Paul's Heart

If My Dad Were Here

This picture still wrecks me, from eleven years ago, the final photo of my Dad and I. He passed away eleven years ago from lung cancer. Eleven years ago was such a complicated time for me, filled with conflict, preventing the most crucial opportunities to this day, I have been unable to attain, closure and grief. As I consider writing a valuable tool in dealing with emotions and thoughts, I wrote “My Dad Was Just Like Me,” which ended up being performed, see the link below:

Each year as this date passes, I relive that time period that culminated on this date, a date that had another significance that until that moment, I barely gave any thought, the anniversary of my first marriage. Forever more, this date would have a more lasting impact and memory. This year’s anniversary of my Dad’s passing has hit me differently though. Sure, another year has gone by that I wish he could see how his granddaughters have grown. Another year, both my daughters now in their twenties, having the relationship with their father that I know my father and I wish we could have had with me.

This anniversary there is a more stark reminder. I want to preface this, by saying what I am going to mention sounds serious, and it is, but with proper perspective which I believe that I have, is not only not scary, but oddly enough, under total control. A nodule on my lung, identified back in 2008 on a chest x-ray prior to my heart bypass, over the last sixteen years, has grown, now being labelled as “most consistent with an indolent lung adenocarcinoma,” lung cancer. When anyone hears me discuss this, their immediate reactions are all pretty much alike, shock, jaws hitting the floor. But oddly, with all the time I have spent immersed in this world of cancer survivorship, I am able to keep perspective, a grander view of the big picture.

I used the word “labelled” on purpose. It is not officially a diagnosis. I am now seeing one of the top doctors in the country, yes, the writing is on the wall, the diagnosis is on my doorstep. If you will, “if it walks like a duck, quacks like a duck…”. The truth is this nodule, one of many that have developed over the years, has grown from barely identifiable back in 2008, to 13mm today. And it got the attention of a pulmonologist who wanted to be a bit more aggressive about it. And you would think with the history of my Dad’s lung cancer, certainly I would take this situation as serously as I could.

Out of all the nodules, I have two more which have begun to be recognizable and grow in size, with the remainder still just “spots.” But from the beginning, this one nodule, a make-up described as “ground glass”, was not believe to pose any imminent threat. To most, the thought would be, “well if it’s cancer, and not too bad yet, get it out of there.” Unfortunately, with my health history and my treatment for Hodgkin’s lymphoma, there are many extra risks with any kind of surgery I undergo. So the school of thought has always been, “watch and wait.” Watch the nodule for growth (how much and how fast, which meant annual CT scans) or changes in shape or make-up. And over 16 years, just as the description says, “indolent” this nodule has grown slowly, until recently anyway.

Again, remembering my Father, whose lung cancer was from smoking, not radiation therapy, but still concerning regardless of the cause, the initial pulmonologist wanted to do a biopsy to confirm the diagnosis. But as I said, this would be risky, a needle biopsy I risked a collapsed lung which could lead to complications. The alternative, what he called a “wedge” surgery, removing the nodule and the surrounding area of the lung, could be even more complicated.

Here is where I put the brakes on, as the doctor seemed to not listen to my immediate concern. My Father was Stage 1, best case scenario with a great prognosis. The did a partial lobectomy (removing part of the lung lobe). Just as a precaution, the oncologist recommended preventative chemotherapy, which from my experience and knowledge, I felt this would be safe and help my Dad maintain remission. But upon completion, the doctor then announced that he wanted my Father to undergo preventative radiation treatments. And that is when the shit hit the fan. My Dad went from Stage 1, to remission, to terminal, within months. To this day, I have no idea what happened, what could have been missed. But now triggered, I find myself in a similar position, a simple cancer, doctors wanting to remove it, and then likely treatments after that.

I would like to think that I have had great doctors, great health advocates. They not only have taken care of all of my complicated health issues, but they also been great listeners, and they care about their patients. As has happened previously, one of my main doctors recognizing my anxiety referred me to a different pulmonologist, one of the top doctors in this area of specialty. I met with her, and together we came to the agreement, now is not the time to do anything invasive or traumatic. She made it clear, she does have a red line, which does buy me more time, before I am faced once again with my mortality, now with my lungs. At the rate of growth, I expect that time to be approximately three years, at which point, an accurate diagnosis, or rather confirmation will be made. And I will go from there.

I have so much more that I want to experience, but it is the last thing that I experienced with my Father, which took him away from me, now guides me. I want to have the time with my daughters as adults, that he and I were able to have. And I know that he would be proud of how all of us got through what we have over the years.

Dad, I miss you so much. I wish you were here.