Posts Tagged ‘fatigue’

Pity Party

09.07.2010

I’m supposed to be almost done with treatment, right? This is supposed to be that rocky but ultimately blissful part where I feel immense gratitude for my survival and start to get pieces of my life back?

Bullshit.

I have Stage 1 lymphedema. (Yes, they stage that too. A poor choice in diagnostic taxonomy, if you ask me. Anyone prone to lymphedema is already traumatized from the last disease that they had staged. Why not leave out the numbers and just call it early, middle, and advanced?)

The Barbies don’t have to deal with lymphedema. Their lives are perfect.

I have to go to physical therapy appointments twice a week. I have to wear a ginormous compression bra 24/7 until my lymphedema resolves. I have to do repetitive exercises that make me want to cry from boredom.

This is not getting my life back.

Today I went to see the physical therapist. I got grumpy. Don’t get me wrong: I adore her. She is fabulous.

She was showing me a “self-tickle” exercise I need to do. She told me to do it everyday, fifteen minutes before I get out of bed in the morning. I’m pretty sure I scowled.

It seemed like yet another cancer treatment geared toward the rich, retired, or childless.

My sleep is dysfunctional. I become unfathomably fatigued somewhere slightly past midday. I often have difficulty falling asleep. I have trouble staying asleep because of the pain in my ribs. Most mornings, I wake up with an alarm because I need to get my kids to school.

The idea of getting up 15 minutes earlier for a self-tickle therapy session brought out my inner adolescent. I told the therapist so. I unleashed the litany of annoying things I am still having to deal with, the losses I am facing, the numerous obstacles between me and My Life As I Know It, up to and including this ridiculous compression garment that makes me feel 30 years older because of its gravity-defying, granny bra feel.

“Hm. Yeah,” she said. “Don’t get up early. Maybe at bedtime?”

I wryly agreed that self-tickling at bedtime would be better. She could see I was still in a bit of a funk.

“What are you going to do to get yourself going again?” she asked kindly.

I frowned, but I was resigned. “I’ll figure it out. I always do.”

Not right away, apparently. I left her office feeling very sorry for myself. I am sick of having these lists of rules; of exercise diagrams with their little arrows pointing to line drawings of bowl cut dudes in seventies-era gym shorts; of all the things I have to do to stay out of pain. No hot baths? No massages in my “upper right quadrant”? Compression sleeves every time I exercise, go on long drives or fly? Maybe I should just forget all of this and let the chips fall where they may.

Pleasantly convinced of the injustice of my situation, I strode to the elevator bank with a nice gray cloud over my head. I pressed the button and waited. I’ve spent so long being a good cancer girl, earnestly following all the elaborate directions they give me, even when they are contradictory or unclear. It was all so unfair.

A moment later, a middle aged cowboy swaggered down the hall, closely trailed by a 14 year old girl swinging herself along on crutches decoratively webbed with hot pink duct tape. The father and daughter were joking and laughing.

Then I noticed. She had one leg.

The cowboy dad held a large plastic bag full of gauze and bandages. They were leaving the same oncological rehab clinic I had come from. Piecing the scene together, I suspect this was a new loss for her.

And there she was, laughing.

Nothing like a little perspective to end a good pity party.

Tags: , , , , , , , , ,
Posted in Survivorship, Treatment | 19 Comments »

Revising Plan B

08.25.2010

We’ve launched another school year around here, and thank goodness, all my kids seem happy.

I too am back at work: writing syllabi, attending meetings, working on my research. I too am happy.

Even though we are only a couple of weeks in, I have already learned the hard way that I am still going to take awhile to get myself up to speed in any way that feels recognizable or familiar.

The biggest difference is that my old fallback, Plan B, is no longer possible.

Working parents probably know what I’m talking about. There is very little room for error when you have your schedule, your partner’s schedule, the kids’ schedules. There are few degrees of freedom. It’s the unexpected things that require a regrouping of Plan A –– a kid gets sick, a car needs repair. Truth be told, even the expected stuff can perturb the delicate balance of Plan A –– early dismissals, dentist appointments.

Up until now, my Plan B has been to take advantage of my flexible schedule. In my job, the work just needs to get done. For most things, it doesn’t matter when or where it happens. I can read, write, grade, review, plan, email at almost any time or place. So my usual way of absorbing these upsets –– my Plan B –– has been to work at odd hours in the evening, often after the kids are in bed.

That time is no longer mine for the taking.

I am lucky if I have much cognitive functioning past 3 PM, let alone 9 PM. This past week, most of my “good work” has to be done by lunch time. After that, I’m able to answer simple emails, file my papers, or straighten my bookshelf, but the heavy thinking time is over.

I am coming up with other ways to insulate my work time. It’s not what I expected, but I think I might pull it off.

My new Plan B?

I’m asking for a little latitude.

The hard part is that I have always prided myself on my punctuality, on making meetings and meeting deadlines. If I say I will do something, I come through. I am having to let that go a bit. Sometimes, I ask forgiveness upfront so that I do not feel the distress of letting somebody down. I’m adding “ish” to any promised deadline. I have to say no to things that are outside of the essential parts of my job, even if I feel a pull toward them for reasons of citizenship or duty.

Because my hair has come back and the worst of my treatment is over, I find that I have to explain myself occasionally. I tell people to think of me as being on energy conserve mode. When I’m on, I work pretty well. But I might unexpectedly need to shut down and reboot. If they still look puzzled, I might truck out the notion that it takes you as many months to recover from treatment as you spent in it.

Eventually, people get it. That’s my new Plan B. I’ll let you know how it goes.

Tags: , , , , , , , , ,
Posted in Survivorship | 5 Comments »

Radiation Fatigue

06.17.2010

tired • sleepy • yawning • dragging • drowsy • lethargic • fatigued • worn out • squeezed out • used up • running on empty • zzzz • burned out • exhausted • épuisée • weary • bone tired • dog tired •drained • zonked • wasted • ready to drop • ready to collapse • bushed • beat up • beat down • lullaby me • pooped • tuckered • worn down • zzzzzzz • naptime • all the time •

• is this over yet? •

Tags: , , ,
Posted in Treatment | 4 Comments »

The Most Ferocious Feeling

02.21.2010

I have had five cycles of chemotherapy, with just one more to go. Now that I’ve ridden my version of the chemo rollercoaster several times over, I can explain a little bit what it has been like for me, starting out feeling healthy, getting a diagnosis that requires medicine that makes me feel sick, taking that medicine, starting to feel better, and then willfully taking the medicine again, knowing that symptoms get cumulatively worse with each cycle.

Here’s the best metaphor I can come up with. Chemotherapy as a treatment is like walking along and arriving at a great chasm in my path. I can’t see the bottom but am told that I must go forward into the pit if I want to continue on with my life. So I reluctantly slide down into that chemo-hole, not sure what snakes or rats or crags or spiders might hurt me along the way down, not knowing exactly where the bottom lies, whether its made of soft mud or hard concrete. I brace myself for the bottom and, once I hit, I recover some, gather up my strength. Then I scale my way back out, climbing toward light and life, looking to find solid ground again. Arriving back on land, perhaps scarred, scared, weary, and even bitten, I must walk forward again, in order to actively choose my life. Soon I face another chasm, another chemo-hole, which may or may not be like the previous one. In general, I have been told, the pits will get nastier as I progress on this path, but I also learn some crag-avoiding tricks and ways to break my fall. But down I go, and somehow, once again, I must try to find my way out of that darkness, knowing that I will crawl back into the light, only have to sink down again.

As somebody who has made life choices that generally avoid discomfort and pain, this is wholly unnatural to me. No addictions, hangovers, or self-destructive behaviors. I’ve tended more toward vitamins and yoga and eating my veggies. But if somebody held a gun to my head and told me that this was the only way to keep living, I would shrug my shoulders, take a deep breath, and march forward. I love my life and do choose, every time, to fight for it.

The time spent at the bottom of the pit is the hardest. There is a moment of time, after I have landed at the bottom and have had the wind knocked out of me, where I am stunned and confused, not quite able to take anything in. But then I get this fighting feeling and want to scramble out with as much might as I can muster. My coming to usually involves hearing my children’s voices, whether in joy or distress. I resent being sidelined from their lives. As soon as I am able, I feel compelled to get out of the hole, no matter how battered down I have been, if only to hear about their day, brush their hair, or ooo and aaah at their latest art project.

This last round of chemo has proven to come with a deeper pit than the previous chemo-holes.  The fatigue is worse, the nausea stronger and longer lasting. Any strategies I had for getting back on my feet have become less reliable. Usually a week out of chemo, I can pretty consistently have a few good hours to do something without wearing myself out. While I lay at the bottom of Pit #5, I once again watched my family through a druggy haze. I saw my husband spent and exhausted as the months of treatment march on, my children feeling lonely for me. During one of our evening snuggles, my middle child told me, “The kids at school think our neighbor is my mom,” referring by name to the wonderful woman who has taken over so much of our carpool. So last Thursday, day 7 post-chemo, I rested all morning to summon a few good hours for my family. From the moment the children came home from school, I greeted them at the door, hung up their coats, sorted out lunch boxes, took the lead in dinner, baths, homework help, sibling squabble resolution, bedtime preparation, stories, songs, kitchen clean-up, and lunch packing. The children practically purred with my attention. I turned to my husband and said, “I got them, Honey. Go take care of yourself.” He hesitated at first, but then happily went off to exercise. Later on, he sat down as I got the children to bed. He promptly fell asleep, the nights of sleep deprivation catching up to him. In all, it was about a five-hour effort on my part, but I was deeply satisfied, almost giddy, with the joy of taking care of the people I love the most.

The next day was Friday, and I barely had the two hours’ energy required to attend my daughter’s school play. The nausea came back with a vengeance. I spent the rest of the day in bed, trying to get my feet back to that solid earth I had thought I had landed on. I felt like I had slipped backwards into the chemo-hole and was clawing at the dirt, trying to stay out. By the evening, I had regained enough energy to share dinner with my family. But new symptoms were also setting in. I woke in the middle of the night with a painful tingling in my hands and feet: the neuropathy spiders had clearly bitten.

In my normal life, on Saturday mornings, I let my husband sleep in while I take care of the children and get us all ready to attend synagogue. Despite the negative consequences of my well-intended Thursday exertion, I kept thinking of how worn-down my husband was with so much caretaking on his shoulders. I felt compelled to do my part and care for my family –– I know how to do this, for goodness sake! –– and to return to some semblance of normalcy. I don’t remember which child woke first that morning, but 6 was the leading digit on the clock by my bed. I got up, made breakfast for the children, cleaned up, supervised their morning business, helped them get dressed, resolved an argument or two, tossed a football, praised a well-built Lego tower, arbitrated clothing choices, consulted on puzzle construction, praised a tough word successfully sounded out. This is the multitasking that any parent is familiar with: the false starts to a job as you are repeatedly interrupted by children’s needs; the surprising, sometimes labored conversations about what might otherwise seem obvious (“Well, you can’t pour your juice in your cereal because then it won’t taste good”); the denial of your own self as your get caught up in the busy hum of the needs of the little people around you.

Under normal circumstances, delaying a trip to the bathroom while you scramble between zipping up a dress and wiping up a spill is par for the parental course. But this kind of self-denial is not well advised in my circumstances. My husband woke up a couple of hours into the busy morning, and I went off to take one of my anti-nausea medications. But my kids knew that Mom was back, and after I wrote down my medicine next to the date and time on my record sheet, I was summoned for assistance with something –– what, I can no longer recall. I got up, helped, went back to getting myself ready, and realized that I had no idea if I had actually taken my pill or not.

I was dejected. Only one day had passed since I had fought off horrible nausea and I was in no position to skip a dose of medication. At the same time, doubling up would not be safe. I sat and wracked my brain, trying to reconstruct my actions. My short-term memory compromised, I could not, with my most concerted effort, recall whether or not I took the pill. I melted into tears, afraid of the nausea that might come if I did, in fact, miss this dose. (Note to all my well-meaning friends: I know about the labeled 7-by-4 pillboxes. I have one and find it useful only at certain times and this was not one of them.)

Saturday was a hard day. At synagogue, I found myself full of envy for parents who are strong enough to care for their children in the basic ways that I obviously can not. I felt, for the first time, deep bitterness and anger for my situation. I understand that this disease is random. I can handle that I have to go through this, but why in the world do my children have to? Why must I be sidelined from their lives? In the brief time I spent in the chemo-hole, so much had happened. My eldest had shot up and suddenly needed an entirely new wardrobe, my youngest had started dabbling with (or should I say “dribbling in”?) the potty. And where was I? Lying in bed, warding off nausea and fatigue, and now neuropathy. My anger formed a rageful prayer inside of me: I must get better. I must see these children grow. I need to not just be cured, but I need to be strong again. I need to be there for them and help them grow up. Anything else is not acceptable.

It was not a supplication but a demand fueled by the most ferocious feeling, my love for my family.

Later that day, back at home, I drifted into sleep. I had the sense that I must change. In my half-conscious mind, I continued to rage: “If I must change, then so be it. But there are certain things that are not negotiable. I will not survive and be whole if I let go of these parts of myself.” As I cried, I listed in my head the qualities that I would not sacrifice or compromise. My devotion. My love. My integrity. My humor. As I finished  my list, I landed on an insight: Fighting is not the only way to be strong. There is power in submission.

As I thought those words, something inside of me loosened and relaxed, a coil wound too tightly released. While I felt this change in a visceral way, my mind was still perplexed. Power in submission, huh? Submission? I don’t readily do submission.  I am a fighter, an active participant in my life: I choose, I think, I feel, I push back, I solve problems. How does submission fit into all of that?

The best I can understand is that I need to stand aside right now. I can best fight  by letting go of all these things and people I care about and love dearly. I need to release my grip on the details of my household and my family and really focus on getting well. It is temporary, but I must submit to my situation and let go.

It does not mean, as a wise friend counseled in the midst of my angst, that I am giving up on parenting my children. I am still present, just off to the side. I still chime in, I still cuddle and read with them. And they are learning important lessons from this experience. They see how others are there for our family. They see the meals brought to our door, the visits from those who come to help and comfort. If we make it through whole, they will hopefully give more readily when others are in need. They will deepen the tender places in their hearts.

My middle child recently wrote a prayer of thanks:  I am thankful, she wrote, “for having a house, a bed, and a loving family. For having food and making my mom’s cancer get better.”

So maybe it’s true. The kids are alright.

And let us say amen.

Tags: , , , , , , , , , , ,
Posted in Uncategorized | No Comments »

Graphing Side Effects

02.01.2010


I am so relentlessly geeky.

Red is nausea on a scale of 1-10. Blue is fatigue on a scale of 1-10. The fatigue gets worse with each cycle and is so much more erratic.

Tags: , , ,
Posted in Humor, Treatment | No Comments »