My funk was set off by my visit to the Cancer Centre on Wednesday. I didn't expect it to get to me as much as it did considering how many times I've been there without letting it get to me. It's harder to go back in there the longer I'm away from it and when I have had to go back to pick up a prescription renewal, I go in at the end of the day and often there isn't a single patient to be seen in there. They're usually washing the floors. This time, though, the place was packed with patients. PACKED! It was a kind of "perfect storm" of cumulative things that knocked me down, I think.
First, though, there are a few possible reasons for me to end up in a funk. Some people experience such moods regularly as a matter of course but I've never been one of those people. I'm pretty much perpetually cheerful and my mood stays pretty level so I find feeling like this out of character and, therefore, troubling. Possible reasons for my funk are ...
- Depression can be one of the side effects of Tamoxifen. Maybe it makes me more vulnerable to feeling bummed. I can't say that it does for sure, though. Many women on Tamoxifen end up taking antidepressants as well. Unfortunately, recent research has indicated that certain antidepressants can interfere with the effectiveness of Tamoxifen. My little 48 bummer isn't bad enough to warrant that and it might not have anything to do with the Tamoxifen for me.
- This little funk might be due to some post traumatic stress syndrome triggered by the visit to the cancer centre. I'm guessing that this is a more likely explanation. Going back to the Cancer Centre might be a bit like a soldier with shell-shock hearing a fire cracker.
- Maybe it's perfectly normal to feel bummed after seeing all I saw and experienced at the Cancer Centre when I was there on Wednesday and after all I've been through this past couple of years. Maybe anyone could expect to feel this way.
Usually the first person I see when I walk into the Cancer Centre is Bonnie at the reception desk. She is the bright spot for me of going there. She is always cheerful, personable, and always recognizes me and remembers my name and she always has something to say. She makes heading deeper into the bowels of the centre a little more tolerable. I didn't see Bonnie on Wednesday morning. Bummer.
Then I went to the waiting area for bloodwork where every seat in that waiting room and almost all in the adjoining area were taken by people waiting for the same thing. Despite that, I didn't have to wait very long. I had a good book with me to distract me from my environment. Still, I found it hard to stop thinking about the young Mom who walked by holding the hand of her little boy who looked to be about 4 years old. The Mom was obviously going through chemo. It makes my heart break to see that. I can't imagine being that Mom. Or, more likely, I can. All too well.
If you recall, I've had a cold this past week. I was feeling quite a bit better by Wednesday. No more headache or sore throat and ears but I had a runny nose and some stuffiness. I made sure I used antibacterial wash frequently while I was at the Cancer Centre. Unfortunately, while I was sitting among all the other cancer patients waiting for blood work and other appointments I developed a tickle that started me coughing, which made my nose run all the more. Of all places to start coughing. In a place like that it makes you an automatic parriah. I remember how paranoid I was about being near anyone with a cold when I was going through chemo and my immune system was so compromised. With every cough, a whole lot of heads turned in my direction and alarmed eyes settled on me. The woman sitting beside me leaned as far over the other way as she could. I might as well have farted. That would probably have been more welcome. To get a glass of water I had to walk through even more waiting areas, coughing into my shoulder the whole way. And yes, everywhere I went, people looked politely(?) horrified. I did get my cough under control and luckily I was soon called in to get poked. Luckily? Hmmm ...
Previously when I was visiting the Cancer Centre weekly during chemo for bloodwork and to get my picc-line flushed and rebandaged I would go straight from cheerful Bonnie at reception to delightful Carol or Tracey in Phlebotomy. Carol and Tracey are the sweetest, most personable people. They always made an otherwise unpleasant experience not so bad. Now that I don't have a picc-line, though, I get a different nurse. In fact, she's the one who drew blood during my very first horrific visit to the Cancer Centre ... when I blubbered like a baby while trying to explain that I wasn't at all afraid of the needle and she asked me if I wanted her to call a social worker. Sheesh! How embarrassing! Even though she's taken my blood at least 5 times since then, she hasn't become any more pleasant and this time kind of took the cake for me. Well, first she's not awful, she's just a little "chilly", which isn't a crime but it's uncommon at the cancer centre. It seems to me they take pains to hire only very cheerful, compassionate people at the Cancer Centre. I'm not sure how this one slipped through the cracks. She's just not very warm ... at least never in my experience.
I've had lots of blood taken from my arm in my life (I used to be a frequent blood donor - I have AB Negative blood) and while nurses often comment on my teeny, tiny, deep, rolly veins, they usually manage to get a needle into one after a couple or five pokes. When they get it right off the bat, I'm always very impressed and I tell them how brilliant they are. I'm used to getting poked and even though I don't like it very much ... who does! ... and I like multiple pokes even less, I'm okay with it. I don't flinch. There's no drama. I tell the nurses right off the bat that I fully expect them to need to poke me more than once and that I'm okay with that. I don't want them to feel nervous or judged.
So, back to "Nurse Chilly". She obviously doesn't remember me. That's okay. I'm cheerful and she's not unpleasant - just not warm. That's no crime. She puts the needle in the crook of my arm and even though I never look, I can tell she's not getting any blood to draw up. That's when she does what some of the nurses do, which I wish they wouldn't. While the needle is still inside, she starts moving it about trying to find a vein. Eventually this does kind of smart and I did jump a little at which she withdrew the needle and then told me, "We're going to try something new". I strongly suspected she was going to go for the back of my hand, which is just what she did. It's her preferred location. Except for intravenous lines and one time when I was very ill and in the hospital shortly after Luke was born, nobody has ever needed to draw blood from my hand. But she suggests it every time. In fact, I'm surprised she even tried my arm in the first place because she almost always suggests taking it from my hand right away. Last time she took it from my hand after reassuring me that it hurts much less than in the arm. That would have been about the third time she'd taken it from my hand and I let her do it while trying to remember why it was I didn't like having it taken from my hand. I couldn't remember fast enough but it all came back to me later. It isn't that it hurts so much at the time but when it hurts is every time I use that hand for the next couple of days or more. That's the bad part because we all know how much we use our hands during the course of any given day. This time I remembered the previous experience and I told her I would rather she try again in my arm. This is when she started to annoy me. She then said she would have had it on her first try if I hadn't "jumped" and that if I want her to try my arm again I would have to stay more still and that I would also have to straighten my arm properly. I hadn't, in fact, jumped. At least not until after several "in skin" needle maneuvers. I thought it was poor form for the nurse to blame the patient for her not being able to get blood from my arm. I feel there's some onus on the nurse to make the experience as pleasant as possible, especially given that I'm a pretty cheerful and accommodating patient. And I didn't mind being told how to hold my arm for her second attempt but I didn't appreciate her subtle suggestion that if I'd held it "properly" in the first place, she would have been able to get it the first time. She did hit a vein during her second attempt but she gave the needle in a place I've never been poked before ... about 4 inches down my arm from the bend. Odd. I really hope I don't get her again in February.
So getting my blood taken wasn't the reasonably cheerful experience it could have been.
Back I go out to another waiting room where I manage to find a seat. It was so busy at the Cancer Centre while I was there Wednesday morning. I've rarely seen it so packed with people. It was pretty depressing. Just knowing that this is only a drop in the bucket of people in our community and surrounding communities who have cancer. Maaaaan. Not a happy thought. While I'm sitting there waiting ... and waiting ... trying to focus on my book ... a family of three walked by. A Mom, Dad, and a boy of about 7 years old. The little fella had a chemo port sticking out of his arm. It made my heart hurt. So many people ... some in wheel chairs ... many with all the telltale signs of hair loss ... some with canes ... many who are pale. Many who are sad looking or in pain. Is it any wonder I slipped into a 48 hour funk? I was there for 2 whole hours.
After much waiting I got into a private room where I could wait for my oncologist who is a very pleasant man. First his nurse assistant ... a brand new one ... asked me several questions and wrote down my answers. For weeks, even months, before these appointments with my oncologist, I keep a record of all my questions and any new developments to report. I went over several of these with the nurse. Then the oncologist came in and did the usual check-up ... I asked all my questions ... reported new developments ... and then, lickity split, I was walking out the door.
As I left the building and walked to my office in the building next door, it occurred to me that I'd left without getting answers to most of my questions. And then I was really bummed. My next appointment isn't for another 6 months - February. Here I was concentrating on asking my questions and then, in turn, I answered the questions that were asked of me. But it didn't really occur to me until I was out of the building that while the doctor and nurse had written things down and asked me questions, they didn't actually give me any answers. Dang! Tricky! They slipped right past me. They distracted me with questions that led in other directions and then I forgot to go back and ask again. I did get one answer but I'm choosing to ignore it. I asked about the swelling and tenderness under my arm. He said it was swollen and that he would expect it to be tender and he mentioned the possibility of lymphedema but when I asked him if I should be doing anything about it or seeing someone he said he didn't think it was necessary. I will ignore that lack of advice and make an appointment with my massage therapist, Pam Fitchner, who specializes in lymphedema. Berny quickly contacted me when I was complaining about it earlier and also suggested I do that. I think she's right and that my oncologist is a little too relaxed about it as many doctors still are about lymphedema, though I will still contend that he's a very sweet man.
And then, after I got back to work, a few hours later when I went to the bathroom, there was blood. Damn! If that was going to happen, why couldn't it have happened before my appointment?! That's one of the questions I'm always asked and I was able to answer with a confident "no" this time only to bleed a bit after my appointment. And no, I didn't have any medical exam "down there" during my appointment. Just bad timing. I didn't get too annoyed by the blood itself. I'm not going to do anything about it unless it happens again and there hasn't been anything since then. Tamoxifen can increase the risk of uterine cancer which is why any spotting of blood is to be taken seriously. I do take it seriously but I would think it would happen more than just once if it was something to worry about. Maybe it was just my heart bleeding out a bit after having had to witness all I saw at the Cancer Centre.
So that was my funk. It's over now. Kevin took me for a drive to Winners, London Drugs, and then through the car wash. All is better now. And I'm making progress with my hand quilting and that's a happy thing.
If you got through all of the above, you deserve a prize. I hope I didn't throw those of you who did into a funk, too. For me reporting how I feel about my experience is practical documentation and it's mentally and emotionally therapeutic as well. And some people might be interested to know how a person might feel even a year and a half after finishing cancer treatments. While I feel more "normal" all the time, it is proving to be a very slow road back to some kind of new normal. I'm not there yet, which comes as a bit of a shock to me still. But it's real and I don't think it hurts to have a real story out there. Mabye it will help someone out there feel less alone if they, too, are finding themselves on a slow train to near normal.
The above photo is taken from the river bank behind the Diefenbaker Canada Centre at the University of Saskatchewan where I work. There are such nice walking trails there and Karen and I were out enjoying the hot weather Wednesday this week. Hasn't the weather been amazing?!