“The new ones?” he asks.
“I guess,” I grudgingly respond. Really, this is me? Really?
The pills have been sitting on the counter for a few days now. The need for a pneumonia vaccine and Zach’s cold have served as noble excuses for my not starting the treatment. Fear of mouth sores, fatigue and vomiting are the true culprits. Perhaps even a wee dram of denial that it has come to this – a third line therapy – so quickly. How can I dread something that is my next and one of only a few remaining hopes? I’ve lived through the side effects before, at least the most common ones. I know that my hair isn’t going to fall out today, if it falls out at all; that mouth sores won’t appear upon taking it. My mind plays tricks on me, actualized in my gut. I’m not sure looking at the box of pills is a risk factor for nausea, but that seems to be its impact.
The pills don’t look evil. They don’t even look powerful. They have none of the foreboding of the bags of infusion meds that used to hang from my IV pole, or the bright red-orange serum that was once pushed into my veins. Exemestane – white and smaller than a baby aspirin, it reflects darkly in my soul and I wish again there were a different path. It will, we hope, diminish the cancer’s food source: estrogen. The Pez-shaped everolimus is a new-ish breast cancer drug in a new-ish class of targeted therapies. It’s target, the mTor pathway: part of a complex signaling pathway that promotes the growth of cancer cells. If you inhibit mTor, you inhibit cell growth. Assuming the pathway is activated in me. We don’t have a biomarker, a blood test, to determine I’m the right candidate for this one. It’s a crapshoot. Lucky 7s….
With nowhere left to hide, I want to find the “take no prisoners” me, but she left a few days ago. I marvel that despite all the experience and knowledge I’ve amassed, it still comes to this, that fear and anxiety remain my steady companion. Slowly I bring the pills to my mouth, one by one, with a prayer leaning to the side of fear over hope. Prayers once came easily but not longer do. My stomach heaves. I pop a borrowed Ativan for good measure and wait for what comes next. My throat doesn’t close; I don’t begin to immediately feel exhausted, and like I did just about a dozen years ago, I wonder if I’ll have the stomach for comfort food come afternoon.
P.S. Have you ever read the tightly-folded packet insert that comes with medications? I’m quite certain that somewhere in there I read that the meds should be taken with Haagen-Dazs Sea Salt Caramel ice cream, and so I must….