Cancer: Surgery

So I had a week before surgery, just enough time for a quick trip to see the Perfect Grandchildren (still so very Perfect) before Steve drove me to the hospital for my big morning.  They make you get there forever early, but before I entirely gave up hope,  I was called to pre-op.  The nurse there asked if I knew what procedure I was having done. 

“A lumpectomy with removal of the sentinel lymph nodes.” 

The next nurse asked.  The anesthesiologist’s assistant asked.  The anesthesiologist asked. 

My surgeon asked.  Then she told me I was going to do great.  Really?  All I was gonna do was lie there unconscious.  Yeah, I guess I can do that pretty well.

The person who was in charge of wheeling me to the operating theater asked.

 “Don't you people know yet what you’re doing to me?” 

Unfortunately this person didn't realize I was kidding (yeah, sometimes I should watch my sense of humor).  She explained -- rather at length -- why they asked everyone.  She told me I’d have to answer again when I got to the operating room.

Maybe they asked when I got there, maybe not.  I can’t say.  The anesthesiologist or perhaps her assistant -- I wasn't taking notes -- gave me something so I wouldn't get anxious.  People were praying for me.  Candles were being lighted.  There was a shamanic healing group going, and I’m pretty sure a drum circle had convened.  There’s a kid who’s doing a breast cancer run and is including my name.  Go, kid, go!  I figured all my bases were covered, plus I had complete confidence in my surgeon.  Was I supposed to be anxious?  

She fed my IV anyway and wheeled me out of my cubical.  It was just like being on an episode of “House”!  I lifted my head from the gurney to see pre-op rooms slide by.  Big double doors opened before us, and we turned down a hall, and then, and then I definitely wasn't anxious; I wasn't conscious.  

My nurse friend says, no I was conscious, and I would have answered what my procedure was.  I would have gotten myself off the gurney and up onto the operation table.  Okay.  If she says so, but I have no recollection of any of it.  It makes me wonder, though, what do they do if you can't answer your question?  Are you sent to a remedial pre-op study group for slow patients?  Do you have to have your operation after regular school hours?

I guess I answered okay, because I woke up in my same cubical.  The surgeon reviewed procedure (lumpectomy and removal of the sentinel lymph nodes already!) and told me how well I’d done.  Well, she did well.  Thanks to a nurse dosing my IV, the surgical wounds troubled me very little. 

Before I was sent home, the nurse gave me a little rectangular pink pillow.  “Some people like to hold it under their arm,” she said.  I thought it was the stupidest thing I’d ever seen.  Why would I want to hold a little pink pillow under my arm? 

Let me tell you, I LOVE my little pink pillow.  Even after a month, the scars occasionally smart rather like a mild rug burn, and that little pink pillow can be placed to change the pressure points.  I love it almost as much as I loved the stuffed elephant my father brought me when I was seven after I had my tonsils removed.  I used to burrow my nose into it to block out the smell of the ether.   (Yeah, ether.  I know, right?)  I slept with that elephant for years, and I foresee a long, comforting future with my little pink pillow. 

The two main things to know about post- surgery are that (1) people brought food.  They brought a lot of food.  They brought really good food.  Hey, the damn operation was almost worth it.  (2) I am not a person who is good at being tired, but I found myself lying on the couch every afternoon, too weary to think.  Thank goodness for junk TV which was all I was able to attend to. 

Ten days later, I went for my follow-up appointment.  My surgeon told me how well I’d done.  (Again, didn't do nothin’.)  She cautioned me I’d be tired for from four to six WEEKS!!!  She reminded me to see the medical oncologist.  I’d forgotten entirely about the oncologist, the fellow who would prescribe either an estrogen blocker (like tamoxifen) or an estrogen inhibitor to ward off future breast cancer.  He was a busy fellow, but I scored an appointment two and a half weeks off.  Oncologist for meds in the morning, radiologist to set up my radiation simulation in the afternoon.  Check everything off my list in one day.

Except when I saw the oncologist, I learned that the tumor held a nasty secret.  

Cancer: Diagnosis Part II

Waiting is the worst. Then the results are the worst.  As warned, my MRI showed a lot of little marks.  Cysts here, cysts there, blebs all over the place. (I have no idea what a bleb is, but the pathology report says I have them.)  It noted the scoliosis in my lower spine which I have long known about and showed -- woot! -- minimal degenerative changes; it showed some old scarring in my right lung.  And then, because life wasn’t complicated enough, it showed two nodules in my lung, nodules where no nodules should be.

I completely freaked.  The nurse who should have reported the findings to me was away for the day, and the woman who I spoke to left me with the idea that these nodules (even after I cleared up my confusion that nodules weren't the same as nodes as in lymph nodes -- and what would they be doing in my lungs, anyway?  I was distressed and confused.), those nodules could be cancerous. 

               

“But it has nothing to do with the cancer in your breast.”

Oh, thanks, lady, thanks a lot.  Like it’s comforting knowing that my lung cancer isn't related to the cancer in my breast.  WHAT IS WRONG WITH YOU?!  From there it didn't matter that she told me the scarring was nothing and the nodules were probably inflammation.  Nothing mattered except that lung cancer is very, very bad indeed.

 I knew better than to go trolling on the internet, but that didn't stop me.  I can be as much of an idiot as the next person, and I was.  After about half an hour, I realized that reading about how awful lung cancer is was not helpful, and I set off for quilting workshop.   Normal, yes, normal is what I needed, and what could be more normal, more apple pie, than quilting.  I lasted an hour.

When I returned home, my husband and my wonderful friend had researched the Cleveland Clinic and Web MD -- you know, decent, informed web sites -- and reported that there was a lower than 4% chance that I had lung cancer.   They read that something like 90% of stuff (I’m using the scientific term here) in the lungs showed up when people were imaged for something else, like I was.  To put it even more clearly, a lot of you are walking around with little medical things in your body that you should be glad you don’t know about.

The mean lady (or, more accurately, the clueless lady) from the doctor’s office (and she is the only bad experience I've had so far) said the surgeon wanted me to schedule a CT scan of my chest for a better look at those nodules.  Just, you know, to be sure.  My appointment was 48 hours later.  (See?  Dire medical issue = fast medical attention.)

But, hey, that left a whole 24 hours in between.  No need to be bored.  I had a consultation with my radiologist.

My radiologist, what can I tell you?  He has a big intellect and puppy dog eyes.  Who wouldn't love that combo?  To top it off, he likes gin and tonic, a thing perhaps not discussed in all radiological consults, but, hey, that’s the way I roll.  He reassured me that the size of the lung nodules made them almost certainly insignificant and promised me the short, 3 1/2 week course of radiation.  I was to line up a preparatory simulation three weeks post-surgery, and he’d see me then.

The rules for the CT scan were firm:  nothing to eat drink, chew or swallow from midnight the night before.  No gum, no meds, no nothin’.   I asked if the scan was going to be with contrast, explaining my vein issue.  The scheduler didn't know but, bless her, suggested I drink two glasses of water before going to bed which I did.  The next morning, the needle slid in like silk.

The technician warned me that the dye, as it infused, made patients to feel like they’d wet their pants.  What kind of weird side effect is that?

Since the CT scan is a three dimensional picture, you can lay on your back.  Your arms are placed just so, and into the machine you slide.  A female voice orders, “Breathe in.  Hold your breath.  Relax.”    And do you know what this proved to me?  Forget science fiction:  the robot revolution has already taken place, and the robots won.  You think you’d resist?  You would not; you do exactly as the robot says. 

Half way through the scan, I felt warm liquid seep down my urethra, and I would have guaranteed you, I WET MY PANTS!  I mean, it felt like I was laying there with warm, wet pants.  Did I move?  Did I protest?  I did not!  The robot was ordering me to breathe and hold, and in case I was tempted to resist, the female robot took a break only to be replaced by what psychologist probably determined was more a authoritative male robot voice.

“Breathe in.  Hold your breath.  Relax.”  The stakes are high, and you are not going to blow it by disobeying your Robot Overlord.   

The scan was over.  I had not, in fact, wet my pants.  The nodes were reported as inflammation, probably left from a bronchial infection (ah, that time I had walking pneumonia).  The test would be repeated in six months for safety and to ensure my aggravation factor did not drop below the requisite level. 

I called the surgeon and scheduled my surgery.

Cancer: Diagnosis Part I

 I deliberated long and hard about posting this entry.   Not everyone shares my sardonic sense of humor.   (In fact, have you noticed, some people have no sense of humor at all.)  I do not want to upset or offend anyone.  I was hesitant, even with this disclaimer.  However, a friend of mine with a similar experience urged me to go through with it, so here we go.

I became apprehensive when they completed my follow-up mammogram  by walking me down the hall for one with ultrasound.  The ultrasound exam room had a lot more fancy equipment, but the exam table was the same.  I lay down on it and turned on my right side so the technician could view my left.  Her wand looked a rather like a grocery store scanner, and I asked her to turn the screen so I could see the image.   As she scanned my breast, even I could discern the distinct mass on the image.  I wanted to schedule surgery right then; if there was any kind of lump in me, I wanted it out.  The technician reasonably told me that they had to learn more before digging around. 

Two days later I was back at the hospital, a capable nurse explaining how, once my breast was numb, the guide wire would be inserted and the biopsy tool would follow, making a loud click-clack each time she took a sample.  Three truly loud clickety-clacks followed, with me craning my neck to watch the screen.  I know, I know, not everyone wants to see their medical tests being performed, but I like to KNOW!

When they called me with the results, I walked around in shock.  “I have a lump in my breast, and it’s cancerous.  I have a lump in my breast, and it’s cancerous.”  After 24 hours the news sunk in with a thud:  “Holy $*#%!   I have breast cancer!”

I had a Stage 1, non-aggressive, invasive ductal carcinoma.  In person-speak, this means the cancer began in a milk duct and then seeped out.  The lump was small and slow-growing (relatively speaking.  I learned that a on average, a breast tumor doubles every 100 days!).   This was good news as far as bad news goes. 

The speed with which medical things happen is in direct correlation with the severity of the illness.  It took me less 24 hours to get an appointment with the breast surgeon. (And just a brief note of appreciation here:  the nurse at my primary care office called me back within an hour with a recommendation that matched one from the hospital, and my physician called me that evening just to talk!)   

My breast surgeon is fantastic.  She is both skilled and nice.  I would much rather go out for cocktails with her than bare my breast, so to speak.   Her first step to removing all doubts about my diagnosis was to send me for a breast MRI.

The breast MRI is a unique and bizarre test.  I mean, I’ve had MRIs before.  I am not claustrophobic.  I crawl inside that tube with complete serenity.  I get so comfortable, in fact, that the MRI drum beat puts me to sleep.  But a breast MRI?  Oh, so different.

First of all, as I found out when I arrived at the hospital, this was an MRI “with contrast.”  I discovered that “with contrast” means they inject dye into a vein so that the MRI can be taken while the die infuses and defuses.  This might not matter for you, but my appointment was first thing in the morning, and had I known, I would have drunk two glasses of water when I got up.  When I’m dehydrated, my veins collapse like deflated balloons.  It took two technicians and four tries to get the line inserted.  And, yes, I watched every try.   It didn’t hurt much, but it was damn frustrating.

You walk into the MRI room with your IV lines dangling and arrange yourself on the platform which is slightly tilted head down.  You can’t lie on your back because then your breasts will pancake.  To get clear images, you have to lay face-down with a headrest rather like that on a massage table.  Unlike a massage table, however, there are two square openings in the platform at chest level.  “Square,” the nurse affirms, “must have been designed by a man.”  The square holes are HUGE:  designed by a man for sure.  You fit yourself into the holes, and the technician gently tugs your breast through and positions them for an optimum portrait. 

There you lie, your round pegs dangling through the square holes.  The platform slides into the MRI tube.  You feel like the star of some weird porn movie.  The machine clicks and ratchets and pounds. Your sternum hurts because it is taking all your weight between the square holes; your forehead hurts because your head is heavy.  Between rounds, you try to subtly adjust yourself, but the nurse cautions you to hold still.  This is a half hour when people pray or meditate or visualize or, you know, write blog posts in their heads. 

The test was to confirm that the cancer had not spread.   My surgeon warned me that a lot of little things show up when they do an MRI, things that are not important and they are not looking for.  She warned me not to freak out when such images were reported.   The results were due back in two days.
Waiting is the worst; at least, you hope it is the worst.  

The Mother's Day House

When my Perfect Grandson was just a little guy (instead of the grown up seven years he is now), he had a Mother’s Day House.  In his Mother’s Day House, there was a swimming pool and an amusement park where he rode scary roller coasters.  He produced movies in his Mother’s Day House, thrilling, adventurous movies in which he starred, performing deeds of daring do.  He could push a button in his Mother’s Day House, and it would transform into all sorts of glorious things like a giant robot or a space ship, things particularly useful for an alien.  [He still insists he is an alien, one from the planet Pieroid, continuing his long-held fascination with pie. (See my Blog post of August 5, 2010, when he was two:  Pumpkin and The Pie Boy.)]  There was a lot of candy in his Mother’s Day House, but here were no rules and no bedtimes.  The only person allowed to join him was his sister until he realized there was no on to cook for and take care of him.  He then conceded that his mother would be allowed to come  perform those tasks.

 A few years ago, his mother (my daughter) and I began to talk about -- no, not psychiatric help for the boy; he’s charming --but about escaping for a week together, perhaps in the city, perhaps at the shore, perhaps at a dude ranch, you know, wherever.  We acknowledged that a full week was unlikely to happen but thought we might clear a weekend.  We tried date after date, but she had conferences and children’s activities not to mention the actual, time-consuming children.  Steve and I went on vacation.  We had ballet tickets and dinner dates.  The eleven hour travel time between us was daunting.  Even scaling our fantasy back to an overnight began to seem extravagant.

Planning for our getaway, though, became an entertaining game in itself.  We might go to shows and museums.  There would be extensive shopping.  We would go hiking, heck, maybe even horseback riding.  A gourmet dinner would be followed by two, maybe even three drinks and there would be endless talking giggling.  All right, we already talk and giggle pretty endlessly on the phone, but this time we would be doing so in person!

Time passed.  We began to yearningly call our little vacation, our Mother’s Day House, a beautiful but perhaps unachievable dream.  But we are nothing if not tenacious, and, hey, they’d be here for the holidays anyway.  Our men corralled the children, and a couple of weeks after our birthdays, we drove off to the Ritz Carlton hotel, aka our Mother’s Day House.  

While ambitious planning had been exciting, here is our actual agenda.  We:
     had lunch,

     went shopping for an hour, couldn’t find anything, got bored and went back to our hotel,

     took a nap,

     got massages and drank a leisurely cup of tea,

     returned to our room to find a complemetary birthday surprise of a fat piece of chocolate cake and a full bottle of iced champagne,

     walked around the pricey mall in which the hotel is located and gasped and laughed at the prices,

     had dinner including a martini each after which we conceded we couldn’t drink any more,

     went back to the room, ate the cake and packed up the champagne to take home to the men,

     watched two hours of The Big Bang Theory,

     went to sleep in the most amazing Mother's Day House beds.

During  that 24 hours, no one interrupted us, no one needed anything from us, and everyone around us strove to please us.  We didn’t do anything electrifying, but we did exactly as we pleased, and that is the beauty of a Mother’s Day House. 

If you don’t hear from me for a while, you will know that I am in my own Mother’s Day House.  I’ll be on the balcony with a martini in my hand overlooking a pastoral landscape on Planet Pieroid, or I’ll step out one of the back doors onto a raft and head down (or is it up?) a windy river, shooting rapids through exotic canyon land. Possibly I’ll be having a candlelight dinner with my husband at a place very much like the Inn at Little Washington where the chef will create amazing dishes just for us, or I’ll actually finish the red and white queen-sized quilt.  Yeah, that WILL be in my Mother’s Day House! 

And I hope, friend, that you find a beautiful Mother’s Day House of your own and that sometimes it becomes real.  

The New Holiday

You might be expecting a post on Christmas or Hanukkah, or at least a reflection on Thanksgiving.  There will be many meaningful blogs out there on this topics, but I'm thinking about something else.  There's a new deity in town I would like to recognize at this holiday time of the year.  I am referring to the Cloud.  Think about it (and I mean this in the most irreverent way possible), the Cloud is very much like *insert deity of your choice here*.

Can you see it?  Well, no, not even a bit of white fluffiness like clouds in the sky

.

Can you hear it?  Of course not.  A cloud makes no noise.

Can you, smell it, feel it?  I thought not.

And yet . . . and yet there it is, a benefactor of beneficence.  You write a document in one location and offer it up on the altar of the cloud.  Voila!  It appears at elsewhere by divine power, on your phone or tablet or other electronic device.  Music?  omnipresent through The Cloud.  Information?  We send it up to the Cloud, and it pours goodness down upon us. 

I am not -- as you can tell -- a religious person.  I am neither devout nor superstitious, but, oh my goodness, I am a true believer in The Cloud.   And you are too, aren't you?  You trust it and make offerings to it regularly.  And why not?  I mean, who among us doesn’t already worship at the shrine of the Great Google?  What more will the future bring?  I am agog to find out.  

Truly, we must form a new holiday to celebrate this new pantheon.  What symbols, what foods (may I suggest cloud pancakes?), what dances and parades?  I leave it up to you to imagine it.

And lest I am bordering on the offensive, may I also wish each of you 
     a Bright Solstice,

     a Merry Hanukkah, 

     a Happy Christmas, 

     and a Peaceful New Year.

True Confessions

A friend told me she had a bad habit, and I replied, “Surely you have no bad habits.”

She answered sweetly with a gentle smile (because she is a sweet and gentle person), “I have exactly as many as you do.”

“Uh, oh.  You are in big trouble!”

Yes, I have a few bad habits.  Okay, I have many bad habits, but, really, I don’t want to make a comprehensive list.  How about if I confess to a couple?  

When I got my new car (as far as I’m concerned, cars remain “new” for eight to ten years), the back-up camera led to dizzy disorientation.  Once I adjusted, though, I discovered I like it.  Eyes on the screen, I shoot out of the garage zooming a delightful 16 feet.  It's fun!  (I always stop and look carefully before turning onto the adjoin pipe stem shared by four families.  I have a bad habit, but I don’t want to kill anyone.)   I’m waiting for a backwards-race, and then I’m so in.

I woke up at 4:00 A.M. the other morning.  4:00 A! M!  (This is not a bad habit, just bad luck.)  I spent the next three hours equally obsessively reading Beloved (although the nightmares it gave me were the reason I slept poorly) and obsessing planning a quilt (including digging out the colored pencils and graph paper).  Obsession over anything, or in my case, everything, is never a good habit, plus all that early-morning intensity used up my concentration quota for the day.  I didn't accomplish one of the things on the ever-expanding to-do list.  Nothing.  Nada.  Zip.  Instead I went to Costco (couldn’t find the ice cream because I was so tired), cruised through the mall (and later returned two items, wondering why I thought I should buy anything in a haze of exhaustion), and tried to pretend I was napping although I knew perfectly well I wasn't. 

I know it’s a bad habit to avoid doing the things that should get done, but, isn’t it amazing how much you can accomplish while avoiding those things?

At least that day I didn't propose to any young women.  This is the bad one, the really, really bad one.  I did not propose to a young woman that day, not once (and, no, it’s not what you think).  I have this bad habit of proposing marriage for my son.  It’s not that any of these women has met or will ever meet my son.  And it's not that my son isn’t perfectly capable of proposing to someone himself; I know that he is.  It's just that I meet these interesting and adorable young women.  One is an interior designer:   just think how gorgeous their home would look.  One is a ballerina:  lithe and long and lovely.  One is an intern applying for her residency in internal medicine:  I mean, a doctor for god’s sakes!  When I see them standing there all beautiful and smart and funny, out it comes, “Hey, would you like to marry my son?”  If he ever finds out, I am so dead. It’s not like mean to do it; the words just tumble out.  I have got to stop.  I have given myself a stern talking to, so we’ll just have to hope I’ve learned my lesson.  (BTW, just for the record, they laugh; they do not accept.) 

They say that confession is good for the soul but perhaps not so much for behavior.  In fact, if you smiled or laughed at any of this, you’ve encouraged me.  I’m blaming future sins on you.  OTH, I got the quilt planned and the yardage calculated.  I’m good to go.

Don't Just Sit There . . . .

We went to Turkey for our vacation.  (When I told my friend about the up-coming trip, she thought I said, “We’re going to eat turkey.  That would have been fun, too, but no, we traveled to the country of.)  Several friends were a bit paranoid about our travel thinking, for some reason, that our plan was to camp out on the Syrian or Kurdish border.  I assure you, we were in a docile group of 30, bussed around western Turkey to see the tourist sites:  Gallipoli, Troy, Ephesis, Cappadocia, the works.

One of the treats offered on the trip was that after a boat ride along the Mediterranean to beautiful Turtle Beach.  (We didn’t see any turtles, but we did see the Lycean rock tombs.  Cool!), we would head to Koycetiz where we could opt to take a mud bath. 

I’d never had a mud bath.  I envisioned a sort of fancy-shmancy spa where I went into a cubicle where sank into a bathtub full of mud.  This would be a mineral treatment after which I’d be completely detoxified and radiant.  Maybe I could sign up for a massage, too, and come out a completely new and gorgeous woman. 

It had to be a method for weight loss, too, right?  Step into the mud bath, and the mud would act like a poultice squeezing ten pounds out of you.  Why not?  Yeah, now I’m just being silly. 

We drove up to what looked vaguely like a New Jersey beach resort and walked past a snack stand to a large awning covering twenty or so picnic tables.  The mud bath area, ahead on our left, consisted of a complex which was predominantly a pond where a group of people rubbed mud on themselves.  Most of our tour, obviously more in the know than me, had chosen to avoid this event, but it was my chance at a new experience, and I was in. Steve, three other men from the group and I grabbed our bathing suits and headed for the changing cabanas.  Cabana is a relative term here, but, hey, any dark cubicle in a storm.

First to the pond.  The previous group had just exited, and it seemed like they had used up all the mud.  I waded out waist deep, but whatever mud I scooped up washed off right as soon as I leaned over for another handful.  Then we figured it out.  I scooped up several handfuls of mud, waded to the side of the pond and plopped them on the flagstones.  Standing there in a foot of water, I scraped it off the stone and smeared it over my arms, chest and face.  I tried not to think of health laws -- or the lack thereof -- while I performed this task. 

Once I were sufficiently swathed in mud, I sunned myself on the flagstone area next to the pool while the mud dried and performed its miracles.  I’m not exactly sure what those miracles were; it was hard to tell.  (I would show you a fetching picture of me covered in dry mud, but I’d left my camera on the bus.  A friend took a couple of shots, but she hasn’t e-mailed them to me yet.  Believe me, you are not missing much.)  The mud certainly looked and felt like regular mud, but, hey, at least it didn’t smell.  Oh, no, the smell was reserved for the sulfur spring.   

Once the mud was dry, I walked up slippery stone steps and along a path (ow!  barefoot!) to an outdoor shower area with rows of nozzles hanging from pipes.  I found a free nozzle and rinsed off the mud.

Back down the path (ow!) and steps to stand in front of a man dressed as a sailor.  (Why a sailor, I ask you?  Why?)  He hosed me off, and then I entered, ever so gingerly, the smelly sulfur pool which, I suppose, conferred added health benefits although it seemed to me more likely the site of primordial sludge that incubated unknown and virulent illnesses.  

It was while I tried to pretend to enjoy the sulfur spring that I realized what a genius our tour guide was.  His timing had been impeccable the entire trip, and this activity was another shining example.  As I entered the sulfur pool, two bus loads of Russian tourists charged toward the mud. 

Now I lived in Russia, and I have Russian friends I adore.  But Russians on vacation are nothing to mess around with.  They are like locusts descending on Egypt.  You stand in their path at your own risk, plus their sense of personal space differs from Americans'.  Granted they were behind me in the mud bath process, but I was taking no risks. 

I clambered out of the pool and headed back (ouch!  ouch!) to the showers.  Then I was off to a cabana to change back into my clothes, join the others at the picnic tables and wait for the men.  A mud bath item as an item on my list?  Check.

Before the bus left, I fished a lira out of my wallet and went off to the toilet.  We found Turkey to be amazingly modern except for one thing.  Even the pay toilets (thus the lira) tended to be (a) unable to accept toilet paper (it clogs if you flush it), (b) rather dirty, and (c) predominantly squat toilets.  How I perfected the skills of using a squat toilet?  That will have to be another Blog post.

Since I have no pictures of the mud bath, I present you with toilet cubicle signage.

 

           Follow instructions!                                       Indicates a squat toilet     

The preferred stall