Sheep-scaping

Posted: November 29, 2011 | Author: | Filed under: cancer fatigue | Tags: , , , , , , | 9 Comments

I need a break from cancer: from thinking about it, from writing about it.

Thank you, Eddie Miller, for providing that break.

photo: The New York Times

Miller is the brains behind sheep-scaping, the newest trend in landscaping. Instead of a crew of guys, Miller employs Panda, Nerd, Princess, and Carol. They’re Jacob sheep by breed, “organic lawn pruners” by trade.

When he graduated from Boston University with a double major — Economics and Environmental Science –last year and couldn’t find a job, Miller founded Heritage Lawn Mowing using sheep instead of a lawnmower. Sheep are cheap, sustainable, and much greener than conventional lawnmowers. Business was booming in Oberlin, Ohio. He started small, with two sheep who grazed in his parents’ backyard, and admits that the impetus for buying the sheep was that his (now ex-) girlfriend thought they were cute. Once the first two sheep chowed his parents’ lawn, Miller started moving his tiny, hungry flock to the yards of friends. While walking his sheep from house to house, he realized he had an innovative business model on his hands. Thus, sheep-scaping was born.

Customers pay $1 per sheep per day to have their lawns sheep-scaped. Most jobs require two sheep and cost on average $8 — far less than the going rate for commercial landscapers. Miller says that Jacob sheep eat broad-leaf plants, dandelions, clovers, and grass. They seem to know not to eat flowers and ornamental plants. “They have a built-in weed whacker,” he said. Because they lack teeth on the top, they don’t rip grass out by its roots.

They’re a delightful breed of sheep, according to the Jacob Sheep Breeders’ Association: “The American Jacobs are an old world sheep which, unlike many other old world breeds, have not undergone improved breeding and out crossing to satisfy the commercial marketplace. They have a more primitive body shape, are slender boned and provide a flavorful, lean carcass with little external fat. The carcass yield from hanging weight to freezer is high when compared to the more improved breeds.”

Ewwwww.

I didn’t need to know that much.

Let’s focus on how cute they are, instead of what good eatin’ they can be.

photo: JSBA

After achieving the holy grail of publicity, an article in The New York Times, Miller and his business seemed destined for success. However, further research on my part revealed that Heritage Lawn Mowing is no more. After weathering a few setbacks, including some sheep sickness, his business suffered a fatal blow in the form of a $150 ticket for “animals at large.” His sheep escaped through a gate and were found wandering the streets. The $150 fine was earmarked for the purchase of a tractor cart that he could use to transport the sheep and their hay as he migrated west to Jackson Hole, WY. Miller made it to Jackson Hole, but the sheep did not.

So now Miller is a sheep-less shepherd in Big Sky Country. He’s set his sights on elk, which apparently are rampant in Wyoming. He wants to work with the National Parks system to develop a permaculture farm with elk and pine trees. I hope he makes it.

 

 

 

A sliding scale

Posted: November 28, 2011 | Author: | Filed under: breast cancer, cancer fatigue | Tags: , , , , , | 6 Comments

Words and images of battle are often ascribed to cancer.  Some cancerchicks take issue with that but I’m not one of them. Having written this blog — mostly about cancer — for the last year, I’ve come to realize that it’s hard to talk about a cancer battle without well, calling it a battle. I’m not even sure what else one would call it. “While undergoing treatment for breast cancer” seems rather cumbersome; “While undergoing treatment for breast cancer, I lost my mind, gained weight, and grappled with a whole new set of issues” doesn’t quite work, but “While battling breast cancer, I lost my mind, gained weight, and grappled with a whole new set of issues” is a bit more succinct. “During the time in which I was ridding my body of cancer” is pretty clumsy, but “During my fight against cancer” works quite well. I like efficiency, so the battle metaphor works for me.

One thing I don’t like about it, though, is the idea that those who “lost the battle” with cancer didn’t fight hard enough or were somehow at fault. Cancer is totally random, people. It strikes those who take excellent care of themselves as often as it strikes those who are not so careful with their health.  Survival depends on a lot of things, and sadly, sheer force of will is pretty low on the list. If survival were tied to will, my sweet mama would be alive and probably ringing me up on the phone right now to ask me if I’ve mastered the art of pie crust yet and to suggest that I let her little darlins, aka my children, have enormous ice cream sundaes for breakfast. She fought like hell and did every single thing her team of doctors at MD Anderson told her to do, no matter how tired she was or how crappy she felt. She endured more awful stuff than I like to remember. She wanted to live to see her little darlins grow up (and to hassle me about not giving them enough treats/presents/leeway/benefit of the doubt). She fought like hell, and waged a mighty battle, and was a tireless, non-complaining warrior. And yet, she still “lost.”

Cancer, and the battle one’s life becomes when diagnosed, is on my mind today, as it often is, but today even more so than usual. Another friend has been diagnosed, and my heart is so heavy. My thoughts return to her often, and I’ve felt just plain sick ever since I heard the terrible news. Cancer comes after people indiscriminately, and it seems to me it gets the good ones just as often as the mean ones. My newly diagnosed friend is most definitely one of the good ones. She deserves so much better than pancreatic cancer. How someone with such a sweet and gentle nature and such a giving heart can fall victim to such a merciless fate is beyond me. And yet, she begins her epic battle today.

I’m not naive enough to wish for a world free of cancer. But I do wish there was a sliding scale. If you’re going to get it, in all its ominous forms, why can’t the scope of the disease be equal to how nice a person you are? Why is it that “only the good die young,” as Billy Joel sagely points out? It’s just not fair for cancer to wage war on someone who is patient and kind when someone who’s vain and shallow gets a free pass. Or for cancer to creep up on someone who’s worked all his life and is ready to finally enjoy retirement, while someone who’s dishonest and rude escapes unscathed. I just hate that cancer pounds on the door of someone who’s trying to do all the right things, yet skips completely the person whose main concern is keeping up with and besting her neighbors. Where’s the sense in cancer claiming a delightful human being who would give you the shirt off her back, yet ignoring the not-so-delightful human being who is petty and small?

I’d like this system a lot better if there were a sliding scale.

Square one

Posted: November 17, 2011 | Author: | Filed under: breast cancer, cancer fatigue | Tags: , , , , , , , , | 7 Comments

“Your present circumstances don’t determine where you can go, they merely determine where you start.”

Thank you, Dr Nido Quebein, for telling me that. After the rough start I had last week, I was disheartened at the idea of starting over — from Square One — in finding a surgeon to do my oophorectomy. I needed a little attitude adjustment and Dr Q’s lovely quote provided just that.

Here’s the thing: my cancer “journey” has been long, complicated, circuitous, and seemingly endless. What is essentially a rather simple cancer that should have been easy to eliminate turned into a wild game of “how much can you take?” Just as I thought I was nearing the end of my “journey,” with what could be my last revision to reconstruction, the game became more intense and complicated  and pretty  much blew up in my face.

The next step of my “journey” should have been quite simple — have a routine procedure to remove my ovaries and eliminate the hormone production that fed my cancer. It’s outpatient surgery and rather easy compared to what I’ve endured thus far. But rather than being simple and working according to plan, it got hairy and I got overwhelmed. The idea of yet another doctor becoming involved filled me with dread, and it was like I was back at the beginning of this “journey,” newly diagnosed and jumping through hoops, frantically doing what’s needed to get to the next step.

Here’s where we are now: after standing on my head and reciting the alphabet backwards while juggling flaming batons, I was granted an audience with the lovely lady who schedules appointments for the next doctor in my ever-expanding roster. Oh happy day, after trying for 4 days to get through to this lovely lady, success was mine! I learned that this doctor only has office hours on Tuesdays and Thursdays because she’s in surgery every other day. Makes perfect sense, as she is a GYN oncology surgeon at the world’s #1 cancer hospital. What doesn’t make sense is why her staff doesn’t seem to be around on those other days. But apparently that’s not my concern and as long as I jump through the right hoops, maintain my headstand and keep those flaming batons twirling, I will eventually get what I need.

Hahahahahahahahaha.

Silly, silly girl.

You’d think I would have learned at some point on this wretched “journey” that even when one does all the right things, and completes all the required steps, one still does not get what one needs.

When a human voice finally appears on the other end of the line, I think I’m going to actually schedule an appointment. I’ve cleared my schedule to accommodate hers. I am ready and willing to appear in her office at MD Anderson whenever she can see me. It’s the absolute last thing I want to do, mind you — see another doctor about another surgery. To add insult to injury, factor in the psychological warfare involved in knowing that this next doc works in the same facility–and in the same department–where my mom sought treatment for her cancer, and  her “journey” didn’t exactly have a happy ending. Not even close.

Nope, scheduling an appointment isn’t that easy. First, there’s the prerequisite litany of questions: name, address, phone numbers, email address, birthdate, insurance carrier, group number, ID number, policy holder’s DOB and SSN. Then comes the question of what’s your diagnosis? When I replied, breast cancer, the lovely lady not so lovingly informed me that this office doesn’t deal with breasts. Duh. I patiently replied that I understand that and know that this office deals with the more southern ladyparts, but because of my breast cancer, I need to consult with this doc on an oophorectomy. Seems clear, right? Then the lovely lady wants to know why I want to have my ovaries removed.

Why, indeed?

Because I’m bored. Because it’s been too long between surgeries for me. Because I miss the prick of the IV desperately searching for a vein in my tapped-out venous system. Because I’m lonely for the company of people in scrubs & white coats. Because I’m hankering for the smell of Betadine and the commotion of the OR. Because I long for the feel of the plastic mask on my face as I lie completely naked under a bright light in a room full of strangers. Because I’m hoping to lose a few lbs before the holiday glut and think the all-day vomiting that inevitably comes to me after anesthesia is a good diet plan. Because I haven’t spent enough time recuperating from surgery while the world around me marches ever onward.

If there’s a contest for most horribly worded question, this lovely lady would win it, hands down.

Once again, I’m called upon to gather my composure and marshal my manners to answer. I resisted the mighty temptation to give her a smart-ass answer and calmly replied, because my oncologist recommends eliminating the source of the cancer-causing hormones. I wonder if the lovely lady could tell I was answering her through tightly-gritted teeth and with fists clenched as I battled the urge to make her ears bleed from a long, colorful line of cuss words. I wonder if I should have told her that when you’re diagnosed with cancer at age 40, with elementary-school-aged kids at home, and when your own sweet mama died an anything-but-peaceful death from cancer at the still-young age of 67, you’ll take whatever steps are necessary to increase your odds against this savage killer.

Lovely lady went on to inform me that I would need to provide documentation of my breast cancer being ER+ and PR+ (estrogen and progesterone positive), along with a host of other documentation. I would need to provide pathology reports from my breast biopsy in April of last year, when the idea of becoming a cancer patient was the last thing on my mind. And go ahead and throw in the pathology reports from my bilateral mastectomy and the paperwork on my last Pap smear, too. Wait–don’t forget to have Dr P, the OB-GYN who referred me to the GYN oncology surgeon, send his notes as well. After that, and after verifying my insurance, the GYN oncology surgeon will review my case and see if there is sufficient evidence to proceed. Lovely lady promised to call me back and let me know where I stand.

For realz.

Ok, so more hoops to jump through, more due diligence on my part. Luckily I’m a rather fastidious cancer girl, and I have a very thick pink binder containing copies of everything the lovely lady requested except the Pap report and Dr P’s notes. Two phone calls and one online consent form later, that information is en route to LL.

Hurry up and wait.

After making the phone calls and gathering my records, I faxed 24 pages of the juiciest details of my breast cancer. All the nitty-gritty deets about tumor markers, mitotic index, prognostic markers, lymphovascular invasion scenario, anatomic pathology diagnosis, sentinel lymph node results, tumor size, and Elston-Ellis modified scores. It’s a fascinating read. And a wonderful trip down memory lane, just as I think I’m putting a little distance between myself and the cancer show.

I’ve done my part, now I wait.

Back to Square One.

 


Hold, please

Posted: November 15, 2011 | Author: | Filed under: breast cancer, cancer fatigue | 5 Comments

I’m not often at a loss for words, but I have been lately. November has been a rotten month for me so far, and I’m beyond ready for that to change. Just when I wonder if this “journey” get any harder or any more complicated, I smacked in the face with the answer: a resounding YES.

My oophorectomy saga continues. It’s a pretty simple surgery, really, especially compared to the other surgeries I’ve had of late. And there’s certainly no shortage of great doctors in my town. But finding one to do the oophorectomy robotically, as opposed to open or laparoscopically, has been tricky. The first referral I got was packing her bags for a 6-week overseas trip. The second one is phasing out his surgery practice, instead training other docs on how to do the procedure. The third one seemed promising, but alas her office has an aversion to answering the phone for patients who just want to make an appointment.

First her office was already closed for the day, at 4:00 on a Thursday. Then the office was closed all day Friday. Two strikes, in my opinion, but still alive. However, when the answering service is taking messages on Monday late morning, I wonder what’s up. By Monday afternoon, neither I nor my OB-GYN’s nurse could get someone, anyone, from that office to call us back to schedule an appointment. Multiple messages left, but not one was returned.

What’s happened to customer service? And is this really the first impression this doc wants to make with prospective patients? It certainly doesn’t give me much confidence in the way she runs her office. My patience with difficult doctors has worn quite thin. In fact, I would describe it as metal-on-metal, or bone-on-bone. It’s not just worn thin, it’s eroded. To borrow a line or two from spunky songbird Kelly Clarkson, “You ain’t got the right to tell me.”

“Well ya think you know it all
But ya don’t know a thing at all
Ain’t it something y’all
When somebody tells you something bout you
Think that they know you more than you do.

Well ya like to bring me down don’t ya
But I ain’t laying down, baby
I ain’t going down
Can’t nobody tell me how it’s gonna be
Nobody gonna make a fool out of me
Baby you should know that I lead not follow.

You ain’t got the right to tell me
When and where to go, no right to tell me
Acting like you own me lately
Yeah baby you don’t know a thing about me
You don’t know a thing about me.”

But I digress.

Luckily, I have an inside source. A wonderful friend who knows people in the know at the massive organization I’m trying to gain entry into. She’s kindly going to make a couple of phone calls to her well-placed friends at MD Anderson and ask what in the sam hell does it take to get an appointment with this doctor? Lucky for me, because I am this close to saying forget it. To keeping my damned ovaries and their deadly hormone production. Surely the gamble of keeping them is easier than navigating yet another health care system and all that entails. Frankly, the idea of starting over with another doctor, after having seen 5 docs last week, makes me want to cry — and y’all know I’m not a crier. The idea of providing the details of my insurance card and reciting all my personal info is overwhelming. And don’t even get me started on how I feel about trotting out my long, complicated cancer “journey” for a new doc. Ugh.

Beer for dinner

Posted: November 11, 2011 | Author: | Filed under: breast cancer, cancer fatigue | Tags: , , , , , , , , | 14 Comments

shortsbrewing.com

Nobody said it would be easy…but I certainly didn’t expect it to be this hard. “It” is my least-favorite part of the cancer “journey,” which is the uncertainty and the waiting. The uncertainty and the waiting are far-reaching and apply to many aspects of the cancer “journey,” whether in awaiting pathology results, trying to schedule an appointment with the litany of doctors involved in one’s care, or marking time on the calendar between the latest procedure and getting back to “normal.”

The uncertainty and waiting applied this week to my attempts to move forward on the long-ago planned but not yet executed oophorectomy. When this whole mess began, and by mess I mean breast cancer so rudely interrupting my otherwise happy, healthy life, I knew that I would at some point need to have my ovaries removed. Those two oval-shaped organs have got to go because of the estrogen and progesterone they produce.

Monday I saw an OB-GYN, let’s call her Dr P, who is part of my OB-GYN practice but not my doctor. She delivered Macy because she was on call when my little girl made her appearance into the world. I chose to see her this week because her reputation as a surgeon is stellar and she is known for her patients not having complications, something that appealed mightily to me, the reigning Queen of Complications. I’m more than ready to take off that crown and pass it on to my successor.

Anyhoo, Monday’s visit with Dr P wasn’t terrible but it introduced a fly into the ointment when she enlightened me to the fact that a laparoscopic oophorectomy wasn’t an option for me because of the abdominal incision on my belly from The Big Dig. This was something I hadn’t even considered and is another example of how much of what one needs to know along this cancer “journey” must be learned the hard way. Hate that.

So I left Dr P’s office on Monday trying to wrap my head around scenario #1: the idea of open surgery, which is most unpleasant to me, and that she won’t be able to use the existing incision but will require another incision, below the 17-incher I’m already sporting. That incision is healing so nicely, and is so razor-thin and in the process of disappearing altogether. The idea of messing with it and disrupting its lovely healing is not my favorite.

In discussing the shifting scenario on Tuesday with the cabal of Amys, my two dear friends whose previous medical professions have made them trusted members of my decision-making team, it becomes clear that while Dr P is a great surgeon, she may not be the right one for me. I’m not ready to give up on the idea of doing this next surgery laparoscopically, which means I need to get a second opinion. As much as my petulant self did not want to set foot in one more doctor’s office, and as much as my weary self hated the idea of making yet another appointment, paying yet another hefty co-pay, and trotting out my sordid cancer history one more time, I knew it needed to be done. I got lucky and there was an opening to see the second Dr P on Thursday. Perfect.

I already had a doctor’s appointment for Thursday, with Dr N to investigate the idea of getting a little nip/tuck for my bladder. If we’re going with scenario #1 and doing open surgery for the oophorectomy, might as well take care of the bladder, which is showing signs of wear & tear that will only get worse with time and my balls-out style on the tennis court. I really like Dr N and went from dreading the idea of the nip/tuck to seeing how it can seriously improve one’s daily life. And I love that Dr N called me the “perfect candidate” for this simple procedure. Hooray! “Perfect” and “simple” are two terms that have not applied to any of my cancer “journey” thus far. After all this time and a case that’s been anything but textbook, I’m the perfect candidate. That was satisfying on many levels. Dr N works with both Dr P and the second Dr P, so it appeared to be a simple case of choose which OB-GYN to do the oophorectomy, and Dr N would coordinate. I’m lucky that Dr N works with both of the OB-GYNs I’m considering, because he doesn’t work with docs in the med center, so lucky me: I have my choice of OB-GYNS and the fantastic Dr N right in my backyard.  I left Dr N’s office with something that’s been painfully absent in my cancer “journey” of late: hope. I was hopeful that this next round of surgery was going to come together, despite the shifting scenarios.

Stupid girl.

That hope was summarily dashed when the second Dr P has yet another differing opinion on how to do this surgery. What was I thinking, having hope and feeling good about the direction I was headed? What an utter fool I was for believing, however briefly, that the tide was turning and for once things were going to work according to plan. Granted, the plan has changed several times in the short span of a few days, and with each new doctor there comes a new scenario for which I have to wrap my head around, but I actually felt good after the visit to Dr N and went into the visit with the second Dr P thinking this would all come together.

I absolutely love, love, love the second Dr P. I loved him before officially meeting him when I overheard his phone conversation with a patient as I was escorted into an exam room. I have no idea what the reason was for the phone call, but he exuded care and concern with that patient via phone, and although I don’t know any details it was clear he was finding a solution. He is everything the first Dr P is not: warm, energetic, full of personality, an outside-of-the-box thinker who was genuinely interested in finding the best solution for me. He agreed with the first Dr P about my belly not having enough wiggle room to allow for laparoscopic surgery, and he introduced yet another troubling facet to this already-troublesome situation: if we do open surgery, whether using the existing incision or making another one, there’s precious little room to close that incision. The skin is just too tight–too tight to allow the area to be inflated for surgery, and too tight to close after surgery. He was also adamantly against open surgery because of the infection risk.

But the second Dr P isn’t giving up, and he hatches a new plan. Scenario #3: consult Dr K, a GYN oncology surgeon who does robotic oophorectomies.

I didn’t know such an option existed. Again, learning the hard way. And by the hard way, I mean the most exhausting and mentally taxing way. I told the second Dr P that as much as I appreciate his obvious care for the best possible outcome for me, I’m a bit on the Type A side. I’m a planner, I like things to go according to plan, I dislike change, and I do not shift gears well. In the span of 3 days, I’ve gone from laparoscopic; to a whole new incision; to using the same incision; to not favoring open surgery; to re-exploring laparoscopic; to nope, it won’t work logistically; to robotic surgery.

That wears me out.

I worked hard to wrap my head around the second Dr P’s plan. I really tried to embrace scenario #3, even though it meant adding another doctor to my roster. The second Dr P was sympathetic. He understands that I don’t want to get another doctor involved, and that I thought I had a plan and now everything is topsy-turvy. He reminded me that it’s worth it to see yet another doctor because he truly believes the robotic surgery will give me the best possible outcome, and with a shorter recovery time to boot. Sounds win-win, right?

Except that, just as I’m shifting gears clunkily and going along with this plan, another *&@%^ complication arises: Dr K, the doctor who would do this robotic surgery, is leaving the country — tomorrow — for 6 weeks.

Really?

Really???

Shoot me now.

That was it. I’d had it. I marshalled every ounce of self-control I had in order to avoid bursting into tears right there. And I am not a crier. Especially not in front of other people.

The second Dr P’s nurse, Maria, saw my distress and said, let me catch Dr P when he comes out of the exam room to see what else we can do. Thank you, Maria.

So she caught the second Dr P and told him that Dr K was unavailable for 6 weeks and that if this already-mentally-unstable patient has to wait that long to even see if scenario #3 will pan out, she may go bat-shit crazy and take us all out in a to-the-brink umbrage from which there will be no survivors.

The second Dr P called Amy and me over to the nurse’s station and hatched an alternate plan: use another GYN oncology surgeon who does robotic procedures. Thank goodness I live in a city that is ripe with specialty surgeons. But alas, both Dr K and Dr B, the second GYN oncology surgeon, work in the med center, which screws up my plan to incorporate Dr N into the surgery. Great googlie-mooglie, the idea of finding another urologist to do the bladder surgery –when I felt so good about Dr N doing it–was altogether too much to think about. I’m really on the brink now.

Sweet Maria offers to call the second GYN oncology surgeon’s office and make the appointment for me. At this point, she could have strapped me into a lunar module and sent me on a one-way trip to Mars. My brain was beyond fried so I blithely nodded my assent.

image courtesy of Johnson Space Center

retrosigns&more.net

Would you believe that surgeon’s office was already closed for the day? And is closed on Fridays, so I have to wait until Monday to even see whether I can get an appointment. Cue the to-the-brink umbrage. And the beer for dinner. Five doctors in this week–and more to come–and I’m no closer to having an answer.

This brings us back full circle, to my least-favorite part of the cancer “journey,” which is the uncertainty and the waiting. I’m uncertain about which scenario will play out, and I’m waiting to get an appointment with yet another doctor, who I fully expect will come up with yet another scenario. Here’s one thing I am certain of, and there will be no waiting on this fact: I’ll be having beer for dinner again tonight.

Jane, get me off this crazy thing!

Posted: November 8, 2011 | Author: | Filed under: breast cancer, cancer fatigue, menopause | Tags: , , , , , , , , , , | 9 Comments

Remember George Jetson? And his ill-fated stint on the treadmill? And him begging his too-cute-for-him wife to get him off the crazy thing? I know how George feels. I’ve never been a fan of the treadmill in general, much preferring to get my cardio fix outside or slog my miles on the elliptical, but this figurative treadmill I’m on now is the pits. Stop the ride, I want off.

I mentioned that I have a heavy issue on my mind and wasn’t sure what to do about it. Yesterday was intended for settling the issue and making the necessary plans to move forward. Instead, it was a craptastic example how nothing goes as planned or as expected on this damned cancer “journey.” Having just come off a week of antibiotic hell after my latest reconstruction revision, craptastic was the last thing I needed. And yet, in typical cancer “journey” fashion, it’s got to be as complicated as humanly possible.

Yesterday started with a trip to the dermatologist for ye annual mole check, and that visit ended with 2 shaved-off moles being sent off for biopsy and the unceremonial removal of 7 or 8 skin tags. Being a melanoma victim, I’m pretty serious about any weird-looking spots on my skin and don’t hesitate to point out ones that need to be lopped off. Like the Queen of Hearts from Alice in Wonderland, I say “Off with their heads.” I was a walking Band-Aid when she got done with me. Then I headed straight to my next appointment, stop #2 of 3 on the Monday doctors’ tour, which should have been a simple fact-finding trip but ended up being an exercise in frustration and confusion.

Here’s the deal: when I was first diagnosed, way back when in a time that now seems like another lifetime entirely, I knew that at some point I would need to have my ovaries removed. The oophrectomy, in addition to being an outstanding Scrabble word, was a foregone conclusion. Think about it: ovaries produce estrogen and progesterone, both of which provide the fuel for my kind of cancer. Cut off the fuel supply and starve the cancer and eliminate any hope it may have of coming back.

Simple, right?

Then the post-mastectomy infection reared its ugly, ugly head, and I wasn’t well enough to undergo another surgery for quite a long time. (Some certain people who read this blog don’t like to see mention of said infection, which I totally get, but it’s kinda vital in the chain of events, so let’s all just suck it up and read on; it was a fluke infection for which no one can be held accountable. File that one under “shit happens.”) Moving on….Then once I was well enough after the infection, I was sick to death of sickness and near-deathness, so the idea of another surgery was most unpalatable to me. I wanted and needed — and deserved, dammit — to get back to “normal” for a bit before going under the knife yet again, so the oophrectomy was postponed. But it remained a constant, a “when” not an “if.”

My stint back to “normal” was short-lived, however, because once I was recovered enough from the mess last summer, it became apparent that we needed to go ahead with reconstruction asap in order to give the now-healed chest wall a vascular system. That poor chest wall had sunk and had been sliced & diced & excised enough times that it needed fresh blood as much as Edward Cullen and his crew does. So the next step in the unscripted and not-nearly-as-exciting-but equally-dramatic-as-Eclipse saga that is my life, we commenced with The Big Dig and relocated blood vessels from my belly to my chest. After a long-ass surgery and a Hades-esque stay in ICU, the blood vessels bloomed in their new home and all was well. With my highly skilled and kick-ass surgeons, the Drs S, The Big Dig was a screaming success and I seemed to be on the right track.

Revision #1 in August and Revision #2 last week were successful as well, thanks to the original Dr S, who never ceases to amaze me with his surgical talent and artistry. That man is pure genius in the OR. Can’t recommend his work highly enough.

Having survived all these surgeries brings me to the here & now, which is the pursuit of the oophrectomy. Yesterday’s visit to the OB-GYN was a fact-finding mission for a surgery that I know in my heart of hearts I should have. Then the OB-GYN throws me a nasty curveball by questioning why I want to do this.

“Want” isn’t the word I would use for my feelings toward the oophrectomy, but I understand that it is elective compared to an appendectomy, say. But no, I don’t want to do it. I need to do it, and I’m being responsible by volunteering for it. But I certainly don’t want to do it.

Almost as much as I don’t want to have my carefully-thought-out plan upended. I listened carefully as the OB-GYN explained the permanence of removing one’s ovaries, the risks of the surgery, and the menopause it brings on. I’m there, I get it. I’m young for breast cancer and for removing my lady parts, but I’m way past childbearing and have been in menopause for the last 18 months, so I am well-versed in the hell that it is.

She spent a lot of time explaining that surgical menopause is abrupt and intense. Instead of the body gradually decreasing the amount of female hormones at its own pace, it’s like an on/off switch. One day you’re normal, the next day you’re in menopause. I’m still not sure what part of my 18 months of chemically-induced menopause she didn’t get, but suffice to say it was like banging one’s head against the proverbial wall. Bang! Bang! Bang!

Some days there’s not enough alcohol in the world to cope with these detours and speed bumps on the cancer “journey.”

(Ooooh, I think I feel a tshirt slogan coming on.)

The mess of the OB-GYN appointment continued when she was finally satisfied that she’d drilled the cons of the surgery into my head enough to examine me. She determined right away that doing the oophrectomy laproscopically (i.e., through my belly button instead of via an incision) won’t work because of the abdominal scar from The Big Dig. She thinks there’s too much scar tissue and the skin on my abdomen is too tight to allow her to maneuver laproscopically. This is one opinion, and a perfect example of why a pro-active patient solicits more than one. Nothing about my ab scar is unusual or unexpected, just makes a laparoscopic procedure trickier.

So the option to not doing the surgery laparoscopically is making another incision. She wants to make another incision, below the existing 17-inch racetrack. Another incision.  Now I’m thinking there aren’t enough cuss words to cope with these detours and speed bumps on the cancer “journey.”

(A companion t-shirt, me thinks.)

Ugh.

A most unsatisfying appointment.

There was just enough time for Amy and me to grab lunch before moving on to my next appointment. And yes, by lunch I mean drinks.

My next appointment entailed removing the two sets of stitches from Revision #2, which I expected, instead of removing them with tweezers or little scissors, there was a blade, which I did not expect. The downside to those super-tiny, uber-tidy mucho-skilled plastic surgeon stitches is that they’re a bit harder to remove than conventional, Frankenstein-style stitches. The blade was like an X-acto knife on steroids, and after the day I’d had, it scared me a little bit. But the good doctor held my hand, soothed my jangled nerves, and tut-tutted over me like the kindest of caregivers, and the stitches were no more. You can barely spot where they used to be because the incisions are so small, and the human pincushion lives to see another day.

But what about those ovaries? What to do about those?

The saga continues.

They’re baaaack

Posted: October 31, 2011 | Author: | Filed under: breast cancer, cancer fatigue, drugs | Tags: , , , , , , | 10 Comments

It’s Halloween, and what could be more terrifying (for me) than to find myself eyeball-to-eyeball with the dreaded oral antibiotics? Not much scares me after dealing with cancer and its many-tentacled aftereffects, but these drugs certainly do make me want to run screaming from the building. 

Bactrim & Minocycline, the drugs I dutifully swallowed twice a day every day for 267 days, are back. Just a quick 10-day course this time around, as a preventative measure following Thursday’s revision surgery. No big whoop, right?

Uh, not so much.

I gladly received two giant bags of IV antibiotics in the OR Thursday. Levaquin and Vancomycin are the old standbys, and they coursed through my veins Thursday morning like a herd of mighty stallions clearing the path of any wily mycobacterium that might be hanging around after last year’s post-mastectomy infection. IV abx don’t bother me one bit, but the oral ones give me the heebie-jeebies.

After puking my brains out all the livelong day after surgery, I was not ready to swallow those pills. I put it off as long as I could, and had to have a “come to Jesus” meeting with Trevor to make me get back onboard the abx train.

You would think that after taking these drugs for 267 days, a mere 10 days would be a piece of cake.

You would be wrong.

Something inside me seized up and said “Uh-uh, no way, not gonna do it.”

I couldn’t convince myself to start taking these drugs.

Trevor astutely pointed out that instead of seeing this short course as easy, my brain sees it as the equivalent of swimming the English Channel because I’ve used up my lifetime supply of mental and physical tolerance.

He’s clever that way.

I knew I had to take them, of course. I knew the risk of re-infection vastly outweighed the inconvenience of taking the drugs. But I also knew just how awful I was going to feel, and while my rational brain said take the drugs, my irrational self whined like a tired toddler way past naptime. 

Here we go again. 

One dose in, on Saturday, my tastebuds were already shot. I tried to savor one last glass of champagne, to toast surviving yet another surgery and to say salud to my improved shape. But the damage had been done, and my lifetime supply of physical tolerance was exhausted. Cue the nausea, the roiling tummy, the overall puniness, the malaise, and the distinct feeling that something died in my mouth. Nothing, and I mean nothing sounds good to me. Not even Halloween candy. And I really like candy. Especially Twizzlers.

I spent the weekend feeling sorry for myself and wondering how long it will take this time to get back to “normal.”

So far no sign of the elusive “normal.”

Macy sent me off to surgery with her best buds, Froggy and Baby Snoopy. They kept me company Thursday in the triage area while I awaited the arrival of my favorite surgeon and his pack of Sharpies. The nurses who took my vitals and started my IV thought it was so cute that my little girl sent her posse to look after me. I explained that she’s only 9 but she’s wise beyond her years.

Pedey the Weasel Dog kept me company all weekend and happily obliged my sedentary schedule. He’s really, really good at being lazy and laying low, and I’m trying to take a page out of his book.

He makes it look so easy.

 

CANCER SUCKS

Posted: October 20, 2011 | Author: | Filed under: breast cancer, cancer fatigue | Tags: , , , , , , , | 8 Comments

Cancer is so not fair.

It just sucks.

It’s such a bitch.

I hate it.

One badly timed comment; one errant remark.

That’s all it takes to go from normal to an emotional wreck. Suddenly I’m on the verge of tears–in front of other people, which is awful, and in front of one person I’d rather take a beating than cry in front of. Pride is a terrible burden sometimes.

Just one comment.

All was going according to plan at my pre-op appointment until one little utterance, slightly misinformed on the doctor’s part and hugely misinterpreted on mine, sent it all akimbo.

I was ready for this next revision. Six days and counting. Schedules rearranged, favors called in, sacrifices made…again.

I had signed up for this revision and was willing to go along with it quite voluntarily, even though it meant more pain and downtime and missing out on some important stuff. Well, important to me anyway: the annual Halloween tennis tournament at our club, which my runnin’ buddy and I won last year and hoped to recapture this year. The rest of the tennis season, for which I’ve only played 2 matches total for the entire season (and lost both, BTW, so suck it, everyone). Our regular Sunday morning match & beer-drinking with our buds Christy and John. Lots of tennis will not be played by me while I recover, yet again from yet another revision. The last-minute Halloween rituals, in which costumes are finalized and trick-or-treat dates are secured. All of this will be superseded by yet another recovery. The everyday, average tasks and duties of a regular life. All put on hold, in pursuit of a normalcy that seems ever elusive, just out of reach.

All I want is symmetry and improved shape to my newly created breasts.

Is that really so much to ask?

I’m well past the point of buying into the BS of “Bummer about the cancer but at least you get new boobs.” That dangling carrot didn’t quite pan out for me. Thanks to the ol’ post-mastectomy infection and a much-more-complicated-than-expected reconstruction known as The Big Dig, the prize at the finish line of my cancer “journey” isn’t much of a prize at all. It’s more a reminder that no matter how skilled the surgeon, no matter how many versions of revision I endure, my body is never going to be the same. It’s never going to look like it did before cancer shat all over my head at the ripe old age of 41.

I’m not stupid. I don’t expect my body to look like it did pre-cancer. I don’t expect my life to be carefree and manageable like it was pre-cancer. But I really didn’t think it would be this bad, this hard. I really didn’t think it would be so bloody difficult to deal with the reality of cancer day in and day out.

Sure wish someone would have warned me.

Because I bought into the “get through the scariest, worst experience ever and you’ll live happily ever after.” And silly me, I thought I was dealing with all the repercussions of the post-cancer life.  I’ve faced the ugliness head-on. I’ve tucked my head and kept on truckin’. I’ve plastered a smile on my face and counted my blessings. I’ve poured out my feelings — good and bad — in an effort to “deal with it.” I’ve done the research and shown up for all the required appointments. I’ve endured more poking, prodding, and pinching. I’ve suffered through humiliations large and small. I’ve managed the pain and the crazy emotions. I’ve found myself smack-dab in the hell that is chemically-induced menopause and lived to tell about it. I’ve made a point to take my medicine, literally and figuratively, even when it tasted like poison and burned my insides to a crisp. I’ve learned to accept that schedules don’t matter to cancer, that there is no way to predict or prepare for the twists & turns that comprise this cancer “journey.”

I thought I was dealing with it all, and dealing with it quite well.

Silly, silly me.

Thank you, google images. 

13 facts about MBC

Posted: October 19, 2011 | Author: | Filed under: breast cancer, cancer fatigue | Tags: , , , , , | 4 Comments

 Metastatic Breast Cancer Awareness day has come and gone , but it coincides with the anniversary of my mom’s death (from cancer, natch), so I didn’t get to really blab about it on the actual day. I want to do that now.

I’ve gotten to know some bloggers who have MBC, and I’ve learned a lot about it. I have an entirely new understanding of it, although I can’t really know what it’s like.

I think about MBC a lot because my brain likes to go to those dark, scary places sometimes when it’s not otherwise occupied with thoughts of what I can cobble together for dinner, whether there’s enough dog food to put off the Costco run, and transporting children to games, practices, and lessons.

When I was newly diagnosed and consulting with oncologists, one of the oncs I didn’t pick said something that has stayed with me. (I didn’t not pick him because he said this, by the way.) He said once a cancer comes back, it’s no longer curable. No matter what stage you start and how fortuitous your prognosis, once it comes back, you move from curable to treatable.

Whoa.

That is frightening.

It’s also true.

I think about recurrence all the time. As in, at least once every day. Not in a wringing my hands kind of way, but in a “this is my reality” kind of way. I’ve done my homework and I’m very realistic. I would be surprised to skate outta this life without cancer yet again crashing my party.

Even though I feel like I did everything right, there is no guarantee that I won’t face recurrence. Bilateral mastectomy at age 41 seems drastic, but I like slash & burn warfare. Even though I have no breast tissue, I am not guaranteed that breast cancer won’t come back. My rate of recurrence is low, statistically, but as I’ve learned the hard way, stats don’t guarantee anything either.

I’m not saying this to be negative. No sir. In fact, there’s a tremendous amount of pressure on cancer patients, especially those with breast cancer, to be positive, to be optimistic, to be chipper about the fight. The irascible Molly Ivins spoke on this topic better than anyone:

“I suspect that cancer doesn’t give a rat’s ass whether you have a positive mental attitude. It just sits in there multiplying away, whether you are admirably stoic or weeping and wailing. The only reason to have a positive mental attitude is that it makes life better. It doesn’t cure cancer.”

Amen to that.

Molly also said this about BC: “Having breast cancer is massive amounts of no fun. First they mutilate you; then they poison you; then they burn you. I have been on blind dates better than that.”

But my favorite thing she said about BC is this:

“Losing a part of a breast or all of one or both has, obviously, serious psychological consequences. Your self-image, your sense of yourself as a woman, your sense of your sexual attractiveness are going to be rocked whether or not you have enough sense to realize that tits aren’t that important. I am one of those people who are out of touch with their emotions. I tend to treat my emotions like unpleasant relatives–a long-distance call once or twice or year is more than enough. If I got in touch with them, they might come to stay. My friend Mercedes Pena made me get in touch with my emotions just before I had a breast cut off. Just as I suspected, they were awful. ‘How do you Latinas do this–all the time in touch with your emotions?”‘I asked her. ‘That’s why we take siestas,’ she replied.”

Molly Ivins died of metastatic breast cancer on January 31, 2007 at age 62. I miss her sass, her liberal bias, and her writing about politicians who are “too big for their britches.” Anyone who uses that expression regularly will always have a seat at my table. The following 13 facts are  in her honor. It’s not much, Molly, but I hope it’s something.

googleimages.com

13 Facts Everyone Should Know about Metastatic Breast Cancer

1. No one dies from breast cancer that remains in the breast. The lump itself is not what kills. The metastasis of cancerous cells to a vital organ is what kills.

2. Metastasis refers to the spread of cancer to different parts of the body, typically the bones, liver, lungs and brain.

3. An estimated 155,000 Americans are currently living with metastatic breast cancer. Metastatic breast cancer accounts for approximately 40,000 deaths annually in the U.S.

4. Treatment for metastatic breast cancer is lifelong and focuses on control and quality of life vs. curative intent. (“Treatable but unbeatable.”)

5. About 6% to 10% of people are Stage IV from their initial diagnosis.

6. Early detection is not a cure. Metastatic breast cancer can occur ANY time after a person’s original diagnosis, EVEN if the patient was initially Stage 0, I, II or III and DESPITE getting annual checkups and annual mammograms.

7. Between 20% to 30% of people initially diagnosed with regional stage disease WILL develop metastatic breast cancer.

8. Young people DO get metastatic breast cancer.

9. There are many different kinds of metastatic breast cancer.

10. Treatment choices for MBC are guided by hormone (ER/PR) and HER2 receptor status, location and extent of metastasis (visceral vs. nonvisceral), previous treatment and other factors.

11. Metastatic breast cancer isn’t an automatic death sentence. Although most people will ultimately die of their disease, some can live long and productive lives.

12. There are no hard and fast prognostic statistics for metastatic breast cancer. Everyone’s situation is unique, but according to the American Cancer Society, the 5 year survival rate for stage IV is around 20%.

13. October 13 is National Metastatic Breast Cancer Awareness Day. To learn more about it as well as resources specifically for people with metastatic breast cancer see www. mbcn.org. We appreciate your support on October 13 and throughout the year.

2 friends

Posted: October 14, 2011 | Author: | Filed under: breast cancer, cancer fatigue | Tags: , , , , , , , , | 5 Comments

Two of my friends got the dreaded call from their OB-GYNs after their routine mammogram. The call that makes you sweat. The call that makes you wish you’d refused to pick up the phone. The call that makes you wonder how the person on the other end of the line can be so calm when you’re freaking out. The call that sets in place a chain of events that have the power to change your life forever.

How ironic that out of all the women in the world, and out of all the women I know personally, and out of all the women I consider friends, two of them got the call. On the same day.

It stinks.

It’s not fair.

I don’t like it.

But that’s the reality of breast cancer.

It’s indiscriminate. It cares nothing for age — both of my friends are under 40. It cares nothing for financial status. It cares nothing for how well or how poorly one treats one’s body. It strikes old and young, wealthy and struggling, health nuts and McDonald’s junkies. That’s the reality. There’s very little rhyme or reason to it. It’s a crapshoot.

I’ve said it before and will continue saying it: I’m so sick of cancer.

The reality of any kind of cancer is shitty. I can’t think of a better word for it. Any cancer is shitty. I speak of the shittiness of breast cancer because that’s the one I know, but I certainly don’t think it’s the only cancer that is shitty. Just a disclaimer and an affirmation that all cancer is shitty. And proof that I really like using the word shitty. And shittiness.

There is of course a good chance that both of my friends will escape breast cancer’s grasp. I’m hopeful that the follow-up ultrasound/MRI/biopsy shows nothing. Calcifications, fibroids, dense tissue, cysts. There are lots of things it could be, and the rate of false negatives is something to hang on to in these situations. The National Cancer Institute puts that false-negative rate at 10 percent. I’m hopeful. “False-positive mammogram results can lead to anxiety and other forms of psychological distress in affected women. The additional testing required to rule out cancer can also be costly and time consuming and can cause physical discomfort,” according to the NCI website. Really? Ya think?

That’s ok. Both of my friends can take the costly, time-consuming, and uncomfortable aspects of the additional testing. It’s the anxiety-causing aspects that are hell. The thoughts that run through one’s mind between receiving the dreaded phone call and getting the additional testing can make one crazy. Then there’s the infernal waiting period between the additional testing and receiving results. It’s a wonder we’re not all stark-raving maniacs popping sedatives every hour on the hour.

This is the reality of breast cancer.

Even when it hasn’t struck, when it’s a mere possibility instead of a certainty. Even when it hasn’t infiltrated your life for real, it has the power to mess you up.  Way before actual diagnosis, the reality of breast cancer is harsh and unrelenting. And guess what? Even after “getting through it” in terms of receiving the dreaded phone call, having the additional testing done, hearing the actual diagnosis, making the decisions necessary, and undergoing surgery and/or treatment, it’s harsh and unrelenting. Coming to grips with one’s new body. Dealing with the mountains of paperwork and bills. Keeping abreast (haha) of the latest research. Deciding what lifestyle changes to make or not make. Navigating the psychological fracas. Coming face-to-face with mortality. Moving through the treacherous stages of emotional distress. Facing the ever-present prospect of recurrence.

This is the reality of breast cancer.

One of my two friends fell victim to crappy insurance. She had some symptoms that caught her attention months ago but waited to get it checked out until the new, better insurance took effect. Even in the suburban bubble, where affluence reigns, insurance hassles prevail.

Which leads me to remind everyone to please take a few seconds out of your day to vote for The Rose in The Pink Well Challenge that I mentioned yesterday. The Rose helps women who don’t live in an affluent bubble get access to the breast health care that can make a real difference in their lives. If you’ve ever spent one second thinking how lucky you are to have whatever version of insurance you have, this is your chance to give back. If you have no insurance and you’ve spent more than one second worrying about that, this is your chance to help others in the same boat. If you have great insurance and have never had a health worry, I don’t want to talk to you right now but you can still help. 🙂

It’s easy to help, but time is running out. Click on The Pink Well Challenge link above or right here, click “VOTE NOW,” enter your email address, check your email for the access-granting link (do it now, not later because I don’t want you to forget), click the link, scroll down to charity #137, enter “10” in the box on the far right, and submit. Tell your friends and nag your family members.

And keep your fingers crossed for my two friends.

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