"bleeder!"

Note: Some contents not suitable for the faint of heart when it comes to blood.

Saturday, June 17th, 2017 was a rough day. It started out like our usual days lately with Mandy resting in bed until about 11:30 or 12:00. I wake her up to take her medicine and make her a fried egg sandwich to start her day. She comes out to the living room and hangs out and watches some t.v. Her dad and step-mom were here, so she was trying to stay awake longer to be able to visit with them. By 2:30 or 3:00 she will normally take a nap until 5:00, and on this particular day we grilled hamburgers and made tater tots, so she was up and able to enjoy dinner. After dinner, Mandy was ready for bed, so she went to bathroom to get ready and next thing I knew she was calling me to help her with a "bleeder."

Let's take a step back in time for a moment. Almost two years ago, the tumor in Mandy's abdomen had grown enough to show up as a golf ball size lump in her abdomen. The doctors at CTCA suggested radiation to see if it would shrink the tumor since chemo was no longer working. We were waiting for the radiologist when the nurse came in and was talking to Mandy about her tumor and said that if the tumor kept growing, it could actually break through the skin. Mandy's eyes got big and she made up her mind right then and there that she would zap that sucker to keep it from doing that! The radiation did not shrink the tumor, but may have "slowed" the growth for awhile, however, about a year after the radiation, the tumor made its debut to the outside world. Ta-da! At first, it was just a small hole, but the hole kept getting larger. Once it reached the size of about a dime, we experienced our first "bleeder." Mandy was in the shower and started yelling for me, as I came in, all I saw was blood everywhere. All over her, all over the shower, it was a scene right out of Psycho! I got a towel over her tumor to control the bleeding and got her dressed and we raced to the ER. I just knew she was going to bleed to death before I could get her there. Once there, it continued to bleed a small stream of blood all through triage. The nurses worked fast and got us back to a room quickly. The doctor came in reading her chart with a puzzled look on his face. Typical doctor, he had never experienced this, so he was excited to take a look. Unfortunately for him, but fortunate for Mandy, the bleeding had finally stopped. It had lasted for over an hour at that point and I was figuring they would need to do a blood transfusion. The ER doc chuckled and said that she didn't really lose that much blood. He said comparatively speaking, this is nothing to what he has seen when it comes to blood loss in the ER. Well, to a Forester, it was a major loss of blood! Little did I know what was to come.

These bleeding episodes continued about every week for several weeks and as with most things cancer related, Mandy and I grew accustomed to it and learned how to handle them on our own for the most part, but still had to go to the ER a few more times when we couldn't get the bleeding to stop on our own. The last time we went, the bleeding lasted 2 hours. It looked like a pin hole in a balloon full of water, except it was a vein in a tumor, full of blood.

Mandy decided to try radiation again last July and August to see if it would help with these "bleeders," and it did. After radiation, Mandy decided to go onto Hospice, and after a couple of months the tumor growth began again and we started to learn the term "fungating tumor." Without going into detail, a fungating tumor is a tumor that has broke through the skin and you actually get to see the tumor exposed. This brought on the "learning how to do wound care" part of being a caregiver so that it would not get infected. Not sure what this says about doctors and nurses, but every time one of them looked at the tumor, and they ALL wanted to look at it, they commented about how "good" it looked. Well, as the tumor continued to grow, veins would come to the surface and then retreat, but since the veins and the surrounding tissue is so fragile, they would sometimes break open and bleed. That's when the term "bleeder" became a regular part of our vocabulary. "Hey honey, we got a bleeder" or "got another bleeder" were words I dreaded to hear. It meant getting Mandy into bed to where I could put a cloth diaper (we discovered this wonderful tool on our own) on it until I could get it to stop bleeding. Then, I would clean the tumor and put a new dressing on it and wrap it up to secure it all. On a real fun night, we would get a bleeder, get it stopped, cleaned up and a new dressing, just to have it start bleeding again. At this point, we were getting so used to blood, that we didn't even blink an eye at it. We just went through the motions and took care of it. That is until Saturday night.

"We have a bleeder" was all I remember Mandy saying. When I walked into the bedroom, there was blood running all over her. She was getting into bed but the cloth diaper she had couldn't contain all the blood. I grabbed some more diapers and our basket of "tumor cleaning supplies" and started to do my normal routine. After we soaked through the first 5 diapers, I started to get a little worried. By diaper 15, I was out of diapers and really getting worried. The tumor had been bleeding for about 20 minutes now. I looked around and grabbed some Depends guards that we use to "pad" the tumor normally. I started putting them on the area of the tumor that was bleeding and watched them soak up blood rapidly. After about 7-8 pads getting soaked, I new I had to do something. Normally the "bleeder" slows down, loses pressure and clots itself, but not tonight. I grabbed some military grade blood stopper cloth, the kind they use on the battlefield to help stop soldiers with bullet wounds from bleeding out, I cut several pieces of it and started putting them at the spot where the blood was coming from. It immediately soaked through two pieces, so I took the top one off and put a third one on. After about 5 minutes, we lifted our last diaper and thanked God that the bleeding was finally slowing down. Another 5 minutes and the bleeding had stopped. An hour and fifteen minutes had gone by and this time I knew Mandy had lost a lot of blood. After about 30 minutes, we stood her up to try to get her blood soaked pajamas off and she almost passed out. We laid her back down, called the Hospice nurse and waited. Her blood pressure was 110/49 with a resting hear rate of 115. Her body was trying to compensate for the blood loss. The nurse estimated she lost at least a pint of blood if not a little more. I vote for the "a little more!"

Mandy was white as a ghost and started having more pain around the tumor following the "bleeder." Between the pain and the anxiety that goes along with it, she is taking a lot of morphine and Ativan. It is now 4 days later, and she has yet to leave the bedroom. I have to help her up to get to the bathroom (about 5' away from her bed) and it takes everything she has to get back into bed. When I wake her up to take her meds, she can hardly keep her eyes open and when she tries to ask me a question about my day, more often than not, she falls back asleep while I am answering her. Now, I know I'm not the most interesting man in the world, but it starts to give a guy a complex. Seriously, this one scared us both. Enough so, that we have discussed how another episode like this could be her last.

Why tell you all of this? Well, for one thing, Mandy wanted to keep everyone updated so that as you say your prayers on our behalf, you know specifically what to pray for. And secondly, I wanted to let people know that whatever situation you are in, God is faithful to get you through it. I told Mandy afterwards that I had to go into nurse/patient mode during all of that or I would not have been able to handle it. If I had looked at her as my beautiful wife, literally bleeding to death, I don't think I could have figured out a way to stop the bleeding. About 30 minutes afterwards, while I was waiting on the nurse to show up, the adrenaline started going away and I started shaking. I thanked God for getting me through this and for helping me find a way to stop the bleeding. I didn't pray to God while it was happening, I didn't call on His name, but I didn't have to. He was right there with me, keeping me calm and clear minded. It is a great comfort knowing that even when I am not focused on God, He is focused on me!

Please keep Mandy in your prayers. Jay.