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.





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.





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.





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.





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.





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.





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.





You may ask yourself, Where does that highway go to?

12 07 2020

So I have cancer.

Stage 1A breast cancer, to be treated with surgery and radiation, possibly chemo, and long-term hormone treatment. Prognosis is good.

~~~

I was years overdue for my first mammogram, when I finally followed through on one of the many scrips my doctor urged on me and scheduled one for early June.

They did the mammo and a breast ultrasound, and sent me on my way. Less than a week later, I got a call: Hey, there was an issue with one side, could you come back for another round?

It’s probably nothing, they said.

So, second mammogram/ultrasound in my life, less than a week after my first one. Then another call: Yeah, we found something, we’d like to biopsy it, just to be sure.

It’s probably nothing, they said.

Biopsy, then. The radiologist was very nice, told me everything that she was doing, said, you guess it, It’s probably nothing.

Four days after that: It’s something.

The first days after the diagnosis, I was simply annoyed. What the hell, I griped to friends, like 2020 hasn’t been bad enough. Then I was angry, because anger is What I Do—and that was useful, because I had follow-up appointments and arrangements to be made and anger gave me the energy to do what, as I griped yet again, was basically a job.

Cancer is a job.

But now, now I’m in the lull before the surgery. I have one appointment at the end of this week, a covid test next week, and then two days after that, surgery.

Anger doesn’t work so well for lulls, for waiting. It worked when I thought that cancer was something I’d have to fit into my life, but not for the reality that my life is something I’ll have to rearrange around the cancer—for the next few months, at least, likely longer.

I’m not afraid that this will kill me. It might, but it’s been caught early, and if it does kill me, it likely won’t be anytime soon.

No, I am unsettled by what I do know—that I am in for a hard time—and uncertain about the rest.

This is my life now, my life with cancer, and I’ll have to figure out how to live it.





We only come out at night

6 04 2020

The walking has become a thing.

I started the night-walks as a distraction from myself, thought I’d go out every once and awhile, but it’s been every night since that first night—with the exception of this past Saturday, when I day-walked.

Mistake.

It was sunny, and while I only hate the sun in July and most of August, it was all wrong. Too bright, too hard: everything was too distinct.

I was restless at home, and thought, what the hell, get my walk in now, maybe venture down some of the alleys I had spotted in Crown Heights.

Aside: Yes, alleys! I love alleys, but Brooklyn is not known for them, and I pretty much assumed you could only find them in a few, tv-famous areas of Manhattan, but one night-walk through CH and I spotted alley after alley after alley.

First thought: Am I going to go down there? Hell, yeah!

Second thought: It’s dark, and this is still New York.

So I waited until Saturday, and as I was making my way back through CH, I glimpsed down those alleys and thought: No.

We’re all mostly confined to our own patches, and for me to have strolled through that back patch would have felt like trespassing, like I was impinging upon what little private space those people had.

I don’t know if that makes sense, but that is the sense I had. We’re mostly tethered to those private spaces, but to have walked—in a public lane, to be sure—in the back of that space would have seemed a violation.

Anyway. Back to the main drag: Not only was everything too set apart in the day, it was also much more obvious that the city was shut down. Empty playgrounds on a sunny day are not normal, and all of the shops which should have been open were instead gated, some with signs saying Sorry. . . COVID-19. . . .

Those signs are still there at night, of course, but pulled-down gates at night are the norm.

Is that it? That night-walking allows some normalcy that the light strips away?

Eh, I don’t think so. My area of Brooklyn is a social place, and were it not for this virus people would be out on the corners or stoops just hanging out wherever; now, there are few of us out.

More likely is that that initial night-walk awakened the memory that this is something I can do; whatever else happens, this I can do.





And the beat goes on

30 03 2020

I am slowly going mad.

I like being alone. I like choosing to be alone. To be alone because I can be nothing else is. . . too much, not enough. Not nearly enough.

How are you?

~~~

I used to walk at night, when I was younger. I walked around Falls some, but this really took off when I lived in Madison. Over to Lake Mendota, out to Picnic Point, or back behind Breese Terrace, looping around the chancellor’s house, sitting on swings in dark parks in neighborhoods built for kid-kids, not college kids.

This continued in grad school, Minneapolis. Walks through Loring Park and the sculpture garden and down Nicollet and to the river, bridges over the river.

I wasn’t well, then, but I can’t fault the nighttime roaming. And my sorrows got some airing-out.

I still walk, of course, but in New York, the walking is always to and fro, from here to there. And almost always during the day.

~~~

But I am, as I said, slowly going mad. I have work—teaching at a distance and still the second job (also at a distance)—and we are not literally locked down. I go across the street for milk and yogurt, over to Flatbush for bagels.

We can still run. I still run.

Here to there, here to there, and home again.

~~~

So, tonight, a night stroll, just around, just to see.

I live near central Brooklyn’s hospital complex. I’m used to ambulances, so I can’t say if there are more; there are plenty, regardless.

East down my street. There were few of us out, some of us masked, some not. The closer to the hospital, the more scrubs, the more masks. Across the street from an ER, in one fast-food place, everyone, workers, customers, wore masks; in the other, none did.

Further east. It’s so quiet. Usually in a damp night sound carries, but tonight, the silence carried.

Turn north, past black women in blue scrubs, bonnets, masks; past the psychiatric buildings, high fences all around, light in every window.

There’s a school, half-lit and empty, classrooms above in a long slow curve around the side, like a weary spaceship waiting for its crew.

Down past the handball court, I notice the one-story railroad apartments. This is low Brooklyn, hidden behind the height of the hospitals and the arch new buildings for the nursing students and medical residents.

I pass a couple of men, one offering the other gloves. Nah, man, he says, holding up a roll of paper towels, I got this. I lose that thread as I notice a building that looks abandoned, but there’s a red blip for keyless entry.

Crabwise, west now. A man stepping off his stoop smiles and says “Make it home safe, mama.” I half-say “You, too,” before realizing he’s leaving his home. “Have a safe night,” I call instead.

Down Nostrand, the noise picks up. The usual ambulances, and the one alarm, a block away? that sounds like a whole building yelling out a London OO-EE! OO-EE!

The women waiting at the bus stop wear masks. I check the driver; he’s wearing a mask.

My laundromat, usually open, is closed, gates where windows would be. Gates up and down the street.

I forget to look up to the sky before heading in.

~~~

I have to remember, there is more than just me, more than the texts and the emails and the voices in the radio. We are not abstractions.

Brooklyn is right here, it’s all around me, a real place.

It’s easy to miss this, during the day, when it all seems like a backdrop, mere scenery on my way to somewhere else.

I forgot that I can see so much better at night.