Cancer Blog #87
By Brian Zimmerman
Begun on July 31, 2021
Email: dyingman1@yahoo.com
My Dying Words
Entry #87– The End
June 5, 2023
Medical Update I: Iwanted to begin this medical update by apologizing for my tardiness in posting. I’m starting with medical update rather than the actual entry because the medical aspect explains the lateness in posting.
The bottom line is that I’m growing weaker. I’m sleeping more, I haven’t had the energy this summer as I did last summer to do most of my mowing (which I actually enjoy). We’ve had to hire a lawn service to begin mowing the weeks I can’t (I’m 0 for 2 for the past two weeks). And, I’m having more of what I call “attacks”. That’s no medical term, just my term for when my chemo side effects gang up on me by increasing in intensity, or reappearing from nowhere in a more intense form. Things like shortness of breath, legs getting rubbery, balance worse (more unsteady probably because of my weakness), neuropathy increasing so my fingers and toes become more numb, brain fog worse than usual (though how you could tell is beyond me. Ha!), eyes more sensitive to light and moving air, worse fine motor control in my hands so I have harder time writing. Because of my fatigue and my lab results show macrocytic anemia (large red blood cells, but not enough hemoglobin, which carries the oxygen to the cells in the body). My anemia isn’t serious (as my hemoglobin isn’t that low) but what causes it can be. First of all, the chemo drugs are hammering my bone marrow. Worse though was the concern that my folate or B12 were very low. The folate and iron were fine. My problem was my B12 level was very low. My B12 was 149 pg/ml (normal are 186-914 mg/dl). A low B12 can cause many of my symptoms I’m having: fatigue, shortness of breath, numbness, poor balance, memory trouble. I’m now receiving B12 shots in my belly via my wife (a former surgical RN. Convenient, huh?) once a week for a month, then once every 2 weeks for a month, then once monthly. Too soon probably to see any real change (as I haven’t).
Plus, they’ve started me on Ritalin (as I think I have mentioned before). It doesn’t seem to be doing much good. I’ll talk to them about that when I go in for my treatment.
And, I have two new problems. One is that I’ve developed bruxism during the day. Bruxism is when you clinch your teeth. I’ve had night bruxism for a number of years so I have to wear a mouth guard at night to keep from destroying my teeth. This bruxism in the day is also a serious issue and I don’t know what to do about it. Another issue I put in my iPhone note for the oncology visit.
The other problem is tardive dyskinesia. That’s involuntary movement usually in the face like chewing or lip motion. It comes as a side effect of certain drugs (no, I’m not on any psychotropic drugs as those are the primary offenders). It probably is coming from one of the chemo drugs, but I haven’t investigated that one either. I’ve had it for some time. It sort comes and goes, but this time it’s staying. Another entry in the oncology note.
Medical Update II: Okay, now it’s after my treatment day (which was Wednesday, and now it’s Friday and my wife just took the chemo pump off me). Several things happened during the appointment: first, the oncology PA I saw believed the bruxism likely was from the drug called Reglan. So, she asked me to take the drug only as needed. My bruxism is much better today (virtually gone), so that was a huge relief as Ritalin can also cause bruxism.
Second, they will check my B12 levels probably the next time I go in.
Third, they have scheduled my status CT scan to check my cancer situation. It will be done on July 19. I’ll report on my cancer status once that’s done.
Fourth, (a lot of entries in my oncology note), I told her that the Ritalin really wasn’t helping so I wanted to just stop it. She countered with, “Why don’t we double the dose?” Okay, I wasn’t expecting that one! So, I agreed, but I haven’t done it yet as I was waiting to see what effect stopping most of the Reglan would have. And, I’m going to ramp up the Ritalin rather than just jumping it up all at once to see what effects is causing. One thing I learned in troubleshooting computer hardware is that when you change two things at once, it’s impossible to track the effects of either. So, at least this way I’ll have some hope of seeing the effects of the increased Ritalin versus the decreased Reglan.
That’s it for this time. I’ll continue to post as things change or as I find other topics related to my condition that I believe might be helpful. Thanks for your patience!
Blog Entry #87
Despite the ominous title, all I mean is that I am coming to the end of this little blog as a regular entry every Friday for several reasons. First, my medical entries normally occur every other week after my treatment with the 3 current drugs. I’ll continue those updates as things change in my condition or as the treatment regimen occurs. My oncologist will do another status CT scan sometime in the next month and I’ll post that to let everyone know how my cancer is behaving and of any treatment regimen changes.
Second, this blog was originally begun at the urging of a number of friends to document what it is like to have a terminal diagnosis as well as chemo treatments. My treatments are specific to the type of cancer I have, and so I report on the drugs and their side effects for my own cancer. There are many other cancer drugs because there are many other cancers as well as other treatments such as radiation and surgery, which I am not undergoing. I’ve documented about all I can for my treatments and feel that I’m probably just repeating what I’ve already said about them, though they are still a daily battle for me.
Third, and probably most important: my blog had to do a great deal with my thoughts on death. As God has granted me an extension of life of more than 2 years, way beyond what the medical establishment expected, I’ve had ample opportunity to give my thoughts on death, especially as I’ve read through the entire Bible interacting with its comments and teachings on dying. I kept going through the Bible because I knew of no other place where the subject of death was discussed in detail (I have now heard that there is a book that I have mentioned in a recent blog entry that has a similar view on death, though without my personal experiences. I just bought the book and will report on that at some point). It bothers me that this topic is not addressed in the pulpits of evangelical protestant circles. Most if not all of the focus there is on the cares and worries of this age. Now that I’ve received a terminal diagnosis and have treatments to extend my life as God grants, I’ve begun to see how important our view of death is for providing a boundary, a limit to our lives. And just as important, it leads us to reflect on what follows death: our judgment. The NT speaks often on that topic and yet it’s rarely mentioned in sermons I’ve heard. This life is not only temporary, as death teaches us, but is also preparatory. The temporary nature of this life should teach us great humility and that we should hold all things loosely: wealth, possession, jobs, achievements, even relationships. But, one thing that dying has taught me is that God cares more about people than anything else in our lives. As important as other matters may be, our relationships are what He is most interested in. And, the first relationship He most cares about is our one with Him. And, second, those with our brothers and sisters as formed and nurtured in His body, the church. Our relationship with Jesus isn’t just a line directly to Him. Jesus identifies so closely with His people that what we do is done both to as well as for Him.
Which brings me back to the other concern, viz., that this life is preparatory. One day we will be judged by Jesus for love or failure to love God’s people as we are governed by God’s law in directing that love. We should always be mindful of that. I know you’re probably tired of hearing about Jesus’ parable of the sheep and the goats in Matthew 25, but it seems to me to be such an applicable passage for our age. There He separates professing Christians from one another, not by doctrine or creeds, as important as those certainly are in guiding our lives and faith, but the by the fruit of those professions of love for Jesus. He focuses on the sick, the widows and orphans, the poor, and believers who are incarcerated for their faith, but Jesus’ questions seem to me to be directed primarily to the professing Christians about their care for other believers in those situations. Jesus identifies so tightly with His people that we cannot have a relationship with Him if we’re not caring for His body. There is a test, an evaluation, coming on Judgment Day (hence the name), and Jesus gives us the test questions. The problem is that we evangelicals just ignore the questions or preparing for them! The difficulty to some degree is that we live in the richest country possibly in the history of the world, and so may have let the social programs of our government crowd out our responsibilities to our people As I’ve said elsewhere in this blog, we tend to see what we’re looking for. If we’re not looking in our churches for the believers that Jesus tells us to see, we are likely to look right past them. We won’t be aware of believers with chronic illnesses, of widows in our midst, much less those in nursing homes, or of single moms who are often functionally like widows. Or, we’ll miss those who struggle financially or those who are or have become believers in jail. As we meditate more on death and judgment, I think it will change the way we think of living, of the stewardship of our money, cars, homes, even the use of our time. Though my thoughts on death have been primarily to help us lose our fear of death, I hope the thoughts I have listed here will help us also to see how the need to face of death shifts our priorities. If we were to live forever in this age, it would lead to a very different view of life. But, the temporary nature of our lives that will one day be judged should change our view of how we should live. I am trying to take these things to heart, even at this late stage in my life. May God grant you that same desire.