So, I guess this is where I screw my courage to the sticking point.

Chemo starts tomorrow. We have really no idea how it will treat me, so we are preparing for many eventualities, from buckets-beside-the-bed on upwards.

But the anticipatory tummy wobbles I had yesterday may actually have been a bug, as Bravest is poorly today.

Anyway, I have a bag of comforts ready to go, the table and alarm clock are both set, and it only remains to say g'night to a few online people. Don't be surprised if there's no posts for a couple of days.

Recovery

I'm doing OK. Things hurt, and my neck is stiff from sleeping in a position I'm not used to. There's no fever, and the sites don't look too red or feel hot (some spectacular bruising, though). But I am moving around quite well, and starting to go a little stir-crazy, which is a good sign. Tomorrow I will put on ordinary clothes (I've been lounging around in mumus) and we will take a short drive and do some errands, just to gauge how tired I get.

Recovery also being a time for reflection, I should -- in the interest of honest reporting, as Bravest is wont to say -- relate that I know that a lot of my tears and flapdoodle before the surgery was due to the pressure of knowing that I have cancer. Even with the tumor out, I will still need a lot of patience and support from my friends and family to get through the next four to six months.

But I am glad to be feeling that mentally, at least, I am back from the surgery. It took about 36 hours for the last of the "logy" feeling to wear away.

Next up: haircut! I am having my hairdresser cut most of my hair off on Saturday, so there won't be so much of it to clog up the shower once the chemo starts in September.

This stuff is just plain grim

I got the info from the surgeon about where I need to be and what I need to do, and it's kind of grim.

For one thing, I get nothing to eat or drink from midnight the night before. The surgery is at 1 PM.  As in, 13 hours with nothing. Which is a long time. All I can say is, they'd better be hooking me up to a nice big bag of Ringer's Solution well before 1 PM or I will not be responsible for my actions.

And this raises the issue of what to do with/about Bravest. I want him there; I feel safer with him there. On the other hand, I can't very well be making sure he gets lunch -- nor can I be walking him to the rest room if I'm getting radioactive dye injected in my nipple or wire guides inserted in my breast. I think our best bet is to stop by the Family Support desk and see what the nice people have to offer, because Bravest himself doesn't really want to impose on either the Wonder Offspring (WO, for short) or on my sister or any of our friends.

(That's pretty much the way he was when he, himself was sick a couple of years ago. "Tell them not to come. Why should they rush in here just to sit?")

And then, I have to wear something that buttons up the front. I own nothing that buttons up the front. And a support bra. The only such creature I have is a sports bra that pulls over the head and is too small for me anyway. All my other intimates are at least 3 years old and were bought because they were comfortable, which means they're not very supportive. (For you mens, that means they don't so much lift and separate; more like keep from flopping around in every direction.) And yes, this is a poor little rich girl problem; spending some money is all that's required. But not what I wanted to spend money on, at all at all.

We'll figure it out. We always do.

In more comfortable news, last night was so hot that neither of us slept much, and Bravest actually ended up on the floor for the one or two tenths of a degree of additional coolness. So today we went out and bought an air conditioner, the smallest unit I could find on line. It was a mere $99, and it's doing a splendid job. I am really, really looking forward to a good night's sleep.

So Much for Drama

This is one of those posts where I offer my friends and family the opportunity to laugh their heads off at me. If this doesn't appeal to you, please make sure your head is fully fastened on before reading further.

Ready? Good.

Today we went to see the surgeon at Dana-Farber, with a view to scheduling surgery. I had written out a whole long list of questions, and we got there in plenty of time for our 11 AM appointment.

The surgeon was an hour late, which gave us many opportunities to overhear the conversations around us -- particularly the folks right behind us who were playing a protracted round of My Chemo's Worse Than Your Chemo, to the non-delight of their involuntary audience.

Shortly after we were settled in the room, the surgeon came running in. "I'm SO SOORRRRRY!" I was taken aback because in all my years of consuming medical services, I've never had a surgeon -- a faculty member at the Harvard Medical School no less -- apologize to me for anything. I mean, where does the doctoral dignity go from there?

This lady apparently doesn't rely on the fear/deference of her patients to make her feel like the Big Woman On Campus. She sat down, and we had a brief conversation about what I wanted to do and what she thought was advisable. Turns out that if I want the surgery at one of the two hospitals she works at in Boston, I will have to wait till mid to late August, but if I want to schlep down to Braintree during rush hour, I could have it done next week.

Oh, I said. It's day surgery.

Oh yes, she averred. Three hours or so of prep, two hours of surgery, an hour of recovery time, and home again. She even uses dissolving sutures, so there's no post-op trip to get the stitches out.

And the little self-indulgent fantasy I had of people tiptoeing respectfully into my (spacious, flower-filled) hospital room, moving past the gently buzzing pumps and glowing computer screens to press my hand and whisper their affection -- that little fantasy sighed and died.

Instead, I get to make sure there's clean sheets on the bed for me to crawl between when I get back home. And the next day, other than a little soreness, I should be as good as ever. I can even take a shower. No heavy lifting and no swimming for two weeks, by which time we should have the pathology report. In other words, the hard part isn't the surgery -- the hard part is the chemo. I might need help with one grocery store run, but that's it.

Heck, I don't even need to get pre-approval from the insurance company. It's day surgery, and I only need approval for hospital stays.

How totally deflating.

(I did speak to the surgeon about wanting copies of everything, which she totally understood. She also immediately printed out copies of my blood tests and chest x-ray, and told us exactly how Bravest would be involved in the process on the day of. And she gave me a hug as we left. No Dignified Doctors, no Hospital Room Drama -- as a soap opera, this whole event is made of fail.)

Oh, I opted for Boston. Even if I left home at 6:30 AM, I couldn't be sure I'd make it to Braintree by 9:00. So it will either be Brigham & Womens or Faulkner Hospital. The latter has been famous for breast work since the days of Susan Love. Either is cool with me.

"Fair" is where you eat fried dough and corn dogs.

So, let's get to the whole issue of fair and unfair. And please bear in mind that this is me typing right now. Tomorrow, the emotional barometer resets and readings could be quite different.

Right now, I think the following things are unfair:

• I got born white, to a middle-class professional family in 20th-century United States of America.
• I had food based on the best nutritional knowledge of the day, regular medical and dental check-ups, all the immunizations available, and any other medical care I needed.
• Even though I'm female, I got to go to school, and to absorb as much eddification as I wanted or was able to make use of. Sure, there were sexist obstacles, but nothing like what young women face elsewhere.
• My parents never, ever, even once implied that my goal in life should be to get married and have babies.
• I went to college, found work, found love, had a baby, got twisted up by life but became untwisted again.

All of this is manifestly unfair. I didn't deserve any of it. Most of it I had no control over, nothing to do with.

And all of this is leaving aside the fact that God gave me, very early in life, a deep belief in him and a corresponding sense of my own -- there's really no other language for this -- sinful nature, then later, through various means, showed me the way out of that Slough of Despond through the sacrificial love of Christ. I don't know why God called me so young. Certainly, it hasn't been because I was destined to achieve any great thing for God.

So for me to claim that having cancer is unfair, or having to deal with the thought and possibly the fact of losing both breasts AND my hair is unfair, or anything else unpleasant that happens to me is unfair would be ungrateful. To say the least.

And if that weren't enough, I live in a place and time when having the type of cancer I have is not a death sentence. Compared to the horrors that happen to other women, it's barely an inconvenience. And if this kills me, I'll still be better off than most women dying today -- I'll be between clean sheets, in a clean room, with plenty of drugs and people who love me all around me.

So, if you feel like what's happening to me is unfair, go ahead and feel that way. I'm not telling you how to feel. I'm just saying that what I feel is sad and scared, but I don't feel that either Life or God has been unfair.

Right now.

Ask me again after my first two chemo treatments.

Oy, such choices!

Here is what the surgeon said:

·        The type is invasive ductal carcinoma. The Invasive part means it’s already starting to break out of the duct where it began. It’s still very small, so it’s PROBABLY Stage One, but we won’t know till the surgery is completed.

·        The grade is Grade 3, meaning this is an aggressive cancer. (It wasn’t visible on a mammogram 15 months ago.)

·        The receptor information is… not good. It’s triple-negative for hormone receptors, meaning I will definitely need chemotherapy AND radiation after surgery (if I go for a lumpectomy).

·        There is a genetic component to this which means I might be facing a double mastectomy and ovary removal, and still need chemo. We’ll get to that later.

Here is what the medical oncologist said:

·        Pretty much the same thing the surgeon said, but with more emphasis on survival rates and such. If I have a lumpectomy and then have the radiation and chemo, I can better than double my survival chances (whatever “survival” means in this context). Overall , the odds are better than fair.

·        Chemo is, at best, four treatments over three months. At worst, it’s more like 10 treatments over four months. And yes, I will be saying farewell for the present to my hair. Best and worst are decided by the pathology results after surgery.

Here is what the radiologist said:

·        Radiation does funny things to your skin and even deeper tissue. It can take years for this to go away.

·        There’s a risk of heart issues (they will need an echocardiogram), but they probably wouldn’t manifest for 10 to 15 years.

·        There’s a .002 chance of the radiation causing cancer.

Now for the interesting part – here’s what the geneticist said.

·        Because I am of Ashkenazi Jewish descent, there is a chance that the cancer is caused by one of three gene variants. IF this is true, I will probably want to go with a double mastectomy and ovary removal, because the cancer has a 65% chance of recurring, and the ovarian cancer risk is also high.

·        IN ADDITION, IF I have this gene, there is a 50% chance that my brothers and sisters have it as well, and a 50% chance we’ve passed it on, and a 50% chance that our children will pass it on.

·        This has consequences for boys as well as girls. The guys would be at increased risk for male breast cancer, and for prostate cancer. 

·        The geneticist is pretty sure this did not come from my mother's side of the family, because aside from Mom herself, all of the women on that side (except for me) are cancer free. She suspects that it’s from my father's side, given the prostate cancer that my grandfather and his brothers had, but it’s very hard to tell without knowing more about the women on that side.

I should have the results of the genetic test next week. If they are negative, I will probably have more tests done to try and rule out a more rare mutation on the same gene. And then I get to choose what to do… Oy, such choices!

About that religious thing

I'm quite religious. Just sayin'. I first prayed when I was about two and a half years old, and God has been a prime relationship for me pretty much ever since.

Now you might think -- based on the mostly fine work done by Dr. Kubler-Ross -- that as part of my own anger, denial, bargaining thing I would at this point be too pissed off to be talking to God. But no. Either I've moved straight to denial (and most of the time that's probably true) or I'm already at acceptance. Not of death, not yet -- but of having cancer.

Cancer is a particularly scary thing for me because both my parents died of it before they were 70. My dad was gone a month before he turned 63. I'm 56. I did a little bit of care for my dad while he was dying, and quite a bit of caring for my mom. I know what dying from cancer looks like, and I have really been hoping for heart disease or stroke instead, which is why I haven't much bothered about being obese.

I also know a little bit about suffering. Namely, when you're suffering physically, you don't really have a lot of thoughts to spare for things like the state of your soul, being united to Christ, etc., etc. The model of slow and holy death one finds in novels from the 1800s is mostly based on the way people died with TB, a disease that tends to put one in exalted emotional states. Mostly, it's not like that. It's beastly hard work until your brain shuts down, and even then there's some core things that keep going. The last sound we ever heard from my mother, for example, was a laugh -- one of us kids had made a weak joke and everyone laughed, more out of tension than any sort of pleasure, and Mom laughed because she heard her children laughing.

I don't think I'm dying here, but I do think about dying quite a bit. I never expected to live to be old, never wanted to be old. Any time anything wonderful has happened in my life, my joy has been accompanied by a small voice saying, "Heaven's better! Heaven's better!" Which didn't diminish the joy one bit. It's as though the happier I am, the more I'm sure that this isn't home, that my real place is elsewhere.

So this intimation of mortality isn't the shock it might be for some people. I don't know how else to put it without waxing into religious language, so y'all just going to have to put up with that from time to time in here.

When darkness veils his lovely face,
I rest on his amazing grace.
When all around my soul doth fail,
My anchor holds within the veil.
On Christ, the solid Rock I stand!
All other ground is sinking sand.