In Suzanne Collins’ Mockingjay the last book in The Hunger Games trilogy there’s a beautiful scene between Katniss Everdeen and Peeta Mellark, the traumatised District 12 tributes and star-crossed lovers. While they’ve both endured the unspeakable inside and outside of the barbaric Hunger Games arena, Peeta was captured by the evil regime of President Snow and tortured with mind-altering drugs. To put it mildly, his grip on reality is completely shot and he frequently needs Katniss to confirm what real and what’s not.
‘You love me. Real or not real?’ Peeta asks, and Katniss responds, ‘Real.’
Well folks, the search is on for my inner Katniss as we progress through a fourth round of home-based chemo-hormone inhibitor therapy.
Yes, you heard right. Round four of treatment is in full swing chiefly because the CA 125 cancer marker (the most convincing indicator as to whether the chemo/hormone combo is actually working) has not returned to an acceptable level. Stopping now, when we’re almost there, would be a waste of good chemo so on I go, smiling through gritted teeth.
From the outset we knew the side-effects of this combo treatment would be cumulative. Until mid-round three these were predominantly physical in nature – an ‘off with the pixies’ feeling in the head: unsteady on my feet and a bit weak in the arms (a double whammy when trying to walk Clark, our ebullient beagle); body aches and pains particularly in my knees and hips; general fatigue, headaches, difficulty concentrating and an intermittent queasiness in the stomach. While these side-effs are annoying and an obstacle to getting much work done, they’re mostly manageable with a piece of vegemite toast, a cup of peppermint tea and a retreat to the couch for an episode of Downton Abbey.
But during round three in June, the side effects took a more emotional turn – low grade anxiety, irritability and that vexing ‘default to the negative’ thing that so bedevilled me last time. I get teary at the drop of a chemo beanie and many things in my reality at present seem to have pointy-ends or sharp edges. It’s not as though I’m viewing my world through a veil of negativity, struggling to stay positive in a rather dismal situation. It’s more like I’ve been befuddled in a worryingly paranoid way. I immediately draw adverse inferences from the things people say to me and often ask myself ‘Did that really happen?’ when I witness something bizarre and usually unsettling. Far too frequently I get myself into a complete tizz about stuff that’s well beyond my sphere of influence or intellectual understanding – like how in God’s name did David Leyonhjelm even get to be a Senator in Australia’s Federal Parliament.
A fair share of the blame for this sorry state of affairs can, no doubt, be sheeted home to the drugs. And in this fourth round of the chemo-hormone inhibitor combo, the goal posts have shifted once more. Both my oncologist and my good self believe that the daily hormone drug (Letrozole) I’ve been taking up until now has been the predominant culprit in my worsening physical and emotional side effects. However, the chemo drug (Palbociclib) needs to be combined with some sort of hormone inhibitor in order to be effective.
So, my oncologist has prescribed a different kind of drug (Fulvestrant) that is injected on a fortnightly basis as opposed to taking a Letrozole tablet every day. With me so far, dear readers? Well, it gets worse. Because of the viscous nature of Fulvestrant, the fortnightly injections have to be administered in the buttocks, one jab in each, preferably by an experienced health professional.
I couldn’t in all good conscience burden my nursing sister sister with the responsibility of jabbing me in the butt cheeks every two weeks, so I booked an appointment with my GP – only to find he was away on leave for a month (lucky bugger). This happy duty fell to one of his colleagues in the practice who, thankfully, shares my sense of humour. The first decent laugh I’d had in weeks spontaneously emerged when this handsome young doctor told me to hop up on the bed and pull down my pants!
So, it would seem the treatment for my cancer relapse has taken a rather embarrassing turn. Real or not real? Definitely real.
Unfortunately, the administration of a different hormone-inhibitor drug (albeit in a very different way) has had little impact on the aforementioned emotional side-effects I’ve been experiencing. Now, I have sore bum cheeks into the bargain!
Byron Katie, author of the seminal work Loving What Is: Four questions that can change your life, tells us, “I am a lover of what is, not because I’m a spiritual person, but because it hurts when I argue with reality.” But like poor Peeta Mellark, determining what actually ‘is’ before one is able to accept it and surrender to the current situation, can be a challenge when one’s grasp on reality is tenuous and drug-induced.
That’s why Katniss and Peeta’s ‘real/not real’ game has become an essential tool in the ramshackle garden shed that my brain has come to resemble over the past four months of cancer treatment. I run the real/not real ready reckoner in my mind countless times a day but fear not, dear readers. I don’t intend to bore you with all of those scenarios in this post – only a few of the bigger ones, purely for the academic insight and, with any luck, the amusement value. Here we go…
- An acquaintance who keeps repeating how well I look is clearly inferring that chemo treatment is easy and I’m milking this relapse thing for all the sympathy I can get. Real or not real? NOT REAL. This person is inferring nothing of the sort and the comment was intended as a compliment.
- My productivity has taken a severe hit and, as my Methodist upbringing dictates, lack of productivity equates to lack of worth. Real or not real? Well, this question is a double bunger isn’t it? The first part about my productivity slowing to an almost halt is REAL enough, but the second bit about this invoking or confirming worthlessness is NOT REAL, despite how it feels.
- That handsome young stand-in doctor suggested anti-depressants to deal with the obvious emotional impacts of my cancer treatment. Real or not real? REAL.
- I’d rather take my chances with Australian Bushflower Emergency essence, lavender mist on my pillow and catching up with the latest episode of Younger on Stan. Real or not real? REAL.
- I’ll never feel well again. Real or not real? NOT REAL.
- This too shall pass. Real or not real? REAL.
This was a difficult post to write because my right mind is not where I left it. Bless you for reading and thanks for sticking with me.