2015-08-01

As a first time caregiver, and a person that was never around anyone that had cancer, being thrust into the position of caring for Annie on a full time basis was undoubtedly the most difficult thing I’d ever done or will do over my life time. I didn’t know there was so much pain in the world until I entered the world of cancer.

When you turn on the news these days, you often hear about all the hate bouncing from one country to another all around the world, for all sorts of reasons. The turmoil and conflicts in the Middle East, and so on. Good news don’t sell, bad news does. And of course the “adults and children of cancer,” and caregivers seem to be forgotten.

Well there’s another war being fought that we don’t hear much about, and it’s being fought all over this country and the world. The war on cancer. It’s so much more difficult to fight and not very well understood. In a battle zone with combat we have an enemy and a mission. Basically, to take a hill, secure a village, and perhaps kill or be killed. In the war on cancer there are many battle zones, heavy casualties, and hand to hand combat can be a daily struggle for the unsuspecting caregiver, where the fear of the unknown is forever present. And the news media, it’s not there for us. It doesn’t care. There is a saying in the literary world, documented in the 2013 Guide to Literary Agents by one of the recommended agents. If you’re going to write a book, don’t write about cancer, as there are thousands of stories out there and they’re all the same. In other words, the manuscript would be rejected. That’s so unfair and not true. But, it is a sad reality of the world we live in today. Yes, of course, if the person is a celebrity or comes from money, all of a sudden their story is news worthy, right down to their journey with hospice. But for the rest of us, the unsung heroes in the war on cancer or other terminal illnesses, we are the caregivers and will forever be on the front lines fighting the battle’s being waged, with little to no recognition. Do we really care? no! Absolutely not! But we reserve the right to our expectations that when we need help for our loved one or patient, we are not met with a wall of denial from some big drug company, ignoring our requests and the request of the doctor, while we try to get a life sustaining medication for, in my case, my wife Annie. We are often left with choices we don’t want to make, or no choice at all.

We are often left with choices we don’t want to make, or no choice at all.
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Cancer is often more than just a battle zone. For the loved one and caregiver it can be an all out war. Cancer has so many weapons at its disposal to deliver a fatal blow to your loved one. One of those weapons is very subtle and can take quite awhile to leave it’s mark, but rest assured, if not dealt with timely and properly, death will certainly follow.

Appetite: The silent killer

One of the first things that comes to mind when dealing with a loved ones appetite, is to never make eating the source of an argument between caregiver and loved one. I can still recall the night I fixed Annie one of her favorite meals at her request. I had the meal on one of our special china plates we reserved for special occasions. When I walked up to her she was laying on her hospital bed in the middle of our living room.

She nervously said to me, “I’m sorry Bobby, but I don’t fancy it now.”

“Comon Annie” I just spent an hour and a half fixing this. But she didn’t fancy it, so I took it into the kitchen and threw it all in the garbage. It upset me for two reasons. One, selfishly I made a special effort only to have the meal rejected. Two, she was in need of a nutritional meal.

A short time later I walked over to the doorway in the kitchen that allowed me to view her hospital bed, where I could see the back of her head. As I looked at her helplessly laying there with her death sentence, I just started crying. I walked over to her while wiping my tears and kissed her on the lips and told her I loved her.

She simply said is a soft voice, “Oh, thank you.”

I learned something that night, besides not making food the source of anxiety. It was awful rich of me to think that I had any concept of how she must be feeling. I couldn’t possibly understand the turmoil that must have been going on in her mind. Annie was going to lose her battle with cancer and she knew it. Of course we lived on hope, as does all cancer patients, but the sad reality was, Annie body had already been too ravaged by the cancer and the chemo she was on. I loved Annie with every fiber of my body, and my actions that night not only upset her, it hurt me too. But the reality for many caregivers is that we are caregivers in training, and sometimes we don’t understand until we make a mistake. I hurt Annie’s feelings and I guess by her rejecting the meal I prepared for her, she hurt mine too. Ironically, that one incident taught me a valuable lesson. Annie’s cancer was not about poor pitiful me, it was about her and her daily struggle to have and keep something most of us take for granted. Her life! It never happened again.

Sometime during the week of September 2008, when we went to the cancer center I had a private word with her oncologist. I was worried about her nutrition, but as always he put things into perspective for me.

For Christ’s sake Bob, feed her anything she will eat! She’ll get some benefit! Ann is dying! We’re trying to keep her alive as long as we can, and just maybe we can get her into a remission if she can hang on a while longer. She needs calories!

During the appointment he decided to give her some medicine to stimulate her appetite. It was called Megace and came in a large bottle as a white liquid. According to Annie, “Yucky stuff.” To my surprise it worked very well. (Note: As a caregiver for a cancer patient, when a new medicine is dispensed to your loved one, go on google and study the side effects. Reason being, with a cancer patient if things can go wrong, they often will. So you need to know the potential side effects.)

When we got home I googled the Megace, and to my alarm I noted that it had a large cautionary warning. It came with a high risk of causing blood clots. So I now had to watch for unusual swelling in one of her legs or both. That was sort of a nightmare as Annie was on chemo, twenty-one days on and seven days off. Her legs were often swollen.

From September 2008 until January 2009, Annie ate well enough to not lose any more weight, but she was still very sick. (Note: On Dec 11, 2008, Annie’s bone marrow was compatible with remission.) But she was always as sick without the cancer as she was with it.

On Jan 19th, 2009 she was admitted to the regional medical center. In the admission notes it stated that the patient is thin, cachetic, and appears ill. (Cachetic means. “A profound state of constitutional disorder, general ill health and malnutrition.”) That was with the Megace. Without it she probably wouldn’t be alive.

While in the hospital they did a scan of her lower extremities. They found blood clots behind both knees, and in each hip. I knew what that meant. And as suspected Annie’s oncologist came over and took her off the Megace.

He decided to switch her over to Marinol.

What is Marinol?

Marinol (dronabinol-generic) is a man-made form of cannabis (also known as marijuana).

Marinol is used to treat loss of appetite that causes weight loss in people with AIDS. It is also used to treat severe nausea and vomiting caused by chemotherapy given to cancer patients. Marinol is for use only when other medications have been unable to control the nausea and vomiting. It was the best medication they had for Annie at the time.

From January 2009 through March 2009 Annie started thriving on Marinol. Her appetite picked up sharply and she started rapidly gaining weight. She seemed to always be hungry. Those two months were the best two months she’d had since being diagnosed with cancer in June 2008.

Then the unthinkable happened. After two months on Marinol the drug company in their wisdom decided to switch her to dronabinol, which is the generic form of Marinol, and a cheaper substitute. After six days on the generic, she started losing her appetite. I talked to her family doctor and he wrote a letter to the drug company and tried to get it switched back. They said no, indicating it was the same as Marinol. So I called them and pleaded my case, but I got the same answer as her doctor. At some point, while all this back and forth with the drug company was going on, I went over to our local pharmacy and spoke to the pharmacist. I explained our situation to her and the fact that Annie was losing her appetite on the generic drug. She asked me to give her a few days to do some research and then get back with her.

A few days later I went over and saw her and she said the generic version was missing one major ingredient, and that was most likely the cause of her not eating and why the generic was less expensive. So in essence the Marinol cost 900.00 for 30 pills, the generic cost 600.00 for thirty pills and did not work for Annie. (Note: What I know now that I didn’t know back in 2009 is that the generic does work for many people, but as with many medications what works for one might not work for another.) Keep in mind at that time the federal government made an agreement with the drug companies that they no longer had to dispense the brand name if there was an available generic. We got caught in a trap, as the brand name was no longer available to Annie.

Never-the-less we were able to move on without the drug. At that time, the two months on Marional helped her gain enough weight that we were able to sustain her on calorie loaded food and some nutritional food too. However, if she’d started losing significant weight I don’t know what I could have done to help her. There was probably nothing I could have done.

On Sept the 7th, 2009, at approximately 6:00 P.M. Annie was admitted to the regional medical center with what turned out to be blood poisoning, swine flu, and extensive bilateral pneumonia. She spent five days on the ventilator. The admission notes stated that she was a “Critically ill, and acutely ill, frail older lady.” When I read those words they really stung. Annie was such a beautiful youthful looking lady, inside and out. As it turned out, it was just another traumatic event that she survived, but got much weaker in the process. Her appetite started going South once again, but was still manageable. And the dronabinol was useless for her so, we were kind of stuck for the moment.

In October of 2009 Annie started having problems with nausea and vomiting. Despite numerous visits to the doctor’s office, and a zillion tests, no one had any answers. Finally after having seen enough, on December 26th, 2009 at 1:00 A.M., I made a caregiver decision. I called the paramedics. About 30 minutes later she was hooked up to oxygen and we were on our way to the regional medical center. Annie had a good appetite, but was always starving, because as soon as she ate something or drank some fluids, she’d vomit it all back up. Then she’d feel better again. The admission notes stated that “Annie is a cachectic, ill-looking, 60 year old female who is alert and orientated. I mentioned the work cachectic earlier but now I will elaborate. On google the word cachectic is used to describe the prisoners at the concentration camps during WW11. That’s a sad reality of cancer.

When she entered the hospital on Dec 26th, 2009, things started getting difficult for Annie rather quickly. She was diagnosed with pneumonia from aspirated vomit. That went on for just over a week, as none of the IV antibiotics were working. In the end it was the fifth antibiotic that finally started sending the pneumonia into retreat. Her nausea and vomiting problem had been put on hold as her pneumonia started getting out of control and they were not sure how this event was going to turn out. Annie’s oncologist said that due to her badly diseased bones and body, she would not be a candidate for the ventilator this time around.

When I asked him what would happen to Annie, his words were soft and to the point. “She will code, Bob.”

When the doctors got Annie’s pneumonia under control, they turned their attention to her nausea and vomiting. Over a period of a few weeks, despite all the methods the doctors tried, Annie could not keep anything down, and was losing weight rather rapidly now. As her doctor said, she desperately needed exploratory surgery to find the answer to her problem, but no surgeon wanted to touch her due to her low platelets. The fear was, when the incision was made she would bleed to death as there was not enough platelets to stop the bleed.

On February the 1st a young surgeon came into Annie’s room, introduced himself, and said he would be doing exploratory surgery in the morning on Annie. He was confident that if she didn’t bleed out, he would find and fix the problem.

Annie had at this point been in the hospital for thirty-eight days. So far she had Ten CT Scans, over Twenty KUB’s (abdominal x-rays), and many chest x-rays. And yet the problem with the nausea and vomiting remained elusive, able to evade the prying eyes of such incredible modern technology. Exploratory surgery, the old fashioned way, would now have to be deployed.

On February the 2nd the surgery was completed and was very successful. He had to remove eighteen inches of her small intestines that were dead, most likely due to her heavy narcotic use. Annie was on over 200mg morphine a day for badly diseased, broken and damaged bones. He inserted a G-Tube into her stomach for tube feeding.

The surgeon told us she could now eat anything she wanted, but soft foods for the first couple of days would be easier on her. Problem was, a frail person before the surgery was now much weaker due to the stress of surgery. She couldn’t hold a spoon, sit up or roll over in the bed on her own. It was becoming a nightmare in the making. Even with her blockage removed, her chances of survival in such a weakened state were not very good. That was according to her doctor.

The afternoon of February 11th I’d been out of the room for a few minutes. When I came back into the room I walked over to Annie’s hospital bed. I thought she was sleeping. As I stood there looking down at her, her eyes opened and as they locked onto mine she abruptly started crying. We had a very sad, difficult, but gentle conversation.

She said to me softly, “Bobby, please take me home. I don’t want to die in the hospital.”

I said, “Annie, I can’t take care of you at home. I don’t have all this equipment you need.

She replied in a tearful voice, you can buy it at the shops.

By that time we were both shedding tears, and I didn’t know what to do; but I made her a promise, whatever it takes, I will get you out of here.

Apparently Annie had heard some bedside talk, indicating that they were going to put her on hospice. And that was the reason for her tears. She had a strong phobia about dying in a hospital.

I got in touch with the hospice doctor and had a word with her. I asked her if Annie was getting any better and she said she was losing more ground every day. She further stated, “She needs hospice now.” I told her that was not going to happen in the hospital and that I was going to take her home, which was honoring Annie’s wishes. But at the same time I asked her to get a hospice company up to the hospital as soon as she could, so I could see what their services were.

The hospice company arrived about two hours later and we had the dreaded conversation. It was okay for awhile, until they told me Annie would not be allowed any IV life sustaining fluids or blood products. At that point hospice was no longer a viable option. I was not going to take Annie home, just to die.

We talked a bit more, and I got to listen to, how in their mind I was making a huge mistake. But the conversation soon switched gears, once they understood I would not be backing down. To my surprise and delight they said they had a good home health company that could take all the equipment I needed to my home for me to use in my caregiver role for Annie.

Despite the tube feeding, and some bites of food, Annie was continually losing weight. By the time I took her home on February 13th, she weighed seventy-nine pounds. And I was warned by her gastrointestinal doctor that including the tube feeding, I had to get two thousand calories a day in her, or in his opinion I would lose her rather quickly.

The hospital wanted her on hospice because she was dying, but would not give me a reason why she was dying. It didn’t take me more than a few minutes to figured out what they weren’t telling me. And it was at that moment, that I knew we had a chance. She was dying of malnutrition. The fact that patients often do much better when they get home in their own environment was huge for me. But I was under no illusion, I was going to have to put in long hard hours just to keep her alive. Tube feeding was going to take between fifteen and eighteen hours a day and we got to listen to that annoying Kangaroo pump. And I had to spoon feed her anything she could eat while she was tube feeding to get her the extra calories.

Bringing a seriously ill patient home from a hospital environment is a daunting task at best, and I was sure of only one thing; if Annie was going to survive we needed the perfect storm. I had no plan, other than dealing with one event at a time, as they happened. I knew it was going to be difficult, but I also knew I was doing the right thing in honoring Annie’s wishes.

The first night we were home, I sat on the sofa watching her sleep and seemed to fall deeper in love with her. Although she looked to be very ill and frail, she looked so precious and relaxed lying on her hospital bed. I had a tremendous respect for her tenacious will to live; but it was now up to me to follow through on my promise. I wasn’t sure if I could bring her back from the clutches of death or not; however, if I could be as relentless in my care giving as she was in fighting the disease, we would be in with a chance.

From Feb 14th, after about one week I was coming to my wits end. I was getting very little sleep, and tired, as the feeding was taking longer than expected. She was usually nauseated and sometimes vomited from the tube feeding. The feeding tube seemed to clog up often from the thick liquid, and that always took time to sort out. Her appetite simply wasn’t there, and although she ate as much as she could it was nowhere near enough.

My Friend and His Miracle

On the seventh or eighth evening after we got home there was a knock at my door. When I answered the door, to my surprise it was Annie’s and my good friend Ray. Ray was a big black man, with a low voice, and stood just over six feet tall. I’d known him and his family for about fifteen years. After our welcome, I pointed over to where Annie was laying asleep in her bed. We then walked to the dining room table and sat down for a chat. Apparently he’d heard from some mutual friends the situation I was in with Annie, in regards to her eating or lack thereof.

While we sitting at the table he just looked at me and said in his low voice, “Bob, how can I help you.”

You can’t help me Ray.

He once again looked me in the eyes and with a questioning voice said, “How can I help you!”

I basically said, Ray I don’t know what you’re talking about. There is nothing you can do. I just have to keep going and do the best I can.

He abruptly excused himself, said he had to go see a friend and would be back in about thirty minutes. I found that rather odd at the moment, but he was like that. Here one minute, gone the next.

When he came back he laid a small baggie on the table with a small sampling of what he called medicinal marijuana in it. He also had a pack of cigarette papers. He told me to roll a cigarette with medicinal marijuana mixed with tobacco and give her a few puffs throughout the day. He said her appetite should pick up and she should start feeling better soon. I was a bit skeptical at first, until he started telling me about his friend who was fighting cancer with medicinal marijuana. His friend was able to cut back on some of his medicine, keep his appetite up as well as help control pain, nausea, and vomiting.

I must admit, when Ray walked in with the baggie, it really caught me off guard. My first thoughts were, should I reject his gesture or thank him? I wasn’t quite sure what to do. I mentioned to Ray that I was worried about getting in trouble and not being able to care for Annie.

He countered with: I know you Bob, we’ve all seen the level of care you’ve given to her, and I’m sure you would die for her. If you can’t help her because you have no other options, it sounds like the outcome is going to be grim, and you will have cheated her out of something that just might help her eat and feel better.

I’d promised Annie I’d do whatever it took to give her quality care, and now it was coming down to this.

I couldn’t argue that point. I’d promised Annie I’d do whatever it took to give her quality care, and now it was coming down to this. If I could have gotten the Marinol it would have helped her, and I wouldn’t of had to make this decision. It made me angry that a drug company can recklessly control the fate of a patient by ignoring the fact that sometimes the generic brands are somewhat different and just don’t work for everyone. When something is not broke, why fix it. And this was despite pleas from me and her family doctor expressing our concerns. They say that money can be the root of all evil, and my inability to get the medicine Annie desperately needed, was all about the all mighty dollar. When I signed back on with the USAF in 1974 after a twenty-three month break in service, my government promised me and my spouse the best medical care available if I completed twenty years of service. I did that, and Annie’s healthcare during her journey with cancer was exceptional. But when it came to getting the drug she needed from the drug company, I couldn’t do it.

sometimes the generic brands are somewhat different
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It was now time to ask myself the question. How much do I love Annie? I loved her with every fiber of my being, my every breath, every heartbeat, and was willing to do whatever I could to make the last days or months of her life as comfortable as possible. We would not go down without a fight. And I’m pretty sure most of you that truly love your loved one would do the same thing. It’s about humanity!

Medicinal marijuana leveled the playing field

The next day I rolled her a medicinal marijuana cigarette and told her to smoke some of it, in an effort to see if it helped her or not. I didn’t mention appetite to her as I wasn’t sure it would work and didn’t want it to be a big disappointment for her.

Reason being, when you’re dealing with advanced cases of cancer and loss of appetite the playing field is not level. Cancer produces and releases a multitude of chemicals into the body of your loved one that will naturally suppress their appetite. This would turn out to be a real test for the medicinal marijuana.

Well it didn’t take long. About fifteen minutes after she had a few puffs, while I was in the dining room I heard her little pitiful voice asking me if I could find her something to eat. I asked her what she’d like and she said raspberries and Breyer’s Vanilla Ice Cream. Great, exactly what I didn’t have. I told her if she wanted me to I could pop over to the market and pick some up. The market is less than a mile away. When I left for the market, I had to wonder if when I got back she’d changed her mind as she had done many times before. In this case, she seemed rather excited when I delivered the bowl full of delightful calories to her.

Annie could not feed herself, but I sure got great joy in feeding her. She was really enjoying the treat. It had been awhile since I saw her enjoy some food. It really did make my heart smile.

It didn’t stop there either. After the ice cream and fruit, she wanted some deep fried pancakes with syrup and mandarin oranges on top. She was pigging out. Between the ice cream and deep fried pancakes she got over a thousand calories in two settings. And with the tube feeding she was going to get her two-thousand calories as well as some nutrition, at least for this day anyway. It was such a blessing to see her eat like that. I would never have believed it was possible. A few days earlier when I was at wits end, I was beginning to think that she might not survive due to her lack of appetite. When a person can’t eat, you can’t make them.

When a person can’t eat, you can’t make them.
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After she ate all that food, it dawned on me but I didn’t want to say anything to her in case it had the placebo effect in reverse. She obvious was no longer nauseated. The Osmolite and Jevity mixture I was feeding her through the tube was a rich mixture and she was always nauseated to a point once she’d had a few cans, and on occasion would vomit it back up. Which is not uncommon with patients that are tube feeding, but becomes a major concern as the patient has to meet their daily calorie intake.

It became apparent after the first hour or so that, this new medicinal marijuana could certainly be a game changer for Annie as far as keeping her comfortable and helping her gain weight.

It was amazing observing her after she started the medicinal marijuana. When I’d asked her if she was ready for her Xanax, other than when she bedded down for the night, she’d usually say no, I don’t need any, I’m feeling relaxed. And I think, because she was so relaxed, I was able to cut back on her morphine, and stopped giving her Percocet all together. She didn’t need it. Her Percocet was only used for break through pain control, and being relaxed as she was, her pain was under control. I don’t know if medicinal marijuana had a direct influence on her pain control or not, but what I do know is that the indirect result due to her relaxation allowed me to cut back on pain medication, and tremendously reduce her Xanax intake. And that was so important to her well-being.

Annie’s oncologist had a spoken rule to me. Bob, stay ahead of the pain. Anytime you have to start playing catch-up to the pain, you may well be one pill away from an overdose. So, being able to cut back on the narcotics a bit was simply amazing.

As you read this, think back to when she was on Marinol a form of cannabis (marijuana). It had basically the same effect as the medicinal marijuana but I couldn’t get it. What a shame.

About two weeks after I started her on medicinal marijuana, one morning I was in the kitchen area and heard her moving around, so I walked into the room. She was trying to get up and set on the edge of the bed. I looked at her with a smile on my face and asked her what she thought she was doing. She said something to the effect she wanted to come out and sit with me in the dining room. Her words gave me a rush of emotion that’s hard to explain, but it gave me a strong sense that she wasn’t ready to give up just yet. So I unplugged the pump from the wall, helped her into the wheelchair, and pushed her into the dining room pulling the IV pole. That was a glorious moment, as the odds of her getting better weren’t very good. At that moment, I knew if I could keep her from getting an infection we were going to make it through this event. I was starting to witness another event, that too many folks, would defied logic. Just think about it! In three weeks, we were turning an event around that I was told would likely end in tragedy; yet we were now full of hope and promise once again.

Imagine if I’d made the wrong decision back in February, and let her go on hospice. I’d be grieving her loss now, rather than enjoying the beautiful woman I loved so much.

Over the next three months Annie kept using the medicinal marijuana. Her weight was coming up and we were able to maintain her on the lower dose of morphine. Her appetite was splendid. On 29 March 2010, her weight was 86 pounds.

Later on 6 June 2010, her weight was now 90 pounds. This picture was taken of her and our grandson Andrew at his high school graduation.

After Annie started the medicinal marijuana, life was so much better for her. I can’t under emphasize the positive effect it had on her well being. Being able to relax under such adverse conditions was remarkable. I was never under any illusions that Annie was going to get better, I just wanted to help her survive and be comfortable for as long as she could.

On June 8th, 2010, we went to the cancer center and got the results of Annie’s twenty-four hour urinalysis. Under the circumstances it was terrible. The cancer was back and tucking right along. We were given a few options that she could try to slow it down, but to her none of them were viable. She didn’t want to be on steroids as she didn’t want the moon face look. Her sister had that when she died of cancer a few years earlier. It appeared that Annie’s remarkable run of beating the odds so many times, would be coming to an end soon.

During the first week of July as Annie was now eating well, her feeding tube was removed. Her weight was 98 pounds. Amazing!

I truly believe that the medicinal marijuana improved the quality of life for Annie in so many ways over the past few months. Without it, she probably would not have made it. Let’s be honest. Her quality of life to you or me would have been very bad. But to her, the sufferer, it was quite good. She relaxed, she laughed, she loved, and she pigged out on the junk food. Just being able to back off on many of her drugs was a huge plus for how she was feeling. She literally went from feeling like a zombie, to being alive again. Priceless!

How can one be criticized for loving ones wife as much as I loved Annie?
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I know some folks will criticize me for helping her the way I did, but how can one be criticized for loving ones wife as much as I loved Annie. I saw more pain and suffering over a thirty month period that humanity should allow. Imagine, standing beside your loved one, she turns her right foot to the right and breaks both femurs, shattering the right one and breaking her right hip in the process. And I got to catch her as she fell. Try to imagine the trauma around that event. Then while in surgery trying to repair her broken bones, her spine collapsed. And that was in the third week after her diagnosis. Annie suffered tremendously from many diseased bones over the 30 month period. She needed all the help she could get.

From July until late September Annie used the medicinal marijuana very little, and mostly for relaxation from her anxiety. Her appetite was very good.

On 22 Sept we were told Annie’s bone marrow was over eighty percent plasma cells (cancer), and she was slowly checking out.

She lived two more months, was never in too much pain, and as I predicted a couple years earlier, when Annie died it would be from internal bleeding. When you’re sitting with your loved one, and their bleeding from under their lips, gums, throat, ear, nose and medicinal marijuana quells the anxiety, how can anybody not want that for their loved one. The hospital can’t stop her internal bleeding from extremely low platelets, as her body always rejected the transfusions. We were on our own.

But, that bleeding event was just the beginning of the final storm. It would come a month later on November 1st, when her ostomy pouch was filing with blood, her urine was full of blood, and she started spitting up bloody mucus from her lungs.

Annie lost her battle on 2 November 2010, dying peacefully at home with our loving daughter doing her comfort care. Our daughters words were, “My momma brought me into this world, and I can help her out.”

For those of you that wonder if a dying loved one can hear you when the loved one is in a coma near the end, here is but one of a few examples I witnessed during Annie’s final hours.

While Melissa was administering comfort care for her momma, a few hours before she died, Melissa was leaning over near her momma’s face and quietly singing, “Que Sera Sera, whatever will be will be, the future is not ours to see, Que Sera Sera.” When she pulled her face away, Annie had tears running down her cheeks. The song had been a family tradition for a long time. Annie’s mom sang it to her when she was a child, and Annie sang it to her two daughters when they were children, now Melissa was singing it back to her to her momma with so much love and grace. Your loved one can hear you even though sometimes they might not be able to respond. So love them, talk to them, keep them company until the end. Help them leave this world in peace.

I’m not in any form advocating the legalization of marijuana, and I’m dead against that. But I saw what I saw, and its effects on Annie cannot be denied. So I believe for chronically or terminally ill patients that cannot get the medications they need through no fault of their own it should be an immediate option. In Annie’s case, her diagnosis was, we can’t figure out why she is still alive. She was never going to survive her cancer, multiple myeloma. But there are laws against putting people to sleep prematurely, and in most states there are laws that prevent them from getting what they need to add some quality to an already miserable existence. I don’t understand. Where is the humanity in that?

Here’s the facts: One medicinal marijuana cigarette which was more tobacco than marijuana lasted about a week with Annie. And that would have been peak usage. There was a period when she used it only for anxiety and used hardly any. It was a gift from Ray, but as there was so little in the baggie it couldn’t have cost more than a few dollars. After Annie passed away, I flushed what was left over down the toilet. The Marinol over the same period of time if I could have gotten it would have been around $7,000. I know, I’m dancing to the beat of a distant drum. Maybe one day!

Annie has one of the top rated online memorials in the world. Over sixty-six thousand visitors.

Because of Annie, her story, is also available in all three formats at Amazon.com. All proceeds go to cancer.

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