Z's Cancer Has Spread

It was on my birthday, June 12th, that we found out Z's diagnosis of small cell squamous lung cancer. It was not inside her lungs but still it was devastating. And it was a late diagnosis since Z doesn't trust or believe in Western medicine. She is a practitioner of alternate modalities (her words not mine). And yet after a while of thinking she could battle this cancer with juice fasts and magic water (my term not hers) the tumor was pressing on her superior vena cava, making it hard to swallow, breathe, talk. It was getting worse fast. Her daughter came and put so many things in order, and it was her influence and research that put Z in touch with the best pulmonary oncologist in Utah at Huntsman Cancer Institute. She got the best pulmonary radiation doctor in Utah. And Z hated every second of her care. I was never allowed to accompany her to any of her appointments despite asking. So I gave her rides to and from her early treatments which she reluctantly agreed to. I helped her put her clean her closets so Z's youngest son and his partner and her son and their son could move in and care for her. They were given the full house and Z was moved out of her bedroom and into the small basement room where it would be cool and quiet. Then I had to butt out, since her kids caring for her meant a great deal to her. I felt their care was not only inadequate, but worse, it created more work for her and very little nurturing care from them. She called me to bring my little French vacuum over to vacuum her bedroom in the basement, crowded with the washer and dryer, piles of dirty clothes, their vacuum and anything else the young woman partnered with Z's son didn't want in the upstairs. I cooked her favorite things and took her anything she craved but I got harder for her to swallow. And all the time I wondered what her son and his partner were doing to help her. The young woman did not work out of the home, but stayed home with her toddler and baby all day. But she never seemed to do much for Z. One day I called to find Z cleaning the fridge. I was seething with rage. She was too sick to be doing anything but getting waited on, fed things that sounded good to her, kept clean and quiet. But any critical comments about her son and his lazy (my word) girl friend and the lack of care, the absence of nurturing they exhibit towards Z makes her jump to their defense. They're sick, they're busy, they're tired. Frankly I don't give a shit what their excuses have been for not shopping, cooking, serving, cleaning up after and around Z. They live in her house rent free to make it easy on them to take care of Z. They have been awful at taking care of Z.

It was months before she told me what stage her cancer was. Stage three. Dire, but not yet matasticized. Her prognosis was 30% chance for a good outcome with aggressive chemo and radiation. She balked and tried to find a way around it. She hated her doctors and claimed the only reason they treated cancer was the big bucks. She said her treatment would buy a new set of golf clubs for her oncologist. I have a close friend who works as a researcher at Huntsman and asked her to check this doctor out. Her report to me was that he was a very good doctor. Not the best bedside manner, but top notch skills. He is the best pulmonary oncologist in this part of the country. But Z could not be convinced that he was not a charlatan.

In the time since June 12th she has had pulmonary embolisms, severe pain in her hips and shoulders, pneumonia, and the pain from radiation burns as they tried to get the tumor to shrink back from her vena cava so she could breathe and swallow. At every turn in this journey there wasn't a day she wasn't pissed off at the doctors and technicians who administered her radiation and chemo. She kept looking for a "natural" cure for her cancer. When her hair started falling out she wanted to stop chemo. She was sure they were going to kill her with the chemo. They didn't understand that she was too "pure" for this level of chemo. She'd been a vegetarian for over 30 years. Her system wasn't like other peoples, she kept insisting. She was furious that her oncologist didn't acknowledge her slight weight as a reason to back off the chemo. Z is 5'8" and weighed 115 when the treatment started. She's now probably 95lbs, if that.

Z got through the first round of radiation and chemo and had a couple of weeks to recover some strength. Then her doctor ordered another round of chemo. She had one treatment and then refused to continue until they did another PET scan to see how much the cancer had shrunk. She got the results yesterday. Her cancer is now in her liver, spleen, and lungs. The original tumor, which was "lung cancer" wasn't actually in her lungs. It was outside the lung and pressing on her airways. That tumor had shrunk some, but the cancer had matasticized. Now she's no longer willing to receive any more Western medical treatment. They offered to give her hospice care. And this offer of hospice is to her a confirmation that Western medicine has failed her.

Before she got the results from the PET scan, she'd found the cure she'd been looking for. It's hash oil. She found a site on the internet that promises to cure lung cancer with the use of hash oil. To my way of thinking anything that gives her hope or makes her feel better is a good thing. She says she's leaving Friday for Southern California where her two oldest sons live. I wanted to get her a first class ticket on a plane, but she wants to have her car with her. So her brother is driving her to Southern Utah where she'll spend the night. Then she plans to drive herself to Las Vegas to meet up with her middle son. He'll fly in to Las Vegas to drive her the rest of the way to San Diego. Her oldest son and his wife and twin daughters live close to the beach in San Diego.

Z is my oldest, closest friend. We met at seventeen as early admissions students at the U of Utah. We were the first early admissions students the University accepted and the only girls in that first group of six. We were as different as it's possible to be. But for some reason the friendship grew and though we have spent years living in different parts of the country, married, divorced, and out of touch, whenever we did see each other the old friendship was just like it always was. She is my Executor, has medical power of attorney for me. We never thought I would outlive her. I'm bipolar and have what used to be called Malignant Hypertension. The leading cause of death for people with severe bipolar disorder is suicide. I wasn't expected to live this long. Now it looks like I will survive her. How strange is the landscape of my life without her in it.

One More Friend Hits The Wall

One of my informally adopted daughters is terribly ill. In the past week she has been admitted twice to the emergency room at the University Hospital. Neither time did she tell me that she was in trouble. Now that she's home and starting to recover, she called to let me know that there was a problem, but now it's fixed. For the time being. She has Cushing's Disease. It isn't really curable, but it can be treated. Unfortunately, the treatments are drastic and require constant monitoring. She's had so many serious surgeries, that scar tissue is now a problem. Stress is a factor in Cushing's and she has been going through a difficult divorce. I am sick with grief and worry. But there is nothing I can do. She won't let me do anything. I feel so helpless and useless.

Z is having problems with her daughter in law. Z's youngest son, his "wife" and her toddler and their infant had moved into Z's house to take care of her. But the daughter in law does not help. Yesterday when I called Z, she was doing laundry and cleaning the refrigerator. I asked her why she was out of bed and doing these things. She said she couldn't take the mess any longer. The fridge was stinking and she was in need of clean clothes. She also said the kitchen floor was so dirty she couldn't stand it. Today she tells me they are moving out soon. That was not the commitment they made with her. This is a drastic change of plans.

I feel useless and furious, and terribly scared. There are so few people I'm really close to, and these are two of the most important to me. I can't go to Z's house and muscle my way in to clean and do laundry. So to deal with my fear and worry I'll clean my own house.

Yes, You Heard It Here; It's All About Me

Two of my very close girlfriends are dying. One fast, one slow. Yes, I know, we're all dying slowly, but MS isn't the usual slow kind of death the rest of us are experiencing, it's a slow agonizing loss of everything but the clear thinking functioning brain that notices all the rest of the profound loss that's taking place quite rapidly. Her diagnosis was the first blow. I was able to help her in small ways in the beginning, since I had gone through the disability hoops and knew the ropes. Trust me, it gave me no pleasure to be this particular kind of help to her. Yes, I'm glad there was something I could do for her, but her diagnosis was an agonizing death sentence with a long time locked up and waiting. It wasn't long after this diagnosis, her loss of the ability to work anymore, that her only child, her son, was stabbed to death in a downtown park. He was going to be her rock, her caregiver. He and his lovely wife were going to make her final long demise less painful. His death was not the first nail in her coffin, it was close to a stake in her heart. I don't know how she survived that loss, but she has always been one very tough cookie.

She was Salt Lake's own version of "The Devil Wears Prada." She was the fashion coordinator at Nordstrom when we were Salt Lake's version of the Fashion Police. It was her great taste and exacting standards that scared us all half to death and kept us always on our toes. I was her assistant. It was her direction and fabulous taste the determined my choices. She did the decision making on all the really big fashion shows. She hired temporary help to pull the clothes and accessories for those gigantic shows and extra help with the fittings. And then there were the terrifying rehearsals at 5 AM. And because of her, my modeling career took off in my late forties and into my mid fifties. Who would have ever imagined that there would be a market for old models? But it was a time of enormous change in the fashion industry. We hired plus-sized models, we hired petite models. It had never been done before. We were trail blazers, pioneers in the fashion industry. And she was our leader. This probably bores you silly if you aren't a fashionista, but it was our lives. Even if what you do is essentially silly, if you do it really well, it can be quite spectacular.

I called her today. It's been a couple of years since her diagnosis of MS, maybe more. And when she got the diagnosis, she'd been ill for a long time. So how long does it take for MS to kill you? When we talked today, she said she was no longer able to walk without a walker. She takes handfuls of drugs to keep her from having spasms and cramping and uncontrolled twitching. Not fun drugs. Not like the good old days, when we partied at the New Yorker. Not like the time she visited Tom and me in Santa Barbara. We were the only two women working at Nordstrom who didn't hide our cigarette smoking. We wore red lipstick and ran in high heels as effortlessly as breathing. Now breathing isn't effortless for her and it has nothing at all to do with smoking.

Z on the other hand never was a cigarette smoker. She didn't care about fashion. She lived for her children and lived the clean and very wholesome life of a woman with a real spiritual belief. I can hear you thinking "What did she ever see in you?" I realize I have made light of her need to believe in homeopathy and Chinese Herbs and acupuncture and a very pure vegetarianism to treat her symptoms for years. But I was desperate for her to fight fiercely to live. So now she's finally given in and like a very good patient is going for her radiation treatments and chemo therapy. But her odds are not good. If I had her cancer, I'd be putting notes on the very good jewelry and nice pieces of furniture so there'd be no bickering about who gets what when I'm gone.

The bottom line for me is that I never was a girl to surround myself with lots of close friends. I could hardly stand anybody. But I grew to love these two women who seem to have nothing in common. Without them I'll be lost. I cannot even imagine a life without them. We had all taken it for granted that I'd die first. Be careful what you take for granted. You may not get what you expected. But what you do get will test you. It will hurt so much you'll think it just might kill you. But it won't. That's the problem. You might end up the last one standing.

Z Is Feeling Better

Z had her first chemo treatment Monday. I was scheduled to pick her up at 2:30 but she called at 2:00 to tell me to pick her up at 4:30. Just as I was looking for my keys, she called again to tell me she wouldn't be finished until 5:30 and her youngest son would be off work and able to pick her up. She sounded very tired and very impatient.

This morning I called her when I got up to find out if there was a schedule for today that I needed to be ready for. She sounded strong and bright. She said she was feeling much better today. I am amazed and ask her a couple of questions about the chemo. She says, she loves her assigned nurse. Aside from being boring, it wasn't that bad. She says their old family friend J will take her to all her radiation treatments. And all she'll need me for is to pick her up from chemo, one day a week. I'm amazed and relieved and so happy to hear her feeling alive again.

Now I have a crashing stress release headache. I know, it doesn't sound fair, but I'm so relieved I've been giddy all day. I tweeted throughout the Sotomayer testimony today on CSpan. I have eaten sensibly so far, but there is still a bit of cake and plenty ice cream.

A Quick Update

Dogs do talk in their way. There is a difference in their vocalizations. Happy is indeed different than a warning. And so much more. Yes, Darkblack is right. You heard it here.

Therapy was much needed and mostly spent sobbing, wailing, and cursing. It was cathartic. And the conclusions we came to about my reaction to what is happening to my friend is completely normal. I am neither manic nor depressed. I am sad, terrified and very very pissed off.

Z may be running out of options for treatment. She has refused chemo so far. When she first saw Dr. Ackerly after he'd seen her medical records, he told her she had a 30% chance for a good outcome with immediate and aggressive treatment. She didn't like him and was thinking over her options. Now the latest estimate is a 10% chance for a good outcome. I think she's going to take her chances with a course of radiation and then trust her own instincts. How do I feel about this? See paragraph 2.

Ms M is on vacation and Roscoe sleeps at the foot of my bed for a few days. He is a comfort.

The Time of Illness

I had two days off. No schedule for radiation, but
The tests for clotting factor went on as usual
Without me. I rested like a long distance runner
My drug fueled system humming along as if I ran
On chemicals alone. Did you know that Warfarin is
Rat poison? This is proof to Z that all medicine is poison
To me it means that someone found a really good use for
Rat poison. I take twice as much Warfarin as Z to keep me
From blowing a gasket, to keep my heart humming along
Like a clock that runs a bit too fast, but steady as she goes.
The bruises that cover my arms and legs don't bother me at all.

Z hemorrhaged again last night but refused to go to the hospital.
She determines that she just needs to cut back on the Warfarin
I ask her why and she says, "What can they do? All they can do is
Give me a transfusion." I wonder why that is such a bad idea. I want
Oxygen. I want oxygen rich blood. I think they might give her Oxygen
But keep my mouth shut. I took her fresh peach cobbler hot from the oven
Vanilla ice cream. She eats it as if she were a starving child and I choke back
The truth that the peaches were purchased at the grocery store and were only
99 cents a pound. I make up a perfectly plausible story about my neighbors friend
Drew who grows peaches in Southern Utah for peach brandy. He always has too many
Brings a bushel basket for the neighbor who passes plenty to me for fresh peach cobbler
Thankfully she doesn't ask about the ice cream. It is Bryer's All Natural, Natural vanilla
She eats it like a starving child. I took certified organic red potato soup, organic milk,
Watermelon cut into bite sized pieces and chilled. I know from having spent a lot of time
With Z that she does not get enough fluids to stay well hydrated. I liked the idea that when
She was in the hospital they pumped fluids into her veins. She says it made her swell. Well,
Yes, when the tissue is hydrated it plumps with pulsing life.

I'm a woman who takes a handful of pills every morning with her first mug of latte.
I don't do a lot of research on the drugs I take or study inserts for dire
Side effects.
Life has some nasty side effects. Life can kill you.
Don't we start dying from the moment we're born?
I took so many risks, still do, daring death to take me
Like a lover, who sees an opportunity when I sleep
I should be so lucky

So, the schedule is set for this week. Radiation every day
Clotting factor and food are on Z's agenda and mine
If all her radiation treatments are in the afternoon
I can take her, park the car and wait with a book
Patiently. I hope I live up to her expectations
I hope I don't disappoint her. Today it was peach
Cobbler and vanilla ice cream, tomorrow begins
The hard part, now that the tumor is bleeding
She's no longer just getting rid of the blood clots
In her lungs. Now the tumor is bleeding. Isn't that
A bad thing? I try not to show my extreme distress
I come home and take a handful of pills with my
Evening cup of Earl Grey Tea and smoke half a dozen
cigarettes. I resolve to keep on doing what I'm doing
As if it will protect me from her loss. What are the odds?

Email From An Old Friend

Peggy

I know that with all the caring you already are giving in so many ways to Z the following may not be worth much to you. But I offer it anyway.

I remember the terror I felt, inside, when I first saw this huge machine that would soon be bombarding my body with killer radiation beams. It made a most unwelcome whirring sound as it rotated and zeroed in on the little red targets that had been painted on both sides of my throat.

It bothered (and frightened) me even more when I had to return years later for another bout with the
"terror rays."

I then read in some periodical that an individual should make make friends with the killer machine that can also heal. So I did. I went in to the room before a treatment and just sat on the bench that places you inside the maws of the monster. And I communicated with it.

Following treatments because easier as I let my mind wander n healing ways.

It worked for me.

Scott

Sublimation's a Bitch

I have held my tongue so long it's strangling me. I know that the area in my throat and chest that is effected by this tongue holding is the exact area that is strangling my friend. But today, while I waited for the phone call to go pick her up from her first day of prep for Radiation at Huntsman Cancer Institute, I have tried to put my house in order and this house keeping has seriously inconvenienced all the dogs. So I have shouted at dogs to move, go outside, shut up, stay! all day long. I finally took to using a water sprayer to surprise Marley in mid-bark at the kids playing in the yard across the alley.

I have stripped all dog beds or their coverings and washed them. I submerged Marley's bed in the bathtub and scrubbed it. It's been drying in the sun all day and is now a lot sweeter smelling than Marley herself. Tomorrow morning Marley gets another bath. I stripped my bed and washed sheets. And I did all this cleaning because I couldn't leave my phone for fear of missing Z's phone call.

When she called I had my clothes laid out to hop into so I would look respectable when I pulled up at Huntsman to pick her up. I wore a sleeveless white cotton blouse and a black cotton skirt. I wore earrings and a bracelet. I wore my good summer hat--it goes with everything. She was waiting in the circle at the entrance, and as I drove up the hill I saw her standing there dressed in a long sleeved brown top with matching brown pants. She is reed slender and this willowy frame from a distance has the look of the girl I first met at the U forty eight years ago in a room full of boys. I do not look like the girl I was. My hair is shorter and I weigh at least forty pounds more than I did as a reed thin girl. I look my age. But at a distance Z looks just like that willowy girl, that ballet dancing girl. And a lump forms in my chest as I think about the journey we both have taken to end up here now.

Tonight her sister-in-law is cooking for her. Tomorrow I pick her up at 3:30 to take her to Huntsman again for a half hour of treatment. She is feeling better all ready.

Marley on the other hand has her very long nose very seriously out of joint. At least I didn't kick her.

Shopping, Cooking, Feeding

Tuesday has been spent shopping for an all organic and very tasty meal for Z. I found eggplant, tomatoes, fresh mozzarella, shaved parmigiana, and organic olive oil. I'm growing basil and oregano and it's organic, so I have the ingredients for eggplant parmigiana. The marinara sauce took longer than anything. I cooked for most of the day. Thank god I have a swamp cooler. It was hot today. I had two burners on for an hour, then the oven for 45 minutes. I wore nice clothes while I shopped and cooked. I say that because I wanted to respect the errands I was on. I wore my favorite white linen sleeveless blouse and a nice cotton skirt. I wore a bit of jewelry. I never do that. I even wore my favorite summer hat.

I made a salad of torn fresh organic leaves of romaine lettuce with a dressing of olive oil, lemon juice, and a bit of soy sauce. I fixed garlic bread using a coarse Italian bread, unsalted butter and fresh garlic, wrapped it in foil and baked it.

I found a very nice small watermelon and cut it into bite-sized pieces of cool juicy sweet fresh from the heart of the melon and then chilled it while the marinara sauce and eggplant were cooking.

I bought organic raisins and bananas. I bought raisin, nut, cinnamon bread for tomorrow's breakfast toast. I took organic cream of tomato soup, a small container of sour cream for the requisite dollop for a start on tomorrows lunch. I bought ten containers for serving sized portions. And then I bought a rum cake.

As soon as the eggplant parmigiana was out of the oven, still bubbling around the browned cheese, I packed two servings and loaded all of this nice healthy clean tasty food into my good shopping bags. I included two shallow bowls, a fork, and two napkins. When I got to Z's it was almost 5:00 PM. I just walked in, went down the stairs and into her bedroom. I told her what I had with me, and she chose to start with the watermelon. We reminisced about all the times I cooked eggplant parmigiana for her: the most recent time was when Tom and I were together, the first time was in LA when she and V owned a chic little Indian clothing store. I was the cook for all the vegetarians who worked there. It took all day to shop and cook and plan for the next days meal. I was also a private cook for a wealthy widow in Santa Barbara in my spare time. Occasionally I forget what a good cook I am.

Z ate with relish. She ate everything I served her. I sat and talked while she ate. She didn't have room for the slice of rum cake but promised me she'd eat it later tonight. When she was finished eating she said she felt like a nap. I packed up the dirty dishes, kissed her on her cheek and let myself out.

Tomorrow, Wednesday, I pick her up after her first radiation treatment.