There’s more good news and bad news on the health front. I’ll begin with the physical and then turn to mental health stuff.
Way back in mid-February I collapsed at the hospital. Anita had dropped me at the clinic entrance and had gone to park. I made it through the sliding doors but then ended up on the floor. Turns out, I was super dehydrated: I was given three litres of IV saline and lots of juice, and still didn’t need to urinate! That was probably at fault. Just to be sure, however, my radiation doctor had me do an ECG.
Well, the electrocardiogram came back abnormal. There was suspicion of a blockage. It was even suspected that I’d experienced a couple of mild heart attacks in the past! Meanwhile, I have continued to be out of breath in a severe way. It’s not just walking up a few stairs that gets me huffing and puffing. Simply standing up can make me feel winded. I have also been prone to fainting. (A few weeks ago, I lost consciousness from standing up too quickly and walking across a hotel room. I went head-first into a mirror and broke it. Ouch. Luckily, I didn’t cut myself.)
I was thus referred to a cardiologist and underwent a bunch of follow-up tests in the subsequent weeks. A second ECG. A holter monitor test. An echocardiogram.
The good news with respect to this first issue is that I finally met the specialist yesterday, five months after the incident, and none of the results showed any problems with my heart. He wants me to do even more cardiac tests to rule out various unlikely causes, but he felt confident that my exertion issues weren’t stemming from the heart. Long/short, that first ECG was a false positive.
The bad news is that we now have no idea why I find it hard to walk up a mild incline, and keep getting lightheaded even when merely rising from a seated position.
There’s also GN-BN on the cancer front. My first bout of chemotherapy was super aggressive and left me enormously fatigued. Worse, far from shrinking the tumour, the “mass” (as the doctors like to call it) actually grew over the course of the treatment; and it grew in such a way that made resection of the cancer too dangerous. Enter treatment protocol number two: different chemo plus 28 rounds of radiation. That didn’t help much either. My aorta remained encased in the cancerous tissue. Treatment regime number three, however, has at last achieved some positive response. In light of the immunotherapy, the tumour got smaller, and it got less metabolically active. Additional good news is that my most recent CT scan did not show any spread of the cancer — it’s still limited to the esophagus and stomach.
How am I doing mentally in light of all this? Same deal: GN-BN. The good news is that I haven’t been depressed (much), let alone actively suicidal. Yes, I still notice “opportunities to commit suicide”. But I have no urges. The bad news is that my fear symptoms continue. They may be less severe and less frequent. It does sometimes seem that way these last days. This could be due to the addition of yet another drug to my cocktail: Vraylar (cariprazine), an atypical antipsychotic. Be that as it may, progress or not, I still get hit with jarring fright several times each day, in a way that can stop me in my tracks. I went to a conference in Toronto this week, for instance, and had to come home early because the fear episodes left me unable to follow the talks. What’s more, I was getting mentally and physically exhausted after just one presentation, let alone eight hours worth.
Dr. D has suggested that I write to the psychopharmacologist at Toronto Western, Dr. Mansur, who consulted on my case a bunch of years ago. I’m to ask him if there are any newer medications that might prove more efficacious against the fear. I plan to do so this week.
In sum, I’m doing okay. I’m not great. I’m not terrible. All told, that’s pretty good, I suppose, given that last August, when the tumour was first identified during the endoscopy, we didn’t know if I’d make it to Christmas 2025!
Addendum (July 13, 2026)
I didn’t write a lot above about how my mental state connects to my physical state. That may strike readers as a serious lacuna. The thing is, there doesn’t seem to be much connection! My fear symptoms long pre-date the cancer diagnosis. I’ve had them for years. They mostly disappeared while I was doing chemo in the fall; what’s more, they didn’t get worse when we were told that surgery would be too dangerous, such that I became permanently stuck living with the tumour. Finally, when immunotherapy helped, I didn’t notice any change in my emotional states from that either.
The exception is that sometimes the shortness of breath can make me feel afraid and sad. But, first, this doesn’t happen that often. Second, that’s hardly pathological: any “normal”, non-Bipolar person, would feel occasionally dismayed in various ways by getting winded merely from, say, getting out of a car.
There is a physiological connection. Specifically, when I get out of breath, my heart rate goes up, my breathing gets heavy, and I can’t readily continue whatever I’m doing. All these things also happen when a rush of fear comes over me. However, I think this is a coincidence more than a causal chain — whether from lung-troubles to fear-troubles or vice versa. The two ailments happen to share a few symptoms.