Part II
So, when we left off, we had just received word that we were going to fight this head on, aggressively and jump through that window. In order to do this, we need to get rid of those nasty 'extras' hanging out in my liver. First up, an MRI to get a good look at them and plan our attack. That is where they found the fourth, tiny little 0.8cm guy just getting big enough to notice. One might think that this would ruin the plan, but it does not. The amazingly smart doctors are going to use cryoablation to attack and kill the small tumors. This involves sticking a special needle into the tumor and then the doctor does some fancy magic thing (I was barely conscious at this point) that brings the tip of that needle down to a temperature of below freezing (I'm sure they told me how cold at one point, but I can't remember that detail just now). It freezes all of the cells within about 1.5cm in each direction of the tip of the needle, so the two small tumors are now frozen to death. Two down, three to go. I did have a couple of very small complications with this procedure, but nothing that should scare anyone away from it. The doctor gave me some Dilaudid for the pain, which as we found out lowers my blood oxygen levels below 90%. We couldn't have known that, but since it was taking a bit to get out of my system, they kept me overnight. Precautionary but warranted. The second complication is that the newest, small tumor was near the surface of my liver, so when they froze it, I essentially got a bit of bad frostbite at the surface. This blistered up like a donut around the puncture site but was not painful. A little silvadene cream to help it heal and we were all good. So see, nothing to scare anyone away from advocating for it for themselves if they need to. Next up, Kevin's wives. My radiation oncologist is kind of amazing because he is going to use stereotactic body radiation therapy (SBRT) to take out Kevin's wives. This is essentially whole dose radiation calculated with some fancy math, by smart people, to the portion of my liver that is housing the two invaders. They were right against my ribs, on the outside of my liver, so we don't even have to hurt the good liver cells that were just doing their job before these freeloaders moved in. I received this radiation in five doses. I got a little nauseous and a little tired, but really no other side effects. We won't get to see the full effects of this treatment for a while. The first time I saw them after treatment they were dark on the inside and bright on the outside. This was interpreted by the radiologist as dead on the inside, but with the outside lighting up, we didn't know if that was a residual tumor or if it was just an effect of the contrast showing the outlines of the tumor. So we were gonna get a better idea of that actual answer on the next scans.
Now it is time to move onto the dance with the drugs. These will attack Kevin directly and hopefully any other little freeloaders that might have snuck out. I'm not sure how the doctors decide who gets how many doses of chemo, but I drew the short straw and have 16 on my dance card. It was explained to me that two of major cancer institutes in the United States differ as to which chemotherapy (A/C or Taxol) they prefer to give first, so since we have just radiated my liver and part of your immune system is produced by your liver, we swap the order normally done at the hospital and I'm gonna start with twelve doses of Taxol and then do the four doses of the A/C chemo. The first round was no big deal. I think the worst part was needing to go to the bathroom in the middle of it and learning how to dance around the infusion pole while in the bathroom. I honestly don't remember a whole of lot issues with anything. My hair started falling out fast enough that it was bothering me, so I got it chopped off after the third treatment and while my stylist gave me a cute cut, I hated having super short hair that wasn't my choice. So, since there are very few things about cancer that you get to control, when you lose your hair can be one of them. So the next weekend, I went back to my stylist and had her buzz it all off. I learned how to tie a scarf and I had some super cool hats from some talented friends and from fellow survivors. I felt SO much better about it. Cancer didn't get to decide when I went bald, I did! After probably six or seven of these dances, I was over them. I started dreading going a little bit more each time because I knew it was going to make me feel worse than I already did. Also, they give you Benadryl before these, and I could not tell you how badly I just wanted to sleep after these treatments. It took me several appointments to convince my family to just take me home and let me sleep for like 2 hours. I used ice packs on my hands and feet each time, which is supposed to help prevent neuropathy in your fingers and toes, so naturally, I got neuropathy in my hips. It felt like I had run a marathon every day and I don't run unless a coach tells me to, or something scary is chasing me. Just a quick FYI, I haven't had a coach since the fall of 2004 and I make a point of avoiding situations in which anything scary can chase me. So, I waddled like an old lady that had gardened all weekend and most of those ladies could have outrun me without even breaking a sweat. So it was one foot in front of the other, sometimes one breathe to the next until you're through it. Some moments were pretty miserable but I got through them. When those twelve treatments were over, I was grateful.
This is where I'm going to take a small timeout and tell you about how amazing my palliative care doctor is. She was my quality of life doc. When there were side effects from the chemo and I didn't feel heard by the oncologist, or I just didn't like his answer, I asked my palliative care doc for help and she gave me what I needed to make that side effect not so bad. I LOVE her and would highly recommend advocating to your primary care doc, or a palliative care doc, to get what you need. Some things can help you to be less constipated (hands down my biggest side effect), have fewer loose stools, or to not be in so much pain from neuropathy.
Alright, back to that dance card I was assigned. Twelve Taxol treatments down, four A/C chemo treatments to go. A/C is no joke, which is probably why so many refer to it as the 'red devil'. Now I was lucky enough to not actually throw up, but boy did I feel like I was going to. And by now, I can't taste a darn thing. I had moments through the Taxol treatments where I could taste a strong flavor, but most things were just a mouthful of a tepid texture and gross. I don't remember a lot of other side effects with A/C, probably because the three worst weeks of my life occurred after the third treatment, and those types of events tend to overshadow other issues one may be experiencing. This is going to be tough for me to recount for you all, but it wouldn't be the whole story if I left it out. I lived alone with my best friend of over 12 years, my cat Nova. The week after my third treatment I had a busy Tuesday planned. I was going to head into work, where that afternoon I was going to take part in a small check ceremony for the lab to give its earnings from a raffle to Project Pink'd, and then I was to head home where Cleaning for a Reason was going to come to clean my house (yes, it is real, take advantage of it). It doesn't sound like much but that morning as I'm getting ready to put on my shoes and head out the door, I step in something wet. Now my cat had only missed the litter box four times in over 12 years and those were all times when he was mad at me and he pooped on the bed. So to step in a puddle of pee was alarming. I called work, told them I was going to get him checked out at the vet's office, and then I would be in. The vet got me in super quick that morning and after some blood work and an exam, we had a good idea about what was going on, but we needed to send some blood out for an official diagnosis. So, with the basic idea that my cat had feline leukemia, I took him back home and headed into work, with just enough time to head to the check ceremony. We snapped our pictures, I got to chat briefly with those that worked so hard to raise the money we were giving, and then I had to head home to let in the ladies who would be cleaning my apartment. I am not exactly comfortable with others cleaning my space while I hang out on the couch, so I cleaned right alongside them for the better part of two hours. I finally sat down the rest, had some form of tasteless food, and while chilling on the couch with Nova, I realized that I was achy all over. I assumed that I had just overdone it with all the running around and cleaning I had done. A little while later, I realized that my skin felt hot and when I took my temp it was over 102 degrees. Anything over 100.5 equals a trip into the infusion center (which I did not know was where I was supposed to go at the time), so I call the nurse number and basically tell the doc I'm on my way. I arrive at the ER (again, NOT where I was supposed to be) and they got me my own little room and worked me up to look for the cause of my increased temperature. After several hours, it was decided that they were keeping me overnight for observation and to continue to run antibiotics through my system in hopes of preventing it from getting worse. This whole time, my friend was with me and she was communicating with my parents, who are three hours away. I think it was around 2 am when I finally got to a room and my friend left for home. They were running so much fluid into my body that I had to pee every 45 minutes and on one trip to the bathroom, my IV pole made a mad dash into the shower while I was washing my hands. It wasn't far, but seeing something flash in the mirror while your head is down, knowing nothing is supposed to be moving behind you, in a closed bathroom can startle a person (good thing I had already emptied my bladder!). The nurses had shown me how to unhook one of the monitors attached to me from the pole it hung on, so that I could take myself to the bathroom. Turns out the heart monitor has a direct line to the nurses' station and when you get a little worried that the lines got crossed and you may never get them uncrossed, hooked back in, and yourself back in bed before they come running in, my heart rate slowly starts going up until the nurses actually did run into my room to see what is going on. It was embarrassing to need so much help just to go to the bathroom. Though the nurses were good sports about getting me all untangled and back into bed for 45 more minutes. Later on that morning, during rounds the doctors tell me that they cannot find a reason for my elevated temperature, so they are officially diagnosing me with febrile neutropenia and after 24 hours of being fever-free, I can go home. So not today, but tomorrow. My dad joined me Wednesday morning, though he went to my apartment to sleep that night, and the same friend who had hung out with me in the ER the night/morning before brought me dinner. It was while she was sitting there with me that the vet called to tell me that feline leukemia had been confirmed and that unless I was prepared to take my Nova to an animal oncologist, he would probably not be around very much longer.
One more side detour here, so I can blink away the tears. When I left for the hospital that night, I didn't plan on staying. Not sure why it didn't occur to me, but it didn't. I packed my pills into my chemo bag and took off. So when my dad came straight to the hospital the next day, I had no spare clothes, and he didn't want to make a trip to my place to then turn back around to drop clothes off at the hospital for me, just to then turn around and go back to my place to sleep for the night. So, a piece of free advice from me to you: every time you go to the hospital at the very least pack a pair of underwear and socks into your chemo bag. It will save you from having to go commando at the hospital.
So I entered the hospital Tuesday evening and on Thursday morning around 10:30, I was discharged. I got home and the first thing I did was call for my cat, who in return howled for me. This was the single most heartbreaking sound I have ever heard. My best friend was in pain, and once I got to him and could see that his pupils are as big as they can go, I know he can no longer see. I lost it. I bawled and just kept repeating how sorry I was to have not been there for him. I knew he wasn't going to get better but I had no idea that in just over 36 hours he would have gone downhill so fast. To say my heart was broken, would be a dramatic understatement. That puddle he accidentally left me Tuesday morning was him losing control of his bladder. His eyesight was gone before I got home, and he could barely walk. When he got up to search for me after I had pulled myself together a little bit and had stopped touching him for a moment, his hind legs were all wobbly and he collapsed a few steps away. I didn't stop touching him after that. I was constantly rubbing his ears, or stroking his chin. I could hear his purring and could see his content expression, and if this was the only comfort I could provide him, I was gonna do it for as long as I could. I had one hour with him before the vet helped to end his suffering. I won't describe that to you all, but I will tell you that it wasn't what I had expected and I never want to see an animal gasp for air again. My dad, who stuck with me through all of this, drove me and my best friend home, where I said goodbye to my buddy and allowed my dad to take him to the family pasture north of my hometown, three hours away. It was hands down the worst day of my life. I know that for some people reading this, he was just a cat, but this little guy had been the only constant thing with me since I got him. He moved with me every time I moved, he rode in the car like a champ, he was there for every bad boyfriend, for every new and exciting job, was the single best cuddle-er known to animals, and had a way of winning over every dog person he met. I was proud of him and I loved him very, very much. In the days afterward, every time I sat down to put on socks, I would miss him running up to my feet to sneak in a few head scratches from my toes. I couldn't brush my teeth without leaving just a little trickle of water running so he could drink from the faucet. Nor could I sleep without his 12 pounds of soft fur snuggled into my arms. It has been well over a year and I still cry thinking of him.
My dear friend, who has been with me for the majority of this week already at this point, took me out to dinner in an attempt to distract me, and while we were out I shared with her that it felt like I might have a hemorrhoid, but I had never had one before so I didn't really know what I was dealing with. She told me to make sure I mentioned it to the doctor at my last chemo appointment on Monday, which I did. This resulted in chemo being pushed back a week and I got to meet with a general surgeon that afternoon instead. It hurt bad enough on examination that the doctor decided the best way to deal with this was to do a surgery where she could get a better look at things while I was unconscious and couldn't feel the pain. The next day, they essentially found that I had an abscess that had formed right on the edge of my anus and they cleaned it out, put a single stitch in there so it would heal up, and gave me antibiotics to take at home. (That might have been the single most embarrassing sentence I have ever put into a public space, so I hope reading this has helped you somehow.)
So there I am at home, with a broken heart and a slightly broken anus, when I can't seem to keep my temperature down. I'm taking my antibiotics and like a dummy, I'm also taking antacids because I seem to be getting heartburn when I take the antibiotics. This probably had a lot to do with not eating, like at all, but regardless the antacids are kind of rendering the antibiotics useless. I had to go back into the hospital because of an elevated temperature, and embarrassingly bend over to the doctor can see my surgical site and make sure it isn't further infected (again, I'm gonna spare you details). I got sent home that time though as it was just at 100.5 and we had figured out that I needed to eat something and to stop taking the antacids. The following week was to be my last chemo, but when we got to the doctor's office, I still had a low-grade fever and when he wanted to push it back one more week, I simply asked him if we could not do it. I was spent and at that moment I couldn't rally enough to feel terrible all over again. Oddly enough, the doctor agreed to wait until after the scans that had already been scheduled were done the next week. He said that if it showed a good enough response, we could be done, but if it didn't we would push through that last round. I got a bag of fluids and went home. My parents were pissed. They thought I was giving up and they were not okay with that. They threatened to not bring out my niece and nephews the following weekend, and they knew that would motivate me to get my *$$ in gear and eat properly so my body could fight. They got me protein drinks and by the end of the week, I was better. I got to see the four little reasons that I was fighting so hard in the first place. While I was still hurting both physically and mentally I was finding the reason to keep fighting through the $h*! show I had become. The scans came back with not much of Kevin visible, we could see him, but he was looking pretty bad so the oncologist informed me that my last chemo was already through my system. What a relief. I had survived the three worst weeks of my life, the rest was gonna be easier simply because it had to be!
That was rough. I think I need another break. Then we can finish this story next time...