Cell 2 Soul: The Humane Health Care Blog

Razor Thin

by Judith Bruder

No, no, not me!
At 83 I’m somehow hefty,
All five feet nothing
That once was five feet two.
No, I mean the margin
Between safety and decline.
One misstep.
Just one!
That’s all it takes
To take me from my home
And into care.
I’m well aware every day,
That every minute,
Every step I take
Must be measured,
Be prepared, planned for, thought out
Before it’s taken.
Handle with care!
That’s the label for my life
At 83.
That’s the difference
Between youth and age.
No more margin for error.
Or if one still remains,
It’s razor thin.

Apropos of Ms. Bruder’s poem is an Op-Ed piece in the January 2, 2018 NY Times, "88 Going on 18." The author, Robert Gottlieb writes:
Knowing I’m a stumble away from a walker has me examining how I spend the days left to me. That is more difficult than it seems as my mind often resembles a theater, transforming the most casual stroll into a play noisy with dialogue.

Also, Late Breaking: Lawrence E. Stager, a pre-eminent American archaeologist who unearthed evidence that anxious ancient Israelites sinned by worshiping a “golden calf,” just as the Bible, died on Friday, December 29, 2017 at his home in Concord, Mass. He was 74.The cause was injuries from a fall, his daughter said.

And more, NY Times January 2, 2017:  Afraid of Falling?  The Dutch Have a Cure.  This is an excellent article that discusses programs in Holland for older individuals.  If you are elderly or have elderly parents, this NYT article is well worth reading/

 

Henriette Thompson: Nonagenarian Pianist and Marathoner

Harriette Thompson, a classical pianist and cancer survivor who started to run marathons when she was 76 and ran the fastest time in a marathon for a woman over 90, died on Monday, October 16 in Charlotte, N.C. She was 94. NY Times Obituary.

[In the past few years, she ran] while wearing white tights to cover the open wounds on her legs from radiation treatments for cutaneous squamous cell carcinoma. Over the last seven years she had also dealt with a recurrence of oral cancer, which first struck her in 1986. The short and instructive New York Times obituary has many teaching points and is inspirational.

1. This 94-year-old musician and athlete died from a fall at the facility she was living in, not from her cancers.
2. Although she had squamous cell carcinoma of her legs and was being treated with radiotherapy the skin cancers were not proximate causes of her demise. This corroborates the work of E. Linos on “Nonmelanoma Skin Cancer in the Elderly.” In my opinion, we pay far too much attention to skin cancers which are billable to Medicaid and Medicare than to having patients use canes or having 94-year-old people being extremely cautious about stairs.
3.  This remarkable woman was a pianist until her death, she was an athlete. She had great meaning of her life.

For me, as a dermatologist, this reinforces the fact that treatment of non-melanoma skin cancer in the elderly, especially people over age 85, is not likely to improve their quality of life. Before recommending therapy, we may need to step back and not scare our elderly patients into having unnecessary surgery but, as experts, we should have honest discussions with them. Lesions in certain areas are best treated (around the eyes, nose, ears); but lesions on the torso and extremities can often be followed by active surveillance.These short You Tube videos will interest some of you.

 

 

Latest Edition

by Carol J. Rhodes 

Grade school, first bicycle,
high school, first date, first kiss,
college, first car, first job,
third floor walk-up flat.
Bought latest edition of Cooking for One. 

Engagement, marriage, honeymoon,
newness of sleeping in the arms of love,
instead of a kiss at the door.
first house, dinner parties, trips.
Gave Cooking for One to a single friend.
Bought latest edition of Elegant Meals for Two. 

Children, carpools, Little League games,
empty nest, daughters-in-laws,
doctors, hospital, funeral,
strangeness of  small apartment.
Gave Elegant Meals for Two to newlyweds
across the hall.
Bought latest edition of Cooking for One.

Author Bio: Carol J. Rhodes lives in Houston, Texas with a household zoo of two poodles and four cats.  She plays bridge once a week, and always has an online Scrabble game going with her best friend.  She can be reached at: rhodes.cATatt.net

"Over the Hill and Picking Up Speed"

At 100, Still Running for Her Life
by Noah Remnick, NY Times, April 23, 2016

"On a cloudless Sunday afternoon in April, a 100-year-old woman named Ida Keeling laced up her mustard yellow sneakers and took to the track at the Fieldston School in the Bronx. Her arrival was met without fanfare. In fact, no one in the stands seemed to notice her at all."

This is a fine piece about healthy aging. Ms. Keeling is an outlier; but it is important to study (and celebrate) the lives of exceptional people. If you click on the article, don’t skip the one minute video!

The Dangers of Polypharmacy

Graphic from Times article

"The Dangers of ‘Polypharmacy,’ the Ever-Mounting Pile of Pills"
By Paula Span, NY Times, April 23, 2016

Although geriatricians and researchers have warned for years about the potential hazards of polypharmacy, usually defined as taking five or more drugs concurrently; it continues to rise in all age groups, and has reached disturbingly high levels among older adults.  A recent study showed that 39% of people over age 65 in the U.S. take 5 or more different prescription medications a day (not yo mention other over-the-counter meds and supplements).

This is a concise, lucid and useful article by one of the Times best health reporters. It might pay to read it and remember its warnings.

See: Dangers of Polypharmacy.

A Poem for My Father

Early Thursday morning May first
I closed the circle with my father
Of whom I am from

Honored to help
Leo’s spirit Free
From his well worn body
92 frail skin and bone
Yet still strong and courageous

Bedridden for two months
He remained a stand up guy
Offering grace and humor

Ethan visited with Leo
Understanding accepting
Sharing open hearts
Leo barely able to speak
Offered Ethan advise
Grandfather to grandson
About the son:
“Don’t listen to him”

Leo enjoyed life long luck
He transitioned at home
His wish and my promise
We together the seven days
Of leaving his body behind

Hospice provided help
Amazing nurses aiding insight
Meds and visits as needed
Combined with compassionate care
From Leo’s wonderful home health aides
Mark and GiGi who gave generously
Of their Warm Haitian Creole hearts

Leo walked through the only door open
Clearly and consciously seeking he stopped eating
We were together throughout this seven day journey
To his well deserved long sought release

Leaving one's body is no small task
We dressed Leo casual for comfort
Who could he still possibly need to impress?

Much to appreciate life’s life lessons
Fortunate to be born a son of Leo
Generous non-judging supportive father
Ever happy he set himself free

40 Years on This Huge Stage

this huge stage presenteth nought but shows
Sonnet # 15

First, there was “Boyhood,” filmed over 12 years with the same cast, a groundbreaking story of growing up as seen through the eyes of a child.

Now, there is “Forty Portraits in Forty Years, photographs by Nicholas Nixon, who chronicles the four Brown sisters annually every year since 1975.

This is an amazing collection.  While “Boyhood” is fiction, “Forty Photographs” is snapshots of reality.  If a picture is worth 1000 words, what volumes are contained in these two score images!

But at my back I always hear
Time's winged chariot hurrying near;
And yonder all before us lie
Deserts of vast eternity. 
                         Andrew Marvell:  To His Coy Mistress.

 

Sam Berns, Age 17, Obituary

Sam Berns, a Massachusetts high school junior whose life with the illness progeria was the subject of a recent documentary film, died on Friday, January 10, 2014 in Boston, age 17.

The full length documentary, Life According to Sam, has been produced by HBO and should be available on NetFlix one of these days.  “What is aging in Sam Berns, is aging in all of us. But in Sam’s body, the process is rapidly accelerated."  For more on the documentary, see MedFlix.

Sam gave a (12 minute) TED talk: My Philosophy for a Happy Life. (Click on link to left for better view than box below)

Sam truly epitomizes the philosophy of Invictus

Out of the night that covers me,

      Black as the pit from pole to pole,

I thank whatever gods may be

      For my unconquerable soul.

World Enough and Time!

The Times had a fine article on the Literature of Death recently, and two thought-provoking pieces came to our attention at the same time.

1. Why there are no big milestones to achieve in my life by Heidi Wilk

[In] minutes my world crashed around me. My husband had a seizure while picking our daughter up from daycare... He was diagnosed with an incurable brain tumour.
My husband is going to die young. We are not going to grow old together. The moment of diagnosis was the saddest and darkest time of my life. Not where I expected to be at 32.  Why?  Download Wilk Barankin

2. The Joy of Old Age (No kidding) by Oliver Sacks
Eighty! I can hardly believe it. I often feel that life is about to begin, only to realize it is almost over.
I feel glad to be alive — “I’m glad I’m not dead!” sometimes bursts out of me when the weather is perfect. (This is in contrast to a story I heard from a friend who, walking with Samuel Beckett in Paris on a perfect spring morning, said to him, “Doesn’t a day like this make you glad to be alive?” to which Beckett answered, “I wouldn’t go as far as that.”).  Download Sacks 80

 

On His Deafness

Milton wrote an immortal sonnet "On His Blindness."
Our C2S contributor describes his own experience with progressive deafness.

SOUNDS OF SILENCE

High-pitched voices the first to go
Louder becoming a screaming noise
Communication confused by multi-tonality
Like, like a stuttering redux.

A missed word, a phrase,
whole sentences gone, the meaning unclear
a reluctance to be wrong in response
silence misinterpreted as taciturn.

Aural uncertainty boosted by reading lips,
chance guesses of the dictionary of glances,
a wink, a nod, eyes widening, eyebrows up
Cultural mismatches even harder to dissect.

Technology minimizing embarrassing moments
for a little while, keeping me alive and sane.
But the process is relentless
The tunnel collapsing, the path narrowing.

The deafening sounds of silence
not peaceful nor comforting
no morning bird nor buzzing cricket
as the sun rises and sets.

For better formatting Download Sounds Meyskens

Frank L Meyskens Jr  12/2012

Meyskens with his muse

Author Bio: Frank Meyskens, Jr., Director, Chao Family Comprehensive Cancer Center, University of California Irvine writes: “Aging is a surprising process. Over 50% of people over age 70 have functionally meaningfull hearing loss.   This loss marks one as frail. Whether or not one is, reading lips only goes so far. One of the most joyous days of my life was the day after I acquired my new super-duper hearing aid and opened my front door and heard the morning cacophony of birdsongs.  After a year of silence,  I felt alive again"