Memento Mori
Memento Mori. The Latin phrase means “remember your death.” What a way to start an update! Don’t be alarmed; we’re all still here. But the last ten days have been a stark reminder that humans have a 100% chance of death. Cancer keeps you in a memento mori state of mind.
Living Wills
When Mike started this hospital admission on the 14th, we were asked again if he had a living will or medical power of attorney. He’s asked this question every time he is admitted to the hospital, but we’ve never gotten around to completing one. However, as a transplant patient, they strongly encourage you have one on file for obvious reasons.
Completing those forms is definitely a memento mori moment. The weight of what we are facing settles on you like a blanket made of iron. It’s surreal to think of such things at such a “young” age, but it’s necessary. I’m sharing this with you to encourage you to have these conversations early while everyone is well. It’s so much easier then to think about your wishes. But I also want to encourage you to adjust them as your wishes change. Before cancer, Mike would’ve told you he didn’t “want a bunch of tubes” keeping him alive. But after some frequent flyer miles in the hospital, you start to learn more medical terminology and you discover the different uses for the “tubes.”
As an example, when Mike was in the ICU back in August, he had an NG tube. NG tubes are commonly known as “feeding tubes.” However, they’re also used for suction. He had to have lots of gastric content removed by suction in the ICU so he didn’t choke on anything that came up and get pneumonia. If he would’ve sworn off all “tubes” beforehand, he wouldn’t be here today. My advice is to talk to some medical professionals and ask what each term on your living will means, just to be sure you’re putting into place the plan you think you are.
Will to Live
In other news, it breaks my heart to share that Mom’s cancer is not in remission as we had thought earlier. Due to all the medical complications she had following her last treatment, Mom has only been home and out of an inpatient medical facility for a total of 10 days since December 5th. She’s been in and out of the hospital and rehabilitation facilities and never had an opportunity to get a follow-up PET scan because those can only be done outpatient due to insurance requirements. (Please don’t get me started on how insurance companies control our “sickcare” in the United States! I call it “sick” care because they want you sick and on a cocktail of pharmaceuticals, but then when you get critcally ill, they would just prefer for you to go ahead and die as soon as possible and save them money. There is no wellness care in this country and it makes me sad, and more than a little angry.)
At the end of Mom’s last rehab stay, she started having some concerning gastrointestinal symptoms. Instead of going home to stay, my brother had her taken by ambulance to the hospital. Thank God he trusted his gut and did that because Mom had a new abdominal mass that was obstructing her kidney and she needed urerter stents to resolve her swollen kidneys! (I had flashbacks to Mike’s exact same situation.) Treatment options haven’t yet been discussed because she {still!} hasn’t been able to have a PET scan. She will be heading to rehab once more and hopefully will be able to have that PET scan afterward to see what’s what.
Obviously, this is very discouraging news. It’s hard for all the reasons you are thinking while you’re reading this, and then some. Mom is very downhearted and I absolutely hate sharing this news. David has done such an incredible job caring for her while we’ve been gone, but he could use lots of prayers because it has been a lot on him. The traveling back and forth and decisions and just the weight of all the news is hard.
I named this section will to live because Mom definitely has the will to live, but she’s got some physical work to do to get strong so she can face any treatments she may choose to do. She’s still trying to decide the cost vs. benefit of treatment and that’s impossible to know until the options are clear. The options won’t be known until after a PET scan is completed. Please pray for Mom’s spiritual, mental, and physical health. She’s feeling understandably low and needs lots of encouragement. She also needs wisdom in droves. This is a hard place to be for anyone.
Living the Transplant Life
You may recall from our last couple of posts that Mike was slated for staying through Day -2 or -1 and then he would receive his new stem cells in the outpatient clinic on Day 0. However, as you would expect from Mike’s history, things didn’t go as planned. They’re not bad, but he did need some extra inpatient support.
After his last dose of chemotherapy, Mike got exceedingly lethargic. Chemo can definitely cause tiredness and weakness, but the team was concerned it was an excessive amount, so they were super thorough (as always!) and checked all sorts of things out. It turned out that his blood pH was extremely acidic (metabolic acidosis) and he needed to be supplemented with sodium bicarbonate. If that term sounds familiar to you, it’s because that’s called baking soda here in the United States. I’ll bet our more international readers knew exactly what it was.
Unfortunately, Mike needed sodium bicarbonate because he was sick, not to make his pancakes fluffy! So, he spent about 18 hours in the ICU to get the more concentrated doses of sodium bicarbonate that his body needed to correct the balance. Let me be clear—the only reason he was in the ICU was because they have the clearance to administer the drug in the most concentrated form and it has to be monitored closely while it’s dripping. pH balance is a delicate thing and can swing it to the alkaline side quite easily because the margin is very slim.
Additionally, Mike’s kidneys aren’t happy—again. The kidney team is on board with his team and they think the downward trend has plateaued. The doctors are pretty optimistic that his kidneys will recover without any medical intervention and have all agreed that it’s a side effect of the high-dose platinum-based chemotherapy he received. There is some discussion happening about whether this will knock him out of receiving the second cycle that was originally planned. We need you to pray that he will not have to forego the second cycle and will be able to proceed as planned. Again, at this point, they’re optimistic about going forward with cycle number two, but his kidneys are driving the car here and we need your prayers to keep the feet on the gas pedal! If you’ve been following our story awhile, you know that kidneys have a mind of their own and will not be rushed!
Your Own Memento Mori Moments
As I finish this up, I wonder . . . how many memento mori moments have you had? I know we’ve all experienced these moments at least once in our lives. Maybe you attended a funeral of someone you loved deeply and considered your own mortality. Perhaps you had a close call with another car on the road, avoided an accident, and realized how quickly life can fade. Maybe you’ve had a health scare. Or our recent political and social climates could be weighing on your heart and mind to the point that you are having an existential crisis. What is it that makes you “remember your death”?
Have you ever considered that remembering your own mortality is a good thing, designed to point you to greater things? Faith in Christ has made me unafraid to die. I’ve asked Mike and he’s also unafraid to die. He’s naturally afraid of other things about death (pain, leaving loved ones, the unknown). But death itself holds no fear for those who know Christ. Death means full, unveiled presence with Christ! And that’s something to look forward to. I don’t know what the future holds. God does. I’m learning to trust him more and more with that as we walk this road, and, while I’d really, really like this journey to end soon and the way I prefer it to, I’m choosing once more to rest in Christ. Because he holds all things together. And he does it beautifully and perfectly.
Saints, please continue to pray.
““Where, O death, is your victory?
Where, O death, is your sting?”
The sting of death is sin, and the power of sin is the law. But thanks be to God! He gives us the victory through our Lord Jesus Christ.”
