roles are reversed, his child is helping him up, and the “You’re alright” part is not true.

By the time I arrived, Nelson had Nate back into bed, and everything was calm. Scripture certainly speaks truth when it says, “Two people are better off than one, for they can help each other succeed. If one person falls, the other can reach out and help. But someone who falls alone is in real trouble.” (Ecclesiastes 4:9-10)

As we sat together and I held Nate’s hand, I said, “I’m so glad you didn’t hurt yourself.”

He responded, “Oh, I’ve got strong bones,” apparently forgetting his bones have cancer and are extremely frail. I nodded and decided it was me that needed recuperation, not him. He seemed fine.

All eleven of us are coping with Nate’s cancer in different ways. Nate is struggling immeasurably, yes, but the rest of us are struggling some, too. My brother came this afternoon to go through files, both Nate’s personal stuff and his law office records. There are still missing pieces to the puzzle, and Nate can no longer tell us where to find them. We did this file-work in the basement so as not to upset Nate.

Thankfully, we found everything we needed, but the process was stressful, at least for me, partly because we needed to hide in the basement and partly because I’m not a numbers person. I can’t imagine handling all I’ll need to handle. The Lord gave us Lars, though, who is a numbers person, and he’s volunteered to take over for me. Although he says it will be “easy”, I know it will add a measure of stress to his life, too.

All of us are trying to handle the strain of cancer in our lives. None of our kids have complained about that, but every so often I see one or another of them sitting quietly just thinking, not reading, not talking, just staring at nothing. There’s a lot to think about.

As for me, I don’t know what to think. Yesterday while running an errand, I passed an elderly man standing on a corner in the rain with a bent cardboard sign reading, “HUNGRY. HOMELESS. GOD BLESS YOU.” An all-consuming sadness came over me, and I burst into tears so overpowering I had to pull my van to the curb. Having grown up in the Chicago area, I’ve seen many homeless people but have never wept like that.

The only thing to do was to get some groceries and bring them back. As I handed the bag to him, I looked into his eyes and ached all over for his misery. Since I was feeling miserable, too, it seemed we shared a valuable experience in that brief encounter. He thanked me four times and said he was going to find immediate shelter (from the drizzle) and eat whatever I’d put in the bag. “It will taste so good!” he said. His smile showed a half-dozen missing teeth, and I promised to pray for him. Back in the car, as I brought his plight to God, I wept all over again. I still can’t figure it out.

I worry about Nate, wondering when he’ll fall again, and I worry about the kids, hoping they’re talking it through with each other. I worry about myself, hoping I don’t come up short when the needs increase and I have to be stronger than I am today.

But God was ready for all this worry and sadness. He had us find another one of Mary’s Scripture rocks today, just in time.

“The God of all grace, who called you to His eternal glory in Christ, after you have suffered a little while, will himself restore you and make you strong, firm and steadfast.” (1 Peter 5:10)