Monthly Archives: April 2016

Twilight

 

Sunset in Chiba-2

Last month, my family and I buried our father. His journey towards the end of his life reinforced lessons I learned from my mother’s final struggle with cancer and death nearly 19 years ago.

We are born. We live. We die.

That is a reality that we all share. But a lot of people I know talk about living and not so much about dying. Unless they talk about death in a religious or philosophical context, death is taboo, or at least is an uncomfortable topic. The mention of death is dismissed as morbid, rather than the liberating exercise that it could be. Many discuss quality of life – whether and how often they should exercise, what they should and should not eat, how they should avoid stress, and what job will not strangle their soul – yet stay away from talk of death. But no talk about life is complete without considering how one approaches the end.

Of course we don’t know when and how we will actually leave this world. But we can think about certain eventualities and how we and more importantly our family will deal with them. Do I have life insurance and is it sufficient? Do I have a will? In addition, we should also seriously ponder upon three other important questions.

The first is “What is our will?” If an accident results in us going into a vegetative state, what should our loved ones do? Do they keep us going even if we will forever be plugged into machines? Do they authorize surgeries just to keep our bodies going for one or two weeks longer? Do they donate our organs? Do they let us continue to exist even after we are reduced to less than the shell of the person we were?

The second is “Who decides for us if and when we become unable to do so?” This is especially important if you are in a relationship but are not married. You do not want your long-time partner shut out by family members for any reason. Please have the necessary legal documents to make sure your chosen representative, and no one else, is authorized to represent you.

The third is “How do we deal with serious illness?” Should we be faced with a serious medical condition, such as a terminal illness, what do we do? Do we undergo chemo, a series of surgeries, or experimental drugs or therapy? Do we waste valuable time and resources depriving ourselves of proper food and nutrients to follow a grueling detox program because some pseudo-science alternative medical entity tells us so, as my father had done out of desperation? Instead of being in a hospital, do we prefer to spend our last days in a beautiful, peaceful environment?

These are some of the things we should not be afraid to ask while we have the mental, physical and emotional objectivity and capacity. Once we are seriously sick, we become less objective and may clutch at straws in the false hope of prolonging our existence. If, due to bad circumstances, we end up in a coma, we certainly will not be in any position to make any decision.

By the way, I’m not saying we should not fight for our health and our life. We must fight. But at some point the nature of that fight changes, and we should be ready to accept and prepare ourselves and our loved ones for the inevitable. Instead of dying a shrunken, tired individual whose last weeks are spent in fear, pain, and suffering, we can choose to spend those weeks leaving behind better memories, ticking off the last things on our bucket list, or simply enjoying the sunset.

More importantly, by being prepared, we hope that we can spare our loved ones the difficulty of second-guessing us and the guilt that that may produce. No one wants to be seen as callous or unfeeling even if the most difficult decision to make is the right one. No one wants to do the right thing only to be riddled with guilt and self-doubt. Indecision, family wrangling (which thankfully my family did not face), fear, guilt, even shame – these are not the legacies with which you wish to burden the ones you love.

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Bureaucrats!

stamp-114353_1280

Every time something works, someone will come along to mess it up.

This morning, I visited my endo for my quarterly checkup. Everything is fine, except for one tiny change in our arrangement which my endo announced at the end of the consultation. Apparently, the National Health Insurance (probably thanks to a bored bureaucrat or more likely a group of bored bureaucrats) has decided that effective April 1 doctors cannot issue a script for more than 60 days’ supply of medicine. Previously, my endo regularly issued 90 days’ worth of metformin (plus 10 days’ allowance in case I need to reschedule my checkup due to any unforeseen event), which covered my needs until my next quarterly A1C bloodwork and checkup. It worked perfectly. With the recent change, however, my script will no longer match my quarterly A1c check and I will be required to pay extra visits to my endo just to pick up meds.

Why? Why? Why? I’m sure that in the larger scheme of things there is a reason for the new restriction. But, I’m also sure that whoever thought of this new scheme did not consider the fact that it is a big inconvenience to a lot of patients.

My doctor and I discussed our options.

Option One, in two months, I’ll pick up one month’s supply of medicine and go back one month later for my A1C checkup and to pick up my next two months’ supply. Repeat.

Option Two, in two months, I’ll pick up two months’ supply of meds and go back two months later for my A1C test and the next two months’ supply. Repeat.

Either option demands that I visit my endo the same number of times. But with Option One, I can maintain my quarterly A1C tests, whereas with Option Two I will have only three A1C tests a year, with a total of three months that are not covered by any A1C check. I suppose it’s Option One for me.

Some of you may be thinking, “What’s the problem? It’s just four extra visits to the doctor’s a year to pick up medicine.” Of course, if I had all the time in the world, the extra journeys to the doctor’s is not an issue. But, like most people, I don’t have that luxury, and I’m willing to bet, neither do those bureaucrats should it be their turn to be the patient.