Tuesday, May 19, 2009

Where’s Patch Adams When You Need Him??????????

Posted Aug 31, 2008 10:16am

Side Note - Must-see movie: Big Fish (PG-13; anyone younger than that might not be interested.)

Last Friday Dave & I spent 3 hours (most of which was in the waiting room) at Sutter Cancer Center Hematology & Oncology Dept. (yikes…) At this stage I’m under the no-nonsense direction of Dr. Delphine Ong. Right from the start, she politely made it apparent she has no need for levity or conversation content that is any less than dead-on serious. Probably a bad choice of adjective, but it certainly describes her demeanor. She is matter-of-fact and methodical, and spent over an hour with us, with a thorough exam, detailed history, research information, online demonstration, and treatment options for the standards of care for my state of health (or lack thereof).

In the cancer world, I’m considered “young and healthy,” which I understood to mean I’m under 70, not on any medication, and have no other medical conditions or health problems. The benefit of this is there are extra medications I can bypass in the chemo process because I have a relatively low risk for some of the side effects chemo can have on my immunity. She also recommended that I not have a port surgically implanted for the time being, because I have “young,” strong veins and a minimal needle phobia. More good news – that means two surgeries I can avoid. The other good news is that I can wait until after my trip, so treatment will start October 10.

My tumor/s are classified as Stage 1 because of the small size, and Grade 2/3 (with 1 being the worst) as far as risk of recurrence. Being on the edge of medium to low risk, she doesn’t want to take any chances, and will consider this Grade 2 (medium risk). That requires a more aggressive program of 6 treatments (one every three weeks), rather than four. More good news – I can schedule treatments for Fridays, which will give me time to rest over the weekend and get back to work on Monday. She said people can generally keep up about 75% of their regular work load (based on a 40 hour week). Since I only work 75% of the week to start with, I'm hoping I won't miss a beat!

My greatest concern is that herceptin is brutal on the heart. Dr. Ong explained that chemo usually involves a combination of three drugs, one of which is already damaging to heart tissue. However, they substitute a different drug for that one when herceptin is involved, so the heart is not getting a double whammy. I'm sure “whammy” was not the medical term she used, but you get the gist. I will also have a base line heart scan before I start treatment, and follow up scans every 3 months to make sure everything is holding up.

When we completed the meeting with Dr. Ong, she escorted us to the chemo room for the tour. After introductions all around, she abruptly vanished, leaving us in the capable hands of Virginia, who scheduled my “chemo class” for 9/11. The chemo room is enormous, spacious, bright and lined with comfy-looking recliners. It's sad to note there is no lack of job security in the chemo industry.

They encouraged me to bring friend/s, snacks, laptop, music or DVD players – whatever would make the four hours or so most tolerable. For the most part, everyone looked like they could have just as well been relaxing on the deck of a cruise ship, except for the presence of the IV lines and the lack of tiny umbrellas in their beverages. It was rather comforting in a surreal sort of way.

Despite my weak protest, Dave insisted that he stay with me through at least my first session, since we don’t know what to expect. I’m not trying to be overly independent; I just don’t see the necessity to have anyone hanging out for the day watching me absorb dripping drugs. I think it’s a good idea to be dropped off & picked up, amusing myself or snoozing during my stay. I assume that will change quickly if, as rumor has it, the treatments make me feel progressively crappier, crazier and in greater need of support.

I plan to bring along my iPod, portable DVD player and humorous reading to start, so if you are nearby and have any funny books I can borrow, I will certainly appreciate them. (I loved the entire Janet Evanovich series and “When You Are Engulfed in Flames” by David Sedaris.)

After those 6 treatments, there will be about 35 radiation treatments (daily except weekends). Those are just a few minutes each, not uncomfortable at the time, but they typically damage the tissue, leaving a feeling of a severe sunburn. I have my remedies ready for that, also, and I’m always open to suggestion. The radiology oncologist at Sutter Sacramento was thoughtful to call me when he received the referral last week, and ask if I would prefer to do these at a closer facility, which would cut my commute in half. You betcha. I’ll be meeting with Dr. Goldsmith in Cameron Park on Sept. 12 to talk about preparation for the radiation.

As the summer draws to a close, I spend a lot of time working in the garden, pruning, weeding, pulling up overgrowth. It’s my favorite place to be busy and reflective for hours at a time, and every task is rich with metaphor. There is bittersweet camaraderie in knowing my life will be synchronized with my garden through the seasons over the next 6 months. I’ll be crowned with color as I drop my leaves this fall, rest dormant to regenerate through the winter, and burst into full glorious bloom in the spring. I’ve witnessed my garden survive this cycle every year, and it always returns more vibrant than ever before. I can do this.

Click here to see the gorgeous scenes of Autumn.

In a gust of wind the white dew
On the autumn grass
Scatters like a broken necklace
Bunya No Asayasu