Life is too short...

This afternoon I met my Mom and my sister, Sue, over at the Pieper Cancer Center near Abbott Northwestern Hospital. When Mom was hospitalized for a mild heart attack in the beginning of December (shortly after moving into an assisted living facility) we asked that she also receive a gynecological exam. Sue and I had seen some signs that there may be problems in that area. After that test and a later ultrasound, it was revealed that Mom had a 5 cm mass in her uterus (her uterus is only 9 cm wide, so it is significant). The million dollar question, of course, is what is it - a polyp or a cancerous tumor and, if cancer, how aggressive it might be? So we met a woman gynecological oncologist from Minnesota Oncology (Minneapolis Clinic). The exam went very smoothly, relatively speaking, for a 97 yr. old woman. It took all of about 10 minutes and Mom didn't experience any pain, just some mild discomfort. The doctor said she removed quite a bit of tissue for a biopsy and that it didn't feel like a polyp. She seemed to imply that it was a cancerous tumor - results should be known by next Monday.

So, of course, Mom wanted to know options:

1. A hysterectomy - surgical removal of the uterus and ovaries - not a viable option for a woman her age who had just suffered a mild heart attack.
2. Just leave it be as it is - it may grow slowly or it may be an aggressive form of cancer (we'll know Monday which kind it is) - symptoms may be mild as they are now, or there may be heavier bleeding and discomfort.
3. A targeted series of radiation treatments - three or four times - targeted directly at the tumor - not to eliminate it, but to "keep it at bay", not growing any larger.

The doctor also discussed DNR and DNI directives with Mom (do not resuscitate and do not intubate) - that they needed to be updated so that Millstream Commons staff and family know her wishes - let's say they/we find her on the floor or unconscious...then what?

Finally, she talked to Mom (and us) very frankly about locating a hospice - particularly if the results are serious. She said that hospice care is very good, not only for a patient dealing with end-of-life issues, but also for family members. For a patient, it helps remove or alleviate the fear of death. For family members it allows for the discussion of end-of-life issues.

Mom took this all in very rationally - says that at this point she will leave it alone. The doctor said that could be her desire now, but not to worry about changing her mind. Mom agreed to update her DNR and DNI directives. As to the hospice, both Sue and I feel that this is premature (Sue says that there is a good hospice unit in Faribault, if that time comes).

So, what do I feel about all of this? It sort of feels unreal...I cannot imagine my Mom not being around...she is my best friend (next to Bob) and offers me a listening heart and unconditional love. I want for her not to suffer and to spend her last days/months/years in a respectful and dignified manner - as a matriarch deserves. It's difficult to see her start slipping...God be with her on this journey.