New Entry after so many weeks

       It seems like it has been many weeks since I have written in here.
The main reason is because my mind has been so blurred with so much to deaden my thoughts and my pain.  One of the main reasons is that I cannot remember things from all the medications which take away the pain.
       Yes, I forget a lot of what has happened from day to day and even sometimes from hour to hour.  So, the main reason is pain.  I don't know how much pain I can take.   I really don't know how much pain i will be able to take.  I guess that is what pain is all about.  Even now I cannot reach a pain tolerance.
        I am told by the hospice people that I need to keep ahead of the pain or it will  be harder to conquer when it does come.
       Along with the pain problem comes constipation.  I have a patch which has to be changed every 3 days.   I take 2 pain killers now.  Because of the constipation, I also have to take another pill to help resist the constipation.   And so it goes!
        On the happier side of life, we have been living life as we approach our 50th anniversary coming up September 20th.  We decided to push up the date from the twentieth to August 17 and celebrated two weeks ago.   The kids decorated Ruthie and Bill's house and we had a wonderful time.   When I figure out how to download the pictures, I will post them on my "blog".
          As I approach the hospice part of living, learning every day how to live the best way I can within the time frame, planning my own funeral, planning what I can including giving my body for science and things that seem morbid, I see that plans like that are like planning anything and shouldn't be morbid to me.  I don't think of them as morbid but give me a sense of peace and comfort instead. 
        Actually, planning your own memorial service  gives you one of the best parts of your life which lets you give to those who want to remember you a gift back to them.
         So, with all of this in mind, I must close this very disorganized "epistle". Who knows when I will stop writing "blogs".   My mind finds it hard to think that there is anything more worthwhile saying.   But, if I do think up something worthwhile saying in the near future,  I will certainly try to write about it.  If not, maybe this is it?😃
       

Pain Patch

     For about 2 weeks I have been taking Tylenol (500 mgs) and Tramadol every 6 hours until the last few days when I have had to take it every 5 hours just to get ahead of the pain.
I have finally decided to start using the Fentanyl patch which is supposed to relieve pain and only has to be changed every 72 hours.   Being changed means changing the location on my body.  It has to be placed on a soft or fatty place on my body like under my upper arm.
     Today, I called the hospice people and told them I was ready for the patch and my sister came over and put it on.  Actually, anyone can put it on, including me.  Rubber gloves must be used so the one applying the patch does not get any of the medicine on them.   The placement of the patch must be wiped off and dried.   I can shower with it on.  
     After a few hours, I started to feel sleepy and laid down.   But when I got up, I had a  little cup of coffee and don't feel that sleepy anymore.  I was told that would happen for a few days.  The actual pain control is not supposed to start for a few more days so I continue to take the Tylenol and the Tramadol.
      Lately, since I have been with hospice, I have noticed the extra care that I have been given from friends.   I so appreciate the cards, the calls, the emails, the comments on facebook, the meal donations and especially the prayers on my behalf for healing, strength and pain control.  I appreciate the hospice care, the family care, the pastoral care that I have been given.   All gifts from God.
     Last night was a very wonderful caring experience for me.  Agustin, Kathy, Paul and I went to Ruthie's where Bill's family was gathered, and Bill's Dad, Wes, prayed for me and anointed me with oil.         
   "The New Testament Greek words for “anoint” are chrio, which means “to smear or rub with oil” and, by implication, “to consecrate for office or religious service”; and aleipho, which means “to anoint.” In Bible times, people were anointed with oil to signify God’s blessing or call on that person’s life (Exodus 29:7; Exodus 40:9; 2 Kings 9:6; Ecclesiastes 9:8; James 5:14). A person was anointed for a special purpose—to be a king, to be a prophet, to be a builder, etc. There is nothing wrong with anointing a person with oil today. We just have to make sure that the purpose of anointing is in agreement with Scripture. Anointing should not be viewed as a "magic potion." The oil itself does not have any power. It is only God who can anoint a person for a specific purpose. If we use oil, it is only a symbol of what God is doing."  

      "Thou anointest my head with oil.....Psalm 23:5b.
      "Is anyone among you sick?   Let them call the elders of the church to pray over them with oil in the name of the Lord."   James 5:14
    

Hospice and Facebook Thoughts from our daughter Ruthie

     I think it is time for another update as I have been with hospice now for over a week and pain is upon me.  I am taking Tylenol and Tramadol at the same time, every 6 hours.  I know a stronger medicine may be coming along next.  To be honest, I would rather not be in pain because it wears you down.  I know there are side effects from the stronger drugs so I will deal with them as they come I guess.   Meanwhile, I am having lots of visitors and things to do.  I am thankful again for dinners being brought to the house because planning and cooking dinners is not my thing.  I eat very little but often during the day.  Still get hungry and still get thirsty, so that is a good sign😃 
     I would like to share with you what Ruthie wrote on facebook this week:
     "Mom just had her hospice intake last week.  We are learning as a family all about the end stages of life and what to expect.  It's quite overwhelming mentally and emotionally quite honestly. Trying to learn how to manage her pain , how to listen to each-other and openly talk about death on this earth. I am thankful for all this time my Mom has had with us, but it doesn't make it any easier knowing this is what we have to look forward to.  Will she suffer long? Will she go quickly like they say pancreatic patients usually do? Will we recognize it? Today I met her sweet hospice nurse whom I happen to know from a Bible study she led my table  a few years ago!!! She was teaching my parents and me all about the comfort kit this morning --how and when to administer in the case of an emergency. 
     Did I ever think I would be learning how to draw up morphine for when my Mom is in pain that's intolerable or give something for hallucinations? How can my saintly mother go through this sting of death.... How Lord? Then.....our nurse put her hand on my Mom's arm and said...."but you're not going to be worrying about any of this because you're going to be partying with JESUS!!"  All of a sudden it was as if the Holy Spirit just made this all real to me.  I don't know what life is like after this life here on earth.  I just know what I believe the scriptures say is TRUTH .  NO more pain and No more suffering! I have to have faith in what I can NOT see, feel, or touch.  My prayer right now is that all my family and friends have this same kind of Peace.  Will we grieve? of course! Will it be hard? absolutely!  Please pray for my Mom and for my sweet Dad and us kiddos! We sure have felt all of the support. 
       Mom  has decided to move their 50th anniversary party up to the 17th of August instead of their actual date of Sept. 20.  Pray please she feels good and can enjoy it!  We all are so excited to celebrate their 50 years of marriage !!! Mom has been planning it and I got the invitations printed today. 🎉'"  
       Miriam Zito Hermosa I love you more than you could ever imagine.  You have been the most Godly example of Christ to me.  You are my Mommy and always will be. I love you!"

Rev 21:4 He will wipe every tear from their eyes. There will be no more death or mourning or crying or pain, for the old order of things has passed away!
Proverbs 3:5-6 Trust in the Lord with all your heart and lean not on your own understanding; in all your ways submit to him, and he will make your paths straight."

Pain and Meds and Hospice Care

     It is Sunday morning and not like any other Sunday morning.   It is the first Sunday I am waking up in hospice care.   I guess it is like joining a "club".   There are lots of things to learn about the organization, the people working with it, the "benefits", and just living and dying in general.
     We have had wonderful visits from nurses, the social worker and calls from chaplains.  I am home and I will be visited as often as I need.  
     Now to the pain.  I have had more pain in the last week than ever before.  Our challenge is to find out what causes the most pain, what to "give" it to stop or subside, when to give it and how often to give it.   Of course, along with meds to help with pain come side effects.
     I have only been using Tylenol and Tramadol so far.  Tomorrow the nurse will come and we will discuss a routine to keep ahead of the pain which is the key.  Unfortunately I have liver lesions so neither of those meds should be used for long periods of time from what I understand!
     Meanwhile, I cannot think too far ahead with "planning" because we haven't gotten that far in our pain management.
     The night before last I barely slept because of pain.  Last night I did not have pain.   So, yesterday when I called the hospice 24/7 for advice, I asked if I could take Tylenol and Tramadol interchangeably.   She said it would probably be Ok for this weekend, but, I might need a stronger pain med.   My nurse visits tomorrow so that is reassuring.    Wonder what that med will be and what the side effects will be?  I guess one has a choice of little or no pain and feeling dull and sleepy in the head, or opt for pain and thinking better.  Right now, I don't deal with the pain very well and I don't like it.  And, what comes with opioid meds is constipation...then you have to take something for that!   Whoopee!!
     Along with the pain there seems to be a lot of bloating and painful gas after I eat no matter what I eat, so I have started taking Gas X, 180 mg.   Seems to help but you are only advised on the bottle to take it twice a day.  So, I am trying that too.  O course, I continue with small portions throughout the day!
      The support and care that the hospice folks give is very reassuring.  I am so thankful for the faithfulness of my family to my condition.  My husband is most caring and devoted, but sad at the same time.  
      "In all your ways acknowledge Him [the Lord]  and He will direct your paths."   Proverbs 3:6

All signed up with Hospice

     The word hospice does sound depressing and negative  but after our meeting today with 2 wonderful ladies, it doesn't sound so depressing as it did before I found out how caring the people are and how the future may or may not be for me.
      Life goes on and I go on.   So, as of today, I am part of  Centra Hospice of Lynchburg.  I will be visited by a nurse and whenever I have a question or concern or pain that I cannot control, etc, they are a phone call away among other things as help is needed!
      Meanwhile, I have a very supportive family, supportive friends from our church and church's ministry  and friends from near and far who are praying and helping with kind thoughts, words and actions!
      Thinking about the negative aspects of dying cannot be part of my mind frame right now, so, I will be thinking about short term future activities like going to the beach for a few days and helping planning for our 50th wedding anniversary party on Sept. 21!  SAVE THE DATE  
     After that it is birthdays in September and October.  Wow, and then there is Thanksgiving and Christmas again😃
      A favorite song I loved to sing is an "older" version of "Give Me Jesus".   It is called "In the Mornin' When I Rise", a "spiritual arranged by Charles Ives.   
In the Mornin' arranged by Charles Ives

Another more "modern" version of this song that is beautiful which I found on the internet this AM is "Give Me Jesus"  arranged by Fernando Ortega.
Give Me Jesus Arranged by Fernando Ortega

Oncologist Appointment, July 22, 2019

      I had a good appointment with my doctor.  Our dear daughter-in-law went with Agustin and me to the appointment.  Routine lab work was done including for the tumor marker!   Then we listened to what the doctor had to say about my CT scan and my future decisions.   We had a good discussion and Hailey took notes.  She really helped us since both Agustin and I don't always remember everything nor have time to write it down.
      Here are some things Dr. Paul discussed with us from Hailey's notes:
         *The CT scan showed that the lungs look stable. 
         *Liver has grown (?) and new spots on the liver.  The pancreas tumor is growing and the tumor is pushing on the small bowel causing pain in the upper left side.
         *Radiation is an option.  But, the Xray beams from outside the body into the pancreas could  have side effects during the treatments like nausea and vomiting, also bladder symptoms because passing through the stomach!
         * Doctor doesn't think the tumor markers are reliable.
         *The swelling (bloating) I have is probably air because no fluid shows up on scan.
         * Back to radiation:  They try to do the shortest course possible, maybe just 5 days.   It would not add any length of life, only to help with pain.   To set up for radiation takes several weeks so if I want that, I need to start soon.
        *The celiac nerve is right by the pancreas and that is what causes the pain!
        *With hospice. Don't wait til the last minute.
        *I will stay with Dr. Paul [forever]😊
      We discussed medications for pain.  I take Tylenol now but the next med would be Tramadol.  I asked if taking Ativan and Tramadol together would be a problem because they are both sedatives (?)  She said maybe just take half the ativan when taking Tramadol.  I only take Ativan at night anyway, so, sedatives, in my book, would be fine:)
       Dr. Paul told me it was good I still had the port in place since later on pain meds, like morphine, can be administered at home with a pump that I can use myself!
       She said my liver tests are OK so still OK to keep taking the Tylenol for now.
          *Hospice will call me to make an appointment to come to my home to discuss everything.
          *I should keep taking the Creon (pancreas enzymes) to help digest food.    Fat is the hardest to digest but starch, pasta, etc easier on the pancreas. 
        So, this is the "report" from our notes.
        With all this being discussed and said, I have a road ahead that doesn't look "pretty" as I heard once a good friend tell me when he was telling me about his Parkinsons'!  
         Now,  I need to focus on the part of taking each day as a gift and continuing my "journey" here as long as possible....hoping even to make it to our 50th. wedding anniversary to be celebrated Sept. 21, 2019 and to a few days at the beach with Margie and George the week before🙏
          Meanwhile, trusting God to get me through this and also my family I need to focus and pray on a special verse in the Bible:
            

Lamentations 3:22-24 The Message (MSG)

God’s loyal love couldn’t have run out,

his merciful love couldn’t have dried up.

They’re created new every morning.

How great your faithfulness!

I’m sticking with God (I say it over and over).

He’s all I’ve got left.

       Great is Thy Faithfulness ~ Mimi & Carlease audio
     
           

An A Fib Episode last night

    Of all things, as I was comfortable in "my chair", starting to watch my movie episode on "Bolivar", I was "craving" some chocolate ice cream.  Got it, sat down again, ate it and immediately started having an  Atrial Fibrilation episode!
     I have not had an "episode" in almost 2 years from what I remember, so I really don't know what "triggered" it except some lifting I did with moving some music boxes around for several hours  the day before yesterday and sorting old music.  Who knows?
     Anyway, the "episode" hits me like I think I am having a heart attack.  I am never really in irregular heart "rhythm" unless I have an "episode" whereas AGustin can be in a fib without feeling anything much of the time I think.  We both take Eliquis!
     As the night progressed we took my blood pressure and pulse which was quite high and the pulse very high and irregular.  The "episode" makes me feel weak, chilly and just worn down completely.  I laid in bed and prayed.  I also took a metoprolol pill, low dose, after about 20 minutes which may or may not have helped.   Later I took my usual low dose Ativan and then, still not able to sleep, took my Tylenol because a little abdominal pain was joining the frustration!   I tried other recommended "solutions", like bearing down, but to no avail.   Just had to wait it out and, heaven forbid, not call the rescue squad or go to the hospital.   No way:):):)
     Lo and behold, I woke up several times during the night and finally, my heart was back into "rhythm".   Thank you Lord and thanks to my very faithful family for praying for me when I texted them very late at night.
      By the way, these "blogs" also help me keep track of health events in my life as I go through them.
      Today I am recuperating and tired, but thankful things are back on track for this old lady:):):)