Some Nice Straightforward Dithering

Yesterday I had my introductory appointment with my chemo doctor, Dr. L. My friend Frieda*, who'd been to the same practice when she was being treated for breast cancer, went with me and took notes.

There weren't really any major surprises about this part of the deal. I'll be getting my chemo through an IV, not through a port as I'd thought (thanks to the UPMC radio ads/public service announcements that've been running lately)-- my Stage 1 cancer doesn't warrant the big-gun doses that come with a port. Half hour of Carboplatin each time, then three hours of Taxol. I could have sworn the doctor said it was the other way around, but that's what Frieda's notes say and that's why I had her there taking them.

I'll have pills against nausea and Benadryl against some of the chemo side effects. Yep, this will all make me drowsy/spacy, and yep, not a good idea to try to drive myself home afterwards.

They'll check my blood cells and CA-125 levels each time. If the cells counts remain sufficient, the every-three-week schedule will continue; otherwise, I'll have to hold off a bit till they come back up.

I asked about supplements. A regular multi-vitamin might be okay, Dr. L said, but dosing up on one nutrient or another won't do me any good and may do actual harm. Better to do my best to maintain a healthy, balanced diet.

What about hydrocortisone creams? I'd read somewhere you can't apply steroids like that during chemo, but what am I supposed to do, mosquito season is here! No, he said, there's no problem with that, I can use them all I need to.

But speaking of skin care . . . I'd hoped my Sun Protection Factor 15 face cream would do, smeared on the top of my soon-to-be-bald (sob!) head. Nope, he said. SPF 50, at least. Wear it all the time outside, whether I have a hat on or not. "I'll get you some," said Frieda, who's recently started a job at a drugstore. "We have it on sale."

As to post-chemo-session side effects, they may not kick in till two days after. If five days afterward I'm still losing my lunch (or throwing up my immortal soul, as Mark Twain once memorably put it), that's the time to call the Cancer Center or the ER.

As I said, this was pretty much all fine-tuning and logistics. I didn't exactly thrill to the thought when Dr. L tole me what his mentor in med school, who is "an ovarian cancer guru" would have said about the fluid-filled capsule that ruptured in me. Dr. O, he said, would have classified my cancer as a Stage 2 because the sac was stuck to the abdominal lining, the peritoneum. "Hey! I don't need that!" I protested, doing the anti-vampire finger cross at him. "1C is bad enough!"

"No, I'm not saying you're Stage 2. Just emphasizing that you've absolutely made the right decision to go for chemo."

Oh, all right. Besides, no cancer was found in the solid areas of that capsule. Or in the scrapings of the peritoneum (taken from where it was stuck to, I should think???)-- they came up negative, as well. So there.

I mentioned that I'd learned online that my particular form of tumor is very rare as ovarian masses go, and that in 95% of those cases (or some number like that), it's benign. Just my luck to come out on the other side of the odds!

Yes, that's true, but at my stage and grade it will respond well to the chemo-- if there's any cells that escaped at all. Nice to hear, since I'd been on a cancer support chatroom where a couple of patients had said they'd been told that this mucinous kind is resistant to chemotherapy. Bugger that. If-- if!-- there's anything there, we gonna kill it dead.

We scheduled the first treatment for June 14th, after my birthday on the 12th and after school's out on the 9th. I'm doing mine on Mondays, so I'll (God willing!) be recovered enough to preach on any given Sunday this summer. The 7th was the date Dr. L suggested at first, but with my case, he said, another week wouldn't matter.

After I got dressed, it was off to the blood lab to give a sample so my base count could be determined (Frieda didn't have the nerve to stay in the room and watch-- shades of her own treatment), then to the scheduling desk, then to an interview with the financial aid counselor, concerning which I shall maintain a discrete silence.

Still all pretty darn straightforward. The dithering part begins with the brochures and pamphlets and certificates the scheduling nurse gave me about wigs and turbans and other headcoverings.

My hair should start falling out two to three weeks after the first treatment. I'm going to have to have some covering options, because this kid is not going "bold and bald." The world is not ready for the horror, nor am I. And laugh if you like, but I have gut-level religious objections against going around shaven and shorn, even chemically. But last night I'm looking at the wig catalog they gave me, and I'm thinking, these are inexpensive, that's good, a lot of them are cute on these young, high-cheekboned models, but I'm not madly in love with any of these styles for me, and none of the available hair colors really match mine, and do I really want to get something like this mail-order? And don't ask me why, but the fact that this company has given all their wigs girls' names really gets on my nerves. "Oh, golly, the best-looking wig is named 'Esmerelda' and a girl named Esmerelda was my worst enemy in grade school and now I gotta go round with her on the top of my head??!!!"

What I want to do is go to a local shop and have somebody advise me. Actually, the cancer center did give me a reimbursement certificate worth $200 that's good at a couple of area wigmakers. But there's still the question of real vs. synthetic and maybe real is way out of my price range and they say that it's harder to care for anyway, but what if synthetic is plastic and fake-looking and-- and-- and--!!!

OK, kid. Calme-toi, m'amie. Frieda has offered to bring me her wigs to show me what they're like, and I'll take her up on that. And I have the number of the nearest wig shop where I can redeem this certificate, and I can call tomorrow and make an appointment.

It. will. all. be. fine!

It may sound weird, but it's important for me to have this hair/head covering thing worked out before I start chemo. People are sympathetic enough already without me running around looking like "that poor cancer patient." And while I can forget and ignore the hysterectomy scar that's healing very nicely on my belly, every mirror will remind me that something in my body turned zombie traitor on me. I prefer to spend as little time as possible the next few months with my hopefully ex-cancer getting in my face.

Home Again, Home Again, Jiggity-Jig

I'm home from my outpatient surgery. Got discharged around 2:30. I've got to see my doctor for follow-up in two weeks, after the lab work comes in, but in his judgment everything looks all right.

Praise God and hooray!

I'm told I'm supposed to rest and do no work the next two days. I established that "work" means going out in the garden and pulling weeds. I didn't ask if it also meant sitting in front of my computer working on church-related matters. Or blogging.

If it does, too bad. I've gotten that "work" done and now I can do my relaxing with a clear conscience.

Test Results

I had my conference with my doctor this morning, and I was surprised to find I didn't have anything to be surprised about.

After all, three weeks ago when the nurse practitioner sent me for the sonogram, she did say I'd most likely be going for a biopsy thereafter. I mean, if nothing had shown up on the sonogram, where'd the initial symptom come from?

Only thing different is that the kind of biopsy I'm being sent for will entail my going under general anesthesia, not a local plus a head drug to send me into LaLa Land. I don't mind that for me-- I deal with anesthesia well enough. But it certainly adds to the cost.

The doctor was good-- or factual-- enough to say that the possibility of cancer is way down low on the list. That's a nice little sop to quiet the kishkas.

I'm to hear next week when the biopsy will be. And see how it goes from there.

After I left the doctor's office, I sat on the banks of the river, reporting in to my friends Frieda* and Hannah*, and watching the boats at their moorings. Something very peaceful about boats, I always think, whether they're going any place or not . . .

And Now, in the Medical News . . .

Almost four weeks ago, I discovered that my body was doing something it should not have been. Nothing shocking, or alarming . . . just . . . out of place.

So being a person of my time, I Googled this symptom, and found that it can betoken anything from stress or a mild infection, all the way up (or down) to cancer.

And that one should see one's physician about it as soon as possible. Which I did, in the next few days.

Findings from that examination were inconclusive. Actually, the test needed could not be run on me in the doctor's office. So I was sent for a sonogram at the regional medical center.

That came off on the 1st. The tech told me I'd have my results back in "one or two days." And that usually, if everything's fine and negative, they won't phone you at all.

I waited the 2nd. No word. The 3rd. No word.

Didn't consider myself out of the woods yet. "One or two days" can stretch to three and even four, if the lab is busy. And Friday the 4th was a holiday and Saturday and Sunday were, well, Saturday and Sunday. A friend of mine who's been through breast cancer and come successfully out the other side told me I should be sure and call the doctor's office regardless, to find out. Said she knew a woman who didn't know her test had come up positive until the hospital called her six months later to learn what treatment she'd undergone for the disease she wasn't aware she had.

Yes, I told F*, I was going to call on the Monday anyway. Count it as the third day.

And I did. Left a message at the voice prompt for "test results." Got a call back a couple hours later: "Oh, yes, your results are on the doctor's desk. He'll look at them and get back with you tomorrow."

No word on Tuesday. Was it because there was nothing to tell? After all, for the past two and a half weeks I haven't observed the symptom that drove me to the doctor's office three weeks ago. If I have any pain, it's my digestive system doing my worrying for me-- a task my brain never asked it to undertake-- and it varies with what and when I eat-- whether I'm occupied with work and other people or sitting around with an idle mind--which all sounds like stress to me.

But Wednesday morning, early yesterday, I got a call from the physician's nurse. She said, "The doctor wants to make an appointment with you to come to his office to discuss the options on your sonogram."

The appointment is set for 9:40 tomorrow morning.

But "options." What's this "options"? Will I have "options" indeed, or is that just doctor-speak for "Either have major surgery tomorrow or expect to drop dead in two weeks"?

I guess I'll find out. Meanwhile, I'm mentally practicing being intelligent and receptive of whatever he'll have to say. I don't want to sit there looking stupid-and-stunned or launching myself into the hinterlands of denial.

And I'm praying there will be nothing to go into denial about.

Time Warped

The other night I was looking up something on a health website. As health websites tend to do, it featured links to other articles the reader might be interested in.

"Ten Reasons Why You're Always Tired." Or something like that. Worth clicking on, since these days I get at least eight hours of sleep, sometimes nine or ten, but still feel drowsy by late afternoon.

(As for feeling bright and cheerful to pop right out of bed in the morning, let's not even bring that up.)

This article suggested that if it takes you a long time to get to sleep (as it does me), maybe you should rethink spending time in front of the computer or the TV just before going to bed. Sitting in front of the bright screen inhibits the body's natural output of melatonin, the chemical that tells you a) it's getting dark, b) you're getting sleepy, and c) it's time to get some shut-eye. Turn off the computer or the tube at least an hour before bedtime, and you should get to sleep faster and have better sleep.

Hmm, think I. There may be something in that. Night is my computer time, mostly, and I've noticed that I can sit in front of the screen for hours on end, feeling tired and tired and more tired, but not exactly sleepy. Could melatonin inhibition be keeping me awake? That, on top of the stimulus that's pushed into my brain by whatever I'm working on and whatever I'm picking up surfing the Web?

Very possibly.

So for the past few nights I've tried not going on the computer after 10:00. Which, given my habit these long evenings of working in my garden till the light is gone and then coming in to make and eat dinner, means I haven't come up to work on my computer at all. And so, no new posts on my blogs.

But tonight I thought I should post something. At least as an explanation. Even if it wasn't exactly worth waiting for.

There is one other thing, about this, however:

Two years ago I was having trouble with falling asleep in the middle of the day, sometimes when I was behind the wheel. My GP sent me to a pulmonary/sleep specialist. I'm sitting in the Great Man's examination room, he walks in, and without preamble says, "All right, who made you come see me? Was it your husband? Your boyfriend? Your roommate?"

I was surprised at the question, but I gave a straight answer: "I came of myself."

"No, you didn't," he said. "Nobody ever comes of their own volition. Somebody always makes them."

A bit (no, a lot) more of this from him revealed that he was convinced that every problem with daytime sleepiness is caused by sleep apnea, one symptom of which, of course, is snoring. He was sure sleep apnea was my problem, and once it was confirmed by the sleep study he was prescribing for me, he'd get me set up with the CPAP machinery.

I was permitted to get a few words in edgewise, and I mentioned that when I'd been working intensively on something (like a sermon), I found it hard to get to sleep afterwards, even when it was very, very late.

"Your work has nothing to do with it. Your subconscious mind is keeping you awake because it knows you're stopping breathing in your sleep and it's afraid of that."

At which point I began to wonder if he were getting kickbacks from the CPAP machine sellers.

Well, I did the sleep study and no, I did not have sleep apnea. The Great Man thankfully left the explanation of the results to a medical assistant, who basically told me, "Hey, if you're only getting four or five hours a sleep a night, you have to expect to fall asleep in the middle of the day."

But after seeing that website article about the melatonin-inhibiting tendencies of staring at a computer screen just before bedtime, I have to wonder why the Great Pulmonary Specialist was so tunnel-visioned as not to think of it.

I think it's worth considering, myself.

"The Creation Waits in Eager Expectation . . . "

Thursday morning I had an appointment at the doctor's office. In time I was ensconced in the examination room, in that state of deshabille that is required of one in doctors' examination rooms. But the doctor did not appear. I waited and waited and waited some more, yet the doctor did not come. There was nothing to read in the examination room, only a few posters of adorable children on the walls and one on the ceiling, depicting a tree being struck by lightning-- which I take as an example of my doctor's sense of humor. Even if there had been anything to read in the room, I wouldn't've wanted to get up and fetch it. It was chilly enough in there as it was and I didn't want to raise a draft.

But I had to do something to pass the time. So I made up a waiting song. And after I went home, I finished it. Here it is:

We are waiting,
We are waiting
For the sons of God to be revealed;
When all creation
Will shout in wonder
When we shall be revealed.

M: Who are the sons of God?
W: All who believe in Christ,
A: Male and female, Jew and Gentile,
We are the sons of God!

And we are waiting . . .

W: How does He give us life?
M: By dying for our sins;
A: Took our punishment on Calv’ry,
Jesus the Son of God.

And we are waiting . . .

M: How does He make us sons?
W: By rising from the dead;
A: Puts His life eternal in us
And makes us sons of God.

And we are waiting . . .

W: What is our hope and prayer?
M: Our rising from the grave;
A: Clothed with Jesus Christ forever,
Adopted sons of God!

And we are waiting . . .

(Copyright 2005 St. Blogwen's Well)

This evening, I wrote down the tune for it. The chorus is behaving very badly, wanting to sound entirely too much like the kids' song "Father Abraham." It's a traditional song, but I hate anything that smells like plagiarism. Nevertheless, it's what the words wanted, so it is what it is.

And my doctor's visit? Oh, that revealed that all is well. And may it be the last of its sort for a good long time!