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Recently I had to accompany my mother to the emergency room at her oncologist's request. She hadn't had a normal bowel movement in months and was so backed up she began vomiting her meals. The specialists found an obstruction in her colon and, similar to what is done in a patient with a coronary blockage, they placed a stent. My mother was in the hospital for 8 days. After discharge, she was able to relieve herself for two days. Then she was constipated all over again, despite hourly enemas and laxatives!

And so it was another trip to the hospital. Her colon has ruptured, they said. It is a surgical emergency. And so the surgeons open up her belly and remove the stent. They don't touch the cancer that caused the obstruction since it's too risky given her weakened condition, and they create a diverting colostomy. In essence, my mother's feces now drains through a hole in her stomach. She will probably be in the hospital recovering for a week. She said after the procedure that she feels "a thousand times better." Thank God for morphine, I wanted to say, but why kill her buzz? A steady stream of loved ones extend their sympathy and kindness. My aunt wants to visit and asks about my mother's prognosis. How will she fare in the forthcoming days/weeks/months?

I told my aunt that it’s hard to predict based on her particular condition. A 60-year-old who is otherwise healthy and undergoes a similar procedure (diverting colostomy) for say polyps or diverticulitis can have decades. A 70-year-old woman with stage 4 cancer who has had cancer for 21 years and has been weakened by the last 5 years of chemotherapy, you just hope for her to survive the procedure (which she  did) and to get out of the hospital alive. Any more is icing on the cake. That may seem pessimistic.  

An optimist would hope for years of living a somewhat normal life - with a bag. Some surgeons say they may be able to go in later and reattach the colon – that is when they get around to removing the cancerous portion which is still in her. A realist would call all this optimistic and deem months of relatively pain-free living a comforting and hopefully comfortable closure to a long and fulfilling life.

The thing in this modern age is with new treatments we are extending the lives of people with cancer more than ever, bringing out new faces in the disease and entering uncharted territory. A woman with my mom’s particular cancer (of the breast) and location of metastases  (to lung, bone, now colon) under the same chemotherapy regimen who has had her procedures (chemo, radiation, lumpectomy, lymph node removal, several pleural fluid drainages, now abdominal surgery) is one in several billion. A population of one. In the poetic sense, she is a snowflake that way.

But the poet in me remembers that all snowflakes must return to the snow, and for me it is less about prolonging my mom's life (which also may prolong her pain) and more about easing her transition to the other side. The step we all must take, into the great beyond. It's easy to talk the talk, that All is One whose nature is Love. Living this truth, that we are beyond birth and death, and our essence is immortal, is where it gets interesting. But isn't that the point of life, to put your money where your mouth is, to walk the walk? It’s a hard-line stance but someone must do it! I just try to be gentle and tender as can be.


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