Tag Archives: death

A New Page Coming to AURV: A Terminal Illness Primer For Caregivers

Lily Pad, FlowerTotal heaviosity. I guess this is something that’s been rolling around my head for a long time – even though I didn’t know it. When one of my oldest friends (to give you an idea of how long we’ve know each other, we used to ride together on the school bus) asked me to share with her my experience as a caregiver to my brother, Charles, the floodgates opened. I spent an afternoon furiously writing down everything that I thought she would find useful in her own challenging situation. I’ve since expanded what I wrote and I’m still working on many parts of what promises to be a long document. I thought that it might be helpful to others.

To many, writing about terminal illness seems like a depressing thing to share and they are right. It is depressing. But others, like me, find strength in understanding and planning. It is easier to face challenges if we’ve done a little mental preparation and some legwork ahead of time. We may not have a firm grasp on our emotions, but we can control logistics. My hope is that this primer brings knowledge and thereby some comfort to those seeking guidance through difficult times. To my regular blog readers: I truly appreciate your loyalty and support – shown via your comments over the past year and half that this blog has existed. Many of you reached out to me after my brother’s passing and I was deeply touched by your tenderness and sympathy. This primer will appeal to a small portion of my readers so please do not feel that you need to Like and/or comment on each post.

The way this will work is, as I write sections, I will post them here on Sundays (a relatively quiet day in the blogosphere). Right now, the complete document is…well, still floating around in my head. When I’ve added something new to the Primer page, I will post the update here on the main page of my blog.

Here we go…

Starting at the Beginning: Why I’m Writing This
When my brother told me – via text message – that he’d been given six months to live after being diagnosed with brain cancer, I reacted by asking – via text message – if he was joking. I remember staring at his message, wondering how to respond. Needless to say, my reply was sorely lacking. My brother, at age 49, couldn’t die! It couldn’t be anything but a joke, right? I’d been conditioned by years of bad movies, books and overwrought television shows to regard the six-months-to-live diagnosis as a pathetic plot tool, a gimmick writers use to eliminate a character who needs to be written out of a storyline.

I was totally unprepared for how to react, process and function with a timer ticking off the last moments of my sibling’s life. I had never known life without him. Furthermore, death had never come close to me. Illness and death were something that happened in other people’s families. Death should be more orderly, more logical – if it must happen, it should happen peacefully and only after a long and fulfilling life and in the order into which we came into the world: first in, first out. Unfortunately, death observes its own rules. We must prepare for death because death will not wait patiently for us to be ready for it.

There was a brief period following my brother’s diagnosis when it seemed we all retreated – or more accurately, we all tried to return to the comfort of an illness-free past. Because my family is scattered to the four corners, with all four siblings living in different states, it was easy to slip back into old routines. This denial did nothing to slow the progression of my brother’s disease, of course, and it became apparent (thanks to the urgings of a concerned friend) that action needed to be taken. I hadn’t been totally idle during those surreal weeks. I had spent them researching (as did the other members of my family) glioblastoma multiforme, an extremely malignant and fast-moving type of brain cancer. It felt like a hopeless situation.

Despite what I was reading, I was determined that my brother would beat the odds. My brother was young, healthy and he loved his life. When Kel and I left home to help him, I had no clear plan, no idea of next steps and I was scared out of my mind to face my brother. I only had the vaguest idea of a plan, based solely on a book I had read written by a brain cancer survivor*. So, I went to Utah with the idea, if he’d let me, that I’d get my brother to follow a treatment path similar to the one described in the book. It was like finding myself on stage in front of a full house during amateur night at The Improv. Dressed only in my underwear.

I didn’t immediately assume the large role I was to play in his journey – he wouldn’t hear of it – and it felt initially as if I was just an observer of his fate. Eventually my family and I became more than bystanders and avid internet researchers. We became his advocates and caregivers and we were a formidable team. I realize how lucky we were to have each other’s support – to have our own strengths and talents to lend.

We were by no means perfect, but our aim was to provide love, care and guidance, and I think we succeeded. What follows is a description of our “on the job training,” what my family and I learned as we first tried to save my brother and then as we tried to make his last days as safe, comforting and loving as possible. The standout thing that I learned is that it is better to plan and be prepared. It is unpleasant to spend any moment out of our busy days planning for the end (of ourselves or of friends or loved ones) – but doing so makes the process easier on everyone, reduces stress, frees time for what is important (being with your loved one) and cushions a very hard blow.

*Ben Williams, author of Surviving “Terminal” Cancer: Clinical Trials, Drug Cocktails and Other Treatments Your Oncologist Won’t Tell You About

Caution:
I am not a nurse, nor a physician, nor a therapist – and I didn’t sleep at a Holiday Inn Express last night. In other words, I’m not an expert. I’m writing strictly from my personal experience and from what I learned along the way of a two-year journey from diagnosis to death. It is offered as a guide and resource. Please read with care and always do your own research – it certainly is not exhaustive. Each person’s situation is different and calls for different methods and solutions. If you find any glaring errors or typos, please let me know and also feel free to add your own thoughts or experiences in the comment section below.

Some of this information may not be relevant to those living outside of the United States.

Finally, apologies to those closely involved in this experience for any errors caused by my faulty memory. Those were swift-moving and stressful times and I’m sure that I’ve forgotten some things and misremembered others.

To visit A Terminal Illness Primer for Caregivers Page, please click here or go to the header section of the blog.

Coming Up: After the Diagnosis

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Happy Birthday

Charles

How do you celebrate a birthday when the celebrant is no longer Here?  Though time has ceased to tock forward for him – my brother will stay 51 for as long as I am alive – it still feels right to honor the day that he came into the world.  His passing does not lessen his impact on my life.  New memories will not be made, but the old provide comfort and smiles and tears.  Happy birthday, Charles.

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Thankful & Thoughtful

Boots, Helmet, Ski Poles

What made him tick.

The things alive do not know the secret… Of late years, however, I have come to suspect that the mystery may just as well be solved in a carved and intricate seed case out of which life has flown, as in the seed itself.  – Loren Eiseley, The Immense Journey

My brother died at 3:25 am July 5.  The pop and sizzle of neighbors’ firecrackers kept him company that night, gray skies and a gentle rain in the morning broke the spell of heat and drought and sun; more soothing than melancholy.  Determined and independent in his dying days as he was as a vibrant, healthy man, I have no doubt his plan was to make it through July 4; July was his favorite month and Independence Day his favorite holiday.

In the hours and days after his death, little things took on weighted importance: the memory of the last meal together at a restaurant; the image of a sweet smile when at last voice and words, but not comprehension, were taken from him; the half-full glass of water by his bed; the backpack on the kitchen table containing bottles of aspirin, ear plugs and a bathing suit from the last trip he took (to California); the tube of toothpaste, indented in the middle by the squeeze of his hand; his beat-up work boots looking as if he’d stepped out of them mere moments before.  It is those things more than the profound and sobering permanence of passing that make me break down.  What is more poignant than the little, seemingly insignificant objects and moments that make up a human life?

Anyone who has suffered through an illness or has helped a family member or friend knows that it is not a solo project.  It is a team effort requiring tens of supporting and supportive roles.  And so I have many people to thank.  First and foremost among them, my family.  My mom and dad dug deep and called on reserves that any 20-year old would envy.  Their strength and dignity through that lonesome night of loss is an example I will carry with me.  My other brother whose advise and care steadied during moments of stress and uncertainty.  My sister was a rock, holding firm during times when I melted like a candle.  Love to my partner, Kel, for keeping the home fires stoked and for caring for our little (furry) one, Ike.  His support has never wavered.  He loved my brother.  The caring embrace of extended family was felt over the long miles.

It is impossible to imagine what this process would have been like without the guidance, knowledge and compassion of our hospice team.  There were many late night visits and phone calls – moments of doubt and fear made manageable by a comforting voice on the other end of the line.  Stacey, Robyn and Carolyn guided us down that very difficult road.  Special gratitude goes to John, the gentle aide who helped my brother maintain his pride and dignity up to that very last day of life.  We were also fortunate to meet Riley, a young man who made our nights easier by his patient presence and his willingness to be touched by a family’s saddest hours.

Thanks and love go to the many friends – old and new, near and far – who sent emails and called.  The comments both here and on Facebook were deeply appreciated.  In challenging times, the true and the false are shown in stark relief: some of my brother’s friends reached lovingly out to us, shared aspects of him we never knew and offered to help in any way that they could.  Fate or coincidence sent Somer into my life at just the right moment.  She shared her huge, loving, nurturing heart with my brother, but also loaded the back of her vehicle – several times – with plant-based deliciousness and made the trek to Bountiful to spend time with me and open her arms for much-needed hugs.  Her beautiful kids never failed to cheer me with their exuberance and their life and energy.  Along with her friends Amanda and Erika (who have never met me, by the way) she provided heart, soul and stomach nourishment.  Thank you ladies of the Good Clean Food Relief Society.

In a strange twist, Faye came into my life on the very day my brother died and at the very coffee shop where he and I would go after his appointments at the clinic.  Over mutual admiration for short haircuts, I learned that Faye has the same type of brain cancer as my brother.  I’m not one to linger long on the oddities the universe occasionally throws across my path, but one would have to be devoid of imagination not to think something rather huge was up.  I hope to spend a lot more time with Faye and to share with her the thin threads of knowledge gathered over the past couple of years.

Merck and Genentech earned my gratitude for providing their prohibitively costly chemo drugs gratis through their assistance programs; big pharmaceuticals aren’t all bad.  Novocure not only requires thanks for pursuing interesting cancer treatment options, I’m indebted to them for giving my brother – free – their Novocure TTF helmet, a recently FDA-approved alternative treatment using electric fields to disrupt cancer cell growth.  Dr. Santosh Kesari at his lab at UCSD prescribed the device and he also, up until the last weeks of my brother’s life, suggested other treatment options.

Lastly, thanks to my brother’s medical team at The Huntsman Cancer Institute, especially to sweet Crelley who has become a friend, and Sean, who spent hours with me on the phone over the past two years explaining complex issues and trying to figure out what made my brother tick.  From the beginning of this journey they provided hope and knowledge and gave my brother another year of life when all seemed lost on bleak November days in 2010.  I often wonder how they can work day after day knowing that many of their patients will live only a short time post-diagnosis.  I am grateful there are people willing to devote their lives to treating such a formidable disease.  May a cure be found soon.

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