Monday, November 20, 2006

November 20, 2006 - Anger

Today I come across a link to a blog written by another cancer survivor (brain, spinal and lung cancer). Leroy Sievers is his name, and he’s a writer and journalist – having worked for CBS News and ABC News. At one time, he was the executive producer of the Nightline television news program. Now he’s keeping a cancer diary much like this one, for National Public Radio.

Here’s something Leroy has written, reflecting on his last year or so of living with cancer:

“My body has changed in some ways that are obvious, and in others that aren't. I have a ridge in my skull where they cut it open to take out the brain tumor. You can feel the screws in the plates that hold my skull together. I'm heavier than I'd like to be. I put on weight when I was on steroids, and I haven't been able to work out much the last year. I hate the extra weight, though my doctors seem to think it's healthy.

Emotionally? Over the past year, I've hit the depths of sorrow, thrown in a little anger, too. Some hope, but probably not as much as I should have. Frustration. The whole gamut of human experience. And maybe that's one of the lessons here. In spite of the cancer, in spite of what we all go through, in the end, we're all just human. We're like everybody else. Except that we're not.

I try to make the most of my life these days. But I was really trying to do that before my diagnosis, too. My view of the future is a little cloudier; it's no longer open-ended. Not everything is possible anymore. I'm pretty much an optimist still, but that has been seriously tested, too.”

I’m interested to hear that Leroy mentions anger. I’m getting in touch with the fact that anger is an issue for me right now – sort of a delayed reaction to what I’ve been through.

During my chemotherapy, I simply didn’t have time for anger. I had to marshal all my emotional resources in the service of just getting by. The reality is, I’ve probably been stuffing my anger about the cancer for some considerable time. When I received first one clean PET/CT scan report, then another (in late May and early September) that was no time for feeling angry, either. I was supposed to feel relieved (and one part of me did, of course).

So what happens to all that suppressed anger? The answer seems to be that it’s coming out, inappropriately. I find I have a short fuse, these days, for petty frustrations. Other people around me have noticed it, too (in truth, they picked up on it before I did). It’s as though there’s a little voice in my head that keeps whispering, “You shouldn’t have to put up with this nonsense: you have cancer!”

I’m finding ways to procrastinate on things I should be doing – like dealing with the accumulated mail at home (comprised, still, of way too many medical bills and insurance statements, that only serve to remind me of my medical condition). Last month, I found it hard to get our 2005 income tax information to the accountant – tackling that job only at the last minute, just a day or two before the mid-October deadline for the extension I’d filed for last spring. Procrastination, of course, is a classic passive-aggressive reaction.

I have the most energy for creative endeavors, like writing and preaching. Having crashed hard into the brick wall of life’s limited duration, it’s as though the things that matter most to me are the things I create, things just may live beyond me. (Maybe, too, that’s why I felt so determined to apply for additional life insurance, during last week’s open-enrollment period.)

It’s possible that my cancer has bumped me up an adult-development stage. Back in seminary, we learned about psychologist Erik Erikson’s stages of adult development. The last three of his eight stages – with the typical ages and the challenges and tasks people typically face at those ages – can be described as follows:

Stage Six, Young Adulthood: 18-40 years, intimacy vs.isolation, love relationships
Stage Seven, Middle Adulthood: 40-65 years, generativity vs.stagnation, parenting
Stage Eight, Maturity: 65 years until death, integrity vs.despair, acceptance of one's life

According to Erikson, the 40s and 50s are the prime time for “generativity” – for creating that legacy we’ll leave behind when we die. What happens, I wonder, when a disease like cancer threatens to move the termination-point of life up a decade or two, or three? Does it mean, in my case, that cancer has abruptly shoved me forward, existentially-speaking, from “Middle Adulthood” into “Maturity” – way before I feel ready to be there? If that’s what I’ve been feeling (or, at least, worrying about), then it’s no wonder I’m feeling a bit angry. It’s the psychological equivalent of “the bends” – what scuba divers get when they surface too quickly.

How I sort all this out, I’m not sure. It’s clear that, remission or no remission, I’m still living with cancer, in an emotional sense.

Tuesday, November 14, 2006

November 14, 2006 - A Little Cancer Humor

I try to keep up with a few other blogs written by cancer survivors. One of them, My Private Casbah, by a New Orleans woman named Bint Alshamsa, is quirky, but amusing - sometimes even profound.

Here’s a bit of cancer survivor’s humor, from her November 2, 2006 entry. I realize it may not be for everyone.

You’ve gotta be able to laugh to get through an experience like this...

Thirteen Fun Things To Do When You Have Incurable Cancer
by Bint Alshamsa

1. If you're planning on getting married before you croak, you can always ask the florist for a discount by promising her repeat business in the form of exclusive rights to your up-coming funeral display.

2. Telling a mechanic that you need to get your car repaired so that you can drive to MD Anderson for a last ditch experimental treatment attempt for your incurable cancer is a good way to get him to finish with yours before he even starts on the dozen cars that were there before you.

3. If no one knows that the oncologist says you're in remission, you can get really good presents from your friends by telling them that this might be the last birthday/Eid/Christmas that you'll ever get the opportunity to celebrate and they'll want to make it a really good one for you.

4. You can eat whatever the hell you want. I mean it's not like you have to worry about having clogged arteries fifty years from now.

5. You can get your partner to "secretly" tell everyone at the family reunion that all of the medications you're taking are making you a bit delerious. After that you can go around throughout the day telling everyone who has ever pissed you off exactly what you've thought of them all these years. (Be sure to include a few jibberish statements every now and then to make it more believable.)

6. During chemotherapy, you can sleep for an extra thirty minutes every morning because you don't have to worry about fixing your hair before work.

7. You can surprise all of the radiation technicians by coming to your treatment wearing a bikini and telling them that you're ready for your tanning appointment.

8. When you're in the hospital hooked up to a bunch of tubes and machines, you can have a good laugh at your sibling's expense by telling all of your young neices and nephews that you got like that from eating too many vegetables as a child.

9. You can sleep in on election day. After all, who cares what candidate wins? It's not like you're going to have to live with them for the next couple of years. Or better yet, do go out and vote and tell everyone in line that you've been a life long(name of whatever political party you hate the most) voter but you're using the final election day of your life to vote for the other party because you've finally seen the light and decided to do the right thing for the first time before you die.

10. Having a few cancerous ribs removed from your chest will make it a lot easier to fit into those too-small clothes you've been saving in your closet.

11. You can tell people who don't know about your cancer that you got all of those scars from saving a small child from being mauled by mountain lions because everybody loves a hero.

12. When you go to the grocery store, always wear something that shows your radiation burns and leave your wig at home. Then when you get in the long line, you can ask people if they'd be so kind as to let you go ahead of them because you have to hurry up and get back home to your wife/husband/partner who is even more contagious than you are. I have it on very good authority that this one works great.

13. Make random strangers angry in crowded parking lot by parking in the handicapped spot and then using your cane as your partner as you do the Merengue all the way to the entrance of the building.

November 12, 2006 - Blessed Insurance

One small comfort, throughout this past year of living with cancer, is that I’ve got some life insurance. This would help provide for the needs of my family, should anything happen to me. My father sold me my first policy years ago, when I was still in seminary, during a time when he was briefly in the insurance business. Some years later, Claire and I each purchased another policy. Additionally, the church’s pension plan provides a modest “death benefit” – efffectively, a term insurance policy – whose payout decreases with age. (I’ve always found that phrase “death benefit” a little odd: an oxymoron, even.)

Do we have enough insurance? Probably not. But at least we’ve got something.

Lately, I’ve been thinking about buying more insurance – although I realize that, with my recent health history, that could be problematic. When a mailing arrived from the Presbyterian Church’s Board of Pensions a few weeks ago, advertising an open enrollment period for additional death benefits, I figured this could be my chance.

An earlier conversation with our regional Board of Pensions representative was somewhat reassuring. A cancer diagnosis, he told me, doesn’t necessarily disqualify me from coverage. It’s a group policy, so as long as I meet their basic medical underwriting requirements, and am willing to put up with a one-year “pre-existing condition” exclusion, there’s a possibility I could still be eligible. There’s no medical exam, just a barebones medical-history questionnaire.

What’s more, the cost is not affected by health circumstances (other than a separate rate table for smokers, which doesn’t apply to me).

We were talking about life insurance just last week, at the Cancer Concern Center support group. I found out that life insurance is a big issue for many cancer survivors. In many cases, if you don’t sign on the dotted line before being diagnosed, you’re either completely ineligible, or you’re subjected to such high premiums that you may as well be. The group seemed to think the Board’s policy sounded unusually generous.

There remains but one other obstacle to my filling out the application: an obstacle that’s within me. “What does it mean,” I keep asking myself, “that I want to get more insurance? Does it mean I’m giving up? Does it mean I believe, in my heart of hearts, that my remission is not going to last long?” Filling out the application seems a bit like an act of self-betrayal.

I’ve gotten over that. Today I complete the application, and leave it for our church treasurer to sign (I’ll pay the premiums myself, but it’s part of my employee benefits, so she has to sign off on it).

I still feel a bit uncomfortable about it, but I’ve put those uncomfortable feelings aside. Completing the application doesn’t mean I’m giving up. It means I’m looking out for those I love.

Monday, November 13, 2006

November 10, 2006 - Under My Skin

Another monthly port flush today. After nearly an hour in Dr. Lerner's packed waiting room (cancer has never been so popular, it seems), I'm ushered into an equally crowded nurses' room. Today it's an oil change for me, rather than a transmission job – so, they've squeezed my appointment in amongst a half-dozen or so patients who are receiving other treatments. Chemo bags hang from hooks on the ceiling over some people's heads (evidently, their treatment is still not long enough to qualify for a lounge-chair in the infusion room). Others move in and out very quickly: they're just here to get shots (Procrit, Neulasta, that sort of thing).

Most of them are considerably older than me: seventy- and eightysomethings. I'm just a newly-minted fiftysomething, but I've got a bum set of chromosomes much like theirs. Or, maybe, not so much like theirs. Mine went haywire a decade or two earlier, in terms of lifespan.

My nurse today is one I haven't seen before. She misses my deeply-implanted port on her first attempt at the docking procedure. Ouch. She tries again, but with a longer needle. This time it works. Pressing the plunger on the syringe, she injects saline solution into the vein buried deep within my chest. My heart muscle dispatches the stuff in the blink of an eye. A second later, I taste the plastic and feel the bubbling sensation in the back of my throat.

The words of an old jazz standard drift across my consciousness. "I've got you... under my skin." Yeah, I've got this little button under my skin, all right. There it will stay, until it's either needed again, or until the doctor decides it won't be needed for a long time. Let's hope for the second of the two alternatives.

My neighbor in the nurses' room, it turns out, is the mother of a woman whose wedding I performed about ten years ago. Her daughter is an inactive member of our church: still on the rolls, although we rarely see her. The mother recognizes me, and tells me all about her grandchildren. We don't discuss her cancer (I assume it's cancer – although, in this office, it could also be any one of a number of blood disorders). Nor do we mention mine. Just kids and grandkids. Life, in other words.

On my way out, I learn that my appointment with Dr. Lerner must be rescheduled. It seems someone in the office miscalculated the date, booking me for exactly three months from my last appointment. This doesn't account for the fact that the CT scan has to happen first – and that, they tell me, would place the scan on the calendar fewer than three months after my last one. "The insurance company would never approve that," they tell me. "If it's a day under three months, they'll bounce it right back." So, we push the doctor's appointment back a week or two, in order to allow time for the CT scan. My scan is now scheduled for November 30th, and my doctor's appointment for December 8th.

"I've got you... under my skin." I hum the catchy Cole Porter ditty to myself, on my way out to the parking lot. So what's really under there? An implanted port, for sure. But is there still more cancer?

Who's to say?

Wednesday, November 01, 2006

November 1, 2006 - The Big 5-0

Several days ago, in a quiet way, Claire and I celebrated my 50th birthday. The actual day was October 28th. I was up at our Adirondack camp (vacation cabin) near Jay, New York. I’d been up there for a week of study leave, writing furiously, as the deadline for my latest book, the third and final installment of the Lectionary Preaching Workbook series, approaches.

I didn’t bolt out of town to avoid a big birthday celebration. Really. It’s just that last week was the only possible week I could get away, this fall. It was Reading Week at New Brunswick Theological Seminary, so I didn’t have to teach my weekly, Thursday-evening course.

On my birthday, Claire rode up to join me, taking the Amtrak train to Plattsburgh, New York. As I met her at the classic, Victorian rail station, I was surprised at how few people got off the train – no more than 4 or 5 individuals. This is no out-of-the-way spur, I thought to myself. It’s the Amtrak main line between New York and Montreal. Claire’s was the only train of the day connecting those two major cities, and it was more than two hours late (equipment problems). It reminded me of how we’ve let our nation’s once-mighty passenger rail system slip into near-oblivion.

So, if you want to know how I spent my 50th birthday, at least part of the time I was waiting for a train. I have to admit that was better than the earlier part of the afternoon, though, which I spent in a dentist’s chair. I’d lost a temporary crown the evening before, and was fortunate, indeed, to find a wonderful dentist, Dr. Michael O’Connor, who agreed to open up his Plattsburgh office on a Saturday morning, even though I’m not one of his patients.

The irony of that experience wasn’t lost on me. It was my fiftieth birthday, and my teeth were falling out. Literally. Tempus fugit.

It was good to see Claire, though. After driving back to our little house, we went out for a nice birthday dinner at one of our favorite restaurants, overlooking the rushing rapids of the AuSable River. The next day we enjoyed some quiet times, watching the snowflakes swirl (thankfully, they didn’t stick; it was still a little too warm for that). At one point, we were treated to the rare sight of a doe and a faun, foraging for food just outside our window.

How do I feel about turning 50? To be perfectly honest, it seems kind of anti-climactic. The sturm und drang of my cancer experience overshadows any piddling anxiety I might otherwise have felt, concerning this milestone birthday.

I’m not upset about turning 50. In fact, I’m glad I’ve made it this far. I was thankful for a quiet day, in one of my favorite spots, with my best girl by my side.

Claire and I are talking about throwing a bigger 50th birthday party, for both of us (she passed that milestone herself, in July). That party will do double duty as a belated end-of-chemo celebration for me, and also to commemorate Claire’s 15th anniversary of ordination as a minister. We’ll probably plan that celebration sometime later this month, if we can find a date that works.

Milestone birthdays are significant events, for most people – but maybe less so, for cancer survivors. For us, any healthy day is a good day.