Update / Opiated, 2017/12/24–26

in wheelie

Last Friday evening, after discharge from hospital that morning; Nitza snapped me sitting on the chair of the wheelie-walker my community nurse brought me from Byron Hospital, on the gravel drive leading from our home to J&O&E&A’s, for a family get-together & dinner (which was truly wonderful, I felt so blessed).

Opiated now, a second whole week,
& now that my oncologist (thankfully!) has found
the opiates & the doses that are working for me
(5mg of slow-release Targin am & pm,
& 2ml of 5ml/1ml Ordine for immediate relief when I need it,
on top of 2 tabs of Paracetamol Osteo three times daily),
& which (although they also make me more woozy
than high, & severely constipate me) help me now to make tolerable
the incessant strong pains in my right flank,
enough for me to still want to get up thru the pains
(sharpest while rising from lying down to sitting),
& to take my morning meds, to pull off thick socks & pyjamas
& put on shirt & pants,
& open my doors to the day.

& I’m feeling it’s the opiates
that will determine much
of the colors of my remaining days & nights.
& I opine that I’ve entered what may be my life’s final phase:
the opiated phase.

&, opiated, so much now also starts taking on rich new colors for me:
my own will to still be here & in consciousness,
my awareness of the constant & sustaining love & caring
of my dear life-partner Nitza, & of the always-there-for-me love & caring
of my sons, daughters-in-law, children & grandchildren,
as I give in to my new dependencies:
I never wanted to be a burden on anyone,
but I’m happy they want to be there for me,
& am learning to accept the truth that Nitza expressed yesterday:
‘You’re more a hero when you give up on being a hero.”
*
In hospital this week I was happy to learn from a whole-body bone scan
that these pains, in & around the right side of my waist,
sharp & incessant for several weeks now,
(which my GP thought might be from some metastasis
of the cancer discovered some 8 months ago in my upper right lung)
are not cancer-related: they’re from a fracture & degenerations & stenosis
in the lower spine & vertebrae.

The scan shows the cancer is spreading but not widely,
& not quickly metastatising, & isn’t the cause of these pains.
& it feels good to know this, like maybe more time left to live…
But, my GP does attribute to it my almost total loss of appetite,
my inability to keep most foods down, the bad taste in my mouth,
my significant weight loss (about 10 kg down from my 68 in May).

But it’s probably the opiates that are causing the loss of balance,
which makes me need to use a wheelie-walker to get around
where there aren’t walls or other props to lean on,
& that are causing the shakes, mainly in my left arm, & in my fingers,
which respond so erratically when I type (you wouldn’t believe
how many corrections in each line you read here!)
(but will & patience mostly get it right in the end.)

& with all this going on, I can’t move around much,
so my overall shortness of breath
from my extensive emphysema & COPD
(I have about 20% of my lung function left)
is now hardly ever a problem. Seated is my most frequent
& most comfortable position. Opiated & seated.
Happier still after a few vapes of mild bush herb
from my trusty Volcano (seems opiates don’t give you much of a high
when they’re working on pains), & I like & need that buzz
(& know that without it I couldn’t or wouldn’t have written any of this),
& with good music streaming into my ears.

Had another happy moment last week & wrote home from the hospital:
“Happy morning! First shits after about a week!
Last evening a nurse gave me a magic formula the nurses here use,
& at 5am I had to go! & it came out in a painless gush.
[a wonderful surprise, the happiest part of this particular episode
(I add now), because the last twice this fortnight
the breakthroughs had been so so painful!]
& again a couple of hours later
– & now again, had to stop writing this to get to the loo in time…
& I feel I’ll maybe need to go a few more times today. Anyway, it’s great relief.
I went to thank the nurse but her shift was over.
but another nurse gave me the formula, I copy it here so we have it on record:
20 ml Lactulose / 10 ml Agarol / 3-10 drops Ducolax.”
(But since that day, nada. At home now, & no formula till tomorrow
when the pharmacy opens after Boxing Day. But I had one good fart
& immediately shared the good news with Nitza. She laughed, & said
she remembered Yoram Kaniuk in one of his last writes celebrating a good fart,
& I happily remembered Yoram, & the time 50 years ago in Ramat Gan
when I translated his novel Rockinghorse for Harper & Row,
& in the next flash remembered learning, some 20 years earlier in Melbourne,
from the narrator of one of Robert Graves’ Claudiuses,
the importance of not repressing a fart.) 

*
Eight months ago, after the cancer diagnosis
& the oncologist’s prognosis
of 6–12 more months of life if I don’t do chemotherapy
& maybe 2 years if I do, I did a few hours of good meditation
(with guidelines from a dear friend),
& I chose to live what remains of my life
without the anxieties & recurring appointments,
scans, constant engagements with my condition,
& without the fears of possible toxic side-effects
a course of chemo would probably entail.
I chose, as my GP summed it up nicely,
“quality of life over quantity of life.” It was she, too,
who described the relatively symptom-free period I experienced
until the side pains started as a “plateau”.
& now it seems I’ve started rolling downhill.
Or maybe I’ve just hit another plateau, who can know? An opiated plateau.

My oncologist now recommends I start some “mild” chemotherapy,
which he says I can always pull out of
without irreversible toxic side-effects
& which I can continue for as long as it works for me, if it works for me,
& if it doesn’t I can then maybe try a course of immunotherapy,
which may be risky because it might trigger one of my 2 auto-immune disorders
(psoriasis, which hospitalized me three years ago
when it flared up all over my body,
but has since been well-controlled through a high weekly dose
of the immune-depressant methotextrate) & might also enhance the other (polymyalgia rheumatica, when all your muscles ache,
especially when you use them, but that one’s been actively painful
for  some months now). & it mightn’t trigger them,
he says we can’t know unless we try, & it mighn’t come to that,
the mild chemo might work. He says he has helped many people with his methods.
I want to trust him. I look into his eyes as he speaks, & see sincerity,
real caring, & confidence, the things I know I want to see & need to see.
I can never know for sure, he may be a very good actor. Yet I feel to trust him,
& to give it a shot. I have an appointment with him a few days from now,
& will give him my decision then. Opiated, like now.

I’m writing this opiated update
for those few friends who have recently asked me how I’m doing;
& for other friends who might want to know;
& mostly for myself, to record my thoughts & feelings
at this maybe final juncture of my life;
& for maybe others whom maybe I don’t know
& who maybe don’t know me, but who may find some interest or value
in the expressed thoughts & feelings
of someone in a situation like mine now & here.
& I’m hoping I’ll be able to follow it up with yet more
such updates further along the line…
& I’m writing it in lines & strophes of verse,
because that’s how it comes best to me.
Is it poetry? Maybe, maybe not. I don’t think it matters.

& yesterday evening I had the sharpest pain yet
in this phase, getting up from an afternoon nap
after lying on my bed facing the doors open outwards
instead of my usual position facing indoors
& the pain was like an anguished 9 out of 10
& lasted like an hour. But it too subsided,
after a dose of Ordine. & later, when I told Nitza,
she said “When you get such pain,
think of the pain women go through giving birth”.
& that’s another good thing to remember.

with wheelie

As I started wheelie-walking up the drive, Nitza called me to turn around, & snapped me again.

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7 thoughts on “Update / Opiated, 2017/12/24–26

  1. Hi Richard, Haven’t seen you for some time, but your blog/facebook successfully enables your friends, including me to stay in touch. (Have not called in as have chosen not to risk being a burden to you and Nitza). have always read your writings enthusiastically and they are there forever. I am in awe of the way you are managing the whole process you are going through, without fear, always the observer. If I don’t get to see you, I remember very warmly the many conversations we had together, your mother’s writings, your philosophical insights will always be with me. I will write to Nitza separately and offer her friendship and support if she wants it.

    Much love

    Jenny

    On Tue, Dec 26, 2017 at 8:34 PM, dikflantz76+… wrote:

    > dikf posted: ” Opiated now, a second whole week, & now that my oncologist > (thankfully!) has found the opiates & the doses that are working for me > (5mg of slow-release Targin am & pm, & 2ml of 5ml/1ml Ordine for immediate > relief when I need it, on top o” >

    Like

    • Thanks for everything you’ve written in this response Jenny! I dearly value your friendship, & am hoping that soon my condition will stabilize enough for me to again enjoy a visit from you.

      Like

  2. Hey there Dick,
    THank you for writing all this down and and sharing it with us. Uri brought it to my attention and I’m glad he did. Pam and I are thinking of you and are feeling great sympathy for what you are enduring. It hurts me to know of your condition but I’d be even more upset if I was denied knowing. Whatever you decide about the chemo, we know it will be for the best. Yes, quality is preferable to quantity, but right now it doesn’t sound like quality. After that bout of pain you describe, there was no doubt relief, but at least after child birth, there is the delight of seeing the new life that you have brought forth.
    Warm wishes,
    David

    Like

    • Thanks so much for these warm & wise words, dear David. It does my spirit good to receive them, & to feel you & Pam are feeling for me.
      & you’re right on both points: what I’ve been going thru since these pains began is certainly not quality — & after the more excruciating moments there is never the delight of new life, only the relative relief of a less excruciating pain. & since these pains aren’t cancer related, & the scan shows the cancer isn’t growing quickly, the chemo question is irrelevant, & trying it would be only an additional anxiety-ridden hassle. I’ll see if the doctors can find some way to treat the spinal condition, & if they can’t then I’ll look for a way to end it all as painlessly as possible. & I’ll keep updating for as long as I can. The latest “news” is that although yesterday I did an entire day without opiates, & got stoned on cannabis, by night-time it was pretty bad, & this morning I just had to give in & take a dose of ordine, & a few hours later another one… & now it’s just bearable again. So – we’ll see how it all goes… — & please pass my thanks to Uri for letting you know…

      Like

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