Wednesday, October 24, 2007

First round of chemo

This is a long post today. I'm trying to get this all out of my head, so it's just going to be a long post.

Today my mother is having a port-a-cath inserted. If the procedure goes well, they will also start a round of chemotherapy today as well. If not, they will begin chemo tomorrow. This is being done at the small regional hospital about 3o miles from my parent's house. The first time mom had cancer, it was ER positive, and they treated it successfully from this small regional hospital. It was a small oncology unit, she knew all the nurses quickly, and many of the patients. In fact, several patients were people she knew from surrounding communities, and she felt at home and comfortable there. So I understand her desire to stay there, where she still knows some of the nurses and she has her original oncologist and surgeon. But this is a much different cancer, harder to treat and fewer options in the treatment.

My dad had called MD Anderson to try to get mom in for an appointment. I love my dad, but he is a racist man. He was a homicide officer for more than 15 years in a large metropolitan area, and he saw the worst that humanity had to offer, and now, he is a racist man. I don't agree, but I guess I kind of understand. Unfortunately for us all, the woman appointed to oversee my mom's case at MD Anderson is a black woman, Leslie. My dad called and asked for an appointment for a "second opinion". My dad's definition of a "second opinion" was to have a second doctor confirm the diagnosis and begin a treatment protocol at MD Anderson. The breast cancer center defines the term "second opinion" differently: it is an appointment with a doctor to have him confirm a diagnosis, and then prescribe treatment at a remote location, i.e. at the small regional clinic mom is at now, and the Breast Cancer clinic doctors have decided not to do that. This is not what my parents wanted, but my dad asked for a "second opinion", Leslie said the Breast Cancer clinic doesn't do "second opinions", and it went downhill from there. By the time I got involved, my dad was furious and Leslie was defensive.

I called mom and dad Monday, and dad told me what was going on. I had him give me the numbers to call, and I called yesterday (Tuesday). It took about an hour, but I finally managed to convince the admitting nurse that the second opinion that my dad was asking for was not the second opinion that the she was talking about, and we managed to figure out exactly what else needed to be submitted to get things rolling. In the meantime, Mom didn't want to delay the chemo any longer.

MD Anderson won't take patients who are currently undergoing treatment from another hospital/doctor/clinic. But mom didn't want to wait, so she agreed to do a round of chemo at small regional hospital.

When I was done talking to MD Anderson, Leslie needed one more report, and then we could have an appointment the second week of November. That's not far off, maybe 3 weeks, which is actually pretty good. But the surgery and chemo were due to start today. What to do? I called home to dad, and we talked, and I told him what was going on, that we could wait for 2-3 weeks and get in at MD Anderson, or we could do the surgery and chemo today. Then I asked him what they wanted to do. For the first time in my life, my dad was flummoxed. He had no idea what to do. After talking for a couple of minutes, I made a decision.

I said to dad, "This is what we are going to do. Mom will go in on Wednesday, have the port-a-cath put in, and start the chemo. When the series is finished, the doctors will look at the results, and then her oncologist will call the breast cancer center and do a telephone consultation with one of the oncologists there, and then mom will move to MD Anderson for treatment."

I said this with an authority I didn't feel, with a conviction that I don't have. I don't know if this is the best idea or not. My dad was so glad to have the responsibility of that decision taken away from him. I made that decision, not him. And he was more than happy to let me make that decision. I have taken that burden from him, I have stepped under him and lifted this off of his shoulders. For the first time in our relationship, I was an adult, making an adult decision, and he was happy to let me do it.

So now I know. My part in this will be to make decisions. My part will be to liaise between my dad and the doctors and nurses, translate, and make my father and mother understand. My job will be to be able to buffer my parents, to remain as unemotional as possible and get the information to the people who need it.

Dear Lord, please be with me. Help me to be strong, and to listen past the words coming out of my father's mouth, to the emotions behind them. Help me to not be so angry, to be constructive, patient, coherent, and realistic in my expectations of my parents, the nurses, and administrators that will be involved in this. Help me to carry this burden, because I don't think I can carry it without your help. Amen

Hey, at least I'm praying, right?

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