Musings of a Recovering Widower: June 2009

Wednesday, June 17, 2009

The Passage of Time

I’m remembering six months ago today and the life-changing weeks, months, and years leading up to that moment when Susan took her last breath. I’m awed by the powerful transformation from winter into spring, both in nature and in our human experience.

A Little History

The original lesion was on the left side of Susan's face. It was not healing, so she made an appointment to see a dermatologist. It took a long time to get in, the lesion was biopsied, and to everyone's surprise, turned out to be positive for melanoma. The surgery to remove the lesion was successful, but failed to find a "sentinel node". Therefore, it was impossible to know at that point if the melanoma cells in the lesion had gotten in to the lymph system. We had to wait it out.

In March of 2004, a growing lymph node in her neck proved to be malignant. Further tests showed that it had also metastasized to her lungs. Her melanoma was then at Stage IV, with "lung mets".

Melanoma has no proven cure or effective treatment protocol. She underwent a number of clinical trials as a research subject. Up until the fall of 2004, nothing was working and she underwent "bio-chemotherapy", a highly toxic blast of 5 chemical agents administered while an inpatient in the hospital. It was an attempt to stop the melanoma cells from their rapid growth. It was a brutal experience for her and for the rest of us. This was an important touchstone in the journey. For the first time, she realized that her quality of life was much more important than its duration. She chose not to do the remainder of the prescribed series. Meanwhile, another clinical trial opened up and she went on that for several months. After a number of accumulating side effects, she decided to find another oncologist and opted for palliative care. The aggressive lymph node in her neck had to come out and then she had to undergo several rounds of radiation. Finally rid of the aggressiveness of the clinical trials, she got back to a higher quality of life, different from before, but satisfying none-the-less. She had already given up graduate school and career, lost some taste and salivary abilities, and suffered from "chemo-brain". But our mantra became "quality of life vs. quantity of life" and she remained relatively healthy for 3 more years. The remaining tumors in her lungs only grew marginally. We did some traveling and focused on doing things that we would otherwise have waited to do.

In February 2008, at what had become a routine visit with the oncologist, she reported having had some balance issues. A brain MRI revealed a tumor and we all knew that we had entered a new chapter in this saga. Melanoma is notorious for lying low like this and then eventually re-emerging in another place -- often the liver or the brain.

She underwent "Gamma Knife" surgery -- a non-invasive, highly focused radiation treatment designed to disable the tumor and buy more time. It was said to be a benign, palliative procedure, but the after effects were uncomfortable for her and involved headaches that wouldn't go away. An unfortunate steroid treatment, a couple of ER visits, more scans that revealed brain swelling and tumor growth, and a reality visit with the oncologist helped her decide that it was time to enter the hospice program and make the end of her life the best that it could possibly be.

Musings of a Recovering Widower

Wednesday, June 17, 2009

The Passage of Time

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