A friend asked me yesterday if the cancer diagnosis / treatment had made me depressed. I had to take a minute to think about my answer, because it's complicated.
I'm generally not someone who tends towards depression -- I'm not sure I've ever really been depressed in my life. There were times when the kids were infants and I was getting my sleep in three hour chunks (for nine months each; it took them both a *long* time to sleep through the night) when I felt exhausted and weepy and like it was never going to end -- but of course, I did know that it would end, so that helped. And there was a stretch when Kevin and I broke up when I was broken-hearted and cried all the time, but that's not really depression either. There are times I got stuck in grad school, or stuck with writing, and that's been hard, but it was always situational and short-term. I have friends who struggle with regular ongoing depression, and what they go through, I haven't experienced.
But that said, I'm having a hard time today, and it's specifically around weight issues. It used to be that cancer patients became gaunt, and I imagine some of them still do. But the anti-nausea drugs are better now, and in fact, women in my particular cancer situation tend to gain weight. "On an average, women undergoing chemotherapy for breast cancer will gain between five and eight pounds." ("Weight Gain During Chemotherapy")
I've already gained eight pounds since I was diagnosed in February, and I have months of chemo and other treatments to go. Eight pounds gain is a *lot* for me -- my weight tends to be pretty stable unless there's something actively pushing it in one direction or another. (I realize that is not true for everyone -- I'm just talking about me and my body here.) A year ago, my doctor adjusted my thyroid meds and I gained ten pounds after many years of holding stable; I wasn't thrilled with that, but faced with the possibility of injuring my heart in a hyperthyroid state, I coped with the new dosage. It stabilized again with my normal eating and exercise patterns -- and then came this cancer diagnosis and treatment.
"Although chemo may make you feel nauseous much of the time, it may also cause you to crave comfort foods like pasta, bread, rice, and mashed potatoes...Aside from diet changes, your body composition is liable to shift as well. Unlike typical weight gain caused simply by overeating and lack of momentum, where you are gaining both lean and fatty tissue, the weight you gain during chemotherapy is comprised only of fat. The change in body composition that is brought on by chemotherapy is normally seen as a part of the normal aging process. Unfortunately, in terms of body composition, a woman going through chemotherapy ages 10 years in the course of a year..."
"For most women going through chemotherapy there is also a decrease in their physical activity. Its a bit difficult to feel like jogging or working out when you are dealing with the fatigue, nausea, and pain often associated with treatment."
So that's where I am. I gained a few pounds during the diagnosis period due to stress and comfort eating (lots of cheesecake and the like). I've gained more weight in the month and a half of neo-adjuvant treatment so far (and at a faster rate), even though I went back to eating normally and sensibly -- in large part, I think that's because the chemo nausea / fatigue has made me much more sedentary on average than I normally am. And chemo is cumulative, so the fatigue periods are lengthening. I want to ride my new bike, bought specifically to help me get some modicum of exercise during this stretch, but I'm often too tired to even face the thought.
I put on a dress today that fit me in January and it was tight and I wanted to cry for much of the day while running errands until finally I came home again, gave up, went upstairs, and changed into something looser. I'm more comfortable now, but still sad. And there's still so much treatment time to go -- six to seven months. "Obviously, some women gain less (or even lose weight) and some women gain more (as much as 25 pounds over their pre-treatment body weight.)" Twenty-five pounds. It's like pregnancy weight all over again, but with no rapid-weight loss (of some of it, anyway) afterwards, and no baby to be happy about.
As a side bonus, it turns out that gaining weight *also* puts you at a higher risk of recurrence. Lovely.
No real conclusions to any of this. I'm down, that's all. Treatment will be over eventually, and then in 2016, I can hire a personal trainer and start taking care of whatever has accumulated in this time. But seriously, it bums me out. This is the first cancer log I've written where I was actually crying while writing it. I suppose this is the first time I've really felt sick.