Hardly a quiver in the dirt

23 08 2020

Do I have cancer?

I mean, the surgeon scooped out the tumor and got clean margins, and there’s nothing to indicate a spread, so: do I have cancer?

I’m still a cancer patient: I start radiation this week, and after that’s completed, I’ll be on hormone treatments for five years, but both of those are to lower the risk of recurrence. Sure, the radiation could zap any stray carcinoma cells—presumably that’s one of the ways it reduces risks—but it seems weird for me to say “I have cancer” when. . . maybe I don’t?

Yes, I know: it’s too soon to tell. Oncologists speak the language of “x-year survival rates”, and one month out of surgery is not enough time to know much beyond what they discovered in the surgery itself. I had a tumor, and now a don’t, and while I know that matters, I’m still not wholly sure what that means.

My puzzlement may stem from the fact that the docs caught this early, none of my tests indicate a propensity to metastasis, and, importantly, I won’t be undergoing chemotherapy. I’m old enough that cancer still carries the implications of chemo and hair loss and nausea and “looking like a cancer patient”; well, I am a cancer patient, but you wouldn’t know it to look at me.

I am not in any way complaining about this: like I said, I am VERY GLAD not to need, and thus not to have to endure, chemo. But it makes it [too?] easy for me to think that my cancer is just this summer thing that I’m dealing with, and not much more than that.

And maybe that’s fine, because maybe it isn’t much more than that. Goddess knows I have carried too much HEIGHTENED DRAMATIC MUSIC into too many situations in my life, so maybe my measured response now is. . . appropriate.

Or maybe this is one of those cases in which I’m refusing to listen to the minor chords that (appropriately) accompany cancer.

I don’t know. I don’t even know how much thought to give to this. It matters, yes, but how, and how much? I’ve yet to find out.


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I can no longer shop happily

12 08 2020

Cancer requires stuff.

If you’re getting chemo, then there’s a good chance that you’ll need something for your head: wigs, scarves, hats—something to cover you and keep you warm.

Happily, I will not be getting chemo, but my particular surgery and the radiation has required me to buy:

  • sports bras (aka cheap compression bras): to keep the girls in place
  • saltines & ginger ale: to deal with post-surgical nausea
  • Aquafor: to deal with the “skin irritation” (aka burns) from the radiation
  • hydrocortisone cream: to deal with the “skin irritation” (aka itching) from the radiation
  • cheap undershirts: to protect my clothes from the Aquafor and hydrocortisone cream
  • aluminum-free deodorant: presumably to somehow not mess with the radiation
  • fragrance-free soap: presumably to avoid further skin irritation
  • cloth masks with filter inserts: Strictly speaking, this is more about the corona virus than the cancer, but since I’ll be commuting into Manhattan every day for four weeks to get zapped, I wanted something that would be both more environmentally-friendly and more effective than surgical masks. (The clinic will still give me a surgical mask to wear instead of my cloth one, but that’s on them.)

My radiation oncologist also suggested I use ratty old bras, since “you’re not getting them clean” after all of the creams; since I already have those, however, that’s not a required buy.

Again, had I needed chemo, I’d probably have had to buy even more stuff, to deal with the nausea (for the tummy) and the effects of nausea (for the throat and mouth), and things I haven’t even considered, and won’t consider, because, honestly, I don’t have to, and this is already enough.

So, yes, I am learning *so much* from this cancer; I would have preferred to have remained ignorant.


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Down here so laughable and small

9 08 2020

I mentioned on Twitter that I’d recently had cancer surgery, and someone—a Dr Lilly Evans—who responded encouragingly also told me to “accept help you are offered”.

I’m not so great at that.

It’s not that I don’t want help. . . sometimes, but that I have difficulty accepting it. . . sometimes.

When I told my friends in NYC that I had cancer and would be getting surgery, they all asked what they could do, volunteered to take me home. I accepted because I knew I’d be in no shape to get myself home, and insisting I could do Everything myself would have just been dumb.

Also, the clinic was clear that I if I didn’t have someone to pick me up, they wouldn’t perform the surgery.  So there’s that.

So I asked my friend C, who lives near me in Brooklyn, to pick me up. She’s one of my oldest New York friends and, as I’d told her, we’ve been drunk together, so she wouldn’t be fazed if I were loopy coming out of the clinic.

Anyway, I’m not sure what more any of them can do. Friends here and elsewhere regularly check in, and C and I have gone on a couple of walks. My parents call and my sister texts to see if I’m all right; it makes it easier that I mostly am.

I don’t know that I will be, come the radiation. I know: don’t borrow trouble, but this is going to be harder on me than the surgery. It’s one thing to have surgery and within two weeks be largely recovered; the radiation will last weeks, with the effects lingering even longer.

It’s also going to drive home that, yes, I am a cancer patient. I was diagnosed at the end of June and had the lump removed about a month later; I barely had time to have cancer before it was scooped out of me.

That’s not how it works, of course. Or maybe, not of course, since I still don’t know how this works, still don’t know how to be a cancer patient. And I suspect that the radiation—and the chemo, if I need it—will drive home that indeed I am, whether or not I know what that identity means.

~~~

It’s easier in the clinics. I’ve told friends that I’ve amassed my own collection of doctors within Mount Sinai, but, really, it’s more that they’ve collected bits of me. The radiologist, surgical oncologist, radiation oncologist, and medical oncologist, each with their own sight into my cells and my treatment, don’t wait to be asked for help. Their secretaries set up the appointments, and I show up.

Taking care of these bits of me is their job.

And it’s one they do very well. Y’all know I’m all about “brand loyalty is for suckers”, but I have received terrific care from almost everyone at each of the Mount Sinai clinics I’ve visited. (And those who haven’t been terrific were still. . . fine.) Everyone from the receptionists to the secretaries to the techs to the nurses and to the doctors themselves have all been real human beings, and have treated me the same.

My second biopsy was rough, in and out of the MRI, and at the end of a long day of testing and waiting. Every time they pulled me out of the machine, one of the nurses would come beside me, put her hand on my back, and cover my hand, to keep it warm. She didn’t have to do that, and I wouldn’t have even thought to have asked for it; I get the sense she does that for everyone.

The doctors have been straightforward, and, during procedures (in which I was conscious), have explained what they were doing, asked how I was doing, asked if I had questions, and, when they could, chatted about. . . whatever. And as soon as they had results, they called, and outlined what was next.

So even if they were there to deal only with bits of me, they still treated the whole of me as what—or who—ultimately mattered. I expected them to be professional; I didn’t expect them to be kind.

~~~

Maybe that’s what makes it easier to accept help from these professionals: that they are professionals. I expect that if they’re good with me, they’re good with everyone. It’s nothing personal, so I can let them take care of me. That’s what they do.

Yeah, I know, that’s what friends do, too; it’s just that with them, it’s all personal. And that makes it hard.


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I got some groceries, some peanut butter, to last a couple of days

5 08 2020

My world, along with everyone else’s, dwindled as COVID spread; with the cancer diagnosis, it tilted.

Less than two months ago and I was wondering about fall teaching, how long New York would be shut down, the election—the election!—and trying to get back to sustained writing.

Well.

You know how a fish-eye lens distorts the view, bringing the center object in too close and pushing everything way far back? Yeah, that’s a cancer diagnosis. I’d guess that’s how it would be in normal-ish times, but in a pandemic, that contrast between fore- and back-ground is vertiginous.

Oddly, the pandemic has made my treatment. . . easier. That I’m teaching online gave me all kinds of flexibility for the many appointments I’ve had (and will have), and that clinics want to minimize contact means that I can fill out most of the “paperwork” online ahead of time. I’m not yet sure of my radiation treatment schedule (besides that it’ll be daily), but I won’t have to race up to/down from the Bronx before teaching my first/after teaching my last class to get that treatment.

And the trains are empty, which means I always get a seat coming home.

Cancer is terrible, and this pandemic is terrible, but their combination, for me, is somehow not twice as terrible, and may even be less terrible.

I don’t know if it’s that abrupt shift between the intimately personal and global, between the entire set of tasks I have to do to deal with my cancer and that feeling of helpless rage over the absolute and complete fuck-up that is the response of the US to this horrible virus that somehow lessens the impact on me.

Or maybe it’s recognition that before the diagnosis I was avoiding something that could make me very sick and perhaps even kill me, and now I’m dealing with something that could make me very sick and perhaps kill me—but probably won’t, because doctors have a better handle on my type of cancer than they do on this type of corona virus.

And while my anger at the cancer has pretty much dissipated, it has only increased at the response to the virus. I live in a city in which over 20,000 of us have died, lived through days in which hundreds and hundreds of people died. Both the mayor and governor made mistakes early on, mistakes which cost some portion of those lives, but they got better, and in the past 3 days zero deaths have been reported.

Other states, cities, could have learned from our mistakes, could have avoided the spike in cases, in suffering, in death, but too many of them didn’t. And even when politicians did the right thing, some portion of the public continues to insist on doing the wrong thing.

And the federal government and current occupant of the White House? My rage has gone supernova: I am blank.

There are no magic incantations against cancer, no magic incantations against this virus. The options are all unpleasant, and have a cost, but just as I as a cancer patient at least have options to avoid even more unpleasantness—and death—so too does the government and we as a society have those options.

Pity too many of us aren’t taking them.


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Totally screwed up, I think that’s alright

28 07 2020

First there was the mammogram, and then the ultrasound. Then the second mammo and ultrasound.

Then the ultrasound-guided biopsy.

Then the blood tests.

Then the MRI.

Then more blood tests.

Then the ultrasound, and the mammo, and the MRI-guided biopsy.

Then the COVID test.

Then the pregnancy test (!), the surgery, and the excision of the lump and some lymph nodes.

Tests at every turn. The first few indicated a problem, the first biopsy confirmed it: cancer.

The blood-work checked for receptivity to hormone treatment (yes: good news) and whether I was HER2+, which would have meant chemo (no: good news).

I also paid out-of-pocket for some additional genetic tests, on behalf of my nieces. Sixty-six of sixty-seven were normal; one contained a SNP of uncertain consequence. I passed that information along.

The second set of blood-work were just basic panels: all fine.

The second biopsy indicated no cancer, but not quite right, either. Something to watch.

The COVID test was negative.

The pregnancy test was negative. The surgeon was able to get a clear margin around the tumor; the lymph nodes were clear—so no chemo on their account.

Now, I wait for the typing of the tumor’s genes, the third reason I might need chemo. I have no expectations on the results.

I don’t want to do chemo—I mean, really, who does? It’s good that it’s available and can be effective in lowering the risk of recurrence, but it’s even better not to need it in the first place. I’m already dreading the radiation; add chemo, and, ugh.

(Okay, my response would almost certainly be more than “ugh”; that’s just a placeholder, preferably for a reaction that won’t be necessary.)

But if I need it, I need it, and I’ll bitch and moan and do it.

I realize that in my last two posts, I’ve been all “whatchagonnado?”, as if I were all brave and determined and “chin-up”. I’m not. I’m not hopeful and self-encouraging. And while I admire stoicism, I am manifestly not a stoic.

I am resigned.

I did have a choice—to treat or not to treat—but since I’ve chosen treatment, this is what I have to do, regardless of how I feel or think about it. (I’m still working through both of those, by the way.) That’s it. I’ve chosen to do this.

So I’ll do radiation and hormone treatment, and chemo if necessary, because I want to be cancer-free. I want to get past this, and the only way past is through. That is the most mundane of realities, one to which I can only bow.

That’s it.


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Cut it up

25 07 2020

Surgery over.

It wasn’t bad, all things considered. I got there at 6, was home before 1—and that included the time it took to get my prescription.

I mean, last week I had a second biopsy uptown that ended up requiring an MRI, and that took me even longer, so, really, no complaints about the time.

Because being sick takes a lot of time. That biopsy, for example: half of the time was spent waiting, and even on Thursday I spent 1 1/2, 2 hours waiting. Waiting to get processed. Waiting for the pregnancy (!) test results. Waiting for the radiologist. Waiting to talk to the nurse, the anaesthesiologist, the surgeon, just . . . waiting.

And then it was done.

A strange feeling, to walk into the OR—which, in stark contrast to all of the dim imaging rooms I’d been in, was bright and busy—climb on to the table, put out my arm for the IV, hear them telling me what they’re doing, and then verrrrrrrry slowly waking up, later.

It was that kind of wake-up where you think, I should be awake, but you just can’t, so you close your eyes again; you repeat that a couple of times, and then, and then you’re really awake, with the nurse offering you water (“Do you want it warm, or cold?”) and saltines.

And at some point you notice you’re wearing a surgical bra.

I don’t know why I find that odd—it helps to keep the swelling down—but the thought of them dressing me in a bra while I was unconscious, well, I find that, I don’t know, kind of remarkable.

It’s not, I know. Maybe because it’s such an ordinary thing after what was, to me, an extraordinary event; maybe because I haven’t been dressed by anyone since I was a small child; regardless, that small act has stayed with me.

The ride home wasn’t fun. My mom had suggested I bring a plastic bag with me, just in case; I didn’t use it, but my nausea didn’t fully subside until today. Saltines and ginger ale have been my mainstay. And while acetominophen works well enough during the day, I find the Percocet helps overnight.

Oh, and not that I recommend cancer, or any kind of surgery, to anyone, but if you do get sliced open, check if they’ll seal you up with surgical glue. I apparently have internal stitches, but externally? Glue. I was able to take a shower the next day, and wound care is a breeze.

I’ve got some nasty bruising, but no blood.

As for what’s next? Heal from this, and then, pathology results willing, radiation—and no chemo.

Not looking forward to that, or to sorting through my insurance and the hospital bills which have already begun arriving, but, whatever, I’ll deal with it. And if I do need chemo? Well, I’ll deal with that, too.

I mean, I’ll bitch about it, because of course I will, but in the meantime: keep on keepin’ on.


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You spin me right around, baby

14 07 2020

Nine days to my surgery, and I’m impatient.

It helps that I’m teaching this month; it gives me something to concentrate on besides my immediate future. And while I don’t love teaching online, it does give me the flexibility I need to deal with the surgery and recovery (and, in the fall, my radiation treatments).

Anyway, I think at first I underplayed how much this cancer would fuck around with me life, but then I think I overplayed it. I went from “this is a pain” to “this is a disaster” and now I’m, like, “I dunno”.

And I don’t. I mean, I know this is going to suck, but I have no idea how I’m going to deal with the suckage.

Consider the pandemic, and how it’s affected each of us. I’m guessing that for most of us, life has gotten harder. I’ve had some really bad days the past few months, but, mostly, I’ve managed. My life is worse than what it was, but not unbearably so.

And maybe that’s how my life will be for the rest of year: worse, but not unbearably so.

Or maybe it will be unbearable; I’ll  bear it, nonetheless.


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Elizabeth Wurtzel, 1967-2020

8 01 2020

Elizabeth Wurtzel is dead. Cancer.

I read Prozac Nation, of course—what fucked-up self-involved late-twenties white woman didn’t read it?—scarfing it down with enthusiastic horror, but begged off her after that.

She was too too too too too much. I couldn’t bear it; what if that was me?

That was the horror, of course: that I was too much.

(The enthusiasm? Oh, “fucked-up” and “self-involved” cover that.)

I was too much, at least when younger: too enthusiastic, too emotional, too attention-seeking, too serious, too much of whatever adjective can be wrapped around a bright and yearning girl who only wanted everything.

That was okay (for me; it must have been exhausting for others) when I was very young, but as self-awareness sidled in I began to question what I could want, what I should want, whether it was okay to want anything at all.

And, eventually, I concluded it was not. If I was not to want, then I was not to be so much, too much.

In retrospect, this was not the best decision, but fitting, nonetheless: from too much to too little.

Wurtzel apparently found a way to keep going amidst her own storms by celebrating them: “I hate anodyne. I hate that word. … I am baroque. I am rococo. I am an onomatopoeia of explaining away.”

Sitting in my small life I can finally appreciate her largeness, admire her willingness to embrace the messiness of her life, and wonder at her refusal to renounce herself.

If she was too much, then so be it.


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Echoing their brief delight

25 12 2019

Christmas songs are the bane of retail workers everywhere. It’s not that they’re bad—some are quite good!—but they are relentless.

And, to be honest, the worse rather than the better ones do tend to be played on repeat over a store’s speakers: the more gimmicky, cheesy, and bouncy, it seems, the more likely is some corporate manager to favor it. The better ones don’t go so well with sales, and the best songs?

The best Christmas songs are religious.

There are bad religious songs, of course, but the truly good approach the sublime: this is the music which twines the joyous and the somber together in recognition of a momentous event.

I am no longer awe-struck by that event, as such awe requires a faith I no longer have. But I can see—hear—that faith and awe in notes pouring out of and surrounding us before waving away nto the yonder blue.

My voice is still wobbly, but I remember what it felt like to sail it over that long O. It was a good feeling.

May you sail wherever you are, and wherever you may go.


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I owe my soul to each fork in the road

28 11 2019

So I was talking to my folks earlier today and my dad said Hey, do you remember Thanksgiving from years ago?

And I’m thinking of how we all used to get together at my grandma’s, my brother, two cousins, and I happily at the kids’ table, the walk after dinner in the cold  Sheboygan night to the bridge we all spit off of, . . .

No, not that memory. Wasn’t that when your apartment was broken into?

Yeah, my first year in Montréal! Thanks for the memories, Pop!

Eighteen years later and I STILL double-check my windows and locks.

Anyway, may you all have had as boisterous or as peaceful a day as you desire.


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