The Hardest Part

I saw my oncologist today. The news was as expected. Zytiga didn't help, and he has nothing more to offer me that I'm willing to accept. My cancer is growing at an increasing rate, and no medication can slow it down now. Since Zytiga didn't work, that means that symptoms should begin for me in the next few months. His original estimate was that I'd start to experience symptoms within six months after treatment stops working. Treatment stopped working in June, which means we're talking Christmas at the latest.

Before you say he could be wrong, remember that he could be wrong either way. So far, he's only been wrong on the optimistic side.

While we expected this news, it's different when you hear your doctor say it out loud. But that wasn't the hardest part of my appointment today. Not even close.

I asked my oncologist when I should start with Hospice. He thinks I should talk to them right away. Not that I'll need them this month or next, but it will help them get to know us and our needs. If I need treatment again - radiation for bone pain, for instance - I can exit Hospice and go back to their office for that. He will refer me to Denver Hospice, and set up a consultation next week. They'll interview my wife and me, and based on that interview, we'll decide whether to go ahead with Hospice now or wait.

But talking about entering hospice care was not the hardest part. It was related to it, though.

My wife went with me today. We knew this was a key consultation and we both needed to be there for it. We were first called in by an assistant who has taken my blood many times. A very sweet lady named Leara. We have become friendly since I started being treated there in January of 2016. She took my blood pressure and got me logged into the system. We talked about our plans for the weekend. When we talked, I had no idea I'd be saying goodbye to her when we left. Now we're getting to the hard part.

After she left the office, the doctor came in. The startling thing he said to me, the thing I wasn't prepared for, was that once I go into hospice care, I won't go to his office for care anymore, unless I opt out of hospice for some reason. The Lupron and Xgeva shots I got today were the last ones I'll get. It started to dawn on me that I was losing my team.

Then my nurse Melanie came in. There were hugs all around, and jokes about how this was her last chance to see my cute little butt. That's how she describes it, anyway. She gave me my last Lupron shot and Xgeva shot. I was actually sad that I won't be getting shots from her anymore. "No more pokies" is the way she put it. I said, "But I like your pokies!" She's the best poker in the business, bar none.

Getting my shots wasn't anywhere near the hardest part. It was the easiest part. But I had started to become very sad. Not because I'm on my way out, but because I knew I had to say goodbye to these people I love so much. I had to say goodbye to my team. I'm still close to tears about that now.

I didn't have to say goodbye to Melanie, thank God. We will continue to be friends, and she will continue to check on me right till the end. I'll have a nurse provided by Hospice, but that person won't be my Melanie. I am so blessed to have her in my life.

Anyone who has read this blog for a while knows how much I love my team. I've said it over and over. I love going there, and I love those people. And it tears me up to think I won't be going back there for blood draws and tests, for consultations and shots. They're not my team anymore. I've lost my team.

While I am very thankful that Melanie will still be involved with us even in hospice care, I knew I had to say my goodbyes to the medical and office staff who have been so kind to me. I was glad that Leara was there when we approached the front desk. I told her that, when we had talked earlier, I didn't know I'd be saying goodbye to her today. She came around in front and we embraced. I asked to see Nikki, another who has taken my blood for tests multiple times. I've mentioned her before in this blog. As with my doctor and nurse, I thanked both Nikki and Leara for their kindness, and for taking such good care of me.

I spoke with Anne and LaShay, who work behind the front desk. They have both been very kind and helpful to me as well. LaShay is relatively new, and it took her a while to realize just how famous I am in that office. But she was soon calling me by name when I came in, and helped me tremendously to get an appointment at University Hospital to discuss clinical trials. I will miss both of these ladies very much.

Then there was Cindy. She works in the office, and helped me straighten out an issue when I was there last Friday for my PSA test. While I was at the front desk and she was trying to help me last Friday, an elderly gentleman walked up and greeted Cindy. He had been there for his annual test. Apparently that test had come out well for years, and he was going back home still cancer-free. He told Cindy that the next time she was in his area, she should stop in and see him and his wife. She agreed and said she would call him.

As he walked away, I told her how much I loved that exchange. It was typical of the treatment I've received there, and of the culture they have. She told me a story of her interview for the position she now holds. She was told they wanted to hire her, but it depended on her answer to one question. Cindy became a little nervous, not knowing what kind of question it would be. Then she was asked, "How do you feel about treating patients like they're your family members?" She knew she was in the right place.

As Cindy and I embraced today and I said my goodbyes, that story came alive to me. That's exactly how they treat their patients. Melanie may be the most personal example for me, but all of them there, from the oncologists to all of the staff, treat patients like family. They become friends with their patients. They do this knowing that many of the relationships and attachments they form will cost them. They form connections only to lose them. That's why these people are angels. If you live in the Denver area and have cancer, I can't recommend Cypress Hematology and Oncology in Porter Hospital enough. They will treat you like family.

I was told over and over that I can come back and visit anytime I want to. And I will. But it won't be the same. Each time they see me, I'll be worse. I won't be able to spend much time because they'll be so busy with patients they're treating. And soon I won't be able to go in at all.

Sharon and I left, and I was in tears all the way home. Cancer isn't the hardest part. Treatment isn't the hardest part. Dying isn't the hardest part. Saying goodbye is, by far. Saying goodbye to the ones who have cared for me and kept me alive these last twenty months. I'm sure Hospice will send new angels that I will also love, but I'll still miss my team terribly. Saying goodbye to them today was the hardest part of all. #waroncancer #bearingwitness