November 16, 2016

The fault in MY stars.

Post-transplant day #1073.  The fault in MY stars.

"The fault, dear Brutus, is not in our stars, but in ourselves, that we are underlings" Cassius says in Julius Ceasar.  He is explaining that if there are any obstacles to realigning Rome's leadership to something more equal, the impetus must come from within.  Food for thought. Especially in relation to cancer, where a person may wonder if at some point they had enough control to avert this.

These last six months.  It isn't that I have nothing to say, it's that I'm not sure how to say it.  How to fashion the murder of crows that passes for thoughts in my brain these days into something rather more beautiful and coordinated.  As John Greene put it, "my thoughts are stars I can't fathom into constellations"; a saying I find very apropos these days.

I have not written much about my cancer as these last seven months have passed.  I start to write, then stop, and it suddenly feels very, very meaningless. I'm a newcomer to this corner of medicine and anything I may have to say has been said a thousand times by a thousand other voices more thoughtful than mine.  And what could I say, but over and over "I'm tired, I'm tired, I'm really very tired."  Even the most patient of caregivers would get tired of that refrain.

And yet, if you want a concrete detail, that is how my cancer stands in my mind: constant weariness, regular exhaustion, severe anemia.  There are also bowel irregularities as my body takes its sweet fucking time adjusting to the new plumbing.  It can ruin my day - I'll leave it at that.

Cancer forces profound realizations upon its victims and their families, in ways similar to transplant. That the cure is sometimes worse than the disease, for instance.  Individual rounds of chemo could be planned for and dealt with and seem somewhat easy, but the long course of it ground me down, exhaustion settling into my bones in a way that felt irreversible (though right now, a month out from my last dose, I'm feeling much better!)

The immediate fatigue 5FU caused me ranged from mild to severe, but it always meant the next week would be a bad week.  April and I began to plan around these weeks and April didn't push me to get much more done than work, eat, take meds, and sleep.  The surgery hurt, the chemo wore me down, but the worst effect, I think, is what this has done to April.

April is the one who has most directly borne the reality of my cancer, outside myself.  She watched me sleep through leaden weekends, took me to the hospital, sat with me throughout.  She double-checked everything the doctors and nurses said against her medical experience and did her own research on colorectal cancer.  And if she was short with me now and then, it just shows she's human.  Her frustrations boil over and I think one of those frustrations is my refusal to panic over the cancer or its treatment.

Now that...THAT is a subject for a whole post of its own: Stoicism as a primary coping strategy.  Not doctor approved, I'm sure.

I got through it.  That's all.  I did not shine, I did nothing exceptional.  I kept my nose to the grindstone at work and limited my extracurricular activities.  I tried not to bitch and complain, even as chemo brain set in and I found myself with a spotty memory.  Very spotty.  On top of the exhaustion and bowel troubles. The memory loss bothered me more than anything, because it means that my cancer has managed (via its own treatment) to get to my brain.  When you find yourself forgetting, you wonder WHAT you forgot, and when.  You wonder how much of yourself might be slipping away, without knowing it.  Blissful...and terrifying.

Now let's face the future:  Last week I had PET and MRI scans.  And Tuesday, my oncologist sat me down and let me know that the spot the PET scan had found had been confirmed by MRI. I have liver cancer.

Once again, I head into unknown territory.  My immediate future involves getting cut open from sternum to belly button, to be able to get at that spot and cut it out.  There will be significantly longer initial recovery than with my sigmoidectomy, the doctors tell me.  (Of course, I hope to prove them wrong.)  And after that, more chemo.  This time oxalyplaten will be added to the treatment, alongside 5FU.  April is understandably upset and has expressed that she's afraid chemo will tip my kidneys into outright failure.  I talked to the liver surgical oncologist today about that issue and he noted that they've had plenty of patients in kidney failure and they will carefully set doses and timing so as to be as easy on my kidneys as possible.

And that.  It's all I know right now.  Tonight I'm reminded that the fault is NOT in our stars, but in ourselves. If I wish to conquer, then I must BE a conquerer. I must work hard at this next phase, particularly recovery, and not allow chemo to control my life so much.  Though...really.... I don't give much chance of that.