Friday, July 20, 2012

Let's Talk About Options - Part 2

I can imagine that this seems to be dragging out. You can imagine how I felt at the time. I was working remotely through this entire month of testings and appointments, getting questions from my two friends at work who were acting as liaisons for the rest of the people in our department, and our family was getting calls and emails from others who were wondering what was going on too. It was a very frustrating time not having any answers to all these questions.

Yet, the time had finally come. We were in the patient room with the doctor and his nurse assistant to find out what he recommended we do to get rid of this beast inside me. Unlike most of the room in the clinics, this corner room (being as large as it was) not only had windows, but it has two walls of them. There was a lot of light in there along with the fluorescent ones above head in the ceiling. You could see several other parts of the campus from there as well, so there were distractions from the conversation qqqthat ensued.

After the typical pleasantries were over. The doctor sat in a chair near the computer and desk in one corner of the room. Near the door, the nurse was looking for a chair to sit on, but my dad had taken the only other one there. She left the room for a moment to find another chair from another room while the doctor pulled up my test images on the computer and the paper files in the folder on the desk. I really think that the doctor didn't want to start talking with us until the nurse returned in order to have a witness to what he said.

Dr. Dominic Femino, M.D.
The nurse returned with a chair for herself and sat nearest the door. The doctor began talking with us and rehashing some of the conversations we had previously with the slew of doctors in the smaller room (which was two doors down from where we were right now). His name is Dr. Dominic Femino, M.D., and he speaks slowly and methodically the entire time. There were moments where he was gathering his thoughts before he started another sentence, which lead me to believe that he didn't really know what he was doing with my case. I was getting more frustrated with each passing moment.

Finally, he decided to take the plunge and provide us with his option for my treatment. He said, "The easiest and quickest way for us to remove the cancer to is take the leg." Boy did he ever take the plunge with that one.

Excuse me?, I thought. My grandmother, ever the dramatic leading lady, jumped backward in her seat, gasped for air and widened her eyes three times their normal size. Mom asked very pointedly, "What exactly does that mean, 'take the leg'? Do you mean amputate it?" Dr. Femino shook his head and said, "Yes. It would be the quickest and easiest surgery for me to perform."

We were all stunned into near paralysis by this blunt, seemingly frigid and brash suggestion of just amputating my limb. I didn't know if I should cry, get really angry, freak out or what. Within myself I was in great turmoil. I clenched my jaw, started breathing very heavily (near a huff), was looking around the room at my mom, then my grandmother, then my grandfather, then the nurse, back to my mom, then to the floor, finally to my dad and back to my mom. With a clinched jaw and glaring eyes, I look at my mom and slightly shook my head back and forth as though I were telling her "no!" And I was. With everything inside me screaming, "You're not taking my leg," I began to shut down externally. I fixed my gaze on the floor and began to swing my leg slowly back and forth while sitting on the patient table. This meeting was over as far as I was concerned.

Every so often I would look up at my mom, but I was done with this. She was fighting back tears as the shock was still fresh for us all. She began to ask questions of the doctor, looking for a way out of this drastic and horrific measure presented to us so callously. In his methodical manner, he began to think about some other options for us. He began by saying that we could leave it alone and do nothing about it all. Eventually, the cancer would spread enough to over take my body leading to death. There was not clear idea of how long that would take. Mom and my grandfather agreed out-loud that this was not an option they would entertain. I on the other hand was ready to let it take it's course over loosing my leg by this guy.

Next, he presented and option of doing a bone scrape. Going into detail, he said what they would do is open up the bone of my entire right hip, basically scrape out all of the cancer they could and piece the bone back together again using bone cement. Doesn't that sound like a lot of fun and not painful at all? He added, "While this would take care of the cancer there right now, it would certainly come back. Maybe to that area, maybe to another area. There is no telling at how long that would take to happen either. But, you will have a recurrence."

Still speaking methodically, Dr. Femino add a final option. It took a while for him to get through this option. It seemed as though he had a lot of hesitation. I was listening to everything he had to say and heard all of these options, but I was still intent on not loosing my leg. I really didn't care, I was keeping my leg. He continued while I was still looking at the floor and sometimes up to my mom and grandparents. This final option would be a lot more work and be a pain experience. "Painful experience? Isn't that what this whole thing is right now, a painful experience?"

The acetabulum
The doctor said there was an option to "spare the limb" by doing a difficult procedure called a 'wide resection.' This would still be considered an amputation, but it would only take the ball and socket along with the affected part of the pelvis called the acetabulum. According to Wikipedia, "The acetabulum is a concave surface of the pelvis. The head of the femur meets with the pelvis at the acetabulum, forming the hip joint." Then a saddle prosthesis would be attached to the ilium (the uppermost and largest bone of the pelvis) with a rod down through the femur bone. Can you say 'ouch?'

At the time, I considered this option because I could still have my leg, but I was still as angry as I had ever been and didn't really want to continue this conversation any longer. But, I wasn't running this meeting.  Mom had a lot of questions to ask the doctor about this procedure, and I was getting more angry by the minute. The more questions she asked, the longer we were sitting here and I had to listen to all of them talk about what they all wanted to do to save my leg yet rid me of the cancer at the same time. I just wanted to do the bone scraping thing and be done with this.

 I missed a few things that were said because I keep saying to myself, "Stop talking. Don't ask any more questions. Let's get out of here. I'm done!" In the long run, it was good that mom was asking all these questions because I wasn't. And, if I was going to make an informed decision about what option to choose, I needed to have someone looking out for me. That was the great thing about having 5 of us in the room with the doctor. What I do remember is that I had to go get a walker to use until we made a decision so that weight was taken off the right hip so it wouldn't fracture from the stress on the cancer affected bone.

Mom didn't have any more questions. Dad had nothing to add. My grandmother was now in a state of shock and couldn't think of anything to ask. My grandfather asked if we could have some time to make a decision and contact the doctor once we had discussed it as a family, and somehow, we were finally going to leave. All I could think about was getting up and walking out the door. Frankly, I don't remember saying goodbyes to the doctor or his nurse and I couldn't get my family to walk fast enough out of the clinic. When we did finally exit the door, someone had to go tell my cousins we were out and ready to go. We stood in the corridor waiting for everyone in the family to be together so we could head to the physical therapy office, which was where I heard I was to go for the walker and lessons on how to use it.

I was fighting back tears as my cousins joined us and we finally started toward the elevator, I was still clinching my jaw and seething inside. My mom tried putting her arm around me to comfort me but I told her "No, not now." I had to deal with this on my own terms. I really wasn't in a talkative mood at this point. All I wanted to do was get this walker and go home. We made it too the main floor and exited the elevator. We were headed toward the physical therapy office for my new look.

Next time we'll talk about getting a new swagger.

“Be angry, and do not sin: do not let the sun go down on your wrath, nor give place to the devil." Ephesians 4:26-27

"And do not grieve the Holy Spirit of God, by whom you were sealed for the day of redemption. Let all bitterness, wrath, anger, clamor, and evil speaking be put away from you, with all malice. And be kind to one another, tenderhearted, forgiving one another, even as God in Christ forgave you." 
Ephesians 4:30-32

Have you let anger take hold of your life in certain situations? Following scripture, we are to let anger go from us. Yet, how do we do that when things of the world appear to be baiting us toward it?

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