Catching Up with Chemo Part Two: Harborview

This blog entry is one of the tougher ones I’ve written.  I’ve tried to keep most of the entries fairly upbeat and truthfully, breast cancer has given me many amazing moments and wonderful opportunities to connect with friends and family, far more than I could have expected.  But if I’m being really honest, it can also be freakin’ hard. 

The story I’m about to tell is about the challenges and stresses of dealing with breast cancer.  It’s deeply personal.  If you’d prefer to read the more uplifting blog entries, please skip this one and read the past entries and the ones to come.  The reason I am posting raw personal details publicly is this: since my diagnosis, I’ve stumbled on several breast cancer blogs that have been immensely helpful.  They’ve made me feel like I’m not alone in this journey, and that I will survive.  However, there are some breast cancer blogs that are all roses and sunshine all the time.  They make me smile a bit, and then I want to punch the writers in the face.  I’m sorry, I don’t care how strong of a person you are, breast cancer sucks.  It is the ones who have had the courage to candidly tell some tales of woe and redemption that have been the most helpful to me.  So, cancer sisters, this one’s for you…

On a mid-October Monday, I checked myself into Harborview Emergency.  For those not familiar with Harborview, it’s probably one of the busier, more frequented emergency rooms in Seattle.  Or, at least, one of the most commonly known hospitals for serious health emergencies.  We’re talking all kinds of crazy trauma, drug overdoses, physical and mental illness, blood, guts and gore. The S gets real in that emergency room.  How I ended up there likely starts with my cancer diagnosis in July, but primarily stems from what had been happening since starting chemo in late August.

I have mostly been lucky with the chemo drugs: barely any nausea or intestinal problems, just a little fatigue and numbness in my toes, a rash here and there.  The main problem since the beginning, however, has been lack of sleep.  The chemo drugs keep me in a weird state of tiredness without sleepiness.  Without some other type of drug to knock me out, I lay in bed, floating above sleep.  Anxiety over cancer, work, family, etc. probably doesn’t help.

On top of it, I caught a cold early in my treatment and it refused to go away.  For over 40 days, I was stuffy and had an obnoxious cough and heavy lungs.  Compounded with lack of sleep, it seemed like the cold would never leave.  Most annoying was that the cough only seemed to come to life when I was in important meetings with clients.  Eventually it morphed into a cough that would sneak up on me and burst forth before I had a chance to open my mouth so at one point, as the center of attention at a large conference table with 30 or so upper managers, I found myself making odd burbling, flappy lip noises and then hacking uncontrollably.  That particular meeting was with a public health agency.  Oh the irony.

To manage sleep, my oncologist prescribed Ambien.  At first, it worked.  Then it stopped working.  On my next visit, my oncologist checked my records and they indicated that I was taking 5 mg of Ambien.  She suggested going up to 10 mg and gave me a prescription.  This is where things went horribly wrong.  Assuming I was taking 5 mg tablets, I started doubling my dose.  It wasn’t until I went to get the prescription refilled that I discovered that the pills were actually 10 mg, so I was actually taking 20 mg of Ambien: also known as overdosing. Totally my fault: I should have checked the bottle.  In no way do I blame my oncologist - she rocks.  Something weird with the records. Afraid that I wouldn’t sleep before a day of important meetings, I took one more 20 mg dose of Ambien on a Sunday night and called the nurse on Monday.  She didn’t hesitate to tell me that taking 20 mg of Ambien was a no-no.

The sleeplessness, the fuzzy-headedness, the cold, and even the Ambien overdose might not have landed me at Harborview had there not been so much other stress happening in my life.  Let’s take a little inventory, shall we?

1. Work: Before starting chemo, I took on a new client (the aforementioned public health agency).  The work seemed paced out and manageable. I would be helping them with their overall communications strategy and supporting a part-time PIO for a period of 4 months.  Totally in my wheelhouse and a great team of people.  I mean, what’s the worse that could happen?  Then the Ebola crisis hit.  The first case of Ebola had landed on U.S. soil and public health agencies across the nation were scrambling to prepare for whatever media S-storms came their way.  The agency also had other emergent needs. I jumped in to help as much as I could while trying to keep up with my other client work and juggle a million doctor appointments.  All the while, I hadn’t told my clients that I was undergoing breast cancer treatment.  I was too afraid that they’d lose faith in my reliability.
2. Parenting:  My husband has been amazing through all of this, but both of us had been struggling with our three (now four) year old.  He has the capacity to be an incredibly sweet, sensitive little boy which often gets overshadowed by the fact that about 60% of the time, he’s an S-show.  There, I said it.  I love him with all of my heart and I don’t want him to go through life like this.  But parenting while having breast cancer gets very complicated. How tough should I be on him when I know a lot of his bad behavior is because he’s stressed about his mom’s health?  How do I balance time with my kids with work and also the need to rest?  How can I make sure life feels normal around him when it’s not normal at all right now?  I had been working my google fingers to the bone trying to find resources on parenting while having breast cancer but kept getting led to publications like “A Mom’s Last Letters to Her Children.”  Ack. 
3. Genes: This is an issue that I can only allude to because to explain the story, I would have to divulge private information about another person. While I am open to sharing my own details, it would not be fair to publish details about someone else without permission.  I also think it’s kind of an odd situation that might not be helpful to anyone else to read about.  So, I’m just going to leave it as this:  there was (and to some extent still is) something horribly, horribly stressful happening in the relationship I have with a relative whom I love dearly and having breast cancer has made the situation worse.  Those close to me know who and what I am talking about.  Nuff said.

So.  There I was.  Stressed over cancer, work, my son, and an important relationship.  Over the course of several weeks, I had slept an average of about 3-4 hours a night.  I had a tiring and embarrassing cough.  Chemo and the pre-meds had left me fatigued, constipated, rashy and bald.  And there was the Ambien, which I have since learned is a fairly evil drug, especially if you don’t actually sleep and even worse if you are overdosing.  During the weekend of my kids’ birthday party, I was up and down, sometimes crying, sometimes screaming, and totally exhausted.

When I woke up that Monday, I knew it was not good.  My mind was racing a million miles an hour with incomplete thoughts.  When I spoke, I felt like I was yelling above a noisy crowd, but that crowd was in my head.  I struggled to keep myself together, but I felt like I was sounding crazy. Trying to facilitate a meeting, I got into an argument with a police captain that continued after the meeting.  Frustrated, confused, feeling stupid and angry, I yanked my wig off in front of him and told him I’d been going through a rough time so I’d appreciate some patience.  By the time I left, I was crying uncontrollably.

I had scheduled a visit with my in-laws so that my mother-in-law could give my wig a trim.  I stopped at a grocery story to pull myself together and buy her some flowers.  But at their house, I was crying again.  I cheered up a bit in their presence, but after I drove away, things went downhill fast.  

My thoughts kept racing, and now it was about all of my failures and embarrassments of the day. I wasn’t keeping up with my work.  My work as a consultant demanded that I be one of the smarter people in the room, but insomnia and chemo drugs made me feel like the village idiot and an emotional wreck. I hated having to go through chemo and the way it seemed to be impacting every facet of my life. I felt ugly and confused and like I would never be myself again.  Yes, chemo was helping me live, but what kind of life?  A life where my body after surgery and reconstruction will look like a crazy quilt and I will be forever in fear of cancer returning?

Suddenly, I realized that I was driving through red lights, as if a part of me wanted to get into an accident.  I gripped the wheel and got onto the freeway, trying to pull myself together, but my thoughts kept drifting to what felt the most comforting at the time: killing myself.  I didn’t know how exactly, but I just wanted it all to end, and soon.  I became so afraid that I would do something while driving that would hurt someone else that I knew I had to get help.  I was on my way to pick up my son and it was clear that he would be in danger if I were to continue to drive while I was in this state.  

Thankfully, even in my fuzzy-headed state, I also knew a lot of people counted on me and loved me.  Among the dark thoughts was this streak of clarity now and then: ending my life would be a horrible thing to do to the people who have been supporting me and who need me.

I drove to Harborview Emergency and checked myself in.  After a short wait, they ushered me in to the emergency psychiatric department.  I had to check in my bag, my jewelry and high-heeled boots (no sharp objects allowed).  

The walls are painted gray, the room was plain and grim.  I could hear the occasional wails  and shouts of other patients and smelled the faint aroma of bleach, vomit and feces.  One of the nurses moved my bed closer to the emergency call button.  “You’re the only female in here right now.  You should be fine, but push the button if you don’t feel safe.”  This was not a place that I would have gone willingly had I not been in such a terrible state.  I laid down, covered myself in the institutional-grade blankets and wept.

A couple of hours later I think (I had no idea of the time), a nurse came in and told me that I had visitors.  It was my amazing in-laws. They were so kind to me, so sympathetic.  I can’t believe they drove to downtown Seattle in rush hour to see me.  My husband was driving up from Olympia with our daughter (Carter had been with my parents for the day).  Josh handed Lovisa off to my in-laws and then stayed with me until I was released.  I was relieved to see him and hold his hand.

I’m so grateful to the psychiatrist at Harborview.  She listened to me, gave me just the right sympathy and kind words, and made a call to the psychiatrist at Seattle Cancer Care Alliance.  Since I’m being completely honest here, I need to divulge that this was not my first bout with depression and suicide. It is something I have been dealing with since I was a teenager. Fortunately, my depression has been well-managed over the past many years with counseling and the right medication. However, I knew I needed the extra support through cancer treatment so I had requested help from SCCA’s psychiatry department two months earlier.  I turns out that my request had been lost in their system. The call from Harborview got it back on track.

Since then, things have gotten much better.  I’m sleeping, my head has cleared, my health is better, and I love life again.  I’m so glad I sought help, and I’m grateful for all of the people in my life who have been supporting me through this ordeal.  Even at my worst, I knew I couldn’t let you down!

The SCCA psychiatrist got me off Ambien and onto a much better drug regimen so I now sleep like a baby.  I have been upfront with my clients about my breast cancer and am pulling back on some of the work.  The aforementioned police captain reached out and we made peace - such a good guy. A social worker at SCCA helped get me in touch with the Young Survivor Coalition so that I can talk to other women my age who are raising small children while dealing with breast cancer.  There’s even a chapter in Olympia! As for the relationship issue mentioned earlier, things still aren’t great, but I am more at peace with the situation.  A nice trip to London and Paris with lots of walking, eating and resting finally kicked that cold. Getting a break here and there from chemo recently also restored aspects of life that I had lost: the taste of food, happy memory-jogging smells, my energy, my mind, and my strength.  Dance, as ever, saves me time and time again and I am grateful to my sweet students and the opportunity to teach each week. I feel like my old self again: the self I actually like and wouldn’t mind having around for a few more decades. It also seems pretty clear that my family and friends want me around, too.

Many people have said that I’m brave, but I’m not always sure.  To me, bravery requires a choice.  People who serve in the military or as police officers or who fight fires or stand up for civil rights under threat of violence: these people choose to put themselves in harm’s way for the good of others.  They could stay home, but they selflessly choose to face danger head on.  I don’t feel like I have a choice, or, at least, it doesn’t seem like much of a choice.  My form of cancer is fast-growing and aggressive.  I either go through treatment or I die.  Is that bravery or just the responsibility we all have as humans? It feels like there is no option of just staying home.

Getting help when I wanted to give up?  Well, okay, I’ll humbly accept the bravery label on that one. It felt like it took some courage anyway.  But I don’t feel like what I’m going through is all that special. I know so many people who have suffered in their lives, whether over death of loved ones, fertility complications, major illnesses, job loss…you name it.  I’m proud to have many courageous people in my life.  I hope my story shows that even in the darkest of moments, there are people who can help.  And life is worth it.