July 1st, 2020 ~ Vol. 90 No. 26
Looking Back - John Kinnear
A Moment in Time – The Game Changer - Part III
Looking Back
John Kinnear photo
Battling back from surgery at the Foothills in late May 2019
Read: Part II - A Moment in Time - A Life Well Lived

“You are braver than you believe, stronger than you seem, smarter than you think, and twice as beautiful as you’d ever imagined”

On January 2, 2019, my wife Lorraine’s 80th birthday, she went for an ultrasound at Pincher Creek Hospital to help diagnose a concerning issue. She had been experiencing for several months an intermittent gnawing pain in her lower right back area, around her kidney. Her doctor ordered blood work and an x-ray and then an ultrasound to get a better picture of what might be happening. Within an hour of arriving home from the ultrasound appointment the Crowsnest Clinic called to tell us to come in for a consult. Right then and there the fear began to grow in me about what might be coming. It never left me. For the next 17 months it was like something had grabbed a hold of my heart and would not let go.

We were told that the scan showed what appeared to be a necrotic mass arising from her kidney and extending into the right renal vein that runs from it to her inferior vena cava. From that point on we were quickly sent down a road of further diagnosis and consults regarding this menacing shadow. An MRI and a CT scan confirmed and refined the definition of what appeared to be a slow-growing cancer. The complicated terminology in the reports describing the CT scans results appeared grim and disturbing to say the least.
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From that diagnostic moment forward I resolved to research and understand every medically related term thrown my way. I was determined to stay right on top of what was going on. I kept copious notes and prepared for every encounter with poignant questions and quick responses to all medical personnel in order to speed the flow of each meeting and improve its effectiveness.

On January 17th we saw a urologist in Lethbridge who told us that because of the renal vein involvement that surgery was imminent but could not be done laproscopically. We were then referred to a urologic-oncologist at Rockyview Hospital in Calgary and there, three weeks later, the significance of the cancer and the process to be followed was laid out. In that specialist’s office, we learned Lorraine had what was classified as stage 3 cancer. It was a sobering moment.

Surgery was scheduled for Friday, March 29th at the Rockyview but that Friday other surgeries ran late and it was cancelled at the last minute. A week previously we had gone through the preadmin (pre-op) process involving interviews with an internal medicine specialist and an anesthesiologist at the Rockyview and Lorraine was banded and ready to go. She was anxious for the removal of that nasty bit of business that had invaded her body and to get on with her life.
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A life that we had envisioned would allow us to be together until the very end because of our age difference. It was our plan. To always be together.

Another attempt to plan a surgery date in April also failed and then the process took an interesting turn when the surgery was moved to the Foothills where a specialist, an expert in vascular operations, came into Lorraine’s case. Surgery was scheduled for May 27th and the week prior, once again, Lorraine and I were run through the pre-op interviews and went home to prepare. An interesting note: as part of the surgery preparation Lorraine was told to drink 16 ounces of regular cranberry juice an hour prior to surgery. Lots of sugar in that drink and it is used for what is known as carbohydrate loading. Apparently it helps reduce anesthetic nausea, stabilize après surgery blood sugar and improves recovery.

Knowing Lorraine’s propensity for pink I was not surprised when I checked the special surgery status electronic board around 2 PM the day of her surgery and found that, of the 60 operations on the colour coded status list, only one appeared in pink. It was hers and of the 13 different colour codes used that particular one meant they were closing her up. It was late afternoon before she was brought to the tenth floor surgical recovery wing and thus began 11 days of intensive care and a long recuperation.
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Needless to say I lived at the Foothills and stayed very close by when I did leave. Her treatment in that wing was extraordinary despite the fact that the work load that the nurses had there was crushing. I did everything I could to support them. They are heroes, every single one of them.

We returned home in early June somewhat optimistic. July follow-up appointments with both specialists seemed to reflect a successful surgery. We were told a follow-up CT scan would be done in 6 months to check on everything. The Foothills vascular surgeon told Lorraine that hers was the best surgery he had had in months and on seeing her, dressed to the nines and looking good, said, “Now get out there and enjoy life.” So we did. As soon as she was strong enough we headed out in the motor home to dance festivals and into the fall began dancing again at Pincher and at Hillcrest. Then that dreaded pivotal moment came for the follow-up CT scan on, of all days, Halloween.

It fell to Lorraine’s new doctor here to call us in once again for a consult after the scan. We really thought we were going to move on but that was not to be. We were crushed by the results that revealed the cancer had somehow spread to her lungs, onto her liver and was still persisting as a shadow in her inferior vena cava. We left numb and in shock but resolved to push on as best we could and live our lives one day at a time. Another follow-up visit to the Rockyview urologist in late November was followed the same day by our first meeting with an oncologist at the Holy Cross Centre.
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In an ironic and purely accidental twist, this specialist turned out to be my mother’s sister’s grandson, which we found somewhat comforting. Lorraine was very direct with him about how she wanted things to be in the event that treatments were unsuccessful. It was very hard to have those discussions. On a lighter note that day she noticed, as he sat directly in front of her offering treatment alternatives, that he twiddled his thumbs as he talked. She reminded him that his great grandmother, Katie Agnes MacInnis, who lived to 103, used to do that also. His clinical assistant burst out laughing at this observation.

Those alternatives were either chemotherapy daily by pill, immunotherapy by infusion at the Tom Baker or a special test trial combination of both. Given that Lorraine had lived with GERD (acid reflux disease) for many years and recognizing that the chemo would be hard on her stomach, she opted for the immunotherapy. Actually, she looked the oncologist right in the eye and said, “If I was your grandmother what would you tell me to choose?” He said, “Immunotherapy” and she said, “Then that’s what we’ll do.

There were two specific targeting drugs selected for these treatments that would be infused every three weeks at the Baker. Immunotherapy drugs are designed to boost the immune system and teach it to recognize cancer cells which apparently have a way of deceiving our immunity into thinking they are normal cells.

Lorraine had two treatments in November and December. Of course in December, on our way into her second infusion, we didn’t make it past the small clothing gift shop at the Tom Baker entrance. I loved shopping with Lorraine anywhere and I wound up picking out a sweet black and white top trimmed in faux fur for her. She donned it prior to walking into the infusion room and the RN who was setting up her treatment chemistry commented,” You look more like you are going for a spa day than an infusion.”

Lorraine handled the treatments with almost no side effects and we were cautiously optimistic. Then exactly one year after her initial diagnosis, on her 81st birthday, she woke up with a badly swollen and bright red right leg. An emergency trip to the hospital and, later that day, an ultrasound in Lethbridge revealed extensive blood clots all the way up her leg to her waist. It was a terrifying moment, when she realized how deadly this could be. Back home in emergency we were counseled on how to wrap her leg, keep it elevated and purchased some compression stockings.

Blood clots are not that uncommon in cancer patients and she was immediately started on daily injections of an antithrombotic and anticoagulant called Innohep (tinzaparin). I was quickly trained on their administration and we eventually became a little more comfortable with this precarious condition. And then in mid-January Lorraine crashed. Hard!

Author’s Note: I choose to take you, my readers, down the road of my dearest Lorraine’s life story because it is a story of a life well lived and a life finally surrendered to the heartbreaking and somewhat terrifying path of cancer. It is my hope that it will help heal me and help in some small way those who may travel down this road. I will endeavour next week to walk you through her final 6 months. It is important to me, and may be to you, that you understand the tremendous resources and first rate expertise that were put into play to guide Lorraine and I through to the end.

Read: Part IV - A Moment in Time – A Perfect Storm

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July 1st, 2020 ~ Vol. 90 No. 26
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