Chemo….Ever heard of Mucositis?

May/June 2013
The goal of traditional chemotherapy is to destroy cancer cells, which are cells that divide rapidly.
But as the chemo wipes out fast-growing cancer cells, they also can damage fast-growing healthy cells. Which is why chemo patients lose their hair.
Due to this, chemotherapy can also damage the cells that line mucous membranes throughout the body, including those inside the mouth, throat and stomach. This can lead to mouth sores, diarrhea or other issues with the digestive system.
This can be very serious and extremely painful. Every part of the body has a job. When the mucous membrane isn’t able to do it’s job of letting the right things in and keeping the dangerous things out, the results can be scary.

I’d pretty much decided by the time he was 24 years old that Cory was a cat. He had 9 lives. He was a walking version of the show, “Survivor”.
He’d survived a major fall from a cliff.
He’d survived a 6 week trip from Ohio to Arizona alone on a Schwinn bicycle that he picked up from a garage sale with $125 in his pocket, a tent and a backpack.
He’d survived a motorcycle accident.
He’d survived Bone Cancer with a grapefruit sized tumor on his arm.

I pretty much expected more of the same this time around.

The first day I truly thought about his mortality was during one of his chemo admissions. The chemo had indeed attacked the lining of his stomach, his mouth, and his esophagus. He was in unbelievable pain, could barely open his mouth and was ingesting Chloraseptic instead of meals because it was too painful to eat or drink.
It was blisters and open sores covering the mouth, through the throat, down the esophagus. Like a burn patient on the skin, but all over the mucous membrane. And the vomiting didn’t help.

Seeing him in pain tore me up. Like any parent, witnessing your child in pain feels worse sometimes than if you were experiencing it yourself, but this was reaching a whole new level.
And the helplessness was awful.

I wished and wished it were me laying in that bed. I would’ve truly taken his place in an instant. I had that thought a million times.

I was on the foot of his bed talking to him. The back of his bed was elevated at an incline and he was talking about how he didn’t feel very good and felt nauseous. It was the normal, daily conversation that week. Then, I’d respond with some question in a feeble attempt to help—when did they last give you nausea meds? do you need the sick pan? do you need to push your button? do you want a squirt(Cloraseptic)? do you want to lay back? do you need to sleep? …..

(“Push your button” was referring to the self-regulated pain medication that he could push the button when he needed it. Of course, there was a maximum dose and time in between, but it basically kept someone from having to be given pain medication when then didn’t really need it. Everyone decided that Cory had an extremely high pain tolerance…when other peoples numbers would be a 9 on the pain scale in the same circumstance, his would be a 7. So this little machine was perfect for him, who might not need exactly what the doctors might think he needed for pain in particular circumstances.)

Anyway, I was asking him something when suddenly he leaned forward with the familiar “Im about to get sick” look. I instinctively went to grab the “sick pan” on his side table and before I could even grab it, he heaved, and blood was everywhere. I held the pan under his face while pushing the nurse button on his bed furiously. The blood kept coming! It seemed like there weren’t any heaves, just gushing. No one was answering the call button! Suddenly, he couldn’t breathe. His eyes were huge and filled with terror, his mouth agape, no noise, no coughing and he started throwing his body all over the place with his arms flailing– I threw my arms around his waist as he started to throw himself off the bed still attached to all his lines that led to the Pole… I screamed Help!Help!Help! at the top of my lungs like it was one huge fluid word. I hear from the hallway, “Someone’s yelling for help!!”and the door was open and 4 nurses came in one after the other. Then I saw the terror in their eyes as they saw the scene.  One said, “Hold him!” to me….I was trying. He was so tall and strong and trying to survive this moment with all his might. One grabbed the suction tube and shoved it in his mouth. “Cory, don’t bite!” one said. He opened it enough that she fed it quckly down his throat. Thank God he started coughing and gasping for air. Thank God, Thank God, Thank God. I felt as if He had heard the prayer I didn’t have time to pray. At the same moment, Cory’s whole body fell limp in my arms, as if he had sprinted a marathon. I looked up to see many had joined us in this smallish room. My mind tried to grasp what just happened. As I scanned the room, it looked like a tornado came thru.

About that tornado….it arrived.

Oxygen mask was on. His mucositis had been bleeding into his stomach. He had aspirated on his own blood.

The doctor was of Indian descent, I didn’t recognize him. He was literally scratching his chin with furrowed eyebrows looking directly at Cory, who’s eyes were closed in exhaustion. Cory didn’t truly meet the standards of admission to the PICU, but the doctor finally said, “I think we will send him to the PICU. We are not equipped here and PICU has a full time Respiratory Therapist and all the equipment needed. He still has blood in his lungs and so he can stay there until it’s cleared because it’s a real risk for infection.” (Practice Run: ICU)  It disarmed me that day, when the doctor had an obvious look of not knowing what to do at first. I got used to it.

That was the day I knew we could lose him in an instant.

Cory spent a week in the PICU and drove the nurses crazy because he was so active. Active and on a lot of loopy medication. They are used to patients whose organs are compromised, often on ventilators and often fully sedated. Cory took 2 hour showers hooked up to his pole, had auditory hallucinations, “Mom, do you hear that? The lady with the dog back there…” as he pointed behind his bed. I stopped correcting him because he would have this exasperated look on his face when I would say, “There’s no lady or dog, Cor.” And he would say , “Listen!!” with big eyes looking at me like I was crazy.  He was constantly up and down to the bathroom, and none too stable on his feet. The nurses looked concerned for his safety from himself on a regular basis. His O2 numbers warranted an oxygen mask and the rattling in his lungs from the blood he had aspirated was present about 5 days, then they sprung him from the PICU.

He had recuperated from his 5th brush with death.

One uncontrollable event, one uncontrollable infection, or one uncontrollable reaction was all it would take. Uncontrollable was the key word. Life lesson of the day.

This was a picture Cory took on his bicycle trip. The caption he wrote says: “I found this right before dusk, where I had to find a camping spot.” He set up his tent anyway.  We often talked about how, without his knowing it, his bicycle journey mentally prepared him for his cancer journey. This seemed an appropriate warning for the cougar he encountered this night–“STOP! STAY CALM!…..If cougar approaches, throw objects &speak loudly!….If cougar attacks–Fight Back!”  There were more cougars to come, and he never stopped fighting back.

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