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January 21st, 2022 – Post #29
My dad asked me to post this invitation:
Tuesday January 25 Beth turns 80. We are inviting friends to join us on zoom at 7:30 PM central to greet her and sing happy birthday. Zoom code is xxxx xxxxx xxxxx and password is xxxxxxx. I know she would love to see you and hear your dulcet voices.
January 25th, 2022 – Post #30
My dad asked me to post the following letter from him:
January 25, 2022
Dave Purcell, husband of Beth since May 30, 1971; father of her children, companion in sickness and health, richer and poorer, in good times and bad until death parts us.
To all of her (our) kin, friends and well wishers wherever you may be, whatever your own circumstances, and in whatever manner you have expressed your love and concern in these recent times, or in the past.
This has been a challenging time for us as we deal with Beth’s grave health afflictions, in the midst of global pandemic which is at best a very wet blanket over our passionate desires for your companionship; during ongoing global problems, and especially at a time when each of you has had your own particular adventures, misadventures, busyness and concerns that we would have loved to process more personally with you.
We miss the physical closeness of being with you in all of our homes, churches, restaurants and other meeting places. But we are so very grateful that despite all of these challenges you have reflected God’s love by reaching out to us in so many ways. Our myriad blessings are impossible to detail except categorically, but rest assured that you personally have been in our thoughts and prayers. And we are daily reminded that paradoxically it is in the toughest of times that the love of God, family and friends is most vitally realized.
At the end of July last year it was discovered that Beth has a tumor growing on the head of her pancreas and impinging on a major blood vessel in her abdomen. For the past six months Beth has been under the care of The Siteman Cancer Institute of BJC Hospitals and Washington University Medical Center. She has received diagnostics, chemotherapy, counseling, physical therapy, and preliminary surgical procedures in preparation for a possible Whipple surgery. We were most impressed by the competence and compassion of all of the folks involved in these procedures. Siteman, and particularly the pancreas team, well deserves it’s reputation as a world class operation.
The Whipple is a complex operation for getting rid of the tumor but involving removal of all or parts of the pancreas itself as well as the gall bladder, small intestine, stomach and duodenum. In her case it would necessarily involve removal and resection of a part of the blood vessel. The surgery typically takes eight or more hours and is followed by ten days or more of hospitalization (with restrictive visiting privileges: no more than one person per day) and weeks of rehab in a skilled nursing facility. Thereafter patients are further challenged by possible diabetes and major digestive and elimination problems attendant to compromise or to loss of function of important organs, reduced physical strength, muscle mass and vitality.
Risks of mortality with pancreatic cancer are grim in any case. Beth’s surgeon has performed hundreds of these cases with great success and very few of his patients have died in the operating room. Nevertheless, even with a successful procedure, some 70% of Whipple patients experience a recurrence of the cancer, 80% of those within two years. Recurrences happen because cancer cells may escape detection and removal, taking up residence elsewhere in her body. I understand recurrences are basically untreatable. A few Whipple patients live for five years or more after surgery. Their quality of life, like their quantity, varies.
The alternative to surgery is to simply live with the damned tumor, working to restore Beth’s strength and vitality which were compromised by a dozen chemo sessions, and enjoying life as best we can. Beth is inclining toward this alternative, strongly supported by both me and our three daughters. Beth is of course a (BJC) nurse of over 40 years experience. Megan is also an R.N. specializing in the care of seniors, Erica is an R.N. who administers chemotherapy. Jody, who has taken up residence with us as a companion, care provider and advocate has considerable experience in palliative care and health care advocacy. As an estate planning and elder law attorney I was involved deeply and on a daily basis in issues of advanced medical decision making and end of life issues, writing and lecturing to the public as well as to other attorneys and senior care providers on the subject. Beth and I were both personally invested in the care of our own mothers during their final times and are well aware of the need to balance heroic measures with strong dollops of compassion for the patient. All in all I think that Beth could not have had better support, from her doctors and nurses, her family and friends, and from her own experience and compassion, in coming to her decision about the Whipple.
After a hopefully good night’s sleep, on this her 80th birthday we are going to tell her surgeon thanks but no thanks.
We look forward to springtime, gardening, visits with our wonderful daughters, extraordinary grandkids, and friends. Covid willing we hope for travel and gatherings. We will take each day and enjoy each moment as it is granted to us.
In writing this to you I want to again thank each and every one of you and to reflect back to you what I have learned from all of this.
As my dad lay dying I asked him for his best advice on what I should consider with my own life. In one of our last conversations he counseled me to turn loose of any resentments I had toward anyone, to hold fast and nurture my love for Beth and for those others who mean so much to me and to feel satisfaction for the good I have been able to achieve in my life with a desire to do even more. As I reflect on our own experiences here I cannot help but urge each and every one of you to reflect on your own blessings in life and to follow dad’s counsel. Consider your estate plan. Make your bed (this latter wisdom from Admiral Bill McRaven’s book First Make Your Bed) which I strongly recommend. Hug and kiss at every appropriate opportunity. Say please, thank you, I don’t know, oops. Pray and meditate in whatever way works best for you. Let’s all keep pitching in to make the world a better place. Pet your dogs and cats, laugh at jokes, feed the birds and just enjoy.
And may the blessings that you have shown to us come back to you and to yours, many fold. Dave
You can read what my mom decided about doing The Whipple here – and some of what my thoughts have been as her daughter through this whole process. It’s kind of a doozy of a post.
*To read more on my mom’s cancer journey from the beginning, or share it, please click below: