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Last Year's Diary

Medical Diary, 2001
Year Six Living with Cancer


Monday, October 2 Office Visit with Dr. Sharma This is the hardest entry I've had to write, for the news is the worst possible: the cancer is growing again and it has spread to the region around the lung (the 'mediastinum') and apparently affected the lymphatic system. Dr. Sharma does not recommend additional chemotherapy because in her condition it would probably kill her before the cancer. He advised making the most of the time left and to concentrate medical efforts in keeping Neila as comfortable as possible. He also referred us to hospice. Neila took it very hard.

We have known for a long time this day was coming, but foreknowledge does not seem to have lessened the emotional impact, and I am not able to write much right now.

Friday, October 5 Office Visit with Dr. Kramptiz Dr. Kramptiz is the neurologist Neila has seen before. Dr. Sharma, in spite of the overall hopeless outlook, thought there might be something a neurologist could do for her since many of her symptoms result from the brain radiation. There wasn't, though he did refer us to a Dr. Virginia Stark-Vance, a "neuro-oncologist," in the hope she might have something--she did not.. He also ordered an MRI of the neck -- a region so far missed by the numerous images Neila has done -- in the "leave no stone unturned" philosophy.
Sunday, October 28 Crisis Neila did not wake up well this morning. She had difficulty talking and was less able than usual to do things like feeding herself. This grew worse as the day wore on until by 4:00pm she was virtually unable to talk or eat and there was noticeable swelling in her hands and feet. I called the hospice nurse who came by the house a little later. After examining Neila and asking us a lot of questions, she said this is just the beginning of the final phase of the disease and that Neila's body is starting to shutting down its vital functions. She told us the signs to watch for are a diminishing ability to eat and drink, difficulty in breathing, a "gargle" in her throat. At each of these stages we should call the hospice nurse because there are things they can do to make it easier on her.

Since our visit with Dr. Sharma on Oct 2, I have come to believe it is time to close this diary of Neila's struggle with cancer, because it is essentially over, and open a new story of a loved one's passage from this life. You will, I hope, understand my reluctance to do this because it could be taken as giving up. We have seen end predictions before and they have proved to be precipitous. Yet I also you hope you will understand when I finally take them to be final. The convergence of opinions from doctors and nurses and Neila's multiplying medical difficulties have become impossible to discredit or ignore. If we do not accept the inevitable now then we risk missing the chance to make her last moments with us as confortable as possible and assure the peace of her passage and the serenity of our memories.

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