Do you or I or anyone know?

I still need to write about Halloween (let's be honest—I still need to write about a lot of things! I still have a list of things to write about from summer break!) but Halloween festivities seem rather trivial in light of recent events.

Though I can't find any evidence of it, I seem to recall my mom's cousin Mary repeating the adage "Life is fragile!" on Facebook (several times). Usually I just smile a little as I look at the hearts and flowers surrounding her reminder. It's true. Death, it seems, is almost as common as birth.

Somehow, even though my brain knows this, I sometimes feel like I'm still in that super-human phase of life—that phase where I'm untouchable. Like, sure, pain and death exist for other people but not for me.

My friend's brother passed away the day before Halloween from an accidental heroin overdose. She had just moved her little family, nine days before, to China. So as you can imagine, she's feeling all sorts of ripped apart right now. My heart broke for her as she described her sorrow.

Life, as they say, is fragile.

When death is for others it feels so matter-of-fact.

When death is knocking at your door it gets personal. It feels like blinking in and out of consciousness. It feels like chaos and like peace. It feels like forever and all at once.

And that is only for the living.

My grieving friend, Rachel Hunt Steenblik, who writes beautiful serious poetry shared a beautiful poem about grieving called What the Living Do by Marie Howe. Rachel has been alluding to this poem as she shares going through the actions of, for example, getting her children dressed in their Halloween costumes while drowning in agony.

As a somewhat sassy poet of an entirely different genre, my thoughts turned to the traditional English/American folk song Oats and Beans and Barley Grow. It goes like this:

Oats and beans and barley grow
Oats and beans and barley grow
Do you or I or anyone know
How oats and beans and barley grow?

But my mind wasn't on oats and beans and the only words screaming in my mind were: "Do you or I or anyone know?!?!?!!!"


Do you or I or anyone know...

• How to tell if someone is mere hours away from death?
• How to load a rapidly failing body into a vehicle?
• How to answer the children's questions of, "Where's Grandma?"
• How to carry on like normal (do we carry on like normal?)?
• How incredibly fragile life is?

Karen has been sick for a while, but we've all been passing this cold around so we didn't think much of it. She was too sick to join us on our outing to the pumpkin patch on October 19 and she was still sick on Halloween. But Benjamin has been coughing for about that long as well so we didn't think much of it. 

She and Reid had tickets to see Lore (live) at BYU on Halloween night, so despite feeling under the weather, she took some cold medicine and stuffed her purse full of illicit (unwrapped, so as not to make crinkly noises in the middle of the performance) cough drops (food and drink are not allowed in the theatre). They survived the evening and thoroughly enjoyed the performance.

That night, in addition to her regular nightly regimen, which includes a medication that tends to make her very sleepy, Karen took some nighttime cold medicine and the mixture of the two was the impetus for a rather unfortunate accident in the bathroom. Karen fell asleep while she was getting ready for bed, but, like, she literally fell asleep. 

Everyone was already asleep by the time she went to bed, but the noise she made when she fell managed to wake several of us up. Rachel mentioned hearing a crash in the night. I, myself, had been nursing the baby in bed, dosing in and out of sleep, and figured that one of my children had fallen out of bed. I settled Alexander and went to check on the kids, but found them all snuggled soundly in their beds. So I went back to bed. 

It was Reid who came to the rescue. He heard her calling for help and found her in a pool of her own blood. She'd hit her head, her nose was bleeding; it was a big mess (I'm told). He cleaned up the mess and helped her to bed and in the morning—November 1—she looked like she had either come from a wrestling match or a Halloween mask contest. 

She had quite the shiner. 

But she was sure she'd be fine.  

As the day wore on, however, she found herself in more and more pain and finally decided she should go get checked out, just to rule out any broken bones or concussion or anything. They found no broken bones, though they couldn't 100% rule out broken ribs because those are difficult to x-ray, but they did find a touch of pneumonia in her left lung (the same side that had been hurting after her fall).

They gave her some pain medicine and, I believe, an antibiotic, and sent her on her merry way. 

And then things spiraled out of control. 

She slept most of the day on Friday, getting out of bed only to meet with her visiting teacher ministering sister. But then she went back to bed and we didn't hear from her this morning (which isn't altogether unusual). 

For my part, I tried to keep the children playing quietly so as not to disturb her. Karen's not really a high maintenance person and I figured her needs were getting met. She's a pretty independent person and when she doesn't feel like being independent she's pretty straight-forward about asking for help. 

I have seen Reid padding up the stairs on multiple occasions since living here, only to watch him duck into the pantry or fridge to retrieve an item, before disappearing down the hallway to deliver it to a sick-in-bed Karen (who had texted to ask him to bring her such-and-such). It's sweet.

But she wasn't acting well yesterday evening. She wasn't expressing her needs as clearly as she usually does. For example, she fell asleep in the armchair in the living room during dinner. She didn't join us at the table and then she just fell asleep, which is out of character for her (especially because Rachel had friends over, which I feel terribly about now (but I figured that since they were just going to watch a movie it wouldn't disturb Karen, who had mostly been relegated to her room anyway (no one had realized how very sick she was at this point (after all, she'd just been to the doctor where she'd been diagnosed with very mild pneumonia, which doesn't sound very serious)))). 

Reid helped her into bed and then that was it. She was down for the night. 

We didn't hear from her this morning, which isn't unusual because Karen isn't a morning person and if given the opportunity to sleep in, she will. 

I had just sat down, around 11:00, to nurse Alexander so I could put him down for his morning nap when Reid called up to me from the entry way. 

"Nancy," he said. "I need some help!"

He sounded so uneasy that I told Alexander that we could nurse after we saw about what Grandpa needed help with and it's a good thing we hurried because what Grandpa needed help with was Grandma. 

He'd decided that she had slept long enough and he brought her something to drink so that she could stay hydrated, but when he tried to wake her up, she wouldn't wake. 

"I think she may have slipped into a diabetic coma," he said. "I need help taking her blood sugar. I don't know how to do it."

By this time, Karen was somewhat awake, though she was not lucid. I asked her where she kept her blood sugar testing kit and instead of answering me she just reached her arms and made a kissy face (in her defense, her brain registered that she had seen a baby (though I don't think she know what baby she saw) and she loves babies (but she was also rather delusional so she was acting like a drunk person who loves babies))).

Reid realized what I was asking about and told me where it was and I got the pokey-thing all loaded and fumbled with getting the test strip into the little reader-thingy. I was shaking so badly I could hardly get all the pieces where they needed to be. I was scared; Karen did not look well. 

I had Reid "milk" her fingers to get the blood flowing and then I stabbed her finger with the lancet but I didn't stab it hard enough (I've never poked anyone else before so I'm sure I jerked away a little) so then I had to do it again and this time we managed to get a good sample of blood. 

"Is that low?" Reid asked.

"It's not low at all," I said. "It's a little high."

But it wasn't alarmingly high either (later, at the hospital, it would be). 

"What do you think we should do?" Reid asked. 

"I think we should take her in," I said. "She does not look good."

Reid went to call the emergency room (who advised him to call an ambulance). I went to call Sister F (Karen's wonderful ministering sister) and Andrew (who was out grocery shopping). 

"Come home now," I said. "Your mom's not well. She needs a blessing."

And so he turned the car around (and now we have no tub butter) and Sister F came running to help.

Once Andrew was home we prepared to take Karen to the hospital. Reid did not want to call an ambulance; instead he called Aunt Linda. She brought over one of Uncle Trevor's old wheel chairs and her accessible van and somehow (between the five of us) we managed to get Karen dressed, out of bed, into the chair, into the van, and to the hospital. 

**********

Sepsis.

I can't help but inhale sharply when I hear that word. It's a dangerous, unpredictable word. We lost Grandma Sharon to septic shock a few years ago so our family knows how serious sepsis can be, and how suddenly the symptoms can become overwhelming. 

Sepsis.

According to the Mayo Clinic, you must "exhibit at least two of the following symptoms" as well as have a confirmed infection (pneumonia takes care of that):

• Body temperature above 101 F (38.3 C) or below 96.8 F (36 C)
• Heart rate higher than 90 beats a minute
• Respiratory rate higher than 20 breaths a minute

We didn't even realize that there was such a thing as "cold" sepsis. Karen's body temperature was definitely low. We didn't even think of taking her pulse or counting her breaths (since she was still alive), But she was as pale as a ghost and had taken another fall that morning when Reid tried to help her to the bathroom (and when your heart rate is wacky you tend to pass out easily). Looking at that we wouldn't have known she had sepsis (and we didn't know that's what she had), but looking at the symptoms of severe sepsis, however, would have been more telling for us, though many of those symptoms could mean anything. For Karen, it meant her kidneys were failing.

According to the Mayo Clinic, "your diagnosis will be upgraded to severe sepsis if you also exhibit at least one of the following signs and symptoms, which indicate an organ may be failing":

• Significantly decreased urine output
• Abrupt change in mental status
• Decrease in platelet count
• Difficulty breathing
• Abnormal heart pumping function
• Abdominal pain

Fortunately, we got her to the hospital in time ("The Mason Popsicle!" she insisted several times before we worked out that she had meant to say "Payson Hospital"; everything she tried to say came out garbled like that so, as you can imagine, getting a straight answer about anything was tricky (add to that the fact that she was not answering questions correctly—she told Reid they had seven children (they don't!))) and when the administered fluids to her she responded to the treatment. Her potassium levels started to drop, which meant her heart rate began to return to normal, which meant her breathing got a little easier and her blood pressure began to stabilize.

Had she not responded well to treatment, she would have been diagnosed with septic shock (again, according to the Mayo Clinic). 

They were still worried about her kidneys when we went to visit her this evening (Reid sat in the lobby with the kids* while we took turns seeing her in the ICU (because small children aren't allowed in the ICU (Rachel got to go in, however) and Alexander, we knew, would scream for anyone he didn't know (but he'll let Grandpa watch him)) because she wasn't producing any "output" despite having been pumped full of fluids all day long (they were forcing fluids into her as fast as they possibly could). So I, for one, left the hospital feeling very worried still. 

Reid texted at dinner to inform us that she'd managed to (*ahem*) produce some "output" for her catheter bag and we were all so relieved that cheers went all around the table (dinner was pizza, which we picked up on the way home from the hospital). This meant that her kidneys were at least trying to filter her blood again.

We're all still very worried but we also feel hopeful. The doctor said he can get her out of the "danger zone" but that she is very sick and there is no magic pill for an illness like this. Recovery will be lengthy. We got her help in time. She had been, the doctor said, mere hours from death. 

Pneumonia can be like that, he said. You can be battling what you think is a mild case of pneumonia and then—bam—your immune system is completely overwhelmed and your organs start shutting down. Sepsis. 

And my mind screamed, How are we all walking around?! If one little thing can knock us down this quickly, how are any of us still here?! We are all miracles—ALL OF US!

Oats and beans and barley grow, oats and beans and barley grow. Do you or I or anyone know...what an absolutely delicate balance our bodies require to stay alive? 

Life is fragile and mysterious. 

Life is a snapshot in eternity.

Life is made up of tomorrows—

Of hopes and dreams

Of love and fear

Of sleep

Of waking up

Of breathing deep.

Life is yesterday and today.

Life is an eternity of snapshots.

Life is miraculous and fascinating.

I hope our tomorrow is filled with good news. If you're the praying type, please offer a prayer for Karen. Or fast for her (I always am secretly pleased when trials like these (Benjamin was born on a fast Sunday) happen on a fasting weekend, not that that's the only time we can fast or should fast but I have just come to see it as a tender mercy of sorts). 

* The kids! I didn't know what to tell the kids! Only Rachel and Alexander saw Grandma in her state of delirium. And then I handed Rachel the baby and asked her to keep all the kids in the basement. And then after everyone had driven off with Grandma I sent the kids to the park with their friends and put the baby down for a nap and worried and worried and worried about how I was going to tell the children before I even now what I was going to have to tell them. 

When Alexander woke up I walked down to the park to join them and still didn't know what to say, so didn't say anything. After about an hour, Zoë asked to go home so she could go potty, so Miriam and I walked her home, leaving Benjamin and Rachel to play with their friends. 

While I was parking Alexander's stroller, Miriam came bursting from the house into the garage.

"SEPSIS!?!"

She hurled the word at me through the dimly lit garage (we really need to get up there and change the lightbulbs), angry, confused, panicked.

"I overheard Dad talking on the phone to someone and he said Grandma has sepsis!!?!" she continued, shrieking, accusing. 

That's one way to break the news to the kids.

"Yes," I answered softly. "Grandma is in the ICU. She's been diagnosed with sepsis. She is not doing well."

"You knew! When were you going to tell us?!"

"Soon. When we knew more."

I didn't know what more to say, so luckily Grandpa called to say Grandma was responding to treatments (hallelujah) and that we could come visit her. Miriam quickly started making a card to take the hospital and got off my back. 

Then we drove to the park to pick up the other two kids and explained that Grandma has sepsis, which is dangerous, and that she was very, very sick but was responding to treatments and was making coherent sentences again so we could visit with her. 

Visiting time was wholly unsatisfactory for the little ones stuck in the lobby, but I think it was good for Rachel to see Grandma (especially after seeing her this morning). Grandma looked awfully sick still, but much better (and much more alert) than she had been in the morning.

(Poor Alexander has spent the day looking for her (he loves her so much (sometimes more than he loves me, I think)). I have a few videos of him pounding down her bedroom door. He was so frustrated that she wouldn't come out to see him and was so sad when I told him (over and over again) that Grandma's not in her room).