Donna’s Cancer Story: Terminal

This is the twenty-seventh of thirty-one installments of Donna’s Cancer Story, which will appear daily in serial format through the month of September to recognize Childhood Cancer Awareness Month.  Each post will cover one month of Donna’s thirty-one months of cancer treatment. 

Tiny Dancer

(All photos courtesy of Joel Wanek, Joel Wanek Photography)

In her last week of treatment, a lump was detected in Donna’s neck by the staff at the proton beam radiation center.  At the end of her morning treatment, I was called back to the recovery room, just as I was every day.  Greeting me, standing over a still sedated Donna, was one of the medical directors.  Oh, no, I thought, what is this?  There was no suspense involved,  “I see a lump in her neck and it is suspicious for tumor,” he said.  Just like that.  The pit that exists in every Cancer Parent’s gut grew from a pea to a watermelon for me within moments.  I had seen the lump in question in passing the night before.  Donna was in our room with her playmate and I was walking out into the hall when I turned around to say goodbye and saw it.  A fear flashed in me, but Donna’s neck turned and it was gone.

Except it wasn’t gone.  It was there and it was suspicious for tumor.   I knew it.  I felt it.  It seemed impossible, as we had had clean scans just fifteen days prior, but cancer knows no boundaries.  It does what it wants when it wants.  True fact.  The suggestion was made to head over to the local hospital for an MRI.  One of Donna’s sedating doctors who had treated her previously was there and had generously agreed to stick around and sedate her for the scan.  We could take her right away.  A dual sedation is never recommended by medical professionals, that’s why Donna had her picc line inserted without it, but in dire cases, you do what needs doing.  Clearly, this was a dire case. 

I called Mary Tyler Dad at home in Chicago and caught him on his way out the door.  He drove directly to Bloomington to meet us at the hospital.  He made record time.  I felt terror.  If you have not felt terror, you don’t ever want to, and if you have felt it, you know precisely what I mean.  Images seem to work better than words, so you can think of it as a swirling, growing, angry hurricane of hell in the middle of your gut.  You are powerless. 

Thankfully, Auntie was with us and came to the hospital.  I don’t remember getting there.  I do remember registering.  Sitting with my family in a waiting room, such a benign, innocuous space.  I don’t remember my children there.  I remember my sister and her knitting bag resting on a chair.  I remember bringing Donna into the MRI room, but not dressing her in a gown or her being re-sedated.  I remember the kind face of the doctor who had sedated Donna numerous times at MPRI.  I remember sitting in the cafeteria with a turkey sandwich in front of me, but not how I got there or how it got there.  I remember Mary Tyler Son wailing, and me not being able to hold or comfort him.  I remember Mary Tyler Dad finding me and holding me.  I remember splitting the sandwich and it tasting like lead fabric.

The scans were complete and we all joined Donna in the recovery room.  She was hungry and ate french toast sticks and syrup.  We were both sticky as she was sitting on my lap.  We were discharged and a friendly nurse wheeled me and Donna out the door to the car, “Hospital policy,” she cheerfully remarked.  In the car on the ride home, we heard from Donna’s doctor in Bloomington that the lymph node was not attached to tumor.  It could be cancerous, but it was not the tumor we had been treating.  That brought comfort.  The plan was to finish out the week and follow-up with our team at Children’s in Chicago.  This put a pall on our last week of treatment and our remaining time at Jill’s House.  Of course, it did.  For Donna’s sake, we worked hard to focus on what she had accomplished.  53 proton beam radiation treatments spread out over twelve weeks.  We had lapped every other guest at Jill’s House.  All our neighbors had moved on and back home. 

Donna’s going away party was lovely.  Our closest friends, the manager and her children that lived onsite, were there and kept us from jumping off a cliff.  There was pizza and decorations and a dance party.  Oh yes, a dance party.  I have such a beautiful sense of that last evening, spent in the company of dozens of people affected by cancer.  Some young, some old.  We all danced together.  We put bean bags on our heads and pretended to be sleeping fish.  All of us.  You have not fully lived until you have danced with young and old alike. 

Obituary Photo 

We got home late on a Tuesday night.  On Wednesday morning we headed to Children’s to meet with Donna’s oncologist.  Within minutes it was clear that there was concern.  It was confirmed by the look in Dr. Stew’s eyes.  He is an outstanding human being, that man, but he does not have a poker face.  We met with a surgeon and had a CT scan of Donna’s lungs.  In hospital time, those things take days or weeks to schedule.  Unless your daughter is dying.  Then, it is mere minutes.  After the scans, we were sent home to await the results.  I dropped Mary Tyler Dad at home with the kids and went along to the grocery store.  We weren’t even home long enough to get milk and bread before the call came.  Donna’s lungs were covered with lesions, her lymph nodes were full of cancer.

I got the call driving down Touhy Avenue, the milk and bread in the trunk.  I had to pull over.  It was Mary Tyler Dad who called me.  I called Dr. Stew immediately.  There was nothing to be done.  The forecast called for a good summer, possibly fall, but Donna would die.  It was the first week of June. 

The plan was to put Donna on an oral chemo that could eek out several more months, we hoped.  She was completely asymptomatic, so preserving time was the goal.  If the oral chemo was easy enough for Donna to tolerate and had the chance of extending her life by weeks to months, we decided it was worth it.  No more hospital stays.  No more scans.  The cancer would run its course, but with Donna living so vitally, we wanted to prolong that as long as possible.  Dear Donna.  My daughter was dying of cancer and to look at her was a total disconnect.  Dr. Stew had said once of her, “She may have a brain tumor, but she is not a sick child.”  He nailed it with that statement.  Donna had lived with cancer since she was twenty months old, but it never prevented her from growing, learning, developing, being a child.  That was one of our blessings. 

I wrote at the time:

“Today, right now, she is not suffering.  She is chatty, hungry, silly, thoughtful, playing catch and riding her tricycle.  Two years ago this week, when it was first learned that Donna’s cancer might have spread to her lungs, we had a prognosis of 2-3 months.  If someone had said on that day that Donna will survive two years plus I would have thanked my lucky stars.  Now that that time has passed, I remain grateful, but hurt in my bones that more can not seemingly be done to right the terrible wrong which grows inside her.  It is so wrong to lose a light this bright, a girl this loving, a daughter and granddaughter and cousin and friend, and sassy willful wonder.  I ache.  We ache.  But there is not a lot of time to ache right now as Donna still thrives.  We must connect to that while we can.” 

And so we tried.  Her VP-16 was disguised in pudding and her Temodar was disguised in ice cream.  These are meds that an adult would swallow in pill form, but Donna was too young for that.  Instead, I put on blue rubber gloves to protect my skin from the poison I stirred into her pudding and ice cream.  God help me.  Donna would sit on her Daddy’s lap and we would all resign ourselves, the three of us, to what was done in the name of preserving the life she had in her.  Like most young children, Donna did as she was told.  It is heart wrenching to spoon feed your daughter poison that you know, at its optimum, will provide a few more weeks to her cruelly young life.  But that is precisely what we did.  A wise RN told us early in that if we let her, Donna would be our guide.  We let her, and it was clear to us that Donna wanted to be with us still, despite the injustices of a mother and father spoon feeding her poison laced ice cream and pudding.  Seconds after the last spoonful, Donna would pop up and out of her Dad’s lap and race to the kitchen room or play room or to her brother.  Yes, she was our guide.

Several weeks later, Donna danced in her studio’s annual dance recital.  It was Father’s Day.  Her hair had started to thin, she would lose it again, we knew, and some low grade fevers from the chemo had started.  Donna had practiced her dances throughout her time in Bloomington.  When we returned, she joined her classes again.  Her teacher and studio could not have treated us with more kindness, sensitivity, or love.  Donna and Mary Tyler Dad were given private lessons to perform with some others in the Daddy-Daughter Dance.  It was Donna’s favorite.  The studio director made certain to accommodate Donna on this day with the knowledge that she would never dance publicly again.  We had reserved seats in the audience.  We got to watch a dress rehearsal so we could see Donna on stage more than once.  A professional photographer was brought in to capture the day for us.  All of this was discrete.  My guess is that the folks in that audience who knew Donna was dying were sitting in the row reserved for our family.  We remain grateful for this beautiful gift of a day where Donna was just another girl, nervous to dance in her first recital.  

Blues Brothers 

Somehow we sat in that audience of over 500 proud and happy parents and we watched our girl, knowing she would leave this world much too damn soon.  Somehow we didn’t wail or convulse or vomit.  Somehow we kept this news to ourselves, stifiling the urge to yell and scream and rail at a universe that could be so cruel.  Somehow Mary Tyler Dad performed with Donna, his Father’s Day gift that must last a lifetime.  Somehow you’re still reading this note.  Somehow I’m still here to write it.  Somehow my beautiful Donna is not with me.

Tomorrow:  The Bubble

Donna’s Cancer Story: Infection

This is the twenty-sixth of thirty-one installments of Donna’s Cancer Story, which will appear daily in serial format through the month of September to recognize Childhood Cancer Awareness Month.  Each post will cover one month of Donna’s thirty-one months of cancer treatment. 

Pensive Donna 

(All photos courtesy of Anne L. Geissinger, Pixeldust & More)

Ten days of this month were spent in a children’s hospital in Indianapolis with a double port infection.  During those ten days I must have thanked my lucky stars approximately 673 times that we lived in Chicago and were treated at Children’s Memorial.  Donna’s beloved tubey had to come out, requiring the insertion of a picc line in her left arm.  These were scary, awful days.  Some of the worst since 2007’s stem cell transplant, and that’s really saying something. 

The origins of the infections were unknown and while many children with cancer experience numerous infections, the only infection Donna ever had was during her stem cell transplant.  The worst thing a Cancer Parent can hear in the midst of treatment is ‘infection.’  Scratch that.  ‘Relapse’ is the worst word, though infection is a damn close second.  Wait, you can add ‘terminal’ and ‘hospice’ to that list, too.

The ten days felt more like ten years and included being transported to Indy from Bloomington via ambulance due to Donna’s raging fever that came out of nowhere and sent her into a shaking bundle of discomfort.  Terrible ER care.  Misdiagnosis.  Hearing from our team in Chicago that Donna had an infection before the Indy team even knew.  How that is even possible is still beyond me.  Alarmist rhetoric from an unfamiliar oncology team that clearly were annoyed by my advocacy skills.  Perhaps because they were on the receiving end of them?  I was told by the head of pediatric oncology that Donna was receiving ‘adequate’ care.  “Adequate care,” I told him, “is not good enough for Donna, or any child in your care.” 

Blue Eye

This is a bit stream of consciousness, so bear with me:

Staying in a hospital room with two children, one of whom wanted OUT (Donna) and the other of whom (Mary Tyler Son) was not allowed out of the room because as an infant he was not yet fully immunized.  This was at the start of the swine flu epidemic, for added drama and paranoia.  A port removal surgery scheduled at 9:30 p.m.  I remember being with Donna in surgery, and Mary Tyler Dad being in Chicago, but have no memory of where Mary Tyler Son was or who was with him during those hours.  My Dad?  You?  

Placement of two IVs in Donna’s hands, rendering her unable to use them at all; we called them her “claws.”  A picc line insertion done without any sedation, Donna screaming to the surgeon, “NO MORE LIDACAINE!”  A surgery without sedation is incomprehensible.  Going back and forth daily to the proton center via a 70 minute ambulance ride so we wouldn’t fall behind in treatment.  The RN that had to accompany us talking on her cell phone the whole ride.  Some EMTs offering Donna donuts on the ride home and others refusing to allow her to eat because of liability reasons.  Donna losing her will. 

That was scariest of all.  When the IVs were inserted in her hands, without any discussion with me about placement, they left Donna unable to feed herself, move herself in bed, or play easily.  She simply started to fade.  It was sad and scary and painful – – no doubt duplicating how Donna was feeling herself.  We got through it, and returned to Jill’s House in Bloomington to resume treatment, but those ten days were scarring in so many ways. 

Donna on her bike 

Remembering these days now, I still feel so impotent to stop what was happening.  I am certain that the care at that Indy hospital must be better than what we experienced, but it feels like Donna’s care was doomed from the moment she was wheeled into the ER.  Having worked in health care for so long, I know that sometimes that is precisely what happens.  Mistake after mistake, arrogant doctors who cover other’s mistakes with defensiveness, unfamiliar staff who saw us as a short time problem to endure.  And Donna caught in the crossfire.   

Later in the month, on another trip home to Chicago for scans, we got the best news possible, that the small lesion in Donna’s neck was shrinking.  The proton beams were working.  Donna was recovering from the infection setback/trauma as were Mary Tyler Dad and I.  We saw the lights at the end of the proverbial tunnel, but I lost some of my fight this month. 

In working to advocate for Donna, in trying to discuss all of the mistakes and mishaps made by hospital staff that harmed our girl, I was defeated.  Even the most basic of things.  I could not take Mary Tyler Son in the halls, which meant I could not leave to get food for myself.  I was not allowed to order food through the hospital.  I was not eating.  A nursing mother not eating and no one seemed to care. 

Family in Bloomington 

When I asked to speak to a patient advocate, the gal I was referred to listened politely, but only wanted to know if I planned on hiring legal representation.  I stepped back.  Donna and Mary Tyler Son needed me more than I needed to grind my axes and rail at the injustices of alarmingly poor pediatric care.  We just wanted to get the hell out of Dodge. 

It was suggested during this period that I might want to start Mary Tyler Son on formula – – that the stress of nursing was too much in the midst of this cancer chaos.  I strongly declined.  Some days the only time I held him was when he was suckling.  I wish I remembered more about his infancy.  Those lost memories are another casualty of cancer.

All of the photos you see today were taken by my friend, a photographer, who visited with her youngest daughter for a week to tend to us and shoot Donna.  More than any others, these photos cut to my core.  They capture Donna in all her splendor, remind me of her wisdom, her wonder, her tenacity, her strangely knowing eyes.  The deepest blue eyes I have ever seen.  My memories of Donna are shaped by Anne’s photos of her.  That is a gift I can never repay.  Taken just a couple weeks after the infection ordeal that was already becoming a memory.   

Wonder

You see, the wind blew with Donna’s health.  When she was well, we were well.  When she struggled, we struggled.  She had no inclination to wallow in or pity her situation.  She wanted to live.  She knew, intuitively, that life was a privilege and she did not waste a moment of hers. 

Tomorrow:  Terminal

Donna’s Cancer Story: Blooming in Bloomington

This is the twenty-fifth of thirty-one installments of Donna’s Cancer Story, which will appear daily in serial format through the month of September to recognize Childhood Cancer Awareness Month.  Each post will cover one month of Donna’s thirty-one months of cancer treatment. 

We found a rhythym in Bloomington, which was honestly a great city.  The people were friendly, the Target was crazy well stocked and clean, the library was incredible and hosted weekly Chinese lessons for kids.  If you had to be away from home for cancer treatment for your child, Bloomington, Indiana was not a bad place to be. 

Donna was doing well, thriving really.  After the tongue debacle and a few more days time to get used to her new sedative, our days became predictable.  (Interesting fact:  Donna got a dose of Propofal every morning — the same drug that was the cause of Michael Jackson’s death.)  I would wake each morning, wash and dress myself quickly and quietly, run to the kitchen to make Donna some portable breakfast, usually involving peanut butter, get back to the room and wake and dress both kids, and head out by 7 a.m. each weekday. 

A lot of time we had family staying in the room next door, so they would be with Mary Tyler Son in the waiting room while Donna and I went to a cot outside the cyclotron room.  This is where the Propofol would be administered.  It looked like milk snaking its was through Donna’s tubey into her port.  Within seconds, I would watch her nod off as I whispered into her ear, “Never forget that you’re amazing.” 

Donna in Easter hat

Her treatment would take only about fifteen minutes, which was when I would nurse Mary Tyler Son, before they called me back to recovery to be with Donna.  She woke groggy and hungry.  She ate her prepared peanut butter feast while I read her three books.  She got super picky and cranky about the books and which order they were read to her.  I learned early on that for fifteen minutes or so, she was the boss. 

On Mondays and Fridays, Mary Tyler Dad was there, so we would be together.  On occasional days, I was alone with the kids and Mary Tyler Son would be with me, or a grandmotherly type would care for him while I was with Donna in recovery.  Looking back, it’s kind of shocking how many arms held Mary Tyler Son in his first few months.  Thank goodness for the kindness of friends and strangers alike and thank goodness that, like his sister, he was such a considerate baby.

Our medical obligations were generally over by 10 a.m. or so.  The rest of the time was ours.  Donna always enjoyed a bigger breakfast when we got back to Jill’s House.  We would do errands, play, head out to see the sights of Bloomington.  There is a great kid’s museum there that Donna adored and the town is within minutes of hills and farms, so some days we would just drive into the country and look at cows.  John Mellancamp, a hometown boy, would inevitably play on the radio. 

The afternoons were my favorite.  The two kids and I would retreat into our room.  Donna would get some books before her nap and easily nod off.  Mary Tyler Son would nurse in my arms and then we would nap, too.  A nap every day is not a bad thing.  Our window had western light, so we would all wake as the sun shone bright and warm.  It was spring, which to me is such a hopeful time of year.  I loved those afternoons.  They were lazy and cozy and restorative. 

Mary Tyler Dad had a different routine.  After Monday morning’s treatment, we would head back to Chicago for the week.  He was alone at home, working, fretting, and lonely.  His afternoons were neither lazy nor cozy.  On Thursday evenings he would make the five hour drive back to Bloomington, getting in about midnight. 

For the first time in Donna’s treatment, there was tension between us.  The kids and I had one routine that worked for us, then Mary Tyler Dad would come in for the weekends and that routine didn’t always work when we were together.  On the weekends, I wanted to be lazy.  Getting us up and out by 7 a.m. was tough.  He liked to walk the mile to the treatment facility, while I preferred to drive.  Every minute counted in the morning and I didn’t want to use twenty of those minutes pushing a double stroller through the chilly morning.  You see, I’m fundamentally lazy.  To my core.

Mary Tyler Dad also liked to schedule things.  “What time are we going to the park?”  “When will you be ready?”  “How soon until we go?”  He wanted, and needed, to maximize those days with the kids as he missed them so when he was in Chicago.  Lolling around until 11 was not his idea of a good time. 

Food came into contention, too.  Having cooked most days or eaten food another had cooked, I was ready to hang up the apron and get out on the weekends.  This was much easier with two of us, so I liked to eat out.  Mary Tyler Dad, alone all week and working later hours to compensate for his time in Bloomington, wanted to cook and eat at Jill’s House.  Push me, pull you.  It was tense.  And don’t forget, we were never alone to work any of this out.  When we were in the room, the kids were there.  When we were out of the room, a dozen set of older couples were within feet of us.  The tension threw us both for a loop.

Donna struggled with this aspect of our time, too.  She missed her Dad something fierce, but it was confusing to have two separate routines.  Toddlers need consistency.  We tried, but I’m not certain if we ever worked it out in the twelve weeks we were there.  Sigh.  I still feel guilt thinking I did not do enough to make Mary Tyler Dad’s time in Bloomington easier for him.  The bone crushing fatigue plagued us both.  We tried, which is all we could do.

During this month, the kids and I traveled back to Chicago for scans in preparation to start spine radiation.  Exact measurements of the lesion on Donna’s spine needed to be done and could not be scheduled quickly enough in Bloomington.  Oddly, neither Donna nor I really wanted to go back to Chicago.  It felt a burden to us both, a disruption of yet another routine.  Gratefully, Auntie was in town and made the drive with us.  Around about Gary, Indiana, an hour from home, Donna got feisty in the back seat.  Really feisty.  Wailing and thrashing feisty.

I likened it to an astronaut prepping for his reentry back into the atmosphere.  Donna worried that Mary Tyler Dad would not be at home.  She worried we would miss him on the road, thinking he was driving to see us in Bloomington.  It was hard.  And loud.  And only stopped a few minuted before we reached our back door.  It was one of the few windows we had that the disruption of living someplace else for treatment was hard on Donna.  I feel so humbled when I think about how much she loved to please her parents.  I wonder what price she paid for that. 

Yeah, I got this.

These two photos show Donna conquering the big girl swing out back behind Jill’s House.  I have such fond memories of folding our laundry and looking through the window, overlooking the swing set.  Donna and my two boys would be just below, Mary Tyler Son napping and Donna and Mary Tyler Dad just having the best of time together.  I can hear her laughter and almost feel the breeze that swept past her cheeks as she swung through the air, so proud of herself.

Donna on the big girl swing

Tomorrow:  Infection