31
Oct
18

cancer, depression, and (looking for) the light at the end of the tunnel

So according to the National Cancer Institute, depression is “a comorbid disabling syndrome that affects approximately 15-25% of cancer patients.”

Also, apparently, women are more likely to experience depression than men, especially in the transitional period between pre- and post-menopause.

I can’t help but wonder what the percentages are of menopausal women with cancer. Sounds like a lot of really sad women.



I did just get my blood work back from the medical oncologist visit on Monday. At which I cried, more on that in a minute. Apparently I am post-menopausal. Who knew?


Does probably explain the subsiding of the hot flashes even though I’ve stopped HRT, the weight gain over the past couple of years, the moodiness, the lack of interest in….well, just about anything. (Phew! That was close!)

So here I sit, with a breast cancer diagnosis and the best possible prognosis. These details include:

  • Estrogen and progesterone positive—100% and 70%, respectively—which means that my good friend The Tumor, (whom I have named Bobba Fett), had every available surface covered with little seats in which estrogen could rest its weary head and on which the tumor could feed; 70% of it was also receptive to progesterone. This characteristic makes it very vulnerable to blocking those hormones in the body. And apparently it would seem that I’m almost out of them anyway, but not so much so that I won’t have to take Tamoxifen or, more likely given my hormone status, Aromatase Inhibitors, for 5-10 years. And AIs sound like a lot of fun, with side effects like joint pain, loss of bone density, weight gain (yeah, I really need that), vaginal dryness, carpal tunnel syndrome (great for a pianist), increased blood pressure, and mood swings (cuz I’m not having enough of those already).
  • HER2 negative. HER2 is a protein in some breast cancer tumors that seems to make the tumor more aggressive, both faster growing and more likely to spread. HER2 negative means no chemo.
  • Lymph nodes negative—no indication that Bobba Fett has tried to set up little colonies elsewhere in my body, although that is always held out to be possible.
  • Negative genetics for any kind of cancer that is currently identifiable through genetic testing
  • OncoDX score of 17 (out of 100)-–which means it is in the “low-risk” category for spreading, albeit still an 11% chance. Husband likes to point out that that indicates an 89% chance that it won’t spread, but somehow that’s not really where the mind goes. At least not mine.

Apprently once cancer is detected it has been in the body for many, many years; little sneaky sleeper cells lurking around with tiny little time bombs strapped to their  backs.

Bastards.

And most people think that this “best possible prognosis” would mean that I was walking on cloud 9, surround by sunshine, chirping birds, and harp music.


But I’m not.

When I posited the theory that maybe I should be to my medical oncologist earlier this week (right before the tears started) she scoffed, and said, “Pah! It’s still a prognosis, and nobody wants one of those.” The recognition of that, and a prescription for a teeny-tiny bit of Lexapro, has made a big difference.
My bullshit tolerance meter is set to zero. But maybe that’s not necessarily a bad thing (equivocation, anyone?)

But I do apologize if I’ve “yelled” at you in anyway in the past few weeks — verbally, via email, or even in my head. I sincerely hope, at some point in the not-too-distant future, that the


sign stops blinking in my head and leaves room for other things. Until then, be well, be safe, get your mammogram, and if somebody snaps at you for no apparent reason, remember, they might have something really shitty going on in their lives right now, and they’re probably really really sorry.

15
Oct
18

happy haiku

Benign were benign.
Malignancy, wide margins.
All lymph nodes are clear.

giphy1

 

 

 

12
Oct
18

waiting for margins

7D8EDE9E-0F01-4946-B72A-8F9EC47EA618

waiting for who?


Guess they’re not coming today.

I know it’s too much to ask to have a nurse available all weekend to call when pathology results are in, but how many women in how many cities around the world have to wait out long weekends when results don’t come on Fridays? There are people working at call centers for when your surgical incision breaks out in a weird red, hot rash at 6 p.m.; they have people doing MRIs on Sundays; pharmacies are even open until 10 p.m. for those last-minute broad-spectrum antibiotics.* Can’t they have a person who calls with pathology results when they come in, even if it’s a Saturday afternoon?

Blimey.

It would also be nice to know if the lymph nodes were negative.

Just sayin’.

 

*Yes, I know all of these things. No, I don’t want to talk about it further.

 

08
Oct
18

how to help

The past few weeks have been quite a ride.

giphy

I mean, I’ve always been a little (🙄) emotional, but sheesh.

CBD drops were helping, until I was told I needed to stop taking them until after the surgery.

One of my dogs ending up with, well, let’s just call it “some gastrointestinal distress” 😬 hasn’t helped.

My lumpectomy is tomorrow.

*Please know that the above cartoon in no way reflects my feelings about my husband. First of all, we don’t even own a La-Z-Boy.

And I am so grateful for all of the messages of love and support I’ve gotten from so many people. The best of which acknowledge the difficulty of the time I’m going through, and/or include specific offers of assistance.

The thing is, while well-intentioned, and appreciated as such, things like “Cancer picked the wrong woman to mess with!” or “You’ve got this! I know (!!!) you’ll be fine!” don’t really speak the truth; a truth we all know. Because cancer is a test you can’t study for, and there are lots of strong women who have lost their noble battles against it.

You want to feel like


but it actually feels more like


I do accept and treasure it all as encouragement. And it might seem odd, but it’s actually more helpful to acknowledge the randomness and lack of control over all of this. As M said to me last night in a text: Cancer isn’t pink, it sucks.


Looking forward to looking back at all this.

03
Oct
18

counting the yays

Genetics came back — testing 42 (I think) genes for possible links to known cancer predispositions.

They all came back negative.

giphy-downsized1

I’ve also been incredibly moved by the number of people who have responded to my first post about all of this, and to my message on facebook. I still kind of feel like

200w_d cancer.

But the “yays” are piling up, for which I am incredibly grateful.

02
Oct
18

screenwriting 101

Someone should write a movie scene, where a woman walks into a large room, wearing an extremely awkwardly-proportioned hospital gown (whose neck is 23” in circumference, anyway? And why are all hospital gowns designed for this person?), climbs up on a table, drapes her breasts through two openings in a plastic frame that looks a bit like a lobster trap, sticks her arm out for an IV, and then gets sent back into a large metal barrel upon which 20 dwarves bang with sledge hammers for 40 minutes.

I think this would be a very powerful scene.

They should then follow up with the same woman going to get her genetics testing lab work done and encountering a young woman in her 20s with a fantasmagoric scar on one side of her head and no hair, holding a sign declaring that this is her last radiation treatment, and beaming with joy thereto. 

Perspective anyone?

Another reminder of how grateful I should be. 

[sigh]

28
Sep
18

down the rabbit hole

So I have breast cancer.

mindblown

I know, right? Like I could have led in so much more gracefully, cushioned the blow a little for all of you.

But that’s not how it feels when you find out. Hits you more like a sucker punch in the gut.

So there it is.

I found out 9 days ago, with the whole process starting 7 days before that with a screening mammogram. The first one in 6 years, which now kind of seems like a mistake, but the surgeon actually told me it kind of worked out well, because it’s small enough and my breast tissue is dense enough it might not have shown up a year ago, in which case I might have decided every 5 years was often enough, and 4 years from now we’d be having a completely different conversation.

Please know that I’m not recommending going 6 years between mammograms. Two might be reasonable, unless there’s a family history. If I’d gone every two, we’d still have caught it when we caught it.

Anyway.

We’ve all had those moments when we realize that life will never be the same. My 5 would be:

  • the Challenger explosion (senior year in college, my best friend came and interrupted my piano practicing to tell me, I didn’t believe her at first and couldn’t believe she would make such a cruel joke);
  • 9/11 — working on a doctoral project, my now 17-year old daughter an infant in her little bouncy seat, watching the television footage of the first tower while the commentators speculated on how such an accident could happen when the 2nd plane hit;
  • the day I realized that I couldn’t stay married to my first husband and father-of-my-three-children anymore;
  • finding out my daughter, then 13, had thyroid cancer, with a tumor the size of a sweet potato; and
  • this.

I won’t bore you with the details, as they are much the same for everyone going down this road: mammogram, follow-up mammogram, 3-D mammogram, ultrasound, biopsy, and you find your life has been hijacked. A barrage of phone calls and pre-ops and appointments and blood work. They measured my head for crying out loud! (apparently there’s a link between large head size and cancer; sorry kids!)

My mind is full of platitudes, and mutually contradicting thoughts that I find myself forced to hold in my head at the same time. Principally: gratitude (it could be so much worse) + anger  (I have four sisters, and I’m the youngest of the five; why do I have to be the one to get cancer [first]?)(sorry sisters, it’s not that I’m wishing this on anyone, but it does seem to be a little unfair)(I know, I know, life’s not fair) + fear (whatifthey’rewrong, whatiftherearepositivelymphnodes, whatifitcomesback, whatifthegeneticstestmakes-mysurgeonthinkIneedtohaveadoublemastectomy, whatifwhatifwhat???). Along with those, which are probably obvious to most of you, are a whole lot more: I love my job, my job exhausts me and often involves shitty hours; my husband is the best person in the world, why does my husband chew like that; my daughter is precious and dear and what would she do if I died when she wasn’t yet in her 20s, my daughter is making me crazy with her selfishness and moodiness and shallow concerns; I want another dog, one small enough to carry around in my purse who I can take everywhere as my “comfort object,” the dog I have not peeing in the morning even after a 30 minute walk is making me crazy [Idon’thavetimeforthis]; I will eat nothing but fresh fruits and vegetables and drink green tea, I want to go to bed every night just a little bit drunk from the half bottle of wine I (used to) have with dinner.

I actually feel a little bit like, maybe for everyone else’s sake, I should just go live in a cave until it’s all over. Maybe a cave on a beach in Fiji.

fijiisland

It could actually be much worse. It’s hormone receptor positive, so very responsive to hormone blocking therapy. Which of course means I’ll be pushed into full menopause immediately, at which point I picture myself a dried up old woman who has gained another 40 pounds and lost all of her teeth. There is, of course, a chance that this scenario is a little alarmist. It’s also HER2 negative, which means I probably don’t need chemo, unless the lymph nodes are positive, which we won’t know until after surgery. It seems to be slow growing, non-aggressive (Ha! Is it just me, or does cancer in general seem kind of aggressive? I mean, what else shows up where it’s not wanted and makes you fight like hell to kick it out of your house?Lucy_Ninja

 

Does it matter that I don’t want it?

As if anyone does.

I had a dream the night after I got the call with the diagnosis. Glowing angels came with golden bowls and scooped the cancer away.

angel

I liked that.

I’ve found a couple of new friends already. Well, not really found. They were friends already. But I would call them better friends now, and I am very grateful.

One just finished her chemo, and had some wise ideas to offer. The most helpful of these was not to get too ahead of myself. Just to focus on what I need to do next, and then I can worry about what to do after that. I expressed to her at one point that I was trying really hard to stay grateful, given how much worse the news could have been, and she texted back that gratitude was overrated. I snorted with laughter. Maybe it would be clearer to say that it’s important, but probably insufficient to the task at hand. At least some of the time.

They gave me a form to fill out the day of my meeting with the surgeon and oncologists. It asked you to rate your anxiety, from 0 to 10. I bracketed the whole thing and wrote along the side “depends on the moment.”

Sheesh.

The thing that feels the worst to me is that I fear I will never feel completely carefree again. I know that I’m 53 years old, and the time for never believing I’m actually going to die is long past. But there is a line now, before which I never COMPLETELY believed I would actually die, and now I know I will. Even though it won’t be from this*. This kind of pisses me off.

And yet.

What I’m not grateful for:

  • the nurse scheduling my biopsy pushing kleenex on me and telling me and my husband how awful this is, that we’ll get through it together, what a “terrible diagnosis” (this was BEFORE my biopsy, note)
  • calling my primary care physician to set up my pre-op appointment for my lumpectomy and the scheduling woman at the desk telling me that there were no appointments available and that they usually get calls for pre-ops more than two weeks in advance (I’m so sorry my cancer didn’t give you all more notice, are you f*ing kidding me?)

What I am grateful for:

  • *that this won’t be the source of my demise–at least that’s what the nurse on the phone said
  • that my husband is my best friend, an excellent cook and lover and cuddler, that he’s willing to accept and forgive me when I’m snappish and defensive (even when I haven’t been diagnosed with cancer)
  • that my children are healthy and beautiful and independent and strong
  • that I have access to some of the best healthcare in the world, and some of the best doctors I’ve ever dealt with, especially my biopsy doctor who was also the radiologist who caught the cancer in the first mammogram
  • all of the friends who have sent me such generous and loving emails and texts and phone calls; my heart is full with their love

I do realize that some other friends will find out through this post, and I hope you will forgive me for not calling each of you personally, and understand. I find I can deal with only a couple of these conversations a day, on my best days.

Love you all.

 

 

 




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