Next Steps

Tags

Cancer, Mother

Dateline: sometime in the future.

“Now what?” That’s the question that’s plaguing me constantly these days. Last we read, mom was in the middle of cancer treatment. So where are we? Well, the news is good. In fact, it’s so stupendously good that it would simply have been unbelievable at the outset.

I refer to the fact that my mother has proven to be a trouper beyond all belief. She handled chemotherapy extremely well. Her only notable side effect was hair loss, and a bit of minor fatigue toward the end. But heck, she’s in her late 80’s and if she’s a bit fatigued, well, she’s earned it. But better than the lack of side-effects, the chemo did its job. Her main tumor did shrink down and develop a distinct boundary. The rest of the cancer was vanquished by the chemo. After a very successful, single, radical mastectomy in late September that also included the removal of several lymph nodes, the pathologist’s report came back negative: no cancer was detected in her remaining tissues.

The news was so good, it was hard to believe. We had a small celebration. Six months prior I felt pretty convinced that the chemo alone would kill my mother. Now she is cancer-free.

Of course those of you who understand cancer realize it isn’t quite this simple. Her handsome oncologist warned that there still could be a few undetected cancerous cells floating around that might still cause trouble. So he prescribed a course of radiation therapy and additional chemo.

So in mid-December, mom finished doing daily radiation therapy, five days a week. That mostly went well, but she’s got a nasty burn on her chest that’s slowly healing. Now she’s resumed chemo which will run through the end of February. After that, any remaining cancer cells should have been blown well into oblivion. And then, mom should be spit out the other side of the system, stamped “cured.”

Then what? Frankly, it’s not an easy question to answer. For me, staying here forever is not an option. Leaving my mother here alone is out of the question. Since I arrived, she decided that it was best to stop driving, a decision I fully support. In addition to the cancer, she has macular degeneration, and from conversation it’s pretty clear her vision isn’t up to driving. And she’s become forgetful, and all of that combined with the various aches and pains of age means she needs someone around to look after her. She doesn’t need a nurse, just a responsible adult who can drive, and help with odds and ends. She’s also at some risk of falling, though stricter adherence to using her walker seems to have solved that problem. Fortunately she wasn’t hurt in the couple of spills she took earlier in the year.

So now what? I’ve thought of a lot of potential solutions, but I have yet to settle on any of them. My initial idea was to take her to Mexico City to live there with me, or perhaps close to me, with a live-in maid who could handle much of what I’m doing for her now. In some ways, that’s still not a bad plan. Financially it works, and it puts me back in CDMX, a place I miss very much. But it would also make my mother entirely dependent on me for everything, including companionship. And while I’d like to spend more time with her than in the past, I’d also like her to have her own life too, with her own friends. As a non-Spanish speaker, that’d be difficult in Mexico City.

I also thought about moving her to Boston, but that’s fraught with difficulties. First, my house is 2 story, and there’s no getting around the stairs. The bedrooms and bath are upstairs, while everything else is on the ground floor. Even getting into the house requires going up 4 stairs at a minimum. I briefly considered building an addition onto the back of my house that my mother could live in. But then I’d be tied to Boston more-or-less permanently. And I’d certainly not be able to easily run off to Mexico or Turkey or India or anywhere else I’d like to see, because someone would still need to look after my mother. Boston is also one of the more expensive cities in the USA, which pretty much rules out her getting her own place there. Alas, finances are a constraint too.

Then I thought about maybe trying to find her an assisted living place not too far from Mexico City. My former upstairs neighbor in CDMX, Carole, said there was an assisted living place with Gringos in Cuernavaca. Unfortunately, neither of us have been able to actually locate that one. Maybe it doesn’t even exist. Who knows? (If you do, please leave a comment.) Then I started Googling for places near San Miguel de Allende on the theory that it’s only 4 hours away from CDMX and would be easy enough to visit regularly. Certainly lack of Gringos shouldn’t be a problem there. It turns out there are a couple of places about 10 KM north of SMA that look nice. But I emailed a friend who lives in SMA and she said that some of her friends had had spotty experiences there, primarily due to the lack of medical facilities. Now, I haven’t ruled out those places, but a red flag has been raised.

Aside from her cancer, my mother has been pretty healthy, but she’s now nearly 90. Sooner or later health care is going to become more important. And for the next five years, she’ll need to see an oncologist every 3-6 months to nip any recurrence in the bud. So that makes SMA somewhat challenging.

The next obvious place is Ajijic. There are loads of Gringos there, along with plenty of assisted living facilities, and a climate I know my mother would love. I’d really like to see her in a place where she can connect with other Americans, or at least fluent English speakers. Though she’s said she’s willing to try to learn Spanish (kudos, mom!), I’m skeptical that she’d be able to learn enough quickly enough to socialize with Mexicans successfully. There are also good hospitals in nearby Guadalajara if the need should arise.

The only real problem with Ajijic is that I neither want to live there, nor do I want to live in Guadalajara. Still, I did do some quick searches on real estate there, and it’s surprisingly cheaper than Mexico City, maybe 35% less, perhaps even less than that. Moreover, decrepit but large colonial houses can be had in the Centro for cheap. But while Guadalajara has a lot going for it, I just didn’t feel like it clicked for me when I spent a week there in 2014. Still, I could probably have a fine life in there, and it’s certainly got loads of gay people who seem to be everywhere. But it’s also full of ugly buildings (my biggest objection), much more so than CDMX. And it’s a much more conservative place than CDMX too. Oh, and the climate is on average 8°F hotter than CDMX. So I was a little on the sweaty side running around the city.

Meanwhile, the fact that Medicare doesn’t cover services in Mexico is also a potential issue. Yes, I realize that cash prices for basic medical care in Mexico are quite affordable, but they could still add up for an elderly person. One thing I’ve considered is moving us to Mexico, but getting my mother established with a doctor in, say, Laredo. We could then go there from time to time, relying on Mexican medicine for emergencies. Of course that’s not an ideal solution. Mom gets monthly injections in her eyes to treat the macular degeneration. I suspect that driving from either GDL or CDMX to Laredo every month would get old fast, though such injections could probably be had in either one of those Mexican cities. The question then is cost.

So I’m still mulling the question of what to do. By the end of February mom will be done with her cancer treatments and her next chapter can begin. Any suggestions? Does anyone know of a good assisted living facility for Gringos in Mexico?

Saludos and thanks for reading and for any suggestions you might have.