Now my cancer is growing aggressively and rapidly restricting my life. Through the combined pressure of fluid accumulating in my body cavity and swelling of my liver and spleen, my organs have pushed through my stomach wall and are now protruding beneath my skin. The doctor who saw me at MSKCC's Urgent Care Center on Sunday and this morning told me that the flexibility of the skin will however prevent my organs from bursting through my skin into the open.
This morning at the Urgent Care Center, the doctor was once again not able to locate with ultrasound any fluid in a location where it could be removed. Because my CAT scans show that my colon is thickening, and putting solid food into my stomach has become too painful for me to bear, she also had X-rays taken of my colon to see whether it has any blockages. Although my colon is not blocked, I was given a list of symptoms of such blockages to monitor. It is also now possible that my intestines could become twisted and blocked as they protrude though hernias in the fascia of the stomach wall. If I develop blockages, the first treatment would entail hospitalizing me with a tube running down through my nose into my stomach.
Because I will probably die soon and almost certainly die within a year or so no matter what treatments I undergo, the suffering and humiliations of further chemotherapy and the risks of prolonging dying now loom large in my thinking. When I was first diagnosed by Dr. Saltz as incurable, then once again diagnosed by him as incurable after the surgeries failed, I told him that my priority was quality of remaining life, not quantity of remaining life.
Increasingly, the quality of my life is eroding. Blood tests show that I am anemic. I can't eat normal amounts of normal foods, partly because my swelling spleen and liver are increasingly squeezing my stomach, thereby restricting its capacity. I can't exercise anymore, beyond walks of a dozen blocks or so.The taut skin of my belly is so sensitive that showers are painful, and I dread the mere touch of fabric. I am starting to be afflicted by fevers of unknown origin. Pain is spreading into new locations in my body-- today, into my right side, just below the ribcage. Last night, for the first time, I took a pain killer-- 500 mg of Tylenol-- so that I could get comfortable enough to sleep.
This afternoon, Susan and I will meet again with the palliative care specialist, Dr. Glare. I am particularly interested in gaining a better understanding of the risks that I will now be running if I prolong the dying process. I know that my circumstances could change quickly, with dire consequences; and that the converse is not true. For mere mortals, time's arrow has but one direction.
