Friday, February 25, 2011

Compassion Fatigue

Often, because of my passion for issues of genocide and human rights, I find myself drawn to articles, movies, books, etc on the topic. Coincidentally I often pick up books on the topic at the worst possible time.

After my grandfather's death I was reading the book by Samantha Power titled "A Problem from Hell: America and the Age of Genocide". At his memorial service I was reading Lt. General Romeo Dallaire's " Shaking Hands With The Devil: The Failure of Humanity in Rwanda". During my great uncle's memorial service I read Philip Gourvitch's "We Wish to Inform You That Tomorrow We Will Be Killed With Our Families". Other's on my shelf range from:
- Viktor Frankl's "Man's Search for Meaning" to
- Greg Mortenson's "Three Cups of Tea" and "Stones into Schools"
- Scott Straus's "The Order of Genocide: Race, Power, and War in Rwanda"
- Brian Steidle and Gretchen Steidle Wallace's "The Devil Came on Horseback"
- Jen Marlowe (with Aisha Bain and Adam Shapiro)'s "Darfur Diaries"
- Don Cheadle and John Prendergast's "Not On Our Watch: The Mission to End Genocide in Darfur and Beyond"

(And that doesn't even speak to the films on my shelf, including that by Invisible Children)


This time I chose to watch the movie "Ghosts of Rwanda," after taking today off to process all I heard about my mom yesterday and be able to spend the day with her doctor, social worker, etc. I had rented the movie on a whim because a local Human Right group had aired it yesterday at the U of MN and I hadn't had the opportunity to watch it. While seeing famous individuals, who I find incredibly heroic, on the screen discussing this conflict I began to sense my numbness.

After leaving the hospital yesterday and making it to the car in the parking ramp I had collapsed into the drivers seat and poured out gut wrenching sobs into my empty car until my gut hurt. Made it home and then cried myself to sleep last night. Sometimes tears are cathartic. In my case it drained all the emotions I had in reserve and when I returned to myself this morning while watching the documentary I realized I had nothing left.

I hated my humanness and inability to retain any compassion beyond what I had lost the day before in my tears. I know it will return but while watching the film I understood the horror of our species and our weakness to accept "compassion fatigue" instead of fighting our mental state and forcing ourselves to recognize the horrors and atrocities in the world. How we as humans become so fatigued by our own situations that we forget about the conflicts outside of our lives. It's like we all assume the rest of humanity is robots and that our problems are bigger than anything else the world might be facing. I HATE THAT!!!

So maybe my choice to read incredibly depressing and morbid books/watch movies while already maxed out emotionally is a little ridiculous. However I think subconsciously I do it intentionally to remind myself that I am "settling" for compassion fatigue and need to be reminded about the conflicts and genocides of the world beyond my daily life. Which sometimes serves as the reality check that I am not a robot, nor are those around me, and there are conflicts bigger than me that are still being fought that I need to be a part of.

So this is my promise to myself to be more honest with my emotions and pains and hurts, and to do my VERY best to take time and pause and re-assess my own compassion fatigue. So that I might be able to share and empathize with the pains that you have, as well as those of the world. (Instead of hiding in my own little bubble).

Sorry if this was hard to follow, I just needed a release for the passions in my heart. Thank you everyone.

With love and an open heart,
Kate

Results are in.

Mom's biopsy results are back:

Her Leukemia blasts are still holding at 9% in her marrow (they had been at 12% before this last round and had been 40% when she went inpatient). Unfortunately this means we need a new game plan because this two types of chemotherapy they have been using, though it worked VERY well during the first round brought too many side effect and is incredibly risky to the health of the patient to perform a third round. So options, per the doctor yesterday are now:

* Try a new type of chemo
* Try a type of experimental treatment (not specified yet but apparently the research nurses are all ready looking into the many options in this)
* Not pursue any type of treatment (I was GRATEFUL that mom's spirit is still holding strong and that she has not agreed to this option).

So needless to say I took the day off from work to process everything we heard yesterday, after doing some of it over dinner with my mom's friend Pat last night. And will be spending the day running quick errands for mom and then spending the rest of the day at the hospital.

Side effects from the last chemo and/or granulocytes (neutrophils)*:
- Her heart and lungs have weakened slightly from the chemo, since the PICC line went directly to her heart so the meds, chemo, etc were the most effective that they could be
- Her hands are still recovering from the rash/rawness that occurred during the chemo and the skin is currently regenerating, so now it looks like she has "zombie" hands.
- She has a had fevers since the end of this last round of chemo, from 15th til today she's been ranging from upper 99-104 (cause is still being determined)
-She's been exhausted from all the meds, tests, infection, after effects from chemo and has been falling in and out of sleep the last two days

Good news: the cultures finally came back negative on her blood samples, as of the 20th, so they were able to install another PICC line for her, so now she won't have to get as many pricks everyday!


* Granulocytes/neutrophils: These are parts of white cells that are being studied at the U of MN and in the current trial. In which the donor is getting medications to increase the number of these cells within their system before donating. They are used to help fight off mom's infection since she currently has no immune system.


More updates to come today I am sure. But off to the day! Post more soon! Thanks everyone.

Wednesday, February 23, 2011

Posts shared from yesterday...

I posted these on my facebook yesterday, then realized that not all of you would see them:

Here's the latest updates:

"Just talked to Mom, she's still got a fever of 103+ (without tylonal) that's been going since the middle of the night Sunday. Prayers that the granulocytes do their job and kick this infection out of there. Sounds like she's sleeping as much as she can. So prayers that she's able to tolerate this whole process, specially the nausea (which is higher than it's ever been before), would be appreciated. Thanks everyone!"

"Good news! When I left mom last night her temp was down to 99.4, and had been in the 99's for most of the day (other than one spike up to 103.4 in the evening). She's off to her bone marrow biopsy today so hopefully we will have an update on her "blasts" (Leukemia cells) sometime tomorrow. Thanks everyone!"

Other notes:
Her hands are almost back to normal, though gloves are still being mandated for her and she has a slight rash on her right arm which is also being monitored. Sounds like it might be a side effect of the granuloyctes. She'll be on her 3rd round, of 5, tonight after she finishs her Bone Marrow Biopsy today.

Her spirits are still good, though finding time to sleep and rest has been hard for her since all the tests and vitals keep her up all hours of the day. I'll try to find time to do another post sometime later this week-once the biopsy results are back. Thanks everyone!

Saturday, February 19, 2011

Information Overload? Maybe...

So here's the update since my post from the 9th (See "Round 2, Here We Go Again..."):

Mom actually ended up having the 5-2-2 chemo instead of the 7-3-3, with her next Bone Marrow Biopsy scheduled for this Wednesday, the 23rd. So prayers that all of the Leukemia "blasts" (cells) will be gone that way we can move onto the next stage: pre-transplant.

In the mean time, right after this last round of chemotherapy, her body decided it would be nice to mix things up. Not only did it spike sporadic fevers (on Tuesday it was 100.7), but also caused rashes on her head and hands. (She was put on general antibiotics immediately, and later went up to double bags to try to prevent any worsening of a potential infection).

The ones on her hands looked like she was trying to turn into a lobster. It was like they had been dipped in dark red paint. The assumed cause was the compulsive hand-washing that she does in combination with her body's shedding of cells, from the chemo. Needless to say she was rockin' some awesome white, soft, gloves to help protect her raw hands from any more exposure. The doctor's also used a prescribed medical cream to rejuvenate the cells on her hands.

After almost a week, they appear to be getting back to normal. Same with the rashy blotches on her head. And the fevers have stayed below 100, as far as I am aware.

(Apparently her hands wanted her to be like Michael Jackson with his gloves? Though I pointed out that Will.I.Am was also lookin' pretty stellar at the Grammy's with some red ones on).

Next battle, the fevers were caused by an resistant infection (virus) and so mom's PICC line, that they used for all her injections and labs, had to be pulled and now she has to be pricked every time they need to do anything. Which sucks. Good/bad news: the clarification of her infection meant that the doctors were able to focus on the exact type antibiotics that are supposed to fight against that virus. Down side, it makes her more nauseous than the chemo did. And as a result her anti-nausea regiment of pills is making her more tired, a side effect of the meds, than she would like.

Funny side note: the reason the doctors had a hard time recognizing mom's infection was because her physical state and over all health was better than a patient typically would be with this health condition. So once again she's the outlier, to the definition of "normal" for this infection/virus. I mean are we really surprised by that? ;-)

Oh AND during all of these event mom got her hair cut twice, once it was shaved to a half inch, and then a few days later it was shaved down to the scalp. (Most of the photos are on facebook-but here's a few...)

This was pre-cut...


Super Mom! She's CERTAINLY my Hero!

Mom's "Rihanna" hairstyle...

The finished product, with me and my sister

my favorite photo-EVER!!! This is my mom to a T. She's beautiful, joy-infused, and at peace. She's incredible and I am SO incredibly grateful to have her as my mother. I love her more than anything else in this world.

Wednesday, February 16, 2011

Update from Mom 2/16/11

Mom's internet is down right now, so here's her latest update:
(See mom's latest blog for the majority of her side effects as of yesterday. One that's not listed is the fact that she had a fever over 100, actually 100.7 to be exact.) Her update today, to me, was as follows:

"Blood cultures came back positive so it has nothing to with [visitors or exterior forces] ! It is likely from a normal skin organism. Plan is antibiotics that they started [her] on, for at least a few more weeks. They will also do cultures every day until they are negative. They may need to take out [her] PICC line and put in a new one in a couple days after the cultures become negative again. This is not uncommon even though its frusterating-it's why they watch everything so closely! Again, [she is] already feeling better with additional antibiotics!"

"They will continue to work on figuring out the exact bug to be sure the antibiotic is the perfect one."

Wednesday, February 9, 2011

Purpose

Tonight at Socrates Cafe in Saint Paul, MN (http://www.socratescafemn.org/) the question I posed to the group was chosen. The question was:

"Is it possible for a human being to live a life without purpose?"

Purpose in this case is that which was defined by Viktor Frankl as: "meaning". He stated that "We can discover this meaning in life in three different ways: (1) by creating a work or doing a deed; (2) by experiencing something or encountering someone; and (3) by the attitude we take toward unavoidable suffering." (http://en.wikipedia.org/wiki/Man%27s_Search_for_Meaning).

I was focusing on the third option as the main idea behind my question. My theory was that everyone, no matter what their background, religion, status (gender, economic, etc) ALWAYS have a purpose. (Even if that purpose is to not doing something that is perceived as morally or ethically acceptable they still derive meaning in their lives by choosing to follow it). There were many other interesting subtopics and statements made by this collection of strangers, who gather together in intellectual pursuit and inquiry, I will share a few of them here.
And I would love to hear your perspective on this discussion if you have one! :)

* Do we have a common/universal "purpose"? Is it self defined or imposed on us by the world?
- "We cannot have a universal "purpose" because there is no universal starting point by which to begin.
~ Couldn't "survival" be our common starting point? A central focus for all of us?
* Is it possible to 'force' a "purpose" upon those who we assume have none, or who are unmotivated to choose one that is moral/society approves?
* What happens when we loose "our purpose"? Is that possible or can our purpose evolve and change?
* Can "survival"/"reproduction" be one's sole purpose? Or are we called to another moral/ethical purpose beyond that?
* "If you follow your bliss, you will never 'work' a single day of your life".
* Is "success" a definition, or affirmation, of one's "purpose"?
* "One's purpose cannot always be seen as foresight, sometimes it can only be defined by hindsight in the cyclical patterns of behavior and thought."
* "One should always test their thoughts/theories against reality to be able to judge them as true."
* "Purpose takes us away from living our lives."
* We must choose a "purpose" when we are in harmony with our 'best self'.

MY FAVORITE QUOTATION OF THE NIGHT:
"We are done. We are more confused than when we started. We are happy."


I love these discussions. They are my brain food/my happy place/my place of conflict and debate with my inner self/ a place of mutual respect and calm/peace. :)

Enjoy!

Round 2, here we go again...

Just got off the phone with mom. Sounds like we are headed to Round 2 of inpatient chemo, an identical repeat of her last type. Same types of chemo for 7-3-3 (Seven days of one type, with the first 3 days including a 2nd type of chemo drug, and then 3 days off). I assume this will be followed by another Bone Marrow Biopsy to check results and if she's low enough after this round then possibly off to Transplant with another 4-6 weeks of inpatient monitoring-assuming everything goes perfect.

Good news is they think she can handle another AGGRESSIVE round of these types of chemo. Apparently they think her organs, and body over all, can handle another rigorous round. So pull out the stoppers on prayers for minimal nausea, infections, strength and plenty of sleep/rest. (She'd just started getting back to solid foods these last few days). Looks like we are ramping up for the big fight sooner than we'd expected.

Thanks everyone for your love and support! You're amazing!

To those of you who've emailed, posted comments, wrote cards, visited or called/sent a random text you all are INCREDIBLE people thank you for pouring your kind thoughts and words upon us. Please keep up the support it's a huge boost to all of our spirits to see your love!

Blessings to all!

Tuesday, February 8, 2011

Good News, Bad News...waiting some more....

It's been a busy two weeks since mom was first admitted to the hospital. Working, visits to the hospital, running errands, organizing support network (via Lotsahelpinghands.com), etc... Sorry I haven't been able to update all of you more. Honestly, I am trying to walk the fine line between over-blogging, meaning I blog too much about meaningless information, and under-blogging, that I am not sharing any information. So at this point unless the mood strikes me or I have some news about Mom to share I am trying to wait.

Back to the main topic:

-Good news: Mom's counts are down to bare minimum, which was the goal of the chemo.

-Bad news: She has NO immune system- so PLEASE, PLEASE, PLEASE be VERY conscious of your health, that of those around you, avoiding cats before visits, showers and clean cloths are a MUST, and avoiding physical contact (hugs) these are all priorities right now.

As of Sunday she had her first major fever (over 104) ***CORRECTION: apparently the highest it got was 101***, still trying to find out the cause of it they took samples and are still trying to see what's going on on the interior. By the end of the night, between the Tylenol and cold towels on the back of her neck they were able to bring the temp back to below 100. At this point, the problem is that her own bacteria, such as the bacteria in her stomach, could be the culprit. It's not necessarily an exterior force.

As of this morning at 9am she had her follow up bone marrow biopsy to see the results of this last round of chemo, we are waiting for results on that as well. I will update all of you later when we have more information.

Prayers for good health and low/no blasts in her marrow would be huge right now. Thanks again everyone!

Thursday, February 3, 2011

Reminder of other precations around mom

If you're planning to visit mom now and are in PERFECT HEALTH here are a few other things to keep in mind:

http://www.chemocare.com/managing/low_blood_counts.asp

Infants, babies and children:

  • Contact with human feces (diaper changing) can potentially expose people to a variety of infections. It is preferable that another family member be the principal diaper changer when you suffer from low blood count. But if it becomes necessary, wash hands thoroughly after changing diapers, and avoid caring for babies with diarrhea. Wear gloves if at all possible.
  • Avoid contact (kissing, hugging) children who have been exposed to childhood diseases or "who do not feel well." This is especially applicable for children exposed to chickenpox and have not been vaccinated, or had the disease. If the immunosuppressed person has not had chickenpox, discuss the possibility of vaccination with your physician.

Pets:

  • Wash hands after handling pets (especially before eating) if you have low white blood count. Avoid contact with pets feces, especially if the animal has diarrhea. Seek veterinary care for animals with diarrheal illness and a fecal sample from such animals should be examined for Cryptosporidium, Salmonella, and Campylobacter.
  • Those who elect to acquire a cat should adopt or purchase one that is over one year of age. People who are severely immunosuppressed are at an unusually high risk of developing a disease caused by Bartonella species (cat-scratch fever). Unfortunately routine testing of a cat for the organism is not beneficial and declawing is not generally advised. To avoid infection with Toxoplasma gondii that may be found in cat feces, have the litter box changed daily, preferably by a nonimmunosuppressed, nonpregnant person; alternatively the person should wash their hands thoroughly after changing the litter box. People need not be advised to part with their cats or have them tested for toxoplasmosis (encephalitis).
  • Avoid contact with reptiles such as snakes, lizards, and turtles because of the risk of salmonellosis.
  • Avoid cleaning fish tanks because of possible exposure to Mycobacterium marinum.
  • Birds, especially if imported from other countries, should receive a clean bill of health from a veterinarian.
  • Special care should be taken in a farm, barnyard, or other outdoor environment. Persons with low blood counts should avoid situations where hay or other fodder is being "pitched." Inhalation of environmental fungal spores, particularly from moist, dark areas (e.g. compost piles) should be avoided at all costs especially if the white blood count is low or if extra immunosuppressive medication is being administered.
So if you're going to see her please be conscious of these factors as well-I had forgotten about the cat litter until I talked to my mom again tonight. So don't clean the litter box right before coming to see her!

Thanks Everyone!

Wednesday, February 2, 2011

It's a "God Thing"...a moment in my day...

Just had a realization moments ago, when accidentally interrupting my roommate praying for her church members. The power of prayer. It struck me how much I am going through right now and how much I have changed from even a year ago.

Do I still have anxiety and sadness over everything going on in my life? Yes, at times but not it's not as dark a place as I'ed been in in the past. The depression and overwhelming state of crisis I may have once been immobilized by a a few years ago is now a thing of the past. And this I CANNOT take credit for. It is the people in my life, the experiences I have been through, and above all God. I cannot imagine how I would be reacting to my current adventure, with my mom's health, if it was not for God.

I was reminded a moment ago of my reaction to hearing the news that my mom's blood disorders progression to Leukemia, only a WEEK ago. My first reaction was shock, then to call my boss at my day job to let them know I was not coming in the next day (since I would be at the hospital with my mom during her admission all day). The moment that was done I sat with my mom til she was tired and she went up to bed. The next moment I was texting my roommate, since she was the only person I knew who would still be awake, and after telling her the news I asked her to pray for us. Her response was that her church had been praying for us for weeks. To which I responded that night with tears of gratitude for the people God had been so gracious to place into my journey.

Seeing her in that moment tonight I was overwhelmed by the love of God that she shared with me that night and has continued to do. As well as so many of you who had at one point been mere acquaintances who are now pouring your love upon us. It's completely overwhelming to think about that prayer covering us all. And I realize tonight that it's God, NOT me, who is keeping us all together and going strong. There really is no possible HUMAN explanation for how I am able to be strong enough to keep going after such a shock other than the power of prayer. Sometimes you just need the reminder.

So this my shout out to of gratitude to all of you prayer warriors in our lives. You are INCREDIBLE and BEAUTIFUL souls who are blessing us daily with your intervention on our behalf. Your acts are beyond measure in their influence, I honestly have no words other than "thank you" from the bottom of my heart and soul.

With all my love and appreciation,
Kate

Tuesday, February 1, 2011

Research Extravangza/ Mom's Life 101

Sorry I haven't had the energy to blog much lately. Life's been a bit chaotic as you can well imagine. Though it was a weekend filled with time away from Mom while I worked and caught up with friends-she had plenty of visitors herself and greatly appreciates all the visits!

Well not much time to write, right now. But wanted to share info with all of you, who are limited in vocabulary/knowledge, like myself, when talking about what my mom is going through. So here are some of the sites that helped me out with understanding what's going on with her right now:

AML (the type of Leukemia she has):
http://www.marrow.org/PATIENT/Undrstnd_Disease_Treat/Lrn_about_Disease/AML/index.html


Mom's two other disorders:
Myelodysplastic Syndrome
http://www.mayoclinic.com/health/myelodysplastic-syndromes/DS00596
Myeloproliferative Disorder
http://www.umm.edu/altmed/articles/myeloproliferative-disorders-000114.htm

Red cell transfusion (what she is starting to need because of her decreased number of cells):
http://www.marrow.org/PATIENT/Undrstnd_Disease_Treat/Undrstnd_Treat_Opt/Lrn_Other_Treatment/Blood_Transfusions/index.html#purpose



BONE MARROW TRANSPLANT INFORMATION:
(The game plan, once she goes into remission from the Leukemia)
Cord Blood:
http://en.wikipedia.org/wiki/Cord_blood
Engraftment (her body's acceptance of the cord blood's cells):
(Days 0-30)
(Days 30-100)
http://www.marrow.org/PATIENT/Donor_Select_Tx_Process/Early_Recovery_Days_30_100/index.html

I will try to give more of an update in the next few days. At this point from what she's told me during visits. She's feeling well, but is progressively getting more and more nauseous. (And as a result food is looking less and less appetizing). She's estimating that she will most likely be loosing her hair starting in about a week and a half.

But over all she's in good humor, just very busy with all of the IVs, Occupational Therapy, Physical Therapy, visits, updating, as well as over all exhaustion. So prayers for energy and good health are key. I am beyond paranoid about the health of those around me right now, so if any of you are even thinking you might be sick-please stick to phone calls. I really cannot afford to loose my good health, I need to save ALL of my Paid Time Off for when Mom goes to transplant...whenever her body and the doctor's decide that she is ready. Well off to finish folding some laundry. Gnight friends!

Blessings!