Joanna – Interview 35
Joanna looked after her husband for ten years after he was diagnosed with acute myeloid leukaemia. Although initial treatment put him into remission the disease recurred after five years in remission. Further treatment did not work and he eventually died.
Joanna’s husband was diagnosed with acute myeloid leukaemia ten years ago in the course of dealing with an anal fissure. By the time he was hospitalised he had perineal gangrene and was high on morphine, so Joanna had to make decisions on his behalf from the outset and continued to do so throughout his illness. She found it difficult to build up relationships with the doctors because of frequent personnel changes. Her husband remained in hospital for nine months having treatment. Although staying overnight at the hospital was an option for Joanna her husband didn’t want her to, but she spent a lot of time there, even working when she could. The gangrenous tissue was surgically removed but the wound never healed well and required a new dressing every time he used the toilet, a task that Joanna sometimes did when he was at home.
Joanna and her husband found it difficult to predict how long his recovery would take and how to plan for his return to work. Believing that her husband would never return to full time work Joanna turned down offers of long term projects that he might not be able to complete. It was therefore important that she maintain her own work commitments, although she had to reduce them towards the end of his life.
It took about three years for Joanna’s husband’s blood counts to stabilise and after five years in remission he was diagnosed with a preleukaemic condition called myelodysplasia which gradually turned to leukaemia. He was invited to join a clinical trial but eventually discovered that he was ineligible. A stem cell transplant was considered but the risks were thought too great. Around the same time Joanna’s mother, who she was also caring for, died from cancer. Joanna believes her husband found this difficult to deal with as he knew that he might also die. He had various chemotherapies but none worked for long. Joanna knew when his condition was deteriorating but found it difficult when he didn’t seem to want to acknowledge or discuss it. He had a series of small strokes that reduced his ability to communicate. Because of this and because she had been so busy dealing with practicalities, they hadn’t really discussed emotional issues.
Joanna obtained an NHS bed for their living room and an emergency call system for when her husband fell and she couldn’t get him up. Although she had been preparing herself for her husband’s death for a long time, and there had been several occasions when she had thought it imminent, when it actually came she was taken by surprise and felt it hadn’t been a particularly good death. Joanna thought her husband had wanted to die at home but with hindsight wonders whether that had been the best or the easiest thing for either of them.
Joanna was also interviewed for the clinical trials section of this site (see Interview CLT25).