Wednesday, December 26, 2012

Happy Holidays

what I learned today

That my husband can do an excellent job creating Christmas magic at 3am Christmas Eve all by himself.
That my children are happy with so much less than what  I sometimes imagine.
That my best can change from day to day, and that is not only normal- it is okay.
That it is okay to allow others to help you.
That letting go of perfectionism can sometimes allow for laughter and joy.
and that when you need to rest and take care of yourself, those that love you will understand... even if they are just three years old.

Sunday, December 23, 2012

Being flexible

As a clinician, one of the things that I believe is that flexibility is a basic necessity for long term mental and physical health.  If you are able to adapt, you can survive.  I teach coping strategies to help to that end.   I often give the example to my students about a strong tree that doesn't move with the wind and breaks - as opposed to something more supple that goes with the wind and rides out the storm.  I tend to be a big strong tree - that sometimes tries to impersonate a willow.

But how do you become flexible?  Is it innate?  Do your parents teach you flexibility by showing you how to handle small and large catastrophes with grace? I have read that in general women tend to be more flexible than men.  I look at my children, and notice that my daughter was born a big strong stubborn tree.  A gorgeous tree.  But one that has a very hard time bending.  My son on the other hand, seems to take things in stride.  I don't feel like I did much different parenting - although I am sure I did.  Your child's innate temperament impacts how you parent each child.  My mother says that as a child I was difficult- high strung, never slept, emotionally sensitive, physically sensitive, and stubborn.  It is interesting the way as mothers we sometimes get to mother tiny versions of ourselves.  I have a whole new respect for my own mother.

But what does this have to do with Cancer?  Well, on December 11th I was told that chemotherapy would abruptly end due to the increasing neuropathy in my feet and hands and some possible foot syndrome.  I was extremely frightened about this notion.  I wanted to finish all six rounds of TCH (Taxotere, Carboplatin, and Herceptin).  Doctors feared that the chemo could cause extensive damage.
I had to shift my understanding of what was happening.  Scary.  I needed something to change my vision of what was happening.  I needed a visualization that would center around my healing.  I wrote the following story - when you read it, imagine a kind of WWII narrator from one of those short news reels that were often shown in theaters prior to the featured presentation...

The  cancer cells had no idea what was happening.  Why would they?  They had been allowed to grow undetected for years in a comfortable section of my left breast.  So comfortable they were, that they didn't venture beyond one lymph node in my left armpit.  
My doctors were brilliant and extremely versed in breast cancer warfare.  After sizing up the enemy, they quickly surmised a course of action to destroy it.  Armed with knowledge, experience, and research, they began their attack.  A strategy that would begin with chemotherapy.  Experienced fighters - Taxotere and Carboplatin would join forces with a newer player, Herceptin to begin the battle.  
With the first infusion, the cancer cells were taken completely off guard.  The medicines found their target immediately and went to work annihilating the enemy.  Cancer couldn't fight back.  By the third round only scar tissue remained.The fourth round killed any remaining cells that might have been hiding from view during the first three battles.
My body was another important force is these battles.  It worked tirelessly with the medicines to do what was needed to win this first battle - and win we did.  The war is not over yet.  The defense forces suffered some injuries, and so for now, my body will rest, train,  and gain strength preparing for the next battle.  Thank you chemo for a job well done.

I know, it is kind of silly.  But it helped me to reframe what had happened.  I didn't want to feel like I had failed.  I wish I had the time and energy to do a comic strip- maybe something I can work on when I am better.  After I wrote the story, I really did try to work on the healing portion.  I began changing my diet again, riding on the exercise bike, maintaining better sleep patterns.  I started to be happy that I no longer had to sit in the big girl chair.  My hair began growing.  And now I was on to my next challenge- figuring out how to cope with surgery.

But, this very long blog post is about flexibility.  My oncologist called Wednesday and asked about the neuropathy- which has improved greatly on the new medication.  He feels it is important to continue chemotherapy.  The one thing that helps me to be flexible, is that I trust my team.  But it is still hard.  I spent a lot of time crying.  I hate chemotherapy.  It hurts - physically, emotionally, spiritually.   But I also know that thus far, it has been extremely successful in obliterating my tumor.  So, I have been working on changing my attitude once again.  Which has not been easy.  I went in on Friday.  My pattern tends to be that I feel fine the first three days, and then it hits me hard - and remains difficult for the rest of the week.  Which means that it will hit on Christmas.  I will do my best to take care of myself, take my medications, and stave off the misery of chemo during the holidays- but I feel crestfallen.  As a mom, I have been preparing for Christmas.  I love Christmas.  I have a basket full of projects needing to be done, gingerbread houses not yet baked, pictures and snowflakes I haven't hung... and now, I don't know what will happen.  Flexibility sucks.  But breaking sucks more.

Tuesday, December 11, 2012

Of all the nerves

This has been a hard week- and it is only Tuesday.  Preceding all chemotherapy appointments, you must do blood work and meet with your oncologist.  These precautions are necessary to insure that it safe to continue chemotherapy and also to help with any side effects that you are experiencing.  My biggest side effect at this point is neuropathy.

Peripheral neuropathy is damage to the nerves of the peripheral nervous system.  At first I noticed some burning sensations in my finger tips - interspersed with the feeling that my fingers and toes had fallen asleep.  Currently, three toes on my left foot and two toes on my right foot are completely numb and tingling - all of the time.  My fingertips also have periods of numbness, but it is intermittent.  The bottom of my feet are also sore, making walking difficult.  I can not go barefoot because the sensitivity is unbearable.  My legs are extremely sore which also make walking challenging.  I am generally very flexible, and have no problem laying a flat palm on the floor without bending my legs.  At this point, I can barely bend over with fingertips dangling at my shins.  The leg pain is also constant and it radiates through out my thighs and calves.  In addition my legs, ankles, and fingers are swollen.  And to top if all off, my right eyelid is twitching like mad.  Sounds like fun, right?

So, of course I mention these symptoms to the nurse practitioner, who I have to say is awesome, because my oncologist is away on vacation this week.  She tells me that it is concerning and proceeds to do some tests that involve pricking me in the foot with a sharp object.  I could feel the pressure of the object, but not that it was sharp.  This coupled with the fact that the pain is now constant in my feet and legs, had her questioning whether or not we should proceed with chemotherapy.  She spoke with the other oncologist on duty who agreed.  No more chemo.  If  I continued, the neuropathy would only get worse.  Chances are good that I would end up in a wheelchair.  And these side effects can often take a year to dissipate after chemotherapy.  In my heart, I know this is the right thing to do.  I can't imagine the symptoms I already have lasting a year- and I super can't imagine them getting worse!  It is already challenging to do the things I need to do in my life as it is.  But, I have to say my heart was broken.

I wanted to soldier through- fight every battle to defeat this thing that has invaded my body.  I worry that with each thing that I can not do, the odds become less in my favor.  And although I am trying very hard to put things in a more healthy perspective, I feel a bit betrayed by my body.   I also didn't like the fact that I had no idea my last chemotherapy session was my last one.  It came and went with little fanfare.  Had I known, I would have celebrated, given roses to the nurses, taken photographs and videos documenting my heroism.  This ending of chemotherapy that I am currently faced with feels so anti-climactic.  I feel defeated.

So, I am trying to find the silver lining and reframe this setback as something different.  Trusting that my body held on for as long as it needed until every cancer cell was destroyed.  Trusting my body as it twitched and tingled, burned and ached to warn me that it was time to stop. Taking pleasure in this gift of the month of December, where I can celebrate the holidays with my children free of nausea and exhaustion.  And getting myself ready for the next step on this journey.