Friday, September 19, 2014

Outta dodge

I got some incredibly surprising news last night that brought me to the edge of undeserving.

Rewind to one week ago and I was marching into the breast imaging department at Vic Gen, feeling a bit cocky ahead of my ultrasound. My PET had revealed a suspicious area under my right arm and Dr. A has felt a thickening there all along.

I was cocky not because I thought it was nothing, but because I've gotten so good at self-talk that I had convinced myself, and everyone around me, that even if the ultrasound showed something and I had the area biopsied, that I was staying the course of my "watch & see" approach and would fight to keep that suspicious piece of shit so small it would never amount to anything in this life.

My nurse that day was lovely - motherly and funny and determined to make me feel comfortable in that room with a billion stories. I was immediately thrown back to 2010 when I had my first ultrasound and the tech kept going over and over the same area before calling a radiologist in to do a core biopsy and fine needle aspiration on the spot. I was all but shoved out of the room when it was over, with my shopping basket of clothes, reeling from the new experience.

When this one got going, it was relatively quick. Some back and forth, then a joke about taking an image of my implant, just to prove she felt me up in the right places. My nurse disappeared at this point to show the images to the Wizard of Radiologists, hidden in a back room somewhere, and I felt good.

As I lay on my left side, a rough towel thrown over me, the ultrasound jelly still on my skin and the nurse not back in the time I would expect her to be if it was really nothing, I started to fall apart.

I craned my neck around to study the images she had left on the screen, and sure enough, there was a long black oval, taunting me. Just when you thought you were out, McCart...

By the time the nurse came back in, I could tell she had someone with her and my tears fairly gushed out.

The fucking radiologist.

"We saw something, Mrs. McCart..." and then blah, blah, blah until I was crying quietly while she numbed my armpit, asked for a "spinal-sized needle" and proceeded to perform the very strange and fairly painful aspiration.

My nurse held tight to my hand the whole time and I held tight back. I didn't once look at the fucking radiologist. I didn't want to remember her stupid face or engage with her. She would not exist.

"We got a good sample, Mrs. McCart."

When it was over, the nurse hugged me, brought me a cup of tea and let me hang out on the bed until I calmed down. That made it all worse.

Six months of stress bit me hard in the ass all at once and my mind went right to dwelling on the asshole nature of metastatic cancer. The cells are different when they spread beyond the original site. They're more aggressive. They don't respond as easily to treatment. They'll screw your husband and steal your promotion, all with perfect hair and white teeth.

I knew that if the Taxol hadn't been able to eliminate this famous spot, then there wasn't much hope of eliminating it with anything else, and I knew I couldn't take more Taxol. There was just pure luck and me now, doing my best to keep it from growing.

"There are a lot of tears in this room," the nurse said. That was all I needed to hear to remind me I wasn't going to be like all those other bloody stories.

By the time I got home, I was zen again. I was determined to file this one away and do exactly what I've been doing, only more. I was hell-bent on not letting this become some depressing chapter in my fight. I got on with life.

Then last night around 7:30 pm, Dr. A called me at home and blew my mind.

"The biopsy was negative."

I think I made her say it a few times, and I asked a shit ton of questions about what else it could be (maybe an overactive lymph node, maybe fighting off an infection, maybe a shitty biopsy sample).

"I'd take it as very good news, Mrs. McCart."

Swoosh... Just like that, I'd won the lottery again. I get to start again. Like, really start again. And it kicks off with a trip to the home country...

Since I was knee-high to a grasshopper, I've loved travelling.

From anticipation to sorting through post-vacation photos, it's all 2-year old giddiness to me and this trip to Italy slapping us all across the face next Friday has dug itself even deeper into my psyche.

When I was rediagnosed, we had to cancel a big family vacation and I've been grappling with the fact that unlike J.Lo, my ass is no longer insurable. Cancel for any reason and I'm fucked.

And like any 2-year old who sees a cookie beyond her bowl of veggie mush, I could only think of the one thing I couldn't have for a very long time. No travel made me feel housebound, Islandbound, stuck. I hated it.

Then my work family, like any amazing family, decided to do something about that and gave me back the incredible gift of anticipation.

Over the past several months, beyond the scans and consults and chemo and endless needles, I've had this unreal joy of planning a trip. It was ridiculous, actually, to be looking ahead to a time of complete mystery to take my family far away. It's not what I'm inclined to do, but it grounded me in something completely outside of the shit of cancer and I'll never be able to tell you what that has meant to my motivation for getting the bad cells gone.

So we're making like my brilliant cancer cells and getting the fuck out of dodge.

A presto, i miei amici. Mi bere vino e mangiare formaggio in tutte le vostre onore!

Tuesday, September 9, 2014

The marriage

After the high of the PET scan results, I got another two great pieces of news that will ultimately lead me toward the next stage of my life: no radiation, no surgery.

Radiation was nixed because the PET scan results were so good and because if I radiated anyway, I could end up with a broken rib or a host of other nasty complications.

Surgery was nixed because the PET scan results were so good and because there's nothing left to resect.

I came into this whole dealio thinking I was a sure candidate for both of those steps, so to be removed from the list makes me feel like I lost the lead in a really bad play. I'm a bit miffed I wasn't selected, but the whole experience would have been a shitty one, so ultimately yay for me.

There's still the game of "what's under my armpit?" to play, so I get an ultrasound on Thursday that may or may not lead to a biopsy during the same visit. If the biopsy happens and there are cancerous cells behind door number three, the options are not cut and dry.

For once, Dr. A wants to be less aggressive.

She recommended that if it's cancer, she would prefer I take a "wait and see" approach rather than blast it with radiation or cut it out. Radiation leads me back to those nasty complications and surgery could leave me with two arms that have compromised lymph systems. It's been bad enough babying my left arm for the past four years, but an infection that nearly ended me in 2013 is a story I don't want to repeat.

I agreed with Dr. A on waiting things out, so no matter how the ultrasound on Thursday turns out, I'm moving into maintenance mode, or a marriage for life with il cancro.

Three years ago, when I came back to work after beating the c-word the first time, the question I heard the most was "did your doctor give you a clean bill of health?" At the time, I was a bit put off by the question. I was released from the care of the Agency after getting "clean margins" from my mastectomy, but there was never a conversation about the cancer being absolutely gone. I felt like a bit of a fraud, but I played the game for simplicity's sake.

"Yep, clean bill!" I would exclaim, because I'm not a social idiot or a debbie downer and most of these conversations were on the way to the bathroom or during a 60-second chat as I passed a cubicle.

Everyone wants a happy ending and beating cancer is undoubtedly inspirational. The real complexity of having it is hard to describe quickly and doesn't really fit on a poster.

Since then, a handful of friends have passed away from cancer far too soon, every one of them getting something like a clean bill of health from their doc at some point - either that exact phrase or something more medical-speak like "complete pathological response". Whatever they heard, I'm sure every one of them did the jig like I did after my PET scan, because it's fucking good news, and you thirst for that shit when you're going through treatment.

The truth is, once you get cancer, it's more like a rocky marriage than a bad boyfriend you kick out after you can't take it anymore. And that's hard to adjust to. I will have to manage this asshole for the rest of my life, like it or not. I still have more or less the same body, and whatever led those cancer cells to take over in the first place is still there. I can try to push them off as long as possible through a great diet, regular exercise and consistent meditation practice, but it will never go away completely.

This isn't sexy or inspirational. And I promise not to be depressing when you talk to me about this stuff as I roam the world again. Because I feel anything but depressed or defeated. I am over-the-moon about coming to the end of a giant hill, and there's really nothing that can push me off that high.

So I will continue to have Herceptin and Pertuzumab pumped into my veins every three weeks. I will likely go on some kind of brutal medicine to put me into early menopause and keep the estrogen at bay. I will continue to have scans at regular intervals to see if those asshole cells are still, after all the warnings, leaving their socks all over the bedroom floor again. But I'll also continue to be so badass, my cancer husband will have no choice but to be quiet and meek and so very regretful of the day he thought he could disrespect me twice.

It helps immensely having a real husband who is nothing like my cancer husband and has gone the distance with me over the past 12 years. He loves my wretched self despite everything I've put him through in the better or worse category.

"In that book which is my memory, on the first page of the chapter that is the day when I first met you, appear the words, 'Here begins a new life'." - Dante








Tuesday, September 2, 2014

Girl riding a horse

I made the trek to and fro Vancouver last week in one day for my PET scan, with the ferry on our side, a jaunt to Granville Island slipped in and a trip through old neighbourhoods to remind me once again how much I miss the city but not the bloody traffic.

They don't let you read or otherwise engage your eyes for the 45 minutes it takes for the sugar water cocktail to pump through your veins and attach to your cancer cells, and I remember my wait in April being excruciating. This time, I had five months of on and off again meditation practice in my arsenal, so I chilled with my third eye.

The scan itself is like the CT or MRI donut hole experience, but completely relaxing with the IV taken out; so much so that I drifted off for a moment and jerked awake when they were scanning my noggin. 

"You're almost free to go, Mrs. McCart, and you can drink and eat whatever you want now... vodka, gluten-free brownies, anything," the tech said. "We just have to check that your brain scan matches up with the CT you did back in the beginning."

This is when the stress I'd been holding off for weeks returned like a slap upside the head.

I had visions of the techs in the observation room pointing and gasping as they looked at my brain light up like a Christmas tree with giant, willow-tree rooted tumours.

"Holy shit, is this the same woman's brain from five months ago?! It CAN'T be! We need to be sure about this... Be cool... just tell her you have to do some administrative check so she doesn't panic. It's THE WORST when people ask you to give them hints about their results. Cancer patients are such jerks."

The next two days at home were torturous.

By Friday afternoon, I stationed myself at my dining room table, playdate central going on around me to keep my brain occupied, my landline and mobile phones on either side of me, volumes turned to max.

I finally called to leave a useless message with the Cancer Agency appointment desk to tell them I was promised results by week's end. PROMISED, you assholes!

Finally, after putting off Frances and her endless "braid my hair!" requests all day, at 5:30 pm, I resigned myself to having a fretful long weekend and left my position as watcher on the wall.

And of course... this is when the fucking phone rings.

The next five minutes I was in whirling dervish mode as I ran from my landline to my mobile to my carrier pigeon, trying to catch Dr. A as she tried to reach me. When we finally connected, I was swearing my head off and she was her usual nerdy self.

She read the report out word for word so I had to keep interjecting with "what does that mean?". The gist of it was that the scan showed no disease in any organs or my brain, no remaining disease in the original areas on my chest and collarbone and only one small "non-specific" area under my right arm, which was there before, is still categorized as "suspicious", and will be ultrasounded and likely biopsied soon.

Best. News. Ever.

"It's really quite good. I'm quite happy with the results," she said with perhaps a very small hint of a smile.

I hung up the phone, cried and made out with my boyfriend.

We've been giddy all weekend, deliberately ignoring the details of the next phase of treatment. I feel like the girl in my "Girl riding a horse" lino print I wept over and then bought from a local artist, Telma Bonet, when I was diagnosed in 2010.

The path in front of me feels open and endless.




Tuesday, August 26, 2014

Long division

My little hairs are starting to sprout again, albeit reluctantly, which means my cells are getting back to the business of dividing.

This freaks me out.

On one paw, I've been complaining about my squeaky face, my sinuses that release all over everything when I bend over, a patchy hairdo, and a noggin with stagnant capacity and the inability to shout "look out for that flying ax!" when my beloveds are in harm's way. On the other paw, cell division means an opportunity for the mean girls in there to start bullying again.

It's been safe up to this point. I've escaped without debilitating side effects. The axes hurtling our way have been minimal since the Middle Ages. Remember Madonna in her Dita days? Screw the haters, I think she looked pretty wicked with no brows, and I've gotten adolescent-level good at drawing mine in so I get pitying stares from only 93% of strangers instead of 100%. I've learned to cope.

Now it gets real, real fast.

My PET scan is tomorrow and I'm trying not to succumb to a bundle a stress, biting the heads off baby turtles and selling my children to gypsies. I'm actively trying to be an awesome mom, a decent friend, and a person who returns phone messages and emails. All the things I've sucked hard at in the past when life gets me by the balls.

I waver between feeling like I need to dissolve in a hedonistic existence of beer and nachos at 10 am, pedicures with happy endings at 1 pm and endless karaoke and cocaine at 3 pm, or submit to the life of a martyr, eating kale while I self-flagellate. If I had a therapist, she'd likely say that whatever I do, I need to do with joy. I know it. Eating chocolate cake at midnight is only half the problem. The other half is the big oily stress mess you put on yourself for eating it.

It's not all food-related, and truth is, I'm golden with what I need to put in my body. It's getting the whole mind/body/spirit package in place so I can do my job of quickly multiplying my natural killer cells and lengthening the time between the division of the mean girl cells scattered hither and thither. I'm about 75% there with that whole package dealio and trying hard not to be all "good" and "bad" about it all like a Cosmo girl.

By the end of this week I'll know whether chemo-sabe has really been my friend or if I have go more martyr than hedonist to stretch this life out as long as possible. It's okay. I can be a bitch about this stuff. I've had a ton of inspiration from the bitches in my life, Madge included.


Thursday, August 14, 2014

Mini-break

After I met Pete for the first time and fell hard for my blonde Kanye, I asked our mutual friend, M, whether she thought he would be interested in a busted dame like me.

I was already in love, but one giant indicator was telling me to run far away: he was just that very second getting out of a long-term relationship with someone who liked to kayak as much as he did. I was about as outdoorsy as Zsa Zsa Gabor, without the wealth or good manners with police officers, and I had never been in a relationship that lasted longer that a Daft Punk song.

"I think Pete needs a little time to figure out who he is," M said wisely.

She was right, but another thing I'm no good at is being patient, so I damned the torpedoes and continued to flirt with my future boyfriend. 

After a few cutesy lunches and walks around our mutual workplace in Burnaby, Pete was inspired to lend me a book of Vancouver walks with his name and number written inside the cover and then waited for me to figure out it was a silent invitation and not an indication of his fear of having his precious guidebooks ne'er returned.

More than 13 years later, I'm still mad about the boy, and want to hang out with him every day and go for long walks.

Pete took some time off this week because we haven't had any extended opportunities since my re-diagnosis in February to just be, sans kids. No cancer shizzle. No schmoop. No talk of what kind of stripper he'll marry if I can't crush this thing as expected. Not that we deteriorate into that stuff on the regular, but sometimes, between the kids and his work and the general running of our lives, we have to cram in a bit of everything in the couple of hours we steal for each other at night.

With entire days to fill with just hanging out, I forgot about il cancro. Like, almost completely at times. 

It generally never goes away entirely, which I don't mean to make sound dire, but when you're trying to be badass, you have to be diligent, which means staying well is always top of mind. I don't wake up crying into my Holly Hobbie pillowcase or go to bed depressed, but on most days, cancer is an agenda item that I'm ticking off over and over again, and it gets a bit much.

The respite with Pete has been glorious, especially since I've been feeling completely fantastic for the first time in months. We lunched, shopped, walked, talked, cooked, cleaned, watched ridiculous Italian travel shows, and just generally enjoyed being boyfriend and girlfriend.

I also fell in love again for the 20,000th time, in a slightly different way that can only come with the shit we've been through together. 

But more than anything else, I lived like a person without this blasted disease. Thanks for the mini-break, Mr. P.


Monday, August 11, 2014

Signs

Frances has been up to her old tricks lately, waking up in the middle of the night to tell me she's scared, or has to pee, or remembered that she forgot to pick up a quart of milk, a stick of butter and a loaf of bread.

I try to be as polite as possible during our 3 am meet-ups, peering over her upper bunk with half-opened eyes, shivering from her stand-up fan and just generally drunk with drowsiness and trying to get the whole transaction over with before my body realizes it's upright.

As a result of these nocturnal interruptions, evenings have been sleepier and mornings tougher to take.

Last Tuesday night around 9:30, I was ready to catapult the kids into bed and fall asleep to a good foreign home-buying show when Stella passed me a note that said:

I feel adventurous tonight and want to go for a drive in the dark before bed. Pleeeease?!

I couldn't resist.

We all hopped in the car - the girls and I in jammies and Pete in more civilized shorts. It was getting cold so I pulled on my giant hoodie with "Bad ass" on the front, put on my purple librarian glasses, washed off the eyebrows and let my patchy brush cut fly free through the open window.

We no sooner turned the corner when I saw our next door neighbours' chihuahua being walked by a stranger. I peered into the woman's face and realized as we were passing that it was the Loch Ness monster of our neighbourhood: my oncologist. She looked at me, I looked at her and we stared at each other like we'd never met.

Even though Dr. A lives just up the road, I've seen her only twice before - once when she was driving down our street in her old Honda and once when she was dropping off keys next door so my neighbour's mother could house sit for her while Dr. A went to Palm Springs.

Each time, seeing her was like seeing a teacher outside of school: surreal and awkward.

Shortly after this, we drove up to UVic and promptly got rear-ended while we waited to get onto Ring Road. Pete and the new driver exchanged heated words while the the dude refused to admit he hit us, so I did what I do best and stepped in.

I emerged from the passenger side, in full jammie'd, badass, glasses, patchy-haired glory and said, "Are you REALLY denying you hit us? I felt it, my kids felt it, my husband felt it..."

The driver looked me up and down for a second and said quickly, "I'm sorry... I'm so sorry."

Then I realized I looked like the perfect cancer patient, deserving of your sympathy and pithy inspirational quotes, not the badass I thought I was. Ugh.

The next morning I was beat and decided to sleep in an extra 30 minutes. By the time I got gussied up to go on my walk, a whole different, more intense breed of people was out on the streets instead of my usual sleepy compadres. As I pulled Lucy close to me, balancing a full bag of dog shit and making room for a couple of focused Oak Bay runners with their black lab, I looked at the man's face to say good morning and saw it was my plastic surgeon, Dr. T.

I get it, universe.

With the runway leading to my PET scan now littered with rose petals and set to the latest Euro-pop and just the right shade of orange lipstick, the sight of two of my major medical team players plus my fear realized that I look more patient than model badass these days are all signs that I can't let up on the road to breaking up with my cancer boyfriend forever. I need to work, bitches.

I've had a few moments lately, as my hormones come back into circulation, when I've thought, "can I just have a day when all this shit is not so bloody top of mind?!", but the woman who thinks those whiny thoughts is a damn baby.

As the incomparable Kate Moss said, nothing tastes as good as skinny feels... or something, something, cancer sucks, something, something, don't lose focus.




Tuesday, July 29, 2014

Numb

I got a curveball yesterday when I met with Dr. A.

I had aced my side effects test with the nurse during my pre-cycle 6 consult but just after she told me she wanted to clone my blood (except the cancer part, peut-ĂȘtre), I told her my neuropathy was progressing.

Neuropathy is nerve damage in your extremities from things like diabetes or chemo, and over the past month or so, I've been noticing tingling in my toes and fingers... not enough to keep me from jammin' on the 6-string with my garage band, but enough to notice when I tie my runners too tight or wash dishes in hot water. 

The way the cancer docs see it, a little nerve damage is okay, but if it gets to the point where you can't do up the pearl buttons on your cardigan, the chemo drug causing the neuropathy must be shot down from the Empire State building.

In my case, it's the Coke Classic of chemo drugs - Taxol - that's doing the damage. It's also responsible for the other typical side effects, including my teenage skin, eyebrow removal, loss of taste and digestive woes. It's the drug that takes the longest to infuse, the one I need to pair up with a bump of Benadryl and a steroid, and the one I actually feel going into my jugular during some sessions, filling me up with a sick, poisonous warmth.

When Dr. A came in the room after the nurse had left, she said she was concerned about the neuropathy.

"We've been very aggressive with your unusual weekly treatments... we took a big chance with you and you've handled it all very well, but this is a judgement call now. There's no real evidence that 8 cycles is more effective than 6, so I recommend we stop the Taxol now."

"Um... I haven't started the sixth yet..."

"Oh... let me look back at things here." Flip, flip, flip goes my giant binder of all things cancer.

At this point I'm thinking Dr. A needs to get to her French chateau, stat. Or at least get a proper assistant to brief her before every appointment. And when I see I weakness, even outside my area of expertise, I get all control-y and assert myself more than usual.

"I feel quite comfortable going ahead with the Taxol to complete cycle 6," I said in all my infinite cancer-trained wisdom. "The neuropathy isn't that bad and I'd like to see this through."

Dr. A got that faraway, focused look on her face, smiled a bit and nodded at absolutely nothing, like she was listening to my 6-year old yammer on about how some dogs are brown, but others aren't. We sat in silence like that for an awkward 20 seconds. 

"I recommend we stop the Taxol now," she said.

Apparently, the nerve damage can continue past the last session, and she didn't want me to turn into a 42-year old with completely numb hands and feet, so the risks outweighed the benefits in her mind. I could have pushed, but I had nothing to offer up and this is Dr. A's only wheelhouse. She knows chemo like no other doc. I couldn't take that away from the little lamb. So I relented.

This means that beginning today, my chemo consists of two drugs, not three. It also means chemo moves from weekly to every three weeks. No nasty steroid and Benadryl side effects, perhaps a growing of caterpillars over my eye holes and an official move to phase two of my treatment, a whole three weeks early.

It seems fitting to insert a gigantic "YAY" here, but like everything in cancer land, a girl needs to take a moment to process and get out of the numb state of a curveball first. 

Chemo is like a safety blanket - albeit one that stinks like shit and slaps you across the face when you're not looking - but a safety blanket nonetheless. Taxol, which comes from the bark of a yew tree, is one of the only proven drugs used to treat metastatic breast cancer that's been around for decades. So it's a jerk, but it still mops your floors. And now our relationship is over for good. 

I'm still in for several more months of chemo, but dependent on how today goes, the side effects may be minimal. And if the PET scan in August shows good news, I will move on to phase three, where the chemo-lite continues but I move onto more dignified conversations about radiation and surgery.

Fuck it. Let's give this unexpected news a big "YAY" for now. I'll move on from the relationship and figure out a way to reverse the neuropathy, even though Dr. A said, with a touch of medical smugness, that nothing helps and only medication can address any pain. 

When my garage band goes big, the good doc will get front-row seats, so she can see my fingers happily bleeding and gets the spit flying from my microphone as I swing it all Joey Ramone stylez. 




Wednesday, July 23, 2014

In praise of 42

Esquire says this is the year of the 42-year old woman. Praise be. If this undisputed fact can counteract the horribleness that people (like me) born in the year of the rat are going through in 2014, even better.

The big problem with Esquire’s claim, other than the obvious sexism and general bullshit of the mag, is that their 42-year women look like Sofia Vergara, Cameron Diaz, Jennifer Garner and Carla Gugino. All symmetrical babes, to be sure, but in the same bodacious, traditionally feminine kinda way. Boring.

Listen, I love curves. I love long hair. I love appropriately drooped (or not) breasts. But madre de dios, I’d love to see a wider range of woman encouraged to show up in wet dreams.

I turned 42 last Friday and have skin like a teenage boy, a sparse buzz cut that releases hair on the regular, like a Charlie Brown Christmas tree, no eyebrows, one tit, a boatload of scars and a body more like an H than an 8. And despite the eye-opening days of early Women’s Studies classes, trading my thigh-high socks for Fakenstocks to really deconstruct all that gender shizz while sitting beside the white guy in the dreadlocks with the soul-searching demeanour I wanted to smack off his face, I’m still working on figuring out the femininity question.

The fact that I’m even thinking about something relatively nuanced like femininity and not maudlin garbage like death by 43 is score one for my state of mind lately. Between the chemo side effects, I’ve been feeling great, especially upstairs, but it's been a conscious choice after a period of self-inflicted hibernation.

I’ve been waking up at 6 am to walk (even this morning, the day after the end of chemo round 5), I’m off white flour and all non-fruit forms of the crack known as sugar (that's a whole other post) and am just generally feeling entirely hopeful and grand about life.

So I uphold Esquire’s assertion that 42 is the absolute shit. I’m not represented in their list of babes, but I feel more like myself today than I did back when I rocked the F-cups. I still hate the pitying looks from strangers when they put 2 and 2 together with my missing eyebrows, lopsidedness and Sluggo hair, but I care less about perception than I did 20 years ago. And I have zero desire to return to the university me, trying to figure out whether it’s ok to look like a ho-bag and study the history of feminism at the same time (if I knew now what I knew then, I’d keep the thigh-high socks a little longer).

Even if I’ve been looking more like David Bowie lately than a parasol-carrying babe, I’m praised often by my live-in boyfriend, who may be sucking up, but I don’t care.

And maybe the whole point of this exercise is that my girls will grow up knowing a woman who looks a tad strange but manages to walk tall despite it, can squash rogue cells with her every fibre, make a mean chicken Milanese and argue the panties off anyone who dares cross her. It's a small percentage of womenfolk I'm influencing, but that uni degree is finally coming in handy.

Monday, July 14, 2014

Cramming

Since my very first deadline, back around the time Xanadu was born and I was wearing the shit out of barrettes with ribbons attached, I've been a crammer. I get all serious like in the days or hours before the thing is due and spend the rest of the lead up doing something more fun, like looking at the room and seeing it needs sweeping.

I can't really blame this one on my parents, but maybe it has to do with birth order and my two older brothers; getting either "oooh, you'll do very well then!" or "oooh, we better watch out for you", depending on which one of them I mentioned to my teacher at the start of the school year. I needed to strike out on my own - to not be the smart, kind one, or the sporty, sassy one, but to be the one who kept you on your toes, always guessing.

Actually, I've done my own 30-second psychoanalysis on this one. I was terrified that if I put too much work into something and did a mediocre job, that my sense of self would be shattered. If I did everything last minute, and got a decent mark, I could always tell myself that if I'd tried harder, I could've joined the 100% club. Classic fear of failure stuff.

Now I'm in the 6-week run up to my second PET scan on August 27, and I had a moment last week of realizing I was doing the same fucking thing I've done all my life. I was doing most things half measure and planning everything for "after chemo", like I was a normal, healthy person who had all the time in the world to figure this shit out.

Sure, I'm walking almost every day, eating better than I ever have and trying to reduce or rather differently process stress, but in the serious scheme of things and the spirit of wanting to live forever, I'm still dabbling. I'm still often behaving like I've had a first-time, early stage cancer diagnosis or worse, like a woman who switches to almond milk because her girlfriends said it was "sooooo good for your skin."

I have aggressive cancer, and I haven't been aggressive enough.

Last week, the heart test results gave me some control back and on Friday, my lack of real dedication hit me like a big crashing wave. I had Pete beside me on a walk along Turkey Head to reflect my jumbled state and we came across a park bench with a memorial dedication for someone I knew, also born in 1972, who died in a motorcycle crash several years ago. I was humbled.

Since then, I've felt renewed. I've got 6 weeks to study for this PET scan and not only am I already deep into the run-up, I'm ready to get the gears from all of yous for a less-than-stellar outcome. No more cramming.

Also, I look like an androgynous imp these days and those Xanadu barrettes would NOT go with my new faux hawk.


Monday, July 7, 2014

Stronger

I hate to admit that cancer has the power to give me my highs and lows, especially when I'm more of an in-the-middle type of girl, but I had a smack and a tickle all in one go today, c/o the administrative side of the disease.

I had my three-month echocardiogram on Friday, with the kids holed up in the waiting room on iPads while I had suctions stuck to my torso and an ultrasound wand slipping around my heart. At last check, in March, my heart showed some deterioration from the Herceptin the last go-round, so Dr. A has been ever-vigilant about ensuring I get no further damage this time.

We started our appointment today with her looking with concern at my test results and telling me there has indeed been degradation. She read out the results word for word, which is very her and was uber helpful, because it contained a lot of cardiologist lingo that made me drift to Tuscan sunsets and the perfect Chianti.

She recommended I see another cardiologist and that we eliminate the Herceptin and Pertuzamab for tomorrow's start of round five while everyone figured out what the fuck to do with my ancient heart and its failure to cooperate. I was focused on the delays all of this would cause and started to sink into the practical, but depressive acceptance I've come to know well.

But because I also take great joy out of annoying my oncologist, I started to ask a bunch of questions until eventually she looked down at my giant cancer binder with confusion and said, "I think I may have the wrong report." Then she leaped out of her chair and stormed out of the room, leaving me to ponder how much shit whoever handed her that report would be in.


Ten minutes later, she returned, red in the face. "I'm so sorry. Someone handed me that report and it was from your last test in March. I'm very very sorry."

"No worries, doc," I said. But I didn't say "doc" because I'm not from the 1950s.

As she promised to call me later with the actual results, the actual results suddenly knocked on the door and handed themselves to her.

She read them quickly and then smiled her little chipmunk smile and exclaimed, "Oh! Your heart has improved! That's very unusual."

Yeah, bitch, cuz I be walkin' 5 km a day since April. That's why your little test was no match for my gigantic heart (actually, I think size and actual hearts are not good bedfellows, but whatevs).

So despite the machine gun blasts of chemo every week, I'm stronger than ever.

I felt like that Wildling giant from GOT. I could pound logs into the frozen ground!


Rather than ask her if I could go away on an international trip in September, I told her the plans were set. She wrote down the dates and she said she'd be close by, in the south of France, at the exact same time. And she said it in such an encouraging way that I got the feeling if I phoned her all panicky because of some cancer question in the middle of my squid ink pasta in Venice, that she'd gladly take my call in her chateau.

We came to a new understanding today, Dr. A and me. She's capable of making mistakes. And I am capable of annihilating this cancer so hard, they'll have to come up with a brand new word for me.

Wednesday, July 2, 2014

Forgetful

I'm getting forgetful.

Don't call on me if you need someone to phone in an emergency or play $25,000 Pyramid. Unlike the affliction where you can't remember who played the mom in Family Ties, regular, useful words like "tent" or "door" or "fugly" have lodged themselves in a part of my brain that is no longer producing enough new cells to keep the flow going.

This is annoying for a person who likes to think she writes. I wish the forgetfulness would settle in other regions of my short- or long-term memory. Like that time I danced for hours with someone I thought I had recently gone on a date with, only to realize it was a different guy. I don't need that one anymore. Or what about when I thought I was ordering "that donut thingy" in the window of a Turkish cafe and was then presented with a plate of shaved, unidentifiable meat that I had to eat in shame. That one can go, too.

Actually, what I'm needing a big break from these days is my bloody self. I've been stuck in a bit of "I'm sick of cancer" ennui recently, and it's not attractive. Sometimes a girl just wants a day where everything doesn't have to have meaning or self-improvement purpose. Like getting teary at my favourite escapist living abroad TV show because shit, man, I'll never get to go there. Or projecting into the future when my daughters could produce or adopt some little sprites and not experiencing the rush of loving kids who didn't come from my immediate womb.

Listen, I know there's a chance I could beat this cell division business for realz, clean up my act and live to be 100 with the help of good living and good drugs. But the reality is, probably not. And I know that any living human could be gunned down, run down or smashed by a falling frozen hunk of airplane toilet sludge at any moment of the day. Life is short. I GET IT! But before cancer, those possibilities were whimsical, not at the front of my brain every single day.

It's even difficult to do unusual things for me, like go to Diner en Blanc, without assigning some kind of bucket list cliche to them instead of just experiencing it.


One thing that's moving me outside the realm of maudlinville is planning our trip in September. We've chosen Italy, because it was the place I would most regret not bringing my kids to if I kicked it in the near future. But beyond that initial morbid thought, the trip is completely impractical, which I love.

I could find out some bad shit from my echocardiogram next week. I could find out some bad shit from my second PET scan in August. I could find out some bad shit if this chemo stops working. It's all entirely possible and a completely idiotic state to be planning an international trip around. But I don't care. I'm done with letting my cells determine my fate.

So we're leaving on September 26 and going to San Gimignano, then Venice, then Rome.

And despite my objections to the cliches of cancer, this one is a bit of a bucket list destination. Besides counting half my self as Italian (sometimes it's the top half, sometimes the bottom), when I was 22, donning Bjork buns and in Venice with my cousin Tasha and her boyfriend (now husband) Dave, I promised myself, sitting in Piazza San Marco, gazing up at the pink lights in the square and hearing  three different string quartets playing to the lap of waves in the Grand Canal that I would come again when I was madly in love.


Thursday, June 19, 2014

Going bizarro

I opened the kimono on Monday, took a deep breath, and told both the chemo check-in nurse and Dr. A about all my side effects. I got a resounding, “So…?” 

When I got to the bleeding nose part, the nurse said, “But it eventually stops, right?” My takeaway: unless I’m craving baby heads for breakfast or actual fire is coming out of my ass, my pathetic side effects are child’s play in chemoland. 

I learned a few other things at that visit by asking more questions than usual. I’m now on cycle four of six initial cycles, so will officially end this phase in mid-August. Fuck yes. I’ll get another PET scan then to see if another two cycles of the same protocol are warranted. If not, I’ll move to phase two, which may just be a combo of the Pertuzumab and Herceptin, the powerhouse HER2-positive fighters (HER2 is my aggressive strain of the c-monster). 

How many cycles is still unknown, but infusion time is 60 mins, with no pre-meds; a dream compared to the four hours I get with all three every three weeks, including the steroid and Benadryl pre-meds. Plus, it would mean saying bye bye to the weekly Taxol, the classic chemo drug with all the classic side effects.

Herceptin can be hard on my heart, but I get another echocardiogram in July to see if there’s been damage. As far as I know, the Pertuzumab causes mostly loss of appetite, but until I remove the Taxol, I can’t be sure if all the other side effects (indigestion, heartburn, hair loss, etc.) are its fault alone.

I did find out why I get all the “you have an unusual protocol” comments from the nurses and other doctors when they find out my cocktail: I’m the first person at the Vancouver Island Centre to get Pertuzumab outside a clinical trial. When Dr. A said it had just come into circulation, she wasn’t kidding. With Herceptin as the HER2 wonderdrug, apparently Pertuzumab is its new BFF and does even more to battle that particular beast. Yay me.

I told Dr. A my family wanted to go away in September and she was surprisingly accommodating. “Just let me know when and we’ll work around that.” And then I asked her a shitload of other questions while she was trying to write me a prescription and in true single-tasker style, she excused herself from the room so she could concentrate on what she was writing. Nerds are adorable.

I felt so buoyed by going against my instinct and being honest about how I was feeling that I truly went against all my pre-conceived notions of my 9-year old and took Stella on my 5 km walk on Tuesday, pre-chemo. 

She was such a great sport and I was so touched by how game she was that I would have called Pete home immediately to put another baby in my belly if I wasn’t barren right now and… well… an actual thinking woman.

Yesterday we went again with Stella’s BFF in tow and went even further, with a cream soda at the end as a reward. It was delightful.


I’m officially becoming Bizarro George Costanza and doing everything the opposite from now on. It can only turn out to be a good thing.

Friday, June 13, 2014

Push it

It's been a tough week.

Chemo was earlier than usual on Tuesday, which I thought was going to be good, even though the kids were home that day, enjoying the strike, so logistics were a bit fucked.

The girls were really good. They let me have a glorious 45-minute nap when I got home and then Frances woke me up with her usual burst into the room, yelling something rando like "I think Putin is evil!" It's adorable, actually, even though you feel like you're rotting in a dungeon and the king has ordered someone to wake you up abruptly and confuse you every hour before you ever get a good REM in.

The real problem was, when she did wake me up, it was only 3 pm, which meant I still had an entire afternoon, evening and night to enjoy the effects of the Taxol. For a couple of hours I sat outside, hunched over, and did a crossword puzzle to keep my mind sharp, Googling most of the answers, because, hey, I'm going through chemo, assholes. The girls played around me, poking me occasionally and I felt like the best mom ever.

The rest of the night was a blur, but with the zing of the steroids I felt like I was back in the thick of having an infant in the house, when your body begs to be released to your bed but your tiny captor reminds you your needs are no longer important. I slept maybe two hours before pulling myself out of bed and retreating to the couch to look up vaccination protocols for Kenya until the girls got up.

In the days since, sleep has been brutal and my cold keeps a vice grip on me, making me lazy and unambitious. But I continued to get out for 5 km every day, not feeling completely bought in to this power walking nonsense but pushing myself to complete something.

I meet up with Dr. A on Monday for another check-in and I've decided to lay everything out on the table: the neverending cold, the bloody nose, the heartbeat speed-up, skip, then catch up when I lay down, the hot flashes, the bad skin.

I've been pretty mum about this stuff because I have this fear that if I admit any side effects, I'll be stripped of my chemo badge. No soup for you!


I don't mean that in a "Oooh, so Carissa's not a master at this thing after all!" complex. It's more that I'm terrified that if I have any complaints, I'll be pulled out of the race for good, with crap options for saving my life. There isn't a shitload of other chemo drugs I can go on. If I have serious adverse affects from these ones, I'll either be forced to stop altogether, or I'll get some chemo lite. And I'm not ready to be punished that way, especially when pushing it with this brutal protocol is having some fantastic results.

Tuesday night, while the girls were getting their book readin' from Pete and not me, I glanced at my chest and saw that my cancerous rash was not only soft, it was skin-coloured. Normal. Not visible. So this is good shit I'm on, my friends. If I could have jigged on the spot, I would.

At that moment, it was okay that my facial features were rapidly disappearing and I had the libido of a eunuch. It would all be worth it if I could continue to the end.

But after putting up with my monitor (aka Pete) badgering me every second of every day to own up to feeling not so hot, I raise the white flag. I'll spill my guts next week and they can do what they will with me.

I'll continue to push it, though, no matter what the surgeon general recommends. And when you ask me if I'm tired like you are at 9 pm, I'll smile politely and tell you I'm coping quite well, thank you.

Monday, June 9, 2014

Work family

While I write desperate love letters to my nose hair, begging it to come back, and wait for my head hair to evolve into the full Donald Trump, I've been trying to shake this wretched cold that just keeps hanging on. I finish up cycle three of my chemo protocol tomorrow, which means I'm about a third of the way through.

I'm mostly handling the indigestion and heartburn. The teaspoon of apple cider vinegar in a 1/4 cup of water before meals is helping, but the Udo's probiotics are the real star. No more Bloaty McBloaterson and days of feeling like a better buoy than a woman. In general, I feel good about what goes into my body these days. I even survived an entire McCart family BBQ this past weekend on one small glass of white wine. I am officially boring, but I'm gonna live, motherfucker.

My sleeps haven't been stellar, which means I've been reading more than usual, focusing on the mind/spirit part of recovery. Some of the more recent studies I've been digesting show, in a nutshell, that the bigger your network of supporters, the more likely you are to beat the shit out of the supreme mean girl that is cancer. So when people ask me, "how can I help?" it's super simple: send your good energy my way and I'll try not to let you down.

I know it's more complicated and often more practical than that sounds when you're battling the beast. Having close family and friends means I have people to do actual things for me when I need it - like drive me home in my Benadryl stupor, take my daughters on an early morning when you're still in your robe but don't give a shit, send your kids over to take mine away for an hour or bring me food when boiled toast seems like a good idea.

Once those basic needs are taken care of, I crave the giant bear hug of near and far friends, and the biggest, bone-crushingest, bordering-on-creepy-but-never-crossing-the-line embraces I get are from my work family.

After eight years at the flying T in a juicy role that has me working closely with people across the country, I get well wishes from all directions and I feel rich and undeserving every day. These are a few that have left me reeling with gratitude recently:

My friend B has used his good words and deeds to give voice to the shit that is cancerdom through his generous involvement in the Ride to Conquer Cancer. He's been personally touched through the recent passing of his father and although we've never actually met in person, this lovely man in Waterdown, ON has become one of my biggest supporters (see the C.M. below on his ride gear? C'est moi!).


My friend P may win the award for sending me the loveliest email ever this past week. She's even named a tree outside her office in Edmonton after me so she can send me a giant force field of love and nature to weather this storm:


I'm beyond proud of my friend EB for so many reasons, just one of which is that she inspired me to stop kvetching and find the thing I like to get fit. She's been so concerned, present, funny and lovely from the very start of this business and now she has the hair to match her fierce support, all the way from Chatham, ON (represent!):


I get a giant lump in my throat when I think of my extra special boy, PB, in Vancouver, who stepped in with grace and urgency (again!) the moment he knew, who tends my work garden with love and sends me the sweetest XOs when I need them most. Actually, my boss, D, and my entire immediate circle of colleagues throws the most touching emails over the fence on a regular basis and even arranged to have cleaners come scrub my gussets while I eat organic bonbons (actually, I don't know whether they scrub gussets, but will ask posthaste).

My lovely A in Calgary tells me what to watch on Netflix when I'm too tired to do anything else and she knew just the right thing to send me when I was worried my message wasn't getting out to cancer loud and clear:


My team of talented hooligans, who, well... they made this "Carissa, the badass" video for me that I'd love to show you, but I'd likely have to kill you. Just know that I'll never stop crying about it. S, C, S, K, D, EB and A, you make my life. I'll be back soon to undo all the goodness that PB is drilling into you.

And finally, there's D, B and J, who have decided to make something incredibly amazing happen on behalf of my entire work family: giving me and my blood family the gift of a trip to anywhere in the world for a week when I'm well enough to travel.

Gobsmacked. Still reeling. Love my family. Promise I won't let you down.

Friday, May 30, 2014

Freak flag

I've finally decided to accept my damaged body and let my freak flag fly.

When I had my first breast surgery back in 2011, it was wrenching trying to figure out whether to lop just one or both globes off. I asked everyone I knew who had gone through the surgery and got a lot of the same hippie talk you get when you kvetch about love in your teens. "You'll know what's right" or "trust your instincts" or, even better, "think of yourself five years after the surgery, not five minutes".

Actually, that last one was mine. I trotted it out to a friend who was going through the surgery just after me and I had all the wisdom of a newborn foal.

The truth is, it's a fucking wretched decision to make, and yes, it's never as traumatic as you think it's going to be in the short term, but the long game can be a bitch on your psyche.

I got both done, for the record, and woke up from the massive surgery with little expanders inside me, so never had to go through the experience of being completely decimated in the chestal area.

One more surgery and several painful saline injections later, I had a new set that were not Hollywood-ready, but were smaller and unmoving and required a whole new wardrobe and state of mind after years of being G-size and unwieldy. People looked me in the eye. I could wear blazers. Construction workers lost interest. Girls didn't tsk at me as much anymore.

When I was fully used to walking around as a small-titted gal, I got a nasty strep infection that settled on an implant and yada, yada, yada, I had to get the left one removed permanently.

I woke up from that surgery finally understanding the sting of being lopsided and it blew. Since then, I've kept the space warm with a chicken cutlet and a rotating couple of special bras that together are worth more than my car, and I've rarely gone out, especially swimming or in anything tight, without the comfort of balance.

When you're on the cancer-go-round, it's a gigantic respite not to have to also present as damaged to every person who glances at your tight sweater and sees something amiss. But lately, the deceptively cute but crazed little 6-year old Id who lives in my house, aka Frances, has been noticing life in general more and in her mean girl ways, making comments about how embarrassing it would be if someone saw me naked with my missing boob.

"Can you imagine?" she says. "I would die."

At first, I was inspired to tease her relentlessly for being so sensitive to what other people think, but now I realize I wasn't being imaginative enough. I must mortify her to teach her a lesson and stop myself once and for all from living in my two-titted bubble world of fakery.

When I started my big walks several weeks ago I wore my beloved cutlet in my sports bra and somewhere around kilometre three it ended up migrating to the middle of my chest for the rest of the walk. So I made the decision to leave the cutlet in the drawer on most days, emerging from my house braless, lopsided and as superfreaky as I am.

I do get a few looks. But I care not. I may burn that cutlet in a barrel one day and then quote Andrea Dworkin for a solid week.

Frances will be scarred forever, of course, especially after I take them swimming this summer and change back into my clothes in front of the world. But if she's ever horribly damaged by life, I hope she feels woman enough to let her freak flag fly, too.

Monday, May 26, 2014

Fight the power

Here's the difference between holistic and traditional in a nutshell... If you have indigestion, the holistic approach says "try x, x, and x and use the method that works for you." The traditional approach says "take this drug."

I know: duh. But it's amusing how self-indulgent traditional medicine is. Pound your symptoms with a hammer until the side effects or the ineffectiveness of the drugs bring you back in here and take zero responsibility for your own health. It's lulling, actually. Take care of me. Solve this. Tell me I play no role in this. Let me continue to do exactly what I've been doing but fix me. It's paternal. And maddening.

Every three weeks I'm obligated to visit a nurse and an oncologist so they can tick some boxes and give me the green light for the next cycle. On the one hand, they're worried I have the movie-size foreshadowings of a cough or shortness of breath, but when I tell them I'm managing, except for the indigestion, heartburn and general bloaty bad guts, they pounce on that like a bad boyfriend who just wants you to shut up about your bloody day already.

"LET ME WRITE YOU A PRESCRIPTION!!" they shout at me, but I tell them I'm trying to eat smaller portions, eat lots of fibre, less food, more frequently, take apple cider vinegar before meals, a probiotic after and I'm suddenly speaking a language they're neither familiar with nor interested in.

The only reason I have these homemade solutions to throw in their faces is because I'm ignoring Google like a good girl and went to see a nutritionist at Inspire Health last Friday. It was glorious. I had kept a food diary for a week, so managed to forgo cravings for Doritos or Texas carnivals selling deep fried butter for fear I'd have to include it on the list. On paper, my diet looked wonderfully varied and followed the 80/20 rule of eating clean/whole foods 80% of the time and doing whatever the fuck I wanted (save deep fried butter) the other 20%. I mapped my bowels, my exercise, my times of relaxation, and my liquid intake, including the 16 oz of green juice every week day. Ding, ding ding!

But the smugness was momentary and the glory wasn't really in the "you're doing very well" tut tuts of the nutritionist. It was in the tips and oh-so-rational recommendations she gave me for everything I was wondering about, including where to get grass-fed beef that didn't require a full tank of gas (Village Butcher, Oak Bay Avenue).

She solved my internal debate of butter vs. Earth Balance (butter won, but get grass-fed, like the brand below, which doesn't actually say it but is):



Probiotic vs. yogurt to increase my good gut flora (probiotic won because it causes less congestion, inflammation and general stomach upset than dairy). She said this Udo's brand was excellent, so I bought it:



And which eggs to buy, because it's getting ridonculous out there (free-range so the chickens eat grass and bugs and other normal chicken things, and organic so they don't ingest pesticides):



She also recommended dealing with my heartburn, which is a result of too little acid, not too much (I'm clearly an idiot for not knowing that) by adding a teaspoon of raw apple cider vinegar into a 1/4 cup of water and drinking it before dinner. Unpasteurized is essential here, and this one is a good, trusted brand I already have. PS - apple cider has a shitload of other health benefits and uses. Look here:



On the subject of oils, I was almost there and she confirmed a few things for me: extra-virgin olive oil for salads or low-heat cooking. Coconut oil for high heat cooking. Moderate amounts of organic butter for flavour, etc.

It's important that the butter is grass-fed and organic because in cows (even though in Canada we don't feed dairy cows growth hormones) any antibiotic use and stress hormones from living a shitty factory life settles in the fatty parts, which includes milk ducts. If the cows are happy and grass-fed, your butter is happy and your cells are less inflamed and able to fight off illness.

Try to steer clear of Soybean (in many processed foods), Corn, Sunflower and Grapeseed oils when you can. They're full of Omega-6 fats instead of Omega-3 fats, and we get such a disproportionate amount of 6 in our Western diet today that many docs believe the tipped ratio is the biggest culprit of modern diseases.

I've learned or relearned a shitload of other things, but the conversation I was most interested in was the one about soy. Despite the use of soy in many Asian diets, the role that it plays in cancer is still relatively unproven. For now, the experts say that eating fermented soy, or soy that's as closest to the bean in form is best, and even beneficial. The phytoestrogens in soy take up the spaces on cells that would otherwise go to estrogen, thus blocking estrogen's effects and mimicking drugs like Tamoxifen. This is a good thing for estrogen-receptive cancer like mine. But the studies are not terribly conclusive or agreed upon and are often based on subjects that began consuming large amounts of soy from adolescence, so I'll continue to stay away from soy milk and fake meats but enjoy miso in moderation.

After an unadvised getaway with Pete this past weekend that left me fighting a cold (do NOT say I told you so), I saw my regular onc again today to get my pre-cycle three check in. She was very impressed with the effect the chemo was having on my chest rash (pretty much gone) and my collar bone node (almost unpalpable), but when I told her I had indigestion and heartburn and was doing a bunch of things to try to control it myself she said, "I CAN WRITE YOU A PRESCRIPTION!"

Monday, May 19, 2014

Passing

When I go on my morning walks, I climb the hill that leads to the Uplands, the tony area of Victoria where the houses look like French chateaus:


and even the medians are baptized with proper names:


I grew up in an area that's the opposite of the Uplands and spent my youth both hating and coveting the Oak Bay hair (so luxurious!), shoulder sweaters and tabbouleh parties. Living on the edge of this mythical place now, I sometimes cavort with women my age who had the bizarro version of my younger life and they lean in for the tales of bush parties, girl fights and growing up to the sounds of dirt bikes and stock car races on the wind.

I'm no more Oak Bay today than I was at 15, but when I walk through the English streets like Midland, Ripon and Exeter, saying hello to the landscapers, renovation teams and a smattering of retired men biking or running like 30-year olds, I feel like I'm passing as a local and I'm embarrassed to say it is good.

Because I still have my hair, pink as it may be, I'm passing all over the damn place. I have a respite from being seen by strangers as sick. If I wear my prosthetic breast, I'm bloody well near normal. That makes everyone else comfortable and it helps me forget for a few moments every day.

I get enough reminders. The "Ca Breast" scrawled on my weekly blood req. The halt to my digestive system for several days after chemo. When I think about saving for retirement or needing to see Stella through the idiocy of middle school. Or when I fall back on my old ways of getting frustrated with my kids when they're schmoopy or lazy. It's been difficult reframing my life and my thoughts again to become even more mindful and present, this time with the knowledge that I'm metastatic and the medical profession sees that as an eventuality. 

The day before chemo is hardest. I feel great. Everything works. I can slip into denial. I don't read my cancer books on these days. I surround myself with celebrity gossip, cookbooks or life hack articles to pretend I'm just a normal girl figuring out normal problems with no sense of urgency about anything.

Today, though, I'm thinking about my list of exotic travel destinations, like the Giraffe Manor in Kenya:


I'm done worrying about wracking up debt over the things I want to do. I'll leave those problems for the next wife, who, let's face it, could very likely be one of those Greyhound-slurping real housewives I sometimes spy through the windows just over the border.

Tuesday, May 13, 2014

A proper send-off

The hair continues to fall out strand by strand, so on Saturday night I decided to finally give it part one of a three-part send-off, with my boyfriend's hot love and emotion in the form of plastic gloves.

And the colour turned out glorious.



With a little side-sweeping and careful angles, you can't even spy all the bright pink scalp and forehead action.


When I went into the chemo room yesterday to get my first real poke from scratch through my friendly neighbourhood port, the nurses (even bitch-face redhead) went wild for the hair, but I think it's mostly because they go wild for any hair after endless days and weeks of bald. I'll be sorry to eventually disappoint them.

The port has healed like a motherfucker. One week in and the scar needs its own star on the walk of fame. The catheter only barely peeks through the skin leading up over my collar bone and into my jug-u-tastic vein. Dr. M is my new girlcrush.


I'm missing my work peeps today as they pull off a show in Vancouver that I started but they'll mos def make better than I ever could. I love you all to bits.

I'm also praying to the goddesses of hips (she'd be a sexy one) that my brilliantly wicked and kind friend Di makes it over the hump of brand new hip surgery so she can get back to her days of nursing injured baby birds back to health, making stiff martinis for her guests and just generally making sure everyone around her enjoys life as much as she does. Love you, girl.

Next up: Is that the buzz of a razor I hear?


Thursday, May 8, 2014

Surgical precision

My port surgery on Monday ended up being completely without drama.

The lead up was wretched. I slept about an hour the night before and developed a not-at-all-annoying tappity tap tap tap relationship between my fingers and thighs after I donned the gown and robe and slid under my first of many warm blankets.

I noted the woman next to me had sneaked a book and I hated her instantly, but the curtain between us saved her from my side-eye. The older gent across the way had checked in downstairs at the same time I had and his name was Dennis O'Leary. Every time a nurse pointed out that his name was like the comedian's, he laughed and said, "well, he's a Leary and I'm an O'", with just the right touch of weariness. I was a little in love with him.

The old codger next to me was getting pins put in his fingers after falling several times and his daughter was sitting with him, annoyed her meter was running out as she waited for her dad's surgeon to arrive.

The middle-aged woman across the room complained about being freezing cold so she was loaded up at regular intervals with oven-fresh blankets until a nurse stopped by and said, "Just to let you know, your husband does not want to leave the waiting room until he can come in here and see you're okay before you go in... He shouldn't be in here, but I'll let him in for five minutes, the poor lamb."

I reclined in my bed for about 90 minutes, observing everything and getting more nervous with each tick. A nurse officially admitted me about 20 minutes before my surgery time (no to dentures, no prosthetic legs, no blood pressure or needles to my left side, yes I want a sign that says that and yes to confirming port surgery on the right side). Then a surgical nurse came by to double check my info and tell me she had had ovarian cancer 23 years ago and was still kicking around, so let's do this, sister. 

And then I saw God, aka the anesthesiologist. He had on a balaclava-type head cover and was tall and a bit Baby Huey looking. 

"Hello, Mrs. McCart. I'll be your anesthesiologist and - "

"What will you be giving me as the narcotic? Fentanyl?"

"Well - "

"And for the relaxant? Valium? And the pain reliever, Lidocaine?"

"Just - "

"And what if I feel pain during the procedure? Will I be lucid enough to speak?"

"Are you a health professional?"

"No."

"Ah, so you're one of those dangerous people who know just enough to ask the right questions but not enough to have any idea what's going to happen. Let me look at your chart first so I know exactly who I'm dealing with here before I tell you you're right."

He confirmed the Fentanyl, the Valium and the Lidocaine, and then, perhaps to punish me, told me in great detail what the experience of being awake for a procedure like this could feel like. He used words like "tugging" and "pulling" and "awareness of some pain". 

"You just have to say the word and we'll give you more Lidocaine. We don't want you so far under that you're flopping all over the place and can't communicate with us."

That's when the uncontrollable leg shakes started up. It's also when the nurse came by to take my glasses away as my whole surgical team showed up, sans my actual surgeon.

"Without my glasses any one of you could be Dr. M," I said. Then there were jokes and leg pats and a few "there there"s as my whole body began to vibrate in anticipation.

"We usually take you into the final waiting area before wheeling you into the surgical room, but I think you're anxious enough without being moved somewhere else right now. We'll all stay with you until Dr. M gets here and we'll stare at the green walls and curtains together and talk about how calming it is."

Dr. M showed up just as my heart rate was climbing past 100 and my usually low BP was, for the first time ever, a normal 120 over 80.

This is going to sound completely sexist and ageist, and just plain stupid, but Dr. M has such a lovely young face that when she came close enough for me to see, smell and taste her better, everything melted away for a moment.

"You'll be quite fine," she said after marking her initials on my neck. "You won't remember anything and the pain will be very minimal after." 

After she left and I shrugged off my robe and tucked my hair into a cap to be wheeled into my cold, cold surgical room I was a wreck again.

When I arrived, everyone was so lovely and dinner party-like, introducing themselves to the blind woman with her arse exposed to the universe. Even the students came up and shook my hand while I slid onto the impossibly skinny operating table.

"This is the first surgery I'll be observing!" one of boy interns said excitedly and I was excited FOR him. Just in more of a shut-the-fuck-up-for-a-minute-so-I-can-figure-out-how-I'm-not-going-to-pass-out-from-the-stress kind of excited.

The arm extensions came out from the table and the IV went in my hand with only a little more pain than usual. The toasty blankets finally made it into the room and now only my legs were shaking and my teeth were chattering. All the while I tried to make everyone feel better for putting me in such an awkward situation by making jokes and laughing heartily at theirs. 

"I'm going to give you something to relax now, Carissa." Magic words.

"I feel that, doc. In my head..." And then nothing.

The next thing I remember, I'm being wheeled out of the room and I'm saying, "Did I talk?"

"Yes, you told us once to give you more pain medication, but don't worry, you didn't reveal your PIN or anything."

And just like that, I felt normal again. No pain. No discomfort. No dizziness. No nausea. No memory.

I was monitored for an hour in the first recovery room, but my vitals were normal and my pain was zero, so I moved to recovery room #2. The nurse there was mostly on her own, but she took the time to wipe off some of the red antiseptic from my neck with a warm facecloth and didn't let any of the other patients get away with trying to skip out early. She was a force with a Snow White voice.

After an hour there with still no dizziness or pain, Pete was called and my chariot awaited in the roundabout. I was wheeled down, as per protocol, but I felt miraculous.

Pete made me some divine Chinese noodle concoction for lunch and then I started to feel the Lidocaine dissipate. I took a couple of Tylenol and slept for two hours, grateful my chemo was moved to the day after.

Getting chemo drugs through the port was a dream. The nurses fawned over the surgical precision of Dr. M, my parents were there to make sure no one fucked up on their watch and everything went extremely well, despite having to recline for a solid 5 hours.

But here's the annoying thing about me. Instead of wrapping two days of significant body stress into a warm duvet, recognizing that I felt like I'd been pummeled in the chest and neck and being able to palpate every centimetre of the catheter attached to my port, under my skin as it snaked up and over my collar bone and into my jugular, I wanted to get out of the house before that marathon chemo session. So I did. And my pain in the ass/saviour companion made sure I didn't wimp out.

 

I had to walk with my neck bent down, my arm straight and with a sloth-like pace, but I went 2 km, mofos.

The day after, I felt that tube in my neck even more, but Stella had two dance performances at UVic that morning, up a giant hill and a 20-minute walk from my house. I was an idiot to do it, and I think I may have used up one of my lives on that hill, but I did it. Almost 4 km for the trip, just to see my baby do the splits, the limbo and a wicked flashlight number to Sweet Dreams. There was no way I was missing that.




Sunday, May 4, 2014

Port-o-call

I go in for my eighth ever surgical procedure tomorrow, my fifth in the last three years. I'm getting a port-o-cath installed, which was my choice, to save my veins from further wreckage.

I know the drill. I even know the hospital staff by name. But it's not a bus stop I'll ever get used to.

Waiting in a hospital bed in the pre-loading dock for an hour, sometimes two, no smartphone or Lainey Gossip to keep me busy, not even an old Stephen King or Reader's Digest to smirk over. Sleep is not possible. You have to time your bathroom trips so the other cattle don't get suspicious. And you have to tell your story to eight different nurses who are there to verify that you are who you say you are and that you're getting the right surgery that day. Your surgeon even has to mark the right spot with a pen and sign it with their initials to prove that they didn't cut off the wrong arm. Medieval.

Port surgery seems to be 50/50 whether you get it under general or local. I was pleased to get a surgeon, Dr. M, who only does locals and I was extra pleased when she turned out to be a woman about my age, telling me at the consultation, "you don't wanna get more nasty stuff pumped through your veins than you need to". But now I'm anxious about seeing and feeling everything in that room, on that cold operating table.

I had a check-in with another oncologist last Friday, and she seemed to think that beside the local, they'd also give me fentanyl, with is a nifty narcotic I got both times I gave birth. In the throes of labour it didn't exactly eliminate pain, but it put me into a slammin' heroin buzz between contractions, which was enough at the time. The idea for this surgery is that they don't want me watching all the hubbub and then giving them a poor rating on Yelp, so the fentanyl will put me into a lovely altered state. As long as I don't feel them messing with my jugular, I think I'll be okay.

I'm expected to get chemo tomorrow, too - the full three drug cocktail - but I finally got cold feet about this overkill of a day on Friday and asked the onc, "what would you do?" She said "move it". So we're trying.

I've been an asshole today to everyone around me, so I'd like to get this less-than-idyllic stop over with before our house becomes known as "the one where that woman yells a lot".

Thursday, May 1, 2014

The long tail

I had a dark moment on Tuesday, but I've now accepted Carissa as my personal saviour.

And this is the thing about cancer. You can be motivated by the challenge or defeated by the dire faces on any given day, but after all the inspirational messages float past your eyes for the millionth time like so much fluff, it's really just up to you. It's not so much courage as just getting on with things.

After I rolled the metastatic word around a bit on Tuesday, I did two things: sign up for a 90-minute consultation with an integrative doc at Inspire Health and begin reading Anticancer by French doc David Servan-Schreiber. I don't take on new cancer tomes easily after all the reading I've plugged into my brain over the past four years, but this one came highly recommended as something as close to a bible for the team at Inspire Health.

The doctor visit started with a hug, which was so very human. I told her everything about my health since 2010 and talked about my life and fears and hang-ups.

She acknowledged the things I was grand-slamming, like juicing, meditating, walking, going plant-based, taking 2,000 IUs of Vitamin D every day.

Then she suggested ways to bring everything to the next level, like eating some nuts with my juice to ensure the fat soluble vitamins were absorbed, meditating on some forgiveness for my GP's laziness and my self-flagellation over not being able to prevent a recurrence, making my walks a no excuses daily ritual and dabbling in everything else, not getting bound up on which supplements might be beneficial, but  focusing on getting enough whole foods instead.

We talked about my family and really getting joy out of being together, whether it's sharing the badass meditation pillow Pete bought me this week:


Or just generally taking a moment where I can:


We also talked about not being afraid to get some high-quality grass-fed red meat into my life every once in a while. Grass-fed isn't just natural, it means high in omega-3s, which heal rather than promote inflammation, and it contains CLA, a boffo fatty acid that has been shown to reduce the risk of cancer and other chronic ailments like diabetes.

Despite living in the land of locavores, it's not easy finding grass-fed beef. The nearest organic butcher told me today their beef is hormone-free and partially grass-fed, but grain-finished. My lovely little grocery store down the road, which packs a shitload of local goodness into its tiny aisles also has hormone-free, ethically raised beef, but it's not grass-fed.

I don't actually miss beef much, but I'm trying to find a way of eating that is plant-based but also includes everything magical, like unicorn meat, which I'd gladly try if I knew it attacked cancer cells (or at least tasted half-decent on a bun).

I came away from the appointment with a second hug and something great for my back pocket. I told the doc I'd had a bit of a panic attack at seeing the metastatic word and she said, "As doctors we're always so concerned not to give our patients false hope, but there's also such a thing as false hopelessness. Don't get caught up in our words and statistics. This is about you and only you, the rest is so much noise."

I was already moving past it all and feeling lighter.

I began reading Anticancer yesterday and I'm already hooked. The doc who wrote the book is no longer alive, but when he was diagnosed with a brain tumour at 31, his prognosis was bleak, with the median survival rate, with treatment, at less than one year. He died almost 20 years after this diagnosis and in the meantime, became one of the godfathers of integrative cancer care in the world.

He talks about seeing yourself as part of the long tail of statistics. There's always a median, with one side encompassing the group of people who die earlier and the other with the group of people who die years and years later as part of the long tail of the trend, sometimes succumbing to something other than their original cancer.

I woke up this morning feeling like the long tail, which is slightly less sexy than it sounds but no less powerful. I can do this. In fact, I can do this with style, motherfuckers. Just you wait.