Journey’s End

We are saddened to say that Debbi’s journey came to an end this afternoon. We are heartbroken but take comfort in the powerful messages of love and support sent our way throughout this ordeal.

Debbi’s funeral will take place tomorrow, May 15th, at 2pm at the Prospect Hill Cemetary in Millis, Massachusetts. People using googlemaps or mapquest can use Auburn Road, Millis, Massachusetts as their destination. Below are some directional tips for anyone needing help…

From New York, New Jersey, and points south…

Route 95 to Route 91 North to I-84 to connect with the Mass Pike East. Take Exit 11A 495 South to Exit 19 for 109 into Millis. Turn left onto Auburn road. Follow to the end. Turn sharp left and take the next right to the Jewish section.

From Cape Cod

Sagamore Bridge to 495 to Exit 18 RT 126 to RT 109 into Millis.  Turn left onto Auburn road. Follow to the end. Turn sharp left and take the next right to the Jewish section.

From Boston and points north…

95 South / 128 South toward Waltham. Exit 16B RT 109. 6.5 Miles on 109 then turn Right onto Auburn Road.  Follow to the end. Turn sharp left and take the next right to the Jewish section.

Shiva will commence on Friday and will run through Thursday morning excluding Shabbos. Shiva will take place at our summer home   45 Jericho Road, PO Box 2075, Dennis, MA 02638.

Signs

Yesterday, I noticed a tear on Debbi’s cheek and another nearer to her eye. As I wiped the tears, Debbi opened her eyes. I do not know if she saw me but I called my children and for a brief time, they were able to say hello to their mother. Additionally, when we repositioned Debbi she also stirred.

Throughout the day yesterday and throughout the night, Debbi has been warm to the touch and her breathing has been tinged with raspiness. Even the Atropine has not been able to dry the lung secretions completely. It is also the case that her urine is darker than normal. The oximeter reads 152 pulse with 80% saturated peripheral oxygen. A pulse of 152 is more indicative of a person in active cardio workout,

Unfortunately, these are all signs that we may be in the final stages of Active Death.  Inability to regulate temperature, the tear, a rapid rate of breathing with a definite rattle, the darkened urine, and the reduction of oxygen to the extremities… the end could come at any time.

We are still committed to taking care of Debbi and making her feel as comfortable as possible. Debbi always lived her life in a unique manner and it will only be over when she is ready.

Asking “Why?” and second guessing are never productive. Yet there are many questions that could be asked. Asking each question leads to another question and soon one realizes that all the questions lead to the dialog in the book of Job. So, the questions are pointless.

That being said, our world is sure going to be a lonely place without Debbi’s shining presence.

UPDATE:

Debbi just came back to us for a little while. She briefly opened her eyes and we gathered by her side. We told her how much she loved us and how much we loved her. I asked for forgiveness once again. All of us together… we shed tears and told Debbi again and again how privileged we felt to have had such a terrific and unique person, full of love, kindness, and compassion for a wife and mother.

Coma?

I do not know for sure if a medical doctor would term Debbi’s current condition a coma but she has been sleeping for more than 36 hours. As I mentioned previously, we may not get her back. I do believe that her hearing is intact and so we continue to shower her with messages of love and tell her how remarkably she fulfilled her many roles in her lifetime… chief among them being Mother and Wife.

Debbi seems to be holding her own meaning that her hands are still warm and soft. Her oximeter readings this morning were 100 pulse and 96% saturated peripheral oxygen. A gentle touch to her forehead indicates that she is not running a fever. Her breathing is even and very regular. She is lying comfortably and not moving. Ralph is doing his job well using his arms and legs to give Debbi hugs on behalf of the family.

Debbi touched many people in many ways. As many as 150 young children may carry her memory as their Pre-K teacher their whole lives. When Debbi was no longer able to teach regularly due to the cancer, we experimented with a web site so that she would be able to read some of her favorite books to her young ones who were able to view the site via the computers in their classroom. We made a beginning, but due to the advance of the disease, hospital visits, my work schedule, life in general… we were not able to go beyond the initial state. The web site debbireads.com currently contains 6 videos. In her memory we may try to expand this with other narrators and story tellers as an online library for children. I frequently like to listen to Debbi read “How do Dinosaurs go to School? by Jane Yolen and Mark Teague.

Speaking about web sites, I was able to secure the web site debbisjourney.com. We will continue to post the blog on buckler.com/blog but will also post to the new site, when it is ready, in order to share Debbi’s writings on a wider basis.

There is not much to do. Debbi is still on a minimal amount of morphine… 3ml/hour. Atropine drops seem to be working as she is no longer coughing. Ativan has been cut back to 1mg two times a day. Haldol is given once before I retire for the night.

There is still a lot to say. Many thank yous are still required. Missed thank yous pile up over the course of ones life and I am trying to replay our time together, in my mind’s eye, to find all the times I should have said ‘Thank you” and I failed. Should have said, ‘You were marvelous’ and I failed. Should have said, “You were the BEST’ and I failed to. 38 years together is spread over lots of DVDs yet I am going through them one by one. I asked for forgiveness days ago and offered the same to Debbi while she was able to converse with me. Still there are many many apologies that are necessary and I hope to whisper them in her delicate ears while she can still hear.

I know that Debbi can still hear me and understand what I am saying to her. I base this on empirical proof from a visit I payed to my mother’s brother-in-law… Uncle Zvi, who was a true mentor to me my whole life. Uncle Zvi was a talented soccer player, coach, and referree. He had a keen eye when it came to sports. Possibly keener than his main profession which was dentistry. Zvi often took me to see his vaunted Boston Bruins. We would sit in the stands rooting on the team but every time Peter McNab would touch the puck, Uncle Zvi went ballistic. He would grab the rail in front of our seats, shoot up to a standing postion with his arm raised, and at the top of his lungs, he would yell out in his combination of Israeli and New England accents, “McNab MOVE YOUR FAT ASS.” Uncharacteristic of my uncle, but Oh how it made me laugh.

Uncle Zvi reserved his best accolades for Ray Borque. Stellar defenseman par excellance for the Bruins for 21 years. Hall of Famer. Records Galore. Never won a Stanley Cup with the Bruins. Wishing for a solid chance to win the Stanley Cup before he retires, Borque asks to be traded to the Colorado Avalanche in 2000. In the next season, Borque was incredible and of course the Avalanche and Ray Borque win the cup in June 2001.

On Uncle Zvi’s last day in this world, Debbi and I went to see him. He was still just as Debbi is still now. After some initial messages as to how grateful I was for his devotion to me, I was at a loss for words. A thought occurred to me that Uncle Zvi would probably like to hear about the Stanley Cup games featuring his favorite player. Debbi and I were fans of the opposing team… the New Jersey Devils. Naturally, the Avalanche and Ray Borque succeeding at the expense of the NJ Devils would be sure to thrill Uncle Zvi.

I was relating to him that in the most recent game of the 2001 Stanley Cup Playoffs, in the second period, Patrick Elias of NJ had a short-handed break-away and got a shot by the Avalanche goal tender Patrick Roi only to have the shot hit the post. On the same power play, Ray Borque connects with the back of the net driving the puck right by Martin Brodeur, the Hall of Fame Goalie for NJ.

I am speaking these words into his ear when I hear Uncle Zvi, silent up till now, strongly say “Borque.” Uncle Zvi, and all the Bruins fans who loved and admired Ray Borque during his many seasons in Boston were so proud of him. On his day to spend with the Stanley Cup, June 12th 2001, Ray Borque brought the cup back to Boston for a rally with 20,000 of his closest fans. Had he been alive, I am certain that Uncle Zvi would have been among them.

Emprirical evidence for me that Debbi can still hear me and process my message of Apology, Thanks, and Love.

There is also still prayer. We are praying and saying Tehillim (psalms) on her behalf. Debbi is on her own schedule and G-d runs the world.

ZZZZzzzzzzzz

I am guessing that the Atropine did the trick because I was not awoken by the sound of Debbi trying to clear phlegm. I turned in at 11pm, got up on my own at 2am, and now am up at 6am. At each of these times I checked Debbi with the oximeter and listened to her breathing. Numbers were good all around and her breathing was even and quiet. 

As I started writing this morning, I began to hear a bit of the sound that kept me awake the past few nights. And, I used up the entire container of Atropine so I will have to put in a call to the VNA. The Atropine included in the Hospice Pre-Staging Kit is packaged for opthalmic use and only contains 2ml. I consulted Debbie A. about the Atropine after the previous post and the dosage was raised to 4 drops every 2 hours. I guess I used up the container a little ahead of schedule. A drop is 1/20 of an ml so the container should have held 40 drops and the squeeze bottle does not deliver 100% of its contents. No matter, I expect to come up with some more Atropine this morning.

I wrote yesterday that I found it difficult to position the tiny container to deliver the droplets of Atropine while Debbi was sleeping. An interesting factoid was revealed to me by a nurse with 20 years of VNA experience including administration of a VNA area. I did not let the notion that none of her experience was gained on Cape Cod stop my from listening closely to her idea. She mentioned that even the lips are part of the mucosa so drops on Debbi’s lips would still be effective. Drug delivery does not have to be inward of her lips. With that idea, I went one step further. I washed my hands very well and applied 2 drops to my right index finger which I then used to massage Debbi’s lips. After a few minutes I repeated the procedure. I think that this worked. Her lips were moistened and the Atropine was delivered.

This not-of-Cape Cod nurse turns out to be a classmate of Debbi’s from her undergraduate days at the University of Bridgeport. A close friend through the years since, possessed with an immense capability to heal even in non-traditional ways. We simply call her Peach. Peach looks at a person as an entity and tries to focus on making the person healthy and not just supplying the recommended therapy associated with a particular disease code. Plus, Peach has a great personality and is just so much fun to be with. Our whole family loves her and loves her family as well.

Peach stopped in to see Debbi as a friend however she also naturally brought her storehouse knowledge of medical care and human touch. I told Debbi that Peach was here. I would like to report that Debbi perked up when she heard this but I can not be sure. Peach helped me reposition Debbi in her hospital jail (I mean hospital bed) and was sure to maneuver Ralph just into the right geometry to provide a cradle for Debbi’s head and to wrap his right arm and right leg to give Debbi hugs while she was sleeping. When we were finished, we made sure to allow Debbi’s right leg to emerge from the bars and rest on the step stool to give her the notion that her escape was just at hand.

Peach also gave emotional support to the whole family. She knows each of my children as individuals and spent time with them collectively as well. Certainly Peach was helpful to me. Peach and her husband Lee just purchased a summer home 30 minutes to the east of us and we hope to be able to see each other’s families more often.

Hmm. What about Debbie A? She was supposed to pay us a visit yesterday and I did not see her. Truth be told it was my fault. I was working on real work for my employer DBRS around 1PM. DBRS has been more than kind in allowing me to work remotely at this challenging time. Anyway, I was typing, computing, calculating, you name it. The keys started to get fuzzy and I literally could not read the screen. I konked out. I was told that Debbie came to see Debbi an hour later, saw me sleeping, and did not want to wake me. Later I called her and thanked her but I admonished her to wake me up next time. Debbie is very expressive and some times she gives you that look that says it all… whatever that means… but you just know it at the time. That is not conveyed by telephone and sometimes it is necessary for Debbi’s care. I told Debbie that I would be able to go back to sleep after her visit so she pledged to wake me from now on. 

Debbi slept the entire day yesterday. I wonder if she will have any waking moments today based on the idea that she may have slept more soundly last night. Maybe she is transitioning and she will just sleep until the end? We are just taking things as they are presented to us but I would sure love to have her back. 

Try 2 drops of Atropine.

Debbie A. our visiting nurse just called to check on Debbi’s status. After providing the rundown, I asked Debbie what I should have done last night to help Debbi avoid the struggle to bring up phlegm. Debbie told me to go in the Hospice Pharmacia ComfortPak we keep in the refrigerator and identify a small container with the red cap. The medicine inside is Atropine in a 1% concentration. The instructions read, “Place 2 drops under the tongue every 4 hours as needed for excess secretions.”

Atropine, like cocaine, comes from a family of drugs called tropane alkaloids. Tropane alkaloids are found in plants like the coca plant and deadly nightshade. Atropine, in specific, is extracted from deadly nightshade whose scientific name is atropa belladonna. In the movie, My Big Fat Greek Wedding, Michael Constantine who plays the patriarch of the family says that every word comes from a Greek root. In this case he is spot on. Atropa is from the Greek atropos which is one of the three fates and its meaning is to “cut the thread of life.” In contrast, belladonna comes from the Italian for beautiful lady because the Italian women used to use the deadly nightshade sap to dilate their pupils… a look that they felt made them more beautiful to their male suitors.

While Atropine is potentially deadly, Wikipedia says that the World Health Organization’s Essential Drug list contains Atropine as a core medicines necessary for a basic health care system.  Wikipedia also writes:

Atropine’s actions on the parasympathetic nervous system inhibits salivary, sweat, and mucus glands. This can be useful in treating hyperhidrosis, and can prevent the death rattle of dying patients. Even though atropine has not been officially indicated for either of these purposes by the FDA, it has been used by physicians for these purposes.

I just gave Debbi 2 drops. She is sleeping with her mouth open just enough to insert the tip of the container and see the droplets emerge. I will monitor her breathing and coughing to see if there is any improvement.

15 Minutes at a time

Debbi slept most of the day yesterday. While she was napping, we planted another 8 hydrangea bushes. I should say Josh planted them. I selected 8 to represent Mother’s day gifts from each of Debbi’s children and from each of the significant others. Josh told me that with this planting, the bed is running out of room for additional hydrangeas. We are up to 37 bushes in the main bed. When we moved into the Cape House the main bed consisted of a stand of 18 trees and tons of weeds and other growth that gave us privacy in the front yard. I liked the privacy and naturally Debbi wanted it cleared out. In our second summer, Debbi contracted to clear the bed of the weeds and overgrowth leaving the trees standing by themselves. End of discussion.

Once the bed was cleared, and knowing how much Debbi liked hydrangeas, I made a trip to the local Agway, and purchased 15 plants. Seeing that they did well in our soil, I purchased a few more bushes each spring. Our sprinkler system did not hit the majority of the hydrangeas and one summer the plantings look so withered that some neighbors stopped by to reprimand us. The following season we expanded the sprinkler system to cover the hydrangeas with more than enough misting liquid and the plants once again yielded their magnificent pompoms. We do not have any signs of buds so far but the greenery on each bush indicates that it will be a bountiful year for the beautiful blue pompoms. I hope Debbi gets to see some of the flowerings in addition to the greenery.

I have to talk to the nurses today. I am thinking that it is becoming harder for Debbi to get through the night. She is on the morphine pump, she takes 1mg of Ativan every 4-6 hours for anxiety / discomfort, 1mg of Haloperidol every 4-6 hours to combat the restlessness, and she is on the oxygen machine which is set to 3 liters of oxygen per minute. At night, especially after 2am, it sounds as if she is trying to clear her throat or clear the phlegm from her lungs. I am sleeping solo in the rice bed and the hospital bed is along the opposite wall. Every time I hear her trying to clear her lungs, I rush to her side and help her sit up so that her effort is more successful. After a few tries Debbi would lay back and drift off. I also tried to get some additional shut eye. It just seemed that every 15 minutes throughout the night we repeated this cycle. No sleep for the weary. Even if I managed to fall back to sleep, I could not abandon my best friend when she was working so hard to clear her lungs. Maybe she did not know I had my arms around her supporting her as she tried but I had to be with her anyway.

In addition, I was nervous about giving her the Ativan and Haldol when she had trouble clearing her lungs. I was scared that using the plastic syringe to deposit 1ml of medicine in the back corners of her mouth could make her cough more. Margo had told me that codeine works to stop coughs by acting on a particular trigger in the brain and that morphine had that same action. Thus, Margot said I could just press the bolus button on Debbi’s morphine pump.  I should have called the VNA hotline with my concern but the switchboard would have asked the on-call nurse to call me back and I did not want the house to get up in the middle of the night without good reason. I am expecting to see Debbie A. today and so I will pose my concern to her and get a new set of marching orders.

Debbi has some interesting sleep patterns in the hospital bed. She always has to have some part of her body outside the bounds of the bed. Right now (7:30 AM) she has both of her feet sticking out of the lower section of the bed just beyond the rails. Knowing that she likes to do this, I pre-staged the upholstered two-step mahogany stairs that match the rice bed just at that spot were her feet are sticking out. This way she is able to have some support for her feet, as she gets uncomfortable, when they are dangling.

At 6AM, I sat her up and surrounded her with king size pillows holding Debbi’s torso more upright in order to make it easier to rise to a sitting position. Being that her head is higher than the pillows, we use our favorite bear, Ralph (given to Debbi by her Physical Therapist of the same name), to cradle Debbi’s neck and head. Ralph the bear is great at giving Debbi hugs and unlike me, he never gets tired. Even with the pillows and Ralph around her, the shiny rails of the bed make it seem as if Debbi is in jail. It is a fitting analogy because she is always trying to get out. Her speech is now soft and slurred but she asks to get out of bed and explaining that she is too sick and that her legs do not work does indeed make me feel like a jailer.

An hour after stuffing the pillows around her and moving her to a more upright position, Debbi is coughing less and sleeping more. She looks comfortable but daytime comfortable… not nighttime comfortable. Just the positioning of the body looks like someone taking a nap in a chair. If someone went to sleep for the night in such an orientation, they would certainly have a sore neck or back when they awoke.

Sometimes Debbi’s breathing is very shallow. Sometimes it seems as if she is barely breathing or maybe not breathing at all. Not wanting to disturb her at these times, I slip the Nonin Oximeter on Debbi’s fingertip, give it a few seconds until the blinking light turns green, and I can then read Sp O2 (the saturation of peripheral oxygen) and the pulse rate without waking her. The oximeter just read 110 beats per minute for her pulse and 98% SpO2. Happily this means that Debbi lungs are working fine in conjunction with her Invacare Platinum Oxygen Concentrator. Together they are delivering enough oxygen to her extremities to register at 98% of the theoretical maximum even if she happens to be breathing shallowly at the moment.

Today, we are thrilled that Debbi is still with us and we hope that she will come out of her shell and be able to spend even a few minutes with us.

Happy Mother’s Day

Debbi received Mother’s Day greetings from all her children and from me as well. She is resting comfortably after the VNA nurses were able to place a catheter that is largely relieving me of diaper duty. 

The sun is shining here at the Cape and everyone is busy tending to the needs of the house in addition to spending time with Debbi. Debbi keeps saying that she wants to get out of the hospital bed but she just can’t stand on her own. I hate playing the jailer but there is not much we can do. Debbi has not eaten in over one week. She drinks sparingly but is not getting any nutrition to speak of. That being said, she appears to be pain free thanks to the morphine pump delivering just the right dose for her. She looks comfortable as she rests.

We pray for her complete recovery but realize that the power to effect that prayer is not in human hands.

A Happy Mother’s Day.
 

Teachers all around

Today Debbi had a visit from Sue S. and Stephanie M. who are teachers at the Drago School 3 in Passaic NJ where Debbi taught until she had to take medical leave. Sue and Debbi talked every morning at 6:30am over the course of many years during their commutes to the school building. Even though Debbi was only awake for about 10 minutes of their visit, Sue shared some memorable stories of Debbi with my children.

While they were here, Jane C., a teacher in the Dennis, Massachusetts schools stopped in to visit with Debbi as well. Much like Sue S., Jane C. is a teacher with many years of experience and retirement is knocking at the door for both of these talented ladies. I introduced them to each other and it was very interesting to hear that Debbi had talked to each about the other. Stephanie M. is much younger and it appears that Debbi and Stephanie had a close relationship as well.

Debbi rested comfortably most of the day and seems ready to sleep into the night. 

P.S. I am no better at changing diapers and a new skill I lack is giving Debbi oral medication while she is sleeping. I feel so guilty squirting a tiny bit of Ativan or Haldol into her open mouth while she is asleep and then hearing her coughing for several minutes. I guess I am just squeemish about causing Debbi any discomfort… not squeemish about the medical aspects… just about causing her pain or discomfort. 

 

The Family meeting flopped

Yesterday we had a situation arise that had some of us going in a different direction. Debbi wanted to get out of the rice bed and sit in a chaise lounge in our bedroom. Trying to do everything in my power to accommodate Debbi’s wishes, I facilitated the transfer and got her comfortable. Some thought that Debbi should simply stay in the bed because of the possibility of falling… especially considering that she did fall several days ago when I was not ready for her to lose her footing.

We called a family meeting this morning to air out that issue and some other issues as well.  As we were talking THUD from the bedroom. We were all talking in the living room and Debbi decided to get out of her high rice bed. She must have eased her feet down to the floor. She walked about 5 steps and got pulled back by the pack holding her morphine pump that was attached to the medi-port in her right shoulder. As she flopped to the floor, she must have twisted and hit her butt first and then her head made the thud.

We rushed to her side and in short order she was back in the bed. We hit the bolus button to give her an extra 1.5mg of morphine and also gave her some Ativan to help her settle down. An hour later, Debbie A. stopped by for her morning visit. We described in detail all that happened and Debbie informed us that except for a little goozle bump to the back of her head, Debbi was just fine. To prevent this incident from happening again, Debbie arranged for a hospital bed to be delivered as well as a more comfortable commode. The Hospice home health care aide Anne visited Debbi for the daily visit and made sure she was clean and fresh.

The bed was delivered shortly thereafter, set up with nice new sheets, and Debbi was transferred to the hospital bed safely by group effort. She is not happy about having the full railings retain her whenever she decides to make a break for it.

The day has been a crazy day since then but strangely, Debbi has been awake and lucid for much of it. Some of the time she is mumbling but she has not really napped all day and it appears that she is comfortable with her pain well controlled. Shabbos is almost here and I am hoping she will be able to bless the children tonight and for more Shabbosim to come.

Gut Shabbos everyone!

VNA Hospice Nurses… The Best Advisors

Debbi had a good night last night. She did wake up and was a bit agitated between 2am and 4am but having the drug regimen suggested by the team and having been educated, the restlessness was easier to handle. In addition, I was awake at the time that it started so it did not get the best of me. Debbi was still shifting from lying down to sitting up to lying down. Cycle after cycle. Drinking became difficult at times because Debbi herself was tired and had some trouble using the plastic tubing we are using in place of a straw. After settling Debbi at 4am, I pulled a pillow next to her left side, and laid down with my left hand on her stomach. I became the vital signs machine that we always saw in the hospital rooms. I could at once sense her her heart rate, respiration rate, temperature, and her agitation. I kept the monitoring going till about 5:30 and when I woke to the sun in my eyes at 6:30, my left hand was still performing the monitoring function.

At 6:30, Debbi’s breathing consisted of four rapid deep breaths followed by about 15 seconds of shallow breathing. I do not believe that this shallow breathing was the sleep apnea described on the Hospice web pages concerning “Active Death” as her chest expanded somewhat and her nostrils flared with each breath. Overall Debbi was comfortable thanks to the proper balance of medications suggested by Debbie A., Margot, and Lyn.

Around 10am, Debbi again started a bit of restlessness. This time however, Debbi, in the midst of a tremor, asked for the kids. In short order, everyone was around her for a 45 minute visit. Debbi’s needs were attended to. A brush was run through her hair that has now grown to over 3 inches. I came across a picture of Debbi with two of her young pupils from school. In the snapshot, Debbi’s hair is as long as I ever remember it. She looks very healthy wearing a white peasant dress and shoes that have ribbons that tie above her ankles. She is simply gorgeous. Her smile is stunning and her brilliant green eyes are dramatic. How different the picture looks compared to the patient lying less than 10 feet away. It is the same Debbi but the physical body is surely different.

I was thinking, this morning, that the answer to the United States health care system might be visiting nurses. I think the government should use a good chunk of the bailout money to recruit, educate, and train a crop of graduating high school seniors. Teach them to be nurses. Spare no expense in making sure that they are thorough in their knowledge. Make their program a work study program that features hands on periods beginning with the simple tasks like diapering (I need to go back to school for this) cleaning a patient, etc. Besides anatomy and physiology, educate them in drugs and their side effects. Differentiate the nurses based on their interests and when they have finished their practicals a few years down the line, let them work in the field at full pay for 5 years before they can move on to the private sector free of school loans.

These trained nurse practitioners could treat many patients that otherwise would have gone to the hospital by expanding the VNA system. The bills that I get from Sloan Kettering are staggering and yet during an 11 day stay in March, Sloan was not able to rid Debbi of her infection. Moving Debbi to Cape Cod, a visit to her physician here, and follow-up at the Cape House by the VNA nurses knocked it right out. You might recall that they used remote services to administer and monitor the Vancomycin IV. Just because the nurses were primarily responsible does not mean that the consulting services of the doctor and pharmacist and the labs were not at the ready… they were only a phone call away. Compared to the bills for the 11 days at Sloan, the charges for the home care are a fraction of the hospital charges. In fact, I think I am about to get a letter saying that the insurance may not cover the charges for the last day of the hospital stay because they maintain that better care could have been given less expensively. I will fire back that Sloan did not do what they set out to and that home care provided a better solution at a less expensive rate. It seems reasonable to me that the insurance company should shield us from those specific charges and make Sloan eat the charges for the last day of treatment.

We can not say enough about our team. Debbie A. walked right in today and instead of popping in to see Debbi, she headed right to see my kids and see how they were doing. Only after attending to them did she find me to take the report on Debbi’s status. How caring, and how considerate, and how fortunate we are to find ourselves with such wonderful resources. I can’t imagine having the where-with-all and the stamina to be prepared to offer the best service I can potentially deliver without having Debbie A., Margot, Lyn, and Mary and don’t forget our talented health care aide Ann whom we expect to arrive any minute. Ann is hands on and bathes Debbi and makes her sparkle. Ann is an equally important part of the team and her radiant smile after being praised for a job well done with Debbi is truly genuine.

Lets stop wasting money on health care and start building an effective system that is many times more efficient than the current system. That it costs less is only a part of the true savings.