Janet's Obituary

DENNIS Janet Victoria (Thring) September 25, 1952 to February 20, 2008, died peacefully at home holding her husband, Mark's hand and surrounded by her loving family after a short courageous struggle with ovarian cancer. Janet always retained her zest for life despite the many challenges posed by her disease. The final phase of her life was eased by the unconditional love and support of her large circle of friends, especially her support team, TELUS management and employees, family and soulmate Mark.

Janet was born to Cy and Ruth Thring (Sinclair) in Yakima, Washington, USA. Shortly after Janet's birth, the Thring family moved to Cy's native Vancouver where Janet grew up with her two sisters Daphne and Marilyn. Janet joined BCTEL in 1970 and worked there until her retirement from TELUS in February 2008. Janet was a unique and special person whose vibrant, fun loving and vivacious personality, outstanding fashion sense, quick wit, contagious laughter and giant smile brightened many a day and endeared her to all. She will be greatly missed by those who knew and loved her. While we are sad for what never will be, we are grateful for what we have had. Janet was truly a gift who has left her imprint upon our souls.

The family appreciates the efforts and skills of her physicians, Dr. Jones her family doctor of 32 years, Drs. Stuart and Lam of the Burnaby General Cancer Clinic, and the assistance and expertise of the Three Bridges Community Health Centre Pallative Care Team, especially Dr. Anne Hansson and nurses Wanda and Jivan.

A memorial service honouring Janet's rich life will be held Monday March 3rd, 2008 at the Shaughnessy Heights United Church at 1:00 pm, 1550 W. 33rd. Vancouver, light refreshments to follow. In lieu of flowers, donations in her name to the National Ovarian Cancer Association are appreciated. Envelopes will be available at the service. Janet may be watching ... pick your shoes carefully!

The end of Janet's Journey

My lovely wife Janet came to the end of her life's journey at 10:15 pm on Wednesday February 20th. The past few weeks were a struggle for Janet but she passed comfortably and peacefully holding my hand. Her sister Marilyn was present as were my parents Betty and Leslie Dennis.

Tonight ends a nightmare for Janet and me that started last May with her diagnosis of Ovarian Cancer. Unfortunately the nightmare did not have a happy ending.

Janet would not have wanted to spend more than a few weeks living as she did for the past week. She was a strong, independent and vibrant woman. Janet hated being dependent on anyone, even those that loved her the most. She would rather be released from the prison that her body became.

Janet Update (and why it took a long time to publish this blog)

I was chatting with my Dad last night and I found myself commenting on writers block. It suddenly dawned on me why I was procrastinating on updating this blog. I was really having trouble finding good news to talk about. When its good news I have no problem telling you all the details. The writers block occurs when there is no good news. With the progression of Janets Ovarian cancer its not always good news. With that as an introduction let me update you on Janet's condition.

Janet went in for paracentisis on Tuesday at VGH. This was the first time she was drained at VGH and she was very pleased with the medical staff. She had a lady doctor from Ireland who actually did the procedure, which involves inserting a needle into her abdomen to drain fluid. Janet is naturally pretty anxious about this procedure and the bedside manner and compassion of the doctor and nurses have everything to do with how much Janet despises or tolerates the actual process. Karen Corcoran, who has made accompanying Janet for paracentisis her personal crusade since last May, accompanied Janet through entire procedure. The VGH medical staff drained about 2.95 litres of fluid from Janet and she was much more comfortable afterwards. Corco made sure that Janet got her standard celebration meal consisting of White Spot fries and large amounts of triple O sauce for dipping. By the time Janet got home on Tuesday afternoon all was well and after the excellent results from the last paracentisis I had high hopes for similar results this time. I was looking forward to a few days of getting lots of calories into her.

Unfortunately it was not to be. By Wednesday night Janet had thrown up much of what she had eaten. It was obvious that even though she felt more comfortable after the draining procedure, she was having almost as much trouble keeping food and calories down as before the procedure. It has been a struggle all week for Janet to keep any food down. Janet is incredibly thin and each calorie counts. For Janet to lose calories at this time is significant. The past few months have been a battle of calories. Calories retained equals winning, calories lost equals losing. This week we have been losing more than we have been winning.

So we are not getting the same "lift" from the procedure this time that we got last time. Janet is weaker and thinner and requires more assistance with daily living. I won't go into the details and lets not dwell on the bad stuff and lets move on to the good stuff.

We started with the home support staff this past week. We had a home care worker in all day Monday and 4 hours each afternoon on Tuesday through Thursday. This was great for me because I was able to leave the house knowing that Janet's care was in experienced hands. Its also good for Janet to get a rest from me. Janet also likes the back rubs she gets from the home support lady while she is having her bath. Apparently I am too rough (no kidding.) In addition to being able to do some leisurely grocery shopping I managed a bike ride around Stanley Park and was able to have lunch out with both my parents at the same time. It was all good.

Janet and I also spent some time last week getting various business affairs tied up and organized. One of the big highlights from those efforts was that the lovely Janet officially retired from TELUS at the close of business on Friday February 15th. This officially brought to a close a career with BCTEL/TELUS that spanned 38 and a quarter years. A true career achievement in anybody's books.

All of you who read this blog have supported Janet and I in many ways throughout the past 8 months. Your love, laughter, good wishes and fond memories have sustained us through many bad moments and we are both so very deeply grateful for that. I want to share a couple of things with you which I hope will help to sustain you in the years ahead. These are things that I have learned from the past 8 months while intimately sharing a life with the lovely and vibrant Janet.

The first is about our attitude towards death. Those of us who are healthy tend to view death from a healthy persons point of view. We naturally don't like the idea of dying because it will stop us from doing all the stuff we like to do, eating, drinking, laughing, loving, thinking, talking, partying, playing etc. When you are really sick though, death is something else. Very sick people aren't doing any of the fun stuff anyway and just living requires a great deal of effort. It also involves enduring some pain and discomfort even if this aspect is well managed. Its worth stopping to remember that death to a very sick person is not like death is to those of us who are fortunate enough to be healthy. I think if you take the worst you ever felt physically in your entire life multiplied it by two and then asked yourself if I had to live like that for the rest of my life how would I feel about dying. You would be approaching how a very sick person feels about death.

I know that Janet does not look forward to death but she does not fear it either. She will be ready for it when it arrives. Please remember that in the days ahead.

This brings me to another important thing I have learned. Death is a certainty, as one of my friends father once said to him "John, none of us are going to get out of this alive." That is most definitely true. We should all live our lives as though each day were our last, because it may be. One of the reasons why Janet does not fear death is because she has really lived her life. Janet grasped at every opportunity to have fun, to eat, drink, talk, laugh, love, think, party and play that came along. She never said no to a single one. We should all do this, because it really smooths out the road on that last mile of the journey.

Okay enough of this really deep stuff.

We are taking things one day at a time around here right now. There is a chance that if you have a scheduled visit with Janet coming up it will get cancelled. We are going to close off non family visits to Janet after this coming Monday and Tuesday. The core support team (and you know who you are) will be an exception. As life has become more of an effort for Janet the reality is it is more difficult for her to have visitors and I also think that as she is not as much fun to look at and be with as she used to be, its harder on the visitors as well. Those of us who deeply love her do not care how she looks or how much fun she is to be with, our cups already runneth over in that department.

If you have not visited Janet and feel it is something that you must complete in your life's journey please send me an email (marknden at gmail dot com) and I will try and arrange something. I would encourage you first though to picture Janet in your minds eye in one of her finest stylish outfits, wearing a pair of her killer shoes and her perfect white smile contrasted against exactly the right shade of red lipstick and ask yourself if you really need to have that image changed. I know that one day I will be re-inserting that image back into my minds eye and living with it forever.

Thank you for being there for us.

Finally an Update or ... How is Janet Anyway?

Sit down and make yourself comfortable because this is going to be a long blog. To steal a line from Steve Jobs 2008 Macworld Keynote Address "there are four things I want to talk to you about today." Lets start with the How is Janet question, then I will get to the others.

How is Janet?

In general Janet is doing well. The last paracentisis (draining of fluid) produced a much more dramatic result than any previous paracentisis. Janet got a whole week of being able to retain most of the calories that she consumed. This is excellent because at this stage of her disease we are really in a battle of calorie retention. Not the calorie battle most of us are fighting which is to limit the amount we are taking in. In Janet's case we are trying keep in as many calories as she expends each day. After paracentisis this is relatively easy because most of what she consumes stays down. However, the calories she consumes during the week after paracentisis and before she fills up with fluid must sustain her until the next paracentisis which is currently scheduled for Valentines Day, February 14th.

Once Janet starts to fill up with fluid she loses much of what she takes in with the exception of water and clear liquids. This is likely because of a combination of mechanical issues, water pressure on her stomach and diaphram and physiological issues, partial bowel blockages being closed down even further by water pressure. Every now and again there are rare exceptions to Janet losing much of what she takes in. Yesterday was an exception because she kept in one and half boost drinks and a small salad with dressing and some nacho chips and dip while watching the last quarter of the superbowl. This is in stark constrast to the previous two days where nothing except water, ginger ale and gatorade stayed down. Not surprisingly Janet's energy levels fluctuate in direct proportion to the amount of calories she takes in, so she is a bit livlier today than usual.

I do need to point something out about Janet's general state of livliness which I have noticed. Janet is very thin, I suspect that most people by the time they reached her state of disease would be completely lacking in energy, very slow moving and with low levels of mental alertness, slow answers to questions and perhaps some confusion etc. This really was the case with Janet before the last paracentisis. Since the paracentisis she has perked up quite significantly. She is definitely weak. For example she needs to rest for about 5 minutes after climbing the stairs in our apartment. When talking to her though, you would think there is nothing wrong with her. She is as sharp as ever. She also moves quite quickly for a person who is as thin and weak as she is. For instance she moves between our bed and her hospital bed (which she uses as a day bed as it reduces the back pain she sometimes suffers from) very quickly. She sits up quickly. Its almost spooky to watch someone as thin as Janet who is still functioning at such a high level. I think if you take another look at the picture at the beginning of this blog, you will agree it proves my above point, it captures her mental state quite well.

This brings me to the next thing I want to talk to you about which is where we go from here with Janet's health.

Health Tactics

Quite frankly 3 weeks ago Janet did not appear to have long to live. Her physical and mental energy levels were low and honestly her quality of life was not particularly good. Since then she has had a bit of a dramatic turn around. Physically not much has changed except that she has consumed more calories and has therefore increased her energy levels. The most marked change is mentally. She is more alert. She is back to reading books, magazines (something she had pretty much stopped doing). She is watching American Idol and insisted she saw the first episode of Lost (live not recorded.) As a result her quality of life has also improved quite a bit. The objective is still to make Janet's life as comfortable as possible but we are going to try and make some small changes in tactics as follows:

1. Transfer Janet from the Burnaby General Hospital Cancer Clinic to the Vancouver Cancer Clinic so that paracentisis is only a 5 minute cab ride away instead of a half an hour car ride.




2. Try and get the paracentisis schedule moved up from 3 weeks to 2 weeks. There is a risk that Janet may fill up more quickly by doing this but at this stage we may well get more days of keeping calories in, which on balance is a good thing.




3. Try and arrage for bloodwork that needs to be done prior to paracentisis to be collected from home. This saves one of the 2 hospital trips that normally accompany each paracentisis cycle.

In addition I have realized that I am going to have to do a better job of pacing myself as the primary care giver. I can be the 7 by 24 nurse (or butler as I prefer to think of myself) for a few weeks, but I don't think I can keep this up for months. I am going to have to get better at delegating, and getting out of the house, when help is around. Luckily with my parents in town and Marilyn's visits, help is quite often around. Iwill also try and work out some kind of better coverage schedule including home care support with the help of the VCH pallative care team. More to come on that though as I further develop the plan.

Next I would like to give you a brief run down on what Janet has been doing with her new found energy levels.

Janet's Recent Past (the partying is over but she still has fun !)

Much of the past week and a half has been family time intersperced with a few visits from friends. When Marilyn was here, Janet and Marilyn concocted up some nice family dinners. Janet came up with the menu and recipes, Marilyn did the cooking and I did the shopping and we all did the clean up. It all worked out quite well. Saturday was my Mom's xx birthday (I can't put the number in here because she wouldn't want you to know what it is.) We celebrated it by eating beef stew, which Mom brought over, and by having champagne and cake with Janet. Janet's Dad has been over to visit quite often. The twins (our niece and nephew Michael and Chanel) pop by on Friday's (somehow they have managed no college classes on Fridays, who knew.) I usually put them to work around here and they are happy to help out. John Nicholson (the twins Dad) pops by frequently and sometimes John and I just sit and chat for a while. Dave and Stephanie, Marilyn's husband and daughter have also been over for a visit. Its all been high quality family time and we have been really lucky to have had the opportunity to fit all of this in.

So that brings me to my last topic which is what happens next ....

What Happens Next

There are a lot of things that happen in this wild and disorderly event called life that we really don't understand and cannot predict. Janet getting ovarian cancer in the first place is but one small example. Realistically Janet is at high risk for a number of things to happen which could end her life quite quickly. If those things do not happen, eventually she will suffer digestive system blockages that will eventually end her life. It could be weeks or months. No one knows. Its very important that when she is feeling good that Janet enjoy her life as much as possible. Janet needs time for herself, her family and for her friends. Visiting does use energy which is in short supply.

If you haven't visited Janet and would like to, please send me an email with your preferred time and date and I will put it in the calendar. Its best for Janet if we can keep the visits to no more than half an hour as she does get tired quite easily. Please do not bring food or flowers we have enough. If you must bring something bring reading material, magazines or books or even old pictures. Janet loves looking at old pictures of times and parties past. We are going to restrict visiting days to Mondays and Tuesdays only and no more than 2 visitors per day in order to conserve Janet's energy. If this really does not work for you and you need an exception you can let me know.

Thank you to everyone for your love and support through this difficult time. I will continue to use this blog to keep you posted on my lovely wife's progress and Janet and I will both continue to track your messages of support. You do not need to log in in order to leave a comment on this blog. Just tick the anonymous box but your name in the comment so we know who it is from.