I'm done with chemo. The oncologist and I spoke before my last treatment and due to my somewhat extreme and adverse side effects he reduced my dose by 50% total last week. He said if the side effects were the same, though he was convinced I wouldn't feel them at all this time, then I would just be done. The side effects were the same and I even had a side effect that had disappeared return. I am done with chemo.
It has been a bit anti-climatic I must admit. There is a sense that something is still hanging over my head. The plan at this point is to continue with Herceptin (a Her2 blocker drug) once every three weeks for the next year. This will be done through IV at The Block Center. I want to go there so I can also receive my IV Vitamin C. The problem with this plan, however, is the condition of my heart. I had an echo done before my last treatment and found that my ejection fraction was diminished by 20%. Ejection fraction is the measurement of how much blood the left ventricle of the heart is pumping with each contraction. A normal ejection fraction is somewhere between 55 and 70. Mine is 40. I looked that up on the American Heart Association website: http://www.heart.org
It says, and I quote, "An ejection fraction between 40 and 55 indicates damage, perhaps from a previous heart attack, but it may not indicate heart failure." May not indicate heart failure. Oh good.
The decrease in my heart function is attributed to the Herceptin. I was not given Herceptin at my last treatment due to the results of this echo. The doctors I spoke with seemed confident that withholding this dose will allow my heart to bounce back and they expect to see an improvement in my ejection fraction next week when I have the echo repeated.
Of course I am concerned for my heart, which has already taken on a lot of hard-hitting drugs in it's day. I had a lifetime dose of a chemotherapy drug called Adriamyacin in 1991-92 which is also known to damage heart function and was found to indeed have damaged mine.
Going forward I still have some very weighty decisions to make. I am concerned about the health and function of my heart. I also want to be sure I am doing what is necessary to deal with the cancer that is Her2 positive and the only reason I would be taking Herceptin in the first place.
I went to a gentle yoga class on Wednesday morning. I've been wanting to go and since the boys are with their Mimi and Papa I took advantage of the opportunity. It was a quiet, soft, slow-paced class. Perfect for my needs. Throughout our time together we practiced ujayi (a form of deep breathing, in and out of the nose). I teach deep breathing to my clients and use a different style, breathing in through the nose and exhaling through the mouth. I found ujayi to be very challenging. I kept wanting to open my mouth, especially since with the exhale we were instructed to make a soft noise that only we could hear. With each exhale I was working to keep my mouth shut and also to coordinate making a noise at the same time. Well, the noise in my ears sounded like panting or choking or at the very least something very uncomfortable. I was struggling. Then the instructor said, "The only rule is not to struggle. No struggling here. Just do what you are able."
I felt freed, released to not breath right, if that's what I was doing. With the next exhale the sound in my head was no longer a choke but instead like a gentle whisper or soft breeze. My pauses in between each breath were not forced or held tightly, they were simple and gentle pauses. This deep breathing practice that I've taught for years took on new life and meaning for me in that moment.
Since then I have reflected on the transition and recognized that once I let go of struggling, once I set myself free from the expectations of doing it "right" I easily entered into a relaxed state where that style of breathing seemed natural to me. This led me to wonder more about the concept of struggle and to consider what else I might keep myself from.
I listened to an interview with Mary O'Malley, author of the book "What's in the Way IS the Way". I haven't read the book yet but I enjoyed the interview and her gentle perspective on life. She talked about the fact that there will always be struggle. Life is like the yin/yang, a dance of light and dark. But if we incorporate and include all of our experiences in life and stop trying to "rid" ourselves of what is uncomfortable or undesirable then we move toward healing.
Graham Cooke, a Vineyard pastor from the UK, has a two-part YouTube series called "The Art of Thinking Brilliantly" https://youtu.be/sYlpHy3Pvl0 in which he also addresses adversity, trial and struggle in life. He poses these questions: What if every trial we face is meant to advance us, to grow us? What if struggle is meant to bring us closer to and make us more aware of the goodness of God?
As I considered all that I had been experiencing and posed these questions to myself I came to this conclusion. To me there is another side to struggle that has nothing to do with discomfort or pain. To me the other side of struggle IS the goodness of God, the light in the dark, wisdom gained in the midst of chaos or adversity. So while I face more difficult decisions I rest in the fact that I am not confronting a foe but instead I am approaching the Throne of Grace and ultimate Goodness. I am not entering a battle but am dancing in the light. I can rest in the fact that no matter the circumstance I will grow here.
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