“Well now we have some business to take care of.”
The inexorable march of this disease since 1996 has inured us to some degree to the unpleasantness that accompanies it. Joanie, especially, seems to be vaccinated against the emotional toll it could have taken on her since the onset. I continued to be amazed, as I learned more and more, and did my best to help her adjust to the seemingly constantly changing circumstances, and the progression of the disease we were now dealing with, that she just kept on believing. It gave me comfort to see how she dealt with it.
Joanie spent a quiet Monday in the oncology floor at St. Alexius Medical Center. She had tried to convince Dr. Thomas to let her go home, but he told her that while her the bottom number on her blood pressure was moving in the right direction, he wanted her to stay at least one more day to until it stabilizes. She was disappointed, as she often had been. He told her they also wanted to do the MRI on her abdomen and pelvis before she went home.
She looked good that morning. Her color was good. Her eyes were bright, and despite her disappointment at having to remain for another day, I was able to get a smile or two out of her.
We had been through this so many times before, we had become accustomed to it. It had been such a part of our lives over the past almost eleven years, it had largely become routine for us, depending, of course, upon the reason for her being there. My job was to be there to see she got what she needed, and my other job was to keep family and friends informed. The latter job had become easier for me, as caregiver, because I had developed lines of communication that enabled me to keep my time on the phone limited.
Tuesday morning came, and now she was really ready to get out. They did the MRI, and I got her home by 1:30 that afternoon, and shortly thereafter was on the couch with her kitties, who were glad to see her, on her lap. Dr. Thomas told us they were going to put off the next chemo treatment for a week, and Joanie was relieved, and I was as well. That meant she would have a full 11 days to continue to bounce back from this latest event.
On January 22nd, I took Joanie to the clinic where she got a chest x-ray and had some lab work done before we met with Dr. Thomas prior to her fourth cycle of Topotecan. She was feeling good, and the time off from chemo had been productive for her both physically and emotionally.
Dr. Thomas told us the x-ray showed no progression of the lesions. Good news. The MRI they had done on Joanie’s last day showed multiple rib metastases, but again no measurable progression. Thomas told us they were going to reduce this round of Topotecan by 25 percent, but she would still get the Neulasta and Aranesp, and prior to the next round in February, they would do a CT scan and a whole lab workup to see where we are.
That round went well. Joanie had few side effects, and it wasn’t long before her calendar at work was filling up and she was to busy to worry about what might be next. We had 16 days to wait until we might know.
On February 12th, we got to the clinic, and they did a CT scan, took blood for a Complete Blood Count, and we waited to meet with Dr. Thomas. We had come that day operating under the assumption that Joanie would start another round of Topotecan for the next five days. It was not to be.
When we met with Dr. Thomas, he told us they were going to scrub the chemotherapy. He told us it wasn’t working, and the CT scan showed, “Clearly there is evidence of progression of metastatic disease in the chest wall.” The words sounded like thunder in my brain. Joanie sat there, mute, and not showing any reaction. It was as if she wasn’t hearing a word he said.
Dr. Thomas then took us through all of the CT reports, and he showed us the CT scan. He said she was failing treatment with Topotecan, and was recommending we see Dr. Carson in Minneapolis to discuss what options might be available, such as a clinical trial versus palliative radiation therapy. I didn’t like the sound of it, but didn’t say anything at the time.
We left Thomas’ office, and before we got to the car, I had called Marcia at Dr. Carson’s office and we had an appointment for the 5th of March to see where we go next.
We went straight home from the clinic, and Joanie asked for some orange juice and sat down at the kitchen table. She seemed somehow smaller, and more vulnerable that morning than I had seen her in a long time. She looked tired, and it was becoming obvious to me she had heard everything Thomas had said, but just needed some time to process it all.
She finished her juice, took care of her Miami Pouch, and laid down on the couch. She didn’t even turn on the TV, which would have been second nature for her, and closed her eyes for a while. She was joined by one of the kittens, and soon had drifted off.
Around one o’clock, she got up, and looked at me as she often did with that look that said, “Well, now we have some business to take care of,” and asked me to give her a ride to work.
On the way to her office, I had to stop at Dan’s to pick up a package of red licorice twists for her, and then I dropped her off. She didn’t call me to pick her up that day until after 5:00.
That night, after she got settled in, we had some wine, cheese, bread and olive oil for dipping, and held each other closer.