Pick Your Poison

My wife two weeks from now.

Bright and far too early at 8AM today, Karen and I ventured out to the oncologist. This would be our first face-to-face with Karen's doctor since all the brain-swelling excitement of the previous weekend. If there were any doubts that the mets in Karen's brainmeat signaled that we'd turned some sort of dark corner it was confirmed by our doc's heartfelt handshake and exhortation for me to "Hang in there." Apparently the ride we're in for is likely to be more than a little bumpy. The appointment was fairly quick, little more than a check-in and confirming that Karen was still on track for chemo. While we were there Karen's newest doctor, the sunny and charming Dr. Moini, phoned in that the results of yet another MRI had come in.

On Tuesday, Karen had undergone the other more detailed and far more coolly named MRI (3-Tesla MRI! That's right: Tesla! And not just one Tesla but THREE FUCKING TESLAS! Woohoo!) and it had revealed modestly good news: she had only the three tumors in her brain. That meant that she could undergone SRS, i.e. Stereotactic RadioSurgery. Basically, it's targeted radiation where they blast radiation at the tumors in the hope that their growth will be arrested (and maybe knocked back a bit). She will not have to undergo Whole Brain Radiation which is more or less a good thing since she'll need only 5 treatments with SRS as opposed to 10 to 15 with whole brain radiation. If they use gamma rays and she turns into the She-Hulk then we're winners all the way around.

The SRS also means that it can overlap with the chemo, proving once again, as I so presciently noted on Sunday, that I know nothing. That's slated for this coming Monday, the 23rd, just in time for Christmas. A little late to the Christmas party will be the radiation which will start on the 26th. All five treatments will be delivered daily, with breaks for weekends and holidays. This means she'll wrap it up on the 2nd of January. As noted in an earlier post, the initial chemo will last about two months or so. There will be PET scans and MRIs around the end of that to see if any of it is doing any good. Unless she's bench-pressing shipping containers and fighting intergalactic menaces, I'm likely to consider any outcome a bit of a disappointment.

While we're trying to be as ludicrously and unfoundedly upbeat at the prospect of Karen voluntarily poisoning herself in a number of different ways all at the same time, I'd be lying if I said that the Greek cancer chorus that has been quietly chanting in the background the last 12 months hadn't shifted into a deafening full-throated roar. We're playing catch up now. We were (marginally) ahead before but now we're about to get lapped. Of course we knew that eventually we'd find ourselves in this position but knowing that intellectually and actually experiencing that short-stop-on-an-elevator heart sink on a minute-by-minute basis is a whole other matter. It is difficult to watch your wife/mother/friend (because Karen rolls with a full-fledged entourage when she goes to the hospital) answer a series of questions that results in her sporting a disconcertingly cheery purple DNR bracelet for her stay.

STATUS UPDATE

• A follow up MRI has confirmed that there are just three metastases in Karen's brain. 
• The absence of other smaller masses means that Karen will undergo SRS radiation treatments which are targeted. Karen's radiation plan calls for 5 treatments on a roughly daily basis. These will start on December 26th.
• SRS radiation also means that chemo does not have to be delayed. This will start on Dec. 23rd.