The way to love someone
is to lightly run your finger over that person's soul
until you find a crack,
and then gently pour your love into that crack.
~Keith Miller

Thursday, August 13, 2015

Stuff ... cracks.

At some point my mother had her gall bladder removed.  She said there was a tiny spot of cancer in her colon.  My brother was with her for the surgery and a few days of recuperation.  Her sister spent some time with her helping too.  My mother insisted that I not come.  It was too small a thing.  Easily addressed by those close at hand.  My mother and I were not close.  We were not close and that has been one of the great sadnesses of my life.  I do not understand how such a thing can happen, just that it did.  My mother said the doctor got "excellent margins" when he removed that tiny spot of cancer and my brother who spoke with the doctor confirmed the truth of that.  My mother was not always reliable with the information she chose to share ... that's my mother.  My mother did not like "negative" words "spoken" in to her life.  Positivity was part of her religious sensibilities. That became quite frustrating for me.  My mother was not open to discussion on a topic that she considered resolved.  Maybe most of us are not.  I asked her what sort of follow up her "tiny spot" would require.  She said none.  The tiny spot was gone. (Halleluia.)

During the time I spent with her in the weeks preceding her death I learned that quite a bit of the colon and her gall bladder had been removed when "the tiny spot of cancer" was seen to.  So many details from that time are a blur, so I'm not sure if I read a report about her medical adventures or if maybe her sister gave me the update.

I am guessing when I say Momma 's liver cancer was actually colon cancer metastasized to the liver.  Her tumors showed up on some imaging that was part of figuring out what was going on with her heart after the event which took her from a primary care check up to the hospital emergency room.  She was not a candidate for any of the usual therapies - no chemo, no radiation, inop ... .  She past quickly, within 6 weeks of the diagnosis.

Tommy and I thought we were dealing with the onset of dementia when (exactly a year earlier) we moved her over near him.  He noticed her becoming more and more forgetful, sleepy and disoriented frequently, crankier then usual (which I couldn't attest to because she was always short with me).  The rapid weight loss was a huge concern to me, she hadn't been significantly overweight before.  She chalked it up to having nothing to do but walk (the halls) in the senior living apartments that we found for her.  When I saw her I was surprised that her stomach seemed swollen ... I mean she had lost a lot of weight, but she looked like skin and bones and tummy.  Plus she slept on her sofa during the day with  her feet up on a foot stool and was awake pacing on her balcony during the night (her neighbors told me that when I was staying in her apartment).  I couldn't call her without waking her up.

Tommy and I both were concerned about the dementia.  I was sad to see her in such a state, but honestly, and somewhat to my shame, I was afraid for how that might be played out in my later years.  When I read up on Alzheimer's research I was thinking of myself as much as her.  While her heart troubles came on suddenly, the forgetfulness and fuzziness seemed to be progressive.  I wasn't really even sure that she wasn't just "playing" with us on the memory problems.  When I came to stay with her I knew it wasn't a problem of Alzheimer's, but I was unable to understand the process of her mental shut down.  As I research some of the info "out there" on secondary liver cancer I see that her symptoms were textbook.

Hepatic Encephalopathy

Encephalopathy means brain disease. Hepatic encephalopathy is brain damage from liver causes; symptoms include behavior changes, confusion, a change in sleep patterns (night-day reversal is common) poor judgment and slow speech and movement. A hand flapping movement called asterixis or trembling hands can occur, according to the National Institute of Alcohol Abuse and Alcoholism (NIAAA). Depression and anxiety are also common side effects. Hepatic encephalopathy can progress to coma and death.
The oncologist said the cancer in Momma's liver was the size of a cantaloupe. She said that it was doubtful that it was primary liver cancer and I could have that tested if I needed to know.  She said that the testing would be painful for my mother, also (if I remember correctly, and I might not be) that the testing process, acquiring tissue for a biopsy, could be fatal.  I declined on my mother's behalf.  
Hepatic encephalopathy is deterioration of brain function that occurs because toxic substances normally removed by the liver build up in the blood and reach the brain.
I think the tiny spot grew to cause secondary Liver Cancer.  My guess is it had already made the leap to her liver and probably elsewhere in the body systems.  At the Hospice House they did, at my request, a test which indicted extremely high markers for bone cancer.  Poor baby.  I am sad that we didn't have the type of relationship which would allow me to "tend" to her better.  I don't feel that I left any avenues to a close relationship with Momma unexplored.  I was occasionally exasperated with "us" but I came to feel mostly compassion towards Momma. There wasn't a road leading to a place for us.  
I am glad she didn't have to live to see another of her sons buried.  I am glad that she is well now.  She did have what seemed to me an almost miraculous rebound the day before she died.  For a few minutes she seemed entirely lucid.  She seemed like younger her, maybe the 35 year old version of her.  I was amazed to recognize her, and it makes me smile to recall her crisp, almost businesslike manner.  "I know I am dying." she said.  "Look after your brother."  
I have more I'd like to express here ... just not now. It is funny to see how the experiences of our lives, or what we make of them, how they manipulate some of our other important relationships.
This is so much on my mind today - partly because I notoriously push grief away and it's catching up with me - but mostly because I have a task which requires me to search through my laptop for stored pictures from the last couple of years.  
The stuff on the past couple of years to - do list is complete.  Now I get to make choices about what comes next for me.  I am fortunate.


vanderleun said...

"Ring the bells that still can ring
Forget your perfect offering
There is a crack, a crack in everything
That's how the light gets in. "

gretchenjoanna said...

My husband died of colon cancer that had metastasized to the liver. He had a tumor removed from his colon and at that time they saw that the liver was full of cancer. He lived nine months, with chemo treatments during six of the months. He had those symptoms that you describe, but we knew the cause, the ammonia buildup in the brain from the liver failure. I'm sorry you couldn't be let in on your mother's illness; it's good that you did your own research afterward to know for your own sake what your heredity is...

Thank you for checking up on me :-)

DeAnn said...

My mom preferred, geez, I don't know how to describe it.
It's not that I don't believe God can do whatever God wants to do. I really believe that.
My mom believed that whatever she asked, and I do mean whatever, once sprinkled "with Jesus name" ... was going to happen. Any thing "spoken" contrary to that infused a corrupting disbelief and spoiled the brew. There was no room in her formula for "me". My lack of faith seemed to be even more powerful then the God of all creation ... my shortcomings were "trump". Pretty bizarre, huh? ... Best to keep me out of the loop. I think that might have been her process, but I really don't know. I do feel that Momma is 'whole" now, or will be. I'm not as sure about how God does things as a lot of people seem to be.

I'm keeping a pretty close watch on my colon. What may be is entirely in His hands and I', peace-filled about it.

DeAnn said...

I am concentrating on ring those bells ... beautifully reminded to ring them. And that other stuff ... not so much. I can't fix what is done.