My Own Endgame

Today marks two months since Tatay passed. Yes, time flies fast. And I’ve given up on my ugly cry. Today also makes me think of the time when my endgame happens. 

Preparing my living will

I haven’t prepared this yet. I should. And as I acquire assets, I should manage how each will be ‘disposed of’ when I die. 

How do I want to go

As if I can control this. But I believe in wishful thinking. I fear pain more than death. Perhaps that is the only thing I want to avoid when I go - pain. I feel that was also how my dad was thinking. Maybe. Can I just go peacefully in my sleep? Heart attacks will cause this massive pain, I feel. Maybe even strokes. Ugh, cancer will be one protracted descent into pain-hell. Would a gunshot wound, direct to the brain, be less painful (if instantaneous)?

Tatay went in his sleep. And that was what I had been wishing for him. But days leading up to it, he was going through breathing attacks, wretched gasping for air. That must have been so painful, some kind of drowning. As he would go through an attack, our worst fear was that his heart would just fail in the middle, and he would die painfully. The Lord was merciful enough to him. He slept and never woke up.

Now a part of me understands why some people would want to control this, through willful dying. I will not go through the thorny ethical arguments. I just understand why.

Do Not Resuscitate (DNR) Order

Hosptial bills, wake and funeral bills. That would just zap all the money I have saved up for. And when I am gone, only the hospitals and the funeral would be wealthier.  I need to have a plan. I need to give directions.

I will put some of my cash into a medical fund. Loved ones can only spend what is there. They will not liquidate any other asset just to continue reviving me. Sounds good but I have no idea how this can actually be executed. Oh the burden this will probably place on the my loved ones as they ‘monitor’ the expenses and make a call for a ‘hard stop’. It’s like watching a taxi meter when you are almost out of cash. “I’ll get off HERE” just as it reaches the limit. 

My siblings and I had an emotional discussion (over FB messenger chat) on this DNR order for Tatay. I wouldn’t want that for my time. So what do I want them to do when my heart stops beating and/or my breathing stops? 

The routine: Pumping the chest. IV shots of epinephrine. Intubation to bring air in. And that awful electric shock. It looks so violent and desperate. Do I want this done on me? Maybe only up to a certain point - 3 minutes. 

Artificial Life Support

Then there is this question. What if I end up in a vegetative state? How long should I be maintained on it? Or should I even be? 

I can be placed on artificial life support but only up to 3 days. (Is “3” the magic number?”). Beyond that, pull the plug. Just recently, I read an article about how AI (artificial intelligence) predicted (at 90% accuracy?) those patients who will pull out of a coma. Maybe if that becomes the practice, that would help determine how long I should be maintained.

Burial or Cremation

I’ve long decided that I want to be cremated. I have bought a niche at the nearby columbary (at the back of the Parish church) where my ashes will remain.  Some people still frown upon cremation. Tatay was totally against it. Perhaps they argue that the resurrected body has to be ‘whole’. Of course I find that baloney. 

Wake and Viewing

I don’t mind lying in a casket first for viewing and paying respects. But the practical me kicks in. If I will be cremated anyway, why spend for the casket? So perhaps this should become more of a visiting and paying respects to my ashes and my picture. 

Funny how articulating all of this makes it sound so technical and matter-of-factly. Well, maybe at this point, it is. And it should be. So when my endgame comes, and all the emotions start pouring in, the people I leave behind would have basis for decision-making.

Endgame: Post Mortem

I have not had my hysterical breakdown, my sustained ugly cry yet. I have had moments of tears and some sobs. But not as much as I had thought or maybe even wanted. I thought at first because I had to be person in chrage.

It was a flurry of activities from last Friday, April 12 to Tuesday, April 16. One had to arrange for the mortuary and funeral services. One had to coordinate with the hospital for the settlement of the bills and the release of the body and the death certificate. Thankfully, Tatay had a life plan that covered some of the expenses. But more importantly, they (The service provider) assisted me from start (pick-up of body from hospital) all the way to burial. Loyola Lifeplan and its service provider, Santuarium, were very professional and helpful. I cannot thank them enough.

It seems almost surreal now. I was there when the doctors and nurses tried to revive him. I was there as they wrapped his body. I had to go down to the hospital morgue to ID his body before it was taken away (they might pick up the wrong body!). Late afternoon, I checked on him again, to approve his appearance, especially his make up. I didn’t like to be the one to do this because I honestly didn’t know how to judge whether it was done correctly or not. Tatay had lost so much weight so even using his pictures as reference was inadequare. Yet my Ate No. 2 didn’t want to accompany me (because that meant leaving my mom). Thankfully, the base appearance was improved. Visitors also commented how well he looked.

Then I was on full event organizer mode as the wake details were being planned. My biggest concern was the food. How does one plan for the feeding of thousands (I exaggerate)? I have to give myself credit for executing that well, including the logistics and venue set-up. (We were so fortunate to have been allowed to hold the wake at the nearby Home for the Elderly, run by nuns. Tatay used to be their doctor.)

And as all of that was going on, I also had to entertain the visitors, especially from my side (colleagues and friends). Telling the story over and over and over again to different people!

Then came the plans for the funeral Mass, and that trip to the cemetery to bury him. I thought this would be my breakdown scene. I even decided not to sing at the mass. But I surprised myself by being so composed, managing to even be lector and singer.

Heritage Park is quite far from our place. But that was where we were able to get a lot. If I had my way, I would have had him cremated and his ashes at the columbary near our Parish. But he explicitly did not want cremation.

It was super warm and sunny that Holy Tuesday. By 2pm, the funeral convoy had reached the park. We started the last blessings and viewing by 230pm. Though sunny, there was a nice breeze all around us. A handful of friends and family joined us. There was a lot of crying, except me. I was holding up very well, till they lowered the casket six feet below. And we all solemnly went home, mindful most of all of our mom’s condition.

With all that over, there still wasn’t any major breakdown. tried to induce crying. I listened to my playlist of super sad songs. I watched “Dad”, that 1989 movie of Jack Lemmon and Ted Danson about father and his son. Yes, I teared up but again, limited waterworks. I remember crying much more when I broke up with an ex. I was thinking that would be the level of my anguish.

Did I love him less? Is there something wrong with me? Have I become this husk of a person? Ok, a bit over the top. But now, after almost two weeks, I have stopped wanting to cry. I suppose it would just come. And even if it wouldn’t, it didn’t mean any of that nonsense.

I love you, Tatay and I miss you terribly. i honor you for being a humble yet exemplary doctor who brought healing, humor and genuine concern to your patients. I hold you in the higheat esteem for being a loving husband and dedicated father to us. I have the distinct pleasure of serving you and being with you to the very end of your mortal life. I hope that when my own time comes and we meet in heaven, you will tell me that I have made you proud.

Till that time, Tatay.


- Posted using BlogPress from my iPad

Endgame: It Is Done.

When it finally happened, I was there in his hospital room asleep. I was awaken as the nurse and the caregiver were hovering over him, checking for pulse. It was 1:11am, April 12.

He had considerably weakened from that last hospital stay. His oxygen levels were low. He finally relented and allowed 24/7 oxygen. We wanted to get him a full-time nurse but none passed his standards. He became very particular about many aspects of his care. Only his night-time caregiver measured up.

That frustrated me. He insisted that the household help be the one taking care of him, as they already knew how to. I tried to reason with him that this would tax them, and they wouldn’t be able to perform their duties to Nanay and to the household. But he wouldn’t take it. I relented. Besides, my sister (Ate No. 2) was consistently watching over, too, together with Ate No. 4. And Ate No. 1, our doctor-sister, flew in from the US since end-March, so I knew he was around expert care.

April 6, c3 and I left for Zambales as planned. That was also the time his gasping attacks started happening. He would suddenly start having difficulty in breathing, literally gasping for breath, even as he was taking in oxygen. It was a like a panic attack with his heart rate racing. The only thing they could do was to increase oxygen flow and tell him to relax. Ate No. 1 listened in on his lungs and concluded pulmonary edema. His systems were now compromised and his heart was working overtime. Heart failure was imminent. Ate No. 2 was relating all this to me and how scared they were that he might go soon. But I reassured her that this wasn’t time yet. Tatay will wait for me to come home.

I was back April 8 evening. I made it a point to stay with him the following day, April 9, a holiday, I witnessed for myself the attacks. It was painful to watch and everybody felt so powerless to prevent it from happening. Thankfully, after a few minutes, he would calm down.

But April 10 evening was different. His gasping attack had not stopped, 20 minutes and counting. The caregiver and I were beside him, trying to calm him down. Yet he wouldn’t. His whole body was jerking and stiffening. We called 911 and brought him to the emergency room. He eventually relaxed, the gasping stopped when he was there. All they did was administer oxygen using the mask. His doctor insisted that he stay for tests, to check what was causing these attacks. He grudgingly agreed (he hated having to go back to the hospital.

April 11, he hardly had any rest or sleep even as he was in the hospital. The attacks would continue. The tests showed there was nothing major that was causing the fits. Though he did need another round of blood, it couldn’t be the reason. It seemed that it was really a psychological anxiety attack. And the only solution for him was to relax.

That evening was my turn to sleep over at the hospital. He specifically requested that a family member should be with him constantly. I arrived at the hospital and he was still restless. He was now complaining of some allergic reaction or side effect that rendered him unable to speak properly. We tried to check what was administered to him. He was then given a dose of antihistamine.

He slowly drifted to sleep and finally got to relax. Ate No. 2 went home. leaving me and the caregiver at the hospital. I also prepped and lied down on the bed beside h is. The caregiver kept vigil over his pulse rate and oxygen levels.

Past 1230am, she said she noted that a pulse, a heart rate couldn’t be detected anymore. She called the nurse to take his blood pressure. I woke up as the nurse came in. We all tried to check for pulse but couldn’t detect any. He didn’t seem to be breathing anymore. Caregiver and I tried to wake him up as the doctors and nurses arrived with the cardiac monitor. They immediately started CPR procedures on him, except for intubation (He explicitly refused that in his DNR [do not resuscitate] order). After about 3 minutes of this, at 133am, I asked them to stop. An ECG machine came in to certify his death.

I teared up a bit as I was calling my sisters to inform them of his passing. But that quickly passed. I kissed him on his forehead and prayed. I left the caregiver and the nuses to take care of the paperwork. I came back to witness his body being wrapped and taken to the morgue.

Numbness came over me by that time I got home, at around 230am. There was still a lot of work ahead. There was no time to grieve yet.


- Posted using BlogPress from my iPad

Endgame?

Earlier today I had my voice lessons. And after the vocal warm-ups, I picked “Nahan” by Ernani Cuenco for practice. I was doing ok with the first two passes. Then on the third, I suddenly choked, holding back my tears. I just realized that I might be singing this song to my father soon.

It was in early 2017 when he was diagnosed with Prostate CA. He was complaining about urination problems then. We thought it was urinary tract infection. And when he had his Xray, it seemed like the bone metastasis had begun. “It lit up like a Christmas Tree” A quote from “Fault In Our Stars”.

He was 81 then and declined any radical procedures or even chemotherapy. His doctor gave him hormone treatment. He responded well until late last year, probably around October. His PSA level started to climb again. His doctor became more aggressive with the treatment options. Yet, the tests seemed to confirm a re-awakened CA. Although he was still ‘clinically’ healthy: no pain, no weight loss.

It made a turn for the worse in December. First it was anxiety palpitations, with loss of appetite. Before Christmas, he contracted pneumonia and we had to hospitalize him. I posted about that last year. Though we were able to bring him home right on Christmas Eve, he seemed to have started to decline rapidly. He was generally weaker, though he would stubbornly try to fight it. We hired a night-duty caregiver and day nurse.

He started to show some recovery. But he had a relapse in January 2019. So we were back in the hospital. We even stayed longer as his body was taking longer to respond to the antibiotics.

But he managed and we took him home. We also just maintained his night-duty caregiver. He was slowly gaining his appetite. He seemed to be getting stronger. Until in mid-March, he had severe stomach ache and was vomiting at 3am. My sister and brother in-law took him to ER and he was given medicine for his acidity. He was home quickly but not for long. By mid-afternoon, he was having severe headache and asked to be brought back to the hospital.

His hemoglobin levels turned out to be very low and he had to undergo transfusion. And he still had a lingering infection that needed antibiotics. And he even had a mild heart attack. The transfusion brought back his color and after a week, he was back home.

Now, it seems that he will not fully recover. The doctors have told us to brace ourselves for the inevitable. But until this afternoon, I was still in denial. My sisters from abroad have visited. And they have been doing their rounds of tearing up. Not me. Not until today.

Nahan

Di ba sabi mo, kay ganda ng lahat. Kulay rosas pa ang mga bulaklak. Tila sa akin ay ayaw kang magtapat. Yan ba ang sabi mong pag-ibig ay wagas.

Ang iyong ngiting dati ay kay tamis. Pag ikaw at ako ay nagkakalapit. Nahan ang yakap mong dati ay mahigpit? At ang ligaya kong matamis mong halik?



- Posted using BlogPress from my iPad

End of An Era 3: Personal Trainer

He wasn’t my first Personal Trainer at FF. I joined FF ABS CBN in 2003 as a walk-in. It was conveniently near my office then.  And I’ve been hearing all the things that have been happening in the gym floor and other areas *wink*.



But I also wanted to be serious about working out. So I signed up for personal training sessions. My first PT was G, and he was the resident gorgeous charmer. He had dimples that dug deep into his cheeks. Yeah, he was hot and cute. And very serious about working out, too. He shared my goal (then) to really bulk up. So he even went out of his way to train me. We would train sometimes at the other gym (almost bakal) just so I’d be in peak condition.



He was also really nice to the other staff. He helped train even the locker attendants. And he encouraged them to aim to be trainers themselves. So when he was about to leave, he endorsed me to one of them. J was ‘promoted’ to being a trainer, and he trained under G. I knew I was going to be in good hands. (Though he wasn’t nearly as cute as G, J was equally serious about my training.)



That must have been 2004.  And he has been my trainer since... well until last Wednesday. Even when ABS CBNbranch closed down in 2013, I stuck it out with him when we all transferred to Trinoma.



He was never a cookie-cutter trainer. He would continually change our workouts. He would apply latest ‘learnings’, coming from the training he attended. He was 100% with me the entire time, unlike other PT’s who would either be chatting away with others, or on their mobiles. He would always challenge me to give more and exert more.



But sometimes it would also be too much. I’ve had some injuries from being pushed too far. And there would be times I would dread workouts with him because these were physically and emotionally draining. During those times, I wouldn’t even be nice to him.



It came to a point, sometime in early 2017, when I had to take a break from our workouts. I told him I was going to rest for an extended period of time. No renewal of our PT. And I signed up with another PT at Viridian. That PT was actually ok, too. But going to be Viridian in Greenhills, from QC was quite a commute. I went back to J in mid 2017. But I laid out some ground rules. And I insisted that my workouts be recorded every time. That was My “It Can Be Done” posts, when I made tremendous gains in achieving my workout goals.



In mid 2018, the company decided to change offices. We were transferring to Mandaluyong by 2019. In November, I told J that it would be my last 36 sessions with him. Our last session was Wednesday.



I sitll don’t have a new PT at Viridian. And I am not in a hurry. I have been using the Boost PT sessions to try out different trainers. I have narrowed my choices to three.



But I will always be grateful to J, my PT for about 15 years. He helped me achieve goals then. And he was always approachable and encouraging. Though he tried not to show it, I knew he was going to miss me as one of his enduring clients. He was always proud of the progress I had made. And he made sure he documented this through videos and photos.

Things will be different now with my workouts, specially when I get a new trainer. I am suddenly doubting whether I would still be as motivated. Or if it is still all worth it. Well, one day at a time.  

End of An Era 2: The Help

In a span of one quarter, two of our long-staying household help will have resigned. Carmen stayed with us for 21 years, Joy for about 12 years.

Carmen was so petite when she first worked for us, just turning 20yo then. She was referred by Nanay’s friend. Her family has been working for them for a while now. And she needed work. She eventually became the cook, learning from Nanay and from my Ates the dishes we grew up with. We also enrolled her in some cooking classes. This greatly expanded her skills.

She left to take care of her ailing Nanay, as she is the only unmarried one who could.

Joy started when she was in her teens. She used to be yaya to one of my nephews. When my brother and his family migrated to Auckland, we took her in. She became my ‘personal assistant’, assigned to take care of my needs particularly. She is spirited and able-bodied but she can also be very forgetful. She has received a number of scoldings from me.

She will be getting married soon and going back to her hometown to start a new life.

I will always have a soft spot for our household help. Growing up, they were always there for us, assisting Nanay in the day-to-day. But beyond that, I got to know many of them on a personal level. As they knew about us, about me very intimately.

I used to even felt offended for them if my Nanay would scold them. I would speak out in their defense. And sometimes, Nanay would take it against me. Haha.

Both of them gave us unparalleled service, dedication and loyalty. I could trust them with money. Beyond that, they have developed such ‘malasakit’ for us, for my parents that they hesitated to leave. But they have their own lives to lead and I wish them well.

And they know that they could always approach me for whatever they may need. For they may have started as employees, but they leave as family.




- Posted using BlogPress from my iPad