Peggy's Surgery

  

 

Two weeks ago, Peggy had a CAT-Scan, which showed that her pancreatic cancer remains confined to her pancreas and ilium. Based upon this result, Marc, her oncologist (see photo), recommended that she have the pancreatectomy which she had been pleading for since her May diagnosis. When Diego Muilenburg, her surgical oncologist, agreed to perform the surgery, Marc ordered a PET-Scan which can show tumors that the CAT-Scan missed.

We saw Diego for her pre-surgery appointment on our 54th anniversary. He can’t perform the surgery until January 27th, which is the earliest day that he, a robot, and an operating room, will all be available. I asked Kirk, our influential internist of 35-years, if he could arrange an earlier date, and he contacted a number of other surgeons but to no avail.

Marc was guardedly optimistic that the pancreatectomy will leave her cancer free except for the tumor on her hip, which is stable, but Diego thought it likely that tumors will continue to appear because of the malignant cells that are already in her bloodstream. Another concern is that her CA-19 (a pancreatic cancer marker) has doubled in six weeks, and this could indicate that her chemotherapy has stopped working. When I shared my fears with Kirk, he tried to reassure me. When that failed, he said that everyone has to die sooner or later, himself included. I considered his words stupid and callous until it occurred to me that he might be worried about his own health (he and I are both 76).

As I see it, the two hardest things about Peggy's illness are as follows: We’ve lived the past eight months in such unrelenting hope and dread regarding the outcome of the latest test, exam, or procedure, that we are finding it increasingly hard to function. For example, we’re frugal people with an environmental awareness that has always kept us from throwing away food, yet we are now composting food daily, partly because we shop in forgetfulness of what we already have. We are also having trouble cooking meals and getting chores done. I used to clean our entire house in a day. Now, it takes the two of us so many days that we’re lucky if we get the bi-weekly job done before it’s time to do it again. We also lose things; we make stupid mistakes; we are unable to follow conversations; and we forget things that were just said or done. These problems are worse for Peggy because of the chemo, but they're bad for me too. 

 

Sleeplessness is also a problem. At any hour of the night, there's a strong possibility that Peggy will be awake reading; and worry and back pain are keeping me awake despite taking up to three Unisom, the maximum dose of Ambien, and 4,800 mgs of Gabapentin. Our second worse problem is that every chemo is making her sicker for longer than the previous one. If the surgery doesn't work, she might very well choose death over chemo, and there's the possibility that she might die anyway.

At least we have good support; Peggy through local friends and through friends in the local, state, and national clothing button societies (one of whom offered to come from a distance to stay with her); and me through my blog, through a Diocese of Oregon online support group, through St. Mary’s Episcopal Church, and through friends and relatives with whom I correspond. Then there's the support that we both receive through our photographer friend, Teddie, who is documenting our long marriage. 

I doubt that anyone attends St. Mary’s more faithfully than I. The church’s two active priests and its retired priest have been generous with their time, and parishioners have given us gifts, among them two handmade "prayer shawls" and the loan of a coastal vacation cottage.  Still others have visited us at home or offered to cook for us, and I am proud to say that I have been entrusted with a key with which to perform my duties as a volunteer sexton. 

Of all who have stood beside us, few have been more committed than her oncologist, Marc who has even called on several occasions, three of them on the same day. Last but not least, when it comes to support, are our four remaining cats (our oldest died a month after Peggy's diagnosis) who are able to bring fleeting smiles to our darkest hours.

After seeing Diego, we celebrated our anniversary by going out for breakfast and shopping at a charity-run store where Peggy bought a 1930s Shirley Temple novel and a knickknack with the word Rejoice on it. We also visited an animal rescue facility where we petted cats and Peggy was given a handmade Christmas ornament. Although our day was precious, horror that I might be alone on our next anniversary occasionally intruded. Until now, Peggy has been optimistic, and her optimism has kept me afloat, but Diego’s gloomy assessment combined with the rise in her CA-19 level has been devastating. It's possible that he won't operate on anyone between now and January 27th who is in such desperate need as she, and I'm angry that she could die because he can't, or won't, do it sooner. I can't help but wonder if she could get the surgery sooner if she were twenty-four rather than seventy-four, or if we contributed a million dollars to the hospital that employs him.