After My Last Oncologist Visit, I Fell Off A Cliff

I had an oncologist appointment last Thursday that marked four years of being done with chemo for breast cancer.

During my previous onc visit in February, I had been a mess: depressed, stressed and miserable with joint pain and a feeling that my endocrine therapy was taking away from me more than it was giving me. At that point, he let me stop the aromatase inhibitors.

Now, half a year later, I felt so different. My blood pressure was 118/83, much lower than the 130s and 140s systolic numbers I was hitting after stepping into the exam room on previous visits. I was peaceful and more hopeful.

We discussed all sorts of “survivor” things. The joint pain had mostly resolved itself and was no longer a hindrance to exercise, one of the things most important to me. My libido could have been higher and my short-term memory was often lacking, but he felt that could also be attributable to working and sleeping in the same room for the past year and a half, coupled with menopause.

Finally, my doctor noted that it was time for another chest MRI. Not the most comfortable of scans, but I’d done it once, I could do it again.

I would love a pet, even if it means having to clean fur out of my keyboard.

It was not until around noon of the next day that I suddenly plunged off a cliff. I was talking to my daughter and randomly mentioned my willingness to look after any pets she might have in the future when she’s living on her own, were she to travel for work, because where we lived now we weren’t allowed to have pets…

…and I was slammed by a massive wave of sadness and regret.

My thoughts zoomed back to my first chest MRI, stripped to the waist, lying on my belly, arms stretched over my head, frightened and painfully vulnerable. All my focus was on breast cancer and what other horrible realities the MRI would reveal. All I could think of was surviving my upcoming treatments.

That MRI meant that my life was on hold. There would be no progress in my career for the foreseeable future, and no chance of moving into a bigger place, one that would allow us to get a cat (note: I’m a dog person, but I would have been happy with a cat!). Animals have always been a part of my life, but our apartment rules prohibited them. I yearned for the chance to have a pet again. It seemed such a small thing to ask, but even that wasn’t available to us now.

That brief discussion with my daughter underscored a profound feeling of loss and despair. Cancer had robbed me of a lot of things in my life that others took for granted.

This was my view before I realized I didn’t have to sit there.

And as I sat there in the depths, I forgot that time does not stand still, things are always changing, nothing is permanent…and I have inside me everything I need to climb out.

Curiously enough, I had recently attended a talk on managing anxiety aimed at cancer patients and survivors. The counselor who presented the information was herself a breast cancer survivor and she told us a story of doing a follow-up chest MRI, which she found very stressful. Afterwards, she was asked by one of the cancer nurses what sorts of mental tools she had used while in the MRI tube to calm herself down. At that point, she realized that even though she taught these techniques to her patients on a daily basis, she had completely forgotten to use them herself!

I had been sitting in the darkness for a few minutes when I remembered her story. Most importantly, I remembered that I didn’t have to feel this way, that it served no practical purpose and that I wanted be happier. The only reason I felt like this was because these emotional plunges had been a habit of mine.

So I twisted a rope out of all those grounding techiques that I’ve posted about and pulled myself up.

~~~~~~~~~~~~~~~~~~~~~~~~~~

True, I still didn’t have a cat. But I was able to take a deep breath and realize that at least I had a future. And that future might contain a cat.

Before You Meet Your Oncologist, Be Aware…

…they don’t pull punches.

This is critical to be aware of when you’ve gotten your cancer diagnosis and are meeting your oncologist for the first time. We all go into that exam room fearful but hoping for good news. We want reassurance that it’s going to be okay.

The problem is, your oncologist can’t tell you that. They can’t say that you’ll get through this fine. Because they’re not going to promise you something they cannot guarantee. What they can give you is statistics. However, that may come in the form of something like, “You have an 85% chance of surviving…”, which sounds great, right, “…for 5 years.”

Is it good news or bad news? Their faces won’t tell.

Now, I don’t know how you feel about this, but honestly, when I heard that I thought, um, is that the best you can give me?

While I adore my oncologist, there was no cute wrinkled nose, no “I’m sure you’re gonna be okay” warm-and-fuzzies. It was all, “this is what’s next.”

I’m convinced that oncologists start their day by practicing how to deliver information without emotion, without giving away whether the news is good or bad. As patients, we literally hang on every word, every hesitation, every wrinkle on our oncologist’s face for an indication of just HOW bad the situation is. Some will reveal more than others, but in my own experience, it was “just the facts, ma’am” for quite a long time.

This could be very frustrating. I learned that I needed to get the “rah-rah” encouragement elsewhere.

On the plus side, however, I knew that if something was bad, my oncologist was going to tell me. He wouldn’t be like that friend who assures you your ugly outfit looks good just so that they don’t hurt your feelings. So if it’s any consolation, you’ll leave the office knowing what’s up, and what the doc doesn’t know yet if they’re still waiting for results. No false promises.

That helps get your head past the diagnosis and moving forward into treatment.

~~~~~~~~~~~~~~~~~~~~~~~~~~

I remember when, after my final infusion, I developed a horrible nail infection that landed me in the Emergency Room. I was stabilized, pumped full of antibiotics and my wound cleaned out. As I recovered, my ER doc came back to see how I was doing because he knew I’d just finished chemo and was familiar with the cancer experience. He told me that he was about to go notify another ER patient that they had liver cancer and wanted to take a breather and come talk to me before he had to break the news to them. It was obvious that he was moved by his patient’s plight.

So this was a great reminder for me that even though the doctors may seem to be stone-faced, they are by no means stone-hearted.