Saturday, May 16, 2009

CHAPTER 6: TURKEY DAY PLANS

My strength is almost gone, how can I carry on, if I can’t find you?
As the thunder rolls, I barely hear you whisper through the rain “I’m with you”
And as your mercy falls, I raise my hands and praise the God who gives and takes away…
You are who you are, no matter where I am
Every tear I cry, you hold in your hand
You never left my side, and though my heart is torn
I will praise you in this storm!
“Praise you in this Storm” by Casting Crowns

Thursday Nov. 27th, 2008: America is busy cooking turkeys, mashing potatoes, and baking pumpkin pies in preparation for Thanksgiving dinner; whereas, my family and I were preparing for my first chemotherapy session. While the rest of America was busy eating home-cooked food, I was busy enjoying my first-taste of the delicious ABVD combo. What is the ABVD combo? And where can you get some of that goodness? Well, I’m glad you asked; that is what I am here for-to tell you! ABVD stands for the 4 chemotherapy drugs most commonly used to treat Hodgkin’s Lymphoma (Adriamycin, Bleomycin, Vinblastine, and Dacarbazine)…you got them memorized? Good, because I am going to quiz you on them next time around. As for your other question of where you can get this tasty combo, well I apologize, but we Hodgkin’s folks like to keep that as our little secret-the only way to get a taste of this treat is by developing Hodgkin’s and then you can get back to me and I will gladly share the secret with you.

Anyways, I was going to receive only my first session of chemotherapy in the hospital, the rest were going to be outpatient. They prefer to do the first session inpatient to monitor the body’s reaction to it, especially Bleomycin which can cause pulmonary (lung) problems or an allergic reaction in some people. They tested a small amount of it on me first; I did not develop an allergic reaction -bummer! Now there was no escaping receiving the combo (ok fine, I did kind of want to get the treatment if it was going to cure me). Speaking of cure, this has become like my favorite word (NOT really). So, Hodgkin’s has a very high cure rate, about 75% of cases are completely cured (with no future relapse I believe). But this becomes a slightly annoying fact, especially when everyone likes to remind me of that statistic every time I question their optimism-the doctors, the medical staff, family, and friends. It is as if the stats make the whole experience easy, just because there is a chance I am going to be cured. Yes, I know 75% is a high percentage, but it is not the same as a 100%. It is not a guaranteed cure, which means the doubts, the fear, and the uncertainty that comes with any cancer diagnosis is still present. Plus, I still had to go through chemotherapy AND radiation, so the experience of cancer is similar to any other cancer whether curable, temporarily treatable, or not. Oh, and to tell someone with Hodgkin’s something along the lines of “this is the good kind of cancer” or “if someone was to have cancer, this is the one they would pick/want” is absolutely ridiculous! Cancer is bad, all of it, in all of its forms, shapes, names, etc. No one wants to have ANY kind of cancer, no matter how curable it may be. Yes, I understand there are some cancers that are more bearable than others, but please do not ever tell someone they have the “good” kind of cancer, got it? Ok, I am done lecturing now.

My first chemotherapy session is not that memorable, besides the fact that I was in the hospital on Thanksgiving Day and I did not want to be. The oncology floor nurses at MC were amazing! Most were extremely nice and sweet, thus making my 5-day hospital stay a lot less miserable. The nurse who was administering my chemotherapy talked to me throughout the whole thing so I did not even notice the passing of time. Since this was my first chemotherapy session, I was not really nervous. I know that sounds paradoxical, but the fact that I had not experienced its side-effects yet meant I could not completely fathom what they were going to be like. It did not matter how many times the words nausea/vomiting/hair loss etc. were mentioned-hearing the words is completely different from actually experiencing them. Still, I was a little worried about the side-effects that were to come, but these days they have some pretty awesome anti-emetic drugs (drugs that counter the nausea/vomiting) that help tremendously.

In medicine we study about the five stages of grief that everyone goes through (or SHOULD go through) when dealing with any difficult situation (death, illness, divorce etc.) The stages are taught to occur in the following order: denial, anger, bargaining, depression, and finally acceptance. I believe that these stages do occur and are in fact needed, but they don’t occur in that same order necessarily-at least not in the case of cancer (or perhaps any chronic illness). Because I knew about the five stages of grief, I was consciously looking for their appearance in my life post-diagnosis. I was looking for the day when I would get to the acceptance stage and everything will become perfectly fine, cancer and all. Well, it does not exactly happen that way. I think I have hit the acceptance phase multiple times already in the past six months, along with the other stages as well. I keep going through the stages over and over again. I have experienced anger, depression, and acceptance too many times already. As for bargaining I do not always notice myself doing it, but I think it happens a lot during my prayers. I think I only experienced denial in the very beginning; after the definite diagnosis, it is hard to deny the fact that I have cancer especially while going through the treatment. My mom tried to take me down that route a couple of times as she voiced her concerns, telling me that maybe I should get a second opinion or maybe there was a mistake in the medical reports. I would consider it for a moment, but then refuse to go down that path of doubt. I trusted MC, and I trusted my doctors. I was in the medical field already as a student and it was easy to spot incompetence, and MC was definitely not one such place! (As if they needed me to certify that for them; as if they did not already have the worldwide recognition they deserved anyways).

I remember the day before when my oncologist (Dr. Scotty) spoke to me about the biopsy results and the treatment plan. I had just been brought up to the room post-biopsy, and I was still pretty groggy. I was trying so hard to keep my eyes open and listen to him speak, but the whole time I was thinking to myself: “why can’t you wait until I’m fully awake to come talk to me, when I’m actually able to focus and communicate!” The next day when Dr. Scotty came to see me during his rounds, I made sure to ask him a bunch of questions most of which he had probably already addressed previously, but oh well, it was his fault for talking to me when I was half-conscious. Dr. Scotty was the kind of doctor you instantly liked; with his Scottish accent, perpetual smile and optimism it was hard not to like him. He explained to me that I was going to have a chemotherapy session once every two weeks for a total of eight sessions (4 months) followed by radiation as they determined necessary. He also seemed to save his biggest goofy smile for when he reminded me, pointing to my long hair, that I will be losing it all during chemotherapy-just seemed a tad bit inappropriate to tell me that with a smile plastered across his face (but that is another story I will get to later).

“When can I leave the hospital?” was what I wanted to know. I was told I could leave the next day-so I just had to slightly modify things in 2008 and celebrate Thanksgiving Day on a Friday…

Have no anxiety at all, but in everything, by prayer and petition,
with thanksgiving, make your requests known to God.
Then the peace of God that surpasses all understanding
will guard your hearts and minds in Christ Jesus.
Philippians 4:6-7

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