Wednesday, July 27, 2011

to sleep; no more

The New York Heart Association standardized the definition for a Class IV heart disease patient as
"Individuals with cardiac disease that results in the inability to carry on any physical activity without experiencing discomfort. Even at rest, they may experience symptoms of cardiac insufficiency or anginal pain; discomfort increases with any physical activity." (1994)

B-type Natriuretic Peptide (BnP) or N-terminal pro b-type natriuretic peptide (NT-proBnP) is a blood test that is used to help diagnose whether or not a patient is at risk for heart failure, and to grade the severity of that heart failure.

BnP is a hormone that serves the purpose of regulating the blood volume in the body, and also helps define how hard the heart must work to circulate the blood. The BnP is the active hormone, and it's counterpart NT-proBnP is an attached non-active hormone.
It is produced in the heart's left ventricle -- the main pumping chamber in the heart -- and when it is stretched from having to work harder, it produces increased amount of the BnP hormone. Before your heart gives out from congestive heart failure (CHF) it will release massive amounts of the hormone into your blood as it struggles with every beat.

Someone who has a heart disease and is taking medications to control that disease, such as an ACE inhibitor, beta-blocker or diuretic will normally have a lowered BnP rate.

The normal range for a person's BnP count in the standard hospital-administered blood test is 0-200. At a BnP count of 200 you're considered at "mild risk" for a congestive heart failure. 200-400 is considered "moderate risk" and the person can be expected to have a slightly limited range of physical activity. 400-600 BnP count is also considered "moderate" but with a marked limitation of physical activity. 600-900 BnP count is considered a "severe risk for heart failure" and when my Grandpa and I checked him into the ER the day after he fell at home in the middle of the night, his BnP level was at 4,900.
His heart was giving out.
Of the above listed New York standardized Class IV heart disease patient description, ever single word of it fit his description perfectly.

His apnea had progressed into central apnea, an increased "symptom of cardiac insufficiency" and while his airway remained open while he slept, often his chest muscles and diaphragm would temporarily fail. The dropping blood oxygen would signal his brain to gasp in breath, but unlike the usual form, he wouldn't awaken with the sharp intake, instead staying asleep.
Gone was the snoring, he slept quietly in his hospital bed between central apnea attacks, but he was dying.
The dementia had progressed to the point where only once or twice for a brief moment each day would he recognize myself or any other family member that was with him every moment.
He had lived for almost 86 years, and I'd known him for only 23 of them but loved him like only a grandson could love a grandpa.

He was given God's mercy every moment of his life and it didn't stop when he entered the John L. McClellen Memorial Veteran's Hospital on 4300 West 7th Street. He had the kindest, most sincere and understanding doctors a terminal patient could ask for. They resisted the urge to keep him unconscious much of the time, allowed his family members to carefully make each decision with prayer and consistency for the desires he'd previously expressed, and they followed up with him often.
C.C. Donald rapidly progressed over the week he was in the hospital--within a few days he began sleeping twelve to eighteen or twenty hours at a time, denying food, and growing rapidly weaker. He was at first more combative, then less, then more again, and soon every waking moment he was "on the job" again, working as a block mason in Southern California.
He spoke only of needing to get back to work, install a window, finish up the blueprints, find another measuring tape and progress on his deadlines.
Deadlines that had long since past, but his frail, weakening heart and mind found peace in the memories there.

Often war vets return to Korea or World War II and their mind relentlessly brings them back to the memories of the horrific things they experienced there, but my grandpa was safe as he traveled back to work, needing to move "that pile of bricks over there."
He loved Jesus and not only read but pored over the scriptures in their original languages daily. He loved my Grandma and had he made it until August they would've been married for 60 years. He had three sons and my Mom was his youngest daughter. The day before he passed away she went to his desk in back at home and found chocolate stashed right where he knew she and all the other kids and grandkids would find them.

Just after midnight, early Thursday morning my Grandpa Donald went to see Jesus face-to-face and singlehandedly ask him more theological questions than Luther, Calvin and Piper combined.
My Dad watched as he slept and his carotid pulsed once, then no more as he passed away quietly in his sleep.

He loved lemonade, the Java Chocolate shakes from Arby's, big, thick slices of bread covered in a thick layer of peanut butter, and big breakfasts with eggs, bacon, toast, and preferably Grandma's homemade  turkey burgers.

Conrad Calvin Donald's Obituary


Tuesday, July 26, 2011


"Hi James, how are you?"

"Good. How are you?"

"I'm great. What're you up to?"

"Another risk to the pregnant woman with diabetes is a dystocia, caused by fetopelvic disproportion if fetal macrosomia exists. Keep in mind they're also at increased risk for recurrent monilial vaginitis and urinary tract infections because of increased glycosuria, which contributes to a favorable environment for bacterial growth, which if left untreated, asymptomatic bacteriuria can lead to pyelonephritis."



"I know, right? You can never be too careful."

July 19th, 2009 Boulder, Colorado

The sign flashed 5:22, and just below it on an old wooden bench a man grizzled and weather worn stared up at me behind thick prescription lenses.
“You know you’re lucky you get to wear your uniform in public. When I was in if we wore our fatigues, which is what they used to call ‘em, I’d get shit thrown at me, spat on, and screamed at.”
It wasn’t difficult to figure out.
“You were in Vietnam?”
‘Yes sir I was.”
I walked over to him and offered my hand.
“Thank you for what you did. It means a lot to me when I hear about how it was to serve when you were hated for it. I can’t imagine the hell you went through coming home to that, but let me tell you that my generation knows the real story behind it and we’re all thankful.”

His hand shook independent of his controlled movement with a slight hint of tremors, and his voice reflected the same term.
“You’re welcome. We did what we had to do, it wasn’t pretty but we knew it was important. Have you  been to Iraq and are coming home?”
I knelt down to have the conversation with him at his level.
“You know sir, I haven’t gone yet, but I wouldn’t hesitate to go if the opportunity arose.”
“Well son, that kind of attitude is important. It means you’re exactly where you need to be. Here, I want you to have this.”
His hand shook as he pulled out his wallet.
“Now I know what you’re going to say, they all say it. They tell me ‘You don’t need to do that’ when as a matter of fact I do. I need to do this because I want to thank you in advance for your career in the US military son.”

I swallowed and my mind sped at a million miles an hour, all kinds of emotion welling up. I didn’t deserve this, he couldn’t afford this, how do I say no, what should I do? But no answers.
He pulled out a hundred dollar bill.
“No sir, I can’t take that. I’m only doing my job, its what I want to do.”
“Now you listen here. You are serving, and at some point you’ll need to accept others saying thank you. I do my part in supporting you boys out there, I send you all care packages out in the field and put in a word to the good Lord on your behalf. I want you to take this and take that lovely girl out to dinner. Somewhere real nice. That’s what I want you to do. Now take it.”
His voice was thick and raspy and his hand shook a little, then he spoke the words that made me turn cold.
"It would give me real joy if you'd take this from me son. My hand's getting tired."

Numbly I reached out and grabbed the largest sum of money a stranger has ever given me.
“Now go’on. Isn’t that your bus? Don’t miss it, she’ll kill you ya know. Don’t keep those women waiting.”
I grasped his hand with both my own and was surprised how much my own voice shook. I thanked him again for setting the standard in serving that I get to follow, and ran to catch my bus as it was pulling away from the curb.
All the most beautiful, right words fled me when I needed them the most. 
I was left without them when I could have used them to build into an old man’s life, but instead he used them to build into me. I sat on the bus silent. Staring out the window and going over and over in my head through every range of human emotion known to man.
There was a million things I could have said or done differently to show him how much I appreciated him, I could have missed my bus and taken the next one as we sat and talked about life, how I wasn’t able to be deployed for at least another year -- I could have asked him about his life and his children, grandchildren, and perspectives on faith...
But I didn’t.
I got on the bus incredibly blessed by someone I spent six minutes of my life with, and wasn’t able to properly thank. 

I’ll never understand why it works that way.

Tuesday, July 19, 2011

an act of forgiveness

Rarely does an article or essay hand me what I've come to affectionately term as a "stay of heart" or "pause." The following is an excerpt from an article I read three days ago on CNN.

"I cannot tell you that I am an innocent man. I am not asking you to feel sorry for me, and I won't hide the truth," Mark Anthony Stroman said from Texas death row at the Polunsky Correctional Unit in Livingston. "I am a human being and made a terrible mistake out of love, grief and anger, and believe me, I am paying for it every single minute of the day."
The 41-year-old prisoner is scheduled to be executed Wednesday for a murder he once said was fueled by "patriotism," but which the state argued was motivated by pure hatred. 
The admitted white supremacist was convicted in the deadly shooting of an Indian man, part of a killing spree that began just after the September 11 terror attacks. His target: those he believed were of Middle Eastern background, in revenge and retaliation for the worst domestic terror incident in U.S. history.
A Pakistani man was also murdered and a Bangladeshi man was seriously wounded in separate attacks.” -CNN

It's not hard to imagine--a man, furious at the genocide carried out own his own countrymen in a vicious surprise attack lashes out, robbing and killing essentially the first people he comes across that look like they're from the same people group as the terrorists. 
A self-proclaimed white supremacist with a long history of violent crimes, his response was nothing if not natural. As he stated himself, he is "a human being [who] made a terrible mistake..." 
There was little extraordinary about it; the man was what my dad would call "a bad person who hurt a lot of people" and it was just another set of vengeful if not misdirected killings.

Rob Bell is now famous (or infamous) for popularizing the statement "love wins." While he treats it as a form of entitlement to the Kingdom of Heaven, many disagree that the entrance fee to permanent residency behind the "pearly gates" can be paid in full with that statement alone. 
Controversy aside, Jesus was nothing if not decided when he said in Corinthians 13:13 "And now these three remain: faith, hope and love. But the greatest of these is love."

Barnes speaks of the sheer power behind Jesus' statement in his concordance of Corinthians 13:13: "[Love is] more important than faith and hope, because, although it may co-exist with them, and though they all shall live forever, yet love enters into the very nature of the kingdom of God; binds society together; unites the Creator and the creature; and blends the interests of all the redeemed, and of the angels, and of God, into one."

The Lord also spoke through the author of Galations saying, "For in Christ Jesus neither circumcision nor uncircumcision has any value. The only thing that counts is faith expressing itself through love" (5:6).

Since the crimes were committed in Texas, the criminal would be facing the death penalty for his violent crimes. Wondering if that would really ever happen in this “day and age” I started to move my mouse to the glowing red dot that would close the web page out, when something caught my eye.
There, tucked away at the bottom of an article I almost didn’t finish, was an astonishing ray of light that pierced through my laptop screen diving directly towards my heart.

“One of Stroman's biggest supporters is the man who survived his ordeal and testified against the defendant. Rais Bhuiyan is a devout Muslim who came to the United States to pursue his education. A decade ago, he was about to be married and was working an extra job.
He says a large "angry" man wearing a bandana, sunglasses and a baseball cap approached him in the store and asked, "Where are you from?" Confused, Bhuiyan asked, "Excuse me?" Immediately afterward, he remembered being shot, "the sensation of a million bees stinging my face, and then heard an explosion."
Bhuiyan believes that his attacker does not deserve to die and has created a website,, to urge Texas to spare Stroman's life.
"In order to live in a better and peaceful world, we need to break the cycle of hate and violence. I believe forgiveness is the best policy, which helps to break this cycle," he said, calling himself a victim of a hate crime. "I forgave Mark Stroman many years ago. I believe he was ignorant and not capable of distinguishing between right and wrong. Otherwise he wouldn't have done what he did."
Bhuiyan traveled this month to Paris to urge the European Parliament to step in and file a formal request for Texas to commute Stroman's sentence to life in prison." -CNN

Romans 5:20-21 states clearlyThe law was brought in so that the trespass might increase. But where sin increased, grace increased all the more, so that, just as sin reigned in death, so also grace might reign through righteousness to bring eternal life through Jesus Christ our Lord.”
“Grace might reign through righteousness?” 
“…to bring eternal life through Jesus Christ our Lord?” 
These statements are so direct, so cutting and powerful. No matter how “bad” the evil is, even a man who goes on a rampage and kills several random and completely innocent people, love still wins. Even as sin reigns in death, it's by definition limited. Life given by Jesus is limitless, and grace brings that to us. Limitless life given to us by him. Righteousness. 
It is grace that brings righteousness and eternal life to the throne. The darkness can't stand against the light.
Love is not arbitrary. It is not a word with a broad meaning and gratuitous generalities that allow for it to “transcend all religions or faiths.” It can function that way, but carefully defined in scripture is how we experience the triumph of love in all circumstances -- even the darkest of evil acts. 
Romans 5:1-2 “Therefore, since we have been justified through faith, we have peace with God through our Lord Jesus Christ, through whom we have gained access by faith into this grace in which we now stand. And we boast in the hope of the glory of God.”

“Breaking the cycle of hate and violence” will help to create a better, more peaceful world. Mr. Bhuiyan was right. But it is Jesus alone who can do that, and he promises he will. In forgiving the man who shot him in the head, Mr. Bhuiyan exemplified the love that Jesus has for his children, and the role we are to play in his kingdom.

Who am I supposed to forgive? Who am I supposed to love, that I might be able to boast in the hope that is our being a part of the glory of our Father -- a right given to me by Jesus?

And this is only part of the story.