Away we go…

Posted: March 2, 2011 | Author: | Filed under: baseball, breast cancer, food, kids | Tags: , , , , , , , , , , , , , | 3 Comments

Of course I’m up early on my big surgery day…you didn’t think I would actually sleep until the alarm went off, throw on some clothes and jump in the car when I could post one last time, did you?

It’s 4:15 a.m. and we’re set to leave the house for the med center at 5:30 for my 6 a.m. arrival. I sure hope that when we pull up, Dr S and Dr Spiegel aren’t fighting it out about who gets to do which part of the surgery and who’s in charge of follow-up care. Of course they wouldn’t be, and I’m 100 percent sure that every aspect of this procedure has been planned, checked, and double-checked to ensure excellence will result.

The last few days have been a whirlwind, with last-minute preparations and socializing. Yesterday afternoon and evening, my phones both rang off the hook, with calls and texts full of good wishes and genuine love. Several people have asked if I can feel the love, and the answer is YES! And THANK YOU! A huge part of why I am going into this big ol’ surgery with such peace is knowing that my posse has got my back. I appreciate each and every one of you. If you happen to come to the hospital for a visit and see me wretching uncontrollably, don’t worry: I didn’t have too much champagne or margartitas. Coming out of the anesthesia tends to make me barfy. Don’t panic. It’ll pass. Last time around I puked in front of lots of visitors; the kids in the room thought it was neat.

Yesterday was another perfect day: my last tennis drill with my team was spectacular. Mid-seventies and sunny with just enough warmth to get a sweat going, and birds singing like crazy because it feels like springtime. I made some good shots and thoroughly enjoyed my teammates’ company. Love those girls.

Loved them extra hard after this: 

Surprise champagne in the back of Julie’s SUV after drill. We tailgated in high style. It was such a fun treat, and I adore you girls for having such a brilliant idea and for sending me off in the most perfect way. I will be counting down the days until I can get back on the court with you.  Meanwhile, Go Alley Cats! Beat Westheimer Indoors today. Hit it where they ain’t!

The rest of the day yesterday was fantastic. Busy, but fantastic. My dad arrived, and  he took Macy to the pet store to buy the daily allotment of crickets for Cincko. That little gecko is on a major growing tear and has been eating at least 12 crickets every day. My dad will be interrim assistant zookeeper while I’m out of commission, so Macy broke him in with on-the-job training right away.
We had our belated birthday dinner for Dad, after a bottle of Vueve Cliquot (yes, I know I had champagne twice yesterday; at the tennis courts and at dinner. Why do you think it was such a great day??). Our Tuesday night tradition of watching “The Biggest Loser” was fun, as always, and there’s something especially satisfying about watching that show after a most delicious dinner.

It was all going swimmingly until Macy‘s bedtime, when I went to tuck  her in and she started crying. The big, rolling tears that linger and pool in the eye before breaking free and trailing down her face. Her ginormous eyelashes were soaked and matted, and the look of utter desolation on her face made my heart crack right in two. She was trying to be brave, but that well of genuine emotion that makes her the astoundingly compassionate little girl she is came gushing out when it was time for her to tell me good-bye. She was trying to be brave, but struggling. We talked for a long time about how mommies always come back, and even when they’re away for a while, they carry their kiddos in their hearts. I told her about my favorite e.e. cummings poem, i carry your heart with me, and how the words can certainly apply to anyone you love, whether a pet or a friend or the most amazing little girl ever. We talked about how she wouldn’t get to talk to me today, but tomorrow I expected a phone call as soon as she got home from school, so she can tell me all about her day. She cheered up a little bit when I told her that I need her to be in charge around here, and help my dad find the jelly in the door of the refrigerator, stay on schedule when driving the carpool, etc. She is on the job. She sent me off with Baby Snoopy, one of her most prized stuffed animals, to take along with me for company. She’s thoughtful like that.

Payton was busy, busy ignoring a math project that’s due Thursday, so he didn’t have much to say in the way of good-bye. Not surprisingly, as he is a man of few words. He too has instructions to call me Thursday with a full report on his first Little League game of the season. I need to see how long it takes him to “lose” his Yankees hat and replace it with a Red Sox version. It’s hard enough on him to have his mom in the hospital, but to have to don the dreaded Yankees uniform too? Poor guy.

I’ll leave you with the “before” photos. Don’t worry, I won’t publish the “after” photos —  you may just have to see them in person.

This is one of my favorite tennis tops. I have it in at least 3 colors, maybe more. Wear it all the time, hence the funky tan lines. Every time I wear it, I notice how seriously flat my chest is. Maybe because of the “V” neck of the shirt, I don’t know. I’ve had this uber-flat chest since May 13 and am quite used to it. In fact, if not for the mess left by the post-mastectomy infection, I could have envisioned not doing reconstruction at all, or waiting a lot longer. But, the mess must be cleaned up, so away we go. And yes, my chest really is that flat in person…until tomorrow!

Leavin’ on a jet plane

Posted: March 1, 2011 | Author: | Filed under: breast cancer, drugs, food, infection, kids, tennis | Tags: , , , , , , , , , , , , , , , , , , , , | 20 Comments

I’m not really leaving on a plane and my bag isn’t packed yet, but as I ready myself, my home, my kids, & my life for the next round of surgery, I find the lyrics to that song running through my head. Peter, Paul & Mary; Janis Joplin; and John Denver all recorded versions of this sappy little love song, with its catchy yet insidious chorus that will get stuck in your head for half the day if you’re not careful. It’s meant to be an ode for lovers, and I’m usually immune to sappy stuff and odes, but with the big surgery rapidly approaching, I must be going soft because this goofy tune is reminding me how hard it is to leave my family, endure a nasty procedure, and be cooped up in a hospital room. I am a terrible patient. No truer words have been written.

I have written a lot about what a terrible patient I am. Not that I won’t do what needs to be done to get to where I need to be in this “cancer journey” but that I hate every minute of it. I’ve also written my fair amount of scathing posts lately about stupid things people say, so I won’t go there now, but suffice to say if you were planning on telling me that at least I’ll be getting some rest, or to enjoy being waited on, you can skip it. I don’t like to rest and I really don’t like having someone wait on me. As a determined two-year-old might say, “Me do it.”

As terrible as I am as a patient, though, I’m ready. I’m at the point in which I’ve prepared all I can, and whatever doesn’t get done will just have to wait. I’ve been a busy little bee lately, feathering my nest and gearing up for what I know will be a hideously gross surgery followed by a long recovery. This process is akin to getting ready for vacation: at first the list of things to do seems miles long, then time ticks on and the list is whittled, and then you become exhausted from and sick to death of all the prep and can’t wait to just get going. While I’m not exactly going on vacation (!), I am done with all the prep and ready to just get going.

I still haven’t watched the video consultation that explains and illustrates the surgery I’m having tomorrow. Maybe I’ll just use my imagination. You know it’s a big deal with you get 12 pages of pre-op instructions, followed by a 3-page alphabetized list of medicines to avoid.

One of my instructions is to shower with Hibiclens, an antimicrobial wash, for 3 days prior to surgery. No problem. You know what a germaphobe I am. Some of the other text from the informed consent section of the paperwork made me laugh out loud, especially the parts about who’s not really a good candidate for this surgery: women who require more complex breast reconstruction (what’s more complex than this surgery??). Women who are good candidates are those who have inadequate chest wall tissue (me); those who have concerns about breast implants or tissue expanders (I wasn’t too concerned but my body apparently is); and those who may have contracted a post-surgical infection. Yep, that’s me.

The literature then goes on to explain that infection is very unusual after surgery. Yeah, maybe for some people. And that patients must inform the doctor if she has any other infections, “such as ingrown toenail, insect bite or urinary infection.” A bug bite? Really??Oh, mercy, if only it were that simple. How I would love to say I have an ingrown toenail instead of a mycobacterium fortuitum.

There’s also a lot of scolding in the section on bleeding: “Increased activity too soon after surgery can lead to increased change of bleeding and additional surgery. It is important to follow all postoperative instructions and limit exercise and strenuous activity for the instructed time.” Yeah, yeah. Blah, blah, blah.

Yesterday was a near-perfect day: I had a few hours at home to get things in order, then on to Beauty Envy to get the hot new shellac manicure. It’s supposed to last a couple or three weeks without chipping; we shall see. I’m not going to be doing any manual labor anytime soon, so the prognosis is good. Got my toes done, too, which is always nice. Even though my toenails are short as can be, they still take a mighty beating from tennis, but they are pink and shiny now. After the nails extravaganza, it was off to lunch to enjoy the sunshine and margaritas in the company of some first-rate girlfriends–a trifecta for sure. You can have your acai berries and super elixirs; for me, there’s nothing more fortifying than the sun on my face and a drink in my hand with my friends.

Today will be equally good with my last tennis drill of the season, then lunch with whichever members of the team are game for a little noontime tippling. I also gotta make a quick belated birthday meal for my dad, who recently turned 75 but looks a decade younger, easily (I’m hoping it’s genetic, but not very optimistic). I’m whipping up pastichio (Greek lasagna) and a pineapple upside-down cake, two of his favorites. He’ll be ferrying the kids to and fro and keeping up with Macy’s near-constant stream of chatter, so he’ll need a good meal. 

Speaking of Macy, she’s at it again: leaving me a note to find when I least expect it but am most likely to need a little pick-me-up. She’s a little apprehensive about me going back for more surgery, but the long summer of me and revolving hospital door must have toughened her up because instead of being sad she’s curious (which hospital? how long will you be there? can we come visit?) and stoic.

She needs a little work on the spelling (I assume that “Your asomest chid” means “Your awesome-est child”) and “Hopefuley” she will keep writing without regard for menial details like spelling. Most important is the message: if Macy says this is my last surgery, then I can go into it with a clear mind and a happy heart.

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.

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.

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.

Can I get that overnighted, please?

Posted: February 19, 2011 | Author: | Filed under: baseball, breast cancer | Tags: , , , , , , , , , , , , , | 9 Comments

I like funny t-shirts. I like snarky, funny t-shirts even better. Or is it redundant to say “snarky” and “funny?” Are there people who don’t think snarky is funny? If so, I have no use for them. Trevor’s grandma, Petie, had a cute little needlepoint pillow on her couch in the sitting room of her Salisbury, North Carolina, home that says “If you don’t have anything nice to say, come sit by me.” I’ve always ascribed to that point of view.

I don’t have a picture of Petie’s pillow, but found this one by using the Google. Now I’m wondering why in the world I don’t own one of these pillows? It would make me smile every time I spied it. It’s the little things, people.

While looking for an image of that cute little pillow, I found this: 

For those of you who are uninitiated into all things Red Sox, that foxy number 46 is my boy crush, Jacoby Ellsbury. He now wears number 2 on his jersey, though looks no less foxy. That’s JD Drew crouched next to him, close enough to whisper in Ell’s ear (lucky bastard). I’m sure they were discussing some serious strategy, or maybe making fun of Dora (aka Alex Rodriguez) who is such a tool and deserves to be made fun of at every possible opportunity.

But I digress.

Here’s the real reason for today’s post (although it could easily become all about Ells. Last season was a long, dry boring one for me because Ells was hurt. Not just hurt, but rehabbing in Arizona, so not even in the dugout and available for close-ups or slow pans by the ever competent NESN camera guys. It was a long season indeed. But Ells is back and ready for action and hopefully lots of on-screen time.)

But seriously, back to the real reason for today’s post.

Look what I found.

Just what I’ve been looking for.

But wow, what bad luck to have found it so close to the Resurrection, instead of during the long months of walking around with a chest flat enough to play quarters on, with no explanation. Ok, that is some seriously bad sentence construction, but you get the drift. I’ve had a freakishly flat chest for a long time, and have longed for a shirt that tells the world that change is underfoot. Or, undershirt, as the case may be. I got that chance with my “cupcakes” shirt, but I can’t very well wear that every day. I hate doing laundry, and wearing my cupcakes shirt every day would require a lot more of that chore.

So I probably need the “under construction” shirt, too. Although, can someone please explain to me why the shirt is modeled by a guy???

Now that is just weird.

But I still want the shirt. Wonder how fast I can get it?

The Big Dig

Posted: February 18, 2011 | Author: | Filed under: breast cancer, infection | Tags: , , , , , , , , , , , , , , | 39 Comments

Yesterday was yet another trip to the medical center, for one last pre-op visit to Dr Spiegel before reconstruction. I really need to think of a catchy title for the surgery, something like Boston’s big construction project, the Big Dig. Come to think of it, there are some similarities between the Big Dig and my surgery: both relate to the Central Artery and Tunneling (in fact, the official name of the Big Dig is the CA/T Project). Both are complicated, involve lots of people, and take a mighty long time to complete. But unlike the Big Dig, which replaced the 6-lane elevated Central Artery (I-93) with  a 3.5-mile long underground tunnel, my surgery won’t cost $22 billion. Hopefully. My insurance company, which has been mighty nice so far, might just stroke out about that figure. 

The Big Dig sounded like a great idea and was intended to be a tremendous boon to an already kick-ass city. But mismanagement, scandal, and skyrocketing costs quickly dominated headlines, and my second-favorite city had a big mess on its hands. Congressman Barney Frank quipped, “Wouldn’t it be cheaper to raise the city than depress the artery?”

Say what you will about Barney, but that’s a good line.

But back to the update on the doctor visit. This was Trevor’s day to meet the lovely Dr Spiegel, her ultra-energetic PA, Jen, and her trusty nurse Sonia. My friend Laura, who is a nurse practitioner in the liver transplant unit at Methodist, met us there, too. Dr Spiegel wanted to brief my caregivers on what to expect post-surgery, and Laura kindly offered to help out. In her white coat and super-stylish glasses, she brought a nice element of professional gravitas to the occasion. She told Dr Spiegel that she’s done some match-making for me and picked out an anesthesiologist she likes and trusts, and Dr Spiegel agrees that Dr Ashmore is the guy for me. Laura and Sonia recognized each other right away, then she and Jen hugged and high-fived, happy to be collaborating on my case. It’s good to have connections.

The visit itself was pretty uneventful. I like uneventful at the doctor’s office. Dr Spiegel  went over a few basics with us but since we were pretty much up to speed on everything, there weren’t any new developments. I’m finished with all the pre-op testing (bloodwork, blood donation, x-rays, EKG, CT-scan), and just need to watch the video consultation on Dr Spiegel’s website to get a more detailed overview of the procedure. I’m not saying I’m scared to do that, but after watching a video on youtube of an actual surgery, on an actual person, I’m not in a big hurry. Ick.

The one topic we did need to cover, though, was the infection. I wanted to bring it up in a way that seemed breezy and conversational, as opposed to, “How the sam hell are you going to keep this bloody nightmare from recurring, lady?” I was pretty sure that wouldn’t go over too well.

I’m not the most diplomatic person, and I tend to say what I really think, even if it’s not pretty or may be hard to hear. It’s a blessing and a curse. Believe it or not, I actually do put a lot of thought into what I say and how I say things, but because I’m pretty direct, sometimes things come out a bit, um, harsher than I intend.

Sorta like, “Are you outta your mind??? You’re not really going to wear that are you?” or “Clearly that person has neither friends nor a mirror; why else would one go out in public looking like that???” as opposed to “Have you thought about what to wear?” Those kinds of niceties take a bit of work on my part. My instinct is to just blurt out whatever needs to be said, and let the chips fall where they may. We’re all grown-ups, right?

Right. Except I really don’t want to tick off the nice lady with the very sharp scalpels. That would be bad. So I fumbled around and probably sounded idiotic by saying, Um, so, uh, like, how worried do we need to be about the um, you know, infection? You know, like, um, during the uh, reconstruction?

She smiled knowingly, and if she’d been sitting closer might have patted my hand and said, there there.  She reminded me that my case isn’t exactly normal, and I tried not to tell her that “normal” is pejorative and listened to what she had to say.

She has a plan, of course, and it sounds like a good one. Usually, in cases of infection, she would wait to do reconstruction, to be sure the infection is truly gone. But in my case, which again is not normal, we need to get in there sooner rather than later and clean up the mess,  i.e., excise the damaged tissue and replace it with some new, fresh meat. And by meat I mean my own flesh. Fresh flesh. Yum.

The plan is to work on the infected side last, and she promised to take her time and wash it all out thoroughly with 6 liters of antibacterial solution. That’s way more than usual. She’ll have separate fields of instruments, and once the instruments touch the infected area, they’ll be classified as contaminated. Remember the scene in the movie ET at the end, when the little guy was dying, and the family home was a warren of plastic sheeting populated by feds in Haz-mat gear? I’m having visions of the Haz-mat suits. But hopefully no aliens. Although I do kinda like the polka-dotted kiddie pools in this scene.

So we’re on track, on schedule, and presumably ready to go. She estimates the surgery will last 8 hours, not 12-15 like I’d originally heard. Of course, we won’t know what we’re dealing with until she actually gets in there and starts cutting and scraping away, but I’m going to be optimistic.

Meanwhile, I’ll be thinking of a name for my own personal Big Dig (if you have ideas, send them em!), and can’t wait to post before and after pictures like this:

Except, I won’t make you look at the before pics, because they’re pretty gross, and that would just be mean.

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.



Fun with t-shirts

Posted: February 3, 2011 | Author: | Filed under: breast cancer | Tags: , , , , , , , | 8 Comments

I’ve been wearing this shirt to the gym (thanks, Jodie!) and always get comments on it. Positive comments that is. At first I was self-conscious about wearing it, then I said to hell with that, I’ve been through a lot so I’m going to wear it proudly. Kinda the flat-chested girl’s version of  “If ya got it, flaunt it.” I’ve no longer got “it” or “them,” as the case may be, but I can certainly flaunt my survivor self.

It’s a good thing the shirt explains everything, though, because when I first started back at the gym after a long absence (thank you, mycobacterium, you SOB), one of the other regulars there asked our trainer what was wrong with me, because something looked different but she couldn’t put her finger on it.

Hmmmm, I wonder what it could be? Maybe the total absence of breasts? Maybe the evidence of rib cage poking through where normally there would be a little padding? Or my inability to extend my right arm fully (I miss you, lymph nodes)?

Well, thanks to the shirt, no one needs to wonder. It’s cleared up and we can move on…to the next shirt.

I can’t wait to wear this one (thanks, Kayte!), right after I get reconstructed. 

Wonder if they’ll let me wear this in the hospital, instead of a scratchy gown.

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