Caution: No sarcasm ahead. Deep thoughts that I can't express correctly and won't come out the way I mean them.
The bad news from last week is that my mother-in-law is going to require radiation treatments. Initially that meant going to downtown Atlanta five days a week for five to six weeks. We met with the radiologist last Wednesday, however, and my burning question for him was going to be, "Isn't there ANYBODY closer to us that can treat her?" Much to my surprise, though, the doctor beat me to it.
I think it takes an amazing person to go into a field like radiology. (I'm sure there are others on the top-10 list also.) A patient who shows up in a radiologist's office is already in dire straits. Either the radiation is being used as a last-ditch measure to control pain, or it's being used in the hope that it can prevent cancer from returning. (Please don't feel compelled to give me a medical lesson on radiology's other uses, because these are the only two pertinent to this story.) My mother-in-law isn't in a lot of pain, but when they removed the mass from the roof of her mouth (correction: they removed most OF the roof of her mouth), they discovered some nerve and bone involvement. Radiation was suggested. The people who work in that field are my new heroes.
I am a little disappointed that we won't see the doctor who is 55 miles away in Atlanta, because I really liked him. He seemed very down-to-earth, and I could sense that he was going to suggest we NOT pursue radiation for an 83-year-old (next week) woman who isn't suffering any pain. He mentioned the hardships of her traveling, the distance, the toll on the entire family. FINALLY, someone who understands our plight! (Oh my, that sounded terribly selfish, and that's NOT the way I meant it.)
I also appreciated the way he spoke to my mother-in-law. Throughout this ordeal, I've become annoyed with medical professionals who assume just because she's in a wheelchair, she can't think for herself. They ask ME their questions, and I just look at my mother-in-law. Sometimes they get the message; sometimes they don't. And don't get me started on the ones who think her hearing is impaired. Sheesh.
The radiologist sat down next to my mother-in-law, and at first he just looked at her and smiled. He was trying to formulate his question. He began, "How well are you going to tolerate...." and then he stopped. He sort of chuckled, and then he asked her, "Can you just tell me how long you're going to live?" He was being facetious, of course, but I think mother-in-law's answer directed the course of action. She said, "As long as I can," and he patted her on the hand. He made it his business to find us a clinic nearer our house that could handle her treatment, and he called and made the appointment himself. Not his resident, not a nurse, but the doctor. He put me on the phone, and when the receptionist started asking me questions, he took the phone back and told her she did NOT need to know that information right then, that we had to get the patient home. What a guy!
I asked him the purpose of the radiation, and he told me her cancer had a 50-75% chance of recurring. The radiation might cut those odds in half, so at worst we would be looking at a 37.5% chance. Maybe. What I thought of later but didn't think to ask him at the time was whether or not the benefits of the radiation treatments would outweigh the debilitating effects. We meet with the new radiologist tomorrow, and I'll ask her then.
It's a sticky situation. I want the choice about pursuing this line of treatment to be completely my mother-in-law's. But I'm not sure she feels she HAS a choice. She just goes from doctor to doctor and appointment to appointment and never complains, but I wonder at what point enough is enough.
I'm not saying this right at all. I'm afraid it sounds like I wish she would just decline treatment and let nature take its course because that would be much more convenient for me. Please believe me when I say that isn't what I mean at all. I'm worried that radiation will render her COMPLETELY unable to care for herself, and her independence is all she has left. What precious little of THAT she has left. She lives alone (at the "T" at the end of our road - I can see if her lights are on or not), but she can't drive, she can't do her own laundry, and she has to have help getting in and out of the bathtub. Yet she doesn't want anyone to come live with her either. (The only real option for that is Hubby's sister, and that would be a disaster. They do not play well together.) I wish she could come here, but we don't have a bathroom downstairs.
She gets around her own house with a motorized scooter. She can pull herself up to the sink to fix her coffee and what little she eats, and she can take herself to the bathroom. We go down there at least once a day, and I do what I can for her when she will let me, but mostly she just takes care of herself. I think some of the medical professionals think we should do more for her, but that's not what she wants.
I worry about the quality of her life if she gets too weak to take care of herself at all. I would gladly go stay down there, even at night, since it's so close and it wouldn't be like actually moving. It may come to that, and I won't mind at all.
Before his conversation with mother-in-law, I could sense the radiologist's dilemma. He finally summed it up by saying if she had another condition, like heart trouble or pneumonia or something else, he would recommend not getting the treatment at all. General frailty itself, though, does not mean the cancer shouldn't be treated. In his words, frail people are known to live a long time. He is worried, however, about the increased likelihood of a fall or some other accident associated with repeated car trips. It's a classic Catch-22.
I can talk all day long about what I would do in that situation, but until I am IN that situation, anything I say would be pure speculation. What I think today might not resemble at all what I would choose to do in the event death were staring me right in the face.
Meanwhile, life goes on. I took her to a baby shower this afternoon. Mother-in-law will be a great-great-grandmother in November, five generations of girls. (My sister-in-law is only 6 years older than I am, and she will be a great-grandmother, and that just boggles my mind. I'm not even a grandmother yet!) Hubby is going with me tomorrow, and we hope to work out an arrangement where we take turns with the radiation appointments. We might even include his sister in the pitching rotation, but that remains to be seen. I don't always trust her to be ... responsible ... enough to take care of her own mother.
I did NOT intend to end the weekend on such a downer of a post. It could be so much worse, and I'm grateful that it isn't. We will simply take things one day at a time and do whatever needs to be done. Have a good week, and I'll keep you posted. Thanks for listening!