Chapter 2 - 1995 to 2009 - before she died

©2010 Tom Weathers

These are posts from the Blind Cat blog written in the weeks before Brenda died. I was beginning to get disorganized, lose track. Things were happening faster. Brenda was getting worse.

Because these posts were written while Brenda was still alive I have left first-person references, even when they are awkward. I have also adopted the convention of showing in italics words written she was alive. This might also be confusing.

(The story at the end titled "Smoking Aside" was written today. I think it is maybe a little funny - or not.)

COPD Chronology

It runs together.

It really started before we moved to Mt. Holly on the last day of December, 1995. Taking the 1 1/2 mile walk from our house to the Dairy Queen I made a joke of placing my hand on Brenda's back and pushing her up the long hill on Graham. But she seemed to need the help. I think Yancie went with us sometimes, and maybe Frank, and maybe Randy too after he and Yancie got together. I carried a bo staff to ward off villains. We drank coffee at the Dairy Queen with friends and listened to Buster make BOOM! noises when he showed up. We hardly ever walked back; somebody gave us a ride. Those were pretty good times.

Emphysema was mentioned for the first time in Oct of 98 when, after she had a nasty bout of bronchitis, I managed to get Brenda to the emergency room at Gaston Memorial. The young doctor said matter-of-factly, "You've got touch of emphysema."

Six months later in April 99 another (or a continuation of the same) bout of bronchitis put her in Carolinas Medical for almost a week. This time the diagnosis was full-blown emphysema. But after getting out she continued to commute 38 miles back to Shelby where she worked in the office of the NC Dept of Transportation.

Sometime in 2002 she was put on oxygen - with a concentrator at home and in her office and small portable tanks for the car.

She still smoked. After getting back from Charlotte Medical she managed to quit for a month and was able to walk to the end of the drive to get the paper. But something at work or at home bothered her so she started back. She managed to quit for good in July 09. But she never did feel better - maybe because by that time the lung cancer had already started to develop.

(I think this happened just before the April 99 episode. She was driving home from work when Big Guy, the old Toyota Land Cruiser that she loves, broke down outside of Shelby. It was on 74 going up the hill from Buffalo Creek. She called me on a cell phone. I found her sitting in the car, with the cold that was turning into bronchitis. It was bleak and dark and chilly. I managed to get Big Guy started and asked her to drive on to Gastonia so we could leave the vehicle at the Toyota dealer and not on the side of the road. She was miserable by the time we got to Mt. Holly. I suppose she would have ended up the hospital regardless but I always felt bad about making her drive.)

She has had a couple of pulmonary doctors - the first in Gastonia and the second one in Charlotte. She likes the Charlotte doctor OK but not the one in Gastonia. I thought he was all right but she said he treated her like an old person.

She switched to the Charlotte doctor in January 04, not long after retiring from the DOT. (She got the Long Leaf Pine award for her 40 plus years of service.) Things went gradually down hill in the years since and on Nov 10, 09 we went to see our family doctor because of the growths that had appeared on her body. They turned out to be metastatic tumors coming from lung cancer.

Little Oxygen Tanks

She went on oxygen in 2002 - concentrators for the house and office and portable tanks for the car and for getting out.

We first used the little tanks that you fill yourself from an outside liquid oxygen supply that the O2 people - Lincare - periodically topped off. But that didn't work because the fittings would freeze up. (I remember going out in the rain in the dark in the winter filling up a tank before she went to work and being shrouded in steam coming from poorly connected fittings.) We switched to the small tanks that you carry around.

She has always hated the portable tanks because they are so heavy. In the beginning, half the time, she wouldn't even bother to carry one. Seeing other people in Wal Mart with their various styles of tanks - apparently not having any trouble, she wondered how they managed to get the good stuff.

We have gone through a variety of shoulder bags and back packs trying to find the ideal carrier. I always told her she tried to carry too much other stuff but she shrugged that off. All the bags had a tendency to slide down and cut her arm with the strap when she leaned over - for instance to get something from a lower shelf.

Over the years, we gradually increased the O2 setting - on the house concentrator and on the regulator on the little tanks. We started out at 2 and are now at 5. At 5 (4 actually because our old regulator doesn't work at at 5 and she can't breath in strong enough to trigger puffs in the new regulator) a tank lasts about an hour. So when we go out (which we haven't done lately) she carries one tank and I carry two spares in the good shoulder bag that I got for her from some semi-fancy luggage shop (Sharon Luggage - I remember now).

Cancer Diagnosis Chronology

The first growth appeared on her inner thigh - late last summer (09) I think. It was cone shaped like a large wen. I told her she needed to go to the doctor but she didn't want to. This is a game we often play. I'll say "You ought..." or "You should...." She will say "Yes, but..." and ignore me. I feel that I have tried. She feels, I don't know. Often these injunctions have to do with going to doctors.

Later two more growths appeared - one each on her chest and stomach. They all got bigger. Finally the growth on her thigh started to itch and get uncomfortable. And another one started on her back.

Around the first of Nov 09 I made an appointment with Dr Beatty - the family doc. Ostensibly this for him to look at my knee (which has been causing problems) but really it was to ask about Brenda. I made an appointment for her to see him on Nov 10th. (Aside: A year and a half later it was determined that my knee pain was – or would be – caused by multiple myeloma, my own cancer. We carry the seeds of our own destruction.)

He did an office xray and told us he saw a mass in her chest. He said he thought the growths and the mass were related. Brenda asked if it could be cancer. He said yes.

Here is what happened next...

CT scan of trunk Nov 13. Showed expanded lymph nodes, masses in chest. Likely to be lung cancer.

Tuesday Nov 17th saw Dr. Coggins, pulmonary doctor. He confirmed possible lung cancer. Mentioned masses, lymph nodes. Said he thought the growths were metastatic tumors.

Wednesday Nov 18th Dr. Stephanidis, a pleasantly quirky fellow of middle eastern descent removed the abdomen tumor for a biopsy. He took it off in his office with me sitting to one side. The tissue was sort of pale and seemed to have roots. There wasn't a lot bleeding. When I said that it didn't seem as involved as the removal of one of my skin cancers he said something like "You expected more excitement." Brenda didn't experience any pain. Although she is hell to get someplace once there she is a trooper. After it was over we went by Einstein bagels where we sat in the car and ate lunch.

Tues or Wed (Nov 24 or 25th) Dr. Coggins called with the results of the biopsy. Confirmed that it was cancer. I don't remember if it was this call or the next that he offered "weeks rather than months" prognosis. But I think it was this call. I also think this is when he told us that he wanted to bring in Hospice.

(Throughout all this there was a gradual taking away of hope as the diagnosis became less and less problematic and more and more confirmed. Initially there was some possibility that it was a very bad infection. Yancie wondered if it could be caused by exposure to cat litter boxes. Brenda said she didn't know what to think, how to feel. The only time we cried was after we were both on the phone talking to Coggins and he told us the prognosis. I remember we were in her bedroom and the sun was shining through the double window and she came around from the other side of the bed and we hugged and cried which we never do.)

PET scan and CT scan of head on Thursday 27 - day after Thanksgiving. It was awful getting ready. I'll write more about this, Hospice, and other things in subsequent posts.

Saturday Nov 28 Hospice showed up.

PET Scan

Brenda has had an x ray, two CT scans and a PET scan. Wonders of science. The PET scan actually involves positrons - antimatter electrons. Tumors are said to light up like a Christmas tree.

Getting ready for all these scans was bad - Brenda hates getting ready for anything. But getting ready for the PET scan was the worst. Maybe she dreaded it more. Maybe her condition was that much worse. But it was important because it would tell the doctors if the cancer had spread into the bones and would help guide palliative radiation. So I adopted my usual drill sergeant role nagging this poor sick moaning woman through the various stages of cleaning up, putting on clothes and drinking two 11 oz bottles of water before leaving at 11:30 AM.

Yancie was able to go with us for the first CT scan but couldn't today because she had to stay home with her two kids. Allie who is seven could have come but not Evan, who is 21 months.

Throughout, Brenda had ongoing "panic attacks" (they are really episodes of oxygen starvation - I'll write about that in another post). At Coggins’ suggestion I gave her two .25 mg Zanax tablets. Up until the very last when I managed to get her dressed I wasn't sure we would do it. At one point she was sitting on the commode trying to put on clothes and at the same time drink a bottle of water for the prep. But at 11:30 I rolled her in the wheel chair to the front door then had her hold onto something while I got the wheel chair to the sidewalk then helped her down the steps and rolled her to the car. In the car we discovered that the new regulator for the portable O2 tank wasn't working properly and I had to switch back to the old regulator.

We got there a little late but nobody seemed to care. The Morehead Imaging Center is a nice new place. The male PET technician was very pleasant and capable. He injected the substance that lights up the tumors in response to the radiation then left Brenda in a little room with a TV to wait 1 1/2 hours while the imaging substance percolated through her system. Still under the influence of the two Zanax (and swaddled in heated blankets) she slept the entire time. I used the guest computers in the resource center to email Yancie then came back in with some free coffee and watched a gruesome episode of Criminal Minds.

She spent 20 minutes in the PET scan machine, advancing a foot or so every three minutes. It was longer and tighter and more scary than I had anticipated but the two Zanax continued to work. It also helped that I could stay beside her and hold her hands (which were extended behind her over her head). She asked me to tell her a story and I tried to recount the highlights of my new novel. It sounded pretty stupid.

After the PET scan we went across the building for a CT head scan. The young female tech seemed capable but not as nice as the other person.

After it was all over she waited in the lobby in her wheelchair while I got the car then we went again to Einstein's to sit in the car and eat a late lunch. This wasn't as pleasant as the visit after the biopsy. She felt worse and we didn't stay long.

Smoking Asides

I always criticized Brenda’s smoking (although before quitting in in 1987 I blew smoke indiscriminately - shrouding newborn Yancie in second hand smoke and once bending over to kiss Lyn Blanton on the cheek poked her with a still smoldering butt).

Brenda set fire to the carpet. She was sitting on the edge of her bed flicking ashes into the tray on the nearby bookshelf. Her oxygen tube lay at her feet; I had managed to get her to take the cannula out of her nose when she smoked. However there was still an oxygen rich atmosphere near the floor.

I don’t remember if she yelled or I just walked in and saw the blazing carpet. In any event either she or I got the fire out easily enough. However a scorched area of melted man-made fibers remained until I had the carpet replaced last summer – six months after she died.

She pretended to be blasé about the whole thing – as if I was making a fuss about nothing. She was wonderfully dignified - would rather be dead than foolish (and got her wish).

Allie always wanted to see the floor that Maw Maw burned, pulling away the little rug Brenda placed over the spot, then looking up with wonder and respect at the woman on the bed who was so like her –the quiet woman who intimidated everybody – who could get by with such stuff.