Sunday 26 November 2017

Cloudy intervals

Cloudy. The sky is grey and white and cloudy. Sometimes I think it's hanging down on me
Cloudy - Simon & Garfunkel

A follow up on the path ahead, and my state of mind

I thought I'd share a few excerpts from my most recent take home reading matter - the pre-read participant information sheet for the Myeloma XII (ACCoRd) trial I am heading for. It might help give definition to the cloud I'm under.

Firstly, here's the synopsis of the treatment duration. At a minimum it would be 5 months. But, depending on how I respond and how I am "randomised" it could be 7, plus 2 months recovering from the SCT, plus 2 further months "consolidation", which would be 11 months. So, I don't know how soon I'm starting, and I don't know whether I'm in for less than half a year, or a whole year. And that's without considering whether I will end off taking "maintenance" drugs indefinitely. Last time, I was so ill that time hardly mattered. This time, a year is tangible children's milestones, holidays, work schedules. All of which are up in the air while I don't know when treatment will start or end.

Next up, here's an opening salvo on the treatment medications and potential side effects...

"The risks... are not well known". Never forget: you're on a clinical trial, not a tried and tested treatment. No-one knows how this will work out. And, assuming there are no unanticipated interactions to consider, then at a minimum, here are the likely side effects of the three drugs in the protocol. I'm reasonably phlegmatic about all of this. Still, it's hardly a reason to smile in the morning.

That's what's clogging up my head, preventing me making any plans, clouding my future beyond the next few weeks. I guess some of the dialm audience - myeloma survivors and others who've experience of recurrent cancer - will understand this. For others, it might be hard to truly take in.

When I was diagnosed, I was haunted by fears of dying. These days, that bothers me much less. Partly because I've got used to it, and partly because I know that I'm not actually that likely to die, in the short term. It's the process of living with myeloma that I have to reconcile to, now. Like anyone grappling with their own mind, I have experienced troughs of deeper darkness, and periods of greater positivity. Right now, I'm fine - I can put it all in perspective.

I don't know if writing this up will elicit horror, pity, compassion fatigue or what. I'm putting it here for one reason only: that I want dialm to be an honest, unfiltered account.

Friday 24 November 2017

Sunny intervals

Hey sunshine, I haven't seen you in a long time. Why don't you show your face and bend my mind?
Cloudy - Simon & Garfunkel

Checkup ... KFLC = 641 ... κ/λ = 95 ... Hb = 11.2 ...

I've hesitated to post this. It's 2 weeks now since my last appointment, and more since I wrote much of what follows. It seems bleak to blog negativity, when really I should just be grateful for each month I keep out of the chemo unit. But life is more complex than that.

My 'eloma appears to have plateaued at the most sensitive moment. Yet again I don't quite tip the balance for treatment, despite last month's advice to the contrary. It's hard to complain - the immediate upshot is a chemo-free Christmas for me. And it is looking increasingly as though I may hit five full chemo-free years since my SCT. What's not to like?

Clouds, and also sunshine. Vilnius

I would love to say I've kept positive, these last few weeks. I'd love to say I can see the purpose, beyond the ordeal. I'd love to boast of maximising the value of my time, of the things I've gone out and done, of the fun I've been to be around. But I would be lying.

I'm conscious, often, not to make special pleading for mm. (There's plenty of other shit dealt out.) But it does have its own exquisite features. Unlike last time, I can see what faces me in its entirety: because I'm not preoccupied with the shock of diagnosis, or the ravages of advanced symptoms. But instead of making it easier, it somehow makes the transaction - the cost, and the benefit - more stark and less appealing.

If the past is any guide, the next few years could be thus:

  • 1 year treatment - chemo and SCT
  • 2(+) years remission - dormant mm accompanied by fatigue and every passing virus
  • 2(+) years relapse - with the clock ticking loudly

And then, with a following wind and a bit of luck, I'll be back where I am now.

I ask myself which of those three phases is the best one to be in.
I guess the answer should be "remission"...
But I've actually felt much better physically in the last couple of years - less fatigued, less jaded...
So I'm tempted to answer "relapse"...
Except I'm haunted by the endless check-ups, discussions, the impending doom...
In some ways "treatment" is the easiest phase...
It's clear what the objective is, and everyone rallies round in support....

But what kind of insanity is that! Am I willing myself into chemo? Everyone knows that being on chemo sucks. If I'm even entertaining the thought that it might make me happier, then I must have lost my mind.

When I first researched myeloma, all those years ago now, one of the things that fixed in my head was the description of hypercalcemia symptoms as "stones, bones, groans, thrones and psychiatric overtones". It didn't seem at all surprising, to me, that the various painful and dignity depriving symptoms would between them tend to impact mental health. (And hypercalcemia is but one component of myeloma.) It's easiest to restrict conversation to talk about the physical indignities, of course. I reckon I'm pretty mentally robust, if I'm honest, but the endless assault of myeloma is still tough.

(Sorry for all the moaning.)

I'll post a follow up, in a couple of days, about the treatment ahead.