Working to Breathe

Kate has been working on breathing. Both in the literal sense as she retrains her system to work around the missing sections of rib and muscle to breathe in and out, and in the yogic sense of using breath to center and ground one's spirit.

Her oncologist has been doing a hard sell on starting the hormone treatments, like, NOW! Since this is metastatic cancer, she was telling Kate that there are most probably micro-tumors hidden throughout her system and the best way to keep them at the micro level is to start hormone therapy as soon as possible.

Kate was slated to start this week, but then took a deep breath and a step back. No question the doc is right about those little buggers hiding out. And yes - the 'run smack into a brick wall' method of entering menopause is her best bet at surviving, and she will start taking the drugs. But.

The histology report showed her cancer to be both likely to spread (we'd figured that much out...) and slow growing (which means !!no chemo!! Yay!!). Will waiting a few weeks to begin treatment really make a difference in her long term survival? After mulling it over this weekend, she decided the answer is 'probably not'.

But, starting the treatment now, when she is still recovering from surgery and slated to start radiation shortly, could and probably would complicate her recovery. It's hard enough to heal when you've been hit from two different angles. Add in a third simultaneous blow? Ouch. 

So the current plan is to start the hormone treatments near or just after the end of radiation. In the meantime, her chest will have had a chance to heal from the surgery so it should no longer cause pain to take each breath. 

Life is easier when breathing doesn't hurt. No question there.

One step at a time.

Healing Steps

I never thought I'd be grateful Kate found a lump indicating her cancer had returned, but here I am, grateful, because it was only because they were doing all the scans to determine how best to treat the lump that they found the larger spiky blob. 

I never thought I'd be grateful to know Kate might have to undergo another trial of fire via chemo, but here I am, grateful, because the possibility chemo might happen means this bout of cancer can be treated, and either vanquished or banished underground for another length of time. (The alternative would mean it was diffused through her system, and growth could only be slowed down, not halted for any length of time.)

Once the final surgery reports came in we received the wonderful news they'd been able to get clear margins after all. **!!whew!!** Game-changing news. 

With the removal of the last drainage tube last Friday, her energy has come bouncing back. It will still be quite some time before the roughly cookie-shaped hole in her chest will be healed; she is missing two 2-3" chunks of rib, along with the corresponding muscles in the intercostal region of her chest (the part of your body between the ribs and lungs - these muscles help you breathe freely). But. Her pain, while still never gone, is now manageable without the help of heavy duty painkillers and she is doing all she can to facilitate the healing process.

She won't know exactly what followup treatments will be recommended until the oncotype testing of the excised tumor is complete, which will be another week or two. She does know she has radiation and hormone therapy in the offing. The medical teams are still saying 'treatable' - no small blessing.

Treatable or not, this is scary stuff to contemplate, too scary. So for now, when we talk, we focus on the best steps to take to begin to heal her current set of bodily traumas. 

One step at a time.

Today, we are here. 

Goodbye, Duane

Duane is - *sigh* - was - my cousin. Three or four years younger than I, I can't recall I'd ever had a real conversation with him until we met up at a family reunion in Virginia a couple of decades ago. 

He opened the conversation by telling me how much he'd LOVED my green Schwinn ten-speed, which I'd saved up to buy when I was a teenager. I was surprised he'd remembered the bike; as we talked it quickly became clear he'd paid a lot more attention to me as we grew than I'd paid to him. (sorry, Duane)

Since then, I've talked to him a lot more. When I took off in my camper van, I stayed for a few nights with him and his wife, Tracey. One fine Saturday, they took me to Wisconsin and introduced me to the sport of Watercross. (For the uninitiated, this is where you wait until summer, find a good shallow pond somewhere, and see if you can drive a snowmobile across it. You just know the sport started with a couple of guys saying, "Here! Hold my beer and watch this!") I still chuckle when I think about that day.

I admired how Duane had worked to do well in life. He once told me he was a slacker in high school, went to college just because he was supposed to; had no idea how to succeed there. But once he got there, he took a look around, figured out how to study, kept working, and ended up as a chiropractor. Not an easy trick to pull off. 

He married young. Somehow, he and Tracey managed to work through all the things they needed to work through to stay and grow together all these years. Again, not easy to do. They had three boys; raised a group of fine young men.

I last saw him just a few weeks ago at yet another family reunion. There were quite a few people there, and though I said hello, I didn't get a chance to catch up with him. I texted him after I got home, telling him I was sorry I'd missed him. He texted back, said he felt the same, and he'd catch me on the next go-around.

The next go-around won't happen - he died from a sudden heart attack earlier this week.

Damn margarita truck!

I am in shock. Regretting my lost chance to talk with him, to find out how life was treating him. It's not like I think the conversation would have been consequential. I just hate it when I don't get a chance to say goodbye to those I hold in my heart.

So, goodbye, Duane. 

I hope you are where the fishing is good and the mosquitoes (mostly) leave you alone. When winter comes, I hope you and whichever buddies you have there (you'll probably add some new ones to the crew, knowing you and your charismatic ways), will be able to ride free on your sleds, flying though the snow, out in the wilderness you loved so deeply.

Peace.

Cancer Sucks. Still.

Man! This is some tough stuff!

Kate's surgery was last Friday afternoon. The first part went well - they were able to get the lump in her armpit out with clear margins and no difficulty. Her implant also came out cleanly, but then they started digging into ol' spiky; the mass that had been hiding behind the implant.

Although I'm told the surgeon was pleased with the final results, I'm not sure in what context that should be taken. I'm guessing it was that she was successfully able to plug up the holes in the two ribs she had to cut into to get the tumor out, because at the end of the long evening, she removed the biggest parts of the mass, then had to call it quits. Kate's chest wall was too compromised to dig further even though they still hadn't gotten clear margins. Because of the extensive cutting, they were also unable to insert a new expander - which means reconstruction will require a lot of creative effort.

(Beyond radiation, which was a given, clear margins or not, I haven't yet heard what treatments they will use to follow up now she's made it through surgery. I'm guessing they'll wait to decide until they get the detailed pathology back on the tumor, which will take a bit.)

Lexi and I ventured in to see her on Saturday. (She's not been alone there - Edwin, her partner, has been a rock.) She looked OK when we got there, but then took a sip of water. As soon as it hit her stomach, you could see the nausea rise, which made her cough, which made her pain levels spike.

We didn't stay long - she'd gotten to see her baby, I got to see mine is still breathing - because what she needs most of all is to rest and get better, not to stay awake to talk. 

She's made incremental improvements since then. They took out her chest drain yesterday, which instantly helped with her ability to keep her pain under control. She was able to eat most of a popsicle last night and keep it down. I'm hoping she'll be well enough to come home tomorrow.

I've been doing what I can to keep Lexi's life on an even keel, helping her get to and from her daily activities. 

I've been in an odd state of denial. My head and heart don't want to believe Kate is hurting so badly, and since she's not here at home, I find myself acting as if she were just off on a trip - that she'll come back soon, safe and sound.

Then the image of her in the hospital, pale and hurting, comes to mind, and I cry for a minute, trying to feel my feelings instead denying they exist and stomping them down. Then, I stop and breathe.

I remind myself of my hard-learned lessons and resolve once again to not let fear run roughshod over my day.

I can breathe.

I can Be. Here. Now.

I can rest for a moment in the beauty and lean on the love which has been SO in abundance already during this trial.

I will not let fear win. Not today.