Kicking Cancer to the Curb: Infusion #11

My secret is out! It may or may not surprise you to find out that I write my blogs well before I post them. Although I am writing about my infusion, it actually hasn’t occurred yet. But, I do promise that, by the end of this post, it will be infusion day. You see, I don’t actually have the energy to finish a whole blog post in one day, which is why I reduced it down to 1-2 blog posts per week.

There is definitely a cumulative effect of chemotherapy that blindsided me. Some days, I feel like a complete idiot that, as a doctor, I was in the dark about the escalating fatigue repercussions of chemotherapy. Certainly I knew about the potential for neuropathy, hair loss, nausea/vomiting and the low counts. But, the level of fatigue and how it progressively worsens over treatments, caught me by surprise. Yes, I’m aware that different chemotherapeutic regimens have different effects on different people. Some regimens kill more normal cells during the process of destroying the relentlessly, reproducing cancer cells, which would obviously require a longer time to recuperate. Unfortunately, as a family doctor, we don’t often see a patient while they are undergoing chemotherapy. Cancer patients already see their oncologist so regularly that they don’t come to see us until months after completing their regimen. So, we don’t generally see them during their darkest hours. At least that is this week’s excuse for my naivete.

But, I digress (which is another common side effect of chemo and also one of my son’s vocabulary words for the week). Today marked my 11^th infusion, which means, that in 2 weeks, I will be receiving my LAST infusion for this treatment regimen. Rather than count my chickens before they’re hatched, I will try to keep focusing on the race, not the finish line.

Today’s doctor visit and chemotherapy infusion was pleasantly uneventful. We left the hospital before 1 pm and that’s after grabbing a quick bite to eat in the cafeteria. (They actually have decent food including wood fired pizzas, grilled food, salads and sandwiches made to order and a variety of entrée choices as well). Chris bought a Cuban sandwich (spicy pork and ham) while I had my usual salad (but oriental chicken). My absolute neutrophil count (ANC) was still hanging out at 300 (normal range is 2,100-7,000). The Benadryl still knocked me out (I slept for probably an hour during the infusion and 2 hours after returning home). The nausea and fatigue started escalating almost immediately with the first chemo drug but always worsens with the final drug, Dacarbazine. On the bright side, I haven’t had a mouth ulcer for a while and no cough, shortness of breath, or fevers that would inhibit me from completing my regimen. In 2 weeks, I hope to complete my last infusion of this regimen and take a break from being a patient and soon return to providing medical care for others.

To combat the fatigue, I continue to try and walk or run, feeling satisfied with a 3 mile walk when I previously would have been discouraged with less than a 6 mile run. When I look around the house and yard, it’s easy to feel frustrated that I can’t complete the things I’ve always enjoyed, like gardening. Fortunately, I am blessed with friends and family who help me out and force me outdoors.

Yesterday, we worked on trimming some branches near a trellis leading to the backyard. The branches had become so overgrown and dense that they were killing the grass below. They needed trimming to allow the sunshine to get through, so the seedlings could sprout and survive. My friend’s mother, in her mid-60s, standing 5 feet tall and weighing less than 100 pounds, reaching well above her head, lopped branches more than an inch in thickness, with incredible ease. She moved along rapidly and I found myself motivated by her strength, as I went to retrieve a stool to reach the higher branches. Upon my return, I setup the stool, but given her short stature, my height was needed to reach some of the taller branches. As we moved along, we started unveiling the clematis that was planted by an arbor. The clematis was blossoming with flowers, laying on top of the magnolia branches, rather than on the arbor. It too, yearned for the sun. We meticulously unraveled the intertwined vines from the boughs and leaves of the magnolia tree, revealing the most delicate, star-shaped, magenta flowers, which hadn’t been seen for years. We then proceeded to my neighbor’s yard to trim some unreachable limbs, and after some pruning, discovered a solitary, deep red, velvety rose coming from a bush I had planted shortly after we moved to this house, 17 years ago (see below).

As the rose was on a fairly long, straight stem and couldn’t be seen well from the other side, my friend cut the flower and presented it to me. I promptly put it in a vase as a reminder of this moment over the next week. It’s hard to explain why, but that rose is special to me. When I posted about it on Facebook, another friend (and previous coworker) expressed it most eloquently. As she explained, this pruning project is a lot like my journey. After trimming the dead branches and getting rid of the “ugly parts”, the sun shines through and sometimes, reveals treasures and beauty, such as the rose and clematis. The clematis is like the friendships and support that I’ve discovered and were revealed after removing the top limbs. Each and every one of you is like a flower on that vine, showing your beauty. The rose, as she so thoughtfully expressed, continued to persevere and bloom where it was planted, despite the thick cover. She never mentioned the significance of the thorns (but who doesn’t have thorns), but acknowledged, “I see the rose even has a stress mark on it (they get grey too!) But it made it through the weight and heaviness of what was around it. We wear our grey well!”

As I sit at my recliner staring at the rose on the table, I reminisce of the boughs and dead wood pruned throughout this journey. Pruning any misconceptions, anxieties, bad habits and disentangling the beautiful flowers that lay beyond the dead limbs, is what I needed, to let the sunshine enlighten and reveal the beauty beyond. Yes, I continued to persevere and push through the dense brush, despite its heaviness and darkness. But, the beauty couldn’t be seen, until the parts thwarting my growth, were trimmed. Reflecting on my past and anticipating my return to work next month, I know that I must setup a maintenance plan to keep out the weeds, prune the overgrowth, water and fertilize, in order for the sun to shine through and flowers to blossom and grow to their fullest potential.

When we can become skilled at selectively knowing what to prune out of our lives, what remains becomes stronger, brighter, clearer. ~ Lisa Byrne

A thorn defends the rose, harming only those who would steal the blossoms. ~ Chinese Proverb