The cancer is adenocarcinoma which is a non-small cell cancer.
Adenocarcinoma: About 40% of lung cancers are adenocarcinomas. These cancers start in early versions of the cells that would normally secrete substances such as mucus. This type of lung cancer occurs mainly in current or former smokers, but it is also the most common type of lung cancer seen in non-smokers. It is more common in women than in men, and it is more likely to occur in younger people than other types of lung cancer. Adenocarcinoma is usually found in outer parts of the lung. It tends to grow slower than other types of lung cancer, and is more likely to be found before it has spread outside of the lung. - American Cancer Society
Evidence of Divine Intervention
One of the things that became very clear to me, after the shock of learning that the cancer was now spreading to other organs was that God was in complete control of this situation. Here’s how. Ruth’s surgery was on New Year’s Day. About the 5th of January they were talking about finding a skilled nursing facility (SNF) to send Ruth so that she could start some rehabilitation to regain her strength. They were pretty confident, by this time that she was fine neurologically, although she wasn't talking much. She was much more aware and able to respond correctly to questions and to follow simple commands and that continued to improve. But back to my point. They started looking for a bed at a SNF about the 5th. There were no beds to be found for many reasons, flu outbreaks at some, other problems at others. Because Ruth was still in the acute care hospital they were continuing to monitor her for abdominal pain which at first was a urinary tract infection. Because the pain persisted after antibiotics they did a CT scan and Xrays and found the liver tumors. Guess what, if she had been discharged to a SNF they would probably not have seen them for much longer. They were also able to manage her pain which by now was considerable. That is now under control, thank God. In fact she has not complained of pain for days.
Last Week on the Road
During the week Ruth is really now beginning to look more like her beautiful self. She is still getting pureed food which she doesn't like so she is refusing to eat. We are having a really hard time getting her to eat even though I keep telling her that even if she is a candidate for chemotherapy she can’t take it in her current condition because she is much too weak. It’s not working and she is getting tired of me telling her that she should eat. When I start to tell her she screams “DON PLEASE”, meaning stop telling me the same thing over and over. Because she is so weak the physical therapy team can’t get her to do anything either. It is beginning to get troubling because we now have appointments for radiation therapy consult and radiation treatments and another oncology consult to talk about potential treatments including the possibility of chemo. This goes on all week. She is able to talk to some family members and friends by telephone and able to answer their questions and tell them that she loves them. She couldn't do that the prior week. The neurosurgery team is pleased with her progress and have removed the staples from the surgical wound so they have canceled her follow up appointment with them. As far as they are concerned she’s good to go now it’s time to really work on the cancer.
It’s now last Friday January 16th and still no beds at any of the hospital’s contracted SNFs, but the case manager is optimistic that today is the day. I tell him that I know that there is a reason that he hasn't been able to find a bed and remind him about the discovery of the liver tumors. He agrees that there must have been some reason things happened that way. It’s interesting how people who don’t want to believe in or admit to the supernatural will say that yes there must be a reason that didn't happen or yes I agree that it’s strange that there were no beds and during that time this or that happened. On the other hand several nurses in the department, who are Christian, knew what I was saying. Anyway I said look you haven’t found a bed in all this time how about on Monday we think about you getting me all the stuff I need and discharging her home. If I have all the proper stuff like maybe a hospital bed if needed, raised toilet seat, shower chair, wheelchair, and some physical therapy, between me and all our friends and neighbors we can get Ruth strong enough to start possible treatment. He agrees but he’s pretty sure he is going to find a bed that day. Well as it turns out the discharge planner takes off and goes home early so there is nobody there to facilitate a transfer even if he did find a bed. So Ruth is there all weekend. That’s God!
This week on the Road
It is now Monday January 19th, MLK Day. They do find a bed Monday mid-afternoon. It’s is near the hospital so I go and take a look and get a tour. The SNF is clean, no smell, nice equipment in the rehab center cordial staff. Ruth is ready to go. She wants to get out of that hospital and wants a change of scenery. She gets there after dinner but they find something for her to eat. She doesn't eat it but they did go to the trouble of finding something.
Tuesday, her first day at the SNF was pretty busy. Occupational Therapy and Physical Therapy came by to assess, her planning on getting started the next day, Wednesday. The medical director is on vacation but the replacement doctor, who is very nice and attentive, came by to see us. Ruth has a small ulcer on her bottom from being in bed so long but it is small and the doctor doesn't see a problem with it. However she does say that Ruth has a slight case of pneumonia and she was ordering IV antibiotics. She didn't see a problem but she would look at Ruth the next day to see if she could still keep her radiation therapy appointments on Thursday. Everything’s good. Ruth is even eating and they have changed her diet to a regular diet with no restrictions. When I say she’s eating we are still having to encourage her to eat and they are now giving her enriched drinks like Ensure. PT says that they worked with her a little and she still needed maximum support but she was coming along slowly.
Thursday Radiation Oncology
The plan was for me to come to the SNF pick Ruth up, take her to her two appointments and bring her back. In order to do this I had to transfer Ruth from a wheelchair to the car then from the car to the wheelchair both going and coming. The staff was going to work with me and give me some training before the first appointment. When we tried to get Ruth from the wheelchair to the car she was just too week to make the transfer so we decided to use non-emergency medical transportation to take us. That’s another expensive story for another time. I forgot to mention that when I came to meet Ruth before going to the appointment the doctor told me that morning Ruth had an elevated plus and shortness of breath but that she appeared fine at that time but if they became concerned about it at the appointment they may want to send her to the ER because after surgery and being in bed there is always the possibility of blood clotting in the lungs.
Keep in mind that this would be the first time that Ruth has been out of the bed for an extended period since New Year’s Eve. We went to the consult met two very nice radiation oncology doctors who explained that Ruth would have 5 radiation therapy treatments over 5 days with the first one to take place that afternoon. Ruth was just too tired to keep the second appointment so we rescheduled it for next week. We went back to the SNF and within an hour after eating some of her lunch and drinking all of her shake Ruth was sleep.
I thought I would sleep in today and go out to see Ruth this afternoon. I get a call about 9:30. It’s the doctor reminding me of the conversation about Ruth’s elevated pulse and shortness of breath from the day before. She was experiencing the same thing this morning. They decided that they should send her to the nearest emergency room just to make sure that she doesn't have blood clots. Well as God would have it she is sent back to the same hospital where she was before going to the SNF. That’s a good thing because I think it’s a great hospital with great people. When I get to the ER they are taking her for a scan of her lungs. After a bit the doctor comes in as says there are not blood clots, thank God, but she does have pneumonia and they need to get her started on antibiotics. But I thought that was what they were supposed to do at the SNF when the doctor ordered IV antibiotics. Then I remembered the doctor did order the antibiotics that morning at about 8 am. When I called back after coming home at 8 pm they had still not started the IV. The excuse was that Ruth has very small veins and the charge nurse couldn't get the IV started so they had to call a specialist in starting IVs and she hadn't come yet (sounds strange doesn't it?). It was after 9 pm when I learned that the IV was started.
That got me to thinking. Although the SNF was clean and the people nice it was obvious that they didn't have enough staff, and I wasn't real happy with the PT folk because I didn't think there were aggressive enough in encouraging Ruth to get up and work.
So we are ending this post in the same place we were when we started it. Remember what the case manager and I talked about last Friday"... how about on Monday we think about you getting me all the stuff I need and discharging her home. If I have all the proper stuff like maybe a hospital bed if needed, raised toilet seat, shower chair, wheelchair, and some physical therapy, between me and all our friends and neighbors we can get Ruth strong enough to start possible treatment. Perhaps this is what was really God's plan all along but we jumped the gun. Let's watch God work.
Proverbs 3:5-6 (NKJV) 5 Trust in the LORD with all your heart, And lean not on your own understanding;
6 In all your ways acknowledge Him, And He shall direct your paths.
Always remember to focus on God and not the circumstance or situation because:
• SOVEREIGN — He reigns over everyone and everything and has never been stressed out.
• UNSTOPPABLE and so are those who follow Him.
• HOLY— God is perfect, which means everything He wants/desires for my life is far greater than anything I could have thought of.
• CONSISTENT — I don’t have to worry about Him being in a bad mood.
• GREATER than any temptation the enemy throws my way.
• BETTER than anything the world has to offer.
• BIGGER than any sin or failure in my life.
• GRACIOUS — He knows every stupid, foolish, sinful thing I’ve ever done (or will do), and yet He loves me anyway!
• ALWAYS here with me — God has NEVER walked away from me. He doesn’t always deliver me from the fire, but He has ALWAYS walked with me through it!
• FAITHFUL — If I fail to see His faithfulness in my past, I will probably not recognize the fruitfulness of my future.
• THE ONE WHO PURSUES ME — He pursues me even on the days I tend to walk away from Him.
• RELENTLESS — He has NEVER given up on me!
• PASSIONATE — His passion and zeal that the scriptures reveal cause me to be in AWE