Aunt Terry and Julie

Our Aunt Terry passed this week. We are all deeply saddened, and our thoughts and prayers go out to Uncle Herbie, and to Dana and Chris.

I'm adding a picture of Aunt Terry and Julie. I wish there were a better one.

Aunt Terry was the most stubbornly cheerful, gleefully ornery and all-around wonderfully spirited person you could ever meet. She embodied Joie de vivre' from the heart of Texas. One could not meet her and not be lightened, if not enlightened. In this way she was so much like Julie. There should be a lot more like her, like them, a lot less like the rest of us. And there should be much more justice in deciding who stays and who goes.

Julie and Goofy

I forgot to post this earlier - Julie and her favorite Disney character, Goofy.

The Black Eye

One day when Julie was about six, and I was about sixteen, I was hanging out in the living room with my friends, and as usual, Julie was there having some fun with us and wanting to play. Somehow my friend Tom got her into the old trick pulling contest. He held her wrist in his hand and told her to pull as hard as she could; and she did. When he let go, bam! She hit herself right in the eye. It wasn't very funny at the time, but after the initial cry she was a terrific sport about it, and ever since it's given us a good laugh.
Thanks to everyone for sharing. If you have a favorite memory of Julie (I'm not saying the black eye was mine, though it was - eventually - funny) please share it.

No Pain

Julie spent yesterday resting peacefully, and feeling no pain! This is great news. I am very grateful to Julie's doctors, hospice, friends, family, and the whole Belfast community for all of their efforts in getting this difficult problem managed.

Some Promising News

Julie's primary care physician and hospice are redoubling their efforts to ensure that Juile's pain is fully medicated. They have increased her baseline pain medication and ordered that break-through doses be given as often as every 30 mniutes until the pain subsides. They are also increasing the frequency of evaluations so that her baseline doses are maintained at a level that exceeds her increasing tolerance.
I'll write more later when I hear how she's doing.
This is a good start.

Julie's Pain

Our parents arrived in Maine today to find Julie once again, or still, in horrible pain. When they called I could hear her wailing, clearly in excruciating agony. We thought this problem had been solved, but apparently it has not been, nearly three weeks after she was discharged.

What is most important is Julie's quality of life for what are most likely the last days or weeks that she has. Metastases to her hips and back are causing her tremendous pain, and everything possible must be done to eliminate that pain. Tolerance to morphine and other narcotic pain medication builds fast, and keeps building. The doses can get very high, but it does not matter. No dose is too high that does not completely stop the pain. Only at doses well above the point of controlling pain do adverse effects, diminished sensorium, or addiction occur.

To this point the medication she has been receiving has not come close to consistently matching her pain, and it's heart-breaking and maddening. The first rule of hospice is that there be no pain, and that's not being done.

Video - Julie, Handle With Care

I put some pictures from Julie's life and family together with a nice song by the Traveling Wilbury's (you know, George Harrison, Roy Orbison, Tom Petty, Jeff Lynne and Bob Dylan).

http://www.youtube.com/watch?v=2EX-tim6tiw