Over the past 6 weeks our family has been moving through a time of diagnosing for my father who presented one morning with a broken left clavicle.  My father called me.  My stepmom was away visiting one of her daughters.  His call was matter of fact.  "I broke my collar bone, and I'm just calling you to tell you that I'm driving myself to the emergency room."  He mentioned that he had been working strenuously pulling down weeds and stuff and felt his collar bone snap....several days later while turning over in bed.

Our bodies are not that fragile, so I'm suspicious and I  asked him to wait and see if he could get in to see his orthopedic.  I would drive him in.

We are sitting in the waiting room and there is a man in a wheelchair.  My father leans over and says in a voice that should have been far lower than it was, "I do not want to end up in a wheelchair." 

We wait a long while, patiently, as we were worked in,  and are finally called. The doc takes xrays.  Comes back in.  "You have a pathological break.  We need to run more tests, and the coordinator will set you up for a CT scan of this break and a full bone scan."  He escorts us over, and he gets scheduled.

After the visit, my father goes to the Cremation Society and gets everything "taken care of."  (I'm realizing now where my utilitarian tendencies stem from).

The tests are done.  The results are in.  The referral to an oncologist is made.  We received a copy of the report.  I had to look up several terms, but the gist is that it appears that he has a cancerous lesions in several places (left clavicle, right hip, T-1 vertebrae and ribs). 

The oncologist visit is a bit strange.  Where as the test states that the presentation of the CT imaging might be multiple myeloma (which is not metastatic).  Blood and urine are collected.  Doctor calls and orders a full CT scan.  "A lesion is found on the liver" my father says.  (A lesion and a hypodense mass 1 and hypodense mass 2 were found on his liver). They are going to do a biopsy on my liver."

Well, there is no liver biopsy, but rather they take a bone marrow biopsy (but my dad thinks they took a liver biopsy later, and I'm just damned unclear where these ideas come from as they are not supported by the tests.  Another followup visit with the oncologist.  Diagnosis:  Stage IV liver cancer (hepatic carcinoma).  No treatment that will help with but adding a couple of miserable months to life.  Call hospice.

Hospice is called. With the social worker and nurse present, we work out our guiding principles so that we are in understanding of what my Dad's wishes are:  no treatment; palliative care only.  My stepmom states, "I'm the boss."  I say, "Nope, Dad's the boss; and our job is simply to honor his wishes."  We discuss when there might be treatment for pneumonia (if lucid) and when not (when not lucid).  That any secondary conditions he can seek treatment to relieve symptoms which is part of palliative care--boils down to, non-cancer related things will have symptoms treated to allow one to get on with the business of dying without being uncomfortable.

So here we are, getting on with the business of dying.  Hospice plan in place?  Check.  Burial arrangements made?  Check. Hospital bed?  Check.  Financial stuff figured out?  Almost.  Trepidation on the future weeks/months?  Check.

I will move back home to assist my stepmom who has taken very good care of my father for these last 25 years.  I will be 56 years old this year.  I am the age that my mother was when she died.  It is likely that my father will die while I'm at this age, and that just feels weird to me.

I'm really proud of my dad for facing this so objectively.  Seeing this brings back all of the unpleasant stuff with my mother's cruel death from lung cancer.  I asked my father to do one thing during this time:  to take his pain meds (which my mom did not do).  I would not let my dog die the way my mother die.  I don't plan on witnessing such an event again, and none should ever have to.

So begins our journey.


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