Join us on the chemo train, won't you?

Taken last week...

How much do you guys hate the Real World San Francisco cast after looking at that picture all week? Could've been worse...could've been Las Vegas. (Does anyone beside me even get that? Has anyone---besides my sibling---watched this show in the last 10 years?)

I just want you to know that every single day I am writing blog entries in my head. Someday, when handsfree thought-to-page technology is developed, I will be extremely prolific. Until then...

So, here's where we stand: The last two weeks have been among the hardest since my mom was diagnosed in February. The pain and vomiting have increased and for a few days it was so bad that she didn't leave her bedroom. As I write this though, she has taken an upturn and is presently sitting at her kitchen table with her sister and a friend of theirs from Pelham, NY where the three of them grew up. I am elated to be able to report that. I don't know what tomorrow will bring and the days certainly do vary, but if she can get a visit with loved ones in, she's still living a life.

She did end up doing chemo last week. After weeks of saying she was done with the stuff, a gut feeling ultimately had her choose otherwise. During the drive to see the oncologist on the day she made the call, she asked my dad and me if we would be "terribly disappointed" if she decided to continue with the chemo and we, of course, told her we would support her no matter what. The bottom line is that her oncologist said that she thinks it's her disease causing the pain and the chemo could help. Since the pain cropped up before the last big dose of chemo that was administered during her hospital stay and also continued afterward, there really seems to be no way to know what is what. A gut feeling is about as close to a definitive as one can get in this game, it seems. Oddly, I too, had a strange change of gut regarding the chemo. I've probably been the most skeptical of anyone regarding this course of treatment along the way (though I've learned that all there is to do in this scenario is follow my mom's lead rather than asserting my opinion). Even when she was in the hospital and the doctor gave her the three months or chemo ultimatum, I questioned whether she should go forward with it. But in the weeks following, I felt something shift in me and I felt myself leaning towards continuing with the chemo (though I didn't really voice this either). My mom came to it on her own; it was what she felt she needed to do.

Now, one could argue that this is how any cancer patient or family member is talked into chemo; when the alternative is to do "nothing," of course a person would find a renewed faith in chemo or any treatment for that matter. I recognize that it could be my desperate desire to have more time with my mom that subconsciously shifted my stance. Maybe the same goes for my mom. But what can you do? Time nor certainty are luxuries we are afforded, so you do the best you can. Do I ask myself every day whether I will have regrets regarding the decisions we have made? Yes, every single day I question every single thing and imagine the sickness of regret that will undoubtedly show up, but the only choice is to make impossible decisions while trying to discern whether time or quality of life is of the essence.

But, the idea of the current chemo treatment is to alleviate symptoms and I have thrown myself behind my mom and that plan. May this treatment shrink her tumors and may shrunken tumors make her more comfortable. Please, please, please. Prior to my mom's diagnosis I questioned the idea of palliative chemotherapy. I thought it a torturous measure demonstrating our culture's inability to accept death as a natural part of life. But, again, when it feels like you're out of options and everything is on the line, you do what you, I've since learned. Still, if I'm being honest, having witnessed how sick my mom is as a result of the chemo, I'm not sure it's something I would do were the cancer mine...specifically lung cancer. I should also state here that there are obviously many stories of people (including lung cancer patients) who have had success with chemotherapy and I certainly am not trying to minimize or discredit that. However, with stage IV lung cancer, chemotherapy is not considered a curative measure which is why there is such debate regarding whether its side effects are worth the benefit. We're banking on the benefit at this point. The goals now---it will probably take at least one more session before we know if it's working---are pain management and also keeping my mom eating (despite the vomiting) so that she can maintain her strength. They upped her meds yesterday and she's been pain-free all day, a huge feat, and also hasn't been sick since this morning (and thus kept two cups of soup, some fruit and a little jello down) which is also huge. Fingers crossed for tomorrow.

A nurse from the local Visiting Nurses Association came to the house today. My mom is enrolled in what they call "bridge," which is a bridge to hospice program that suits her needs since she is currently not considered end-stage but has a "terminal diagnosis." A nurse will come twice a week to assess my mom's health and help manage her meds as the combinations may change as things go along. I liked Carolyn very much and feel glad that my mom will be getting this kind of consistent care. Still, when I really think about the the fact that she's in a pre-hospice program (which I try not to do), the stark reality of everything sets in and I want to scream "How the fuck did we get here?"

And then I change the subject because there is another focus of life right now and it's not to be overlooked; that is celebrating my mom and helping her to enjoy each day as much as she can. Such words are the stuff of graduation cards and self-help books, but it is a literal goal we are all trying to help her achieve (and still I---and probably you---strive to embrace that one need not be facing death to work towards such a thing). And there have been wonderful moments. Last Friday night, most of my sisters (and a couple of husbands and a nephew) made it to the house for a big Italian dinner around the dining room table, a bowl of spaghetti passing between hands. At one point when I was taking the trash out, I could hear the sports announcer from the high school just up the street providing a play-by-play of the Friday night game. As I lingered in the darkness, the voices of the crowd and later the band carrying over the quiet of the fall night as it had when I attended that high school, and my sisters before me, it felt like a different time, another life.

I was bone tired as we sat and talked around the table after the meal, having been at the hospital all that day for chemo. My mom, plenty of sedative drugs still in her system, was closing her eyes at the table.

"Mom, do you want to go lie down?" I asked her.

She looked around the table at everyone and then gave me a smile that said she was grateful for my concern but also not interested in taking my advice.

"Not yet," she said tenderly.

And I got it. She rather be asleep at that table than anywhere else in the world.

That's the plan we're really supporting.