It's 8:30 a.m. and you have already been up and are back to sleep. On another cancer patient this behavior might look like cancer is weakening you. Cancer hasn't really changed your sleep patterns; they have always been weird. Throughout our lives you have risen at odd hours, done some usual and unusual tasks, and gone back to sleep when the rest of the world is waking from its typical, solid, uninterrupted eight. I know a lot of men have to get up once, twice, maybe three times a night, and you do too. But this is different. You get up, go out into the family room, read, check email, watch TV, meditate, and return to bed for a couple more hours of sleep. When I work, you get up, make my coffee, make my breakfast, sometimes make my lunch, see me out the door, and then return to bed. Cancer has maybe enhanced this routine by extending the time you spend in bed. Your naps are longer, you are less-likely to suffer periods of true insomnia, and your nap clusters are longer after your chemo days when fatigue occasionally colors your whole world.
Laura is here. She stayed on after Kyle returned to work, and she and I will indulge your every wish today. We talked about bike riding and having brunch out. I am excited for this day. The weather is perfect, and I am on Spring Break. Glorious, fabulous, blissful Spring Break, two weeks of freedom from rising early, running full-steam and wrangling the spectrum of five-year-old behaviors.
We celebrated with a small dinner party last night. We had initially planned another one for Saturday evening but I hadn't fully recovered from my flu, and you canceled it because you didn't like the way I was looking. I was edgy and unhappy because you had created more of a mess in the house, and that meant I was going to spend Friday evening and Saturday cleaning. You rescheduled for two weeks from now. That works for me, and my aunt and uncle will be here from Boise. It could be even better. It will definitely be better. But I have a problem with the way it went down, and I will address it later in this blog. I have already addressed it with you. Last night we had pistachio-encrusted seared ahi, garlic mashed potatoes, Mediterranean veggies, and THE butter almond cake. Suzin brought appetizers, and I had some Guggisberg cheese left from my cousin's last visit. I had originally planned on wasabi mashed potatoes, but you said wasabi is no longer agreeing with you. With only six of us, it was a relaxed, intimate evening that required no putting on of appearances. The flowers from our front walkway were stunning in the rounded vase I used. We all fit comfortably around the table. I would like to feel that relaxed at all our gatherings.
My friend from my childhood, Debbie, finished her paintings of Matt and Quincy. They were even more perfect than they had been last week. Debbie always tries to capture an animal's personality by including a favorite toy or something that illustrates what the dog likes to do. We had talked about putting in some kind of food but instead she painted them sitting in front of our house, with the irises in full-bloom going up our walkway. They are incredible! And with her artistic touch, she painted Quincy in front of the left side of the house, and Matt in front of the right side, with both portraits ending at the front door. I was deliriously happy when she brought them over yesterday! Do we frame them together, or separately? Each is 10" x 10". We gave them to you after dinner. You want them framed together; I think separately would accentuate the way the house is divided exactly in the middle. She even painted the screen door with the sunburst in it. I couldn't be happier. Finally a gift you won't return.....
Monday, March 29, 2010
Thursday, March 25, 2010
Another Flying Week and You're Almost 65
Writing a blog about your so-called 'terminal' cancer really isn't something that can be done in isolation. The rest of life weaves its way in and out of my writing. Does it interfere? Or is life a tapestry that can't be unraveled? Dad, dogs, family, work, friends, the flu. They become inextricably woven together. They will all spill into this blog at one time or another. But your cancer is the unspoken dye that colors everything now. We don't get to choose whether or not we can remove it. This cancer is not a choice. Pancreatic cancer never goes away. "We" have cancer. Our lives have cancer. And when the cancer is gone, there will be no more "we". Then, maybe then, I will have a life free of cancer, but "we" never will. When my life no longer has cancer, it will no longer have you.
You wore your fanny pack for 48 hours. It emitted a gentle little 'whirring' sound every so often. You were slightly nauseous at times, but never enough to throw up. In the end, after the pack was removed, I asked what the side effects were, and you said fatigue, headache and not much else. They want you to do this 16 times. Every two or three months they will do a CT scan to check the tumor size. If they are able to shrink it to half its size, they will do the surgery. The procedure will take 10-12 hours and you will be in the hospital for two weeks. If they are unable to shrink the tumor and do the surgery, the tumor will at some point in time grow enough to choke off the blood supply to your entire intestinal tract. I don't know what we will do then. With my counselor's help, I have decided not to think about that. Your next fanny pack was supposed to come on Monday, your 65th birthday, it will have been two weeks, but they are letting you do it on Tuesday instead.
Beth came down on Friday. She took a long shower and then you dropped her off at the health care center to see Dad. I arrived about an hour later, we spent some time with him, and then she and I came home. She saw how much better he is now and she was relieved that if this is her last memory of him, it will be one of more clarity and mental presence. She had brought down the wonderful book his father had made for us of our family history. Dad was engrossed in it. We had a relaxing evening at home. We were able to go over Dad's business and review the plans in his trust. I hadn't really firmed up a potential appointment with Dad's financial adviser, so that didn't happen the way I had hoped. You let us have a lot of 'girl time'; you made us dinner and we soaked in the hot tub. Early Saturday morning we got up but you were gone. I thought that maybe you had gone out to breakfast with David. We got into the big van with the bikes and headed off to Starbucks. You called. You had been at Trader Joe's and wanted to go riding with us. I dropped Beth off to pick up our coffee order and came back for you. We had another gorgeous ride on the bike path, the weather was perfect but the birds weren't out for Beth to get to enjoy. We decided we would try it again on Sunday morning. Beth and I had arranged for our childhood friend, Debbie, to come over. She came by for lunch. We ended up talking for three hours before we were able to stop and visit Dad. Debbie was so thrilled to see Dad, and he remembered her and her family well. It was a fabulous reunion. We are so much alike and have had so many common experiences during the years our lives headed off in different directions. Debbie taught art in private schools for several years. She has three children, she and her husband are devout Christians, and times are tough for them. Yet she still has the same sweet, loving disposition she always had. She and I started taking violin lessons in elementary school, and she still plays in local orchestras and productions. I have vague recollections of sketching and drawing with her when we were little. She has kept that up too. When she recently quit her job as an art teacher she decided to go back to oil painting, except this time she does oil paintings of dogs. I had sent her some jpgs of Matt, Quincy and Stevie, and she painted them. They are beautiful! They look exactly like our boys, and she is adding her own artistic touch to them. It's exciting! I told her I would pay her for them. I think I finally have a gift for you that you'll like! She will bring them over this weekend. The only problem I have is a frame.....But Del makes his own, and he and Ann are coming out in two weeks.
Sunday didn't materialize the way we had hoped. On Saturday Beth and I stayed up watching 'Kitchen Nightmares' and you, she and I had a late dinner. We went to bed around eleven because we were going to go bike riding at 8:00. In the night I started feeling a dryness in my throat, then a croupy cough, and by morning I was running a fever. Oh, yuck! I hadn't come down with a cold; I had the flu! I dragged myself out at 7:45 to tell Beth. She was gracious about having to change her plans, and you drove her to the airport at 10:15. I was in bed for three days. Three days with a fever can feel both like a blink of an eye and an eternity at the same time.
It was tough to return to work on Wednesday, and my kids had been off-the-charts with their behavior. B had been wearing a belt to school and taking it off at lunchtime to use to hit the other children. Someone had removed the science experiment. I mean, there was nothing left but an empty jar. The sub had left me a note that they couldn't do the seed-growth pages for the science journals because there were no seeds growing. S was hatching a plot to have an all-out sand war. With what sand? I thought. The district removed it all because the neighborhood cats had been using it as a latrine. Then I found one area, a place where an old tree had been removed from it's island in the center of the blacktop. Somehow that circle was filled with sand. I had seen sand coming out of S's shoes. It was the first time in years I had had sand on the classroom rug. It was making sense now. He was randomly attacking others with handfuls of sand during lunch. D was bringing interesting things to school. SD was masticating the cuffs and necks of his shirts so badly. I have started calling him my 'little cloth eater'. Someone in another class had been dropping the girls' bathroom pass in the toilet every day. Julie was pissed. Someone had started peeing daily on the boys' bathroom floor in my room. As we were getting ready for lunch, the assistant principal came in the room. She was angry about what had been going on. And she told them so. She read them the riot act. I think she scared the daylights out of them, but at that point they deserved it. She told me about the belt and had B remove it and give it to me. She walked the most silent line in history to the cafeteria.
By the time I was finished with school, going to therapy and visiting Dad, I was extremely tired. When I went to pick you up from yoga at the Wellness Community, I was not in a good mood. You were 15 minutes late and wouldn't pick up my phone calls. Why do you do that? If I don't answer your calls, you read me the riot act. But you consistently don't answer mine. Is that fair???? And then if I bring it up, you act like I'm the biggest bitch on the planet. Is that fair? But that's a game you've always played with me. If I complain about something you do, you attack with swift force, trying to immobilize me, trying to shoot me dead in the water. Why do I back down? I feel I have a right to approach you in the same manner as you do me when I don't answer your calls. And the only time I don't answer your calls is when I am on a call to another person and I don't feel it's a good time to interrupt my conversation. We went to dinner nearby and ran into some minor district honchos. You weren't exactly friendly. I was uncomfortable. Once again, the woman who has never liked me was there. At least it doesn't bother me now like it did 35 years ago. I still don't think you're going to answer my calls.
The Good Wives Club had a warm meeting. I am feeling more relaxed in the group and my trust is growing. There is an affection flowing between all of us now. We are developing a kinship. Karen was back from her vacation and Janet suggested I tell her about my talk with my dad. I said I'd cry again. They said they wanted me to tell Karen. They said it would be incomplete if Karen didn't hear me tell it. They were right. So I did it again. Tears and all. And Karen was wonderfully supportive. I told them that next week I would tell them my cookie stories. They don't know that for me, telling them the cookie stories is the sign that I now trust them.
By today I had wrangled my students back into some pretty decent behavior. Teaching happened. I think some real learning happened too. I was happy. It is getting back to normal, just in time for Spring Break to come and throw them all out of their good habits.
For at least a month now, the dogs have been coming in at night. Matt was getting very upset that he was left our in the yard while Quincy was lavishing in the comfort, warmth and affection of the house, so you were bringing him inside to sleep with you in the middle bedroom while Q-ball slept with me. Quincy's paw is well enough now that we have taken the bandage off and you put him in the back yard for several hours a day. I think, I have a feeling though, that the dogs will be coming in every night from now on, whether or not they have boo-boos on their paws.
You wore your fanny pack for 48 hours. It emitted a gentle little 'whirring' sound every so often. You were slightly nauseous at times, but never enough to throw up. In the end, after the pack was removed, I asked what the side effects were, and you said fatigue, headache and not much else. They want you to do this 16 times. Every two or three months they will do a CT scan to check the tumor size. If they are able to shrink it to half its size, they will do the surgery. The procedure will take 10-12 hours and you will be in the hospital for two weeks. If they are unable to shrink the tumor and do the surgery, the tumor will at some point in time grow enough to choke off the blood supply to your entire intestinal tract. I don't know what we will do then. With my counselor's help, I have decided not to think about that. Your next fanny pack was supposed to come on Monday, your 65th birthday, it will have been two weeks, but they are letting you do it on Tuesday instead.
Beth came down on Friday. She took a long shower and then you dropped her off at the health care center to see Dad. I arrived about an hour later, we spent some time with him, and then she and I came home. She saw how much better he is now and she was relieved that if this is her last memory of him, it will be one of more clarity and mental presence. She had brought down the wonderful book his father had made for us of our family history. Dad was engrossed in it. We had a relaxing evening at home. We were able to go over Dad's business and review the plans in his trust. I hadn't really firmed up a potential appointment with Dad's financial adviser, so that didn't happen the way I had hoped. You let us have a lot of 'girl time'; you made us dinner and we soaked in the hot tub. Early Saturday morning we got up but you were gone. I thought that maybe you had gone out to breakfast with David. We got into the big van with the bikes and headed off to Starbucks. You called. You had been at Trader Joe's and wanted to go riding with us. I dropped Beth off to pick up our coffee order and came back for you. We had another gorgeous ride on the bike path, the weather was perfect but the birds weren't out for Beth to get to enjoy. We decided we would try it again on Sunday morning. Beth and I had arranged for our childhood friend, Debbie, to come over. She came by for lunch. We ended up talking for three hours before we were able to stop and visit Dad. Debbie was so thrilled to see Dad, and he remembered her and her family well. It was a fabulous reunion. We are so much alike and have had so many common experiences during the years our lives headed off in different directions. Debbie taught art in private schools for several years. She has three children, she and her husband are devout Christians, and times are tough for them. Yet she still has the same sweet, loving disposition she always had. She and I started taking violin lessons in elementary school, and she still plays in local orchestras and productions. I have vague recollections of sketching and drawing with her when we were little. She has kept that up too. When she recently quit her job as an art teacher she decided to go back to oil painting, except this time she does oil paintings of dogs. I had sent her some jpgs of Matt, Quincy and Stevie, and she painted them. They are beautiful! They look exactly like our boys, and she is adding her own artistic touch to them. It's exciting! I told her I would pay her for them. I think I finally have a gift for you that you'll like! She will bring them over this weekend. The only problem I have is a frame.....But Del makes his own, and he and Ann are coming out in two weeks.
Sunday didn't materialize the way we had hoped. On Saturday Beth and I stayed up watching 'Kitchen Nightmares' and you, she and I had a late dinner. We went to bed around eleven because we were going to go bike riding at 8:00. In the night I started feeling a dryness in my throat, then a croupy cough, and by morning I was running a fever. Oh, yuck! I hadn't come down with a cold; I had the flu! I dragged myself out at 7:45 to tell Beth. She was gracious about having to change her plans, and you drove her to the airport at 10:15. I was in bed for three days. Three days with a fever can feel both like a blink of an eye and an eternity at the same time.
It was tough to return to work on Wednesday, and my kids had been off-the-charts with their behavior. B had been wearing a belt to school and taking it off at lunchtime to use to hit the other children. Someone had removed the science experiment. I mean, there was nothing left but an empty jar. The sub had left me a note that they couldn't do the seed-growth pages for the science journals because there were no seeds growing. S was hatching a plot to have an all-out sand war. With what sand? I thought. The district removed it all because the neighborhood cats had been using it as a latrine. Then I found one area, a place where an old tree had been removed from it's island in the center of the blacktop. Somehow that circle was filled with sand. I had seen sand coming out of S's shoes. It was the first time in years I had had sand on the classroom rug. It was making sense now. He was randomly attacking others with handfuls of sand during lunch. D was bringing interesting things to school. SD was masticating the cuffs and necks of his shirts so badly. I have started calling him my 'little cloth eater'. Someone in another class had been dropping the girls' bathroom pass in the toilet every day. Julie was pissed. Someone had started peeing daily on the boys' bathroom floor in my room. As we were getting ready for lunch, the assistant principal came in the room. She was angry about what had been going on. And she told them so. She read them the riot act. I think she scared the daylights out of them, but at that point they deserved it. She told me about the belt and had B remove it and give it to me. She walked the most silent line in history to the cafeteria.
By the time I was finished with school, going to therapy and visiting Dad, I was extremely tired. When I went to pick you up from yoga at the Wellness Community, I was not in a good mood. You were 15 minutes late and wouldn't pick up my phone calls. Why do you do that? If I don't answer your calls, you read me the riot act. But you consistently don't answer mine. Is that fair???? And then if I bring it up, you act like I'm the biggest bitch on the planet. Is that fair? But that's a game you've always played with me. If I complain about something you do, you attack with swift force, trying to immobilize me, trying to shoot me dead in the water. Why do I back down? I feel I have a right to approach you in the same manner as you do me when I don't answer your calls. And the only time I don't answer your calls is when I am on a call to another person and I don't feel it's a good time to interrupt my conversation. We went to dinner nearby and ran into some minor district honchos. You weren't exactly friendly. I was uncomfortable. Once again, the woman who has never liked me was there. At least it doesn't bother me now like it did 35 years ago. I still don't think you're going to answer my calls.
The Good Wives Club had a warm meeting. I am feeling more relaxed in the group and my trust is growing. There is an affection flowing between all of us now. We are developing a kinship. Karen was back from her vacation and Janet suggested I tell her about my talk with my dad. I said I'd cry again. They said they wanted me to tell Karen. They said it would be incomplete if Karen didn't hear me tell it. They were right. So I did it again. Tears and all. And Karen was wonderfully supportive. I told them that next week I would tell them my cookie stories. They don't know that for me, telling them the cookie stories is the sign that I now trust them.
By today I had wrangled my students back into some pretty decent behavior. Teaching happened. I think some real learning happened too. I was happy. It is getting back to normal, just in time for Spring Break to come and throw them all out of their good habits.
For at least a month now, the dogs have been coming in at night. Matt was getting very upset that he was left our in the yard while Quincy was lavishing in the comfort, warmth and affection of the house, so you were bringing him inside to sleep with you in the middle bedroom while Q-ball slept with me. Quincy's paw is well enough now that we have taken the bandage off and you put him in the back yard for several hours a day. I think, I have a feeling though, that the dogs will be coming in every night from now on, whether or not they have boo-boos on their paws.
Monday, March 15, 2010
A Week Flies By....
The week went by as deliria for everyone. Dad is still in the hospital but he is much better. He has beaten the double pneumonia (Ah! If only this medical knowledge had existed when his mother had pneumonia in 1931....) but the congestive heart failure is in overdrive. The doctors, all three of them, have told me that this is not something they are able to control anymore and that this is the end. Not the end within a matter of hours but in a matter of weeks or months. Earlier in the week he was gasping for air, they couldn't infuse oxygen through his nose and he was on an oxygen mask. It was hard to understand what he was saying, not just because of the mask but because he seemed unable to control his lips and articulate distinctly. He was moved from ICU to PCCU and now today he is in a regular hospital room where he's sure to get lots of neglect from the nurses. They need to put a posey vest on him at night or he will get out of bed and try to walk around. Then, of course, he will fall. Carmi puts the vest on him when she leaves and takes it off when she gets back in the morning. He might be in the hospital one more day only. Then he will be transferred back to the health care center for skilled nursing. I hear he can be there for 20 days under Medicare. The doctors said he could come home if we had 24 -hour care for him but I didn't feel comfortable with that. He is still on oxygen and he is very weak. His heart rate is in the 80's now but even I can see the irregular beats on the monitors.
On Friday I had the first conversation with a doctor where I was told that this was the end. It made me very sad. I cried at lunchtime. I was worried that Dad didn't know how much I had valued what he did for me all those years. I was sad you had spoken for me in your conversations with Dad, had grossly misrepresented my recollections of him and the job he had done as a father. The principal and my friends kicked me out. Told me they'd take care of my class and close up my room for the weekend. I went to the hospital, and Dad was asleep for most of the time. He had visitors: David, Sonia (his beloved former secretary) and Paul. It was Paul who pulled Dad out of the fog. Paul has a marvelous way of engaging people in conversation by connecting to past experiences and tying them to the present. He kept connecting Dad, "Remember when Cathy and I were on our honeymoon and we stopped in Los Angeles and you took us to Shutters?" "Remember that time Brownie called you and told you about the fundraising?" On and on he went, and at last Dad was completely in the conversation. What a gift he has! And I wonder if he even knows what an impact he had on Dad. After that, when Dad was awake during the weekend, he was lucid. He slept almost constantly, maybe 20 hours a day, but when he was awake, he could engage in more meaningful conversations than before. His color is returning, and I say he's like an old Timex watch. Takes a licking and keeps on ticking. Of course the ticking is arhythmic, but it's ticking.
Beth and Mark drove down with Haley and Maddie (the terrier) but could only stay about 15 hours. They/We weren't sure how much time we had left with Dad. He was somewhat incoherent during their visit. They were not sure how much he understood of what they were saying. They had to get back home. But since then Dad has improved, and Beth will come back down this weekend. The weather will be beautiful, we will have more time.
I rode my bike both Saturday and Sunday. It was too perfect to describe. I had my iPod on and listened to music, mostly my WOW 2008, and had what I consider to be incredible worship time. It couldn't have been more right for riding. The sky was all blue, there was no wind, there were very few pedestrians cluttering the bike path, and it wasn't too warm or too cold. The wildlife was out! Egrets, pelicans, grebes, mallards. I am beginning to understand why Dad has been a birdwatcher since college. Birds are starting to fascinate me. I told Beth to bring clothes and shoes for biking, that I was going to take her on a ride that would be like heaven on earth.
It wasn't until Sunday morning that I had time alone with Dad when he was awake and alert enough for me to thank him for the job he did parenting me. I thanked him for being the one person who always kept his promises to me, for being trustworthy and reliable, for loving me when I didn't love myself, for believing in me when I felt like an utter failure, for telling me I could learn anything I wanted and that I was brilliant, for supporting me emotionally and financially, and for being my biggest fan. I told him that if it hadn't been for him, I don't know what I would have become. I told him I loved him both before and after I said it. I cried but didn't sob or lose my composure. And when I was done, he looked at me with the most loving eyes and nodded. It was one of the most beautiful moments of my life. I am so incredibly glad I had that moment with him. I looked up at the clock. It was 9:00 a.m. on March 14, 2010. I will remember that moment forever.
Our long-awaited trip to the oncological surgeon was not what we had wanted. Although your tumor hasn't grown, it's still too large to perform the surgery. He does a nice bypass where he takes some femoral artery or something and grafts it to the SMA above and below the tumor. He can do it if the tumor isn't too large. Yours extends down too far. He would have to miss several of the branching vessels that feed blood to the intestinal tract and he said you would not like that at all. He said your quality of life would be so bad that you would hate him. You would have pain, discomfort, and a severely impaired ability to digest food. Probably a ton of dead intestinal tissue too. Therefore you will have to undergo two or three months of chemo with the hope of shrinking the tumor and doing the surgery then. If that's the case, then you will be on chemo from the middle of March until the beginning of June, and surgery and recovery would go from the beginning of June until sometime in August. And that would only be if the chemo shrinks the tumor enough for you to have the surgery. It doesn't seem like a long shot to us now.
On Thursday you went in for a mediport. It was a minor surgical procedure but they wouldn't let you drive yourself home. I 'picked you up' at lot C at the hospital and drove you to where you had parked your car. You drove yourself home and have been basically fine but caught a cold the next day. At first I didn't know if you were reacting to the procedure but it seems you might really have a cold. Today you got your first go around with the new chemo: two hours in a chair at the oncologist's office and the rest of the 24 hours with 5FU on a pump. You are wearing a fanny back. Laura would say you're a geek. Today you're a brave nauseous geek.
On Friday I had the first conversation with a doctor where I was told that this was the end. It made me very sad. I cried at lunchtime. I was worried that Dad didn't know how much I had valued what he did for me all those years. I was sad you had spoken for me in your conversations with Dad, had grossly misrepresented my recollections of him and the job he had done as a father. The principal and my friends kicked me out. Told me they'd take care of my class and close up my room for the weekend. I went to the hospital, and Dad was asleep for most of the time. He had visitors: David, Sonia (his beloved former secretary) and Paul. It was Paul who pulled Dad out of the fog. Paul has a marvelous way of engaging people in conversation by connecting to past experiences and tying them to the present. He kept connecting Dad, "Remember when Cathy and I were on our honeymoon and we stopped in Los Angeles and you took us to Shutters?" "Remember that time Brownie called you and told you about the fundraising?" On and on he went, and at last Dad was completely in the conversation. What a gift he has! And I wonder if he even knows what an impact he had on Dad. After that, when Dad was awake during the weekend, he was lucid. He slept almost constantly, maybe 20 hours a day, but when he was awake, he could engage in more meaningful conversations than before. His color is returning, and I say he's like an old Timex watch. Takes a licking and keeps on ticking. Of course the ticking is arhythmic, but it's ticking.
Beth and Mark drove down with Haley and Maddie (the terrier) but could only stay about 15 hours. They/We weren't sure how much time we had left with Dad. He was somewhat incoherent during their visit. They were not sure how much he understood of what they were saying. They had to get back home. But since then Dad has improved, and Beth will come back down this weekend. The weather will be beautiful, we will have more time.
I rode my bike both Saturday and Sunday. It was too perfect to describe. I had my iPod on and listened to music, mostly my WOW 2008, and had what I consider to be incredible worship time. It couldn't have been more right for riding. The sky was all blue, there was no wind, there were very few pedestrians cluttering the bike path, and it wasn't too warm or too cold. The wildlife was out! Egrets, pelicans, grebes, mallards. I am beginning to understand why Dad has been a birdwatcher since college. Birds are starting to fascinate me. I told Beth to bring clothes and shoes for biking, that I was going to take her on a ride that would be like heaven on earth.
It wasn't until Sunday morning that I had time alone with Dad when he was awake and alert enough for me to thank him for the job he did parenting me. I thanked him for being the one person who always kept his promises to me, for being trustworthy and reliable, for loving me when I didn't love myself, for believing in me when I felt like an utter failure, for telling me I could learn anything I wanted and that I was brilliant, for supporting me emotionally and financially, and for being my biggest fan. I told him that if it hadn't been for him, I don't know what I would have become. I told him I loved him both before and after I said it. I cried but didn't sob or lose my composure. And when I was done, he looked at me with the most loving eyes and nodded. It was one of the most beautiful moments of my life. I am so incredibly glad I had that moment with him. I looked up at the clock. It was 9:00 a.m. on March 14, 2010. I will remember that moment forever.
Our long-awaited trip to the oncological surgeon was not what we had wanted. Although your tumor hasn't grown, it's still too large to perform the surgery. He does a nice bypass where he takes some femoral artery or something and grafts it to the SMA above and below the tumor. He can do it if the tumor isn't too large. Yours extends down too far. He would have to miss several of the branching vessels that feed blood to the intestinal tract and he said you would not like that at all. He said your quality of life would be so bad that you would hate him. You would have pain, discomfort, and a severely impaired ability to digest food. Probably a ton of dead intestinal tissue too. Therefore you will have to undergo two or three months of chemo with the hope of shrinking the tumor and doing the surgery then. If that's the case, then you will be on chemo from the middle of March until the beginning of June, and surgery and recovery would go from the beginning of June until sometime in August. And that would only be if the chemo shrinks the tumor enough for you to have the surgery. It doesn't seem like a long shot to us now.
On Thursday you went in for a mediport. It was a minor surgical procedure but they wouldn't let you drive yourself home. I 'picked you up' at lot C at the hospital and drove you to where you had parked your car. You drove yourself home and have been basically fine but caught a cold the next day. At first I didn't know if you were reacting to the procedure but it seems you might really have a cold. Today you got your first go around with the new chemo: two hours in a chair at the oncologist's office and the rest of the 24 hours with 5FU on a pump. You are wearing a fanny back. Laura would say you're a geek. Today you're a brave nauseous geek.
Saturday, March 6, 2010
It CAN Get Crazier!
Saturday at last! I can sleep in and drink my coffee sitting down. In theory.
I woke at 6:26 to a sound. Oh, no! We left the hot tub on all night. The motor always wakes me up when we do. Oh, well, at least I can enjoy my coffee before I have to take a shower, visit Dad at the hospital and go to a funeral.
Imagine my surprise when I walked into Dad's hospital room and found a strange man in the bed! And my next thought was: where is my dad? He had been taken up to the ICU. He was in distress. The pulmonologist and cardiologist were both there. The short story was that his lungs have been filling with liquid too quickly. They have been giving him lasiks and diuretics but it hasn't helped. The pulmonologist told me he'll get over this. The cardiologist told me he has less than a 50% chance of getting over this. Dad looked more like the cardiologist's description. I sent out a text to multiple recipients and started making phone calls. David showed up. He seemed pretty much in control of himself but, just to be safe, I didn't tell him what the cardiologist had said. It's tough for me when he cries. Carmi and Gail came in. There were so many of us, the nurse had to kick us out and enforce the 'two visitors' policy.
You picked me up for lunch and I left my car at Suzin's house. At lunch I told you that I think Dad is particularly distressed about his relationship to you, and I believe he really wants to see you and know that you forgive him for his pecadillos against you. You asked me what I would like you to do. I said I wanted you to talk to him, make peace with him, let him know that you forgive him. You said you really are sorry the two of you didn't like each other. I asked what you were planning on saying to him and you said, "I'm sorry you and I didn't like each other." I said that would not be okay. "What would you like me to say to him?" you asked. "I would like you to thank him for being a good father to your wife. I would like you to thank him for believing in her when she didn't even believe in herself, for supporting her through hard times, lost years, and helping her become the person she is today. If it weren't for him, I don't know where I'd be or what I would have become." And then I started to cry. Can't you see that this man, with all his shortcomings, saved me from my idiocy during my lost years? Saved me from the despair of my first marriage? Told me I could become whatever I wanted? Could learn anything I put my mind to? Listened to me whenever I needed him----including long, expensive phone calls from Ohio when he had patients waiting for him? Tell him you see the good he did, even though you and he are almost as different as two people could ever be.
I called Beth again, told her what the cardiologist had said, and asked her if she wanted to see Dad one last time. She said yes. We'd set it up, get her down here, I would let her know for sure tomorrow.
When I returned after lunch, Dad was looking much better. How amazing that such a change could take place in an hour. He was a little calmer, a little less-distressed looking. His eyes could focus a bit. We stayed another hour. I was all dressed up for the funeral with pantyhose, suit, heels. I wanted to get home and get into something more comfortable. I was taking a pass on the funeral. I asked the nurse if I could come back and spend the night on the sleeping bench in Dad's room, and she responded that they only let people do that when patients are unstable and critical, not for stabilized patients. Oh, I guess my dad is stable now. News to me.
It's pouring down rain, I'm tired, my high heels gave me a blister, and I'm not spending the night at the hospital. Dad is sort of stable, Beth is coming down anyway and she's bringing Mark, and by missing the funeral I didn't have to have another encounter with my ex. It got crazier but it's not all bad.
I woke at 6:26 to a sound. Oh, no! We left the hot tub on all night. The motor always wakes me up when we do. Oh, well, at least I can enjoy my coffee before I have to take a shower, visit Dad at the hospital and go to a funeral.
Imagine my surprise when I walked into Dad's hospital room and found a strange man in the bed! And my next thought was: where is my dad? He had been taken up to the ICU. He was in distress. The pulmonologist and cardiologist were both there. The short story was that his lungs have been filling with liquid too quickly. They have been giving him lasiks and diuretics but it hasn't helped. The pulmonologist told me he'll get over this. The cardiologist told me he has less than a 50% chance of getting over this. Dad looked more like the cardiologist's description. I sent out a text to multiple recipients and started making phone calls. David showed up. He seemed pretty much in control of himself but, just to be safe, I didn't tell him what the cardiologist had said. It's tough for me when he cries. Carmi and Gail came in. There were so many of us, the nurse had to kick us out and enforce the 'two visitors' policy.
You picked me up for lunch and I left my car at Suzin's house. At lunch I told you that I think Dad is particularly distressed about his relationship to you, and I believe he really wants to see you and know that you forgive him for his pecadillos against you. You asked me what I would like you to do. I said I wanted you to talk to him, make peace with him, let him know that you forgive him. You said you really are sorry the two of you didn't like each other. I asked what you were planning on saying to him and you said, "I'm sorry you and I didn't like each other." I said that would not be okay. "What would you like me to say to him?" you asked. "I would like you to thank him for being a good father to your wife. I would like you to thank him for believing in her when she didn't even believe in herself, for supporting her through hard times, lost years, and helping her become the person she is today. If it weren't for him, I don't know where I'd be or what I would have become." And then I started to cry. Can't you see that this man, with all his shortcomings, saved me from my idiocy during my lost years? Saved me from the despair of my first marriage? Told me I could become whatever I wanted? Could learn anything I put my mind to? Listened to me whenever I needed him----including long, expensive phone calls from Ohio when he had patients waiting for him? Tell him you see the good he did, even though you and he are almost as different as two people could ever be.
I called Beth again, told her what the cardiologist had said, and asked her if she wanted to see Dad one last time. She said yes. We'd set it up, get her down here, I would let her know for sure tomorrow.
When I returned after lunch, Dad was looking much better. How amazing that such a change could take place in an hour. He was a little calmer, a little less-distressed looking. His eyes could focus a bit. We stayed another hour. I was all dressed up for the funeral with pantyhose, suit, heels. I wanted to get home and get into something more comfortable. I was taking a pass on the funeral. I asked the nurse if I could come back and spend the night on the sleeping bench in Dad's room, and she responded that they only let people do that when patients are unstable and critical, not for stabilized patients. Oh, I guess my dad is stable now. News to me.
It's pouring down rain, I'm tired, my high heels gave me a blister, and I'm not spending the night at the hospital. Dad is sort of stable, Beth is coming down anyway and she's bringing Mark, and by missing the funeral I didn't have to have another encounter with my ex. It got crazier but it's not all bad.
Friday March 5
Today was one of those long faculty meetings but through the years our leadership has endeavored to make these meetings efficient and meaningful. The assistant superintendent announced that, as of yesterday, there were enough people taking the early retirement incentive to bring down the number of pink slips to 62, a little less than 8% of the district's teaching staff. It's an improvement over the initial 90. The K teachers had a meeting with the district literacy coach and I felt eyes looking at me to represent not only who we are now, but to speak almost as an historian on many aspects of the teaching practices we had over the years.
As usual, the instructional day flew by. The kids were great for the most part. At afternoon free-choice time Eboni came in and we did our serious weekly debriefing of American Idol. My days as an erstwhile singer have caused me to get sucked-in to that show. She and I have detailed discussions of performances, 'pitchiness', stage-presence and star potential. I can't call who the winner will be, I haven't done it yet, but it sure is fun to live out these young people's dreams week after week. Eb is a great thinker and I love her perspectives on the competition. While we were talking, B started destroying other children's Lego and train projects, and I had him come sit at the table near me and Eb. He is so detached from his actions. I am so worried about him.
After school I had two parent conferences, mostly about the progress reports but also about behaviors and things going on in their homes.
I rested before visiting Dad in the hospital. Dad got panicky in the early evening. He was having trouble breathing and they put him on an oxygen mask. He told Carmi he thought he was dying and that he wanted her to call me. I felt bad I hadn't gotten up their earlier but I was exhausted and needed to rest after work before doing a hospital vigil. He was trying to get out of bed. He always does that when he gets disoriented, and the hospital hired a CNA to stay in his room 24/7. Both he and the patient in the other bed were trying to get up. The hospital knows if a patient gets up and falls, they will be sued. The CNA is definitely a cost-saving measure.
As usual, the instructional day flew by. The kids were great for the most part. At afternoon free-choice time Eboni came in and we did our serious weekly debriefing of American Idol. My days as an erstwhile singer have caused me to get sucked-in to that show. She and I have detailed discussions of performances, 'pitchiness', stage-presence and star potential. I can't call who the winner will be, I haven't done it yet, but it sure is fun to live out these young people's dreams week after week. Eb is a great thinker and I love her perspectives on the competition. While we were talking, B started destroying other children's Lego and train projects, and I had him come sit at the table near me and Eb. He is so detached from his actions. I am so worried about him.
After school I had two parent conferences, mostly about the progress reports but also about behaviors and things going on in their homes.
I rested before visiting Dad in the hospital. Dad got panicky in the early evening. He was having trouble breathing and they put him on an oxygen mask. He told Carmi he thought he was dying and that he wanted her to call me. I felt bad I hadn't gotten up their earlier but I was exhausted and needed to rest after work before doing a hospital vigil. He was trying to get out of bed. He always does that when he gets disoriented, and the hospital hired a CNA to stay in his room 24/7. Both he and the patient in the other bed were trying to get up. The hospital knows if a patient gets up and falls, they will be sued. The CNA is definitely a cost-saving measure.
Thursday, March 4, 2010
I Suppose It Could Get Crazier
The day started with Dad calling out at 5:30 a.m. And where did we find him? Lying on his back. And where was he lying on his back? On the floor in the kitchen. Not really in the kitchen but on the threshold between the kitchen and the front room. Do you realize the significance of that? Dad had opened the door and had fallen right there at that boundary point, straddling the line that separated his part of the house and ours, the point the door closes off. How long he had been there, I don't know, but he was cold and shivering. The furniture in his arms' reach had been jostled, even the little rug under the piano bench was folded up, as he had tried to grab onto anything her could to pull himself up. His bathrobe lay in a heap on the floor and he was in his long red-and-white-striped nightshirt.
I had bolted out of bed and immediately run out to him. He looked up and said, "You look like one of my daughters." I thought I looked more like Clarabelle the Clown. My hair was standing straight out to the sides. Dad had on regular socks, not the kind they give patients at the hospital that have the little rubber paw prints on the bottoms, but regular socks that cause you to slip and slide all over hardwood floors. And fall. You put on some sweats and asked Dad if he felt like he was hurt or had any broken bones. Then you lifted him up (by yourself---what were you thinking??) and I helped you get him into the wheelchair. On the way to the bedroom Dad asked to stop at the bathroom. While in there he asked if we were anywhere near where we lived. I said yes.
When we put Dad in bed, we turned on the electric blanket. It was cranked all the way up! Yikes! That would be hot even for me! On top of the blanket Dad had the bedspread, a lap blanket and a large bath towel. He was coughing slightly. I turned the EB down to 3 and, after talking to himself for a while, I could hear him move into the heavy, throaty breathing of sleep. My day had just begun.
I had been up til 11:40 trying to confirm the substitute for my class this morning so I could go to the oncologist with you. The 5:30 'wake-up' wasn't quite what I had planned. Carmi showed up at 7:30 and you asked her to start 24-hour shifts. It was at that moment that I realized Dad was headed back to the hospital. It all fell quickly into place: accelerating disorientation, crazy talk, aimless walking, a cough. He has something, probably another infection. Carmi said she'd call the doctor and see if she could get an appointment. They had just gone in on Tuesday and the doctor found nothing wrong with Dad.
We ran off to the oncologist's. What an education that was! The doctor was kind and thorough. He gave detailed explanations on the type of tumor you have, what stage 1, 2, and 3 clinical trials are, how they can differ in the slightest of ways, and why it's okay for you to participate in a stage 1 trial. He said you got a good, general, safe chemo regimen at Kaiser but how chemo can --and should---be tailored to a patient based on the patient's responses to prior chemo treatments. He talked about how you should tell him about every prescription and supplement you take. He said the Big Mucky Muck we saw at UCLA is an example of someone who is out there doing extreme experimentation, that they all know each other, and go to the same meetings. He's a little less edgy but experimental. We were comfortable with him. He will work with the oncological surgeon. They will look at the new CT scan and decide which will come first, the surgery or another round of chemo. You will definitely have chemo. The surgery is something we hope for and they will do whatever they can to make it happen, but more chemo is a certainty. And he will monitor it to help you keep up your quality of life.
I went to work but it was early so on the way I went to the bank and Coffee Bean. I got a fattening drink, a yogurt parfait to eat at lunchtime, and money so I could pay Florinda the Magnificent. Then I sat in the parking lot at school and made phone calls. I had to update Beth on Dad. I also wanted to get info on In Home Supportive Services from Beth for a member of 'The Good Wives Club'. What I didn't realize was that by sitting in the car, I ran down the battery because the lights stay on until you set the alarm. Or something like that. Well, the short story is that I ran down the battery.
I reached my classroom just as two of my little boys were being sent to the office for fighting. D had punched S who then scratched D who then retaliated by biting S. God it was good to get back to the insanity of work! How I absolutely love just about anything those little guys do! (But of course I can't show them.) Welcome back to the Land of Cute. My friend was 'punting' as I walked in. She's a good sport. She was going over the homework they had done last night 'Draw a picture of what you want to be when you grow up and have your grown-up write the description you give'. Most of them wanted to be teachers. I hope that speaks well of their experiences with teachers so far in their little lives.
At 2:30 you picked me up so we could go to the cardiologist. You had selected the cardiologist Dad sees; you've certainly been in his office enough with Dad. The doctor greeted us himself and ushered us into my favorite exam room: The Fishing Room. I don't know if my favorite part of that room is the book called "Two Dicks Go Fishing" or the lower-half of duck models affixed to the ceiling. Then there are lots of fish paintings and mounted fish. I keep hoping one of them will start singing. I love those goofy things.
The doctor listened to your heart and was concerned about your leaky valve. "I can hear your leaky valve all the way up in your neck," he said. "And I can hear your aorta, which is located back near your spine, all the way up in the front of your chest." Oh, no, my brain is groaning, how can your heart be so out-of-whack? He ordered an EKG, which was done on the spot, and you will go back on Monday afternoon for a cardiac ultrasound and a stress test. When he asked you about your physical shape, you did your macho athlete posturing about how we used to ride bikes for an hour and a half at a good clip last summer but now only ride for about a half hour. Actually, I think you fibbed a little there, but I wasn't going to challenge you in front of the good doctor. He was impressive, thorough and clear. You must past his three tests: EKG, ultrasound and stress, before he gives you the go-ahead for surgery. He said lots of people can do it with leaky mitral valves. Ten to twelve hours on the table with a team of oncological surgeons is tantamount to 24 to 36 hours of surgical man-hours. It will be tough but he says you look and sound pretty healthy. He needs to be sure.
I went right over to the ER because that's where Dad and Carmi were. I was stunned to find out that Dad has bilateral pneumonia and his congestive heart failure has gotten out of control for the first time in several years. The signs of illness were there in the form of his disorientation and early risings, but the typical physical symptoms were lagging behind. They admitted him to the hospital.
When you dropped me off to pick up the car at work, jumper cables in hand, but the car started right up without them. The clock said it was noon but the car ran and got me to our sushi place. We ordered some of our favorite rolls but I just wasn't in a good eating mood. I took part of one home for lunch tomorrow. Tomorrow is Friday, I can't wait for this week to be over. I am tired and, more than that, I am fatigued in a way that makes me feel melancholy. I have not been a melancholy person in my adult years and don't like the trips to the past where I get weepy or feel cracks in my self-control. I suppose it could get crazier. I would like to get a solid eight hours of sleep.
I had bolted out of bed and immediately run out to him. He looked up and said, "You look like one of my daughters." I thought I looked more like Clarabelle the Clown. My hair was standing straight out to the sides. Dad had on regular socks, not the kind they give patients at the hospital that have the little rubber paw prints on the bottoms, but regular socks that cause you to slip and slide all over hardwood floors. And fall. You put on some sweats and asked Dad if he felt like he was hurt or had any broken bones. Then you lifted him up (by yourself---what were you thinking??) and I helped you get him into the wheelchair. On the way to the bedroom Dad asked to stop at the bathroom. While in there he asked if we were anywhere near where we lived. I said yes.
When we put Dad in bed, we turned on the electric blanket. It was cranked all the way up! Yikes! That would be hot even for me! On top of the blanket Dad had the bedspread, a lap blanket and a large bath towel. He was coughing slightly. I turned the EB down to 3 and, after talking to himself for a while, I could hear him move into the heavy, throaty breathing of sleep. My day had just begun.
I had been up til 11:40 trying to confirm the substitute for my class this morning so I could go to the oncologist with you. The 5:30 'wake-up' wasn't quite what I had planned. Carmi showed up at 7:30 and you asked her to start 24-hour shifts. It was at that moment that I realized Dad was headed back to the hospital. It all fell quickly into place: accelerating disorientation, crazy talk, aimless walking, a cough. He has something, probably another infection. Carmi said she'd call the doctor and see if she could get an appointment. They had just gone in on Tuesday and the doctor found nothing wrong with Dad.
We ran off to the oncologist's. What an education that was! The doctor was kind and thorough. He gave detailed explanations on the type of tumor you have, what stage 1, 2, and 3 clinical trials are, how they can differ in the slightest of ways, and why it's okay for you to participate in a stage 1 trial. He said you got a good, general, safe chemo regimen at Kaiser but how chemo can --and should---be tailored to a patient based on the patient's responses to prior chemo treatments. He talked about how you should tell him about every prescription and supplement you take. He said the Big Mucky Muck we saw at UCLA is an example of someone who is out there doing extreme experimentation, that they all know each other, and go to the same meetings. He's a little less edgy but experimental. We were comfortable with him. He will work with the oncological surgeon. They will look at the new CT scan and decide which will come first, the surgery or another round of chemo. You will definitely have chemo. The surgery is something we hope for and they will do whatever they can to make it happen, but more chemo is a certainty. And he will monitor it to help you keep up your quality of life.
I went to work but it was early so on the way I went to the bank and Coffee Bean. I got a fattening drink, a yogurt parfait to eat at lunchtime, and money so I could pay Florinda the Magnificent. Then I sat in the parking lot at school and made phone calls. I had to update Beth on Dad. I also wanted to get info on In Home Supportive Services from Beth for a member of 'The Good Wives Club'. What I didn't realize was that by sitting in the car, I ran down the battery because the lights stay on until you set the alarm. Or something like that. Well, the short story is that I ran down the battery.
I reached my classroom just as two of my little boys were being sent to the office for fighting. D had punched S who then scratched D who then retaliated by biting S. God it was good to get back to the insanity of work! How I absolutely love just about anything those little guys do! (But of course I can't show them.) Welcome back to the Land of Cute. My friend was 'punting' as I walked in. She's a good sport. She was going over the homework they had done last night 'Draw a picture of what you want to be when you grow up and have your grown-up write the description you give'. Most of them wanted to be teachers. I hope that speaks well of their experiences with teachers so far in their little lives.
At 2:30 you picked me up so we could go to the cardiologist. You had selected the cardiologist Dad sees; you've certainly been in his office enough with Dad. The doctor greeted us himself and ushered us into my favorite exam room: The Fishing Room. I don't know if my favorite part of that room is the book called "Two Dicks Go Fishing" or the lower-half of duck models affixed to the ceiling. Then there are lots of fish paintings and mounted fish. I keep hoping one of them will start singing. I love those goofy things.
The doctor listened to your heart and was concerned about your leaky valve. "I can hear your leaky valve all the way up in your neck," he said. "And I can hear your aorta, which is located back near your spine, all the way up in the front of your chest." Oh, no, my brain is groaning, how can your heart be so out-of-whack? He ordered an EKG, which was done on the spot, and you will go back on Monday afternoon for a cardiac ultrasound and a stress test. When he asked you about your physical shape, you did your macho athlete posturing about how we used to ride bikes for an hour and a half at a good clip last summer but now only ride for about a half hour. Actually, I think you fibbed a little there, but I wasn't going to challenge you in front of the good doctor. He was impressive, thorough and clear. You must past his three tests: EKG, ultrasound and stress, before he gives you the go-ahead for surgery. He said lots of people can do it with leaky mitral valves. Ten to twelve hours on the table with a team of oncological surgeons is tantamount to 24 to 36 hours of surgical man-hours. It will be tough but he says you look and sound pretty healthy. He needs to be sure.
I went right over to the ER because that's where Dad and Carmi were. I was stunned to find out that Dad has bilateral pneumonia and his congestive heart failure has gotten out of control for the first time in several years. The signs of illness were there in the form of his disorientation and early risings, but the typical physical symptoms were lagging behind. They admitted him to the hospital.
When you dropped me off to pick up the car at work, jumper cables in hand, but the car started right up without them. The clock said it was noon but the car ran and got me to our sushi place. We ordered some of our favorite rolls but I just wasn't in a good eating mood. I took part of one home for lunch tomorrow. Tomorrow is Friday, I can't wait for this week to be over. I am tired and, more than that, I am fatigued in a way that makes me feel melancholy. I have not been a melancholy person in my adult years and don't like the trips to the past where I get weepy or feel cracks in my self-control. I suppose it could get crazier. I would like to get a solid eight hours of sleep.
Tuesday, March 2, 2010
Medicare, Day 1
Yesterday was a huge day. It was a good thing I had stayed home from work with a cold; you were having your first appointment at St. John's, and I got to go with you. After getting lost twice, we finally got to the hospital's 'garden level' where the cancer treatment center is. It was pretty posh, and the other people in the waiting area looked like they were well-heeled. You had to fill out lots of paperwork and spend quite a bit of time convincing the secretaries that you were not on Kaiser's Medicare Advantage. Since you had just cleared that up with my school district, you were very sure of it. They kept saying you had Kaiser for Medicare, you kept saying you didn't. You prevailed. They were apologizing and getting cards for you. You only had a $155 deductible to pay. We spent a lot of time waiting, even after you were finished with the paperwork, and I had to go feed the parking meter. It was a lot of walking, not good for my cold. I had had to call in the relief caregiver early on Sunday because I couldn't take Dad to church. I stayed in bed all day and missed the neighborhood ladies tea, much to my dismay.
Saint John's seemed to be empty, big, and beautiful. All the patients were white. They looked well-0ff. The facility was state-of-the-art. And the parking was a nightmare. $12 flat fee or street parking in two-hour spots. And the parking structures are out of the question. I don't think they'll be giving me any free parking passes.
When we were taken into the waiting room, the nurse asked us from how far away we had come. Apparently, they have patients from all over. The fellow you were talking to in the waiting area had come down from Bakersfield. I get it. It's famous.
The doctor was so informative. He came in with a colleague. They examined you. I saw him pull your socks down to check for edema in your ankles and look for healthy veins. They looked at your skin and asked me about different spots on your back. One doctor asked you if you had a leaky valve. I said no, you said yes. WHAT??? Since when have you had a leaky valve, and why hasn't it been repaired?? We talked about your medical history but, despite your multiple medical conditions, he thinks you're pretty healthy, a good candidate. I agree. And there IS a surgery that can be done! AHA!!! But it's tricky, as you well know. It involves grafting the SMA (superior mesenteric artery), which is no small task. We learned more from your latest Kaiser CT scan as the doctor put your disk in the computer and went over it. There is not only an SMA but a SMV (superior mesenteric vein). That makes sense: what goes in must come out. Both have been impacted by your tumor. The SMV has found other pathways for returning the de-oxygenated blood to your heart. But the SMA is going to be strangled if the pressure is not relieved. The surgery he has performed is a Whipple (removal of a portion of the pancreas along with the tumor) that involves grafting and rebuilding the SMA. The normal Whipple doesn't mess with the SMA or SMV. And the only pancreatic cancer patients who live five years or more have had the Whipple. I am calling this new procedure a 'Whipple Plus'. What makes it tricky is that at the point where the SMA and the tumor come together is a network of branching vessels leaving the SMA to take blood to the intestines. The SMA is the blood supply for the entire intestinal tract. And that's a busy place down there! He would need to make a graft and replicate the vessels. The surgery would take 10 -12 hours and is delicate. There is a 3 - 5% chance you could bleed out right there in the operating room. There is a chance he could get in there and discover it is too difficult to attempt, and he would just have to close you back up. He has done about a dozen of these 'Whipple Pluses' but, despite that small number, no one else in the country has done more than he. He ordered another CT scan, this time with thinner sections, and you had it done this morning. He is wondering whether or not he should wait until you have tried the new chemo you will be taking at St. John's before he does the operation. If your tumor responds to the chemo by shrinking, then it would create a better surgical scenario. Neither one of us heard a clear answer from him on that one. I guess the new CT scan will give him the information he needs. The doctor will be out of town for the rest of this week. He will call you after he has reviewed the latest scan.
What we both liked about this meeting was that we had finally found a doctor who didn't look at you like you were a dead man. It was so nice to meet someone who was trying to find a way to not only keep you alive but who would try to eliminate your cancer. This was a good change for you. It's not a coincidence that you are turning 65 exactly at this time. It's not a coincidence that your tumor is not growing at this time. It's not a coincidence that I was ill Monday. (I can hear the Christians chuckling....) It's called a God-incidence. Too bad you don't believe in it.
Today you said you hadn't seen a cardiologist since your follow-up to your triple bypass three years ago. You haven't? You said that along with an appointment with the new oncologist on Thursday, you have an appointment with a cardiologist, Dad's cardiologist. Well, we've certainly made enough visits to his office, and he's the only person Dad will obey without question. And you're thinking of changing psychiatrists too.
Saint John's seemed to be empty, big, and beautiful. All the patients were white. They looked well-0ff. The facility was state-of-the-art. And the parking was a nightmare. $12 flat fee or street parking in two-hour spots. And the parking structures are out of the question. I don't think they'll be giving me any free parking passes.
When we were taken into the waiting room, the nurse asked us from how far away we had come. Apparently, they have patients from all over. The fellow you were talking to in the waiting area had come down from Bakersfield. I get it. It's famous.
The doctor was so informative. He came in with a colleague. They examined you. I saw him pull your socks down to check for edema in your ankles and look for healthy veins. They looked at your skin and asked me about different spots on your back. One doctor asked you if you had a leaky valve. I said no, you said yes. WHAT??? Since when have you had a leaky valve, and why hasn't it been repaired?? We talked about your medical history but, despite your multiple medical conditions, he thinks you're pretty healthy, a good candidate. I agree. And there IS a surgery that can be done! AHA!!! But it's tricky, as you well know. It involves grafting the SMA (superior mesenteric artery), which is no small task. We learned more from your latest Kaiser CT scan as the doctor put your disk in the computer and went over it. There is not only an SMA but a SMV (superior mesenteric vein). That makes sense: what goes in must come out. Both have been impacted by your tumor. The SMV has found other pathways for returning the de-oxygenated blood to your heart. But the SMA is going to be strangled if the pressure is not relieved. The surgery he has performed is a Whipple (removal of a portion of the pancreas along with the tumor) that involves grafting and rebuilding the SMA. The normal Whipple doesn't mess with the SMA or SMV. And the only pancreatic cancer patients who live five years or more have had the Whipple. I am calling this new procedure a 'Whipple Plus'. What makes it tricky is that at the point where the SMA and the tumor come together is a network of branching vessels leaving the SMA to take blood to the intestines. The SMA is the blood supply for the entire intestinal tract. And that's a busy place down there! He would need to make a graft and replicate the vessels. The surgery would take 10 -12 hours and is delicate. There is a 3 - 5% chance you could bleed out right there in the operating room. There is a chance he could get in there and discover it is too difficult to attempt, and he would just have to close you back up. He has done about a dozen of these 'Whipple Pluses' but, despite that small number, no one else in the country has done more than he. He ordered another CT scan, this time with thinner sections, and you had it done this morning. He is wondering whether or not he should wait until you have tried the new chemo you will be taking at St. John's before he does the operation. If your tumor responds to the chemo by shrinking, then it would create a better surgical scenario. Neither one of us heard a clear answer from him on that one. I guess the new CT scan will give him the information he needs. The doctor will be out of town for the rest of this week. He will call you after he has reviewed the latest scan.
What we both liked about this meeting was that we had finally found a doctor who didn't look at you like you were a dead man. It was so nice to meet someone who was trying to find a way to not only keep you alive but who would try to eliminate your cancer. This was a good change for you. It's not a coincidence that you are turning 65 exactly at this time. It's not a coincidence that your tumor is not growing at this time. It's not a coincidence that I was ill Monday. (I can hear the Christians chuckling....) It's called a God-incidence. Too bad you don't believe in it.
Today you said you hadn't seen a cardiologist since your follow-up to your triple bypass three years ago. You haven't? You said that along with an appointment with the new oncologist on Thursday, you have an appointment with a cardiologist, Dad's cardiologist. Well, we've certainly made enough visits to his office, and he's the only person Dad will obey without question. And you're thinking of changing psychiatrists too.
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