The Wild World

Fall and the Sukkot Moon

A scrim of clouds played with Orion and the Sukkot Moon, revealing and then hiding, hiding and then revealing. The walk to the mailbox is short, but as I take it my mind whirls up to the distant stars, to Greek myths, to the peak of Black Mountain faintly illuminated by the moon. It is a delightful way to start the day, quiet, usually no cars, still a bit early for commuters.

Scattered clouds change the night sky, creating mystery. A lesson in the occult. If you’re an early bird and can see the sky, I recommend this consciousness expanding morning ritual. It places the day in context. The universe observing itself through my eyes. A quiet joy.

We drove down the hill yesterday in the early morning, out of the house at 6 am headed for Corneal Consultants. Kate’s first cataract surgery. On the way she asked me, Do you know why Kirby Puckett was such a good hitter? No. He batted right, but had a dominate left eye. Oh. I see. I was a good hitter. I have left eye dominate and bat right handed. The stuff you learn about someone.

In case you got to wondering, as I just did, about the relationship between eyeball and river uses of the word. Latin cataracta waterfall, portcullis, from Greek katarakt─ôs, from katarassein to dash down, from kata- + arassein to strike, dash Merriam-Webster. I’ll have to check the OED later.

It went well. She’s wearing a clear plastic eye-shield and the dark pupil of her dominate eye gives little space for the beautiful blue green of her iris. Drops every two hours. A visit to the doctor today.

On the way into Evergreen last night to pick up pizza at Beaujo’s an emergency vehicle came out of the fire house, cutting through the rush hour traffic which lined both lanes of 73. While I drove as close to the slight drop off as I could, an Elk cow looked in at me. Neither Gertie nor Rigel went nuts. Thankful for that.

In a front yard on the other side of Cub Creek nine or ten of her sister cows laid on the grass, eating their cud, looking very relaxed and at home. During the rut and into the winter the elk are more present in Evergreen. Not like Estes Park where they wander into businesses, but still visible.

Today Alan and I have brunch at 11:00. The first time I’ve seen him since my bagel table in late September. Kate had a bad couple of weeks and he had acting in Cabaret, singing at the High Holidays, and the Rotary Club’s recycling day. Looking forward to catching up with him.

Kate’s friend from both Bailey Patchworkers and CBE, Jamie Bernstein, has agreed to take her to her follow-up appointment so I can see Alan. Thanks, Jamie and Kate for setting it up.

Simcha

Fall and the Sukkot Moon

Over to Aspen Roots. No, not a nursery, our hair stylist Jackie’s place. We’re as beautiful as we can get for a couple of days. Thence to King Sooper for soup ingredients: golden leek and potato. Picked up fresh sage, fresh thyme, leeks, Yukon Gold potatoes. And, some pita chips while Kate went to the bank.

Back home to cook. Simple, but labor intensive. A pound and three quarters of potatoes halved and sliced thin. Garlic sliced thin. Leeks washed and, yup, cut thin. Made a bouquet garni. Cheese cloth with the sage, thyme, bay leaves tucked in and tied up. Fun, but I find it tiring to stand so long. Maybe an hour plus.

The soup went with us to the mussar evening group. It was enjoyed. I’m always a bit nervous taking my cooking outside our house. My cooking style is innovative, not always to the recipe.

Kate presented on joy, simcha. I read Wendell Berry’s poem: Before Dark. We discussed the barriers to joy, how to cultivate, recognize joy.

Rabbi Jamie had to leave the group early. The second or third kid who drew swastikas on cars at a school parking lot came in for a talk. With his very dressed up parents. Jamie does this every once in a while. Last year he spoke to a kid who didn’t believe in the holocaust, an active anti-semite. He said the kid came around in the conversation. This kid and the others had followed along. Still pernicious, of course, but different.

Home in the behemoth. We have a Nissan SUV that looks like a gun boat and drives like an RV. It was the only thing they had at the Enterprise agency last Friday. The new Rav4 is at Caliber Collision having its rear bumper and rear door repaired. Kate’s accident a month ago or so.

Leaving early this morning, about 6:15 for Corneal Consultants in Littleton. Kate’s having her first cataract removed. The next one in two weeks. Hope to get some mitigating in later today.

Guy Card

Fall and the Sukkot Moon

So my guy credentials are more or less intact.

More. Got the chainsaw to work, cut down one tree. Mitigation started. The starter rope was cranky, not dysfunctional. Means I got it all put back together correctly except for that one little hose. Over the next few weeks I’ll gradually cut down the trees that the guy from Elk Creek Fire marked.

After I limb them, the slash will need to be moved to the front so the Elk Creek crew can come chip it. Much cheaper ($0) than the the six hundred bucks I paid for my first big slash chipping in 2016. A sign will go up in the front offering my downed trees to neighbors who heat with wood.

Right now I’m planning on paying somebody to put the landscape cloth and river rock down. Seems like too much work and I don’t think I’d do a good looking job. Whether it gets done this year will probably be down to the weather.

Less. The lupron continues suppressing my guy hormone. Hot flashes have lessened, as Sherry said they might. A lupron influenced mood swing now and then. Fatigue and sarcopenia are the major side effects right now. I’m working out, but not advancing as much on the weights as I’m used to.

Cardio is harder, too. That might be the copd (or ashtma, I’m a bit confused on this right now.) or it might be the fatigue and sarcopenia. Or, it might be that I’ve not pushed myself enough. This is important to figure out. Cardio is one of those key non-medicinal elements in fighting whatever brand of lung disease I actually have. Resistance, too, because chest muscles have a lot of influence on breathing.

Anyhow this will all settle down over the next month or so. I see Lisa again for a followup on the lungs, November 11th. I want to know exactly what I have, copd or asthma. Is there a difference?

I also want a better handle on what I can do to stay healthy. Example: pine pollen. I moved 900 miles west and 8,800 feet up to discover I have an allergy to pine pollen. Initially annoying, but with the lung disease it might be a real problem. Probably see an allergist.

Not to mention I want a prognosis. Is this mild or moderate? Does it have to progress or can I slow it down, stop it?

November 5th I see Anna Willis, Dr. Eigner’s P.A. In case you haven’t kept a scorecard handy Eigner is my urologist. He did the prostate surgery in 2015 and he ordered the radiation and lupron.

I have two main questions for her. 1. Does the .03 PSA mean the radiation didn’t work? See a few posts back. 2. How long do I have to stay on the lupron?

In spite of this post and the others on medical issues I don’t spend much time thinking about them. I’ve done what I can with the prostate cancer. It doesn’t worry me though there are questions I have. The lung stuff is a little more up front for me. That’s because it’s new and I don’t understand it well yet. Even so most of my day and my nights (I’m sleeping well.) are unencumbered.

As buddy Tom said, chop wood and carry water. Where I’m trying to be right now.

Wandering. Bored. That’s me.

Fall and the Full Sukkot Moon

Made shawarma yesterday. Not bad. Used both my cast iron skillet and the instapot. Seared the chuck roast in the pan, deglazed and put it all in the instapot. An hour or so later, done. This is a favorite food for me, so I’ll work to perfect this. Also made tabbouleh and bought some hummus. A real Middle Eastern meal. Put some of the leftover meat in the borscht I made for Kate a week or so ago.

Kate, a much better cook than I am, backs me up, gives me the benefit of her knowledge. On Friday, for example, I wanted to make french toast from a baguette that had dried up. It had to be easy, I imagined, but I still didn’t know how. Instead of using a cook book I asked Kate. Vanilla in a beaten egg, coat the bread, fry them. Cinnamon and sugar on them while they’re cooking. And it was so.

Both of us have less of an appetite in the evenings so I made this meal for late lunch, Sunday dinner.

Still bored. I guess that’s the feeling. Don’t wanna do this. Don’t wanna do that. Wandering around. Tried the chain saw, get started on fire mitigation, Round II. Starter rope won’t pull. Guess I really fixed it when I took it apart and put it back together. Going to the chain saw e.r. today.

Had some success yesterday with wu wei. When I cooked, I cooked. When I ate, I ate. When I painted, I painted. But I got back to wandering around. Felt like I was waiting for Godot.

In that mood I decided to mess around with my webhost. They’re the folks that provide a server and security for Ancientrails. Got right in there and changed my PHP settings, then added SSL. Closed out AncientrailsGreatWheel and CharlesBuckmanEllis. Don’t use them, no need to pay for them.

Felt good about all that. Clicked on Ancientrails to see if things had changed. Ah, they’d changed. Ancientrails had disappeared! OMG. So I messed around a bit more. No joy.

Knew that this was not a matter to settle while I was tired, so I waited until this morning. It was baaaaccckk. Why? I don’t know. But, I’m glad.

Still not able to load images. Gotta get on that in a more disciplined way.

This whole year plus, since last September 28th, has been a transitional time for both of us. At first the transition focused on Kate’s health, especially her malnutrition and her bleed. Then, while in for her pneumothorax in April, a pulmonologist thought he saw lung disease. That got added to the cart.

In February, I had the flu and my annual physical. PSA 1.0. Too sick to recognize it for what it was. But you know what happened when I tumbled to it. Radiation, lupron. Ongoing. Last month I went in to see Lisa about some tightness in my lungs. COPD. Oh, damn.

The transition has forced us both to acknowledge that our lifespans are probably not as long as we imagined. Sobering. But, o.k. They were limited to begin with. Death is not an optional experience. Or, as an Arab saying goes, Life is an inn with two doors.

The wandering and the boredom, I think, comes in here. A month ago I was imagining beating prostate cancer and living into my 90’s. Now? Not so sure. What does that mean? A foreshortened life span? Maybe. And what would that mean? That’s where my ikigai got lost, I think. Unclear how to live into this reality.

So, wandering and bored it is. Except when I engage. You know cooking, shopping, doctor appointments, fire mitigation. Getting the new Rav4 repaired. At some point a new direction will emerge. Perhaps it will simply be what I’m currently doing, but I don’t think so. Just don’t know.

Ikigai gone

Fall and the Full Sukkot Moon

Each morning Orion is a bit further to the west, hunting must be better on the other side of Black Mountain. That’s where he’s headed. This morning the full Sukkot moon lit his search for game, hanging in the west over the northern most peak of Black Mountain. Seeing Orion, Cygnus, Draco in the early morning sky makes me joyful. Visiting old friends each time I go out for the newspaper. A reminder of how non-earthcentric our galaxy and the universe are.

Trying to reach down inside, find an ikigai. Hard right now. My usual pattern of working daily on a novel or the garden or fire mitigation has disappeared. Not been seen for months. Yes, I get Ancientrails done each day, and I’m glad for that, grateful I have the early morning time.

Rabbi Jamie talked about loneliness in his erev Rosh Hashanah sermon. Embrace it, David Whyte counsels. Lean into it. What I’m experiencing is not the same as feeling alone, lonely, but I sense I’d do well to lean into this defocused state. It’s similar to loneliness in that it involves distance, but in this case I’m not feeling distance from others, but distance from a self I’d come to appreciate.

I’ve chosen, so far, to feel uncomfortable about this. Why aren’t I getting anything done? Why has my writing stopped? It’s not like I don’t have time, I do. But when I have time I could use, I wander around, not sure what comes next. Sometimes I paint. Sometimes I read articles on the web. Sometimes I read a little. Could read a lot more. I say I want to.

What if instead I decided to go with the schedule I have rather than the one I want or think I need? What Self would emerge then? Taking the pressure off to be something, someone else? That would be the wu wei move. Let life be. Flow with it, don’t force it.

My old Tao Te Ching teacher, I took a series of online Taoism classes several years ago, says forcing things is a Westerner’s style. When I read that, I thought of my choosing to take arms against a sea of troubles and by opposing, end them. Guess I’m a Westerner.

Actually, I’m more bi-cultural. Strong forcing, yes, but also a willingness to let things take their course, to emerge, to flow with them. Right now feels like a wu wei moment. Perhaps for a good while.

Seeing Dr. Guber

Fall and the Sukkot Moon

Kate had a much better day yesterday. She decided to conserve her strength for the appointment today so we missed Yom Kippur. The parking at CBE gets problematic on the High Holidays and walking much distance creates breathing difficulties for Kate.

On to Harvard this morning. Harvard Avenue that is. Denver has a small cluster of streets with names like Yale, Vassar, Bates, Cornell, Dartmouth. In or near them is Denver University and Iliff Methodist Seminary. Also, Porter Adventist Hospital and its campus with the offiices of Dr. Gruber, the cardio-thoracic surgeon.

Kate’s seeing him for a consult on the lung biopsy and assessing the new nodule found on her lungs. The lung biopsy involves taking many small samples of cells from her lung tissue. Diagnosing what kind of interstitial lung disease she has depends on the relative amount of scarring (not treatable) and inflammation (treatable). It also allows pathology to look at the specific types of cells.

Once diagnosed she can get treatment and a prognosis. The problems? Well, taking the samples collapses the lung. This means a chest tube to reinflate it. The chest tube is painful even after the anesthetic wears off. There is also the risk of pneumonia and/or ending up on a ventilator.

Here are some positives. Kate’s in much better physical shape overall than back in May when Ed Smith put the feeding tube in. She’s had a prednisone burst which improved her breathing and made her feel better.

Then there’s that new nodule. Will require a biopsy, too. How to do it? That and whether she’s fit for a lung biopsy is the purpose of this consultation.

Just to add a bit of interest the temps dropped wildly from yesterday. And there’s snow! 15 degrees right now.

Days of Awe

Fall and the Yom Kippur Moon

This is a day of fasting, prayer, and repentance for Jews in all places. Yom Kippur. The holiest day of the year, one when the soul is bare before the Self and all creation. Asking and seeking forgiveness. Putting in the past wherever you fell short. Cleansing for the year ahead. The Day of Atonement.

Kate and I will probably go to services this morning though we missed Kol Nidre last night. She wasn’t feeling good.

It’s been a tough week or so. Again. Her feeding tube has been giving her fits. Leaking. Since it’s now her primary source of nutrition, any hassle with it is significant. And, her shortness of breath seems to be worsening.

We see a cardiac-thoracic surgeon tomorrow morning to plan both her lung biopsy (which she dreads, understandably) and how to assess the new nodule that was found during her last c.t. Not a pleasant prospect, either one.

I’m dog paddling these days, trying to keep my head dry. I work out, cook, shop, do the laundry, dabble with gouache. This doesn’t sound like much, I know, but in the times between these activities I have no motivation. Frustrates me a bit since I have other things I want to get to: fire mitigation, revising Superior Wolf, starting a new novel, getting back to sumi-e, going to classes at Beth Evergreen. Some day soon.

Live Now

Fall and the Rosh Hashanah Moon

Outside Punta Arenas, Chile, 2011

Nights are chillier. The aspens are golden and the winds have howled for the last few days. Fall has arrived, changing the days, too, shortening them, cooling them down. Kate and I approve.

Yesterday was a quiet day. Kate made doctor’s appointments. I worked out. We napped. Had a family business meeting. Treating these illnesses, though mostly covered by insurance, still racks up some impressive bills. Not out of our ability to pay, but requiring in two instances, two or three months rather than one check. Families with less resources might be sunk.

Aeon, a website with excellent essays on a variety of subjects, had a piece on living with chronic illness: It Take Psychological Flexibility to Thrive With Chronic Illness. This very question has been on my mind quite a bit, how to thrive with Kate’s illnesses and, since March, a couple of my own.

As this article says, it’s easy to get stuck in the round of appointments, procedures, tests, results, daily surveillance. The illness, in addition to its physical effects, occupies psychological space, too.

Some days there is no help for it. Take this week. Monday we saw Tabitha, Dr. Gidday’s P.A. It took a while to get into see her. She ordered a chest x-ray. We went to the imaging center and had to wait for the x-ray to be read and for Tabitha to decide next steps. The next step was a c.t. scan. Requires a referral. We went to lunch, then went back to Tabitha’s office. She got a c.t. ordered, but it was at four p.m. It was one-thirty.

We went home, a 30 mile drive, so we could feed the dogs and nap. At three pm we got back in the car and drove to Littleton again, to a different imaging site. When we got there, the order hadn’t been faxed over so we waited an hour before the scan could be done. We waited some more while they read it. After it was read, the radiologist couldn’t get either Dr. Gidday or Tabitha on the phone because it was well past five.

Back home. It was that same night that Kate’s feeding tube came out. On that day the illnesses dominated.

The next day was the E.R. at Swedish. Another five hours there, then driving back home in rush hour.

During all of this Kate’s shortness of breath made walking any distance difficult, accelerating the fatigue and reinforcing it. Anyhow you get the point. Managing all these events, getting to them, absorbing their information took lots of time, energy. Hard to get that book written or those quilts made.

Part of it, of course, and this is the chronic piece, lies in the now one year plus of these kind of days. A lot of accumulated stress. Fatigue.

These lines from the Aeon article resonated: “Generally, living as rich and meaningful a life as possible when you are struggling with a chronic illness requires a great deal of psychological flexibility. With chronic illness, rigidity in your thinking and behaviour is the greatest barrier to living well with your illness. The only thing you can count on is the fact that you never really know what your day is going to look like, and that things are always changing.”

We’ve been focusing on each day as they come. One day at a time. We’ve worked hard to stay in our relationship, not snipe at each other when things aren’t going well. We’re successful in this, mostly.

This article showed up when I was wondering, how can we live a good life given the realities we face. My catch phrase: live until you die. Paint. Cook. Write. See the grandkids. Stay involved in Joe and SeoAh and Jon’s lives. As we can go to Beth Evergreen, plays, music. Sew. Take care of our own needs: shopping, cooking, bill paying, the house.

An ongoing conversation for us, now informed by this wise essay and our own years of spiritual and psychological preparation. Will keep you up to date.

Yet More

Fall and the Rosh Hashanah Moon

Piling on. Saw Dr. Gidday yesterday. Follow up on the c.t. scan from Monday. A new nodule on Kate’s lung. Will have to be assessed for malignancy. Dr. Gidday also prescribed a burst of steroids to possibly help with her shortness of breath. Since we have no diagnosis for her interstitial lung disease this is what physicians call an empirical treatment. Basically, making an educated guess.

Kate reluctantly agreed to a lung biopsy, a procedure that will be both painful and dangerous, but is the only way to definitively diagnosis which of two basic types of interstitial lung disease she has. The treatments for the two types are very different, and a pathology defined diagnosis is the only way to know the difference.

We got the name of a cardiac-thoracic surgeon whom Dr. Gidday trusts. The biopsy will happen sometime in the near future. Kate’s new pulmonologist, whom she likes, is unavailable, off for two weeks. He’s at National Jewish, the U.S. hospital for respiratory disease.

A lot. More than we need right now, but this stuff doesn’t honor fatigue or worry. It just keeps coming. Kate’s done well, keeping her spirits up mostly, but a steady stream of new matters to consider makes that difficult.

I’m doing well. Did a six-minute walking distance test (self-administered) yesterday. Walked as far a healthy person my age, something like 1580 feet. Means my exercise capacity is still in the normal range. That’s a good sign for life-expectancy with COPD. I’ll take any good signs I can get right now.

Another E.R. Visit

Fall and the Rosh Hashanah Moon

One more trip to the E.R. Well, after a no-good, pretty bad Monday, described below, we got home around 6 pm. Both tired. Both hoping things would just magically get better.

They didn’t. When Kate went to bed, the feeding tube that is her main source of nourishment popped out. The nurse at the E.R. said, “It happens.” Kate, being Kate, inserted a #16 Foley into the ostomy, the hole in her gut, and inflated its small balloon with ten ml of water. The Foley plugged the hole, but didn’t serve well for her nighttime feeding.

Kate said this day sucked. Yes, indeed it did.

She had to have a new feeding tube, right away, because that’s how she gets the bulk of her nutrition and calories. Our primary care folks said, “Call the surgeon.” She did. Ed Smith, a solo practitioner, no spring chicken himself, was out getting a total knee replacement.

The E.R. was the next best place. So down the hill we went. New feeding tube number 1, but following up with them on the shortness of breath, number 2.

Dr. Stader, a helluva nice guy, took over. What is that? A 16? Yes. Kate had handed him the defenestrated feeding tube. The feeding tube and the Foley both have a small balloon attached to the end of the tube. It’s inflated by using a syringe to push water into it. See pic. The yellow capped port is where the water goes in.

Getting the new tube in was easy. They had to inflate it a bit more after the first try, but it worked fine last night. Yes, in a first, our fourth trip to the E.R. did not result in a hospitalization.

Kate also gave Don, Dr. Stader, a cd of her c.t. from Monday late afternoon. It had not been read. Don and the E.R. radiologist reviewed it and found no sign of a pneumothorax. Kate had feared that her shortness of breath was a second one, the first one happened back in May or June.

They did find abnormalities, interstitial lung disease, but no obvious reason for a sudden increase in, as they say in the E.R. notes, SOB. We checked out, went to the car, and drove back up the hill. She’ll followup with both her pulmonologist and Dr. Gidday.

This is getting old we both remarked while she was on the hospital bed in Swedish E.R. room #20. But, so are we.