Confessing to a Problem, Part 2

Seems to me, if someone has a problem with one of the standard ways the Church traditionally has interpreted Scripture, he or she had better go to Scripture to define what the problem is. Just saying, "It's inconvenient for me" or "I just don't like it" won't cut it.

And when it comes to the way the Westminister Shorter Catechism expounds the Fourth Commandment, it bothers me how the Westminster Divines chose to defend their interpretation Biblically. The Catechism is written for Christians and presumeably is written with the people of the New Covenant in mind. In that case, why are the vast majority of Scripture supports taken from the Old Testament? Why cite random verses from the seventeenth chapter of the book of Jeremiah in favor of strict Sabbatarianism, when the promises appended there to such adherance clearly have to to do with the physical people of Israel. There I am told that if I keep the Sabbath as commanded, "then kings who sit on David's throne will come through the gates of this city with their officials." But the ultimate King from David's line has come, His name is Jesus Christ, and He sits at the right hand of God the Father almighty in heaven. My Sabbath keeping (or lack thereof) isn't going to cause Him to rule and reign-- He already does!

They cite Isaiah 58:13b, "If you call the Sabbath a delight and the Lord's holy day honorable . . . " So why not also mention what Jesus said in Mark 2:27, about how "The Sabbath was made for man, not man for the Sabbath." What about the wonderful verses in Hebrews about the Sabbath rest waiting for the children of God? Why are Questions 60 through 62 all about what we have to do or not do, instead of focussing on what God has done for us? "I am the Lord your God, who brought you out of slavery, out of the house of bondage. Therefore . . ." Whatever happened to the Third Use of the Law, to show Christians how to live in gratitude to Jesus Christ for the salvation He has given?

Seems to me, the Christian Sabbath should be a time of refuge and renewal. It should be a time gladly to lay down the burdens of the week and enjoy freedom in the Lord. This may be why the Westminster exclusion of "recreation" bothers me so much. Isn't re-creation what the Sabbath is for?

And how can Answer 62 say that "God has allowed us six days for our own employments"? We belong to Him in Christ, don't we? Doesn't all our time belong to Him now? Are we not to glorify Him fully seven days a week? What's with this (forgive me, this is how it seems!) petulant "I let you do what you want six days a week; you better pay attention to me on the seventh!" Do we really want to reduce God to the level of a nagging wife?

On the contrary, it seems to me that the Lord's Day should be like the date night reserved by happily married spouses: a time to pay attention to and delight in one another without the distractions of work and children and bills. And that that can include such recreations as make the individual more conscious of and grateful for who the Lord is and what He has done. For me, that can mean pottering in the garden or making bread. Or getting together with friends, as I already frequently do at the OPC parsonage after morning service-- where we assuredly do not restrict our conversation to theological topics only!

Does my disquiet with this part of the Westminister Shorter Catechism mean I would throw it out and totally reject what it has to say?

No. The strictures of the WSC, legalistic as they are, address a portion of sinful human nature that is the same now as it was in the days of Moses or the days ot the Westminster divines. They were addressing evils and abuses they were confronted with in their day and applied the Word of God to the question.

But this gets us back to the whole Westminster-only question. On this past May 4th the Fighting for the Faith Internet broadcast featured a talk by Ligon Duncan on Did the Fathers Know the Gospel? Dr. Duncan's answer is yes-- partially-- at least inasmuch as the challenges of their time moved them to write in its defense. More specifically, the question asked is "Is the whole Gospel of Jesus Christ represented and set forth clearly in the writings of the Church fathers?" And the answer has to be no. For faithful as those men where as individuals, their writings inevitably assumed and thus left out those parts of the Gospel not being attacked in their time. Their writings thus are guides for the pilgrim Christian, but not the last word.

Every Christian creed and confession (with the possible exception of the Apostles" Creed) was written in response to some contemporary onslaught against the faith. As such they are of their time, and to be applied in every time, since human sin manifests itself in similar ways throughout history. But no one creed or confession can claim to have to last word in guiding us into the knowledge of what the Scripture causes us to believe and do. Not even the Westminster Standards. That would be to elevate them to the status of the Bible itself, which we must never do.

This doesn't help me in the middle run, you know. The PC(USA) for a large part pays mere lip service to any of her many creeds and confessions and may be in danger of running aground and breaking up much sooner than later. If I would choose to flee to a denomination like the Orthodox Presbyterian Church, how can I in honesty subscribe to Westminster only, knowing its limitations?

Well, I'll leave that to God and time. In the meantime, with the Westminster divines or in spite of them, I find it's good to set my mind and heart weekly to accept the gift that is God's holy Sabbath, preparing for it as I would that ideal Christmas Day. Because after all, it's first and foremost what He has done for me in His Son Jesus Christ, and only secondarily, what I do-- or don't do-- for myself or Him.

Confessing to a Problem

Traditionally, at least, my denomination, the Presbyterian Church (USA) is a confessional church. We have a whole book of confessions we confess: The Second Helvetic Confession, The Heidelberg Catechism, The Westminster Confession, The Declaration of Barmen, and a good handful of others. We're even looking at accepting yet another at this year's General Assembly. We claim that these are faithful guides to what the Scripture leads us to believe and do.

Other Reformed and Presbyterian denominations subscribe to only one triad of faith affirmations: The Westminster Confession, The Westminster Shorter Catechism, and The Westminster Larger Catechism, collectively known as the Westminster Standards. Westminster Standard churches charge that with all our creeds, catechisms, and confessions, we of the PC(USA) really have no standards at all. They say that having so many symbols of faith (boy, that's a good, old-fashioned theological word!), we feel we're free to pick and choose, and end up thinking and believing whatever we jolly well please. Thus the rampant degenerate liberalism (which is no true, generous liberalism at all) of our denomination.

I'm all too aware of the evils of the drift of doctrine in my part of the Presbyterian Church, and I've felt a certain admiration for those Presbyterian Churches who steadfastly adhere to Westminster. They, at least, seem to know what they believe and why they believe it.

But something's happened lately that's made me wonder if "Westminster Only" is the holy grail it's said to be . . .
The past two Sundays I've attended Morning Instruction at the Orthodox Presbyterian church where I go when I'm not filling a pulpit somewhere. The OPC is a Westminster Standards only denomination.

The class, led by the pastor, begins with memorization work. First, the children and youth recite their Bible verses. Then, the adults repeat from memory the featured questions and answers from the Westminster Shorter Catechism.

The object these past two weeks has been Questions 58 through 61, on the Fourth Commandment, on keeping the Sabbath day. This past Sunday I brought in my copy of The Book of Confessions and thought maybe it'd be cool if I could memorize one or more of these answers for recitation myself.

But then, as the others were doing their recitations, I listened to and read and reread what the Westminster divines had written. I grew very disturbed in my soul, and decided, no, at this time, at least, I could not repeat back these words. For to repeat them aloud is to affirm and accept them, and as written, I'm not sure if I can accept these words as the best and most faithful guide to the meaning of this Commandment as given in Scripture.

My biggest problem is with Question and Answer 60:

Q. 60. How is the Sabbath to be sanctified?

A. The Sabbath is to be sanctified by a holy resting all that day, even from such worldly employments and recreations as are lawful on other days; and spending the whole time in the public and private exercises of God's worship, except so much as is to be taken up in the works of necessity and mercy.

And even more with Question and Answer 61:

Q. 61. What is forbidden in the Fourth Commandment?

A. The Fourth Commandment forbiddeth the omission, or careless performance, of the duties required, and the profaning of the day by idleness, or doing that which is in itself sinful, or by unnecessary thoughts, words, or works, about our worldly employments or recreations.

And with certain parts of Question and Answer 62 (which we haven't really gotten to, but it goes with this group):

Q. 62. What are the reasons annexed to the Fourth Commandment?

A. The reasons annexed to the Fourth Commandment are: God's allowing us six days of the week for our own employments, his challenging a special propriety in the seventh, his own example, and his blessing the Sabbath Day.

Confronted with Questions 60 and 61 in particular, I found myself thinking, what a gray, straitened, and depressing thing to do to the Lord's Sabbath! I can't help but get a picture of a family of dour, legalistic Puritans sitting at home or in their pew at church doing their dire best not to do anything recreational, not to do anything "unnecessary," not to be idle but at the same time avoiding anything that smacks of human work, not to talk about anything earthly, not even to think of anything that could be construed as untheological! Good grief, how could even the most sanctified Christian find joy in the Lord under those conditions?!

I examined myself: Was this my own sin talking? There could be some of that, yes. But like Job, I can't say that my own depravity is all there is to my reluctance to accept this full weight. I have some biblical objections as well.

But I'd better save them for a further post. This is getting long.

Something Really Silly . . .

. . . and then I'll go deadhead roses.

I was being a little negative in my last post about the chemo baldness covering catalog the Cancer Center gave me on Thursday. But I have to admit that the models all looked very nice in their hats and turbans and scarves. And I don't think it's just because they're all young and high-cheekboned and wrinkle-free.

I have some scarves in my wardrobe, and I was online last night looking up tying techniques. I found some really cute ones here. But I found one site, which I will not link to out of consideration for the cancer-patient model, where the look was depressing and just plain awful, no matter how many twists and tails she gave it.

Was it because she was older and chubbier and jowlier than the girls in the paper catalog? Was I looking at her and thinking, "Oy vey, is that the best I'm going to look in a scarf? Yuck!"

But then I discovered what was wrong. The model in question had a low forehead to start with. And then she had tied every last one of her scarf styles tight, tight, tight to her head, just a little below her (former) hairline. No matter what style she sported, she looked as if somebody had sliced off the top of her head à la Thomas à Becket and the scarf was just bandaging the gory wound.

Give the paper catalog company credit. All their hats and turbans are built up in the crown, all their pre-tied scarves are worn down just above the eyebrows, and they all look stylish and cute. What's more, they sell a little quilted cotton cap and a padded scarf liner you can wear under your scarves and kerchiefs to add height and volume. Good thinking!

I'll keep this in mind. High and tight-- tacky. Low and loose, lovely.

Now I really go gotta deadhead roses!

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.

Easing Back into It

Sang last night in our first choir concert of the Spring season. It went well. Some friends brought me a stool I could perch myself on. And when, during the first number, I discovered that holding up my black folder was too much of a strain on my sore abs, I lay my music down on another stool that'd conveniently been left in front of me.

I should have the music memorized by now, anyway.

It's a little frustrating to be able to do stuff like this and still not be allowed to drive or mow the lawn or even take out the used cat litter out to the trash can in the alley, but I guess that's how it goes.

And Sunday, when we have our big concert, I think I'll bring a lightweight folding music stand. Can't depend on that other stool being there.

Alarmed

Today I was looking at the copy of the pathology report I got at my surgeon's on Monday. I wanted to find out just what sort of ovarian cancer I'm dealing with so I could accurately put in the information on a cancer support website.

FINAL DIAGNOSIS

PART 1: ADNEXA, LEFT, SALPINGO-OOPHORECTOMY: MUCINOUS CYSTADENOCARCINOMA OF THE OVARY, WELL-DIFFERENTIATED . . .

Wait a minute. Left? left??

What the-- ? I could have sworn the problem was with the right ovary!

I read the report on the right one, and it said, "ADNEXA, RIGHT . . . ENDOMETRIOTIC CYST WITH CALCIFICATION IN THE OVARY." But that wasn't the 6 cm ovary with the Stage 1A tumor.

This shook me up! Ever since February 19th I was sure everyone had said the tumor was on the right!

I called my surgeon's office and talked to the nurse. "Yes," she reported, "the mass was always on the left. It's out now. Does it matter?"

Yeah, it matters. If I heard that wrong, what else have I missed?

It may be my intellectual pride talking, but this error of mine bugs me more than anything.

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.

For What It's Worth

I'm starting to question the value of spending too much time reading websites and watching YouTube vids on ovarian cancer and ovarian cancer survivors/fighters.

Maybe later-- assuming I have to do chemo-- they'll be a comfort and a support to me. But right now, ya know, it really isn't useful for me to be glued, say, to the video made by one woman with Stage 1C who celebrated her five-year "cancer-free" anniversary and two weeks later found out her belly was riddled with tumors (how the hell did they miss that, I wonder?). Or to be reflecting on the implications of how "They're not talking about a cure any more; I'm now just 'in remission.'" Or gawking at another vid a 3C sufferer posted last summer noting that she's now been through six, count 'em, six major surgeries, and consequently wondering what it Means that she hasn't responded to any comments since then . . .

It's not that I'm unwilling to face potential reality. It's more that I'm taking to heart what my Lord Christ meant when He said, "Who by worrying can add a single hour to his life? . . . Therefore do not worry about tomorrow, for tomorrow will worry about itself. Each day has enough trouble of its own."

So right now, my job is to recover fully from last week's surgery. So far, so good, and I've really glad I asked my surgeon about the self-absorbing sutures before I went into the OR. My incision is healing into something I can be going on with for a lot of years to come. I'm not saying I would have been depressed by the sight of staples; I'm pretty good at detaching about these things. But from the pictures they just look more . . . makeshift, somehow.

Then as I recover, in a little over a week, on the 10th, I have my strategy appointment with my surgeon. Yeah, I hope I find out how on earth the stupid tumor came to rupture. But beyond that, I hope to be finding out what my treatment options and strategies might be.

After that, we'll see when the time comes. There is absolutely no point in my getting bent out of shape stressing over things before I truly have to take them on.

Besides, what's the worst thing about losing time to suffering and to undergoing an early death? Besides the suffering itself-- Lord forbid I should minimize that! -- I mean. Is it not the diminished chance to experience and enjoy life? So why and how should I fail to experience and enjoy life while I've got it, especially now when I'm actually feeling rather well (all hail, Vicodin!)?

The other thing is, why should I waste my time fretting over possible death from cancer, when I will have to die of something or other eventually anyway? Why should I let Death petrify me if it should approach wearing that particular mask, as opposed to any other? Is Jesus Christ not my Savior? Has He not borne my sins and my death in His body on the cross? Did He not rise again to give me life eternal? For me, to live is Christ and to die is gain!

But I am convinced that I shall remain in this land of the living for quite awhile longer. There may come a time when reading about survival rates and possible complications and recurrances and so forth will be edifying. But right now, I intend to enjoy the life I have. And if that means watching episodes of Gordon Ramsey's Kitchen Nightmares on Hulu.com, so be it.

In Today's Breaking News . . .

Got a call early this afternoon from the physician's assistant at my gynecological-oncologist's office. The lab results from my surgery were in. And guess what? My surgeon is not God. Turns out the mass he removed from me last Thursday was not, after all, a low malignant-potential tumor. It was bog-standard ovarian cancer. Stage 1A, Grade 1.

Which if you're going to get ovarian cancer is the stage and grade you want it to be. The PA said they took and analyzed "a gazillion" specimens and everything except the right ovary was negative.

So that means they got it, right?

Not so fast. Turns out the mass ruptured during surgery, so Dr. C himself puts it at Stage 1C instead.

Now I thinks to meself, I thinks, How on earth could that have happened . . . ? Did somebody poke a finger in the wrong place and Pop Goes the Weasel?

Yeah, right. That naive bit of dubiety rises from my imagining that my ovaries and other bits were just floating around loose in my abdomen and the tumorous one simply had to be picked up and cut off. No. Things in the body are adhered and attached to other things so they won't rattle around in your insides and get all tangled up. And considering that my right ovary/tumor had a very delicate-looking septation off one end of it (I know-- I saw the picture at my gynecologist's office in February), it's not surprising it should have torn a bit in the removal process.

In a couple of weeks I may well find out if my angle on this is correct, because I'm to come in for a follow-up visit with Dr. C and the PA. Still working out the logistics on getting a ride into town, but it'll be either on the 10th or the 17th.

The way I'm thinking about it is, the mass was a Stage 1C ovarian cancer, and we'll be discussing how to keep it in the past tense.

. . . Yeah, that very well could mean chemo.

Idoanwannadochemoidoanwannadochemoidoanwannadochemo!!!

Yeah, nobody does. But people take it and they get through it and come out fine the other end. And if they have to fumigate my belly, so to speak, to make sure all the cancer bugs are gone, that's what we have to do.

The Lord is good; His Spirit is with us, and I am reminded that the reason ovarian cancer is so scary is that most of the time it's not discovered until it's in a later and much less treatable stage. It's not that ovarian cancer cells are more virulent or potent than the kind that settle in elsewhere.

And even though this has turned out to be what I feared back in early February, it's not the same. Thanks to the providence of God working through my gynecologist, this mass was discovered early. And if the fight needs to continue a bit before total victory is won, so be it.

+++++++++++++++

Otherwise, I'm doing pretty well this first full day home. Swelling and bruising going down, pain well under control even without constant Vicodin. Enough energy that I have to remind myself not to do Forbidden Things. Got up mid-afternoon and came down for some lunch; then early in the evening I got dressed (yay! I can get into my corduroy jeans!) and my friend Frieda* and I went out for a stroll around my garden to see what's in bloom.

After supper she sat down at the piano and played some music she'd brought, then started in on hymns. Unfortunately, the hymnals I had on the piano ledge didn't have some of the hymn/tune combinations we wanted, and I knew better than to run (!) up to the third floor to get the hymnbooks that do. So I set my Welsh hymnal before her and she played "Sanctus" and "Aberystwyth" for me while I stood there and sang them yn Cymraeg.

Oooh, danger! danger! Don't get someone who's even part-Welsh started singing Welsh hymns at 10:30 at night! Especially one who's only five days post-op! I wanted to sing more, more-- and knew I needed to stop before I messed myself up. Not from pain-- I'm trained to do intercostal breathing, so it didn't affect the surgery site. But from pure exhaustion, that I would have ignored from the hwyl of the words and the music.

No. There are times to sing till you drop. Tonight was not one of them.

Knowledge Is Power

My surgeon Dr. C was in at 7:30 this morning, the whole parade of interns, residents, and so on in train, and he confirms that I can go home today, hooray.

(True, all systems are not Go as yet, if you know what I mean, but they have ways of dealing with that . . . Yes.)

Dr. C sees no need to wait for the pathology report; everything points to my "low malignant-potential tumor" as having been Stage 1; that is, confined to the one ovary. That bit of me and rather more is now out, out, out, which means Problem Solved. The tumor was only 6 cm long, compared to the 9.7 it was scaled from the February 19th sonogram, so there's no way to get a comparison to see if it grew in the last two months. But it's nice to know it wasn't as honking big as my gynecologist originally thought.

No chemo, Dr. C confirmed. Great to hear; I wouldn't have looked forward to that, even if I did have insurance.

This is all very good, but I had more questions. Only 15% chance of recurrance, right. But if it does come back, how will I know?

There'd be lower digestive tract problems that don't respond to anything else. In fact, where LMP ovarian tumor fatalities come about is due to bowel obstructions and the attendant sepsis, not because its cells infiltrate and change an affected organ.

Where would it come back?

Someplace in the abdomen.

And the response?

Surgery, again, unless that meant taking out something I couldn't do without. In which case they'd try chemo, even though it's not that effective, since the LMPT cells are so close to normal cells it's hard to hone in on that target.

But, says Dr. C, why am I fretting over this!? We're only talking 15%!

No, I'm not fretting! In fact, it makes me fretful that he should think I'm fretting! My academic mind wants to know all the facts, sort through them, arrange them as needed, and go on from there! In one of my favorite novels, Dorothy L. Sayers' Gaudy Night, the hero Lord Peter Wimsey, is shown to be a paragon among men because he correctly interprets a female academic's question about a certain male wardrobe malfunction not as skittishness, but as a desire for precise information. My Dr. C is not necessarily a paragon of that calibre, but he knows his medicine. So if he wants to chaff me for being a worrywart, he can do it, as long as he answers the questions.

Though maybe I should admit to an smidge of Eeyoreishness . . . My prevailing feeling is that with me, a 15% chance of anything is like 0% should it be about something good. Like if I should play the lottery or if we're desperate for rain or I'm angling for a job. But if it's something undesirable . . . it may as well be even odds. I mean, I already "beat the odds" and got this weird kind of tumor, didn't I?

Never mind. Knowledge is power, and the more I'm master of it, the better. Anyway, who wants to be one of those patients who don't have all the available facts and goes around believing and talking as if her doctor is withholding information and may be doesn't know what he's talking about?

Adventures in Medicine

Well, I've been in the hospital since Thursday morning and coherent enough to get online since Thursday night, but only this morning did I find a person here at UPMC Mercy who could show me how to get connected on their wireless network.

And that was by coincidence, since I'd intended to read the newspaper my friend Frieda* bought me yesterday this morning over breakfast, but I guess it fell on the floor over night and the cleaning lady cleared it away. I lamented the loss of my paper to the nurse (a guy) and he said, "I see you have your laptop with you. Why don't you go on one of the newspaper websites and read it there?" And he showed me how.

Believe it or not, breakfast this morning is a medical adventure in itself. I still haven't passed gas (a very important indicator!) so far, so technically I shouldn't have anything by mouth. And I'd been feeling queasy. Etc. But my surgeon's fellow in their practice, Dr. K, who was in early this morning, said they could try me on some liquids this morning, regardless. 4 ounces of apple juice down the hatch so far, and working on the grape. So far, so good.

But people (all two of you!) will want to know about the surgery on Thursday.

Here's the good news: My surgeon, Dr. C, says everything looks good; the mass they took out wasn't cancer and there was no sign of cancer anywhere in the abdominal cavity.

Here's the routine news: They've taken all my ladybits and scrapings of everything else in there (from the lower lungs on down) to the lab to make absolutely-certain-sure there's no cancer anywhere.

And now, the ambiguous news: The ovarian mass, while not cancerous, is nevertheless not a "normal" cyst. If I understand correctly, it's not even precancerous. What they're calling it is a "low malignant potential tumor," and I have no idea where the hyphens should go on that. Dr. K says they'll go over all that when I'm discharged.

The mass is not invasive and therefore not a cancer, but wasn't a benign thing to be having in me, even so. There's a 15% chance it could recur, and there's nothing that can be done to make that risk nil. There's no role for chemotherapy or radiation to obviate that 15%, because, well, it's not a cancer! But if I understand the doctor's message right, it's the short of thing that can pave the way for a cancer in the future.

I think. The inconvenience in all this is that Dr. C had leisure to talk to my friend on Thursday, but not to me-- I was in the Recovery Room. So I couldn't ask any questions!

She said Dr. C told her "Nobody wants to hear this sort of news. Everybody wants things black and white."

Well, maybe, but my first reaction was, "There I go again, being original! I never can seem to do things the ordinary way!"

And if I want things to be black and white, it's not just for my health's sake, but so I can explain it simply and easily to people and not bore them going off on tangents.

Oh, well. It is what it is. And if my breakfast of juice and jello will stay down nicely, that will be one less adventure to confront!

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.