So, we’ve had a bit of a scare the last few days. Friday night, Dad started complaining of constipation – despite having had a bowel movement just the previous morning. By 5 a.m. Saturday, he was completely miserable, not sure which he wanted to do more: poop or vomit. We went to his primary-care doc’s Saturday walk-in clinic – they prodded, he yelped, and off to Cape Cod Hospital’s ER we went.
The first thought was that Dad had gallstones. Then the tests started coming back. The good news: the gallbladder was fine. The bad news: he had a “mass” or an “obstruction” in his colon. Faster than you can spell “admission” he was checked into a room with one of the best views of Hyaniss’s Lewis Bay you’ve ever seen. The news from yesterday’s colonoscopy is that the problem is diverticulitis, not a tumor.
Obviously, there is a relief that colon cancer appears to be ruled out (at least until the next series of tests). But diverticulitis raises its own series of issues, and a question: is this less-than-drastic diagnosis really better than one that simply adds to the slow, chipping-away that’s been happening to Dad’s quality of life over the last several years?
This situation isn’t really a surprise. Dad had some digestive problems back in March, and a stool test came back positive for blood. Both his primary-care doctor and gastroenterologist urged a colonoscopy, but Dad refused, and, honestly, I was quietly relieved. There were some health risks for him with the test – the prep solution works by pulling all the fluid out of your organs to flush out your bowels, and that can be very hard on compromised kidneys. Plus, Medicare won’t pay for hospitalization, or even an aide, to help with the prep. The guy has trouble now just getting from the sofa to the bathroom without tipping over, so I had horrible visions of some extremely messy falls after having to make that trip multiple times over a period of hours, getting weaker all the while.
Of course, if he’d had that colonoscopy, the doctors might have caught the diverticulosis that is the root cause of the diverticulitis infection that now has him laid up in the hospital. But treating diverticulosis means becoming especially careful with your diet, which is asking a lot of an 89-year-old whose steak, bacon and Scotch are among the very few pleasures his life has conspired to allow him at this point. He simply wouldn’t have done it – in his almost 90 years, he’s probably eaten 23 green beans and three or four peas, so becoming a fiber-rich herbivore would mean a complete life change. And I’m not about to turn into the diet police; since I forced the process that led to him losing his license, I’ve made the decision not to push back on what others might think to be ill-considered choices if they don’t carry a risk of hurting someone else.
At this point, the doctors are still trying to figure out why the infection is persisting. Yet another National Geographic-like exploration of his colon may be in store tomorrow. There may be yet-to-be-found causes that could be much worse. But already, I’m beginning to wonder about how he recovers from this. His oxygen levels are dropping precipitously when the nurses try to get him walking, so his leg muscles could well be losing what little strength they have from lack of use. I’m sure there will be a rehab stay once the infection is controlled, but what will his life be after that? My house just won’t accommodate a wheelchair, so there may be a real question regarding his ability to return home.
Which brings me back to the diagnosis. Is the current guesstimate of diverticulitis really better news than a fast-moving cancer that might have taken him quickly, but with still enough time to say his good-byes? Instead, rehab could just be a transition to a nursing home, where, yes, he might live longer than with cancer, but to what end. So, as I recount this information to others, and they respond, “Well, thank God it’s not cancer,” I smile and nod, but inside, I’m beginning to wonder, “Really?”.