Friday, January 30, 2009

*update* still alive

Hi guys,

I’m super way behind on this update. So, first things first... David’s alive! and, the good news is that he’s slowly starting to feel better.  We’re still not sure about his long term prognosis, but right now I’m just happy he’s started to eat again, and I heard him swear in French this morning, so that’s always a good sign (and funny).

 So, I’m sure there’s still a bit of uncertainty about what exactly is wrong with David, some of you may of heard a partial update – I’ll try to explain it, although I’m not sure I totally understand it myself. Although David presented with symptoms that matched both leukemia and lymphoma, bone and lymph node biopsies came back negative and doctors are fairly certain David has a very rare and serious blood disorder call hypereosinophilic syndrome (about 100 reported cases).




Trying hard to smile.
 A bit of info of hypreosinophilic syndrome, if you are interested. Basically the doctors think that there has been a translocation of one or more of David's chromosomes (13/14 and/or 14/15). This translocation is thought to have occurred randomly, without known source. In David's body this translocation is causing white blood cells to multiply out of control in his bone marrow. I understand that white blood cells usually help fight infection in the body but in David's case this proliferation of cells is attacking his immune system, affecting his lymph nodes, liver, spleen, blood and bones. The doctors are working closely with the Cancer Agency to map David's genes and are performing an array of molecular tests (FISH tests?) to try to gain more info. We don't expect to have any new news for some time, and are hoping that the somewhat experimental drug regime the doctors have started may help David feel better, but only time will tell. Again, we’d like to stress how impressed and confident we are with the medical team at VGH.  
 
Want out. But settled for 20 minutes outside.

Right now David needs to work on putting a bit of weight back on, he’s lost a bunch since he got here. He figures his crash diet entitles him to a free trip to Mexico based on a bet I had with him that he couldn’t lose 10 pounds... After what we’ve been though, I figure he should take me to Mexico, but whatever. I think we’d both be happy if he was allowed to leave the hospital.

If you’d like to visit, bring it on. If possible, give us a call first – 604-875-5400 ext.  60636 which is direct to David. If you can’t call, forgot to call, hate the phone. Just stop by. If it’s not a good time, we’ll just send you away. Don’t worry, it’s not because we don’t like you.

And, also, thanks to EVERYONE that has provided support, food, accomodation, smiles, hugs, emails, all that good stuff. Would be a hell of a lot harder to get through this without you guys.

Lots of love,
Cindy and David

Thursday, January 22, 2009

*update* the mess

Hi guys,

I understand that you've all heard the news about David. We'd like to provide you with an update and maybe answer some of what I expect are frequently asked questions. Before I get started, please understand that we still do not know what exactly is wrong, but we do have complete confidence in the medical team and we know that they are doing everything they can to figure things out.

Ok, here's a bit of what David's gone through so far. I'll start at the beginning. David's repeated the story about 30 times to every doctor and nurse that's come by, so I should be able to recount some of the 'highlights' for you guys.

In the first week of January David became very fatigued and started to complain of stomach cramps. Figured he had the stomach flu and we didn't think too much of it. I figured I could cure him with lots of soup. By Friday (the 9th) David's stomach cramps were worse and he was even more tired. You guys all know he's a good sleeper, but this was extreme, even for David. Went to a medical walk in clinic on Friday night, had blood tests on Monday and Tuesday recieved news from the doctor that his white blood cell count was extremely elevated and the doctor suspected lukemia. David was told to go home, wait for the Victoria Cancer Agency to call and arrange further tests. In the meantime David got progressively worse. More tired, painful cramps, and he pretty much stopped eating and drinking anything. Friday night he was extremely weak and in a lot of pain so I took him to Emergency in Nanaimo. They found him a bed immediately and did some more blood tests. The test results came back as an unusal type of white blood cells. The doctor admitted him to hospital and found him a 'closet' down the hall from emergency to spend the night - which we really appreciated - small but quiet. She also immediately contacted specialists at VGH and it was decided pretty quickly that he would be transferred to the VGH. We arrived in Vancouver on Saturday night by ambulance and David was admitted to the Lukemia and Bone Marrow Transplant ward. He was in rough shape when we got here, in a lot of pain and had to answer a lot of questions. It was an extremely rough night. 

After that things become more of a blur for me. Everything has happened very quickly, been very confusing, and with my limited level of sleep these days I have a hard time recounting exactly what happened when. The doctors have been gathering a lot of information so that they can formulate a diagnosis. David's symptoms when we got toVGH were extreme fatigue, intense pain in his abdomen, sweating and very swollen lymph nodes in his groin and neck. To try and get a better handle on things, the doctors have done a CT scan of his torso, a bone marrow biopsy, a biopsy of his neck lymph nodes, an echocardiogram, an EKG, an ultrasound of his adbomen, a chest x-ray, and taken countless blood samples. If I dropped him on the Downtown Eastside, he'd fit right in. We've seen oncologists, kidney dudes, surgeons, therapists, socail workers - you name it.

Besides the symptoms he came in with, David's run into a few complications in the hospital. Most notable - he's puffed up like a blowfish due to the fluids they've pumped into him. This fuild is getting 'stuck' in his legs, maybe because of his swollen lymph nodes. The fluid has led to small blood clots in his legs which we were told are not a huge issue, but he's now on drugs to prevent more. There's also fluid between his lungs and whatever the surrounds the lungs, which they attempted to drain yesterday. Unfortunatley the drain was inserted 'incorrectly' and David was in A LOT of pain - late last night they had to yank it back out.He's feeling better with it out and this morning said "it feels like I've been hitten by two truck". As far as medications - I'm not really sure what they've got David hopped up on. He's on super strong pain meds and antibiotics and a spectrum of other stuff that I don't really understand. He's also started to receive blood transfusions and a bit of oxygen to keep his lung function up.

I know all this is a lot to take in. Although it's been a messy couple of days david's been amazingly strong through everything. Although we're both terrified we're coping, laughing when we can.

View from the 15th floor. The fog finally lifts.

A few more answers to frequently asked questions:

Internet:
Yes, we have internet in the hospital room. If you'd like to email David or I, please do. We usually read emails together every night and appreciate a laugh or kind word.

Cindy:
I'm staying with David 24 hours right now. This is where I need to be. I do still have clean underwear (I hear Lana was concerned). I'm very tired and trying to remember to eat. There's a fridge and microwave here so I'm stocking up with leftovers and soups that people are bringing me. I'm slightly confused but hanging on.

Minou (our cat):
Safe and sound with my parents. The little bastard has nicely adapted to his intierm owners. He should count his lucky stars he was one of the things we remembered to grab when leaving Nanaimo. The fish unfortunately were not as lucky.

The house:
Will be okay, we've got someone checking on it.

Visitors:
We'd love to see you all. We know you'd love to see David. Right now we'd appreciate it if you could hold off a bit longer. When David's ready we'll let you know and we'll start slow. David gets tired really quickly and there's still lots going on.

Phone calls:
A few people have the number to David's room. We welcome calls throughout the day, but not 20 calls a day.


Saturday, January 17, 2009

the first 24 hours

I remember leaving home, the decision made in a hearbeat. No turning back. A rush, mad. Quickly before the emotion of leaving was able to enter our hearts. I told David to put his shoes on, he hesitated, sitting perched on the second to last stair, looked up and whispered, "What if I never see this place again?" "You will" was my strong answer. "Let’s go, we need to go now." From the car we waved goodbye to Mins, our cat in the window, and David whispered "I don’t want to leave."

Ten minutes later I had located a hospital I had never seen before, in a town I was just starting to accept as my own. I dropped David at emergency. "Go in and sit down. I’ll just be a minute." I blindly pulled my car into the emergency parking, parked effortlessly in the first empty stall, got out, glanced at the Staff Only sign, cursed under my breath for not paying more attention, got back in, reparked, and analysed whether I should pay for parking for pay or risk a ticket. I stood for a moment in the middle of the parking lot trying to decide. My gaze shifting between my car, the emergency room door, my car, and back again. Shivering slightly and wishing I had brought a warmer sweater, a jacket maybe. My parking ticket decision was made for me as I located, in the distance, the parking ticket guy making his way down the line. Great, I thought, now he’s going to think I saw him, he’ll make his way to my car while I’m at the machine and I’ll have to try and fight my way out of a ticket. I don’t need this right now. I rushed to the machine, tried desperately to will it into accepting my card, thanked it when it did and half walked, half ran back to the car to place the ticket on the dash. I made it there before ticket guy, and diligently display my ticket face up. He took no notice of my presence. I made a mental note to re-pay for parking if we were still here in two hours and headed back towards the hospital wondering why it was necessary to make people try to decipher parking machines in the midst of an emergency.

When I entered emergency David was sitting slumped over in the last of a row of shopping cart style interlocking blue emergency wheelchairs, only just inside the door. "It’s busy", I said trying to find a seat and opting instead to stand awkwardly in the hallway across from the entry. The sliding emergency doors opened and closed and opened and closed as David sat blankly. A woman toting a clipboard took his name and proceeded to walk through the crowded waiting room asking if there was anyone else that was not on her list. I immediately doubted that we would be seen by anyone soon. It felt like we’d just put our name on a list for a table for dinner in an overcrowded restaurant – by the time they call you’re so tired of waiting that you’re not even sure if you are going to enjoy eating dinner anymore. I imagined waiting for hours wondering when someone would remember us. 'Cindy and David? Table for two? Right this way please.' I saw a nurse glance up from the admitting desk and lay her eyes on David. "You’re not well", she said. "No", he whispered. She told him to come and sit down at the admitting cubical, and started asking questions. "What is your address? Do you have a care card? Why are you here?" I was standing beside David, my hand on his shoulder when he whispered his response: "I might have leukemia." "We’ll find you a bed", she said. And with her response I felt a weight larger than life lift from around me.

David was whisked immediately through a second set of sliding doors and into a maze of nurses, doctors, patients and medical equipment. I retreated to my earlier post and continued to stand, even more awkwardly now against the wall, under a TV that was set to repeat meaningless news indefinitely. Every time the sliding doors opened I craned my neck to try and catch a glimpse of David. He had disappeared. And so I waited. I had no idea at the time, that this would be the first of a seemingly endless series of waiting sessions.

After David was admitted a young male RN emerged from behind the oh-so-secret sliding doors and told me I could wait with David. It wasn’t standard, but considering, he would make an exception. Considering… great I thought we’re a special case. But deep down inside, I already knew that. My intense desire to catch a glimpse of David, to sit near him, to see him, to watch him, overshadowed any thought of the circumstance we had entered.

When I saw him, he was curled into a fetal position, insignificant on an undersized hospital stretcher. He smiled weakly, sweat was careening down his face. Any effort to speak was too much to consider. I held his hand. I don’t remember crying. Hours passed and folks were wheeled in and out. The RN’s were busy. It was Friday night. They drew blood, they took a chest x-ray. We waited for a doctor to see David and hypothesized that the chest x-ray must be for lung cancer, which lead to us agonize over the possibility of such a result. I retrieved a bag of groceries from the car that I had forgotten to unload earlier. Updated my parking and continued to wait. David’s pain level skyrocketed since he had now missed a dose of Robaxacet or Tylenol or whatever he was taking to calm the pain at home. I munched on baby cookies and Gatorade that I had purchased earlier in hopes that David would be able to stomach one or the other. They would have only joined the unopened packages of cookies, granola bars, cerals, puddings, and soups that I had tried to get him to eat over the past week.

I tried to read, but I wasn’t really reading anyway. We watched a family across from us with a teenager. The on-call doctor was called in and the boy, healthy until recently, was admitted. Diabetes maybe. He was moved out of the emergency room and upstairs to a ward. That quickly – one minute your life is normal, hopelessly boring if you’re lucky, and the next you’re in the hospital.

Three hours after we walked through the emergency doors, David saw a doctor and two minutes after that David had his first experience with IV medication. Morphine. Direct injection. I saw it move through his body replacing pain with relief and comfort. He commented with a giggle that it was the best high he’d had in a long time. He could talk again.

I left in search for a payphone promising to be back momentarily. I wandered in a daze through the halls of the hospital hitting dead end after dead end, and not wanting to stray too far. An RN asked me if he could help me. "Pay phone?" I squeaked out. "Oh, no, not around here – everyone’s got cell phones these days." "Oh." I replied. "Here come with me, use this one." "Thanks, oh no, I can’t, it’s long distance." "Yeah, you can. Don’t worry about it." "Oh, ok, thanks. There’s no one I can call here. Thanks." I pulled a crumpled piece of paper from the front pocket of my jeans, uncurled the warm edges and smoothed in out on the counter by the phone. It took me three tries to dial the entire number correctly. "Mom? Is that you? Mom, we’re at the hospital. It’s not good. David got too sick I had to take him. Yes, we’re in emergency. In Nanaimo. I don’t know what they’re going to do. We might be here all night. No, he’s not going home. I might go home, I don’t know. It might be late. Don’t leave the cabin now, stay there. There’s nothing you can do. Try to call me later. Ok. It’ll be ok. I’ll be ok."

On the way back through the emergency room I caught the RN’s eye and told him, "Thanks for the phone. It meant a lot." "No worries" he replied, and meant it. "They’re doing amazing things these days with leukemia." Word of David’s case had spread quickly. "I wish you the best." "Oh, um, thanks." Leukemia. Right.

Still making my way back to David I passed the nurses station and overheard our young doctor on the phone speaking with someone about a high white blood count and Vancouver General Hospital. I did everything I could to keep walking, to accept not being able to hear every word, even though I wanted to. I returned to a much calmer David, stretched out on his back in a semi-seated position. "They’re talking about you on the phone. I hear them say Vancouver. If they give us a choice between Vancouver and Victoria, we have to ask for Vancouver. We have friends, family. I’ll have somewhere to stay. There’s no one in Victoria."

A few minutes (an eternity?) later the doctor from the phone, Dr. Cooper approached David. She pulled the curtain around the bed to give a semblance of privacy and leaned on the siderail of the bed bending over to be as close to eye contact with David as possible. She was upfront. Direct. "We’re not sure what you have. It’s very likely a lymphoma, possibly similar to Hodgkins. It’s rare, I’ve only seen it in textbooks. I don’t have the expertise to explain it in detail. You had blood tests at a clinic on Monday, is that correct?" "Yes." David replied. I squeezed David’s hand. He squeezed harder in return. "The white blood count was elevated." "Yes.", he said, "They think it could be leukemia." "Yes", she sighed, "the counts have doubled. This is progressing quickly. I paged the Victoria cancer agency and no one returned my call. It’s Friday evening. They might be gone for the weekend. I paged Vancouver as well. A hematologist" (a what? I thought) "called me back immediately. There’s no time to wait. They’re going to find you a bed. It might be in a few days. They’re hoping for tomorrow." "Ok", I said. "It’s ok, Vancouver is good. We have family there." "You’ll need the support" she said. "Vancouver has the best facility to treat you. It’s Friday night. I spoke with the specialist within minutes. It’s the best place. We’re going to move you out of emergency, maybe upstairs if we can find you a bed for tonight. It’s late already, you need as much rest as you can get."

David was wheeled out almost immediately and into a dark room, packed full of other patients. I could only stand at the foot of the bed. I was forced to go home. David made me promise to be careful on the road and the hill near our house. The night was icy cold and the air was crisp enough to take your breathe away for just a moment when you stepped outside. The last of the most recent snowfall was crunchy underfoot, clinging to road edges and shadowy nooks. Making the nights just a bit sparkly around the edges.

I walked outside into a world coated in a thick layer of sparkling crystals, like overdue ice cream left in the freezer for too long. A thick fog held itself precariously close to the surface threatening to engulf me in a wet blanket of greyness. I navigated my car down the hill sliding slightly into the driveway. I was home. And it was shockingly empty. I made kraft dinner, watched tv, paced, checked the phone messages. And slumped into the desk chair with defeat. I can’t even check messages on the best of days, but somehow I managed to and retrieve two messages from the my parents at the cabin and one from my sister. She and Don would be on the first ferry in the morning, I should call if I didn’t want them to come. I didn’t call.

I slept, I think, but not in our room. The sick odour emanating from David was still clinging to the sheets. When I had walked in earlier after an afternoon of shopping for random things we really didn’t need, trying to distract myself from the boy in the bed that refused to eat drink or walk for days I knew we needed to leave. That we were dealing with something that soup and tea and Gatorade just couldn’t fix. He was at the hospital. It was the right decision. Right? Wasn’t it? He wasn’t my responsibility anymore. My relief overshadowed by the fear of what may lie ahead. I was up and out by 8 wondering if I should wait for Tammy and Don or if I should go to the hospital. I taped to the door a sign: 'At hospital'.

The morning was crisp and the frost thick. I lost control of the car on our hill and slid headlong down the road on a picture perfect winter morning. My heatbeat crept up into my throat, threatening to pound out of my neck. I stopped dead in the middle of the road, slightly askew from the sliding action. Told myself to not be such an idiot. Of course it’s icy. And proceeded at a steady crawl down the remainder of the hill. Onto Westwood, over the overpass, left at the green H sign and back into the emergency parking. Ticket face up. Check.

I retraced my steps back though emergency and to the coat closet I had last seen David in. When I asked the closet nurse if he was still there she looked at me blankly. "G-A-U-M-O-N-T hypen G-U-A-Y." I spelled it and repeated "Gaumont-Guay". Thinking to myself come on people it’s not like I’m looking for John Doe here. She clued in. "Upstairs. He was taken upstairs last night." "Oh, where, how do I get there?" "4th floor, elevators around the corner." "Oh, ok, Thanks." I retreated from emergency like a ghost, invisible in the madness.

At the nurses station on the fourth floor I inquired as to David’s whereabouts. There was a bit of confusion over whether I could see him or not. But in I went. "Wash your hands please first." Ok. Fine. Washed. He was sharing a room with an older man. He seemed relieved when he saw me told me they moved him in the night. "Yeah, I know. I had to find you, I’m not supposed to be in here. Tammy and Don are coming." "What? Why?" "It’s ok" I said. "We need them. There going to be here soon. I’m going to go see if they’re here yet."

I walked with purpose and intention back through the hospital and out again through emergency, looking to my left as I exited. Tammy and Don were there, about 200 meters away. Walking towards me. Their faces were long, and I realized suddenly how much David meant to them. How much he meant to me. Even though I tried not to, I thought of Spence, Don’s friend. He had leukemia and passed away a few years ago. I gave them both a hug because it seemed like the right thing to do and blurted out that it was cancer and it was everywhere in his body. "It's in his lymph nodes and his blood. They’re going to take him to Vancouver. There’s nothing they can do for him here except give him pain medication." I wasn’t sure what else to say. We were all quiet. In shock maybe, our heads trying to decipher these foreign words, definitely.


A fog.

Tuesday, January 13, 2009

the sky falls

As so, it turns out that it takes much less than an instant for your life to change. On an unremarkable afternoon in January, with nothing more than a glance, our world suddenly stopped. Like someone had reached out from under the covers and hit the pause button. Cars and trucks halted on the street, pedestrians frozen mid-stride, the birds, so constantly chattering, silenced in anticipation of what was about to happen. "…Leukemia", David said, his head already buried in my shoulder. "They think it’s leukemia..." And then, not more than a heartbeat later our friendly someone hits fast forward, and suddenly without warning our world collapsed around us. Buildings imploded into heaps of brick and drywall. And the sky, once so blue and full of hope hit the ground with such force that it shattered into a billion little pieces. In response to the impact, a cloud of shimmering sky-house-dust rose from the ground billowing upward and suspended momentarily before settling back down to earth. We held each other for what seemed an eternity, trapped in shock and wondering if we too had been reduced to dust. We slowly pulled ourselves apart and looked around to survey the damage. A vast wasteland or rubble and crystallized sky dust lay around us, the sky, now void of blue, seemed lower, touchable and saturated with greyness, cast deep shadows on the heaps of rubble. It would be some time before the sun dared to shine on us again. Terrified, we staggered to our car, still parked where we had left it only minutes ago. Inside, in it’s familiar sameness I started to cry. "Let’s go home" I said. As I drove out of the parking lot, I glanced in my rearview mirror and couldn’t believe what I saw. People, dusting themselves off, heading towards the rubble, picking up pieces carefully and starting to reassemble – our life - piece by piece. And so, that’s how our new life began. With the help of people we’d never met, friends we hardly knew and a family so much stronger than I could have ever imagined.

Sunday, September 14, 2008

borderline imaginary

the air is calm
the light bright blue white
cystal clear
among the lost and wandering souls
silence
we are all
borderline imaginary

Sunday, June 15, 2008

words about nothing, from a time when everything was ordinary

I sit down quickly, like I've stolen something and am attemping to hide. The ferry is full, I'm happy to have a seat. There's a man one row ahead of me. He glances at me, holding his gaze for just a moment beyond my comfort level and then turns back to his wife. I open my book, spread out my bag onto the seat beside me and officially claim this spot. It's not stolen, it's mine. I fumble a bit to make my ipod play as I silently curse it's popularity, slighly regretful to have bought into the commercialism of it all. I watch people pass. A thin man munching on cheesies. Two girls, young maybe 15, uncomfotable in their own skin, trying to appear older than they should. A man with a handlebar moustache the ends curled precisely into a curious grin. The man in front of me leans over and kisses his wife. I'm not even close to impressed, my seat too close, I am trapped helplessly in their moment. Which, in my opinion lasts too long. Beyond a moment, barreling towards being uneccessarily annoying. I stare at the ground for a long time and then focus my gaze on the passing scenery. My mind wanders. I have to pee, I might lose my seat. I make a made dash to the bathroom. In my rush, I of course, end up in the stall with no toilet paper. I curse under my breath, pull my pants up enough to shuffle and make a quick decision to exit my stall in hope to enter the next. My execution is flawless. Disaster averted. I return to my seat, my book and bag appear unscathed. I sit back down and try to ignore the guy in front of me. I have M+M's. The peanut ones. I open them and pour out a handful. 5 orange, two blue and a brown. I eat them too fast. The bag quickly empty. Out of the corner of my eye I see an elderly lady dressed in white. White everything, except for a pair of rediculous blue sunglasses. It's not sunny. I start to choke, but recover quickly, no one notices. There is nothing unique about my life. I glance down at the sleeve of my overpriced ski jacket disappointed to notice for the first time a small hole wearing though the cuff. Nothing lasts anymore.