It's all a matter of perspective

This will have to be very quick because Steve is coming over soon to help me move one of mom's chairs, but I was on Facebook earlier and Christine told me I really should update the blog -- a suggestion with which I completely agree -- before too much longer.

The problem is all of the stuff I need to update everyone on. I guess I'll try to hit the highlights (and yes, there were highlights) from Friday.

First of all, I made it to Halifax without incident and once I got there I managed to find Brad without (much) trouble. I heard him wrong and told the cabbie the wrong turn off, but mercifully for me it was just one exit early off the Bedford highway and it really didn't add any time to the trip. We talked about a lot of stuff that I may get back to later, but for now I'll skip ahead to when I left the office and went to meet mom at Dr. Rendon's office.

Mom, her brother Greg, his wife Zita and mom's friend Janet were all there by the time I arrived and we got in pretty much right away. I think I sat for maybe two minutes there before they were calling us in, which is kind of what I expected since I arrived pretty much exactly at the minute her appointment was scheduled. He was obviously tied up with other stuff, though, because we sat there for nearly fourty minutes in his office before he got in to see us.

Nice guy, didn't rush us at all. Scary young, though. He gave me the impression of knowing his stuff and we know another renal specialist who was taught by him, so I'm comfortable that he's not as young as he looks, but he's got a total baby-face. I wouldn't be surprised if he still gets second looks when he goes into a bar and orders a beer. The poor guy was also dying from a cold, so he didn't shake hands or anything and used his hand sanitizer probably a half-dozen times while we were talking to him.

Okay, off to the facts of the appointment.

He briefly examined mom and asked for a fair bit of her personal history then reviewed the reports he had in front of him. One report was missing, the bone scan, I think, and he sent out for it too but he looked at the raw data while he was waiting.

He didn't have any real revelations for us about the cancer. He's very confident that the kidney is the primary site. Yes it has spread to her lymph nodes along the aorta and there are tumors on both lungs. He didn't think it was anywhere else, though, and he didn't think that there were problems with her other kidney (more on that later, if I forget, someone remind me, please). He said he had no idea how long she'd had it but he was very confident she didn't have it in 2006 when she was in to see the doctor in Charlottetown, (Reed, I think?) so it's probably less than three years old but he didn't know if it was three years less a day or six months or what.

Janet asked a few specific questions about what he thought, she'd done her homework, and he gave us pretty much the answers we expected (see above). He'd also said that since mom had an appointment with Dr. Kahn (that's the spelling I heard him use, so I think that's probably it, I probably got it wrong before) on August 11th, he wanted to have a talk with Dr. Kahn after that to discuss the appropriate ordering of treatment. That is, do they start with surgery, then do chemo or do they do chemo first, then surgery, then most likely more chemo. Dr. Rendon was saying that right now he felt that chemo then surgery was the right approach, but he also ordered a biopsy of the tumor on her kidney right away so we'll see if that changes the plan at all.

I had three questions after that. The first was a softball: Monica told us she thought the tumor on the kidney might also be attached to the bowel. He said that it was possible but looking at the data he had he didn't think it was likely. That would vastly simplify any surgery that is required.

My two real questions were the analytical part of my mind taking over. If he's proposing chemo-surgery-chemo as the strategy, what makes us decide to do that first transition. Obviously if chemo isn't being effective, we don't want to do surgery since it's not likely to improve Mom's quality of life. If chemo is being effective, though, we'd have to take her off it before we do surgery, so that's not a good idea either. I only got partway through my question before he realized where I was going with it and he gave me pretty much the only answer I would've accepted at this point.

The chemo they're likely going to use has only been on the market for 2-3 years at this point so they don't have set procedures for using it yet. He said I was posing a really hard question and that they really would need to just play it by ear and see how well she responds. The goal is to reduce the size of the tumor on her kidney before surgery but if it's going to go away he doesn't want to cut at all. So points for Dr. Rendon, I liked his answer, even though he didn't have anything to say that really made me feel good.

Anyway, the second one was about her appetite. If you didn't spend a few whole days with her you cannot believe how little the woman is eating right now. Tea, half a slice of toast and maybe half an orange has become a "not bad" day for her eating. So I really want to see her get more food into her. He gave her a prescription for some steroids (type later) which we filled today, which I guess has had some pretty awesome results with other cancer patients.

Mom asked the big question, of course: how long. He put as many qualifiers in there as he thought he could (again, no surprise) but he felt that we might be looking at two years for her now. It's funny, because three weeks ago if I'd been told that there was a chance my mom might live as much as another two years I'd've been destroyed. But that was three weeks ago. Now I'm told we might have two more years with her and ... well, I can't say I'm relieved but I can say that I was in better spirits on the ride home from Halifax than I've been in for a very long time.

Okay, gotta run, more later.