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Wednesday, 15 August 2012 16:38

The Best Good Thing We Could Hope For Today Featured

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Doctor Robin’s assistant called us around ten o’clock to let us know that the Doc was a little backed up and needed to move our scheduled appointment from 11:40 to noon. No biggie, but nice of the Doc to call. Last time we had an appointment I had complained about sitting too long in one of the clinic’s hard chairs, but that was back when I was still experiencing pain in my back. That she remembers is not only another sign of her commitment to humane patient care delivered with compassion, but it is also another sign of her personal commitment to me. To us. To our little family’s well being.

Small things like this note that itself was probably jotted down on my folder matter a great deal to us because they underscore putting the patient’s needs and feelings first. Sure, I can now sit comfortably in a hard chair due to the success of the radiation treatment, but Doctor Robin didn’t know that yet. So instead of risking that I might be uncomfortable, she simply consulted her notes and had her assistant make a phone call. No biggie, as I say, for the Doc or for the assistant. But the call and all it represented meant the world to us.

This meeting this morning promised to be an important one. I have been off the chemo for over a month and I have completed the radiation therapy as well. I am working diligently to reduce my dependence on the narcotics and steroids. I have ended my use of the short-term oxies and with tomorrow being my last day swallowing the measly one-half tablet of the steroid, I will shortly be totally steroid free. So, I am making better-than-expected progress meeting these treatment goals.

That said, today our agenda is to review my most recent blood work and scans and together - San, Nic, the Doc, and I - to discuss “the next step.” That discussion will involve an estimation of what else should or could be done - if anything - to alleviate any remaining symptoms (e.g. pain, swelling, etc.). It might also involve a discussion of additional chemotherapy treatments, depending on Doctor Robin’s interpretation of my CA-19/9 marker in relation to other existing data. So, as I say, this meeting promised to be an important one.

***

When you sit in one of the examining rooms at Four Winds there isn’t much to look at. The room is furnished with three small wooden chairs, a small round mobile stool unit on wheels, an examining bed that raises and lowers, and two desktops with the usual tools of the doctoring trade: cotton swabs, plastic gloves, bandages, and tissues. Behind the closed door cabinets are probably other medical trade devices, but I can only guess what they might be given they are behind closed doors. On two of the four walls are small, framed prints, both of which depict old town cobblestone street scenes. Both scenes have a light at the end of the street, an opening to whatever is on the other side of the wall, which, if you are an oncology patient and this is an oncology clinic suggest a hopeful secular and sacred end.

Ashley takes my vitals and we exchange some small talk. Yes, none of the meds have changed since our last visit, except in frequency of use. Yes, I still am eating and drinking well, and I have no problem with bowel movements. I am sleeping just fine. My blood pressure is checked with the standard arm device and it is fine. My temperature is checked with a digital thermometer and it, too, is normal. The saturation of oxygen in my blood is gotten from a clever little black device known as a pulse oximeter attached to my index finger; it is also normal. Ashley goes over these numbers with us and then exits the room.

Doctor Robin enters with a smile and we all hug. Our conversation focuses on a comparison between the empirical data from the blood work and how “good” I look, particularly when compared to how bad I looked the last time we were in this same room together. The really, really good news is that all of my organs are functioning just fine, and if you ignore (just for a moment) the CA 19/9 marker (which is up to 5800), there is nothing to suggest that I am in peril.

Doctor Robin uses her hands to frame my face, “this is the vital sign I pay the most attention to,” she says. “Last time you were in here I was worried because you looked bad.” She smiles, sympathetically. “You were in pain and it showed on your face. But look at you today.”

San and Nic explain that I had a curious sleeping spell over the weekend wherein I was literally out for 20 hours at a stretch and that 20 hours I was in a deep, deep sleep. “But on Monday morning sleeping beauty here” - San gestures to me - “ awoke and was back to his normal self.”

“Sometimes pain will do that to a body,” Robin explains. “When you are in as much pain as he was in the whole body absorbs it and the whole body has to get rid of it. So a long stretch of deep sleep is the body’s way of healing itself.”

“I did wake up a very different person,” I said.

“Now here’s the question for you today,” Robin leaned forward and took my hand. “Last time you were here you said you felt ‘diminished.’” Her eyes hold mine. “How do you feel now?”

“Not diminished,” I reply. We all laugh. “In fact, I’m feeling well enough to work on my class, which begins next week. I’ve also worked on some writing too. And I feel well enough to walk a few laps around the house; I’d go outside and do it but it’s just too hot.” No further explanation necessary for those of us who live in Chandler, where, for the past 10 days it has been over 110 degrees, with the local temperatures (meaning right in Chandler, not over in Phoenix, which tends to be a couple of degrees cooler) hovering around 112-116.

“That’s the best answer we can hope for,” she said. “Our goal has been to get you back to as close to normal as we can.” 

“Well, if I didn’t know I have cancer, then all I’d have to complain about is my swollen ankles/feet.”

Robin says, “Yes, I can see that.” She examines my right foot. Since I wore the new “compression” socks my foot and ankle are not as swollen as they were, but it is still noticeable. “Sometimes a water build-up from the steroids causes the swelling, so let’s see what happens when you are no longer using them. And you are still recovering from the radiation, which can also cause swelling.”

We were done, except for the one marker that had yet to be discussed. 

*** 

“Your blood marker has been all over the place and while, yes, it is somewhat elevated, there is no way to know for sure why. It could be a residual from the radiation. But as you know, this blood marker is not a precise measurement. What I’m taking as a more precise measurement is this marker” (she outlines my face again). “Which is why I think we just continue to live with it for awhile before we have any conversations about other treatment options.”

Whew! What a relief. This is just the sort of outcome that San, Nic and I wanted to hear. We have been discussing other treatment options and have come to the conclusion that we don’t want to undergo any further chemo (the recovery is too hard on me and detracts from quality time) if we can help it. That my face buys us more time away from treatments is not only a good thing, it is the best good thing we could hope for today and for the foreseeable future. 

Hurrah!!! 

*** 

A trip to the Four Winds Cancer Clinic would not be complete without a visit to the treatment side of the house and some big hugs with our oncology team - Gerri, Jan, Lauren, and Monica (we already hugged Terri). When they hear our good news they are ecstatic as well.

We exchange ribald humor about what happens when a fully functioning Bud gets a new bed (now that I have no pain in my back the clinic is ordering me an adjustable hospital-style bed), as well as about Monica’s newest rescue dog - another baby Basset Hound named Ruby.

I have such wonderful caregivers! We are truly blessed.

*** 

OK, so let’s look at today’s meeting this way (if you could see me, I’d be turning my head about 90-degrees). When you enter this phase of cancer it is less about treatment than about acceptance. Yes, I am doing fine. Today. I look good. Today. I am relatively pain free. Today. I am able to do most of the things that you and I consider normal activities. Today.

But it is one day at a time. That won’t change. And I hope to get in as many of those “one days” as I can before I leave the party. I don’t want to go, but it has been written somewhere that I must go, and so be it. In the interim I have had this profound year to review my life and gather around me those I care about and love for those final conversations that everyone should get but so few of us do. I’ve been honored with a book and visited by friends and family members. There is little left to say that hasn’t already been said.

Again, please don’t get me wrong. I’m still here. I’m not exiting any time soon, so far as I know. But that’s it, isn’t it? We never do know.

The only thing we do know for sure is that today is ours for the making, for the doing, for the loving, for the caring and sharing and daring. Offer up your prayers for others and open up yourself to receive the blessings of the universe. End each day with the personal heartfelt thanks to others that you would want to be said at the end of your days, and you will never end your days without that sense of thanks you wanted to say and you hope to hear echo through that long last night.

Today we got really, really good news. It is time to savor it. Tomorrow we are visited again by our ol’ pal Stew Auyash, which is a huge gift and a welcome one. Beyond tomorrow, who knows? We all face the same Milky Way when we look at the skies and the same questions for all of us still apply.

But that is the day after tomorrow. Today, what’s left of it, and tonight, what already beckons to us is waiting for our embrace, our celebration of life and of love.

You look good! What are you waiting for?

***

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