Cancer: a love story

YES. IT DOES HAVE TO HAPPEN ALL AT ONCE!

I don't know why it does but it just seems to happen that way so there is nothing to do but deal with it. Prioritize as best as you can and then deal. I have been feeling increasingly amounts of fatigue four days out of seven without being sure of the source since I have so many reasons to experience fatigue. Last week I saw my Florida nephrologist who always seems bemused by me as he says: "I don't suppose you're ready to come in and get your dialysis port, are you?" And I laugh as I say: "No!" I have thirteen percent kidney functioning remaining but I am hanging onto that remainder for dear life. But for the first time I began to question myself and wonder if I was being stupid...or maybe frightened.

The doctor thinks that the fatigue may well be a function of the kidney deterioration and I began to question that if he were right perhaps the effects of the fatigue is too high a price to pay for resisting dialysis. However, I don't have other significant symptoms of kidney failure like vomiting or itching which I would hate. So I spent the week talking with friends, thinking about what to do, and planning on returning to Boston to talk with my specialists there. The dialysis I plan on doing is Peritoneal Dialysis which is self administered while you sleep. Fun, huh? And you have no idea how squeamish I am. But I understand PD is more convenient, effective, and overall effective so I will just have to do it. Just deal with it. But you can understand how I might be reluctant to begin the entire process.

And, oh, did I mention that a routine visit to the dermatologist revealed that I have some skin cancer on my face. Apparently, the origin has nothing to do with this Florida sun but began in my childhood. I get to deal with that tomorrow.

And now my dog, Lucky, has become increasingly aggressive in his defensiveness. He has bitten two friends and menaced two others over the weekend. Yeah, this past weekend. You know the one where I was struggling to determine whether or not I needed to begin dialysis? Why now? Do I really need to deal with this now? Well yes, I do. I can't actually put any of it off. I can't afford to allow myself to become too sick before I commence dialysis and I will not have a dog who, while most of the time has the sweetest, most gentle nature, erratically bites people.

My priority yesterday was to call the veterinarian but before I could my Florida oncologist phoned to tell me that the cancer markers had fallen from 7 three months ago to 6 last month and had just fallen again to 3 - all a very positive sign that the chemotherapy is working effectively. However, what is not so positive is the fact that he believes I will have to be maintained on this chemotherapy. I'd rather not but under the circumstances I will just have to deal with what is. But then he told me I was very anemic and arranged for me to receive a six-hour double blood transfusion which I am doing as I write this posting. Now this has given me hope that the transfusion will do much to allay my fatigue and I can continue to postpone consideration of dialysis. Dealing doesn't always have to mean doing!

In the meantime, the vet called and we will begin Lucky, who is both anxious and co-dependent, (go figure) on anti-anxiety medicine and some behavioral modification. For example, sleeping with one of us makes him more co-dependent and less independent, as does sleeping on the furniture. Sleeping on the floor makes him more independent and self-reliant. This explains why when he is secure around us everything is fine but if he is startled by the unexpected presence of some new, less bonded person he becomes insecure and his defense becomes aggressive even though he has never been an aggressive dog. More with which to deal.

And deal I do. And will, as each challenge arises. It often appears that it is all too much or at least would be much more manageable if these things came one at a time but they frequently don't. And yet, with a bit of organization and prioritization, things get handled one way or the other. And if you look closely in the rearview mirror the road is strewn with the debris of past challenges with which we have had to deal ...but few catastrophes!