December 14, 2020, this was the day everything began to change. This was the day my mom went to urgent care, due to a worsening cough, that no amount of steroids or inhalers were helping. My mother went to urgent care, where they performed a X-ray on her chest and found nodules on her lungs consistent with cancer. Urgent care helped her make an appointment with a pulmonologist (lung specialist doctor) to evaluate the staging and severity of the cancer diagnosis. The pulmonologist scheduled multiple test, positron emission tomography (PET) scans, computer tomography (CT) scans, and biopsies, before they scheduled her with the oncologist (physician specializing in cancer).
December 21, 2020, was the day of the PET scan. This is a scan that uses contrast that is then uptake by organs that are effected by the disease process. For my mother these results were very frightening. The PET scan showed that the cancer was in multiple organ systems through the body, the lungs, the heart, the lymph system, her spine, and her hips just to name a few places. With the amount of metastasis shown in the scan it was easy for the doctors to diagnosis this as stage four cancer.
December 28, 2020, was the first appointment with the oncologist. This is where we got the results of the PET scan in full. This was the day we were official told the cancer was stage 4 lung cancer. We were told there was no operation that could be done to remove the cancer because it has spread too far. We started to scratch our heads on what to do next. The doctors scheduled for a lung biopsy so they could identify the type of cell that caused the cancer.
January 2, 2021, this was the first trip to the ER for mom. She was extremely short of breath. She was having a really hard time breathing and getting to and from the bathroom in her own home. We took her to the ER where they found her oxygen saturation was 82%. They put her on 3 liter of oxygen with a nasal canula to increase her oxygen levels. They did do a chest X-ray to see if her lungs were full of fluid and found that the left lung was full of fluid that needed to be drained. They told her to follow up with her physician and sent her home.
January 5, 2021, was the day of the lung biopsy. I took my mother for this procedure and we arrived at 0730 in the morning for what was going to quickly become a long day of testing. The team got her into the pre-procedure room and stared getting her ready. Got her into a gown, started an IV and took labs, the doctor came in to talk with us about the procedure and the risk and benefits of having it done. She quickly got taken back to have the biopsy done and was brought back to the room we started in after about an hour. When she came back she was on oxygen and complaining of a lot of shortness of breath. The nurse called the physician that ordered the biopsy to inform him of the out comes and mom was quickly taken back to have the fluid drained off her lung, this is a procedure called a thoracentesis. After a few more hours I was able to take mom back home where she continued to have a lot of pain and shortness of breath.
January 6, 2021, Mom was suppose to go for a pulmonary function test (PFT) but was still having increased shortness of breath. I called that morning and canceled the test followed by calling right away to get her in to see the pulmonologist. We went in later that morning and got prescribed home oxygen due to mom’s inability to keep her pulse oximetry above 90 percent. The oxygen was suppose to be delivered that afternoon but ended up coming three days later after a lot of phone calls. But this oxygen was very helpful for my mom’s breathing and situation.
January 8, 2021, was the second visit with the oncologist for mom. This was the day we were told the biopsy results and found out that mom had Squamous cell carcinoma. This is a very aggressive form of lung cancer, as we were quickly about to learn. The physician decided to be aggressive in his treatment, but made sure we were all informed that this was terminal and these treatments were for palliative reasons. Immediately following the oncology appointment mom went right down to the radiology department to prep for her first radiology appointment coming up.
January 11, 2021, was mom’s first radiology appointment. This was a really quick appointment where they focused on the tumor that had grown on her spine and the multiple growths in her lungs. She went home after and was resting for the day. My sister stayed the night with her after this treatment to make sure she was doing alright.
January 12, 2021, mom woke up coughing more than usual and started coughing up pink-frothy sputum. We increased her oxygen from 2 liters to 3 liters to help keep her pulse oximetry level up. My sister called than nurse line to inform the oncologist of what was going on but we had an appointment the following day.
January 13, 2021, we went for a second radiology appointment and met with the physician afterwards. Mom’s cough had improved so no new imagine was ordered, we were just told to keep a close eye on these symptoms. We had radiation every day the rest of this week with no further issues.
January 17, 2021, mom was taken to the emergency department because she was coughing more and was requiring more oxygen at this time. She did not feel safe staying home and wanted to get checked out. They did another x-ray and CT of her chest and found she had a significant amount of fluid on her left lung. She got admitted this time and they were able to do another thoracentesis the following two days to drain the left lung before she came home.
January 20, 2021, the day after mom was discharged from the hospital we followed up with her oncologist who scheduled a respiratory assessment because mom was requiring more oxygen after discharging. Then she had her first round of chemotherapy. She handled it very well with no side effects.
February 7, 2021, mom was readmitted to the hospital for increased shortness of breath and anxiety. They had to increase her oxygen levels again. They did another chest CT during this admission and we found the cancer had now spread further in her left lung and to the right lung now.
February 9, 2021, mom decided to make herself a do not resuscitate (DNR) and a do not intubated (DNI). This was a long discussion we had with the hospital pulmonologist and my sister and I were involved before any of these decisions were made. Mom was discharged from the hospital a few days later and was feeling a lot better.
February 15, 2021, mom had her second chemotherapy appointment. Again she had no side effects and handled the chemotherapy very well.
February 18, 2021, I was staying with my mom and had woke up to make us breakfast, she was still asleep at the time but I knew she would be up soon. When she woke up something seemed very off. I quickly ran over to her and noticed that her left eye looked much different from her right eye. She was having left sided weakness as well and double vision. I quickly called my sister to get her to the house and called 911 because mom appeared to be having a stroke. Once we were at the hospital all of her scans came back negative for stroke, but she started having focal seizures and was quickly admitted again. During this admission they also found she had a large blood clot in her right leg. This was when the palliative team joined her care. They strongly urged her to get her affairs in order at this time because the inevitable was quickly coming.
February 22, 2021, mom was again discharged from the hospital and was much weaker this time and not doing as well. We started planning a final family trip at this time. My sister and I planned to take some time off work to be with our mom knowing she was getting worse.
February 25, 2021, we took a family trip to a near by lake town to spend time together. We had a taco night, we played a lot of family games, and most importantly we just spent time together for the weekend.
March 4, 2021, we added on an appointment with the oncologist because mom was having more increased shortness of breath and increased oxygen demands. The physician had her go for a CT of her chest again to see if there was any new tumor growth or more fluid around her lungs. We found out she had a Pulmonary Embolism (PE), better known as a blood clot in her lung. She was to be started on a home blood thinner to help dissolve the clot.
March 7, 2021, was the final admission to the hospital for mom. She was requiring more oxygen than we could provide at home for her. The scans they did during this day were significantly worse than they had ever been. Mom was so weak at this point she spent more time sleeping than anything.
March 8, 2021, the last time I had a full conversation with my mom. She asked me to bring her yogurt and then looked me in the eyes and asked to go home on hospice. I spoke with my sister about her request and she agreed and spoke with mom about her wishes. The family was on board for this transition in care. I spoke with the physician on her case that day and got everything set up for her to come home the following morning.
March 9, 2021, the final day. Mom was suppose to come home but her oxygen needs were too high to get her home, the hospice team did not thing she would make it through the ride home. We decided, as a family, to withdraw care in the hospital and make her comfortable there. We started the process around 2 in the afternoon but did not take the oxygen off until all of her siblings had a chance to go see her and say goodbye. By 8:20 pm she was going. My sister and I at her side when she took her final breath, exactly as she would want.
My mother lived a beautiful life that was shorter than expected but she touched so many lives during her short time here with us. She is a person so many will never forget. RIP to my beautiful mother, who I think about every single day.