Fran DiGiacomo

The conscientious pharmacist handed me the basket of medications, each packaged with the usual plethora of pamphlets. “Are you familiar with this new drug? Be sure to read the patient information material,” he cautioned.

As a career member of the chemo club who has chalked up 14 years of treatments for advanced ovarian cancer, I take the term “survivor” seriously. Where I once carelessly dismissed those inserts, I’m now a devout reader of the info accompanying each drug, especially the paragraph titled “Possible Side Effects.” After surviving such random effects as instantaneous throat closure, full-body rash and peeling toenails, I dutifully scanned info on the new prescription. Yeah, yeah—the usual fainting, swelling eyeballs, purple teeth, hallucinations and precocious puberty&mdash;huh? Excuse me, but&mdash;precocious puberty? Sign me up!

I didn’t know there was such a thing. My family was staunchly religious—puberty was not allowed. In fact, I don’t remember ever experiencing puberty at all, and I’m pretty sure “precocious” was a dirty word in the small community where I grew up.

Many of us in the chemo club have tucked away somewhere that “Blue Sky” list—a list of “things to do while skies are blue.” In a fit of impatient frustration, mine had recently been banished to the bottom of the bird cage. I hastily retrieved it, scribbled “precocious puberty” on the list of ambitious intent and tucked it safely in the bottom of my desk drawer.

As a veteran of food restrictions, special diets and the gourmet gauntlet, I will confess to occasional reckless debauchery; and if you dance, you’ve gotta pay the fiddler.

As I was considering how to maximize this new entry on my list, I was reminded of the side effects of unbridled exploitation: Consequences. Oh, cruel irony! This new prescription promised to radically increase the heart rate. Hmm. So my choices were heart attack or precocious puberty? What was the dosage on that again?

As a veteran of food restrictions, special diets and the gourmet gauntlet, I will confess to occasional reckless debauchery; and if you dance, you’ve gotta pay the fiddler. I won’t go into the details here, but during the course of double-digit O.R. events, most of my original equipment has been donated to cancer. So I’ve learned that every decision has consequences. For instance, root beer float equals blood transfusion.

You see, having had my colon removed, piece-by-piece, with numerous debulking surgeries, my nemesis is liquids, particularly sweet liquids. Milk is also something I must consume in small quantities. So the abundance of carbonated liquid added to the sugar and ice cream in a root beer float will cause me to lose a great deal of fluids very quickly. A loss of fluids means danger of dehydration and loss of valuable minerals—potassium, magnesium, etc. When this situation occurs, the quickest way to replace what’s lost is to receive a pint of blood.

Through no fault of my own, I recently found myself staring down the barrel of a root beer float, and in the space of a hummingbird’s heartbeat, the straw was between my teeth, delivering the life-affirming/life-threatening liquid.

As I noisily slurped the last dregs from the bottom of the glass, I acknowledged the ancient wisdom: “Forbidden fruit is so much sweeter.” The salacious rush to savor that root beer float was a bit like forbidden sex—in the cool aftermath, it’s never worth the risk.

Scouring the glass to remove all incriminating evidence, I made a silent note to self: Make appointment for blood transfusion; one pint should do it. Confidentially, I’ve had 27 blood transfusions, and not all of them were due to root beer floats. Life is just not as simple as it once was.

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Life is more complicated after a cancer diagnosis.

Weighing the Consequences

“This is really painful, isn’t it?” she said. I nodded in agreement. 

“Do you mind if we begin?” She was trying to be sensitive, but I resented one more intrusion into my life. Art is my nirvana/meditation/sanity/soul, and I needed to be at the easel. Finally, I faced her squarely. “Did you bring anesthesia?” 

It was more of a challenge than a question, but my fabulous caregiver husband had prepared her. She pulled from her briefcase the required remedy — fresh, gooey fudge, generously embedded with pecans and drizzled all over with caramel. Survival comes in many forms. 

“Let her start the examination,” I relented. My husband took her down the hall to the bedroom and opened the closet. I heard the audible gasp and knew the dreaded diagnosis: Critical Closet Mass. 

I wasn’t even into my second chunk of fudge before she was in front of me, wild-eyed and demonic. 

“Well?” I looked up at her, mumbling through the delicious gunk in my mouth. “How bad is it? What’s the recommended procedure?”

“Radical de-bulking. Immediately,” she replied.

Whoa. I wasn’t prepared for this! I needed more time to plan and adjust — maybe hide some things. She obviously didn’t understand the complex clothing requirements of a chronic cancer lifestyle. I led her back to the closet and explained my system, which had evolved over several years of chemotherapy and surgical events in the double digits: 

 Between-chemo clothing, for when I can wear normal people clothes

 Chemo-infusion outfits, warm and cozy — with access to my medical port

 Drug-reaction clothes to accommodate a full-body rash and peeling blisters

 Easel clothes already spattered with paint 

 Fat clothes for when my Graves’ disease, which requires steroids, is acting up.

While my method was alphabetical order, my closet looked like alphabet soup. The closet doc was clearly overwhelmed, so I didn’t even try to explain what every experienced chemo-club member knows: Never throw anything away, because shopping is impossibly difficult. So we stood there, our eyes locked in silent negotiation. 

My husband had promised to find an experienced specialist. This one’s toughest assignment so far had clearly been too many pairs of red shoes — I calmed her with an offer of fudge.

It was just in time; her gaze was moving up toward the top shelf, stacked with the most essential clothing item for a perpetual chemo patient — hats. She stared in disbelief at my prized collection, which started 23 years ago with my first cancer diagnosis. You know the drill &mdash; if it fits and you look good in it, buy one in every color.

“Fran, you just have to let go,” she whispered. Was she kidding? I’ve spent years clutching at life with my fingernails (beautifully manicured, thank you) and now somebody says, “Let go.” I don’t think so.

“Do it for your husband,” she pleaded. “You wrote in your book, ‘Dare to dream’; your husband dreams of using the closet.” 

I sighed in acceptance. It’s not just the quantity. During dinner the night before, my husband had tactfully remarked on how much styles had changed over the years while I was “out to chemo.”

Maybe it’s time to throw it all out and start over. You can bet your boots that this is going to require a lot of fudge. 

 I'd Rather Do Chemo Than Clean Out the Garage: Choosing Laughter Over Tears, 

was first diagnosed with breast cancer, and has lived with metastatic ovarian cancer for eight years. She considers herself a "PhD," Perpetually hairless Dame. 

The doorbell rang but i sat motionless while my husband greeted our visitor.  He made the appointment with this new specialist against my wished and was now directing her to the living room, where i sat staring at my cleched hands. As a career cancer patient, i was fed up with specialists.  Sensing my reluctance, she put her briefcase on the table and studied me patiently.  

Whoa. I wasn’t prepared for this! I needed more time to plan and adjust — maybe hide some things. She obviously didn’t understand the complex clothing requirements of a chronic cancer lifestyle.

Learning to let go of some fashionable old friends.

Fran DiGiacomo

Weighing the Consequences

Diagnosis: Critical Mass

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