Late afternoon
The nurse has come and does her evening programme. I look over and see Lara's head at a particular tilt which I recognize all too well. She is despondent. I walk over and softly ask her what the matter is. "I am so tired of all of this, this whole routine!" She is about to say that she wants 'out', but stops herself, waiting for a more private moment. "I know, she says, I will just have to go through the process."
Doctor Willemot calls in with the results of the blood test taken this morning. All values are pretty much stable (although low), except for the hemoglobin which has gone from 8.2 to 7.0 in four days. That is not good. It explains why she is feeling weak. I ask her about the level of antibiotics (now since weeks at 4 grams a day). She will take it up with the doctors at St. Luc on Monday.
By 8:00PM she has developed enough of an appetote to eat a soya burger and finishes in time to walk over to the TV-room and watch Palais Royale. Tonight's episode has a review of Queen Elisabeth's sixty years of reign and she didn't want to miss it.
zaterdag 2 juni 2012
Senior
Afternoon
So I went to the Musee du Cinquantenaire to see an exhibition that is widely advertised on billboards around town under the inviting title of 'Bon appetit!' The modest exhibition focuses on how our views of nutrition and meals have evolved over many centuries as a result of smaller and more significant discoveries. They show relevant objects from all over the world, some of which go back to 2,500 years BC and as recent as the beginning of the 20th century. All very educating and entertaining.
There were two downers in the personal sphere. One is that at the reception, the person selling me a ticket inquired if I was a senior citizen? The first time this has ever happened to me! Then again, for two euros discount, I was not inclined to ly about my age.
Then in the exhibition itself, one of the themes they discuss is milk and butter. Fine. Suddenly I see a large black and white photo of a pony-drawn milk cart, with the capped vendor selling loose milk which he pours into the buyers' receptacles from a measuring can. Children hang around to be in the shot. The scene is uncannily familiar, for I remember those carts from my own youth. (Bart was the name of our vendor, and we used to truck along for a couple of blocks and share the excitement.) I check the caption, and sure enough: the photo dates from 1950. I was five years old then. There is no question about it: I have become museum material !
On the way back, Lara calls me and alerts me to the fact that our fridge is depleted beyond an acceptable level. Would I please swing by the supermarket? And she gives me a list of items.
So I went to the Musee du Cinquantenaire to see an exhibition that is widely advertised on billboards around town under the inviting title of 'Bon appetit!' The modest exhibition focuses on how our views of nutrition and meals have evolved over many centuries as a result of smaller and more significant discoveries. They show relevant objects from all over the world, some of which go back to 2,500 years BC and as recent as the beginning of the 20th century. All very educating and entertaining.
There were two downers in the personal sphere. One is that at the reception, the person selling me a ticket inquired if I was a senior citizen? The first time this has ever happened to me! Then again, for two euros discount, I was not inclined to ly about my age.
Then in the exhibition itself, one of the themes they discuss is milk and butter. Fine. Suddenly I see a large black and white photo of a pony-drawn milk cart, with the capped vendor selling loose milk which he pours into the buyers' receptacles from a measuring can. Children hang around to be in the shot. The scene is uncannily familiar, for I remember those carts from my own youth. (Bart was the name of our vendor, and we used to truck along for a couple of blocks and share the excitement.) I check the caption, and sure enough: the photo dates from 1950. I was five years old then. There is no question about it: I have become museum material !
On the way back, Lara calls me and alerts me to the fact that our fridge is depleted beyond an acceptable level. Would I please swing by the supermarket? And she gives me a list of items.
Museum
Saturday 2 June
I may not be the best person to judge any significant evolution in Lara's condition, for I see her the whole day, every day. But I need to tell you, dear friends, that things are not looking up. I glance over from where I am sitting writing, and if I take away her quiet breathing, it is not difficult to imagine what she will look like before long, the poor thing.
It struck me this morning, over breakfast, as she sat across from me at the table. Shrunken, hollow eyed, tired, her body slightly shaking under a restive tremor in her right foot - 'Igor'. A shadow of what she once was: a radiant, vibrant, thriving woman. Now she concentrates on eating her soya yoghurt and apple for breakfast, and there is no energy to spare on conversation. She is trying to keep her food down, and manages to empty both her plate and her coffee cup. But she does find the time to verify if I have made the hospice a cup as well. I have. Always an eye out for other people.
Give me a smile, I said, for I really need one from you. The corners of her mouth lightly twitch, her eyes narrowing. You have done better, I tell her in a mock complaint. But the intention is none the less, she defends herself. I know, I know.
Doctor Isabelle Willemot came by early this morning and was not unhappy. Pressure still 92 over 50. Nausea situation overall improved with the new medication. Lara can hold out for another week or two weeks, Isabelle tells me before disappearing in the elevator. I find that hard to believe - but I have been wrong before.
I think I will go out and go to a museum. It is not good for me to hang around too much in the house.
I may not be the best person to judge any significant evolution in Lara's condition, for I see her the whole day, every day. But I need to tell you, dear friends, that things are not looking up. I glance over from where I am sitting writing, and if I take away her quiet breathing, it is not difficult to imagine what she will look like before long, the poor thing.
It struck me this morning, over breakfast, as she sat across from me at the table. Shrunken, hollow eyed, tired, her body slightly shaking under a restive tremor in her right foot - 'Igor'. A shadow of what she once was: a radiant, vibrant, thriving woman. Now she concentrates on eating her soya yoghurt and apple for breakfast, and there is no energy to spare on conversation. She is trying to keep her food down, and manages to empty both her plate and her coffee cup. But she does find the time to verify if I have made the hospice a cup as well. I have. Always an eye out for other people.
Give me a smile, I said, for I really need one from you. The corners of her mouth lightly twitch, her eyes narrowing. You have done better, I tell her in a mock complaint. But the intention is none the less, she defends herself. I know, I know.
Doctor Isabelle Willemot came by early this morning and was not unhappy. Pressure still 92 over 50. Nausea situation overall improved with the new medication. Lara can hold out for another week or two weeks, Isabelle tells me before disappearing in the elevator. I find that hard to believe - but I have been wrong before.
I think I will go out and go to a museum. It is not good for me to hang around too much in the house.
vrijdag 1 juni 2012
Tahoe 2009
2009
It straddles California and Nevada at around 1900 meters altitude: the largest alpine lake in North America, reaching 500 meters deep. For me, the most attractive feature is that Lake Tahoe is attractive all year round. Lara has many childhood and teenage footsteps around the lake. We have been there together at least ten times, summer and winter. Gordon, Lara's brother, and his wife Tanya own a cabin there (a grievous understatement in the eyes of European real estate owners) and so do Lara's step-parents, Connie and Ed. We have battled snow storms in the winter and been delighted by snow showers in the summer. Skies can be deep blue and so can the water.
I offer you a picture of June 2009, less than three years ago.
Loyalty
Not only have we been faithfull to each other, the length of our marriage, we have also remained loyal. Right now it may seem that I am the loyal one, since my wife is ill and needs me to be dedicated to her well-being. I have been and will be.
She, for her part, would be just as loyal when I would be in dire straits - and in fact she has been. Lara was the one who hadn't trusted my cardiac health for some time when we were just back from our posting in Cairo. One day she coaxed me into a doctor's office in the Hague Westeinde Ziekenhuis, next to the apartment where we lived temporarily. After an ECG turned up nothing, Lara demanded I be subjected to a bicycle stress test. The doctor dismissed her as hysterical. No doctor in Holland would refer him to a stress test on the basis of an ECG like this! "This is not Geneva or the USA!"
A year and a half later, in 2002, when posted in Brussels, she surreptiously connived with my driver, Joao, and my secretary, Edith, and drove me to the hospital in Aalst for a stress test. I happened to have landed in one of the top five cardiac centers in the world. The test lead to a next one and within two weeks I was on the operating table to bypass an 80 percent blockage in my main cardiac artery. One little blood clot and I would have been dead. Hugo Vanermen, a leading thoracic surgeon, put in five bypasses to be on the safe side. I had picked him especially, since he had successfully operated on King Albert the year before! He would not be about to lose the Dutch Ambassador under his hands, I figured. And he didn't. (We have become friends since then.)
Without Lara's insistence I would now be speaking from the grave. She stuck as close to me as posible during the five hour plus operation. As I was wheeled in, she only let go of my hand when the swinging doors swallowed me whole. When I woke up in the recovery room, I found that my right hand was being held by both of hers. She came to visit twice a day during the days that followed until I was released after ten days, while keeping family and friends informed and managing their respective visits. She would hover over me during my months of recovery.
I am told that many a husband "would have walked" when faced with what Lara and I are currently going through together. Lara nor I can relate to that in the slightest. We are in it for the whole Spiel. Both ways.
She, for her part, would be just as loyal when I would be in dire straits - and in fact she has been. Lara was the one who hadn't trusted my cardiac health for some time when we were just back from our posting in Cairo. One day she coaxed me into a doctor's office in the Hague Westeinde Ziekenhuis, next to the apartment where we lived temporarily. After an ECG turned up nothing, Lara demanded I be subjected to a bicycle stress test. The doctor dismissed her as hysterical. No doctor in Holland would refer him to a stress test on the basis of an ECG like this! "This is not Geneva or the USA!"
A year and a half later, in 2002, when posted in Brussels, she surreptiously connived with my driver, Joao, and my secretary, Edith, and drove me to the hospital in Aalst for a stress test. I happened to have landed in one of the top five cardiac centers in the world. The test lead to a next one and within two weeks I was on the operating table to bypass an 80 percent blockage in my main cardiac artery. One little blood clot and I would have been dead. Hugo Vanermen, a leading thoracic surgeon, put in five bypasses to be on the safe side. I had picked him especially, since he had successfully operated on King Albert the year before! He would not be about to lose the Dutch Ambassador under his hands, I figured. And he didn't. (We have become friends since then.)
Without Lara's insistence I would now be speaking from the grave. She stuck as close to me as posible during the five hour plus operation. As I was wheeled in, she only let go of my hand when the swinging doors swallowed me whole. When I woke up in the recovery room, I found that my right hand was being held by both of hers. She came to visit twice a day during the days that followed until I was released after ten days, while keeping family and friends informed and managing their respective visits. She would hover over me during my months of recovery.
I am told that many a husband "would have walked" when faced with what Lara and I are currently going through together. Lara nor I can relate to that in the slightest. We are in it for the whole Spiel. Both ways.
Diane
Friday 1 June afternoon
The first thing Lara does upon awakening is trying to settle her stomach. To this end, she takes one tablet of Pantomed (20 mg of pantoprazole). Following breakfast and coffee (and every time she ingests anything) she takes an old-fashioned medication called Kaolin. It is a white powder made of white clay, recommended by Doctor Schroyens, our homeopathist against reflux. It comes in a plain paper bagg and you take it one flat coffeespoon at a time. Motilium does not agree with her. Carbobel (carbon) does.
Even before breakfast she takes her Staphysagria, now only once a day (was three) but at a dilution of LMK, which in homeopathic terms is a significant dose. (From there we can elevate to CML, and on to dilutions of 500.000 and one million, we will see.) Half an hour later, after she has been washed, she takes a spoonful of baume pulmonaire, a cough syrop containing codeine (a morphine derivative), which in view of her low resistance, puts her to sleep before long. She only takes it three times a day for that reason. Otherwise, a less aggresive cough syrop she uses is called Thymo Septine.
Of course intravenously she receives Novalgine (paracetamol) and Litican (against nausea also), both twice a day. Plus Litican in tablets, in case she needs them in between her morning and afternoon infusions.
What's causing all this nausea, in my mind, is the extended uses of antibiotics. Meronem (very broad spectrum gram-negative) at a rate of 4 grams a day since when she was in the hospital in February must by now have destroyed her complete intestinal flora. I will discuss with the doctor if a lesser dose would not be advisable; but perhaps the damage is already irreversible. Sometimes the treatment is worse than the ailment.
Despite all that, she selects her daywear with care, giving me instructions as to where to find what. I come back with a flowing dress by Diane von Furstenberg, one of her favorites (and mine too). But she needs a broche to keep it together at the top. As it happens, she dishes one up right out of her sidetable.
The first thing Lara does upon awakening is trying to settle her stomach. To this end, she takes one tablet of Pantomed (20 mg of pantoprazole). Following breakfast and coffee (and every time she ingests anything) she takes an old-fashioned medication called Kaolin. It is a white powder made of white clay, recommended by Doctor Schroyens, our homeopathist against reflux. It comes in a plain paper bagg and you take it one flat coffeespoon at a time. Motilium does not agree with her. Carbobel (carbon) does.
Even before breakfast she takes her Staphysagria, now only once a day (was three) but at a dilution of LMK, which in homeopathic terms is a significant dose. (From there we can elevate to CML, and on to dilutions of 500.000 and one million, we will see.) Half an hour later, after she has been washed, she takes a spoonful of baume pulmonaire, a cough syrop containing codeine (a morphine derivative), which in view of her low resistance, puts her to sleep before long. She only takes it three times a day for that reason. Otherwise, a less aggresive cough syrop she uses is called Thymo Septine.
Of course intravenously she receives Novalgine (paracetamol) and Litican (against nausea also), both twice a day. Plus Litican in tablets, in case she needs them in between her morning and afternoon infusions.
What's causing all this nausea, in my mind, is the extended uses of antibiotics. Meronem (very broad spectrum gram-negative) at a rate of 4 grams a day since when she was in the hospital in February must by now have destroyed her complete intestinal flora. I will discuss with the doctor if a lesser dose would not be advisable; but perhaps the damage is already irreversible. Sometimes the treatment is worse than the ailment.
Despite all that, she selects her daywear with care, giving me instructions as to where to find what. I come back with a flowing dress by Diane von Furstenberg, one of her favorites (and mine too). But she needs a broche to keep it together at the top. As it happens, she dishes one up right out of her sidetable.
Carpe Diem
Friday 1 June, noon
I just happened to look at some pictures people sent to us by email, plus some of my own, showing Lara on Xmas morning 2010. She's unwrapping presents in the company of her siblings, in-laws and cousins, in North Star, near Lake Tahoe, California. Alacrity is in the air, the atmosphere is snug and cozy, pajamas, sweaters, morning attire, mugs of coffee. A next photo shows us around the dinner table that same day having a great time. Taken later that Xmas day, is one of Lara working the rowing machine in the local fitiness club, right after we had done laps in the open-air heated pool, at 2600 meters altitude!
All this took place about one week before the first symptoms of leukemia began to manifest themselves, on 3 January 2011. We were still completely oblivious of impending doom. We lived our days in a carefree and joyous environment, unawares. As if life would carry on as it was - thanks perhaps to our habitual toast every time we clunked glasses together: 'health and riches, and we'll take care of the rest'. Little did we know.
What it taught us was a lesson we wouldn't have a chance to ever again forget. Live every day as if it were your last. Take out of it whatever is in there. Pluck it. Cram into it whatever fits inside. Avoid evenings that are sudddenly there and you turn around to see how little ways you've come. Life is precarious. Fortune is fickle. Don't let it slip away like sand between your fingers. Avoid regrets of your own making, for you may not get a second chance.
I just happened to look at some pictures people sent to us by email, plus some of my own, showing Lara on Xmas morning 2010. She's unwrapping presents in the company of her siblings, in-laws and cousins, in North Star, near Lake Tahoe, California. Alacrity is in the air, the atmosphere is snug and cozy, pajamas, sweaters, morning attire, mugs of coffee. A next photo shows us around the dinner table that same day having a great time. Taken later that Xmas day, is one of Lara working the rowing machine in the local fitiness club, right after we had done laps in the open-air heated pool, at 2600 meters altitude!
All this took place about one week before the first symptoms of leukemia began to manifest themselves, on 3 January 2011. We were still completely oblivious of impending doom. We lived our days in a carefree and joyous environment, unawares. As if life would carry on as it was - thanks perhaps to our habitual toast every time we clunked glasses together: 'health and riches, and we'll take care of the rest'. Little did we know.
What it taught us was a lesson we wouldn't have a chance to ever again forget. Live every day as if it were your last. Take out of it whatever is in there. Pluck it. Cram into it whatever fits inside. Avoid evenings that are sudddenly there and you turn around to see how little ways you've come. Life is precarious. Fortune is fickle. Don't let it slip away like sand between your fingers. Avoid regrets of your own making, for you may not get a second chance.
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