Baby Lohse

Picture of Baby Lohse at 11 weeks, now 16 weeks 4 days!Matt and I are super excited to welcome Baby Lohse #1 in August! My biggest anticipation right now is to feel the baby move.

Before we will be ready, however, there is still a lot to do. Today, I am organizing things to make more room in the house. It's going to be a bit snug, so I am looking into ways to store things more efficiently, such as under the bed and on the walls.

In between daily chores and work, I am finding some time to read. I am currently reading The Womanly Art of Breastfeeding by the La Leche League.

Should You Go First

I stole this story from one of our nurses. She admitted a man to hospice a few days before his 65th anniversary. His wife wheeled up in her wheelchair to give him his regular morning kiss. "That hurts, honey," he said as she climbed up on him to reach his lips. Then she pulled this poem out of her purse to show the nurse and said she was planning to read it to him at their celebration.

Should You Go First

Should you go first and I remain

To walk the road alone,

I'll live in memory's garden, dear,

With happy days we've known.

In Spring I'll wait for roses red,

When fades the lilac blue,

In early Fall, when brown leaves call

I'll catch a gimpse of you.

Should you go first and I remain

For battles to be fought,

Each thing you've touched along the way

Will be a hallowed spot.

I'll hear your voice, I'll see your smile,

Though blindly I may grope,

The memory of your helping hand

Will buoy me on with hope.

Should you go first and I remain

To finish with the scroll,

No lenght'ning shadows shall creep in

To make this life seem droll,

We've known so much of happiness,

We've had our cup of joy,

And memory is one gift of God

That death cannot destroy.

Should you go first and I remain,

One thing I'd have you do:

Walk slowly down that long, long path,

For soon I'll follow you.

I'll want to know each step you take

That I may walk the same,

For some day down that long, long road

You'll hear me call your name.

A.K. Rowswell

I get paid to...

Hold a purring cat in my lap or be loved on my dogs while doing my job.

Watch loved ones say final goodbyes.

Take out the garbage and recycling when that is the patient's primary concern of the day.

Try to help a patient with a 5 minute memory come up with ways to "remember" to take her pain medications and know if they even helped.

Drive all over one of the most beautiful settings in the world with snow capped mountains, rivers, trees, salt water, fresh water, and ships.

Get stuck in traffic.

Visit patients in wealthy mansions and dingy apartments filled with spiderwebs and cockroaches.

Get severely scolded for not taking my shoes off.

Get scolded for even thinking I should take my shoes off.

Talk to families about things to expect and what to do as their loved one dies.

Listen to patients talk about plans to use the Death with Dignity act to end their lives.

Try to answer difficult questions asked by terminally ill patients, like "So...how is your life going?"

Witness the tenderness of care from a husband for his wife.

Step into the chaos of multiple families coming together for one purpose: comforting and caring for Bestefar (Norwegian for grandfather) to the end.

Hear stories of family, work, life, and grief over loss.

And sometimes...be present as life departs.

In all of this, I think I learn more about life than about death itself.

Things and Work

Times you don't want people to think you are young: when you are their nurse.

On Thursday, I went to a couple's house to visit the husband who is on hospice services. The wife and I had barely started talking when she said, "You just don't seem old enough to be doing this kind of work." On the next visit and hour later, the patient and I were in the middle of conversation when she said, "How old are you? You look like you are 15." Friday, one of my patients first words were, "Get away. You are not old enough to take care of me." I just told her what I was there to do and continued, but she called me "that babe" the rest of the time. She also questioned me frequently as to where I got my nurse training.

So you see, when you are a nurse, it is nice for people to think you are older so they respect what you say. I think the reason they've been saying this is because the weather has warmed up so my face looks rosy again. In the winter, even though Seattle is so warm compared to Minnesota, I'm always cold. Maybe I look older when I'm cold:)

Something that make me squeal with delight: looking out my window an seeing the Olympic mountains with the sun setting behind them. Do you really know how much that means to me after not having a westward facing window for 4 years?

I love my job. I haven't written much about my job as a hospice nurse. My day starts out in the office at 8am. I get my assignment of usually 3-4 visits for the day. As a float, I fill in for nurses when they are on vacation, sick, overloaded, or if they have a day off in the week because they are working over the weekend. Usually I have never met the patients or their families. I spend some time looking up notes about the patient, gathering supplies I may need, and asking questions of other nurses or social workers if I need to. I put the patients' addresses in google maps to see what route and order is most efficient, then, sometime after 9am, I call the patients and set up times to meet. I try to give a range. Sometimes for the first appointment I will say 9:45-10:15am. Especially if any of the visits look like they may be long and complicated, I may ask the last patient if I may arrive between 2-3pm. That leaves me room to take extra time if I need to, get caught in traffic, etc... Some days the patients are doing well and the visits are easy as we chat about how things are going, how they are feeling, family dynamics, what they did with their lives.

Some days, you walk into a high intensity situation with multiple patient, family, or care giving problems. Those visits can take a long time! It may include more thorough patient assessment, phone calls to pharmacists and doctors about medical treatment options, to pharmacies to fill medications, to the social worker for lots of things, to my manager or another nurse, to the person in charge of ordering medical equipment, etc... Visits like that have potential to make a huge different for the patient and family, but they take a lot more time up front during the visit as well as later with phone calls and documenting those extra things.

So, on a super good day, I might be able to do 4 visits in 8 hours, but usually 3 visits and the work associated with them takes me 8 hours. Yesterday was my longest day so far. I spent 2 1/2 -3 hours just driving, visited 4 patients, and spent over 12 hours finishing my work. I knew it was going to be long when I was assigned 4 patients rather far from Seattle. Then I read the notes, and knew that most of them could be long visits as well.

The first visit was easy. Show up, talk to the patient's daughter about how things were going and how the patient was doing. Talk to the patient a little bit who had dementia and was pleasant but couldn't carry on a conversation. Take vitals and find out that her blood pressure was very high. So, the visit was easy, but off and on all day I was trying to get in touch with the doctor's office or they were trying to get in touch with me. Finally, our triage nurse took over on that because I had too much to do. The next visit started by talking to the patient's sister about her experiences with death in her family and what she was seeing and thinking about her sister, whom she was trying to care for. The patient had declined a lot in the last couple of days. We talked about signs and symptoms of end of life and things that she can do to make the patient more comfortable. Part of that includes administration of pain medications, but most of the things I taught her had to do with swabbing the patient's mouth to keep it fresh and moist, putting lip balm on her lips, dressing a newly developing bed sore, and turning the patient from side to side every couple of hours to keep the sore from getting worse. It was hard to even leave the home because as I was trying to get out the door, the patient needed to go to the bathroom and the family wanted me to help them. They needed extra help with care giving, and I can't be there all day to do it. I was rushed because all of this was taking so much time that I knew I would be late for my Cambodian interpreter appointment at the next visit.

I ended up being a half hour late, but I helped the family more and called back later to go over instructions again and see how things were going. The Cambodian appointment went well, but I did need to make a few calls and emails related to that. I was hoping I could make it to the final appointment by 3pm, but traffic began to get bad and I was late for that. Then it took awhile because the patient had just come on hospice the day before and was having nausea and vomiting and pain all day. To make matter worse, I forgot to take my shoes off when I entered the home. I know to do that in any Asian home. I even did it at the last one, but I forgot. The first thing that happened when I walked into the room with the patient was to get scolded for having my shoes on. I apologized profusely and went back out to take them off. How could I forget? That visit included a phone call to our pharmacist to get recommendations about new meds to try for the vomiting and pain (though the patient's oncologist does not think anything will help it), calling the doctor, calling our nurse who sends narcotic orders to the physicians for signatures, and calling a local pharmacy to order the medications. I didn't get home until 5:45pm and had multiple notes to write and people to contact.

Over all, it was a good day because things were getting done that would help these patients, but it was long. However, I'm not complaining. I get pain hourly. Matt gets a salary. Matt worked all day yesterday and all night. It's 10:30am now, and I still haven't heard from him. So I don't really mind a long day when that's the case. Maybe this gives you a picture of what I do as a hospice nurse:) I really really love it!

The Great Divorce

One of my friends loaned me The Great Divorce by C.S. Lewis. It was supposed to be something about heaven and hell, and somehow I just didn't get time to read it, or maybe it didn't sound super interesting at the moment. A couple of weeks ago, a girl was telling me that it was one of her favorite books to read on an afternoon when she doesn't have anything to do. So...after a few months of it sitting on my coffee table, I picked it up and began to read...

Here are a few lines that I liked, but you have to read the book to get the whole context:)

"Ye cannot fully understand the relations of choice and Time till you are beyond both."

"...Heaven, once attained, will work backwards and turn even that agony into a glory. And of some sinful pleasure they say, 'Let me but have this and I'll take the consequences': little dreaming how damnation will spread back and back into their past and contaminate the pleasure of the sin. Both processes begin even before death. The good man's past begins to change so that his forgiven sins and remembered sorrows take on the quality of Heaven: the bad man's past already conforms to his badness and is filled only with dreariness."

Update

I was going to post about my job, but instead, I'm just going to give a quick update on life. I am loving my job! It's hard to imagine one that I would like more:) More on that later.

Matt and I have been looking at real estate. We thought we should start looking for a place early, but it's been a whirlwind because we started working with our realtor about two weeks ago and are making an offer on a place now! We'll see how negotiations go. The whole process has been stressful, overwhelming, and exciting. The place we are looking at is just 2 miles from work for Matt. It's up on Beacon Hill and has a view of downtown Seattle and the Puget Sound with the Olympic Mountains in the back ground. From just a block away, one can see the Cascade Mountains to the east and Mt Ranier to the south.

This afternoon, between taking a second look at the property and meeting with our realtor, we went to Seward Park where we were blown away by the view of Mt Ranier across Lake Washington. We just sat at the edge of the lake watching ducks diving in the water and gazing at the mountain. We can't believe this was our first time to discover this park and can't wait to have more visitors so we can show it off!

A New Kind of Norm

Today I was driving back home from West Seattle looking at a view of the water (Puget Sound), the shipping docks, Olympic mountains, and tall Seattle buildings.  I've never been a city girl, but I'm learning to find a city beautiful.  I always thought mountains and plains were picturesque, but man made buildings?  Yesterday another nurse said that seeing the shipping docks reminds her that there are other places in the world.  

I stopped along the way at Uwajimaya, a huge Asian food market.  My friend had been wanting fresh basil plants, and they had them.  However, they needed to be potted, and I realized I don't have a pot, potting soil, soil period!  I don't have a yard or a pasture.  I need to clean the inside of my windshield and thought if I did it outside in the sunshine it would be more fun.  Where can I do it outside?  On the street?  My life has changed.  I live on the 5th floor of an apartment building right in the middle of tall buildings.

My life has changed in other ways.  Now I drive to people's homes and nursing homes to provide hospice care patients and their families.  Instead of caring for people in the ICU with all kinds of beeps and alarms, I am meeting them on their own turf.  Instead of being relatively in control of the situation, I far from in control as I try to empower them to work through issues and deal with disease and the end of life on their own terms.  My job is to trouble shoot for possible solutions with them, but when I walk out of the door, they get to do what thy want to.

Another change: now that I'm married, I no longer eat tacos, salad, sandwiches, and soup every day.  I have enjoyed trying all kinds of new foods here in Seattle and expanding my cooking horizons as well!  With my new job, my hours tend to be around 8-4 on the days that I work, so I have time to keep up on the house, groceries, laundry, cooking, and cleaning.  

My friend, Elaine, wrote me a very special email about how much she has enjoyed my blog over the last few years. I'm going to make another attempt to get back into it.  If not for everyone else, for myself.  Over these last few months, I've had to refer back to posts about experiences at work to remind myself of why I love nursing.  Like a journal, it gives me occasion to laugh and cry.  In the present, though, it helps me process the things I am dealing with in life.  For those of you who enjoy the photos, I hope to continue to post them, but my computer where I have most of them is so slow that blogging takes forever.  I'll find a way soon.

Possible upcoming posts: my job, end of life issues, euthanasia, Seattle, mountains, cooking, books...

Our Wedding

We did get married in Texas on May 30th! My lovely bouquet was put together by Aunt Pam. Four out of the six kinds of flowers were hand gathered in the pastures by my bridesmaids and girl friends and I the day before! Our friends Peter and Leslie took these pictures for us on the ranch where I grew up. We had a reception there following the wedding.Our ushers, bridesmaids, groomsmen, and the flower girl and ring bearer.My sisters and I:) L-R Anna, Amy, AngelaMy mother's side of the familyAbove: my father's side of the family

Below: Matt and I with my parents.

Life has been so busy since then with the honeymoon, Sarah and Bob's wedding, driving out to Seattle from Minnesota, and getting settled. We finally got internet, so hopefully I will rejoin the blogger world to share thoughts and pictures with what fans I might have left:) I plan to add to this post as well, so check back! I have so many pictures to share from going to Africa, home, the honeymoon in St. Lucia, and of course, the beautiful Seattle area! I also have people wanting to see our apartment...so if I can get around to taking pictures and posting them, you can see that as well!

Back from Africa, getting married!

Back from Africa.... Getting married in two days....

So many pictures....

So much to say....Will have to wait....

Hope you all haven't completely given up on my blog:) Over the last few months, there has been too much to blog about and no time to do it. We returned from our medical trip to Cameroon and safari time in Kenya only to get Matt graduated from medical school, move out things to Seattle, and come home to Texas to get married! After the honeymoon, we will be back in Rochester for Sarah and Bob's wedding before driving Matt's car out to Seattle so he can start residency! So, who knows when I will blog again, but I will when things slow down!

Matt and Amy

I know this is long overdue, but Matt and I got engaged on November 29th, and the two months since then have been super busy with Matt interviewing, us planning the wedding, and working!
If you wonder why I haven't been blogging much...here's what's going on! Matt just finished interviewing all over the country for general surgery residency programs. I went on some of those. Wedding planning started right away. It will by May 30th in Gruver, TX. Besides all of the planning, we are planning a trip to Cameroon, Africa, for April 1-May 12th. My sister, Anna, is going with us as well. Matt will do his last medical student rotation there, and I will do nursing work. That means that I will stop work here in March, go to Africa, be in Rochester for Matt's graduation on May 16th, then go home to finish planning. We will find out where we will go for Matt's residency on March 19th. Right now, top choices are on the west coast.

So there is the short of it. I am actually at work right now, but I have no patient until my surgical comes back, and no one needs help, so I took a moment to update this. Until later...

Weather this Morning

-23, feels like -50

Guess I'll break out the scarf and hat for walking to work...

Fall Days

Finally blogging...check out my last two blogs as well about my recent trips to Georgia and Washington DC.

Fall walks and bike rides are pictured below. From the trail with Mayo Clinic in the background.
Thinking today might be the last chance this fall, I biked the 25 mile round trip from Rochester to Pine Island in two hours.
Countryside on the way to Pine Island on the Douglas Trail

Minnesota scene: barn and fields!

The trial and bridge near my house.

Above is the Zumbro River and a bike path bridge that crosses it. I've been biking every chance I get and walking with friends. The colors have been marvelous and the smell of leaves is in the air.

Washington DC

DC with Micah and DanielBowling in the White House
The White House at night after our west wing tour
Gettysburg. They say it was the battle with the most casualties in the Western Hemisphere.

Amy and Daniel

All about Sebastian

I've been too busy living life to blog, but here are some pictures!Ben, Sebastian, and the grandparents

Getting aquainted with Granddaddy...
How many positions do you sleep in?
These two pictures are to showcase the hat and booties that Aunt Angela made and the blanket that Anita made.