Back on deadline

July 23, 2011

Dr. Chang's latest drawing of Joyce's lung.For the adrenaline junkies among us, there’s nothing like a deadline to get us focused and back on schedule.

The news received Thursday morning brought me another “wake up and smell the coffee” moment, making me feel my personal deadline more intensely.

Joan and I met with Dr. Chang, my thoracic surgeon, to get his read of my last scans (CT and PET), what he thought the glowing meant (cancer or merely effects of radiation treatments), and whether they’d ever opt to operate.

The verdict: can’t really tell anything except there are no new spots of cancer. Cancer seems to be shrinking, but hard to see how much. Can’t presently tell whether the FDG (glowing Fludeoxyglucose) activity in lung obscured by radiation damage is cancer or merely pneumonitis. Even if cancer appeared dead on scans, making surgery an option, they’d only do if a biopsy proved the cancer ousted from lymph nodes. Downside: after radiation, lung tissue is damaged enough to impact healing. So, what would have been a six week recovery time, pre-radiation, would be longer and recovery dicey. Bottom line: would I want the surgery even if the situation were go? Hell, no!

We asked whether the second tumor (which had blocked airway to middle lobe) is really gone. Dr. Chang whipped out his ballpoint and drew us a diagram on the examining room table showing what he thinks happened: the blockage was probably from a lymph node adjacent to the bronchus, not within the lung. Radiation had either eliminated it completely, or shrunk it down so far that the airway is now wide open. Is the cancer still there in the lymph node? No way to tell without biopsy.

We left Dr. Chang’s office strangely relieved. We don’t really know exactly what’s going on in Joyce Croker’s right lung, but we have a better idea of what MIGHT be going on, and how to proceed. Plan of action: complete the chemo and prednisone treatments, wait a while for pneumonitis to subside, then another PET scan. Then…we’ll see.

Meanwhile, I’m taking full advantage of the elevated adrenaline levels the prednisone affords. Most mornings I’m up (way too early), zipping around getting stuff done like some hairless version of the Energizer Bunny. Those yawner tasks I’ve shoved into a closet for years are being ticked off my list, the house is becoming more organized, and I’m tackling issues at work (mostly people and personalities) I’ve long hidden from. Life, while more sharply felt, is sweet and available RIGHT NOW to be grabbed by great big handfuls. Just being able to breathe without pain makes my day. Even the mundane, the day to day, has become a comforting ritual. Is this all related to being hopped up on prednisone? Don’t think so, my friends. I believe I’m back on deadline.

And Joyce loves her deadlines.

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Posted by Joyce Croker

A short stop in normalcy

July 10, 2011
Joyce Croker at Santa Monica Beach. Photo by Diana Lundin

Joyce in Santa Monica. Photo by Diana Lundin

Being normal was never high on my list of priorities. Normal was one of those adjectives I kept stored with banal, trite, average and the like. Like pastel colors, the concept of normal can be pleasant enough, but I’ve always gone for memorable over pleasant.
The life I was born into; caucasian, middle-class, protestant; was something I heartily rebelled against in my youth. I didn’t realize at the time how terribly normal that rebellion was for a gal like me. For religion I chose Wicca over Methodism, then developed eclectic tastes in music (from Ma Rainey to Mozart), literature (Didion to De Sade) and female companions. Never mind about the companions…just know they have ranged from the oddly sweet to the not-so-sweetly odd.
Despite all of that, I managed to turn into a happily married, middle-aged dweller of a middle-class neighborhood in Los Angeles. Except…I haven’t felt normal since last November, when I discovered I had lung cancer. Suddenly, the idea of feeling normal seems pretty darn special.
Due to (what seemed to be) endless medical appointments, tests and treatments from November through the end of May, that sense of normalcy hasn’t been part day-to-day life for me. The second week of June found me finally recovered from the last chemo treatment and feeling mighty…normal. My energy and appetite had mostly returned, my scalp was beginning to sprout new hair and it was back to backyard cookouts, hikes with friends, and enthusiastically executed yard work. For nearly a month I’ve been blissfully engaged in summer activities typical for people in this country. My wife and I even attended the Fourth of July Dodgers game…and were thrilled by the usual magnificent fireworks displays and exhuberant patriotic music. So, here I am, finally overjoyed to be that average, middle-aged woman having a little vacation in the land of normalcy.
The vacation is over. I’ll begin taking a high dose of prednisone daily for the radiation pneumonitis, then undergo the first of two more rounds of hair killing, energy destroying, chemo on Friday. Oh, well…we’re aiming to kill some more cancer cells; a slow process, but it’s working. By the end of August, with this batch of treatments behind me, I’ll return to my normal little life, which will await in all of its common, yet fleeting, splendor.

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If at first you don’t succeed…

April 8, 2011

Joyce with Barium-Sulfate SmoothieMonday morning was spent undergoing another CT scan. Unlike previous smooth-running CT scans, this one took longer and was less than pleasant.

I arrived for my appointment at 7:30am, having had nothing to eat or drink since the previous night. First, I was given a barium-sulfate “smoothie” to gulp down within 15 minutes (if you see this on the menu at Dairy Queen, don’t order it). Next, a sweet little nurse stabbed my right arm several times trying to place the IV for dye infusion. After an hour’s wait, I was taken to the scan room. The technician gave me scary pink koolaid to drink. (“The barium was for your intestines, THIS is for your stomach.”) In this age of medical miracles, couldn’t they create a DELICIOUS tasting fluid–modeled upon, perhaps, a nice Lafite ’82? OK, nasty pink stuff ingested, I’m finally on the scanner. After a test proved the IV placement was faulty, they ushered in the same little nurse to place another IV, this time in my left arm. Now I had an IV dangling from each arm. Gotta say, I’ve never been big on symmetry. Another infusion test was run. Oops, the IV was now leaking iodine. After an adjustment, it was determined the infusion device on the scanner was broken. A quick move to an adjacent scan room, some minor adjustments to reduce the leaking, and I was all set.

They released me a little after 10am. The actual CT scan took less than 3 minutes.

My take-away from all that? Sometimes, getting the results we’d hoped for takes longer than anticipated.

This morning, my radiation oncologist told me that Monday’s CT scans show a reduction of 15% to the primary tumor, and “some” improvement to the tumor in my middle lobe. These are not the results I had hoped for, which were more along the line of, “Hey! The cancer has completely disappeared and you’re N.E.D (no evidence of disease).” Not this time.

Luckily, my doctor has had a Plan B in mind from the beginning. He recommends undergoing localized radiation to further reduce the secondary tumor, since that’s the one that giving me the most discomfort. The initial, exploratory bronchoscopy is already scheduled for next Thursday morning. If they find disease is still present in the bronchus, in a few weeks a radioactive piece of metal will be placed in the airway next to the tumor via bronchoscopy. My doctor says they’ve had good response applying this treatment to this type of tumor.

What I am not looking forward to: due to the complex nature of the prescribed procedure, they’re going to see whether I can tolerate a bronchoscopy done without general anesthesia. This means they’d numb my nasal passage and throat with lydocaine, and will “explore” NOT knocking me out for the procedure. I don’t know how you all feel about having a tube shoved up your nose all the way to your lung, but this girl is not a fan. However, I’ll give it my best shot and try not to knock the poor doctor across the room. (Sorry, Doctor; un-sedated redheads can be dangerous in the O.R.!)

So, another procedure to look forward to. If it works, it’ll be worth it. If not…we’ll try something else.

If at first you don’t succeed…

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Making hay while the sun still shines

December 18, 2010

I’ve chosen this rainy day to begin posting to the blog I set up just after my 56th birthday last March. At that point in my life, I was feeling great, but quite cognizant of the short “sprint” to age 60. I was looking to improve physically, by returning to the gym; emotionally, by facing yet more of my demons; and spiritually, by continuing to work the steps in my 12 step program.

What I didn’t know last March was that the chronic cough I had been complaining of to my doctor for over a year wasn’t caused by allergies or late onset asthma. It was due to a tumor growing in the airway to the middle lobe of my right lung. I have lung cancer, the last thing I would have expected as a lifelong non-smoker and member of a fairly cancer-free family.

“Sprinting Towards 60″ has taken on a new meaning for me. I read in a recent “New England Journal of Medicine” that non-small cell lung cancer is the leading cause of cancer deaths for both men and women in this country. I’m not afraid of dying, but I certainly have issues about leaving my wife and partner of 19 years alone. My friends have been lovely and supportive. The specialists at Kaiser Permanente, once I was finally properly diagnosed, have been informative and helpful. The hard part is waiting for results from various scans/tests I’ve been undergoing: has the cancer spread to other organs or not? Will I have the partial lung removal in January or not? In short, will I actually make it to 60?

So, for now, I’ve decided to get through all this by writing in this blog, following doctors’ orders and taking up knitting…and by thanking the Goddess everyday for the friends, loves and adventures I’ve had and still have left. Frankly, this isn’t that big of a change for me, the change for me is talking about it publicly.

L Joyce Croker

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Posted by Joyce Croker