Thursday, July 12, 2012

The Waiting Game

In January, Tom had the experience of having a prostate biopsy to gain more information about feelings of pressure on his bladder.  We have a "free" health care system in Canada -- we obtain medical information and advice as needed, but we have to seek out assistance from a primary general or family physician, who then makes a referral to a specialist.  In this case, the specialty that provided the consultation was urology, someone who focuses on the urinary and reproductive systems of males.  Tom has (we have) been waiting since winter to uncover and understand why that bladder was being pressured (more than normal! more than you would expect from a male who has had a tiny bit of experience with beer drinking and has managed to hold his own, although never to the extent of some of his partying beer-guzzling friends -- but I digress...).  At the same time, he started to have pain in his right hip/pelvic region (now officially recognized as the acetabulum), which got attention from both his primary care physician and the specialist to whom he had been referred for the biopsy.

Our health care system is truly a blessing -- I have since heard stories of people in that big country to the south who cannot afford anything but a basic diagnosis and live without additional assistance because of the cost.  We, as consumers and supporters (through our taxes) of the Canadian health care system, still have a personal obligation to understand as much as we can and make decisions that are appropriate for our health needs.  In spite of everything, of all the information from the specialist and family doctor, this has still been a waiting and processing game. As a consumer of the information, you are still very much on your own when it comes to understanding the terminology, the consequences or possible side effects of the treatments that are recommended, and the way your own brain processes the word "cancer" when it comes to a diagnosis.  And I'm not the one with this particular diagnosis. In each of these steps, from wondering and asking, to discovering, to hearing, to seeing, there's been a wait.  Day after day we waited, until we met with the urologist.

The big C -- that's all my brain focused on once we met with the specialist to discuss the biopsy results.  The finding was of cancer cells in each of the snippets that had been removed from his prostate. I'm speaking from my own perspective -- Tom had a slightly different (more mature? more focused?) response -- some relief, a lot of black humour, and ultimately, a very positive and deliberate response to dealing with this invasion in his body. The suggestion was that a radical prostatectomy would be needed; lymph nodes would also be removed and biopsied; that's what happened on July 4. 

I didn't really sleep the night before -- it doesn't help that we are having a hot and humid summer, and our upstairs bedroom is as stuffy as it gets when things have been hot for a week. So I turned on the stand-alone air conditioner, which droned its way through any of my subconscious.  Tom did manage to sleep for a while. At the hospital, prior to surgery, he was offered something to relieve the anxiety and help him relax -- he was already quite relaxed, but the effect of 1 mg of lorazepam allowed him to drift off while we waited.  I suggested that I could use some as well... this highly addictive (and effective) product wasn't extended to me -- darn!  I was left to wait, and told to be there at 12:30 to meet up with him post-recovery.  It's a strange feeling to let someone you love be wheeled away into the big unknown -- they would inject him with needles, tubes would be inserted, medications would take over his breathing and his brain, people would cut him open and start to snip things away to get at the tumour that was sitting in and around his prostate.  I came back home for a little while, then headed back to the hospital under a black, thundering sky.  What were they doing?  How would his body respond? How would he be afterwards?

Checked in with the nursing station on the 4th floor of the Grace Hospital, but they sent me to the "day room" to wait.  A little bird of a man showed up, engaged me in a strange story about being left in his house for 3 days on a cold floor in the winter before neighbours got worried and broke in to find him there unconscious. The story was full of details related to an incident in the winter that had undermined his efforts to volunteer for Winnipeg Harvest following an unsuccessful Cheer Board volunteer stint, but strange segues kept me wondering if he had slipped to another level of consciousness. Enough reality to keep me guessing; something wasn't quite right though, given that he had been in hospital since before Christmas of 2011. Regardless, the conversation occupied my worried mind for a bit.

Finally they came to let me know that Tom was in the room, and he was quite "funny".  Exact word used.  A relief to me -- when Tom is on, relaxed, and engaged with the world, he is very funny.  Funny enough that I laughed so hard I spat food on him one of the first times we talked together.  So... I sat with him, the nurses came and checked his blood pressure, temperature, heart rate, etc., every 15 minutes, and he insisted I give him several New Yorkers and Macleans magazines I'd brought for him. A quick commentary on Justin Trudeau's profile versus full face photographs  -- which one looked better.  Some bits from the New Yorker. More introductions of the medical team who were providing assistance.  This is his brain after surgery -- I was impressed.  Then as my brain wandered a bit (I was tired, I must say in protest), he started on a story about chicken in red panties being threatened by Gestapo, or the Nazis.  With that I snapped to attention.  What was he reading?  He wasn't reading -- he'd drifted back to a bit of a slumber and started talking about something he was seeing.  So THIS is your brain on drugs... impressive!  A few more stories about green lights flashing by, certain shapes drifting in and out of the walls, and I realize I saw how a visual person processes the anaesthetic and narcotic haze following surgery.

He's now home; says he's feeling better every day with 40 staples and an in-dwelling catheter for another week. Recovery takes its time, and he has some work ahead of him. Hip pain was back once the epidural drugs were taken away, and that's still a concern.  We meet with the specialist next week to uncover and discuss the next stage.  The lymph nodes were clear, but there was extensive tissue involvement with the tumour in and around the prostate.  So that's what we need to figure out next.

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