Beating the Odds-- So Far

Not mine, but illustrative

I don't believe in food-as-medicine.

Yes, I believe in getting one's nutrition as much as possible from healthy, wholesome, locally-grown food eaten in reasonable amounts and proportions.  But when it comes to the esoterica of when and how and how much and in what combinations, my response is "Non credo."

You've seen them.  Articles from nutrition pundits who tell you to eat a cup of fresh blueberries three times a day every day for the rest of your life.  I like blueberries, but not that much!  Or blog posts insisting that all grains are inherently bad for people and one should never eat them.  Or the book that tells me I should never eat red meat after three in the afternoon, and then only if I've done four impossible yoga poses before sunrise.  And don't forget the earnest folks who tell you you can't possibly be healthy unless you consume some exotic fruit or herb found only on some South Pacific island the Polynesians have never heard of.  No.  Can't swallow that.

But there's a way lately that I have been taking a more therapeutic attitute towards food, and to some extent it's paying off.

A couple of things dovetailed this spring, and a very portly dove it was, too.  The first is that the low blood sugar I've put up with since my college years at least seemed to be getting worse.  I found myself getting lightheaded more frequently, and even feeling I was going to faint a time or two.  Yeah, some people would say I should run off to the doctor and get tested for diabetes.  That's not me.  If I can deal with it myself, I will.

The second thing is that I noticed that I'd gained a lot of weight since my last post-chemo weigh-in in late February.  Above the waist, where I generally don't put it on.  Rolls of flab on my back.  No more definition in my upper arms.  The pot around my belly button greatly increased.  I hadn't changed my eating or activity habits at all, but here it was getting difficult if not impossible to fit into my clothes.  What's this all about?

So towards the end of May I decided to tackle both these problems at once.  I'd change my eating habits.  I wasn't going on a diet, oh, no.  Nor would I renounce any particular food.  I've been at this weight loss game long enough to know that that's the recipe for desperation and disaster.  No.  Instead, I began to stretch out my meals.  Instead of eating three largish meals a day four to six hours apart, I'd spread them out.  Have the protein at one little meal, then two to three hours later have the starch I would have had with the protein.  Be conservative about portion sizes, and learn to enjoy, say, new potatoes boiled with just salt, pepper, and parsley, no butter or gravy.  Of course I had to go back to enforcing my no-eating-after-9:00-PM rule.  By all this I hoped to keep my blood sugar even and kickstart my metabolism so maybe I could lose a little weight.

I'm still at it.  It's been interesting the past month.  My birthday is in mid-June, and customarily I share the celebration with my friend Frieda*, who was born in late May.  We celebrated this year on the 2nd, and I made our favorite sour cream chocolate layer cake.  Sent a good two-fifths home with her and shared a couple more pieces with a small neighbor boy who has no compunction about opening my fridge and begging for whatever treats he sees inside.  This left me about half the cake.  You know it took me three and a half weeks to finish it?  I could say I'm "restricting" myself to one dessert "meal" a day, but the fact is, I don't feel like having more than that.  The cake was a little dry by the time I ate the last piece the other day, but it was still good.

Sometimes stretching meals out can backfire.  Couple weeks ago I ate something that was evidently past its use date.  Evidently, judging by all the painful pot-sitting I had to put in that morning and afternoon.  Banana bread.  Spoiled banana bread.  Ordinarily, I would have finished that ages before, but not this time.  I've learned to put things in the freezer if I'm not going to eat them in a reasonable time.

Happily, this regimen seems to be working to even out my blood sugar.  I might still feel a little lightheaded when I finish one of my snacky-meals; normally, that would justify my eating more right then.  But with a shallow nod to the food-as-medicine advocates, I tell myself, "No, let the food work.  You wouldn't take another dose of aspirin if your headache wasn't gone the moment you swallowed the first two tablets, would you?  All right then."  And most of the time, the airheadedness soon goes away.

However, it didn't seem that I was losing any weight.  I have two body scales in the house, neither of them accurate, but their inaccuracy was not encouraging.  I was still being squeezed by those fat rolls above my waistband, and the post-hysterectomy pot below my waist was as protruding and obtrusive as ever.  What was wrong?  I can swear I'm eating only two-thirds to a half of what I was before, so why aren't I dropping the pounds?  It's not like me to get cancer head before my post-chemo checkups, but I found myself wondering if something was Wrong.  Especially since my digestion isn't totally back to normal after that bout of food poisoning.  Oh, lord, what if the cancer had come back and got into my intestines?

It didn't bear thinking of.

So I didn't.  Instead, I went online and looked up "menopot," a cute name for the very uncute bulge we women often develop in our midsections post-menopause.  None of the articles I read was specific about the precise location of the bulge, above or below the waist, but all agreed that it was endemic, annoying, and about impossible to get rid of.  I gathered also that I shouldn't gripe that I'm fighting it now, after my cancer surgery.  The remarkable thing, apparently, is that it didn't set in seven years ago when I hit natural memopause.

So my triannual post-chemo checkup was this morning.  And withal I braced myself for possible bad news.  But all my test reports came in normal, all my numbers are good.  So with my former ovarian cancer, I am continuing to beat the odds, so far.  And as to my weight on the doctor's official scale . . . ?  Down.  Five pounds from my February weight.  Being weighed in jeans.  Which may mean I've lost six or seven pounds since the end of May, since I know I gained some since the February weigh-in.

And I have to admit that those jeans are size 8 slims, and it's easier to zip them.  And my tape measure says I've lost a half inch off my waist in the past month.  So enough with the pessimism!  When it comes to post-menopausal weight gain, it looks like I'm beating the odds there as well.

So far.

Coming Through

This past Monday was my last chemo session!  GodwillingGodwillingGodwil-ling that's the last of the Taxel and the Carboplatin.

I should have been done the last Monday in September, but my persistently-low white cell counts made it necessary that my treatments have four weeks between them, not three, after the second infusion in early July.

Anyway, all six are past now, and I've really come through it pretty well, considering.  My eyelashes, eyebrows, and most of my head hair are gone, but I expected that.  I never lost my sense of taste and actually gained about three pounds.  My luck, right?  It's just that every time I'd think of eating raw vegetables out of my garden, I'd get a scratchy feeling in my tummy and headed for the bread and pasta instead.  Everybody says my color is good (whatever that means), and with the wigs I manage to pass for healthy with people who don't know me well.

I am being annoyed with a spot of peripheral neuropathy in my fingers and toes, since my fifth treatment the end of September.  My toes feel continually like there's crud between them, and my fingertips sometimes feel like sausages.  But they don't actually hurt and I do all right, regardless.  I mean, I can still fasten my jewelry and obviously, I can use a keyboard.

About the only thing that's bugging me in any real way just now is a bronchial infection I developed about a week and a half ago when I overdid it raking leaves a few days in a row and can't seem to shake.  This is a real joy (not), since I'm heading into my lowest white cell count.  I wasn't able to come in to teach when I was called this past week, and won't be able to until this clears up.

Here's the funny thing, though:  It really looks like my head hair is already trying to come back!  I noticed this on Tuesday, the day after No. Six.  Little white or light blonde spikes, all over my head.  They say it's supposed to grow in baby-soft and fine, but this definitely feels prickly to me.

Oh, well.  At least it's not red, like some bright soul suggested.  Not that I have anything against redheads; I just don't have the coloring for it.

I'm Not Sure

I had my first stint substitute teaching today since before my surgery last April, and I'm not sure I have the stamina for it.

If I were a better cat-herder-- I mean, a more proficient emergency teacher of 2nd graders-- I might think differently.  But by the end of the school day I was nearly weeping from exhaustion.  And now it's almost 7:00 PM and I'm sitting here still in my work clothes starving to death because I'm too shattered to get out of my desk chair.

Except for one child, who was so obstreperous early on that he started kicking the aide and had to have Security called on him, the kids weren't malicious or bad . . .  they just didn't know how to stay in their seats quietly doing their work.  They didn't understand that finishing a test early didn't give them the license to walk around the room bothering those who were still working.  They didn't realize that the end-of-the-day leaving chaos was not a good time for them to blindside me with fundraising forms, saying they had to take them to the office. And as my limited energy ran out, so did my creativity.  By 3:00 PM I was reduced to saying, "I know nothing about that.  Ask your teacher on Monday."

I'd just say No to substituting until the chemo treatments are over, except that a) I need the money; and b) I'm on a tiny bit of Unemployment Compensation, based on the subbing I did last fall and winter, and if I turn down work it's deducted from my benefit amount.  I don't know: the full possible benefit is equivalent only to two days of work and may not be worth demolishing my health over.  But again, anything coming in helps and it seems wrong to forfeit it.

My throat is sore, my sinuses are blocked, and I need to go eat. But I'm on to preach on Sunday with a sermon still to write so I won't exactly be resting this weekend.  We'll see what my blood counts look like when I go in for my chemo Monday morning.  The way my body feels now, I'm frankly glad I can't accept any teaching work that day, whether they can infuse me then or not.

Round Two, Week One

Received my second chemotherapy infusion yesterday.  Nurse Nell* was willing to forego trying to put the cannula into the back of my left hand this time, but the first wrist vein we tried eluded the needle when she put it in.  So it was back to the tried and true sites on the inside of my wrist.

No flashbacks to the keg parties at the college dorm from the Benadryl this time.  When I told Nurse Nell it hadn't made me feel sleepy, just drunkish, she gave it to me more slowly.  And as the afternoon wore on, I was certainly tempted to catch some ZZZZs!

I exercised some discipline and used the first hours mending two more sweaters.  I will not have the schoolchildren next fall laughing at the holes under the arms of my cardies!  That wasn't a penance, despite the heat outdoors.  They do an excellent job at the Cancer Center keeping the interior climate controlled, not too chilly and not too warm.  Haven't needed to use the quilt I brought yet.

This time, though, I didn't get as much Western Civ literature read.  Brought my laptop and wasted a lot of time trying to get online via the fragile guest wireless signal they provide.  Managed to make a couple of Facebook status reports, but otherwise I was refreshing and refreshing and trying, trying, trying to reconnect more than I was working or surfing.

My pod mates were all older gentlemen.  One being treated for abdominal cancer (Eh.  That's the metastasis from my ovarian cancer I'm trying to avoid), one getting chemo for colon cancer, and the other one, I didn't ask.  The colon cancer guy was on infusion eight in a course of twelve.  Wow.  He told me that people "sail through the first one or two treatments, but it gets rougher after that."  Uh, yes, I've heard that can happen . . . meaning that every good day or week I have is to be received with conscious gratitude.

(I'm on to preach at least three times this summer.  Wonder if I should write those sermons now, while I'm still feeling half-decent?)

They must all have been getting different medications than I, because none of them were sporting chrome domes.  Me, I'm thinning out more every day.  (More on that below.)

It was interesting, too, that I was the first one in the pod and the last one out.  I started my pre-meds a little after 11:00 AM and finished up my chemo at 4:30.  Only one other woman was there getting chemo after me. 

My report time was actually 9:45, but I saw the doctor and had my bloodwork done first.  Found out from him that yes, I may take my beta-blocker pill if I need it; yes, I can have a glass of wine or a beer if I want it; and the reason I've had the munchies the past week and a half is because that's what Decadron, the steroid they give me pre-chemo, works.  It has been weird:  First ten days post-chemo, I've craved small meals of very healthy food.  Then bang! my blood sugar was crashing at the most unexpected times and I wanted chips!  donuts!  cornbread!  hot dogs!  at all hours.  And don't show me a piece of lettuce, though every lettuce plant in my garden should bolt from neglect!  I gained nearly a pound and a half since the 21st.

Today I'm back to the healthy eating phase.  At the moment I'm consuming a nice salad of lettuce, shelled snow peas, purple sweet peppers, mushrooms, and shredded cheese, the first three ingredients all from my garden.

Last night, I ground up some more leaves and mulched more of the vegetable garden.  I'm feeling quite normal today, too, maybe because I'm heeding the instructions and taking my anti-nausea pills even when I feel just slightly queasy.

My American Cancer Society wigs have come in and the best of them is the "halo" (tonsure!) you have to wear under a hat or scarf because it has no pate to it.  All of them need the bangs feathered out and thinned down, and I'm wondering if I've been a little too daring in ordering the Sabrina model in the golden blonde.  Though I've historically been on the blonde side, the dark brown of the Caitlin looks more "me," somehow.  And whichever one we're talking about, I think I have to get used to more bulk at the top.  Must be the Current Style.  But these aren't so bulky and wiggy as my "official" cancer wig is.  It still looks awful.  I tried it on for Frieda* when she came to pick me up yesterday morning and she thinks it definitely needs major pruning.

Oh, well.  I'm thinking of taking my whole wig wardrobe over next door the next time everybody gathers on the neighbors' porch and letting them say what they think.  If the golden blonde is agreed to be Too Much, I can always try again in my usual dark brownish (aka "dirty") blonde.

Once I'm satisfied I have at least one whole wig I won't be embarrassed to be seen walking about wearing in public, I'm going to drape a towel around my shoulders, take my hog-bristle hairbrush, and brush, brush, brush my hair right outta my head.

Do You Want to Go for a Ride?

I am two years and six weeks old. I am lying on a strange, high bed set outside a door in a long, gray corridor full of doors. Suddenly, a dark-haired young man in a white coat looms over me. His face is marked by disapproval, and a little alarm. His expression voicelessly rebukes me: "Why aren't you asleep?" (I know this grownup look.) He recovers himself, applies a smirk, and says to me, "Little girl, do you want to go for a ride?"

"Do I have any choice?" I think to myself.

I don't. I'm about to be taken to surgery to remove a benign cyst that has closed my left eye. I am not aware of this, or I had forgotten it, but I yield where I cannot rebel. More young men in white coats come, the high bed turns out to have wheels, and off I go.


Yesterday afternoon I had my first follow-up appointment with Dr. C, my gynecologic oncologist. Though nobody told me this ahead of time, I figured the agenda would cover checking up on how I'm doing post-op and discussing my further treatment.

I've been remarkably free of what is called "cancerhead"-- uncontrolled and fearful obsessing over one's cancer and its implications. But going into this appointment, I had three things I hoped would happen or that I would not have to face.

First, that I could ask my surgeon how my ovarian tumor came to rupture without coming across as judgemental or as casting aspersions on his competence.

Second, that he would not, in anywise, suggest or recommend radiation therapy. It's one thing if you're fighting breast cancer, but there's too much essential equipment in the abdomen that can get permanently fried. And according to accounts I've read online written by women who have gotten radiation for ovarian cancer, at some point in the process they administer the treatment by way of rods put up your . . . well, you know. O noes!! Du nawt want!!!

And third, that it would all be straightforward and conventional and I wouldn't have to make any hard choices. Did I want to go for a ride? I don't know, you're the prominent gynecologic oncologist, you tell me!


It worked out well that Ellen*, the friend who drove me to the doctor's office, is a Registered Nurse-- not in oncology, true, but knowledgeable and able to take notes while I asked questions. Did I want her in the exam room with me? You better believe I did.

So there we are, waiting, and in comes Dr. C wearing a bolo tie. Don't mess with Texas? He grins and says, "Boy, you just have to cause trouble!"

"Yeah, gotta be original!" I quipped back.

How original I am, he was about to tell me, right after my exam. Seems that when they got me open, they found that the tumorous ovary was lying on top of a sac of clear yellow serous fluid-- "It looked like pee, if you want to know." The ovary was adhered to it and it was adhered to the tissue below/anterior to it-- "Like endometriosis-- I had a terrible time getting it all off." It was this sac of liquid that ruptured; the problem ovary itself came away whole. And the quandary is, was that sac part of the tumor or something entirely separate stuck to it? The serum in it looked nothing like what was in the ovary (which Dr. C said "Was full of brown sludge.") And when the lab tested some of the serous fluid, it came up clear of cancer cells.

So that took care of concern No. 1. I'd figured adhesions came into it . . . Could that have been the septation Dr. P my gynecologist had shown me on the sonogram in February? "Oh, that ovary was full of septations. Like a bunch of grapes inside." But attached like a bubble head out the end of it? No, Dr. C didn't see anything like that. "Could what we saw have been this sac behind the ovary and on the sonogram it looked like it was in the same plane?" "Very possibly."

Which led us to the question of what to do about it all. "You've got a choice," my surgeon said, "And there's no right answer." **

Oh, no!!! You're just supposed to tell me what to dooooo!!!!! . . . Take me and my gurney and just wheel me down the hall!!

"Here's your choices. We can assume that the fluid under the ovary had nothing to do with it and the cancer was restricted to the ovary. The lab had to take several sections before they found the cancer in it. That would put you at Stage 1A. The tumor was Grade 1, very well differentiated, and that's the least aggressive kind. Chemotherapy would make no difference in your prognosis, the surgery took care of it all. We'd just monitor you every three months with a CT scan, an office exam, and a CA-125 test. And you'd watch to see how you felt and if you had any symptoms. Then we'd go to six months if there was no sign of recurrence, until you were five years out.

"Or . . . we can assume that the sac we found was part of the tumor, and since it ruptured, that puts you at 1C. A third of the time a test of fluids can come up showing no cancer cells but cancer is present. You can do chemotherapy to make sure there's no cancer in you, and again, we'd do the tests and watch and see."

He paused. "So what do you want to do?"

Oh, phooey. So this time I have a choice whether I want it or not.

Dr. C said that even at Stage 1C, the recurrence rate is really low, only 10% - 15%. "The probability is that you are cured."

He went on to say, "Now, chemo is poison. It's there to kill the cancer cells. It will kill healthy cells as well. But if you do chemo, things go back to normal. But with radiation, the damage is done and can't be undone. And there's a lot in your abdomen that can be damaged." In other words, radiation is not indicated for me-- yay!!!!

"It's up to you whether you want to do chemo or just watch and see."

I felt myself poised at the brink. I flirted with the idea that I could take my chances and not have to undergo the expense and rigors of chemotherapy after all. A reprieve?

But what if I was wrong?

I asked more questions and Ellen did, too. Dr. C said, "Have you ever heard of the term 'analysis of errors'?"

Ellen had; I had not. "No . . . is that like Worst-Case Scenario?"

"Not exactly. It's considering what could happen if you make the wrong decision. If you do chemo and there was no cancer there anyway, you've gone through all the stress of chemo for nothing. But you'll never know that."

"Like, 'See how great my elephant repellant works-- we never have elephants around here at all!'"

"Exactly. And if you don't do chemo and the cancer does come back . . . We couldn't talk about a cure anymore. The cure rate for recurrance is only 3 to 5%. "

Oh! I'd say that was a piece of information I needed . . .

"I'd be in remission only?"

"Yes, and remission for ovarian cancer would probably get you only two and a half more years. We can't just go in and take a tumor out. When ovarian cancer remanifests itself, it's all over the abdomen. Have you ever seen algae on a pond?"

"Yes."

"It looks like pond scum. It covers everything. We can do our best, but we can't get it all." And if I understood him right, at that stage you can't use the first line platinum-based chemo drugs, because the cancer will have developed a resistance. Or was he conflating this with what happens if one does chemo and it comes back anyway?

He explained that the metastasized cancer covers the organs and keeps them from reasbsorbing the four to five liters of fluid that wash through everyone's bellies every day. Which is why women with advanced ovarian cancer bloat up. "It's called ascites."

"Was that sac of fluid you found in me ascites?"

"No, no sign of ascites in you."

We asked more questions. He said they've developed good anti-nausea drugs that you get before chemo. "They make you drowsy, so most women just sleep through the therapy. Afterwards-- it depends on each person, you'll probably feel like you're getting over the flu for the next couple of days."

Ellen said, "I've had patients who've asked me, 'Is there alternative medicine for this?'"

"If there was, we'd give it," Dr. C answered her. "The alternative is, you can die."

More questions, more answers, more going over and clarifying what had been said before. Talked about statistics: Every year (in America?), about 20,000 women get ovarian cancer and in the same year 16,000 or so will succumb to it. And about odds and percentages. One can play them when dealing with large groups, but when it comes down to oneself, the odds are either 0 or 100%.

If it were to come back, my kind of ovarian cancer would recur somewhere in the abdomen. It isn't metastasized through the bloodstream, so it wouldn't go to the brain or bones or wherever.

Some comfort, when you consider all the damage it would do in one's midsection! Though maybe it's good to limit the twinges one could get cancerhead about.

For me, though, the fact that my cancer was caught at Stage 1 weighs heavily towards total cure, whichever way I would decide. Unlike for 80% of ovarian cancer patients, who aren't detected until they're Stage 3 or 4.

Finally, Dr. C looked me in the eye and said, "All right, do you want to do chemotherapy?"

I looked back at him and said slowly (and I thought, meaningfully), "I don't want to do chemo . . . "

"All right," he said briskly. "That's your decision."

"No, listen--"

"No 'buts'!"

"No, listen! Do I want to do chemotherapy? No, I do not. Do I think it might be wise to do chemo? Yes. Do I think the consequences of not doing it now and wishing later I had are too great? Yes, I do. So yeah, even though I don't want to, yeah, I'm going to do it."

Sheesh! Enough with the drama already! I didn't want to get ovarian cancer, either, but I've got it-- or at least, I need to make damn sure I've no longer got it-- so I have to deal with it, whether I want to or not.

Dr. C told me what it would be, and it was very familiar from my on-line reading. Six courses of Carboplatin/Taxol, one every three weeks. Happily, there's a UPMC chemo center a mile and a half from me, so I won't have to get a ride downtown. "The chemo's the same everywhere in the hospital system, no matter where you get it." He'd have his nurse look up the number and get in touch with the chemo doctors to set up an initial appointment.

I asked, oh yes, what about leukemia as a side effect? Ah. That's a danger for very young women, in their teens and early twenties, whose blood cells are still developing. (Or something of the sort.) "You're still young," he allowed, "but I think you're a little past that!"

Yeah, I'm not a little girl anymore. And this time, when the medical guy asked did I want to go for a ride, I did have a choice in the matter. Later this summer when my hair has fallen out and I'm feeling groggy and grotty and my mouth tastes like old aluminum, I may temporarily regret my decision. But given the fact that I've got my support system and my financial aid in place and my momentum's going, and given the consequences of being wrong, I think I've made the right one.

___________________________________
**Some dialogue word-for-word; other parts reconstructed or conflated.

Fall Back and Regroup

I've had to postpone my surgery. I've caught the nasty local Kleenex-box-emptying cold and feel like boulders have been rolled over me all night. Surgeon's office says no, I shouldn't be operated on in that condition. Call back and reschedule when I feel better.

She says, "It's elective and not urgent surgery, so you can set your own time." This tells me my gyn-onc is very confident in his diagnosis and it's only a cyst. Still has to come out, though. Just not day before yesterday.

Still, I feel like a wimp. But a sensible wimp.

Good News

Quick bulletin, then I have to get back to cleaning the house:

I had my liver ultrasound on Friday morning. Before I headed for the hospital to get it, I called my surgeon's office. Nurse told me the CT scan had shown an "indeterminate lesion on the left hepatic lobe." Not a mass, she said, but it was showing more dense than water (water would be good, since that would be a benign cyst).

Well, I heard from the surgeon's office yesterday morning. The findings? The "indeterminate lesion" is a benign cyst. No malignancy. Perfectly harmless, perfectly normal. People get them all the time. Nothing needs to be done with it.

They had me run up to the local hospital Friday afternoon to pick up the CD with the CT scan pictures. Of course, I stuck it into my computer . . . Happily, I'd been researching on line about liver lesions, so I knew what to look for and didn't panic from confusing the ordinary liver structure for masses and malignancies. Yeah, I could see what they needed to know more about. It was dark, like water would show, but not dark enough.

And on the Web, I found out that ultrasound is often used to complement CT scans when dealing with indeterminate lesions, because one can show/confirm what the other can not.

And praise God! my ultrasound showed that as to my liver, all is well.

Still gotta get the ovarian tumor out day after tomorrow, and God willing, my surgeon is right and it'll prove to be only a cyst, too.

Ominous

Today I got called in to teach at an elementary school I'd never been to before. Despite what I'd heard about the difficulties of its open plan design and about the recalcitrance of some of the students, the day went rather well.

It wasn't until I was well on my way home that I thought at all about perhaps getting the results of Monday's CAT scan today. And I don't know why, but as I was putting my key in the door and wondering if there'd be a message on the answering machine, I thought to myself, "I don't have a good feeling about this."

And immediately reflected, "Yes, but my pessimism won't make things bad if they really are good, and I would like very much to be proven wrong."

Yes, the machine was flashing and beeping. It was the nurse at the surgeon's office, who had called this morning. The CT scan results were in, and I could/should call her to discuss them.

And, she said, there were a couple of things they needed me to do before the 25th.

One was to go to the local hospital where I had the scan and pick up the films. I'm to bring them with me when I come for my surgery. So (unless the envelope is sealed) I guess I could take a look at them myself after all.

As for the second thing, she said, "We also need you to get an ultrasound done, of your liver, prior to the surgery."

I sat there, still in my coat, on the arm of the sofa next to the phone table. My liver. Liver cancer. She's telling me the tumor on my ovary actually is malignant and it's already spread to my liver. Stage IV.

And again I have to face my own mortality. I've relaxed a bit from a month ago when my gynecologist gave me the word about the ovarian mass. I wasn't prepared for this, at this point. Maybe later, later, later, when I'd fought the good fight for awhile and was getting tired of it all. But now? Frankly, I was and am rather scared.

Feeling that way, I know it's time to rally the prayer troops. That's what kept me out of anger and despondency a month ago; that's what's going to do it now.

So although I'd planned to spend the evening patching my upstairs hall floor and working on my sermon for Sunday (I'm subbing for a very ill pastor over in Ohio), I used most of it letting people know my latest need. Facebook, email, phone (that call was to my mother), and yes, don't laugh! the community blog frequented by regular commenters on i can haz cheezburger.

And looking at online information about liver cancer. Oh, joy. Another of the types with only subtle symptoms, most of which I don't have. But now I'm wondering if the feeling of pressure I've had on the right side of my abdomen and just under my ribs is my liver being enlarged, and not referred pain from the ovarian tumor at all. Absurd, how I didn't feel it at all lately until after I got that phone message, and now I do with a vengeance.

I'd still like to write a page or two of sermon before I turn in. But I can't stay up too late-- they've scheduled that ultrasound for me at 8:45 tomorrow morning, at a hospital a few miles down the road towards Pittsburgh. Nothing by mouth after midnight. Right. I'm getting good at this.

I'll try to put in a call to my surgeon's office and talk to the nurse about the CT scan results before I leave for the ultrasound. Better I should know going in what it is they want from this new test and face it squarely, in the power of the Lord.

(Heaven knows I have none of my own.)

Tests

Yesterday I had my neutral pulpit preach and pulpit committee interview for the church over in the next county.

I told myself to treat it just like any other pulpit supply engagement; to preach the Word and minister to the people and give God the glory. But I couldn't help it-- I was afflicted with a slight buzz of nerves. Not enough to make me mess anything up, but enough to make me trip over my mouth just a little more than usual. And to have lousy breath support during the hymns, despite what's been beaten into me at Monday night community choir practice.

The pastor search committee took me to a local family restaurant afterwards for the interview. It surprised me that they didn't take advantage of the loooonnnnng wait we had to get our food to start with the questions. Instead, general conversation prevailed. They waited to get down to business until everyone was halfway through their food. Not that good an idea with me-- I'm a slow eater, and if I have to interrupt my eating to answer or ask questions, I'll be slower still.

Interview seemed to go well . . . good interchange of ideas, lots of information given about the church and its ministry. But I don't think they asked me that many questions. Five or six, tops. And then the chairwoman looked around and said, "I think we've heard all we need to hear. Blogwen," she asked, "Is there anything else you wanted to ask?" And there was just that something that told me the answer she expected was, "No, thank you, of course not."

I ignored it. Maybe I shouldn't have, but if my asking more questions about the church and reflecting how my experience and ideas would fit in with them was going to blow my standing with a nominating committee, I don't know that I'd want to accept their call. Because if that's all it would take to lose their favor, better it should happen now rather than later, when I'm wrestling with church crocodiles.

In any event, at that stage it seemed the atmosphere stiffened. Arms were folded over breasts. Eyes seemed to convey a profound lack of interest. I asked how soon they hoped to make a decision, to judge whether I should say anything about my upcoming surgery. Chairwoman told me "We're in no hurry. We've just signed our interim pastor up for another six months. Though of course we can break that, if we get the Right Pastor in." Very, very non-committal.

They hope to all get together this coming Sunday to sort through the candidates they've interviewed and come up with a short list. They'll let me know after that.

Then it was over, everyone got up, and the previous friendly atmosphere prevailed once more.

So who knows what that will all mean.

This morning, then, I went in for my CT scan, up at the local hospital. I'm not totally sure what it's supposed to show; I mean, if the gyn-onc thinks the tumor is benign and I'm getting everything out in a week and a half, why not just do it and save the money? But I went.

Didn't realize they make you drink nearly a liter of iodine-laced sterilized water after you get there, then sit for an hour or so while it runs through. I guess the idea is to deposit the chemical, because they do let you use the loo before the scan.

Then, unlike others I saw there in the Radiology Imaging waiting room, I did not have to strip off and put on a hospital gown for my scan. Just lay there on the table-bed in my street clothes, with an IV drip going into my right arm. Thought it was very fortuitious that I happened to put on a pair of slacks with a side zipper this morning; nothing to get in the way of the x-rays.

There was a slight mishap when the nurse-technician didn't get the IV needle in right the first time and made me bleed on the bedsheet. But she got it in on the second try and fetched a towel to keep me and my cashmere sweater out of my own blood. And the only thing that (momentarily) concerned me about the procedure was the requirement that I lie with my arms stretched straight "above" my head. I have rather dodgy shoulder joints, which have been known to pop out of joint when I get into positions like that. Well, it hurt a little, but nothing shifted.

Through the IV they run another chemical-- I forget which one-- that interacts with the iodine and the x-rays to give a good picture. "It'll make you feel really warm for a minute," said the nurse tech. Fine with me-- I was freezing after all that cold water. When that was in me, I was ready to go.

The CT machine is like a big donut that they slide you in and out of. The funny thing is that a computer voice orders you to "Breathe in!"-- and I did, in my best choir intercostal style-- and then it told me to "Breathe!" What? I did just breathe! When may I exhale?

I asked the technician. Oh. For this machine, "Breathe!" does mean "Exhale."

Ha. Try telling that to my choir director.

I underwent this process three times, then the test was over. I asked about the breathing. That's to keep your organs still, she said. I asked could I see the pictures. That's for my surgeon to show me, she said. His office should be calling me on Thursday or Friday to tell me the results.

OK. So that's two tests in two days and we'll see how well I did on both.

Mild Hysteria

My surgery is two weeks from tomorrow. Today my MD cleared me as healthy enough to tolerate it. Too bad I'm not healthy enough to not need it!

And today I got the pathology report from what they sampled last Friday. No uterine cancer, thank you very much. And CA-125 levels in the normal range.

Which is good. But not always good for my attitude. Because it makes me wonder, do I really gotta go through this?

I mean, there's the "discomfort" of the post-op itself. Pain! Swelling! Mindless-making drugs!

Then there's the six weeks of enforced inactivity. Right when my house needs so much renovation! Right at the start of gardening season! Right when I should be taking advantage of the last weeks of the school year and getting in a lot of substitute teaching!

And what am I to make of what I read about hysterectomies online?

There's one site (which shall remain unlinked and unnamed) that seems dedicated to the proposition that 99.9% of all hysterectomies are needless and avoidable and only perpetrated by devious, greedy doctors out to make a quick buck at the expense of downtrodden women. What it tells you about the aftereffects will curl your hair. Nerve damage! GI tract disablement! Your ribcage falling down to your hipbones! Not to mention lifelong depression, loss of maternal feelings, and perpetual heartbreak, regret, and distress.

Then there's another site (which shall also remain linkless and nameless) where women who have had hysterectomies compare notes, and on it we have women complaining that their gynecologists wouldn't take their pain seriously and refused to take their bothersome female plumbing out.

Of course, this site makes its own contribution of stress, such as the contributors who say it was over six months to a year before they "got back to normal."

So with all this rattling around my brainpan, again, I can't help wondering, Do I really have to have this surgery? I mean, the gynecological oncologist is of the opinion that the ovarian tumor isn't even cancer! Can't we just ignore it and wait for it to go away?

. . . Oh yeah. Right. At my age, these things don't just go away. At my age, I really shouldn't have a goose egg in my abdomen like this. And malignant or "benign," the thing is growing. It's bad enough that it's already given me a pot belly I can't get rid of by any exercise of dietary discipline. But now it's interfering with my digestion. Benign or not, it can cause mechanical trouble. And they won't really know what sort of thing it is until it's removed.

So it's time to accept the PITA, and keep doing what I need to do to be as ready as possible when the time comes.

Promising

Outpatient surgery yesterday went well. And I'm blessed in that I have no trouble with anesthesia, before, during, or after.

And . . . how to say this without TMI . . . ? Let's just say that apparently it's been verified that the symptoms that got me to my gynecologist's in the first place-- the pain and the bleeding-- had nothing whatsoever to do with the mass on my ovary, and were, in themselves, annoying but harmless.

Meaning that it was a happy coincidence, or an act of Providence, rather, that caused this tumor to be discovered at this point.

The cancer surgeon is still pretty confident that it's benign. Hope he's right.

And it still has to come out. Along with everything else in there, what fun. That's in less than three weeks. All sorts of things I gotta do before then!

Exploratory Surgery

Tomorrow at the crack of dawn (6:30 AM) I'm due at the hospital in downtown Pittsburgh for exploratory surgery.

Well, ok, for a D&C. The other day at my first appointment with my gynecological oncologist, he examined me and said, "This doesn't feel like a cancer."

That doesn't mean we get out the bells and trumpets and kick up a celebration. No. But it is hopeful. Better odds than before.

However, says he, "That bleeding you're having. That ovary's not causing that. We need to do a D&C and see what's going on there."

So that's what's happening tomorrow. In and out the same day.

They'll biopsy whatever they find. Whatever it is, I still have to get the whole works out, which will happen March 25th. When that occurs, far as I can tell, best case scenario will be that the mass on my right ovary turns out to be a belated, post-menopausal fibroid and the bleeding was caused by, say, endometriosis.

Worst case would be that the tumor is, after all, a big nasty cancer and it's spread to my uterus. And who knows where else.

Best or worst case, it's all in the hands of God (with some help from the hands of my surgeon), and that's the best place for it. My job is to go get some sleep.

Where I Was Yesterday

I planned to write this post yesterday, but got busy doing other things. Which is good.

Friday, after I got the word about my extremely-possible ovarian cancer, I was strangely free of sensations of fear. No unseen hand viciously squeezing my gut, no leaden weight at the heart, no noose at the throat. I was full of nervous energy, yes, but I channelled that into thinking and planning and letting people know.

Friday night, I actually slept pretty well. But yesterday morning I didn't feel like lying in the way I usually do, and got up at 7:00. This is good-- I can't afford to be a slugabed. What wasn't good was that shortly after I got up, even when I was just greeting my animals and going about my morning routine, it hit.

No, not dire thoughts of fear and panic. No, no wild feelings of Oh My God, O My God! No, I was hit with a sensation of oppression in my upper arms, an annoying, distracting pain that all day tried to keep me from doing what needed to be done.

Weird, really. I know it's hormonal; adrenalin, probably. But it usually takes me in the gut. Why the arms?

I don't know. All I know is that I was tempted to do the flight-avoidance thing. To go back to bed or find some computer card games online to play (I've deleted them from both my computers). But that would be silly!! The thing I most resent about facing my mortality is that I may-- I say, may!-- not have the time to do all the things I've planned and want to. And am I now going to waste a perfectly good day on absurdities? I'll save that for when I'm feeling really grotty and have no choice.

More later, but it's time for me to head to church. Blessings to all!

Baptismal Anniversary

About ten years ago I was Scarred for Life by a psychologist who interpreted my Minnesota Multiphasic results to say that I was a terrible hypochondriac. I was never so insulted in my life-- in fact, I'd laughed at the questions on the MMPI designed to detect an over-attention to one's health. I have no idea how he came to that conclusion, since I'm usually the last one to run to the doctor or automatically to think I'm ill or to make my health the main topic of conversation. What the MMPI should have shown was that I'm too stinking sensitive to what other people say about me, especially authority figures. So his words keep recurring to me and made me eager to disprove them. More than before, I've been reluctant to follow up on random symptoms, or to say much about my state of wellness, unless to my intimate friends.

But that has to change. At least, it's going to, starting today. Because . . .

Well, I'll let the private message I sent this afternoon to a select group of Facebook friends* tell the story for me:

I thank you for praying for me and I ask your continued prayers. I had a sonogram early this afternoon for some gynecological symptoms (sorry, gentlemen, don't mean to embarrass you) and as it turns out, I have a greatly enlarged right ovary. In fact, it's 4 to 5 times the size it was when I had a previous sonogram in June of 2008. They won't know 100% what it is until I have surgery (yes, the whole lot has got to go), but my doctor was frank when he said that he can't think of anything other than a malignancy that would cause such rapid growth in someone my age.

He's referring me to a gynecological oncologist, whom, God willing, I will hear from by this coming Tuesday. After that I'll begin to know when and where and what.

As I said, please continue to pray for me. Some might be thinking, "Well, prayer didn't work that time!" After all, the test didn't come up negative. But you'd be wrong. I've known such a result was possible and the other day I was very angry and upset at the prospect of it. My major risk factor for ovarian cancer is that I've never had a child, and I was thinking, "Blast it, I never got to use these organs for the purpose God gave them and now one of them is going to betray me?" I was afraid I'd have a major hissy fit all over the doctor's office. I don't say I'll never feel like that as the days and weeks go on, but this afternoon I did not. I was able to keep my cool and listen to what my doctor had to say. And I'm able to think clearly about what I need to do now. That, my friends, is God answering prayer.

So please, do keep praying for me.

First, that my faith in my Lord and Savior Jesus Christ will remain strong-- that I'll happily find out just how strong He is.

Second, that I won't use this as an excuse to get depressed and be snippy or obnoxious to those who really do care. And pray I won't be afraid to ask for help whenever I need it.

Third, that I'll get the things done I need to get done and won't mope around, or waste time on Internet forums and so forth.

Fourth, given that I have no insurance and a very NONlucrative job (substitute teaching), that the money will be found from whatever sources both for the medical care and for keeping my household bills paid till I can get back to work again.

Fifth, and most importantly, that I will with God's help successfully come out the other side of this (comparatively) whole and healthy and have many more years to minister and teach and enjoy the fellowship of my good friends.

I'll let my other FB friends know, too, but wanted to make sure that those of you who responded to my earlier status were immediately informed.

Love,
(St. Blogwen)

But what has this to do with baptism? Well, today is the 54th anniversary of the day I was baptised. On that day my parents confessed the faith of Jesus Christ on my behalf and pledged to raise me in the nurture and admonition of the Lord, against the day that I would confirm those promises and make that confession for myself. And on that day, God, through water and the Holy Spirit, applied the blood atonement of His Son to me, to wash away all my sins and unite me with Him forever.

I now face a baptism of a different kind, but I still go through it with my Lord Jesus. It's no coincidence that my Psalm this morning was No. 130-- "Out of the depths I cry to thee, O Lord!" and my Old Testament reading was Isaiah 52:13-53:12, the Song of the Suffering Servant, by Whose wounds we are healed. The fire will get hot at times and the floods deep, but He has promised never to leave me nor forsake me, and He will bring me through.
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*If you weren't on the list, I beg you, please don't be insulted. It was the people who'd responded to my status post Wednesday night about having a medical test today. I figured they were the ones who'd seen it and would be wondering.

Counterproductive

Lately I've noticed that half my wardrobe I can't even fasten up any more. I have neither the time, money, nor desire to replace it, so I must lose some weight. Not a prodigious amount-- fifteen pounds would do it; even ten would go far towards solving the problem.

So about two weeks ago I began, and thanks to some simple measures like not eating after 9:00 PM and taking an omega blood sugar formula and not buttering my toast I'm already down four pounds or so.

But now comes an interruption that which threatens to stop and reverse my progress, a catastrophe involving falling plaster and an unexpected setback in my house renovations. This leads to nerves, which generates excess adrenalin and crashing blood sugar, which means I want to eat something, anything, NOW, even if I had a meal only an hour or two ago. And I can't think straight until I have.

Not good, especially since being too fat will keep me from squeezing around the ladder on the stairs.

I'll try stuffing my face with lettuce from the garden. I'm not too optimistic that'll do the trick, but we'll see.