116 – Slowing the Slide Towards Death Part 6: 10 December 2024
The group of close friends attended a restaurant on 15 January 2020. This is one of the last photos I have of Margaret before the cancer began to utterly destroy her body. In this photo, Margaret has just given a birthday present to Anne Ryan, her wonderful Irish friend who so completely deserted Margaret no more than six months after Margaret was diagnosed with her fatal cancer.
The birthday present had been put together by Anne Ryan’s niece Paula Ryan. This photo shows the first page of the present Paula made for us to give to Anne.
3 1/2 years later, I sent a text to Paula telling her about the miraculous cat scan results on 17 July 2023 showing that the cancer had vanished. Paula immediately ceased all communication with me. I presume she felt she no longer needed to communicate with me because Margaret’s cancer had disappeared.
I have no idea what crimes
Anne Ryan told her niece Paula that I had supposedly committed.
Both
Margaret and I had thought Paula was lovely. We had also thought Anne was lovely. obviously, we were badly mistaken.
****
After my visit to A & E on 9 June 2020 and my
commencement of treatment with Rikodeine, my health steadily got better and the
coughing completely ceased completely. I
started to think that the coughing fits had been banished for good.
I took the Rikodeine for 3 weeks and then stopped taking
it because I no longer needed it. By the
end of June 2020, I was free of the debilitating coughing attacks. Life started to look good again.
The relief from suffering was very short lived.
****
Margaret’s follow up operation to the 25 February procedure to remove the polyps from her digestive system had been cancelled
because of the Covid epidemic. The
follow up operation finally happened on Monday 29 June 2020. We believed that this follow up operation was routine and it would confirm that the polyps were now permanently gone
and no further action would be needed.
Dr Ho did the operation and he took tissue samples. An appointment was arranged with Dr Neo so
she could give us a formal report on the findings of the operation.
Margaret and I attended the report back appointment on
Thursday 10 July. What Dr Neo had to
tell us was very different from a routine report telling us all was
well and we should have a good life.
The tissue samples taken by Dr Ho had been sent for testing and the news could not have been worse.
Margaret had ampullar cancer and she would probably be dead by Christmas 2020.
The “Gold Standard” treatment for
ampullar cancer was a Whipple’s Procedure.
If Margaret had the Whipple’s Procedure, and if she survived the
surgery, she would “on average” live for 3 years until 10 July 2023.
****
Mayo Clinic says this about ampullar cancer.
|
Ampullary cancer is cancer that starts as a growth
of cells in the ampulla of Vater. The ampulla of Vater is located where the
bile duct and pancreatic duct join and empty into the small intestine.
Ampullary (AM-poo-la-ree) cancer is rare. Ampullary cancer forms near many other parts of the
digestive system. This includes the liver, pancreas and small intestine. When
ampullary cancer grows, it may affect these other organs. Ampullary cancer treatment often involves surgery to
remove the cancer. Treatment also may include radiation therapy and
chemotherapy to kill cancer cells. |
Put into plain English, the ampullar is a T junction
where the Pancreatic Duct meets the Common Bile Duct. A cancer in this part of the body rapidly
blocks the digestive system and death is both swift and agonising.
****
Dr Neo explained that although a Whipple’s Procedure
was possible and it might delay death if Margaret survived the operation,
chemotherapy and radiotherapy would NOT be possible.
This is what Mayo Clinic says about the Whipple’s
Procedure.
|
The
Whipple procedure is an operation to treat tumors and other conditions in the
pancreas, small intestine and bile ducts. It involves removing the head of
the pancreas, the first part of the small intestine, the gallbladder and the
bile duct. The
Whipple procedure is also called a pancreaticoduodenectomy. It's often used
to treat pancreatic cancer that hasn't spread beyond the pancreas. The
Whipple procedure is a complex operation. It can have serious risks. However,
this surgery often saves lives. |
Put into plain English, the Whipple’s Procedure involves
removal of large parts of the digestive system.
The remaining parts of the digestive system are then stitched together
in the hope that they will be able to become a smaller, whole system again. In most cases, the recipient of a Whipple’s
Procedure needs to have a colostomy bag to remove any bodily waste. Some patients die as a result of the
operation and the quality of life of those patients who survive the Whipple’s Procedure
is poor.
Margaret could choose to have the Whipple’s Procedure and perhaps live “on average” until 10 July 2023 or she could accept that she would probably be dead by the coming 2020 Christmas.
****
****
Margaret had been a cancer nurse at Flinders Medical Centre (a major South Australian public hospital) for more than 30 years. After we left Dr Neo, I asked if she had ever heard of ampullar cancer. Margaret said she had never heard of ampullar cancer. Her cancer nursing experience was confined to cancers that were treated with chemotherapy and radiotherapy. Because ampullar cancer was unable to be treated with chemotherapy of radiotherapy, she had never heard of it.
****
****
We spent 3 nights in Port Elliot, south of Adelaide
from Monday 27 to the morning of Thursday 30 July 2020. It was bitterly cold and the Covid epidemic
regulations meant we were the only tourists in the whole town. I cannot remember ever having such a
miserable “holiday”. I did not have the
energy to take any photos to remember our stay there. I wanted to hold Margaret and never let her
out of my arms.
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