Bone Cancer: Part 3: PET-CT Followup in Kirk's Office

Kirk (see photo) said that the PET/CT Scan showed two areas where cancer is likely. One is the ping pong ball lesion on her ilium that we already knew about; the other is a spot in her pancreas that we didn't know about. Although Kirk assured us that her life can be prolonged, I later learned online that her odds of surviving until next year are only 10%. 

During our visit with him, she asked that Kirk do the following: 

(1) Prescribe something for her rapidly worsening pain. (He gave her Tylenol with Codeine, and told her to let him know when she needs something stronger.) 

(2) Put a note in her chart saying that she wants to begin the process of obtaining life-ending medication through the Oregon Death with Dignity Act. He readily agreed to do this, and added that it's best to apply early (perhaps, he was thinking of instances in which people have been accused of goading a sick relative into suicide).

When we got up the next morning, the results of the blood tests that she had on her way to Kirk's office were online. They were normal with the sickening exception of the CA 19-9 pancreatic tumor marker. The normal value for this test is 37; Peggy scored +1000.

As we were leaving Kirk's office the previous day, my eyes had met his, and I saw in them an expression of horror unlike anything I've ever seen on anyone. I couldn't imagine the reason for this because I had thought that, since Peggy's body wasn't riddled with tumors, we had years, together, rather than months. When I got home and googled pancreatic cancer survival rates, I knew the reason for his anguish.

For decades, he has never seen one of us without also seeing the other, but I fear that we're nearing a time when, for however long I live, I will see him alone. 

I was working on my grocery list while waiting for Kirk to enter the exam room. When I turned the paper over to write on the back, I found a poem that I had written in the late '70s. When Kirk arrived, Peggy shared it with him, and he spent a long moment pondering it.

I would take Peggy's disease into my body in a heartbeat and count myself lucky to do it, so why is it that I cannot escape the selfishness of continually thinking of my own pain? 

Bone Cancer: Part 2: May 19: PET/CT Scan

The following was written on May 20, the day after Peggy's  CAT/CT scan. I have but little time for editing.

We didn't get fifty feet from the house on our way to the hospital for Peggy's PET/CT scan before feeling the sickening rumble of a flat tire. Our neighbor's car was home, so I ran over to ask if he could take us to the hospital. He said he was in an online business meeting and asked if I could wait five minutes. I said that we were having semi-emergency, and he left his meeting. While I was talking with Kevin, Peggy was running in circles, holding her head in both hands, and screaming: "NO, NO, NO, NO NO, NO, NO!" A passing bicyclist asked if she needed help. She said no, but then called him back. He promised to have her on the road in no time. When Kevin and I arrived, I told him that we didn't have the time to wait for a tire change, even a speedy tire change. After making sure there was nothing more he could do, he left.

While checking in at Oregon Imaging, Peggy was unable to remember her birthday. She desperately wanted me to be with her when the technician started her radioactive iodine drip, but the woman who came to take her to the back refused.  I waited for Peggy to speak, but when she stood silent and defeated (behavior that is rare for her), I said, "My wife is here to find out if she is going to die. She is very afraid, and she needs me to be with her." The employee then said (grudgingly, I thought) that I could go as far as the next waiting room, but absolutely no further. 

When a Hispanic imaging technician named Katie entered the waiting room, I asked her if I go with Peggy to the IV room. Upon seeing our tears, she said, "Absolutely!" We immediately believed that Katie was both a good technician and a good human being, so I trusted that I was leaving Peggy in good hands.

I next took a walk around the outside of the large hospital. On the quiet backside, I happened upon a solitary man whose employee ID badge read, "Daniel Martinez, Driver." When our eyes met, he asked me how I was. I could tell that he really wanted to know, so I told him through my tears. When I was done, he asked, "Are you a man of God?" I said no, wondering if he was about to preach to me. He instead said that I was going to need support and suggested that I see a psychologist. I said that I am on good terms with an Episcopal priest, and that I would talk with him if Peggy has cancer. Daniel's phone then rang and he had to go to work, so we shook hands and went our separate ways. I spent the next two hours walking in and around what is the biggest hospital between San Francisco and Portland. It was then that I took the enclosed photos

On May 21 (the day after I wrote the above), Peggy got an early morning email saying that Kirk wanted to see her in his office at 5:00, and that he had ordered blood tests and another MRI. I will continue my account today if possible, but if not today, then certainly tomorrow. It might seem like a cliff-hanger of an ending, so I'll just say that we still have but limited answers.

Bone Cancer: Part 1

The following was written on May 13, and is the first segment of an ongoing narrative. Please forgive me for leaving you in the lurch; I will get you caught up as soon as I can.

In February, Peggy began to complain of pain shooting down her upper right thigh. On March 5, she went to her internist of 35-years, Kirk Jacobson for diagnosis and treatment. Kirk thought the pain was coming from her hip and ordered a hip x-ray. When nothing was found, he ordered a lumbar spine x-ray. When Peggy saw Kirk again on April 11, he ordered an MRI of her lumbar spine. When bulging discs and stenosis were found, he sent her to a pain specialist named Adam Kemp for a possible nerve block. Peggy saw Kemp on April 24, and was told that the pain might be caused by an inflamed tendon in her right hip, so he ordered an MRI. She had the MRI done six days later, but couldn't see Kemp's schedule for a follow-up appointment until June. 

Because her pain was worsening daily, she called Kemp's office on May 7, and said that she couldn't wait until June to see him. She also asked for a copy of her MRI results but was inexplicably refused. Due to a cancellation, she was able to see Kemp the next day (May 8). While she and I were waiting for him to enter the exam room, a woman walked in, handed Peggy a piece of paper, and walked out. Peggy saw that the paper contained her MRI results, which alluded to "the possibility of metastatic bone lesions to the iliac bone." Kemp hadn't looked at the results prior to entering the room, and, upon seeing them, blamed Oregon Imaging for not alerting him to their seriousness. 

He then ordered three additional imaging tests, but when Peggy called later that day to make an appointment she was told that one of his orders needed clarification. An order that didn't need clarification called for a CT scan of the right hip, and Peggy had one done on May 10, two days after seeing Kemp. This time, she asked Oregon Imaging to send her the results directly. On May 12, they emailed her a report which contained the terror-instilling words: "This most likely represents osseous metastatic disease". 

Eight days later, Oregon Imaging still didn't know what Kemp wanted done despite Peggy, Oregon Imaging, and me making repeated and impassionedd (at least on my part), efforts to find out. She called Kemp's office a final time on May 14, to say she was done seeing him so there was no need for him to clarify his orders. His office called the next day to say that his orders had been clarified. During the week that we wasted calling Kemp, Peggy called Kirk (her internist), and explained the situation. Kirk immediately ordered a PET-CT scan, which is to be done on Monday, May 19.

 

Bone cancer that originates in the bone constitutes only 1% of all cancers. Secondary bone cancer is terminal and can originate in many places. In women, it most commonly migrates from the breasts or lungs. If she has boner cancer and if it came from her breasts (she has yearly mammograms), her odds of being alive in five years is 13%. If the cancer spread from her lungs (she has had lung problems since getting Valley Fever in Fresno, California, in 1986), the likelihood is that she will be dead this time next year.

An Afternoon in Heaven

Looking west from near the summit, source unknown

1,518-foot Mt. Pisgah got its non-Indian name 175-years ago when an early settler felt such joy upon seeing Oregon's Willamette Valley from its summit that he named it after the mountain from which Moses saw the Promised Land. The 2,363-acre park that encompasses Pisgah today offers oak prairies, fertile bottomlands, a dense conifer forest, 17-miles of trails, and a 209-acre arboretum, along with deer, rabbits, bobcats, coyotes, numerous hawks, and an occasional bear or mountain lion. We invariably see multiple large hawks and an occasional buzzard riding the mountain's air currents. On our last visit, we saw a colorful bird called a paraglider.

Pisgah was born 40-million years ago as a pool of subterranean lava that, over the millennia, hardened into basalt, diabase, and a smattering of snow white mesolites. The erosion which exposed the mountain continues to keep the depth of its soil shallower than the length of my hand. At the flat bottom of the mountain, the soil is deep and rich thanks to erosion from Pisgah itself and to deposits that were carried from the Cascade Mountains by the Coast Fork and the Middle Fork of the Willamette River. 

February through May are my favorite times to visit Pisgah because that's when leaves open, flowers bloom, and hundreds—perhaps thousands—of burbling streams bring beauty to the eye and music to the ear. I get a thrill from finding the very place where one of these streams breaks through to the surface.

In the photo, Peggy is relaxing on one of scores of benches that honor dead loved ones. A nearby bench commemorates the life of a 31-year-old murder victim, and another contains drawings done by the six-year-old girl to whom it pays tribute. I'll enclose a photo of one of the many dedications that touches me. The mountain in front of Peggy is 2,058-foot Spencer Butte, the highpoint of a 12-mile trail that will someday encircle Eugene.

After moving to Oregon in 1986, Peggy and I climbed Pisgah three times a week with a group of six to twelve friends. It was still a working ranch, and despite being afraid of the cows, Peggy called it my holy mountain, and everyone would sing The hills are alive with the sound of music...when we summited. We climbed year round in good weather and bad, although it meant descending in the dark of winter. Now, the rancher's cows are gone; the park closes at dusk; most of our friends have moved or died; and we almost never hike to the summit. 

We seldom choose to a destination, but when we do, it's often a mysterious labyrinth within an abandoned quarry. Because most visitors take primary trails, we usually have the quarry to ourselves, and we enjoy examining the offerings that were left since our last visit.

We recently spotted two coyotes. They were too fast for me to film, but I got a photograph of their scat and Peggy recorded their voices (turn your volume up and note the distant reply). Ten minutes later, we met a woman who excitedly reported seeing a bobcat. We later found bear scat.

A barn and a large Quonset-hut remain from ranching days, and we sometimes picnic in the latter while enjoying Fancy Cloud Friends' latest artwork: https://www.threads.net/@fancycloudfriends .

In January of 2024, Eugene was hit by an ice storm which closed the park for two long months. Its effects remain obvious in the form of downed limbs and broken trees--note the Douglas Fir Cone on the standing trunk of a dead maple. Soon after I moved to Oregon, a forestry student who has since died taught me to identify these cones by looking for the tails and hind-feet of scurrying mice. Each of these tiny cones can produce dozens of 330-foot-tall trees.

I'll close with an example of Mt. Pisgah's seasonal streams. While they might be less memorable than booming waterfalls hundreds of feet high, my life is far more enriched by these humbler members of the waterfall family. I am pleased to say that I have the good fortune of living but nine miles from the one place on earth that I most enjoy visiting. 

 

A Tour of my Refuge and Sanctuary

This is my bedroom. The walls of my bedroom are pink, and the walls of Peggy's bedroom are green. Every two weeks, we clean house, and it is then that I change out many of my decorations. It is for this reason that you might see the same item in two locations. We bought the silk painting atop the mirror in Nuevo Laredo, Mexico, in 1972. When silk-paintings of John Wayne and Elvis Presley became popular, Peggy wanted to discard our desert scene. I go along with most of what she wants, but on this occasion I demurred. The cat painting to the left of the mirror came from a St. Vincent de Paul Store in Eugene, and the wall-hanging above my BiPap is a pressed-plastic picnic scene that came from a junk store in Wisconsin. 

 

 

The brown heart to the right of the second photo was a gift from a British blogger. I call both Peggy and the sleeping squirrel to the left of the photo, Fluffy, Fluffer, or Fluffy Squirrel.

 

I used to have 44-plants in my bedroom, but am now down to the ones in the photo plus an Aglaonema that stays in the den. The white cat was a gift from an elderly neighbor named Helen who has since died. In front of the white cat are wasps' nests (I love wasps and bees), petrified wood, and ceramic pieces by the same British blogger who gave me the heart.

 

 

In January, my collection of Civil War books reached the point that I paid $50 for the above bookcase at a Habitat for Humanity store. When the ensuing book shuffle was complete, my Civil War books were in the hall, and my new bookcase contained books about cats, knots, and domestic plants. The poinsettia blanket is one of several bed-coverings that I use to keep cat fur off my spread.

 

 

Our youngest cat—five-year-old Harvey—is relaxing amid my cat library. His luxuriant ruff isn't visible, but his snarky expression is. He is so beautiful that I become the world's first bitch to a cat.

 

I bought the white rabbit holding the carrot at a junk shop sixty miles from town while on an outing with my friend Walt (https://snowbrush.blogspot.com/2023/11/invitation-to-suicide.html). Determined to maintain my manly image, I didn't buy it that day, and so it was that Walt had to drive me back for it the next day. The plaster-of-Paris animal to the right of the rabbit was so well-cuddled that it's identity is indecipherable. I love many damaged possessions. For example, I used to collect broken-legged horse knick-knacks because I couldn't bear the thought of the store throwing them away. I didn't realize that my father knew about my horses until he started crying about them the year he died.

 

The dark-colored cat below the stuffed cat is Bastet, my only overtly religious symbol. I bought the fox to the right of Bastet at the Jackson, Mississippi, zoo when I was seven in honor of a wolf that spent his nightmarish existence pacing rapidly back and forth inside a small cage. I thought my fox was a wolf until twenty years ago Peggy laughingly informed me of my mistake. The blue mug to the right of the "wolf" contains bookmarks that I cut from Christmas cards. 

 

 

My mother made the needlework tree as my Christmas present in 1976.

 

The wolf in snow came from a long-forgotten antique store run by a delightful lady named Penny who died of Alzheimer's. The rock on the floor fell from Symbol Rock, a 40-million-year-old Cascade Mountain basalt formation that an extinct Indian tribe worshiped, as do I.

 

 

I read in bed from 10:00 until 1:00 each night and am often joined by four cats (all four are in the photo). A fifth cat joined us until he got mad at me for swatting his tush when he attacked my defenseless girl cat, Scully (she's sitting in the photo). That dire event occurred five years ago, yet I'm lucky if he joins me twice a year. I have multiple nicknames for my various cats. For example, Scully answers to Girlfriend, Beauty Girl, White Whiskers, and Pretty Lady Cat. As is the way with men, my love for my male cats often wears a disguise. For example, Brewsky (the tabby at my feet) is Sweet Man, Patriarch of the Cat Side of the Family, and Lard-Ass; while Harvey goes by Sweetheart, Pretty-Pretty Cat Man, Most Beautiful Cat on Earth, and Shithead. 

 

Albert Schweitzer well-expressed my own delight in cats when he wrote:

There are two means of refuge from the misery of life, music and cats.            

Please Accept My Apology

Since Donald Trump's inauguration; the beauty of my bedroom; the solace of nearby Mt. Pisgah; and the affection of Peggy, our cats, and some of you, are like islands in a stormy sea. What I would like to do right now is to share a pleasant post that I have been working on for weeks about my bedroom. Unfortunately I feel ethically compelled to first apologize to you for what is happening in America. I'm especially concerned about the feelings and opinions of readers who live in Britain, Canada, Australia, India, and—prior to the invasion—Ukraine (https://dablogfodder.blogspot.com/). It is they who constitute nearly all of my active readership, and this is what I want them to know:

(1) I am ashamed of what my nation has become, and I am frightened that it will continue its hellish dissent into totalitarianism.

 

(2) I cannot divorce my personal identity from my national identity. 

 

(3) I worry that my non-American readers will also be unable to divorce my personal identity from my national identity, and that this will lead them to abandon me.

 

(4) Only a callous, arrogant, petty, and vicious nation, could elect a demon like Trump and stand passive while he destroys its democracy. Although offering you my apology might seem pointless, I don't know what else to do, and it is surely better to apologize than to behave as though everything were normal.