Cancer, I’m learning, can throw a nasty curve ball.
I took an afternoon nap about a month ago and woke up with no voice. I expected the issue to pass and so did my doctor. But weeks later I can still only speak with some effort in a hoarse whisper. It’s like that old Dad joke when someone talks too much through the TV show and you pretend to mute them with the remote. Only I’m the one who’s been muted. A more serious look into my throat determined that my left vocal cord is paralyzed. You need two vocal cords vibrating healthily to be able to make noise. My family is familiar with vocal cords. My wife Barbara’s bout with thyroid cancer ten years ago left her in danger of a tracheotomy because only one of her cords survived the disease and subsequent surgery. Her voice has slowly grown from a whisper to a nearly normal tone as the remaining cord grows stronger and compensates. This is particularly bad timing, however, since I have invited a lot of people to an “author’s reading” this weekend. I am the author. (The book is a delightful travel memoir entitled “Three Cents a Mile.”) And now I can’t be heard, not even with a microphone. The reading will be done by family members. The source of the paralysis is apparently a cancer tumor in my chest that is pinching the nerve leading to the vocal cord. That was a revelation to me because it was the first I heard that I had cancerous tumors in my chest. There is a temporary remedy to my voice problem. It involves a long needle either through my open mouth or through my neck to inject the vocal cord with a gel or another material to plump it up -- giving the healthy cord something to vibrate against. But it’s not happening before this weekend and I haven’t had a real conversation with the doc yet about the procedure and possible side effects. In the meantime, all my phone calls start with, “Can you hear me now?” My aging dog either truly can’t hear me or is using this as an excuse to ignore me. And my wife, accused in the past of not listening to poor ol’ me, is anxious to not give me an opening and is hyper alert. So much agita over the sound of silence.
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If you follow this blog, you will remember my daughter as the young woman who would not be put off by my inability to attend a Yankee game with her because of my worsening cancer. It had been her Christmas present to me. So she painted my head to look like a baseball and we had a grand ol’ time watching the game on TV. This won’t-be-denied daughter, Maura, has now turned her birthday into a cancer fundraising event. As she describes in her pitch, she has been haunted by the spectre of cancer in both of her parents since she was 12, first my prostate cancer and then my wife’s thyroid cancer. And she is grateful for the advanced treatments that have allowed her parents to live as long as we have. “As I'm turning 24 today, this year marks half of my lifetime spent focused on tumors, treatments, and tests. I am incredibly grateful to have had twelve full years with my parents from diagnosis to today - something a lot of patients and their families don't get,” she wrote. But my favorite part of her appeal is the F-bomb she drops on cancer. I’ve been wanting to say that for years. I encourage you to read her post -- and to donate. It’s what she wants for her birthday There will be no more chemo for me.
I’ve wrestled with how to deal with the unstoppable advance of my prostate cancer, and decided that more chemo is not the answer. And I am relieved at that decision. On the “weenie” side, I guess this means I am not “fighting” cancer like a tough guy. To heck with that. That bout is rigged. You just endure and last as long as possible. And the point of all this treatment is not just to live longer, but to live well. Living well has become more important to me than just hanging around. My wife, daughter and son have all said that this decision is up to me and they are good with whatever I decide. God bless those, including my unsinkably cheerful cousin Mary, who are enduring much tougher chemo regimens and will keep doing so. But chemo for me was never going to be a set number of sessions and then I would be done. It was scheduled for every three weeks for the rest of my life, which was estimated by my doctor recently to be about nine to twelve months. The nasty drip had succeeded in reducing the cancer in some areas of my body, but was not effective on the cancer in my skeleton, which my oncologist wanted to address with a second bag of chemo. He has urged me to consider the extra chemo. Stopping altogether, he has advised, could shorten my life even more. The cancer literature assures patients that stopping chemo does not mean giving up, but in my case there may be an element of throwing in the towel. I have been sick and getting sicker for more than a decade. There was the surgery, then the radiation, hormone therapy, experimental drugs, radioactive drugs, monthly shots in my stomach and quarterly needles in my butt among many other things. The side effects were tough on my body and my ego. They ravaged my plumbing, gave me uncontrollable sweats for years, made me gain weight, played painful havoc with my joints, turned my sex life a fond memory, and made going someplace overnight or even out for drinks with friends something to avoid. Those procedures and meds, however, succeeded in keeping me alive for twelve years through two jobs, my children’s high school and college graduations, and my final mortgage payment. It allowed me to be there for the harrowing crisis when my wife was struck by a car. Being alive and relatively healthy was a recurring theme at many Thanksgivings and made Christmases and July 4ths even sweeter. The nightmarish side effects of chemo, however, were in another category altogether and left me essentially housebound. It was taking a drastic toll on my mind and my spirit. Now without the spectre of chemo, there is a ray of hope that I can live better, do more, see people, go places, enjoy meals, and actually have fun. It seems every med I’m prescribed comes with the same warning: May cause fatigue, nausea and constipation. Or diarrhea. I even have a bottle of pills intended to end my months-long misery with nausea. Near the top of the side effects alert is that they “may cause stomach upset and nausea.” They did. At times I have to remind myself that they are intended to make me feel better, not worse. Pill bottles litter my house like beer cans did long ago. The little orange containers are not placed in any strategic order. Many I have just stopped using and they get left where I last shook out a pill from them. At times I am baffled about what drug I should take. My doctors seem to be baffled too, at times contradicting each other. There are a lot of opinions between an oncologist, orthopedist, radiologist, gastroenterologist and a nutritionist. The radiologist suggested using the oxycodone for help with stomach discomfort. The oncologist, who prescribed the oxy, made a “that’s ridiculous” face when I asked about it. (Sometimes the pill does help.) The oncologist says my type of chemo (docetaxel) is not causing my nausea. It must be the ulcers diagnosed in March, he insists. Gastro guy says of course the chemo is contributing to my bilious stomach and ending chemo might bring respite. (He wasn’t urging I stop chemo, just answering my question.) My son gave me a vial of pot oil drops, supposedly good for stomach upset. Not sure they work, but I know they don’t get you high. A bottle of steroids has gone untouched, the strategy for its prescription long abandoned. There is a small shopping bag of meds that I have given up on because they had the side effect of making me really sick. Plus, there are over-the-counter items to deal with the alternating bouts of constipation and diarrhea. Both which can make you fatigued. And nauseous. To add to the confusion, there was a seemingly unrelated incident, although I don’t think anything is unrelated anymore. I woke from a nap on a recent afternoon with no voice. Five days later, it’s still just a hoarse croak that can only be understood within several feet. Maybe the cosmos is tired of my complaining and has muted me. I will call a doctor after the Fourth of July, but am afraid he will prescribe another pill that will cause fatigue, nausea and constipation. Or diarrhea. |