Part 22: Anxious Thoughts

The woman watched as the nurse attached the needle to the syringe filled with chemo. The transparent yellow liquid glistened inside its plastic shell. It was the woman's second injection in her second round of chemotherapy and she was grateful that aside from some fatigue, watery eyes, muscle cramps, and occasional mild nausea, she had not experienced any overbearing physical side effects from the treatment thus far. Mentally, however, the anxiety of her last appointment still plagued her because the syringe in the nurse's hand seemed wider that day.

"Are you sure that is the same dose as last week?" the woman asked delving into the details of her traumatic experience from two days prior. "That syringe looks different from what I remember."

"Yeah. It's the same," said the nurse. The husband peered over to look the computer screen and concurred.

"Okay," replied the woman, still in need of convincing. 

She stood up and turned her back towards the nurse who, shortly thereafter, slowly dispensed the yellow liquid into the woman's backside—so slowly, in fact, that it caused the woman internal alarm. 

It's never taken this long for them to give me the shot. What's she doing?

"Um...are you almost done back there?" asked the woman, starting to become anxious while the needle held its ground. "This seems to be taking awhile."

"Almost, I'm just doing it slowly so that it doesn't sting."

“It usually hasn't taken this long, so I'm just trying not to..." The woman didn't finish her sentence. A tingling sensation began to flood her body and she fought the urge to close her eyes. "Umm...I feel weird."

"Just a second," said the nurse. "I'm almost done."

"I...I think I need to sit down or something," the woman replied trying to remain calm. 

Instinctively she began to sit back down the the chair, the nurse scrambling to get a band-aid over the injection site. She turned pale and her skin became clammy. She felt like she was going to pass out. The nurse quickly closed a blood pressure cuff around her upper right arm and began to get a reading. The woman's blood pressure had dropped in half. She breathed deep, trying her best not to freak out, but she was scared. Luckily, in a few minutes, she was back to normal, though noticeably shaken up from the experience. The nurse ensured that her vitals remained stable and then freed the couple to go on their way. 

It had been a shaky start to chemo round two, but on the bright side, her HCG levels had dropped by 90% since her first round—down to 2400! Prayers being offered up from around the country and around the world were notably gaining momentum. She only hoped that these next two weeks held similar results.

Part 21: Inconsistencies

Relieved that her appointment with Dr. Substitute was over, the woman walked over to the appointment desk and picked up her schedule. She casually reviewed it as she made her way back to the waiting room and at second glance noticed something slightly disturbing: there were no chemo treatments listed. She turned around and asked the assistant, "Umm...I'm supposed to have some chemo scheduled, but I don't see any of the appointments here?"

"Oh. You will have to go to the chemo desk for that," the assistant replied.

Ooookay. That would have been nice to know!

The woman tried to be patient and headed to the chemo desk. The response she received from the attendant there was equally disheartening: "We don't have any record of you needing chemo."

A bit frustrated, the woman replied, "Well, I know I'm supposed to have chemo today. The doctor told me so and I watched him order it."

Convinced, the attendant made some phone calls.

As the woman sat, thoughts of what should have been filled her mind. She was supposed to be 16 weeks along heading to OB appointments and worrying about buying pregnancy jeans. Instead, she was here in a room full of cancer patients waiting to receive chemo. The two extremes were irreconcilable, and somehow she would need to find a way to reconcile herself to the latter in order to move on with her life.

Thirty minutes later a nurse finally called the woman back to receive her injection. Upon entering the room, the woman noticed that the nurse had two syringes filled with chemo.

"Umm...Is that the correct dosage? I've only ever had one shot," said the woman nervously.

"Yep, it's the same dose as last time. It just depends on how the pharmacist mixes it," replied the nurse and continued preparing the needles without any noticeable concern.

"Are you sure it's the same dosage?"

The nurse looked down at the syringes and then back up at the computer screen. "Yep, it's the same."

"Uhh...okay," the woman said, hesitant.

The residual sting of the shots were like background music to her thoughts as she walked towards the elevator replaying the events of the day. It had been a long one scattered with inconsistencies that made the woman feel uneasy. In the midst of her anxious distrust, the only thing she could do was surrender, trusting that the doctor knew what he was doing, the schedulers knew what they were doing, the pharmacist knew what he was doing, the nurse knew what she was doing, and that ultimately God was in control of it all.

Part 16: Serenity

Hours passed as the woman sat in her hospital bed dressed in the usual with a twist: a flowered gown, blue robe, tan slippers and black wind pants. Might as well be comfortable if I have to sit here all day, she thought. She and her husband threw around jokes to lighten the mood and pass the time while they waited for the beginning of this new phase in the seemingly never-ending drama—the chemotherapy. It had been an hour since the woman last checked on her bleeding so she hopped off the bed and went into the bathroom.

“The nurse wants to weigh you again,” the husband said as she came back out.

“Umm…okay,” she replied. She stepped out of her room and onto the scale. Turning to the nurse she asked, “So, why are you weighing me again?”

“I just want to verify we have the right information in your charts. The chemo dosage is based off these numbers and I just want to make sure we have it right,” the nurse explained.

The woman watched as the number on the scale rose.

“Huh. I thought so,” said the nurse.

“What do you mean? That looks right,” the woman confirmed. “81 kilograms—179 pounds, just like two hours ago.”

“Your charts say you are 91 kilograms. Just looking at you, I see you’re a head taller than me, but you didn’t look to be 200 pounds.”

The woman was shocked. “Is this standard for you to make sure the patient looks as heavy as their charts say?” she questioned.

“Actually, no,” replied the nurse. “It just occurred to me as I was looking at you. Now, I know you’ve been waiting awhile to get this first dose of chemo. They were just about done verifying your dose, but with this new information, they’re going to have to start the process all over again so it will be a little longer.”

“Not a problem,” the woman assured. “I think I’d rather have the correct dosage. Thank you so much for being so observant. This is a God-thing.”

The woman gave her husband a mutually understood look. The implications of an incorrect dose were unknown to them, but they knew they had been spared from yet another pot hole in this journey.

A few more hours later, the nurse returned ready to administer the woman’s chemo shot. It was quick and virtually painless, nothing like the images she had conjured up in her mind when she envisioned receiving chemotherapy. True, they did have to use special blue gloves and the woman had to utilize a special spatter screen over the toilet, but that was the extent, though somewhat alienating.

And so it began. For an indefinite amount of time the woman would have to undergo bi-weekly rounds of this treatment. Week one consisted of every-other-day intramuscular (IM) injections of Methotrexate. On the off days, the woman would need to take a recovery vitamin called Leucovorin to help her body replenish what was lost due to the chemo. Week two was her recovery week as her body would work to build  immune system back up in preparation for the process to begin all over again. They would also bi-weekly track her HCG levels to zero, after which point would begin the monthly draws for at least six months to ensure everything stayed that way.

Drifting off to sleep she thought about the long road ahead and a prayer came to mind:

God, grant me the...

Serenity to accept things I cannot change,

Courage to change the things I can, and the

Wisdom to know the difference

Patience for the things that take time

Appreciation for all that I have, and

Tolerance for those with different struggles

Freedom to live beyond the limitations of my past ways, the

Ability to feel Your love for me and others and the

Strength to get up and try again even when I feel it is hopeless.

Part 15: Submission

“Absolutely not,” the woman protested. “I will not get back on that stupid pill. Do you know how long I was on that thing? I’m already going to have to wait at least six months before trying again, probably more. Adding this to the mix will just make that wait even longer.”

The debate had already been going on for a few minutes, the gynecologic oncologist proposing one idea, the woman giving a counter argument for another.

“It is very important that you not get pregnant while on the chemo,” the oncologist rebutted. “If somehow you did, the results would be devastating to you and your baby.”

Beneath the professional façade a genuine concern pleaded from the oncologist’s eyes. It was not just the plea of a doctor who had witnessed suffering and the unthinkable over many years in her practice, it was the plea of a woman and a mother who understood the innate desire for new life. It was this sincerity that broke through the woman’s resolve.

“Okay, I submit,” the woman replied. “I still don’t want to take that pill, but if you think that is best, I will do it. I’m 100% on board.”

The oncologist moved on to speak of the specificities of the chemotherapy treatment. They would begin by giving her Methotrexate, a drug that inhibits DNA replication in rapidly producing cells, like the ones continuing to reproduce in the woman’s uterus. This would kill off the existing cells and prevent new ones from forming. There were other drugs that could be used as well and possibly would be if her body didn’t respond to this first one, but those were more aggressive and had more side effects. The oncologist wished to start with the lesser of the evils.

This does not sound fun, thought the woman reclining back in her hospital bed. She was discouraged. I hope this stuff doesn’t wreck my body.

“When this is all over, I want to see pictures,” the oncologist said, interrupting her thought.

“Pictures?” said the woman.

“Of your next baby. I ask all my patients to send me pictures. You will get through this. Your type of the disease is nearly 100% curable, and I am confident that you will make a complete recovery. When you are ready to try again and you have your next baby, I want to see pictures!”

The woman was taken aback. She had been so caught up in the weight of her present situation that she hadn’t much thought about the light at the end of the tunnel. I can’t believe how confident she is about this, thought the woman. Could it really be true? I can't even imagine, but maybe she is right. The time will come some day when I can try again and I will have another baby. The emotional wounds from the past two months were still too fresh for the woman to completely buy into the idea, but deep down a hope filled the empty space in her heart left over from the loss. A freedom came over her as she not only submitted her treatment into the hands of the doctor, but also submitted her all into the hands of the Healer.