2nd to last Post

Stan here:

Sad to say that it is time to close down this blog. Several people at the service asked if this poem could be on the blog so following is that poem.   In  a day or so I am going to post one more time with some reflection and thank you's.  Even though  very sad, our family learned a lot through this entire journey and I thought after this I might pass on a few thoughts that may be of help in the event that any of you are called on to face events like this of similar nature.

A poem for this Day and Something I want to Say.

It was about 44 years ago that a ship started to sail

In the hold were a few cents and a desire to never fail

On the mast was a man in a basket with a telescope

All relationships should start with this level of hope

A wedding, a party, and soon the study of nursing

A test, a quest and medical issues rehearsing

A passage to adult life and the pursuit of a medical careers

A bill or two from the Harper School that left us in arrears

A love for the piano and the ability to make it ring

A happy smile when she could hear that ring and sing

Of every note she sang and played over all her 60 years

Of every trip she took to far corners with no fears

Of every friend she met that were captured by her smile

Of every time she had to hold her happiness if even for a while

Of every time she played a sport like golfing with her dad

Of every time she told me she that her dad made her glad

In this regard a shift to a honoring her father and her mother

In so doing a deep feeling for her sister and two brothers

In fact to tell the truth a love for most all people she met

In so doing a return feeling from them, no lie, good bet

Kinda happens to all who hold high the right values in life

Kinda helps to always worship and hold high the virtues of a fine wife.

When life starts together you never sense a dark spot on the lens

At this juncture I must share something with all of our friends

Trouble entered our scene some 35 years ago

Full term infant deaths, pain deeper than you can know.

The telescope of life though, remained focused on the hope

That her future held a within its boundary the power of her hope

That has included the birth of two boys and a daughter

Gathered in to her arms as a gift her God brought her

Treasured in a way that was enhanced by the trouble

And followed by a love that I think was at least double.

In 2012 on a trip to a reunion

A moment occurred that caused great confusion.

"Something is wrong with my dress it does not fit

I have pain when I stand I have pain when I sit."

And so started a journey of courage and endurance

A life that was guided by the Lords assurance

A life that was blessed with 4 years of making each day right

A life that was witness to how to live a really strong fight.

A ship now arrives at an undesired destination

A family now tries to find some explanation

A thinker knows though of something that can be sure.

A God we serve in the end will make it pure

Let us all go forth with this level of hope

Let this life show large in every telescope.

Let it bask in the glow of new found eternity

Let us be assured of this with God granted certainty 

I must share with you that this poem was hard for me to read at the funeral.  But it was not near as hard to read it to you guys as it was to Deb several weeks ago. It was the first time however that she said I could read it without chopping out a verse someplace.  She was honored by it and that was important to me.  

Stan

Obituary

Following is Debbie's obituary and details of arrangements. This was kind of hard to write, as the reality sets in...

Debra Jean Hoksbergen was born on June 28, 1955. Her life ended on February 21, 2016. While the end of her life was very difficult, she can be honored and remembered in countless joyful ways. Her life was complemented by the gifts God granted to her, and she used those blessings to live life to the fullest.

From an early age, she enjoyed the gift of music and spent countless hours playing the piano with a passion that rang to the heavens. Her family and friends were at the core of her life and she enjoyed them all. Deb cared deeply for the people she knew by extending a hand of welcome, evaluating cuts or a possible broken arm, and wrapping arms around you during hard times. She enjoyed her nursing career and provided care over many years in surgery, neonatal, labor and delivery, endoscopy, and birthing classes. Deb's incredible work ethic was evident whether caring for patients or completing any project with which she was involved.

She had a deep love for her husband and children, her parents and siblings, and for all people she encountered in life. Many years ago Deb had to endure the loss of three infants. Jason Brandon, Megan Leigh, and Grant, who were born with Potter’s Syndrome and died shortly after birth. So the treasure of life took on special meaning when we were blessed with 3 healthy and thriving children.

Dear wife of 41 years to Stan. Loving Mom of Ross (Rumy), Alden (Mary) and Mieke (Aaron) Mutschler. Proud Grandma of Ainsley and George Hoksbergen, Lorelei Mutschler and number four, a grandson soon to be born to Ross and Rumy. Deb had a deep desire to meet this little one, but will now get to witness this from heaven.

Beloved daughter of Jim and Sylvia Vermeulen and daughter in law of Shirley Hoksbergen. Cherished sister of Krista (Tim) Schaafsma, Jim (Nancy) Vermeulen, and Ken (Shelly) Vermeulen.

Deb had a special smile. As her family and friends viewed this smile, they could sense a love that transcends any words.

After the diagnosis of ovarian cancer, Deb battled 4 1/2 years in which she had the deepest level of pain but the highest level of perseverance.

God takes home a soul, the world loses a friend, the husband loses a love, the children lose a mother and the grandchildren lose a mentor. However, we all gained the gift of a person that was special in so many ways.

To celebrate the gift of Deb's life, a service will be held at Beechwood Church, 895 Ottawa Beach Rd. Holland, MI 49424 at 11 AM on Saturday, February 27. Visitation will also be at Beechwood on Friday from 3-5 PM and 6-9 PM.

Memorials may be made to Hospice of Holland, 270 Hoover Blvd., Holland, MI 49423, or Beacon Ministries c/o Beechwood Church, (Deb helped co-found this organization, which provides free baby items to local migrant families).

To share a memory please visit vermeulenfuneralhome.com

The Journey is the Destination

Stan Here:

At around 2 AM on Sunday morning Deb peacefully passed away.  After spending 24 hours in a very quiet non-movement state she had a brief time at around 10:30 of being able to open her eyes and we were able to communicate  for the last time.  This was not in verbal form. Instead a light smile, a few tears and some idea that the words we said to her were reaching her. It was evident as Saturday went on that it was likely the end of life.  A different breathing pattern and some other signs that life could not be able to continue for much more than a day.

After resting all day Saturday, the end came in a very peaceful way. Mieke decided to stay overnight and was sleeping, holding Lorelei, next to Deb. She woke up around 2am and noticed her hand moving slightly and slow breathing. A few moments later, she was no longer breathing.  There was no final struggle and a very peaceful look on her face even after her death.  I will post again soon with arrangements but one thing I do know is that her service will be at Beechwood Church next Saturday at 11AM.

294 is the score

Stan Here:

These blog things somehow keep score.  I think some people write blogs and somehow advertise on them.  So built in to the program they have some stats and a moment ago I looked at that.  I was interesting to me that the one I am writing now is the 294th time we have posted something on the blog and we tried to never do so unless something had changed.  I did count up the other day the total number of hospital days and that is 149.  There have been 9 pretty major surgical procedures.  Mixed in between have been some pretty good days, a few trips, some days of little or no pain, 3 grandchildren and a 4th on the way.  It was really hard the other day when Hospice came here and it took three of us to get Deb from a chair to her bed.  I asked the Hospice nurse later if I had just seen the last steps and she shook her head up and down.

I must tell you an amazing story.  The trips from the bed to the chair were getting more difficult by the day. Pretty much a walker and a person on each side to assist.  2 nights ago I slept on the couch in case anything was needed by Deb who sleeps in the living room on a hospital bed. I woke up around 3 and she was sitting in the chair and had done so unassisted.  I asked how she had reached the chair and she had no recall of the trip.   Hospice uses a term and it is called "terminal restlessness". I am told that they have had it happen when patients who are 90 years old and have not been out of bed for 6 months have been found at the end of a hall a long way from their room.

The latest around here is that each day we witness a declining condition.  This morning we had a pain pump installed that will control the pain but it will make it so that Deb is not able to respond all that much.  We had to do so because the pain and the restlessness had reached a point of even the slightest touch or bed adjustment leaving her calling out in pain.  Deb has not had any food now for 2 days and with the medication level now she will not eat, nor has any desire to eat.  She is able to open her eyes at times but not able to express much what we can do for her. Her parents came to see her today but even that was kind of hard as she just is not able to express the normal emotions that come with human life.

So  number 294 has to exist as a good score in bowling only, but very hard and sad to write.  Folks, it is just tough to watch. I am starting to understand that many of you have experienced something like this with a parent or spouse.  Forever I will have a deeper understanding of all who have needed to endure something like this.

Thanks for staying with us.

Stan

Just the Facts

Stan Here:

When I was  kid I used to watch a show by the name of Dragnet. One of the characters was a guy by the name of Joe Friday and as he was was investigating the cases he would often say "just the facts maam." So this report has just that. They are kind of blunt but they are the facts.

Going back several days Deb had a fine weekend of being alert, with her children and grandchildren, with visitors, and moments where the quality of life returned in a good way.  Tuesday morning it was evident though that a strong decline in condition had taken place.  This was evidenced by increases in the pain, some levels of confusion, a change in color and alertness and all of the rest of the stuff that points to a decline in condition.  On Wednesday things  reached the point where I called Hospice and when the nurse arrived and the vitals and signals indicated that action was required on several fronts
Blood pressure was down to 80/60 and blood oxygen counts were down.  They brought in a oxygen machine to help with that. They changed some of the pain meds and they had a meeting with us to let us know that it was clear that the final stages of life would be experienced in a short time.

Deb's sister is here today to help with the care but Hospice encouraged me to have no other visits so that Deb could attempt to have the changes in treatments reach the point of being of being more lucid and have a few days in the future better than the ones of late.  Presently we are struggling. No other way to put it.

And those are just the facts.

Stan

The Medical Mile

Stan Here:

I can recall three of four times when someone gave me directions and they told me the place I was looking for was on the "medical mile" in either GR, Ann Arbor, Cleveland of Minneapolis. I must tell you that as I have viewed the medical mile in Ann Arbor and Cleveland it is more like the medical 2 miles and while I have not seen Mayo clinic I understand it is even larger.  Not sure why I wanted to start like this other than to say that what we have here is more like the medical 10 feet.

Debs world has been confined of late to a 10ft circumference between chair and hospital bed as even small movements have been overwhelmed by increasing weakness and pain.. The largest medical issue right now is swelling and pain in both legs and especially in the left leg that has some discoloration and more advanced swelling than I think I could have thought of before.

We want people to know that we have had over 4 years to prepare for this.  I think Deb has always known that some of the worst medical times are yet to come and now we are in that stage.  An outside observer might say that perhaps the best option is sedate to the point of sleeping all the time.  I must tell you though that bright moments and smiles do happen as she interrelates with her caregivers (all who she knows well) and in this way this part of life has brought both value and quality.  Also, the grandchildren bring moments of quality and today they are coming to see her and this is very important to her.  So we are trying our best to provide those moments during this time.

All of this would not be possible without a very appreciated effort on the part of many friends who have shown support in a special way during this time.

So that is the update from the medical 10  feet.  That 10 feet has with in it a strong  person, strong friends, a strong will for life, and a strong vision of a future  life beyond this one. In that way we are blessed even though at moments it is hard to remember those facts.

Stan

P.S.  For the medical people out there the Methadone has been increased and the short term pain relief is something we are trying to decrease.  We are looking for a spot of being "in the game" and controlling the pain as best possible.  Yesterday Deb was able to visit with her caregiver in the afternoon for several hours and I think the changes in the meds have helped that

Home

Stan Here:

In the Wizard of Oz Dorothy had to click her heels and say the words "There is no Place Like Home" several times. I am not sure about the heel kicking but Deb wanted to come home from Freedom Inn.  She was allowed to do so with the provision that at least for a week there are always 2 people here to help and fortunately we have friends and family that are willing to assist us with this.  I am the chosen 2nd person.

Deb is a fall risk and there is enough care needed now that it is hard to provide with one person.  So for all intents and purposes walking is minimal but getting her up can be a challenge with one person.  We had the option of continuing care at Freedom Inn but she wanted to come home real bad so we are trying that route. We had some different opinions in the family about what was best in this regard but Deb was having trouble with the idea of staying there.  Freedom Inn did a god job but somehow being in any place of that nature takes a toll of its own in way that you cannot describe until you have experienced.

The swelling in her legs is a problem right now and she is having trouble and pain with her right leg especially It is very swollen and hard to the touch.  So that has been causing a problem for the last few days.  It seems like she will have a good day and then the next day a tough one so we are asking people who might wish to visit to call her number 616-299-2996 and somebody will answer that phone and provide some direction on that.

Her spirits seem better here at home so at least that brightens a pretty tough situation.

Stan

Correction

Stan Here:

I want to take a moment to correct something from the last post.  Deb took a call yesterday and told me she was going to Holland Hospital.  Like I mentioned she has been somewhat confused and this morning I found out that she was going to Freedom Inn which is a local skilled nursing facility here in Holland.

She is there now for a 5 day respite stay during which time they will try adjust the meds and build a plan to better care for her at home. We have been doing a good job here but she has had 3 falls and we will need to make some adjustments if in fact she can come home after the 5 days.  That decision will also be made over the next days. Presently she does not have all of the pain and at least that is a good thing.

They are decreasing the methadone as it is felt that the dosage might be a little high right now.  It is also believed that the confusion and falling are partly due to the methadone.  The combination of that and the progression of the disease are perhaps   both culprits of some of the recent problem.  Deb has a black eye from one of the falls in our restroom.

It is very difficult to get her back on her feet after those falls so we had no choice but explore other options like the above. She cannot have visitors today and I will let you know if that changes.

My cell is 616-335-0195 if people have questions or suggestions.  Not that much to do here and I would be glad talk if anybody has any ideas.

Stan

Fusion and Confusion

Stan Here:

Somehow years ago I became interested in Theoretical Physics.  Problem is that when I get to about the third chapter of any of the books I start to not understand very much about what they are talking about.  I does make me think more about the planets and light years and gravity and black holes and all that goes along with that.

In that frame I do not pretend to understand very much about the power of prayer, but I must tell you all that many of you have written and are praying for Deb's pain to be relieved and that has been granted. In our modern world and modern medicine it is always possible to medicate to the level of no pain.  The problem of late however is that somehow the methadone they use has brought her to the point of being a touch beyond where they think she needs to be  We have been visited by moments of confusion and deep sleep.  Also some falls in attempts to do the basic daily functions.  Compared to the pain though we are in a better spot. There was nothing worse than the pain she was feeling.

Hospice has recommended that Deb spend a day in the hospital (which is going to happen Thursday) to see if we can find a spot someplace in the middle.  I think we will find that spot. So if all of our friends could pray for finding that balance it might work.  The relief from pain worked but they worked a little too good. In any event we are in a better spot than a few days ago.

Newton's third law of motion is "For every action there is a equal and opposite reaction".  So the action here has been to use methadone and the reaction has been a confused and sleepy life for Deb and little pain.  I would suspect that the next action will be to decrease the dosage and we are hoping the reaction will be a better balance.  If God can grant one thing we are hoping that Deb can somehow meet our 4th grandchild which is due to be born to our oldest son Ross and wife Rumy in April. Seems to us sort of light years away but it is possible and keeps hope going. And hope is a powerful thing from where we stand.

Stan

A caucus of our own

Stan Here:

The way I understand these caucus things is that everyone in Iowa goes to a gym and they move from one corner to the other to be counted for a vote.  Not sure I have that exactly right but somehow I think by the time each one of the candidates votes they will have enough money spent on them to fill a pretty big piggy bank. Also not sure why they pick Iowa first but I think it has something to do with professor Harold Hill. I mean if he could sell all those band instruments out there it must be true that these politicians think they can sell some of their big ideas out there.  We will see what happens.

I know if we did a caucus here everyone we know would move to the side of the room that had a sign that said "No Pain" "No more Cancer" "Take up your Bed and Walk" and most everything else like that.  And the fact is that today Deb had a slight relief  from the deep levels of pain.  I emphasize the word slight here.  Anything is better though than the last week (or more) where it seemed like everyday things were getting worse.

Hospice has changed some of the pain meds.  They have increased a few and taken away a few others.  It seems like a fine line of keeping her alert and awake and it seems to me they are trying to find that illusive spot.

We did have a day yesterday of having the grandkids here with their parents. The old Deb smile was evident on a few occasions.  Have not seen that all that much of late.

I am not sure what caucus sign we are standing under here.  The challenge of this life is large though and the battle has some adventures with it that are really tough.  Maybe that would be a good banner for her to stand under, "Really Tough".  I would put my vote in for that one.  Not far away from that maybe a banner could hang that says "Really Nice".  Our friends and relatives could stand under that one.  I know from all of our family the people under that one would get all of votes.

Stan