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THE Gratitude Journal

When did Gratitude begin?

I remember looking out into the night.  I wondered what was across the street.  It looked like white table clothes, but no one ever came to eat.  I now realize it was not even a restaurant, but I did not know it at that time.  I remember thinking, would we ever go out to eat again with white table cloths.  You have a lot of time to think while you are in hospitals.  Your days and nights kind of mesh together in this fluid-like trance.  At this point, the only eating I was doing, any “food” was I was getting was TPN through my port.   This is when gratitude started for me.  I was so very grateful to have the port and I was grateful TPN was an option since I refused the NG tube with all my being.  This is when gratitude was born within me, an October evening in 2015 at Norton Suburban in Louisville, Kentucky.

Guess I did not expect to learn about gratitude in a hospital, but I sure did.  In every single situation, in every procedure, every medicine, every pain, every CT scan, every x-ray, every poke and prod by a nurse or a physician, I was still able to find something to be thankful.  Okay, maybe not every single time, but there were more times than not, my condition, my surroundings, my resolve could have been worse and I recognized that and focused on the gratitude.

Maybe this was because the C word had been the topic of conversation and the cause for every single blood test available in the medical field. When you finally realize it is not cancer, you automatically think it is not that bad, it could be worse.  It could be cancer.  Maybe this is true unless you have met the little beast called severe acute necrotizing pancreatitis. I am not comparing the two, I just think when your mind has been attempting to process peritoneal cancer for weeks, anything sounds better than that that dreaded C word, and you instinctively become grateful.  Of course, I was grateful I did not have cancer, but little did we know, I was embarking on the roller-coaster ride of my life, quite literally, however, this roller-coaster did not have an attendant checking safety belts and preparing you for the ride.  I was just set free rolling along the tracks with no safety belt – or so it seemed at the time.

You have a lot of time to think.  It feels like nothing but time some days.  You have time to speculate.  Time to question. Time to rest. Time to regret. Time to hurt. Time to heal.  At times it feels like you are at odds with yourself, you need this time for your body to heal but you also have this time on your hands for your mind to wander.  It is at the time, you do not realize you are unlocking the secrets to a happy life down the road.  You do not realize you are fighting for your life, or do you?  The mind has a funny way of melting such experiences in just the right way; you know what is going on, but not fully.  There is literature and research for this.  The semi-conscious state you are in.  The medications they use in the ICU and the anaesthesia they use for your procedures.  This all creates a sort of melting fog in your brain.  You look back on this time and feel gratitude and you feel grateful for this time.

When you have a bathroom in your hospital room WITH a door AND a shower AND you are allowed to use both on your own – you do it!  Now it is not truly, 100% on your own.  Your nurse has to unhook all of your IV’s, which at this point, it was only three IV’s.  She also has to discontinue the TPN and securely cover your port.  This is all a process within itself.  Nevertheless, when all of those little sequential steps are complete, you are free; you can shower!  How it is all fun and games until you get naked and get in the shower, finally figuring out how to get the water to a decent temperature you realize you can barely stand.  And this is not, I’m so tired I can’t stand sort of way, it’s the panic, I cannot stand, I cannot hold myself, I am beyond grateful there is a bench in the shower and totally understand why there is.  I also understand why that emergency ripcord is hanging there.  I am sure people need that more than not. As I take a seat in the shower, the tears start and I cannot stop them.  I realize I do not have enough energy to wash myself, let alone my hair. This may not seem like a big deal, but after countless days in a hospital, you just want a clean body and clean head of hair. I just sat there, let the water stream down, and cried. I was so scared. I was so scared I was going to have to pull the ripcord and have God knows who come and find me naked and bawling in the shower. Before the words, “keep pushing through,” meant what they mean now, that is exactly what I did that day.  I pushed through the fear.  I pushed through the weakness. I pushed through the pain.  I was able to finish my shower.  It is in moments like this you experience a grateful heart, you learn and appreciate gratitude.

When it is time for your next procedure or your next x-ray, you are sincerely grateful for the change of scenery.  It’s hard to explain, but day after day and night after night in the same hospital room, feeling so miserable, just the little bit of change and movement feels great.  In addition, you are extra grateful because this means they are going to change your sheets.  Even when the procedure is unpleasant or downright awful, it makes you appreciative. You appreciate the care you are receiving. You appreciate the attention.  You appreciate clean sheets.  As happy as you were to be on the move, you appreciate arriving back to your room with a clean and fresh (well, hospital fresh) bed. It is almost as if it comes full circle, you can’t wait to get out of your room and you can’t wait to get back to your room.  Isn’t that what we do in life though, we are always onto the next best thing, anticipating where to go next, what does the next chapter have in store, when we don’t just stop and smell the roses.  We do not slow down enough to appreciate clean sheets.

The importance and appreciation of nurses is an entire book.  They, rightly so, are the backbone of healthcare.  Not just the backbone, they are the right arm, the left arm, the spine, the brain, well, you get my point.  Nurses are be all – end all, everything to healthcare.  As a patient, you become accustom to new nurses.  You have shift change and unit changes and if you are in the hospital long enough, turnover.  However, when you have a nurse that knows you and knows your case, you are so very grateful.

When it is time for another CT scan, how do you find gratitude?  Well, when the medical staff has taken the time to keep the solution cold, ice cold, you are very grateful for the tiniest thought that went into this practice. It really is the little things and having to drink a room temperature solution on a stomach that cannot keep anything down, well… it is unpleasant to say the least.  That little bit in temperature change makes all the difference in the world.  It is a tiny gesture but it makes all the difference in the world.

The nights at the hospital had a profound effect on me.  There was something scary yet something so peaceful and safe.  You become very grateful for routine.  It gives you something to look forward to day in and day out.  4:00 a.m.  blood draws are like clockwork.  For some reason, I enjoyed those.  Even now, years later, I look back on those and feel such peace.  Remember it’s the little things, it’s clean sheets.   I think I liked the early morning blood draws because it means I made it through another night.  The nurses were always so kind during this time, gentle and nurturing.  It also made you realize that your care was a 24/7 thing.  There is such a calm peace in the quietness of the hospital at night.  Safe is the best way to explain it.  Now the doctors would usually round at 7:00 a.m. or thereabouts, that is when I would wake up again.  I was grateful every single time a doctor would come and check on me.  Some more than others, of course.  Moreover, there is a difference between hospitals too.  At IU, Physician rounding was like clockwork, almost down to the minute, whereas at Norton, it was anyone’s best guess when the doctor(s) would be by to see you.

Breakfast – Lunch – Dinner was never routine for me, but I could smell it.  I have been able to find gratitude in everything.  Nothing far-fetched, just gratitude.  I still cannot find gratitude in the hospital smell.  If there was one thing that surely would trigger my PTSD, it is the hospital smell.  What is hospital smell?  It is the perfect mix of sickness, food, and hand sanitizer.  My stomach does an unhealthy flip when I write this, just thinking about it.  It is a warm smell and you smell it everywhere.  It is not only warm from the food, but from the sickness, the warm bodies that fill the hospitals with the sickness  and germs, hence the hand sanitizer.  The sense of smell is linked with memory, probably more so than any of our other senses.  As I sit at my computer now, I can remember that smell.

The little whoosh of saline between medications.  I became acutely aware and thankful for that little whoosh.  The memory of the little whoosh and medication I can remember today.  It was a "normal" day at IU pre-surgery, I was actually sitting up for my medication with my favorite nurse. I was out of bed, sitting with my Dad.  It all happened so quickly.  I don't know if she was just in a hurry or didn't think it would matter, but this morning she skipped my usual saline whoosh.  I noticed, thinking to myself, she would know and I guess you didn't need to always push the saline.  It wasn't but a minute and I asked, "can they give you too much medicine?" and then I just screamed, my heart start racing but I felt paralyzed and all I could do was feel the temperature rise up through body to my neck and ears like I was burning up.  I am not sure what they did, I think I was just flushed full of saline.  But I was able to earn the watchful eye in the sky behind me.  I guess because it was ICU, there was a nursing station, like a watch tower, with someone watching me the rest of the day.  What made this whole thing worse was it was my favorite nurse and we knew what she did or didn't do, but mistakes happen and nothing worse happened.

Folding furniture.  Gratitude for folding furniture.  There is a quiet calm that comes in the evening in the ICU, or really in the hospital in general.  I never thought much about it until every single night, my husband slept on some sort of folding furniture.  The plastic rubber style. Easy to wipe down I am sure.  I would lay there in this safe, serene, calm feeling of night and watch him sleep.  I am so thankful for the hospital staff allowing him in every room I was in and able to spend the night.  What sleep that must have been for him. 

Hospital-acquired infections. This is now a data point I collect at work.  A standard statistic when it comes to quality and safety in healthcare.  I never thought I would be grateful to have acquired one myself. I am.   After a couple of days at IU, I was told I had C-Diff.  I will always remember the medical student that tested me for it. She was very kind and I could tell she was very smart.  I woke up one morning and you would have thought my ICU room was a crime scene.  You didn't think visiting your wife or your daughter or your sister in the ICU could get worse.  It could.  C-Diff could strike.  It never really bothered me much at all, given all that I was dealing with, I didn't notice it.  My poor family though, they had to suit up with gowns and gloves to come in by me.  Literally suited up as if they were cooking on Breaking Bad.  Just like in Frozen, the cold never bothered me anyway.  The C-Diff never bothered me anyway.  It was one more antibiotic on my poles of IV medications.  My surgery was delayed because of it.  It was an inconvenience for my family.  There are too many to count, but one instance that I truly learned gratitude.  I was so grateful to have C-Diff.  You know what?  When you have C-Diff you cannot share a hospital room?  You know what would have been the death of me?  Sharing a hospital room.  I was literally dying and sharing a room would have been a nail in my coffin.  This was a nod from God.  A wink from above. Grace intervened. I am certainly grateful for acquiring C-Diff because it allowed me to recover during my step down days in a private room.   Granted most hospitals are only single occupancy - IU still had double rooms.  Roommates.   I know this could have been a huge complication and it is a terrible illness, it truly ended up being my saving grace for me and for that bout of C-Diff, I am grateful.

Fresh air.  It was just past dusk one fall evening in Louisville.  It had been an exceptionally difficult day and we all needed a break.  The thing about hospitals, they aren't really conducive to breaks.  Donny was able to take me for a ride in the wheelchair to a roof garden.  This was the only other time I had fresh air for months.  Funny how it's the little things you take for granted on a daily basis end up being those in which you treasure.  I remember sitting outside, the sun had gone down and there was a fall chill in the air, but it smelled and felt so good.  I took a minute and looked in the other hospital rooms around the garden, the rooms that overlooked the garden.  When I say garden, it was a cement roof top, with benches and room for wheelchairs to pass through or just sit for a moment.  It was a cement oasis amidst the illness and sick that was just on the other side of those windows.  It was that time of night when it's easy to see in windows when the lights are on.  I would look in the other rooms and for just a minute it was easy to forget I belonged in those rooms.  I would see those "sick people" and feel for them, forgetting I was about to go back inside as one of those sick people.  I felt such gratitude that evening, I can still feel air in my nose and on my skin, I was able to get out of bed and I was able to sit upright in a chair and I was able to get some quality time with Donny in the fresh air.  I am grateful.  Little did I know that sitting in a chair and getting outside again wouldn't been an option for me for several months.  I picture that evening and feeling often. Grateful.

"You will be brilliant."  My mom gave me a journal that Christmas that says My Brilliant Ideas on the cover.  I still have the journal, surrounded by my collection of journals. I guess my ideas have yet to be brilliant - maybe someday soon.  I am so grateful for the "minions".  When I write minions, I mean it with the highest form of flattery, the utmost respect, the most endearing and loving way.  The "minions" are student doctors.  They. Are. Amazing.  I am so grateful for the Indiana University Medical Program and the learning hospital. I am so grateful to have had experiences with so many students.  They are so eager to learn, genuinely happy to be there and sincerely concerned about your well-being.  I firmly believe you receive better care at teaching facilities.  I happen to mention a bowel movement to one of the minions.  She tested me for C-Diff and sure enough, diagnosed me with C-Diff.  As we know, I am not displeased what-so-ever with my C-Diff diagnosis; and had it not been for an eager student wanting to learn more and run more labs, we will never if it would have been diagnosed and treated appropriately.   This same minion, as she was violently removing my drain tubes, told me, "one day - you will be brilliant"(Side Note: Read the previous sentence with an English accent as the student doctor was from England (and it's always fun to say brilliant in an English accent)).  It was such a kind observation, and yes, slightly random comment to make, but it stuck with me.  I will remember her and the comment for the rest of my life.  I am grateful for the top-notch, attention to detail care, provided by the brood of minions.  Mad Gratitude for the eager beaver minions.

The middle room, which is where I learned gratitude.  This was trip number countless to the ER.  It was just Donny and me; we were in the ‘middle room’.  I really wasn’t feeling well, I was in a tremendous amount of pain, extremely nauseous, which brings on the anxiety and we were in this make-shift room with a curtain, I think it’s safe to say it was a closet at one point. There was a tremendous amount of action across the hall.  The lady in the room across the hall had the lights out, the only light in the room was from the monitors.  As I began to focus on something other than my ailments, I became acutely aware of what was happening across the hall.  This poor woman was having a miscarriage.  This was awful.  Terribly sad.  The darkness of the room was poetically perfect for the darkness of what was happening; this was the only time I remembering praying and it was not for myself.  I was praying for that family across the hall the loss they were experiencing.  As I was praying for her, an overwhelming calm came over me.  It was an overwhelming feeling like; I’m going to be okay. I am going to make it.  Grateful.  Keep Pushing Through.  I was in pain, but not the pain and loss across the hall.

Gratitude does not always happen immediately.  In fact, I believe many of the moments, events, things we are grateful for now, did not start out that way.  You look back now that the story has been written and realize what a role that played and you are so thankful, but while you are in the throes of it… not so much.  Insert Dr. Mark.   He is quite literally, everything you do not want in a doctor.  He is loud.  He is rude. He is arrogant.  He does not listen. He wears cologne.  Now I know you are thinking, not that bad.  Picture the second ghost in Christmas Carol, the larger than life ghost of gluttony – Dr. Mark is that – larger than life.  To this day, this was the absolute worst conversation of my life. The WORST conversation I may ever have to have in my life.  It was so hard. To this day, I cringe when I think about it.  However, I am so grateful for the conversation. I am grateful for the hard questions.  I am grateful the truth was finally coming out.  Drinking was a deep secret and a huge concern of mine.  I will forever be grateful of smelly Dr. Mark and his tough questions.  The sun was shining so bright that day. You know those crisp fall days when the air is clear and sun is bright, that was that day.  I literally remember sitting in my hospital bed and the sun was shining so bright in my eyes when I was answering the toughest questions.  He was doing me a huge favor; I just did not realize it at the time.  Quite literally, the light, the sunlight was being shined on my dark secret.  I do not remember much after this conversation – just that the outcome of that conversation saved my life.    Dr. Mark was able to pin-point everything to the pancreas.  We have mad gratitude for Dr. Mark because of his knowledge of Indiana University Hospital – Center of Excellence for the Pancreas.  It is from this conversation Dr. Zyrmonski was brought into my life.  I still need to thank Dr. Mark for opening the blinds to my drinking and shining the light that day and introducing all of us to the truth, whether I liked it or not.  This is the power of gratitude.  You become truly, deeply, grateful for someone you do not necessarily like, someone who defines creepy, someone who made you very (maybe the most) uncomfortable in your life, yet you literally owe him your life – grateful for him.

Physical Therapy – having to walk when you can barely stand.  Where is there gratitude in this? They would make me get up and I had so much going in me, I had two full IV poles, Donny took one pole and one arm, the physical therapist took the other pole and the other arm.  Y’all, I hurt so BAD. I was SO scared.  This was another one of my worse moments, where I truly pushed through and made myself get up and walk.  I did not know if I was going to puke, pass out or have my heart just give out…  I did not let on; I did not let anyone know.  I kept pushing through.  As I was taking one of my first steps, in walks my mom and dad.  The look on their faces to see me trying to walk gave me enough oomph to go a few more steps and never mention a word about how I felt.  At that moment, I was so grateful for Donny literally holding me up and PT coming in at the right time to show my mom and dad.  I now find gratitude here.   Speaking of therapies, there was a breathing therapy I had to keep practicing because of the PE’s that were invading my lungs.  It was plastic and it stood on my little table, you had to blow and have this little dot/ball hit a certain level.  I am sure it would be a piece of cake now; it was not laying in that hospital bed.  For starters, it was scary because it showed ‘anyone and me who was in the room, just how difficult breathing was…  But, today I have no problems with my lungs, my breathing, no real issues with Pulmonary Embolisms, I am grateful for this breathing therapy too!

Think about your hair.  You probably don’t give it much thought at all.  Now think about what you are eating.  You probably didn’t give it a second thought as to what will help your hair to grow.  I didn’t either.  When I thought about cancer – I thought about hair loss, but that was short-lived.  When your body endures traumatic situations, the ICU, multiple sedations, this essentially stuns your system.  It freezes time and your hair stops growing – entirely.  It stops then and there.  Your body is so focusing on surviving, keeping blood pumping, oxygenating, organs functioning, your body doesn’t think about maintaining or sustaining hair growth.   Compound this with the fact , your body is very compromised and mal-nourished, your hair isn’t going to grow anyway.  Guess what?  No-one tells you this.  No-one tells you, your hair is going to fall out right around the same time you start recovering, say three to four months down the road.  It was at this time I became acutely thankful for hair. I noticed everyone’s hair. I researched options for hair growth and found out one thing.  Nothing but time will remedy this.  There is no quick fix to re-growing hair.  It just takes time.  I was patient with the process and (yet again) allowed my amazing body to perform its wonders.  It took almost a year, but my hair came back.  It came back a little thicker, a lot darker, and a million times healthier.  Through this lesson, I think more than a lot of the other lessons, patience and an awareness of the everyday little things, especially within your body.  I was able to grow hair again.  You never think about growing hair until all your hair comes out in clumps in the shower.  Thankful, grateful and blessed for all those teeny tiny hair follicles growing strong (and dark).

Music is used in all sorts of therapies.  I did not have my wits about me to consider using music while I was in the hospital.  There are times I think it would have helped or been a distraction, but there are also times I realize I wouldn’t have probably remembered much music anyway. There is one song I remember, and to this day, it brings right back. Rachel Platen releases “Fight Song” earlier that year and her follow-up single was “Stand by You”.  We were in the basement of Norton, I was in bed, laying the hallway, with a couple blankets, so cold and in so much pain - waiting for my second paracentesis.  Donny was right there by my side and that was the first time I heard “Stand by You”- she talks about scars and strength and support. It. Was. Perfect.  Fast forward to a couple months later, when my anxiety was almost unbearable and I wanted to escape, I would escape to the car.  Thing was, I couldn’t drive, so Donny would drive me around to look at Christmas lights.  I heard all these new songs on the radio, but the songs were not new, that is when it hit me, I didn’t know the songs because I hadn’t listened to music in months.  See, time stood still. I left for the hospital one day in August and I came home in mid-December, I missed an entire season of my life.  Talk about triggers, just hearing new songs on the radio that night was a time stamp for how long I’d been gone, for how much I missed.  Every time I hear a new song on the radio I am brought back to that winter day, in the car and so grateful to be where I am and enjoy new music.

4 a.m. I am grateful for the 4 a.m. wake up call for blood draws.  Yes, I was thankful to be alive another day.  I was also thankful for the blood test.  It is truly amazing what they can tell you based on your bloodwork.  Granted it may not always be what you want to hear, but it is definitely, what you NEED to hear.  I knew the blood draw would bring an update and usually a little bag of something I was lacking. I am so grateful for healthcare lab works.  In addition to the lab work, I was grateful for the nurses, they were so kind and gentle during the 4 a.m. blood draw.

Grateful for the first appointment with my family together at the hospital.  This appointment was to have my port put in.  Talk about gratitude.  Talk about gratitude. I am thankful every single time I see the scar on my chest. Grateful, of course, the cancer diagnosis was wrong, but so very thankful I already had my little port before we knew any better.  The port ended up allowing me to go on TPN for nourishment.  All this time, everyone wanted me to eat and I couldn’t eat.  They all thought I had an eating disorder.  My body was telling me NO!  The pancreas couldn’t take anymore.  When the NG tube became an option, I have never been more grateful for something in my whole life. I was able to receive nourishment via the little miracle under the skin. I was actually sad to see the port go, talk about a life-saver.  I truly, honestly learned gratitude from my port.  My gratitude journal is all connected, inter-connected.  Full circle. I am thankful for my wrong diagnosis because it gave me my port.  The support from the port (TPN) was truly able to sustain me, with zero infections and zero blockages the entire time.  Truly a nod from God there.  Port equates to gratitude.

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