Sunday, July 12, 2020

An Unexpected Reaction during this Unexpected Journey

My last chemo was Thursday, July 2nd. I was elated. Finally, I was done with the weekly trips to the infusion center and everything they entailed! I had the typical side effects after chemo: sleeplessness from the steroids on Thursday night and Friday night, then a physical crash on Saturday and Sunday. I believed that I would feel a little better each day starting Monday, and the process of recovery would be smooth and easy.

Then I had some trouble sleeping Sunday night, and woke up Monday morning with a new side effect: stress and anxiety. If you have never experienced this, it feels like your blood pressure is up (I checked mine and it was normal) and you are just stressed about everything and anything that pops into your mind. Now, mind you, I do have some things in my life to be stressed about. I have breast cancer, and until I have my surgery, which is still not scheduled but will probably be a few weeks from now, I will not know if my cancer was all killed by the chemo, or not. After surgery, I'm still facing weeks of radiation and then maybe months of oral chemo. On top of all of that, we are living through a global pandemic, so I have the threat of possibly contracting COVID19. In addition, I teach college dual-enrollment classes, and we still don't know if we will be teaching online or in person starting in mid-August. I don't know if I'll be physically capable of doing my job if I have to teach in person, because I don't know if I'll be recovered enough at that time. The timing of all of these things coalescing at once is enough to be extremely stressful in anyone's life. 

I stayed stressed from Monday through Thursday, but managed to make it through my MRI Thursday morning okay. I called the oncology office and spoke with one of the chemo nurses. She said it's fairly common for people to feel this way after they are done with chemo. She said if it gets bad I can call for a prescription for something to help with it. I'm not too keen right now at putting more drugs in my body, though, so I'm not sure what I should do about that. I already have an Ambien prescription to help me get to sleep, and some nights I take a half of one of those so I can relax and fall asleep. I called my parents and they prayed with me, and my mom sang to me. I got my family and friends praying for me. I got a good night's sleep Thursday night, and Friday I felt much better. Ahhhh, I thought; the stress is gone and I feel better now. I had a great day Friday. Then I had another really rough night's sleep Friday night, and yesterday, Saturday July 11th, the anxiety was back. I struggled through the day with it. Last night I took a whole Ambien, and got a great night's sleep.

Today I'm still feeling stressed, although it doesn't seem as bad as yesterday. I don't want to get in the habit of taking Ambien so I can sleep. I don't know if I should call tomorrow and get another prescription, for something to take during the day. I am praying a lot, meditating on Scripture a lot, trusting God in all of this. I know that He is good, that He loves me and my family, and that He wants me to have His peace, which passes understanding. My sister Ruth suggested Psalm 121, which has helped immensely. Give it a read and you'll see what I mean.

I will update on here after my appointment with the surgeon on Tuesday. 


Wednesday, June 24, 2020

Breast Cancer in the Time of COVID-19 Part 5: The Weirdness of it All

NOTE: For the Introduction to this series, with links to Parts 1-4, click HERE.

Now that I've written about how I found out about my breast cancer, how the battle began, the side effects of chemo, teaching online during chemo and COVID-19, my mental and emotional battle, and the support of family and friends, I want to sum it all up with this post about the utter weirdness of it all. It has been the strangest experience of my life, so far. Everything is different than I ever imagined 2020 being, and has been since January. 

It's strange enough to be told you have cancer. It feels surreal. Suddenly everything has changed, and other people are making you appointments for medical imaging, procedures, bloodwork, and chemotherapy. There isn't really any choice in the matter; if you don't have treament, the cancer will grow, and will eventually disfigure and then kill you. Your body goes into an ongoing fight-or-flight mode. At least this is how it was for me, in late January and throughout February into mid-March. Up until that point, I felt like I was handling things pretty well, juggling work and treatment and time with family and friends. But then another major event rolled into the mix.

The COVID-19 virus seemed like something far away back in January, when I was diagnosed. By mid-March, however, it was evident that this was going to affect our lives far more than we had thought. On March 11th it was declared a global pandemic, and as schools headed into Spring Break, we teachers were told that everything would be shutting down for two weeks, or more. Suddenly EVERYTHING was different. 

I knew that with a suppressed immune system I would be having to avoid large crowds and isolating myself somewhat during chemo, but I had no idea that my whole family would have to shelter at home, wearing masks to go do grocery pickup and wiping down the groceries with sanitizing wipes. We had no idea that the pandemic would last over three months, that friends of ours would lose their jobs, that the economy would be so affected, that uncertainty about infection rates, contagiousness, and personal risk would multiply, or that now, in mid-June, we would still not know when it will all be over. The anxiety of having cancer is multiplied exponentially by a health crisis of this magnitude. I'm sure it's the same for anyone with a health condition that makes them more susceptible to a virus, or with children who have underlying health issues. It feels like it affected all the areas of our life that the cancer had not yet touched.

Before the COVID-19 pandemic, I could have still been teaching, seeing friends, going out to eat, meeting with church family, and generally living a normal life except for being ultra-cautious about germs and illness. But with the shelter-in-place guidelines, all of that ceased. In a way, it took a lot of the pressure off me. I could teach from home, so if I didn't feel the greatest, I no longer had to make the decision of whether to go out and teach or call a sub. Dealing with all the side effects of chemo has most likely been easier for me because I haven't had to travel around to various locations to teach, and haven't had any pressure to go out and be social. 

Now that our state has begun opening up, it's still weird, mostly because of all the unknowns. How much longer will we have to be concerned about getting COVID-19? A few months? A year? Forever? How bad would the virus really be? Is it possible we have already all had it, or been exposed to it, and just don't know? Should we wear masks in public, or does that make us not breathe enough oxygen? How do we know what to believe that is written online? There are many things that are uncertain. 

When will our lives ever get back to normal? Or will they not? Will we have a new normal, a different way of doing things based on my having had cancer and our avoidance of COVID-19? These are still unkowns. I tend to concentrate more on the knowns: my family, my friends, the things I have to do each day, and the beauty of nature when I reflect on it. 

Fortunately, one thing has not changed during all of this: God. His presence in our lives has been a constant throughout all of this turmoil and trial. I have had peace and strength that can only come from Him. He is not surprised by all these events, and so the weirdness of it all is mitigated by the knowledge that He has a plan, even though we don't know what it is. Thus, I have had to trust Him and put my future in His hands, as I always have since the day I first began to follow Jesus Christ. My future has always been in His hands, even before I was diagnosed with cancer and before COVID-19 swept across the globe. That makes the "weirdness" seem unimportant, compared to eternal things.

And so, I conclude my official series on having cancer in the time of COVID-19, but I will continue to write about my experiences. After two more rounds of chemo I'll be having an MRI, then surgery, and then radiation. Many more blog posts to come...

Thursday, June 18, 2020

Breast Cancer in the Time of COVID-19 Part 4: The Support of Family and Friends

In my last post, Part 3 of this series, I mentioned that when I got my diagnosis I was at lunch with three friends, who immediately prayed for me. That was just the beginning of the incredible amount of support I have received from both family and friends. I don't know how anyone goes through a cancer battle alone, without supportive friends and family members. I have been supported, from the very beginning, in a variety of ways by many, many people. Let me tell you about my social media support, my Amazon Wish List, the Meal Train, the random acts of kindness and gifts, the #WeRunForAlice movement, the constant prayer support, and the cards, letters, texts, and messages from friends. 

The first thing I did after my friends prayed with me was to call my husband, Eric. We then told our children that same day, and both my parents and his parents. My next step was to tell my five siblings and Eric' sister. Once we had told family, I began to tell close friends through phone calls and text messages. Finally, I posted on Facebook. It was one of the hardest things I've ever done. Immediately the responses flooded in, with words of comfort, support, and prayer. Within a day or two, nearly 400 people had commented, and I saw my prayer warriors enjoin the battle by my side, I created a page just for my cancer journey, and a crowd of people signed up to get the updates that way. A few friends, in particular, have already gone through breast cancer, or are still in treatment for it, and they reached out immediately to give me advice and support. My college friend, Holly, snet me a list right away of things that might help my battle be a little easier, things to help along the way. I can't remember if she suggested this, or somebody else did, (I think Holly did,) but somebody told me I should make a Wish List on Amazon, and let people know about it. Holly kicked things off by sending me a few things that she knew would come in handy.

When somebody is diagnosed with cancer, or if one of their loved ones dies, most of us want to help in some way, but it's quite hard to figure out exactly how to help. In my case, there was really nothing anybody could do at first except pray. I hadn't started chemo yet, and I was just trying to keep teaching and handle all the emotional upheaval that comes with a cancer diagnosis. But I took the time to make a Wish List on Amazon, and my daughter Caroline and I published it on Facebook. What happened next really took my breath away. Within a DAY the Wish List items had all been bought! How incredible is that? We're talking about a fairly big list, with a lot of stuff on it: hats and beanies for when I lost my hair, a heating pad, a video camera to make vlogs, slippers, socks, an ice beanie, stomach settling drops, lotions, blankets, hand sanitizer, sanitizing wipes, shirts to wear during chemo, books about breast cancer, acupressure bands to fight nausea, and much more. Within an incredibly short time, they had all been purchased and sent my way. Several people encouraged me to add some more things to the list, so I did. Again, they were bought up quickly. We spent the next couple of weeks making Unboxing Videos for my YouTube channel, showing all the things I had gotten. It was overwhelming. Everyone provided for my needs, which would have cost our family a LOT of money. This was a tangible way they could help.

Next, my daughter set up a Meal Train site so that we could have people volunteer to provide meals twice a week, and Eric's mom would bring a meal another night a week (with leftovers and soup to provide one or two more meals!)  Once again, my frriends and family offered their love and support. Signups for meals, gifts cards to restaurants, and digital gift cards for apps like GrubHub, Seamless, and UberEats came pouring in. My mother-in-law committed to cooking for us every Thursday while I have my chemo treaments. Friends in the area have brought over delicious home-cooked meals. Other friends have sent gift cards or money, once again providing for our family. I love to cook, and usually cook almost every night for our family. During the semesters, when I'm teaching, I do a crockpot meal once or twice a week and cook the other nights. Sometimes we plan to have leftovers ("bonus food!") one night a week. But now, during chemo, I don't have the energy to do this. The amount of standing involved, and the quick moving around the kitchen from task to task, makes me tired and dizzy. Eric, Mary, and Bobby can all cook various things, and are learning to cook more and more during this time. But it's nice to have three days a week taken care of by other people. In fact, nice is not a powerful enough word. It's a major, monumental help to us.

Along with meals, we have had many people show us acts of kindness, randomly, out of the goodness of their hearts. Hand-made lap quilts, hand-sewn little pillows for the shoulder strap on my seatbelt (they protect my port, and once I have surgery they will be soft on my surgical site,) flowers, candy, other gifts of food, hydration powder, meat (grass-fed beef!), custom-made T-shirts, baskets full of fun goodies, encouraging sayings on home decor, random gifts like the running recovery sandals one dear friend just gave me...all of these cheer me up and show me that people truly care. 

Another group of people that has shown me incredible love and support is the local running community. Our Run Family, as we call them, is a wonderful group of people who always encourage and support one another, no matter what happens. At fun runs and races this means cheering everyone else on, no matter their level of running ability. Fast or slow, walker or runner, it doesn't matter. We are all just happy that everyone showed up and is doing something to be healthy. When our Run Family members move away, they are still part of our family. It's like a relative has moved to another state. We stay in touch as well as we can on social media, and when they come back to town for something, it's a family reunion. One of our Run Family members who lives in Virginia now came up with the idea of using the hashtags #IRunForAlice and #WeRunForAlice so that the runners can tag me on social media, and I can enjoy seeing their runs during this time when I cannot go running or go to races. This has been fantastic for me to see! Just before I started treatment, I ran a 10K race, and a whole bunch of the runners, particular the Stroller Strong young women, showed up decked out in pink, with signs and even paper copies of my face/head, to cheer me on in my last race for a while.

They continue to support me like this. Our friend Brittany carries my paper face with her, so that I can "be" there for things, and sometimes they call me on FaceTime so I can be involved, like when a whole group of runners from Savannah went to Atlanta to watch a lady we know (Dawn Grunnagle) run at the Olympic Marathon trials. There I was, in the group picture, with my run family. Look at the right-hand side of the picture, at the phone in my daughter Mary's hand:
We also have a big ultra-runner/trail runner group here in Savannah, and although I'm not either of those things, Eric loves to run the trails and has done several of the runs and races with the group.  In January, Eric and I volunteered  a race they direct, the Daufuskie They have decided to bless our family with the proceeds of one of their races, the Savannah Stone Stairs of Death. The ultra runners like the Rough Runners and other race director companies like Endurance Race Services and Fleet Feet, often use races to fundraise for people and organizations in our community. In fact, just last year several of our local run family members partnered with ERS to raise funds for us to help pay Mary's medical bills from when she had thyroid cancer. It's incredibly humbling to ask for help, and equally humbling when a group of people suddenly asks if they can help you out like this. The running community takes care of its own.

Finally, I receive a constant stream of support from both family and friends in the forms of phone calls, cards, letters, texts, emails, Facebook posts and messages, and sometimes showing up at our door while on a run or walk. These things help more than anybody can ever know. It helps me to maintain contact with all of my friends, even when I'm isolating myself from most of the world because of my compromised immune system. The threat of COVID-19 heightens the level of caution and the acccompanying anxiety as I contemplate possibly becoming infected with it. I have to be extremely careful, so I am, in effect, cut off from most of my aqcuaintances and friends and most normal activities. When people remember to text or call, it means the world to me. 

As I said at the beginning of this post, I don't know how anybody goes through cancer treatment without a virtual battalion of fighters coming alongside them, fighting the battle with them. God has provided me with an amazing group of friends, both here in Savannah and all over the world, and the most wonderful family ever. How can I not be thankful?
 


Wednesday, June 17, 2020

Breast Cancer in the time of COVID-19 Series Intro: What the Series Is

I realized today that I haven't written on here since just before I started chemo. Life got pretty hectic right about then, with chemo every other Thursday, and I spent my extra time from mid-February to mid-March making YouTube videos for the channel I started to keep friends and family updated and teaching my college classes while managing chemo side effects. In March I developed a sinus infection which progressed to bronchitis and a horrible cough, and my damaged immune system struggled to fight the illness. I coughed for about eight weeks.

To revive my blog and catch up to present day, I'm going to do a series of posts over the next few days, describing my intital chemo side effects, the shift I had to make to online teaching due to COVID-19, my mental/emotional battle, the support of my family and friends, and the weirdness of going through this during the COVID-19 pandemic. This is to give you an in-depth look at my fight, and to keep a record for myself.  I'll put a link to each post here, so you can read the ones you find interesting. If there are other topics you'd like me to address, please comment and let me know.

Breast Cancer in the Time of COVID-19 Series:

Previous Posts about my cancer battle:




Wednesday, June 10, 2020

Breast Cancer in the time of COVID-19 Series Part 3: My Mental and Emotional Battle

When you hear the word cancer what goes through your mind depends on your own experiences. Have you had cancer before? Has a loved one had it? What type of cancer? How did treatment go? Did they die? Was it a horrible experience? What emotions are evoked? We each have our own background and thus our own inner landscape regarding this word. When it turns out to be personal, that is, when we wind up being the ones with cancer, it launches a mental and emotional battle whether we are ready for it, or not. In my case, I was mentally ready to hear it for a variety of reasons, but I don't know if that has made this fight any easier. The mental and emotional battle, which is perhaps easier to call the spiritual battle, is an on-going, ever-changing confrontation in my mind between my fears, concerns, and uncertainty on one side and my sense of peace, calm, and trust in God on the other. 

Let me back up a little. When I was growing up, I didn't really deal with any relatives having cancer. I knew of various distant relatives who had it, or friends of friends, but nobody within my immediate circle was struck with cancer. Then, about fifteen years ago, my mother called me to tell me she needed a breast biopsy. This turned out to be a type of breast cancer called Ductal Carcinoma in Situ. My sweet, loving, wonderful mom had to have a unilateral mastectomy, and then take Tamoxifen, a chemo drug, for five years afterwards. This was scary, unsettling, and downright awful, but I never thought even once that my mom would die from it. The cancer was tiny, had not spread, and my mom kept such a great attitude throughout it that I did not fear. Then my father-in-law had prostate cancer. Again, this did not seem like such a big deal. He did radioactive seeding, and the cancer was defeated. Okay, we all thought, so there are cancers that are not such scary bogeymen, but are defeatable and manageable.

Then, in 2007, my eight-year-old son was diagnosed with Non-Hodgkin Lymphoma. 

Whoa.

This was not the same. My sweet, loving boy's life was at stake. I knew how tough this fight could be. We basically lived at the hospital for nearly three months. He had five week-long rounds of chemo with nasty side effects, and he became a thin, pale, energy-less facsimile of himself. There were times I cried and asked God why he hadn't just given me cancer, instead. My husband did the same. We cried together, we prayed together, and we tried to trust and stay calm. I could write an entire book about the experience, and probably some day I will, but to sum it up here, it was awful.  We felt so powerless, and could only do what the doctors said to do, and comfort our son as best we could. Thank God, all of the chemo worked and within about three months he was declared in remission from the cancer. He has remained cancer-free ever since then. But the experience took a toll on our family, especially on our son, who still, sometimes, deals with the stress, trauma, and anxiety of those dark days. 

Eventually our family emerged into the light of the post-cancer stage, and moved on. We laughed, we celebrated holidays, we traveled, we learned, and we wound up not thinking about it too much anymore. Then, at Christmastime in 2017, we heard the word cancer again, this time because our daughter, who was then 20, had to have her entire thyroid removed because of cysts and lumps, and one of them turned out to be papillary carcinoma of the thyroid. Her recovery from the surgery had been quite rough, and it was at her one-week follow-up appointment that the surgeon spoke those terrible words. "We had a bit of a surprise on the pathology report," he said kindly. "One of the lumps was cancerous." My stomach began to churn and heave, but I stayed calm on the outside. I looked at her; she looked at me. "Okay, I said, what do we need to do?"

Here we go again. The uncertainty, the knowing that cancer can cause people to die, the sense of being powerless and helpless against this foe that does not care who you are, what you've done, or how you want your life to go. Cancer just invades and takes over.

For our daughter, the treatment consisted of radioactive iodine, administered after two weeks of a strict little-to-no-iodine diet. She then had to stay away from all of us for several days except for brief interactions. I delivered meals to her room and checked on her frequently. She has now had two iodine scans since then, and has been free of cancer both times. She has another scan this Fall. We're still paying off her medical bills from all of this. But we figured our family had dodged a bullet yet again, and could move on to the post-cancer stage, getting back to normal life. My daughter doesn't take any day for granted, though, and I think none of us do.

Now back to my current reality. You can read about how I found my cancer and was diagnosed here. I'll fast forward through the story, which began last November, to January 23rd, when my OB/GYN called me. For a few days, since my ultrasound, I had been trying out the words in my head: I have cancer. Somehow, after the ultrasound, my mind and heart knew the truth already, and I began to prepare mentally for it, so that when I finally heard the words, it was not the horrible shock you might think it would be. 

That Thursday I was eating lunch with three of my closest friends, knowing that I would hear something that day or the next. We were laughing and talking, just generally having a good time, when my phone rang. My OB/GYN is also a friend, since I've been going to her for eight years, and for a few years I gave her educational advice and support about her teenagers, when they were in high school. She is also my eldest daughter's OB/GYN, and delivered both of my beautiful granddaughters. She knows me well enough to know that I didn't need any sugar-coating or build-up. I just needed the facts. "It's cancer, Alice," she said.  "It's also in one of your lymph nodes, so you'll have to have the whole gamut of treatment, surgery, chemo, and radiation. I hate this for you." I hate it for me, too, I thought. I knew that she was truly sympathetic, as her sister is fighting ovarian cancer and she is worried about possibly getting cancer, too. I agreed to keep her posted on my treatment, and we signed off. I walked back to the lunch table, sat down, and told my friends, "Well, that was my doctor. I have breast cancer."
I HAVE CANCER.

All three of them took my hands, then stopped and prayed with me immediately. I sat quietly weeping, letting their words wash over me as they talked to the God of the universe, asking Him to give me strength, peace, calm, endurance, perseverance, and ultimately total healing. And thus the battle began with prayer and with the support of friends and family. (More about that in my next post.)

But the main battle, the mental, emotional, and spiritual battle, is inside my own head every day. We all have this battle, but for me having cancer has intensified the struggle to stay upbeat and positive. Negative thoughts and emotions can crop up any time, and it's an effort of the will to combat them. I try to do it with Scripture, and with common sense or logical thoughts.  Scripture helps immensely, and thinking logically about things supports my mental well-being. For example:

What if I don't beat this cancer, and I die from it? 
    Scripture: 2 Corinthians 5:1  For we know that if the tent that is our earthly home is destroyed, we have a building from God, a house not made with hands, eternal in the heavens.  6-8 So we are always of good courage. We know that while we are at home in the body we are away from the Lord, for we walk by faith, not by sight. Yes, we are of good courage, and we would rather be away from the body and at home with the Lord.
    Common sense: All human beings die at some point; we just don't know when we will die. I could die tomorrow in a car crash, or from some other disease. There is no reason to walk around being frightened of dying. 

All of this treatment is horrible to go through, so I'm just going to wallow in self-pity and depression. Why do I have to go through this?
    Scripture: Romans 5:1-5 Therefore, since we have been justified by faith, we have peace with God through our Lord Jesus Christ. Through him we have also obtained access by faith into this grace in which we stand, and we rejoice in hope of the glory of God. Not only that, but we rejoice in our sufferings, knowing that suffering produces endurance, and endurance produces character, and character produces hope, and hope does not put us to shame, because God’s love has been poured into our hearts through the Holy Spirit who has been given to us.
    Common sense: My treatments are the best way that doctors have figured out to eradicate the cancer cells in my body, and I have various methods of dealing with the side effects. The unpleasant effects will be temporary, and are something I must endure in order to beat the cancer. I can do this, and come out the other side a stronger, tougher person.

You get the idea. Any question or thought I have can be answered thus. 

Not that I don't have bad times, but my inner monologue in general stays positive, rather than being negative about everything. Yes, I have doubts and fears. I want to grow old with my husband, and see all three of my children established in their own homes, and see my grandchildren grow up. I want to keep teaching for many years, helping many young people become better communicators of their thoughts and of what they have learned. I want to run with my friends, and go to the beach and swim, and hike trails, and play games, and play the piano and sing, and cook good food. I don't want to die from breast cancer in my 50s, or any time, for that matter.

But you know what? I can still do most of these things right now, and the few that I can't, I'll be able to do again in a few months. I can keep living life, even during treatment, and enjoy every minute of it. This is what we should all be doing, anyway: living life joyously and gratefully each day, since we never know what day will be our last. 

The battle continues...

Saturday, June 06, 2020

Breast Cancer in the time of COVID-19 Series Part 2: Teaching Online (aka The Silver Lining)

When I began my chemo treatments back in February, I was teaching college classes full-time, that is, dual-enrollment classes for high school students. I had four English 102 classes and one Spanish 102 class, all of them meeting three times a week except for one of the English classes, which met twice a week for a longer period of time. That means 14 class sessions a week, and I also had four different office hour times blocked out in between. I should also mention that these classes took place at three different locations across Savannah, which were our Point University campus and then two of the private schools, across town from each other. Some days I taught or had office hours at all three locations. Normally that schedule is fine, and keeps me active and on the go. But I had my worries and doubts about being able to keep it up during chemo. I had several colleagues lined up, ready to substitute if it all became too difficult for me. I had chemo February 20th, and then March 5th, and was able to manage it. 

Here is how it went: Chemo was on a Thursday afternoon. Friday I was still hyper from the steroid they gave me on Thursday, and I could teach all three of my classes that day (all at one location, thank God.) I got home and rested. Then Saturday and Sunday my body would "crash" into nausea and exhaustion. Lots of anti-emetic medication and rest, and some good nights of sleep, and by Monday morning I was ready to teach again. I did some teaching sitting down, and my students were amazingly understanding and nice about it all. About the time of my second chemo treatment on March 5th, my hair started falling out (see Part 1: Side Effects) and so I first cut my hair super-short for a few days, and then shaved my head. My students were right there in the battle with me, suggesting a mohawk style and encouraging me to brave the shave and take control of my hair. My next chemo would be March 19th, during Spring Break.

During that week before Spring Break, we all became aware that the COVID-19 outbreak had become much more than we expected. It became apparent that the epidemic was about to become a pandemic, and that things were about to get really strange. I had long talks with all my students about what online classes might be like, and how we would handle it, if we suddenly had to go online for "a few weeks." We left for Spring Break not really knowing if we would be back together in the classroom again for a while. 

Let me interrupt myself here to say that this past school year I was blessed with some truly incredible students at all three of the locations where I taught. I feel this way every year, and it seems like every year teaching just gets better and better. I love being in a classroom with young people, helping them to learn, grow, develop, improve, and become the young adults that God has called them to be.  Every year, as soon as I have class lists, I begin praying for each student by name so that when first semester begins I just have to put faces to the names. Still, I often have one or two students who are hard to reach, or a class that has a more difficult attitude as a group, and these things can present challenges. This year I didn't have any of that. I thoroughly enjoyed each of my classes, and looked forward to teaching them every day. At one school, a young man decided (after my diagnosis) that I needed "walk-on" music when I entered the room, much like baseball players have as they approach the plate to be at bat. Each day, when I arrived, he had music cued up, and sometimes he and other students danced. The songs were either appropriate to my cancer battle: "Beat It," "I Will Survive," "Don't Worry, About a Thing," and "Stayin' Alive," (which came with two students doing a choreographed Travolta dance,) or they were great 80s music or other songs that he knew I would like. My class on campus made it their mission to cheer me on through my treatments, bringing me gifts of things that could help, and praying for me. At the other school all the students were pulling for me, and several of them brought in presents. One young man rather shyly handed me a bag, and said, "Both of my granddaddies have battled cancer, and these are some things they said were helpful." Inside were two different types of Lifesavers mints and some ginger cookies, both of which have helped greatly through the nausea of chemo. Two of my students revealed to me that their moms had breast cancer last year, and they put me in touch with them for support. All of this is to explain why the idea of not seeing these students in person for a while was sad and disappointing.

Of course, that's exactly what happened. Early in the week during Spring Break, we found out that classes were moving online, at first for "a few weeks." Within a few weeks this was extended to the remainder of the year. During that Spring Break week, however, I and all my colleagues had to quickly figure out how to turn an in-seat course into an online course practically overnight. As the English and Spanish department head, I had to ensure that all the adjunct professors in my department were up and running. They all stepped up to the plate and knocked it out of the park! In one week everyone had class materials uploaded, calendars and checklists updated, and Zoom meetings scheduled. My class meeting times decreased to once a week for the previously twice-a-week class, and twice a week for the previously thrice-a-week classes. But my workload was about to increase as I created videos and PowerPoint presentations, graded papers online (it's far easier with an actual hard copy of the paper and a pen!) and created tests and lessons in the online environment. I emailed all my students to fill them in on how things would work, and we officially moved to an online format.

The students continued to be amazing. These precious young people signed in to Zoom from their isolation, sheltering in place at home. They could not hang out with their friends at school anymore. They couldn't play their sports or participate in any other extra-curricular activities any more. They had no prom, no special events at the end of the year. Even though the ending of their Senior year (for most of them) was basically ruined, they came through academically. They did their work, participated in class, spoke up, took tests online, adjusted to the new format, and in general excelled in an academic environment that was completely new to them. I became more impressed with them than ever. Some students who were always shy in class "spoke up" eloquently in the online Discussion Board format. Some students who were more gregarious in the classroom became more introspective and better listeners. Yes, a few of them disconnected somewhat, which was understandable given the bizarre circumstances. None of us had ever experienced anything like this before. I tried to make sure to communicate regularly and reach out to any of them who seemed to be struggling. The majority of them proved how adaptable and malleable they truly are. 

The low point, I think for all of us, was when one of my precious students lost her daddy to COVID-19. We were all praying for him, praying he would pull through and be healed, but sadly he passed away. This was sobering and depressing for all of the students at that school who were classmates with his daughter. She was such a trooper through it all. What can any of us say to help her grief? I was at a loss for words. I plan to stay in touch with her for as long as she'll let me from now on. 

As for us professors, we came through it stronger and with more abilities in our "toolbox," as some like to say, than we had before. I've talked with my adjuncts, and they all agree that we came out of the semester knowing a lot more about ourselves, our classes, and the educational and pedagogical techniques and modalities that we can use to educate and encourage our students. 

The silver lining for me in all of this, in case it hasn't crossed your mind, is that I was able to teach ALL of my classes from home, even on days when I didn't feel so good from chemo. Sitting in my dining room, I opened up a Zoom meeting and watched as my students all joined the class remotely. They still cheered me on my journey. I showed them my bald head, and advised them that they should be happy I put on makeup! We joked, laughed, talked, lectured, discussed, questioned, answered, sang, and generally did all the things we normally did in person, but now we did it all together but separately. The class of 2020 is seared indelibly in my mind. I can't wait to see what God has in store for them as they move on to college and beyond.

Friday, June 05, 2020

Breast Cancer in the time of COVID-19 Series Part 1: Side Effects

The introduction to this series is here.

My side effects from Adriamycin (generic name is doxorubicin) and Cytoxan (cyclophosphamide) include nausea, fatigue & dizziness, changes in the color of my nails, intestinal upset, changes in taste, hair loss, and dry eyes and skin. These have continued to various degress under Taxol and Carboplatin. So let's take these one at a time. Please remember that side effects are different for each person. My experience may be completely different from yours, or your friend's or loved one's experience.


Nausea

The nausea during my A/C treaments kicked in pretty hard by Friday night or Saturday morning. I have two prescription anti-emeticss, Zofran (ondansetron) and Compazine (prochlorper) which can each be taken every eight hours, so you can alternate them every four hours to give constant coverage against the nausea. This worked pretty well during my A/C treatments. During my current treatments, with Taxol (paclitaxel) and Carboplatin, the nausea is not as bad when I just have Taxol, but the Carboplatin makes me feel really sick. This past weekend I had not felt sick at all on Saturday, so I didn't take any anti-emetic, and I woke up at 6:15 Sunday morning feeling really nauseated. It was too late to take a pill, and I threw up. A lot. Once the vomiting stopped, I waited about 30 minutes and took a Compazine pill. Zofran has to be dissolved on the tongue, and it tastes weird to me, so I chose the pill I could swallow with a sip of water. At 9:30 I started throwing up again. Again, I waited a while after I stopped puking, about 45 minutes this time, and then took a Zofran. Once I began alternating the two drugs, keeping both in my system, the nausea was under control. But I was exhausted from the vomiting, worried about dehydration, and unable to eat without feeling sick. I spent the day lying on the couch, sleeping and sipping on ginger ale, Powerade, and then Pedialyte that a friend brought over. It was a rough day. By late in the evening I was able to eat and keep down some thin mashed potatoes and a piece of toast with cinnamon sugar on it. Monday I kept alternating the anti-emetics, and was able to eat more normally, but still felt extremely tired.


Fatigue and dizziness

Using the word "fatigue" for how I feel these days just doesn't seem strong enough. The tiredness from chemo is a deep, bone-tired feeling, where you feel like you're carrying around half again of your body weight and your muscles don't respond correctly to your brain's commands. At least mine feels like that. I usually "crash" like this on Saturday afternoon, Sunday, and Monday, so Days 3-5 of each round (the day I get chemo is Day 1.) It makes me feel like all I want to do is sit and watch something, or play a game on the computer or my phone. Along with the fatigue comes dizziness when I stand up too quickly or bend down to pick something up and then rise up again. It's like how you feel when you've been terribly sick and are recovering, trying to regain your strength. Maybe you've never felt that way; I hope you never have. By Tuesday the fatigue lifts considerably and I start to feel more energetic again. But I usually don't feel totally normally physically anymore, not even by Wednesday or Thursday, and then I have more chemo.


Nail changes

One weird thing is that some of my nails have turned dark purple at the base or over most of the nail. It isn't very dark, but it's noticeable. My fingernails have also gotten sort of ripply and ridged. Apparently this is all normal and to be expected.


Intestinal upset

I'll forgo discussing the intestinal upset and just say that it can go two ways: the Immodium way, or the Colace/Miralax way. You can figure that out. 


Changes in taste

The first thing I noticed was that fruit tasted like soap. Then many other foods began to taste metallic or like chemicals. Many foods that I used to like now sound unappetizing to me. For a while, toward the end of my A/C treatments and while I had the sinus infection, I lost my sense of taste entirely, probably because I couldn't smell anything at all, and nothing sounded good to me to eat. (And before you ask, NO, they did not test me for COVID-19. I did not have a fever, sore throat, or deep cough in my lungs. I still wonder, though....) A few friends who are cancer survivors suggested I switch to eating only with plastic utensils, and that has helped tremendously. Since I've been on the two new chemo drugs, my taste buds have revived considerably. I am able to taste food better and enjoy eating again.


Hair loss

I lost most of my hair two weeks after I started chemo, back in March. On Day 13 after Round 1 it started coming out in handfuls. I decided to take control of it, and cut it short, in a pixie cut:


Then Eric helped me shave it into a mohawk:



But it was falling out horribly as I put stuff in it to spike it up, so I only kept the mohawk for about 15 minutes. Then we shaved it all off. I started wearing comfy chemo hats;

At that point, I hadn't started losing any eyebrows or eyelashes. Now that I'm on Taxol and Carboplatin, my scalp hair has begun to re-grow, and my brows and lashes are falling out. My lower lashes are almost totally gone, I have about half of my upper lashes, and my brows are seriously thinned out. I was using a lash serum the whole time on my lashes and brows, but they just can't hang on. I'm having to use an eyebrow pen to fill them in now. 

Dry eyes and skin
Finally, chemo has dried out my skin, even though I try to stay hydrated internally. My feet flake and peel, and my face, hands, and legs are horribly dry. Even my eyes are dry! I had to call my ophthamologist to get recommendations for eye drops, eye gel, and eye ointment that I can use during the day and at night to relieve the dryness. The eye dryness was worse on the A/C protocol, and has abated somewhat during T/C. But it's still there. I'm applying facial moisturizer multiple times a day, and body lotion on my arms and legs several times a day.

Well, there you have it. My side effects.