The Closest Cafe

Well, we’re officially almost two-thirds of the way through 2010, one of the most challenging years of my life.

I’m so happy to share that the past 2 months have been really great – summer has been filled with glorious sunshine, cheerful birthday parties, rewarding work, and personal fitness. I even went so far as labelling August 16th as the “best day of year” after a wonderful time celebrating my daughter’s birthday.

During the previous day, I had the “Glee-ful” experience of choreographing, teaching, and performing a “flash mob” with 11 kids during our daughter’s pancake breakfast birthday party... Talk about total and complete silly fun!!

I felt that all was well, until lunchtime at work the following day. I was hungry, but hadn’t had time to pack a lunch, as the fridge was full of pancakes, pudding and cupcakes! I was craving a turkey sandwich and was running out of time before my next patient was scheduled. So I headed off to the closest lunch spot – the cafe at the BC Cancer Agency.

I briefly hesitated, knowing that this building was the site of several previous visits with my dad, during his illness. But I thought that I’d be fine – I’d been parking in front of that building for weeks and had no emotional reaction .

So, in I walked, feeling hungry and confident that everything was going to be okay. I was wrong.

I ordered a turkey sandwich, then glanced briefly down the corridor. Unfortunately, I let my guard down for a brief moment, and the memory of my last visits there flooded back. I thought about how my dad needed help filling out the computerized well-being questionnaire and how he said he was feeling unbearably nauseous. Mom and I had chatted about the decor and friends she knew who volunteered there. Dad was wearing his Kahki pants - the belt fastened with a buckle featuring an RCAF emblem – the belt which was so important then, as he was losing weight rapidly. I remember his slow shuffling gait, and how he waiting impatiently as I retrieved the car from the staff parking lot - I insisted that he conserve his energy. That was only a relatively short time ago, in February. Now, it was August and he was gone. February was a lifetime ago.

“Turkey Sandwich ready.” The lady behind the counter spoke. Oh no. The simple hunger that I felt a few minutes before was now replaced by the intense visceral burning of sadness – the kind of hopeless grief that can only be relieved by a period of tearful solitude. A period of time which was not booked into my afternoon schedule. So I forced down half of the nauseating sandwich – with only my left brain to encourage me to chew. I took a few deep breaths and concentrated on the walk back to the outpatient building so that I could fully focus on my afternoon patients. I successfully held the tears back until a more convenient time.

Now, I am able to put this episonde into perspective. This was an intense moment of sadness during a great week. In May and June I was experiencing these moments several times every day. For much of 2010, it felt rare to experience true happiness for an extened period of time, but now, I am enjoying hours, even days of joyful energy, as I regain the ability to be fully present with family and friends.

But I will likely be unable to eat a turkey sandwich for a long time. It will get added to the list of everyday objects now associated with sadness and grief – an Olympic hoodie, Mom's silver serving tray, Dad’s belt, the scent of cranberry scented bamboo sticks, and “Mr Bojangles”

Perhaps, next time I'm hungry at work, I'll go to Subway.

One Final Miracle

Early in May, our family learned that a lifelong friend of my Dad’s passed away. His name was Lionel “Mac” McCaffrey and they had been friends since they met while both serving in the military. I recall hearing stories of Mac's infamous St. Patrick's day parties, which my Dad attended annually during the years they lived in the same city. Mac and my dad kept in touch over the years and shared the occassional visit. Mac was in my dad’s thoughts frequently over the past year as Mac often sent interesting emails - links to funny jokes, websites, youtube videos, etc.

When we found out that Mac passed away on May 1, we decided not to tell Dad. He was in the advanced stages of cancer and we felt that this news would be devastating and might dampen his already fragile spirits. As well, my family and I were all diligent about watching for “signs” that can be given by those nearing the end of life. These signs, or final gifts, can be spoken in dreams or while the person with the illness is in a state of delirium or altered conciousness. We felt that if Dad described seeing Mac, this could be an indication that his journey was nearing the end.

However, Dad never described seeing his friend. He asked about him when talking with mutual friends, but those involved were instructed to politely avoid telling the truth about Mac’s passing.

Then the miracle occurred.

After my dad passed away on May 27th, I called the funeral home to arrange transport to pick him up from my parent’s home... When the van eventually arrived, my sister glanced out the window toward the driveway. Her voice was shaking when she spoke “Oh my God! You have to come and see this!” We joined her at the window and we all looked out toward the ominous black van. Then she said “Look at the license plate”.

The letters on the plate read: M-A-C.

I suppose this could be considered a co-incidence. One can mathematically calculate that the possibility of this combination of letters occurring by chance is one in 17,576 (or 0.0057%). But this co-incidence gives my mom, my family, and Mac’s wife a profound sense of comfort. Not only do we know that they are together, but we feel that they wanted to let us know that they are safe in each other’s company.

Thank You All For Your Support...

Now that my dad’s battle with cancer has ended, it is time to reflect on the whirlwind of events that the past several months has brought. Although this has been a terribly difficult time, as we watched my dad deteriorate over a period of a few short months, I have also witnessed the goodness in those around me, in my family, friends, and almost strangers. It is with heartfelt gratitude that I attempt to extend my thanks to those who have reached out and offered support to make our journey a little less difficult.

It is impossible to name the countless healthcare workers involved in my dad’s care over the past several months, but I’d like to name a few:

• To the community nurses especially Linda and Sue who gave us so much comfort, support, and hands on care.

• To Lucie, who guided me on a profound personal journey of forgiveness and compassion, before it was too late.

• To the countless nurses and councillors with the Palliative Response Team – your expertise was always delivered with caring hearts, and we thank you for allowing us to keep our dad at home and leave with dignity. Especially those who taught us to recognize the final gifts my dad communicated to us through the episodes of delirium in his final weeks.

• To the doctors, especially Dr. Jones and Dr. Ryan who came into our home and addressed Dad’s needs. And to Dr. Tara Pickering, my sister -in-law who patiently answered every question and concern.

To all the Sooke Moms (and Dads) who took care of our daughter, usually on short notice – I hope that she brought the same joy with her visits as your children bring to our home - especially Carrol, Leanna, Daphne, Ryan, Jenn, Deb, Andrea, Britt, Gorana, Keri, Caryn, Trish, Lori, Suzanne, Shannon, Heather, Tracey, and Noah.

For the hugs, phone calls and messages of support, as well as the memorable laughs and good times – Carrol, Jason, Leanna, Colin, Daphne, Ryan, Joan, Lori, Kendall, Jenn, Caryn, Aaron, Melanie, John and Joanne. To Andrea, Jessica, Deanna and Our Lady Star of the Sea CWL - thanks for the wonderful meals!

And to the support at schools and classes - Mme Robertson, Trish, Roseanne, Shan, and Niki.

To my co-workers, the therapy services and 5A staff at the VGH, especially Mubeena, Debbie, Linda, and Melissa - for always being there, professionally and personally.

To Pat, our family friend who did so many tasks for us – especially for scanning so many photos, thoughtfully labelling each photo and burning discs for all of us. Thank you for the coffee and snacks and all of the driving duties...

To my online friends – your messages of support, general kindness, and hugs always made me feel like I wasn’t alone, especially Cathy, Yukari, Janice, Laura, Jodie, Carrol, Kevin, Scott, Cris, and Dom.

To my sisters – I cannot express how much it meant to be a part of Dad’s inner circle with you. You both visited dad daily and committed your time and availability 24/7 for months. We all “pitched in” and shared in the decision making, visiting, food prep, clean-up, organizing, archiving, information gathering, gardening, emailing and so many other necessary duties – yet it felt good to give back. You showed the meaning of going the extra mile.

To my brother – your uber energy and inability to sit still for five minutes allowed us to all breathe easier when you were visiting from Calgary. Your competence is mind-boggling, whether you’re cooking, housekeeping, lawn-keeping, running, playing with the kids, or shopping, you always remained calm and offered support to everyone around.

There are no words to describe how much love and respect I have for my Mom. It’s been an especially difficult time for her. I could write a chapter but will say only this: Your strength is astounding and we were all moved by the love and patience that you tirelessly gave Dad – you were the sole caregiver for a significant portion of Dad’s illness and it wasn’t an easy job but you did so well. I am so proud that you are my Mom.

To Roger, my amazing husband - you were always there for me and my family; you offered everything, always. You have been a rock to all of us. You have stood by me when I didn’t deserve you; you rubbed my back on countless sleepless nights; you allowed me the time to pursue my hours of walking; you bit your tongue when dinner was less than sophisticated... again! . You have the most gentle spirit, you are as kind to me as you are to everyone else. For you, I am forever grateful.

And to all other friends, extended family, church members and supporters - I THANK YOU...

I dedicate this song to all of you... xo

Two Days After Superbowl Sunday

February 9, 2010 was a day I’ll never forget. It was two days after the Superbowl and the festivities had already faded. My dad was being discharged from the Victoria General Hospital, not because he was well enough to go home, but because there was nothing more “they” could do for him. In late January, he was admitted with symptoms of nausea which turned out to be a serious bowel obstruction for which he required surgery. Peri-operatively, the surgeon discovered widespread metastatic cancer, which had gone undetected in a CT scan a few weeks earlier. So the operation was completed and Dad spent a few more days in hospital recovering .

With the prescription of T3’s in hand, I prepared his transport wheelchair so that we could get to the car and go to the BC Cancer Agency. It was our understanding that a PICC line would be started so that Dad could begin immediate chemotherapy. Dad was grumpy that day and he refused the wheelchair, choosing to walk out of the hospital on foot – I could not convince him to conserve his energy.

However, the PICC line was never inserted. The oncologist at the cancer clinic explained that chemotherapy was not indicated as the cancer was far too widespread to be affected by chemotherapy, and the negative side effects would likely outweigh the benefits. So the “fragile” conversation began. Carefully worded questions were followed by painfully vague answers. I just wanted to know how long. EVERYONE will want to know: how much more time does he have? I knew that my parents were shocked, worn, fatigued, and sad - my job was to get this information right. I knew I would be repeating this story over and over and over again and I HAD to get it right!! I was the only trained healthcare professional in the immediate family – I was the self-designated quarterback, for now ....

So I made sure to listen carefully and clarify: “A few months – as long as there is no major event” A FEW MONTHS!?! But he was fine at Christmas, 6 weeks ago!! Then bloodwork was done, nausea set in, and he was taken to hospital -- now you are telling me a few months!! I switched off the emotional side and thought of clarifying questions that “people” will want to know. I had to keep it together, help, support, think, remember, and listen. The visit didn’t stop there: there were prescriptions to fill (forget those T3’s, it was time for the deluxe narcotics), appointments with home nursing and the outpatient pain clinic to be made, and paperwork to be completed. Who knew that I’d be filling out the Palliative Care Benefits paperwork only 6 weeks after Christmas!

I dreaded going home to an almost empty house to make those phone calls to share the devastating news with my siblings. Now I was going to have to be the one answering carefully worded questions with fragile, vague answers – I was, after all, the quarterback.

(Despite the gravity of that day, I still feel honoured to have been there. Our family was treated with overwhelming compassion and support from all the staff, professionals and volunteers at the BC Cancer Agency. It made the whole experience slightly more tolerable to be surrounded by caring and kind strangers. A huge thank you to all of the individuals who dedicate their time and energy to helping patients and families with the experience of cancer)

2010 Linear Walk - Completed!

Well, I did it! No, I did not complete an Ironman or stand on any podiums, but I got off my ass consistently 3 days a week for months to get my feet and legs in shape for a 32K walk from the Juan de Fuca Rec Centre to the Sooke Castle! My first "Linear Walk"...

I must admit, it was not as hard as I thought it would be, primarily because I stuck to a formal training schedule, for the first time in my life... The schedule was not very technical, but it was created by 2 physiotherapists and a marathon runner, so it was well thought out. For 3 months, it was shuffled around my kitchen, as I had intended to type it up formally, but I grew to love the doodling and coffee stains. It was my guide to fitness as my training became one of the most positive aspects of my crisis-filled life. It was my time to think, cry, reflect, re-energize, and listen to my ipod without any distractions!

My training gave me some sanity through two of the most difficult months of my life, as my father was found to have a recurrence of an aggressive form of colon cancer, from which he received a whirlwind of tests, subsequent surgery, only to be followed by a poor prognosis and rapidly declining health. At times, I thought that my walk in May would become a memorial walk for my dad, but he is continuing to fight to this day. I was proud to visit him the morning of the walk to administer his medication and to tell him "Today is the day I do my walk, Dad". From his bed (where he spent 23.5 hours/day on average), he smiled, nodded his head, and said "Don't forget to drink lots of water".

It's hard to believe that when I started training in January, he was up and about 16 hours/day, and puttering in the yard every chance he got, working on my sister's truck, tinkering with old electronics or doing yard work. I almost felt guilty during the following months - as I was working on gaining strength, my dad was losing strength so profoundly. I never skipped a day of training, other than taking a week off with a bad cold, and not a kilometre went by when I didn't think of him and his enduring strength....