Today (Friday) was such a great day. It started good and just continued to get better as the day wore on. Yesterday we had a continuous care nurse at the house for about six hours due to the events of the previous day. She was very comforting to have around, but she was able to leave early because Brian had improved so quickly. Our nurse visited again as well yesterday to follow up on the changes in meds. In addition to adding several medications, she also ordered many meds in liquid form so Brian has a choice between pills and liquids, depending on how he’s feeling. Methadone has been a great fit so the Dilaudid is really just used as a breakthrough on occasion. Brian is using several meds for vomiting and has increased the dosage of his anxiety drug, but decreased the frequency of use. Those changes are working. However, the biggest change is no more sleeping in a bed. He sleeps in his stress-less recliner, dubbed the “cancer chair” back in 2007 after his surgery. We rearranged the living room tonight so the love seat, where I sleep, and cancer chair are side-by-side. At least this way we can cuddle long distance by holding hands! That, and he can slap me on the head to wake me up for meds in the middle of the night.
Yesterday was also the first time we met Brian’s hospice doctor, Dr. Roney. He’s incredibly nice, compassionate, informative, and straightforward. He evaluated Brian and then just chatted with us for quite a while. Obviously he has looked at Brian’s records thoroughly and knows where things stand. He asked if we’d discussed prognosis yet,which we have and haven’t… We did, of course, speak at length with the oncologist after receiving the unsurprising diagnosis on February 10th, but we asked only for a vague prognosis, which was “months, not years.” I admitted that we’d both consulted with Google because Google knows all! (You do know everything on the Internet is true, right?) Everything we looked at from reliable, scientific sources gave us a pretty good idea what to expect, but we’ve really kept that to ourselves until now, and I’ve debated with myself all day about saying anything or just leaving it alone. The nice thing about debating with yourself is that you win either way.
“It” is the elephant in the room that no one wants to talk about. However, the more I thought about it, the conclusion I came to is that “it” is nothing to shy away from discussing. There’s no real point in dodging the question. So, let’s get to “it.” Here’s what I know from reading about melanoma. Actually, a disclaimer first: I’m not a doctor, this is not a medical journal, nor is it a Comp I paper where I plan to cite my sources in a tidy bibliography. My information came from various places and I’ll leave it at that. Okay, here we go. Melanoma is a unique cancer, and not a pretty cancer. It plays dirty and the more places it finds to root itself and do its deed, the better it gets at playing to win. One organ is not so bad. Melanoma has a chance, but odds are in the patient’s favor. Start adding organs and the odds change. If melanoma swoops in and takes the liver and lungs, the fight is on and it’s a hard battle. Brian had melanoma in four organs on the day of his biopsy, two of them being the liver and one lung. He had a tumor on his head already growing, albeit very slowly. Since that time we have found new tumors on a regular basis. These tumors are currently responding to medication that sort of stunts their growth, but after a while the meds will stop working and the tumors will grow. Melanoma is stealing his muscle mass. Feed yourself and cancer eats your food; starve yourself and cancer eats your body. It’s a tough battle. I do sneak in extra calories wherever possible. No more low fat foods for Brian! The survival rates for melanoma in four or more organs is dismal and there is simply no cure. There are possible ways to buy time, but that’s a deeply personal choice a person has to make and it’s ultimately cruel to ask a person to make a choice based on anything other than their own desires.
Brian is healthy except for the fact that he has stage 4 metastatic melanoma. His heart is strong. His lungs sound good. His liver is enlarged and hard in some areas but not showing signs of failure right now. Had he not been so healthy going into this, the prognosis would be worse. So, it turns out it really does pay to eat right, exercise, and treat your body with care. When Dr. Roney told us that he’d be surprised if Brian is still alive in four months I was surprised, but I don’t think it showed. And if it had shown, it would not have been shock at such a small number of months. Brian and I had a heart to heart a while back and he said he was sorry that he probably wouldn’t make it to September 26th, our 20th anniversary, after all. I said I knew that. As time has gone on, I have been hoping for Memorial Day. I’ve not voiced that until now. I’ve put on my smile just as he has, and said with enthusiasm that we were shooting for September 26th. So my surprise yesterday was relief. Relief that we may get two months longer than what I’ve been prepared for.
I know that doctors can be wrong and patients can defy odds and miraculous things happen. I’m an optimist. But I’m also realistic, as Brian is. This cancer has obviously been there long before any outward sign showed. It’s been making its plans, setting up its pieces in strategic places, and plotting a takeover. There are really rough and depressing days filled with tears and fatigue. There are really good days like today, which Brian said was absolutely wonderful, that are filled with smiles and laughter and energy. Brian’s goal now is to enjoy every day he has as much as he possibly can.