There were a litany of advantages to calling this blog a diary. It gives a considerable degree of artistic latitude and an avalanche of protection to the scrutiny of the squawkers so willing to judge and cast doubt.
Life lately is at a tipping point. That place where life changes indelibly and irrevocably. It is death lurking. The ominous threat has found my mom. She is 74, (everyone always asks me that, so, I will answer it from the git go).
She has breast cancer, no big thrill of the exotic here. Thing is it wasn't the most usual of presentations. It is a real example of how medicine and our options, lessons learned and advancements have influenced us.
My mom had a unilateral (one sided) mastectomy 23 years ago. At that time I was away sailing on big ships at sea. Pretty much out of reach for anything other than a fax, or satellite call which no one ever (ever!) made of short of, and singularly for one thing, and one alone; death. If you got called to take a satellite call you knew it was bad. You knew it was going to be really, really bad. Knowing this most family members spare you the notification until the ship hits the shore. No sense fretting alone for the rest for the months long voyage. I wasn't in the picture for her day to day life 23 years ago. She found a lump, went to her doctor and they had a small chat. She elected, (as she did this time too), to be as aggressive as possible. It was removed with very large margins that included the entire organ. The lump went with the breast. It is exactly what we do in vet med. (Except of course women like to have their boobs back after they are taken, so in human medicine there is this branch called "reconstructive." No such stuff in vet med). My mom is tiny, like really tiny. No one would ever know anything happened. She wore the same clothes and never missed a beat. Nothing was done for follow up, or clean up. Things have changed for oncology two decades later..
23 years went by,, and in mid 2019 she found another lump. It generated a quick call to her general practitioner, who sent her to dermatology under the suspicion of being an ingrown "something". The dermatologist sent her to a plastic surgeon who sent her to oncology. Took four months for this table tennis match to play out. Four wasted months with her prior history being dished out at each appointment and loads of passing the buck..
A fine needle aspirate at the oncologists led to a "high degree of suspicion" that her cancer was back. She elected for a matching mastectomy. It was done within a few weeks.
She stayed one night in the hospital post op. Went home with drains, but feeling pretty good.
Four days later she started with back pain. Over the next few weeks it got to the point she couldn't walk. Four doctors over four weeks and finally it was so bad she was admitted to the hospital for "pain management." Now I am not a human physician, and no one likes a back seat driver, and yes, hindsight is always 2020, blah, blah, but the fact that she, or anyone would have to go through so many weeks of being given driveled aliquots of escalating pain medications is something that NEVER happens at my practice. EVER. If a pet is brought to us in pain we provide lots of pain options. We don't start at skimpy and let pets suffer. If the client declines them I provide them for free. Pain under my care is not acceptable.
Over eight weeks of trickled paltry doses of every medication imaginable and available, some of which were included in her week plus hospital stay and the medications were still not enough to manage her pain. She, to this day, is still unable to leave her bedroom. Its heartbreaking to think you might end up spending your last days bed ridden from incurable, unmanageable intractable pain.
Early on, like right as the biopsy was delivered I sat her down to talk about what I know her doctors won't, we talked about ALL of the options.
"Mom, once you decide you are sort of committed to the journey that they have planned out for you. That is about six months of chemo and radiation. It should be something that you want to do so that you can have the best chance at the best outcome. It will be a long, hard, tiresome and toilsome journey, but you have to have the long game in mind when you start that race. Or, you can sell everything you own, lock up shop, and just not get on that bus. Move to Paris, drink wine, enjoy whatever it is, wherever you want. It's your choice."
Things changed before the wait began at the bus stop.
After 5 days in the pain management hospital stay, and her tenth diagnostic proved still yet unfruitful, and me being there daily, we called another all hands meeting.
"My mom has been here for 5 days. She is on, or has been on, every possible pain medication including opioids. She has morphine given intravenously every 4 hours, and she is still in pain. This isn't soft tissue. This is something more insidious. We all know that,,, right?"
Quiet faces replied.
"What modality is left to find the answer? What haven't we done, or, need to do again?"
"A bone scan." Her doctor replied.
"Ok, can we get one?"
It was ordered and done a few hours later. That night all of her doctors met in private in the basement, which is apparently where the diagnostic machinery is housed. That night they broke the news to her. I wasn't present but it was reported back to me as, "it's really bad."
Didn't we all already know that? I asked myself. I had given up pushing her to do anything other than find an answer and not over exert herself which only brought on more pain than she could bear at week two.
All of this has been a cascade of events without enough time to really put our feet on the ground to make any sort of plans or decisions. It is a tornado of shit and no umbrella will shield you.
The prognosis is, they say, (they being her tiny oncologist who is unwavering, exceedingly smiley and abundantly optimistic, after all how else do you be, get,, stay this way, in this field? Or, she's really new to this?), one to three years.
This sentence, her stay of her own bodies execution, is also a really big terminal exclamation point. No subtly, no chance of a get out of jail card. It's like a done deal.
Now it is natural to presume that you know your parents fairly, if not exceeding, well. I would be so bold as to say that I know my mom better than anyone, her husband included. This whole new twist in our lives has me having to rethink those words. I am perplexed, perhaps even shocked and peeved, about her reaction to all of this. All of the doctors, all of the tests, all of the pokes, prods, probing inquisitive conversations, the constant turnstile of nurses, social workers, therapists, scars, bruises, drains and pill bottles, never mind the hidden emotional and mental anguish without a destination to dump them at. This is a journey of destructive accumulation not liberty, peace, or freedom. She will lose all of that if it hasn't already been willingly surrendered to this disease taking them, one by one. As they slip from her fingers she retreats deeper into her home. Her world shrinks to a place without public view. There is no plan for ticking off the Bucket List of life. No anger, no list of experiences to dive full-on cannonball dive into. No making the biggest splash to fully immerse and drown yourself in, damn the torpedoes! I'm having the greatest difficulty here. Feeling like fighting, arguing, and challenging every one, their expertise, their opinions. Why isn't she doing what I would do? Just living on my terms, my way, to the last breath,, And yet, maybe that's what she is doing, just not in the way I would wish for her?
It has been months but she has her medical answers. She has their recommended treatment plan. It's just not the plan I want for her. It's not the fireworks fanfare that a finale should have. She wants to stay home. Exist within her three rooms she has handicapped access to and be visited as often as possible.
Don't we all want to exit with the fat lady singing some crescendo to a lifetime worth reminiscing over?
And so for all the things she can't do, didn't do, and has't yet experienced, I find myself filling buckets of lists of experiences I can't live this life AND NOT DO! I can't accept having lived without having also nicked more notches into my belt. There are so many places yet to go. Things to see. Blogs to write. Videos to make. Things to eat on sun setting shores that span the globe. Hands to hold, pups to belly rub upside down, and cats to purr on my shoulder as we bid another long day of hard work I am immensely proud to be asked to participate in. I only have this lifetime to try to fit all of these into. I just don't know when to start. I don't know how to be my moms caregiver companion as I remind my own wanderlust to sit quietly, as it has for the decade of sea, the decade of clinic ownership, the decade of giving to the patients I so adore and the cement it barnacles in between my toes as she whispers her beckoned calls to stay with her, just a little longer.
Thank you to all who ask, who offer help, words of encouragement, concern and love. I am genuinely grateful.
To the girl I feel obliged to fill and conquer a Bucket List, I hear you too. We will go, soon enough, try to be patient a little longer.
Related story;
For the me inside still serving the greater good of the companions in our community I am here in the following spaces;
YouTube channel
Facebook Page for Jarrettsville Veterinary Center
Jarrettsville Veterinary Center website (with our price list)
Pawbly.com is the place for those who don't visit me at the clinic to help with their pets care, And it's
FREE!
Life lately is at a tipping point. That place where life changes indelibly and irrevocably. It is death lurking. The ominous threat has found my mom. She is 74, (everyone always asks me that, so, I will answer it from the git go).
She has breast cancer, no big thrill of the exotic here. Thing is it wasn't the most usual of presentations. It is a real example of how medicine and our options, lessons learned and advancements have influenced us.
 |
| Maize Quest Corn Maze October 19, 2019 |
23 years went by,, and in mid 2019 she found another lump. It generated a quick call to her general practitioner, who sent her to dermatology under the suspicion of being an ingrown "something". The dermatologist sent her to a plastic surgeon who sent her to oncology. Took four months for this table tennis match to play out. Four wasted months with her prior history being dished out at each appointment and loads of passing the buck..
A fine needle aspirate at the oncologists led to a "high degree of suspicion" that her cancer was back. She elected for a matching mastectomy. It was done within a few weeks.
She stayed one night in the hospital post op. Went home with drains, but feeling pretty good.
Four days later she started with back pain. Over the next few weeks it got to the point she couldn't walk. Four doctors over four weeks and finally it was so bad she was admitted to the hospital for "pain management." Now I am not a human physician, and no one likes a back seat driver, and yes, hindsight is always 2020, blah, blah, but the fact that she, or anyone would have to go through so many weeks of being given driveled aliquots of escalating pain medications is something that NEVER happens at my practice. EVER. If a pet is brought to us in pain we provide lots of pain options. We don't start at skimpy and let pets suffer. If the client declines them I provide them for free. Pain under my care is not acceptable.
Over eight weeks of trickled paltry doses of every medication imaginable and available, some of which were included in her week plus hospital stay and the medications were still not enough to manage her pain. She, to this day, is still unable to leave her bedroom. Its heartbreaking to think you might end up spending your last days bed ridden from incurable, unmanageable intractable pain.
 |
| September 16, 2019, my house cook-out. |
Early on, like right as the biopsy was delivered I sat her down to talk about what I know her doctors won't, we talked about ALL of the options.
"Mom, once you decide you are sort of committed to the journey that they have planned out for you. That is about six months of chemo and radiation. It should be something that you want to do so that you can have the best chance at the best outcome. It will be a long, hard, tiresome and toilsome journey, but you have to have the long game in mind when you start that race. Or, you can sell everything you own, lock up shop, and just not get on that bus. Move to Paris, drink wine, enjoy whatever it is, wherever you want. It's your choice."
Things changed before the wait began at the bus stop.
After 5 days in the pain management hospital stay, and her tenth diagnostic proved still yet unfruitful, and me being there daily, we called another all hands meeting.
"My mom has been here for 5 days. She is on, or has been on, every possible pain medication including opioids. She has morphine given intravenously every 4 hours, and she is still in pain. This isn't soft tissue. This is something more insidious. We all know that,,, right?"
Quiet faces replied.
"What modality is left to find the answer? What haven't we done, or, need to do again?"
"A bone scan." Her doctor replied.
"Ok, can we get one?"
It was ordered and done a few hours later. That night all of her doctors met in private in the basement, which is apparently where the diagnostic machinery is housed. That night they broke the news to her. I wasn't present but it was reported back to me as, "it's really bad."
Didn't we all already know that? I asked myself. I had given up pushing her to do anything other than find an answer and not over exert herself which only brought on more pain than she could bear at week two.
All of this has been a cascade of events without enough time to really put our feet on the ground to make any sort of plans or decisions. It is a tornado of shit and no umbrella will shield you.
The prognosis is, they say, (they being her tiny oncologist who is unwavering, exceedingly smiley and abundantly optimistic, after all how else do you be, get,, stay this way, in this field? Or, she's really new to this?), one to three years.
This sentence, her stay of her own bodies execution, is also a really big terminal exclamation point. No subtly, no chance of a get out of jail card. It's like a done deal.
 |
| September 24, 2019, at JVC. |
 |
| August 25, 2019. My last photo of Jekyll. He died the next day. |
Don't we all want to exit with the fat lady singing some crescendo to a lifetime worth reminiscing over?
And so for all the things she can't do, didn't do, and has't yet experienced, I find myself filling buckets of lists of experiences I can't live this life AND NOT DO! I can't accept having lived without having also nicked more notches into my belt. There are so many places yet to go. Things to see. Blogs to write. Videos to make. Things to eat on sun setting shores that span the globe. Hands to hold, pups to belly rub upside down, and cats to purr on my shoulder as we bid another long day of hard work I am immensely proud to be asked to participate in. I only have this lifetime to try to fit all of these into. I just don't know when to start. I don't know how to be my moms caregiver companion as I remind my own wanderlust to sit quietly, as it has for the decade of sea, the decade of clinic ownership, the decade of giving to the patients I so adore and the cement it barnacles in between my toes as she whispers her beckoned calls to stay with her, just a little longer.
 |
| Easter egg hunt 2019 |
To the girl I feel obliged to fill and conquer a Bucket List, I hear you too. We will go, soon enough, try to be patient a little longer.
Related story;
Human Vs Veterinary Medicine: Real-Life Case Meets the Dueling Ring. Who's Better and Why?
For the me inside still serving the greater good of the companions in our community I am here in the following spaces;
YouTube channel
Facebook Page for Jarrettsville Veterinary Center
Jarrettsville Veterinary Center website (with our price list)
Pawbly.com is the place for those who don't visit me at the clinic to help with their pets care, And it's
FREE!
I love your honesty and clear writing. Sympathy to ye all at this difficult time.
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