In which it is possibly explained why people call me "Upbeat"

Well, you know how it is. You find out you have a life-threatening illness, and you have to annouce it to your friends.

I was reading over some old emails prior to deleting them, and found that this is how I had announced TWCT to a friend who is an Episcopal priest (but hasn't found a place to exercise that priesthood since moving to New Mexico):

" Hi,

First, thank you for your long and newsy letter. I understand – not as fully as you live it, but I do understand – what it is to have a sense of unrealized priesthood. Lately, the desire to preach is on me again, not that our priest isn’t good at it, but I have Thoughts.

Or I had thoughts. Since the 17^th, they’ve all been focused on one thing. I have breast cancer.

(This space reserved for a variety of highly mixed emotions)

I won’t dump all the medicalese on you. [Her spouse] can do that if he wants, and you want. Suffice to say that my choices (oy, such choices!) are between a lumpectomy followed by chemo and radiation, or depending on some genetic stuff they are now doing, a double mastectomy and ovary removal.

I never expected to live a long time, but I was really hoping for heart disease. Of course, I may beat this and emerge a curly-haired blonde. I’ve already decided that since I have the most beautiful middle-aged hair on the planet, and since anything less would make me very sad, I am going either with bandanas or really cheesy wigs in colors like bright green. But not pink. The first person to pin a pink ribbon on me is getting a punch in the eye."

My hatred for pink is undiminished. But this also made me realize that "someone is getting a punch in the eye," has pretty much characterized my approach to dealing with the Boobeaucracy. And you know, while it may have been a bit hard on some of the people who had the misfortune to get in my way and some of them may not have deserved it, on the whole it wasn't a bad approach.

Except for one thing. I have already told the Bravest Man Alive loudly, vociferously, repeatedly, and with great variety that any obit for me is never, ever, EVER going to say, "after a long battle with cancer." It may say, "died, after a long battle with what she called the Boobeaucracy, from cancer."

I will most certainly end up dead. But I will never be defeated.

(And no, I haven't had any bad news. Just... going through a few things, is all.)

First HAIRCUT!

The Bravest Man Alive gets his hair cut every six or seven weeks. When we first got married, I was a Wild Thing -- No one was gonna touch this magnificent mane, nossirree! But then, his usual barber was closed one week, and we wandered into Irina's, a salon owned by a Russian lady.
Who gave him a really great haircut.

I watched Irina cut hair for a solid six months before I let her touch mine. I'd had a really bad experience with a Brookline hair salon early in our life there, and I was sick and tired of people letting out their artistic visions on my head. (Also, I don't drink in the daytime, and the mild discussions about family and vacation spots I hold with hair stylists could barely be called gossip, so the wine-and-celebrity-trash-talk scene was unappealing.) When I finally sat down in Irina's chair, she went at my head like a contractor who's just been waiting for the final bit of paperwork. Clearly, she'd had a plan in mind for months.

The results were pleasing, and I've worn my hair on the shortish side ever since. It worked because I have (or had) very "Russian" hair, thick and wavy.

Fast forward 13 years and we're settling into our new home in Malden. Obviously, schlepping to Brookline was not feasible, so we began shopping around. Unfortunately, Malden and the surrounding towns are full of places devoted to big, puffy 'dos in unlikely colors on people who are significantly older than I am. So, I asked a church friend whose hair I admired for a referral.

Enter The Hair Cafe.

The Hair Cafe would be an impossibility in Boston. It's huge. It takes up the entire second floor of a major business block in downtown Malden. And it's staffed entirely by kindly ladies (old and young) who keep track of birthdays, decorate the place for every holiday, and serve coffee and cookies to all comers.

I wouldn't trust most of the stylists anywhere near my head (see comment about big hair and unlikely colors, above), but Debbie is different. She's not into trying to make my head into an artifact. And yesterday, yesterday, she applied scissors for the first time to my "after hair". I was getting a Kewpie-doll cowlick on top. She also gave me good advice about managing the hair while it grows out -- comb most of it straight back as I used to do, but comb the edges right around my face forward.

And, sure enough, people at church could not stop talking about my hair. It was kind of bewildering to hear about how cute and curly it was, until I got home and discovered that the hair which was wet when I left the house had formed itself into perfect Betty Boop spit curls around my cheeks and eyebrows.

Hairlessness is strange

Today I had the nice lady who cuts my hair shave it all off.

While it would be nice to believe that I wasn't going to lose my hair at all (and it certainly looked all strong and springy), certain signs from regions other than my head are warning me that the lossage has begun. So, she gave me a wiffle, which feels really strange. Girls almost never have cuts like this, and I had no idea that hair was so firmly directional in its growth. And family legend is correct -- I do have two birthmarks above and behind my right ear. I can't see them, but confirmed that they were their. The lady with the clippers referred to them as "raspberries," so they are not large.

I don't look as bad as I thought I was going to, which is a relief. The eyes looking at me in the mirror are still mine, and with a headscarf on I look like something out of Bruegel. Or a Pirate Queen. Or both!

Since we had a warm and humid day, the cooling and evaporative functions of hair were immediately apparent by their absence. But, I will adjust. I think I will be more comfortable, though, when the hair finally does fall out and I don't have to deal with all these prickles.

I wish phrenology were still a science. Then I could Bare All for Science by simply removing my hat.

Honestly, I was a little distressed thinking that I might become distressed. And it is a bit distressing. A very ashes-to-ashes moment, seeing all one's hair on the floor like that.

"Behold your servant, Lord, a sheep of your own sheering."

A long day, and a lot to digest (doing the math)

We met with the oncologist today. It was a long session, and some of it I need my notes for. For example, she obligingly outlined the whole anti-nausea regimen, which I cannot remember off the top of my weary head.

But here's the basics:

• The tumor was 1.1 cm. The margins were clear, though one was kind of close, due to the position of the tumor at the back of the breast.
• The two sentinal lymph nodes were clear.
• HOWEVER, there was some sign of Lymphatic Vessel Carcinoma, meaning that cancer cells had started to leave the tumor and were moving into the lymph system within the breast.

I am kind of freaked out a bit by the last item, but it didn't seem to concern the oncologist at all. So I am tamping down on the freaking, or trying to.

I was then presented with a number of choices, which I am not going to discuss in detail. Instead I will outline what I'm going to do. Which is:

1. Start chemo on September 12th, and have chemo every other week for four weeks.
2. Have a shot of a blood-stimulating drug the day after chemo that will speed up my recovery.

The more usual course would be to have the chemo every three weeks, but the oncologist thinks that 1) I am a fine candidate for this faster method, and 2) based on the usual schedule for radiation following chemo, I could be all done by early January. Whoo-hoo!

Now, the math. I am putting this here because several people have asked me, "Do you HAVE to do chemo/radiation?

The answer is yes, and here's why:

• If I do nothing, the chance that the cancer will metastesize somewhere else in my body, like my brain, is about 15%. Chemo will half that, down to 7.5%. Or, to put it another way, it will increase my chances of NOT having metasteses from 85% to 92.5%.
• If I do nothing, the chance of cancer recurring in the same breast is about 25%. Having radiation drops this to 10%. Or, a 90% chance of not needing a mastectomy in the future.

I hope that's clear to all and sundry, including me.

There's a bunch of logistics I have to clear, including making sure I can get the blood-boosting drug. And this fast chemo regimen is really going to wipe me out, energy-wise. I may just crawl into my hole and not come out for two months.

Oh, and it seems that the loss of hair is VERY predictable. If I start chemo on 9/12, my hair will fall out on 9/30.

More on the drug names and such in our next.

Oh, and there was a definite Boob Wars moment. As we were ushered into the exam room, our usherette handed my a clipboard with a "List of your medications, please confirm them," on it. IT WAS COMPLETELY WRONG. All that was there were the two post-surgery prescriptions (neither of which I need any more) and an asthma inhaler as prescribed by the folks in the ER two weeks ago.

I have given them the extensive list of my medications three times now. And I sat there and watched the pre-op nurse type them in, from a printout given to me directly by my PCP.

I'm feeling pretty mellow towards Dana-Farber at the moment, but if this happens again  there will be hell to pay. Or maybe just heck, if I'm feeling merciful.

Bless the Lord, oh my soul,

And forget not all of his benefits.

The surgeon called. The margins are clean, the signal nodes were clear; I am done with surgery. Any treatment after this is on the off-chance that a cell or two slipped by, and to teach that area of my breast to behave itself and not go wildly multiplying.

Time from biopsy to post-surgical phone call -- two months and one day.

The scars are about two inches long apiece, and look like this:  /
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And if I was living in another time or another place, I might not even know yet that I had cancer.

Praise Him with the sounding cymbals!