This is hard to write.
But not for the reason you might think—not because I have bad news or a difficult update to share.
This is hard to write because I feel like I’m hibernating. Let me try to explain.
When the new year rolled in a few weeks ago, the usual chatter ramped up about resolutions and resets. It was a season for fresh starts and new endeavors. Offers to help improve your body, mind, or soul were abundant—join a gym! Start Duolingo! Read the Bible in a year! January is the season of improvement, of betterment, of doing something to make your life more organized or more productive or more enjoyable.
The only thing I wanted to do was hibernate. The prospect of filling a den with cozy warmth and curling up for an extended period of drowsy napping sounded like the most wonderful seasonal activity I could imagine.
This is hard to write because you don’t have much energy when you’re hibernating.
Hibernation is the process by which some animals are able to conserve energy for long periods of time. Their heart rate slows—the marmot’s heart beats only a few times per minute—their body temperature drops, and their metabolism crashes. The arctic ground squirrel hibernates for seven or eight months without eating or drinking. Some bears will wander and forage if it’s warmer or food is easy to procure but then head back to their dens if it's cold or difficult to find food.
I was not in fact slowly morphing into a bear or a hedgehog. My hibernation was not directly due to the winter darkness, though doubtless that has intensified the desire to do precisely nothing. Rather, it has been a hibernation born of treatment fatigue.
This is hard to write because of the fatigue.
The fatigue has not been primarily a physical tiredness. That’s part of it, but it feels more like mental and emotional tiredness. Even though my body has the energy to be up and moving around, my mind seems to exist in a perpetual fog of “I can’t even!”
The other word scientists use to describe bears’ hibernation is torpor, which feels perfect to describe the past few months. (And to be precise: Bears only experience torpor, not actual hibernation.) One dictionary describes torpor as “physical or mental inactivity; lethargy.” So, yes—if lethargy is torpor and torpor is part of hibernation, then I have embraced my inner bear this winter.
I’ve had to ration my mental energy in particular, since I do wish to remain gainfully employed and full-blown hibernation is frowned upon as an employee activity. Writing takes more energy than other tasks, which means that writing for The Incurable has been on a hibernation hiatus.
This is hard to write because writing is tiring.
How long will this hibernation—this torpor, this lethargy, this fatigue—last? Well, similar to actual bears, no one knows for sure. But it does seem mostly to be the effect of my targeted therapy treatment, the one that suppresses my white blood count so significantly. In the past few months, I’ve had to be on antibiotics twice, indicating that I’m not staving off infections as robustly as we’d like. And this leads me to the …
Treatment Update
This past week I had my quarterly appointment with my oncologist. But—he wasn’t there, and instead I met with Miss Terious. [Not her real name. Miss Terious did tell me her name but I don’t remember it.] I assume she is a doctor? She didn’t tell me who she was or why I was meeting with her and at first I assumed she was a nurse, not because woman = nurse and man = doctor but because usually the person who calls me from the waiting area is the nurse. Miss Terious called me from the waiting room but then we went straight into the consultant room and no one else was there and she was halfway through my scan results before I realized that my appointment was apparently going to be with *her* and no one else was going to be making an appearance.
A note: Maybe don’t surprise your hibernating, torporous patients with completely random new medical providers without explanation!
The unexpected presence of Miss Terious aside, it was a helpful appointment. My scans continue to show stable disease. That is the good news. Miss Terious felt like my fatigue levels were significant and serious enough that we need to consider some options for the targeted therapy. I’m already on the lowest possible dosing regimen so we can’t reduce it further. Instead, I’m going to take a break for several months and see whether I have the energy to emerge from hibernation.
I have a couple of important scans coming up. My usual scans are from “neck to knees” to check for progression. I’ll have another one in a few weeks to also check my noggin, which we have so far done only once a year. Then I’ll have another “neck to knees” scan this spring after the targeted therapy pause. We always hope for no progression of disease, but especially so for that scan. If the disease remains stable, that will give us more options to consider for managing that treatment line.
Prayer Notes
Someone prayed about the veins in my hands for my last bone med infusion! Thank you! I had the gentlest nurse who was so careful and promised me she wouldn’t try to insert the IV unless she was sure she had a good vein. She did indeed get it in on the first try, and I barely felt it. I’ll get that treatment again next month, so feel free to keep praying for gentle nurses and cooperative veins.
I would love to experience an energy boost from this targeted therapy pause.
Pray for no progression on upcoming scans.
A Little Music Lagniappe
One delight from being a mama bear is having my cubs share their musical discoveries with me. This Canadian singer, Ché Aimee Dorval, has one of my favorite voices—I could listen to her sing an encyclopedia. Luckily for all of us, she’s just released a new album, and it is gorgeous.
Apparently Substack is now including a button down here to allow you to “pledge” for this newsletter, which would convert to a paid subscription if I switched on that option. I’m curious—what to you would be worth paying for? Extra subscriber-only posts? A subscriber-only podcast? Or something else? Right now I don’t have plans to introduce a paid version—and I’d keep a free version even if I did—but since Substack has raised the question, here’s your chance to have your say! Hit “reply” or leave a comment.
Ich denke an Dich und bete für Dich. Umarmung Babette
I love getting these updates from you, especially to know how to pray. Thank you for taking the time and using energy to send this. We love you!