Many Happy Returns

My youngest child turned 30 today. Six days later, my eldest child will turn 33, and though the present is clearly momentous, I can’t stop the flashbacks to the past.

I remember their births feeling like the first miracles of my life. I can still recall their even breathing and sweet breath as they lay sleeping on my chest, the warmth of their skin against mine, and the magic of their first smile.

Yes, I had given them life, but they had given me life, too, and purpose. I was a mother, entrusted with their care and their growth and their success as human beings. The task was tremendous and terrifying and joyful and overwhelming, and all together the most important work of my life.

The first time they called me Mommy felt like fireworks and Christmas Day combined. I remember the first time they squeezed my hand, hugged my neck, and cried on my shoulder. I remember when their tears became mine; when their milestones became more important than mine; when their achievements caused more pride than my own. I remember their walking without my aid for the first time, finally allowing me to let go of the back of their two wheeler, watching them walk into their classroom alone, and all the crying after the good-byes—my tears not theirs.

Then there was all the praying for them during tryouts, recitals, performances and games. I hated their disappointments even though I knew intellectually that they contributed to their resilience and determination. I hated their failures even though it was I who taught them that they would learn more from them than their successes. I hated their sadness even though I knew joy was right around the corner.

And joyful it was for me, watching them excel in school, on the athletic field, and on stages of all sorts. To this day, I have never enjoyed a theater production more than ones in which my daughter sang and danced in various lead rolls. Just thinking about when others asked for her autograph still gives me chills.

I still feel pride about my son playing football, not because he excelled in the game and was being pursued by Division I Universities but because of the perseverance with which he sought that goal and the hurdles he overcame—worry about not growing tall enough (He’s 6’4 now.), lifting weights that weighed more than he did to get strong enough, and running more laps than seemed humanly possible.

It wasn’t just that my children were so successful at all they were involved in, but they had grown into successful people—considerate, respectful, and caring about other people. It was a thrill when others would tell me how amazing and accomplished my children were. It was confirmation that I wasn’t just prejudiced about my own children, but that I had really done a great job as a mother, and nothing was more important to me.

But it wasn’t the opinion of others that was most important. It was what my children thought. My most precious belongings are still the thank you notes and letters of gratitude they wrote even through college. They are still what can lift my spirits and bring tears of joy.

I consider it a gift to have stayed home to raise my children. I was able to instill my values, my expectations, and my work ethic. I was able to experience the everyday joy and the unexpected magic. I was also able to love without reserve and without condition.

They are adults now, carving their own way and letting go of parental control has been the hardest challenge in my life. I can no longer direct or protect, and that may be the toughest part of parenting yet, but I have to continue to trust that what I instilled when they were young will continue to play out in the choices they make as adults.

Surgery Savvy

I've just had a surgical procedure, and though I knew it was critical to ask the right questions before and after the surgery, I wasn't as clear about my rights as a patient, and, though we don't always think so, we do have rights and, ultimately, we are in charge. We can both refuse and direct treatment.

That being said, we must remember that the patient is the lay person in the place. We need to trust our surgeon, after having asked all the questions we can about the procedure, complications and his track record.

We need to interview our anesthesiologist and be sure he knows about all our allergies and ailments. In my case, a neck spasm that I had been struggling with muddied the waters. It hadn't occurred to me at all. My very good intake nurse hit upon the problem and insisted I tell him because it could impact the tube going down my throat after I was out.

The most important component to a pleasant recovery is definitely your staff of nurses, who I really believe run the hospital anyway. I experienced both heaven and hell in post-op and during the night. When I was in the most pain, one nurse tried to "explain", fairly sarcastically, why it was painful, instead of just giving me more pain meds.

I almost lost it and then made it clear that I wanted another nurse to watch over me, and the one who ultimately sat at the end of my bed throughout the rest of post-op was a much better caregiver. She was attentive, thoughtful, and quick to resolve problems.

Nighttime at a hospital is crazy. If sleep is really a critical component to getting better, you won't have a prayer until you're released. I'm quite sure I was awakened four times each night. It certainly seemed like I was getting more attention from midnight until 5:00 a.m. than I did all day, and at least one of my nurses was as cranky as I was about having to function on any level during that time slot.

So what are your rights? This is what Methodist Health System suggests.

"You have the right:

-to be informed about the care you will receive.
-to get information about your care in your language.
-to make decisions about your care, including refusing care.
-to know the names of the caregivers who treat you.
-to safe care.
-to have your pain treated.
-to know when something goes wrong with your care, an honest explanation and an apology in a reasonable amount of time.
-to get an up-to-date list of all your current medicines.
-to know what kind of security the hospital has and whether they will keep information about your case private.
-to be listened to.
-to be treated with courtesy and respect."

Be sure you know beforehand if there are any procedures that cannot be done at that facility and if you can get a copy of your medical records and test results. Visit the Agency for Healthcare Research and Quality at www.ahrq.gov for their "Twenty Tips to Help Prevent Medical Errors".

Find out who you speak with if a problem arises and how the facility handles complaints. If you are still not satisfied, file a complaint with the licensing authority at www.jointcommission.org.

Anticipate all you can. An ounce of prevention is definitely better than a pound of cure. Then listen to your head and heart. If you’re not comfortable about anything, assert yourself. You are you own best advocate.

Hot Under the Collar

I've just had the pleasure of three weeks in Switzerland and New England where the temperatures didn't rise above 75. It was heaven. I've gotten home to Texas and temperatures range between 102-105. To say it is hot is an understatement. It feels far more like the opposite destination of heaven.

I guess I've not acclimated yet because as I was trying to do some gardening, I felt a little overwhelmed even though I was doing it in the morning and thought I had hydrated enough before. When I started to research about what might be happening, I found some interesting information about the difference between heat stress and heat stroke. I thought I'd pass it on.


The Risk of Heat Stress

Your risk of heat stress depends on many things. These include:

•Your physical condition

•The weather (temperature, humidity)

•How much clothing you have on

•How fast you must move or how much weight you must lift

•If you are near a fan or there is a breeze

•If you are in the sun.

Too much heat can make you tired, hurt your job performance, and increase your chance of injury. You can get skin rash. You can also get:

•Dehydration. When your body loses water, you can’t cool off fast enough. You feel thirsty and weak.
•Cramps. You can get muscle cramps from the heat even after you leave work.
•Heat exhaustion. You feel tired, nauseous, headachy, and giddy (dizzy and silly). Your skin is damp and looks muddy or flushed. You may faint.
•Heat stroke. You may have hot dry skin and a high temperature. Or you may feel confused. You may have convulsions or become unconscious. Heat stroke can kill you unless you get emergency medical help.

Judy Hedding in her article "How To Recognize, Treat and Avoid Heat Stroke" suggests the following.

1.If someone's body temperature reaches 105 degrees, they could have heat stroke.
2.If a person has heat stroke, the person probably isn't sweating much.
3.With heat stroke, the skin will be hot and red.
4.The person may be dizzy or nauseous.
5.If a person has heat stroke, his/her pulse may be rapid.
6.Immediately call a doctor.
7.Get the person out of the sun.
8.Take off the person's outer clothing.
9.Apply cool water or apply cold packs to the person's body to lower the temperature.
10.If the person is conscious, provide small sips of salt water.
11.Do not give any drugs, alcohol or caffeine to the person.
12.To prevent heat stroke, wear light, loose fitting clothes and a hat in the sun.
13.Drink a lot of water (even if you don't feel thirsty) to prevent heat stroke.
14.To prevent heat stroke, take in a little more salt than usual with meals. This helps retain water.
15.If you are out in the heat walking, hiking or playing sports, make sure you carry a phone with you. Never hike or play golf alone during the heat of the summer.

Tips:
1.Understand the difference between heat exhaustion and heat stroke. The first aid is different for each.
2.Do not ever leave a child or a pet in your car in the spring or summer. Not even for a minute. Not even with the windows open.
3.Every year children and pets die in cars.

My suggestion for when it is over 100 degrees is to make a tall glass of iced tea, put your feet up and pass the time in an airconditioned room. Whatever work you have outside can wait until the temperature drops a bit.

Stay cool. Your life may depend on it.

Finding America the Beautiful

I spent days at the start of my summer vacation in what I thought was the most beautiful place on earth, and most certainly Switzerland is absolutely gorgeous, but in trying to complete my bucket list, I am presently traveling with a friend and writing colleague in Vermont and New Hampshire, the only states in the East I’d never toured before, and I actually may have found heaven on Earth, and it is in our own backyard—so to speak.

The green mountains of Vermont are truly magnificent. Carpeted with massive trees in every shade of green I’ve ever seen, they shelter rolling corn fields, are home to the Morgan, one of the earliest horse breeds developed in the Unites States, and support an American populace that proudly displays flags from 1776 all along Main Street.

Each of the small towns throughout our New England journey has oozed with pristine beauty and unequaled charm, the kind of charm, in fact, that you can only find in America.

In one town, the after-dinner attraction was a Marine Band that entertained the whole town from the gazebo in the town square. Listeners were curled up on picnic blankets or lounging in lawn chairs. Some of the youngsters were draped over the Veteran’s monument and brass canon that decorated the square or were gazing up wide-eyed from the grass that encircled the gazebo’s base. Old and young alike were enthralled by the young men in uniform who played their patriotic songs.

In another town, there was an outdoor recital and all the townspeople were in attendance not because the dancers were famous but because being featured were the tiny daughters, in tap shoes and tutus, of families who’d lived there for generations. Their ancestors, many generations of them, had carved their roads into the mountain sides, dug the gray stone from dangerous quarries for the homes and churches that still stood tall, and they had withstood the tough winters to bring in the harvest of farms still owned by these great, great grandchildren. These little girls were the town’s tiny daughters and that meant coming out in support, whether they were in your blood line or not.

We saw townspeople attending outdoor fish fries, walking the streets around at sunset with ice cream cones and candied apples, and docking boats after a day on crystal lakes and sparkling rivers.

They chatted on verandas that wrapped around their quaint Victorian homes painted in pastels and festooned with flowers of every sort—baby’s breath, huge holly hocks, yellow jonquil, and pink lilies. A cacophony of color, there was a profuse garden at every turn, whether of man’s design or nature’s.

It was a Norman Rockwell painting very much alive and well. Bubbling brooks and rushing falls graced every town, and the covered bridges carried you back to the days of America’s true pioneers.

My favorite was on the way to the historic home of our greatest American sculptor Augustus Saint-Gaudens. Carved into the arch of the bridge dating back to the 1800’s was the stern warning of being fined if one did not walk instead of ride their horse across.

America the beautiful is indeed that. Whether in the mountains of Vermont or on the emerald beaches of Florida or amid the red rocks in Arizona, there is no more versatile or gorgeous a place. Magnificent nature aside, though, the American people are just as beautiful—still strong, still resilient, still fighting to hold onto what has always made us so very special.

Surgery Ready?

Are you about to have surgery? If so, preparation is key to a successful recovery. You should be armed with the right questions to ask before they cut you open, and you should prepare your home and family for convalescence. Here's what's critical.

1. Educate yourself about your procedure. I know that sounds obvious, but we have become so immune to the disclaimers by doctors and hospitals that if we really took that list seriously, none of us would ever have surgery. Be sure about what the negative consequences really are and consider how you will resolve those problems should you fall into the percentage of unlucky people who do not recover well.

2. Take a friend or relative to the doctor's visit. Often we're too uncomfortable to be definitive about what we want or too embarrassed to ask necessary questions. Your advocate should not have the concerns that stop us from asking for pertinent information or expressing our concerns.

3. Prior to surgery, ask if you should stop smoking, drinking and taking various medications. For example, sometimes a surgeon won't operate on a patient if they have been on steroids within a certain period of time because they impede healing. Ask also about herbal replacements you take or something as simple like aspirin, which can cause bleeding. Notify your surgeon about any changes in your health between your pre-op appointment and going into the hospital. Fever, rashes or even a cold could impact success.

4. Cook and freeze food that would be easy to heat and serve. You really don't know what your energy level is going to be. Put away loose rugs, fix unstable steps and put in bars if that facilitates safety in the shower. Arrange any services and equipment you might have to use--oxygen tank, wheel chair, bed rails, and home health care.

5. Ask what you can expect for after surgery; when you can resume activities; what the danger signs for a problem will be; if you will need a ride.

6. Take only what you must to the hospital--no jewelry, money, or medications. You risk loss, and they will dispense the medicine you need. Do take a list of medicine that you use and your insurance card, and make friends with the nurses. They really run the hospital. The better they know you, the more attentive and helpful they will be. Also, fewer mistakes are made when people know something about you and your condition beyond the chart.

7. When you're in the hospital, notice what your medicine looks like and when it is given. Dispensing medicine incorrectly is the most common mistake made in a hospital, so ask about changes and remind the staff if you've missed a dosage. Also, watch to see if your caregivers wash their hands, the single most important way not to spread germs, and if they use gloves. Be sure they hand you the call button. You want to have that within reach at all times.

8. Be sure to check your wrist band for errors and make sure it lists your allergies. Despite the fact that a morphine allergy was repeatedly included in my dad's chart, he was given it at multiple hospitals.

Check, check, and check again--everything and everyone! If you are physically and mentally able, you should be your own best advocate, and please don't be shy. You won't see these people again, but you may have to live with a mistake forever.

If you are not able to be your best advocate, ask someone to watch over you. Their presence in the hospital and their energy on your behalf will make all the difference.