This Tuesday, Feb 23rd, I’ll have a CT scan with contrast dye for a closer look at my heart after a recent stress echocardiogram showed something questionable. Over the past few months I’ve had increased shortness of breath, rapid heartbeat, dizziness, and more fatigue.
This is not totally unexpected since all the treatments potentially do heart damage, and affect red blood cells . And bone metastases alone (of which I have a lot) disrupt your bone marrow causing decreased blood cell counts resulting in anemia that causes shortness of breath, rapid heart rate, and fatigue .
Red blood cells (made in bone marrow) carry oxygen throughout the body. With low blood cell counts, even during mild exertion, your body can’t cope. Your heart beats faster and increases your breathing rate so your tissues get enough oxygen. This is frequently not enough, leading to tissue injury or even acute heart failure. My red blood cell counts are consistently below normal. A normal count for women is around 4.0 to 5.0 million RBCs per mcL or 4.0–5.0 x 1012/L  –– my latest count was 2.9 M/mcL.
Even washing my hair now can cause exhaustion. I’ve been slowly doing less and less (working from home, going out less) due to shortness of breath and fatigue. Yesterday was a new level of wakeup call as to how much this is affecting my mobility. I rode the subway for the first time in ages, then some walking around Manhattan, and could barely stand at times or get up the subway stairs that only a year ago I could trot up. I don’t experience this so much when just walking around the apartment, or sitting, however once outside it seems even slight exertion halts me in my tracks. It’s not the same everyday, I have better days and bad days, but over all this is becoming more of an issue.
About Tuesday’s tests, hmm… I don’t know whether to pray for heart disease that can be treated or to pray they find nothing and then know these symptoms are just the inevitable progression of stage 4 cancer. If they don’t find any treatable heart disease it may be time to start thinking about stopping traditional cancer treatments all together. There is a point at which the treatment side effects outweigh the benefits, especially with stage 4 where you are just trying to hold off the disease with as much quality of life as possible. It’s not like other cancer treatments where they blast you with the big guns and the goal is a cure and then your body can later recover when all treatments stop. With stage 4 your treatments never stop, until you decide they do. (And that’s a topic for a whole other post.)
This month in Psychology Today there’s a fitting article about dilemmas that run through my mind on a daily basis. These are true not just for the chronically ill, but also for those with metastatic disease. Take a read (click here) and let me know your thoughts. What are your tips for answering these social and personal dilemmas? Share below –– I’d love to hear from you. (If you don’t see the place to write comments go to http://hopeandcourage.com and click on this post’s title and that should take you to this individual post page where you can leave comments.)