Driving Notice

For anyone driving in this region, let me provide a warning:

Throughout Maryland, Virginia, and Washington, DC red light cameras and speed cameras are all over the place.  They are predominant within the Southern Maryland area and are all over Waldorf.

The red light cameras are pretty much self defined, but the speed cameras have some strange regulations.
Speed cameras are in designated school zones, however the days and times do not correspond to schools being in session.  The speed cameras are active throughout the year, Monday-Friday (regardless of holidays) from around 7am to 6pm.  Example:  School zone speed camera at the school by my house will be active Christmas Day from 7am - 6pm even though school is out for the holiday.

Just thought I would warn everyone.

Ray

Lodging in Waldorf

For anyone making arrangements to be here in Waldorf for the viewing and funeral, I'm afraid that the Casa de Arcement isn't up to guests right now.  Spare bedrooms have been converted into medical supply storage rooms and I'm afraid that I might not be able to get them straightened out in time for any arrivals.

Here are some of the decent facilities in town that may accommodate you:

Hampton Inn Waldorf

Hilton Garden Inn Waldorf

Residence Inn Waldorf

Courtyard Waldorf

La Quinta Inn Waldorf

Country Inn & Suites Waldorf

Don't forget - If you have any questions/concerns, let me know:  Ray's Email

Funeral Home Site

The funeral home has established a site updating the events for Barb.  It can be found at Raymond Funeral Service

Dec 20 Status

Friday, December 20, 2013

Just finished arrangements for Barb.

Barbara Jean Kohlmeier Arcement, 64, Waldorf, MD      Barbara (Barb) Jean Kohlmeier Arcement of Waldorf, MD died on December 19, 2013 at her residence.  She was 64 years old.    She was born in Lyons, NE on September 9, 1949 and was married to Raymond J. Arcement, Jr. on July 10, 1970 in Columbus, NE.    Barb was preceded in death by her parents Kenneth and Lydia Lutz Kohlmeier.    She is survived by her husband of 43 years, Raymond J. Arcement, Jr.; son Eric Arcement and wife Victoria; daughters Stacey Welchner, and Nicole Patterson and husband Michael; four grandchildren, Kyle, Zackery, Nathan and Luke; brother Kenneth Kohlmeier and wife Linda; sisters Sharon Carr and husband Harley, Edith Aerni and husband Rich, Marge Wolfe and husband Mark.   Barb was a dedicated wife, mother, and grandmother.  She loved time with the family and also enjoyed camping, sightseeing, and her church ministries.    She was a supporter of her husband’s military career and followed him around the world for two decades.    Visitation will be at Raymond Funeral Service, 5635 Washington Ave, LaPlata, MD on Friday, December 27th from 5-8 PM.  Funeral service will be conducted at the Lutheran Church of Our Savior, Bryans Road, 7365 Indian Head Highway, Bryans Road, Maryland on Saturday, Dec 28th at 11 AM with interment following at Trinity Memorial Gardens, 3221 Mattawoman Beantown Road, Waldorf, MD.   In lieu of flowers, tribute/memorial donations may be made to LCMS World Mission at https://lcms.org/give/internationalmission.

On Friday the 27th viewing for the family will start at 4pm.

There will be a luncheon at the church following interment

Love, Ray

Dec 19 Status

Thursday, December 19, 2013

All immediate family members have been notified.

Barb passed this morning.  Nicole spent the night here to tend to her medications, etc. and spent time just holding her hand.  When we tried to administer her morning dose of medications, Nicole stated that she didn't need them - she was at home with her Lord.

It has been a peaceful week with no pain nor discomfort.  She was comfortable, at home, and with family members.

All the kids came over this morning to be with me and I do appreciate it.

I am meeting with the funeral director tomorrow afternoon to make arrangements and will let everyone know what is going on.

May the Lord welcome Barb into His Glory and make her new body pain free and serving Him.

Love,
Ray

Dec 14 Status

Saturday, December 14, 2013

Since her regime of liquid medications began Thursday, Barb has been resting comfortably.  She has not exhibited any sign of pain or discomfort.  Granted she is asleep most of the time with only a few moments of awakening.  She has taken several sips of water the past couple days and a taste of Ensure - not too much nutrition though.

I finally broke down and let Eric spend the night with her.  It was nice to get a decent night's sleep in my bed.  He managed to medicate her throughout the night.  Stacey was going to spend the night here tonight, but it looks like she managed to get the flu from Kyle.  I don't want her here.  Nicole has traded nights with her and will be here after her birthday dinner with Michael.  She will be spending her birthday night with her Mom.

We must thank God for a caring and compassionate family.   I'm not saying it has been easy, but with the Lord's help we have been hanging in there pretty good.  The folks from Hospice keep telling me that we are doing better than most.  It must be the training and persistence of Barb in putting our trust in Christ to help us.

Our pastor was here yesterday afternoon and annointed her with oil and of course we prayed over her.

I would also like to thank all of you for your prayers and support.  I know it sounds shallow, but it really means a lot to us.

As always - Love,
Ray

Dec 12 Status

Thursday, December 12, 2013

I wish I had more optimistic information to pass on, but here are the facts:

This past week has been hard on Barb.  She hasn't eaten any solid food and has barely had water.  She was spitting out her pills and I had to start crushing them and mixing with water and administering via dropper.  She has had several bad nights of agitation and mantras and has been talking to her deceased mother now.  I have managed to give her Ensure a couple of times this week for nutrition, but far from what is recommended.

Her nurse was over this  morning and we went over a new routine for her.  From her checkup the following was deduced:
   - disorientation
   - agitation
   - talking with the unseen or dead family members
   - not eating and drinking fluids
   - complaints of heavy body and being tired
   - increased desire to sleep
   - dark urine output
   - blotchy, purple knees
   - incontinence
   - restlessness and/or no activity at all

From all the symptoms she is now presenting, the nurse stated that she is in her final stage with maybe a week of fight left.

She is now off all her oral medications and is only on liquid morphine and lorazepam every four hours.  Her personal needs now have to be tendered to in the bed since she is unable to get placed on the commode.

Please keep her in your prayers for comfort and no pain.

Love,
Ray

Dec 7 Status

Saturday, December 7, 2013

I can't say that there has been many "good" moments this past week, but she has managed to have a couple.

Last night Nicole was here and Barb made a "funny" to her.  Not too sure what it was about, but Barb started giggling and was pleased.  When Nicole was leaving she told Barb that she loved her and Barb responded with "I Know!".  That was a great moment.

This morning while I was grilling her with my regular questions like "are you in pain", "do you need to potty", "do you want something to eat", I wasn't getting any responses, then I said "do you want to kiss me?"  She smiled and shook her head yes and I leaned over and she kissed me.  That was a blessed moment for me.

I don't think the pain is really bothering her this morning, but anxiety is.  It is very hard to figure out what to do when she can't tell you what is going on.

At least right now she is resting comfortably watching Saturday morning tv.

Love,
Ray

Dec 3 Status

Tuesday, December 3, 2013

Sorry I haven't posted anything for the past couple of weeks, but things seemed pretty much the same with nothing new to state.

Things have changed now.

Over this weekend, she has been having extreme troubles with pain and anxiety.  I now have to get her on a routine of steady doses of quick-acting morphine and a vallium-type drug (lorazepam) just to attempt to keep her comfortable.

Her appetite has diminished again and I will have to put her back on the stimulant so she can maintain some strength.

She still knows who I am, but can't express her thoughts.  She starts mantras when she really gets bad and they last for over an hour.  Hopefully, the steady doses of lorazepam will help this.  She can't really tell me when it is pain or anxiety so that is a crap shoot.

Let me apologize to all who have tried to call, but I haven't answered.  I have taken up the new mother's routine of sleeping when she sleeps (or at least trying).

Please continue to pray that she is comfortable and not in pain.

As always - Love,
Ray

Nov 14 Status

Thursday, November 14, 2013

Didn't provide an update yesterday since everything seems to be pretty much the same.  She has received visits from the hospice nurse and now the aide has come and set up sessions for bout 3 times per week to bathe her, etc.

The director of spiritual care is scheduled to come tomorrow to meet both of us and of course the social worker will be coming also.

I think I will only start posting a status if something changes now since she is pretty much in a routine.  Still losing her thoughts, etc., but I do manage to get her to respond to certain things at times.  She is eating great now.

Love,
Ray

Nov 11 Status

Monday, November 11, 2013

She had a pretty restful day today - no real pain or discomfort.  It appears that she likes home-cooked food since she is eating everything I put in front of her.  Nice to see her appetite back.

All three kids managed to stop by today for a visit which was nice.

Now to get into a new routine for all of us.  Have to get things done when I can.

The nurse should be back again Tuesday, but her vitals, etc. have been looking pretty good, less a lower than normal blood pressure.

Love,
Ray

Nov 10 Status

Sunday, November 10, 2013

Barb had a good night's sleep last night.  Nicole stayed with her while I slept upstairs.  She awoke this morning to the dog giving her attention and Barb appreciated it.  She eat all her breakfast this morning, most of her lunch, and all of her dinner this evening.  I guess my cooking was missed.

The hospice nurse came this morning and gave her an evaluation and set up a plan for us.  More to come on Tuesday when her regular attendant get here.  The nurse liked the arrangement we have for her.

She spent several hours today sitting in the lounge chair and was alert most of the time.  Of course she spent a lot of time in her new bed resting.  For the most part, she was quite responsive and aware today.

While the girls were here with her I managed to get some shopping in so I can give her some home cooked meals (the pantry was low).

Now we all have to get in the right routine to make sure we don't surprise Barb with something new.

Love,
Ray

Nov 9 Status

Saturday, November 9, 2013

Around noon today Barb was released from the hospital,.  She has been resting peacefully here at home.  We did get her to eat about 1/2 of a sandwich and a cup of pudding - Every little bit helps.  She has been quite alert since we got home and sat up in a chair for a couple of hours before going back into the bed.

I have to get on the same pain med schedule that they had in the hospital because Barb tells us too late when she is hurting - it takes a while for the meds to kick in.

Just did a nebulizer treatment on her and now she is watching NCIS on tv.  She looks comfortable.

The hospice folks will be here in the morning to set up their routine.  I hope Barb has a restful night.

Love,
Ray

Nov 8 Status

Friday, November 8, 2013

The results of the spinal fluid test came back negative.  That ruled out numerous things that would cause Barb's disorientation and confusion.  The diagnosis is that this is a result of the brain radiation that she had last year.  It takes anywhere from one to two years for this to occur.  There is no way to rectify this.

Since they put her on an appetite enhancer she has been eating somewhat better.  She is no longer taking any antibiotics or steroids.  The only meds she is on is for her appetite and pain.  All IVs are out so she is no longer fighting those.

She is scheduled to go home sometime tomorrow and is now in an in-home hospice care.  I have a hospital bed all set up for her, along with her oxygen concentrator, nebulizer, and related equipment.  We won't set up a schedule with the hospice nurses until she actually get home.

This afternoon Eric has been busy putting in a ramp coming up to the deck.  He did a great job and it's really appreciated.

We have a dog that is anxiously awaiting Mom to get back home.

Of course everything is set up downstairs as she can't manage any stairs.  I have set up the couch as my bed to be close to her.

Throughout this entire ordeal, I could not have asked for better support from the kids and the thoughts and prayers from all of you.  Family and Christ are the only comfort.

As always, Love,
Ray

Nov 7 Status

Thursday, November 7, 2013

Thank God for caring and loving children.  They have been great.  Someone is with Barb all day and night.  They are even giving me the nights off.  It has been a blessing to get some "meaningful" sleep even with my mind racing.

Barb spent a good portion of today sleeping as she didn't sleep much last night.  More IV pulling and new lines set.  Someone has to keep an eye on her hands pretty much all the time.  The nurses have tried big boxing-style gloves and arm coverings, but she manages to "break the code" and get them off.

Still don't have the results of the spinal tests, but her ammonia levels are normal.  She hasn't eaten much since last Friday and they are giving her medication to increase her appetite.  It must be working since for dinner tonight she ate a small chicken strip, most of her potato wedges, the entire piece of Boston cream pie, and her entire Ensure.  They are now supplementing her meals with Ensure.

They still have her on antibiotics and pain meds, but have taken her off morphine and now is just on percocet.  It appears the morphine just increases her disorientation and all.

No decision yet as to her release.  We are meeting with the Hospice director tomorrow morning to evaluate if she is a candidate for in-patient Hospice care or home Hospice.  Many of you know how she had taken over the dining room table as a "craft" table.  I am now clearing off all that "stuff" so I can take the table down and make room for a hospital bed in case she returns home for care.  I thought I would plan ahead pending her release conditions.

Please continue to keep her in your thoughts and prayers and ask the Lord to provide the best solution to her condition as we know He will.

Love,
Ray

Nov 6 Status

Wednesday, November 6, 2013

Another exhausting day.  The didn't do Barb's spinal until about noon today and she had to rest flat for a couple hours after the procedure.  Long time for her.

She managed to pull another IV line out today.  They are having a hard time finding a place to start new ones.  She has been very aggressive today and has been fighting just about anything we have been doing.  Eric spent the day with us with Stacey coming in after work.  Nicole will be spending the night with her again as she did last night.

Eric and I managed to get a meeting set up with the head of the county hospice for us to get some info from her.  We are still looking at our options once she is released.  Right now the recommendations we are looking at are hospice (both inpatient and home care) and nursing homes.

We probably won't get the spinal results until at least tomorrow if not Friday.  Once they are reviewed by all the doctors, they will give us a "final" recommendation for care. There are still many things to be weighed pending a formal prognosis.

Driving us all nuts now that nursing home, etc. are becoming a reality.

As the Lutheran Service Book states "Our Help Is In The Name Of The Lord'.  Our trust lies with Christ.

Love,

Ray

Nov 5 Status

Tuesday, November 5, 2013

Today had its ups and down.  She would do great for a while, then all of a sudden become lost again.

The MRI she had done last night showed no new signs of activity so that put us on another path of diagnosis.

Now she had a neurologist check her out and he has ordered an EEG to check her brain patterns and a spinal tap to check her spinal fluid for signs.  Not sure yet when they will conduct the tests (probably later tonight).

They are also going to check her ammonia levels as this tends to follow the on again/off again pattern of her thinking.  Physical therapy folks are also going to try to work with her tonight to see if she can get around.

The big plan right now is for her pulmonologist,  neurologist. oncologist, and attending physician to get together tomorrow and see if it would be best and safe to send her home, or stop chemo treatments and put her in hospice.

Will have to wait more to find out the game plan.  The waiting game is never ending.

Thanks for all your best wishes and offers for help, but we are playing it one day at a time right now.

Love,

Ray

Nov 4 Status

Monday, November 4, 2013

Not too much has changed since yesterday.  Barb did have several hours of meaning dialog, but that came and went.  Her appetite has been good and some of the "fighting" has stopped (we found distractions to keep her hands busy).

Her oncologist ordered a brain MRI to see if there is any new activity of growth there.  When I left the hospital last night they we just wheeling her out to the lab.  We have already been talking with the case manager about home care.  They are looking into home health nurses coming in a couple of times a week for vitals, rehab, etc., and are looking into the county senior care which comes in to bathe her and stuff like that.  Nothing has been finalized yet though since her condition is still shaky.

I wish I had more to tell you guys, but anyone who has been in the hospital before knows - it's hurry up and wait and we'll tell you what's going on later.

God's blessings to all of you for your prayers and support.

Love,

Ray

Nov 3 Status

Sunday, November 3, 2013

I meant to call all of you today, but needless to say things got hectic and now I am exhausted.

Barb has been having trouble for the last week.  She has been experiencing a swollen left leg and foot for about three weeks now.  She has had several dopplers to see if it was being caused by a blood clot, but not clot is being shown.

She has been sleeping downstairs on the couch for the past week, with me in one of the loungers.  During the night she gets up and ends up on the kitchen floor, but was not harming herself.  Even during the day she has lost orientation.  Besides turning off the breaker for the stove so she doesn't start a fire, Nicole noticed she was putting her hand in the garbage disposal.  Now I have that breaker off also.

Her recent bout started yesterday (Sat) with me finding her on the floor of the kitchen.

This morning I woke up before she was moving and decided to shave and shower before she got going.  When I returned downstairs I found her in the kitchen on the floor unresponsive.

After her gaining some of her facilities I cleaned her up and tried to get her back to the couch, but she could only move a couple of feet and was stuck on the floor again.  I checked her oxygen level and it was 74 which is critical.  I called the EMTs and they transported her to the hospital.

After about 5 hours in the ER they managed to get her stable.  They did run another doppler and it was normal.  They also did a CT of her abdomen and lungs.  She has fluid on her left lung again and the scan also show that the cancer had spread to her abdomenal wall, spine, and pelvis.  Her breathing remained rather sporadic.  

She was admitted after they stabilized her.  After several hours she became more coherent, they after a while she became aggressive again and began pulling IV lines and anything else she could pull out or rip off.  She gloved her hands to see if that would prevent her from pulling things out, but she managed to remove them with her mouth.  Now her IV, etc. are wrapped to see how that works.

When I left the hospital a little bit ago she was going to sleep.  Hopefully that will help keep things where they belong.

Since I hadn't had much sleep this week, Stacey is staying with her tonight.

Will let everyone know how she is doing tomorrow.

Please keep her in your thoughts and prayers.

Love,

Ray