The Night Before and The Days After

Yesterday’s post was a timely reminder.

In order to bring my story into the present I’ve had to write about the recent past.

And yet, one of my most important strategies for fighting my cancer is spending a lot of time being present and in the moment.

While it’s been useful and therapeutic to make a record of my journey so far, I’d like to use today’s entry to quickly jump to the present day. There’s been a lot of thinking and believing and figuring things out in that time, but I can write just as easily about these things in the present tense, or simply dip back into the past when I need to.

And it’s the first day of spring soon, so it will be the perfect time to tell you about the fairies.

As for the recent past, the two big hurdles were the night before chemotherapy and the few days after it.

Chemotherapy involves taking your immune system to the edge of a cliff and convincing your cancer to jump first.

The process may include some nasty side effects, including some long term, potentially serious health issues.

Combined with surgery, it is also the best available treatment for triple negative breast cancer. This cancer is aggressive and spreads quickly. You might hear of people that were diagnosed with breast cancer who postponed treatment while they went on holidays or had a baby. There is not just one type of breast cancer. Some of them are slow growing. Mine isn’t.

Because I spent a good part of my life as a detective in the police force I spent a lot of my time in the weeks following my diagnosis investigating my cancer. As an investigator, you learn the difference between ‘evidence’ and ‘opinion’. You also understand that correlation is not causation; the fact that two things happen at the same time does not PROVE that one caused the other. These are important things to keep in mind when you research chemotherapy and come across all of the negative things that have been written about it.

When I was teaching young police to be detectives I used to point out to them that every paedophile I had ever arrested had owned a fridge. This did not, in any way, prove that fridges caused people to become paedophiles. It’s a deliberately ridiculous example but I hope it makes the point. Someone might go on a radical diet or take a ‘miracle’ supplement. Their cancer might go away. The fact that the two things occur at the same time does not, in itself, prove that one caused the other.

There’s a lot of people out there trying to sell you their ‘cure’ for cancer. There’s also a lot of people writing a lot of very negative things about chemotherapy.

I am extremely grateful to the author of this article:

http://www.sciencebasedmedicine.org/chemotherapy-doesnt-work/#respond

He’s tracked down the most commonly cited research used by the anti-chemotherapy camp and debunked it. He’s also provided some excellent commentary on the nuances of medical research and the current state of treatment for cancer. It’s a very long read and rather heavy going but if you’ve been frightened by something you’ve read on the internet you’ll probably find a direct criticism of it here.

For those of you that would prefer a quick summary, here’s what I got out of it:

  • Cancer is not one disease. It is a large group of diseases and they all respond differently to different treatments. Research into chemotherapy for one cancer is not necessarily relevant to any other cancer.
  • People arguing against mainstream medicine and ‘evil big pharma’ will selectively use research that supports their opinion.
  • The same people will often rely upon a summary of that research, or someone else’s interpretation of it, rather than taking the time to read and understand what the research was actually about; as a good example, there’s an often-quoted paper where a large percentage of oncologists say they wouldn’t have chemotherapy but the actual research is old, involved a specific treatment for a specific cancer and was known to not be very successful at the time. This makes that particular piece of research irrelevant to my treatment, or yours.
  • Sometimes the body heals itself of cancer, either through the natural healing process, the influence of the placebo effect or some other as yet unknown mechanism. Some people choose alternative practices based on these results. Some people beat their cancer using alternative medicine and some die.
  • Some people turn to alternatives when mainstream medicine can’t do anything else for them. In the process, some of those people blame mainstream medicine for not being able to cure them. Nobody wants to hear that they are going to die.
  • Medicine is always evolving. We know this because we can look back on what was happening ten, fifteen or fifty years ago and see how things have changed. What we have right now is our current best practice. The fact that it’s not perfect doesn’t mean it’s not good. It will never be perfect (unless we figure out a way for us all to be disease free forever, and I can’t see that happening).
  • Some of what used to be called ‘alternative’ has now become mainstream medicine (for example, acupuncture). Some of what is currently mainstream will be replaced by better treatments in the future. Some of what is currently alternative will become mainstream. Medical science is in a constant state of change. That is not a valid reason for rejecting what is currently the best available treatment for my cancer.
  • While it is possible that, among the many different claims of a ‘cure’ there is something that proves to be useful in the fight against cancer, I’m not prepared to take that risk.
  • I don’t think that I should avoid participating in current best practice in the hope that there will be something better just around the corner.
  • Chemotherapy is not the best treatment for all kinds of cancer. For some types of cancer the risks outweigh the potential benefits.
  • Triple negative breast cancer tends to respond well to chemotherapy, either before or after surgery. The available data strongly supports this form of treatment as my best option.
  • I will support my medical treatment with complimentary medicine (as opposed to alternative medicine) on the basis that there is strong evidence of the benefits of doing so.
  • I allow for the possibility that this treatment may not be successful and I will cross that bridge when I come to it. In the mean time I intend to use my imagination, my reasoning and my belief to support my wonderful medical team and to gratefully accept what is, at this point in time, the best available treatment for my cancer.

For me, it’s been critical to confront all of this and come out the other side of it with a clear head. Some people just don’t read it. That works too.

If you’re someone that’s chosen to go down the alternative path then I respect that choice and wish you the very best for your recovery. I’m going to stay over here with science, the double blind trial and current best practice along with my yoga, meditation, healthy diet (and fairies). But please don’t send me your anti-chemo propaganda. I’ve read it. It undermines me. And please don’t talk to me about ‘evil big pharma’. Right now I’m relying on their drugs to help me beat cancer.

If, like me, you’ve chosen chemotherapy then you’ll probably find the night before treatment is a challenge. I coped by contemplating the time it had already taken me to get here and how keen I was to finally start treatment. I had a warm shower before bed and relaxed with a recorded meditation on my iPod. My husband held me until I fell asleep. When I woke with the jitters at 2.34am I did some deep breathing and gave the cat a cuddle. I drank a glass of warm milk and went back to bed. It’s a hard night and it’s good to have a strategy for it. Do what you can to be as peaceful as possible.

On the day of treatment I decided that it would probably be better to have a good friend with me than my husband. He’s been wonderful and incredibly supportive but when he’s around I’m more worried about how he’s coping than what’s going on with me. I was very lucky to have a dear girl friend visiting from interstate and she stayed with me for the first part of the treatment.

In the information they give you about chemotherapy they suggest having someone come with you. I found it was also good to have some time to myself. I put my headphones on and listened to relaxing music while I meditated on those wonderful cancer drugs fighting my tumours. I welcomed the treatment into my body. I drank water and imagined it helping the drugs get to the cancer. I felt peaceful and powerful.

I complimented and thanked the staff at the hospital. I thought about how lucky I was to live in country with such a high standard of health care. I was grateful, deeply grateful, for the people that put our public health system in place, for my wonderful doctors, for the caring nurses and for all of the scientists that have worked so hard to find better ways to treat cancer.

My husband arrived for the last half hour of treatment so that he could hear any followup instructions and give me a hug. This worked well for me.

Depending on whether you have your treatment on the ward or in one of the many out-patient facilities it’s worth spending some time thinking about how you’d like that to go and what you’d like to do during treatment. Some people like to chat or read or nap. It’s a good idea to take a bottle of water and some snacks. You may not be hungry but, if you are, then something you know you’ll enjoy will often be more appetising than hospital food.

They will give you ice to suck during treatment. This will help you to avoid mouth ulcers. Take some in a cup with you when you go home and keep using it for about half an hour after treatment. My thanks to the beautiful nurse that gave me this advice.

Write down any instructions you’re given about medication, or make sure someone writes it down for you (and check that you understand what’s been written). I managed to get my anti-nausea medication a bit mixed up on the second day because the hospital discharge notes were confusing. Fortunately I’d been given phone numbers to call and it was all fine. Ring people if you need them.

Following my first treatment I developed a huge, ugly bruise on the back of my hand. Following my second treatment I put a wrapped ice pack on my hand when I got home and I only have a small bruise. If you want to do this then please make sure you wrap the ice pack. Too much cold on already sensitive tissue is a bad idea.

I’ve already written a long post about preparing for chemotherapy and the sorts of things that will be useful. If you haven’t already seen it, please treat it as a menu and not a prescription. Always rely upon what your medical team tell you and make choices that are right for you. We are all on our own journey.

So far my reaction to chemotherapy has been fairly good. My first week is the hardest, mostly because I feel so tired and a bit bloated. My appetite is low but I still manage small, healthy meals and I haven’t had any mouth ulcers or major digestive adventures. Best of all, I have not had any nausea.

If this cycle (my second) runs the same pattern as my first then by next week I will be feeling really well, and I will keep feeling that way until my third treatment.

This morning I checked in the mirror and my left breast is now noticeably smaller. My cancer is shrinking. My treatment is working.

Tomorrow I’ll tell you about the fairies. Promise.

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