Saturday it will be exactly two years since I first heard the words 'you' and 'cancer' in the same sentence.  Just to recap the sequence of events since the beginning of this blog was some time ago:  in October of 2010, I began having severe pains in my left shoulder.  I went to my primary care physician, someone I thought was also my friend though he hasn't spoken a word to me since that visit, for an x-ray.  He found nothing and sent me to a doctor who specialized in physical therapy and who diagnosed a torn rotator cuff.  I had cortisone shots and therapy, but the pain didn't decrease.  Next he decided it was bursitis, so there was more cortisone and therapy with the same lack of results.  Finally in April 2011, after six months of misdiagnosis, he sent me for an MRI.  On the 13th of April, having retired the year before but still teaching one class as an adjunct, I was in an empty hallway on the second floor of our building on my way to the restroom when my phone rang.  It was the doctor who gave me the results of the MRI: tumors that were destroying the left scapula.  I had fifteen minutes to digest this information before my freshman composition class, which I taught without, I think, revealing what was really going on in my mind.

The next month--it seemed never-ending--was spent arranging appointments at KU Med.  The assumption at this point was that I had bone cancer, and I underwent full skeletal x-rays which revealed how much of the scapula had been destroyed and of more immediate concern a large hole in my right femur.  The orthopedic surgeon was amazed that the femur hadn't shattered and that I hadn't had any pain there.  As Mohamed and I were leaving the Med Center on a Friday, the nurse called with some good news: the tumor in the scapula hadn't spread into surrounding tissue.  The good news was short lived, however, as Dr. Templeton, the surgeon, called me at home on Saturday morning to say that the CT scans had revealed that it wasn't bone cancer, but kidney cancer which had metastasized throughout my body.  "That's not good news" was my intelligent response.  Dr. Templeton agreed.

Friends were advising that I go to the Mayo Clinic or to M. D. Anderson for a second opinion, but an operation on the femur was urgent, so I immediately entered KU Med.  I remember the day before we left, Mohamed asked me whether I was afraid.  Naively I said no.  I envisioned something like a hip replacement--temporary discomfort followed by feeling better than before.  The first day they did an embolization, which I had to look up online.  "We don't have to do it," said Dr. Templeton, "but if we don't, you'll never get off the table."  The next day was the operation itself.  None of the bone of the upper femur was salvageable, so the top half of my femur is titanium with an extension into the lower half and the ball part of the hip joint is plastic.  All of the muscles had to be surgically attached to the titanium.  I spent nine days in the Med Center, Mohamed at my side the whole time.  I was "fitted" with an abduction brace.  "One size fits all," said Dr. Templeton blithely, "which means one size fits no one."  It cut into my skin, and the first technician couldn't get it to fit.  Finally, after three days, a second technician managed to make it less painful.  I wore it 24/7 for the next 46 days, each one of which I counted down.  I couldn't shower.  I couldn't take it off to sleep.  It took a few days to master the seven stairs to the bathrooms in our house.  I had an oversized wheelchair (because of the size of the brace), which was difficult to maneuver around the house.  I had radiation treatments here in Topeka, first on the hip, then on the shoulder.  The latter seem to have been quite effective, and neither had any major side effects.

Luckily, I had great support from friends and colleagues and, of course, Mohamed.  Visitors came from France, Hawaii, and elsewhere in the U.S.  Even getting me up the stairs in the wheelchair and into the house during a rainstorm became a major ordeal.  Meanwhile, my care was given over to Dr. Vanveldhuisen, an oncologist, and the new life began.  The prognosis, he said--and everything I read on the Internet confirmed it--was 10-11 months.  I started on a daily regimen of chemo, fortunately taken orally.  I deal with the side effects every day.  They're not pleasant, but then since it's been 2 1/2 years since the cancer had spread, I'm a year and half past my expiration date, so I have nothing to complain about. 

Last week, the side effects were worse than usual, so for the third time, I gave myself a four-day break in the chemo.  The first two times, I had felt rather smug not opening the Votrient bottle, but since over the last six months the primary tumor had resumed growing (though slowly) I was reluctant this time to take the break.  For the first three days, the diarrhea lessened, though to my surprise the fatigue did not.  On the fourth day, however, all the side effects resumed, and yesterday, when I started the chemo again, was fairly miserable. 

Next Friday, we go back to the Med Center.  I'll have bloodwork, CT scans (to see whether the tumors are growing), and, for the first time in nine months, full skeletal x-rays.  Even though the secondary tumors have been stable in size, it will be good to know whether they are gnawing away at the bones.  Ever since the surgery, I've had constant discomfort in the right hip, but no real pain.  And I haven't felt pain in other areas where there are tumors, so I'll hope that's a good sign.  I'm not a worrier by nature (as I always say), so I haven't spent much time thinking about next Friday, though when I do, I have to admit that I'm a bit apprehensive.  So far, though, so good.  And now, since I've been up for over three hours, I feel a crash coming on.  Every morning at this time and every afternoon at about 2, I absolutely cannot stay awake.  In the afternoon, I crash for at least two hours, often longer.  I'm a barrel of fun these days.  Living with cancer is boring...until it won't be.