Cancer and Dentistry part 2

My brother was scheduled to come to the hospital where I work for a second opinion regarding his dental problem-basically his teeth are so bad that the only option is to pull one tooth and risk the whole delicate mess to collapse.

He was given the same recommendation that the tooth is “unsalvageable” so he will “allow” them to remove that one tooth.

He was at my work on Friday afternoon so when I saw him Saturday I asked how his “patient experience” was….big mistake. He started off saying that…it’s your choice…but if I had an option to work there or anywhere else I would quit that job and go anywhere else!

Alrighty then…please don’t hold back…I know its got its problems but I was planning to stay there another 10 years or so until I can retire but really, do tell me why my place of employment is the worst place in the world to work?

He went on to describe how the employees were all just standing around talking about their social lives, they didn’t acknowledge him and barely made an effort to answer his questions. I don’t in any way dispute his depiction, I witness this all the time but in a public health care setting I hardly believe that it makes it worse than, say…. a hospital in Zimbabwe?

After the tirade ended, I told him that we have a new medical director and he is asking for feedback-perhaps he would like to provide his personal and in depth feedback directly to him? He didn’t take that up but he did apologize later for getting “huffy” and thanked me for my generosity.

I think he was just tired, cranky, not in his usual medical environment and did not get the answer he wanted from the dentist.

At the cinema with the Inner Fire #1

As you may or may not have noticed-I made a news years non-resolution to see a movie and to clarify this excludes netflix, you tube or an airplane. I resolved to go to a real life moving picture house, buy a ticket and plop myself in one of those comfy seats…popcorn optional.

My first choice, not my choice really but my daughter wanted to see LaLa Land. Predictable, yes but we have been working on the logistics for a few weeks and it only happened on the day of coincidentally, hours before the Golden Globe awards at which it pretty much swiped all the categories across the board.

Saying all that, I’m not sure that I would say it was the greatest movie ever but I did enjoy it. The adjectives I’d use are: unique, quirky, good special effects and cinematographic techniques, bright, mostly positive, great dancing numbers. I’d rate it 8/10, 4 out 5 thumbs up, definitely recommend…to most people.

The whole experience was relatively pain free considering we went at 10:45am on a Sunday. Tickets were $6 each which I tend to feel enhances the experience because I don’t feel totally ripped off if its not that good.

I feel pretty chuffed with myself for actually accomplishing 1/12 of my goal. Last year I planned to make all three sessions of bootcamp and failed miserably…

On to February!!

New Years Non-Resolution

For something completely different-

I have lots of friends who love movies-they go out to the movies all the time!

I don’t-I rarely see films other than what I watch on planes.

I’ve decided that in 2017 I’m going to go out to a movie once a month, every month for 12 months. I think I can manage that.

Be prepared for my post cinema critique.

going to the dentist

A week or so ago my brother started dropping some subtle comments about a toothache. A toothache in a person with Stage 4 tongue cancer is not really a good sign. He’s had a ton of radiation to the left side of his neck. His toothache is on the right but I doubt that will give him a free pass.

He’s gone on to describe his dental history which includes several root canals in places like Oman and Thailand. Apparently this last holdout tooth is the supporting structure for this international dental scaffolding that sounds about as structurally  sound as a toothpick house.

Sometime I’ll run down the begats of exactly where I got each of my root canals.  Each one is like a reed.  The only reason I’m still able to eat is because each “reed” is still there.  If I lose one tooth it’s going to cause a domino effect where within a short time they’ll all either have fallen out, tipped over to where they’ve had to be pulled, or already been extracted for other reasons.

My brother went to the dentist and was prescribed antibiotics for a small “abscess”. When he followed up he really had his heart set on a root canal. He wasn’t too thrilled when the dentist said he could only do an extraction.

The rationalizing for this decision came fast and furious:

  • The VA doesn’t want to spend the money
  • He’s dying so why does he need a tooth
  • They are overworked and just can’t be bothered

Once again I found myself defending the entire medical community against this attitude. No, I don’t think that’s what they think and maybe…possibly…there is a clinical, research based rationale for the dentist decision.

After speaking to his oncologist who spoke to the dentist the word used was “unsalvageable”.

Now the thing to understand about this is that my brother gets the majority of his nutrition from tube feedings via his g-tube. The small amount of food he takes by mouth is actually defined as “pleasure feeds”. The loss of this tooth and the likely crumble of the surrounding teeth is a massive insult to his quality of life.

Granted he could make better food choices-he’s obsessed with meat/protein in lieu of soft mushy vegetables but I understand its just one more step down the path he does not want to go.

The next step is that he has an appointment for a second opinion at the VA hospital where I work….oh boy….grumpy brother will be at my workplace!!

Patience

Let’s face it, things are not going well in my multi family dwelling. I am so pissed by my brothers continued lack of insight that I am barely talking to him and he is avoiding me for the brief periods of time when I am home.

My grown son who lives downstairs is equally lacking in any sense of fairness and respect for others.

They both must go and I have no patience for either.

I am normally a very patient person so this situation is not a result of me being impatient.

One of the simple examples of how I learned patience is by describing how I learned to make a particularly well loved Christmas cookie~the Florentine.

img_0362

As a young, inexperienced wife I bought a rather boring Christmas book with recipes, stories and crafts. I read the recipe for the florentines and thought it sounded good. The directions didn’t seem to difficult but a few simple sentences can be misleading without cues like-you really need to use lemon juice to get a shiny crispy side or 6 tablespoons means exactly 6 level tablespoons.

For several years in a row I tried these cookies over and over again with the same sad results. They all ran together, were burned around the edges or stuck to the aluminum foil.  I threw out lots of inedible cookies but slowly i managed to salvage a few and the results were so tasty that I vowed to give it another try next year.

After about 10 years of trying I had some real success. I managed to have enough to share and everyone loved them so I just kept honing my technique.I am the first to say these are some finicky cookies and take about 3 hours to patiently watch the oven and make sure they don’t burn but at the 30 year mark I can say that today I made a double batch of near perfect florentines. No discards and because they get paired up I actually managed to make an exactly even number.

I just want to say again that this did not happen overnight, nobody showed me how to make these cookies. I just kept trying til I figured it out for myself and most importantly I  I didn’t give up.

Now I have that wonderful sense of satisfaction that I have mastered this recipe for myself, that I know every nuance, every right and wrong way to make these cookies and I can replicate them every year. That, my friends is patience.

A moratorium

My brother has gone from a regular night schedule —Pretty much quiet from 10pm to 6am but with increasing trips to the bathroom and coughing spells —to a night time free for all.

I can excuse the coughing and piss breaks because those can’t be helped but I draw the line at putting away a full rack of clean dishes at 3am….when I have to work the next day!

I emailed my feelings to him early Friday morning from work using his style of direct and to the point-

Can we please agree to keep the noise down/to a minimum between the hours of 11pm-5am?

No response or acknowledgement-My empathy river has pretty much run dry.

He has said he feels he has a toothache coming on and was chuffed that he was able to snag some dental care at the VA. He is missing the part about the significant radiation therapy that he had on his throat, neck and jaw back in the spring. I’m guessing he may have osteoradionecrosis.

Perhaps the most severe side effect of radiation therapy is osteoradionecrosis (ORN), or bone death. This condition occurs in three to ten percent of patients. Osteoradionecrosis develops as irradiation diminishes the bone’s ability to withstand trauma and avoid infection, and it can be facilitated by poor nutrition and hygiene. This process may be spontaneous or result from trauma, leading to non-healing soft tissue and bone lesions, followed by bone necrosis. The non-healing bone may become secondarily infected.

The photos of this complication are not pretty so I’ll refrain from posting but feel free to google if you have a strong stomach.

A good deed

I know my brother is lonely. I know that he is bored particularly since the weather has turned cold and he can’t get out on his bike. I feel bad that I don’t come home after a long day at work chirpy and dying to chit-chat. I also feel bad that every time I turn around my brother has another demand. With the last one I wanted to say tell me about your living arrangement in China…did you have a concierge service that you submitted all your requests to???

After a rather trying end of last week into Saturday, I spent a lovely day with my daughter and grandson at the conservatory. One of the problems around here is that my grandson is very selective about who he wants to spends time with and specifically screams at the sight of my brother. Mixed gatherings such as Thanksgiving and any old meal time or party are very problematic.

Luckily, I was feeling slightly more relaxed -I still had to make a trip into work to clear the OR’s after some work was done. Surprising even my self I asked my brother if he wanted to take the ride into my workplace just to get out. He nearly jumped off his seat like I was dangling a few $100 bills in front of him! He was in his shoes and jacket in a heartbeat panting like a dog at the door.

We drove to my work and enjoyed the city skyline at night, he waited while I did my little inspection and we headed to the chain home store for a special lightbulb. He was pleasant and agreeable the whole time.

As we headed home he motioned towards a Taco Bell-3 crunchy tacos!

He’s much easier for me to deal with when he isn’t breathing down my neck. He was even more relaxed when I got home today. I can do this.

 

A brief glimpse

One day last week my brother came to me as I was putting away my laundry. He looked a little distressed as he said to me-Can I have a hug?

I complied…against my nature asking-“What happened?”

He said-“I’m  dying and I’m scared”

He continued-“I’ve lost my family, my friends are gone….you are the only one I have left”

I hugged

Then I  wondered if this was the time to contact his daughters…

Maybe he was coming to terms with the whole scenario….maybe he was ready to make peace with his family…

After the brief hug he recoiled and said “That’s fine, I’m good, I can go on”

Shortly after he was back to his usual critical self

Mean people get cancer too

I guess if I was starting a brand new blog about caring for my 60 year old, three times married, ex alcoholic, estranged from his daughters and living in china for the past 10 years brother who landed on my doorstep 10 months ago with a baseball size tumor at the base of his tongue~that’s what I would call it~Mean people get cancer too.

We were always the closest of all my siblings in age and being the two oldest knew the most about our shared family story. But life has a habit of knocking people around a bit, as above and while I have always been the grumpy one he was as I remember the “golden” child. Blond, blue eyes, clever and creative~mom’s favorite!

I’m not sure the exact route he took to his own particular isolation, how much inflicted on him vs self inflicted- but I can say that if you imagine that mean old man who scares little kids for walking on his lawn….that is my brother.

He just has this acerbic tongue attached to a selfish brain with no filter. I am by no means a shrinking violet but even I am intimidated sometimes…in my own house!!!

So while I will do my best to care for him til the end it is not easy. Make no mistake~Mean people get cancer too~and not all of them have a personality change or epiphany.

Why is there blood all over my bathroom?

I came home Saturday morning to find blood splatters

  • all over the bathroom
  • the kitchen sink
  • the bathroom sink

And no activity from my brother. Truthfully at this point anything can happen.

When he appears it becomes apparent by the bandage and discoloration over his eyebrow that something happened.

He tells me casually that he fell going down the stairs and proceeds to list for me for the inadequacies of the hall lights motion sensor.

Not long after he asks me if I have any oxy’s. Oxycontin. No, I don’t. I gave you the Norco I got after my surgery.

He tells me how he enjoys the high of the oxycontin. I can appreciate that he wants to escape reality.

But the question is did he fall because of the lack of lighting or because he was shitfaced on oxycontin?

I started to feel sorry for him thinking maybe he is getting frail, he’s had a good ten months and maybe the chemo is just frying him. I thought about how guilty I will feel that I didn’t do more.

Then tonight I came home to the usual in my face confrontation about the deficiencies of my house and family.