The Ugly Side of Cancer

At the beginning of this journey I had no idea what to expect.  A cancer diagnosis throws you on a curve, changes your life.  There no longer is an 'normal' as you knew it.

I remember that day in March of 2010 when we first learned of the breast cancer.  It was stage I, which was the most curable kind.  The tumor was small enough, and the doctor assured us that surgery, followed by radiation and five years of medication should resolve things.  My mom wanted the surgery as soon as possible, so it was done on April 1st.  I remember the joy, the relief we felt when on May 9th we learned that no chemotherapy would be required.  It would be a month of radiation and then a daily pill.  The cancer would be gone.

Our return to normal lasted two months.  Rather than feeling better after the surgery, my mom grew more tired and breathing became a challenge.  On the May long weekend, I sat in the emergency room at her bedside when a nurse informed us that preliminary tests showed that a large absominal mass was highly indicative of stage IV ovarian cancer.  Our hearts sank.  That summer we spent every day together, surgery went as good as could be, and the chemo worked.  Inbetween we were faced with a coma and infections that can easily turn deadly while one's immune system is compromised, but the first round of chemo worked.  We enjoyed a newfound normal the following year and traveled to Hawaii.  It was a wonderful mother-daughter trip.

In keeping with tradition, bad things would always happen on holidays (breast cancer diagnosis on St. Patty's, breast cancer surgery was on Easter, and ovarian cancer diagnosis was on May long weekend).  We had just had our Thanksgiving turkey when everything changed in an instant.  We learned later that this was the beginning of a recurrence.  It was intensified as we went to Montana for a few days at Christmas, and was officially diagnosed as a recurrence just after my mom's 60th birthday.  We were happy to have shared that birthday together, for since the beginning of life with cancer, it was this day that she looked forward to.

Again chemo knocked things out, but not for long.  Long enough though for us to enjoy our most memorable Christmas together in what felt like normal health.  We went for walks, had breakfast on the terrace, sat in the hot tub, went for drives, and perhaps most memorable of all, celebrated Christmas with the locals around a campfire in Carefree.  How fitting that town's name was.  Everyone was handed a candle and you'd get the flame from your neighbour.  It was precious.  The minister (it was some non-denominational church) talked about light.  My mom told me about light.  We looked up at the stars on a clear night.  It was beautiful.

After our return home in January we started to see the real ugly side of cancer: the inability to eat, to walk, to drink, to lift one's legs, to talk.  I think we all knew what this meant, though no-one said it.  I'd try to get a few hours of 'normal' on Saturdays, returning home to show my mom photos on my camera.  She loved seeing photos of my adventures.  Last year as I took my trip to the West Coast something had told me that I must go then.  I am now happy to have been able to share all that trip planning with my mom.  She gave me tips on food to take backpacking, places to stay, places to see.  I remember calling her from km 8 on the West Coast Trail, the first time I had reception in over six days, to say I did it.  Often times we would sit in the nook, overlooking the valley and looking at the mountains, and go through photos.  Those are precious memories.

As February rolled around, the pain was almost unbearable.  After a couple of hospitalizations, doctors finally got the pain and nausea under control.  A bowel blockage is very typical of advanced ovarian cancer, and a friend who is a palliative care nurse had just told me a few weeks earlier that once one is admitted to hospital, this is what takes people's lives.  In the end my mom was unable to get up even with our help. The ambulance came and took her to the local hospital where they stabilized her, then took her into the city.  That Thursday night a week-and-a-half ago as I sat at my mom's bedside in the same emergency room, she said to me that she didn't feel she'd make it out.  It was difficult.  My breaks were five-minute walks to to the parking lot to grab something.

I spent my days at the hospital, knowing that I did not want my mom to think that I had left her.  I knew our time would be limited and I wanted us to have that time together.  While neither the nurses or myself are really sure until when she remembered things, on the Saturday as I went home, she said to me "Everything is ok.  Sleep well."  It was 6:18pm and I had a hunch that evening that those would be her last words to me.

After the stress from the last couple of months I decided to get in a mini hike nearby with a friend, but once again, something felt off.  I went to meet her in the morning, a beautiful, crisp spring morning.  I remember driving and thinking that if my mom's time had come, this would be a beautiful day.  Five minutes later I received a call from the hospital that I should come in.  She had likely developed a blood clot and her oxygen levels were decreasing.

The day's activities were vivid.  After having designed hospitals I knew much of the secret lingo and I know what the code teams are.  A code was called, R1 for resuscitation.  ICU outreach was there and asked us about her wishes.  She did not want to be ventilated.  She did not want to be on medication and hooked up to machines if there would be no real change of a meaningful life with interaction with friends and family afterwards.  We declined resuscitation and ICU, and care switched to comfort care. 

I spoke to my mom all day and said things that I've been meaning to let her know for a very long time.  I asked her to squeeze my hand, but she was unable to.  Tubes were sticking out of her mouth, oxygen was flowing for comfort.  She became agitated, so got an ativan.  it didn't help much, so the nurse switched to a different medication.  For hours my mom kept pushing away her oxygen and I believe it was her way of saying no more.  The nurse said it would be up to us.  The oxygen was turned off, suction removed another 300mL of fluid.  The room became quiet, except for the horrifying death rattle.  It was excruciating to watch this, to see a loved one like this, wondering if this is like drowning, but spread out over hours.  Her eyes were mostly closed, but around 8 or 9pm opened once more, presumably to take one last look at us.  The staff was wonderful, giving us enough space, but being there in case we needed anything.  I remember the nurse coming into the room to take a look around 10:10pm.  She was so caring and informed us that it won't be much longer now.  Maybe an hour.  About five minutes later my mom took her last breath.  It was still, no movement, and her face ended up looking more relaxed.  I didn't want to let go.

They called a pastor who came around 11pm to say some blessings.  Mostly it was a conversation from her to us.  How she's now at peace.  How she'll hold us a spot.  Memories we've shared.  One day we shall be together again.  In the meantime, I'll be journeying on my own.  I left the hospital around 11:15 and sat on a bench by the river.  It was a beautiful clear night, crisp, with a light approaching from the distance.  In a way it was beautiful.  I know I will miss her dearly, but take comfort in knowing that she is no longer in pain.  ♥