In the hospice

Hi folks, this is Roger Bourland, Andy’s older brother. I’m out spending the holidays with family, but mostly to spend some time with Andy. In that you have not heard from him for a while, I am taking the liberty of updating you on his status.

Andy is in the hospice now and happy to be there. It is a beautiful place with a wonderful staff. On Sunday, we had a birthday party for his daughter, Hannah. It was a typical Bourland party: rowdy, fun, loving, good food, and merriment. Andy was in great spirits. He had many pictures taken with the family. After a few hours his energy dwindled and he went to take a nap. The family cleaned up and left the hospice. I apologized to one of the nurses for being so noisy and she assured me that it was not a problem and was happy to have had us there for him. This week, smaller groups have gone to visit. A small group went on Sunday to watch the game. Yesterday, he needed the day to regain some energy so we left him alone to rest. Today my husband and I will go over and bring “It’s a Wonderful Life,” one of his favorite movies, and watch it with him. Tomorrow, New Years Eve, a few of us will go over to celebrate the New Year.

Several of us have urged him to do a few more posts. He seemed a little nervous about doing it “being the perfectionist that I am” and as blogging takes sustained mental energy, he fatigues easily these days. So, I’m hoping to help him in this process by proofreading his posts, or being his faithful scribe. Whatever the outcome will be, I’ll keep his readers up to date.

He was deeply, deeply moved by the warm responses you all have given him on his recent posts. Our family thanks you for your outpouring of appreciation and concern for him.

As a part of my effort to be prepared for the worst as I hope for the best, I’ve been under home hospice care for the past month and a half.

In my case, home hospice care means I have a visiting nurse coming by about 3 times a week, checking on my health status, taking all my vitals and talking to me for a while about how I’m doing. It also means that I get a weekly visit from the hospice social worker, who helps me to identify, understand and make decisions on a variety of really complex issues.

This past week, my social worker (Celeste) came by to discuss one issue that I thought was rather cut and dry, but proved to be a whole lot more complex.

… and that is, whether I would prefer to die at home or in their Hospice House.

Well, I thought that was a pretty simple issue when she brought it up, and told her that when I am in decline and dying, I would of course want to be at home, surrounded by my loved ones.

Good enough, said Celeste, but we’ll probably need to bring in a hospital bed so that you can be properly cared for. Any idea on where in the house it ought to go?

My wife and I bounced around some options and finally concluded that we could set up my hospital bed on the first floor (Celeste is concerned about me going up and down the stairs) in what is now our TV room.

But there’s a rub…

My son and 3 stepdaughters like to catch up on their TV watching on weekends, and there would be no place for them to sit, nor would I even want to be around while the stepdaughters watch those teenage situation comedies they are inexplicably drawn to. We figured a workaround for that (the kids could watch the TV in the master bedroom, since I won’t be there anyway).

But then there we realized that if you put me in a first floor room, I have no access to a shower or bath. Hmmm… OK, we’re going to have to think about that some more.

Another, rather odd issue occurred to me: if I were to die in the TV room, would the kids be creeped out or concerned that my spirit may be lurking in the room.

At about that time, my stepdaughter Elinor (15) arrived home from school, so I asked her how she would feel about the TV room were I to die in there.

Oh yes, she answered immediately, I’d be totally creeped out and wouldn’t want to go in there for at least a month.

So I wasn’t too far off the path by surmising that that would be a problem.

Do you have arrangements made to have friends or family with you during the days when Jeanne is at work? With her new job, after all, she’ll be a 45 minute drive away 9 hours per day.

Well, the only relative nearby is my daughter, Ashley (28) who works full time and would also be a good 45 minute drive away.

And all of our friends work. Most, a good distance away from here. So that’s not an option. There’s a woman (a retired nurse) who lives down the street from me and is always around, so that’s a fallback option, but we haven’t spoken with her in over a year.

Now I’m investigating the Hospice House option, as the home option (when my health starts going into the final decline) seems to be fraught with problems.

But without Celeste, and her loving courage to ask and flesh out the implications of the tough questions, I might have gone merrily along my way only to find myself in a real bind when I need help the most.

There’s a special place in heaven for people like Celeste.

Many of you who know me might have noticed that I have not been around much over the past six months. Prior to that, you may have seen me at various marketing conferences and events. There’s a reason I’ve pretty well disappeared from the scene. I’m living with a chronic illness that will take my life anywhere from a few months to a couple of years from now.

For some background…

Back in 1998, I passed out on an exercise machine at a health club, wound up spending the next week in Lahey Clinic in Burllngton, MA as they gave me one test after the other to determine, finally, that I was suffering from cardiomyopathy. What caused my cardiomyopathy was still in question, but at least they knew what it was. They prescribed some medication for me, installed a brand spankin’ new pacemaker in my chest, and sent me on my way…

Flash forward 4 years to October 27th, 2002. That morning, while doing a strenuous Tai Kwan Do workout with my girlfriend (now my wife) Jeanne and my daughter Hannah, I experience a sudden loss of all strength in my body and felt light headed and dizzy. I tried to walk it off to no avail. What I didn’t know at that moment was that I was in the process of having my first of three heart attacks that day.

Jeanne drove me down to Lahey’s emergency room and, after many hours of negotiating our way through a series of runarounds and incomprehensible delays, when my second heart attack started kicking in, they finally started to do something to help me.

That night, in order to save my life, my cardiologist, Dr. David Martin and my thoracic surgeon, Dr. Richard D’Agostino performed emergency quadruple bypass surgery. It was during that surgery that the doctors discovered the cause of my heart problems: one half of my heart was severely burned (leaving it black and leathery, very inflexible) due to 14 weeks of high intensity radiation treatments back in 1973 when I was being treated for testicular cancer.

Apparently, the burns affected me all the way from my groin to my left shoulder, which caused damage to all my organs in between. So we finally had a diagnosis for my original cardiomyopathy, it was called radiation induced cardiomyopathy.

So a treatment that saved my life back when I was 18 years old was the cause of my heart disease — which will ultimately kill me — some 30 years later.

When I came out of surgery, the doctors were very pessimistic, feeling I wouldn’t leave the hospital alive. Indeed, it took me a long time to recover, and I was never the same afterwards.

A few weeks later I was diagnosed with congestive heart failure, which means my heart doesn’t pump strongly enough to pump blood to all my organs. It also results in a lot of swelling in my legs, ankles, feet, and most recently my belly (my belly looks like I’m several months pregnant — all of it is heart failure related fluid) which I can’t get rid of no matter what I do.

In the ensuing six years, I’ve been hospitalized dozens of times for a variety of heart failure related maladies. Each hospitalization has taken it’s toll: I’ve gotten progressively sicker and weaker with every hospital stay.

One of the problems that surface for advanced heart failure patients is a low Albumin count, which is known in medical circles as Hypoalbuminemia. Albumin is a protein produced by your liver which functions to convert the nutrients you take in into muscle and good things your body needs to function.

A normal Albumin count is around 5. You’re considered to have a low Albumin count at 3.2. My albumin count (since we’ve been tracking it beginning in January of 2007) has ranged from 1.4 to 1.9. Those are dangerously low levels. It’s not a sufficient level to support life. In my case, it translates into a severe level of malnutrition. Though I eat food, it doesn’t convert to the nutrients and other good things my body needs to survive. So I’m literally starving to death. If you saw me, I’m emaciated (with the exception of my aforementioned swollen belly. For that reason, I’m prone to wearing baggy pants and sweaters, so it’s not obvious to people who come by for a visit. I don’t want to freak them out.

So, coming full circle, I have two factors working against my living more than a year or two: congestive heart failure and a dangerously low level of Albumin.

Generally, if a person is suffering from terminal cancer or kidney disease, a doctor seeing a low Albumin count like mine will shorten their prognosis significantly. It means they are dying.

But up until fairly recently, there had been no research on heart failure combined with low albumin counts. I came across a research abstract on Google last night that talked about just that.

It’s pretty dense reading, but let me translate it for you.

The UCLA Cardiomyopathy Center studied a group of 1726 patients with advanced heart failure. They split them up into two groups, one which was comprised of CHF patients with normal (3.4 and above) albumin levels and one with Hypoalbuminemia (below 3.4). They tracked their one year survival rate, and the patients with normal levels of albumin had an 83% survival rate, while those with Hypoalbuminemia had a 66% survival rate. Over a period of 5 years, those with Hypoalbuminemia are 2.2 times more likely to die from heart failure than those with normal albumin levels.

So heart failure and Hypoalbuminemia are a deadly combination, which is why my medical team concluded I’ve got anywhere from several months to two years to survive.

I’ve outlived pessimistic prognostications several times over the years, and I plan to live every day as a healthy person rather than playing the role of the sick patient waiting to die. I don’t give up that easily.

Nevertheless, I’m very weak, have very little strength, can’t walk a full city block, haven’t been able to work in many months, and have great difficulty eating more than a very small portion of food at any given time without getting very full.

I’m prepared for the worst but hoping for the best.

Should my time be short, I’m at peace with that too. I’ve lived a great life, have had many wonderful blessings, have been able to touch many lives and have no lingering regrets or unfinished business.

If it’s my time to go, I go in peace.

If you happen to know someone who knows me, I hope you will feel free to send them a link to this article to update them on my health and my future.

I’d love to read any comments you want to leave, and will be happy to respond to any questions you might have.

Thanks for following this overly long blog entry…

As the father/step-father of 5 teenagers (give or take a year), I get more than my share of exposure to the lives of this generation we are currently raising.

Just as I did when I was their age, they have their share of annoying verbal habits, chief among them being the derisive comment that something is “so gay”. I have yet to hear “so gay” meant as a compliment or word of praise about something, so I can only assume that it is meant as a criticism of whatever it is they’re describing that way.

I happen to have an aunt and a brother who are gay, as well as many friends. The vast majority of them are bright, intelligent and highly creative individuals who are an absolute pleasure to be around.

So as you might imagine, I bristle when I hear “so gay” as an adjective to diminish or criticize something or someone.

I came across this video in a report on CNN. Apparently teen idol Hilary Duff is heading up a campaign to make people aware that the phrase they toss out so carelessly is in fact hateful and homophobic.

It’s only 30 seconds long. Well worth checking out…

I ran across an interesting storythat I wanted to share with you.

It’s about a 62 year old man named Don Doane.

Don was an avid bowler. Every week on the same night for the past 47 years, Don bowled with a group of his buddies at the Ravenna Bowl in Ravenna, Michigan. He was a decent enough bowler, but not once in those 47 years did he ever bowl a perfect 300 game…

That is, until October 16th. That night, he was on. He crushed it. He nailed a perfect 300 game.

And then, while high fiving all his good friends and celebrating the moment, Don Doane dropped dead.

Not only did he go out doing something that he passionately loved to do, he went out on top. I mean, if you’re gonna go, that’s one GREAT way to go.

I don’t know if you’re like me, but I absolutely love to track pre-launch campaigns for Internet Marketing products. I learn so much in the process.

Fact is, there are a couple going on right now that you really ought to pay attention to, just to see how it’s done right.

The first one I’d recommend is Frank Kern’s (whose interview with ClickBank University you can check out at http://www.clickbankuniversity.com/index-kern.html).

Here’s where you can get on his notification list for his videos and check out a particularly good one: http://www.masscontrolsite.com

Another excellent example of using highly informative videos to presell a product was created by Armand Morin:
http://internetmarketingexplained.com/blog/

Be sure and check all those videos out before he takes them down, which should be fairly soon…

Then there are two GREAT examples of videos that actually take the place of a sales letter. One is from John Reese:
http://www.income.com/images/ima/imavideo.html
and another is from a guy I met on the Warrior Forum by the name of Jason Dinner, http://jasondinnercoaching.com/TheResults/indexpdc.html

You may wonder why I’m pointing all this out to you.

It’s because at ClickBank University, we’ve got a great 5 part series of videos on the “Fundamentals of Camtasia Studio” which, if you follow it, will teach you all you need to know to be able to create fantastic videos along the lines of what Frank Kern, Armand Morin and John Reese are doing quite successfully right now.

So be sure to incorporate video into your marketing mix.

That’s the thought for today…

Taking a breather from my normal postings about my business, I wanted to let you know that my wife, Jeanne Walker Bourland, has just launched her first blog, Full Contact Parenting!

Jeanne, of all mothers I know, is indeed, a “full contact mother”. She gets right into the thick of it with her kids. Isn’t afraid to mix it up with them or love them to pieces. Those kids know they have a fully committed and involved mom and they absolutely love her for it — even though she can drive them nuts some times.

I think it’s a blog that is uniquely Jeanne. It’s what she was meant to write about.

In a time where most moms have chosen to work outside the home (not that there is anything wrong with that), she’s fully committed to being a stay at home, full time mom to her kids, aged 11, 14 and 16, and my son, aged 13.

Her blog is about as open and honest as anything I’ve ever read. She’s truly poured her heart and soul into it. She sugarcoats nothing and what you read is pure, authentic, Jeanne.

I actually think that blog stands a chance of developing quite a following.

So now I need to live up to her example.

I’ve already broken my New Year’s Resolution where I promised to blog every day, but I’m still committed to staying in regular touch with you, my readers.

And if I can do so with the authenticity and passion that my wife does, I’ll do well.

So bookmark FullContactParenting.com and read it whenever you have a minute… and leave her some comments! She’ll love to hear from you.

Take care,

Andy