I was admitted to the surgical recovery ward an hour after coming out of surgery. I called my wife and parents and updated them that I was out and what that probably meant, they headed straight back. I saw my surgeon with just my parents in the room, and she confirmed my suspicions. When they opened me up they found many, many more dots, ‘thousands’. It was too much to take out, it was too much to even attempt the hot chemo as the hot chemo that would have been attempted would have been the same kind of chemo I had been getting through IV all those horrible months, the same chemo that had obviously failed. I was now officially a palliative cancer patient. I would probably be given palliative chemo but basically - I was going to die soon, some time in the following year or two.
Facing off your own mortality is hard; Realizing you are not going to be there for your kids is much harder. I felt terrible for them more than for me. My youngest was about to turn 4, my 13 and 11 year old were too young to lose a parent, to have to live most of their life with a memory of a dad long gone, to have to grow up without me in their life. When my wife got the news she was in a car. She felt she had to stop the vehicle, get out and scream on the side of the highway to express the pain. This was not an easy time.
But I still wanted to fight for as long as possible. My oncologist discussed with us our palliative chemo options - which is basically chemo that is just meant to prolong my life and not to save it. There were a few options. Statistically I would have a year or two from diagnosis, but it was questionable if you go by the initial cancer diagnosis, or by the stage IV diagnosis. I consulted with some other doctors, famous oncologists in New York (Dana Farber), Boston (Sloane Kettering) and Israel (heads of famous oncological departments as well as the famous Feurer and Fisher), and they supported that decision. The rest of my life will be on chemo, or so I thought.
Recovery was quick as there was no chemo used, just a small laparoscopic cut. I was out of hospital a week later.
A month or so later, in September 2018, I took my daughter on a weekend trip to San Francisco. Other than taking regular pain medications I was functioning normally. We walked the streets of the beautiful port city, a family member we met there commented that had he not known he would never have guessed I wasn’t healthy. The CTs were still clear as the dots were too small to show up, yet they were growing and spreading constantly in the background.
I started chemo soon after we returned. Again I would get infusions every two weeks, again I would feel sick and nauseated for several days following each injection, then slowly recover in the following few days, with some last good days before I had to go back and start the next round.
The first CT with negative results came back within a couple of months. Growth was seen next to my stomach and liver. My oncologist switched me to another type of palliative chemotherapy. Two months after that, a CT came back showing that the cancer was growing still, and has expanded to one of my ribs. In March, my chemotherapy treatment was switched again to a semi-experimental chemo and I started radiation for the growth in the rib.
I started putting things in place for after I was gone. I red worked my will, started writing letters for what to do after I was gone, started working on farewell letters to my family and to individual members, started throwing away old papers and binders and cleared my office to leave room for a bedroom for one of the kids. By going over all my old files I got to review my life and how my choices created my past and by extension - formed my present.
We went on a last trip back to Israel to say goodbye to my family there. Before the trip I stopped my chemo so I wouldn’t be dealing with the symptoms of the chemo. Little did I know that would be my last dose ever.
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