No More Forks

Thursday was one of those days where our emotions were on a roller coaster.  Dave and I had talked about the effects the treatments were having on him.  During the last week, he has had six one liter infusions of saline water, two very painful MRI’s, and he was exhausted the entire time.  We made an appointment with the kidney doctor to try and answer a few questions, and to get some straight input from her. 

No one could answer the question about why his kidneys had failed again right after the chemo medication was administered.  She discovered that our primary care doctor had restarted Dave on a blood pressure that had probably irritated his kidneys.  Coupled with the chemo, it was too much for his system.  She then talked about several different things Dave could do.  But she said all we are really doing at this point is chasing numbers on the blood draw tests.  The question of long term comfort for Dave had gotten lost along the way.  She actually came out and asked Dave what he wanted.  He said he wanted to be comfortable and feel good enough to be able to do some things with his family.  Right now all he was doing was going to the labs, getting infusions and tests, and coming home exhausted.

She said that would be her goal in the same situation.  She would not do any of the things she had just talked about.  Just go for pain management and fight the fatigue as much as possible.

 Dave had asked Tony to take him to the doctor’s to be the interested bystander.  When they returned Todd and I sat down to discuss with them what had been said and our feelings.  We all came to the same place.  When we went to the oncologist he had several question to try and figure out why things happened the way they did.  He had been on vacation so he could only read the notes and talk to the nurses. 

Soon after he came in the room I realized he was thinking the same as we did.  The clinical trial had put Dave in the hospital for eight days.  The chemo made him extremely tired and played a role in the latest kidney problem.  It was now time to work with hospice to make the time left as good as possible.  The doctor would keep up with how things were going through the hospice nurse, and we could call to see him at any time. 

Intellectually this was a fairly easy decision because it is the best way to make sure the quality of life is the goal.  Emotionally is an entirely different story.  I have to deal with it in small pieces.  This is one of the pieces.  From the beginning Dave had said his goal was quality not quantity, and we lost sight of that after the hospital stay.  Somehow the recovery got mixed in with treatment.  Now we are back on track.  Hospice called later in the day.  Our first meeting with the nurse is Wednesday at ten.  Meanwhile we will be learning to find what really is important.