Coping Skills
I left a whole bunch of things at home this morning as I rushed out of the house ten minutes behind schedule, and only realized my mistake(s) as I was merging onto the Mass Pike. I called home to ask Mr. Wonderful to email me the shopping list so I could stop on my way home. Being the Mr. W that he is, and since he was coming downtown anyway for a meeting, he offered to bring the other stuff to me at The Cancer Factory. Timing was tricky, as I was running back and forth between two buildings for appointments that couldn’t seem to start on time, but someone smiled on me, and he pulled in just as I was dashing back across the street for my CT scan.
Short story long, he brought me the things I had forgotten, packed in a little reusable bag from lululemon (a store at which I hope to spend a lot on exercise clothing in the future). Printed all over one side of the bag are inspirational quotes, admonishments to carpe diem, etc. One specific line caught my eye: “Life is full of setbacks. Success is determined by how you handle setbacks.”
Particularly poignant this week. Yesterday I cornered a despondent and stomping #1 Son, grouchy because his brother hadn’t wanted to play outside with the dog with him. From somewhere deep within the storage pool of mothering instinct came the line, “You can’t let your happiness depend on the actions of other people. They all have their own thoughts, their own desires, and they can do as they please. If you can’t be happy unless they do exactly as you wish, you’ll always be disappointed. Be happy with your own actions, and let that be enough.” (I have no idea where I got that from, as I can be quite susceptible to the problem at hand myself, but it sure sounded good. I should probably needlepoint it on a pillow.)
It’s been a tough week to be me. Although both kids have been in school five days, for six hours at a stretch, by Tuesday night I had come down with the week-off-the-mystery-drug-fever again, and felt like a sodden lump of sand. A “quick” four-hour trip down here on Wednesday for two types of blood draws and pee-in-a-cup showed no reason why I should have a fever. Nonetheless, by mid-afternoon I’ve been ready for bed, which did not accommodate yesterday’s pot of chicken-noodle soup (I had to do something with Monday’s leftovers) nor the 6-to-7:30 soccer-clinic-on-the-complete-opposite-side-of-town-in-a-downpour-wait-in-the-van nightmare. By 8PM I was fish food.
And as I slumped despondent on the couch with hot tea and layers of wool, watching The Blind Side with the hubs, I was put in mind of something my own mom used to mention (from her infinite pool of mothering instinct). When asked the eternal question, “What do you hope for your children in their lives?”, she never responded the expected, “I just hope that whatever they do, they’re happy;” she always said, “Life is full of times that won’t be happy. I want my kids to be able to cope.”
Which is, I think, what’s been going on here at Carcinista Central. Whatever the cancerverse throws at us, we find a way through it, and most of the time we are actually happy (although some days I just sob on the steering wheel). We lean on each other when we need support, take time away when we need to be alone, and take risks knowing that the family and friends who love us will be there to pick us up if we crash.
I’ve just met with Dr. A, and my CA-125 and CT scan have deteriorated a fair amount from ten days ago. While that’s never good news, at least the results are definitive: I’m going off the study and starting chemo when I get back from First Descents. I am glad that my week in Colorado will be drug-free, but I know I’ll still be a tired mess, push-ups and pull-ups notwithstanding. It’s a program for cancer survivors, after all, even if I am the oldest and illest one there – I’m sure they’ll understand. I’ll nap if I need to, bow out of activities if I must, but I’m going. If they have to shovel me onto the plane in a wheelbarrow, I’m going. Mom taught me that much.
Besides, six hours all by myself in first class? Each way? I wouldn’t pass that up for anything.
Quick Update
So. Multiple conversations at The Cancer Factory today elucidated the rationale behind the slightly ambiguous bi-directional recommendations of my multi-partite team of oncological specialists.
If the previous sentence took you three or four tries to make sense, you now know how I felt.
My CA-125 finally came back at about 10:30, reading 137, a five-point increase over the previous test two weeks ago. That might sound like a statistically significant increase, but it’s not. Dr. B finally came to see me in the clinic and we hashed back and forth for a few minutes. I told him that the steady increase in my CA-125 since mid-July gave me the impression that the trial wasn’t working, and shouldn’t we oughta switch to chemo? He said that despite the CA-125, which may not be a good indicator for this trial (and certainly hasn’t been a good indicator for me very often), my CT scans showed good stabilization in my disease up to the scan two weeks ago. Even as my CA-125 was rising, my scans showed stability in the disease.
Dr. B did apologize for his earlier discussion with me, and his email to Dr. A, that gave the impression that he wanted me to quit the trial and switch to conventional chemo this week. He wanted me to meet with Dr. A to discuss the next steps in the event that I go off the trial in the future, not to actually plan my switch, which is what she and I talked about last week.
We talked together about getting another data point next week with a CT on Friday to see how my lungs look, as apparently Drs. A and B discussed (after my appointment with Dr. A) that my lungs didn’t look all that definitively worse on the scan after all. Once we get that scan, THEN we will decide what to do. I’ll need a Vitamin B12 and a folate shot a week before I start Carbo and Alimta, so I would do that next Friday and then start chemo after my trip.
Or, the CA-125 and CT will both show relative stability, and we’ll keep on with the trial, because there aren’t that many good PI3K Phase I trials available right now, and to jump off this one at the first sign of trouble would be foolhardy, as I probably wouldn’t be able to get back on it again. And if nausea and fatigue keep being a problem on the trial, I could go to the reduced dosage (330 mg vs. my 450 mg) that’s being used as maximum for the Phase II trial now going on, to see if that reduces my side effects.
Short story long: keep on the trial this week. Next week is my week off the drug. Friday’s chest CT will decide if I continue the study or switch to chemo, which I’d start late in the month.
Clear as mud, right?
Family Friend Supports Cancer Research; Please Help!
Hi All:
I have a favor to ask. A good friend of mine, Dan Pike, is competing in the Ironman Lake Placid this weekend (2.4-mile swim, 112-mile bike, 26.2-mile run!) in memory of his cousin Dorcas Ann Casey, who lost her battle with synovial sarcoma, a rare soft tissue cancer, in 2008. Dan is raising $25,000 to support the Dorcas Ann Casey Fund that will benefit synovial cancer research at Memorial Sloan-Kettering Cancer Center.
Dorcas was the source of much comfort to me during the early stages of my cancer fight; she sent care packages with comfy slippers and yummy candles; she sent books of inspiration and letters of support. She and I had a rollicking time the last time I saw her (with my GI-Jane-short hair) laughing at the random ridiculousness of the whole cancer trip. I was so sorry to hear she’d lost her fight.
If you’d like to join me in supporting my dear friend Dan in his heroic task this weekend, please visit the link below which whill take you to his page on Fred’s Team, Memorial Sloan-Kettering’s site for fundraising.
To donate online:
http://mskcc.convio.net/site/TR?px=1771450&fr_id=1370&pg=personal
To contribute by check, please make checks payable to MSKCC, noting “Pike Ironman/Fred’s Team” in the memo line, and mail to:
MSKCC
Attn: Elise Cook, Annual Giving Officer
633 Third Avenue, 28th Floor
New York, NY 10017
Thank you all for your help – let’s keep fighting to get to a place where cancer is just a distant memory. Please feel free to forward this to anyone you know who will help!
Photo courtesy Dan Pike.
Help Me Help You
Over the past couple of days I’ve answered a few cancer babes’ questions about their support teams. These ladies have been relatively new patients, and while dealing with their own fears and worries about their new diagnoses, they are feeling the changes in their relationships with their spouses, significant others, or family members. Reactions have ranged from anger, to cool distance, to hovering, to quiet resignation. They’re all okay, for initial emotions, but the reactions surprised the patients and added another worry to their lists. I’m saddened to hear of the insecurities they’re feeling, right when they need to feel safest and most secure.
In a perfect world, when we are diagnosed with a serious illness, our loved ones would rally to our side, offering support without need for recognition, organizing teams of ride givers, casserole bakers, and garden weeders while maintaining enough distance so we could rest and recuperate without concern. They would have easy and affordable access to support groups that give them the chance to vent their own frustrations and receive advice and affirmation from others who have been down the same path. Their emotions recognized and validated, they could be the supportive, understanding, flexible caregivers their sick ones need most.
Last time I checked, this world was far from perfect (really!), and being the perfect patient or the perfect caregiver may not be possible. But with support, understanding, and strong communication, we can learn to help each other through. I’ve put together a list of tips to help open the lines of communication, and a few resources to go to for advice or help.
- Ask each other how you’re feeling, what you’re scared of, and what you need from each other. Some people think the best way to support a sick loved one is by remaining stoic and swallowing their own fears. It sounds so simple, but sharing what you’re thinking about with your closest allies will not only help them recognize what they are feeling but also understand that you feel the same way. Make sure to see things from their side of the illness; while you’re worried about losing your hair and not being attractive anymore, they may be thinking about losing time at work, feeling like they have no control over the illness, or betrayed by your absence. None of these feelings is “wrong” – it’s only important to identify it and talk about it.
- Try to include your caregiver in decisions about your treatment, to give them a sense of having a little control as well as an opportunity to ask questions of your medical team (with your permission, of course). I know it was helpful, especially in the beginning of my disease when I felt like I’d been run over by a freight train, to have a family member at appointments and treatments with me to ask or answer questions that I had forgotten or spaced on.
- Diversify your list of helpers. I’ve spoken before about the priceless lotsahelpinghands.com – by giving others the chance to do for you you’re also lightening the burden on your chief caregivers. They need to live their own lives in addition to caring for yours.
- Recognize their efforts and make sure they get a break. As a recipient of numerous SpaFinder.com gift certificates, I am a big proponent of the extravagant pampering appointment: it’s customizable; it appeals to both genders, whether your hubs needs some manscaping or just a massage; and it’s something that most people won’t buy for themselves.
- Spend some time with them and don’t mention your illness. It’s so easy, like always discussing the kids with your spouse even on date night, to get pigeonholed into talking about cancer. That’ll just get everyone down. See a movie. Go out for dinner. Spend an afternoon loafing around the local bookstore. You had a relationship with this person BEFORE you got sick – maintain it and it’ll be there AFTER you get well.
While you’re laid up (and there will be plenty of that), spend a little time on the internet looking at resources to help you support your caregivers. Whether they’re joiners and would love to get into an IRL support group, an online forum, or would rather just read some helpful tips to get them through, there are plenty of places to look for more information. Here are some of the best that I’ve found:
- American Cancer Society (www.cancer.org). There’s a whole section for caregivers, with tips for getting through and a section on finding local support.
- American Association of Marriage and Family Therapists (www.aamft.org). Marriage and family therapists not only help couples with their marriages but entire families dealing with crises, traumas, and major illnesses. I chose our therapist from the list on this site based on his experience with young children. (He hasn’t met our kids yet, but knows our family well should I croak it and they need support.) Many therapists will accept medical insurance, and many carriers cover a certain number of sessions per year as adjunct treatment to your illness.
- Ovarian Cancer National Alliance (OCNA) has a great online support community (http://www.inspire.com/groups/ovarian-cancer-national-alliance/). For patients, family members and caregivers, it’s an amazing group of people dealing with and supporting this disease. Post a question, ask for advice, or just kvetch about how crummy you feel – all comers are welcomed and supported with open arms.
- And, for that matter, Inspire.com has online support groups for other cancers, too. Top-notch.
- Gilda’s Club (www.gildasclub.org) has joined forces with The Wellness Community. With Clubhouses in cities all over (although, unfortunately, not mine) and now a thriving online forum, The Living Room, support is available for everyone in the family.
My parting thought? Talk. Talk to each other, about the easy stuff and the tough stuff. Talk about how you feel, what you’re afraid of, how you’d like to be supported. Be open to hear things you might not like; be honest about what’s going through your mind. Talk like it’s the last chance you’ll get. It probably isn’t, but there’s no time like the present. Cancer has certainly taught us all that.
Back Seat Driver
A friend and I were talking this weekend about her upcoming vacation. She and her family are flying to Wyoming and renting an RV for a week of sightseeing – mom, dad, six- and eight-year-old sons. She was joking about her outrageous organizing tendencies, and her pre-vacation lists of what to pack, what to do, what to buy. We both decided, though, that the way to go about a traveling trip like this was not to adhere stringently to an agenda (“Come on, kids, eat quickly! We’ve gotta get going if we’re going to make the World’s Largest Ball of Tinfoil before 3 PM!) but to follow the planned route easily, staying relaxed and making allowances for spontaneity and unforeseen events (like ice cream stands). There are far fewer temper tantrums, from children or parents, if everyone’s going with the flow.
I thought about how this is the best way to parent, too. We all have preconceived notions about what parenting will be like (toddlers cheerfully playing house; our elementary school kids racing off the bus to give us a hug and tell us about their day; family dinners with animated conversations, in-jokes, and clean plates), and one of the hardest parts of growing up into our roles is realizing how far reality diverts from those notions (toddlers throwing poop; elementary school kids sulking into the house without a word; family dinners where everyone refuses to eat, speaks only potty talk, and is sent from the table in tears straight to bed).
Cancer has been like that. As I digested my diagnosis, back in May of 2006, I put together my idea of what treatment would be like: lose hair, spend summer in bed, fight like hell, receive clean CT scan, move on with my life. But as I struggled through treatments, trying to maintain some semblance of my former self, feeling horrible, I realized cancer had other ideas.
Boy, does it ever. My vision of a complete remission was marred by not one recurrence but two, the second of which refuses to let go of my innards. My vision of flowing locks has been replaced by persistent brown Nancy-Reagan-head and the cruel fact that no one checks me out any more, because I look like their mom. My early forceful, driving thought that I’d kick ovarian cancer to the curb and live a long, grateful, loving life has taken a back seat to the slow but steady drip of the odds stacked against me.
I’m not throwing in the towel. Not by a long shot. I’m still in it to win it, whatever road I have to drive down to get there. If this trial doesn’t work (I’ll know more by this afternoon) I’ll start another one. I might bitch about side effects, but I’m damn glad to still be here to experience them. I’m learning that the more I roll with the punches, accommodate changes in schedule, drugs, doctors, scan results, pull back my long-view to three months instead of three years, the fewer temper tantrums I need to throw. My expectations of life as a cancer babe might be growing up.
photo courtesy http://www.dcrw.org
Give Me a Break
The trial continues. Week Two of taking the fabulous drug daily, all nine capsules of it, and I’m beat. Possibly from the effort required to swallow nine capsules at once. I’ve never had a problem taking pills in the past, but this really frosts the cupcake. Why, in our era of superb medical advancement and death-defying technology, is this pharma company incapable of cramming 450 mg of my mystery drug into five capsules? Or three?
Aside from increasing my snark quotient, said mystery substance is wearing me out. Maybe it’s all the peristalsis, or maybe I’m just getting old. Or possibly since I’ve been actively fighting this beast for over eighteen months now without a break, I’m losing my elite-athlete-like (ha) endurance. I’m a lover, not a fighter. And I don’t think four weeks off to wash the Avastin out of my system counts as a break. Every time I stop to examine my alternatives, though, I realize: they suck. So back at it I go. But I’m really sick of:
- Flirting with nurses to make sure I’m the favorite
- Peeing in a cup
- Repeating my last name and date of birth to prove I’m really me (who the hell would pose as a cancer patient?)
- Sleeping with my support stocking on
- Having the inside of my mouth taste like an ashtray and not getting to smoke first
- Being too tired to play tennis, swim, ride a bike, walk up the stairs, cook dinner, host a playdate
- Short hair
On the bright side, I am not bald, throwing up, peeling, recovering from an abdominal incision, or dead. I can still drive, give directions, boss my kids around, surf the internet, and laugh at a dirty joke.
I think I need an attitude adjustment. Possibly an expensive spa treatment. Fortunately, I have one scheduled for Thursday morning. Hope I can drag my sad old carcass in there.
Thanks for listening. We now return you to your previously scheduled Eastern Seaboard Inferno of a day.
Bet You’re Wondering…
…how my trial is going. It’s certainly been an interesting week.
Monday I spent twelve hours at D-F. TWELVE. You see, when you agree to participate in a clinical trial, and that trial is being sponsored (read: paid for) by a company with a potentially viable therapy (read: big chunk o’ change) at stake, they own you. And the horse you rode in on. So after fasting for four hours, I had some blood drawn, peed in a cup, and took an EKG. (Guess they were expecting different results than the EKG I had had seven days prior.) Then I waited for my drugs to arrive. Two hours later, I was given an orange prescription bottle with nine grey capsules in it. They tasted horrible, but I had breakfast in my sights (an hour after taking them), so down they went.
After an impromptu visit to the ladies’ while I was getting some lunch in the cafeteria, I realized the meds were having an adverse effect on my GI tract. Like, for the next four hours. Immodium for that, plus Zofran for the nausea, and I was okay again. Blood draws at one, two, four, and eight hours after my meds meant I left at six, not eight, but by the time I got home it might as well have been midnight.
Not only do the study funders now own copious quarts of my blood, but they also collected my urine for the first 24 hours after my dose. Yes, all of it. In big gallon jugs. On ice. In a cooler in my room. As a décor item, I don’t recommend it.
Tuesday morning I dragged my carcass out of bed for a big diner breakfast, feeling like I’d spent the previous twenty-four hours in an airport moving heavy luggage around, but coffee and chow set me right. And by Wednesday, I was feeling nearly normal (whatever that is). So the daily trip back to The Cancer Factory for my 10:30 AM blood draw wasn’t the end of the world, although traffic was so bad sometimes I thought it was close. (Tourist season. Meh.)
The long and short of it? It seems that the drug doesn’t really affect me adversely, and a pre-dose Immodium should (hopefully) negate the GI issues. Oh – but there’s another thing: apparently, women who have had similar reactions to mine to the drug also spend their one-week-out-of-four without the meds fighting a raging, itchy, full-body rash with either steroids (aaaarrh!) or Benadryl (zzzzz). So I’ve got that going for me. Next week should be very interesting.
And I’m supposed to stay out of the sun. Yeah.
The up side? A noted 40% reduction in disease load in similarly affected women. I’ll take it.