Elizabeth’s memorial service is organised for 7th of October at the National Library of Australia. Further details and RSVP are at this page: https://register.eventarc.com/35675/memorial-for-elizabeth
Elizabeth’s memorial service is organised for 7th of October at the National Library of Australia. Further details and RSVP are at this page: https://register.eventarc.com/35675/memorial-for-elizabeth
Elizabeth died the morning of the 12th of July, surrounded by friends and family.
Which is what we have written on social media, and in newspapers, but I feel that this place deserves a less sanitised farewell. Elizabeth wrote uncensored discussions of cancer, she was honest about what happened with her body, and to just say she died, passed away, etc. feels insincere.
Elizabeth died the morning of the 12th of July, surrounded by friends and family, but below I am going to talk about what that means (feel free to leave it at this).
*Photo courtesy of Alex Seton. The piece is Eternally Yours, a collaboration between Elizabeth (words) and Alex Seton (plinth, skull).*
there’s a point i want to make about this picture other than how beautiful the composition is: it is about a month old. and i don’t look a damn thing like it any more. the face, the posture – i’ve shifted. i look sicker. but the ones i had taken when my sister and mum visited this week? my face looks calmer. it looks softer. and it looks like i have finally started to let go.
i came to a really important decision this week.
the night after my previous post – my day leave post, i had a stoma bleed at home, and i couldn’t manage it. it wasn’t a serious bleed, by any means. it wasn’t a huge amount of blood. they would have taken more blood from a blood test. but i just can’t live like this. i can’t live with the uncertainty of a bleeding piece of bowel protruding from my stomach; a time bomb waiting to swell the bag against my thigh of warm, bright red blood. and there’s no set idea of time. no predictability. no idea. at any moment, i could just have a bag full of blood, hanging off me. and then, what do i do? is it bad enough to go to hospital? do i just throw off the bag, stare around the edge, and try and clot it? do i just act like this is ok, like i am ok? i’m not ok. i’m not ok. i am not ok.
this is my body, and this is me, and this is my body in end stage cancer. there is no shame in this, in these end stages, and there is no weakness in my death, no failure as the inverse of success. as always, there is no battle i am losing.
but this time:
i was brave. this time, right now, i stand up and i say i am strong, and i am brave, and i am proud of myself, because i have chosen to stop chemotherapy at the time that is right for me, and i have chosen to go into hospice care at the time that is right for me. my doctors all support and encourage these decisions as also being right for me – as a part of what has always been my longer term treatment goals and aims, and my own quality of life decisions i had set up. when it looks like we’re getting to the 3 months mark, we start palliative treatment only due to the limited benefits of chemotherapy according to a lot of clinical studies. thank you google you are not a doctor.but this time, the doctor backed me up. he looked at me with great kindness and compassion and told me that this decision would very likely offer me a quality of life and in fact, perhaps, a lessoning of symptoms for a bit.
it is not easy to say ‘i am not going home again.’
it is not easy to say ‘i am ceasing chemotherapy now, because the treatment is causing me more physical discomfort than i am willing to tolerate for the gains.’
it is not easy to disregard the notion that ceasing treatment, and choosing to go into care is not the strong, warrior option, but the giving in.
i am not giving in. i am working with my body. i am listening to my body. and i am listening to my needs. my doctors explained that the chemotherapy i was on would likely purchase me time. not quality. my quality of life is not, and would never be, improving as a result of any current chemotherapy treatment they have available. and for me? time is not my priority. for some people, it is. for some people, time is what they would prioritising over any other needs. for me, it is quality of life, and comfort. i have no desire to drag myself through this. these endless bleeds, the slowly increasing pain, the exhaustion.
my anxiety, while waiting to find out where i am going, and when, has been completely unbearable. i spent two days feeling as though someone had a vice around my neck, and i was constantly choking when i breathed out, as though the pressure was compressing my ability to breathe. it’s not cancer. it is, entirely, my own intense anxiety at the waiting, the hospital room just hovering here and me in it, and no real idea of when or how i would ever leave it. this ties back to my funding email. gasping. gasping, and gasping, and my own anxiety around how few staff they have for me to ask for help. it’s not an anxiety i am used to, though, so i think i need to navigate its own strange language. i do this slowly, like i am right now, from bed.
next week, i will read stories to a tiny human being i love, and will never see grow up. but for the time i have left, i will have the memories of her tiny, serious face looking at me. i will spend time with the people i love most in the world. i will live in the moment with my family, and come to a place where we end up communicating in a way that is loving, and that will leave us all with the memories of people who, no matter what, are family.
i have a lot to look forward to, and life to live, and that life may be very, very limited by the idea of ‘time’ in the long term, but i refuse to let it be limited by quality, or value, just because i’ve withdrawn treatment.
it is hard. i cannot be inundated with people right now, because i need the quiet. i am often confused by the people who i feel drawn to spending time to, that i need to spend time with. it is an interesting thing.
hospice was the harder decision than stopping treatment. treatment was always a slight reluctance on my part, and it was sealed for me when my i realised how much one of the chemo drugs upset my stoma. i’ve had the stoma for some time, but not whilst i’ve been on this particular treatment, and it causes very, very unpleasant bowel symptoms. you know what’s worse than gross bowel symptoms? seeing the direct result of what your actual bowel is doing because it sticks out of your body. it’s confronting, and painful, and there’s nothing you can do about it. i am in a lot of pain, a lot of the time. i am unsure right now, after taking my breakthrough, if i should take some more. i am trying to be better at that as well.
the question for me is too, what is the ‘time’ buying me? i have lived a life of beauty and richness. and i am sad, and i am a bit angry that it has to end now, at 32, thinking about the histories and stories i would have built around me were i not to be dying. but i also know a month or two of this, or three, or five? or whatever?
these are all individual questions for each person to answer. but for me, i am not giving in, or letting the cancer take me passively. i am actively taking control of my treatment goals, stating them with my doctors, and working forward to get where i need to be for this particular, final part of my life.
stoma wise, it’s the only part of my body i’m interested in trying to sort more aggressively, just from a palliative sense. just for the fact that it causes me so much stress. if the ongoing therapy i’m having continues to fail, there’s an Option Two we are looking at. it’s not about time; this one is entirely about comfort, and there’s no comfort in what that goddamn monster of a thing is doing. there are two more procedures, one moderately invasive and one quite invasive that can be done to my portal vein in an attempt to reduce/stop the bleeding. i think there are some significant risks involved, but for me, those risks would by far outweigh the benefits. i am at the point, in all seriousness, where i would be willing to risk dying earlier if it meant i didn’t have to deal with this constant bleeding. i’m not exactly sure of the details, and it’s caught up slightly in the movement into the hospice, and will involve Balancing Things Conversation. a week in hospital? for two weeks not bleeding? can i come to deal with the bleeding better mentally? what exactly, at the end of the day, will i be gaining? conversations.
urgh. my body is nothing but itch right now, due to the morphine i’m taking after the ward has run out of fentanyl. BUT THINK OF THOSE PRETTY PAINTINGS IN THE NEW CANCER BUILDING GUYS! how pretty is it?!!
for me it’s really important to state that everyone’s treatment journey is individual. for me, what i am doing is correct, and right, and when i realised that the decision what what i needed, i felt tremendous relief. it felt sacred. it felt as though i had really been brave in choosing to do something that could be read in so many ways: but that i did it in the way i chose to do it.
and i cannot thank my medical team, and the nursing staff enough for their support. the looks on their faces of relief, of agreement, and also, of affirmation that they too were proud that i had chosen this aspect of my treatment, and that continuing, for me, was not the decision that would be most beneficial to what i want. i am tired guys. i am proud, because i am brave, and i am strong, and i am not giving in. other people who chose to use different pathways at the end stages are also brave, strong and all of those things if those are compatible with their plans, needs, and desires, and it’s so very important to have these options and feel supported in the choices we make by our medical teams. i cannot thank my oncologist and my palliative care team enough, or the nurses who stop by to stroke my hand remind me that making my choices in empowering.
‘end stage’ is about moving into a new place for me. a place where i focus on my needs, my wants and can finally put the details of the medical things behind me. sorting the stoma will help this for me.
(i just hand a half hour nap while writing this. for context? i’ve left the bed once today. i am tired guys).
i move into hospice care on monday. i will live in a room by the lake, with my own courtyard, with a view. i will pick the little things that make me feel at home, and they will come with me. maybe i’ll feel tremendously better once i am in there? maybe i will just feel safe, and ready. but it is the right place for me. it is the right next step for me, and i hope you, my lovely readers, will understand that though it might be sad, it’s also a time of empowerment, strength and of letting go for me to live the final stages of my life as i would like them to be lived.
and i mean physical steps. we have a lot of steps leading into our apartment, and no lift, and our day to day living space is upstairs, meaning more steps to get up to my bookshelves and large couch.
i got up them. it wasn’t easy or comfortable or pleasant, and i cried when i saw them, and i did it. it’s just my fitness levels had dropped so much, it was harder. i also realised that scooting around with my little frame is way, way easier than walking with a cane. so scooting will be a Thing. which will mean more ways of adapting to getting out of the apartment with other people. but i’m hoping that time should help – the physio is confident that with a bit of time, i should find it easier.
at the moment, i’m technically still in hospital, but i’m on ‘gate leave’ for the weekend – my space in the shared room is kept for me if i need to come back in to save an ER visit, and i have that added security for the first two nights of being at home. so tonight i sleep at home, then i return in the afternoon to get my wound next to my stoma changed, go home again for sleeping, and then on monday, we go through proper discharging and preparing me for returning to living outside those tiny white and blue curtained walls again.
i have to set up my life now, too; with more appointments from more medical teams, and for me to use the resources i have available to me more effectively. there are many of them here – the ACT is exceptional like that – it is about me finding out those services and using them more effectively than i have been. the small things like managing bills. the bigger things like managing my anxiety.
i’m going to write in more detail for Palliverse (which is a palliative care blog i love, and contribute to) about some of the changes i’ve been making in my treatment path, and decisions i’ve made about my care, and how as a patient the effect me – just because that content lot more about the medical side of stuff – i do always recommend having a look at the work they do to learn about palliative care, and the different ways that people with life limiting and terminal illnesses can choose to make decisions about care and treatment, and the personal and professional cross overs. as i’ve mentioned before, palliative care and management of medical conditions – and it’s definitely NOT just for cancer – is very important to me, and with a lot of discussions that happen around end of life care management, i fear are misrepresented or under represented. if it’s something you’re interested in looking at, or understanding more for yourself, your family or friends who may have life limiting conditions, or just in general, it’s a great blog to start with.
i still can barely piece the last two weeks together that i spent as an inpatient. i’m finding the higher doses of pain killers both challenging, but extremely important for actually managing what’s happening – pain and discomfort (which i still sort of feed out differently in a way that’s complicated and hard to explain) in my body. i know i’ve been in hospital, and i can vaguely tell you what happened, but i have no sense of the time between events, the time things have happened.
my position in the ward was right next to the nurses station, making it noisy. very, very noisy. relentlessly noisy. this wasn’t the fault of the nurses, just the fact that this is how a hospital operates. but my sleep’s been shattered, and that’s not helped my mood or my ability to really understand what’s been happening clearly very well. i had days of wanting to cease treatment. days of just… just faded out haze, of falling asleep while checking my phone halfheartedly. i looked at photographs on instagram a lot. i ate. and i ate.
eating has become a … thing. i’m far more self conscious about the Steroid Face than i thought i would be, and i feel uncomfortable with myself for these feelings being so strong. i wasn’t expecting the changes to be so fast, or so visible, and i wasn’t expecting the hunger to continue. combined with complete inactivity, i look very, very different to how i have looked before when i see myself in the mirror and i’m adapting to it.
breathing is also… a tightness in me that i am not familiar with.
one of the things that i’ll be going into more in my other post is my own control issues though, now. i am stopping the speculating. i spend a lot of time on it. ‘is this liver mets hurting? muscles? i should tell my doctors i think my clotting factors are failing’. this isn’t helping me. it is also a very, very hard habit to break. what i need to focus on is moments, and pleasure, and finding what it is, and how it is that i want to spend these days, these weeks, these months.
it is June. it’s June. i had them make sure to write up the day and month every day in hospital on the wall, otherwise i got too confused, and now we’ve flipped through to winter. i … i honestly didn’t think i’d see winter. i didn’t think i would see the next series of Orange is the New Black. i never thought i’d stare into the park and look at the leafless trees next to the pine trees, that view i love so much, from our apartment i love so much. and it is June, and i am here, breathing still, though coughing on the couch (i have been in a bed for two weeks, come on, no, stop it).
and now, i focus on what brings me joy. what is it that i can do here, in canberra, within the limitations of my body which are slowly creeping in? i love presents. i love buying and giving presents. i love fancy hotels, and fancy food. and i can still eat and still gain pleasure from food. i love the zoo, and i loved my Jamala lodge experience (the Zoo Thing i did). i love animal photos. i love my friends.
a part of this too is accepting the things i can’t do anymore without the cost being greater than the gains. my daily visits to coffee shops – it’s small, and lovely, and today i had a pie at my current local daily stop-off (it was also Sunday and they get extra treats on Sunday, and they make the BEST pound cake you could possibly dream of). what do i DO with this time? what do i do with the means to be able to get more things done (by which i mean the insurance pay out i got, which has given me a freedom which i am trying to do my best to use without feeling too guilty). i like going on long drives in quiet times.
i’ll never look at the sky out of a plane again. i thought about that, and i cried, and then i didn’t feel like i needed to cry about it again. you know how many times i’ve looked out the window of a plane? what a glorious thing. what a glorious, glorious thing to have seen. i am so lucky.
i also focus on what i need. i need sleep. i need time alone to process. i need to write, but i also need to do it on my terms, if that makes sense? i’ve got things i want to say, and i am not sure of how ‘platforms’ work, but there’s things i want to get out there. how do i do this while focussing on what my needs are though? because that is something i struggle with. i write this blog because i enjoy it, and because it gives me a place to calm down. it’s a part of my own therapy. i wonder if it would operate as a book, a solid thing, a tome – the editing would be hard, because it is, by its nature – ‘bloggy’ – because that is how i write, and how i’ve written since i was 15. i mean, it’s coming up to 20 years of me blogging off and on, in one form or another. a physical item works differently. but i like physicality – it’s why i enjoy being published in journals, (as well as the fact i like validation. come on. we all like validation). but what are the things i want to say? i have a lot of things.
the care i have had through my medical experience is beyond the expectations of anything i could have imagined i would get as a patient. i do not mention my doctor’s names because i know (well, i sure did) that the first thing you do is GOOGLE, and i know that i often share small moments i have with my doctors that add to the personal as well as the professional relationship, and it’s a part of what makes me feel guarded about it. but at the end of the process, as i move along, i will be mentioning names, i will be saying how these people are the only, the ONLY reason i am alive, and how i don’t just owe my life to them, i owe quality, understanding, empowerment, my mental health, and so so so much more.
the medical system in the ACT – particularly the way the budgeting of the cancer care facilities has been set up – has been one of the hardest things for me to be seeing this year.
my treatment has been at The Canberra Hospital, overwhelmingly as an outpatient through the Canberra Regional Cancer Centre. the facilities at this centre are astonishingly good, and brand new. the artwork that you stare at during chemo is stunning. it smell like a hotel foyer, and looks like one as well. however, the third level never got finished being built because they ran out of money. there’s just one abandoned level.
i have been in the cancer ward in the main building which is entirely separate from the outpatient facilities for over three weeks over the last six months. the lino is creeping off the floor wall in gaps, and it feels shabby and forgotten, as though the people dying of cancer are here, shoved up the back, while those who will more likely live through, or live with cancer have a glistening white resort. this is not to deride the difficulty of what people who do not end up in a hospital often – it’s a very different space. but i can tell you right now, the times where i have been in the far darker places have been in a ward late at night.
emotional-buzzer support teddy become necessary – a teddy bear i kept with me (and no, i’m not ashamed of that) – which i found was the only way that keeping the nurses buzzer both within reach and from randomly falling out of the wall due to poor wiring, or from just randomly starting to beep without me touching it. the paint peels off the wall. there are never, ever enough staff; the ones that are there do an amazing job with the resources they have, and i never once felt neglected in my care – at times, often not triaged high up, but that was due to the nature of why i ended up in hospital in the first place, and the nature of what was keeping me there – i wasn’t a high triage need, and the biggest issue ended up being the medication mix, and also i think, to a degree, my own mental place with where i am in my treatment and my illness, my body and my death.
i had a pin board. i put images on it of a lion and a tiger and a bear from the Canberra Zoo, and a photo of Alex holding Pounce (one of the cats), and a star chart out of a box of fancy cosmetics that Aesop put out – i bought myself a big collection of nice smelling skin care so i could feel more human during the time i was in there, even if some nights i couldn’t get out of bed to wash my face properly. i might look like the moon but damn, my skin is in great condition. i had one broken chair for visitors; the arm of it kept falling off – and no place for me to sit during the day other than the bed.
the rooms are almost all shared – there are a few private rooms, up the end, and they are the rooms we speak about quietly, with sitting areas outside, and couches next to the bed, and lower lighting. they are away from everything else, and they are kept clear, and that is the only way those rooms should be. but they are still in the noise. the spaces are tiny and from a physical sense of moving within them, between those endless seeming blue curtains, very difficult to navigate. there is nothing that even resembles privacy, as you try and find the right supine angle to balance the shit pouring out of your colostomy bag, the smell filling the room, three other people quietly holding their breath as much as they can at two am while you try not to cry at what your life is, my 32 year old existence where i get genuinely excited when i manage to remove a towel without blood from it, or manage a bag change without smearing my own shit onto my arm.
i love beautiful artwork, and i love the fact my outpatient cancer experiences have been enhanced so much by the new and excellent facilities available. i love it very much. you know what i love more? the capacity to know my nurses buzzer is going to work reliably at three AM in the morning when i am in a huge amount of pain, rather than having to crawl out of bed, with wobbling knees, a hand pulling the gown around my arse more securely and my stomach bent over, tears running down my face asking for breakthrough pain medication. or a third level that had something actually on it.
it is good to be home. it is really, really good. it is also always really, really scary at first to get used to the changes that being in an old space, faced with a new context. i will adapt, and i know i’ll find a way to navigate all of this again. right now, i am enjoying the couch. i am hoping the pain in my stomach remains below a 4, so i don’t need pain killers. i am looking forward to dinner that’s not off a hospital tray. i am trying to think about now, and not next week, or that there’s no buzzer to call A Medical Professional instantly, rather my phone to call them. someone is close. i am safe. we are safe.
so i’ve been admitted and in hospital for another week now.
i’ve been trying to stay sane. it’s not… overly easy. the drug combination has not done great things to me – it’s not even my existing mental illness, but just what can happen – and i’ve been struggling to hold onto a sense of clarity and sensibility, and more to the point, the self awareness i am so used to.
i thought i was manic, until my psychiatrist told me slowly and gently that i am actually suffering from morphine/dex/every bloody other combined drug delusions. it means i have no idea what happened, what’s happening, and when it happened.
i am terrified i made it all up, because i became deeply paranoid that everyone in the hospital hated me. i still get this distinct feeling every single night that they move me to this other PLACE in the hospital. it’s hard to know where i am, so i’m placing orienting objects around the room to try and remind me where i am. i had a team of palliative care doctors around me when the pain hit – they saw it as the same time i did, and gently, on the spot, gently discussed other management techniques because what i was using clearly didn’t work. i took on the opiates that aren’t fentanyl feels hard, started on morphine, and now accept that oral morphine will be what i use.
i have a hard feeling this flat. i don’t feel depressed as such, just strange and tired. i fall asleep at random – just sitting, and then suddenly, gone. i have no idea what to actually do with time — i think about the hours to fill in the day and almost become anxious. i worry some days that i’ve given up now, that my goals to get home, to get better, have ceased to matter. i think right now, today, i have given up to a degree. sitting here, waiting, waiting, waiting to die, as my body falls around me, crumbling.
i had a few stoma bleeds as well. my bloated body – from my hairy steroid face down to my stupid puffy ankles – tore – and there’s this semi-circular wound where the skin pulled back from the stoma, and is now open and needing to be covered. but it’s familiar and solve-able, and the stoma people were totally relaxed about the whole thing. i felt a lot better after that. i still blame myself. i still blame myself for everything.
for a rare time, i question even writing this, and posting it – it’s been a deeply private week of thinking about quiet things, and writing list after list after list of what has been going on. i’ve stopped writing all the lists, which makes me think i am maybe on the road to clarity again. i feel so unclear. everything. unclear. i’ve even gone as far as starting to ask people, reach out to specific people, and ask to see them. it is very very hard for me to do this, because i figure often unless someone ELSE wants to see me, they have no interest in seeing me, and asking them will end in both of us feeling embarrassed. me for imposing, and them for having to see me. but that’s not how it works. and even those tiny visits help. or longer ones.
the lists are telling. i write lists of fears, of dark places, of plans, of goals. i have to set up a little folder that catalogues what to do in cases of medical emergencies, working out what they are. i need to accept that this state of being – this strange hovering understanding that hospital is now somewhere i need, and being here, in a bed, sitting here, giving up that control as much as i can, is going to happen again. i guess it’s up to me how long i push this. how long i care or can do this.
i don’t know if i should think in finite terms because i don’t know what is healthier. i don’t know what i want to do with my time – seriously do – or how to priorities. i have a much stronger psycho-social team now, and i need to work more effectively with them in order to get me into a more solid place.
i am scared of this pain returning. i am so so scared.
out of all of this does come the good news, that my bones are clear of cancer. abdomen, we just… it’s not much point me knowing anymore where is what, we just palliate. but how long? how hard? how sharp? there’s Stuff we can do if the stoma bleeds – the ones caused by the veins rather than the would – but it’s more surger, and questionable as to how well it will work. the doctors look guarded about it, but need to offer it as an option. i don’t think i’ll do it. i think i’ll risk the bleeding out. my body is starting to be flecked with varicose veins. but the pain of bone mets? i’m more likely than not to be free of this, and that makes me feel confident.
my plans – my list of plans – makes me feel safe. if what then when. folders. easy access. step plan. control. control. as someone who has always had weird control issues, the last few months have just sent me into a spiral of needs around controlling situations. it is ok. it is ok.
i miss home, i miss alex, i miss the cats, i miss my life. i miss having a concept that i was living. i am going to sit in the mall and watch people pass me by, and i will see out people and i will use my time do things that matter to me without guilt. i will plan out perfect days, beautiful days, real days. i don’t know what to do with this time. it’s not about ‘wasting it’ as much as doing things i want. what do i want? right now, massages. i’m getting massages.
and i know what i’ve had to do is start to prepare for my life to end now, and i don’t know what that means, or when it is, or what form it takes, and that lack of control is terrifying to me, and also it is important, because this is a place we all will go, and we all need to go, and it is just my time to be doing it, and i just happen to be helped by writing through it which is why it ends up out there, splayed all dirty-like. i envy people who can draw these experiences and thoughts together into a coherent piece, a coherent place, into some sort of Book Like Thing. i started and stopped it because my writing is erratic, it is shivering, it is a series of essays, and i feel probably the least uplifting way of cancer monologuing anyone could do.
a lot of this above is about palliative care, too. which i write about elsewhere, but i feel exceptionally strongly about. i believe in palliate, as soon as you can. i believe in getting in the teams together before you hit a crisis – and i think for me, having read a fair bit about the palliative care things in the ACT (‘what does it look like? where do i go? what are the services? how can they help?’) i sort of prepared myself for when we started getting the team in. it took some time to be ok with the word, which i’ve talked about before. and the concept. and the transition. it is a safe transition though. i have an inpatient team who are making me feel safe, and we don’t talk about dying, as such. this is something i want to emphasise so much – is that it is the part where we are focussed on life. on removing pain, on understanding how i understand the world through what i need right now.
i know the choice to involve palliative care teams – and when you choose to do it – is deeply individual. for me, it is something that has eased a lot of the burden of working through ‘dying’ – i use inverted commas here because it is not a moment, it is a process we all step through, and an awareness that death is near and close and how we manage that in relation to what goals and purpose we have is important.
at the moment, i have three ‘teams’
i have what i call my psycho-social team – which is the three arms of 1. social work (practical needs), 2. psychology (emotional needs) and 3. psychiatry (medical and also emotional needs).
there is then my oncology team – the man the legend my oncologist and my nurse care co-ordinator, and while i’m in hospital, the really great minion doctor who works with my oncologist (i think they are the registrars? i get confused between residents, interns, junior doctors….) who also pops in to see me. he’s young, and also very, very good, and i seeing him in action makes me happy, knowing that there will be patients supported by another oncologist who both has beautiful bedside manner, and a really good grasp on what he’s talking about and an ability to communicate that with a deep sense of humanity. they take care of the oncological side – the cancer killing/moderating/slowing growth side of things, and taking direct action around the cancer, and supporting me through those things. they also work in to make sure i am feeding through to the other two teams, because right now they are as, if not more essential to my wellbeing in the … long term?…. they also know me the best. the nurse care co-ordinator system they have in place here is incredible, and without her, i can’t imagine how much harder this all would have been.
then, we have my palliative care team – two doctors, a nurse, and i Think there’s a separate social worker? i am slightly hazy. there are three people who visit me and talk to me, and they are all wonderful, wonderful, wonderful people who focus on helping me with the pain, with the realities of the changes time will bring to my body, and by simply standing or sitting with me, and being there. it is hard to describe how it operates, or why it is important. it is more than the act of sitting with someone as they die, which i think is what people imagine palliative care to be – it is about an active involvement, an active exchange between patient, medical teams, and life.
i guess that’s what i need. that sense of life back. and you know, it’s funny, but this silly blog post has made me feel better about it all. i actually feel better now after these words are out, which is, i guess, why i started this blog in the first place. it heartens me that you guys who read it get something out of it. i hope it helps you if you have cancer, or a loved one with cancer, or even just want to learn more about what it is to have a different sort of experience in waters you are yet to have to chart. because we all come here, by some boat or another.
i can’t even clearly remember when i last updated.
though firstly welcome to new readers. there are a lot of you. here are some basic things:
i talk a lot about gross stuff, but try and warn for it.
i do not post comments messaged to me relating to alternative treatments. i have written in the past about about my reasons, and i respect all cancer patients and their own decisions regarding treatment. in return, i like to be afforded the respect of not being offered treatment options for my cancer that are not being suggested or managed by my carefully chosen multiple disciplinary team who, between all of them, have a tremendous amount of experience. i follow this path, i am happy with my decision to do so. i like to make people aware of this so they understand that this is an important thing for me. i appreciate and understand that it comes from a good place, but unless someone’s seen all my PET, CT, MRI, ultrasound, and blood test results for the last 24 months, and dedicated their life to specific areas of medicine that treat, manage and cure illnesses located in the areas of my body that are compromised, and have spend a significant amount of time discussing my needs, wants, options, and plans with me, i honestly do not have the mental or emotional desire to have this as a part of my life.
this is a personal space for me. i do not argue or enter into heated discussions in the comments, not because i think arguing and discussing aren’t vitally important, but because this is my blog space, and i started it as a tiny, never read collection of entries about how i like balcony gardening. you like the battle metaphor? that’s fantastic! you support aggressive treatment paths for all individuals? GREAT! you do you! my blog comment area isn’t going to be your place to process your feelings about these issues though. similar to what i say above.
i use this to process my feelings. i hope that it assists others, especially other cancer patients, carers, and those close to people with cancer, to understand a little bit better.
we got back from tasmania, and i arrived home, tired (understandable?). then, i got a bit confused. a bit disoriented. not sure exactly what was going on. vague. i fuzzily suggested the ER, and got an ambulance there, to discover a red blood count of 50 (under 90 requires a transfusion).
so, short stay. solve blood count. home. i was so tired. i was so so tired. it did end up ok. i am so fuzzy about it all though i’m not even sure what happened for several days. i had my computer here, i didn’t use it. i didn’t just sleep, i had some visitors but not heaps — it’s been a sort of willingly solitary stay — and my body tried to recover. the stoma. we did a CT scan, and confirmed i have portal vein hypertension, and it appears that there’s something weird in the bile ducts. cancer? just getting fucked up? no one really knows. we could probably find out? is it worth it to do it, for the invasiveness of the testing at this stage of my cancer? to me, probs not.
but, the portal vein hypertension issue confirmed – we now know for certain that the bleeds are essentially being caused by varicose veins in and around my stoma. this is a very unusual and not often documented side effect of portal vein hypertension. it’s treated in the same way varicose veins are. only those veins are a few cm in, on the stomach/pelvic area. sclerotherapy, i am pretty sure it’s called. not uncommon.
the first go, we did one vein, and the doctor explained we’d likely need to do quite a few more to get the bleeds under control. it hurt. i was in, i was out, and went back to the ward. that night, no bleeding. nothing. none. i was so excited. WE FIXED IT. Onc suggested we wait – that he’d prefer me in hospital at least overnight, with a bed booked so i didn’t need an ER admission – while he was interstate. and then, last night, in ten minutes my stoma bag filled with blood again.
i was thrown. today was hard. today was really hard. i comfort ate an entire small fruit cake after the bleed, in the middle of the night. i am tired, and still wired. and i spent the day well – i felt ok for visitors, the social worker told me i coped really well with a hard situation and so did my clinical nurse, and i’ve got appointments to see about three other med teams while i’m in here just to get everything in order. this is because my team are amazing.
then though, at about 4 this afternoon, i had a doctor i’d seen once before come rushing in, saying i needed an emergency angiogram. i was baffled and terrified, and had no idea what was even going on. this was an ultrasound procedure. angiograms are one of my least favourite things. they hurt for days, they scare me for no rational reason, and the last one i had lead to a treatment that failed much faster than i sure as hell had hoped. i was also halfway through changing my colostomy bag, just after a severe IBS episode, so had me and a nurse struggling with bags and poo and emergency bleed supplies, and i was told i needed to leave, now, for an emergency.
’emergency’ just means they triaged me high on the list; something suddenly horrific hadn’t just shown up. it was ok. but god. it was not well placed, and it was not worded well. i insisted the doctors called my nurse, which they didn’t – by some weird chance i ran into her and it was ok, but i very much dislike people ignoring me when i say ‘please leave messages with my medical team, i am on palliative treatment and am, despite how i look, terminally ill and facing liver failure. they need to know things’ – i am polite, and clear, and simply say ‘i’ve had my team for 24 months, and their strong preference is to be informed of this sort of information even if it is just leaving a message on a phone.’ i do not like that being ignored, and my doctors like it even less. i have never had it happen twice from the same junior/reg doctor. and i don’t want to shit on them – they are amazing, passionate, and fantastic people, ‘baby doctors’ – i’ve had some incredible baby doctors in my time, often ones i’ve told extensively how positive my experience has been and passed up the line of command so that others knew too. but sometimes? i’ve had issues with them listening to me when it comes to details of my cancer after a five minute interview where they don’t recognise the names of multiple treatments i’ve had – which is hard. i know, without a shadow of a doubt, that i know more about my cancer than an early career doctor i just met does. a good early career doctor judges that within seconds, gets a senior doctor, reads my notes again, and contacts my onc. a … maybe one who is a bit less well suited to some forms of medicine…. will look at me like i’m a bit of an idiot, and ignore me. anyway.
the sclerotherapy hurts. it hurts badly. i take strong pain killers. i was on intravenous pain killers during the procedure. they gave me more throughout, to the point i had trouble walking after. but inserting the locals into that area – about 20 or so – was some of the most intense, hard to describe pain i’ve had. i’ve never actually gone from no pain to barely being able to say ‘8’ (pain scale 8 out of 10) in a matter of seconds before. the doctor performing it was amazing, and he told me how well i was going, and there was a nurse who stood at my head, gently stroking my head and talking about all her and her kids pets. as soon as we started speaking i could manage the pain better. she told me about their cat named buttercup. she just talked at me about animals, about my hobbies, about nice places we’d eaten, about how we love the smell of Aesop products, me through an oxygen mask mumbling to the point i’m not sure anyone could hear me through, and her just clear, calm, and consistent. ‘Keep talking’, the doctor would tell me, tell her.
they had to x-ray repeatedly to try and find more veins, and i’ve never had trouble holding my breath before, but it was a struggle.
i don’t know why this was so hard. i am normally better at pain management. i am normally better at all of this. the stoma thing has just thrown me so much. i shook throughout, and had an anxiety attack through the pain killers. none of this is like me at all. i was gasping under the oxygen mask. my hands gripped the edges of the arm rests, and i shivered, and shivered.
i am actually interested to unpack exactly what about this threw me so badly. it was out of character. i managed two major surgeries better than i dealt with a minor day procedure. it’s not even that i’m upset at myself for being like this – sometimes we react in weird ways – i am just actively interested to know why it is that i did. maybe it’s the IBS, the general bowel feels, and my sense of strange blame that the whole reason i have issues with my stoma is my own fault, no matter what anyone tells me (more unpacking!).
so now i am tired. and wired. and bloated. i am scared of going to sleep in case my bag fills with anything. the whole stomarama means that i’m generally struggling with all things stoma related, which given that i need to deal with it several times a day, is a pretty all round shit thing. i’m scared of it. i’m scared of the bleeding, of the clotting, of it not clotting. my onc said that, with my liver, there’s going to come a point where the possibility of it not clotting will become a real and present reality.
i am trying to be ok with this. it’s almost a week in hospital, but i feel disoriented by it. the stoma Thing has impacted so severely on my quality of life, so much of the time. i hate it. i hate it.
i am planning a treat for myself. alex needs a break. a proper break. a break which is not ‘i am in hospital’. so i’m making up my own hospice plan: Luxury Hospice. cause i’m not at a point of requiring hospice care, but i can’t really go interstate. i feel like i’m safer here; oncology team. bowel surgery team. palliative care team. community nurses. but you know what i can do? go to a nice hotel. stay there. have Luxury, and eat delicious foods, and wear a fluffy bathrobe, and just enjoy being somewhere swanky. i love hotel rooms; their strange anonymity and intimacy, the odd ways of personalising something that is in its nature needing to be rather impersonal. i would, during those days, use these services, not alex, for emotional and physical support at night, and at the times where hospices would be caring for me, and not my carer – i don’t require mobility aids at the moment, or a lot of things that many people with late stage cancer do. i want to enjoy that. my pal care team LOVE this idea and want to help me organise it. medical team think it sounds like a fun idea as well.
i have it down to two hotels by location: Hotel Hotel, or The Hotel Realm, though Hotel Hotel is near/in the same complex as a cinema. both have multiple food places, Realm has a High Tea spot i would love to take my friend Fi to though. but we could just uber there?
i also need to organise another Jamala Lodge thing because the last one made me so deliriously happy. i still don’t know why.
right now, there’s a beeping machine going off in the room, and it’s half past 12, and i should go to sleep.
i have been in some media things too, mostly talking about not being a hero (you can be one! i am just not one), or being brave, strong, or engaging in a battle (all things that you also can do! i just don’t).
it is also national Palliative Care Week. i will try and get out a good post on palliative care tomorrow or soonish; it is something i feel strongly about, and would like to advocate for a lot more. Palliative Care is your friend, folks. you live longer, better, happier lives when you have a team that can focus on making sure your treatment is about your quality of life, living your life, and helping you focus on your priorities. it’s a scary word, especially when you’re under 40, but it’s powerful, and it’s a service there for us as well – and not just a service, but a whole methodology – a way of thinking about how we manage our illnesses and help those around us to understand our illnesses too.
the stoma seems to settle for a bit, and then just flair up again. i’m getting a better handle on it, but i had a bleed in the middle of the night. i didn’t need to go to the ER, but it took out a few hours to make sure it was ok, and i called out the night time community nurses to help me in case i couldn’t get it to clot on my own with pressure. my stoma itself keeps swelling, so i keep needing to change the sorts of bags i have – there’s now about 10 boxes of bags just sitting around i need to return, or do something with, because if the stoma is too big for the hole in my bag, i risk knocking the edge, causing more bleeding, and starting the cycle again. my stoma nurse admits that this isn’t a problem she’s encountered, because most people get them after the cancer’s resolved or being, not when the cancer is essentially ripping the body to pieces. sinking boat, sinking boat. we are plugging up the gaps. the water keeps coming in. all we can do is try and slow the sink, make it easy, make the last gasps of air between everything else. right now, for no rational reason that i can think of, the fucking air isn’t draining from my stoma bag. it’s filling up like a goddamn hot air balloon, meaning i need to fiddle with it and risk a bleed, and you know, i just. i just don’t even. i feel resigned, tired, frustrated, and so completely over it.
the output looks jaundiced and ill. somehow, i don’t. maybe it’s just my excessively full of carbs diet, or my otherwise … god knows what’s happening in my body happening. i don’t particularly feel like more CT scans just to be told ‘well, bad shit’s happening’ or ‘it’s hard to tell what’s happening’ or ‘well, the bloods are doing this so we’re not sure it matters what’s happening because the liver is dense and weird anyhow’ because it’s fairly clear that bad shit is happening. and more scans means more appointments means more needles means more checking. maybe there’s a drain they can put in for an errant lymph node. maybe we can just hold it all off for a bit. maybe i can just try and have some nice days where i do nice things like get that soda i like.
the medications they’ve put me on now to help with the stomarama have been a strange mixed bag. i think the steroids have helped my mood. i know the beta blockers – to slow the bleeding – have done incredible things for background anxiety, and already lowered my heart rate. i’m still not on blood thinners, which is both nice (no needles) and anxiety provoking (what if i get a clot??!?!?!). i start chemo tablets again on wednesday. the lack of anxiety has, in a lot of ways, slowed a lot of my sense of urgency about everything, and i’m not sure how to process that – is this good, is this bad? the bloods should indicate if i should go back on the clexane. i guess. what’s going to kill me faster? what’s winning here? Quality. Of. Life.
quality of life is such a key, and strange term. i struggle to know what quality consists of. is it me feeling like i can deal with this? is it my capacity to be able to wake up each day and see the value and the richness? last night, in the middle of the awful, i reminded myself that, were i not going through this, my life wouldn’t actually be some perfect paradise. that sans cancer, everything in my life wouldn’t be MAGIC and GOOD. we’d still have to do the dishes, and i’d still get depression sometimes, and my partner would still go through things, and every night would not be some amazing joy filled orgy of adventure and thrills. it’s a simple thing to forget. it is also something i wonder if i do to try and minimise what is going on, in order to give myself more guilt about ‘how it could be worse’. that perspective is fairly useless, and i know that. i guess we move it around as we need to, in order to cope and understand what we need from ourselves. the cats are grooming each other’s faces and they are sitting on my feet, being emotionally supportive of me. i am thinking about this, about eating pasta bake, about reading my book tonight, about going to tasmania, about things in my life with value and goodness. i do not want to just sit here thinking about the fact that my bag isn’t deflating like it is supposed to be. quality of life, quality of life. definitions change.
i find myself less patient at the moment, perhaps more than i have ever been. i pride myself on trying to be a patient and kind individual, but something snapped in my head about my ability to just take stuff. it is liberating.
it seems, in the course of writing this, taking a break, and wandering around, the bag is settling. quality of life.
when i was watching Grand Designs, they mentioned the guy building the house in it was 50. i got suddenly for a moment exceptionally jealous that he got to be fifty.
right now, i just want to make plans to go to tasmania and to go back to the zoo again for another zoo sleepover night where i get to stay next to a big animal and watch them sleep, or at least know they are there, and see them eat treats. i get to make plans once we’ve talked to my surgeon tomorrow, and i get to think, then, about being alive in June.
we’re ordering my stoma supplies for June next. so, you know. optimistic.
it has been eventful.
first of all, a content warning: Blood, and Stoma Stuff. if you are new to having a stoma, please read this taking into account that i am on blood thinners AND chemo. i had a bad experience, which will possibly something you may, but please don’t let it freak you out. overwhelmingly, mine has made my life better, and the reasons it’s a pain are not the stoma on its own! they have issues, they are ick, and you will have struggles, but you CAN do it – and if you aren’t in a point to be reading bad stoma experiences, please stop here.
i will be talking about bleeding as well. if that’s not a thing you are ok with, be wary.
second of all: i am aware of issues with zoos. please be kind and let’s all leave the zoo conversation for another blog, k?
i have had this Thing booked at the Canberra Zoo where you stay in this fancy hotel room in the middle of the zoo in an animal enclosure. we got the bear! she is a rescue bear from a circus, and old and sleepy, and she likes grapes. i have always wanted to do it; because it’s fanciful and over the top and who stays at a zoo, seriously, but it’s not cheap, but i scoffed at the cost on impulse and booked it for last night a few weeks ago, for as soon as we could get in. i really wanted to sleep near the bear.
in the morning, i had a blood transfusion. my iron’s a bit low, it’s no big deal, i get them sometimes. and the day goes on, post transfusion. i eat pasta for lunch. i read some dumb stuff online. i go to change my stoma before we leave so i don’t need to worry about it later.
and it had an arterial bleed. not major. we aren’t talking huge amounts of blood loss – or much at all, but it spurted, and seeing blood spurt from your body – particularly a stoma which is the colour and texture of the inside of your mouth – is just this automatic ‘holy SHIT this isn’t supposed to happen’ sort of thing, and i couldn’t make it clot after 20 minutes of solid pressure. i had a complete breakdown in the bathroom, mopping blood off the floor and screaming ‘i just wanted to go to the zoo’ over and over and over again. like, this small-ish thing (it’s not a big bleed. it would have stopped probably sooner if i wasn’t in hysterics), completely broke me. i realised with this sudden huge weight that for all this time i have been carrying this feeling that what i am going through is minor compared to what i am doing to everyone else around me.
that is bullshit. it is actual legitimate bullshit i’ve been telling myself, and i don’t know why.
i expect i should pick up every piece, that i should not feel as bad about these things happening to me as when they happen to other people. i feel like that when my chemo day is delayed, or i am sick, and someone else is put out that this is worse on them, than on me. i feel like asking for lifts and getting people to help me is more of an effort and harder than the fact i’m often getting said lifts to chemo or doctors appointments or other horrible things. i focus on the fact that my crying makes other people sad, not the fact that i am crying.
but last night? it was entirely selfish. no one else was going to give as much of a shit about the zoo thing (WHICH WAS AMAZING) as i did. no one. this was my thing. this was something i desperately wanted to do, so badly, and this fucking bleeding falling apart worthless miserable body of mine seemed still stoic and determined to take it from me.
i called my nurse care co-ordinator with no idea what to do. i was barely able to speak, but she talked me down enough to get me to call for 000, got an ambulance whose paramedic helped me into clothes while i was sobbing naked on the floor in the bathroom and yelling about the zoo while trying to mop up blood, and got me to the hospital. my oncology team, remaining as always as people who i owe my life – not just medically, but quality, but everything to – managed to get me seen to, triaged, and a senior ER doctor who chemically cauterised the bleed (which had pretty much slowed enough to not be an issue, but i didn’t want to take the chance), and to just let me out without waiting for blood results or anything else. by some amazing chance, the man in the bed next to me’s brother was my last ambo (from my previous bleed) and he heard me crying while i was waiting. he bought me tissues and patted my hand while i sobbed hysterically. i don’t know who you are, you incredible man, but i fucking owe you a chunk of my limited sanity. the kindness of strangers, of loved ones, is astounding. i am surrounded by such huge kindness, such huge generosity. i think it’s… i get overwhelmed just wanting to give back, to give and give somehow, but i don’t know what i have other than words really to do.
i was hours late, but we got to the zoo in time to see the lioness get some food before dinner. we went on the tour this morning. i slept near a big brown bear. i did the goddamn thing, even if i didn’t get to do the afternoon things because i was at the hospital. i won. i fucking won this goddamn round, and i will be damned if i don’t win a few more like this. i am tough and i am stubborn. i freaked out during the dinner, and had to go stare at the fish after having an anxiety attack and needing to get to the bathroom to cry. and i ate my dinner. i kept it together through the evening, and i cried a bit, and i talked a bit to alex. and we slept a bit later, but in the middle of the night i got up, and i saw the bear sleeping up against wall, her giant paws and my tiny hands, and i ate a mini-bar chocolate and had juice because i am really just a 10 year old with mini-bars (i love them so much for no rational reason).
the whole thing taught me a lot. i couldn’t sleep much last night – i was wired as fuck, and my brain felt like it had been fried. i disassociated in the hospital because i was so upset – my mind floated away because if i stopped to think i started to shake and almost scream with the pain of having to keep doing this, of the constant effort and stress and anxiety and sheer force of will i have to keep doing, every day, to even just stay alive. even on the days where i’m just drinking juice. on the days i go to cafes. on the ones i feel feel gratitude. this is really really hard. people with cancer reading this? you are permitted to feel as though this is hard on you, and that you are falling apart. you are permitted to feel that real honest truth: no one else, a lot of the time, gets it. it is bitterly isolating, and so, so lonely, and just so hard. the contact i share with my other cancer folk has been so vital for me, because the different angles on the same sorts of experiences help. but this is you. it is your body. it is you and your body. in your body. and that is something that situates you as completely alone. it is ok to feel as though this is hard.
i’m off clexane for a week. we need to sort the bleeds out. i need to sort how i take care of myself a lot better. significantly better. i have been blaming myself and blaming myself over and over again, and no, no no. no. this has to stop. this isn’t my fault. this isn’t my fault. people care about me, and it is going to hurt, and i am going to need things from people, and that is ok because as humans we DO need things from each other, and that is what makes friendships and relationships and people better, and it is OK to want these things and i am not weak or stupid or childish to want to think about my needs now.
i want to do the zoo thing again. this time with the afternoon tour.
here are some stoma tips though, guys (obviously listen to your Stoma Professionals not me, but this is what i learned):
call your medical professionals. get them as soon as you can, and listen to them. do not be afraid to call emergency in your country. it is an emergency if there is blood spurting everywhere, and you need to get help. if you are confident you can clot it, then wait it out (my stoma nurse said) but if in doubt, call them. you aren’t going to end up stuck in the hospital for the week after a small bleed, and if you are with palliative care, they should advocate for you to get home as soon as they have clotted/cauterised it.
it is ok to feel anxious.
it is ok to have a breakdown about something scary.
try and stay calm. don’t try and fix everything. but try and try and try and stay calm.
it is ok to feel hopeless, helpless, and like you have no idea what is going on.
there are people who will help you. they are your doctors. let them help you. i have an astonishing medical team. the melbourne move? it breaks my heart to not be able to do it. but not having to leave my oncologist and nurse care co-ordinator actually feels more important right now.
(for those interested, the zoo thing is Here)
i have been a bit… i’ve been struggling to know where to start with lately, not even remembering where i left off. it was my birthday. i broke out of hospital when i was anaemic because i wanted to go to a wedding and stay at a BnB in the middle of nowhere and i did both those things. my birthday was good and i could barely eat my fancy meal but i had a mouthful of everything and it was all delicious and worth it. then my doctors told me, the next day, that my liver was failing.
it’s still failing, just a bit slower. it’s… holding its own. there’s no definitive way to work out how or why without invasive tests that seem somewhat pointless about now if i’m taking a ‘less aggressive’ approach to disease progression – my only concession to this is being obstinate about taking the chemo tablets, even at sub clinical dosages, to try and do anything at all. there is no definitive way to know what is happening in my body unless they try and work out if my bile ducts are being choked by tumours or lymph nodes or if my liver is just packing it in. there’s no way of knowing how to stop it. i am here, my body is here, i am in my body, and i am out of control of everything. i had fancy soda today. it was lemon, but there was this syrup with it. i added the syrup to the soda, and it went purple, even though the syrup was blue. it was real good.
and this leads into this strong sense of… intensity seems the wrong word, because i’m just repeating ‘strong’ again. the possibility of moving to melbourne – one of the only things i wanted – is out of the question – the physical stress of moving may be too much (or may not be) – and i am tired a lot of the time. i don’t know if i’m tired because i am justifiably depressed though.
i worry about everyone around me. i want to make this ‘easier’ and i want to somehow leave meaning, some track, some trace, something for the people who have given me so much. and it is selfish because i want to survive.
because i don’t want to die.
i’m coming to feel like ‘mindfulness’ is bunk. i can sit here and observe the motion of the pleasure of eating a mandarine (i love mandarines more than almost any other food) and i can ‘exist in the moment’ at the push and pull of everything else in my head, as though ‘this moment’ is more authentic than all the moments that have lead to this one, or all the ones that will follow. or i can understand that all these moments exist, and i will feel things. ‘let the feelings wash over you’ ‘appreciate the way you feel when you just being’ is all good and well until you realise that your state of ‘not being’ is close.
and ‘not being’ is a solid thing, you know. i know i will live on, both here in writing, in memories, in the impact i have on people, but that isn’t alive. that’s not travelling to mongolia (i once almost randomly booked tickets to mongolia one day at work in 2011. with literally no cash other than my credit card. i wanted to go to a yurt. i am bipolar!). it is not having a little goat farm in tasmania (i would be the shittest farmer) and it’s not living a life where for the last almost-two-years i’d been getting up and going to work and sharing my life with my partner as a human being rather than a dependent. i’d give up the fact that my words have now gone global for that, you know? i want that imaginary life. i want to be alive.
i can’t donate my body to science. the university in canberra that takes cadavers doesn’t, for some reason, accept GI cancer bodies. maybe it’s not a research speciality. i thought about contacting them, or my liver surgeon – my liver is, of course, spectacular – but the idea of an eco burial in the new site in canberra appeals to me a lot. it’s a shroud in the ground with a tree over the top, and i feel blessed i get that option; no box or burning, just dirt. and i am not blessed, and it is garbage to think of the options of my rotting body as a blessing, because i don’t want to die.
my own time post diagnosis has also been, compared to so much of what i’ve seen, effortless. i had support, an amazing medical team, a body that was robust enough to cope with an astoundingly large amount of treatment (i mean, i’ve seen people on message boards who’ve had 50-100 cycles of chemo, and god, i’m at almost 30 and that’s bad enough – but still, it’s a lot), and both income and medical insurance. i have had limited side effects. i look, for all intents and purposes, still fairly normal, if a bit on the thin side and occasionally a slightly odd shade of yellow. i wonder if i should feel gratitude for this, this gratitude influx.
i was talking to my therapist (one i used to see years ago in brisbane, and who, for some reason, i just needed to talk about dying to – as though in some way our history would help me, and it has) about how hard things in our lives make us stronger and she told me to stop. and she said, ‘that is psychobabble. it’s hard. it makes our lives harder. it hinders the things you want to do. it doesn’t make your life better.’ all of this: i haven’t grown because i have cancer. i am not now some stronger, better, braver, more courageous person because i’m waiting for my liver to fail. i am sick, i am 32, i am going to die, i am going to miss out on living a longer, probably very normal and average (as well, most people’s are) life, where i do things and did things and make an impact on some people and fuck up other things. what has this taught me? that i can have cancer? well done. slow clap. shocking. yeah. we’ve all come on the journey. we’ve all seen what it looks like, and you know what, you’ll all get to see it again and again and again as, well, everyone dies.
for some people – and here, i talk mostly to the people who i know offline – this might be the first time they really see ‘death’ – the process of someone they know, their own age (ish) dying. the act and use of social media for me in this is tied into it. my twitter is private for personal reasons but i kept it open for years. my facebook is locked down mostly because, well, seriously, who has an open facebook these days, but i use it to communicate with groups of people. i guess a part of me wants to make it less shocking by sharing details.
i get trapped in creating meaning as well. my incredible nurse care co-ordinator (when i get sicker, i’m listing all their names, but i still keep it confidential just because it seems weird to me to blog using their names, even though i know some of you read it, which is flattering) often has to just tell me that it’s ok if all i want to do is sit around and watch The Hunger Games movies or re-watch Star Trek, and that i don’t need to spend every moment engaging with the world. she told me that watching The Hunger Games is meaningful because through doing this, i am taking my mind off things, or enjoying myself, or whatever it is we do when we watch trashy movies or TV that we like, and that this is ok. i don’t need to be in this mindful and meditative zone where all i do is feel profound about my observations about life and death.
because you know what they are? crying a lot. my observations are that i cry a lot because i don’t want to die. i could make it more complicated, still, or use pretty words, or use some sort of amazing metaphor but it it’s all garbage because at the heart of it, i am 32 years old, and i don’t want to die. i don’t want to be ‘dying’. i don’t want to be a patient who is no longer ‘curable’ and using terms like ‘life limiting disease’ because it lessens the blow of dying. but that is what it is. it is staring at my hands typing this and knowing they will be white-washed bones by this time next year – or less than that, i don’t know that much about decomposition. it is knowing that the slow decline i’ve written about before is here, that i am on that space, that i am in that space, and that i am starting to fade. and that it flickers up, and down and i have days where i feel completely normal, physically, other than a slightly odd niggle in my right ribcage, verses days of intense exhaustion. and pulling that out from depression is hard as well.
so i don’t think creating ‘meaning’ makes sense right now. i’m going to do this thing where you sleep next to a bear at a zoo on friday. yeah, i know. zoos. i know this guys, they aren’t great. we’re planning a trip to tasmania. i am trying to plan past june. i am trying, trying, trying to have hope. i’m not hoping for a cure, i am hoping to just be alive, just that little bit longer. to have minimal fevers, minimal stoma garbage, minimal pain, minimal nausea, all that sort of stuff. i want to keep it under control, i want to live, i want to be alive, i want to be alive.
i don’t want to die.
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