“Ignore what you fear and latch on to what you hope.”
January continued to be an important month. Even though Dr. Thomas told us the disease seemed to be stable, the pain issue had escalated, due to the involvement of her ribs. The metastases in the ribs were the prime culprits when it came to the pain, and even though Dr. Thomas had prescribed upping the dose of Dilaudid, it was still a problem.
Her brother’s visit had given her a lift, but there were still times when I looked at her and in her unguarded moments, her face told me everything. This photo was taken around the last week or so of the month, and you could see how tired she was.
That was not the face she wore when she left the house for work, but it was the kind of image that would change daily at home. The more she worked, and the more involved she was in the business of the campaign, the more energized she would become, and I could tell that in her face as well.
She was going to lunch with Mikey Hoeven, she was seeing her friend Vicki for lunch at the Ground Round, she was going to Boneshakers with Tara Holt and Patsy Thompson, and we watched the Super Bowl in early February at Orell and Cathy Schmitz’ home. She was being as active as the disease was letting her, and was doing it to the point that when she would get home, she would be really tired, but it was a good tired.
Joanie was scheduled for a CT scan on the 20th of February, along with an appointment with Dr. Thomas. The night before she got quiet, as she had done so many times prior to what could be a good appointment, or an appointment that would be another disappointment. By now, of course, she knew that each meeting like the one we would have tomorrow would be the most important one she could have. Joanie’s way of getting ready for whatever we would find out was to withdraw, and keep her thoughts to herself.
Little things could set her off now, and she could be impatient with me over something that would be considered insignificant any other time. I had learned that from the beginning, and it didn’t bother me at all. What bothered me was there was nothing I could do to ease her pain and give her comfort at a time like this but be there.
She had no appetite that night. All she wanted when she got home from the office was to get in her sweats, head for the couch and wait for either Bailey or Brandy, or both to join her. She would turn on the TV, but the sound would barely be audible, and she would sit and stare at it for a while until she would ask me to get her Diet 7-UP and a cherry popsicle. That would be her dinner on this night. Since she wasn’t supposed to eat anything after midnight, it didn’t seem to matter much. After the news was done, and a program she wanted to watch came on she would turn up the sound and sit there with a book within reach, and a cat on her lap.
She would ask me for her pain pills from time to time, and when I was ready to turn in, she would ask for another cherry popsicle, and tell me she was going to stay up for a while longer. She had Ambien available, but didn’t use it that often, because even when she did, she told me she didn’t sleep that well.
The next day, we made the appointment for the CT scan, and then we went upstairs to wait to be called into to Dr. Thomas’ office. We sat in the brightly lit waiting room, on those hard chairs, and Joanie began to shred her Kleenex as she’d done so many times before. Both of us were concerned about what we were going to learn this morning.
When we were called into his office, Dr. Thomas and after he was done with the preliminaries, he got down to the business of the CT scan. He pulled them up on his computer, and began to show us that the disease had progressed.
The scan showed the nodule in the left lung had increased in size. The scan showed that the “chest wall masses have consolidated and progressed and is,(sic) affecting at least 2-3 vertebrae with cord involvement.”
We were told the pleural effusion was still present on the right lung, but hadn’t gotten any worse, and the radiologist’s notes indicated “probable metastatic disease involving the right kidney.” The kidney involvement was something we hadn’t even considered before, but the doctors were more concerned about the right side chest wall mass and the rib destruction. The involvement of the T6 vertebrae was really troubling to Thomas. He had indicated to me when we talked one day about the encroachment on the spinal cord that could result in paralysis. Here again, Joanie was totally unaware about that possibility, and that was just fine. She already knew enough and was worried enough about what she knew.
Thomas did tell us he was going to write to Dr. Dusenbery at University of Minnesota Medical Center-Fairview, to see if Joanie might be a candidate for further radiation therapy. Katie, of course, was totally familiar with Joanie’s case since she had been her radiologist since the beginning of this journey in 1996.
The blood work that day did show she was once again had a mild case of hypocalcemia, low calcium levels, and Thomas said he wanted to check that again in a couple of weeks to see if it was getting better or worse.
We left his office that day somewhat disappointed, but at the same time we were clinging to the sliver of hope that came with Thomas’ statement about writing to Katie. Joanie grabbed hold of that statement, and began supposing what might happen if Katie might find something. That was the way she was. If there was something out there that was going to help her, she had the great ability to ignore what she feared, and latch on to what she hoped. It was a spirit that had helped her through some really dark times since 1996.
As I reflected on what had happened that morning, I couldn’t help but think how grateful I was to Dr. Thomas. He knew how dark things were, but just by telling us he was willing to contact Joanie’s other doctors in Minneapolis it told us he wasn’t giving up.
That was what Joanie needed to hear, and that was the hope she latched on to.