Wednesday, August 6. 2014
Two weeks ago, I celebrated my six-month anniversary of my bone marrow transplant, which was “way back in January” already. The celebration wasn’t very different from an ordinary day: I drank a delicious cup of coffee, ate some things I can’t remember... I also celebrated by drinking a concoction of morphine and Versed (Midazolam). The combination of drugs made me feel very delightfully relaxed. The doctors wanted me relaxed so that they could drill through the bone in my lower back (”Ooh, your bone is really tough!” said one of them) while I laid on my stomach. It feels very odd but I can’t really say it hurts. They were extracting a core of my marrow to test it for cancer. Afterwards they gave me a juvenile pneumonia shot, which I don’t remember. Every day since then I’ve been reminded of the shot, for I still feel the soreness in my arm(s). Come back next week for the results of the bone marrow biopsy, they said.
All my medical records are online. When I got the robo-message that my results were in, I couldn’t resist taking a look at the results - beat the doctors to the punch! We don’t want to spend those extra days worrying! Actually resisting would have been quite easy, if Kerry hadn’t asked me about it: “Don’t you want to know?” I didn’t. If I’m going to get news, good or bad, wouldn’t I rather get it in person, from somebody who can answer questions so my mind doesn’t wander uselessly? Overall, that is how I think. So I caved to pressure, reading the doctorly gobbledygook and comprehending nothing. Nothing but the words “abnormalities.” Yikes, I thought, maybe something here isn’t quite right. I decided to say nothing to Kerry, so as not to disturb her with needless worry, and to wait until Friday. Later that same day, Kerry logged in to have a look for herself. She noticed the word “relapse,” which I somehow hadn’t, and knew what that meant. We decided to live it up that evening: after the coffee, we went to a burrito place (my burrito tasted awful) and then an ice cream place I usually enjoy, where my cone also tasted bad. We hoped we’d misunderstood the online medical records somehow, or that they’d made a clerical error and would be laughing, embarrassed about it when we saw them on Friday.
Nobody was laughing on Friday. Expecting bad news, I invited the whole clan to my cancer clinic visit: Kerry, Amber, my mom and dad. My doctor has been all smiles ever since I’ve known her - ever since January sometime, when we met, all the way up till the previous cancer clinic visit when I saw her. Ever since January, I’ve been getting mostly good news. Sometimes a little bad news, but mostly good. I’ve been clearly on an upward trajectory since the last time I went into remission and had my bone marrow transplant.
My doctor looked very serious. She is always pretty serious, but her seriousness was disturbing this time because this time she was not smiling. “What are we going to do?” she asked. She went on to explain a few things: the return of cancer is why my platelets are dropping again. She said I don’t have a lot of cancer, if you go by the numbers. She talked about getting me into a new clinical trial at the Mayo Clinic, three hours from where I’m currently living. She talked about the various options I have now: how the drug I used to get into remission before my bone marrow transplant (NexAVAR / sorafenib ) is no longer an option for me (I think it’s less effective, or ineffective the second time around). There are other clinical trials. There are other combinations of chemotherapy. Discussing the various treatment options, my doctor used the phrase “high mortality rate.” She also used the phrase “If we can get you into remission.” Hearing the word “if” from my not-smiling doctor was not uplifting. This was the same doctor who told me before my bone marrow transplant, that the two-year survival rate for people who go through that procedure -- ordeal would be another good word for it -- was 15%. I chose to ignore that number when I heard it, and assume it didn’t apply to me. It was only some weeks later, when I became more lucid and realized that statistic could apply to me, that I felt uncomfortable about those numbers for the first time. I’ve survived six months so far...
I used the phrase “upward trajectory” earlier because it suits the theme of space exploration, which is how I think of my leukemia treatment. Decades ago, I don’t know how many decades, AML would have just outright killed me, or maybe the doctors would have tried a bunch of crazy experimental things on me, before it killed me. In November of 2013, they tried a bunch of things and the doctors still thought I was going to die. Somehow, I didn’t. I likened my bone marrow transplant in January to the moon landing: how much knowledge had to exist, how many people had to work together, how many things had to go just right, for them to use toxic chemicals to kill my bone marrow, harvest stem cells from a perfect match donor (my brother Andrew, thank you!), and grow new stem cells in my body, all without killing me -- as I had no immune system, and then after some time went by, virtually no immune system. Wow! And the point of my personal moon landing, the Promethean Moment Concerning Dan Rasmussen, wasn’t to show off military might or to embarrass the Russians and other commies -- it was to save my life, to cure my blood cancer and enable me to live a longer life. So that I’d have more time to spend with friends and family and people who aren’t friends yet. To enable me to rectify my shameful progress thus far in saving the whales. As I’ve joked to friends who appreciate dark humor, “After all that effort the doctors went through, I guess I can’t kill myself now!”
Hearing that I again have cancer brings to mind, continuing the space theme, the explosion of the Challenger space shuttle, or the lifeless body of Dr. Frank Poole (from 2001: A Space Odyssey) drifting away from the Discovery One towards Saturn. I like the second metaphor better because it’s more hopeful. As fellow readers of Arthur C. Clarke’s 3001: The Final Odyssey know, in the distant future Frank’s body is recovered and they revive him. He’s reborn to experience all the change that has happened since his first death.
When I first learned I had leukemia back in November, I wasn’t very afraid. I’d been feeling crappy for months prior and was relieved somebody had a clue what was wrong with me and that they were to set about fixing it. I knew very little about leukemia and how serious it can be. I underwent an intense dose of chemotherapy and went into remission in December, only to relapse again sometime in December or early January. I wasn’t afraid this time either. I was still recovering from being drugged out of my mind, and don’t even really recall being aware of what was happening. I recall doctor visits and much talk of “blasts.”
This instance of finding out I have cancer is different from the others. Mentally, I’m about as close to “with it” as I ever am. I’m aware of the situation and of the risks. I feel nervous. Physically I’ve been feeling very near normal, with a few exceptions. Daily headaches, occasional backaches, every couple weeks I poop my pants, and weakness. I’m in better physical shape than “The Average American,” who doesn’t run or bicycle, but pretty weak compared to what I’m used to. Yesterday I was riding my bicycle around town and crapped out trying to go up “rathole hill,” a hill which is challenging but doable when I was in top form. As I walked uphill, I struggled to breathe. My stomach felt tight, and I wondered if I was suffering from anxiety (a familiar feeling from my 20s) or if it was some ominous cancer-related thing going on. Today I felt more winded, just from walking, and suspect it’s because of low platelets.
Tomorrow I’ll head to Iowa City to learn more about my treatment options. I’ll probably spend an extra couple hours getting an infusion of platelets. When people ask what they can do to help me, I can’t often think of much. I always forget to say “donate platelets” or “donate blood,” but those are things you can do to help. I’ve gone through bags and bags and bags of both blood and platelets.
I’m not losing sleep over anxiety* or letting it ruin my day, and I hope you’re not either.
* I’m losing sleep over writing this. Feels like it took all day!
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