Contingency Plans

I’m still dealing with the fact that I am terminal. This condition comes with all kinds of thoughts and considerations, but mostly questions. I can tell that I’m in decline. That’s obvious. But how long do I have? And how will I know when my time is really running out? Exactly how terminal am I? After all, we are all terminal, eh.

The doctors are unbearably optimistic. It feels like they are in denial, or like they don’t want me to get upset and do something premature, like offing myself. But it seems obvious to me that a time will come when I will want to head for the exit door. When the party is over, I will to want to leave quietly, skipping the indignities and pain of a long and lingering circling of the drain.

I chose this image for circling the drain from a Google image search. Most of the images available showed the screen of the drain blocking larger chunks from going down. But this one conveys the real horror of the expression: There’s nothing to catch me when the inevitable happens and I’m sucked down into that black hole of oblivion.

I was quite annoyed when I read that, according to the rules of MAID (Medical Assistance in Dying), ten days notice is required before I could have a doctor’s help in doing myself in. You mean, I would have to pick a date ten days in advance of a visit from Dr. Kevorkian? Then I would have to lie around waiting for his arrival? This would be hard to take. I don’t want some bureaucrats dictating how and when I exit this planet. I just want them to get the fuck out of my way. So please, just give me the pills or the syringe and walk away.

And then, once the ten day cooling off period had passed, I would be required to sign my name to a consent form? What if I can’t do that? What if, during the ten days, I have slipped into an intermittent coma? What if I become a brain locked in an unresponsive body, unable to speak or move or hold a pen?

Yesterday I learned that my understanding was flawed. I was discussing my situation with the palliative care treatment doctor, Doctor Katherine King, a kindly maternal woman who checks in on me once a month and never gives me any argument about renewing my opioid prescription. I was explaining that my fear is of being blind sided by a sudden loss of capacity or cognitive ability which would prevent me from giving consent. I know that my situation can change overnight. A stroke. A fall. A further loss of function. And suddenly it’s obvious that my life is not worth living. At that point I want to just go. I don’t want to have to make an application and wait ten days, hoping that when the ten days are up I will still be able to give consent.

Dr. King, or maybe it was the angel who was on the conference call, Angela J. Lorenz RN BSN CHPCN(C)Palliative Care Coordinator, Island Health ((Angela, Such an appropriate name.) informed me that this isn’t the way it works. The ten days notice is from the point when I make an application to be on the program. Ten days after that there is no waiting period. I will be able to just call the doctor and exit, assuming the doctor will make a house call.

So it’s more like buying a gun with the intention of shooting myself and having to go through a waiting period before I can take possession. Once the waiting period is over and I have the gun, I can put it to my head and pull the trigger whenever I’m ready.

That’s a comfort. Now if I can just talk them into giving me the medication and leaving it with me, to use when and if… But this isn’t going to happen.

Of course, what I really want is to give my sister or my wife written instructions to send me off as soon as I’m unable to communicate. Then I could stop worrying about losing control. But this is not allowed under the present rules.

Hopefully this will change as the public becomes more accepting of our right to terminate and the damned Catholics stop raising objections. For now, ability to confirm consent is required up to the point just before the medication is given that will put this amazing body into park and turn off the ignition.

It’s another beautiful Fall day. The squirrel is back at the bird feeder that I hung on the clothes line. For now there’s still a lot to enjoy about being alive. I’m just making contingency plans, eh.

Now I’m Growing Tits?

The injection I had during my appointment with Dr. Atwell in Victoria is a drug intended to block my production of testosterone. The new drug, the apalutamide, is an AR antagonist, which means it blocks the action of testosterone. Between the two of them I’m getting to learn what a thirteen year old girl experiences. My breasts are swollen and quite painful.

At least I don’t have some horny teenaged guy trying to fondle them. On the other hand… no, let’s not go there.

The thought crossed my mind that since I can’t have an erection any more, not since the brachytherapy blasted the nerve that runs through my prostate, and now that I’m developing breasts, maybe I should go all the way and transition. Now that would be an adventure.

Unfortunately, I would be a six foot two monster of a woman. Far too ugly for any man to find sexually attractive. So I guess that’s just not an option. I have no interest in becoming a “two bagger”.
Shit. I can’t believe I thought that, much less wrote it. The culture I grew up in was so very misogynistic and that’s reflected in the jokes we told each other. So in case you lead a sheltered life, I’ll explain what a two bagger is. That’s a woman who is so ugly you need to bags to fuck her. One to put over her head, and one for you in case hers falls off.

I have mixed feelings about using profanity in these posts. But generally I’m giving myself permission. The five stages of dying, according to Kubler-Ross, are denial, anger, bargaining, depression, and acceptance. I’ve always felt that the first four of these are a complete waste of emotional energy. If this is my new reality, I might as well skip the drama and go straight to acceptance. But the first four stages come to the surface sometimes, and in unexpected ways.

Denial: I do find myself thinking, hey, I’m not sick. I don’t have any pain. Why did I listen to the doctors and allow them to lock up my mojo. This isn’t really happening.

Anger: Fuck fuck fuck fuck fuck and shit and cunt and asshole too. I will fucking swear if I feel like it. Why the fuck not. This sucks and I have a perfect right to be pissed off about it.

Bargaining: Okay. I will accept treatment. I can put up with losing my masculinity, losing the ability to have an erection, developing secondary female sex characteristics. It’s a deal. I just want to live.

Depression: I’m going back to bed. Yeah, I know that these times of consciousness a not going to last. I know I should be enjoying every minute while I still can. But I just don’t care. Why should I. It’s game over anyway and I like sleeping.

Acceptance: I’m not alone in this. I have a wonderful community of supportive friends and a loving wife I can talk to and cuddle with. Every day this side of the grass is a good day. Look at how beautiful the world is, how intricate are the forms and variety of life. I’m just a part of a very natural cycle that we all share.

I said in my last post that there is no escape from this. I’m constantly reminded. Last time it was a message saying I have a bone scan scheduled on February 13. Yesterday it was a letter from the Medical Imaging Department of the hospital letting me know I have a “CT Chest, Abdomen, Pelvis w/contrast” scheduled for February 21. Looking at my calendar when I entered this latter date, I notice that I have another Lupron injection due on February 28. Nope. Can’t forget for a minute that I have cancer.

But I’m not dying. Not yet. Not for years and years, they tell me.

Fuck.