The attack dog, cancer.
The insidious thing about cancer, besides the obvious damage it inflicts on the body and the threat to life, is the mental aspect that accompanies its diagnosis. Cancer, it seems to me, is the attack dog of major diseases. Once it sinks its teeth into you it doesn’t want to let go, and it messes with your mind, whether you are the patient or caregiver.
There have been major advances in diagnosis and treatment of most kinds of cancer, and with early detection many are able to be contained and eradicated. Timing is critical in being able to call off the dog.
Joanie knew this, though we never really discussed it. She knew that had she been having regular Pap smears, she might not be in the situation she found herself in. The only time she ever said anything that indicated she might be thinking about that was when she admonished some of her female friends, on the evening of the day she was diagnosed, that they’d better be sure to pay attention to that test.
Joanie never spoke about what should have been done, or could have been done. Neither did I. She knew the futility of talking about it without ever having said a word to me. When she was faced with the diagnosis, she knew what went before didn’t matter, and the important thing was what we do now to call off the dog.
The good news and not so good news, and with it again the question.
As anyone who has been a patient dealing with a serious disease, or a caregiver to one knows, options are always cropping up that force one to deal with the question of what do next.
The good news resulting from Joanie’s surgery was this. They took 26 lymph nodes to have them analyzed for any possible cancer. All 26 nodes were negative for cancer. That was the good news. The cancer hadn’t spread. The not so good news was that the cancer was still there and had to be dealt with.
After their exams and surgery , they staged her cancer at II-B. We had come down to Minneapolis thinking that they had staged her cancer as II-A, and she could have the radical hysterectomy and go home okay. The attack dog had other ideas. Now she was a candidate for radiation treatment, or a combination of radiation and chemotherapy.
We met with Dr. Carson, and she outlined the options for treatment for us to consider. On the one hand, Joanie could do the radiation treatment at the the U of M. The treatment would be six weeks long, or if Joanie was comfortable, there was the option of having it done in Bismarck.
After talking to Dr. Carson, we next had a meeting with Dr. Kathryn Dusenbery, a radiologist-oncologist at the U of M. She is the head of the Radiation-Oncology department at the U of M Medical Center, and would be the doctor in charge of Joanie’s radiation treatment should she decide to have it done there. Joanie was immediately comfortable with Dr. Dusenbery, or Katie, as we would come call her. She had been one of the other doctors involved in Joanie’s surgery.
Katie outlined what would be a six week long regimen of external beam radiation along with two radiation implants, both which would include a two or three day hospital stay. The implants would require a certain amount of precision as the tubes that would receive the cesium beads would be inserted under a general anesthetic and then x-rayed to ensure they were in the proper and optimal place. If they weren’t, they would be adjusted before the rest of the procedure would be completed. She would then be brought up to her room on 7C and they would insert the beads, where they would remain for the specified time.
The external beam treatments would be daily, five times a week for the duration These would be done on an outpatient basis, and each session wouldn’t take much time at all.
Like Dr. Carson, Katie told us the option was open to have this done in Bismarck, and if we wanted to consider that she would send the records to a radiologist there. Joanie and I talked it over, and since it was going to be a six week program, Joanie told her to go ahead and send the records and we would make a decision on where she would have it done after we had met with the radiologist in Bismarck.
The problem with doing it in Minneapolis was food, lodging and transportation for six weeks, something that involved an expense that was going to really strain our budget. For us, the lodging issue was taken care of when Ginny, Joanie’s sister, offered that she could stay with her and Ed, her husband, while she was getting treatment. Ginny lived in St. Paul, and how we found her is a story for another time. Joanie, was adopted. She had never known her natural mother, and as it turned out, when she found out about her natural mother and family, she discovered she had a sister and that was Ginny. Ginny was to become an important part of this story in the coming years.
That generous offer was something we thought about while deciding between Bismarck and Minneapolis. That was a decision we had to make rather rapidly, because at the Katie wanted to begin treatment on June 3rd, and Joanie wasn’t discharged from the hospital until May 27th, and we would have arrangements to make if it were to be done in Minneapolis.
The ride back to Bismarck from Minneapolis was another long one. Joanie, I could tell was having a difficult time with the prospect of being gone from work, home and her kitties for six weeks, but at the same time she had become very comfortable with both Dr. Carson and Dr. Dusenbery. I had as well. I just told her we would go to the appointment with the radiologist in Bismarck on the 29th, and any decision could wait until after that meeting. I had the feeling, which I left unsaid, that she was going to opt for Minneapolis even if it meant being gone for so long.
In the short span of 20 days, we had gone from shock to hope, to disappointment, to hope and to another disappointment and now we were pinning our hopes on our next option. The attack dog, cancer, has a way of doing that to you. Just as you feel like it might let go, even a little bit, it grabs on tighter, to let you know you are in real fight.
We knew we were.