Starting Over

In her annual address to the British Parliament, Queen Elizabeth II referred to 1992, the 40th anniversary of her ascension to the throne, as her “annus horriblis” or horrible year. In the Queen’s case, the marriages of three of her children were failing, reports of their affairs were being gleefully reported in the press and a fire caused substantial damage to her home, Winsor Castle. It looked at that point, like the British monarchy could be in trouble but they recovered and with Kate and William’s strong marriage and recent baby, seem to have experienced a new renaissance. Last year, 2013, turned out to be my horrible year. The troubles began in October 2012 when I discovered, that my 89 year old mother had stage 4 colon cancer. This knowledge, which would be troubling in its own right, was devastating to me. My mother lived with me and she had survived a previous bout with colon cancer in her late 50’s. Mom had always been rigorous about her follow up care and had undergone colonoscopies every three year. When she turned 83, her doctor informed her that she didn’t need any more of these procedures. She had been cancer free for 25 years. So the discovery of this cancer, which should have been detectable at a much earlier stage if she had continued with the colonoscopies, had been missed. Earlier in the year, Mom had complained of pain in the area of her right ribs. Suspecting a cracked rib, her doctor had ordered an x-ray but nothing appeared to be amiss and the pain subsided. My mother routinely took pain medication to deal with chronic back problems and this probably masked most of the pain associated with the cancer. Over the summer Mom’s weight began to drop and when the pain under her ribs reappeared, her doctor order a CAT scan which showed the cancer was forming a blockage in her colon and that it had already metastasized to her liver. Mom’s primary care doctor, Hal Kramer, delivered the news and then immediately went into action to help us deal with the next steps. Although he knew that the cancer was terminal, and told us so, he also told us that we didn’t want my mother to die from a blockage. He contacted the surgeon who had operated on his own mother-in-law and called me at home to make sure I had arranged an appointment. When he found out the appointment had not been made for the following week, he called the surgeon’s office himself and had it moved up so that the surgery could be scheduled right away. My mother began to prepare for her surgery on the Sunday just as hurricane Sandy approached the area. The preparation, which was designed to clean out her digestive system, made her violently ill. The surgery had been scheduled for Tuesday, which was the day Sandy was supposed to hit the area. The governor of Delaware had already declared a state of emergency. I called the surgeon, Dr. James Tikellis to ask him what to do. He felt that since the hospital was likely to cancel any non-emergency surgeries as a result of the storm, I should have Mom stop her prep and he would reschedule for the following week. By Monday morning, Mom seemed to be recovering but by Wednesday it was clear to me that something serious was wrong. Mom was almost continually nauseous and retching. I wanted to take her to the emergency room but she didn’t want to go to the hospital. I brought an air mattress down into her apartment so that I could sleep close to her in case she needed me. Neither of us got any sleep and her condition deteriorated. She was becoming seriously dehydrated by the continual retching. Having been warned by both by Dr. Hal and by my sister, who is a nurse, about the symptoms of a blockage, I became increasingly worried and finally called 911. We arrived in the emergency room at Christiana Care at 4 AM. The doctor listened to my report and then immediately commenced treatment. Fluids and pain medication were administered and then my mother was taken for a CAT scan. At 10 AM, Dr. Tikellis came into the room to tell me that my mother’s colon was now blocked and emergency surgery was necessary. The operation almost didn’t take place. Mom’s heartbeat was irregular but after a consultation with the surgeon, the anesthesiologist and Mom’s cardiologist, we decided to go forward. When the surgery was over, Dr. Tikellis told me that while he had been able to remove the tumor in her colon, Mom had a large tumor in her liver and a smaller one in her lungs. That was the bad news. The good news was that he had been able to sew her intestines back together so that she did not need a colostomy bag and he was sure she would recover from the surgery and be able to go to the Florida Keys for one final vacation. It was something to look forward too, perhaps just what she would need to engage her will to get better. I returned home feeling a little more hopeful. Then I listened to the message on the answering machine. My horse, Sonny, had gone dead lame. Sonny had been experiencing sporadic lameness issues for about a year. I had been working with the vet to diagnose the problem. We’d done x-rays and ultrasounds, all inconclusive. The problem seemed to be worse when Sonny moved on a circle. I had rested him for the entire summer, taking my lessons on my local Parelli instructor, Jane Bartsch’s levels mare, Lynn. Jane even allowed me to ride Lynn in a three day Carol Coppinger clinic that fall. I had been using a red light on Sonny’s hoof and thought he was making progress but the message on my answering machine was grim. Sonny was so lame that he hadn’t come in from the field for breakfast. Sonny is an incredibly food oriented horse. If he was willing to miss breakfast, I knew he was really hurting. I rushed to the barn, hoping it wouldn’t be as bad as it sounded on the message, but when I got there I found Sonny in his stall and not wanting to walk at all. There was no apparent wound and although we couldn’t find any real sign of heat on the foot, both the barn manager and I thought it most likely an abscess. Since the vet was already scheduled to be there on Monday to give Sonny his flu shot, we decided to treat it as if it was an abscess and see what happened. We applied a poultice and gave Sonny some bute. By Monday no abscess had broken out but my vet, Dr. Clark Cushing, agreed that was the most likely cause and suggested we continue the poultices and bute. As the week progressed, there was no evidence of an abscess breaking through the wall of the hoof but Sonny was slowly improving. Dr. Cushing came to the conclusion that there probably wasn’t an abscess and perhaps Sonny had sustained a tendon injury in his hoof. He suggested I discontinue the poultices and start him on a course of Previcox, a stronger anti-inflammatory medicine. This was actually bad news. I knew that Sonny would recover from fairly quickly from an abscess. Any type of tendon injury that was bad enough to make him go dead lame however would probably require an extended recovery period. But at this point, I didn’t really have time to worry about this because Mom was coming home from the hospital. My sister and brother-in-law had arrived from Maryland to help when Mom was released from the hospital. Lynn is a register nurse and her husband, Dan, is a physician’s assistant so their arrival was no small thing. They were so much better prepared than I to deal with Mom’s recovery but they were only going to be able to stay for a week. In the spring, before they knew that Mom had cancer, they had decided to move to Florida. They arranged to have a house built near Tampa and had sold their house in Maryland. They were now scheduled to pack up their all of their belongings and move in the middle of November. I knew that my sister felt awful about the timing. I was just glad they were going to be here for the first week. Mom came home from the hospital weak and disoriented. She could only sit up for a few minutes without being in pain. She didn’t want to eat anything. She was also having issues with incontinence. The tumor in her colon had been at the junction between her large and small intestines. That junction has a valve that slows down the flow of the semi-solid small intestine waste into the large intestine. Between the serious inflammation that had resulted from the blockage and the absence of that valve, Mom’s digestive system was a mess. The surgeon had failed to mention that this would probably happen. It was not uncommon, I learned from researching on the internet, for this to happen following blockage surgery. In the best case it could take weeks to resolve and in the worst case scenario it never would. I cried when Lynn and Dan left the following week. I don’t think I have ever felt so helpless and alone watching them pull out of the driveway. Mom was still very weak and she was also depressed. Sitting up was painful for her and she didn’t want to eat. I knew that I needed to get some nutrition into her if she was going to recover from the surgery but meals were a struggle. We both soldiered forward but the atmosphere at home was grim. Then one afternoon I received a call that would prove to be a lifeline for both Mom and me. The call was from my niece, Karole. Karole was Mom’s only surviving grandchild. Her brother, Mark, had died in a car accident when he was only 25. Karole lived in California and didn’t get back to visit very often but she was between jobs and offered to come and stay with us to help take care of Mom. She could come right after Thanksgiving and stay until New Years, she told me. My sister had offered to pay her airfare. Mom and I both leaped at the offer. Mom was slowly improving. She was still bothered by incontinence but the episodes were becoming less frequent. She was able to sit for longer periods of time and she was getting crabby, which was actually an improvement from her earlier impassiveness. I was tired of being stuck in the house all the time but I didn’t feel comfortable leaving Mom alone. I had done no Christmas shopping and I was depending on Bree, our barn manager, to handle Sonny’s recuperation. I hadn’t been to the barn in weeks. Karole arrived the Saturday after Thanksgiving and she was a godsend. In addition to giving me the freedom to get out of the house, she turned out to be a terrific caregiver for Mom. She was incredibly attentive to Mom. When Mom took a tumble and ended up with a sprained ankle, Karole applied an ice pack at 20 minute intervals until the pain and swelling were gone. Besides that, in her presence, Mom’s spirits began to rise. She insisted we decorate for Christmas and put up her Christmas village, an elaborate display of miniature buildings and figures that covered the entire dining room table. Now that I was able to spend more time at the barn, I was determined to get to the bottom of Sonny’s lameness. On both Previcox and Isoxsuprine, he had recovered somewhat but was still off when moving in a circle. There had never been any heat that Dr. Cushing was able to detect in the foot and given the inconclusive x-rays, he was baffled by the continued lameness. Finally I decided to make an appointment for Sonny with Dr. William Riddle, a lameness specialist in nearby Port Deposit, Maryland. On the morning of our scheduled appointment, Bree trailered Sonny and me to Dr. Riddle’s clinic. Using a combination of x-rays, thermography and nerve blocks, Dr. Riddle was able to diagnose Sonny’s problem as a chronic tendonitis resulting from navicular degeneration. On the x-ray he showed me the rough surface of the navicular bone. The tendonitis was cause by the tendon rubbing across the uneven surface of the bone and aggravated by the upright and narrow construction of Sonny’s hoof. He suggested a series of injections and rest. He felt that Sonny’s prognosis was only moderate at this point. I was disappointed at the prognosis but relieved to finally have an answer. It was clear that Sonny’s career as a levels horse was over but I was hoping that I would be able to trail ride him in the future. The entire family was arriving for Christmas and we were doing everything we could to raise Mom’s spirits. To help assure her that she was going to get to the Florida Keys, we had tee shirts made for the family and friends. We were calling ourselves “Mom’s Pit Crew” and even got a tee shirt for Mom’s doctor. I left the shirt at Dr. Kramer’s office on the Monday before Christmas and then next day I received an e-mail with a picture of Dr. Kramer, wearing his tee shirt and requesting that Mom take him with her! Dr. Kramer even called Mom on New Year’s Eve to wish her a Happy New Year. On January 9th, Sonny returned to Dr. Riddle’s for his second injection. When Dr. Riddle had given Sonny the first injection, the pressure from the inflammation in his hoof had caused blood to well up out of the needle when it had been placed into his coronet band. He had shown great improvement after the first injection and I was really hopeful at this point. There was still a little fluid that came up out of the needle before the second shot, an indication that there was still some pressure in the foot, but this liquid was clear, indicating that the inflammation was greatly reduced. We discussed treatment options and settled on a series of injections that could be administered by Dr. Cushing. He also suggested that I continue the Previcox and Isoxsuprine until spring, and then gradually wean Sonny off so we could re-evaluate at the beginning of July. On January 10th, I took Mom for her final visit to the surgeon. Much to our great relief, Mom’s issues with incontinence had completely resolved and she was also much more comfortable sitting for long periods of time. Dr. Tikellis was amazed at how well Mom had recovered. He had told me after her surgery that it would take a normal, healthy adult eight to ten weeks to recover from this type of surgery but with Mom’s age and compromised immune system, it could take her twice as long. Yet here she was just less than ten weeks after her surgery looking pretty good. He cleared her for the trip to the Keys and Mom came away from the doctor’s office happier than I had seen her since she received her diagnosis three months before. It had been a hard three months but we’d made it this far and in a couple of weeks we would be on our way to the Keys. We had a lovely time in the Keys. For the past few years I had been renting a three bedroom condo on Long Key which is about a third of the way between Key Largo and Key West. It is a small complex, only twelve units, and is right on the Atlantic Ocean. We have become friendly with several of the owners there and Mom loved the warm weather, spectacular sunrises and heated pool. Because it is a three bedroom unit, it is large enough for friends and during the six weeks we stayed on Long Key, friends from as close as Coral Gables and as far away as Grand Junction, Colorado, came to spend time with Mom. On February 27th, Mom celebrated her 90th birthday and the entire condo complex got in on the act. My best friends from Delaware flew down to join us and we gave Mom a rousing party around the pool, complete with presents and lots of good food. I think Mom was actually thrilled to have made it to 90. Both of her parents died relatively young and she had often told me that she hadn’t expect to make 80 let alone 90. Near the end of our stay in Florida, Mom announced that she wanted to spend a little more time in Florida and that she was going to stay with my sister for another month. We had visited Lynn and Dan on our way down to the Keys. They had a lovely new house in a 55 and older community located just south of Tampa. It contained a nice guest bedroom and bathroom where Mom could be comfortable and so toward the end of March, I transferred care of Mom to my sister and headed home on the Auto train by myself. I was grateful for the break. As much as I loved Mom, being a full time caregiver is hard work and I was feeling a bit frazzled. There were things that I needed to get done around the house and I wanted to spend some time with Sonny to evaluate where he was in his recovery. And although Mom had done pretty well in the Keys, I could see that she was slowly getting more fragile and knew that as the tumor in her liver continued to grow, she would eventually go into liver failure, a condition that she could not survive. Sonny was doing pretty well when I arrived in Delaware and looked pretty sound when trotted in a straight line, but he still wasn’t up to any work and I was anxious to get back to my Parelli studies so I needed a horse. I was fortunate to find an affordable solution right at the barn. A friend of mine who owned two appaloosas that I had worked with on and off had decided to get out of horses. She had actually offered to give me one of them several times but worried about the financial commitment that owning a second horse would entail, (I am retired and Sonny was already costing me a fortune in medical bills) I had declined. It turned out, however, that our barn manager’s boyfriend, a nice guy just out of the navy, wanted to buy the larger of the two horses but couldn’t really afford the board. The barn manager brokered a deal whereby I could take a half lease on the horse, making the situation affordable for everyone and so Dillon came into my life. Mom returned to Delaware at the end of April. My sister flew with her and when I picked them up at the Philadelphia Airport I could see how weak and exhausted she looked. We managed to get her home but just as she got to her apartment she began to retch. We were able to bring the situation quickly under control and both Lynn and I wrote the incident off to the stress of the trip but it was to become a more and more frequent occurrence as Mom’s cancer progressed. Mom seemed glad to be home in familiar surroundings and was in relatively good spirits, looking forward to our annual Kentucky Derby Day Party, scheduled for the first Saturday in May. Lynn had remarked about Mom’s increasing confusion while she had been with her in Tampa and we both thought she would benefit from being home, but right away, I could see that there had been deterioration in Mom’s mental state. I guess it should not have been a surprise to me. Mom was 90 years old, on some pretty heavy pain medication and dying of liver cancer so she was probably suffering from an increased level of toxins in her blood. But my mother had always been mentally sharp. It was something that all of my friends remarked about and more than the physical decline, this metal decline threw me for a loop. It wasn’t just that Mom’s memory was failing. I could have dealt with that. It was that her personality was changing and she was confused a lot of the time. It was very hard for me to deal with the confusion and often when she became confused, she became agitated or angry. I knew that her behavior was a result of her conditions found myself also feeling frustrated and angry at time and would occasionally speak sharply to her out of the frustration. Each time that happened I was then filled with remorse. It was a difficult cycle that got worse as the summer progressed. In 2006, when my father was dying of cancer, we had used Vitas Hospice and they had proved to be a godsend during his finally months. Soon after my mother’s surgery, she had asked Dr. Kramer to arrange for hospice care and they had been with us ever since. Although I was willing to do almost anything Mom needed, I was a little uncomfortable bathing her and the hospice aides, a group of caring younger women, had been a huge help from the beginning. The hospice nurses also tried to help me understand what to expect as Mom’s cancer advanced and were quick to respond to any medical situation that might occur. Mom continued to have good and bad days but as spring melted into summer, the bad days began to outweigh the good ones. I still felt comfortable leaving Mom for short periods of time on her good days so I was able to continue working with Dillon and monitoring Sonny. My next door neighbor, Helen, who was good friends with my mother, was also happy to come and sit with her when I had to be away for more than 30 or 40 minutes. I had put a monitor in Mom’s bedroom so that I could hear her at night and get to her quickly if she needed me. On June 1st, we began weaning Sonny off his medicine. First we took him off the Isoxsuprine. This caused him to be a little gimpy. The change was not dramatic but it was big enough to make me realize that the medicine had been helping him. Then we started to wean him off the Previcox. Within days of taking the last dose, his lameness came back with a vengeance. It was almost as bad as it had been in November, with him reluctant to move around. I was devastated. I put him back on both medicines and made another appointment with Dr. Riddle. I had pretty much decided that if it would make him comfortable, I would have Dr. Riddle permanently nerve the bad foot and then I would retire him. Dr. Riddle took another set of x-rays and together we looked at new films side by side with the pictures taken in December. In just six months, the degeneration of his navicular bone had gotten much worse. When I asked Dr. Riddle if nerving Sonny would be a solution, he wasn’t encouraging. He told me that he couldn’t be sure how long a nerve block would actually last given Sonny’s conformation and the degree of damage. He also said that given how fast the disease had advanced in the six months since the last set of x-rays, nerving the foot to allow Sonny to move around without pain would in all probability result in even faster progression. Finally I asked Dr. Riddle what he would do if Sonny was his horse. Dr. Riddle is a kind man. On each of my visits to the clinic he had remarked on what a nice horse Sonny was. When I asked this question he looked away for a moment. Then he put his hand on Sonny’s neck and rubbed him. Finally he looked at me and said, “I know you love this horse, but if he were my horse, I would probably put him down.” I just nodded my head. I was close to tears at that point and was almost afraid to speak. I told him that my mother was dying and I wasn’t sure if I could lose Sonny right now. He said that we could always do more injections and keep Sonny comfortable with anti-inflammatories for a while but at some point it would become more than we could manage. I thanked him, loaded Sonny in the trailer and cried all the way back to the barn. Early in July, Mom had a pain crisis. Up until that time, we had been doing a pretty good job of keeping her comfortable using a morphine patch and some breakthrough medicine. For some reason the pain got out of control. Mom became very agitated and I wasn’t able to calm her down. I was beside myself. Hospice bought nurses in 24 hours a day for a week. Using massive doses of pain killers and a combination of anti-anxiety and anti-depression medicines, they managed to get the pain back under control but we seemed to have reached some kind of turning point with her illness. One of the symptoms of liver failure is a general sense of not feeling well. Shortly after the pain crisis was resolved, Mom began telling me that she “just didn’t feel good”. There was really nothing I could do about it. She stopped eating. I tried tempting her with her favorite foods but dishes she had always loved, she turned up her nose at. She might eat a few bites and then push the food away. I made her milkshakes with coffee ice cream, her favorite or vanilla ice cream and chocolate malt. Her weight loss began to accelerate. She was wasting away before my eyes. At the end of July, Lynn and Dan came up for a week so that I could get away for a few days. I booked a short vacation with a good friend. We went to a lovely bed and breakfast in Charles Town, West Virginia. One night we went to the race track and proceeded to lose every cent we wagered. We wandered around our old haunts in the Shenandoah Valley, where we had worked together for the DuPont Company many years before. I returned home more relaxed than I had been in several month, happy to discover that Mom had actually been pretty good while I was away. I had come home on Saturday, a day early because the weather had been terribly hot that week, temperatures flirting with the 100 degree mark, even in the mountains. I noticed that my cat, Mac, a 20 lb. bruiser with bad eyesight, was acting a little oddly but didn’t think much of it and went to bed early. When I woke up in the morning, I found Mac in the exact same spot I’d left him in the night before and it was obvious to me from his behavior that there was something seriously wrong. Because it was Sunday, my normal vet wasn’t open so I packing him up in his carrying case and rushing him to the emergency clinic that was recommended on my vet’s website. At the emergency clinic, a technician came into the small exam room where we were waiting and took Mac back to see the vet. After a short wait the vet came into the room where I was waiting and told me that it was a good thing I had brought Mac in. Apparently he had a urinary track blockage, a not uncommon but potentially life threatening problem in male cats. Fortunately we had caught it early and it was easily treatable but Mac was going to have to stay at the vet for a day or two. She told me that a technician would be in shortly with an estimate of the cost of the care and some paperwork. The technician arrived minutes later. I took one look at the estimate of $1800 and started sobbing. I couldn’t afford that, I sobbed. I told them that they were going to have to put him down. I told them that everything in my life was dying; my mother, my horse and now the cat. I was inconsolable. I called my sister but I was crying so hard I couldn’t even tell her what was wrong. Apparently I could be heard in the waiting room. The technician left and the vet returned. She told me they didn’t want to put the cat down. They could remove the blockage and keep Mac overnight. I could take him to my own vet in the morning for the follow up care. That would only cost about $600. I pulled myself together enough to tell them to go ahead and then cried all the way home. The incident with Mac highlighted to me how fragile my emotional state had become. Most days I was just barely holding it together. I found that I had a hard time concentrating on anything. If I got the bed made, I felt like I had accomplished something. I had always been an avid reader but now I could only read about a page of anything without losing focus. My mother had always been uncomfortable with anyone crying in front of her so I tried to be her rock but at night I often cried into my pillow. I felt angry at the situation I was in. I was a scientist by training, used to being able to solve any problem but this was something that I couldn’t fix. I felt helpless and frustrated. I was angry at being trapped in the house all the time. I was angry at my mother for being sick and then I was angry at myself for being so selfish. I didn’t like myself very much anymore. Despite the fact that Mom had been pretty good while Lynn and Dan were visiting, my sister must have recognized how bad things had gotten for me. A couple of days after she returned to Florida, she called me and told me that she was going to come up for a week each month while Mom was still alive. I was so grateful for that show of support that I started to cry. I hated myself for my neediness. After Sonny’s last visit to Dr. Riddle, I knew that I needed to find a place where he could retire. I loved my current barn but with an indoor arena on the property, it was a high rent district now that I was supporting one and a half horses. The first barn I thought of as a place for Sonny’s retirement was Stray Fox Farm where my horse, Max, had lived for the last 10 years of his life. Max had also had a navicular problem but he lived to be 32 years old and I was able to trail ride him occasionally until the last year of his life. At the time Max was alive, the barn was run by Bob and Phyllis Malin. We had become close friends during the years Max was boarded there and I knew they would take good care of Sonny. The barn was being managed now by their daughter, Lisa, who told me that right she didn’t have any openings right now but she would keep me in mind. Miraculously, within two weeks she had a boarder move to Pennsylvania and called me to say that she had a spot for Sonny. In the meantime I had been taking lessons with Dillon but I was struggling. Before Sonny’s lameness we were a solid level three on line and at liberty and we were working on our level 3 freestyle skills. Sonny was still struggling picking up his right lead consistently, a problem I now knew was most likely related to the navicular issues in his right front hoof. I was riding bridleless at the walk and the trot and was building confidence at the canter. I felt that we were getting close to being able to pass our level three freestyle audition. I didn’t really want to be switching horses at this point and if I was going to switch, I needed a horse who was at least as far along in his development as Sonny. Dillon was proving to be a sweet guy, anxious to please and a quick learner but he was starting from Parelli ground zero and I found that demotivating. I felt like I was starting over. Just when I had gotten Sonny to the point where I could work on my level three freestyle skills, he had gone lame. Now my only option was a young, relatively green horse that wasn’t even confident in level one skills. I felt like I was going backwards. It wasn’t where I wanted to be. At this point in my horsemanship journey I needed to be working on my riding skills but here I was saddled with a horse that didn’t have the basics. By the beginning of August, my mother had become so weak that she needed assistance to get around. She refused to use a walker and I was afraid that she was going to fall and hurt herself so I had a single bed moved into her living room and began sleeping downstairs. That way, if she had to go to the bathroom in the middle of the night, she could call me and I could get up and help her. The only problem with that plan was Mom’s unwillingness to wake me up in the middle of the night. Whether out of confusion or a desire to remain independent as long as possible, she would get out of bed without calling. Usually, she put her light on and that was enough to pull me out of sleep. She was getting up several times a night. I wasn’t getting much sleep and was getting tired and cranky. Everyone told me I should try to nap whenever Mom napped but I found it almost impossible to sleep in the daytime. One night she got up to use the bathroom and did not turn on the light. When a loud noise woke me up, I rushed into the bedroom to find her on the floor. When I asked her what happened she didn’t seem to know. I got her to the bathroom and then back into bed but the incident made me realize that I needed help. The next morning I called my sister and we agreed that Mom needed someone with her at night. I arranged through a home care agency for nursing aides to be with Mom from 9 pm to 7 am but I continued to be her primary caregiver during the day. By that time, I didn’t feel comfortable leaving Mom alone for more than a few minutes. I had great support from our friends who would come over so I could go to the store and once a week, Helen would sit with Mom so I could take my riding lesson. Then Mom took a bad spill while Helen was with her, hitting her head on the corner of her bedroom dresser. I was at the barn getting ready for my lesson. I was just putting my foot in the stirrup when my cell phone rang. Helen was frantic. She had gotten Mom up and back in bed but she was afraid that Mon had a concussion. I called hospice right away, untacked Dillon and rushed home. I arrived home before the hospice nurse to find Mom sitting in bed laughing about what happened. I didn’t think it was at all funny. This was the fourth fall she taken that week, all because she refused to ask for help. I knew she was sick and confused but I was scared that she had fallen and I was furious. I began to yell at her and then I began to cry. By the time the hospice nurse arrived I was sobbing. The nurse examined Mom and was pretty sure Mom didn’t have a concussion but she was very concerned about Mom falling. She insisted that we get a hospital bed with side rails. Even in her confused mental state, Mom was adamant that she did not want a hospital bed. With the degenerative disc disease in her back, Mom found hospital beds uncomfortable. She and the nurse argued furiously while I sobbed in the living room. I was trying to control myself because I knew she could hear me but I couldn’t stop. I think my mother didn’t want the hospital bed for another reason. I was pretty sure that she saw the hospital bed as the beginning of the end. My father had spent his last two months in a hospital bed and I suspect that when the bed arrived, Mom saw it as a physical representation of her eventual death. Finally Mom agreed to the bed. She called me into the room and apologized for scaring me. I felt horrible. Here my mother was dying and I was acting like a spoiled child. The hospital bed marked another turning point in my mother’s illness. After the bed arrived, Mom pretty much stopped eating. At the end of August my sister came for another week. She was shocked at the change she saw in Mom since her last visit. That week, to save some money, Lynn and I took turns staying with Mom at night. Mom was now showing evidence of sundowners syndrome, a common problem with Alzheimer’s and other dementia patients. People with sundowners show increased confusion in the evening and often don’t sleep well at night. Mom’s confusion was increasing as her liver continued to fail. Often she would sleep most of the day and then be up most of the night. The first night Lynn stayed with her on this trip Mom spent a couple of hours taking everything out of her wallet and purse one item at a time and then placing each item deliberately back in. By the end of the week, Lynn was convinced that I needed more help. In addition to the night aides, I contracted for aides to be with Mom several hours each day during the week and we split the cost. I lived for the aids to arrive. It was a timely decision because shortly after Lynn left for Florida, I came down with a terrible sinus infection. I ran a temperature and ended up on antibiotics. My primary care physician told me to wear a mask any time I went near Mom. As soon as the nighttime aide arrived, I fell into bed and slept until my alarm clock went off in the morning. It was several weeks before I began feeling better, just in time for my sister’s next visit. As my mother’s liver continued to fail she was having increasing bouts of nausea. These were often accompanied by dry retching which made her miserable. Her doctor prescribed, Haldol, an anti-psychotic medicine that is also used to control agitation. Haldol proved to be a miracle drug to control the retching. Unfortunately it could not be used as a preventative, but only once the problem had appeared. Usually it took less than 5 minutes for the drug to eliminate the symptoms but it was a miserable 5 minutes for both Mom and I while the drug took hold. By the beginning of October, my mother had gone without any solid food for over a month. She was wasting away before my eyes and there was nothing I could do about it. The liver failure was giving her a jaundiced look, with her skin looking a yellowish gray. I had gone from being angry to feeling just helpless all the time. I wasn’t sleeping well and couldn’t seem to get any pleasure from the things I had always enjoyed. Even seeing the horses didn’t help much. Sonny seemed to sense that something was wrong. Given his dominant nature, he had never much liked being groomed and would often reach around and nip at my clothes or shake his head in displeasure but as September rolled into October he began submitting to the curry comb and brush as if this was his all-time favorite activity. Dillon continued to be his sweet, lovable self, rushing to the gate to meet me when I arrived at the barn and progressing to level two skills during our lessons. But the worry over my mother was never far from my mind and both horses took advantage of my lack of attention. I was scheduled to take Dillon to a three day Carol Coppinger clinic in Frederica, Delaware the third week in October and I was determined to attend as long as Mom was in stable condition. I arranged with the service to have 24 hour coverage for the four days that I would be with Dillon in Frederica. Because the farm was only an hour from my house, I would be able to return relative quickly if problems arose and I would also be able to spend each night at home. I had no idea how Dillon would react to the clinic because I had never ridden him in a group of horses before but I knew he would be OK in an indoor arena so on Friday. October 17th, Bree trailered Dillon in the afternoon to Hartland Equestrian so that I could introduce him to the arena and let him get used to the presence of strange horses. When I arrived, Carol was already conducting private session with some of the participants and she asked me if I would like to have one of my two fifteen minute sessions before I returned to Newark. I jumped at the chance to get Dillon into the arena. Before we started to work with Carol, I let him walk around and investigate anything that looked strange to him. He was surprisingly calm and by the time we finished and I had fed him and tucked him into his stall for the evening I was beginning to feel confident that we were going to do alright in the clinic. I have been attending Carol’s clinics in Delaware for several years now and always feel like I am among friends there. Jane Bartsch, my local Parelli instructor and my friend, assists Carol when she is in Delaware and there is a regular core of attendees who I’ve come to feel close to over the years. The environment is always supportive so even though I was emotionally ragged over my mother’s condition, I wasn’t worried about exposing my emotions with the group. During the morning session we worked with our horses on line. Even though Dillon had never been in a clinic situation before, he was fabulous. He didn’t seem bothered by being in close quarters with a dozen other horses and I found myself more able to focus than I had been all summer. After lunch, we tacked our horses up and prepared to ride. I felt confident that Dillon was ready. He had been calm and relaxed after our morning session and when I worked him around me after he was saddled, he appeared to be OK. But as soon as I settled myself into the saddle I sensed there was something wrong. He felt all humped up and crooked to me. I tried adjusting myself in the saddle and walked him around the arena but the further we went, the more he felt to me like he was about to explode. It unnerved me so much that I dismounted. The minute my feet hit the arena floor, I began to cry. No one could see me at that point. I was at the far end of the arena and Dillon was between me and the rest of the participants. I took some deep breaths and tried to get myself under control but I couldn’t stop crying. Months of pent up emotion; frustration, anger, powerlessness, fear, regret, remorse and a crushing sadness came boiling over. I put my forehead on Dillon’s neck and repeatedly wiped my eyes but I couldn’t stop crying. Finally it was clear to me that I wasn’t in an emotional state to ride. I led Dillon out of the arena, untacked and put him back in his stall. By this time everyone had noticed that something was wrong but they all assumed the problem was with Dillon. Carol sent Jane to find out what was wrong. I could barely talk. I waved Jane off and for the rest of the afternoon slumped miserably in a chair, watching the clinic participants ride their horses and barely holding myself together. The next morning I arrived to hear Carol tell the class that she had decided we were going to ride the entire day. I had been counting on working with Dillon on line in the morning. I took him out of his stall and warmed him up with the rest of the class knowing that I wouldn’t be able to ride. No one questioned my decision. I sat miserably through the morning session, angry at myself for wasting the money to come to a clinic that I was emotionally unfit to participate in. That afternoon I had my second private session with Carol. I asked for help with maintaining gate on line but I was so dispirited that Carol let me stop after 10 minutes. I arrived on Monday feeling a little better and determined to salvage something out of the clinic. In the morning we worked on two line driving from zone five. I had never done any driving with Dillon and was pleased when he took to it quickly. Soon we were driving all around the arena, changing direction fluidly at a walk and a trot. Even Jane was impressed with how he was doing. After that we played with some group liberty and once again, Dillon showed surprising maturity. By the time we were ready to tack our horses up, I was hopeful that I would actually get into the saddle. Dillon has always been difficult to bridle. When I first started riding him I discovered that he had some serious dental issues that had resulted in sores in his mouth. After the dentist filed off the rough edges, he was less sensitive but he still fussed occasionally before accepting the bit. Monday afternoon was one of those times and before long Dillon and I were fighting over whether or not he was going to take the bit. Unfortunately Carol noticed our struggle and came over to ask me if that was how I was supposed to bridle a horse. I was riding right on the edge of an emotional break and I snapped back at her that no, it wasn’t the way I was supposed to bridle a horse but it was the way I was going to do it today. There must have been something in my tone that warned her back and all she said was “Oh” before she stepped away. I managed to finish and mounted up before I changed my mind about riding. This time Dillon felt OK to me and I proceeded to finish our warm up without incident. By that time, Carol was giving the entire class a lecture about the correct way to bridle a horse, demonstrating with Legend, who was reaching down to take the bit out of her hand. Chagrined, I rode over to where Jane was standing told her that I thought the lecture was directed at me and then confessed what had happened while I was bridling Dillon. She told me not to worry, she was sure Carol understood what I was going through. The rest of the clinic was a blur. I didn’t ride as well as I might have but at least I was on the horse. Dillon was not really relaxed but he didn’t feel ready to explode and I managed to control my emotions enough to ride safely. All in all I felt like it was a win. On the Tuesday morning after the clinic, my mother seemed to me to be much worse. Her color was almost gray and the features on her face were sunken. She was almost too weak to get out of bed now and was sleeping almost all the time. I was happy that my sister was scheduled to return again to Delaware on Friday. I was afraid Mom wasn’t going to live much longer. By Thursday, Mom had become incontinent and we could no longer get her up to use the bedside commode but she was still recognized me and when Lynn arrived on Friday, Mom seemed happy to see her. Saturday morning Mom asked me to get Helen for her. When I texted Helen, she texted back that she was out shopping and she would come as soon as she could. By the time she arrived, Mom was barely conscious but she was able to squeeze Helen’s hand. Mom was slipping away but I didn’t realize how fast she was going. When I came down to the apartment Sunday morning, I noticed that Mom’s breathing had grown erratic. Mom’s usual night aide had not been available on Saturday night and the aide that was with her had not noticed the change. I ran upstairs to get Lynn and when she saw Mom she told me to call hospice. The nurse who responded assessed the situation and told us that Mom was now “actively” dying. The nurse started administering oxygen to ease Mom’s breathing. At around four pm the nurse told us there had been another change in Mom’s breathing pattern. When we went into the room she appeared to be struggling for air. We both sat on the bed with her and told her we loved her. We told her that we would be alright and that it was OK to go and be with Dad. Mom took one final breath. It looked like she was yawning. And then she was still. I couldn’t believe that after knowing Mom was going to die for a year, when it happened, it seemed to be so sudden. I thought I had been prepared for this but I wasn’t. I felt lost. The following days were a blur of activity. Lynn and I had to arrange the funeral. We asked the hospice pastor, a lovely man who had supported me and Mom for several months if he would perform the service. He suggested that we have the hospice music therapist sing at the service. I asked her to sing the song “Beyond the Sea”. It had been a favorite of my father. My parents had grown up at the beach in New Jersey and my father had been a boat builder. The words to the song reminded me so of both of my parents. They seemed a fitting way to honor them and it made me happy to think of them together again. Somewhere beyond the sea, somewhere waiting for me My lover stands on golden sands and watches the ships that go sailing Somewhere beyond the sea, he’s there watching for me If I could fly like birds on high, then straight to his arms I'd go sailing It's far beyond the stars, It's near beyond the moon I know beyond a doubt, my heart will lead me there soon We'll meet beyond the shore, we'll kiss just as before Happy we'll be beyond the sea, and never again I'll go sailing After Mom’s death, Lynn, Dan and Karole stayed with me for a week. We cleaned out the apartment and gave Mom’s clothes to Goodwill. We wrote thank you notes to the many people who sent flowers or donations in Mom’s memory. We looked at picture albums and talked about good times. We laughed and we cried. Then everyone went home and left me with the cats and my memories and my sadness and my regrets over not being more patient and understanding. Three months have passed since my mother’s death and I am still struggling to make sense of my “annus horribilis’. It was for me a year full of loss; loss of my mother, of my Parelli partner and for a time of my freedom. But it was also a year that caused me many times to recognize blessings. For twenty two years I was blessed to have my mother living with me as an adult. I was blessed to know her in a way that many children never know their parents. For seven years I was blessed to have Sonny as my Parelli partner and benefited from his forgiving nature as I struggled to move ahead in my horsemanship journey. For the entire time that my mother was sick, I was blessed with family and friends who helped me provide such loving care as she completed her journey on earth. I was humbled by love and support they provided both to me and Mom. So, whether I like it or not, whether I want to or not, I’m starting over. I have to figure out not only what I am going to do about my horsemanship journey but also what I am going to do with the rest of my life. This year of caring for my mother and of struggling to be selfless when all I wanted to do was return to the normality I knew before her illness has changed me in ways that I may not yet completely understand. I hope that the changes will enable me to be more supportive and understanding, to be more patient and thoughtful. And I am sincerely hoping that as I set off as a person who has experienced growth as a result of experiencing loss, in a new direction, 2014 will become the first of many ‘annus mirabilis’, or wonderful years in the years to come.