Monday, November 23, 2009

Monday early morning

During lunch with my girlfriends, V, S and M yesterday, someone reminded me that just a week ago I was so very sick. It was hard to believe.

No posts over the weekend because it was a good weekend, a quiet weekend, a normal weekend. Cancer-wise, I remembered to take all meds (B vitamins and magnesium) both days. May hair is showing is is made of the same stubborn DNA that comprises the rest of me - it continues to cling to my head. Although V asked if I had gotten it cut again since she took me to get it cut the week after my surgery (3 weeks ago). I have not gotten it cut. It's not falling out yet, but neither is it growing anymore.

Otherwise, I took Jessie to the park on Saturday morning. No heron. I attended synagogue services on Saturday morning. Stayed around the house the rest of the day, odds and ends. Sunday my friend L came over mid-morning and we went to the park (but not Jessie - poor Jessie!). Still no heron. I think she may have migrated. I will miss her, but it makes me happy in a way to think of her migrating. LIkely it means she's going to a location where many other herons winter (oooh, first time I think I have ever used "winter" as a verb!). I like thinking of her in a community of herons somewhere warm, rather than all alone here in the frosty fall awaiting winter's cold. I met V, S and M for lunch on Sunday. A lovely long foursome talk. And later Sunday, David went with me and I bought an office chair to use for working at home.

A wonderfully pedestrian weekend.

Today is my first day working part-time. A milestone,

Peace.

Friday, November 20, 2009

Friday afternoon

A good quiet ... normal ... day.

It was raining this morning so no park walk for Jessie and me. Instead a long damp (and weirdly unseasonably warm) walk through the neighborhood, followed by damp dog smells in the apartment. I took myself out for coffee and a roll and read a book. I went to Staples and tried out desk chairs. If I am going to work 20 hours a week from home, I need something better than an old straight back wooden chair. Home. The kids sent confirmations of their flights for their mid-December visit. I spoke with Kim about arrangements for beginning work next week. Etc. Etc. In other words - truly a normal day.

In cancer-treatment specific news: Hurrah, I remembered to take the new magnesium capsules at breakfast and - more-or-less - after lunch. My hair continues to stubbornly cling to my head. The 3-color glossy "Chemotherapy and You" booklet says that hair loss typically begins 1-2 weeks after treatment, but nurse E told me 3 weeks. For some reason I have more confidence in nurse E than in that booklet. Still, I try to become prepared for the day/night I reach up and unconsciously touch my hair and a clump comes out. H advised that her hairdresser will be happy to shave my head, give me a buzz cut (perhaps it would be less traumatic for fuzz to fall out than clumps of "hair"?) or whatever I'd like. Recalling the conversation with H about going to her hairdresser, I realized I felt a surge of panic, thinking she meant I should go now, in the next day or so, and I was freaked out. Then I realized that was my own dread. H was just telling me that when/if I want to do this, her hairdresser will be happy to help.

That's it. A good boring day.

Peace.

Thursday, November 19, 2009

Thursday night

A nice normal start to the day: Jessie and I went to the park, walked both loops. I didn't see the heron, but I have chosen not worry about that.

Today was blood count day. I can't say I was really worried about it, more curious to see what it involved. I arrived and was weighed - I think they weigh you every time you're there. I learned that I have lost 5 pounds since the first chemo treatment, and a total of 12 pounds since the day of the surgery. I certainly don't mind, although if weight loss continued in a linear progression over the course of the entire 20+ weeks of treatment, it could be problematic. I doubt that will happen. And nurse E didn't even mention it as a concern, so...

They drew my blood, and then I waited. Then I was taken by a nursing assistant to the group chemo room. There my pulse, blood pressure and temp were taken (all fine). Eventually nurse E came and talked with me about my experiences over the past week. She had suggestions about a gentler plant-based laxative. I told her about the slight numbness in 3 fingers of my left hand; she didn't seem worried, but told me to keep taking my B vitamins. Eventually my blood counts came in. They were all fine, very good in fact. One category, I had 13.2 and the bottom range of "acceptable" would have been .8. Quite a difference. Good red cell count. Good white cell count (due to the NuLasta).. Good platelets (but I knew that would be okay; over the past couple years I've donated platelets and was able to do a double or triple due to my high platelet count). The only unknown was magnesium level; I guess it takes longer to get that reading. Nurse E said she'd call me later with those results. If it was too low, I might have to come in one day next week for an IV magnesium infusion. If slightly low, I'd have to take magnesium tablets.

One interesting thing was spending about an hour in the group chemo room. It was good. There was spirit. There was camaraderie. Not evenly among everyone there, but still. (Most everyone in the room - about 8 patients - were nurse E's charges, which I think was part of it). I realized that if I am in the group room next time, that will be fine. Maybe I've adjusted some, taken a first good stride toward acceptance, but it was good to find myself among people I know are in my shoes, and I in theirs. And of course, I realized that of those in that room, many are in shoes far less hopeful and harder to wear than my own.

That was the morning. The rest of the day was good. I cleaned up my home "office" a little bit. Did some grocery shopping. Went to the post office to mail some letters and my brother J's birthday present. As I was leaving the PO, nurse E called; turns out my magnesium was just slightly low, so I bought the mag pills and now have to take those 3 times a day. That makes 10 pills a day on a regular basis--okay, all vitamins/minerals, but I am not a keen (or experienced) pill taker.

Other news - I think both my kids and my grandson will be coming to visit in mid-December. They're coordinating and I'm waiting to hear final dates.

It's supposed to rain tomorrow. That's okay. It's been a good day.

Peace.

Wednesday, November 18, 2009

Wednesday morning

Feeling better today. Jessie and I walked both loops in the park. A quiet day. Crisp. The heron was hunched down in her new usual spot.

Today I need to check with the disability insurance company and make sure things are set up for me to start work half-time next Monday. Also I'm going to try to do some cleaning up - my kids are coming, so perhaps I feel that old nesting instinct stirring. Actually things are wildly out of control around here; David and I have both been distracted for a while.

Today is one week anniversary of first chemo. Hurrah. Tomorrow is first blood count day. My fingers are crossed.

I'm well.

Peace.

Tuesday, November 17, 2009

Tuesday afternoon

Hello. The sun is shining again. I did get up this morning and take Jessie to the park for our walk. In the end, I cut it a little shorter than usual. I found I was still a little weak, probably the side effect of the fasting, vomiting, diarrhea-filled weekend. But it was a crisp fall morning. When we first arrived, I didn't see the heron. We walked the back loop, which is our usual route. By the time we finished that, I was feeling fatigued. Normally I would do the front loop and rest on a bench in the Eddy Rock Garden, my favorite place. But I wasn't feeling up to the second loop. So I sat on a bench by the pond, something I rarely do. It was a little later than usual - perhaps 7:00 am. The pond seemed very quiet. Still. Empty. Nothing moved. So we sat in the sun. Then one little brown duck flew in and landed, and squawked up a storm. Then another. Then 4 Canadian geese landed on the far side of the pond. Suddenly I saw motion here and there. What I had thought was emptiness and stillness, was quiet water with ducks gliding through it. I still didn't see the heron, but I decided not to worry. I watched the ducks and the geese spread out over the pond. One duck in particular laughed like a hyena, I kid you not. One single loud guttural "He" followed by a series of falling "he he he he he he he he" notes. A laughing duck. It actually made me laugh. I decided not to do the front loop but to walk around the pond itself, a slightly shorter path and perhaps more interesting to Jessie. As we turned toward the north side of the pond, the sun moved to my right shoulder and suddenly I could see the heron, out on the small float in the middle of the main part of the pond. The sun's glare had hidden her before. But there she was, all alone. So different than the community of ducks and geese. Tall. Grey-green. Looking all hunched over. I wondered where she sleeps. Has she built a nest? Perhaps in one of the tall pines that stand on the larger of the two little islands in the middle of the pond? I didn't linger to wonder long - I was feeling tired and we walked back to the car and came home.

As far as how I'm doing overall, physically and emotionally, last night I think I hit a first (albeit small) wall. I should have known, I guess. There was a hint in what Dr. M said when David and I met with him to get the treatment recommendations (that seems a long time ago now, doesn't it?). I remember him saying that the chemo's effectiveness PEAKED about 10 days after the treatment. I have only now reached day 6. Six measly days. Not even 1 full week out of the 20 or more weeks this "treatment" will continue. And guess what - I discovered I don't like it! I had some time this morning between when I woke up at 5:30 and when I took Jessie to the park, to stew in a little bitter self-pity juice. Yes, I am recovering from the weekend bout of laxative-related vomiting and cramps, etc., but last night I realized for the first time that I was now feeling the effects of the actual chemo drugs. Tiredness, dog (sorry Jessie) tiredness and real changes in how food tastes. I look at a plate of food with anticipation, eat 3 or 4 bites and find I don't want any more. Heartburn (so far dealt with by Tums). Very slight numbness in my fingertips - which I believe is a serious side effect that I'm supposed to report (I missed the B-vitamins on Sunday because of the vomiting and those are supposed to counter that side effect). Between last night and this morning, I guess I came up against the fact that I I have reached only the cusp of understanding what all this is going to mean, how this is going to affect me. Only six days have gone by! How is it going to be in 60 days? 90 days? How will I deal with radiation? With more chemo after radiation? I guess I thought that I had started chemo this time from a relative position of health Before all this started, I wasn't feeling sick; I felt well. When I got through the immediate aftermath of the first chemo without the stereotypical side effects - vomiting, etc. - I guess I thought somehow I would be different. Not me. I wouldn't fall prey to the same maladies as the rest of the world of cancer patients - at least not yet. I thought I had bypassed the chemo's side-effects, but they hadn't even gotten started yet. Not only was I being unrealistic, but I learned I was still in some denial about the whole experience.

Well the day has picked me up, starting with getting back to the park. I'm feeling physically stronger. My kids are both trying to make arrangements to come for visits in December (my son bringing my grandson). My friend J from work made by hand and sent to me a very very soft deep pink angora/wool cap, which she says I'll look gorgeous in and - if not (J is a realist, one of the things I really like about her) - it will certainly keep my bald head warm (hair not yet falling out, by the way). Yesterday I received a beautiful fruit basket from a work colleague, R, and his wife P. So thoughtful. My aunt M and cousin C sent a beautiful card with even more loving thoughts written by each. Friends are staying in touch by email, phone, comments here. I am only on day 6 post-chemo, and the gifts of love and caring that people are showering on me are piling up. How lucky I am. So lucky.

Peace

Monday, November 16, 2009

Monday morning

Well, I'm back after a rough weekend. Sorry if the regularity of my prior postings followed by a 2 day gap caused any of you, my sweet family and friends, to worry. I'm okay.

To pick up from Friday afternoon's post, Friday evening the predicted bone/joint pain side effect of the NuLasta shot began kicking in. I took a Motrin and that helped some, but when I went to bed, the pain seemed to be increasing a lot and I really dreaded not getting any sleep, so about 10 pm I took a Percocet. As a result I slept well, some discomfort but it definitely took the edge off the real deep bone pain. The problem with the Percocet - as I guess everyone in the world other than I already knew - is that it causes constipation. I was already well down that road, likely as a result of the chemo drugs generally and the Compizine I took on Wed night for nausea. So by Saturday I was suffering big time from constipation. The weather was rainy, so I didn't take Jessie to the park in the morning. It wasn't too bad a day; I was uncomfortable, residual bone/joint aches/pain, increasingly bloated feeling, but nothing terrible. But as the day went along, the constipation plagued me more and more. By that evening, I was really worried about it. I ended up calling the oncologist on call at the hospital on Saturday night, and she told me I could take a laxative; in fact, to start with 1 pill, if that didn't work, take another, and another up to 4 pills total. So I took 1 pill before bed; another one when I was still tossing and turning 3 hours later; I slept some and took another one at 6 am. I guess I over did it.

The result was that on Sunday I began the day able to use the bathroom one time, and that was it, and only with much effort. Meanwhile, my insides felt like they were being torn up. And to top it off, I starting vomiting (a reminder that this is to be an uncensored - well, almost uncensored - blog). As vomiting goes, it wasn't terrible. I hadn't eaten much on Saturday - afraid of being stopped up - and I ate nothing at all on Sunday, so there wasn't much to come up. It actually did make me feel better. I spent the entire day on the couch clutching a big blue bucket or leaning over it. David was here and caring for me, while also rebuilding his "new" bike. It was comforting to hear the sounds he made has he clanked wrenches, and pulled wheels and did other stuff. But he was always there for me, too. The worst part was that I felt weaker and weaker; I did try to drink water and soda. I was worried about becoming dehydrated.

By late yesterday afternoon, I actually started to feel a little better, well enough that I asked David to make me a piece of toast. It took me an hour to eat that one piece of toast and I couldn't quite finish it. But it seemed to mark a turning point. No more vomiting after that. (I think the vomiting was the result of some reaction to the laxative, nothing else.) I began to feel just slightly alive and aware of things through the evening. David heated some chicken soup and I ate a little broth. That helped, too, I think. I went to bed feeling very very weak but much better. I tossed some, but mostly slept through.

I woke up - surprise surprise - with diarrhea, but to tell the truth, that was a real relief. It's gotten better over the morning. I'm trying to get my strength back by eating - yogurt, toast and some scrambled eggs so far - and drinking fluids.

What gets me about the whole experience is that it didn't even seem to have to do directly with the chemo, only indirectly - NuLasta, side effect pain, pain killer, side effect constipation, laxative, side effects vomiting, cramps, and eventually diarrhea- and the 18 hours of this has left me feeling so incredibly weak and depleted. But worse than the physical feelings, is a feeling of vulnerability. This is ALL new to me. I've never taken pain killers or dealt with their side effects. I've never taken laxatives and have no way to judge their impact on me. I feel like I wasted some of the days I should have been feeling "good" (relatively) dealing with this whole physical cul d'sac - and that pisses me off. I want to own every single good day. I know there will inevitably be bad days, bad days truly tied to the chemo and radiation. Why rush into that state? Soon enough it will be here to be dealt with.

So for today, my goal is to get my strength back and put the weekend behind me. I hope to feel strong enough to take Jessie to the park tomorrow morning and find out what the heron has been up to without my watchful eye.

Peace.

Friday, November 13, 2009

Friday afternoon

Well, in the end I got out of bed last night and spent time here adding a post, and then hunkered down on the couch and read for a couple hours and ended up back in bed about 4:00 am. Then David came home, early. I was able to go back to sleep and slept until 7:30, late for me. But I think the interrupted sleep - 5 hours on the couch and 3 in bed - wiped me out a little. I haven't done much today. I didn't take Jessie to the park because it's cold and overcast and it was too late to get there and have a good walk and get home and eat something before I had to take the Emend ($100/anti nausea) and steroid pills. So we went for a walk in the neighborhood, then I got coffee and had breakfast and took my pills. So far no side effects from the NuLasta shot that I can pin down. I mean I feel achy in my hip joints and shoulders, but that could be 5 hours sleeping on the couch and the overcast weather or general age and decrepitude.

Apart from reading (I'm re-reading "In the Country of Illness" by Robert Lipsyte; I learned about this book from H. a woman I met through my ex-husband S, who was in his cancer support group; it was incredibly helpful to me then as a caregiver; now I am reading it from the perspective of a cancer patient - sobering; one interesting thing is how far treatment standards seem to have come since the book was written - about 10 years ago I think), I spent most of the day on the phone - calling the disability insurance carrier several times, and being called back by them eventually; calling my employer's employee assistance unit and being called back by them, calling Kim and talking to her about all this (and other stuff), calling Dr. M to try to speak to his office manager who handles the paperwork for disability claims (she had left for the day; I was told to talk to her on Monday). So many details, requirements, forms, questions, restrictions, rules, inquiries, hand-offs from person to person. I mean I am feeling pretty well and had some difficulty dealing with it all. I can't imagine what it would be like for someone really in pain or otherwise dealing with significant physical problems (like how would you talk on the phone, take calls, answer questions, if you had to park yourself over the toilet to throw up all day?) At any rate, it appears the process has been started by which I may go back to work part-time next Thursday, from home (although getting approved to work from home longer time as part of short-term disability appears more complicated; well - one thing at a time).

Now we're waiting for UPS to deliver the "new" bike David ordered on eBay, a vintage Raleigh, which he will begin anew the process of making his own. It is supposedly in the area, and to be delivered today.

Since I brought up H above, as having given my ex-husband S, and me, the book I mentioned, I want to say something more about H - may she rest in peace. She like S was a retired teacher, originally from NY or NJ, I forget, relocated to Atlanta like S. They met in the support group. She was older than he; in her late 60's when we met her I think. She wrote poetry. She was caring and kind. After the first chemo protocol given to S gave him TB rather than curing his bladder cancer, he had to undergo a major operation in which they removed his bladder and built a new one from a piece of intestine. He was in intensive care for 7 or 10 days and in the hospital at least 2 weeks. And every single day he was in the hospital over that time, he received a card in the mail from H. Sometimes with a separate note, sometimes just a card with a brief message - kind or funny, some times a poem would be enclosed - but a card arrived for him every one of the days he was in the hospital. I will never forget how much that meant to S. I was there every day, of course, and others visited. But something about H taking the time to write to him daily - that really touched him, and in turn, me. H. was in remission at that time, but sometime during the next 18 months of S's follow up chemo and radiation treatments, her cancer returned and she died. She was a wonderful person; I feel lucky to have met her - may her memory be a blessing to her family and to all whose paths crossed hers.

Peace.