Half Time Remarks: Part 1 of 3

"Half Time" as in "Chemotherapy is over, Radiation ahead" -- and I might just come to think of subsequent surgeries at Over Time.

Part 1 is some bits and pieces:

1. After Half Time remarks, the nature of this blog will be a bit different. I plan to keep the record of the radiation experience, because you're all desperate to know what that's all about, right? But I won't try to post something each day.

The change in the nature of the blog is due to the change in the nature of my little adventure. In the past months, there was a lot going on--medically, physically, spiritually and emotionally. Writing about all of it was a terrific way for me to process all of that while bearing the additional fruit of the record of my experience.

But now, it seems like there's less to process. So there's less to write about. So there'll be less writing.

2. Many of you have sent along various items relating to Mammogate, e.g. that government task force recommendation regarding mammograms and when women should get them AND, in an extra-brilliant addition, whether doctors should teach women about self-exams.

There's nothing I can say about this that you probably have not already said for yourselves.

Except for this, which you might not know about: The American Cancer Society, for their part, notes that under the House health care bill, this task force recommendation would make pre-50 years mammograms a Class C preventative measure, and proposed insurance requirements would cover only Class A and B preventative measures, so officials looking to calm the storm my suggesting that this task force's work is meaningless are being a bit disingenuous.

While Leslie was here, we were in Wal-greens, scouting for a lip liner that had been discontinued--and we found 3 of them in the discount basket! Not sure what Leslie will do after those are used up, but I feel her pain, as Clinique discontinued a lipstick that was the perfect color for me and I've yet--8 years later!--to find another that suits me as well.

There we were, rummaging for lip liner, when a woman said to me, "Do you have breast cancer?"

Well. I was bald and wearing my pink "Chicks Fly" hat that Aunt Jill bought me. And I think it's my age that tips people towards guessing cancer of the breast. . .

"Yes," I told her, "And I recognize you from the Rocky Mountain Cancer Center, right?"

Conversation ensued. It was the day after Mammogate broke open and we soon were talking about it. I registered in just a few seconds: This woman was taking it personally.

So was another women I talked with in the chemo barn the following week. So was my Dad, who brought it up over the phone and got so upset I had to tell him, "OK, take a deep breath. . ."

So do I. I'm mostly annoyed over the comments on self-examination. Granted, I'm one of 0.5% of breast cancer patients--those of us under 40 with no family history of it. If we don't find it ourselves, it will kill us, because mammograms don't start until you're 40 under current recommendations.

And, as one of the 0.5% of breast cancer patients--a statistical blip to a bureaucrat--who is alive today directly because of all the awareness programs and professionals who've made self-examination as commonplace and teeth brushing--I pretty much feel like telling this task force, "Fuck you."

A larger point is that, as 1 in 10 women develop breast cancer, everyone knows someone with it. And therefore, nearly everyone takes this personally, especially the half of the population that both knows someone with breast cancer and who has breasts of her own.

Makes me wonder about the timing of these recommendations, given that the public reaction was entirely predictable. I'd almost say that this whole thing was a plot by the Vast Right Wing Conspiracy to plague Obamacare, except that I don't think there are currently any Republicans with the power and enough cleverness to have engineered it. . .

3. Speaking of Leslie's visit, we had a delightful time. Something about Rounds 5 and 6 were a lot more comfortable than 1-4. I had no GI discomfort at all. The fatigue was a little worse, but my body felt generally better.

So, whereas during Round 3 when Laura was here, I mostly just sat there and watched her cook copious amounts of food for our freezer (which lasted right through to round 6!), I was able to do a bit more with Leslie, and that was fun.

She cooked for us, too. But without the mission of freezing meals for us, she made the kind of meals that require stove top cookware instead of a crock pot and stock pot. All of which is to say that she cooked one meal in my house and then declared that I had to buy new pans.

We were off to the TJ Maxx Home Goods store where she picked out two pans for us, and then she was very happy to use them all week.

She's gone. The pans remain and guess what: It is a delight to cook with terrific cookware! I don't know what it is, but using these pans that are genuinly non-stick and that heat so evenly has changed the very meaning of cooking for me. I love to use them! I look forward to cooking now!

Who knew? Seriously. Who among you knew this and never told me?

4. While Leslie and I sat in the chemo barn awaiting my last neulastin shot (woo hoo!), we chatted with this gal across from us. She had a helper dog with her, and you know how dogs are great for stating conversations.

(Note on the chemo barn: Several patients bring their dogs. I've seen at least 3 little ones and 1 big one and this lady's animal was the only certified helper dog among them.)

She was a beautiful woman. Mid-50's, with a brain tumor that had spread into her neck. She soldiers on.

She learned that Leslie was my sister and then said, "Oh, sisters!" She had to spend 2 months in the hospital to get a stem cell transplant and her sister took a leave of absence from her job in Boston, flew to Denver and stayed in the hospital with her. "There's nothing like a sister," she said.

Leslie and I were both crying.

Very true. There's nothing like a sister.

Some Pink I Actually Liked

Copied from an e-mail Sister #2 sent me:

Pink Glove Dance for Breast Cancer Awareness


" Our daughter-in-law, Emily (MacInnes) Somers, created,
directed and choreographed this in Portland last week
for her Medline glove division as a fundraiser for breast
cancer awareness. This was all her idea to help promote their new pink gloves.
I don't know how she got so many employees, doctors and patients to participate, but it started to really catch on and they all had a lot of fun doing it.

"When the video gets 1 million hits, Medline will be making a huge
contribution to the hospital, as well as offering free mammograms for the community. Please check it out. It's an easy and great way to donate to
a wonderful cause."


Ap!: It made me laugh, and then cry and cry and cry. But that might just be the standard after-effect of a chemo-round. . .


If it doesn't buffer well, you can find it at this link:

http://www.youtube.com/watch?v=OEdVfyt-mLw

And I'm not certain if watching it on this blog will count towards the 1 million hit donation. . .

Radi-elation

I'm glad to be looking at radiation because it means chemotherapy is behind us. Here's what the approach of radiation has looked like:

Plan A: When Dr. Science mentioned radiation at my first appointment with him, I swear he said "3 weeks." I figured I'd knock it out soon after chemo and be done by the new year. Plan A lasted until Chemo Round 5, when Plan B was unveiled.

Plan B: 5 weeks of radiation, 5 days a week. He swears he never said 3 weeks. . . So. I figured I'd rest up after chemo, spend 2 weeks over Christmas with Bryan and the kids in Florida, by his parents, then come back and start the radiation in January.

I had gotten pretty keen on Plan B. I liked the idea of being recovered from chemotherapy, and of having a nice break from treatment, and of enjoying the whole month of December without having to use any cancer words.

Then Leslie and I went to my appointment with Dr. X-Ray.

He has a real name. But he is a radiologist. Am I supposed to resist giving him a name with a bit of jazz?

We both liked him. Very down-to-earth guy. Grew up on Long Island. Lived in Hinsdale, IL for many years before relocating to the Springs. We talked suburbs for a while. Very personable fellow.

When he told me the radiation would likely be 7 weeks long, I did not like him any less.

I posed Plan B to him, e.g. waiting until the new year, and his first response was to say that we have no data on how waiting 6-7 weeks affects the outcome. But, he said, if I really wanted to wait. . .

No, no. I'm not here to make medical history. Staying within normal parameters seems like a fine idea, and that means starting within 3-4 weeks of the last chemo treatment. And that means starting 7 December or so. And that makes for Plan C: 7 weeks, 5 days a week, starting early December.

We hope to get down to Florida in late January.

Other notes from the Dr. X-Ray visit: he noted that I am "thin."

I finally said out loud, instead of just writing about it, "I love it when doctors tell me I'm thin."

He laughed at this. But he's got a wife and a daughter, so he knows the score.

He mentioned the side effects of treatment: fatigue, possibility of lymphedemia, sun burn on the skin that will turn into a tan.

About the fatigue--I am hoping it will be of a different sort than what chemo produces. It comes from the body's efforts to rebuild cells, and that seems friendlier than the body's efforts to process poison and all the drugs taken along with them to control side effects.

About the lymphedemia--25 - 30% chance that radiation will trigger it. Let's pray against this. As you all know, it's the one thing I really want to avoid.

About the skin issues -- Dr. X-Ray concluded the description of burn into tan by saying, "So, it will end up looking pretty good."

"You mean, aside from the missing breast and scar running across my chest."

This made him laugh a little, too. "Yeah, aside from that" and then went on to describe what radiation of 20 years ago did to the skin. Ugh. Once again, I am so thankful for the technology that has come before me.

So there is your scoop. To paraphrase the Ghostbusters, shortly before they cross beams and nuke the StayPuff man: "Plan C. I like this plan and I'm excited to be a part of it."

The Last Round

A week ago, Sister #3, Leslie, and I went to the chemo barn for Round 6.

Before the chemotherapy comes a blood draw from my port and then an appointment with Dr. Science to talk about the lab work and any other issues.

Sister #1 didn't get to meet Dr. Markus during her visit because I had a substitute doctor that day. This is only relevant to the extent that Laura, sister #1, is. . .very. . .normal. She behaves normally. She quite reliably doesn't say or do anything outside of normal parameters of American middle class society. So even if she had met Dr. Markus, I don't know that there'd have been anything to report.

Leslie is normal, too. No, really. She is. But sometimes, just to have a little fun in her day, she chooses to take half a step outside of normal and just let it ride. Just see what happens. Because it's fun. Because it's entertaining. Because, why not?

You're wondering: Like what? I don't know. It's hard to describe. She just has these. . .feminine wiles that distract and charm most men, causing them to get idiot looks on their faces.

And she's reading this blog. I don't think I'm saying anything that's not making her smile right now.

Going into my appt with Dr. Science, I couldn't help thinking, "Is this going to be one of those slightly-outside-the-envelope kind of moments for her? Could she reduce this brilliant man to an idiot look?"

He came in, I made the introductions, we got to talking about Round 5 and how I was feeling fine. He and I high-fived over starting the last round. All very normal.

I sat up on the exam table so he could listen to the heart, lungs, etc. . . I asked him a) how long after radiation one had to wait before having surgery and b) whether I could have surgery while taking the protein treatment, Herceptin.

A) 4 weeks
B) Yes

So, Leslie, who was sitting on the side chair as Dr. Markus and I were by the exam table, started doing calculations. 4 weeks this, radiation lasts that long, then this, then that--running these numbers, Dr. Science and I just staring at her, waiting for her point to emerge.

"So by early April, Aim," she concluded, "Poonph!!" and she motioned her hands by her breasts, making small ones into big ones.

Dr. Markus and I turned from her to look at each other.

He, not quite with an idiot look but at least one that was a bit bemused, and I with a half smile and a shrug.

I told this story to others, in front of Leslie, and she said, "I totally toned it down, you have no idea."

And for this, the good doctor and I are thankful.

As for the medical portion of the appointment. . . what next?

Radiation, which I shall explain tomorrow.

And then the big question: How do we know for certain that the heebie jeebie cancer is gone/has not come back?

1. I'll continue to go every 3 weeks for herceptin through August, at which times, they'll do a full blood count and monitor my blood chemistry. Sometimes, cancer in the system will register in those numbers.

2. I'll keep track of my own body, and if something feels different or seems to hurt or seems off, I'll tell him about it and have a scan of some sort.

"That's kind of intimidating," I told him. Having such a serious consequence predicated on my own judgement? Yeesh.

But he explained, of course, that I'm the best judge of my own body and that I "am not a whiner" so when I tell him about something he'll "believe me."

Not a whiner?

"Well, sometimes people come in with a long list of ailments and it's hard to know what has to be addressed. You're not like that, so if you complain about something, we'll know we have to look into it."

Here that, everyone? I'm not a whiner! I'll take that as the day's compliment. Though I note here that Dr. Markus is the one physician attending me so far who has yet to tell me that I'm thin. . .

Finally, unrelated to my own condition, is Dr. Science's, the day we saw him. I noted that he'd gotten some sun. He pulled out his finisher's medal from the San Antonio marathon. 26.9 miles. "This is why I'm walking funny," he said.

We congratulated him, wanted to hear all about it. And had his family gone with the for the weekend to cheer him on? No. He'd told his wife he was leaving for a medical conference.

What?

She doesn't like for him to do stupid things, he explained.

But how did he train without her knowing?

"I'd go out for a run and come back 3 1/2 hours later. . . But I do so many stupid things, this hardly registered with her."

I asked if he'd let his kids in on the secret--they are 7 and 6.

He said, no, they'd have blabbed.

"Oh," I commented, "They've got tight shoes."

What's that?

"They're shoes are so tight, it forces the truth out of their mouths." --shout out to Uncle Fe, who brought that expression into our family. . .

At the end of the appointment, with tears, I told him what an excellent physician he was and I thanked him for his compassion and for always making me and Bryan feel like he had all the time in the world to talk with us. I know some people do this cancer thing with doctors whom they don't like and don't trust. I'm so thankful that I am not one of them.

But before the appoinment ended, I asked Dr. Markus a probing question: what percentage of his job was sad work? He's an oncologist. A lot of his appointments probably carry sad news.

His eyes teared up and he said, "Quite a bit of it. We get really attached to our patients."

Did he carry that sadness home with him?

"We have different ways of coping. Some of us run until our legs fall off. . ."

So, a hearty congratulations to Dr. Markus on finishing his marathon. Not a stupid thing, in my estimation, but an heroic one. Especially if it's therapy to aid an heroic work.

Wellness Update

Sunday evening.

Had a terrific visit with Sister #3. Plenty to tell you about her visit, and the impression she made on certain physicians, but not tonight.

I'm such a tease.

I cried a lot this week, every time I thought of how I am done with chemo. It's very surprising how emotional this end has been. I can't think of a good reason for it except to say that I don't think I've ever felt this kind of relief before, and I guess relief produces tears.

The other part, I realized during worship service on Saturday night, is deep, deep gratitude. To all of you. Seriously. Your comments, knowing you were reading this blog, knowing I had so many amazing people in my corner were all a genuine help along the road thus far. You should all very proud of yourselves and even productive.

"What did you do this year of significance?"
"I helped a friend get through chemotherapy!"

And then there was that time of worship with the Lord. My, my. . . I haven't had too many moments as intense as that one.

To be able to come before Him after Round 6 and say, "You promised not to forsake me and You didn't. And You did so much to make those weeks a lot easier than they could have been. . ." it was breath-taking.

There is that famous hymn "all is well with my soul," written by a guy who'd just lost his wife and daughter at sea, and it echoes a theme found often in the Bible and throughout the Christian life--that God is Sovereign, and come what may in personal circumstances, the thing that makes the worst conditions OK is the very character of the Living God--that He's faithful, powerful and good. And because of Who He is, one way or another, the story is going to have an ending that the believer can be thankful for.

I haven't--and we haven't--lived in anything close to the worst of circumstances. On a scale of 1 to 10 of Bad News, I'd say the year so far has been about a 3. But even so, now that I'm on the other side of that rough patch of surgery and treatment, and have experienced--not just been told about--walking with the living Lord of Lord through a narrow passage, I see the point of that hymn.

What a Mighty God.

I have much to tell you about radiation, The Visit, as I mentioned, and the coming Extended Blogger Break I'm planning on. But I'm still tired enough from Round 6 that I turn in early. And I haven't seen my husband in a week, so it'd be nice to talk to him while I'm still conscious. . .

Thank you again, truly, truly. I'm living with an embarrassment of riches.