Peace be with you

Dad passed Saturday, August 30, 9.05am. 

We could not have witnessed a more peaceful death.  

Mom's best friend, Auntie Josie, arrived from CA the night before. After our usual three nights in Jersey City, Al & I decided to make a run to Parlin. I wasn't sure if we should leave Jersey City that night. Dad had vomited what seemed like coffee grounds a few times in the last couple of days and had pretty much been out of it what with the morphine, fentanyl and ABR patches. But every time we'd gone back to Parlin for a night, Dad was still there the next day. 

Mom called 7.20am on Saturday morning, asking us to come up to Jersey City then and not to wait until lunchtime.  In a second call, she asked us to swing by Our Lady of Mercy to pick up the priest since he didn't have a car.  

We arrived at my parents' home around 8.45am. Auntie Aurea and Uncle Regino were also on their way from CT.  

Father Ralph gave Dad his last rites.  (I think we've had a dozen priests from more than one denomination provide last rites to Dad during his hospice care at home).  His breathing was staggered, his fingertips cold.  

"Al & I are here, Dad.  We love you.  Go meet everyone now." 

On oxygen, Dad snarled with every last breath. Then he stopped.  Three gurgles followed. (I'd been listening for the gurgles for more than three weeks). And that was it.  

Dad actually waited for the very final word of his last rites to be uttered, and he waited for Al & me to be at his side too.  

I will cherish that moment for the rest of my life. 

Family & friends:  Thank you so much for your prayers and thoughtful words of sympathy.  We appreciate your heartfelt condolences tremendously.  Love & peace be with you.

Given the long holiday weekend, we are currently finalizing Memorial Mass details.  Dad will be cremated. At Dad's request, there will be no wake.  Though some Catholic churches are particular about cremation, we are hopeful that the service will be held Saturday, September 6, 10am, at Our Lady of Mercy Parish, 40 Sullivan Drive, Jersey City, where Mom & Dad attended Mass every morning until he no longer was able to do so.  Final details to follow.  Thank you for your patience.  

   

The Chaplet

"For the sake of His sorrowful passion." 

"Have mercy on Amante, on us, and on the whole world."

Ten times.  Five rounds.  Using the rosary.  

And prayers in between.  Prayers that the Sisters of Charity failed to teach me in my thirteen years of all-girls Catholic school.  Lucky for me, I still know how to pray the rosary.

Every morning, 10am, with Henry, the Eucharistic minister from Our Lady of Mercy.  A senior volunteer, he comes to pray with Dad and offer him communion. Today, he brought an elderly Filipina friend, Matilda, to pray with us too. It's usually Henry, Donna (the nurse's assistant who happens to be Filipina too), Mom and me for 30-45 minutes praying The Chaplet.  

I've usually had turbo hot Dunkin Donuts coffee by then. (DD is located just two blocks away from my parents' home, so it's a short walk.)

Dad is no longer communicating verbally.  He slept through the entire day today.  His breathing can sometimes be labored.  Mom has stopped force feeding him and is relying more on the Comfort Kit. Sometimes.    

Mom has been concerned that Dad is no longer passing urine or moving his bowels.  His sugar remains high. (Mom still tests it three times a day.)  She consulted with the hospice nurse and asked if she should give Dad an additional shot of insulin.  The nurse responded, that's to be expected.  No need to worry.

Mom cries silently.  No loud or deep sobbing.  Just quiet crying.  

When we have to move Dad (sometimes he looks uncomfortable or just to prevent any bed sores), Mom asks Dad to put his arms around her neck so that she can more easily lift him.  He used to be able to do that.  Put his arms around her.  

When Dad was still verbal but fading somewhat, Mom asked him to kiss her.  And Mom lovingly kissed Dad lips to lips.  It was a comforting and desperate kiss. Just one more kiss.

Mom is in despair.  

I worry.  

Dad is dying comfortably.  And I am relieved. 

Every time I check in on Dad (probably every 10-15 minutes), I say a short prayer. Please die quickly and peacefully.  Soon.  Please.  

[Meditation is helping.  Deep breaths.  So are the walks in Bayonne Park.  Not completely insane yet. Just tired.]

Family & friends:  Thank you once again for your thoughtful and encouraging prayers. Your love & support mean so much to us.  And we send out heartful intentions to you too, that your woes may not be too heavy & that you take the time to experience life's wonder every day.  

  

See the sun

Thank you so much for your prayers & love that support us at this time.  I have no doubt that your peaceful intentions keep us patiently sane.  

It feels like Dad has begun to enter the next phase of his journey.  Having lost some of his speech ability recently (in addition to not being able to see or hear well), he has been communicating less.  He complains of a sore throat and the inability to feel his tongue.  When we first discovered that Dad's speech slurred, Dad asked why did his voice sound different.  

With our encouragement, Mom has been using the Comfort Kit more frequently as Dad has been in considerable pain, more restless and more confused as the days go on.  Though we do appreciate his moments of extreme alertness too.  

The combination of morphine, fentanyl, and ABR patches seems to provide around-the-clock relief to Dad who has also been experiencing more noticeable chest pain. This morning, he requested cold air, so we attached the oxygen tubing for a short while.

I thought experiencing my husband's quadruple heart bypass almost two years ago was difficult. Experiencing my mother's guilt and devotion as well as my father's inevitable passing leaves me seeking comfort from a peaceful Spirit.  

This past Sunday a good friend, Patrick, and I shared with Dad that the sun was out, and it was a beautiful day to play tennis or golf.  Dad threw his arm in the air to demonstrate his backhand followed by his golf swing.  

"I would like to see the sun," he said.

Go see the sun, Dad. 

a daughter's misunderstanding

patiently

i witness

my mother

my father's wife

his doting nurse

struggle

with the advent of

her husband's death

and 

i realize

my mother

is 

a

person 

too

i 

am 

reminded

to 

have

compassion

for my mother

my father's wife

[thank you to all of our family & friends who continue to support us through their prayers & love.]

Two weeks & three days . . .

. . . since Dad's last dialysis treatment.  

It is so hard for me as a daughter to watch my mother not be able to let her husband, my father, die peacefully. As Mom hangs on, she wakes Dad in the middle of a peaceful sleep so that she can offer him food, which he refuses to eat.  Mom pushes Dad to take just one more sip of Glucerna (dietary supplement), to try one more bite of arroz caldo.  And with what strength Dad has, he pushes back, waves her hand away and asks Mom, why does she insist on frustrating him?   

Mom has been hesitant to use the Comfort Kit which hospice provides. Not wanting to see Dad completely sedated, she has been refusing to apply any additional pain & anxiety relieving patches or consider the sub-lingual morphine as a possibility. 

Hard to watch.

I sometimes massage Dad's head right above his brow with some eucalyptus oil. He says it's just enough to help his headaches, and it has a nice scent but not too strong.  Must be some special potion.

An advocate for my dad, I have tried to suggest softly to my mom that Dad is fully aware of what is happening to him.  Though he has his confused moments, he understands when he is in pain and knows that he no longer wants to eat because he wants eternal life.  He said so.

One night Tita Beth, a neighbor and friend from across the street, came over to pray with Dad. At the end of the rosary,  she asked Dad to let go of all of his anxieties in his heart and give them up to God, who would relieve him of all that he was burdened by.  Crying, Dad shared that he kept so much inside and all he wants to do is have the courage to let go because he wants to die and see eternity. 

Hard to watch. 

We called for a hospice nurse to come to the house when we realized that Dad's speech was slurred, and his left side seemed weaker.  The hospice nurse confirmed that Dad's cancer has probably progressed to his brain a bit given his intermittent confusion and impaired speech. Acknowledging how difficult it is for especially family members to see their loved ones in care subdued, she encouraged Mom to use the Comfort Kit so that Dad can be comfortable as he nears death.

Mom opened the Comfort Kit last night.  Finally.  

Waiting

Which kind of waiting is worse?   Waiting to have a baby or waiting for my dad to die peacefully? Definitely the latter.  He seems to be hanging on. While he is bed ridden, his heart rate and blood pressure continue to be pretty normal on the average. No edema, no fluid in his lungs though when he coughs, there is some blood.  Dad has his lucid moments as his pain killers are specifically timed.  Though he can't see, he recognizes voices. Sometimes I think his hearing is selective, and his sense of humor still emerges every so often.   

I see how exhausted Mom is, and I ache because I am too.  Each of us is overwhelmed by and heartened by family and friends' visits and phone calls.  Each of us has a testy moment every so often, and I have to walk away and re-center myself.  This is not easy -- for Mom, for me, for Al, for our family members, for any one of Dad's friends.  

We've had family visiting from CA (Auntie Luz, Dad's cousin who's like a younger sister; Uncle Boy; Uncle Tante, Dad's brother; Auntie Eli; and my cousins Elinor and Ray).

Among family visits, Dad has also mentioned that Manong Alex (Auntie Luz's son), Lola Cion (Dad's mom) and Uncle Turing (Dad's cousin) have also visited. They're all dead.  

Dad fell from his bed yesterday.  We happened to be eating a little lunch, and all of a sudden we heard a thud.  Cousin Ray, who could easily play for some football team, went to the bedroom, and picked Dad off the floor.  Disoriented Dad had to pee and thought he could easily get up.  

Dad has never tried to get up on his own.  I was stunned for the rest of the day.  

It will be two weeks tomorrow since Dad has had his last dialysis treatment.  

[Thank you once again to everyone who prays, calls, emails or stops by.  Your thoughtful concern and compassion heartens us and provides us with courageous support.  We cannot thank you enough.]

I learned a new word today

Repass.  

Definition:  The gathering that occurs after a burial ceremony has taken place. Al & I spent the morning calling funeral homes about cremation fees and such. Then we made our phone rounds to a few restaurants where we could have the REPASS after Dad's memorial service.  

While memorial services provide formal rites of death, a REPASS "demonstrates the continuity of life even in the face of death."  

New word for me.  Repass.

[On another note, we've been unable to keep up with working out regularly for a while now what with all that's been going on with Dad.  So I try to catch yoga on FIT TV when I can.  And the 30-minute yoga sessions have forced me to take a moment to sit still & breathe.  Namaste.]

Bedside manner & random heartaches

A daughter's devotion is helping your cancer-stricken father sit on the commode because he can no longer walk and then wiping his ass clean. 

Getting Mom to understand that Dad doesn't need certain meds or his vitamins because doctors are not working to make him strong, but to keep him comfortable is the hardest mother-daughter conversation I've ever had to have.

Dad asked me, "Did I do a good job raising you?"  I said, "What do you think?"

Dad is weak.  He eats only when Mom shoves food into his mouth.  Doped up on pain meds (morphine, fentanyl, percocet) around the clock, he sings. He dreams.  He shouts, "I'm dying."

Dad is strong.

The Lord is My Shepherd

I walked in a little late to Mass at Bayonne Medical Center because Mom mentioned that the service was on the third floor, but it was actually on the second.  Dad was in a wheel chair.  Mom was standing dotingly behind him.  

If you know your Catholic/Christian songs, "Here I am, Lord" can be a tear-jerker.  And I lost it.   I suppose I was overcome by the Spirit.  

"Is it I, Lord?/I have heard you calling in the night./I will go, Lord, if you lead me./I will hold your people in my heart."  

Dad hears God's call (even if he can't hear us sometimes).  

Making August's Memory

As many family & friends know, Dad will be in the hospital this weekend. We have consulted with Dad's doctors and have decided to halt dialysis. Dad stopped chemo in June.  Things will naturally take their course. We will be making arrangements to have hospice at home.  

It has been difficult to see Dad in constant pain, unable to walk, unable to get out of bed. He is tortured day-to-day. We want Dad to be as comfortable as possible.  Know that he is fully aware and has said that he has had enough and welcomes no treatment at all.

Thank you, everyone, for your ongoing heartful thoughts & peaceful intentions.  

I forgot to mention -- When we were settling into his hospital room yesterday afternoon, Dad changed into a gown and asked that the shade be closed. He said, "The angels might see me."   

What makes us most confident about our decision is that Dad has shared, "It's better to go straight than to take the winding road."  Poetic, isn't he?

[While I know that this is the right decision, in trying to be peaceful I am wrought with much anxiety and worry especially about my mom.  We're both afraid to see my dad physically leave us as his body shuts down. But I am comforted by the fact that seeing him tortured in pain on a day-to-day basis is no way to live.  Dad wants to be at peace, and I want that for him too.  Needless to say, this will be a most memorable birthday.]

August's Anxiety

In addition to spending weekends in Jersey  City, Al & I have been trying to alternate the weeknights we visit with Dad & Mom.  Our schedules are so hectic what with commuting into Manhattan for work, driving to and from Jersey City, and making sure that we do sleep in our own home in Parlin every so often too. (Parlin is 35 minutes from Jersey City and a 90-minute bus ride into NYC on weekdays with high traffic.) 

Tonight Mom shared that Dad said, "Maybe Sheelagh hasn't come by because we haven't given her a birthday present." 

(Mom reminded him that he's got a couple of more days before wishing me a happy birthday.)

Nice to know Dad misses me during the day.  Thanks, Dad!

breakthrough

i hold it in 

as long as i can

unwilling to 

breakdown

i keep myself

busy

with work

with concern

tired

afraid of not knowing 

what to do next

feeling like i am

losing control

i 

can't 

do 

this

i 

finally

breakthrough

Surgery postponed again

Dad's surgical procedure to have a permanent access portal has been postponed AGAIN due to a low blood platelet count. Since our trip to the Dominican Republic, Dad has been experiencing more severe pain and has been eating less.  Dad says he cannot hear at all in his left ear, so his internist has referred him to an ear specialist (might be nerve damage) -- one more doctor to add to Dad's star list.

Recently my mom asked me to talk to Dad's oncologist about new clinical trials on ABIRATERONE for patients living with advanced prostate cancer and which had been highlighted on ABC News.  At first, I was hesitant to ask the doctor about these trials because ever since the doctor has provided us with a prognosis, I have had to resolve within myself to accept the inevitable.  But my mom made the request.  When the doctor responded to my question, I felt that she didn't want to completely shoot my mom down and so she provided a soft answer -- "These medications haven't been approved."  

Since the day I spoke directly to Dad's oncologist about Dad's prognosis (a summer afternoon, & I was on my cell phone outside Bayonne Hospital during Dad's hospitalization in mid-June), his doctor shared with me that she had already explored a number of clinical trials which my dad was not eligible for due to the aggression of his cancer and co-morbidities (cardiovascular disease, diabetes, kidney failure).  But she doesn't have the heart to keep telling my mom that . . . my mom who grasps at any hopeful treatment.

Any chance I can make a request to postpone death for a while?

Author of "Last Lecture" has died

Did I mention that Randy Pausch died (of pancreatic cancer) on July 25? I've been heartened by his cancer journey and recently viewed his graduation address to Carnegie Mellon University alum. Check out his life at: http://www.cmu.edu/homepage/beyond/2008/summer/an-enduring-legacy.shtml. As you can imagine, I am quite saddened by his death leaving me quite reflective of our own family's experience.

Back from Santo Domingo, DR

Al & I are back from the DR.  And what a trip it was!  We flew into a major thunderstorm, and our flight was diverted to Puerto Plata where the plane refueled and hung out until the storm passed and we were given the ok to fly to Santo Domingo.  So our trip took a little longer than we would have liked. Our five-star hotel was lovely, and I had my share of pina colodas by the pool.  

Patrick & Joanna's wedding was a true taste of Catholic charismatic culture. The ceremony, scheduled to start at 7pm, began a little late and ended by 10pm.  We then drove to the reception

which was 45 minutes away on a military base. During the ride, Al & I were reminded of Manila's streets, poverty and raw humanity.  The reception venue was most elegant with its aquamarine theme, open air space and vaulted ceilings. While dinner wasn't served until midnight, we were pleasantly entertained by the extensive wedding photography, including the various poses that the bride & groom were directed to do through the entire evening. Felicidades, Patrick y Joanna! 

The kicker was the flight back home.  I must've eaten rotten plane food or maybe it was all of the ice that I requested for my coffee during our stay. During the last 45 minutes of our return flight, I vomited three times into a bag -- the one that the plane provides -- which I planned to hold onto until I could dump it when we got off the plane.  The bag broke, and my own vomit spread all over my shorts and backpack, and some dripped onto my flip flops and the floor. 

Poor Al who sat on my left and the woman who sat on my right.  I tried going to the bathroom, but it was the last 45 minutes of the flight, the plane was landing, and the bathroom doors were closed. Since the bag broke, I had to just leave it in the magazine holder in front of me. Nasty. My stomach cramping, I smelled horrible as we walked through customs.

Dad had his check-in with the oncologist today. He seems to be getting weaker, in worse pain and eating much less.  Mom has been giving him Glucerma as a nutrition supplement.  He's also napping more what with being on FENTANYL patches and PERCOCET to manage his pain.

Fentanyl is a powerful opioid analgesic with a potency 81x greater than morphine.

Percocet is a combination of oxycodone and acetaminophen used to relieve moderate to severe pain.

No doubt Dad is dreaming more too.  Dad shared this dream with Mom today -- that he died, and the doctors cut his ear off.  (Dad's actually been having trouble hearing in his left ear.  Doctors recently removed a big piece of wax, & he constantly requests his ear drops.) Dad must've been a tortured artist in a previous life . . . or will be one in the next life.