Friday, January 29, 2010

Political Commentary

Marty and I listened to the President deliver his State of the Union address Wednesday night. The man is, if nothing else, one of the best orators of our time. It helps that I agree with most of what he says, but he is undeniably a talented man, and I appreciate that he can develop and deliver a coherent sentence. It gives me hope for reducing the sucking sound we hear everywhere.

In my view President Obama is not a radical left wing nut but a pragmatist with populist tendencies. It is clear he believes the government should play a large role in improving the lives of its citizens. It's equally clear by the looks on Republican's faces at the SOTU, they don't agree. That's America, not agreeing, that's okay. But, to simply call Obama a radical is at best disingenuous and at worst ignorant. He's just not that simple.

Last night I think he articulated what many of us are thinking and wanting, and for me, reinforced why I voted for him. I think he is populist in his desire to reregulate banks and financial institutions, I think he is populist in wanting the government to draft a jobs bill to help people go back to work, I think he is populist when he implores our Congress not to give up on health care. I think he is pragmatic enough to know we need to use all of our resources for energy, I think he is pragmatic when he gave tax cuts to so many, I think his pragmatism shows when he draws a line in the sand for Iran and when he calls for capital gains tax cuts for small business.

In many ways Obama’s life would be easier and certainly more appealing to his base if he acted as radical as some want to paint him. Trying to live a nuanced life where you listen to all sides, where you are open to the opposition is a lot more difficult than being an ideologue. When you take a hard and fast stand on everything it's really easy, you don't have to think, you just have to parrot a party line or talking point. I believe Obama to be a nuanced man, that's why I voted for him and why I will vote for him again if given the opportunity. We don't need ideologues in that office anymore.

Ideologues on both sides are responsible for the grid lock everywhere. Ideologues on both sides are the reason we have not reformed health care. Republicans would like all of us to believe they are willing and ready to negotiate. Reality says, they have said, we want to defeat something like health care because it will harm Obama, it will further our political interests. They only want to negotiate if they as the minority party can act as the majority. It's not policy they are concerned with, they are concerned with elections. That doesn't seem particularly patriotic, it seems self serving. I really don't think the Democrats are any better, I just agree with them more often than not.

What I really want to see is the President step up and be the leader I think he can be. I think his first year has been one of some success and some clear failure. I don't think John McCain, Mitt Romney or thank God, Sarah Palin would have done any better or frankly done much different. I want to see Obama be more aggressive, I want to see my President get behind is own words that he would rather be a great one term president than a mediocre two term president. I too want him to be a great president. I would hope everyone would, it's what our country really needs.

Tuesday, January 26, 2010

Your Turn

I must say I have not missed work one day. I have not missed the meetings, I have not missed the storms (it took about a year to relax when it rained), I have not missed the pressure, I have not missed the obsessive antagonistic attitude one must have in management and I have not missed getting up and staying late. I have missed people.

I am genuinely a people person. I like people. I like quite people, loud people, sweet people, grouchy people, and fat ones, round ones, skinny ones, old ones or young ones. I like people. I like to listen to people talk. I really am interested in another person's story, in why they are where and what they are. This is what Marty taught me, don't just pretend to be interested, be interested; don't just pretend to listen, really listen and understand that our life’s experiences give us a window on who we are. Clearly I married a psychologist.

Most people who have worked with me can attest to my somewhat intrusive nature. I ask questions, sometimes personal questions. I ask not out of a prurient interest but I just like to know you and I get to know you by the stories you tell about yourself. It goes back to the five words I learned from Marty, "how do you feel about that?"

I want you all to try an experiment with us. I don't know everyone who reads my rather verbose ramblings but I have told our story and now I want to know yours. This will scratch an enormous mental itch of mine.

I know some of you are young (relatively), some are older (delicately put), some know Marty and I very well, some may not know us at all, but I want you to take a few minutes and in the comments leave me your story . It can be as long (I'm not sure what the comments character limitations might be) or as short as you want. It can be anonymous or you can use your full name and leave your social security number (not really). What I want to know, what we all want to know is who you are, where you came from, what you do with your life and why.

I read all of this to Marty. I read all of the posting and most of the comments to her. She really likes the blog, it is a way for her to connect to people and that has always been paramount for her and me.

I know she will love to hear your stories. She is like me, a student and lover of people. She’s always been that way and has not changed. All it takes is one of you to start and then others will follow so who will be the first to tell their story. Give it a shot.

Monday, January 25, 2010

Who She Knows

Someone asked me the other day if Marty would recognize them.  My standard response and a response that is approved by Marty,  is she remembers everyone she knew before the stroke and some of those who are with her all of the time after the stroke and all of those who are really important to her.  She may not remember names but she recognizes and absolutely knows who they are and what they are to her.

There have been two people she has obviously etched in her memory since she had her strokes.  Two that she never forgets their name and knows immediately -- Lyle (go figure), Erin's significant other, and of course Noah. 

She always remembers Noah's name and knows exactly who Noah is and to whom he belongs.  Make no mistake, she knows her grandson and she knows she is a Grandmama. 

Marty relishes her chances with Noah and what I hope is we are able to give Noah and others a very real picture of who Marty really is, what her story is and what she has been to so many.  That's his Daddy's job and that's my job.  Noah will have to know Marty's old normal through us.  .

Maybe in the long run it's not so important that Marty knows who other people are -- I really want other people to know her, all of her.

Saturday, January 23, 2010

Coughing and Wheezing

Marty is still coughing and wheezing. Marty's husband is still obsessing, going quietly crazy and driving her nuts. Renae, caregiver supreme, tells me I'm doing better than I did two years ago. She tells me we would have been to the emergency room a couple of times by now, two years ago. I don't feel the improvement.

Marty's blood test and sputum culture both came back earlier this week with good news, no infection. Still, she is coughing and hacking around and wheezing. It's the wheezing, the asthma that is the most troubling to me. She seems pretty okay with the whole thing, I'm the one who needs the treatments now. I still remember Marty's words when I would get anxious, take a deep breath, and breathe. Okay, I'm doing that, my breathing is fine -- it's Marty's I'm obsessing about.

We have been to the office and received the counsel of Great and Wise twice this week. The first appointment was to check Marty, the second appointment to provide clinical teaching and cognitive therapy for her husband. Like the mystery noise in your car which quits when you take it to the shop, Marty is always breathing quietly and smoothly when we see the good doctor. They are really generous with me at that shop and allow me my psychoses.

Marty tells Great and Wise, "Larry just doesn't know what to do with me when I'm feeling good." Maybe I am a bit hyper vigilant. Could be.

Marty asks Great and Wise, "What can they do for me at the hospital that we can't do at home." She says this to pre-empt any attempt to even go the hospital. She is really crafty that way because Great and Wise lists the litany of things we do at home and says, "Nothing." I get a "so there" look from Marty. She's brain damaged only when it is convenient for her. She can still make her point, which is I don't want to go anywhere close to the hospital.

I wrote once that you can tell how our life is going by the number of trips we have made to the doctor or the hospital. Given that, it hasn't been the best of weeks, we have seen and talked to her doctor way too much but I have managed to avoid a trip to the ER, so far.

Marty still battles the stroke recovery and whatever particular respiratory malady is the flavor of the day. Me, I just battle myself.

Wednesday, January 20, 2010

Tuesday, January 19, 2010

Sweating

I'm not really sure when the "flop sweats" became a clue of anxiety for me. Any time my anxiety level starts to move higher than the five it normally is, I start to sweat (women perspire, men sweat). I've been sweating a bit lately. In my new life of leisure the most likely source of this sweating is Marty.

Over the last 3 or 4 days Marty has been hacking, coughing and wheezing a lot. Normally coughing is good for her. This coughing is hard, loud, frequent and probably painful. We have done all of the stuff we normally do: trip to the Great and Wise, blood drawn, steroid shot, sputum collected and being cultured. Now we wait and see what comes of the tests. It could be an infection, it could be exacerbated asthma from the coughing, or it could be a new thing we need to handle. We will see. In the meantime we treat the symptoms.

Treating the symptoms, easy to say. This entails more breathing treatment, steroids, chest percussion, nasal lavages (very gross) and worst of all deep suctioning.

I've written a bit about deep suctioning but I'm not sure I've ever really managed to quite grasp the ugly essence of this particular procedure. No one likes to do this, certainly not Marty. It's painful, its' uncomfortable, it's invasive in the extreme. You have to insist that experienced Respiratory Therapists do it or they won't because it is so uncomfortable. It is the only procedure done on Marty where I simply had to leave the room. I finally found a nurse to come to the house and she showed me how to do it. I now do it and the only person who hates it more than Marty is me.

First you need the equipment. You need a suction pump with all of the assorted hoses and canisters. You must have sterile gloves (not easy to find size large). You must have the suction catheters which are long, thin sterile tubes, 14 French for adults. And, of course, you need sterile lube.

After you get everything prepared, don the sterile gloves, stretch the end of the catheter a bit to soften it, you then coat the bottom end of the catheter with the sterile lube. Marty lies flat on her back, we have found this works best for her. The caregivers sit on the bed with her and hold her right hand. Marty insists that they stay and hold her hand and provide tissues. It's the only thing she really demands.

I then take the end of the catheter and slowly insert it into Marty's left nostril, the right side bleeds too much. This is where she starts to say, "Oh, Oh, Oh" and coughs and gags. The gagging generally gets a bit worse as I snake the catheter down, twisting a bit as I go, through the sinuses. If I meet any resistance at all, I stop, pull back slightly, twist some more, and continue to insert the tube trying not to scratch her throat or her sinuses. I push the catheter down through the sinuses into her throat with her coughing and gagging until I find some resistance, the epiglottis.

There we start a routine where I ask Marty to blow in my face as hard as she can. This process gets her to take a deep breath and open the airway. If I time it just right I can then get past the epiglottis as it opens and into the airway and start suctioning. I know the tube is where it's supposed to be if Marty's face starts to turn red, she starts coughing really hard, and sputum is sucked into the tubing. If I don't get it the first time, we keep trying until we get it. Marty and I do this like a practiced dance; we do it together and are generally pretty successful, it takes a long time and multiple tries to get it right. But, to say this whole process sucks doesn't really do justice to the invasion of the body.

Think about having someone cram a tube down your nose. Think about the times the Doctor has gagged you checking your tonsils and then multiply that level of discomfort. Think about having the wind knocked from you as you are trying to cough thick crap out of your lungs. Then ask someone who really loves you to do all of that to you. Maybe that's why I sweat.

Last night Marty was really having a hard time getting to sleep. I had basically avoided the whole suctioning thing last night hoping to wait until morning. I had asked Marty what she thought, she agreed, wait until tomorrow. About midnight she was trying really hard to clear her chest and lungs by coughing hard, over and over. We really couldn't wait until morning or sleep would never come for any of us.

We suctioned. She was tired, I was tense and it was harder and took more attempts than normal. It wasn't easy, but we got it done. After suctioning it always takes her a few minutes to get her breath back and for her to get her composure back. If she talks it's always very raspy and breathy. Marty looked at me, reached for my hand and said, "I love you very much." Trying not to tear up myself I said, "I love you too". It's a hell of a way to show it.

Thursday, January 14, 2010

Lost and Found

I hate to admit it but I'm one of those guys. I am one of those husbands; I was probably one of those sons. I'm one of those "Do you know where it is?" kinds of guys.

You women know the kind. The husband who wants something not right in front of him and before he looks says, "Honey, do you know where my xxx is?" You know that guy. That's me. I've always depended on the kindness of those around me to know where my xxxx is.

It always starts the same. Someone asks you to do something. You know, like get ready to go somewhere.

"Marty where’s that blue shirt I wore that last time?"

Marty, "Did you look in the closet?"

Me, "Oh, okay, good call."

Marty, "Why don't you look before you ask the next time?"

Me, "Sure I will."

Over the 30 some odd years (actually only the last four and the middle six were really odd) we have been married the same scenario has played out countless times. My brain just won't let me seek objects out until I have asked the same stupid question. Where is it?

For the most part I no longer ask Marty where stuff is. The stroke has changed the dynamic. Now I put most of our stuff up or sometimes I choose to simply hide it from myself. I know asking Marty won't really help. I ask the caregivers but they almost always snicker, sort of make fun of me and then just ignore me. I then set out on an epic quest to find my underwear or whatever else I have lost.

Prior to Noah's baptism my Mother asked me if we still had the infant ring she had given to Matt at his baptism. Yeah, right. This was before I was sort of in charge. I didn't have any sort of license to know anything about baby's jewelry. But, it was a good question and it really got me interested because I thought it would be great if Matt and Noah could have this ring at Noah’s baptism.

I poked around a bit. I asked Erin if she had any idea where it might be and found nothing. I finally decided to ask Marty and she said, "It's in my jewelry box, in a plastic bag." I looked and sure enough, in her jewelry box in a plastic bag along with some other baptismal keepsakes was the ring. Her power to recall stuff that occurred prior to the first stroke is really pretty amazing. You just have to get her focused.

I often long for the halcyon days of being just a guy who walked around a little clueless always asking their significant other where their stuff is. I'm still pretty clueless on a lot of days and sometimes, sometimes I can still count on my bride to know where I can find my stuff.

Monday, January 11, 2010

Grace

"An outward sign of an inward grace." I first heard this description of Presbyterian sacraments from the right Reverend Bob Moon, the pastor of the First Presbyterian Church in Hillsboro Texas. I was just getting back to the Presbyterian church and learning theology and polity while taking my first officer's training class prior to Deacon ordination in the Hillsboro Church.

There are two sacraments in the Presbyterian Church, communion and baptism. Bob used the above quote to help us all understand why Presbyterians do what they do. We believe that God is omnipotent, loving and generous and that human kind basically kind of sucks. We believe God's grace is for all and God does not depend on us to earn his grace because, well, see the previous statement, we kind of screw up everything pretty much all of the time so if God waited for us to be good enough, not going to happen, therefore God's grace. Thus, in our theology we use human signals, human signs of God's grace and love for all of us. We find these in our sacraments.

Marty and I saw "an outward sign of God's grace" this weekend when we saw our first grandson Noah Robert Kinard baptized. We saw Noah and three other infants, through the church, baptized and introduced as children of God. We saw and heard the people of the church say they will take our grandson in their hearts and minds and live their own baptisms by keeping him in their heart and prayers. We saw our children stand with their first child, as we did 30 years ago, and promise to renounce evil and raise and teach Noah in the ways of Christ. We saw, with my parents, who stood with me 55 years ago as I was baptized, the connection of our faith and the grace of God in our lives.

In our church in Waco we always sing "Jesus Loves Me" as our minister, Jimmie Johnson, takes the baby down the aisle, in the midst of the church and introduces the child to the congregation. I'm a bit chagrined to confess I always, always find this moment particularly moving. In Matt and Sarah's church in Dallas, the concept is the same as the minister introduced each of God's children to us. As I watched Noah being held by the minister who married Matt and Sarah I could feel the power of the moment. I looked at Marty in her chair as she intently watched the whole ceremony and I was once again reminded of that inward Grace that God freely gives.

Tuesday, January 5, 2010

King Noah Robert

Get your fat finger out'a my ear, please.

I can't believe they fired Mike Leach!!!!!



Great Grand Mama Kinard and Noah at the lake

Exhausted

Marty said, "I act like I feel happy. In fact, I really am happy. But I'm really tired of this"

Marty's husband asks, "Tired of what?"

"Being infirmed.", she replies.

For Marty, "infirmed" covers a lot. I know she is happy to "be" but I also know she constantly fights to think clearly, to see and understand things with an old clarity, and to say what is on her mind and in her heart.

I can see Marty's daily fights with clarity are exhausting for her. She lost what she always thought was the best part of herself, her ability to think and communicate. She's aware she lost it, losing it hurts her heart and she constantly struggles to get it back. It's a monumental and never ending war within her.

I watch Marty in crowds of people. I watch her when we are out at a restaurant. I watch her when we are with friends and I see behind her eyes; I see her mind churning and reeling, trying to engage in a way that is familiar. It tries to fire and just can't quite turn over and start running in the way she remembers. It's frustrating and she gets tired and turns inward. Coping with her new normal, finding ways in which she can function with the constraints of her broken brain is constant and I think, incredibly taxing emotionally, physically and mentally.

Recovery from a stroke, recovery from any completely debilitating event is life long. Recovery requires energy which requires rest. It took us a while but we finally discovered that the more physical and mental R&R Marty could get the better she felt, the better she related, the better she could engage. For Marty the mere act of engaging takes a tremendous amount of strength and energy, she needs the rest. Her daily struggle to participate in the simplest forms of life is the greatest testament she can give to all of us.

Over the holidays I watched Noah, our brand new wonderful grandbaby who is perfect in every way and is probably the smartest kid in the world, lie on his back and watch the ceiling fan as it slowly rotated over his head. He kicked, he moved his arms and his hands and he moved his head from side-to-side. He was constant motion. It's not surprising he requires so much sleep. When he is awake everything is a stimuli and he is firing on all neurons. It has to be exhausting.

I see him and his constant motion and I think of how hard Marty has to work to engage and be a part of all of the things she used to take for granted. I think it's like constant motion in her brain. I'd be tired of it too. I hope, like her, I would never get too tired to keep trying.