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[Cancer]

[cancer] Recovery curves

I’ve spent quite a bit of time the past few days with (and regretfully less time with the delightful , sadly). We’ve been talking about a lot of things, including the dynamics of illness and recovery. I had an insight which I don’t yet fully understand, but I believe as I pick at it, this insight will inform my continued journey of cancer.

I’ve been arguing for a while both sides of the question as to whether I should view my situation as chronic or acute. The cancer is most likely acute in the medical sense that I still reasonably expect a full recovery and a return to my baseline pre-cancer health. In other words, the adaptions of chemo are not permanent as they would be with MS or lupus or other chronic conditions.

At the same time, between surgery, chemo and post-chemo recovery, even assuming full recovery, I’ll have been significantly out of my baseline health profile for ten to twelve months. That’s far longer than the acute distress of influenza, or even minor to moderate trauma. In other words, my behavioral and emotional/social adaptions effectively need to mimic those of a chronic illness, in that they stretch over a long term, far past the six-week window of habit formation and habit breaking. To put it more simply, going to bed with the flu for a week doesn’t really change your life. Going to bed with chemo for six months does.

This chronic vs acute distinction has a lot of implications I’m still exploring. It’s not a judgment, it’s not an issue of attitude, it’s an analytical tool. And talking to about his medical experiences of this last year has expanded that tool, as I’m now noodling with the idea of recovery curves.

In an ordinary acute illness, minor-to-moderate surgery, or minor-to-moderate trauma, without further complications, the recovery curve looks something like this:

recovery_curve_1

You experience a rapid decline, then you slowly improve until you return to your baseline. The degradation in quality of life and the medical stress is front-loaded, while the majority of your time is spent getting better, both literally and figuratively.

Chemotherapy (at least for someone with my general prognosis) has a recovery curve that looks something like this:

recovery_curve_2

You experience a slow decline over time, with a relatively compressed period of of getting better once the chemotherapy has conclude. The degradation in quality of life and the medical stress is continuous (albeit uneven), while the improvement is narrowly backloaded. (Cut the recovery backload off that curve, and you have something approximating the long term course of a true chronic illness.)

What does this mean? Heck if I know, yet. But it’s interesting to me. It has implications for my self-image, my self-management, how I allocate and acknowledge my emotional, social and physical resources. Hopefully I’ll produce a much more cogent analysis in the next week or two. In the mean time, I’m curious what you guys think, especially those of you who have ridden either of both of those recovery curves. And if you bear a true chronic illness, how does this read to you?

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