Kaity Kasper


The State of Affairs v.6.

Well, here we are.  Just 5 hours away from the last dose of round five.

Which means that there is just one round of this bad chemotherapy left.  And right now, I'm willing to say that calling it "bad chemo" is the greatest understatement I have ever made.

But in three weeks - 21 days - hopefully the really grueling part of all this will be a thing of the past.

I'm still torn between maniacal laughter and wracked sobs when I think about that.

*   *   *

I finally got to meet my new oncologist - Dr. McGuire.  He was a delight.  Throughout all of this I can't help but continue to be grateful for the way that God placed the Massey Cancer Center in my life nearly a decade and a half ago.  While I wish in some ways that I never had to use them - never mind seek their care twice - the people in that building continue to mold and shape me into the person I was meant to be, and I am certain Dr. McGuire will be no exception. 

So that's a relief.

One of the first things I had heard about Dr. McGuire is that he is a serious expert when it comes to chemotherapy.  So it didn't really surprise me that he knew so much about the impacts of the ABDV regimen I had received for Hodgkin's back in the day.  Dr. McGuire was surprised that I have done as well as I have in tolerating my current chemotherapy regimen because apparently patients who received ABDV struggle to tolerate future chemotherapy.  So that seems good.  It also explains for me a bit of why I feel like I am being hit harder by this chemotherapy than I was last time - my bone marrow was damaged by the ABDV, making it that much harder on my body to go through this again.

But a friend also pointed out to me between rounds four and five that my experience with Hodgkin's and this experience with ovarian cancer are really two entirely different animals.  Yes, Hodgkin's was cancer and could have taken my life, but the numbers were always so much better.  The truth is, until we got the results back from the post-round three CT scan there was a very real chance that I was going to die as a result of ovarian cancer.  And I haven't let that sink in.  Honestly, after the first week post-surgery I hadn't let myself think about the chance of death - I built a wall around those thoughts to stop them from screaming.  There was no other way to move forward.  But its true, and at some point I will need to sit down with that reality.  But I'm not entirely there yet.  I do know, though, that the more aggressive and advanced nature of this cancer meant more aggressive chemotherapy this time - so of course it would be harder to endure.

*   *   *

Many of you ask me about my blood work often.  It would be nearly impossible to explain all the various things they look for when they test me each week.  But the short update is that while my platelets continue to drop lower each round (leaving me short of breath and dealing with clotting issues) my white counts have stayed high enough with the Neulasta that I haven't needed a mask and haven't been under house arrest for quite awhile now.  And, in even better news, after a scary climb following round three, after round four my tumor markers dropped again.  So we are on the right track.  

*   *   *  

So what has round five been like?  Nausea has been out of control.  I've napped a lot.  Chemo mouth is in full effect.  And I am sitting here today with bone pain that is worse than any round before. 

According to my intuitive, this is common - the progressive worsening of side effects with each round.  He explained that it takes quite awhile for our bodies to flush out as much of the toxins as they can following a dose of chemotherapy - longer than the two weeks I have between my rounds.  So each time we start again, we are - in essence - piling additional toxins on top of what is already still sitting in my body.  So the side effects get worse because they are caused by an ever-increasing load of toxins.  Make sense? 

I've definitely learned what helps and that is useful.  I am eternally grateful to friends with large bathtubs, the manufacturer of Jolly Ranchers, and the people who invented seltzer water.  I couldn't get by without those things right now.

So I know I have my worst round coming.  But I have to believe it will help knowing that its the home stretch. 

*   *   *

For better or for worse, I have a number of cancer survivor friends.  One reminded me last week that the period following the end of chemotherapy is the time when depression is most likely to set in.  And while mine has been here for awhile, I know she is right - and I can feel another type of depression settling into my bones.

Why is this?  Shouldn't the reprieve from all of this make those of us who lived it happy?  Of course.  But its more complicated than that.  After you have invested 100% of your energy into one thing - and that one thing goes away - you are left with all the other stuff you didn't have time to think about before. 

There is the chance of recurrence.  And the fear every time there is a follow up test.  For me, this time, there is still a year of maintenance chemotherapy - which I am grateful will be so much less painful but which will still serve as a constant reminder that we aren't out of the woods yet.  There is survivor guilt - a very real thing.  There are so many things that come to a head in the after - so many things that can't hit you until the hard part is done - and that brings a new set of challenges waiting just after the finish line.

I am sure I will write about this more in the next few weeks.  For now, I will just say that while I am grateful that the end is near, I know the road hasn't ended yet.

But for now, here's to nearing the end of round five.