November 19: Day 172

Our greatest fears lie in anticipation. When those fears are coupled with a death sentence, a timeline, a diagnosis, a set of circumstances, the fear can take on a life of its own. This is cancer. 

Mom started this journey feeling crappy. Turns out, 'that' crappy was nothing compared to this crappy. She started out with a diagnosis. 'That' diagnosis carried with it a tragic finality and was defined; but it's always the anticipation of the next slip or physical decline that packs a far heavier punch. This is cancer.

We are quickly reaching a point where we find ourselves asking Mom, what quality of life she has in a particular moment, hour, day, and what we can do to continue to provide her with some more of that. Increasingly, she doesn't know.

We know from the diagnosis, the Google searches, the incessant questioning of doctors, second opinions, message boards what's coming, but still cancer has a strange way of consuming everything and yet also creeping up on you. It shows up when the walks one day become shorter even though the air is probably thicker, the inability to get from place to place becomes harder but the car is farther and yet we're also searching for a wheelchair, the legs feel too heavy and then won't just move on their own, the naps drag out and then the bed is in the living room, the conviction of the voice leaves and it appears my Grandma's creeped in. 

The physical deterioration slides in and sneaks up, even as you watch closely. And yet, peering back only a month, and it seems so much brighter there; even though the grim reality never really looked all that great then either. Again, cancer.

The primal aspect of our humanness hangs on, continues to fight, and yet, in the middle of all of this disease, all this fear, it seems the only answer lies in letting go. Not to be mistaken for giving up as the two are so unfairly intertwined, but indeed, in letting go. It is only in letting go, that there is peace, presence, no cancer, acceptance, stillness. We still play our best hand, we still fight like hell, we put all the right pieces in place, but we also let go. It is only here that we can begin to ponder that there might just be something far better ahead than that which we may leave behind. The body's ultimate failing might just be the only vehicle that can effectively carry that message, given how awesome life is here.

***

Thursday (Nov 14) marked the fourth infusion of Avastin, Dr. Karwal's trial (for liver cancer) drug. Ideally and yet improbably, four infusions in, Mom's condition would improve. We'd march on, continue the infusions. Except, four infusions in, her condition is deteriorating fairly quickly. Given the decline, the question becomes, is the drug making her sick, or is the cancer making her sick(er)? Or both? 

The accumulation of both the Nexavar and now the Avastin do bring with them some side effects, although both drugs are typically fairly low on the totem pole of awfulness, as far as cancer drugs go. So Thursday, Dr. Otteman will do another CT and evaluate where to go from here. 

If the CT shows that the cancer is still stabilized/not growing, a decision will be weighed over whether the side effects and physical decline are worth continuing. If the CT shows that the cancer is growing, that means the Avastin is not working, and we will discontinue infusions. At that point, the road forks and the focus becomes ensuring Mom is comfortable and as pain free as possible. 

Today, we let go...and take a long, deep inhale of this gorgeous sunny, crisp, November day. We continue to lean in on so many of you (and will even more in the coming days). We are forever indebted, grateful, and in awe.