SNAPSHOT PART 2 CONTINUED

                The next time I came to visit, the two were sitting at the dining room table; the tea cozy was  at the center, and the old man was leafing thru the mail.  They did not look like they were in any hurry to walk.

               We were just sitting here thinking how lucky we are to be  here with all this,”  she gestures with her hands thown up in the air, then points to the adjacent window thru which you can see miles and miles of forests and the great pacific ocean beyond. 

“ain’t that right honey,” she looks over to her husband.

      I was just thinking that I grew up on a farm” he remembers” and we had lots of chickens.  My first job was a door to door egg salesman.  You would be surprised how nice everyone was to me.. I usually had all my eggs sold at the end of the day.

           Do you happen to know how much a dozen eggs costs now in 2012?” I ask.

He looks over to his wife perhaps for some help with the answer but then he decides. “I’d imagine about 60 cents,”

His wife looks down but does not say anything.

“No, its about 4x that much, I say.

“I cannot believe that, he speaks louder than I have ever heard him “ How come?”

               Well honey, everything changes” she says in her most matter or fact voice.

And the next thing that happens is two heavyweights from the past come to the table,

       "You know my dad was there when ,” he stops for a moment to try and remember the name,  “Edison, yeah Thomas Edison turned on the first light switch and that got my dad so excited that he ended up manufacturing all sorts of switches and did really well too.”

“He also happened to be there the day the wright brothers took flight for the first time.”  My dad must have been about 9 or 10.  Think about it. It still sends chills down my spine to know that people can get in the air and fly everyday and my father was there when it all began.

“ I can’t believe it,” she quickly pats the back side of my hand,  “but I am getting lots of calls from my church, everyone wants to know when I am coming back,”  she begins,  

“I think I will let my daughter in law take me to the hairdresser this week and see how that goes.  Who would want to see me looking like this anyway?  I always try to sit in the back of the church so I would not have to far too walk.”

“

Whats that dear,” her husband leans over to try and pick up the conversation.

“Oh I was just saying to anina, that its time for me to get my hair done.”

He looks at her for a long time with his hands in his trademark resting place crossed on his chest and then looks at me across the table while pointing towards her.

“If it weren’t for this lady, she does everything around here. She sure is smart and knows how to do things.  I really can't thank her enough. "

She gets closer to me and says quietly; “He says that to me everyday .      My first husband was good too BUT so many woman tell me how lucky I am to have a  man that appreciates me.  It makes all the difference in the world.  Believe me.

For better or for worse.  I believe.  

a snapshot of my day

When I arrived at my 93 year old patients house, she was seated at the dining room table with her husband.
"Would you mind if we took my husband on a walk with us today," she asked,  "My daughter in law would be so happy. "

The husband we are speaking about is 105!!!  Not a thing wrong with him except he sleeps a lot, cannot hear too well, cannot see too well, walks with a 4 wheeled walker and as his wife always tells me; "his favorite thing is opening the mail and sorting it in piles and re reading it over and over. "

I am here to see her.  She broke her hip and is doing great.  She is so attuned to her husbands every need that it takes awhile for her to realize I have come to help her with her recovery.

"He loves the red grapes.. they are so good."  she says to me as she is looking at her husband. "go ahead honey,  aren't they good this time.  He also likes crackers with honey.. Its a particularly good combination."

And just when I have excused myself for a second, I come back into the room and I see my patient helping her 105 year old husband to stand up    and put on his sweater and that is how I found myself with the wife on my one arm and her husband on the other side of me with his  four wheeled walker going outside to catch the last of the afternoon sun.


We walked and talked as we went up their driveway (he commented on what a lousy job the last guys did who paved the road) His wife added; "yes but we don't care anymore.. We are not driving.."

I told them both how good they were doing with their walking and when we arrived back at the house, she told me that he could now go and sit in the living room and he will have his tea.

She took the tea cozy off the teapot and poured him his tea in cup with a saucer and put it down on a table beside him.  The sugar bowl with the teaspoon was right beside him as were a few cookies.
"Go ahead honey, " she said,  "I'll join you shortly."

He did not answer her but put two teaspoons of sugar in his teacup and stirred and looked at me and smiled and then looked around for his cookies.

"You would be surprised how hot that tea is eventhough I boiled the water over 1 hour ago. isn't that right dear?"

He looked for the saucer on which to put his cup of tea and folded his arms in front on him and closed his eyes.

"He'll fall asleep right here," his wife says as she came around with her own cup of tea.

 As I get ready to leave,  I tell her that I would prefer that she use her cane outside when she walks again:

"Oh no," she responds with well rehearsed timing. "that would be for old ladies."

BREATHING LESSONS

"Don't forget to breathe,"  I remind my patients almost everyday.  It sounds funny but its so true.. I mean deep diaphragm breathing...in through nose and out through mouth  breathing.    

I say: "Smell the flowers and blow out the candle."  and most people laugh immediately and realize that yes they do not know how to breathe.  

Pay attention to your breath:  "Is your breath high up in your chest?"    "Is your mouth open"   "Are you anxious because you have not taken a deep breath today?"  "When you exercise, do you hold your breath some of the time?" 
As a dance teacher once told me;    "Let your body follow your breath."

Respiratory ailments is the catch all phrase for those with severe breathing problems:  Pulmonary disease, emphysema,  asthma, acute respiratory distress and chronic obstruction of the airway passages.  Anyway you want to name it..   IT IS SHORTNESS OF BREATH!

Every  twitch, twang and tweek of your muscle fibers  goes into the job of getting air  in thru the nose down through the trachea, through the bronchi into the bronchioles which  connect into the tiny air sacs (alveoli) containing the capillaries which  distribute  oxygenated rich blood throughout every cell in your body.   

I have seen how this disease looks:  The chest muscles prominently expanded, the shoulders drawn up high,  sallow skin stretched taut,  eyes vapid,   voice waxing and waning in volume.  Even  to force the facial muscles to smile seems like an enormous effort.

 I can get out my tools: the oximeter, the blood pressure cuff, the thermometer and stethoscope and get lots of measurements and we both agree on the numbers and we go through the motions of some sitting exercises to increase the heart rate and improve endurance with activity but still... every breath you take can sometimes feel like it could be your last.   

When I first heard a patient tell me that she will not leave the house without her portable oxygen tank completely full,    I had never even thought about needing to take "air" with you.    You literally  do just enough activity governed by how much oxygen IS  in your  tank...talk about self regulating or you will literally "run out of breath."

So take a slow deep breathe again.. where the air travels to the lower portion of the lungs where the oxygen exchange is most effective.. heart rate slows, blood pressure decreases, muscles relax, tensions relax and the mind calms.. and remeber how it feels to come up for air once in awhile.

"LA DOCTORA"

 No, I am definitely not the doctor, but the Physical Therapy Assistant.  I have been called; "LA DOCTORA" by mostly my Hispanic patients.  Walking thru the door of my patients home,  I feel like I am part of the slowly dying off club of those that make The House Call.  I am dressed in  my starched white lab coat and am carrying my proverbial little black bag. (only this time I have to sling it around my shoulder because it is  loaded down with so many more paper forms as well as necessary tools of the trade) I like to imagine myself as the Country Doctor of years past, coming to pay my respects to the family and to the  patient; bringing all the cures tucked away in my little black bag.   

I have the names of many diseases shuffling around in  my mind as I try to keep them all straight.  Lets see Who was the Hip replacement?  the Congested heart failure? the nurse that worked for 30 years in emergency rooms and now has esophageal cancer?  the woman who owned the candy store I used to go to...has frequent falling?  early onset alzheimers? parkinsons like gait, tremors of unknown origin,  and on and on and on...

I reach into my black bag, pull out the stethoscope to take your vitals, listen to your breathing,  look at an incision from a knee surgery, put my hands on your forehead, ask you your pain level,  make you grip both my  hands as hard as you can... "Come on harder, you can do it more, more," I say, and then I stop and file away this data and let you, the person,  tell me your story.

 I sit next to you usually on the couch or else on your bed with you.  You begin from the usual drop down menu: (in no particular order)  the onset of illness, what hurts, what makes it better,  medications you do not understand, hospital stays where knowone answered your call light for hours so you just took yourself to the bathroom even though the doctor stated strictly that you must never get up alone,   the nurse that got mad at you because you did not eat enough,  the caregiver who brought you clean fresh sheets and smoothed them down so flat you felt you could sleep like a baby again, the family member that chose not to come to visit,  your job.. how long will they hold it..and the beat goes on (as the song goes)

As I sit and listen, I think of the expression  "a laying on of hands."   


In religious terms, it is called "the divine healing. the placing of the hands of the healer upon the person to be healed... or  more specifically; the consecration: setting someone apart for the service of god; next, the transmission of a divine gift and finally the anointing with a healing oil...
In some ways this expression conjures up the pentecostal healings that still continue today... where  the almighty leader sets his hands on shoulders or head of a parishioner and behold the person would be able to walk again...or talk or any such bigger than life magic!


    We have our modern day charlatans, Hood winkers, hucksters, fraudsters, swindlers of the traveling medicine shows, disguised as the big bankers and insurance companies,  who lay claims to being able to cure anything while emptying out your pocketbooks at the same time.."the too good to be true" idea that will never fail to dazzle your wounded and tired souls   BUT,   I am talking about the laying on of hands as a metaphor for the art of  re-assurance,  conferring faith on another that things are destined to be better and that if you feel I have heard you out, have listened well, that you the patient and me "la doctora" have entered into some sort of an unspoken pact...and we  both get to feeling much better  as I reach out to shake your hand and thank you for your time...