April 4, 2014

eternal vigilence

     It did not begin with a phone call but instead a text.  I glanced down at my phone which is never more than a step away from me.  It's been that way for at least four years now.  I read the text from my mom, roll my head and mumble quietly, "Ahhhhhhh, shit!"  I did not need this.  My son had been off one of his medications and was just getting back to some level of stability and now this.  But I remind myself that though I don't like my role, neither does anyone else.  My dad didn't want cancer.  My mom didn't want to always being worrying about his health.  And neither one wanted to "bother" me knowing full well the fury that would be unleashed if they didn't bother me.
     My mom was texting me that my dad had been running a fever.  While not a Luddite, I am skeptical of a lot of gadgets because they just don't work well (the home electronic blood pressure cuffs are absolute crap, especially the wrist ones).  Give me an old mercury thermometer and I'll tell you with both great precision and accuracy the actual temperature.  I told my mom to wait 15 minutes.  Measure it three times on my dad.  Then measure it three times on her for comparison.  Get back to me.  His temperature was consistently about 2.5 to 3 degrees higher than hers.  I call them and start the rapid fire questions that I can now do in my sleep thanks to my training, "nausea, vomiting, diarrhea, muscle aches, congestion, blah, blah, blah."  In the background I hear my dad state loudly only half joking, "I'm not going," meaning the ER.  Well, now this requires a house call.
     I drive over to my parents and perform a quick exam on my dad.  "I don't see any signs of a URI (upper respiratory infection) or anything going on with your lungs.  But you are definitely DEHYDRATED big time."  He had also slept 18 of the last 24 hours which was more than unusual for him.  I show my mom how to tell that he is dehydrated and she proves to be a quick study. 
     Back and forth we go.  It was clear that none of us want to have to go down to MD Anderson's ER.  My dad just celebrated his two year old birthday from the stem cell transplant.  He's still feeling elated about reaching that milestone.  Now that gets destroyed by a little on-again off-again fever?  I'm known for being blunt sometimes and this is one of those times.  I tell my dad, "look, you and I both know that this is probably some virus that will just run its course, you'll sleep it off, and you'll be fine.  But there are a long list of things that are unique to you that can kill you.  I have neither the emotional energy nor the patience to go over that list.  Unless you want me waking you up every hour to check vitals on you, you're going to the ER.  And I ain't taking vitals every hour tonight."
     My dad listened to reason and decided that he did need to go.  He was not being unreasonable.  He was just so disappointed.  He wondered aloud, "is the rest of my life going to be like this?  Everytime I get some bug that causes a fever I have to go to the ER?  No matter how long it's been from the SCT?  You wouldn't go to the ER for the same symptoms."  He knew the answer before I even said it.  It's the price of living with cancer.  And I don't care what kind of cancer you have.  You'll notice that reputable cancer hospitals NEVER use the word "cure".  They use the word survivor.  Because they know that there is always the chance it will come back.  Or, a different cancer altogether as a result of all the mutations that the chemotherapy and/or radiation caused. 
     The price of liberty is eternal vigilance.  Nowhere is that more true than in a cancer survivor.  Every cough, every sneeze, every new backache must be analyzed through the lenses of "is it coming back?"  You and I take these things for granted because they will not kill us.  But not the survivor.  No, they must be eternally vigilant.

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