I was sitting on the patio the other day. It was a nice cool Florida morning that you get on the east coast before summer sets in for good. While Sampson the Chihuahua busily chased a variety of bugs and lizards around reminding them that they were a little late in vacating the premises from the previous nights yard party, I caught a glimpse of a squirrel watching me from the limb of the tree that overhangs a backyard fountain, he was wondering when I would be moving on so he could get a drink, hopefully before the water turned warm from the Florida sun.
Butterflies flittering in the cool morning breeze, staying just out of reach of the small brown dog running wild in the grass. The daily bird fight for tree branch supremacy taking place in the background.
I sat in my chair watching the ongoing dramas of the backyard opera unfold before my eyes, and I was content, dare I say happy. Lucky, maybe thats the better word. I sat and thought about the scare I had a few months ago when my follow up scan had revealed that at the spot where my tumor is located and had been laying dormant for the past couple of years, a large mass had appeared. I thought about the various tests and scans that I underwent from November to February. Most of all I remember the relief I felt when I finally received a call from the University of Florida telling me that this large mass in what remains of my right lung was not cancerous. A small lizard caught my eye and I watched it fearlessly climb the side of the fountain, although he had no idea what was awaiting him at the top of his climb, the very same fountain that the homeland security squirrel had kept under surveillance for quite some time now, patiently waiting, never losing site of where he w as or what he wanted. As I watched that fearless little lizard, he stopped suddenly, sensing the danger from a low flying bird, he stayed perfectly still and then when danger had passed, he made his way to the water basin. It occurred to me that I was more apprehensive in the months from November to February then during the time when I was diagnosed and being treated for small cell lung cancer. I think more then anything else, because unlike my friend the lizard, I did not sense the impending danger. The fact that something was not right came as a total surprise. I had gotten comfortable with where I was in my recovery and was rewarded for that complacency with a swift slap in the head as a reminder that If I want to continue to survive, I should never let my guard down. At the point in time after I was originally diagnosed, I was receiving radiation twice a day along with chemotherapy. Everything was what it was, the only unknown at that point was whether A) I could surviv e the treatment and B) Would the treatment be enough to stop the cancer. But this last thing was out of the blue and for a period of time, a crew of different Doctors from different institutions and back rounds couldnt figure out what it was or why it was there. So here it is in a nutshell.Once you survive the initial treatment and that treatment provides positive results, you start to slowly put your toes back into lifes swimming pool, carefully testing the water to see how cold it is. Step by step inch by inch you commit a little more into living, At some point prior to cancer, you might have fearlessly dove in without even knowing how deep the water was but now you move a little slower, a little more apprehensive, forever aware that there could be danger ahead as the water gets deeper. Before you know it, as time passes you once again find yourself wading in the water. If your very lucky, you never again have to be startled back into reality by someone yelling, GET OUT OF THE POOL! just as you were getting comfortable. So I get this phone call from a doctor at the University of Florida with my test results. From what they could tell, the mass was not the tumor becoming active but basically a cloud in my lung comprised of dead cells and tissue which had succumb to the prolong effects of radiation treatment. Are these fresh cells that have recently died or past relics from the epic battles that took place inside my lung a few years prior? We may never know.
Some things we know all too well..
We know about the side effects of radiation treatment as we are receiving it. We have a pretty good idea of what to expect from chemotherapy treatments. But what about a couple of miles down the road ? What are the long term effects and should they be a concern?
Heres what I think I know.( I had radiation to the brain, so sometimes I get a little confused.)
For the first five years after lung cancer treatment, you see your oncologist every three then six months as time moves on. Five years is the benchmark. Its all about Alive at Five baby. After that Im not sure (Get to five and well talk). I believe that you fall under the responsibility of your regular physician. I know I have written quite a bit about fighting cancer and what it takes to survive as you are going through treatment, but I think this is the first time that I have dared to let myself think beyond the five year wall. I guess the recent flare up, startled me back into the realization that this is no longer a sprint for me its a marathon and It might be ok for me to start thinking long term again. I know that lung cancer is notorious for its rate of reoccurrence. So thats the first culprit I have to be always aware of. I know that some of the other possible long term side effects from radiation and chemo treatment range from kidney and liver issues, cataract s, severe tooth decay, hypothyroidism, intestinal problems and then a variety of secondary cancers and lung disease. I know that if you have had radiation to the brain, you are open to memory loss, difficulty concentrating and bouts of confusion. I know that not a whole lot is known about the long term effects of these treatments, maybe because in the world of lung cancer, five years is long term. Heres what I know for sure. 1) Any long term side effect you receive from lung cancer treatment should be considered as the price of admission for being allowed back into lifes swimming pool. 2) Lung cancer is an ongoing fight, the true definition of beating lung cancer is simply holding it off for as many years as it takes to die from something better. Like old age. 3) As it is with fighting the initial battle, the long term vigilance should involve a proper diet, exercise, stress maintenance, regular medical checkups, staying aware of yourself ( if it dont feel right, its prob ably wrong) get it checked out. You might want to keep a journal from diagnosis onward to help keep track of changes and challenges along the way. 4) Enjoy life, if we are discussing long term, (a few miles down the road past the five year rest stop.) then you my friend are fortunate. I hope that you are finding ways to take advantage of the additional time you earned by surviving. Bottom line on long term side effects . Dont spend any time worrying about them. Its pointless and worry leads to stress. Just be aware of yourself and watch for changes within. Remember there might be setbacks just react as needed. If you do experience long term effects keep one thing in mind, you are still alive, even when the odds were stacked so heavily against you, is there really anything so great that you cant now handle?
So now its time for me to begin moving forward with my day. I push my daily bout of thankful reflection to the back of my mind and start thinking about today. At my feet lay my little dog napping, exhausted from his back yard triumphs of chasing butterflies. I look up and there still sits the squirrel patiently waiting for his drink. Just below him, sitting in the fountain is the lizard, who bravely faced the unknown to get where he needed to go. My thought today is that if I could learn to live like these three little guys: Without fear like the lizard, Vigilant like the squirrel , and always willing to chase butterflies like Sampson the pup. I might just make it quite a ways farther down the road then anyone expected.
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