Paul's Heart

Life As A Dad, And A Survivor

Role Reversal – Taking Care Of A Parent


A parent’s worst nightmare, having to care for a child for whatever tragic situation, cancer, accident, illness.  And then the ultimate, the loss of life because of the complications.  At funerals you will hear a phrase “a child is supposed to outlive his parents.

Last week, my father was officially told that he has lung cancer.  Over the last week, he has had several tests done to determine staging (how bad the cancer is and where located).  Emotionally, he is worried about two main things, one, care for his invalid wife – my dad is her caregiver.  And then of course, there is the fear of dying.

It is an early morning appointment, 7am.  My employer already tolerates me with frequent absences for my own health issues, to attend appointments in the care for my wife, and now will add for this.  Up until now, both of have held it together.  My defense mechanism is doing what it always has, switched to auto-pilot.  My dad, is almost in an acceptance mode.  There was one moment when he almost seemed to look for a deal, if he successfully quit smoking, which he is still dealing with.

My dad does not have any desire in technology, so other than his cell phone, that is as far as he will go.  But during this crisis, he probably wished that he would have access and the ability to use a computer.  So when the doctor’s office gave him information to receive notices via email, and be able to check on some of his records via the internet, he simply had everything referred to me.  On Friday, he had asked me if I had looked into his record, which I answered honestly that I had not.  That was actually kind of a hint that he wanted me to check if his scans were in that would tell how what stage his cancer was.  With several days until his appointment, I encouraged him to wait until then.

Then was today.  My dad and my stepbrother were waiting at the hospital by the time I had arrived.  We walked into the atrium waiting for my dad to be called in to be registered.  We entertained ourselves with small talk as anything medical made my step-brother nervous.  We were called into an exam room which was fairly small, definitely not large enough for the three of us, and five doctors to be in.  But the purpose for being put in here, was to put my dad, and my step-brother and I at ease.  Sure, the nurse took my dad’s vitals, but she also offered him some coffee, asked if there was anything else she could get him.

The hospital social worker came into the room then.  She explained the resources available to her, and that she would be available or how to reach her, should my dad, or any of his family have any emotional needs that needed to be met.  I expressed to my dad, while he is a fairly reserved and self-sufficient person, meeting this counselor was going to be one of the most important people he will meet during this process.  Most importantly, she was going to be another advocate for him.  If my dad was feeling uncomfortable about bringing up a topic with the doctor, having an issue with a hospital bill, pretty much any issue, she would be willing to help and guide him through whatever steps would be necessary.

Just then a nurse opened the door and said that the doctor was ready for us.  We were escorted down the hall into a conference room.  Wow.  It was not just the five doctors, but a total of nine staff members, all to make sure that my father understood all of his options.  The group had been meeting while we were waiting, discussing all of the options available to my dad, and what would be best.  I remember my diagnostic and prognostic stages and nothing even came close to the efforts for my dad.  It was so impressive.

My dad’s pulmonologist began the meeting, by informing us of good news.  The tumor was isolated to just the one particular spot.  There were no cells anywhere else, the cancer had not spread, this meant Stage 1, the best case scenario.  The bad news was that the best recommendation was not what my dad wanted to hear, surgery would be the best opportunity.  The concept of radiation therapy, or a combination of radiation and chemotherapy were explained as possibilities, but surgery would present the best opportunity for a cure.  He would end up losing half of his lung.

We did hear from the head surgeon who had address my father’s needs as far as dislike for the original surgeon that he had met, which basically came down to bedside manner.  But the chief assured my dad that another very qualified surgeon would be able to do the surgery.  We were introduced to the radiation oncologist, just in the event, further down the road, radiation therapy would need to be considered.  And then we met the oncologist that will be dad’s for the rest of the journey.  But what was more important to my father, was that the pulmonologist would stay involved.

I assured my dad, that Dr. K would remain inolved, that he was only a phone call away if he had any concerns or questions.  But for all purposes and plans, he was being turned over to the oncologist and the surgeon.  Dr. K would see him again in the near future as follow up, but of course would make himself available if my dad requested him.  This part was huge for my dad to hear, as he expressed extreme trust for this doctor.  And that is a crucial thing to have in your arsenal against cancer.

So now that the diagnosis, stage, and treatment plan had been decided, there were preliminary things that needed to be checked out before the surgery could be done.  Most importantly, confirming that his heart would be able to take the procedure of losing part of his lung.  A visit with his cardiologist has confirmed that something is of concern with his heart at this point.  Future testing is being done to see exactly what it is, and then it will need to be determined  if it needs to be taken care of before, during, or after the lung surgery.  What is not the ideal situation however, is delaying a procedure that right now is confined and has not spread.  Timing is definitely a critical factor.

Fortunately, my father’s head is in the right place.  He understands what has to be done.  He has faith in those that will be responsible for saving his life.  He is going through some normal reflections that all cancer patients go through, “what if’s” or “what went wrong”.  Another holiday is coming up, and as I have written before, I have really grown to dislike holidays for this very reason.  But my dad started a tradition years ago, by wanting to get his children and grandchildren together on Easter.  It is the one holiday that I promise him.  This year will be no different, but definitely as important if not more so.

Madison’s Top Ten


 

The first half of my oldest daughter’s childhood will be gone.  She has turned ten which I expect to bring in all kinds of changes to deal with the second half of her childhood term, the teenage years.  My mind often switches to memories of Madison, as many of her homework assignments often have to do with places she has visited, things that she has done.  There are things that stand out in my mind and take no time to recall.  They are Madison’s Top Ten memories.

1.  “Family #7!!”

This is what our guide in China yelled out as the caregivers who had escorted our soon-to-be children, began said goodbye to the babies they had taken care of until this great day.  There were ten of us families, and we were number “seven”.  All of us were strangers when we left Newark, New Jersey and in an instant, we all became family, sharing a special moment that will last forever.  We becamse what many in the adoption community call a “Forever Family.”

Madison had been dressed in three layers of clothing, sweating profusely inside.  She was approaching a year of age so she had some teeth, her four front teeth which allowed her to place her fingers around the teeth and create the perfect seal while sucking her thumb and finger.  She did not cry often, and when she did, it was for food.  Cheerios made her very happy.

2.  Wildwood, New Jersey

While every child loves the beach as well as the ocean, Madison associates the beach with something else, amusement piers.  We have several dozen pictures of Madison riding different carousels all over the country which by her third birthday, meant different rides.  And by her sixth birthday, kiddie rides just were not cutting it.

Unfortunately, I do not recall the name of it, but Madison had gone on her first “adult” level roller coaster at age seven.  The coaster was one of those momentum driven rides filled with hills and fast, winding curves.  It was not a large coast like you would see at a Six Flags park or Disney, but it was not a miniature coaster either.  Her smile had smoke coming from it and she rode the ride three more times before we headed home.

3.  “Do Not Cross This Point”

One of my roles as a parent, is to teach my children to follow rules.  After all, rules exist for a reason right?  But what happens when your daughter just looks up at you with the “Daddy you will make me the happiest daughter in the whole wide world”-eyes, and is asking you to be a non-conformist, which I do not have a problem with anyway.

And so, while visiting Seattle, Washington a few years ago, we went sight seeing to Snoqualmie Falls (not sure of the spelling).  It took quite a hike to get to, but the view from the platform was breathtaking.  Madison imagined out loud what it would have looked like up close.  Of course, I tried to explain to her that the warning sign “Do Not Cross This Point” was there for a reason, as in “the dam could be released at any time, the water could rise at any time, the rocks were difficult to climb, etc.” but Madison would have nothing of it.  Once she saw the throngs of people disobeying the warning, including with children, there was no convincing her that we could not go.

We dropped down from the platform and began our hike across the rock bed, and just a coupld of hundred feet, there were were at the bottom of the falls.  It was fantastic.  It was also a sign of things to come that Madison was going to be an adventuresome little girl.

4.  Madison’s Husband

I know.  Madison is only ten, but she has evidently been married for at least three years.  I am not sure if the boy knew it or not, but he did by the end of his birthday party.  His party was being held at his karate class studio by his instructor.  The Sensei (teacher) was quite good at handling the throngs of six and seven year olds, much better than I could.  Now the boy is quite a character, a bit on the goofy side, but what he did next would play right into Madison’s reaction.

Sensei was trying to teach a particular move.  It involved striking the boy (not physically), but the boy decided to take a dive anyway for emphasis.  To which Madison jumped up from her spot on the mat screaming “don’t you hurt my husband!”  All at once, the entire studio got silent as Madison attacked Sensei’s leg with a ferocity.  I do not know who was in more shock, me discovering that I had a son-in-law already or the second-degree blackbelt who clearly was not ready for this particular attack.  Three years later, they are still “married”.

5.  Madison The Headbanger (Part 1)

It is a longer story that I will cover in another blog, but Madison has always loved music.  She loves to sing it, play it, dance to it.  The first song that she ever heard back on United States soil that I can recall is ACDC’s “Back In Black.”  I have a wide variety of taste in music, and in general, just keep my Ipod on “shuffle”.  So you never know what you are going to hear.  But the ACDC song had just come on, and at that particular moment, I had looked back through the rear view mirror, and there I saw it.  Madison “head banging” to the beat of the song.  It was a beautiful moment.  There would be plenty of other memorable music moments, such as the first song she ever sang – “Since You’ve Been Gone” from Kelly Clarkson at the age of fifteen months.  We couldn’t understand the words that she was singing, but she got the chorus spot on!

Her knack for picking up music by ear has been remarkable.  So remarkable that she can usually pick up the music notes by the middle of the song.  And if there is a catchy lyric…  She got a lot of attention at the age of four when she began to sing “Girlfriend” by Avril Lavigne which of course drops a couple of bad word bombs at daycare.  Fortunately, she was singing the edited version of the song.

6.  Madison The Headbanger (Part 2) and These Are Real Tears (Part 1)

As parents, Wendy and I have done a pretty good job differentiating our girls’ cries, between the “this really hurts” and “I want attention”.  Madison is quite a tough little girl when it comes to crying.

But as she began to realize that there was an entire world waiting for her once she became vertical, it was not soon after that she also learned that she needed to learn about depth perception and height.  Her first and most difficult lesson came as she got stuck under our kitchen table.  I say “stuck” because instead of crawling out from under it, she was determined to walk out.   And with that, came the first thud.  We now realized how much Madison had grown in the year or so that she has been with us.  But there was no cry, so we left her to discovering her world.  Not worried, here came the second thud.

Okay, clearly she was determined, and Wendy and I just looked at each other.  “You don’t think…” and just like that, came the third thud.  Still no cry, she finally appeared out from under the table, but on her two legs, ducking under the edge of the table.  There were tears, but not from pain as she was not holding her head.  They were tears of frustration as she wanted to accomplish this goal on her own, and was having a hard time.  If there is one thing that I will say about Madison to this day, she is a determined little girl.

7.  These Are Real Tears (Part 2)

We are sitting at the dinner table one evening a couple of years ago, when Madison decides that she would like me to consider buying a reptile for her, in particular, an iguana.  Now I already maintained in our house, all at one time a dog, three cats, two guinea pigs, and two frogs which as far as I was concerned was more than my maximum that I had desired in my house, let alone, my lack of appreciation for reptiles.

So it was only natural, as I am known to do, I responded “no”.  Sensing it was the “iguana thing”, Madison turned on her bargaining powers and decided to rattle off all kinds of other reptiles as if that was the issue.  My answer was still “no”.  Realizing that I was firm on this, Madison decided to show her manipulation hand way too early in her life by proceeding further with this argument.  First came the frustration.  Next came the anger.  Then came the sadness and it was not just sadness, but it was accompanied with tears.

I looked over at Wendy who under normal circumstances would have caved long ago, worried that she would do so now.  I was trying to telepathically send her signals “be strong, do not cave”, and just then it happened.  Madison burst out laughing with the tears pouring out of her.  I let her know just how good her skills were at trying to mold her parents which is when she warned me, “you think that’s all I can do?’

8.  Attention To Detail

We had just gotten done vaccuuming the carpet when Madison had found some little particle in the carpet that had not been picked up.  It was the backing of one of Wendy’s earrings.  This is just one example of Madison’s sharp eyesight.  But when it comes to things that interest her, she has amazing recall to details, such as certain areas that we have visited, specific exhibits, even vacation memories.  Now if only we could get her to remember where her sneakers are.

9.  Snow White Has Nothing On Madison

Madison will save every living creature if she has it within her ability.  It is one thing for your child to bring home a stray animal, or yell “watch out” as you swerve and total your car to avoid a squirrel lollygagging across the street, but Madison has such love and respect for all living creatures that even those lacking intelligence can count on her, repeatedly.  Such as the bugs that keep falling into our pool.  She scoops them back out, puts them down on the ground, and then back in they go.

10.  Daddy’s Little Girl

The moment when I realized that Madison was one of the most caring little girls, was when I had to have my heart surgery.  It had been three days since Madison had last seen me, the first time ever that we had been apart from each other.  Wendy walked her into the hospital room, where I was still connected to all kinds of tubes and wires and a huge white patch covering my chest.  She gently climbed up on my bed, said she missed me, that she loved me.  She only asked a few questions about what had happened, and then asked if she could watch my television.

Madison, you are so special to me.  I love you always.

Daddy

Survivor Guilt


The following is a link to a newsletter article that has been published in Memorial Sloan Kettering Cancer Center’s quarterly newsletter for cancer survivors.  This was my second submission.  I am copying the story here, but for it too look really cool (and of course, see the other topics that are discussed) make sure you check out the link.

http://www.mskcc.org/sites/www.mskcc.org/files/node/4333/documents/bridges-spring-2013.pdf

Question:  I recently lost a fellow cancer survivor and am experiencing survivor’s guilt. Do you have any suggestions for coping with these feelings?

Answer:  First, please let me express my sincerest sympathy for the loss of your friend.  Survivor’s guilt is a common and often underestimated feeling experienced by both patients and caregivers. As a survivor or caregiver, we are expected to just be grateful and simply move on. Do not ask questions. But we do.  A year after my own treatment ended, I trained and participated in a peer-to-peer program with the American
Cancer Society called “Cansurmount.”  The concept is to match survivors of cancer with patients who are struggling with their own diagnosis, treatment, or survival.

My first patient was a 14-year-old girl who would eventually pass away from the same cancer that I had, leaving me to ask, “Why her and not me?”
As someone who was fortunate to have beaten the odds, it was not long before I found myself facing an unexpected and insurmountable wall
of self-doubt, which I refer to as my survivor’s guilt. Perhaps survivor’s guilt is a way for our hearts and minds to remind us of where we came from, and what we have endured. The important thing to realize is that this feeling is often overwhelming, but can be alleviated.

With technology, I have been able to widen my experience and knowledge of cancer patients and survival. I have participated in Internet support
groups for over 15 years and finally accept that with 22 years of survival behind me, I am a long-term survivor.  Surviving also means that I have
experienced loss. In just over a decade, I have said goodbye to well over 100 friends and relatives who were not able to achieve that remission.

The question I still ask myself is always the same, “Why them and not me?”  But what gets me through each and every day is knowing that my survival mattered to those who have passed.  My experiences inspired them just as theirs inspired me. There is no way to know the reasons that some survive and, sadly, others pass. The answer can be as simple as the one that comes from a parent when a child asks, “Why?” and the parent responds, “Just because.” It is cruel and it hurts.

It matters that you are here now and asking this question because at some point someone else will read your question when they are questioning
their survival and know others have gone through a similar experience.  Reach out for help. Support from others with personal experience or
professional knowledge (like the staff of the MSKCC Counseling Center) is essential to help us understand that what we feel inside is common and
expected, and can be overcome.

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