The 20-Year-Plan

February 5, 2009
(cross posted from Coffee and Chemo)
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Something has been bothering me for a while now.
 
A few weeks ago (or maybe it was a few months ago), during one of my meetings with my oncologist to discuss switching to Taxol, I casually asked if this change is going to “interfere with my 20-year-plan.”
 
My doctor immediately became serious.  “Who gave you that number?” he queried, adding “I did not give you that number.”
 
“I know,” I responded, reassuringly.
 
I completely made up that number.  It is a random number, representing my intention to live with this cancer-thing for a long time. 
 
But then, I got worried.
 
“Why,” I challenged, joking, “is it too short?”  Then, I added, verbalized my fear, “Or is it too long?” 

But my oncologist would not play that game.

“I do not do numbers,” he declared, quite seriously, “You know that.”

I do.  But the Pandora’s Box was open.  Perhaps I was just living in my own little fantasy world.

So, today, I got up my courage and asked, “Am I deluding myself?”

Now, though this conversation has been plaguing me for months, it was not immediately obvious to my oncologist that I was referring to his comment about my 20-year-plan.  So, I reminded him of our conversation and, a little bolder now, repeated my question.  “Am I deluding myself?”

“It’s a bit of a long shot,” began my oncologist. (ouch)  I imagine my face fell a bit. “I am not telling you something you do not know;” he continued, leaning forward in his chair, eyes locked on mine, “you are familiar with the statistics.  But you also know that I do not make predictions.” (yeah, I know)

He cited a patient of his who has been living with metastatic breast cancer for 23 years. (He did not give me any details, of course)

“It is reasonable,” he continued, a bit softer, “to plan for the future.”

And, though it is unusual for him to give his opinion about what I should do, he added, “I think it is right to live your life that way.”

I wish I could remember exactly what else he said, because he gave me a rare compliment about how I am handling living with cancer exceptionally well.  It was really nice.

Then he asked me if I knew I had 18 months left to live, would I do anything different?

I said I would get things in order.  To which he responded, quite sternly, “you should do that anyway, and it has nothing to do with cancer.” 

Then he continued, “my guess is that if you knew that you had only a year and a half left to live, you would accelerate your lifestyle, not slow it down.”

I conceded that his assessment was accurate.  But still, I persisted. “I talk with my children about the future, even about the long-term future.”

I wanted him to understand that it was important to me not to be deluding myself, and also not to be deluding my family.

He got it. 

“Planning for the future is the best thing you can do for both you and your children.” 

He wanted to make sure that I got it too.

I got it.


Cancer vs. The Common Cold

January 15, 2009

(cross posted from Coffee and Chemo (here and here))

It occurred to me that having a cold might affect my ability to receive chemo tomorrow.

I emailed my oncologist, who wrote back: “come and we will decide tomorrow–sounds like you will get a little break”

What does that mean?

Do I have the nurses open my port as usual?

I am scheduled to receive both Taxol and Herceptin. If “we” (and by “we,” I mean “he”) decide to postpone treatments, do we postpone both medications? By how long? A few days? A week? What is a “little break?” (To me, a “break” would be at least a month! We know that is not happening, as we have already established (here) that we can not postpone the Herceptin by more than a week)

Last week, my doctor told me that we would evaluate the efficacy of my treatments in the next two weeks. How does postponing treatment affect our ability to evaluate if the drugs are working?

All these questions, just because of a stupid cold, from which, we agreed last year (see here), cancer patients should be exempt!

It seems that when push comes to shove, the common cold trumps the cancer card!

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Apparently, a “little break” is one week.

I received Herceptin today, but no Taxol. My next Taxol treatment will be next Thursday.

I was a little nervous about skipping the treatment, but my oncologist was pretty insistent. When I pressed him about it, he offered to give it to me if I was willing to sign a waver, taking full responsibility for any possible complications. I politely declined, to which he responded “I thought that’s what you’d say.”

So, I will focus on kicking this cold, which is pretty much taking up all my energy and then some.

I felt a bit better this morning, but by the time I got home I was wiped. I went straight to bed and slept for three hours!