The Day Before Chemo

tom hills

Walking in the San Jose hills the day before chemo.

The day before chemo is a happy day, full of energy, full of life. But there’s also a shadow, an unknown of what the next round of toxic infusion will bring.

That’s because the effects of chemotherapy are cumulative and somewhat random. What was bad during round one, like nasal issues, is easy in round two, while something new inevitably pops up to take its place. Loren has, fortunately, been almost completely nausea-free, but there’s always the fatigue, which seems to be cumulative.

There’s also a shadow because we are nearing the end of Loren’s first six rounds of treatment. Sometime in March, or maybe April, the docs will take a look with another scan and we’ll see how things are going.

Externally, two things are positive: Loren does not have any coordination issues, though she is developing some minor neuropathy (numbness) in her fingers. And her cough is definitely gone. But we won’t know for sure how her tumors are doing until the MRI compares them with last time.

We are hoping for huge shrinkage. And doing our best to live each moment in the sun, despite the shadows in the future.

Copyright 2017. All rights reserved.
#cancer #breastcancer

This is How We Fight

chemo

Loren’s first chemotherapy session at the Stanford South Bay Cancer center.  Election day, 2016.

This is how we fight cancer. With the latest chemotherapy drugs, infused every three weeks in a surprisingly cheery infusion center.

Round one was kinda long. Loren was there all day, receiving each drug slowly, one at a time. The idea is to do it real slow the first time around, in case there are any adverse reactions.

No adverse reactions, we are happy to report. Loren did great and got herceptin, perjeta, and taxotare, as well as a supportive drug aimed at supporting her immune system.

Chemotherapy is a funny game. The goal is to attack the cancer cells directly with the targeted agents, and gently poison all of her fast-growing cells with the taxotare. That’s why the side effects include hair loss — your hair grows quickly — and digestive issues — your gut is lined with tissue that is designed to wear off and regrow quickly.

After chemotherapy, the game is to get the poisons out of your system as quickly and efficiently as possible. So Loren is drinking 2 L of water a day to help flush it all out.

Copyright 2017. All rights reserved.
#cancer #breastcancer

This is How We Fight

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Loren in the Radiator at Stanford Cancer Center South Bay. She says she gets to keep the mask when they’re all done.

We fight with radiation, at least at first.

Loren’s treatment begins with ten days of radiation, administered in ten-minute doses every weekday for two weeks.  The she gets a week or two off before beginning chemotherapy.

She is receiving whole brain radiation to shrink the tumors there.  Each day she receives 300 rads of radiation, for a total exposure of 3,000 rads over two weeks.  So far, the main side effect has been short-term memory loss, which also affects concentration.  Besides that, she’s just a little tired.

Her first round of chemo will be a cocktail of three drugs: taxotare, herceptin, and perjeta.  Taxotare is a general chemo drug, while herceptin and perjeta are Her2-specific drugs, designed to attack that specific form of cancer. Side effects from the taxotare are the usual ones you think of — hair loss, nausea, and fatigue.  Side effects from the others are much milder.

The plan is to punch Loren and her cancer as hard as we can with radiation and chemotherapy, to shrink the tumors in her brain and lungs.

Copyright 2017. All rights reserved.
#cancer #breastcancer

This is How We Fight

IMG_4235We fight it with coffee in bed — every morning — looking out the window and catching up on our messages.  And talking about cancer, if that’s what we need to do today.

I read some dopey self-help article a month or two ago about how to feel less stressed about work.  One of the suggestions was to set aside a little bit of time each day to worry about work.  Just half an hour or so, same time everyday, where you can fret about office gossip and office drama, upcoming meetings and project deadlines. The writer quoted psychologists who said setting aside some time to fret acknowledges the importance of your worry, but doesn’t let it take over your life.  It gives it a time and a place, but only a time and a place.

It’s been surprisingly effective for us.  We talk and worry (though not every morning), and then get on with our day.

I like to call it our Cancer Hour.  It’s not Happy Hour — that comes later in the day — but it gets us going in a pretty good way.

Copyright 2017. All rights reserved.
#cancer #breastcancer

My Empty Wheelchair 

At the surf memorial in Santa Cruz.

 I can be a bit of a mother hen.

So when Loren started having trouble trouble walking every now and then, I immediately went out and rented a wheelchair.

“Just to be safe,” I said.  “You can walk alongside as much as you want, but if you need to sit, then at least we have it.”

Our primary care doctor had laughed when I suggested the wheelchair on Friday.  “We’re not going to disable you just yet,” he said.  “I’m sure you’ll be fine.”

But I got the wheelchair nonetheless.  I justified it along the lines of not wanting to limit ourselves.  Loren did have trouble walking on occasion, and her left leg would give out suddenly, especially when she got out of the car.  It happened twice on Saturday, as we were running errands to pick up prescriptions and buy Loren some gription — yoga socks with rubber grips on the bottom.

I started thinking we should maybe stay closer to home, not risk Loren falling or me having to carry her all the way back to the car. I started thinking that would be wise, at least until she got her balance back.  I started thinking we should limit ourselves.

We got the wheelchair instead, and went to Santa Cruz to walk along the Cliff Dr. on Sunday.  I pushed an empty wheelchair all the way from Swift St. to the pier, then back again.  Four miles total.

Loren walked alongside the entire time. Teasing me for being such a mother hen.

Copyright 2017. All rights reserved.
#cancer #breastcancer

There’s No Good Way to Learn You Have Cancer

textsI think we rooted for lymphoma on Wednesday.

I lose track, because we rooted for so many terrible diseases that week. I know it was after we stopped rooting for a rare, life-threatening infection, something that would explain the lesions and swelling in my wife, Loren’s, lungs and brain. We rooted for that all day Tuesday, the day I cried in the shower and whispered and prayed, “Please don’t let this be the way you take her away from me. Please don’t let this be the way.”

I know it was long after two young, long-faced ER doctors walked into our lives Monday night, closed the door, and leaned against the counter.

“We got the results from your CT scan,” one of them said, taking a deep breath. “It looks like you have metastatic brain cancer. We’ll give you a moment.”

I remember now. We rooted for lymphoma on Thursday, the day before a histologist confirmed that Loren had stage four breast cancer.

*****

Loren didn’t seem quite right the week before her diagnosis. We were in Sonoma County, visiting wineries. Loren was tired and took a nap most every afternoon. She was unusually agreeable, too – going along with my suggestions without her usual debate – but she was getting over a bad cold and had just finished teaching summer quarter at Palmer College of Chiropractic.

But Loren had trouble walking. Not all the time, but every now and then, especially when getting out of the car. She stumbled after a minute or two, weak on the left side, and needed to sit down for a moment. But then she was okay.

We thought it might be a pinched nerve – or worse, maybe a minor stroke. The young ER doctors at O’Connor hospital in San Jose thought it was a stroke, too, and they tested her repeatedly.

“Raise both arms, smile, don’t let us push down on your foot,” they said.

“Can you feel this?” they asked, lightly touching both sides of her face.

“Can you feel that?” they asked, lightly touching both sides of her legs. “Hmm. It doesn’t look like a stroke, but we’re going to order a head CT just to be sure.”

****

Our primary care physician confirmed the biopsy results and handed us off to an oncologist at the Stanford Cancer Center South Bay Friday morning. He met with us in person – “This isn’t the kind of thing you do over the phone,” he said – and wished us well. “You’ll have to decide what you want to do with your time,” he added. “Maybe keep working, maybe not. You should decide what’s important to you.”

Since then, Loren and I have talked about end of life directives and our general lack of regrets. We talk about money and make financial plans. I plan for the short term and Loren plans for the long term. I tell Loren I will take care of her and her job is to get well. She tells me her job is to figure things out now, while she’s well, so she can take care of me when she’s gone.

It’s overwhelming, but the outpouring of love and support from friends and family near and far, new and old, is overwhelming, too, but in a good way, a way that almost evens the score. Our friends Mike and Sharon dropped everything and drove up from L.A. the day they heard the news. Loren’s brothers flew in from Canada and Australia, and everyone is making plans to come see us in the next couple of months. We’re scheduling the visits one at a time, not because Loren’s not up to a crowd, but because we want to savor each and every person, each and every moment we have together.

Loren says I should remarry after she’s gone. But I don’t know what I will do. It’s too soon for that kind of thinking.

I do know, however, that if you are lucky enough to have a great love in your life, it’s inevitable that one of you will die first and the other will be left behind to die alone.

I’m happy it’s most likely going to be me.

Originally published November 8, 2016, in the San Francisco Chronicle.

Copyright 2017. All rights reserved.

A Story I Don’t Want to Tell

At a winery near Hollister.

My wife, Loren, was recently diagnosed with stage four breast cancer. I do not know how long she will live, or when she might die, so this story has no foreshadowing, no fancy or reassuring literary devices. It will just happen, like life, and I hope I have the courage to tell it all the way through.

I don’t know if this story will have any value, or if it will teach us anything at all about how to live each day as it comes, perhaps with a little bit of grace. I think this story might help me feel less alone — help all of us feel less alone — as we live our lives the best we can, especially in the face of serious illness.

This is a story I don’t want to tell. This is a place I don’t want to go. But this is where cancer is sending us.

So we go.

We invite you to join us.

Copyright 2017. All rights reserved.
#cancer #breastcancer