It seemed like a good sign that I heard the first robin singing before dawn on my last day of chemotherapy. Spring seems like a good time to recover, recuperate, regain strength and stamina. I took some tulips and homemade chocolate chip cookies to the chemotherapy unit to say thank you to the nurses. My lovely nurse of the day, Roula, of Greek heritage, said she would skip a meal if necessary to buy flowers. So clearly, she was exactly the right person to receive the tulips.
Roula was so flustered by the flowers that she accidentally gave me the best seat in the house, the seat I had last time, and then apologized profusely that she had to move me. My final seat didn't have a window view, but I did have a remote. My view was of one of the nursing stations and the four seats across the aisle, which eventually filled with an older woman, two older men, and a man who appeared to be in his mid-late 50s (he got the best seat, the one I had last time.)
Like the nurse last time, Roula had to make two attempts to get the IV in. I guess the veins in my left hand have had enough chemo... fortunately it's done now! I was happy she didn't have to move to my right hand, which would have been awkward because you can't really use the hand that the IV is in. But once she got it all set up, things went smoothly.
I was able to have a lovely visit with the 31-year old woman I met a month ago. She was having her third chemotherapy and had settled into the routine. We will keep in touch. She brought me a lovely jade plant and a beautiful thank you card.
I also met another woman, closer to my age, who was having her first chemo yesterday. She had travelled from Brighton, more than an hour away along the 401. Although she had had three other bouts of cancer, she had never had chemo, and she was "scared to death." We first spoke in the registration line-up, then in the chemo unit waiting area, and then I found her in the unit as she was getting her treatment. She was dismayed by how quiet and unfriendly the other patients were. One of her friends who had chemotherapy had had the experience of lots of support from the other patients, and she was hoping for the same. I guess it depends who is there. (We need more people like Yellow Sweater from Mexico!)
Near the end of my treatment, an older woman, maybe close to 80, came to sit in the chair beside me. She was trying to get her headset untangled and asked Roula to help her, but Roula was focussed on taking out my IV. I watched as the woman fumbled with the headset for awhile; once Roula had disconnected me, I asked her if I could help. She said she is mostly blind and her fingers don't work very well because of neuropathy but she had managed to get the headset untangled. Roula explained that pre-Covid, they had wonderful volunteers in the unit, who would help with that sort of thing. She hoped they would soon have volunteers back again. It must be a very different place—more lively, less frightening—when family members or friends can come and hang out with the patients, and volunteers can help with the sorts of requests that the patients don't like to ask the busy nurses.
Many people asked me if I was going to "ring the bell" to mark the end of chemotherapy. I had always imagined I would. A wild, victorious, raucous ringing. But despite having spent many hours (hmm... how many?) in the chemo unit, I never heard any bell ringing. And then someone I know having cancer treatment in Toronto said she didn't want to ring the bell to avoid upsetting other patients, some of whom will die when they finish treatment. This had never occurred to me.
It turns out that there was a study done in the US, published in 2020, that randomly assigned patients to ring the bell or not after treatment finished. During follow-up, those who rang the bell remembered their treatments with more distress than those who did not, contrary to the authors' hypothesis. One news report about the study also including comments from a patient advocate who resented the whole thing. Hmmm... the qualitative researcher in me was intrigued. Of course, the published study was quantitative, raising more questions than it answered.
I did some online research. There are American videos of people with balloons and cake and crowds of supporters making lots of noise. Wow. Okay. No wonder other patients might be disturbed. The more research I did, the more I understood the objections, and possibly even the research study, because it seemed to me that many people rang the "bell of hope" with "happily ever after" fantasies. It seemed that many people saw ringing the bell as "the end" of "the cancer journey," which, of course, it is not. Maybe that explains the distress that the American researchers found.
I spoke to Roula about this. She said she thought that ringing the bell should signify important milestones, and that patients should make their own decisions about when those milestones are. Those who might be taking chemotherapy for the rest of their lives could ring the bell when THEY decide they have reached an important milestone. Let's just say that I think Roula has accumulated a lot of wisdom over her many years as a nurse.
And Doug, Liz's husband, who had phoned on Tuesday, had me promise him that I would "ring that bell."
So I decided that I would ring the bell, but not in the wild, raucous way that I had once thought. I wanted to remember and honour Liz, who didn't make it through cancer. I also thought about Thich Nhat Hahn and his careful ceremony of "inviting the bell", and his monks, who always stop and focus on their breath whenever they hear bells (including the phone!). I decided I would ring the bell 3 times, once for Liz, once for the wonderful staff, and once for my gratitude for life, including the chemo (which will help me live a longer life). I was very emotional.
The nurse who did my very first chemo, Nicole, was there to witness and took photos and a short video. We gave each other a big hug afterward.
Finishing chemo is certainly a milestone. I'm glad I rang the bell, and rang it in the way that I did. I still have to finish the two-week chemo cycle, including the days 7-10 (next week) when my immune system is practically "non-existent" (according to the oncologist). In my books, "liberation day" from chemo - two weeks later - is March 9th - when my immune system will have recovered. I hope most of the chemo side-effects will be gone by then too, though I expect the fatigue and neuropathy will linger for awhile.
I have an appointment with the surgeon on March 25th, and will likely have surgery in the first week of April. A breast MRI will be scheduled soon. The decision about radiation therapy will depend on the pathology report from the surgery, but is likely. So, there is still a ways to go, still more milestones to pass and celebrate. But chemo is done.
Thank you, as always, for reading and for your ongoing love and support.
