[International Guest Post]
I live in Trivandrum, the southern tip of Indian peninsula. I am sixty years old male. I was working in the State Forest Department making me to stay a long period away from home where my father lived. He was a widower and house keeping was done by an elderly lady who was with us for a long period. He was then seventy years old and very healthy. He used to narrate us the gymnastic experiences of his youth and even at this age his physique was good. I didn’t even remember him bed ridden even for one day.
One day while at home he complained of a sore throat that does not resolve even after three weeks. I advised him to gargle with salty hot water, which I used to cure a sore throat during acute cold. After one week I got a telephone message from him that the ENT specialist in the local hospital has advised him to have a thorough check up at the Medical College where more facility is available. He requested my presence during the checkup. After a preliminary medical checkup the doctor has ordered for a series of medical tests. He has fixed a date for laryngoscopy. A laryngoscopy is an examination by use of a tube with a small lighted camera. A cranial CT scan was also conducted. Studying the results he has further gone for a biopsy. It took altogether about one month from the preliminary tests to determine it was a throat cancer. He explained to me that the cancer has affected the vocal cords and voice box.
The doctor was prescribing that treatment is surgery followed by radiation. I expressed the concern whether the cancer is completely curable after the treatment. Doctor said it all depends on the stage of the cancer, the location and size of the tumor and, probably most importantly, the age of the patient and their general state of health and attitude. It could even damage his vocal chords or even leave him unable to speak. I have discussed the details of treatment he has to under go and we decided to take the advice of the doctor to under go the surgery. After surgery a tracheotomy tube was inserted and this tube was used for breathing. This small steel tube opened at the middle of the neck below the chin. After surgery he was given radiation for about one week.
The nose was not at all used now for breathing; breathing was only through the tracheotomy steel tube opening in the neck. It was all painful for him. Immediately after surgery in the bed, he was suffocating for breath. The tracheotomy tube was occasionally blocked by blood and sputum, this blockage caused chocking. The breathless stage one can imagine. He was wriggling with pain. He cannot express himself his needs. We have provided him a writing pad and a pen so that although suffering from pain he can express his wants. Food was liquid form and nostril feeding was done. He was suffering from pain and irritation and helplessness. Day by day and moment by moment he was becoming depressed and wanted to die badly, which he expressed in writing and my presence is what he needed always. I have taken a long leave from my job and decided to help him by my presence and nursing. Gradually he practiced breathing through the tracheotomy tube and food was taken through mouth as in normal case. The urgent nursing technique like cleaning the tracheotomy tube to avoid bacterial infection and to rub off occasional sputum from the tube opening was practiced by us.
After two months in the hospital, he returned home and was feeling better. But altogether he came out from hospital as a different man physically and mentally. The empathy of the family members and friends were sincere and he admitted his inability to speak. He tented to become more pious and serene. We provided a house maid to attend him. I started going for my job and things seemed to be better. Now he was living with my family, which included my wife and two children. His grand children never avoided him afraid of cancer. They expressed their affection to their grand father. This I think was the major factor of his relief, which he expressed to one of his best friends who occasionally visited him. But some of our relatives and friends kept away from him afraid of that the cancer is contagious and some of them did not want to see the breathing through the steel tube, which some times produced bubbling sound of sputum.
The doctor warned us the possibility of secondary growth of cancerous tissues in and around the affected area. Although he cannot speak and breathing was not done through the tracheotomy tube, his spiritual belief guided him to have a balanced mind. Two years passed after his surgery and all of us were happy that he was leading a normal life. Periodic consulting was done with the doctor. One day he complained of difficulty in swallowing food. We made the food creamier, still his irritation increased. Doctor was of the opinion that the secondary growth started. He prescribed some medicines to reduce the suffering from pain, which according to him were only sedatives and in take of medicines were not helpful in curing.
The last food taken by him was a dinner at the New Year family get together on January 1st of 1993. After that he did not take any solid food since it was difficult to swallow. The secondary tumor growth has blocked the entire food transmitting path that nostril feeding was difficult. Doctors now recommended making a direct opening to stomach by surgery and supplying food, if we accept the treatment. But he also advised us to consider the weak condition of the patient. Finally we decided not to make him suffer further with one more surgery. He was other wise healthy that all the other systems were functioning normally. He was not diabetic nor suffered from high blood pressure and his heart was functioning well.
It was a great suffering to see him dying inch by inch or tissue by tissue without food and water. We could hear his breath becoming hard and hard and the hard intake of breath was not at regular intervals. The vibration of effort of his hard intake of breath itself lasted for one whole day. I can only look at his face which was suffering from pains which words could not explain. The present stage was something like this; he wanted to put an end to the suffering and we also prayed that his life may be taken at the earliest. On July 15th evening by 7.20 he stopped breathing. There was a sudden change in his face. He was dead and face was now calm with out sufferings and the face was serene and peaceful, although he was dead I was relaxed to find this calm face.
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