Conversations About Death: I

Bob King Diaries; O7.o5.2o17

Visiting with Bob, discussing the recent Grenfell Tower fire in London…

Both Bob & I have strong emotional attachments to London. I lived there for a semester in college studying Art History, in my Long, Long, Ago.

Bob had been traveling frequently to England during the last 14 years prior to a health decline that prevented him from his normal routine of flying into Heathrow Airport 2 or 3 times a year. His partner for many years was a Russian woman named Nadia, who lived in England.

Bob and my mother had been married for 16 years, but they divorced in 1974.
Neither of them ever remarried, and it wasn’t until Bob & Nadia met that he had a love in his life that I can remember.

When the fire happened in Mid-June, we were both stunned and saddened by the tragedy. Such tremendous loss in a place that held precious memories for both of us.

Me: “What a terrible way to die… burning to death.”

Bob:  ((quiet pause)) “Yes.”
“I’ve been trying to think of what a good way to die might be.”

I am all about End of Life care, and making one’s own funeral plans long in advance. I’ve been trying to get Bob to discuss his wishes in the event of his death since the 1980s. It’s always been important to me.

It has always disturbed him.

Bob’s brother and sister-in-law died within 4 weeks of one another, in 2o15.
He participated in the periphery, as I was helping my cousins with Hospice care.

There was a combined small private family gathering for both of them on the same day; Aunt Donna’s remains were interred, Uncle Frank’s ashes were scattered along Parson’s Creek outside of Marcola, Oregon.

Marcola is a tiny unincorporated community outside of Springfield, OR. Which is outside of Eugene.
Bob, Frank, and Donna grew up together, attended the same high school.

Bob declined to attend the family gathering. He never did articulate the reason for this. I presume he was experiencing too much grief with the loss of both Frank & Donna in such a short period of time.

Bob has always thought me to be a morbid little creature. He loves me dearly, but he cannot relate to my need to connect with people during the precious last hours and days of life.

When he said he has been trying to think of a “good way to die,” I was caught off guard. Sometimes it’s hard to discern when he is serious vs joking.
Joking about death does not seem to be his thing, however.

He had three falls last week. This, he will joke about.

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Bon Voyage, Boy Child

I anticipated that yesterday might be the hardest day of my adult life.
Mr. Blitch and I took our 16 year old son to PDX at O2:30 for a flight to Panama.
HH’s first time out of the country (other than Canada, but really ~ Most kids from the PNW get up to Canada at some point).
A first very hard ‘Farewell’ for us as parents.

Our Boy is traveling with an amazing organization: Amigos De Las Americas.
Participants from across the US, and from 8 Latin American countries have been preparing for this adventure over the last many months.
The Core Components of the Amigos program include:
1) Training  (pre-departure training in health & safety, community development practices, personal leadership, and cultural understanding (about 100 hours for this training).
2) Language & Cultural Immersion
3) Youth-Led Community Service
4) Mentorship
5) Reflection & Continued Engagement
6) Health & Safety

Mr. Blitch and I have tremendous faith and trust with this group ~ enough so we were willing to let our One & Only pursue this major life journey. We were terrified, but also beyond proud of our kid for wanting to do this.

Group photo of the Portland Amigos participants at the farewell gathering:
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The Amigos program offers these young people the opportunity to travel to small or medium-sized communities where they will live with a host family, facilitate extracurricular activities for children & youth in their host community, and learn the process of planning and implementing a community development project.

2o17 Amigos project placement sites
* Dominican Republic (San Juan)
Theme: Civic Participation
* Costa Rica (Pérez Zeledón)
Theme: Environmental Sustainability
* Nicaragua (Madrid)
Theme: Civic Participation
* Nicaragua (Matagalpa)
Theme: Public Health
* Ecuador (Chimborazo)
Theme: Youth Entrepreneurship
* Paraguay (Guairá)
Theme: Public Health
* Colombia (Barranquilla)
Themes: Global Health, Engineering, Social Transformation
* Panama (Coclé)
Theme: Environmental Sustainability
* Panama (Azuero)
Theme: Environmental Sustainability (Azuero is where our boy, HH, will spend the next 7 weeks)

So, after months of participant training, and the amazing support and guidance we received from the Portland Chapter Amigos Volunteer Board members… we took our HH to PDX at 0300 for his departure.

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Part of what one signs on to as the parent of an Amigos participant, is that you say your Fare-Thee-Well at the airport, and then agree to an official No News Really IS Good News” policy. We know that HH will have one opportunity to call us, about midway through the 7 weeks he will be gone.
One phone call.
((Gulp))

There is one other individual who is missing HH tremendously. His sweetheart, Mz. Ivy.
She had been away visiting family in Idaho during the last several days prior to HH leaving the country. They had one last, quick, visit prior to his departure.
They got matching haircuts….

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And finally, as parents of the Amigos 2017 travelers, we are treated to occasional glimpses of the participants via Instagram. (“amigosazuero”)
I had one year of college Spanish, about 25 years ago, so I had to look up the translation for this amazing glimpse of my kid:

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We are very proud of our caring supervisors. Have left for their first week of route!
We are friends2017

HH is on the far right, sporting his treasured Billy Joel cap.

I cannot quite put my feelings or emotions into words at the moment.
An acutely uncomfortable mixture of pride, irrational fear, excitement, and terror. Something like that.

Holding my son, and all the other Amigos in my heart, and in the Light.

 

 

Waking Up to Sweet Things

Portland, Oregon. O6.2o.2o17  O4:45

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The Father’s Day 2o17 post had to go sit quietly by itself in the ‘Drafts’ holding area. It was just a wee bit too painful to tend to in real time.

So, Sweet Things will be the theme of today.

I woke up at O4:3o this morning. This may sound awful, but it’s a huge victory.
According to my CPAP machine, I slept a full 7 hours.
This is a big improvement from my normal 4 to 6 hours of nightly sleep.
And, I did not have any nightmares.
None that I remember, anyway. I will have to ask Mr. Blitch when he wakes up.
Apparently, sometimes, I wake him up talking or screaming in my sleep. Sometimes I am very well aware of this, sometimes not.
Oh, you don’t have this problem? Well. Lucky you.

What do I have nightmares about?
These things (in no particular order)…
1) my job
2) #45
3) my mother
4) my father
5) dance auditions from High School (circa 1983-1986)
6) that I don’t really have my bachelor of science in nursing (BSN) degree. There is still a college history class that I didn’t complete…
7) someone named ‘Jennifer’

So, today is already a great day!

Here is my better list – Sweet Things of Today:

1) My son HH and our neighbor, Max, slept out in the backyard last night. HH on the hammock, Max slept on the grass. There really are some sweet teenage boys in ‘Murica. I know of at least 7 or 8 of them. Good students. Musicians. Young men who are respectful towards girls and women. This does still exist.

2) My friend Julie’s daughter turned three yesterday. Her papa, Mr. Beastwood, gave her a rad pink, black, and white drum set for her birthday.
And, apparently, she learned that she’s going to be a big sister this winter.
Everything about this family is tremendously cool. Creative, super smart people. Julie and I used to work together at my previous job. She is one of the smartest women I have ever known. She taught me everything I know about Epic medical electronic systems. I could not survive or thrive at my current job as an Oncology Nurse Navigator if she hadn’t encouraged me to change my stubborn Luddite ways, and embrace the advent of medical technology.
When I graduated from the University of Portland School of Nursing ten years ago, my first job was as a night shift Bone Marrow Transplant nurse in a large teaching hospital. Paper charting was still a thing then. The noc shift nurses would grab calculators in the early morning hours to frantically add up each patient’s I’s and O’s (Intake/Output fluid balance) and ANC (Absolute Neutrophil Count) prior to the arrival of the Nurse Practitioners, Physician Assistants, and Hematologist-Oncologists at o6:00.
I was working the night when our Epic system “went live.” It was insanity. All managers on duty, people who had not worked through a 12 hour night shift in their lives. All the night nurses were snickering at them as they struggled to stay awake. Good times.
Anyway, Julie and her husband are outstanding people. They make life better though science and art. I truly, deeply, admire and appreciate them.
I mean, Holy Shit, had I been given a drum set when I was three years old? What might life have been like? What roads might I have traveled down? Kudos to them. Strong parenting. I am thrilled there will be a new addition to their family in the near future. Our world will benefit from this new arrival.

3) Mr. Blitch has gotten his groove back. After a couple years of limited time in the studio due to chronic back pain, parenting, “other work,” and me being away at work for 40 to 50 hours per week…. I went down to the studio this morning and found this:

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4) And then there was this…

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Self Soothing Behaviors

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My job is stressful. Pretty much every aspect of my life is stressful.
Every day I drive to work, wondering when I can fit in my next visit to my father.
~ I have him situated in a very nice adult family care home, which is somewhat conveniently located in the midst of a triangle formed by my house, and the 2 hospital locations that I bounce back and forth between.

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I’m a person who does better when I write things down. Words, drawings… mapping things out helps me get through life.
If I can somehow frame something within the boundaries of a piece of paper ~ there may be hope for me to survive another day.
Seems fitting that I ended up becoming an Oncology Nurse Navigator.

Non-pharmacological interventions for stress relief
Prior to heading out from my home in SE Portland, I make a trip to the backyard oasis that has been created by Mr. Blitch. I visit my Marigold (aka my therapy chicken), and snip some fresh Rosemary. I keep it in a glass in my car console.
The 18 mile car commute is eased by the smell of rosemary oil on my fingers.
Once I make it to my main job location, I can settle in ~ check my messages and the incoming referral line, make a few hard calls.

On my break ~ assuming there will be one at some point of the day ~ I head to the hospital Healing Garden.
I will always be rewarded there by some kind of tremendous beauty.

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Piano Tuning

I actually have 2 piano stories.
The first, will take me years to complete. It is excruciating; it makes me squirm and rage. So best left untouched for the now.

The other piano story, is one of friendship, and heart, and community. A much more pleasant and easily digestible tale.

We are (?) care taking, housing, no: blessed with, the care of a piano belonging to a friend.

We just had it tuned. And while I appreciate it and cherish its presence in our home every.single.day, I am feeling inspired to sing its praises anew.

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I played piano when I was a child… The comfort and joy in the playing weren’t there for me.
I viewed my practice as a chore; similar to the way I view a garden (flower, vegetable or otherwise): it’s a place you are sent to toil & pull weeds. Not a sanctuary or place of growth and joy.

Our son, Harrison, began playing about a decade ago. We found a teacher for him who has been a prefect match. Music theory, scales, chord progressions, are all covered as they should be. But from there, the sky is the limit. The songs they play are chosen together ~ whatever suits the mood. Ragtime. New Orleans jazz. Indiana Jones movie soundtrack music. The Beatles.
Just to name a few. A very few.
Recent musical obsessions of my son’s have included Stevie Wonder, Elton John, and now: Billy Joel.
To hear the songs of these artists played in our living room, by my son, on this amazing piano… Makes my heart explode. In a good way.

The piano belongs to a family friend, a member of my Quaker community. I met this woman when I was in my early 20s, long before I met Mr. Blitch. The piano is one she had in her home when her sons were young, and they had a spacious house with plenty of room. Two decades later, her sons are grown, living far away in places where they can’t have the piano. She also moved, to a beautiful home in the SW hills of Portland. There is a steep and treacherous walkway from the street to the entrance of the house, not a great place for this beautiful Baby Grand.

When Harrison was little, we were renting a small upright piano. My friend learned that we were making monthly payments that were hard on our budget right around the same time that she needed to move her piano into a “foster home.”

So we have this amazing instrument. We treasure it, and appreciate its presence. We’ll keep it until one of her sons moves somewhere where they would be able to enjoy it again themselves.

And we have Jeff Baxter. Harrison’s piano teacher for the last 8 years. Harrison is 16 now, so Holy Cow ~ half of our kid’s life has been touched by this amazing person.

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Jeff has his own son now, a super fun kiddo with the most excellent name of Arlo Baxter.
This is our community, our tribe. We raise our kids in this sketchy, sometimes terrifying world ~~ and music provides comfort, sanctuary, hope.

This is how we teach our children to survive. Music heals. Inspires, enriches.
Lullabies, hand clapping songs, symphonies, folksongs, requiems… All phases and stages of human life are accompanied in some way by music.
Without it, what would be?

Feeling tremendously grateful for so many things. Making every day a celebration.

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Insomnia

Things I Am Not Loving About Aging/Perimenopause:

1) Insomnia
2) Fatigue
3) Decreased ability to handle my liquor
4) Age spots (on my once flawless, nay, porcelain-like skin)
5) Weight gain
6) Irregular menstrual flow / spotting (more unexpectedly ruined pairs of underwear than a tween-age girl)
7) Migraine headaches
8) QTR (Quick To Rage)

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And, WHAT THE HELL is the matter with People?

In a desperate/practical attempt at self preservation, I have completely left Facebook. I also have strict rules for myself about my news intake. I have a 30 minute auto commute to work, and not surprisingly, #Fucking45 has made any kind of news difficult to digest.
I let myself check the TV news for weather and natural disasters prior to heading out for my dog walk with my geriatric Labrador.
I indulge in 5 to 10 minutes of OPB on my drive. When I catch myself screaming out loud to the radio, I switch over to audio books from my beloved Multnomah County Library.

I just finished Swing Time by Zadie Smith. (The link there will take you to the NPR book review that introduced me Smith’s book.)

Now I’m on to The Handmaid’s Tale by Margaret Atwood. Handmaid’s Tale was published in 1985. I read it for the first time in 1987, right after I graduated from Berkeley High School. I cannot think of another book that I read during my teen years that affected me so deeply. To this day, if I stand in my kitchen and am baking with butter, I recall the story and rub a pat of butter into my dry skin in tribute.

This morning, was a day off work for me. I awoke at about 4am, with a headache. I turned on the local TV news, and was treated to this:
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Seriously. What the ACTUAL Fuck?

TV back off now… moving on.

Things That Make My Heart Explode (In a good way)

Pretty much, my husband and my son.

And my chickens. I do not know how I made it into my 40s without having chickens in my life.
Chickens are better than Citalopram, Prozac, Ativan, combined.
When I feel sad, anxious, as if we are facing The End Times…. I head directly out the chicken coop. Everything is happy, healthy, and good, in our chicken coop.

And my son, HH, who will be leaving soon to spend 7 weeks in Panama with the Amigos International program.

This was my Mothers Day card. My son made it, he’s 16 and digs calligraphy.
My life is good. Insomnia, tough job, perimenopausal rage, and all.

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“Over~Exuberant & Weird”

…was what someone called me today. 
I will pretty much leave it at that. Or, second thought: I am appreciative of the fact that the speaker at least has a decent vocabulary.

Have I mentioned that I’ve had a bothersome earache for over 2 months now?

I have been unable to get in to see an Ear~Nose~Throat physician, so after polishing off a week of patient care, and elder care, I squeezed in a Saturday appointment at my own doctor’s clinic.

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“We” are now trying a different antibiotic, and steroid ear drops.

In other news: I seem to be growing a lovely blond mustache and beard.

And, I’ll take exuberant, even overly so, over lackluster, or phlegmatic, any day.

 

 

Rabbit Hole Survival Strategies

Mr. Blitch is working an early morning bookkeeping shift for 7 straight days. Up at o3:OO, out of the house by o3:30, into the vault by o4:OO.
Yesterday (Saturday), I woke up when he left the house. Once awake, the hamster wheel that resides in my brain sprang to life.
There must be some residual from my 12-hour noc shift nursing days that enables me to snap from peaceful slumber to stone-cold awake & alert. And once there, not so easy to return.
I decided to make the most of it, and get in some Oncology Nursing Certification studying. Quiet house, deadlines always looming: seize the moment.

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Half the day passed by. I ventured into the kitchen, down to the laundry area to stretch my legs and throw in a towel load. I became acutely, uncomfortably, twitchily, aware of the dog hair swirling around my feet. Our kitchen, the Bane of My Fucking Existence, had dirty dishes piled up over every minimal square inch of counter space.
An irrational, yet too-familiar, rage started creeping up from deep within.
Did I mention I’m on steroids? Crohn’s? No. Well, not directly.
I’ve had an earache for about 2 months. I’ve been to see my PCP twice now for it. We’ve tried antibiotics, nasal sprays, allergy medicine, the gamut. Now we’re trying steroids. It’s not helping. I even have *real* Sudafed. (Sudafed is only available by prescription in the state of Oregon. Thank you very much, Central Oregon Meth Labs. Way to ruin Over-the-counter decongestants for the rest of us.)
A fun fact about Crohn’s disease, is that some of us can develop Ear-Nose-Throat manifestations in tandem with our usual GI inflammation.
Ear pain, steroids, fatigue, stress. It can become a fairly speedy road to rage.

Text to my friend, M:  “Do you ever have thoughts about moving out of your home? (Asking For A Friend)”

M, back to me:  “I think maybe you’ve been studying too long and need a break. Why don’t you come over and we’ll go for a walk?”

Still in the possession of a modicum of sense, I was able to recognize M’s offer as a Beacon of Sanity, and drove straight to her home.
On the short drive, my mind started cycling again with unfinished blog fodder.
I dictated the following to my phone, and the phone actually got it mostly right:

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Easter Sunday & Mohs Surgery Monday

Bob King Dairies; 4.16.2o17 to 4.17.2o17

Bob tells everyone he doesn’t have much of an appetite, and he doesn’t give a hoot about any kind of holiday. Yet somehow, he never passes up an opportunity to eat some of Mr. Blitch’s cooking.
He says little to nothing to his grandson. Nor to his son-in-law of 19 years, for that matter.
But he will grudgingly follow his daughter out to the hen house for a visit to Marigold. It’s the small price he must pay for his supper, and he knows it. Humor the Urban Chicken Whisperer, and you will be rewarded with a meal.

Bob and his daughter; Bend, Oregon, August 2oOO, and Portland, April 2o17:


SCD Easter meal:
~ Grilled Chicken
~ Roasted Beet Salad
~ Salad greens
~ Homemade Blueberry*Apple*Ginger jello
~ Apple-Rhubard grain-free crumble


Life: Celebrate that Goodness every-flippin-day!!

At this point in the Blapplegate Family home, any single day when no one is ill, and no one is working, is a day to celebrate togetherness and Life. Just simply being alive, being upright, being bipedal, and being somewhat functional.
This year, a special guest made the appreciation for Capital-L-Life rise even more to the surface: a dear family friend who had recently completed many long months of treatment for breast cancer was at the table. Just a few days prior, she had gone in for her first mammogram after treatment. The news was all clear and all good, and there was much to celebrate.

 Deuxième partie: Mohs

I wasn’t sure how to tell Bob that the pathology had come back from his latest skin biopsy with unfavorable results. (Unfavorable = cancer, in this case)
Again. His 4th skin cancer in left last few months.
It wasn’t even so much the news of yet another cancer; he’s grown accustomed to it by now. Born a true redhead in 1933, growing up on farms in Nebraska and then Oregon’s Willamette River valley, his skin was somewhat doomed.
It’s more the anticipation of an appointment: he doesn’t sleep well for several days prior, his terror of simply being outside is renewed. If I mark an appointment too far in advance on his wall calendar, it swallows his focus.
This time, I took a chance… I waited until I was driving him back home after the Easter meal at our house. I mentioned it casually: “Dad, the derm office contacted me… they didn’t like what they saw on that last biopsy. They want to whack that little spot off your cheek. They had an opening for tomorrow, so I took it.”
He was in good spirits, and he took the news surprisingly well. To his way of thinking, he got a twofer. Two days with me, literally the only person he allows into his world any longer.
What Bob doesn’t know is what a huge fucking deal it was for me to obtain this particular day off from my work as an Oncology Nurse Navigator. I had in fact made the appointment 5 weeks ago. Our dermatology clinic only performs Mohs procedures on Mondays. Mondays only, and only mid-day, right when I have the responsibility of setting up and taking notes for a weekly Cancer Conference. Presence of a Nurse Navigator is required, and getting coverage involves requesting another Nurse Navigator to drive from our main hospital campus 18 miles away. In short, it’s damn near impossible.

Anyway, things have improved since last year, when I had to literally travel from Bob’s hospital room at that other hospital 18 miles away and drive to fulfill my Monday obligation at the more remote hospital where I usually work. The support of a new manager has made it possible for me to occasionally request, and get, coverage.
(And oh yes, it’s also the law. It’s the Fucking law: https://www.dol.gov/general/topic/benefits-leave/fmla
Just saying. But I digress…)

So, MOHS!

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(Image cred: Terese Winslow, Medical & Scientific Illustrator)

I made a change in my time management strategy as Bob’s caregiver last month: I bought a laptop, so that when I’m idling away the hours at medical appointments with Bob, I can multitask and study for my ever-looming Oncology Nursing Certification exam.

Mohs procedures are done in stages. The visible lesion is removed, and sent to an on-site lab for a peek under a microscope. The surgeon will keep removing only small slices of skin until they are confident there are clear margins (‘clear’ meaning the tissue is free of cancer cells).

If a patient is fortunate, they may obtain the clear surgical margin in just one or two slices. However, the appointments are made with the understanding that they may have to do multiple incisions, and the process may take 2 hours or longer.

I was feeling optimistic today: I had snacks for myself and Bob, I had my fancy new laptop, I had the day off work. We checked in early, and headed to the downstairs surgery suite. I stayed in the room with Bob to review the consent, and keep him company while they numbed him up.

They booted me out when it came time for the actual cutting. I cheerfully headed back to the waiting area, and pulled out my laptop. Ready to …. ready to realize that I could get no online service in the basement of this building.

Silly me, I don’t know how I never noticed this before, but this Derm clinic is located in a historic NE Portland building. It was originally a private mortuary. Later, it was purchased by Multnomah County, and became the county’s morgue.

So there I am, seated in the bowels of the former county morgue, with no way to access my study content. Did I bring any of my books or flashcards? Hell no, I had finally let go of my Luddite-with-slightly-Amish-tendencies ways, and stepped into the Modern Era.

And this was my reward.

So I sat, and became the new BFF of an elderly Veteran who was waiting for his wife. It was sweet. It was not how I needed to be spending my time, but it was sweet.

Bob came out in between slices. We shared a banana. I made him a coffee in the waiting room lounge. Free Coffee!! He was, I believe, in heaven. The doctor and nurses are incredibly kind, they dote appropriately on him.

He was done in about 2 hours. He had missed his lunch at the care home where he resides. Snacks are one thing, but it was 1:30 in the afternoon. One-half a banana and a couple handfuls of peanuts can only carry a person so far.

Me (starving): “Dad, can I take you out for Chinese food (his favorite)…?”
Bob: “Oh, no, I don’t think so. They saved some clam chowder for me back at the place.”

Off we go. I deliver him, with his pressure bandage covering half his face, and leave him to his chowder. (There is also a small plate on the side with a Bob-size treat: 5 crackers, a small cluster of grapes, and 3 Oreos.)

“Thank you” he says, as I depart. “Thank you for… caring for me.” You are welcome, dad. You are very most welcome.