One Year Down...the rest of my life to go

I am now "officially" a one-year survivor.
the picture on the bottom is me (in case you've gotten really used to my new look) one year and one day ago at the Hotel Angeleno the night before my lumpectomy surgery. The photo on the top is me this morning, one year later, cancer-free and on may way to work. And you know what's really important about that photo? Right, Seamus. Well, and I'm cancer-free, but no, really, really important?.... Look at those cute shoes!! I can get my no-longer-swollen-no-longer-really-too-very-much neuropathetic feet back into my cute shoes! It's enough (almost) to make me forget that my hair has reached some really weird hard to deal with stage.

I had just mentioned that I was pretty much over the whole cancer thing. Move along cancer, nothing to see here. But last night I had a really weird cancer dream. Not so bad I'd call it a nightmare, but definitely weird.

In the dream, I was having surgery again. Only I was on a table in someone's house. Basically, my surgery was going to take place on a coffee table in a living room of an old house. With a bunch of crazy looking scientist or professor types sitting in chairs around the room. I started asking the crazy bearded men who they were and what their role in my surgery was and they answered in really nonsensical ways and were basically making jokes. Which was, you know, upsetting. The surgeon came over to the coffee table and I said "I find this really disturbing. I want to know who these men are." And he said "I know. They're here to help." And I said "But they won't tell me what they're doing. It's really bothering me." And the surgeon said, "I know. That's why I'm doing this" and he proceeded to give me a shot to my brain!!

Dream Teresa was quite clear that this shot was going to knock her out and she was quite upset about this, but nonetheless out she went. Then Dream Teresa woke up (real Teresa was still asleep and dreaming...you're following that, right?) and the crazy bearded men were all gone except one of them who was asleep in a recliner. Now awake, Dream T saw that her bare legs were covered in what looked to be black felt pen drawings--sort of like vertebrae drawn on my legs. And then Dream T noticed that the sleeping bearded man had bare legs with orange drawings on them. Suddenly (because that's how things happen in dreams) my mom was there and I was asking her where the doctor was. She told me he was upstairs (remember, this surgery took place in a house!). I asked what time it was and then said I was worried because it was so late and I hadn't had the surgery yet. And my mom said, all sad, "You did have the surgery."

Just as Dream T went to look under the blanket at my chest, the gurney that I was suddenly (it's a dream!!) on, started rolling out the door, down the walkway and onto the sidewalk. How embarrassing! I had to grab a tree branch to keep from rolling away. Luckily, my mom came after me and wheeled me back into the house before the imaginary neighbors glimpsed me in my hospital gown (you know, in case they aren't used to surgeries being performed on their block of craftsmen style homes).  Back in the house, bearded man was wide awake and my dad was suddenly there but leaving for his own doctor's appointment. (Giant hint this is a dream: my mother and my father haven't been seen in the same house together since about 1977). Dad assured me that I'd be okay and left. Mom said she go look for the surgeon and left. And there I was, alone in the middle of a strange house, on a coffee table in a hospital gown, with drawings on my legs. But...I was healthy. So that's when real Teresa woke up and decided coffee was a good idea. (Wine maybe less of a good idea.)

And yes, the surgeon in the dream was played by the good and great Dr. Karam. I just didn't want to put his name in the actual story in case somebody read quickly and with low comprehension and didn't realize it was a dream. We don't want his stellar reputation besmirched with rumors of coffee table operations and shots to the brain.

See what a difference a year makes? Last year's surgery was very real. This year...not so much!
Happy Anniversary to me!

(In celebration I had chips and guacamole for lunch and the girls in the office gave me a celebratory cupcake too. How's that for an "F you, cancer"?  )

I'm on vacation...not in surgery

Vacation continues! We're in Chicago now. Had a great drive yesterday from Springfield, Missouri, through St. Louis, on to Springfield, Illinois (we toured Lincoln's home!) and into Chicago just in time for a midnight martini! Which is why again we have a summer re-run. Let's all fondly recall surgery day (hey, it was a good outcome!).

(originally posted Friday, January 30, 2009)

How Medicine Made me a Hot Babe--the nuclear medicine portion of our program

Wow, sorry about that long post yesterday. Apparently I needed to vent all that. And now you probably need some of my Vicodin just from trying to read it. I'll see if I can be more precise. Or funnier. Or just less gory.

When we last met, I was just about to go into surgery...well, surgery day. We were up at 5:30 and while there is no point to make-up and dressing nicely, I did shower and do my hair (since I wouldn't be able to do either for another 48 hours) and I donned the pink sweat-sort-of-suit. We dutifully reported in to the surgery center at 7 a.m. So did about 173 other people. Wow. And apparently it was half-off surgery for children day because they were lined up out the door. And crying. Children cry when confronted with surgery. I cry when confronted with 7a.m. and no Starbucks. It was not a pretty, nor quiet, scene.

After they one by one took pretty much everbody else back to surgery and Chris and I were still stashed in the corner (shaking, crying and promising we'd never, ever have children), I had to remind the front desk lady that I was expected down in nuclear medicine at 7:30 (it was 7:35). She said "for what?" Ummmm...aren't you guys supposed to know that? I kid you not, I got the "I'm new at this" response. Eventually a nurse came and got me and then another nurse took us down to nuclear medicine. Which is every bit as scary as it sounds. So scary they stash it away at the bottom of the 'North tower' and you have to take a secret elevator to get there. You'll know you are there by the arctic temperatures that accost you upon entry.

Two other things happened when we entered. A lab coat wearing man, we'll call him Larry (because that was his name) entered and the receptionist said "we have a such-and-such brain serious major procedure today" (I'm paraphrasing) and he said "Really? I haven't done one of those in 20 years." Comforting huh? Please god, do not let me find out my brain is in my right breast.

Also in the waiting room was a somewhat swarthy looking man in his early 40s, unshaved and wearing a leather jacket and boots, and next to him was a woman who looked like "mom"--just not his mom. Mom like Mrs. Cunningham, or June Cleaver, or any of those moms who did not have swarthy looking sons. They took swarthy back into the treatment rooms and five minutes later a tech comes out and says to mom "Mrs. Jones? Your son-in-law would like you to be with him for the procedure." Mom smiled sweetly (and knowingly) and got up and went back. Really? Who does that? His mother in law??? And where was his wife? I'm really hoping this had nothing to do with his prostate.

Then it was my turn and oh yeah, Chris came back with me. We were greeted by "not in 20 years" Larry. Larry was quite chipper (he likes inflicting pain, it's just obvious) and he says to me, "So you understand why you're here and what we're doing?" I, who haven't had Starbucks, said "um, yeah, kinda...I just know it's painless." And he laughed at me. Full on laughed in my face. I stopped dead in my tracks. He said "Oh, come on. It's four injections. It's going to hurt. There's going to be pain." BWAHHAHAHAH!! Thanks, Larry. This was the part where they were injecting radioactive material into my breast to find the sentinel node. I don't know how I got the rest of the way down the hall into the treatment room. Once there I was happy to find that Larry the Ass was not the doctor. Larry is not even a doctor. The doctor was a young woman (of course she was young), Dr. Tabib, and far, far kinder.

I will describe what was about to happen by medical terms, courtesy of John Link, M.D. and his book "Breast Cancer Survival Manual" (which I read cover to cover yesterday):

"Doctors use the radioactive tracer as follows: They inject it in and around the cancerous area (or under the nipple) at the time of the initial cancer surgery. ...In the operating room using a portable Geiger counter known as a gamma probe, the surgical team identifies the first draining node and removes it following the removal of the primary cancer. The pathologist then analyzes the node using a technique called frozen sectioning. He freezes the node by using liquid nitrogen and then cuts the tissue into thin slices and views them under the microscope. If he sees no cancer, no further surgery is performed."

So, I had four injections around the cancerous area. And I guess, again, where mine is located is somewhat fortunate for these parts. 3 out of 4 of the injections weren't really much. But the one closest to the nipple...yeah, um... ow. Not off the charts, and certainly tolerable, but Ow. Enough to make me bite my lip. Did I mention that Larry is an ass?

Then we had two hours to kill while the radioactive material is finding its way through my breast (no, I couldn't feel anything) before I was to return for "pictures." We chose not to hang out in the arctic zone. Instead we delivered my health care directive and HIPAA release to patient services (I'm still being a lawyer) and then sat in a sunny window reading. I was reading David Sedaris's "When You Are Engulfed in Flames" and Chris was reading "Then we Came to the End." Perhaps we should have thought about our selections ahead of time.

We returned to nucler medicine and waited for "pictures." At least they gave us blankets this time. When they came to take me back this time there were other patients around--they do bone and brain scans and all sorts of "man you are really sick" stuff, and again, I'm squeamish. There was an old guy on a gurney in the hallway asleep (please god, he was just sleeping) who was just skin and bones, with his mouth open and his body contorted. Yeah, that eliminates any possible feeling bad for myself I could have mustered. (And why do they always leave someone on a gurney in the hallway??)

The "pictures" turned out to be not as simple as you would think. I was picturing a quick little x-ray and I"m gone. Not so fast. Again, I had to lay down and then this panel comes down on top of me (they ask again "are you at all claustrophobic?" so that gives you an idea how close the panel gets). And they take two "pictures" that take five minutes each. The tech points out on the screen what they are doing. So I turned my head to see the screen. As I'm waiting out the five minutes I noticed that there were actually 3 screens. The one he pointed to, a much bigger one in the middle and then one in my periphery vision that I can barely see. But the big one in the middle, while difficult to see, is scary looking. It's got a lot of red, some yellow, some pink, and a big ol' scary looking jagged-edge black spot in the middle. Wow. I've seen lots of scary pictures of my cancer but that one was the worst. Probably because of the red everywhere, and it was obviously extremely close up since they were looking for a little tiny lymph node, but that one was freaking me out a little. I kept trying to figure out where this famous lymph node was on the screen amidst all that pulsating blood. Finally I decided I just couldn't look at that screen anymore and I went back to the perfectly harmless looking black and white screen he had told me to look at. It had a nice little countdown clock on it too and that helped.

Eventually, the pictures were done and he said "good job. We found the node. I'm just going to mark it on you." Which they do. He drew on my underarm to pinpoint the node for the surgeon. Then they said I could sit up , so I did. And there in front of me was the scary, frightening, big computer screen....with a beautiful red, yellow and pink sunset and the black silhouette of a palm tree sticking up in the middle of it. The words "Polynesian Spa Music" were written across the top. But in my defense, I couldn't see that from my position under the panel!! (Louise, if you are reading this--you have to be reminded of the glass dancing booths at this point). It's possible I was nervous. But Chris got a big kick out of my story when I came back out. I blame Larry.

Seriously, squint sideways at this.... you can see cancer can't you??

Alright, back up to surgery we went. With my pictures in hand and a notebook full of medical info on me (which the nurse gave to Chris originally and made him swear under penalty of death he would return to her when we got back to the surgery center). Oh, and I had to go in a wheelchair...because of the whole "I see cancer in the sunset" thing, I'm sure.

Surgery is a giant blur to me. I remember this much: the anesthesia nurse was Steve and he was very kind and good at what he does (and was the first voice I heard when I woke up, which also let me know I was still in the surgery center and not in the hospital, which meant good news on the lymph node thing, at least in my mind). The other anesthesia nurse (apparently there to supervise Steve) was an attractive woman with a really cute, colorful surgical hat--until I noticed it was images of coffee and said "latte" "coffee" and other such words all over it, which is just cruel to me in my then state. She was concerned I might rip it off her head when the anesthesia kicked in and I lost the last two inhibitions I had left. Apparently, I did not. But I don't know because I never saw her or her hat again.

Oh, and the infamous blue dye shot straight to the nipple? Yeah, I had it, but I don't remember it. Dr. Karam assures me that I felt it because I "tried to help"--which is to say I tried to knock it away. And I was out of it. It's just crazy that they do that to some women without anesthesia. Other things to note--the blue is not indigo blue. I thought it would be like ink. It's not. It's more of a dark turquoise color. Sort of pretty. Just not, you know, for a breast. It's already faded away however. I think. There may be something there under the bandages, but I can't tell at this point.

So that was surgery day. You know the rest of surgery/ recovery day (or can scroll way, way, way down or click on the Archives for the "A Very Big Breast Day" posting to read it). Now we just wait to hear if Dr. Karam got clean margins around the tumor (i.e. no cancer cells at the edges, which means he got it all and no further surgery is necessary).

I go back to see Dr. Karam next week and at the same time will meet with a medical oncologist about the chemotherapy and treatment options. I've now heard and read enough to know that my best chance of not having a recurrence of cancer is indeed the chemo and radiation. My kind of cancer and my "test" scores indicate a high chance of recurrence (I have no idea the actual percentage--my own guess from the reading is 20-25%; I assume they'll tell me this in the next meeting). So even if Dr. Karam got all of this tumor, there is still the chance that there are some dastardly cancer cells still on the loose and ready to wreak havoc. They must be stopped.

Today I'm going to enjoy a leisurely day off. There will be sleeping, reading, and probably a phone call or twenty. Or maybe I'll start planning our Christmas/ Jimmy Buffet's birthday trip to Maui now. Since, you know, I've got tropical sunsets on my mind.... Aloha.

How Medicine Made me a Hot Babe--the nuclear medicine portion of our program

Wow, sorry about that long post yesterday. Apparently I needed to vent all that. And now you probably need some of my Vicodin just from trying to read it. I'll see if I can be more precise. Or funnier. Or just less gory.

When we last met, I was just about to go into surgery...well, surgery day. We were up at 5:30 and while there is no point to make-up and dressing nicely, I did shower and do my hair (since I wouldn't be able to do either for another 48 hours) and I donned the pink sweat-sort-of-suit. We dutifully reported in to the surgery center at 7 a.m. So did about 173 other people. Wow. And apparently it was half-off surgery for children day because they were lined up out the door. And crying. Children cry when confronted with surgery. I cry when confronted with 7a.m. and no Starbucks. It was not a pretty, nor quiet, scene.

After they one by one took pretty much everbody else back to surgery and Chris and I were still stashed in the corner (shaking, crying and promising we'd never, ever have children), I had to remind the front desk lady that I was expected down in nuclear medicine at 7:30 (it was 7:35). She said "for what?" Ummmm...aren't you guys supposed to know that? I kid you not, I got the "I'm new at this" response. Eventually a nurse came and got me and then another nurse took us down to nuclear medicine. Which is every bit as scary as it sounds. So scary they stash it away at the bottom of the 'North tower' and you have to take a secret elevator to get there. You'll know you are there by the arctic temperatures that accost you upon entry.

Two other things happened when we entered. A lab coat wearing man, we'll call him Larry (because that was his name) entered and the receptionist said "we have a such-and-such brain serious major procedure today" (I'm paraphrasing) and he said "Really? I haven't done one of those in 20 years." Comforting huh? Please god, do not let me find out my brain is in my right breast.

Also in the waiting room was a somewhat swarthy looking man in his early 40s, unshaved and wearing a leather jacket and boots, and next to him was a woman who looked like "mom"--just not his mom. Mom like Mrs. Cunningham, or June Cleaver, or any of those moms who did not have swarthy looking sons. They took swarthy back into the treatment rooms and five minutes later a tech comes out and says to mom "Mrs. Jones? Your son-in-law would like you to be with him for the procedure." Mom smiled sweetly (and knowingly) and got up and went back. Really? Who does that? His mother in law??? And where was his wife? I'm really hoping this had nothing to do with his prostate.

Then it was my turn and oh yeah, Chris came back with me. We were greeted by "not in 20 years" Larry. Larry was quite chipper (he likes inflicting pain, it's just obvious) and he says to me, "So you understand why you're here and what we're doing?" I, who haven't had Starbucks, said "um, yeah, kinda...I just know it's painless." And he laughed at me. Full on laughed in my face. I stopped dead in my tracks. He said "Oh, come on. It's four injections. It's going to hurt. There's going to be pain." BWAHHAHAHAH!! Thanks, Larry. This was the part where they were injecting radioactive material into my breast to find the sentinel node. I don't know how I got the rest of the way down the hall into the treatment room. Once there I was happy to find that Larry the Ass was not the doctor. Larry is not even a doctor. The doctor was a young woman (of course she was young), Dr. Tabib, and far, far kinder.

I will describe what was about to happen by medical terms, courtesy of John Link, M.D. and his book "Breast Cancer Survival Manual" (which I read cover to cover yesterday):

"Doctors use the radioactive tracer as follows: They inject it in and around the cancerous area (or under the nipple) at the time of the initial cancer surgery. ...In the operating room using a portable Geiger counter known as a gamma probe, the surgical team identifies the first draining node and removes it following the removal of the primary cancer. The pathologist then analyzes the node using a technique called frozen sectioning. He freezes the node by using liquid nitrogen and then cuts the tissue into thin slices and views them under the microscope. If he sees no cancer, no further surgery is performed."

So, I had four injections around the cancerous area. And I guess, again, where mine is located is somewhat fortunate for these parts. 3 out of 4 of the injections weren't really much. But the one closest to the nipple...yeah, um... ow. Not off the charts, and certainly tolerable, but Ow. Enough to make me bite my lip. Did I mention that Larry is an ass?

Then we had two hours to kill while the radioactive material is finding its way through my breast (no, I couldn't feel anything) before I was to return for "pictures." We chose not to hang out in the arctic zone. Instead we delivered my health care directive and HIPAA release to patient services (I'm still being a lawyer) and then sat in a sunny window reading. I was reading David Sedaris's "When You Are Engulfed in Flames" and Chris was reading "Then we Came to the End." Perhaps we should have thought about our selections ahead of time.

We returned to nucler medicine and waited for "pictures." At least they gave us blankets this time. When they came to take me back this time there were other patients around--they do bone and brain scans and all sorts of "man you are really sick" stuff, and again, I'm squeamish. There was an old guy on a gurney in the hallway asleep (please god, he was just sleeping) who was just skin and bones, with his mouth open and his body contorted. Yeah, that eliminates any possible feeling bad for myself I could have mustered. (And why do they always leave someone on a gurney in the hallway??)

The "pictures" turned out to be not as simple as you would think. I was picturing a quick little x-ray and I"m gone. Not so fast. Again, I had to lay down and then this panel comes down on top of me (they ask again "are you at all claustrophobic?" so that gives you an idea how close the panel gets). And they take two "pictures" that take five minutes each. The tech points out on the screen what they are doing. So I turned my head to see the screen. As I'm waiting out the five minutes I noticed that there were actually 3 screens. The one he pointed to, a much bigger one in the middle and then one in my periphery vision that I can barely see. But the big one in the middle, while difficult to see, is scary looking. It's got a lot of red, some yellow, some pink, and a big ol' scary looking jagged-edge black spot in the middle. Wow. I've seen lots of scary pictures of my cancer but that one was the worst. Probably because of the red everywhere, and it was obviously extremely close up since they were looking for a little tiny lymph node, but that one was freaking me out a little. I kept trying to figure out where this famous lymph node was on the screen amidst all that pulsating blood. Finally I decided I just couldn't look at that screen anymore and I went back to the perfectly harmless looking black and white screen he had told me to look at. It had a nice little countdown clock on it too and that helped.

Eventually, the pictures were done and he said "good job. We found the node. I'm just going to mark it on you." Which they do. He drew on my underarm to pinpoint the node for the surgeon. Then they said I could sit up , so I did. And there in front of me was the scary, frightening, big computer screen....with a beautiful red, yellow and pink sunset and the black silhouette of a palm tree sticking up in the middle of it. The words "Polynesian Spa Music" were written across the top. But in my defense, I couldn't see that from my position under the panel!! (Louise, if you are reading this--you have to be reminded of the glass dancing booths at this point). It's possible I was nervous. But Chris got a big kick out of my story when I came back out. I blame Larry.

Seriously, squint sideways at this.... you can see cancer can't you??

Alright, back up to surgery we went. With my pictures in hand and a notebook full of medical info on me (which the nurse gave to Chris originally and made him swear under penalty of death he would return to her when we got back to the surgery center). Oh, and I had to go in a wheelchair...because of the whole "I see cancer in the sunset" thing, I'm sure.

Surgery is a giant blur to me. I remember this much: the anesthesia nurse was Steve and he was very kind and good at what he does (and was the first voice I heard when I woke up, which also let me know I was still in the surgery center and not in the hospital, which meant good news on the lymph node thing, at least in my mind). The other anesthesia nurse (apparently there to supervise Steve) was an attractive woman with a really cute, colorful surgical hat--until I noticed it was images of coffee and said "latte" "coffee" and other such words all over it, which is just cruel to me in my then state. She was concerned I might rip it off her head when the anesthesia kicked in and I lost the last two inhibitions I had left. Apparently, I did not. But I don't know because I never saw her or her hat again.

Oh, and the infamous blue dye shot straight to the nipple? Yeah, I had it, but I don't remember it. Dr. Karam assures me that I felt it because I "tried to help"--which is to say I tried to knock it away. And I was out of it. It's just crazy that they do that to some women without anesthesia. Other things to note--the blue is not indigo blue. I thought it would be like ink. It's not. It's more of a dark turquoise color. Sort of pretty. Just not, you know, for a breast. It's already faded away however. I think. There may be something there under the bandages, but I can't tell at this point.

So that was surgery day. You know the rest of surgery/ recovery day (or can scroll way, way, way down or click on the Archives for the "A Very Big Breast Day" posting to read it). Now we just wait to hear if Dr. Karam got clean margins around the tumor (i.e. no cancer cells at the edges, which means he got it all and no further surgery is necessary).

I go back to see Dr. Karam next week and at the same time will meet with a medical oncologist about the chemotherapy and treatment options. I've now heard and read enough to know that my best chance of not having a recurrence of cancer is indeed the chemo and radiation. My kind of cancer and my "test" scores indicate a high chance of recurrence (I have no idea the actual percentage--my own guess from the reading is 20-25%; I assume they'll tell me this in the next meeting). So even if Dr. Karam got all of this tumor, there is still the chance that there are some dastardly cancer cells still on the loose and ready to wreak havoc. They must be stopped.

Today I'm going to enjoy a leisurely day off. There will be sleeping, reading, and probably a phone call or twenty. Or maybe I'll start planning our Christmas/ Jimmy Buffet's birthday trip to Maui now. Since, you know, I've got tropical sunsets on my mind.... Aloha.

A Very Big Breast Day

THUMBS UP!!! Surgery went as well as it possibly could have. That's Dr. Good Karma (and Hands!) giving the thumbs-up post-surgery (also holding the Jaboulet 2005 Parallele 45 Cote du Rhone we gave him as a thank you for all his good care). He located the sentinel node, removed it successfully and voila! The report came back that it was cancer free. Woo-hoo!!! So the lumpectomy proceeded and by 1:30 I was waking up (I remember absolutely nothing of the surgery--which is how I hoped it would happen).

Took a little while to get recovered enough to leave the recovery room and the guy next to me seemed to be taking priority (well, to be fair to the nurses, the dude was demanding priority!). Chris and I spent a couple of hours listening (no matter how hard we tried not to) to a rather loud and extensive diatribe from next-curtain-over patitent Roger about how unfair it was that they wouldn't let him leave until he peed and he couldn't pee (I'll spare you the details but clearly his surgery was "down there"); that was followed by the many things that "normally" make him pee and his demands for the same (to wit: walking, the elevator in their home, coffee, and running water). So while I quietly lay there counting the moments until Starbucks was possible, the nurses offered this guy everything from cranberry juice to apple juice (eventually he asked them to mix the two!!) to coffee while he strolled up and down the room in his high fashion gown discussing his urinary progress!!! But then my incision started to ooze and well, that got the nurses attention. Apparently I bleed a lot. That's mostly what my delay was--took awhile to get the incisions (yep, two--one for the lymph node and one for the cancer that is no more) to stop bleeding. And ironically, I really needed to use the little girls room (and yes, it was blue. Tidy-Bowl blue!)

Eventually we were released. I'm sure Chris was as relieved as I was since I at least got a nap and he, poor baby, was up at 5:30 a.m. with me and roaming hospital waiting rooms for the day (except for a nice break when Emily picked him up for lunch--thanks Emily!). My plans for Starbucks however were foiled by the stairs between me and the Starbucks in the hospital. I wasn't up for that. I tried to settle for a Dr. Pepper and chicken noodle soup at the cafeteria, but quickly found myself in the bathroom almost, but not quite, well...getting nauseous. So the Dr. Pepper was slowly sipped and the saltine crackers were savored. Not really up to the standards we had set last night, but I really needed to get rid of the "no caffeine in 24 hours" headache.

Finally, back at the hotel at last, I took off my cute pink hoodie and....well, let's just say the incision was oozing again (saturated is the word they use. TMI?). We may not be seeing that pink hoodie again. Chris to the rescue though. He got the ice pack in place, put me to bed (I zonked out. Best nap in a long time), called Dr. Karam and about an hour later Dr. Karam showed up in our hotel room! He fixed me up, changed out everything, gave me a full report on the surgery (all good!) and rode off into the sunset (with his wine--the picture was taken in the hotel room. Yep, he does house calls too!!).

All is good now. I haven't even had to take the Vicodin. Tylenol seems to be working fine. Chris gave up Lost for Sex and the City reruns, we've had a room service dinner and I'm back to my delusion of a long weekend away at a great hotel. Oh, and cancer has left the boobie!!

Thanks for all the well wishes and thoughts and prayers, and calls and emails and Facebook comments, and blog comments... it was nice to see when I got back to the room. Tomorrow I'll tell you more about the medical parts. I have plenty o' stories! Did you know there are a lot of sick people in a medical center??

A Blue Day

So today's theme was not pink. It was blue.
Perhaps the universe was reminding me that all is not pink. Or rosy. Oh, wait, the universe always reminds me of that. First, I went to the Mayor's State of the City address (kudos to me; kudos to you; kudos for all my friends; and you only get that joke if you were there)--first public appearance since I broadcast my diagnosis across our tiny little town. More on that in a later post probably. But it was fun and I was in a jovial mood when I got back to my office. Except there was a message for me from Sasha at UCLA. Hmmm... this is not a name I'm familiar with. And by way of a little background, among the many, many, many things I have marveled at in the great institution that is UCLA Medical Center is that no matter how often I show up or how many "procedures" I have, no one-- but no one-- has so much as uttered the word co-pay to me. Or even "pay." Or "how do you intend to...." Never. [Okay, wait, the parking lot attendant always holds us up for $11, but that's not a co-pay.] I called Sasha. And Sasha as sweetly as can be informs me that Blue Cross informs her that my coverage lapsed on January 1. Right. So now I need cardiac care. Know any good clinics?

As calmly as possible, I said "that can't be right. I know I've paid the premiums and I've had the same insurance forever." She told me that I should call Blue Cross and straighten it out. Honestly, it took me three tries to dial the number correctly. And while I waited the 6 days, 19 hours, 43 minutes and 8 seconds they had me on hold, I perfectly envisioned my life as a bald, bankrupt, bag lady. And the bag was not Coach. Turned out it was Blue Cross's mistake (and they even said that!). They'd input my policy date wrong, but my coverage goes from January 1 to December and I was fine. Covered. They'd correct it and UCLA could call back in 15 minutes. Phew.

I recovered and went about my day being a lawyer rather than a "cancer person." Then, at about 6:30 a friend who has "been there/done that" circa 2007 called. She gave me all sorts of great information and of course we compared types of cancer, treatments, procedures, and the general poor state of health care in the Riverside area (it's a theme). Then we got to discussing my upcoming surgery. There's a part where they shoot blue dye into one of the twins (the ailing one of course) and well, let's just call it dead center. With a needle. They do this to find the road map to the sentinel node. Well my friend had this too. And so did my guru the Cancer Vixen. Both of them describe the pain as "off the charts." On a scale of 1 to 10 it's an 11. And my friend has three children. The children are not adopted. You do the pain math.

I'm a wimp. Who isn't with that kind of info. I hung up the phone and emailed the great and wonderful Dr. Good Karma. It's now about 7:45pm. I asked if this would be the case for me. Give it to me straight. Then I closed up the law shop and went home. To panic. I should have just reached for my Blackberry. He responded in less than a half hour. And because it makes me laugh for several reasons (mostly at myself) here's the response:

"The blue dye is the one I use in the operating when u r asleep so u
won't feelit plus my skilled hands will keep the any pain away ;-).
u may get some staining of the breast that is temporary and
ure urine turns blue and green for a day (
the college kids I treated always get a kick out of that.
The shot u get in the morning is for that tiny bit of radioactive
material that also goes to the sentinel lymph node and that
is not painful. I use both techniques so I can make sure to find
the sentinel node. "

Sounds like fun huh? Hey, after what I thought it was going to be...that's a good time right there. And yeah, my doctor's a Black(crack)berry addict and uses those abbreviations and a smiley face.

I am blue no more. Until next week anyway, when I will be quite literally...blue!

The Treatment...The Team

It took 7 hours but we are back from UCLA and my brain has been jam-packed with information (some of it I'm just rejecting out of...well, mind). Surgery (the "lumpectomy" just really isn't dramatic enough is it?) is scheduled for January 28th at 11 a.m. Of course, I need to get there at o'dark thirty and I can't have coffee, wine, gum, candy, heroin or scrambled eggs after midnight so by 11a.m. I'll pretty much be begging for anesthesia (and/or death; but I realize some of you might not find that amusing right now). The good doctor promises an IV of Starbucks when it's all over. He's quite funny but that better not be a joke. And speaking of the good hands man, that's him. Dr. Amer Karam. What he's holding is a spectacular drawing of what's going on inside my "right breast 10 o' clock"; yeah, it made me nervous about his manual dexterity too, but he just overslept when they taught "cancer cartoons" in med school. Still, if you ever hear the words "highly suspicious of malignancy" give the man a call. And yeah, I know, he looks young. He assures me he's done seven breast surgeries before (okay, he said "hundreds" but I heard "seven"; I'm like that). I'm trying to remember that I was 23 when I graduated from law school and I expected everyone to take me seriously. I'm taking him seriously. It's the cancer I refuse to take seriously.

Oh, and IT WAS MY GOOD FRIEND STACEY ALDSTADT WHO REFERRED ME TO UCLA and personally made sure I got to a doctor long before the medical community of Riverside could even find my chart or return a phone call. Thank you Stacey. Thank you, Thank you, Thank you. No, really. Thank you.

And that brings me to other supporting players. Here's my January team:

Dad on the left, Dr. Karam, and Chris. That was our little team today figuring out my whole "treatment plan." I focused on margaritas, martinis and wine (when each was applicable); Dad asked medical questions (how is this relevant??? Geez. Dads.); and Chris took scrupulous notes while trying not to giggle every time Dr. Karam said "breast" (which the dude says a lot. A lot.)

In the end, the plan was the lumpectomy and search for the "sentinel node" on the 28th (more on that sentinel later; it's kinda fascinating). If all goes well (meaning there's no cancer in the lymph nodes) I'm home that evening (well, after a 5 to 6 hour drive home in rush hours traffic). I insist on being back at work the following Monday. I have appointments scheduled!! Then after a week or so, I go back to Dr. Karam. If he got "everything" in the first surgery, well, Dr. Karam ends our relationship and it's goodbye to him (unless one of you starts dating him; and there seems to be volunteers among you). But alas, that is not the end of my cancer journey. Then I have to go see an oncologist and convince him or her I don't really need chemo, or I just need chemo light. Dr. Good Karma, who thus far has not been wrong about a single thing (apparently he didn't miss all of his med school classes; just the drawing one) seems to be preparing me for the inevitability of chemo. So that will likely start sometime in March and go on for 4 months. Reminder: Birthday Bash in February still an option! I'm thinking Friday the 13th! Totally appropriate. After that will be radiation. Which should be delightful in Riverside in you know, July or August! Stay out of the sun? Are you kidding me??

So basically, not much changed today. Except we have actual dates and a sort of schedule. Oh, and they had me do 1) a chest x-ray; 2) blood tests (4 vials); 3) a urinanalyis and 4) an EKG in preparation for surgery. They managed to accomplish all of that in about an hour. Astounding. And I didn't have to drive all over the place and carry my records myself. I could do the whole testing journey in super-cute 4" strappy silver sandals walking only as far as the elevator. Oh, and there was one "it could be worse" moment when Dr. Good Karma told me one of the tests was a pregnancy test. I may have threatened his life if he came back to me with "you're pregnant." (Security was called prematurely in my opinion!!) This whole cancer thing may be over in 8 months. Pregnancy? The child never goes away, right? I'm 45. My dad came to my appointment today. (Thanks, Dad. ;-)