Lack of Food – For Thought

As I begin my post-chemo week of not eating/having minimal interest in food – and losing weight accordingly, I can’t help worrying and wondering if this is a beginning of sorts. You see, what little I know about medical outcomes/chronic conditions is that maintaining/losing weight is an indicator of something; good, bad or indifferent, maybe, but something. Otherwise, why would the oncology nurses who take my vital signs: blood pressure, temperature, oxygen level and pulse, always have me step on a scale? My weight must be important.

I don’t suppose gaining weight, however, is nearly the problem/concern that losing weight is, at least when you’re being treated for a “terminal” form of cancer as I am: non-small cell lung cancer, stage IV. And neither do I know if the weight loss occurs because I don’t feel like eating as I do now or is it because I’m still eating normally and yet am losing weight in spite of it? I just know – or think I know, that losing weight is a bit of a harbinger. Now whether it’s reversible, I don’t know. I only know that when it happens to me, every week to 10 days after my alimta infusion, I crater emotionally – for a variety of other reasons, too, and inevitably begin to contemplate my future, or more immediately, my present as it relates to my future. Unfortunately, despite the experience I have dealing with this 10-day struggle, I can’t always fend off the daemons.

I tell myself a multitude of very familiar reminders: it’s nothing new, it’s merely the predictable side effect of the drug; you’ll/your weight will bounce back, you always do; the treatment is keeping you alive/even shrinking your tumors (based on the most recent CT Scan); perhaps now you’ll be able to extend your infusion interval to five weeks (as nine months previous, you had extended it to four weeks from three) and have one more relatively normalfeeling/eating week before that next infusion; and finally, even if the Alimta stops doing its maintenance-type thing (going on three years), there is now an entire new class of drugs/treatment: Immunotherapy, “OPDIVO,” as an example, if you’ve seen the commercial, designed to stimulate one’s own immune system to target the tumors with fewer side effects, that didn’t exist when I was first diagnosed, so there are more treatment alternatives than ever before and considering my collateral kidney damage, more choices is particularly encouraging.

Yet all this internal bucking up, along with support from family and friends – who know Kenny’s post-chemo eating drill, doesn’t always stop the irrational, illogical and perhaps ill-conceived thoughts that penetrate and permeate whatever selfdefense mechanisms I have employed – repeatedly, to stem this tide of negativity. As much as I would like to believe that familiarity breeds contempt and that my life will go on with nary-this-being-a-blip-on-myradar, this “familiarity” doesn’t breed anything but anxiety and all the related mental deficiencies associated with not exactly feeling your oats. And even though I’ve been here and done it since September, 2013, I still never know/can’t know if this lack of eating and/or lack of interest in eating portends or not. Moreover, sometimes I wonder if the uncertainly is really the killer? I know it’s not the cure.

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