Feeling blue

Just finished my second chemo injection. I felt shitty going in, maybe because I couldn't sleep last night. There was some question as to whether chemo should go ahead; I had obviously picked up a virus, with the sore throat and fever last week and the ulcer in my mouth. My oncologist was prepared to delay chemo for a week -- she's worried the mouth sore will get worse -- but I really didn't want to get off schedule. And when my blood tests came back, my white and red blood cell counts were all great. So we went ahead. On Dr. Lee's instructions, I sucked on an orange popsicle while I was being infused, apparently to keep the drugs away from that area by temporarily freezing it.

But I seem to have rib pain again, and the blood indicator for bone metastasis (alkaline phosphatase), which had been slightly elevated, is now way up. Why would the chemo make the rib pain go away for a week or so and then stop working? The doc hopes it's an anomaly. Meanwhile, my shoulder blade is still keeping me low. I found the day depressing, but I need to take a cue from a young woman who was also getting chemo, who looked perfectly well but has Stage 4 breast cancer, metastasized throughout her body, and is on permanent chemo of the sort I had five years ago. She was preternaturally cheery and seemed to have accepted her fate as something that simply ran in her family. She truly did appear to be living in the moment.

On the other hand, I could take my cue from philosopher Alain de Botton (see article in Maclean's April 6 issue, p. 43), who believes it's important to accept that life is, indeed, an utter vale of tears, but thinks we should take comfort from the fact that we're all in it together.

Pollyanna moments:

• As usual, good friends made me laugh at the beginning and end of my long chemo day. Though when I'm feeling sad like this, I kind of want to be left alone, it is good to be dragged out of my funk from time to time.
  
• When I got home, I found one of my brothers had left a card and some daffodils at my doorstep (and there was a photo of some daffs in my email inbox from Neil).
• On Saturday, I got to see two of my not-so-little-anymore nephews play hockey. I nearly fainted at one point (and nearly did a face plant out of my wheelchair) -- I guess codeine on top of the virus and lack of sleep was a little too much. But it was fun to be with my family and to see those little guys whose diapers I changed grab the puck in a breakaway. In the words of Jane Siberry in "Hockey," "He'll have that scar on his chin forever / Some day his girlfriend will say...hey...where... / And he might look out the window...or not."
  

Oral hygiene

The past couple of days have been a bit miserable, despite the welcome presence of dear friends visiting from Alberta. I was warned that I might get mouth sores from the chemotherapy and that I should practice excellent oral hygiene and rinse my mouth four times a day with baking soda and water, which I did for the first few days after my first chemo injection. But I got confident the sores wouldn't arrive, and slacked off. (Standing at the sink to brush my teeth can be quite painful, although my recent purchase of an electric toothbrush has helped some.) Sure enough, I sprouted a big split-lip type of lesion right around the same time my hair began to shed, more than two weeks after the injection. I've got some prescription stuff to gargle with now, but the sores make it difficult to eat, drink and talk. At about the same time, I got a wicked sore throat that kept me up for a couple of nights, and last night I developed fever and chills. I am supposed to head for the Emergency department if my temperature exceeds 38 degrees C; last night it was 37.9, so I just stayed in bed (returning to the Emergency room is not top of my list of things to do, especially at night). Now it seems to have gone back to normal and my throat is feeling quite a bit better. I have hopes that the mouth sores will subside with treatment--but my shoulder blade is killing me. Boo-hoo.

On Wednesday, I went to see Dr. McCharm, the surgeon who removed my lymph nodes. I'm really discouraged about the fact that, since the surgery almost two months ago, I have been unable to walk much, and my underarm is still numb and hard and painful. "I told you it'll be like that for the rest of your life," said the doc with his usual grin. What I remember him saying before the surgery was "It will never feel the same." Naively, I took that to mean that it would get better but there would be some permanent minor residual pain in my arm. I shudder to think it will always feel this way, like somebody sewed my underarm to my shoulder blade from the inside. He conceded that the havoc he wreaked on the ligaments and nerves in my underarm could well have affected the musculature in my back, which is why I have so much trouble walking. Not great news.

Meanwhile, I told him that the person I went to for lymphatic drainage massage had been unwilling to massage my actual incisions for fear of stirring up cancer cells. He said there was no reason to worry about that, because he had removed the tissue with clear margins, and he was in favour of massaging the incisions. I wish I'd done it sooner--it feels like there's serious adhesion going on there.

Pollyanna moments:

• Playing Lexulous online with Matt in real time, sitting side by side, each with our own laptops, in my living room.
• Hugging Ken because he's not too tall.
• Finishing a great book: Down to This: Squalor and Splendour in a Big-City Shantytown by Shaughnessy Bishop-Stall, a worm's-eye view of the rise and fall of Toronto's Tent City.