Wednesday, March 27, 2013

Life Changes Like That

The last post was about the trip to Eureka. It was about looking hopefully at the future, seeing a place of green and peaceful retirement. I didn’t mention it in the blog entry, but Steve was dealing with dripping sinuses and a winter cough. This is not unusual; he’s had “holiday colds” many times in the years we’ve been together.

When the cough persisted into January, I urged him to go to his doctor at the VA clinic in downtown L.A. He did, and the doctor gave him some antibiotics and sent him home. But the cough persisted after the regimen of pills was completed, and Steve was feeling short of breath, so he returned to the clinic, put himself on a waiting list and, luckily, was seen by another doctor. They took an X-ray of his chest and found fluid in his right lung, so he was shipped off to the Long Beach VA Medical Center via ambulance, since the emergency room at the West L.A. VA facility was having sewer problems and was temporarily closed.

They kept him overnight in Long Beach; walking pneumonia was the diagnosis. He was given an IV drip of antibiotics, then sent home the next day with another course of pills. I picked him up in Long Beach and drove him to his car, which was still parked at the downtown clinic. The doctors at Long Beach had told him to return to the emergency room there if things didn’t improve.

Oddly enough, I had been broaching the subject of quitting smoking with Steve since January. It wasn’t a New Year’s-resolution kind of thing: I had just counted up the amount of money we had spent on cigarettes over the course of the year and come up with a rough estimate of $3600. We had been looking for simple ways to economize, and that seemed like a good place to start. After all, nicotine patches are now about 30% cheaper than cigarettes, and the gum even more so.

After a week of antibiotics at home, Steve hadn’t improved and was still short of breath. On Tuesday, as he was getting ready for work, he barely had enough wind to take a shower and get dressed. After 90 minutes at work, he returned home and asked me to drive him down to the emergency room in Long Beach.

After a second X-ray there, it was determined that the level of fluid in the lung had increased, and he was admitted into the hospital for treatment. The next morning, they drew off almost two liters of fluid from the lung. A biopsy of the fluid revealed adenocarcinoma cells, and the initial diagnosis was lung cancer.

Steve remained in Long Beach on Wednesday, undergoing a battery of X-rays and CT scans, while I stayed at home working on several business projects. A bronchoscopy and several biopsies were scheduled for Thursday morning, so I went down to visit him that afternoon. The doctors said they were holding him over until the lab results returned on Friday. I asked them to wait until I arrived on Friday to give their final consultation on the case, so I could be there for the prognosis and recommendations of treatment.

I got there a little after noon on Friday, and around 2 o’clock two of the attending physicians arrived with more specific information: There was a mass in the right lung, a small mass on one vertebra and also on the bottom of the sternum; lesions were apparent on the liver and pancreas. I asked if this was a case where complete remission was likely and they were doubtful. The doctors suggested that we wait until the consultation with the oncologist to get more specific information, since she would have reviewed the test results from the week and have a better understanding of the case. So Steve was discharged that evening and came home for the weekend.

Of course, the weekend was spent simply wrapping our heads around the bad news, telling ourselves that our generation had a bleak view to the word “cancer,” and that treatment plans were far more sophisticated nowadays; survival rates, even without complete remission, are counted in years now, not weeks or months. The biggest anxiety, however, was in simply not knowing what was next on the agenda; the biggest epiphany, realizing that life had changed in the course of a few short days.

Monday was the appointment with the radiologist, and he was very helpful in describing the general approach to treatment: chemotherapy was the way to go to start with, then radiation might very well be prescribed in between courses to deal with specific problem areas. His tone was far from dire, and his attitude seemed to be serious but not remorseful or maudlin.

Since December, Steve has pulled just about every muscle in his back, sides and stomach during his coughing fits, and coming back from Long Beach, he pulled another. He spent the day on the heating pad and slept that night in the recliner in our bedroom. Yesterday he spent the same way. I kept busy with errands and chores, stocking up on food and household supplies for the next two weeks, emptying trash, cleaning the cat box, doing the dishes.

Steve has his oncology consultation today (Thursday), and we should learn what the plans and schedule are for his course of therapy. We’ll also have a chance to talk with the other members of his treatment team, including a social worker who can give us all the information we need about disability benefits, support groups, on-site living arrangements and the like. I really feel blessed that we landed in Long Beach, because I don’t think better or more attentive care could be had anywhere in Southern California.

Long Beach is a wonderful, sprawling facility and the staff is attentive and responsive. They even have free valet parking. Visiting hours are “always,” and when I identify myself as Steve’s husband, I am afforded all the respect and privileges a spouse should receive. While filling out a form that listed next of kin, Steve said, “What should I put down under ‘relationship’?” I replied “Husband; it’s the truth.” Several nurses have even congratulated us on being married. At least at the VA, “don't ask, don't tell” is something it seems everyone was ready to put in the past. It’s uncanny that the Supreme Court is hearing these two cases on same-sex marriage at this time when our marriage is so vitally important to us.

The most reassuring thing is that hospitalization and treatment are completely covered, with no insurance company approving anything. We can focus our concern on Steve and his recovery, and not some catastrophic financial impact of this life-changing event: Steve was planning on retiring in June, in any case.

Friends and family have been wonderfully supportive since he posted the news on Facebook (what a 21st-century way to make the announcement). Tales have poured in from cancer survivors and folks who had loved ones who lived with the disease for 10 and 15 years beyond diagnosis and treatment. But, as one survivor said, “Each case is so unique, so different.”

As for me, I’m glad that I don’t have a 9-to-5 job that demands my attention, and that my work can go with me anywhere I can set up my laptop and access the Internet (I’ve already asked about wifi spots near the hospital in Long Beach). My schedule is totally flexible and, as long as my clients can reach me by phone and I can retrieve my e-mails and graphics files, I can continue getting my work done.

So life has changed, turned on a dime. This first week seems a horrific and terror-filled one, but I know that we will settle into the adventure ahead (dubious though it might be) and ride it out to its conclusion.

Death always has been at the end of life. When one hits 60, it’s hard to avoid the realization that there is far less left of living than has already passed. Steve has knowledge now of what probably will end his life, but when that will occur is still as uncertain as it always was. And with that knowledge, hope arises that it will be a good long while, and that the days between now and then can be filled with meaningful things.

I told Steve, first priority is treating his disease and getting control of it. Next to that, the most important thing is deciding what will bring him joy, and that’s what we'll do. Because, after all, enjoying yourself and having a good time is what retirement’s all about.