Saturday, March 17, 2012

Done

Last update:
Just got the report back from the cellular test:
No significant intraepithelial lesions or malignancy
Presence of normal microbial flora. No sign of significant cellular alteration.

So, that's that.

Well...

What now?

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I'm done. This week the doctors finally told me that (apart from a cellular test that we haven't got the results for yet) all the tests and scans have shown that I'm in the clear.

For the first time in almost exactly a year, (diagnosis was March 9, 2011) I have nothing cancer-related to think about and no doctor appointments at all for two whole months. It's really over, for now. I have follow-ups every two months for three years, then every four months for two more. If I get to the end of that, statistically speaking, I'm considered "cured". Five years.

They were slightly worried for a time about an inflamed lymph node in my left hip, but it seems that this was not malignant but only a result of the banging around I got during surgery.

I thought I'd break radio silence once more to relate the good news, and to thank everyone here for the help, the donations, the prayers, the emails, the books and the general support and friendliness. It sounds a cliche, but I really mean it when I say that it made a lot of difference.

But I have a lot to think about, so intend to continue to be scarce for a while.

The whole experience has not been without heavy costs, and I don't mean only monetary. I'm changed. My outlook on the world has changed. And I am not sure now exactly where to go from here. I find I'm slightly frightened at the prospect of indefinite living. I spent the last year seriously preparing for the possibility that I would die and now that this has receded back to its normal remote corner of probability, I find I am at something of a loss.

Not having cancer, not having anything to fear, is turning out to be quite a difficult thing to adjust to.

I was very surprised to find that I fell into a deep depression shortly after receiving the news in January that the histology report had come back clean after surgery. It seemed terribly abrupt, as though I had been trapped in a runaway rail car for a year, concentrating with all my strength on not panicking, and now it had suddenly slammed to a halt. The silence and stillness are deafening and strange.

For a year, every day, I had to remind myself very strictly not to make plans or even entertain thoughts about the future. I've learned the trick of shutting down whole trains of thought: "Stop. Don't think about that." What I was doing with my life, where it was going, what the future held, were all topics that were off limits because every time they came up, there was the big, terrifying sign post in front of it all that said, "You might be dead".

Of course, maintaining strictly disciplined control every day of one's thoughts, hopes and dreams about the future for a full year is tiring work. And it had the odd result of making the past much more present in my mind. I've also spent the last year thinking very hard about what I have done up to this point. The question, what are you going to say to your Maker when you meet Him has been prominent.

I have since recovered somewhat from depression, but it is prowling around the edges of my awareness like a dark predatory thing, waiting for a chance to come back. The sudden attacks can be shocking and frightening. Of course the abrupt cessation of much of my normal hormonal function has not helped, and the treatment for that was only started four days ago, and has not really started to work yet. The doctor said it will probably help.

I have read that post-treatment depression is very common for cancer patients, though as yet little discussed in the medical literature. There are a few places in the US where these issues are dealt with for patients who are in recovery, but this awareness has not yet made it over here. The articles and research studies I found said that it is actually a mild form of post-traumatic stress, which makes sense. You spend a long time in a terrifying battle for you life, against an enemy that is at once alien and horrifying and profoundly personal and intimate, and all the while, normal life, daily activities, even normal thought patterns have to be suspended. There are illness, weakness, nausea, pain, terrifying surgeries and losses.

At the end, if you have survived, you are damaged, reduced and in many cases physically mutilated. Deeply and permanently changed, with prospects for the future that are different from what you had imagined before cancer, almost as though it has made you into a different person, someone you don't know. And when it is all over, you feel bereft. The doctors have waved good-bye and you feel almost abandoned.

For a year, I've had my thoughts and actions, every waking moment, tightly focused and oriented towards this one thing. Now that it's over, I almost don't remember what I was doing or thinking. And even if I do start piecing it all back together, there is no way I can go back to the same old me. Everything from now on is going to be new.

So, I'm going to stay quiet for a while, for which Lent seems like an appropriate time.

See y'all at Easter.

HJW



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