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Imbolc                                                                    Valentine Moon

20190218_073058Oh, my. Physical yesterday and a visit for Kate to see Lisa, too. We often go for each others appointments, especially with Lisa, our internist. I got a clean bill of health though I have to have labs drawn today. My follow-up chest x-ray was clear. Clear. No pneumonia, no disease process. Just clear. Wasn’t expecting that after the first one, but hey…

Kate’s situation continues to be problematic. From her most recent hospital visit Kate got a referral to a pulmonologist. While treating her for the pneumothorax, collapsed lung, the pulmonologist at Swedish saw signs of what might be interstitial lung disease. Could be another complication of Sjogren’s.

When Desiree wheeled the ekg machine out of the room, my heart’s fine, too, Lisa turned to us. “You’ve got to think about moving.” Oh. My. “I don’t want to. I like where we are. And the last move was awful.” “Health is number one, right?” Right.

As I wrote a few posts back, the thought has occurred to both of us. Kate’s suffering more from the altitude than I am. However. My O2 saturation hovers around 90 here, just barely enough to consider healthy. There’s a case to be made for my being helped by a move to lower ground, too.

January, 2015
January, 2015

Move. The word makes me clench. Spent a lot of last night in bed trying to figure out how to cope with this. Severe cognitive dissonance between my love for our home, for Shadow Mountain, for the Rockies, and my love for Kate and for my own health. In the end, no contest. We gotta move. Hate to say it. Feels like a failure of sorts, though I don’t know why.

Just how low do we need to go? Don’t know. That will be important. Several factors will converge to create a sweet spot for a new place: altitude (low enough for easier breathing for both of us), enough room for the dogs, quiet, and no more than approximately 30 minutes from Evergreen. I’d also like to see a single level and forced air heat. Not to mention that a new place has to fit our budget. Oh, joy, another mortgage process.

When? Not sure. Maybe in the next three months.

I will not pack anything this time around. I’m packed out from the last move. I’ll have to dramatically reduce my library, I’m sure. Maybe it’s time. A lot to consider, a lot to do. Just when we’re both at our tip top physical best, too. But Lisa’s right. Health is number one.

Hail a New Creation

Imbolc                                                                         Valentine Moon

My life flows on in endless song;
above earth’s lamentation,
I catch the sweet, though far-off hymn
that hails a new creation.      “How can I keep from singing?”  Robert Lowry

When I opened this page, Robert Lowry’s hymn came to the surface. I could sing this verse with no pauses for personal editing. The rest of them? Not so much. But, no matter. This one has a powerful, here and now message and it came to me from my unconscious.

third phaseThe woes of the body, our lamentations here on Shadow Mountain, are of the tactile world, the one bound up in life and death; but, they are not of the soul, the spirit, the ohr, the imago dei. No. In my soul (a word I’ve come to use more freely of late, meaning that part of me that bows to the god in you, namaste.) I can hear the sweet, though often very far-off hymn. It hails a new creation coming into existence even now, one shaped by the lamentations, but not determined by them.

That new creation is a new sort of intimacy for Kate and me, one forged not in the upbeat, I did it, achievements of the family and career second phase, but in the existential reality of the third phase. In the third phase the body begins to let go of life, gradually, a bit here, a bit there. At the same time the fruits of a lifetime of meditation, awareness, thought, friendship ripens. The soul begins to unfold, ready.

Rudolf Steiner, the founder of Anthroposophy, said that September 29th, the Saint’s Day of the Archangel Michael, is the springtime of the soul. (odd coincidence. Kate’s bleed was on September 28th) What I’ve always liked about this idea is that it marks soul growth as occurring best in the fallow time. The fallow time, especially after Samain, Summer’s End, on October 31st, is that point when the growing season ends. An analogy to the third phase seems apt to me. The fallow time is a time for going within, going deep, finding nourishment in the eternal parts of ourselves, our soul.

That is what is happening for us. Our souls are flowering in the decay of the body. That flowering of the soul (I see a lotus.) is the new creation, perhaps not as far off as it seems.

Blessed be.

 

Then the heparin lock

Imbolc                                                                         Valentine Moon

tpnTwo saline flushes, then the heparin lock. Clamp the picc line. Half of the thiamine bottle, one each of the white cap and blue cap bottles, all injected into the tpn bag of milky, 950 calorie nutrition. The thiamine is yellow and floods into the bag creating a branched, river like stream. Shake the bag so that the vitamins and other additives mix up. Spike the bag with the plastic spike that connects to the tubing. Clamp the tubing. Connect the cassette that holds the tubing to the pump. It slides in and locks. New battery for the pump. Turn pump on. Wait, go through the pump’s programming. Unclamp the tubing. (lots of alcohol wipes in here. sterile technique required since the picc line ends just above the heart.) The tpn nutrients gradually, a milliliter at a time, snake up to the connector. Saline flush. Wipe. Connect tubing to picc lock. And, voila, breakfast, lunch and dinner.

I do this by myself this morning, with Kate’s assistance of course. The tpn pump, in Kate’s case, runs almost 24 hours, delivering approximately 41 milliliters of nutrition an hour, every hour. The objective here is not so much weight gain as getting her tuned up nutritionally for surgery. The feeding tube placement procedure is not major surgery, but it is surgery and she is frail. Most of the time people learn how to do this for a much longer duration. In our case 10 days. Learning new things everyday.

Still slowly emerging out of the cocoon in which illness places us all. Perhaps I’ll have imaginal cells (a real thing, see butterflies) which will alter my being, transform me into someone new after the last three weeks. I’m ready for some new, even if it’s taking up again the things I was doing before with changed purpose.

It’s 10 degrees here on Shadow Mountain, but, in Colorado fashion, a warmup is on the way. 47 on Tuesday.

And, btw, yes, it has occurred to us that 8,800 feet is not the best position for us with our ailments. Not likely to change soon however with the dogs and my almost pathological aversion to the idea of moving. The move that got us here felt like a last time for that sort of thing. Difficult.

Still Here

Imbolc                                                                             Valentine Moon

A new chapter. Mt. Evans’ Hospice and Home Health Care (personally wish they’d reverse the order of those nouns) has begun to come out. First, nurses to help us understand and adapt to Kate’s picc line and the changing of the tpn pouches every 24 hours. Both Julie and Michele live on Warhawk, very close by. Reassuring. The feeding helps, 950 calories or so over 24 hours, and balanced for her needs as I mentioned before.

Second, Kate had her first p.t. session yesterday and will have o.t. next week. This is important since Kate’s activity level has been minimal for months.

It’s a lot of change in a situation that has already caused lots of change. This is forward progress though. Kate sees Edwin Smith on Tuesday and hopefully the feeding tube placement will get scheduled and done soon after.

We get a grocery delivery today. That will be welcome. Once I feel better we can forego delivery and go to pickup. Still order online. They bring the groceries out to your car and you take them home. Ted plowed our drive this morning. 5 inches or so overnight. Happy about that.

I’m much better, but still mending. Chest x-ray on Thursday. Follow-up. No word on that yet.

 

More Health Stuff.

Imbolc                                                                  Valentine Moon

Gradually getting more stamina. Felt good enough to go in and pick up Kate from Swedish yesterday afternoon.

She’s home now, again. Trying to imagine what this whole ordeal must be like from within her frame of reference. Difficult. So many procedures, hospital and doctor visits. So many different interventions. And the needle sticks. She has rotten veins and it often takes four, five times to put an iv in or draw blood. Sounds medieval.

Home health from Mt. Evans’ Home Health Care comes by today to hook up the tpn. They offered to come last night around 7, but Kate was too weary. A delivery guy from an outfit called Medspeed dropped off two thermo insulated white boxes and an ordinary cardboard one, supplies. We’re entering new territory here with home health care and medical apparatus on site on Shadow Mountain.

Kate has had an important insight. Now that she’s well hydrated through the tpn nutrition her dry mouth is much, much better. We need to figure out how to keep up that level of hydration for her. This is a big deal because the dry mouth makes eating difficult.

We see Edwin Smith on the 28th about placement of the feeding tube. He wanted her on the tpn to get her stronger. Since medicare has severe restrictions on the use of tpn, we were lucky to get the ten days granted to us. Somebody was a good advocate.

I’m feeling incrementally better each day. Able to stay up longer, do more. Still watching it because I want, need, to stay healthy. Follow up chest x-ray today, probably. I have my annual physical on Monday. There will be lots to talk about.

I’m over my foot on our neck whine. Back to head down, move forward, take it as it comes.

Of course this whole process, starting with Kate’s bleed on September 28th until now, has been stressful. As near as I can tell, I’ve not added to the stress by becoming anxious about outcomes. Not sure the toll the stress has taken on me, though I imagine it did lower my immune response to whatever viral truck slammed me down to the pavement.

Grateful for all the care and time and thought given to Kate, and to me. Grateful for the snow and the cold, more like Minnesota this last week or so, and welcome. Grateful for those dogs who wag their tales and put up with our chaotic schedule. Grateful for the Valentine Moon, for 72 years. Grateful for my recovery that’s underway. Grateful we live Rocky Mountains. Yes, adversity unveils gratitude. Strange. True.

 

 

Imbolc                                                                             Valentine Moon

FortThree weeks ago I drove through Denver around 8 pm exhausted and wondering why I was so damned tired. Getting home was hell. Today, thankfully, I’m able to be up  and get things done. Still operating at about half to three-quarters power, stamina not great, but improving. Stronger today is my day phrase.

Kate sounds great. Needing to recover I’m still at home. One thing I learned over the last three weeks is that if I’m not healthy, it makes our life here very difficult. I’m going to get back to normal so I can help her as much as she needs. A difficult balance, especially with her in the hospital.

They may insert the feeding tube while she’s at Swedish, too. This will give her two sources of nutrition, one intravenously and the other by drip directly into the gastrointestinal tract. She will able to eat meals as well. Several advantages here.

First. She’s been stuck at 78-82 pounds for months. Nothing nudges her out of that range. She needed a different approach.

Two. Electrolytes and other necessary nutrients will be carefully balanced in both the tpn and the feeding tube. Her diet up to now has been what she could tolerate with an emphasis on calories and protein, not overall nutrition.

Three. This will reduce, hopefully eliminate, her always nagging feeling that she wasn’t eating enough. This should help her get back to eating normally, without the attendant anxiety of trying to gain weight.

Four. Since she’s wanted this for several months now, these supplemental feeding tools give her a psychic boost, which she needs.

Five. Our big hope with this intervention is that it will lift her into a normal weight range where her diet and her stamina can both improve while the secondary effects of malnutrition drop away.

We’ve seen plenty of false dawns in Kate’s journey to this point. I’m hoping this is the one we’ve been waiting for.

Black Mountain White

Imbolc                                                                         Valentine Moon

I’m just gonna say this. May be a little whiny, but it’s on my mind. Hey, universe! Would you get your foot off our necks? Or, at least let up long enough for us to catch our breath. Geez. OK. There.

Kate’s collapsed lung resolved with concentrated oxygen therapy. Thankfully. The picc line went in yesterday and she’s getting her first infusion of nutrition through it as I write this. She’s very happy that, as she said, “Something’s happening.” She’s dealt with the weight loss, the fatigue, Sjogren’s, food aversion for so long. As one just coming out of a still debilitating illness, I can only imagine what it would be to feel the way I feel now everyday. With no change maker on the horizon. This picc line may be the beginning of a turn around. I sure hope so.

Meanwhile I’m weak, still. Feel like the diseases of the past two weeks plus have left the field of battle, but the wreckage is still under repair. I’m 10 pounds behind now, limited stamina, and less energy. I’ll improve over the next few days, I’m sure. I look forward to getting back to things.

Lot of learnings, most not consolidated yet. They will be over the coming weeks.

Here’s something uplifting, at least I think so. Black Mountain white.

20190218_073058

Health Cares

Imbolc                                                                              Valentine Moon

Feeling much better. All except my bowels which took a beating. I’ve eaten very little over the last two plus weeks, down 10 pounds. Not as hydrated as I normally am. Result: intractable constipation. Since Saturday afternoon, my recovery has been interrupted by this. Beginning to resolve this morning, I think. Sure hope so, misery after misery.

I’ve lost about two weeks. By that I mean, I don’t recall events during the time when illness dominated my body. It’s an odd feeling, but I’m grateful for it. I remember blurs of discomfort, but little else.

Kate went back to Swedish E.R. yesterday. Jon had to take her due to my severe cramping and general dis-ease. They admitted her, though I don’t know exactly what for. She has an appointment with a home health company today to insert the line for her tpn feeding, don’t know what’s going to happen to that.

This was not the most festive birthday week I can recall. Maybe the least? Either way the earth keeps spinning and racing along its orbit.

 

Year 72.1

Imbolc                                                                       Valentine’s Moon

rag cutter with bales of cloth scraps
rag cutter with bales of cloth scraps

Starting my 73rd year feeling better. Better, of course, is relative. In this case relative to a lost two weeks. I mean that almost literally. The last two weeks were a fog. I know things happened. I know I did things. But what were those things? Mushed together in a perceptual porridge put through a blender. Indistinct.

Saw the doc yesterday. Left lobe cleared of pneumonia according to stethoscope. None in the right lobe. But wait! There’s more! Yes, another “incidental” finding. Atelectasis in my lower right lobe. Sounds ominous, right? Could be old, probably is. It means that some of the aveoli have collapsed.

When Tabitha listened to my lungs, she thought she heard pneumonia in my lower right lung. It was the atelectasis. So it’s significant. It can be the precursor to other bad things like lung cancer. Hope not. Still, when you consider my history. Smoker in my 20’s and early 30’s. Working in two different factories where asbestos and fiberglass were used. Cutting rags to make fine rag bond paper. I did this last job for a year or so and worked in a room filled with the dust from, of all things, Munsingware scraps from making underwear.

SEX-DRUGS-ROCK-N-ROLL-1”I’ve known for years that something like this could come up. If I could go back and change the choices I made while my chooser was broken (grief, alcoholism, lack of wisdom, plus general youthful stupidity), I would. But, I can’t. In my own vernacular, those problems are bought and paid for. That is, I did things that may cause serious problems for me physically, now, later in life. Can’t deny it, ignore it, or wish it away. It’s not clear right now of course whether this will be a serious issue or not, may not be clear for some time, though I imagine there will be a follow-up CT to more closely i.d. the causes of the atelectasis.

We all have to die of something. If this is mine, well, so be it. Not gonna dwell on it, but I do acknowledge it. I don’t blame anyone, not even myself. My 20s, as they are for so many of us, were a time of transformation, mutation, evolution. I learned so much, felt so much, did so much. There was another path for me through that thicket, many paths, I’m sure, but the one that transpired is the one I followed. And, it may be beginning to have consequences.

In other news Kate’s stent is open. CT proved that. Hopefully today she’ll get a pic line put in and get started on some nutritional supplements by iv. TPN, total parenteral nutrition. This should help her overall and make any surgical procedure, like the feeding tube placement, more likely to succeed. A home health service will send nurses here to set it up. Eventually, I’ll manage it. A step in a good direction for her.

Sun. Blue skies. Black Mountain standing tall. All things that will be here no matter how any of this turns out. And, again, I find this a source of deep consolation.

 

Valentine’s Day on Shadow Mountain

Imbolc                                                                      Valentine Moon

Well, no matter what else happens I can say I made it to 72. Valentine’s Day on Shadow Mountain. Black Mountain obscured by low lying clouds, but still visible. A thin dusting of snow on the solar panels and the driveway. 32 degrees.

The pneumonia continues. Rattling in the chest, coughing, back to night sweats, shortness of breath, some fever. Not how I imagined my birthday, but there you are. I go to see Tabitha, Dr. Gidday’s p.a. today. Hopefully I’ll learn some more. Kate’s ct is today, too. I scheduled my appointment close to hers so I can take her to the imaging center at Porter Adventist, then scoot over to Dr. Gidday’s office for my 11:30.

I’ve been sick 15 days now. Figured out the last time I was this sick was not Austria, but when we lived on Edgcumbe Drive in St. Paul. Never diagnosed. Kate thought it might have been myocarditis. That was 29 years ago. It’ll be ok with me if it’s another 29 between bouts like this.

I’m up in the loft early. Feels nostalgic after 15 days of mostly miss on the mornings. I’m ready to get back to my old life, resume painting, teaching, writing. Not yet. There’s this big bump in the road.

A while back I read an interesting article about snow. A heavy snow eliminates boundaries, covers fences and streets, rocks, even mountains. The world becomes white, curvilinear, jagged edges smoothed. The affective mood of the landscape undergoes a transformation, becomes more connected.

Illness has a similar totalizing affect. The landscape recedes. Old linkages like grocery stores, schools, churches, synagogues fall away. The house, or even a room, becomes a world. In this world there is struggle, the body trying to hang on to life, an invader not caring about that life, but wanting the resources the life has to offer. It’s a raw, pitched battle, tough to watch, tough to experience. Not all illnesses are this extreme of course but pneumonia at 72 is a life or death matter. Either the pneumonia is defeated or the body dies. High stakes.

Like a heavy snow the world around this struggle transforms, becomes homogeneous. Can it help? It exists. No help? It disappears.

Writing from inside that shrunken world.