A Letter from Our Special Nurse

Debbi & I received this moving letter from Tulsi, a nurse at Sloan Kettering that we have mentioned several times in this blog. Tulsi writes,,

Hello from Sloan..

Dear Debbi & Jan,

I’ve been meaning to write you for some time; I cannot believe how fast this is all happening. I feel like it was just yesterday that the three of us were in room 518A, laughing in the midst of uncertainty. As a cancer nurse, one would think that I would be used to patients filtering in and out of my life like routine clockwork. And I guess in some ways, they do. Every once in a while however, I meet a patient or a family that sticks with me. Your family has done just that. believe it or not, I read your blog every day. It’s my morning ritual, I read CNN, I watch the news, check my email, and then I read your blog. You are so brave and your words are so inspirational. I admire you for continuing to write the blog, even after so much has changed. Sometimes, I find myself laughing at your funny stories and other times, I find myself so very sad for what you are going through.

When this journey started, I did not have a doubt in my mind that Debbi would beat this, that she was one of the people that HAD to be okay. I guess I had that thought process because I realized that I saw a lot of my own mother, and my own story, in Debbi and your family. Debbi, you have become more than just a patient I took care of a few times; you have become someone I feel like I know in my personal life and care so deeply about. I cannot imagine how tough this must be for you and your children. From what I’ve been reading though, you are a strong, cohesive unit, and you are all so lucky to have each other.

Please tell Debbi that I think of her often and I am so glad you and your family are able to enjoy these moments at the Cape. I wear my pink fleece proudly, and I smile each time I put it on. Please let me know if you need anything at all. You are all in my thoughts and prayers

Love,
Tulsi

To Tulsi we say THANK YOU for your caring and for making Debbi so comfortable while she was in your care. Even though you had many patients to care for, somehow you always made Debbi feel special. This was no easy task as there were times, as you well remember, that Debbi was very sick or that she had an adverse reaction to a drug even though she was on the lowest dosage. I, at times, even stalked you through the halls and almost into other patients rooms in order to get Debbi the attention that you were able to provide. You were kind to a fault and always eager to go beyond your normal duties to see that Debbi was at ease. Debbi and I were so impressed with how you carried yourself and how you projected caring and warmth and love. You outshined the other nurses in whose care we were placed during your non-duty hours. We wanted to return some small token of our thanks and Debbi hit on the idea that you might not yet have a fleece with the MSKCC insignia.

The fleece had a lovely feel to it and as I brought it up to the 5th floor, I knew Debbi would enjoy giving this to you as much as she enjoyed wearing her own fleece to the many chemo sessions and hospital visits. I will never forget your face when Debbi presented you with this demonstration of our gratitude. It was as if someone had entrusted you with a cherished item to safeguard and to hold dear.

Debbi and I send you hugs and kisses aplenty. We hope that your smile and caring ease the journey of all the patients for whom you provide care and compassion. And, in your own personal life we wish you fulfillment of your every dream.

Love,

Debbi & Jan

More tremors and slurred words, que sera sera

Anne, our Hospice home health care aide, visited this morning. In one fell swoop, she gave Debbi a sponge bath, changed the bed linens, and laundered the old ones. Debbi looked very happy in her clean clothes and clean sheets. Anne freshened up the table that we use to store Debbi’s current medicine (the section of the table towards Debbi’s bed) and also the side away from Debbi where all the medicine that we once tried (but no longer use) is stored. Why keep the rejected drugs? Well from an earlier post we know we can not sell them… actually we keep them because we do not know when, or if, they might be needed. That section of the table is threatening to take over the current medication space!

Debbie A. also visited this morning. I suppose that her message was not as cheerful. Debbie A. said that even though I could not see it, Debbi is beginning to deteriorate at a faster pace. Because I am here with her every day I suppose it is harder for me to see. Certainly I have seen her tremors become more pronounced and her enunciation less so, but I guess I did not see the subtle change in Debbi’s coloration that Debbie A. pointed out to me. Debbie concluded that Debbi will probably not make it out of the month of May. However, Debbie A. immediately added on, “Of course, Debbi never does anything that we expect her to.”

Not being able to convey Debbie A.’s exact tone and body language when she gave me the news, Josh & Shira were both given Debbie’s phone number to hear the news from her directly. I understand that as of Friday, Shira is moving here “permanently” to be by her mother’s side.

Funny, isn’t it, how one second one can be a “pillar of strength” and the next moment be reduced to a pile of mush. I was just sitting and chatting with my wife and Debbi said to me, “if the radio was playing, I would like to hear the song, Que Sera Sera.” For those of us who have forgotten the lyrics to this Jay Livingston – Ray Evans song, I include them here…

When I was just a little girl
I asked my mother, what will I be
Will I be pretty, will I be rich
Here’s what she said to me.

Que Sera, Sera,
Whatever will be, will be
The future’s not ours, to see
Que Sera, Sera
What will be, will be.

When I was young, I fell in love
I asked my sweetheart what lies ahead
Will we have rainbows, day after day
Here’s what my sweetheart said.

Que Sera, Sera,
Whatever will be, will be
The future’s not ours, to see
Que Sera, Sera
What will be, will be.

Now I have children of my own
They ask their mother, what will I be
Will I be handsome, will I be rich
I tell them tenderly.

Que Sera, Sera,
Whatever will be, will be
The future’s not ours, to see
Que Sera, Sera
What will be, will be.

Debbi began singing this to me. She knew every word. She sang every word working hard to overcome her slurring and working hard to sing it on key. Well, somehow, this opened the floodgates and I began sobbing uncontrollably. I guess that between Debbie A. delivering news that the end is closer than the horizon and Debbi reminding me that Whatever will be, will be without her (at least in the physical world)… it was just too much for me.

Having lost my own mother at 17 years of age, after my father lost his mother at 15, I did not want this terrible curse to continue and yet it is upon us. Que sera sera.

P.S. I received some notes asking if Debbi got her ice cream and french fries for dinner last night… of course she did. She ate about 10 french fries and had about 6 spoonfuls of Captain Frosty’s soft vanilla ice cream just like she requested.

Almost back to “normal”

Undoubtedly, Debbi has been sleeping much of the day. In the time that she was awake, she was able to walk herself to the bathroom, she sat in the sunshine on the two person chaise lounge with Rea & Yonah  by her side & Aaron right next to her for about two hours, and she was able to participate meaningfully in conversation with those around her. Her speech can be a little slurred at times but can then come back to normal and she does tire easily.

Debbi just asked me, at 1:30pm, if she had already eaten her lunch. I told her she hadn’t ordered any. She replied, “then for dinner I want to put in my order right now for French Fries and Ice Cream.” So that is what she is going to get!

Within quick succession there were two medical deliveries today. First Meclizine (to combat naseau and dizziness) and Lidocaine patches (placed directly on Debbi’s left shoulder to reduce pain) were received from FedEx. Secondly, a commode chair was just dropped off by the Cape Medical Supply company. This chair can be used as a stand-alone toilet. For now we have set it up over the john so that Debbi does not have to bend so far and she also will have the sturdy side hand grips to help her get seated and to help her rise up as well.

We gave Debbi one 12.5mg tablet of the Meclizine when she was dizzy a bit earlier. We are watching carefully for the symptoms we noticed during the Scopolamine episode. Meclizine, which is an antihistamine also known as Antivert, has side effects including hives, difficulty breathing, swelling of the face, lips, tongue or throat, possibly blurred vision, dry mouth, constipation, and possibly dizziness. We are monitoring Debbi very closely to see if this drug will be helpful.

The hydrangeas continue to grow their green leaves. The plants that many have sent adorn her bedroom in vivid colors. The sun is shining. Debbi is enjoying the day.

Criticality Status… now shown to “only” be a drug reaction

6PM update:

Debbi just called me from the bedroom. I think she has woken up from the scopolamine stupor. She walked with confidence to the bathroom, noodged me about who knows what, and is busy making calls to Josh & Shira who had to go back to work today. She is enunciating clearly. Interestingly, she says she has no recollection of the hallucinations. Debbi is lively and animated and is interested to hear of her antics over the past 48 hours.

It is so exciting to have Debbi back. Hooray!!

4PM update:

Debbi slept the entire day until 3pm when Debbie A. our expert veteran visiting nurse arrived to change the needle in Debbi’s port. Debbie woke Debbi and told her that she was about to change the needle. Debbi started coming around. Shortly after the needle was changed Debbi began participating in the conversation and the more she talked the more she was able to enunciate clearly. The discussion lasted about 15 minutes.

Following our talk, Debbie sat with Rea, Aaron, Stephanie, and I and gave us her impression. She said that around 85% of the incoherency we saw was due to the scopolamine based on her observation but that some of the behavior of the past day and a half was most likely due to disease progression.

Debbie gave us a copy of the Hospice pamphlet entitled “Journey’s End.” Shira has said, “when they give you the book, it means the end is near.” I do not know when that will be so we are all just trying to take care of Debbi day by day.

It is now 5:30. Debbi has slept since Debbie left and seems to be in a very deep sleep.

Noon update:

Debbi has been sleeping most of the day. During the time that she was awake she was able to carry on a small conversation enunciating her words clearly. That being said, she did revert to some incoherent expressions and hand gestures before falling back to sleep. We are carefully monitoring Debbi’s oxygen levels and helping where ever possible to keep her comfortable.

Critical Day, Critical Night

Over the past several days, and not particularly because of the road trip, Debbi has been experiencing dizziness and nausea (probably related to the dizziness). Debbi was prescribed a Scopolomine patch and when that patch did not seem to work, a second patch was added.

Last night Debbi began babbling incoherently. I stayed up until 2am listening to her. Nothing made sense but it was very interesting. Sometimes Debbi was teaching in her classroom talking to the children and moving her arms directing them in song. Other times Debbi was painting and talking about the colors she was using as she punctuated her expressions with sweeping arm and hand movements.

After she awoke this morning, the behavior returned. I placed a call to the Visiting Nurses and was told that Debbi A. would visit early this afternoon. I had given Debbi Ativan, Lexapro, and 800mg of Ibuprofen as was her daily morining regimen prior to calling but held off on all meds from that point until Debbie A. showed up. After Debbie observed Debbi, she asked for the scopolamine patches to be removed and asked that Debbi refrain from all other medicines except for some Haloperidol at bed time. The Haldoperidol is used to control dizziness and delirium.

Well today has been all about delirium. Imagine walking into a movie theater showing a 3D movie but nobody had ever told you about the 3D effect. You observe the audience reaching out to grab flowers and rings that they visualize as real but it turns out to be just a dual camera trick using different focal lengths so they are just grabbing at empty space. In Debbi’s case, we are the observers and she is the audience. She reaches out to orchestrate scores and to grasp items that must be real to her but can’t be seen by the rest of us.

This delirium or incoherency also made it very difficult to maneuver Debbi from the bed to the toilet. Even though it is only about 12 feet away, this proved to be a difficult task. Firstly, we can not use Debbi’s shoulders or underarms to support her because this transfers her weight to her scapulae. We also have to be careful of her trunk because there is some tenderness where her right kidney was removed. Finally, her mental state also made things challenging either because every motion made her uncomfortable or she wanted to touch something or open a certain drawer along the way.

Throughout the day, we all took turns sitting by her side while she rested. She maintained a continual running commentary of various topics again employing hand and arm gestures freely. On some occasions, she interacted with us as characters in her drama.

At one point, Debbi sat up and saw a soccer ball on my tee shirt. She asked for a pair of scissors so I gave her a pair knowing that I could grab them away from her at any time. She reached out and felt the area where the silk screen logo was located, she pinched a fold into the soccer ball logo and was about to cut out the logo. Needless to say, I retook the scissors before she could act on her vision. No more sharp objects for her!

Joshua was lying in the bed with Debbi. Debbi motioned for him to come closer and I don’t know what chapter Debbi was acting out but evidently it called for the heroine to strike the evil magpie in the throat and that is just what Debbi did.  Josh was with her later in the day and I guess this time the magpie was supposed to be struck in the chest. Again it happened just that way.

At bedtime, I gave Debbi 1ml of Haloperidol as Debbie A. had instructed. Debbi also indicated that she was in pain and after she pressed the “magic button” requesting her morphine pump to dispatch another bolus, but was met with a beep signaling that a full 30 minutes had not passed since her last request, Debbi asked for some Roxinol (liquid morphine). Debbi is allowed to have 1ml as needed up to 4x per day. The roxinol is delivered via a plastic syringe having no needle. The syringe is slender so I usually give Debbi about half of the dose under her toungue, wait a few seconds for her to process the liquid and the alert her and squeze the plunger to deliver the second half of the dose. Once completed, Debbi reached out for my tee shirt, grabbed a fold of material within the large soccerball logo, and proceeded to spit the second half dose into the tee shirt’s folded section. Who knows why?

After learning that hearing is the last sense to go, we were always careful to save any laughter until we were out of earshot range. While tragic and disappointing that Debbi had to go through this possible overdose of Scopolamine, there was an aspect humor within the total framework along with many curious moments. We all took turns sitting with Debbi as I mentioned before and during these visits we would listen and sometimes ask questions on what we heard. I once asked Debbi during one such story, “What was the combination to our safe at home?” She replied matter-of-factly…”2087″ even though we do not have a safe.

Thus far I have avoided discussing the topic of today’s blog… “Critical Day, Critical Night.” What makes today so critical? Debbie A. told us that in some patients, Debbi’s symptoms are signs of a scopolamine overdose and the symptoms leave within 24-36 hours of removal of the trans-dermal scopolamine patches. Debbie also mentioned that in some patients, these symptoms are part of the disease process and may not be reversed.

By late evening, Debbi was able to get out of bed and walk to the bathroom by herself with just some guidance to make sure she did not lose her bearings.

We, having positive outlooks, are hoping and praying that the scopolamine was the culprit. Given that Debbi is very sensitive to medication, that we were instructed to use 2 patches or twice the normal dose. and that the list of possible side effects match Debbi’s incoherent behavior perfectly, we are looking forward to her coming out of this quagmire in the next day or two.

Well, maybe it wasn’t such a good idea???

Since our outing described in yesterday’s blog, Debbi has been hit with dizzyness and nausea leading to two to three episodes of vomiting per day. I really don’t think it is because of the trip to Bed, Bath, and Beyond and I did check things out with our very competent visiting nurse Debbie A. but I heard through Rea that Debbie brought this up at the weekly meeting where the status of all Hospice patients is reviewed.

As Rea told it, Debbie A. (a highly competent nurse practitioner with a gregarious and fun loving personality) exclaimed at this meeting, “Guess where Debbi Buckler went today??? She went to the Mall… Can you believe it?” Meanwhile she did say “Go for it” when I asked her beforehand.

Oh, well…

Now Debbi is using two small Scopolamine patches each the size of a dime placed behind each ear. The web says that Scopolamine is useful in the treatment of motion sickness in a dose of about 300 micrograms per day. It also says that an overdose can cause delusions and delerium. Debbi has been experiencing dizziness and Debbie A. says that it is the dizziness that is causing the naseau. Therefore, Debbi is also taking 1mg of Haldol (Haldoperidol) which is an antipsychotic in order to stop delusions. For a few nights now Debbi has awoken in the 2am-4am time span with bad dreams. The Haldol is supposed to help stop this and in addition it has a side effect which is said to reduce severe forms of nausea. The Wikipedia article describing this drug also notes that a side effect is “the release of the hormone prolactin, with the possible emergence of breast enlargement.” If only I had read this 30 years ago!

All in all it seems that the above meds are not having the desired effect on Debbi yet. I am writing at 11pm on Saturday night and we were on the phone with Debbie A. earlier in the evening. Debbi was directed to use one of the special suppositories that is laced with 6 different anti-naseau drugs. Plus, Debbie A. made arrangements to visit us tomorrow and re-evaluate the situation.

Just after Shabbos began, Debbi was overcome by nausea and needed to throw up. Not having the usual basin handy, I handed Debbi a plastic garbage can so that she did not have to rush to get to the toilet. Wouldn’t you know that the bottom edges of this garbage can were not sealed well and a little of the vomitus leaked out and stained the brand new sheets. Maybe I will sneak out to Bed Bath and Beyond and buy a new set. Then I can take off the stained set, remake the bed quickly and she will think it was magic!!

Debbi’s condition at presents dictates that one of us be by her side any time she is on her feet. We, of course, do not want to risk another fall especially one that would instinctively trigger her to put our her left arm for stability and might cause a jarring action to her left scapula.

Speaking of shoulders, I was in contact with Dr. Michael Zelefsky, Chief of Brachytherapy at Memorial Sloan Kettering and well known to readers of this blog. I asked about a palliative dose of radiation for Debbi’s shoulders. Michael said this might be a good idea and I am forwarding him information on contacting Dr. David Lovett, head of the Davenport-Mugar Cancer here at the Cape Cod Hospital. If the doctors agree on a course of action, I would expect Debbi to be discharged from Hospice, re-admitted to palliative care, undergo the radiation treatment, and be re-admitted to Hospice.

I continue to be amazed by the Hospice program. Medications arrive by FedEx, even on Saturday. The Hospice visiting nurses are only a phone call away and they respond to the answering service rapidly. As I described a few days ago, these Hospice nurses know how to get things done. Their confidence and demeanor instill a calming effect on their patients and they certainly have gone out of their way to answer my questions on the benefits of the various treatment regimens they are employing and on Debbi’s well being. Furthermore, the social work dimension of the Hospice equation has been of tremendous benefit to Debbi and especially to the children and to me in keeping a measure of peace and acceptance while still striving to make Debbi as comfortable as possible.

The sky has been beautifully clear and in the sun it is indeed warm but the winds have been very active. Hopefully tomorrow will be the same but without the wind. If so, I would like to help Debbi venture out to see her Hydrangeas growing in the beds that Shira beautifully mulched. Or maybe she will just view them from the front door. So far we have seen that moving slowly and not making sudden turns seems to forestall the dizziness. It should prove beneficial to note any discomfort so that we can more accurately pinpoint any triggers to Debbie.

And now for something completely different!

I have been a bit busy with some work issues so did not get a chance to write till now and now there are only 40 minutes to Shabbos so I am compressing reports for two days into one.

Yesterday morning I looked at Debbi and she seemed kind of bored but I thought that in terms of her medical situation she seemed like her normal self. Thinking back to National Lampoon’s Animal House, I suggested to Debbi that we go on a “road trip.” Several around here thought it was a crazy idea but I thought it would be possible and would serve Debbi well. I checked with her Visiting Nurse and described my planning an she said, “Go for it!” Plus, the targeted store was less than one mile from the Cape Cod Hospital where Debbi usually gets treated.

Debbi wanted new sheets for the bed. If I went myself, you can be sure I would come back with the wrong sheets. So, I loaded the portable oxygen, the oxymeter, the liquid morphine, and some general first aid equipment.  The goal was to minimize the time that Debbi would be on her feet. I walked her to the front door and helped her down the two steps into the transport wheel chair giving her back control of her portable morphine pump. I pushed her to the car that had already been loaded as I mentioned. I helped Debbi into the front seat that had been pre-adjusted for her and gave her an “airplane pillow” to comfort her neck. Throwing the wheel chair into the back of the Grand Cherokee, we were off to Bed Bath and Beyond.

As I expected, Debbi fell asleep before we were at the end of Jericho Road. The trip to Bed Bath and Beyond took longer than normal as I drove slowly and was careful not to accelerate around corners. Debbi woke up just as we pulled in the parking lot and true to form, we started arguing about where to park!!! I helped Debbi into the wheel chair, whisked her into the store, and once inside, she had to guide me to the section where the sheets were kept because I had no idea where to go. From the wheelchair, Debbi was able to feel the texture of a sample of each of the different sheets offered for sale. She selected a powder blue [as I read this section to Debbi… she said they were sky blue!!!] set having a 800 thread count. After checkout, we went back to the car, reloaded Debbi and the wheel chair, and headed back to the Cape House.

As Debbi was transferring from the transport chair up the front steps, she felt nauseous and did throw up. Nevertheless, once she was back in bed she said she was very happy to have gone.

Today, the home health care aide changed the bed linens as Debbi sat in the bedroom chaise. Debbi was very happy to have nice new clean sheets that reminded her of the beach.

In order to enhance the hydrangea beds, we all voted to use dark mulch which was delivered this morning. Shira helped me move and spread 8 cubic yards of mulch around the various beds.

At a certain time when Shira and I were outside, Rea was listening to music as she cooked, and Shuie was working, Debbi got out of bed, walked to the bathroom, lost her balance and fell just short of the toilet. Nobody heard her cry for help. Luckily Shira was working on the front beds and heard Debbi rapping on a window near where she fell. Shira yelled to me and we both came running, wood mulch flying from our shoes and clothing, to help Debbi.

We are indeed lucky that she did not break any bones or hit her head and from now on we are going to have to be much more careful about her walking anywhere by herself. in fact we will all make sure she is accompanied for every footstep.

Debbie, the visiting nurse ordered some medicine to help with her dizziness and we will have to see if that works.

So now the house is buzzing as the cooking gets finalized and I have to get all my computers off of the dining room table as all all the sibs will be here for Shabbos dinner.

Good Shabbos everyone.

Sharing time with Yonah

Debbi thrives when she is with her grandson. I was watching her interact with him this morning while they both were sitting in Debbi’s big bed. She had played a game with him reaching out his rattle for him to grasp it. After a short while, she took it back and offered it to him again. Then she placed the rattle in his lap and he would grab the plastic toy with its many beads that make the shoop shoop sound. Variations on this model evolved until she got his focus and with him watching, she would hide the rattle under a fold of the blanket.

Any time Yonah would reach under the covers and get the rattle, Debbi let out a chuckle. Her smile and laughter are still a delight to all of us and it seems that they come more often when Yonah is in her presence. I wonder what the order is? Maybe Yonah is at the top of the heap, then her hydrangeas, then the kids, then me??? Just kidding… but it is quite refreshing to watch Debbi at work.

It is easy to forget that as she sits on the bed with Yonah, that Debbi’s life’s work has been raising children. Even from before our children were born, Debbi was in the childhood raising business. She probably began by taking care of her nephews Jeff & Mark. Jeff was a toddler when I came into Debbi’s life. We took Jeff to see Mary Poppins. During the movie, Jeff yelled out, “Hey Uncle Jan, how do they change the channel on that big TV!” I started laughing out loud but Debbi had a different reaction. A more nurturing reaction. She was more concerned about Jeff’s feelings and tried to engage him in a learning situation.

Her undergraduate degree is in Early Childhood Education and one of her first jobs was with the CHARLEE program which focused on children, often siblings, that had to be removed from their homes into foster care. CHARLEE raised money, rented and eventually bought their own homes so that siblings suffering such a tragedy did not have to be split up.

Eventually Debbi and I became weekend group home parents. Then a situation arose where 4 siblings had to be removed from their home due to problems with the parents. Debbi immediately volunteered our home with us becoming full time group home parents as the best alternative to keep the siblings together. I was finishing my PhD at the time so I often worked on the computer from home. Yes, Aaron, they did have computers back then!!

CHARLEE sent Debbi and me to the Menninger Clinic in Topeka, Kansas for training on how to be effective parents to these children. Needless to say, Debbi was like a fish in water there while I had more difficulty with the nurturing, touchy-feely stuff. My brother Scott wrote in to remind my that at Menninger, Debbi was nicknamed “The Walking Hug.”

Soon afterwards, the 4 sibs moved in with us. They went to school during the day while Debbi worked and since I had a more flexible schedule, I played with them until Debbi arrived home. Debbi did an excellent job making them feel at home and trying to make them feel loved in our home. Eventually, CHARLEE built a house and the 4 siblings and two additional children moved in with Debbi and I as the weekday parents and another set of parents, the weekend parents, moved in to give Debbi an I some relief… you guessed it… on the weekend. Soon after, I completed my PhD and we moved to Pittsburgh. Debbi has had some contact from some of the 4 sibs over the years. A sure sign of her devoted efforts to these children who are now in their thirties or early fourties.

Next, of course, was our own children. Debbi was the mother Par Excellence. I think that readers of the blog are well aware of her skills in this area. And, certainly there are the many youngsters that Debbi has taught through the years. I have always enjoyed going into her classrooms and interacting with her students… especially after November in the school year. By then, she has all her charges whipped into shape and they are little gentlemen and gentlewomen who loved to be lifted in the air and tickled. Soon their teacher is disciplining me and telling me to let them behave!! Sure, she can make them crazy dancing and jumping all around but evidently her craziness, controlled and measured, is much different from the chaos of my craziness. Go figure!

So, to see Debbi with Yonah, even on a casual basis, there is deep deep talent lurking below the surface. Even though she is not nearly her old self, some of her basic character traits are still running strong. Traits like love, like teaching, like relating to young children … even older “children”,  traits like nuturing and like building confidence in those around her. Traits that many of us, especially me, wish we had studied under her tutelege and paid more attention to her technique over the years.

Well, it is time for class so I better go check in with the teacher.

A Calm Settles

For the first time in her life, Debbi has been able to sleep until noon thanks to her new morphine pump. She awoke today to see her grandson’s smiling face while Jan took her vital signs (all normal). Despite her pain and discomfort, Debbi was able to note the positives that have come from her illness. She is particularly grateful to be able to live under the same roof as Yonah and to have all of her children together. Debbi attempted to move around a bit but lost her balance; Jan came to the rescue to help her back into bed.  

All is calm and quiet here after the morphine pump adventure the other day and for now, Debbi is able to rest as comfortably as she can. Rea has received heartfelt messages from friends and colleagues which she plays for Debbi. Debbi is moved to tears by the love and encouragement people are sending her way. We all especially appreciate the flower deliveries; our house is beginning to look like a botanical garden.