Final Thoughts

Somehow, it just did not feel right having the funeral arrangements be the last post on the blog.

So, I contacted Kathy Pruitt and asked if she would allow me to post the eulogy that she gave at Mom's service. She graciously agreed.

For those that were not able to attend the service, Kathy did a wonderful job and captured Mom perfectly.

WHAT’S IN A NAME?

Norma Ruth Smith

Norma once told me how she got her name.  Her mom was expecting her first child and in those days, no one knew ahead what the baby would be.  Trix was in the park and saw a beautiful little girl on a swing.  After watching from a distance and dreaming about her own child, Trix saw the mother help the little girl down from the swing and say, “Come on, Norma Ruth.  It’s time to go home.”  Trix thought if she had a girl,  she’d name her that lovely name, and so she did just that.

Now Norma did not always seem too impressed with her own name, but she accepted it just like she did everything in her life and made the most of it.  “I’m just plain old Norma Smith.  I’m just Norma normal,” she’d often remark.

Knowing Norma for almost 40 years as a neighbor, friend, and fellow teacher, I think I am qualified to say her definition is both accurate and inaccurate, depending on exactly what she meant.

If Norma meant “stable,” then, yes, I agree.  Norma led a very stable life.  She grew up in a small town with a mom, dad, brother, and sister...the Richardsons.  I was always a  bit jealous of Norma’s great family who seemed to love each other so unconditionally.  Norma was an honor high school student and played a crackerjack game of basketball (I saw the pictures).  She graduated from Texas Tech and started teaching.  She married the man she loved and STAYED married to him.  She raised two fine, bright sons. She loved being both a grandmother to her three grand kids and an aunt to her nieces and nephews.  I can still see her in my mind’s eye, sunbathing in her backyard pool and reading her favorite white Harlequin romance novels as she floated.  She paid all her bills on time and incurred no debt. She was a frugal shopper (I’m being nice in my choice of words here!).  After being a master teacher for almost 25 years, she went to work as an educational consultant at Region XI Service Center and forged new friendships there.  Overall, Norma seemed exceedingly content with her life.

If by being “normal” Norma meant “ordinary,” then that is where I beg to differ with her.  She wore a black, form-fitting strapless dress to her prom.  Wow!  She was my heroine.  Also, she rode in the fastest car in Lubbock County and married the driver of that car.  She got her own motorcycle and often road behind James on his as they traveled through the southwest mountains and plains.  Norma was brave.

She tended her beloved rose garden and often shared flowers with neighbors and friends.  On one of several “girl” road trips, Norma became the lead singer of 50’s rock and roll, as well as Motown, songs.  She knew every single word of every single song, so the rest of us in the car gladly became her backup singers since, at best, we only knew the choruses.  She had a clear sweet voice I can still hear.

During the many years we lived next to each other on Mimosa Park, Norma and I walked 3-5 days a week for almost five years.  We chose either the high, sunny road or the low, shady one, depending on the fickle Texas weather.  Once we realized we were lost and almost one and one half miles from our homes.  We didn’t feel lost because we’d been too busy repainting/redecorating the homes we passed so often.  We’d been too busy discussing the funny and poignant events in the lives of our students, fellow teachers, administrators and, of course, our own families.  We were “together,” the operative word, processing our lives as we walked, talked, rejoiced and grieved.  I was never lost when I had Norma by my side.  She was my stabilizer.

You have probably been remembering your own experiences with Norma, as I have shared mine.  If we took all the stories in this room alone, we’d be able to weave a tapestry of a life well-lived, for it’s in the small stories that we see the big picture.  That tapestry would be strong, beautiful, functional, and resilient, just like its inspiration.

I think I can say for many of us that we will never look at a computer monitor again or place our hands on the home keys, without thanking Norma Smith for helping us overcome “tech” fear.

So, I ask you again, “What’s in a name?”

Answer: An extraordinary woman who loved well and was well-loved.

“COME ON, NORMA RUTH, IT’S TIME TO GO HOME.”

Kathy A. Pruitt

And so with that, I think it's time to close up this blog. I know Mom was pleased with my use of this technology to keep everyone up to date and there is a certain amount of therapeutic value in writing that I am glad that I experienced.

Thank you to everyone, everywhere, that followed her story.

Mike Smith
Keller, Texas

Funeral Arrangements

Here are the arrangements for Mom's service.

Date: Thursday, August 19th, 2010
Time: 10:00 AM

Location:
Thompson's Harveson & Cole

702 Eighth Avenue
Fort Worth, Texas 76104
817-336-0345

Open visitation at the funeral home will be from 10 AM - 8 PM on Wednesday, August 18th. I doubt that my Dad will be there, but for those wanting a chance to say goodbye to Mom...

In addition, her obituary is scheduled to appear on Wednesday in the Fort Worth Star-Telegram and the Lubbock Avalanche-Journal.

A Long Journey's End

This was the post I hoped I'd never have to make, even though I knew I would have to eventually.

Mom passed away last night. She fought long and hard, giving it everything she had, and outlasting the doctor's prognosis by several months.

She always said she wanted to win and even though she was presented with an un-winnable situation, she never gave up.

For all of you that have been following, thank you. Mom appreciated all the comments and true to her technology roots, was happy that I chose this way to keep everyone up to date with her situation.

Arrangements are pending right now, but I will have those sorted out today. I will update here once they are in place.

--Mike

Yesterday, the hospice team placed Mom on "continuous care", which is used when they believe that she has had a worsening in her condition. This was prompted by a visit from them at our request because Mom seemed less responsive than usual.

This "continuous care" is initially set up for two to three days, but will remain in effect longer if the hospice people believe it to be necessary.

Mom's nurse did pull my Dad aside this morning and tell him that Mom is in her decline now.

That's certainly not news to anyone, but I have to say, it is still hard to hear.

There is not much new news to report, I am afraid. Mom continues to hang in there, although I believe I have noticed a very slight deterioration over the past several weeks.

Hospice continues to look after her. The aids come five times per week and the nurse comes once per week or whenever dad or I feel like she needs to come. This happened at the end of last week when Mom had a bit of a symptom change involving how she was holding her head as she rested in bed. My dad was concerned, so we got the nurse over there and checked everything out. According to the nurse, and this makes perfect sense, Mom was just trying to get comfortable. No harm, no foul. But it did demonstrate how well and responsive the hospice agency is to any concerns that my dad has.

It's more and more difficult to communicate with Mom and most of the time she won't talk back to me or respond other than to sometimes smile. I know she hears what is said and probably likes hearing it, but there is no feedback anymore. So, I tell her anyway. :-)

If you're still reading this and keeping up with Mom, then thanks. I know she appreciates the thoughts and comments directed her way.

It's been a while since I updated everyone on Mom's situation. Nothing much has changed over the past couple of weeks. She is enrolled in hospice care and they are taking good care of her.

This past week, she was taken to the hospice's in-patient facility downtown. She was taken there because my Dad had to go to the hospital himself. His situation turned out to be a kidney stone. He is out of the hospital now.

All this is happening while I am in Tokyo (where I am now, coming home Saturday). Beth has been managing all of it and doing a fantastic job.

The hospice company is doing a good job and I believe that Mom is getting a good level of care from them.

Mom's cognitive abilities have gone downhill a bit over the past couple of weeks. It's very difficult for her to communicate, but she still laughs at the TV and will appear to recognize friends and family.

We appreciate everyone's thoughts and all the help that has been provided.

Hospice

This afternoon we registered Mom with a hospice agency called Vitas.

Mom, Dad, and I (well, mostly Dad and I) had a good meeting with their RN and went over all of their services and ways of support. They are very thorough and comprehensive in their direction of care.

Mom will be cared for in the home and will not be leaving unless it becomes necessary to do so.

Even though this was a difficult step, it was a necessary step and will provide Mom with the care she needs as she takes those final steps.

I hope that this also provides some comfort to my Dad as he deals with the inevitability of what is coming. I know it is giving me some small peace of mind knowing that Mom will be cared for in the best way possible, given the circumstances.

Results

We took Mom to see Dr. Aurora today and get the results of the MRI and to discuss future treatment options.

Dr. Aurora told us that the MRI showed that the cancer had worsened. There were more spots on the brain, and there was increased cancer on the spine.

Based on this, and the fact that she's had two complete rounds of chemotherapy with two different compounds, plus radiation, she decided that it was time to stop.

So, we are discontinuing treatment. While this news was not unexpected, it was still difficult to hear. But the impact that chemotherapy was having on Mom was not worth the results that she was getting. It just came down to that.

Dr. Aurora said he did not know how much time was left, but that he wanted whatever time that was to be as comfortable as possible.

We will be meeting with a hospice organization this week and more than likely begin that aspect of this journey.

I wish the news was better. But sometimes, it just isn't.

Again, thanks to everyone for their thoughts and good wishes. They are appreciated, as is everything that everyone has done to help Mom and Dad.

Last Friday, Mom went for an MRI. Let me tell you, I was very proud of how well she did with it. The doctor has asked for four scans to be conducted, in sequence. With each scan lasting about 45 minutes, she on the MRI table for about 2 1/2 hours. That is hard enough for healthy people to do.

She did great, though, and stuck it out so that all the scans could be completed. We are waiting on the results, though Dr. Aurora said if anything serious was seen, he would contact us quickly. So far, no contact, so I am hopeful that the scans showed what was expected.

We now have a home-health organization providing care for Mom twice a week (for now). Thanks to everyone who sent suggestions on companies. I hope that Dad will eventually become comfortable enough with having them around that he will get some rest, but if not, he'll just have to deal with it. I'm most concerned about making sure Mom has some help.

Next on the agenda is to get a ramp built at the front of their house. Does anyone know of any companies that specialize in ADA-compliant ramps for elderly people? If so, drop me a note.

Mom is doing about the same as she has been for the past month or so. She is still spending lots of time in bed sleeping. One thing that is different is that there really is no established routine anymore. Some days, she will be up by 10 AM, other days she won't get up until 2:30 PM or 3:00. It's driving my dad crazy. Well, crazier.

Our next appointment with Dr. Aurora is June 28th. We will talk again about whether or not we should resume chemotherapy treatments.

Update

Dad and I took Mom to the doctor today for a regularly scheduled appointment. She had lab work done and we met with Dr. Aurora.

Getting her to the doctor was not as bad as my Dad had feared. In fact, it went about like it has gone for the past several months, so that's a load off my mind. I was expecting, based on some of Dad's input, for it to be a pretty difficult experience. Luckily, that wasn't the case.

Her lab work went well and her results were good. Her weight was stable as well. Both good signs.

We then saw Dr. Aurora, and after his examination and assessment, we discussed taking a somewhat extended break from chemotherapy treatment. The premise is simple: There is a concern that Mom will be further weakened by more chemotherapy and be unable to bounce back, therefore leaving her in worse condition than we started. Dr. Aurora advised that since she has had such a large amount of chemotherapy over the past six months, she wouldn't be hurting anything by taking a break. She will use this time to hopefully regain some strength and stamina.

We will see Dr. Aurora again on the 28th of June to reassess. If her strength has returned to a good level, she may start chemotherapy again. If not, then we will discuss a more long-term strategy regarding her treatment options. Although the options are simple: Either have chemotherapy or do not. We will just have to see how the next several weeks transpire.

Mom is feeling okay, but she is very weak and tires easily. She spends many hours a day in bed asleep. Her cognitive abilities are about the same, and it is hard for anyone to really get a good answer from her about something. If you ask her a question, you are very likely to get a completely different answer five minutes later. In addition, she continues to have very little short-term memory. Her mother, sister, and brother-in-law were here Saturday and Sunday, and she doesn't remember that they came. Such is the way things are.

For everyone who has continued to help, we certainly appreciate it. Everyone has gone above and beyond what most people would have and it has made a huge difference. Thank you.

Just back from a trip to Mom and Dad's house. Mom was in bed resting and reported to me that she wasn't feeling very well. She couldn't go into much more detail than that, however.

She's spent a good bit of time in bed this past week and does appear to not be bouncing back as we had hoped she would by taking this week off from chemotherapy treatment. It's unclear right now whether or not she will get her treatment as scheduled on Tuesday afternoon.

Dr. Aurora did say that delaying two weeks would not make any difference in the effectiveness and it seemed to me that his contention was that if Mom didn't appear to bounce back this week, that we should delay one more to give her a chance to regain some strength.

When she does get up, she is pretty weak and has trouble getting from one part of the house to another. I say "trouble", but I guess I mean it is a struggle and it tires her out.

It's now been six months + ten days since her initial hospitalization and diagnosis.

For everyone who has been thinking of Mom, thank you. For those who have been helping out, in whatever way, be it food, cards, poems, thoughts, yard mowing, or simply saying hello, it is appreciated.

No chemotherapy treatment today.

After examining Mom, Dr. Aurora felt that she wasn't as strong as she should be to receive a treatment, and he recommended that we take a week off. We have a treatment scheduled for Tuesday, June 1. Dr. Aurora said that if necessary, we could even take two weeks off. It wouldn't make any difference in the effectiveness of the treatment, due to the overall amount that she has received to date.

We then discussed quantity v. quality of life again, and all agreed that we are going to have to make some decisions in the near future. Mom understands this and we talked, and she agreed that getting chemotherapy only to allow her to spend all her time wiped out and in bed isn't what she wants. We are probably nearing the point where the treatment could be as bad as the disease.

To be clear: We are not there yet, and we are not discontinuing treatment, but we are thinking about what the future holds.

Dr. Aurora is also concerned about spinal cord involvement, and has ordered an MRI to look at that.

Mom was comfortable with the decisions that were made today and seemed to be in a relaxed mood once we arrived back at their house.

Thanks to everyone for their thoughts, notes, and support. We certainly appreciate it.

It's been quite a while since I've updated everyone on Mom. Sorry for that, but I've been out of town for the last two weeks and haven't had much to add.

Today, I visited for a short time and Mom seemed to be doing about the same. She is noticeably weaker than prior "off weeks" from chemotherapy. It could be that the chemotherapy's cumulative effect is beginning to take a toll. She's not out of bed much any more, but does get up occasionally.

Tomorrow, we are scheduled to see the doctor and get another treatment. It will be interesting to see if Dr. Aurora feels that Mom can tolerate it. It would not surprise me to see him put it off for a week to see if her strength improves. Hard to say.

If I could ask those that are reading a favor: If any of you have had any experience with home health care agencies (self-pay or supplemental insurance pay) could you please drop me a note and let me know the name of the company? I have two brochures from companies that I am going to research, but if anyone has any first-hand experience, it would really help.

More updates after the doctor tomorrow.

Post-chemotherapy Update

Mom's chemotherapy treatment went well yesterday.

We saw the doctor as well, and he was very happy with Mom's condition. Her blood counts are all good, and more importantly to him, her weight is being maintained. He indicated that weight was the single most prognosticative factor for a cancer doctor. And he was very happy that hers was where it was. And no, I won't mention what it was. I don't think Mom would like that.

The plan now is to do two additional treatments with the Taxotere, which Mom seems to be tolerating better than the previous drug combination. Dr. Aurora wants to do the two more treatments and then do the scans to see where we are.

Mom appeared to be pleased with the news and happy with the results of the doctor's appointment. Her cognitive abilities are about the same as before, but the "loopy-ness" that she experiences as a result of the dexamethasone (steroid) that she takes before, during, and after chemo seems to be a little reduced this time around. Hopefully the dosage adjustment that the doctor made has helped with this.

She's giving the fight all she can and is holding her own.

I'm sorry for the lengthy delay in posting an update on Mom.

I was over at their house yesterday, doing a grocery run, and Mom seemed to be doing pretty well. She had physical therapy in the morning and was happy that she was able to do all that was asked of her by the physical therapist. She looked good, seemed stronger than she has in the past, and we had a good bit of conversation. She asked about the kids and was able to talk back and forth with me about them, and also about some other things.

This is pretty typical for the days leading up to a chemotherapy treatment. She will have her next one on Monday, May 3rd. These have been going well and she is tolerating the Taxotere just as well as she tolerated the cisplatin and Alimta.

So, things aren't really changing much, which in her circumstances is probably a good thing.

Thanks to everyone for the continued support, thoughts, and visits.

Not too much has changed over the past week. Mom had her chemotherapy on the 12th, as I mentioned, and has spent this past week recovering. She is extremely tired and we wonder if the effects of the chemotherapy are cumulative (they probably are) and so recovery takes a bit longer each time.

Her physical and mental states have not appreciably changed, either, with the exception of her being so tired.

We have a lab appointment this Thursday for blood counts and then the next chemotherapy treatment is scheduled for May 3rd.

Mom had her chemotherapy treatment today. It was a bit of a challenge, actually.

Her cognitive function was significantly less than it has been recently, and whether that's due to the steroid that she gets prior to, and during, her treatment or the disease, is unknown.

At any rate, we did get her to the oncology office and get the treatment done. I'm not sure that she said anything that made any sense the entire time.

That said, you can tell it's not delusional or demented in any way. What she is thinking is up there, but she just cannot get the words to match up with the thought. She has expressed to me in the past how frustrating it is, and you can see it when she tries to say something.

The human mind is a remarkable thing, but when there is a short somewhere in that circuitry, the strangest things can happen.

Mom's lab work looked good, and physically, she is doing pretty well. She's begun using her walker to get around the house and is very good with it. She has mentioned that it gives her more confidence when she is walking around and makes her feel more comfortable.

I took her outside Saturday afternoon to sit on the back patio. She really enjoyed it and we talked about the flowers and the overall condition of the yard. She had enough going on to tell me that something needed to be done about "that backyard" and that her flower garden "needed seeing to". It was a nice time and one that I'll remember. She loves being outside and one of her goals early on was to be able to go swimming this summer. We'll see how that turns out.

Mom had her doctor's appointment today and we reviewed the results of the latest series of CT scans.

The scans showed no growth of the cancer (no shrinking, either) and Dr. Aurora indicated that he was happy with this as it showed that the cancer has stabilized. So while this may not be extraordinary news or even outstanding news, it was good news. Mom was happy with the results and excited to have "won" something again.

Now, what she has "won" is three more chemotherapy treatments with Taxotere. Dr. Aurora feels that this offers the best chance at continuing to keep the cancer stable and not growing.

So, we will have these three treatments over the course of the next ten weeks, culminating in another series of CT scans to see where things are.

Mom is doing okay physically. She actually gained weight since her last doctor visit. Don't let her find out I posted that. Her blood counts are good, her blood pressure is good, and she is not in any pain.

Mentally, her cognitive function continues to be about the same. Not much changes there except when she takes her steroids during her chemotherapy treatments. At that point, and for a few days afterwards, she is completely off her rocker. But we expect that, and the benefits outweigh the negatives.

We are now set for an infusion next Monday and we will continue with the program.

Thanks for all the support. We really do appreciate it.

Beth and I took the kids over to visit Mom and Dad yesterday afternoon. My grandmother, aunt, uncle, and his wife (my aunt as well) were visiting from Lubbock.

Mom was doing okay, but you could clearly tell she was putting on a show for company. She tries really, really hard to make sure that everyone gets the impression that she is doing fine. Sometimes I wish she wouldn't do that because it becomes pretty obvious that: a) She's not doing fine, and b) It really makes her tired. But, that is the way she is.

I think overall her condition remains about the same as it has been for several weeks. I don't know if that's a good sign or bad sign, or even any kind of sign at all.

We have a doctor's appointment on Monday to discuss the results of the CT scan that Mom had on March 29th. I suspect we will be making some decisions about future treatment plans then.

I realize that the updates here have become less frequent and I wanted to make everyone aware that the reason for that is pretty simple: things aren't changing as rapidly as before. I guess we've reached some sort of plateau.

I also want to continue to express our thanks to the people from the ESC Region XI Service Center. You are amazing. The help and support that you have provided has been so important and well-received. Mom and Dad (and I) really do appreciate everything.

I am sure I will have an update after our appointment on Monday.

Today, we're supposed to be heading to the hospital for a CT scan to help gauge the effectiveness of the newest chemotherapy treatment.

We have an appointment with the doctor next Monday to review the results and see where we go from there.

Mom is hanging in there, although I don't think she is particularly thrilled with the idea of yet another test.