Treatment day - 7 Taxol down, 5 to go! I've so far only had to delay treatment once for one day when my liver cried foul a couple of weeks ago, and if I stay on schedule I'm due to finish chemo on June 24th, a date that appears tantalizingly close. And while the annoying to alarming side effects continue to mount (heat "surges" - not flashes in my experience - and lots of nose bleeds are the latest bit of fun), Taxol so far remains infinitely easier than AC for me, knock wood!
The light at the end of the tunnel has also gotten brighter with some good news regarding the surgeries that will follow the chemo: "ob-gyn" and "plastics" (maybe that was the field for Benjamin Braddock) apparently play well together, and my surgeons from the two departments have agreed to coordinate their work so that I'll be able to get my ovaries out and my chest more perfectly flattened at roughly the same time. (I don't guess they'll be cutting over each other's shoulder, but I'll only need one visit to the hospital and OR.) Furthermore, my oncologist has given the go-ahead for an August target date, so I have reason to hope that in about three months' time I will be able to make the shift from treatment to recovery mode. Many report that this is a surprisingly difficult shift psychologically (in part because it entails a shift from a highly active to a more passive confrontation with a terrifying threat, in part because one is often flooded by all of the grief, confusion, fear, etc that one has held off from feeling while focused on surviving treatment), but I look forward to it nonetheless.
On my way there, I've been drawing on the behaviorist elements of my dog training experience to make treatment more tolerable. The thing I'm always emphasizing to my students when they're trying to create positive associations with not-so-positive experiences for their animals (like vet visits!) is that the order of things is hugely important. The question to keep in mind is "what predicts what?" and the ideal answer is that "bad predicts good." So if you're trying to teach your dog that nail clipping is wonderful, take things very slowly, but most importantly take care that the presence of the clippers (or the touch of the clippers to the paw, or eventually the clip of a sliver of nail) predicts the arrival of something wonderful, and not the other way around. Pretty much anyone who's been through chemo has personal knowledge of how badly things go wrong when the timing is reversed, and there are lots of dogs who've stopped liking peanut butter and other previously irresistible treats when their owners regularly get them out in anticipation of (or simultaneously with) a painful or fearful situation/stimulus.
For the eight very hard weeks when I was on a dose-dense regimen of Adriamycin and Cytoxan, I wasn't fully prepared for the breadth and depth and sheer strength of the associative ripple effect - not ripples but waves! - those poisons would generate. I should have known better from Mom's experience that the classical conditioning (the establishment of habits of association vs. habits of action, a.k.a. operant conditioning) would extend well beyond the foods I'd ingest, but I didn't expect it to pollute the clothes I was wearing or the cross-stitch pattern I was working on!
The difficulties in managing this sticky, creeping ick - Dr. Seuss's oobleck comes vividly to mind - were heightened at the beginning of treatment, when my reactions and their timing remained unpredictable unknowns. Whereas with most kinds of pain, stimulus and response are usually linked closely in time and easy to connect causally, with nausea the cause and effect are often separated by hours, and everything that lands in between may get caught up in the wide net of disgust.
Once I had a better (and very hard-earned) grasp on this reality, I began to use it to my advantage and to limit the collateral damage more skillfully. I all but banished Pete from the infusion room and played a lot of an iPhone word game to which I'd become uncomfortably addicted. I play a lot less of it now, and I still light up when I see my beautiful husband!
With Taxol the situation changed dramatically, and at the core of that change for the good was the sudden and welcome relief from nausea. (Anytime I complain about my mood swings on steroids, I try to remember the awfulness they're holding at bay!) What's more, my sense of taste has mostly returned. Days when it's dulled are rough for this hedonist, but on days when I have a palate I'm as Pavlovian a creature as my dogs, and treatment is getting to be much less onerous when I follow it consistently with "treats," in my case a good lunch in a favorite neighborhood. (I'm fortunate that the infusion center is in shouting distance of tens of excellent lunch spots!) I'll soon start salivating at the sound of the I.V. alarm. ;-)
Count me a happy animal today.
If you knew her, you might recognize that those are Mom's shoulders (or a slight approximation). They thrill Michelle Anthony, my charming nurse practitioner - I may not be busty anymore, but I remain robust! Thanks, Mom.