Butter is Amazing. My Aorta approves.

 So tired after clinic yesterday I binged on butter - why? #aorta #yangsheng #healthyeating

Healing: Receiving Serious Health Diagnoses, Anger & Bargaining Responses

 Today we are briefly discussing the anger and bargaining phases of the grief model outlined by Elisabeth Kübler-Ross. 

Receiving Serious Health Diagnoses

When a person receives a cancer or aortic dissection or aneurysm diagnosis, after the initial shock and denial phase, they may experience the anger and bargaining phases. These stages are characterized by anger directed at various sources, manifesting in numerous ways and also often an attempt to negotiate, usually with a higher power, in a desperate hope to reverse or lessen the reality of their situation.

During the anger phase, it is crucial for the individual with the diagnoses and their loved ones to understand that this reaction is a normal part of the shock and grieving process. As we mentioned in the previous post, mental health professionals can provide essential support during this time, helping the individual express their anger in healthy ways and explore the feelings underlying their anger.

Some of the ways anger may be expressed by persons diagnosed with aortic dissection and/or cancer can include:

Anger at the Unfairness: After the reality of the diagnosis sets in, it is common for individuals to feel a deep sense of injustice. They may question, "Why me? Why now?" This anger can stem from the perceived randomness and unfairness of their situation, especially if they have been living a healthy lifestyle or are young with many unfulfilled plans. I personally have asked the ‘why me’ question time and time again.  This reaction is normal and I now acknowledge these feelings as valid when I begin to dwell on the ‘why me’ questions.

Anger at Physicians and Health Care Providers: Some people may feel anger towards their physicians or healthcare providers. This can result from frustration with perceived delays in diagnosis, dissatisfaction with the course of treatment, or simply as a transference of their fear and helplessness.  I personally am so over directing anger at my doctors.  After years of dealing with both my diagnoses and my doctors I am frankly just tired of blaming anyone, including my attending health care professionals. However for others, blaming doctors is a recognized emotional response.

Anger at God or a Higher Power: For those with spiritual or religious beliefs, anger may be directed towards God or a higher power. Individuals may feel abandoned or punished and may struggle with their faith during this challenging time.  I've been there done that with this type of anger.  Today my world view has more of a Daoist flavor so there aren’t really any ‘Gods’ or ‘Personal Higher Powers’ that could even hear me.  But for those with beliefs in a higher power, this avenue of blame is normal.

Anger at Oneself: There can be feelings of self-blame, especially if the individual believes their lifestyle choices may have contributed to their illness. They may also feel frustration at their body for "betraying" them.  Today, after many years, I’ve learned to love myself for whom I am, dissection and cancer and all.

Anger at Family and Friends: It's also common for individuals with a terminal illness to experience anger towards their family and friends. This can stem from a perception of being treated differently or from frustration over others' inability to fully understand their experience.  Caregivers, family and friends have it as hard as us, IMHO, in dealing with those of us that were diagnosed with these serious illnesses.

It's important for loved ones and caregivers to practice patience and empathy, avoiding taking any anger personally. Encouraging communication and providing a safe space for the individual to express their feelings can be beneficial. Over time, as individuals processes their anger, they may move towards the other stages of grief, such as the other phase we are going to briefly discuss here, the bargaining phase.

As for the bargaining behavior often experienced, here are some ways bargaining behavior may present:

Negotiations with a Higher Power: A person may seek to make a deal with God or a higher power, promising to live a better life, devote themselves to service, or make other significant changes in exchange for a cure or more time. 

Regret and Remorse: The individual may spend a lot of time thinking about what they could have done differently to prevent their illness. They may regret past lifestyle choices or not taking symptoms seriously earlier. This period is often characterized by guilt and self-blame.

Revisiting Past Choices: The person may start obsessively considering different scenarios in which their illness could have been prevented. They might think about what could have happened if they had made different decisions about their health, diet, or medical treatment.

Seeking Alternative Treatments: In their desperation to find a cure, the person might start exploring alternative treatments and remedies, often in cases where conventional medicine has provided no solution or hope.

It's important to note that, like all the stages of grief, both the anger and bargaining stages are not experienced by everyone, and can occur in any order. Additionally, these stages are not rigid categories, but rather part of a framework to help us understand the typical emotional process involved in dealing with terminal illness.

It's also crucial to approach a person in the anger and bargaining stages with empathy and patience. Many of us are grappling with the harsh reality of our imminent mortality and are seeking to exert some control over our situation. Mental health professionals can provide invaluable support during this stage, helping us process our emotions and gradually move towards acceptance of our diagnoses.  Like my mother used to say, “after ten years its not the first thing we think of when we wake in the morning”.

I’ve found that dealing with these serious medical diagnoses is a journey, one that has many twists and turns.  For me, acceptance of my diagnoses took time.  Today my understanding of the grief processes has led me to appreciate each and every breath and moment.  Next post we will discuss the last two remaining phases of diagnosis grief; depression and finally acceptance.  Many blessings as always, Kevin.

Healing: Receiving Serious Health Diagnoses & Survivorship

 When diagnosed with a life-threatening illness, such as cancer or as in many of our cases an aortic rupture or dissection, we may often experience a range of emotions and psychological responses. 

Me wearing a wound vac and chillin after my second open chest aortic procedure

The response to such life impacting news can be likened to grief, as we grapple with the loss of our former "perceived as OK" health status and we begin to confront own own mortality. The processes we encounter often mirror the five stages of grief and loss initially outlined by psychiatrist Elisabeth Kübler-Ross in her book “On Death and Dying”.  If you've never read this book you should.

Here's a brief look at these stages as applied to any diagnosis of a significant medical condition or illness but especially written here for aortic dissection/aneurysm or and/or cancer survivors as these challenges are two I am personally familiar with:

1. Denial: This is often our first reaction. We may not accept the diagnosis or may think there has been some mistake in the test results. Denial serves as a psychological defense mechanism that helps us cope with the initial shock of diagnosis.
2. Anger: As the reality of the situation sets in, we may feel anger and resentment. This can be directed toward ourselves, our doctors, loved ones, or even a higher power. I kept asking myself, "Why me?"
3. Bargaining: This stage involves negotiating or pleading with a higher power, doctors, or even oneself. We may seek to make lifestyle changes, try alternative treatments, or adopt healthy habits in the hope of reversing the disease.
4. Depression: This stage is characterized by feelings of sadness, hopelessness, and despair. We may become overwhelmed by the potential implications of our disease, including pain, disability, and especially the prospect of our untimely death.
5. Acceptance: Over time, we may reach a stage of acceptance. We acknowledge the reality of our situation and may start to make plans for our future care or end-of-life arrangements. This stage is not about being okay with the cancer or aortic dissection but rather about acknowledging our physical and mental challenges and working with our diseases rather than fighting against them.

These above stages are not linear and we may cycle through them multiple times, even experiencing more than one stage simultaneously. Importantly, not everyone will experience all stages, or in this order.

Receiving support from mental health professionals, such as psychologists or counselors, can be vital during this time. Health care professionals can provide strategies to cope with our trauma and emotions associated with our diagnoses. Additionally, joining support groups, either in-person or online, can also be beneficial, providing a platform to share experiences and feelings with those who are going through a similar situation.  Facebook support groups have been a tremendous help for me and I know for many others.  I've also met some awesome people in these support groups who inspire me and give me hope.

It's also important to note that our journey with our challenging illnesses is unique, and there's no 'right' way to react or cope. The primary goal is to find ways of managing the illness and maintaining quality of life that work best for us.

As discussed above, one of the initial stages we may encounter is denial.  Denial serves as a psychological defense mechanism that buffers the immediate shock of our diagnoses. It is a normal and in some ways, a healthy initial response, as it allows us some time to adjust emotionally to the diagnoses and to gather strength for our journey ahead.

I've personally found that denial can manifest in various ways and progress through several stages, including:

1. Shock and Disbelief: This is the immediate reaction to our diagnoses. We may feel numb, and there's often a sense of disbelief, as if what we've just heard can't be possible. We might think, "This can't be happening to me."
2. Dismissal of Diagnosis or Prognosis: We may question the competence of the medical professionals involved or insist on multiple retests, seeking a different opinion in the hope that the initial diagnosis was mistaken. We may also downplay the seriousness of the disease or believe that we will be the exception to the prognosis. This was especially true for me.  I spent so many hours on the internet researching how I would be spontaneously healed of my extensive aortic dissection.
3. Avoidance: In this stage, we might avoid medical appointments, refuse treatments, or avoid talking about the disease with friends and family. We might keep ourselves extremely busy so as to not have the time to confront the reality of our condition.  Again, I see a period of time where I did everything possible to try and get my doctors to allow me to stop taking the meds I was prescribed, including anticoagulants, beta blockers, statins, aspirin and others.  I was convinced that if I was not taking these prescriptions then I’d wouldn’t necessarily be sick.
4. Rationalization: We may also try to find explanations that could discredit our dissection or cancer diagnosis. For instance, we might attribute our symptoms to less serious conditions or to factors like stress or fatigue. We may also overemphasize stories of misdiagnosis we’ve heard or read about.  I too, to an extent was guilty of thinking my doctors may not have really known what they were seeing on the CT scans.  Ditto me on that.

While denial can serve us as a protective function initially, prolonged denial can be harmful.  Unreasonably prolonged denial can delay necessary treatment and prevent us from taking steps to manage our condition effectively.  For a caregiver, friend or medical professional it’s important to approach those of us in denial with frankness and truth but also with empathy and understanding, providing us with emotional support while also encouraging us to face the reality of our dissection or cancer.

Professional help from a psychologist, counselor, or a psychiatrist can be very helpful during our denial phase. Mental health professionals can use various therapeutic techniques to guide us gently towards acceptance of our conditions, providing us with the psychological tools needed to handle our diagnosis and the implications. As we mentioned above support groups can also be beneficial, as they allow us to interact with others who are facing similar challenges.

Both cancer and aortic dissection have been a challenge for me.  Its been well over a decade since my ascending aortic repair and I’m still living with a  complex descending dissection. It’s been seven years since my melanoma surgery, fifteen years since most of my large colon was removed and three years since half of my kidney was ablated for renal cell carcinoma. During these times I’ve experienced denial on a regular basis. Today, with the help of family and health care professionals I find myself able to recognize the stages Mrs. Ross describes in her book On Death and Dying.  Living with serious health challenges is just that, a huge challenge.  Kudos to us survivors.  Next blog post I’ll be discussing the second dimension of dealing with this type of trauma, the Anger phase.

Many blessings, Kevin

Nature Healing: Exploring Ecotherapy as a Health Modality

 Spending time outdoors (I call this outdoor time 'ecotherapy') can be incredibly beneficial for individuals experiencing trauma for several reasons. 

Ecotherapy & the study of the Languages of Nature has helped me with my aortic dissection healing

Here are a few key ways in which it can help:

1. Stress Reduction: Exposure to nature has been shown to reduce stress, with research demonstrating that spending time outdoors can lower heart rate, blood pressure, and levels of the stress hormone cortisol. Trauma can create chronic stress conditions, and mitigating stress is a significant step towards healing.
2. Mindfulness and Presence: The natural world can encourage a state of mindfulness, which involves focusing on the present moment rather than ruminating on past experiences or worrying about the future. This can be particularly helpful for individuals dealing with trauma, as it can provide a break from distressing memories and anxiety-provoking thoughts about the future.
3. Physical Activity: Outdoor environments are conducive to physical activities like walking, hiking, or cycling. Regular exercise has been found to reduce symptoms of Post-Traumatic Stress Disorder (PTSD) and can stimulate the release of endorphins, the body's natural mood lifters. Physical activity can also promote better sleep, which is often disrupted in those dealing with trauma.
4. Increased Social Interaction: Spending time outdoors, particularly in public parks or community gardens, can lead to increased social interactions. Social support is often a crucial component of trauma recovery, providing opportunities for shared understanding, emotional expression, and reassurance.
5. Restorative Environment: Nature has been described as a 'restorative' environment that can improve concentration and motivation. This is beneficial for those healing from trauma, where cognitive functioning can often be affected.
6. Improved Mood: Research has also linked exposure to green spaces with improved mood and mental health. This can be especially beneficial for those recovering from trauma, who may be experiencing issues such as depression or anxiety.
7. Ecotherapy: A form of therapeutic treatment which involves doing activities in nature. It can help to improve your mood, reduce feelings of stress or anger, help you take time out and feel more relaxed, improve your physical health, improve your confidence and self-esteem, help you be more active, help you make new connections, provide peer support, and provide a sense of belonging and community.  Ecotherapy benefits us through a variety of ways, such as;

• Improved Mental Health:
• Reduces Stress: Exposure to natural environments has been shown to lower cortisol levels, a hormone that the body produces in response to stress. This reduction can help mitigate feelings of stress, anxiety, and depression.
• Improves Mood: Nature has a calming effect that can elevate a person's mood. The simple act of taking a walk in a park has been found to trigger the release of endorphins, the body's natural mood elevator.
• Enhances Cognitive Functions: Natural settings can be restorative for our cognitive abilities. Research suggests that nature can help restore attention, improve problem-solving and creativity.
• Improved Physical Health:
• Physical Activity: Ecotherapy often involves physical activities such as gardening, conservation work, or walking, which can help improve cardiovascular health, muscle strength, and overall physical fitness.
• Exposure to Sunlight: Outdoor activities increase exposure to sunlight, which facilitates vitamin D production. Vitamin D is important for various bodily functions, including strengthening the immune system and bone health.
• Lowered Blood Pressure: Spending time in natural environments has been linked with lowered blood pressure, beneficial for heart health.
• Improved Emotional Well-being:
• Building Connection: Engaging with nature can help individuals feel more connected to the world around them, combat feelings of isolation, and build a sense of belonging.
• Mindfulness: Natural environments encourage mindfulness and can make it easier for individuals to focus on the present moment. Mindfulness has been linked with a range of health benefits, including improved emotional regulation and reduced rumination.
• Improved Social Health:
• Community Engagement: Many ecotherapy activities involve social interaction, promoting community engagement and social skills, which can be beneficial for individuals feeling isolated or struggling with social anxiety.
• Increased Self-Esteem and Self-Confidence: Accomplishing tasks in nature, like growing a garden or hiking a trail, can instill a sense of achievement, thereby boosting self-esteem and self-confidence.

Despite the noted benefits, it's important to mention that ecotherapy is not a one-size-fits-all solution.

Spending the day swimming in Wakulla Springs recently was so very relaxing

What works for one individual may not work for another. For some, ecotherapy might best serve as a complementary approach alongside traditional therapy or medication.  This form of therapy is based on the idea that people are connected to and impacted by the natural environment. It leverages the benefits of nature to promote healing and growth. 

While I personally attribute time outdoors to having contributed to healing PTSD and trauma associated with my aortic dissection, it should be noted that ecotherapy isn't considered a replacement for professional treatment methods such as psychotherapy, medication, or cognitive-behavioral techniques. Rather, it's an adjunct therapy that can support and enhance these other treatment modalities.

Regardless, I've found that spending time outdoors has provided me with so many healing health benefits since my dissection and aorta operations and highly recommend discussing ecotherapy with a professional for anyone seeking to anyone seeking relief from mental or physical trauma.

Send Off for Jerome, Aortic Dissection Warrior

Jerome, my friend, you fought a good fight and kept the faith.  You defied the odds for a long time.  You inspired me to move forward each day.  Now you rest.

Today's post is a tribute to a friend.  His name is Jerome and he lived just outside Gainesville, Florida.  Jerome endured his aortic dissection (AD) in 2012, about a year after I had mine.  During his dissection and repair surgery he became a paraplegic due to strokes.

Although neither of us new each other at the time, Jerome and I both spent time researching aortic dissection on the internet.  Soon thereafter, Jerome contacted Dr. Peter Tsai of Aortic Warriors, one of the original founders of the world wide aortic awareness AD movement and the creator of September Aortic Awareness campaign.  

Dr. Tsai sent me an email.  Dr. Tsai had read a few of my AD posts and asked if I'd contact Jerome since we were both in Florida.  I called Jerome and exchanged emails.  Jerome and I talked or emailed every day, encouraging one another through the challenges of dissection life until yesterday when he passed away.

Jerome was a young man still, in his 60s.  He made the most of each day, despite being confined to a wheelchair and living alone.

He would take his scooter, ride out to the backyard fence and feed carrots to his neighbor's horse most days, and watch old westerns on television.

When aortic dissection occurs the inner lining or our body's major artery tears apart, leaving the vessel weakened.  Over time the weakness results in the aorta dilating and eventually leaking away the blood that our heart is pumping.

Jerome was an inspiration to me because he was challenged even more so physically than I.  Fortunately after my dissection I could still walk, though it took some relearning.  Seeing another human survive in spite of circumstances more dire than my own made me realize that, yes, I can and will do this.  Thank you my friend, for giving me this gift.

Jerome would regularly say, 'carry on, enjoy every moment you have, no matter all the sh*t that is happening'.

He would also want me to encourage others to be screened for aortic aneurysms and vascular health.

Here are a few excerpts of the emails Jerome shared with me over the years.

Sept 3, 2019 

Kevin, yes nasty way to start a day, had my cereal, and several cups of coffee and several oatmeal  cranberry walnut cookies and-a cinnamon raisin bagel and-thinking of asking VA if they have a standing grab bar I can get them to install next to the right side of my living room lounge that I might use to get myself off the floor if I am down like that for future use rather then calling 911. I will see how that goes. I use to to be able to pull myself up on lounge-using my good right hand and pulling on right  arm rest but when I tried last night it feels like I might pull arm rest off and become a useless futile effort. Will check into this and see.

Enjoy your day, Jerome.

Geeez Jerome, what a way to start the day.  I am sorry you had to endure that but am glad you did not break any bones or do damage to your body.  That is a shock though for sure.  Good thing you had your phone handy too.  Yes, what a life we lead.  Trying it is.  Here's to a better day for both of us.  Kev

Kevin, Morning to you. I just had to call 911 because I slipped out of my recliner when I tried to reconnect the control remote to its cable  that had-come undone, and once I was on the floor I can’t get back up so had to call for a lift assist. What a life I have to lead, but I am still alive right.everything is a struggle , but somehow we just keep going, Day after day after day.

Yes coffee time soon, maybe sooner for me.enjoy, Jerome.

…

Aug 17 2019

Kevin, yes rained here on and off all day as well. . I went over to feed treats to the horse and my scooter got stuck in the soil next to the fence so I had to slide off-seat stand on ground in water next to left side of scooter and reach down with my right good hand and lift up back of scooter out of rut it had wallowed out with rear idler balance wheels and reset onto ground out of rut. Then I had to just throw the apple slices and carrot over fence onto ground for horse. I hope he was able to get them out of mud and water. Then I just fast forwarded out of area and back onto driveway and home.I have   to find another part of fence where I won’t find it so soggy to be able to hand feed horse.i had my home phone with me and was almost tempted to call for fire rescue paramedics, but said to myself Let’s try this one more time to lift scooter out of rut. So it worked and didn’t have to call, thankfully!

Yes my Friend the night is here and coffee time on the horizon. 

The roofers have my roof weathered in with protective felt and polyurethane for weekend and will be back Monday to finish up . So hopefully all turns out good on that, no leaks do I see anywhere so good.

You take care my Friend and have a good night. Jerome.

…

April 17, 2019

Kevin, yes my CNA sweep up remaining glass for me them mopped up the floors because I had blood all over the place and had me take a shower to get dried off blood so she could see where to put bandaids on me. Yes I am the problem child for sure, but I did survive as you and I know how to do. Rest of day was try and take it easy day but you know how that sometimes goes because we still need to get things done that only we know how we want them done , so we struggle till we get thru our problems. 

You take care my friend and enjoy your night . Coffee soon, Jerome.

Gheez Jerome what a sucky way to start the day  I am sorry for you.  You may be in a wheel chair and that does suck but I will tell you that you are an ongoing inspiration to me.  I look forward to our communications because I feel you are one of the few people who understand what this life with dissection challenges is truly like.  My day was ok, I can't remember all I did but go for a short walk and stop by Harbor Freight for some zip ties for the chicken coop.  Its not even 7 pm here CST and I am already ready for bed.  The weather was balmy here today but we've got some strong storms coming in tomorrow.  Hope your CNA got the glass up and bandaged up your foot.  Once again night is upon us and we are still in the realm of the conscious.  You rest well if that is possible.  Tomorrow the weekend is almost here.  Kev

Kevin, I may have made it thru the night but I didn’t make it thru this morning , I was unloading the dishwasher and a glass baking pan slipped and shattered all overthe floor , cut my feet several times, blood all over floor and finally got most of glass picked up, will let my CNA sweep and mop the remaining amount, what a chore from wheelchair and one hand and foot usage,  this is not the first time this has happened to me and am sure not the last. Bad day start for sure.

Hope yours is better then mine, Jerome.

December 14, 2018

Kevin, yes, you did have a bastardized day with your candy bar. Mine was no better, forgetting to turn off lights as I leave the rooms and having to go back and do so. Then as I clean coffee pot out tonight I had water vinegar and baking soda spill on floor and made a mess to clean up, damn near slipped on my ass catching myself falling back into wheelchair luckily, what a life of laughs we-give others to laugh at! For sure but not us laughing at. We are clowns on the run just trying to survive day to day, but at least we are still surviving my friend, you hang in there as I will-on my end, so I am happy for that and only ran out to get my mail and send a bill outgoing to box. 

Take care my friend and and enjoy, Jerome.

Long day Jerome. Rainy and overcast making for a dreary day. Went to the library then to the health food store. Bought some groceries including a chocolate bar. Got back in my the truck and looked for the chocolate bar but wasn’t in the bag. Looked again and no chocolate bar. Wife looked no chocolate bar so I went back in with receipt and told them they didn’t put the chocolate bar in the bag. They thought that was strange but gave me another one anyway. Got home and unloaded bag and there were two chocolate bars in the bag. But we’d taken everything out of the bag back at the store looking for the first bar. Sometimes Jerome I think I’m losing it. Or at least slowing down. Sheeez. I still try and keep going but it doesn’t seem like it’s getting any easier.  Hope your Friday was ok. You should be getting this rain soon. Kevin

October 26, 2018

Kevin, Morning to you, I am having much difficulty just taking my catnaps let alone sleep, due to that cyst on my upper back just above chest. I called my primary office yesterday and nurse tells me the primary is out for several days and will check if on call  doctor will be available to relieve it in morning of next couple of days outside normal  prior scheduled patients but also have to be able to put in my file to be able to get me my transportation  to get in to see on call doctor at time available, and was told if pain gets to unbearable to come into ER. It is getting very close because I may have to wait until next week, but then that brings up the cost  ambulance service to get me there, when I broke my hip and went to VA ER the ambulance bill was $820which I never understood why so much and 

LVA wouldn’t pay any of it and I was only able to get Medicare to pay $540 and I had to pay rest. So much for the assistance of all that are supposed to assist us as we get older!

And as for my getting around in house in wheelchair I can’t carry  an.thing if I was using my walker, so don’t have a choice and then outside one handed use of wheelchair  I won’t be able to get up door entrance ramps and same into garage to use washer and dryer or put garbage in garbage can so have to use scooter. So yes difficult but only way I can do things. Our lives are just way to ***ked up and very complicated with constant struggles daily, but then the question becomes what is the alternative, Death which neither of us wants to go down that road. Boils down to must do them to survive or go into nursing home, take care my friend and enjoy your day.

Friday, October 26, 2018, 

Body sore and stuff like a cadaver today. Jerome. I don’t see how you can do what you do being in wheelchair. This stuff sucks.  Our weekend begins. Today. Enjoy yours. Kev

September 23, 2019

Kevin, Morning back at you. I envy that you are still capable to physically deal with those type of home repairs and drive a car, but I Have unwillingly accepted these facts that I can no longer engage in, but the cards were dealt to me in the order to which they came and I have to play the hand unfortunately I received with the best knowledge I have left to try and finish the game to the end.

Enjoy your day and still catnapping here And drinking my coffee and in a couple of hours will go attempt to see horse to feed him his treats. Later, Jerome.

Monday, September 23, 2019, 

Good morning Jerome.  Happy Monday.  I'm feeling a bit sleepy this morning which is normal for me, probably a carry over of monday mornings before dissection when I was trying to solve all of the problems around me in rapid succession.  Seems like I can't focus on what I'm doing then I move on to the next thing without finishing the first and end up getting nothing done.  Just the body care in the morning seems overwhelming sometimes, like brushing teeth, making coffee, taking medications, making bed, etc... is overwhelming.    I ordered a hot water heater to be delivered tomorrow.  The lightening strike we had a month ago hit our hot water heater and it has not been working fully even though I tried to get it to work, replacing elements, etc... So that will be a huge challenge for me even though it is an on demand wall mount heater and not too heavy.  I just will need to cut the water off to the house and remove the old unit and then replace with the new unit.  So today I think I'll take it easy.  Might sit in the sun this morning and soak up some rays.  Hope your weekend was good and you have an excellent Monday.  We just keep on going don't we.  Best, Kevin

Sept 25 2019

Kevin yes making  another day from the last. , yes, I get the downs as well my Friend, most of the time, this s*it we go thru  every day a new or more complex struggle, I guess we were the chosen ones, you and I  and a few others, because others couldn’t endure what we have been thru or were weaker then us.

Don’t mean to put them down either but we were just lucky enough to survive and others were not as lucky. I love you my friend you are an inspiration in making my days move from one to the next.you take care and as you say coffee time soon on the horizon, Jerome.

Tuesday, September 24, 2019, 

What kind of steaks Jerome?  They sound good. I’m feeling down tonight for no special reason I just get this way occasionally it’s feeling sorry for myself. Hey coffee time will be here soon though. First we gotta do this night thing though. You rest well and tomorrow is another day as Scarlet says. Kevin

I am so glad I had the privilege of getting to know Jerome.  He'd tell me to move on and enjoy the day I've been given.

And as he'd suggest, I am encouraging whoever reads this to schedule a checkup with your cardiologist and discuss dissection, aneurysms and your aortic health.  Remember, everything is good until it isn't.

Finally read more about aortic dissection and Ritter Rules on the John Ritter Foundation and Aortic Warriors websites.

RIP buddy.