85. Decisions Do not Have A Rewind Button. Part 2.

Cassette RecorderJust a quick re-cap. We are talking about ‘Decision Regret’ where someone in a health setting, eventually regrets the decision they made regarding the course of their treatment. Jay had reconciled with his father James after a long period of estrangement.…..

Jay cannot remember the exact year, it was either 2015 or 2016 that his dad started talking about having some pain in his back. His dad had a lot of tests done but doctors couldn’t figure out what it was. They thought it might be related to James’ injury from jump school in the Air Force when he had hurt his shoulder during a night jump. They kept running checks on his shoulder thinking that it was  nerve damage or something similar. Eventually they found out it was in fact prostate cancer.

James was very fortunate, they caught it extremely early. It was only about the size of a pencil eraser. The doctors gave him a number of choices. They said they could him a hormone shot to try and shrink the tumour, target chemo or remove the prostrate altogether. A doctor actually recommended that he should just go ahead and remove the prostate, “because why take the chance you know?” but he opted for the hormone shot and active surveillance instead. Everyone in the family had lived a long, relatively healthy life. Heart problems were more common. Jays’ grandad had heart problems and died of a heart attack while Jays dad had already survived two heart attacks. So, prostate cancer was never on anyone’s radar, there was just no history of it. He was seventy six years old.

It was to be about six or seven months, after being diagnosed that Jay’s dad finally told him it was prostate cancer. He didn’t want Jay to worry because he was taking care of his mother and had enough on his plate. He assured Jay that he was fine and was more concerned with how Jay was doing.

Further down the line James missed one of his check-ups because Lynn didn’t want to leave the Bahamas. So, he came back a couple months later than he should have. Up to that point everything was fine. There was no growth and his PSA numbers were exactly where they should have been

During that missed appointment the tumour had become active again and had grown.

They started discussing more aggressive treatment option, chemotherapy.

Then one day, he told Jay that it had spread, but that’s all he said. He didn’t say anything else.

In Jays mind he was thinking it was okay. It was prostate cancer. It had spread to the lung, bladder and stomach but they could cut that out and they were giving him chemotherapy. Lynn was always giving these overly rosy assessments of everything. Everything was fine, don’t worry about your dad, he’s got such great care. Jay has got two emails where she’s talking about, ‘such great care’, ‘Oh, they’re so lucky’, ‘It’s going so well.’ Then one day Jay got a call that he had been rushed to the hospital. Jay convinced himself that it’s just a precaution.

His dad was in the hospital a day or two and came back home. Jay didn’t realise he was in so much pain. His PSA had passed the 200 count and he had taken so much Tylenol in a short space of time that it had ulcerated his throat. The hospital spoke about another round of chemo and it was going to be more aggressive than the last one because the first round didn’t work.

His dad went in and when he saw him come out, it was the first time in his life he would remember his dad looking old. He tried to act the same, that everything was alright even though he had trouble standing. Selfless as ever his focus was on Jay – “how are you doing?”, “How is your mother doing?”

Jay did not know that until his second or third hospitalisation when his dad wasn’t released, that it had spread to his spine. His dad was having to do drink soup and a lot of liquid foods because he was having trouble swallowing from the chemo. He had visibly lost weight, was incontinent and using a catheter from all the procedures they had done.

Lynn would continue sending out these emails “He’s fine”, “It’s no big deal”, “Everything’s under control.” Jay would remark ‘Seriously, what a piece of work.’

Eventually the hospital sent James home.

Jay and his brother Dan, who he does not get on with, put aside their differences and had to physically help him their dad into the house, he had lost so much weight at that point. They both knew there was something going on, but his dad or Lynn didn’t want to say.

The next morning, Jay got a call from Lynn. Jim had gone to bed that night and something had happened. She had called the ambulance and Jim had be taken to the Critical Care Unit. On the way to the hospital, the ambulance crew had to pull over and resuscitate him. By the time Jay got to the hospital they had seven IVs in his dad and a mask over his face.

Jim was desperately gasping for air, his body was going in and out of spasms and one of his eyes was partially glazed over. You could barely tell that there was someone there and it destroyed Jay. Beforehand, Jay had called the family and they were able to put their differences aside to come together to come and see their dad.

The next morning, Lynn called Jay. The doctors had said that they can’t give Jim any more pain medication, because he was filling up with fluid and to drain the fluid they would have to take him off the pain medication. His kidneys had also shut down.

There was another decision to make. It would be a final one.

Either keep him on life support and watch him go through organ failure one by one or continue with the pain medication and let him go a peaceful as possible.

A few hours later, Jay watched his dad die.

Jay struggles with his dad’s decision. His dad was in his early 70s, he has five kids already, he didn’t need to reproduce with Lynn. There was no reason why he should not have opted to have his prostate removed. He never understood it. His dad did actually ask if they could remove it once it had spread but they said to him it was too late now.

When the prostate splits it is too late, the cancer will readily spread all over the body. If the patient has had radiotherapy the prostate will fuse to the bowel wall. There is a big clue in the name of the surgery to try and remove the prostate after radiotherapy, it’s called salvage surgery.

Lynn also had her cancer battles. She had fought vaginal cancer and had had a double mastectomy.  Her words were, “She had to make the right decision this time and she couldn’t do the same thing. Jim had done.” There was a severe and tragic consequence for Jim missing his appointment by several months. It wasn’t made any better by other doctors telling Jay “If your dad had just been there a few months earlier, they would had seen it was active again.”

Did Jim’s death bring the family back together? No, unfortunately, quite the opposite.

Jim had a yearly ritual where he would see his lawyer and amend his will as his finances changed. He had put everything into a trust to be split evenly among the five kids. Even Jays sister, Lisa, who had not talked to her dad since 1995 was never taken out of the will.

However, Lynn and Dan, who happens to be a ‘dodgy’ lawyer, would make another decision. Lynn refused to let them see the last will that his dad had made and unfortunately no-one had a copy. Instead, she had joined forces with Dan and found a will dating back to 1986 which was worded very differently.

The rest of the family are all pretty much on the same page as far as wanting to take Lynn and Dan to court.

But that’s a decision they have not made yet.

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