Monday, August 29, 2016

Preparing

This is a follow up to my previous post on "Processing Dying".

As I type this, Dad is still among the living.  Not in good shape by any means.  And to remain private, I will not get into any particulars.



We did get news today that I already knew to be true.  But finally hearing it from his primary doctor handling his case was very hard to hear and deal with.  It also puts an even bigger strain on my already strained family.  I just keep reminding myself of the term: "Death  is easy.  Dying is the hard part."  This is so fucking true.

Why, as a society, do we not talk about death?  Yes, we see it all the time in the news, on our Facebook feeds, in movies, books and video games.  But do we actually "see" it?  Do we experience it and share those experiences with others?  Why is this such a taboo subject?  Following my posts on this blog that I place on Facebook, I have gotten so many responses from friends who could relate in some way.  Of those friends, how many of you have shared your stories with many others?  We need to talk about death and dying more.  It happens to everyone.  This should not come as a shock.  Granted, it happens much sooner or suddenly than planned for some than for others.

I tell myself that I understand dying is a part of the circle of life (enter Lion King theme music here) and that when it comes, it will come.  But as I go through this process, I also realise that on some level, I am afraid of death.  I know part of it is the unknown: will it hurt?  will I suffer?  What comes next, if anything?  But I think these are questions many humans have when it comes to thinking of death.  So why is it so scary?  More questions that come to mind, now that I am witnessing this process first hand is: When the time comes, will I be able to make the decision?  Will I have all my "ducks in a row"?  Will I have accomplished the things I wanted to accomplish in life?  Will I leave things undone/unseen/unexperienced?



I try to live my life as if it were my last.  That is why I go out and adventure as often as I do.  No time like the present.  I want to make sure that if I lay somewhere dying, I have accomplished things I am proud of.  That I have done things in my life that make me smile and know I have lead a fulfilling life.  That I may not have accomplished all my goals, but at least I died trying to have fun and enjoy the life I have.

Now Friends, this next part some may not be able to handle yet.  It may seem invasive.  But please, I write this with all honesty and experience learned from my family's current situation.  I write this to help you process dying (of whomever) in a much easier way.

1. If you do not have a living will/advance directive yet, go make one.  Right.  Now.  No, do not wait till later.  Do not even finish reading my blog post.  Go do it now.  This is VERY important.  Not only for yourself, but for those that love you.  Let me tell you, it puts ENORMOUS strain on a family when there is no will in place and those decisions need to be made and the family does not agree on all variety of plans of action.  Save your loved ones this strain.  Write out your medical and post-life wishes.  Make it clear.  Make copies of your living will.  Let your loved ones know where they can find copies.

Here are some links to living wills from a brief google search:

Caring Info: look up your state's form
Do your own Will.com
Estate Law: will template
Mayo Clinic: explains will vs advance directive
American Bar Assoc: explains care directive options

2. Keep all of your life info in one place.  Things such as: passport, social security card, birth/marriage certificates, mortgage/loan paperwork, lien paperwork, car/home titles, 4th grade report cards, etc.  Let someone you trust, may it be family, friend, lawyer, whoever, know where that stuff is stored (safety deposit box, lock box, etc.).

3.  Be aware at some point, shit may hit the fan.  And part of that shit is you being unable to make decisions for yourself.  This may include choosing to live or die.  Be aware that this decision, when passed on to others, is extremely difficult for them to handle.  So make sure to tell those that you love, that you love them often...in whatever form that is (word, gift, written, etc.).  I realise everyone shows their love differently.  Do not judge others for their differences from you.

4. Wherever you have things stored: retirement, banks, places you pay dues to- clarify with those companies what their polices are if anything happens to you.  Does someone need a Power of Attorney?  Does someone need your Death Certificate?  Can names be added without your consent?  How can permissions be added?  How are decisions made without you present?

5.  Technology.  It is everywhere.  Write down locations (websites) where you have an account (of any type).  Record your user name and password for all those accounts.  Add that list to your "in a safe place" list from Point #2.  Useful links:

PC Mag: Getting organised passing on PW
Computer Hope

6. Post death preparations.  Record them.  What do you want done with your body?  Are you a donor?  What kind of funeral do you want?  Who is paying for it?  Do these arrangements.  Buy your plot of land and headstone.  Write down what you want said on your piece of rock to mark your gravesite.  What kind of food to you want served?  Flowers?  What do you want done with your shit after you die?  Write the damn will already.

I have also had some ideas come to me while processing this.

Idea #1: this hospital, of which I have spent much time in, has very few, if any pro-active lifestyle things in it.  There are no stairways accessible to walk.  Must use elevators.  There are no places to walk without getting hopelessly lost, or in a narrow corridor conducive to maintaining a speed walk pace.  Outside is fairly miserable with the humidity index almost the same as the air temp outside.  Or monstrous storms raging outside.



There are a lot of organisations for the dying.  And for the family, in terms of palliative care.  Religious stuff.  Basically stuff for the emotions and mind.  But what about the body?  I feel that family members of terminal patients are under tremendous stress.  Yet are there any programs out there to help them take their mind off the situation by getting them to be physically active?  Active in whatever way they are comfortable with: walking, jogging, swimming, crossfit, weight lifting rucking, kayaking, etc.  I think it would be great to have a core group of local people that come to take the family, especially family from out of town, out to do an hour or so of physical activity.  Talk if you want.  Or just listen to the music on your headphones and be quiet.  Does not matter.  What I do know is that I went for a 6mi run yesterday.  I looped from the hospital to one bridge, crossed the river, across the river/hospital and down to another bridge to come back to where I started.  And it was wonderful.  It let me reset.  It gave me my Zen time that was so badly needed.



Idea #2: Proud GORUCK Parent.  We need these in sticker or patch form.  I would love to present one to Dad.  He is so proud of my GORUCK achievements.  He tells anyone that will listen about me doing them.  I think it would be a nice gift to parents that are proud of their offspring's physical endurance achievements.

Edit: I forgot to add a note to people who work with the medical field:

If you work with or around terminal patients, please look fully at their chart before talking to them.  Please see if their chart indicates length of time assumed that they will be alive.  Please look and see if the chances of them going home are zero.  Please look to see if their condition WILL NOT get better.  Please do not set unrealistic goals for that patient.  And please, for all that is holy to you, DO NOT GIVE THEM A FALSE SENSE OF HOPE!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
Because do you know what happens when you do those things?  Even if in an effort to be nice and you think you are helping, you may not be.  You may, in fact, be doing horrible damage.  And then it is left to the family to try to undo the damage done.  And you know what, if you are dealing with someone who has dementia, the damage is done.  It cannot be undone.  That false sense of hope that was given, is that much more a burden the family must bear.  And they are already handling a mighty heavy burden.

So please, do not say things before looking at the chart and consulting the family to see what their wishes are.  It hurts so terribly much to have come to a decision among the family.  A very hard decision.  To have come to terms with the decision.  And then come back the next day to have the decision changed.  To have that peace ripped from you.  To slowly watch the person you live get worse and worse with no chance of getting better.  Yet that person holds on to some false hope someone told them, thinking there is a chance to get better and go home.

Shame on you, to whomever did this.  Shame. On. You.

Wednesday, August 17, 2016

Processing Dying

This is an update/continuation on my post titled "Parenting the Parent".

We finally got a diagnosis.  After all the medical contacts we made.  After all the doctor's office visits done.  After all the trips to the Emergency room.  We finally (mostly) know what is wrong.

My rental for the week: Ram 2500 Duramax Tough Diesel.  Much needed for all the hauling.

But first, let us talk about those initial medical profession visits and contacts that we made in the months prior to the diagnosis made (last week).

I understand there are patients out there that go see the doctor and really do not want to be there.  They become sullen.  Close off.  Do not share information unless prompted continually to do so.  Fine.  Yes, those patients are a pain in the ass.  They may be rude and disrespectful.  Believe me, I totally understand handling those sort of people and how difficult they can be.  But via the Hippocratic Oath, it is the medical professional's job to work through those behaviors and figure out the root cause of the medical issue(s).  And my family feels that we have been failed by this process.  Clearly my father has been having a lot of issues, especially in 2016.  And through all those visits to offices and Emergency Rooms, you would think someone would have stepped forward and said, "Stop.  Something is not right here.  All these visits do not seem to be fixing the problem.  Maybe we are only treating a symptom and not the underlying issue."  But, no.  No one stepped forward and suggested this.

Instead, for months now, my father has been telling the truth.  He has been suffering greatly.  And no one would listen to him and truly try to figure out the why.  Even social services came in.  Interviewed him.  Spoke to those medical professionals.  And their response: it is up to Dad's doctor to place him on a hold and get him help.  Wait, what?  I spoke to his doctor and they told me they also submitted a report to social services asking for their help.  WTF.  So, who helps my dad?  Who will step in, when family is pleading for help stating nothing is working and he is getting worse, and provide that desperately needed help?

Do you know how terrible we, as a family, now feel knowing the diagnosis and knowing he was trying to get help by calling 911 and his family?  That he has been suffering greatly all this time?  In pain and we ultimately told him to suck it up since the doctors stated nothing was wrong.  That he was right all along.  That all this suffering could have been prevented had someone truly cared to look at the situation and try to figure it out.  Let me tell you, I would never have thought to research and come to the conclusion of what his diagnosis is.  And I really feel, as non-medical professionals, it is not our job to come to the diagnosis conclusion.

I know it is not our fault.  But we, especially my mother, feel a great sense of guilt.  And anger.  My father suffered, dammit!!  And his time left in this world is greatly limited.  If only we could have made his last few months/years in this life more comfortable than they have.  If only.  I know.  No sense dwelling on that.

Returning from a backpacking trip to a plethora of text messages expousing the immediacy of the problem,  Key words like "unresponsive", "gravely ill", "breathing tubes" all make for a road trip home immensely stressful.  Plane tickets were immediately purchased.  Key in, my shut down phase.  Where I basically stop communicating with others, especially those closest to me as I attempt to suffer in my pain by myself and assess all that I am feeling.  I build those walls around my emotional self super high and reinforce them.  And for those that I push away, I am sorry.  I really do not want to be closed off and aloof.



I have learned a great deal this past week about end of life care and insurance.  I now know the difference between palliative care versus hospice care versus acute care.  Palliative is when the patient has an end in sight, sooner than later.  And that treatment is not much of an option.  Comfort and care are what is provided.  Palliative is discussing end of life options: to rely on machines to provide life supporting measures versus opting to not use them and thus ending life.  Hospice is provided for people whose end is near.  And by near, I mean in three to four months.  Acute care is for people whose end is also in sight, but in a longer period of time, i.e. longer than 3 or 4 months.  Both services provide comfort for the patient, not life-prolonging/saving treatments.  That is what rehab programs are for.  And, my dad is no longer eligible for rehab care.  His end is in sight.

I worry.  The nearest Acute Care facility is at least 60-70miles from my parent's house.  Which means that my mom could not visit him daily.  Which means that he would be alone often.  And someone being alone, facing death who is already depressed and scared, is not a healthy recipe for peace and comfort.  I feel bad.  I want to provide help and be there for him.  But my life is more than 1,500mi away from there.  I immediately flew home after hearing the news that he was in critical condition and the end very well may occur.  My sister and brother in law came home, too.  We stayed and watched over Dad.  We cried.  And sniffled.  And imagined a life with him no longer in it.  Something none of us had ever truly contemplated.

View of Mississippi River from his hospital room

We helped clean up my parent's home.  Transported things that needed transporting and/or removal.  Helped care for the dog.  Gave my mother a chance to vent and/or "relax" (as much as a spouse can do that when the person you have been married to 45+ years is facing death and the medical bills keep piling up).  I learned a lot about medicare and medicaid.  And am glad that there is coverage available for his care.

Transported ~700lbs of books from the home.  At least another ton left to go.

It is hard to see your parent in a hospital.  Hooked up to respiration machines (intubated), knowing if they are removed, that is the end.  I support my father and whatever decision he comes to.  I feel terrible knowing his frustration at not being able to verbally communicate.  Attempting to use hand signals, nods of the head and writing things down...and then attempting to decipher the scrawl.  I am afraid I will never hear his voice again since his life is now dependent upon those machines to breathe for him.  I feel bad that I never once saved any of his multitude of voicemails he has left me over the years.

I am thankful to be dating someone familiar with death and the process of dying.  Someone who can listen to me explain what I am going through and feeling.  And offer up their experiences and thoughts on the matter.  I think that alone has helped me immensely.  For the majority of my life I have viewed death as a process.  We all will reach it some day.  Some sooner than others.  It should not be a thing feared.  It is another step in the circle of life (yes, thank you Lion King, for spreading that mindset).  But this is the first time in my life I have been faced with the impending death of a person that I care greatly about.  A person that has always been in my life.  It is strange to think of life without that person.  I know my life will continue on.  But I think what stresses me out the most is thinking that he is scared and frustrated and no happy.  Beyond all else, I want him to be at peace.  I want to provide him with happiness.  And I am afraid I am failing at that.

I am now back in Idaho after being by his side for the past week.  Shuttling between the CCU at the hospital and home.  Trying to be strong and not cry, but at times, failing miserably at it.  Tracking down doctors to explain to both him and us what is going on.  Joking with the nursing staff.  Telling Dad how much I love him and explaining day to day activities to keep him occupied.  Watching him express his frustration at being tied down to prevent his tubes from being pulled out.  Seeing him unable to talk and attempting to communicate however he can.  Watching his face when the doctor explained the diagnosis and eventual outcome and life expectancy.  Holding his hand.  Cherishing the time I have left with him.

Returning to work today was hard at first.  I communicated my desire to supervisors prior to returning that I did not want to be asked about my father and wished for my coworkers to not address it.  Which no one did today.  I had multiple people walk about and pat me on the back.  No words exchanged.  I nearly cried every time.  I have gotten much better as time has gone on.  I can talk about Dad to my close friends and not break down.  It is what it is.  Or as my UMC put it: "Death is easy.  It is the dying that is hard."  And truer words could not have been spoken.  So very true.

So I will continue to try to find volunteers to go spend time with my dad and get therapy dogs in to give him comfort.  I may not be there to provide my own.  But knowing that he is getting care and is happy is what I shall continue to pursue until the end...whenever that will be.

Thursday, August 4, 2016

Animal Lovers: Friend or Foe?

When most people call themselves an "animal lover", usually this sparks some sort of reaction of the party being told this.  Most people probably relate on some level and a conversation about current and/or past pets ensues.  Laughing and merriment occur.  Key terms such as "rescue", "spay/neuter", "beaten", "abused", "rescue", "lovable", "shelter"....and oh, did I mention "rescue" yet?  Are often included in aforesaid "animal lover" conversation.

For me?  The term "animal lover" has a completely different connotation.  I cringe when people say it.  Especially when asking me if I am one.  When I hear someone call themselves an "animal lover", I am instantly on edge.  I am distrustful of that person and extremely weary of them.  That phase is a warning to me that I am now dealing with a different sort of person.  Through a variety of questions and probing, I must figure out if that person is a common sensical, i.e. sane, animal kingdom appreciator, or is that person a fundamentalist animal lover.  Yes, that is right.  You read that correctly.  I wrote: Fundamentalist Animal Lover.  And in my world, I interact with these people on a regular basis.  They do exist.  And in fact, a few people reading this right now, very well may fit in that category...and probably do not even know it.


I find this article/video by Amy Schumer quite accurate in its basic concepts of many "rescue" pet owners today: http://www.slate.com/blogs/browbeat/2015/05/21/amy_schumer_doggy_daycare_sketch_spoofs_self_righteous_rescue_dogs_owners.html


We tend to live in a world where everyone is a unique snowflake.  An individual.  Independent of the collective as a whole.  And part of that is having something to boast about.  A source of pride to share with others.  For many people, this can take the form of being the white knight and "rescuing" a shelter dog.  And I applaud those of you who have taken the time and effort to go to an animal shelter and adopted a dog (or cat or whatever) from there.  There needs to be more people like you out there to do that sort of thing.  And, of course, if we could teach people to spay and neuter their pets, we would not have so many shelters full of temporarily unhoused animals.  But that is a conversation for another day.


How many of you out there that have adopted a dog (for the sake of this blog post, let's refer to dogs as the primary animal type we are talking about) from a shelter know the dog's exact history before you got it?  And when I say exact, I mean, how old was it when it was given up to the shelter?  How did the shelter acquire it?  Did it live with adults?  Kids?  Other animals? Etc.  If you cannot honestly answer almost all of these questions, how do you know it was abused?  How was it rescued?  When you say rescue, do you mean you rescued it from the shelter where it was housed or from the previous life it lived?  If you are referring to the shelter, why did the dog need rescuing?  My understanding of shelters, is that they are there to adopt dogs out, right?  Meaning they want their product (the dogs), to look and behave the best they can so that they are marketable, i.e. adoptable.  Meaning that the animal is being cared for: fed, housed, watered, exercised, socialised, etc.  So please explain to me why the dog needed to be rescued from this sort of facility?


Now, if you are referring to the dog's previous life it lived prior to the shelter, I think the shelter (or animal control or Joe Public) would be the ones that "rescued" the dog when they brought it to the shelter.  I am not sure adopting the dog from a facility that provides from the dog is really called "rescuing" the dog.  But you know what, it is merely semantics.  Go ahead and use whatever term you like.  Just do not consider yourself better than others and be a pompous self-righteous prick about it when you say you "rescued" your pet(s) of those are the circumstances of which you procured your pets.


With that being said, there actually are circumstances in which the animal is genuinely rescued from the circumstances in which it was living.  Animals being starved/neglected in atrocious manners.  Many times it is Animal Control (local law enforcement) or an animal rescue group that intervenes in these situations.  In other cases, it is Joe Public that gets involved and removes the dog from its current situation.  Those people/groups are rescuers.  These people/groups most likely know the history of the animal, or at least have a better grasp of its living conditions and history and can advise whether the animal was "cruelly" treated or not.  And let me clarify what I mean by "cruel", I do not mean a dog that lives outside.  A dog that does not cuddle up with its humans at night.  A dog that is not fed canned food or human food on a regular basis.  A dog that gets to go for walks and/or play at the dog park.  All of those actions are certainly beneficial to the dog, but the dog's quality of life will not be lacking in any significant way to cause it death without those things.  When I say "cruelly" treated, I mean the dog's basic needs are not being met: not enough or no adequate housing, not enough or no nutritional intake, not enough or no access to water, no ability to exercise, no ability to protect and/or defend itself and no access to medical treatment (if needed).  Those things (or lack thereof) are considered cruel.


And now, back to the Fundamentalist Animal Lover.  They exist.  They are everywhere.  And it is VERY hard to talk common sense to these people.  I feel that this article sums it up nicely: http://www.npr.org/sections/visibleman/2007/10/whyi_i_hate_animal_lovers.html


And let me quote my favourite line from it here.  And please, when you read it, consider the words.  Think about them.  Do they apply to you?  Then consider taking a step back and brainstorming how and why they apply to you and at what point is your breaking point to reach back to the land of common sense.


"I'm put out by the animal-loving crowd that loves animals so much some of them have made death threats against the woman who runs the shelter that gave Iggy a second shot at life in the first place. Death threats for having the audacity to follow her shelter's guidelines. I guess there's some sort of twisted logic in threatening violence against a human over a dog.

If you value animals over humans.
I like animals, as said. However, I don't value them over beings who walk upright, have opposable thumbs and can one-click their music over iTunes."
This quote is perfect.  I could not agree more.  Why?  Do you consider me now to be heartless and cruel?  That I wish death upon animals?  Of course not.  I wish for every living thing to have its chance at life and the pursuit of whatever makes it happy (in a healthy, not-injuring-others kind of way).  But I have met far too many people that fit into that quote's description.  I have seen the terrible things these people are capable of...all in the name of being an "animal lover".

Do not get me wrong.  Dogs/pets are fucking amazing things.  They make life better.  They make the world a more enjoyable place to live in.  Me?  I cannot imagine not living with pets.  I do enjoy dogs.  And by dog, I mean something 30lbs+ that I can at least not worry about crushing if I accidentally step on it.  This article from USNews sums it up quite nicely:

"Studies have shown, for instance, that simply petting “a familiar and friendly” dog can lower your heart rate, make your breathing more regular and relax your muscles, ​Coren says. In one unpublished study, people had significantly lower blood pressure just two months after adopting dogs when compared to pet-parents-to-be who were still waiting for their puppies, reports the American Heart Association. The organization concludes that owning a dog "may have some causal role" in reducing heart disease risk. "

Two other amazing stories of dogs and people:
Gobi: the endurance runner: 

I can tell you with certainty, that the majority of the people I have cited for animal cruelty have described themselves as "animal lovers".  "Oh I would NEVER do that to my pet" or "I loooooove my pet.  It is a part of my family."  Or my favourite, when you advise an owner of his or her pet's bad deeds while the owner was not around and did not witness the event(s): "My pet would NEVER do that. You are clearly wrong".  Yeeeeah.  Or this one, "You're just picking on me." Oh that's it exactly.  I definitely look forward to being verbally abused, being confronted to in an (assumed) intimidating manner, threatened to be injured by the animal(s) and attempting to calm down all parties involved.  Yes, that is definitely me picking on you.  *facepalm*

Someone please tell me this, because I cannot wrap my head around it: why are there usually more people standing outside a courtroom, or joining a facebook page or writing to the newspaper or contacting the local news regarding the stories of animals, may it be a cruelty story or sob story, than those cases involving the same issues, but replacing pet/animal with child?  And do not tell me this does not happen.  I have seen it first hand.  Many times.  Why do people feel compelled to "fight" for the rights of animals more than they do for children? (Study by Psychology Today on the matter)  You do realise that those children, if no intervention is involved, may grow up to be the very people you fight against who abuse animals?  So why not fight for children, too?  Why not care enough about them and their shitty life and situation to get involved and show them what healthy caring relationships are rather than let them wither in the system?

Here, read this.  It may help enlighten all you Fundamentalist Animal Lovers:
I have seen, read and been exposed to more threats of harm (bodily or otherwise) to my person or those I know or organisations I know from self proclaimed "animal lovers" than any other group out there.  To threaten to kill someone for signing over their pet to the shelter?  Seriously?  Or threatening to murder an animal cruelty suspect's family?  WTF is wrong with you people?  Actions like those make "animal lovers" no better than the criminals I deal with daily.  You know what you need?  A good dose of common sense?  You want to see atrocious things committed by humanity, join your local law enforcement?  Go join the military and make sure to get in field combat experience.  Then tell me how precious some things are over others.  Get a reality check.  Animal Rights is a thing for those who are priviliged.  Yes.  By far and large, most of the "animal lovers" who are active and fundamentalist tend to be women, white and middle to upper class.  People who have not truly seen the atrocities of the world around them.  And no, I am not talking about Fido starving.  I am talking about that five and ten year old down the street from you witnessing Mom's current Beau beating and raping her in front of them.  Then starving since Mom has to get her next fix and all the money for food was spent to get it.  The kids that are covered in ring worm.  The house that is covered in fecal matter, moldy food, trash and flies.  The kids that sleep in that filth and know no other life.  

So the next time you threaten your local animal shelter for not living up to your "no-kill" standards, take a step back.  Reality check yourself.  Go do in kind donations to your animal shelter and human shelter.  Help bring up the next generation to respect and "love" animals how you do.  Give them a chance, too.  Kids did not ask for the life they are being raised in.

And by the way, there is no such thing as "no-kill".  So if you refuse to bring a dog to a shelter that is not advertised as no kill because it incenses you- do us all a favour, get some common sense.  No-kill is legal hoarding.  The shelters I have been to that advertise as no-kill, were nothing more than legal hoarding.  The smell was atrocious.  They are horribly over capacity, thus causing rampant spread of disease and therefore the quality of life of the animals there was beyond sub-par.  I am not saying all no-kill shelters are like this.  But by and far, many are.  And do you realise that when they do reach their capacity (whatever it may be), they begin to turn animals away.  Yes, that is right.  If they cannot euthanise animals (for medical, safety and behavioral issues), then they fill up.  And when that happens, all those cute fluffy wuffy animals running around loose in and out of traffic, laying by the side of the road injured- yep, you guessed it.  They are turned away.  Thus massively increasing their risk of injury or death.  So, which is better?  A no-kill shelter that leads to suffering on a massive scale or a shelter that euthanises for medical, public safety and behavioral issues?

You do not believe me.  Even PETA agrees with what I have said.  Read/watch it here: http://www.peta.org/features/deadly-consequences-no-kill-policies/

Also, keep in mind, the no-kill shelter title can also be a misnomer.  Go educate yourself before you profess more bodily harm profanity to your local animal shelter that is not titled "no-kill".

Note to self, add these books to my reading list (as related to my ranting topic above):

**Go read the synopsis for both of these books.  I bet you'll learn a thing or two.  Or at least have your interest piqued.**
/end rant