Monday, February 10, 2014

Sympathy for Atlas

So I had my surgery and, as expected, it was no fun at all. Chest tubes? Yeah, I guess they're great for keeping your lungs inflated and draining crap from your chest, but as far as comfort goes, they could stand a lot of improvement. In any case, the surgeon removed one (not two as discussed) tumor from my right lung and felt that it was large enough to provide a sample for all three tests that were proposed. I spent a night in the hospital and then returned home with the hope that soon I might have some answers. Then, about a week after I had my surgery, I received a phone call from Mayo telling me that the tumor that was removed had more scar tissue than they expected and that because of that there was not enough viable tumor tissue to do two of the three tests (the least expensive one, and the most expensive one). So my hopes were pinned to the one test that was left. The nurse told me that they had sent off my tumor sample to the company that does that test and felt pretty confident that there was enough in that sample for them to run the test on. But a week ago I received another phone call from Mayo saying that the sample that they sent had only 20% tumor purity and that they were unable to run that test either. The company that does that test asked for another sample to be cut from the tumor but that there was a very small chance that they would be able to successfully run it.

To say I was devastated by this news would be a vast understatement. The surgery was misery, and the mere thought of repeating it is enough to bring me to tears. And we haven't even mentioned the failed tests to Kylynn (please don't if you see her) because she is still shaken up about the surgery. Things have been tense around here and tempers short. Eric and Kylynn are feeling the stain and stress, as am I. I can't speak for them, but I would say that trying to hold everything together here at home, with Kylynn's schooling, Kylynn's activities, and process all this Mayo stuff is like when I try to carry laundry downstairs without a laundry basket. I have to hold everything close to me and hold it tightly. Something on one side will start to slip so I adjust my grip and then something on the other side falls. In the end, it's a huge effort and invariably something gets dropped and I have to go back and get it. No fun. And Kylynn has been feeling the stress around here and doing her best to deal with things, but she's nine... and that just adds another degree of difficulty to my "juggling" act. I feel like maybe I am mixing my metaphors....

Just by coincidence Kylynn and I are working on a Greek Mythology unit right now in literature. We started by discussing Chronos and the Titans. We talked about Zeus overthrowing his father and the war with the Titans and how Zeus locked away all of the Titans who fought against him, all that is except Atlas. Atlas led the Titans in battle against Zeus and for that he was punished by being made to hold the world on his shoulders. I had heard the story of Atlas many times before but never really gave it, or Atlas, much thought, but after telling Kylynn the story I could not get Atlas out of my head. I looked at artists' interpretations of what they felt Atlas looked like and I was intrigued. Here was this man (albeit fictional, but still) whose only crime was fighting for what he felt was right and because he lost he has to carry the weight of the world for eternity. Somehow, lately I feel a kinship with poor Atlas, though I dare say Atlas carries his burden with more grace and dignity than I.

So where does that leave us? I don't really know. I return to Mayo at the end of this week and will see what is proposed. But until then, Atlas and I shall blunder on together. Him skillfully balancing the world yet looking a little, is it wistful? bewildered? and me carrying my too large armful of dirty laundry, dropping things, while still trying to hold aloft my feeble, flickering lantern as we wander through some of the rainiest days.

Monday, January 13, 2014

Have you ever carried at lantern through the dark? As you carry them they push the dark back and create a circle of light around you as you move on your way.  The thing about that circle of illumination is that it small and beyond it, the darkness is absolute. Stand outside my small circle and I may feel your presence, but I cannot see you. Lanterns are handy things to have in the dark, and yet, I cannot help but sometimes feel, as I carry a lantern, that sinister things lurk just beyond its glow waiting for my light or steps to falter so that they may close in on me...

Well, I didn't get my two Mayo free months. Instead, yesterday I met with a couple of doctors from the Individualized Medicine team at Mayo and with a surgeon to discuss my next plan of action. The plan is not so much of a treatment plan as it is looking for information to guide decisions about treatment. This whole process seems complicated and has some twist and bends to it, so let me see if I can simplify it a little.

This coming Friday I will be having a surgery to attempt to remove at least one, but more ideally two, of my lung tumors. The surgeon is hoping to accomplish this using a scope and about three small incisions. However, most of my tumors are not very close to the surface of my lungs so there is a chance the surgery could turn into a more open one. Once they have some viable tumor samples the plan is to run a number of tests on them. Which or how many of the tests will actually get run is largely dependent on what our insurance is willing to pay. (One of these tests has a $15,000 price tag on it. If insurance won't pay it, it's not getting done unless I find a money tree in full bloom... and it's winter.) These tests are looking to, on differing scales and ways, analyze the tumor's DNA and look to match a treatment to it. That is way over simplified, but in the end it comes down to trying to find a treatment with a super good chance of working.

What are the odds? Not great. There's a greater chance that the tumor DNA is going to bury its secrets and tell us nothing at all. But the chance that we will find some answers is still large enough that it is worth a shot. And, as you should know by now, I am a huge believer in the Han Solo philosophy of "Never tell me the odds!"

But, aside from all the potential benefit that this Individualized Medicine approach might hold for me, there is another component, or facet, that was only hinted at and alluded to. One that seems almost more weighty and important than my individual outcome. Once again, in the world of cholangiocarcinoma, I am heading off into uncharted territory and my outcomes may help shape future treatments for others with this same disease. That's an important thing to me. It helps, a little, to know that what I am going through now may help someone else later and save them from a similar ordeal.

...So I take up my lantern and head out into the unknown again. I am happy and proud in some ways to carry this lantern. I can feel the presence and hopes of others behind me, watching and waiting to see where I lead. But carrying the lantern can be frightening and wearisome too. There are times when my light falters and the sinister presences draw closer, and I am afraid. I will, however, press onward as long as there is a lantern that needs carrying and I have strength enough to lift it.

I do not know what to expect from this surgery or from these tests. I have great hopes but I also have fears. It is sometimes difficult to carry the lantern, but as long as there is darkness that needs illuminating I will plod forward, even on the rainiest days.

Part of a beautiful illustration by Jane Dyer from one of my most favorite children's books, Child of Faerie, Child of Earth, written by Jane Yolen