The battle is joined.
Before we had to see Dr. Carson and Dr. Maddaus on the 24th of June, most of the time was spent getting Joanie back in shape. I got her to walk almost every day, and then she would spend time tending her new “garden” in the backyard. Actually, she more or less directed me in the tending part of it. She was still restricted from any heavy lifting because of the surgery, and she made the most of it. We would go to one of the plant places in Bismarck, and pick out more plants to spread around the deck and the yard, and of course, watering those was one of my regular duties. I didn’t mind. Our backyard park was looking pretty good.
During this time we didn’t talk much about what lay in store for her next, preferring to revert to our agreement to not let this disease dictate our lives any more than it already did, and to enjoy the good times when we had them.
The day came to leave for the trip to Minneapolis, and her appointment with Carson and Maddaus, and her routine was the same as it had been for any of the other countless trips we had made already. I didn’t rush her, since we had all day to get there. We would be staying with Ginny and Ed in St. Paul, and we would be there by six. She was looking forward to seeing them, and especially eager to see her three-legged friend, Piper. As always, he was glad to see her as well.
Joanie was apprehensive about what was coming, something I considered normal. I was as well. We still didn’t have the complete picture, but just a glimpse that included chemotherapy. The hair thing was still weighing on her.
Dr. Carson was her first appointment the next day. It wasn’t until one o’clock so she had plenty of time to stew most of the morning. We did go for a bagel and coffee at a place on Grand Avenue in St. Paul, and then she wanted to go shopping at a couple of her favorite stores there. We skipped lunch, since neither one of us was hungry, and were at the clinic shortly before the appointed time.
We checked in, and it wasn’t long before a nurse came to the door of the waiting room and called her name. It was time to get the full story. Dr. Carson came into the examination room, and after greetings and small talk, she got down to business. Carson was really good about dealing with negative news in a positive manner. This was one of those times when she really had to work at it though. She told us what the pathology report had shown, the lymph node involvement, and the biopsy from the neovagina, and said that everything indicated that chemotherapy was the next option as far as treatment was concerned. The fact that it had moved off of the cervix and metastasized to the lung indicated the problem was now systemic, and the only way to control it was with chemotherapy.
She said that, and then the question was what kind of chemo, and what kind of treatment. We didn’t have a clue, not having done any research since that would have only confused us more, since every cancer is treated differently, and every patient is treated differently depending what kind of cancer it is and where it is.
Joanie sat there, quietly listening to Carson, and I could tell by the look on her face this was unwelcome news, even though she knew it was coming. I think she’d been praying for some kind of miracle to occur before she got to the meeting with Carson.
Dr. Carson then suggested that she consider taking part in a clinical trial that was going on at the University. We had no idea what that was, but Carson went on to explain that this trial was a study being conducted to determine the efficacy of using three cancer drugs to treat recurrent cervical cancer. She told us standard treatment for advanced cervical cancer was either Cisplatin, or Cisplatin and Ifosfamide (Ifex) combined. This study was taking a look at using a drug called Paclitaxel (Taxol) in combination with the other two drugs. The sponsor of the study was Bristol-Meyers Squibb, and the Dr. Carson was one of the investigators at the University of Minnesota Fairview-University Medical Center, along with four other doctors.
Participation in the study was voluntary, and it would involve one infusion of the three drugs every 28 days for a total of six treatments. In between there would be weekly blood draws, which could be done in Bismarck, to keep tabs on the affect of the chemo on her white and red blood cells and kidney and liver functions. All of the treatment would take place at the Masonic Cancer Center located next to the hospital, and each one would take about six hours to deliver the drugs. She would meet with Dr. Carson before every treatment for an assessment by her.
Joanie asked her about nausea, and Carson said there would be drugs available to deal with any nausea or vomiting as a result of the treatment. Then Joanie, smiled and asked her the most important question on her mind, “Will I lose my hair?” Dr. Carson, said there was a good chance she would, but it would grow back if she did when the treatment was over.
Joanie asked me what I thought, and I told her if she was going to have chemo, taking part in a research study might be a good thing, so she agreed, and told Dr. Carson to sign her up. Paper work completed, Carson said she wanted to do an exam before she left, and when that was done we went to see Dr. Maddaus. That appointment would be less stressful.
We left the clinic and went next door to the Masonic Cancer Center for the appointment with Maddaus. When he came in, he was in good spirits, and as he always did, made Joanie immediately comfortable. He wanted to know if she had any respiratory issues he should know about, and she told him none. He took a look at her wounds, and said they appeared to be well healed. Joanie and him talked about what was in store for her, and he told her she had made the right decision by taking part in the clinical trial. He then told her, that as far as he was concerned she could go, and she would never have to see him again. She smiled, thanked him, and we left.
It was now around three o’clock in the afternoon. Joanie said she was going to use the rest room, and then she wanted to go to Sally’s. We got to Sally’s and she ordered a glass of wine, and we talked about what had just happened, and what it meant. She was looking for some reassurance that she had made the right decision, and I told her emphatically she had. She told me she was going to beat this thing, and I said I think you’re in the right place to do battle with it.
That night we went to dinner Tavern on Grand with Ginny and Ed, and the mood was upbeat, despite what she was facing. She was resolute, and determined to take charge of this, and I thought that boded well.
The next day, before we left town, she wanted to stop at Dayton’s downtown so she could look at hats. Hats she could wear when she would lose her hair, which she was sure she would. We looked at many hats, and she ended up buying two, and I think she did so reluctantly, as if by doing so she was accepting the fact she would have to endure losing her hair during this treatment. She never wore either one, even when she lost her hair. She ended up wearing one a friend had made for her.
It was now Wednesday, June 25th, and we had until July 14th before we had to make this trip again, and it would be another one of those trips filled with uncertainty, trips we had become very familiar with, but until then, she was jumping back into work and life with new energy.