Better Vision, Better Outlook

Jeff watched an orange laser light show, his chin and forehead resting against the metal frame mounted on the ophthamologist’s microscope.  Dr. Pendse projected crosshairs on Jeff’s left eye and zapped away – by quadrant - the debris left after cataract surgery in November.  Then he whooshed the bits to the edges of Jeff’s field of vision where they will be absorbed by the body.

Jeff’s description of the procedure was matter-of-fact, no hint of his pre-cancer squeamishness.  This is the man who once nearly passed out at the eye doctor’s office.  Well, okay - he was, after all, having metal removed from his eye.  This time, though, he had been more nervous about whether his vision could be improved rather than the means by which improvement might be accomplished.  Once finished with the laser procedure, he went home and took a nap. 

Happily, hours later he believed his vision was better.  He told me that there is “still something there, like a hair” but things appear much clearer.  A week later Dr. Pendse performed the procedure in Jeff’s right eye and, again, “something’s in there” but there is improvement.

Eyes, kidneys, liver and skin have all been affected by the transplant experience.  And, of course, there is the fatigue.  Fatigue is a curious thing.  It can sometimes be ignored and sometimes must be acknowledged and given into.  Jeff takes naps three or four times a week for one to three hours each.  Twice a week those naps occur when Jeff is with our granddaughters.  On the weekends we work around his naps, adjusting our plans as necessary. 

Fatigue can also cause depression or, at least for Jeff, confusion.

“How can I be so tired and not be sick?  How do I know it’s just fatigue?”

I remind him that his blood counts have been great so… no cancer.  I suggest he talk to Dr. Porter about his concerns but whenever he goes to the doctor’s office, he forgets to mention them. 

Jeff asked me to go along to his next visit.  With a little prompt from me, he asked the doc about disease recurrence.  For a large percentage of patients who are, as Dr. Porter explains, “destined to have a recurrence”, it happens within two years of transplant.  For another large percentage it happens by five years post-transplant. 

I remembered seeing charts showing the five-year survival rates in patients with MDS and AML who had bone marrow transplants.  At the time of diagnosis, those numbers were frightening - with that terrible drop in the first two years and then a too-low percentage surviving five years!  And we’d feared that “you have an incurable cancer” meant that the survival curve continued a downward trend after five years - although the rate of this decline was unknown to us.  We imagined the chart only needed to show maybe, what? - another five-year period before reaching a no-survivor vanishing point.

Dr. Porter said the issues Jeff is having (related to treatment and meds) are annoyances – particularly, he guessed, the vision issues.  Jeff will always have to take immunosuppressants for GVHD.  However, Dr. Porter does not see any of these issues as insurmountable.  If asked, he would sign a life insurance form “cured of leukemia”. 

The language of cancer is interesting to me. I am pragmatic in most things; I ponder probabilities – it helps with planning for the future, right?  (Ha!)  With a few words from Dr. Porter I began to consider that Jeff could be in a group of people for whom recurrence is not inevitable.  Jeff, on the other hand, was always sure he would survive.  His faith - which I mistook for denial early on – and his humor have kept us both from going to dark places. 

At the kidney specialist’s office, an intern was searching online for the results of Jeff’s “echo”, the echocardiogram that was done after his November hospital stay for chicken pox.  Jeff sat behind her and called, “HELLO, Hello, hello, ‘ello…”  The intern chuckled.  Jeff was very pleased with himself.

As we approach the six-year anniversary of his transplant, it seems more and more likely that we will have a lot of time yet together. 

I read this to Jeff, as I always do before posting.  He laughed and said, “Just in case, we’re keeping our life insurance policies up to date.”

Now who is the pragmatist?