Archive for March, 2010

Gray areas…

Thursday, March 25th, 2010

WOW! Gray’s Anatomy just began with a scene of two physicians debating end-of-life care… One opting for comfort care and morphine… the other accusing the first of “killing” the patient…

As a Nurse Practitioner who prescribes morphine for end of life care and the management of symptoms, I experienced a variety of feelings (responses):

Proud of “Gray’s Anatomy” for addressing a very tough issue; a very real world tough issue. Dying. and Death.

Proud of the job I do on a daily basis…educating and counseling patients and families and helping them work through these tough choices.

Proud of the nurses I work with who carry out the orders to keep the patients comfortable.

Proud of the Hospice staff who come into the nursing homes and provide “extra eyes and ears” so these folks are kept as comfortable as possible.

This is never an easy topic. And there are no easy answers. But when you, and/or your loved one, are ready to let go, I pray there will be compassionate and knowledgeable providers available to help you make those decisions.

And remember, I’m always here as well.

Ripples of Hope

Saturday, March 6th, 2010

Speaker Training, post-lunch fatigue…Noel Gardner,MD, MDiv. from the University of Utah takes the stage. Thinning blonde hair, lanky, plain clothes; he’s left his daughter’s thirteenth birthday and his son’s championship b-ball game to speak to the speakers about Depression.

I wonder about his priorities, until he speaks with quiet passion about the disease.

Yes, Depression is a disease, a physical disease. As real as heart disease or lung disease; just as disabling but more disheartening in it’s lack of physical appearance to the outside world.

Dr. Gardner tells a half-hazy audience of a mentor who could evaluate a heart murmur with his ear instead of a stethoscope to a patient’s chest. He says as health care providers we should “learn to put our ears against the chests of our patients and listen to their hearts, to their heart stories, to the broken heart places inside.” Thinking about the 80 and 90 year old hearts I love and treat for pain and depression on a daily basis almost brought me to tears…

He points out that each patient with depression has a story that encompasses their past/present/medical/social/relational/spiritual/etc aspects. And each health care provider has a story–the chapters we bring to the patient through book learning and life experience. And even the molecules we prescribe have a backstory. Those of you who know my Storyteller side know this grabbed my attention …

He then describes the isolation of depression, quoting that we experience our joys with others but our misery tends to be solo. He explains the ripple effect of depression on every aspect of life–our appetite, activity, mood, sleep, sex drive, and our connection to God and others. And the impact is not just in the present but can run between generations.

But Dr Gardner believes, and I do also, that depression treated into remission creates its own ripple…and that if we can get folks to remission, we can impact everything in and around their lives.

There is hope. There is treatment. And it’s not all in the shape of a pill. I’m not talking about specific medications here, though they have their place, but if any of you may be suffering or know someone who is, read this blog carefully and contact your doc or Nurse Practitioner, or minister or a Social Worker… Because as Dr Gardner, the post-lunch-wake-em-all-up speaker concludes, after depression comes “a depth, a certain wisdom and power, a real compassion.”

And from newfound strength we can launch ripples of hope in all we say and do…

For more information about the symptoms of depression, check this link: http://www.webmd.com/depression/guide/detecting-depression