In a Special Afternoon

Away in one corner, she sat there quietly, unnoticed.
She's 98. In a wheelchair.
Alone with a maid as a caregiver in her humble abode.
She's not my patient.

In a special afternoon, I saw her.
My "Missy" habit just kicked in automatically, floating through my cerebrum:
"Is she depressed?" "Does she have dementia?" "Does she have any sores?"
"Wonder what chronic illnesses she has?"

In that special afternoon, I saw us.
When she started talking, there's a gentle glow around her.
My questions above were answered within a few minutes talking to her.
She's definitely not depressed, not demented, no sores and have no any chronic diseases.

She sing Praises without dentures but with much more gusto than anybody I've seen.
Her eyes glowed with a child-like glimmer when she talked about God.
About nearing home. About how all children, even her own, are children of God.
I sat and listening to her over a cup of water.
Which at the end of conversation, I ended up more thirsty than before.

Thirsty to know what's causing that glow and serenity.
Though a Christian, I'm still very very thirsty to know how much faith is needed to get this peace I'm seeing in front of me that afternoon.
How much courage is needed?
How much letting go is needed?
How much thankful I need to be?
How did she cope when the world turns against her?
How much strength is needed?
How much reliance on Him is needed?

A filled her, and a thirsty me. I'm the patient that afternoon.
I faded into the background....
Lizzy, you have much more things to know and learn. Gambatte!!

Pride

He's 84 years old and sitting on the wheelchair.

His insulin injections are a combination of Regular and Intermediate acting twice a day.

He is drawing the dosages himself and injecting himself.

I doubted his ability.
I doubted that he could draw the right prescribed doses.
I assessed him like a teacher to a student.

He shook his fists fiercely at me, eyes glimmering with tears of frustration and tiredness when I ask him "Is this 12 units?" the third time.

I have hurt his pride.

Pride is most probably the most precious thing that he had hold on to till this moment. Even at age 84, he does not need anybody to inject for him. In just a minute of encounter I had belittled that in my "professional" way.

Fragility in life, I've failed to see and experience once again.

Losing Vision

Today, I met an elderly patient who is losing her vision. I cannot say she's totally blind. But the vision loss is enough to rob her TV programs and her walks. Although the doctors had told her that her eyes will not be cured 5 years ago, she is still very sad by the very fact.

Getting old is a tough chore. Getting old with physical changes and chronic diseases is even a tougher chore. A purely degenerative physiological change like altered eye vision can rob someone of joy, freedom and autonomy. This old lady feels exactly that. She lamented to me the whole consult session that she could no longer walk out of the house as she use to. She is guilty of the high medical fees she incurred to her children. 3 bottles of eyedrops per month that cost nearly 100 dollars is a bite into her heart. She feels useless and wish to die if can.

Silently in the corner of the consult room, her daughter silently listened without rebuking, or arguing. A smile, bittersweet smile on her face, as if saying "It's okie mum, I know you are hurting but we love you just the same. It doesn't matter as long as you are with us."

A loss in physiological vision has caused a loss in a greater vision.
If only she has seen with her heart.

Can I Marry?

I used not to think much when Brenda mentioned to me that her dream is to get married. At the age of 23, to any gals out there, getting married is not a dream. It's a goal! It can be achieved. Till recently I've watched a Japanese Drama Serial, "One Liter of Tears". This drama was taken off from a real life story about a 15 year-old girl diagnosed with degenerative small brain disease, from having difficulty in coordinating movements required of daily living (e.g. eating, talking, walking etc.) to finally bed-bound and totally dependent.

Brenda was different, she had Type 1 diabetes. Yet her frequent admissions to the hospitals for DKA and complications of diabetes led her to ask the same question, "Do you think I can get married someday? It will be a dream come true if I can."

The point I realized after many years, it doesn't matter if one chronic disease is more serious or more debilitating than another. Having one already encodes the intense emotion of disliking oneself. How then could one who dislike himself/ herself have trust or faith that someone else will like him/ her wholeheartedly, without reserve, without betrayal and most importantly without abandonment.

Sometimes Loving oneself is difficult for someone whose healthy, it's definitely much more difficult for someone who has chronic disease(s).

Unhappiness Breeds Intense Negativism

I know it sounds really un-empathatic to say "try to be happier". It is not easy to have a chronic disease. Everybody knows that. However, the act of just being unhappy will breed self-pity, discontentment, dissatisfcation, frustration, anger, depression, denial of pleasure and anything else except happiness. Of course anyone also have his/her own right to be unhappy.

Being happy is not easy for someone with chronic diseases or chronic pain. Thus the act of just smiling even with pain is seen as courageous to those people whom you have touched along your way. I'm constantly amazed and filled with awed that at times I might even hide a tear, when someone with such great pain or misery enter the consult room with a smile. Being unhappy takes away everything, it's like a wallowing mud of unhappiness and discontentment. I met a really unhappy patient today, just hope he can take a look and appreciate the beautiful blue sky one day.

HbA1C%

HbA1C% has always been to used to guage patient's control of glycemic control. This clinical measurement has also guided a lot of practitioners in managing the diabetes condition. When medicine and nursing moves towards evidence based practice. This indicator is used once again to prove if certain interventions in the area of education, self-management, medicine etc is effective. In quality measurement of medicine and nursing services, this indicator is also a popular one to have on board.

HbA1c% a good estimate of glycemic control yet is complex in its nature. It is definitely worth pondering next time if this indicator is used. Is it appropriate for what it is going to reflect on?