Wednesday, February 10, 2010


You are, after all, what you think.

Your emotions are the slaves to your thoughts,

and you are the slave to your emotions

~From Eat, Pray, Love by: Elizabeth Gilbert

Life is perplexing…one minute it gets so rough and has us asking for an end to it. The next minute, something good happens and you see us begging for another chance at it, for a few more days, for a few more birthday celebrations! During the hardest times of this journey, when I was so sick I could not even think; so drugged and my brain so fuzzy that I could not even recall events or conversations that have taken place-it was during those time that I wished for an end to it all no matter what that meant. I wished that if I was going to be cured that it would be soon. But, if it was not in the cards for me to recover then I wanted the misery to end (no don’t worry, I’m not suicidal, I’m just a cancer patient.) However, one piece of good news and we have a glimpse at the beauty of life. We quickly change our minds apologizing to the powers out there, asking them for forgiveness for even thinking such morbid thoughts. I believe most people having to deal with mortality on a long-term basis, due to an illness or some other cause, experience such paradoxical feelings. After hearing about the optimistic results in September, I got encouraged. I knew that I was not yet done with treatment and that there was a lot that still lay ahead, but at least now I had some hope-I could go to those treatments and face them with resilience knowing that victory was possible and not just an abstract concept.

My strength and hope was further restored in October after another batch of satisfactory results put me and the people I love on an all-time high! Dr. Scotty planned to administer a 4th round of RICE chemotherapy before having my body scanned again; however, I really wanted the scan done after the 3rd chemo round. I had no desire to wait another month before finding out whether the treatment was effective or not. My reasoning was as follows: if the RICE had stopped working and the tumors did not shrink from their previous size then there was no point in putting myself through another round of the same chemo, and it would be wise to consider changing the drug regimen. On the other hand, if-although that was a big IF and not really anticipated by either Dr. Scotty or me-the tumors were completely gone then we can argue on whether or not I needed another round of chemo at all. The only scenario that I could see myself getting round #4 of the salvage chemotherapy was if the tumors had continually shrunk since the last scan but were not completely gone; in that case, RICE would have shown to be effective and another round of it might prove to be exactly what was needed. Thus, upon my insistence and request, I was scheduled for another PET scan on the morning of October 13th, 2009.

Now let me diverge a bit from the topic to tell you a little about those pesky PET scans. They are not painful or invasive or even scary like MRIs, but they can drive a patient mad. Why, you ask? Well, because when you are a patient with a serious illness, like say cancer, and you know your whole future and well being depends on what this little scan is going to show/not show, then you really do not want to be left alone with your thoughts. Unfortunately, that is exactly what happens the day of the scan. You see, 45-60 minutes before the PET scan is performed, the patient is instructed to sit quietly with minimal movement on a recliner in a small quiet room with dimmed lights. There is of course a reason behind doing this other than the emotional torture of the patient. That reason goes back to how PET scans work. The scan looks for any metabolic activity, and having the patient rest quietly for a period of time would minimize/eliminate false positive results that can be caused by metabolic activity in active muscles. The point is to calm the muscles down so they do not light up and show activity on the scan-that includes all muscles including those around the jaw that can be activated by talking, so talking is not permitted either. A normal PET scan would not light up anywhere except for the area of the heart, because the heart is a muscle that has constant activity that should not be stopped. If, however, a person has cancer or another active condition such as an infection for example, then the affected spots in the body would light up. After the allotted rest time is over, the patient is taken to lie down on the PET machine table and the actual head-to-pelvis scan takes about 20-30 minutes. Anyhow, I found out that the “rest time” was no rest at all-mentally speaking. If I just sat there quietly and did nothing, then my brain would wander to dangerous places that I did not want to visit especially not on scan day! So I had to actively think about other things the entire time to keep my brain from going astray. I had to make up “happy thoughts” or think of completely unimportant things like how nice/rude the PET tech is or even the weather! Yes, those 45 minutes lasted forever, and I would always be so delighted when the door to that little prison would open and light would enter the room-it meant that “rest time” was up. Music would be a great distraction in this situation, but first time I had a PET scan, the tech told me IPODs were not allowed…say whaaat? It’s not like my brain is not going to be active just because I am not listening to music, in fact the music will actually calm it down more. Plus, there was music playing on the overhead speakers-bad music, but music nonetheless. Anyways, as I found out at another scan a few months later that was just a picky mean tech; IPODs did not violate PET scan rules and their use was perfectly permissible.

The morning of October 13th came, and I went through the PET scan routine described above and hours later went back home to patiently (or not-so-patiently) wait for the results. My plan was that I would wait until the end of the work day, if I did not receive a call by that time then I would call the next morning to inquire about the delay. Around 4PM the phone rings…caller ID shows (and loudly announces-since our phone has voice caller ID as well) that the call is from “MC”. I jump out of my chair and run to pick it up, before I do I whisper “oh please God make it NOT be any more bad news!”

“Hello, can I please speak with Nancy?” said the familiar voice on the other end of the line.

“This is she”

“Nancy, this is Angela (the physician assistant-PA) from MC. How are you doing?”

“Well, it depends on what you are going to tell me”

At this, her tone changes immediately to reflect a happier higher-pitched voice, and I could tell then that it was going to be good news. How good though?

Angela continued: “your PET scan from today shows no uptake, which means you have no active cancer”

Oh my God! Am I really hearing those words?! I was not expecting this at all. My hands were visibly shaking and my heart was racing.

“Seriously? It is not showing anything? It is all gone?” I stammered

“yeah the lungs and abdomen are all clear with no activity. I am glad I could deliver good news to you today Nancy.”

Click, the call ends. It sounds more like a dream than reality. I hung up the phone and my mom and sister are standing right there anxiously waiting for me to finish the call, and tell them the news.

“It’s all gone…the scan was clean” I said as tears started streaming down my face uncontrollably.

My sister kneeled down in front of the chair I was occupying hugging me and crying too. She and mom were both screaming “really? Are you serious?”

My mom had the flu the day before so she could not come near me due to my susceptibility to infection because of my low white blood counts. So she kept screaming at me from across the table saying “I want to hug you Nanous!” (one of my many nicknames) “Oh, why did I have to get the flu now?!”

The three of us were crying (tears of joy this time around), smiling, and laughing all at the same time!

“I have to call dad. What time is it there now?” I said. My dad, who was still working overseas, was 10 hours ahead in time, but he would want to hear this sort of good news immediately.

“it’s 2AM” mom said “but it does not matter, let’s call him”

I dialed dad’s number. Man! My hands were still trembling. I did not care that I was going to wake dad up in the middle of the night, and I knew he wouldn’t either. Of course, dad was happily shocked; he too was not expecting this. I mean no one was-Dr. Scotty said it was very unlikely that the tumors would be completely gone with just another round of chemotherapy. It goes to show that science’ and physicians’ knowledge extends only so far. However, because of the nature of their jobs they are sometimes forced to make predictions that they base on numbers and statistics, but in the end they are just that-predictions. Anyhow, the phone call with dad did not last long since he was still in a drowsy sleepy state. The next morning he called us again. He talked to mom and told her that he had woken up thinking it was all a dream, but then he kept thinking to himself ‘it couldn’t be, I distinctly remember talking to them.’ Yet, he still had to call us to confirm that it had all happened!

Next up on the list were my brothers. My 20 year old brother was in Atlanta in college, and he was squealing on the phone like a 13-year-old girl upon hearing of the vanishing of the filthy cancer (he is going to kill me for writing this about him haha). My other brother was at work and he just wanted to skip his shift and come home; I told him that we could celebrate at night when he got back.

Mom got on the phone next and started calling our entire extended family, and let me tell you, we are not a small family! But I cannot blame her; the news was just too good not to share with everyone. In fact, I did the same with my friends; I started texting people and quickly realized a mass email would be much more efficient. Within minutes I was flooded with texts and email replies. I even felt that some of my family and friends were more thrilled at the news than me, if that is at all possible. It is times like these when a person realizes how blessed they are to have such a strong support system. I was grateful to be the bearer of good news for a change.

One of my best friends, MA, called me a few hours later and said: “I just got out of bible study. I was especially praying for you yesterday and today, and when I saw your text I was like ‘ok God, I get it! You answer prayers.’ ”

“MA, I don’t know if I want to cry, laugh, or smile”

MA replied “we can do it all! I learned a term this month in my neurology rotation that can apply to us right now, we are experiencing what is called ‘emotional incontinence’ ”

I could not think of a better way to describe how I was feeling that fall day in October…

The LORD is my light and my salvation;

Whom shall I fear?

The LORD is the defense of my life;

Whom shall I dread?

Psalm 27:1-3