Ana’s Chemo
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Ana and Tommy (2018) (Photo courtesy of Ana Segovia)
“I found a lump in my breast a few days ago. I had a mammogram and ultrasound yesterday. Today they did a biopsy. I have cancer and it has spread to my armpit.”
I froze.
“My lymph nodes in that area have enlarged because of the cancer. Please pray for me.”
Pray? What about I cry first? But her husband, Tommy, already beat me to it.
“I am not afraid,” Ana wrote. “My sadness comes from the thought that if I die, he will be alone.” Uhm, not exactly. They have two girls – Inia and Kat – but true, both have long grown and moved from home.
Over the next days, weeks and months, Ana and I wrote each other every day. Writing was our preferred way of communicating as it was less interruptive and repetitive. “Better or worse?” I always began, wanting to know if today was better than yesterday.
Well wishes before her first treatment. (Photo courtesy of Ana Segovia)
It was a better day when we got the overall picture. There were cancer cells and enlarged lymph nodes dancing shamelessly in her right breast and armpit but at least they didn’t step foot on her bones and liver. Ana’s fearless team of doctors at Kaiser Permanente set a plan to kill all them bad cells with six aggressive chemo sessions three weeks apart followed by surgery and perhaps radiation or more chemo.
Her chemo treatments and side effects were explained. The procedure would go like this: 1) You check in with the receptionist who will take your temperature and weight. 2) You will be led to a cubicle with reclining chairs. 3) A nurse will introduce herself to you then attach a needle to a port that has been implanted in your chest. She will then connect that needle to a bag of special cocktails mixed just for you. In your case, you will have four chemo bags (of two chemo drugs and two antiher2 drugs) that will each be infused into your blood stream over 30 to 40 minutes. The process is painless, they concluded, and Ana decided it would be a good time to say prayers or catch up on Facebook and Netflix.
Waiting for chemo to begin (Photo courtesy of Ana Segovia)
Some patients, apparently, do not get ports implanted in their chests. The port is a small reservoir with a silicone tube that attaches to the vein. Without this implant, patients are fed through their veins by needles which could be both laborious and painful.
Either way, the body would react to the cocktails. To Ana, the forewarned side effects were nothing short of frightening. “I got scared because all the drugs going into my body will supposedly kill the cancer cells but at the same time there will be reaction from my heart, my nerves, my bones, my hair, etc. I will have to take various medicines to fight off those reactions. I will be weak and feel like I have the flu.” She added, “Isn’t that awful?”
You’re asking me?
On June 12, barely a month from the day she learned about the dreaded C, Ana walked into the hospital with a bag packed with a blanket, a book, Munchos, an iPad, a charger, cold packs for her hands, electrolyte drinks, a prayer book, and a crucifix. With a worldwide Covid-19 pandemic going on, no one was allowed in the hospital with her while she underwent her first chemotherapy treatment.
She was in good spirits. “I am now settled here in my private room with my own TV and windows to the right and left. My BP was 137/82 and no fever. I drank about 10 pills and my port is now connected to a pack of clear fluid. Very comfortable and no pain except when they poked the needle to connect to my port.” That was excellent news.
The next day was still good. “I must say that everyone’s prayers, masses, and positive vibes have resulted in no side effects! Maybe they will come in 24 hours but for now, I can do anything!” We breathed easy and thought all we had heard about chemo had been overly inflated.
But on Sunday her body started acting up. “It was a bad day,” she wrote. “Dizzy. Nausea. Achy tired bones. I felt like throwing up all the time. And this metal taste in my mouth! I could hardly eat and get up all day!” I tried to relate to the symptoms but all I could think of was a bad hangover and I knew it had to be worse than that.
On day six after chemo, I received alarming news. “Worst night ever! At around 1 a.m. I woke up, cold sweat, severe heartburn (as if I was having a heart attack), stomach cramping, throwing up! Dizziness. I told Tommy I prefer to die than to have chemo again!” Oh my. This was just the beginning.
She went on: “It kinda subsided at 3 a.m. and I was able to sleep a bit. Now it is diarrhea. I thought I was getting better but instead the symptoms got worse. I talked to my doctor and pharmacist. Need to drink more water. Tommy told me to daydream about good things. I am trying.”
But there were no good things. The next day Ana was in the emergency room with horrible diarrhea, nausea and stomach cramps. She was dehydrated and was hooked up to an IV. They changed her nausea medicine and sent her home. Later she was told that her chemo dosage would be decreased.
“Thank you Lord, my refuge, my fortress, in you whom I trust!” she wrote. “Oh, and my oncologist – she’s the best!”
But the cramping, dizziness, mouth sores, nausea, metal taste, etcetera stayed.
On day 15, Ana sent pictures. For as long as I’ve known her which is 50-plus years, Ana has had long, shiny and bouncy hair that puts all shampoo ads to shame. But today there would be no swinging long hair. Her tresses were falling off slowly, little by little.
July 2. “I woke up this morning with clumps of hair falling off. I asked Tommy to cut off my hair. He cut it as short as possible but there was still about an inch left. In the shower those short hair continued to fall off. After my shower I asked him to shave it off. I am now Mr. Potato Head. Very sad to look at me so no pictures. I have to tell myself it will grow back.
“I just realized my eye lashes and eyebrows are also falling off! How awful! But it is just hair. Stop the self-pity.”
The fourth of July came and there were no fireworks or freedom parades as Ana went in for her second chemo. After seven hours in the hospital, she and Tommy found a mom and pop restaurant with outdoor dining. Ana watched as Tommy ate and focused on what’s important. Ana was alive. “Tom said it was his best 4th of July celebration!”
The best 4th of July celebrated by Ana and Tommy, 2020. (Photo courtesy of Ana Segovia)
“Better or worse?” I continued to ask, noticing that there were more and more worse days than better days. She was eating much less and small achievements like walking half an hour on the treadmill became major accomplishments.
She asked, “I wonder if chemo makes me emotional? I cry a lot now when I am by myself. I know I am not the only person in the world going through this. I also know that many people have it worse.”
“I have cried so much already. I told Tom to go somewhere because I don’t want him to see me like this. My body cells are being eaten up by the chemo.” But with each crying fit she knew exactly what to do. “I pick myself up and go forward.”
The following week my best friend went to a cannabis dispensary and bought two kinds of cannabidiol or CBD oil. One was to alleviate anxiety and the other was to help her sleep. She wrote that it did help her sleep, but she didn’t want to tell her doctors about it because they might make her stop. Ha!
Unfortunately, relief was only temporary. After the third chemo, she continued complaining about nonstop vomiting and diarrhea. She was again rushed to the emergency room for hydration and change of medications. She wrote: “I will be discharged at 10:30 a.m. Story of my life. I will discuss chemo with my Onco next week. I need an alternative. This is too much suffering. I am better off dead.”
And the next day, “Please do not worry about me. We leave everything in His hands. I am back in the hospital.”
On August 11 I was surprised to read that she had gone for acupuncture. “I need all the help I can get,” she said, and would try the ancient treatment for a month. “If there is no change, then I just wasted my money. But if it helps, Alleluia!”
After Ana lost all her hair, she experimented with wigs. (Photo courtesy of Ana Segovia)
Four days after her fourth chemo, the response to my question of better or worse was “Worse. Worse. Worse.” The doctor had concluded that she had “anticipatory anxiety” or a fear or dread of oncoming nausea. This would cause so much anxiety and make matters worse than they really were. Oh, Ana. Can this be true? Whatever. The conclusion meant she needed one more medicine to take, this time to ease the stress.
Voila, a good day came in the middle of hell. On September 2nd they found that the lump in her breast was down from size 3.8 to size 2.0. The lymph nodes had also decreased in size. The chemo was working.
It was after her fifth treatment that I learned she hadn’t been driving in a while. She was too slow to get in the driver’s seat and too weak to step on the brakes. I learned she had stopped cooking after the third treatment and the treadmill was history. Even talking required too much energy so she no longer answered phone calls. Chemo had completely ravaged her body.
Ana was back in ER on September 14 for excruciating stomach pain. She had to be taken by wheelchair where she sat limp as a rag. She had lost over 15 pounds.
September 25, the last day for chemo, could not come soon enough but even as she thought she would finally be home free, she was again rushed to the hospital to address the critical results of her blood tests. “My red blood, white blood, magnesium, platelets, everything was low! I am now getting blood transfusion and magnesium. I hate this cancer!”
So did I. I hated cancer as much as I loved this woman. Ana was the life I needed after I lost my husband. Every year we ventured to more places together, each time learning more about the other and laughing harder and harder with every new thing we learned.
Finally there was good news. Exactly four months to the day of her first chemo, Ana received word that there would be no more chemo. No more chemo! And to this she shared, “If I were told to have more chemo I would have said no. I cannot go through that anymore. I would rather die.”
But that fear was moot because today she was told that her body responded very well to the treatments. “Supposedly my body ‘metabolically responded completely’ to chemo. I think that means cancer cells are no longer active in my body. In the PET scan, if the cancer is active, the cells are lit up. But mine was all dark. I guess they died! Woo hoo! Prayers answered!”
Sigh.
She wrote, “I will still need surgery but I am on the road to recovery. Thank you for sticking it out with me and making sure I did not quit. Chemo was hard but” with a drastic reversal of opinion she completed, “that hardship was worth it.”
But was it worth it, really?
I was treated for very early stage breast cancer when I was 55 and all I needed was a lumpectomy and radiation. But if lightning were to strike twice and I was diagnosed with cancer again, would I consent to undergoing chemo? Would you?
Chemo is a bitch of a cure. I had heard complaints from a number of friends, but it wasn’t until now when it reached one of the most important persons in my life that I realized that everything I had heard and read before had been grossly understated.
Knowing what I know now, would I be willing to endure the same pain and suffering? Perhaps I would look to see if there were equally effective treatments in alternative medicine. Or, could I survive without treatment at all?
It’s a tough call.
Bella Bonner and Ana Segovia in NY, 2019
Bella Bonner is a journalism graduate of the UP Institute of Mass Communications. Among others, she worked as a grant writer and hotelier in Texas where she lived for 30 years. She has retired, returned to Manila and spends her days in sports, traveling and writing a personal blog, "Chicharon Diaries."
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