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
Tuesday, 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
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
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
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
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
Saturday, August 30, 2008
Through the Diagnostic Wringer
The presence of cancer cannot be verified except by biopsy, a microscopic look at cancerous cells taken from the suspicious tumor. Any opinions prior to that analysis are merely suppositions. To collect a sample tissue from a tumor on my liver, the procedure applied was an “UltraSound guided needle biopsy,” a minimally invasive surgical procedure, conducted in early November, 2006.
The surgeon introduced himself, and, not waiting for my response, leapt into legally required disclosures for which I had already signed an agreement printed in three point type. First item he mentioned was that the procedure he was about to perform could result in my death. He then recited a lengthy list of successively less dire possibilities until he ran out of doom and gloom.
With a considerably subdued patient and having finished his legal duty to the hospital and his practice, he brought my insides into focus on the monitor. How many of us get a chance to see our insides while they are functioning? I wasn’t going to miss this show especially since the surgeon had pointed out that I might not survive, so I declined a sedative.
Surgeon, pathologist, nurse anesthetist, and UltraSound technician, each armed with specialized equipment, squeezed around me in a closet-sized room. We watched the careful progress of the needle through my skin, into my liver and positioned to suck up a tissue sample from the tumor. The surgeon passed the first extraction over to the pathologist for approval. Thumbs down; a second pass at my liver produced a sample that satisfied him.
Next: segue to treatment.
Copyright 2008
www.lindalater.blogspot.com
Posted August 30, 2008
The surgeon introduced himself, and, not waiting for my response, leapt into legally required disclosures for which I had already signed an agreement printed in three point type. First item he mentioned was that the procedure he was about to perform could result in my death. He then recited a lengthy list of successively less dire possibilities until he ran out of doom and gloom.
With a considerably subdued patient and having finished his legal duty to the hospital and his practice, he brought my insides into focus on the monitor. How many of us get a chance to see our insides while they are functioning? I wasn’t going to miss this show especially since the surgeon had pointed out that I might not survive, so I declined a sedative.
Surgeon, pathologist, nurse anesthetist, and UltraSound technician, each armed with specialized equipment, squeezed around me in a closet-sized room. We watched the careful progress of the needle through my skin, into my liver and positioned to suck up a tissue sample from the tumor. The surgeon passed the first extraction over to the pathologist for approval. Thumbs down; a second pass at my liver produced a sample that satisfied him.
Next: segue to treatment.
Copyright 2008
www.lindalater.blogspot.com
Posted August 30, 2008
Monday, August 25, 2008
Diagnostic Whirlwind
This blog was born to keep family and friends informed of new developments in diagnosis and treatment of this cancer. Now, almost two years later we return to look at that time to better understand the flurry of events and emotions between the first whisperings of illness and November 19, 2006, the date we started the postings.
Our family doctor reviewed my complaints in early October: diarrhea, fatigue and leg pain. The series of tests he ordered would help us, he said, eliminate possibilities and zero in on a single likelihood. The ultra sound was to investigate complaints of persistent leg pain over a long period. It came up clean, no anomalies. Next, a chest CT to check the condition of my lungs. The results of this suggested a CT of the abdomen/pelvic area. Next was an extensive array of blood analyses. After a thorough review, the doctor called me into his office three weeks later on October 26, 2006 at 4:30pm. I went alone. The first words out of his mouth: “The results of these tests indicate cancer.”
That is what I appreciate so much about this doctor. He is unfailingly direct, leaving no room for misunderstanding or misinterpretation. He showed me the CT scan which revealed a 1” diameter tumor on my pancreas and numerous shadows showing more tumors piercing the smooth grain of my liver like potholes in macadam. My reaction split at once: I set aside the impact of his words in order to clearly hear the information. I gazed at the shadows on my liver, willing them to disappear, yearning for a rewind and revision of the scene, wanting to defer acceptance just a little longer.
Next: Refining the diagnosis.
Copyright 2008
www.lindalater.blogspot.com
Posted August 25, 2008
Our family doctor reviewed my complaints in early October: diarrhea, fatigue and leg pain. The series of tests he ordered would help us, he said, eliminate possibilities and zero in on a single likelihood. The ultra sound was to investigate complaints of persistent leg pain over a long period. It came up clean, no anomalies. Next, a chest CT to check the condition of my lungs. The results of this suggested a CT of the abdomen/pelvic area. Next was an extensive array of blood analyses. After a thorough review, the doctor called me into his office three weeks later on October 26, 2006 at 4:30pm. I went alone. The first words out of his mouth: “The results of these tests indicate cancer.”
That is what I appreciate so much about this doctor. He is unfailingly direct, leaving no room for misunderstanding or misinterpretation. He showed me the CT scan which revealed a 1” diameter tumor on my pancreas and numerous shadows showing more tumors piercing the smooth grain of my liver like potholes in macadam. My reaction split at once: I set aside the impact of his words in order to clearly hear the information. I gazed at the shadows on my liver, willing them to disappear, yearning for a rewind and revision of the scene, wanting to defer acceptance just a little longer.
Next: Refining the diagnosis.
Copyright 2008
www.lindalater.blogspot.com
Posted August 25, 2008
Subscribe to:
Posts (Atom)
