Saturday, October 31, 2009

a cute short haircut

i got my hair cut today. the "Cancer 101" manual (not to be confused with the "Chemotherapy and You" textbook) suggested getting "a cute short haircut" before beginning chemo, as a way of "taking charge of your cancer."

oh yeah, i'm in charge now.

my hair hasn't been this short since the tragic pixie-cut incident of 1966.

the woman who cut my hair this time worked hard to do a really nice job. i didn't have the heart to tell her it didn't matter. she told me to come back in six weeks so it would keep its shape. i gave her an extra big tip since i know that won't be happening.

a very big deal

i want to apologize to all those women out there who have gone through this. i thought that because an early-stage breast cancer diagnosis is so common, and because the survival rate appears to be so good due to so many medical advances, and particularly for those women who didn't have to have a mastectomy or chemo, that somehow it wasn't all that big a deal. concerning, yes, absolutely, but they'll all be ok, right? i realize now, and i am shuddering with shame as i write this, that i must have thought it was a bump in the road.  

i realize now that no matter how good the prognosis, it is a big deal. most women try so hard not to worry others and to be positive (unlike me) that it is easy to misread the situation. if you have a friend or relative or even aquaintance with breast cancer just know that--whatever she says--it is a very big deal.

Friday, October 30, 2009

what is essential to me

my oncologist told me that i will be really, really tired. that i will be able to do "whatever is essential to me"--but not much else. i loved how she put that; it is very poetic.

but then later i thought, oh this is one of those f%*&ing-learn-about-the-important-things-in-life cancer moments and i became thoroughly irritated. i don't want to have to make every moment count. i want to be able to blythely and carelessly squander time on non-essential things. i do not want to become a better person through cancer. i was perfectly happy with my flawed self.


not much happening on the old cancer front right now... i like to think of it as a ceasefire.

i start chemo next thursday, after my cancer cells have been lulled into a false sense of security. i have to take a set of medication the day before, then have the chemo which takes a couple of hours, then go back the next day for a shot of something that is supposed to help my immune system.

apparently i will be in survival mode. the nurse told me that if i don't already floss everyday (um, no, i have sinned and have had to pay for my sins with a root canal so leave me alone) that i shouldn't start flossing now, and that if i lose my appetite i should just go for the calories--any calories. i'm thinking i'll keep a few boxes of brownie mix on hand. i can't imagine ever not wanting brownie batter.

i hope those last words don't look like ironic forshadowing later on.

Monday, October 26, 2009

avoid tanning beds

i went to chemo class today. i was disappointed--i thought it would be an actual class. but no, it was me, Chad, and the very nice nurse practitioner.

she did give me a textbook, though: "Chemotherapy and You." it has a handy little section called "Side Effects At-A-Glance." in addition to the common side effects, "fatigue, nausea, vomiting, decreased blood cell counts, hair loss, mouth sores, and pain," there are the less common ones such as "bleeding" and "memory loss." they also offer this helpful tip about hair loss: "Protect your scalp when you are outside, and avoid tanning beds." well, there goes my plan.

it's all about the numbers

the lifetime risk of a woman developing breast cancer is one out of nine. women diagnosed with early-stage breast cancer have a survival rate of 98%, overall. however, according to the supertest, women with my extra-special type of tumor have a "distant recurrance" rate of 20%. that means that their chance of developing metastasis is one out of five. chemo reduces that risk to 14% or one out of seven. having great medical care and no other major problems reduces it a little bit more.

chance of anyone dying from a shark attack: 1 in 300,000,000. no wonder we don't have shark attack awareness month.

squirrels and me

the problem with being really disorganized is that while you can do just beautifully most of the time, if one little thing goes wrong, like, say breast cancer, you are screwed.

i find myself relating to some of the squirrels i see out there now. not the fat planned-ahead-sitting-on-the-telephone-lines ones who probably have their acorn stashes alphabetized but the little procrastinators who didn't really believe winter was coming and are now frantically trying to get it together. i hear you, little friend.

Saturday, October 24, 2009

logical fallacy #1

logical fallacy: everyone i meet who has had breast cancer is fine; therefore, i will be fine.

error: you can't meet dead people.

Friday, October 23, 2009

not me

there's a lot i didn't think would apply to me...

maybe i should re-read that manual.

they told me so

it's happened. i can't keep track of my doctors' appointments.

they told me this would happen in the Cancer 101 manual but i didn't listen. they even provided an organizer for me. but no. i assumed this wouldn't apply to me. that i would be able to keep shoving cards and scraps of paper into the bottom of my purse and remember everything. after all, how many doctors' appointments could i possibly have?

where did i put that organizer?

Thursday, October 22, 2009

no, thanks

i don't want to do this. i pass on the being brave, doing what you have to do thing.

i have chemo class on monday. i would prefer to skip that.

i am supposed to have a "mediport" put in. i would prefer to skip that too.

it's the size of four quarters stacked up and sits under your skin, just below your collarbone. doctors think it's a great advancement because it saves your veins and makes it really easy to hook you up to chemo and to take blood and whatever else that needs to go in or come out. i think it's the most depressing thing yet.

really, no, thanks.

what's all this about hats?

i ordered hats. they are actually kind of cute.

of course, i will need a whole new wardrobe to go with them. especially as i have lost eight pounds due to my special surprise-you-have-breast-cancer-plus-you-need-root-canal diet plan.

did i mention my oncologist thought upping my anti-depressants was a good idea?

a good hair day

i noticed that my hair looks particularly nice today.

too bad it's going to f*&^%ing all fall out.

grace period

i imagine that a great patient does not use the words "shit. oh shit. shit--this sucks" when being told something she doesn't want to hear.

fortunately my oncologist is too compassionate to hold it against me. i'm pretty sure. there is probably a grace period. a kind of drop-your-lowest-test score kind of grading policy.

when i stopped cursing, i told her she did a really good job of telling me, which she really did. she seemed to be genuinely happy about that. she said i should tell my surgeon.

how adorable is that?

Wednesday, October 21, 2009


i should have known it was not good when the insurance company agreed to pay for the super test.

i met with my oncologist (did i really just say my oncologist?) to discuss the results of the test.

she said she was surprised, and that my surgeon was surprised, by my score. apparently my tumor cells are quite ambitious and high-achieving. she recommends chemo to put them in their place.

yep, we're all surprised.

Tuesday, October 20, 2009

a great patient

when i saw my surgeon recently for my imaginary tumor, she said that my oncologist (who is a good friend of hers) said that i was "a great patient."

this is not good. i did not know that there were great patients. 

the problem is if there can be great patients, there can be awful patients, and barely adequate patients, and slightly better than average patients--and i have no where to go but down.

what if i get bad news at my appointment tomorrow? how does a great patient react? calmly, philosophically, positively, maybe just one little tear but then a brave smile and a determination to soldier on?

what if i get good news? is a great patient grateful, appreciative, thankful for this life-changing experience?


i am clearly about to fall from grace.

Sunday, October 18, 2009

better than root canal

you know how people say they would rather do anything than have a root canal? now i know.

having spent yesterday having an emergency root canal, i can honestly say that it was worse than any breast cancer procedure so far.

so i can add that to my things to be grateful for: it's better than a root canal.

Friday, October 16, 2009

my journey

i took a train  from st. louis to new york many years ago. i was excited because i had splurged and gotten a sleeper, and it was snowing and everything out the window looked so pretty. but in the middle of the night in the middle of nowhere in the middle of ohio the train stopped. after several hours, they made us all get off the train and put us on a chartered greyhound bus. they put us on the bus and then pretended the bus was a train, going through the grey and sodden snow to stop at every little train stop between mid ohio and new york. it took three days.

i have read several times that "breast cancer is a journey."

well, if so, mine is not a sidhartha-like journey into the meaning of life; nor is it a vince armstrong conquering obstacles to triumph in the end journey; nor is it even a wake up in the morning with a more positive attitude journey. mine is like that stupid boring endless bus trip, with my endless, tiresome thoughts rolling and bumping along in the night.

Thursday, October 15, 2009

risk analysis

the super test that i have been waiting for will indicate whether or not i am at high risk of a recurrance and whether or not chemo at this point would be effective at reducing that risk. (given that pesky one-in-fifty risk of dying, reducing that risk would be a positive thing as far as i'm concerned.) 

the test costs $3,000. my health insurance company has not approved it at this point. this is because if the test shows good news for me, it is money wasted for them. beyond that, it is busy comparing the risk of doing nothing with the risk of my cancer recurring and them having to pay for more complex surgery and other more extensive treatment later (bummer for them) with the cost of doing the super test and possibly having to pay for chemo now.

hmm. wonder how that will work out for them.


ok, i found something new in a different area. it felt like a teeny rusted barbell.

i was pretty sure i was dying. i was quite brave, i must say. i was only irritated by the younger second wife chad was inevitably going to have. thanks a lot, chad.

my surgeon said it was just a big vein. yuck.

she didn't even charge me the co-pay. 

Wednesday, October 14, 2009

still waiting

ah-hem. da-da-da-da. how 'bout those redskins? (i hear they are a football team) okey-dokey. all right then.

who knew breast cancer would be so boring?

Monday, October 12, 2009

the camel's nose under the tent

we are still awaiting the results of the super test which will compare the genetic fingerprints of my tumor to the tumors of 65,000 other women and indicate whether or not chemo would be appropriate.

i must be doing well though as the oncologist is clearly not worried--she, chad and i spent most of the meeting discussing her very bright ADD sixth-grader and where he should go to school ( we recommended The Field School).

however, chad did attempt to ask her questions about post-menopausal symptoms (due to the tamoxifen which will soak up any remaining estrogen my body tries to make) and the doctor and I both looked at him like the chair had spoken.

i know he was just trying to help, but he should know by now not to try to enter the pink tent.

Wednesday, October 7, 2009

it isn't a cold

a few weeks ago one of our school parents who was diagnosed with early breast cancer last year called me to see how i was doing. i was in professional mode, therefore i was fine, everything was fine. then she said, "katherine, it isn't a cold." this from a woman who was continuously positive, uncomplaining, and upbeat with all of us at school, at work, and with her family. she is right.

the survival rate for women with breast cancer has been improving year after year, thanks to all the extraordinary work by researchers and fundraisers and pink ribbons (that I disparaged in an earlier posting) and people who have walked and made donations and bought things with pink ribbons.

so now, here are the most recent five year survival rates: for women diagnosed with stage I breast cancer (that's me), the survival rate is now 98%. for women diagnosed with stage IV (Elizabeth Edwards, for example), the surval rate is 24% (hence John Edward's cruel promise to his mistress of a rooftop wedding after his wife dies).

i was thinking... 98% on a test is a great score, an "A" or even "A+". i am very grateful to be in that category. but then it occured to me that what 98% actually means is that one out of fifty women won't survive. and while i am pretty sure--based on nothing, really--that it won't be me, it will be someone.

it is not a cold.

Monday, October 5, 2009

the normal curve

someone was telling me a story about her friend, a doctor, who has breast cancer. apparently she was receiving chemo at a clinic when a patient of hers walked through and recognized her. the patient blurted out "Does this mean I have to find another doctor?"

the person telling me this story was horrified by the woman's self-centeredness. but I understand it completely.

here is how my internal monologue goes.

reading the morning paper. republicans resist healthcare reform. bastards. i have breast cancer. without my health insurance i would be screwed. can you believe i have breast cancer? oh god, 129 people died in an earthquake in indonesia. that's awful. i can't believe i have breast cancer.

at school. she did what? what was she f*&%ing thinking? i have f*&%ing breast cancer!

and so on.

i'm sure she is a perfectly nice woman, well within the normal curve of narcissism to altruism. it's just--she has breast cancer.

Thursday, October 1, 2009

my favorite check-out lady

i have been avoiding my favorite grocery store check-out lady.

she is one of those people who just radiate kindness, and i was afraid that when she asked me how i was, i would blurt out "i have breast cancer!"

but yesterday i was feeling good. i hardly noticed the muzak, i did not stand overwhelmed by the choices in the cereal aisle. i was purposeful, grabbed what i needed and headed to the check-out lanes.

with two lanes open, the line was shortest in my favorite check-out lady's lane. i could do it; it was a good day. when it was my turn, she smiled and asked, "how are you today?" "i'm just fine!" and smiled back. all right, good job.

when she finished ringing up my stuff, she asked "would you like to make a donation to help fight breast cancer?"

"I'm sorry--what did you say?"

"would you like to make a donation to help fight breast cancer?"

shit. "Um, sure, ok."

"how much?"

shit. everything in our checking account? that seemed a little extreme, given my $13.97 purchase. "five dollars?"  five f*&!%ing dollars? i will rot in hell.

"thank you for your donation," and she smiled at me.

"no, uh, thank you, and thank everyone, and well actually i was just diagnosed with breast cancer a few weeks ago..." shit.

"oh, i'm so sorry." she reached out and touched my hand. "if you ever need anyone to talk to, anyone just to listen, i'm here."

she is the best check-out lady ever.