Pfizer booster

As part of my ongoing participation in the Pfizer/BioNTech COVID-19 vaccine phase III trial, yesterday I received a third vaccine injection, seven and a half months after my second. There was a blood draw to test levels of antibodies, T cells, etc. and the blood work will be repeated in a year. I will continue a weekly symptom check through a phone app and have a couple of phone appointments over the next year, too. The data collected will be used to inform on-going decisions about how often boosters may be needed in the future.

I’m fortunate that my side effects have been milder than they were with the second injection. I have a very sore arm, which is obviously from the shot. I’m tired and have a bit of a headache, which could be side effect and could be just life in general these days. Today is the one-month anniversary of Paco’s death, so how I am feeling could be attributable to that rather than to vaccine side effects. When spouse B and daughter T, who are also study participants, received their third doses, they both lost a day to fever, body aches, and fatigue; because I had had a similar reaction to my second dose, I was expecting a similar experience, but apparently have lucked out.

In the United States, a third dose of the Pfizer vaccine is approved for those aged 65 and up, people who have medical risk, and those in certain professions that have close contact with vulnerable populations. It’s possible that the third dose will be recommended more generally in the future as more data become available. It’s also likely that emergency use authorization for children aged 5-11 will come soon, with shots in arms starting in early November.

Recommendations on booster doses for Moderna and Johnson & Johnson are expected soon, as well as the possibility of mixing manufacturers, for example, someone who had the J&J vaccine having a booster from Pfizer. All the companies are continuing to study the vaccines for long-term efficacy and side effects, as well as safety, efficacy, and dosage for children six months through seventeen years. Currently, in the United States, only Pfizer is approved for ages 12-17.

Another helpful development is that Merck has applied for emergency use authorization of molnupiravir, an oral anti-viral to combat COVID. It would be given to patients in the early stages in hopes of keeping their illness from becoming severe. While it is already possible to give treatments by injection or infusion, such as monoclonal antibodies, this medication would be easy to prescribe and administer for home use. A decision by the FDA is expected within weeks.

Meanwhile, over the summer, COVID cases were devastating parts of the US, especially states with low vaccination rates. Total fatalities are over 700,000 with over 44 million cases recorded. In some areas, hospitals were so overwhelmed that they had to send patients out of state to receive care. This applied to COVID patients and also to patients suffering from other serious conditions. Two states, Idaho and Alaska, had to implement crisis standards of care, which means that whether or not an individual receives treatment beyond comfort care is determined by the likelihood of survival as there is not enough capacity to treat everyone that needs help. This resulted in non-COVID deaths from heart attack, stroke, etc. – patients who ordinarily would have been treated successfully but who died because there were not personnel, equipment, and space available to treat them due to intensive care units being filled with COVID patients.

The delta variant was the power behind the summer surge, but, at least, the fear of it encouraged more people to seek vaccination. The increase in vaccination rates is helping the case numbers to fall at this point. Still, the current rate of fully vaccinated people is only 57% with 66% receiving at least one dose. I am hopeful that the Pfizer vaccine being approved for elementary age children in the coming weeks will add significantly to our vaccination totals, at least in states where the vaccination rate among adults is higher.

There are still terrifying amounts of misinformation floating around about the vaccines that are keeping some people from taking them. Unfortunately, this is keeping the pandemic alive, resulting in illness, death, lack of access to medical care, and the possibility of even more dangerous new variants developing.

We are all in this together. Please, everyone, get vaccinated if you are eligible and follow reputable public health guidelines on masking, avoiding crowds, handwashing, etc. Your choices affect your family, friends, neighbors and community directly and your nation and the world, as well. We can’t truly end this pandemic until there’s no population anywhere still vulnerable to COVID-19.

If you won’t do it for yourself, do it for someone you love.

tribute to Paco

My 96-year-old father, known here as Paco, died in mid-September, but I have been struggling to write about him. A good share of that is that the writing/analytical/organizational part of my brain has been too busy with all the phone calling and notes and paperwork that follow a death, which are by turns taxing and emotional and fraught. I’ve also been trying to find peace after so many months of complex medical and care situations which I found both exhausting and traumatic. I’ve also taken a week to attend a reunion residency with the Boiler House Poets Collective at MASS MoCA, which has been helpful both in reconnecting with family history as we are from the North Adams MA area and reconnecting with myself as a poet after so many months of sneaking in poetry time only intermittently.

But in this post, I will try to tell you more about Paco and our family.

People have asked me how my Irish-American father came to be known as Paco, which sounds more Spanish. My firstborn daughter E was the first grandchild on both sides of the family. As she was learning to talk, she couldn’t manage to say “Grandpa” and – after a few instances of calling him “Bucco” – settled on Paco as his name. This became his name with all the other grandchildren and often for other family members. It was natural for me to use it here on the blog.

It was a revelation for me seeing Paco interact with his grandchildren. Because my younger sister and I are only two years apart, I didn’t remember my father as a dad to young children. Unlike so many men of his generation, he reveled in playing with very young children and singing to them. One of the great blessings of our family life is that Nana and Paco retired near us when E was three and before T was born. Having them be so close by all those years was wonderful with walks and outings and school events and concerts, theater, and dance recitals, games and carousel rides and countless volleys of ping pong in the basement. Nana and Paco gave us so much love, care, and support for so many years; it was natural that we would provide the same to them as they grew older and developed health problems.

Paco had served in the US Navy as a SeaBee in World War II and Korea. The SeaBees were the Construction Battalion – CBs, get it? – and Paco was drafted before he could finish high school. Most of the SeaBees were older men, already established in various trades, who took Paco under their wing and taught him what they knew. The skills he developed there in electrical work set the stage for his career. Paco didn’t talk much about his service when we were growing up but, in his later years, he got some SeaBee caps which he would wear out in public. I was always amazed at how many people would comment, thank him for his service, and share their own stories of service by themselves or family members. Those tributes continued into his last days. One of the first things Hospice did after admitting him was to bring a certificate and a memorial quilt square to him. We are also applying for a service medallion to be added to his memorial in the mausoleum.

Paco worked for 43 years for New England Power Company, the last 23 as Superintendent of the Upper Deerfield River in southern Vermont/western Massachusetts. I wrote the poem “Hydro Superintendent” about him for his 90th birthday. We lived in a house that was owned by the company and often visited the powerplants and reservoirs. One of his biggest accomplishments as superintendent was overseeing the construction of Bear Swamp, a pumped storage plant built inside a mountain. Paco knew every detail of that project, which brought in contractors from as far away as Japan and Switzerland. It was so much fun walking through a giant tunnel to get to the huge powerhouse with its two turbines that could generate electricity and then reverse to pump water back to the upper reservoir. I started my interest in renewable electricity and energy storage technology young, thanks to Paco.

One of the things I admired about Paco was his work ethic. He always worked hard to get the job done right but he was also part of the team, even when he was the leader. He would help the crews do emergency work rather than just ordering them to come in. He hired the first Black and the first woman into his stations which had previously been staffed entirely by white males. (Point of information: Rural New England was not very racially diverse at the time. Some areas still are not diverse now, decades later.) He was always compassionate and understanding when employees encountered personal or family difficulties. He was also not one to “toot his own horn.” I found out how well-regarded he was by his staff through others, not from him.

We admired Paco even more when we discovered he had accomplished so much with undiagnosed dyslexia. When his youngest granddaughter S was diagnosed with an inherited form of dyslexia, Paco discovered at age 80 why he had always secretly struggled with reading and writing. S and her family launched the Paco Project to raise funds for Learning Ally to help others with print or visual disabilities access the world of books. We are proud to direct donations to Learning Ally in memory of Paco.

Paco was also proud to finally become a high school graduate. I applied for his diploma through Operation Recognition, a program which awards diplomas to veterans who left school before completing their course of study. In 2008, the same year that eldest granddaughter E graduated from high school, Paco received his diploma from Drury High School in North Adams, Massachusetts, the school that he and Nana, as well as I and my sisters, had attended.

Paco’s ancestors came to the United States from Ireland but he had never visited. Nana was too claustrophobic to consider flying, but after her death in spring 2019, my two sisters took Paco to Ireland to visit.

Paco and an Irish rainbow

We were blest that all four of his grandchildren got to see Paco over the summer. We were especially grateful that granddaughter E with spouse L and great-granddaughters ABC and JG were able to visit from London UK. Because of the pandemic, we had not been able to see each other, but in August, just before the final and more precipitous portion of Paco’s decline, they were able to make the trip.

four generations with Paco, Joanne, granddaughter E, and great-grands JG and ABC

There were a few days during Paco’s last week where he was very agitated but we were fortunate to have some calmer moments. T was the only one of the grandchildren nearby enough for one final visit, which wound up being the day before he died. It was one of the most heartbreakingly tender encounters I have ever seen. T sang Irish songs to Paco and held his hands, which were still a bit restless from a medication side effect. She talked to him and I know that he could hear her because he was able to respond a bit. I admit that I couldn’t help but cry and that I am crying now as I try – and fail – to find the words to convey how special that last hour between them was.

It also happened that all three of Paco’s daughters got to spend time with him, both alone and in various pairings, on the day of his death. It was not clear that this would be his final day, so it was not that it had been planned, but I’m grateful that it turned out that way. I’m also grateful that in his last few days, I was finally able to sing to my father, something that my sisters had been doing but that I struggled to do. I sang both verses of “Over the River and through the Woods” to get to Paco’s favorite lines, “Hurrah for the fun! Is the pudding done? Hurrah for the pumpkin pie!” (Paco loved all kinds of pie.) I sang the Shaker hymn “Simple Gifts” because it is comforting to me and several beautiful Irish hymn tunes. Occasionally, I would get too choked up to continue singing but I usually managed to get through. On that last day, Paco could not respond but Hospice told us that the sense of hearing tends to remain and can even sharpen as the other senses are shutting down. My younger sister was alone with Paco when he died but I arrived soon after for my very last good-bye.

I have been so moved by the many people who have reached out to me during Paco’s decline and since his death. There have been so many kind words, both written and spoken – remembrances, prayers, thoughts, stories, expressions of gratitude for a long life well-lived. I was very touched when a friend that I made through Facebook but whom I have never met in person added my father to her Kaddish prayer on Yom Kippur. It has been the love I first learned from my parents but now experience through so many family and friends that has kept me going through all of this, even during the most difficult times. I thank all of you.

Last week, I went to the hair salon for a haircut with Diane, who has been my stylist since 1983. I told her about Paco’s death and she gave me a hug and told me that she had something to show me. It was her new puppy, who was sweetly asleep in his crate. She told me his name was Leo.

Leo was my father’s name.

a momentous visit

While my blogging has been haphazard for months due to my father’s declining health, I wanted to share a post about the recent visit of our daughter E, her spouse L, and their daughters, four-year-old ABC and one-year-old JG. As people who check in here at TJCM periodically may recall, they live in London UK and the pandemic left us unable to visit each other. This meant that when they arrived in the US, it was our first chance to meet JG in person.

All the adults are fully vaccinated, but the children are too young to qualify. While our area of upstate New York is not a COVID hot zone, the transmission rate is still high enough due to the delta variant that we were very cautious about taking the girls to indoor public spaces. While I had scaled back my expectations for the visit a lot, I hadn’t scaled them back quite as much as I should have. For example, I had hoped to see a few more friends than we were able to. Unfortunately, Paco, my 96-year-old father, had more health challenges appear and his unit at the nursing home had to go into lockdown due to a couple of COVID cases among vaccinated staff.

In a way, though, it was nice to have them in our home, doing normal, everyday things like we had when E and ABC lived with us for over two years while waiting for E’s spousal visa to be accomplished.

B, with an assist from ABC, got to bake yummy treats for breakfast.

Everyone enjoyed watching the birds at the birdfeeders. ABC especially liked the tufted titmouse and goldfinches, while others were partial to the cardinals.

We enjoyed watching other wildlife, too. ABC even spotted some deer near the back fence. We also spent a lot of time watching the bunnies eating various leaves and flowers in the lawn.

You probably can’t see the bunny, but – trust me – it’s there.

One thing that they don’t have at home in London is rocking chairs. JG especially loved the one that was her size!

JG was an early walker so we missed her being a babe-in-arms, but Auntie T did get a taste of what that phase was like when JG got so tired she actually fell asleep in her arms.

L took the girls on walks. Here is ABC at the 1 mile – or is it 1 smile? – mark on the Rail Trail. Our area, like many others in the US, has re-purposed places where there used to be railroad tracks into recreational trails.

We also got to visit the parks and carousels. Broome County has six vintage carousels and it was very nostalgic to revisit them with ABC and introduce them to JG. ABC made friends everywhere she went.

L and ABC enjoyed rides in the carousel chariot
JG loves being on the swings!
JG also enjoys being on the move!

We got to enjoy a lot of playtime with the girls. ABC, at four, has a great imagination and enjoys making elaborate scenarios. She is also quite operatic! Besides singing songs that she knows, often from Frozen I and II, she likes to make up songs while she is playing. With both her parents being accomplished singers and instrumentalists, she appears to come by music naturally. She is learning to play the piano, so we got to experience her lessons with her daddy.

ABC is also a beginning reader, so sometimes she would read to us and other times we would read to her. It was an honor to be chosen as the final bedtime story reader. Of course, she also requested a bedtime song before going to sleep.

The most important event of the trip, though, was the one visit we were able to make with Paco in the outdoor courtyard of the nursing home. ABC was being her charming self, singing and dancing and clapping for Paco.

The most precious photo is this one of the four generations.

Paco’s health has declined so much in the weeks since we had this visit that he has now been admitted to hospice care. I will be forever grateful that Paco had the opportunity to meet his second great-granddaughter who won’t remember that day and to see his first granddaughter E and first great-granddaughter ABC who certainly will.

SoCS: pins

I don’t often wear jewelry other than my wedding ring and watch, but in the summer I sometimes wear pins to keep my V-neck dresses from getting too low. 

Most of my pins are old and came to me through family. I wear a blue and gold flower one that my dad gave to my mom back at the time of their wedding in 1954.

I recently wore one that is even older. It was my maternal grandmother’s and is a cameo, a sea scene in white over an orange background.

I guess this is the point where I would take photos to add to this post, but I’m not home. I’m with Paco (my 96-year-old father) in his room at the nursing home. He is continuing to decline and a hospice referral went in yesterday. The admission process will probably take awhile given that this is a holiday weekend in the US. I’ll try to post updates going forward but my track record is not great. Everything is too unpredictable.

*****

Linda’s prompt for Stream of Consciousness Saturday this week is “pin.” Join us! Find out more here: https://lindaghill.com/2021/09/03/the-friday-reminder-and-prompt-for-socs-sept-4-2021/

SoCS: again with the complications

My life is beyond my control.

The latest wrinkle is that, just as we had worked through the latest set of medical complications with Paco and thought we could arrange another visit with the UK branch of the family before they return to London next week, there were not one but two breakthrough COVID cases discovered in the nursing home staff and the unit is closed to visitors, probably for two weeks.

Because Paco is considered a compassionate care case, we still have limited visitation, but visits need PPE, including N95 masks, and are restricted to no more than two people for about an hour per visit.

Not conducive to visits with a one-year-old and a four-year-old.

We were blessed with an outdoor visit last week and have some pictures to prove it.

That will have to do because I have no control over the situation.

Just hoping that Paco will be able to stay medically stable while we get through this period. He is fully vaccinated, of course, and everyone will be tested multiple times during the lockdown. Fortunately, he was not in close contact with the staff members who tested positive and who were doing the right thing by being fully vaccinated but the delta variant is even more formidable than the original form of the virus.

So, we’ll just keep on doing everything we can.

Even when it’s not ever enough.

I guess “enough” is not a valid concept here.

Even when the best we can do is not close to the best we had hoped for.
*****
Linda’s prompt for Stream of Consciousness Saturday this week is to begin a post with My. Join us! Find out more here: https://lindaghill.com/2021/08/27/the-friday-reminder-and-prompt-for-socs-aug-28-2021/

Pfizer vaccine approval

Today, August 23, 2021, the United States Food and Drug Administration has announced the full approval of the Pfizer/BioNTech vaccine against SARS-CoV2, the virus that causes COVID-19, for people aged 16 and up. People aged 12-15 are still being immunized under the emergency use authorization. It is also expected that, in the coming weeks, Pfizer will apply for emergency use authorization for children aged 5-11. Research is ongoing on children 6 months-4 years. Also, most adults will become eligible for a third dose to boost immunity, given from 8-12 months after the second dose.

Meanwhile, both Moderna and Johnson & Johnson, the other two vaccines available under emergency use authorization in the US, are continuing their research and applications to expand their age ranges and gain full approval, too.

It’s possible that, for some people who have been reluctant to be vaccinated, the full approval of the Pfizer vaccine might be enough to convince them to receive it. The US has seen many more shots being administered in recent weeks as the delta variant has surged and people realize that nearly all the people being hospitalized and dying are those who were unvaccinated. Unfortunately, it takes several weeks to build immunity from the vaccine so the delta surge will likely continue into the coming months.

The other expected impact of the full approval of the Pfizer vaccine is that more employers may mandate that their workers be immunized before returning to in-person work and more businesses may require immunization (or alternatively a recent negative test) for their patrons.

As regular readers may remember, my spouse B, daughter T, and I are all part of the Pfizer Phase III trial for the vaccine. B and T were lucky enough to receive the actual vaccine in August 2020 while I wound up being in the placebo group. When the vaccine received emergency use authorization, the study was unmasked so that people in the placebo group could receive the vaccine, which I did in February 2021. I will continue to be followed as part of the original study through August 2022. B and T, meanwhile, have entered into the third dose phase of the study. They will be providing data for the continued study of how much immunity boost occurs with the third dose and how long it lasts.

I continue to mourn for all those who are suffering as a result of the pandemic. Please, everyone, listen to the public health specialists in your area, receive the vaccine as soon as it is available to you, and mask, distance, and wash hands as directed. Please, do everything you can to protect the health of yourself, your loved ones, and your community.

SoCS: blogging mode

A few days ago, I posted about going into a new blogging mode.

I shouldn’t have.

While I did manage one post in line with my new mode, a complication has arisen with Paco’s health. I’ve had very little sleep and no real idea of what today will bring.

This is where I would usually say something like “stay tuned” but I have no idea if it will be a few hours or a few days or longer before I have an opportunity to post again – about Paco or anything else.

I’ll be heading over to the nursing home as soon as we get to a reasonable hour – unless the phone rings before a reasonable hour arrives…

*****
Linda’s prompt for Stream of Consciousness Saturday this week is “ode or a one or two syllable word that rhymes with ode.” Join us! Find out more here: https://lindaghill.com/2021/08/20/the-friday-reminder-and-prompt-for-socs-aug-21-2021/

an update and a plan

I have been posting less than usual over the last couple of months as we have been dealing with health difficulties with my father, known here as Paco. He had a couple of falls in June, resulting in some cracked bones, which have been healing well while he has been in a rehab program. Unfortunately, he also suffers from dementia, which has worsened, and from a number of other health conditions, which are not unexpected in a 96-year-old but which have necessitated remaining in a nursing home rather than being able to move back to the assisted living floor where he lived previously.

It has taken a lot of time with in-person visiting and inordinate amounts of time dealing with paperwork and red tape. My sisters have been coming into town to help, but I am still not finding time to write as much as I would like.

On Monday, I’m happy to report that the UK contingent of our family – our daughter E, her spouse L, and their two children 4-year-old ABC and just turned 1-year-old JG – arrived from London for a two week visit. It is our first opportunity to meet JG in person. She is adjusting to our actually being flesh-and-blood people rather than images on a screen. It’s amazing that she is able to deal with being a different place with different people after being in lockdown so much of her life, especially when you consider it took two large airports, a plane, and the longest car ride of her life to get here. Also, five hours worth of jetlag. It’s also amazing how much ABC remembers from when she lived with us, given that this is her first time back here since she moved to the UK in October 2019.

Because of the delta variant’s prevalence, we haven’t ventured much from the house over these last days and probably won’t be taking the children to many indoor spaces, given that they are too young to have been vaccinated. We do plan a visit to Paco later this week. When the weather is better, we will also be able to go to the parks and take rides on the carousels for which Broome County is known.

My younger sister is here visiting and helping with Paco and my older sister and her spouse will arrive next week for a few days. My plan is to carve out a bit of time for some posts which will update topics about which I frequently post; I’m hoping to be brief, which is always a challenge for me!

Let’s see if I manage to follow through with this plan…

SoCS: a week

What a topsy-turvy week it has been with my dad!

I can’t bear to go through the details but I will say that things appear to be on an upswing at the moment with some hope for stability on the horizon.

There will be a rare event to end the week, though, as B and I will be attending the wedding of two of my poet-friends this afternoon.

Best wishes to the happy couple!

*****
Linda’s prompt for Stream of Consciousness Saturday this week is “wee”. Join us! Find out more here: https://lindaghill.com/2021/08/06/the-friday-reminder-and-prompt-for-socs-aug-7-2021/

SoCS: blue

Since I was a child, my favorite color has been blue.

The color of my eyes and my mom’s and dad’s and sisters’.

The color of the sky at midday.

The color of some of my favorite clothes, although not jeans, which I never learned to like wearing.

I still like blue. I’m wearing it today.

But today, thinking of blue makes me think of how I’m feeling.

Blue.

Most of my #SoCS posts in recent weeks have been giving updates about my father, who is struggling to recover from falls, broken bones, infections, and we aren’t totally sure what else, while dealing with dementia and the wear and tear of ninety-six years.

I am doing everything I can to keep him as comfortable and content as possible and he is doing much better than he was ten days ago. We finally have the rest of his things in his skilled nursing/rehab room.

His Irish-themed banner and plaque are on his door, which makes it easier for him to find his room in the hall of similar-looking doorways. We finally got a temporary phone number working, although he needs help to answer calls and we aren’t sure if he can re-learn how to dial.

Baby steps.

It’s just hard for me not to feel blue. As much as I understand that this is just the journey we have been given in this last period of his life and that we are doing everything we can for him, I can’t help but feel sad.

All the time.

It’s hardest when I am with him, although I have a really good game face and manage to be cheerful – or seem cheerful – when I am interacting with Paco. He is sleeping quite a bit, which is probably good. Most of the time, he isn’t really aware of how much he has forgotten, so he is not blue, which is a blessing.

I am blue for both of us.
*****
Linda’s prompt for Stream of Consciousness Saturday this week is to use “color/colour” as a noun or verb or choose a color to write about. Join us! Find out more here: https://lindaghill.com/2021/07/23/the-friday-reminder-and-prompt-for-socs-july-24-2021/