Pain and Suffering

My mother cautioned me to other choices when I mentioned the prospective, now actual, title of this post. But everybody knows that metastatic lung cancer is no cakewalk. It causes the victim pain and suffering—and eventually death. And, if it happens to someone you love, it causes you pain and suffering, if only empathetically.

Notwithstanding the recent, surprising tumor regression, my father has been sickly for a week. Nausea. Lack of appetite. Dizziness. Difficulty climbing stairs. I followed him up to his bedroom this evening, noticing the syncopated rhythm of his footsteps and the cane: step, step, thump. [Pause] Step, step, thump. He had to stop at the first landing where, with his head resting on the banister, he said softly but with a noticeable hint of anger, “Weak as a kitten.” His frustration at his own enfeeblment was wrenching.

It has become hard to attribute his current symptoms to his most recent chemo treatment. My mother and I each wish we could learn the cause, because maybe then we could find a way to mitigate his discomfort. Knowing also would help alleviate our nagging back–of–the–mind apprehensions—the kind which never really leave you when someone you love is terminally ill.

At least he is improving.

In Brief

Hi,

I’m sorry I haven’t been posting regularly. I’ve been fighting a deadline at work. I’ve also been told that—even in the wake of record profits—Wells Fargo is cutting budgets and I and the other consultants on my team are soon to be terminated. So I’ve also been freshening up my resume and pounding the pavement at the same time. But enough about me.

My dad has had a lot of nausea in the wake of his recent (4th) chemotherapy treatment, last Tuesday. He has eaten very little and slept poorly. Having seen this before, in the wake of chemo infusions, we were initially gladdened by recent news that further treatments would be less–affecting oral. Unfortunately, Dr. Canin has since decided that, owing to the unexpected amount of regression of the pulmonary tumor, the primary cancer site, future chemo treatments will not be oral after all, but will continue to be intraveneous. I trust that the suffering my father is experiencing therefrom is worth the hopefully consequent continued prolongation of his life. I’d say so, but that would be my selfishness. In the end, it is solely my dad’s decision.

I have also learned that the bone–hardening infusions my father has been receiving (the most recent being last week, too) are not as I thought iridium, which is an element, but Aredia, which is a trade name drug. It’s basically Fosamax times ten.

More soon.

Four for Four

This week, all at Kaiser Permanente, in Walnut Creek.

Monday: Appointment with Dr. Canin
Tuesday: Chemotherapy Apointment
Wednesday: Post–chemotherapy examination for post-chemotherapy Taxol intravenous infiltration
Thursday: Iridium infusion

Waiting for hours. Driving back and forth between Berkeley and Walnut Creek. My mother must be exhausted but she doesn’t really show it.

At the very least she deserves beatification.

“Considerably Shrunk”

My dad saw Dr. Canin today. The discussion focused around the significantly favorable results of my dad’s latest CAT scan. My parents reviewed the radiographs, which clearly showed considerable regression of the pulmonary tumor. My mother’s stated opinion is the title of this post. (Don’t forget that she was a registered nurse, so her opinion isn’t of the laity.) My dad might be an outlier after all.

Tomorrow will be my dad’s fourth chemotherapy, which as before, will be adminstered intravenously. After which I am sure he will feel tired and probably nauseous for several days. However, succeeding treatments will be oral. Yes, he will simply take a pill, which will be far less toxic, with fewer and lesser side effects. We are all very happy about this.

The news keeps getting better and better, though he is still weak and having frequent bad days. And, it is important to note, there has been no discussion about the metastases. I need to follow up on those....

Inurement

It has been just under two–and–a–half months since I found out my dad has lung cancer. I am emotionally exhausted, as I know my parents, sister and other relatives to be, as well.

At first, everything was new, everything was an unknown, a cause for alarm. Amped by the epinephrine, cortisol and other stress hormones coursing through our veins, our emotions were at a fever pitch. I won’t say we’ve since become blasé, but the shock, anger, fear, anguish and foreignness are dissipating, instead being replaced by understanding, acceptance and growing knowledge. The one constancy is uncertainty. That won’t end till, well, the end.

We’ve learned a lot:

• There will be more chemotherapy (the next round is Tuesday, January 23rd).
  
• There will be unpleasant side–effects.
  
• There will be more mysterious procedures.
  
• There will be more long days.
  
• There will be more—increasingly—bad days.
  
• There will be more good days—relatively few, most likely.
  
• New symptoms will appear.
  
• Old symptoms will recur.
  
• Affordances will be made.
  
• There will be some joy.
  
• There will be frustration.
  
• There will be fear.
  
• There will be lots of pain.
  

It’s going to be like this for a while. Maybe a year or more. (Very unlikely.) Maybe just a few weeks. (Rather unlikely, given the recent regression of his tumor.) Nobody seems to know, or at least be willing to predict.

‘Chemotherapy’ has given way to ‘chemo’. The procedures are becoming familiar. The myriad appointments are all blurring together. The daily phone call to my parents begins with asking my dad how he feels and ends with discussing the latest medical news with my mother. It has become surprisingly routine.

We are living with cancer.

Clarification & Amplification

Since yesterday’s principal post, I’ve received congratulatory messages concerning my father’s improvement. For example:

Let’s hope the trend continues indefinitely! Please give him my best wishes for a speedy recovery.

Those are nice sentiments, and I certainly agree with them in spirit. Unfortunately, reality is frequently in conflict with our wishes. And so it is here. To underscore what I said yesterday: He is not going to get better, not really. He will experience a brief improvement after which he will resume his downhill slide, almost certainly thereafter irreversibly. Well, he could experience spontaneous remission. And I could win the California Lottery.

But why not at least pass on the wishes? Well, my dad is a dispassionate, philosophical, scientific pragmatist—except about Republican politics, a topic on which frequently he raves. He understood clearly when Dr. Canin said “Well, you don’t have that much time left,”, though the statement certainly was abstract. He appreciated the significance of Dr. Canin’s further comment that, for patients like my dad, chemotherapy isn’t a cure; on average it prolongs life by just six to ten weeks. My dad understands that he is going to die. Soon.

Consequently, I think that wishes for a speedy recovery are ill–advised and inappropriate. But I will not edit your hopes and feelings. After reading this post, if you still would like to convey similar hopes/wishes/sentiments to my father, please [removed]. She’ll be able to pass the message on to my father sooner than I would.

Admittedly...

I am happy!