Little did I know that I would soon be wishing for her to do that again. Our Popsie’s kidneys are failing, and she only ever leaves a few drops anywhere. She hardly drinks anything, and eats even less, so we will likely soon be saying good-bye.
She has lost her appetite; put differently, she’s gotten a lot pickier. The new diet (for kidney care) is only part of the reason. I wish she would drink more, because that would dilute the things her kidneys are trying to get rid of, and make her feel better. But she doesn’t know that, and we can’t explain that “you won’t like it, but you really have to drink two quarts of water today.”—or in her case I guess it would be “a full cup of water.”
The doctor came over to administer subcutaneous fluids and draw some blood to see how things are going. But then what?
I can see a few different directions this could go. One would be to aim for the Vulcan slogan, Live long and prosper. In this scenario, we’d try to dress up the kidney-health diet, learn how to administer sub-q fluids (as the doctor calls them), and so on. We would likely witness a long, slow decline, and at some point would decide for her to end it. To be fair, in this plan we’d be deciding on her behalf to start it.
Another possibility would be my slacker paraphrase of a hospice-esque priority, viz., to choose the best possible today, regardless how many possible tomorrows (of unknown quality) we might forgo. A motto for this scenario might be, Let us eat and drink, for tomorrow we die. (That’s in the Bible by the way.)
A friend told me about his mother-in-law, who moved in with him and his wife in her later years. As it happened, she was nowhere near her last year, but nobody knew that at the time. He told me that they encouraged her to eat “healthy” foods until she got to be 90, but after that, she went the Epicurean route. She went to restaurants and ordered mounds of tasty deep-fried stuff. Of course she couldn’t finish it there, so she brought it home and ate more of that TDFS until it was time to go back and get more! Let us eat and drink, for tomorrow we die! Well, that last part came maybe nine years later. Yep, she only made it to 99.
In case you don’t see my tongue nearly puncturing my cheek, I think they made terrific decisions in that case. I suppose they may wonder from time to time if they should have started in Mom’s 85th year instead…
From Atul Gawande’s masterpiece Being Mortal I learned that for certain kinds of cancer, you live longer and more comfortably by going for palliative care than you by opting for one medical intervention after another. By the way, under the palliative option, you also don’t wipe out your grandchildren’s inheritance.
Lest you think me a reckless Epicurean, a couple of thoughts. In my single years (back when dinosaurs roamed the earth), I took one of those quizzes you sometimes see in the paper. According to my answers, I was a guy who “lives life to the hilt and seldom takes stock of where he is going,” which my housemates thought was hilarious. Apparently I liked to think of myself that way, but the reality was, as one put it, “I can’t think of anyone less like that than you are.”
I think she was right, actually: we saved for the kids’ college education; we have enough in various accounts that I can retire any time we’re ready; I have life insurance beyond the employer-supplied policy in case something happens to me before we’re ready; etc.
Another thought, which perhaps is a mere continuation of that one, is that I do somewhat believe in taking care of oneself. I read a few months ago that the ability to run a nine-minute mile is associated with better outcomes, and consequently decided to get on the treadmill a few times a week. I got down to a 9:00 mile and have since slacked off to running a mile at 6.4mph. I do this 2–3 times a week, and I’ve gotta say, “epicurean” would not be the word.
If a guy goes to the doctor, and the doc says to lose weight and eat less fast food, and he ignores that advice and dies 15–20 years before he should, I think that’s tragic because the world (and especially his family) is poorer by 15–20 years’ worth of contributions he likely would’ve made.
Popsie is some ninety years old, according to a “poodle years” conversion chart I found today. The Humane Society thought she was somewhere between six and nine when she came home with us in 2009 (yes, about ten years ago) so she’s probably 16–19, a ripe old age. She’s entitled to her version of TDFS, and this morning I made her some fried rice. It had a little (just a little, in case Dr. Lowery reads this) chicken, and some carrots, and some of the juice that was in the leftover container.
For the best possible today.
Toward the end of her life, my own mother said she wanted no more surgeries. No more tests. By this time the doctors knew she had some kind of cancer in her pancreas—which is probably what killed her appetite. So she was done.
When the doctor came by yesterday, I saw Popsie’s distress around needles. She doesn’t want any more needles and in fact doesn’t even want to go to the vet’s office.
But of course it’s not quite that simple. In the middle of writing the above, the doc called and talked about the level of ionized calcium in the blood sample, and appetite stimulants (quite a common treatment for kidney disease in dogs). And I began to think, “Well, if her appetite picks up and she feels better and enjoys walking and can pee a puddle like she used to…” but then I remembered, she’s a 90-year-old lady, and she doesn’t want any more needles.
But if a couple pokes this week means she could enjoy another six months, would it be worth it?
But she’s a 90-year-old lady!
But…
1 comment:
Beautiful Collin. My very last pet is at the point where I have to do something, but I can’t just yet. Hugs and love. We’ll all be crying with you.
VR, Gail Anagick Schubert
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