Update

Mom started chemo today. Up until now, the cancer has been on the attack. Today, Mom goes on offense and takes the fight to the cancer.

We, Alia (sister ) and Mom and I, arrived at the Abramson Cancer Center early for an 8:45 a.m. appointment — extra early, as I never know what I-76 is going to be like during rush hour.

Despite our enthusiasm to be here on-time or better, we ended up sitting and waiting for about an hour.

There are so many people here, apparently it is too easy to get overlooked. Despite the fact that we checked in early, apparently they forgot to ”assign a room” to Mom to meet with her provider, and it was not until we went back to the desk to check that we got things moving.

This is the second time something like this happened here, and we should have been more aggressive today with making sure Mom was being seen within 15 minutes. Next time we will be on top of that.

However, like the last time, once things got moving, they got MOVING. In minutes we were being seen by our provider who reviewed everything and answered questions and spent so much time with us.

From there, we scheduled Mom’s next 3 appointments and checked in for infusion. I think ”infusion” means chemo. Or close enough. Infusion is where you go to get chemo so we will go with that.

We got a big private room with a nice view and plenty of natural light.

The nurses handling all the work are tremendous — efficient and cheery and confident.

While we were waiting for pharmacy to mix the chemo — they don’t do that until the last minute, and every chemo dose is custom made for each patient — we were visited by a pharmacist who went over Mom’s entire list of medicines and supplements. He talked about how each worked with each other, what the side effects could be, and what we could do to counter the side effects, and so on. He gave us a folder full of info and his card with his cell phone that he said we could use anytime if we had any questions.

While the pharmacist was meeting with us, Mom’s chemo arrived and the nurse hooked it up and got things flowing.

After a few minutes, Mom had a reaction to the chemo; she lost feeling in her throat and had trouble swallowing. I was out getting coffee, but Alia was here and witnessed the rapid response team arrive in about a second. They paused the chemo and gave mom some steroids and got things settled down, and eventually re-started the chemo, but at a slower rate.

This being the first time, we were prepared for anything. We were told many times how each patient reacts differently, and there would be some trial and error.

Still, it was quite scary for Alia and I am sorry I wasn’t here.

But mom is fine, and that La Colombe coffee is the best on the planet.

Once the chemo was flowing again, we were visited by a nutritionist. We’ve been working so hard the past few weeks to stock my Mom’s house with the best possible foods, and it was wonderful to hear the nutritionist state that we were on target. She had some great explanations for some things, and some great tips, and also left a folder full of recipes and information, and her cell phone number if we should have any questions.

This place does love their folders. Each one is custom designed. Some graphic designer landed this gig and is probably funding his whole operation with this work. Custom folders for every team. Good for them. I am not jealous. It’s fine. Everything is fine.

So, with the delayed start and with the slowed-down chemo, we are here for a few more hours than we anticipated… but what we anticipated was potentially being here all day, so, no worries.

Mom is comfortable — napping, watching TV, playing crosswords.

We talked about what games to bring for next time, what foods to bring for next time, and who might come next time.

We are focused on next times, on all the next times.

We have faith this will work, and we will have many years of planning ”next times” with Mom that have nothing to do with hospitals and pharmacists and nutritionists.

As for today: that should be about it for today; hopefully we will be on our way home shortly.

Until next time…

Today my younger sister Alia (also a nurse) and I (not a nurse) took Mom back to the Abramson Cancer Center to have Mom’s port replaced. Mom had a port put in about 10 days ago at a different hospital, but when we switched to Penn, their infusion team said they could not use it. At all.

Not going to lie — the poor port placement was a factor is Mom choosing to switch her care to Penn.

This was Mom and my second time here, and my younger sister’s first. Again, the whole experience was outstanding. The entire staff there is kind, efficient, competent, confident, cheerful, and empathetic. There really is something to be said for going to a facility that is built from the ground up to care for cancer patients in the best possible way.

However, there are so many people — so many patients, so many staff — that it is very sobering and always a little sad: everyone here is here to fight cancer. It is a little staggering.

But today was a good day!

We arrived exactly on time (you are welcome) and were immediately greeted and checked-in, and before we knew it we were being led straight to Mom’s room. My sister and I were both able to sit with Mom in the room the whole time.

When the surgeon came, he asked to look at the existing port. He said, “That…uh… that sucks.”

Soon they were wheeling Mom out and Alia and I sat and talked about all sorts of things, from the trivial to the serious. It was some good sibling bonding time; our family relationship is, I think, our greatest strength.

In no time they were wheeling Mom back, with the new port in and the old port gone.

Mom said she was able to remain awake during the procedure, and while it did not feel great, it was not “too bad”.

They had us out of there — Mom was easily able to walk the whole way from the room through the Center down to the parking garage — in no time.

As we were getting on the elevator to go down to the parking garage, and man and woman joined us.

“They gave me this shirt!” the man said with more than a little excitement. He held up a shirt. “Today was my last radiation treatment!”

We were effusive in our congratulations. He was beaming. The woman with him was beaming. There was so much joy in the short ride to level P3.

He wished us luck and, as we walked away, I heard him say to the woman “This is a really good shirt, too.”

I think there are signs everywhere. You might think meeting that man at that moment as we took our last preparatory step before Mom starts her chemo was a coincidence, but I believe I know better.

The sun was out after two weeks of cold, rainy weather. We are full of hope and encouragement.

We made it home in time for the Phillies’ opening day pitch.

And on the first day of baseball season, hope springs eternal.

Today was a beginning sort of a day.

My mom has cancer. My heart is broken.

I can’t believe this is our story, this is her story. I can’t believe this is the day that reality begins.

Mom had her first appointment at the Abramson Cancer Center at University of Pennsylvania; it was a meeting with Dr. Peter J. O’Dwyer, a medical oncologist.

People who know about these things felt we were so very fortunate to get an appointment with Dr. O’Dwyer. Some people felt like it was something of a miracle.

I’ll take it! We need somethings to break our way, hopefully this is a big one.

My older sister Angella, a nurse, is running point on all the medical stuff, along with my younger sister, Alia, who is also a nurse; I volunteered to be the wheel man. The driver. The Uber. I spent most of my college years at Penn for ROTC, right at the South Street bridge, and when I wasn’t playing Army I was picking my then-girlfriend-now-wife from one of the Penn dorm buildings. Now my oldest child goes to school there, so I felt very comfortable negotiating the sometimes chaotic streets.

Even still, I spent a good bit of time prepping my route. I wanted to make sure I delivered as stress-free a transport as possible; getting lost or missing turns seemed like the last thing I wanted to do.

I spent a bit of time the night before rehearsing my route with my wife, who is a far superior navigator than I am. I called an old friend who had made my trips with a spouse to this very place and got the tea on the parking situation.

Before we left, I studied the map over and over again.

It is super easy to get there, and super easy to get home, but it is a little congested in the immediate area. It is like a city within a city on those blocks, with massive buildings dedicated to being hospitals and research centers. Everywhere you look is a monolith of mirrored glass housing Western medicine’s best hope for fighting disease and illness, for helping the sick, for curing and caring.

It can be overwhelming.

My prep time was time well spent as things went perfectly on the ride down and I dropped everyone — Mom, Pop, and Angella — off at the main door exactly when we wanted to be there.

After parking I wandered through the incredibly bougie building. It is just a few years old, and it is extraordinary in every way. It felt like the saddest and yet most hopeful place in the world. Everyone in there was, in some way, living this story that we, our family, just began.

Everyone was connected.

Everyone was battling cancer.

Some were patients, some were family, some were medical staff, some were building staff… but they were all part of the same fabric.

We were all there because of one thing: cancer.

Just past the main elevators in the main entrance area is a massive display of the names of the people who helped fund this place. My friend, the one that gave me the contextual insight on how to best negotiate parking and drop-offs and pick-ups, also told me that her spouse, who had tremendous success here and is running road races and living their best life, has a family member on that way. They told me that every time they came here for an appointment, the first thing they did was notice and recognize their family member’s name on the wall, and feel a connection. Hope. Life.

I walked over and noticed their names, too. I felt a connection, to someone who helped make this wonderful building happen, and to someone who is alive because the people who work in this wonderful building did what they do best. My hope was to tap into some of that good vibe. I’ll look for the name every time I come here, too.

I tried to sit in the lobby — I was not supposed to go with Mom as she is only supposed to have 2 support people with her — but I was feeling some feelings sitting there surrounded by all of the everything and the everyone battling cancer.

I wandered out to take a walk; it was rainy, and I wasn’t up for an adventure.

Just outside I was faced with two options: a food place that sold La Colombe coffee (possibly the best coffee in the world), and a Starbucks (not the best coffee in the world, but possibly the most consistent coffee consuming experience in the world). I opted for the lesser coffee and the most expected experience. I just wanted to be someplace normal, someplace that I recognized, someplace that didn’t fee like a cancer battleground. I stand by my choice.

Except, everyone in there was either a hospital worker, a construction worker, or a weary, bleary, teary person seeking solace in a familiar cup of coffee like me. No relief for me there.

Plus there were these two men speaking Greek and, I don’t know, they kept staring at me like we were enemies. I felt like I was sitting in their seats, but they came in after me. Was this their seat? Was I violating some protocol I did not know? Why did they look like they wanted to fight? I tried to read my book, but my imagination kept running away with all of these scenarios of me fighting off an attack by too burly men speaking Greek who mistook me for some foreign agent or something. If there was going to be a thing, this chair would be useful. If I could get to the otherside of them, I could escape, or get to the hot coffee and use that. I needed to make a distraction. It was all happening too quickly… except it was not happening at all. It was just a boring old Starbucks and that was probably just the way these men looked. My mind is all over the place.

I should have gone for the La Colombe. I know this.

So I finished by coffee and left; no eye contact, no fights, nothing. I wandered back into the building, and my sister texted me that mom was still waiting to be seen, and I could easily come up and sit with them.

I decided that was the best play.

As soon as I got there, mom was called to be seen. After a while, she and my sister came out. Mom looked relieved. My sister looked relieved. Me and my dad looked scared. Mom needed some labs run, but we were able to chat, and she felt content. I relaxed.

She really liked Dr. O’Dwyer. This is going to be the place. This is where the big fight is going to go down. Abramson Cancer Center is the arena. Mom (and her fam and her new Doc and all of the people here) vs. Cancer.

We were looking at 4 rounds of chemo, each two weeks apart, and then some scans to see how well it was working. After that, 4 more rounds of chemo, and then, possibly surgery.

We went over all of the details on the ride home, all of the expected effects, all of the strategies for keeping Mom feeling strong enough to keep up the fight.

The die is cast. The fight is on.

Here we go.

The new normal.