I had to slow down or die

By Al Kags

Last September, I came this close to dying. I had been travelling on some family business when I found that I was getting weaker by the day. My mouth was getting extra dry despite drinking copious amounts of water and I had significantly lost weight.

Losing weight in itself had been a mission of mine (at the beginning of last year I weighed a whopping 116 kg!) and I had been steadily coming down the scale but in September, I suddenly lost 10kg – just like that!

I came back to Kenya and I was scheduled to leave for the UN General Assembly in New York two days later. The plan was that I would get home early in the morning and hang out with my wife Liz and children that day. The next day I would go to the office, where my team would prepare me for the meetings I would attend in the big apple.

Things went according to plan – sort of. I spent the day with the kids but by then I was so weak that I was not quite conscious. I was moving and talking, but it was like I was in a dream state. I went to the office on the next day and my colleagues were shocked to see how gaunt I had become – my skin was grey, I was thinner than they thought. Still, I had work to do and a trip the next day so I toughened up and focused on the day.

By noon, I couldn’t take it anymore. I went home and two hours or so later, my friends came by and drove me to the hospital. I just needed our friend, a doctor, to review me and give me “something” to tide me over through the New York trip. My friend runs a specialist clinic at Mater Hospital and so we went there.

I signed myself in, went through triage and there, I started to appreciate just how bad things were. My blood pressure was 150/120. Normal blood pressure is 120/80. At that level, it was deemed an emergency and I was fast-tracked to see a casualty doctor. This doctor was visibly disturbed as he asked me questions. Normally, what doctors in casualty would do is to send one over to the lab for tests and then he would review them when they were out. Not on this day. He dropped everything on his plate and focused on me.

Nothing looked good. My blood pressure was very high. When they checked my blood sugar, it was too high to give a figure – it simply said “HHH” – High, High, High, which meant that it was higher than a reading of 33. Normal blood sugar should read between 4 and 7.2. They checked on the levels of various minerals that you need in the body – Potassium (which helps your muscles move), sodium, etc. I was in the negative on all of them.

It’s an emergency

In short, I was severely malnourished and dehydrated (had lost more than 10 per cent of my body water), my blood pressure was high and I had sustained ridiculously high blood sugar levels for several days or weeks and therefore I had become diabetic. They checked my hormonal levels and cortisol (what I call the tired hormone) and adrenaline (the fight or flight one) were too high.

I was diagnosed with Diabetic Ketoacidosis, a major emergency. I was also told that my body organs had gone into shock. It was a wonder, the doctors told me, that I was even conscious. “Even if you could not afford this hospital, I am required to detain you and stabilise you whether you like it or not,” the doctor told me as I protested being admitted – to the High Dependency unit no less!

“Besides,” said the doctor, “You are also exhausted and you need to rest.”

I was under intensive care for about 7 days and then I was allowed to the ward to regain my strength before going home. In that time, I was simply in shock and devastated that I had irrevocably “broken” my body. As the days went by, I learnt that I had had no organ damage and that although I was diabetic and hypertensive, I have a chance to live again.

Too much advice, too little sense

In the first few days of my recovery, I received a lot of advice – most of it confusing and some of it contradictory. I was told to prepare to inject myself with insulin for the rest of my life, that I could no longer eat and be full. I needed to be very careful about what I ate. I was told many stories of people who had lived long lives like that. My life was about to completely change.

I later went to see my family doctor, Dr Dennis Nturibi, who runs a lifestyle modification programme for many urbanites – especially executives and for the first time. I started to understand what was happening to me.

Let me break it down for you in the way you can explain it to a five-year-old. Normally, your body functions automatically. Imagine all your organs as departments in which little people work and operate the machinery that is your organs. When you eat the food goes to the stomach, where the little people in there pour in chemicals and enzymes that extract sugar from the food. They pour that sugar into the bloodstream.

When there is a lot of sugar in the bloodstream, a message is sent to your pancreas. The little people in the pancreas are called Insulin and their job is to swoop into the bloodstream, arrest the sugar and throw it in the cells. In each of the billions of cells in your body, a little person burns the sugar and therefore generates energy which your body needs.

In my body, the system crashed. After many years of flooding my bloodstream with sugar, the insulin tribe had become overworked – they were working overtime to arrest sugar from the bloodstream and put it in the cells only to find that there was too much to deal with. So they went back into the Pancreas and shut the machines down. They were on strike.

Now that there was no sugar being delivered into the cells, even though it was flooding the bloodstream, the cells sent alarms to the brain, which told the people in the mouth to take in more sugar. Eventually, there was too much sugar in the bloodstream – and the blood became like syrup. That is why blood pressure went up. The system eventually crashed altogether and I was in intensive care.

The wonder diet

Dr Nturibi told me that I was not going to die and that there are ways to reverse the condition. If I was consistent and I worked towards it, I would stop all medication and insulin in time. The secret was food.

He introduced me to a diet that has had a tremendous impact in my life. I was off insulin in three weeks and off all medication within five weeks.

My diet is simple. I eat a green salad three times a day, before every meal. For breakfast after salad, I have black tea and arrowroots or sweet potatoes or oats. My favourite meal for breakfast is last night’s food. For lunch and dinner, I have a lot of vegetables, a lot of plant protein and some whole carbohydrates – brown rice, githeri, potatoes, brown ugali. I do not eat processed foods – not even juice (juicing is processing fruit), I avoid animal protein (milk, meat or cheese) and I quit sugar and alcohol altogether.

“So long as you are eating the right things, eat as much as you want,”

Dr. Dennis Nturibi, Ask-a-Doc
With these measures, I have continued to lose weight steadily, my blood sugar is normal and the little people in my pancreas are back to work. Of course, none of it would be possible if it wasn’t for Liz, my wife who has been both a caregiver and “policewoman”, making sure that I stuck to my diet – even when all I wanted was a burger, fries and an extra thick chocolate milkshake.

“Here’s some fruit,” she’d say.

I have learnt to plan ahead of every day and to pack my salad, food and fruit for the next day. That way I am never hungry because hunger is what makes us eat unhealthy things. So long as I have the right things to eat near me all the time, I am using food as the best medicine of all.

What is diabetic ketoacidosis

Diabetic ketoacidosis is a serious, sometimes life-threatening complication that affects people with diabetes. It is brought about when the blood becomes too acidic from a high amount of ketones present. Ketones are produced when one doesn’t have enough insulin to turn sugars into energy and thus the body turns to the fat. The liver then turns the fat into ketones and sends it into the bloodstream.

Ketone production can be brought about by:

· Untreated Type 1 diabetes

· Long periods of low food intake

· Restricted diets

· Prolonged intense exercise

· Alcoholism

Complete Article HERE!

We can’t be squeamish about death. We need to confront our worst fears

Patients, their families and their doctors need to be open about the inevitable as the virus sweeps through our population

By

As the coronavirus spreads through the population, there is one fact we can all agree on. Whether we like it or not, society’s greatest taboo – death and dying – has been thrust unequivocally centre stage.

How could it not, when government strategy is to allow the virus to infect huge swathes of the country in the hope of building sufficient “herd immunity” to protect from future harm? The virus has killed an estimated 3.4% of those it has infected, according to the World Health Organization, although this figure is expected to decline as the true number of people infected becomes apparent. Herd immunity, according to Downing Street’s chief scientific adviser, requires a minimum infection rate of 60% of the population. Thus we may face a potential early and unexpected death toll of hundreds of thousands of Britons.

There is, therefore, a glaring imperative to confront the topic so many of us long to squirm away from: the inescapable fact of mortality. As a palliative care doctor, I am intimately acquainted with our reluctance to square up to dying, and with the unintended harms of such squeamishness. Advance care planning – the phrase doctors use to describe proactively how much medical intervention you would wish for in extremis – is too frequently neglected, by patients and doctors alike.

Sometimes, for example, if an oncologist is less than candid about a patient’s frailty precluding any further rounds of chemotherapy, a family may be unaware that time is running out. Profound and vital conversations between family members never happen. Final messages hang in the air, forever unsaid.

Suddenly, the patient is comatose and fading. And no one has sought to find out if they would like heroic efforts at prolonging life – or if, perhaps, their final wish is to die at home, neither gowned nor tubed, with no machines and only loved ones at their side.

We are fast approaching a crunch time. NHS intensive care beds will be imminently overwhelmed with patients in dire need of mechanical ventilation. Italy’s experience has shown all too graphically that peak infection rates demand draconian rationing of health resources. In Lombardy, for example, some beleaguered hospitals have been forced to impose bans on ventilators for coronavirus sufferers aged over 60 – this despite knowing that it is predominantly the elderly who will die.

As Britain approaches peak infection, we therefore owe it to each other to start talking now. Would your mother, approaching 80, even wish for an intensive care bed? Do you, her anxious offspring, even feel able to find out? No one can pretend these discussions are easy. Our dearly beloved mums and dads are no less loved for their years; how on earth do we begin to broach the prospect of each other’s deaths?

If there is one thing I have learned from my time in a hospice, it is that these conversations rarely measure up to the degree with which we dread them. Indeed, for some elderly patients – conscious of their frailty – a little candour about the future can bring immense relief. It is fine to stumble, feel awkward, grope your way, get the words out wrong. In the end, all that matters is motive: the sincerity of your fumbled aim to tease out your loved one’s views.

Two medical truths may help you find the strength to talk and listen. First, every medical intervention has cons as well as pros. Even for young and healthy patients, intensive care is a gruelling experience that can leave serious, long-term medical problems. For the elderly, survival is more doubtful, let alone full restoration to good health.

Second, not every problem can be fixed. Sometimes, a disease is so aggressive that intensive care cannot cure, but only harm. When doctors conclude intensive care is not an option, it is not discrimination but a weighing-up of what might work, the sober balancing of benefits and risks.

In the end, an advance care plan need be nothing more technical than a chat over a cuppa. Steel yourself. Find out your loved ones’ wishes and tell them yours at the same time. There is kindness in being informed and prepared.

And – please – know that however besieged the health service becomes, we will never stop caring for every patient. You may be young, you may be old, but we will always do our best. How much you matter to us will never, ever run dry.

Complete Article HERE!

Protecting Trans Bodies in Death

Your life. Your death. Your rights.

***SELECTED SOURCES/ADDITIONAL READING***

“DYING TRANS: PRESERVING IDENTITY IN DEATH” http://www.orderofthegooddeath.com/dy…

“The Supreme Court is finally taking on trans rights. Here’s the woman who started it all.” https://www.vox.com/latest-news/2019/…

“R.G. & G.R. HARRIS FUNERAL HOMES V EEOC & AIMEE STEPHENS” https://www.aclu.org/cases/rg-gr-harr…

“A transgender woman wrote a letter to her boss. It led to her firing — and a trip to the Supreme Court.” https://www.washingtonpost.com/nation…

“Transgender woman dies suddenly, presented at funeral in open casket as a man” https://www.miamiherald.com/news/loca…

“Transgender People Are Misgendered, Even in Death” https://www.vice.com/en_us/article/ex…

Getting Familiar with Life’s Certainty: The D-Word

“I’m gonna die, you’re gonna die. So is everyone we’ve ever loved and hated. And that’s OK.”

By Molly Marco

When I thought about what to write for my End Well blog post, I struggled to think of something different than what I submitted last year. The story I share in last year’s piece is one I’ve now told a million times. I know it well — where to put the emphasis (“Ever onward!”) and what will get the audience’s applause. Conversely, I know what parts of my story people may want to deny or avoid: Death. Dying. Fears and deficits that come with a brain cancer diagnosis.

In July 2016, my brain tumor was discovered after I fainted off a bar stool at a downtown Detroit coffee shop. Turns out, it wasn’t just a simple faint: I had a grade 3 anaplastic astrocytoma. A grade 3 astrocytoma is a junior glioblastoma (or, more accurately, a glioblastoma is a grade 4 astrocytoma). It is incurable and considered a terminal diagnosis, though many patients prefer to call it a chronic illness. That doesn’t mean I’m dying tomorrow — unless, as my neuro-oncologist once told me, I get hit by a car or something like that — it just means we don’t have a fix.

We expect my tumor to, maybe, charge up and for those rogue astrocytes to return — either as anaplastic astrocytoma again, or GBM. One or the other, no lesser. I won’t get better, we just hope that we can hold it off as long as possible before its encore performance. Worse than reoccurrence or GBM? There’s not really anything worse. It’s a turd sandwich.

Though come to think of it, there is worse. Worse is denying that reoccurrence is possible. Worse is convincing myself that I am cured and “cancer-free” (no brain cancer patient should ever be told that falsity) only to crumble and fall to pieces when new growth appears on a future MRI.

After Molly finished her chemotherapy, she got this tattoo. | Memento Mori: Remember you must die. Amor Fati: Love your fate

Worse is not mentally planning for future treatment, including palliative and end-of-life care. When to demand my off-switch to be clicked, so my family isn’t left making the difficult choice for me.

There may come a time when I can’t write and I can’t speak, so I plan to make these decisions while I’m still in control of my think-box.

Losing my mom last year and my aunt recently brings certain things to the forefront of my now with urgency: Death is guaranteed. Death will happen. I want to be ready. Not because I’m morbid or depressed, but the opposite of that. The thought of leaving this world — everyone and everything I love — scares me. The thought of the act of dying scares me more than death itself, to be honest. I need to be on better terms with death and dying.

If death is anything like falling off a barstool and passing out, I can handle that. The thought of an eternal afterlife I can’t even comprehend, but that sounds cool, too. But dying in pain and afraid? That is what I fear. I don’t want that. However, I choose to talk about it so I am as familiar with death and dying as I am with my own name. It’s not because I crave death, it’s because I love being alive with every fiber of my being. I love life so much.

And if we’re honest with ourselves, we can admit that in loving life — truly loving life — we can accept death as a thing we all do. There should be no stigma attached to something absolutely guaranteed from the moment we come into existence: I’m gonna die, you’re gonna die. So is everyone we’ve ever loved and hated. WE ARE ALL GOING TO DIE. That’s that. And that’s OK.

Last year, I suggested we live our best lives and live them right now. This year? Live our best lives, live them right now, because one day — you are going to die. Learn to let it be OK. And be ready.

Complete Article HERE!

With Dementia, More is Needed than a Boilerplate Advance Directive

By Katy Butler

My parents lived good lives and thought they’d prepared for good deaths. They exercised daily, ate plenty of fruits and vegetables, and kept, in their well-organized files, boilerplate advance directives they’d signed at the urging of their elder lawyer. But after my father had a devastating stroke and descended into dementia, the documents offered my mother (his medical decision-maker) little guidance. Even though dementia is the nation’s most feared disease after cancer, the directive didn’t mention it. And even though millions of Americans have tiny internal life-sustaining devices like pacemakers, my mother was at sea when doctors asked her to authorize one for my father.

Our family had seen advance directives in black and white terms, as a means of avoiding a single bad decision that could lead to death in intensive care, “plugged into machines.” But given that most people nowadays decline slowly, a good end of life is rarely the result of one momentous choice. It’s more often the end point of a series of micro-decisions, navigated like the branching forks of a forest trail.

In our family, one of those micro-decisions was allowing the insertion of the pacemaker, which I believe unnecessarily extended the most tragic period of my father’s life, as he descended into dementia, near-blindness, and misery. In the process of researching my new book, The Art of Dying Well, I’ve met many other people who’ve agonized over similar micro-decisions, such as whether or not to allow treatment with antibiotics, or a feeding tube, or a trip to the emergency room, for a relative with dementia.

If there was one silver lining in my father’s difficult, medically-prolonged decline, it is this: It showed me the havoc dementia can wreak not only on the life of the afflicted person, but on family caregivers. And it encouraged me to think more explicitly about my values and the peculiar moral and medical challenges posed by dementia. At the moment, I’m a fully functioning moral human being, capable of empathy, eager to protect those I love from unnecessary burdens and misery. If I develop dementia —which is, after all, a terminal illness —I may lose that awareness and care only about myself.

With that in mind, I believe that “comfort care” is what I want if I develop dementia. I have written the following letter —couched in plain, common-sense language, rather than medicalese or legalese — as an amendment to my advance directive. I’ve sent it to everyone who may act as my guardian, caregiver or medical advocate when I can no longer make my own decisions. I want to free them from the burden of future guilt, and that is more important to me than whether or not my letter is legally binding on health care professionals. I looked at writing it as a sacred and moral act, not as a piece of medical or legal self-defense. I’ve included it in my new book, The Art of Dying Well: A Practical Guide to a Good End of Life. I invite you to adapt it to your wishes and hope it brings you the inspiration and peace it has brought to me.

Dear Medical Advocate;

If you’re reading this because I can’t make my own medical decisions due to dementia, please understand I don’t wish to prolong my living or dying, even if I seem relatively happy and content. As a human being who currently has the moral, legal, and intellectual capacity to make my own decisions, I want you to know that I care about the emotional, financial, and practical burdens that dementia and similar illnesses place on those who love me. Once I am demented, I may become oblivious to such concerns. So please let my wishes as stated below guide you. They are designed to give me “comfort care,” let nature take its course, and allow me a natural death.

  • I wish to remove all barriers to a peaceful and timely death.
  • Please ask my medical team to provide Comfort Care Only.
  • Try to qualify me for hospice.
  • I do not wish any attempt at resuscitation. Ask my doctor to sign a Do Not Resuscitate Order and order me a Do Not Resuscitate bracelet from Medic Alert Foundation.
  • Ask my medical team to allow natural death. Do not authorize any medical procedure that might prolong or delay my death.
  • Do not transport me to a hospital. I prefer to die in the place that has become my home.
  • Do not intubate me or give me intravenous fluids. I do not want treatments that may prolong or increase my suffering.
  • Do not treat my infections with antibiotics—give me painkillers instead.
  • Ask my doctor to deactivate all medical devices, such as defibrillators, that may delay death and cause pain.
  • Ask my doctor to deactivate any medical device that might delay death, even those, such as pacemakers, that may improve my comfort.
  • If I’m eating, let me eat what I want, and don’t put me on “thickened liquids,” even if this increases my risk of pneumonia.
  • Do not force or coax me to eat.
  • Do not authorize a feeding tube for me, even on a trial basis. If one is inserted, please ask for its immediate removal. 
  • Ask to stop, and do not give permission to start, dialysis. 
  • Do not agree to any tests whose results would be meaningless, given my desire to avoid treatments that might be burdensome, agitating, painful, or prolonging of my life or death.
  • Do not give me a flu or other vaccine that might delay my death, unless required to protect others.
  • Do keep me out of physical pain, with opioids if necessary.
  • Ask my doctor to fill out the medical orders known as POLST (Physician Orders for Life Sustaining Treatment) or MOLST (Medical Orders for Life Sustaining Treatment) to confirm the wishes I’ve expressed here.
  • If I must be institutionalized, please do your best to find a place with an art workshop and access to nature, if I can still enjoy them.

Complete Article HERE!

Feeling Anguish?

Listen to Your Body. Not to Other People.

An exploration of different ways exercise and movement can be used to help with grief, trauma, or any other kind of big emotion.

By

The body says what words cannot. — Martha Graham

I love swimming in Austin’s amazing Barton Springs Pool — it’s cold and enlivening. Most of the time I swim there three times a week, year round.

But last year my dad and my dog died in the depths of winter.

It doesn’t get that cold in Austin, but it takes much more mental discipline and grit to jump into the cold spring water when it’s 25–45 degrees outside than when it’s 95!

When my dad and my dog died, everything in me demanded that I pull in, curl up, and treat myself tenderly. Treating myself tenderly did not include swimming in the cold. It was hard to allow myself to give in to not swimming for an indefinite period time, especially during a phase of my life when I’m not getting any younger so exercise is essential for maintaining my energy and health.

Yet I remembered something crucial I’d learned about grief back in 1992 when my first husband died. After living all the way through that hell (and after helping many of my clients live through grief), the most important thing I’d tell my 1992, 30-year-old self from here is:

Pulling in, curling up, and convalescing will allow your grief to heal you. You will regain your energy over time, especially if you treat yourself tenderly now.

So last year after the deaths, I listened to my past self and surrendered to the urge to stay in where it was warm and to snuggle into my soft sheets. By summer, I was still sluggish and weighed down by grief, so I gave in to the urge to remain in the dark with the blinds drawn (instead of swimming) even when the summer sun beat down at 99 degrees.

(Note that I was not depressed. I didn’t feel bogged down and paralyzed with depression’s deadness. I was simply grieving. I can tell the difference. I’m going to write an entire post about discerning the difference between grief and depression soon.)

Even though I had learned the hard way that listening to my body in grief was the most useful strategy, I hadn’t lived through another big loss myself since learning the lesson. Living through fresh loss with insight gleaned from my past loss was like carrying a mini-mentor with me through the whole process. So I held onto faith that my body was telling me what I needed.

Thus it seemed miraculous to my present self that listening to my body’s need to lie around and restore during the most ripped-open phase of my grief did indeed allow me to heal and restore:

On my birthday in November, eleven months after my losses, I spontaneously needed to swim. Hard. In the cold water.

My body and soul needed to move — to expend energy, to feel blood pumping through my veins and cold water on my skin — in order to affirm my gratitude for still getting to be alive to mark another year while people I loved were no longer fortunate enough to have bodies that could know such joy. My arms reached and my legs kicked, and I felt at one with all the people I love, past and present. My heart burst wide with wonder as I felt it all.

Swimming on my birthday reignited my desire to swim regularly, so I picked it back up again, at the beginning of winter, without any hesitation. My body guided me through the whole process, down and through, and back up again. Amazing.

(Not that I’m “finished” with my grief, and not that I don’t still have sluggish days. It’s just that the phase of needing to pull in constantly has moved through, at least for now…)

***

If you’re grieving your own loss, or experiencing an intense emotional situation of some other kind, your body might tell you something similar to what mine did during this time of my loss. Or it might tell you something different. Every loss and every body is unique.

When my first husband died in 1992, that loss was a traumatic loss — sudden, unexpected, out of the natural order of things. The losses I experienced last January were different. They were in the natural order of things as my dad and my dog were both old and weakening — extremely painful but not traumatic. They were two distinct flavors of loss.

In 1992, I not only lost my husband in a devastating way, I also lost my entire identity and way of viewing the world. Nothing made sense any more. I was entirely disoriented and shattered.

So my emotions then were explosive, roiling, fierce. Sadness would practically knock me to the floor with its force. Rage at the universe over injustice burst out of my chest and throat. When I tried to rest and pull in, anguish pushed me to kick and scream. The feelings were so potent I needed to move them through my body.

I was a runner back then (before I blew out my knees), and running saved my life.

I buckled my year-old baby into our blue running stroller and ran until I couldn’t breathe. The pound, pound, pound of my feet upon the earth rattled the overwhelming feelings out of my body and into the earth. The earth absorbed them without complaint. Sweat poured down my chest and ragged breaths tore at my throat to match the intensity of my emotions, and helped me regain my sanity.

I’d arrive back home, fall onto the driveway, and sit on the blistering concrete while my son toddled around filling buckets with water from the hose. My breath would settle, and I’d feel able to make it through a few more hours.

Then, I could pull in and rest for a few hours after my boy was in bed. Before the roiling began again. At 2am. Every day. For a very long time.

***

There’s a whole lot if information I have about why movement and rest of different sorts help with intense emotions such as grief. I’ll write about that in another post.

But here I’m offering my own stories to give you permission to listen to your own body, to allow it to guide you through whatever kind of physical activity or rest will help you the most during your grief or other kinds of difficult emotions right now.

Unfortunately our culture is full of shoulds and prescriptions. People will tell you that you MUST move to prevent depression, or to pull yourself out of the (very normal) sluggishness of grief. Others will tell you that you MUST get your rest and not push yourself so hard.

In 1992, I definitely needed to learn the difference between listening to my body’s need to move for emotional expression, and my fear of sitting still to allow myself to rest. We all need some of both. But that was my lesson to glean. A lesson that was presented to me as a f***ing opportunity for growth within my grief. Not something that someone else could prescribe to me.

I wouldn’t have such faith in what I learned if I hadn’t wrestled with the difficulties myself.

I want you to know that your body is the container for all of your grief emotions, so your body will tell you what it needs. We’re socialized out of listening to our bodies, so it can take effort to learn to listen to the natural signals we’re getting. But I’m hoping that by hearing my stories, and having me articulate for you that both rest and movement of different sorts are extremely useful and natural ways of tending to your grief and other emotions, you’ll feel free to experiment.

Listen to your body.

Listen to your feelings.

Your grief is unique to you. Your loss is like no other.

Movement and rest both help, in their own ways, in their own time.

Let me know what works for you or what doesn’t…

Complete Article HERE!

Death at a young age compounds the intensity of grief


Many people out there are suffering because of the death of a child.

By

A kind reader has reminded me that in a recent column when I gave examples of sad losses, I did not mention the loss of a child. She was right. I didn’t, although I have written about the death of a child in the past. I suppose it was not on my mind because we aren’t supposed to lose our children, not before us. I’ve corrected this in recent columns.

But as I thought about it, I know it happens more often than we’d like to think about. In just the last few months, several readers have written to me about their grief over the premature death of grown children in their 30s or 40s — one from the flu, which was particularly bad this year. Another was from a car accident, but it could have been a motorcycle crash, opioids, a heart attack, cancer — or war, mass shootings, anything that causes young deaths.

It feels both tragic and all backward when someone loses a child, no matter what age, whether young or adult. With our heightened expectation that life expectancy here in the U.S. is quite long, most of think we will live to be real old, and that modern medicine can cure just about everything.

Many of us are baby boomers, where we feel we will live just about “forever,” even though we really know life is finite. So a young or middle age death just doesn’t fit. We are truly caught off guard. It just seems wrong.

Recently a friend mentioned she was still “trying to get her head around” the sudden death of a 30-year-old friend. One reader who lost a 45-year-old son explained that part of the grief is the loss of family legacy, and all the bright future and promise of their lost son. It’s heartbreaking.

It also happens that people sometimes lose their spouse in their 40s or 50s, left not only alone but often with young children to raise as a single parent. This means somewhere there are also parents grieving over that death; the spouse was their grown child. So any death at a young age very much compounds the intensity of grief.

Some people have lost another young adult they were close to — a friend, a neighbor, a niece or nephew. To the bereaved, these young people could be so close they seem a lot like their own children. And to complicate matters further, such grief may be pretty much “invisible” because most people think intense grief is reserved for immediate family members.

Another type of invisible grief is over a miscarriage or infant death. This is virtually never mentioned in conversations, even among close friends and family. And if someone says something, it can be hurting or inappropriate rather than comforting, such as “there will be other babies,” or some similar unthinking comment.

So the point is: There are many people out there suffering because they have lost a child, and many have lost adult children. They need our support. One’s child is always our child, no matter what age. And some of this grief is rather “invisible” for several reasons — sometimes people just do not realize how heavily the death is weighing on their friends or relatives. They just don’t understand.

Some of it is long-term grief that will never go away. I don’t believe we need to dwell on grief all the time, but do try to be as supportive and as understanding as you can, even though it’s not something people usually discuss in everyday conversation.

Complete Article HERE!