Sister Cranky Pants: Depression with Cancer

As much as I'd like to deny it, with cancer, comes depression. Some of it from the anger, frustration, fear, etc. that you get from simply having the disease, some of it comes from physiological changes due to chemotherapy, and some from the effects of the chemotherapy.

I have found that I have been able to handle the disease-related depression much more easily than that brought on by the effects of the chemotherapy.

I think that part of the reason for this is because my disease has only been nominally symptomatic in the last three years. I’ve really only had bone trouble. Other than pain from that, it really hasn’t caused me real discomfort. The chemotherapy on the other hand, has been a giant pain in the infused ass.

I feel nauseated. I have a headache. I feel bloated and disgusting. My brain has trouble keeping up with conversation. As a result, I get cranky when I can’t understand what someone is trying to say to me. So I have a group of people, especially KB, who are doing all these things to help me out and I respond with cranky faces and barbed retorts. When I see the looks on their faces,  I end up feeling terribly guilty. I end up feeling like I don’t deserve to be treated well, that I should just be rejected by all of humankind and left alone to wither away, or barf up my guts, whichever comes first. I feel like rolling up into the fetal position and disappearing, and that my disappearing would be the best thing to happen for everyone.

Complete self-pity, I know.

Which makes me loath myself even more.

It’s a horrible circle that I have to talk myself out of. I also know that I have to control my nastiness. Some people have told me that it’s understandable, that I should take it easy on myself, etc. But I have always believed that you can’t use cancer as an excuse to be a douche bag, and I still believe that. I still have self-control and choice and I need to exercise it, despite how I feel.

It's time to give Sister a swift kick in the Cranky Pants.

Second Line Treatment

Last Friday was the first day of my 2^nd line treatment. I was hoping to go into it feeling emotionally strong and physically healthy, but due to some familial stressors and my recent hip surgery, this isn’t the way things went down.

I went into this dragging my emotional feet. I did NOT want to take these heavy-duty drugs again that compromise my mental state and make me feel utterly crappy. Nonetheless, last Friday, I was in the infusion chair, ready to receive the treatment that the doctor believes will give me two to three more years of progression-free existence. When you break out in a rash, have rampant fatigue, and hate the sight, smell and thought of food, thinking, “2-3 years. 2-3 years. 2-3 years,” is not necessarily the motivator you’d think it would be.

I’m several days out from my infusion and I still feel like crap.

I’m guessing that once I’m done with it and (if) I get those 2-3 years, I’ll think it’s worth it. At this moment, I’m not so sure.

**For family & friends who might be worrying. Don't. This is just an expression of my feelings at this precise moment. 

Affirmations Schmaffirmations

 

Today was my last of 10 radiation treatments for cancer that is encroaching on one of my sacral nerves and causing some really lousy sciatica-type pain. Thankfully, it has helped to a degree, although I’m kind of worn out by it.

Anyway, in the inner waiting area at the radiology clinic, there sits a basket that, overseen by a paper smiley face on a stick, is full of small sheets of paper on which are typed a variety of life-affirming notes – what we now call ‘affirmations’.

 

Being a self-avowed cancer curmudgeon, I don’t find affirmations of any kind very helpful. I don’t find them helpful because I don’t find them honest.

Now I understand that affirmations help people.  A lot of people, obviously, or we wouldn’t be using them so much (they even come in our chocolate candies – opened a dove chocolate square lately? Doesn’t velvety chocolate say all it needs to?).  And if they help you, more power to you.

But sometimes, they are out-and-out lies.

 

Really? There is no one and has been no person on this planet to whom only good things have happened. For one thing, random shit happens to people. All people. It just does. Secondly, none of us are always good people. Sometimes, we say mean things, we are impatient with our children, we slap our dogs on their noses, we gossip, we lie, we take the last brownie when we know it’s our spouses favorite, we operate out of self-interest. And some people do much, MUCH worse things. The consequence of doing some of those things is that bad things happen. We’re impatient with our teenager and they yell and slam doors. We eat the last brownie and our spouse makes a snarky comment about the size of our butt. NO ONE deserves only good things in their life. No one.  Because, frankly, we don’t DO only good things in our lives.

 

 The devil is in the details. Not many of us will kill our neighbor’s annoying cat, but many will lie to our neighbors about knowing the location of said cat if it turns up missing. It’s the small stuff that does matter because it’s accumulative. It is the building blocks of our everyday lives, of our everyday selves. We are our actions.

So, maybe instead of believing that we should always feel good and have only good in our lives, we should feel a little badly about the bad stuff that we do and expect the bad stuff that we get in return. If we engaged in a little honest reflection and de-affirmation from time-to-time, perhaps we would become people who don’t need our chocolates to tell us how great we are what we deserve out of life.

Getting "The Face" and the Need for Formal Cancer Etiquette

Since my diagnosis, I have been the recipient of The Face on several occasions.

I have tried to imitate "The Face" here:

In my experience, not much content comes with The Face. Maybe a little, awwww-poor-baby sort of mewlings, but basically, it's just The Face - and what do you do with just a face? Really? So what I end up doing is making a comment like, "What are you gonna do?" or "You gotta do what you gotta do?" Still the face continues to just look at me. I end up just walking away.

I think that this happens because, despite the great numbers of people with cancer today, we as a society, have not kept up with creating standard appropriate and helpful social responses to people who have really scary diseases. As a result, you get things like The Face or (worse) weird, nonsensical, unhelpful, sometimes-insensitive comments / suggestions/ wisdoms. 

Sometimes it's easy to get a little honked off when, after revealing to friends that you have cancer, you receive a response like, "Yeah. My dog died of cancer. Cancer sucks," or "My uncle died of that kind of cancer. He got cancer and was dead in two months." But I think that, at least after a while, most of us realize that these comments (and The Face) come from well-meaning people who are uncomfortable about illness and ignorant about how to respond. Also, there's probably some self-importance in here, but I digress.

The best advice that I can give to someone who is at a loss about how to respond when someone with a cancer diagnosis is keep it simple. Don't offer diet advice or talk about alternative treatments in Mexico. Don't share cancer stories that had bad endings - or happy endings for that matter. Also, don't avoid the subject. Try to imaging how you would want someone to respond to you if you were the one with the diagnosis. Comments like, "I heard about your diagnosis. I was so sorry to hear about it. How are you feeling?" "Please let me know how I can help" (only offer this if you mean it). "I'm thinking/praying about/for you." These are simple and kind statements that focus on the ill person instead of any advice or cleverness, and lets them know simply that you care. In my experience, this goes a long way and gives significant comfort and some relief.

“Or, rather, let us be more simple and less vain.” ― Jean-Jacques Rousseau

Happy Anniversary, Beloved.

Four years ago today, my husband and I were married at the Cook County Courthouse in downtown Chicago.

Both of us had one marriage and several long-term relationships under our belt. Married too young to people with whom we had little in common except for geographical location, our past relationships had operated from a goodly amount of emotion, drama and sometimes violence.

When we met at school in 2004, we were both very tired of that sort of thing and found it refreshing that our attraction was not founded on sex, or scandal or romantic drama, but a pairing of the minds. He’s a philosopher. I’m a sociologist. We had many interesting things to talk about.

Our relationship moved along with little effort. It was easy. We got along. Neither of us had to be more or less that what and who we were. It was so good, in fact, that we used to tease one another that, sooner or later, some bad mojo was going to come and sweep one of us away.

And so it happened.

On October 4, 2010, I called him from my sports doctors office, crying, saying, “They think I have cancer. It’s in my bones.”

It’s the stuff bad Lifetime movies are made of – but this is real.

Since that day, he’s become part of my larger family. Getting to know my parents and siblings, becoming friends with my sister’s husband, my children and their partners, and warming up to the idea of being a grandpa without ever having been a father. He delights in my (our) children’s successes and winces and becomes frustrated at their challenges. He sometimes offers quiet advice and suggestions. He’s sincerely intrigued with the psychology of our developing and growing grandchildren

With this latest cancer recurrence, He knows that he comes one step closer to becoming my caretaker. Although he feels unequipped for such an undertaking, he is ready to do whatever is necessary, including helping me recognize when enough is enough when it comes to treatments.

After my death, he’ll become the one who will see to my honest memorial. It will become his duty to help my children and grandchildren remember who I was, reminding them of what they meant to me, and helping them figure out what I meant to them. He will be around to help make decisions and parse out money for their secondary education that I will leave in trust for them.

Each anniversary reminds us that “Till death do us part” will come far too early for both of us. But until that day, we continue to move along with little effort, allowing each other to be exactly who and what we are, and having many interesting things to talk about.

Convalescence and Escaping Cancer

Lower Harbor, Marquette, MI

I like the word 'convalescence'. Something about it is more warm and comforting than the words, 'recuperation' or 'recovery'. The word 'convalescence' swirls with soft blankets and warm soup and fuzzy slippers.

Originally, I was just going to stay at home after surgery, hang out, watch movies, nothing special. Then The Bickster asked what I thought about going to Marquette while I was 'convalescing'. Knowing that this would not be our usual U.P. trip of tent camping and back-trails hiking, I hesitated. Being surrounded by all of those temptations and not being able to partake might be too frustrating. But after some discussion about having a different kind of vacation - one just enjoying rest and relaxation in a beautiful natural setting, I decided that it sounded like a pretty good idea. I hopped online and booked a room at the Days Inn for seven days and yesterday, we flew the coop.

There is something else to getting away after this surgery other than having a nice place to heal. There is this faint idea that I can escape my cancer, if only for seven days. Seven days of not thinking about the treatments that lie ahead. Seven days of not thinking about possible suffering and premature death. Seven days over which I have a modicum of control. Seven days.

Realistically, I can't entirely escape my cancer while I'm here. Still plenty of reminders - the pain from surgery, plenty of pills to take, and the oppressive constipation that comes from surgical anesthesia and pain medication that, believe you me, can turn anybody into one bitter pill. But something about putting distance between me and those who treat me makes me feel more free from my cancer.

Now that we are here and settled in, I'm starting to relax, body and mind. I've got several distracting yet mellowness-inducing projects to work on including:

1. several knitting projects including a winter hat for #1 and baby blanket for Ginger #4
2. recording a book for Ginger #2
3. reading #3 & #4 Flavia de Luce mystery novels
4. sketching
5. awesome used bookstore tour (six in the area!)
6. Enjoying the nature of this place and the company of my oh-so-lovely husband and wacky lab.

Comfort comes in small slices for people with stage IV cancers. For me, my small slice of comfort today is that for these seven days, I have decided to be cancer free.

(Ugh. That feels so pathetic. Sigh...)

Report: Biopsy, compression screws and treatment changes

There’s a lot going on in Ruth’s Wonder-full world of cancer lately. I’ll try to report it as succinctly as possible. This post is for reporting purposes only. Reflections may come later.

 

Biopsy: My onc suggested to me that I submit my tumor for large-scale genetic testing. A place called Foundation Medicine has invented a new test that analyzes tumors for more than 200 genes / mutations. The tumor will be tested for mutations for which it has already been tested (in case someone goofed) for which there is targeted treatment, and also for mutations for which there is currently no treatment. By knowing what your mutations are, you are more likely to be involved in and benefit from clinical trials. They had run out of my original tumor tissue, and so last Wednesday, I had a needle biopsy (which I gotta say, is the easiest procedure I’ve had yet). Realistically, it will take about a month to get the results.

Compression screws: The first part of July, I fell (I’ll spare you the details) and, although I didn’t realize it at the time, I cracked my left femoral neck bone. The bone was already weakened from an old tumor which had left the bone soft/hollow and ready for injury. In order to keep the crack from becoming a fracture for which I’d have to have a hip replacement, the doctor is going to insert three compression screws from the outside of my femur through the femoral neck and into the femoral head, holding all of the pieces together. Surgery is tomorrow and then at least two weeks off of work. I have a couple of knitting projects in the hopper to keep me from going completely bananas.

Treatment changes: As I’ve mentioned before, my cancer had started to grow – slowly – but grow. With two scans – both lung and bone showing growth, it is now time to change my chemotherapy mix. My onc originally gave me two options – one more toxic than the other. I opted for the lesser toxin combined with an agent that I used in my original, non-maintenance chemo (carboplatin + gemzar). I’ve also asked to stay on the Avastin to keep brain mets away and there will be a new skeletal agent as well. I’m a little concerned because instead of treatment once every three weeks, I will receive treatment once a week for two weeks and one week off. It sounds like a good recipe for one sick puppy to me.

At this point, I’m not sure if they’ll be waiting to get the genetic testing results back before this new chemo or not. There’s also some new experimental immunology-type treatment that’s in the hopper with my onc. I think she’s applied to receive some or be a part of a study or something. If that comes through, I could be eligible and that would be a different course of treatment. Again, I’m not sure what the timing is on that either.

Until I do, I am striving for 

 .