Breathing--it's that important

Picture from www.beckyjanedavis.com

If you walk into my therapy gym and ask if I tell corny jokes, I'll be the first person to raise my hand. I admit it, I'm no stand-up comedian. Additionally, my sense of humor is somewhat (ok, very) black and dry. Quite unlike the coffee I drink, but that's a whole other blog post... I blame it on my dad the engineer, his time in the military (even though he was out long before I was born, cynicism CAN be inherited), and an entire childhood of both watching M*A*S*H and listening to Aggie jokes.  Seriously, there needs to be a support group for people who have been forced to listen to Aggie jokes... So it's really no surprise that my collection of professional humor is really just corny, recycled one-liners designed to get a quick grin. Many times they contain a point that I'm trying to make to my patient while not sounding nagging. Several that get recycled more than others are "Don't stop breathing on me, bad things happen when you stop breathing" and "Breathing is beneficial. I highly recommend it to all my patients." They usually get the desired effect--the patient who has been holding his breath under the strain of whatever exercise laughs a bit and resumes breathing. This is an important step as I have a record of 10+ years CPR certification that has never been used on anything that can in fact breathe. I do not want to break this record.


Breathing is something I've been thinking about a lot this last week, primarily because it's been such a struggle secondary to a severe sinus infection.  One day my O2 saturation level was even below that of one of my patient's that I was walking down the hall!  After several sleepless nights filled with coughing and labored breathing, I desperately called my doctor and begged for the soonest possible appointment. And, yay for the strong antibiotics and prescription cough medicine, I'm actually sleeping. With the help of Afrin, I'm breathing again too! (and my husband is also glad that I'm no longer tossing and turning as it kept him awake as well.)  Breathing is beneficial. In modern medicine we tend to think of the heart and it's importance to life, but it was actually breath that was chronicled as the start of human life.

Genesis 2:7 "the LORD God formed the man from the dust of the ground and breathed into his nostrils the breath of life, and the man became a living being." Job affirms his belief of the divine origins of life: "The Spirit of God has made me; the breath of the Almighty gives me life." Job 33:4 Two chapters earlier one of Job's friends addresses not only the physical, but also the spiritual design of God, "But it is the spirit in a man, the breath of the Almighty, that gives him understanding." Job 32:8 (emphasis added on all verses.)

 Breathing. Spiritually, how are you breathing? Are you taking deep breaths and enjoying the sweetness of a God who loves you? Are you free and unrestricted with Him? Or, do you have something obstructing your spiritual lifeline, stopping you from filling your lungs? I'll confess that many times I let the stress of my life interfere and I forget to breathe. I find myself perplexedly gasping for breath and wondering why I feel so winded and weak. Bad things happen when you stop breathing. Instead of running to the Creator and letting Him fill me, I continue with the same, inefficient way of managing even when I know it isn't working.

Question: which is the more important part of breathing, inspiring or expiring? (breathing in or breathing out) The answer may surprise you. It's actually breathing out. When you expel the old, stale air from your lungs your body will automatically take in a nice, deep breath full of fresh air. What are you getting rid of, expelling from your life? Are you holding onto things that are slowly strangling you and preventing an influx of that which is good? For me, there are many things that I hold onto and stubbornly refuse to do what is best. It's not that I don't want to breathe, I just don't place a high priority on it when the truth is that time with my Savior is the most important. Without breath there is no life.

Breathing. It's that important.

The Deaf One

Recently I've started seeing a patient who was born deaf. We'll call her Jane. (You'll probably notice that all of my female patients are named 'Jane Doe.' If the story requires naming another one, you'll find Janet, Janine, and Jinny... along with their spouses John, Jim, and James. Just making sure Im observing HIPPA.) She'll tell you that fact and shrug her shoulders, saying in the blurred pronunciations of one who cannot hear her own voice, "I don't know why." For her, communication is obviously something that she has struggled to achieve. She speaks sign language, but few do so she has adapted other skills as well. She reads lips incredibly well as long as the speaker looks directly at her. Imagine trying to learn to speak if never heard a sound, yet she has achieved the ability to make herself understood however cumbersome it may be. She has endured this her entire life and is not bitter or questioning about it at this stage in her life. She is one of the sweetest and happiest residents in the entire facility. Or maybe I'm just biased, but I'm really enjoying working with her.

Today she showed me again what an amazing attitude she has. The facility I work in recruits various types of talents and performers to visit and entertain the residents. Today it was an elderly man armed with a slightly out-of-tune guitar and a repertoire full of comical ballads popular when our residents were much younger. I looked through the crowd and there sat my deaf one, smiling and obviously enjoying herself. A common view from people blessed enough to live in their own homes and take care of themselves is that "I'm not going to a nursing home. Nursing homes are for people who are waiting to die." Jane certainly isn't sitting around waiting to die, she's getting as much as she can from life. Most people won't go to something that they can't fully benefit from, but she participated the best she was able and enjoyed all that she could. And I was humbled.

so you think your patient can dance

Yesterday I danced with a patient in therapy. It started out as simply as great opportunity to work with a patient. I had finished with one and noticed the next patient on my list in the main room in the dance sponsored by activities. Great! I don't have to chase her down and it shouldn't be too difficult to get some movement out of her. What that time turned into was more than I had anticipated.

She agreed eagerly. As I knelt beside her to remove her foot pedals, she reached for my hand. "Did I ever tell you about the time that I danced with Fred Astaire?" Apparently she was a background dancer in one of his movies when she was a teenager. Her eyes shining, she took several minutes to tell me about the perfection that he expected and how much she learned from the experience. It was obvious how much she treasured that opportunity. As I reached for her hands, she stood up and eagerly started tapping her feet. I'll be brutally honest and say that both of my feet are left. It's true--I can't dance. That sad fact, however, doesn't stop me from trying and I was more than willing to make a fool of myself for the sake of... well... her, the experience, the therapy. It didn't matter that I have never been able to dance and that she is no longer able to fly about the room. (although she still has really good timing!)
She looked up at me, eyes gleaming. The only time her eyes left mine were to smile at other people. For a few minutes she was reconnected to the person she used to be and the life she used to have. I'm definitely no Fred Astaire, but dancing with me brought those memories to life. For that short time the reality of living in a nursing facility rolled back a bit and she was again doing something that she dearly loved. I don't have any idea how long it had been since she had danced.

I had no clue that the afternoon meant so much to her until today when I talked to the OT who treated her afterwards. Apparently that was all she talked about yesterday. Who knew the Hokie Pokie and a couple of slow dances could mean so much? These are the moments that make me internally shout, "I LOVE MY JOB!!!" Therapy that gives a person back their life.


And so we danced.

A Simple and Needed Hug

She has global aphasia. It's a language problem she developed after a stroke. The portion of the brain that controls speech is not working correctly. She can process her own thoughts, but the mechanism for transferring those thoughts to speech just doesn't cut it. Additionally, most of what she hears from other people is Greek to her. Basically she's trapped in her own brain. She's more there than most people give her credit for. Usually she will start a sentence with garble, the middle will be intelligible to those that care to try. The sad thing is that most people write her off as crazy simply because they cannot understand her. Cognitively she's still very much with us.

This evening, though, her speech was far easier for me to comprehend. During our walk we stood and had a conversation while looking out a window. I always thank my patients for working with me at the end of the session. Most of them will thank me in return for taking the time to work with them as well. When I helped her into her wheelchair and reset her alarm, her face lit up and she spread both arms out wide. As I leaned forward to wrap my arms around her shoulders, my eyes teared up and I wished I could tell her what that meant to me.

Rewind three years. I didn't start out wanting to work in geriatrics. I work with patients and get close to them, hold their hands when they're in pain, hold the bucket while they throw up, hand them Kleenex when they're crying. Sometimes, despite the best that they and I can do, they can't go home. Many times they go back to the hospital, or bounce between the ER and the rehab unit like a yo-yo. I've lost patients to ALS, pneumonia, cancer. I've helped families guide their way through the maze of decision-making for their loved one. That's not even counting the advanced dementia and the way it steals a person right in front of your eyes. It's like ripping your heart our every day. But some days your patients can reach right back to your heart and mend it with a smile and a hug.