Monday 21 April 2014

Tough Pill to Swallow

It's not often I have to do something I don't want to do. Maybe this makes me spoiled or stubborn but I like to think of it more like problem solving or conflict resolution. However, for the past week  I've had to do just that because my course of treatment has changed and I am now on a prescription that I don't want to be on. It's literally been a tough pill to swallow each morning for the past seven days.

After reviewing my scans since treatment started six months ago my oncologist recommended that I switch medications since the one I've been taking was not working well enough. The cancer in my lung has stabilized (good news) and there has been no spread yet to soft organs like the liver or brain (also good news) but there has been significant spread through the bones (not good news). My eye tumour has been harder to assess. It does not appear to have increased in size but there is a lot of fluid around it that is impairing my vision and making it difficult to know for sure whether it has increased in diameter. Both doctors agreed it was time to change the drug protocol. I guess you could say they see eye-to-eye on this issue. (Sorry--sad attempt at #tumourhumour).

My qualms about taking this new drug stem from the potential side effects that I've read about through my own research and talking with other cancer patients. I knew it was a possibility I would have to take it one day, but that day came sooner than I had hoped. Obviously, the final decision for any course of treatment rests with me. My doctor did not force me to take it nor did he shame/guilt me into the decision. In fact, he couldn't have been more gentle and understanding. It was the first time since starting treatment that I had a complete meltdown in front of him. There have been some teary moments at times but this was full-on-ugly-cry mode. I did not want to hear that I needed to take this drug and in that moment I understood how my kids felt when they were little with colds and I made them take that awful, pine needle-tasting cough syrup. I wanted to go back in time and tell them they didn't have to take it in an attempt to reverse this bad karma moment I was now facing.

I explained my fears to the doctor and he acknowledged and validated them. For almost an hour he told me stories about other patients, handed me tissues, and, eventually, told me why he was recommending this as the next step. He outlined his A-B-C-D treatment plan for patients with Stage 4 cancer. Step A is what I had been doing and it was not working. Step B meant switching drugs and in six months he'll reassess. If things have stabilized I will stick with Step B, otherwise it's on to Step C which is actually the same drug from Step A but with another drug added to it. Lastly, and hopefully a long way off, is Step D which is intravenous chemo.

Ultimately, I agreed to Step B, albeit reluctantly (I still don't fully understand why I can't skip Step B and go right to Step C but I do understand the need for order). Some of the side effects of this new drug mimic that of IV chemo such as nausea, hot flashes, weight gain and hair thinning, but those are all manageable and things I've lived with before and can handle again. The biggest concern I have is related to blood clots and stroke. This is an invisible side effect and can hit with little warning and for someone who likes to be in control at all times, this is not a great mindset to have. My anxiety over this didn't get me further than the resident social worker's office. It was suggested I try deep breathing and visualization, but when all I could see was the bold warnings on the prescription package my deep breathing turned to hyperventilating.

Before leaving the doctor's office he stressed that it was important I embrace this next step otherwise, subconsciously, I could negatively impact its effect by forgetting to take it or taking it at different times of the day. I doubted this would happen. No matter how much I didn't want to take this drug I knew how important consistency was with chemo treatment. Admittedly, there have been mornings I've stayed in bed longer than I needed to just to put off swallowing my morning ritual of meds, but I eventually get up and face the music. I told the doctor I understood and was somewhat offended that he thought I would do anything to sabotage my treatment, unknowingly or not. Then, I forgot to take it on the first day I was supposed to start. On day three, I planned to take it with me when I went out for breakfast but left it at home by mistake and so ended up taking it much later in the day. It appeared there was something to this subconscious scheming after all.

So, it's been a week today and I've had to take stock. I've had to accept that it's better to be at Step B than Step D. I've had to weigh the risks against the benefits. I've always been a gambler so when it comes to the worrisome side effects I need to believe the odds are in my favour. And, I need to figure out anxiety-reducing techniques that work for me. Ironically enough, the one that is getting me through this week so far is also A-B-C-D-related. My oldest daughter recently sent me a voice recording of my 3-year-old grandson reciting the alphabet. It is the sweetest, purest 20-second sound bite I've ever heard. Since first receiving it I've played it several times, including this morning, right after I took my pills. It made that medicine go down easier than a spoonful of sugar.

Until next time.......carry on.


  1. Aww Cindy - I am sorry to hear of the progression in your bones and that this new treatment is causing you so much anxiety. I hope that this new regime is effective in getting those mets under control for you and that the side effects are minimal. I am not sure that forgetting to take a pill here and there means you are sabotaging treatment. It just means you are human. I always have a couple of pills in my purse for such instances that I am out at the time that a dose is needed. Just a (hopefully) helpful idea.
    Wishing you brighter days ahead.

    1. Thank you, Barb! Good suggestion and one I will follow from now on! Hope you are well.

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