Treatment

The Rougarou

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‘Twas a few days before Thanksgiving, and a boogeyman was lurking in my chest.

What, that’s not how this story goes?

It WAS the Saturday before Thanksgiving though as I lay in bed watching TV with my husband when I suddenly had sharp pains in my left rib. “That was weird,” I thought. I actually sat up, grabbed my side, and told him about this sudden, stabbing pain. It went away though, enough for me to fall asleep a couple of hours later to my nightly binge on Real Housewives.

Listen, it’s honestly cancer’s fault I’m a Real Housewives addict now. That’s what happens when you have massive surgery and are put on bedrest over the summer months. I exhausted my DVR, that’s my story, and I’m sticking to it.

ANYWAY…

The next morning though, I felt fine so I decided to go with my daughters to our gym, but I quickly realized that was a mistake. I felt worse now; the pain was back. It subsided enough to where I was able to drive home, but it kept coming and going to the point I felt like someone was squeezing my shoulder blade constantly. I finally decided to text Dr. V that afternoon.

Yes, my oncologist and I text occasionally. Welcome to modern oncology! Way easier and less frustrating than going to the ER, where no one knows what to do with you as they keep repeating, “So you have cancer?” and “So you’re on chemo?” (Do I LOOK like a chemo patient?!) until they finally break down and call your oncologist anyway.

“Hey Dr. V, really sorry to bother you on a Sunday but I’ve been having mild to moderate stabbing pain on the left side of my chest and under my left shoulder blade off and on today. BP is 124/86. Is this something to worry about tonight, or can I just see my PCP tomorrow?”

“Take a 325mg aspirin and hold the Cabo. Are you on the Eliquis? See me or Chris tomorrow but if it doesn’t stop in 1-2 hours, head to a quick care for an ECG today.”

So, I popped an aspirin and started the clock, praying I could avoid an urgent care visit in the middle of flu season with sick people everywhere.

The pain subsided about 90 minutes, but I dutifully went in to see Dr. V the next morning.

“We need to talk,” he says as he walks in the room.

Just like in relationships, this is never a good sign.

He’d originally been concerned about my heart. Then he started to suspect a pulmonary embolism. He was now quite confident it was a pulmonary embolism.

“You know what this means if it’s a PE, right? No more Cabo. Period.”

“But what then?” I ask, emotionally clutching Cabo like a life preserver, a boogeyman repellant.

“You’re off trial, you’re off the drug, you’re off treatment period. You’ve been in complete remission for 2 years now; that’s 2 years we didn’t think would happen with this kind of response.”

“But what about when it comes back?”

“Then we put you back on Cabo.”

“Will it work?”

“It should. No reason to think it won’t. I really think even if this isn’t a PE, we’re rapidly approaching the point where being on treatment is doing you more harm than good.”

“I can’t relapse, though. I don’t think I can go through that again.”

The tears start welling up in my eyes. I think about how many times I’ve cried in front of this man. Once again, I call to my mind’s eye my mom laying in her bed in ICU, except yet again in this repetitive nightmare, it’s me in the bed, a shell of my self, begging someone to put me out of my misery already. He wordlessly turns, grabs the tissue box, passes it over, puts his hand on my shoulder.

“You can do it again, and you will. You need to think about how this treatment can kill you too. You already know how toxic this drug is. I don’t have to tell you that.”

I gulp a few breaths, wipe my eyes. Thank him, hug the nurse and the scheduler, get into my car and cry a bit more. Some days – when it’s the third time that day I’ve puked, when I self loathe at my swollen legs from the chronic DVT and the poor post-surgical circulation, when I feel like I can barely keep my eyes open from the thyroid dysfunction – some days, a drug holiday sounds wonderful. Blissful. Glorious. God, grant me just a simple day free of drug-induced symptoms and I’ll never complain again.

But then, I remember, those symptoms are because of a drug that’s saved my life. That’s keeping the cancer from an almost certain relapse. Who am I to sneer at that?

But then, I remember, Dr. V is right. The wrong side effect at the wrong time could land me in the hospital. Worse, in the morgue.

Later in the week, the day before Thanksgiving, the results of my CT Angiography came back. No PE, or more than likely, one that had already broken up before my scan. I could continue on treatment, for now. Dr. V sat down with me and Patrick as we negotiated, debated. Continue on? Stop treatment? My clinical nurse pipes in, “We can do one more dose reduction?” Dr. V is not thoroughly convinced, but he agrees we can try it. For now. As he gives me the look. The “you really need to start preparing yourself” look.

So for now, I’m on 20 mg of Cabo. It’s the lowest I can go. Every appointment from now on will be a debate – do I tempt fate, and play the game of active surveillance? Or do I keep using my pacifier and hope it doesn’t take me out?

Ah, the ubiquitous truth about cancer…..

The boogeyman never goes away.

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