Category: Induction Treatment

The Gangs of Coletta

Anger is one of those emotions that can be easy to default to and rapidly multiply – not unlike the bastard leukemic cells that invaded my body. As I lie awake processing the news from the night before, my instinct was to rage, to amplify my indignant stance with such vigor that it would disengage my comprehension and alleviate my terror. This of course was an alternative to the Delorean time machine that I would have preferred but that might be on purchase order for the next several decades. Great Scott!

Time seemed to stand still as my anarchist mind abandoned all control of its optimist environment. The Gangs of Coletta we’re multiplying- dominated by The Wicked What Ifs, Hellish How Longs’ and Angels of Death. I felt as though I was having an out of body experience, staring at someone that I didn’t recognize and never wanted to be. I’m sure this is true of any diseased patient that is playing cliffhanger in their mind and so you might think I drew comfort from that universal commonality. Fuck no – because logic and reason were abandoned in my brain- remember ^?

I continued to overload my brain with a barrage of pessimism, a short circuit ensued that would have me catching Zzz’s for a few hours.

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Day 2

Waking up on a makeshift bed in a hospital cell, my hopefulness in the possibility of the dirty L word being a figment of my imagination quickly dissipated. Reality can be a crude state, especially when it materializes from the unexpected – bluntly stabbing with every breath and consideration for the downstream impacts. As I started to transition from the “me” side of the equation, a new set of concerns mounted as I anticipated the hysteria from my family. I should mention that this is now the Saturday before Thanksgiving so you can appreciate my reluctance in wanting to reach out and make any impromptu announcements before clearings up some of those x’s. I did call one person…

Everyone has that 1 go-to person to level set, a walking talking Ativan that you want to have to navigate a bad situation…introducing my sister, Magellan. I’ll refrain from going into the details of the conversation and allow you to infer the reaction of any sister who has been told that their brother has cancer…

With my pregnant wife at my bedside, I was eagerly awaiting the ominous transport to Princess Margaret. With my sister en route and still in the discovery phase of the grim news – I decided to sidestep this conversation with my other immediate family until we knew more.

Upon my arrival at PMH, my senses were wildly sensitive to my surroundings. I can distinctly remember being attached to my first IV bag and the corresponding oncology stamp that lit up the screen of the IV pump – another affirmation of this grotesque reality.

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Throughout the course of the day, my processor was being overloaded with hypotheticals though it became clear that a bone barrow biopsy would be required before ordering treatment. Again, true to form, my situation would be more complex to manage because of my existing anti-coagulation therapy. Translation : the medical team have to manage my mechanical heart valve (that uses blood thinners as a preventative mitigation tactic for clots) against the fact that the leukemia is essentially suppressing every back-up clotting protocol (which puts me at high risk for internal bleeding) HENCE the catalyst to this adventure, the blood in my urine.

“Let us have the specialized teams weigh-in on this and we’ll get back to you with their recommendations ”

We were inching but knew more than the day before. And so day 2 came to a close.

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ENIGMA

This is my experience and perhaps a loose frame of reference for those of you facing similar challenges. If you’re able to relate, that’s great and if not- bear in mind that every journey is unique. Here is where I started

DAY 1 – My first 24 hours

Our life runway is often thought to be infinite, falsely reassuring us that we’re able to lift-off unrestricted by time. This inaccuracy can and does result in a monotonous life, circling the same daily perimeter – slowly but surely erroding our quality and lust for living. We do because we’re told to and buy-in to the status quo and social norms that are imposed on us. We accept them because they sometimes yield what we’re conditioned to think is important: money, possessions, status, an all out dick measuring contest. It’s interesting how your perspective can change…

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Red Flag

My Friday was like any other; the bookend to a stressful corporate workweek with the promise of some much needed couch time for this self-professed homebody. Having received our pregnancy news earlier in the week, I was walking on sunshine with little regard or attention to life’s oddities- albeit someone ^ was waving a red flag (quite literally). I know you’ve heard the expression seeing red but I was straight up peeing red – not as alarming as you might think because of my history of blood thinners. It was catalogued in my mind as a low priority issue and probably related to my INR (which I had tested earlier that afternoon) for my mechanical heart valve. A simple blood draw would clear things up and I could have my anticoagulation therapy adjusted. I forgot to tell you, like most Italian families, many of us have come to the conclusion that we’re members of the medical community – unofficial physicians but MDs in our own right. Granted, we have spent a lot of time in hospitals so that has to count for something? In this case; however, my gut thought it best to seek reassurance from one of those hoity-toity licensed doctors to weigh in on the prognoses. So in my true form, I decided to kill 2 birds with 1 stone. My wife picked me up and we were en route.

Who’s the other bird?

Unfortunately, my main man –also known as Nonno was checked-in to the hospital earlier that week. This encouraged me to get to the hospital so that I could be assessed by an emerg doctor and visit Raffaele.

The first visit was to the emergency department, which I should mention is in a large trauma hospital or cesspool of germs. Every beige vinyl chair was inhabited by some kind of sick person who looked like they had been de-prioritized by virtue of having a pulse. This did not bode well for me or my symptom although I went through the motions and registered with some preliminary tests. Later, the charge nurse was able to confirm my assumption by assigning a 10-12 hour timeline to the vast majority of patients (because of that damn pulse). My gumption was now weaning and abandoning the thought of being assessed here, after all I felt decent and my high INR count was likely the reason for the bleeding. And so, I moved on to the other bird in the mix and made my rounds to visit with my grandfather and ever-present family member stationed bedside.

The problem with self-diagnoses is

I get that no one likes hospitals but I have a revulsion so strong that I would describe the affect as borderline anaphylaxis (without a shower). Driving home I felt as if I were charging to a finish line, my Neverland fueled by happy thoughts of my wife, bed, and shower (my benedryl for hospital exposure).

Pulling onto my street, the phone rang in my car displaying an unknown number that my intuition told me was urgent but that I would have normally rejected.

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“Hello…”

“Is this Adam Coletta?”

“Speaking”

“Hello sir. I am one of the physicians at Sunnybrook Hospital and I understand that you left the emergency department before the blood work results had come back”

“Yes, I actually followed up with my family doctor who had the results of my INR earlier in the day and mentioned that it was likely the cause. I will follow-up on Tuesday”

“Actually sir, what we found was that you White Blood Count was nearly 8x greater than the normal range and I would recommend that you return to the emergency department immediately”

“Would you be able to translate that for me considering I’m currently pulling into my driveway which is an hour from the hospital but I can go to a local hospital if it’s urgent”

“Typically these cells are used to fight infection which could mean that you’re currently fighting a large virus. These results have also been linked to cancer”

It is a surreal feeling to hear that you could, maybe, possibly have cancer over the phone and then to explain to your wife that you need to return after things were seemingly fine. I did because I had to and repeated the registration motions at yet another hospital. Here, my nonchalant attitude transformed into fear- fear of the unknown, fear of the blood result and what this would mean for my wife, my unborn baby and me. Throughout the course of the day my stress tachometer had been rising where I knew the worst case scenario would inevitably blow my mental engine.

As I waited for my fate, I felt as though this day was becoming a true test of my mental stamina. Maybe an unconventional way to realign my priorities moving into the next chapter in my life but that things were otherwise fine. So I waited and waited, unsure whether my preference was to face a devastating reality or stay peacefully ignorant to the issue at hand. Either way, time was up.

“Adam Coletta”, the nurse exclaimed and motioned for my wife and I to enter an empty and eerily quiet room. After a day of seeing doctors in scrubs, there is something quite unnerving about 2 doctors in professional work attire coming to speak to you – even more so when their body language tells you that they’re uncomfortable delivering the message.

And so it went something like this:

Medical jargon followed by the results of the recent blood draw support a diagnoses of Leukemia. Which kind? – I don’t know, how advanced, I’m not sure BUT I will consult with Princess Margaret and have you transported in the morning. I’m sorry.

In this moment, my worst fears became reality and my mind imploded thinking back to every bad news story, disease focused movie tragedy and personal cancer encounter I had in the past. The sting of the word was so intense that my breathe faded as I turned  to my wife to try and absorb the shock and get a sense of her understanding of the situation. Framing the diagnoses as a malignant cancer further electrified the air in the room as every hair stood on its end and our reality flipped upside down. This is the part where the doctor reassures you that they will do everything they can and leave you to your own devices in a quiet room to process the gravity that had already brought us to our knees. So we tried to process but quickly realized it to be an insurmountable feat given the enigma of the diagnoses.

With so many questions left unanswered, my mind spiraled out of control awaiting my transport to a cancer center which would now transform me into a cancer patient. Not quite the chrysalis to butterfly metamorphosis I was hoping for.

My instinct was to disassociate myself from the situation until I had answers or insights into my survivorship because I’m not going down without a fucken fight…

The course was now set for unchartered territory and I could only hope for a more specialized and  strategic oncologist at the helm.

Next stop – Princess Margaret Cancer Hospital.