A Second Opinion

Today he went to see the surgeon who had cared for him during his 2011 recovery.  He wanted to lay out what his daughter, the doctor, had told him about not having surgery and seek his opinion.   The surgeon confirmed what she had told him about having surgery.  He did not disagree with any of her six reasons to not have future surgery.   The surgeon suggested that he ask the oncologist if there were any new protocols at MD Anderson studying NETs and to get with them if he wanted to fight the NETs more aggressively.   The surgeon thought there might be a chance to do an ablation from the back without perforating the bowel.  But, he did not disagree with ‘don’t perforate the bowel’.   When he got back from the surgeon’s office he sat down and didn’t do anything the rest of the day.

Live With It

The decision to "live" with cancer sucked. 

There was a scene in The Vikings episode he watched today where a character did the "it's a good day to die" deal and then volunteered to be a human sacrifice. 

He struggled with how could possibly accept his fate cheerfully. He didn't know how only that he had to somehow.  Enoch and Elijah were the only two men who didn't die.  We all die.  The test is to die well.  He prayed that God will give him the strength. He didn't have it of himself. 

And if he was worried about his wife, the best gift he could give was to be the best husband any woman ever had for the "x" amount of time he had left.  

 

And who should he tell and when.  Surely not before he saw the oncologist again.  Maybe it would be best if he didn't say anything.  He didn't want people getting weird about it.  Maybe he'd wait to say something until there was a bigger problem than just waiting to see what happens with the tumors.  

Or should he tell anyone beyond his family and closest friends?  If he tells someone not in the inner circle, they'll say I'm sorry then they're stuck in an awkward situation.  So he or they say something about everyone dies and no one knows when they will.  But he's still standing there thinking about the fact he IS dying.  And, they're thinking, "yuck, what am I supposed to say to that?"

He lost 2 pounds last week and 3 the week before.  He wasn't  doing anything to account for the loss. He wondered if the C was eating him up.  Who knows it might beat dieting.

He was tired more that he wanted to admit.  

Sleepless Night

 When he went to bed, his wife asked him if he was okay.  he replied probably not. Then he began crying.  He felt like he was letting her down. 

   

He couldn't sleep with a bi-pap and cry at the same time so he went into the great room for a couple of hours and just thought about things.    

   

He didn't want to go through what would be entailed with a shorter bowel.  And he didn't want to go through months of wound therapy because his belly split like it did last time.  But, if she wanted him to he would. 

   

He decided that he would get a second opinion about what his daughter, the doctor, was said from the surgeon who nursed him back to health the last time and from the oncologist.

   He decided that he would not have any surgery or oblation.  No surgery was easy. He didn't want the side affects.  

   

He thought his small bowel was a breeder of neuro endocrine tumors (NETs).  The 3 lymph nodes that are now tumors if removed would only be replaced by more tumors.  And that eventually the NETs would go to his Liver, Lung or Brain and take him out.       

   

It had taken almost 10 years for the nodules in 2011 to cause problems if they were in fact the cause of his internal bleeding problem and not just some directiculum that decided to bleed.  He didn't think he'd get 10 years this time before they cause problems.  But he'd get some time and it will be high quality life like he was experiencing now, not short bowel diminished.

   

But, damn it, this is not the way he wanted for things to work out.  His wife needed him.  He felt horrible about deserting her.  

   

When they talked in the morning she said, "All I ever wanted was to marry a man who loved me totally for who I am.  And I got to do that."  

He cried!

Now What?

He had a daughter who was a physician.  In a conversation with her mother (his wife), she said "you must not let anyone operate on him."  

Because that could mean any number of things, he asked her during a visit to the beach what she had meant.  Did she mean she didn't like the local doctors and hospitals and wanted him to go to Houston for his next surgery?

Unfortunately, it wasn't that simple.  She meant his chances of recovering from surgery with good quality of life had a very low probability.  

Her thoughts were: 
1. He had big time problems with low blood pressure last time and probably would again. 
2. Diabetes has left his tissues very weak. She compared them to wet Kleenex and said that sewing wet Kleenex doesn't work.  And, that the reason he had a gaping wound last time was because of this problem. 
3. She thought he had so many antigens in his blood now that he couldn't count on there being enough blood if something goes wrong in surgery. 
4. Last time he was in near Kidney failure.  He should expect that again.  And he might wind up on dialysis.
5. He has short bowel symptoms now.  If more of his small bowel is removed, he will have problems with dehydration because he would not be absorbing enough liquids.  He might be forced to drink Ensure for nourishment because it passes through the gut the slowest or be hooked up every night for TPN.  And he would experience much more problem with diarrhea probably to the extent that he would be home bound. 
6. The possibility of an infection taking him out is high.     

He asked her what would happen if he had the oblation  procedure.  She said she thought poking a hole in his bowel trying to reach the nodules was a bad idea.  The weak tissue healing problems and the possibility for a puncture becoming infected leaving him in the same messed up bowel situation that he had last time.  Therefore not a good idea 

She said he could fight the cancer and probably have these results which would limit the quality of life or he could decide to make the most of the time I have left and do nothing. 

He asked, "What do we do if it metastasizes to my Liver or Lung."  She said to ask his oncologist.

He thought Holy Shit!

Free Fall by Robert Crais

Today I read Free Fall by Robert Crais.

#4 in the Elvis Cole PI series.  Elvis Cole is hired by a young woman to find out what is going on with her fiancé. Mark Thurman is an LA cop and she thinks he’s in some sort of trouble. When Thurman himself shows up in Elvis’ office and basically says ‘go away I’m involved with another woman’, Elvis figures his work is done. Jennifer Sheridan, however refuses to believe it and convinces Elvis to keep digging.

And the madness is on!  A good read.

Savage Run by C. J. Box

Today I read Savage Run by C. J. Box.

Laconic Joe Pickett returns to his slightly offbeat duties in Wyoming's Bighorn Mountains in C. J. Box's Savage Run. Joe is called to the scene when an exploding cow kills a famous ecoterrorist, Stewie Woods, and his bride of three days, who were peacefully spiking trees. A visit to the cow's pugnacious owner leaves Joe defensive, angry, and curious: Why doesn't the rancher ask any questions about the bizarre accident that happened on his land? Then Joe's wife, Marybeth, begins receiving phone calls from her high-school boyfriend—-the peculiarly healthy-sounding Stewie Woods. Stewie may or may not be alive, but his old pal Hayden Powell and other environmental activists are all turning up deceased in strange circumstances. As the body count climbs, Joe tries to sort out the bad guys, the good guys, and the truly dead guys in this sometimes funny, sometimes angry sequel to Box's award-winning first novel, Open Season. Box depicts the spare beauty and cussed individualism of the inter-mountain West with the sure hand of a seasoned writer. --Barrie Trinkle

Joe Pickett is still my favorite game warden.