Getting ready to bloom

Well, okay, the plum tree is already in bloom, and I still have two more chemo infusions left. But still.... I'm trying to rush things, and why wouldn't I? This spring has been painfully slow in coming, and obviously I'm not just talking about the weather. Who can resist the urge to usher in little blossoms and flowers?

I keep a close watch during spring, searching the tulips, daffodils, and blossoming trees a few times each day for any new micro-moves toward bloom: A bud here, a new shoot there, a bit more color popping out of the Redbud. Might simple and diligent observance nudge them a bit further along in the process? Maybe not; the blooms will come in their own sweet time. But each little step is celebrated, and I'm glad to be witness to them.

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Today is a good day. A vertical day. Not only that, for the first time since before surgery, I ran. Actually, I went for a run/walk combo out on the trails out on the prairie--two minutes walking briskly, two minutes slowly jogging--for about a half hour. That's my kind of therapy, my own little micro-moves toward full bloom.

Going with the flow

I'm sitting here in the chemo suite this Wednesday morning, port accessed and awaiting my pre-meds: Zofran, dexamethazone, Ativan, Aloxi, and Emmend. Quite a cocktail, and those aren't even the chemotherapies (Adriamycin and Cytoxan). A few minutes ago, my friend Cathrine emailed me the following image, which I love:

Note that the red beverage matches the red drug Adriamycin. I love this because it illustrates both humor (an absolutely essential component of treatment) and confidence in the power of the drugs. But it also conveys the potential celebratory aspect of chemo. I say "potential" because I doubt that many think of the infusion of highly toxic chemicals into the body, and the accompanying nasty side effects, as cause for celebration. However, I do believe there are things to celebrate in this process. The obvious things, which those who are adept at seeing the silver lining in such experiences may note, include the knowledge that treatment is working, and that every infusion amounts to a fairly significant bitch slap against the disease, as well as the continued joy in all aspects of life outside of Cancerville. But it is also worth celebrating the resiliency of the human body and mind as they undergo chemotherapy.

Two weeks ago, one of the nurses in the chemo suite advised me to "go with the flow" with respect to the exhaustion and the body's need to sleep, and that was excellent advice. This is also the case with the mental fuzziness, or chemo-brain, that accompanies this course of treatment. I have no need to fight these side effects. Although there is a teeny part of me that worries about the work I am not getting done, my body needs the sleep, and sleep is an extraordinary restorative process. It is, counter-intuitively, a beautiful thing to witness from the inside out what my body does to heal itself; to remain as healthy and functional as possible in the face of toxicity. Now I'm not "going with the flow" with the nausea as much. Instead, I am doing what I can to counteract it through both medication and diet. And yet, nausea too is a sign of my body's automatic processes of managing the assault of chemotherapy. It is not fun, and it is not pretty; it is in fact rather shitty. But when we view that as the response of an otherwise healthy body, it can also be viewed as a sign of resiliency and strength.

Emotional resiliency is tougher to achieve, but I am finding that recognizing and embracing the ability of my body to manage the physical side effects helps me shift my frame to one that is more psychologically manageable. Drugs help, too, no doubt about it. So in some ways, going with the flow with respect to the emotional and psychological toll of this means embracing the fact that getting the help of anti-anxiety medicines and occasional sedatives is not a sign of weakness, but rather can indicate strength. (See my post on strength and grace.)

In addition to my body's automatic responses that indicate resiliency, I am celebrating a very good second week post-infusion. I was able to eat regularly, and actually exercised a few times, albeit lightly. What gifts! These are things to celebrate. And now, as I wrap up this post, the Ativan is taking effect, and I am beginning to fade into loopy-land. I will be going with this flow with humor, confidence, and as celebratory a tone as I can muster.

Cheers, Y'All!

Update on chemo effects

Several people have asked how I've been holding up since I started chemo last Wednesday, so here's an update for you all. Nausea was the news of the day on both Wednesday night and all day Thursday. Some you know that I really do not do nausea well, so that was really unpleasant for me. On the flip side, I never actually got physically ill, so the word on the street is that I have been handling this well as far as sour stomachs are concerned. Note that I am on stronger anti-nausea medications this time around, so I shudder to think what this would be like without those. We can all thank the gods of science for Emend and Aloxi (not to mention Zofran)!

What has probably hit me most is tiredness... no, exhaustion. Exhaustion pure and simple. On both Thursday and Friday I took three naps, and one of them actually took me by surprise. The kids had gone to school and Craig had left for work, and I had (apparently) sat down at the end of the sofa to figure out what I might do next. About an hour and a half later I awoke from a fairly substantial slumber, head nestled on the arm rest of the sofa. This exhaustion has been coupled with a foggy-headedness that I've never experienced before; just a complete feeling of "wha? huh?" swirling around me, and even some occasional lightheadedness. While my tiredness has persisted, it has gotten better as the days have gone by, and I'm not taking daily naps anymore. I'm feeling somewhat weak physically, and a little on the pale side, and Dr. Dad is pretty sure I'm anemic from the chemo. The foggy-headedness is still present, but not too severe.

Aside from the nausea during the first two days, perhaps the most annoying side effect has been a bitter and metallic taste in my mouth that won't seem to go away. I'm hoping that also subsides between now and my next treatment (April 16th), but we'll see. Hard candies help temporarily, but it also affects how things taste to me. This makes wanting to eat a bit more of a challenge than normal for me, but my appetite has improved since Wednesday, so I'm not too worried.

So that's pretty much it. This is not a recipe for productiveness at work, but on the other hand, that's not the point of all of this is it? It's been important for me to remember that when I'm drooling in a stupor on the couch or feeling "urpy" (as the chemo nurse put it the other day), those are symptoms not of disease, but of big-ass bitch slaps. While the first course of chemo and the surgery knocked the cancer out for the count, this is now a process of kicking any remaining cells while they're down.

No mercy.

Back in the chemo suite

Well, here we go. As I write this I am beginning my new course of chemo, and from what I understand, it's a doozy. The meds this time include Adriamycin and Cyclophosphamide (a.k.a. Cytoxan), and will be administered four times, everyone two weeks (8 weeks total). The list of side effects is enough to make one nauseated by itself: hair loss, mouth sores, lowered white cell count (with increased risk of infection), diarrhea, nausea and vomiting, decreased apetite, lowered platelet count, skin changes, and my favorite--red urine. This last one is because Adriamycin is a Kool-Aid red colored agent (see photo below), and so that shows up in your urine when you pee. Lovely.

I'm a bit nervous going into this. I'm glad to have it underway, I guess, as the sooner it starts, the sooner it will be over. I'm nervous for the side effects, but also because I'm being treated with antibiotics for cellulitis on my chest--a minor complication from the surgery. The antibiotics could make the digestive side effects of the chemo worse, and if the infection starts to get worse (if the antibiotics aren't really working), then I'm at risk of a more serious infection given the likely effect of lowered white cell count. However, 24 hours after each infusion it is standard to get a shot of Neulasta, which boosts white cell count. So we're hoping that will help prevent any major infections.

I also worry about the nausea itself, as it is likely to be worse than what I experienced in my first 12-week course of chemo. I've been told to just eat whatever sounds good or tastes okay, even if it's only sweet things or salty things for a whole week.

At the very least, this should be interesting! And it's important to remember that this course of chemo will constitute quite a major bitch slap in this whole cancer treatment trip. I'll end with a photo of Grace and Patience N. Hope next to the syringe of Adriamycin.

Starting my new course of chemo with Patience and Grace.