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 April 2008 Post Book Essays Reflections on Peeking Again Into the Next World - April 22, 2008 "So, Where Did February Go?" - April 12, 2008 Sunday, March 9, 2008 Reflections on Peeking Again Into the Next World - April 22, 2008 The other day, Steve pointed out to me that our family has been gathered at my bedside no less than four times in the last six months, to say good-bye to me. Thinking about this has a surreal quality, especially since I was totally unconscious or unaware or mercifully spared any memory of these medical crisis points. I'll confess, however, that the aftermath left me shook to the roots for a while. For all my brave talk about my surrender and my readiness for whatever is coming, when the rubber hits the road and it's no longer an abstract notion somewhere out in an indefinite future, the impact is different. When I got out of the hospital after my last sojourn (and one foray towards that passage again), I was extremely anxious for several weeks. This anxiety had its roots, I'm sure, in having been gravely ill again. It was compounded by coming off Oxycontin too precipitately and a total aversion to food, which had led to alarming weight loss and weakness. For me, having gone so far towards death was hard to pull back from. I found that I had reached a certain degree of resignation and mustering the energy to be fully back in this world, in fighting shape, was really, really hard. The fact that my chemo had continued to work, bringing tumor markers down even when I had missed a dose, clouded the issue for me, too. For my family, my reluctance was frustrating and confusing. After all, they had seen me in extremis, in a state which I could not recall. To their eyes, I was so much better. The cancer wasn't killing me (as they pointed out); not eating was what was killing me. I found myself weary beyond any weariness I had ever known. At the same time, I was agitated and nervous, which wore me out all the more. The solution was amazingly simple: eat. The doctor in Nashville put me on Megace, which made me completely ravenous within two days. Once I began eating, my body and then my mind and finally my spirit got a clear message: live! For about three weeks, I was able to eat with total impunity every forbidden thing I had craved and that had been off limits since my teen and young adult years, before middle age, menopause, and slowed metabolism had made me have to watch my diet. I ate ice cream, boxes of Girl Scout Thin Mint cookies, braunschweiger sandwiches, cheese, cheese, and more cheese, whole milk, Pecan Sandies, chocolate, milk shakes, bread and butter and great cups of hot tea laced with milk and brown sugar And as I put on the pounds and regained strength and stopped cannibalizing my own body, my hope and my fight and my feistiness came roaring back. It's a strange thing, to know something absolutely with your intellect and not be able to act on it. My aversion to food was like that. I knew I had to eat and I just couldn't. One day about two weeks into my returning to eating, a breast cancer buddy who had also had anal cancer (enough, already!) came to visit and to bring me some wonderful, healthy, high cal and high quality food. As we sat down to visit, I remembered suddenly that when she was being treated for her anal cancer, she had a period during which she simply could not eat. Here was someone who totally understood how I had felt! What a relief! She commiserated and encouraged me, sympathized and empathized. She agreed that you could know with every cell of your cerebral cortex that you had to eat and still be unable to do it. So, here I am, six weeks later, fully back
in this world, mindful of the closeness of the Other One, twelve
pounds heavier, eating well, and thankful for these days and
for the resilience of the human spirit and of this remarkable
body we're given.
"So, Where Did February Go?" - April 12, 2008 Well, I was rocking along (OK, limping along), tolerating low, low white counts, avoiding infections, getting cabin fever from isolating myself throughout the winter. I got a cold the first week in February. Steve and I went on with our plans to celebrate our 10th anniversary the weekend of February 8th. I felt kind of crummy, but this was a milestone I thought I wouldn't see, so I optimistically tucked my wedding-night nightie into the corner of the suitcase and we headed off for lovely cabins on the Ocoee River. As the weekend progressed, I felt worse, but no fever materialized, so I kept pushing fluids and figured the cold was just getting the better of me. We relaxed, ate good food, and enjoyed the beautiful scenery and weather. We got home Sunday afternoon and I fell into bed, into a deep sleep. At 4:30 the next morning, I woke up feeling feverish. My temp was 100.6 which, for those of you who have been on chemo will remember, is regarded as a medical emergency when your immune system is suppressed. I called Nashville as soon as I knew someone would be in office and we headed off to our Chattanooga oncologist for bloodwork. At Dr. Johnson's, my temp was 101.4 and I began having shaking chills and vomiting. His nurses tended me in an exam room, starting an IV, giving me Zofran, and clucking over me until a room was ready for me to be admitted. By then, my temp was 103. The infectious disease guy later commented, "Given your white counts, it's amazing that you could even mount a fever!" The next three weeks are spotty in my memory but the first 10 days or so involved persistent fever and five antibiotics. I had fluid again on my lungs on the right. Drawing it off wasn't adequate and eventually a chest surgeon was called in, and it was decided to do another sclerosing procedure, this time under general anesthesia, using talc as the irritant. The anesthesiologist promised me adequate pain control, including an epidural that would remain in place for several days post-op. When the chest surgeon got in, using a scope, apparently I had a massive pneumonia on the right. This hadn't shown up on X-ray because the telltale sign of pneumonia is the infiltration of white blood cells into lung tissue. Since my white counts were in the basement, there weren't any to show up on X-ray. He cleaned out lots of debris and scarring from the sclerosing procedure I had in Nashville during my October hospitalization. He also didn't introduce any talc, fearing to cause more infection and saying that the inflammation of the lungs was enough to cause the desired adherence with the pleural lining of the chest anyway (which it was). I also had fluid on the left lung for the first time, so I had chest tubes on both sides. I was moved from the oncology floor post-op to the floor where the nursing staff is accustomed to tending to chest surgery patients. I remember almost nothing of that week. I had one crisis with a cardiac arrhythmia and family was called to the bedside once again, expecting I wouldn't pull through, but the problem finally resolved after several hours. Eventually, I was transferred back up to the oncology floor, continuing on antibiotics. Finally, on my 56th birthday and after three
weeks in the hospital, I was discharged, 13 pounds lighter, weak
and anxious, but happy to be going home.
I have been in the hospital for three weeks with pneumonia. I'm on the mend and hope to write more soon. Thanks for your good wishes. Debbi |
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