Thursday, May 27, 2010

Sharing

I don't mind sharing - drinks, food, space, thoughts, whatever. I have always seen myself as very generous - with my time, with my money, with my material possessions (presuming that I have something worthy to use/borrow/take). As a kid I was completely willing to share anything with my sister and hoped that my willingness to share would translate into her being willing to share her prized (or not so prized) possessions with me. But, alas, she was never interested in any of my things and the answer was always "no" to whether I could use her Barbie or wear one of her shirts. That didn't necessarily stop me from using the item anyway. Sorry, Eve. :-)

The last several months have proven to have more "share requirements" than I'm used to. I've had to share my husband...a lot.

In the last 15 days, I've talked, really talked, with my husband maybe two times. It's been somewhat unusual given that his older brother (who we haven't seen for 3 years) and 2 of his brother's 3 kids (both of whom had NEVER been to Texas before) were in the area last week. And we spent a long weekend down at the beach in Galveston. And my parents have been here for a visit, including the weekend in Galveston.

I will (very willingly) continue to share Josh as much as possible. He's got lots of fans who want his time and attention, all which help him stay positive and happy. So any time you want to take him to lunch, come visit, or stay with us for a while, do it.

Perspective

I'm convinced that Josh's mind-body connection is very strong (much more so than maybe most people, but certainly mine), often to detrimental effects. Stresses in his life are likely to be born out in physical symptoms. Many years ago, maybe when he was in his late 20s or early 30s, he had an episode of shingles. It's an annoying, very painful, usually pretty temporary condition that is typically seen in people older than 60. And now he has a nasty noma he's fighting against.

In the fight, the mind-body connection now shows up in psychosomatic symptoms. The day before the second round treatment, Josh woke up in the early morning with a metallic task in his mouth - something that hadn't appeared until a day or two after the first round. During our last drive down to Houston for the third round treatment just two weeks ago, Josh started feeling the uncomfortableness in his digestive system that usually appears as the chemotherapy is starting and continues for several days afterward. The mere anticipation of the chemotherapy affects Josh significantly. During our visit to Galveston, I took a moment to talk with Josh's mom about schedule coordination during the week of Josh's fourth round. He overheard and insisted we stop because just the thought of another round disturbed him.

And it's not just the negative thoughts that have power over Josh's body condition...it's the positive ones, too. As Josh laid in the bed at MD Anderson getting the first 2 hours of simply saline drip as part of the first round of treatment (to flush out his kidneys), he suddenly felt really good physically. His aches and pains were virtually gone; he was able to lie in the bed without any discomfort - something he hadn't been able to do for several months, even on a significant number of pain medications. Simply knowing that he was finally getting treatment after many weeks of waiting relaxed him. Certainly a demonstration of his strong mind-body connection, this time a very positive one.

A good friend of mine recently caught up with these blog posts and offered a bit of sage advice that I hope Josh will take to heart: change your perspective.

Throughout Josh's blog posts here, he's mentioned several times the "poison" that they put into his body and how bad it makes him feel afterward.
"nasty stuff it is" Day 5???, April 5, 2010

"I am about to have a bunch of poison pumped into my bloodstream voluntarily and it is going to make me feel like crap for the next 4-6 days" Round 2, April 21, 2010

"two poisons they inject into my veins every three weeks" No Pain, No Gain, April 30, 2010
My friend has wisely counseled that Josh frame the chemotherapy in his mind as healing, a great thing, a great investment of time. Visualize during the 7 hours the power of the healing medicine pumping through his body, creating a healthy system, fighting and destroying that noma. Start looking forward to it.

As Isaac (Josh's younger "doctor" brother) keeps reminding me, there will be physical symptoms that Josh can't just will away with the power of his mind. But a change in perspective, a focus on the positive, certainly could be a very powerful tool to help minimize the physical aftereffects and maybe eliminate the physical symptoms Josh has experienced before the treatment.

Monday, May 24, 2010

Relationships

It is Monday evening and I am finally alone. Time for a little down time and to reflect on the whirlwind of activity that took place over the past couple of days. I am coming off the tail end of a weekend mini-vacation that included 2.5 days and 2 nights with 14 other family members. This included 2 brothers (one of which I have not seen for 3 years) and some form of representation from their immediate families, parents, my immediate family, my in-laws, our foreign exchange student from Germany and two dogs. We treked down to Galveston to spend 2 days on the beach and some quality bonding time. I know, it sounds like it has all the ingredients for a great plot for a movie. I can just see it. Let's take 15 family members and send them on vacation together, make them bunk together in 3 condo units, eat all the meals together, and give them lots of time to talk and mix it up. Let the dysfunctional hilarities begin!  But it actually went quite well. Sure, trying to get 15 people to all move in a common direction can sometimes be akin to hearding cats, but all in all I think everybody had a really good time. I know I did.

That brings me to my topic for this entry: relationships. Those of you who have been following this blog from the beginning may remember that I wrote about this topic very early on, but I coming off the weekend I just had I felt the need to write about it again. Relationships are so important. Family is so important. I wouldn't trade anything for the memories that I just made down in Galveston. I truly love all those people and that just makes life all that much sweeter, all that much fuller.

I realize that this sounds cliche, and I am not just saying it because I have stage 4 cancer, but life is just too short to let issues come between you and the people you love. For some reason or another, everybody seems to like me. I am not bragging. I am just stating something that I have observed over the span of my life. I really don't have any rifts between me and any family members that I know of. If I am wrong on that then please call me up. I think part of the reason is that because I don't like it when people are mad at me; I will put forth the effort to correct the situation. I am not saying that I will give up an arguement and say I am wrong when I am not. However, I will work with the person and try to get past whatever is causing the friction. And I think that is the key - the desire and the willingness to work at correcting a problem. The relationship is the most important thing here. However, nothing can happen until the communication channels are opened up and somebody has to make that first move. Families are messy and sometimes the rifts seem insurmountable. But again, life is too short, and nothing is impossible. If I didn't believe that then I might as well stop taking the chemo right now. But then I would miss out on all the great family memories that are yet to come and that is something I am not willing to do.

Whatever the reasons that are keeping you from calling that person in your life that you just can't see eye to eye with, try to work through them. Open the channels of communication. I would like to say that to a couple of people I know, but I am not going to call them out publicly . Hopefully, they are so moved by my eloquent writing and in-your-face honesty about such an important topic, that they will feel so compelled to pick up the phone and call that estranged family member. Imagine all the great family memories you could be creating.

Thursday, May 20, 2010

It's nice to be me again

This last go-around with chemo was my third dance with the nasty chemical cocktail and you think that having gone through it twice already, I would have learned by now. I am referring to being aware of how I am going to feel and to my physical status the week following my chemo treatment. I am going to attempt to describe it to those who have never experienced it.

The chemo that pulses through my veins literally puts me into a drug-induced stupor or almost even a trance. Other than irratibility, I feel little emotion. No joy, no happiness. While I might have one coherent thought at a time, putting together a chain of lucid thoughts is a no-go. I try to work, but cannot focus long enough to really accomplish anything of substance. And that just adds to the frustration. I rotate from room to room in the house until each place becomes uncomfortable. And I can't go somewhere because driving for me would be dangerous. Movies are bland and provide little repreive other than to pass the time. I realize that is literally what I am doing - passing time.

And forget what you see in the movies where the hero, after being injected with some serum, manages to will himself to focus and overcome the side effects long enough to break his/her bonds and defeat the bad guy. No amount of adrenaline or will power can lift the veil that clouds my whole person.

I am passing time. And it is only the passing of time that offers any solice that this too shall pass. This go around it happened about 4am while I was sitting on our living room couch, unable to sleep. Even though it was too early in the morning, the sun came out in my world and I experienced an emotion that had only been gone for a week but felt so much longer: happiness. When that chemo cloud lifts, it is like night and day. Lucidity and clarity return, but most of all I like the happiness. To experience the full range of emotions instead of just the dark side.

I realize that for the week after chemo that the person in the mirror "isn't me" and that there is nothing I can do about it. But it sure feels good to have that cloud roll back and be me again.

Wednesday, May 19, 2010

Integrative medicine

[For all of Josh's fans out there, Josh told me today he'd blog tonight or early tomorrow morning - he's on the road to Houston to greet his older brother and kids who are here from the Seattle area. Stay tuned for his update as he's come of the fog...]

With Josh's noma, I'm reading articles that previously wouldn't have piqued my interest. As we explored going to MD Anderson back in March, one of the first things that Josh's brother brought to our attention and was further solidified when we met the team that would be focused on Josh's care (which, by the way, we haven't seen at all after the first visit, which is somewhat disappointing that they're more reactive than proactive, but understandable given the volume of patients they're working with) was the concept of integrative medicine.

In a recent article in CNN health, we learn that health care is slowly moving away from the "break-fix" mentality and more into whole-person solutions that go beyond traditional Western medicine. Certainly, the advances in diagnostics, medicines, techniques, etc., have significantly contributed to more lives saved, extended or made otherwise more comfortable. But an increase in the acceptance and offering of Eastern modalities purports to serve the whole being, not just the physical maladies.

MD Anderson has staff dedicated to integrative medicine, entire areas in both cancer center complexes for classes, acupuncture, relaxation massage and the like. Yet another reason we're terrifically happy and blessed to have Josh being treated at MD Anderson. He's under the care of an incredibly smart and passionate doctor (who is interestingly wary of the "alternative therapies" aforementioned, warning against "going off the reservation"), but Josh has the desire and guts to try all kinds of other methods that might have significant impact.

Maybe it's coincidence, but...
Up until this morning, Josh hasn't been himself thanks to chemo-head (or chemo-brain or cobwebs or fog or whatever you want to call the strange lack of focus and lack of positive emotion that results from chemo treatment for a lot of people). Last night the kids and I used Qi Gong techniques (which Josh and I learned at an MD Anderson class before his second round) on Josh. Picture him standing in the middle of the three of us as we each imagine we have 18-inch fingernails that we rake slowly through this body from top to bottom and then shake out the bad stuff into the ground, over and over for a few minutes. And this morning he's like a ray of sunshine - cheerily greeting me and talkative as we drive to and from the gym, all psyched up for the trip to Houston and then Galveston.

I, for one, believe in the power of whole-body solutions.

Tuesday, May 18, 2010

Day 5

It's already day 5 and Josh still isn't back to his "normal" self. He's not sleeping very well and is struggling a bit longer with the chemo-head this time. But despite this, he's continuing to push himself physically.

  • On Saturday, he helped Ethan with a project for Science (create an aluminum can crusher out of limited supplies that crushes speedily) by routing grooves:


  • On Sunday, he made it through church, although several times when I looked over, he had his eyes closed.
  • Yesterday he took the kids to their school awards ceremony while I was out of town for work. Both he and kids said that it was actually a case of enduring the ceremony that recognized individually many hundreds of kids in 6th through 8th grade.
  • He's worked out at the gym for a couple of the days and has diligently taken walks around the block (including one at 4am when he couldn't go back to sleep).
  • He's eating good meals.
Keep plugging away, Josh, and remember that you're nearly halfway done with the 6 chemo treatments. It will all be worth it!

Friday, May 14, 2010

Day after round three

Well, if you read Anna's blog before this one you heard the good news. My tumors reduced in size by 50 percent! This is indeed good news. Only twenty percent of people have this kind of response. Turns out my little pain experiment appears to be a success.

So I asked the doc given that it goes down 50% after just two rounds then after completing the six rounds he wants to go, logically the tumors should go away, right? Not so. He said that they aren't clever enough yet to totally get rid of the tumors. I just want to say that I am out to prove him wrong. I am emboldened by this first set of results and through prayer, diet, and exercise on my end, and the chemo on his end, I WILL BEAT MY NOMA!

Also wanted to give another big shout out to my family for all their love and support. They were there with me again yesterday, crowding up the little patient room, waiting with baited breath to hear what the doc had to say about the scan results. Especially want to again thank my little bro. Talking to the nurse that was administering my chemo, she shared that her father had to wait 3 months to get into MD Anderson and that was very typical. Through my little bro's connections, I got in within a couple of weeks, and part of that delay was because the doc was on vacation. Thanks again, bro!!!

Thursday, May 13, 2010

Percentages

47%
How far Josh is through his first chemotherapy regimen of six 7-hour stints of toxins pumped through his body. On the drive down to Houston this time, he started feeling the discomfort in his stomach and esophagus that he gets after chemo. Psychosomatic.

57%
How far Josh is through this particular stint of chemo. He's lying in Treatment Room 15 (2nd floor near elevator B) right now watching a Robin Williams stand up comedy video with his brother. His parents were here for the doctor's visit today and hung out for the first couple hours of the chemo. I will drive Josh home to Murphy when he's done at around 1am so that he can deal with the worst of the after-effects there.

50%
How much Josh's tumors in his chest have reduced in size since his x-rays and scans 6 weeks ago, after only two stints of chemo.

20%
Percentage of people in Josh's situation who see such a good response from only two stints of chemo, per his doctor. Thumbs up!

Monday, May 10, 2010

Is it worth it?

I was reading my brother's latest blog post and once again find it interesting to hear others talk about my situation. It is interesting to hear his take on what I am going through and I am flattered to hear how brave he thinks I am being. His entry made me think back to when I was sitting in the appointment room as we met with the MD Anderson doc for the first time. The doc went over my options with me and I distinctly remember option #4. He said that if I felt like I didn't want to start chemo or if, after receiving chemo, it all becomes too much for me to handle, then he can put me in a hospice situation and make me as comfortable as I can be. I immediately dismissed that one and haven't thought about it again. Who would give up? My brother states:
He's having the equivalent of the Somme thrown at his body with 4 more waves to come. And I wonder, how many of us would be brave enough to make that exchange.....
(By the way, I had to Google Somme to find out what he meant.) I'll admit that having experienced it twice so far, I do not look forward to chemo. The seven days after are no walk in the park. However, quitting is not an option. I won't even go down that road. To quit would mean certain death. Let me say it again: NOT AN OPTION. But I have not thought of myself as brave in this situation. I am simply doing what I need to do to give myself the best chance of living. Who wouldn't do that? It seems like a natural response.

Thanks bro for thinking I'm brave.

Small world

I'm sure you have said "Wow! Small world..." many a time. Coincidences, eerily similar experiences, smaller degree of separation that you ever thought imaginable, shared moments with people you knew but didn't know how overlapped you are. We had two such moments over the last several days.

Josh and I were out on Saturday afternoon taking down the side of our patio enclosure that we built 4 to 5 years ago (plans are to convert it to a dining room for true interior living space). A neighbor two houses down from us with a daughter that is Ethan's age came by to say hi after learning a few days before that both she and Josh are "partners in crime," fighting their respective nomas. And she's going to the same doctor that Josh started with here in Plano and they're both in between their 2nd and 3rd rounds of chemo. Despite the basic similarities, their fights are much different, especially with how they're affected by the chemotherapy. Josh has a good 5 days of down time, hers is more like 2, but they both have the "not yourself" feeling with the quick-to-snap, unexpected outbursts. Small world.

At Ethan's basketball game on Sunday, the sons of two different families we know were playing on two separate adjacent courts to ours. It gave us a moment to catch up with each of the families and give hugs. Small world.

Friday, May 7, 2010

Anticipation

Throughout Josh's experience with his noma, I've been reminded of my experiences with pregnancy and labor. I see a lot of similarities.

1. There is pain in the process. Lots of it. It's expected, a known.

2. In dealing with the pain, you go inside yourself, focusing on getting through the pain. In my labor to bring Ethan into the world, I spent time rocking in a chair in the room during contractions, completely tuning out anything that Josh said (I did listen to the nurse - selective hearing, I guess). Obviously a quick-fix pain reducer like an epidural (that takes away the "inside yourself" feeling) isn't possible for Josh. He will slug out the bad taste in his mouth, GI issues, nausea, and the I-don't-want-to-do-anything-but-lie-on-the-couch feeling all by himself. Our job is to let him get through it, providing support, massages and food as he's willing/able.

3. As much as they want to, your loved ones can't take away your pain. I understand now the helpless feeling that Josh describes while watching me in pain during labor with our two kids. I want to take away the pain, would gladly trade places with him, but alas.

4. Through the pain, you hope for a positive outcome. For pregnancy and labor: a healthy baby who will turn into a loved, loving and contributing human being. For chemo: the reduction or elimination of cancer.

Right now, Josh is mired in the thoughts of the upcoming 3rd chemo treatment on Thursday (May 13th), knowing that he's going to feel lousy for several days afterward. But we're hoping for a great outcome at the end of the suffering. Prior to the chemo treatment, he gets scans (chest CT, chest, PA & LAT) to see what effect the chemo is having on his noma. We meet with the doctor on Thursday afternoon at 3:30pm to hear the news. If the scans show no improvement or a reduction, then it's chemo as scheduled. If the scans show a worsening of his noma, we go another route.

We're anticipating Josh being in the chemo bed at 4pm on Thursday with the same dose of Cisplatin, Doxetaxel and Zometa as he's had for the other two rounds. But we hope for something even better... The lack of pain and complete stoppage of pain medication for the last two weeks has to be an excellent sign.

Tuesday, May 4, 2010

Death

I have intentionally avoided the deep and dark topics with this blog. Instead, I have used it as a tool to keep friends and family, and any who cares to follow along, familiar with my day-to-day battle with cancer. But it only seems natural that when one discovers that one has stage four cancer that a discussion on the topic of death would logically be in order.

It took burying my son's goldfish this weekend to push me over the edge and attempt to write on this subject. We buried my son's fish of over 3 years in the backyard next to Boo, our beloved cat of over 15 years who passed away in October of last year. My son's tears upon feeling the loss of a loved one strangely and strongly compelled me to write this entry that I have probably avoided. And as of right now I don't know where it will take me.

I remember watching an IMAX film a couple of years ago called Life or something like that. It was about...life. I distinctly remember a line from that movie (here comes my token movie quote)
"From the moment we are born, our bodies are dying"
Death is all around us. Most of us have experienced the despair of losing a loved pet. Others have felt the sting of the passing of a close friend or family member. On that regard I have been mercifully spared. Sure, I have had grandparents pass away. But in reality, I was not close enough to them to feel the full depths of pain that come from losing a loved one. While I have felt the great loss of losing a beloved pet, I can only imagine the depth of emotion that must come from losing a spouse, or a child, or a sibling. Yet that very thing is happening every day all around us. People are losing loved ones all the time. Some die quickly in accidents like the mining accident that has been in the news recently, and for others it is a long drawn out process, like someone afflicted with cancer.

When you have cancer, you become much more aware of all the cancer stories that are going on around you. It is amazing how many people I come into contact with that have a first-hand experience with cancer, meaning either they themselves or somebody close to them has/had cancer. I am on a weekly email prayer chain distribution for a relatively small church and it is frightening how many times the word cancer appears on the list of those asking for prayers. Simply walking into a place like MD Anderson, where all they do is treat people with cancer, and to see how busy it is, you get a taste of how cancer has touched the lives of so many. And cancer doesn't discriminate. Sure there plenty of edlerly there, but there are also a lot of people such as myself and even younger. There are sad stories of lost battles and triumphant stories of overcoming great odds. I prefer the latter.

I am afraid to die. When I first heard that I had cancer and then again each time I got news from the doctor that it is worse than expected, the terror of "I don't want to die" kept ringing in my head. I realize that being a Christ follower and accepting that spending an eternity in heaven should be a source of comfort in times like these, but nontheless I am afraid. The thought of my children growing up without their father and my wife growing old without her husband has brought me to tears on several occasions. That is exactly why I put that picture of my kids above my monitor. A daily reminder to fight this thing like I have never fought for anything ever before. I want to be there when my son graduates from college. I want to walk my daughter down the aisle when she gets married. I want to grow old with my wife. Will I get that opportunity? Only God knows. But I am asking him for that very thing every day.

My dad has a story of a plant nursery in Houston that won't guarantee the plants they sell for a year like Home Depot or Lowe's will. Their answer when asked why is "how can you guarantee a plant when not even human life is guaranteed for a year." There are few guarantees in life. Ironically, death is one of those guarantees. Hopefully just not yet.

Monday, May 3, 2010

Vows

Our church, Chase Oaks, has been in a four-week series about marriage called "Forever. For real?" in which we've covered topics ranging from conflict management to the lure of adultery. On Sunday, at the end of the service, which was the last Sunday in the series, the pastor called all the married couples up to the front to renew their vows.

Josh typically eschews anything that takes him in front of a crowd (even when he's amidst a crowd when going forward) and resisted when I asked him to participate. After some prodding, both from me and from our exchange student, Julia, Josh and I stood up at the front with many other couples, were told to face each other and hold hands. We've never placed much importance on vow renewal and Josh has said, "I meant what I said on our wedding day. I don't need to repeat it."

Then, husbands first, then wives, we said to each other a form of the traditional wedding vows (with a line added in about remaining faithful to each other to emphasize the point of the sermon that morning):

I, Anna, take you Josh, to be my husband, to have and to hold from this day forward, for better or for worse, for richer, for poorer, in sickness and in health, to love and to cherish; from this day forward until death do us part.


Both Josh and I had tears running down our cheeks throughout the vow sharing, made sure we had a longer kiss than our small peck that we managed at our wedding nearly 16 1/2 years ago, and then walked back to our family as they clapped.

Josh and I talked afterward that the experience we shared at the front of the church just then, even though it lasted less than 2 minutes, was one of the most profound and moving moments in our shared lives. We know what those vows mean now...so much more than when we were 21 and 22 years old, one of us freshly out of college and the other with one semester left. We barely knew ourselves, much less each other.

I am with Josh through the worst (diagnosis with a supposedly terminal disease doesn't get much worse) and in sickness, just as I'm there when things are going very well for both of us.

My advice to you: Don't hesitate to step forward and participate in an opportunity in which your first reaction is to run the other way. You never know what impact the experience may have on you.