Fun With Cancer

If there was a good thing about getting chemo it was the nurses. Now that I type that out it sounds kind of inappropriate, but my feelings for my nurses were always purely platonic, except on those occasions when my feelings were, “Ow! Hey! That hurts! Watch it!” Now if I were thirty years younger and still single my feelings still would have been purely platonic because I’ve always been a realist and still would have known the only reason my nurses were nice while they were sticking needles in my arm is because they were nice and enjoy working with people and sticking needles in their arms, which is what prompted them to go into nursing in the first place. I had four rounds of chemo, a grand total of twenty-eight separate days of dealing with nurses. Most of them were straightforward, professional types who came in, handed me my meds, maybe gave me some apple juice, and then left until the IV bags were empty and my needle needed to be pulled out. Before the first week was over I’d had minor surgery to install a port in my chest, a large plastic bulb that they’d stick the needle into rather than wrecking my veins and making me come out looking like a heroin addict. Having a needle stuck in the port hurts a lot less than having it in a vein, and I could tell the really professional and experienced nurses because when they stuck the port it hardly hurt at all. And I quickly noticed that if they were using cold saline I’d get a cool feeling in my chest, sort of like a peppermint melting under my skin, and then I’d get a faint taste of salt in my mouth. Most nurses would smile and say, “Yes, a lot of people notice that.”

I have a new respect and appreciation for nurses, but I guess it’s only natural that I would get to know some nurses better than others. Three in particular stand out. I’ve changed their names to protect their innocence even though the only thing they’re guilty of is jabbing me repeatedly with a large piece of metal.

Donna-After introducing herself Donna asked me, “Do you go by Chris or Christopher?” I told her “Chris” was fine and that the only people who normally use my full name are my wife and mother, and they only use it when they’re mad at me. “I’ll remember that,” she said. She was very brisk, very professional, but also very talkative. Donna excelled at multitasking, which I think was what made her such a great nurse. She could ask what I did for a living and what my plans were for the weekend while preparing my injection and drugs, all without missing anything. When she inserted the needle in my port I didn’t even feel it. When I told her I tasted saline she said sarcastically, “Everybody says that but I don’t believe it.”

After that I’d come in every day hoping Donna would be my nurse again. She wouldn’t be, but one day a couple of weeks later I’d get up to go to the bathroom only to find the closest one in use, and the next closest one also in use, so I had to wander all over the ward looking for an open bathroom. I finally found one and then realized I couldn’t remember where my room was. Donna was sitting at a desk and the third time I walked by her she snapped. “CHRISTOPHER ALLEN WALDROP, ARE YOU LOST?” She then turned to the nurse next to her and said, “I can call him by his full name because I’m mad at him.”

Dan-There’s a huge gender gap in the nursing profession. I’m not sure why, but most nurses are women, especially the famous nurses—Florence Nightingale, Mary Mallon, Walt Whitman. Interestingly when I was in college living in a dorm almost everybody on my floor was studying to be a nurse. That was before the administrators realized they’d accidentally put me in an all-women’s dorm, but that’s another story.

Dan was also talkative, but nicer than Donna. We talked about TV shows, what I did for a living, what our respective plans were for the weekend, and his tattoos. He had a couple of piercings, and when he put my needle in he did it with such grace I wondered if he’d done his piercings himself.

Lucy-More than any other Lucy made me appreciate that there’s nothing like a good nurse because she was nothing like a good nurse. I first met Lucy one morning when I was still in the waiting room and she came out to tell me my white cell count was so low she didn’t think giving me chemo would be a good idea, but she was checking with my oncologist to be sure. I know nurses are sometimes the last line of defense between patients and doctors, that doctors can make mistakes that nurses sometimes have to be there to catch, but she was trying to step in and make a medical decision. That didn’t bother me so much as the way she told me that my chemotherapy for testicular cancer might have to be put on hold until a mild cold would no longer be a major health risk. Having shared my diagnosis online I wasn’t exactly embarrassed, but I did wonder why she felt the entire hospital needed to know exactly what was going on at that moment.

Later she’d take me back for my infusion for the day. Fortunately this was a day when I was only getting a single short injection. Lucy prepped my port then without warning jabbed me with the needle. I felt like I’d been stung by a wasp. I gasped.

“Just take a deep breath.”

Thanks, Lucy. Most nurses told me to take a deep breath before inserting the needle—they gave me some warning, but then most nurses weren’t busy talking to someone else at the same time they were giving me my injection. Lucy would continue carrying on a conversation so I had to keep moving forward in my chair to prevent her from pulling out the needle. She noticed this and turned around to say, “Stay with me, honey,” before resuming her conversation.

Later I’d feel sick. A different nurse would tell me that sometimes happened when the drug was administered too quickly. I’m glad I’d been treated by Lucy. She made me appreciate the other nurses so much more.

I was diagnosed with cancer on June 17^th and started chemotherapy on July 7^th, not quite three weeks. I tell people that and they say, “Wow, things happened quick.” And I say, try it. I spent most of that time recovering from surgery that, in spite of being minor, was still surgery and left me with some pain, meeting my oncologist, talking about my chances, and preparing for chemotherapy. Well, there wasn’t much preparing to do, and my wife did an amazing job of stepping up and doing a lot of what needed to be done. She bought a moisturizing mouthwash because chemo would probably give me dry mouth, and an electric razor because I’d have a compromised immune system and a cut could be deadly. She bought a bunch of toothbrushes because I’d need a fresh one each time I started a new round of chemo. She’s also worked in medical research and went into meetings with doctors armed to the teeth with questions. Anything I could have thought of to ask she had covered, and more.

She also acted as a filter for information. At times I was tempted to look up information myself, but I didn’t. I’ll always wonder whether this was a good idea or a bad one, although it seems like it was the better choice. A little knowledge can be a dangerous thing. A lot of knowledge can be even worse. And while ignorance may not necessarily be bliss—I’d lost nine pounds when I started chemo—I’m not sure whether knowing all the fine details of my particular cancer would have helped my anxiety. The disease didn’t scare me nearly as much as the remedy.

I’ve never talked to anyone who emphasized this so much, and maybe it’s because I’m an idiot, but from the outset the one question in my mind was, what will chemotherapy be like? And it was a question I was afraid to ask because I thought it didn’t really matter what it would be like. Imagine you’re being chased by bears and your only hope of escape is to climb a cliff. And you’re afraid of heights. But you’re lucky: you’ve got an experienced climber who’s going to guide you up the cliff. Would you stop and wonder what the experience of climbing would be like? Or would you just shut up, do your best to swallow your fear, and get on with it? That was my strategy. If you’re thinking it would be a good idea to stop and ask for tips on how to climb, well, you’re absolutely right. I wish I’d thought the same thing at the time.

I wasn’t entirely ignorant. I may not have known the specifics of chemotherapy, but I had heard and read other peoples’ stories. I knew there was a pretty good chance of losing my hair, which sounded fun, but I also knew I could probably expect fatigue, nausea, and weight loss. I knew that chemotherapy could lead to trips to the emergency room and long hospital stays. I knew, from others’ experiences, that if they had to resort to really aggressive treatment it would leave me so wiped out death would start to seem like an appealing alternative. At the outset I knew I wanted to live, and the doctors kept telling me that I had a really good chance of beating the cancer, but I wondered, what if it turns out not to be so easy? What if things take a turn and get worse? I wondered if I, like another cancer patient I’d read about, would one day stand at my hospital window and contemplate jumping.

I spent most of that time in a weird mix of denial—my wife was the one who noticed that my right leg was the size of a tree trunk after my first couple of treatments, whereas I was just thinking, “I don’t remember these shorts being this tight”—and preparing for the worst. And I realize it must have been frustrating that I tried to make everything a joke. I’d reasoned that no one is better prepared for life-threatening illness than comedians because when you’re up there alone on stage your only choices are die or kill. And I thought if I pumped myself up on optimism and humor I’d be better prepared. If I fell from the cliff laughter could be my lifeline. It was good that I was coping but bad that my focus was too narrow. I’m happy to be a survivor, but I have regrets. My biggest regret is getting cancer in the first place even if I didn’t have a lot of choice in it, but a close second is not being more aware of what treatment was doing to me. That was important information that needed to be shared. Mentally I was coping, but I needed to be engaged with the physical part of my recovery too. “What’s wrong with your arms?” my wife asked one night. Oh, hey, I was so giddy from having been out that day cracking up strangers with my emergency room stories that I didn’t realize chemo had given me an allergic reaction to sunlight.

And in the end I got lucky. Chemo turned out not to be as bad as I thought it would be, or as bad as it could have been. I didn’t need radiation, and doctors had figured out ways to counteract some of the worst side effects of the poisons they were pumping through me. I had a few bouts of nausea but they passed quickly. I felt tired, but I never wanted to die. And when, on my first day of treatment, I was shown to a room the first thing I noticed was that the windows were sealed shut, and that it was only about an eight foot drop. Nurses came in and gave me apple juice and a warm blanket, which was emotionally reassuring but also nice because you could store meat in the infusion ward.

Of course it wasn’t just luck. My wife pulled me through a lot of it. Something else I should never take for granted, though, is how much I benefited from the experiences of others. Cancer patients who had come before me contributed information that improved my chances.

This is a song I had stuck in my head for nearly three weeks:

So I ran into an old friend I hadn’t seen in a while, and he asked me how I was doing. I said fine and asked how he was doing. He said fine, then motioned toward his body and asked, “All clear?” And that’s when I realized he was asking, seriously, “How are you doing?” It’s a question people sometimes throw out just out of habit, but for me it’s one more thing that’s taken on a whole new context. It’s been a year now since the longest two days of my life, forty-eight hours that felt like a year because I was diagnosed with cancer, rushed to the emergency room, and then taken in for an orchiectomy. It was only as they were wheeling me into surgery that someone thought to ask if I’d like a prosthetic replacement, not enough time
for me to ask, “Can I get a bionic one?”

It’s now been a year since the day I was diagnosed. Most of the time it feels like nothing’s changed in that year, but then I stop and realize everything’s changed. Until that day I hadn’t spent the night in a hospital since I was four. I hadn’t been out of work due to illness for more than two days. I could say “I never get sick.” I could say “I have no allergies.” I didn’t take any medications regularly. I hadn’t had a doctor’s appointment in three years.

Events tend to get telescoped in memory, but at the time it seemed like time itself slowed down. I became very focused on time. My second night in the hospital, the one I spent alone, seemed to move so slowly. I couldn’t watch TV or read even though the book I happened to have with me, Mark Twain’s Roughing It, was strangely appropriate. I had a really cool nurse who talked to me about the future, then reached over, picked the book up, and said, “Swear on the spirit of John Wayne…” then she looked at the cover and said, “I mean Mark Twain that you will get through this.” It was the best thing that she could have said. Like a young Samuel Clemens I was facing an uncertain future. Like him I was determined to push on, and I was determined to look back on the whole thing as comedy rather than tragedy. The strange thing is thinking about the future seemed to slow the present. When I walked to the window at the end of the hall the lights of the cars below made long streaks like a long-exposure photograph. I couldn’t sleep. When I tried the pain in my leg that had been the symptom that drove me to the doctor flared up. I called the nurses to ask for medication three times. If I’d called again they were going to come back with a needle of black tar heroin. And then it was all over and I was home, then back to the emergency room in the middle of the night because I sat down on the toilet to pee and stayed there for what felt like hours while nothing happened. A nurse gave me a pitcher of water with instructions to drink all of it then told me I might need a catheter which scared me into going like a fire hose.

The few days before I started chemo seemed like months. I could barely sleep or eat. Then, after my first week of chemo, things fell into a comfortable routine: five days of treatment, Monday through Friday, then just an injection on the following two Mondays. The off weeks I had nothing to do. I found ways to keep myself occupied, but time still seemed to crawl by.

One of the drugs I was taking made my appetite come back with a vengeance. For days I’d dreaded my wife asking, “Have you eaten anything?” because I didn’t want to eat. Then suddenly all I wanted to do was eat. I hopped out of bed early one morning and made myself French toast with chocolate hazelnut spread and pecans. That was at seven-thirty. At ten-thirty I had a sausage biscuit because breakfast had been hours ago.

My hair started falling out just before my second round of chemo, and I thought, well it’s about time. I thought it was never going to happen. It had only been three weeks. It felt like years.

Even as I fell into a comfortable routine of chemo I kept the final day, September 22nd, in mind.

Six weeks after finishing chemo I went back to work, but the days didn’t have a chance to blur. There were the holidays, and then, after some tests, I learned I’d have to be back in the hospital, this time for major surgery. The wait until that day seemed endless, and then the day itself seemed like an endless pattern of being shuffled from one desk to the next, progressing through a series of doors until they finally moved me from a rolling bed to the operating table. I have a sense of time passing in a deep but dreamless sleep before I woke up to my wife and a bearded man saying my name, and a dull pain down the middle of my body.

In my hospital room I read, wrote, watched TV. An old friend dropped by. Another friend sent flowers. I finally worked up the courage to sit up, to amble to the bathroom, to even take a shower.

Finally I was deemed well enough to be released, after three whole days.

Around Christmas everything that had happened over the previous six months finally seemed to collapse on me while we were watching a Peter, Paul, and Mary special. Thanks to my parents I listened to Peter, Paul, and Mary before I could walk. The fact that Mary Travers had fought cancer, and lost, a few years earlier hit me hard, especially during “Puff The Magic Dragon”. Make drug jokes if you want but that song was a major part of my childhood soundtrack, and it affected me deeply because I think it was one of the few children’s stories that was brutally honest about life.

Dragons live forever but not so little boys.

Painted wings and giant strings make way for other toys.

One gray night it happened, Jackie Paper came no more,

And Puff that mighty dragon, he ceased his fearless roar.

Even as a child I wondered what happened, because the lyrics make it clear Jackie Paper doesn’t just grow up. Maybe Jackie Paper dies. Maybe Jackie Paper also has cancer. Or maybe it’s just that from the perspective of a dragon who lives forever Jackie’s childhood is over in an instant. As a child, maybe from the first time I fully understood the words, the song made me look through the glass darkly to understand that it’s inevitable that we grow up, that we grow old, that we die. Listening to that song for the first time after I’d finished treatment and surgery made me think about how close I’d come to death.

It also might have just been post-surgery hormonal changes that had me sobbing uncontrollably.

Time began to get back to its normal pace as I went back to work, fell back into old routines. I had another breakdown when my urologist recommended I have a second orchiectomy. When they asked for my approval to have the first one I said, “Sure, great, go ahead!” And I looked between my legs and said, “So long, Dexter, it’s been nice knowing you. Don’t let the ass hit you in the door on the way out.” And logically a second orchiectomy was an easy decision. My urologist told me that without chemo there would be a five to seven percent chance of cancer developing in what I had left. He wasn’t sure about the numbers after chemo, but I calculated that the low end of that scale was still one in twenty. My cancer is very treatable but it’s also pretty rare. I didn’t want to push my luck. My oncologist also supported the idea of a second orchiectomy. Who am I to argue with two of the people who saved my life? And it’s not as though I would miss Lefty. At this point the attachment was purely physical. What I’d become attached to was the misconception that I was done. When he suggested another surgery I felt emotionally deflated. Was this never going to end? Every time I thought about it I felt like crying.

It also might have just been post-surgery hormonal changes. I’ve been on hormone therapy for a little over six weeks now, and I can’t tell whether it’s that or time or maybe a little of each that’s perked up my outlook.

The surgery is now scheduled. It’s something I have to look forward to, and, yes, I really am looking forward to it. I’ve been extremely lucky. Some people are in treatment for years, and in addition to chemo have radiation, transplants, infusions. For them it’s like going twelve rounds in the boxing ring with a heavyweight opponent. For me it was more like a late evening brawl between a couple of guys too drunk to hit each other most of the time. And I’m grateful for that. I also have to keep in mind that even though it felt like forever things happened really quickly. That’s made it hard to adjust my perspective, but realizing that it’s only been a year has made it easier. A year isn’t that long. No, it’s not
ever going to end. Cancer is going to be with me for the rest of my life, but given time things will get better. How am I doing? I’m fine. I really am.

My blood pressure spiked at 639 over 225. Or something like that. It’s been high ever since my surgery in December. It seemed natural for it to be high after a procedure that involved slicing me open from my nipples to my navel and pushing everything aside so they could yank out some lymph nodes that, in the end, had a few teratomas which are a benign kind of tumor that can turn into anything like skin, teeth, or eyes. I would have been okay with that, since they could keep watch on what was going on down there, but the doctors didn’t think it was such a good idea. They don’t think my consistently high blood pressure is such a good thing either. I talked to my primary care physician, or PCP, who thought it might be from the surgery. He thought an artery going into one of my kidneys may have been kinked. Because the kidney wouldn’t get enough blood it would think the whole body wasn’t getting enough blood and would produce a hormone to raise the blood pressure. The kidneys also filter your blood and produce urine, and are the site of the adrenal glands which produce the fight-or-flight response when we’re in trouble, all things that seem completely unrelated, and yet no one can explain to me while growing an eye next to my liver would be a bad thing, but that’s another story. My PCP prescribed a drug that would lower my blood pressure. To deal with my hot flashes he’d also previously prescribed a daily testosterone medication. At this point I’m beginning to think I should stop calling him my PCP and just call him my dealer. Maybe I’ll do that the next time I’m sitting in the exam room listening to The Eagles song Journey of the Sorcerer on an endless loop on the office intercom.

“The problem with your artery can probably be fixed non-surgically,” he told me.

“How would they do that?” I imagined some guy punching me in the back until my artery was straightened out.

“They’ll make an incision in your leg and use a probe to place a stent in the artery.”

I’m not a medical professional but any time the phrase “make an incision” is used that’s surgery. I told him this and he agreed, but went on to say it would be very minor surgery.

“They’ll just give you a local. You’ll probably be awake through the whole thing.”

“Maybe not,” I said. “The last time they gave me a local I went out like a light.”

“Oh? You’re a cheap date.”

I’ve got the greatest doctor in the world.

The greatest Doctor not of this world.

After I met with my PCP I was referred to a very smart cardiologist who told me she didn’t think it was a problem with the artery, which was a huge relief. If I can skip the surgery, no matter how minor it is, that’s a good thing. When she told me it might be a part of my kidney dying that didn’t sound so good, but she said, “It’s not quite dead,” in a Pythonesque voice, and that reassured me that I was dealing with a professional with priorities. If it didn’t bother her that a small part of my kidney was on its way to join the bloody choir invisible I wasn’t going to let it bother me, especially since the goal is to get my blood pressure down.

To that end, though, she prescribed another drug. And then she had some tests run and noticed that my thyroid was low, so she prescribed a drug for that too.

For three months last summer I had a killer cocktail pumped through my body, and on top of that I had regular doses of pills. I was prescribed anti-anxiety meds, pain pills, pills for nausea, pills to make me piss like a racehorse, an array of blitzers, tinglers, zippers, and baby aspirin. Most of these I didn’t take more than a couple of times because I didn’t need them, and the ones I did need I weaned myself off of as soon as I could. Drugs just aren’t my thing. It’s not that I’m afraid of addiction—I’m not. I can’t even remember to take a multivitamin regularly. I’m too lazy to be an addict. Think about it: addicts are the hardest working people in the world. They have to be because nothing will stand between them and their next fix. Eventually for most it’s not even pursuit of the high that drives them; it’s the need to feel normal. And deep down I think that’s what worries me. I don’t want to be tethered to something, especially a drug. It feels so limiting. What if I get stranded on a desert island? Yes I’ll have bigger things to worry about, and maybe eating coconuts and fish all day will naturally level out my blood pressure and thyroid. And if I look at it one way it depresses me to think I’ll probably be taking some of these drugs for the rest of my life, but looked at another way the phrase “the rest of my life” has taken on a whole new meaning over the past year. A life of popping pills is better than no life at all.

And then I realized I already am an addict, and have been for a long time. I start every morning with a cold coffee with milk. I didn’t realize how important that was until my wife and I were staying in a hotel and I started a couple of mornings with a Coke instead. I was getting the caffeine, but it just wasn’t quite right. The third morning I went to the hotel coffee shop and ordered a gargantua triple cappuccino over ice.

“Is that for here or to go?” the woman asked as she frothed the milk.

“Just pour it in an IV bag and stick a needle in my arm.”

Try getting that on a desert island.

The hot flashes started around January. I didn’t think much about them. I was still having lingering issues related to chemotherapy. My hair was still coming back and so were my nails. It was less noticeable, but my blood was recovering too. For a long time after chemotherapy I couldn’t walk long distances without being short of breath. The low blood counts started during chemo. One morning my white cell count was so low that a nurse came out to yell at me from across the waiting room that they weren’t sure I would be getting chemo that day. I thought about yelling back, “Thank you for letting everyone in the hospital know that right now a bad cold could kill me.”

Before chemo, before anything else, in fact, there was the orchiectomy, or having the offending testicle, which was on its way to becoming a goose egg, removed. I didn’t have much time to prepare for it emotionally because it happened two days after I got the news that I had cancer, but I took it in stride. I thought about when a friend of mine had his three male cats neutered. One of them was named Curly. Curly was a character, always doing something bizarre like climbing the kitchen cabinets or flipping over the litter box.

Curly was last in line to get neutered, and before the vet made the final cut my friend said, “Maybe you’d better leave him one testicle just in case we want another like him.”

After my own half-neutering there was chemotherapy. When I finished chemotherapy I thought, well, this is it! Back to life as it was before.

Then I had the follow-up work and found I had to have surgery.

When I finished surgery I thought, well, this is it! Back to life as it was before.

And then I had some other follow-up scans. These, I assumed, would be the first of my biannual, eventually to become annual, checkups. The tech who did my ultrasound had trouble finding my testicle, which had apparently retreated out of fear after it saw what happened to the other one. So she called in another tech. And they called in a third tech, and finally the radiologist had to come in and say, “No, no, no, don’t you know anything? It’s between his legs.”

The first time I had a CT scan I just felt an incredibly warm sensation in my groin, like it was being microwaved. The second time I threw up in the middle of it. The third time I just felt like I was being microwaved again. Back to life as it was before.

I met with my oncologist who told me everything was fine. Back to life as it was…okay, I need to stop saying that, because I also had to have a follow-up with my urologist. This required a blood draw first thing in the morning. Then my wife called me to say they’d made a mistake on the first blood draw, and I was thinking, did they accidentally draw phlegm or something? I went back that afternoon and had another blood draw.

Then my urologist called to say the blood draw needed to be done first thing in the morning because he was checking my testosterone and that’s when it’s highest.

So I got my blood drawn again the next morning.

My urologist told me my testosterone was between ten and thirteen.

“That doesn’t sound too bad. What’s normal?”

“Forty-five.”

Actually that’s the low end of normal. Decreased testosterone is a fact of life. It’s part of growing older. If I may speak to my fellow Y chromosomes for a moment: you may have seen advertisements for drugs intended to treat low testosterone. These advertisements may have asked if you’re feeling tired, if you have mood changes, or if you no longer get the sort of erections that embarrassed you when you were in middle school and had to go up in front of the class to answer a math problem. If you’ve experienced these symptoms chances are you’ve just got a condition known as Getting Older. The only treatment is a healthy dose of Deal With It. This is available without a prescription.

Low testosterone, the sort that needs to be treated with hormone therapy, only comes from chronic conditions like cancer or being kicked really hard in the nuts. Low testosterone needs to be treated because it can cause things like muscle loss, aches, and migraines. Migraines are typically described as headaches even though they should be called everythingaches. When you have a migraine your hair hurts.

Low testosterone can also cause hot flashes. It wasn’t my blood after all.

There are three important lessons here. The first is, there is no such thing as life as it was before. The second is, every little thing can be significant. If you’re having hot flashes and you can’t find any reason why you might be having hot flashes tell your doctor. And third, spay and neuter your pets, but if you have a favorite cat leave one testicle just in case. Once it’s gone it’s gone.