A cease fire.
Seems to me, fighting a disease is about attitude, not just medication and surgery. The will to live kicks in when the organism is threatened, and when a person decides they are going to fight, rather than give up, the chances of the disease winning are diminished accordingly. Now, having said that, there are times when the disease decides to run and hide for a while, giving the organism the illusion it has won the battle, if not the war. If nothing else, you could say a period like that amounted to a cease fire.
The last several months of 2005 and the first month or two of 2006 was such a time. Joanie was doing well, and while the issue of the pleural effusion had yet to be resolved, it didn’t seem to be bothering her, or affecting her daily life negatively. The question of the pain remained, however it appeared to be manageable for the time being.
The holiday season was muted this year by our friend Karen’s situation. I had frequent conversations with Wayne, and was kept up to date on what was going on with her battle with ovarian cancer, and the news wasn’t good. She had a very difficult time, and by the time the holiday season rolled around, we knew it was but a matter of time. Joanie had come to terms with what was going on with Karen, but had not been able to bring herself to stop in and see her until right around the holiday. I had stopped by their house, and after I left, Joanie called me, and told me she wanted to stop and see Karen. We went back, and she was able to spend some time with her, and afterward she told me she was glad she had done so in spite of how difficult the whole thing was for her. Karen died a short time later, on the 6th of January, and so the new year got off to a somber start for all of us who counted Wayne and Karen as friends, especially Joanie.
Joanie’s first appointment of the new year with Dr. Carson was set for late January. Carson wanted a CT scan prior to that meeting to evaluate the pleural effusion and to check on the nodule in her left lung which had been observed some time ago. They had been keeping an eye on it, and weren’t overly concerned about it lest it begin to increase in size dramatically.
They did the CT scan on the 18th, and the next day I had the radiologist’s notes. After all this time I had learned to look for certain words that would help me understand what they were saying, and I did see some language that gave me pause.
The notes said, in part, regarding the nodule in the left lung, “…the indeterminate pulmonary nodule on the left has increased in size and is certainly worrisome for a neoplastic process…” That meant he felt the nodule might be cancerous, at least that’s what it meant to me. He also noted that a PET scan might be helpful in “further definition” of the nodule.
Regarding the CT of the abdomen, the notes read, “CT examination of the abdomen demonstrates some vague regions of increased soft tissue seen within the fat just anterior to the liver.” Those words, once I understood them meant to me, as a layman, there was some soft tissue in front of the liver that needed looking at. There was also some soft tissue in the pelvis that was noted by the radiologist that I assumed would have to be looked at as well.
Any caregiver, in a similar situation could do just what I was doing. I had been trained as a journalist to do research in a hurry, and during the years of helping Joanie through this period, that training had come in handy. The internet was a tremendous help, enabling me to do the research necessary for me to gain at least a partial understanding of what I was reading. Without the net, the same process would have meant hours in a library. Joanie, by the way never asked me about what was in the notes, only if there was anything bad. My stock answer, which was based on my own ignorance of the details would be, “Not anything that I can see, so we’ll just wait and see what Carson says.
CT scan in hand, we met with Dr. Carson on the 27th of January. Joanie’s examination went well, and while nothing was done about the pleural effusion that day, Carson told us whenever we’re able to get the fluid drawn off her lung, they would send it to the lab to determine if there was anything that indicated recurrent disease. Should it indicate recurrent disease, she would recommend Joanie be treated with the same chemotherapy protocol she had responded to so well before. That statement alone, gave us pause, and something to worry about.
Before we left that day she said she was going to order a PET scan, to get a more definitive picture of what had shown up on the CT scan. She said the PET could be done in Bismarck. The PET, as I’ve noted before involved injecting radio-active glucose into the veins, and after it had time to circulate, they did the scan. Since cancer cells metabolize glucose faster than normal cells, the cancer cells would light up, giving doctors a better idea of where the problem areas were, and provide them a better diagnostic tool when developing a course of treatment.
We left the clinic and walked over to Sally’s to sit down and have a drink. We weren’t going to go home until the next morning, and so we decided to spend another night and treat ourselves to a good dinner and talk about anything but what we had heard earlier in the afternoon.
It was as if she had decided that the disease was still in hiding, and the cease fire was still intact.
We would know more soon enough after the PET scan in February, and for the moment we were going to enjoy the evening, and cap it all off with a Baileys, as we had done so many nights before. Over the last ten years of this battle, we both had become very good at grabbing, and holding on to those brief moments in life that meant so much to us, and tonight was one of them.