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My Mom is actually doing really well. It has almost been three months since her final chemo, and her hair is about 1/4 an inch long and she is getting her energy back. Her energy is not coming back fast enough for her, since she has always been a very driven woman, so leaving a job half done *frets* her - a lot. But better is coming, and the general feeling is that cancer will be at bay for at least five years.
As I mentioned before, my Dad has been diagnosed with Alzheimers. The doctor overseeing his care for that condition noticed something odd in some of Dad's blood work back in May, and ordered another round of tests, including a full skeletal xray set of every bone. All those tests came back inconclusive, so Dad was finally sent for a bone marrow biopsy in the middle of October. This Thursday Dad finally had his first appointment with the doctor that will oversee the treatment for his cancer. He has "smoldering" multiple myeloma - which is a cancer of the bone marrow.
The "smoldering" means that his readings are just under the line for a full diagnosis, and it is not uncommon for people in this condition to continue in this state for years.
Basically, there are plasma cells in the bone marrow that make antibodies for the immune system. Sometimes they mutate and so lose their ability to self-regulate. In that case, they make too many cells. Sometimes they make too much calcium which causes problems for bones, and/or sometimes they create too much protein which causes problems for kidney function, and/or sometimes they cause anemia.
Dad has the abnormal plasma cells, but currently his only issue is anemia. Nothing abnormal is showing on his bones, and his kidney function is fine. Because anemia can be caused by a lot of things, the doctor will be checking for other possible causes. In all the blood tests done since the beginning of the year, while Dad has been anemic all along, the readings for the anemia have not changed.
Therefore, going forward, the doctor will be asking for blood work every three months. If things don't change, that is all that will happen: blood work every three months.
This is a relief, and it has taken part of the weight off my Mom's mind - the possibility of Dad needing to go into chemo while she was still recovering from hers really sank her spirits. This, while not completely out of the woods, is a very excellent outcome - although the anxiety of waiting so long for answers is also spirit-sapping.
Sadly, Dad's Alzheimer's is progressing (in fits and starts), and he lost his driving licence this past Tuesday. His understanding is such that he is more upset about the loss of his licence than he is about the cancer diagnosis. Mom & I are not sure Dad believes this is a diagnosis for him - he seems to be treating it as a hypothetical situation about an unknown person. But he really *knows* that he no longer has a driving licence.
Dad remembers riding in the horse-drawn wagon to visit his grandparents, and his family didn't have a car until he was in his teens. (For those of you who haven't visited Canada, the Prairies are a collection of provinces on a vast plain where you really can watch your dog run away for five days. Walking to something was a serious investment in time and energy.) Dad rode the Greyhound for 24 hours from Calgary to Midway (pre-Roger's Pass) to visit Mom when they were courting. Having unfettered access to a car is not only extremely useful, and in some cases utterly necessary, but it is also a big factor in a Canadian's sense of independence and autonomy.
While we lived in a big city, we didn't need a car. We didn't have one for 12 years and seldom missed it (can't get out to Spanish Banks without a car - taxi is pricey and problematic, little transit bus only runs weekdays during the day). Now that we are in a small town, we would be utterly hooped without a car.
Alzheimers is very weird how it steals little nibbles of a person, slowly slowly. I suppose a steady loss is occurring, but the evidence noticeable by those of us outside seems to be at certain points where the brain no longer has enough information to make a coherent narrative. You know that the brain is a pattern-recognizing wizard, often seeing patterns (animals in clouds) where there are none. It is amazing how little information we generally need in order to make up a useful narrative about what we have seen or what's going on. Every now and then, though, we don't quite have enough information, and we make narrative fragments that don't hang together. In a general conversation, we can bluff our way along, letting others speak and nodding knowingly until more information becomes available. But sometimes the narrative fragments never gel. Often it is about a subject we don't care about, so nobody knows. Sometimes we carry on in misinformation until something causes the whole picture to shift and we "get it".
In some situations now, Dad is always floating in a sea of narrative fragments that might or might not gel. Add to this that he has profound hearing loss from his work (high pitched whine from natural gas pipeline measurement stations over 35 + years), and he often cannot gather more useful fragments. He either falls asleep out of boredom, or he gets upset because he can't figure out what we're talking about.
Sometimes he is with us with the whole narrative, and his face sharpens, and he becomes happier because he can join us. Sometimes he is adrift in the sea, and he seems to be looking out from a long tunnel way far away where he feels isolated and he can't figure out how to get back to us.
Part of the reason Mom's energy is not rebounding as quickly as she would like is that she is now hyper-vigilant about where and what Dad is doing. Sometimes his narrative stream is all connected and he is fine; sometimes he is ricocheting from fragment to fragment and he may forget to follow through on an action (turn off the burner under the kettle). One doesn't know which until something goes funny, so one is always alert.
As I mentioned before, my Dad has been diagnosed with Alzheimers. The doctor overseeing his care for that condition noticed something odd in some of Dad's blood work back in May, and ordered another round of tests, including a full skeletal xray set of every bone. All those tests came back inconclusive, so Dad was finally sent for a bone marrow biopsy in the middle of October. This Thursday Dad finally had his first appointment with the doctor that will oversee the treatment for his cancer. He has "smoldering" multiple myeloma - which is a cancer of the bone marrow.
The "smoldering" means that his readings are just under the line for a full diagnosis, and it is not uncommon for people in this condition to continue in this state for years.
Basically, there are plasma cells in the bone marrow that make antibodies for the immune system. Sometimes they mutate and so lose their ability to self-regulate. In that case, they make too many cells. Sometimes they make too much calcium which causes problems for bones, and/or sometimes they create too much protein which causes problems for kidney function, and/or sometimes they cause anemia.
Dad has the abnormal plasma cells, but currently his only issue is anemia. Nothing abnormal is showing on his bones, and his kidney function is fine. Because anemia can be caused by a lot of things, the doctor will be checking for other possible causes. In all the blood tests done since the beginning of the year, while Dad has been anemic all along, the readings for the anemia have not changed.
Therefore, going forward, the doctor will be asking for blood work every three months. If things don't change, that is all that will happen: blood work every three months.
This is a relief, and it has taken part of the weight off my Mom's mind - the possibility of Dad needing to go into chemo while she was still recovering from hers really sank her spirits. This, while not completely out of the woods, is a very excellent outcome - although the anxiety of waiting so long for answers is also spirit-sapping.
Sadly, Dad's Alzheimer's is progressing (in fits and starts), and he lost his driving licence this past Tuesday. His understanding is such that he is more upset about the loss of his licence than he is about the cancer diagnosis. Mom & I are not sure Dad believes this is a diagnosis for him - he seems to be treating it as a hypothetical situation about an unknown person. But he really *knows* that he no longer has a driving licence.
Dad remembers riding in the horse-drawn wagon to visit his grandparents, and his family didn't have a car until he was in his teens. (For those of you who haven't visited Canada, the Prairies are a collection of provinces on a vast plain where you really can watch your dog run away for five days. Walking to something was a serious investment in time and energy.) Dad rode the Greyhound for 24 hours from Calgary to Midway (pre-Roger's Pass) to visit Mom when they were courting. Having unfettered access to a car is not only extremely useful, and in some cases utterly necessary, but it is also a big factor in a Canadian's sense of independence and autonomy.
While we lived in a big city, we didn't need a car. We didn't have one for 12 years and seldom missed it (can't get out to Spanish Banks without a car - taxi is pricey and problematic, little transit bus only runs weekdays during the day). Now that we are in a small town, we would be utterly hooped without a car.
Alzheimers is very weird how it steals little nibbles of a person, slowly slowly. I suppose a steady loss is occurring, but the evidence noticeable by those of us outside seems to be at certain points where the brain no longer has enough information to make a coherent narrative. You know that the brain is a pattern-recognizing wizard, often seeing patterns (animals in clouds) where there are none. It is amazing how little information we generally need in order to make up a useful narrative about what we have seen or what's going on. Every now and then, though, we don't quite have enough information, and we make narrative fragments that don't hang together. In a general conversation, we can bluff our way along, letting others speak and nodding knowingly until more information becomes available. But sometimes the narrative fragments never gel. Often it is about a subject we don't care about, so nobody knows. Sometimes we carry on in misinformation until something causes the whole picture to shift and we "get it".
In some situations now, Dad is always floating in a sea of narrative fragments that might or might not gel. Add to this that he has profound hearing loss from his work (high pitched whine from natural gas pipeline measurement stations over 35 + years), and he often cannot gather more useful fragments. He either falls asleep out of boredom, or he gets upset because he can't figure out what we're talking about.
Sometimes he is with us with the whole narrative, and his face sharpens, and he becomes happier because he can join us. Sometimes he is adrift in the sea, and he seems to be looking out from a long tunnel way far away where he feels isolated and he can't figure out how to get back to us.
Part of the reason Mom's energy is not rebounding as quickly as she would like is that she is now hyper-vigilant about where and what Dad is doing. Sometimes his narrative stream is all connected and he is fine; sometimes he is ricocheting from fragment to fragment and he may forget to follow through on an action (turn off the burner under the kettle). One doesn't know which until something goes funny, so one is always alert.
