Archive for November, 2011

posted by Amy on Nov 21

On Mondays I go to a support group for people with Stage IV breast cancer. Today one of our members told us she has quit being treated and has arranged for hospice care in her home. She was calm and dignified. Someone asked her how she was feeling and she said she was fine. Several of us told her we’re sad for her, but it also makes us sad for ourselves. Barring a miracle, or some other really bad luck, we will all be following in her footsteps eventually.

Support groups specifically for people with Stage IV cancer are few and far between, and I feel blessed and lucky to have this group, even though it can be pretty intense, as it was today.  We don’t always talk about death, but we don’t ever have to pretend it’s not sitting in the room with us. The group is self selecting for people who would rather get things out in the open than try to run and hide. We are kind and supportive and good to each other. We can talk about whatever we want to talk about. We laugh a lot and we cry sometimes. It is a sacred space.

Stage IV cancer is a zigzag path for most people. They have times that the disease progresses, and they have to try some new treatment and deal with the side effects. There are periodic scans and anxiety about the results. Then maybe they get some relief–a little break from treatment, a little time that it’s stable or even retreating. Some people are “NED” (no evidence of disease) for long periods. One member of our support group has been getting Taxol and Herceptin for eleven years. She still has cancer, but it’s stable. On the other hand, in the office where we meet there’s a group picture from years ago, and the only two people in the picture who are still alive are our group facilitator and that one eleven-year survivor.

At some point in the dance with cancer the whole routine gets to be too much. There’s too much pain, too many side effects, not enough benefit from the drugs, and the person decides she’s had enough and stops. And then the cancer finishes its work. Last year Elizabeth Edwards announced that she had discontinued treatment, and the next day she was gone. I’m pretty sure she must have stopped some months before she announced it, to give herself time to prepare her family for the end, to say goodbye to her loved ones, and prepare herself. I hope so, anyway. She was a public figure, so I believe she delayed announcing the decision to the last minute just so she could die in peace, and not have to talk to anyone she didn’t love.

I don’t want to die, but I’m not afraid of it. I think the world passes away and that’s all. It’s not scary and it’s not even sad for the person who dies. I don’t want to leave my kids or my friends or my studies, but we all have to take our last breath at some point. The process starts with the first breath we take. It’s inevitable.

I like realizing I’m in good company. My parents and grandparents, some of my friends, and some famous people who’ve been important to me are no longer alive, but they live on in my heart. I have had many, many happy days. I have made beautiful memories with the people I cherish. I hope I have touched other lives in good ways. I will live on in them and in their futures. And it’s quite possible that the membrane between the living and the dead is more transparent and permeable than the living realize. My mother died in 1976, but I still feel her presence, especially when her grandchildren do things that I know would please her.

When I was 16 I had a job as a nurse’s aide in a nursing home. In the space of about a week, two patients died while I was feeding them breakfast. If I had known they were dying I think I would have held their hands and stroked their heads or something, but it was completely unexpected. Both of them were nonverbal, and they were both cooperating with the feeding, so I guess they also didn’t know they were about to die.  It was kind of freaky that the two events were so similar, and happened so close together, but it really wasn’t bad. I think that was about the time I decided that the best plan for life is to live as fully as possible with as few regrets as possible. For the most part I think I’ve done that.

I’m not planning to exit any time soon. I feel fine, and things seem to be going well with my treatment. I will do all I can to stick around. I am making plans for what to do after I graduate, and I have some exciting ideas.  If I get to live 30 or 40 more years, I’ll make the most of every single day. And if it’s less than that, then that’s all the more reason to make the most of it.

posted by Amy on Nov 3

I just made it through three and a half intense weeks in which I wrote a paper, wrote the hardest take-home midterm exam I ever took, and then did a presentation in my narrative sermon seminar that counted for 50% of my grade. For that, I had to do a 50 minute lecture on a sermon method, then deliver a sermon demonstrating the method. Each project would have been better if I had not had to do the other two, but I’m taking three classes, so that’s the way it goes. I’m glad they’re done. It’s also great that the due dates were spread apart.

The paper was for my History of Western Philosophy and Social Ethics class, and it was called “Dissecting Aristotle’s Political Animal.” The presentation was on a book called Confessing Jesus Christ. I preached on Amos 5:18-24, which is one of the lectionary texts for next Sunday. Three of the five classmates who heard it said they didn’t hear the gospel because they don’t like politics, or political sermons.

The passage (which is really two separate sections) is a warning that when the Day of the Lord comes, it will be a bad day for the Israelites, contrary to what they expect. They think YHWH is going to come and defeat their enemies. (As Anne Lamott says, you can be pretty sure you’re making God in your own image when you think God hates the same people you hate.) According to the prophet Amos, they are God’s enemies, because of the way they treat the poor. The passage ends “let justice roll down like water, and righteousness like an ever-flowing stream.”  I talked about how being God’s chosen people means both trusting and obeying God, both worshiping God and obeying God. The Sinai covenant makes specific demands about loving
God and neighbor, including debt forgiveness and distributive (really redistributive) justice. If that’s political, then so are parts of the Bible.

One of the people who gave me a thumbs down is a preacher who is auditing the class. He says he decided in seminary not to preach political sermons. He says people would leave if he did. I would certainly never tell people how to vote, or favor one political party over another. I agree that one should not preach political sermons.

I don’t think my sermon was political. I think it was prophetic. I took a couple of shots at Congress as a whole, but I didn’t take sides. (They made it too easy for me. On Tuesday they voted 396 to 9 to confirm that the 55-year old official motto of the United States is “In God We Trust.” At last! Bipartisanship!)  A recent survey showed that the more people read the Bible, the more liberal they become. I don’t see how they could avoid it. There are something like 2,000 verses in the Bible that deal with money, greed, social justice, and oppressing the poor. If  members left because they didn’t like hearing biblical sermons with prophetic truths about social sin, I would be glad to see them go.

On the health front I’ve had a bit of a setback. Despite the fact that I think there should be a one-cancer-at-a-time rule, I’ll be going in November 23 for a biopsy of my thyroid, which has some suspicious-looking nodules on it. It might not be a new cancer. It might be metastatic breast cancer. Or it might be benign, as most thyroid nodules on older women are. I should know by November 30. I would not have known about the thyroid nodules, because I have normal thyroid function and no symptoms, but both of the reports of the CT scans recommended an ultrasound of the thyroid, and I finally got a referral to an endocrinologist and started down this path. All I can say is I wish I hadn’t let all my life insurance expire.

Right after I got the biopsy appointment Tuesday I felt sad, tired, and defeated. I’m worried about losing my voice. As a singer and preacher, my voice is important. I play the cards I’m dealt, but that would be a tough hand.

It’s interesting how something like this exposes feelings and attitudes. In 2002 I had a detached retina in my right eye, and the retina in my left eye was torn. For a few terrifying weeks I confronted the possibility of going blind, and I wondered how I would manage. One of my favorite hymns is “Be Thou My Vision.” It took on much more significance during that time. I became convinced that God would take care of me, and that whatever happened I would be alright. And I’m alright now.

I’ll see my oncologist next Monday. I feel fine. My feet and ankles were swollen all summer, but they’re close to normal now. I still have a little neuropathy in my toes, but it’s not too bad. I can walk unimpaired and it doesn’t affect my balance. I was having some side effects from Arimidex, but that’s greatly improved too.

The best news is I don’t have brain metastases. I got a brain MRI a couple of weeks ago, and it’s all clear. Breast cancer can get into the brain, and most cancer treatments don’t cross the blood-brain barrier. Brain metastases can be treated in other ways, but both the tumors and the treatments can cause cognitive impairment. I am extremely grateful that my brain is OK.

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