Writing and Coping Until the End

EDITORIAL NOTE: Judith Graham, who writes the Navigating Aging column at Kaiser Health News and who I've known for several years, interviewed me about my cancer diagnosis along with my decision to write about it for this blog. It was interesting for me to try to answer her wide-ranging questions as best I could and she pulled it all together in her usual excellent manner.

Oddly, although I wrote today's blog post yesterday before I read Judith's story, they turned out to be sort of companion pieces. You can read Judith's story here.

* * *

One of my oldest blog friends sent an email earlier this week noting:

”...it's heartening to know that you're not going to turn your blog into a 'Watch me die,' fiasco but continue it as a 'Watch me live' play-by-play.”

My thought was then and still is, “Oh god, I hope he's right. I'm not sure.”

In this final life predicament of mine, I'm flying blind. No one is prepared for this and in my case, I am unwilling to read about how others, knowing their approximate expiration date, have navigated the remaining time.

Writing is how I help myself figure out things. I was doing it a long time before there were blogs, even a long time before there was an internet and when I decided to let you, dear readers, in on my cancer diagnosis, I also declared to myself that I would write whatever was on my mind - or as close as I can determine - as if I were writing in one of my old analog journals.

What is new on Time Goes By now is that there will be fewer reported and researched posts. Most will be like this one, conjured from the thoughts and feelings flitting around the synapses of my brain.

These are easier to write, less time consuming and I need the extra hours in a week now. One thing I have learned in this first month is that knowing death is relatively imminent means there is a lot to do to be ready. When not procrastinating, I am busier than before this happened.

My end-of-life documents are long-since prepared and appointments with medical people are arranged for the next couple of months.

But there is homework to do and decisions to be made about palliative care issues and assisted dying, cremation to arrange, many last letters to write, visits with beloved friends, cleaning out my home of what will become useless detritus when I'm gone and much needed quiet time with myself.

Surprises eat up time too – more time, it feels like, than when such things happened “before.”

A week ago, hot water disappeared from my pipes and it was determined that a new water heater was required. Wh-a-a-a-a-t? At this particular moment in my swiftly shortening life, when I have a last chance to ponder my soul's relationship (or not) with the universe, my water heater dies? Before I do? Who thought that was a good idea?

And dear god, have you noticed what it costs to replace a water heater these days? Geez.

A day or two later, while carrying a big bundle of dirty laundry to the washing machine, I tripped on a dragging towel or bed sheet and crashed to the floor, banging my knees and my forehead horribly.

Although I quickly determined that nothing was broken or bleeding, the pain was terrible - throbbing away. I lay on the floor for a bit catching my breath and after a couple of minutes burst into tears – heavy, deep, uncontrollable sobs that went on and on.

My wits were still enough with me that I could tell right away, it being my first cry since this diagnosis, that my weeping was not at all about the pain in my knees and head.

While I lay there and in keeping with my slighlty off-center sense of humor, a cartoon I had seen recently came to mind of a woman lying on her floor. Parodying that awful TV commercial, she says, “Help. I've fallen and can't think of a reason to get up.”

Nor could I. For awhile.

After 15 or 20 minutes that old, impossibly cheerful Jerome Kern/Dorothy Fields song intruded on my misery: “Pick yourself up, dust yourself off and start all over again.” Really? At this point in my life I've turned into that much a Pollyanna?

Apparently so.




The Day After the U.S. Midterm Election

On the morning after the 2008 presidential election, the first thing I heard on the news was an announcement of who intended to run for president in 2012.

And so it has been ever since. If we have not heard yet today who will run in 2020, we soon will (they can't help themselves, these politicians), thereby continuing what has become the perpetual 24/7/365 political campaign.

There is no governing in the U.S. anymore - just campaigning.

Except for issues that affect old people in particular, Time Goes By is not a political blog. But yesterday's election is different.

As many have said, it is a referendum on President Donald Trump and probably by the time this post is published today or you are reading it, we will know whether he succeeded in helping the Republican party maintain control of the entire federal government or if the Democrats managed to take the House and/or the Senate.

As I write this on Tuesday, I am worried about either outcome. If Trump prevails, it is frightening to imagine what legal and illegal acts his sense of empowerment will unleash on the country and the world. It will not be pretty.

And if the Democrats manage to wrest control of some part of the government, it is frightening to imagine what legal and illegal acts (in addition to his claiming victory anyway) Trump's sense of empowerment will unleash on the country and the world. It will not be pretty.

This election is my last. I was first allowed to stay up late to track the vote count in the 1952 election between Dwight Eisenhower and Adlai Stevenson - I was eleven years old – and I have been doing it in every election since then.

When Trump was elected in 2016, before I knew of my cancer diagnosis, I told anyone who would listen that whatever else happened, I would be pissed off big time if I did not live long enough to see how the Trump era ends (everything ends eventually).

Count me pissed off. And count me pissed off further that if special counsel Robert Mueller III drags his feet, I may not know that outcome either.

But at least I have seen this election and because nothing else today is as much on anyone's mind, let's see what we have to say about it in an open political thread below.




A TGB READER STORY: Practicing Patience

By Jane Seskin

I met up with a stroller in the lobby of a building, caught my foot on a wheel, twirled to stay erect, then fell to the floor.

My side a week later was a muted rainbow. I fractured a bone in my right wrist, was put in a cast ending below my elbow which hugged my thumb. I was told my hand would be immobilized for six to 10 weeks.

I didn’t realize in the moment the cast was applied to my dominant hand it would upend my life. Early on I knew I would need to inhale some of the skills I nurtured in others as a psychotherapist. My litany: be patient, acknowledge your feelings, allow yourself to be vulnerable, ask for help, practice self-compassion.

As an independent, type A senior single woman, I didn’t understand I would have to learn those lessons over and over again.

For the first week, I carry my arm around in a white sling. I’m apprehensive on the street. Feel vulnerable in crowds and by people walking toward me looking down at their screens. I’m nervous someone will bump into me and frequently call out: “Heads Up!”

A friend observes as we leave a movie that I’m listing to the right. At night I’m thinking pasta. I’m thinking sourdough bread and butter. Carbs - always a bad sign.

I cannot hold the ancient but still usable receiver from my landline, drink from a cup or mug (In restaurants: “May I please have my coffee in a takeout container?”), eat with a fork and knife, peel an orange or a hardboiled egg, apply lipstick, wash my face, brush my hair, carry a pocketbook, an umbrella, use my wallet or write with a pen.

I struggle to put my key in the door and then turn it to open. My everyday life has been compromised. I’m on leave from my Senior Aerobics class that has weekly energized me. My patience sits on a swing on a windy day and I am frequently seconds away from tears.

I’m frustrated opening a plastic bag of salad, cutting vegetables, unscrewing a jar of marinara sauce. I’m angry at my helplessness, tired from the efforts and sad to have to acknowledge - I am incapacitated.

In the third week I stop fighting the situation. Stopped being so angry with myself for feeling out of control. For being slow. I return to the scene of the accident, a large bustling lobby in a crowded shopping center. I pace up and down the marble floor where I fell. I’m grateful I didn’t crack open my head when I went down.

What I was living was my present experience. My moment in time. I began to answer “having a hard day,” if I was, when someone asked, “How’s it going?”

I have fleeting desires. I want to shop. I want to buy new clothes. I can’t get my arm through long-sleeve tee shirts and jackets. Putting on a coat requires major breathing and a little dance step. Can’t pull things over my head. I’m now wearing a diet of button down, snap-close shirts.

It takes additional time to get dressed in the morning. I often stop, just stand still. Count backwards from 100. Running shoes gone in favor of clogs and boots that have no laces to tie. The days are cold. My fingers chilled. I wear a sock on my hand and feel I will break into puppetry at the sight of a child.

Five weeks. I’m not in pain. There is an occasional feeling of heaviness in the hand, of throbbing in the wrist. I take no meds. Perhaps a cinnamon raisin walnut scone some afternoons with a cup of espresso.

To blunt the tedium I read murder mysteries and poetry, listen to Keith Jarrett, practice meditation and do my work which is engaging and stimulating. (This is an exploration for me and with clients on what it means to be hurt, to feel dependent, to ask for help. I reassure someone: “My arm is injured. My brain is intact.”)

Nine weeks. My cast comes off! I’m keenly aware this has been a transitory injury, a taste, a forewarning of frailties to come. I acknowledge the minefields in my day and will continue to make adjustments. I learn to practice patience.

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[EDITORIAL NOTE: This feature, TGB Readers' Stories, appears every Tuesday. Anyone age 50 and older is welcome to submit a story. You can do that by clicking the “Contact” link at the top of every TGB page or at the Guidelines/Submissions page.

Please be sure to read and follow the guidelines before submitting a story. It will save me a lot of time.
]




Dying My Way

Today marks four weeks since the doctors told me cancer has reasserted itself and there is no treatment. That news was not a surprise. Although I had been pronounced cancer-free since last January, I knew it was more likely than not to return.

Right now my timeline is squishy. Chemotherapy begun last Wednesday is designed to slow the growth of the new tumors and thereby extend the estimated time during which I will feel healthy before cancer symptoms begin to kick in.

As you might imagine, a lot has been running through my mind, ping-ponging around as I explained in a post last week, on a wide variety of end-of-life-related thoughts and feelings.

Even so, I have found a lot to laugh about in all this. I've always had a well-developed sense of the macabre – so much so that it's been a long while since I've thought of it as black humor. To me it's just funny alongside every other kind of funny. (Unless I'm whistling past the graveyard and don't know it.)

In the interval where I live these days between the belief (shattered now, of course) that I am the one immortal and my ending, there are personal decisions to be made. An important one to work on has been about how I want to spend my final months.

The broad outline is already settled and I will write about that in time. But an issue came up Friday when I was approached about reviewing a book that, the editor wrote in an email, explains what's wrong with how we die these days and what people can do to die in a manner that is better – at least, according to the author, a medical professional who has worked with terminally ill people for some years.

If the book were a general critique of (to borrow an old phrase) “the American way of death,” I might not be as offended even if the title does read as too much a projection of the author's personal preference for end-of-life.

After 25-plus years of studying aging, death and dying I know that no one really understands growing old until they get there themselves. I have unlimited gratitude and admiration for caregivers of all sorts. They are special in ways I cannot match but they do not KNOW about old age in a real sense until it is their time.

Similarly, I have learned now that living with a death sentence cannot be imagined. No one can understand until or unless they are tagged with that verdict.

What puts me off is the evident certainty in the book title (particularly couched in its boomer-generation phrasing) and the description I received that the author knows what values and priorities should define a person's dying days.

Let me be clear about that: There is no right way to die. Equally so, there is no wrong way.

* * *

NOTE: I am not telling you the names of the book and the author for several reasons: I have read only a fairly thorough description of it in an email, it will not be published until next year and it contains information about navigating the medical establishment during one's last weeks or months that could be useful to people who have not researched this as extensively as I have.

Further, in the 15-year history of this blog, I have made it a rule to write only about books I can unequivocally recommend which is not something I want to change at this late date.

In these circumstances, it would be unfair to me to leave readers only with my personal objections. Hence, no title or author.

* * *

Making a choice about how to die - which is another way of looking at being given a medical death sentence - is highly personal, maybe the most personal act in a lifetime.

So I am going to rely on what I have come to believe from all the decades of study I've done to inform how I spend the remaining time of this last journey.

Most of all, I do not want to be influenced by anyone else's idea of what they believe is a good or right kind of death.

I am being careful to do some things - and just as careful not to do others - to ensure that my death (and the getting there in the interim) is my own. Among those things is not to read other people's advice about how to die.

Have you given this choice any thought?




ELDER MUSIC: Songs of Irving Berlin

Tibbles1SM100x130This Sunday Elder Music column was launched in December of 2008. By May of the following year, one commenter, Peter Tibbles, had added so much knowledge and value to my poor attempts at musical presentations that I asked him to take over the column. He's been here each week ever since delighting us with his astonishing grasp of just about everything musical, his humor and sense of fun. You can read Peter's bio here and find links to all his columns here.

* * *

Irving Berlin

Israel Beilin (or Baline according to some) was born in Tolochin, in Russia and went to America when he was five. Somewhat later he acquired the name IRVING BERLIN.

Besides the hundreds of songs, Irv wrote the score of a couple of dozen Broadway musicals and 15 or so films. Pick the name of a singer out of a hat and she/he will have sung something of his songs. Here are just a few.

Alexander's Ragtime Band was one of his first hits, and one of his biggest. He wrote it in 1911 and he also performed it that year. Over time, many have recorded it, some several times. One (or two) is (are) BING CROSBY and AL JOLSON.

Bing Crosby & AlJolson

The version today was recorded in 1947.

♫ Bing Crosby - Alexander’s Ragtime Band


I Got Lost In His Arms was written for the musical “Annie Get Your Gun” and was sung in that by Ethel Merman. Ethel is a long, long way from being my favorite singer, so I’m glad the ROSEMARY CLOONEY recorded it.

Rosemary Clooney

Several more people have recorded the song including, rather surprisingly to me, Suzi Quatro.

♫ Rosemary Clooney - I Got Lost In His Arms


Blue Skies was written after Irv and his wife Ellin had had their first daughter. It’s an optimistic, forward looking song as befits that occasion. The song first saw light of day in a Ziegfeld production, and later Al Jolson performed it in the first talkie, “The Jazz Singer”.

It’s been recorded many times and been to the top of the charts quite often, including fairly recently when WILLIE NELSON recorded it (and other similar songs). Naturally, if Willie is around I’ll probably choose him.

Willie Nelson

♫ Willie Nelson - Blue Skies


There were several candidates for the song Heat Wave, but I narrowed it to two. I played them both for Norma, the Assistant Musicologist, and she instantly went with SOL K. BRIGHT & HIS HOLLYWAIIANS.

Sol Bright

I was leaning in their direction as well, so it was unanimous.

♫ Sol K. Bright & His Hollywaiians - Heat Wave


Change Partners is a song that Irving wrote for the film “Carefree” in 1938, where it was sung by Fred Astaire. Since then there have been quite a few versions that made the charts. The one I’m interested in today came from considerably later, 1967, from an album that FRANK SINATRA and ANTÔNIO JOBIM recorded together.

Frank Sinatra & Antônio Jobim

It’s lucky Frank sang, as otherwise it sounded rather like elevator music to me.

♫ Frank Sinatra - Change Partners


Apparently, I've Got My Love to Keep Me Warm is a Christmas song. It mentions icicles and snow and all that palaver. That doesn’t sound like Christmas where I live – all sunshine, shorts, T-shirts, drinking cool white wine in the shade. Anyway, I’ll just skip over that and let the MILLS BROTHERS warm you up.

Mills Brothers

♫ Mills Brothers - I've Got My Love to Keep Me Warm


Irv didn’t think the song Say It Isn't So was much good so he put it away in his bottom drawer. Somehow or other Max Winslow heard the song and took it along to Rudy Vallée who sang it on his radio program and made it a big hit.

Rather than a vocal version, I thought that the BENNY GOODMAN QUARTET captures it beautifully.

Benny Goodman

Like Nat King Cole down below, I’ve always preferred Benny in his quartet to the big band. Somebody must have liked the big band though, as they were very popular.

♫ Benny Goodman - Say It Isn't So


ROSEMARY CLOONEY makes a return visit, this time as a duet partner of GUY MITCHELL.

Guy Mitchell & Rosemary Clooney

Irv wrote You're Just in Love for his musical “Call Me Madam” where it was sung by Ethel Merman and Russell Nype. As mentioned earlier, I’ll skip Ethel if I get the chance.

Fortunately, several other versions made the charts. Rosemary and Guy’s was the biggest seller, and the one I prefer.

♫ Guy Mitchell & Rosemary Clooney - You're Just In Love


Irv was rather fond of counterpoint, or “double songs”. The previous one is an example of that, as is this next one, Play a Simple Melody. The version I’m using was originally attributed to “Gary Crosby and Friend with Matty Matlock's All Stars”. Of course it was immediately obvious who his “friend” was.

Here are BING CROSBY and GARY CROSBY with the song.

Bing & Gary Crosby

♫ Bing Crosby & Gary Crosby - Play a Simple Melody


It was difficult trying to select which version of What'll I Do to include, as several of my usual automatic inclusions were present; most notably Chet Baker and Julie London. In the end THE NAT KING COLE TRIO trumped them all.

Nat King Cole Trio

His trio is the way I like Nat best, and this is a beautiful version.

♫ Nat King Cole - What'll I Do


As an indication of his longevity, I’ll end with a tribute, a song Irv didn’t write. It’s by IAN TYSON.

Ian Tyson

The song is Irving Berlin (Is 100 Years Old Today), and it shows his incredible influence in all genres of music.

♫ Ian Tyson - Irving Berlin (Is 100 Yrs Old Today)


Irving Berlin




INTERESTING STUFF – 3 November 2018

DON'T FORGET – CHANGE THE CLOCKS TONIGHT

For most of the United States, it's time to change our clocks tonight to standard time – one hour back.

FallBack

Some of our tech clocks make the change on their own but I still have some old-fashioned analog clocks I need to do by hand. Just before bedtime.

DON'T FORGET – VOTE ON TUESDAY

Vote I happen to believe voting is not just a civic duty, but a moral one. Aside from laws that apply to everyone, voting is the only thing a democracy asks of all citizens. Please, please do it on Tuesday.

HUNDREDS OF YEARS OF HUMAN BONES

This is amazing, what reader Nana Royer sent. It is about the Sedlec Ossuary (The Bone Church) in Kutna Hora, Czech Republic. It is a world Heritiage Site containing the skeletons of between 40,000 and 70,000 people.

Wait until you see all the ways they are displayed.

TINY DRONES COOPERATE TO OPEN HEAVY DOOR

According to the YouTube page,

”Researchers from Stanford University and the Ecole Polytechnique Federale de Lausanne in Switzerland built small drones, which they call FlyCroTugs, that can move heavy objects by coordinating their actions.”

It takes these little, electronic critters a couple of minutes to get going but you sense them communicating with each other.

7TH GRADER WINS TOP SCIENCE PRIZE

My friend John Gear sent this item about a 13-year-old (!) who won an important prize for a new science invention. Business Insider reports:

A 13-year-old boy from Oregon has won the Young Scientist Challenge by inventing an artificial intelligence treatment for pancreatic cancer.

“Rishab Jain created an algorithm to improve cancer treatment by using AI to locate and track the pancreas in real time.

“A prime challenge in radiation treatment is locating the pancreas itself, which is often obscured by the stomach or other organs, resulting in healthy cells being inadvertently hit. Rishab's algorithm improves accuracy and increases the impact of radiation treatment, according to organizers of the competition.”

All I have to say about this is THIRTEEN? The rest of us might as well not bother. Read more at Business Insider.

NOTE FROM RONNI: All the remaining items are about animals. I had so many this week I could have done the entire post on animals. I restrained myself. Since I was told of my latest cancer predicament nearly four weeks ago, there is been a noticeable and fairly large uptick in my interest in the natural world.

TRACKING BIRDS OF PREY

The You Tube page tells us:

”On a remote mountaintop in Eastern Nevada, a dedicated team of conservationists has been keeping watch for over 30 years. Their mission? To count and record every single raptor and bird of prey that flies past to keep track of their populations.

“Over the years, HawkWatch International has counted over 13 million birds across their network of observation sites. Since hawks sit on the top of the food chain, any drastic changes in their populations signals problems with the balance of their eco-system.

“If these hawks start to disappear, HawkWatch is the first to blow the whistle so we can take steps to address the problem.:

REMY THE HARVARD CAMPUS CAT

Harvard University has communal cat.

091218_Remy_0008

The Harvard Gazette explains:

”Jessica Shires, department administrator in Harvard’s History and Literature Department, said that when she started the Facebook page 'Remy the Humanities Cat' with a couple of colleagues, she was surprised to learn how many fans the feline had made in his travels.

“'Little did I know how far his visits spread across campus,' Shires said. 'Occasionally I’m reminded by Law School, STEM, and museum friends of Remy that he’s not just a humanities cat. I suppose now I’d probably be more inclined to call him ‘Remy the Interdisciplinary Cat.’”

“Remy’s owners have known about his double life at Harvard for years now through the many phone calls they receive — up to 10 a day, as late as 2 a.m. — from across campus. 'We have picked him up from numerous Harvard buildings over the years,' Watton says.”

There is much more about Remy, including a recent disappearance and retrieval at the Harvard Gazette.

DOGGIE AMBASSADORS

Yes, this appears to be a sort of commercial for the Fairmont Hotels but it such a nice idea that I can't object to posting it. The Youtube page tells us:

”Since 2001, Fairmont Hotels around the world have been home to a highly esteemed (extremely adorable) fellowship program. Fairmont’s Canine Ambassadors aren’t just a hotel guest’s best friend and the perfect four-legged concierge—they’re family.

“These formally-trained pups know the halls of the hotels and the people who work there. They’re also experts in mountaineering, constantly exploring the landscapes surrounding Fairmont Banff Springs and Fairmont Chateau Lake Louise.”

GARY AND SEAL IN THE SCILLY ISLES

This is so adorable you will not help but kvell at underwater videographer Gary Grayson's encounter with a friendly seal:

* * *

Interesting Stuff is a weekly listing of short takes and links to web items that have caught my attention; some related to aging and some not, some useful and others just for fun.

You are all encouraged to submit items for inclusion. Just click “Contact” at the top of any Time Goes By page to send them. I'm sorry that I won't have time to acknowledge receipt and there is no guarantee of publication. But when I do include them, you will be credited and I will link to your blog.




The Most Important Vote of Our Lives

Many have said that next Tuesday's midterm election in the U.S. is the most crucial in our lifetimes and they are right. It is. It is.

Much is at stake, perhaps even democracy itself, but for certain, if the Republicans retain control of both houses of Congress, one of the first things they will be gunning for next year is what they call “entitlements” - Social Security, Medicare and Medicaid.

The GOP likes that term “entitlements” because it sounds like a free giveaway, which the programs are not. They are “earned benefits” and don't let anyone tell you otherwise. Every worker pays into them all their working lives.

We know the Republicans will come for these programs because unlike the president who just lies when he says he will protect them, the Republicans tell us right out loud what they intend to do.

Referencing comments from television personality and now economic adviser to the president, Larry Kudlow, in September, Alternet reported,

”...the White House will push for cuts to life-saving safety net programs like Medicare and Social Security if the GOP retains control of Congress in November.”

When they say we must “reform” Social Security and Medicare, that's code for “massive cuts”. Here is a chart of more Republican code words from the National Committee to Preserve Social Security and Medicare (NCPSSM):

CodewordsMedicareSSA

Majority Leader Mitch McConnell has never, in his long career in the Senate, made it a secret that he wants to cut the entire social safety net.

Now he's insisting that Social Security, Medicare and Medicaid must be slashed. Here's how his lies go, according to the The New York Times last week:

”This month, the Treasury Department recorded a $779 billion deficit for the 2018 fiscal year, stemming in large part from a sharp decline in corporate tax revenues after a $1.5 trillion tax cut last year,” writes Jennifer Steinhauer.

“'It’s disappointing, but it’s not a Republican problem," Mr. McConnell told Bloomberg News in an interview. 'It’s a bipartisan problem: unwillingness to address the real drivers of the debt by doing anything to adjust those programs to the demographics of America in the future...'

“That is code for wanting to tackle entitlement programs like Medicare and Social Security, which Republicans say need to be reined in to address the ballooning federal deficit,'” McConnell continued.

Yes, you read that correctly. McConnell wants to pay for the massive, unnecessary tax cut for the rich on the backs of the poor, the sick and the old.

And the Republicans can do that, they can get away with it if they retain control of both houses of Congress.

It's not like the country supports McConnell, Kudlow and the rest of the Republicans. As Business Insider reported early this week:

”According to the Marist/NPR/PBS poll, 60% of Americans would rather reverse the GOP tax law to deal with the growing deficit. Just 21% of Americans would rather make cuts to entitlement programs of Medicare, Medicaid, and Social Security.”

Don't think this is just an old-people's issue. It affects everyone of every age who works, children of workers too and spouses of workers. Yes, the earned benefits programs need some shoring up. But there are a lot of good ideas from smart people about how to do it.

In fact, many of those ideas have been around since President George Bush tried to privatize Social Security 13 years ago and failed because the American people saw through the sham then and they do again now. But if the Republicans continue to control the entire federal government after next week's election is the huge cuts can happen.

Living in a vote-by-mail state, I sent in my ballot last Monday. If you live where there is early voting and have already done that, good for you.

If you intend to vote in person on Tuesday, please keep all of the above in mind and more: If you can help some others get to the polls, please do it. But most of all, whatever it takes to get it done, please, please vote.

It will be the most important vote of your life.




The Ping-Pong of Thoughts Toward the End of Life and The Alex and Ronni Show

It has been three weeks since the doctors told me there is no treatment for my cancer and that video above is a pretty close representation of what my mind, since then, has been doing.

It's all over the place skipping from one feeling, thought, idea or notion to another without finishing the previous one. I can go from considering death as the last great adventure to paralyzing fear in a second or two.

Or from pondering the mystery of cancer cells gone awry in a way that is certain to kill themselves by killing me, their host, to wondering how I should now choose the books I read.

From wondering why I can't yet make myself order my cremation (it's not hard to do, for god's sake) to clicking over to YouTube to watch cute kitty videos while worrying that I'm wasting what time I have.

And so on. Random. Purposeless. Unproductive.

There is no instruction book for end of life especially in a culture, the United States, that hides death and dying from everyday life so that we who are near checkout time are on our own with few, if any, examples to call on.

In fact, for all the hundreds of books and thousands of articles, studies and news stories I've read about ageing, death and dying, there is hardly anything written by or for the dying person. Almost all of it is for, by or about the caregiver.

Which is not to take a whit away from the kind, dedicated people who take on that burden privately and professionally. They are special in ways I am not nor could be. But their experience is different from the person doing the dying.

What I have discovered is that little cultural attention is paid to this period of time between dire diagnosis and death. It is fairly easy to find out what the final days, hours, moments of life will be like – at least from the outside. There are many sources.

But no one tells us about navigating the period of time - be it weeks, months, a year or so - when you can no longer fool yourself into believing you will live another 20 years and become one of the ancients.

So I'm making it up as I go along. What most keeps me engaged are friends online and in person. They are my comfort and ease who, depending on distance, have stepped up without being asked, keeping in touch by phone, email, inviting me to lunch and dinner and offering open-ended help now and in the future.

Even as someone who always has needed and still needs more time alone than many others, nothing else keeps my mind from ping-ponging hither and yon as much as close contact with people I love.

* * *

If you would like to see Alex's entire two-hour show with other guests following our chat, you can do that at Facebook or Gabnet on Facebook or on YouTube.




A TGB READER STORY: Medical – In the Beginning and Near the End

By William Weatherstone

In 1941, I had my first operation - for tonsillitis. I could not enter school at that time unless they were removed.

In 2017, (near the end of my life now at 81 years old), I had open heart surgery to hopefully extend my life-span.

As a child, it was a horrendous experience to go through.

When my wife entered the nursing home in Blind River, Ontario, I moved there from Elliot Lake to be near her.

During the couple years that I was living in Blind River, I had a small apartment over a commercial store in the downtown strip. I would at times drive the 40 miles back to Elliot Lake for food supplies as well as visit with friends. Returning home, I would have to carry bags full up 15 stairs and down a long hall to the apartment. It would take three loads to empty the car.

During the transfer, I found that after each trip upstairs, I would have to sit down for a few minutes to regain my breath.

After my wife died, I moved back to Elliot Lake.

It was getting worse, the breathing and tiredness. Just walking from the car to the building entrance, I would have to stop twice to catch my breath again. From car to building was about a couple hundred feet.

My next medical was in a few days and when I got there, I explained to her what was happening and right away she started tests and made an appointment with a cardiologist in Sault Ste. Marie for more testing. It started with a complete stress test and then an angiogram.

That appointment was strange. They started with a nurse coming in with a shaving kit to clear out the crotch area, for going through the groin with a camera to fish its way to the heart exploring the damage.

Once on the table, the surgeon checked my wrist vein for size and took that route up through the arm artery and into the heart.

I was wide awake through the whole process and was waiting for them to start. After a while I was wheeled back to my bed area wondering why they did nothing. To my surprise it was done completely. It was so smooth and totally painless and hard to believe.

If going up through the groin, you would have to wait for four to six hours with weighted bags on the groin incision to close & heal, whereas the wrist job is about 45 minutes to an hour waiting time.

So far, this procedure was easier than my first tonsillitis operation.

The results were sclerosis of the aorta heart valve. (The opening was closing.)

For my next appointment, he sent me to a heart surgeon in Sudbury for a final interview. During this meeting, he explained all the procedures required. On his desk were models of the replacement aorta valves, a pig valve, a cow valve and then a metal mechanical valve.

A couple of days later. he gave me a call and said that he found a new type mechanical valve that he was going to use. I took the information as I would now be an old guinea pig to test these new devices.

The date was set and I blew into Sudbury the day before checking in to the motel right beside the hospital. I showered with antibiotic soap and was on the gurney by 6:00AM, rolled into the O.R. and promptly put down.

I had mention to the surgeon during our interview that if I woke up and had hoses or anything down my throat, I would panic and throw a real sh*t fit and would not take any responsibility for my actions. He simply responded with, “Tell it to the anesthesiologist, okay?”

Okay.

Just as I was going to be put down, a doctor of some sort looked at me looking as miserable as one can at six in the morning. I asked if he was the gas man. Yes. I told him about the waking up problem, then I was gone into the blackness of the afterlife – or so it seemed.

When it was over, I had two quick chokes to fight off and then all smoothed out. (I’m alive, I think.)

Nothing like my 1941 operation where my guts were throwing up all over the place and my first real pain experience like my throat being torn from my body, headache like never before and, finally, only being soothed with ice cream, the medicine of the gods.

This time, I was moved into ICU (without the ice cream) but still painless and wondering what would happen next?

Shortly (I think) afterword, my two buddies arrived after a 400 mile drive to see if I was still alive or not. I think they felt obligated somewhat because I was there for both of them when they had their bypass surgeries years ago.

After the visit, I was transferred to a semi-private room with one other patient. It was on the top floor and just under the helicopter roof pad.

We seemed to get along quite well, but in a few hours, he was being released, leaving me in privacy.

Not being geared for long stays in a bed, and with too much sleep, I became wide awake at 2:30AM. What does one do now? Fortunately, I had the bed beside the window, so became a star gazer.

All of a sudden, there was a great whirling sound. I looked up above and saw three great big bright floodlights coming down on me with this whirling, beating sound. I was mesmerized, just waiting any moment for Scotty to beam me up into the Enterprise or perhaps worse, could be the Klingons?

It wasn’t five or 10 minutes later that the paramedics brought their passenger from Timmins into the empty bed, letting me know that I was safe and not going to be beamed up anywhere. (Oh, darn.)

We got along fine especially since I knew his part of the country intimately.

His problem wasthat he'd had stents put in that failed and then had to be rushed back. For warranty, I assumed.

I was pushing to get out early, at least by Sunday, the fourth day. Unfortunately, my surgeon was off on Sunday but had planned for another heart surgeon to take out all the stitches and any attachments, such as the colostomy bag. Only a heart surgeon is allowed to do this.

During this process everything was going along fine while I still had the intravenous plunger in my left wrist. While everyone was shooting the crap, his assistant took out the intravenous attachment and was hanging onto my wrist thinking that he was holding the blood flow closed while it sealed itself.

While totally in conversation with the (gorgeous) nurses (to make an impression), I started to feel my wrist and up my arm getting extremely warm. I looked down and the artery was spewing blood out like a firehose, with no fire to go to.

There was blood all over the place. The assistant holding my wrist started to throw a fit and was totally caught off guard. The heart surgeon was Joe Cool. He came around the bed and promptly put a stop to the blood flow. All he said was, “Damn, need a clean shirt.”

Me, in the meantime had thoughts of having to stay over for a new blood supply. Not so. Joe Cool said I could still go home. Ha-ha, bravo, I’m on my way before they change their minds.

Comparing my first encounter with the hospitals, painfully removing my tonsils, with this new encounter, cracking my ribs open and throwing my heart out onto the workbench for a valve job - it was totally painless.

A great amount of progress has been made since 1941. Thank God.

THE END (Hopefully not)

* * *

[EDITORIAL NOTE: This feature, TGB Readers' Stories, appears every Tuesday. Anyone age 50 and older is welcome to submit a story. You can do that by clicking the “Contact” link at the top of every TGB page or at the Guidelines/Submissions page.

Please be sure to read and follow the guidelines before submitting a story. It will save me a lot of time.
]




The Great Time Goes By Hook Up

Depending on your age these days, “hook up” can be a loaded term. Here is how the Urban Dictionary defines it:

”To have any form of intamicy with a member of the prefered sex that you don't consider a significant other. Usually, when said by modern youth it means to make out, and when said by people between the ages of 20 and 35 it generally means to have sex, and if a very old person says it, it probbably means to simply spend time with somebody.”

(Yes, those three mis-spellings are as they appear on the Urban Dictionary hook up page.)

But you can't argue with the definitions themselves. They are accurate. Undoubtedly, you have discerned that today I am referring to the “very old person” usage (although what you do in your spare time is up to you).

On Friday, long-time TGB reader, Jean Gogolin, left this comment:

”I can only say I wish I knew everyone in this community of yours personally, Ronni. I wish we could all get together, perhaps a few at a time, and talk and talk, and talk, and then hug. We're doing the next best thing at a distance.”

This isn't the first time a reader has asked about contacting another reader. Not too long ago, Diane emailed to ask about contacting other readers:

”Just wondering if there is any way to get in touch with some of your bloggers,” she wrote. “I contribute occasionally and feel connected to this group. When I read someone is from Austin, Tx, or somewhere in Texas, I have an urge to email them to see if they want to meet for coffee. Is there a way to do that?”

There must have been something in the air because within a couple of days, several other people had made similar requests via email and in the comments.

These folks are on to something. What makes this blog as special and vibrant as it is, is the terrific group of readers – or, at least, those who comment – who carry on thoughtful, useful, informative and funny conversations below my scribblings and it makes sense to me that some would like to get to know one another.

So I have decided to do a one-time-only Great Time Goes By Hook Up. To preserve everyone's privacy, I cannot publish email addresses. In fact, I cannot even pass an email address on to another person without permission. So here is how it will go.

Track down the most recent use of the screen name of the commenter you would like to contact. (If that person's name is a link, meaning you can click on it, it usually opens that person's blog or webpage. You can then probably skip this Hook Up and contact him or her via that page. See Jean Gogolin's link above as an example.)

If it is not a link or there is no contact information on their page, copy the commenter's screen name exactly and also note the date of the blog post below which it appears.

Click on the “Contact” link at the top of any TGB page. An email form pre-addressed to me will open. Tell me the commenter's screen name, the date of the post on which you found it and state that you would like to contact that person.

I will then make contact and ask if he or she would allow me to pass on their email address to you.

[IMPORTANT NOTE: Understand that if you contact me for this purpose, you are giving me permission to send your screen name to the person you want to contact.]

I will then contact the person you wish to hook up with and if he or she agrees, I will send that person's email address to you.

Three other things:

  1. Be patient about a reply. I have no control over how long it takes a person to answer my email.

  2. Please, please, please contact me only via the “Contact” link at the top of TGB pages. This is a time consuming project for me and it will move easier and faster if the initial requests arrive color-coded in my inbox as they are set up to do via that Contact link.

  3. The window for my receiving your requests to contact a commenter is open until 12 midnight on 31 October 2018, Halloween night. And no, this is not a trick, it's a treat.

That mostly covers it except for this: Thousands of people read this blog and it is remarkable that there are next to no trolls so it is unlikely there will be a problem. But if someone you have connected with through TGB becomes abusive or suspicious in any way, cut off communication immediately.

In fact, you might want to use a disposable email address to begin with.

As with anyone you meet online, if the friendship moves from email and/or phone to in-person, be careful before you meet, choose a public place and do not share personal information such as birthday, home address, etc. until you feel secure.

The Great Time Goes By Hook Up has been floating around in the background for a long time, maybe years. I'm happy to finally be doing it.




ELDER MUSIC: Classical - Various 6

Tibbles1SM100x130This Sunday Elder Music column was launched in December of 2008. By May of the following year, one commenter, Peter Tibbles, had added so much knowledge and value to my poor attempts at musical presentations that I asked him to take over the column. He's been here each week ever since delighting us with his astonishing grasp of just about everything musical, his humor and sense of fun. You can read Peter's bio here and find links to all his columns here.

* * *

Here is some more music, seemingly at random, for your delectation.

LOUISE FARRENC was born Louise Dumont into a family of sculptors.

Farrenc

She decided to eschew the hammer and chisel for the piano and became very good at it indeed. She also took up composing and married Aristide Farrenc who played the flute.

After a bit, he grew tired of traveling around and settled down as a music publisher. Louise flourished as a composer, initially just for piano, but later chamber music which turned out to be what she was best at. One of those pieces is the Piano Quintet No. 1 in A minor, Op. 30, the fourth movement.

♫ Farrenc - Piano Quintet No.1 in A minor Op.30 (4)


JIŘÍ LINEK was a Czech composer whose output was mostly religious music. Apparently Jiří didn’t ever sit still long enough to have his picture taken.

He especially liked the harpsichord and quite a few of his other works were for the instrument. Jiří was really prolific, more than 300 compositions to his name and he like to incorporate Czech folk tunes into his music, in the mean time he was really aware of the current developments in music. That’s demonstrated in his Symphony Pastoralis in C major, the first movement.

♫ Linek - Symphony Pastoralis in C major (1)


I was lying in bed the other morning listening to the radio and I heard this next piece of music and thought it was delightful. I also wondered if I had it. It turns out that I did.

The composer is Antonín Vranický who is probably better known as ANTON WRANITZKY.

Wranitzky

He was yet another Czech composer (thus the first name) who spent a lot of time in Vienna (the second of his names) where he was taught by Mozart and Haydn (talk about learning from the best). Possibly because of this he later became a well respected music teacher.

He also wrote music – his symphonies and violin concertos are especially well thought of. Decide for yourself about one of the latter, the third movement of his Violin Concerto in C Major. Op. 11.

♫ Wranitzky - Violin Concerto in C Major. Op. 11 (3)


JEAN SIBELIUS is the best known Finnish composer.

Sibelius

He is, in my opinion, the second best Finnish composer – I’d give the title to Bernhard Crusell. Of course, you may disagree, and I hope you do as that’s what this column is all about.

Anyway, Jean is a staple on concert platforms, especially his symphonies and tone poems such as Finlandia and the Karelia Suite. However, I rather like his short pieces for piano, especially the ones released as Impromptus, Op. 5. This is the sixth of those.

♫ Sibelius - Impromptu VI Op. 5


Here is something rather unusual, at least it is from my point of view. It may even be from yours. I’ve discovered amongst my music collection something called a Choral Concerto, and the person who devised such a thing was named DMITRY BORTNIANSKY.

Bortniansky

Dim (or Dm I suppose) was from the Ukraine, and is best known for his liturgical works and, as mentioned earlier, choral concertos (a whole bunch of these).

These latter compositions feature singing rather than instruments in the traditional concerto form. To demonstrate this (and I don’t hear much in the way of actual instruments backing the singers in this one) here is the first movement of his Choral Concerto No. 27.

♫ Bortniansky - Choral Concerto No. 27 (1)


CARL DITTERS VON DITTERSDORF, or Old Ditters to us who know him well, was a friend of both Mozart and Haydn.

Dittersdorf

Indeed, the three of them used to play string quartets together bringing in Johann Vanhal as the fourth member. In that arrangement Mozart played the viola, but today I have a viola sonata by Ditters – he was very versatile. It’s the fourth movement of the Viola Sonata in E-flat major.

♫ Dittersdorf - Viola Sonata in E-flat major (4)


I really like string quartets; I’ll have one of those in most columns of this sort. The one today is by FRANZ RICHTER.

Ritter AugustGottfried

Franz is another who straddled the divide between Baroque and Classical music, and unlike most who did that, he mostly came down on the Classical side. He was extremely prolific, with more than 80 symphonies under his belt. There were also 39 masses and other religious compositions, several concertos, sonatas and the like, and six string quartets.

Here is the third movement of String Quartet in B flat major, Op.5 No.2.

♫ Richter - String Quartet in B flat major Op.5 No.2 (3)


It’s seldom that you get the double bass as a featured instrument but this is one of those times. There are a couple of composers who like to feature the bass and JOHANNES SPERGER is one I hadn’t encountered before.

Sperger

It’s not surprising to learn that Jo was a bass player himself, but he didn’t restrict himself to that instrument. He was quite prolific and wrote 44 symphonies, lots of concertos, sonatas, choral works and all sorts of other things. However, it’s the bass that we’re interested in today; this is the third movement of his Double Bass Concerto in D major.

♫ Sperger - Double Bass Concerto in D major (3)


Somewhat later than everyone else today is AUGUST RITTER.

August Ritter

He was a contemporary of Mendelssohn and was apparently an excellent organist. Most of his compositions were for that instrument, but I have instead the first movement of his Sinfonia Concertante in B. To my ears it sounds as if was written much earlier, around the time that Mozart was doing the same thing.

♫ Ritter - Sinfonia Concertante B-dur (1)




INTERESTING STUFF – 27 October 2018

MY FRIEND THE GARLIC GURU

My friend, Tony Sarmiento, grows his own garlic in his backyard and is considered a guru of garlic. Recently, reporter Adrian Higgins of the Washington Post took notice:

”Tony Sarmiento, who gardens in the Woodside neighborhood of Silver Spring, is a guy versed in the theory and practice of garlic cultivation.

“From simple raised beds between the neighboring garage and his own vine-clad garden shed, he cultivates approximately 120 bulbs a year, setting the cloves in loamy soil in simple grids a hand span apart.”

Here's Tony in his garden, photographed by Higgins.

Tony Sarmiento Garlic Guru

If you're interested in growing your own garlic, the Post story has some useful information.

PEANUT BUTTER AND MAYO – I AM VINDICATED

I grew up eating peanut butter sandwiches with mayonnaise. Whatever else might be included – banana, cucumber, jelly, etc. - there was peanut butter on one slice of bread and mayo on the other.

To this day, that is the only way I enjoy peanut butter sandwiches but when it has come up in conversation that I use mayonnaise, people recoil. Not only are they disgusted, they've never heard of it. Now I learn from Atlas Obscura:

”During the Great Depression, people valued high-calorie combinations of protein and fat. Meat and dairy were costly, and consuming enough energy could prove challenging. Enter peanut butter and mayonnaise on white bread.

“The combination became a staple in Southern households in the United States and, in some regions, it was as ubiquitous as peanut butter and jelly.

“For the next 30 years or so, the PB&M was a favorite in many American kitchens, perhaps because adding mayonnaise to the era’s rustic, coarse nut butter may have been key for spreadability. Newspapers from the 1940s in Salt Lake City, Utah, and Troy, New York, both advised adding mayonnaise to 'moisten' or 'thin' peanut butter before adding bacon or shredded American cheese.”

So you see? I'm vindicated at last. You can read more here.

MONARCH BUTTERFLY ANNUAL MIGRATION

The largest insect migration in the world ends each year in Michoacán, Mexico. Millions of monarch butterflies travel from the United States and Canada to pass the cold months in the towering trees of this beautiful forest. On their incredible journey, the butterflies travel around 2,800 miles.

Take a look:

CANNON BEACH'S BUNNY PROBLEM

According to the Oregon Public Broadcasting website, the coastal town of Cannon Beach is overrun with bunny rabbits. It seems that many years ago, someone released pet bunnies into the town and nature took its course.

”Pets don’t usually do well in the wild. They can’t easily find food and aren’t well prepared for predators. But for some reason, these rabbits survived to do what their species does best: Reproduce, again and again and again.”

And now Cannon Beach is split between those who love their fluffy neighbors and those who want them gone. As one resident, Melodie Chenevert, explains, she and her husband

”'...took to buying 10 pound bags of organic carrots at Costco. We’d cut them up,' she said. 'And every morning Gary would put the flag up and pretty soon there were 10 or 12 bunnies sitting in the driveway staring at him.'”

Cannon Beach Bunnies

That image is taken from the banner of the Facebook page Mrs. Chenevert started for the bunnies.

You can read more about the controversy here.

THE BECKHAM CREEK CAVE HOUSE

Take a look at this huge and astonishing cave house in the Ozarks near Parthenon, Arkansas. (The most fabulous shot is at the every end.)

The Cave House was for sale earlier this year. Another source says rooms can be rented overnight, hotel-style. There is more information and some additional photos at Travel and Liesure magazine.

OR, HOW ABOUT LIVING IN AN ORIGAMI APARTMENT?

A company called Orisystems (derived from origami, the art of paper folding) has designed a one-room apartment that hides several other rooms – more or less.

Here is the company's sales video:

As the sales copy explains:

”Guided by the principal that interior space, particularly in high-density urban innovation centers around the world, has become too expensive to be static and unresponsive, Ori’s breakthrough innovation, technology and design create dynamic environments that act and feel as though they are substantially larger.”

What do you think?

You can learn more at the Orisystems website and The New York Times.

THE ACHOO AFFECT

Have you ever heard of the “Achoo Affect”? I never had. Here's how it's explained:

”Have you ever stepped out on a sunny day only to be struck by a bout of sneezes? If yes, you likely suffer from a rare genetic condition that has been baffling scientists for millennia. Photic sneeze reflex — also known as autosomal compelling helio-ophthalmic outburst, or ACHOO—affects 10% of the world’s population.

“Scientists from Aristotle to Francis Bacon have had their own conjectures about the syndrome, but modern science has proved all these theories wrong. As scientists today continue to try to solve the ACHOO effect, the answer might not be as simple as you think.”

Here is more about it:

WHO INVENTED THE REAR-VIEW MIRROR AND WHY?

It had never occurred to me to ask and now I discover that the reason it was invented isn't what I - or you, probably - would think.

THE HISTORY OF HALLOWEEN

Halloween is nearly upon us and you undoubtedly already know that the holiday goes back centuries. I sort of recalled that but I was fuzzy on details. National Geographic got me back up to speed.

* * *

Interesting Stuff is a weekly listing of short takes and links to web items that have caught my attention; some related to aging and some not, some useful and others just for fun.

You are all encouraged to submit items for inclusion. Just click “Contact” at the top of any Time Goes By page to send them. I'm sorry that I won't have time to acknowledge receipt and there is no guarantee of publication. But when I do include them, you will be credited and I will link to your blog.




Answers to Reader Questions About Death and Dying

Quite a few readers took me at my word in Wednesday's post that you could ask me anything about this new and final journey in my life, and it would be churlish of me not to try to answer.

Please keep in mind that these are one person's answers at a very early point on the road. I might change my mind later or see the issue from a different point of view, and don't forget that there are no right or wrong answers. Each of us has his/her own path.

* * *

From SIMONE:
“Are you angry about having this cancer? If so, about what/or whom? And how do you handle the anger?”

RONNI: I'm not angry and that might be related to my rejection, when I was first diagnosed last year, of the idea of “fighting” or “beating” cancer but to follow the instruction and direction of medical experts who have much more experience with cancer than I do. Without dismissing such potential causes as smoking, pollution, genetics, radiation, etc., I see cancer as a random occurrence.

Early on, I read about some cancer patients who get hung up on “why me?” My response was “why not me?” Most of my family died of cancer and, 40 percent of all Americans will have some form of cancer during their lives. Knowing all that pretty much eliminates the possibility of anger or blame.

From HAROLD:
“People have told me that once others find out you're terminal that becomes your identity, so you might not want to lead with that. At what point in conversation does your health status usually come up? I know it's on your mind, but do casual acquaintances need to know and do you want them to?”

RONNI: All kinds of things (that I will discuss in a future blog post) fall away at just about the exact moment the doctor says, “there is no treatment” (which is their common expression for “you're terminal.)”

At least, that is true for me and one of those things that fell away is any concern at all about what any person thinks about me in any regard. How others identify me is not my concern.

Before I published my first blog post about this diagnosis, I told the people I love and feel closest to. I missed three or four but they later read the blog posts and we've since talked about it together.

I also announced it at the next meeting of my current affairs discussion group although three or four had already read the first blog post. These are people I see regularly at our meetings, who had kept the group going during the months I was recovering from surgery last year and are an important part of my life.

In other circumstances, it depends on the nature of the gathering, who is attending, what we're talking about and if it is appropriate to discuss at that time. My point is to not deliberately make it a secret which would inevitably become awkward.

From LINDA:
“The wish you expressed...to die 'awake, lucid, not drugged or in pain, is where I always get hung up when I come to thinking about my own dying time. Because so often, when nearing death, to be pain free (or at least pain-bearable) IS, absolutely, to be drugged, not lucid, not awake."

RONNI: Good question. Note that I said I “wish” to die wide awake. Each person's situation is different but if I can arrange to die as I described, it is my first choice. My new palliative care physician tells me that not everyone with cancer experiences pain or, not great pain so maybe I'll be lucky. And if not - well, too bad. The doctor knows my desire in this regard and will work with me.

From KATHERINE:
"Since you are a writer Ronni, how about telling people you are writing/living your final chapter."

RONNI: I think that's what I'm doing at this blog, Katherine. If you mean other people who don't read TGB, I've told them if the subject comes up.

From NANA ROYER:
"I wonder if you're aware of the existence of Death Cafes."

RONNI: Yes, and I wrote about them a few years ago. I had an infuriating experience at my first one that put me off. A woman at my table, no matter what else the rest of us were discussing, promoted her counseling business, handing out flyers and such.

During a break, I complained to one of the organizers who said he would speak with the woman but she continued to tout her business during the second half.

A year or so later, a friend talked me into attending another death cafe in a different town and by god that woman was there – just not at my table. Death cafes ought to be a good thing, getting together in safe places where we can let go of past taboos about discussing death and dying.

From IRMA:
"A quick question: Do you think we know we have died?"

RONNI: I have no idea. Does anyone else want to take a whack at that?

From NATASHAM:
"Ronni, how do you deal with your feelings about terminal illness? Do you see a counselor?"

RONNI: Hmmm. Complicated. The short answer is that so far – this is still new to me – I don't “deal” with them or do anything about them. They just are.

Fear is the big one. Three or four or five times a day, it invades my whole body. It feels like each individual cell is quivering with fear. Everything stops for me. Except the fear. More, deeper, heavier than I've ever felt.

And after a couple of minutes it goes away and I can catch my breath again. I've learned now to wait for that.

I don't see a counselor and won't seek one. Everyone deals with their demons in their own way. Mine is to make room to feel whatever I'm feeling, to try to understand it. It can be painful but I haven't died of it yet and I've learned some things about life in general and about myself.

One more: Several readers, on Wednesday, wrote that we are all terminal. That may be so philosophically but believe me, in my case anyway, it has nothing to do with being told there is no treatment and you will die of your disease. Hearing those words has focused my mind in whole new ways that bear no resemblance to “we are all terminal.”

Let me wind up this Q&A session with a note from reader Jackie:

“The best thing that old friends and what few family members are left can do for me - just spend their time with me talking about everything under the sun.”

Oh, yes. The best antidote I have found when I get a bit maudlin about my new circumstance is to spend time with a friend or friends talking, talking, talking. It always leaves me light-hearted.




Being Terminally Ill

EDITORIAL NOTE: To name this ship we are on together now for this final journey of mine, it was a close vote among Curiosity, Ronni's Ship of Friends and This End Up. It is the votes sent by email that put This End Up over the top by three votes, and so it is. I'm not sure how we're going to use the name of the boat yet but feel free to offer your suggestions.

* * *

The headline today is my new status: terminally ill. After knowing this for two-and-a-half weeks now, I still don't fully believe it. First of all, I feel as healthy as the best I have ever been. Nothing hurts. I have no symptoms. I can do anything I need to do.

Except for one thing: I have been disabused of that marvelous notion humans have all our lives of being the one immortal: you might die one day, but not me.

When I wake each morning, that seems to remain so. I lie there looking forward to the day, eager to get going, maybe reviewing a list in my head of things I need or want to do.

It's always been like that but now it doesn't last long enough for me to finish the list, as I am rudely interrupted recalling that I live in a different country now – the land of the terminally ill.

Isn't that a horrible phrase, “terminally ill.” It's too clinical, even industrial. It ignores the humanity of the life that will be extinguished and it sounds so imminent, as if I am already on the first bus out of here - a bus being driven, of course, by the grim reaper, hood in place and scythe in hand.

But that's not true of me. For awhile anyway, I've got some time. None of the doctors and nurses knows exactly how long in my case but, given some chemotherapy, six to eight months before symptoms begin to kick in has been mentioned.

Me? I take the prediction with some caution. The time could be shorter or it could be longer and since there is nothing I can do to affect the timing, the only rational choice for me is to carry on living.

Without, however, losing sight of the impending exit date. To ignore it would be absurd.

On the day I learned of my new status, some decisions came to me immediately. I've mentioned giving up the daily workout I've always despised, and now I get to eat all the ice cream and cheeses – my two favorite foods – as I want.

I explained in an earlier post that I have no bucket list and I am uninterested in them except for this thought that came to me three or four days ago: I want to go somewhere to spend time playing with a whole passel kittens – puppies would work too – you know how they climb all over you and lick your face and squeak and squeal and tumble around and make you laugh like a four-year-old.

Maybe more than once I want to do that before I go. I need to find somewhere near here that will allow it.

Another decision I made right away is that I will not keep my new status a secret. I proactively tell people whom I want to know or who need to know, and I will tell others as needs be.

That can turn out to be tricky.

Indeed, I need to avoid that barren phrase, “terminally ill,” because it sure does push people away. Even without it, few know what to say to a person whose days are officially numbered. Except for some.

Many years ago, when we were decades younger than we are now, a friend and I joked that if either of us ever had a terminal disease, the healthy one would interview the other to death.

As a matter of fact, she and I had a long phone call over the weekend. Sure enough, she asked a lot of questions and among all sorts of other topics, we talked about my new status, my predicament as it were, some of the details and we toyed with some of the unknowables, having a fine ol' time doing it.

Afterward, I was curious about what the internet says about talking with people who are dying.

The Mayo Clinic has a pretty good page about how to be with a loved one who is terminally ill. Some other online advice feels suspect to me: choose your words carefully, don't ask questions, talk about something other than cancer.

Huh? Just speak. I don't care what words you use. Ask any questions at all and god, at this point, certainly talk about cancer and dying all you want. I can't promise my responses will useful because I've never done this before and I'm still learning. But do say what you want to say.

The one big thing I don't want is advice about other treatments, getting second opinions and miracle cures. Too many of those have already arrived over the transom of my email account and so far, I have been polite to the writers.

But after a dozen or more of them, I'm done with politesse. If there were anything that could cure this cancer, the medical people who care for me work at a world-class cancer institute and they would know about it. If there were real miracle cures, believe me, they would not be a secret to anyone.

For as long as I can remember, I have been curious about dying. When I have explained myself through the years, I've said that I want to be awake, lucid, not drugged or in pain because I want to experience the event of dying as clearly as possible. It is the last great mystery of life and I don't want to miss it.

In knowing that, however, what I had never considered is the process of being terminally ill, the path leading up to that death.

This is a wholely different place from how we live before something like this happens. It changes everything. Not, perhaps, the acts of daily life (I don't intend to alter that much). Instead, it shades and colors everything in ways that are new to me.

I'm only just beginning to work with that and try to figure it out.




A TGB READER STORY: What's the State of Your Mind?

By Jean Shriver

When does a person cross the line from graceful aging into the land that’s labeled old? It all depends. On what? On your genetics, on your eating and exercise habits and maybe on your luck.

In our seventies my husband and I took a bike trip to southern Tuscany and as we pedaled away, the word “old” never crossed my mind. We zipped along quiet roads, ate lunches in picturesque hill towns and slept in inns that had once been aristocratic homes. It was a blast.

But you know what they say, ”seventy is the new sixty”. Right? And then do you remember the next line, ”but 80 is still 80?” Which has turned out to be true in our case.

For instance, I went 80 years without breaking a bone and then in the span of three years broke my shoulder and then my pelvis in two places. I recovered well but running to get the phone is no longer an option. Now I walk sedately to answer its insistent ring no matter how long it takes.

What other changes have crept into my lifestyle? I write down things that are too important to forget. I ask a younger person for help when I want to thread a needle so I can sew on a button. I wear hearing aids. I get help in carrying heavy boxes I used to tote without concern and I am increasingly hesitant to drive the freeways.

But I count it as a plus that I am still upright and still driving. My husband, who has spinal stenosis, is now in a wheelchair.

And as my body moves more stiffly, I work hard to keep my mind agile. I read the newspaper daily and force myself to explore areas where I am not comfortable like science and philosophy. I read some mysteries for fun but I try to sandwich them between meatier fare like The Written World, about how stories have influenced history across the ages.

Last night I read how the Maya developed a writing system totally independent of those of Europe and Asia which reminded me how we once climbed Mayan pyramids in Mexico. Before falling asleep I often revisit good times in Europe, Turkey and Nepal when we could travel anywhere we wanted.v vFriends, old and new, are an inspiration. Through church and through writing groups I am able to exchange ideas with people of different ages who have different viewpoints than my own. This, I find stimulating.

At this stage in life, we often lose people who are important to us and need to make an effort to stay in touch with others lest we become isolated. My husband and I are lucky to have family nearby which gives us contact with several generations.

Last week, a woman I knew in high school invited me to New York to meet with several others we both knew in college. Suddenly I am examining my wardrobe with a critical eye, checking out theater offerings in Manhattan and feeling extremely sprightly.

Though the four of us are all 85, we burble like girls as we call and write about our upcoming trip. We have ambitious plans for museum visits, evenings out and walks in Central Park.

Hey, maybe age is just a state of mind after all.

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[EDITORIAL NOTE: This feature, TGB Readers' Stories, appears every Tuesday. Anyone age 50 and older is welcome to submit a story. You can do that by clicking the “Contact” link at the top of every TGB page or at the Guidelines/Submissions page.

Please be sure to read and follow the guidelines before submitting a story. It will save me a lot of time.
]




Two Excellent Stories of Youth and Elders Together

In a world that has devolved into 24/7 bad news, it is a treat to run across two stories in one day that are all about making the world a better place and, in these two cases, show how elders are indispensable to the ideas.

Although too many people and institutions deny that ageism exists (or when they concede that it does, insist that it is without consequence), there are others who get it and who are finding ways to help old and young find common ground.

This is important because we live in an age-segregated society where weight is generally given to the interests of youth over those of elders, so finding mutual points of engagement can only lead to more understanding and then more respect among generations, improving outcomes for all ages and, perhaps, the culture at large.

What both of these innovations tell us is that it's all about spending time together and listening.

ANTI-AGEIST PROGRAM IN MEDICAL SCHOOLS
Having studied ageing for the past 25 years, I thought I knew a lot and I suppose that's true in some areas. But this statement from Dr. Ronald Adelman, co-chief of geriatrics at Weill Cornell, who developed an annual program to correct medical students' ageist beliefs about elders, was an aha! moment for me:

“'Unfortunately, most education takes place within the hospital,' he told Paula Span of [The New York Times].

“'If you’re only seeing the hospitalized elderly, you’re seeing the debilitated, the physically deteriorating, the demented. It’s easy to pick up ageist stereotypes.'”

Well, duh.

Obvious, isn't it. But in all my reading about medical care and treatment – or lack thereof for old people – it had not occurred to me or, apparently, to anyone who was writing those articles, reports and studies I read.

Further:

”These misperceptions can influence people’s care. In another classroom down the hall, 88-year-old Marcia Levine, a retired family therapist, was telling students about a gastroenterologist who once dismissed her complaints of fatigue by saying, 'At your age, you can’t expect to have much energy.'

“Then, in her 70s, she switched doctors and learned she had a low-grade infection.”

I've heard this story again and again from friends and acquaintances and I found myself in a similar situation some years ago. I fired the doctor too.

Marcia Levine was among the elders who were speaking with second-year medical students about their lives.

The Times tells us that at least 20 medical schools around the U.S. have some form of required study about (excuse me for quoting myself) what it's really like to get old that involves old people themselves.

”Some schools, like the Medical University of South Carolina and the Icahn School of Medicine at Mount Sinai, match students with older patients they follow throughout their four-year educations, making home visits, accompanying their 'senior mentors' to doctors’ appointments, and visiting them if they’re hospitalized.”

According to the Journal of the American Geriatrics Society, in the 10 programs of this type they reviewed, “the universal goal of positively influencing student attitudes toward older adults was resoundingly achieved.”

There are 141 accredited medical schools in the United States. They should all be using programs like these. You can read more at The New York Times.

MORE THAN HALF A CENTURY SEPARATES THESE ROOMMATES
The Boston Globe reports on a new program matching college students in need of cheap digs with old people who could use a little extra cash:

”...according to one 2017 survey, some 90,000 spare bedrooms [in the Boston area] are going unused in the homes of aging empty-nesters.

“That got a pair of MIT urban-planning graduate students thinking: Those rooms might be valuable to young people, especially students. And they might also provide a way for older people, who increasingly are living alone, to stay in their homes as they age.”

This isn't the first of such programs. Another I've read about allows music students from a nearby school free or low-cost rent in their own rooms at a retirement community in exchange for regular concerts for the elder residents.

Given today's high rental prices and the terribly debt students incur, this seems to me to be, as they say, a win-win.

Although both were wary at first, 77-year-old Sarah Heintz and 25-year-old Dean Kaplan hit it off:

”They bonded over a shared love of politics — both volunteered for Elizabeth Warren’s campaign — and an affinity for cooking.

“Under the terms of their lease agreement, rent is $800 a month (about half the cost of apartments Kaplan had been looking at before the arrangement with Heintz), knocked down to $700 if he devotes eight hours each month to helping Heintz with a range of chores.

“But even without that incentive, they said, they’ve discovered they like doing favors for one another. He helps in the garden and gives her a hand logging into her e-mail account; she offers him rides to Market Basket and recently taught him the proper way to gut a fish.”

Besides helping each other with the practicalities of life, living as full time as roommates can't help but foster understanding between youth and age for which there are few enough places to do that:

”Each weekend, Heintz and Kaplan plan some kind of event — dinner with neighbors, afternoons in the garden — and he has taken to picking her brain on a variety of topics, from botany to the year she spent at a French cooking school in the ’70s.

“'It’s the type of repository of knowledge that you can’t Google,' Kaplan said.”

No kidding. Read more at The Boston Globe.

These are both excellent and important programs that should be encouraged in every way.




ELDER MUSIC: 1932

Tibbles1SM100x130This Sunday Elder Music column was launched in December of 2008. By May of the following year, one commenter, Peter Tibbles, had added so much knowledge and value to my poor attempts at musical presentations that I asked him to take over the column. He's been here each week ever since delighting us with his astonishing grasp of just about everything musical, his humor and sense of fun. You can read Peter's bio here and find links to all his columns here.

* * *

1932 certainly produced some terrific artists and fine music. Here is some of it.

I’ll start with the old groaner himself, BING CROSBY.

Bing Crosby

You need no introduction to Bing, and I imagine you need no introduction to one of his most famous songs, Please.

♫ Bing Crosby - Please


I’ll always welcome the MILLS BROTHERS into my columns.

Mills Brothers

They seem to like listening to rumors (and spreading them as well). Well, who doesn’t? The song is I Heard. They also indulge in a little scat singing.

♫ Mills Brothers - I Heard


Speaking of scat singing, here’s the man who invented it. LOUIS ARMSTRONG is also another who is pretty much an automatic inclusion.

Louis Armstrong

Louis is very laid back on this song, he even plays his trumpet with mute, at least for the first half. He lets rip later on during Body and Soul.

♫ Louis Armstrong - Body and Soul


It sounds to me as if LONNIE JOHNSON listened carefully to Cab Calloway, who also appears today.

Lonnie Johnson

Lonnie’s song definitely sounds like Cab’s most famous song. Lonnie even sounds just a little like Cab on Winnie the Wailer.

♫ Lonnie Johnson - Winnie The Wailer


AL BOWLLY really traveled the world, which was a little unusual in the early years of the 20th century.

Al Bowlly

Not just to the places you’d expect, but to Africa – Mozambique, South Africa – and Asia – India, the Philippines, Indonesia. He also seemed to have two bands, one used for recording and the other for live performances.

Alas, he was killed in an air raid in London during the war. The Billy Cotton Band wasn’t his usual recording band (that was Ray Noble) and with them we have I Can't Get Mississippi Off My Mind.

♫ Al Bowlly Billy Cotton Band - I Can't Get Mississippi Off My Mind


I’ve already mentioned the next artist. CAB CALLOWAY made a career out of his song Minnie the Moocher.

Cab Calloway

Not just the actual song that he performed pretty much for the rest of his life, but variations on it as well. This is one of those: Minnie the Moocher's Wedding Day.

♫ Cab Calloway - Minnie The Moocher's Wedding Day


Like Bing, FRED ASTAIRE’s song is one of his most famous.

Fred Astaire

Not just Fred, this song has been associated with quite a few other singers as well. It’s Night and Day, written by Cole Porter for a Broadway musical "Gay Divorce". That play was later filmed as "The Gay Divorcee" that starred Fred and Ginger Rogers.

♫ Fred Astaire - Night And Day


Nobody who is reading this column needs me to tell you about PAUL ROBESON.

Paul Robeson

Okay, a little reminder, he was a star athlete, a lawyer, an actor in both film and stage, a champion of civil rights and an advocate for indigenous peoples around the world. He was also a great singer as you will hear on Got the South in My Soul. In spite of the name of the song, he was from Princeton, New Jersey.

♫ Paul Robeson - Got The South In My Soul


I’ve always been amused that NOËL COWARD affected an umlaut on his first name which suggests that he pronounced it with two syllables, as in the Christmas variant, rather than one which is usual for that name.

Noel Coward

That, of course, was the sort of person he was (or tried to be). This year he gave us his most famous song, along with Ray Noble and His Orchestra, Mad Dogs and Englishmen.

♫ Noel Coward with Ray Noble & His Orchestra - Mad Dogs and Englishmen


GEORGE OLSEN started as a drummer and later became a band leader of the group called George Olsen and his Music.

George Olsen

After he retired, he owned a successful restaurant in New Jersey. Several singers made a name with his group; one whose name isn’t familiar to me is Paul Small, who sings vocal refrain on It Was So Beautiful.

♫ George Olsen - It Was So Beautiful




INTERESTING STUFF – 20 October 2018

81-YEAR-OLD-MARATHONER

The latest video in Nike's Just Do It series is a woman who took up marathon running at age 81:

”A few years after her husband had passed away, New York-native Marjorie struck up a conversation with her friend, a marathoner, at the dog park one day. 'Do you think it would be okay for me to run the marathon?' Marjorie asked her.

“Seven months later, Marjorie was at the starting line of New York City’s most prestigious race for her first 26.2. With 50,000 other runners.”

My friend, Erik Martin, a Nike employee here in Portland, Oregon, pointed out the video to me. We agreed that in general, neither of us is fond of news stories, ads and promotions, etc. that hold up elders as paragons that all people of age should aim for in extreme sports situations that few people of age can reasonably handle.

But we like this one beause it is well done and it is important to see elders included in the overall idea of Just Do It. Even if we can't all run a marathon or climb Mt. Everest, there are plenty of other games and sports we can participate in.

You can view all the Just Do It series of videos here and read more about Marjorie here.

SEARS FILES FOR BANKRUPTCY

Most Americans our age can recall when the name was Sears, Roebuck & Co. back when we were kids, and now we see the passing of an American icon.

My first thought on hearing the news of the Sears bankruptcy is that it had been the Amazon of its day – it certainly was in my household when I was growing up - and I'm not the only one who had that thought. There's a story about Sears' importance in American life at The New York Times.

The Washington Post has the business particulars that led to the bankruptcy.

PAPER PROPS FOR MOVIES AND TV

A gazillion details go into the magic of making movies and TV shows appear to be as real as real life, and if the people who create those details do their jobs well, you and I never notice the make-believe.

This guy creates paper props and there's a lot more to it that I'd ever bothered to think through.

”Ross MacDonald makes his paper by making paper. For the last 25 years, he’s created tens of thousands of paper props for movies and television shows like Baby’s Day Out, Silver Linings Playbook, Boardwalk Empire and Parks and Recreation..

“From handwritten letters to driver’s licenses, each piece is custom made and thoughtfully imbued with backstory. Step into Ross’s Connecticut workshop to see how movie magic gets illustrated, aged, cut and copywritten.”

IF YOU CAN WATCH THIS VIDEO AND NOT VOTE...

...you must be dead inside. (From friend Jim Stone.)

OBITUARY RECOUNTS THE MYSTERY OF ONE MAN'S LIFE

The Washington Post reported on the obituary of Rick Stein, age 71, who recently died in a plane crash - a man about whom his closest family and friends could not agree. His daughter wrote the obit:

“He owned restaurants in Boulder, Colorado and knew every answer on Jeopardy, she tells us. “He did The New York Times crossword in pen. I talked to him that day and he told me he was going out to get some grappa. All he ever wanted was a glass of grappa.

“She quotes Stein’s brother as saying Stein couldn’t have been a pilot; the two owned a jewelry and Oriental rug gallery together. His sister says she thought Stein was a cartoonist and freelance television critic for The New Yorker.

“Then the rest of the family weighs in:

“David Walsh, Stein’s son-in-law, said he was certain Stein was a political satirist for Huffington Post while grandsons Drake and Sam said they believed Stein wrote an Internet sports column for ESPN covering Duke basketball, FC Barcelona soccer, the Denver Broncos and the Tour de France.

“Stein’s granddaughter Evangeline claims he was a YouTube sensation who had just signed a seven-figure deal with Netflix.”

The daughter, Alex Walsh, said her father had “an endless appetite for comedy.” To not spoil the fun, I'm sending you to the entire obituary at Delaware Online to read the whole thing. You must read clear to the end to really get it.

WILDLIFE CROSSINGS SAVE LIVES

This seems so obvious I cannot understand why the crossings are not standard requirements for every highway that runs through a wildlife area.

THE KEEPER OF THE GHOST TREES

This is a beautiful story not only for the oddity of the flora but the man who keeps watch.

”Hidden deep in the woods of the Henry Cowell Redwoods State Park is a small cluster of unusually pale, phantom trees. These 'ghost trees' are albino and extremely rare. Out of the roughly 400 albinos in the world, there are 13 in the park.

“Due to threats to their ecosystem, only a select few people know of the trees’ exact locations. Dave Kuty is one of them. As the unofficial caretaker of the albino trees, his love for these redwoods has followed him the past 40 years.”

MARJUANA LEGALIZATION

As I have mentioned in the past, I use a tincture of cannabis (THC) as a sleep agent and it works quite well. It's easy for me because I live in one of the U.S. states that has legalized use of marijuana for medical and/or recreational purposes.

This week, Canada became only the second country in the world (after Uruguay) to legalize recreational use of marijuana nationwide. The first dispensaries opened their doors last Wednesday.

”Adults will be able buy cannabis oil, seeds and plants and dried cannabis from licensed producers and retailers and to possess up to 30 grams (one ounce) of dried cannabis in public, or its equivalent,” reports the BBC.

“Edibles, or cannabis-infused foods, will not be immediately available for purchase but will be within a year of the bill coming into force. The delay is meant to give the government time to set out regulations specific to those products.”

The BBC also included a map of marijuana use throughout the world:

WeedUseInternational

A couple of weeks ago, Pew Research published findings on support for nationwide legalization of recreational marijuana in the United States – about 62 percent approve:

”As in the past, there are wide generational and partisan differences in views of marijuana legalization. Majorities of Millennials (74%), Gen Xers (63%) and Baby Boomers (54%) say the use of marijuana should be legal.

“Members of the Silent Generation continue to be the least supportive of legalization (39%), but they have become more supportive in the past year.”

GOT A PEST PROBLEM? CALL THE QUACK SQUAD

“They’re short, they waddle, and they come to eat the snails,” the blurb tells us.

“Meet the quack squad, nature’s very own pest control. Every morning, duck farmer Denzel Metthys releases over 1,000 Indian Runner ducks on the Vergenoegd Winery in South Africa. Trained to march in a long line en route to the vineyard, these ducks mean business.”

* * *

Interesting Stuff is a weekly listing of short takes and links to web items that have caught my attention; some related to aging and some not, some useful and others just for fun.

You are all encouraged to submit items for inclusion. Just click “Contact” at the top of any Time Goes By page to send them. I'm sorry that I won't have time to acknowledge receipt and there is no guarantee of publication. But when I do include them, you will be credited and I will link to your blog.




The Alex and Ronni Show: On the End of Life

Before we get to this week's Alex and Ronni Show, let's decide on a name for the boat we are all on during what I now know is the final voyage of my life.

On Monday, reader Genie commented in reference to my choice to continue writing and publishing this blog for as long as I can during the weeks and/or (hopefully) months remaining in my life. ”This morning I imagine you as the captain for this journey,” she wrote.

Then, Tarzana suggested a contest to name the boat:

”I can already think of many possibilities,” she wrote. “Courageous, Hope, Gratitude, Fortitude, Journey's End and so forth. Your loving readers are much cleverer than I so I'd expect some real stunning, even humorous entries.”

More readers left their suggestions and I chose five of them for us to vote on. In alphabetical order, they are:

Ark de Triomphe
Curiosity
Ronni's Ark
Ronni's Ship of Friends
This End Up

There were a lot of other good ones but choices need to be made so here we are.

You may vote by leaving the name you like in the comments below (do not send email; they will not be counted). You don't need to say anything else but you certainly may if you want. Voting ends at midnight Pacific Time on Sunday 21 October and I'll announce the winner on 24 Wednesday 2018.

(Or, you can just count in the comments to figure out the winner for yourself.)

THE ALEX AND RONNI SHOW
On Tuesday, my former husband and I recorded another episode of The Alex and Ronni Show. We spent most of the time discussing my new life predicament. There is a lot of laughing. Which is a good thing.

* * *

If you would like to see Alex's entire two-hour show with other guests following our chat, you can do that at Facebook or Gabnet on Facebook or on YouTube.




Medicare Enrollment Period for 2019: Important Information

Okay, enough for now of this dying stuff of the past few days. Let's get on with the particulars of living – in today's case, Medicare.

On Monday this week, the annual Medicare open enrollment period began. It runs until 7 December which isn't very long if, like me, you procrastinate over such tedious work. But it's important so pay attention. I'll make this a easy and clear as possible.

Let's start with this (deceptively) simple overview of the process:

Here are the things you can do during this fall enrollment period:

If you now have traditional Medicare (Part A for hospital coverage; Part B for outpatient coverage), you can switch to an Advantage plan (Part C) if you wish

If you now have an Advantage plan, you can switch to traditional Medicare

If you dislike your current Advantage plan, you can switch to a different Advantage plan

If you have a Part D prescription drug plan, you can choose another or you can purchase one if you did not do so when you were first eligible

BACKGROUND INFORMATION
Remember, traditional Medicare (Parts A and B) is offered by the federal government. Advantage plans and Part D (prescription drug coverage) are commercial products although they must meet certain requirements of the government.

Here are the 2019 premium and deductible changes for traditional Medicare :

Ninety-nine percent of traditional Medicare beneficiaries pay no Part A (hospital) premium. The deductible, when you are admitted to a hospital, will be $1,364 for 2019, up from $1,340 this year.

The new Part B (outpatient) premium, deducted from your Social Security benefit each month, will be $135.50 in 2019, up from $134 this year. The deductible will increase to $185 from 2018's $183.

There is more detailed information on Part A and Part B premiums and deductibles here.

The grandmother of all Medicare information sources during fall enrollment is the Medicare and You 2019 book.

In the past, it was snail-mailed to every Medicare beneficiary in the U.S. Some people still get it that way. If you receive yours electronically or if you have misplaced it, you can download a copy online here. [pdf]

For Advantage plans (combined Parts A and B in one package with, most of the time, Part D), and for stand-alone Part D plans to go with traditional Medicare, there are differences from state to state. You can find information for each individual state here [pdf].

A NOTE ON SOME DIFFERENCES BETWEEN TRADITIONAL MEDICARE AND ADVANTAGE PLANS
Advantage plans sometimes have no monthly premiums and usually offer additional services such as coverage for vision, hearing and dental along with reduced gym membership fees and such which make them attractive.

However, each one also requires that you use their roster of physicians, hospitals and other service providers. Also, just this week, The New York Times reported on some Advantage plans that have been improperly denying claims.

Traditional Medicare leaves some gaps in coverage which beneficiaries fill in by purchasing supplemental (“Medigap”) and (Part D) policies but there are no plans with vision or dental or hearing coverage.

Generally, between the two Medicare possibilities, traditional Medicare delivers the widest choice of hospitals and doctors and with supplemental and prescription drug plans added in can result in much lower out-of-pocket costs particularly for people with serious health conditions.

That certainly is true for me over the past 16 months of heavy use and I'm now quite grateful I stayed with traditional Medicare. But needs, obviously, differ from person to person.

CHOOSING YOUR 2019 PLAN
Year after year, Medicare has been improving their Plan Finder pages - there can be more than two dozen plans depending on the state. You will find the beginning page here where you can follow it through the steps either for Plan D or Advantage plans or both.

I could take you through every step here, but as it turns out, Portland, Oregon's local newspaper, The Oregonian, has just published an easy-to-follow instruction video. Here it is.

(Note that the online pages may look somewhat different from those in the video, but the information is the same.)

Because this was produced in Oregon, the telephone help line number at the end of the video is for Oregon residents only. You can search for help where you live by Googling something similar to “choosing a part D plan in [state]”.

Or, you can telephone Medicare (1.800.MEDICARE) where a representative will help you through the entire process however long it takes.

Or, you can find personal help in your state through the nationwide State Health Insurance Assistance Program (SHIP) at this website. I've known several SHIP helpers and they are smart, well-trained and extremely knowledgeable people.

JUST DO IT
Okay. You have six weeks to get this done. With Part D, it is important to work your way through the minutiae of formularies, tiers, deductibles, etc. to find the best plan for you.

It's tedious, but doing it last year over two days in short bursts, I saved a lot of money on the Part D premium, deductible and copays. My drugs still cost me a small fortune and dumped me into the infamous donut hole for awhile this past year. But if I'd kept my previous policy the drugs would have cost a lot more.

THE DONUT HOLE

There are good changes to the Part D donut hole in 2019. It is complicated to explain and I've already carried on too long. There is a explanation at Kaiser Family Foundation.