Saturday, April 9, 2011


Portmanteau words are fun mashups of ideas—turducken! bridezilla! refudiate!—and in part, we have Lewis Carroll to thank for that. In “Jabberwocky,” the epic poem in Through the Looking-Glass, he created several of these words (“slithy” for slimy and lithe). As the character of Humpty Dumpty said, “You see it's like a portmanteau—there are two meanings packed up into one word.” A portmanteau was a kind of suitcase that folded up its compartments into a single portable whole, just like one of these words.
I learned a new portmanteau word this year: chemopause, or chemotherapy-induced menopause. It’s one of the many unanticipated side effects of chemo, and it happened suddenly, like a light switch being turned off. I had one period after my first infusion, then … nothing. My oncologist said my ovaries were “stunned.” He estimated an 80% chance that this would be permanent, especially since I am now taking tamoxifen, which further suppresses estrogen. I wasn’t that far away from the real thing, but for me, menopause turned out to be not the initial-cap Change, but a mere lower-case side effect. Then, a couple of months after I finished chemotherapy, it came back, just once so far. It may come and go as it pleases, apparently.
As momentous as this development could have been, I’ve been mostly bemused by it. I’ve had bigger things to worry about. During active treatment, I schooled myself to focus on what was in front of me rather than to think about all the implications of cancer and its harsh treatments. I suspect, however, there will come a time, in the next months or year, when I will need to examine my feelings about chemopause and all the other experiences and changes I’ve been through.
I’ve learned there’s a word for that, too: survivorship. Survivorship encompasses all that comes after cancer treatment, physically and emotionally. It’s the post-treatment plan of tests and checkups that will all be, I hope, negative—this is one trip I don’t want to pack my portmanteau for again. But survivorship is also a processing of the changes, the new realities, the new fears. And it’s finding a way to adjust to normal life, or to create a new normal, after the overwhelming absorption of active treatment is over.
My oncology nurse told me that some people don’t feel protected after chemo is over; my radiation oncology nurse warned me that many people expect to be thrilled the day they finish treatment, but find that they aren’t. While I’ve been quite happy to be done with most of active treatment, I suspect that there may eventually be a letdown, once the intensity and focus of the last year returns to a more typical level. And, as a mother and an orphan, I have to admit that being the recipient of so much caring has been deeply comforting. Yes, there is relief—how could there not be?—but there may also be a void, and perhaps a lack of purpose.
Last fall, I kept catching myself saying and thinking, “Next year I want to …” and “In the spring, I’ll …”. Here’s my short list: continue to write this blog occasionally, join a writer’s group and get serious about writing fiction, get back to regular exercise to regain the strength and endurance I’ve lost, have more dates with Dan, see more live theater and music, go out with friends more, take a really good family vacation. Time will tell if I actually do most of these things, but I’m already starting.
When I finished my last chemo infusion in November, my nurse started singing (to the tune of “Happy Birthday”) “Happy last chemo to you.” She treated it like a little graduation ceremony, my own commencement. And on my last day of radiation, I was given a diploma—another commencement. I’ve always thought it odd that the word “commencement”—the end of high school or college—doesn’t address the ending of something but rather the beginning of something else, something undefined. My challenge is to define what I want to begin now, and to make it happen.
A year after the mammogram that started all this, I feel like I’ve been given a gift: the gift of seeing my life as not mundane and everyday. Call it a course correction, call it clarity, call it an epiphany. Sure, I’ve lost something: that illusion of safety, the thing that lets you go about your day blithely certain that there will be a tomorrow. Along the way I also lost a little flesh, some hair, that period—at least temporarily. But here’s what I’ve gained in return: more life. I call that a good trade.
Commence living.