Saturday, October 31, 2009

Halloween

You have been in the hospital since Thursday night. You wouldn't go until the baseball game was over. After all, it is the World Series! Outside of the World Series, you're not much of a baseball fan. I worried that we would be in the waiting room for a long time but I think a half hour is pretty decent in an ER these days, especially with the swine flu going around as it is. As soon as the triage nurse took you, things moved along rapidly. They were ready for you, took you to a room, hooked you up, sent in the surgeon on duty, and moved you upstairs to a room where they put a suction tube into your stomach through your nose and got you on an IV.

Friday you got an IV PICC. What an amazing gizmo that is! A pharmacist formulates a liquid composed of all your meds and everything your body needs based on whatever is in the computer database on you. Wow! Sweet deal.

When I saw you you looked so much better. Your color was good and you were perking up. I brought you mints and hearing aid batteries. I didn't know you weren't supposed to have mints. The whiteboard in your room said 'Nothing to eat or drink', But I only brought you a few mints. You asked me to go get you a Sprite. I said, "No way". You started arguing with me, and then, as you sometimes do, you starting cajoling me. And you hurt my feelings. There have been so many times in our lives when you have belittled me because I wouldn't let you have your way. I was not going to go against the doctor's orders. You are the kind of person who feels that rules are made to be broken. I'm the kind of person who believes the rules, especially when since this is a life-and-death situation, are there for a reason. When the nurse came in you said, "My wife is the kind of person who always follows the rules. I'm not. People like her need rules because without rules they wouldn't know what to do. They wouldn't be able to find their way through life". I felt humiliated. Up to that very moment, I had been a pillar of strength. I had a million balls in the air, I had a cold, and I was juggling them all with ease. But the insult crushed me. I was deflated and knew I couldn't take that ever again. The nurse told me it was okay to get you a Sprite. He would put it over your ice cubes and then pour it off leaving your ice cubes with a sweet lemon-lime taste. When I returned, I took the Sprite out to the nurse's station and then I went back to your room and told you how badly you had hurt my feelings. I told you I wasn't going to be able to handle that kind of talk and survive the stress I'm under. I was angry and you had embarrassed me in front of two nurses. My strength was shattered. I went home. You text-messaged me and apologized. I wrote back and said that there wasn't any room for criticism, badgering or negativity now. You got the picture. Do I have a right to be angry with a terminally-ill cancer patient? Yes, I do. With you I have to constantly redraw the boundaries.

Today you apologized again, this time in front of friends. I stayed with you for five hours. I bought you another Sprite and a lot of TicTacs. You wanted all of them. I balked. You said,"I'm dying. What's the difference if I have TicTacs?" You have a trump card there.

Thursday, October 29, 2009

Endoscopy

This was the day we waited for, the big endoscopic ultrasound. This would be the day of the long-awaited biopsy via new technology that would tell us what is going wrong inside your body.
We left the house while it was still dark sure to arrive in plenty of time for your ten o'clock appointment. The car flew along the route, freeway to freeway, leading us by its updated GPS. We talked. You said you are comfortable with knowing you have cancer. You have accepted it, and it was okay with you if we told people. I asked about specific people, and you okayed them. I, however, said I didn't want to tell the people at my work yet. I don't feel safe with the admins and am not too sure about my contract language for using my sick and necessity days. The district is in a financial crunch and they might be looking hard at ways to save money.

We arrived three hours early.

They took you in right on time. You were done in less than two hours. The nurse summoned me from the waiting room, inviting me to sit with you in recovery. She pulled a rolling chair up to the side of the bed. You were snoring; it sounded peaceful and content; I took it as a good sign. There was some blood spatter on your sheets. It was a little unsettling but I decided not to let it upset me. I didn't realize I was crying, and you woke up. You were groggy but struggled to wake. My eyes were just leaking. I took your hand and told you to go back to sleep, we had plenty of time. You started to speak but feel back to sleep mid-sentence, "I thought it was diff......" You woke again seconds later,"Could you ask the nurse to get me some water. I'm so thirsty." You ran your finger over your lips but the nurse said it was still too soon. And you fell back to sleep, your hand in mid-air.

The doctor came in. He brought over his report, complete with photos. He told you your esophagus is inflamed and ulcerated from all the vomiting. Your stomach is still full of food despite the vomiting. The duodenal sphincter is so constricted he couldn't get the scope past it. The part of the pancreas he could see had no tumor on it. He feels you have cancer, but not pancreatic cancer. However, since you are losing close to a pound a day, can't get much of anything through your intestines, and you're weak and dehydrated, he contacted your GI surgeon and told him you have an urgent need for a bypass. You need it within the next few days. We weren't sure if this was good, bad or no news. Not pancreatic cancer? He couldn't see all the pancreas. What if it's pancreatic cancer but on the part he couldn't see?

By mid-afternoon your surgeon had called. He wants you to go to the ER tonight so they can get you on IV's to hydrate and nourish you. He also wants you to get something to decrease inflammation. He is planning on doing surgery on Wednesday. He will give you the bypass and then try to get a tissue sample for a biopsy. You told me this when I got back from walking. Then you said, "I'm afraid to go into the hospital. I'm afraid I won't ever come out."


My day has been a flurry of text messages and phone calls. I have had to recharge my phone twice. There are loving, supportive people behind us. They will call, visit, email and encourage you.

What can I say to you to ease your fear? That I think the hospital is the best place for you? That I think you stand the best chance of getting some strength there? That I know home hasn't been the best place for you the past two weeks? That it's painful to watch you wasting away. Can we see this as a blessing that you might not have pancreatic cancer? Can we hold on to hope? I can. Can you?

Stretcher-bearers unite!

Wednesday, October 28, 2009

Wednesday

Today you talked to 'everyone', you said. You spoke with the surgeon, the doctor who will be doing the endoscopy and biopsy tomorrow, and you spoke with our family physician. You cancelled your appointment with Susan because you didn't feel strong enough to drive and walk up to her office by yourself. The surgeon agreed to do a duodenal bypass. As it turns out, stents aren't the success in the duodenum that they are in the cardiovascular system. They clog up. Maybe you'll be able to eat again.

It was an uneventful day. But you vomited even the water you had consumed, and walking from the car, to the grocery, and then to the video store completely wore you out.

Tomorrow should be a hallmark day. You will finally get your biopsy. It seems like we have been waiting for this for so long yet it's only been two weeks. But two weeks can be the rest of your life when you have cancer.

Tuesday, October 27, 2009

Big Mucky Muck

Yesterday we were lying in bed and you said to me, "I'm not afraid of dying." We do that a lot now. We lie in bed holding hands. It's a sweet thing most old folks don't do. Ah, but we're not old folks; we never will be. There's something eternally young about our spirits. I guess I am relieved to hear you aren't afraid of dying. I am not afraid of your death either. In my mind's eye I can stay with you until the very end accepting your passing whenever it comes, whether or not it is this year or five years from now.

You also said, "And I don't feel cheated." I said, "I do." You said you were sorry I feel that way. There was a flicker of realization in your eyes as you took in my comment. You recognized that I was waiting for my professional working life to be over so we could be free to have more adventures, like we did before Laura was born. Now we weren't going to have that. I was going to be a widow in my retirement; you weren't going to be there to go driving around the country with me, to move to exotic places and teach in American schools with me. I was going to be left to do this without you, and my golden years were now going to be lonely.

Today we saw a big oncologist who specializes in pancreatic cancer. He had a lot to say and we were both comforted in just knowing there's someone who could have a plan. He will work on a consult basis with Kaiser. He said you could get a gastric bypass around your duodenum or you could get a duodenal stent. This would enable you to eat again and would be easy enough to do. Both the procedures take about an hour to perform. Then he said to refuse radiation as part of your treatment. Radiation only treats a localized area but by the time most pancreatic cancers are diagnosed, they are so far along that the cancer is already being carried to other areas of the body through the lymphatic system. Targeting a specific area would only treat the tumor itself, not the messenger service that is delivering the cancer to the rest of your body. He recommends a systemic chemotherapy. He wrote down four types of chemo you should take, their dosage, frequency and duration. He said the Kaiser docs can call him and he would work with them. We were heartened by this news. We aren't thinking you are going to live another ten years, we just know there is a chance you can have a better quality of life than you have now. Maybe we can take those trips we've wanted to take. I had abandoned hope on them during the last week.

You told our neighbor, Rose, the prayer warrior. I was in the house and you were talking to her on the front porch. I could see the sadness, shock and compassion on her face. She'll get on it. She and hers will be praying for you mightily.

Keith said we all could be stretcher-bearers for you.

Sunday, October 25, 2009

Sunday and Monday

You started the day by getting up with me in the morning. You ate two soft-boiled eggs with me and Dad. You said you were feeling better and that maybe tomorrow you could go to the DMV to find out why they didn't send you your driver's license renewal. Our insurance company won't renew our policy without proof. Who would have thought something so simple would be so difficult? You are weak and you need someone to go with you to stand in the line. We are fortunate Laura's boyfriend is here and will do it with you.

I took Dad to church. He was particularly critical. He commented on every driver, every pedestrian. I found myself trying to take the negative sting off his criticism. He said, "Oh, lady, don't cross now". I said, "She has plenty of time; the light is with her". When a car did a u-turn in front of us he said, "Hey, Mister!" I said, "He thought he had found a parking spot on this side but it turned out to be a driveway, so he made a quick left to go into a parking lot on the other side of the street." After a few more comments, I said, "Dad, you're being very critical this morning. You have said something negative about almost every other driver and pedestrian." He said, "I have?" "Yes, you have." Then he was quiet for the rest of the ride. What happens when you are gone? Do I confront Dad every time we go driving? Does he do this when his caregiver is driving him during the week?

I asked Carmi today about Dad's criticism. Her experience is similar to mine. Usually she can let it go but sometimes she says something to him. She says he is constantly making comments about others when they are out. She's pretty cheery but I got the feeling that every now and then it gets to her.

What a blessing it was to have Laura here. Our child is becoming a wonderful young woman! She and boyfriend both took you to the DMV and were on hand to take you to the ER this afternoon if the doctor called and fast-tracked you. She sent me texts on your health during the day. Our conversations this evening were far better than I could have dreamed. She is so concerned with your health. She said she wants to be a better support for you ----and for me---than she was when you had your triple bypass. She wants to move back here to help us; she's even willing to take a chance on putting boyfriend back in his old stomping grounds, the scene of his crimes, as it were. I never thought she would want to help! I thought she'd want to be here if your end was near and you were declining quickly, but it was music to my ears to hear her say she wanted to be here to help me. And boyfriend is right there with her. He is being very supportive. I'm glad we decided to give him the benefit of the doubt.

When I came home from work today there was a letter from the Parking Violations Bureau about a ticket you had gotten in the CNG Crown Vic. They said they no longer allow hybrid and cng vehicles to park free at meters. Please send a check for $50. I was frustrated. We have spent more on tickets on those cars. At least now they have a policy they won't be contradicting. We'll put money in the meters. You asked me why I was upset. You asked me if there was anything you could do for me. I said, "Get well."

You and I had another discussion about faith. I told you I thought you had nothing to lose by being a Christian, that it's a good way to live. You said you had some fundamental problems with it: you don't think Jesus is the son of God and you think the Bible contradicts itself over and over. I said I used to think that until I read it a couple of times. I asked you if you believed in Intelligent Design. You said in a way. You believe God is the ultimate Creator but that you also believe in evolution. Again you said you like and respect the way I practice Christianity-----I corrected you with my favorite phrase: 'the way I try to practice Christianity'.

Thursday, October 22, 2009

Good Days/Bad Days

Today you woke up and you didn't feel well. Yet the night before last we went out to dinner for crab legs. The menu said 'Russian crab legs'. We asked the waiter the difference between Russian crab legs and king crab legs. He said there was probably no difference; the restaurant was owned by Russians and how would anyone know if the crabs had been fished out of Alaskan or Russian waters anyway. We laughed and had a beautiful meal. Now I wonder where those Russian or Alaskan crab legs are. Your feelings color my days. I don't like that, but that's the way it is. I don't know how much time you have left, and when you don't feel well, I worry that you will only be here for a few more weeks.

Will we be able to go to Thanksgiving up north? Will you be well enough to go to Idaho for our traditional family Christmas revelry? My siblings are crazy fun. Being them would be good for you, good for me. They are kind and generous and loving, qualities you only saw in your mother and chose not to adopt. Why should you? She didn't get her way. She didn't rule the roost. She died of cancer. Nice guys didn't win in your family. People said and did nasty things to each other. Your sister didn't want to come to the dinner table at night. She was the object of your father's anger, discontent and disappointment. You watched. You were younger, powerless, bewildered. It wasn't nice, that thing your father used to do. People in your father's family died estranged from their blood. They turned their backs on one another. Your grandfather died and no one had ever known he had a brother in the same town.

My family wasn't perfect. In fact, my parents took dysfunction to great heights. But somehow my siblings and I have healed and moved on to a better place. We learned to laugh and find joy. We have all had our struggles and our sadnesses. Our mother and stepfather had great senses of humor; we chose those over their craziness. Thankfully. The rest is working itself out.

My siblings are already learning from our situation. They have suspended their holiday celebrations with others to be with you and me during this time. They will be here for us. They will be silly, funny, loving, supportive, prayerful, kind, attentive. They will be there for us to lean on, go to, or will come to us even though we are hundreds of miles away. My younger sister has an enormous heart and capacity to be there for people. Of all of us, she inherited Mom's ability to nurse people through horrible health crises. She has a heart for healing and nurturing. My brother has the capacity to love people regardless of their failings or sins. Beth has been my prayer warrior, my comfort. I am so blessed by them, so proud of the people they have become. They will be with us through the good days and the bad days. But true to your family's pattern, your sister has vanished, and not without good reason. You were mean to each other. I mourn your void of family, sad for you that the person who shared your childhood, your blood, your past, is no longer in your life. She will not only be absent, she will be unaware of your struggles, your pain, your good days, your bad days, your end.

Good days, bad days, bad days, good days. My life will hang on your health. I don't like it but it does. That happens when people love each other. I will take you to the hospital. I will go to all your doctors' appointments with you. I will hold your hand, your head, your body. I will be your rock. I will be strong for you. It's how I am.

Wednesday, October 21, 2009

Our Child

If there is one shining thing from this marriage, one golden piece of sunshine, it's our child. Our beautiful, headstrong, unique and sometimes frustrating child. Our nineteen-year-old who is going on thirty five. ("I'm an adult now. You have to let me live my life! I can make mature decisions. I can take care of myself. You're suffocating me." "Mom, I've been throwing up all day and I can't keep anything down. I just tried to drink a glass of milk and threw it up immediately." "My bank has charged me seven overdraft fees. Can you transfer $245?")

When you had your triple bypass, her reactions were varied. In the beginning she was concerned. I could see her playing off my reactions, so I focused on staying sensible and taking care of business while being there for you every step of the way. The first few days were quite stressful. It didn't help that some lady had rear-ended you the week before and the car was in the shop. Laura and I had to get a loaner car, and it didn't turn out to be as easy as I had anticipated. Then the ccu nurse tried to give you the wrong meds and I had to take the ward to task on it. During those initial days Laura was with me all the time and she was worried about you. As you recovered and started getting out of bed and becoming your old self again, she relaxed. She realized her dad was going to be fine. And as your recovery continued, she developed a rather cavalier attitude to the point that when you went to emergency six weeks later, while I was visiting my sister, she didn't come and pick you up when you called her. She was helping her boyfriend wash his car. In our driveway. You took the bus home. You never forgot that. You never forgave her. I don't blame you. We were concerned that now, three years later, she wouldn't grasp the seriousness of pancreatic cancer. We went to the desert to see her.

She had the flu. Could you believe the timing? We felt we needed to tell her sooner rather than later. Saturday we drove out, stayed at a friend's vacation home, and checked with her frequently to see if her fever was gone. It broke on Saturday afternoon. We asked if we could have lunch on Sunday. We figured her boyfriend would be with her. She's that way. When she has a boyfriend, she's as good as married. After growing up with us, how could she be so dependent on a guy? How can she jump into relationships and get joined at the hip? We have been so independent of one another. Did she feel an unfulfilled need for attachment? Is that how our relationship played out in her?

We arrived at Suzin and Larry's in the late afternoon. It was hot. The desert can be so mild in October but then it can have hot spells, evocative of summer at its most brutal. This weekend was one of the latter. Suzin said we'd need to bring a cooler because their refrigerator had konked out and the new one wasn't being delivered for another week. As usual, we brought too much stuff. Good thing their place isn't small. They have so much square footage there, if only that much were common in our area. We had talked about going to a movie; I had wanted to go swimming in their community pool. We watched TV after we unloaded the car. You couldn't keep any solid food in your stomach so you had brought our blender to make protein drinks. You had a protein concoction, and I had leftover manicotti from home. Shortly after 6:30 you just got up and walked into the bedroom. I didn't see you again until I went to bed at 11:00. Your sleep patterns are off-kilter. You were awake at 4:00 a.m. You went for a hike and then to the grocery. I was awakened at 6:50 by you knocking on the kitchen door. I let you in and headed back to bed. You were all ready to make breakfast and go out. When you realized I was still in sleep mode, you entertained yourself by going to Walmart. How shopping delights you! You were so happy when you returned! You had found pants, undies, a new cooler and a cheaper protein drink.

We met Laura at a park. You and I had planned it. We would bring food. We would sit across from them, and they would be downwind of us. No germ-sharing. Lots of fresh air and breeze to blow away the flu. What we hadn't planned on was the boyfriend coming down with the flu that day. He was considerate and kept his distance. We ate, we made small talk, you finally started. "We wanted to talk to you about the problems I have been having with my stomach. I have something and I want you to know it looks like cancer. They're not sure yet but they are saying it's pancreatic cancer. They say they won't be able to operate. I will be seeing some more specialists and they will run more tests. Right now things don't look good. I wanted to tell you right away so you wouldn't feel like we were keeping information from you. I want you to know what's going on. I love you."

She reacted sweetly, and I was so proud of her. She has grown since your bypass! She wept quietly. She asked some meaningful questions about treatment and possibilities. Boyfriend moved over and put his arm around her to comfort her. When she was finished, she told you she loves you, and that she wants you to keep on fighting, not to give up. "Don't disappoint me by giving up," she said. "I love you."

The good part was that we didn't ruin a good weekend for her. The flu had done that. We knew she didn't really know how dreadful the diagnosis is. We worry she will keep on going with her regular schedule. Some people her age don't understand mortality. Already she has said she doesn't want to miss school and is going to boyfriend's grandparents for Thanksgiving. She doesn't know this might be your last Thanksgiving. You asked me to talk to her about coming up north with us. I put in a call to her. I will tell her. She will have to consider taking a leave from her school if your condition starts taking a dive. I am looking into taking a leave from my job. It's an interesting time for checking our priorities. Love over duty. Family over school. Taking chances with security, putting futures on hold. Because we're family, and we love you.