I'm giving away free tissue samples; at least that's what it feels like

The stereoscopic needle core biopsy wasn't as bad as I expected. Certainly, it wasn't as bad as last time. Perhaps it was more tolerable because of the meds, perhaps because of the extra lidocaine given up front, perhaps because I knew what to expect, perhaps because they had a "best of" Chopin CD playing.

It was lengthy, but not painful. I'm now familiar with the stinging shot of lidocaine. I didn't feel it when the MD put the needle core in to get samples. I heard, but didn't feel the samples taken.

What a relief.

They mopped me up (the MD said there wasn't much blood and the RN said there was), put bandages on my, stuck a big-ass bag of ice in my bra over the wound, and sent me home.

I came home, ate some lunch, and napped for four hours.

Prior to the procedure I asked what would happen if it was negative and this spot keeps showing up on my mammograms. Surely they're not going to want to do a biopsy each time it comes up. She said that unless it changes, they note that it's calcification that's already been biopsied.

I should have the results in three to four days. If it's positive, they'll schedule a visit with a surgeon when they call.

Oh, good. I was worried that my worries were over.

I'm pro-choice and I'm choosing...

One year ago, I was recovering from a "generous lumpectomy" and removal of 17 lymph nodes from under my arm. And the week after Thanksgiving, I started chemotherapy.

A few weeks ago I had a mammogram. It was the first since I was diagnosed with and treated for breast cancer.

I was nervous about getting the results. I contacted my oncologist and asked him to call me with them, thinking he'd contact me sooner than the usual method. I was not thinking that the results would be anything other than negative. I wanted that happy news as soon as possible.

Regardless, I got a voice mail on my cell phone from mammography, asking me to call back. I did, and whoever answered the phone stumbled around, saying, "The mammogram on your right breast was normal...  let me read through this...  on your left breast....  hmmm...  there appears to be something that they want to take a closer look at...."

She was killing me. She was fumbling around. She was not following through on the information delivery method I thought I'd orchestrated.

She got the RN who'd left the message for me to call me back, and she was much better. No nonsense. "There appears to be an area of calcification near the surgery site."

I know what that means. I learned all about calcification last year. It means it could be early cancer and the only way to find out is by doing a biopsy.

A few days later, the spouse and I saw my oncologist. He said he thinks it's scar tissue, and that I had choices in how to proceed. I could have a biopsy, I could have an MRI or I could wait six months and have another mammogram.

I asked him what he would do. He said "I think for you, rather than worrying about it, you may want to have an ultrasound-guided biopsy." He showed us the mammogram images, and sure enough, there was a little solid white dot. He said an MRI wouldn't do much more than confirm that there was something there.

I thought about waiting six months and having another mammogram. I thought about how surprised I was last year to learn that not only did I have breast cancer, but it had spread to my lymph nodes. I thought that if that little dot is cancer, I didn't want to give the little shit the opportunity to spread, so I told my oncologist I wanted to do a biopsy.

I chose.

He wrote the orders for the procedure.

Later, when another RN called to prep me about the ultrasound-guided biopsy procedure, in the middle of our conversation she stopped herself and said "Hold on. The radiologist's recommendation is different from what your oncologist ordered." Apparently the radiologist had ordered a stereoscopic biopsy, a procedure invented in the middle ages and not improved upon since then. She said she'd call me back. When she did, she informed me that I needed the stereoscopic procedure, which involves laying on a cold stainless steel table with a hole in it for my breast to dangle into. Under the table, a mammogram machine and radiologist lay in wait. The torture begins, it goes on and on, and it's so uncomfortable that it should be banned.

But apparently it's the only way they can see and get at such a small little globule of misfortune.

There must be something in my chart that says I'm anxious, because she recommended that I take 1/2 a Lorazepam right before the procedure. She said it would help me tolerate the discomfort.

A year ago, I would have clung to her saying that like Kate Winslet clung to her whatever she was hanging onto in the freezing water at the end of Titanic.

I now know that when medical professionals say "discomfort" or "uncomfortable" it will indeed be everything those words imply.

I had been prescribed Lorazepam when I was getting chemotherapy. Chemo causes nausea, so they'd load me up with steroids to counteract the nausea. The steroids kept me awake, so they gave me the "beddy-by" Lorazepam to counteract the side effects from the medication that was counteracting side effects. As she was recommending this, I told her I still had some left, and wondered to myself, like a junkie, if two pills would be better than 1/2 of one. I want to keep my suffering to a minimum.

Last week I saw my naturopath. She was distressed to hear my news, and gave me some recommendations for supplements. One in particular I found interesting. She said that during a biopsy like the one I'm having, it's possible to drag cancer cells through healthy tissue as they're extracting the thingy that grabs the tissue samples. The supplement she recommended is supposed to stop that from happening. Magical thinking, perhaps, but I'm game.

I told her about the Lorazepam conversation and she said "I'd take two."

That's what I like about her.

Unhunkering up, as opposed to hunkering down

 

If you'd like to start at the beginning of this blog, it's here.)

Last Monday was my last radiation therapy treatment. Since then, I've been trying to be happy about treatment being over. I don't know if it's my innate personality or the degree to which I have been hunkered down this past nine months, but I'm not naturally unhunkering.

I have made efforts to unhunker. On Wednesday, I asked my coworkers who have been especially supportive of me to go out to lunch with me at the Tamarind Tree. I was impressed that 27 responded "yep", including the CEO and my former Director.

I spent most of my time making sure everyone got the meals they ordered, and when I finally sat down to eat, I wasn't very hungry. Typical of me, but how could I have done it differently and had it turn out so nice?

*******

About 30 years ago I had a motorcycle accident. I was merging onto I-5 in Bellingham when a car rear-ended me. I went flying and I thought "Oh, shit!" Then I thought "My last words are going to be 'oh shit!'"

Obviously they weren't my last words, but for the six months following that accident, I was unusually happy. Strictly speaking, I was high because I was alive.

*******

That hasn't happened with cancer. There's been no remission high, so far.

*******

We had family and friends over yesterday to celebrate with us. It was a very nice crowd and they brought some great food. Their assignment was to bring finger food that begins with "C".

One of the funnier finger foods was salsa from my cousin Charlotte. She apparently thinks that since it came from Costco, it began with a "C".

*******

This is my last post. I'm ready to move on, and relearn what life is life without cancer and its treatment.

I'll be taking hormone-blocking pills for a number of years, go in for frequent exams to make sure that the nasty disease hasn't reappeared, and watch impatiently as my hair grows back in.

In my opinion, none of these are blog-worthy.

Thanks for reading,

Rebecca Roush

Ouch

I had my last radiation therapy treatment yesterday. The techs gave me a certificate for "graduating", and being one of their favorite patients. I asked how many get these certificates. "Most" was the answer.

I still feel special.

I want to savor this moment of being done with chemo and radiation, but I'm not sure how to. Perhaps meditating on it. Perhaps putting on my roller skates and skating like a bat our of chemo. Perhaps counseling. I don't know.

My breast and armpit and collar bone are burned. The skin is peeling. It hurts and is scary-looking. "I'm a freak!," I tell my husband. "No, you're not," he says back, "You're my Reb Roush."

That makes me feel better.

******

I'm supposed to start the Tamoxifen today. I'm taking so many prescription drugs and supplements that I'm beginning to understand how people get confused about their meds.

I laid out all my morning pills this morning and considered the Tamoxifen. I decided I'd take it when I take my prescription medications, to keep them the pharmacology lumped together.

Cancer-free..... but the medication's problematic

It's Friday, which means I have one more radiation treatment on Monday, and then I'm done.

Hard to believe.

Since this last Monday, I've been getting "boosts", which take a shorter amount of time than the treatments I was getting before.

The hospital made a mold specific to the area of my breast being treated by the boost. This mold will be melted down and recast for someone else, once I'm done with it.

It is placed in the "electron cone" contraption that is attached to the machine that gives the radiation treatment.

The boost is superficial therapy around the surgery scar on my breast. Electrons are the treatment during the boost, and since electrons are superficial, they don't go very far into my tissue.

When I was receiving the "regular" radiation therapy, I was receiving protons, which traveled all the way through my tissue, treating it as it went.

This photo, slyly edited to be discreet, shows the drawing the techs made on my breast with a surgical pen. It's the same outline as the mold, so they line up the machine to match the drawing before they start the machine.

My skin is doing pretty good, but I do have radiation burns. I've been told that the radiation will continue to burn my skin a week or two after the treatment stops.

*******

After radiation treatment today, I headed up to see the Oncologist, where the spouse was waiting. I made a few contributions to the hat basket, where chemo patients can freely take whichever hat they want to cover their bald heads. Each time I do something like dropping off the hats, I feel I've made a firm step away from the rigors of treatment.

Since my cancer was hormone receptive, next week I'll start taking hormone-blocking medication. This will decrease the chances of the cancer coming back.

The Oncologist said I'll take one kind of hormone-blocker (Tamoxifen) for a few years. It prevents estrogen from feeding estrogen-dependent cancer cells. Once they're sure I'm post-menopausal, I'll take "aromatose inhibitors", which sound like something that stops bad smells.

Tamoxifen has side effects, of course. Hot flashes will probably get worse. The Pharmacist told me that I'll probably get "central obesity". Isn't that a great phrase? Apparently the spare tire I've grown since being in treatment will remain or get worse while I'm taking this medication.

Oh, and a few other possible side effects, such as uterine cancer, blood clots, etc. One thing the Oncologist and Pharmacist both said was that it will probably speed up the slow-growing cataracts I was diagnosed with a few years ago.

My period may return. Regardless, if there's any sign of blood coming out of my groinicological area, I'm to immediately see my GP to ensure I don't have Tamoxifen-caused uterine cancer.

Gee-Zuz.

Today's conversations with the Oncologist and Pharmacist reinforced what I've learned while in treatment: Different medical professionals, when speaking on the same topic, will give different and needed information.

Such as, there are some ingestibles that contain estrogen, and so will need to be avoided. Soy products and yams are examples. And something called "black cohosh", which as far as I know I don't take.

My Oncologist said nothing about soy. The Pharmacist told me this important bit.

I guess tonight I'll be eating the tofu that's left in the Norge.

I told my Oncologist that my feet still hurt, and he told me that sometimes when nerves heal (they were damaged by the chemo-induced neuropathy), they may hurt. My finger joints have been aching, and he said that's probably also the nerves healing.

At the end of the appointment, I had to prod him. "So, am I cancer-free?" "Yes!" and he shook my hand.

*******

So, my last radiation treatment is on Monday. A month from now, I return to be seen by the Oncology Radiologist and the Nurse Practitioner. In six months, I have a mammogram, and I continue to have them annually, which isn't any different than I had been doing.

And I start the Tamoxifen on Tuesday.

Both the Nurse Practitioner and the Oncologist spoke of the importance of exercise. I've been riding my bike to work one or two times a week. Next week, when radiation's done, I can return to a regular bicycle commuting schedule. I've missed it.

*******

Between the post-cancer meds and the supplements my Naturopath wants me to take, I practically have a meal's worth of pills in the morning and evening. I will be taking pharmaceutical medications for many years, because of the cancer. I'm not happy about this, but I will behave.

*******

My hair is growing in nicely. It's definitely a pelt. I now look like I have a very short haircut. The hair is soft and when I run my hand across it, the texture indicates it's going to be wavy or curly. I hope so. After a lifetime of very straight hair, I wouldn't mind having some curl, even if it's for a short period of time. It's the least the awful cancer treatment could do, to make up for its nasty visits.

Meanwhile, in post-treatment treatment...

Great.

Hair, and the advantages of cancer treatment

My body is blossoming in hair. All the places that lost hair (which was everywhere) due to chemo are now sprouting like mad. My head is pelted, my groinicological area is pelted, my legs and eyebrows have hair again, etc. And, regretfully, my hag hairs on my chinny-chin-chin are coming back with a vengeance.

I am pondering never cutting or shaving my hair again, to experience the opposite of being so bald.

The hair on my head seems to change every day. Last week, it was clearly white on the sides and dark on top. Now it appears to be an even mix all over, and could be getting wavy.

The only place that isn't as hairy as it was before is the armpit that was operated on. I have a four inch long scar under there and I suspect that surgery removed some hair follicles.

When I see hairs in the bathroom sink at work, I know they're not mine.

*******

I now have six remaining radiation treatments. On Tuesday, they'll begin the "boost", of which I'll get five treatments. Then I'm done with radiation therapy.

I cannot wait to be done. I am more than tired of all this.

*******

It's been six months since I had surgery. Seems like a couple of years ago.

There are residual effects from the surgery, including continued numbness on the underside of my arm, my nipple looks like it's being tugged in from someplace inside my breast, and of course the two big scars.

*******

I've been thinking about the positive side effects of breast cancer treatment.

I've made a list for possible reference:

1. Spare time because of no hair (washing, drying, curling, etc.)
2. No need to shave legs or armpits (but then again, no desire to be seen in public in a skirt or sleeveless dress)
3. No scouting for facial hairs to be plucked because they're not supposed to be there
4. The heating bill goes down in winter (chemo-induced menopause and its associated hot flashes)
5. A socially-sanctioned period of it being okay to recline a lot (a revelation to those of us who have "look busy" bred into them)
6. Getting a seat to oneself on the bus because of how you look
7. No more menstruation (finally!)
8. Post-surgery pain meds
9. Learning about surgery drains
10. Learning what kind of nurse your spouse is....  or isn't
11. Learning to suspend fear