Wednesday, May 2, 2012

Sample Chapter One: No More Tears


A Place with 'No More Tears'


I know what I am talking about because I felt Heaven. Hum Drum. Cross your fingers or tie a bow around one finger and remember that throughout this book, I live drip to drip (intravenous fluid) and battery to battery (9 Volt, to be specific). The Hum Drum is my pump, pumping in fluid 24/7, so that my heart does not empty of blood, and I can stand up without fainting (syncope). Drip, drop. First the car accident occurred, and then I was bedridden. On my first ER visit, I went to a place.
It is a place with ‘no more tears’. I know, because I’ve been there.  

Even though I’ve never heard a lecture on this subject. Not from any church I have ever attended since I accepted Christ as my personal Savior in second grade Catholic school. Not from elementary or high schoolteachers, not from the philosophy Professor in college, and not even from the Holy Spirit class in medical school. Not from Professors of internal medicine, pediatrics, obstetrics/gynecology, oncology, cardiology, surgery, anesthesiology, nor critical care. Not from the priests or the religious clergy standing with me, as patient after patient died in the intensive care unit (ICU) over a span of probably hundreds of deaths and four years learning or leading others in how to help a dying person leave this world with dignity and grace. To be there as each person took his/her last breaths, ‘gave up their spirit’, and died.  And frankly, I cannot even recall the specific Bible scripture that references Heaven as being a place of “no more tears”.  Remember: hum drum. Drip, drip. It keeps me alive.

But I was there, outside the door to Heaven, and I was filled with profound relief and ecstatic joy at never crying again. I felt it so purely and so overwhelmingly that I hope to impart on you one iota of what it feels like to have ‘no more tears’.  And to impress upon you an indelible story that will change your individual human world forever. To let you know that you too can really, truly be at Heaven’s door and be possessed with the monumental knowledge that you would have ‘no more tears’ for all of eternity. To feel ‘no more tears’ and revel and bask in the enormity of an eternity of it.
Unimaginable. 

Hum drum, drip drop. I am a living miracle, wearing a gray Camelback tiny backpack that my son picked out for me, modified with a button, to hold an intravenous bag and a pump. It goes with me everywhere; I cannot live without it. The fluid allows blood to go to my brain. Beep! The pump computer reads, "Occlusion", so I punch outward my left arm, hoping that the motion straightens out any part of the catheter that is kinked. It does, and I can relax a little after the alarm went off.  But that "KNEE-KNOW, KNEE KNOW" double alarm irritant AKA my CADD pump. It really hurts my head.

Heaven. It is neither just a feeling of tranquility, nor a fleeting touch of an everlasting sense of peace. No foo-foo words like that are able to impart the skimming of the waters of the feeling. Not placing time in a bottle and having a standstill or momentary feeling of ‘no more tears’ that you realize is time-limited because something will happen or someone will say the wrong thing to you and then your ‘no more tears’ will be lessened or gone. Instead, it is an all-encompassing beginning that starts outside the door to Heaven, before you even pass through the door to Heaven. It is an inkling, a blink of the eye.  First you don’t have it, and then suddenly you have it all.

You are bathed (i.e., submersed, surrounded, uplifted, and glowing) with one immediate trait of knowledge: no more tears. Hum drum, drip drop. To simultaneously comprehend that your most beloved ones on earth would be actively crying for you forever, either literally or in their own memories. To know they are crying for you now, as you lay in the Emergency Room gurney with death’s mask on your face, pale and green with blue veins under your eyes. 

Hum drum, drip drop as I am writing this book. On the way to Heaven, one realizes a few things. Knowing that your sons and your daughters would grow up without you guiding them through life, laughing with them, playing with their hair, or tucking them into bed.  Knowing that your loved ones would not see you again, and that you would not share a snack or a meal with them. Unless they ended up with you in Heaven when they died. Hum drum, drip drop as I thank God for another day, and another battery. 

Each time we insert a new catheter in my arm, we realize that we may not be able to use this arm again, as we ascend upward from my elbow (i.e., antecubital area) to my upper arm with each different catheter. Hum drum, drip, drop. Eventually, the radiologists want to go into my neck veins. When we run out of arm veins. Hum drum, drip, drop. A sound very ‘vampire-ish’ to me, and it does not cause me to have great enthusiasm for this procedure. I think we will.....wait. When we run out of arm veins. Once we run out of arm veins, we'll use neck veins. Hum drum, drip, drop. Hum drum, drip, drop.

If there's nothing "new" out there by then, I have been told that I'll be a patient with dysautonomia and all her veins used up. Hum drum, drip, drop. My life is as long as the veins last, as long as the PICC line lasts, as long as we use sterility in procedures such as iv tubing changes every three days so we don't get another presumed PICC line infection. Hum drum, drip, drop. My PICC line is in for life, they say. But God has a plan.

Getting back to Heaven, and knowing that you will not cry for your loved ones; hum drum, and drip, drop. I live second to second, knowing that any minute I can fall, have a blood clot go to my brain. But even that information would not take away your own feeling of the purity of basking in the permanence and purity of ‘no more tears’. To be so very filled with ‘no more tears’ that you are stunned at yourself when you vehemently and most assuredly say to yourself, “They are crying for me on earth.  But I am not crying for them.” And knowing that you will never, ever shed one more tear that rolls down your cheek and lands on the floor. Hum drum, drip, drop.

You see, I was hit by a lady and then sustained a traumatic head injury with other rare injuries that took faith in God, the support of my husband, perseverance, my own medical knowledge, and ‘doctor shopping’ to ultimately reach a long list of diagnoses. Hum drum, drip, drop. I had to micromanage myself as a physician, and think as a physician, in order to reach this point in my life where I can stand up and walk around. Hum drum, drip, drop. I may as well accept this rather peaceful pace of the pump. But the hum drum wakes me up all throughout the night, and I hate it when the PICC line iv gets accidentally pulled out. We drop all plans and realize it will be another hospital stay for me. Anywhere from 3 days to 2 weeks. Pop! At any time. Hum drum, drip, drop.

My three-year old was in the car during the accident. Hum drum, drip, drop. I am constantly reminded of the palatable beauty and pleasure that interacting with children brings. Now six, she has an old soul and never knows when her Mommy will be taken to the hospital. Or if her Mommy will be home when the little one gets home from school. She never knows if this is the time that Mommy will die, and when I come home from the hospital, I have to teach her to trust in loving me again. Hum drum, drip, drop. My iv bag holds one liter, so it lasts 16 hours or so. I hope someone took my next bag out of the refrigerator to thaw, because I do not like cold fluid going directly into my superior vena cava, which dumps blood directly into the heart.

I was not in an intersection or at a light or stop sign when the accident occurred. Hum drum, drip, drop. It was a bright and sunny day, around 2:00 pm on a Tuesday. BAM! My first and repetitive thought was, “I didn’t do anything! I was just driving on the street!” She hit my left passenger wheel, rippled under the gas tank, pulled away some of the rear bumper, then BAM! I faced a slew of oncoming traffic, since now I was across my lane and into opposing traffic. Hum drum, drip, drop. Apparently she hit someone behind me and I thought I would be repetitively accordioned like a standstill tennis ball; hit from in front, then hit from behind over and over again.  My rear axle was broken.  The truck behind me (the second BAM!) was totaled, as was the lady’s car, a Beemer that was now accordioned up to her front seat.                         

Everyone walked away from the accident, including our 3-year old our daughter and our chocolate Labrador, Ella Bella.  Slowly, my conditions creeped up and declared themselves to the point that my life is the way it is today. Hum drum, drip, drop.  Did I mention that no one stopped to help? Every car wiggled its way around our three displaced vehicles and proceeded along as if life was normal. One lady had her window down as she kept driving away, and I kept shouting, "Will somebody stop? I have a baby in the car!" Hum drum, drip, drop.

As time would eventually tell, to date and to my knowledge, only I was injured in the accident. Today, other mothers volunteer to me that I was plodding around because I "took" all the injuries the same way as any good mother would want it to be: so that my child would have none. Hum drum, drip, drop, and hope my PICC line stays in through Christmas. I still agree with them, and I feel so blessed that the others in the car seemed fine. I am convinced that if the lady had not hit me first, her impact on the truck would have cost the truck's passenger his life. To this day, I am inwardly glad that she hit our car first. Remember the sound of the pump. It never stops. Hum drum, drip, drop.

Two months later, I lay in my bed upstairs. Something was very wrong with me and I felt death was upon me, slowing taking my soul away. Unbeknown to me, my left vertebral artery had begun to dissect.  I looked out the leaded glass windows to the pepper trees and oleanders beyond, thinking that I would never get to garden again. Hum drum, drip, drop. I looked around our room, focusing on the bedroom set that we picked out after being newly married, recalling that I never wanted to purchase another set again. The bedroom set, handmade from Bali, was unique and tropical, classy and fun at the same time. It was a good bed to die in. If I fell asleep, I knew I would not wake up. I was tired. Hum drum, drip, drop.

I don’t know why I didn’t telephone my husband, who was downstairs. Instead, I reached for the phone in a last-ditch effort to relay my thoughts. Hum drum, drip, drop. I called my sister in Maine, barely able to whisper my sentiments. I told her that I felt that I was going to die. I said, “Make sure and promise me that my daughter will always be in touch with your daughter. I want all my clothes to go to my daughter, and my son and husband could figure out the rest.” I didn’t have the energy to say much else other than, “I feel like I’m about to die” and “I love you forever”. I didn’t really believe it, or I would have called my husband. I just felt so tired and only later did tell me what I said, as I had forgotten. Hum drum, drip, drop. Through God and an excellent doctor, the pump and fluid have saved my life. Otherwise, the alternate path awaited me.

I lay on my stomach, feeling pulled downward, hot and heavy on the bed. My eyes watered and the tears dropped over my nose as I waited for the inevitable deep sleep to overcome me and take me away. Hum drum, drip, drop. I was ready to rest. To let my soul go.

(My sister apparently was upset as we hung up. Immediately she began stewing in Michigan for twenty minutes, wondering whether or not to contact my husband, Michael. After twenty minutes, she then called Michael and he immediately raced up the two-flights of wooden stairs to reach me.)  Hum drum, drip, drop continues day and night.

Suddenly, I was being pushed and prodded. I could hear Michael’s voice in the distance but I couldn’t turn over. He turned me over and later said that I had the ‘look of death’ on my face. As doctors, we both knew what that meant. He asked me to confirm whether I called, telling her I felt like I was going to die. I confirmed it. He asked me if I wanted to go to the Emergency Room and I was too tired to think. Hum drum, drip, drop. That's what I needed then, only no one knew about my diagnosis yet. Our Nanny Sarah rounded up supplies and in sundries, the house turned into a hornet’s nest of determination and deadlines, and to the Emergency Room we went. Maybe we should have called an ambulance; we'll never know. Hum drum, drip, drop. The Bag is almost like my Enemy at times. I love you sometimes. Other times I hate you. Either way, you are not mine and I do not accept you. One day, you will be out of my life. Hum drum, drip, drop.

Andrea, a friend who happened to be staying at our home, held my hand the whole way to the hospital. I made her promise to take a year off to be a Nanny for our daughter if I died. She agreed and she kept me talking, which sequentially kept me breathing, which by God’s grace helped molecules of oxygen go to my brain. Hum drum, drip, drop. I am convinced that this most assuredly left me with less of a brain injury than I otherwise could have sustained. 

Flashing forward in time, among other things, I did end up with two small strokes in my midbrain. Hum drum, drip, drop. The midbrain, particularly a place called the pons, contains centers for such basic bodily functions as respiration, blood pressure regulation, heart rate regulation, and vomiting. Not the traditional stroke in the outside curly cerebrum brain that leaves people unable to talk or walk on one side, or smile on one side (and may eventually go away). No. Because it is I, something else had to happen. Something rare. Hum drum, drip, drop. Instead, this was a stroke that made my heart rate and blood pressure so unregulated and disjointed that I would faint just by standing up.

At this time, we had no "diagnosis' and I 'presented' to the Emergency Room (ER) feeling “like I am about to die”.  I don’t think there’s a medical billing ('CPT') code for that presentation.  Soon thereafter, I was unattended and a Catholic priest came to my right side, opened a jar, and put liquid on his fingers. Hum drum, drip, drop. I knew it was my Last Rights with a blessing of Holy Oil.  He prayed, made the sign of the cross, and anointed my forehead.  

I immediately drifted off to Heaven, iridescent bubbles going before me in groups of two or three. There were some bubbles traveling alone, but most were in groups. It was as if someone was blowing child’s bubbles behind me, and instead of straying away randomly, the bubbles honed in on a central and elongated tunnel of sorts. The bubbles hopped along ahead of me toward a bright light, a door. That’s when it hit me. I felt the overwhelming ‘no more tears’. 

Stop. Stop. Try to feel this place. Sh..sh....sh..... Close your eyes for one minute. Now. Feel this place.
I knew it was my Time, and I knew that if I stepped over this hyper visualized and magical Doorway, I would be in Heaven and would not be able go back to Earth. I could feel, and I knew, that the following people were standing there waiting for me: God, Jesus Christ, Mother Mary, and my beloved father. 

God was patient, as I was torn in one direction: to be a Mother. I kept looking backwards and seeing planet Earth. I looked again. I stepped back and bowed in humility to God, “I know it is my Time. But if it is okay with you, I would like to watch my daughter grow up.” The words were silent, yet the words were said as if they were spoken. God listened to me. Just like He listens to you every time you have a problem. 

Perhaps he remembered how I tried to helped the less fortunate, to make people laugh, all the devotion I had to Him throughout most of my life (e.g., except during my Terrible Teen years). Hum drum, drip, drop. Above all, He listened to each and every bubble that went ahead of me; each was filled with a prayer of intersession for my recovery. I knew that I had hundreds of people throughout the world praying for me, and I knew their prayers were encased in the bubbles. It was as if God was tilting His head slightly to better hear what they had to say, as He simultaneously had me presented before Him. Hum drum, drip, drop. He listened to them. Just as He listens to those who say they are praying for you. 

God listened to the prayers of intersession from others, and He listened to my acquiescence and humility that His Will be done, not mine. I roasted in the ‘no more tears’ most luxuriously, comprehended the Entrance to Heaven, and gently floated and faded back into my own body. I believe that only milliseconds had gone by, as no loss of consciousness occurred. As far as I recall, it was like taking a nap. 

Since then, I wake up every morning. I hear the hum drum, and the drip, drop. Before I open my eyes, I praise the Lord that I get to be on planet earth for one more day. I check my iv fluid to ensure it won't run out in 10 minutes, and then I listen and wait until I hear the birds. I, just like you, fight the good fight to stay alive, despite all the medical odds. I am surrounded by other walking miracles. So are you. 'Miracle people' are all around you. They range from the most respectful to the least desirable people around you, but they are miracles nonetheless. 

Now it is a pleasure to teach those around me, primarily my caregivers and my family. Hum drum, drip, drop. God has brought people into our house to help me, and has surrounded me with people that He has sent for us to help. He has given me insight and strength to go beyond the medical books, beyond the Medical History, beyond the normal, to relay this book to you. I could have and should have died and gone to Heaven. Just three months ago, it was rumored in my neighborhood that I looked like I was about to imminently die. Have traveled three times and my life is going to continue. My Life.

 ‘No more tears’. Imagine it, if you can. Stay in it as long as you can. Earn it by accepting Christ into your heart and asking forgiveness for your sins. We all have sinned. But Heaven is a real place and God is a real God. Pray that His Will, not yours, be done in your life. That He will open the doors that need to be opened before you, and He will close the doors that need to be shut before you even get there. Allow Him to work in your life. Human to human. Hum drum, drip, drop. Person to person. 

One moment, not one day at a time. Treat it both as an order and a challenge. Enjoy the journey and laugh along the way. Hum drum, drip, drop. I am less inclined to hold back my tears of joy, because someday I will have ‘no more tears’. While you can, revel in your own tears of joy. Because in Heaven, there are no more tears ever again.

I've felt it, the No More Tears.
It is not possible for there to be anything like it here on planet Earth.
It is not here. It is in Heaven.
I know, because I’ve been there. 

Hum drum and drip, drop continues. Every time I reread this Chapter, I am dissatisfied. There is no way for me to explain the things that I saw at the door of Heaven. It is as if written words can not truly convey the enormity of this to you. I come back and I still come back again to read this Chapter, and my description falls far short.

I felt the rays of light from heaven, touching my feet. I felt the warmth of pure joy, the peace that passes all understanding, and the sense of being in flight. To be absent from the body is to be present with the Lord. In one blink of the eye, there was outer space, the door to Heaven itself, and the planet Earth behind me. I know the Psalms teach us the Lord is our Shepherd and we shall not want (i.e., but be happy and satisfied with what we have). I know that God leads us 'through the valley of the shadow of death' and leads us to still waters. Shadows don't hurt us. It was as if a mild but strong magnet into Heaven was pulling me, but I was not ready to leave Earth.

I never saw the 'tunnel'; I made it straight to the door of Heaven. I never saw or felt the 'valley of the shadow of death'. Hum drum, drip, drop. I trust God for each moment, each smile from my family's face, each hum of the hummingbirds that cluster around my leaded glass window seat. Hum drum, drip, drop.

Humbly grateful, I spoke up. I asked God for mercy. I believe that God took a long look at my past life. He considered all of the things I did with my life. He considered the current stream of iridescent prayers of intersession from the host of other people that I knew were praying for me. Prayers went to God’s ear from Florida, Chicago, North Carolina, California, Canada, Pennsylvania, Texas, and beyond. They were still coming in behind me, floating randomly forward towards God in a fairy-tale manner, like pixie dust is to a magic wand. Floating. Hum drum, drip, drop that the doctors say will never end. He allowed for a seemingly predestined life to not follow the predicted pattern of simple fate, but to deviate from statistically by showing me that mere humans actually trigger actions or pleas that create a domino effect that leads to change God's mind. Really.

A human, and a group of humans in prayer, were able to influence God so that life and miracles could occur. Hum drum, drip, drop. And so my children could retain their mother. 

A human was able to influence God. He was listening to my pleadings, and the prayers of others. I am grateful for every hum drum and drip, drop. It has allowed me to pass on what I have learned. To give you hope and inspiration, exercises and bodily strength to recuperate after a life-changing event has occurred.

I am not special. You too can live for God and lay your life down on the floor before him, most humbly. But do not just go to God when you need him, or when you want something. You should have such a good relationship with Him that God makes things happen for you, he gives you signs when you ask for it, to ensure He is leading your life. I have asked for a sign from God many, many times when I really needed to know He was holding me in his arms. God has never failed me.
Hum drum and drip, drop. I have to remember to change my battery before I fall asleep for the night, otherwise I'll be shuffling in the dark to accomplish this task. Don't leave home without an extra bag of iv fluid; you never know if there's going to be an earthquake or a traffic jam. Of course, I never run out of iv fluid. At least not yet.

God considered my request to live. The enormity of this still makes me feel so small yet important to God. I think I've had people waiting for me to die ever since the first ambulance whisked me away. My Cardiologist's office has been impressed with my determination to get out of bed. To sit up, stand up, and walk. 

You probably do not have to think about walking around after sitting in a chair. You just get up and walk, without any conscious effort as to your motions. For me, there is an exceeding amount of energy spent in doing such seemingly simple tasks. I change positions with conscious effort, and I walk with every step being deliberate.

It seems that every three months, my central iv line has been getting infected. Time after time, I have made it 'out' of hospitalizations and when I got home, I was like a petrie dish just waiting for another central line infection. Now, I am simplifying my life (#1 Rule) and am determined that at Christmas time (i.e., in three months) I will NOT be in any hospital. 

Again, I need this fluid for the rest of my life, they say. I do not accept it. My peripherally-inserted central catheter (PICC) iv line pumps in sugar water at 65 cc/hr. I've been down to 50 cc/hr, and up to 100 cc/hr, based on the color of my face (i.e., white versus pink). All 24/7. My PICC line(s) have needed changing from the left arm to the right arm or vice versa, every three months for almost a couple of years, now.  Every time we put the PICC line in the left arm, it left a scar and undoubtedly some residual wound to the vein itself, including clot (thrombus) formation. Then we go to the right arm, and the PICC line needs changing again, usually due to infection. 

Eventually, if you look at the length of the veins in each arm, one can imagine that I will "run out" of veins. Then I may have to resort to having a PICC line tunneled into the internal jugular vein in the neck. Until that one runs out, then maybe the doctors and nurses can then save my left neck vein for last. Statistically and increasing with time going by, one can see that one day there will be no vein left. Hopefully, by then, my child will be grown and the Lord can take me back to Heaven, where I will be waiting for my husband.

God granted me the ability to return to Earth and be a messenger to you. He not only wants you to be in the crowd of individuals that believe in Him, but He wants you to live your life for Him. When we accept Christ in to our hearts as our personal Savior, we die to ourselves and become alive to Christ. It does not stop there.

Sorry, I did not make the rules. "No one goes to the Father except through the Son". If you know the Bible or if you know Jesus, you, too, will go there. Try to live your life as if you went to Heaven and then came back to Earth, just as I believe I did. What would you do differently? Your priorities would change, especially how much you cherish your children and your spouse, as well as your loved ones.
Once we have died to ourselves and have become alive for Christ, we must seek his face, and listen for that still, small voice of the Holy Spirit that He left us with (Christ did not want to leave us alone, so He sent us the Holy Spirit).

One last thing before I forget to write this somewhere in this book. When I was before God, I do not think that He viewed me as a Baptist or a Catholic, or any denominational or nondenominational affiliate. He viewed me as a Christian. It did not matter which Church I attended, or if I attended Church and did home Bible Study instead. Things would be okay as long as I did my best to live for Christ and maneuver through life helping others to know God and His endless mercy and healing qualities....

For more, please obtain No More Tears: A Physician Turned Patient Inspires Recovery.

Dr. Margaret Aranda



No More Tears: A Physician Turned Patient Inspires Recovery
by Dr. Margaret Aranda
BUY IT NOW: www.drmargaretaranda.tateauthor.com/other-works/
ISBN: 978-1-62205-838-2

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No More Tears en Espanol
Face Book Page: Stepping from the Edge
Little Missy Two-Shoes Likes to go to School
From Menarche to Menopause: A Journey through Time



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