Half Baked

My anal cancer treatments passed the half mark this weekend.  All cancers are difference and so are treatment effects.  Here are mine during the first three weeks. 

Week 1. The first week's main event saw few unpleasant side effects other than The Bag (see link to the $48,000 chair). 

Week 2. During the second week the chemo effects washed up like detritus from an oil spill and provided continuous indignity and weirdness.  Some examples:

•         I was a bit random with my anti-nausea meds the first week, and on the way to Albany for my daily radiation -- a speedy 45 minutes up the highway with few exits -- I realized I was about to vomit with a great degree of violence.  Making not the wisest choice, I opened the window and let loose without considering the physics of speed and wind direction.  Back it came inside, stopping first at my face.  Lesson learned: take the meds regularly and keep a plastic bag in the car.  
  
•         Our car suffered a flat so we borrowed a friend's truck for one day's ride to Albany. Our friend is obsessively neat about his things, and Michael hates borrowing stuff from him out of anxiety that something bad will happen to it.  Although the drive itself was uneventful, about half way up my hair took the opportunity to fall out, first onto me, then onto our friend's lovely leather seat.  Desperate, I pulled hunks out and clutched them like an Adam's Family bouquet until we got off the Thruway and could stop. This time I was able to open the window and hurl my bodily traces out without a comeback.
•          Food tastes like ethnic meals in a country you never want to visit again.  Something happens to your taste buds so that anything you eat is transformed into peculiar unfamiliar chemicals with a mothball undertone and repellent mushy textures. I can't figure out if I'm actually tasting what food is really like, if the chemo is mixing it all up, or "It's People!"  Here's what I can stand eating: Greek yogurt, cooked fruit, and hot dogs. In that order.    The second week saw an explosion in mouth sores.  They did not enhance the taste of the food. I have not lost one pound.
•         I will not bother to describe the other intestinal indignities, which would only amuse small children.  

Week 3.  On the third week, the chemo effects settled down, and the radiation effect – The Hard Man -- hasn't kicked in much yet, except for a couple of ulcerated areas that apparently have healed up.    Naps are lovely.  I collapse around two or three and sleep like a baby.  At night I wake up around four, but. then, even without cancer I always wake about around four.  Same-o Same-o.

Summary

Perhaps the most disturbing aspect to the whole process so far is the metamorphosis of Self into some unfamiliar, unpleasant animal.  Ones impulse is to hide in a cave and let those lovely naps take over.  Aside from death fear, I think a lot of the depression comes from this perception.  So, during my early AM wake-up, I get up and meditate, letting all the strange body sensations and the churlish thoughts drift off until I'm back where I belong, the deep heart that came with me at birth and will be my companion to the end.  It makes me happy.   

  

The $48,000 Chemo Chair

"I love this chair!" The man in the neighboring chemo pen was talking to the nurse. "Supports my back.  Never gets sore.  I could sit here forever! I looked it up on Google.  It costs $48,000.  You better keep an eye on it.  I may take it on my last day."

Not exactly like the one I had but close enough. 

My own chair had cheap looking upholstery--plastic with shiny metallic threads--and was as rigid as stone, which I tried to soften up with a couple of pillows.  The hard composite arms were too narrow to rest an elbow on, and only one knob that tipped the back was available for any adjustment. In other words, I was sitting in an airline seat, only a little wider. The curtain was drawn between my neighbor and me so I couldn't see his extraordinary chair.  I very briefly nurtured a scheme of coming in early and nabbing it before this guy did and then remembered that my own stay in the chemo playground would only occur on two days – this one, my first treatment day, and one more five weeks later.

Two months ago, after many weeks of annoying symptoms that I assumed were from my hemorrhoids, I finally decided to see a surgeon to get rid of them.  After the examination, he said.  "You don't have hemorrhoids.  You have anal cancer."  That's when the brain stopped peacefully yattering. It became a nothing. A blank. He followed quickly with, "The treatment is tough, but it's very curable." The mind edged up again, and continued processing.

Anal cancer.  WTF.  Regardless of its position, it isn't the same as its colon and rectal cancer neighbors. It's pretty rare and occurs mostly in people with HIV and women over 60 (that would be me), with most cases caused by the human papillomavirus, or HPV (also me). The virus is mostly famous for causing cervical cancer, but it also triggers my very own anal and many oral cancers. (Parents of teeners – get your kids vaccinated!) HPV is usually sexually transmitted, and I had, indeed, been a lively young woman, but now I'm 75 with decades of virtue behind me. Obviously the HPV had been skulking about until my aging immune system wore down so it could leap through to bill me for the wages of my sin.

Well, this might be it, but although leaving three quarters of a century of life is not tragic or even particularly scary, the urge to continue is stupidly stubborn.  So with a certain amount of liberal guilt, I am adding to the costs of our exorbitantly expensive health care system and throwing my body into its slurry of chemical and technologic treatments.

Now, before the 1970s people with anal cancer were surgically mauled and then usually died miserably.  Then Norman Nigro, whom no one has heard of but who deserves some minor variant of Nobel prize, developed a treatment protocol that avoided surgery and cured most patients.  And the Nigro protocol, is it's called, is still used: 60 Gy of radiation every weekday over a five week period, with continuous administration of the chemotherapies fluorouracil (5-FU) for the first and last 5 days and mitomycin, which is administered on the first day of each chemotherapy treatment. According to my radiologist, the tumors "just melt."

So I'm on day 5. I've had five rounds of radiation that haven't done anything special yet.  But, every week day over the next six weeks, Michael will drive me for the hour commute between Hudson and Albany to receive a ten minute radiation zap. Over time, the radiation will accumulate, and with 2 degree burns to the nether region, become nasty. Take it as it comes.

The chemo side effects supposedly aren't as bad.  On Monday, the nurse administered the mytomycin (which is purple) into my chemo port through an enormous syringe.  (The port had been surgically placed last week during a pain-free procedure--thank you Fentanyl-- when, fully alert and from under a sheet covering me from head to toe, I passionately argued with the team in support of the first Blade Runner movie and for a nuanced approach to the #metoo movement.) After the mytomycin, another nurse used the port to umbilically tether me day and night to a 10-pound case filled with a container of 5-FU and a large battery. I lug it around as a shoulder bag during the day and put it next to me in bed at night. Every few minutes it whirs like a rewound tape while pumping its poison into my veins, which at night feels like I'm cuddling up to a dysfunctional Sony Walkman, circa 1979. To keep clean, I can only sponge – no bath or shower. Today, the visiting nurse will come to our house and take it away, giving me a three-week reprieve until she comes again to hook me up for its final five days.

 I'll only have to go to the chemo room once more for the mitomycin plunger, during which I will sit for the second and final time in an airline seat – even if my neighbor's has become available.  This is because, as he left on my first day and passed my station, I commented on his good fortune.  "I really envy you. Your chair sounded fabulous." He frowned and looked puzzled, "But you have the same one."  

Note: I Googled chemo chairs and found the article he probably had referred to, which did say that our chair cost $48.000, but it was for 13 of them.  So each one was around $3700.  After digging further, I couldn't find any similar chemo chair that cost more than $3000, and most were on sale for half price.