Family Ties

My folks retired to Houston and lived there for 20+ years before down-sizing, selling their home, and moving to an apartment in St. Petersburg FL to be closer to family support (one of my elder sisters lives there).  

I didn’t mention this earlier, but much of the summer and fall of last year my brothers, sisters, and I helped Mom & Dad prepare to move, . . . deciding what to bring with them (what would fit in their new place), . . . preparing their house for sale after they left (new paint, new carpet, yard work, many minor repairs, and thorough cleaning inside and out), . . . deciding what to do with all the stuff they left behind (of their five children, who wanted what and how to get it to them, with a goodly amount left over for goodwill, and the rest to the dump), . . . and working with the realtor on pricing, open houses, responding to offers, and negotiating the close of the real estate transaction.  

This entailed multiple trips to Houston to meet with movers, the realtor, repair crews, painters / carpet layers, interior / exterior cleaners, gardeners, junk-haulers, etc., and many, many calls to arrange / coordinate times for these folks to be at the home to perform their work.  The air travel and working around their house became another feature of my convalescence, and there were days when my ankles became markedly swollen after being up and about longer than I had been up to this point.  

An elder sister and I spent a long weekend on a herculean effort, moving from room-to-room through the house sorting items between those for family friends & helpers, goodwill, recycling, and junk, . . . and then preparing all items for appropriate movement.  As you can imagine, this was both physically and emotionally draining, as we came across many left behind items that conjured childhood memories, and we had to be judicious about what could be salvaged and passed forward and what we would leave behind forever.

Eventually everything came together as planned, and when the house sold in late August my folks were pleased and it all seemed to have been worth the effort.  None-the-less, Mom had indicated hesitancy about moving from their Houston home.  She had teased---but not really---that she didn’t want to go, . . . wouldn’t go, . . . would stay there at the kitchen breakfast table.  Mom especially enjoyed sitting there reading the newspaper, listening to the news on the radio, and looking out of the large picture window at birds & squirrels visiting the bird feeders Dad hung from tree limbs on the other side of the driveway outside the window.  Dad was hesitant as well, as he enjoyed golfing with his buddies and singing in the church choir.

Both Mom & Dad loved living in their Houston home, and they had made a number of accommodations around the house to address the risks, such as putting in a chairlift on the stairs, installing a day-bed in the downstairs office and installing a shower stall and toilet in the utility room off of the kitchen. Additionally, they had a long-term disability insurance policy that kicked in and paid for an in-home service to provide simple day-to-day care.  

It was a good situation for them, but their kiddos (me and my brothers & sisters) were concerned about their living alone because of the lack of interaction with others, the risks of not having medical response nearby, and the increasing amount of support they would need as their memory capabilities diminished.  Over the years, we had gradually introduced the concept of their downsizing and moving closer to one of us, and eventually they grudgingly acquiesced to our encouragements.

I would discuss downsizing with them using a climbing analogy.  I described the choice to remain in their home as analogous to a technical climbing team who had climbed past their turn-around time and although it was still light out and climbing was enjoyable, it was going to get dark soon, and then climbing would become perilous.  Also, as they aged, I alluded to their gradual loss of rock-climbing capabilities and stamina and hence they would become less resilient in responding to complications and this also increased the risk of experiencing catastrophic consequences of a fall, a broken hip, and then six months of life, tops.  Brothers and sisters spoke to them as well, and one sister invited them to visit a St. Petersburg senior living complex where they ultimately chose to live.

Unfortunately once in Florida, Mom's health rapidly dwindled, and she became progressively weaker as the weeks passed.  She was in the hospital before the Christmas holidays to address a racing heart, and because she had become so weak and fragile, the doctors required she stay for several more days of observation.  Then, the doctors prescribed a follow-on week at a skilled nursing center for physical therapy to improve her strength and ease of movement, and she moved there after the new year.  Mom was increasingly miserable, and I was shocked to receive a call from Dad on January 13th that she had died overnight at the skilled nursing center.  Just the day before an elder brother and I spoke, and we both agreed that although her decline had been increasingly rapid, she had at least several more months if not years.

What the kiddos didn't understand or avoided comprehending, is that our folks were already so fragile that the move to Florida---rather than guarding against a critical incident that would result in a rapid downward spiral in health---actually instigated Mom's rapid descent.  Using the climbing analogy, we implemented a futile rescue attempt.  Mom & Dad were already climbing into sunset, and it was already too late to attempt a rescue.  We didn't realize that while in the midst of moving them from Houston to St. Petersburg they were very close to being benighted, and although they had acquiesced to our efforts, they knew in their hearts that it was too late, that we should just leave them be where they were and allow them to enjoy the last of the sunset as best as possible.  How sorrowful I am at this realization in 20/20 hindsight.     

My elder sister Lynn wrote and arranged for Mom’s obituary to be placed in Houston & Baton Rouge newspapers.  She organized the memorial service, invited all our relatives, rented the venue, hired the caterers, . . . did just about everything.  Elder brother Bob prepared an amazing slide show that ran in the background throughout the gathering.  I acted as master of ceremonies and spoke on my family's behalf.

My father is devastated by the unanticipated loss of his partner of 65+ years, and it’s like half of him is missing.  He is so sad and lonely.  He is miserable.  He regrets.  He would never have agreed to move from their Houston home last summer if he had known the love of his life would be gone in the new year.  He feels guilt for having taken her from the place she loved best, causing turbulence and complications during the last months of her life.  Marie was not happy in St. Petersburg, and Dad feels as though perhaps she just sort of let life go and left him, sneaking out the back door when know one was looking.

Now I see that the climbing analogy I used to encourage them to downsize and move to an apartment was correct, but I gleaned the wrong lessons from it.  True, Mom and Dad had climbed well past their turn-around time, but it had become so late in the day that the only reasonable thing to do was to admit there would be no getting back down safely, and so the only choice was to enjoy the remaining time on the rock, ascending their last summit and becoming benighted up there, but blissfully so.  Instead, we encouraged them to acquiesce to an emergency descent, and so with our prodding they tried to beat a hasty retreat even after it was too late to do so safely, and Mom fell on the way down.  We didn't realize how dangerous it was to change course and retreat when the climb party is frail but in equilibrium.

I flew to St. Petersburg to accompany Dad on his travels to Mom’s memorial service in Houston.  He had been experiencing acute pain in his lower back, and we were able to make an appointment with a Houston specialist who had helped him in the past, and so we stayed after the ceremony for an extra couple of days until the appointment.  We had several very nice days together, and took the opportunity to visit the sight of the memorial service again and the gardens surrounding it.  There was an especially lovely Japanese garden that we very much enjoyed walking through. 

The doctors visit turned out very well, and the flight back to Florida was uneventful, but it was so difficult to leave him alone and grieving in his forlorn and empty apartment.  I suggested that he should reconsider all the decisions that had brought him there.  If they had not moved from Houston, and Mom had passed there in their lovely home, and if he now found himself widowed and alone, what would he do under those circumstances?  Likely, he would move from the Houston home, and so that part was already taken care of.  Perhaps he might still choose Florida as his new home, and if so, then that part was already taken care of as well, and then he would just need to figure out how to carry on without Mom.  But if another alternative now seemed to make more sense, he shouldn’t think twice about asking for help to make another move.

I have suggested that rather than living alone in an apartment, he might also consider moving in with me in Seattle.  At first, he expressed concern about cramping my style, but I made it clear that I was serious and would be honored to have him live with me.  It would be a pleasure to care for him now as he had cared for all of us while we were growing up, and that I would very much welcome having his company.  We'll take our time discussing this alternative.  We want to be certain of what will be the best situation for him, now that Mom is gone.

Family ties have taken precedence over consistency in focus on convalescence, as well they should. 

A Better Reason

The rest of October flew by with me biking to work every day, staying until late and biking home in the dark. 

The Burke Gilman Trail after 10pm is an interesting place.  First of all, in many places the trail is far enough from the road that there is practically zero ambient light, so you bike by the moon & stars and hope for the best.  Second, the trail gets a little wild after dark so there is noticable scurrying in the brush on either side and I imagine the reflection of little critter eyes in the glare of bike head lights flashing by.  Third, oncoming bikes with super-bright lights---intended to “see” rather than “be seen”---are blinding and I whisper casual oaths under my breath as they approach.  A few considerate riders shield their high-beam lights, but most don't bother and I do my best to guess where I am in relation to the side of the path. . . . can’t see a blessed thing.

Then also, people occasionally leave the ubiquitous green and yellow bikes-for-rent sprawled near the path making for difficult-to-perceive and unexpected near-miss obstacles.  Speaking of the ubiquitous green and yellow bikes-for-rent, . . . by day, folks peddle these bikes slow and steady, and us bike commuters can make our way around them all right.  After 10pm however, a few of these bike renters are as well lit as the bikes themselves!  Having emerged from the local pub and unsafe to drive a car these riders feel steady enough to rent a bike.  But I digress.

I have implied the cause of not pushing hard on convalescence has everything to do with being super busy at work, but that is not fully accurate.  Truth is other distractions have arisen on the home front.  This is tuff to talk about.  It is not like falling off a climbing gym wall which is easy to overcome by comparison.  This hurts in a different way.  So very, very sad.

Procrastination

Well, the bright work project certainly was a distraction and it proved how adept I am at procrastination!  By end of August I had layed on seven coats of varnish and decided to call it good enough for this season.  Seven coats will keep the teak protected and so the bright work project is in a safe temporary holding pattern.  Next spring I’ll add an additional four coats and call it good. 

In September and the first two weeks of October---without the excuse of needing to drive so that I could get to the boat after work fresh enough and with enough time to make progress---I have returned to biking to work, and I am really feeling improvement.  I am able ride faster for longer, and I feel less muscle ache during the ride and afterward.  Also, I have discovered several short-cuts from the standard Burke Gilman Bike Trail route that shortens overall distance and eliminates several busy intersections, so there are only one or two spots where I might have to stop.

Also, I have continued working on left ankle range of motion, and it is frustrating how little progress I am making there.  Although I am able to bend it a considerable amount by leaning against a wall (first facing in and leaning far forward and then facing out and leaning far back), without the added pressure the ankle is still very stiff and doesn’t yet bend back and forth of it’s own accord.  

Thankfully, I am sensing gradual improvement in feeling in my left foot.  In addition to pins & needles I am now also feeling internal stinging & itching (which I suppose is a good thing), and now I am able to feel whether the foot has successfully slipped into a slipper when getting up out of bed at night with the light still off, which is more than I could do several months ago. 

The doctors indicated there’s typically a two-year window for repairing nerves and recovering feeling after an injury, so I still have eight more months of potential progress.  It is really important to have good sensation in your feet for technical rock climbing, because you have to be able to feel how well your foot is attached to the a particular placement on the rock (or climbing wall), so I have continued to hold off on climbing until I have better sensations my left foot.

No more procrastinating, . . . time to get back to hiking and the thrice weekly workout routine!

Distractions are OK, as long as they are kinetic.

So, . . . in addition to climbing and getting out into the Alpine, I love getting out on the water, and have owned a wonderful sailing craft for years.  Care & feeding of "Rhythm" is a labor of love, and requires countless hours of just "messing around on a boat." I will be testing my full-body convalescence with a big summer-time boat project requiring bending, stooping, kneeling, and crawling around all while applying significant "elbow grease."

Several weekends ago, with a sharp scraper and heat gun, I began peeling off Rhythm’s exterior varnish.  The ship’s log indicates it has been 10 years since last she was back to bare teak, so this is several years overdue.  Typically, the base varnish coat begins detaching from the wood substrate after seven or eight years depending on climate.  Teak is an oil-saturated wood which, on the one hand, protects it from deterioration due to the elements, but on the other hand, destines brightwork to a decade life-span at best.  It makes sense to “scratch & patch” the first tell-tale failure points, although the repaired areas are lighter in color than the rest.  Eventually after many patch jobs the brightwork looks mottled, and with new areas delaminating in increasing size & frequency, the daunting task of scraping off all the old, sanding to clear wood, and then building up a new varnish system, becomes unavoidable.

Getting to the point where I was ready to apply fresh varnish took over 100 hours of heavy duty sanding, working first with an orbital sander, then a hand block, then free-hand, and finally using small “invented” tools to work in tight corners.  What you see prior to laying on the first coat of varnish is what you’ll live with for the next 10 years, so the prep-work needs to be thorough.  Similar to varnishing, sanding requires multiple passes, first with 80 grit sandpaper (to clear the remaining old varnish and “shape” the wood), then 150 grit (to smooth the 80 grit surface and reveal the wood grain), and finally 220 grit (to increase resolution and beauty of the wood grain leaving a silky smooth surface).  Thinking through the routine now, there are eight unique passes over the wood before it’s ready for the varnish primer coat.

After sanding and detailing, you need to tape off the surrounding surfaces in preparation for applying the varnish primer coat; only professionals lay on varnish without masking tape that catches errant brush strokes, drips, etc.  It will take the rest of the summer to build up enough varnish coats to call it brightwork, . . . at least 220 hours to complete 12 coats @ 7 hrs to varnish and 9 hrs to sand after each new coat, plus un-taping and re-taping after every 3rd or 4th coat. 

Thankfully thus far no setbacks or accidents other than small burns from the heat gun and sanding off my finger prints.  I have had to change the security feature on my mobile phone that reads my fingerprint until they grow back.  Sometime, I’ll tell you about the time (10 years ago) when I picked up the heat gun by the wrong end, . . . now that caused some damage!

It's been a year (tomorrow)!

A close friend emailed me early this week wondering whether the anniversary date is getting close and I realized that yes, it is either June 30^th (this coming Saturday) or tomorrow (the last Thursday in June), . . . right around the corner in either case. 

Thursday morning feels like the more appropriate marker as it aligns with last year’s weekly routine, so I’ll drop by Vertical World tomorrow first thing for a moment of silent reflection and thanks giving.  If you haven't yet, you should visit Vertical World's website sometime to get a sense of their amazing climbing walls.

I have experienced further improvement in walking gate smoothness and speed in the last week or so after starting a very modest course of aspirin in the AM and PM.  I happened to be reading something that indicated aspirin is excellent for reducing inflammation and joint pain, and after restarting with it (and bumping up dosage slightly to AM &PM) I noticed immediate improvement.  My left ankle hasn’t looked this svelte in months, and I can step right through the ankle bend with nary a twinge.  Pretty cool.

Last week I had the last visit with the spine surgery team (one year hence), and they were all "your healed, get out of here!" They still warn that because fewer vertebra are carrying the bending/twisting load there's a likelihood that they will need to fuse the next one down in 10 years or so.  I asked, and they indicated that strong core muscles will slow the degradation, . . . 10-minute abs here I come!

Pain, drugs, and backing off the meds at Anderson House

Before Harbor View could discharge me to a skilled nursing center and free up a bed in their trauma center, I had to be off of intravenous pain meds and stable on oral meds.  This all seemed to be happening pretty quickly and it gave me concern as pain meds were definitely still required to maintain an even strain, but in the last couple days at Harborview I gained confidence meds could be administered effectively orally and leaving Harborview wouldn't result in a major set back.

Looking back on the transition from Harbor View to Anderson House, I can understand how cautious I felt about "change for the worse," but there's no question that Anderson House was a much better place to begin convalescence.  Harbor View is a place to get put back together, . . . not a place to mend over a longer period of time, . . . It's hectic, fast paced and staff are stressed, . . . it's like a war-time mash unit!  Regardless, I still ended up wanting to hang onto "the devil I knew" versus being cast off into the unknown.

In a much earlier post I indicated what a good living environment Anderson House provided for early convalescence.  Peace & quiet, helpful & friendly staff, a large private room, good food, encouraging & resourceful physical & occupational therapists, access to an shaded outdoor patio, . . . overall Anderson House put together an excellent program.  No skilled nursing center can fully meet expectations every minute of every day, but Anderson House came pretty close.

Naturally, there were times (usually around the meal hours) when assistant staff were heavily engaged getting people up and out of bed for meals, and so I needed to adjust expectations to account for these busy times.  On rare occasions, my needs would become unforeseen & urgent (think, I need a bed pan!) and there just wasn't anyone immediately available.  Oh well, . . . suppose there are worse things than dealing with these relatively minor consequences / inconveniences.

Anderson House nurse staff were almost always timely with meds and were uniformly friendly, helpful, compassionate, and looking out for my best interests.  Right off the bat it was apparent they were not as maniacal as Harbor View staff about reducing med levels, as they were not under the gun to discharge folks and free up beds.  We still did the "what's your level of pain" dance, but they were much easier to work with in making adjustments.  They instilled confidence that if we tried reducing meds and it wasn't working we could always readjust.  I was anxious to demonstrate zero dependence on pain meds and so we established plans to reduce first one prescription, then the next, and then the next.  Then we worked through each plan and celebrated being weaned off of each med. 

In retrospect, there were several comical / farcical episodes associated with coming off various drugs (Oxycontin, Dilaudid, and Gabapentin).  I weened from Dilaudid first and without memorable complication.  Although Oxycontin is a great pain med, it can be addictive and it definitely causes constipation.  So on the one hand, I had a choice of maintaining Oxy dosage at the risk of becoming dependent but also at the cost of frequent suppositories, and on the other hand, I could work down the Oxy and transition from suppositories to prunes.  Seems like a no brainer right?!  Yah, but you gotta' be careful about backing off of Oxy or you'll find yourself in a very uncomfortable state.  Looking back, it's comical to reflect on the fact that I initially leaned in favor of continuing suppositories!   There were definitely celebrations by all involved when I zeroed out the Oxy and was able to keep things moving with prunes and coffee!

The last med I was on was Gabapentin, and when I talked to the doctor about it she indicated it "just soothed nerve endings."  So later that day in a moment of hubris, I told the nurse to go ahead and zero out the dosage rather than go through a more gradual reduction regime.  Mistake!  Around bed-time it became apparent what Gabby was doing for me, . . . and what it felt like to go without. Going cold turkey off of Gabby resulted in turning up the thermostat in every square inch of skin to top-bench sauna temps. 

Holy fish cakes & mother of pearl, what an uncomfortable night!  Not "pain" per se, but incredible debilitating/maddening discomfort.  The next morning I had a "conversation" with nurses & doctors about the benefits of more gradually backing off of Gabby, and I didn't take the last pill of it until several weeks later, well after I was discharged from Anderson House and living at The Ballard Landmark assisted living center, the retirement home that housed me while I was still non-weight bearing and refined to either bed-rest or a wheel chair 24/7.

Since leaving the pain meds behind I have been on a daily regime of one aspirin, four Tums, and a drop of vitamin B, . . . the aspirin to keep blood a little thinner than usual to reduce the negligible odds of a blood clot breaking off of ongoing internal repair work going on in my shins/ankles/feet, Tums for calcium bone-building material, and vitamin B as a catalyst to absorb the calcium. 

Seems to be working, . . . the last time I visited the foot orthopedic team they were impressed with the amount of bone generation that has occurred since surgery.  They said I can do just about anything I want other than play basketball and sky dive!

Better living through orthotics

Can't believe I had been trying to walk distance without orthotics!  Wish I had looked into them much sooner; and it just shows what a stubborn cuss I can be.  Walking with and without them is a night and day difference, and at this point I wouldn't imagine going anywhere without them.  Miraculously, they totally smooth my walking gate, and it feels fantastic to be able to walk smoothly versus hitching along. 

The orthotics team made several sets for me, and I keep one set in shoes I leave at work (to save weight and volume in my backpack when biking/commuting) and another set remains at home.  It is easy to swap them in and out of whatever foot gear I am going with.  The orthotics aren't necessary or helpful while biking, and that's the only time I go without them.  The contrast between clumsily walking in non-adjusted bike shoes to & from the bike, compared with gracefully gliding along once on the bike, is poignant.

The jury is still out on the clam-shell brace.  It feels constricting, and it gets warm and, well clammy, inside, and that is something I'll just have to get used to.  Also, where my foot exits the brace there is an unavoidable lip / transition from the brace to my shoe that crosses the bottom section of my foot that is still recovering nerve sensation, and it is causing annoying discomfort after just a little bit of use.  Maybe I can lessen the sensation by adding a cushioning extension / transition.  In any case, I don't think it's going to do the job in it's current configuration.

Finally, the brace works fine when walking on mostly flat terrain or when stepping up onto things like curbs, benches, rocks, stairs, etc., but because the brace restricts so much ankle motion, it is difficult to walk up simple, smooth, inclined grades, and the steeper the grade the more awkward it becomes.  It'd be no problem climbing a boulder field, or kicking steps up a snow slope, but walking up a steep trail may be a bit difficult.  Hmmm.  I'll do more testing.