The trip was a great success, I got to show my kids new parts of the country they haven’t seen before, I got to say goodbye to many of my friends, and we had a large family reunion with my cousins, second cousins and their kids. It warmed my heart to see my kids play with their first and second cousins, made me think of future family reunions my children will attend without me.
Towards the end of the trip I started feeling worse than usual, my pain started getting bad, when we returned to Edmonton I went to the ER a couple nights later. After multiple tests, the doc said I probably just have a lung infection. He sent me home with some antibiotics. I was home but the pain was not subsiding, a few days later I was in so much pain I couldn't even drive, I got a ride to the emergency room from a friend. In the ER they identified a bowel obstruction and admitted me to the hospital. Apparently the cancer has spread enough to create a sort of sheet that surrounded my small intestine, hardened it, and created a blockage. They put a tube through my nose to my stomach to relieve the pressure for a couple of days and started me on a short course of steroids for a few days. The steroids did their job and relieved the blockage. After I was done the steroids course I was released home with a warning that most likely the obstruction will come back. I just didn’t realize how quickly it would.
It took barely a week for the nausea and pain to return. One night in mid May it was bad enough that my wife called EMS who took me back to the hospital for a longer term admittance, this time on long term steroids.
In between all these admittances I was trying to restart my chemo. My oncologist wouldn’t treat me while I was admitted, and once I was released, I only had one opportunity to book and make an appointment with her. The other appointment, the one to run more tests and restart my chemo, happened while I was readmitted, so I had to cancel that appointment. As a result I hadn’t had a chance to restart chemotherapy since I stopped it before my trip. I have been now two months without treatment, and doctors were starting to have the ‘hard’ conversations with me. In the one meeting I did have with my oncologist between early and mid May I agreed to change my goals of care from an ‘R’ status which would meant that hospitals would attempt to resuscitate me if my heart stops working and will intubate me if needed, to an ‘M’ status which would preclude those two options. In my last admittance, during the second obstruction which was while I was at the UofA, the conversation of whether or not I should be undergoing any treatment came up. Treatment was harsh, with all the nausea and pain that it brings, it can and has been shown to reduce life expectancy in the later stages. If I forgo treatment, I would be eligible for a bed in the palliative unit - where they care for my symptoms and make sure I stay comfortable. I wasn’t keen on going that route, but as I could see the strain on my family, and the dire prognosis (The attending physician predicted I had about a month around that time), I agreed to forgo treatment and try and get a palliative bed. It probably was the best decision, and it was supposed to be temporary, but it turned out to be probably the last hospital move I would ever make.
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