Weekly Update #88

It feels like everyday in the last two weeks since I last wrote could be an entry of its own, but that’s not quite true. What is true is that it has been an overwhelming whirlwind of activity and I’m not quite through it yet.

I decided to go with the trial at MD Anderson (MDA) after consultation with my medical team and my family. My medical team made it clear that I had several good trial options that it would make sense to try (with the MDA one being a little better) and that what I should consider heavily is who I wanted to treat me. I have nothing negative to say about the clinic in San Antonio, but I had such a great connection with the trial doctor at MDA. Weighing heavily in favor of Houston is also that I have friends here who I stay with and visit with, making it a far less lonely prospect than San Antonio where I have no connection. And finally, the history at MDA, even though it wasn’t 100% positive experiences, gave me a level of comfort that I lacked in San Antonio.

I am glad that I did have that prior history with MDA, because it truly is like a machine here that you get on and go wherever it takes you, and it ma have scared me enough to back out if this were my first time here. Appointments show up on your calendar and you get what you get and you don’t get upset. And then they’ll disappear and be rescheduled for a different day with the same department but somehow a different building? I found the scheduling part left me feeling unmoored, waiting to find out what was planned for me and mostly without the ability to give input. One thing on my side was that my trial coordinator was the one who knew everything I needed scheduled and how the process was going, so I was able to get some updates from her.

She was also able to help me out with my only scheduling dealbreaker – please let me be home on my daughter’s 9th birthday. I had a blood draw that was technically supposed to be that day, but she found the note in the protocol that said it could be done the day before. I do all this cancer treatment so that I can show up and be a mom to her, and I so appreciate that my coordinator saw that – those are the things that make you feel like a person and not just a patient.

It is exhausting to detail all the tests I’ve done, but I want to have it here for people who read this and want to know about trial life, and for myself to look back on. Last week I made a day trip for blood work and a set of EKGs and an eye check up, all to check that I was good for the study, and an x-ray to prove that the port I had inserted at another facility is real. I am glad I had that eye exam because it turns out that my prescription has changed a ton in the last year and I need new glasses. I came back this week for a COVID test (negative) in advance of a lung biopsy. That biopsy attempt went poorly and I had a panic attack on the table. So a second biopsy, this time with anesthesia, was scheduled for the following day. Oh, and then I had a CT. I had to spend the night because of the anesthesia, which was a good rule, I truly was in no shape to drive. I finally got to go home and spend one night in my own bed and with my family. And then the next evening I came back because I had to be at the hospital at 7:30am today.

And then there’s today. More blood work and EKGs and eye check ups. A visit with the doctor to make sure I was ready to start the trial. And then boom, the trial itself. It is fascinating to watch happen, so many moving parts that have to be precisely orchestrated. Pre-chemo blood draws timed just right before the chemo starts and then a line of EKG and blood draw folks outside because their tests need to be done within a set number of minutes after chemo ends, but with a definite hierarchy that I am not privy to. At one point I had both elbow veins accessed plus my port and the little sticky pads for EKGs all over me for later. One elbow vein is for blood draws, they do them at a different site than where the chemo is infused. And my port wasn’t working so they had to access an elbow vein instead (3rd time for that poor baby today), but left my port accessed so that the port specialists could give me some anti-blood-clotting agent. It’s been 3+ hours and they haven’t arrived, but their window doesn’t close for another 40 minutes. After that it will be too late for today and I’ll instead deal with it next time.

This is so long and I’m sure so indicative of how wearing this process is. I’m feeling better now that its underway. And my moment of joy from the past two weeks is sitting on the couch with my dad and stepmom, listening to my daughter play piano for us. I had a lovely visit with them, and hearing her play, the proof of her hard work and the thing that she loves, fills me to the brim with joy.

Weekly Update #82

Hello! If you’re a new reader due to my Seamwork article, welcome. If you don’t know what that means, allow me to explain. Seamwork is a digital sewing magazine; this summer I pitched them and they accepted it for their September issue, which came out yesterday. The topic is “What To Make When You’re Dying” and is about when I’ll stop sewing garments for myself and start making items for my family, and what those objects might mean in their lives when I am gone. It is intense, and I am proud of it. I have to admit, and this is not fishing for compliments, I always assumed I was a mediocre writer and any compliments from my friends were kindnesses. I am really sitting with the compliments that it is beautiful and I am a good writer and trying to let that sink in.

Last week I was bummed because I had so much energy and knew it was short-lived. I am so thrilled that so far I have maintained it and I have no complaints about side-effects. If I can keep feeling this way on this chemo that would be amazing. We just have to hope that it keeps me stable so it’s worth continuing on.

One thing I do have going on, but not from the chemo, is more pain. And I am really frustrated because two weeks ago I knit for a few days in a row, and then a few days later the pain hit and a week later it is still here, even though I haven’t been knitting. I am trying various stretches, changed to my sleeping position, etc to see if I can make it feasible to knit on a regular basis. Getting to knit once a week sounds incredibly depressing, when I have the time for so much more. I need to go back to the handouts I have from my classes with Carson Demers, the knitting ergonomist, and see what he recommends. I might also reach out to him or one of my PTs (#sickpersonlife) for some help. I know it shouldn’t feel like this. And it has made me afraid to try anything else, lest I make myself even more sore.

At some of my recent cancer advisory board meetings we have been talking about an incredible project I wanted to share. I think that if you weren’t aware before, COVID has made it clear to everyone how difficult it is for members of the Navajo tribe to reach adequate healthcare. One of the local clinics is trying to open an oncology department. This means they could receive treatment on their own land, have native healers be part of their care alongside Western medicine. All this plus, it’s on their reservation vs the current closest oncology office, 200 miles away. If you read about my family and wish you could do something, please consider donating here. I am so lucky to have everything I need and so many things I want. This clinic could use your support far more than I.

Finally, this week’s joy is listening to my daughter play piano. The acoustics in our house mean that the output from the piano float down the hall to my temporary office, so I can sit there on Saturday mornings and hear her working on Carol of the Bells and the Simpsons Theme. You can guess which of those I find more moving.

Weekly Update #79

I have been putting off writing this week because it feels like there is not too much to say, although that’s not quite true.

I continue to have low appetite and lose weight. The few things I have tried from the nutritionist so far clearly aren’t enough, so I need to step it up. She wants me to be drinking high-protein high-fat smoothies between meals which feels pretty hard but I will attempt it. All of the things I am supposed to try feel hard since I don’t have very much energy.

Last week I had a fever one evening which led to a couple days of recording my temperature and blood pressure and heart rate every couple hours and texting it to my doctor. I’m glad I was able to avoid having to get a COVID-19 test, to keep me out of the places where they are administered. One weird thing I noticed around the day the fever hit is that I was experiencing some delirium. We took me off one of my heart medicines and are continuing to keep a close eye on me.

I am so tired I keep falling asleep sitting up in my chair trying to accomplish things on my computer. Or in the middle of watching a show with my husband. Or when I am stubbornly reading instead of sleeping and drop my phone on my face. I don’t know I don’t immediately nap when I’m tired. Sometimes I guess because I am trying to be awake for medicine timing or what to take a longer nap later, but I alway regret not just sleeping the moment my body wants it.

My joy this week is Coca-Cola. I have been craving it and knowing I am low on calories decided to allow it into my life after a very long time without soda. It just tastes so good and the caffeine helps with the fatigue.

Weekly Update #66

In the past two weeks I took all the doses for round three of this oral chemo, Lonsurf. I am so incredibly glad to be on the other side of the active part of this round; it was a tough one. I was really nauseous and we began to work our way up the anti-emetic ladder. Continual nausea is so demoralizing. I was picking between eating or drinking most of the time, my body didn’t have room for both. It is such a relief to just drink when I’m thirsty and not regret taking more than a sip.

In past cycles this week is when the sleepiness is strongest. I have already taken a nap today and wouldn’t say no to another; we’ll see how I handle the week. My daughter and I did more walking last week – we went out for physically distant visits with friends where we chatted from opposite ends of the lawn – and I think that helped with my energy levels. So I’m going to try to put forth the effort to make that happen again this week, hoping that the act of doing it makes it easier.

I have some big cancer-related COVID-times fears that I want to talk about. It’s intense stuff related to my death, FYI, if that’s something you want to skip, avoid the next two paragraphs.

I am really scared that I will die during this quarantine. I believe the estimates that we might be only 1 month into 18-24 months mostly at home. I’m 1.5 years into an estimate of having 3-5 more years to live. The math includes an uncomfortably large overlap. I have had the benefit of time to make plans for the end of my life, and they include traveling to see people and definitely getting to hug those I care about again. It is incredibly sad to imagine not getting to mourn with the people I planned on mourning with.

And here is the other, selfish, fear I have around dying during this quarantine. I am afraid that my death will matter less to people, due to the pandemic that surrounds us. I always imagined my death being one of those things that makes people go home and hug their children tighter, a senseless loss. But we’re having thousands of senseless losses each day due to COVID-19. Won’t it numb people? How can it not? I feel like dying now would make me a small name on a long list, and nobody’s death should feel that way.

I hope everyone continues to stay safe and healthy.

Weekly Update #65

Another two weeks have passed. Time feels so weird in this pandemic time. I was looking back at my last entry and it all feels so far away. I had forgotten nearly all of what was happening then. I’m sure I’ll feel the same way reading this in a week.

Last week I had a scan on Monday. It was incredibly bizarre to go to a clinic at this period in time. We scheduled my scan at a local branch of a radiology practice, rather than the office I normally go to attached to the hospital, to lower my risk. Even still, before I could enter I was interviewed by a pair in head to toe PPE including face masks and coats. They took my temp, asked screening questions, checked I was on the list for that day, and then finally opened the door for me to go in. One thing I hadn’t realized is how much masks hide people’s facial expressions. I could tell the woman at the front desk who checked me in was truly smiling because it reached her eyes, but for most others it was impossible to tell what they were thinking or trying to silently communicate.

The scan involves injecting a constrast dye, and we wanted to use my port so we’d go through the cleaning process I’m supposed to do every 4-8 weeks (depends on who you ask) instead of setting up a separate appointment. The tech who accessed it was unhappy with the amount of blood return he got and recommended a dye study test be done to follow up. In a normal world that would have been done last week. In today’s world we’re putting it off at least 2 months. The tech mentioned that his wife crochets and when I asked him about it he showed me page after page of her projects on his phone. I love a proud crafty husband.

That was a lot of lead up to the scan results, which were stable. So, the plan is for me to stay on the same chemo for the next two months. I like that idea, I feel safe on this drug that I can take at home and only requires two blood draws out of the house over the four week cycle. While stable is always good news for me, this doesn’t feel like good news. Partially because my blood marker, CEA, is climbing, which means that the next scan could have bad results. And apparently this drug, Lonsurf, rarely does shrink anyone’s cancer, its role is really just to keep them stable. That sounds desperate to me, makes it feel less safe.

There is still a clinical trial at MD Anderson that we are hoping to enroll me in, and it is scheduled to accept new patients in June, which is when my two months of treatment will be up. I never imagined that I would be leaving the house in June and am surprised my doctor thinks that will be reasonable, but she’s far more informed about the risks than I am. And really, all I can do is wait until then and see what happens.

As for how I’m feeling physically – mostly just very tired. I’m still needing a nap most days, on top of 9-10 hours at night. An amount that wouldn’t be a problem if I didn’t have to be in charge of schooling an 8 year old, but is tough in the circumstances. I have managed two runs in the 3.5 weeks I have been home. A few more walks than that, but generally not much activity. I know it’s so important to help fatigue and for my health, but it requires a herculean effort to achieve some days. If anyone has any hints on staying active despite fatigue I will take it.

As always during this time, I hope you’re all well. I’m thinking of my cancer community and what a hard time this is for us all. I’m thinking of my friends and how much I wish we could be in person hugging. My ears are always open if you’re having a hard time. ❤

Weekly Update#64

This is my first update since I started self-isolating two weeks ago, which happened to coincide with the two weeks of my chemo cycle where I take the medicine.

It has been really hard to have my household at home to see what my experience looks like; normally I get to do lots of my resting while they are at work and school and save the best of me for time with them. The past two days we have been starting homeschool for my daughter, but have also been the days with the most fatigue and I feel so much guilt for letting down both my husband and my daughter. We all have extra stress going on and I wish I could be relieving some in our household, not adding more.

Another way I wish I was helpful and feel like I am letting people down is sewing masks for my local cancer clinic. I contacted my oncologist and said I’d be happy to step up if there was a need, which she immediately responded that there was. I thought I would finish these on Friday of last week and they’d be able to use them all this week, but instead it’s Tuesday and I still have so much sewing to do plus I need to launder them before dropping them off. I know they’ll help whenever they arrive but it’s so frustrating to lack the energy to finish this task that is so important to me.

The active treatment during a pandemic part of my life is going surprisingly well. I am so glad to be on oral chemo right now, which I take entirely at home, and the pharmacy even ships the medicine to me. I can do my check ups via telehealth, which has been going really smoothly. I only need to leave my house for blood work biweekly, which I am doing at a low-traffic lab location and following disinfecting protocol afterwards. I will have a scan this week or next which will also require me to leave the house.

My pain has finally been trending down, which is great news. I am glad to be on way fewer pain meds. It also is a hopeful sign (though no guarantee) that my new chemo regimen is effective – much of my pain is from cancer so often less cancer means less pain. Again, I have a scan soon so we’ll know one way or another. I don’t love this treatment overall, but for a global pandemic it is pretty optimal so I would like to be able to stay on it.

I hope you’re all doing okay, friends. If you want to vent about your hard times in the comments I will read and send you so much love. I am having my own struggles, but still have plenty of empathy left for y’all.

Not Like This

Last night I got the call from my oncologist – it is time for me and my family to go into self-isolation. I need to leave the house as little as possible, wear protective gear when I do, and disinfect when I get home. We should pull my daughter from school, whether it is closed or not. My husband should work from home if possible. It is scary and disappointing and inconvenient, but the primary emotion it brings up is one I haven’t accessed much during my cancer – anger.

I am angry at the idea that I have suffered through 4.5 years of cancer treatment to be threatened by a virus that is a mild cold for most. I am angry that it didn’t need to become a pandemic, but our global governments have mismanaged it into one. I am angry that my small joys are being stricken from me – going to see movies, midday naps while my daughter is at school, volunteer work at my cancer center. I have plenty of books and yarn and TV to fill the hours, but it is demoralizing to have no end in sight. And I think I am most angry that I am not even immunocompromised. These are all the right steps to take because the risk of things going bad for me is too high, and it shatters my illusion that I can live like a healthy person. I can’t count on good hygiene to let me do the things that are important to me.

I feel like I should close on a positive note, with a list of all the businesses and people who have been so generous and found solutions to keep some normality during this season. But I’m not ready to go let go of my anger and move to appreciation yet. Maybe by my normal update next week.