Showing posts with label plans. Show all posts
Showing posts with label plans. Show all posts

Thursday, December 4, 2008

A big day

I'm coming up on one of those days that's common in the life of a cancer patient: a Big Day. On Monday I'll check into Mercy Hospital in Baltimore and on Tuesday Dr. Armando Sardi will attempt to remove my chemotherapy-resistant tumors and fry any stray cancer cells with a heated chemotherapy flush.

He told me to expect an average hospital stay of two weeks for this procedure and three months for full recovery. But I know from my big surgery in 2005 that complications could prolong that by at least a factor of three.

I don't know exactly what shape my body will be in after the surgery. I'll probably have a new colostomy. I might have a urinary ostomy. The previously irradiated section of pelvic bone will be removed if it's still harboring malignancy. The doctor might find that there's too much disease to treat when he opens me up and just leave it be. Or all could go wonderfully well and this could finally clear me of the cancer I've been wrestling with for more than four years.


How do you prepare for a day of such uncertainty? I spent extra time with family at Thanksgiving and celebrated some parts of Christmas early since I won't be able to travel to be with them. I have already finished wrapping presents for my girlfriend and my mother who will be in town with me. For my scientific consulting business I have made arrangements to work from home during recovery and put projects in motion to continue in my absence.

But it's hard to predict just what will happen beyond Monday. It's like driving on a strange road in thick fog. There are other times in life when we all experience such uncertainty: the first day of school, the first day of college, the first day at a new job or the first day in the military. Those are days like this where there's a known unknown, an experience which we'll look back at someday and appreciate what changed at that moment. Another big day.

Sunday, September 16, 2007

Interruptions

A new school year is starting, and I happen to be in Michigan as September cools toward October. This is where I spent most of my first days of school, from kindergarten to college and graduate school.

I went to a college football game yesterday, the first one I've attended in person since finishing my last degree in 2003. Being back on campus made me think more intensely about the environment of school: the things I enjoyed, the things I miss, and the things I'm happy to be done with.

I became ill during my graduate schooling, and in retrospect my symptoms were probably caused by my cancer and went misdiagnosed for four years. The illness did slow me down sometimes and stunt my activities, but mostly I chalked it up to aging and a delicate constitution and continued about my business. The cancer was not diagnosed until the symptoms became more intense a few months after leaving school.

I wonder what I would have done if the diagnosis was made while I was still a student. Would I stay enrolled? Skip a semester? Leave entirely? I would probably have wanted to stay, but after experiencing surgery and chemotherapy I can't imagine that it would be possible to keep up while going through those.

And if I took a break when would I know to go back? In reality, doctors never say "Congratulations, we've removed the cancer and you're cured!". The results always feel very fragile — the drugs unpredictably knock the cancer down to immeasurable levels and you hope that it doesn't grow back, at least for a while. The chemotherapy may take months or years, and you have no idea how long a break will last when it comes.

Can you commit to years of schooling when you doubt that you can get through uninterrupted? What do you do if a final project is coming due and you start to feel something funny in your body? Do you push through and see the doctor later, or do you drop the schoolwork to go for consultations, lab tests, and scans? What happens to your social network, coursework, and housing if you get pulled away in the middle of a semester and can't return for a year? Does it even make sense to pursue education when you have a fatal disease?

I've met other young cancer survivors and I feel sad for those who were struck in college or graduate school and had to drop out. Myself, I answered many of those questions consciously before I knew what was making me sick and decided that finishing my doctorate was an invaluable goal. Particularly the final year of school I completed through stubborn determination and health be damned.

I'm realizing now that those issues don't stop with graduation. The intense, planned, compulsory institution of education is past (unless I go back as a teacher, which I'd like). But the freeform development of postgraduate adulthood is still enormously impacted by cancer.

Right now I am on a biweekly chemotherapy cycle. I get an infusion on the first day, take poisonous pills for seven days, and then recover for seven days. Out of that I usually feel pretty good for the last four days of recovery, bad for the last four days of poison, and so-so on the other six. My mental capacity fluctuates from good days to bad. I lose memory, quickness, creativity, and ambition on the low days. I imagine that if I were in school I would forget and disregard my classes on one week and realize how far behind I've fallen the next.

I'm trying to figure out how to plan and evaluate events with the knowledge of what's going on in my body. What in the past three years has been a true reflection of my character and what is a temporary handicap of my illness? It's hard to know in the midst of this great disruption.