Dear Friends and Family,
I am feeling silly today. (Perhaps giddy would be a more appropriate description.) My hands are linked behind my head and my feet are up on a stool. I am watching my bride sleep as if she is floating on a cloud. Even though we are still in the hospital, for once I feel relaxed. There is no hint of pain on Nancy’s expressionless face.
Unlike many other times, I also detect no worry. As I look more closely, Nancy’s beautiful bald head sports several brave strands of hair. I have to suppress a laugh. The little hairs randomly dot her scalp, standing straight and tall like telephone poles. They seem to whisper to me, “Look. I’m back already.”
The early morning light is uneven, and even as I sneak close to her, I can’t distinguish the color of the new growth. (We do have the same great, albeit tiny, view of the mountains through our window in Room 844. Today, however, clouds mostly obscure the sunrise.) Though I’m eager to know if Nancy’s hair will return as blonde, red, white (or even blue, I don’t care), it may be many months before we know the answer. Nancy has just completed her second round of chemotherapy. The new, cute hair strands will soon adorn her pillow, leaving her head bright and shiny again.
I’ve been pondering how to better explain Nancy’s medical treatment. Having watched more TV these past months than in entire previous years, I’ll utilize that medium. Pretend you are sitting with me and we are watching TV. A commercial for Nancy’s major chemotherapy drug, AraC, interrupts our game show, sitcom, or sporting event.
“Take AraC and watch the ‘bad guy’ leukemia cells melt away from the bone marrow,” a soothing TV pitch woman begins.
On the screen, the image of a cave emerges. There are stalactites and stalagmites in every direction. However, this cave looks different from any that you and I have seen before. The cave is fluorescent pink. The brightness almost hurts our eyes. The caption below the cave entrance reads “Inside Nancy’s Bone Marrow.”
As the camera pans the cave, we notice that there are black spots on the walls. The camera zooms in on one of the spots and what is revealed is startling. Each black spot is an ugly, gnome-like creature with a twisted, wrinkled body and a horrid face sporting a nefarious smile. The creature’s eyes protrude on stalks from its face and are huge and bloodshot. The shifting pupils stare at us eerily as if searching for prey.
The new caption on the screen is a single word: LEUKEMIA.
Suddenly, a brilliant gold-colored gas flows through the pink cave. One by one, the dark creatures fall from their perches on the walls, vaporized in a puff of gray smoke. When the gold gas disappears from the picture, the bone marrow is transformed. In just seconds, it has become a deep (and healthy) red.
The soothing TV voice continues: “In three times out of ten, AraC will eradicate the leukemia cells. Just like Drano ridding scum from your toilet’s pipes.”
The scene changes. Now on the TV is a swing set resting amid a field of knee-high, bright-yellow sunflowers. As we get closer, we see a little boy being pushed higher and higher by his mother. A close-up of the boy and his mother show matching freckled faces and award-winning smiles. As the mother turns away from the camera, she removes her long, flowing blonde ringlets that are revealed to be a wig. The boy’s eyes widen in surprise at his mother’s lack of hair, but he gently touches her fuzzy head with one finger, then two. The little boy eagerly rubs his mother’s head with both of his tiny hands. They both laugh. The boy kisses his mother’s cheek.
The soothing voice continues in the background during this scene: “Of course, AraC is not for everybody. Occasionally . . . well, actually often, there are significant side effects. The most common side effects are vomiting, diarrhea, headaches, and painful skin rashes. Please call your doctor if your kidneys fail, you have brain damage, or die. Actually, if you die, have someone else call because it would be a very long-distance call and our toll-free number might not work. You should not take AraC if you do not have leukemia. In fact, you probably should discuss taking this medicine with your doctor even if you do have leukemia. AraC is a dangerous drug.”
Once the commercial is over, you are back to watching Jeopardy or some other “entertainment” diversion. (Me? I’d be shaking in my chair, worrying about AraC’s potential problems.)
We just imagined the ALL-LEUKEMIA channel. The cave part of the “commercial” is a technique I mentioned previously in my letters called visualization. Nancy and I use it with each of her chemotherapy treatments. She sometimes falls asleep. When I visualize, I either laugh or cry when I’m finished.
Nancy has just awakened me from my Walter Mitty–like revelry: “Winnie, what are you doing up so early? I hoped you would sleep late today. Didn’t you have only four hours the night before last when you were on call? And maybe just five last night?”
I jump from my chair, move to Nancy’s bed, and place a loud kiss on my favorite mole atop her shiny head.
“You are right, my love. But I feel great. Look at your IV bag? Not only did you sleep all night, you’re less than an hour away from finishing this round of chemotherapy drugs. And you’ve had no side effects.”
Nancy and I look at each other without speaking.
Six doses of AraC are fading into the rearview mirror. Nancy and I were plenty nervous when her initial bag was hung six days ago. I had flashbacks to the first day of her first round of chemotherapy when she entered the hospital, when Nancy’s lungs filled with fluid and she required more oxygen by the minute. There was scary talk about the ICU and a respirator. I remember wondering if Nancy would survive that first day.
Chemotherapy drugs, though lifesaving, are dangerous. Unbelievably dangerous. Just like in my made-up commercial. And even though Nancy has only received the same drug at the same dosage for the same amount of days, this round is different. A new Nancy has returned to the battle this time.
Strong.
Confident.
Ready.
And with Popeye muscles.
For us, AraC is Nancy’s Vitamin C—her special orange juice. Despite the negative risks, Nancy has now made it through six doses without a hitch. In fact, she has actually watched DVD’s (and Jeopardy) and eaten like she was still on vacation at home. (Well, not exactly. The food is nowhere as delicious as the gourmet meals provided by our local friends.) Yesterday, we even did twelve laps up and down the hall in a single outing. During Nancy’s first hospitalization, three laps was her personal best.
Today, I write this letter with a smile stretched all the way across my face. Nancy’s smile is similar, too. We know that it’s just a single day among a long line of difficult days to come, but we will enjoy every last feel-good minute.
Why?
AraC’s expected and desired effects will increase dramatically over the next several days. Nancy will, like last time, become severely neutropenic with no white cells to fight infections. Already, this morning, she has been asked to wear a mask for her walks in the hall. Her platelets will drop critically low, necessitating replacement platelets every few days to avoid serious bleeding. Her oxygen-carrying red blood cells will continue to decrease, and soon Nancy will require transfusions again.
The result?
Nancy will once again be at high risk for fevers as unusual germs attack her body. She will have to be careful to avoid bumps and the resultant bleeding. She will be physically weakened due to the coming anemia.
And yes, sadly, she will once again feel just plain crappy.
Our arsenal is full, however. We have ever-increasing experience. Nancy’s scary first month of treatment, called induction, is now just a vague memory. She still has no sign of recurrence, so she is technically in remission. When the final red drop of AraC enters her veins, we’ll have made it through the first round of consolidation chemotherapy. It’s called “consolidation” because the new chemo helps “consolidate” our gains against the cancer. If she can make it through this next rough period, we will be able to go home for another two-week vacation.
“Let me get that for you, sweetie,” I say as I see her reaching for the book on the far end of the nightstand. Nancy ignores me. She sits up, stretches an arm, and retrieves the other book she is reading, the thriller The Lions of Lucerne by Brad Thor, a friend of ours.
“I can do it, Winnie. I should do everything I can while I still feel so good.”
Yes, Nancy does feel good and I am giddy.
On the phone last night, she described recent events to a childhood friend. It was the first time she had called someone other than family.
“You know, except for this awful disease, it has been a really positive experience. I’ve learned a whole lot of people care about me . . .”
Critically, Nancy is basking in the warmth of your love and support.
And I can think of nothing more important in helping with her fight.
Thanks so much from the bottom of our hearts.
Summary: This morning on day seven of hospitalization two, Nancy is finishing her chemotherapy, having tolerated it well. Though she feels great now, we know she will get sick again as the medicine attacks her and her leukemia.
All our love,
Winnie