Monday, September 29, 2008

Circling, Waiting to Land

In ten days, we leave for the next round of imaging, blood work and physical exams at MUSC in Charleston, South Carolina. I live in limbo, anticipating improvement, dreading reversal. Doubts most often plague me during these pre-trip days. Subjectively, I feel better now than I did prior to the last trip in July, almost too well. I ask myself: Do I really feel better, or is what I am feeling merely hope coloring my perceptions. For the most part, the numbers on the lab values show favorable trends to which I credit belief that a return to health is underway.

The pace of treatment has slowed to a steady repetition of the same pattern of treatment: Take a Zactima tablet once a day to treat the cancer lesions in my liver; take Warfarin (the generic version of Coumadin) to treat Deep Vein Thrombosis, a side condition often brought on by cancer.

One by one we find ways to reduce the side effects of chemotherapy and incorporate them into my treatment plan. The collective effect of these minute changes becomes the reality of sustained improvement. I see a favorable progression of hope to belief to reality taking shape, and it encourages me as I face the uncertainty preceding another round of testing.

As I wait for action, I am set on edge as by a continuous screech of fingernails on a blackboard. Distracted and unable to concentrate, I feel like Elizabeth Taylor’s portrayal of “Maggie the Cat” in Tennessee Williams’ film classic Cat on a Hot Tin Roof without the solace of playing opposite Paul Newman.

Yours from Fantasy Land.

Copyright 2008
www.lindalater.blogspot.com
Posted September 29, 2008

Friday, September 26, 2008

Crossing the Threshold: Growing Up

On D-Day (October 26, 2006) the doctor diagnosed my collection of complaints as cancer. I had crossed the threshold. Looking back, I now recognize the true significance of that event; though the truth has been slow in dawning. No thunderbolt tore the skies; no scales fell from my eyes; no sudden clarifying vision overtook me. I had to live the consequences before I could recognize them.

The passage was rather like emerging from adolescence and realizing suddenly that adulthood was upon me. I was disoriented, with few reference points. I still looked and sounded the same. But inside something had shifted; my mind had stepped slightly to one side while my body remained where it was.

The old habits of thinking, of expectations, the routine that carried me through the day had dissolved, and no amount of clutching could stanch the dribbling away of the familiar. It is rather like crossing a stream on stepping stones, losing sight midway, leaving only the mind’s eye to reconstruct the pathway to safety.

Gradually I became aware of subconsciously reframing my definition of adulthood, given a new set of circumstances. I dropped old ways that were no longer useful to me, and began to investigate ideas and practices that had long been dormant or unknown to me. For example, humor. Formerly I thought of it as a weapon, aimed by me or at me. Now I more often think of it as a hot air balloon, easing life’s burdens especially when I climb into the basket and light the burner. With each reinterpretation of life’s building blocks, I perceive others more sympathetically, and feel more human.

Have I grown up yet? No, but I like the path I’m traveling. Please join me in this journey of discovery.

Copyright 2008
www.lindalater.blogspot.com
Posted: September 26, 2008

Tuesday, September 23, 2008

Sampson Syndrome

Throughout my youth, Dad-built gymnasiums appeared in our backyards shortly after each family move: trapeze, swing, slide and horizontal bar. They kept us kids at home, occupied and growing up with healthy habits. Even the neighborhood boys admired the Chapman girls’ athleticism. Enduring physical strength was the legacy for our young growing bodies.

As a result, my muscle memory still hungers for satiation. It goads me into regular, physically challenging activities. My body doesn’t feel comfortable until it has achieved a balance between activity and rest.

For this gift, I thank my father for providing and my mother for fostering an active, healthy attitude about sports. I draw on this memory daily to help me rebuild the strength I lack right now.

From the early days of this illness, strength has been a crucial indicator of health. My gauge is the Lift Own Weight (LOW) scale. This came about because, being sailors, we plan Man Overboard Recovery routines. One of them, for able persons, is to bring the boat alongside so the individual can climb aboard using a ladder. During a rehearsal ashore, I realized that I could not Lift my Own Weight to make such a climb. My LOW number was ten, scaling zero as “perfectly able” and 10 as “totally unable.” That frightened me; a patina of anxiety overlay each sailing excursion.

Now, two years later, I happily report that I have regained enough strength to lift 40% of my body weight. I have yet to figure out which combination of body parts will allow me to hoist the remaining 60% of me aboard. Ahoy to progress!

Thank you for your support of returning health.

Copyright 2008
www.lindalater.blogspot.com

Posted: September 23, 2008

Friday, September 19, 2008

Weight

For most persons with cancer, weight is a critical issue. Every doctor’s visit starts with the routine of “checking vitals” to spot trends (up, down or stable) as early as possible and start appropriate treatment.

A year ago, I weighed in at 90 pounds after having lost 24% of my pre-illness weight of 118 pounds. That was the lowest point to date. My normally muscular legs couldn’t even be called slender. They were stringy. Twenty-eight pounds on a person of my size (just over 4 feet 11 inches) is a ton of chubbiness!

Very soon thereafter, however, I climbed back up to 95 pounds with the assistance of an ice cream diet recommended by my doctor. (Such a hardship!) After a few months of adding several ounces a day, I now hover in the vicinity of 100 pounds. My fervent desire is to stay there permanently. My only regret is having done it with the unwelcome assistance of a very scary illness.

The gremlin of thwarted goals, however, has reared its ugly head. A new medication, begun a week ago to treat side effects of the chemotherapy, has its own side effect of weight gain, and today, the first extra pound appeared. A close watch now will tell me whether or not I have slid back into the old habit of see-sawing weight. I welcome this if it signals a return to health.

Any breakthrough inspirations on managing the cold war of weight management will be bulletined out at once. Stay tuned.


Copyright 2008
www.lindalater.blogspot.com
Posted September 19, 2008

Tuesday, September 16, 2008

To Sleep, Perchance to Dream

Dreams have always been a form of entertainment for me, like watching movies in the ultimate home theater. The impact of a film, can be measured by the degree to which viewers are drawn into the story. Think “Psycho”, for example, and the shower scene immediately comes to mind. One dream frightened me so when I was a child that I shiver now when I recall it. I can still clearly see the awful terror on the face of a Pilgrim girl, having dipped a bucket of water from the common well, being chased up a hill by a loud, terrifying tribe of angry Indians brandishing tomahawks.

Before now, I have had few dreams of paralyzing fright. The usual assortment of mildly disturbing dreams have played on my mind’s marquee: the embarrassment of appearing naked in public, or the anxiety of being unable to deliver a critical message. Occasionally I have awakened myself to laughter caused by the antics of my mind’s imagination. Lately, however, I have begun to have dreams of violence in which I am threatened with bodily harm by knife-wielding assailants or lurking shadowy figures.

My personal film producer has been working double time over recent months concocting situations that carry me to the extremes of fear. One recurring theme places me on the roof of a ten story building, crouched on slate with my toes desperately gripping the tiles closest to the gutter, perspective magnifying the height and paralyzed with fear. I cry out in terror, awakening myself before the predicament becomes more critical or resolves itself. Michael gives me a gentle shake and a few comforting pats, and I return to a sound sleep.

I would rather awake laughing, so these days I more often read humorous books before sleeping rather then the absorbing mysteries I usually favor.

Sweet dreams!

Copyright 2008
www.lindalater.blogspot.com
Posted September 16, 2008

Thursday, September 11, 2008

Walking

“Walking is good for you.” All my life I have heard that ad nauseum. Repetition, however, has not deterred me from periodically slipping away from the habit. The worst part about walking is getting started again after a lapse.

If I miss a day or, worse yet, two or three days, the guilt begins to pile up, making it even more difficult to get back on track. When I finally do, the payoff is relief from guilt and an intense rush of virtue that somehow brings everything back into balance. Walking is great exercise, but for me the emotional benefits, in terms of self-regard, outweigh the physical benefits.

Time of day for walking is important; mine is the morning. Aside from waking and taking my medications, walking is the next highest priority of my daily “To Do.” The only way I can insure that it happens is to walk before anything else intrudes. All else waits.

If Michael joins me, as he often does, the walk time is spent in amiable companionship: comfortable silences interspersed with long and short term plans, items for the grocery list, menus, the calendar, and current events. It is a challenge after all these years to come up with entertaining topics to keep the conversation going.

We walk 1.4 miles total, usually in about 30 minutes. If the weather is inclement, we hop into the car and head for the YMCA treadmill machines. The environment there isn’t as scenic as our local walk but it keeps guilt at bay with an unbroken string of walking days.

Remember: “Walking is good for you!”

Copyright 2008
www.lindalater.blogspot.com
Posted September 11, 2008

Sunday, September 7, 2008

Progress in Perspective

Progress is blindingly fast when viewed in a nano-blink of a geological eye. But, lived day to day, progress seems interminably slow, especially when looking for change. Looking back from now, I am appalled to realize how sick I was in the final days of 2006 without being aware of it at the time. The illness was gaining momentum, entrenching itself more firmly while we searched for an understanding of what was happening and what to do about it. We worried about not having enough information to decide whether or not to worry!

Many factors blocked what we defined as “progress” toward therapeutic interventions. The death of my oncologist with attendant grief and memorial events, reassignment to another oncologist, seasonal delays due to holiday time off for medical professionals critical to the diagnostic process and, finally, the need to enlist a second opinion to clarify the diagnosis. There was no foot-dragging, just unavoidable delay due to immutable obstacles.

Now my status is “stable.” The changes in the most recent 6 month period marked by three measures are minimal as measured by imaging and palpation of my liver. CEA blood analyses continue to decline (good) and Calcitonin, equivocal at best, is actually fluctuating within a fairly narrow range, trending downward (also good). These are hard won positive benchmarks. I should appreciate them more. But being a creature more prone to action that reflection, it seems to me the improvements are taking an inordinately long time to show themselves. I must tone down my “hare” instincts and take to heart the lessons in patience and persistence demonstrated by Aesop’s turtle barely a geological blink ago in ancient Greece.

I’m counting on you for turtle company!

Copyright 2008
www.lindalater.blogspot.com
September 7, 2008

Thursday, September 4, 2008

Same Time Next Quarter

Our oncologist greeted us yesterday for our 3-month visit with polite handshakes and an open, receptive manner. His first words are always: “How do you feel?” The inquiry probes well beyond a polite cliché. He really wants to know. And so we launch into a recital of observations meant to track changes between appointments.

We read from our log, in which we record symptoms, side effects and medications in hopes of correlating one with another to get a tighter grip on effective treatment. So far, the observed changes don’t track with any change in medication or behavior. Symptoms waft into and out of my awareness, some with punch, and others with subtle shifts toward or away from discomfort. Nausea, for example, is the most creative and persistent of all side effects, sometimes hanging around for hours or days and other times departing as quickly as five minutes after manifesting itself.

Both oncologist and nurse diligently searched for something to counteract nausea, prescription or not, that would not interfere with other medications I take. It is so constantly with me that I am almost convinced it is “normal” at least for the course of this illness. Its presence takes the edge off my pleasure with life, living and friends and erodes a positive attitude, a vital component in fighting the challenge of this illness.


A liver and thyroid palpation complete the visit by checking the size and location of tumors shown on the most recent CT scans. When asked what the palpation indicated, the doctor shrugged like someone saying “What can I say? Nothing new to report.” This confirms the findings of the imaging, that is, conditions are stable. The MUSC head and neck oncologist found exactly the same condition and expressed his reaction with an identical gesture. How encouraging to have consensus!

Thank you for being with us.

Copyright 2008
www.lindalater.blogspot.com
Posted: September 4, 2008

Monday, September 1, 2008

Segue to Blog

November, 2006. The liver biopsy procedure was finished in less than 45 minutes. With gritted teeth we waited the promised 3-4 days; a week later we still had heard nothing. The reply, when it arrived, was ambiguous: metastatic carcinoma with neuro-endocrine features and an unknown primary, the source of the cancerous cells. Another two months would pass before enough diagnostic clues accumulated to suggest a treatment plan.

Meanwhile, we kept our own counsel and awaited more accurate information or, at the very least, an informed prognosis. Withholding news of this magnitude was agonizing. We yearned for, and needed, the support of loved ones but felt we could not saddle them with the weight of the news without also passing along information, however tenuous, that would help them understand what we were going through and faced in the future. After six weeks all we had learned was: I have cancer but we don’t know what kind or the source of the malignant cells spewing throughout my body. Imagine a general receiving the message to attack without an identified enemy or a direction in which to aim weapons!

With Thanksgiving looming and a family trip scheduled, we were obligated to notify the family. The task was daunting, and the prospect of repeating the devastating news over and over was exhausting even before beginning. Starting a blog seemed the most efficient means, staying in touch while preserving our resources for the enormous task of self-education ahead.

At this point, the narrative is taken up by the November 19, 2006 blog posting. It was quite a roller coaster ride before finding a measure of stability with the Astra-Zeneca Zactima experimental drug, started August 2007. Your support has been invaluable in sustaining our spirits, and a positive outlook does indeed make the medicine work better, just like our parents told us.

Copyright 2008
www.lindalater.blogspot.com
Posted: September 1, 2008