Monday, January 30, 2012

Food, swallowing and the breath

Today driving home from the hospital, I did NOT buy an ice cream cone.

The mental comment that my father-in-law had going in my head has been the one I've heard ever since I've known him. He'd say that he ate hamburgers, ice cream, or whatever he liked because he watched his own father not be able to eat once he got colon cancer. Later it would be his own wife he'd watch starve to death from the same cancer.

My father-in-law now has colon cancer himself and has been hospitalized for the past 2 1/2 weeks with no food, unless you count IV fluids and a nasal feeding tube with his "milkshake." The only thing by mouth he's had, has been the barium liquid for radiology tests.

Since the abdominal surgery to remove a tumor, he has been one very sick guy. First there was a surgery that he did not want, followed by a sluggish recovery, then sepsis less than a week after the surgery, with shingles cropping up after the infection. He's been in bed weakening for over three weeks.

Today was the first attempt to feed him "solid" food.

I went to the hospital after lunch not knowing that today they'd be trying to feed him. Apparently, he had choked when trying this first meal.

After a quick swallow study and a consult with a speech therapist (who not only work on speech but also swallowing), we learned that the study indicated that he could eat pureed foods fine. But liquids would slide into his lungs. No problem, give him thickened drinks.

The speech therapist left. The nurse said the family could feed him. She was too busy trying to give meds out to feed him. The speech therapist wouldn't be back until tomorrow to work with him.

My step-mother-in-law looked at me and suggested I feed him. I think she believes that this requires special training. But I also sense that the physical care of him is too emotional and difficult for her to do.

I know how she feels. I have been working in geriatrics for over 20 years, but when it is someone you love, the emotional side kicks in. I wind up feeling drained and overly sensitive after visits with him.

There is also the knowledge that he'd just choked an hour or so before, which left me feeling like I hoped to God he didn't choke on me either. What if I killed him?

All of this brought up bad memories from almost 30 years ago.

I was visiting my grandmother's uncle at a nursing home after he'd broken a hip. He was like a father to her.

My grandmother had the idea that when she hugged him last that his neck was stiff and that he was already dying on her. I'm not sure why she thought that, but I didn't think that it was right to leave him alone in the nursing home.

The next day, I stayed with him for the day. He probably was dying. There was a yeasty smell to his breath that I have never smelled before or since. His breath was labored; he rattled when he breathed. He was dying.

When I came back, an aide was feeding him. Why? And then, he inhaled a spoonful of food into his lungs. His eyes opened wider and he struggled. I said why were you feeding him? She said because she was told to. Then a nurse came in and told me to leave.

He died shortly afterwards. Exactly when, I don't know because I wasn't in the room.

I'd grown up on a farm and saw lots of animal deaths. I'd seen dead people in funeral homes laid out. I'd seen a dead old man on my 13th birthday laid out on Rt 15 after a tractor trailer had hit his car - only a little blood trickled out of the nose and ears of his lifeless body. There was no doubt that he was stone dead.

But, I hadn't seen the struggle of suffocation in humans until the aide fed my dying uncle's lungs.

Working in geriatrics. I've seen lots of elderly with impaired swallowing function inhale their drinks, food, saliva, medication, etc. It is a horrible way to live. It is such a struggle for them to exist with this agitation.

Residents in nursing homes hate to watch others gasp with their choking as they try to eat at their table. They lose their own appetite.

As I've been writing this, I keep trying to clear my throat. I imagine my throat constricting. I cough a little. Sinus drainage exaggerates all of this.

I no longer need to eat for my father-in-law since he is back to oral nutrition. But now I find myself wanting to breath without aggravation for him.

I'm not sure what the prayer is for him at this point. Maybe this is a good time to meditate on mindful breathing... and swallowing.

Tuesday, January 17, 2012

The Desire for Comfort

Lately, I've been looking on-line at big fluffy dogs. I'm attracted to Great Pyrenees after seeing a pair of siblings last year. Large working dogs, friendly but not extroverted either, I could see myself owning one for about a week before the reality of commitment would hit.

I go through this every now and then, this desire for non-human, mammal companionship.

I grew up with a collie that looked just like lassie. We farmed and Poochy was always nearby. I was six when Pooch disappeared. It took us kids a month before we figured out the dog was gone and asked mom where he was at. Pooch died with cancer and was put to sleep. He'd already lost his tail, so we knew it was true.

Over the ensuing years, we had several black labs that always ran away to the neighbor farms. They were goofy and more trouble than they were worth.

Once married and with kids, we tried collie mixes, but our farm was too close to the road and the dogs would get hit. I didn't see the point in having a dog if you were going to pen it or chain it up all the time. Even though my kids think I am tough, I couldn't bear losing another dog to cars and felt the dog's quality of life was important, too.

Quality of life.

My father-in-law was hospitalized suddenly last week after feeling sick since New Years Eve. A scan determined that he had a tumor in his lower intestine. The doctors did surgery this weekend. The question isn't whether or not he has cancer, but what stage the cancer is.

His tail hasn't fallen off yet, but he is 84 years old or 12 in dog years.

I've been in relationship with this man for more than my 30 years of marriage to his third son. (This is how he introduced me to his youth pastor at the hospital- wife of the third son.) After marrying, I moved into a house not 50 feet from my in-laws. Partner was the only son who stayed to work on the family farm. Our kids were raised next to their grandparents. Whoever said that when you marry, you marry into the whole family certainly got this situation down.

I had gained another father.

Father-in-law took care of mother-in-law when she was diagnosed with colon cancer back in the late 1990's. So many memories of crisis and how colon cancer can be so devastating. And, she wasn't the only family member who had colon cancer in the family. His father and a sister died from colon cancer, too. There is a lot this family has experienced when it comes to this form of cancer, especially pain and fear.

Since the uproar started last week, Partner has spent most of his waking, non-work time at the hospital. Rightfully so.

I spent some time at the hospital, but not nearly so much as I should. Father-in-law likes to pick on me by talking trash about political issues. I have a tendency to be active in local community issues - usually to his chagrin. This verbal sparring was interesting the first 10 years of our relationship. The past 20+ years have not been so fun, reflecting the larger split growing in our country.

Once his pain meds started to work last week, he was back to his old ways. With everyone else, he seems to tell stories. With me, he says inflamatory things to get me going and did that the first evening I visited.

Upon leaving the hospital, I hit up two McDonald's - one in town by the hospital and the other close to home - to get an ice cream cone -at each. About the time I finished the first cone, I came to the exit for the next McDonald's. I was still mad and figured this was better than buying a pint of Ben and Jerry's. (Don't ask me to make sense of that logic!) And, the experience was wonderful,... smooth creamy vanilla, finished off with a crunchy cone. Calm down, dear. Damn that man knows how to get at me.

What I didn't realize was that this was when I started my search for dogs more earnestly.

The thing is that I don't really have the time or money for a big dog. I like a clean house. My grandson is allergic to animal dander. I like to be able to leave for a day or two. A dog will scare away the birds and wildlife that come on the property. What about people who have been traumatized by dogs and come to visit? Oh, so many reasons why not; and, not so many reasons to take on the responsibility of having a dog.

Cats are easier, but Grandson is even more allergic to them. I can tolerate the hairball mess. A little food and water, a litter box, and voila, you think they are your friends. But don't let them fool you, they don't really care about you.

Dogs connect at a soul level for me. I think it is their expressive eyes. Horses have it, too, but I'm not bringing them into the living room or having them in my car.

I'm not talking about other people's dogs here when I talk about connection. I'm talking about a personal relationship, a partnership, a friendship.

When I stopped by Partner's work yesterday and talked with co-workers, I was surprised that Partner said something about needing to spend more time with me in front of everyone. I asked why? He said because he knows that when I start talking about dogs, he's not around enough.

Why didn't I make that connection?

And if my kids are reading this: your dad is way more than just a pet. Believe me, our relationship is much more complicated and deeper than that.

The thing is, the kids are gone, the house is too quiet, and I just want to reach down and stroke some fluff while a pair of big brown eyes search out mine for life.

For now, this is a fantasy unfulfilled. Sometimes life is easier that way. But I bet my dog would have loved to go through the drive-through with me and share an ice cream cone on a cold winter's day. for Great Pyrnees rescue information and to see the photo. Photo taken by Jack McQuade. He has his own website at Enjoy.

Wednesday, January 4, 2012

Whispers of sweet nothingness

Sitting in this morning's meditation group, I had an overpowering urge to listen a little harder, soften my heart, and settle a little more.

Like waiting for a bird to appear in the palm of a waiting hand, my soul was reaching out to something so tiny and precious that I needed to be in a group with equally silent and still souls to practice this deeper quiet. This is the power of the sangha, the practice group.

Lately, I caught a brief echo from the Universe's whisper. At first I didn't know what to make of it. I don't know who or what this Other is, but it is calling with a rare tickle that catches my attention and is gone.

Rumi's tiny poetry speaks volumes: this space is like lovers sharing the quiet of the dark awake, alert and softened by a tender intimacy where every cell is alert and waiting.

This Other isn't "out there," but resides in our hearts, our broken and pierced hearts; This Other resides in the compassionate heart space everywhere in our bodies and just beyond.

I imagine the warmth of holding hands, the joy of pointing out the stars together, or hushed murmurs that even the animals dare not bother to intrude upon, except for the call of the owls in the night echoing in the hills.

"Shhh," my heart calls to my head, "there, there," as I wait patiently for this Lover to signal its arrival with a breath.

Is it always this close, I think? As close as our breaths?

I relax and inhale more deeply, reaching out to touch something, but nothing is there.

The air blows a wisp of hair from one side of my forehead to the other, like a mother's loving gesture.

Once, I was walking across the kitchen to put away the dishes and the whisper/non-whispered Silence woke me up, giving me a twinge of awareness. Yes, wow'ed me with presence and rearranged my molecules like a lover's hair the next morning.

Lately, I've experienced this quietness fall over me as I work in therapy sessions. I want to gentle the couples in front of me and remind them that God is at work beyond the realm of reason, beyond fixing these trite squabbles that rattle and terrify them so soundly. Or, I wish I could drain the drama and fear from women in session who don't know themselves.

We only have this moment: how do you want to live your lives?

How do I want to live my life?

I am no better than anyone else, no more enlightened. It is the question I pose to others because it is the only question that matters. I keep waiting for an answer that make sense. And, that is the problem.

Like the ancient's who sought after God, the Divine Cloud mists and obscures a clarity that cannot be known. Somehow my path is hidden leaving me to trust that there is great beauty and brilliance under the cover of the night's dome.

How could it not be so when whispers of sweet nothingness call?

I continue to practice the ordinary things of daily life - attempting each thing one breath at a time with the Universe reciprocating and sharing with all who draw breath - with a deep resonance that is beyond human hearing.