Apropos

Posted: February 28, 2011 | Author: | Filed under: breast cancer, drugs, infection | Tags: , , , , , , , , , , , , , , , , , , , , , | 6 Comments

Two pieces of news today, all contained in one handy-dandy post. First, this comic made me laugh, even though it’s not applicable to me since I need both sides. Luckily, I don’t have to save up for one or both sides. Thanks to the Women’s Health and Cancer Rights Act of 1998, it’s covered.

So for those litigious souls out there who’ve pestered me to “make sure the doctor/hospital/insurance company/orderly/mammogram technician/parking booth attendant/janitor pays to clean up the mess that infection caused,” you can rest assured that I’m getting what’s owed me, so to speak.

Yes, people have actually said that to me. That I need to make sure somebody else pays for what happened to me.

Cha-ching.

If only it were that easy. Or if only I were that shallow, or had the energy to try and create a lawsuit, then all my troubles would be over.

As if.

I don’t hold anyone responsible for the post-surgery infection any more than I hold the sun responsible for rising each day. Some things just happen. Yes, I know there’s a scientific reason for the sun rising, something to do with the pull of the tides or the rotation of the Earth or some such phenomenon. But that’s not nearly as interesting or titillating as ambulance-chasing lawyers drumming up skeevy lawsuits.

If not for the Women’s Health and Cancer Rights Act, I’d be calling Jim Adler, the “Texas Hammer” real soon. The “tough, smart lawyer.” I bet he could get me top-dollar for my medical misfortune. But I’ll leave him alone for now and let him focus on the important cases, like the nasty 18-wheeler wrecks in the middle of the night.

Thanks to the WHCRA, a federal law says my insurance company has to pay for my reconstruction. The law refers to “mastectomy-related services,” which sounds a lot more exciting than it really is. Wonder if I can campaign to make mani-pedis part of the “mastectomy-related services.”

I first heard about the WHCRA while reading Promise Me, by Nancy Brinker. She’s Susan G. Komen’s little sister, who made the promise to her dying sister in 1981 that launched the global breast cancer awareness movement.

Thankfully, “breast cancer” is now a household term instead of a shameful secret, as it was in the past, and health insurance companies can’t deny the coverage required to fix the problems that breast cancer surgeries and treatment create. I could fill this entire screen with facts & figures, befores and afters, thens and nows, of breast cancer. But instead I’m thinking about the WHCRA.

Because of the WHCRA, I don’t have to worry about whether I can afford to clean up the mess that breast cancer (and its bad-news friend, the post-surgical infection) created. I don’t have to make a t-shirt that says “Will Work for Boobs” or wash dishes at Dr S’s house in exchange for my surgery. As if being diagnosed, going through surgery and dealing with the infection weren’t enough. I’m so glad I don’t have to sing for my supper as well.

The second piece of news is pretty important. Maybe not as important as the WHCRA, but only because that affects a whole lot of women, and this bit of news affects me and me only.

Today, Monday, February 28, 2011 is my 200th day of oral antibiotics.

Yes, you read that right: I have been on oral antibiotics, twice a day every day, for the last 200 days. Bactrim and Minocycline, also known as “these damn drugs,” have been my constant companions for 200 straight days.

I’m not great at math and am too old to waste time trying to get better at things that are useless, and for me, trying to get better at math is useless. It’s just not going to happen. I know I should believe I can fly, touch the sky, be whatever I want to be or some other such drivel as churned out by Mariah Carey and the like, but I don’t believe I can get better at math, and frankly, I really don’t want to get better at it. I’d much rather spend my limited time and energy on other stuff, like playing as much tennis as humanly possible.

But if I were better at math, I would be able to say what percentage of an entire year I’ve already spent on oral antibiotics. Oh, never mind; who cares. Let’s just suffice to say that 200 days is a really, really long time, and if you think otherwise, I don’t want to talk to you. Ever. Or at least until I get off these damn drugs.

If you want to know why I’ve been suffering this cruel & unusual punishment for so long, read this. I just can’t explain it again; I’m too exhausted from trying to do that math and figure the ratio of time spend on these damn drugs verses time not spent on them. Well, here’s the Cliffs Notes version of the story: I got an infection from the tissue expander on the right side after my bilateral mastectomy on May 13, 2010. The infection was (is?) tricky and was hard to diagnose, but we finally learned, in mid-August that it was a mycobacterium fortuitum, which is a wily little bugger that is insidious and hard to kill. The most powerful weapon against this bug is two different antibiotics taken twice a day for a very long time. Like forever.

200 days is a blip in the universe of long-term drug therapy. Every time I feel sorry for myself for still having to take these damn drugs, I remember my infectious disease docs chuckling softly and shaking their heads at my pitiful temper tantrum and infantile whining about why I still need to be on these damn drugs. They tsk-tsk me and handle me with the kid gloves I require of them, then sweetly remind me that many of their patients are on antibiotics for 2 years. 2 years. I’m no math genius, but I’m pretty sure that’s longer than 200 days.

Ok, so a little perspective is good, but still, I feel the need to mark the 200th day of twice-daily drug therapy. Judge me if you must, but consider this: there’s more to taking these damn drugs all this time than meets the eye. Think of the numerous trips to Walgreens to pick up said drugs, along with the other prescriptions I have to take, and the fact that none of them start on the same day, so one of them always needs to be refilled. Thank heavens my sweet oncologist added me to his personal pharmacist’s home delivery service, and now the FedEx man brings these damn drugs right to my front door, all at once. I’m sure they miss me at Walgreens.

There’s the sheer volume of pills I’ve swallowed. Twice a day every day for 200 days is a lot of pills. Again, I’m no math genius, but wow that’s a lot of pills.

There’s also the stress of remembering to take these damn drugs twice a day every day. It’s such a habit for me now that it will seem strange to not be doing it, when that day comes. Strange, but wonderful, too. I can’t wait. Actually, I can’t even think about it because I don’t want to consider how many days I will have been on these damn drugs by that time. But you know I’m going to be counting, right?

And then there’s the issue of what foods don’t mix with these damn drugs. Can’t eat dairy products for an hour before or two hours after I take these damn drugs, because dairy can inhibit the drugs’ absorption. If I’m going to go to the trouble to take these damn drugs, I certainly want them to get into my system and fight that mycobacterium.

And last but not least, there is the scorched earth tendency of the antibiotics to kill the good bacterium in my tummy, along with the bad bacteria elsewhere. I’ve gotten used to the near-constant morning sickness that comes with 200 days of these damn drugs, but I still dislike it. A lot. When the extreme nausea comes to call, no matter what I eat or don’t eat, whether an hour before or two hours after, I feel rotten. And don’t tell me your hard-luck story of how you had morning sickness every single day of your pregnancy, because at the end of that pregnancy, you got the best prize ever: a baby. Well, depends on the baby, I guess; some of them aren’t such prizes in the early days. Maybe the best prize ever is a puppy. To some people.

So by golly, I’m gonna celebrate having made it through 200 days of these damn drugs.

We highlight a president’s first 100 days in office, with either a favorable or scathing review of the job he’s done thus far. If our country can create a tradition based on a mere 3 months, I am well within my rights to celebrate having survived 200 days of these damn drugs. And since we all know it’s 200 days and counting, with nary an end in sight, I certainly will celebrate this milestone. Right now. Today.

I don’t know if it’s a nationwide tradition, but at my kids’ elementary school, they celebrate the 50th and the 100th days of school. Kindergarten especially makes a big deal out of these milestones, as well they should. Macy invited me to come to one of these celebrations and even talked me into wearing matching poodle skirts for the ’50s theme. And celebrate we did! A lot of those little kindergartners probably don’t know from one day to the next whether they’ll make it in the dog-eat-dog world of all-day school. No naps, no crying allowed, curriculum requirements that increase every year; it’s a jungle in there. That’s why they make a point to celebrate the milestones along the way, like the 50th and the 100th day. Why isn’t there a celebration for the 200th day of school, like there is for my 200th day of these damn drugs? Because the kids only go to school 180 days total each school year. So I’ve been on these damn drugs longer than the number of school days in an entire calendar year. Egads.

Ya know how we just watched the Super Bowl a few weeks ago? On February 6, to be exact. Well, on July 20th of last year, the media outlets that handle the infamous Super Bowl advertising spots were counting down 200 days until the big game. So in July, they’re thinking about selling ads during the Super Bowl, which won’t be played until February. End of July to first of February. 200 days. Curiously enough, on July 20th of last year, when the media hawkers began the countdown, I was in the hospital, for the second time post-mastectomy, with the infection.

Another significant stretch of 200 consecutive days of anything is the so-called 200 Days of Dread: a period from the spring of 1942 to November 3, 1942 in which Germany’s Afrika Korps under General Rommel marched toward the Suez Canal and Palestine, causing Jewish people there considerable and understandable stress. Not to minimize the significance of this event in World History, but yes, I’ve been on these damn drugs as long as the Afrika Korps threatened the Palestinian Jews.

And guess what? I haven’t missed a single dose of these damn drugs in all of the 200 days. Not one dose. Surely there’s a trophy for that.

This is too good to keep to myself

Posted: February 27, 2011 | Author: | Filed under: Uncategorized | Tags: , , , , , , , , , | 6 Comments

So it’s Sunday morning, I’ve got my coffee to quell a roaring headache (from the pollen and not the champagne that Mr Cremer pours with a heavy hand. I love a heavy pour). I should be pulling everything out of the pantry and organizing it (again) in a manner that will make it easy for the little people who live in my house to find exactly what they need the precise moment in which they need it, because I’m gonna be parked in a room at the med center for a while and unable to do their bidding.

Once I finish that, I need to gather up all the laundry in this house and wash, dry, hang/fold it all and return it to its original home in each recipient’s dresser and closet, then try to convince those recipients to wear the exact same clothes (turn ’em inside-out if you need to for variety) for the next 3 days so that when I leave the house for the hospital, the chore I really hate will remain completed for more than 2 hours.

I still need to put away the groceries I bought yesterday (I already put the perishables away, as soon as I got home, so don’t worry about spoiled milk and moldy cheese). Then I need to clean out the fridge and discard anything that won’t get eaten while I’m gone so it doesn’t confuse the folks who try to eke out a subsistence in my absence.

One of the big tasks hanging over my head is to sit down with the calendar and make a master schedule of all the events I will miss in the next little while, to ensure that the kids get where they need to be and that Trevor and my dad (who’s coming to help run herd on my little calves) know who’s coming and who’s going. Also need to take a peek and see what events are upcoming for which I need to stockpile, be it a birthday gift or card that needs to be readied.

Instead, I’m getting ready to go play tennis and scratching my head at one of the weirdest stories I’ve ever come across. No wonder I can’t get anything done; this is all-consuming.

If you missed this story on your local news, you must read it now. Thanks to Amy Hoover for calling my attention to what is by far the craziest story I’ve heard in a long, long time.

It will take you 30 seconds to read it, maybe a minute if you slow down to read thoroughly and fully digest all the details, unlike some of us who skim wildly to find the juiciest bits.

I don’t even know where to start with this one. I’m glad the story was so short, because there are so many points on which I’d love to wax poetic. But where to start?

Ok, I’ll start with the woman’s photo. My first thought was, I sure hope she was driving to the hair stylist’s because she needs to touch-up her color right away. Yikes! I haven’t seen roots like that since Macy pulled the world’s biggest tap root out of our flower garden last summer. I mean, that sucker was as tall as Macy. And now this woman’s roots rival that super weed.

Next: her ex-husband was in the passenger seat, as she’s driving to meet her boyfriend AND grooming herself for said meeting. Huh??? Presumably it was her car, since the ex was in the passenger seat, so why was he going, too? I could see it if he were dropping her off, but what in the world was he doing in the car? And more importantly, what was he going to do once she got to her boyfriend’s house? I’m assuming he knew what activity she was engaging in at the same time she was driving a car, so why didn’t he tell her to pull over and let him drive so she could finish her other task.

Moving on: she’d been busted the day before this insanity for DUI and driving without a license. So driving while shaving her nether-region is what she does while sober? Holy tequila shots, what does she do while drunk? That must be a whole ‘nother story. Probably much longer. And crazier.

And finally: the woman and her ex drove a half-mile after the crash and exchanged seats; ok, I can see how that makes sense in the mind of someone crazy enough to do what she was doing. But my question is: if the officer had witnessed a similarly insane situation, why on earth didn’t he share that one, too?

Now I’m really curious.

Turf wars

Posted: February 26, 2011 | Author: | Filed under: breast cancer | Tags: , , , , , , , , , , , , | 9 Comments

I wish I knew how to make this blog play music. I bet it can, since I’m pretty sure it’s smarter than I am, but I haven’t figured it out yet. I need a jazzy yet foreboding score to set the scene. Think Star Wars theme song combined with Indiana Jones theme Song with a little West Side Story mixed in.

I knew this was going to happen. I was partly dreading it, but a little curious too to see how it would play out. It played out, all right, and yesterday by 10:30 a.m. I was exhausted by it. Thanks to a beautiful bottle of Vueve Cliquot that Trevor presented at dinner last night, now I’m over it.

But it’s such a great story, I must share.

Those of you who’ve been along for the ride since this summer, when I was updating my trials & tribulations via Caring Bridge, know that I have an especially close relationship with my plastic surgeon. I’ve written a lot about the many ways I have tweaked him, and I hope to continue to do so here. In fact, I plan to. I will invent new ways to tweak him if they don’t present themselves organically, because I love him and really enjoy tweaking him. He likes it, too.  Trevor and I used to joke while endlessly waiting for Dr S during my multiple hospitalizations last summer that I would write a screenplay when this was all over entitled “Waiting for Dr S.” The title will be “The Tweaking of Dr S.” He always showed up, and he always brought his A-game to my bedside. I love that man.

I had great and ambitious ideas about transferring all my Caring Bridge posts over to this new, improved blogsite but it hasn’t happened. Yet. So for now, if you’re interested in reading (or re-reading) about the tweaking of Dr S, I’ve copied & pasted one of my faves at the end of this post.

As I’ve said before, surgeons and bedside manner don’t always go together. No peas & carrots there.

Because I don’t have enough on my plate or on my mind in the last few days before the big surgery, I had to go see Dr. S one last time. Personally, I though we had covered everything, and whatever we missed I certainly had covered with Dr Spiegel. But Dr S insisted I come back, one last time, to be extra sure everything is covered. I asked a simple question. I just wanted to know how he and Dr Spiegel are dividing up the work involved in this long, complicated surgery. Seems simple, right?

A little background: once we decided on the type of reconstruction surgery, Dr S referred me to Dr Spiegel. (Correction: once the post-mastectomy infection ruled out the easier option of tissue expanders to implants as my reconstruction, the option with which I was left was DIEP. Nitpicky? Perhaps, but I like full disclosure.) I did not want to go see Dr Spiegel. Nothing personal, I had just had it up to here with doctor’s visits, and I didn’t want to add another doc into my personal rotation. I’m 100 percent satisfied with the care I get from Dr S, and don’t feel the need for another doc. I was still under the mistaken idea that I could pretend to be a normal person in the interregnum between healing from the infection and reconstruction. Wrong! There is no “normal” anymore, so no interregnum.

I didn’t want to do it, but I did, and I have to admit, I’m glad I did, and Dr S was right. Yes, I said it: Dr S was right.

When Dr Spiegel told me that she and her assistant usually do the DIEP procedure themselves, but that Dr S was welcome to be involved, I got nervous. He doesn’t like to “be involved,” he likes to be in control; that’s why he’s so incredibly good at what he does.

It sounded so simple coming out of her mouth: She and Jenn usually handle the procedure but if another plastic surgeon refers a patient and wants to “be involved,” he is welcome.

I guess I envisioned two teams working together toward a common goal. Teamwork! Division of labor! Cooperation!

No, instead it might  be a little more animalistic than that. They are the dogs, and I am the soccer ball. Great.

Back to the simple question: Dr S didn’t quite answer me yesterday when I asked him exactly which part of the surgery he’ll be doing on Wednesday. See, Dr Spiegel may be a bit more experienced with microsurgery (the part of the DIEP procedure that involves harvesting blood vessels from my belly and reattaching them in my chest). This is presumably why he referred me to her. He is exceptionally good at the “artistic” side of plastic surgery, and I know beyond a shadow of a doubt that he will do a phenomenal job.

To me, finding out which surgeon is doing which part of the surgery is a perfectly normal thing. If I hired two laborers to do work in my home, I would ask which one would be doing which part of the job.

Dr S understandably didn’t want to disclose too much, but my guess is that Dr Spiegel do the blood vessel part, and he would do the transferring of skin and sculpting that skin into a nice rack. He also said that any revision surgery and all my follow-up visits would be with him. Ok by me.

 

There is no free lunch, dammit

Posted: February 25, 2011 | Author: | Filed under: breast cancer | Tags: , , , , , , , , , , , , , | 18 Comments

Some things just go together like peas & carrots, as Forrest Gump would say. Like idiot people & dumb comments. I’m still scratching my head about this one, but am putting it behind me and moving on. I’m trying, people, really trying, to smile sweetly and listen open-mindedly, but I don’t think I can stand it any longer. Do I really have to listen to one more person tell me how lucky I am to be getting “a free tummy tuck?” Reconstruction is serious business, people, and while I’m all for finding some good in a difficult situation, I AM NOT GETTING A FREE TUMMY TUCK. Yes, I realize I was shouting, and I apologize.

First of all, it’s not free. It comes with a whole slew of costs. While I may not be paying cash out of pocket, there are costs. Boy howdy are there costs. Any economist will tell you that even if something appears to be free, there is always a cost to the person or to society as a whole. I know this because I almost failed Economics in college and had sticky notes with econ principles taped all over my apartment that semester. (My near-failing grade had absolutely nothing to do with the fact that the class was taught by a wickedly cute TA who made it hard to concentrate. Yes, we flirted, then I was stupid enough to assert that I needed to earn my grade in the class and not coast on his goodwill and the fact that we drank beer together a few times at a seedy bar. True story. So stupid. The assertion, not the flirting.)

This “free” tummy tuck comes with a hip-t0-hip scar; 6 Jackson-Pratt drains, 5 nights in the hospital; 4 weeks of sleeping upright and in a chair; not being able to raise my arms for a week; a ban on lifting anything heavier than 5 lbs for a month; and no workouts for 6 weeks. Oh, and if you’re wondering how soon I will be able to get back out on the tennis court…don’t. Don’t wonder, don’t bring it up, don’t ask. Don’t even think about it. Don’t even speculate. Got it?

Can we talk about opportunity cost? Please, let’s talk about anything other than how long I’ll be on the DL for tennis. While I’m not paying actual money for this surgery, there’s plenty of opportunity cost, which means that to get one thing that we want, we usually have to give up another thing that we want. This is the idea behind the “no free lunch” adage. We could delve into economic efficiency, utilization of resources, societal costs, and other economic principles, but we don’t need to because (a) they’re pretty boring; (b) I never really learned them that well in the first place because of the prof crush & beer; and (c) all we really need to know is there’s no free lunch. Plus, I think I burned the textbook after that class was over. Bad, really bad.

Yes, I will come out of this surgery with a flatter stomach (something I could easily get from more time in the gym, BTW). And, as my cousin Susie said, I’ll be waking up to a nice present (new boobs). Both are true. But they’re not free. I reminded her, and will remind everyone who will listen, that I was pretty happy the way I was.

I don’t know where this place is or who these people are, but after all this talk of economics and surgery stuff, I want to go there. I might even stand in line for an “extreme” margarita. Don’t know what that entails, but I know I want one. Or two. Maybe I can even get a free lunch.

Pedey, aka Weasel Dog

Posted: February 24, 2011 | Author: | Filed under: breast cancer, kids, pets | Tags: , , , , , , , , , , , , , | 15 Comments

It’s been brought to my attention that I have written about Harry and Cinco the leopard gecko, but not Pedey, the other canine member of our household. Well, excuuuuuuse me.

Pedey, oh Pedey. I don’t even know where to start.

He’s a cutie, for sure. We weren’t planning on getting a puppy, not really. Not that day, anyway. IMHO, any day is a good day to bring home a new puppy, but not everyone subscribes to that point of view, so you gotta tread lightly.

Flashback to May 3, 2008. It was Payton’s 9th birthday. I went to Petsmart to pick up something for Harry and the Houston Humane Society was there with the mobile adoptions. I figured I’d scritch a few pups, get a dose of puppy breath, tickle a few fat bellies, and move on. Then I saw this: 

Oh. My. Gosh. I was smitten. That face! Those floppy ears! The speckled feet! The fat belly! The little white blaze down his nose! 

Did I mention that it was Payton’s actual birthday? 

And that I now really, really, really wanted a puppy?

And that I really, really, really wanted this puppy?

Long story short, Payton fell in love with Pedey (his mama taught him well), and we had to have him. Trevor, being the good sport that he always is, gave in, even though we already had one dog too many for him. Payton and I reasoned that Harry needed a dog, and since it was almost summer, the kids could help take care of this puppy.

Welcome to the family, little guy.

I think you’re going to like it here. We have a mentor for you named Harry. He’ll show you the ropes. He makes the mean face sometimes, especially when he has a chewie, but just ignore him.

We’ve got a best friend lined up already (Snoopy), a pool should you become a water dog, lots of toys & treats, and unlimited belly rubs.

It took us a while to come up with the right name for the new guy.

Since he was officially Payton’s dog, Payton got to have the final say. And he decided on Pedey, after his favorite Red Sox player, Dustin Pedroia. The dog is nothing like his namesake: he’s cowardly, lazy, and clumsy with a ball. But the name stuck.

He settled right into our life and weaseled his way into my heart. Let me state for the record that I’ve never had a small dog, and I’ll admit, I’ve never quite understood the appeal. Now before you carry-dog lovers out there go ballistic and send me death threats, let me be clear: I don’t dislike carry dogs or their owners. I’ve just never understood the benefits. 

Now I get it.

He was of course the cutest puppy ever. (I can say that because Maddy, the best dog in the universe, has gone on to her Great Reward, and because we adopted Harry at age 2 and never knew him as a puppy.)

He likes to snuggle more than rough-house. He would rather sleep than do just about anything else (preferably in my lap). 

We call him The King of Comfort, because he always manages to find the most comfy spot available. 

If he’s not fast asleep in a prime spot, he’s camped out under my desk chair. 

Sometimes his legs or tail peek out from underneath the chair, and sometimes he’s completely hidden and I forget he’s there until I scooch the chair back and accidentally scare him half to death.

Sometimes he gets in the chair, right behind me. When he was tiny, it worked out just fine. But now he’s a little too big for that, but he still tries it sometimes. 

He still manages to fit. Mostly.

He likes to make a nest when he finds a comfy spot for sleeping. He will either wedge himself tight in between pillows & cushions, or get himself wrapped up in blankets & comforters. He will also stay in bed until he’s good and ready to get up, instead of leaping up the instant my feet hit the floor, like Harry does.

We don’t know what kind of dog he is, besides lazy & shiftless. Beagle, maybe? He has short, coarse hair; very different from the labs’ hair I’m used to. He has a very wrinkly brow and often looks quite contemplative. It’s mostly for show, though, because he sure doesn’t seem very smart. 

He’s not all that well-trained, either, because he was so cute we were always holding him instead of schooling him to sit and stay. 

He never did learn to love to swim, like the other dogs do. He doesn’t really even like for his feet to get wet, hence the need to be in my lap as often as possible.

Dana Jennings, a wonderful writer for the New York Times said, “Good dogs – and most dogs are good dogs – are canine candles that briefly blaze and shine, illuminating our lives.” I’ve had 4 dogs in my adult life: Maddy, the best dog ever in the history of all dogs. So good, I still get teary when I think of her, several years after her death (and y’all know I’m not much of a crier). So good that the urn of her ashes is on a side table in my bedroom, her name engraved in a simple, beautiful script, the urn way too small to contain all the love and memories she provided. Then there was Lucy, who we got to keep Maddy company. Her canine candle was pretty dim, and there is no urn for her. Then came Harry, and now Pedey. A short but very full doggie history.

Pedey was so happy this past summer, when I was convalescing from surgery and multiple hospitalizations. I don’t usually lay around much, but I had to then. And he loved it. He was always right by my side or in my lap, sleeping away. We joked that we should have snuck him into the hospital, so he could have slept on my bed with me there.

Well, Pedey, rest up; in a few days, I’ll have some more down-time. Are you ready?

The to-do lists

Posted: February 23, 2011 | Author: | Filed under: breast cancer | Tags: , , , , , , , , , | 4 Comments

The title says lists, plural, because I’m a realist and have never figured out how to willfully deceive myself. Other people I have no problem willfully deceiving, but myself, not so much. I have a list of what I want to get done, and another for what I will probably get done.

The countdown is on to my surgery. Yikes. One week from today, I will be at the hospital. Yikes. Reconstruction is a much-anticipated thing for most breast cancer patients. It means getting your body back (in a new, sometimes improved form). It is voluntary and scheduled whereas a mastectomy is required and imminent. It is symbolic of having made it, having endured, having gotten through the worst part. It is also scary, for sure. I don’t recall being scared before the mastectomy in May. Maybe I was, but have blocked it out. Now that I’ve seen photos of other mastectomies and have a better understanding of how the procedure is actually performed I certainly could be scared, but being scared after the fact isn’t very effective.

I’m guessing I don’t recall being scared about that surgery because things moved very fast (3 weeks from diagnosis to being wheeled into the OR); I was wrapping my head around the fact that I had been diagnosed with cancer at the tender age of 40 and with two young kids at home; and there were a ton of things to do to prepare. Not just the battery of tests, but the nesting. That nesting really should be an Olympic sport. I know I’d have to beat out some OCD pregnant women, but I think I could bring home the gold. 

I’m not nesting this time around. I’d maybe only get the bronze. And it would probably be a bit of a pity vote. I just haven’t been putting in enough time flitting around the house, cleaning out closets, organizing the pantry and re-folding every blanket in the linen closet.

Since becoming a repeat customer at the hospital, I know what’s in store form me next week: the scratchy sheets, the one-size-fits-someone-giant gowns, the smell, the noise, the yucky food, the parade of nurses in & out of the room, the abundance of tape stuck to my body, the JP drains, the pain, the nausea, the lack of peace & quiet.

Ok, maybe I’m not scared but annoyed. I’m not so good at sitting still and being dependent. And I have a lot of that coming up. So I distract myself by making to-do lists. It makes me feel better. There’s something very satisfying about setting goals and crossing things off the list.

Things I want to accomplish before surgery:
(insert long list here)

Things I will actually get done: play a lot of tennis.

Now that’s a good list.

Another trip to the med center

Posted: February 10, 2011 | Author: | Filed under: breast cancer, tennis | Tags: , , , , , , | 8 Comments

It was supposed to be the first match of the new tennis season. I was paired up with my running buddy, we the defenders of the Witches’ Open 2010 title, were scheduled to play at Houston Racquet Club, a beautiful club that is heavily wooded and shrouded in tennis tradition. It’s one of my favorite places to play an away match.

When I re-signed with my Alley Cats team for the spring season, I knew I probably wouldn’t get to play the entire season, since I need to get this reconstruction done. But for me, a few matches is better than no matches, and after my post-mastectomy, post-infection absence and convelescence last season, I’m happy to be upright and on the court. You hear people say that a bad day on the court is better than a good day in the office. True, but that adage rings even truer for those of us who have stared an ugly disease in the face. The fact that my game is better than ever is icing on the cake. Or fuzz on the yellow ball. Or whatever.

But alas, the weather gods conspired against me. We got another blast of Old Man Winter, and as if the frigid temps and gusty winds weren’t enough, it rained and sleeted, and the season stalled before it even began. This South Texas girl is tired of winter. “south Texas” and “winter” do not go together. And my tennis days are numbered–again. Barring any weather delays, I’ll play three matches before going under the knife in a few weeks. I don’t even want to think about how long I’ll be out–of the game or under anesthesia during surgery!–but I’m realistic enough to know that the season will be over before I’m ready to play again. Sigh.

So instead of playing tennis, I was a dutiful patient and headed to the medical center for more pre-op testing.

I hate going to the med center, and I hate testing.

Ok, let me rephrase: I appreciate that one of the world’s best medical facilities is a 20-minute drive, down a toll road no less, from my house, and that I have a vehicle that gets me there, cash in my pocket to valet park, pro-active and organized doctors who have a plan for me, and health insurance to cover the frightful expenses. And an added bonus, one of my BFFs works at Methodist in the med center, so I get to see her in her white coat and definitely in her element. That is very cool to see.

So while I hate going there and hate everything about the testing, I am grateful. That counts for something, right?

Everything about hospitals and testing bugs me. I’ve ranted about it before so won’t rehash but let’s suffice to say that everything from the smell to the idleness of waiting my turn just bugs me.

Today was relatively easy in the grand scheme of medical testing, though: just 7 vials of blood for lab work, an EKG, and a chest x-ray. The new Outpatient Services facility at Methodist is beautiful: spacious, well-lit with banks of windows showcasing stellar views, comfy chairs, quiet rooms for those of us with sensory overload, knowledgeable staff and supremely trained nurses and technicians. The phlebotomist who stuck me got the needle into the vein on the first try, something I very much appreciate.

I still hate it, though.

I was happy that I remembered to take Dr Spiegel’s orders with me, since I’ve had them for a couple of weeks.  I would have been really mad if I’d gotten all the way down there in the cold rain to be told I had to go home and get the orders. Score one for me.

I checked in and chose a soft beige leather chair. I barely had time to settle in and fire up my kindle before a tour guide called my  name and asked me to follow her to the business office to once again show proof of ID and insurance. After a quick “skim this, sign this,” it was into another waiting area, this time closer to the procedures area. It’s akin to moving from the waiting area to the exam room at the doctor’s office. Even if you have to wait awhile in the exam room, you’ve at least progressed along in your journey.

After again firing up my kindle and peeping out the room-long windows at the grey, misty cityscape, I settled in for yet another indeterminate wait. After about half an hour, an older couple came in and sat behind me. I could see them out of the corner of my eye and could hear murmers of their conversation.  I did not, however, make eye contact. I’ve learned the hard way to treat my fellow patients the way I treat fellow travelers on a plane: don’t look right at them or give any indication of interest in their life story.

Mean? Maybe. But I’ve never claimed to be Miss Compassion, and while I’m sure there are sob stories that are sobbier than mine, I don’t want to hear them. I have no room in my life for the problems of strangers. Now, before you write me off as aloof and uncaring, let me state for the record that I will render aid if necessary. If an elderly woman walks off without her sweater or umbrella, I will chase her down and return her belongings. If the granny with a double knee replacement drops her pen while filling out yet another medical form, I’ll reach it for her. I’ll hold the elevator for young mothers with strollers and errant toddlers. But don’t ask me to take an interest in and listen to your sob story. Not gonna do it.

I was trying my best to tune out this couple behind me in holding pen #2 but despite my efforts, I noticed the man becoming more and more agitated about how long he was going to have to wait. I was tempted to advise him to pipe down and settle in, since he just arrived, and really it was only 9:15 a.m. He was upset about not knowing exactly how long this was going to take. Outpatient Services is first-come, first-served. Open from 8 a.m. until 6 p.m. Come early and be prepared to wait. Duh.

Does anyone ever know how long “this” is going to take, whatever “this” happens to be? If you’re at the med center for outpatient testing, you’d better plan on being there awhile. Looking around, I noticed that everyone else had a book, magazine, soduku puzzle, knitting, laptop, and even a portable DVD player to pass the time. Everyone but the man behind me, who coincidentally was the only one asking how long “this” would take.

His wife tried to shush him, and I tried to tune him out, but he got louder and more upset. He tried to talk his wife into leaving, telling her he didn’t think he could stay any longer for the procedure.

Then he started to cry.

Yes, a grown man started to cry about having to wait for a medical procedure. I don’t know what he was having done, but I do know that they don’t even do anything scary there: cardiology testing, x-ray, and lab work. I know for a fact that other floors contain other scary options, but the 17th floor is pretty tame.

His wife tried to shush him some more in a way that made me think of little kids being told to stop their crying before they were given something to really cry about. She told him to dry it up, he told her he couldn’t, and she told him that yes he certainly could. After they went back and forth a bit, she hollared at him: “James Langston, you stop that right now!” And he did. Tough love in action. Right on!

Mr. Langston coerced his wife into asking one of the tour guides who walked by how many people were ahead of him for testing. She took his name and went to check. He blubbered a bit more, then she came back to report that there were three people ahead of him (one of which was me, thank you very much). That set him off anew, and he was caterwaling pretty good by this point. The tour guide shuffled off to straighten the magazines or restock the pamphlets or something, anything, to get away from James Langston and his weeping.

I’ve spent more than my fair share in doctor’s offices, hospitals, and outpatient testing areas lately, and no matter which facility I happen to be in, I can’t help but notice that every other patient is a lot older than me. As in, there’s no way they still have small kids at home, and I’m almost certain they aren’t juggling the kinds of things I am. Packing lunches? Nope. Overseeing homework assignments’ completion? Don’t think so. Ferrying kids to and fro, from school to sports to lessons to playdates? Uh, no. Worrying about getting out of there in time to not be last in line for carpool pick-up? Not today. Rushing to the store to pick up juice boxes and Fruit by the Foot? Negative. I’m betting these geezers don’t even remember that they ever did such things. (Ok, that was harsh, but it felt good to get it out. I’m done.) It’s just one of the many things that sucks about being a resident of Cancerland, and being a young resident blows especially hard.

Still in holding pen #2, I read the same page of my book 15 times without comprehending a word. I wasn’t trying to be nosey but I couldn’t help but wonder what James Langston was so afraid of, and why no one had thought to give him a Xanax. James Langston could have used one, for sure. If I were a more compassionate person, I might have offered him one of mine. But I’m not, and I guard my stash very carefully.

Just as I was about to start to feel a wee bit sorry for him, though, he grabbed a nurse and begged her to take him next.

And she did.

Crybaby James Langston leapfrogged to the front of the line, leaving the rest of us in his dust. He’s either the biggest baby or the shrewdest patient. I have no idea which.



Now that I have a surgery date…

Posted: February 2, 2011 | Author: | Filed under: breast cancer, drugs, infection | Tags: , , , , , , , , , , , | 5 Comments

Now that I have a surgery date, if you feel compelled to join the Greek chorus that’s asking if I really want to have the surgery, don’t.

Just don’t.  

I don’t want to hear it.

I don’t need to hear it. 

Isn’t the fact that I have a surgery date evidence enough of my decision to go forward?

If I didn’t want to have the surgery, would I really have a date? Would I be putting myself through the mental anguish that accompanies such a decision and the days that stretch on between said date and today?

Sometimes I hate people. 

Mainly those who say stupid things, but Sarah Palin & “President” Mubarak are on my list too. If you like either of these idiots, you may want to unsubscribe from this blog, because I will most likely rip on them and their idiot-ness a lot, esp when I’m in a foul mood like I am now. And if ripping on dumbasses makes me feel better, then Katy bar the door because I’m gonna do it. 

So there.

And don’t tell me that people mean well, and sometimes they just don’t know what to say. They can suck it. If it’s that hard to come up with something not stupid to say, then perhaps they should zip it.

But back to the surgery. Reconstruction is a big step. It’s a scary step. It’s a horrifying assault on my already-beleaguered body. If things were different, I wouldn’t be in a hurry to do it. By “things” and “different” I mean the path of destruction left by the blasted mycobacterium.

I hate that myco almost as much as I hate Sarah Palin. Sheesh, just typing her name makes me mad.

Ok, reigning it in.

That darn mycobacterium wrecked things up good. If it was just a question of having a flat chest, I’d be in no hurry for reconstruction. I kinda like my flat chest. It’s simple. It’s low-maintenance. I never have to wonder if people are paying attention to what I’m saying, because they’re certainly not distracted by cleavage (there is none). But thanks to the infection and subsequent tissue excision (gross, I know), it’s a mess that’s gotta be fixed.

And thanks to the infection, I can’t just pop in the implants and go along my merry way. I remember being asked as a kid if I had to do everything the hard way (I was a little stubborn back then). The answer is yes. Yes, I do.

I do not like surgery. Or hospitals. Or hospital gowns. Or hospital linens (scratchy, so scratchy). Or hospital food. Or the hospital smell. Or needles. Or being an invalid. Or depending on other people. Or waiting on other people to show up and do what they need to do so I can get outta there.

I do like the drugs, though.

But not enough to rush into a big, long, complicated surgery. So while I don’t actually want to have this surgery, I need to, to clean up the leftover infection mess. It’s going to be hard, and the recovery will be long. I won’t see a tennis court for several months. I will once again be at the mercy of other people’s kindness. But I need to do it, so I will. And I will leave you with another mantra from my childhood: If you can’t say anything nice, don’t say anything at all. Thank you, Thumper. Preach it, little rabbit. 

And if you can’t follow Thumper’s advice, and still feel compelled to tell me how dangerous this surgery is, or how complicated, or ask me to think about how it might affect my kids, or any other stupid thing that flies out of people’s mouths, then consider this: 

Official diagnosis

Posted: February 1, 2011 | Author: | Filed under: breast cancer | Tags: , , , , , , , , | 4 Comments

While looking through my paperwork from Dr Spiegel and mapping out the next month of pre-op stuff I have to do, I found something that made me laugh out loud.

I hope you find it funny, too.

If you don’t, there’s something really wrong with you.

This is the orders for the EKG and labwork I have to get done before my reconstruction. 

The handwriting is kinda hard to read, and the picture is pretty fuzzy, but if you look closely you’ll see that for Diagnosis, it says “absence of breasts.”

Other than laughing hysterically, I don’t know how to respond to that.

Healer

Posted: January 7, 2011 | Author: | Filed under: breast cancer, literature | Tags: , , , , , , , , , , , , , , , , , , , | 4 Comments

The body is a miracle, the way it heals. A factory of survival and self-repair.  As soon as flesh is cut, cells spontaneously begin to divide and knit themselves into a protective scar. A million new organic bonds bridge the broken space, with no judgment passed on the method of injury.

Wow. That’s pretty prose.  I wish I had written it.

I’d love to claim it as my own, but that would be wrong, and Lord knows I need the great karma wheel to turn my way. I can’t afford to tempt the gods of fate, as they seem to like toying with me.

Carol Cassella wrote that prose. If you’re a fiction fan and don’t know her work, I encourage you to get her books sooner rather than later. Whether you run to the bookstore or download onto your e-reader, get on it. You won’t be sorry. She’s an anesthesiologist-turned-author whose first book, Oxygen, is one of my all-time favorites. Her second book, Healer, wasn’t quite as good but I gobbled it up in hopes that it would be.  I liked her right off the bat, because she’s a Texas native and a Duke graduate. A girl after my own heart. She’s also the mother of two sets of twins (!) and how she got anything done, much less wrote 2 bestsellers, is a mystery to me.

I read Healer this summer, while I was trying to heal. I was struck by the passage above, and loved how dramatically it introduces the book. From the very first sentence, I was hooked. While I certainly didn’t set out to turn this blog into a space for book reviews, sometimes things happen that way, and I’m an equal-opportunity blogger, so there we are.

As a physician, Cassella understands the intricacies and magic of the human body. As an author, she’s able to capture that and express it so that someone like me, an impatient patient, can read it and say, yeah, that’s right–the body is a miracle!

I needed that reminder. I was so focused on wanting my healing to occur faster, I didn’t realize that the fact that it was happening at all was amazing.

Equally amazing is the education this experience (e.g., the “cancer journey”) has provided. I’ve learned a bunch of lessons I never wanted to learn, such as how utterly unfair life can be. I’ve acquired skills I never thought I could and hope to never have to use again. Anything involving packing a wound or administering IV drugs at home falls into that category.

I’ve certainly learned a new vocabulary. Not just the new definition of “normal,” either. Things like nosocomial (originating in a hospital, as in a nosocomial infection). Like debridement (removal of foreign material or dead tissue from a wound in order to promote healing). Like aromatase inhibitors (drugs like Tamoxifen that lower estrogen levels in the body by blocking aromatase, an enzyme that converts other hormones into estrogen). Like oophorectomy (surgical removal of the ovaries).

I’ve learned how to get a good night’s sleep in a noisy hospital. I’ve learned the difference between DCIS (ductal carcinoma in situ) and invasive breast cancer, and that they’re both plenty scary.  I’ve learned that an injection can leave a bruise for close to 3 months. I’ve learned that the practice of medicine is both a science and an art. And I’ve completely forgotten what it feels like to wear a bra.

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