The Last Day

Late this morning, Nancy finally ended her struggle with cancer. She passed away at home, where she was most comfortable, with the hospice nurse and a very sweet health care aid by her side. I, and our children, arrived home shortly after she passed away. I believe that Nancy chose to leave us when we all out of the room, but close enough to say goodbye once more after the machines were silenced and the tubes removed.

Visitation will be at Schrader Funeral Home - (636) 227-5511 - 14960 Manchester Rd, Ballwin, MO from 3:00 p.m. until 8:00 p.m. on Friday, July 27, 2007.

At this time, we are planning to have the funeral service at St. John United Church of Christ at 11:00 a.m. on Saturday July 28, 2007. If the time of the service changes, I will enter an update to this blog. The obituary will probably be in the Thursday newspaper.

I would like to thank everyone for your continued support with comments, cards, flowers, visits and prayers. Nancy was never in any pain – even at the very end. To me, that is God’s greatest blessing for Nancy.

A Wider Gap

Today we met Annie Ellison, the Health Care Aid that will be staying with Nancy for 6 hours each day this week. To me, she seems wonderful. It doesn’t take long to realize that Annie has a deep respect for human dignity and wants nothing more than to make Nancy feel comfortable and me to feel at ease, knowing that Nancy will be in good hands while I am away working at the university. Nancy said that she didn’t want someone who was “chatty” because that might make it difficult for her to rest. I think Annie is a little chatty, but if she is, that doesn’t seem to bother Nancy. The compassion that exudes from Annie disarms you and is very comforting. I am certain that Annie was the perfect match for us.

The hospice nurse, Janet, visited today and was concerned that Nancy is still getting too much fluid, or that she isn’t getting rid of as much as she did when she first started hospice care. I agree that Nancy's limbs seem very puffy and tight, much the same as they did when Nancy was pregnant with our kids over 20 years ago. Nancy’s IV fluids have been reduced again and Nancy is now also getting oxygen because her breathing is becoming labored. I feel that slowly, the gap is widening -- Nancy is slipping away from us -- and closer to God.

I really don’t want what I am about to write to sound insensitive, because I think the story I want to tell you is rather touching. Last night, I woke at about 2:00 a.m. with the sounds Nancy makes when she is searching for something with her hands on the tray beside her bed. I turned on a light to assist her – only to find that she was apparently having a dream and during it, she removed her colostomy bag and now its contents were spread all over her hands, her nightgown and the bedding. When she woke up enough to realize what had happened, she tried to tell me how sorry she was for making such a mess. I tried to reassure her that it would be OK; I knew I could clean her and her bedding easily enough, but I was more than a little nervous about not knowing how to replace her colostomy bag. Even though she had replaced it close to a hundred times since the surgery that required it, her hands don’t work well enough now to do it herself and she is having so much trouble communicating, I didn’t know if she would be able to “walk me through” it. Most of the supplies for bag changing were next to the bed in a small black zipper-bag that she usually carried with her when she was away from home. However, she knew there were additional required items required that were unintentionally “hidden” in several locations in our bathroom. The next half hour felt like a combination of a game of charades and putting together unassembled furniture with the instructions translated badly from Chinese. If the subject matter hadn't been so sensitive, our comedy routine could have been part of an "I Love Lucy" show. I eventually found the missing supplies and we stumbled through the bag change... but we did get the job done! When it was all over, we both laughed and hugged. Nancy felt good that she was still able to teach and I felt relieved that we had succeeded in completing a task with which I was never very comfortable. Following that event, even with my lack of sleep, the day seemed bright and full of promise. Although I know that Nancy isn’t going to regain her health, it helps me to know that there are still highlights for her to enjoy.

In your comments to this blog, several of you have recounted a touching moment or funny story that reminded you of a happier time for Nancy with you. Now I am asking for more of those stories. Please e-mail your stories to me at the following e-mail address: eetman@yahoo.com. Thanks, I know it will bring Nancy some joy to know that you carry fond memories of her.

... and Another

This weekend was supposed to be a highlight for Nancy, with her Dad, her brother and his family coming for a visit. Unfortunately, early yesterday morning, about 2:30 a.m., Nancy had a seizure. It wasn't a long seizure -- maybe only a minute or less, but there was no mistaking the signs... it was a seizure. I was afraid that the seizure would last a long time, but it didn't. Initially, I could tell Nancy was frightened and she felt anxious. I tried to assure her that I was by her side and that she was OK. After spending a little time trying to calm her, I realized that she didn't really respond to my words except to open her eyes each time I called her name. At this point, I phoned the hospice night call number and was told there would be a visit from the "on call" nurse within an hour. By the time the nurse, Peg, arrived with a companion, Nancy was responding a little more than immediately after the seizure -- but her responses were still weak and confused. I was relieved to find that Nancy didn't remember that she had a seizure. In fact, each time I told her, she didn't remember that she was told about the seizure before either. Peg said that Nancy was following a typical pattern of post-seizure behavior. After speaking with Nancy's oncologist, Dr. VanAmburg, who just happened to be on call for the weekend, Peg started Nancy on lorazapam, a benzodiazapine that is often prescribed for anxiety. She said it could help prevent a future seizure, but other medication would be available on Monday should this prove inadequate. Peg and her assistant helped me a lot by teaching me some tricks to work with Nancy now that she was less responsive and may not be able to get out of bed. Those hospice nurses are great. When the nurse left, the house was quiet again. Nancy seemed to be resting and totally unaffected by the recent string of events.

I don't think I slept after that because sleep was the last thing I felt I could do at that point.

Later, Amy & Henry picked up our niece, Becky, at the airport at 9:00 a.m. and brought her over to the house. Nancy was starting to feel a little more awake and spoke with Becky, as well as she could. I realized that there had been a definite change in Nancy's ability to communicate, when compared to before the seizure. Nancy's short term memory seemed to be limited and she failed to remember more words for things that she wanted me to bring her or do for her. I could tell she was frustrated by this and I began to worry that if this trend continued, soon I would be unable to understand what Nancy wanted and needed by relying on the things she said.

By lunchtime, Nancy's Dad, her brother Dick, her sister-in-law, Sharon and their son, Andy arrived by car from the Chicago area. Everyone was sad that Nancy seemed to be having so much trouble communicating, but we all tried to support her and offer suggestions when the words she searched for were not the words she wanted to use.

Nancy is now definitely unable to get up anymore. She hardly has enough strength in her arms to pick up a drink glass and bring it to her mouth. All of her personal hygiene activities must now be attended to while she remains in the hospital bed. I had to inform the home health care agency of this change so they would be prepared when they arrive tomorrow morning to stay with Nancy while I am at work. At one point, I made everyone leave the room while I changed Nancy's bedding and attended to some of her hygiene needs and I realized that just these simple activities really tired Nancy out. However, when I asked her if she wanted to rest -- and for me to keep everyone away while she rested -- she said, "No, I want them back." That response was a pleasant surprise for me to hear and it let me know that even though the post-seizure decline and her new medicine would make communication more difficult, Nancy was still happy to have her extended family around her and she didn't want to miss spending this time with them.

The rest of the family, Ryan & Kelly, arrived before dinner and Nancy got plenty of time to visit with everyone. After dinner, the young people left to see Ryan & Kelly's loft downtown and to visit the City Museum, where Kelly is doing her summer internship. The rest of us (older folks) visited with Nancy and each other and then went to bed at a reasonable hour -- in contrast to the much later time our kids would be in bed. No more seizures in the night... yea!

Nancy's family left today, a little after noon. While they were here, they not only visited with Nancy, but they helped me with some of the "around home" chores -- Dick helped by spreading insecticide on the lawn and running errands. Sharon helped around the kitchen and with the laundry. Everybody else helped with food preparation, clean-up and by keeping Nancy company and bringing some happiness to her day.

Kelly's friend and former roommate, Ellen, came to visit this afternoon and they are now planning on visiting Doug and some of their other friends for the remainder of the day. I told Kelly that I remember something I hadn't thought about since our kids were small. That is, when your kids take a nap, you need to take one too. Don't try to clean or organize or catch up on other work. Take a nap -- you will need your strength for when they awake. Now, I realize that I am a little tired so I think I will take a nap -- along with Nancy.

Taking the Next Step

Well, today is the last day I will be relying on friends to stay with Nancy while I am at work. Owen DeBoer, who stayed with Nancy early this morning, noted that I have to help Nancy with just about every move she makes -- for performing even the simplest of tasks... like standing up and turning around or changing her position in the bed. On Monday, we will begin having assistance from a "health care aid" named Annie Ellison, who will be here every weekday from 8 am 'till 2 pm to help Nancy with daily care needs. Having Annie here for 6 hours a day will give me enough time to get work done at the university and still have some quality time at home with Nancy each day. Our neighbor, Janny told me that she could be here for awhile before Annie gets here if I would need a little extra time at work on any given day.

Nancy's regular hospice nurse, Janet, phoned me at work this morning to let me know that Nancy may now be overloaded with fluid after having been dehydrated for so long. Getting this fluid thing right without lab tests is really an inexact science. Janet said Nancy's tissues were puffy and appeared to be getting some edema -- especially in her ankles -- although Nancy hasn't complained of any discomfort. So, we are now reducing Nancy's IV rate somewhat to correct the problem. We are making several little "care-related" changes in Nancy's daily care routine as we find that they help her be more comfortable as her strength decreases. The hospice philosophy of doing what is necessary for the comfort of the patient instead of treating the disease makes more sense after all the "treatments" have become ineffective.

Thanks to our friends, John and Anita Reger, that big limb that fell out of our backyard maple tree in Tuesday's windstorm is now useful firewood. Anita called me after hearing that my chainsaw refused to cut the limb and offered the assistance of her husband, John and herself along with their newly repaired chainsaw to cut up the limb. With their help, it didn't take long to cut up that 20 foot, limb that was about 6 inches in diameter at its thickest part. Since we don't use our fireplace anymore, and they don't have one of their own, they offered to haul off the wood for Anita's sister's fireplace. Not only do they make service calls, they haul out the debris as well. Thanks.

Nancy and I are looking forward to a visit by her Dad, her brother Dick and his family this weekend. We feel blessed to have the love of so many friends and family who have offered to share their time and talents to help us through this difficult time. It is with your generous help that we are able to keep going on with such a positive attitude. Thank you all.

Just Keeping Up

Here is a picture of me as I sit with the computer and enter new information into this blog... with Cricket at my side. It's hard to tell Cricket's head end from her tail end in this shot because she is so dark. Nancy's "Home Health Aid" calls her the "rocket" because Cricket has so much energy that she darts from place to place with amazing speed. Cricket is about 5 lb now and all puppy. We have to wear her out before placing her on Nancy's bed or she will jump like a kangaroo all over Nancy. We all love her though. Her antics bring great joy to Nancy's otherwise often uneventful days.

I think we may have come close to the point where Nancy isn't battling dehydration in addition to the cancer. The IV fluids have been increased gradually until Nancy seems less thirsty and her blood pressure and heart rate suggest that her hydration is better.

As Nancy is becoming weaker with the passing time, I have inquired about adding a daytime Nurse's Aid to cover my absence from 7 a.m. to 1 p.m. during the weekdays. It has been great having friends and family members staying with Nancy while I am working, but with Nancy becoming less able to stand and move about, I don't want to ask friends and family to feel anxious or uncomfortable in caring for her. If we get all the arrangements made today or tomorrow, that Aid will start on Monday. Funny, but the first caveat offered by our Hospice social worker, who is arranging this extra help, was to let me know that personalities being what they are, I shouldn't be embarrassed to let the agency know if Nancy and the Aid don't get along. Apparently, it often takes a couple of tries to get a good match. Oh, what fun!

I will not be going to work today since our friend, Diane Tilton, who was going to stay with Nancy today had an unexpected family illness to attend to. However, before leaving work on any given day, I make sure that I will have things to work on at home, should this sort of thing happen. Besides, I could use a little extra daylight time to prepare the house for our 5 house guests that will be here for the weekend... I still haven't tackled that big tree limb that fell in our windstorm on Tuesday. Nancy's Dad, her brother Dick and his wife Sharon along with our niece, Becky and nephew, Andy will arrive on Saturday. Fortunately, I am all caught up on laundry with plenty of clean bedding and towels for everyone. It is good that Nancy has this family event to look forward to this weekend.

"... watch out for that tree"

I just thought I would include a photo of the tree limb that fell directly where people had been sitting last night at the Commitment Ceremony. I am now happy that we were blessed with an abundance of heat for the ceremony -- rather than encountering a strong wind like the one that dislodged this tree limb from high atop the large Maple tree in our yard.

Commitment Ceremony

I promised I would put some photos on this site showing the Commitment Ceremony from last night. I will add some more details later but I wanted people to see these when they viewed the blog.


Yesterday was such a special day for Nancy and for both the Stephenson and Richter families. Thanks to Sue Valentine and Carol Kolar, a very intimate and classy Commitment Ceremony Reception was prepared and everything was perfect.

Thanks to everyone who sent flowers and best wishes to the young couple. Although I have posted a few pictures of the ceremony and post-ceremony festivities, Kelly and Doug mentioned that they were planning this event to their wedding photographer when they had their engagement pictures taken last Friday. Mark, of Anmar Photography, offered to come out to the house to take a few pictures so they would have this extra special ceremony as a part of their wedding album. Well, Mark may call 360 pictures a "few" but that seems quite allot to me. Mark took the pictures at Amy's wedding last October and we all were very pleased with the results -- and we really like the way Mark gets all the good shots but never seems to be "intrusive". We are anxious to see how he captured the sensitive emotions and exuberance of the evening.

The ceremony was outside, so that meant getting Nancy dressed, make-up included, and into a wheelchair for a trip to the backyard patio for a 20-25 minute ceremony. Nancy hasn't had to get dressed for quite awhile, but she was determined to be a part of this event -- no matter how exhausted she got during her participation. The ceremony was beautiful. Kelly had burned some CDs earlier in the day for some light music to accompany the ceremony. As you can see in the photo, Nancy & I were on the patio (near the patio door) and Doug's parents were beside us. Rev. Janet Pillman put together a beautiful and meaningful ceremony describing how this commitment was just a beginning for the couple. There were vows of commitment and Rev. Pillman included some pertinent and meaningful scripture readings as well as a special ritual in which each person attending the ceremony passed around an object that had special meaning for Doug and Kelly. While holding the object, we were asked to ponder the meaning of Doug and Kelly's commitment and to offer a silent prayer for them. The object was a "snow globe" that was the first gift Doug gave to Kelly when they were sophomores in high school. That present had even greater meaning for Kelly because it also played music, "Edelweiss", a song that Nancy and I sang to all our children before they went to sleep as infants and toddlers.

Although the weather was beautifully clear, it was hot. There was a welcome breeze once and awhile but Nancy was definitely exhausted and ready to be back in bed as the ceremony concluded. We all (even Nancy) shared a champagne toast to the couple, enjoyed some very tasty food and then topped off the evening with that beautiful Commitment Cake from Party Pastries. Unfortunately, Nancy only got the champagne and she didn't like it that much... back to Gatorade, Popsicles, Coke and other clear liquids. Thanks to all of the family members who endured the heat to celebrate this special event with Doug and Kelly. I don't think any of us would have missed seeing how much meaning this ceremony had for Nancy and Kelly.

Today, we had a quick storm pass through just after noon while I was visiting with Carol Kolar -- just before she returned home to the Chicago area. The winds picked up, a little rain fell, and then it was all over. In my peripheral vision I thought I had seen something move outside the patio door, but it didn't register that the object was something big. Later I looked outside to see a very large branch on the ground, right where family members had been sitting just last evening. I am so happy that branch didn't fall last evening when one of those breezes came through. The weight of that branch could have posed a serious health hazard to the people sitting under that tree.