Tea and Birthdays

Cancer—and its treatment—has a way of taking things away. Some such things are to be expected, but others come as a surprise. Two annoying if relatively unimportant surprises lately concern my tea and my birthday.

Chemotherapy tastes terrible. That is, it leaves a nasty taste in my mouth for about a week, which interferes with my ability to enjoy drinking just about anything but especially tea. Now, anyone who spends time with me knows how important my tea is. It's one of the good things in life, both soothing and fortifying. Drinking tea has always felt like self-care—until I had chemo, in which case I'd take a sip or two and then just stop because it didn't taste good anymore. Last Saturday, not long before the effect wore off, Gita had the bright idea of suggesting that I try my tea with milk, something I don't usually do. I tried it and it was indeed much better that way. So while it was too late to do me much good this time, I now know what to do about my tea if I have to have chemo again. 

When you go in for chemo, or many another stressful or painful medical procedure, they need to make sure they're giving the infusions (or surgery, or whatever) to the right person. So at multiple times during a chemo session—for each blood draw, and each new medication attached to your drip line—they ask you when your birthday is. 

"Birthday?" they ask, and then, Jab! There's a needle in your arm. "Birthday?" and then there's poison going into your veins and a bad taste already circulating in your mouth. 

It's enough to make a person seriously twitchy. I'm getting a little break from the routine now, since I'm done with chemo, but in a little over a week I'll have to get a radioactive tracer injected for my PET scan ("Birthday?") and will eventually get my next dose of immunotherapy ("Birthday?").

All this in a year when my birthday is going to mean a lot to me. Last birthday I was in too much pain to enjoy it. This year, with my mesothelioma diagnosis, reaching my birthday will be cause for significant celebration, so I want to get the most out of it. It's been a while since I did much of anything celebratory, though, so if anyone has any suggestions for what to do when the time comes in November, do let me know.

Bad-tasting tea and unhappy birthday associations are small annoyances, however. There are other challenges facing my family just now that I want to acknowledge. Gita was notified recently that the funding for her post-doctoral program is being cut off as part of the ongoing spending cuts in the US government. Meanwhile, my parents are in failing health, and my siblings are having to care for them without my help.

On a cheerier note, it's spring. It's Easter. It's a good time to be hopeful about what my chemo has accomplished and about reaching my next birthday. I've been doing some gardening in honor of the day and the season, but I get tired too quickly to make as much progress as I'd like. Gita helped me with the pictured plantings yesterday.

Happy Easter to all!

Chemo Plant #4

I've made it through the worst of the chemo after-effects, so it's time for one last chemo plant. This plant order is particularly meaningful, as it has some history behind it.

When I was a child, I used to pore over seed catalogs each spring. (I still do, though now there are more of them and I get to place my own order.) Each year my eye would be caught by the Canterbury bells (Campanula medium), whose cup-shaped blossoms struck me as perfectly and exquisitely shaped—floral platonic ideals, almost. I never did get to grow them, though. For one thing, money was in very short supply, and I knew better than to ask for things that had purely aesthetic value. For another, these plants are biennials. One would have to plan very far ahead and reserve a place for them in the garden for two years before they would bloom. With these two strikes against them, Canterbury bells remained unattainable and even came to symbolize for me small, impractical, but deeply personal longings.

I grew up eventually and earned my own money and made my own gardening decisions. A couple of times over the years I've tried to grow Canterbury bells, either from year-old roots or from seed. Success has been scant, though, mostly because it turns out that the local white-tailed deer find them quite tasty. I have gotten the occasional Canterbury bell to bloom in my garden, but they have never really lived up to my dream of them.

The culprit, just outside my front door

Then I started this chemo plant enterprise, and I decided that, even if for just once in my life, I would like a healthy, abundant stand of Canterbury bells. So this morning I ordered ten plants. This commits me to finding a way to keep the deer off them, but I have some ideas about how to do that. With my improved health, it may even be feasible. 

 

Ringing the Bell

I'm starting to emerge from this round's post-chemo weakness and malaise. It's a great relief to think that I won't have to have any more of these poisons—at least not anytime soon. 

Backing up to the actual chemo day, my blood counts were pretty good and my doctor was again very happy with me. In fact, he said that he is so confident of my progress that he will not believe any apparent bad news from my upcoming PET scan. It turns out there is something called "pseudoprogression," which is caused by the immune system attacking the tumors under the influence of the immunotherapy and causing them to swell temporarily. If there is any apparent progression of the tumors on the scan, he's pretty sure it will just be pseudoprogression and not real progression. Doing a PET scan, which shows tumor activity, rather than a CAT scan, which is more accurate for size and position, helps to clarify the situation but is not foolproof. If there is doubt, I'll get another scan six weeks later.

It was extremely heartening to have my oncologist be so positive. He even said I could Ring the Bell.

At the infusion center there is a ship's bell that hangs near the exit. Patients are encouraged to ring the bell when they meet a major milestone in their treatment. When the bell rings, everyone in the infusion center—nurses, techs, and other patients—clap for the victorious patient. 

I rang the bell. 

I rang the Bell

It was an intensely emotional moment. No more chemo: what a relief! Good response to the chemo: cause for hope! The emotions were not unmixed, however. No more chemo does not mean no more cancer. For over two months I have been living in the chemo moment, just trying to get through this treatment. Getting past it means that I am more aware of what comes next, which includes—probably—a terrible decision to make about surgery (more on that another time) as well as the shadow of this cancer hanging over me for the rest of my life.

I'll continue to keep you posted on the journey.

My chemo cheering squad

Fourth and Last Round Done!

I've made it through my last round of chemo! Both side effects and further details to follow on their respective schedules. Spoiler: my oncologist continues to be very happy with me. 

Smiling because it's over

Kill the Cancer

Tomorrow I go in for my fourth round of chemunotherapy, assuming that my blood counts are good enough. It looks like this will be my last round of the chemo part of the therapy, though I'll stay on the immuno part.

I won't need the first part much longer!

No one wants to show up for chemotherapy—it's downright brutal stuff. However, it needs to be brutal—brutal enough to do terrible things to my cancer. So to get myself in the right frame of mind, I've off and on been singing "kill the cancer" to the tune of Elmer Fudd's "kill the wabbit." At least it makes me smile.

Overall, I'm much encouraged by how much good the chemo seems to be doing me, though we'll need to wait for a PET scan to confirm that. At the same time, I'm worried that it might not have done as much good as it needs to, particularly given that I still get a pain when I breathe in deeply. Any part of the cancer that remains can form the seeds of its resurgence—which is what usually happens with mesothelioma. Admittedly, some of this anxiety is misplaced, as I will keep taking the immunotherapy. This immunotherapy drug, Keytruda, was approved for mesothelioma only very recently, and I am hopeful that if I am indeed the "good responder" that my oncologist thinks I am it will make a very big difference. So it's not actually the case that everything depends on tomorrow's treatment. But this is mesothelioma I'm up against, and anxiety is not always avoidable. 

Meanwhile, I did get my taxes done, so that's one less thing to worry about.

_____ and Taxes

They say that nothing is certain but death and taxes; but with both of these inevitabilities on my mind lately, I've been noticing an important difference between them. Death is certain, yes, in that no one makes it out of here alive. But death is equally uncertain, in that we can't know exactly when it's coming for us. Taxes, on the other hand, have a strict deadline: April 15, to be specific—at least here in the US.

So here I am, trying to finish my taxes before I go back in for chemo on Monday. I'm also trying to make progress on the index to my book. I could wish for more pleasant ways to spend my third and best week between chemo cycles! 

Meanwhile, Chemo Plant #3 has arrived, in time to cheer me up as I contemplate Chemo Round #4. In the photo I'm wearing a T-shirt celebrating the bicentennial of the Cherokee syllabary as a way of inspiring myself to finish my book proofs and index.

Chemo Plant #4, a 'Day' Avocado tree