Do What Mom Did - drink coffee!

In this society, we are often over zealous on what and what not to drink or eat. Today, I am remembering my mom (or "mother" as she preferred to be called) and her living habits. She listened but did not change her living habits when a news article came out saying - don't eat this, do drink this, that is bad for your health, etc etc. What she did do was give me a pattern that seems to work out in the long run. She told me when she was 86 years old, when I was telling her I needed to cut down my intake of coffee - "Hey, I am 86 and I drink lots of coffee every day. You like coffee? Drink it. Your body says it is good for you." Keep in mind that my dear wife says - "don't drink so much coffee; it is bad for you." Well, I can go to sleep on several cups, sooooo .... Different strokes for different folks.

Today as I was reading the news, I came across yet another scientific study that says coffee has its possible benefits (isn't it odd that there is such a reluctance to commit to a conclusion?), so that is my motivation for speaking out on this. Give me coffee. I got a cup in my hand right now!

So I am sharing the news with you. Starbucks is a health joint(maybe I should be a bit more politically sensitive - there are other health joints out there). If you want to avoid Dementia - drink coffee. If you want to lower your risk of Parkinson's disease or lower your chances of arterial disease, drink coffee. OK, now I am stretching this a little, yet I have read several articles on the subject this morning and the conclusion is that coffee is perhaps not bad for you and in fact perhaps good. See? I can be non-committal also. Java now, Java tomorrow, Java forever! My pot of java is mine to drink.

You can Google this yourself, but I will give you the New York Times story that started all of this today. "Coffee Linked to Lower Dementia Risk" If you want to see a pretty nice summary of health effects, you might look at this web page - Coffee Science Information Center - summary of findings

Intensive Care (ICU) - procedural issues, hope for the future

Intensive hospital care over the years has become an increasingly important specialty in the medical profession. It is staffed by folks who are under significant stress and who typically aim to make the patient comfortable while administering procedures to improve and stabilize body functions to a state of self sufficiency. While under the care of these special people, a person will be constantly monitored and there will be a rapid response to discomfort and any threatening change of condition. However, I have an experience to tell, as many of you probably do as well, where there are serious issues with the processes and procedures.

In my case, a fairly healthy somewhat weak elderly person incurs a fall, perhaps due to a mild heart attack. She is unable to rise but crawls to an emergency call button in the middle of the night and attempts to get help but passes out just before she gets to the button. Her distress is not discovered for more than a day.

When discovered, she is transported to the hospital and treated in the emergency room where her condition is stabilized. Then she is taken to the ICU unit to be treated and monitored until she can be moved to a regular room. In the ICU, the family is solaced to see her being cared for intensively. She is connected to a heart monitor and a breathing monitor; she is apparently comfortable. Now her family sees and hears that her vital signs indicate that she is OK. One day later, this person is conscious and able to discern what is happening around her. Things are looking up!

In two days, she looks better and is moved to a regular room. She smiles and is happy to be around her family. The heart starts to beat at a high pace, so she is moved back to the ICU. Now after two days, new problems surface. Her skin is damaged by laying on the floor. She is beginning to suffer more from the weakness of being bed ridden along with the trauma of the fall and laying on the floor.

In a day or so, due to her skin condition, a special mattress for burn patients is ordered. That would seem to help and it probably did. Yet the burden of weight on those same damaged tissues presents a serious threat to her health, sustaining the wounds, even though she is turned every two hours. She is on some serious pain killers for her skin. Nurses keep saying that they are trying to make her as comfortable as possible. That is their goal. Then I am approached by the doctor. Levels of care are explained to me by the attending internist. He says she is in serious trouble and that we need to know the levels of care the hospital offers: (1) All emergency care needed to sustain her life, (2) All care to improve her health but without certain life saving procedures such as heart electrical stimuli should her heart fail, (3)Discontinue life saving techniques altogether and give her everything to make her comfortable until she passes, (4) Take her to a facility for the terminally ill, away from treatment facilities.

We chose the first level. This lady (my mom) had elected to live to the age of 90 or beyond. She was mentally competent and was able to live independently. She had events coming up that she did not want to miss. She wanted to live! So we gave her our full support.

Over the next three weeks in ICU, her health bounced around with good days and bad days. At one juncture, the internist wanted to talk to her and see if she still maintained her posture of recovery irregardless of the pain and difficulties involved. He took her off of sedatives with our consent. He told her to our surprise, that her condition was grave and she had less than a 5% chance of living through this. She could not have surgery because of her weak condition, and it appeared that she would need the surgery if her colon did not start to function very soon. He felt that her colon would never restart. In tears, my mom agreed to go to level two support. I intervened telling the doctor to at least tell her she had a fighting chance! Now I could tell that she was beginning to give in to the illness. She would never recover from this declaration by the doctor. No superman saving techniques would be allowed now.

The next day, dramatically her colon starts to function. She is recovering and able to eat now. Off with the intravenous liquid feeding. This afternoon, the doctor changes his prognosis to a 60% chance of survival, but is unable to tell her so under the same conditions as before. He does say the words, but in my estimation, she does not understand what he says. She does not respond. We remain at level two support.

A few days later, her lungs can no longer sustain her. She has liquid in her lungs and even though she is not running a temperature, the doctors say she needs breathing assistance. She has been on oxygen for a couple of days. So as an emergency procedure, her family decides to put her on a respirator. This is not considered a level one procedure but must be administered as such, because we waited until the last minute to allow it. Now she is on a respirator, a liquid food diet administered by tube, a kidney dialysis machine, and bi-daily skin care.

Her health gradually deteriorates.

Finally, after one month of intensive care, we honor her written request to be taken off of life support systems. She passes away hours thereafter.

In retrospect, I can see very significant opportunities for improvement in the processes and procedures I saw during this long time in the ICU. For one, I feel she needed to be floated, suspended in a water type bed where the medium would be about the same density of the human body. She needed to be removed from the consequences of the gravity of this earth. Medicine apparently does not offer such support systems. I ask the question, why not? Isn't such an invention available? It is an obvious solution to the problem. When we are in water, there is great relief by flotation. Then we look at the other obvious and related part to this. Should not there be some way for a person to get exercise in this environment? Is the ICU patient supposed to abandon all exercise? Is the patient capable of some form of exercise? Isn't exercise supposed to be part of maintaining the human body?

I had this general topic on my list of things to write about, but until today, I had not seen anything supporting this thought process. Today I just read one in the New York Times (see link below). This is a good start towards improving the ICU. I plan to respond, supporting this study on exercise for those in an ICU, especially for those with extended stays (more than 2 days).

It is my sincere belief that my mom died before her time, even though she was 87 years old, because of ineffective procedures and archaic thinking in the ICU. Her age and the related ICU strategies is another subject that I will write about some another time.

New York Times article - A Tactic to Cut I.C.U. Trauma: Get Patients Up

Christmas - the thought is all that counts

How many times in our lives are we told "it isn't the gift but the thought behind it that really counts"? Some will argue that gift giving is better left alone if it is not full of personal thought. I guess from my personal point of view, I agree on the most part. However, I could tell you about one of my relatives who gave the same firecracker gift to me every year, and I remember her well for it. So I can attest to the fact that gift giving has its place even if the person giving does not know much about the person to whom it is given to. A relationship between two people is established and sustained, partially through the gift giving process.

Oops, we just introduced another concept to the equation - "process". Sure, gift giving is a process. For example, if you give to impress, that is the beginning of a process to gain something or expect something in return, thereby initiating a process. If you give to signify love, you expect to be loved. If you give to educate, you want feedback on how the education thought you had helped the one you wanted to educate. Some gifts are very simple and low cost such as a Christmas card. You hope to get a card back in return, not just a card to show off on a mantle or Christmas tree, but one that communicates socially, boosting the relationship you have with another person or family. Some gifts are intended to be worn and you want to see the recipient wearing it and enjoying it, and be remembered by your gift. Sometimes, the gift needs immediate feedback. A simple "thank you" will suffice. There are charitable cases where the gift needs no feedback except the fulfillment of helping another human being survive. But after the gift is given, it too goes through a process even when anonymous. But giving without feedback and reward, even if the reward is self gratification, is empty and defeats the purpose of giving. So the thought of the gift is related to the process.

I tried to test this concept on some of my grandchildren. The value of the gift was not going to be very important, but I would maximize its value given the economic outlook. Although a bizarre approach, I wanted to do this in a way that would create a laugh and be remembered, mainly because the two grandchildren are quite intelligent and they both have some attributes in common which I thought I could leverage.

So thinking that the new year could be an economically stressful one, we decided that the gift would be for the parents as well. So even under economic stress, the boys would be able to go to an entertainment facility next summer on a season pass that we gave them.

Christmas would not be Christmas if the children would not open wrapped gifts. Just a piece of paper in an envelope seemed totally inappropriate. So I packaged the tickets in some gift wrapped boxes. To tie the gifts to their Papaw, inside each box contained an ordinary leaf from a tree; the leaf was attached to a handwritten note indicating what kind of tree it represented and in a tone of good humor. The ticket was hidden underneath the leaf in an envelope. I wanted to take this a step further however. So for the eldest, I made up a large box and put trash in it. Yep, I said trash! All recyclable stuff including boxes, paper, plastic bottles, everything I could find to make sure it looked like trash. I made it where the boxes would be challenging to open (work is required for everything one desires to have in life) and the true gift difficult to find in the box (value is recognized relative to other things). I wrapped the boxes with normal Christmas paper and added a stem of Yaupon berries to decorate the box. This was to connect what I love to their gifts. I warned the parents in advance that something strange might happen in the opening of these gifts.

For a moment, I felt a little tenseness among the adults in the room when my grandchild opened the big box. He looked at the contents and said, "trash!". Of course he has a great disposition and understands his papaw and how different my approach may be. We all laughed. Now what? I put a couple of additional envelopes in strategic locations within the box with a written message that indicated he had not opened the true gift yet, so he would go through a search of the box. He opened those envelopes first, because they were most visible when he opened the box. I could feel a sigh of relief when he finally discovered the actual gift, which was hidden under a piece of Styrofoam packaging material in the box. He laughed and appreciated the gift. His brother went through the same process. They both showed everyone in the room the leaves and my blog's business card. Both can now name those two trees by the shape of their leaves. Both boys are outdoorsy, and I want them to learn more about the forest about them. This worked out fine. It will be a Christmas that both kids will always remember. The process? They will remember where the tickets came from next summer when they go to the entertainment facility. The eldest will always remember the trash gift; I have made a place in his life that he will always remember. (He said a "new tradition", but I doubt we will see this again for a long long time). I am reasonably sure I will hear about this again in the future.

So now you see the rest of the story. Gift giving is not just getting the appropriate gift for the child. It is being remembered for the gift, family tradition and the bonding event memory of everyone there, the learning of something new, and finally the inclusion of everyone in the family to make sure all benefit from it. Mission accomplished.

Don't be afraid to be creative; select gifts with purpose and thoughtful knowledge of the recipients. It is the thought that really counts!

Baby Boomers getting a bad deal for retirement

Let's do the twist! A failing economy for Baby Boomers is not exactly what the doctor ordered for this time of their lives. This generation has many workers ready to enjoy the fruits of their work, but alas! It is crumbling underneath them. The American dream really was put in place by a generation before them, but this group of people certainly lived the American dream. It is with this generation that the world has been explored with the realization of globalization and far reaching technology visions. These people were born under the nuclear threat instituted by the generation before them, lived most of their lives through the cold war and its related nuclear threat, and worked to secure the world. They experienced fear as fear had never before been experienced. Why should that fear be extended into retirement?

And yes, this and the following generations have comprised what we know as the generations of consumerism, as well as those of "anti-consumerism", counteracting the destruction of the earth. Witness the population explosion. Not only was it here in this country, but worldwide after World War II. Soldiers returned home to start families and catch up with lost time. They were world-savvy, prepared to work and play in other countries as well as in the USA. Like a bulldozer, streets of life were carved out of the earth as fast as possible to return to normality. The birth rate soared! Construction soared! Consumption of materials soared!

There has been a significant concern that these people would leave the employed in recent years. There would not be enough workers to support the economy, nor would there be enough money in Social Security.

I suppose that will all change now. 401K's have greatly diminished value by as much as 50%. So much for the lifestyle of this population. Oh sure, some will retire. Some have plenty. Many many others will see this not only as a loss of wealth and quality of lifestyle, but as a future threat to their financial security as well. Surely the stock market has proven that we cannot depend on it. We cannot depend on commodities either. Oil prices are down. Sure, gold is up, but I have known people who lost their shirts in gold during the 90's. The bottom could fall out on it at any time. It is at a fictitious price level, inflated by a temporary demand.

This generation's financial solution is to continue working as long as it can. That is the only way to secure the future. Putting money under the mattress does not seem a good idea either, nor holding it in a money market account. Face it, retirement money is indexed to the health of business, here and afar. So the flower generation will likely continue to rock and roll for a few more years. Maybe retiring at 70 is better than 66 and certainly better than 62.

I have found a site where this type of thought is shared by several writers - Boomer Cafe.

Celebration of Death - planned departure from life

It is with a great deal of confidence that I say these words are not normally connected. This is a story where this was quite the case. Although sad to lose a loved one, you want your loved one to leave this world surrounded by love and appreciation for who you have been and best wishes for next steps of existence. That is of course unless you are adamant that there is no after life. And even then, most people will most likely bend towards the possibility anyway that there may be something in store for the person about to depart. Whatever the opinion on this matter, if you get the opportunity to celebrate a death, it can be a very satisfying event. No, it will not change your grief of losing someone you have loved perhaps your entire lifetime, nor will it remove the sadness that death simply must be a part of life. It does bring the picture into focus and let's you have those final moments with your loved one, celebrating life's joys, accomplishments. Hope and aspiration are gone at this point. Those things are left with the ones you are leaving behind.

We had this opportunity. It sort of fell in our laps. One of my sons and I discussed this idea when the doctor said it was about over. She was now on life support systems and there was no hope that she would ever be able to live independent of them. She directed us to pull the plug if that situation ever arose in her health. My mother had been fighting a multi-organ failure, caused by a fall and lying on a hard floor for about 36 hours. For one month in the hospital ICU she fought kidney failure, heart issues, digestive system failure, and severe skin failures. She was 87 and carried with into the hospital the goal to live to be at least 90. She had things to do, places to go. It was clear from the onset that she was to going to go down without a string battle. This was bothersome to the staff at the hospital. They wanted her to be without pain, totally comfortable. That is another story to be told. The point here is that she really did fight to recover. However, at every turn where she would improve, another thing would go wrong. The final blow was her lungs. She could no longer respire on her own, constantly battling new outbreaks of liquid on her lungs.

At 11AM, we met with the staff to discuss her condition. The decision was made to let her go. We would pull the respirator off. The doctor said it could take a few hours for her to pass away, but she would do so within 24 hours afterward. So the idea - let's take her off of the medicines that are keeping her sedated and unable to be conscious but keep her on pain medicine. The hospital staff resisted that idea but we won out in the debate, although we allowed some of the sedation on their advice but little of it. We called close friends and family to tell them what was going to happen. We would not take her off the respirator until the evening when everyone could get there. Some might have to travel some distance.

That afternoon, the sedatives began to dwindle in their effect. We had actually lowered them by request the night before but the staff had increased them in the morning, so we reversed that and by mid-afternoon she was able to communicate with her eyes and follow us by moving her head.During this time, we chose to be with her and watch her vital signs. At 6PM came the doctor.

He with the help from an assistant removed most of the tubes and then the breathing apparatus. Her food intake and other medical treatments by tube continued. The tubes for the kidneys were also removed. Everything to make her more comfortable! We had arranged for a CD player to be brought in and her bible was close at hand so that we could read to her.

The room began to fill rapidly. We made sure she knew when every person who came into the room. Her favorite hymn music was being played and one member of the family sat on either side of the bed holding her hands and occasionally hugging her. We would talk about things of the past and what was coming for the family. We talked about celebration - her life. It had indeed been a beautiful and long life. She had even a great great grandchild. Her children had lived a religious life and been successful. Some of her grandchildren had joined her church also. She had been a fine example to all of us and all of us wanted to be like her, accomplishing things, being a contributor to family successes throughout our lives. Yep, 87 years of continual service to God and family, well worth a celebration in which she should participate. And she did, as weak as she was, participate in her own celebration of life. She would soon enter into the world of the dead

Immediately after the respirator was cut off from her, she breathed rapidly and gasped for breath. I talked to her about how to make that easier and she changed to deep breaths. The oxygen level in her blood was not sufficiently high to sustain life for very long, so we understood that she was in a departing process. We would have been quite happy if that had been reversed but it did not. This would be better for her now and we knew it.

Now she was dying. Her heart continued to beat as it did before. There was a glimmer of hope in my mind, but I was prepared for the end. We talked. We laughed. We loved. As we changed who was next to her and as time passed, things being discussed about her and us and how we had finally reached where we were, her friends and some family had to get something to eat and get some rest. We had celebrated and the night was upon us. So after some three hours, the room quietened. Within five minutes, she gave up with two of her grandchildren by her side. I received a text message and then a call - "better come back". We ran. Her last heartbeats were showing on the monitor. We sat with her as she passed away, letting her brain cells fail and her heart to totally quit. She was dead. We cried. "She has gone to a better place." It is now the wait she has and hope in death for her savior's return. That was surely on her mind at the very end. Her family and friends had said good-by with great love! She can rest in peace.

Anxiety in the middle of the night

Having lost a loved one very recently, I am realizing there are parts to life one recognizes deep in the mind, which are evasive when all is calm and routine. When life's balance is interrupted by tragedy or unexpected death, or even expected death in the family, the human mind can reel off various triggers as one sleeps. Such a trigger went off this morning, alerting me subconsciously that something was wrong. Then the conscious part of the brain too over and I woke up. Not to forget the incident and in fact share it, I am writing this little entry into the blog.

So what happened? Nothing and that was the problem. For years, I have looked after my 87 year old mom who lives in another city, making sure someone was doing something for her or someone had something planned for her, or I had contacted her and said something to her to please her and make her feel loved.

I woke up in panic mode, thinking I had not done anything for a long time and had let things slip.

She passed away six weeks ago. Lesson? Be there for your parents when they get old. Make sure they are part of your daily routine. They will not be there forever and time moves so quickly! Part of liv'n is dying. We all know that. Also part of liv'n is caring and making sure those who are dying get to enjoy that which remains. We may be less aware of that. Everyone living is dying. We are probably too busy to realize this. There is less urgency in it.

The Last Lecture - reading to identify self and lessons learned

An incredible life journey for a common man with a common life reveals powerful lessons in life. Death of course is part of life. Early death is a tragedy. How do you turn a tragedy into a legacy for your family and friends? It has something to do with attitude. Here are the lessons I embrace from Randy Pausch, the author, who lived a life of only 47 years. I see him very similar to myself, so his book struck home very strongly for me. I hope that you read his book also and finish with a different circumspect vision of yourself as I did. This is the reason this book is so popular. It is a short but not one to be taken lightly.

• Family is foremost in all things. The father and mother play very important roles in a child's life. Being a father is to see that the child gets the opportunity to dream and set his roots into his vision of life, but guided and encouraged by his parents to be his own individual person. A daughter is very special and a good father will recognize that and see to it that she has the relationship needed to eventually embrace life as a woman with strong family and interpersonal values. Who falls in love with your daughter first? It is the father! I too am a member of the "wrapped-around-my-daughter's-finger club". Both sons and daughters learn from team sports, which by the way are not an extension of the parents but a learning experience of the child. Give your children as many opportunities as you can for this indirect learning. It is a "head fake", the type where your children learn what you want them to learn without them knowing it. The relationship of man and wife is difficult to maintain and grow. Direct communication and the realization of gaps is very important. Acceptance of the our mate is paramount to a good relationship regardless of perceived flaws.
• A positive attitude which seeks resolution on issues is like coasting downhill to happiness. Everything else becomes easier. Whining gets one nowhere; no one wants to hear it. When we're done whining, we are not any happier.
• What others think of us is not very important. What we think of others is. Look for the good in others and good will eventually come of it, especially if you specifically note it. Apply this rule to your children. They want to know that you like and appreciate about them. Tell them exactly why.
• Advice to a daughter - watch what the guys do, not what they say. Sweet talkers are a dime a dozen. The good ones operating from the heart are not so numerous.
• Define experience - what you got when you didn't get what you wanted.
• Be personal with people. Write notes by hand. You will be remembered and appreciated much more when picking the right time to write a note by hand. Typing on paper is impersonal. When meeting someone new, invest the time and effort to remember that person. At that time, that person is the most important person in the world to you.
• Give what you receive. Call this "forwarding on". Your rewards will be numerous.
• Preparation is a way to achieve and enjoy. Think ahead and do "what if's". That can improve the quality of your life tremendously.
• There are three parts to an apology. Tell it like it is, not what you want it to be. (1) What did I do wrong? (2) I feel badly for what I did. (3) How can I make it better?
• The truth will set you free. It also sets the stage for others to open up to you. Embrace it as a habit.
• Inventory your childhood dreams and live them. Do not forget them. Set doable goals to achieve them. They are the backbone of your existence.
• Remember your roots and the guiding compass you were given. Every step of the way is influenced by that compass.
• One can live in two cultures, taking the best of the two together. Just identify the best and move on.
• It is alright to be heads over heals in love with someone. Enjoy it.
• We are given a hand to play. Play it!
• The brick wall that we cannot seem to climb over is often our most valued asset. It shows us how badly we want something and when we do manage to scale it, we are much better off for conquering it.
• Humility goes a very long way to acceptance and love. That trait is durable and worth every penny invested in it.
• There are professional and personal legacies to be dealt with in this life. Take steps to ensure you have both in your sight long before you face death so you can look back on it and be consoled when you do eventually pass away. You never know when it will come.
• Early death is not the same as late death but the approach probably should be the same. Treat life as if you have a short time to live. Every day, every hour is important. Manage your time.
• In death, be reassured and give reassurance to those you love that in your passing, part of each person you love also passes with you. You take something of everyone you love with you to the grave. This is good and your family and friends should know that. You are comforted by that little something you take with you.
• Understand that in death there are two types of insurance. The traditional financial kind and the less definable emotional type. Your job is to prepare both for your family.

  you read the book, I suggest watching the video of his actual last lecture: http://www.thelastlecture.com/

If you have read this book, I would love to hear what you learned from it and how you feel about your life relative to it.