When my oldest son came home from work, I tried talking to him about everything I was going through. He just wasn't having it. He doesn't want to show any emotion or even talk about my impending death. I am so worried about him. I just wish that he would talk. I hope when he gets to attend counseling this week, he will open up some.
Today is my 8th month Cancerversary! Go me! I am hoping for many more. To celebrate, my husband bought me a double chocolate malt. It was exactly what my mouth was craving. I have the greatest husband in the world.
An emergency room physician has written a great piece comparing what dying is like today compared to a century ago. The experience today isn’t necessarily better. Everyone needs to read I Know You Love Me — Now Let Me Die by Louis M. Profeta MD.
The majority of humans will experience a gradual decline and loss of function in their lives before they die. Everyone–healthy or otherwise–needs to talk with loved ones NOW about what quality of life means, and how they would prefer to spend their last days. Because we WILL die.
Unfortunately, one can have all the Advance Directive paperwork in place and still have one’s wishes overridden by the hospital if the papers are not in the right hands at the right time. Also, Advanced Directives cannot cover every possibility–for instance, do you want your pneumonia treated with antibiotics if you’re already cognitively impaired by dementia? That’s why it’s so important to make sure loved ones know your wishes and will ensure they are carried out to the best of their ability.
I pray all of us and our loved ones will make the most of whatever time we have together, and know when it’s time to let go of the yarn — whether for ourselves or for those in our care.
Please remember to touch and be touched by your loved ones before the yarn is all gone.
When I became a metastatic lung cancer patient, my view of life changed. I no longer had unlimited time to consider my options and wait to see what might happen. My available time was compressed, foreshortened. If I wanted people to know how I felt about them, I had to tell them — NOW. If I saw something I wanted to accomplish, I had to do it — NOW. I was more willing to takes risks, without concern for personal failure, because I wanted to experience life in the time I had left. Once I was dead (which was coming all too soon), whether I failed at something wasn’t going to matter.
I began to think in terms of trade-offs: If I chose to spend my time on activity A, that means I wouldn’t have time or opportunity to do B, C, D or E. If I could only choose one, which was most important to me? Might I have the chance to do it at some other time? If it remained undone when I died, would anyone care?
My tolerance for small talk and indirect answers (which wasn’t too great to begin with) shrank even further. When having a conversation, I thought about what I was accomplishing by this communication. Was I communicating just because I was enjoying it? Was I helping someone else? Was I learning something?
Intense, huh?
In my cancerversary reflections, I asked myself questions. Did I stay focused on what meant the most to me? Did I show my family how I feel about them? Did I make a difference in the lives of others? Did I accomplish my most important goal? Did I behave in a way that reflects who I want to be?
My top priority is my health. I must take care of myself so I will have more time to tackle my other priorities. This means I need to get enough sleep, eat properly, exercise and take time to relax. I freely admit I’m not so good at this.
My next priority is family and friends. My bucket list really consists of a few items: (1) Help my daughter try to become as independent as she can be before I pass away. (2) Take this trip to San Diego for all three of my kiddos and for a romantic getaway for my spouse and myself. (3) Make good memories with family and friends.
My challenge, as always, lies in maintaining a balance. So this day, for my cancerversary, I reflected on the past eight months and ran a perspective check.
As a metastatic lung cancer patient, I have spent significant time thinking about my death, which will likely come sooner rather than later. I believe it’s important for people to accept death as a part of life and discuss end-of-life preferences with loved ones while life is still pleasant.
But Smith’s piece is not about awareness of death and treatment options. It is about the best way to die. And Smith gets it entirely wrong. I cannot accept his conclusion that cancer is the best death.
In Smith’s admittedly romanticized vision, a dying cancer patient “…can say goodbye, reflect on your life, leave last messages, perhaps visit special places for a last time, listen to favourite pieces of music, read loved poems, and prepare, according to your beliefs, to meet your maker or enjoy eternal oblivion …it is achievable with love, morphine, and whisky. “
The reality is that death from cancer often does not conform to Smith’s vision. Death by cancer happens when tumors cut off your air supply, compress your heart so it can’t beat properly, block your gut so you can’t eat, cause organ failure, erode your bones, press on nerves, or destroy bits of your brain so you can’t control your body or think properly. Sound painful? Without pain medication – sometimes even WITH morphine and whisky – it is. Yet according to the European Society for Medical Oncology, the majority of people in the world who die of metastatic cancer are NOT given the option to receive pain medication such as morphine. “Among patients with terminal cancer, 80% are estimated to experience moderate to severe pain due to inequitable access to medicine.” And this isn’t happening only in third world countries.
Not all forms of cancer give patients the luxury of time to set their affairs in order, resolve family issues, or tackle that bucket list. In my too-familiar world of lung cancer, the majority of patients are diagnosed when the disease has already spread to the brain or other organs. Among the lung cancer patients I’ve come to know online through their own posts or those of their caregivers, death can claim patients before they have established financial security for their family, raised their children, finished college — or even had time to recognize that they are dying. Many linger after they’ve lost the ability to do what they love, communicate, or think clearly. Most will eventually find themselves dependent on others for their basic needs while still aware of the emotional and financial stresses their illness imposes on their loved ones.
This is not the death I would prefer.
And then, Smith tacks on his ulterior motive: “But stay away from overambitious oncologists, and let’s stop wasting billions trying to cure cancer, potentially leaving us to die a much more horrible death.”
Wow. If you follow this reasoning to its logical conclusion, we need no medical profession. You’re going to die at some point, and being cured of one disease just means you’re going to die of something nastier later. When you get sick, just take the morphine and whisky and get it over with. Too bad we wasted our resources discovering antibiotics that cured the top three killers in the USA in 1900: pneumonia/influenza, tuberculosis, and gastrointestinal infections. Now people must die of heart disease or cancer instead.
**Deep breath**
I’ve lived long enough to know what different kinds of death look like. A parent died from dementia over a decade. Friends were struck down quickly by accidents or sudden sickness. Other friends have dealt with organ failure, cycling in and out of good health. And too many in my online and real life community have died of cancer. Some metastatic cancer patients pursued clinical trials and aggressive treatments in search of a cure, while for others, solely palliative care was a brave and appropriate choice. Ultimately, only the patient can decide which approach to treatment is the best for them. Thanks to cancer research, most have some options, and some live comfortably for years.
Few of us know for certain how or when our death will come. It would be lovely if Richard Smith’s idyllic vision of cancer death were true: we could all know when death was near, take time to prepare, then take a pill and die comfortably. Those who live in states that support death with dignity can actually make that choice, but most just have to wait for the credits to know how their story will end.
If I could choose my form of death, I would live each day with full awareness, do and say what’s important while I can, enjoy life and my loved ones as much as possible, and die quickly in my sleep.
I would not choose cancer. If I could choose.
Some cancer patients become obsessed with the WHYs: Why do I have cancer? Why now? Why me? Why is it in my lung instead of somewhere easier to treat?
If I spent time pondering all the WHYs, I would have less time for LIVING with cancer.
One good thing cancer has done for me is clarifying what’s important. “Important” is spending quality time with family and friends, being kind to and doing something useful for others, appreciating the natural world, learning to be a better person, and taking care of myself as best I can. I am curious by nature, and love to learn the whys of the universe. Yet, in the case of my cancer, the answers would have no beneficial impact on my treatment or what I do with the time I have left. It’s like being obsessed with a good whodunit novel–nice to know the ending, but who shot JR makes no difference in real life.
I probably will never know exactly when, how or why I developed the type of lung cancer I have, or why it behaves the way it does. And I’m OK with that.
Love you all and truly mean it and God loves you too,
Shanna xoxo
Official prayer warrior page for my fight against lung cancer: facebook.com/hope4shanna
Official blog Facebook page: https://www.facebook.com/shannabananahealthandfitness
Official prayer warrior page for my fight against lung cancer: facebook.com/hope4shanna
Official blog Facebook page: https://www.facebook.com/shannabananahealthandfitness
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