Thursday, January 7, 2010

Round 9

Well, the only thing worse than getting chemo, I’ve decided, is not getting chemo. Many of you know and some have wondered why you didn’t hear from me last week. What should have been round 9 last week never happened. I received a call from Karra in my doctor’s office on Monday as I was picking the girls up from gymnastics camp. We were stuck in traffic on Rockville Pike (I always remember that R.E.M. song ‘Don’t go back to Rockville....Waste another day.”) As if driving to Rockville in rush hour traffic isn’t annoying enough, Karra called on Monday, December 28 to say that my blood counts were too low to get chemo the following day, meaning my marrow wasn’t producing enough white blood cells or red blood cells to be safe to receive another dose. It’s such a fine balance. And the golden number (what they call your absolute neutrophil number) is 1.5 - you need to be above 1.5. A normal person is about 7.0. My counts were 1.0 (not a long way to drop to zero). Essentially, I was immuno-suppressed, susceptible to infection and a bit anemic (not a good combination). I felt like I had just gotten my SAT scores back and I had failed and I wasn’t going to get into college. That number - a 1.5 became a 650 - the bare minimum you need to get in somewhere decent. At first I accepted the call at face value. I knew this was standard for chemo patients and frankly was lucky it hadn’t happened until now. I knew it was not the end of the world. I knew the carboplatin that they give me does this. But then it started to eat at me. How could I fall below a 1.0 - afterall, I was eating well, exercising, maybe not resting quite enough. What could I do to get the levels up? Nothing I was being told.

So I muddled through the week. Greg and I worked on our book about our time in Jerusalem over New Year’s. The girls spent New Year’s Eve in Charlottesville with their great grandparents and my mom and my sister, Cassie. I finished the introduction and afterword to the book - tentatively titled “A Jerusalem Story,” drew a thumb nail sketch of the first time I had met Zachariya Zubeidi - at the time one of Israel’s most wanted - recounted my last interview with Hamas’ Sheikh Yassin before an Israeli missile incinerated his body as he was being wheeled out of a mosque in Gaza in his wheelchair. Good times.

Then Monday rolled around. The girls started back to school. I went to Pilates. Danced a jig - probably because the girls were back in school. Stopped by Georgetown to get my blood work done on the way home. Never felt better. Sensed something was up when I didn’t hear back with the all clear from Karra. On my way home from dropping late Christmas presents off at Sarah Williams’ house, I get a call from Dr. Isaacs who says my counts are 1.1 - blah - not good enough for chemo and only up a bit since the week before. Impossible, I think. Not going to take this lying down. I beg her for the chemo. “C’mon, I am really tough,” I tell her. “I can take it. Don’t worry.” I suggest we just do one of the drugs at least, the taxol, which is easier on the system. She says that’s a possibility and we decide to try again tomorrow (as in this past Tuesday, January 5). We would draw the blood, see if the counts are any higher and take it from there. Deal.

So I went home and started looking for all the red meat I could find - I decided I would simply trick the phlebologist by having so many iron rich foods running through my system. I craved a bloody steak. Ran up to Whole Foods and found the most grass fed, hormone free piece of meat that I could find. Yum. (I know it is no kale and barley, but a nice piece of steak sounded mighty good and again I thought I could trick the phlebologist.) Christine Merkle (my wonderfully attentive personal chef thanks to all of my naughty dear friends) had also dropped off some veal piccata that at first I worried might cause me to lose my membership in PETA and my standing as a vegan. (I guess I am a fallen vegan.) So that morning January 5, I hopped on the exercise bike in my bedroom, got my endorphins up, and then raced downstairs to have some steak and veal piccata for lunch before heading to the hospital. En route Molly Henneberg e-mailed me. “If it’s’s...” That’s when I called in the big guns. Molly put out the word that I needed a little help. The prayers went up. Greg and I marched up to the chemo ward (a few minutes late - I needed a little extra time for lunch.) And there were my Dad’s great friends (our dear family friends) Neal and Cathy. Cathy had stepped into the hall because Neal was getting his chemo and they couldn’t find a vein. He had been getting it for a year for esophagal cancer (inoperable, metastisized) and somehow before Christmas had been given clean scans - suggesting the cancer was in remission. He was a cowboy from Kansas who had had polio since he was a boy and he was still fighting back stubbornly, refusing to yield. HIs wife told me what Neal’s approach to his diagnosis had been. Instead of becoming a vegan (he was a cowboy don’t forget) he opted for single malt for breakfast and a quick trip to Georgetown Cupcake whenever he felt like it. It was an anti-cancer diet I could learn to like. His wife decided Neal and I should write a cookbook giving cancer patients a range of recipes and options to combat this annoying disease.

The nurse found a vein in Neal’s arm and Greg and i made our way to our seat. #9. Neal had the more private seat #12. Mine was by the nurse’s station. Whenever we arrive at chemo I feel like we come prepared for a transatlantic flight. I have my laptop, my iPod, a few magazines (thanks to Jacqueline, Katy and Juliette!), a book (right now I am reading “Born to Run” by Christopher McDougal about the Tarramahura tribe in Chihuahua, Mexico and their obsession with Chia seeds, and, of course, running - needless to say none of them ever get cancer.) Cathy came to visit us in our economy seats. We waited for my blood counts.

Before long the nurse returned with the pronouncement. Drum roll please: 1.5. Up from 1.1 the day before (I had tricked the phlebologist with my veal and steak) and the nurse handed me the phone. It was Dr. Isaacs. At first I begged her again to give me both the chemo drugs (taxol and carbo). The oncology nurse shook her head and put her fingers together to make a zero - suggesting that if they gave me carbo my counts would go to zero - not smart, I could likely be hospitalized. Not smart. So we agreed we would do the taxol this week and we would give my marrow one more week to recover before zapping it with both carbo and taxol next Tuesday. It just so happens that next week the Today Show is coming to follow me around for two days on Monday and Tuesday. They have invited me to appear on their show on Thursday, January 21. They are putting us up in New York for the night and Greg and I will take the girls up on the train (if all goes as planned) for a little outing. So let’s see what a little rest and lots of calves’ liver (Christine brought me a whole pan of calves’ liver in balsamic vinegar on top of a pound of spinach tonight) will do for my red counts on Tuesday.

My Aunt Barbie sent me a favorite quote from our grandfather (my Dad’s dad) who was known as “The Eagle”. Born to Irish immigrant parents in South Boston and called Eagle because of his “eagle eye” down on the docks where his father worked as a longshoreman. My grandfather worked as a customs inspector until Congressman Joe Moakley of Massachusetts and later Speaker “Tip” O’Neil helped him rise to Commissioner. My Dad’s godfather was Speaker John McCormack. Eagle liked quoting Winston Churchill, especially the Harrow speech of 1941.

“Never, never, never, never.

Never yield to force and the apparently overwhelming might of the enemy, never yield in any way, great or small, large or petty, except to convictions of honor and good sense.”

Reminds me of the Outward Bound motto: “To strive and search and not to yield.” I loved Outward Bound. I did its 3 week survival course which included three days in the woods without food when I was a high school junior. It wasn’t exactly no food for three days. They gave you an emergency supply of GORP (good old raisins and peanuts). I picked out all of the M & M’s on the first day.

One last thought: my dear friend Mary Boies sent me a FedEx package over the holidays. In it came a note that read: “It was either Lord Kitchener or Gordon who said that if a soldier going into battle tells you he is not scared, he is either 1) lying or 2) a Gurkha.” Inside the package was a Gurkha knife (for close combat, carving, if you will.) I laughed out loud and put the knife on my desk. Annalise walks in the next morning not long after the news of the Detroit bomber broke and says as she walks past my desk: “What’s with the knife, mom? You’re not Al Qaeda.”

Darn right, but with another round of chemo under my belt, those little Al Qaeda cells are nearly gone from my body. And Gordon was right. I’m not a Gurkha, though I sometimes like to play one on tv.