What's With Oncologists Anyway?

Today I got the "second opinion" (I'll explain the quotes in a moment) from Dr. Bosserman in Rancho Cucamonga. An exhausting day. Chris and I both took naps when we got home. But before I delve into all that....you're a fickle crowd aren't you? First I get "mentions" (okay, they may have been complaints) that I'm wordy. So last night, I took pity on you (and yeah, on me) and only put up a really simple almost-only-pictures post. And only 28 of you even bothered to check in on me...as opposed to the over 100 page views a day that had been occurring. The drop-off started with Chris's post and I tried to blame him (he's willing to take the blame, but it's becomes sadly obvious that's not the case). So I realize...you're bored with my cancer! Yeah, me too. It's like I've got nothing else....for 6 more months. Hey people, cancer can't always be funny.

So yeah, back to Rancho Cucamonga. I started out very, very grumpy and it went downhill from there. I didn't sleep well (shock!) and we had to drop off Seamus (thanks again Shawna D. and Destiny!) and be in RC by 9:15. Which may as well be 5:15 to me. Actually, 5:15 would have been better--I'm usually wide awake from 4 to 5 each morning. We went to Wilshire Oncology, which is, quite surprisingly, not in LA. I have no idea where that name comes from. Nice enough place, although it seems weird, after the megaopolis that is UCLA Medical Center, that one just goes to a regular ol' doctors office for something as all-consuming serious as chemotherapy. The office was way over-the-top decorated for Valentine's Day. Think kindergarten classroom manic pink/red/ hearts/candy decorated. Then imagine every one of the staff (not the doctor; her coat was still white) in some version of pink heart scrubs. I hate that stuff. Hate it. I don't do cute. I didn't do cute in kindergarten (and not just because I was already like five feet tall). Then they explained that they do this for every holiday. Let me do that crepe paper cardboard cut-out godawful colors pukey-cutesy math for you. 12 weeks of chemotherapy starting February 26th. I get St. Patrick's Day (because yeah, everyone wants to be in a green room with scarey leprechauns when hooked up to a machine that feeds them nausea-making fluids...mmmm, tasty), and then I get Easter (because bunnies and chicks and jellybeans are exactly what I'm going to be craving halfway through chemotherapy) and then, the coup de grace...I'll get Mother's Day too! Because the sap that pours out of Hallmark et al for that particular holiday and the forced sentimentality of it all makes my stomach turn when I'm healthy. It's just unfortunate that I won't be sticking around long enough for chemo-fireworks.

Once I got past that and then past the fact that they handed me a "mandatory" binding arbitration agreement (if I sue, no right to a trial...because right, juries love cancer patients and not so much the doctors, and so why wouldn't I give up my right to a trial??? And doesn't the mention of litigation and how they protect themselves from it coming up before I've even laid eyes on the doctor just give you the warm fuzzies? Yeah, me too. Or maybe that was the candy hearts.) Okay, but the place was clean, the staff was friendly and....they had pink donuts. With candy sprinkles. Which by the way, you shouldn't eat if someone is about to take your temperature...I didn't know that. I do now.

I thought at this stage of my breast cancer journey (yeah, everyone calls it that; I'm willing to be extradited) I was past the part where I walk into a room and whip my top off. I've done that so often for so many people I was starting to worry that one day I'd walk into a client meeting and take my top off, or you know, the grocery store frozen food section (which is a lot more like a doctor's office than you'd think). At any rate, I was wrong. Doctors can only see you if you are wearing a paper dress.

I donned the paper dress and eventually met Dr. Bosserman. Who, first impressions, was just a lot smaller than I expected. How can someone who kills cancer be so tiny? She is however obviously extremely competent (she told us so) and I don't think I've ever met anyone who talks faster than I do, but I have now. She completely agreed with Dr. Glaspy and paused for about 10 seconds longer than he did about the "guaranteed hair loss." There was a lot of name dropping (including an attorney that I also know, who is extremely well known for his bad-faith insurance litigation, so I'm kinda wondering why that came up--I think she meant she could get my insurance to approve things very quickly) and a ton of information. But here's the thing...I almost couldn't get a word in edgewise! I'd get half a question out and she'd dive into the answer--sometimes she correctly guessed what I was about to ask, sometimes she didn't, and sometimes...I was stunned into silence and forgetfulness (Of course, today I also walked into Starbucks and forgot to buy coffee, so there may be something else going on).

Call me crazy, but isn't it surgeons who have the bad rap for being ego-maniacs with bad bedside manners? And wouldn't you think an oncologist...you know a doctor who sees only patients with cancer... would be very compassionate? So now I've been spoiled by a surgeon who was compassionate, solicitous, funny and oh-so-calming (and hey, he's the one who had to tell me I had cancer in the first place) and I'm delivered unto two oncologists who both seemed too busy to talk to me, couldn't really see me as person (just a patient), and were, dare I say it, a tad arrogant. And hey, don't get me wrong, I want confidence. I want to know the doctor is good...but it's like they tell you in every writing class "show, don't tell."

An example of the "I don't see you as a person" oncological phenomenon. Both Dr. Glaspy and Dr. Bosserman asked me about my career. Here's how those conversations went:

Dr. G: Where did you go to law school?
Me: Loyola, right here in LA.
Dr. G: How'd you end up in Riverside? (and you could hear the "hell" implied--twice--as in how the hell did you end up in hell?)
Me: Well, I really wanted to ...[at this point he looked down on his chart, started writing, then glanced out the door and stood up]...work with frogs, at a Burger King, where homeless people are my only friends, and then pink. I also like pink. But not really. [That's not what I said, but trust me, he doesn't know that.]

Dr. B: What kind of law do you practice?
Me: I work in death and taxes. I'm an estate planning lawyer.
Dr. B: Don't lots of lawyers do that? That's just wills and trusts, right? [said while staring across the room at a calendar and calculating my next appointment]

Because you know, anytime you mention what someone does for a living, it's endearing and not at all rude to put "just" in front of it. "So you're just an oncologist?" "Ah, I see, you're just a priest?" "Just a stripper?" "You just wrestle crocodiles?" It totally works. Try it.

It wasn't all bad, and I did like Dr. Bosserman (I've got a weak spot for intense professional career-driven women) and she did offer to give me a research article about my particular chemo-cocktail (which isn't as commonly used yet; sort of cutting edge, as I understand it). I just wasn't you know, whipping out the camera, snapping photos and explaining my blog. (Her lawyers would be calling).

At any rate, Chris and I discussed. And discussed more. And basically, it's a tie--that gets broken by the fact that Rancho Cucamonga is only a half-hour drive away and UCLA is anywhere from an hour and 15 minutes to 3 days away. RC also seemed to have much more in the way of supportive programs--for example, they don't just hand me 14 prescriptions. They ask me for my pharmacy phone number and they call them all in for me. They also have a pre-chemo planning meeting with the nurse who trains Chris and I both for about 45 minutes on what to expect and what to do and all that. They also have a wig program and lots of options there. And they were willing to make my appointments now--they're that confident they'll get the Blue Cross approval in time. And one of the frustrating parts of this is not having control of one's schedule.

So, February 23rd at 3pm Chris and I go get chemo-trained. It's like boot camp for baldy. Then on February 26th, I'm in "the chair" and getting the drip for the first time. We picked a Thursday because the sick days will definitely be over by Monday and I'll be back at work. I'm told I'll be slightly nauseous and very tired the day of treatment and then a little more so the next. But should be better Saturday and Sunday (so of course I'm thinking, "well good, then I can go into my office on Sunday and get caught up". If I tolerate it well, I can switch to chemo on Fridays and still be back to work on Monday. This is the great and grand plan.

Oh, and we saw the chemo room--most crowded on Tuesdays and Thursdays we're told. And yeah, it was crowded. Nice big comfy recliners that look a lot like the ones you get pedicures in at places called "Happy Nails." Chris can stay with me for the whole time, but I'm not going to do that to him (although he insists on staying the first time at least). Yeah, he's cute like that.
Really, I figure you'll all be right there with me because I can bring my laptop. And if you thought watching Chris's hair grow was going to be a good time...wait until we get to the drip details--drip by drip. I know. I'm excited too.

See you all at the really super cute oh my gawd pink party!!

The One Where the Readers get a Break

MY NIGHT:




























THE END.

My Cancer and Me, We go Way Back

The good news is that yesterday and today were pretty normal days for me. I got to be much more of "Lawyer person" than "CANCER person" (and no, those are not actually the same thing) and that was pretty nice. The bad news is I don't really have a blog story for you. Or is that good news?

But I have been reading. Gone, for awhile, is the great reading streak I was on B.C. (and come on, you know what that means) when I finished The Elegance of the Hedgehog, The Little Book, and People of the Book in just a few blissful weeks of fireside fiction-fest. No, now I am all about such exciting and all-too-true books as "The Breast Cancer Survival Manual" and "Breast Cancer: Real Questions, Real Answers."

Perhaps this amply demonstrates my life change.
BC v AC.







I'm thinking it's less fun, AC. But, I'm certainly more informed. So I'll share some of that information.

I've learned many surprising things, but way up on the list was this fact: by the time a breast cancer mass (fancy word for "lump"; unless you are trying to apply it to your spouse--It doesn't work the same) can actually be felt, those dastardly cancer cells have been hard at work in the breast for 6 to 8 years. Years! I've had cancer for years! (I'm totally expecting phone calls, cards and flowers from some of you...the way you've treated me...and I had cancer then!!!). Modern technology can't detect the cancer in the beginning years of growth (nope, not the mammogram, not an MRI, and you can't feel it either...these are just little tiny bad-guy cells), so it's only after they've divided and multiplied and turned into a gang that they get discovered. In Dr. Chan's book "Breast Cancer: Real Questions Real Answers" on page 68 he has a nifty little chart. I wish I could insert it here but I can't (copyright or some such; damn lawyers).

Basically, it follows the life and times of a fertile little cancer cell which then reproduces to be 2 cells in about 100 days, then 4 cells at 200 days, 8 at 300, 16 at 400 up until at about 5 years the cancer party is now about 1mm in size. Millimeter...not centimeter. Only at 8 years have they divided in number to get to the 1cm size, which is generally considered the smallest "palpable" tumor (meaning you can feel it--if you were trying; the machines might pick it up before this...if you were getting regular mammograms). At 10 years that could be 2 or 3 cms, or larger, depending on the rate of growth.

Let's just think about my rude little invading tumor bastard (just a little pet name I have for it). I have been good and I've had a mammogram every year since I turned 40. So that would be 5 mammograms that didn't pick up on the party going on. The last of these was July of 2008. Then in maybe November I could actually feel something, but I wasn't sure what it was. By December it was clearly "a lump." And it turned out to be a 1.7cm lump. It had maybe been growing there for 8 years??

Among the many tests and numbers and scores and ratings that go on when the folks in white are figuring out what sort of nasty little bastard has invaded, is one known as a Ki-67. No idea what that stands for, but it's "...a test that detects a protein that is important in cell growth in the nucleus of the cancer cells. If a cell is about to divide, there is a lot of this protein present within the nucleus and this can be seen by a special staining technique with a microscope. Having more than 10 percent of cells with Ki-67 staining is considered elevated. The higher the number, the greater the growth rate of the cancer. Very fast-growing breast cancer can have a Ki-67 levels of 60 to 80 percent, indicating that 60 to 80 percent of the cells are preparing to divide." (Thank you Dr. Chan, "Real Questions Real Answers" p.61).

My Ki-67 was 50%. Quite a party of evil. Which explains the change from July to December. It also, in part, explains the chemotherapy as necessity. We don't know if there are other cells starting a party o' bad somewhere else in my body that just hasn't been picked up yet--some of the gang-banger party attendees could have flowed out into the street and down to a neighbor's where they are hiding out (cowards, really) until there's enough of them to make their presence known. We need to flush those out and banish them.

As I believe I mentioned before, I didn't really spend a lot of time with the "how" or "why" this happened to me. Despite triple over time with the Catholic Church as a kid (Catholic school, regular mass attendance, and CCD), I'm not that big on guilt (I mean mine; I'm all about inflicting it on others). But I did wonder, momentarily, if increased wine consumption of the last few years (I blame and credit France) and/or my new found taste for red meat (I couldn't tolerate it as a kid so never ate much of it--much like chocolate--but man, can Chris grill an incredible steak. And once he started melting bleu cheese on top of it....I was a goner) had anything to do with the cancer. But it couldn't have. This bad little party of infidels has been there for 8 years or so! And both books and many articles I've read and all doctors I've talked to (and yeah, there have been a lot) seem to say "no" to just about any "did ____ cause the cancer?" type of question I or anybody else may have.

My favorite "real question" in that book is basically did stress cause the breast cancer. The answer is that studies have not shown that stress causes breast cancer. But um, yeah, let's think about this...Breast cancer is most typically found in older women. Let's be wide-sweeping and assume that means women over 40 (since that's the group they suggest get mammograms). And the cancer has been growing for years. Okay, so you are testing to see if women who had stress in their life were more likely to get breast cancer....ummm...where's the control group for that??? Where do you find the group of women over 40 who haven't had major stress in their lives to see what their rate of cancer occurrence was?!! If stress caused cancer, I'd be Stage IV. We all would.

So what have we learned? a) Teresa is very, very wordy, but you can't say anything because the poor thing has had cancer for 8 years now! b) Do your self-exams--know what's normal in your breast and what isn't and get things checked out before the party gets out of control!! and c) I didn't start this cancer thing, but I'm darn sure going to end it!

Last Sushi in Perris

Okay, not Perris. Riverside. Or anywhere for me, for awhile. (But last sushi in Riverside does not at all sound like "Last Mango in Paris" thus, I claim poetic license. Oh, and I have CANCER!!) And it's not that I eat sushi all that often (because, yeah, I live in Riverside) or even love sushi all that much--I spent three weeks in Japan 100 years ago and that about did it...although I did love Nobu Malibu for STACEY ALDSTADT'S birthday 62 years ago (and we saw Rose Marie and Kirk Cameron..no, not together... but Stacey counted both as "celebrity sightings"...and yet she scoffed at our Brad Garrett sighting...) ...wait...am I rambling? Sushi. Back to the sushi. Or the end of sushi.

Once "they" told me that the not-so-very-long list of things I cannot eat or do during chemo included sushi, well, you know I wanted sushi. And once again it was BREIN and RORYANN CLEMENTS of OMAKASE (http://www.restaurantomakase.com/homepage.cfm) to the rescue (and also somebody who claimed to be Roryann's mother but she preferred her other daughter, Erin, it was just totally obvious, and what kind of mother does that...). We met them for sushi at Sushi Asahi, in, of all places, a little strip mall over next to the Van Buren Drive-in (which by the way, is a great place to go see a movie or two with a bottle of wine--or two--and a picnic if you just happen to have a really cute beagle with a serious separation anxiety problem. Beverly Hills Chihuahua and Bolt however, should be avoided as barking dogs over the radio in a car with a trapped beagle = noisy, and um, trouble. Especially since theoretically, the drive-in does not allow dogs.)

But the sushi--the sushi was excellent! Despite the fact that it was cold out, and apparently that can cause a little less flexibility if one was, say, recovering from surgery, generally unable to use chopsticks, and had a fairly limited reach of the right hand, I was still able to battle my way to several (thousand) pieces of truly delectable sushi. The fact that my favorite was called "Diablo" was purely a coincidence. And the fact that Brein was next to me and an entire glass of mango iced tea dumped onto his lap and thus sidelined him from the sushi free-for-all for a solid 45 seconds, also coincidence.

So, while I can't eat sushi for awhile, you can. And I promised helpful information on this blog. So there you have it. Sushi Asahi. Van Buren. Go. Oh, and Omakase (downtown Riverside; phenomenal food). Go. Eat. Be happy. You never know when some guy in a white lab coat is going to tell you to stop.

Growin' It Out for Cancer

Hi Everybody, Chris here. Teresa was kind enough to turn over her blog to me tonight for this very special post. Basically she's tired and I'm giving her the night off. Hey, as exciting as our lives are and cancer is, you can't expect top-notch, hilarious, memorable material every night. That's why you're stuck with me instead...(rimshot)

So as you probably know (since you're reading this blog, and if you're not a registered follower, WHY AREN'T YOU A REGISTERED FOLLOWER YET???), Teresa has cancer. I know, big-time shocker! But her surgery was successful and now she's on to chemotherapy. Huzzah! Where as the oncologist said, she's GUARANTEED to lose her hair. GUARANTEED. (His emphasis, not mine).

Expecting this even before the surgery (apparently some of her pessimism is rubbing off on me), I did what any good boyfriend would do--I offered to shave off my hair in solidarity with her during her chemotherapy. I mean, if you're going to have one bald person in the family, why not two, right? Three, though, wasn't going to be an option. Seamus is far too reluctant to go the shaving route with us. He gets freaked out at the site of a Mach 3. Plus, apparently certain dogs actually need their coats to live. Who knew?

And as it turns out, though, Teresa was just as reluctant as Seamus to go through with my whole head-shaving scheme. She's always loved my thick, full head of hair ("Democrat hair," she calls it, as you probably already know from last night's post) and the last thing she wanted was for me to get rid of it when she lost hers. Christ, she nearly breaks down in tears whenever I get a regular haircut, and I usually end up keeping most of it then. Why have two bald people in the family when you only need one, she said? And who am I to argue? I mean, she has CANCER, for crying out loud! (and don't think she ever lets you forget it.)

Ergo the head-shaving/solidarity thing was right out.

So, we decided to go another way with it instead: instead of shaving my head in solidarity, I would grow out my hair during her chemo and radiation sessions. Less hair for her, more hair for me. She's Curly, I'm Larry and Moe. I get to look like Clinton, she gets to look like Jimmy Carville (and that's Hillary Clinton, for those scoring at home...that woman has quite a head of hair!)

Long story short, I had what may be my final haircut of 2009 (gulp! or at least until August gulp!) Saturday and decided that, much as Teresa is sharing her cancer-related experiences with you on this blog, I'll be sharing my hair growth with you as well. Remember, I'm doing this for cancer, so no, it's not just an excuse to get pretty pictures of me up on the internet. No matter what anyone tells you.

Once a month, we'll take pictures of me (and I'm sure you'll agree that I do photograph spectacularly) or more likely my hair and post them on the blog so you can see the progress my hair is making during Teresa's treatment. And don't worry, I'll save you the trouble of making the joke now: yes, this is going to be as much fun as watching hair grow.



As you can see from the baseline "before" photos at the top and the measurement photo just above, I had my stylist (okay, the woman at Supercuts) cut it fairly short to begin with, about 1 inch long on top at its longest point. And yes, those are gray hairs. Please don't flood our mailbox with bottles of Grecian Formula and Just For Men; I enjoy the salt-and-pepper look. It makes me look wizened and feel smarter than I actually am (like when hot chicks wear glasses, or anyone adopts a British accent).

So yes, get ready once a month to have new photos of my hair posted on the blog. I know: super exciting, right? But here's the thing: 1.) my hair grows really, really fast. Like Usain Bolt speed-of-sound fast, 2.) I think the longest I've ever gone without cutting my hair is 3 months--all told, this is going to be at least 6 months' of growth, possibly 7 or 8 or even longer (if I keep it up post-treatment while Teresa is still, well, shiny. We'll see. That will be a game time and psoriasis-related decision). I've never grown my hair out that long. I have no idea what's going to happen, and 3.) unlike most normal people whose hair grows down as it gets longer, mine doesn't. It grows up. And big. Like pompadour big. Like Del Shannon in 1957 big. Like Roman Centurion helmet big. Like Kid from Kid n' Play big (okay, maybe not that big). My running joke has always been that as my hair grows, it develops into a White Irish Afro (or Wifro, as I've coined it). Apparently we're going to find out what a full-on, full-blown Wifro finally looks like. And you too will get to see this unnatural phenomenon develop before your very eyes. It'll be like paying two bits to see the bearded lady or the six-toed man. Except this is free. And there's much less of a chance that you'll get molested by a carny...

Anyway, that's what I'm doing to support Teresa in her fight against cancer. I'm lettin' it grow. I'm growin' it out for cancer. And I hope you all enjoy and appreciate all the agony, misery, and increased expenditures on haircare products that I'm going to endure over these next 6-9 months. I'm doing it all for your amusement...Actually, scratch that. It's primarily for Teresa's amusement. And Seamus'. Because Seamus loves a good laugh at Food Guy whenever he can get it.

Oops, there goes my word count. The last thing I want is to be labeled as "wordy". There's not enough room for two of us like that on this blog.

See you all in March, everybody. Longer, shaggier, and substantially more democratier than before.

And may God have Mercy on my hair, and yours as well.

Yours in Dep,

Chris

Cancer is Expensive

Who knew? Maybe they haven't found a cure for cancer because there is so much money in it. Cancer Vixen figured out that start to finish it was just (barely) under $200,000 for breast cancer treatment. And hers was remarkably similar to mine.

So, yeah, the bills started rolling in today. Don't get me wrong, I've got insurance...good insurance (so I keep being told; which really makes me worry about what happens to people with "not good" insurance). It's still shocking to see the bills. I've paid $20 every time I phoned or drove by a Riverside health care facility (luckily, there just aren't that many of them) and I had to pay $250 for my deductible the day before surgery (new year, new disease, new deductible!), but that's basically been it so far. Until I opened the mail. The bills thus far only include up to the biopsy (and I think only 9 of the 42 departments involved in that have billed so far). The biopsy was January 9th. I've still got a month of bills to go! And counting...

My big plan today was to just relax and be home doing "normal" stuff while Chris was at Riverside Plaza interviewing future (or, um, maybe not) Princetonians for the afternoon. It started out okay--six loads of laundry or so. Right. I know. Who knew laundry could be a good thing. But in between whites and colors I sat down to pay bills online and get myself organized. Wow. Apparently it takes one tree of paperwork per medical procedure and procedure must be defined, by insurance folks, as one arm movement, hand gesture, step or thought. So I got billed separately for 6,439 items. I think they missed the extra bandages and surgical tape I received as a parting gift though, so bonus points for me!! And call me a skeptic, but I wanted to match up what my insurance said I owed vs. what I was being billed for. They say lawyers love their paperwork? Somebody is getting paid by the pound at Blue Cross, that's all I can say. And Riverside Community Hospital (who somehow owns and/or operates the facility that did the ultrasound and mammogram in December; which frightens me deeply--RCH, not the mammogram) has already sent a total of 6 bills--three of which were duplicates. They must be counting on the "squeaky wheel getting the bucks" theory or just hoping I'm really bad at math. Or just used to not being paid and a tad paranoid.

So between the time off work (I think I'm already at the equivalent of 9 days off work since this started December 18, 2008...not counting the couple of Saturdays I would have normally worked if I wasn't CANCER person; and when I don't work, I don't earn), the co-pays, deductibles and 20% pay for multiple procedures...yeah, cancer is freakin' expensive!! In better news though, also in the mail was Blue Cross's approval for a hospital stay should I need it immediately following the surgery that occurred 10 days ago.

Oh, and I filled out the 1/2" of paperwork needed to go talk to the Rancho Cucamonga oncologist. Luckily my job was made much easier by the fact that the "family history" portion very clearly was only concerned with "biological" family members. This eliminates 4/5 of my family. And yet, I still didn't have most of the information they needed. For example, 3 out of 4 of my biological grandparents were deceased before I turned 18. I don't know their ages at time of death or causes of death, nor can I imagine how that's relevant...so long as it wasn't breast cancer and it wasn't. And really, how is it relevant whether I'm heterosexual or homosexual and what religious preference I (don't) have?? I'm liking UCLA better and better and better. Plus, AMY HARRISON gave me all the second, third and fourth opinions I would need (UCLA has apparently saved the lives of just about anyone she's ever known...and I did see Amy the night before I first went to the doctor in December....hmmmm......).

A couple of other random notes...I was not lab experiment number 13. I was disqualified from the research. Yeah, I spent an hour in a tube the night before surgery for nothing. Okay, not quite nothing...from me they were able to learn that they can't do the MRI Spectroscopy testing on women who have the micro clips implanted in the breast during the biopsy. Don't ask me what the microclip is, other than some sort of minuscule marker to help find the spot later (and $352 on the bill). But it's there and it messes up the spectroscopy. So I flunked the research portion of my breast cancer studies.

And finally, Chris offered to shave his head in solidarity when I start chemo. Honestly, Chris has a gorgeous head of hair--really, it's "Democrat hair" (think Kennedy, Kerry, Clinton...yeah, you got it).


I would finally cry if he shaved his head!! I don't even like it when he gets it cut short! I've got wimpy, high maintenance, pain in the butt, limp hair. Who cares what happens to my hair?? So he came up with a better idea.

And he'll share that with you Sunday night, when I turn the blog over to him. For now, I'm going to go watch a silly movie. And the dog had better not die!!

I Got Nothing.

Yeah, I've really got nothing for you tonight. I'm pretty tired. I mostly worked today. But also, I've realized that my "Cancer Wins" concept (or the "Cancer Card" as the Cancer Vixen refers to it; and yes, that's her again on the left) doesn't actually work. That's just so my luck. I'm thinking it's worked twice in all of 7 weeks. Once with the aforementioned client and once when I asked JACK CLARKE (no idea if he Googles himself) to take over an emcee gig for me in April (and he would have done it even if I hadn't played the cancer card--he's just that way). But I've had a friend not able to get together because her spouse didn't think "cancer wins", an "opposing party" say "I'm sorry to hear that. And now, about me and the agreement I need" and today my older (bizarre on a good day) sister unsubscribed to my blog because she is, apparently, pissed off at me for suggesting that if she comes to the Birthday Boobie Bash on the 13th it would be good if she, you know, behaved herself. But she unsubscribed...so she's not going to see that I just said that, right? And unsubscribing must be the 2009 version of taking your ball and going home right? Except, I still have the blog...so it's the "I know you are but what am I" of '09...no, that's not it, it's the '09 slammed door or hung-up phone? Oh yeah, and it's ridiculous and not at all in keeping with my "cancer wins" theory!! Particularly if it's followed by "anonymous" rude comments posted to the blog. Wait for it.....

On the brighter side, thanks for the recommendations on oncologists. Funny, no one called or emailed with a Riverside oncologist recommendation!! But, I do have an appointment with Dr. Bosserman in Rancho Cucamonga on Thursday. She was recommended by Dr. Glaspy and another friend whose mother was a patient of Dr. Bosserman. And although they originally told me two weeks, they managed to fit me in on Thursday. Now, I've really got to fill out that 1/2" of paperwork. And, my therapist is also in Rancho Cucamonga (you think I'm this calm, optimistic and well-balanced without professional help?) so my Thursday is looking pretty full.

And today I had my last hair cut of 2009 (and the natural blonde highlights were restored). I think my poor hairstylist is going to need more martinis than I am the night she shaves my head! From everything I've read and heard, it's better to just bite the bullet and shave the head after the first chemo treatment. Since I really don't want to be sitting at my desk or, my luck, in a meeting with a new client when suddenly clumps of hair fall out onto the desk or table, it just makes more sense to shave it off. I'm thinking at home on a Friday night with a big, big, big martini and a wig, scarf and all sorts of accessories readily available for warmth or humor or fashion or denial. Whichever is needed. But that just seems like an easier way to deal with it. Easier being relative of course. After all, the doctor guaranteed my hair would fall out. How often do you hear a doctor guarantee something?? So, I've got 4 maybe five more weeks of hair. After I get over the initial shock, I think I'm going to like being able to get ready in under two hours in the morning (hey, there's still coffee to be savored slowly each morning) and not spending money on hair care products and cut and color. Right, 'cuz I'll be spending it on wigs, co-pays, gas, parking fees and prescriptions.

Okay, that's a whole lot of nothing. And Chris is giggling away in the other room watching "Airplane." Which is just about perfect silliness right now.

Reporter: What kind of plane is it?
Johnny: Oh, it's a big pretty white plane with red stripes, curtains in the windows and wheels and it looks like a big Tylenol


Speaking of Tylenol...off I go.

Pink to the Rescue

Okay, so I see (or hear) my description of the meeting with Dr. Glaspy concerned some of you as well. Thank you for your comments, emails and calls. But, um, no. I'm still not dying. But yeah, who knew cancer could be life threatening?! I'm doing the chemo and my odds are good. (I'm actually a pretty good gambler).

There are a lot of things that are quite strange about CANCER. Like the fact that there are so many different kinds (jeez, no wonder they haven't found a cure for it!). And then there's the part where when you actually have cancer--and by that I mean the clearly identifiable little bastard known as "the lump"--you feel just fine. It's only after they start treating you for it and excising it, exorcising it, zapping it, and radiating it into outer space that you actually begin to feel sick. Or bad. Or worried. Or....like a patient. With health issues.

Today, I felt like a patient. Which is perhaps a delayed reaction, but I rather liked the world I was living in (and will now be returning to) where I was spending time at UCLA but was not a patient (in my mind anyway!). I felt like a patient today because I worked and no matter how hard I tried to just be a lawyer, the looming health care issues kept knocking on my door saying "Excuse me, if I could just have a minute of your time..."

My assistant heard from a client yesterday who asked if I had cancer--because she overheard someone talking about it in a restaurant!! Right. I have a blog that anyone (with you know, electricity and a computer), anywhere, anytime could read. So it's not like it's a secret. But I'm pretty good at compartmentalizing my life and I had this crazy idea that my clients and perhaps my referral sources maybe shouldn't know. In the way that children should not have health issues (or die--but that's not happening!!) before parents, attorneys should not have health issues (or die--but that's not happening!!) before their clients. I told clients on a "need to know" or "they will be totally fine with the news" basis. Okay, and now it's on a "daily specials" list somewhere. Time to re-think my approach!

Then I went to lunch with a banker who I have met perhaps twice. There seemed to be some synergy (did I really just use that word??) in our client base and opportunities to work together and I realized as we discussed a few things...ummm....I may need to mention that "you won't really see me at quite so many events and uh, if you do I'll be bald. And fat. er. And lunches or introductions might be difficult coming in the next few months." So at the end of lunch I just went ahead and told him. He did a spectacular job of not immediately glancing at my breasts! And was remarkably kind (although I'm sure he's thankful I waited until after he ate and even at that he's thinking it's the oddest lunch he's had in awhile!).

By the time I got back to the office I was exhausted (not from the lunch so much as from waking up at 5a.m and not being able to get back to sleep). But then another "survivor" stopped by and really cheered me up. Because a) she had also consulted with Dr. Glaspy (the oncologist I talked to at UCLA) and found him to be "the best", b) she had lost 20 lbs in her chemotherapy and c) she had really cute hair!! Both the "cranium prosthesis" and the few inches of growth of curly hair she was growing back (she was done with chemo in July). Truly inspiring.

But then I went to work and had to return the phone calls (yes, plural; I cringe) of a client who got angry that I was "never in" and took it out on my poor (and did I mention pregnant?) assistant yesterday. Michelle is not, blessedly, in the habit of handing out personal information about me and this client had the misfortune to call twice when I was out for surgery and then yesterday when I was at UCLA!! So I had to fess up. And um, yeah, it works to say "I'm so sorry I couldn't return your call earlier. I have BREAST CANCER and was busy getting a lumpectomy." It works. But it's awkward at best. And I don't really want my clients working around my schedule or feeling like I won't be able to take care of them. He saw me not too much before surgery and I'm sure I looked perfectly healthy to him.So yeah, weird. Cancer is weird.

Next up was the ever-so-gentle reminder from Chris that I still needed to call the 2nd opinion doctor in Rancho Cucamonga. I called. They sent about a 1/2" of paperwork to fill out, plus I faxed all my "reports" over to them and....I may have an appointment in about 2 weeks. Yikes. Here we go again with the Inland Empire "not enough doctors" health care problem. And I deal with paperwork all day long, normally. I find I can't even look at that stack of paperwork I need to fill out, just so I can sit around waiting for an appointment 2 weeks from now. How many times do I have to fill out forms about my and my family members' history of heart attacks, cancer, psoriasis, menopause, tonsillitis, skin rash, anemia, shoe size, stroke, common cold, and favorite colors?? Maybe I'll deal with it tomorrow. (Next up: I'll make a dress out of the curtains!!)

I finished as much work as I could, closed up shop and walked out into the freezing sleet and wind. Alright, rain. And wind. And below 70 degrees, so I was instantly miserable. By the time I got to the car (which was like, 100 ft from my office door) I had worked up quite a little pity party.

I put in my anthem CD. Pink. Not just because of the color pink--I promise you that's a coincidence. I have no taste in music whatsoever. None. I'm tone deaf and grew up hearing nothing but my dad's constant Elvis music and my siblings head-banger noise then known as some-form-of-rock that I'm way too uncool to even know the name of (I just know it was ear-splittingly loud; and I was trying to read). So other than Jimmy Buffett I rarely like an artist enough to actually buy their music. But I like Pink. Chris gave me the Pink "Funhouse" CD as a stocking stuffer when we tried to pretend it was Christmas. I have found she has great "angry" music that eventually makes me smile if not laugh outright. And I like her strength. Pre-surgery the lines I had in my head were "Just a crack in the crystal ball. And I'm not afraid at all. No, I'm not afraid at all." (Repeat. Um, repeatedly. As necessary.)

Most of the CD is songs she wrote while going through a divorce. So she says. To wit: "This used to be a funhouse. But now it's full of evil clowns." But I ask you, how is that not about my right breast??

So today, Pink gets the "photo op" in this blog post. Because she made me laugh, because she cheered me up before I'd even gotten a half mile away from my office and because I think I can totally rock that hairstyle about 3 months after chemo.

Poster Children

On your left is the "Poster Child" for "perfect surgeon." And on the right is the "Poster Child" for...chemotherapy. First things first (although the meetings actually occurred in reverse order), today was my post-surgery meeting with Dr. Karam. My incisions are heeling nicely and no further surgery should be necessary. The bandages are all off and one day the bruising will be gone too. He also thinks the scarring will be minimal. He was however hesitant to break it off with me entirely, and I go back to see him in April. I think that's because he wants to see what I look like bald, but hey, who doesn't? And speaking of bald, Dr. Karam and I each thought our hair was looking particularly flat in this photo. His excuse was the surgical hat he was wearing previously (not from my surgery; it seems he has other patients). My excuse was....I don't know. Bad hair day. Gotta have 'em while I can!
(That's "Bad Hare Day" again by Robert Deyber, over to the right there).

There were also parting gifts. Dr. Good Karma gave me a book written by one of his colleagues (and with a forward by Dr. Glaspy, see below). It's called "Breast Cancer: Real Questions Real Answers" by David Chan. But on the very long drive home from LA Chris and I decided they probably rejected the title "Breast Cancer: Fake Boobs Real Answers."

Prior to our meeting with Dr. Karam, we met with Dr. Glaspy today. Dr. Good Karma says that Dr. Glaspy is "the man" and his word on chemotherapy is sacrosant. I'm sure that's true, but I have to say I've been spoiled by Dr. Karam, so obviously any other doctor was going to pale in comparison. Dr. Glaspy was, um, to the point, well, no, he rambled for awhile about being on a gambling river boat...so, um,...abrupt...direct? Well, okay, just lacking the finesse or charm of say, Dr. Karam. I don't know. But I had my only three mintues (during the now 7 weeks of CANCER) of thinking "I'm going to die??"

He was talking about what he does as like being on one of those casino river boats where he sort of strolls up and down figuring out the odds for people based on the particular hand they've been dealt. And my odds, he was saying, are not as good as some of the other gamblers on the boat. I was thinking 80% chance of recurrence; Chris was thinking 75%. And we were both thinking, "start the chemo now please!!" Dr. G's point was that "my" cancer may or may not have been left behind at UCLA Medical Center. And we currently do not have the technology to know for certain; they can only estimate based on statistics. So finally he gave me my odds, based on my pathology report (all about "my cancer.") There is a 30% chance of recurrence anywhere in my body. Which means a 30% chance of metastasis, which means a 30% chance of not living to collect social security. 30%, understandably, is considered unacceptable. BUT, if I do chemotherapy, that gets cut in half--15%. Oh, and my cancer is triple negative--which means there are no other treatment options that would work. No hormone receptors, no HER-2, and no something else (I think I stopped taking notes at this point), so no other treatments. This is why he called me the "poster child" for chemotherapy. There are no variables to my case that would cause oncologists to debate whether I was or was not a good candidate for chemotherapy. I am. Woo. Hoo. The chemotherapy is to give me the best chances that this doesn't come back anywhere else in my body. The radiation (after chemo) is to "save the ta-ta" only.

What he recommends is 4 chemotherapy treatments (I'll spare you the particular cocktail recipe--but it's interesting how many there are), 3 weeks apart. So 12 weeks of chemo. Which isn't all that bad. Then he says "the only side effect that is guaranteed is hair loss. You will lose your hair." He must have thought I was harboring delusions about this. I admit I had tiny, tiny hope that would not be the case. I had also heard that usually they will say "3% of women do not lose their hair" or something like that. But, nope. Guaranteed. He sort of seemed like "don't even bother me with your concerns or hopes or crazy ideas that this might not happen. It'll happen." And okay, there's a certain helpful aspect to that sort of "no bullshit" approach, but he could have at least said "I know that's tough, but it does grow back." Or, I don't know, offered up a 1% chance?? He did say that it happens about 2 weeks after the first treatment and it won't start growing back until after the last treatment. So 10 weeks (March to Mid-June) of absolute baldness (which is not a vodka, but should be) and then it will start growing again. Oh, and it might be darker and it might be curlier. I have stick straight hair (note photo!); this would be shocking! So, by the time we head to Maui for Jimmy Buffett's birthday in December, I may have like 3" of (dark curly) hair. Hats are a distinct part of my future!

So then we were shown the chemo treatment portion of the facility. Big comfy and yet scary looking recliners with a little snack bar and a few accouterments. I can bring my laptop, but can't use a cell phone. (Blogging while chemo-ing!). Then we met the nurse practitioner who manages the case and gives the chemo. I like her a lot. She gave me all the instructions (not as much as I thought) about what I can and can't do or eat or drink (wine is still okay!!) and more bad news (weight gain is normal; because you know, what's bald without fat?), and then gave me more prescriptions than I've ever had I think in my entire life combined. But the last one made me laugh. She handed me a prescription for a "cranium prosthesis." I get a new head!!!! This is apparently how insurance covers payment for a wig. Hysterical.

I am still going to get a second opinion. Not so much because I'm hoping for a different answer, but because I'd like to see if we could accomplish the same thing closer to home. As I understand it the chemo-drip day will be a pretty full day and I won't be bouncing back to work afterward. And the next day is also likely to be a "not able to work" day, but after that, Dr. G thinks I'll be fine to work. "But everybody is different." So feasibly, since it's only 4 trips to LA, we could do this. But then Chris is sort of stuck in LA waiting around with me (which he's more than willing to do) and then there's the drive home (when I might be sick). So we're going to look around and see what other options there might be. (Chime in by email or comments below if you have a good oncologist referral in the Riverside area--or closer than LA anyway). Because when we get to radiation (July), that will really need to be nearby.

Busy day, huh? Yeah, it was a lot. And Seamus spent half the day at the Riverside Humane Society (where some of the folks there volunteered to take care of him) and then went home with Destiny and Shawna because he was "highly anxious" (which is a euphemism for barking his head off and buggin' everybody else). Thanks to all who took care of him today. I guess this is finally getting to him too. He's not big on schedule changes. Now he has assumed the normal zonked out on the couch position by the fireplace. I may have to join him.

From Inside my Cancer Bubble

A few folks have mentioned that I'm a bit "wordy" with my postings. So I'll try to keep this one short (well, short for me, since I'm prone to those parenthetical meandering tangents. Is that redundant? Can a tangent still be a tangent if it doesn't meander? Discuss amongst yourselves.)

This morning my assistant Michelle had to email me at home and gently remind me that she (who is 8 1/2 months pregnant) had a doctor's appointment and that I was supposed to get in early (before 10) so someone was in the office. This came as a surprise to me, despite the fact that it's on my calendar and well, yeah, you can kinda tell she's pregnant (because she normally weighs 6 1/2 lbs and currently she's pushing the limits of eight, maybe nine pounds). But still, other people have doctor's appointments? Wait...the world keeps going while I have CANCER? Apparently so.

And then there's this whole self-indulgent blog thing. I write it pretty much nightly, as cheap therapy. But it never really occurs to me that other people read it (so I'm convinced that 3 people are coming to the Friday the 13th Boobie Bash...and that's all the wine I'm getting, until I have reason to think otherwise). Today two different people quoted parts of my blog postings back to me and I reacted as though they'd read my secret thoughts. (How did they know this?) Or secret thoughts of some really disturbed person that I might have one time known. And then I got an email from a friend whom I had just recently thought "hey, she doesn't even know if I survived the surgery or what the heck is going on. She doesn't call, she doesn't write..." And her email said "I'm so glad to hear things are going well. How great to see a picture of Corby." I had to think, "where did she see a picture of Corby??" (Sunday posting...just a few down.) So I guess she does know that I survived. But how do I know that she knows? And how does she know that I know that she knows? I don't! I live in a cancer bubble!!

Inside my cancer bubble I know things like this: I've received three different calls from Dr. Good Karma telling me that the lymph nodes were all clear. Today was the "official official" word. Several tests are done, it seems, so now we're all clear on this. And also: the tumor was "officially" 1.7 cm. Not the 1.5 we thought from the ultrasound, nor the 2.0 we thought from the MRI. 1.7. I guess the little bastards can be tricky and you have to cut them out and pin them to slide to really get them to give up the information. And finally, "my" cancer (although, I believe I have relinquished it to the UCLA Medical Center at this point) was at Stage Ic. And did you know they add letters after the numbers? I'd always heard Stage I, II, III, IV. I suppose now that "they" know there are so many different kinds of cancer and different risks they had to come up with more scoring techniques. It's sort of like what they did to gymastiques in the Olympics last year (no, not the part where 8 year old girls pretended to be teenagers; just the scoring part). So now I'm in deep discussions with Dr. Karam over whether it's properly stated as 1c, 1C, Ic, IC or, my personal favorite I(c). (Note strong resemblance to the surgery...)

And finally, in my cancer bubble, I think things like "it all sounds so serious: CANCER. But really, I'm far more likely to die in a car crash and wouldn't that be ironic?" I usually think this as I make left hand turns without consciously checking for oncoming traffic. I'm not fond of driving and I've been in two roll-over car accidents--both on freeways, or well, off a freeway in one case. I was only the driver in one of those and a contributorily negligent front-seat passenger in the other (Hi Gary!!). But still, it's a legitimate thought.

I wonder if this bubble I'm living in can be dangerous? When I get out, I'm going to ask someone. But here's the thing--at her doctor's appointment, Michelle was told she had herpes. Because they were holding someone else's chart!! Some other pregnant lady who actually does have herpes (not Michelle. Let's be clear on that). That doesn't happen to me inside the cancer bubble!!