Sunday, January 29, 2012

Where courage comes from....

Right now, at this moment, I feel wonderful. I am lying on the couch with Butters on my life. Aside from a small twinge in my side and an ache in my legs, I am not in pain. More importantly, the terrible feeling of illness that's been with me for the past few days has lifted. I felt well enough to walk around the block just now. So long as I don't try to actually do anything, I feel okay.

I'm absurdly grateful. I was starting to think I wouldn't feel anything but completely weak and shaky from now until the end of chemo. So to think I might have the energy to cook a meal, walk the dog or attend a meeting seems very exciting. You take what you can get.

And here's the really great news. Four days from now, I get my final dose of chemo. Even if the two weeks following are as bad or worse than the last few cycles have been (which assumes I get yet another cold virus), the end is in sight. As the end of the cycle draws nearer and my cells start to heal, they will actually get a chance to do so. No toxic cocktail will flow into my veins as soon as I'm strong enough to tolerate it. Now that's a thought to celebrate.

I am glad, in retrospect, to have had chemo first. Surgery and radiation seem far less daunting now I've climbed this mountain. In fact, I'm not worried at all about mastectomy any more. I'm more worried about nausea from the anesthetic and pain from the operation than losing a breast. I honestly couldn't care less. Maybe I've already done my grieving, but I don't think that's it. They can take what they need to and good riddance.

Just give me my energy, some time free of pain, the chance to see my kids grow up. I wouldn't even care if my hair never grew back. I'd like the numbness and tingling in my fingers to go away. It does for most people, but if it doesn't, I can live with that, too. Just can't wait to get back to living!

Finally, thanks to all of you who took the time to say my writing matters. I have found myself at the center of a storm of love and compassion. People I knew in high school, college chums, colleagues, family, all taking time to throw some caring my way. It's breathtaking.

I have always believed that it is our compassion and altruism, our curiosity and our love of expressing ourselves that defines our greatness. We live in a world driven by the competitive and pleasure-seeking parts of our brain and the Mitt Romneys of the world have benefitted greatly. But we remain unsatisfied by the results. We want a better world than one driven by greed.

I find it takes courage to believe in people. In my work, I help my clients build companies that tap into our need to care, rather than treating people like cogs in a machine. Its not that incentives don't work, it's that they work in a very limited way and always have unintended consequences. We love to game systems that treat us like slot machines. In fact, we can't help it. But we can do better, and we truly want to.

Those of you rooting for me to get better aren't doing it for yourselves. Most of your lives barely touch mine and, though you might miss me, it's the idea of me that matters. We just want to keep everyone in the lifeboat. So, thank you for caring, not just because it touches me and gives me courage to know I would be missed, but because it gives me courage to be reminded that we crazy humans do care about each other. That gives me an even higher order of hope. The reminder that, when this is over, I have work to do, will keep me going when all else fails. Thank you for that.

Thursday, January 26, 2012

Am I still me?

What a relief! After I had managed to drag myself off the couch, put on some makeup and work clothes and prepare for a now very rare meeting offsite, my client called to say the candidates had cancelled. Now, this is bad news for my dear client and I am heartily sorry. But I can't lie. I am happy to be spared the ordeal. Back to bed, Thank God!

It is hard to describe the fatigue that is chemo. When absolute anything is an effort, you find stuff out about yourself, and not all of it good. It can be pretty pathetic. I mean, wouldn't you think that being reduced to 10% of your normal output would make you want to do only the most important stuff? Instead, I end up watching stupid tv reruns or cleaning the sink. I mean, who cares if the damned sink is clean? I have freaking cancer! Yet the crazy need to feel you've done something has great sticking power, even near rock bottom!

When you are this tired, you do what is easy. Its kind of disappointing! I know, I know, it's temporary. I get that. This is just a tactical retreat into the land of being poisoned in order to kill the cancer cells before they kill me. I know I'm doing a pretty good job with a shitty situation, all things considered.

And yet. It's morbidly fascinating to see first hand how easy it is to simply let your life go. It just goes away. You wake up, you are tired and feel like crap, and, before you know it, another day in your possibly short life is gone. Just like that. I guess a fair number of us live that way without being sick. But it makes you think. I mean, what is your life? Is it what you do? Some bucket list of actions you've taken, impact you've had? If so, I'm in trouble. Not much output these days!

So what does it mean to be really alive? My Aunt Kathy has Alzheimer's and spends her days in a twilight world of simple awareness. She likes to have her back rubbed, she laughs occasionally, but mainly her brain has deteriorated to the point that it's hard to say whether she, Kathy Keenan, is anywhere at all. Yet, almost every Saturday, my Dad and his other sisters and their spouses gather to visit her and then go out to dinner. They feed her, try to get her to respond, and enjoy each other's company. What still exists of Kathy is their love for her. The space she created in their lives when she was actually an actor on the stage (and was she!) is what remains. Her impact on the world is now created almost entirely by others who choose to make her important, though she'll never again know it.

Although I am still very much alive and plan to remain so, I wonder what has become, temporarily, of who I was? That dynamic, creative actor, the one with fingers in many pies at once is simply gone. She has left the stage, bowed out. All the things she might have done during this time will not happen. They are lost forever. Not such a big deal, but if you think about life as a series of "accomplishments", then I have ground pretty much to a halt for now! I'm not judging myself for this, I'm just fascinated by how different it feels to be me without the energy to do anything but lie around. Some days I wonder if I still exist!

For now, at least, I write. I write, therefore, I am. And, every few days, a small group of people from all over the world stops what they are doing and reads about my life with cancer. I send some electrons out into the world filled with stories and musings, dumping the insides of my brain into the ether. Small ripples into the world from my couch. Will anything change as a result? Will someone act differently some day somewhere because of what I've written? Unlikely, I think. But it's fun to think so. Love to you all.

Colleen

Wednesday, January 25, 2012

Good port news

Nothing like a little good news from time to time. The port installed in my chest (gross) managed to migrate across my chest to a new vein (super gross) AND seems to have managed to find a perfectly good home in its new vein delivering chemo and other various substances to my bloodstream at least as well as an IV in my arm would. So, after a long drive to Westfield and nothing to eat all morning, having to lie on a table with a gown on and get poked yet again, I have the all clear to use my port again. Hooray!

This second-to-last chemo round is going better then the last. Once I decided to adopt the "lost weekend" approach by taking enough Percocet to manage the bone pain, it was less overwhelming. A week from treatment this morning, I am definitely stronger. For one, I can walk again, and am off Percocet.

I feel reasonably alert and am working again. Not the dynamo I used to be, but able to think clearly and work with my clients. Butters and I will be on our own for two days while Steve is at a meeting, so the timing is good. Thanks for will of you following along with me!

Sunday, January 22, 2012

Bone pain and next steps...

This weekend is about staying on top of the pain. With the help of Percocet, this isn't too hard. Like a clock, the pain in my bone marrow kicked in 24 hours after my neulasta injection. Along with the pain seems to come a kind of weakness in my hips and legs that makes walking feel very uncertain. I think this is a preview of what being old feels like!

Being on Percocet isn't half bad. I feel dopey and silly, which is fun. The pain still comes throgh and a heating pad seems to help. I actually managed to clean the kitchen, vacuum the downstairs, catch up on filing and wash the kitchen floor yesterday. Hardly the stuff of champions, but it's something at least.

Joseph and Margaret are both back at school and Steve, Butters and I are living the empty nest life again. I do enjoy the serenity and order. It is nice to be able to concentrate on getting well and helping Steve wage his ongoing battle against colds. Steve's lousy immune system has been a trial as long as I've known him. To be an apparently healthy person who works hard to stay fit, eats well, takes vitamins, while constantly having to remain vigilant about getting colds that turn into sinus pain all the time really stinks. The best news is that vitamin D, in the form of uv light therapy, seems to be doing with other treatments have not. We are optimistic. As it is, I have told him he's not invited to the hospital when I get my surgery, since I need him well to help me recover. It will be sad not to have him there, but I will be well supported with family. He will take excellent care of me when I get home.

At my next chemo visit on feb 1, I imagine the next phase really begins. There is talk of restaging the cancer, which sounds like more tests and scans. I am fascinated by this idea of restaging. Even in the best case scenario, where they find no more evidence of cancer outside the initial area, what does that really mean? Will it change their treatment plan? If not, why not skip the testing?

There is this lovely word "recurrence", of which I have a high likelihood with this cancer, and that goes to the heart of things. Two possibilities: First, that cancer cells are already active somewhere no scans can find them yet. If that is the case, then being declared "cancer-free" is essentially meaningless. The second possibility is that, while no cancer cells are extant, the underlying conditions in my body that allowed the cancer to begin still remain. This is reflected in the description of cancer as "a systemic disease, not a tumor disease."

What they recommend for treatment will tell me a lot about how they conceptualize it. At this point, the plan (I think) is to remove the entire breast then irradiate the surrounding tissue and lymph nodes that were cancerous. I am not sure whether they will remove the nodes, there seems no talk of that. I have to find out why. Not that I'm in a hurry to have them gone. My first surgeon removed nodes under the arm because she said it was not possible to biopsy them otherwise. A subsequent cat-scan biopsy at Sloan proved this to be wrong, about which I have every cause to be angry, unless they all end up being removed.

Meanwhile, we wait in the dark. I don't find the MSK folks to be working a real team. They seem to pass people in a sequential fashion from, say, oncologist to surgeon to radiologist. One gets the sense or territory being respected...not in the interest of the patient. It is going to take effort on our part to keep it all fully integrated. It is frightening to think of the many who need to do this without the education, resources and, frankly, the confidence to tackle the system. We can and should do better.

Thursday, January 19, 2012

Feeling good!

I feel good today for the first time in 3 weeks. Let me define good. Good feels lousy. I am tired and my stomach is upset and I feel slightly jittery from the steroids I am on. But good feels like sitting up all day rather than lying down, having two coaching sessions and in- between being at the computer managing to clear up a number of items. Good is working a pretty full day before going in for my neulasta shot, and not needing a nap. Good is feeling as if I have my life back, instead of this half-life of lying on the couch in between coaching calls and watching movies on my iPod, not even making dinner. Blech.

Over the next few days, I'll taper off the steroids and also see how bad the bone pain from the Neulasta will be. I will continue to avoid crowds in an attempt to stay healthy. I think I picked up two separate cold virus over the holidays and that's been the problem. Anyway, am hoping this lasts! Glad to be up and around again.

I am writing this with Butters on my lap. Life is sweet!

Wednesday, January 18, 2012

Migrating ports and other weirdness...

I saw my chest x-ray today. The port catheter I have has "migrated." This was no slight shift in position but a major pilgrimage. The claim is that the catheter originally snaked straight down into the jugular vein. Then it moved on its own back upwards, took a left and ended up across my breast bone in a smaller vein, 3-4 inches away. Apparently, this is something that does happen, crazy as it sounds. But I wonder if that isn't where it was from the beginning. They did not xray it then. How do they know it went correctly the first timeg? if it did move, my guess is it moved over a month ago, when we first had the trouble with blood return.

Before this started, I didn't know what a blood return was. When you get an IV, they push saline into it and then draw it back to see if they get blood. Blood is good. Means you are well into a vein. No blood is bad, means you need to start over. Those of us with small, crappy, slippery veins learn all about blood return or the sad lack thereof.

Today, no blood would have meant the cath was not in a good vein and we couldn't use it for my chemo. Even though this would have meant struggling with IV nastiness, I was relaxed. I felt sure somehow we could manage to get a good return and avoid gigging into my veins. I had the same nurse who was with me when we had trouble before and she was more nervous than I was. I sat up straight, held my chest out, she drew back the syringe and beautiful red blood flowed into it. We cheered. I would never have thought I'd be so happy to see my own blood.

So, with no allergic reaction, and 9 hours at the cancer center later, I'm through another treatment. I have to decide what to do about this port, and I need not to get another cold. Then we move on to surgery and the radiation. There will be decisions to be made, which is the hardest thing of all.

Right now, I am eating my mom's pecan pie with ice cream. Knowing its not good for me, I figure I'd better really enjoy it!

Tuesday, January 17, 2012

The letting go of things...

It's surprising what you can live without. As I plough on, things have fallen by the wayside. At first, it was hard not to have hair. Now I have lost my eyelashes, my lids are often swollen and I have dark circles and grayish skin. Yet I go out and don't bother with makeup. Gone are the headscarves, in favor of easy hats, which I take off when hot. I simply don't care much how I look these days. I feel almost invisible, or as if I am traveling in a parallel universe, in which the people I interact with are playing a game I have opted out of temporarily. The caring is something I used to have that I've let fall out of my pocket somewhere. Maybe I'll pick it up again some time. Maybe not.

My new face in the mirror is now familiar and the woman who used to look back at me seems very far away. I wonder if she will reappear, or perhaps a third person, with curly hair (that happens sometimes), with the gray I used to color (but won't be able to when when it's very short)' older and more careworn than she who entered this gauntlet? Or maybe the filter behind the eyes is so changed that I will never again see myself the same way, even if I look the same to everyone else. My immortality has dropped away. The unenchanted princess who looks back at me, with amused and knowing eyes, is the companion of my remaining years. She is okay. I like her just fine.

I had a chest X-ray today to make sure I have bronchitis and not pneumonia, and they saw that my mediport has migrated. The end that snakes through my vein has moved. Apparently this happens, particularly with younger patients. Who knows why? So, they tell me we will try to use it anyway for my last two treatments. Tomorrow we shall have the fun of seeing whether it works. I think this actually happened a while back. During my final A-C chemo treatment, we had a blood return problem. The only way we could get a return was for me to take a deep breath, let it out and repeat with my head turned to the side. If that works tomorrow, we're okay. If not, it's back to the poor, scarred veins in my arms and hands for the chemo IV. Wish me luck.

So here is another thing I've let go of. Not, long ago, this would have upset me quite a bit. I would have worried that there was something I should've done to avoid this problem. And I would be very worried right now about maybe ending up with an IV tomorrow (after 3-4 tries, perhaps). I think what I've let go of is the idea that there is some way it is "supposed" to go tomorrow and I can somehow do something about it. Now I tell myself it will be fine, will go smoothly, and then let it be what is. I'm just too damned tired to worry about it.

Last night, Steve and I got to reminiscing. I was remembering my childhood and I suddenly said "My God, I have a wonderful life!" I am really having a fabulous life. Most of the problems I've had have been in my own mind. So today, bronchitis and all, I am grateful. I am thinking of all my friends at ActionCOACH conference without me and I miss them and laugh thinking of the fun I've had with them. I think of my family, my childhood and college friends. I know wonderful people, have heard and performed great music, acted in great plays, made art, enjoyed art, made love, been loved, seen so many cities and gorgeous places, read so many books, eaten such good food.

And I have mattered to people. I have done a little bit of good in a lot of places, made people laugh, opened their eyes to new ideas, made them a bit more thoughtful, a bit more compassionate, a bit more sensible, I hope. And I'll continue to do so. I look forward to getting my strength back. My work is to help organizations bring out the best in people. There is much to be done. Looking forward to being back, stronger than ever!

Tuesday, January 10, 2012

2 flights of stairs...

Camp Chemo is on the third floor. I decided at the beginning to walk up both flights before my sessions if I could. So far, up to session 6 of 8, I have. So far, I can do it without resting, although there is a walk across the second floor to the second fairway that breaks the climb. What is significant, is how much harder it gets. In the beginning, I could march up with vigor, arrive at the top very slightly breathless, and recover in seconds. This last time, I climbed slowly but purposefully and arrived at the top truly sucking wind. It takes almost 10 minutes for my heart rate to return to normal and my muscles to stop aching from lack of oxygen.

I wonder how much better this would be had I been in great shape when I started. I wonder if I should push myself harder now. I have started doing Pilates again twice a week and our last session two days after chemo felt like I would kill me. Yet I could feel how good it was for my body to move and breathe hard.

Right mow, it seems I'll never again take feeling good and strong for granted. I fantasize about running hard, lifting and climbing and moving heavy objects. We will see how I feel when I do truly have to work hard to rebuild that strength. Being able to maintain the gratitude for still having that possibility will be a legacy of chemo worth having.

So, two weeks after Christmas and I am finally writing again. Why silent? I have been busy, it's true. I am working more, getting out to client meetings doing more phone coaching, etc. The kids were both home and we saw more of them and their friends. And all of the holiday stuff took time for me, as for everyone.

But mainly, I've just been tired. The chemo, as predicted, kicked my body into early menopause (temporarily or, as hoped, permanent...who wants to go through this twice?). Suddenly, I am wake up 4-5 times a night boiling hot. Gone are the restful nights I had been having despite the chemo. Between this and the cumulative impact of the chemo, I am pretty freaking worn out by now. But here I am again, your trusty correspondent from the cancer front lines.

What can I say that would be enlightening? Chemo sucks? Think you've gotten that by now! Here's what I want to be able to say: I want to report that I have discovered the secret to wavering life when I am in pain, feel like crap, fear death. If I could do that, and teach others how to, then this whole mess would feel worthwhile. But I have discovered no magic bullet to maintain inner peace and joy throughout this. Full dislosure: I am sad, angry, defeated and crabby often. I hate being tired and in pain much of the time.

But, if I have is discovered anything, it is a fierce desire not to give up or give in to the simple logic of pain and illness. I am not willing to allow my sense of well-being to rest on how I feel. I want something more sustainable, something within my conscious control, so the quality of my day and my life depends not on how tough the chemo demons that day were, or what emotions or impulses bubble up from my subconscious.

There are many books written that purport to have this key, that tell you to "only love yourself", or "find a higher purpose" "connect with others," "do yoga", "meditate," "pray," "do affirmations to train your brain." I am open to them all, trying, evaluating. At the moment, I can say only that the effort continues and that I'll let you know what I learn. No one said this would be easy! And who says easy is the point, anyway? The adventure continues...

Colleen

Colleen