The other side

Dying at 30.  That shakes me to the core.

Another one of my high school classmates is slipping away as I type this.

For Qui

She has battled leukemia for over three years.  But its not the leukemia taking her life, its an infection (e. coli) that gained entrance via a bedsore, and due to her compromised immune status and all the underlying issues, it spread rapidly and caused septic shock.  Now the infection is in her brain and will soon spread to her lungs and heart.  All aggressive treatment has been stopped and they are “making her comfortable”.

I know what all of that means.  I know what is going on right now.  I’m a hospice nurse.

Although I am 1500 miles away, I can feel the pain of the community.  My best friend from childhood, lets call her Pooh, went to see Qui in the hospital yesterday.  Again, I flipped into nurse mode as I prepped her before she went in, what she might see, what she might not see, why Qui may not be getting tube feedings or fluid, why she may be talking funny.

A year ago, I was doing the same thing, only it was my family doing the hospice dance.

My paternal grandfather had a series of unfortunate health events last year.  It was one catastrophe after another.  At 80 years old, he insisted on living alone and living 5 hours away from his kids.  Yes, he had some family nearby, but not the sort that would religiously check on him.

A fall caused a brain bleed and required brain surgery early in the spring.  He came up here for rehab and stayed until late summer.  Then he insisted on returning to his home, and living alone.

He had a massive stroke in October.  Brought on by a completely unnecessary medical procedure.  Luckily, my aunt was staying with him at the time, or who knows when someone would have found him.

They attempted to rehab him from the stroke, but it was futile.

I was the one visiting the day the doc came and suggested hospice.  I called my dad, he called his siblings.  I was there for that meeting.

It is no fun being on the flip side of the hospice coin.  Suddenly, the doctor is giving you the speech that you have given to so many others.  Words like “comfort” and “end of life”.  Suddenly, its real.  You will lose a family member.

I have always thought that hospice was a gift.  You get a chance to say your goodbyes.  You can have “closure” and say all the things you wanted to say before someone passes.  Whereas in sudden death, all of that is left unsaid.  Its not always like that.  In my grandfather’s case, he wasn’t exactly coherent most of the time.  He couldn’t reply to questions, he couldn’t carry on a conversation, and he was extremely confused.

He made it difficult.  He lingered for six weeks.  And in those six weeks I think I aged about five years.  As the family hospice nurse, I was expected to know everything: “can we feed him?”, “can we give him this medication instead?”, “why is he making that face?”, and the worst one “why hasn’t he passed yet?”

He couldn’t eat because the stroke affected his swallowing ability.  Everything he ate dumped directly into his lungs.  But he was confused and thought we were torturing him.  He told family from out of town that we were starving him.  Then we figured out that he didn’t want to “eat”, but just wanted a “taste”.

He pushed my dad and uncle away and doted on my aunt.  That was much like his entire life with his children, but seeing it at end of life was difficult.  I have seen it plenty of times in my patients, but in your own family, broke my heart.

Family I had never met before came in from all over Texas.  I heard stories about my grandfather and grandma, saw pictures.  One second cousin told me that my grandpa was her inspiration to go to college and make a better life for herself.  So many mixed emotions for me.

Working all day with my own patients, trying to juggle texts and phone calls from my family during the day regarding my grandfather, and visiting him at night just took its toll.  I stopped visiting my grandfather so much.

I had said what I needed to say to him prior to a trip I took with Sunshine for her birthday to Disney.  I was at peace.  I figured if he passed while I was away, I would be ok with it.  He didn’t, but after I had made my peace, I visited less frequently.

I saw him the day before he passed away.  By this point, he was sleeping 20 hours per day, essentially a light coma.  He would talk about my grandma being present (she passed in 2004) and smelling her perfume.  At times he thought that I was her and talked about her beauty.  Again, I have seen this many times in patients, but experiencing it from your family is amazing.

When it was time, he declined rapidly.  We received a call from the nursing home that he had an “event”, and he was found with labored breathing during morning rounds.  They felt like this was it.  Using my experience, I did a quick assessment and confirmed their suspicions.  We called his hospice nurse (of course I wasn’t assigned to him).  And everyone who could, made it to his room.  We shared stories about his life.

My head was on his chest when he passed away.

I gave the eulogy at the funeral.

I know what Qui’s family is going through.  I know it too well.  Just sitting there by her bedside, watching each breath, counting respirations.  Looking for any sign that she is slipping away.  The odd sense of anxiety, wishing that it would be over, but not wanting her to go.  I call it the “death watch”.

Qui kept a CaringBridge website to update her MANY friends and family during her battle.  Her last personal entry brought me to tears when she wrote that she knows that she is dying.  I have always wondered how a person can deal with that kind of news.  I worked with terminally ill patients for years, yet I have never asked that kind of question directly.  How can someone process that they will no longer be living?

Facebook is humming, Qui took full advantage of technology to talk about leukemia and bone marrow donation.  She will leave a legacy behind.  So many people learned about cancer, leukemia, bone marrow transplantation because of her.  She will live on.

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An unplanned trip down memory lane

I just got word tonight (via facebook, of course) that a friend of mine from high school passed away.  I haven’t actually shared spoken words with her since high school, or actually seen her since graduation, as she moved out of the area way before I did, but we caught up a few times via the internet.  She had chronic health problems since she was a child (juvenile diabetes) and was extremely brittle (that is a term that means uncontrolled with her blood sugars).  Even throughout high school she was in and out of the hospitals with blood sugar issues and complications.  I know in the past few years she had been found passed out in public and spent time in the ICU.  And I know as a nurse that diabetes, especially her type, is not kind to the body.  I’m not sure what happened this time, but I’m glad she is no longer suffering.

She used to pass out those glucose tabs (that they give to diabetics) out like candy during class.  She was the first diabetic I ever met, and through her I found out I wasn’t squeamish around needles (that helps when your future occupation requires poking people with needles).  I can still see her handwriting in my mind.  She had this really loopy handwriting,  mainly all curves.  She was smart as hell and wanted to be a biomedical engineer, but I’m guessing her health got in the way.  She went through a lot more in her life than just the diabetes, and I hope she has found peace.

She isn’t the first classmate of mine to pass away, but the first one whom I would actually go to the funeral, if I was living in pgh.  And the first that isn’t drug related or a suicide.  Or a shooting.  Or a drug related shooting.  Or an accidental drug related quasi suicide.  I graduated in 2000.

This makes me think about high school, as I’m sure everyone does from time to time.  Those four years for me, weren’t so great and lasted so long in my mind.  Now four years go by in a nanosecond.

Thanks to the wonder of the internet (and Mr. Zuckerberg) I am in nearly daily or at least weekly contact with a good portion of the majority of those that shared my high school.  I have found out that at least 2 boys silently pined away for me and found the courage to tell me 10+ years after the fact (I honestly thought one hated me because he actually used racial slurs to tease me.  Turns out he didn’t know it was a racial slur when he said it in the 6th grade).  And many people act like we were best friends in high school, even though, if this were 13 years ago, they wouldn’t even look at me let alone acknowledge my existence.

I dealt with a lot of negative attention in middle and high school due to my ethnicity and the lack of others like me in that area.  I would have people come up to me and ask me “well, what are you?” and I would reply “human, what are you?” And that continued into nursing school and into my career.  Grown adults would ask me if I was Hawaiian or Samoan, or biracial (technically, yes, but not what they were thinking).  They never thought to ask if I was Latina.

Maybe that’s why I haven’t been back in three years.  I did not make my 10 year reunion, no cash, and I’m not sure I wanted to go.  I would have seen the girl that passed away last night at the reunion.  Maybe I’ll feel better about it at the 20th.  I don’t think it is me not letting go of the past, its more about me not justifying the airfare to see people who treated me poorly.

Everyone gets made fun of as a kid.  Make fun of me because I said or did something embarassing in class.  Make fun of me because I’m a klutz.  Make fun of me because I’m a bookworm or because I can’t kick the kickball in gym class.  Don’t make fun of my ethnicity.  I can never, ever change it, its who I will always be, and it is something I will pass on to my children.

That’s a road down memory lane I was not planning on taking.  Cleansing breaths.

I hope one day I can think about that time in my life and not have painful memories.  Maybe one day.

I know my friend didn’t have such an easy time of it either.  Rest easy MB.