An appointment and some art

Lovely surprises lurk around every corner.

Sounds like a corny message from a fortune cookie, right? Certainly not what you expect from this little blog, which is typically full of snark. Allow me, if you will, to deviate from the gnashing of teeth, shaking of fists, and renting of garments usually contained within this site.

I had an appointment at the med center this morning to have my wonky thyroid checked out. I love the fact that I live in a city that is home to the world’s largest medical center and that world-class care is available to me.tmc_map

Some fun facts about the med center:

  • some 160,000 people visit TMC every day
  • that equates to 7.2 million people a year (more than the populations of Los Angeles, San Francisco, and Houston combined)
  • 106,000 people work at the med center
  • 50,000 people are students at TMC
  • TMC is made up of 21 different hospitals, 13 support organizations, 8 academic and research institutions, 6 nursing programs, 3 public health organizations, 3 medical schools, 2 universities, 2 pharmacy schools, and a dental school
  • this beast of an institution is spread across nearly 1.5 square miles, and the 18 miles of public and private streets surrounding it would take the average person 6 hours to walk in its entirety
  • the highest concentration of life-sciences professionals in the country live near and work at TMC
  • TMC contains 7,000 patient beds; if stacked up, the beds would stretch 1.65 miles or 7 times the height of the Empire State Building
  • a baby is delivered every 3 minutes at TMC
  • a surgery is performed every 3 minutes

Indeed, everything is bigger in Texas.

Ok, so being the most kick-ass med center isn’t enough. TMC also throws up some pretty nice artwork–hence the lovely surprise. This morning while hoofing it from the endocrinologist’s office to the radiology department (a portion of the 1.5 square miles mentioned above) for an ultrasound, I passed some unusual artwork and stepped in for a closer look. Picasso said, “The purpose of art is washing the dust of our daily life off our souls,” and I was all for giving my soul a little spit-shine.

The minimalist approach of the first piece caught my eye, with its interesting color combination and deft brushwork. The combination of long, thin brushstrokes and fat, wide ones hold a lot of appeal. IMG_3281

The second piece is much busier and conveys a very different energy. The squiggles suggest movement and a fast pace, and the composition suggests the artist has a lot to say and says it quickly.


Painting number 3 is a bit more purposeful and controlled. The brushstrokes suggest a certain scale to me, and my first instinct is big. Or perhaps the suggestion of large size comes from the predominance of orange, which to me is a color that speaks out loud.


Back to a minimalist style for the fourth piece. The ratio of color to white space is quite different from the other pieces. While the pieces share a similar color scheme, they are vastly different.


The fifth painting could have been done by the same artist as painting number 4, with its similar colors and use of white space. The restraint that comes from the white space impresses me, as my instinct would be to cover a canvas with as much color as possible. Restraint has never come naturally to me. IMG_3290

Hmmmm. Very intriguing. I’m no art critic, but I like what I see, and I definitely like these pieces.

Would you believe that each piece was painted by a resident of the Houston Zoo?

The first piece was painted by Shanti, an Asian elephant who, according to her artist bio, is pretty serious about her craft. She dips her paintbrush into sand to give her paintings a mixed-media effect, and unlike the other elephant artists, she curls her trunk around the brush rather than holding it with the “finger” at the end of her trunk. She employs a keen concentration while painting and then likes to unwind by horsing around in the pool (she’s known for swimming in circles to make waves while the other members of her herd are in the pool).

The “busy” feel of painting number 2 can likely be attributed to its artist: an otter named Wednesday. This playful painter likes to walk through a puddle of paint and then step onto her canvas, hence the stippled look of the predominant green paint. She has been known to take a break from painting to go for a swim, then return to her canvas and let her wet feet create a true watercolor. Her motto: Will paint for fish.

The purposeful, controlled painting number 3 belongs to another Asian elephant named Methai. Before becoming a painter, Methai was a circus performer in Thailand. She’s a musician as well as an artist and can play several instruments, including the harmonica. Methai is the most prolific elephant artist at the zoo, and like Shanti, she too is all business when she paints: she is known to squint her eyes in concentration.

Painting number 4 was done by Harry, a White-faced Saki monkey. He’s a tree-dweller from the South American rainforest who mastered the art of painting quickly. He works fast, often completing his masterpieces in mere minutes, and tends to be pretty laid-back, although rumor has it he sometimes gets a bit frenetic about his work and ends up with paint all over him once he leaves the studio.

Credit for the last painting on exhibit at TMC goes to Cali the sea lion. The smart, playful sea lions are a crowd favorite at the Houston Zoo, and when Cali isn’t putting on a show or hunting for fishy treats, she’s churning out paintings like the one on display at TMC. She holds a paintbrush in her mouth to create her masterpieces, then hops back into the pool to frolic with her buddies.

Nietzsche said “The essence of all beautiful art, all great art, is gratitude.” After seeing this beautiful art, this great art, I’m grateful for Shanti, Wednesday, Mathai, Harry, and Cali.



Surgery update

The knee surgery went well yesterday. Got up at the crack of dawn to truck on into the Medical Center and was at the surgery center at 6:10 a.m. Sherpa Amy came prepared with a rollie bag full of projects and snacks, even a picnic lunch. She reminded me to tell the doc that morphine is not my friend via IV but intramuscularly in the behind works fine. She brought me home while Trevor filled my prescriptions, then helped Macy with her knitting. I would love to sing her praises even more but don’t want to risk someone else wanting to partake of her medical concierge services. I’m selfish like that.

After filling out the requisite paperwork, I was escorted back to anesthesia land, one of my favorite places. The anesthesiologist was flat-out awesome. He looked about 25 and played football in college. Based on the size of his thighs, I’m guessing he special-orders his scrubs. He held my hand and said he was taking me to the prom–his little joke to distract me from him inspecting my veins, which are combative and uncooperative on a good day. One quick poke to my left hand, and my prom date was in.

My surgeon came to visit and to double check that I did want the lateral release procedure in addition to the arthroscope. I said yes, please. Ever since I learned that my kneecap was dislocated, I’ve been creeped out and was ready to get it back in line.

After our chat, I got half of my anesthesia cocktail but had to wait for the other half until I got into the OR. I had to haul myself up on the operating table, which would have been difficult if I’d consumed the entire cocktail. I vaguely recall being in the OR but don’t remember getting on the table.

A couple more pics of the lateral release:

Next thing I know, I’m waking up in recovery and fighting hard to keep my eyes open. I’m weird about wanting to prove that I’m ok and ready to go home. Even when I know in my heart of hearts that I should stay, I want to go. Kinda sounds like the basis for a country song. I’ve got an ace bandage from mid-calf to a several inches above my knee, and lord knows what’s under the ace bandage. I’m not all that curious to see. I know that there are 3 incisions, all of which are stitched closed. The ace bandage can come off tomorrow, and I’ll get a look at the stuff inside.

The good news from the surgeon: both procedures were successful. The bad news: I have no cartilage under my knee cap. None. Nada. Zip. So while my kneecap is realigned again, I’ll still be dealing with the pain. Hopefully not as bad as it has been; I’m optimistic, or delusional, either one fits. Dr Alani also said that even after the scope and the lateral release, I can’t do squats or lunges. Ever. Sigh. That makes me quite sad because those are things I actually like to do. I’m weird that way. And stubborn, too: the fact that he says I can’t do it incites me to try. My handlers are going to be hard at work on this one.

Because there’s no cartilage under my kneecap, I will most likely need a knee replacement at some point down the road. Add that to my list of things to do.

Today I have 2  goals: to take my twice-daily antibiotics without letting myself be transported to the awfulness that was 267 straight days of antibiotics after my post-mastectomy infection. I can do this. The second goal is try to bear some weight on my right leg and see how the knee responds. My guess is that its response will be angry. I’m tempted to start weaning myself off the pain meds, but I can hear my handlers protesting that it’s too soon, and that I’m going to need the meds even more after I try to put some weight on my bum leg. But the Lortab makes me itchy and spacey. I can’t take anti-inflammatories because of the PRP he injected into my knee. The autologous injection’s purpose is to stimulate the inflammatory response that helps our bodies heal. Anti-inflammatories short-circuit that response. Same for ice: I’d like nothing more than a big bag of ice on my knee right now, but it too can hinder the PRP’s success. So no ice, no OTC meds for me.

The surgical center staff talked a lot about the pain associated with the lateral release, and I smiled knowingly because I’ve been through so much worse. All I have to do is toss out the words “bilateral mastectomy,” “nosocomial infection,” “multiple tissue debridements,” and “DIEP reconstruction,” and the nurses realized that it’s all relative. An IV in my hand, a few little incisions and some cut connective tissue don’t scare me. Looking back on my previous surgeries reminds me that while it’s a hassle to hobble and a drag to be on crutches, it’s a piece of cake comparatively speaking. If one good thing has come from all the surgeries I’ve had it’s that I’ve learned to be much more patient with the healing process — a big step for a busybody like me. Instead of gnashing my teeth because I’m on the DL again, I’m sending happy, healing thoughts to my beleaguered body. As my sweet survivor sister Jenny reminds me, “It’s temporary.” Hopefully I’ll be recovered in time for some fall tennis, when the sun-soaked TX weather eases a bit.

Fighting from the front lines

I’m always on the lookout for inspiring stories about cancer: patients, survivors, battles won, valiant fights fought. This story found me, via the local newspaper last week, and it’s been on my mind ever since. I am bowled away by this woman. Her attitude is nothing short of fantastic, and her drive to make a difference in the “war on cancer” is inspiring, for sure. Because I’m juggling 4th grade homework on units of measure and a 7th grade study guide on Texas history with the usual chores, animal herding, and the ever-elusive hunt for something healthy/yummy/pleasing to 4 different palates before another weeknight at the baseball fields, I’m going to just relay this story simply and without a lot of editorializing. You’re welcome.

Chisa Echendu had her eye on a doctorate in medical research from Baylor College of Medicine, right here in good ol’ Houston. The 32-year-old Nigerian native had every intention of spending her career in a lab, peering into a microscope and solving medical mysteries.

But then the doctor became the patient as she found a lump in her breast in 2006. At age 26 and halfway through her molecular virology doctorate, Chisa was diagnosed with breast cancer.

“I didn’t think it was serious,” she said. “I was 26, I didn’t have a family history. I was busy in the lab, busy with publications.”

Cancer, however, has no regard for one’s schedule, plans, hopes, or dreams. Chisa learned this first-hand. After her diagnosis, Chisa’s professors suggested she put her studies on the back burner while she faced chemo, surgery, and radiation. But Chisa said no. She was determined to make sure cancer didn’t steal everything from her. She remained resolute in her goal of finishing school, and her attitude is inspiring. She said, “I didn’t want a pity party, I just wanted to be like everyone else and take care of my business. People go through more challenging things in life. I had hope to get well, good resources, good physician tools. Some people are worse — without anything — and they just keep going.”

Instead of feeling sorry for herself or asking “why me?” Chisa not only pushed through the endless parade of problems one confronts with a cancer diagnosis, she refocused her goal. After enduring endless doctor’s appointment, multiple body scans and medical tests, chemo brain, recovery from surgery, and fatigue from radiation, Chisa decided to get out of the lab and fight cancer from the front lines as a radiation oncologist. So after 4 years of med school, she will take on another 5 years of training to help others on this wretched cancer “journey.”

Being a young breast cancer survivor filled Chisa with “more of a sense of urgency” in pursuing her goals. “I feel like I’ve been given a second chance. There is no time to complain or make excuses. Like everyone who goes through difficult times, you gain more strength, a sense that you can accomplish anything you want to do.”

With 2-year-old twin daughters at home and a lot of schoolwork ahead of her, Chisa is proving that she can indeed do anything she wants to do. What an inspiration.

On this day in history…

bag packed, Snoopy donated by Macy to keep me company

One year. 365 days. Or, 366 days with a leap year. Either way, a year is a long time, a lotta days. So much can–and does–happen in the span of a year. Each day is ripe with possibility, and none was as much so as March 2, 2011. Ralph Waldo Emerson once said, “Write it on your heart that every day is the best day in the year.” Looking back at this day last year, I’m taking his advice and am going to write it on my heart: being one year out, exactly, from The Big Dig makes this day the best day in the year. This time last year, I was once again in a hospital gown while my cabal of surgeons brandished multi-colored Sharpies to designate the roadmap that would lead us out of the ravages of infection.

pre-surgery note from my sweet girl

I haven’t yet processed all the thoughts and emotions attached to this day one year ago. I don’t know when or how that will happen. My reconstruction surgery was big. Epic, even. After a long and winding road of “whatever can go wrong did go wrong” post-mastectomy, getting to the point of being able to have reconstruction was major progress. All of the research, doctors’ powwows, appointments, testing, and paperwork involved was just the tip of the iceberg. Then came the actual procedure, and then the recovery. None of those, however, are as arduous as it is to wrap  my head around the “journey” that reconstruction was–and still is–for me.

Because I haven’t yet wrapped my head around my reconstruction “journey,” and because frankly I’m kinda scared to pick at that scab and let loose the torrent of emotions lying under the surface, I’m not going to write about it. Yet.

Instead, I present highlights from the surgery day and the days and weeks that followed. As you loyal readers will remember from this time last year, it was several days before I was able to sit at my computer and type. My trusty stand-in bloggers were the hubs, Trevor, and my surgery sherpa and dear friend Amy. They filled in for me when I was unable to process a coherent thought, sit upright, or use my arms.

While I never got bogged down in the “Why me?” school of thought regarding the complications that ensued from my cancer “journey,” I know now that there are a lot of thoughts and feelings still untapped regarding the perilous trek from normal person to breast cancer patient to survivor. So busy was I handling the logistics of each new complication that dealing with the emotional fallout took a backseat to just getting through each new hiccup. I know all you arm-chair psychiatrists out there are shaking your collective heads and tsk-tsking me for tamping down these thoughts and feelings. I would pass the same judgment on any other poor sap in my shoes. However, you do what you gotta do to get through the worst times, and “when you’re going through hell, keep going,” as Mr Churchill so sagely advised.

Mr Churchill would probably also advise me to quit talking about it and get to it, so here, without further ado, are the highlights (or are they lowlights?) of The Big Dig.

After the surgery was finally complete, Trevor was eerily prophetic when he forecasted the tough days ahead: “She is still awake but in a bit of pain. They are not fooling around with it at least and they just upped her pain-med clicker along with a nice big slug of morphine. We have some tough days ahead while she recovers but everything looks great so far.”

morphine pump with a very large keychain

After surgery and the recovery room, I was shipped straight to ICU for an unpleasant stay  that seemed endless. In Recovery Trevor wrote, “We made it through the first night in ICU. The nurses checked on her every hour last night so she didn’t get too much sleep though. They have ordered a regular room for her but they won’t let her out of ICU until she sits up in a chair for an hour. They just wheeled the chair  in, this is gonna hurt.”

I remember how ominous it was when the chair was wheeled into my room. A hush filled the room as everyone realized what was about to take place. Anyone who’s had a C-section knows how difficult it is to move straight after, and with a hip-to-hip incision, “difficult” barely covers it.

Trevor wrote about making the switch from ICU to a regular hospital room: “Finally out of ICU. It took forever to get out of there, there just seemed to be always one more thing. They had to take blood and couldn’t get enough from the line in her hand despite much digging and infliction of pain. They finally just opened up her chemo port and had it done in a snap. Of course they had already packed her up for transport so the morphine pump was temporarily disconnected. But Nancy is a bad ass and toughed it out.”

I have no recollection of this at all. That’s probably a good thing. I’m glad I was a bad-ass about it, though.

In So Long ICU Amy wrote: “She’s super tired.  Come to find out her new breasticles have to have their arterial blood flow checked once an hour and it’s been that way since the surgery ended yesterday and will be through tomorrow… cat naps abound.  They made her get up and have a ‘sitting trial’ time for an hour and she did really well.  To hear her tell the doctors about it, it was ‘hard’ but as an observer she handled the “trial” with grit and humor–typical Nancy. Tomorrow’s plan is to do a little bit of walking and take a shower.”

It wasn’t long before the wailing & gnashing of teeth commenced. As soon as I made the transition from drugged up to mildly lucid, I figured out that this wasn’t going to be an easy recovery. In Utter Exhaustion Amy explained: “I’ve only had to charge her the $10 for ‘having to put up with your complaints fee’ twice today.  As much as Nancy would like you to think she’s a troublesome patient, she is not, at all.  In fact, the staff enjoy her very much.  Her easygoing nature was complimented today when she had to make the effort to get in the chair to sit for another hour.  Le, her nurse, commented about how Nancy’s attitude really made her job easier.”

I put on a happy face for my medical peeps, but was a bit more realistic with my closest caregivers.

Amy continues: “Complaint number 1: This particular complaint is what brought on the $10 charge twice today.  The ICU room was hot, very hot.  In fact there were heaters brought in just for this purpose…two of them.  Seems that the stomach tissue that they harvested for her new rack doesn’t realize that it has to get its heat source from her body instead of the outside air, so for the next few weeks Nancy needs to have a warmer than normal outside air temperature.  I think the docs even suggested turning off the AC at her house once she gets out of here, but Nancy and I decided to let that one go over our heads.  Nancy actually assessed herself the charge after I mentioned that I charge $10 at my house for being ‘grouchy, irritable, or just plain mean.’ Then she said, ‘And you can charge me another $10 for this one…..’ Complaint number 2:  Headache.  A bad one.  She’s been dealing with this all day.  The nurses say she had a pretty major dose of morphine in the ICU so that is a side effect of morphine and it should work itself out as she uses less and less morphine.  Because of this, Nancy has decided that Mr. Morphine Pump may not be summoned every time the pain surges. She’s thinking about it before she presses the button.  On one side there’s the headaches.  On the other side there’s the pain.  It’s a delicate seesaw to manage.”

“The good news is that despite the pain, she managed to move from her bed to the recliner, sat for an hour, then ambulated back to the bed with only 1 morphine pump at the beginning of the whole scenario.  The nurses are impressed with how tough our girl is!”

I still owe Amy $20. Maybe more.

My intrepid sherpa wrote the Morning Report the day after I was released from ICU: “This morning the muscle tightness and tenderness in the belly incision reared its ugly head and has taken the forefront in the battle for attention.  While Nancy hasn’t actually called it pain, I think that may be the best word for it. There’s a lot of bruising around the hip-to-hip incision, and the docs said that they did had to work hard with her muscle layer there as well as on her chest wall so this is to be expected.  She has been given Flexeril (a muscle relaxer) to help with this and the added benefit is that it makes her VEEEERRRYYY sleepy.  So, even though at 5:15 AM, Nancy was confident that she was up for the day and we did the teeth brushing and face washing that comes with a new day, she was within minutes back to sawing logs.  Good Girl!  She has been dreaming out loud and woke asking me, ‘Is that due tomorrow?’ You can take the Mom out of the home but you can’t take the Home out of the Mom!”

Whatever assignment was due hopefully got done; I have no idea what it was!

Rejuvenated?? was written 2 days after surgery, by Amy: “Mr. Morphine Pump and the rest of his crew are yet again dust in the wind. Nancy is free of anything that follows her on a pole.  She does have 6 drains and 2 doppler wires, plus her central line access port, so she’s still got a little gear. The big event today was a shower. Well, all I have good to say about that shower is that Nancy is clean.  One word I could use to describe how Nancy tolerated the event was that she was speechless.  So, suffice it to say that the pain from the ab incision reached out and grabbed hold of her. By the time she had recovered enough from the trauma of the shower to find her voice she said, ‘That’s NOT happening again!  I’m clean enough!'”

Finally, I was able to post for myself and in 1 Week Ago, I got to it: Long story short, the flaps [newly fashioned breasts from belly tissue] were cooperating, the morphine headache abated, some regular food arrived, and life rolled on. At some point they moved the flap checks to every two hours instead of hourly, which was mighty nice. It’s amazing how your perspective changes in a situation like that. After umpteen hours with no food, a simple PB&J was a delicacy. After being awake most of the night, a short cat-nap seemed a decadent luxury. While I feel a whole lot better and am ready to get back to normal, my handlers think one week post-op is a bit premature to jump right back into the day-in, day-out routine. I am trying to take it easy. I’m resigned to the fact that I’m back to one outing a day for a while, and sadly, a doctor’s appointment counts as an outing. Yesterday I had a small entourage escort me to for my checkup, and we had a bite of lunch (sans margaritas) beforehand. The handlers insisted on snapping a photo of this maiden voyage, and there was some talk of me earning a margarita for every device I had removed at the subsequent appointment. Between the two doppler wires and the 4 JP drains, somebody owes me 6 margaritas. No salt.” 

Of my $82,996.75 bill for The Big Dig, I wrote: “I would have expected my pharmacy fee to be much higher than $4,306.50. Maybe as a repeat customer, I get a discount on morphine.”
And the Breaking News: “There are lots of things I’ve been unable to do in the 10 days since The Big Dig, and y’all know I’m a very impatient patient. I tend to rush things and push the envelope, and sometimes that results in a set-back, or at the very least, a lot of frustration for my handlers. I’ve been trying, really trying, to be patient, to not rush things, and to avoid any potential set-backs. I’m not much of a people-pleaser by nature, but I do try to keep my handlers happy. They make a lot of noise when they’re unhappy with me.”

A little later, in Wisdom from the DL, I got real about my hatred of all things invalid-related: “I’ll never be good at being a spectator in my own life, and I’ll never be one who enjoys the journey in my haste to get to the destination,but I have learned the value of time & place and that sometimes you have to be instead of do. I’ve learned to chant It’s temporary a thousand and one times to remind myself that while this is my life, it won’t always be like this.”

One year later–one very long year that was equally horrific and hard yet insightful and triumphant–I’m still reminding myself.

Beer for dinner

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

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

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

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

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

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

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

Stupid girl.

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

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

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

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

That wears me out.

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

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



Shoot me now.

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

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

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

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

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

image courtesy of Johnson Space Center


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

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

Some days…

Some days I want to open up my skull, scoop out my brain, cradle it lovingly & pat it reassuringly and tell it there, there, one day this bad stuff will be behind us and everything will get back to normal. Those who’ve walked this “cancer journey” before tell me that this will happen. Other days, I want to open up my skull, scoop out my brain, and kick it across the room, saying, is this the best you can do? Can you at least try and keep up here? 

Today is a kick-it-across-the-room kind of day, and it’s early. It’s still dark outside, for cryin’ out loud. My brain should still be sleeping and recharging so it’s ready to face the day. Instead, it woke up–and woke me up, too–several times last night, disrupting my Ambien-induced slumber. Stupid brain. Doesn’t it know that sleep is the one guaranteed relief from the cancer-laden thoughts that course through my head? Unless I’m dreaming about cancer-related stuff, that is, and that too I blame on my idiot brain. How come those dreams are never good? Where are the unicorns and fields of four-leaf clovers? Where are the feel-good scenes that bathe my brain in serotonin, ensuring that when we wake up, we do so with a big smile and feel like we’ve had a nice hug. Where’s Charles Schultz when I need him? 

Now I can’t remember what this post was about. Stupid brain.

Today will be a long day. In addition to the choppy slumber and frustrating half-thoughts, I have 3, count ’em, 3 doctor’s appointments today. That’s about 3 too many for me.

First up is Dr Grimes, infectious disease guru, to hopefully shed some light on the MRSA part of the infection puzzle. I’m expecting to get culture results from my visit to him last week, and he will order blood work as well today, to seek more answers to the great infection questions that seem unending.

Then it’s off to Dr Spiegel to get down on my knees and beg her to please please please pull these damn drains. Today is 4 weeks, people. Four long weeks of being tethered. She’s not easily swayed, so my visit to her may end in tears. Or shouting. Or both.

But, wait — I have my appointment with Dr S to round out the day! That ought to be good. He always has something interesting to say about my pitiful situation. Half the time I don’t have the foggiest idea what he’s talking about, but it’s always interesting.

Stay tuned.

1 week ago today…

I was out cold in the OR, having unspeakably nasty things done to my body to restore the damage wreaked by the post-mastectomy infection. Whew!

The first couple of days of week 1 are pretty hazy, thanks to my BFF morphine. Love that stuff. But my BFF knows its proper place, and we have short but infrequent get-togethers. This time around, my BFF gave me a terrible headache, which was quite rude, so I bid adieu to the pain pump as fast as I could.

Let’s start from the beginning. Or as much of it as I can remember. Readers, feel free to chime in when you notice I’ve left something out. We got to the Medical Center on time (6 a.m.) and I got right into my pre-surgery room. My beautiful gown and compression stockings were waiting for me, but I waited until the very last minute to don them. After some precursory steps, like accessing my port for the administration of the really gooood drugs, a gaggle of white coats entered the room.

Dr Spiegel led the way, with her PA Jenn next, followed by their resident, Dr McNight, then my favorite plastic surgeon. He was the only guy in the room. Yahoo, girl power! He had a cool wooden box in his hand and when I asked if it was a present for me he gave me one of his looks. Someday he’ll appreciate my humor. Inside the box was not a present, but his loupes, which sadly he didn’t offer to model. I’d love to see him in a pair of goofy glasses.

Dr Spiegel and Jenn started marking my belly and I’m so mad I didn’t think to take a photo because it was cool. They used a blue sharpie for arteries, a red sharpie for blood vessels, and a black sharpie for incision lines. Lots of arrows and lines later, there was a roadmap of sorts. Very cool. At one point, Dr Spiegel wasn’t happy with an incision mark so she had Dr McNight scrub it off my belly with alcohol and re-do it with the black marker.

After that it was time to head to the OR, and they must have given me a cocktail in the pre-surgery room, because I don’t recall anything after the sharpie party. When I woke up, some 8 hours later, I felt pretty good…but it was because I was wrapped in the loving embrace of some big-time anesthesia. Dr Ashmore, my hand-picked anesthesiologist, did a fantastic job of putting me to sleep, and more importantly, waking me back up. It was good and restful.

I’m not too sure about whether I was in a recovery room or went straight to the ICU, but once I got to ICU I recall that it was HOT. And I’m a Texas girl, so I know about some heat. The docs had warned me that the room would be warm, to help my newly transplanted blood vessels learn to regulate themselves in their new northern home. But wow, was it hot. Between the high temp, the two heaters, and the squeezing of the compression hose, I was roasting. I tried to be nice about it, and I think I only lost it once, when I begged one of the ICU nurses, probably Carol, to please please please just crack the door and let some AC in. Just for a second. She declined my request.

I spent the night in ICU, but thankfully the flaps, aka former belly skin & fat that were magically transformed into breasts, behaved and there was no drama (other than me begging Carol to crack the door, turn down one heater, turn up the thermostat or bring me a gallon-sized frozen margarita). The flaps had to be checked every hour, yes every hour, with a hand-held doppler. There were (until yesterday) some wires stitched on top of my chest that somehow transmitted audible sound of the blood rushing through my newly transplanted blood vessels through the doppler. It sounded a lot like a fetal heart monitor. And we heard it a lot. My flaps were cooperative, and the nurses were able to hear the blood rushing almost instantly after putting the doppler onto my chest. One nurse told me that sometimes it took 20 minutes to find the sound. I started to panic after a few seconds of not hearing it, so can’t imagine the size margarita I would need if it took 20 minutes to register.

The ICU room had a wall of windows with mini blinds, and the nurse was right outside the door at a desk looking into my room if not attending to her one other patient. Some people might think that would make you feel very safe and catered to, but it made it hard to sneak anything by her because she was always watching. If she wasn’t watching, somebody else was walking by. It was a constant parade of doctors, residents, nurses, PCAs and other people peeping into my room.

I got released from ICU after some really delicious jello and a contraband peanut butter & jelly sandwich (liquid diet…pffft) into a regular room on the 8th floor of Dunn Tower. Lovely view out the window of the heart of the Texas Medical Center, and more importantly, no heaters. It wasn’t exactly chilly in the new room, but so much better than the ICU room. Nevertheless, I did beg to have the tight, scratchy, hot compression stockings removed. Those nurses were not swayed by my shameless begging.

Apparently the docs were pretty pleased with their handiwork, and if you missed Trevor’s and Amy’s guest blogs while I was too loopy to post, go back and take a peek. Long story short, the flaps were cooperating, the morphine headache abated, some regular food arrived, and life rolled on. At some point they moved the flap checks to every two hours instead of hourly, which was mighty nice. It’s amazing how your perspective changes in a situation like that. After umpteen hours with no food, a simple PB&J was a delicacy. After being awake most of the night, a short cat-nap seemed a decadent luxury.

I’m sure I said some goofy stuff and probably offended someone at some point with my off-color humor. Apparently I channeled my mom, too, telling my friend Laura who works at Methodist and who visited me several times a day, “Thanks for dropping by.” Every time she came by. I was just being mannerly and didn’t realize I’d seen her a few hours previous.

There are conflicting reports on how the turf war between the Drs S played out. All parties are being quite cagey on the details of who did what part of the surgery, and like a good murder mystery, we may never know who real killer was. I have my suspicion, but even asking point-blank hasn’t garnered an answer, so we may have to label that information “permanently classified.”

I did get to skate out of the hospital a few days ahead of schedule, and even though I received impeccable care, I couldn’t wait to get out of there. Coming home is always sweet, but never as sweet as when I’m leaving a hospital room.

I have more mobility than I did after the mastectomy, but not as much as I’d like. The first few times I had to get up without using my arms but relying on my legs and abs, the hip-to-hip incision on my tummy protested mightily. But it got better every time, and now I do it almost without thinking about it. Almost. I still can’t walk completely upright because the incision is still very tight, but I’m not quite the Quasimodo I was in the hospital. I get a bit straighter every day.

I came home with 6 JP drains this time, and had to upgrade my VB sling bag to a bigger VB bag that could accommodate the drain party. I knew from last time around that 4 drains fit nicely, with a little extra room for my Blistex, some folding money, and a teeny ziplock bag of pills, should they be necessary. Six drains would have burst my handy little bag right open. Wonder how many drains this lady is toting in her VB bags?

I had my first real shower today, not counting the seated variety the hospital offers. Again, it’s the little things we take for granted. I’m down to just 2 drains and back to my sling bag, thanks to Jenn removing the 4 drains up top yesterday. She gave me a good report; everything looks good and is healing nicely. 

While I feel a whole lot better and am ready to get back to normal, my handlers think one week post-op is a bit premature to jump right back into the day-in, day-out routine. I am trying to take it easy. I’m resigned to the fact that I’m back to one outing a day for a while, and sadly, a doctor’s appointment counts as an outing. Yesterday I had a small entourage escort me to see Jenn, and we had a bite of lunch (sans margaritas) beforehand. The handlers insisted on snapping a photo of this maiden voyage, and there was some talk of me earning a margarita for every device I had removed at the subsequent appointment. Between the two doppler wires and the 4 JP drains, somebody owes me 6 margaritas. No salt.

Although I complain about going to the med center, there’s always something interesting to see along the way. Getting out of the suburbs is a good thing, and there’s a whole ‘nother way of life in this big city of ours. Last time I was at the med center for some testing, I saw this car and had to take a picture, to show Macy. I knew this car would appeal to her:

She loved the polka dots and said she’d like to have that car, then she saw the back and said forget it. Fickle.

Yesterday on the way home from the med center, I saw this:

and had to snap a picture. Yes, it is a zebra car, complete with a long tail. Gotta love the big city.