Good Days and Bad Days

Before I started treatment for Hep C, I did not give a lot of thought to Good days and Bad days. I certainly had good and bad days and they were straightforward to identify. Fight with my wife, Bad day. Finish a piece of art, Good day. Stuck on the bridge because of an accident, Bay day, the two starting pitchers on my fantasy baseball team that day both win and throw shutouts, Good day, etc. etc. But the majority of days were just days, some good elements, some bad elements, a lot of generic, average elements. That all changed with the onset of treatment.

Much of the advice that you get about how to approach treatment, how to manage it and how to respond to it, involves not letting it take over your life. You have to continue to live your life as much as possible, that is why you are undergoing treatment, to have your life be about your life and not about your disease. But invasive drug therapy for any disease for which it is required, has a way of making that difficult. Some therapies are periodic and regular. You go in for chemo once a week, or radiation for a few times a week for a month, in other words, a regular defined pattern of treatment. With Hep C, it is a defined treatment regimen, but there is both a daily and a weekly portion of the regimen and the total treatment generally is a minimum of 48 weeks. The weekly interferon injections build up over time to eventually give you a high constant serum level of interferon and the daily Ribavirin keeps that drug at a steady serum level as well. This creates a situation that gives you a constant set of side effects that do not fluctuate in the same way as someone who gets a chemo dose once a week. The side effects may vary individually on a daily basis, but the fact that you will be feeling side effects every single day is constant throughout the length of the treatment.

So you get attuned very quickly to Good days and Bay days. Nausea and dyspepsia, Bad day; Walking up stairs without gasping at the top, Good day; Feeling some energy and enthusiasm, good day; realizing that you said a total of 10 words to your co-workers over the course of the day, bad day – these things become signposts of your days and can easily begin to take over how you feel about your life. You can find yourself sitting inside at home instead of getting outside for a walk or talking to a neighbor or calling your sister or any of the vast number of things that can keep you connected to your life.

A Bad day with the treatment does not a Bad day make. You can have nausea and cramps for most of the day and have a wonderful conversation with an old friend in the evening that makes any day a Good day. You can feel exhausted and breathless and then pick up some take-out food and a movie and have a wonderful night with your family and have a Great day. You can also screw up a day when you are feeling physically good and mentally sharp by having a verbal dustup with a coworker.

This is all very uplifting and such, but the reason I am musing about this is that having the flu on top of Hep C treatment, is a Bad day. And the Bad day lasts several days. I have spent whole days inside the house on weekends when I was dealing with interferon doses but at least felt like I could leave the house. I felt that it was somehow my choice that I was a hermit, that I could get out if I had enough juice, a good reason. When you have the Flu, you don’t really go out unless there is not choice. I don’t want to be the typhoid guy who infects everyone so I don’t go out. This drives me crazy in normal flu years, but given the fact that exhaustion from the Hep C treatment has given me more days in the house than normal this winter and it really feels like a run of Bad days.

But hey, I am about to send an email to an old friend about visiting on Easter weekend, and I will be calling my mother after that. I am trying not to have my life defined by my treatment, but it can certainly creep up on you quickly if you let down your guard.

When baseball season starts, that will solve everything (really, everything). How bad can a day be when there are box scores to read and games to listen to on the radio? The baseball diamond can be a strange place to see a pattern to the universe, but it’s as good a place as any.