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Monday, October 10, 2005

doctor visit #1


Other people can somehow come up with coherent narratives around such experiences, but not me. I'm just a big bag of impressions, and I don't know what the hell is true and what isn't.

The occupational therapist came today, gave Mom a grabby-thing and some theraputty and a bunch of exercises and advice. It was good information, but it wore Mom out a bit, which we hadn't expected at all. If I'd known it would be such a busy visit, I would have scheduled it for Wednesday, when she had nothing else on her calendar. Oops.

So we saw the oncologist today in Bremerton. Mom missed her appointment last Thursday, and the one before that, due to panic attacks in the car. Jerry didn't even manage to get her out of Port Townsend, he said. So this time we gave her a half of a Lorazepam (or something like that) for anxiety, and it made her really groggy. So weird, because she has been fairly perky the last couple days, and now she was just zonked out. She just sat in the wheelchair with her eyes closed while we talked to the doc, and oddly, he didn't seem at all surprised to see her so listless. She apparently walked into her last appointment five weeks ago, so this must have been a big change. Well, maybe he's unflappable. On the other hand, maybe he's expecting this. You know, it's only been a year since this whole thing started, and her condition has deteriorated pretty significantly in that time.

From my notes on the doctor visit, here's some of what he said. This cancer has been etremely difficult to monitor, from the start, so it may be getting worse, even if nothing shows up on the MRI. She is definitely much too weak for more chemotherapy. We might consider putting her on Tarceva, a very expensive cancer drug that has had very good results in a few people, but we are going to have to weigh quality vs. quantity of life, and also to find out whether her insurance will cover it. The Zometa injections she has been getting were to restore some of the bone mass she lost to the cancer in her back, but he said it's to prevent the bones from collapsing, and since she isn't walking she can stop those treatments.

The rest of it was mostly about what a stellar patient she has been, and how lucky she is to have so many people helping her, and that must be because she's been such a wonderful person all her life. And to Jerry, that he is doing a superterrific job of taking care of her, his instincts are right on, this must be really hard for him, and he can be proud for the rest of his life of the good work he is doing here. All of which is indisputably true. But his saying it at this time rather leaves me with the impression that he doesn't expect her to live much longer. That impression may be bolstered by how scarily unresponsive she is right now, as a result of the Lorazepam, and it may be completely wrong, I don't know.

I don't know. What I thought when I first came here was that she can't last more than another year, she's just so weak. But she's lucid, mostly, and reasonably cheerful, and able to do the exercises the occupational therapist gave her, and I began to think she might improve enough to move into the wheelchair at least, and have some kind of a normal life. Now the oncologist's behavior makes me think she's dying. I guess what it probably is is that her chances are not very good, but she still might survive for quite some time, and even improve, and we have to plan for that, just in case.

I had a list of questions that Robert gave me to ask, but I didn't ask them. Because what I've realized in the last few days is that Jerry isn't just doing this because she's a friend. He's taking care of her because he loves her, and the doctor knows this too. Somehow we were thinking that there are things the doctor could tell me that he wouldn't tell Jerry, because I'm the daughter, but there aren't. Jerry has all the information that the doctor has, and me blundering in asking questions that have already been answered looks like arrogance at best. So the whole truth is what they've been saying all along. We just don't know.

Note: I changed the time to this time zone. Just FYI.

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