Friday, August 29, 2008

Drink the Bubbly of Your Choice Because

I just heard from Dr. Solemn. He told me that the pathology came back and there is no cancer in my tissues.

Wednesday, August 27, 2008

I'm Okay

Surgery yesterday went fine. Solemn and IH did their thing. They discovered the cavity from my previous surgery, at end of a little corridor inside my breast, almost like a small chamber at the end of a cave. Solemn re-excised the tissue, IH filled in the cavity with fat from another spot in my breast and closed the incision. He didn't reposition my nipple (thank God) as he planned to, because it made an acceptable return to its proper place on my breast, once he was done with his work.

I'm a little stiff and sore, but really want to avoid the pain meds, as they keep me awake at night. Last night I got up and watched a show about people wanting to know what their houses were worth, a show about a couple wanting to move so the wife would have more room for her doggy day care business (don't you want them for neighbors?), an infomercial about total cleansing, and the rerun of CNN's talking heads, blah blah blahing about Hillary's speech last night.

Okay, I'm rambling about nothing, so I'm going to go. Back when I'm more lucid.

Tuesday, August 26, 2008

Surgery Today

Today is my surgery, a so-called partial mastectomy (lumpectomy) and scar revision. I will also get my portacath removed. It's not been easy to be a front seat passenger all these months because the seat belt hits the lump on my chest where my port is.

I haven't had much chance to talk about the loooong journey I've taken up to this point. I was considering a California team of surgeons for my next procedure. But since we seem to be back at a relatively simple place in my treatment —nothing drastic is going to happen — I decided to have this at home and recuperate in the bosom of my family.

Well, off I go. See ya on the flip side.

Tuesday, August 19, 2008

Crucifixes and Cancer

Oops, there's a few people who don't know my surgery is not today. It's next Tuesday, Aug. 26, at 12:30. Dr. Solemn will be doing the re-excision of the tissue, and Dr. Impossibly Handsome will be prettying up what's left over, immediately after Dr. Solemn is done with his work. It's a day surgery — I'll be home in my bed that night.

The reason for the delay is, Dr. IH changed the venue to the Big Imposing Catholic Hospital (BICH), and I was not made aware of this. I told Dr. Solemn's office I just can't be involved in the Catholic health care system unless it is a matter of immediate loss of life. So they changed the day of the surgery and returned it to The Other Hospital — where it was supposed to be in the first place.

I visited a breast cancer patient at the BICH in July. She had just had big surgery and was out of the ICU and recovering in a regular room. There's new construction going on at BICH, and we could hear every power tool the crew was using. The crucifix on the wall of the room jiggled while they worked. If I'd known her better, I would have offered to pull it down and stick it in the trash. I don't know what happens when you remove a crucifix at BICH. Maybe they don't let you.

Anyway, this issue goes very deep for me. I was raised a Catholic. A churched and confirmed Catholic. Not the yeah-my-grandmother-never-missed-Mass-but-the-rest-of-us
-only-went-drunk-on-Christmas-Eve kind of Catholic. Add this to a family history of breast cancer, and it makes for a transformative experience, let me assure you. BICH does help out the poor with health care, and I've even contributed to that fund. But it doesn't mean I have to let them be part of what happens to me.

Saturday, August 16, 2008

Cancer On 120 Grams of Protein A Day

When I was pregnant, my diet wasn't good. The What To Expect When You're Expecting, superior-type granolas would not have approved! But I was very scrupulous about my daily vitamins, extra folic acid, and calcium. Almost the day after I had my baby, however, my discipline toward supplements dropped off to nothing. With the pressure of gestating a human off me, I felt free to slack off.

Even before my cancer diagnosis I had returned — somewhat happily — to a new regime of taking supplements for so-called brain health, mostly vitamins and some amino acids (like tyrosine and GABA+). When I was diagnosed, I snagged an appointment with Mr. Sought-After Nutritionist, Ph.D. Sought-After added some things to my regimen, namely taurine, glutamine, CoQ10, and melatonin.

Taurine is one of the things in the energy drink, Red Bull (ew).

Glutamine powder, mixed in a small amount of water, supposedly grows a barrier on the gut and helps with neuropathy (tingling in the extremities). I know that when I was on chemo if I missed one of my thrice-daily doses of glutamine, my burned-from-the-inside-out feeling got worse. I never had any mouth sores nor any neuropathy, which are common side effects of chemo. Glutamine has the texture of that same grit they use to polish your teeth when you go to the dentist, but very little taste. It doesn't stay in suspension very long, so it helps to down it fast from a tiny Dixie cup. My brother called it booger juice, but it really didn't bother me to use it. Its benefits were so noticeable.

CoQ10 supports the soft tissues and protects heart health. High quality CoQ10 is not cheap. I had to avoid it and my vitamins the day before, the day of, and the day after a chemo infusion so as to not interfere with the cancer treatment. My heart used to be healthy before they gave me chemotherapy and I'd like to think it's still all right.

Melatonin had kind of a heyday about 15 years ago or so as an insomnia fighter. It doesn't cause drowsiness. It seems to work by sitting on estrogen receptor sites and cuts down on estrogen in the body. Estrogen keeps women awake at night, and it fuels tumors.

I also added DIM, another supplement that has a role in estrogen processing. It's not cheap to use it, either. Luckily, our health plan offers a discount on this particular supplement.

My new regimen also included a low glycemic diet, which indicates no tropical fruit or white flour. No salads made of leaf lettuce — too dirty for a person with a compromised immune system. Add 8 oz of a processed tomato product every day — lycopene fights cancer. Eat 120 grams of protein daily — all kinds, all sources, including red meat twice a week.

This last one was much harder to do than you would think. For example, 8 oz of red meat only has about 64 grams of protein. You still have another 60 to go. Eat a pound of steak, then? Maybe not. Check the nutrition information on a food label some time and you can see how difficult this really is. I'm pretty sure I mostly did not ever get up to 120 grams of protein every day. I bet I got half of that. It's a pain in the neck to keep track of. I can only drink so many whey protein smoothies before I feel annoyed about it. A great protein source is that Fage Greek yogurt — 15 grams in a serving! The word is out about Fage. HEB was totally out of it when I went there the other day. But even so, you still have about 100 grams of protein to consume, somehow.

I'm talking in past tense because, with the horrid chemo out of my life and that crisis now over, I feel pretty slacker-ish again. When will I ever learn? A fellow cancer patient recently admitted to me that she, too, is often AWOL from her supplements. How much better could she feel if she would just get on board and stay there? As you can see, there is a lot of self-reprimanding we do. We have to be model patients, after all. We have to do our cancer the right way. Everyone's looking. I'm supposed to still be on all of this stuff, all the way through radiation.

I wistfully nibbled only a little salad when I was on chemo, dreaming of the day it was no longer off limits to me. I'm a little surprised that I'm not enjoying it now the way I thought I would. I nearly forget to buy lettuce when I shop now, having steered clear of it for six months. Organic leaf lettuce has gone up since I last bought it, I was kind of shocked. I'm also still skipping eating bananas, melon, and pineapple. After you eliminate something from your diet, it's harder to return to it than you think.

My taste buds aren't wrecked anymore, with chemo over, and that metallic taste is gone. But I still feel like I'm not really experiencing food the same way I did before I began to be treated for cancer. My late therapist described the condition of depression as, "The salt is gone out of life." I still feel like the salt is gone out of eating. It holds so little pleasure, not in its anticipation, nor in its reality.

Some of this could be attributable to our household's new, gluten-free regimen. But that is another story.

Tuesday, August 5, 2008

Yo-Yo Recovery

By about noon yesterday I knew something was not right with me, but I couldn't quite believe it. I had had such good energy the week I was in San Fran, but not a lot of rest. So I thought I was just a little run down. But I went for labs yesterday and my white count is low. Waiting for the other labs today to find out if I'm low on iron or B12.

What the hell?? I thought I was on the upswing. But I'm told that recovery is more of a yo-yo than a slow climb up Nob Hill (see right).

Sunday, August 3, 2008

A Reply

From a friend, in reply to my query:

I think I would feel somewhat bemused and mostly cheered up. Having recently been in the position of uncovering and having to move my old journals I think I can say that I have recently found the same thing to be true. I thought I would be horrified at that girl and her emotional excesses, but I found she is still right there, and basically I am happy to have found out that I am still that girl. Or maybe I am finally learning to stop caring what other people think so much.

Saturday, August 2, 2008

Walking On Thin Ice

Everybody knows this Yoko Ono song, right? Elvis Costello covered it many years ago but I cannot find that version on iTunes. I don't know the lyrics. Maybe it's not really about walking on thin ice.

But that's what I'm thinking about as I contemplate my next move in my treatment. On July 10, I went to see Dr. Popular to discuss my scans. His office had phoned me and told me they were clear, but I thought, hey, this is worth more than a phone call. Let's talk. He tells us that the CT and the MRI did not show any evidence of residual cancer and the bone scan is clean. They can see my prior surgeries and my gall stone (yes, isn't that yucky? I have a gall stone), but that's it.

Huh, I say. Okay. I guess I still go get surgery anyway. Yes, he says.

The next day we go see Dr. Solemn, the surgeon. He needs a new nickname. He comes into the examining room and he's animated, excited, bouncing off the walls. This is great! he exclaims. Your MRI is normal, your CT is not suspicious, this is all as good as possible!

Yes, but … what is YOUR deal? I'm thinking. He leaves the room so I can take my top off and my husband and I briefly confer over Solemn's new demeanor. "I guess he's just being upbeat but doesn't want to go, 'Hey! When are we doin' that mastectomy?!'" I offer, as I pull on that adorable capelet thingy. Still, we can't understand his behavior. I've got cancer, for Pete's sake.

Solemn returns eventually (he's taking and making phone calls outside the room, he's a busy guy) and examines me and tells me he feels no masses in either of my breasts. That's also great. I get dressed again, and after a while he comes back in the room. He suggests I consult immediately with the radiation oncologist. He says there's no advantage or disadvantage to doing surgery after radiation. But I could have my lumpectomy (partial mastectomy) anytime and a plastic surgeon can clean up the tissue …

Wait, we say. What? We thought we were in here to talk about my mastectomy and, well, we were gonna go all the way here and make it a bilateral (that's the term, NOT "double mastectomy") and be done. I have cancer, and I was told it was not good. I had a tumor that was over 8 cm in length, kind of a cigar shape, and I had a tiny bit of cancer in my lymph node. We talked about this in January when we first saw you, Solemn, and again in April. This is what we thought we were going to discuss today.

Whatchu talkin' bout, Willis???

Oh, you can still do that, he says. But a partial mastectomy is no better or worse than a total mastectomy. Solemn/Willis tells me my risk of local recurrence is low (4-6%) and a new recurrence in my other breast is also low. He tells me a bunch of other stuff that I stop listening to because I am stunned by this new information.

Okay, I say, cautiously, What you're saying is, I have options. Yes! You're in the best shape you can be, he says. Does this happen to a lot of people? I ask. No, he says. And then tells me to see the radiation oncologist and consult a plastic surgeon and formulate a treatment. We stumble out of the office in a daze.

The next week we meet the radiation oncologist. I need a clever nickname for him. He wears no dress shirt and tie, no jacket, no starched medical coat with his name embroidered on it. Just casual. It would be easy to mistake him for someone who just works there, not the doctor. He's kind of hilarious and quirky. He looked at my personal info, noted that I put down one or two alcoholic beverages a day as my consumption rate and winking, says, "Ah, good. You can't be an alcoholic if your doctor drinks more than you." Unlike Solemn/Willis, he prefers I get surgery first, then come to radiation. He thinks I will need 28 treatments of radiation to my lymph nodes and tumor bed. I will need 10 more treatments if, for some reason, I still do not get negative margins in my next surgery (that means: if they still find cancer cells in my excised tissue, even though I am supposed cancer-free).

Thus, the overworked thin ice metaphor. Apologies to Yoko.

Friday, August 1, 2008

Lurkers, Awake!

Okay, you lurkers, you interlopers. I'm going to ask a question, and you better answer! Either on the blog, or by email, or phone, or pen-and-parchment.

How would it make you feel if you knew (and had written proof) that the things you think about — your job, your creative life, your family, your friends, your home, your health, your travel, your WHATEVER — basically don't change? That whatever you thought or said about any of those things years ago is the same thing you would think or say now? Would you be bemused, depressed, or cheered up? What would you do with this not-new information?

Tell me, because it's important.