Friday, August 4, 2017

Great and Wise Got Broke

Marty’s doctor, Great and Wise, our medical Sherpa, our entrĂ©e to all things medical, our health security blanket is broken, at least temporarily.  We don’t like it not one itty bitty bit.  He’s kind of important to Marty’s health and my sanity.

This man got sick, he will recover, and I am certain it roiled the medical community in little ol Waco.  I know it caught his 1000 or 5000 or so patients by surprise when he posted on face book that he had experienced a heart attack.  

This is the guy who has sat by the bed of so many who were sick and afraid, who has been with people at their very best moments and their very worst.  This is the guy who has held hands with people as they have let go of life and been there when life started for some. 

He’s not supposed to break, ever.  I guess supposed to has nothing to do with real life.
Marty and Great and Wise go way back.  She first came to know him when she was working in conjunction with an indigent care organization in Waco called the Family Practice Center.  Marty was training academic physicians to be better teachers and Great and Wise was learning to be a really great doctor.  She always, always talked about his compassion.

When he set up a local family practice office Marty was looking for a physician with the kind of smarts, compassion and concern that Great and Wish had, the rest is history.  Having G and W as her family doctor when she had her strokes is the single best thing we had going for us.  

I didn’t know at the time what a big deal it was that he was Marty’s doctor, I didn’t realize exactly how important he would be to us, I do now.  I remember when Marty was in Dallas in rehab and she was and medically she was having a difficult time.  The third time she was hospitalized for pneumonia I decided it was time to punt.  I searched through Marty’s phone book and called Great and Wise one Saturday afternoon and asked if he could bring us back to Waco.  The next day we waved to Dallas in our rear view mirror.  He saved my sanity that day.

When you have a chronic medical issue, when you are the brittle patient Marty is there are things you discover you need in a physician.  You really need someone who is available, someone you can contact, someone who directs their clinic to get you in when you need to get in and see the doctor. 
You have to have someone who listens, who takes the time to hear what you have to say and actually hears what you are saying and takes it into consideration in developing a treatment plan.

 And what I never really understood, what seems at first glance inconsequential is you really need continuity of care.  You need a doctor who knows you, who knows all of the ins and outs of what ails you and those things that don’t ail you.  You need a doctor who guides the other docs you have to see, you need a doctor who follows your hospitalization and knows your care routine well enough to know when you need to be in the hospital and when you don’t.  

Great and Wise does all of these things for Marty and for me plus some other great stuff, like creating trust.  Great and Wise insists that his people, the nurses, the front office staff, the back office folks all do the same, all practice the same patient centered caring medicine.  All of them make a hard life better.

I can remember talking to Toni, one of Great and Wise’s past nurses, sitting in the office waiting for the good doctor and telling Toni, “I don’t know if Marty really needs to see Great and Wise, I think this visit is for me.”  She patted me on the back and said that’s okay, that’s the way our office works.  Not once, not one time have I ever felt stupid for calling or going in.  Not once has anyone in his office ever made me feel guilty for worrying about my wife.

I suspect Great and Wise will be getting back to his great and wise self in the next few weeks.  He initially indicated a four to ten week recovery period and then some nonsense about four weeks.   My guess is Mrs. Great and Wise will have something to say about the whole re-entry thing.  

Our goal here is for Marty to be immaculately healthy for the next ten weeks because a sick Marty and a sick Great and Wise is bad for Marty’s Husband.   Our world needs doctors like this man to be a happy, healthy and strong Great and Wise.  

At this point our doctor, our friend, our overall good guy needs to, for once, put himself first and foremost.  He needs to take the time and space to recover.  We want him back, we need him back in our corner, but mostly, mostly we need our friend well.

Friday, May 19, 2017

Her Soul

I suspect we all do it to some extent or another, viewing the past as better than the present, you know, the good old days.  For instance, when I was a kid I don’t remember the sun being so hot.  We would be outside all day long and I just don’t remember feeling the sun beating down on me like it does today.

Now I don’t really think the sun is hotter, I think that’s the simply the way I remember it because time has a funny way of tempering the temperature of our history.

The other day we were visited in our home by the Right Reverend Leslie from First Presbyterian of Waco.   I will always have a special place in my heart for the Right Rev because the first time she ever visited Marty in the hospital she walked in while Marty was alone and started feeding her spaghetti.  That’s not an easy thing to feed someone.   There are things people have done for you that make a lifelong good impression; gently helping my bride eat spaghetti is one of those.

Sorry, I digress.

The Right Rev is talking to me, talking to Marty and I’m talking to her, probably too much, I do that you know.   It’s one of those days where Marty isn’t responding very much and I start thinking, well wishing more than thinking, wishing that the Right Reverend could have known the old Marty, before the strokes robbed us of the old Marty, before the strokes gave us the new Marty.

I’m not sure, but the more I think about it the more I think that’s not a very healthy approach to the here and now.  Yeah, it’s good to have memories, it’s good to know what was, it’s okay to miss part of what was but the simple truth is, the sun was as hot back when I was a kid as it is now and what we have to live with is how the sun feels today, right here and now.

My memories of Marty before are mostly good memories but she wasn’t perfect, I wasn’t perfect, our relationship wasn’t perfect.  We fought, we cried, we felt pain, we felt anger, we hurt each other and for each other.  Yet, yet, the parts of what was are so alluring because somehow, in my revisionist memory, the sun didn’t feel as hot back then.

More importantly longing for what was robs you of what is right now and frankly what is with me, what is with Marty right now, today, is pretty damn good.  Do I wish she was back in charge, do I wish she could stand and grab me and kiss me, do I wish she would make some snide remark that would make me do a spit take, do I wish we could talk about the deeper meaning of King Arthur’s Sword, do I wish we could argue about where to park again?  You bet I do.

But I/we can never allow that longing for what was short change what we have right here and now.
The today Marty, the Marty Right Rev has met and gotten to know is worth knowing.  Marty is a woman who has fought strokes and won.  Marty is a woman who has lost the pieces of her she prized the most and she has survived countless indignities with the core of who she is intact.  Marty is a woman who has experienced the worst in life and kept living, kept living in spite of her body, in spite of what her body did to her.  

What must never be forgotten is that Marty’s core, her soul, the real Marty, the essence of the woman I knew and now know is still there.  It’s quieter, it’s more reserved, it’s suffered from catastrophic illness, but her core, her soul, that which is quintessentially Marty is still there.

It all goes back to something Marty told me, almost daily; be in the here and now, accept and embrace what is and don’t worry too much about what was or what will be.  

This is easy to say and hard to do on a daily basis.  While I relish the idea that the sun was not as hot on 12 year old shoulders as it is on 63 year old shoulders, while I need and want to remember that feeling of the 12 year old boy, I am where I am now, I am with my bride today, not yesterday and she is pretty damn fine today, who cares about the sun anyway.

Thursday, May 11, 2017

The Oral Dude

We, and when I say we I mean Marty, started the process of implants a couple of weeks ago.  And, when I say implants I don’t mean the soft squishy silicon kind, I mean the dental kind.

We have had a good run of health lately and it is past time to revisit the dental issue Marty has experienced most of her life.  I don’t like dental stuff, the very thought of it gives me the heebie jeebies, and when I say heeby jeeby I mean massive, light headed, creeps.

I’m not sure why I have such an aversion to the tooth and gum, but I do.  I have sat beside Marty and held her hand in a lot of medical situations in the past years but when it comes to removing teeth, I have to excuse myself lest the dental hygienist has to break out the smelling salts and that looks bad for an old man.

We have been mulling this whole ordeal for about two years.  We first visited the implant guy some many months ago and Marty said nope, nada and I just didn’t have the conviction to put her and our bank account through that assault on her mouth.  

Over the ensuing months Marty lost more teeth and more were becoming less viable.  Even Marty agreed it was time to do something and implants seemed the best option for my bride.  Marty is a fidgeter with everything and I can’t imagine dentures would ever stay in her mouth….so implants were the best solution.

The implant thing is a multi-stage process.   You have to get molded for a temporary prosthesis you will wear for months, you get teeth extracted, titanium posts inserted into the bones in your mouth and then the temporary set of teeth fitted and screwed into your mouth.  Exciting huh?  

Getting the mold done was a big nothing.  The big stage, removing teeth and screwing metal into her gums took about five hour.  Marty was not sedated except the Xanax I gave her a couple of hours before she hit the chair.  

I moved Marty into the chair and stayed until they brought the 21st century torture devices and left poor Marty to the good graces of the nurses and the oral dude.  I’m told they numbed her mouth really well and she sat there with people pulling teeth, cutting her gums, hammering and screwing posts in her for five hours.  In case it’s not clear, my wife is one tough chick.

All went as planned and we got Marty home about 4:30 and of course took her to bed, got her some ice packs, some pain meds and soup.  I’m a firm believer in pain meds, reasonably used, and they make Marty real sleepy which is clearly the way to do oral surgery.  Sleep through the recovery to the extent that you can.

The next day my bride was bruised and swollen, she looked like she had been through a street fight and lost.  We went to the dentist for them to check the temporary teeth they had screwed into her upper gums and all was good.  Marty, for her part, due to the pain meds was way high by this time.  

All was fine.  Marty’s pain was manageable, she was more than a little high from the meds (she’s a cheap drunk anymore), and the temporary teeth were doing fine.  Marty was bruised, battered and drugged, other than that, peachy keen.
The bruising got worse, the pain got better, and slowly, as the bruising turned from purple to yellow and moved around her mouth and to her left eye, the eating got better and she could have something besides soup.

Today, the yellow marks on her face are gone, the teeth look dandy and eating is just fine as long as we stay away from really chewy hard foods which we would do anyway.  We went back to the oral surgeon, he checked and she is doing well.  The oral dude recommended we start using a water pick, which should be a huge mess every time we use it, but okay, we shall do that too.

Every time we go through one of these “procedures” I am reminded of how far we have come in Marty’s recovery and what a tough, resilient person my bride is.  Do what she had done to me and I’m out for a month.  

Not Marty, she just deals with each and every new assault to her body and she quietly and simply does the next thing.  She doesn’t complain, she doesn’t moan, she doesn’t pitch or make life hard for those who care for her the most and want to help her.  

She is one tough mama and now she has a really cool set of temporary teeth just waiting for the new ones like an impending Christmas present. 
God gave me the right woman.

Wednesday, March 29, 2017

Hope -- More than a Town in Arkansas

Hope.  Hope is one of those words, over used, under understood.

I sort of think I get hope.  I think I understand hope and I’m pretty sure I recognize that without it life is, well hopeless.  Can you think of anything worse than being or living in abject hopelessness?  I can’t.

There are all kinds of hope.  There’s Bob Hope, the Cape of Good Hope, I hope you are well, my best hopes for you,  hope springs eternal and one of my faves, hope and change.  There’s I hope my parents are healthy, I hope my children are happy, I hope my grandchildren are safe, I hope our leaders are wise, I hope my wife is free of infection, I hope the next illness isn’t her last. 

Then there are hopes and prayers, for me, that’s the big one.  For me, hope is really nothing more, but nothing less, than a prayer, a prayer for the future; because hope is almost always about the trails we have yet to walk.

Marty, just by surviving the two strokes and a myriad of other bodily insults, has inspired hope in me.  Yes, I hope she stays healthy; I hope she continues, even ten years past the events, to improve, to get smarter, to get healthier, and to get stronger.   Mostly she simply lives and breathes and shows me that hope does spring from rather dark times.   

What Marty has taught me, what she lives every day is very real, very tangible hope.  She takes her own hopes and mine with her everywhere, every day.

Hope, and maybe a little bit of denial, is what sustained our family in the darkest days of our journey.  Hope is what I had when I looked at her broken body too close to death and whispered, don’t you leave me and she said, I’m not ready yet.  Hope is what she had, we had, as we came home and started a forever journey in recovery from the strokes.  Hope, sometimes, is all we or any of us have.

Hope is a new born baby, hope is a smile in the face of adversity, hope is starting anew or continuing an old trail, hope is at the bottom of the mountain and at the top, hope is for all time for all people.  Hope is what keeps all of us taking the next step, hope is how we battle fear, how we battle our own demons, hope is how the least of us continue their struggle to be the best of us.

When I look at my children and grand children I have hope for what lies ahead for them and for our family.  I am amazed at how smart, how dedicated, how loving, how strong they all are.  They will have trials, they have had trials, but they will move forward and carry my hopes, and their hopes forward through their lives.

I look at my bride, I see her as she is, I remember her as she was and I have hope, I believe in her, I believe in her life and our life, and I hope and know that love is there and we are better than okay.

Hope is not magical thinking.   Hope is a serious process about real things, future things.  Hope precedes action and action fulfills hope and all of that makes life worth living.

Friday, March 3, 2017

Death's a Bummer

It’s a familiar conversation.  It’s not new to either our talks or thoughts.  We have thought and talked about it before, maybe too much, maybe to the point of ridiculous, who knows.  It was a beautiful day outside so why not go outside and talk about death and dying.  Don’t you do that?

The home health nurse, a woman we have known for years because her son and our daughter were friends, brought it up in a recent visit.  She is a familiar face; certainly the topic of dying wishes is a familiar topic.  She wanted to know, we needed to decide, what do we want, what does Marty want if, God forbid, IT happens.

I told the nurse we knew, I told her we had already done the whole DNR thing at the hospital, I told her I had the medical power of attorney and Marty and I had had THE talk.  She said we needed to talk some more.  

So once again, we played the whole, let’s pretend you stopped breathing game.  Oh boy, fun times at the Kinards house. 
The weir d thing is, somehow, some way it seems different, the whole let me die thing, when you are at home, as opposed to being in the hospital.  I really really didn’t like saying, “Sure, don’t make her heart start beating again” when we were in the hospital.  

It’s exponentially harder and cuts more to the bone for me to say “let her die” when we are in our home, a home we have had for almost 30 years.  It feels different, in our home it feels more like quitting than it does in a medical setting.

We talked.  It was a lovely day outside so why not talk about dying.  It was like spring, the sun was warm on my face, it was relatively quiet, and the wind wasn’t blowing, so why not visit about how you want to be treated in a near death situation.

Marty is almost always game for the discussion, she never really shies away from confronting her own mortality and she has never, not one time, not one scintilla waivered about what she wants.  She very simply does not want to be restarted, she doesn’t want heroic measure, she doesn’t want tubes down her nose, her throat and in her body, she wants to move on when that moment arrives.

I know, without a doubt, without any equivocation what Marty’s wishes are about all of this.  The question has never been knowing, the question has and always will be my own courage to step back and let her go.  I can talk about it, I can talk a really strong game, I can say, “Sure, you bet, whatever you want.”  

Can I do it, can I let go, can I be strong enough, can I be certain enough, can I be resolved enough to be what Marty wants me to be?  The truth is, I don’t know, everything is a theory until you are confronted with real life.

I don’t know about this whole dying thing.  I know people who are convinced that there is more existence after life.  I don’t know if I’m there, I envy that certainty.   I wish death didn’t seem so dark to me, but it does and I don’t know if I can simply watch my passion pass on without fighting one more time, I simply don’t know.

What does make me feel better is what Marty told my some years ago  in one of our many conversations about living and dying.   I asked Marty if she was afraid of dying, if she worried about it at all.  She said of course she worries about it, and then she looked me straight in the eye, broken brain and all and said, “But really, I think that dying is just another way of being.”

That makes her feel better, and guess what; I’m going to go with her on this.  

I hate the conversation a lot more than she does.  She knows, and I know this is talk that needs to happen.  You should do it too.