Loose Strife

Laura got the results of her latest PET/CT body scan today. There were no new tumor sites and her existing bone mets were metabolically “quiescent”. We were surprised.
The other day Laura asked me where her liver was as she held her mid-section and got weepy. The liver is a common site for metastases in breast cancer and Laura worried that the strange rumbling feeling might be her liver. It wasn’t.
She’s been having troubles keeping food down, she’s lost five or six pounds in the last month, she’s quite fatigued, and headaches — “normal” ones, not the super-migraine kind she had before — are now common. Her sleep pattern is out of whack: she sleeps from about midnight until almost noon, and sleeps more in the afternoon when she can. Part of that I recognize as depression related.
Her vision has deteriorated so much in the last two weeks that her new lenses don’t work anymore. This little part of the story alone is ironic. About two months ago Laura was discharged from the palliative care team of the visiting nurse association. It became clear that Laura was not dying. Instead, she surprised everyone with an almost complete recovery in her walking. But before the turnaround was obvious, the head nurse signed a form for Laura to get a handicap tag for the car. Because of a box that was checked on the form, Laura received a notice at the beginning of June for her to forfeit her license. She didn’t give it up and instead has been driving herself around western Massachusetts to shop and go to appointments and so on. I was thrilled for her and happy for myself that logistics would be simpler. Three weeks ago we even tried to get a doctor to sign a letter that she was capable of driving, so she wouldn’t have the forfeiture demand hanging over her. The letter wasn’t signed because the doctor wasn’t fully familiar with Laura’s case and told her to wait until her regular oncologist returned from vacation. And now, in the mean time, Laura’s vision has worsened so that she really shouldn’t be driving until her glasses are fixed. But her doctor, now back from vacation, wants to wait to figure out what’s causing the change in vision.
So because of all these problems we’re not overjoyed with the scan results as we might normally be. Instead, Laura will be getting a brain MRI in the next couple days. (The MRI is a hassle just by itself. Because Laura has a programmable shunt in her brain, the magnetic fields from an MRI can de-program it. As a result, she has to be checked by her neurosurgeon after the scan to reset the device. The MRI facility at our nearby hospital in Northampton demands that her shunt be checked within one hour of the scan, but they only have open slots for a scan at night until next week. The main outpatient MRI facility in Springfield has a new policy where they flat out refuse to scan her. The MRI at the hospital in Springfield where her neurosurgeon is located was flooded and is closed for weeks. It’s still to be resolved.)
We’re getting nervous again. I keep wondering whether the symptoms are all just drug complications. In February she wasn’t taking any drugs except an anti-depressant. And now, among the daily, weekly, semi-monthly and monthly pills, shots, and IVs, she takes ten drugs. White Rabbit was written for her. Maybe she needs detox.
The problems are very unlikely to be all drug complications, but if the brain MRI is negative, then she will probably experiment with removing individual drugs.
All that said, she’s also doing really well — that is, she’s much better than was expected. So I shouldn’t complain, but I will anyway.