There have been a lot questions about the effects of Emily’s chemotherapy, along the lines of: How is she REALLY doing? She looks different, but what is it? Is she as happy as she looks in her photos?
Following each of Emily’s chemotherapy treatments, I [Michele Taylor, MIL] spend 7-10 days in LA with Emily and Miles to help care for my daughter-in-law. As her nurse, maid, cook, and couch companion, I am able to witness firsthand Emily’s fight and, in particular, the effects of the chemotherapy. As such, I offered to address some of these effects to help everyone understand what Emily is going through.
The greatest challenge from chemotherapy has been the management of nausea. There are several medications – one injected, one swallowed, and one that dissolves on the tongue – all of which last different lengths of time and carry different side effects. Managing the meds and the food preparation is a delicate balancing act. It goes beyond making her comfortable. Too much medication can lead to severe agitation and discomfort; while too little can lead to nausea and vomiting. And just when you think you have it down, and make a plan for the next round, circumstances change. For example, we initially prepared all of Emily’s favorite foods during chemotherapy week to entice her to eat, but then those foods became intolerable as her brain associated them with nausea. Later, we had to eliminate all cooking in the house as she became highly sensitive to odors. With the completion of the sixth round, treatment will no longer include carboplatin, the chemotherapy associated with the harshest side effects, and we are hopeful the new “chemo-lite” cocktail will produce less nausea.
Overall, the chemotherapy’s effects on Emily’s outward appearance have been minimal, particularly in light of what others have experienced.
Emily has always had very thick hair. When told that chemotherapy would cause her hair to thin, Emily’s reaction had a positive spin: “Cool, I pay a boatload right now to have it professionally thinned and now my health insurance will cover it!” And while Emily’s hair has thinned progressively with each treatment, I can attest as the person who operates the Swiffer each morning that their dog Ginny is well in the lead when it comes to shedding.
No more salon mani/pedis on the schedule as Emily can’t risk any cuts. One of her meds reduces the blood’s ability to coagulate; the others reduce white blood cells to fight off infections. So she either paints her own nails, or uses the new peel-on polish strips (when she feels a strong desire, as she did last week, for black plaid fingertips).
Primary symptoms have been a combination of acne (from steroids) and dry skin (from chemotherapy), and internal bruising under the eyes (from meds). She is also paler, which is associated with chemotherapy and not being allowed out in the sun. And, in her defense, we frequently shoot photos of her early in the morning when she is without make-up, even though she says, “No, don’t take a picture of me now! [in the same breath], ok wait, [smiles], go ahead.”
Prior to the start of chemotherapy, Rich cooked up a storm and Emily put on some pounds in preparation for treatment. Printed material from the hospital instructed her to eat anything that sounded appealing. Emily has always been thin, with a robust metabolism, and we were concerned that chemotherapy would lead to massive weight loss and deplete her nutritionally. Maintaining or gaining weight was a top priority. Six rounds down and Emily is now a good 15 pounds above her normal weight, and at times is surprised by her own reflection in the mirror.
After her last doctor’s visit, she called to enthusiastically report: “The weight gain is from water retention and it’s a side effect of the chemotherapy! I can expect to gain 1-2 pounds every round, no matter how much I exercise or eat. So, I don’t know what you had planned for tonight, but I’m thinking maybe burgers and sweet potato fries!?!”
Emily will be the first to tell you that memory has never been her strongest asset, but now she has “chemo fog,” a cognitive dysfunction associated with short term memory loss and difficulty concentrating. When we asked if she’d like to play a board game a few days after treatment, Emily responded, “No, that involves thinking . . . and thinking hurts my brain right now.”
Does she find it frustrating? Not in the least; she has embraced it with relish. Making no move to find anything on her own, she plants herself in the center of the room and asks, “Where is my make-up bag? Has anyone seen my sunglasses? Has the dog been fed? I love this!” Between Emily’s chemo brain and my propensity for reorganizing drawers and closets, I know to answer the phone on the day after returning home: “Hi, Em, what are you looking for?” And then I get to hear her laugh.
It is natural to look at photos of Emily playing in the championship softball game six-days post chemotherapy and conclude that she is experiencing few debilitating side effects. What you don’t see is her struggling to catch her breath as she circles the bases over the course of the inning, or that she collapsed and slept for 14 hours once she got home. Still, there was never a question whether she would play, because she is a true competitor, and determined to get the most out of life (and this was, after all, the Championship Game of the F Division of the Santa Monica rec league, so there was a lot on the line).
With family and friends managing household duties, and an amazingly supportive employer that has arranged part-time disability, Emily has been incredibly fortunate to get all the rest she needs to allow her body to both fight the disease and recover from chemotherapy rounds. She is in bed by 9:30 PM and sleeps 10-12 hours, then adds twice-daily meditation sessions, and frequent naps.
The three week chemotherapy cycle consists of a “sick week” similar to having a nasty flu with nausea, fatigue, and restlessness, a “risky at-home week” where she must avoid large public settings and air travel when white blood cell counts are low, and a “normal week” where Emily returns to work and is able to socialize and get back out into the world, although if Miles had his way she’d never set foot in a shopping mall again (yeah, good luck with that one, Miles).
The chemotherapy schedule has been friendly in that Emily has been able to make quite a few of the big dates on the calendar, although she had to forgo her 10-year high school reunion, a cousin’s NYC wedding, and our family vacation to Costa Rica. On the other hand, her lung cancer has resulted in some very fun, memorable events, like the 5k lung run, the college volleyball game in her honor, and a fundraising gala in San Francisco.
So many lives have been altered since the news in late June that Emily was battling advanced lung cancer. But what hasn’t changed, and what never falters, is Emily’s spirit, Emily’s smile, and Emily’s determination. It’s no act. Emily chooses to be a positive force in the world and I have never witnessed anything to the contrary. It is what makes her so special and what makes us believe she will beat this.
(Love you, EmBen 🙂 )