Showing posts with label musings. Show all posts
Showing posts with label musings. Show all posts

Friday, December 28, 2018

1-day Breathers vs going on Long Vacations

Source
Every year, most of us look forward to going on vacation which is usually travel-related.
We work long hours straight for months then the most awaited time arrives.  We go on a 1-week, 2-week or 3-week long vacation.  Then when we come back from the trip, we say - it's back to reality!  Until the next vacation time again. πŸ™Š  Or we say - the trip was the best but I feel so tired. I think I need another vacation to recover from the vacation. πŸ™Š πŸ˜‚

This year, I experimented on something new. I didn't book any  trip but instead I went on 1-day breaks on random days so I would have more frequent breathers throughout the year.  On some of these days, I attended important occasions like birthdays or funerals, some days were for personal business, projects, volunteer work and errands, other days were to catch up with friends visiting overseas, and there were also days which were really just for me - to do whatever I wanted to do whether it was to catch up on sleep, read, swim, get a massage, re-pot some new plant sprouts, or just be idle at home and enjoy my solitude.  πŸ˜…

Were the short breathers any good? Yes!

  • If you have 15 annual vacation leave credits, you could look forward to some kind of vacation 15 times during the year. Those are 15 opportunities to decompress. πŸ™ŠπŸ˜œ
  • Since the activities don't require travel nor are jam-packed with hour by hour itineraries, you don't feel tired after each 1-day breather.   In short, you don't need a vacation to recover from a vacation. πŸ˜‚
  • You save a lot - no hotel and airfare expenses - but it brings a different kind of joy as you're able to create other kinds of experiences and memories too.
  • You're able to finally do some of the things you've been saying you would do as soon as you have the time.  The one day breathers become your freed up time.  If you went on your usual trip, the year may end with you not having found the time to do some of these things again as you have your usual activities on weekends.
  • You get to somehow experience the life of a retired person - you can do whatever you want to do with your day.  When you go to stores during work hours, you could just be the only customer. πŸ˜‚  When you go to the salon or spa during work hours, they could accommodate you even if you don't have any appointment. πŸ˜‚ When you swim, you have the pool by yourself.  πŸ˜‚
If you're up for a different kind of vacation, try one day breathers sometime.  Wednesday is a great pick coz after working for just 2 days, yay, it's vacation time, then after another 2 work days, it's the weekend.😊  Friday is a great pick too if you want to enjoy longer weekends.    But you know what's even better than 1-day breathers and long vacations combined?   If you're able to design your life so well that you would never have the urge to decompress. 😜   

Saturday, October 14, 2017

Simple joys that don't cost anything

A lot of articles and books recommend that you keep a gratitude journal coz it has a lot of benefits like it lowers down stress levels and gives one a greater sense of calm at night.  But I don't keep a gratitude journal because if I do, its content would be a hodgepodge of ordinary things and everyday sights, and I'll most likely write the same things over and over.  πŸ˜‚ 

Here are some of the things that bring me joy and I'm thankful for -  in random order.   And the best part is - most of them don't cost anything.  😜


  • Being able to quickly fall into sleep wherever and whenever e.g. on the plane, in a hotel, in another person's place, in the car (as long as I'm not the driver! πŸ˜‚).
  • Having a restful sleep and being able to sleep straight through the night. πŸ’€
  • Waking up in the morning without a set alarm.  
  • Simply waking up in the morning - realizing I'm still alive!😜 
  • Quality time with family and friends.
  • Having all my 5 senses intact - sight, touch, smell, hearing and taste.  
  • Going home for lunch on a work day (mid-day "me" time!πŸ˜† )
  • Being able to empty a shelf/shelves after decluttering (this means I'm able to live on less). 
  • Quick catch up chats with friends.  I don't see them regularly and some of them are based overseas living in different time zones so it's difficult to catch one other.  But when we do chance upon one another, even just 5 minutes of catch up time brings so much joy.  
  • Seeing or being with babies and/or kids. πŸ‘ΆπŸ‘ΆπŸ’–
  • The sight of grandchildren assisting their elders or grandparents. πŸ˜ŠπŸ’–
  • The sight of old couples holding hands and laughing together. πŸ‘΅πŸ‘΄πŸ’•
  • Seeing a rainbow.  
  • Being able to empty my email inbox (though this rarely happens!😜)
  • Having quiet time to read a book.
  • Having quiet time to write.
  • Uninterrupted weeknights and weekends. πŸ™ˆπŸ™‰πŸ™Š
  • Sitting on my La-Z-boy rocker recliner or any rocking chair.  The rocking motion is therapeutic (translation: lulls you to sleep!πŸ˜‚).
  • Taking a walk at the park.
  • Having siesta after a heavy meal.  πŸ˜‚ 
  • Going back home after a trip (coz I'm excited to hug my pillows and sleep on my real bed). πŸ’€ 
  • Seeing a new plant sprout. 
  • Staying in bed on a rainy day. πŸ’€
  • Enjoying a bowl of soup or cup of tea.
  • Having no meeting appointments on my calendar - this means I can focus on my to-do list.   
  • Cancelled meetings -  it gives newly-freed up time which I could use for something else. 
  • Being able to empty my fridge before a long weekend or a trip so my fridge can also go on vacation. πŸ˜‚ 
  • Watching the sunset.   I love sunsets more than sunrise coz I don't like waking up in the dark and waking up too early.  Haha..
Oh my, I just realized a lot of the random simple joys that popped into my head are sleep-related.  It's a clear sign I am sleep-deprived!  Haha... πŸ˜‚   

Thursday, October 5, 2017

Tips on How to Prevent Back Problems + Life Lessons

Have you ever gotten a back problem?  It's excruciatingly painful, right?

I've so far had 2 episodes in my lifetime and they are both travel-related (due to heavy baggage!😜).  The first one I ended up seeing a chiropractor but I'm glad I did coz the chiropractor taught me how to  properly get up from the bed (turn to your side near the edge of the bed and with one arm in front of your upper body, push up to stand and let your legs swing towards the floor).  He also gave me stretching exercises which greatly improved my back and which I still do everyday.

The second one was last year when I tried to weigh our luggages using a portable scale but I forgot to bend when I lifted them!  When I woke up with back pain, I initially thought it was due to the bed so I did some exercises to ease the back pain (wrong move coz this just worsened my condition). The following morning, my upper body felt like it was disconnected from my lower body.  Yes, I could walk - but really slow - and it was so painful to get up from a lying down or sitting position.  I can't even laugh coz my lower abdominal muscles hurt when I laugh.  Riding a car is excruciatingly painful too - every bump, brake or sudden turn cause your insides to hurt.  And when I lie at night, I was stuck with one position coz I could no longer move the moment I lie down. 😱😒   

What made the situation worse at that time were:  (1) I was overseas, in Copenhagen, and (2) in a few days was my return flight to Manila.  The flight was about 18 hours.  Do I need a wheelchair so I make it to the boarding gates?  How will I be able endure the long-haul flight?  How will I pull out my heavy luggage from the carousel (coz my friend gets off in Singapore which means I'll be alone in the last leg of the flight)? 😰  So I did a lot of research on what I could possibly do and here are the things that worked for me: 

1.  To get up from a sitting position, the best technique I found was to move my butt until it's near the edge of the chair, then slowly push up using my hands against the arm rest.  (When I stand up though, I look like an elderly - I'm in a hunched position holding my lower back and I walk in that hunched position. But after a few steps, my back finds its position and I'm able to walk with a straight back.)  

2.  I massaged the pressure points (where I could feel the pain most) in a single direction (e.g. downward only).

3.  I meditated frequently during the day and imagined all the painful parts of my body were healing internally.

4.  Prayed a lot!  πŸ™πŸ™πŸ™

I survived the return flight to Manila (without the need for a wheelchair) and strangers helped me with my luggage. Whew! 😌

Within 12 days (since the problem occurred), my back fully recovered. I didn't have to see a doctor or chiropractor.  I would normally seek medical help but for this one, I knew the pain was due to pulled muscles, not broken bones.

Since then, I've been more careful when lifting or carrying heavy objects - never forget to bend.  I actually don't even want to  lift anything heavy now if I could avoid it. Haha.... πŸ˜†

I thought bending properly when lifting heavy objects is all I need to remember so I won't hurt my back again.   But last week, I accompanied someone to the rehab doctor and I learned other bad habits I unconsciously do which could possibly hurt the back too.  Take note, I wasn't even the patient but there I was, probably more attentive than the patient.  πŸ˜‚

Below are the new things I learned from the rehab doctor - with visuals I found online for easier reference.  

Here's the proper way to wear socks, sandals with straps, or shoes with shoelaces or zippers - 


Proper posture when putting on your shoes (Source)


Proper way to wear shoes (Source)

Here's the proper way to mop or sweep the floor.  You could also bend both of your knees.


Proper posture when mopping or sweeping the floor (Source)

I couldn't find a visual for the last common mistake we unconsciously do but it's the correct posture when washing your hands or face on the sink.   The correct posture is - you also need to bend your knees to adjust to the level of the sink.

The rehab doctor said that we don't have to wait until we're old or until we start having back problems to start practicing these because these are the correct postures regardless of one's age.  Need to start correcting my bad habits asap. 😬

I call my back problem experience last year as my early lola (grandmother) moment.  It wasn't a pleasant experience but right after I recovered, I realized I was also lucky because it made me realize a lot of things.  For example, it doesn't mean just because someone looks young and healthy, he/she is as strong or fast as you are.  When we see people who are walking slowly,  maybe they wish to walk faster but they just couldn't because they have physical limitations which we couldn't see.    When we see people who don't smile, maybe they wish to smile but they just couldn't because they don't have any reason to smile or they are in so much physical pain.

The experience also gave me an early glimpse of what lies ahead.  Someday, our minds may still be active and alert but there will come a time when our bodies won't be able keep up with what our mind  wants or wishes to do - no matter what.  So whatever you want to do now while you still physically can, it's time to do it now. πŸ˜‰ 

Wednesday, August 23, 2017

How I Became an Accidental Minimalist

I can't believe it's been over 4 years since I've become an accidental minimalist. Accidental because I didn't mean to become a minimalist.   One day, I just decided to dispose all of my furniture except for 2 small pieces  (shoe cabinet and console table) with the intention of redesigning my place.  And yes, when I say all furniture, that included my bed frame so I was just left with a mattress on the floor.  πŸ˜‚

And then when I went shopping for furniture, I purchased a dining set BUT while I was waiting for the invoice, the sales personnel asked me to sit on a La-Z-boy and that was it - love at first sight sit! 😍 πŸ˜‚   I cancelled my dining set transaction and bought the La-Z-boy instead.  Wahaha.... πŸ˜‚

For 6 months, I never went shopping for any other furniture coz I was super happy with my La-Z-boy that I didn't feel the need to get any other piece.  Please note though that I don't like entertaining guests (it's the introvert in me) which explains why I only need one chair very little. πŸ˜‚


My La-Z-Boy

In those 6 months when some close friends dropped by my place, they had to take turns in sitting on my one and only chair while the rest had to sit on the floor.  πŸ˜‚ πŸ˜‚ πŸ˜‚

On the seventh month, I was forced to buy a table and chair coz I had to finish a case study for a short course I enrolled in.

My TopTop Table and Ghost Chair

The table looks big in the photo above but that's only 27 inches in diameter which means it's really good for one person.  And which means I have to empty the table every time I work and every time I eat coz it's both my work table and dining table. πŸ˜‚  And which also means it can't be used for duck, cover and hold purposes during an earthquake.  I actually tried and I think I have better chance of surviving under the mattress. πŸ˜‚

So for the last 4 years, those are just my pieces of furniture.  I never bought a bed frame or any other piece coz I realized it was easier to clean when you've so little.

And then last month, I went to Shanghai with friends and we stayed at the Fairmont Peace Hotel.  In the evenings, I had to do some work and I super loved the big work desk in the room! 😍    I knew then I had to get a proper work desk (which also means my other table would officially become a dining table).  πŸ˜‚

So last weekend, I went around to look for my work desk and the store delivered it today. Yay! The furniture store though forgot to bring the chair so I have to use my one and only movable chair in the meantime.  πŸ˜‚  


A proper work desk - finally! 

I had to take a photo of my new desk while it's still uncluttered coz I don't know how my desk would look like by next week.  πŸ˜‚

BTW, see the cork board on the wall? That is my Kanban board.   When I started using the Kanban method last year, I started with post-it notes on my wall.  πŸ˜‚     I strategically put the cork board on that spot to cover the bracket holes of my old TV  - which I also gave away coz I realized I rarely turn it on.   I'm happy watching on a small screen - my iPad.  πŸ˜‚

So no sofa,  no dining set, no TV....  I wonder - is this minimalism or is it just a an introvert's space designed for one's self and not for entertaining guests?  And I haven't even started talking about my dishware - my 2 sets of plates and bowls.  πŸ˜‚

Saturday, April 15, 2017

Tips when visiting a Home for the Aged or Nursing Home

Source
I've a soft spot for kids and the elderly.  Kids because they are just so adorable - no explanation needed. :)   Elderly because they remind me of my parents, grandparents, grand-aunties & grand-uncles, titas & titos, ninongs & ninangs (godparents), the parents of my friends, and all the elderly people (including strangers) who have touched my life and imparted words of wisdom which I never quite understood until I hit my mid-20s.  So ok, they were right about almost everything!  Wahaha....

Anyway, sometime last year, I heard one talk which mentioned that the elderly is one of the most marginalized groups in our society and that fewer people visit homes for the aged than orphanages.   I guess people gravitate towards helping kids more than the elderly maybe because it's easier to interact with kids, the mood is lighter and activities are playful and fun.  Versus when you think about the elderly, it evokes some kind of seriousness, nostalgia, and even some degree of sadness.

After realizing how marginalized the elderly are,  I made a mental note to visit a home for the aged but unfortunately, I never got around doing it last year.

Last weekend, I was supposed to do other things but the idea of visiting a home for the aged just occurred to me out of the blue.  I called up the home for the aged I was eyeing to visit last year and inquired what they needed. A friend and I got the supplies and headed there.

When we delivered the boxes of supplies to the kitchen, the nun exclaimed "Do you know you're an answered prayer?!".  She explained to us that the day before, they didn't know where to get their food and pantry supplies so as usual, they just prayed to God and trusted He will answer them. And there we were bringing exactly what they needed. (But of course, if we didn't call to ask what was on their list, we would not have known what they needed!  So if you want to be an answered prayer too, make sure to call the home you plan to visit to check in advance what they need. Haha...)

Anyway, during our visit, there was some outreach activity scheduled that morning so it looked like we wouldn't be able to interact with the elderly. :(   But the nun told us we could tour the facility before we leave.

When we reached the second floor, we saw another nun who was with an elderly on a wheelchair (it seems that she opted not to join the outreach program).  The nun said it was lola's (grandmother's) birthday -  her 87th birthday if I remember right.  To free up the nun, we said that we could take care of lola for a while.

Before we knew it, the morning outreach activity was finished and all the other lolos (grandfathers) and lolas (grandmothers) returned to their respective floors.  We talked to more lolos and lolas and before we realized, it was lunch time already! We decided to stay on to assist feeding the lolos and lolas....  and we stayed on until the lolos and lolas were safely tuck in to their beds for their afternoon siesta.  One thing just led to another.  The nun who welcomed us in the morning was so surprised to see us still there after 4 hours.  All the while she thought we have left!  Haha...

Anyway, if you're planning to visit a home for the aged or nursing home, I've compiled some useful tips below:

-  Ask for advice on how to best handle each person from the people taking care of them.  They know the behavior of each individual  - if they are in a good/bad mood, what gestures or words would make them smile or be obedient, what words or topics you should avoid bringing up, etc.

- Do gestures that show your respect such as making "mano" (bringing the back of their hand to touch your forehead).  They also appreciate any sense of touch such as holding their hands, gently rubbing their arms or shoulders, or gently stroking their hair as you talk to them.

- When you talk to them, be sure you're at eye level.  If they are on a wheelchair, kneel on the floor or pull a chair so you can talk to them at eye level. 

- Don't ask about their birthday.  Some of them get agitated and some get overly excited when they realize their birthday is coming soon.  They might have a hard time sleeping for weeks in anticipation of their birthday.

- Don't be surprised if they ask you the same questions every 3 minutes coz some of them have Alzheimer's disease already.  This isn't an exaggeration.  A lola asked me the same set of questions (always in the same sequence) every 3 minutes.  If you begin to notice that the conversation becomes repetitive or going around circles, most likely, you're talking to someone with Alzheimer's.   Just go along and answer every question as if it's the first time it was asked - every time.

- Be patient. Some could be really grouchy no matter what you do to please them. But don't take it personally.  You have to remember that they have emotionally gone through a lot - some have been abandoned by their family members and others no longer have any living relatives who could take care of them.   In addition to the emotional burden, imagine the physical challenges  - being weak and helpless, experiencing bodily pain and discomfort, having blurred vision, loss of hearing and limited mobility.  Then there's also the threat to mental health such as losing one's memories to Alzheimer's and dementia.   It's ok if you weren't able to make them smile or laugh even after giving your best effort. What matters is they know someone still cares about them.

- When feeding the elderly,  slice their food into small pieces and mix everything with the rice.  Be attentive if they chew on something hard.  Just allow them to spit it out and cup it in your hand. And don't forget to wipe their mouth clean when food leaks.  When assisting them to drink, make sure to tilt the cup slowly to control the flow of water into their mouth.

- Listen to them - it's probably the most simple gesture you could do to make them feel they are cared for.  The elderly love to talk a lot - they could be anecdotes about World War II, stories about their proudest moments, or sometimes their complaints about life.  Just let them initiate what they want to talk about and go along with that topic.  As much as possible, don't ask personal questions as it might trigger sad or bad memories - unless it's the elderly himself/herself who initiates the topic.      

- Respect their privacy.  Strictly no photos and videos, and no publicly sharing of their private lives and identities.

- Plan your visit during off-peak season - away from Christmas season. From what I know, donations and visitors in charitable institutions spike from November to February (around Christmas season).  So better if you could time your visits in between so hopefully, there would be a steady stream of volunteers and donations throughout the year.

- Contact the home for the aged to find out what they items they need. Sometimes, they have a surplus of certain items and they lack in some.  So to be sure what you bring is useful, better to check with them beforehand.  Some nursing homes are also open to voluntary services like feeding, bathing, walking the elderly, giving haircuts, etc.

The home for the aged we visited is called the San Lorenzo Ruiz Home for the Elderly operated by the Little Sisters of the Poor.  Here are the contact details if you wish to visit, donate or do volunteer work:

San Lorenzo Ruiz Home for the Elderly
50-B Lancaster Street
1300 Pasay City, Manila, Philippines
Phone:  (632) 8329689 . (632) 8322915

When we said good-bye to the nuns, I asked one of them if she won't be having her afternoon siesta to which she joyfully replied, "No, I don't need to rest now because when I die, I will get eternal rest!"  Haha... :)

Anyway, I wanted to end this blogpost with a beautiful quote I read from the book "Final Gifts".  It's a quote from Dr. Cicely Saunders, founder of the modern hospice movement, of palliative care.  She once said (addressed to the dying) -  “You matter because you are you.  You matter until the last moment of your life.  We will do all we can not only to help you die peacefully but also to live until you die.”  

Beautiful, right?  Now if only we could, in our own little ways, help contribute to that - not only when we visit nursing homes but even in our chance encounters with the elderly. :)

Sunday, April 9, 2017

How to Communicate and Understand the Needs and Wishes of those Nearing Death

My recent read is about dying and death.  Call me a weirdo but I love to read books not just about life but also death.

I think about mortality a lot because it keeps me grounded not to take everyday moments for granted.  Thinking about death also makes me appreciate every single day that I'm still alive.

Ironically, thinking about death isn't sad and depressing.  Go research about the Bhutanese, the happiest people on earth.  They think about death 5 times a day!  I'm not at that level yet though - I only think about death once a day! Haha...

Anyway, going back to the book I read, it's entitled "Final Gifts:  Understanding the Special Awareness, Needs and Communications of the Dying" by Maggie Callanan and Patricia Kelley.   The authors are hospice nurses who take care of  terminally-ill patients and after having witnessed so many deaths for 20 years, they were able to identify similar patterns and recurring themes among the dying. 

For example, you've probably heard stories of people who passed away right after a family member from overseas came to visit.  Or someone who passed away right after a special occasion like a birthday, or after a special milestone was achieved like a graduation of a grandchild.   These are not coincidental.  It's a recurring theme among the dying across different cultures. It is as if the dying person has chosen when to die.  But this is just one, there are several more recurring themes.  

Callanan and Kelley say the messages of the dying fall into 2 categories:

(1) Attempts to describe what someone is experiencing while dying.

The experience of dying frequently includes glimpses of another world and those waiting in it. Although dying people provide few details, they speak with awe and wonder of the peace and beauty they see in this other place. They tell of talking with, or sensing the presence of, people whom we cannot see—perhaps people they have known and loved. sometimes religious figures.  They talk about the need to prepare for travel or a change, or mention some place we cannot see, or describes seeing a bright light.   They know, often without being told, that they are dying, and may even tell us when their deaths will occur.

(2) Requests for something or someone that a person needs for a peaceful death. 

Dying persons’ requests are sometimes difficult to decipher. Their recognition of the importance of these needs, along with concern for family and friends, can cause the dying to control the time and circumstances of death until those needs are met. These requests often involve someone else; they may be for meetings or the healing of relationships.  Or it's a desire to reconcile personal, spiritual, or moral relationships, and requests to remove some barrier to achieving this peace.

For #1, what are the ways the dying attempt to describe to us what they are experiencing?

-  The dying often use the metaphor of travel to alert those around them that it is time for them to die. They also have a deep concern about the welfare of those they love, asking themselves, “Do they understand? Are they ready? Are they going to be all right?” It seems dying people need permission to die. If given, that permission provides great relief; its absence can make the dying process more difficult and lengthy. The dying intuitively know when—and often why—this permission is being withheld, by the behavior of those around them. This withholding indicates that those they love don’t understand their struggle, nor are they prepared emotionally to deal with the finality of their leaving.

To give the person permission, you could assure him/her that “Everything will be fine”  or tell the person “Just let go. I’ll miss you, but I know you need to go now.” 

- Dying people, days or hours before the actual death, often interact with someone invisible to others—talking to them, smiling, waving, nodding, or reaching out for someone or something unseen.  The unseen person’s (or persons') identity often is clear to the dying. Generally they recognize someone significant from their lives—parent, spouse, sibling, friend—who is already dead. There is often a sense of pleasure, even of joyful reunion, in seeing that person again. 

Some see religious figures—angels, perhaps, or spirits. Even when people don’t recognize the figure they’re seeing they don’t appear upset or frightened. They usually were calm as they talked about it, and seemed comforted and more peaceful in the presence of their invisible visitors.  

There's one story in the book wherein the patient was an atheist and she saw an angel by her window.  It still didn't make her believe in God or angels but she told her mom that it felt good to know that she won't die alone as someone who loves her is waiting for her.  

These gestures give us glimpses of whatever dimension exists beyond the life we know.... Knowing that a dying person may be reunited with someone they cared about reinforces our hope that love and important relationships may be eternal.

So when dying people start mentioning of seeing people who have been dead for years, don't contradict them by saying they must be dreaming or hallucinating. Such comments may discourage them from further sharing their experiences. Instead, just encourage to talk more about it like what they see or how they feel, etc.

-  Many dying people tell of seeing a place not visible to anyone else. Their descriptions are brief—rarely exceeding a sentence or two—and not very specific, but usually glowing. They may describe the place as beautiful or lovely, but the response to “Tell me more . . .” often is a dreamy look and a shake of the head or several false starts and then: “I can’t.” Even so a glimpse of this other place seems to bring peace, comfort, and security to the dying person—reactions shared by those able to listen and understand.

-  When dying people repeatedly mention significant items used in family occasions but the timing is off, they may be trying to communicate that he/she may not make it until that occasion that's why he/she is already requesting to celebrate it in advance.  

There is a story in the book where the patient kept telling his wife to "get the sparkler cake now" - the sparkler cake is what their cook bakes for them on their wedding anniversary.  But the wife thought the husband was confused coz their wedding anniversary which is 4th of July was still a month away.  Every time she told her husband their anniversary is still weeks away, the husband would insist to get the sparkler cake now.    The hospice nurse explained to the wife what her husband was probably trying to communicate to her so she had the sparkler cake made and celebrated their wedding anniversary in advance.  The husband died on June 30 and was buried on July 4, their wedding anniversary.

The authors say "in ways that are direct, or subtle, or even silent, dying people are showing us that they do know when their deaths will occur, and that they are not distressed by this information. By listening and understanding these messages, we are given unique opportunities to prepare ourselves for their loss, to deal with our fears of dying, to use well the time that is left, and to participate more significantly in this life event."

For # 2, what kind of requests does a dying person need to die peacefully?  

They could be (1) Reconciliation - whether with a specific person or God;  (2) Removal of a barrier standing in the way of a peaceful death; (3) Unfinished business; (4)  Particular circumstances to die peacefully e.g. choosing the time of their death or the people who will be there. 

The challenge though is sometimes, their requests are vague or indirect and may be missed or ignored, leading to frustration, anxiety, and sometimes agitation (which often the response is to sedate the patient).

Agitation is at its peak if the dying person is close to death and he/she realizes death won’t be peaceful without this reconciliation. This may be what occurs when someone seems to die in pain; rather than physical, the pain may be emotional or spiritual. These types of pain can be harder to relieve, and far too often go unidentified or ignored.   Understanding issues that need resolution can enable us to better assist dying people and help us realize the need for reconciliation and completion in our own lives.

There's a story in the book where one day, the patient became restless and anxious and she was complaining “I can’t find the feed for the horses!”.  The hospice nurse, to encourage her to explain further, asked "Why do the horses need feed?”.   Then the patient answered “I’d never make them take me on this trip without feeding them first!” she answered. 

The hospice nurse then tried to decipher with the patient's family what could feeding the horses meant.  One of the patient's granddaughter connected it to the farm where her grandma grew up were grandma's family used horses and wagon to go around.  Then they tried to decipher what could she have meant by "I’d never make the them (horses) take me on this trip without feeding them first!”.  Who could be the unfed horse/s who won't allow her to go on her trip if she doesn't feed them?.  They realized the horses may symbolize her children.  Apparently, the patient had an estranged son.   If there's even one unfed horse, she won't be able to go on her trip.  So the family arranged for a reconciliation between mother and son. Since the reconciliation, the patient never mentioned about feeding horses again.  The son spent quality time taking care of her mom for the next 2 weeks until the mom peacefully died.  

Another important thing we need to know - just before they die, and usually without warning, some patients can muster an unusual strength. Unfortunately, some use that strength to try to get out of bed, and subsequently fall. Afterward, the family feels a terrific amount of guilt, and may blame the fall for causing the death. A frightened and tearful family member may say: “Dad just died. He was trying to get out of bed and fell to the floor! We’ve been with him all the time, but I’d just run down to the kitchen for coffee. I feel just awful. It’s my fault; if I’d been there this wouldn’t have happened! How could this have happened, anyway? He’s been semiconscious, barely responsive for the past two days, didn’t even have the strength to hold a glass of water. He was too weak to move at all by himself! How could he get over the bed rails? I don’t understand it! How can I live with this?” 
Instead of assuming the worst, it’s best to ask a few questions: What were the dying persons trying to do? Were they seeing someone or some place invisible to us? Were they trying to go there? Was someone that we couldn’t hear calling them to come?

The authors aren't suggesting that it’s all right for dying people to fall out of bed. But what they want to highlight is no one knows the reasons for this phenomenon of reaching out—and sometimes climbing out of bed—in the last moments of life. The fall may not have caused the death; the person might have died at that time, whether he fell or not. The fall may have resulted from his response to something he was experiencing while dying.

Sometimes people wait for some other reason: perhaps a grandchild’s birth, or a son’s graduation, or a family member or friend who needs to say goodbye.  We've heard a lot of these stories - this is probably the most recurring theme we're familiar with.  But what's new to me is the information that some people choose to die when their loved ones are away to spare them the anguish of witnessing their moment of death.  Some even choose to die alone particularly those who are very private. (Uh-oh, that's me! Wahaha...)

In the book, here's a common story to illustrate when a patient chooses to die when their loved ones are away:  Family member/s or friend/s has/have been by the patient's bedside for days or weeks.  One random night, the patient tells them to get some rest.  That same night, it is when the patient chooses to die.   If you've experienced something similar, instead of feeling guilty for not being there, also consider that maybe it is how the patient wanted it to be.

That's surprising info for me - that many dying people are able to exercise some control over their deaths - of the time, the circumstances and the people present. 
A long time ago, when my dad passed away and I was trying to better understand the grieving process, I read somewhere that one of the stages you undergo is guilt where you try to connect yourself to your loved one's death even if there is no direct connection. It could be thoughts like - if only I did ___ or if only I was there, maybe he would still be alive.

I like what the authors wrote in the book.  They said - 

Understand that if the dying person wants you there when death comes, you probably will be there; if he doesn’t, you probably won’t. So keep going about the business of living without worrying about whether you’ll be there or not, and don’t feel that you’ve failed if you aren’t there when it happens. Recognize it as the dying person’s choice and possibly a gift of sparing you.

Beautiful insight, right?  Especially after knowing that the dying could exercise some kind of control over their deaths.  Thus, if there's some kind of guilt, regret or unresolved feeling that has been bugging you over the death of a loved one, understand that perhaps that was how he/she wanted to go. 

So many learnings from the book.  Hopefully knowing all these would help us assist those who yearn for care, closure and reconciliation should the need arises.  

Friday, April 7, 2017

How to interpret the meaning of your night dream

Source
When I dream in my sleep, they are usually vivid - vivid in details and in color (I know some people who dream in black & white). Sometimes they are so vivid that I'm not sure if they really happened until I wake up and realize that the dream's setting is of a different day, time or place. Haha...

The other week, I had a weird and somehow entertaining dream.  I'll narrate it here but no judgment, please!  Haha... After the dream, I'll tell you how to interpret and decipher if a dream has meaning.

So here was my dream -

I was home (though in the dream, the unit looked different from where I live now).  The unit was at the ground floor.  If you exit at the front door, it's a residential area while if you exit from the back door, it 's a commercial area.

I was organizing stuff in the unit (seems like I just moved in) when the doorbell rang.  At the door, there were 2 technicians who came to install my broadband connection. I had to rush fixing my stuff so I can let them in.

The following day (imagine, the timeline in my dream was 2 days! Wahaha...), a friend (unidentifiable in my dream though) and I were walking to my unit and as we were approaching it, I saw the front door ajar.  I immediately knew someone broke in.  When I rushed in, I saw that the place was almost empty except for a chair and table.  I rushed to the back door to see if I could still catch the thieves - maybe they are still loading the furniture in a truck.  But there was no truck in the back alley - only a parked bicycle!  My thought bubble was - could that be one of the getaway vehicles of the crooks?  Wahaha....

I got out of the busy commercial street trying to scan the passing vehicles for some suspicious vehicle carrying my stuff. I even remember seeing a calesa (horse carriage) on the road. Haha....

Since there was no sign of the crooks (they must have gotten away already), I decided to head back to the unit.  When I entered the living room, I was surprised to see 3 people - one was seated on the chair and the two were busy packing items on the table.

I asked them - "Hey, who are you? What are you doing here? Did you take my stuff?"

The girl seated on the chair (who looked like the leader of the group) said "Yes."

I asked - "But why did you do it?"

Then she answered - "Coz our mom passed away but we don't have money to buy a coffin".  Then she stood up, showed me a body bag on the floor, unzipped it to reveal a woman's corpse!

I said - "That is really so sad. I'm so sorry."   I no longer felt bad about them stealing my stuff.   Instead I felt so sad and sorry for them.

My friend interjected and told me - "What?! Will you let them get away just like that?  You should be mad!"

And then I said - "It's ok coz they need to buy a coffin so they could properly bury their mom."

Then I approached the 2 people packing on the desk and asked them - "What are you doing?"

They said - "We're packing your last few items for shipping."

I was puzzled.  I asked - "Where are you shipping them?"

They answered, "To the winning buyers online."  (That's apparently how they disposed of my items to raise funds! Wahaha...)

My friend interjected again - "Hey, those are your remaining stuff! Don't allow them to ship them out.  Get them back!"

To which I replied - "Wait, let me think what I need."  Then I scanned the unit and saw my closet.  I asked "Are there any clothes left in the closet?" (coz I realized I need a change of clothes plus I recalled that I bought some new clothes the previous week which were still unworn.  I thought sayang that I wasn't able to wear them yet. Haha...)

But they answered - "Sorry, your closet is empty already."

I replied, "Oh, ok."

Then I suddenly remembered something I badly wanted back.  I asked - "Do you still have my action camera and the SD cards?"

Then they said - "We're so sorry but we already sold it including the SD cards."

Then I said - "Can you please trace the buyer so I can contact him/her and get a copy of my video files?  You may continue disposing all of my remaining stuff but can you please help me retrieve the SD cards, please?"  To which they said yes they'll try to trace the buyer.

And that's how my dream ended.  Wahaha....

They say that when you dream, it could mean a lot of things - it could be a warning, a manifestation of some unfulfilled wishes, unresolved feelings, factual truths, or maybe it's just a compilation of unrelated events happening in your life.

So how do you know if your dream has real meaning?   First, it's important to reflect what are the possible incidents/triggers that might have led you to dream about a specific person, object or event coz if you don't take that into account, you might overanalyze and conclude that your dream has some grand meaning when if fact, it's just a compilation of unrelated events happening in your life.

For example, what could my dream possibly mean?  How come there was a corpse? Why were the crooks packing and shipping my items?  What's with the action camera? :)

Before you overanalyze and interpret, here's my reflection about the obvious meanings and some hidden truths about my dream:

Why the place looks different from my current condo  - I've been toying with the idea if I should move to a new place.

Why the unit's front and back doors open to residential and commercial areas  - I've always enjoyed the best of those 2 worlds - a quiet neighborhood but still near to commercial areas.

Installation of broadband connection -  I've been thinking if I should get one coz I've just been using my mobile phone as hotspot. Haha...

The break-in / theft - Maybe it's a warning?  I need to take precaution so it doesn't happen.

Trying to catch the thieves and look for clues -  I love Sherlock. But I'm more like Sherlack in the dream - lacking in deductive reasoning.  Wahaha...

Woman's corpse in a body bag - That night when I had the dream, I watched a zombie tv show which had that exact scene -  unzipping a body bag revealing a woman's corpse. Wahaha....

Why was my reaction like that - still cooperative to the people who stole my stuff?  In real life, I'm really like that! In college, I was walking along a busy street near my university and a snatcher stopped me in my tracks because the gold bracelet he just ripped off my wrist was missing. Both of us searched for it and when I suddenly found the bracelet hanging on my bag strap, guess what I did?  I said "here you go" and handed the bracelet over to the snatcher!  Wahaha....

What's with packing items and shipping them?  While I was watching the zombie tv show that same night, I was preparing packages to be shipped out the next day.  They were Christmas gifts for some kids I never got to see over the holidays.  They've been gathering dust for the last 3 months so I had to dispatch them already before it's Christmas season again. Haha...

What's with the unworn clothes?  It's funny but I did buy some new clothes the previous week. Haha... And like in my dream, it's really sayang (such waste) if you lose something without having had the chance to use them yet.  So I guess this is a reminder for me to double-check if I still have unused items which I need to start using or give away if I don't actually need them.

And what's with the action camera? I bought an action camera in December which my cousins and I call GoPoor (coz it cheaper vs a GoPro! Haha...).  And there are 2 reasons why I bought it:  (1) Other than photos, I want to preserve memories of family members in videos coz I don't have any video footage of my dad which I could easily watch when I miss him.  Photos are good but videos of them interacting with you on camera allow you to preserve memories better - you could replay a memory exactly how it happened - how that person looked into your eyes or waved at you at that moment you took the footage.  (2) I want to capture videos of my travels the way I saw the place.  It would be a more visual way to re-live travel memories vs photos.  Plus, I think it might be more time-saving to edit a video than to sort hundreds or thousands of photos (but I've yet to prove this. Haha....).

And what's with my strong desire to retrieve copies of the video files?  During the holidays, I did take family videos and yes, the files are still in the SD cards. But more than just this being a pending item on my to-do list, the real significance here is if you were to make me choose what one material item I would like to save, that would be photos or videos of loved ones.  As proof, many years ago, photos were also the only items I thought of securing when our house was threatened by lahar flows.

Like in my dream, after the bad incident happened, I didn't mull over all the material things we lost.  I was just so relieved that all my family members were safe and that our family photos were kept intact.   (Btw, you might be wondering why physical photos are such a big deal to me?  During my childhood, there were no digital cameras and no social media sites yet so the only proof of childhood memories are physical photos. Haha...).   Anyway,  it's amazing that even in my dream, I'm so consistent - I'm still able to identify that among all material possessions, I'm ok to let go everything except for family mementos.  Haha...

Thus, in order to decipher if a dream has real meaning or not, you really have to identify what are the important elements first, and then reflect what could have triggered you to dream about each element.  As you can see in the case of my dream, at the onset, it seemed that my dream is super scary, right?  But after breaking it down and analyzing the elements, I realized that it's just a hodge-podge of what's happening in my life with some hidden truths and useful reminders.  So the next time you dream something that seems scary or bad, don't immediately panic.  :)

Oops, but there's one remaining element in my dream which I couldn't quite figure out  - what's with the calesa (horse carriage) on a city road?  Wahaha.... :)

Friday, April 15, 2016

Learning how to swim - as an adult

Source
When I was a kid, I never learned how to swim.  The only thing I learned on my own was how to float on my back.  Take note, it's just floating on my back, not backstroke.  Wahaha...

The reason?  I'm scared of deep water.   When I was a kid, I was scared that my floater would suddenly get punctured while in a deep pool.  Now as an adult, even when I am wearing a life vest in open water, I am scared that a strap might suddenly snap out.  Wahaha... 

But I love water and I like going to the beach.  So about 3 years ago, I added "learn how to swim" to my bucket list but as usual, I never got around doing it.   

Two months ago, I caught up with some ex-colleagues and for whatever reason,  we talked about swimming.   We decided to meet up one Saturday so they can teach me.   I couldn't control my arms and feet, I drank a lot of water from the pool (wahaha...) and water kept entering my ears.  But that attempt got me going so I googled for swim coaches and swimming lessons for adults nearby.  

Three weeks ago, I finally decided to enroll in a swimming class for adults.  During the first session, here's the conversation with my 2 classmates:

Me:  Why did you enroll?
Classmate 1:  I want to be more efficient with my strokes so I don't get easily tired in triathlons.
Me:  <Gulp!  He's a triathlete!>
Classmate 2:   I want to improve my form and just like him, my goal is not to tire easily.
Me:  <Cringe!  They both know how to swim!  Uh-oh...>
2 Classmates:  How about you?
Me:  Survival. I just want to learn how to swim. Wahaha...

We had twice a week sessions.  The coach would give us drills which we had to repeat until we got the correct movements, then the drill progresses.

In between our classes, I practiced on my own.  After class, my classmates and I also stayed behind to further practice.  

On our 4th session, I was able to swim freestyle for 12.5 meters straight.  Why 12.5 meters?  That's the middle of the pool - the exact spot before the pool's depth becomes 6 ft, then 8 ft!   Haha...  When I achieved that feat, even the lifeguard and the attendants cheered and clapped (because sometimes I would chat with them and they knew I started from zero skill).  Haha...

The weekend after my 4th session, I kept on practicing on my own and was able to successfully swim across a 25-meter lap pool - not just once but 4 successful attempts. Yay! But that pool is shallow so I was relaxed and there was no fear of deep water.

On our 6th session, my coach said it was time for me to try to swim across the 25meter pool - but as I mentioned earlier, the pool we use for class was half-shallow and half-deep - up to 8 ft deep!  Waaa....

My coach asked me to start from the deep end so that if I don't make the entire stretch, hopefully, I'll reach the shallow part.  But I was so scared that I held on tightly to a pole for the next 10 minutes and tried to negotiate with my coach to postpone it until the next session.  I am sure I looked stupid in the pool.  Wahaha... 

See, even if I knew my coach was there to save me if I drown and even if I knew there was a lifeguard on stand by, I was still so scared.  I couldn't detach myself from the wall!  The thought of deep water - in this case, 8ft. - paralyzed me. 

Another coach suggested that I try to stand at the bottom of the pool to get a feel at how deep the water is (while still holding on to the pole!).   I did that twice and it helped because when you reach the bottom, you do get pushed up to the surface.  So I thought - even if I fail and sink, I would get pushed up to the surface and maybe, when i reach the surface, I could hold on to the wall for safety. So with that, I was ready to overcome my fear and I finally let go of the wall. 

And guess what?  I made it across the full 25 meters. Yay!  

It's amazing how I made progress in just 3 weeks.  But there's still so much to learn like improving my form, strokes and breathing.  And for the record, I am still scared of deep water!  But at least, I've already started with baby steps.

Just some tips if you also plan to learn how to swim:

1.  It's ideal to enroll in a class or get a coach because they have a technique of teaching progressive drills and before you know it, you're able to swim already.   I've read a lot of reviews online and this is how most people describe the experience - regardless of the swim school or coach.

2.  You need to practice in between classes because swimming requires muscle memory.  

3.  It helps to watch video tutorials. One of my ex-colleagues shared that he learned the butterfly stroke just by following a Youtube video tutorial! Wow...  In my case, I downloaded the complete set of "Total Immersion's Perpetual Motion Freestyle" (USD19.95 from the TI website) since Total Immersion (TI) is the technique used by my coach.  I would watch the short videos every now and then so hopefully the movements get imprinted on my mind.

4.  After the session, if you feel there's water in your ear, just tilt your head sideways - the affected ear should be parallel to the ground.  If the water does not come out, you can create vacuum by placing your palm flat against the ear, then pressing against it for a few seconds.

5. After swimming, you'll feel super hungry! The first time I spent 2 hours in the pool, I ordered a pizza and pasta!  Wahaha.... Just drink water first after swimming because you're actually thirsty. Ok, you're really hungry too (but not as hungry as you think) after quenching your thirst.  

6.  Just have fun! Instead of being embarrassed that I don't know how to swim, I proudly shared with everyone that I had zero skill so they'll have high tolerance if I look stupid in the pool.  Haha...

So if you also don't know how to swim and you've always wished you knew how, stop wishing.  Just do it!:)  Google for a swim coach or swimming lessons for adults in your area.

It's never too late to learn something new.  In fact, I came across one video of a man who learned how to swim TI-style at age 93! :)    

Sunday, February 14, 2016

Being Mortal: Medicine and What Matters in the End

My recent read is Being Mortal:  Medicine and What Matters in the End by Atul Gawande.  I know it sounds a bit morbid (haha...) but I actually think about mortality a lot (every single day!) and it's not morbid at all.  My perspective is if I make it another day, I am thankful that I have been given another 24-hour lease on life. 

They say that people who think about death constantly are generally happier. The Bhutanese for example who have been tagged as the happiest people on earth, think about death not just once but 5 times a day as part of their culture.

Anyway, going back to the book, the author, Gawande is a practicing surgeon.  Reading the first few pages got me hooked.  

Gawande shared a story about a patient who had cancer that couldn't be cured. Doctors hoped it could be treated so they had emergency radiation but it failed to shrink the cancer.  The patient was offered 2 options - comfort care or surgery to remove the tumor from the patient's spine.  The hope was that the operation would halt the progression of his spinal cord damage. But it wouldn’t cure him, or reverse his paralysis, or get him back to normal life.

No matter what the doctors did, the patient had at most a few months to live. The procedure was also inherently dangerous and the recovery would be difficult.... The operation posed a threat of both worsening and shortening his life. But even if the neurosurgeon had gone over these dangers, the patient wanted the operation.

What happened? The operation was a technical success. Over 8.5 hours, the surgical team removed the mass .... the pressure on his spinal cord was gone. But he never recovered from the procedure. While in the ICU, he developed respiratory failure, a systemic infection, blood clots from his immobility, then bleeding from the blood thinners to treat them.  On the 14th day, the patient's family told the team that they should stop and take off the artificial ventilator that was keeping him alive. 

Heartbreaking story. But that story illustrates the dilemma of some doctors and the limitations of medicine.  It was a disease that could not be cured.  After the operation and the complications which came after, the chances of the patient returning to anything like the life he had even a few weeks earlier were zero, Gawande pointed out. 

Most stories of real people we know (who got terminally sick) sound similar - doctors recommend one treatment after another, giving the patient hope that maybe something good would result this time and maybe it could extend one's life longer.  Some successfully recover, but for some, it gets worse; they lose their quality of life and are physically in worse shape than before.

After hearing this doctor's perspective, it makes you wonder if a patient and his/her family are able to really fully grasp all the risks that come along with a procedure. Are they able to think through the probabilities shared by the doctor?  Is 10% success rate for example worth pursuing given the risks involved?  Does the potential positive outcome far outweigh the potential risks?  If it were successful, would the patient live way longer than the average person who didn't get any intervention?   

I remember a story relayed by my mom about an aunt who was diagnosed with cervical cancer in the 1980s.  She decided to get cobalt treatment which I think was the best known treatment at that time (not sure though if it was still new or considered experimental back then).  Around that same time, another person in their town was also diagnosed with the same cancer but she decided not to get cobalt treatment.   The cobalt treatment weakened my aunt's body and she eventually passed away within several months or maybe a year since she was diagnosed.  On the other hand, the person who never got cobalt treatment got to live more than 10 years.    Would my aunt have lived longer if she didn't get cobalt treatment? We'll never know.

But deciding on what to do when someone is diagnosed is really a tough decision to make.  Given the rollercoaster of emotions one is in, it would be almost impossible to think clearly and objectively as the tendency is to focus on the solution that would give us hope to extend one's life - no matter how small the probabilities are.

The author himself experienced this situation when his dad, also a surgeon, was discovered to have a tumor in his spine.  His dad didn't pursue an immediate operation since he was more worried about what the operation might do to him (total paralysis) than what the tumor would. He didn’t want to risk losing his ability to practice surgery for the sake of treatment of uncertain benefit.  

Because of foregoing the operation, Gawande's dad was able to preserve his quality of life and achieve what he wanted (which is to practice surgery) for several more years until symptoms worsened and the pain became untolerable.  When he reached that point, that was the only time he considered having an operation.  At every stage of the disease, the dad, together with the rest of the family, carefully weighed the probabilities and risks of every proposed medical procedure.  The family also made sure that each decision made was what the dad really wanted.  

Making sure what the patient really wants is very important, Gawanda emphasized.  Apparently, about 2/3 of patients undergo therapies they don’t want, but they only gave in because it was what their loved ones wanted. Gawande cited common stories of patients like a grandparent who was put on life support against his wishes, a relative with incurable liver cancer who died in the hospital on an experimental treatment, and a brother-in-law with a terminal brain tumor who endured endless cycles of chemotherapy that had no effect except to weaken him.

Gawande said that the patient needs to be asked the following questions to know his/her innermost wishes: 

- What are his/her biggest fears and concerns? 
- What goals are most important to him/her? 
- What trade-offs is he/she willing to make and not willing to make?

By finding out one's answers to these questions, you will be able to help the patient enjoy the life that he/she wants.  And in most cases, people prefer to lead normal lives and die peacefully at home with their loved ones instead of being bed-ridden and strapped to life support machines in the hospital - even if this meant a longer life.  

Gawande said that a doctor's mission is not just about ensuring health and survival.... it is to enable well-being. And well-being is about the reasons one wishes to be alive. I like that perspective and I hope doctors adopt this perspective. 

People with serious illness, Gawande shared, have priorities besides simply prolonging their lives. Surveys find that their top concerns include avoiding suffering, strengthening relationships with family and friends, being mentally aware, not being a burden on others, and achieving a sense that their life is complete.  

Gawande also mentioned that how we seek to spend our time may depend on how much time we perceive ourselves to have. When you are young and healthy, he said, you believe that you will live forever. When horizons are measured in decades, you do not worry about losing any of your capabilities  but as your horizons contract—when you see the future ahead of you as finite and uncertain— your focus shifts to the here and now, to everyday pleasures and the people closest to you.  You become less interested in the rewards of achieving and accumulating, and more interested in the rewards of simply being. 

Now I understand why my outlook in life is like this! Wahaha...

Another topic comprehensively covered by the book is about the elderly in the US and how they are brought to nursing homes when they could no longer perform the activities of daily living. Yes, there is actually a formal classification system for the level of function a person has. There are 2 types:

The first type is the 8 Activities of Daily Living:

1. use the toilet

2. eat

3. dress

4. bathe

5. groom

6. get out of bed

7. get out of a chair

8. walk

If you cannot do these without assistance, then you lack the capacity for basic physical independence.

The second type is the 8 Independent Activities of Daily Living:

1. shop for yourself

2. prepare your own food

3. maintain your housekeeping

4. do your laundry

5. manage your medications

6. make phone calls

7. travel on your own

8. handle your finances

If you cannot do the activities above, then you lack the capacity to live safely on your own.

So if one lacks the capacity for basic physical independence and to live safely on his/her own, they bring the elderly to nursing homes, or retirement communities, or hospice, or resort to assisted living (there are actually several options now depending on what suits the elderly's needs and wants).

Of course, for most of us Filipinos, this set up is still unthinkable since we take care of our elderly at home.   In the US, resorting to nursing homes wasn't also always the case.   Like us, they used to take care of their elderly at home too.  As proof, in the mid-19th century, poet Emily Dickinson and her younger sister stayed with their parents in their parental home until they died.

So what happened? How did it evolve?

Gawande cites several reasons.   Here are some -

- In the past, it was rare for people to reach old age. If they do, they were the go to resources for knowledge and wisdom.  (Remember how we used to ask our grandparents, parents, aunts and uncles about history, and why and how questions?)  But with technology and the internet, this has eroded.  Now, one could easily search for answers online.

- Since human life span became longer due to technological advancements in medicine, this made parents and children live together longer at home, causing tension.  Living under the same roof resulted to struggle for control — over property, finances, and even the most basic decisions on how to live.

- According to historians,  the elderly of the industrial era did not suffer economically and were not unhappy when their children left them on their own. As children left home for opportunities elsewhere, the parents discovered that they could rent or even sell their land instead of handing it down. Rising incomes and the pension system enabled them to accumulate savings and properties, allowing them to maintain economic control of their lives in old age and freeing them from the need to work until death or total disability.

In gist, Gawande pointed out that the shift in behavior mutually benefitted both the old and young. It gave both of them more independence and control. But the problem arises when the independence for the elderly becomes impossible. :(

Gawande said that our most cruel failure in how we treat the sick and the aged is the failure to recognize that they have priorities beyond merely being safe and living longer; that the chance to shape one’s story is essential to sustaining meaning in life; that we have the opportunity to refashion our institutions, our culture, and our conversations in ways that transform the possibilities for the last chapters of everyone’s lives.

He further shared that we are running up against the difficulty of maintaining a coherent philosophical distinction between giving people the right to stop external or artificial processes that prolong their lives and giving them the right to stop the natural, internal processes that do so. At root, the debate is about what mistakes we fear most—the mistake of prolonging suffering or the mistake of shortening valued life.

In the case of Gawande's dad, he told the family how he wanted the end of his story to be written. He wanted no ventilators and no suffering. He wanted to remain home and with the people he loved - and that was how they let him be. 

Lastly, here are some insightful words from Gawande about mortality -

Death is not a failure. Death is normal. Death may be the enemy, but it is also the natural order of things.


I think the book is a good read for those with loved ones undergoing health problems, those who care for the elderly, those who are curious about what happens in old age, or simply, those who want to reflect about mortality.  :)

Monday, January 25, 2016

2015: My Year in Retrospect

I got this idea of writing your past year's highlights in retrospect from another blog.  I thought it's a brilliant idea - you could quickly review what you did, what you discovered, what you learned, what happened and what new things you did for the year.  Plus, when you start having memory lapses, it's going to be a great cheat sheet. Haha... 

So here's my 2015 in retrospect -

The most important highlight of my year was seeing Pope Francis when he visited Manila in January.  We were able to catch his motorcade in P. Burgos and though it lasted just a few seconds, I was overwhelmed.  This is a screenshot from a video I took.  :)



Some new things I did this year:

- I got more active in the stock market. :)   

- I was able to finally develop an exercise habit.  What worked for me?  I followed an advice to have an identity-based goal e.g. I'm the type of person who doesn't miss a workout instead of a performance-based goal e.g. I want to be healthy or lose xx pounds.   In the early weeks, there were days when I felt sluggish to exercise but then, I reminded myself that I'm the type of person who doesn't miss a workout so I didn't miss a workout until it became a habit.  :)



- I tried teaching.  It was a full day workshop, once per quarter, but it was for 7 hours per session!  What I realized?  It takes weeks to develop and design a module, and it's hard to talk and stand for a prolonged period. If ever I consider teaching again, I think I could only do 2 hours max per session.  Haha... But it was really fulfilling especially when you see participants, who had zero knowledge about the topic at the start of the session, be able to compute and analyze metrics at the end of the day. :)

- I got into plants. I look forward to checking on them in the morning.  It particularly amazes me to see a tiny sprout grow bigger each day.  As a bonus, having plants at home has health benefits too.  :)



- I started cooking more often and I actually love to eat what I cook! Love your own.   Harhar....  

Just a quick background on my cooking (in)abilities - though I've taken up cooking lessons in the past, I'm not a talented cook.  What frustrates me is everytime I follow a recipe, the outcome doesn't look as nice as the photo in the recipe book! Haha... 

So what suddenly got me into cooking last year?  One day, a colleague brought Adobong Atay (chicken liver marinated in soy sauce) and I loved it.  I asked her how it was cooked and I tried cooking it.  My Adobong Atay was yummy (at least for me! Haha...).   

Since then, I've tried to cook whatever I feel like eating as long as the recipe is 6 ingredients or less. Haha... And I don't follow recipe books anymore but concoct my own - just a like a chef!  Harhar...

- Musicals and shows I watched in 2015 -  Beauty and the Beast in January,  Defending the Caveman in February, Lion King (in Melbourne) in March, Idina Menzel's concert in June, Singin' in the Rain in September, No Filter 2.0 in October and Cookin' Nanta in November.



- My travels in 2015 -
  • Melbourne with a friend in March (but it was more of a business trip since we wanted to check out a trade fair)

  • Seoul with my cousins in April

  • Cebu and Bohol with my mom in May

  • Bali with high school friends in June

  • Taipei with a college friend in November (originally booked in August but it coincided on the days Typhoon Soudelor was heading toTaipei so we just decided to move our trip to November.)

  • Batanes with a college friend in December 


- Number of books I read - 18!     My top favorite reads among the 18 are (in random order)  - Empty MansionsElon Musk The Hard Thing about Hard Things, Growth Hacker Marketing and Mindset.   

Btw, my Kindle 2nd gen finally conked out in 2015 so I finally got a Kindle Paperwhite.  Thank you old Kindle for the last 5 years. :)

- Movies I watched on the big screen which I really enjoyed and/or learned life lessons from:  The Intern, The Martian and The Force Awakens (which reminds me I've yet to write my Star Wars cheat sheet before I forget all details of the movie marathon I did.  Haha....)  


  
I think that's about it for my 2015 highlights. :)  

After doing this retrospect, I realized that this is a good exercise. Why?  Because every end of the year, we usually rant that a year has passed by so quickly!  But when you start looking back, you begin to realize that you did have some activities (now whether you consider them productive or meaningful is another thing! Haha...).  But for me, that's really up to you - your own rules ... your own definition of enjoyment .... your own criteria of what's worth your time with the 365 days we've been given.  :)