Sunday, July 13, 2008

Physically Phtttt

Before being diagnosed with breast cancer I rather fancied myself as an athlete. I was fit or I would be as soon as I weight lifted again and added that extra day of running…and er.. took off about 15 pounds.

I have kept records for the past five years and my weight has not changed, give or take a pound or two in either direction.

I dutifully trundle off to Weight Watchers each week, pay my fee and learn I have gained or lost ½ of a pound! I privately call W.W. Fat Losers or F.L. because that is what the weight loss program was called in the TV show called Third Rock From the Sun. But the funniest program regarding weight loss is found on Little Britain. It is so discriminatory in tone that I cringe while I snicker nervously.

When I had the lumpectomy in April 2007 my goals were to get back to walking in the morning and running at the end of the day. After about 5 weeks I could resume this level of activity, although I sensed my stamina was a little curtailed.

Then in June 2007 chemoville started and after each of the 4 treatments I would fight, fight, fight to feel normal. My friend Laurel told me her husband Hillel recovered more quickly from his chemo if he drank about 4 litres of water a day and walked around as soon as possible. So I drank litres of water (mini medical pit bull made me a check off sheet to track this) and I would walk as much as I could to help my system cleanse itself from the chemotherapy drugs. J. would call me about day 4 after chemo and remind me I would feel myself again.

As soon as my baby toes stopped hurting (no reason I could see for the pain in the toes) about a month after each chemo treatment, I could put on my running shoes again. But I could not walk in the morning and then do any other exercise – no gym, no yoga, no weight lifting…just one activity a day. The oncologist and nurse practitioner laughed at me when I complained of this. I think I was still in ‘this treatment is just for a lark’ phase because there was no evidence of cancer related fatigue. Aside from my hearing loss, lack of concentration, inability to read, and uncontrolled eye movements I left chemoville mostly intact.

Five weeks of radiation started in October. I really did not mind radiation although it does zap the energy. It is the nature of the beast that about an hour after treatment I needed to sleep for an hour.

If I was at work after the treatment I would go to the underground parkade, cuddle up with my blanket and pillow for an hour, and then head back to work, refreshed. No one knew. And, it was proof to my self that despite the nap, I was still the same.

Once all treatments were over, I thought it was all done…but no, not finished at all.

In February 2008 I went on a month long holiday. With fewer distractions I was forced to face just how fragile I was. I said to Pepsi in amazement: “Hey! I am frail.”

“Yes,” he agreed kindly. “You are for now. Just relax.”

I could walk a little ways but I needed frequents rest stops. My digestive system wheezed and whined at the slightest variety. I got sick for a week with a fever and other even more unattractive concerns that required close proximity to facilities. We resigned ourselves to foregoing any tours in buses or boats of the country side. And elephant ride was out of the question. Sigh. It was a big shock to find my new normal was a weak and frail thing.

While on holidays and at the start of this blog, I determined upon my return I would publish some writing. I am counting this blog as this goal accomplished.

Learning to play some music has not transpired. I never seem to think of it and that autoharp (don’t be afraid June Carter) is stored safely in its case.

And, lastly I registered in a half marathon with my beloved J. and her partner M, as though this would catapult me into renewed vigor and back to what I remember myself to be…an athlete.

Oh, and one last goal, I was clearing out the paper monster of 15 years of business files and packing it up to got to the shredder. It is such heavy work that I can only do it about an hour at a time but it is my goal for this year.

In tandem with this, my friend Sandra with lung cancer had a series of strokes from the cancer that had spread to her brain. She was admitted to palliative care.

Never fail for failing to start is my motto so I began to train for the half marathon in March and April 2008. Erk!! It was so hard some days I ran feeling completely light headed. Should have been a clue to yours truly but evidently not. I thought I was not eating properly so I began to eat high protein bars and forced myself to run and then run hills on top of this. An obvious point is that 20 year olds run much faster than 50 year olds. I suffered under the allusion that if I just tried harder or ate more protein bars I could keep up.

Sandra’s life continued to dwindle away despite her cheerful hopes for the future. I visited her several times a week and each time I left her side I felt heavier and heavier in my heart.

One day after my morning hourly walk I had to go back to bed for an hour. My energy completely petered out. I could go to work but when I returned I had to nap before dinner, could not even do the dishes and went to bed, after napping on the couch all evening. I hardly had the strength to take a bath. On week-ends, I spent all day in bed and then evenings on the couch. No socializing at all, except I visited Sandra. This continued for quite a few weeks. I had to withdraw from the half marathon. So my new normal became a very inactive couch potato. My image of myself as an athlete went phttt.

Sandra died May 9 and about three weeks later I noticed a small return of a lightness to my being. I am nursing this back to a full spectrum but slowly and cautiously. First I added yoga, then weight lifting and now running. I tried to nap last week end and found that I didn’t need more sleep. Hurrah!

So, carefully I am planning my return to a healthier weight and fitter physique…but gradually. I might have learned my lesson. Time will tell.

Sunday, June 22, 2008

Sandra the Highland Steer

Sandra called me at work at the end of August 2007 to tell me she was in the same boat as I was. She said she had been trying to reach me for a week.

"What do you mean?" I asked with dread in my heart.

"I have just been diagnosed with stage 4 lung cancer " was her response.

I started to cry and had to ring off. I cried all day long and all evening.

The next day I called her significant other and my very dear friend of over 30 years, AJ.

He said she had told him telling me had gone badly. I agreed that sobbing and crying was tough for someone facing lung cancer.

I contact Sandra again and told her that I was done crying and we had some things to face together. She agreed. She said her reward for overcoming cancer was to go to Cuba. I suggested she go right away but she said she needed to wait until her battle was over.

And so, for the next the next 9 months, Sandra showed me what courage in the face of no propect for success looks like.

Obsessive Behaviour Seeking Universal Control

The first inklings of obsessive thinking arose during chemoville. I would get up in the morning during the first week following chemo and make myself blueberry pancakes with yogurt and maple syrup. If I tried not to do this, I became obsessed with eating them.

My mind would tell me I deserved blueberry pancakes. I had suffered and had earned the blueberry pancakes. I could not think of anything else. After a while, I simply gave in and made them as soon as the craving arose. It is of note that after that first week had passed, pancakes never crossed my mind. I seldom, almost never, eat them now.

During chemo I was like a baby again. Wake up. Eat. Clean myself. Nap. Walk around. Lunch. Nap. Walk around. Eat dinner. Nap. Bed time. If I ignored the nap need I literally began to shake from the inside out until I went to sleep.

Need I add after the last description that in contrast to most people who get chemo and experience significant weight loss, my notable family appetite did not desert me.

The other obsession that only just about has faded is about money and my income. I was petrified to spend a penny for fear that....I don't know what would happen. In my line of employment I hear from people continuously who lose everything when faced with a serious illness such as cancer. I felt that something had been forceably taken from me and the only way I could quantify the something was to think of it as money. Even though logically I knew I would lose little income if any during the cancer treatment.

My employer has a very generous sickness plan...60 days at 100% of salary and 80 days at 70% of salary, before starting long term disability.

I became unnaturally focused on not going over 60 days. Very focused and probably obsessed. I had calendars, grids, running totals,and estimated future needs. I am sure I went back to work from chemo early so that I would use as few days as possible.

The website that collects this data to report on totals is about three months behind. I contacted the benefits administrator constantly to check my totals versus hers of days I had used. Poor woman...she was dealing with nut.

In the end, I used 54 of 60 days. There, I had control even though my entire universe was doing the cha cha. Didn't I? Well, maybe just control over writing lists.

When I started this blog in February I had some mighty big plans. I wanted to write some more, learn to play some music and to run a half marathon. I had to drop out of the marathon plans, I can't strum a note but at least the writing is starting to emerge. However, nothing is finished yet.

Sunday, June 15, 2008

Radio City Here I Come

If you had to go to Safeway, or to the library every day, Monday through Friday for five weeks, I predict you would start to weary. But this is the treatment pattern for radiation therapy. Some people get less and some even more than I got. But because I had a lumpectomy, I was scheduled to get radiation therapy.

My radiation oncologist was quite a character. His English is impeccable but not quite idiomatic. He met with me and my posse in another one of those amazingly, teeny treatment rooms that line the hallways at the Cancer Institute…or at least the room seemed that way with me, the oncologist, Pepsi, F. and J. who took notes of course.

He examined my breasts and then asked me; “How old are you?” The posse snickered because his tone of voice was amazement. I didn’t have the courage to ask why. He then discussed treatment options as if I really had an option except not having radiation. Finally he reassured me in all earnestness that because I have such small breasts, here he emphasized that several times, I should avoid the toxicity that many women with bigger breasts experience from radiation treatment. That was good, I think.

So off I went in October/November to start the last leg of my treatment process. I thought I would have been done all treatment by September but I hadn’t even finished chemo until then. The Cancer Institute prefers that patients wait about a month until they start radiation.

There is a preliminary calibration process so that correct and same amount of radiation is directed to the breast and underarm at each treatment. The only indignity in that was I had three anchor spots tattooed, yes, I am now tattooed, just under each breast and the centre of the breast plate.

My daughters were fabulously entertained that I, too have a tattoo. J. and F. declared they would get the same three spots tattooed on their chests in solidarity with me. I know that J. got a spot for sure but F. got something more. Hard to guess, since she recently had the word “Yarr” tattooed on her bottom lip to show her true pirate nature.

I arrived in the waiting area where I would be arriving every day for five weeks. I got changed into a little shortie nightgown and a housecoat that was so wrinkled that I thought they should be ashamed. I put my clothes in the lockers provided, straightened my wig and sauntered into the waiting area. It is hard to be cool in a wrinkled hospital issued house coat. The men in the same waiting areas get on pajama bottoms to facilitate the radiation on their prostrates. We sat there pretending to read and cautiously peeking at each other. It felt very similar to being in a detention hall.

A technician came to get me, I got my attendance card marked and I went into the radiation therapy area which is completely lined in lead.

I took off my nightgown and housecoat and laid on the table. The technicians fiddle and fuss to ensure that the dose is the same each time. The three tattoos are anchor points for tracking this. Everyone leaves the room but me. Lights flash, buzzers sound, the machine rotated around me and it was over. The technicians are just splendid. They get me in and out in a very short time.

One day the radiation machine didn’t work. They sent me back to the waiting room. Everyone looked up at me and I announced, “I broke the machine.” Everyone laughed so hard at that I realized I had jibed at the common enemy over whom we had no power.

I continued to work throughout my radiation treatment. I tried to schedule the radiation in the afternoons so that I could work in the mornings. As the doctor predicted my small breast saved me from radiation burn and I had absolutely no toxicity. But I began to get tired. Finally, when I had about 8 treatments left, I got up for work, got dressed, and realized I couldn’t get out the chair. I tried hard but there was no way I could go to work. So I called in sick. I had the same experience the next day so I signed myself off sick for the rest of the treatments. And, then, the treatment was finished. Not done yet, but finished.

Saturday, June 7, 2008

Get by with a little help from my friends

I have a routine that I treasure. When I can carry out these activities, I can imagine that everything is right in the universe.

Starting on Sunday I run or walk, depending on how debilitated our bodies are at that that particular moment from injury, treatments or surgery, with my friend Peter. Following that I have coffee and rearrange the world, or at least what social life I have, with Alison. On Sunday afternoon you will find me with Susan and sometimes her son Nick in the off leash walking the four dogs. She has the three dogs.

Every morning Monday through Friday I walk for an hour with Gerry. Sometimes my wonder Yorkie joins us, but never if it is wet or chilly. She hides until I leave the house.

On Tuesdays, I have yoga with Jennie. One year we took Zen meditation from a monk in a small stinky apartment. We attended a session on grief through the Jungians. That was intense. People cried at every meeting. Some years we have attend alternative religious sessions when K. our yoga takes a break. This year we are taking belly dancing. No recital for me, I already warned her.

On Saturday mornings and sometimes Wednesday after work I run with Michael. Beautiful life I think.

And, about 11 or 12 years ago, Alison and I started a bridge group of eight women. So far only one woman has dropped out…well, she moved to British Columbia but she comes back annually so we play with nine women. Someone is always glad to sit out.

The Bridgettes, as I have lately decided to call us, meet through thick and thin at each other’s houses. We eat cheezies, bridge mix, drink, catch up, commiserate and oh, yeah, we do play a hand or two of bridge. When we started out, we had to break for summer and holidays with children but that is all history now.

We don’t have many hard and fast rules except one..no criticism of each other’s playing, despite how bone-headed the play might have been. Like trumping your partner’s ace. Once we had a woman who joined us for a bridge retreat who said to one of us, me in fact, “Why would you do something that stupid?” I said that she played bridge at a much higher level than I did. Maybe I might have trumped her ace. But, this woman was not welcome at further bridge games. That is the Bridgette basics.

We have seen each other through many life changes such as divorces, unexpected job loss, 9/11, parental deaths, strokes, and children’s marriages.

Menopause has meant that we continually lose track of who dealt, what’s trump and what was the bid….this conducted to the sound of fanning and jackets being cast off as we have hot flashes.

And we have our own unique medical cluster. We are about the same age, ethnic origin, education and socio-economic status and four out of nine of us have had breast cancer. WOW!

Beth was the first with breast cancer. She dove into the diagnosis and treatment with vigor and courage. It was surgery and then radiation. We beat our breasts to beat that cancer back from our Brigette. To symbolize how covered her with our love we made her quilt. The cancer came back in her bowels so she has been going through chemo to continue to beat that brute back for over year. She has such courage. So far so good, especially since she found a new love.

Berni was next. She faced surgery, then surgery again, followed by radiation with courage and dignity. Again we rallied the troops. We delivered so much food to her house that the message got passed for us to hold back on the food. Berni and her husband could not being to eat all the food that showed up.

As Berni’s husband worked in construction we set up a schedule to drive her to radiation which was once a day for four weeks. I coordinated the schedule. There were some dicey moments setting this up because there were people who wanted to do more than their share, leaving others with no chance to Drive Ms. Berni. I had to be firm with these overachievers. They were not allowed to hog one whole week.

We wanted to remain along side of Berni as she moved through this experience. And we did this thanks to the talented seamstress in our midst who made her a blue jacket with our names written on the red lining. She can feel our support when she wears this garment.

Bobbi broke the news to us at bridge that she has been diagnosed with breast cancer. We were all prepared to jump into breast cancer support mode when she gently told us that it was not her way to make a big fuss. She wanted to get her surgery and whatever treatment was needed and just put it behind her. A large portion of her breast right up to her breast plate and twelve lymph nodes were removed. Even though she didn’t want anything we could not accept this. S we gave her a sophisticated pink scarf, soft and beautiful to wrap her in our loving thoughts.

The last to date is me. My friends came to chemo with me, sent me cards, called me, emailed me. I felt so loved and supported. And, they came up with the most perfect show of their strength and love for me. It is a string of worry beads made up of quite large and wonderfully coloured stones and stored in a marvellous handmade bag. I brought it with me to the Cancer Institute whenever I went. Just touching the beads gives me a thrill of pleasure and comfort.

So the Bridgettes provide me with an enduring sense of womanly community. Whenever we meet one of the women will stare hard at me. I wait for the verdict. "Your new white head of hair looks good and so do you." I breathe a sigh of relief. I am safe for a while.

Sunday, May 25, 2008

Cancer School

The Cancer Institute offers classes and education on every step of the process. This education starts with a volunteer led tour of the facility so you can find your way through the myriad of clinics, treatment areas and other services such as the wig shop. People are always sitting on the couches waiting for their tour along side of the reception desk where I checked in for my appointments after flashing my red ‘club card.’ I looked at their faces and they shared the same look of being pole axed. However I could not bear to look at the young mothers with babies in stollers.

There was quite a big class for chemo school, and mainly people older than 70 years old. I was told that, unless I went chemo school, and naturally I did not want to go, I would not get chemo. The nurse practitioner walked us through the process for chemo, and it was helpful to know what was going to happen. At the class there was an older man who attended all alone. My mini medical pitbull J was with me taking copious notes. He said in the class, “They have been telling me all this stuff about cancer and that I need chemo. I don’t know what they are talking about and what cancer is this?” The nurse practitioner told the man to wait after class and he would help him find some answers. Talk about floating alone in a scarey ocean.

At the rehabilitation class I attended I heard information that I had not learned before. Women gain between 10 – 30 pounds during breast cancer treatment. There is no clear information why exactly this takes place but it is a combination of emotion, chemicals and drugs and the body’s reaction to the assault it faces. Or maybe it is the reduced activity that is normal reaction to feeling poorly. A volunteer told the group that after a year, she found that the weight had gradually been lost.

Cancer related related fatigue is another side effect of cancer treatment. Some people report levels of fatigue to the extent that they are exhausted after simple daily activities like tooth brushing or dressing. Whatever the level experienced, the only way the fatigue begins to dissipate is through exercise. One woman told me that hearing that was about the most debilitating information she had heard. She said, “Imagine being told to exercise when you are experiencing the worst case of flu you have ever had?”

I couldn’t exercise to the extent that I liked to do. I complained to the nurse practitioner and the doctor that after my hour walk in the morning with my friend, I could not weight train or run. The doctor and the nurse practitioner literally laughed in my face. Luckily I found their reaction funny.

The other lingering effect of chemo was on my nails. My finger nails were affected first and then my toes started to show the effects. The nails become ridged, with pits and black lines. Chemo ended in September and by February my finger nails were clear fo black lines and ridges. I needed to trim my nails back nearly to the quick because, after the lightest contact, they would disintegrate like rotten rubber right off the finger tips.

My toe nails were simply grotesque. There was a kind of horrific thrill to look at them. I wanted to share this part of my journey with my daughters but they drew the line at this. Finally by February I could glimpse normal nail growth at the base the toe nails but it was a slow process. And, also a helpful reminder that I really did have cancer and I went through 7 months of treatment.

I understood the purpose of chemo was to kill free floating guerilla cancer cells in my system. It also gave me the best complexion I have ever had. Not something I recommend of course, but buh bye rosacea. I got many compliments on how great my skin looked. "Oh, thanks." I’d say modestly, "but I owe it all to A/C." (The chemicals in my chemo cocktail.)

The other aspect of chemo is all and I mean all of the body hair vaporizes…..pfft…gone. Of course the pubes were nekkid and sad but I was interested to discover the importance of nose hair. Bend over to tie the shoes without it, and drips ahoy!

Sunday, May 18, 2008

Hair today, Wig tomorrow

About three weeks after the first chemo my scalp began to hurt. Even the wind blowing my hair hurt. I had gone back to work after about 5 days and since every person I know or every have known was aware of my breast cancer I did not have to keep up an act.

One day at work I touched my hair and a great clump came out. Like the tongue continues to seek the hole in the tooth, I kept reaching up and finding more and more hair come away. I rushed into the bathroom and ran my hand along my hair and a great freaking slath of hair was in my hand. Suddenly I could see myself seated at the lunch table, lean over to slurp soup, and a hunk falling on my plate. EEEEEK!

I called F. and told she needed to do the shave. I went to see her and she gently, gently shaved my head, from the back to the front to reduce the shock. I was sad but at least I had a wig I liked.

My friend Judy gave me two wigs and when I showed them to J. and F. their faces were absolute pictures. Ha!

'No fucking way!' was the mildest comment. They were set to make me buy a wig when we tried out the FREE wig shop at the Cancer Institute.

J. and visited the wig shop. I must have tried on about 50 - 60 wigs until J. was satisfied. Of course I had to wait for F.'s verdict before I know I could keep it.

The wig is a ear length, long-banged, red wig. Initially people noticed but after a while, like new glasses, no one really noticed.

So from June 2007 until December I wore the wig. My head was cold continuously. There is a surprising amount of warmth generated by our hair. My hair never started to grow until the end of November, a full 2 months after the end of chemo.

My husband Pepsi has a charming way of dealing with the changes to my appearance. For the breast with the slice out of it, he says it is like a giant winking eye. But he reserves his greatest enthusiasm for my bald head. He slavered over the shape and feel of my bald head. When my hair finally started to grow in he moaned over the new growth and maintains if he had my hair he could win in politics. So lucky to have a husband like him.

Head shaving was a contraversy with my family. J. and Pepsi both decided to do this out of sympathy. I just stared at them. Get serious. It is bad enough I am bald. The idea died.