Saturday, February 14, 2009

The Final Stage of Cancer

I've been putting off writing about Shin's final weeks, but I do think it's important to share it.

I recall that as Shin and I learned that her situation was terminal, we were very uncertain about what the final stages would be like. The mystery and uncertainty were frightening. Blogs that we followed where a cancer patient died, usually ended without it being clear how it happened. Shin had a friend who died of cancer in the past year, and when Shin asked husband how it happened, all he could say was "it's too horrible to talk about". We have another friend who's father past away and had chosen to remain conscious for as long as possible instead of increasing morphine, which led to final stages that were very difficult for our friend. In the final weeks I think Shin was at peace with the fact she was going to die soon but I think we were all afraid about how it was going to happen.

I think if we knew then what we know now, we would have been less frieghtened. And although if feels rather personal writing about Shin's last days, and she didn't want to be remembered as a sick person on her deathbed, I think Shin would have wanted me to share her experience. So I'll collect my thoughts over the next few days and update on the final stages.

Here is one note of general encouragement. One night, the palliative care doctor and nurse stayed for dinner and then stayed to talk more to Shin's parents and answer their questions (this would be 9pm and our palliative care doctor had a toddler at home). We said that Shin seems quite at peace to us, and asked is this unusual? I imagined most people really struggling with their death. The doctor said no, that the vast majority of her patients are at peace when they die. We also asked if religion made a big difference. She said no that She herself was Christian, but in her experience most people find peace with religion or without.



Anonymous said...

Tony, take your time. Just a gentle reminder that this blog is what Shin had intended to leave for Josie and Toby

Anonymous said...

I think most of us have heard that the suffering of cancer patients during death is very horrible and very torturing and painful. That's why I am very happy that Shin left in peace and without suffering.

Is it because of the medicine or different cancer that enable the patient to leave in peace and without pain?

I wonder why is it that there are so many cancer patients suffering so much when they can actually "don't have" or can reduce a great deal of pain but yet they are really scary and that's what most of us heard of the pain and suffering of them.

I believe religion may or may not help,depending on individual but as I wrote before, Shin is a free thinker but her love, kindness, compassion,etc, are what someone with religion don't even is same to her, I think she may also gone through emotion "scare and struggle" of dying as in can't bear to leave her love ones,etc, (which is normal), but I think you, Michelle, Alicia, the pallative care doc and nurses help that a lot. Hope more will know and have confident in them so that the cancer patient will suffer less or don't have to suffer before and during their dying.

Thanks Tony for sharing and I understand why you have been putting off...although many of us are concern and wish to know and also this can record down for Josie and Toby to read later, and most important can "educate" us (which Shin must be very happy about your sharing), we will not "rush" you, take your time,ok? :)

Hope you and the kids are doing well...Give yourself time and the kids too.Take care.

I am sure the number of comments will not be as many but they maybe reading "in silent" and give you and the kids support silently too.

Leighbee said...

I truely believe that you are the most indomitable family I have ever had the pleasure to be connected with... True valour xxx

Anonymous said...

One of the factors which prolongs the suffering of a cancer patient is that his loved ones or the cancer patient himself cannot accept death. Instead of letting the patient go, the patient is resuscitated and the suffering prolonged.

There are patients who fear that they may be addicted to morphine and avoid taking it or if they do take it, they take less than the prescribed dose. Some want to wait till they are nearer death before they go on painkillers but they do not know that the time is now and it is not easy to tell them so.

A person who dies from cancer that is widespread in the liver may suffer less than a person whose cancer has not spread to vital organs but keeps growing in a particular region eg colorectal cancer where a person can suffer extreme pain in his/her private parts.

These are some of my observations. I have seen loved ones die of cancer and I too have a personal encounter with this dreadful disease. In my opinion, one of the reasons why Shin did not suffer much in her final stages is that she and her loved ones had a good understanding of her illness and they were prepared for her death.

Emily said...

Hi Tony, thanks for sharing. It'd really help in preparing those having to deal with walking the 'final stage' or 'last journey'. Your experience has given us courage. Regards, Emily

Karen/BCDIY said...

Tony, you cannot imagine the comfort Shin's blog has made to the many people who have visited our website. I spoke with Shin a several months ago, as we had noticed that we were receiving referrals from her blog. So, in turn we posted her link on our website, too. She has brought much comfort to so many - we sincerely hope you will keep her blog alive, so others can share her journey and learn the lessons Shin posted, and also what a wonderful woman/mother/wife she was. Our loving thoughts surround you today and always. Blessings to you and your family. To Shin - we will be vigilant in keeping your flame alive.
Breast Cancer DIY Team (USA)

Anonymous said...

God Bless you, Tony. It must be painful to relive Shin's last days but your love of both Shin and your children gives you the strength to share and teach. Thank you for your thoughtfulness.

peto said...

Hello Tony,

I have lost 2 uncles to colon cancer and pancreatic cancer respectively 6 years ago and my aunt to breast cancer 2 years ago.

I've always end commenting to Shin that I will be sharing my uncle's and Aunt's cancer ordeal with her but unfortunately never did ... because it was kind of hard to share with Shin on my view of my uncle's and aunt's death hoping it can help her last moment decision making in any way.

After receiving my cousin call one night that he will be admitting my uncle the next day, I immediately went to visit him.

I was shocked to learn how fragile looking and weak my uncle had become; have not visited him for 2 mths since I sensed that our frequent visits seems to trigger a strange sort of "are you guys checking on my expiring date, again?" silent treatment.

He was just all skins and bones sitting on his bed leaning against the wall but still he managed to give me a smile, sighing "at last I get to see peter."

Later, when he realized that his church friends came to visit, he insisted to be help out of the room to meet them in the hall even to much of our protest; "basic courtesy" he retorted.

We spent the next 15 to 20 mins just to move him out of the bed onto the wheelchair very slowly under his careful supervision because every little movement experienced a "blackout".

It was amazing how he still able to be the livewire among his friends, joking, laughing and singing hyms eventhough he did not have the energy to seat. He was very happy and enjoying the moment.

Mr house doctor finally came since missing my cousin's call the whole day to "Golf".
As soon as he checked my uncle's pause, he summoned an ambulance.
That was where I overheard him whispering to the church friends that "Van" does not seems to record any blood pressure and the pause was very faint. He should be dying any moment.

Overhearing that, I suggested to the house doctor if we should let my uncle remained with his friends and to summon the relatives.
To my surprise, he told me it was better to send my uncle to the hosp mainly due to 2 reasons.

1. To help my cousins to complete the dying process although both my cousins are in their late thirties.

2. Since the ambulance was already summoned.

Reaching the hosp, overheard the first doctor talking to the house doctor: "wah why you arrange to come. It is a lost cause and waste of money."
Later, another doctor updated with much confidence to all "Patient is fine now after blood transfusion. He should be fine!"

We all went home after learning that his condition had stabilized as claimed.

2 hours later upon reaching home, I received a call from my cousin that my uncle will not make it any moment. Rushed down to hosp and witnessed my uncle;s terrifying death.

To me, my uncle death could have been a wonderful one; dying surrounded with love ones, friends, relatives and more importantly a painless one if only he remained at home then.

After reading your update on Shin's last moment. I am very glad with the choices taken and I am sure there is no better ways for one to leave with all their love ones and friends by their side.

I am sure of that because I have lost my mum 2 months ago on the hospital bed, unexpectedly into a coma. She will never know what happens thereafter she closed her eyes to sleep that night.
Such irony, after all i have learnt from nadya's hospital ordeal and yet I broke the rule of not being with my mum enough to prevent more horrific hospital handling.

Tony, I have wanted to show you Nadya's "Shinsmile" from my cell phone during Shin's memorial but did not have the opportunity eventhough you are infront of me on several occasions.

Shin's memorial service was my first and it was wonderful!

On the lighter side, during the pink paddler singing. A lady beside me actually handed your mum tissue when i obviously needed one more than her.