Careening Around Cancer - A Surreal Odyssey: Prelude

I awoke one morning in 2016  to find that my voice had risen at least half an octave.  I disliked this whiney six-year-old voice.  I had been there and done that as a whiney six-year-old in a stoic family.  My dislike of the voice did nothing to change it.

About this same time food was becoming difficult to swallow.  I had a barium swallow test.  Barium is opaque to x-rays.  The victim is given barium-laced drink and foods of graduated difficulty to swallow, while the x-rays take pictures.  I had a narrowed esophagus.  A gastroenterologist stretched my esophagus and invited me to an explanation of his findings. 

At the same time, my wonderful PCP, worried about my weight loss, arranged a PET scan; the PET scan showed that the 14 ½ year old breast cancer was now metastatic to some vertebrae and to a mediastinal (between the lungs) mass.  Of course, I went to the explanation of the PET scan and returned to my favorite poisoner for chemotherapy.  I forgot about making the esophagus appointment

The chemotherapy made me bald again - no big deal – been there, done that.  The Oncologist’s organization gave me some colorful hats and I was happy to read or doze in a reclining chair for a few hours each week.  The only troublesome side effect of Taxotere was that it damaged the peripheral nerves in my hands and feet; stroking silk feels like stroking sandpaper.   I have become even more clumsy and my hands and feet tingle, not unpleasantly, most of the time.  I use pliers to open twist off caps.  I continued with my Oncologist until the organization that had head-hunted him from Martha Jefferson fired him, a nasty ploy, I thought. 

I returned to Martha Jefferson and found a knowledgeable and sensitive new oncologist. My hair grew back, on a gentler, but effective regimen. After happy months at Martha Jefferson, I signed up for a clinical trial at UVA.  I read in C’ville  about a new bi-specific, hybrid, antibody, one part of it attached to killer T cells, and the other to cancer cells, creating a bridge.  Intrigued with the ingenuity of the idea, I looked up the researcher in the UVA phone book and called; I expected that an efficient secretary would answer and tell me to go fly a kite.  I was nonplussed when Dr. Lum’s answering machine answered.  I hesitantly offered my services as a guinea pig.  

The next week a doctor who ran some medical clinical trials at UVA called me.  He said that Dr. Lum’s idea was not yet ready for trial, but he had a monoclonal antibody that was.  I interviewed him later and agreed to join the clinical trial of Margetuximab.  The end point  of the study was progression of the subject's cancer or the subject’s death.

For me the trial involved going to UVA’s Emily Couric Cancer Center for infusion weekly and undergoing various scans every so often.  I went faithfully to my appointments, despite the dreaded UVA hospital parking garage.  I continued to lose weight.  My blood pressure had been high a year ago and I took Lisinopril for it. As I lost weight my blood pressure plummeted.  I remarked to the doctor running the study that I must consult with my PCP about stopping the blood pressure medication.  The doctor running the study made clear to me that he was now my doctor and that I should stop taking Lisinopril.
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On December 31, I woke up with a voice that was practically only breath.  Ox said he wanted to go to Lowe’s and Kroger.  I asked if I could come along;  I wanted to buy food like eggs, jello and ice cream that I could swallow easily.   I’d read while he was in Lowe’s and go with him to Kroger.  As we walked into  Kroger I started gasping for air and emitting a choking cough.  Ox got me sitting down at Kroger’s little coffee shop where I half lay across the table gasping.  A kind, concerned worker came over to us and asked if she could help.  She stood by as I continued to gasp.  After about 15 minutes the fit subsided.  The kind worker came with us to help me into the car.  Ox thanked her and offered her a twenty dollar bill.  She demurred, saying she was “paying it forward.”  Ox asked me if I’d like to go to the emergency room.  New Year’s eve in the emergency room sounded ghastly.  I said I just wanted to go home.

The very best thing that I have learned from this return of cancer is how truly kind. People can be.

Egrets and Dolphins - OH MY!

When we visited Chincoteague last Christmas season, we drove out in the rain towards the ocean on Assateague Island.  Rain on the ocean is often beautiful.  As we drove back towards Chincoteague, the sun came out; blue skies showed through the thunderheads, and at a pond-side marsh we saw a tree illuminated by sunbeam, completely covered with white egrets.  Though we visit Assateague often enough I had never seen such a large group of egrets, and I had seldom seen egrets in trees.  We discovered that a flock of egrets is called a congregation or a colony of egrets.

We often stay at an inn on the tidal Eel Creek on Chincoteague Island.  A great marsh with brackish pools lies beyond the creek. Large glass doors look out from the living room onto the creek and marsh. Two rusty trailers sit to the west of the inn’s wooden landing, and two lonely trees stand in front of the trailers.  In the mornings, as the sun comes up, we often hear the dawn squawk at the inn – several species of birds give voice at once to the rising sun.  Then the dawn parade starts.  Varieties of geese and ducks swim grandly west on the creek in formation or not.  Solitary heron and egrets fly with great slow heavy wing strokes to the ponds on the marsh.  The fishing day has begun.

The morning after we arrived in Chincoteague a few weeks ago, I slept till nine.  Ox, a sensible tourist, woke just before dawn.  He looked out our living room doors and saw the two trees covered with egrets facing east.   Each tree had, what he described as a priest egret at the very top.  As the sun rose the priest egrets, and seconds later the rest of the congregations, gracefully flew east to fishing spots on the creek.  Ox reported that the moment felt like a well-practiced sacred ritual.

The next morning as Ox slept, I looked out the doors before dawn.  Again the trees were covered with egrets, this time facing west.  At the top of each tree was a priest egret.  The world was hushed.  As the sun rose, the priests flew west and out of sight, followed by the congregations.  The dawn squawk sounded.  The directions the egret congregations flew likely had to do with the tidal currents in Eel Creek and the fish.

Ox decided that we should once again take Captain Dan’s boat tour around Chincoteague Island.  When we had done this before we’d learned a great deal about the island history and wildlife.  On our first trip we saw three bald eagles and a variety of birds as well as the famous wild Chincoteague ponies.  [I am not overwhelmed by the wild ponies as they are vaccinated every spring, fed when forage is sparse, and rounded up a couple of times of year.]  Captain Dan is a 3^rd or 4^th generation Chincoteague fisher.  He knows the history and wildlife of the island and of Assateague well.

This trip, the highlight was a sighting of about five pods of dolphins.  I have seen many dolphins before, but only on PBS.  These dolphins came into view as we came to the channel that led to the sea.  The five pods of dolphins ranged from five members to two.  In each pod as one dolphin rose to the surface the next dolphin dove, weaving a wonderful tapestry of motion.  The graceful arcs and rhythms of the dolphins left me speechless and awestruck.

OH MY!

Pests on the Beach: Canada Geese, Wolves and Lifeguards

The swimming beach at Mint Springs Park is enclosed with a tall, black, vinyl-clad chain link fence.   Canada Geese, who live in the park day and night during the school year, only visit the park at nighttime in the summer.  The pond is open for swimming during summer days.  Cars and trucks litter the parking lot.  The noise of children and teens enjoying themselves fills the air.

A pleasure of dusk at the park is the sound of a gaggle of geese coming in for a landing on the pond.   With hysterical hoarse honks and much back feathering about 25 geese land on the pond; they swim directly to the beach.  Earlier, on spring evenings, they spent time on the dam, pecking in the grass, or over by the picnic tables near Shelter One before they swim to their nighttime beach.  Canada Geese are not tidy; the geese defecate everywhere they land. 

 

At night the tall chain link fence gives the geese protection. The park is rife with predators.  Sometimes at night a few coyotes howl.  Bears, raccoons, hawks, and foxes visit after hours.  Occasionally a skunk perfumes the air.

While many of the geese sleep sound in the beach enclosure, a few keep their necks erect scanning the surrounding park for threats.  These sentinel geese detect enemies digging under the fence. One night recently, Ox waited for me as I walked around the pond.  It was almost dark when I returned to his picnic table. He said “Come, I want to show you something”.  The light had almost gone.  I could barely make out the form he pointed out.  Beside one of the lifeguard stands I saw what looked like a moth-eaten wolf, lowered head pointed at the herd of geese.  The wolf didn’t move.  The geese didn’t move. The sentinel geese didn’t more, and, oddly, didn’t even utter.

The next evening the wolf mystery was partly solved.  In the earlier evening light, the wolf, now lying on its side under the lifeguard stand, was clearly a rubber or plastic wolf.  My first hypothesis was that a lifeguard, clowning, wore the wolf on his head to amuse the children.

The evening after that there were two wolves at the beach, each lying under a lifeguard stand.  I took pictures.

We drove to the park later than usual one night.  We stood on the footbridge over a side pond ringed with young willows and watched as turtles surfaced their heads; when they spotted us, they sank into the murk leaving concentric rings in the water.  A rangy woman came up to us.  She said that she often came up here in the evenings to swim.   She talked to the life guards one evening.  They were worried, she said, about the pond as a source of disease.  After a day at work in the sun a couple of them felt tired and had headaches.  They feared that the geese might be a source of infection.  Suddenly the wolves made sense.  Hypothesis two is that the wolves are intended as goose repellents.

Obviously, as the goose flock sleeps under the wolves' noses, the wolves did not immediately work as goose repellents.  However, for the last two nights we have arrived at dusk and stayed until past dark, and the goose flock has not shown up.

For the last two weeks, all but one of the gates onto the beach has been locked with chains and padlocks.  The first time we noticed it, one gate had an unsecured chain wrapped around it.  After that first night the chain wasn’t even there.  I have a lawless streak and had a desire to surprise the lifeguards.  Last night, as Ox stood watch, I opened the gate, took each wolf from under its lifeguard stand, and posed the wolves on the stands.  I felt a surge of scofflaw joy as I did this.  Ox wiped my prints off the gate as we left.  You see before you a 77 year-old woman turning to the dark side and a couple of wolves coming out from the shadows.

 

                                                                                    

Solace at the Park

We have consoled ourselves this July for missing the wedding of a much-loved niece in California, by visiting Mint Springs Park every evening.  We go just before sunset, late enough in the day that few people are still at the park.  There are almost always one or two families of fisher people, sometimes a pair of lovers stroll over the dam hand and hand, sometimes mothers with small children play on the slides.  Twice the owner of the scofflaw dog has let him out at the top of the park to run, joyful and unleashed, down to the lower pond.  Every evening there is some surprise waiting for us at Mint Springs.

One night we found joy in the birds.  As we drove up to the park, a heron flew round the pond to the far marshy bit where the stream comes in from the hill above. 

Red-wing blackbirds had flocked and nested here for many years.  Muskrats gnawed down the cattails last fall and winter.  This spring the flock of red-wings returned, checked out the sparse remnants of cattails, and flew on.  This night we discovered two nesting couples of red-wing blackbirds had returned to the diminished stand of cattails. (Sadly, the muskrats, we have heard, have been relocated by park people; their silvery v-shaped wakes always thrilled us.)

We walked around the pond, passing quietly behind the flock of geese that often hangs out on the dam.  Though Canada geese are the hysterics of the bird world, they are so used to us that when we walk behind them they barely murmur anymore. 

 

Tree swallows, swooped over the pond, graceful streaks of blue, and flashed their white bellies as they switched direction.  As we rounded the pond to the farthest and most remote corner, we spooked the heron, who took off from the water with great, slow wing strokes. 

 

A little further into the woods and we heard the cacophony of a few coyotes.  Their howls are high pitched and eerie.

The sundown was the feature of another night.  A line of orange sunlight shone over the western notch and backlit the hills.  Piles of clouds in the east colored first gold, then orange, then rose, and faded into dark gray.  Reflections in the water were brighter than the colors in the sky.  The crescent moon shone in the western sky.   Every night that I have not brought a camera, we have had a beautiful sunset.

Tonight we were tired and sat for half an hour at a picnic table on goose beach watching turtles’ heads surface, gasp air, and then disappear in concentric rings of water.  We listened to the frogs – crickets, green frogs and last, the deep voiced bullfrogs.  Dragonflies darted, touching down to the water from time to time.  Fireflies rained upwards.  A movement caught the corner of my eye just as Ox said “Look, Jenny.”  A young raccoon, oblivious of us, sniffed around the picnic table five yards south of us; he was poking around for supper.   As he got closer to us, I got a little nervous and we stood up.  He startled, then waddled with deliberate speed behind the nearest trees.  He peeked out from behind a near tree, then from between two trees, and as we left so that he could dine, he climbed up the farthest tree.