The Roller Coaster

I saw this on the PostSecret web site a few weeks ago, and put it in the back of my mind. But now, unfortunately, it means a lot more to me right now.

 

And so merrily we roll along.

 

Highlights:

• I gave a final today, returned to my office, then immediately received a phone call that my son had a 102 degree fever and needed to be picked up from day care. ARE YOU F-ING KIDDING ME?!
• I scooped up pretty much everything that was on my desk in my office and went and got my son, crying the whole time. Like, I realize things could be worse, and for that reason I do not want to complain, but COULD YOU CUT ME A FUCKING BREAK HERE?!
• I got my son and took him home, and eventually my husband (who of course was working with his boss today) came home, and managed both kids while I headed off to my MRI.
• The MRI sucked.
• In reality, it probably wasn't that bad except that I was already in a very bad place mentally, and the IV injection was insanely painful due to the fact that I am on Xarelto, and all the injections as of late have left both of my AC veins ridiculously swollen and bruised. The MRI itself involves lying face down in this contraption that holds and squishes your boobs, which is extremely awkward and somewhat humiliating if you're already feeling super emo. 
• So of course I cried the whole fucking time.
• Fortunately, a breast MRI doesn't take nearly as long as a hip MRI.
• And then, after the MRI, I tried to pull myself together to go to my EMT class to take the final exam, and... I really couldn't pull myself together.
• This is hard, for a number of reasons, one of which is that I hate failing, and I have a public persona of always being put together. I also hate the idea of not being able to pass a class that people who haven't even graduated from high school yet are going to pass. I like to consider myself a competent and responsible person, one who should be able to pass a class that pretty much anyone who is 18 or older can take and pass.
• Also, there are people in my EMT class who are either former students of mine, or current students in the biology department at my college, and other things that make it hard for me to not be able to cry when I need to cry.
• Fortunately, a lot of these people are pretty cool, including my instructor and one of the women who sits next to me in class regularly.
• Because of the timing of my MRI and the fact that I didn't have time to go home between the MRI and class, I got to class a little early, and had a rare, one-on-one opportunity with my EMT instructor. I unloaded everything on him, and told him that while I really wanted to pass the class, and was trying to hold it all together for the next week, I wasn't sure if that would be possible.
• He assured me I could pass the class, and that he would do what he needed to to make it happen. This wasn't an easy thing for me, but at the same time, I do feel like I've been extremely dedicated to this class all semester and 'deserve' this. I felt so thankful that my instructor recognized the effort I've been putting into the class since January, and also felt like it shouldn't go to waste.
• After this conversation with the instructor, I sat down to try to study for the final in the 20-30 minutes I had before class started. However, immediately thereafter, one of my classmates came in and plopped down next me, and started chatting.
• Awkwardly enough, this classmate is actually a patient care tech and anesthesiology tech at the very place I am going to have surgery in a week. I realized this earlier in the day, and was thinking it would be SUPER WEIRD, and was thus trying to think of a way to tell her.
• Also of note... this woman is super competent, but also super snarky (which I LOVE, because I'm also super snarky, which is perhaps why we've gotten along so well). She can easily pass the 'competency' part of the practicals but sometimes fails because she 'exhibits inappropriate affect with patients.' LOL.
• Anyway, she sat down next to me and we started talking about our level of preparation for the exam. Finally, I said the exam really wasn't high priority for me, and then told her about the breast cancer. Given her personality, I was sort expecting some super insensitive remark, and was ready to be okay with it, but in her typically snarky manner, she replied, 'Jesus Christ, I'm so sorry!' And right then and there, I knew things were going to be okay. Then she asked me who my doctor was, and when I told her it was Dr. L, she assured me that she was THE BEST. (OMG, YES, SHE'S THE BEST!)
• It was all good, and reassuring enough that I didn't start crying all over again.
• Then she said that one way or another, she would definitely see me next Monday, which made me glad I had told her. I said I would be sure to throw up on her. LOL. (A common theme in EMT class is that you will definitely get thrown up on.)

On a different note, so far I've been telling people about this on a 'need to know' basis, but today I finally told my book club friends about all of this, since I am supposed to host the book club in a few weeks. I got so many amazingly supportive responses, but perhaps the one that's most meaningful at this point, which is something I alluded to previously, was: The hardest lesson you are going to have to learn is to let go of the idea that letting others help out will make you look, feel or seem weak. It's not true, let us take the kids, buy groceries, make dinner, do homework or housework, or whatever. 

 

It's enough to make me start crying all over again. As a pretty 'closed' person with not very many close friends, it is creepy to think I have a friend who can sees this in me, as if s/he is reading my mind. At the same time, it is also such a privilege. There have been many times in my life when I have not had friends to lean on, even in the most difficult of circumstances (like lying in bed on bed rest for three months with literally just me, myself, and I). In a way it is comforting to know that perhaps the hardest part about this won't be constantly throwing up or losing my hair, but instead learning to accept others' help.

End-of-Semester Insanity + REALLY GOOD NEWS

Things are pretty crazy right now. This is always a crazy time for me in terms of work, and this cancer crap has added a whole new dimension of craziness. Yesterday I told the Chair of my department what was going on, just because I had told enough people in the department about it that I figured it wouldn't be long before heard it through the grapevine. He has been good enough to me that I would rather him hear it from me. Plus, I've been asking colleagues to cover for me, which is my business (which is one of the things I love about my job), but at the same time, I want it to be known that it's not because I'm taking off for an early summer vacation. As expected, the Chair was extremely supportive, and assured me that no matter what, the department would accommodate my needs. Also, since we will have a new Chair in the fall, and this might potentially affect my work in the fall, he asked me if I wanted to tell the new Chair or if I him to. I asked him to. I told him it's not as if it's a secret, but at the same time, it's not something that is really easy for me to talk about with other people, especially those I don't know well. And I discovered this is one way people can help me a lot: by telling other people for me. People who should know, but people I feel awkward telling.

Anyway, here is how the next eight days are shaping up:

• Saturday (tomorrow): EMT class from 8 AM - 5 PM
• Sunday: Hopefully rest (isn't it Mother's Day?) and get caught up with grading (Needless to say, I am SO. FAR. BEHIND.) and studying for my EMT class
• Monday: Give a final from 10:20 AM - 12:20 PM; MRI at 4:20 PM; EMT class from 6:00 - 10:00 PM (includes the written final exam - eeek). I think the MRI is to try to see if the cancer has spread to other areas within the breast tissue. Dr. L was originally undecided about the MRI, explaining that they often pick up a lot of 'noise' and sometimes end up resulting in unnecessary stress/extra biopsies; however, after doing her own ultrasound and discovering some suspicious-looking lymph nodes, she decided to order an MRI. That does not seem to be a good sign, now that I think about it.
• Tuesday: PET scan at 9:00 AM. This is to follow up on the suspicious spot on my rib and look for other cancerous areas within my entire abdomen. (I think?) This involves fasting and dye and is going to take at least two hours and doesn't sound pleasant at all. Then at 3:30 PM, I have an appointment with a genetic counselor. Apparently if I want to have further genetic testing done, I have to meet with a genetic counselor. I'm not sure how I feel about this, but since I don't know my family history, I decided it might be a good idea.
• Wednesday: Give a final from 8:00 - 10:00 AM; EMT class from 6:00 - 10:00 PM. On Wednesday afternoon, I was supposed to have a consultation appointment with Dr. Not Friendly about PAO surgery (remember my hip?), but needless to say, I canceled that appointment. I can so not think about my hips right now, even though we are having terrible weather and they are absolutely killing me. Oh well. The good news is that they are not literally killing me. I'll have to start rethinking how I use that phrase. LOL.
• Thursday: Meet with the medical oncologist at 10:00 AM. I am supposed to give a final from 8:00 - 10:00 AM, and I guess technically I could be there for most of it, but... I have an awesome colleague who is going to cover it for me (a different one than the one who covered for me this week). So... I'm just going to let her cover the whole thing. Back to one of my survival strategies: Let People In, and Let People Help.
• Friday: Nothing scheduled so far. Hopefully I'll be able to actually, like, get some work done. Apparently Cheri actually scheduled my PET scan for Friday morning, but then my husband didn't think it was soon enough and called around, and I got the appointment on Tuesday at a different place - the place that knows me reeealllly well now. Gee, it has been a whole week since they've seen me; I guess it is time for me to visit them again, haha.
• Saturday (a week from tomorrow): I have my practical exams all day for my EMT class. This is a big deal. While it's small in the large scheme of Waning's Current World, I have put A LOT of time and effort into the EMT class for the past 4.5 months, and I would really hate to see it all go to waste. I hope, hope, HOPE I can hang on enough to pass the exams, which would be a challenge for me even under normal circumstances. (I am a book person, not a hands-on people person.) If I can't, then I can't, but I'm really hoping I can hold it together for just another eight days. There have been times throughout the semester when I have not been in the mood for class, yet the class has always lifted my spirits. I have thoroughly enjoyed it and learned so much, and I hope that for the next week, the class will be a welcome distraction. Things are getting fairly intense, though, so it's hard to predict how everything will unfold. Again, my stress level is already at an all-time high, and I'm trying not to put extra pressure on myself about this, but still. I would love to be able to pass my practicals so that I'll be eligible to sit for the national exam when I feel up to it.

On a different note, I mentioned that I understand it's hard to know what the right thing to say is in situations like this. I don't even know what I want people to say, and I only know what I DON'T want them to say after they say it. LOL. As someone who often says completely the wrong thing, I can totally relate to the horrible feeling of not knowing what to say, yet wanting to say something. A few years ago, my brother and his wife lost a child in the third trimester of my sister-in-law's pregnancy. It was extremely devastating, and I had NO IDEA what to say. What can you even say to people who just had to deliver a dead baby in the middle of one of the happiest places in the hospital? There are no words for that. I remember having a conversation with my brother where I kept saying, 'I'm so sorry, I don't have any idea what to say,' and him responding, 'I know.'

But today, I made a new discovery: while it is easy to note the things you don't want people to say to you, it is just as easy to make a note of the things people say to you that are awesome (and keep them in your arsenal for the future). I came home from work and discovered that my daughter had a friend over. My daughter knows about the cancer, although it's hard to know how much the 9-year-old mind can grasp about the situation. When her friend's mom came to pick her up, she said, 'I know third graders don't always convey information accurately, but Lilly told me you have breast cancer?!' I was totally not prepared for that, as I don't know this woman very well, despite the fact that our daughters are pretty good friends, and I was a) surprised that this type of information could make it through the third-grade grapevine with such speed and accuracy, and b) surprised she brought it up (not sure I would have if the situation had been reversed). I replied that it was true, and the conversation that followed was Textbook Perfect. Basically this woman said all the right things, even though I had no pre-conceived notion of what 'the right things' even were. Like I said above, I only recognized these as the 'right' things after I actually heard them, and realized they were actually making me feel better, and not like I wanted to run away and start sobbing. And they are really quite simple, actually. The two major themes:

• I'm sorry; I really don't know what to say except I'm sorry. (I know this feels LAME when you're saying it, because I've said it so many times, and it has felt lame, but I now know it's really okay on the other side of it.)
• Please let us know if we can do anything; we'd really love to help. (Granted, don't say this if you don't mean it, because I just might take you up on it.

Anyway, a few concluding remarks:

I'm going to bitch about a lot of stuff here, and some of it is going to be sort of vague, due to the fact that I want to retain some anonymity here. I realize this is a public spot, but I'm choosing to write all of this here not because it's about me, but because it's about the more personal side of the things I'm experiencing, and I've personally learned a lot from reading about others' personal experiences with similar issues.

If you are reading this because you know me and care about me - and that includes IRL and Internet friends - please know that if I'm complaining about an annoying person, it's not you. Yes, if you know me, you know I'm passive-aggressive, but I will not exercise that trait here, I promise! I just don't want to create an environment where people are afraid to talk to me or e-mail me or leave comments or text me or whatever because I am super pissy and they are worried about saying the 'wrong' thing. It is the comments and e-mails and texts you send me that uplift me and help me get through this, and I really want you to know that.

* * * * *

While I had planned to end this post with the My Friends Are Awesome And I Love You message, I got some awesome news somewhere in the middle of the post. And because I love you, I also want to share the good news with you.

Upon returning to the computer sometime mid-post, I also had a notification of new activity on the patient portal I signed up for, at Dr. L's recommendation. When I met with Dr. L on Wednesday, she encouraged me to sign up for the patient portal, saying that any test results she got, she immediately released to her patients, so we could see exactly what she saw. She also said that it was good because while she always called patients with test results, she knew it could be a lot to take in, so you could always go onto the portal and read a report of what she had told you. (I've written about patient portals before, and how I have mixed feelings about them, but so far the patient portal with Dr. L has been an amazing resource. I've even been able to read about my hips...)

Anyway, I logged onto the patient portal and read the new message, which said:

Hi Waning, great news, the node was negative for cancer. I am happy with proceeding with surgery if you know what you want to do, or we can wait for your genetic results.
Give me a call Monday and let me know what you'd like to do.
Jane Kay Listens

I read the message and immediately wanted to start crying (out of happiness - duh!), while at the same time thinking it was weird she hadn't called me to share this news before sending me an e-mail about it. Of course, I then checked my cell phone, and she actually had called me, around the same time I had been having Awesome Conversation With Daughter's Friend's Mother, and had left a message conveying all of this. Have I mentioned that I love this woman?

I also found it interesting she signed the e-mail as 'Jane Kay Listens' as opposed to 'Dr. Listens,' considering most of the people I work with refer to themselves as Dr. So-and-So, even though they are 'mere' Ph.D.s and not even MDs. Like... I get it... to a certain extent. But still. Anyway, it's a story for another time!

This is the best BEST BEST news I've had in so long, so I'm just going to go with it. :)

The Shit People Say

On Monday, I wrote about how a lot of people say really irritating shit when you tell them you have cancer, but that you have to be tolerant. Today, I discovered the limits of my tolerance.

This afternoon I picked up my daughter from her piano lesson, and her piano teacher was going off on her about not practicing. Then she went off on me about my daughter not practicing and how it is a waste of her time and our money and yada yada yada if my daughter doesn't practice. I agree, and my daughter not practicing piano (and generally not putting much effort into anything) is an ongoing issue. But... it's a really low priority right now. My daughter is not a bad person, she just lacks self-discipline, sort of like a pretty typical nine-year-old. We are working on it, but it is a process, and it is an uphill battle considering we live in a culture of instant gratification, where young people expect everything to be spoon fed to them. And admittedly, I'm not ever going to win any Mother of the Year awards, either. I love my kids to death, but I'm pretty much a terrible mom. So there you go.

Anyway.

Finally I told my daughter's piano teacher that in my daughter's defense, the past couple of weeks had been pretty rough. She kept yammering on and on and on, though, so finally, to try to get her to SHUT UP ALREADY, I told her that I just found out I had breast cancer. Honestly, I really wasn't going to say anything, but geez, can you cut us some slack here?!

Unfortunately, that just made her launch into her own story about breast cancer. The annoying thing about breast cancer is that it is so common that everyone knows someone who had breast cancer, and therefore everyone thinks they are an expert on breast cancer. And because breast cancer has a high survival rate, everyone has tips on how to beat it, because they know someone who did X and she is fine now. In the case of my daughter's piano teacher, her mother had breast cancer. Not a shock. A lot of people's moms have or had breast cancer. The thing is, most people's moms don't have breast cancer at the age of 40 (and actually, the two women I know of who did have breast cancer in their 40s ended up dying of breast cancer, in their 40s).

So she immediately started lecturing me about how her recommendation would be to get a double mastectomy and just get it over with. She proceeded to tell me how her mother had wanted to have a double mastectomy right away, but the doctors wouldn't do it because it was too risky because she was diabetic and had heart disease. So she had a mastectomy on the breast that had cancer and then six years later she got cancer in her other breast and then had that one chopped off and was mad because she had wanted it chopped off six years ago. She went on and on about how her mother had a good relationship with her father and knew that he would continue to love her even if she didn't have breasts so she was secure enough to not even have her breasts reconstructed; she just wore a prosthetic and she looked completely normal in clothes. Oh, and then she died three years after her second mastectomy (but not of cancer).

Gee, what a heartwarming story. WTF?!

First of all, don't lecture me about having a mastectomy if you don't know anything about my particular case, or even if you do (unless you're my doctor or genetic counselor). And don't talk to me about a mastectomy as if it is not a big deal. It is a big deal. Obviously, it is better than dying, but even so, it is not something you can talk about in the same tone you use to talk about what color you are going to dye your hair. Also, your mother getting breast cancer at the age of 70 is not the same as me having breast cancer at the age of 40. I'm sure I'd be approaching all of this with a much different mindset if I were 30 years older. In 30 years, I'm sure I won't be spending nearly as much time hanging out at the pool in a swimsuit as I do now.

At my appointment yesterday (it's hard to believe that was only yesterday), Dr. L made a point of saying that she did not want to be overly aggressive just because I am young. That is not to say that she wants to be overly conservative, either; however, she said that the knee-jerk tendency is to bombard younger women with all sorts of super aggressive treatments, even if there is no evidence that they help. She said her philosophy was to treat people based on their tumor characteristics, not their age. For most women, a lumpectomy + radiation is just as effective as a mastectomy. It's called evidence-based medicine.

The thing is I'm really not a super sensitive person - not about things like this, anyway; it takes quite a lot to offend or upset me. As I was mulling over why this conversation upset me so much, I was thinking back to a conversation I had with a woman in my EMT class last week. We were talking about breast implants - haha. The whole breast conversation started because we were doing EKGs, and to hook a person up to an EKG machine, you have to, well, get fairly touchy. Anyway, this woman declared that she didn't understand breast implants because 'I have the hugest boobs and I hate them.' I told her she did not have huge boobs (she really doesn't), and she then informed me she was wearing two bras, and 'I've pretty much been wearing two bras ever since I started wearing a bra.' LOL. Then she added, 'I've often thought that if I got breast cancer, I'll just tell them to cut my boobs off and leave them off.' The irony in the timing of the conversation was a bit much, as it was the same day I had my biopsy, but... I thought it was pretty funny. In fact, I still chuckle when I picture her saying this. She'd probably die of embarrassment if I told her that I actually do have breast cancer.

I've ranted about this before. I really hate reading lists of '10 Things You Should Never Say to Someone Who...' (fill in the blank: just had a miscarriage; just got divorced; just got whatevered). I'm sure I've said a kazillion things in my lifetime that were on those lists, without malice in my heart. But geez, people. If you are going on and on about something and the person is getting ready to cry and is walking away from you, take it as a sign to shut the hell up.

When Life Gives You Lemons...

A couple of my friends have sent me this link, so I thought I would share it here:

http://www.slate.com/blogs/the_eye/2015/05/06/empathy_cards_by_emily_mcdowell_are_greeting_cards_designed_for_cancer_patients.html
 

I LOVE THEM! :)

Unfortunately, there is some mixed news on the cancer front, and the day isn't even over yet.

The good news is that the estrogen and progesterone tests for the tumor came back, and it is highly sensitive to both estrogen and progesterone. This means the tumor should be very treatable. 

The bad news is that the spot on my rib that showed up in the chest CT is slightly suspicious, so Dr. L consulted with the oncologist I'll be seeing next Thursday, and they agreed it needed further investigation. So I will need to have a test to check it out. Dr. L did say that it looks more like trauma than cancer, but I honestly can't think of a time I ever injured my ribs. And as she put it, 'Breast cancer does like to invade bones.' 

The location also seems suspect, considering it is my on my left 7th rib. According to the report: There is a lytic lesion with a sclerotic rim in the anterolateral left seventh rib and measuring up to 0.6 cm in axial dimension. Also: There is a mildly prominent left axillary lymph node which is nonspecific. Both of these things have the potential to be... bad.

Ugh. 

And apparently I am deficient in Vitamin D.

The good news is that I suppose it is better to know the bad news before the treatment plan is established. And I feel confident that Dr. L is being extremely thorough. So far she has been absolutely fantastic. That said, remember how long I stuck with my orthopedist because he was such a nice guy? And how I finally came to the conclusion that I don't need a nice orthopedist, I need one with whom I will not have a long-term relationship? While Dr. L has been great in the 36 hours that I've known her, talk about a doctor you hope not to have a long-term relationship with!

Consult with the Surgeon

I saw Dr. L, the surgeon, today, and she was fabulous. That is a relief.

There is so much I want to say, so many details I want to capture about all of this, but in the interest of trying to allow myself some rest, I will have to write abridged versions of everything, at least for the next few weeks until I get to the end of the semester and the end of my EMT class. Today was pretty much the longest. day. ever. Major events:

1. I had an appointment with the surgeon at 9:20, with a 9:00 check-in time. The appointment lasted until about 10:30.
2. After meeting with the surgeon, we met with the 'nurse navigator,' whose job is to help us get through all of this. It is truly an amazing resource to have because I'm already overwhelmed by everything, and she basically scheduled all of my future appointments for me.
3. After meeting with Cheri (I better give her an actual name because I have a feeling she is going to be someone I talk about a lot in the next few months), I went to get a chest X-ray and a blood draw while my husband took off to get me something to eat. The surgeon also wanted a chest CT, and I was not allowed to eat for two hours before the CT, for whatever reason. The CT was scheduled for 2:40, so I need to be sure to get something to eat before 12:40.
4. After the chest X-ray and the blood draw, I sat down in the lobby of the medical center and ate a quick lunch and then took off to get to work. At work, I checked in with the colleague who covered my classes for me and then printed off some exams.
5. I dashed off to get my CT, which was at the north branch of the hospital about 20 minutes away.
6. I had a chest CT with contrast dye.
7. I raced back toward town to pick up my son and take him to gymnastics. I got a brief moment of quiet while my son and daughter were in their lessons. (My daughter gets a ride from school with a classmate whose mom owns the gym.)
8. My son had the Mother Of All Meltdowns after his lesson. And I Could. Not. Deal. Major parenting fail. Oh well.
9. I took the kids home, ate an early dinner with the family, then headed back up to work around 6:30 PM to give an exam for an online class I teach. (They have to take the exams in person.)
10. I told the class I was Very Tired, and I wanted to leave right at 9:00, so they needed to finish the exam by 9:00.
11. At 9:00, the one student I was worried about, who always takes fooooooreeeever, turned in her exam, then said she needed to talk to me. One gigantic sob story later, I was ready to leave by 9:30.
12. I came home to a gin and tonic waiting for me in the kitchen, which I am enjoying now.

Very generally speaking, the theme as of right now is cautious optimism. Some highlights:

• The tumor is relatively small. Dr. L said, 'Anything under 1 cm makes me happy,' and it looks like the tumor is just at 1 cm.
• The tumor is 'well differentiated,' which means it is a slow-growing and not aggressive tumor. Supposedly this makes it very likely to be a hormone-driven tumor, probably by estrogen. Also, according to Dr. L, hormone-driven tumors are more common within five years of having a child, due to all the changes in hormones that occur with pregnancy. Given the fact that I have a 3.5-year-old and the tumor is classified as 'well-differentiated,' the odds are that the tumor growth is being driven by estrogen.
• The good thing about this would be that there are fairly effective estrogen blockers.
• Overall, all signs are pointing to the tumor being very treatable.
• The major complicating factor in all of this is my DVT, which will need to be managed during and around surgery. This is also the reason the surgeon wanted a chest X-ray and chest CT - to make sure my lungs are clear, since I've never actually been checked for a pulmonary embolism.
• Unfortunately, if the tumor is an estrogen-driven tumor, the only treatment for pre-menopausal women is tamoxifen, which... can cause blood clots. We'll have to cross that bridge when we get there.
• Right now the recommendation is a lumpectomy, although that could change if it turns out that I have one of the genetic mutations that makes me at high risk for recurrent breast cancer (think Angelina Jolie), in which case the recommendation would change to a prophylactic mastectomy.
• Unfortunately, the genetic testing for specific mutations can take a while, up to a month. Since the chances of having one of these mutations is relatively small, the surgeon was okay tentatively planning to proceed with a lumpectomy ASAP.
• She said that the results of my ultrasound from the imaging place had shown that the lymph nodes around the tumor looked good; however, then she did her own ultrasound and said that she saw a few suspicious spots. So she did a biopsy of one of the spots and also ordered an MRI; the results of these could be potential game-changers. The original thought was that it was unlikely the tumor had spread, but now it is less certain.
• The biopsy she did wasn't nearly as bad as the one I had a week ago, although it was still slightly unpleasant.
• The chest X-ray was uneventful, as was the blood draw.
• The chest CT was unpleasant, but fast. I was nervous when I heard it involved iodine, as I know from the arthrograms that having iodine injected into the hip joint is very painful. However, for this type of imaging, the iodine is injected via IV, which is not painful, but makes you feel extremely hot, and like you are peeing yourself. (I'm not kidding - fortunately the tech warned me about this.) Fortunately the feeling is very short-lived (less than a minute). Overall, it was nothing compared to the other things I've had done to me in the past few months.
• The good news is that my chest CT was clear, which is a relief. I wasn't really worried about PE so much as the idea that the tumor had already metastasized. All in all, it was worth the discomfort for peace of mind.
• I had one of those talky techs who told me after the CT that everything looked fine, then Dr. L called me around 4:30 to confirm that my chest was clear. Unfortunately, this was in the middle of my son's Mother Of All Tantrums at the gymnastics center with approximately 20 judgmental parents staring in horror, so I did not answer my phone when it rang. Her message sounded positive, although she said there was something weird with my 7th rib? And wanted to know if I had ever injured it? Or something? Unfortunately, I accidentally deleted her message before I could listen to it again.
• I have an MRI scheduled for Monday.
• I have an appointment scheduled for next Thursday with a medical oncologist/hematologist. She will take care of the non-surgical portion of my treatment - radiation, chemotherapy, etc. The sort of funny thing is that I mentioned how my dad has been doing crazy intense research on the best doctors, and just this morning he sent me a recommendation that is actually IN TOWN - a recommendation from a senior faculty member, an oncologist, at University Hospital. I briefly glanced at the recommendation and the link (and I do mean BRIEFLY), and the only reason it made an impression on me at all - and this is going to sound horrible - is because a) it was a woman (I've clearly been spending too much time with orthopedists, who are, like, 100% male) and b) she was African (which is really not something you see a lot of where I live; this town is, like, 80% Caucasian, and most of the diversity is due to military influences). The doctor also has a very mind-boggling name. LOL. Seriously, I'm not a hick, but I actually looked at the name and thought, whoa, if I ever went to see her, I'd definitely have to ask ahead of time how you pronounce her name.
• ANYWAY, when Cheri, the nurse navigator, asked me if I had a preference as far as oncologists go, I said that I had just gotten a recommendation, then proceeded in hick fashion to explain that I couldn't remember the name of the doctor but she had a funny name. LOL. Eventually we figured out who I was talking about, and the name really isn't that hard to pronounce once you know which letters are silent. Ha.
• But this is huge, because I actually used one of my dad's recommendations, which should hopefully make him and my mom happy enough to get through at least some of this, and not question whatever therapies she suggests. (She does have extremely impressive academic credentials; hopefully she is as impressive as a practitioner.)
• Supposedly I am also supposed to meet with a genetic counselor at some point? I'm not exactly sure why - that got lost in the chaos of everything. They called me as I was trying to get my son from daycare and told me that they had an appointment available on July 9th. WTF? I was sort of like, um, whatever. After a bit of back and forth, the scheduler told me she would see if I could get in earlier and I was sort of like, whatever. (Not to be a snob, but I TEACH genetics and am not convinced a genetics counselor can tell me anything I can't figure out of my own.) And to make a long story short, this appointment is sort of up in the air at the moment.

On a different and less medical note, a really weird thing happened before I went to my appointment this morning. I was a little early, so I went to the restroom before my appointment. I was aware there was someone else in the restroom, someone with a little kid. I came out and was washing my hands and I saw the woman and the kid looking at me, so I smiled. Then as I was walking out the door, the woman stopped me and declared, 'Waning!' I looked at her, my mind racing, trying to figure out who she was. I'm not good with faces, and I am TERRIBLE with faces out of context. Even if I know someone fairly well, if I run into her/him outside of the normal context in which I'm used to seeing her/him, I often don't know who it is. Fortunately, the woman realized I didn't know who she was and told me, and I immediately knew who she was. (I am good with names and numbers.) (And in fairness to myself, I feel like others are at an advantage when it comes to recognizing me, because I am not Caucasian, and therefore stand out more than your average, well... Caucasian.)

I've mentioned before that in a previous life I was a diver and a diving coach, and so was my husband. The diving world is fairly close and tight-knit, so even if you don't know people, you know a lot about them. This woman is the wife of a coach my husband and I know fairly well. She and her husband have an assload of kids (I'm pretty sure it's at least eight), and last I knew, they were done, which was pretty much biology in action, as this woman is older than I am. I'm not sure of her exact age, but it's definitely mid- to late 40s. As I was standing there trying to figure out the age of the kid she had with her, I guessed he was around four of five and was thinking, 'NO WAY! She had ANOTHER KID?! WTF? However, she then went on to explain that this was her youngest, and he was actually seven, but he had a disease of the esophagus that required him to have a feeding tube, and that they were on their way to therapy. She mentioned something like, 'It has been hard.'

I sort of stood there, contemplating. We were in a fairly large medical complex, so there could be a number of reasons for being there. I could tell she was obviously curious about what *I* was doing there, but at the same time she was very respectful. Finally I was like, 'Well, I just found out I have breast cancer, so I'm on my way to see a surgeon.' After that she was like OMG I am so sorry, and gave me a huge hug, and eventually we went our separate ways.

It was just weird because while I truly feel that what I'm going through right now sucks, I realize it could be worse. At the same time, I've never been one to be overly optimistic. I realize you can always find someone who is worse off than you are, but I don't think that necessarily means your situation doesn't suck. However, even in the heat the of moment, I found some comfort in the fact that I was heading off to an appointment about a probable lumpectomy rather than an appointment for a seven-year-old who looked like a four-year-old. I've been through a lot of things with my kids, and know that dealing with issues with kids sucks. Big time. If I have to have a major issue, I'd rather it be with me than my kids.

I guess the major take away message is that life throws each and every one of us curveballs that we have to deal with, and there is no point in wasting time trying to figure out if this is fair or not, or how it compares to what others are going through. You can always find someone who is worse off than you are to make yourself feel better, and you can always find someone who is better off than you are to make yourself feel horrible. But in the end, it is probably best just to stay within yourself and deal with your own reality.

In conclusion:

I feel as if I've hit the ground running, and for me that's a good thing. One of the things I wasn't sure about when all of this started was what sort of timeline we were looking at. I'm pleasantly surprised by how quickly things are moving along. After dealing with the snail's pace of other specialties, it is hard for me to believe that in one day, I had a biopsy, an X-ray, a blood draw, and a CT. Everything is moving so fast I don't feel like I even have time to breathe, but in the end that's a good thing. As my PCP said, waiting without knowing is the worst, and I've definitely found that to be true.

So here's to thankfulness for moving forward.

Cancer, DVT, and Hip Pain (in that order)

I saw my primary care doctor today; I'm not exactly sure why. Ever since his PA left, he has been overwhelmed, and it has been ridiculously hard to get an appointment. I set up this appointment several weeks ago, I'm sure as a follow up to one test or another. (I lose track.) I was going to cancel the appointment, but then my husband suggested that I keep it, so I did, more for him than for me. He picked me up at the university so I didn't have to give up my parking spot, and when we went into the doctor's office, he signed in as if he were the one being seen. LOL.

The appointment was fine. Basically it was a lot of hand-holding, and a lot of 'this is what you should expect,' which was actually good, because this is new territory for both of us. Dr. A apologized for not having more information, and said that he understood that waiting was the worst part. However, all he had was the preliminary pathology report stating that I had an invasive ductal carcinoma, so we would have to wait a bit more for specific information. He did say that no matter what, the priority at this point was having surgery to have the tumor removed, and that future treatment would depend upon what was found during surgery, as well as the more specific results from pathology. There are some more specific things I could discuss, but... I'm too tired. I love being surrounded by a bunch of people who know a bunch of stuff about cancer, but it is also tiring. While most normal people ask about the stage of cancer, my colleagues are curious if I have a TNM stage or HER2 results or... other things I haven't heard of before. It's enough to make my head explode.

Toward the end of the visit, Dr. A noted that my husband looked worse than I did. My husband shrugged and mentioned that 'it comes and goes.' Since I didn't want his male ego to be damaged, I offered that the anxiety seemed to bounce back and forth between us (which is true). Finally, Dr. A asked how the rest of my body was doing. I gave him the abbreviated version of my hip saga, then we talked briefly about my DVT. As I was talking, he pointed to his chest, then his leg, then his hip, and said, 'I know your hips are affecting you a lot, but the priority is the cancer first, then the DVT, and then the hips.' I know this is true. My hips will not kill me, but DVT and cancer definitely can. The irony is that at any given moment, it is my hips that give me the most grief, but I can't think about them right now. Dr. A did say we would have to talk about alternatives to Xarelto once I had the surgery scheduled. He concluded by asking if I need prescriptions for anything and I said I needed a refill for Xarelto. Then is asked me if I needed anything for anxiety. LOL. I joked that I had plenty of wine. Later, when I mentioned to my colleague that it would terrible if I could not drink wine while doing chemo, she reminded me that I could always smoke pot, haha. Oh the awesomeness of living in a place with no money to fix roads, but where you can go to the local dispensary and buy pot - pot candies, pot brownies, pot soap, you name it.

All in all, I am feeling pretty positive right now. Seeing my doctor and talking to a few colleagues and friends about the ordeal has helped me so much, which is actually surprising, but in a good way. The colleague who is covering my classes tomorrow - the one with whom I have a questionable relationship - has been amazing. I hate to say it, but it's true. The thing is I'm not sure I would have even told her except that on Monday, I had a little extra time between my classes, so I came up to my office and checked my e-mail and discovered that I had an appointment with the surgeon at 9:00 AM on Wednesday, which is pretty much the worst time ever for me in terms of my work obligations. When I told my second class that I would unfortunately not be able to make it to class on Wednesday, they were really upset (which I get, seeing as how it is the last class of the semester and a review day, but still... college kids being upset about a class being canceled? WTF?). So I told them I would try to get a colleague to cover for me, and while they were watching a video, I ran upstairs, and this particular colleague happened to be in her office, so I unloaded on her. I knew I only had 10 minutes until the video ended, so it all just came out. In the end, it was a good thing.

Anyway. I have been investigating the surgeon with whom I am meeting tomorrow and have so far turned up nothing but good information, so I hope that she is as awesome as she appears to be in the virtual world. If I hate her, I'm not sure what I will do. At this point, I'm inclined to take a kitchen knife and just saw myself open. However, my recent experience also makes me understand the importance of a good surgeon, especially with something as weighty as this. But I guess all I can do is wait and see. And think lots of good thoughts.

Lean on Me

A while ago, I wrote about the five stages of grief, DABDA. I have to say I haven't experienced any of these yet. I'm mostly feeling sad. Sad and irritable. OMG. Irritable. I'm already a very irritable person, and this latest bump in the road certainly brings out the worst of this major personality flaw that I have. Speaking of bumps in the road, to make an analogy, on Saturday, I spent the day at a local fire station, with their EMT and paramedic. I live in a place where people are not willing to pay taxes, so, surprise, surprise, we have the worst roads ever. Potholes galore. Trust me, these are horrible in a car, and downright dangerous on a bike. But after Saturday, I realized they are way, way worse when you are in ambulance. I can normally manage my irritability, but it's now at a level where I feel like I am strapped down in a cot in the back of an ambulance and screaming at every freaking pothole I hit. It's not a good feeling.

To make things worse, it's that time of year when I get really pathetic and groveling e-mails from my students, and I feel like responding to each of them with, Look, during the past semester, I've been suffering from debilitating hip pain, dealing with life-threatening deep vein thrombosis, and I just found out that I have breast cancer, yet I have come to work every freaking day and tried to force some information into your lazy freaking ass, and graded all your freaking exams and homework in a timely manner, so if your reason for needing an extension on a freaking three-page report can't beat that, then go freaking screw your freaking self.

Don't worry... I've yet to actually respond to an e-mail like that, because all I need on top of all of this is to lose my freaking job.

(Did I mention that I have been really freaking irritable lately?)

Obviously my mind has been going nonstop since Friday, and I've been dealing with a bunch of stuff that I couldn't begin to summarize here, so I'll just hit the highlights. The two biggest things I've noticed are:

1. When you tell people you just found out you have cancer, they will say a variety of things, and some of them will be freaking annoying.
2. Generally, people will really want to help you. That's the awesome thing about cancer (LOL) - it freaks people out much more than something like debilitating hip pain. You could be limping around for a year with no one really batting an eye at you, but if you tell people you have cancer, suddenly people are like, I'm so sorry - let me know what I can do to help out. 

Epiphanies related to these points:

1. You have to cut people a break. They aren't trying to be annoying; they just don't know what to say. And if you think about it, do you really know what you want them to say? Probably not, so whatever. Get past it. The fact that you're talking to them at all means you cared enough to tell them, so assume they care. Otherwise blame yourself for telling someone who doesn't give a shit and will say stupid shit when you tell them shit.
2. Let the people who want to help help. This is probably the most important realization I've had in the past 48 hours: I need to let other people in, let other people be a part of all of this. I need to let people do what they do the best, help in the ways they know how to help. This is not just about me, it involves a lot of other people, some of whom are more freaked out than I am (namely my husband and parents).

That said:

• I am glad that my primary care provider in all of this is my husband's doctor. Even though I've had mixed feelings about him in the past, he cares a lot about my husband and therefore a lot about me. He has shown a lot of compassion about all of this, and knowing that he will take care of my needs is a big thing, but knowing that he will take care of my husband's needs is an even bigger thing. It will also take some of the pressure off of me in terms of making sure my husband is okay throughout all of this. 
• I need to figure out a way to let my parents help that will not drive me crazy. My parents are academics and think that unless I go to the university hospital, I will die. I am not opposed to going to the university hospital, but depending on the treatment plan, it could be very inconvenient. Of course inconvenience is worth it in a life or death situation, but I don't know how bad this is. Overall, I need some space to get more information and draw my own conclusions about my healthcare providers and the treatments they suggest. So... I've been letting my dad contact all of his connections at the medical school and forward suggestions to me. I thank him and then let the e-mails sit in my inbox. But hopefully it makes him feel useful.  
• I'm pretty overwhelmed right now, and I am anxious to see a specialist and get more information. I have an appointment with a surgeon on Wednesday, one that was recommended by my primary care doctor. (My dad had his friend at the med school vet her, and supposedly she has excellent credentials. She is not, however, an oncologist.*) I feel very lucky that I was able to get an appointment relatively quickly, as waiting and not knowing is really the worst part for me. I'm anxious to get the ball rolling one way or another. 
• Unfortunately, I am supposed to teach all of Wednesday morning, and my appointment is right smack dab in the middle of both my classes. (Apparently they called the house this morning and my husband took the first available appointment with no regard to when it was.) This normally wouldn't be a big deal, but it is the last class of the semester before finals week, and I had promised my students we would spend the entire class reviewing for their exam. Obviously getting in to see the doctor ASAP is a top priority for me, but I do feel bad. Fortunately, one of my colleagues, who also teaches this class and is thus familiar with all of the content, agreed to cover my classes for me. This colleague and I haven't always been on the best terms, but she was SUPER nice about it and SUPER supportive. Her mother also happens to be a pathologist, and she said she would be happy to ask her to look at my biopsy results if I wanted. Back to point #2 from above: Let people help.

* According to my dad's friend: I don’t know Dr. L, but I’m glad to see that she’s now part of the University Cancer Center, and that should mean that she has a lot of expertise to draw on. She’s a surgeon, with an impressive training and experience record, and I assume she consults with experts in other forms of therapy. Invasive ductal carcinoma usually is treated early by lumpectomy, though it can be preceded by some form of chemotherapy, and is commonly followed by that, and/or biological therapies like the monoclonal antibody Herceptin, depending on the results of typing that the pathologists do. Ask her to discuss the total plan with you and Waning; some of it may involve trips to University Hospital if certain therapies are only available here. And if at any time you fell you need a second opinion I’m sure that could be had at UH as well.

Overall, I feel better about everything than I did even just 12 hours ago. Perhaps you noticed that I calmed down significantly from the beginning of this entry to the end. That's because I started this entry last night around midnight and just finished it now. I just need some time. Time and deep breathing.