Looking Back to Last Year: Hard Won Lessons.

As this year comes to a close, it is natural to look back over all that has happened in the past twelve months.  As I do look back and remember, I have to acknowledge that this past year has been one of the most difficult years of my life. In the past twelve months, many things happened that changed my perspective on my life.  

In February, I was hospitalized with a near fatal kidney infection which became septic and caused damage to my kidneys, liver, bladder, and heart. I spent two weeks in the hospital moving from ICU to the GI ward, and then finally released into home nursing care. It took another four months to recover from the sepsis causing me to have to have a central venous catheter port implanted under my collarbone in June. The central port was implanted because I am now dependant on receiving most of my nutrition, fluids, vitamins, medications, lipids, fats and proteins from an IV connected to an artery just above my heart. This is a huge change in my daily life; a milestone moment in my medical condition. Becoming dependant on partial or total parenteral nutrition is one of those milestones that signals my condition has gotten far worse.  It is comparable to a cancer patient being told they have moved from stage III to stage IV with most research pointing to a 3% survival rate beyond five to six years.  If fact that is how my doctor’s presented it to me so I could understand the enormity of the situation.

Hospital stay in Febuary, with both service
dogs giving healing

The announcement of my change in condition was a game changing proclamation in my medical treatment.  We moved from discussing how all my treatments were geared to help me live a more normal quality of life to now discussing how all of my treatments are geared towards delaying the inevitable.  This is the kind of fundamental shift in perspective that affect every part your life.  I have been keenly aware that my medical condition was not curable and that I was for the most part inoperable, in terms of doing anything to change my situation. Both of my specialists in hematology and gastroenterology are also oncologists and used to handling patients in the later stages and they have been incredibly instructive in how to maintain quality of life while delaying a bowel rupture.  I am not one to place a lot of importance on timelines for survival in medical treatment. I have been told I would die or should be dead in a certain number of months many times previous and I have successfully exceeded my expiration date now three separate times.  So when my medical team discusses timelines I think of them more as guidelines than a hard date. Anyone who has dealt with serious medical condition knows that every person reacts differently to treatment and it is far more important to focus on the daily tasks and how to make each day more livable than to focus on how many months the research says you have left.  Like previous times, I am staying focused on the daily tasks and working on getting through this week and then planning for the next and so on and so on.

At the Infusion Center at Dominican Hospital, April.
With myservice dog, Ellie

Me with Ellie, my service dog during a training
class at Operation Freedom Paws

There is one great thing that a milestone like this does for you; it kicks your need to live in the moment into overdrive. Suddenly the importance of being present becomes very real.  My medical condition has always been a blessing in that sense, by giving me a real honest understanding of mortality at an age early enough to be take advantage of the knowledge and work towards more loving relationships with my friends and family while I still could. It is one of the reasons, why we have never put off traveling. Please don’t misunderstand me – I am not giving up the fight, rather I am focusing on living as much a possible.  The big balance point is how to live as much as possible and not place your body in harms way? For me it turns out to be a precarious balance between treatment and activity.  I am now at a place where I have to plan out every activity on how it fits within my treatment schedule and how my body is doing physically.  That is a fun juggling act when your body does not always cooperate.  For me a weekend trip can cause a week’s worth of needed rest.  So my daily life becomes a bartering game and series of trade offs.

The medical treatment needed to keep me going presently is complex enough to overwhelm most people, but then add on the ridiculous complexities of transitioning from private insurance on to Medicare and you can begin to understand the nonstop battle for medical care that consumed my life from September through the end of the year.  Medicare has a well-known gap in coverage that does not cover home infusion care. As most private insurance companies have come to accept that home infusion is a far more efficient and far less costly way to treat patients who need IV infusions.  Medicare falls behind in not covering this treatment and instead requiring patients to go inpatient to hospitals or nursing homes.  There is current legislation to fix this up for vote in congress, as the national study revealed that this gap in coverage costs Medicare around $80 million annually. As the vast federal program evolved with its complicated coverage components, home infusion fell partly through the cracks. Medicare does cover the actual drugs given in the home. But it pays nothing for the supplies - tubing, bags, needles, pumps - or the administrative, pharmacy, and nursing services that may be involved. This leads to very high out of pocket costs.  I had to buy a very expensive supplemental plan to help me afford to continue the treatment, which I need to survive.  The cost for my treatment now costs me roughly 75% of my total monthly earnings, and will triple my annual costs.  That kind of financial reckoning forced me to reevaluate what was important and rewrite all of my advanced care directives to reflect the new level of financial burden I expect my medical condition will place on my family’s finances over time. 

Me following surgery to implant the central catheter port, in June. Ellie
amazed my surgeon by performing the task to help me lower my BP, he stood
by and watched us work the task and lower my BP 40 points in 5 minutes.
He had never seen a service dog perform a direct medical task, we impressed
him and the staff that day.

Me with my portable IV pump, it is now
my companion monthly, for 10-14 days.

A closer view of the inside of my IV pump - it
all fits inside the R2D2 bag, which rolls.

Between the changes in my medical condition and the transition from private insurance to Medicare most of my concentration has been all used up.  I found myself staying away from social interactions, and I ended up being homebound for the predominance of the year.  It was necessary to do the level of healing and research that had to be accomplished this year, but it took a toll on my friendships.  I had been warned that I would lose most of my friends when I began really sick. In fact nearly every person I spoke to that had experienced the end of life journey from one side or another, the lost of friends was their first lesson to offer me.  I knew it would happen intellectually but experiencing it emotionally is something no one can prepare you for, no matter what they tell you.  Thankfully most of the fall offs have been the expected absences due to life, which are all understandable. But I have had a few unexpected moments that were deeply hurtful, where long time friends somehow decided my need to ask for space in which to heal was some terribly selfish action to become a bad friend.  I fully admit to being less available to be a sounding board or open place to vent friends’ frustrations over their own life issues, in the past year.  I have had to circle my wagons close to focus on caring of my self. I was deeply surprised when one long time friend concluded that I was a tragic drama queen because I could not take the time to listen to their complaints, in a timely manner.  I guess I should have expected it, and I had been warned that something like that would occur but it still hurt when it happened.  It hurt and it taught me a to change my perspective, like everything else did this year.

Jeff with Selah while teaching the training class at
Operation Freedom Paws 

Jeff with Selah, teaching doggie yoga at OFP

This past year has been hard fought and hard won. As I move in to the next year I go with a far different view of what is needed and expected.  I am still trying to live in the present and cultivate loving relationships with people who can have a deeper awareness of what I am facing daily, and offer a support to that process.  I still focus on the daily tasks and being grateful for the myriad of blessings in my life.  I am remarkably blessed to have the unwavering support of my husband through all of  this, together we make a strong team as we journey onward into the days ahead. I am extremely lucky to have his love and support every day.  We are extremely lucky to have the support of our service dogs, and the ongoing training and emotional support from Operation Freedom Paws, which has become such a vital part of our family. 

Some of our extended family at OFP,
at a local event supporting our veterans.

This past year was so very difficult and many mornings were met with a prayer for it all to be done, what kept us both going through it all was the tremendous support from our extended family of the staff and clients of OFP.  They provide a network of people who understand disability and illness and continually remind us of how our lives can still be placed in service to help others, giving our family a purpose beyond the daily medical treatments. I am forever thankful to all my friends, family and extended family, who have been there without question to do the smallest things counting for the largest blessings in our lives.  We could not have made it through this year without those people who have been there to help when I could do nothing more than try to make it through another day. Those people brought us food, watched our home, cared for my husband, keep us sane, washed my hair, send messages and did the smallest of kindnesses; which made the difference in our family giving up hope.  To those of you who have been there, I can never thank you enough for all you gave us, when you had no idea how much it meant.  You are the reasons we are still fighting and still wanting to give what is left of our lives to help others.  

Tomorrow we wake and start the New Year with hopes that next year will be easier and we can benefit from the hard won lessons of the past year.

Jeff with Selah and Myself, with Ellie in my lap. Picture taken by Vicki Topaz, on the set of her sequel to her film project:
Heal! Veteran's Speak about PTSD

Living With Chronic Diseases - Two Remarkable Articles of a Doctor Talking to a Patient and the Patient Talking Back: Great Resources

Sometimes when you are living with a chronic medical condition the world does not make much sense.  You learn the limits of your body in all kinds of strange ways.  Pain that would drop the average person to the floor over time becomes your daily roll out of bed. Spending hours trying to figure out how to dress for a medical appointment so you don’t look too put together and the doctor does not believe you or you don’t look too bad and the doctor thinks you are giving up. The things you start to find normal are far outside what most people see as normal.  Most people go to doctors to fix a problem, they have a medical issue and they and the doctor work to resolve the issue.  But with chronic illnesses sometimes there is no fix.  In chronic illnesses sometimes you go to a doctor to start a relationship because you know one day you will need their expertise even though all their expertise will not fix you. 

Ellie and I in another hospital stay, a recent round of sepsis. Those are words
you don't really think your are gonna say a lot. But I have learned that over
anything is possible. I have had three rounds of Sepsis now. 

This open letter to a doctor - it was in response to an article written by a doctor explaining why chronically ill patients with non-fixable conditions scare doctors. Both the first article and the open letter response are very well written and explain so much of what I have lived and experienced in the past 15 years.  If you are starting down the journey of a chronic illness, living with one or helping a loved one live with one - these two articles are a definite helpful read, they are honest and candid about the interchanges between patients and doctors and how human frailty on both sides of the coin can be a point of the clearest and most beneficial care. Here is the open letter from a patient with chronic illness to doctors: http://themighty.com/2015/11/to-the-doctors-of-chronic-illness-patients/

The original article written from the doctor's perspective is linked in in the  open letter and here is the original url as well: http://www.degosdisease.com/patients/stories/letter-doctor-those-chronic-diseases-read-it-its-so-valuable

Both of these pieces hit me so close to home with what I am going through currently in my battle with my own non- fixable medical condition.
I am about to start a new relationship with a GI specialist which in the best case will be the doctor and surgeon who has hospital privileges at the closest hospital capable of dealing with a life threatening emergency surgery that is the possible outcome of every bowel obstruction I experience. I have bowel obstructions at least a couple of times a week, they are part of my existence and they are becoming more serious and more frequent and that is just how this goes. This is the eventual outcome and one that is the realistic preparation for an episode that will occur in the next couple of years of my life. One of these bowel obstructions will rupture my bowel and parts of my intestinal tract will loose blood supply and die off. When a bowel obstruction goes bad it happens fast and the only solution will be an emergency surgery within hours to prevent death. I have known this fact for a few years, and it is just part of my medical condition. It is not unfair, or sad, or overdramatic or anything other than what will eventually occur. I consider this knowledge a blessing. I know the day will come, I don't where or when but I know it will occur. My attempt to have a good working patient doctor relationship with an excellent GI doctor is part of my preparations to survive that day. I will need a damn good GI surgeon who understands my case history and has dealt with very complicated, multiple previous surgical reconstructions; which have left my abdomen full of scar tissue and very little small intestine.

Ellie and I in the hospital, stays are so much
easier to tolerate because I have her with me.
Before I had a service dog, the predominant
experience of hospital stays is how much time
you spend alone. Hospitals are remarkably
lonely places considering someone opens
your door to come in and poke or prod you
two hours.

I am starting this relationship knowing full well that there is no solution, no cure, no magic, new, or experimental treatment.  There is only the clean up of a ruptured dying bowel and the salvage of any part of my GI tract that could keep me from living completely on IV nutritional replacement.  The surgery will end in some part of the function of my GI tract happening in a plastic bag outside my body.  I know this, once he/she has read the 15 years of medical history he/she will also know this. Then there will be the collective silent head nod as that realization is shared. My hope is he/she might have a perspective which may delay this surgery for a little while longer, and that together we will research on how to delay it for as long as we can.

This is a scary appointment, one I am nervous about.  I am extremely lucky to have a great general doctor who has known me and helped me survive the last 15 years. It took me a long time and many failed attempts with other doctors to finally find and build a good working relationship with her. She has worked with me to help me live through three different expiration dates, that I was not supposed to survive. She has seen the progression of symptoms; she has seen me fight tooth and nail to stay alive.  She also is willing to work with specialists, read and research articles. She always admits to me when she does not know what to do, and we talk through how to approach things.  She is the first doctor who I have ever felt that treats me like a person with equal intelligence and resourcefulness. I am extremely lucky to have her as my doctor. It is why I travel 2.5 hours to see her 2x a month. I don't drive anymore so securing transport to her office is a juggling act of multiple schedules with multiple people. And the distance is why I need to open a relationship with a GI specialist who is closer, because when a bowel obstruction goes wrong it goes very wrong very fast and I have only hours before it goes too wrong to fix and I die. To prepare and to continue to fight to stay alive I have to have a working relationship with a GI specialist and surgeon within range of the closest hospital that can handle a serious bowel rupture in a patient with multiple previous surgical reconstructions. That is the honest reason for the visit and that is a hell of a "hi my name is bomb" to bring into the exam room on your introductory visit.

My hope is that this new doctor will appreciate the candor and the realistic expectations of the situation. That out of this intro we build a relationship that will help me keep fighting for as long as possible.

A hospital stay over valentines day - the balloon sang
"hot stuff" every time it was moved, so of course we tied it
to my IV pole so I would be a parade float walking the halls.
My husband recounts that he got me the singing balloon to
the nurses keep track of me . . .
I used to try and make a break for the vending machines.

I don't really like the idea of my health update posts to be public, not because I don't want people to know about my medical condition, it is already fairly public knowledge. When you walk around with an IV line hanging out of your chest going into a rolling IV pump and your service dog people tend to notice that you have a medical condition. But still I always question if I share too much, because it feels almost too vulnerable to share this level of honesty with my friends. People don't react well to words like death and eventual outcome in the same sentences.  Most people want to see positive affirmations of how you are fighting the good fight mixed with some dark humor about where does that doctor think that tube is going???  But so far the good coming from people reading my experiences is outweighing the fear of the bad and if just one person get something helpful, then it has been worth it.  With how hateful so many comment threads have become in recent months on so many public social media sites, I am not willing to subject my decisions about my health care to a stranger who's goal is to use the comment thread to insult or belittle my situation. The world belittles and degrades sick people enough already. I share my experiences with my medical condition in hopes of helping to educate others on how to advocate for their own health care. I don't have any answers; I only have experiences that might spark an idea or discussion that could help some one else.

photo of one of my IV poles with 8 bags
running, it reminded me of a crazed chandelier
I remember texting that joke to a friend with
this picture and they got offended.   

Today I am sharing my experiences as sparked by some other peoples' experiences with chronic illness.  I highly recommend passing the links on to anyone you may know starting their journey with a chronic condition, living with a chronic condition or their caregivers as both of these articles are excellent resources.

A drawing I did of myself in the hospital
I try really hard to keep my sense of humor, this is a common
theme with other people going through similar medical situations,
because if you don't laugh, you cry.  

A funny side note: In the open letter, the sign that Catherine Richardson is pointing to in the picture here to the left, is hilarious to those of us who have had this exact sign on many of our hospital room walls. Limitations/Special Instructions: No Food :(  - I have had more times than I can count. I actually rewrote the sign in my last hospital room to read much the same way with the following answers: my doctors - lost track, my goal - not die, and the I am going home - as soon as I poop or fart.  it made the nurses giggle and a couple took pictures of it before they erased it. Oh and the French Braid Catherine is wearing is the perfect hospital hair trick - because you know you will not get to wash your hair for 5-6 days. For someone with my amount of red curly hair - if not tied down my hair can get to epic size before they come hose it down with that itchy no rinse shampoo stuff.

One of the great things I got from the open letter Catherine wrote is how similar our experiences have been, that I was not alone. One of the hardest things to come to terms with is the isolation that happens during chronic illness, another eventual fact; you spend a lot of time alone.

A photo of Catherine Richardson - the author of the open letter.  
A friend pointed out that we looked similar - I laughed and replied,
"well you know us sick girls, we all look alike"

Warning Vent Ahead:

Today I had to block someone from my Facebook page, it is of no consequence who they were because they did not have my best interest or the interest of those I love in their minds and their intent in their comments was to be hurtful and I don’t have room or energy for people like that in my life.

Ellie and I after I was released from ICU
- with Septic infection in my bloodstream.

There is no doubt I live with a very serious medical condition.  I have more medical records and test results from the past 15 years that most people accumulate over their entire lives.  My condition is real, proven and something I strive to live with in a positive way.  There is no way to fake blood tests, Sepsis is pretty straightforward life threatening infection and hospitals don’t let you hang out in them for fun. When I am in ICU it is for a reason. That IV line that connects to my body every month is real and I don’t pull that IV pump around for giggles and grins, it saves my life. I would not wish the level of pain and anguish I have lived through with my medical treatments and condition on any other person.  My condition is terminal and I will go through an eventual decline that will continue to limit my abilities to do things and that is my reality and it sucks but I know that it will come and that is why every day for me is precious.  Every day I awake to see my handsome talented husband, and our beautiful service dogs is a glorious day. 

Ellie and I getting another week of infusion treatment

 

Ellie and I post op - following the surgery to get my central port.

Some years ago I decided to be open and honest about my medical condition, I blog and write about it in great detail sharing experiences of hospital stays and pictures of intense treatments. I share this to help people understand what we as a family live with and to help others know that even when things seem bleak there is always something positive to hang on to in the darkest hour.  Pain in my life is a constant and it does effect my ability to do some things and it does wear on my emotions but it does not rule me.  Pain ebbs and flows, up and down, back and forth and I float along in it like the waves of the ocean. Some days the waves crash and pound my body against the rocks and other mornings I float along smooth as glass.  But the pain level is not what is important ever. What is important is kissing my husband good morning, holding his hand when mine is trembling, feeling his hand on my back when I cannot sit up, the softness of Ellie’s fur in my fingers and the love in her big brown eyes when she lays her head in my lap.  Those simple acts of love matter more that anything else and that is what is held on to during the pain. Pain is an electric impulse through a nerve bundle and it has no malice for me it just is part of what makes me a stronger person.

My Portable IV pump - it fits inside
my R2D2 rolling bag

My IV line attached to my central port and
connected to my portable pump inside R2D2.

So when some one asks me, “how can my husband and I travel to places and scuba dive if I am disabled?” I get livid.  Disabled people do all manner of things.  Scuba just happens to be what is sacred to us and it is so because when we are under the water we feel strong and whole in our bodies the way we used to before our illness and injuries.  I dive because it makes me feel normal for 1 hour at a time.  It is same reason Wounded Warriors and other Non-Profit organizations help disabled people learn to dive so they can feel that sense of freedom again with their bodies.  I am blessed to know disabled people who win buckles in national Rodeos; I am honored to know disabled people who race cars, run the rapids in kayaks and sky dive.  The difference when a disabled person does some adrenaline type sport it takes more planning and modifications of the equipment.  But life for a disabled person takes more planning and modification. That planning and modification does not make what the person is doing any less spectacular or the person less competent, frankly it usually highlights how remarkable the spirit and strength of heart that person possesses.

Isla Mujeres - Cliff of the Dawn - and one of the most
beautiful and healing places for me.

So when someone implies I should not be celebrating the 5^th anniversary with my loving husband in a tropical island where we can go scuba diving because I am disabled – I tell them to go pound sand and block them from my page.  We save and scrape our pennies all year to make that trip and we are not going to expensive places; we go there because it is mystical and magical and filled with other people we love. Our family dinner downtown on the island, I had my favorite thing Lima soup for 60 pesos or 3.29 USD.  Our hotel room cost less on the island with every meal and drink included than a Best Western room costs here with nothing included not even a bottle of water.  Again, we go to that island because it is not about the money – it is about the wonderful people there whom we have worked with for years and who care for us like family.

We dive because it makes us feel whole - and we are lucky to
have made friends with great dive masters who understand
how to accommodate our conditions so we can dive safely.

My husband knows more than anyone else how many times a doctor has expressed how little time I have left, or how awful the later parts of my decline will be.  My husband more than anyone else understands that I have surpassed my medical expiration date 5 times and I have coded and come back 3 times.  My husband has been the one pounding on my chest breaking my ribs to get my body to breathe again, and he has held my hand when there was non one there but the sound of beeps from the machines.  I will go back to that tiny little island every year to celebrate our love until there is no way to do it.  I will grab my IV pole and roll it onto the plane and through the airport and on that damn ferry until I can no longer.  Because there will come a day went I can no longer make that trip and will only have the pictures and the memories.  I will not apologize for living what is left of my life to the fullest and for spending each day with a smile on my face and making great new memories in my heart. 

We are as goofy underwater as we are on land -
Life is short, so we fill it with laughter.

 My husband is a damn honorable, talented and huge hearted man.  He spends his life giving back to others, helping others to give thanks for how he himself was helped. I have seen him go do this work with his hands trembling from pain and come home in total agony, but again it is not the pain that matters. What matters are the people, who he connects with, who he can help on some level and who through helping them heal his own soul.  I try and help whenever I can and I will until my dying day. Because that is who we are, it is no trick or game; it is who we are and what makes us happy. We are blessed to have found and be a part of similarly thinking people who get it in their bones that in helping others you refuel your spirit and heal your soul.

Another view of the waves at the Cliff of the Dawn -
To the Mayans this was a sacred island where you
came to heal . . . I kinda agree with them.

So I blocked the idiot – removed and deleted any and all nasty posts he said to me, because the time I got left will be spent positively, in service to my community and in making this place better than I found it in any way I can for as long as I can. As I see it there have been multiple changes for me to have been ‘called home’ and each time I awake and come back so someone in high places still has work for me to do and I will keep doing it until I am done.

For those who don’t like it – don’t let the door hit ya on the way out.

 

Jeff and I, exhausted after a dive.  Yes it is hard for us to do it but the memories
are worth it. I can tell you when I have those weeks ing the hospital and things
are real tough, these are the pictures and memories I hang on to, and fight
so we can go back there and make more memories.

The white sands of North Beach on Isla Mujeres - with some of our greatest joys and passions, the work Jeff does with Operation Freedom Paws, paw prints for our service dogs, and the Rolleflex camera and the love we share around all of it.

It Is What It Is; Almost By Definition

So I don't know how to express this - so I am just gonna let it fall out. I have been alone quite a lot since going to the hospital in February. Being alone as a sick person is not unusual it is in fact the norm most of the time. When you are sick you spend a lot of time on your own by yourself. You are alone in the hospital, you are alone at home, and now even when I am out in the world I am still alone; alien to the rest of the world around me. This last crisis of illness has been particulary hard, in terms of the loneliness factor. It was arguably one of the more difficult medical hurdles to overcome in the past few years and the treatment was unpleasant in the best moments and really damn painful most days. 

Just got out of ICU with second case of Sepsis,
I spent little over 4 weeks in the hospital and then
another 20 months in home nursing care.

I have had serious sepsis 3 times now and each time it kills off a part of me, the first time it took my intestines and my marriage, the second bout took a gaping whole in the muscles of my abdominal wall and my dreams, this time we were scared it would take my heart valves not so far it may only be a kidney or so. I don't know all this bout will be lost but I know part of my souls has gone along with it. This bout has been hard And I was and am alone a lot. I have Ellie of course, my service dog and trust me if not for her I would have gone crazy pounded my head against doors (and if I did that a little she is not gonna tell you). Ellie has been the unconditional love wrapped in fur that has given me reason to go through one more day. She is on many occasions the tether to me to stay in this fight. During this infection sepsis craziness I began a slow, stumbling melt down into a really dark hole.

In recovery from Something -
you start to loose count

It happens, my therapist says so. It happens, you get close to death medically and you think about it, you think about it a lot, you calculate the medical bills, if it would better if you were not here making more medical bills and you debate which is better to be here or just to slide under the waves. It happens, it is normal, and it is part of the processing of being really sick; and it sucks. I am a positive person, considering the amount of medical crisis I have been riding shotgun down the avalanche for during the past say 15 years, I tend to classify myself as really freaking strong and positive. 

Ellie and I in the hospital: heaving her with
me is how I get through it all

But as much as I long to be a walking motivational poster, or wise sick person who em parts the wisdom that only comes from standing on the edge of the knife over the abyss; I have my bad days too. I have more cracks in my armor than can ever be repaired and wholes in my soul which are slowly filling with the puddles of sorrow.

Lately I have noticed I don't feel like I fit in anywhere any longer, like I have been sick too long to be normal. Walking around with a rollingIV pump does not do much for the fitting in part and the stares and questions I get if I manage to walk into a Safeway are all pretty invasive and demoralizing. Everyone stares, I am used to that even without my little rolling Iv pump - cause everyone stare with me with Ellie. Only now they don't ask if I am training her - they can tell that she is my service dog, my illness is in no way invisible. So the staring is a little different, it is more filled with pity and even suspicion some times. Mother's pul their children away and to the far side of the soup aisle squeezing their little bodies up against the cans scraping their little faces along the campbell's line up as they try and side step by single file as far from me as possible just in case my terminal might rub off on them. One poor little girl who really wanted to pet Ellie got yanked into last week by her mom who screeched that is a service dog for a really sick person you cannot touch it. I just stood there and let the egg of that comment run slowly down my face and splatter on the floor in front of us. 

One of my first first really big hospital stays for yet another
bowel blockage,it was two day before Valentine's Day
and Jeff brought me this huge flaming heart ballon that
sang Hot Stuff every time you hit or moved it. At first it made me
resemble a parade float but it came in handy when the
morphine made me start hallucinating on day 3 and I kept trying
to escape. It is hard to get away when you walk like a snail
with a giant pole and a flaming ballon that sings hot stuff.
It is no a tradition for me to get singing balloons in the hospital
always tied to my IV poles.

We have had visitors, and that is nice and hard sometimes, because I don't have much energy; so I get tired and don't want to be rude and say I need to go lie down. But more so I just don't feel like I belong in the world of the living much any more. I can handle the isolated run to a doctor's office, that has a real purpose and I still fit in those places. The trip to walk to the yogurt aisle of Safeway, is usually more for Ellie so she can feel like she worked today - or at least that is how I work myself up to do it is for her. Cause if I keep forced on getting her in and through it then I don't have to see the stares and pity and fear. I just feel like the is not a spot for me in the world out there any more, I know that sounds weird . . . but it is what I am wrestling with these days. I have been down and out of it for nearly 5 months now and by all accounts I got at least a few weeks of slow recovery from bed rest to go. by all accounts this last medical crisis has been tough on me and prolly more so on Jeff. 

Ellie and I do CBT breathing exercises and
meditations to help cope with the pain

I used to be a highly social person - I am the type that recharges by being around and interacting with and talking to people. but hers of illness have changed that in me. Because to be sick is to be alone it is just what happens. So my battery does not recharge much any more, that battery of my soul that got it's spark from laughing with others and telling stories and being in the social action. that part of me is turning inside out, I am not experiencing panic attacks when I go out and I am around crowds of people. I want to crawl inside myself and pull my eyelids shut like the rain flies on a tent. 

Ellie is a damn good service dog and one of the reasons I am still here:
Sometimes we we just rest.

I get anxious around people now, nervous when they approach and I back away when they ask about my dog or my pump or what ever. and the whole while I feel like I have unplugged from myself and I am hovering over looking down on the whole scene from across the room watching my disassociated body moves through space and I float behind in this invisible version of myself as a parade float. Maybe it is because I don't seem to have a purpose other than get well, ok I am working on that I am working to get well, then what I will just have another medical thing and I will have to get well again. it all seems so weird, so foreign, so not me.

Me going through a 6 hour Iron infusion. this was my first major
 iron infusion after learning that my lack of absorbing Iron or B or
any vitamin for that mat err was not happening in my GI Tract.
I had been hospital led 2 weeks earlier for a hemoglobin of 5.8.
I also found out that the years of vitamin deficiency had damaged
my bone marrow so I was having great difficulty making blood.
When you receive Iron is is stored in your bone marrow and makes
the marrow swell inside your bones. This is why large dosages of
IV Iron can cause bone pain. At this point the doctors were giving
me mega doses, 650ml.On the first couple rounds of this I was
fine because with the loss of bone marrow my surviving marrow
had room to sweep inside my bones.  After I had a successful
stem cell transplant which helped me restore some of my lost
bone marrow, the next round of mega dose iron made the new larger
quantity of marrow swell inside my bones and it caused intense
agonizing pain as the marrow swelled and pushed on the
bones it causing the bones that hold the major deposits of
marrow to fracture from the inside out

I started all of this my saying I don't know what to say and I still don't, and much less do I understand why I feel so alien from the world. I just do, it is what it is; almost by definition.

Let me make clear that this is not a condemnation of not getting enough visitors or anything like that. Nor is this a pity me plea, or a cry out for people to come rushing to the house to cheer me up, it is not anything like that. And know that if people did run to my house I would most likely hide from you, too scared and weirded out to come out to see you. This is just the stark realization that I don't fit anywhere comfortably right now and that feels real empty and weird and alien and I don't know how else to explain it.

My enthusiasm for being told I would spend the summer in a body brace
cast thing to help my bones heals after mega doses of iron and swelling bone
marrow fractured them from the inside.  

Ellie doing what she does best, making the pain less and the love more.