March 20, Our Day Started Stupid

As I mentioned, our day started stupid. All of Peggy’s doctors except her new one are in Eugene, and we had driven ten miles up I-5 before realizing that we had left her new doctor’s address on the kitchen table. Upon googling him, Peggy found that his office is next door to the hospital in Albany. I had thought that he was next door to the hospital in Corvallis, but what could I do but trust the internet? Minutes after exiting the Interstate in Albany, we got lost. What with roadwork, the absence of a paper map, and Peggy’s iPhone (I don’t even have a phone) not being set up to give us directions, it took us quite a while to find the right address. Fortunately, we were on time. Nick’s name not being visible outdoors, I went indoors to inquire. 

The three people at the front desk did their best to understand what I was trying to say but because I have a speech impediment that makes talking difficult before late morning, I had to write the name Nicholas Tedesco on a post-it note. They had never heard of him, but upon looking him up, one member of the trio said that I was at the wrong town and hospital. While I drove to Corvallis, Peggy tearfully called Nick’s office to say that we would be an hour late. Fearful that the voice on the other end of the conversation would cancel her appointment, Peggy began to cry as she said, “I have to see him today.” The clinic’s operator then helped us to get there by giving detailed directions through fifteen miles of roadwork and redlights.

Hip pain was what initially drove Peggy to her internist in February, 2025. Four months later came the dreaded diagnosis, and although five rounds of radiation quieted the tumor, the pain returned when her chemo regimen failed in early January. Despite Marc’s assurance (Marc is her oncologist) that the tumor on her ilium is too big to remove, I asked Peggy to see a surgeon who specializes in bone malignancies. My suggestion wasn’t based upon the thought that Marc was wrong, but rather my hope that an oncological orthopedic surgeon could protect the hip from developing what we were told would be an inoperable fracture. Although she worried that Marc’s feelings would be hurt, Peggy finally agreed to see Nick.

Two weeks ago, Peggy started on a new chemo regimen about which Marc made the strange statement, “It gives me no pleasure to do this to you.” The first two post-treatment days weren’t bad, but as the drugs continued to flow into her body from the pump around her waist, she ended up moaning in bed for much of the following week. Her entire body hurt; she was too nauseated to eat; her right hand trembled; and she couldn’t stop shivering. Yet Marc had only started her at 80% of a full dose, and the side effects of chemo worsen with every additional treatment. I seriously wondered if she could bear even one more treatment, and my own prospects for holding up to her suffering weren’t looking good either.

Nick offered three options. The first—continuing chemo—fell on deaf ears because of her reaction to the one she’s on and Marc’s apparent lack of other options. Nick’s remaining suggestions consisted of either a small surgery or a big surgery. The small surgery could be done in three hours on an outpatient basis, and would involve placing three hollow screws in the upper bone of her right hip, ablating the tumor, and filling the area with cement. If successful, this would stabilize the bone and remove the metastasis (only time would tell if it had been entirely removed). If unsuccessful, Peggy might be unable to walk and would have to undergo the big surgery to regain function. 

Another option would be to have the big surgery instead of the small surgery. This would mean the replacement of both the upper and the lower bones of her right hip (in most hip replacements, only the lower part of the joint is removed). This would get rid of the cancer in her hip, but healing would require many months, and the worrisome spots on her lungs would remain untouched along with the possibility that cancer had spread to other parts of her body. Either surgery would require that she stop chemo immediately, and this could allow the cancer to spread. Peggy followed Nick’s advice and chose to have the small surgery, which will be done on April 1.