Another fear has been bubbling up inside me just this past week or so. This has to do with my process of dying. We know the likely cause of death for me will be liver failure. That will be more clear after my medical appointments on 5/8 and 5/10, but it's the reasonable educated guess at the moment. The more I learn about liver failure, the more afraid and concerned I become about the experience of my last months of terminal decline.

It seems more likely than not that I will encounter mounting cognitive deficits and emotional problems. The mechanism for this is rising levels of toxins in the bloodstream as liver function declines, especially ammonia buildup across the blood-brain barrier.

Which led me to think about this blog. I'll probably keep posting, trying to narrate my experience, until I simply cannot. I now have this vision of a very public decay, my perspective narrowing and my peevishiness rising, my vocabulary becoming constrained and my patience failing, dementia and delerium taking over my discourse. Like reading the last parts of Flowers For Algernon.

What will I be reduced to before the end? How will it read to my friends and family and my audience here?

I am not ashamed. I will not hide this from the written record of my life. It just feels, well, potentially tragic. And fills me with great sadness that I might go out with an extended whimper.

So many things to be sad about as the options close off and the future both narrows and shortens before me.