Wednesday, September 15, 2010

July 31, 2010 Good News

I practically bounce out of my oncologist's door, Tigger fashion. I hadn't expected anything in the way of good news. I thought I would discover the slow-but-steady destruction of my heart, evidenced by a rise in blood pressure. And I expected an analysis of my bone density test to reveal rapidly spreading osteoporosis. These two things are the common side effects of the tiny pill I take daily to prevent the return of my estrogen fed cancer. A necessary evil.

But my blood pressure is back to its pre-cancer level and the bone density test reveals no change. And my blood analysis reveals normal counts. "Do you continue to see me quarterly?" I ask Dr. Kato, who is notably grayer. He checks my chart and smiles, enjoying any opportunity to dispense good news. "Six months," he says. "It's been two years," he adds. "I'm a two year survivor," I say, mulling this over. Two years since my diagnosis. It seems much longer.

The news of these reports leaves me feeling energized. I leave his office feeling taller and lighter. As we head home though, checking the time, I think of Kate McCrae, the six year old who is, at this moment, climbing onto the Pet scan table to discover whether her malignant brain tumor is gone or growing. I am instantly sobered and pray my own good news will be hers.

Tonight I nervously open an email from Kate's mother. I subscribe to her site through The Caring Bridge. I pray silently, "Please God." Tears spill while I read of this young mother's prayers as she takes the phone call to hear the news. The results of Kate's Pet scan are "Negative!" No new growth! I read the email twice absorbing this great news. I have yet to meet the McCraes and yet, I read this news as if they are family. I rejoice with them as if it is my own family. No new cancer, the ongoing story ending we all crave for someone in our lives.

For now, I feel a deep sense of peace. Looking back on the storm that was cancer in my life is far less frightening. The capital "C" is gone for now and I can see the normal challenges of life in a more balanced perspective. The important things have been put in their proper order. Like a broken bone, my life has been reset, grown stronger than before. For now, it is enough.

June 7, 2010 Testing testing

I am waiting for another routine test - a bone density test. I had one a year ago. This is to determine how my bones are faring after a year on Arimadex, the magic anti-cancer pill I take everyday. It's a tiny white pill that inhibits my body from producing estrogen which my cancer cells feed off of in their quest to grow, divide and conquer. It's the current wonder drug for estrogen positive breast cancer. But like all good things, there's a down side. Side effects include increased blood pressure and thinning bones. Battle scars, I think to myself knowing that at least my blood pressure is on the rise. It's a bit like Alice in Wonderland, with less than totally predictable outcomes. One pill makes you larger and one pill makes you small - but how small?

It is freezing in the waiting room I share with a half a dozen women in this women's center at Scottsdale Shea Hospital. All of the other women are in gowns awaiting various tests. All are shivering and I am wondering what the point is. My test does not require disrobing. One woman who is down from her hospital room is draped in blankets. Your son is here they tell her - he just arrived from out of town. Her face lights up.

I think about each woman and what they are facing. Some routine tests, some looking for answers to frightening questions. I think of the frightening answers we sometimes get and remember the long journey I have been on. I have been blessed to have been given words of hope - remission. I realize I am smack dab in the center of a season of Hope. And that realization takes me back to the first week following diagnosis and the "Don't Waste Your Cancer" blog I found. I was seeking Hope and found it there in John Piper's words. My Hope IS in the Lord and Oh how Faithful He has been.

May 1, 2010 On Humility

On Saturday I prayed for humility, that God would continue the good work He began in me. It is a prayer I have prayed a few times before. Each time I have found my world turned inside out, my face on the floor before Him. I am afraid of this prayer and tell Him so. "The fear of the Lord is the beginning of wisdom," I am reminded.

Sunday I am able to return to church for the first time in weeks and during worship I find myself suddenly convicted, my ugly sin of judgment and a critical spirit exposed before me. I confess this to my Lord. Oh wretched soul am I.

On Tuesday, after returning from Phoenix appointments, I receive a call to list a home. "You knew my wife Paula," the caller says. "Oh, Paula. I am so sorry. I loved her." Four years ago Paula was in my bible study. There were four cases of cancer represented at our little group of eight. Two of the women and two of the women's husbands. I remember wondering then whether the Lord was preparing me for something. The two women who were both battling recurrent breast cancer and have since passed on, including Paula. "It's been three years," he reminds me. "I've remarried." This is something to thing about. I try to picture my husband remarried. Another woman in my place, holding my grandchildren. It is a sobering call.

On Wednesday I go to a home for another listing. I had visited with this couple last Fall. Now they are ready, she says. Then she proceeds to tell me her breast cancer is back after 11 years. But she's ready to beat it again, she adds.

Later that afternoon, I go to my weekly nail appointment and a subject comes up reminding us all of a mutual friend, Emily. We pause to remember the brave battle she lost last summer to bone cancer that began 15 years earlier as breast cancer.

I arrive home broken and humbled. Time is short, the Lord tells me and I, in my weakness, cry selfish tears. I want more time. But there are no promises and I think of Kate McCrae, the precious little six year old from Phoenix who's been fighting a malignant brain tumor for nearly a year. Jumping up and down on her hospital bed, she asks her parents,"If this treatment doesn't work, does that mean I'm going to die?" Unexpected, they scramble to explain the reasons for the yucky medicine and treatments. The three of them share their tears before Kate adds,"but I will be in heaven with Jesus. That can't be a bad thing." The agree but tell her how much they'd like to keep her around a while. With a smile back on her face, she resumes her jumping. "I'm going to ask him to jump on a trampoline with me. I'm going to call Him Jeez." I see His face smile at that. Remembering Kate has kept my self pity in check for nearly a year now.

I lay in bed last night thinking of the grandchildren I hope to know one day, praying for the time to do so. This morning I return a missed call from my daughter. She tells her father and me on speaker phone she is planning a special 60th birthday present for me. She's pregnant! The baby is due around my birthday in January. I cry out to God with thanksgiving. He has heard me. El Roi. He sees. And I am indeed humbled.

May 1, 2010 Second Fill

We head down on our weekly trip to my plastic surgeon. I have a couple of questions for Dr. Mosharrafa. Last time he referred to the large accumulation of muscle in my right armpit as "healthy tissue". I've decided this is euphemistic for something - but what? The other les pressing question is to determine his eye color. Somewhere I remember writing about his blue eyes and this time I intend to double check that. It doesn't seem right. "Perhaps they are a light amber color," I mention to a friend. "Why would I think they were blue," I wonder, struggling to picture them. "Reflection from surgical scrubs?" she suggests.

When we arrive I whisper conspiratorily to Veronica, who doubles as the receptionist and the "fill" administrator, "do you have any numbing agent like lidocaine, to soften the pain of the 'stick'?" "No," she smiles sympathetically, "we don't". I describe how the oncology nurses would spray my port to numb the stab of the needle. "I brought my own benzocaine spray," I tell her. She agrees I can try it.

She looks concerned, or at least confused by the bulge under my arm. "Has the expander slipped over here?" she asks, prodding. Obviously, this is not normal. She has the doctor come in to check me. But his story hasn't changed though he elaborates and I learn the meaning of "healthy tissue". It turns out that my muscle is almost double the thickness of normal muscle. "So maybe I come from a line of washer women," I suggest, picturing a great grandmother hunched over a wash board scrubbing madly. "Or rowers," he throws out. I look into his shining eyes, his very dark brown thickly lashed eyes, and see he is unconcerned. My summer affliction will be whittled away with the exchange surgery at the end. It sounds painful. I sigh, resigned. "More drains?" I ask. "Probably," he says. I'm sure glad chemo and radiation was such a breeze for me because nothing about my surgeries has been easy.

Veronica returns and I decide to forgo the benzocaine. She's careful to let the alcohol from the antiseptic dry and this time there is no pain. We agree to a fill on my left side only. It needs to catch up with the flap side. I stand up and look down. It is impossible to imagine anything close to a normal look in my future. And for a brief moment I wonder why on earth I am putting myself through this. One ray of hope I have gleaned from eavesdropping in reconstruction chat rooms is that, in the end, no one has regretted their decision. Hopefully, I tell myself, I will agree.

We head across town to see Dr. Kato. Entering the oncology building I feel a darkness come over me. I once saw this as a place of hope but it feels different on this side of chemo. I would like never to come back here.

I am ushered in to the phlebotomy department and Valerie greets me quietly. Hers is the name on my chart. "No blood draws from Valerie." The last time she drew blood, she left a silver dollar sized bruise. But she is it, there is no one else. "Your going to use your smallest needle, right?" I say. She puts down a half opened needle package and reaches for a smaller model, muttering something about it taking twice as long to draw the blood. But it hurts less, I mutter back.
Dr. Kato pops his head in and instructs Valerie to "room" me when she's finished. She complains that he is grumpy. "Bad day?" I ask. "No, he's grumpy all the time these days. Carla quit," she adds. Carla was his main nurse. "Because he's grumpy?" I ask. She shrugs as we follow her to the examination room. My husband seems grumpy also, but I realize he's been able to hear none of our whispered conversation and I am sympathetic to the deafness that shuts him out.

Dr. Kato enters with a tired smile and attempts to do his exam but my swollen under arm makes it impossible to check my lymph nodes. He seems annoyed and I suddenly see his world, moving from cancer patient to cancer patient hoping not to find any new concerns. He asks how I feel. "Still taking the Arimadex?" Yes, I say. I don't seem to have any side affects like I did with the first drug. He asks if I am taking Calcium and Vitamin D and baby aspirin daily. Yes, yes and yes, I say. He seems surprised my "fills" are not painful. I think I've grown so accustomed to the "too tight bra" feeling since my mastectomy, this doesn't feel much different. My blood work is good and I am told to come back in three months.

The patient ahead of me at the appointment desk is ordering a bone scan. She nervously smiles at me. "He just wants to be sure it's nothing," she tells the scheduler who makes no pretext of concern or interest. I see the woman is attempting to assure herself she is not experiencing a metastasis. How much time, I wonder. You think about those things in a place like this. But today, I feel good. I am not in much pain. My back where the muscle was removed burns and aches when I'm unsupported so I can't stand or walk too long for a while but it hurts less and less each day.

We walk out into the warm sunshine of Spring in Phoenix and I close my eyes and breath in the heady scent of grass and flowers. Nearby a mourning dove coos reminding me of lazy Hawaiian vacation days and I think to myself, it's good to be alive.

April 20, 2010 Inflation on the Rise

Today I had my weekly doctor visit. I expected a quick "everything looks good - next week we'll start your fills". Instead Dr. Mosharrafa asks how I feel to which I reply "much better!" "Me too," he says. His allergy eyes have cleared up. "You're ready to start your fills," he says. "Today?" I ask. "Yes, if you're up for it," he says. "Veronica will be in to get you started." "How does she know where to insert the needle?" my husband asks. So Dr. Mosharrafa places a little device on my chest which is a magnetic gizmo reminding me of a well driller witching for water. The magnetic cylinder "points" to the port.

While we wait, Shoyei picks up the sample expander from the shelf and runs the little device over the valve - it works!

Veronica, who doubles as the front desk girl, enters lugging two giant syringes. I try not to look. I probably won't be able to feel them, I tell myself. My chest is still mostly numb. But I am wrong. It's not excruciating, but I definitely feel the needles enter. My husband is squeezing my hands a bit tightly, easing his own apprehension for me. At least afterwards, there is no pain.

I've done a fair amount of research on this and have been expecting something akin to having teeth braces tightened. However, Dr. Mosharrafa says I shouldn't have any pain. Rather than 100 ccs every other week, he does 50 ccs weekly. Time will tell but I leave happy - finally underway. I am looking at 12 to 14 fills before the exchange surgery which will replace the expander with a permanent implant.

Afterwards my husband and I go to lunch and discuss what size I should be. Surprisingly, he is encouraging me to go smaller - in keeping with my advancing years. Fifteen years my senior, he is always pushing me forward on the aging cycle. I find this amusing but totally agree. I'm after a sense of balance, that's all. This is certainly not a conversation I ever imagined having.

As we leave, he helps me into the car humming Don Ho's "Tiny Bubbles" with a smile, muttering his irreverent version - "tiny boobies on her chest, one points east, the other points west". "Hmmph," I say, "too close to the truth right now." At least we're laughing.

April 16, Pillow Talk

My back hurts. At least I think it's my back. When I close my eyes and gently touch the new skin on my chest, it is the strangest sensation- I feel it on my back! So I suppose it's possible that what I perceive to be my aching back is the spare muscle temporarily parked under my right arm. It's all pretty confusing. I read on a cancer blog about the odd phenomenon experienced by women who have the latissimus dorsi reconstruction. You can be doing something like picking something up that would normally use that back muscle and instead your new breast suddenly flexes. That should prove entertaining.

I kept my routine teeth cleaning appointment yesterday thinking I'd have no trouble lying on my back but halfway through, my left chest muscle went into a cramp. My sweet dental hygenist recognized the pain on my face and waited for it to pass. She has just nursed her husband through cancer. I was worn out by the time I got home.

I have fallen off my own pedestal. I am not as tough as I thought. Last night I gave in to a dreaded Percocet and fell asleep pain free. I can do a lot to minimize the pain by trying various positions until the right position causes the pain to cease.

My daughter and son-in-law visited last week-end. We went out to eat three times and each place we went, Carrie went to the car to retrieve a pillow and blanket which she then plumped behind my back for me easing the strain. She didn't ask me, just reached for her Dad's keys and took care of business. Now that's nursing! My St. Joe's nurse was like that. She wasn't satisfied until she'd made sure every angle of me was supported with a pillow. The morning nurse commented about how many pillows I had so I know I had special treatment. They throw their pillows away after each patient or let the patient take them home! I brought home five! So I will remain the pillow lady a while longer, dragging my little entourage of fluffy support with me from bed to chair to car.

My nurse is suffering from shut-in-itis. You wouldn't think a born-and-raised island boy would suffer island fever but he always has. He started young, leaving home at nine to travel with his piano teacher living in different big cities and attending different schools year after year, Los Angelos, Buenos Aires, Rio de Janeiro, San Francisco. Then becoming a pilot and flying internationally, he was just never trained to stay put. He would love a quick trip to somewhere - San Diego? But I am not up to it. There aren't enough pillows for such a trip right now. I don't think I could go that many hours in the car yet. He understands but he paces the house like a caged animal.

I have been able to work from home which helps me feel like I am rejoining the world. I had expected to be back in my broker chair full time by now. I am so blessed to have an amazing team filling in the gap but I sure am anxious to join them. Five more days? That's my plan.

April 13, 2010 Cruising Along

We are heading down to Phoenix to have my tube/drain removed. I am trying not to think too hard about it, the memory of the sensation of having a sword pulled out of my side. I remember it was about a count of ten and then it was over so that's what I'm planning on. However, I was "under the influence" of two Percocets back then. This time we've brought one along in case I need it afterwards. It's not that I'm trying to play the martyr, not at all. I simply despise the hangover feeling of Percocet.

I will be anxious to know if I can drive yet because that will spell freedom. And what kind of exercise I can do to get my strength back up. I tried to sleep on my side last night well supported by 8 pillows. But I awoke with deep pain in my left chest. I am clearly trying to push the envelope. So I will stay on my back a while longer.

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We've left the doctor's. The tube removal was a very brief pain and I am so happy to be unplugged! I'm also glad I didn't take any Percocet to get through it. Dr. Mosharrafa, through his red allergy eyes said I "looked good". He seems pleased with his work.

However, I have been admonished to lay low for another week including no driving. No driving, freedom. One more week. I intend to be a model patient so I don't risk rejection again or any extra procedure to deal with fluid caused by too much activity. So.......it means more chair time, doing a lot of reading and online Scrabble and working on my writing. I have a feeling this will be a tough week on me and my husband.

I asked Dr. Mosharrafa about exercises but he said too soon. So I will wait and it will be hard.

One more week aboard Ship Shoyei. My husband calls out through the days his version of a bosun's whistle with a "Now hear this, now hear this, the ship's mess is now open for breakfast" or "closed until twelve hundred hours ". He's also found a way to make our tea kettle blow like a train whistle approaching a crossing. So I will close my eyes and imagine myself on a cruise or a trek to some exotic port, grateful for his never-dull companionship. Next stop...