Nov 26: Martha

It's 12:30 am, I should be going to bed. But that ain't going to happen right now. Picked Zerla up at vet hospital, got home, turned right around again. She's in terrible pain, being readmitted for a few days of pain control which is difficult when balancing her constipation issues from narcotics. It tore me up to see her agonized mewing and crying, unable to stand at all, her rear legs looked useless to me and it was terrifying. Having her there will be for the best. (Except for when the credit card statement comes in....)

What is prompting this early am posting however is my cousin-in-law, Martha. When last mentioned a couple months ago she was recovering from the thoracotomy in August which removed the lung cancer from her lower right lung after three months of chemotherapy had shrunk and stabilized the tumor. The surgeon and oncologist were very positive about the outcome, despite finding cancer cells in 1 of 8 lymph nodes and the pleural lining of the chest wall.

In early October she called me, very upset, telling me that she was having the same symptoms as she had before the diagnosis: weakness, extreme fatigue, drenching sweats at night, coughing. Additionally, there was a growth on her head, which she described as being around the hairline and walnut sized, not in the position to be a lymph node. She felt like she was being blown off, her doctors were not addressing her worry that it represented the cancer returning. She called me in part for medical advice, but even more because she knew that I wouldn't dismiss her concerns, wouldn't give her false platitudes that 'everything was going to be OK, everything is going to be fine'. She called me because she couldn't let on to John and the kids her terror, her worry, that was consuming her, because she knew that it was the cancer. Because no one else would give any credence, any acceptance to the possibility, allow her to talk about the worst case scenario. The dark uglies are worse when they just bounce around in your brain and aren't allowed out, for expressing in words you gain at least a modicum of control over them.

That next week the growth was biopsied and she was given a CT scan of the chest. I called John from the airport, while waiting for the flight to England. The biopsy was positive, as was the CT of the chest. The cancer was back, and had metastasized. She had already re-started chemo.

While in England, on my spiritual pilgrimage and celebrating my recovery, I was acutely aware of the specter of her prognosis. I left donations and prayer cards in most of the cathedrals I visited, prayed on the Tor and at Chalice Well. Hey, you never know who's listening. It was impossible to make sense of--I was the sick one who was supposed to be dead and instead was skipping around the English countryside while she, always hale and healthy, was having poison dripped into her and being bombarded with radiation to stop the spread of disease.

In talking with John several times over the last few weeks it was obvious that things were not going well. The chemo was really affecting her. I offered to come up to give whatever support possible, but she didn't want anyone around. There were no longer good days, but good hours and they were never predictable. At one point the scans showed a decrease in the tumor in her spine, the numbness in her foot was better. But the next scans weren't so good.

And she was withdrawing, didn't want people around, didn't want to exert the energy to converse, to interact. I had warned John and her about this--the turning inwards. I reminded her in that last conversation we had. You turn inwards first to fight what is happening inside you, then to hammer out an agreement with it, come to an understanding or compromise. In my experience it is one of the things that has to be done alone, no one can go with you, no one can relieve the pain of the admission to yourself of what is happening: you are dying.

John called this afternoon, left me a message to call, his tone let me know what his words didn't. I called back repeatedly, there was no answer at the house, left messages on his cell phone like a Twitter junky: "I'm on my way home, have the cell on." "I'm home" "I'm still at home, leaving in 2 minutes." "I'm in the car going to the vet's" There was only one explanation for his not calling back--I knew he was at the hospital. He called me at 9 pm, when I was on my way home with Zerla (before turning around and going back to the vet hospital again).

Martha had a really hard time with the chemo end of last week, started vomiting everything. They treated her as an outpatient, gave her bags of fluids. She needed a couple transfusions. She would improve, go home, then get bad again. Then Monday, just two days ago, she got much worse. She's gone dramatically down hill in the last 24-48 hours. She is conscious, but not very cogent. The doctor pulled John aside today and discussed DNR orders. The hospice consults were done today, will be back tomorrow, although they are not in place as of this minute. He says that the doctors are stunned, mystified at how rapidly this has happened, how very quickly this decline has come and how it is advancing.

John has truly risen to the occasion through all of Martha's illness. He is being thoughtful, strong, sensitive, asking the right questions, making excellent decisions--I am so incredibly proud of him. His voice broke when he told me that he was doing OK now, but wanted me to know because if he started to lose it he wants his father and me there to be the clear-headed ones. The kids don't know how bad it is, he will have to tell them tomorrow. How do you tell a 17 & 14 year old about something that you don't understand completely?

So I'm on stand-by, although with Zerla back in the vet hospital it clears any obstacle. My schedule was open in anticipation of taking care of her, so nothing much to cancel. Waiting to hear from John in the morning.

There isn't much any of you can do, except to keep Martha, John, Lyle and Emma in your thoughts and prayers. There isn't any question of the outcome, just the timing. And no matter when that is, it's going to suck.

Thanks for letting me vent, Laurie

Nov 23: Zerla update

Up too late, so will make this quick. Fortunately in later tomorrow and in the office.

Zerla got worse last night, her walking went downhill, she was in a lot of pain. She purred and purred when I pet her, I spent as much time as my back could take sitting on a pillow on the floor, even checked e-mail with the laptop on the chair! But whenever I touched her knee she whimpered, couldn't bear any weight. I was also concerned that she hadn't used the litter box since coming back on Saturday evening.

Didn't want to panic, made sure she was comfortable overnight, but she was no better this morning. Loaded her up and started to vet, which is my old one, so about 45 mins away. Arranged for coverage in the office, which was made easier by a light schedule for the morning and a cancellation on the doc's schedule so he could do the stress echo.

Turns out she is severely constipated with stool through the entire colon, not uncommon after anesthesia and morphine. She will need IV fluid and enemas (which it is worth paying someone else to do!). But worse is that one of the three pins used to repair her knee came out, so was rubbing against the bone, which is why she was in so much pain. She will have to be operated on again tomorrow morning, although they assure me that it will be quick and not involved.

Even my poor kitty can't have an uncomplicated surgery!

Thanks for all the concern, Laurie

Nov 21: Zerla

Zerla had her knee surgery two days ago, the vet said everything went very well. Right now she's confined to the study wearing a plastic cone collar so she can't get at the incision, and a large portion of her right rear flank is shaved with the incision and lots of stitches--more than I thought there would be. She looks pretty pathetic, the collar can't be comfortable. She seems to be limping more today than she was yesterday. The vet is supposed to call tomorrow and will hopefully be reassuring. From the time I picked her up she just purred and purred, and just loves it when I sit on the floor with her and pet and scratch her ears. Problem is my hip and back don't take that position for too long!

Went to the closer UU Fellowship that I started going to a few months ago. Trying to develop more friends in the area. It's a little easier now because I've been going to a discussion group that meets for 10 weeks, almost everyone was there this morning, so more of a sense of belonging. The group ends this Tuesday, but I'm hoping we can agree to get together regularly because it's a super group of people.

Cleaning the room for Zerla yesterday was somewhat frustrating. There was so much to do, and I was happily planning other things to do around the house to clean and pick up. Housekeeping is not one of my talents, and there is a tendency for every horizontal surface to have stuff piled on it. I really need to be more disciplined in reading and going through stuff so it doesn't pile up like that. And my other excuse is that it's not just picking up, it's organizing because the place hasn't been organized since I've been here. But I'd love to have it looking decent enough that people could be invited over to hang out. The frustrating part is that there's only a couple hours of energy to get a lot of things accomplished. So just when there is stuff to run up to the garage, or several trips of things to go down to the basement, things to be moved around and repositioned, all of a sudden my body goes "Time's up! You're done!" My goal now is to discipline myself to do a little bit every day. Let's see how that goes....

Thanks for checking in, Laurie

Nov 19: It seems as if it's been even longer

Much has happened in the last couple weeks, although nothing earth shattering, really. Just trying to get back to life.

After getting over the swine flu went back to work, of course. Still need to use the inhaled steroids as still coughing. No one likes a lot of coughing, but having a sternum (breast bone) that is, in essence, permanently broken makes it particularly unpleasant. I've gotten used to the chronic pain but have needed more Tylenol of late. And with more pain the fatigue seems to be worse.

The last two Tuesdays I've gone back into one of the hospitals for a half a day to do rounds. Hospital medicine is different from being in the office and the lack of treating patients in that setting has been evident when I've been on call. It's also been wonderful to see all the hospital staff again. But it really tires me out, even though it was only for 5 hours last week and then 4 hours this week. The resulting fatigue lasts for a couple days. So that's what has kind of sucked the energy out of me.

Saturday Joanne and John brought over a kitchen table she had ended up with, to replace the too small one that I've had for 20 years. This one is a little too big, making me feel like a kitchen-table-Goldilocks. John thoroughly scrubbed and cleaned the table while Joanne and I drank coffee and watched him slave, which is just about as much fun as two women can have without liquor being involved. That fun was a nice memory as the rest of the evening unfolded....

Did you know that cats have kneecaps? This became important information at 10 pm in the emergency vet hospital. Zerla, the tortoiseshell kitty, suddenly started walking strangely with her right rear leg, crying in pain. When it went completely limp repeatedly there wasn't a choice but to take her in emergently. Her kneecap is now popping out with almost no provocation, even kicking up the sand in the litter box. So, she's having knee surgery tomorrow. And then about eight weeks recovery, keeping her from jumping or playing. But the surgery is supposed to be highly successful and will get her back to normal again. Ah, the joys of pet ownership.

Hey, taking care of my recovering kitty is a great excuse to stay home and rest from the extra activity. That's my story, at least. Thanks for checking in, Laurie

Nov 2: Oink, oink

Went to work last Thursday, actually was there late because a very nice gentleman went into sustained vent tach during the last stress test--welcome back!! Friday stayed home, did several things around the house. Felt tired, but temperature almost back to normal and body recovering. Had one scary episode of extreme dizziness in the afternoon which I attributed to sitting cross-legged for a while. But then Saturday morning I woke up vomiting, felt horrid while running errands. Nauseous, lightheaded, body aches, temperature back up. It's embarrassing to admit that it was only when calling the coordinator to cancel my involvement for Sunday's service that, after hearing my symptoms, he announced to me: "Laurie, you've got swine flu!"

I'd started to suspect it a couple hours before that, but resisted checking the CDC site until after he said that. No mistake. Already had the cough and congestion, but the sudden onset of dizziness and vomiting, recurrence of body aches, the temp going back up again.... Yup, it's the swine flu.

Honestly, it's not that terrible. Just feel tired and achy, although a little lightheaded after activity. Unfortunately, still running low-grade temps, and you're considered contagious until a full day after the temperature returns to normal. Too late now to take the anti-virals. Someone said to me today "Oh, you must feel just terrible, people say they feel like death with this thing!" Well, I've got a different definition of that feeling.... Hey, after you've been in heart failure and gasping for breath a little flu is a piece of cake--this will pass without major surgery.

And, since I'm still taking the antibiotics for the asthmatic bronchitis my INR is wacked out again. At least with the home monitor it can be immediately treated, which makes me feel better. I was running errands on Saturday before the recognition that it was something really contagious, managed to drop off a thumb drive with 284 vacation pics on it (edited down from 971--really!), and my tenant picked them up for me Sunday, which was very nice of her. So having those perks me up--the Stone Henge ones came out really well.

Very frustrating for work--vacation 2 weeks, only worked one day last week, out today and tomorrow at least. And, of course, comparisons being made with the last international trip for two weeks when I came back sick that progressed to severe asthmatic bronchitis and then the finding of the mitral valve disease. They may not let me leave the country again after this!

Will update a few more things in the next couple days. Laurie