Dec 1: Zerla & Martha (the latter the longer part)
Zerla has had a rough few days. They called me from the vet hospital and told me the reason she was in so much pain was that the left knee had dislocated and wasn't going back into place--she must have been really suffering. So, she had her left knee done yesterday. Both rear legs, poor little fuzzy girl. The up side is that she has become the darling of the place; the vet techs tell me she's their therapy cat because she is so sweet and purrs like mad when they come over and talk to her and scratch behind the ears. The vets all say how wonderful she is. She's clearly sucking up a lot of attention and loving it! Since she's having problems moving around it seems best to leave her there for a while longer, because she'd be all by herself in a separate room here at the house and me gone all day.
After the last posting I went to bed, tossed and turned, came to a decision at 2 am. Thanksgiving morning I woke, showered, packed a suitcase, called my friend/tenant Marilyn and asked her to take care of the other three cats, called my mother and apologized for bailing on Turkey Day (we were just going to a restaurant and she can always eat in the dining room of the retirement home), called my boss and told him I wasn't going to be able to do on call for him or work Friday and started heading to New York. I called John and announced that I'd made a command decision and would be there in less than three hours. There was a second long pause and then a very relieved "Good". He said he wasn't going to ask me to come but was very happy I'd made the decision. He repeated this in stronger terms throughout the rest of the days I spent there.
After looking at Martha's labs it was almost impossible to believe that she was still alive. Her calcium had been sky high, her potassium and magnesium critically low. There is no logical explanation for her heart not stopping, because that's what happens with those abnormalities. The doctors had told John they expected her to die, he signed a DNR order, which prompted the call to me and the rest of the family. And yet by Thursday night she was talking in entire cogent sentences, Friday night she was discussing the undertones in Southern Gothic literature, which is beyond me on my best day. She continued to improve mentally, even from morning to night, each day.
I'll spare you the parade of people that appeared over the next couple of days.
The facts are these: the cancer is metastasizing (spreading) so rapidly in her bones that it actually pushed the calcium from her bones into her blood, the other electrolytes were affected because of the calcium. She is anemic because the cancer is affecting her bone marrow production. All the lymph nodes in her right axillae (armpit) are dead, so her right arm has lymph edema, which you usually hear about with women who have breast cancer. It means it is swollen to double the size of the left, the shoulder and armpit are excruciatingly painful. The CT scan done two weeks ago shows mets (cancer spread) to the right scapula, a couple ribs are almost eaten through, it's in her adrenal gland, pancreas, liver and left hip. The MRI a month ago showed three lesions in her brain. For those of you just reading about this, it began as lung cancer. She is only 51 years old, never smoked a day in her life, exercised, did yoga and has eaten organic foods for years. All of this has transpired since her diagnosis in April of this year.
Despite the pain, the now useless right arm (she is left handed) and the advancing of the cancer throughout her body, Martha still wants to keep fighting. She wants more chemo and more radiation. The oncologist explained that the best case scenario was that it would slow, possibly stop, the spread, but there would be no cure and no decrease in what was already damaged. While she could not repeat the basics of the conversation to me two days later she is otherwise completely alert and cogent. And she is adamant that she is going to fight the cancer.
It is beyond words to describe how much you can admire someone for their refusal to give in, but feel such overwhelming sadness knowing the futility. This is not a battle she will win. But she isn't ready yet to succumb, although the reality is the unwillingness to accept death. The unknown is still more terrifying than the known, however painful it is physically and mentally.
John has been an absolute rock through all this, has supported her, cared for her and loved her. There were moments when he was sitting on her bed and the two of them were just gazing at each other, the emotion and love actually visual. It almost felt intrusive being there. But John's pain will be unimaginable. They have two children, Lyle 17 and Emma 14, whose lives will be forever affected.
Many years ago, March 2001, John and Martha did their wills and legal paperwork. At that time Martha asked me to be her health care proxy along with John. She didn't want him to have to bear the burden alone, have to make decisions on her life and death by himself. Of course I agreed. When she called me early in October, knowing her cancer was back, she asked me again to be there for John, to help him make choices, to support him. I gave her my word, again. I would have done so anyway, but it was helpful for both her parents and brothers to know that my involvement was what she wanted, had been decided on years ago, in formal legalese complete with notary stamp. (If there were advertising on this blog it would be a great time for an attorney's commercial!)
John and I are in agreement that we will honor her wishes, although he understands as well that the cancer will win. But who knows what her strength of will can accomplish? Lots of people will tell you stories of loved ones who lasted months and months past their predicted death. While my cohorts in medicine all think we're crazy, it wouldn't be right to deprive her of what time she has left--on her terms.
She wanted me with her, helping with the toilet and washing her. I suspect she remembers my repeated comments about the low point for me being unable to wipe my own butt and wants someone who understands the indignity of it it all to be helping her through it. Her last comment to me before I left Sunday was that I was her inspiration. What the hell do you say to that?
The next issue will be where she goes once she can be discharged from the hospital. As of this writing she is unable to get out of bed or up/down off the toilet without assistance. That would make coming back to the house involve a hospital bed and nursing care. It turns out that things have changed dramatically and you can actually be in hospice while still getting chemo and radiation. While we know she won't accept that idea at this point, my suggestion to John was to present it as a temporary thing, that she could go off hospice when she improved but that it gave more options for her care now. We'll see how that flies.
I'll be going back up again after work Thursday night to be there on Friday for conversations with doctors, case managers, nursing, etc. At this point we can only take things one day at a time.
There is nothing that anyone can do, but I ask for your prayers and love for my family at this time. Regardless of what happens when, the next couple of months are going to be very difficult for all of us.
Thanks for checking in, Laurie
P.S. It's time for all you 'lurkers' to show yourselves and leave a comment--please! It will be easier for me here than individual e-mails.
After the last posting I went to bed, tossed and turned, came to a decision at 2 am. Thanksgiving morning I woke, showered, packed a suitcase, called my friend/tenant Marilyn and asked her to take care of the other three cats, called my mother and apologized for bailing on Turkey Day (we were just going to a restaurant and she can always eat in the dining room of the retirement home), called my boss and told him I wasn't going to be able to do on call for him or work Friday and started heading to New York. I called John and announced that I'd made a command decision and would be there in less than three hours. There was a second long pause and then a very relieved "Good". He said he wasn't going to ask me to come but was very happy I'd made the decision. He repeated this in stronger terms throughout the rest of the days I spent there.
After looking at Martha's labs it was almost impossible to believe that she was still alive. Her calcium had been sky high, her potassium and magnesium critically low. There is no logical explanation for her heart not stopping, because that's what happens with those abnormalities. The doctors had told John they expected her to die, he signed a DNR order, which prompted the call to me and the rest of the family. And yet by Thursday night she was talking in entire cogent sentences, Friday night she was discussing the undertones in Southern Gothic literature, which is beyond me on my best day. She continued to improve mentally, even from morning to night, each day.
I'll spare you the parade of people that appeared over the next couple of days.
The facts are these: the cancer is metastasizing (spreading) so rapidly in her bones that it actually pushed the calcium from her bones into her blood, the other electrolytes were affected because of the calcium. She is anemic because the cancer is affecting her bone marrow production. All the lymph nodes in her right axillae (armpit) are dead, so her right arm has lymph edema, which you usually hear about with women who have breast cancer. It means it is swollen to double the size of the left, the shoulder and armpit are excruciatingly painful. The CT scan done two weeks ago shows mets (cancer spread) to the right scapula, a couple ribs are almost eaten through, it's in her adrenal gland, pancreas, liver and left hip. The MRI a month ago showed three lesions in her brain. For those of you just reading about this, it began as lung cancer. She is only 51 years old, never smoked a day in her life, exercised, did yoga and has eaten organic foods for years. All of this has transpired since her diagnosis in April of this year.
Despite the pain, the now useless right arm (she is left handed) and the advancing of the cancer throughout her body, Martha still wants to keep fighting. She wants more chemo and more radiation. The oncologist explained that the best case scenario was that it would slow, possibly stop, the spread, but there would be no cure and no decrease in what was already damaged. While she could not repeat the basics of the conversation to me two days later she is otherwise completely alert and cogent. And she is adamant that she is going to fight the cancer.
It is beyond words to describe how much you can admire someone for their refusal to give in, but feel such overwhelming sadness knowing the futility. This is not a battle she will win. But she isn't ready yet to succumb, although the reality is the unwillingness to accept death. The unknown is still more terrifying than the known, however painful it is physically and mentally.
John has been an absolute rock through all this, has supported her, cared for her and loved her. There were moments when he was sitting on her bed and the two of them were just gazing at each other, the emotion and love actually visual. It almost felt intrusive being there. But John's pain will be unimaginable. They have two children, Lyle 17 and Emma 14, whose lives will be forever affected.
Many years ago, March 2001, John and Martha did their wills and legal paperwork. At that time Martha asked me to be her health care proxy along with John. She didn't want him to have to bear the burden alone, have to make decisions on her life and death by himself. Of course I agreed. When she called me early in October, knowing her cancer was back, she asked me again to be there for John, to help him make choices, to support him. I gave her my word, again. I would have done so anyway, but it was helpful for both her parents and brothers to know that my involvement was what she wanted, had been decided on years ago, in formal legalese complete with notary stamp. (If there were advertising on this blog it would be a great time for an attorney's commercial!)
John and I are in agreement that we will honor her wishes, although he understands as well that the cancer will win. But who knows what her strength of will can accomplish? Lots of people will tell you stories of loved ones who lasted months and months past their predicted death. While my cohorts in medicine all think we're crazy, it wouldn't be right to deprive her of what time she has left--on her terms.
She wanted me with her, helping with the toilet and washing her. I suspect she remembers my repeated comments about the low point for me being unable to wipe my own butt and wants someone who understands the indignity of it it all to be helping her through it. Her last comment to me before I left Sunday was that I was her inspiration. What the hell do you say to that?
The next issue will be where she goes once she can be discharged from the hospital. As of this writing she is unable to get out of bed or up/down off the toilet without assistance. That would make coming back to the house involve a hospital bed and nursing care. It turns out that things have changed dramatically and you can actually be in hospice while still getting chemo and radiation. While we know she won't accept that idea at this point, my suggestion to John was to present it as a temporary thing, that she could go off hospice when she improved but that it gave more options for her care now. We'll see how that flies.
I'll be going back up again after work Thursday night to be there on Friday for conversations with doctors, case managers, nursing, etc. At this point we can only take things one day at a time.
There is nothing that anyone can do, but I ask for your prayers and love for my family at this time. Regardless of what happens when, the next couple of months are going to be very difficult for all of us.
Thanks for checking in, Laurie
P.S. It's time for all you 'lurkers' to show yourselves and leave a comment--please! It will be easier for me here than individual e-mails.
8 Comments:
At 4:32 AM,
Anonymous said…
I will be thinking of you and your family, Laurie. I know how frustrating it is to feel helpless when it comes to someone you care about being in pain. I'm sure your presence is a comfort.
At 6:16 AM,
Tom Thomaa said…
I admire your dedication to following Martha's wishes in the face of such a nasty prognosis. May you succeed in bringing her some peace and dignity. My best to John and Lyle, and Emma.
Tom
At 7:32 PM,
Michael Kahn said…
Hi Laurie,
I admire your ability to be there for Martha and respect her wishes. You all are in my thoughts.
Much love,
Michael
At 8:54 PM,
Anonymous said…
It broke my heart to read your description of Martha's most recent turn of events. While I cannot possibly imagine what she's going through, I admire her strength and courage as she faces this difficult battle. I will certainly keep them all in my thoughts and prayers. I'm glad that you can be there for them during this time, too.
Stay strong
Kim
At 8:20 AM,
Barbara Preuninger said…
Martha is in my thoughts, and you too. Aside from her miserable luck generally, at least she has the good fortune of knowing you! I will hope for her recovery, even if it seems hopeless. And if she can't recover, then I hope she can choose to fight or accept it on her own terms.
At 10:04 PM,
Anonymous said…
Laurie,
I wish you strength and peace as you offer stability and support for your family.
For Martha I wish continued strength and courage as she continues her fight against an unruly enemy.
At 12:12 AM,
Anonymous said…
Laurie,
again you show how strong you are.
May you take comfort during this horrible time knowing that you are helping her deal with this on her terms! She knows and feels the love of those around her. She also can spend more time fighting the enemy within knowing that you are helping her family through this.
You, the cat, and the family is in my thoughts and prayers!
Deneen
At 11:27 AM,
Anonymous said…
love u and thinking of u, my favorite 'partner'...
Joanne
Post a Comment
<< Home