My Left Quad, Part 2, and Heels

Back in January three weeks after my accident and before I started physical therapy, my left quad was not firing. It lay there inert, not flexing. It had atrophied to the point of not functioning. My physical therapist Evan asked me to flex my quad and I had no idea how. I remember the look on his face when we went through a range of exercises and nothing happened. He looked at my leg and I could see the gears moving. What do I need to do to get this dead thigh back in business?

Last Tuesday before I went to Ohio, I went to physical therapy and I saw the same look on Evan's face as I did in January. Three weeks after the surgery, I could do ninety leg lifts and I earned my way out of the brace. My quad was reasonably strong. As I progressed, Evan added new exercises and reduced my leg lifts to forty-five a day once a day, which should have been fine, except...

Like the single sex herd of dinos that managed to reproduce in the first Jurassic Park, my body found another way. Instead of my quad getting stronger, my hamstrings took the lead. I was on the bench at physical therapy. Evan told me to flex my quad while he had his hands around my left knee in a stranglehold position. I flexed.

"That's your hamstring," he said.

Fuck. 

The Bad News: I've been working the wrong muscle group for the past few weeks.

The Good News: At least Evan and I figured this out sooner than later.

The Bad News: Back to leg lifts. This sucks.

As my father had told me after my surgery, "It is all uphill from here, but at least when you get to the top of the hill you'll be in really good shape." So I had a little backslide on the way up. Eh. I suppose the goal is to get me up to the top of the hill so I can ski back down it someday. Who knew the uphill part would be the hardest?

And heels. We had tickets to see Billy Elliot at the Village Theatre in Issaquah* last night.  I wore a dress, but I have no matching shoes. I tried wearing a few pairs of heels, but they make me feel like I am walking downhill, which is not fun for me yet. These heel weren't even that high. I wonder if my shoes miss my feet. I ended up wearing my Noat sandals, which are wonderfully comfy, but style-wise a notch above Birkenstocks. Is this my solution, a dressy Noat? Perhaps.

The Krista in Satin Gold by Naot. Also available in Pewter-Metal and Black.

Egads! What does this mean? I like my comfortable shoes, but is this too far? I know I am deeply into middle age, but I am not ready to be doddering. And yet, maybe this is the best thing. I read an article in this week's New Yorker by Mary Karr. She rants against high heels. As I type, "Heels" was just autocorrected to "hells," which nicely summarizes Karr's view of spiky, towering shoes.

* Great show, by the way. I love the Village Theatre. It is such a cozy venue.

Gunsmoke and My Funny Valentine

Walk: 1.15 miles around Antrim Lake

Time: 45 minutes including one break.

(At that rate, it would take me more than two hours to go around Green Lake.)

I was in Columbus this week visiting my mom and dad. Last week, my father called and was concerned about my mother’s lack of appetite. For about eight days, she was refusing food and ate very little. This is common behavior for the end stages of Alzheimer’s. When the body starts to shut down to die, it stops taking food and water. My father had also put my mother on hospice. Jack thought I should make the trip to support my father in case she continued not to eat.

When I walked into the Memory Care Unit on Wednesday, my mother was sitting in the dining room with her friend Kate. When she saw me, my mother smiled in recognition. She couldn’t say name, but she appeared to be delighted to see me.

“You have a wonderful mother,” Kate said.

“I agree,” I said. My mother beamed. My mother was more pleasant now that she had been a few years earlier when she was in the early stages of her disease. Before she was diagnosed, she was extremely difficult. At one point, she had told Claire Adele that she was no longer her favorite grandchild, that the Boy was now her favorite grandchild. Both of my kids cried for an hour.

“How could she say that?” they said. I didn’t have an answer, but I sat with them while they sobbed.

My mother, father and I sat in the cafeteria for an hour and a half while my father attempted to spoonfeed my mother. She was able to grasp a saltine in her hand and nibble it over the course of five minutes. She would take a bite of food once every few minutes. Sometimes she would take it, other times she looked pained as the food entered her mouth. My father would intersperse trying to feed her with giving her chocolate milk, water or Boost. The water was in a plastic cup with flowers on it with a pink lid and a straw. Effectively, my mother was a toddler, except moving in the wrong direction. I remember reading Martin Amis’s Time’s Arrow, where the world moved in reverse. I hope my mother's life doesn't regress to the where she is an unresponsive blob of disintegrating cells curled in the fetal position.

Dee, the caretaker, recommended not giving her crackers.

“She might choke on it,” she said. “She choked on one yesterday.” I winced. My father said she has to eat soft foods, so I was optimistic to see her eat a cracker. This disease only goes one way—downhill. Hopes dashed. After lunch, my father helped us to gracefully depart.

When I visited my dad in January, he asked what he should do with all of the stuff around the house--pillows, flowers, candles and other tchotchkes—that my mother had collected over the years.

“Bring them to her room,” I said. He did, but her collection from a four bedroom house was too large to fill her one room.

On Thursday, my father and I went to visit her again. In the guest room at my parent’s home, I found some silk tulips in a small bowl. I decided to bring her a “gift” of these flowers. I knew she would like them as she purchased them herself years earlier.

When we got to Danbury, my mom saw me coming down the hallway. She smiled and waved, excited to see me. Again, I was happy she recognized me. Eugene, one of the other residents, waved at me, too. I supposed my mother might wave at anyone coming in. like Eugene did. As my mother was wheeled closer, I handed her the flowers.

She smiled. “Oh, shoes,” she said. Most of her sentences from the day before were word salad like this.

“I am glad you like them,” I said, not bothering to correct her. “They are fabric so they will live forever.”

She laughed at my joke and I was shocked. A few minutes later, we were seated in the dining room, waiting for lunch when I sneezed.

“It must be the flowers,” I said. Again, she laughed. Did she understand what I was saying? Did she follow the timing of my remarks and assume there was a punch line? Did she not understand a word we said, but felt it was something amusing?

There was a time years ago when Jack and I were in the car, and she was in the backseat. Her hearing was in decline, and she’d often have to ask to have things repeated. I was in the middle of a funny story when she laughed. But she laughed before I got to the funny part. Jack and I looked at each with alarm. I now wondered if my mother's laughter was just part of what she was used to--not really getting it but still wanting to be a part of something.

Later, she looked at my purse. I didn't bring a real purse with me to Ohio--only my large, clumsy green backpack which can hold my laptop, a few books and a large bottle of water. My dad said my mom has dozen of purses, so I could borrow one of hers. So I did. All through lunch, she kept looking at it. My father later commented that he thought she was eyeing the bag. I agreed. Did she recognize it as hers, or did she just like it?

My mom's purse

After lunch, my father, mother and I went to my mother’s living room where there is a flat screen television above the fireplace. An old Western was on. A man in a black shirt with a black hat was yelling at a woman in a white dress. It was rather intense, and I was wondering if we should watch something else. I feared she might pick up the anger and fear and she would feel those emotions. I scanned the stack of movies on the mantle, hoping to find something more suitable as my parents continued to watch.

“This is Gunsmoke,” my father said. My mother nodded in recognition. There wasn’t much dialogue and there was lots of swelling music. A low bassoon played when the bad guy was contemplating and when Marshall Dillon was making plans to save Beth Wilson from Carl, her former beaux who just got out of prison. In the eight years since, she married Mr. Wilson and had a daughter. Now Carl was back to reclaim Beth. She wasn’t happy about his return to Dodge City.

“I bet Marshall Dillon shoots this guy in the end,” I said. My mom and dad laughed. They had seen the show before.

My father and I made fun of Beth after she bonked Carl on the head and ran to hide.

“Why is she running into the mine shaft?” my dad said. “That is the worst thing to do when being chased by a bad guy.” A minute later, Marshall Dillon shoots Carl, as I had predicted. I was gloated in my correct assumption, and again, my mother laughed. Perhaps this show with lots of actions, little dialogue, heavy emotions and rousing music was easy for her to understand and follow. In January, we watched The Lucy Show, which was all dialogue and took place more or less in Lucy's living room or her office. If you didn't understand the words, the show made no sense. You could follow this episode of Gunsmoke if you didn't speak English, which was perfect for my mother.

Another episode was coming on, but it was time for my father and I to leave. “Tell us about the next Gunsmoke when we get back,” my father said. Again, she laughed.

I began to wonder if she were becoming lucid. What if she were to wake up the next day and say, “I am just fine! Let’s go home.” Or, “I am fine. Why am I here?” I wonder why she is in a sterile, newly opened home in the middle of Ohio. The day before, I was pushing her around the concrete courtyard with a high plastic beige fence. I don’t know why the fence was so high or why it couldn’t have windows.

Friday, we went to lunch again at Danbury. My mother hadn’t eaten breakfast today. She was a little more vacant than she appeared in the previous two days. My dad asked me to get some music, and everyone in the dining room voted on Frank Sinatra. My mom was a little miffed that I left the table. She didn't know where I went, and perhaps thought I had abandoned her. Her mood faded, and seemed a little vacant. She fidgeted with her fork and napkin. She lifted her empty spoon to her mouth.

When the music came on, my mother started sing My Funny Valentine when it came on. She didn’t have much conversation that day except for singing.

As my mom sang, my father started to cry. The man who smiles and tries to make her laugh started to shed tears. And I started to cry to.

The sad music made me think that maybe she should be some place more cheerful. Should she be in a small Italian village overlooking the Mediterranean Sea, wearing sunglasses and a broad rimmed hat, in the hot weather instead of in the middle of Ohio? I imagine she might have had a large family, larger than the one we have. Or perhaps the whole extended family—cousins and aunts and siblings--would all live in the same village.

If she were there, would she know the difference? Maybe she is already there or someplace similar in her mind.

French Dip in a Styrofoam Box and My Madeleines

Note: I wrote this on the plane late last night.

I am flying to see my parents in Ohio. I had the worst flight experience ever. The flight was late from Seattle and I missed my connection in Dallas to Columbus. They scheduled me for a second flight, and that was delayed due to weather. When we finally took off, lightening was flashing out my window. The turbulence was so bad there were few bumps were my seatbelt kept me from bouncing out of my seat. I was reading a book while the plane loaded. Once we took off, I had to put it down to hold on to the armrests. I longed for my dog Fox to be sitting my lap. We didn’t gain much altitude for what felt like ten minutes. I’ve heard of pilots trying to flyover storms, but it seemed like this pilot was trying to fly under the big black cloud. Would we fly all the way to Columbus at cruising altitude of 4,000 feet? Maybe I am used to flying out of Seattle where the planes need to reach a high altitude soon to make it over the Cascade Mountains.

I missed my connection in Dallas by twenty seconds, if that. I was driven through the airport on a cart since my knee isn’t up to running through airports quite yet. The gate attendant had already printed out my new boarding pass for the flight two hours later. I was annoyed that the only flight of the day that departed on time was the one that I missed.

At the Dallas Airport, I stopped at the TGI Fridays for dinner since this restaurant was directly across the gate where my flight was departing. I ordered a looked at the menu and debated between the hamburger and the French dip.

“The French dip is one of the most popular items on the menu,” the cashier said. “You can get a hamburger anywhere.” It was settled. I got the French dip, a salad and an unsweetened iced tea.

They packed up the food in Styrofoam boxes so I could take it with me on the plane. I ate all of the salad and half of the sandwich. I now have this with me on the plane.

In a normal world, half a sandwich and soggy fries in a carryout box would seem like not a big deal, but this is my—and perhaps my father’s--madeleine. When Marcel Proust ate a madeleine cookie as an adult, the taste and smell transported him back to his childhood. A more modern version of this is in the Pixar film Ratatouille where the food critic Anton Ego tastes the ratatouille prepared for him by the rat chef and is transported back in time to childhood where his mother serves him the vegetable stew after he falls off his bike.

Every time I visited my parents since I was an adult, I’d walk in the house and open the fridge. Inside would be three or four Styrofoam takeout boxes each with a half and sandwich and soggy fries. My mom was famous for not finishing restaurant meals and bringing them home. I am the same. French dip was my mother’s favorite sandwich. She would always get it with au jus. She was really picky about French dip sandwiches, always hoping to find the perfect one, and often being disappointed. I think she was hoping that she would find something akin to an Italian beef sandwich,* which she grew up eating from corner takeout joints in Chicago. TGI Fridays also brings back a memory form my childhood with my mom. Back in the late 1970’s before TGI Fridays was a massive national chain, my mom and Mrs. McCann took my friend Amy and I there for a special mother-daughter lunch. I remember we had baked potato skins, something I never had before. I had never been to “lunch” before, where the purpose of going out to eat was to socialize.

Here I am flying in to see my mother before she dies, carrying with me a Styrofoam box with a French Dip sandwich. It probably has been a while since his fridge was full of carryout boxes. I hope he doesn’t mind that I am bringing one.

* Gourmet magazine once had an article about local food, and featured Italian beef. They talked to a local who told them about da stance. Da stance was how you had to stand while eating an Italian beef sandwich so you wouldn’t drip the juice on your clothes.

Misleading, Mother's Day and the Roller Coaster

My dad sent me this picture of my mom on Saturday. She looks really good--alert, smiling at the camera, good color and nice hair. Her eyes are bright. I was beginning to think maybe my concern for her and fear of her impending death were exaggerated or premature. The Memory Care Unit where she lives had a Mother's Day Tea, and my parents participated. It is hard to see her wheel chair in this picture. You have too look for it to notice it. My dad posted this picture on Facebook and many of his friends make nice comments about what great picture this is.

"She does not look imminent," Jack said. Imminent is a medical code word for about to die. Jack is an intensive care pediatrician, and he has seen numerous children and teenagers die. "It is really hard to die," Jack has told me before. He knows death can be a slow process. While I agree that my mother looks good, I fear my husband's sense of imminence might not apply to the geriatric crowd.

I asked my dad if I could Skype for Facetime with them on Mother's Day. He did, and he called me to Facetime while they were eating lunch in Ohio. I was already at the YMCA doing my morning physical therapy workout. I took a break from the weights to talk to her on my iPhone.

She didn't notice I was there. I said "Happy Mother's Day!" a few times, but I wasn't sure she heard me or understood I was there.

"She might be a bit flummoxed by the phone," my dad said. It was as if I were trying to connect with my dog Fox over Skype. Fox doesn't get it that someone is on the other side of the screen. Talking and looking at someone while on a phone or computer was not new fangled technology for my mom. We have been Skyping with her and the kids for years, before she was diagnosed with Alzheimer's. Videochats are a great way for grandparents to keep in touch with grandkid who live far away. My kids were far more talkative on Skype than when you hand them a phone and expect them to talk to their grandparents. Artwork, leg projects, new toys and Fox were often shared via video chat.

While my mother might have been flummoxed by the phone, she was surprisingly out of it. Later that afternoon, I called my dad.

"That picture you posted of Ma is great!" I said.

"That picture is misleading," he said. I imagined my dad taking a dozen or more pictures to get one where she is looking at the camera and smiling at the same time.

Later, my father talked to Jack about my mother. My father tends to be more open and direct with Jack during difficult situations. My dad tends to be slightly evasive with me when he is in stressful situations.

"I was really worried about her earlier this week," my father told Jack. "I am not ready to lose her yet." I imagined my dad talking lots of pictures of her, never knowing which one might be the last.*

A friend of mine's father-in-law died of Alzheimer's. She said he had a day or two of clarity several days before he died. I am not sure if that will happen here, but I am preparing myself for that possibility. At the same time, I remember when my grandmother was ill. The doctors released her from the ICU while she was still in bad shape. I feared they were letting her out so she could die in a more peaceful environment in the next few days. I was wrong. She ended up going home and she lived for a few more months.

This is the challenge of the roller coaster at the end stage of a disease. Anything can happen. She could have a stroke in the middle of the night and die, or she could stabilize and live for another six months. I know she will eventually die, but when and what it looks like remains the mystery.

* That was a bit maudlin. Sorry.

Tea and Perfect Accessories

It was my friend Sarah's 50th birthday this week. I can't believe I have friends who are the same age as me who are fifty. I have other friends who are older than me who are fifty, but none who are the same age. In a few years, I will have friends who are younger than me who are fifty. That is really depressing.

Sarah didn't want a gift for her birthday--instead she wanted to go to lunch and then go tea shopping. We had a great lunch at Liam's in U Village where I had the curry mussels. (I highly recommend them. They are an appetizer but I get them for my main course.)

After lunch, we headed to Teavana, which is now owned by Starbucks. There is a giant Teavana store next to the U Village Starbucks. I normally buy my tea at Queen Mary which is in my neighborhood, but I am happy to shop other places. I suppose in some ways shopping at Teavana is shopping locally since Starbucks is based in Seattle. I digress.

My friend Sarah and her husband are both coffee drinkers, like most Americans. I turn in a hyperactive chipmunk when I drink too much caffeine. Once I went to breakfast with my friend Diane. The restaurant didn't have decaf, so I ordered a regular mocha. I talk a little fast in general. Fill me with caffeine and I am bouncing off the walls. Most people think I am making up how hyper I get when I drink caffeine. At the end of the meal, Diane was convinced.

"I will never let you regular coffee again," she said.

Once I had a miserable case of the flu and I went to Seven Roasters Cafe and got a regular mocha. I went home, and started cleaning the kitchen and dancing around. "This is the best cold ever!" I thought. Then the caffeine wore off and I was back in bed.

When Sarah comes to my house, we drink tea. I have a massive selection because I like to drink a different kind of tea everyday. I buy loose leaf tea since there is a much bigger selection available and most tea shops sell loose leaf tea. When I go to Sarah's house, she has a small selection, which is to be expected since she and her husband both drink coffee.

"I want to get some loose tea so you don't have to drink tea in a bag when you come to my house," she said. Aww. That was nice. "Show me what kind of accessories I should get." So I did. I showed her the different kinds of tea pots and mugs with strainers for loose tea. Then we came upon the Teavana Perfectea Maker.

I own one of these and I rarely use it. I used my Forlife tea mugs with matching strainers every day. The Perfectea Maker looks cool in the store when they show you the demonstration. It is plastic and you fill it with tea and hot water then put it on top of a mug and the tea pours in through a hole in the bottom. I used it when I first got it, but then it was hard to clean so I stopped using it. One of the little plastic legs broke off which makes it lopsided. If you bump the bottom of the tea maker while there is tea in it, it will pee tea all over the place. You can tell when a glass mug is full, but not an opaque one. I've overfilled ceramic mugs and have had tea all over my counters. In short, I am not a fan.

"Don't get this tea maker. You are better off with a good strainer," I said. Chet, the salesboy, continued to show Sarah how supercool this tea maker was. Ugh.

"But I like it!" Sarah said. "I am going to get it." Okay, fine, I thought. It is her 50th birthday, she can get it if she wants. I won't argue. I guess I succumbed to the sales pitch, too. Teavana needs to sell the accessories so they can see the loose leaf tea. It is vicious circle of tea hell, unless you are already a tea drinker. I thought about giving her my Perfectea Maker, but then thought no. Mine is a little broken, and Sarah should get a new one if she really wants on.

This morning, my husband came home from work and brought in some tea that was given to him by a colleague who is from China. This colleague recently returned from a visit, and brought Jack some fancy tea. "This is the tea they give dignitaries when they visit China," Jack told me. Inside the package was a picture of Vladimir Putin receiving this tea from Chinese officials.

I drink a lot of tea and I have never seen tea like this before. It is whole leaves rolled out flat. It is very cool. I was really excited Jack got this as a gift.

And of all my tea accessories, this is what best could accommodate these very large, exotic leaves gifted to us from China:

Dying isn't Straightforward

I think my mother might be dying, but I don't know for sure. My father is the only one who sees her, and he is an unreliable reporter, through no fault of his own optimism. My mom is refusing food, but occasionally eats a little bit. My guess is that she is eating about 100 calories a day and drinking maybe eight ounces of apple juice. Maybe. She has good days when she eats. She has bad days when she eats less or nothing.

I was late in replying to an email from my friend Eleanor. I apologized and I told her the situation with my mom.

"I was beginning to worry.  Indeed, I thought you might be in Ohio.  If she has stopped eating, and they don’t force feed her, she may not live more than two weeks, especially if they don’t intravenously hydrate her.  This is life."

Another friend Barbara had a similar thought. When I told her I would be in Ohio next week to see my mom because she wasn't eating, Barbara said, "I hope you make it in time."

I don't think these women were being callous or uncaring, just honest, honest with a sense of "It's is better to face the possible negative outcome and prepare for the worst." These are women who know where the candles and flashlights are when the electricity goes out.

And then I talk to Jack, who bizarrely predicts she will live longer than we think. "It is really hard to die," he said. "I've seen terminal cancer patients that keep hanging on. The human body can survive for several weeks on a little bit of water and a tiny bit of food. And your mother isn't built like Auntie Ange." Auntie Ange was about four feet tall and weighed about seventy pounds.

My dad is having a hard time as far as I can gather. "I am going to write her obituary," he said. He can't tell me when he thinks she'll die, and he doesn't yet know the prognosis. He is moving into acceptance, though, that it will be sooner than later.

Unlike coming into this world, dying isn't straightforward. With pregnancy, there are many things that can go wrong, as I know too well. Once those bad things are taken out of the equation, you can pretty easily predict that a baby will arrive in 40 weeks, give or take a week or two. You can plan on the place and in some cases, the date and time. With dying, there is no schedule, no plan, no map.

Goals and Feeling Better

Bike Time: 45 minutes 

Distance: 9.19* miles on interval training

When I first hurt my knee, my medical team asked me what my goals were for recovery. I said I wanted to walk my dog. Now I see this is a harder, more ambitious goal than I had originally imagined now that I am back walking Fox for short walks.

While walking Fox through Ravenna Park is far less ambitious than Lindsey Vonn flying down a ski slope at 78 miles per hour, it is not without its challenges for someone who is recovering from knee surgery. I am having to walk on uneven grassy fields and gravel roads that slope downhill all while holding a dog on a leash, walking fast and trying to stay balanced. I want to walk him up and down trails, not just on sidewalks. For me, this is hard. Not impossible, just hard. I was walking with Jack this morning, and he didn't realize how slowly I moved on a lumpy lawn in the park.

I am getting better, though. This week was the busiest week I've had since my surgery, which is good. I was out and about and enjoyed being with people instead of spending much of my time by myself. I ran into a friend on the sidelines of the soccer field. It turns out she was a physical therapist before she had kids.

"I bet you are a great patient," she said.

"Yeah..." I said but was thinking Not so much this week. The downside of being busy was that I found it harder to squeeze in my exercises. Tuesday, I asked my physical therapist Evan if I could take a day off and he said, "If you take one day off, then you might take another and another." (Translation: "No.") As much as I would like a day off, I can see his point. Once you are on task it is easier to stay on task. Eating one cookie isn't going to make you gain twenty pounds, but eating one cookie five hundred times will.

Part of feeling better is that it doesn't feel so awful if I start to slack. In the first few weeks after the surgery, I was terrified to skip my exercises. What if I couldn't bend my leg properly or walk up stairs like a normal person ever again because I did 35 leg lifts instead of 45? I was really motivated. It is not that I am unmotivated now, but my motivation is less since I have made progress. I am not out of the woods, but I can tell that I am going make it out.** Or maybe I am like the hare who decides to take a nap mid-race and blow the whole thing. I suppose that can happen, too.

I still have goals, I need to keep looking at them so I am motivated to keep working. Friends are starting to call and ask if I can go for a walk. I want to say yes. I need to get in shape for my vacation this summer. 

Perhaps what will also motivate me is a small, odd goal: I also want to sit on my left foot again. I used to be able to sit on my chair and tuck my left foot under my bottom. I can do it with my right foot, but it isn't that same was with the left. Again, this goal is not quite as ambitious as a Lindsey Vonn goal, but if it keeps me going, that's good enough.

* I bike every day, but I only post my milage on days when I've have a good number to report. I don't mention when I bike 7.34 miles in 45 minutes.

** Sorry about cliche day on my blog.

Tears and Shit

I was going to write about my mom's continued decline with Alzheimer's, death and my knee this morning. Instead of settling down to work, I cruised through Facebook. I saw a post from my dad where he took a picture last night from his walk about Antrim Lake. I am glad he got outside and spent sometime in nature.

Sometimes when life is hard, we keep a stiff upper lip. Then, something from out of the blue will throw us for a loop.* As I was flipping through Facebook, I came across a friend Alex who posted a story about her daughter trying out for a boys' soccer team. Her daughter plays in the same soccer club as my son, and the club let her daughter play with the boys. I've known this woman for a few years through various committees. I am not that close with Alex, but I started to cry when I scrolled through her old photos and saw her daughter getting her long blond hair cut into a "short sporty boy cut." Based on the posts, I am guessing Alex's daughter is going through a gender identity transition. I had no idea. Here she is, posting pictures and stories about her daughter in such as warm and supportive way.

The whole thing brought me to tears, and I don't know why. I think I have been keeping it all together with my mom and dad, this story broke the dam.

I was at lunch this week with a friend and she said, "I didn't get a chance to tell you about my shit."

"What is your shit?" I asked, sincerely wanting to know.

We all have our shit in our lives and at times we have more than others. By shit I mean those I challenges that require deep thought, great problem solving skills and patience. Maybe shit means accepting hard things we don't want to accept, like death of a loved one or suffering through an incurable illness. Maybe it is an inner struggle about choices we've made in our lives, or changes with family and circumstances. I wouldn't say having a child go through gender identity issues is "shit" (as that could be considered unkind), but rather it would be something that would have to be navigated with grace and sensitivity. There would likely be shit involved, like watching your child get bullied or harassed. Alex's daughter is lucky to live in Seattle where there is a high level of acceptance for differences. Alex is also lucky to have a mom who support her and has her back. I imagine Alex going to the soccer club leadership with her daughter and asking them if she could tryout for the boys team. My mom once told me quote from Greg Louganis, the Olympic diver. Someone asked him how he stands the pressure of having to make a perfect dive each time.

"I think 'My mom will love me no matter what happens,'" he said. It reminded me of Alex.

Reading about Alex's daughter pulled me out of my own shit, even if just for a bit. I am not super religious, but I pray that Alex and her daughter find peace, strength and courage as they go through their journeys. I guess that is what I also hope for myself and my family as my mother faces death.


* Sorry about the grossly cliched sentences. Once I got started, I couldn't stop.

Retail Therapy and Slowly

My dad said he has resorted to buying stuff when he was getting down about my mother's Alzheimer's. He read in a book that caregivers should get out of the house and do something for themselves, even if it is small. He attended to my mother twenty-four hours a day, but occasionally he'd sneak out to the hobby shop and get a remote controlled airplane. I think he has acquired dozens of planes and drones and helicopters in the past few years.

While I am not taking care of my mom (I live 2,000 miles away) and I am in no way caring the burden my father is carrying, I do have a little bit of guilt that I can't do more to help him. In honor of my father, I made my own stress purchase today. Thanks to the Boy, I am a Lego fan. Like him, I look for sets with interesting pieces and parts. Birds, eggs, and an "Anger Management Class" sticker? A pig with a tattoo riding a Hog? I'm in.

I like game, but I have no desire to see this movie. Thank goodness my kids are at the age where we can see movies with real actors instead of only cartoons.

I also bought a bottle topper that seals the bubbles in leftover sparkling wine. I also bought a bottle of sparkling wine, not for celebratory purposes. QFC had sparkling wine on the endcaps and I thought it looked good.

I am also doing a lap dog therapy. Fox is happy to serve.

My dad does not have a direct communication style. He told me my mom is refusing to eat, but I had to look stuff up on the internet last night to determine she might be near the end of her life. I know he doesn't want to worry me, but still. Last night, I read on NIH's National Institute on Aging's website that not eating is possible imminent sign of death for people with dementia. It is possible my mom is dying, and giving her a feeding tube is out of the question. The NIH and my mom's living will are both against feeding tubes for people dying of Alzheimer's.

My mom could die in the next week or two. Or, she could live for another six months or two years. We don't know.  My dad said people who are in hopsice do better than people who aren't in hospice. I thought he was being optimista until my physical therapist told me that hospice patients have a longer three month life expectancy than similar patients who aren't in hospice. I guess my dad heard correctly.

It is hard to decide what kind of mode to be in: the panic, move fast mode, or the quiet, calm, take things as they come mode. Last night, everything started to move in slow motion for me as I figured out this could be the end. I knew Alzheimer's was fatal, but I also knew it is a long, drawn out way to die. I was more worried about her living in a catatonic state for years than her dying soon. I guess I am going to take this slowly.

DNR

Do Not Resuscitate.

My dad is going to sign the paperwork for my mom to enter hospice. As part of this decision, he will also sign approval for the DNR. If she has a cardiac event, they will not try to get her heart to beat. Instead, the caregivers will let nature take its course.

What does this mean? I am not sure. Are we admitting defeat, letting death win? Death always wins. Dying is the deal we unwittingly make when we are brought into this world. Our bodies will eventually fail.

Alzheimer's is a terminal illness. For the past several years, my mom has been well cared for and tended to by my father. He is a devoted spouse--an example, Exhibit A. He has given her everything he has to give. This past week, she has been refusing to eat. This could be a phase, or it could be her body's way of saying the time has come for her to die.

I did a quick google search of "Alzheimer's disease not eating" and found an article from the National Institutes of Health:

"Our modern culture tends to treat dying as unnatural. Our technology allows us to forestall death, yet cannot prevent it. Family members need to be informed, with great compassion, sensitivity, and patience, about the dying process and how natural and inevitable it truly is. The body is shutting down. The natural process of dying means that the body no longer wants or needs food or fluids. This is often viewed as unnatural by caregivers, and even some healthcare professionals. However, we need to explore our own feelings and attitudes toward death and dying before we can help families through this transitional process, this time of loss and change," comments Darby Morhardt, MSW, Social Worker, Northwestern University Alzheimer's Disease Center. Cessation of food intake results in the release of endorphins, which reduce pain. Feeding tubes and hydration block the release of endorphins and can result in weeks of "unnecessary suffering" Dr. Post said.

This might be the end of the line. This reminds of the great song of the same title by the Traveling Wilburys, the impromtu, all-star band of 1988-90 with Tom Petty, Roy Orbison, George Harrison, Jeff Lynne and Bob Dylan. Maybe the song isn't about death, but it feels that way to me now.

Well it's all right, even when push comes to shove

Well it's all right, if you got someone to love

Well it's all right, everything'll work out fine

Well it's all right, we're going to the end of the line

Grandpa and the Boy

My mom's Alzhiemer's is accelerating. She was having such a hard time remembering how to walk that she is now wheelchair bound. She is having a hard time eating, as well. She has a few mini-strokes last month, which doesn't help. I fear her rapid deterioration means she might not have much longer to live. I always have heard the downside of Alzheimer's is that people outlive their bodies long after their brains die. Now, her body is starting to fail. I am starting to think she might die within the next two years, likely sooner.

My mom is in a long-term care facility, and my dad said he feels like he is living like a single person even though he is still married. When he comes home at night, he has no one to talk to. I can see the loneliness in my father, I don't think he will be one to manage well without companionship.

The Boy turned thirteen this week, and both my father and physical therapist said boys at that age start thinking about girls. (Jack moved a lot at that age, and is kind of hazy on his early teens.) I can see the Boy starting to date in the next few years as he enters high school.

This afternoon, I had this really crazy thought--there will probably be a time in the next few years when my father and son are both in the dating scene. I am not sure how I will take all of that. I don't want to see my father suffer in loneliness, but to have to watch my son and father start dating at the same time would be a little odd. I figured that my son might be dating in the next few years, but I hadn't thought about my dad. My dad and the Boy talk on the phone about quad-copters and legos and rockets, which is cool. Would they talk about dating? Here I would be, sandwiched between my son and father. I guess that is why they call it middle age.

I got this idea about my dad dating when I was a reading The New Yorker article about the movie The Meddler starring Susan Sarandon. I haven't seen the movie yet, just the trailer. Hollywood is catering to aging Baby Boomers and having movies with plots about their lives. Susan Sarandon is a widow who is lost without her husband. After driving her daughter, Laurie,* a little bit nuts (the title is The Meddler), she ends up dating J.K. Simmons who looks uncannily like my dad. When I saw the trailer, I thought Oh my god! My dad is dating Susan Sarandon! I knew it wasn't possible because my dad is a Republican and Sarandon is supporting Bernie Sanders. Also, my dad drives a BMW motorcycle, and Simmon's character drives a Harley.

If they are making movies about widows and widowers dating, I suppose it is because it is a real phenomena. I will have to be ready for it when it happens.


* My family called me "Laurie" growing up. My mom thought "Lauren" was too big of a name for a little girl.

Cat Walk and Turning a Corner

Bike Time: 45 minutes 

Distance: 8.73 miles

I was walking the dog with Jack this morning. I am just returning to walking the dog, and only for short walks. We crossed the street at a stop sign, and cars were waiting as I hobbled across. At these times, I am very self conscious of my gait and my speed. The other time I feel self-conscious is when I walk into physical therapy and Evan watches me walk. I feel like a combo of a fashion model on a catwalk and a golden retriever at the Westminster Dog Show. (At least the dogs get a treat after they are evaluated.) Jack said I was limping less. He is comparing my street walking to my gait first thing in the first thing in the morning. When I get out of bed, I have pirate leg -- my left leg is unbending and stiff. As my leg warms up, it bends and I look less like Captain Hook. My street walk looked good today, but my right leg still moves faster than my left, especially when I am trying to cross the street. I can tell, even if an untrained eye can't.

I do feel like I've turned a corner and am feeling better. Last week, I ran into friends around town, and they asked how I was doing. Each time I said I was feeling better, and I meant it. I was sincerely feeling optimistic. Normally, I would smile and grit my teeth. Now I just smiled. My plum (the fluid and stuffiness in my knee) is getting smaller and my range of motion is improving. I am less stiff and at times, my knee feels loose like a normal knee.

On the way back home from walking Fox, we stopped at the coffee shop around the corner. I saw a man in his thirties with a leg brace and a compressing wrap around his knee. I said hello and asked what happened.

"I tore my ACL," he said.

"Me too!" I said. "I am nine weeks post-surgery."

"I had surgery two days ago," he said. "They are repairing my previously torn ACL."

"Ouch," I said. It turns out he tore his ACL eight years ago, and had it repaired with an allograft. The repair didn't last, and he needs two surgeries now to fix it, the first to repair the allograft holes, and then to install the new ACL. There are two and half months between surgeries. I don't think I could stand it.

"You are going through this twice. Is it worth it?" I asked. I met another man at physical therapy last week who was on his second ACL repair. My concern isn't that this will fail, but rather there is a lot of effort in the healing process and a lot of time not being fully functional.

"Totally worth it," he said. "I play soccer and snowboard. And you look great! You can walk downhill!" I was basking in his kindness, especially from someone who has been down this track. Walking downhill is hard, and I am walking down hills, even if it takes forever.

After we walked on, I asked Jack what he thought about having a second surgery.

"The guy was probably in his early thirties, and the thought of never snowboarding or playing soccer  again for his entire life was probably unacceptable," he said. As much as this recovery is a challenge, I can see Jack's point. At times, it is hard to remember why I had the surgery. It is hard to see long-term when I've never been in this spot before. Bizarrely, I feel optimistic when I see someone going through the surgery twice. They must feel the payoff is worth the price.