Sunday, May 10, 2009

Mother's Day

Today is a national day of recognition, for all the mother's out there. As I woke to see various people's statuses on various online programs commenting as such, one item had the word "mother" in link form, taking me to my oft frequented site dictionary.com. Pages of definitions, all of which ultimately indicate one thing, that "mother" means a female parent.

As I thought on this a bit I recalled a common phrase I used to hear quite a bit at my old job, and growing up. "Any male can be a father, it takes a man to be a dad." While I'm certain I'm not the first to apply it to mothers, I don't recall off the top of my head ever hearing it phrased as such.

My brothers will be the first (and usually second and third and fourth and...) to remind me, as well as inform everyone else, that i am a "momma's boy". A term they often meant as a put down, wikipedia even hints to such..."male who has a very, perhaps too, close bond with his mother, often making him soft". You may call it denial, I even laugh to myself a bit thinking about, but I will continue to insist that their is detrimental about my relationship with my mother growing up.

Whether it was the 8 or more calls a day to her at work when my brothers tormented me, building lego castles by the couch when I was home sick from school (that I hear can lead to accidently rolling off the couch and splitting one's head open), her advising me on science fair projects that often took me to school, county, and regional accolades, or her constant and unyielding support through a sport she was ultimately terrified that I was doing in the first place.

I blame/credit my mother with lots of things; my complexion, eye color, chocoholism, my video gaming habits (though she'll deny that one)...but ultimately it's at the core of who I am that I give her the most credit. Think my close nature with my mother growing up good or bad, I'm quite sure it's a major factor in who I am today, my emotional nature, my big 'soft' heart.

So for that, and so many other reasons I can't put in to text, I am extremely thankful for and to my mom. Most of all, for always being there with open arms, that I probably all too rarely take the oppurtunity to fill.

Happy Momma's Day!

To my Mom most of all, but also to my grandmothers, my sisters, and all the other mom's in my life...and any other's that happen upon this, that in so many of their own ways are doing the things that make a mother a mom!

Monday, May 4, 2009

Where there's a will...

...there is less debate, less stress and strain, and ultimately less suffering and difficulty for the family.

I'm referring to a living will and health care power of attorney documentation. Between my internship work in cancer patient support and my current work with cardiac patients this topic has been brought to my attention on several occasions. Initially I thought nothing of it, as I felt it was something I didn't need to be concerned with for many years. Over the last few years however, following encounters with patients and their families I have grown to understand the true value of these simple pieces of paper.

On more occasions than I'd care for, I have watched as a family agonized over what must be the most intense decision possible...whether or not to cease care on an ailing loved one. Our initial urge, I think, is that this is a no-brainer. Do whatever it takes as long as it takes to give me a chance to have my loved one stay around. Or, on the other side of the coin..."well mom has been suffering for quite some time, she has lived a good life". And on some occasions, it can be a relatively comfortable decision. More often, it's when things are sudden, not according to plan, when suddenly a seemingly completely healthy 50 year old man collapses with a heart attack and is on a ventilator. Just yesterday I was playing golf with him, surely he'll recover from this. How hard is it as a family member to sign to cease support and treatment then? Or possibly worse yet, when it's a child.

There are numerous benefits to these documents (living will and healthcare power of attorney). Most obviously that it ensures that your personal desires and wishes are carried out when you may not be able to do so personally. From my perspective, that of a counselor working with patients and families, is the piece of mind it can provide to family members. Often times even when it has been discussed, even in a loved one I've known and been family with for years, that final decision to cease care can potentially be extremely difficult. Sometimes just having a piece of paper, justification for the decision, something that reminds us "this is what he wants" can relieve significant amounts of strain.

In one final scenario I have seen involves a family member on life support after an unexpected event. His children, siblings, nearly all of his family has accepted the current situation and are ready to withdraw care...however, no documentation exists and he has a new wife, who by law, is next of kin and now in control of the decision by default. Now whichever side you agree with, what is clear is this would likely cause stress at the least and family tension, anger, and many other possibilities.

I'm going to provide some links now that give a little more information, but if you have any questions or concerns ask a lawyer, your primary physician, or your local hospital.

And please, despite age, situation, etc, please consider taking the time to complete these. Encourage loved ones to complete them, and ensure that others know where they are, how to access them, and discuss your wishes. A document is no good if loved ones or medical staff don't know it exists!

I brought it up with my parents a few months back, with no follow through. So in part, this is to remind me to follow up on these matters myself.

FAQ about advanced directive from my place of employment


Living will instructions and basic form

Healthcare: POA form

All in one information resource about end of life choices etc

Thursday, April 30, 2009

Hakuna Matata


When I was younger I had this poster hanging on the wall in my room. I ran across it, in mint condition, rolled up in the corner of the closet in my old room at my parents house a few weeks back. I chuckled a bit to myself thinking back to those days, but honestly thought little of it and moved on with the mission I was on scouring the closet for some other specific item from my past.

Earlier this week I was in with a patient and her husband discussing the various emotional aspects of heart disease. My contribution to those conversations many times consists of the same content about expected fear, anxiety, and possibly depression, the importance of communication, and the effect those emotional effects can have on one's physical health. The contribution of my patient's and their loved ones however can often greatly differ.

On this particular day the husband of a patient was quite talkative and discussed several things from growing up on the farm, to faith and religion, and his work experiences in the hospital. His wife (the actual cardiac patient) contributed some, but often gave way to her more verbose husband. Among all of this, one topic in particular caught my mind's eye...WORRY. It seems another family member in the hospital that day had referred to worry during one of their discussions as the "singly greatest sin of all". He went on, with great intensity, to discuss the effects of worry, the various references to it in religious lessons as well as more secular works of wisdom as well. Now I'm not sure I buy in to the religious aspects of the discussion, but it certainly got me thinking...

Some weeks earlier, you'll recall from a previous blog post, I spent several hours with a lady living with brain cancer in addition to her heart disease. And somewhere in the recesses of my brain I had logged a comment she made, though I had not given it even a first thought, until now. "Well yes I worry...well no, it's no good to worry. I am concerned at times, but I won't worry about it." And as I left the above patients room the other day, and began wandering down the hall to my office, this topic of worry consumed my present mind.

According to Dictionary.com 'worry' is in this case best defined as "to torment oneself with or suffer from disturbing thoughts; fret". Followed by several more entries that elicit unpleasant images (including to harass or bite which I found most appropriate). In contrast, the initial definitions for 'concern' are "to relate to; be connected with; be of interest or importance to; affect" as well as a few more, some relating to worry, others of a bit varied connotation.

Exploring further Wikipedia: Worry led me to some interesting additional information. A Liebert and Morris theory on anxiety from 1967 provides that "Worry refers to negative self-talk that often distracts the mind from focusing on solutions to the problem at hand". While Dr. Edward Hallowell speaks of two main types of worry: "Toxic worry is when the worry paralyzes you," whereas "Good worry leads to constructive action".

After all this analytical exploration of worry, my exploration got personal. I could hear my girlfriend in my head on occasion over the last few months; "don't worry", "there's really nothing to worry about", "I don't want you to worry". And from there, I thought of other topics of 'worry' in my own mind and how these worries effected me. Combine this with recent discussions with my parents about indigestion and the likely stress related causes and it became very clear...even I, the guy that teaches stress/anxiety reduction, the guy who often classmates in grad school referred to as the care-free guy, the one that nothing seemed to bother, am quite susceptible to WORRY.

So here I am, all my recent worries ever present to me (work, car insurance, house hunting, my relationship, my family and friends) when I flash back to that poster, sitting in the corner of the closet. "Hakuna Matata", and yes I do expect all of you to sing the song to yourself (or out loud for some of you, you know who you are), it mean's no worries. Does any part of me think I won't worry anymore, no certainly not. Is part of me motivated to try, most definitely.

How bout you? What's on your worry list today? Is it productive worry, or is it stalling you in your tracks? Let's all focus less on the problems, and more on the solutions!

HAKUNA MATATA!

Monday, April 20, 2009

A Great Day to Fly...

*I realize this is an extremely long entry, but I hope you find can take the time to read and hopefully enjoy it


It was Spring of '97. A soon to be young man of 16 sat flipping channels, having been out enjoying the beautiful sunny day. His parents had decided to lie down for a Sunday afternoon nap. Some time later the phone rang. He sprung from the couch to rush and answer it in as few rings as possible. It was his aunt on the other end.

"Hello"

"Hey, is your mom there?"

"She's taking a nap right now, want me to have her call you?"

"I think you should wake her up."

He walked to their room, and knocked on the door, informed his mother of whom it was and that she had asked to wake her and handed her the phone. Something already didn't seem quite right, and it seemed everyone in the room knew it. He turned to walk away, through the short entry hall to his parents room and sat at a chair at the dining room table just outside. He could hear his mother on the phone and see her from where he sat...and then, a crushing blow seemed to hit his mom as she covered her mouth and tears formed...and without a clue as to who or what, he began to cry. His Dad was out of bed, and had moved around to her side. "Daddy and Scott are dead" she said...a pause...then she pointed her husband to their son, crying just outside the door. His father moved to him and wrapped him in his arms. They moved to the bedroom, he wrapped his arms around his mother and the tears flowed. They packed some things and made the 2 hour trip to be with their family. Some days would pass, mostly a blur of silence, consoling, lots of hugs, and some standard rituals of our culture; visitations and funerals.

It seems that morning his grandfather and uncle had gone out to fly. His grandfather owned and flew vintage open cockpit bi-wing planes. His uncle had caught the fever and was working on his pilot's license as well. The two were performing aerobatics for on-lookers over a lake not far from home when something went tragically wrong. He himself had been there just the weekend before...the last time the plane was in the air before that day. He and his grandfather had made the flight, toured the lake, performed their usual antics and stunts the previous Sunday just before his visit came to an end...a fact that would stick with the boy for years to come. You see for a few years prior the young man had passing thoughts. If and when he was to die surely it would be there, by his grandfather's side doing what they loved! But somehow, he thought, fate screwed up. The plane hadn't gone down the week before as it should have and now his uncle had taken his place...

It's been 12 years today since we lost my grandfather and uncle, an event that ultimately would direct my life to where it is today. For several years after I struggled greatly. I had lost the 2 men, other than my father, that I loved most in this world as well as my favorite hobby in life; flying with my grandfather. For more than 2 years after the crash in my mind I was certain that something went terribly wrong, that i was supposed to be gone instead of my uncle. A tremendous amount of guilt that at times would eat away at me, cause anger and bouts of extreme sadness. It would be my first true lesson in grief and loss. Over time I've worked through it. The etched images of the loss, how it happened and the tears that accompanied them would gradually fade. As time passes on, when I think about them (a nearly daily occurrence still to this day) far more often there are images of the antics, the fun, the laughs and smiles we shared that override the tears...the living outshines the dying. Don't get me wrong, there are still times when the tears flow like rain. Last night being one of them, anniversaries and holidays have a way of doing that I find...as does the occasional completely random moment. I would likely point back to them, losing them, the way I saw it impact myself and my family as the reason I am where I am today, working as a counselor, predominately focused on grief and loss.

I learned much more from them. It is a lesson that guides my life. You see my grandfather and uncle lost their lives doing one of the things they loved most in this world...we don't all get that luxury. While this was hard on my family, still is at times I'm sure, I know it's how my grandfather would have wanted to go...without my uncle of course. I think both of them, given the choice, if they were able to do so with out hurting us, would have chosen just such a way, or something very similar...I know I would.

When I think back now it's easy to envision rolling out the plane, preparing for a flight, dropping tools on each others heads while working on the plane or hanging plywood over the windows at the beach before a hurricane (during which my grandfather had every intention of riding out with out necessary rations, a gallon of milk and a dozen cake donuts), digging massive fox-holes on the beach with my uncle for the kids to play in, riding in a station wagon filled with airplane fuel (words don't do it justice), and so many more fond memories. But one memory, above all these, sticks with me daily.

I would spend weeks or long weekend with my grandfather as often as school allowed. Every morning from the time I was about 10 we would get up and start the day. At some point he would walk to the window, I would rush over to lean on the seal and look out just as he was. And if I was lucky he would say "Looks like a great day for flying..." and off we went. I would watch the world shrink beneath us, feel the wind on my face, and in an action my grandfather referred to as a "free plane wash" fly literally through the clouds. I would reach my hands out of the cockpit, the moisture would hit my palms like needles...I was literally touching the clouds...and to me, to fly equated to truly living. And that is what both my grandfather and uncle did. Live fun and love big. Both of them had such huge hearts and fun loving spirits, it was infectious.

To this day, rarely does a sunny day go by that looking out my front door, looking out the window of the car, sitting outside at an event...do I not hear my grandfather's words...and he's right...everyday is a great day to fly.

Daddy Jim and Uncle Scott, you are deeply loved and truly missed!

-To any readers: Thank you for taking the time to read this. After writing it I realize it may not be as meaningful or insightful to others, but perhaps if nothing else, this one was therapeutic for me...so again, thanks!

Thursday, April 16, 2009

The innocence of youth...

Today I received not one, but two reminders of the how amazing little kids can be. Let me start by sharing.

The first is from a blog I highly recommend and enjoy frequenting...it speaks for itself.

Life In Forsyth - Mail call!

The second, comes from my oldest brother, sharing the actions of my nephew...indicating that he (my brother) "has a two year old who is asking why Nemo doesn't have a mommy. Seriously." followed shortly by "now has a two year old who insists that Nemo's Mommy was at church during the whole movie, while Nemo's Daddy was trying to find him. Only in the home of two pastors..."

Both accounts instantly made me laugh (lol if you will), perhaps enhanced by the fact that I know both children. Then a series of thoughts went through my mind over the next several minutes. I thought back to a toddler on the beach many years ago running around naked, as children at the beach often do, when he abruptly stopped to pee...not in the water to hide, not behind a towel or boardwalk, but right there a few feet from the water's edge with arms stretched out by his side simply letting it fly, arching in the wind.

At this point I make some personal projections on these situations as I see them. The first young man showing his independence, not allowing difficulties or lack of perfect ability to stop him. At the same time, taking the time and energy to communicate to the people he cares about. When is the last time you stopped to write a letter to someone you love? The second one showing what I feel is amazing insight, while also taking the time to question what's before him. Honestly, how many of you considered where Nemo's mother was or anything similar? The last child seemingly so carefree, without societies "rules" or "norms" infringing on his enjoyment of the day at the beach. When was the last time you really let go (and no, I don't mean your bladder) and took time to just relax and enjoy the world around you?

I guess it got me thinking, at what point in life do we suddenly start taking ourselves so seriously, perhaps too seriously. When does everything else become more important than living, laughing, loving. Why does it seem the 'musts' and 'have-to's go higher on the to-do list than the 'want-to's.

And then even as I type this I wonder if even in considering all this, if I'm not doing the very thing I'm calling in to question.

Tuesday, April 14, 2009

How lucky I am...

Some of you are a bit familiar with my work, but for those who aren't let me give a brief insight. I work on the cardiac floors of my local hospital. My job roll is completely new and thus constantly evolving, though the basic premise is to explore psychosocial aspects of the patients heart disease. I frequently discuss mortality, stress, anxiety, depression, relaxation techniques etc. with patients right after a heart attack, awaiting open heart surgery, suffering from heart failure, and a few other cardiac based concerns.

With that said, every day I receive a list of patient names, sometimes very short to non-existent other days quite staggeringly long. I then round the floors, determining whom would benefit from my services and then I proceed in to see them. Some days it is easy to get caught in a routine, saying virtually the same things even when i try hard not to...and other times, well, other times things are completely different.

A few weeks back I had the pleasure of meeting a lady, admitted to the hospital for chest pain after having made her way there herself. Rather petite, with skin worn by the years and elements and a somewhat raspy voice from years of smoking she was pleasant to talk to and used the words "sweetie" and "dear" when addressing me and other staff. In relatively good health all her life until that night, she was mildly concerned but not too worried. What came in as chest pain, turned out to be a heart attack, and for many of my patients this instant smack to life's greatest reality from a life of essentially good health is quite a shock, and ultimately a life changer. The real kicker in this case however, came a few days after admission. She already received a stent to a blocked artery for the heart attack when a routine x-ray would then show what appeared to be masses in her lungs. They would proceed to do a gauntlet of tests and procedures before ultimately deciding she had lung cancer. She, from the day of the x-ray, voiced knowing what it was and prepared herself to hear of it spreading to her liver, kidneys, or other parts of the body. And most unfortunately, she was right...the cancer had metastasized to her brain. Over the next 2 weeks I would spend approximately 10 hours or so with her, sometimes in 5 minute chats and other times more than an hour of discussion. She decided to decline most aggressive forms of treatment and only receive what would keep her mostly pain free. Yet through all of this, I watched a woman stay staunch in her faith, smiling and laughing with me between times of tears and much praying by herself throughout the day. She had accepted her fate and set her mind to focusing on enjoying every day as best she could, for however many days that may be. Doctors would give her likely a few months to a year.

Why I feel fortunate...This woman's story will never be written in a book or turned to film for theater or tv. The reality is she will likely die soon with very few people really even knowing of her...however, there in what were her most fragile moments, as she contemplated her life, what good she had done with it and what she would do with the little bit left...she chose to spend several of those hours with me, sharing herself, how she felt during this ordeal, stories from her life, jokes she heard, whatever the topic was that day...and for that I feel blessed!

And so it begins

I decided to start using this blog space that I originally created solely to follow other's blogs and post comments when I felt the need. I never really thought myself to be much of a blogger, after all if you ask around it's pretty clear that reading and writing are not my favorite things. With that said, my hopes in posting here over however long it lasts, is to share with you some of my experiences, my daily encounters, or knowledge shared with me. You will likely find that a lot comes from my work with patients, people, family members...but some may come from random events, a headline on the news, a tv show.

I hope at least someone will bother to read at least some of my posts, and if lucky, share comments, their thoughts, and own insights on the content or topics that may come up...and if nothing else, get a little more insight in to who I am.