Daniel's Christmas Letter: Christmas Eve, 2022

 

 

 Dearest Daniel,

I know I haven’t been very available lately. As you know, your brother Matthew passed in his sleep seven days before the fourteenth anniversary of your own departure from Earth. Losing a second son has been difficult, and also very surprising. In some ways, the time of year, was like your passing, but in many other ways it was quite different. You went from being awake and conversant and collapsed and died quite quickly. I was able to try CPR, but I got nowhere. We had trouble reaching EMS on the phone that day, and it took twenty minutes to get someone out to help and to get an AED. This time, Matthew had gone to sleep late the night before and also had been perfectly fine. He passed sometime in his sleep, probably in the early morning hours. With you, we knew right away, but with Matthew, it was likely hours before we knew, because it wasn’t unusual for him to sleep late after being up late the night before. This time, I wasn’t able to try CPR, and the AED we bought to keep here in the house could not be used because Matthew had been dead too long. This time was also different in that when we called for help, the dispatcher answered immediately and a paid EMS crew, no helicopter this time, arrived at the house in what I believe was about four minutes. With you, I was in shock, and I didn’t cry until your body had been taken from the house. With Matthew, I knew too quickly this horror, and I cried immediately. I was less together this time. With you, I felt your spirit was probably hovering above the room and that you needed me to handle everything, and that I might frighten you by descending into tears and hysterics and so I didn’t. With Matthew’s passing, I felt that it had occurred possibly hours ago and that he’d followed you to Papa Lawrence and to God as soon as he could. I felt terrible that I had not known in time to try to save him.

This time was also different in that the medical examiner declined to examine you last time. We procured a private autopsy, which didn’t really give us much other than a cardiac arrest potentially due to a potentially hereditary sudden arrhythmic condition, such as Long QT Syndrome. This time, the politics of sudden death is quite different and the medical examiner claimed jurisdiction. We never did receive a phone call from them and we waited a week through Thanksgiving. Eventually, we transferred Matthew to the same location that did your autopsy. We still don’t have a report, but we surmise from the things said that could be related to the flu shot he had received 38 hours prior to dying in his sleep.

Yes, we are all deeply sorrowful for this turn of events. We also tried to correct the things Matthew had not liked in your Celebration of Life, and had one for him that would have been more to his liking. I believe you both saw what we tried to do there.

Please know that although it is desperately difficult to have half our children beyond our own horizon, we know that you and he accept that we all belong to God and that we return to Him. I don’t know why God chose to call each of you, but I know we will all eventually be together again. Until then, you are both still our sons, and we will see you again. Please know we will continue to do our best with your siblings, your niece and nephews, and your animals, some of whom are still alive from your own time, Daniel.

Please know that we love you, Matthew, and my Dad with all our hearts. You also have your Dad’s parents there, who knew Matt and loved him very much. They both passed before you were born. There are other ancestors there who can also guide you. Please tell Matthew what I have said in this letter, and tell Papa Lawrence also. Matthew’s friends also miss him a great deal.

Merry Christmas Daniel, and everyone. I still remember our last big hug as if it were yesterday.

 

  Love, Mom

 

Sudden Death Strikes Again.

           

                     It is with great sorrow that we announce the passing of our beloved son Matthew.  Matthew died suddenly, as of yet uncertain cause.   Matthew had a flu shot two days before his sudden passing, but it is also fourteen years ago this week that his younger brother Daniel, died suddenly of what is surmised to be Sudden Arrhythmic Death Syndrome.   Matthew had been worked up for this following Daniel's death, as were his other siblings, and although one sibling had a cardiac ablation as a result, Matthew was felt to be clear of such a problem. In this life, there are no guarantees.

                  We await autopsy results, and pray they are definitive.

                     Matthew was in his early thirties and had worked as a Cybersecurity Engineer, and most recently as a Fire Alarm Design Engineer.  He was a terrific son, brother, uncle and great friend.  His passing is a great loss.

https://www.forevermissed.com/matthew-d-krehbiel

       

Perhaps an Answer

                

 

      Any parent who loses a child here on Earth carries a certain amount of insensible guilt.  God gives us a child, and our first obligation is to try to keep that child safe in a world that is full of hazards, at almost every age. The challenge, which is to love, educate and teach that child not only to live in the world but to flourish in it, is a large one.  So, we look for the best schools, the best churches and the best doctors, and even then sometimes, we miss something, or something somewhere goes awry.

             I remember the day Daniel died as if it were yesterday. One moment my extremely bright youngest son was talking to me, and the next moment, I heard a crash in the bathroom. I found him in a full cardiac arrest, and I began CPR. I asked other family members to call 911 and ask for the medical helicopter for a child in a full cardiac arrest. I remember wondering what could possibly have done this to my healthy child who'd had a clean physical just a couple of weeks before.

            Despite the sheriff's office using the AED and a very competent team of professionals from the helicopter, we were not able to restart Daniel's heart at any point during his code.  This has always bothered me because I have been lucky.  In the hospital setting or outside it, I have never had a patient who received immediate CPR for a witnessed cardiac arrest, not respond. (Although in all honesty, I might have gotten them back only to have them die later that day.)  It has always bothered me that Daniel did not respond in any way to the CPR. It was as if he were gone when he hit the floor.

           As longstanding readers will recall, initially his autopsy was very good. His coronary arteries were as clean as a whistle, which is not true of a number of 12 1/2 year old American children. His brain was normal, although they were some incidental findings that did not cause death. Pathologists were left with a healthy child who was clearly dead.  Daniel was made a teaching patient, and different pathology teams at a world class teaching hospital each took a crack and what might have happened.  Because Daniel had entered the bathroom, vomited, collapsed and fallen forward, the pathologists felt that this had likely been a sudden arrhythmic death, which is basically a spontaneous disruption of heart rhythm of unknown cause.  While toxicology was sent, the doctors used the time to question our family on other cardiac or arrhythmic deaths among our relatives, or other arrhythmic disorders among those who remained living. I shared that we had a fair amount of atrial fibrillation among the over age seventy members of the family, although no one we knew had died in the manner of Daniel.   Eventually, because sudden arrhythmic death syndrome or the other diagnosis SUDC, which is sudden unexplained death in childhood, are disorders from a functional problem not a structural one, and nothing of any interest was yielded from toxicology, Daniel's passing was attributed to a sudden cardiac arrest of uncertain etiology, or cause. His DNA and other samples were sent to the Mayo Clinic who was studying whether he might have one of the many identified familial causes sudden cardiac arrest. Some of these are Brugada Syndrome, Wolff-Parkinson-White Syndrome, Long QT Syndrome, Short QT Syndrome, etc.  A long time afterward, Mayo Clinic communicated that Daniel did not show evidence of any of the familial arrhythmic syndromes that could be identified from DNA samples at that time.  Perhaps he had a syndrome that has not yet been identified, they speculated. (Of course, this began the odyssey of having our remaining children examined and having a preventive cardiac ablation done on one of them.)

          Fourteen years later, I am still left with the feeling that I have missed something, and that this is somehow my fault, even to some small degree.  Since then, some clues have emerged within the remaining family.  There are family members who have erythropoietic protoporphyria (EPP), some with Crohn's Disease and one with cystic fibrosis.  All of these disorders are associated with, or can lead to a Vitamin D deficiency.  Interestingly, even as a young person, I have been found to have a very low Vitamin D level at intervals. I have also been fairly resistant to having this corrected, requiring relatively large amounts given over a long period of time before it is corrected.  How could this be ? I have asked.  The answer I get is that some people lack the enzyme to manufacture Vitamin D from sunlight and cholesterol.  No one asked whether this could have been a familial issue.  Even if it had been, there had not been an association between low Vitamin D levels and sudden arrhythmic death. However, there is now.

            Recent studies have shown that people, including children with low Vitamin D levels have a much higher rate of dying from a sudden episode of arrhythmic death.  If Daniel had a familial tendency to have low Vitamin D, coupled with a missing enzyme in order to make Vitamin D from sunlight, could this be the missing part of the puzzle ?   Physicians do not routinely test for Vitamin D levels, and they don't often check in children. There was no known reason to check, and at the time, no known association with sudden arrhythmic death. It is only now that we know from several recent studies that low Vitamin D is associated with ionic channel disorders which can lead to sudden alterations in the EKG such as the QT interval.  

             For those of you who have a medical or personal interest in this, this is one of the authoritative articles, which I believe is the easiest to understand.

 

 https://journals.viamedica.pl/kardiologia_polska/article/download/82363/61698

 

             When Daniel died, we had not had history with other family members that indicated that we were all Vitamin D deficient.  We all took vitamins, except for Daniel who wouldn't swallow pills and was not sold on taking his chewable Flintstone's vitamin daily.   I do so wish I had known this.  In 2008, physicians did not suspect that any of us were low in Vitamin D, and perhaps they didn't even know of familial Vitamin D use disorders.

             It is my hope that this post reaches someone that it may help.  Some of us persist in having low vitamin D levels even when supplemented, and this may require regular monitoring as well as prescription amounts of this vitamin.  To simply blindly replace Vitamin D without proper monitoring may be equally dangerous.   If you suspect this is an issue for your family, please see your doctor and ask for a Vitamin D blood test.

 

 

An Update on Daniel's Cat "Tosh"

        

 

     The original post concerning "Daniel's cat" Tosh, was written thirteen years ago tomorrow.

 Tosh is now a mature cat, still has occasional respiratory allergies and is doing very well.

 

 

 As you may remember, the last thing Daniel and I spoke about before his passing was a cat. We spent the prior day, Thanksgiving with my eldest son Adam's fiancee and her family, and they had a remarkable cat named MacIntosh, which they call Mackie. Mackie had been rescued by Adam's fiancee's sister and myself from the inner workings of a new car at the Post Office. I had been unsuccessful and Adam came with tools and the owner of the car was gracious enough to let him remove and reattach parts in order to save the little cat. Despite his cat allergy, Daniel became quite attached to MacIntosh and took Claritin in order to play with him. Of course, I had to turn down Daniel's request for his own cat. He accepted this, due to his allergies, and a moment later, he went into the bathroom, and passed away.
Yes, those of you who attended Daniel's "Celebration of Life" saw a cat in a carrier politely and seriously enduring his funeral, and that was MacIntosh.
A couple of weeks ago, a friend of Daniel's and mine, gave us a kitten. It is a cat that resembles MacIntosh a great deal. This cat will be raised as "Daniel's cat" and will be loved and cared for. Eventually, when his full life is complete, he will pass and become Daniel's very own cat. Meanwhile, "Daniel's cat" is bringing great joy here. He is named MacIntosh II, or "Tosh" for short. This cat is similar, though not identical to MacIntosh the First in appearance, and I think is a bit more active and perhaps more of a mouser.

A Culture in Decline

               

 

         Some years ago, our family lived in a lovely neighborhood in a Virginia suburb. We had four large bedrooms, a full finished basement, an acre lot, and it was an ideal home for homeschooling.  It also had the benefit of having been my in-laws home. When they had died in their fifties, and my husband had inherited a quarter of the home, he financed the remainder and bought his siblings out. My in-laws would have been happy to know that their grandchildren would be growing up there. This enabled us to have the space we needed to raise our family without a high mortgage.  Daniel was born while we lived in this lovely home.

                  Although we lived there for a few years, our disillusionment with the area began fairly quickly. It was a good neighborhood, but almost immediately, strange things happened, that had not been happening in the neighborhood our last house had been, even in the same county. At our new colonial, children would show up during the school day and tell us that their mother had said that if they were ever sent home from school sick that they were to come to our house, because we were the only home where someone was home during the day. We wouldn't have minded this had a prior arrangement been made, but we had no idea who these children or their parents were, and we had intended to go to a dental appointment one of those days.  We became aware of a number of homes where domestic issues were common. We also had a schizophrenic man come to the door one day claiming that "People in the neighborhood wanted him dead".  Once, a beautiful mailbox flag I had hanging beneath the mailbox was shredded, most likely with scissors.  As time passed, there were more and more feral children running through the neighborhood, seemingly without any sense or supervision.

                When Daniel was one, we bought large acreage in another part of the state, built a smaller home than we had in the suburbs, and moved. We wanted the children to have the opportunity to have livestock, and to gather skills that are most often learned in rural environments.  We also wished to head off their becoming good consumers, which had already been happening.

                 Our children thrived both academically and socially in an intensely rural environment, and I know we did the right thing.

                 Tonight I am sad to learn that in the very same neighborhood with the beautiful colonial where we once lived, that there has been a mass shooting. According to police, there was a party where there was a fight. Police were called, but while they were en route someone was shot. Many were shot and at least one has died. At least four different weapons were fired during this altercation.  Someone was killed on the very same road in which my children rode their bikes when fairly young.

                 The problem is not firearms, just as collecting all the steak knives, hammers and tire irons wouldn't change it. The problem is a culture in decline. The problem is that no one is home to raise children. Mothers are working, parents are divorcing, and day care centers can't be parents to children.  Children are growing up to have no acquisition of empathy, and are connected only to a violent and vicious peer group collective via phones or computers. The culture is annoyed by children, doesn't understand them, and does not defer pleasure to do what is right for them.  We saw this at the end of the nineties, and the shootings are simply a symptom of it.

                  Please pray for our nation and particularly for its children.

Happy Birthday, Daniel 2022

 

This is the posting to your twenty-sixth birthday. Somehow, we are almost fourteen years from the date of your sudden departure. We still miss you very much. Yesterday, your nephew lamented to your sister that he missed you. It seemed a ridiculous thing to say, even for a young child because he had never known you on Earth. However, you departed at the end of 2008, and he came to Earth in 2014, and so there may have been time between 2008 and 2014 for you and he to get to know one another. Perhaps he is telling the truth when he says this. Please know that no matter how long you have been gone from here that we still think of you daily and we miss you and Papa Lawrence. Sometimes, I allow my mind to drift and wonder what you would have done here on the Earth had you remained. There are a lot of situations on the Earth that have deteriorated since your departure, in politics, in medicine, in government, and in education. Sometimes, I am pleased you were spared some of this on the particularly bad days. You are always my son, and I always love you. Sometimes, when something momentous happens, like when I met your newest nephew for the first time, I feel your spirit beside me. I love you deeper than the oceans, and wider than the seas.

 

 

 

A Missing Month

             

                         Photograph taken by the Richmond Times Dispatch on Interstate 64 which has fallen trees on both sides of the highway.

 

   I hadn't meant the entire month of January to fly by without any postings anywhere, and yet this is exactly what has happened.  The entire family caught a non-COVID influenza like illness which felled everyone like trees just after Christmas.  Just after, an unexpected storm with very wet snow and ice occurred overnight causing actually trees of all kinds to break wiping out everything from power lines to telephonic pedestal boxes and rupturing the actual roofing of many.  The result was a bit more than a week without electricity, and a bit more than two additional weeks without landline phone, cellular phone and internet.  A couple of additional storms made both restoration and getting out again less likely.

                  We pumped water for ourselves and the farm animals using the generator, and we ran the generator for a few hours each day, but shortages of diesel and propane meant that we could not run anything for very long.  In addition, shortages of hay for horses, dog and cat food make life difficult for us when we did get out again.

                Please check on your family and friends in the American Southeast.  This has been an uncommonly cold and difficult early Winter, even without the complications of supply line disruptions and fears for COVID.

                 Frankly, I'm glad Daniel missed this month here on Earth !