One Moment in Time...Josephine Bonanno, 1924-2011

     June 27th did not begin well at all.  On that morning I received a call from the Intensive Care Unit doctor from Paoli Hospital asking to arrange another family meeting for the next day.  Once again, my sisters Stephanie and Lisa and I hashed out what we might hear at that meeting.   We already knew instinctively that Mom's recovery was slow to nil. 

     When I arrived at the hospital that afternoon, the doctor came into the room and sat with me on the couch. She explained that the daily chest X-rays, which had once shown improvement in her lungs, had now begun to show decline.  Nutrients and medicines administered through the feeding tube were just sitting in her stomach and not being absorbed by her body at all.  It was increasingly difficult to keep her blood pressure up and her fever down.  She said the news was not encouraging.  I agreed to prepare the gang for the meeting so they didn't go in blindly. 
    
     My mind was such a jumble of images:  On one hand, there was Mom laying in the bed struggling to be understood with the tracheostomy on her neck, with swollen hands that we would massage constantly, and with droopy eyes that could hardly stay open after many medications and insufficient air intake.  On the other hand, there was this regal woman who dolled herself up nightly to dine with her friends at Wellington, her independent living facility, and who took pride in boasting of her status as Mom, Grandma, Grandmom, Mommom, Sister and Sister-in-Law, Aunt Jo, Friend.....she loved being loved and she loved loving back.  In the background of these images in my mind were sounds similar to the many beeps, honks and toots of every car horn one could think of, and these sounds probably entered my mind as a result of the countless machine noises in the hospital.  At that point, I was ashamed of myself for what I was thinking...I either wanted her to get up and walk out of that hospital room and continue to wow everyone who was blessed to meet her, or pass away on her own.  I wanted it to be like the last time she was in the hospital, and she wouldn't let us take her home until I had gone to her apartment to get her curling iron so she could do her hair.  I wanted to see just one more regal entrance, one more gathering at which she could be a presence.

     When I got to the hospital on the day of the meeting, Mom, who was not able to speak throughout her ordeal but mouthed words and needed a lip reader, mouthed to me as clear as could be, What time is the meeting?  "Huh?" I answered.  The doctors were in here and you were supposed to be here with them!  Dumbfounded, I assured her that I was not supposed to be there until the afternoon and that the doctors would be at the meeting.  This was my first clue that she had more than an inkling of what was going on.

     The meeting time had arrived.  The doctor repeated with my sisters present what she had told me the day before, and that the options were to continue with what we were doing for a few more days hoping for an unlikely change, to transfer her to a long term care facility where she would most likely need the ventilator for an extended time or even for the rest of her life, or to change the focus of her care to making her comfortable.  It had become obvious that she would never return to her friends at Wellington, and that she would no longer have the active lifestyle she knew, and most of all, that she would be uncomfortable.  We were blithering messes.  We wanted our Mom back.  We didn't want to call those that were closest to her to come and say goodbye to her.  It wasn't fair.  We were going to ask her if she wanted to change the focus of her care.  What if she thought we were giving up?  Would she give us that frustrated wrinkled-brow?  Would we understand her intent?  Would we be riddled with guilt because we weren't sure what she was trying to say?  We were assured that they wouldn't hasten death or cause death, they would just make her comfortable.

     We all went back into her room, the patient advocate talked to her about her comfort level and asked if the she was comfortable with the assisted breathing apparatus.  She shook her head no. She also answered negative when asked if she had any pain.  The advocate explained to Mom that her care focus needed to be changed, gave her all the options, and asked her if she wanted to focus on comfort.  That's when all our doubts and fears were addressed and all our insignificant questions were dismissed, and all the important ones were answered.  Without hesitation, Mom smiled and nodded at the professional's question.  She was then asked if there was anything she wanted.  HEAVEN!  She mouthed, again clear as day.  For the first time in weeks, we felt a sense of relief!  We stared at her smiling face for a couple minutes, and couldn't help smiling ourselves.  She then raised her hands from her sides and mouthed with such happiness and conviction, MY DECISION IS MADE! 

     A couple times during the day, Mom was asked if she wanted the hospital chaplain to come to her room.  Indeed she did, and the hospital chaplain was wonderful.   But she kept mouthing the name of a priest who had become a staple in her life as a result of  his affiliation with a Catholic college program my daughter Karen was involved in, and because his mother lived at the same independent living facility.  Again, I repeat, this woman tried to get us to understand her for a month to little avail, yet today, she was deliberate and clear in stating her desires, and she said his name distinctly several times in a couple of hours.  After we made several phone calls, this great man rearranged his life so he could grant Mom's wishes.

     Soon the room was filled with everyone who needed to be there, save the grandchildren whose geographic proximity wouldn't allow it.  She had become so peaceful and radiant in those couple of hours, yet she was still our Josephine, taking in everything and sharp as a tack.  She panned and scanned the crowd from one end to another and just beamed mouthing I love you all.

     Father suggested that we speak with her privately, one at a time.  When it was my turn, I said "Hi Jo!"  It's something I said to her often.  "You've been fighting for so long."  She nodded.  "You don't have to fight any more."  She grinned and nodded with clear and peaceful eyes that were even more beautiful than a month before when she was in better health.  I assured her that Steph, Lisa, and I and all the grandchildren and great grandchildren would be fine.  Again, she nodded and smiled.  She had indeed made a decision she was ready to carry out.

     When everyone was back in the room and she had been annointed, and all the prayers had been said, and the semicircle of her folks had formed around her again, I asked her if she was ready to get the uncomfortable stuff removed.  One last direct communication:  she shook her head no and began scanning the crowd again, saying I love you several times.

     The second time I asked her if she was ready, she nodded.  Within minutes she was more comfortable with the morphine button nearby, and her children holding her hands.  She still looked adorable as she pointed to the morphine button as she felt she needed it.  She smiled and took in her surroundings until she finally fell asleep.

     The overnight vigil included Aunt Rose,who was my father's sister and my mother's partner in crime at Wellington.  Also present were Lisa, Stephanie, my daughter Karen, my wife Jackie, and myself.  Just before six in the morning on Wednesday, June 29th, Mom passed away, and it was peaceful.

     Thoughts enter my mind of Mom reconciling with Dad and with my sister Janet, whose loss she survived but never quite recovered from, and finally with her Mom and Dad in heaven.  The magnificent sendoff at the hospital is replaying repeatedly in my brain.  All these thoughts are comforting.  Though they are not comforting enough to mask the sadness and grief, I am sure that in time we can all heal knowing that Mom's sendoff was as she wanted it.



Mom and Lisa met Josh Groban after Lisa redesigned
 his 'Awake'  album for a contest and won!

Celebrating Janet's 60th birthday in 2009.
 Top L to R: Me, Mom, Steph. Bottom L to R: Lisa, Janet.

Mom and Me
Memorial Day 2010

    Mom was a survivor.  In 1994, at 69 years of age, a mass was discovered on a muscle in her leg.  She was told to get her affairs in order, and that she had the most agressive form of cancer in that muscle.  The muscle was removed and within months, she was walking normally and cancer free.  In April of 2005, she was diagnosed with chronic lymphoma. That same week my sister was diagnosed with pancreatic cancer, and it was decided that my father needed more care than Mom could give him at home, given her condition.  He entered the dimentia unit of a nursing facility and passed away six months later.  She survived radiation and chemotherapy, as well as well as other treatments and medications.  She always made herself look physically beautiful during all these trying times, and was never anything but strong and courageous. 

     To have friends from all facets of one's life, even without Facebook, is a gift.  From her oldest and dearest friends and cousins, who were her extended family from South Philadelphia, to her youngest great grandchildren, to her extended family of the last six years at Wellington, it's been a hell of an 86 years filled with friends and family, smiles and tragedies, and throughout it all.....love.

    Thanks, Mom.  We are who we are, and we're all together because of you.  That in itself is the greatest gift.  Rest in peace, lovely lady..............

One Day at a time, Phase II...........

     I'm not a doctor.  I don't even play one on TV.  If someone handed me a stethoscope right about now, I'd place it next to my IPod dock speakers to see if it amplifies the sound;  If I had a blood pressure cuff, I'd bundle that pile of  branches I cut from the bushes around my house for the Monday brush collection;  The feeding tube syringe would be great for watering those little houseplants we have laying around;  and last, but never least, a bed pan would make a more than adequate paint roller tray.  I have been a medical ignoramus.

     Now, my dear Mother has been in a hospital bed in the Intensive Care Unit of Paoli hospital since May 31st. First, there were three days of oxygen; next two weeks of being hooked up to the monster ventilator; and finally, after a grueling family meeting where Mom blinked twice to continue receiving treatment, ventilation through a tracheostomy and a feeding tube.  I have become the dimwitted advocate for this little lady, giving written and verbal consent for medical happenings which I have never heard of before, and am frightened and honored to do so.

     My problem with all of this is the same as as everyone's.  There is no timeframe for her recovery.  Each two steps backward is being treated so she can take a step forward.  Each facet of her well being has been treated:  from the high heart rate to the high rate of respiration, from the temperature rising to the blood pressure falling, from the lungs having too much in them to the stomach not absorbing enough nourishment and medications fed through the tummy tube, and from the high blood sugar to the swelling in her hands and belly.  The logic behind the lack of a definitive recovery timeline is that this was the mother of pneumonia attacks, and an illness this serious in a person of her age is critical, and it is going to be a long recovery.  Since she gave the two blinks of her eyes last week, she has begun a rigorous regimen of medications, treatments, therapies and emotions.  Just like all the family and her friends, I want her better....now!

     The removal of the tubes and tape from Mom's face signified the beginning of the second phase of her recovery.  Though she is in a bed all the time and still quite sick, some genuinely poignant moments have come our way.  The biggest and best was when I got a text from my little sister Lisa shortly after Mom woke up after the procedures of that frightful Friday.  It said, 'She can smile now!  It's beautiful!'  It's fun to see her eyes widen, as well as the smile and wink that follows, when a grandchild comes by for a visit.  It's rewarding to finally, after a week of struggling, to be able to read her lips when she needs something.  It's awe inspiring to watch her benefit from the phenomenal care she is getting at the hospital she's in, and comforting to watch her trusting eyes as the devoted nursing staff tends to her every need.  It's fortunate that, though no hospital is fun to be in, every effort is made to make families comfortable.  It's relieving whenever a sign of improvement is evident.  Her color has been good, the swelling has been diminishing, her blood pressure and sugar are stable.  Most of all, she asks to go home and looks incredibly annoyed at any of us that inform her of the times in the last few weeks that she can't remember.  If that isn't a sign of improvement, I don't know what is!

     No, she certainly isn't out of the woods yet.  It's still one day at a time.  Maybe if I confess my sins against her and pray hard, things will be better:

     Ma, I'm sorry that after I got my driver's license and told you I was driving Lisa and me to church, I actually parked the car on Quaint Street and she and I  just talked.  I'm sorry for those times as a wee one when I didn't feel like coming in to do.....you know.....and did it outside.  I'm sorry I let one of the neighborhood kids talk me into breaking into another neighbor's garage only to subsequently lock me in the garage and leave the scene.  I'm sorry that long after you thought I had gone to bed, I snuck downstairs and  sat quietly on the family room steps where you couldn't see me and watched whatever programs you watched.   If you get better now, I promise I'll tell you these stories in person!  I'll stick my index finger on the inside of your elbow until you slug me....just like old times.  I'll say all the Italian cuss words you taught me whenever you need to giggle.

     It is to her credit that she has a family full of members working together to see that she is getting the care she needs, and supporting each other through this crisis.  I am thankful for the heartfelt prayers of all her friends, all my friends, all my sisters' friends, all our children's friends, and anyone who has asked us about her, or even thought of us during this difficult time.  We are certainly remaining positive and hopeful as more and more time passes.  Nothing is etched in stone, and she may continue to take backward steps, but until they tell us that there is a symptom they won't treat, we're going to move forward optomistically expecting this stubborn and strong lady to recuperate, and realistically ask for her healing.

One day at a time..............

    
    
    
    
 

One day at a time.............

It's been a hell of a couple of weeks.  Mom's pneumonia has been a frightful villain.  Mom hasn't been responding to the ventilator too well since my last communication.  We had a family meeting yesterday morning...my two surviving sisters, two doctors, a nurse, a patient advocate, and me.  The options coming out of that meeting were either inserting a tracheostomy and feeding tube, or making her comfortable. Mom opted to go for the trach and feeding tube.  The procedures to put those in and get her off the monster machine will be today.  No guarantees, but if it is not successful and they think there is nothing else they can do, she can decide to be made comfortable at any point.  The feeding tube needs to stay in for three months but she'll be able to eat again and not use the tube if she goes in that direction.  Time will tell.  The outcome may be the same, but I'm stunned and proud of her for being with it enough to make this decision on her own, especially since Stephanie and Lisa and I made sure she knew we would support her 100 % with either decision.  The hospital staff reiterated this to her.  She's one tough cookie.  We'll see what the next couple weeks bring.  I've learned to be optimistic and realistic these past few years. Either way, it will be good to get all those tubes out of her mouth and face.  We're taking one day at a time.

Last night, after everyone had left the hospital, and I was about to leave, I told Mom I was getting ready to go home and she began trying to communicate something.  First she moved her thumb back and forth.  I grabbed it and rubbed it, and with her eyes she said that this wasn't what she wanted.  She began to move her hand back and forth.  I rubbed it, and once again with her eyes, she looked frustrated.  I proceeded to find a paper given to us with lots of visual commands that she could point to....hot or cold, pain, television, everything you can imagine.  No success.  There's even an alphabet on the paper and I asked her to put her finger on the first letter of what she was trying to say.  No dice, just a pitiful look of frustration on her face. I said, "Mom, I know you're trying to tell me something, I'll keep trying to figure it out."  The next thing I knew, she was moving her hand back and forth and swaying her shoulders, dancin' in that bed!  I said, "Do you want your position changed?"  She nodded.  To be sure I was correct in my assumption, I asked if she wanted me to summon the nurse to change her position.  Another nod.  Two nurses came in and changed the pillows propping her swollen hands and got her head into a comfortable position and left.  I said, "Mom, are you more comfortable now?"  She nodded, and I said I was going to go home now, but that I would be back tomorrow.  I got a wink from her, and proceeded on my way.

With every story of suffering, there are those laughable moments, and this hospital stay is no exception.  One afternoon when I got to the hospital, a soap opera was on.  I was tooling with my Netbook computer, and would look up at the television periodically.  Then a scene came on with a nun and a pretty blonde exchanging some crazy dialogue about the trouble they were in and how they felt about each other. The nun was a man!  My coworkers understand soaps better than I do and talk about them constantly, so if I really want to know what's going on with that one, I'll have to ask one of them.  Better yet, I'll just pretend I never saw it!  The next day, a physical therapist came in to massage Mom's swollen arms and to get her to do some leg exercises.  While he was there, I was telling my sister Lisa of the crazy scenes I had seen the day before. She laughed and said, "Yea, Mom likes to watch The View, so the TV was probably left on." The physical therapist said to Mom, "You like the show filled with man haters!"  Mom, who will never quite lose her sense of humor nodded proudly.  Everyone in the room laughed out loud.  She's still got it!

Just one month ago, we had her marching through Philadelphia for my daughter Karen's graduation from Temple University.  She's one hell of an 86 year old!!

One day at a time............

The Same Scene With a New Perspective

BLUE                    W              T              S                       GREEN

DARKNESS           I               I               P                 SUNLIGHT

BLIZZARD             N             M              R                         CALM

GRAY                    T              E               I                     VIBRANT

ANXIETY               E                              N            CONFIDENCE

MELANCHOLY     R                              G                  CONTENT

SICKNESS                                                                   HEALING

The Silver Lining

It's been rough watching my Mom on oxygen for three days, and then on a ventilator for seven and counting.  Now, I have this inner feeling that things all around are moving in an upward direction.  There's talk of weaning Mom from the ventilator beginning tomorrow.  Tonight she winked when she saw my daughter Karen.  Then my sister Stephanie said, "Don't I get a wink, Mom?"  Mom winked at her.  Never one to be outdone I said, "Can I have two winks Mom?"  I got my two winks!  :)   

THE WEEK FROM H.........EAVEN: The Graduations

                                                                                                                   

 Hard to believe, but in just one short week, I became the proud father of two college graduates!   

 

                                                                                                                         

My son John graduated from Indiana University of Pennsylvania on

May 7th, 2011. 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
My daughter Karen graduated from Temple University in Philadelphiajust five days later on May 12^th.

   

Wasn't it just yesterday that the principal of my oldest son Kevin's preschool had to grab one of John's hands while I grabbed the other one, and together we dragged him to the car.  You see, John threw a tantrum because his big brother got to be dropped off at school and he wanted to stay, and I had newborn Karen on my back in a carrier.  The other preschool  parents looked on  with sympathy and relief that it wasn't their child.  My desire to low key my arrivals and departures at   that school was severely jeopardized.  John has grown up into one of the most laid back and caring individuals I know. He is comfortable in his own skin and we are so proud of him and celebrate his milestone!

...and Karen...what can't you say about Karen?  This is the girl who had a neighborhood kid fall on her on a backyard jungle jim and exclaimed that she couldn't breathe.  We rushed her to the car and took her to the emergency room, had her examined, and got the good news that no bones were broken.  Years and years later, she and I rode in the car together and she informed me that about half way to the hospital, she began feeling better, but didn't want to tell me because we were so close to the hospital and she thought I would get mad.  Karen has grown into a caring, kind and hard working girl.  She has grown her hair and donated it to Locks of Love several times. She is a leader, a learner, and a doer.  We are so proud of her academic and professional achievement!  Catch her on Action News by following the link below!

http://abclocal.go.com/wpvi/video?id=8127890&syndicate=syndicate&section

There were many famous and fantastic speakers at their graduations, but John and Karen were our stars!

Congratulations kids.....We love you!

...No, Sirius-ly!

_PROBLEM:

     _{I am a stickler for clean, uninterrupted sound when I listen to my music.  Years ago, when I played records, I listened until the record was scratched, and either I heard the same lyric in a song over and over and over again…or I didn’t hear the lyric at all because the record skipped.  I didn’t make any conscious movements because I didn’t want to make the record skip.  I wanted to hear the music as it was meant to be heard.} 

     _{I never listened to 8 track tapes because, although they didn’t skip or scratch, they interrupted a song in the middle while the track changed, and then the song resumed a few seconds later. It was unsettling to say the least.  I was never fond of cassette tapes either because they never had the oomph in the sound provided by a record and usually there was an unwanted hissing sound with the recording.}

     _{Then cd’s came along and I resisted buying them because one would need to take out a second mortgage to replace his record collection.  Finally prices came down and I did make the jump to cd’s, but, alas the jump was a short one because now we have ITunes and can download music and put it on an Ipod, so I can have thousands of songs on a little doohickey.  My cd’s could be put on ITunes and the Ipod too!  I could carry my whole music collection in my palm!}

     _{So why…..why I ask you…do we have this thing called Satellite radio?   I never did like listening to the radio much because I can’t stand commercials, and I like to select the music I listen to, not have some computer or deejay select a music mix for me.  Now I am driving in the car with Satellite, and am listening to a comedy channel with Bill Cosby telling me about his childhood hernia, and the kids in the hood and Fat Albert were ‘hey-heying’, and I was laughing and laughing, and I couldn’t wait to hear the final punch lines.  Then it happened.  I passed a row of trees and…..hissing coming from the radio!  No Bill Cosby, no hernia, no Fat Albert, no doctor, no nothing…for 15 seconds.} 

     _{By the time I was finished with the row of trees, the signal returned and there was no more Bill Cosby, but a different comedian with another funny story.  I wasn’t going to miss the end of this one too, so I switched to 60’s on 6.  They were playing the best mix of commercial free music!  Creedence, Marvin Gaye, and ‘I’m a Believer’ by the Monkees.  My favorite part of the song was coming!  The part where Mickey proclaims, OOOOOHHHHH, I’m a believer and I couldn’t leave her if I tried… but with today’s advances in music listening, it became   OOOOOHHHHHH, I’m a b (ssssssssssssssssssss) eave her if I tr (ssssssssssssssssssss), Ah Yes I saw her face, now I’m a believer…….} 

     _{You can’t play a record in a car, and you may have a hard time finding something to play it on anywhere.  No cars come with cassette players any more.  I find the radio unbearable.  If I have five different stations programmed in, all five are having station breaks and commercials at the same time, or playing songs that are just okay, and all the voices are sounding alike to me.  Now, I am the proud owner of Satellite radio and am paying for the agida*…yes, paying for my digestive system to be compromised by interrupted music and comedy routines.  After a couple days of listening to Satellite, I am listening to a music mix that someone else has selected for me, and I am hearing the same songs and comedy stuff over and over.}    

_SOLUTION:

_{When the radio gets kind of boring,}

_{And I want my own tunes to start roaring}       

           _{I get my playlist out}         

          _{And soon I get blissed out}

<sub>And play all the music I’m storing! 

*agida - ah-jid-ah - Italian - indigestion, heartburn!</sub>