[cancer] Talking to my oncologist about mental and emotional health

Saw the oncologist yesterday immediately after my bloodwork. This isn’t the usual order of things, as they prefer to see me the same day as the chemo infusion, but that’s how the scheduling fell out. As, happily enough, I managed to get through this past chemo cycle with no major side effects crises, we wound up talking about my mental and emotional health instead of doing another round of crisis management.

I told her I’d been experiencing a lot of depression and despair these past two weeks. Episodically, not continually, but frequently and strongly. We talked about the blatantly obvious reasons for this, and the less obvious ones.

Obvious to anyone: I have cancer. Duh. And I’ve hit the point in the chemo cycle where I am hard of thinking, and everything has a huge, dire edge. I’m very worried about having another metastasis and jumping right back into treatment in the spring, doing all this shit again and losing another year of my life to the disease.

Less obvious unless you’re familiar with my personal situation: I continue to very much miss my vanished primary relationship, and am at a point where the emotional support of such a relationship would be hugely important if I had it. Also, this is about the time last year when my relationship with [info]calendula_witch really began to disintegrate, so there’s lots of bad echoes these days. And then there’s the whole no more writing thing that’s come on during this chemo cycle, with its attendant consequences for Sunspin, and more generally, my writerly identity.

We discussed whether to go on antidepressants. [info]kenscholes is convinced I need them. I am very resistant to adding yet another psychotropic drug to the hellbrew that goes into my body every two week cycle. She recommended Celexa as being compatible with my other medications, but strongly felt my depression was situational (with which I agree) and that I should wait until I’m off chemo and see how things are going. In terms of depression, I’m still quite functional within the limits of chemo; I don’t spend my days in bed, I meet all the obligations my reduced energy levels allow, and so forth. So it’s an open question.

The most disturbing part of the conversation was when we got back to the potential for further metastasis. She was pretty blunt, and said that my fear was justified and it was quite possible that was what would happen. 50/50, frankly. There aren’t kind words for this, that’s my life with cancer, but it still was kind of a whammy. And yes, I’d rather hear the straight dope than something kindly, but that doesn’t make it any easier.

All in all, a worthwhile but not satisfying conversation. This is the world I live in.

5 thoughts on “[cancer] Talking to my oncologist about mental and emotional health

  1. I’m really praying you fall on the joyful side of those odds and we get to celebrate a long friendship in times ahead.

  2. stevie says:

    Jay

    50/50 are still pretty good odds; I have survived for decades with odds far worse than that. 26 years ago my lungs were colonised by a strain of Klebsiella pneumoniae which, after 9 years, had mutated to the point where gentamicin was the only antibiotic which it was sensitive to. And then it went away, for reasons unknown, and I didn’t die.

    At around the same time I stopped counting my hospital admissions because it was replaced by a strain of Pseudomonas aeruginosa; that strain is now hypermutating and multi-resistant. My life expectancy is therefore once again more or less non-existent in statistical terms, but I do have the awareness that remission exists, and that no-one understands how or why it happens.

    I have had severe bronchiectasis since childhood and I recognise that it is very different for people who have always been healthy; speaking as a very long-term survivor the only advice I can give you is that it is really unhelpful to dwell on all the things your illness has cost you.

    This is something which I have seen in a lot of people who have suddenly become seriously ill; it’s almost as if they think that if they point it out then the illnes will become ashamed of itself and slink off. The illness doesn’t care; it just is.

    And you don’t even get a free pass on not being blown up by an exploding oxygen regulator; these things happen and you either accept that it’s the only game in town or you throw in the towel.

    I would defend on the barricades anyone’s right to throw in the towel, but I don’t think that you have reached the point where you want to do so, which is why I’m expending some time in suggesting that you should stop thinking about what you have lost and start thinking about what you have which is worth living for…

    1. Jay says:

      No, I am not throwing in the towel. I’m just tired and afraid. There is a difference… ;| I am sorry for the difficulties of your journey.

  3. Ruthie says:

    If I had reservations about more drugs in my system I would ask my doctor if I should be concerned that the anti-depressants would hurt my recovery and my body’s ability to heal. I don’t like drugs either and am always concerned about bad reactions but sometimes there are no bad reactions. If there were I could ask the doctor to wean me off or discontinue the drug at the doctor’s direction. If I were in a situation where I couldn’t do a cardio to get my mood up to where most normal people live and couldn’t take my fish oil and had a medical condition that was making me depressed I might seriously consider taking anti-depressants temporarily and only on the condition that they work well. Whatever you decide Jay it’s the right decision. Sometimes medicine/chemo is an art. Chemicals/meds react differently on different bodies. more hugs. (((Jay)))

  4. Ken Scholes says:

    Not convinced you need them but convinced you’re depressed (for good reason) and that they could help you weather that depression. I’m glad you talked to the doc about it

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