Shayne on You: Consider the quality of life

Dear Maggie,

My seventy-four-year-old mom is dying of ovarian cancer that has spread to other organs. The doctors have given her three or four months to live. She doesnít seem to be in unbearable pain yet, but sheís lost her appetite and refuses to eat. Now her doctor wants to do a surgery to remove several feet of her intestine, where the cancer has spread. Sheíll need to wear a colostomy bag. The surgery will give her a bit more time, maybe a few more months. She is looking to me to make this decision for her, and I donít know what to do. Please give me your thoughts.

Signed,

Desperate Daughter

Dear DD,

Iím so sorry for what you and your family are going through. Iíve been through it too, so I know how hard it is.

It always stuns me how hard doctors fight against death. I guess itís what theyíre trained to do, but it seems to me that training needs a little tweak here and there. Imagine going through life battling against something so inevitable. Every one of us is going to leave this physical form. Itís the only possible ending for every single one of us. And yet when it approaches, we pull out every weapon available to stave it off. And in the end, it comes all the same. It canít be otherwise.



So the question isnít whether to save your motherís life or not. The question is whether to allow a surgery that will give her more time. And what you need to think about, and think about honestly, is what that time would be like. What is her quality of life going to be? Believe me, cancer is not kind at the end. I think it was the final six to eight weeks that were the worst for my own mom, and if I could have shortened that time for her, I would have. So the part of your momís life you would be extending, would very likely be that awful part. Moreover, recovering from the surgery is going to take a lot longer, so part of the time you gain for her would be canceled out by that. Why give the cancer more time to ravage her? Would she really prefer an extra few months with a bag of feces attached to her side? Would you?

Hereís more to ponder. A dying personís digestive system will shut down on its own. They donít feel hungry. They arenít ďstarving,Ē or suffering. The body is using all its energy for basic functions and can no longer deal with digesting food. The result of the lack of food is a release of chemicals in the brain that have the same impact as narcoticsóthey ease the patientís pain. Itís the bodyís natural way to deal with this. So try to resist the urge to push food on her.

My advice, and Iíll give it straight up, and with the benefit of hindsight, having gone through this with my own momónix the surgery. Take her home if you can. Call Hospice: theyíre living, breathing angels on earth and they can help you more than you can even imagine. Get through the holidays as best you canóeven enjoy them a little with your mom. Try to accept that this transition to the other side is as natural as breathing, or being born. And help her to come to that understanding too. I think people who get aligned with it and are able to relax about it, tend to pass easily and peacefully, while those who fight to delay the inevitable, or approach it with fear and dread, pass with far greater suffering. (Only to find that peace and ease the minute they cross over, and probably spend their first few moments wondering what they were so worried about.)

Make this holiday a special time with your mom and youíll never regret it.

Thatís my honest opinion.

Good luck,

Maggie

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