NATURE'S TIME

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Patty and I have Health Care Directives. I reread Patty’s directive today - death on my mind, as we start the ninth year of Patty’s diagnosis of Alzheimer's - now advanced!

Both of us choose no extraordinary life sustaining measures. The document refers to breathing and feeding. I believe the idea is not taking extraordinary measures to extent life beyond it’s natural ending.

The state of medical capabilities is unbelievable. I am grateful. It seems medical advances can extend existence forever. I recall Richard going in and out of the hospital every few weeks. The medical world worked to extend his life, finally to the point of Richard making a personal decision to let nature take it’s course - he died in hospice at home.

As Patty approaches a mere 100 pounds I struggle with the idea of the possibility of a feeding tube. I processed my feelings with other care-givers. I emotionally dealt with the idea of starving to death. I believe the directive is a good decision - one of trust in nature. I was reassured that starving to death is not painful and that the medical world is tolerate to removing a feeding tube, even given their oath to sustain life at all costs. God knows if Patty will continue with her poor eating habits. Slowly she continues to lose weight. I was counting calories - I discontinued.

Dealing with an attitude shift of “keeping comfortable from doing what is necessary to “being healthy” hit me hard at Patty’s annual physical last week. Her doctor said to Patty, “you are due for a breast exam.” After saying it, the doctor’s eyes and mine met, without words, agreeing that the exam, given the Alzheimer's, is ludicrous. She (the doctor) quickly moved to suggesting watching the PBS series The Crown, and Victoria. I thanked her indicating that we just finished The Derell’s of Corfu and were looking for the next series to watch.

Yesterday, a call came from the dermatologist - another spot of skin cancer to remove in January - the first removal executed two years ago. Do we continue the visits to the dermatologist? My new mindset says no.

Are steroids an extraordinary measure for Patty? Steroids, magically cured, almost immediately, Patty’s severe immobility from PMR two years ago… and again and again - two subsequent times - carefully adjusting the dose of prednisone recommended by my favorite Rheumatologist. Patty would not have survived without the steroids. Now what, with my new mindset?

My new mindset is to not go off the deep-end when Patty doesn't take her prednisone. I hand her the medication, with a comment on why she needs it, and that’s it, It’s been two days and she sees no reason to take the medication. Maybe it will be different if the immobility returns!

Scars