posted by Amy on Jan 1

I’ve been getting various kinds of cancer treatment since June, 2011 after being diagnosed with what turned out to be advanced (or metastatic) breast cancer in April, 2011. The first confirmed cancer metastasis was in my liver. The liver lesions were resolved on the first round of treatment and have not recurred (knock on wood). I’ve had breast cancer metastases in one of my lumbar vertebrae since April, 2012 and in my lungs since April, 2013.

In late 2013 I started having a dry, nonproductive cough, and I noticed some problems breathing on exertion. Eventually the cough was diagnosed as “atypical GERD” (gastroesophageal reflux disease), and I embarked on an ever-escalating program of medications for that. At its worst, it was causing voice production problems (from acid slopping onto my larynx). For someone who preaches and sings (and talks a lot) that was annoying.

Then there was the cough I got from radiation pneumonitis. I had 12 rounds of radiation to one area of my right lung where the cancer had been causing pneumonia by blocking the ability of the downstream lung tissue to function properly. I felt really good for about two weeks after that ended (on October 3). The GERD even got better. Then I started coughing really hard and long–hard enough to gag. I sometimes coughed up various kinds of secretions. I was also having trouble swallowing. And I was very short of breath if I moved my body at all. Within two weeks of the onset of these symptoms I felt very sick.

That was early November. I started taking Prednisone for the pneumonitis, and it is helping. But by the last week of December a wandering pain in the right side of my face had gotten intense enough that I was taking Ibuprofen around the clock to dull it. Sometimes it felt like a toothache, sometimes like an ear ache, and sometimes it seemed to be in my jaw. I had a slightly sore throat. No fever, except for one night. I finally went to the doctor, and one of the questions he asked was whether I had been coughing. I told him I cough all the time, from the GERD, from the pneumonitis, and most likely from the cancer itself. He diagnosed a sinus infection and put me on antibiotics. He said that cancer, cancer treatment, and steroids can all suppress immunity, so it was no surprise that I got a sinus infection.

Come to think of it (now that the antibiotics have kicked in), there really was yet another kind of cough going on. I had the symptoms for several months, so the sinus cough undoubtedly overlapped the other kinds of coughing. And since the “wandering pain” had started “wandering” down into the part of my back along the rib cage where I first had pain when I got pneumonia in June, I would not be at all surprised if some of the inflammation in my lung was actually a low-grade bacterial infection.

But now I hardly cough at all. I can take a deep breath–or 10–without triggering a coughing fit. The scan in November showed that, except for the pneumonitis, there was a good treatment response to the radiation therapy. I am on a new chemotherapy for the cancer. The antibiotic is zapping the bacteria. And I feel pretty good.

I had “a cough” for several months (or years, depending on how you look at it), but it wasn’t just one cough. My body was trying to tell me something, but it took me awhile to get the message. It’s almost like one of those nesting Russian dolls. One kind of coughing had to be fixed before another one could be identified and addressed.

Maybe it’s the same for other kinds of bodily or psychological distress. Maybe symptoms overlap or get mixed together, perhaps masking true therapeutic effects or obscuring conditions that need treatment.

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