Irony Thy Name is Ironical

In the greatest stroke of irony since Alanis Morissette wrote a whole song about irony which included absolutely zero instances of said irony, Karen got her new driver's license today.

Yesterday, our radiation oncologist told her she had to abstain from driving for at least the next six weeks. O. Henry high-fived us from the grave.

Backtracking a bit, Karen's license had not been renewed by the DMV since she had medical issues which could hinder her ability to drive. Without a valid license, Karen had to stop driving and this limitation on her independence drove her nuts and you really couldn't blame her. A steady march of losses both large and small is one of the defining qualities of the cancer experience and this latest in a string of indignities especially stung.

However, a few weeks ago, I took her to a delightful 8AM interview where we reassured the DMV that she currently had nothing going on that would impair her driving ability. Confident that the driving populace faced no immediate threat from her 5 minute trips to Starbucks, Safeway, or church, she was granted a temporary license.

But then: brain lesions. Karen's radiation treatment went well enough these past three days aside from some headachiness. We were a little startled to discover that the Tumor Board had upped her brain mass total from "one, maybe two" to a definitive "three growths." Still, everything was pretty small and there is no reason to believe that she won't respond as well to this round of brain treatment as she did the last time.

But with yesterday's final brain-zapping, Karen was told that the lesions as well as the treatment left her at a disadvantage when it came to driving. She could have a tiny seizure or stroke or something that would not even really register as such and could be experienced as little more than a sliver of lost time not unlike having your attention drift. Not exactly the sort of thing you need have happen when you're driving that big ugly minivan of hers.

24 hours later...the brand new license that represented sustaining an especially prized degree of freedom and agency arrived literally one day late.

Ideally, this is just a short setback. They have accelerated the schedule for Karen's next MRI to six weeks from now instead of two months. If the results are good, she'll be back on the road then. If not, well, Miranda and I will need to invest in chauffeur caps.

Head Games Part the Second

It says something about the course our lives have taken when the loss of our Internet/TV access for 14 hours (more or less) causes less more consternation and hand-wringing than the fact that one--maybe two--teeny slivers of new brain lesions have appeared inside Karen's noggin.

Karen had another MRI this past Monday and that was how we discovered the new met(s) there. While the sites she had treated previously continued to appear dormant, there was a brand new 5mm lesion on the front left portion of the brain. Another even smaller possible lesion was on the right but we'll need to wait for the star chamber of the hospital's ominous-sounding Tumor Board to determine just what the hell might or might not be happening there (it will involve fancy computer software that compensates for changing patient head positions in successive MRIs).

But that one lesion is pretty definitive so Karen will need to have it treated. And if that other one needs attention, it'll need treatment as well. As before, the course of action here will be zaps of radiation. The lesions are small enough that they could probably murder death kill those suckers in a single shot but to minimize any collateral damage to the surrounding brainmeat, the treatments will be spread out over three treatments. These will start the day after tomorrow, Tuesday the 7th.

Now, tumors in the brain are, as you'd imagine, no joke. I think if there's one thing that Karen is especially fearful of it's brain metastases. The lingering effects of her first and significantly larger radiation treatment (compounded no doubt by "chemo brain") are frustrating for her: struggling occasionally to pull the right word from the fog clouding the vocabulary chunk of her brain, some short term memory issues, and some general forgetfulness. And it's hard not to remember with a degree of dread what it was like the first time these mets appeared. Struggling to recall how to play a DVD. Wanting to say something but not finding the words. Having to nod or shake her head to yes/no questions we posed to find out what was on her mind that she couldn't say. All of that is not something she wants to return to. Who could blame her?

And yet...we took it surprisingly in stride. Because the mets are super tiny and we've been down the radiation road before and really there's no point to wetting our pants until, well, there's a good reason to urinate like firehoses. This seems totally manageable and not an especially big deal, all things considered.

So....yay?