My Battle with Merkel Cell Cancer

your brain and body work. As the oxygen level drops, your brain stops working right and
your body takes measures to protect the organs and brain. Dad's blood pressure and
pulse, combined with the increasing chill in his extremities, made it nearly impossible to
get an accurate blood oxygen (SpO2) reading. The pulse oximeter stopped working on
his left hand fingers. They tried the right hand fingers, but no luck. I suggested his toes,
since the socks were keeping his toes warm, but that worked only for a minute or two.
They tried his ear lobe. Ultimately, they fitted him with a special SpO2 measurement
device that read from the forehead. Since we were non-doctors, our focus was only on
the machine readings we knew to be significant -- pulse, blood pressure, and SpO2. I
was relieved to have the SpO2 reading available again, but it was dropping steadily and
that was pretty distressing. I don't remember quite when in the sequence of all these
things that the pulse oximeter stopped working, but it seems like it was around here, give
or take an hour.
The CT scan results were back and they were not good. The doctor took us back to the
computer, spent some time logging in, and then walked us through the results. I've
looked over my dad's shoulder at the x-rays and CT scans he would read since I was old
enough to look over his shoulder, and I never quite figured out how he saw what
mattered in those images. Just like my dad would sometimes do, the doctor walked us
through my dad's CT results.
I know that MCC is a terrible cancer, but at that moment it seemed to be possessed of a
primal malevolent intelligence, and decided that if dad was going to rob it if the ability to
inflict more pain, it would at least make his death as frustrating, inflicting one last round of
bad luck or even irony. Dad's left lung wasn't sick. It showed some possible signs of slight
pneumonia, but was in pretty good shape. It would be able to get plenty of oxygen to his
brain and body -- if only the Merkel Cell Carcinoma had not wrapped itself around the left
bronchial branch and squeezed it shut. The right bronchial branch was wide open, easy
airflow in and out, and would be able to get plenty of oxygen to his brain and body -- if
only it wasn't filled with fluid from pneumonia. So MCC left him with a functioning lung he
couldn't use, and a compromised lung he could use. His SpO2 kept falling, and now we
knew why.
** Email: Date: Wed, 18 Apr 2012 18:29:33 -0700
Subject: Ct results
Left lung better than right, pretty clear but left bronchial branch is totally blocked so he
can't use that lung tissue. Right ling quite bad, lots of infection but open bronchi. They
may insert left bronchial stent tomorrow. Central line going in now.
Sent from my iPhone **
Dad had refused intubation but said (in very brief words due to the BiPAP mask) that he
would consent to a bronchial stent. Such a stent would open up his left lung. I'm still not
sure why a stent wasn't put in on an emergency basis. My non-medical guess is that with
his heart in atrial flutter, they didn't think the additional anesthetic would be tolerated -but
I really don't know. I don't even know if he was still in atrial flutter.
At this point, they were approaching a shift change. The ICU nurses work 12 hour shifts,
and they usually kick out family members for an hour around shift change so that the
outgoing shift and properly brief the incoming shift. I really didn't want dad to be alone at
this point, and was starting to worry about how I would deal with the shift change "please
leave for a bit" request. They required us to leave because they needed to create a sterile
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