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Cancer Has My Father

As I've already written on one of my other blogs, my father has cancer.

Why start another blog with this?  Because it's been dominating my thoughts lately and it's about time I explore the reciprocity of the situation.

This time was different.  The first three times, it was a disease that snuck up on him and manifested itself as tumors that could be removed surgically.  Granted, not all of every tumor was excised, but each time the brunt of it was gone, and each time the remaining pain was related to post-operative healing (abdominal surgeries, all).  The first two times it was decided surgery was the only viable option, it was widely held that chemo and radiation treatments would be ineffective.

The third time, after the surgery they opted for radiation treatment.  They had left bits of tumor in after the second surgery, rather than remove a kidney, and those remained after the third as well; they wanted to see if there was another way to treat what was left.

This time, they thought there had been enough advances (and the tumor was in a scary enough state) that chemo and radiation would help, and that the surgery would be on a resultantly smaller tumor.  Chemo, on an intensive in-patient basis, eventually made him completely bald but did not halt the growth of the cancer.  Radiation, for six weeks of outpatient treatment, left him progressively more tired as it had the last time he endured it, but apparently had as much effect as chemotherapy.  Finally, it was time for surgery.

The day of the surgery (May 8, for what that's worth), I caught second-hand that they didn't get the tumor.  My quiet nature had me in the right waiting room but unbeknownst to the doctor, who hence did not visit me immediately after the operation.  I heard from the nurse in the recovery room who had heard from the anesthesiologist that they were unable to remove it.

"They" (this time) were a team of I'm-not-sure-how-many doctors, including the head of surgical oncology (who did eventually speak with me), the doctor who had performed the last successful surgery, and a team of vascular surgeons who were only able to gain control of the blood flow on one end of the vessels the tumor is wrapped around.  It was the last point that prevented a six hour ordeal in resulting in anything more helpful than a follow-up colon infection.

I have not so far mentioned the blood clot.  I don't know that there's any relationship between the clot and the tumor other than the fact that they're both sources of pain.  The clot is in his right leg, and is partially responsible for its swelling.

I have not so far mentioned the indignities.  The NG tube is an old nemesis, and has come, gone, and returned.  Hopefully it got pulled today, but it should have come out yesterday, when he was ostensibly to return to a liquid diet.  The catheter is a necessity when one is essentially bed-ridden in an ICU (he's on his second stint in his second ICU, this time the MICU, first time the HICU post-op) and wired for sound, blood pressure, oxygenation and whatever else.  The diapers are the only way to limit the number of changes of bedding that would otherwise accompany the diarrhea.

I don't know how many treatments, tests, scans and attendant preparations he's undergone.  I know there was a triple enema one day, followed by not getting the scope as expected.  That was followed by two more cleansings and finally a scope and some biopsies.  I know he had a central line left over from chemo, and that he's had another put in so they can get blood samples more easily.  I know he's nearly out of usable veins.  I know he's been on a bunch of antibiotics, has spiked two fevers, has vomited (prompting his second trip to the MICU) despite being on IV drips, and no longer has any trepidation about his "pain button".  After his first surgery, they introduced the pain button -- a grey-cased hand-holdable thumb-pushable button on a wire leading to a morphine dispenser.  Feeling pain, push the button, get morphine, stop feeling pain.  He was worried about morphine addiction after that first surgery, but this time the pain button is his friend.

He is retaining fluids.  Both legs are swollen, though I think the blood clot helps the right leg retain the size advantage.  His testicles are reportedly the size of softballs and make sitting up difficult.  If they do switch him back to a liquid diet (apple juice, broth and the ever-derided Gel-Treat) he is hopeful that they will reduce the IV intake to balance and, of course, eventually pull some of those tubes on out.  He's disconnected enough of them accidentally in attempts to get to the bathroom, before the diapers became part of his routine. 

The first three times it showed up, there were hospital stays followed by convalescent periods followed by gradually returning strength.  He kept his amazing upbeat attitude throughout.  The hospital visits were three weeks or so.  This time, there is no end in sight to the hopsital visit because there is no telling when the infection will be beaten.  It has already been a full four weeks and we are on the second day of his fifth.  His birthday was spent in the ICU.

His attitude has faltered.  Most days it remains.  We enjoy the small victories whenever they appear.  Unfortunately, the elephants in the room are the blood clot, the tumor and the infection.  They are the baby elephants.  The mama is the knowledge that the only hope for treatment is now clinical trials.  Because of that, I think this time the disease has him as much as he has the disease.

I know he'll beat it.  The stubborn my kids have doesn't all come from their mother, and the stubborn I have doesn't all come from my mother.  I just wish I knew how long it would take, and how I could help with anything other than moral support.  I don't want cancer to have my father, or my children's grandpa.  Right now, though, it does.

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