And so it ends; And so it begins

I felt the need to talk a little bit about my dad, as he approaches the amputation of his lower leg on Monday.  I guess I feel like, if you know a little about him, you will love him as I do and you will hold him in your heart and prayers as he loses his battle to keep that leg and begins his new life of rehabilitation.

I'm going to tell you, to the best of my knowledge, what I know about him. I'm sorry, Dad, if I get the facts wrong.

My dad was born in a small town called New Ulm, Minnesota. The few times I have visited in my life I was struck by how small everything was, including the people. The only way I can describe it is that the yard gnomes all grew up and built a town in the middle of nowhere. He became an accomplished gymnast in his youth and went on to win a gymnastics scholarship to the University of Minnesota. He got injured during a training and had to leave behind the world of competitive gymnastics.

Somehow he found his way to Portales, New Mexico to study Anthropology at Eastern New Mexico University where he did get his undergraduate degree. He tells the tale of a professor stealing his final paper and getting it published. He will tell you that it was not the steal that stung but the fact he was awarded a C for it. At some point he married a woman named Sue and had a baby boy named Jason (I have two half brothers named Jason).

They later divorced and my dad ended up in Gallup, New Mexico where he met a young widow who had three children and they fell in love and got married. I think he worked for the county and/or public health. All I know is he tells one story about an abundance of printer paper and one about why you should never, ever, even if your life depends on it, eat hotdogs from gas stations. There was a story too about the weevil to rice ratio that is acceptable for human consumption.

They moved-all six of them-to Oklahoma so my dad could get his Master's in Environmental Engineering and then I think moved back to Gallup for a time. My father commuted to Albuquerque to get his MBA and then they moved to Albuquerque where they had me. When I was nine months old they moved to Denver for almost three years. I think that is where he got sick.

They had moved there for work and my mom struggled to find employment and my father was either layed off or fired. He took it hard and got very depressed. During that time my mom noticed my dad's sudden loss of weight and urged him to go to the doctor. My father tells the tale that he and the doctor laughed about how uppety women could be and that he was probably fine but they would do some labs just to appease her. It turned out that my dad was in diabetic crisis. Later that evening he got a frantic call from the doctor saying he needed to go immediately to the ER. And so began my father's unflappable negotiation strategies that make me so nervous for him but also have taught me how to get better care for Lily. He told the doctor that he was busy having a St. Patrick's Day party and was not going to blow the night in the ER. After some conversation the doctor agreed to meet my father at his office and give him the insulin and diabetes education he would need. At 33 years old (I think), the same age I am, my father was diagnosed with type I diabetes.

I feel the need to pause because I have noticed that as Americans get fatter and more and more people get type II diabetes the more I feel the need to defend people that get it. My father has a type that was previously called Juvenile diabetes because it usually got kids when they were very little but then they realized that it need to be classified more by the pathology of the disease-the complete loss of function of the part of the pancreas that produces insulin-instead of age of onset. It is not caused by lifestyle-but even if it is I am really uncomfortable with the judgement I hear passed on people that get obesity related illnesses such as type II diabetes. Maybe because I spent a year classified as obese and am only now, once I realized that my thyroid was not being properly medicated, just a little overweight. Mostly I think I don't like it because it is judgmental and not helpful and I wish people would stop.

A short time later they moved back to Albuquerque and they have lived in the same house since.

So, my father learned how to manage his insulin and blood sugar and lived a surprisingly healthy existence for a long, long time. I don't remember my father pre-diabetes so it was just something my dad did. He poked his finger a few times a day, was often in the kitchen in the middle of the night eating a peanut butter sandwich to counteract an insulin attack and he squeezed his belly and injected it with insulin before every meal.

As I reflect, I am sure he had some health struggles because he traveled three weeks out of every month for most of my adolescent life. I get so sick when I travel because the food is always so heavy. I know he went to a kind of fat camp when I was a kid but it seemed like that was mostly because he had a morbidly obese boss that paid for him to go so he would have a buddy. Penny Marshall was there with them but she left after only one day because the accommodations were not to her standard or something or maybe she couldn't smoke-I don't remember.

My dad has done some cool stuff and though I spent a ton of my youth and young adulthood resenting him for being gone a lot, today I have grown to appreciate what he was doing while he was away. He and my mother went to both of Clinton's Inaugurations, he went to Taiwan, and he has grown to be a leader in his field-which is too complicated to explain right here. If I could have wished for anything different it would have been for a little more balance. Just a few more camping trips or to DC in the summers. A few more conversations when I was a teen. You see, my father and I are more alike than anyone else I have ever met and maybe I wouldn't have felt so alone and so wrong for so many years if I knew I was like him. But, maybe not.

But, he always had bad knees. He went for years in so much pain with bionic braces but he still traveled and played golf almost daily. The doctors started to talk to him about knee replacements but they kept saying that he needed to wait as long as possible for the technology to get better and until it was a last hope because his diabetes put him at a high risk for complications. So he waited and waited until probably about six or seven years ago, He had two total knee replacements in two separate surgeries. He seemed like a new man for the first year or two and enjoyed golfing more than ever.  But his knee started swelling. After weeks and weeks of waiting to see his primary physician my father went in on November 3, 2008. It was a saturday morning and he was immediately referred over to the ER where they drew fluid out of it which was putrid and black. At this very moment I had just taken my then six month old daughter to the ER because she was having a life threatening seizure. This was a day for the record books. I called to let them know she was admitted and something was very wrong with her brain and my mother said that they were loading my dad in an ambulance and taking him across town to the Westside of Albuquerque where he would be ushered into emergency surgery to clean out his knee joint. They talked about the possibility of having to amputate the leg. It turned out that they didn't have to amputate the leg but he had to stay in the ICU for 9 days and then go home on IV antibiotics for a few weeks because he was septic from an infected knee replacement.

Several weeks later the infection came back so doctors surgically removed the knee joint and replaced it with a concrete joint that was impregnated with antibiotics. He wore that for-I don't remember but I want to say it was like nine months. Then they replaced his knee and things seemed to be going pretty well for a time.

I think the thing that always kept my dad in good condition was the fact that he kept moving and three knee surgeries turned out to produce all of the possible side effects that the early orthopedic surgeon had warned him. Beginning two years ago my dads toes started to die because of the side effects of a long term use of insulin. The insulin causes plaque to build up in the arteries and so he developed peripheral vascular disease in his legs. His body couldn't get enough blood to the toes. I don't want to make this a million page long blog so let me just say this. He has had 19 surgeries in the past four years on his legs, arteries and heart. He has two stints in his heart and and ICD-defribulator and pacemaker and on monday he will have #20-the heartbreaker. The fight for that foot-to my father a piece of his freedom and identity will have to be removed and he will embark on a new chapter as a man with only one foot.

Some have been very blasé with him, including me, in an attempt to comfort him but the one thing I learned through my struggle with my daughter is how refreshing it is when someone just says "Man! That sucks!" He doesn't care if people are making great strides with prosthetics, at least not right now. He doesn't necessarily think getting to see his grandchildren grow is worth the amputation I think because he can't be assured that he won't be so out of his mind with pain all the time or so limited in mobility and lifestyle that he will be able to be anything other than a burden. And finally, I think he is afraid, as we all are, that this is just the beginning. What happens when the blood supply to that part goes? What about the other leg? How far does he want to take this?

So Papa, all I can say is that this sucks and I'm sorry that you have to go through this. You have been so brave and honest and I pray that you have the grace you need to get through it.  I can't tell you what to do but can only say that I just can't imagine a world without you so I pray every day that this goes well, your pain will be controlled, and you will have another twenty years of your new normal and will grow to love it.

To my friends that pray for others, I hope that you hold him in your thoughts on Monday and the days that follow.

Eternally grateful,
Lisa