Join Our Celebration of Mom

Help us celebrate who mom was and what she's left behind--from her art and life philosophy to her family and famous cherry pie.

We hope to see you there.

- The Hamm Family

Celebration - Saturday, May 9th, 3:00 pm
Red Cross Building (E.B. Hamilton Hall)
Fort Vancouver
605 Barnes Road
Vancouver, WA 98661

Cherry Pie Chowdown - Post-Celebration to 7:30 pm
You bring yourself; we'll provide mom's pie.
Mom and Dad's house
2223 D Street
Vancouver, WA 98663

-0-

Our beloved Diane. Died 4 am, April 29, 2009.

These snapdragons are treasured in our family and they have been the view from Mom's bed for the past few days. Dad and Lorie wrote down these words from Mom about the dragons early Sunday morning:

"...For me that picture has always been a picture of joy-[a] picture of our family. I have loved that picture; it contains our family lightness. Darkness helps contrast the lightness so you appreciate it. Unless it’s there, you don’t see the joy. And it’s noisy, and there is chatter and activity, just like a barnyard. I would have to paint you a picture but given my present state…."

Bless all of you for your kindnesses, large and small.

-nate


We will post details of the memorial service in a little while

Picture of the evening

I'm sitting in the red chair in the living room, at mom's feet. This is the chair the family has snuggled in, read in, cried in, dozed in since my childhood. (Mom and dad once said they'll be giving each of us kids a "red chair" when we marry; for now, we all share this one.)

Mom is in the hospital bed. We moved her there yesterday in order to more easily adjust her resting position. I'd hoped she would die sitting on the couch--more homey, less medical--but the bed makes sense given how difficult it's become to move her.

She's asleep. A slight grunt comes with nearly every exhale. A washcloth on her head. The knobby blue shawl covers her skinny shoulders and deflated breasts. On the bookcase, a mug of flat gingerale, untouched since this morning. Beautiful flowers to my right. A card from Sarah, with a picture of Port Townsend's Chetzemoka Park (mom's favorite), displayed to my left.

Jesse and Nathan are on the couch. Nathan: researching the stages of death...what to do afterwords...trying to prepare for something you can't really prepare for. Jesse: reflective and quiet...so gentle.

An unframed painting of mom's is propped along the windowsill..it's of pears...four versions in a row like stop action photography. Mom rediscovered the painting when we sorted through her sketches three weeks back; dad liked it so much he snagged it for his office but hasn't had a chance to take it there yet.

Aunt Lorie kisses mom's forehead and heads to bed. Dad settles in on the green couch.

We sit. Watch. Wait.

Is this the last night?

Valarie

Where we are

Sorry, all, but no cheery pictures at this time. Doesn't quite fit where we're at right now. Fortunately, Lily, Isaac, Elissa and Nigel dropped off this magnificient box of colorful doughnuts that we determined picture-worthy (and taste bud worthy, too).

Mom had a significant pain increase over the past 24 hours. Went from 3 mg of morphine an hour to 8 mg. Took us a while to get her evened out; she refused to take the oral pain meds yesterday afternoon. Can't blame her--last thing she really had any control over. Today, she's sleeping, somewhat fitfully, but doesn't appear to be in as much pain as yesterday. Her lucid days have likely come to an end. No urnination...very little fluid intake.

Even though we knew this was coming, it's still terribly painful.

One bright spot: we think we've found the right place for her memorial service. Tentatively scheduled for May 9th. Odd to be planning this already, when she's alive; even odder to be planning something so meaningful without her.

Valarie

On Sunday, Mom had some ice-cold watermelon--one of the few things that won't plug her up. She devoured it in about 30 seconds. Ginger ale finally has competition.

We are in a bit of a holding pattern here. Mom has told us repeatedly that she is ready to go--that she wants to go. And her vitals and mental clarity have led us more than once to think she would go very soon. But come each morning-time she has lasted the night, her tough body plugging away; her spirit weaker but still there. Yesterday she kept Dad and Lorie busy from 3 am until 5 am recording her thoughts on dying...a philosopher to the end.

The hospice nurses are of course circumspect--the I-have-no-crystal-ball metaphor is frequently used and continually unsatisfying. Their estimates range from a week to weeks, though in the next sentence they caution that her condition could change rapidly.

I can't speak for the others, but I feel very much in a time bubble, where the days pass quickly or slowly with much activity or none at all. There are so many parts of her history and her approach to la vida that I know I will wish I'd asked her about. But there is scarce perspective from her bedside in the living room, leaving me few triggers for those questions. And it would be impossible and exhausting and selfish on my part to try in any case. Instead I am attempting to content myself with the little gems of herself that she shares every now and then.

"Carry on my sweets," she says.

-nate

Mom was never a heavy drinker, but has more than made up for it in the past few days. This little smile will show up and she'll say "get me some of the special stuff," and we'll run to the kitchen and fill up a little glass with ice and ginger ale. We are rewarded with a happy look on her face and the satisfied little "ahhh" when she finishes and lets the straw fall from her lips.

-n

Jesse's home! (The bundle of brown hair, lower right.)

With all of our energies focused toward mom these last few days, the hours pass in a rush or not at all. Even though we haven't responded to all your love and thoughts please please know that they're getting through. Every card and email elicits a laugh or a cry or a smile or a good thought in all of us here. (Fyi, we're working on getting the Zumba video from Meg.)
-n

While you might imagine things are mostly serious around here, every now and then some humor happens. Like this afternoon, when Mike, Lorie, Dad, Mom and Mary were thoroughly enjoying a video of Val and Mom doing Zoomba in the kitchen. (Meg recorded it on the sly weeks ago.) Will let all of you imagine Mom and Val sashaying around in the kitchen as they do.
-n

Most of us have spent a little time next to Mom, enjoying her company, soaking up a bit of her warmth and passing along some of ours.

And crying. But right now, that can happen anytime, anywhere around here.

The light comes in through the windows and fills Mom's room. She and Dad had it painted yellow, with a white ceiling. It feels big and warm and comforting.

Val and mom this morning, with the ginger ale.

-n

Yesterday, Dad and Mom went outside. It really was lovely, warm and smelled like spring and we sat out on the porch swing and chatted. Today too, but we had her bundled up and wrapped head-to-toe. She's so beautiful and calm in the quilt Sarah made for her.

Early morning musings

Laundry whirs in the dryer. Mom rests. The house is quiet after a full day of family visits, of mom's gentle requests for gingerale, of getting her up and down from the bed, and finally--on her request--out for a stroll in the wheelchair in the sunshine around the block.

Hospice also made their first call--a gentleman named Jim. Here's my snapshot: a discussion about milligram vs millilitres of pain meds, the incessant beeping of the automatic med dispensing machine, Jim talking loudly on his cell phone beside my mom's bed because he couldn't figure out the med dispenser--I gave her ear plugs--insurance, funeral homes, mom wanting to sign her signature on the forms: small, long, slow, impossible to read except for her classy "D" for "Diane".

Fortunately, that visit came to a close. And after a long nap, mom perked up late in the afternoon. Her speech was a little clearer, and her eyes are bright--she's soaking up the love around her.

This is what she wanted, this is how she wanted to go. At home. With family. She told me numerous times how much she'd appreciated the way her father had passed just a few years back...he'd fought against the paralysis of his stroke, then accepted where he was and absorbed the life around him to help ease his way out of his own.

I don't know where mom is in the timeline. Don't really know how to do this whole preparing for death thing. Feels like such a gift in some ways...as though mom is breaking the trail and testing the waters for us as she always has. Guess someone has to go first. You just don't want them to go quite this way or quite this soon. Had lots of things I wanted her to be here for. Know she's come to terms with not having them; it's more my deal now than hers.

And I don't know how to watch a man, my father, grieve for the fading of his wife, my mother, who's been his partner since they were college students. You just can't fix it.

He is doing right by her every step of the way.

Valarie

On Sunday afternoon, we spent a nice hour with Mom, Dad and Val outside next to the water. Apple and cherry blossom trees were blooming all around...it's spring and it was lovely. Couldn't have asked for a better day.

-n

Home, again, Finally.

Mom is sleeping now in the Dining room (as she should be, it's 4:30 AM), easily and every now and then drowsily asking for some ginger ale. Yesterday was a big day. (Minor medical details follow.) A small procedure removed the most irritating nose tube and put in a more comfy (and easier for us to handle) direct stomach pic line. Her bowels are constricted in a few key places and the doctor says the severity and number of these intestinal speed-bumps will only increase. So traffic in her small intestines is at a standstill and appears as though it will stay that way despite a last ditch medical effort on Saturday and some good work by Mom in the past two days. So she's home now, and Ralph and Lorie and Dave are here too.

The folks at the hospital were real good to mom, and her brand of sass and smiles charmed the lot of them, those that could be charmed at least. While they were sorry to lose her company, it was with a lot of relief (and perhaps a little trepidation for me at least--at the hospital there is at least the illusion of getting better) that she and Dad and Uncle Dave cruised home in her favorite zippy little car yesterday about 9pm. I followed shortly thereafter in the subey after a brief loss of composure. She's wanted to come home ever since she got there and we wanted her back home, away from all the beeps and thumps and loud talk and that damn hospital bed that always interrupted our conversations with a loud and insistent wheezing at particularly important moments.

Val's housemate Emily brought by some fine chicken enchiladas for us last night and after testing some of the gear left for her by the hospice folks we called it an evening and ate and rested. Having the crew here is so good--catching up on everyone, talking about mom, planning out just how this is all going to work. There are laughs too, and smiles, and the sort of generally upbeat nature that defines our families. Grandpa Harold would approve--other than sporadic sobs 'n tears no one appears to be feeling sorry for themselves overmuch. We all know where this leads and all we can do is keep her comfortable and calm and aware of our love.

I haven't been much of a writer on this blog--more of a reader, along with most of you. Living so far away in NH kept me out of the day-to-day here. But we do what we can. So whenever I have been home I've taken as many photos as the family could bear, and then some. And in the last few days I've done the same, snapping away somewhat selfishly when maybe it wasn't the best manners or propriety. But we only have one take and Mom ain't coming back, so.... Photos will be up over the next days and weeks as this endgame plays out. An ongoing electronic wake or something.

It's getting towards the end of this third watch of the night, and the sky to the east is lightening up with that pale yellow that fades upwards to violet. Dave and Ralph are on next and I'll see if I can get back to sleep.

love to you all

nate

Glide Path

Although last Tuesday's surgery to insert stents got Diane's kidneys percolating again and lowered her blood pressure, pain and nausea became increasingly difficult to control. This culminated Thursday night when on returning home from work I found her listless and confused. Valarie arrived to help and we decided to book Diane first class by ambulance to ER. We were met at the hospital by her oncologist Dr. Rushing and, with the help of a great ER doc, through the course of the night determined that she has some sort of a bowel obstruction. She was admitted as an inpatient with a plan to try and get her cleaned out.

The plan got more complicated however when she began to throw up early Friday morning. That removed the option of treating this from above with medications and fluids. So this is where we are: They have not given up trying to resolve the frozen bowels. A procedure will take place this morning to try and "restart her engines". We wait 24 hours to see if it works. If it does not they will insert a tube into her stomach so that acid and fluids can drain and not nauseate her. At the same time they will insert a tube into her right lung so that fluid will not build up and cause her more pain and breathlessness. We are told these are both very portable, painless devices.

The bigger picture is that the chemotherapy agent Doxil is not doing the trick. The cancer is advancing. Dr. Rushing will not administer another chemotherapy drug unless her bowels are working. However even if they do start functioning the next drugs have a 12% to 15% chance of having some effect. Even then the effect would be largely marginal. Remission is no longer in the picture with mainstream ovarian cancer treatment.

As a family we have done some research on alternative therapies and we just do not want to go there. You all know Diane. She has a clear, strong sense of how life is to be lived. This is not it. So while we are still holding out hope that she can turn all this around (and would not put it past her to do so) we are preparing to bring her home and for hospice care. She is so brave.

For those of you who wish to see her, you are all welcome. Please stay in touch so that can coordinate with and make the most of each visit.

Jeff

Here's to happy kidneys

Breaking news, just in from dad:

"Dr. Arroyo just came in to say they have finished and Mom is in recovery. He was successful in getting both stents in although the right side was much tougher than the left. So much so that he almost didn't get it through.

She's in recovery now and expect to be able to bring her home today. The stents are good for three months or so."

Go kidneys, go!

- Valarie

On the Not Quite so Light Side

Diane heads into the hospital tomorrow morning for, hopefully, an outpatient procedure to insert stents into both of her ureters. Apparently tumor mass is constricting these ducts (they connect the kidneys to the bladder) to the point where urine is backing up into her kidneys and hindering their function. As a result a toxin in the blood, creatine, is building up. The fluid retention is also elevating her blood pressure quite high. We'll update you all tomorrow evening.

Jeff

and to keep us from getting too serious....

So the nurse faxes me back the Family Medical Leave authorization form I need for work. The doctor has filled out all the fields....date of diagnosis...side effects patient is coping with...there are also some specific yes/no questions:

Does the patient need ongoing care? Dr. Rushing has marked "yes" with an "X".

Is the patient experiencing ongoing symptoms? "X" for "yes".

Is the patient pregnant? A big fat "X" on the "yes" line.

No ovaries, but apparently still pregnant. You are a miracle, mom.

Valarie

On the couch

Mom and I sit on the couch after a long week.

On Tuesday, we met with the doctor. No change on the Doxil. Still hasn't kicked in. Dr. Rushing says to give it another four weeks to see if her CA125 goes down.

Throughout the week, her creatine levels went up and down. Indicates how well her kidneys are filtering out toxins. She and dad go in tomorrow to see if it's time to see a urologist.

On Friday, she headed in for some fluids at the clinic. Blood pressure high...and then a headache so splitting they gave her morphine. It's taken her until this afternoon to get her legs beneath her again. She was pretty wobbly. And yesterday she was sick.

And yet, today, while Dad drops Jesse off at the train station, mom and I curl up beneath the quilt Sarah made, and we talk. I watch her eyes--her pupils are dilated from all of her medication--but she's breaking through the fuzziness to be there for me.

"Honey," she says. "Even though I'm loopy, I wouldn't want you not to tell me about how you're doing. There isn't drowsiness I wouldn't push through to talk."

I cry. And she holds my cheeks in her hands. She's still my momma--and so brave.

Valarie

The great juggler

So lately (though it's better this week), it's been going something like this:

pain.
take pain med.
get nauseaus.
take anti-nauseau pill.
throw up anyway.
get weak.
take different anti-nausea pill.
get loopy from anti-nauseua pill.
get backed up.
get dehydrated.
more pain.
more pain med.
pain med bad on kidneys.
stop that pain med.
take more of first pain med...

You get the picture. I would call it perhaps the most difficult and painful of juggling acts, and it's been beating mom up lately. Talked to the nurse on Friday and she mentioned how much everyone loves mom at the clinic...and how they're all amazed at how little pain medication she's taken...Think mom finally realized that the pain has reached a point where it's more preoccupying and disorienting than the loopiness the meds cause.

One of the most difficult parts of this whole deal is how consuming the disease is. It seems bad enough to be going through it; at least you want to be able to enjoy some of the things that make you feel normal. But so much of mom's time is in management now. On Friday, she spent from 1:00 until 9:00 in the hospital getting a CAT-scan and her weekly lung drain.

BUT all is not despair. Like I said at the beginning of this post, she was well enough for me to mosy on over with Alex on Saturday night to parade off my dress and haircut for an awards ceremony that night. She and dad were cuddled on the couch watching a movie together. Love seeing that--and dad's gentle kisses to her forehead.

We're off to see the doctor tomorrow. COME ON DOXIL!

Valarie