Good is Good Enough

I got good news from my oncologist on Tuesday. It wasn't great or miraculous news, but it was good. It wasn't what I was expecting though. I was looking forward to a break from chemo and surgery to remove the masses. When this journey started my oncologist recommended six months of chemo and then surgery. My surgeon wanted three months of chemo then surgery. I liked his plan better so that's what I was hoping for. But that is not what we are doing. My mother told me that I may have had my expectations too high. It's possible that's true, but I don't want to lower the bar here. I want to keep expecting great and possibly even miraculous results.  Instead I think I need to reframe my assessment of my progress.

Here is the data. I have a copy of my CT report comparing the pre-chemo CT to the 3-month treatment CT.  I read it. Then re-read it. Then read it while my mom googled medical terms. I think I've got it. The report used the term "markedly reduced" to describe the mass on my liver. My oncologist seemed happy with this. I did the math and found that it has shrunk by about 25% with six treatments. That number sounds good to me. It's still too big for surgery at this point. So we do more chemo and hope for a similar or greater reduction. The lymph node that showed signs of cancer prior to chemo appears clear now. My bladder, uterus, and ovaries "appear unremarkable" which is CT speak for no visible signs of cancer.  All good news.  The cancer we knew of is shrinking and there isn't new cancer popping up. The chemo is working its cytotoxic magic in my body.

Chemo #7 started this week. I should finish up #12 right as Sara gets out of school for the summer. On the morning of chemo #7, I was a big whiny baby about having another three months of this. When Sara whined that she didn't want to get out of bed.  I crawled in bed with her and said "I don't wanna go to chemo.  They're mean to me and make me feel bad."  After a few minutes of mutual whining, we decided we could not live in bed so we got up. I'm quite sure after a 2-3 month break from chemo for surgery, I would be an even bigger baby going back. As my mom and Shawn pointed out we've got momentum behind us. Plus we have a system down for this chemo thing. Day 1 we drop Sara at school, head to McDonalds for a bacon egg and cheese biscuit (high calorie / high protein diet), arrive at the infusion center for my appointment, survey the room for the best seat, get hooked up, recline, podcast, nap, and leave with my pump and fashionable fanny pack. My mom will read, crochet, or go shopping if the waiting room chatter is too annoying. Day 2 is loafing or low effort tasks. Day 3 I finish up by getting unhooked from the pump and sleeping the rest of the day. On Day 4 and 5 I rest a lot and slowly return to normal so I can go back to work on Day 6. And so it will go for five more treatments. 

I'm hoping that I'll be ready for surgery after the 12 treatments are complete. I know I will not be completely done with chemo because I will likely have to do clean up / maintenance chemo to ensure everything is gone. I'm just hoping the biggest chunk is over by mid-May and that my body keeps tolerating it and responding well. 

There is No Road Map

When you are dealing with a serious illness such as cancer, you have to become comfortable with uncertainty.  If you are person who can go with the flow all the time, you will be much saner than me.  I don't like uncertainty.  I plan.  I like my calendar.  I fill in boxes with activities, to do items, appointments, etc. Knowing what comes next is comforting. It helps me sleep at night knowing what the next day or the next week brings. 

With cancer treatment there is no firm plan.  I started at Point A (stage IV cancer), and I'm hopefully headed toward Point B (cancer in remission).  In my mind, there should be a road map - follow this path, stop at these milestones, take these exits, and you will find yourself at Point B in a certain amount of time.  This is a plan I can put down on my calendar and mark off days to reach Point B. Only it does not work like that dealing with the unpredictability of cancer, pharmacology, and the human body. There is not a road map at all.  It's more of a general direction that can be reached in a variety of ways.  Point B is over yonder. Head that way and see what happens.  Different than the precision of a road map, it is more like making your way across a stream by stepping on rocks.  You don't know if you will be able to make it across on the path you can see from the stream bank. You have to get in the stream and start taking steps to see where the next step will be.  You have to have faith that the path you are on will lead you to where you want to be.  You have to listen to the guide who has seen many people across the stream before. You have to be willing to stop and look around a bit for the next step.  You might need to backtrack and start across a different way. You may make a misstep and land on your ass in the water.  Or worse - get washed down stream. 

I'm somewhere in the middle of the stream now with six chemo treatments behind me. My oncologist and I are stopping soon to reconnoiter and survey the path ahead. I have a CT scan coming up and then we'll talk about which step to take next. I am hoping for a break after chemo #7 so that I can get healthy for surgery. I will sit on my rock in the middle of a swirling stream acting like life is normal for a while. I'm looking forward to that.  I am ready to write in some normal time on my calendar.