Sunday, February 21, 2010

A mother and cancer - Part 2: "Cancer's Gift"

My parent's gravesite - a black marble bench for us kids to sit on when we come and visit. (Photo by Lon Horwedel)

The decision to go ahead with cancer treatments was probably tougher and more painful for my mother than the treatments themselves. After all, by going through with it, she was going back on her word. She always vowed she would “eat a gun” before she would put herself through that hell. But there she was, last week at the Cleveland Clinic, being fit for a modern-day, but really more medieval, stabilization mask to help keep her perfectly still while the doctors radiate the tumor in her throat - five times a week, 38 times in all.

Of course, the 24-hour-a-day chemo drip she’ll have to endure the first five days won’t be a picnic either.  Everywhere my mother goes that first week in the hospital, she’ll have an IV pole as a dance partner, slowly poisoning her body one drip at a time until every rapidly dividing cell in her body, good or bad, is painfully extinguished. Despite all that, she knows the first week will be her best - the radiation won’t start to really do its damage until much later, and the chemo most likely won’t have her begging for mercy until the middle of the second week.

That first week she’ll still have her hair, she’ll still have an appetite, and she’ll still have her teeth. Later in the treatments, the chemo will claim her hair and her desire to eat, and the radiation probably will cost her some teeth. If her throat swells too much from the treatments she also may need a tracheotomy and a feeding tube - that’s if she’s lucky enough not to die before any of the side effects kick in.

So, why do it? Certainly none of us kids, or my father, wants to see her suffer, but we don’t want her to die either. In the end, it didn’t really matter what we thought, this was her decision, and hers alone. What probably tipped the scale was knowing that if she did nothing, she wasn’t going to die peacefully in her sleep six months down the road. She knew, and the doctor’s affirmed, that by doing nothing, her last six months would be a slow and painful trip to her demise until she either choked to death on her tongue or died from starvation.

Whatever route my mother took one thing was for sure - it was going to suck. So, in a world of suck, she decided to take a route that at least gave her a chance for survival, knowing, of course, that even if she does survive, the cancer someday will return and kill her.

But cancer, with all its power to take away life one malignant cell at a time, also gave me a gift. After 10 years of watching my mother battle this horrific disease, as well as seeing my aunt, my best friend, and countless others perish at its doorstep, I can honestly say it no longer strikes fear into my soul. I’ve become numb to the word “cancer.” It carries no meaning for me anymore. At this point it’s nothing more than my zodiac sign. Cancer takes away so much that it’s hard to see any good it can do. But this squamous cell carcinoma, the same cancer that will eventually kill my mother, also gave me something in return.

It’s given me a decade of not taking anything for granted, of treating each day with my mother still on this planet as a true gift. It lets me fully enjoy our phone conversations and it helps me relive my wonderful childhood every time I return home for a visit. We all knew the day would come – it will come for us all – but my mom’s cancer has shortened her time line and made everyone in our family soak in each moment more fully and with a much greater perspective.

As gruesome as it may sound, cancer has given us the chance to prepare for the moment, even my parents, who recently bought a plot in our hometown cemetery  - a beautiful black marble bench with all our names engraved in the stone. My mom wanted us to be comfortable if, and when, we ever came to see her grave -so much so, she gave us a place to sit.

Cancer also has given us a chance to do things with my mom we might not have done otherwise. My sister took my mom to Italy a few years ago to fulfill one of her lifelong dreams. My brothers make it a point to come by the house as much as possible, and my wife and I did what little we could do by giving my mother three grandchildren she could teach to swear and pass on a lifetime of dirty jokes.

In the next six weeks I’ll be making frequent trips to Ohio to help out my mother as much as possible. In that time, I’ll see her health steadily decline as she fights to keep up her strength, and even though I’m not overly religious (spiritual for sure, but not overly religious) I will pray.

I will pray for a lot of things, but mostly I'll pray my mom will stay strong and keep up the fight, because as nice as it is, neither I, nor my siblings, nor my father, want to sit on that bench at Riverside Cemetery any time too soon.

Friday, February 12, 2010

A mother and cancer - Part 1: "The shoe has dropped"

Mom sleeping on the couch with dad, circa 1982. (photo by Lon Horwedel)

The first shoe dropped 10-years ago when my mother was diagnosed with cancer (squamous cell carcinoma) in her throat. She was only 53 at the time, but already she'd lived about 14-years longer than she thought she would.

My mother did everything early - by choice - because she figured she’d be dead before she turned 40, just like her mother who died from ovarian cancer at the age of 39.

My mom was only 13 when that happened, but really she was more like 30. She had to be. For two years she watched in horror as radioactive rods were thrust vaginally into my grandmother’s body as a last ditch effort to kill the cancer. It didn’t work, and witnessing her poor mother having her “insides burned out” before she died, left my mother with a minefield of emotional scars that never really healed.

While my grandmother was slowly dying, it was my mother who did all the cooking and cleaning for her family - way too much to lump onto the shoulders of a young girl trying to come to grips with mortality. And when my grandfather remarried shortly after my grandmother’s death, it put my mother over the edge. She wanted out, and she found her out by getting married at a young age – real young, 16.

My grandfather, of course, didn’t approve of my mother’s plans, so she crossed the Ohio border with my dad and got married in Michigan where it was legal to wed at such a young age without parental consent. But when she returned to Ohio, she was stung again, this time by her school, who expelled her for being married - not pregnant, just married. The school didn't want her "influencing" other girls in her class, so my mom, the smartest person I ever met, never graduated from high school, and that left behind even more scars that never really healed.

When she was 17, she had her first kid - my sister Dina - and by the time she was 23, she had three more. I can’t imagine having one kid at that age, let alone four, but I never thought about any of that back then. Back then I only knew it was cool having the youngest mom come and visit my school on parent’s day. While other kid’s parents looked old to me, my mom always looked young and pretty. It made me so happy I wore it like a badge of honor.

Unfortunately, the Tour de Kids took its toll on my mother’s reproductive organs. Five years after my youngest brother was born; she had most of her ovaries removed as well as a hysterectomy. At that point, two things were certain, at 28, she was done having kids, and if she did die before she was 40, it wouldn’t be from ovarian cancer. Again, more scars, but at least these scars would heal.

Through it all, my mom (still a child herself) raised me, my brothers, and my sister, on heavy doses of The Beatles, The Stones, Led Zeppelin, The Moody Blues and The Who. She introduced us to rock operas like Tommy, Hair, and Jesus Christ Superstar. My dad was guilty too, often looking like he and Peter Fonda had just walked off the set of Easy Rider with his long sideburns and a denim jacket that had a giant marijuana patch sewn on the back above the words Do yourself a favor! To me, my parents had it all figured out, they knew all the answers, they were, dare I say it ... cool! But now I realize they were just growing up too - right along with her kids.

When my youngest brother flew the nest and the house was finally empty, my mother was barely 40. She’d outlived her mother ... and her prophecy. The years that followed wouldn't be so kind. Her sister Lori would die young from lung cancer, and her brother Frankie would die young as well from a freak allergic reaction. She was devastated. Again, more scars.

When my wife was pregnant with my youngest son, we got the news about my own mother's cancer. Cancer comes in so many packages, you never know what to expect. Some people beat it; some people don't. And some people will just battle it, and battle it, and battle it, until it finally kills them. 

I didn't know what my mother would do, or how she would react, but I knew my mother wasn’t about to go to battle and lose. She’d spent several years working for the Erie County Chapter of the American Cancer Society. She’d seen plenty of cancer’s ravaging effects up close, but more importantly, she’d also seen the ravaging effects of cancer treatments. No, this wasn’t a path my mother would travel. She was fine with surgery as a treatment option, but there was no way she was going to go through radiation or chemotherapy.

For the past ten years my mother has cheated death. In 2005 she even spent a month in the hospital in a coma, but somehow she pulled through. “God has chewed me up and spit me out so many times I’ve lost count.” She told me. With every recurrence, she’s been lucky enough to have the skilled doctors at the Cleveland Clinic cut away at the cancer and buy her a few more years. A few more years of seeing my kids, her only grandchildren, get older - a few more years of watching her own kids continue to grow.

Slicing out a cancerous tonsil bought her an extra birthday; the removal of her soft palette - another Christmas; hacking away a third of her tongue – the Fourth of July. Whenever the cancer would return, the doctors would cut ... and cut ... and cut, until they hit clean margins. 

But this time it’s different. This time there are no clean margins. This time there’s nothing left to cut. This time a tumor has lodged itself deep inside her throat near her epiglottis, spreading to her lymph nodes as well. This time the cancer is invasive - Stage IV. This time she's either going to have to undergo the chemotherapy and radiation treatments ... or be dead in six months.

After 10-years, the other shoe has dropped.


…to be continued.



Monday, February 8, 2010

Sweet Tooth

The heavenly sight of chocolate filling the cases at Kilwin's. (photo by Lon Horwedel)

Sunday is Valentine’s Day – a day for love and romance, a day for flowers and jewelry, but more importantly … a day for chocolate!

Ahh, chocolate. In a world that looks down on, or even makes illegal, most sins of pleasure, somehow, chocolate gets a free pass. In fact, I could walk out my front door right now, drive down to the corner gas station and score a Snickers bar, or better yet, a Baby Ruth, and not have to worry about a thing.

Of course, sometimes I feel like a nut ... sometimes I don’t, and if it melts in my mouth and not in my hands, that’s cool too. But this time of year, I’m really more a sucker for the Forrest Gump boxed variety of chocolates, you know, the kind where you bite into one hoping for a cherry filling, only to find you got maple cream instead. Not to worry, I have perfect, boxed chocolate etiquette - I always finish what I start, even if it’s something as horrid as mocha or rum. My sister, on the other hand, will happily take a bite out of a chocolate and then put the half-eaten piece back in the box if she gets one she doesn’t like.

When I think back to my love affair with the dark, smooth and creamy, it probably started when I was five or six. That’s when Willy Wonka and the Chocolate Factory came out in the movie theaters.  At the time I was more of a fruity, candy kind of guy – Chuckles, gumdrops, jellybeans, and that sort of thing, but when poor Charlie Bucket found that dollar in the street and used it to buy a Wonka Bar, it changed my life.

Just the way he slowly unwrapped that candy bar with his grubby little fingers had me salivating in my seat before he even got to the chocolate. By the time he found that stinkin’ golden ticket, I was in a cocoa coma (although I have to admit, Augustus Gloop plopping into Wonka’s chocolate river kind of grossed me out).

But what if, like Willy Wonka, you lived in that world of chocolate every day? Could you take it? Would the smell of chocolate drive you nuts? Or would you become immune? Would you, God forbid, even get sick of chocolate?

To find out, I visited Kilwin’s Chocolates & Ice Cream in downtown Ann Arbor earlier this week. There I found co-owner Chera Tramontin happily working behind the counter humming to the oldies station playing on the radio. The fact that Tramontin looks nothing like the Biggest Loser contestant you might expect to find behind the counter of a chocolate shop made me wonder if she even liked the stuff, or maybe was allergic to it.

But it turns out she does like the stuff … a lot.

“So, just how much chocolate do you eat in an average day?” I prodded.

“Oh God, that’s embarrassing,” she said, “I don’t even want to answer that … I really don’t want to answer that … I probably consume daily, about a half a pound of chocolate … at least! And when the cook is cooking next door – we have a great cook here, she’s fabulous – and when she’s working on some experimental stuff it’s always ‘try this’ or ‘taste this’ and whew, you’re buzzing by 3 o’clock.”

Tramontin admitted her daily dosage of chocolate rarely has her seeking out lunch. And no, she never gets sick of chocolate – maybe one type of chocolate, but variety seems to be the key.

“I’m definitely dark chocolate, but I switch around depending on my mood … I really do, this week has been caramel and peanut butter.” She laughed.

And what about the stock variety chocolate? The M & M’s and Reese’s Peanut Butter Cups of the world? Will she eat those too?

“Oh, I admit it, I’ve become a chocolate snob.” Tramontin said. “I don’t eat that other stuff anymore.”

Apparently, the rest of Ann Arbor also is a little snobby when it comes to their chocolate … or at least more health conscious. Tramontin said the Ann Arbor Kilwin’s branch is the only one that sells far more dark chocolate than it does milk chocolate.

“None of our other stores can believe it.” She said. “We have customers coming in all the time asking us for the percentage of cocoa in our dark chocolate.”

When I told Tramontin about my half-eaten-morsel-leaving sister, she chuckled and then showed me a little Kilwin trade secret.

“See how the swirl on the top that chocolate looks like the letter R?” She said. “That means it has a raspberry filling … and that one that looks like an M - that has a maple nut filling, and this one with the fork marks – that’s a turtle. Now you never have to be surprised again.”

After 20 minutes I could take it no more. The intoxicating scents and the stacks and stacks of fresh chocolates had me standing in a puddle of my own drool. I said goodbye to Chera and walked out Kilwin’s feeling a little like Charlie Bucket after he found his golden ticket – only instead of a golden ticket, all I had was a pocket full of lint!

Happy Valentines Day!