"You know what I'm thankful for this year Nede?"
"What Mom?"
"That we're all finally Vanden Bosch's."
"You know what I'm thankful for? All that God has done for us over the years."
"Me too Sweet Girl!"
Wednesday, November 26, 2014
Sunday, November 9, 2014
every last breath is sacred
Sometimes I feel like my world gets so small here. I have traveled back and forth weekly, daily, in a 20 mile range. I have spoken to the same 15 expats and had the same Portuguese conversation with every Mozambique because that's all my language abilities allow for me. I haven't watch anything outside of kids movie or episodes of the Big Bang theory (I'm not complaining-- bring on season 7) for well over a year. I'm bad at reading the news because the time I take to sit at my computer I get distracted and would rather read a blog or shop through TitleNine. But recently, through some blogs I got sucked into the news and followings of dear Brittany Maynard. For a few weeks I would wake up, Googled her name to see what the latest was. And, like many, my heart broke when I heard that she had died. As a hospice nurse and a strong believer in the philosophy of palliative care and hospice, I got all heated up many evenings as I read the latest. I know that I have only heard a fraction of this story because I'm not in America at the moment to understand what's going on. But I couldn't help but think, why is palliative care and hospice not being spoken of? Why is the palliative care model of "there's never nothing that can be done" not being considered? I know that I've never walked with cancer or had someone closest to me suffer and walk the difficult journey, but as a hospice nurse I have walked with many. And, each patient that I have cared for I have considered it an honor to believe that there's ALWAYS something we can try to alleviate suffering. I have worked with hundreds of amazing people who also believe in this philosophy and have dedicated their lives to palliative care and hospice. I have been taught by many the beauty that we can't always take away the problem but we can ALWAYS walk along on the journey.
Through all of this I have been moved by others who are walking similarly challenging paths of cancer like Kara Tippetts and Maggie Karner. Their approach to their prognosis is completely different than Brittany's. They desire to make the best of every moment that they are allowed. I think they would say that yes, cancer is robbing them of many good things but they are choosing to fight the devastation to the very end-- trying to milk every last drop of goodness from their sweet lives. As a semi-newly-wed I can't imagine giving up even one second that I could possibly have with my husband or any of my family and friends. And, as a hospice nurse, I know there are many with great passion to turn life-robbing diseases into journeys of peace and, quite frankly, filled with dignity. And, when done well, this can be strikingly beautiful.
My perspective also changes as I step out in palliative care here in Mozambique. In a nation where the life expectancy is 49 years old (UNICEF, 2012), where the pain medications available are Tylenol, Advil and diclofenac, I think it's fair to say that there are loads of people here that would willingly sign up for a program that promises to say "we will walk with you and never succumb to saying, 'there's nothing we can do.'" Because there's always something, at least in America, there's always something. I think the difference is that here in Mozambique the attitude is always (or most often) "That's life. What can you do?" Burial after burial all that one can do here is keep walking on in hope. And they do, they are always hoping for more. And, in America the moment we feel like we've lost "control" we fight to gain that control back. When really, we weren't meant to be in control (nor do I want to be in control of my life because, it's guaranteed, I'd goof it up. I hope my life is an example of that, by giving up "my" control and having faith in Him who loves me and always has good planned for me (us). My life is far greater than what I could have accomplished alone.-- that can be another blog:) Each breath is counted, each breath is valued-- whether here, where too many breaths are cut short, or there, where we (try) to "control" our every breath-- every one is held. Every one is precious and every one is Holy.
Try explaining health care options including physician assisted-suicide to a nation with a life expectancy of 49. Life's precious my friends. I only dream of giving people here a few more years, days, seconds of sacred breath.
So, now, as I close my computer, leaving the land of "control" on the other side of the pond, I enter back into my world of a 15 mile radius without the options of treatment or choices. As I do, I pray for those with cancer, those with AIDS, those children dying of malnutrition. I pray that someone near to them will walk closely on their hard journey noticing every breath, holding every moment and recognizing the giver of every good gift.
Because, Dear Ones, they are indeed, sacred. Every. Last. Breath.
Scriptures to consider: Psalm 103, Psalm 139, James 1:17
I pray every last word here is accepted with deep love and care.
Through all of this I have been moved by others who are walking similarly challenging paths of cancer like Kara Tippetts and Maggie Karner. Their approach to their prognosis is completely different than Brittany's. They desire to make the best of every moment that they are allowed. I think they would say that yes, cancer is robbing them of many good things but they are choosing to fight the devastation to the very end-- trying to milk every last drop of goodness from their sweet lives. As a semi-newly-wed I can't imagine giving up even one second that I could possibly have with my husband or any of my family and friends. And, as a hospice nurse, I know there are many with great passion to turn life-robbing diseases into journeys of peace and, quite frankly, filled with dignity. And, when done well, this can be strikingly beautiful.
My perspective also changes as I step out in palliative care here in Mozambique. In a nation where the life expectancy is 49 years old (UNICEF, 2012), where the pain medications available are Tylenol, Advil and diclofenac, I think it's fair to say that there are loads of people here that would willingly sign up for a program that promises to say "we will walk with you and never succumb to saying, 'there's nothing we can do.'" Because there's always something, at least in America, there's always something. I think the difference is that here in Mozambique the attitude is always (or most often) "That's life. What can you do?" Burial after burial all that one can do here is keep walking on in hope. And they do, they are always hoping for more. And, in America the moment we feel like we've lost "control" we fight to gain that control back. When really, we weren't meant to be in control (nor do I want to be in control of my life because, it's guaranteed, I'd goof it up. I hope my life is an example of that, by giving up "my" control and having faith in Him who loves me and always has good planned for me (us). My life is far greater than what I could have accomplished alone.-- that can be another blog:) Each breath is counted, each breath is valued-- whether here, where too many breaths are cut short, or there, where we (try) to "control" our every breath-- every one is held. Every one is precious and every one is Holy.
Try explaining health care options including physician assisted-suicide to a nation with a life expectancy of 49. Life's precious my friends. I only dream of giving people here a few more years, days, seconds of sacred breath.
So, now, as I close my computer, leaving the land of "control" on the other side of the pond, I enter back into my world of a 15 mile radius without the options of treatment or choices. As I do, I pray for those with cancer, those with AIDS, those children dying of malnutrition. I pray that someone near to them will walk closely on their hard journey noticing every breath, holding every moment and recognizing the giver of every good gift.
Because, Dear Ones, they are indeed, sacred. Every. Last. Breath.
Scriptures to consider: Psalm 103, Psalm 139, James 1:17
I pray every last word here is accepted with deep love and care.
Thursday, November 6, 2014
well done God
I would just like to say, "Well done God!"
You're laughing?! Well, did you know that God was going to have me here for what felt like an eternity to then eventually bring me "the one my soul loves"? Then reignite my passion for hospice and palliative care? Did you know that "the one my soul loves" would not just bring me great joy and deep love but that his ministry, that he's dedicated his life to, was going to complement mine perfectly and make both all the greater?! If I can depict what happened on Tuesday you'll say it right with me, "Well done God!"
We carpooled on Tuesday so my scheduled visit with "my little guy" involved Chad and another friend. We didn't know if he'd be home but we wanted to just pop in and see how he was doing. Chad was locking the car and lagging behind. Rebecca, myself and another friend started down the hill to his house. We were discussing whether or not we thought they were going to be home when I started hearing singing. My senses were taking in so much that I actually felt confused. I swore I heard Rebecca singing but that wasn't possible, she was just 5 feet behind me walking down the trail. Just then, in my confused state, I heard Chad from about 50 meters back, "He chasing you from behind." Having recognized him from photos, Chad knew the face that jumped out behind the banana tree. After giving a friendly wave he started chasing after Rebecca and the white girls!
Sure enough "my little guy" came jogging down the hill with the Audio player (from inside his Wildlife Story Teller-- stuffed bear we gave him) loudly playing the recording of Rebecca and others singing praises to God and telling Bible stories. I wish I could journey you more closely along on this story for you to fully understand the beautiful depth that was encompassed in this moment! He was radiant! Sure his shirt hadn't been changed or washed since I saw him last week but he was a different boy! And, I think this day was different that it would have been 6 weeks prior. His life is changing.
I don't really know but I imagine that this is how his morning had gone. Old grandmother needed to go to the field to work the land or there's going to be no food this year. "My little guy's" too unwell to be of any benefit in the fields. I'm guessing granny said, "'Little guy' you stay here, don't get in any trouble you hear?" She locked the door to the house of mud bricks and tin roof, off she went and there he sat-- grateful. At least now he had stories and songs to listen to. By mid-afternoon he probably got bored of sitting under the mango tree. He decided to wonder around a hundred meters or so from his house, but of course, he kept his treasure of hope playing in hand.
And then, a big green car pulls in, parks under the mango tree and white people come out. I'm sure he thought, "I've never seen that big car before. I like riding in that small purple one." Then, he saw from afar his new friend Tia Rebecca and Tia Dara and there were 2 other white people!!! And, "THEY CAME TO SEE ME!!!!!! I better run to them, I don't want them to think they've missed seeing me!"
And, so he came through the banana tree, listening to the hope of Jesus and, quite frankly highlighting 3 white peoples week and touching one Mozambican's heart! This brings me back around to saying, "Well done God" for bringing my heart together with my husband's to literally change the life of one little palliative care patient in a Mozambican village.
"WELL DONE GOD!!!"
You're laughing?! Well, did you know that God was going to have me here for what felt like an eternity to then eventually bring me "the one my soul loves"? Then reignite my passion for hospice and palliative care? Did you know that "the one my soul loves" would not just bring me great joy and deep love but that his ministry, that he's dedicated his life to, was going to complement mine perfectly and make both all the greater?! If I can depict what happened on Tuesday you'll say it right with me, "Well done God!"
We carpooled on Tuesday so my scheduled visit with "my little guy" involved Chad and another friend. We didn't know if he'd be home but we wanted to just pop in and see how he was doing. Chad was locking the car and lagging behind. Rebecca, myself and another friend started down the hill to his house. We were discussing whether or not we thought they were going to be home when I started hearing singing. My senses were taking in so much that I actually felt confused. I swore I heard Rebecca singing but that wasn't possible, she was just 5 feet behind me walking down the trail. Just then, in my confused state, I heard Chad from about 50 meters back, "He chasing you from behind." Having recognized him from photos, Chad knew the face that jumped out behind the banana tree. After giving a friendly wave he started chasing after Rebecca and the white girls!
Sure enough "my little guy" came jogging down the hill with the Audio player (from inside his Wildlife Story Teller-- stuffed bear we gave him) loudly playing the recording of Rebecca and others singing praises to God and telling Bible stories. I wish I could journey you more closely along on this story for you to fully understand the beautiful depth that was encompassed in this moment! He was radiant! Sure his shirt hadn't been changed or washed since I saw him last week but he was a different boy! And, I think this day was different that it would have been 6 weeks prior. His life is changing.
I don't really know but I imagine that this is how his morning had gone. Old grandmother needed to go to the field to work the land or there's going to be no food this year. "My little guy's" too unwell to be of any benefit in the fields. I'm guessing granny said, "'Little guy' you stay here, don't get in any trouble you hear?" She locked the door to the house of mud bricks and tin roof, off she went and there he sat-- grateful. At least now he had stories and songs to listen to. By mid-afternoon he probably got bored of sitting under the mango tree. He decided to wonder around a hundred meters or so from his house, but of course, he kept his treasure of hope playing in hand.
And then, a big green car pulls in, parks under the mango tree and white people come out. I'm sure he thought, "I've never seen that big car before. I like riding in that small purple one." Then, he saw from afar his new friend Tia Rebecca and Tia Dara and there were 2 other white people!!! And, "THEY CAME TO SEE ME!!!!!! I better run to them, I don't want them to think they've missed seeing me!"
And, so he came through the banana tree, listening to the hope of Jesus and, quite frankly highlighting 3 white peoples week and touching one Mozambican's heart! This brings me back around to saying, "Well done God" for bringing my heart together with my husband's to literally change the life of one little palliative care patient in a Mozambican village.
"WELL DONE GOD!!!"
he's known
Let me tell you about my day...
On Friday, I arose early, before Chad and even before Nede! She, my trainee, had spent the night so we'd be ready. Ready to take "our little guy" to the hospital for his echocardiogram. For 10 days I had been elated that I had gotten a doctor to order an echocardiogram. I had high hopes that he'd then be put on some medications in which would slow his little heart and give him a bit more energy and strength.
We arrived just past 8 and were told the doctor would be there at 10 to do the test. Okay, annoying but I'll wait. In the meantime we chatted, He drew, we sang, I spoke to the "administrator" of the sonography section of the hospital, etc. The time passed.
Nearer to 11 the doctor arrived-- the pediatric doctor. She called me in to kindly inform me that they "don't do echocardiograms here", we'd need to be transferred to Beira where there is a specialist. Nearly 4 hours away, depending on the enormity of the potholes, would we really have to do this? And, more importantly, what would it be worth? If we find he has cardiac condition needing surgery which is absolutely unavailable, it's not worth it. If we find he needs chronic medications? What if they're unavailable in this country?
What are my palliative care goals for this "little guy" of mine?
With much disappointment in knowing I'm not going to get the medical clarity that I had hoped for, I was in fact pleased that we weren't sent away. Instead, two doctors collaborated and opted for a repeat chest xray (to compare the enlargement of his heart to the one on record from last year). Fair enough-- we were sent off to xray this little chest. The poor, sweet thing had obviously been in this dark, cold room before as he was wiggling out of his shirt before the command was given. Much to my horror, in order to get this shot taken I had to elevate this nearly 40# kiddo by holding his hands extending straight above his head and lifting him up in the air with his back pressed against the back of the xray machine. With my arms trembling and wondering what sort of exposure this was having on my unprotected body, I prayed it would be over quickly before I dropped him and lost the chance for the 1 diagnostic available to us. Phew, we did it!
Much to our delight his lungs have cleared of tuberculosis and his heart has significantly decreased in size! Praise be to God.
Even though I still have unanswered questions regarding this child's health, we celebrate the small things here. But, as I think about it, maybe they aren't small at all. In the 1 year of knowing this child he's gone from SEVERE malnutrition, tuberculosis and weakness (where he couldn't even walk) to now gaining weight, clear of TB, his heart is miraculously diminished in size. I can't explain these things with or without medical diagnoses but perhaps the greatest palliative measure for my "little guy" is that he now knows he's known. We sat with him for nearly 7 hours because we care. And that my friends, may just be what is curing this one little heart!
On Friday, I arose early, before Chad and even before Nede! She, my trainee, had spent the night so we'd be ready. Ready to take "our little guy" to the hospital for his echocardiogram. For 10 days I had been elated that I had gotten a doctor to order an echocardiogram. I had high hopes that he'd then be put on some medications in which would slow his little heart and give him a bit more energy and strength.
We arrived just past 8 and were told the doctor would be there at 10 to do the test. Okay, annoying but I'll wait. In the meantime we chatted, He drew, we sang, I spoke to the "administrator" of the sonography section of the hospital, etc. The time passed.
Nearer to 11 the doctor arrived-- the pediatric doctor. She called me in to kindly inform me that they "don't do echocardiograms here", we'd need to be transferred to Beira where there is a specialist. Nearly 4 hours away, depending on the enormity of the potholes, would we really have to do this? And, more importantly, what would it be worth? If we find he has cardiac condition needing surgery which is absolutely unavailable, it's not worth it. If we find he needs chronic medications? What if they're unavailable in this country?
What are my palliative care goals for this "little guy" of mine?
With much disappointment in knowing I'm not going to get the medical clarity that I had hoped for, I was in fact pleased that we weren't sent away. Instead, two doctors collaborated and opted for a repeat chest xray (to compare the enlargement of his heart to the one on record from last year). Fair enough-- we were sent off to xray this little chest. The poor, sweet thing had obviously been in this dark, cold room before as he was wiggling out of his shirt before the command was given. Much to my horror, in order to get this shot taken I had to elevate this nearly 40# kiddo by holding his hands extending straight above his head and lifting him up in the air with his back pressed against the back of the xray machine. With my arms trembling and wondering what sort of exposure this was having on my unprotected body, I prayed it would be over quickly before I dropped him and lost the chance for the 1 diagnostic available to us. Phew, we did it!
Much to our delight his lungs have cleared of tuberculosis and his heart has significantly decreased in size! Praise be to God.
Even though I still have unanswered questions regarding this child's health, we celebrate the small things here. But, as I think about it, maybe they aren't small at all. In the 1 year of knowing this child he's gone from SEVERE malnutrition, tuberculosis and weakness (where he couldn't even walk) to now gaining weight, clear of TB, his heart is miraculously diminished in size. I can't explain these things with or without medical diagnoses but perhaps the greatest palliative measure for my "little guy" is that he now knows he's known. We sat with him for nearly 7 hours because we care. And that my friends, may just be what is curing this one little heart!
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