Thursday, October 22, 2009

A chair that will never again be filled...

at least not by my dad. Because, you see, he's not coming home. The brain damage from the stroke is too extreme and the cancer is growing so rapidly, that his life expectancy is from four to six weeks.

Bud, Tom and I will meet with the Palliative care nurse in the morning. At that time we will decide our next step.

I will now close this blog, as there is no point in continuing.

Thanks to all of you that care, and have followed along. May God bless you all.

I can't say when you'll hear from me again, but if you want to try me through email, I think it's on my main FB page. If not, well..it's andrewnelson63@centurytel.net.

May God bless you all and thank you for caring.

Love,

Drew

Wednesday, October 21, 2009

I wish I had the answers...

To open this evening's missive, I'd like to address a question that was posed the other day, and I'll not say by whom, but this individual asked, "Why are you blogging about this? Who the hell's gonna' read it anyway?"

A fair question, I suppose. The answer? Many. There are friends reading these words that have known me since I was six years old. Though I might not have seen or spoken with them in many years, they remain interested in friends and friendship. I thank them for that. Most of them also know Pop from years past.

Beyond that, when one is sitting alone in a quiet house, with no one to talk with, writing (at least for me) is cathartic. I made the choice to not post a bunch of "Dad updates" on Facebook for a reason. I wanted to give people a choice to read about it, or pass on it. Admittedly, I do alert when there's something new and if you so choose to read about it, it's up to you.

So, speaking of something 'new'. Pop had a massive thrombotic stroke last evening. Thrombotic, meaning that it was not a 'bleeder'. Simply put, he had a blood clot that entered the left side of his brain and, it has rendered him non-verbal, paralyzed on his right side and the right lung (the one with the cancer) has been rendered non-functional.

Ergo, it's no longer just about his cancer. It's two-fold now, cancer and a major stroke. The question is how will it, or can it, be treated? That is the $64,000 question. The answer to that question we do not know.

In detail, Pop has cancer. That we've established. Now, in addition, the following factors have come into play;

Thrombotic stroke, which carries the following side effects:

Ataxia-Loss of muscle coordination.
Dysarthria-Speech difficulty. He cannot speak at this time.
Dysphagia- Difficultly swallowing. He's currently on a nasal gastric tube.
Hemeballism-Involuntary muscle twitching. There has been a reduction since last evening.
Nystagmus-Uncontrolled eye movements.

There's also evidence of Miosis and Ptosis which are respectively, an involuntary contraction of the pupil and a drooping eyelid. Both were definite evidence of a problem last evening, whereupon I summoned the ambulance.

(Sorry, I've taken six family /friends phone calls since the end of that paragraph. I started this message at 7:15 if memory serves.)

When the ambulance arrived, Pop was still cognizant and communcative, he even got on the gurney without assistance. Later though, according to the EMT (about a block away from the house) he became unresponsive and they rolled red and siren the rest of the way to BMH-Desoto.

When I arrived at the ER, Pop was thrashing and in the above mentioned conditions for the most part. As of today, there is little change.

What happens next is up to God. If His choice is life, I'm on the front line. If not, well, Pops wishes are well known to me and they will be honored.

God love you all. I know I do.

Drew

12:30am Wednesday morning...

I'll just throw it right out there, last night at around 7:30 Pop had a major stroke.

Cancer and now this, good Lord, if this man can stand up to this and come out of it, I will forever call him the toughest fella' that ever lived.

What started as a routine day, ended in the hospital.

Truly, I'm too tired and too stunned to continue this right now. I'll do my best to fill you in later on today.

Monday, October 19, 2009

Goodness, what a day!

Of course, with any OPS procedure you have to get up at the crack of dawn to be at the hospital by 7am and then...you wait. Wait, oh...until about 9:45 for the actual procedure to begin. Then again, there are plenty of sick folk's in the world. Truly ill, not just some nitwit with the sniffles looking for a day of from work so he can go drink beer and fish. (Save for the 'sniffles', a cold beer and fishing doesn't sound so bad to me.)

Anyway, in the word's of Gleason, "And away we go!"

The procedure performed today was a reasonably simple one that involved inserting a PleurX (r) catheter into Pop's right pleural cavity in order to extract any fluid that had built up in the past few weeks. And boy howdy, it certainly made its presence known as the pulmonologist drew off over two liters of fluid. That's a little more than half a gallon of fluid....a half gallon. Good Lord Almighty! It's no wonder he was having difficulty breathing.

Upon his return from the procedure the X-ray indicated pneumothorax in the right side pleural cavity. In other words, there was air in the cavity and it needed to be extracted as well. Shortly after that discovery, the surgical assistant came into the room with another PleurX setup and withdrew 250 more mL of fluid and, at the end of the process, the evidence of the pneumothorax made its presence know by emitting an audible air and foam effusion.

Somewhere around 3:00, after another X-ray, Pop was released and we made our way home, stopping for a burger and shake. He ate about two thirds of his burger and complained of feeling tired and weak. I put him to bed and me, well, I stretched out on the floor to watch a little TV. I promptly fell asleep, only to wake up after hearing him cough at about 5:15pm.

He got in his wheelchair and I rolled him to the table, whereupon he finished a half-tepid chocolate shake. He said he still felt pretty lousy, but would be OK while I went to the genetic bouillabaisse that is Walmart to pick up a prescription.

By the time I got back home, he was back in bed. This raised my level of concern, not to the panic stage, but to the 'check his vitals' stage. And so I did, taking three BP readings from each arm, I determined thaat he was in hypotension (low blood pressure) and that did raise my concern. To explain, after this type of procedure, hypotension is a potential side effect. That said, pulmonary edema induced hypotension is potentially lethal because, after reexpanding the lung and having drawn so much fluid off the lung, edema (more fluid) can effuse inside the lung, thereby causing circulatory failure. Keep in mind, Pop has experienced three MI's, two strokes and suffers from atrial fibrillation. So, my next move? Call the physician..

After my explanation that I had measured his BP in each arm three times, listened to his chest and back (yes, I own a good stethoscope), we reached the conclusion that this is most likely post-procedural side effects. After all, Pop is not experiencing any breathing problems (a little crusty, perhaps) but, overall he's not in any pain, nor is he in AFIB (a little tachy, perhaps) but not in AFIB, as the symptoms of that are quite obvious.

Pop's asleep now. I'll have an ear open all night, because with hypotension, there is the risk of 'postural hypotension'. In other words, if he needs to get up, he needs to do it slowly, otherwise he could get lightheaded which could cause a slip off the bed or, should he try to stand up, he could fall, which at 80 years of age, could cause further damage. I pray for a quiet night.

Tomorrow, Tom (my brother, of course Bud is too) will take Pop to the Cancer center at BMH. I think they are only going to do a CT, but they could go ahead with the radiation therapy. I don't know. As for me, I'm going to the park to decompress. But since I'm on LOA, I'm going to cold call and try and sell some web design. It's been a few years, but I've still got my chops.

But FIRST, I get to drain the pleural effusion. That should be interesting, but I think I've got a good handle on it. That's in the morning...

Right now, I think I'll go abuse any non-Bama, non-Saints fans over at Facebook. Tonight, I need a little humor.

Waiting...

Arrived BMH at 6:45am. Still waiting for procedure to begin. Should take about two hours.

Sunday, October 18, 2009

Me and Pop


A fairly quiet weekend...

The clindomyacin finally moved out of his system, and thank God for that, as we were up every two hours for most of the week. That stuff not only gets rid of the bad bacteria in your system, it also eliminates the good as well. It left him drained and dehydrated but, fortunately, with the change to Flagyl, he's finally starting to come around.

Tomorrow we begin the 'beginning', if you will, of this process. Though the Oncologist had already peformed the CT scan and 3d tomography, it has to be repeated. Why, you might ask? Seems that Pop has fluid (pleural effusion) on his right lung (the one affected) and it needs to be drawn off.

(Side note: The fluid was there while he was in the hospital, but they needed it to build up and then drain it, so that they could differentiate between fluid and tumor.)

So, at 7am in the morning, we will be at BMH-Desoto for a new bronchoscopy and the insertion of a PleurX catheter. If the pulmonoligist leaves it in place, it will be incumbent on me to perform the drainage procedure as necessary. (Note: Since BMH-Desoto has wi-fi, I will update this blog as the process moves along.

If everything comes out OK tomorrow, then Tom will take him back to the cancer center at BMH for a new CT scan and tomography on Tuesday morning at 10am. At that point, they should re-mark his skin in an effort to pinpoint the targets for radiation.

To Pops credit, he is eating better. Tonight I prepared 'skillet chicken' and brussel sprouts. He was a proud member if the "clean plate club", for the first time in a while. Additionally, he has put a few pounds back on, from 192 to 198. Granted, that's not much, but it's better than it was.

As mentioned, I'll try to add to this blog from the hospital tomorrow.

Friday, October 16, 2009

I had written a rather long..

and self serving post, but that doesn't matter.

Suffice to say, I am where I am, I do what I do, and I am secondary to all that is before me.

I'm here because I'm supposed to be here. God has His plan.

Take care,

Drew

After being in the dark for a few days...

we finally get cranked up next week.


I finally had the opportunity to speak with the pulmonologist's office today, and I followed that with a call to the Oncologist that will be handling Pop's radiation therapy. Both were informative, and I must say that the Radiation Oncologist, Dr. John Burnett, seems a bit of a 'firebrand'. A trait that I like and I was left impressed with our conversation. The dosimetrist, Damien (and I hope I've spelled his name correctly) was instrumental in connnecting me with Dr. Burnett, and for that I was most appreciative.


In digression, my day began with a call to the office of Memphis Lung Physicians, whereupon I was informed that they didn't have much information beyond the fact that Pop is scheduled for a bronch and pulmonary effusion removal Monday morning. All of which I knew, of course, but they were most pleasant and cooperative.


My call to the West Clinic was met with more information than I'd received since Pop's release from the hospital. Damien and Dr. Burnett were effusive in their respective explanations for the delay in treatment, yet they were as aggressive in their determination to treat this cancer as rapidly and effectively as possible. Picture John Wayne and Matt Dillon riding into a lawless town perpared to kick butt...that's the impression I was left with, and I certainly pray that God works through their gifts and leads them to a successful conclusion to this initial round of treatment.


That's it for now...as I seem to be in a reflective mood. A mood not neccessarily given to the technicalities of what next week will bring.

Thursday, October 15, 2009

Repaying my debt...

If you are ever in my situation and your family member is prescribed Clindomycin, ASK FOR AN ALTERNATIVE!!! Without going into graphic detail, it causes the recipient to have diarrhea, and lots of it. It's totally uncontrollable and occurs, for Pop at least, about every two hours. Thank God that scrip has been changed. I may not sleep again tonight, but perhaps..perhaps, tomorrow.

That's the day I've had. Well, two days...since about 4:30 yesterday morning.

Balance that with the fact that we still haven't started radiation therapy yet. The cancer is so aggressive, yet we have to wait until Monday for them to draw some fluid from around his right lung. I blistered the phone lines (to no avail) trying to find out why we were experiencing this delay in treatment. I got nil, until I involved our primary in this. So, tomorrow, I will be at the office of the pulmonologist / oncologist to get answers. I will get answers, and yes I will be a prick if necessary. I don't care.

From all the research I've done, the prognosis for this cancer is...wait for it...anywhere from seven months to five years. Think about that, the survivability ranges from seven months to five years, and it all depends on how soon the cancer is discovered. As I mentioned previously, Pop didn't have it in late August, yet it took only five weeks to take over his right lung. Five weeks, and we've yet to start radiation? At this point five years seems way too optomistic. I'm gonna' light a fire under someone's ass tomorrow.

As an aside, I tried to get the American Cancer Society to allow me to use their logo on this blog. While they were very supportive and understanding, they disallowed the use of that logo. Really, all I wanted to do was to give people the opportunity to link to their official site, but they pleasantly (truly, they were quite pleasant) denied me that opportunity. They cannot, however, stop me from asking you to support them. Simply Google "American Cancer Society", visit their site, and support them if you can.

Like so many other's with family members with cancer, I need rest. Good night.

Wednesday, October 14, 2009

Sitting in silence, with questions on my mind.

Just put dad to bed. It's been a difficult day for him, what with the rousing start at 4:30 this morning. We were supposed to go to the doctor today, but he just wasn't up to it. Not that it would have made any difference anyway, as they were going to check his Protime level. Something of a pointless endeavour considering he's not on any blood thinner right now.

I rescheduled his appointment for tomorrow and I will have question's. For instance, the pulmonologist has him scheduled to be at Baptist Desoto Monday morning to draw some fluid off his lung. They were aware of said fluid while he was in the hospital, so why didn't they do it then?

No one has even mentioned when we will begin radiation therapy. Why? This cancer wasn't present in late August and now it's all over his right lung. If it's that aggressive, what in the hell is the hold up?

To qualify, tomorrows appointment is with our primary physician, so he may not have all the answers. Let me reassure you, however, by the end of the day I'll have the answers. I'm really not someone you want to screw with in a situation like this, not with my dad.

4:30am

His breathing, just when walking across the hall to the bathroom, became so labored that I had to help him back to bed. Any more of that and I don't know if his heart can take it.

Guess I'll get a cup of coffee and see what today brings.

Tuesday, October 13, 2009

He's tired and so am I...

Sat with Pop tonight and had a good, long talk. I told him, at least from what I can gather from the research that I've done, the survivability expectation ranges anywhere from seven months to five years. Those figures, taken from various studies, just confound the hell out of me. "Seven months to five years". What is confounding are the variables. This treatment combined with another treatment, but wait, this other treatment might work better when combined with chemo (he's not a candidate), combined with...hell, I don't know.

Here's what I do know, and we talked about it tonight, Pop is prepared to live...he's also prepared to die. Damn, that's difficult to write. Tonight though, I finally stirred up enough courage to ask him about his feelings.

His response? I'll try to give it to you as accurately as possible...

My question to him was as follows;

"Pop, how do you feel about this? The cancer and what the future may hold?"

His response was with little emotion and matter of fact...

"Son, I could die tonight, I could die tomorrow, or I could die five years from now. I'm not surprised that I have cancer, but I'm not going to give up. Hell, yes, I'm going to fight it, but if I lose, so be it. I'm eighty years old..you've got to die of something".

At that point, I reminded him of my promise. Years ago, before mother died from complications of Alzheimer's, we agreed that we wouldn't allow her to die in a nursing home. We kept that promise. She died at home.

I'll never put my dad in a nursing home. I did, however, ask his thought's about hospice. To that, he was agreeable, as he understands that he really wouldn't be cognizant of what was happening anyway. Furthermore, hospice is miles away from a nursing home with regard to care and compassion.

As I write this, I am conflicted. As much as I want my dad to live, the last thing I want is for him to suffer the agony of end stage cancer. If this enemy attacts the lymphatic system, his bones, his brain or, most deadly, his bloodstream, I just don't want to watch the man that I love so much suffer. Suffer in a most horrific manner....

I'm prayerful that he'll beat this, however, I'm reminded of how tired he is, tired of fighting his heart problems, tired of being tired, and now, tired of this new offense on his body.

Monday, October 12, 2009

PDA

Image Credit: Penn Medical



and no, I'm not writing about the public display of affection. Specifically, I wish to address in more detail, 'poorly differentiated adenocarcinoma'. In other words, the lung cancer that Pop has contracted.


Cutting this one short...Pop's breathing is horrible. Doubtless I'll be up all night.




So now Pop is home..

and believe me, I'm glad he's here. Once he heard that his release was imminent, he became a true pain in the ass. I love him, but if the timeline didn't suit him (and it never did), he was apt to raise cain.


Pleased, I am, to have him home, but now comes the difficult part for me, as I'll be listening, checking and making sure that he's faring as well as possible. After a hospital stay, everyone is weak, and Pop is pretty drained. His legs are tired from not using them and he gets short of breath.

I'll be listening throughout the night. And, should he cough up blood, we'll be heading right back to the ER.

In the span of a day...

Finally, Pop is home.
Ready to go home!


Where is Crankshaft?




Sunday, October 11, 2009

So what kind of cancer is it?

If you expect that someone that has smoked for sixty-seven of his eighty years might contract lung cancer, you'd be correct. Yes, dad started smoking at the age of thirteen using the only 'tobacco' available to country folk at the time, "rabbit tobacco". It is, apparently, what the kid's of that day and time smoked.

It did not, according to Pop, have any hallucinatory side effects. Which, should that have been the case, would have provided for a law banning the inhalation of said weed. And it is from I've gleaned, just that, a weed. A weed that, to this day, still grows wild wherever wild weeds grow.

Anyway, back to the cancer. The diagnosis is that of "poorly differentiated adenocarcinoma'. It is aggressive (it wasn't there in late August) and, surprisingly, is prevalent not only in smokers, but also in women and those that have NEVER smoked.

I'll try to provide more detail later. Today has been long and, frankly, in the past two days I've been bombarded with so much information, I'm still trying to process everything.

Dad and his cancer..

Lord, what an insidious beast, this cancer. Five weeks ago, it did not show up on any x-ray, CT scan or other tests. Then again, at that time the physicians were more focused on his atrial fibrillation which, when combined with thick blood, can throw off blood clots and kill you via a stroke.

Last Thursday, October 1st, they discovered that his right lung was collapsed. This revelation came after his admission to the emergency room for atrial fibrillation, hereafter known as "afib". From the intial x-ray, the primary physician stated that it didn't look like too much to worry about. By the end of the day, it seemed like a whole lot to worry about.

Since Pop was still in afib, they elected to keep him overnight and begin preparation for a Monday brochoscope, a procedure where they send a bronchoscope into the bronchial tube via the nostril (ponder that)and take a look, so to speak.

(Here's a curiosity, even with dad still in afib, the doctors ordered him pumped full of Vitamin K to thicken his blood (something you do not want while in afib) and sent him home with me Friday afternoon. Long story short, we were back in the ER Saturday night, and he's remained in the hospital since.)

The pulmonologist thought, "Well, we'll go in, find out what the obstruction is, remove it and the lung should re-inflate." I was hopeful, yet skeptical. And, as it turns out, I was right to hold that skepticism. It is cancer.

A confirmation of that fact took almost 24 hours and innumerable phone calls, but the diagnosis was there in living color, as we would soon find out.

In the next post, more detail about the cancer.

The name of the blog...

A friend asked me about the name of this blog. It is quite curious I suppose, but the answer is fairly simple.

"Consarnit" was my grandfather's 'curse' word. When my brothers and I were little, Pap wouldn't use hell, damn, or anything of the like in our presence, so 'consarnit' was his expletive of choice when we were around.

It's my understanding that when we weren't within earshot, he could verbally peel the bark off a tree.

So, there ya' go. That's why it's called "Consarnit".

Saturday, October 10, 2009

You are here...

This is where I'll keep you updated on Pop. I might even even comment on other issues of the day.

Stay tuned.