Chemo Continues - For Now

Today we had a routine appointment with Yvonne's neuroncologist at London Regional Cancer Program (Victoria Hospital). He noticed Yvonne's poorer condition -- not able to lift her left leg when he asked her; although I was surprised she was able to still hold out her arms reasonably well and squeeze his hands when directed. Her bloodwork showed her platelets (which sometimes in the past have taken a hit with the Temodal chemotherapy) were staying up, which is good. I noted a significant amount of her hair has come out in the past few weeks when I comb it each morning, after the radiation was completed May 14.

At first Dr. Macdonald seemed to be questioning whether the chemotherapy was doing much good. I countered that it's difficult to say when we can't tell how much worse she would have been if she had not been receiving chemo! Later I admitted that, although we don't have those results, as neuroncologist he does see a lot of patients that are likely similar to Yvonne, and I asked how she compared to them. He said, on that basis, if the chemo had been shrinking the tumour significantly, he would have expected her to be resuming her former functioning. I suppose an example would be reading aloud for him the sign on the door as she was able to do April 13, and certainly could NOT do today.

In the end, he relented and approved continuation of the chemo at least until her upcoming MRI July 9. That day he plans for us to stop in so we can see the resulting images (the radiologist report won't be ready until at least a day after).

He also approved an increase in the steroid Yvonne is taking (dexamethasone) which helps reduce swelling inside the brain (although it results in a puffy face). We had been tapering off it from the initial 16 mg/day to current 4 mg/day, but she is going back up to 12 mg/day in hopes this will help her functioning.

There was a bit of discussion about whether she should be going into the hospital in near future, and whether a "DNR" (Do Not Resuscitate) order would be appropriate. I explained I had been reluctant to put this in place as she had been still relatively functional until a couple of weeks ago. The nurse questioned me about it again Wednesday. I had a discussion with a fellow pastor this week, who was of the opinion it is probably the compassionate approach at this point. A "DNR" would need to be in place if I am to arrange an "EDITH". Yes Edith was actually Yvonne's maternal grandmother's name! (incorporated into our daughter Meredith's name) But this "EDITH" is short for "Expected Death In The Home" and means if Yvonne died at home, we wouldn't have to call 911 emergency services; procedures would be handled quietly through the visiting nursing service already in place. I like the low-key aspect of an EDITH, but had not yet mentally or emotionally crossed the bridge of the DNR order it would necessitate.

I realize from a point of view of individual "quality of life", Yvonne's state is diminishing significantly. However I also see it as a 'system' issue, not just the 'individual' one. She has a generous team of volunteers who have been lavishing love upon her with their time and their tasty cooking. Our children have started a Whatsapp Group called "Hi Mum!" in which they and the grandchildren have been submitting videos on a more or less daily rotating basis for Yvonne to watch (and she does enjoy watching them). From a Biblical viewpoint, as her husband I am "one flesh" with her (Genesis 2:24; Matthew 19:6) so I too am part of the equation. To evaluate "quality of life" solely from an individual point of view seems shortsighted; Yvonne is part of many overlapping circles of significant caring, mutually-enriching, relationship.

Late this afternoon, the Occupational Therapist stopped by in response to a report issued through our PSW (Personal Support Worker) network. Wednesday "W" the PSW was escorting Yvonne from her recliner to the washroom with the walker when Yvonne's legs collapsed under her. "W" called me at work and I came home a bit early to help get Yvonne up off the floor and into bed. "W" said the time was probably coming when more equipment would be needed in order for them to do their job safely. So the Occupational Therapist today agreed and we are looking into: a "sit-to-stand lift" (example), a hospital bed (saves PSW's back when doing personal care, and our present bed doesn't have clearance for the sit-to-stand lift underneath), and a commode chair (our ensuite bathroom is pretty tiny to try to get equipment like a lift or transfer chair into).

Thanks everyone for taking time to follow Yvonne's progress, for your prayers, and support!