Thursday, May 7, 2009

Back on the Train

The last few weeks have been up and down, but ended on an up-note: according to my doctor, I am 99.9% cancer free. After two weeks of tests and a suspect lymph node, this is fantastic news.

A few weeks ago, I had a CT scan and the images revealed an enlarged lymph node next to my spine, between my kidneys. A subsequent PET scan revealed that the image in the CT scan was actually my diaphragm, and it found no positive evidence of abnormal metabolism (tumors). My treatment from here on out will most likely be surveillance, repeated and frequent check-ups for several years to monitor against recurrence. No radiation or chemo required.

(Yes, I realize I'm using the language of medicine, even though I previously questioned the use of terms like surveillance. But it's just simpler to use it, even though it means I'm buying in to a line of thinking. That always carries risks, but right now those risks seem acceptable and not as great as the risk of being unclear).

It’s hard to write this. Not because it’s emotional, but because I feel like I’m done accepting the whole situation (not done with the situation, just done accepting it). This is a dangerous place to be. I went hiking last weekend, with two friends, and not only did I keep pace, but I maintained conversations while going uphill. I’m still in fairly good shape. All my basic tests – heart rate at rest, blood pressure, blood sugar, temperature – are perfect. I’m working eight-hour days, four days a week, and I feel fine. Physically, I’m okay, and I want to get back to hiking, training and strengthening up.

And mentally, I’m incredibly positive, motivated, and hopeful. Couple that with physical fitness, and there’s a risk of growing complacent about surveillance, and bored with the idea that I survived cancer. By bored, I mean moving on to the point where I displace the idea, where it doesn’t affect me on a day-to-day level, where enough time has passed that it isn’t a frequent topic of conversation. My illness doesn’t define me, but as a friend said, I define the illness.

I need to keep that definition fresh.

I meet with another doctor today. He's the head of oncology at Providence, and he was Lance Armstrong's doctor. After speaking with him, I'll have a full understanding of my options. I can choose to have radiation or chemotherapy, but it would be preventative, rather than curative, and I'm pretty certain I'll go for the surveillance. Seems like the easier, less invasive, and less expensive option. Besides, it won't reduce my risk of recurrence by much, and if it does recur, there's still nearly a 100% chance of beating it then. Constant monitoring will also keep me disciplined and on my toes.

So, good news. Eventually I’ll write about the last two weeks in more detail – the CT and PET scans were fascinating, but stressful, and I want to record my perspectives and experiences, even if it’s just for my own sake. I have a bunch of other writing projects and book reviews to work on, the weather is getting nicer, and I know I can handle the trails. Time to brew some maté, crack a book, visit a doctor, and head off to a night at the bookstore. Not a bad life, that.

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