"There are known knowns. These are things we know that we know. There are known unknowns. That is to say, there are things that we know we don't know. But there are also unknown unknowns. There are things we don't know we don't know." - Donald Rumsfeld
I know that seeing a quote from Donald Rumsfeld on my blog might make you wonder just how much mind-altering medication they've put me on. But his explanation of knowns, unknowns, and unknowns that are unknown, when removed from the context of him obfuscating US intelligence in the Middle East, is actually a helpful frame for capturing my thoughts today. It's day 11 of my first 21-day cycle of IVEG. At this half-way point, I think it's safe to say that there are now some important things I know for the coming months (I have at least two more cycles of this treatment scheduled) and still some significant unknowns.
What I know:
My four day hospital stay wasn't too brutal - I had lots of great company (thanks to friends and my fantastic sister, Becky!) and was so carefully monitored and medicated, that it all went smoothly. The first few days out of the hospital were rough as I experienced about every unpleasant side effect in the book. But I began feeling better this weekend and was glad to be able to celebrate and observe Rosh Hashanah and Yom Kippur. More than anything, I'm just grateful to know more of what to expect the next time around. Being able to plan ahead for when I'll need support, when I can work, when I should rest, which prescriptions to refill when, etc. makes the whole experience more tolerable.
What I don't know:
Some side effects will begin in nadir between days 10 and 14 when I'll likely be neutropenic and my immune system will be most vulnerable. Amongst these known unknown side effects that I am most anxious about is the huge unknown of whether I'm going to lose all my hair this week. You see, as I mentioned in my previous post, this chemo regiment is a combination of drugs I've been given before. Given the mixed hair-loss results from those experiences, I don't know what to expect for the next few days, and after all this time, I'm still not sure how to best prepare myself.
What I don't know I don't know:
Then there are the unknown unknowns. If you have ideas on how to prepare for these, I'd welcome suggestions. In the meantime, I find myself continuing to reflect on all of this during these recent days of awe in the Jewish calendar - a reminder of how significant and insignificant we are and how much and how little we can possibly understand about what happens to us, around us, because of us.