Wednesday, August 25, 2010

"I am not a Pollyanna." Joseph McGuirk

I'm sorry for the long dry spell of news. I've been trying to get organized a little bit and figure out next steps.


I spend most of every day at the clinic getting supplements (blood, platelets, potassium) and have been coming home with overnight packs of more fluids. Since the second round of chemo ended Sunday I feel pretty lousy most of the time and have had trouble keeping any food down at all.


Yesterday I met with a pain management doctor (palliative care) who I met with in the hospital last summer. She came up with a couple of creative ideas that have reduced the vomiting considerably. So I am more comformtable than I have been.


Today, Dr. McGuirk stopped by my little pod at the clinic and we had a one on one conversation. He opened with "I am not a Polyanna. I have to tell people they're going to die frequently in this practice over the last 20 years." He also predicted that I will feel worse before I feel better after this second round of chemo. For about 5-10 days. Hopefully I will not experience all the uneasy options, but I guess it's likely I might have one or two more than I do now. I can't imagine anything worse than the nausea and vomiting but my mind has kind of shut down much of the pain and symptoms from last summer.


Anyway, the upshot of our conversation is that he thinks it's possible to get me a couple more years on this earth, always reminding me that I am in charge. Right now the track is set until we reach the point of deciding whether to do a T-cell booster from my brother. Some other things have to fit into place between now and then (PET scan, bone marrow biopsy) but that is the next non-passive decision.


A T-cell booster, if successful, will cause more graft v. host disease. It will also be a long shot to hit the little window of success that McGuirk believes exists because the biology of my leukemia has been very different than any other he's worked with. My personal reaction is I may not want to live two more years like the last two. Isolation, pain, nausea, vomiting, midnight runs to the hospital, etc. No matter what McGuirk believes and hopes. There is a quality of life question here to be considered.


So I am setting in motion the actions to wrap up my life. Things to leave for my grandkids, nieces and nephews. Sorting out my business, which if you are a customer, I will be contacting you with some options in the next 10 days to 2 weeks.


Chloromas are terminal. Sooner or later. There is something about the science of the cells needing to be able to move in and out of the lymphatic system. And repeat transplants make the cells stickier and stickier so they don't move easily. They get stuck and they create chloromas.


I welcome your comments as always here. Love your cards. I'm interested in ideas and plans for this end of life stuff. Feel free to call and schedule a visit. I'm open to talking about all of it, crying about it, laughing about it.


My sisters, brother, and cousins and parents have been steady sentinels for me over the last weeks. Conor and Annie and Mark visited last weekend with the grandbabies while I was still feeling relatively sane if not "healthy." This Saturday we are having a blowout family gathering in my backyard, moved from its previous destination of the park. I am fortunate to have a huge backyard, overlooked by a huge deck (which I built myself!)


~Cathi

Editor's Note (Conor here)
Mom asked me to review this post and I wanted to leave what she'd written in tact as they're her words and there's nothing I want more than for her to 'own' the rest of her earthly time.

That being said, I want to add that McGuirk said there's a 'glimmer' of hope she could make it through this. Yes, it's < 1% but it's a glimmer. The only things we know definitively are what Mom alluded to above as well as the fact she is completely done with chemo. There's no reason we would do another round, which is welcomed news after who knows how many rounds the past 2+ years.

The way I've been explaining it the past week is that on 7.12.08 (the morning after her initial diagnosis), we sat in her hospital room and said 'ok, if you don't make it through this, this is what happens.' And we agreed to put the negativity aside and focus on surviving - never discussing again what would happen if she didn't make it. Now we do need to acknowledge that negative option is 99%+. So we make plans accordingly and enjoy the time we have.

This isn't the first nor last time I'll say this, but I want to let everyone know we, as a family, appreciate the tremendous support we've received since 7.11.08. It's been an amazing feeling getting everyone's emails, cards, phone calls, Facebook posts, and visits / caretaking. And as a son I cannot express how proud I am of the fight mom's put up. She's always been strong, but this ordeal has made it that strength even more apparent. I thank God daily for such an amazing mom to learn from and befriend. And I'm more than sure that everyone reading this would agree.

10 comments:

Anonymous said...

Not sure how I excited I am about a pole position for this post, but here we are! There are never words to describe life or end of life. I do know that you have fought and continue to fight the battle of your life. You have had many victories and helped with many new breakthroughs in regards to beating leukemia. While we understand we have to face reality at times, it is nice to continue to fight our battles. We love you very much and have enjoyed and will continue to enjoy all of our time with you...no matter how long that will be!

Love-
Mags and Craig

gail said...

Cathi,

You have lived such a brilliantly amazing life in so many ways. Your two incredible sons are the absolute proof of that!

I know you will never give up your desire to live a good and righteous life full of wonderful moments and celebrations - of everything from lillies in the front yard to watching your grandchildren arrive in the world. Those memories will live on forever through every person you have ever touched.

You have given me such sage advice for so long. I have saved every piece of wisdom you have shared with me. I can only hope to have but a fraction of the insight you have into how this world works.

You are my hero. I love you.

-gail

Glen Moulton said...

I commend your courage, the courage to battle and the courage to address the end of life options. I always believed any plan is some plan. I find it paralyzing to start something with no goal or plan, kudos to you for tackling a huge project.

I very much appreciate your update and I continue to pray for you.

Anonymous said...

Cathi,
It's hard to know what to say to news like this but you are the bravest woman I know. In the end, we are all what we leave behind and no matter what happens or when it happens, we will have a lasting legacy of fun, friendship, strength, love, and laughter because we knew you. I know you will find a way to enjoy every minute, month and year, whether that's a few more years or a few more decades. I will continue to pray for you and your family. Know that you're surrounded by love always.

Love you cuz.
Donna Bunyard

Anonymous said...

I am sad, I am MAD, I am crying and Dear Cathi I am with you all the way.I love you dearly.
Nedra

Anonymous said...

Cathi and Conor,
Once again, Cathi is holding the light for all of us. Once again, our friend does not disappoint us. She faces challenges and shows us the brave way of handling life AND end of life. We will ALWAYS hold Cathi and her bedrock family in our hearts. We love you so, dear Cathi. It feels, just now, like our tears will never cease.
Sara Grier and Tom and Paul Pistorius

Anonymous said...

I have said it before and I will say it again. Thank you for showing us how it is done. By opening up your life and your fight with this disease you are helping ALL of us. You are showing us how to live and how to die and taking the bull by the horns. Words can not express the sadness I feel trying to comprehend the fact that beating this thing does not appear to be happening. I am at a loss. Please know that I love you and want to see you soon.
Love your cousin,
Cheryl

Walt said...

Cathi,
Great courage and great post. Meager words can not express how I feel, but I believe in you and believe in the strength of your courage.

Robbie Stanley said...

Given how sobering it is to acknowledge where you're at with this, I hope it brings some relief to maintain some control over the time you have left. Making tough decisions is one of the things you do well. Whether is means not having more chemo, or how to manage your business and move forward, you will make decisions that are right for you. And don't forget that you've built a large army of supporters in the past two years. Please don't forget to use us in what ever way will help you accomplish what you want done.
Much love,
Robbie

susank said...

Cathi,
I am so sad. You have always shown how to live with courage, wisdom, energy, initiative, warmth and good humor. What a role model and friend. I hope to see you soon. Susan