Clematis

Last Friday night I drove the Mercury to the synagogue and several times someone asked me how I was. I said I was fine except a little sad because I was about to sell my dad's car and it was my last night with Bob, the car. One after one they explained to me how I should feel - happy to getting rid of an old car like that. Immediately after selling the car, I walked into Whole Foods on my carless walk home (good to get a little exercise), and ran into another close acquaintance. Same conversation. How can people be so dense? I held my ground but didn't slap any of them. One of them told me about how someone in their family had gotten rid of a loved one's possessions in a flash, and described this like it was a badge of honor to be free of sentimentality. It is such a personal thing - people need to be able to work through this on their own with compassion and without pressure.

I sold my dad's Mercury Grand Marquis today. I just don't have room for two cars at my condo, and I don't really need an extra car. I just loved having it and feeling as if my dad was driving me around. I was more interested in rehoming the car to someone who would love and appreciate this car that was loved by me and my family for 26 years. I was able to interview prospective buyers and find someone who was looking for a car like this and was very excited about getting it. Also, this guy's name was Charlie, like my dad. That was cool. But I feel crushed about having let go of his car, even though it was the obvious thing to do. Tonight I wrote the following for my Memoir Writing course. Summary: Grief is such a trip. So much commonality from one person to another and yet every experience of grief is unique. It can seem like you are lost out on the ocean with no life raft in a high gale. Everyone around is an expert ready to tell you how you should feel and what is really going on. Why were none of these people in my life willing to listen to my own experience? I know how I feel and don’t need anyone to explain to me how I should feel. Possibly the most annoying of all my early grief bystanders was my dad’s neighbor Mimi. It would seem like I should have been able to find some comfort in her presence, and to talk to her about her experience of having lived next door to my dad for ten years. When my dad was well, Mimi and I got along well. It wasn’t until he was near the end and after the end of his life that I felt the urge to slap her into oblivion. My dad lived very close to me for the last ten years of his life, after my mother died. Over those ten years we became closer and more dependent on each other in different ways. I tried desperately to save him in so many ways, and watched helplessly as he repeatedly got worse, and then better, but never quite as well as before. Toward his end, my life was a frenzy of racing in and out of his house, my house, and the hospital like a revolving door, fetching things for him and trying to keep my own life from falling apart. Scene: One day In his last December I parked right behind my dad's car in front of his condo, and was headed for his door, but there she was - my dad’s neighbor Mimi. “How’s your dad doing?” I really didn’t have time for this but, “Well, he fell in the kitchen and got a stress fracture in his lumbar vertebrae, and he’s in the rehab hospital for two or three weeks.” “Well this is near the end. He’s not ever coming back.” “How could you possibly know that? His doctor says after the therapy at this hospital, he’ll be stronger than he’s been for years!” “No, he’s headed downhill. I saw the same thing happen with my dad. This is exactly the same.” “No, Mimi, this is not the same. My dad and your dad are not the same person. If they were, we would be sisters and we are not!” I turned from her and rushed through his door, slamming the security door on my thumb. Dang! The bruise took weeks to emerge from under my cuticle and I watched it creep along my nail bed during the months after my dad’s death. Another day not much later, I was fleeing into his house and there was Mimi, “How are you doing?” I don’t know what I said – probably not much because I couldn’t stop crying. But as usual she had plenty to say. “You know, your dad is out of pain now. He’s in a better place now.” Better off dead than alive with me? Huh. I tried to control myself, but couldn’t really. “How could you possibly know anything about his pain? Or know where he is? Have you got his address at this new place?” A brief startle, then a smirk from her, “Oh yes, he’s living at 100 Heavenly Way.” I turned and headed for the door of his empty condo. Better to hide than to slap her. This time I avoided slamming my hand in the door.

Thank you!

I am taking a class this semester on memoir writing and I wrote what is below. The assignment was to write about an interaction with another person from our past, and then the same interaction from another person's perspective. How could I know it would be the last day of my dad’s life? His doctor referred him to the rehab hospital for three weeks, after which he would be stronger than he had been in years. Yes! Watching him decline had been agonizing and I was SO relieved. But after a week in the hospital, the staff summoned me for a “family meeting”. I had no idea what this meant and negotiated over the timing of the meeting, wanting to go to the pool on the way. They were very accommodating and kind to me. I was ushered into a conference room; around the table sat all of his therapists, the head nurse, and several administrators. They gestured to an empty chair at the table next to my dad slumped in a wheelchair. My mind whirled as I grappled with what they were telling me – what was the real agenda for this meeting? Gradually it consolidated into a pattern. They were telling me that he wasn’t doing well and they planned to discharge him after only ten days. They were giving up on him. One therapist told of picking him up for his therapy as he clutched the curtains around his bed in an attempt to keep them from dragging him away from the bed. How could this be? I looked at my dad, who had gone from looking somewhat embarrassed to looking very asleep. How could he sleep through this? What was I supposed to do without him? They suggested I think about it for a day or two. Today I watched Laura clean out my old Mercury and delve through the deep abyss of its trunk. She seems finally ready to sell it. It has been hard watching her sift through all of my old possessions, and along with it sift through the past. I tried to keep her company and advise her, as I do every day since my body’s death. It has been more than three years since I was forced away from her, but even in death I do what I can to help and stand by. Time is relative – especially for me. It won’t be that long before we are both in this form. I am grateful that she can hear me talking to her, but it doesn’t really resolve anything. She still grieves. In addition to practical advise about tires and money and whatnot, I’ve told her so many times, “I am SO sorry to have left you. I just couldn’t do it anymore.” I remember that day at the conference table. She thought I would recover and we would have more years of fun together, but after decades struggling with Parkinson’s I woke up every day exhausted. I knew how badly she wanted me to get stronger, and I couldn’t bear to tell her that I didn’t have it in me anymore. So there we sat with all those donkeys at that enormous table as they avoided telling her directly what they and I already knew. I was about to move on.

Thanks, and sorry to hear about your father.

Yeah! I'm in a holding pattern right now and plateaued, but at least I'm not gaining weight at the beginning of the new school year and all its stress...

I am finally getting ready to sell my dad's car, Bob -the Mercury Grand Marquis. I feel sad about it but I really don't have room for it, and a car is an expensive and bulky sentimental item. I am parking my new car, Udevash, in my neighbor's garage and Bob is in my carport, but my neighbor wants to move to Reno to be near family, and when she does Bob has no place to go. It seems like a big connection to my dad to be letting go of my his car. It's been like having him drive me around. Nevertheless, he keeps talking to me about it, and that has been helpful. This morning I did the final cleaning out of the trunk, and he hung around with me for the entire task, making comments about this or that and what I should do with things...toss it, put it in the house, etc. A couple of times he said, "Oh, you need to put that in your new car and keep it there!" A dust cap from a tire..."Your bike is missing one of those"...sure enough it was. I found something in an illegible plastic bag and heard, "Oh that's a raincoat - you should keep that in the back of your new car." Ok. He used to buy things he saw advertised on TV, and he'd buy two - one for me and one for him. Some of these things were junk, but many were good items and very worthwhile. Eventually now, I have both of them, his and mine... I sure miss him. I also found a giant folder that enclosed MRI scans of his entire back, slice by slice. It was done a few months before he moved to AZ in 2006. I wonder what was going on that required these scans. He didn't talk to me much then about a lot of things. "What am I supposed to do with these, Daddy?" No response and then, "Oh just stick it in the garage." Ok. There seemed to be something else he really wanted me to find, and I kept digging. Finally - found it! Two long plastic boxes...I wasn't sure what they were but opened them up to find some long warning things - like for it your car is disabled by the side of the road. I had never seen them before and thought they were surely no good now, but they had no batteries, but long reflectors that you pull out of their cases and arrange into big triangles to warn people. He didn't have to tell me to put them in the Matrix. A few weeks ago I cleaned the car inside and out, except the trunk, and the oddest thing happened. I installed a Bluetooth stereo in the car about a year ago and was listening to Janos Starker play the Bach Cello Suites while I was cleaning out the car. Suddenly in the middle of the cello suites I heard the opening bars of a tune called "Neria" by Oliver Mtukudzi aka Tuku, who died not long ago. This is one of my all-time favorite artists, and my dad had listened to him with me frequently. But the song Neria is one that Tuku wrote to his daughter about how much he loved her. So here I was all verklempt over cleaning out my dad's car and preparing to sell it, and out of the blue is this song. Nice to have him still hanging around with me. It's not the same as when he was alive, but it means so much to hear his voice and feel his concern. If I ever need them in the Matrix, he'll remind me where I secured them in a spot near the spare tire. I love that he's still taking care of me...

I'm not sure where that is...I'll look for it. I just read the last three pages on this thread to catch up. I have been writing about my last month on my thread Still Slogging Along...

Lena is still adjusting to her Chinese herbal remedy. Sometimes she just eats the food with the supplement, sometimes she refuses to eat it, and usually she complains about it and then eats it eventually. She does seem to think that I am clueless and have no idea that I am contaminating her food for no good reason. Sigh. I wish there was a way for her to understand what it's all about. I have been working a LOT. Last year I was doing two evaluations per week, but not all of the time. This wasn't really enough work and I had to pull some money out of my retirement accounts to get through the year, so I decided to get more work this year. This year I am doing four per week, which seems really crazy. Then last week and next week I ended up with five evaluations in a week. I have a really strict schedule that I have been following. I do evaluations on Mondays, Tuesdays, Thursdays, and Fridays. Wednesdays and Sundays I write reports and make food for the next two days, packing it up in bento boxes. Saturdays I don't do any professional work since it's Shabbat, but catch up on personal things, plan meals, and shop. I am staying close to the intermittent fasting schedule, getting plenty of sleep, and getting to the gym 3-4 times a week. It is not easy to stick to that. I lost twenty pounds over the summer and have been working hard to maintain that. I would like to lose some more, but given my work load, I am probably doing well to stay even. Last summer I managed to lose fifteen pounds, but then gained some of it back during the school year. Nevertheless, it's pretty great - I have spent the summer celebrating each little loss, and overall it's not little. I can wear clothes I had in my storage unit I didn't think I'd ever wear again but couldn't quite bear to get rid of. I was struggling with my weight during the last few years of my dad's life, but then after his death and the car accident I steadily gained - about thirty pounds. Now I am lower than I have been for some time, and it is such a relief. I have a friend who has been encouraging me via texts on a regular basis and that has been extremely helpful. She also told me about the 16 hr-8 hr intermittent fasting plan, which I think has been the key to my success.

I am so sorry to hear about Arlie's final end. I haven't been on the site since I've been very overloaded at work, but I think about you frequently and wonder how you are doing. There will never be another Arlie but I do hope that you can find a dog who can help you on your path.

I was bitten by the dog of a friend a couple of years ago, but it was an accident. I was cat & dog sitting for a friend and gave the two dogs something the cats didn't want in a two section pet food dish. Suddenly Alice decided she wanted it all and there was an instant dog fight and I was just too close. Lena bit me once by mistake as well; I was giving her some treat, it was dark and she nipped my thumb grabbing the treat. We were both shocked. I think a lot of bites come from the animal being afraid, and some dogs have serious emotional issues just like people do. My friend's dog Alice is now taking Prozac, and my sister had a dog, Bug, that also took Prozac because, like Alice, he was so high strung (anxious). Bug bit my dad once. He yelped and my sister and I both said in unison, "What did you do to him?" since he had a long history of teasing animals. It seems like it is a rare dog that bites out of sheer aggression.

Lena seems to have gotten fairly used to her new supplement. When she has several options, as in this trifecta breakfast, she eats that part last, but she eats it and is not crying and complaining about it. She seemed a little thinner after being ill and is now making up for lost meals. I have read that cats with kidney disease tend to lose weight and I don't want to see her get scrawny so I feed her any time she likes as long as the food is part of her plan. Not long ago I was always trying to get her to lose a little weight; her first vet said she should, and she did lose about half a pound. Now that is the last of my worries; I am more concerned about her hydration and overall health. She seems ravenous all hours of the day, and I am enjoying watching her eat. This is the cat I am used to...

Awww...I feel for you and think about you and Arlie every day...

That seems ridiculous and unnecessary...

Awww...that must be really hard. I feel for you...

I love Lena's new vet. We are slogging along. She got better when she started on the antibiotic, and then better after she had completed it. Now we are adjusting to life with kidney disease. We went to a Pet Partners evaluation to see if she could keep on as a therapy cat. She made her preferences clearly known with some hissing, snarling, and unsavory comments. I surmised that meant no, and she is now a retired therapy cat. She was prescribed a Chinese herb called Rehmannia Eight, and it is to be ground up and mixed with her food, more than once a day. She is also taking a probiotic/prebiotic/anti-inflammatory supplement for pets, the powder from two capsules per day. She does not like the supplements at all and has all kinds of things to say about me ruining her food with supplements. She cries and whines when she sees it, and I feel really badly about ruining her food for her, because she loves to eat. I finally found a compromise about this. I mix up the supplement with some food in the morning and put it in a container. Then, at each meal I put the unadulterated food on one side of her bowl and a little of the stuff with the supplements on the other side of the bowl. She eventually eats all of it. When she has eaten all of a given day's food with the supplements in it, she can have pure cat food fo the rest of the day. She is eating about six small meals per day. This seems to be ok. I hate to put something in my darling's food that she thinks is nasty, but I think it's good for her health...

That's too bad that you can't get a local vet with whom to build a relationship for Arlie. I think the roaming vet and her assistant/husband are good hearted people who love animals, but I think this kind of slippery slope happens when professionals are isolated and have inadequate resources. You don't think of resources you don't have at your disposal. Since she does not have an ultrasound, she cannot get a sterile urine sample from a cat because you need to guide the needle to the bladder with the ultrasound. She should be working closely with someone else and/or making a lot of referrals until she can figure out how to better equip her mobile vet clinic.

Thank you! Lena's new vet said that she is in the very very early stages of kidney disease, but the reason she was feeling sick, lethargic, cranky and not hungry was that she had a UTI. She prescribed an antibiotic and a Chinese herbal remedy called Rehmannia Eight Combination, that is supposed to help her with hydration and delay the progression of the kidney disease. She also told me that Lena does not have to change her foods at this time and is nowhere near needing subcutaneous fluids. Better yet, she told me that there is every reason to believe Lena will have a long life and she will be happy and healthy for many years. Her old vet, the roaming vet, never called me back, but her husband/assistant did. I told him about the UTI and what the new vet said, explaining that she was able to make this diagnosis with the additional information from the UA and ultrasound. He said that they were going with the strong recommendation they had given me of aggressive treatment - subcutaneous fluids and changing her food to that nasty low protein stuff made mostly from pork liver - because they were figuring her clinical symptoms - feeling sick - were due to a very rapidly progressing kidney disease, and that is why they had told me she would not be likely to live very long. Had I stuck with them, they might have been right, because she would have been struggling along with an untreated UTI. I find that disturbing, but am not obsessing over it. I am very much relieved that Lena once more has a vet I feel very good about. Lena's first vet, Dr. Brown, who had twins a couple of years ago, leading me to search for a new vet and I ended up with the roaming vet. So now Lena could see new vet or her first vet. Only problem is that their office is in Flagstaff and that is an hour's drive away, but I can do that. It is a much better alternative than having her seen by someone in whom I have no confidence or trust. And Lena has been on the antibiotic for three days now and is feeling much better. It is a big relief. I was so worried seeing her mope around. I love her SO much!

I was very impressed with Lena's new vet, and Lena seemed to like her as well. She said that it really is essential to have a urinalysis as well as a blood test to make this diagnosis. She also told me that even if Lena does have kidney disease, she is likely to have a long life with good care. She also told me that there are a lot of options to slow the progression. I will know the results of the new lab work tomorrow, and am hoping and praying for the best...

Lena has an appointment for tomorrow for with the vet that my friend Paula recommended. She is the vet who bought Paula's practice when she retired. This is good. Paula did say that Lena's bloodwork was suspicious and it is possible that she may have kidney disease, but if she does at least I will have a diagnosis in which I can have confidence of accuracy. Of course I am hoping that the ckd diagnosis was incorrect. I'll keep you posted when I get any news.

I have been doing my homework, obsessively and perseveratively as is my specialty, researching kidney disease in cats, diagnosis, prognosis, treatment, and so on. The vet is stuck on Royal Canin renal diet. When I read the ingredients, I thought no way ever, because it is highly processed and its primary ingredient after water is pork liver. Pork Liver! This is a cat who sleeps next to a stack of yarmulkes. I have gone to great lengths to buy her the most natural and whole-food products I can find, just like I do for myself. I just can't believe she has chronic kidney disease at the age of 8-1/2 after eating a diet selected to prevent that for the last five years. It doesn't seem possible, and maybe it's not. I found out that there are some other things that could have resulted in her lab results. I also discovered that a complete assessment includes a urinalysis at the same time, blood pressure, and an ultrasound to actually look at the kidneys and other organs. You have to rule out infection, kidney stones, kidney obstructions, and some other things. Also, if dehydration is a possible factor, the cat's hydration needs to be stabilized and the labs repeated in about two weeks. This vet only did one blood test and called it a diagnosis. I had a friend many years ago who told me that when she went to medical school, one of the first things they were taught was that you can't treat a number. If you see an abnormal number on a lab result or other finding, you do a thorough assessment to arrive at a diagnosis, and only then can you consider treatment options. I had a doctor years ago that I saw in Sedona and I didn't think that much of him, but it's a small town. When my dad moved out here, he went to my doctor, who was getting ready to start treatment of something about which he had a number but no further assessment upon which to base a real diagnosis, and my dad was going to do it. I said no, not my dad. I found another doctor, who did a thorough assessment and Dr. #1 was just wrong. He was going to treat my dad for a condition that he did not have. It's unfortunate, but you have to do your homework, for yourself and your loved ones. And I surely do love my cat! After a few days of trying, I finally got hold of my retired vet friend Paula. She worked for somewhere near 40 years before she had to retire because you can't be a Vet and take blood thinners. She had a sterling reputation, and was highly respected. Anyway, she asked me for the history, lab numbers, etc. and she told me that I was right in what I had come up with. She said that these results were indicative of a concern in the kidney area, but there wasn't even close to enough information to reach a definitive diagnosis, and certainly not such a serious one that requires such significant life changes. Not time to panic yet, she said, and that time may not even come. This is good.

I feel so so sad about Lena. I went to synagogue tonight and sat there crying during the service. In six weeks I will have had her for seven years. I thought we would have twice that again, and now it looks like the bulk of our time together may be over. I love this cat so so much. Who knows how much time we have left? I only had one very short conversation with the vet since she called me while I was at the register at the grocery store, trying to help the cashier sort out the groceries for my elderly neighbor and myself. I have talked to her husband (who is her assistant) twice. He said that they were talking about Lena and plan to come see her this week when they are in Sedona to give her fluids. Then sometime soon he will show me how to give her subcutaneous fluids. I bought an IV pole on Amazon...

Thanks, Marty. That is nice that Kay's church is praying for Arlie. I wonder if my synagogue would do that - I kind of think not, but it may be that my friends there might.

I did give George my info and also my progress and where I got stuck - finding info about phosphorus. He may well do better on that issue than I have. It is horrible to watch our beloved furry family members suffer and not be able to do anything about it. I have thought for at least a year, off and on, that something was not quite right with Lena. She has been a little crankier, most of the time, and sometimes she just seems to be tired and lethargic. Also, she started throwing up in a pattern that I realized was related to having an empty stomach early in the morning. I started feeding her earlier in the morning, and that was helpful but not totally effective. I felt like I was being told from all sides that all of this was normal for cats and I was probably just worrying excessively over nothing. But looking back, I think she was actually showing symptoms - the intermittent lethargy, mood change, vomiting - all of that is classic for chronic kidney disease (CKD) in cats. But nothing significant showed up on her bloodwork. Her SDMA, the early CKD marker was 12 two years ago and then 13 one year ago. 14 is the top of normal. This year it is 16. I suppose I could have had bloodwork done earlier - at six months rather than eleven months, but no one suggested this. Actually, no one ever suggested that I get bloodwork or pet insurance for Lena - I just came to this myself. I wish I could have known earlier, but I don't think that was actually possible. It is not generally diagnosed until there are other signs on the bloodwork like elevated creatinine, and that did not show up until just now. I really thought I could help Lena dodge the bullet of CKD by giving her this fabulous wet food that is high in moisture and low in everything you don't want (fat, carbs, synthetic chemicals, sodium, fillers, etc.) Who knows? It is entirely possible that she would have gotten it sooner had I not switched to that food from the dry food five years ago. I suppose it's natural to wonder if we could have done things differently. I remember once Lena's water ran out and was dry - maybe it was twice. I responded by getting her two bowls and bigger ones, so it would not happen again. I don't think that brought on kidney disease. I know in my head that I have been very careful in my care for her, sparing nothing that I could ever think of. The bad news in that is that there is not really much more that I can do. Well, I can give her subcutaneous fluids, and there may be more that is possible, but it is a progressive disease that affects an awful lot of kitties...

Hi George - thanks! I sent you my info in a pm. Cats with kidney disease are supposed to have high liquid, low protein, and low phosphorus. Lena mostly eats Simply Nourish canned food; it's a PetSmart brand. It is human quality food that is low-fat and virtually no carb. It is low protein (10%) because the moisture content is so high (83%). The phosphorus is supposed to be low, but this is a little unclear. I called the company at 888-839-9638 to find out about the phosphorus and I didn't get the best answer. He asked me for the flavors. She mostly eats Chicken Stew, Chicken & Duck Stew, Chicken & Vegetable Stew, and Tuna & Potato Stew. He told me the numbers ranged from .59 to .70, and these are good numbers but he told me it was grams per 3 oz can. The numbers should really be a percentage of DMA (I think that means Dry Materials Analysis). If those numbers really are .59% to .70% of the DMA, that is fabulous because it means that the food she loves and I feel good about and have a stockpile of is perfect for her. Lena has a history of eating anything that says "cat" on it, but she seems to be getting more fussy. Not real crazy about new brands unless it is mostly gravy/liquid, and some of those it's hard to find out the phosphorus on. I found a product called lil' soups that Lena more or less inhales, and that is great because it's mostly liquid. But I can't find out anything about them. Like the phosphorus... The other thing that people do for cats with chronic kidney disease is to give them subcutaneous fluids to help flush the system and add more fluids. That is supposed to slow the progression and also to make them feel better. I also read something about tracking their weight (daily), but I'm not sure what that's supposed to do...something about fluid retention and processing by the kidneys? I'm not sure.