Thursday, March 11, 2010

Treatment, First Time Around

So chemo started. And we discovered my arteries are hard to find, which meant I had to have a peripherally inserted central catheter inserted into my arm, going to my heart. I had a small breakdown when this was told to me. Understandable, I think. All this crap going on in such a short time, and now you tell me you are going to insert a foreign body so you can hook me up quicker to the drugs.

Excellent.

Oh, and get ready for the radiation.

But before we do that, we want to double check that you actually have what you have been diagnosed with. It is so rare and makes no sense whatsoever in someone my age. So another bronchoscopy. Because if it is something else, we won't have to radiate your brain, and we would really rather not do that. I reply that this better be necessary because I really didn't enjoy the bronchoscopy experience the first time around. Yep, it's necessary.

A second bronchoscopy. How's your gag reflex? Pretty strong, I think. Well, do you gag at the dentist? No, but I still think.... No worries. Bronchoscopy away. Ooops, turns out you do have a pretty strong gag reflex. Which is what I said, but hey, what do I know? I'll just go throw up now.

Results? Same as before. Radiation and chemo. By the by, radiation is kind of like getting a sunburn. And it potentially could cause cancer in you any number of years from now. You will have a higher risk of breast cancer, or potentially some other form of cancer. So the cure could cause the disease again.

Chemo is starting to make my hair fall out by now. But fortunately the nausea and vomiting aren't bad yet. The radiation? Takes three weeks. Not fun, but not as bad as it is for others it seems. Doesn't hurt too badly, but it does make my cough worse for a while.

Third round of chemo comes at the end of March. I get a week off between the end of radiation and before the return to chemo. This three day cycle doesn't go nearly as smoothly as the first two did. I am not able to keep anything down over the weekend, am dehydrating and getting weaker. The stairs are a challenge. Tuesday, off to the hospital again where I spend a couple hours getting IV drugs to stop the nausea, as well as saline to rehydrate.

I feel like bloody Superman after. The IV drugs were steroids. I don't sleep for 2 days, I am so wired. Fabulous feeling, really!

Elly comes right after Easter, and unfortunately, though I had tried to time it otherwise, it is during the last round of chemo. We spend a couple hours each of the three days playing cards and whatnot. We do some touring, but I am pretty weak and having fun with nausea -- but not nearly as bad as the time before. I just don't feel like eating.

Oh, and it turns out the chemo did completely toast my white blood cells. Shots are sent home with me. Seven days worth to try and jumpstart my marrow into producing white blood cells again. I can't give myself the shots -- it is just too much, so my dad is pressed into service. Thanks to the supergees, my immunity returns.

But hey! It was over! I did it. I made it through, and it was hard, but not as hard as I had thought it would be. I start recovering some of my strength. I walk every day. I volunteer at the BC Children's Hospital foundation once or twice a week.

And the checkup comes in a month. The X-ray is clear. Good news. But the X-rays were always clear. I press my radiation oncologist into doing a CT scan before starting the next round of radiation.

And there is a nubbin left where the tumor was. Not what one would hope for. It could be scar tissue, it could be viable tumor, it could be that the radiation is still working on the tumor and that will go away. The only way to find out is to wait. But what about the cranial radiation? We can go ahead with it, or we can wait.

If we go ahead with it, and the tumor is still there and viable, then the treatment has no meaning because the cancer could still spread into my brain. If there is only scar tissue left, then there are no worries.

Is there nothing else that can be done? No way to check? My doctor says she'll present my case to her colleagues and ask if anyone has any suggestions, or is willing to do something outside the ordinary for me. So now I just have to wait and see what she might come up with. More waiting. I am getting very skilled at this waiting.

Sunday, March 07, 2010

Annus Horribilis

To quote a friend. The past year really wasn't the year I intended to have when I started out. And I chose not to write about it, not to journal it, not to blog it, not to do anything about it at the time. It was a little too much, too real, too close. But now I have had time and am thinking I shall -- in dribs and drabs -- write about the year that was. It seems wrong to completely ignore a time that has completely overthrown my world. Some will be reflection, some will be merely a retelling of all the crap that made up that year.

So, here goes a little bit.

Wednesday, January 21st, I went to the hospital with my father. When we went in to see the doctor, there were two nurses in the room with him, which was my first hint something wasn't right. Up until then, there had only ever been one nurse.

The doctor told me I had a small cell carcinoma in my lung. Cancer. My first thought was that I have never smoked, that couldn't be right. The only person in my family who never smoked. And I am the one with lung cancer. He explained the course of treatment, and explained that it is pretty much the same anywhere in the world, and that no, it wasn't operable. That particular piece of information was disturbing, as I had talked to a lung doctor who explained what usually happens with lung cancer, which includes surgery. I didn't really find out why they don't do surgery until after I was back home.

So I had a choice to make -- stay in Japan and go through treatment while hospitalized, or go back to Canada and do it there. If I stayed in Japan, my family would have come to help and support me, but the idea of having to take care of them while also having to take care of me was too much. After a couple of days of thinking and getting things sorted for a return and treatment back in Canada, I decided to go home.

Everything was just so surreal. It took me a while to really grasp what was happening. That I could even have lung cancer. And I don't think it helps that no one can tell me why or what caused it. But it seems that the place I chose to make my home was essentially trying to kill me. Happy days.

I got back to Canada and started to learn about small cell carcinomas. I never looked it up on the internet, which a friend did, who then had a breakdown in front of her computer. I imagine it is a good thing I never looked it up as I suspect the descriptions tend towards the dire. I know the information I got leant towards the dire.

Small cell carcinoma is not the "good" kind of cancer to get. It is aggressive and spreads rapidly to other parts of the body. It is usually found (85% of cases) too late to do anything other than pain management. It starts in the lungs and usually grows rapidly there, and quickly spreads to other parts of your body, even getting into the brain. The reason it is inoperable is related to its aggression. Apparently it is known to even spread to the surgeons hands. Fun stuff. Generally, it is found in very heavy smokers in their 50s, or older.

I have been informed many times that my case is unique in so many ways, and I really wish it weren't. I would so give anything to have been ordinary and normal. But if I am going to be special, hey, may as well go full throttle!

I was lucky in that my tumor grew in the bronchus, rather than the lung proper. This caused me pain, and eventually a cough which had me going to and from various doctors for months to try and locate the cause. If it had been in the lung proper, I would never have known until it was too late. So mine was able to be found early. My oncologist here said he had never seen it found so early, and so small. Small mercies I guess.

It's hard to be grateful for these little blessings though. Very hard. How do you get happy about cancer in any way, shape, or form?

Thursday, March 04, 2010

3am

And I don't mean the song by Matchbox 20 either. 3am and once again I am going without sleep. It seems to be more common than not lately. So many things to think about that even were I to write them down I would have still more to add to the list. All the niggling little details involved in packing up a life and trying to divest yourself of 8 years worth of belongings. Who will take what off my hands? Can I sell it or do I have to write it off and give it away -- which hurts when considering that these are often things I am going to need to repurchase on this left coast. I need to go back to bed. I need to let it go -- it will sort itself out eventually. But that doesn't make it easier to make my mind move on and let go.