A couple of stories and well wishes

Today is a day that I will send out good wishes for those that are dealing with chronic disease.  I tend to think in terms of cancer, cuz I am a cancer nurse.  My actual title is Oncology Clinical Nurse Specialist.  Ya, I know, sounds like I know something.  Well, I know enuf.  My introduction into treating cancer was with women.  That would mostly be ovarian and cervical cancer.  Breast cancer is usually not treated in the GYN area.  Then, I moved to the hematology/oncology area when I transplanted to NC.  Here, I really fell in luv with my profession.  And my patients.  My favorite were the acute leukemia patients, AML.  They were tough, fighters, and just plain wonderful!  I luved every one of them.  That's when we were doing primary nursing, so once you got a patient, he/she was yours for the duration.  Not the best thing, cuz relationships form....which is a whole other story.  But I have memories of sitting on the edge of the bed, asking "Nancy" what she really wanted.  She had been thru so much.  Now she was relapsed, yet again, and weary of it all.  We talked, and she said she wanted to die at home with her family.  So, I was her advocate, and to make a long story short, I sent her home to die.  I still have the little cross-stitched bookmark she made me that simply says "thank you". 

Another story......"Skip" had lymphoma.  He appeared healthy enuf, but he had relapsed and was in house for treatment.  His pain started in his chest area.  No big deal.  We started him on pain meds.  Oral meds didn't seem to do it, so he was switched to IV.  The pain got worse.  No one could figure out what was happening, and the docs were very conservative with the morphine.  That was back in the day when there was a fear of addiction.  Bah!  Why would it matter, anyways?  The pain continued to get worse and spread to his abdominal area.  Hmmmm.  Cancer?  Shouldn't have been.  They were all the wrong places.  I would sit by his bedside and just talk to him, giving him his meds as soon as I could.  So sad.  Nothing helped.  One morning I was awakened at home by the phone ringing, very early.  It was my nurse manager.  She said she knew I would want to know what had happened to Skip.  He had coded during the night, and was gone.  I cried.  He was very special to me.  It turns out the cancer didn't kill him at all!  It was the evil aspergillus infection.  In compromised people, it is a killer.  There is no medicine that effectively eliminates it once it has settled in.  I won't give details here, but the pain he was feeling was a deterioration of most of his internal organs. 

So where is this going?  Quality of Life....  Sometimes it is better not to treat, and let the patient have the best days he can until he can die in his own home, with his loved ones.  And, sometimes another patient may need to just be on that morphine drip to be comfortable.  Addiction be damned!  For those of you that are dealing, or have dealt, or perhaps will deal with a chronic cancer sufferer......think about it.  And, my thoughts are with you.