Just Keep Going

Hello again.  It's been a long past week.  I spent about six days in the hospital receiving round 5 of my chemotherapy treatment.  Each of the rounds alternate between two different regimens of drugs.  So that means I only have to do this particular regimen one more time before I'm done, in round 7.  The typical pattern I've experienced is that it takes me a couple of days to recover from a round of treatment.  So when I return home from the hospital I'll have two to three days of feeling pretty rough, and things ease gradually until I'm back to a more normal state.  In the past I've gone through this short recovery period and then had to undergo more treatment the following week.  So just when I was feeling good again I would get knocked back down by a nice dose of poison to the brain.  This round is the first time I don't have those follow up treatments.  I'm extremely happy about this.  Right now I'm at my most vulnerable.  My blood counts are low and my immune system is on the fritz.  I'm finally recovering from what was a fairly uncomfortable and challenging round of treatment physically.  And so to be allowed to continue to rest and feel better each day is a huge deal.

I've been living this reality of having cancer for about three months now, but I'm still adjusting to the idea of it.  It's just so foreign to me that I would be this sick, this far from healthy and functional.  I go to the cancer clinic for my appointments with my oncologist and I'm almost always the youngest person there.  Everyone else is old and sick and looks terrible.  I'm exaggerating a little, but it's kind of bizarre to be there.  I don't feel like I belong.  My point is, I am still wrapping my head around this, on a daily basis.  Even though I'm immersed in it and just getting pummeled by the reality of it, it just hasn't quite sunk in.  Part of me feels like it's a good thing.  After all, who wants to be comfortable with the idea of having cancer?  I don't intend to ever settle into this.  I intend to survive this treatment and move on with my life, healthy and happy as ever.  But I have to accept where I'm at.  I have to embrace the reality of it, because it takes a lot of will power and resolve to survive cancer, to rebuild your body, and to thrive afterward.  So I have to be identified with it, while keeping it at arm's length.  At least, that's how I'm thinking about it today.  I'm not sure how other people deal with this same dilemma.  I do think it would be really helpful for me to talk with others who are in my situation and find out.

I have continued to feel bolstered by the renewed resolve that I experienced before going back to the hospital last week.  Accompanying my recommitment to undergoing chemotherapy has been a commitment to surviving chemotherapy, and surviving it well.  I don't want to suffer through each day, even if I don't feel good.  I want to kick ass.  I don't want to crawl around feeling beaten down and defeated.  I want to be a rock.  I want to be solid and strong.  And more and more I'm feeling that way.  It's encouraging. And I think it's a huge component of what cancer is all about.  Maybe it's the fact that there's nothing I can point to physically in terms of a root cause for my disease.  Nothing that I've done that I can say, ok that's why I have this, that's why this has happened.  But I just feel that there is a really big psychological factor in cancer.  In having it, in beating it.  I know there are physical things that caused it to happen.  But because I don't know exactly what they are I can only really focus on what I can control.  And the biggest thing is my state of mind.  It's like the guy who was given a month to live with lung cancer and decided that he would survive.  And he did.  There's definitely something to that.

Another subtlety of this mental shift of mine has to do with not fighting against the idea that I have cancer.  I have it.  I have to deal with it.  I have to go through this experience.  And that's ok.  It is what it is anyway.  Before I was feeling strongly that I wanted to be doing more during this time.  I wanted to be working part time, I wanted to be more productive, I wanted to be doing.  Anything.  But now I've been able to accept the fact that what I'm going through is intense enough.  I don't need to be doing more.  What I'm doing is pretty darn tough.  So I'm going to put my focus on doing it well.  Surviving this so I can really get back to doing the things I love and am excited about when it's all over.  And not worrying about the fact that I can't do those things right this minute.  Sure, I'm bored at times.  And it's part of the challenge for me to be inactive.  I find fulfillment in doing things, especially physically active things.  So it's really difficult to have to sit out, so to speak, for six months.  But right now this is my job.  Making it through each day so that I can give back when this is over.  That's what motivates me, keeps me going.  I am excited thinking about it.  And it feels so much better to just take care of what's in front of me, and not to worry about what else I 'should' be doing.  This is it right now, and I'm finally feeling ok with that.  That's a weight off my shoulders for sure.

I don't know what the next several weeks will bring.  It seems like each round of treatment is getting harder for my body to deal with.  But there are other things that are getting easier.  And I only have three more to go now.  Three more weeks of sitting in a hospital bed while the second hand of the clock ticks around.  Some days it's all I can do just to let time pass by without losing my cool.  But I'm doing it.  I'm surviving.  I'm outlasting this process.  Soon it will be over and the horribleness will fade.  The sharpness of my discomfort will fade.  I will be able to think clearly, see clearly, hopefully use my voice clearly again.  One of the things that clicked for me last year when I was rock climbing all the time was that to succeed you just have to keep going.  To persevere.  I learned how to make that shift mentally when I was getting close to falling or to feeling like I wouldn't make it.  To choose to keep going.  Just keep going, I would tell myself.  So far that's worked pretty well.

Committment

With each round of chemotherapy I find myself having to recommit to the process of treatment.  This past week, for the first time since I was diagnosed, I began to feel like the cancer I had is gone.  Obviously I have no way of knowing whether that's true or not.  But intuitively I just feel like it's gone, like I don't have cancer anymore.  Even if that's true, the remaining three months of chemotherapy will give me the best chance of avoiding a relapse.  And if there's one thing I'm sure of, it's that I never want to go through this again.  So I find myself recommitting to chemotherapy.  Considering the prospect of spending another week in the hospital getting pumped full of drugs, and then dealing with the subsequent side effects.

After this past round and the challenging experience I had with a neutrapenic fever, this recommitment is a challenge.  I desperately want to be done with this process.  I desperately want my life back, my body back.  I want to play outside and spend time with my friends, and to have days during which I don't feel nauseous or exhausted.  And I know that I will have those things.  When I finish chemotherapy I will be able to return to a normal day to day existence.  The problem is that I don't want to live in the future, waiting, on hold.  I don't want to spend the next three months thinking that things will only be better when, and so forth.  I want to be happy now.  I want to feel ok now.

This illustrates the psychological battle of having cancer.  Part of it, anyway.  The other part being that there are certain things that will never be the same.  And there will always be the possibility that it will come back, or that I'll have some kind of long term complications from the chemotherapy, or something else along those lines.  I'm not as worried about those things, however.  It never helps to worry about something you have absolutely no control over.  I can only move forward and try to believe that things will be ok.  But this day to day process of waiting out my treatment is taking its toll on me.  It's a challenge to stay present and to stay positive, knowing that this will all be over at some point but having to wait for that day to come.  I'm hanging in there with it.  I'm doing my best.  I'm trying as hard as I can to take care of myself.

Yesterday I decided to stop taking pain medication, which I've been taking for the past couple of months every day.  So my body is in a bit of turmoil, but it's not as bad as I thought it would be.  It got to the point where I was wondering whether the meds were causing me more problems than they were fixing.  We'll see how it goes.  I may have to take them again.  But I think I just needed to know that I didn't need them.  The same way I needed to know that undergoing this treatment is a choice I'm making.  Not something that was just forced upon my by circumstance.

So I've recommitted to chemotherapy.  I've recommitted to the fight.  I've recommitted to giving this my all.  The same way I do every day.  Tomorrow begins round 5 of my treatment.  I've officially reached the halfway point.  Three months from now I'll be done and I'll be recovering and focusing on healing my body as best I can.  For now I will just do my best to survive and to persevere.  I will meet each challenge head on, and will face each day with as much courage and strength as I can muster.  The support of those around me helps significantly with this.  Knowing I'm not alone, and that there are others out there pulling for me makes a huge difference.  Thank you for your continued support and love.  Round 5, here we come.

Frying Pans And Fire

I just arrived home this afternoon after spending five days in the hospital.  I had checked in this past Thursday morning with a fever, knowing I would probably need a blood transfusion and would be in a neutrapenic state (have low or no white blood cells).  So far, with each of the four rounds of treatment I've undergone, I've experienced a need for a blood transfusion, due to being anemic, and I've been neutrapenic.  This means that my immune system is pretty severely compromised and that my ability to fight off infections, even small ones, is more or less non-existent.  Well this was perhaps the worst infection I've had yet in this process.  My fever was fairly high at times, just below 103 or so, and lasted for a few days.  I expected to check in, get some antibiotics and some blood, and be home in two or three days at the most.  Instead I spent five days in the hospital, sweating and feverish, and in just about the most pain I can remember. There were definitely times during my stay at which I had to intentionally remind myself that I would survive the infection and that I would be healthy again, and would eventually get to go home.  It's like that I suppose, having a fever.  It can be disorienting.  Time stretches out and gets a bit fuzzy and dreamlike.  And when I woke up Monday morning and the doctor came in to see me, shared the news that my blood work looked good and I could go home, well I can't tell you how happy I was.

I knew that this past week would be a difficult one, and it was.  I had received my sixth and final intrathecal chemotherapy dose (injected directly into my cerebral spinal fluid).  And I knew that it would hit me hard.  It definitely did.  I felt the effects of that dose almost immediately, and by that evening I was already laid out, exhausted and feeling ill.  I did not know I would get such an intense infection.  

Hard is an understatement.  The problem, for me at least, is that I had to try to figure out what to do to deal with the discomfort I was in, medication-wise.  I already take pain medication to deal with the stomach discomfort caused by chemotherapy.  This allows me to maintain a pretty reasonable level of energy and appetite and to function well enough that I'm not miserable or in bed all the time.  So when I get really sick and the level of pain I'm experiencing kicks way up like that, I'm not sure exactly what to do.  I don't want to take IV pain drugs, like morphine or dilaudid, because they don't last very long and they are really strong, which means they make me feel disoriented and just plain bad over time.  Dilaudid actually makes me throw up, like immediately, and the other ones are almost as creepy.  So I'm having this intense pain, and I'm taking narcotics already, and what the heck does one do?  Well I remembered that I had previously taken two different oral pain meds, alternating them so I could take medicine more often than if I was taking just one type.  And that's what I ended up doing while in the hospital over the weekend.  I suggested my previous concoction to the doctors and they agreed to serve it up.  It eased the pain enough that I was able to survive the worst of the infection without writhing in my bed all night, and was finally able to break through the fever to see the light of day again.

I did have a few moments while in that bed that were pretty crucial, psychologically.  Those moments I've been talking about where a bad situation is reinterpreted as just a situation, and a breakthrough is made.  It was a good experience to have a huge challenge and to shift through it and overcome.  It was a good experience to face a mountain of anxiety and to watch it dissolve into thin air as I realized that it wasn't reality, it was just my interpretation thereof.  I guess if nothing else, this whole thing is really good practice for that, again and again, over and over, week after week.

I ended up getting two separate blood transfusions during this hospital stay, two platelet transfusions, three or four different antibiotics, and definitely a whole bunch of narcotics.  It was like stepping into what you expect to be a wading pool and dropping in over your head.  I think that was why it seemed so unusually challenging.  I was certainly not expecting the Spanish Inquisition.  Needless to say, I'm converted.  Or at least my body is.  

Halfway There

I had my sixth and final intrathecal chemotherapy treatment today.  This was the last piece of the fourth round of treatment for me, which means I am now officially halfway there!
So far the lumbar puncture treatments have been the most intense in terms of side effects, so I'm extremely happy to have had the last one.  I'll need to ride out the next week or so of feeling less than hot due to the chemo and my low blood counts.  But man do I feel good to be done with those.

I'll have four more rounds of the IV chemo I've been getting every three weeks.  So four more week long stays in the hospital, and four more sessions of recovering.  And then I'm done with chemotherapy and on to the maintenance period and I can get back to "normal" life.  I'm over the hump.

I still recoil sometimes when I look in the mirror at my pale bald face.  It just doesn't look quite like me. But I'm in there (if I focus on my eyes I can see me).  I haven't gone anywhere.  I'm still fighting and I'm still Chris.  A survivor.

Wellness

I've been reading this book, Cancer: 50 Essential Things To Do, written by a guy who was diagnosed with stage VI lung cancer and given a month to live back in 1984.  The story is that he ended up surviving his diagnosis, and was inspired to learn from other cancer survivors.  What do people do, how do they approach their situation that makes the difference between life and death?  The book is great.  It's encouraging and informative.  It includes a bunch of stories about people who have overcome cancer and are thriving in their lives.  It's uplifting.  And that is really the point of the book.  To uplift.

In terms of my physical lifestyle, before I was diagnosed with cancer I lived an extremely healthy life.  I ate a ridiculously clean diet, free of sugar, wheat, dairy, and processed foods in general.  I didn't drink or do any drugs, I got adequate sleep, I didn't even go out late.  The problem was, I didn't have any fun either.  I was so fixated on being 'healthy' that I completely missed really being healthy.  What I mean by that, and what this book suggests, is that there is far more to one's health than the physical well-being of our bodies.  Or, rather, that physical health is closely related to mental and emotional health.  This is something that most of us understand instinctively.  We can relate to the idea that when we feel good about ourselves we feel better physically.  And it's something I've talked about quite a bit around this experience of having cancer.

What I've found, in enduring the physical challenges of chemotherapy treatment, is that the psychological challenges I face are actually greater than the physical ones.  I may feel like crap on a daily basis, be sick to my stomach, or completely exhausted, or even be anemic or have some kind of infection, but the main thing that determines my overall experience is my emotional state.  It's a matter of perspective.  One person may interpret an experience one way, and feel bad about it, and another person may take the same circumstances and find joy or hope or some kind of fulfillment.

I think this is something, as I've said, that most of us understand.  The problem is that it's difficult to put into practice the art of interpreting what's happening in a positive way.  The reason I'm so interested in this subject, is that through my experience in developing and fighting cancer I believe that the psychological component(s) of my health have been just as influential as the physical ones.  To put it simply, when I got cancer I had never been more physically healthy (in theory), and I had never been so emotionally unwell.  Does that mean that my emotional state 'caused' me to get cancer?  Who knows.  I don't believe there is one single factor at fault.  And I'm not sure that it matters in the end exactly what caused the cancer.  It happened, and I have it.  But what does matter is that I learn from what I'm going through, and that I use the experience to help me live my life in a more effective way.

The point of this book is to understand that surviving cancer is about creating wellness, which is about taking responsibility for one's health in all areas.  The idea that I have significant influence over my wellbeing, through the things I do, think, and feel, is empowering.  It gives me a goal to move toward, and the author provides some ideas for ways to achieve that goal.  The book has been helpful, and encouraging.  But most important it's served as a reminder that I'm not a victim, nor am I a passive bystander just along for a ride.  I may not be in control of what happens, but I am in control of how I feel about it, and how I think about it.  And that may be the most important factor in my health overall.

Today I think there is hope for me.  That thought makes me feel good about my situation and about myself.  It helps me to let go of the anxiety that I feel about my physical health.  It helps me to feel the love and support that is there all the time, from myself and from the world around me.  That's a beautiful feeling.  The world isn't out to get me, it wants me to succeed.  I'm not sure if that's literally true, but that's how it feels.  And that feels pretty darn good.