Cliches To Live By

Despite powerful visualizations of ringing phones...I did not receive a call from my about-to-be new friends at the Chemo Booking Desk and continue to be on tenderhooks, trying to keep living, Mama-ing. healing, working, exercising, eating right, staying psyched, certain and centred; knowing that any day now that which I have just penciled into my Moleskine agenda book will need to be erased, re-thought and re-booked.

So what's one to do when the waiting gets tough? There's only one answer--do what's wanted and needed in the moment, minute, hour, day. And last night what that looked like was a mini Cancer Vacation! I had bought my daughter Charlotte 4 tickets to see So You Think You Can Dance Canada as her Winter Solstice gift. Charlotte and a fellow-dance-fiend buddy, Charlotte's beloved godmother Laura and I and 10,000 other wildly pyched, screaming-prone fans took in the fabulous show.

Earlier in the week, prior to the pleural tap, as I began to fear that I might drown from the inside out, the possibility of my making the show seemed increasingly unlikely. I began to hatch plans B, C, D and E but didn't say anything to Charlotte knowing how much she was looking forward to us all going together. Taking things day by day has never been so obviously essential. "Hope for the best, plan B for the rest," or something like that. We had a fantastic time. Part of my delight was watching the glowing face of Charlotte and her friend during the show and then watching them dance through the streets of downtown afterwards, full-to-the-brim with pleasure and possibility.

I went to bed happy and content, only to wake up two hours later my right arm numb and my back completely in spasm. It's a powerful reminder to say "Yes" to that which I wish/want/should do today as the next day it may not be an option. I'm not saying that to be dark and gloomy. It's just my experience. Not only that, the back pain won't last, but the memory of last night will.

Breaking News

There was a message on my cell phone yesterday afternoon from my oncologist telling me that she had some good news for me--tests had been done to the pleural fluid that had been drawn from my lungs and some other tests and that it had been determined that the cancer is HER2 positive. This used to be very, very bad news for women as it represents a very aggressive form of breast cancer that used to have a very poor survival rate. With the advent of a targeted therapy, called Herceptin, survival outcomes have moved to very poor to--well I'm not sure if better than average--but certainly much better than they were.

For some reason I cried when I heard her message and not in that happy, I'm so lucky way. I'm not sure why. Perhaps because I have just gotten my head around the current as-soon-as-I-get-the-you're-next-on-the-wait-list call from the Cancer Agency chemo desk and now I need to get with a new program.

Dipping back into the Internet's murky pond of data regarding cancer and its treatment options, survival chances etc. is not for the faint of heart. One of the infuriating things to read about are the medical studies that compare one cytotoxic drug to another and then conclude that one is "superior" because on average the patients in one arm of the study had 9.3 months to disease progression versus the other arm that had 7.9 months (don't worry Mom, these aren't my stats). Call me a limited thinker but I'm hard-pressed to get giddy over an additional 1.4 months--especially if the drug procotol involves six months of chemo that render the recipient pukishly-baldedly-cane-walking-muscle-angstedly sick (again, not necessarily true in my case). On the bright side, there's also some humour available. Apparently Herceptin is contraindicated if one is allergic to Chinese hamster ovary. Actually now that I think about it maybe that's not funny, maybe that means that I'm going to have Chinese hamster ovaries injected into me.

Time to have some green tea and work on upping my gratitude attitude.

Creativity and Cancer

I have come across some truly inspired responses to facing cancer. crazysexycancer Kris Carr and Cancer Vixen Marisa Marchetto clearly managed to have and hold onto their creative juices through bad, ugly and good times.

Check 'em out:

http://www.crazysexycancer.com/
http://marisamarchetto.com/

Oh Canada!

1pa·tient \ˈpā-shənt\ Etymology: Middle English pacient, from Anglo-French, from Latin patient-, patiens, from present participle of pati to suffer; perhaps akin to Greek pēma suffering
1: bearing pains or trials calmly or without complaint Source: Merriam-Webster Dictionary

Have you ever thought about how weird it is to call sick people "patients?" I have often wondered in the last ten years if it is meant to be a subliminal message to all of us who have the somewhat debatable good fortune to be part of Canada's socialized medical system.

I had been raised with the notion that it was one of the great things about our country...essentially free access to healthcare for all Canadians. As I grew up I started to hear about problems with wait-lists and the like but it wasn't until my beloved and very elegant grandmother, 89 at the time, spent 48 hours in the hallway of an hospital emergency room because there were no beds available and then was actually released before she was even admitted, only to return a few days later because surprise! she still needed medical attention--that I realized that our system had some profoundly serious flaws.

Soon after I became an active participant in the not-so-wonderful world of doctors and hospitals: wait lists and wildly powerful receptionists who could rebuff or re-book as they so desired; doctors who could not always offer what they hoped or even promised; incredibly caring people and incredibly calloused ones.

In 2000, in the months leading up to my 40th birthday, I had three surgeries in less than 12 weeks plus 16 days of radiation plus countless hours in countless other heathcare providers' offices receiving complementary treatment. Partly due to my personality, partly due to the fact that my cells were behaving like a jet-lagged, nap-needing, not-yet-nursed toddler, and partly due to the fact that I would have far rather been at home with my just-turned three and five-year-old children, I was anything but patient.

I've been having flashbacks to those times almost ten years ago because I am still waiting to find out when I will begin chemo and I am reminded of all of the razor's edge moments of attempting to be perfectly im-patient. Too far over the edge and those will the magic say-so will not tell me what I want to hear; too patient and weeks can go by waiting for the phone to ring only to be phoned to be asked why I had missed my long-awaited appointment for a test--a test that unfortunately no had told me had been booked.

One needs to be skillfully squeaky but never stridently shrill. Effective and karmically-neutral navigation of our medical system calls for skillful means, a sincere interest in being relational and mindfulness that any boon to me means bypassing other ill people.

My mind has been pretty calm while I wait for for the chemo-commencement call, but my body's been very actively misbehaving. Even though I just had fluid drawn from my lungs just over a week ago, it had returned by yesterday morning to the same extent as when I had the fluid drawn. I had emailed my oncologist, Karen Gelmon, on the weekend to let her know that it was coming back and then again yesterday morning, asking "At what point do I be concerned?" Karen G. had told me that if the chemo is effective that it would really aid with this fluid build-up but there was still no word on when that might begin.

I tried to have a nap yesterday afternoon and when I lay down I had the sensation that my throat was closing. That got my attention. I tried calling my GP but she was gone from the office until Thursday. I tried calling my oncologist's assistant but there was no answer. I decided to page my GP and started to pack a backpack with toothbrush, reading material, water etc. just in case I might need to go to Emergency. I didn't hear right back from my GP, Karen B., so I also kept calling Karen G.'s assistant and finally got through. She said that she would email her to call me. By now the kids were home from school and we were all on tenderhooks as we waited to hear.

Karen B. called and said that she felt that I would be fine overnight so long as I slept upright and that she would make some calls to get me in to have a fluid tap today. We were mid-conversation when another call came in and I quickly looked at the phone display which read "Canadian Cancer Society." I told Karen that I would call her right back. Thinking that it was my oncologist, I answered the incoming call only to hear a man's voice: "Hello, I'm calling from the Canadian Cancer Society. Can we count on you to canvas your neighbours in April to raise much needed funds for cancer research? It would just take..." "No," I replied. In that crazy-making telemarketer way, he continued with his spiel as if I had not just given him my response. "...a few hours of your time and...." "I have metastatic cancer and I said NO!" and with that he thanked me and wished me a nice day.

I grinned thinking about the tremendous comedic timing of that call. Last summer after my surgery, as I clawed my way back to health or at least the experience of healthy in a living-with-mets way, there were hilariously absurd things happening to me on a daily basis. Kelly and I would often be hysterical talking about them and we concluded that "you just can't make shit up this good," that real life is truly funnier than anything a novelist could dream up. But I digress.

I called Karen B. back and she said that I could go in right away to the Cancer Agency to have the procedure or they could find me a time in the morning and then I received a call from my oncologist, Karen G, saying that they couldn't actually fit me in the next day and that I should come in right away and they could do it. I called Charlotte and Zack's godmother Laura and she and her wonderful husband Tom said that they would be right over to hang out with the kids, get them fed, sit on them 'til their homework was done and off I went.

By the time I arrived it was almost 5:30pm. The normally teeming-with-people building was practically deserted. I went up to the 5th floor as directed and met with the doctor who was going to do the procedure, thanking him for staying late to do it. All went well with the fluid draw. The last step was to have a chest x-ray to make sure my lung hadn't collapsed. They said that x-ray would be ready for me in about 15 minutes and that I could go wait in the lounge. by the time I went to x-ray it was about 7:30pm. There was a young woman sitting at the desk in the dark. I apologized profusely for causing her to stay so late. "Oh, don't worry about it, " she said, "I just came back."

So what's the take-away from all of this? Sure, our medical system is structurally flawed but it is chock-full of fantastically caring and competent doctors and nurses, technicians and assistants. I am in good hands and I also squeak real good.

Chemo Grrl's Mission About to Commence*

Chemo Grrl--with super healthy-cell protective powers--is set to embark on her mission to the underworld. I'm wait-listed to begin chemo as early as Wednesday, January 28th. I will receive 12-24 hours notice of my first treatment and then will receive an as-yet-undetermined number of weekly doses.

I'm attaching an audio interview of a fellow named Mitchell May whose story of recovering from a devastating car accident is the single-most inspiring story that I have ever heard. It is 53:30 minutes profoundly well-spent. It makes you believe that not only the improbable, but the impossible is, possible. It is a doubt-buster extraordinaire. I'm going to listen to it while the Taxol enters my system, just to make sure that my body/mind is on-board with the kill-the-cancer-but-not-the-body program: http://www.synergy-co.com/audio/NewDimensions.WMA

*A huge thank you to Chris for giving me the okay to post the image of his fabulous super heroine "Chemo Girl." Chemo Girl is TM & Copyright Chris Yambar & A Way With Words Foundation 2009. For more info, click on: http://www.lifemaxxhq.org/. With the desire to respect trademark and add my own touch, I have put the slightly fiestier "grr" into the spelling of my personal super heroine.

In and Through the Body

Up until the cancer conundrum began ten years ago, I had always been absurdly healthy. My one hospital stay was when I was born. I sailed through my two pregnancies without even a split second of morning sickness, heartburn or swollen ankles. My kids were both born at home, brilliantly healthy.


I remember having a conversation with my mentor, Lalitha, about that years ago. She said that that was a good thing because in the Western Baul lineage-- spiritual work is pursued "in and through the body." She proceeded to tell me wild and wonderful stories of people's bodies being "on the line" as they pursued their investigations of the unknown.


It never occurred to me--that day or any other day--that part of my evolution as a human being might involve having body bits removed. It did not feel like a spiritual experience to stop nursing my daughter in order to have a breast biopsy, followed up quickly by a lumpectomy, a mastectomy and an oopherectomy. It was a truly terrifying time. My kids had just turned three and five. On top of all the surgeries I had radiation to the chest wall as the cancer was locally-advanced and had invaded the chest wall. I was given a 50% chance of survival. As an aside, "survival" in the world of oncology is a time frame of five years. Needless to say, I did not feel reassured by those stats. It took me three or four years to really start to feel well. The hardest thing to overcome was having my ovaries removed and being surgically thrown into menopause. I had been warned that the side effects were more brutal than chemo but I also believed that it would be worth it...that it could save my life to radically reduce the amount of estrogen that my body could produce. The fabulous thing is that I did overcome it. My body adapted and I was healthy and happy once again.

One of the things that I did to recontexualize my experience was to have a kick-ass tattoo of a yogini inked over my mastectomy scar--a not-so charming railroad track of staples that were used to join the tissue back together. I also discovered that there is an ideal pursued in many Eastern traditions of union between the divine masculine and the divine feminine--a balance of the energies of shiva and shakti. Imagine my surprise when I discovered that in art--be it paintings or bronze, this deity--Ardhanarishvara--is always depicted as half man/half woman and that the male side is the right side and the female side is the left. It didn't make me feel any closer to enlightenment to discover that my body now had exactly that form but it does intrigue me and--on lucky days--inspires me.

I had my annual follow-up with my oncologist in May 2008 and casually mentioned a little cough I'd been having (slightly tearfully which I guess means I actually knew what was up) and on the spot she had me go up for a chest x-ray just to rule out any recurrence. She said that I could come back with the x-rays and see her again. I have mentioned how fabulous she is, right?

The chest-x-ray indicated that there was a recurrence and a CT Scan was ordered to confirm. Not that there is a good time to get a cancer recurrence but this was definitely not good timing. My son was moving back to Canada to live with me and his sister after 3 1/2 years of living primarily with his Dad. I had a huge jewellery show coming up. I was basically asymptomatic so I decided just to tell a few of my intimates, make my diet sparklingly clean, start seeing a naturopath who specializes in cancer, up my exercise, receive more acupuncture treatments and hang tough.

Just days prior to my son Zack arriving in Vancouver I ended up in the Emergency with what turned out to be a very dangerous amount of fluid around my heart. I had it drained and hightailed it out of there as quickly as I could to get ready for my son. I went to see my oncologist the day before Zack was due to arrive and she took one look at me and sent me upstairs for a chest x-ray and then gave me the bad news that I needed to be admitted into the hospital to have an operation to prevent the fluid from building up again around the heart. I was in the hospital for 8 days and left 12 pounds lighter and feeling like a little, old granny with advanced heart disease. I thought that that was it, that I would never be able to ride by bike on the hills near Spanish Banks or up at Whistler. My friends and my kids were terrifically supportive and little by little I regained my strength and stamina to the point that in two short months I was back cycling up steep hills. I was insanely grateful for my body's strength and stamina.

My buddies have been reminding me of all of this as I await the chemo assault. I have an incredibly strong constitution--notwithstanding the rather paradoxical fact that my body is trying to kill itself--and I can and will get through this latest in-and-through-the-body opportunity. My aim, of course, is to do more than just survive chemo. My aim is to actually eke out some kind of insight-rich experience . That said, I forgive myself in advance if I just manage to endure it with a minimum of whining and poor-me-ing.

Internet Intimacy

Depending on how your mind works, Internet Intimacy either sounds rather racy or like an oxymoron. Given that my kids and Mom read this blog sometimes, I'm planning on keeping things relatively tame on the racy front. What I wanted to talk about was my experience of starting this blog. I started it on a whim last weekend. Basically I just wanted to write a bit about my decision to do chemo--a pretty momentous decision for me given how opposed I had been to doing it during Round 1 of my cancer adventure. The reason I decided to start a blog is that I wanted my friends to know how I was doing and what was up with me but I knew that I wouldn't always have the time to do that either by individual phone calls or emails.

My experience so far is that by giving people access to me and my process via my blog, I am receiving way more support and good wishes than I would be otherwise. Friends, close and not-as-close, can know for sure that I do not want my privacy respected, that I do want contact, that I do want them to be involved.

I am a big believer in the power of good wishes--those of a religious bent would say prayer--but my big fat opinion is that you don't have to believe in God to be caring, kind and compassionate and you don't have to believe in God to be able to wish someone well from afar and actually be able to lighten their load by doing so. Not that it's not a good or even wonderful thing to believe in God/Goddess/the Divine/the Universe, I don't mean that at all. It's just that I happen to think that non-believer's good wishes count as much as believer's prayers and I am wildly appreciative of it all.

I know that it's still early days, that I haven't begun chemo yet, that I am still strong and appear healthy even though I have millions of cells that are behaving really badly. That said, I'm thoroughly enjoying writing this blog. I'm completely touched by people's comments on the blog and their private emails to me. Thank you. Also, just so you know, I love, love, love having "followers." Does that make me a raving egomaniac? Will it go to my head and I'll grow a beard, get a bible and start preaching at the corner or Granville and Robson? I give advance permission for an intervention if that occurs but frankly it's more likely that I'll need an intervention from buying any more boots from the Fluevog that just so happens to be in the same block.

The Mind: A Fabulous and Fearsome Thing to Watch

I was jarred awake. Mind still thick and groggy from what clearly was not a lengthy enough time passage from last night's lights out. Something was terribly wrong. I did a body scan. Was it the fact that my breathing is already a bit crackly and wheezy even though I just had fluid drained from my lungs on Monday? No. Was it the pressure building from still-too-much-but-not-enough-to-do-anything-about-it amount of fluid in my abdomen? No. Then I remembered,the poorly timed--i.e. just before bed--research that I had done about the chemo that I'm going to be taking as and when I get my start date (another blog, another day). Yes. The "problem" as it so often is was with the mind.

I'll speed-reverse back to the beginning of the day to fill you in. As always, before I go to appointments at the Cancer Agency, I spent a bit of time thinking about what I wanted to wear. My goal over the years is to not look like someone who is sick and has cancer but today called for something else--the inaugural wearing of my new hat--a Solstice gift from Kelly. I even managed amidst the morning mayhem to email Kelly the picture so that she could participate vicariously.

Kids off to school, I set off for my double-header day at the Agency. An IV of Pamidronate to keep my bones happy and an appointment with my oncologist. I had my usual lucky parking karma and as I plugged the meter I met the gaze of a middle-aged guy who had just navigated himself from car to wheelchair and who clearly was headed to the same location as I was. He took one look at my hat and was transformed from a crouched-over man mired in the challenges he was facing to a vibrantly alive, handsome guy. He flashed me a mega-watt smile which I did my best to return.

"This hat has seriously fun possibilities," I decided as I walked--with a bit of a jaunt--into the Clinic. First stop, top floor to the chemo and IV zone. I had been here once before and had been completely traumatized by the experience. In maybe a dozen rooms, all with their doors open, people in varying degrees of health, receive their medications or blood transfusions. Some people are clearly very, very ill and in pain. It is hard to see and harder still not to take on some of their suffering. The first time I asked to have my chair turned around so that I could look out over False Creek and the North Shore mountains rather than at my room-mates. This time though I was better prepared: water, green tea, rescue remedy and an IPOD chock-full of the latest "Q" podcasts and "The Daily Show." My room-mates were very pleasant...a chatty Brit who had a friend along and a woman who was clearly not feeling that well. An uneventful, even restful 90 minutes were spent, the last 25 of which with me trying to stifle my giggles as I watched my comedic hero, Jon Stewart.

So why was the first experience on the chemo floor so intense that my oncologist put me on oral pills so that I didn't need to have monthly IV's and then today's experience be so different? It's still the same place, still full of very ill people. The only thing that has changed is me or I should say, my state of mind. And of course with a different state of mind I noticed different things, how lovely all of the nurses were, including the one whom I asked to do some sleuthing about why I was not yet showing up in their system with a chemo start date and the lovely way that both my room-mates looked me in the eye as I left and wished me "Good Luck."

I am choosing that I want to have the IV and I have chosen that I want to have the chemo. It is no longer the boogey-man in the closet, the horror of horrors. I have changed my mind and because of that my experience is/will be/could be completely different.

Next stop, second floor, the large waiting room for patients with appointments to see their medical oncologists. Again, for years, I found being in this room to be traumatic. Almost always I would be the youngest person in the waiting room and I would sit therethinking--amidst a crowd of people with a wide array of creative attempts to cover up their chemo-induced baldness--"I don't belong here. I don't belong here. I don't belong here." Today though I just walk in, sit down and pull out my knitting. Klick-klack-klick-klack. I've just discovered that pulling out knitting is just as effective as lighting a cigarette at a busstop (just for the record I haven't smoked in over 20 years) and sure enough mid-first row of knit one, purl one, I was called in.

Karen came in after a bit of a lag and commented on how well I was looking. I had just seen her 5 days before and as well as having the chemo conversation with me she had put me on thyroid medication as my blood work indicated that it was really not working properly and that this would at least partially explain why I had been feeling really blue and low-energy in the fall. I agreed that I was feeling really good. "I'm at my best for some reason when I face adversity. It get's me all feisty and full-of-life." She asked me if I was feeling creative and thinking to the starting of this blog and the jewellery designing I've been doing and planning and, I said "Yes." We talked about how artists often describe happy events such as a new love relationship as being problematic for their art. We laughed at how messed up that it is and I said with my audaciously hopeful state of mind that perhaps it was possible to hang onto the creativity without needing the angst and that I looked forward to investigating that possibility post-chemo.

Karen went on to say that she had me on the wait-list as urgent but that she still did not know when I could start. I pulled out my list of questions and reviewed with her what she had given me as my chemo options. I had originally chosen one drug--Taxotere--to be administered every three weeks but in doing some more research wondered if I should reconsider and take a sister drug--Taxol--once every week. I told her that I was almost as scared of the steroid drug that is administered prior to the chemo to try to alleviate allergic reactions, nausea and inflammation. The contra-indications read like a carbon copy of my family medical history and I was concerned. Karen said that the efficacy of the two are essentially identical. Some people find that coming in less often preferable she explained but the up side of the weekly treatments is that they are less toxic as you receive a smaller dose and therefore don't have as strong side effects. When I added my concerns about taking a lot of steroid medication she explained that with the weekly dose I would take much less and we agreed that was the way to go. I asked with the weekly dose when I would feel the worst and she said about Day 2 or 3 but and started to say something else. Mid-sentence she stopped herself and as she left the room that I was going to do great. I knew that she was helping me to manage my mind and I replied that good as that sounds that I needed to be prepared for anything and to line up support just in case.

The rest of the day was happy and uneventful. As I've been doing lately I got to bed as quickly as I could, the kids joining me to hang out for a while and me being the first one to go to sleep...except that I didn't. I thought to myself...I'll just take a quick peek on the computer and read up on Taxol so that I'm prepared for any side effects there might be.

I ended up on a site where women who have taken Taxol have posted their experiences with the drug, here's a glimpse:

"I would start feeling sick the day after I got it, and this sick feeling would last about 5 days, and then I would recover day 6 and 7, and then it was time for the next dose. I got severe fatigue that felt like a horrible flu, very serious weakness, digestion problems, acid reflux, diarrhea, lost menstrual cycles after 4 weeks, some mild tinging in toes and hands. Some itching. At the end, serious muscle and joint stiffness - that felt weird and annoying. A lot of taste distortion and lack of appetite sometimes."

"I have not had any of the normal side effects - no nausea, fatigue, body aches. I work 32+ hrs. a week (75% on my feet)and have not missed a day of work. I take myself to and from treatments. My treatment effectiveness is being monitored by CT scans and CA125 blood tests for tumor markers. Both show my tumors are rapidly shrinking. I was determined not to let Taxol get the better of me."

"Numbness in feet and hands, joint pain, short term memory loss, confusion, can't add or subtract although I was a math whiz before Taxol. I was sick. After a year of being off Taxol, I still have numb feet and hands, confusion, no short term memory, can't talk many days, I feel like a complete idiot. Taxol was a high price to pay for my life."

"I am now 2-1/2 months into treatment. Side effects are predictable. Day 2,3,4 post treatment some fatique, loss of hair, including nasal lining, I always had osteoarthritis so I can not attribute joint & muscle pain to taxol. Taxol was prescibed as pallative, but I now am almost normal, scan show the cancer has stopped progressing and bone mass in regenerating."

"I suppose since Taxol saved my life I have that to be thankful for, but the side effects are devastating. My neuropathy is getting worse as time goes on and I'm 5 months post chemo. I have had to change positions at my job to a desk job from a job that I was on my feet all day. I'm 45 and feel like a 90 yr old woman. My quality of life sucks!!!!

"The side effects quite predictable.Day one and 2 fine, symptoms appeared on day 3 lasting 4 to 5 days. Numbness in feet,hands constantly.Each session it seems more pronounced.Red face on day 2 and body rash for a few days.A HUGE amount of pain throughout body FOR A GOOD 4 TO 5 DAYS.Knees and hands of late have permanent discomfort.Joints in hands feel arthritic and are swollen. My CA125 LEVELS HAVE DROPPED PROMISINGLY WELL.Have had 6 Taxol sessions every 3 weeks and started another set of 3 every 4 weeks.Last one in 3 weeks time.Hair loss, but fabulous wigs to be found.Eyebrow and eyelash loss.Chest pains on 8th dose of Taxol.Nauseous each time but abated with drugs,Tastes different.Tiredness.Have found excercise( walking)as soon after as possible improves my condition. Wonder if I will ever get feeling in my extremities again?"

"Mostly just a little tired the day of and after taking Taxol. Very little nausea. At the end of the treatments however, I experienced severe leg cramps, and neuropathy in hands and feet."

"Fatigue was the only important one; one day mostly in bed for each weekly cycle. My hair fell out, but who cares? None of the nausea/vomiting I've experienced with other chemo drugs. No peripheral neuropathy. Only very mild and occasional joint pain."

Clearly this was not the best thing to ingest right before bed. It explains the sudden wake up in the middle of the night. It makes me feel shaky. How can a jewellery designer work with numb fingers? I was psyched up for whatever lousy symptoms I might have during treatment but symptoms that keep getting worse after treatment? I hadn't even contemplated that. Can I just be like the woman who decided not to let Taxol get the better of her and sail through? Clearly that's the mind-set of my oncologist and naturopath. Is it that easy? Here I am ...writing in the middle of the night...with the rest of the household sound asleep...all alone with my mind. How do I want to frame this foray into the unknown? Will I apply the principles that I have studied and practiced with my spiritual mentor Lalitha for over a dozen years? Will I just observe what my mind is wanting to do with these women's accounts and not get hooked into what-if hysteria? Will I give in to fear? Will I remember how resourceful I am at finding the help I need when I need it? Will I stop these machinations, turn out the light and go back to sleep for a couple hours so that I'm not a complete wreck for the rest of the day? Yes.

I just have one last thing to say: Fuck Cancer.

Straight Talk About Death. Chard In My Son's Sandwich, Not So Much.

Our friend Tom came by this morning to help create a guest room/rec room in the basement. He arrived just after my 13-year-old son Zack had asked whether there would be enough money available whenever I might die for Sadie to be able to continue her raw food diet as he wasn't sure he'd be able to make enough money working at Tim Horton's to pay for her food. I was just reassuring him when Tom walked in the room and I filled him in on the topic of conversation.

Tom said something like: "Wow, I'm a bit startled that you guys are talking about you dying in that way but I think that it's great." I responded by saying that I figure that dying is a part of living and then the kids and I started cracking wise with our pet-peeve euphemisms...I said that I certainly had no plans to get "lost" or "pass away." That I would just die. Be dead.

The pre-school bustle continued and I began to make Zack a sandwich while Charlotte, his 11-year-old sister, grumbled that she didn't understand why she had to make her own lunch. Right or wrong, it has something to do with the fact that Zack generally wouldn't take the time and would starve or eat junk food if I didn't. But I digress.

Tom sat at a kitchen stool while I sliced a large piece of focaccia, smeared mayo on one side and mustard on the other, lay down organic turkey, then sliced tomatoes and then ruby chard and began to wrap it up. "I'm impressed Zack!" commented Tom on observing me put chard into my teenage son's sandwich. I desperately tried to catch Tom's eye to cease and desist but it was too late.

"What!" exclaimed Zack. "You put chard in my sandwich! Oh my God Mom!" his eyes rolling around and practically popping out of his head and onto the kitchen floor. Tom made an earnest attempt to mitigate the damage but finally gave up, commenting that given how forthcoming I was about death and dying it hadn't occurred to him that I might surreptitiously be sneaking extra nutrients into my son's lunch. "That's because your child is still three months away from being born," I replied.

Straight talk about death. Chard in Zack's sandwich, not so much.

The Audacity of Hope, The Power of Kindness

It is the eve of Barack Obama's inauguration and the mood on both sides of the border is palpably celebratory and hopeful. The collective conscious mood of doom and gloom resulting from the churning of the 24/7 media machine: wars, genocide, starvation, corruption, disease, torture, environmental idiocy and economic free-fall that is taking a such a toll on our psyches has shifted as we put aside our fears, doubts and cynicism for at least a day or two. One giant combined breath of hope with fingers crossed for good luck. "Yes we can," Obama said the night of the New Hampshire primary and perhaps enough of us are are willing to become involved in our community that truly we can--together--make the seemingly impossible, possible.

In my little middle-class, middle-age microcosm, I too am experiencing the audacity of hope, strengthened faith and profound gratitude at the outpouring of goodwill, prayers and support for my kids and me. I am thunderstruck by the generosity of my intimates and their willingness to re-jig their very busy, already full-to-the-brim lives in order to do whatever it takes, whenever it takes and however long it takes to support us.

I can never, ever, ever again contemplate for a split-second the notion that I am not dearly loved and closely held. The power of their kindness is the fuel that will see me through whatever challenges lay ahead.

I am humbled. I am elated. I am not alone.

The Chemo Conversation

January 16, 2009

Today at 9:20 am, I had an appointment with my oncologist to review the results of my latest CT Scan and bloodwork. I had last seen her a month ago and we had agreed that I would take a month off--go have fun with my kids, play in the snow and enjoy life. I had done just that but was now feeling the effects of increasing fluid in my lungs and a clear knowing that I was going to be having the long-awaited and rejected chemo conversation with her.

Just to back-track for a moment: I was first diagnosed with locally-advanced breast cancer in 2000. I had all sorts of treatments--allopathic and complementary. Really you could say that I had done everything except that is for chemo.

Okay, so back to today. Karen was her usual caring, compassionate and no-nonsense self. The tumour markers were up and there was disease progression. She recommended chemo and she presented a couple of different options. I asked her what she would expect my prognosis to be if I did nothing and I did not like the answer she gave me though it would make for a good book title--actually it's already the title of a book.

I told her that my highest priority is to live and die with dignity and that my greatest fear is to undergo treatments that rob me of that ability. We agreed that I would investigate the chemo option further by talking my trusted coterie of heathcare providers and spiritual inspirers and let her know.

My naturopath agreed that I needed chemo and had all sorts of great arguments for why I should do it: the best time to do chemo is when the cancer is really active, never having done chemo increased my chance of a response (something my oncologist had also said), the chemo could act as a catalyst to make all of the complementary treatments work even better, there were all sorts of ways to mitigate the unsavoury symptoms of chemo etc. etc. etc.

I spoke with to my counsellor friend who has devoted several decades to supporting people living with and dying from cancer. Knowing how much quality of live means to me, she pointed out that I could embark on chemo one step at a time, assessing at each phase whether I wished to continue.

I spoke to my spiritual mentor. I told her that as far I could tell I wasn't scared of dying (though I definitely have some apprehension about pain and suffering) and that I don't really believe that choosing one treatment over another is what will prolong my life. The oncologist had said that she didn't want me to end up having regrets at the end of my life and that she wanted me to be there for my kids. I have the same desires though perhaps not the same ideas of how to accomplish that. My mentor mostly listened as I worked my way through my biases.

As I spent the afternoon taking in all this input and trying to digest and assimilate the situation I was in and the choices I was facing I started to think about how rigid my point-of-view is to allopathic medicine. It struck me as funny that I had never before considered that one could "embrace the unknown" via cyto-toxic therapies. My oncologist had suggested that this was a possibility but it took me a couple of hours to be able to even grokk that what she was talking about never mind contemplate this notion. There's also the desire to be able to tell my kids that I did "everything I could" and for them not to be vulnerable to conventionally-minded well-wishers who might at some point indicate to them that it sure was too bad that I had never done chemo. Finally, I got to thinking that doing chemo would be a good way to practice dying with dignity. I may be pleasantly surprised but I have the sense that there will be times during chemo that my body will feel like it is dying and I will get to see what my mental response is and get to practice having the response that I wish to have down the road.

So I decided "Yes" and am waiting to hear when I will begin.