Tuesday, August 25, 2015

Landsharks and Cheese

The blog has been pretty quiet of late because, well, our lives have been pretty quiet as well. In a wholly unexpected way, we've grown kind of bored with the whole cancer thing. It's actually transcended the everyday it had become to reform into something that is tedious and not especially deserving of conversation or attention.

Not that it doesn't assert itself regularly, in some sort of attempt to remain relevant in our lives. But its presence is now more like that of a house guest that has overstayed their welcome than the rabid honey badger tearing through our lives that it once was.

Sadly, no Candygram for us.
This is not to say that it has lost its teeth. It can still inflict injury. So maybe the more accurate model is of a house guest with shark tooth dentures and an unsettling habit of randomly chomping passersby.

But for the most part, we continue to just plug along. Early in August, Karen and I went to the wedding of my writing partner and all around swell guy, Eric Neigher, down in LA. The wedding was lovely and Karen happily stuck it out until the end (albeit after spending the bulk of each day in bed while I busied myself with work). Evenings, we'd venture outside to a relatively underpopulated courtyard so Karen could smoke her weed and we'd talk and talk. The weather was warm every evening and, with all due respect to the truly spectacular nuptials, these evening conversations might well have been the best part of our long weekend there.

But that trip was a sneak peak of what lay ahead for us. Karen's energy was clearly flagging and it only worsened after our return. Even a visit from Karen's sister, Liz, was not enough to rally her and she began spending more and more time in bed. A four-day string of bad headaches somewhere in there got us all concerned and then they disappeared for a few weeks only to begin to resurface although to a lesser degree, oh, right about now.

Not resurfacing: that vanishing energy. The truth is, right now, that Karen is at best at 60% capacity. And that is cancer-impacted capacity, not Karen-is-healthy capacity. Where before she bounced back pretty well from the Cyramza, she isn't now. Her days are now largely spent in bed, reading, watching TV, and napping a lot. Along with the loss of energy, she is dealing with frequent bouts of nausea and weakness so debilitating that she not infrequently needs assistance getting up from a chair or out of bed. The nausea comes with the added awesomeness of diminished appetite and the fact that nothing really tastes very good to her anymore.

In light of all of this unpleasantness, it wasn't really surprising that our anniversary was kind of nuked. Our 25th was situated smack in the middle of the month but we pushed the observation thereof out a week in order to accommodate what we hoped would be a week of chemo recovery. But that recovery never really came and as a result, no Cheese Penis.

Pro Tip: Googling "cheese penis" gets you far fewer Cheeto pix. than you'd hope
[A moment of explanation: noted food scold Alice Waters has a lovely restaurant in Berkeley called Chez Panisse and because I am at heart a 12 year old boy I have referred to it as Cheese Penis since about five seconds after I knew about it.]

We had always meant to gobble up some Cheese Penis and I had made reservations for August 20. When the day came it was completely and utterly clear there was no way Karen was going to make it. She was utterly sapped. So I called Cheese Penis and asked if they did any kind of takeout. Of course not. The Cheese Penis doesn't come to you, you come to Cheese Penis. But when I explained the particulars of our situation, that policy changed. While I'd have to order from the cafe menu, they agreed to help us out. So I ordered a number of items--sadly, there was no Coq au Fromage to delight my middle-school sense of humor--and ran out to get it.

There was, as there always is, a shit ton of traffic but I was home in about two hours and Karen was none the wiser. I got her weeded up, dusted off my waiter skills in order to plate things nicely, and surprised her with a delightful three course meal. As romantic an anniversary as you could want, provided, of course, your definition of romance includes having your daughter chomping away on a Subway sandwich and fretting about work right across the table from you. Still and all, not too bad.

So if you're hankering for a tasty meal, I have to say: You could do worse than eating some Cheese Penis.

And now here we are. And where exactly is that? A waiting room apparently.

Right now, we are maintaining a holding pattern to figure out just what the deal is and what it's going to be. Next week, Karen will have an MRI to determine if the radiation treatment she had for the new brain mets was effective. If so, she'll be cleared to drive by the doctor (but probably not cleared by Common Sense since even she admits she's not in good enough shape to drive). If the radiation hasn't worked we have no clue what's next there.

We are also waiting on scan results, provide of course there is a scan. Our oncologist requested a new PET scan but even though this hews to the identical same schedule and criteria as every other PET scan Karen has had over the last 2.5 years, our insurance company declined it. A new request for a different, less expansive scan has been made but we do not have any idea when or even if it will occur. Karen is due for her next chemo infusion one week from today so they need to get it in prior to that to determine that she should still keep getting the Cyramza.

And the Cyramza question is a real concern now. Given Karen's symptoms, she could just be suffering from the accumulation of meds over the last several months or the Cyramza may have stopped working...which is exactly what it is supposed to be doing (or not doing, I guess) at precisely this point on the timeline.

If it's not working, the next drug (and her improbable fifth line of treatment) is pembrolizumab, the same thing that Jimmy Carter is getting pumped into him. As per usual when we sense a treatment's efficacy is waning, we have some trepidation and a sense of bracing for impact. But for the most part, we're just bored and trying to keep as much distance between us and our house guest as we can.