THE DEATH WATCH-TWENTY-THREE

Today turned out to be a very long day. I had to be at the hospital at 6:00AM for the installation of a temporary central line. Immediately after this was inserted into my neck I was wheeled into Dialysis for the procedure they refer to as “Phoresis”. What they are trying to do is get a background count on my platelets before the anti-body is introduced into my body to see if the anti-body can generate more platelets to fight the cancer cells. The machine they hooked me up to is like a dialysis machine in that it takes my blood out of my body and passes it through the machine before it returns it to me. The machine has a centrifuge which separates out the platelets from the whole blood and collects it for the trial so they can get an accurate count. In about a month’s time after I start getting the anti-body I will go through the same procedure again. From start to finish the process takes about three hours so the bottom line is, I didn’t get home until 2:00PM. Having not eaten or had any pain medicine since early morning, it was a very long day.

THE DEATH WATCH-NINETEEN

Death Is Not The End

by Bob Dylan

When you're sad and when you're lonely and you haven't got a friend

Just remember that death is not the end

And all that you've held sacred, falls down and does not mend

Just remember that death is no the end

Not the end, not the end

Just remember that death is not the end

When you're standing at the crossroads that you cannot comprehend

Just remember that death is not the end

And all your dreams have vanished and you don't know what's up the bend

Just remember that death is not the end

Not the end, not the end

Just remember that death is not the end

When the storm clouds gather 'round you, and heavy rains descend

Just remember that death is not the end

And there's no one there to comfort you, with a helpin' hand to lend

Just remember that death is not the end

Not the end, not the end

Just remember that death is not the end

Oh, the tree of life is growing

Where the spirit never dies

And the bright light of salvation shinesIn dark and empty skies

When the cities are on fire with the burning flesh of men

Just remember that death is not the end

And you search in vain to find just one law abiding citizen

Just remember that death is not the end

Not the end, not the end

Just remember that death is not the end

THE DEATH WATCH-FOUR

It’s Wednesday and I just got back from getting fitted for my Radiation treatments, which consisted of my lying on my back in a form that will be adapted to me so that with the lasers aimed at my tattoos I will be correctly position for the radiation. They will be using the tattoos that they made for my earlier treatments but the target will be set a bit higher since the tumor is in a different location.

Ever since the doctor said that the cancer had spread into the bones I have had pain throughout my body. I suspect that this may be due to the chair sleeping I’ve been doing and the mind set rather than the cancer. I will be getting a better picture of what to expect when I see the doctor next week.

THE DEATH WATCH-THREE-Addendum

One of the problems I will have to face is the veritable plethora of long faces on people who have learned of my condition from my wife. I tell those I want to tell in the way I want to tell it but invariably I get the “We’re praying for you …” and I lack the nerve to reply honestly.

There is a quote from Shakespeare that I recall from my youth that seems apropos at this time. First I have to tell you the story of my recollection. When I was about ten I was at an all boys summer camp in Maine and I was in a play called “The Valiant”. I played a priest in a prison where a prisoner was about to be executed and my roll was to walk ahead of the prisoner while reading from the Bible. My only line in the play was the quote, which until recently, I thought was from the Bible.

"Cowards die many times before their deaths,
The valiant never taste of death but once."

THE DEATH WATCH-THREE

Tuesday is here and I have an appointment for tomorrow. I guess I’ll work on my “Estate Plan” until then. There are a few things that I should try to take care of so that my loved ones won’t be burdened. I can’t believe that I have to talk to a lawyer to prevent my wife from having to pay inheritance taxes on my meager retirement funds.

THE DEATH WATCH-TWO

The results of the biopsy, taken on Monday, alerted my Radiation Oncologist who called on Wednesday to set up an appointment with him, preceded by a CAT scan. Monday I had the CAT scan and Tuesday morning I saw the doctor. He felt very badly about having to tell me that not only was this cancer located in a new part of my esophagus but that there seemed to be some extra spots on my lungs. The spots were too small to identify clearly and the lung is a very difficult place to biopsy so he suggested I get PET scan, which isolates cancer sites. The bottom line seemed to be that what was happening now was not curable and that we had to work out a treatment procedure. I scheduled a PET scan and also visited with my other Oncologist. He agreed that the PET scan was the first thing to do and then we could discuss options for my treatment. The first order seems to be to try to reduce the size of the constriction with radiation and then see if chemo seems worthwhile doing based on the extent of the cancer spread.

Thursday I had the PET scan and by that afternoon the doctor called to say that the cancer had spread into the bones. It is now Monday and I am waiting to hear from the doctor’s office about scheduling the radiation treatments after which we will discuss what further treatments are possible. I will probably get a better idea of my Time-Line, although I’m not sure how much of this the doctors can predict.

I plan to tell the doctors that I have only two requests, one, that I don’t die on a holiday and two, that I don’t die in pain. A question that I will have to ask my lawyer is that if my life insurance policy has a suicide clause, does that apply here in Oregon where doctor assisted suicide is legal. I have yet to discuss the doctor-assisted suicide with my doctors. Working in a Catholic hospital may prevent their participation.

Further thoughts at this time revolve about my loved ones and how they are reacting to the news of my terminal illness. I have not had the experience of trying to ease the impact on them because I only know that for myself I am not concerned. I guess I will be exploring these items in future items I hope to write.

THE DEATH WATCH

I have not written in this Blog since February because I really had nothing much to write about and I had very little incentive to just sit and write nonsense. However, since February I have been fighting with a worsening condition related to my esophagus. I started to have trouble swallowing and I was told that it is a very common occurrence to have scar tissue build up in the location of radiation treated cancer.

In April I had a CAT scan and it was determined that I was Cancer free and that not getting the esophagus surgically removed was not a bad decision.

Since February it has been harder and harder to eat food but I was told that I had very few options short of actually cutting out the entire esophagus and attaching my stomach directly to my throat. I didn’t particularly like that option. Another option was to have a feeding tube re-inserted. I had the feeding tube that I had during Chemo removed when I got my taste buds back. As the condition worsened, however, I was reduced to drinking protein shakes and Ensure. I was losing weight, which was a good thing, but my general health seemed to stay good.

Just prior to going East for my 50th class reunion even the liquid diet was becoming more difficult. The crises hit about a week before we were headed home when I even had trouble swallowing my own saliva. I had been crushing all my pills for high blood pressure, diabetes etc. but that now also became impossible. Obviously I was also not getting enough water into my system so I was getting dehydrated. By the time we got home I was in bad shape and my physical condition was not helped by the delay leaving Boston and the entire airport waiting due to missed flights. By the time we got home I really felt like I needed to be hospitalized. The doctor we called suggested I go to the Emergency Room at the hospital where my Oncologist was located so that’s what we did. My only goal was to get a stomach tube put in and I was prepared for feeding through the tube from now on.

My hospital stay turned out to be a bit longer than I anticipated because my Oncologist wanted to get a complete picture of my condition so before I had the stomach tube inserted my dehydration was stabilized and I met with a GI doctor to see what could be done about the closing of my esophagus. The GI doctor suggested he could insert an endoscope and try to dilate the scar tissue, in ever increasing amounts, so that an opening could be created. In addition, he said that it looked like the constriction was too high up in the esophagus to allow a stent to be inserted. I left the hospital with a stomach tube and a clean bill of health with reference to my blood pressure and my diabetes. I have not taken any of the medication since.

Although I started the endoscope procedures with the GI doctor, I had an underlying belief that the cancer had returned. In the period between June and October I had almost weekly procedures, which only temporarily fixed the problem. After a procedure I could swallow soup for a day or two but just prior to the next procedure I was back to having to spit out my own saliva. It got to be a real drag. My regular GI doctor went on vacation and his stand-in was the one who found the new cancer.

Thus begins The Death Watch.