Dear EndGame, I for one have been patiently hoping to see one of your updates; this one is really quite remarkable. I'm so pleased for Maryanne and for you.
I noted your remark 'why would I tell her that this is wearing on me? That is between my therapist and me'. This, while she had told you she'd noticed your tiredness. Sibling relationships, eh?! Often just as full of undertows and so forth as any others. Hard to navigate even in good times, let alone the really hard times.
I only mention it because, in the months soon after my sister died - and I was finding it difficult to connect with our eldest sister on much of a level at all - I read dear old Dorothy Rowe on siblings (from the library, so I don't have it to hand).
Probably that's a non sequitur in this context....
Still, I believe you'll take it as in good faith, and with great concern for you. You're an excellent chap.