Friday, May 31, 2013

Bloody Noses and Anxiety

I am convinced that I am going to bleed out due to a bloody nose. I am on a loading dose of a blood thinner,Xarelto, taking two pills a day in order to dissolve the blood clot in my neck. Part of the problem is likely due to the description my doctor used when telling me about the drug. Coumadin, she told me, has an antidote for excessive bleeding. The patient is given vitamin K, and that restores the blood's clotting ability. Xarelto, she said has no antidote. It was the words "no antidote" that made me particularly nervous. She went on to say that when a patient on Xarelto begins to excessively bleed, they are given a transfusion and the med flushes out of the system within 10 to 12 hours. So in other words, that is the antidote. But no, she had to tell me there was no antidote. So now every time I get a bloody nose, I am convinced that I will bleed out. By the way, if this is true, please do not call me and tell me this. I have one week left on the loading dose, and then I will be down to taking one pill a day. I just need to make it through this next week. Thank God for Xanax.

Really I should be fairly chilled out at this point, but something about this blood clot has me back into the anxiety of what will happen next with this cancer. I am unfortunately spending too much time thinking about it, when I should simply be enjoying the fact that my last scans were stable. To paraphrase Michael J Fox, if I worry about what will happen, it may or may not happen. And if it does happen, I've experienced it twice. So the challenge is how do I stay in the moment?

I was talking to my friend Mary Rose the other day on just this subject, and she tells me that when she spends too much time dreading the future, she literally curls her toes to remind herself that her feet are right here in the present. A simple way of staying put. And frankly, it works. Mary Rose is a wise woman.

But the other part of the equation is acceptance. Lately I've been spending too much time thinking about that mammogram my gynecologist did not order (she had just dropped me to the new every two year guideline). The result of this kind of thinking is anger and hurt, which frankly is not going to help. So, as they say, acceptance is the key. Anger, hurt, and sadness is not going to change the fact that I have Stage IV breast cancer. I still remember someone asking me if there was Stage V breast cancer. I told them that that would be dead. It's good to have a sense of humor about this.

There are moments that are better for me. Finding the clinical trial for a breast cancer vaccine for HER2+ breast cancer was a hopeful moment. Having the researcher write me, telling me that, while I could not take part in this phase I study, she would put me on the list for phase II, and that it was very good news that I was stable. This made me even more hopeful. I hope to be here for her Phase II. But the most hopeful thing of all is the fact that there are many breast cancer vaccine trials being conducted right now. The idea that a vaccine can stop breast cancer certainly gives me hope for the future.

Other helpful moments are when I can help somebody else. I've tried to contact a few organizations who connect cancer fighters with each other, so that the person who is further down the road can support the person who is just starting. At this moment I've been told to wait a little longer before starting this effort. But I do post on the site breastcancer.org, and occasionally something I say helps someone else. That is a good moment for me, a moment not wrapped in the anxiety for my own future.

I've been told by others with advanced breast cancer that it just takes time to adjust to this new way of living. I've always been somebody who is close to my emotions. Denial has never really been my forte. But perhaps a little denial is in order here. I am hoping that once I get into a cancer groove, I can slip easily into denial, and for the moments I focus on the fears of the future, I can just curl my toes to remind myself that I'm right here right now. But then again, that is easier said than done. Meanwhile, there is Xanax. Thank God for Xanax.

Friday, May 17, 2013

I Am An Old Hat at This Medical Stuff

My doctor called at 9 p.m. tonight to give me the results of my bone scan and CT done earlier today. The results we're very good. Things are stable and there is no new cancer growth. However, during the CT, they found a blood clot in my neck.  Likely this is due to my chemo port, which connects into the vein in my neck. My doctor was obviously concerned and wanted me to go to the emergency room for an ultrasound and MRI of my brain. After that I'll be given blood thinners, something that makes me feel truly old (the only people I've known on blood thinners have been 65 years and older).

So here I am at the emergency room at George Washington University Hospital, hooked up to an IV, blood work done, waiting to be taken to the MRI. I arrived here at 10:30 p.m. and it is now 1:41 a.m. Not bad in emergency room terms.

I think most people would be very disturbed by this development, but I am not really shaken. Compared to the terror of the cancer spreading further into my body, a small blood clot that can be dissolved with blood thinners seems almost mundane.

I am just happy to have the stable scans.  As I was telling someone earlier, having a diagnosis of stage IV cancer is somewhat similar to being a prisoner on death row. The scans are like a governor-provided reprieve from the chair. So now that the governor has called, and said don't take her to the chair yet, I'll get back to trading cigarettes with the other inmates. As long as I have three hots and a cot, along with TV, I'm good.

I guess all that knocking on wood to ward off the cancer worked. And believe me I am happy for the reprieve. Thanks, guv.