Laura 2.0

There were very few tears after I got The Call. Unfortunately, I had been mourning her death for a year.

I was so focused on her dying that I forgot she was still alive.

She, obviously, knew she was still alive. Making plans, buying clothes and bags, planning parties. Death took her despite her unwillingness.

The memorial was beautiful; just like her. It was so.weird to have a 'party' about her, without her. Seriously, I kept waiting for her to pop out from the side of the stage or come running down the aisle and leap to the stage.

Her husband is a lawyer and spoke at the memorial. When he started, he explained the only way he was going to get through it was to remain in 'court-mode'. Strong. Detached. Unemotional. Factual. Being a nurse, I often get this way. My husband calls it 'clinical'. I suppose everyone can do this to some extent. Take emotion out of it and do what you have to do. During her illness, I was too clinical. Seeing her as a patient instead of a person. My cousin. She was a patient, but she was not my patient. With my experience in hospice care, I saw the writing on the wall. Even when her doctor told us she had a month, I knew she wouldn't make that. My knowledge and experience was my Achilles heel.

It has been 16 months since her death. It isn't any easier to accept but time has blurred acute pain. Her voice is fading from memory, no more texts or calls, no more Hand and Foot losses.

Why am I telling you about Laura? Because I want to point out some clues that may help you or a friend or loved one.

1. Persistent cough
I am, now, hypersensitive to patients with ongoing coughs. A chest xray is such a simple, and relatively inexpensive test, to reveal a myriad of possible problems. My recommendation is if a cough is not getting any better in one month, ask for a chest xray. Most coughs should improve in 3-4 weeks. If there is no improvement go see your PCP.

2. Vocal changes
This can be attributed to many etiologies, but it needs to be addressed. Cough with vocal changes needs to be assessed. Go see your PCP.

3. Unexplained loss of consciousness
While Laura did not completely pass out, she had two episodes of dizziness, altered state, lack of coordination, flushing, and difficulty concentrating. Again, coupled with her other symptoms, go see your PCP.

4. Difficulty getting comfortable
This was the buzz phrase her husband said that clued me into her final days. Dying patients often have this problem. It was common in hospice to see this near the end of someones illness. It doesn't always mean death is imminent, but it means there is something wrong and you need attention. Even with medication, if patients cannot get comfortable, there is something that needs to be addressed.

Laura was such a sweet, accommodating, optimistic person. She wanted to feel better after the Zpack. She didn't want to say it hadn't helped. She didn't want to be a nag or create a scene. Would she still be here if they had done the chest xray earlier? I don't know. It certainly wouldn't have hurt anything.

Finally, if you have been seeing your PCP for awhile and have anything new or suddenly different in your health please make an appointment and be frank. "This is new. This is different", should be vocalized. If you do not believe you are receiving the appropriate care or treatment, ask for a second opinion or see a different provider.