Tuesday, December 11, 2012

My Life With Cancer

 My life with cancer began almost 30 years ago.  In my twenties I worked as a nurse at our local Children's Hospital.  While most patients in this area, at that time, were managed by St. Jude's in Memphis...getting their assessments, plans, surgeries, inductions, etc., initiated there...our hospital  provided some maintenance medications and managed extraneous illnesses and sepsis for those little patients when they needed it in a hurry and/or to help avoid one more trip away from home for those families.  Being good at IV starts (some patients had ports and some did not) I often helped in their care.  I purchased a bag of dill pickles from the grill in the kitchen downstairs before every shift when I knew Michael was on the floor.  He was an incredibly bright, and a little bit bad, completely bald fellow of 6, whose diminutive size made those unaware think he was a child of around 3.  I knew better.  And once he started talking...they did too. I also knew he was probably smarter than I was, and certainly had the "old soul" wisdom that children in his position seem to gain.  Despite his mouth ulcers, he loved sucking on the dill pickles I would bring....often threatening me with a "knuckle sam-ich!!!" if I pretended not to have them.

I administered vincristine, methotrexate, adriamycin, and cisplatin.  Those old drugs with their horrible side effects frightened me. I didn't feel I knew enough to give precious little bodies such vicious poisons.  I worked hard to learn more and take the best care I could of my little charges.

I spent hours bent over crib beds helping doctors put life saving lines in babies with various cancers, gave evil cocktails of antibiotics and anti-fungals to children with super-infections secondary to their immunocompromised conditions after chemo. Once I stayed at the hospital over 24 hours in order to assist in hospice care for a family watching their 4 year old little girl die after multiple surgeries, including a pelvic exoneration and innumerable rounds of chemo, due to a Wilms tumor that had ravaged her abdominal cavity.  Sadly, the parents had suffered almost more than they could endure.  They could not agree between them, on the course of action to take during their child's last hours.  Each vacillating almost as the wind blew, between the desire for a full code and to let her pass in peace.  As one of the few nurses there (why me I'll never know) who could keep them calm, I was asked to stay on until she passed.  She was on a continuous morphine drip.  In between, when her heart rate would rise and she would moan in pain through her unconscious state, I had orders for various other narcotics to administer rectally and as an IV push.  The medications I administered through that long day and night and into the early morning again were more than enough to render an adult unconscious many times over. I would push them slowly, longing for peaceful, calm respirations, that let me know I had eased her pain - Simultaneously fearful that my drugs would stop them completely, while almost wishing that they would.  She finally died peacefully in the arms of her parents, united in their love for her once more.  I have thought of them many times over the years and hope that they have found peace.

And then came melanoma.  Who knew?  Since then I have experienced much of what the film below addresses.  Excisions, biopsies, surgeries, radiation, PET scans, CT scans, MRI's, various types of tumor testing.  Even the latest in the feeble, yet somehow resourceful and inspiring human battle against cancer....immunotherapy.....as a rattie in my anti-PD1 trial.  Attempting to prevent melanoma from hiding itself in its protective shroud and allow my immune system to dispatch it....for good.  It is a bit long, but I think well worth your time.  Click on the link below to see a history of the past 50 years on the front lines with cancer.

The Enemy Within

The film brought so many thoughts and emotions to the surface for me.  All my patients.  So many more than I can begin to mention here.  The pretty teen with Hodgkins and her bright pink and blue wigs.  My peculiar perspective having lived on both sides of the fence. The incredibly brilliant doctors and scientists who bet their careers on their beliefs and worked relentlessly to prove their hunch...to the benefit of us all.  The strange position I have found myself in over the past 3-4 months:  Via some strange crossed wires within the machine that is marketing and companies who know more about you than you think they possibly could....I have become the recipient of an onslaught of material and advertising for all sorts of melanoma drugs that AS A PROVIDER (not patient) I can administer to my patients.  Something, as a Pediatric Nurse Practitioner in a primary care setting, I am not even qualified to do!!!!  And there's Patti, representing for melanoma in the film.  I think of her daily.  Wishing her and hers my very best.

So....there it is.  My life with cancer. Strangely tied to amazing children, their brave families, researchers I have never met, current experts in the field whose names flow off my tongue as though they live next door, incredible people whose strength and bravery I admire and seem like friends, though most of us will never meet. What tangled webs we weave.  How much we have yet to learn. - c

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