What Would Happy Do?

This blog is being written on May 11 – Mother’s Day - the day when we honor amazing women who function as the be-all, do-all, glue that holds the family unit together day in and day out. Also on this holiday, we memorialize those who have paid their motherly dues in years past and are now at rest, like my mom, Happy.  Interestingly, she was born Laura Elizabeth; however, at the age of two, her irresistible dimples gained her the appropriate nickname – Happy - that stayed with her all of her life.

Here we go again - Marla receiving Zometa treatment.

My mom was certainly the matriarch of our family.  Besides being kind and nurturing, she was an amazing homemaker, an accomplished cook, a seamstress extraordinaire, and more often than not, she was also the family peacemaker.  In her 90 years on this earth, I never heard her say a cuss word or talk despairingly about anyone. She was a phenomenal woman, and if I say so myself, she and my father raised three pretty darn good kids.

I remember as a child when I skinned a knee, had a cold, or endured the measles and mumps, my mom immediately became the family healer.  She always knew what to do when my brothers and I were sick.  I thought she possessed special powers when she gently placed the back of her hand on my forehead and proclaimed I had a fever.  She was usually right.  Her instant cure for a cold or cough was slathering Vicks Vapor Rub on my chest at bedtime, followed by a hot cloth pinned to my pajama top.  The following morning, I was miraculously fever and cough free. 

Without question, my mom was an encourager and a positive force in my life. And she proved to be an experienced “medicine woman” time and time again.  Now, more than ever, I would give anything to hear her soothing words and feel the soft touch of her hand on my forehead.  

You see, exactly one month ago, on Friday, April 11, my dedicated oncologist, Dr. Issam Makhoul, looked me in the eye and told me that the cancer had returned.  One day earlier, I had a follow-up PET scan that revealed a small spot on each lung, my liver and my pelvis. Needless to say, I was stunned at the news.  In two short months, the one centimeter spot that was evident on my right lung had quickly advanced to other organs, as well as my lymph nodes. The official diagnosis?  Stage IV metastatic breast cancer.    

It was apparent that Don, my significant other and a physician himself, and Dr. Mak were expecting me to show some type of emotion after hearing the news.  I could barely breathe let alone cry or kick the trash can across the room.  Instead, I told Dr. Mak that we needed to get a plan in place and get the show on the road.  I knew that if I took too long to think about what I was facing, I might curl up in a ball on the floor and sob uncontrollably. So, I had no choice but to be the aggressor in this situation. 

Dr. Mak explained that there are more than a dozen types of traditional, intravenous chemotherapy and a few oral drugs that we could try and shared the pros and cons of each one.  Ultimately, he left the choice up to me.  I decided to start with an oral drug called Xeloda that requires me to take three, 500 mg. tablets twice a day for two weeks, then I would have one week off to give my body a break.  Dr. Mak was pleased with my choice.  In addition to the Xeloda, he prescribed a monthly dose of Zometa to be given intravenously.  Since there are signs of cancer in my pelvis, the drug will help strengthen my bones.

According to Dr. Mak, the most common side effects of the oral chemo are diarrhea, which can become severe, bone and muscle aches, and a condition called “hand and foot” syndrome that can cause the palms of the hands and soles of the feet to become irritated and painful.  The good doctor smiled and looked at me when he said the drug seldom causes hair loss. His declaration made me laugh because it was the only bright spot in an otherwise crappy day. 

Dr. Mak rolled his desk stool in front of me and put his hands on my shoulders.  He looked at me and said, “Young lady, there are two kinds of Stage IV cancer; the good kind and the bad kind and you have the good kind.”  He suggested that we would see how I tolerated the oral chemo and, after three months, another PET scan would be ordered to see how the spots were reacting to the chemo.  Depending on the results, we would continue with the same drug or try a combination of other chemotherapy until something puts me into remission.

Don and I asked questions of Dr. Mak for nearly an hour on that fateful afternoon. During that time, Dr. Mak made one statement that will ring in my ears for years (I hope) to come.
 

“Our goal is to keep trying different drug combinations that will keep you alive for at least five or six years, and hopefully, by that time there will be a new drug or treatment that could extend your life for another 20 years.” Even though his comment was honest, compassionate and encouraging, it was at that moment I realized how serious my condition is and that I could die.  Talk about a sobering moment! 

As Don and I prepared to leave the office, Dr. Mak handed me a prescription for the Xeloda to be filled the following Monday at the UAMS pharmacy.  In addition, he wrote the order for the Zometa to be administered intravenously in the comfort of my old hang-out -  Infusion 1 at UAMS, where I would no doubt see familiar RNs, like Mr. Nurse Ratched and Sweet Cassie. 

Don and I said little on the way home.  He was still waiting for me to show some sign of emotion.  It never happened.  Instead, he could see the determination in my eyes and hear the confidence in my voice.  My only thoughts were that cancer is NOT going to win this battle. 

The following two days were tough.  I spent a lot of time contacting family members and close friends, sharing the latest diagnosis with them.  Stage IV cancer doesn’t roll off the tongue easily, but I learned to say it with optimism, rather than gloom and doom.  The most difficult calls I made were to my brothers.  As I shared the results of the PET scan with them via a phone call, the pauses in the conversation were deafening.  Throughout my journey this past year, my family has been my strength, my courage and my inspiration. I have no doubt that they will continue to be during this next hurdle. 

When Monday, April 14, finally rolled around, I was actually excited and ready to implement the plan. Ironically, this was the day I was to have my reconstruction surgery.  Instead, I was on the chemo trail again, battling to be cancer free, a requirement before the surgery can be rescheduled. 

I dropped the prescription off at the UAMS pharmacy and walked around the corner to Infusion 1.  The tech escorted me to a recliner and I settled in for the 15-minute infusion of Zometa.  Sweet Cassie, one of my favorite RNs, immediately made her way to my chair and was almost tearful when she saw me.  “Let’s kick some butt,” she said, which was exactly what I needed to hear. 

A few minutes later, I returned to the pharmacy to pick up the prescription. The pharmacist asked if I had ever taken the drug before.  I shook my head “no.”  “It’s a great drug,” she said.  “And it ought to be; it costs $7,000 a month.”  I was having trouble wrapping my brain around what she had just told me.  If I wasn’t dealing with a life and death situation, I would have gotten on my political soap box and ranted that no drug should ever cost that much money, especially in this country.  Instead, I grabbed my sack of gold, thanked the good Lord that I had insurance, and headed for the house where I prepared to take my first dose.

After the first week of Xeloda, I had few, if any, noticeable side effects, which concerned Don.  In his mind, he thinks the chemo isn’t working unless there are side effects. At the beginning of week two, the diarrhea set in, as did the achy bones and muscles; however, it wasn’t unbearable, just uncomfortable. When I shared my symptoms with Don, he cheered.  Before I had time to think about it, I flipped him the bird, which instantly made me feel better.

I am now in my second, two-week cycle of the drug and, so far, there have been no signs of the “hand and foot” syndrome.  However, the diarrhea has intensified as has the muscle pain, but it’s a small price to pay if the drug is killing the cancer cells.

As I battle cancer for the second time in one year, I often think about my mom.  She dealt with numerous broken bones and hips later in her life and not even during those circumstances did my brothers or I hear her complain.  She would often tell me that when life hands you lemons, you just make lemonade. And, that’s just what she did… time and time again.  Like mother, like daughter.  Her strategy is now my strategy.  Lemonade, anyone?