There’s this thing with cancer awareness months that sets me off into unreasonable head-space land.
“Don’t Give Up… Never Give Up.”
In a perfunctory search, and some talk with my sweetheart, this phrase is related to Jimmy Valvano’s speech, and his foundation, and the search to cure cancer. That’s a good thing to try not to give up on. Search for a cure.
Somehow, it gets used as a rallying cry to patients.
This infuriates me. Sometimes, there is no more. Sometimes, you are literally causing yourself extreme physical anguish with treatments that are barely prolonging your life at a dreadful cost. Sometimes, those treatments don’t even do that, and all you are doing is allowing your test results to aid in statistics for drug companies to further research. Which is not bad, if you have the mental and emotional strength to put yourself through that physical pain and horror.
Some people don’t, or do for a time, but eventually realize that it’s affecting their ability to enjoy the last moments of their life with loved ones. Sometimes, the hardest and best thing to do is to say “no” and to look your oncologist in the eye and say, “It’s time.”
And if you have a good oncologist, one who is not just obsessed with eradicating the disease, but also with helping the humans in his or her care, the doctor will say, “Ok.” The doctor and his team will switch you over to the palliative care team. You will enter hospice care. It may happen at home; it may happen at a hospice house; or it may be a blend of those things.
Making that decision is not giving up. It is not a failure to fight the hardest fight of your life. It is the next step. Because it’s not easy to say goodbye. It’s not easy to stop. It’s not easy to say, “I am going to become a part of nothingness and my body will return to the earth,” if you are an atheist (or other believer in things that do not involve afterlife). It’s not easy to say, “I’m at peace with my decisions, and I believe that whatever the afterlife holds, I will be ready for that adventure now.” Because you are leaving people behind, and they will suffer your absence. And you will be intimately aware of that. And even once you reach the moments where you aren’t quite as aware of that, there will still be moments of seeming lucidity where you see people you thought predeceased you with those who are keeping watch over you. And in the event you choose to be mostly alone, you will still be with your own thoughts and memories.
It is a lot. It is still a battle. It’s not an easy, thoughtless choice; choosing to end your battle with cancer by living your life.
These canned statements for awareness make me so desperately angry, to the point of violence. Fuck cancer. Fuck what it does and is. But do not equate stopping treatment with giving up.
It’s about that time again.
I should probably say that when I use the word “depression” for myself I don’t mean the clinical sort. Every once in a while, I debate going to a licensed professional and finding out if I have a mild version, but as I can usually shake myself out of the mood or just wait it out, I haven’t bothered. It costs money and energy that I’d rather spend on other things.
In 2004, in September, I separated from my ex-husband. Our marriage had been in various stages of implosion and explosion for at least 4 years (although, with the power of hindsight, I suspect that it was having problems much longer). My dad was fighting lung cancer that had metastasized and gotten more complex (it got into his larynx, among other things), and somewhere between then and October is when he and mom told us that he was going to back out of his trial program. The benefits were nowhere NEAR outweighing the negative side effects. We also abruptly lost my mom’s youngest sister to a rare form of blood cancer. For us, there was no warning. I’m not clear on how much warning her kids and husband had. She’d felt horrible for years and finally was getting pushier at getting doctors to listen. I went back to see mom and dad in November for Thanksgiving. Dad had a collapse and had to go into the hospital. The next 3 weeks are a bit of a blur, but we finally got him admitted to hospice and home where he finally felt safe leaving us on his birthday, December 16th, 2004. He was 62.
Six years later, 2010, in late fall (I want to say November, but it’s actually blurred and I don’t trust that), mom also chose to check herself into hospice. Mostly because her doctor was honest. He might be able to give her up to a few more months. Maybe longer. But it would hurt and she might spend a lot of it in the hospital. Hospice would allow her to be at home. On Christmas Night, she finally was able to let go. She was 64.
Two years after that, in October, I lost Domino, my cat of 14 years. He was more than just my cat. He was my baby boy. I still tear up sometimes thinking of him. That was 2 years ago.
It isn’t all bad.
I still love the fall, even though it hurts to remember. Some of my best family memories are of Halloween, Thanksgiving and Christmas. Mom loved the cooler seasons. Dad loved any excuse to be silly and eat food that was probably too rich for him but oh-so-delicious. I’ve inherited all of that.
We adopted our two current cats right after the Thanksgiving after losing Domino. I thought it was much too early, but I was also probably worrying Terry a bit with being so sad and he missed having someone furry and welcoming in the house. We were only going to get one, and found a shelter participating in a Black Friday event at a pet store in town. We picked out Shadow, and took her to the vet, who gave her a relatively clear bill (she had the feline equivalent of kennel cough), but strongly suggested another kitten about the same age to help keep her company and to socialize. So we went back out the next day, and found Phoenix. After a week or so of separation to allow their individual upper respiratory sicknesses to get through their systems, they got to meet each other and actually began to get along much more quickly than I expected.
And I can’t forget that my sweet hubby proposed to me on New Year’s eve.
So there are good things to look forward to, most definitely, but I can very much empathize with people who suffer from seasonal affective disorder as well as depression. I have a much higher likelihood of wanting to hide somewhere cozy with a book during this time of year. And for the last few years, that’s been more about escaping than just enjoying whatever I might be reading for what it is. I don’t think that’s a bad thing. I feel much better, even if the book makes me cry (The Ocean at the End of the Lane by Neil Gaiman did). In its own way, that’s a welcome catharsis from the greyed out feeling I experience a lot of the time. Sometimes I can forget. Or keep a mask firmly in place.
But it’s part of the season now.
I have a few friends who post Thankful posts. One does it whenever she needs a pick-me-up, I think. Another sometimes tries to stick to a Thankful Thursday schedule, but I think really she does it to remind herself of good things in this world, too.
I have a complicated relationship with things I’m thankful for. Some of them make me sad, you see, so … they don’t really so much pick-me-up. On the other hand, they’re still good things, and I’m thankful for them. They’re just often more part-and-parcel of who I am, as opposed to immediate.
So, below, a few…
As of tomorrow, Phoenix will have been on a 5mg dose of prednisolone for 30 days. So, we scheduled in an appointment for him to be weighed officially, generally checked over, and get his prescription renewed.
He’s been doing pretty well lately. I feel like he’s hit a plateau in his weight, which is frustrating. He should be more than 10 and a half pounds, and he’s just not, but in general he plays and has a cheerful, laid back attitude on life (unless instigated by Shadow into a tag or boxing match). He’s had a few somewhat lethargic spells over the last month, but in general I knew he’d gained a bit of weight, his coat was looking good and his paw pads seemed much less swollen.
The results are as follows: he weighed in at 9.6 pounds (and that was after 8 and a half hours of fasting), his temperature was not remarkable, his teeth and eyes looked good, his heart and lungs sounded good, his paw pads are a teeny bit puffy but better. The vet still couldn’t find his spleen by palpitating, and his lymph nodes are still drastically reduced (almost not locatable, definitely not biopsy-able sized).
So, we’re leaving things as is. He’s going to continue the current dose of prednisolone for another 50 days. We’re going to hope he continues to gain weight back up to at least his highest point (which was 10.4), and make sure he’s still enjoying life and being well-spoiled.
Like I told the doctor, the part of me that has had experience with human cancer especially wants to get the nasty badness out of him. The part of me that is terrified at putting cats under any sort of general anesthesia is willing to wait if this treatment continues to work. The doctor is excited that such a relatively mild treatment is working. Steroids are hard on any body, although cats can handle oral type, and prednisolone especially, relatively well. They do compromise the immune system though, and so some plans to train the cats to harness and leash, and take them on park outings this summer have been shelved. Insect bites and other outdoor flora and fauna could be especially hard for him to fight the effects of.
Overall, I’m very happy. Phoenix was very happy not to be poked or prodded any more, or shaved again, or had blood drawn. And he was especially happy to have access to food again! More than anything, having his appetite back is probably going to help him.
So. Today we took Phoenix in to have his spleen aspirated, in order to test the acquired tissue and determine the type of cancer.
The vet called less than 2 hours after I dropped him off and started the conversation with, “So, Phoenix is looking really good… ” at which point I agreed that he’d been eating better, was being a very good boy and eating the pill pockets with his prednisolone in, and in general had a good energy level and appetite. He was also waking me on a regular schedule for two breakfasts. (I have determined my cat is at least part hobbit, but that’s hardly a post…)
He agreed that he looked very good, and had gained weight and had good energy and… was going to drive us all crazy. “I can’t find his spleen by standard palpitation and obviously don’t want to just go poking around with a needle. We have a few options…”
Those options involved getting an ultrasound tech back out, or perhaps even exploratory surgery. But in general, since he was responding so well to the steroid and his lymph nodes had even shrunk (which was a good thing – yay shrinkage!/bad thing – one less thing to try to aspirate!), perhaps we should just stick with the least invasive treatment method. If it is lymphoma, well… eventually, that will become obvious. If it’s not… If it’s the mass cell… perhaps the steroids will be enough for a time, and we can avoid the splenectomy for a bit.
In some ways, it’s utterly frustrating. I still don’t know what’s wrong with my boy.
In other ways, it’s honestly probably the least stressful for him. He’s happy. He’s getting wet food almost as much as he wants it, and nibbling at dry when he wants, and treats when he likes. He’s encouraging his sister to play tag and other kitten games, and even occasionally coaxes us into cuddling, scritching, petting, or otherwise loving on him. (He has to work so hard for those extra snuggles, we are heartless I’m telling you.)
He’s too young for any of this. But I have to keep reminding myself, other than feeling low on energy or just tired… he doesn’t know what’s wrong. If we can help him feel well, that’s our job as pet parents. To help him feel his best and take care of him. So I have to try my best to live in the moment, do our best to help him feel well, and try not to drive myself crazy with wondering exactly what is wrong with him.
I get very attached to pets, but more specifically to cats. I actually went through a stage where I was fairly anti-dog. I’ve relaxed on that stance fairly recently, perhaps because I haven’t had to care for one. But I think that helping care for dogs during the year I lived in Georgia, as part of a volunteer group, actually helped me see a variety of dogs and be a little less annoyed with them.
I still connect more deeply with cats and while I will agree dogs can be very rewarding, I think I see the relationship with cats as being on a more equal balance. They have more autonomy and less of a pack mentality. As a result, they see you as a partner… maybe as a parental figure but just as often a litter mate. Dogs need a leader, and if they don’t have one they attempt to be that leader. Cats are okay with no one being the declared leader, although they will work within guidelines and rules, and actually prefer a schedule.
The attachment part can be an issue for me. When I had to make the decision a little less than 2 years ago to let Domino go it was heart-rending. I had been very upset when the cat of my teenage years was put to sleep due to health issues when I was a young adult, and when we had to make the decision for Francis who we’d adopted as an adult, but it wasn’t anything like letting Domino go. He was my baby. I’d raised him from a kitten. I’d gotten him through a near-death experience as a kitten with a spider bite. I imagine it was a fraction of what it would be like having to help a human child through a horrible life threatening ailment and saying goodbye. Although it seems odd to admit, it hurt worse than helping both of my parents through hospice care.
As a result, I really wasn’t sure I wanted to adopt a new cat anywhere near as soon as we did, and I certainly had no plans of adopting two. The second one came about because the vet pointed out that as a kitten, Shadow might socialize better with a playmate. So we went back to some of the shelter pages we’d been looking at, found another adoption event at one of the pet stores in town, and went out and met Phoenix.
Terry had liked both of them. Shadow for her quirky tail (although when she climbed up my arm to look around better, I admit I appreciated her curiosity), and Phoenix (well, really his brother Battle) for their silvery blue fur. (The shelter supposed they might be Russian Blue mixes… the vet said they were probably just grey tabbies, heavy on the grey/blue coloring.) In person, Battle turned out to be a major handful and not particularly inclined to cuddle or socialize with us. Phoenix on the other hand, was willing to play with his brother, bat feathers and balls around, AND be picked up and snuggled and purr. So I asked if we could consider Phoenix over Battle. Also, I liked Phoenix’s face more. It seemed more calm and amused at the world, whereas Battle was incredibly focused and hyper all at once. We passed approval and Phoenix went home.
I was not dealing well without cats in the house. I know that. I know it was worth it to bring them home. I don’t regret that decision. They have brought us a great deal of joy and love and made the house feel inhabited again.
Both were shelter cats. They had issues with upper respiratory problems. The feline version of kennel cough, basically. Phoenix’s lymph nodes in his back legs were pronounced enough that I knew that’s what they were and was concerned. He’s always had an amazing attitude, and aside from a slight fever early on, been playful, eaten, and done well.
Until this last month. He started isolating and eating less. His paw pads were swollen and I thought the lysine to boost his immune system and various allergy fighting things we were doing wasn’t helping as much as it ought. The isolating really bothered me. Hiding behind the couch to sleep isn’t his style.
So we took him in. Vet couldn’t see anything wrong, but did a blood draw and we gave him a steroid shot to try to help the allergies … he’s over a year old, so his system should be able to handle it better now. Then I got the very worried call on his blood count: his white cells were through the roof. He’d lost almost a pound. So we got a good general antibiotic and put him on a week of that. He gained a smidgeon of weight, looked much better, but we did another blood draw to be sure. Another worried call. White cell count was good but hematocrit had plummeted. His glucose levels were also odd, but that COULD be stress and the fact that we had not fasted him. So another focused antibiotic to fight bacteria. That helped. The hematocrit levels came up to almost normal. But he still wasn’t gaining weight. On the plus side, his appetite was returning, his paw size was down, and the steroid shot seemed to have helped. He was playing. The next week, he’d lost a bit of weight again, so… we went ahead and did an ultrasound of his abdomen to see whether he had a blockage. Something confusing his tummy and not working through his GI tract.
I wish that’s what it was.
Unfortunately, we got the call last Friday that his spleen, kidneys and other organs are not well. They suspect lymphoma or mass cell carcinoma. To be sure, they’d need to do an aspirate test on his spleen. Either way, it’s cancer.
At best, he has less than a year. At worst, a month or two.
And I’ve fallen in love with him, now. He’s attached himself to me and trusts me. And at some point, I’m going to have to say goodbye. Yes, with Terry’s help. He’s OURS, not just mine. I know he’s had a good life, but it’s so damn short.
I can almost understand how people at the end of their rope threaten people who can’t really help them. Because if I had a cancer researcher handy I might shake them thoroughly, and ask why such a frustrating, complicated disease still exists. I know logically it’s not because they aren’t trying, but just at the moment, it really doesn’t matter to me.
He’s not even 2 years old.
Obviously, I had to work up to talking about this. I might not talk about it anywhere else for a while. I’m prone to tearing up if I try in person. Well, and just typing this.
We have some decisions to make based in part on whether to do the aspirate test (which might come back negative for everything as these things do) and how best to keep him happy, which he is currently. He wakes me up for breakfast, begs for treats, plays tag with Shadow, snuggles on the couch, and basically, aside from being too thin, is acting normally. Occasionally, now that I’m hyper-vigilant, I will see momentary flashes of dilation in his eyes and wonder if he isn’t experiencing a bit of pain, but he doesn’t isolate too badly, and seems able to distract himself. So we’re trying to take things day by day as best as possible, and do everything we can to spoil him rotten and love him dearly, just as we have since adopting him.
So I’m sure I’ll blog about it again, but don’t be surprised if I lurk more than be active in social media, or blog about something completely different as well.