Good ol’ Dr S

It’s been too long since I’ve posted a good story about Dr S, my most-favorite and much-abused plastic surgeon who saw me through the worst of the infection(s) this past summer and with whom I have an ongoing love-hate relationship. I love to needle him, and he hates to see my name on his clinic schedule!

I saw him Friday for a check-up (I love the way “check-up” sounds so simple & innocent, and misleadingly free of scary stuff like tumors and fat necrosis and scar tissue and reconstruction). He’s usually pretty prompt, and out of the many, many office visits I’ve had with him, I really haven’t had to wait too long for him. The few times it has happened, though, it has made me mad and I let him know it. I understand that delays happen, and the doctor isn’t always in control of the schedule, but I’m just an impatient person and it annoys me. My bad.

Friday was no exception. After waiting nearly an hour in the waiting area (so aptly named, that place), I waited some more in the exam room. I’ve explained before that although I am “just” an at-home mom, my time is still valuable, and I prefer him to keep some other patient waiting and get to me first. Not that I want some other patient to have to wait longer than me, but really once you’ve been diagnosed and gone through a nasty surgery and then the whole infection scene and multiple hospitalizations, well, ok maybe I do want someone else to have to wait longer. Surely all of that mess garners some sort of street cred or extra credit or something that allows me to go to the front of the line. But no. Like so many things related to cancer and subsequent recovery, there’s no easy way, no priority boarding, no free ride.

So after an hour of waiting on Friday, Amy and I were joking, as we’ve done before, about the many ways we could get his attention. We can usually hear his voice through the exam room walls and can gauge if he’s wrapping things up with the previous patient (although sadly, we can’t make out all the words and so can’t really get a sense of what they’re discussing, and y’all know how nosey I am; being able to properly eavesdrop would pass the time quite nicely). We’ve considered texting him from the waiting area and the exam room (yes, I do have his cell number), or knocking on the walls and hollering, Hurry it up in there, we’ve got to get back to Sugar Land for carpool!

Well on Friday we hatched a new plan and decided to write him a note and slip it under the door. We ripped the paper covering from the exam table and scribbled, You’ve got 5 minutes. Then we stuck it under the door.

Ballsy? Perhaps. Rude? A little. Effective? Most definitely. He burst through the exam room door post haste, note in hand and grinning wildly. He needed a little shake-up to his day. He muttered something about how he’s never in all his years had a patient give him so much grief. I replied that I’ve never in all my years liked waiting, something I’ve been imminently clear about from day one with him. Y’all may recall from my previous blog on Caring Bridge that I told Dr S at our first consultation, shortly after my diagnosis, that I know full well and good that he has other patients; I’m not his only patient, but I expect to be his number-one priority. I was kidding then, but oh how eerily prescient that little wisecrack turned out to be. Six months later–and today is exactly six months since my mastectomy–that man is still not rid of me.

Here’s the really funny part, though — he actually tried to blame his lack of punctuality on Daylight Savings. He said his schedule has been messed up since the time change, and I guess what we’re supposed to infer from that is that it’s not his fault. Time change, huh? It must have been pretty clear by the look on my face that I wasn’t buying that, because he asked me why I was looking at him as if he were FOC. I wasn’t familiar with that acronym so he said what about FOS? That one I know, and told him that I did indeed think he was FOS. Totally FOS. Since we “fall back” with the time change, he should have been an hour early!


cancer fatigue

I got a new jacket for tennis, since it’s getting chilly around here in between hot flashes. I noticed this tag on the jacket and am a bit freaked out that my first thought was that this jacket had some kind of special feature for my port. So sad. Even after I read the “access for embroidery” words on the tag, my brain was still trying to figure out what this had to do with my port: is there a special pocket for my port, like how some workout clothes have a teeny pocket for an iPod? How cool is that? But weird, too, since I can’t exactly take my port off and zip it into a pocket — it’s sewn into a vein!

Uh, not cool. It’s sad. Way sad that my brain is so conditioned to think about all things cancer-related that this is where it goes. Boo! Upon further contemplation, I realized this pocket is a shortcut for an embroiderer, to make it easier for them to stitch a logo or something on the jacket. It has nothing to do with my port. Sheesh.

On a happier note, I experienced something pretty great today: I took my friend to her doctors’ appointments. It was not only nice to spend the day together but also fan-freakin-tastic to be just the driver and moral support and not the patient. I’ve spent a lot of time in doctors’ offices lately, and while I still have my share of appointments on the horizon, I’m ecstatic that I’ve reached the point of being able to give back to my friends, who have given so freely & generously their love, presents, support, presents, meals, presents, rides, presents, child care, and presents.


It’s just rice

Most people probably spend the extra hour we gain in Daylight Savings by sleeping. I usually use that extra hour to clean, as something around here always needs cleaning. This time, however, I’m going to spend the extra hour reflecting on my good health.

It’s a tenuous state. And after my little scare this week, I’m planning to savor it even more. In case you missed the update, I had some fluid on my right side that Dr S wanted to drain so he made yet another hole in my chest wall on Tuesday. All week the gunk that drained out of the latest hole was pretty nasty looking, and infection was on everyone’s mind.

Friday I saw the newest member of my infectious disease team, Dr Samo. I wanted him to see the gunk and tell me unequivocally that I had nothing to worry about. As much as I try to live by the “don’t borrow trouble” mantra (thank you very much, Amy Hoover), this gunk was worrisome.

As I drove into the Medical Center Friday morning, I was mentally reviewing the all-too-familiar list of things to pack for a hospital stay, just in case. I even wondered if I should pack a bag, since I had no idea what to expect from this doctor visit. Imagine my relief when Dr Samo was universally unimpressed with my gunk. I’m really glad. He said he agrees with Dr S, that we’re not looking at infection but simply some unhealthy tissue that’s not getting enough blood supply and dying a slow, gunky death. That kinda creeps me out, to think of decaying stuff on the inside, but compared to infection it’s positively lovely. Big sigh of relief.

There was some great comic relief in the waiting room of Dr Samo’s office. An elderly lady was waiting with her daughter, and both were pure country. They talked r-e-a-l slowly and with a heavy twang. No idea what they were there for, but they had a hilarious conversation that was too funny to not overhear. Mama said to daughter (very s-l-o-w-l-y), Next time you go to the store, I want you to bring home an orange. After a very long pause, daughter asked why, and mama said, to eat of course. Daughter chose to dredge up some ancient history by mentioning the apples she brought home from the store that mama never ate. Mama knew she was busted, and deftly changed the subject to someone named Timothy, who apparently isn’t much into fruits & vegetables, but according to mama, eats more than you think. She went on to say that when you think about it, Timothy eats salad (r-e-a-l g-o-o-d), and will eat peas, corn, potatoes, baked beans and rice. Daughter let the baked beans go, but pointed out that rice isn’t a fruit or vegetable. Mama said, well sure it is; if not a fruit or a veg, what is it? Daughter said, It’s just rice.

So there you have it folks, at the end of the day, it’s just rice.


supplies

I was just wondering what I could blog about, since it’s been a while since I’ve posted anything. Now that my life is more or less back to normal, there’s just not as much fodder for posts. This is a good thing, because it means my health isn’t full of breaking-news updates, but a bad thing because I really like writing and many of you kind souls have said you really like reading my posts. So I was pondering this while doing something seemingly insignificant but actually quite momentous over the weekend. I put away all my medical supplies.

There’s been quite a collection on my bathroom counter since August. Way back in late July & early August, while I had home health care for the IV antibiotics, I amassed a huge pile of supplies. Everything from wound vac stuff (remember Sucky?) to heparin flushes to alcohol wipes to gauze pads. And a bunch of other stuff in between. I hated every piece of medical paraphernalia from the moment it entered my home. I know I should be grateful for it all, and for the comprehensive health insurance that paid for everything. And I am. I truly am grateful, and think a lot about how much more stressful this whole mess would be without insurance. But I still hated all the supplies.

I hated the supplies because they reminded me, in a very tangible way, of how perilous my health was. No one ever talked out loud about how dangerous this infection business really is, but you’d have to be be pretty dense to not get it. I certainly didn’t need a reminder to know that my situation was serious — I lived it every second of every day. Even now, 2-plus months after all that mess, it still scares me, just a little bit. I still look over my shoulder and don’t entirely trust the good health I’ve been enjoying lately.

So this weekend I got cocky and decided it was time to pack away the supplies. I no longer needed the saline and gauze to clean a wound, or the antimicrobial silver dressing to put inside the wound, or the antibiotic cream and tape. My skin can finally breathe now that it’s not encased in plastic dressing and tape. I’ve been lax in taking my temperature every day, and only do it every other day. I still have the syringes and teeny little vials of B12 liquid that gets injected in my arm once a month. And I still have a stash of pain pills, which I don’t need but I like knowing they’re around, just in case. But for the last several weeks, I haven’t needed to get into those supplies.

Once that nasty wound finally healed, there was little need for the plethora of stuff, but I was so used to having it on my bathroom counter, it all really seemed to belong there. It became a fixture, I suppose. Until this weekend. When I got cocky, again. Last time I got cocky, I decided I didn’t need the probiotic anymore, even though I’m still on two antibiotics twice a day. That lasted exactly 2 days. But several weeks had passed without incident, so I guess I got bold and decided it was time for the supplies to go.

Silly, silly girl. When will I ever learn? I’d been feeling not quite right for the last several days. Nothing I can really pinpoint, but something seemed off. So when I saw Dr S today he immediately noticed a reddish-purpleish spot on my right side that seemed pretty puffy. I think his exact words were, What the hell is that??? Never a good sign. So he poked around for several tense minutes and sure enough that spot felt different than the surrounding tissue. He squished it pretty good and said there’s fluid in there.

I won’t repeat the litany of curse words that went through my head at that exact moment, but suffice to say it would make a former Marine or tattoo artist or school lunch lady proud. That was some professional cussing going on in my head. The quality of the cussing almost distracted me from the inevitable: Dr S moved away from the exam table (which is like a second home to me) and headed for his supplies. He never says much but we’ve been down this road before, or as Payton’s speech teacher Ms. Pointer would say, this is not our first rodeo.

No, sadly, Dr S and I have been rodeoing together long enough that I know that when he heads for the supplies, he is going to come back with a sharp object in his hand and a very determined set to his jaw. He did not disappoint me.

He sliced me right open,  and sure enough the fluid came rushing out. Not as dramatic as the “black gold, Texas tea” segment on the opening scene of The Beverly Hillbillies but it did bring that little blast from the past to mind.

Long story short, we don’t know what’s going on. It’s probably nothing serious (repeat that phrase 1,000 times for good measure). He cultured it, so maybe we’ll know something by the end of this week. Or maybe not, because one thing I’ve learned in this long, rotten education is that you don’t always get an answer right away, and you don’t always get the answer you want. Fingers crossed that we’re not talking about an infection here. I shudder to think about the prospect of another infection, or a variation on the one I already had, especially since I’ve been on 2 oral antibiotics for something like 12 weeks. Yes, you read that right: 12 weeks. Nearly 100 days of twice-daily abx. If I’m not covered then I may just have to give up, tell the bacteria to come & get me. Have at it.

I’m not ready to start waving the white flag just yet. But I will get the supplies out of the bathroom closet and put them back on the counter, where they belong. At least for now.


Oh no, not again!

So I have this little spot on the area formerly known as my right breast, which is now known as the right chest wall and was, over the summer, the site of a whole lot of activity. Things have been really calm lately, so I guess it was time for something to happen. This little spot popped up a week or so ago, about the time I started playing tennis again. Because I so enjoyed being back out on the court, and because I really needed to believe that I was finally out of the woods, I tried to ignore it. It wasn’t very big, it wasn’t all that red, and it only stuck out a little.

Well, if I’ve learned one thing from this whole mess, it’s that ignoring a spot in the hot zone doesn’t work. Never. No matter how hard you try. So once this little spot got a little bigger, a little redder, and stuck out a little more, I knew it was time to make the call.

I’ve gotten to know Dr S’s office manager, Marcie, and his nurse, Brenda, really well. Maybe too well. So when Marcie answered and I told her what was going on and I asked her if she wanted to ask him if he needed to see me, she said she wasn’t going to ask because we both know the answer. And yes, she does just lay it out there like that. Personally, I find it refreshing.

My  next check-up with the good doctor isn’t for another 3 weeks, and Marcie said there’s no way he’s going to wait that long to see you, so get yourself on in here. I tend to do what Marcie says. Dr S, not so much, but Marcie for sure.

When Brenda saw the little spot, she made that face. That “I skipped the poker face” lesson in nursing school. That face that makes me want to run screaming out of that building and never come back. So not only did she make the face, but she said he’s probably going to want to biopsy that. Commence running and screaming.

He wasn’t in that exam room five seconds before he hollered at Brenda to get him a syringe and a needle. I said, Wait — a syringe and a needle? Why both? What are you going to do? He looked me right in the eye and said, I don’t know, but I need a needle! A this point, it was too late to run screaming from the building, but I wanted to.

He poked the spot with the needle– more than once — and then used the syringe to try and collect something but nothing came out. The spot appears to be nice and harmless. Perfectly innocent. It’s probably scar tissue, so we’re just going to watch it. Keep an eye on it. See what happens.

Works for me. I’m thinking I’ll be out of there in time to get the cheap rate on the parking. Just wanted to ask him one question though, real quick as he’s out the door.

All I wanted to know was the name of the doctor in Miami who pioneered the technique that he’s thinking of using for my reconstruction. I’ve done a little research, but not much, and wanted to make sure I was headed in the right direction.

I have a lot of questions about this procedure, and it’s a big decision to make now that it’s not as simple as tissue expanders to implants. But I wasn’t going to ask the questions right then, because that’s a conversation for another time. I just wanted to know if I was on the right track in my fact-finding.

If you missed my post on Caring Bridge a while back about the “examine the fat” game I played with Dr S not once but twice, for two times the humiliation, you’re in luck because I’ll be dadgummed if he didn’t want to play it again. And as we all know, whatever Dr S wants, Dr S gets.

(If you want to read the original post, go to http://www.caringbridge.org/visit/nancyhicks/journal/2. I haven’t figured out how to add a link to this blog so if that doesn’t work, go to the old Caring Bridge blog and look at the journal entry for October 6th).

Why that man insists of tormenting me, I will never know. But I think he really enjoys it. Just as I’m wrapping my head around yet another change in the game plan, from TRAM-flap reconstruction to this new Brava technique of building new boobs out of fat that’s been relocated, he throws me another curve ball. Now he’s thinking that maybe the Brava technique isn’t the right option for me after all. Maybe we need to re-visit the TRAM-flap, which means he needs to pinch an inch and see how much building material I have.

I said uh-uh, no way, not again. We have done this twice and I’m still recovering from the humiliation. I’m not doing it again. He didn’t go so far as to say he doesn’t remember, but that’s my suspicion. I guess I should be flattered that my fat is so unremarkable as to render him striken with amnesia not once but twice, but I’m too wrapped up in being humiliated, again.

That man doesn’t take “no” for an answer. I said it repeatedly, and y’all know I’m no weenie when it comes to making myself heard. I told him politely then with some choice words that I wasn’t going to show him again. His response: Come on, it’s not like I’m a stranger.

THAT’S THE PROBLEM! Once you lose the “stranger” status with your doctor,  you move from clinical to personal, in a hurry. I know this man too well and have quite frankly been through enough already and really shouldn’t have to suffer yet another indignity.

However, knowing him as well as I do and having been through as much as I have with him, I know the fastest way to get through the unpleasantness is to just, well, get through the unpleasantness. And that’s how I found myself once again playing the “examine the fat” with Dr S.

And guess what? The result was exactly the same: He scrutinized my belly and said there’s probably enough to make a B-cup. But only on one side. I said, I know you think I’m really demanding, but I insist on having a matched set. We had previously discussed the idea of doing the TRAM-flap for one side, and using an implant on the other side, but I said then and said again that I don’t want to do that. Just seems like asking to be lopsided at some point down the road. He actually agreed with me, which scared me just a little.

So he seems to be leaning toward the TRAM-flap again, and away from the Brava technique. He gave me the website to research, I said, ok fine, we’ll talk about it later. And I thought I was out of there.

As I was checking out with Marcie, though, he called me into his office. It’s not quite like it was being called to the principal’s office as a kid, but a little disconcerting still. He’d pulled up the website and wanted to go over it right then & there. I didn’t even want to think about how many patients were waiting for him.

So we looked at a bunch of photos and I was quite underwhelmed with the results. Maybe it’s because I was perfectly satisfied with the set-up I had, pre-mastectomy. I’ve explained that to Dr S before: that while he does amazing work, and the majority of reconstruction patients whose photos I’ve seen look way better after than they did before, I was just fine where I was. So the “new boobs” as a prize for going through breast cancer, mastectomy and reconstruction isn’t a big draw for me. Excuse me for being underwhelmed.

As if I’m not confused enough at this point, he introduces yet another option: taking the muscle from my back, under the shoulder blades, and using that to build the new pair of goods. We looked at some photos of that, too, but I had one question: how would that affect my serve? Seems to me that slicing the muscle away from an area that is used to torque the body and generate force while serving the ball means bad things for one’s game.  I’m not going through life with a permanently wimpy serve. I’ve suffered enough.


10 tips

So I’m getting groceries, minding my own business and trying to get on with my so-called normal life (as normal as life can be after breast cancer but before reconstruction), and I see a pamphlet titled “10 Tips for Getting a Mammogram.” This ought to be good.

Tip #1: “Yearly mammograms are recommended starting at age 40 and should be done every year for as long as a woman in in good health.” And if you’re not in good health? More often? Less often? That kind of construction bugs me.

Tip #5: “Try not to schedule a mammogram when your breasts are likely to be tender, as they may be just before or during your period. This will help lessen the discomfort.” Really? They think that’s going to help? I say try to schedule a mammogram after slamming 3 grande margaritas to help lessen the discomfort. But then I remember that I have neither breasts nor periods anymore, so I guess I can go straight to the margaritas.

Tip #8: “Only you and the technologist who positions your breasts will be present for the mammogram. Most technologists are women.” Most technologists are women? Now I’m really curious about the ones who are men. What percentage? Do women complain about having a male do their mammo? Is there a support group for male mammo techs? Are they cute?

Tip #9: “The entire procedure should take about 20 minutes. Your breasts will be compressed between 2 plastic plates. The compression may be painful, but should only last a few seconds.” I could make a smarty-pants comment about how long the pain of a mastectomy lasts but I’m not even going to go there. I will tell you it’s more than a few seconds.


6 years later…

Today is National Metastatic Breast Cancer Awareness Day. Congress said so, and in making such a proclamation, let’s hope we get some action. Action beyond pink ribbons and promotional tie-ins like toilet paper and cups of yogurt. The estimate is that some 160,000 women are dealing with metastatic breast cancer, but I suspect the number is much higher. Metastatic means the cancer has spread. Stage IV. There is no Stage V. Every BC patient’s worst nightmare. Because being diagnosed at all, regardless of stage, isn’t nightmare enough.

I’ll save the mets post for another day, because there’s another commemoration taking place today, and I won’t be able to rest until I get this post out of my head.

Or so I thought.

I sat down at my computer to mark this important day, but I got nothing. I am stuck. The enormity of the topic overwhelms me. I want to write just the right thing, but in my quest for perfection I’m struck down, unable to convey the importance that screams to get out.

It’s not often that I’m at a loss for words, particularly on this little blog. I rarely have trouble thinking of what to write, and most days the topic guides me. Sometimes a topic pops into my head and I have an overwhelming urge to write. My fingers on the keyboard can hardly keep up with my thoughts as they tumble out of my head.

But today, I’ve got nothing.

And rather than make myself crazy on this day, this important yet heartbreaking day, I’m going to re-run the post from last year. I added a few more pictures, because this time last year I was brand-new to blogging and hadn’t quite figured out how to manage the images in my posts. But more importantly, I added a few more pictures because I need to remember what she looked like.

My heart is heavy as grief once again rears its ugly head and reminds me that she is gone, forever. 
It’s been exactly 5 years since my mom died. Lots of people have written about loss & grief, and most of them have done it more eloquently than I. If you knew her, you loved her. Plain & simple. She was one of those people. She never met a stranger and could talk to anyone. The stories are endless, and if I think really hard I can conjure up the sound of her laugh. I have to work hard to remember her voice, though, because her “sick” voice is the freshest one. I also have to think back to how she looked, pre-cancer, before the dreaded disease ravaged her body yet was unable to extinguish her effervescent personality.

My mom was an incredible cook. She grew up on a farm and lost her own mom at age 13, so she assumed more responsibility than a middle-schooler should. She taught me a lot in the kitchen, although I’ll never match her skill with pie crust. I try every year at Thanksgiving and Christmas, and end up exhausted, frustrated and having used a month’s worth of curse words. One year at Christmas she gave coupons for a homemade pie, and those were highly prized gifts for sure.

She was a “white” woman who married into a Greek family. “White” means anyone who’s not Greek. Sometimes the Greeks aren’t happy about “whites” joining a family, because they want their kids to marry other Greeks. My mom didn’t let that stop her. She ingratiated herself into the lives of the Greek women and learned their culinary secrets. It wasn’t long before she was the best cook in the bunch. Not bad for a “white” girl.

My sweet mama was the quintessential suburban at-home mom: PTA president, Girl Scout leader, queen of homemade Halloween costumes. She put a homemade meal on the table every night for dinner, and I was halfway through elementary school before I realized that the homemade cinnamon roll that was my lunchbox treat was a rarity.

She had a love of learning that I see echoed in my own kids. I’m sure she flourished at college, probably thrilled to be responsible only for herself for the first time in years. She was president of her sorority and got this fancy necklace to wear during her reign. The look of pure happiness on her face makes me smile all these years later. In her typical over-achieving way, she graduated college in 3 years, then became an English teacher before she became a mom. My whole childhood, she had us look up words in the dictionary to learn how to spell. I won the spelling bee in 4th grade, and to this day am proud of being a good speller. She instilled a love of words and reading that I’ll carry with me my entire life.

When Trevor graduated from business school in 2004, she was as proud of him as if he were her own child. In fact, once he married into her family, she considered him a son. Not a son-in-law, but a son. She was sick at the time this photo was taken, but hid it well. She didn’t want anything to interfere with his big day.

She had a lot of success in life, but her greatest achievement was being YaYa. She loved her grandbabies to the max, and when she knew she was losing her battle against cancer, she spoke of her sadness in not being able to watch them grow up. She’s missed out on a lot. But loss is a 2-way street, and the 4 kids who were lucky enough to have her as their YaYa, albeit way too briefly, have missed out as well. As each year passes, and her grandbabies grow up, they change and take on new interests and habits. She would have loved every minute of it. Something tells me she would have been quite adept at navigating whatever stage those little darlins are in.

Here they are on the day of her funeral.

Andrew was 8, Payton and his cousin Megan were 6, Macy was 3 when YaYa died. She was 67. Way too young, all the way around.

Life isn’t the same without her. While the pain of loss has lessened over the years, it’s still there, and I suspect it never goes away. No one in your life loves you the way a mother does. And no matter how old I become, I will always miss my mother’s love. Oliver Wendell Holmes said that “mothers carry the key of our souls in their bosoms.” That certainly was the case with my mom.

Milestones are hard when you’ve lost someone so dear. Every year, the week or so leading up to the anniversary of her death has been miserable. I find myself transported back to the time of  illness and all of the unpleasantness that entailed. Taking care of her was both the hardest thing ever and the greatest honor. I went into it knowing it would be hard, but having no idea how brutal. Balancing that with taking care of my young family was grueling, no doubt. But I wanted to come out of it with no regrets, and I’m happy to say that I did.

This year, however, was different. I wasn’t dreading the date. Maybe because I’ve got a lot on my mind and a lot on my plate. Maybe because as I get ever closer to regaining my “normal” life after my own cancer battle, I have a new perspective. Maybe I’m just getting absent-minded in my old age.

For a while after she died, I looked for her in crowds: at the grocery store, at a baseball game, at any random gathering. I knew, of course, that she wasn’t there. At least my rational brain knew that, but I looked anyway. I don’t know when it was that I stopped looking, but at some point, I started to see her. Not really her, but glimpses of people or expressions on faces that recalled her: the woman at the gym who looks a lot like her from the back. The resemblance in my niece to my mom’s photos as a child. My aunt’s hands, which look just like my mom’s.

This year, today, on the anniversary of her death, I wasn’t looking for her, but she was there. Today in my much-anticipated first tennis match since my mastectomy, my opponents’ names were Barbara and Ann. Guess what my mom’s name was? Yep, you got it — Barbara Ann.