The bitter ex-nutritionist

Before my unfortunate encounter with cancer, I was an avid health nut. A total hippie granola-head. I had been a vegetarian for the better part of a decade and ran 20 miles a week, mostly for health reasons. My body was super healthy and I had the beginnings of a six-pack. I would routinely offer unsolicited health advice on diet and exercise to anyone who would listen. Basically, "eat lots of oatmeal and drink lots of green tea." This would solve diabetes, obesity, depression, cancer, and eventually provide world peace if adopted on a larger scale. To me, the discipline of exercise and the spiritual practice of vegetarianism was the answer to all problems. I had even seriously contemplated a career as a nutritionist at one point, because I thought that I could be an example of health and well-being. I had really wanted to become a nutritionist in order to advocate for vegetarianism for health reasons. Obviously, the whole "health reasons" thing didn't work out so well for me.

It was entirely *"inconceivable!"* to me that I would end up in an oncologist's office with a diagnosis of bone cancer. I think that the doctor was surprised at how well I took the whole thing. I didn't cry. Honestly, one of the first thoughts that ran through my head when I was diagnosed was not, "Oh no, I'm going to die!" but "Rats! My healthy living example is totally ruined now. Nobody is going to want unsolicited health advice from me anymore."

In the weeks following my diagnosis, I became a bitter ex-nutritionist. People would stare at me in shock as the former gym rat chain-smoked seven cigarettes in one hour. If anyone dared to say anything, I would just shrug my shoulders and say something like, "Well, I'm probably going to die anyway so I might as well enjoy myself," or "I just suffered through a three-day session of chemotherapy which is literally intravenous mustard gas. Compared to that, these are like vitamins." These are great ways to cut the conversation awkwardly short. You really can't argue with it. When people think you're going to die, they are afraid to say anything to upset you. However, my fiance suggested that I might give myself lung cancer while I had bone cancer, and then I'd really be in trouble. I have no scientific argument against this, except to say that I think there is some kind of rule about somebody not getting two cancers at one time. If there isn't, then there should be.

Anyway, I eventually came to my senses and abandoned the stress-induced chain smoking (bad Jennifer!). But my previous dietary restrictions have become quite relaxed. If somebody wants to have a steak, go have a steak. You want to eat a piece of apple pie? Have at it! And I don't run 20 miles anymore, because that would entail a dressing change on my line complete with sterile procedure and a headache (if you don't know what I am talking about, be glad that you don't). And I don't want to be a nutritionist anymore. If I were to enter this profession, I think that either everyone or no one would want to see me. Just read the following scenarios to see what I mean:

To someone struggling with their weight: "Dangerous stimulant diet pills are great way to lose weight! Just take buckets of diet pills and then eat an entire chocolate cake in one sitting! Who says that you can't have your cake and eat it, too? Oh, those heart palpitations are no big deal..."

To the diabetic: "Oh yeah, go ahead and invest in a large warehouse-size box of candy bars. That's a much more enjoyable way to control your blood sugar than those stupid shots! And hey, you know if it doesn't work out for you, you were probably going to die anyway..."

To someone who drinks too many caffeinated drinks: "Oh, you don't have to stop drinking nine cups of coffee a day in order to control your jittery nervousness! Just go out and get yourself a six pack and sit in front of the TV every night. That will calm you right down! You might want to consider smoking too; it's a very effective method for dealing with stress."

To someone with cancer: "Since you're trying to gain weight, I would discourage you from eating vegetables or fruit. No. Buy several cartons of your favorite ice cream and eat them all day, all the time - breakfast, lunch, and dinner." Oh wait, I actually was told this. Due to severe mucositis (don't ask), I subsisted on ice cream for about six weeks. You would think that eating ice cream nonstop would be totally awesome, but it's not. This does very unfortunate things to the human digestive system, which I will not even go into here...

And so, I have most decidedly decided to not be a nutritionist. I will let other more annoyingly pious health-nuts than me enter this noble profession in the service of humanity. Writing this article has stressed me out, so I am going to go eat an entire box of Little Debbies now...

* Because of the movie "The Princess Bride," I am not capable of writing the word "inconceivable!" without quotation marks and an exclamation point.

On a totally unrelated note, I was querying on Youtube for the music videos of one of my favorite bands, Le Tigre. Apparently they don't have any, but many fans make their own and post them on there. This one made me smile:

My glass isn't half-empty - it's full of zombies...

About a month ago I went in for a routine clinical visit with my principal oncologist. Everything had been going very well. I had been weened off of Oxycontin and had resumed my normal chemotherapy schedule, and my scans (though a little ambiguous) supported remission. Life was good. So of course I brought up my prognosis, which I expected was considerably better. The doctor smiled, patted me on the shoulder, and reassuringly said that I "had a 90% chance of survival."

Alas, this only happened in TV-sitcom land where everyone has perfect hair and every story has a perfect ending. In onco-world nobody has perfect hair because they don't have any and every story isn't perfect. The doctor cleared her throat and matter-of-factly informed me that my "odds are much better now. You only have a 30% chance of a fatal recurrence." My chance of survival has almost doubled compared to my initial prognosis, which is pretty cool. But no 90%. No cigar. No really, there are no cigars. Where are my cigarettes? I need one.

As I was leaving her office, the thought of skydiving randomly popped into my head. Why hadn't I gone? Because I had been afraid of dying. But statistically speaking, I have a much better chance of surviving a skydiving attempt than I do at surviving cancer. And why hadn't I taken that trip to Alaska a couple of years ago? Because I was afraid of airplanes. My odds are much better with airplanes than with cancer.

A lot of dreams which I had had over the years floated through my mind, ancient dreams which I had abandoned long ago out of fear. I have had several fears much more legitimate than airplanes, vague ephemeral spooks like J.K. Rowling's Dementors which have haunted my daydreams and sucked the joy out of my life. Everyone has their own personal demons, whether it is some sort of personal tragedy, a fear of rejection, or any number of things. What power did these stupid little demons have over me, other than that which I had freely given? What could they do to me that cancer couldn't do? Why am I still afraid? Cancer is King Kong, and I kicked King Kong's arse - well, at least I 70% kicked King Kong's arse.

That night, I had a very strange dream. I had just gone to my oncologist and received the disappointing news. I had a 30% chance of dying of a cancer recurrence. I drove home and as I pulled into my driveway, I noticed that there were a bunch of zombies running around outside, as if this were just the most natural thing in the world. I noted to myself that I had at least a 50% chance of perishing from zombies, in that weird omniscient way that we just know things in dreams. So of course since I was up on my zombie survival skills, I ran screaming into the woods.

For most people, having a nightmare where they are told that they might die of cancer is bad enough. But noooo...I have to add zombies! I don't know if this makes me a "glass is half-full" kind of person or a "glass is half-empty" kind of person. Apparently my glass is full of zombies.

Anyway it's always those things which you least expect. I had been afraid of airplanes, when really I should have been afraid of cancer. And I had been afraid of cancer, when really I should have been afraid of zombies. Nobody knows when they are going to be hit by a bus or have a vending machine fall on them or be attacked by a rabid herd of flesh-eating lamas. In my mind, I could either submit to a sense of fatalism about the whole thing or get up and fight those zombies. Or cancer. Or whatever. I'm not going to let anybody put an expiration date on me.

In case you are concerned about zombies, our President has addressed this pressing issue. I know that I can sleep at night now.

I'm not taking a ride in a chemo limo

So on Wednesday I went back for my second blood test this week. Hypothetically speaking, I should have started chemo today. Yes, it's VAC time! I have become quite a connoisseur of toxic chemicals: vincristine, cytoxan, and the dreaded "red devil" adriamycin (shudder).

The key word in the last paragraph was "hypothetical." In the real world, where my bone marrow hates me, my body decided to stop producing white blood cells. The average person has 5,000 to 10,000 neutrophils, a kind of white blood cell, per milliliter of blood. I have 600. No, that's not missing a 0. This total crapola is a condition called "neutropenia."

This means that I can't get chemo. It also means that I am supposed to lock myself in a hermetically-sealed bubble in my house, insist that visitors enter a special decontamination chamber before risking personal contact, and obsessive-compulsively wipe down furniture and house pets with antibacterial wipes. If I venture outside, I must don a Hazmat-approved Biohazard suit. Yep. Call me Bubble Girl. Actually I am supposed to wear a surgical mask if I leave the house, but I have found that people refuse to get into public elevators with me when I do this. Hmmm, I wonder why?

So anyway, I will not be taking a ride in a chemo limo. Maybe next week?

Taking after dear old grandpa...

A lot of people in my family have used an alteration in their appearance as a form of self-expression. For example, a cousin of mine apparently has problems remembering his name, so he has tattooed it on himself so that he can easily refer back to it. I have several cousins with tattoos which commemorate special events in their lives. My sister dyed her hair pink. One of my grandparents had a nose ring and ears gaged down to his shoulders - he was totally punk rock.

This is my great-great-great grandfather George Lowery (AKA Chief Rising Fawn AKA Agi'n'agi'li).

• Me at 15: "Hey mom, I want a nose ring."
• Mom: "No! You certainly may not young lady."
• Me at 15: "But my grandfather had a nose ring! I'm carrying on the family tradition! I'm taking after dear old Grandpa. If I wanted to rebel, I WOULDN'T get a nose ring. I would be clean-cut."
• Mom: "Well, you do have a point..."
• Me at 15: "I want to get my ears gaged too! I don't even know what gage it is when you have your ears down to your shoulders, but it looks cool.

I have wanted to get a tattoo for many years, but nothing has ever jumped out at me as especially meaningful. I filed it away in my mental file cabinet as something that I would get to eventually. Then the other day, when I was in one of my favorite stores on Bardstown Rd., I saw a Día de los Muertos diorama with skeletons playing musical instruments. The macabre humor of the happy skeletons and the absolute absurdity of life and death inherent in the piece somehow reminded me of the past year of my life and how this whole cancer thing has warped my perspective of the world. Aha! I thought. I need to get a Día de los Muertos skull tattoo over one of my surgical scars to commemorate my battle with bone cancer in my skull!

One of the designs I am considering

I have been a counselor at Church camp, I carry around a Dark Crystal lunch box, and I collect unicorn figurines. I am EXACTLY the kind of person that you would think would have a skull and cross bones tattoo, huh? I'm not getting it because I'm obsessed with death or to fit in with the bikers at Sturgis or to appease my friends who all got skull and cross bones tattoos. Not everyone will "get it," but it's something that is deeply meaningful to me.

Anyway, talking about my grandfather reminded me of one of my favorite Eddie Izzard specials, Dress to Kill. George Lowery was one of the negotiators for the treaty which resulted in the Trail of Tears for the Cherokee nation. For those who don't know their history, this was basically when a bunch of white men wanted North Carolina and decided to boot the Indians out. The Cherokee went on a thousand mile trek which resulted in the death of thousands, and eventually ended up in their new homeland of Oklahoma. According to Eddie Izzard, apparently my grandfather did not have a flag:

God is my personal cosmic vending machine

So I went into the clinic today for a pre-admit this morning, in the hopes of having a hospital admit tomorrow. Alas, it was not to be. My platelets hate me. Eighty-five thousand is not high enough for chemo. I can just imagine any remaining cancer cells being like, "Yay!" and jumping up and down. Maybe I should go get some weed-killer from the garage and rig up a chemotherapy pump with an old lawn mower, an empty milk jug, and some aquarium tubing. I would probably end up poisoning myself, which would sort of defeat the purpose of life-saving chemo. Ugh.

On a totally unrelated note, I feel like I have done a poor job of informing people about how "out of it" I get during chemotherapy. They will come in for a pleasant chat, and then are completely unprepared when I fall asleep mid-sentence or start talking to the wall. One actually did go like this (alas, I am NOT exaggerating for comic effect):

• Unsuspecting visitor: Hey Jen! How are you?
• Me: Sooooo gooood. How’re your-jeh?
• Unsuspecting visitor: Just fine. What are you doing there?
• Me: Ummm…er jeh…so how are things go?
• Unsusupecting visitor: Just great. Is that a coloring book with a fish that you are coloring…or…getting marker all over yourself with? Did you mean to draw on your face?
• Me: Imma…ber…How going are…thiiiings?
• Unsuspecting visitor: Not much has changed in the past 5 minutes; everything is still great.
• Me: Uh…so I’m sooo haaapyy that things are great with yourr liiiife…what…eh…how are you?
• Unsuspecting visitor: Um…I’m in a hospital.
• Me: Oh my gosh! Why?!!! (I wish that I were making this line up)
  

This was when I was on a pain pump Junish/Julyish, and this amusing conversation was later related back to me. I am no longer on a pain pump, so I am more alert. However, I still tend to repeat myself a lot, get confused, and sometimes just stop mid-sentence with no idea of what I was talking about. And I probably won’t remember very much, if anything, except that you showed up (maybe). Thankfully this is mostly temporary, and I regain lucidity about a week following chemo.

So this brings up lots of opportunities for you. If you hate your cousin because she gossiped about you and you found out about it, you can come in and tell me all about it. Then you can pretend that I am your cousin and tell her (me) a piece of your mind and scream at her (me) all that you want. I might fall asleep or be confused and look at you pitifully like “What did I do?!!! …pout, but I will forget all about it in a few minutes or so. Do you have a burning secret which you must tell somebody but that NOBODY can know? I am the perfect solution to that problem! Just pour your heart out to me and know that your secret is perfectly safe because I have forgotten it already. Do you like to boorishly lecture about some arcane subject that nobody wants to hear about? Just come on in and tell me! I will stare blankly at you and make disjointed statements that have nothing to do with anything. When you are expounding about, “And THAT is the crux to discerning the role of internally desiccated socially constructed paradigms in our cohort,” I will nod knowingly and say something intelligent like “strawberry ice cream is yummy but I threw it up all over myself earlier.”

Generally it is not too scary to talk to me and you are free to laugh at me if I say something stupid; I probably will. Several people have come up to me and have been like, “Oh man, I don’t know how to talk to you anymore. I don’t want to offend you.” Trust me, you will not offend me. I am not cancer. This is really cheesy, but true: “I have cancer but cancer doesn’t have me.” I have bouts of crushing existential sadness regarding the general human condition if I let myself listen to a The Cure album for too long, but I don’t really feel sorry for myself because I'm happy to be alive (if that makes sense). If people want to know how I’m feeling or doing that is totally cool. If you cry or whatever, I don’t mind. If you think that your bout with chicken pox was comparable to cancer and you know exactly how I feel, I certainly didn’t have your chicken pox - so for all I know it was as bad. If after a bad case of food poisoning, you wish to compare puke stories – sounds like fun!

Only one time do I remember someone actually making me MAD. This was off chemo, so maybe other people made me mad while I was on chemo and I forgot about it, but anyway... About the only place where I draw the line is if you are “convicted” that I did something to make God angry enough to give me cancer, and you want to “help me get right” with God so that he will give me back my health. I know that I go to Church because God is my personal cosmic vending machine who will give me everything that I want as long as I am a “good Christian” robot who is in the pew every Sunday and goes through all the right motions. Just forget all those things that Jesus (and pretty much any religion or metaphysical system) said about loving people . If I pray for a Cadillac and get it, then I am a good Christian. If my neighbor doesn't, he must have done something wrong. Oh wait, there are little children in the hospital cancer wards? What?! Oh something must be wrong with their spiritual lives! You know, they must have had a gambling problem or something (those elementary school poker tournaments must be stopped NOW).

But honestly, I am too nice to say this to anyone's face. Most likely I will respond by babbling about throwing up strawberry ice cream earlier. And you won’t know if it is because I am really confused or because I just want you to shut up for your own good so that you don’t mess things up with God too much.

The world's worst Christmas present

My mom knows that I love Bette Davis, and so we have been ordering every one of her movies off of net flicks. Today I was at first excited as the screen flashed up the ominous title "Dark Victory," and looked forward to 90 minutes of escapism. But alas, it was not to be. The quintessential Bette Davis character Judith, a feisty 23-year old, lives an exciting and privelaged life. But suddenly, she feels unwell. After a surgery, it is disclosed that she has cancer in her head and that she will suffer a fatal recurrence. She breaks up with the man that she is engaged to, because she does not want anyone to marry her out of pity. As a consolation, she decides to lose herself in the numbness of hedonism. After a confrontation with a friend, she realizes that she should get married because she wants to live out the last months of her life in dignity. At the end she collapses and the screen fades away. Credits roll.

Hey folks! You want to know what movie NOT to buy me for Christmas?! Unless you HATE ME. One guess...

The flying pink unicorn of cancer

Here is a picture of me in the hospital a couple of days ago – but I could just as easily have used a picture of anyone else with cancer, because we all look like funny little bald people.

Here is a picture of me just two days later. I have gotten good at the wig and makeup thing. To quote a favorite author of mine, Anne Barone: “Didn’t Voltaire say that illusion was the source of all happiness?!”

I am nearing the end of treatment (one to two months left), and have already ended my radiation days. I really don't have much nostalgia for them. One of the ongoing realities of having had cancer is the never-ending follow-ups that you have with various specialists. Today was radiation follow-up day.

My radiation-oncologist is an interesting fellow, who prefers to bike to work and lets pediatric cancer patients hit him with a pie at the conclusion of treatment (I was given the option because of the nature of my cancer and it was so tempting). I told him that I didn't hate him for subjecting me to two months of hell, and I actually like him because he did a great job and I'm not dead. He also took the trouble to read over the studies I had brought in which highlighted a particular concern that I had, even going to the point of finding another more comprehensive study to counteract the concerns of the prior studies.

He said thanks. Then he told the resident that I was an interesting case and he would not see another like it again. I proceeded to inform the resident that I was the flying pink unicorn of cancer, and rattled off all of the statistics verbatim (only 1 in 333,000 people get it, only 10% are above the age of 20, only 4% begin as extraosseous lesions, and only 2% begin in the skull). When I was leaving, the resident told me to, "Fly away pink unicorn, fly away!" This made me feel special. Then I got to stop and visit with a couple of my favorite nurses, which made me happy.

Seriously, I have the highest opinion of The James Graham Brown Cancer Center in Louisville and all of the phenomenal nurses and doctors who work there. I have thoroughly researched every treatment option for Ewing's sarcoma, and I am convinced that I could not have received better care at any other hospital than I have received at Kosair Children's Hospital and at The James Graham Brown Cancer Center.

Plus I got Pony balloons at Kosair. Aren't you jealous, people at adult hospitals?! You don't have balloon Tuesday! Ha! I think that I actually pointed this out in an earlier post, but I'm saying it again to rub it in your face.

Whatever en Français

So I really don't feel like writing about cancer today (even though this is my "cancer blog") because cancer is annoying. Before I became "cancer girl," wherein people would refer to me as "that girl with cancer," and not "that groovy chick," or "Jenn," or "hey you," I was often known as "Frenchie," because of my total love of French language and culture. I was supposed to spend the summer in Provence, but I got cancer instead. My body decided that it would much rather be hooked up to poisonous chemotherapy in a hospital bed than lounging on the beaches of the Riviera. But I digress. Anyway, I will be going on a linguistic detour and you are welcome to come along.

One of the many reasons that I love the French is because they have so many ways to say “Whatever.” They originated blasé, and gave the English language the word apathetic. One of the classic French stereotypes is the blasé French man or woman smoking their cigarette and drinking their glass of wine, and generally looking like "I don't care." Not that I’m advocating that anyone turn to booze or tobacco to deal with their problems, but that's the stereotype. And the French do drink more and also eat more saturated fat than we do – and they live longer! Zut alors! (aww shucks) There are many books about this phenomenon, called the French Paradox, but my favorite are the accessible chick-lit books by Anne Barone.

From my conversations with French people, I have observed that they don't seem to care so much about the everyday things (at least this is my impression). They prefer to talk about a new book or wine or something hyper-intellectual or existentially deep, and don't seem quite as prone to gossiping or dieting competition or other stupid things because I suspect that they just don't care. I have certainly noticed that they have more ways of saying, "I don't care," than we do in English.

Some of the many ways to quote Rhett Butler and say "Frankly, my dear, I don't give a damn," in French:

Que sera sera = What will be, will be

Tout m’est égal = It’s all the same to me

C’est la vie = That’s life.

Ça va = Life’s ok (lit. it goes)

Ça me fait rien = It’s nothing to me

N’importe quoi = Whatever

Ça plane pour moi = That’s how it’s going for me (I'm not sure, but I think this is dated slang; it means something like “great,” but in an ironic sense)

The classic Gallic shrug - that nonchalant way that French people shrug (about the weather, their boyfriend leaving them, an alien invasion, or anything really)

I couldn’t think of anything else, but I’m sure there are others. Oh well, tout m’est égal. On a sort of unrelated note, here is a completely demented video of the end of the world, with a stereotypical French response. (Warning: this contains every curse word imaginable, cartoon violence, offensive cultural stereotypes, and is not exactly terribly edifying - though its redeeming qualities include that it does contain a strong anti-violence message and is crazy funny):

The End of the World