Thoughts About Cancer

I've been thinking a lot lately about cancer.

Before my dad was diagnosed with esophageal cancer a few years ago, cancer and I had only passed once in a dark hallway. A friend I used to work with had a recurrence of breast cancer when I was working with her; we later lost touch, but I hear through friends she's doing well after a scary year or so. Other than that friend, I can't recall another time cancer has come anywhere close to me. There's no history of it on either side of my family, which is one of the reasons why my dad's diagnosis was such a shock.

In some ways, I guess I was lucky that cancer hadn't been more a part of my life before my dad's diagnosis, especially as the past few years it seems that the disease is making up for lost time.

After my dad got cancer, one of our cats then was diagnosed with lymphoma. We put him through a year of chemotherapy, and he's doing splendidly well now. My father's cancer wasn't as amiable, however, and he died in December after it had spread to his lungs, lymph nodes, and spine.

Between my dad's death and the memorial gathering we held for him in early February, the elder sister of one of my college girlfriends was diagnosed with a rare form of leukemia. She began chemotherapy and has spent the majority of the last eight months in the hospital. She got a bone marrow transplant a month or so ago, and things were looking up. Then a couple of weeks ago her body started showing signs of rejecting the new marrow. Her doctors have been grappling with the graft/host issues ever since, and yesterday I heard that the doctors can do no more.

Ever since my dad died at the age of 72, whenever I hear about someone whose parent is still alive at the age of 80, 85, 90, or more, I have the immediate and selfish thought of, "That's not fair." And it's not, I suppose. Yes, at 72 he had lived a good, long life, and had gotten to watch his children grow up. But I still maintain, in the selfish way a daughter who has lost her father would maintain, that he should have had another 10 years.

What my friend is now going through, on the other hand, is unfair to the point of being criminal. Her sister is only a couple years older than we are, in her late 30s. She is married to a wonderful man who adores her to pieces, and they have a precocious little boy who's five or six years old. She will not live to see her son grow up. She will not grow old with her husband. Her son will not have his mother around for the rest of his life. And there is no way on this earth that is anything but tragic, unfair, and wrong.

There are blessings in the midst of all of this, in that my friend's family is very close - her parents and their respective partners are all good friends. The family unit is incredibly tight, and they've been leaning on one another for months now as they work their way through this. But no parent should have to face burying their child. Ever.

Last night as I sat on the sofa watching TV and thinking about my friend and her family, I looked at my cat sleeping next to me. I watched the side of his body move up and down slowly with each breath he took, and I couldn't help but wonder why he had lived and my father had died. Why was my cat spared and my friend's sister is in her final hours? I love my cat dearly, and I'm glad we chose to put him through the year of chemo and I'm glad he responded well to the treatment. But what kind of disease spares a house pet and takes two people instead?

And I think that's just it; cancer is, at heart, completely and utterly unfair. It makes its living by being unfair. It's ruthless, heartless, unforgiving, rude, cunning, and sadistic, but all of that pales in comparison to how heart-breakingly unfair it is.

All the positive thoughts I'd been thinking for my friend's sister to get better are now being transferred to the whole family, in the hopes that they can see their way through this.

---

A friend sent me this poem shortly after my dad died, and I still find great comfort in it. I've been thinking about it again lately, and will eventually send it to my friend and her family. When the time is right.

"Dirge Without Music" - Edna St. Vincent Millay

I am not resigned to the shutting away of loving hearts in the hard ground.
So it is, and so it will be, for so it has been, time out of mind:
Into the darkness they go, the wise and the lovely. Crowned
With lilies and with laurel they go; but I am not resigned.

Lovers and thinkers, into the earth with you.
Be one with the dull, the indiscriminate dust.
A fragment of what you felt, of what you knew,
A formula, a phrase remains,—but the best is lost.

The answers quick and keen, the honest look, the laughter, the love,—
They are gone. They are gone to feed the roses. Elegant and curled
Is the blossom. Fragrant is the blossom. I know. But I do not approve.
More precious was the light in your eyes than all the roses in the world.

Down, down, down into the darkness of the grave
Gently they go, the beautiful, the tender, the kind;
Quietly they go, the intelligent, the witty, the brave.
I know. But I do not approve. And I am not resigned.

Bad Blogger pt. 437

Oh, so many things going on, and never enough time to write about them... Here's a quick snapshot:

• Bub had his last chemo appointment last month, and got a clean bill of health from the oncologist last week, but ever since that visit (although he didn't get any chemo or even have blood taken) he's been mostly uninterested in food. I'm seriously stressing out about it - there are few things worse than when a pet won't eat, because, of course, he can't tell us what's wrong. We've got him on an appetite stimulant now, and we're trying every kind of food we can think of, but we're still in a wait & see mode. We may have to bite the bullet and pay for an x-ray or ultrasound to see if there's a tumor in there somewhere that the vet can't feel (maybe behind his ribcage) that's making him feel poorly. It sucks, but we're keeping our fingers crossed that it's just a temporary thing and he'll start eating again soon. And that the cancer hasn't come back.
• We're making progress on the things we need to get our Italian visas. One item was that our newly-minted birth certificates had to get what's called an "apostille" from the state in which they were issued. Which meant sending them back to the East Coast states from which they'd just arrived (to another department, but still). They both arrived back here at our house today, so we've checked another thing off the to-do list. Our marriage certificate didn't need an apostille, because we got married in Scotland and that meant it was already "good in the European Union." We certainly didn't plan that when we got married, but that's a bonus. Next step is to get the birth certificates and marriage certificate translated into Italian, and then we have to figure out if we need to actually go down to San Francisco to visit the consulate in person, or if we can do it by mail. We've received mixed responses on that question, but ultimately we'll do what the guy in the consulate tells us we need to do.
• I've become all-consumed by the Euro soccer tournament, especially as it concerns the Italian national team - the Azzurri. I get completely worked up & stressed before & during every Italy game, I scream at the TV when they do something stupid, and I swear like a truck driver. I actually made my throat sore during one close game. It's highly amusing to Chris and my co-workers (I've watched one Italy game at the office, and hope to not have to repeat that for fear of more ridicule). Italy plays Spain on Sunday, and if they lose their tournament is over. I'll no doubt start stressing out on Saturday. Hell, who am I kidding? I'm already stressing out about it. I never thought I'd be this into a sporting event. The bummer is that I realized (thanks to Chris) that I have a haircut scheduled for Sunday right in the middle of the Italy match - a haircut that was scheduled months ago, when I had no idea about the outcome of this tournament. So we've got to record the thing and watch it later when I'm done, and in the meantime we've got to ignore the internet, the phone, and all incoming text messages on the off-chance some so-called "friend" tries to talk to me about the game before I've seen it.

Okay, I think that's it for now. Hope you're all well...

One Month Ago Today

My father died one month ago today. His death wasn't unexpected, as you may remember he'd been battling cancer for some time, but the speed with which the cancer spread in the last months of his life was much faster than most of us thought it would be. When he was given a terminal diagnosis back in early October, the doctors then said he'd have between six and eight months. He died roughly two and a half months after they told him that.

It's been, needless to say, a tough month. The holidays came and went, and they sucked. I've been mostly reclusive since Dad died, because social situations aren't easy. I feel like I'm either put in the position of having to explain everything over and over again, or pretend like I'm fine and nothing happened. And I'm not able to do either one. So, I've just been avoiding people for the most part. I'm just starting to break out of that pattern, but I can tell it's just going to take some time.

Just before my dad died, a friend told me that the whole five stages of grief thing, the one we've all become accustomed to over the years, has recently been called into question. That while those five stages are generally common to all grief processes, going smartly from stage one into stage two into stage three, and so on, isn't usually how it goes. People move fluidly between the stages, and not always in numerical order. And they also move back and forth, so "progress" isn't always in one direction, either. In my experience with my father's illness and his dying process, I can verify that while those stages of grief look good on paper, the whole thing feels very muddy in real life.

There were tiny bits of silver lining that came with my father's death, thankfully. For one, Chris and I were scheduled to leave for the holidays on the 22nd of December, but we weren't yet in transit or on the other side of the country when we got the call that he'd gone into the hospital. We were able to cancel our travel plans, drop everything else and be in the hospital for two days. I shudder to think of the panic I might have felt if I were 3,000 miles away and unable to get back in time.

Related to that, I'm also incredibly thankful that my brothers were also able to drop everything and be there. My father died surrounded by his three children, his "favorite" son-in-law (that's what he always called Chris), and his wife. And as devastating as it is to lose a parent, I'm so proud of all of us that we were able to be there for him. My father, always the teacher, was giving us all life lessons up to and beyond the moment he died.

My brothers and I are planning a memorial gathering for Dad in early February, and as an homage to one of my father's humorous quips we're having it in a Chinese restaurant. See, he was a cultural Jew, even if he was an avowed atheist from adolescence onward, and he had a saying - "Jews can't eat pork. Unless it's in Chinese food." He loved his Chinese food with pork, so we're going to eat it in his honor. We'll be surrounded by people who knew and loved Dad, and who will have funny and wonderful stories to share. And, I'm finding, it's nice to have that to look forward to.

I have some other future-oriented good news which also makes "looking forward to" something easier, but I'll save that for another post. For now, I just wanted to take this moment to remember my father, who died one month ago today.

A Few Words About My Father

As you may remember, my dad was diagnosed with esophageal cancer last year. We all thought he'd successfully beaten it, until last month when the mass in his throat (which the doctors had previously thought was scar tissue from the radiation treatments) was biopsied and they found the cancer had returned. And this time, it's on the offensive. The doctors say the cancer has spread to his lungs, lymph nodes and bones, and they've said there's nothing they can do except palliative care.

I don't care who you are, or how comfortable you think you are with the concept of dying, this kind of news isn't going to be easy to take. My dad is dealing with it like a champ, having said that he rolled a Porsche in 1959 and "every day since then has been gravy." Yes, he's feeling some discomfort and sadness, and he's reacting heroically to the situation as far as I'm concerned. (And if you think I'm biased, or that I'm Daddy's Girl, you're right on both counts and I don't care.)

Dad had been neglecting his blog, but he's started it up again and is chronicling his journey. For me, it's incredibly helpful to stay updated this way because talking is difficult for him and the blog allows him to communicate with everyone without getting on the phone. Plus, he's able to say things that might be tough to say in person. Which means when I talk to him I already know all of what's going on and I don't have to ask a bunch of annoying questions. I can just tell him I love him and we can talk about whatever the hell we want to.

Go over and have a peek at my dad's blog - the first cancer-related post is here, and you can navigate through the archives (October and November 2007 are the cancer-related ones so far) under the "Archives" links on the right-hand column. And if you've got some spare kind thoughts floating around, send 'em his way. Being a staunch atheist, he's not so keen on people praying for him - so if that's the way you operate, just don't tell him that's what you're doing. :)

I've heard the debate so many times about, "Would you rather death be sudden, or would you rather know in advance when you were going to die?" And I've even engaged in the debate. But the truth, which hit me when I first heard about Dad's most recent diagnosis, is that it doesn't matter one iota which you'd prefer. Because you don't get a choice in the matter. You get handed what you get handed and you have to deal with it the best way you know how.

I may update y'all on Dad's situation now and again, but if you're interested in following what's going on with him I'd recommend that you check in with his blog.

The End of July

Chris' last day at work is tomorrow. He's looking forward to taking the month of August "off" to decompress, but he doesn't sit still well. He'll be pottering around the house checking things off his to-do list all month, I'm sure, in between long bike rides. He deserves to take a little time and relax, so I hope he gets to do that. And then, well, we'll see what happens next.

This has been such a year of transition and turmoil for us, I think we're both exhausted but at the same time not taken by surprise anymore. I think we've learned to take each new roadblock or speedbump in stride, which, even though it's been tiring and annoying at times, is a good thing to be able to do.

At any rate... A couple updates on other things:

• My dad went home from the hospital quickly, because the doctors think the hole in his esophagus will heal itself. He'll go back in this week for another check up so they can see what's going on in there, and then hopefully they'll have some solutions for him. He's in good spirits, but it's a frustrating situation.
  
• We met with Bub's oncology vet today, and she's very optimistic that he's doing really well. His loss of appetite after his last chemo was explained, too, because she'd increased his chemo dose last time. So, that was good to hear - it wasn't an anomaly, it was reasonable. And I'll continue to obsess over how much he eats, so hopefully the weight he lost last week will be back by his next appointment. He begins going in every other week now, so he should be able to recoup better.

Does humidity cause head colds?

I'm sure it doesn't, but man - after several days of extremely high humidity levels around here (something we're just not accustomed to in these parts), I came down with a head cold yesterday. It's just annoying right now - keeping me from sleeping, making me sneeze incessantly, causing my nose to run ad infinitum - but I'm OD'ing on vitamin C and Zicam in an effort to keep it from getting any worse.

In other news:

• My dad was in the hospital again over the weekend, although my understanding is that he'll be coming home today. His esophagus had been growing scar tissue ever since they got rid of the cancer that had been there, and the scar tissue was closing up his throat so he couldn't swallow. The doctors were scraping away the scar tissue and ended up poking a hole in his esophagus (they apparently warned him that was a possibility). He'll go back in a week to see if the hole is healing itself, and in the meantime he can't swallow anything - including water. He's had a feeding tube back in for a few weeks now, it'd gotten so bad. I kind of wish they'd just go in and remove the offending piece of the esophagus so he can get back to a somewhat normal life - although the recovery time from that kind of surgery is weeks, it still seems like it'd be better in the long run. But I'm not the one who'd have to be in the hospital.
  
• Bub's appetite isn't back after his last chemo appointment (last Weds.), and he's due for his next round this Thursday. I'm not comfortable taking him in right now, since I don't feel like he's rebounded from the last one. I left a message for the doctor today, so we'll see what she says. The last time he went in for this same drug, they sent him home because they said his bloodwork showed he wasn't up for it. I'm wondering if it's the same situation this time. He's shedding like crazy, so the chemo is affecting his fur - it's not falling out in big clumps, but it's definitely falling out. The saddest part is he's losing his whiskers - he's only got two on the right side of his face, I noticed yesterday.

A Few Notes

First of all, I heard that my friend Michelle is already at home, she's recovering from her brain surgery so well. She's damned amazing, that's all I can say. As I told her, "Cancer clearly doesn't know who it's fucking with here."

Second, my dear boy Bub was scheduled to get his 4th dose of chemo today, but the vet called Chris to come pick him up after just his preliminary exam - apparently his white blood cell count was lower than they'd like, so they sent him home with a week's worth of an antibiotic and we'll try again for the chemo next week. He's only put on a tiny bit of weight, which is disappointing (although any progress is a good thing) because it seemed to us like he'd gained quite a bit. I guess optimism doesn't make the best scale.

Finally, I used to do these more often - when I drank more tea - so when I brewed myself a cup of tea today, I thought I'd save the quote on the tag to post here for y'all:

"He who has begun has half done. Dare to be wise; begin!" - Horace (65-8 BC)

Kicking Cancer's Ass

So, a quick update on my friend Michelle - the positive thoughts worked. She got through the brain surgery yesterday with flying colors. She was even talking not long after coming out of the haze. We joked that not even brain surgery can shut this girl up. She'll be in the ICU for a few days, then in another part of the hospital for a few days (maybe a week, I can't remember) and then will go to her folks' house so they can look after her. Then at some point she begins a 9-10 day regime of radiation, which isn't going to be fun. And then, I guess, we'll see.

And my dear cat Bub had his 3rd chemo appointment today, and when I got home from work this afternoon I fed him his newest favoritest treat - lunch meat. He just gobbles the stuff up. I also cooked some hamburger for him, which he likes, but not as much as he likes the lunch meat. He's gotten both turkey and ham and seems to like both equally well. The other day I made cold cut sandwiches for Chris and I, and he hovered around us (meowing loudly) as we ate. He even tried to swipe my sandwich. We've created a monster, and we couldn't be happier.

If you can spare some positive thoughts...

...my friend Michelle is, at this moment, undergoing brain surgery to remove a tumor on her brain stem. It's her third bout with cancer. She's 42. I'll be thinking about her all day today, sending positive energy to the hospital in Chico, and hoping for the best. Brain surgery isn't easy, and this one is a risky proposition - but the alternative isn't acceptable to Michelle. She's one tough cookie. Cancer clearly has no idea who it's dealing with.

This Cat is a Fighter

Bub is a fighter, all right, and I mean that in a couple of senses. First, the good news and then the funny news.

The good news is that at his second chemo appointment on Wednesday, the vet apparently couldn't even feel the tumor anymore. Now, they didn't do an ultrasound, so it's probably still there a bit, but the fact that it has shrunk enough that she can't feel it after only one treatment a week ago is really exciting to us. And after the initial first couple of days post-chemo last week, Bub was nearly back to his old self, playing and eating almost like normal. We're quite pleased with that, our little guy fighting off cancer so well.

The funny news is that he's also becoming more and more of a fighter when it comes to taking his daily pill. He's on steroids just for the first month of treatment (we've got three weeks to go), and it's a decreasing amount each week. Last week it was twice-daily pillings, and after that it's only once a day - but that doesn't keep him from fighting harder and harder each time. He's never been good about taking a pill, but it now takes both Chris and I to do it and it still takes two or three tries. He's crafty about it, too - he'll chew on the lump of food (pill hidden inside) until he finds the pill and then he'll push the pill out the side of his mouth, cleaned completely of cat food. Yeesh. So far, he still loves us anyway.

After his second chemo appointment this week, he doesn't seem as logey or sleepy as he did last week but his appetite was basically non-existent yesterday (the day after chemo); I'm not panicking like I did last week, as I'm confident that he'll be eating again soon (hopefully today), but I'd love to find something he really liked - something he couldn't even refuse in his post-chemo days - that I could feed him each day-after. I haven't found it yet, but I'll keep trying. I swear, if I find that he likes liver pate, I'll feed it to him once a week...

"Wacked Out Nip Nuts"

So, the latest thing is that Chris has decided catnip is like medical marijuana. He got a little container of "the good stuff" and has been sprinkling it on the floor for the cats to eat and roll around in. The hope is that it might help stimulate Bub's appetite (or at least make him happy!), but of course all the cats are benefiting. Chris has taken to calling them all "Wacked Out Nip Nuts" when they're rolling around on that one spot on the floor, day after day. It's pretty amusing.

Bub's eating more, too, which makes me happy - in addition to his twice-daily feedings of wet food he's been eating more and more of the regular dry food that's always out, which is great. And he's even gone back to his old habit of "hunting" his sister down and tackling her. So he's obviously feeling much better. He still isn't crazy about the whole pilling process, but Chris had gotten very good at it so it's far less time that they both have to deal with it.

A Little Progress is a Good Thing

First of all, thanks to everyone who sent me nice notes and sent positive thoughts my little guy's way - it worked.

Bub ate a little tuna fish last night - maybe a tablespoon at the most, but it's more than he'd eaten in the 24 hours before that so I just about did a jig. He's also acting more and more like himself again, which is really nice to see. I talked with the vet assistant today and she gave me some more ideas of different foods to try (including chicken or turkey baby food!), so we'll see what interests him. She also said that his body would begin to deal better with the chemo after probably the 2nd round (which is next Wednesday) or maybe the 3rd, so that his recovery time would be quicker after each round after that. I'm hoping she's right.

Honestly, the biggest thing for me was that I had no idea what was coming next - I knew he felt bad, and I knew he wasn't eating, but I had no idea how long it would last or when (if) he would feel better and start eating again. Now that I've seen him bounce back a little bit, I'm much more encouraged. And that's a good thing, too.

If Knowing is Half the Battle, What's the Other Half?

Somehow I thought that knowing what it was would make it all better, or at least give me something to hold onto, but since we got the lymphoma diagnosis for Bub on Tuesday I've been a wreck. We ended up being at the vet for hours on Tuesday - they had to squeeze him in at the clinic next door to get another ultrasound and get a sample of the tumor so they'd know what to do to treat it, which was good to do, it just meant the poor guy was cooped up in his little carrier for hours in a waiting room occasionally full of barking dogs. He was terrified, and I wasn't much better off.

We made it through all that, although I was absolutely shattered by the end of Tuesday - I cried on and off all day long, almost as much out of frustration and the inability to make Bub understand what was going on than anything else. I've always had a harder time dealing with animals suffering that people suffering, just because you can't explain anything to them - they're just scared, or hurting, or whatever, and you can't tell them things are going to be okay. It really sucks.

At any rate, the diagnosis of lymphoma is what I expected it to be, and now the little guy is on chemo. He got his first IV injection at the vet's office on Tuesday, and he could be on chemo for up to a year. We'll know more after four weeks of weekly chemo appointments whether he's responding to the treatment, and then we'll know better what to do next. For this first month he's also on a cat version of the steroid Prednisone, which is supposed to help suppress his immune system (since lymphoma is a cancer of the immune system). I thought my big, easygoing boy would be easy to pill, but he's anything but. If he's as much of a fighter against the cancer as he is against the pills, the cancer doesn't stand a chance.

We got a pill in him on Tuesday night and then couldn't do it Wednesday morning. Chris found Pill Pockets online and found a store nearby that sold them, so he got some and went home at lunch to feed Bub his pill disguised as a kitty treat. He actually gulped it right down, so we were optimistic. He took his pill (encased in its treat) again last night, but this morning didn't want anything to do with it. Worse, he didn't really eat anything last night and wouldn't touch his food this morning or any of the various treats he usually loves. I'm the first to admit that I'm panicked about that - he's already so thin, he can't afford to lose any more weight. And yet it makes sense that the chemo would make him feel cruddy and like he doesn't feel like eating. He still seems hydrated, so that's good, and the vet assistant said the steroids should help him regain his appetite - so I'm going to hope he'll eat something tonight.

I'm still ready to cry at the drop of a hat. I feel so badly that he feels badly. Before he was diagnosed, but already clearly suffering from some of the effects of the cancer, he was "fine" - he was his usual active and playful self, happy as a clam. Now he's logey and has no appetite, and I can't help but think that if his four-week checkup doesn't show that he's responding well to the treatment that we've done a horrible thing to him. I don't want to think that way, but I almost can't help it. I know I'm being paranoid, I know I'm being overprotective, I know I'm worrying too much - and I don't know what else to do. The thing that's doing me in right now is the same hyper-sensitivity that caught the weight loss in the first place. It's the only way I know how to be. I want to force him to eat, but clearly can't do that. And yet every time he walks away from food I get more and more stressed and worried and anxious.

The vet says she's not worried that he didn't eat this morning, and that I'm supposed to call her back tomorrow if he's still not eating. Chris took Bub to our local vet this morning to get a demonstration in pilling, so he got his Prednisone today and Chris now knows how to get it in him reliably whether he'll eat that Pill Pocket thing or not. So at least there's that. And yet all I feel is a pit in my stomach about my poor sweet boy who now, as a result of us trying to fix him, feels like crap and has no idea why. I really hate this.