This too.

It’s just dust. But it won’t pass.

“…this, too….”

Everyone, I think, is familiar with the saying: “This too shall pass.” I like that as a mantra during difficult times as a way to recognize the impermanence of ALL things. If taken sincerely to heart, the words can be a reminder that tough times don’t last—maybe it eases suffering, maybe not. Maybe it’s just a way to tell oneself “just hang in there a little while longer. This will end, I promise. This too shall pass.”

A more adept student of mindfulness practice will remind themselves that the exact same mantra applies during the good times too. But most of us forget that. Good times are impermanent as well—they don’t last. Feeling great about anything lately? (Pay raise? won a competition? compliment from a friend? bought a new pair of whatever? saw a great show? met a goal? found a $20 bill on the sidewalk?)

“This good feeling you’re feeling right there? Don’t get too used to it. This will end, I promise. This too shall pass.”

There is a different mantra or prayer that can be used that might actually be more meaningful when seeking a life of equanimity, acceptance, love, and compassion. Just simply take the last two words away. You’re left with magic:

“This too.”

We need this now; because THIS won’t pass:

Dad has been diagnosed with congestive heart failure.

~~~~~~~~~~~~~~~~

Again, if done with sincerity, those two words have power. They have the power to take oneself out of the fight. When the inevitable happens, it’s futile to wish for anything different. “This too” tells the Universe that you get it; that this too, whatever your “this” might be, has been given to you by the Universe to be woven into the tapestry of you. Like Alan Watts had said “There isn’t a grain of dust in the whole Universe that is in the wrong place.” Every single thing, person, action, outcome, conflict, resolution, problem, consequence…diagnosis, is (was, will be,) in its perfect place. In the moment, unless you are an extraordinary individual, we don’t get this. It is only in retrospect that we might, we MIGHT be able to piece together the Universe’s intent in placing that grain of dust, that box of darkness, on our path and in our lives. Ultimately, we don’t have to understand the Universe’s intention (that would be arrogance anyway). In fact, it’s better we don’t and that we don’t even try. THAT is what FAITH is for. And so, given any grain of dust that appears as if it were placed to simply trip us up and make us miserable, our RESPONSE is the only thing that matters.

Our response means everything, and gives meaning to everything.

“This too.”

“This too is happening and it becomes a part of me now.”

Note, this is not a resignation to give up and give in! You have to understand the subtle difference that gives those two words their power while retaining one’s sense of empowerment to positively effect an outcome. If you had to add two additional words to drive this point home, those two words might be “…so then?”

~~~~~~~~~~~~~~~~~~~

Heart failure (HF), also known as congestive heart failure (CHF) and congestive cardiac failure (CCF), is a complex syndrome of a group of signs and symptoms that commonly include shortness of breath, excessive tiredness, and leg swelling. It may cause shortness of breath when exercising or while lying down, and may wake a person up at night. Notably, chest pain including angina is not typically caused by heart failure, but can occur if the heart failure is caused by a heart attack.

(Wikipedia, 2022)

~~~~~~~~~~~~~~~~~~~

Congestive heart failure—or simply heart failure—occurs when the heart muscle doesn't pump blood as well as it should. When this happens, blood often backs up and fluid can build up: in the lungs, causing shortness of breath and wheezing; and in other tissues, especially in the legs and feet, causing swelling (edema).

Certain heart conditions, such as narrowed arteries in the heart (coronary artery disease) or high blood pressure, gradually leave the heart too weak or stiff to fill and pump blood properly.

Proper treatment can improve the signs and symptoms of heart failure and may help some people live longer. Lifestyle changes — such as losing weight, exercising, reducing salt (sodium) in your diet and managing stress — can improve your quality of life. However, heart failure can be life-threatening. People with heart failure may have severe symptoms, and some may need a heart transplant or a ventricular assist device (VAD).

One way to prevent heart failure is to prevent and control conditions that can cause it, such as coronary artery disease, high blood pressure, diabetes and obesity.

(Mayo Clinic, 2022)

Dad was just diagnosed this week with congestive heart failure.

“This too.”

So then?

~~~~~~~~~~~~~~~~~

CHF is one of those maladies that can sound MUCH worse than it really is—although it must be taken very seriously because it IS very serious. CHF is not “heart attack” and does not necessarily mean to imply imminent death the likes of which happens with cardiac arrest. Symptoms and severity of CHF can span a wide range and treatment can be relatively straightforward. And when controlled, a person can live for quite a while with a relatively nice quality of life. But the term sure is scary. And there is no doubt now: my Dad’s heart, his magnificently kind and gentle and large heart, is failing him. Such the irony.

These are three very different yet relatable maladies in humans: heart attack, cardiac arrest, and congestive heart failure. One does not necessarily lead to another—they are each distinct entities. None of them fun times, mind you. A person can be afflicted with one and not the others; or be a victim of two, or all three. Cardiac arrest, though, is a very different story in that THAT means the heart has stopped beating—not a good thing if you have a heart. Cardiac arrest = “sudden death.”

As things stand now, Dad has not, to our knowledge, ever suffered from a heart attack. And his heart has never “arrested.”

In his excellent book “How We Die: Reflections on Life’s Final Chapter,” Dr. Sherwin Nuland shared that deaths due to heart attack (localized heart cell death due to oxygen starvation—i.e. blocked arteries) have generally decreased over the years as medical advances, public awareness, diet, lifestyle changes, and, perhaps most importantly, bystander response, have improved.

But, this reduction in heart attacks and cardiac arrests also mean that life spans have coincidently lengthened, which means that incidents of congestive heart failure have increased. People are getting older. Which means hearts are getting older. And hearts are, by design, built to fail…at some point! Congestive heart failure means “continued life” but at a cost to its quality and duration.

Dad was experiencing new-ish symptoms of reduced stamina, labored breathing during physical movement, unusual tiredness, wheezing, excessive coughing, an increase in blood pressure as his heart was working harder to move the increased volume of fluid through his vessels, and increased swelling in his legs (edema: when the fluid “backs up” in veins, it tends to seep into surrounding tissue causing swelling). Dad’s POLST, or advanced medical directives, state that we do whatever is appropriate (but not heroic) to provide relief, comfort, and pain palliation. I initially inquired with Dad’s primary care physician if oxygen was now warranted even though Dad’s oxygen saturation numbers (we have a monitor!) remained consistently strong. A doctor visit in Yakima confirmed the CHF diagnosis with a symptom that included a buildup of fluid in his lungs. Not a good thing. But relief of Dad’s symptoms at least is relatively simple and expeditious with the inclusion of a diuretic medicine as part of his daily regimen of meds. And so…

“This too.”

[Time out for humor: When the doctor prescribed the diuretic, he also said “Be ready now. Your going to be going to the bathroom a LOT more!”

He said that to dad. He looked at me. He said that to both of us.

Thanks Doc.

THIS for a guy, and by association his “genie caretaker,” who is already setting records for toilet visits. But, I’ll take it. Bring it on.]

~~~~~~~~~~~~~~~~~~~

So, “this too.” Right?

Yes.

And of course.

And why wouldn’t it be?

~~~~~~~~~~~~~~~~~~

Eldering 101:

The grain of dust that is congestive heart failure is in its proper place in our Universe. Consequentially, the box of darkness has also borne gifts: compassion increased; time is cherished even more; patience and spaciousness expands; understanding grows; we feel more; and yet another path on Dad’s Journey Home is taken. Just as the Universe intended in all of its perfection.

It’s the only real and proper response of an Elder to dust of this nature:

Congestive heart failure?

This too.

So then?

Grow your love.

And for it all, with “this too” as our northern star guiding light, we can also invite appreciation and gratitude. We have been made more human; this human life manifestation is precious because of its evanescence.

“Not a single grain of dust in the whole Universe is in the wrong place.”

The Eldering lessons are there. They are ALWAYS there.

~~~~~~~~~~~~~~~~~

Dad is old—admittedly a term completely relative. Soon, he and his heart turn 84 years (on September 12). But Dad is not Parkinson’s, or dementia, or, now, congestive heart failure. Those are things that are a part of the tapestry of him—but they are not him.

He’s just Dad.

And he remains the same gentle, kind, and generous soul.

With just a lot more love added in.

“This too.”

T plus 61 days and counting. And giving up dusting the place—it’s “this too,” as it should be. Dust and all. Because that’s where magic exists.