Joy and the Art of Muddling Through

Posted on: Fri, 07/27/2018 - 11:20 By: akpratt
End of  season dahlia bouquet

So it begins. The Chinese proverb springs to mind. "The journey of a thousand miles begins with the first step." And so it is on an inauspicious Tuesday that I take the first steps on my treatment journey.

Del picked me up about 8:30am at my apartment and dropped me at the Fraser Valley Cancer Agency. I  registered and waited for the nurse to come and find me. My appointment was for 9:00am and as time drifted towards 9:30am I wondered if I had been forgotten. I was almost finished my crossword and was wondering about what to do next when I was called. Nurse Nisha was most apologetic. Turns out that my creatinine values on the previous days lab tests were different from Thursdays. So my dosages for the paclitaxel had to be recalculated and the doctor tracked  down to sign off on them.

Finally let the premedication begin. There is a prescribed regime to reduce the incidence of allergic reaction to the paclitaxel(it includes a good wack of Benadryl by IV.) Apparently the first 15 minutes are crucial.  And to my amazement I flew through with no challenges - as long as you don't consider dragging an IV pole to the bathroom every thirty minutes a challenge. I was instructed at the appropriate moment to take my anti-nausea pill for the next drug - carboplatin.  And soon it was over. I had managed to finish my Suduko but the last few clues of the crossword were still eluding me. As I texted my boys - it was anticlimactic - no allergic reaction, no nausea - yet, and in general uneventful. A very pleasant surprise indeed.

On to radiation. I had a couple of hours to kill so I sat in the sun and enjoyed the solar radiation of a beautiful BC day. The nurses weighed me again because dramatic weight changes can throw off the measurements for the radiation. Then I sat and wait for my five minutes in the linear accelerator. They had a little trouble lining me up but for the first time it went pretty smoothly. They take an X-ray to begin with ensuring that they are aiming at the right place and then fire away. It happens amazingly quickly. The only real surprise was that there were some shots taken from the back as well as side and front. I hadn't been expecting that. The main focus is the large mass in my right lung but some radiation was also given to some of the larger masses in the medial lymph nodes. Nothing wasted on the mass in my left lung - for now.

I experienced no immediate side effects. Yet. I did have a two hour nap when I got home which I suspect is  a side effect of all the IV Benadryl.  Word on the street is that Friday will be when the treatment will begin to hit me. Potentially achy joints and muscle pain. Fatigue. Another words I'll be ready for the weekend.

I have just finished Day two of radiation (28 more to go.) I did have a surprising reaction last night that nobody mentioned. About midnight I started hiccuping and felt the beginnings of a wave of nausea. I jumped out of bed and grabbed my take-it-any-time antinausea medication and popped a pill. Then reading the instructions realized that they wanted me to eat something 30 minutes after taking it. Staying awake was easy with the hiccups and after twenty minutes and a couple of chocolate covered shortbread cookies, I was back to sleep. Talking to the nurse, I did exactly the right thing.

One of the things that I was given was a series of red cards. One is a direct after-hours line for the on-call medical oncologist. Another one is a page to be handed in at Emergency should I end up there at some point to ensure that I'm treated as an immuno-compromised  patient. All taken as warnings that this is a serious disease and treatment.

I have had a few mixed emotions as the treatment begins. I read an article on Sunday about the psychological trait of resilience.( The article outlined six ways that resilience can be developed:

  • Prepare for the worst.
  • Be emotionally self-aware.
  • Write it out.
  • Build a community.
  • Know your purpose.

I wrote a paper on "Burnout and the Cross-Cultural Experience" for extra grades in my Human Resources class. One of the major findings in my research was that resilience was a key factor in coping with trauma and stressful situations. I realized that in many ways I have been prepared for this experience/journey I'm now embarking on. A mixture of curiosity, excitement, and patience are marking this phase of the journey. As Sandra mentioned in a text to me earlier today, "It will go by quickly."

When Facebook and Twitter figured out that I was dealing with cancer judging by the ads they were showing me, I decided to make a general announcement. Once again I was amazed by the heartfelt outpouring that I experienced. In the note I mentioned that I was toying with the idea of blogging about this journey. I'm still putting the final touches on it but in the next day or two should be up and running. Well walking any way. I have ambitious plans to use some of the new REACT technology I have been learning but that may take a few weeks to implement.

Some people have wondered at how well I have been taking this. My dear friend Dick put it this way, "I have seen a lot of people facing this disease and you just seem so upbeat and positive. I wondered for a while if it was denial but then I realized that you probably have a better grip than many on your situation."

I'm both awed and encouraged by this. The best way that I have so far of explaining it is this. I had initially been focused on the distinction between curative and palliative. I was looking at the numbers. Recently I read an article that looked at the question really as one of prolonging life. We are all going to die. Morbid I know. And the question for me has become what kind of life can I have in the time that is left to me? Joy in my sorrow. Enjoy the moments of gratitude. Recognize the beauty and the tragedy in the world around me. Reach out and touch others with the comfort that I have been given. There is an awesome amount of grace that I have been extended. The least that I can do is return that grace.

Psalm 23 ends with the promise:

Surely goodness and mercy shall follow me
    all the days of my life,
and I shall dwell in the house of the Lord
    my whole life long.

I serve a merciful God who blesses me with the promise of living in His house.

Prayers are always appreciated. As I make the transition to a self organized daily schedule pray that I would find profitable things to fill my days.  And as I continue treatment that I would have the opportunity to comfort those around me.