What's Left of Me
Page 78
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The doctor continues, “This disease is most often not curable. The way it’s treated is symptomatic. We look at what you’re experiencing and the results of the tests on your heart. Based on the tests we’ve done so far on you, your heart is in early stages of cardiomyopathy. You will need to be on heart medication for the rest of your life.”
“Okay, now I’m really confused,” I say. “Why are you mentioning surgery if this isn’t curable?”
“Because over time the heart can become overly large, putting a lot of strain on your body as well as weakening the muscle. Your heart valves can thicken and become narrow, making it extremely difficult to pump blood through your body. Our goal with medication is to keep that from progressing. Surgery won’t cure it, but it will reduce the risks of heart failure. A small percentage of patients are treated successfully with medication alone, and are eventually able to go off the meds while being monitored very closely. I will do everything I can to try and get you to that point.”
My mom doesn’t speak; she just continues to cry softly in her chair. I squeeze her hand, letting her know everything is okay.
I thought I was done with it all. Chemo is done. My transplant is over. My markers are low, and my blood counts are great. I thought the surgeries, medication, and tests were going to be over with. I want them to be over with.
I need to be done with it all.
Nothing is ever as it seems.
“What happens if the medication doesn’t work?”
“Your heart will become weaker, potentially causing you to go into cardiac arrest. But you will be closely monitored to prevent it from getting to that point.”
My mom’s cries become a little louder.
“If we have to do surgery, where does that leave me?” So many questions are bouncing around inside my head that I’m not even sure I am making any sense or getting them all out.
“I simply can’t answer that right now. There is no way of knowing the condition of your heart in the future.”
Not letting him add more, I interrupt raising my voice a little, “Hypothetically speaking, what happens? What have you seen?”
“Every patient is different. There is no way of knowing how your heart will tolerate the medication. You may be okay with just that, or, over time your heart may become too weak, necessitating that I go in and open the valves back up, or place a stent. If I can’t repair that damage, then, based on what I see at that time, we’ll have to look into other options. Worst case scenario, you go into cardiac arrest, and we have to look into bypass surgery. At this point, I can’t tell you what will happen, or even if you’ll ever need surgery.”
Cardiac arrest.
I have gone through hell and back. I have survived cancer—twice. But I can’t survive this.
“This won’t be easy, Aundrea.”
When has life ever been easy?
“Will the medication be enough? I don’t know. I hope so. My job right now is to keep your heart from going into failure.”
Failure. “Failure?”
“Aundrea, with dilated cardiomyopathy, you are at a high risk of going into heart failure, which is why it’s very important we start you on medication and monitor you very closely to make sure it’s working properly.”
“Fucking great,” I mumble.
“Aundrea!” my mother yells from the chair next to me.
“I know this is a lot to take in, Aundrea, but Dr. James isn’t telling you you’re going to go into heart failure. He’s simply giving you all the worst case scenarios. Maybe we should all take a moment to breathe,” Dr. Olson offers.
“I think that is—”
“No. I don’t want a break. I just want to hear this right now.” I speak over my mom. “I’m tired of breaks. What happens if—when—I go into heart failure? Are you saying I may have a heart attack?”
“Not necessarily, no. I’m saying that eventually your heart may start working overtime, causing major stress on it, as well as your body. Which, in turn, causes your heart to slowly, over time, shut down. What happens then? Well, you may need a permanent device implanted in your heart, like a pacemaker or, as I said a minute ago, you might need bypass surgery. Yes, you are at risk of having a heart attack, but that is what we are trying to prevent. We are trying to prevent all of this.”
I swear under my breath. I can handle being told I have cancer. I’ve been told it before and I know how to deal with it. I’ve beaten it before; I can do it again. I was prepared for that news today. But this? This is something I never imagined.
“I need time to process all of this.” I start to stand.
“Excuse me?” Dr. James asks.
“I can’t sit here. I was prepared to be told my cancer was back. Not this. I can’t think clearly. I need to get out of here. I’m sorry.”
“Aundrea, I think it’s important that you sit back down and hear everything Dr. James has to say.”
“Aundrea, you said you didn’t want a break. Let’s discuss this, okay?” my mom says, pulling on my hand to get me to sit back down
Did I not make myself clear? “I’m entitled to change my mind! I am tired of people telling me what to do and where to go.”
I have so many emotions running through me that I can’t even think straight.
Being pissed sounds so much better than crying.
“Aundrea,” Dr. Olson says in a soothing voice, “I know this is hard to take in right now, but if—”
“Okay, now I’m really confused,” I say. “Why are you mentioning surgery if this isn’t curable?”
“Because over time the heart can become overly large, putting a lot of strain on your body as well as weakening the muscle. Your heart valves can thicken and become narrow, making it extremely difficult to pump blood through your body. Our goal with medication is to keep that from progressing. Surgery won’t cure it, but it will reduce the risks of heart failure. A small percentage of patients are treated successfully with medication alone, and are eventually able to go off the meds while being monitored very closely. I will do everything I can to try and get you to that point.”
My mom doesn’t speak; she just continues to cry softly in her chair. I squeeze her hand, letting her know everything is okay.
I thought I was done with it all. Chemo is done. My transplant is over. My markers are low, and my blood counts are great. I thought the surgeries, medication, and tests were going to be over with. I want them to be over with.
I need to be done with it all.
Nothing is ever as it seems.
“What happens if the medication doesn’t work?”
“Your heart will become weaker, potentially causing you to go into cardiac arrest. But you will be closely monitored to prevent it from getting to that point.”
My mom’s cries become a little louder.
“If we have to do surgery, where does that leave me?” So many questions are bouncing around inside my head that I’m not even sure I am making any sense or getting them all out.
“I simply can’t answer that right now. There is no way of knowing the condition of your heart in the future.”
Not letting him add more, I interrupt raising my voice a little, “Hypothetically speaking, what happens? What have you seen?”
“Every patient is different. There is no way of knowing how your heart will tolerate the medication. You may be okay with just that, or, over time your heart may become too weak, necessitating that I go in and open the valves back up, or place a stent. If I can’t repair that damage, then, based on what I see at that time, we’ll have to look into other options. Worst case scenario, you go into cardiac arrest, and we have to look into bypass surgery. At this point, I can’t tell you what will happen, or even if you’ll ever need surgery.”
Cardiac arrest.
I have gone through hell and back. I have survived cancer—twice. But I can’t survive this.
“This won’t be easy, Aundrea.”
When has life ever been easy?
“Will the medication be enough? I don’t know. I hope so. My job right now is to keep your heart from going into failure.”
Failure. “Failure?”
“Aundrea, with dilated cardiomyopathy, you are at a high risk of going into heart failure, which is why it’s very important we start you on medication and monitor you very closely to make sure it’s working properly.”
“Fucking great,” I mumble.
“Aundrea!” my mother yells from the chair next to me.
“I know this is a lot to take in, Aundrea, but Dr. James isn’t telling you you’re going to go into heart failure. He’s simply giving you all the worst case scenarios. Maybe we should all take a moment to breathe,” Dr. Olson offers.
“I think that is—”
“No. I don’t want a break. I just want to hear this right now.” I speak over my mom. “I’m tired of breaks. What happens if—when—I go into heart failure? Are you saying I may have a heart attack?”
“Not necessarily, no. I’m saying that eventually your heart may start working overtime, causing major stress on it, as well as your body. Which, in turn, causes your heart to slowly, over time, shut down. What happens then? Well, you may need a permanent device implanted in your heart, like a pacemaker or, as I said a minute ago, you might need bypass surgery. Yes, you are at risk of having a heart attack, but that is what we are trying to prevent. We are trying to prevent all of this.”
I swear under my breath. I can handle being told I have cancer. I’ve been told it before and I know how to deal with it. I’ve beaten it before; I can do it again. I was prepared for that news today. But this? This is something I never imagined.
“I need time to process all of this.” I start to stand.
“Excuse me?” Dr. James asks.
“I can’t sit here. I was prepared to be told my cancer was back. Not this. I can’t think clearly. I need to get out of here. I’m sorry.”
“Aundrea, I think it’s important that you sit back down and hear everything Dr. James has to say.”
“Aundrea, you said you didn’t want a break. Let’s discuss this, okay?” my mom says, pulling on my hand to get me to sit back down
Did I not make myself clear? “I’m entitled to change my mind! I am tired of people telling me what to do and where to go.”
I have so many emotions running through me that I can’t even think straight.
Being pissed sounds so much better than crying.
“Aundrea,” Dr. Olson says in a soothing voice, “I know this is hard to take in right now, but if—”