experience, treatment

Unspoken: Part 1.

This post is the first in the series I am writing on the subject of chemotherapy and fertility. It has taken me the most time, intentionality, and courage of anything I have written to date.

As always, the experiences and opinions voiced in this article are mine. My story is not the story of all women, but a tiny piece in the large mosaic of the complex issue of fertility. I wrote honestly and openly – mostly because I wish I had the opportunity to read another patient’s account regarding fertility treatment. The intent of this post is not to overshare, nor is it to cast judgment on others who would, or have made, different decisions. I believe that every person deserves the right to make informed choices about their bodies, and that includes reproductive health.

Last week was Infertility Awareness week in the United States. 1 in 4 men and women struggle with infertility. I believe that the more we share our truths about the complex issue that is fertility, we can help mitigate the stigma and end the cycle of isolation, shame, and grief that is so often at the center of fertility struggles.


 

crisis
Image of the sign borrowed from ABC20

There’s a small sign that hangs in my office at school that my coworker was gifted years ago. It reads, “just take it one gigantic, earth-shattering crisis at a time.” I love that sign. It’s honest, isn’t it? Because life doesn’t usually hand us challenges in neat packages. Instead, you get something akin to those Russian nesting dolls. You think you’ve tackled your problems, but as you unpack it and delve deeper, you reveal more and more than you saw upon first sight.

In the middle of March, I was prepared for the start of IV chemo. What I didn’t expect was the life-changing decision I’d have to make before it even began.

The day I agreed to start Doxorubicin is a bit of a blur. Thankfully, I had done my homework on the drug, so as my oncologist rolled through the list of side effects during our appointment, I simply nodded in understanding. I knew that fatigue was the biggest side effect, as well as hand and food syndrome, lack of appetite, nausea, and mouth sores. Check, check, check, check, and check.

I paused when he mentioned there were other, less common side effects that I’d need to sign off on. I was handed a plastic electronic pen with which to sign a consent form. This digital consent form was my acknowledgment that, among other things, there is a small but real chance that my monthly infusions could leave me with leukemia, send me into early menopause, or eliminate my fertility. My oncologist recommended in the next breath that I set up an appointment for a fertility consultation. A nurse from the sarcoma program would coordinate with the fertility office and call me to schedule.

I took a deep breath. I signed.

The next day, while in a tech rehearsal for the musical I was choreographing, I received a phone call from the nurse. The fertility clinic couldn’t see me until April, which would be pointless, as any fertility treatments needed to conclude prior to the start of my treatments. Luckily, there was likely to be a cancellation the next day so I could be seen- provided I could call and confirm in the next fifteen minutes before the end of business hours. I did, sent a text to my mom asking her to accompany me the next day, and quickly shot off a flurry of emails to find a sub for my classes.

As rehearsal continued, I sat and struggled to make sense of what just happened. I googled the cost of egg freezing, the process through which my future fertility would be more possibly secured. I tore through the desmoid tumor patient facebook group, searching for the terms fertility and egg freezing.  I got a vague understanding that this consultation would need to be the start of a much longer, much more involved process than I had anticipated. The weight of this decision slowly settled in.

While this may seem like a cut and dry decision of whether or not to freeze my eggs, there’s something you need to understand about desmoid tumors. Scientists have no idea what causes them, but there is some evidence to suggest that they’re hormonally driven. My own tumor tested positive for estrogen receptors, which indicates that any change or increase in hormonal activity gives the tumor a chance to grow. It’s a common subject of discussion on the desmoid facebook group. Many women shared that their tumor grew exponentially during pregnancy, presumably both from the change in hormones and the inability to treat the tumor while carrying a baby. An article was just published on March 20 of this year with the partial title “Bedouin woman with a dormant neck nodule that grew explosively during her pregnancy.” And while the risk of infertility after this round of chemo was small, I already had this rare disease, this one in a million tumor. A 1% chance of something going wrong had already proven itself 100% possible.

Was I willing to freeze these eggs if even carrying a pregnancy would be that risky? Every woman whose tumor had grown said they wouldn’t change a thing because it meant they had their beautiful baby, but I couldn’t imagine needing to undergo more intense treatment immediately after giving birth to a child. Surrogacy was another option if I wanted a biological child, but with a teacher’s salary, the $70,000 – $100,000 price tag seemed unattainable, especially when adoption was something I would be willing to consider. And then the deeper question: was motherhood something I even wanted? I never had that deep, unflinching “yes, absolutely” when asked if I wanted kids someday that so many people I know carried with them, as certain as their own name. I didn’t worry too much about it, especially since I wasn’t in a relationship, and I was 29. Wasn’t there time to think this all through?

It turns out, I had even less time than I thought. Treatments take several weeks. I would need to begin immediately.

I had 19 hours to make a decision on whether or not I wanted a biological child, and if so, how much I was willing to pay for it. Because while it was a side effect of my necessary chemotherapy treatment, insurance wouldn’t cover a dime.

With exasperation and fury, I remarked to someone that it felt like a bad crossover season of The Handmaid’s Tale and 24. I could barely see past the start date for chemo. How on earth was I supposed to make a level-headed decision about the rest of my life? I paced back and forth across my living room floor, unable to sit down, frantically searching for the right decision.

This is the unspoken battle of any life-altering diagnosis: it robs you completely and utterly of any sense of security. I cried more in those 19 hours than I had in the year since my diagnosis. Grief is not relegated to death, at its core, it is the deep and painful acknowledgment of loss. At 29, I was grieving the loss of a life I thought I would have all over again. Any sense of freedom is derived from having agency and choice, and I was watching my choices disappear behind variables, side effects, life events I couldn’t predict, and dollar signs. I wondered how much more my heart could continue to break and repair itself.


To be continued.

treatment

Staying Afloat

'Dark Sea', Winterton-On-Sea, Norfolk
Photo credit: Pete Bridgwood

This is not going to be a fun post to read. It was not a fun post to write.

I had another scan this week. If you’re wondering what the results were, I’m going to politely ask you to read this entire post. There’s a reason, I promise.

Monday: Insurance

My scan was on Tuesday, and Monday was an in-service day at work, which meant no students or classes to teach. “Scanxiety” had long ago set in and I was looking forward to a bit of distraction. I walked out of a meeting at 9:45 to find a voicemail from the radiology department of UPenn. The speaker informed me that my insurance company had denied my request for my MRI, which was scheduled for 9:00 the next morning. Furthermore, if I couldn’t get it straightened away by 2 PM, I would lose my appointment slot. I was floored: why was this an issue now and not when I made the appointment back in August? The shock quickly changed to panic. If I couldn’t make my MRI, my oncology appointment the next day would be pointless, and it would take me potentially weeks to get in again.

As I tried to reach the Nurse Practitioner with the Sarcoma Program at Penn, our HR person at work helped me reach my insurance company, since my case manager was not able to be reached. This insurance company put me in touch with a third party that does insurance authorizations and was apparently responsible for the refusal. The third party informed me that I already had an MRI on file and could not have repeat imaging done without winning an appeal of the decision. I finally reached someone at the Sarcoma Program on the fifth try an hour later, and the nurse assured me they’d work as fast as possible. It was 11 AM by now, and we were racing against the clock to get this so I could keep my appointment. As I bounced from phone call to phone call, 2 PM passed. Fortunately, my new best friend in the Radiology Department told me the Director of Radiology would extend the deadline, as the office was actively working to straighten things out.

Does it sound chaotic and stressful? Let me assure you, it was.

At 5:15, I got a call from the Nurse Practitioner that my scan for the next day was on. She shared in my frustration, as she had to reorganize her whole day as well, and apologized that I had to go through it. Then she shared the hold-up: the third party thought I was not currently in treatment.

Tuesday: Scan

I arrived early for my MRI. When I give my name at check-in, the receptionist sighed, “oh, I’m so glad your authorization went through!” (I guess my issue was quite well known at that point amongst the staff at the office.)

I went back to prepare for my scan get the IV for contrast put in. The tech remembered me from the last visit when it took four attempts to get a vein. I was embarrassed – was that my reputation there now?  They got it on the first attempt this time, though they went through a vein in my wrist, which hurt whenever I moved in the slightest. I listened to Queen inside the machine, since I listened to Michael Jackson the first two scans, and I was looking to break my streak of bad luck.

I was ready for good news.

Wednesday: Appointment

I stayed up as late as I could on Tuesday night and tried to sleep in late on Wednesday. My appointment was at 2:15, and I could feel my heart beating through my chest beginning around 9 AM. I did everything I could to keep myself calm and distracted: read, watch Netflix, even practicing hand lettering, which was widely unsuccessful with my shaking hands.

By the time I was ready to go over the bridge, I felt like I was going to get sick or burst out into laughter. At the start of my appointment, the nurse took my blood pressure, which was through the roof. I told her I anticipated as much and described how anxious I was about the appointment. With a wide grin, she said that I sounded like I was on speed.

A few minutes later, my oncologist walked in. He said my tumor was “the same.” Specifically and scientifically, it was the same in two directions, grew two millimeters in the third. I had prepared myself for two results: growth or shrinkage. I knew that if this thing grew, we’d opt for aggressive treatment. If it shrank, we’d stay the course. I hadn’t really thought through what it would mean if I basically got news.

My oncologist suggested another oral chemotherapy. I couldn’t help it: the tears started flowing. I’m sure it was confusing to my doctor; it was confusing to me.

Here’s the best I’m able to explain it: I had worked so hard to get myself comfortable with the idea of more aggressive treatment. I was ready to take time to focus solely on battling this disease and shrinking this thing that’s been only growing since I started treatment in March. (And yes, just a few millimeters still counts to me as growth.) To try a new oral chemo felt like starting back at square one. I was trading fatigue and nausea on one drug for fatigue and edema on a new one. He also shared that it would take six months to chart any change or progress.

I expressed my frustration: I was ready to shrink this thing, and I was discouraged and tired from 9 months of failed treatment. (Hearing that I was tired, my doctor offered that since Desmoids are so unpredictable, I could do nothing and see if it stayed the same on its own. That scared me even more.) It’s not that I wanted more aggressive treatment and the slew of side effects that go with it: I wanted change. And if it meant aggressive treatment to get to a place where I’d have some tumor-free years, sure, bring it. I was less afraid of change than I was of the status quo, of mediocrity, of more of the same. I understand and agree with his call, but it doesn’t hurt less.

The rest of the meeting was talking and listening and to be honest, I don’t remember most of it. What I do remember are the words that have been ringing in my ears ever since: “This could just be something you live with your whole life.”

It was terrifying to hear, but not because it’s the first time I’ve heard it. I’ve just never heard anyone other than the voice in my head say it.

In the Water

The reason I asked you to read this whole entry is that it’s long and frustrating and boring. It’s a glimpse into what my day-to-day life is like living with an incurable form of rare cancer. Despite my best efforts, no one wants to read about battling with an insurance company. It’s just not an exciting narrative.

Being on chemo is like treading water. You’re tired, it’s incredibly overwhelming, and at all times you’re aware there’s a chance you might drown. You see other people swimming perfectly and you’re unable to get into a rhythm. Sometimes you feel like you’ve gotten the swing of it, and others you’re gasping for air desperately trying to afloat. You’re aware that the sun is sometimes shining or the water is comfortable, but it’s not always a thought you can register. You ache for the ability to become buoyant and swim. Imagine then, treading water, while others swim by and tell you that you’re lucky that you haven’t drowned.

I’ve struggled with sharing these scan results and appointment outcomes. When sharing my scan results, I’ve frequently had people suggest other perspectives. I have heard things like “at least it didn’t grow,” or “well, you’re not heading into surgery.” These are both accurate and completely valid points, but it does not change how I feel, especially when sharing the news so soon after my appointment. I’m disappointed and frustrated, and I think I have every right to be. I hope to live well into my eighties and to think that I could be fighting this thing for over 50 years is devastating. I want to get to that place of optimism and determination, and I do think I will. But now, in all honesty, I’m just not. People often comment on my strength, and truthfully, don’t feel stronger than the next person. It’s simply not realistic to act strong all the time, either.

Right now, I’m not feeling strong, I’m feeling tired. I’m feeling frustrated. I’m feeling disappointed. I need some time to regroup and figure out steps I can take in the next few months to feel fulfilled and happy, chemo and all. I think I’ll get there. First, I need to figure out what that means to me.

Thanks, as always, for following along with my triumphs and challenges – and for your willingness to listen.

PS: For a helpful perspective on empathy from someone who studies it for a living, check out this short animation with words from Brene Brown. She’s got some great advice on what’s helpful and what to avoid when speaking with someone who’s facing a challenge.

appointments, experience, treatment

An ER Visit and a Chance Meeting

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Fabulous rainbow image courtesy of pinterest.

I spent last night in the emergency room. On my list of things to do during the last week of school, this ranks far down towards the end, perhaps just above “give my kindergarteners espresso.”

First, some background. With my medication, I’m nearly always experiencing some form of nausea or loss of appetite. I’ll eat very little at a few meals, unable to choke down foods I previously loved; then I’ll be hungry a few meals later and try to eat as much as I can to take advantage of that window of opportunity. I have to eat even when I don’t feel like eating, which for anyone who has experienced it before, is a complicated issue. I’ve had people comment to me, “I’d love to have that problem!” or “It must be nice to feel like you can lose some weight.” These statements are really hard to hear. If I had my choice, I’d rather feel strong and healthy over sick and skinny, desmoid tumor or not. I suppose the “weight loss” impact might seem appealing, but without nutrition, my body doesn’t have the fuel it needs, which is exactly what happened this week.

At times my nausea is improved by eating (counterintuitive, I know) or at least subsides after a little food and a lot of rest. I spent Sunday laying low in my apartment: I did not feel great upon waking, but I managed to eat some oatmeal by the early afternoon, took a nap, finished a book, and felt better. On Monday, little appealed to me at lunch, but I made one of my go-to dinners: a falafel wrap with spinach, cucumber, tomato, and goddess dressing. I got to bed a bit early and decided I’d discuss the nausea with my oncologist the next day at my monthly appointment.

I never got to that appointment, because I was soon experiencing what I assumed as Stomach Virus Number Three of the past 30 days. I sent a text to my sister Jenna, who was scheduled to attend the appointment with me and is currently in nursing school. When it was clear that the virus was not letting up, she and my mom drove up to my apartment in the early hours of the morning. (I’ve said it before and I’ll say it again: my family is the greatest.) They took turns caring for me for the ten hours I was actively sick, looked after my super confused and anxious dog, and tried to catch some sleep ON THE FLOOR and on my couch. (Seriously, who does that? I can’t say enough how lucky I am.) When I was well enough to be in the car, they brought me to my parents’ house.

For two days, I had the ultimate recovery fake-out. I’d be fine during the day, eat a piece of toast and drink Gatorade, and send an email to my boss saying “should be good for tomorrow!”, only to end up sick that night. Finally, my oncologist’s office offered to get me a spot sometime the next day for an infusion of fluids and anti-nausea medication. They called in an oral anti-nausea medication and an anti-spasm prescription for my stomach cramping. But when I couldn’t even keep that down, my Mom went into “Mama Bear” mode and gently, yet insistently, offered to take me to the ER. We have an agreement: both of us always respect the other’s choices, but there will be times when we can straight up insist on having the final call. I knew I was in no place to make decisions about my care, so she googled which emergency room had the shortest wait, and off we went.

So, that’s how I ended up hooked up to an IV bag with fluids to hydrate me, anti-nausea to ease my belly, and morphine to take the edge off the pain. I finally felt some of the relief I deeply craved, and I remarked to my mom that it was the best choice I’d made in days.

Shortly before I was discharged, I would discover the full truth of that statement. One of the attending nurses on duty walked in and introduced herself. She had read about my medical history and said she had to meet me. Why? She herself had a desmoid tumor. I was floored and blinked twice to make sure this story wasn’t crafted by the morphine I’d been administered. As she worked on my discharge paperwork, she shared with me about her diagnosis, her surgery, and about her life five years later without a recurrence. Having only met one other Desmoid Tumor patient before (hi, Dakota!), this unscheduled and unorchestrated meeting was completely out of left field – and confirmed my belief that the ER was the best choice.

What’s next? Good question. I don’t really know. I’ve got another appointment with my doctor to discuss changing my medication. Since my white blood cell count was good on my latest labwork, it could be that these bouts are not actually stomach viruses, but a side effect of my medication. My oncologist advised me to stay off my medication until we can discuss it in more depth.

For now, I’m happy to be back on the couch with Fixer Upper reruns, water to drink, and slices of banana to snack on when I feel up to it. It’s been a wacky week, but as I’m continually reminded, living with this diagnosis means nothing that ever goes according to plan.

treatment

Zero to Eighty

 

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Photo by Angie from Pexels

 

The past two weeks have been an absolute roller coaster. There were highs and lows- even a few actual nausea bags, thrown in for authenticity.

Let’s recap.

May 3rd – Setting the Bar Low

I had my root canal. Even though it was unofficially ok’d in a message, the oncologist’s office never sent the forms over to the dentist, so I spent 35 minutes playing Nancy Drew trying to find someone to write a letter stating I was approved. The office was none too pleased.

* This is an important thing to remember if you know anyone with any kind of chronic health issue: we spend LOTS of time on the phone tracking down doctors, paperwork from doctors, or obtaining authorization to see doctors. Please give us a pass if we get off the phone and seem irritable and/or frustrated.

Thankfully, my mom reached someone at UPenn around 9:30 and an official approval letter was sent via email. (My oncologist, who is great, later sought me out to give me an apology over email and in person. ) As soon as I let the staff know “the letter’s on its way!” they stuck the numbing QTip on and got to work.

The root canal was exactly as you expect it would be: painful and awkward. Let’s not spend too much time lingering on this event, lest we conjure up any memories of dental work past.

I left and was back at work by lunchtime to run a rehearsal for our fourth graders.

May 4th – Climbing to New Heights

I watched my fourth graders take the stage in The Lion King KIDS. Let me tell you, it was remarkable. (I don’t consider this a biased stance, because I had very little to do with it. The way I see it, if you do the right kind of work as a director, you mostly pose questions or considerations and run away, leaving the actors to find the right solutions.)

I mean, c’mon, look at these photos!

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The Circle of Life continues!
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Visiting the “Elephant Graveyard”.

They made me very, very proud, and I was very, very happy.

May 5th – Still Ascending

May 5 was my 29th birthday. I checked on the DTRF donation page and was blown away. My little $500 goal had been met – seven times over. 

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It’s pretty safe to say I’m still in shock.

I don’t have the email addresses for everyone who was generous enough to donate, nor the time to thank each of you as personally and as thoroughly as I’d like. Please believe me when I say, each and every donation means so much to me. I just don’t have the words to thank you enough for all you’ve given. I am eternally grateful and indebted to your generosity.

May 6 – The Peak

I threw myself a ridiculous unicorn-themed brunch to celebrate what I’d like to call the “Victory Lap” of my 20’s (aka, age 29). I wore an outrageous unicorn crown that I made, ate unicorn cupcakes and other rainbow-themed food, and felt the love of being surrounded by family and friends.

 

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A peek at the outrageous, wonderful crown that happened.

 

May 7 – Freefall

Overnight, I caught a lousy stomach bug. After a few hours, it passed, but I woke up feeling tired and irritable. I had arranged for a substitute teacher so I could take the day off work and attend a follow-up appointment with my oncologist.

On the way to the appointment, my Mom voiced her concern that my tumor appeared larger. I honestly have little way to gauge the size of it: I see it every single day. During my appointment, my oncologist agreed that it looked slightly larger. He agreed that I needed to get an MRI, preferably that week. The doctor also said I had a decision to make. Either stay on Nexavar if I could manage the side effects, find an alternative oral medication, or head to surgery.

This made my stomach drop. Really? We were still talking about surgery? The tears began to make an appearance when I told him, under no uncertain terms, did I want to try surgery before exhausting my other options. Thankfully, he wholeheartedly agreed. I decided to stay on my current medication and adjust my expectations for my lifestyle. I’ll take tired, sore, and nauseous over cut open, please and thanks.

The ability to hold to that decision, however, was contingent on the results of that week’s MRI. My insurance required pre-authorization on the request, and once that was in, I’d be good to go.

May 8 – Another Drop

Tuesday started as a normal day. I went back to work, had a normal breakfast and lunch, but by the afternoon, I was locked in a heated battle with my insurance company. They directed me to an outside company which handles authorizations, and that company rep claimed that they did not have the information needed to process the MRI request, even though UPenn had already sent over office notes. I then made numerous calls to both the authorization company and UPenn. It was infuriating.

*Remember what I said earlier? Please be patient with your family and friends who have chronic or severe health issues. They make these phone calls weekly, if not every day.

By Tuesday night, I was feeling tired and not too hungry. By midnight, that “not too hungry” became violently ill. This thing took hold of me by the ankles, shook me violently, and left nothing but the good sense to send a text to my mom.

 

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I call this one, “Still Life: The Virus.”

 

May 9 – Leveling Out

My mom arrived on the scene by six AM, with cleaning products, Coca-Cola, Gatorade, and bread on hand. She gave me a bit of flat soda to make sure I could keep down liquids, then drove me back to my parents’ house where I could rest and not worry about taking out the dog on my own. (Valuable, as I couldn’t stand straight.)

I don’t remember too much about that day, other than my family taking care of me. I won that family lottery, in case I don’t say it enough.

The only silver lining of that day: I got an appointment for an MRI the next day.

May 10 – Beginning to Climb Again

I had my MRI. It was quick and relatively easy. I listened to some Michael Jackson on a Pandora playlist and held my breath when the technician told me to, and then it was over.

I kept down a few pieces of sourdough toast, some water ice, and by evening, even some rice and beans. (My sister, the insightful nursing student, stopped me from adding sour cream.) I got back to my apartment that night for another solid night’s rest before heading to school the next morning.

May 11 – Another Peak

What a beautiful day, right? I was feeling able to eat for the first time in a few days and put on my favorite dress to celebrate.

I kept myself busy while I waited for the phone call with the results of my MRI. At 3:30, as I was leaving work, it arrived: my oncologist confirmed there has been no significant growth of my tumor. (Cue the confetti!) He said while it may have grown a hair, it’s essentially still the same, so his recommendation was to stay the course with my current medication and get scanned again in three months. I happily agreed and said I’d see him for my monthly appointment in June.

For those of you without great calendar skills, three months of treatment puts me as due to be scanned in the middle of August. Other desmoid patients who have been treated with Nexavar have seen results between 6-9 months, so this scan might not show anything significant, which would still be OK by me. Let’s be real: is this truly great news? To a cynic, probably not. (I see your point, I’d rather not have this tumor, quite frankly.) But after the low bar of achievement was set, on top of thinking I was headed to the operating room, this was like finding out I had won the lottery.

Exiting through the Gift Shop

I’m still making sense of this whirlwind of two weeks. For now, here’s what I’ve got in hand:

  • A fundraising campaign that’s far surpassed all my expectations
  • Another musical production under my belt
  • Reassurance that my family and friends are not going anywhere
  • The knowledge that my tumor’s just fine, for the time being

This weekend, I think I will celebrate. My body’s not quite ready for champagne, so for tonight, it will be some of my other favorites: a great book, some self-care, and my pup at my side.

treatment

Detour.

Did you know chemo can cause issues with your teeth? I didn’t- But now I do!

Because I need a root canal.

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Musical theatre reference courtesy of Steve Martin. Image courtesy of pinterest.

Here’s the scoop: I’ve had a spot of sensitivity since my last cleaning in December or January. (Who really knows when; it’s all a blur.) Then I got diagnosed, started my medication, and bam!  Excruciating pain since last Friday. My oncologist advised me to hold off on my medication to see if it was a side effect. No such luck. I went to the dentist this past Wednesday. I was x-rayed and the proclamation was made: it was time for a good old-fashioned drill party. (But first, I needed my doctor’s approval and over a week of antibiotics to make sure an infection doesn’t occur.)

Evidently, when you are on my medication, it can cause dry mouth. Not a huge deal, but your saliva is actually a key player in making sure debris doesn’t hang out in your teeth for too long. (Everything bagel or not, all food needs some help.) No saliva leads to more hidden issues, which leads to more cavities. Or in my case, do not pass go, do not collect $200, get a root canal.

This Thursday, I’ll have my tooth root-canaled (is that a verb?), head into school to run a 1 PM rehearsal, then hopefully get cleared to start my medication again.

By the time I get started again, I’ll have been off my chemo meds for about two weeks. That doesn’t seem like a lot, but even if my tumor hangs out and doesn’t grow in that time, my body already has no idea which way is up or down. Right now, it’s having a full out MTV Spring Break of a time. “No medication?! Awesome! Here’s your energy and appetite back! Go wild!” Next week, I’m anticipating a bit of a challenge as I get acclimated all over again.

I’m trying to think of this as less like a road block and more like a detour. I have a lot of great things to focus on: the astounding progress we’ve made with the DTRF Fundraiser, the great retreat I went on this past weekend, and a musical opening this Friday that I’ve been working on since November. I’ll be honest though: even when I feel Pollyanna about it, I’m still in more pain than I’d like and have developed a borderline addiction to Orajel.

The moral of the story: if you have a diagnosis like mine, even when you brush and floss, expect the unexpected. The detour will arise inevitably. Best advice I’ve got at this point: pack easy-to-chew snacks and have people you like along for the ride.