To the Bone

For 13 months, we've remarked on how these cancers "cut to the bone."  From Mom's very difficult surgery recovery; to dealing with uncommon circumstances of her disease; to Craig's horrific symptoms, tumor growth and frequent hospital visits; to seizures; to skin tears that left our Mom's arms more wound than skin, cancer has cut to the bone on so many levels, figuratively and now -- as of tonight -- literally.

We've been monitoring Craig's skin tear near his tailbone for several weeks now. It began as a simple red mark and quickly bloomed from a mild blister to full fledge skin tear, despite rotating his hips and distributing pressure with an alternating air mattress. His normal protective fleshy layers have disappeared, going the way of his weight and body fat. Now nearly skin and bone, there wasn't but tissue paper to stave off the force of friction and pressure.

Jill and I changed his dressing tonight. Earlier this afternoon, Craig remarked that his tailbone no longer hurt - the egg crate pad we cut to size and placed under his tailbone seemed to be working. We carved out a small hole for his tailbone to rest and be relieved of any pressure. As I looked at his wound, I discovered why. In the middle of a red circle about the size of a quarter lay exposed his grayish white tailbone free and clear of the last protective layer of skin. It was startling to see. Not to startle Craig, I mouthed what I thought it was to Jill. Diane eventually came over and we showed her. I mentioned that he likely was no longer feeling acute pain because he had broken through the nerve endings of the skin to the bone.  

We flushed the area with sterile saline, added sterile morphine gel to a protective layer of gauze and then bandaged that sucker up. Jill called the hospice team and confirmed that we did all we could to help him tonight. Sandy, the hospice nurse, will pay a visit tomorrow and we'll develop another strategy. Unfortunately, such wounds are all too common for bedridden folks with such little body mass. We've been rotating him to the extent his tumor filled belly will allow; we've given him protective surfaces to lie on; and we've added padded dressings to his tailbone. For so long and for so many obstacles, it's as if a missile's been launched and we stand on the shores trying to figure out how to bat it down or divert it, with a fly swatter our only arsenal. Aggressive cancer, thrush, bed sore -- it seems the hits keep coming for Craig without defense.

Out of view, Diane, Jill and I broke into tears. It's a helpless feeling watching his wound split to the level of bone and not be able to do a damn thing about it. I'd give my own skin if it'd help, let alone any other body part if it would ease an ounce of his suffering. Our goal now is to continue keeping him comfortable and, with any luck, protect it from splitting further. Fortunately, there's scant blood supply in that region so we needn't worry about him bleeding, and it turns out the region isn't as prone to infection as long as we maintain good sterile/cleaning practices. Still, his bone lays bare -- showcasing the symbolic yet very real vulnerability of his condition. Breaks my heart.

So goes another event that cuts to the bone. ~E