Hunh...

A little over a week ago, I was having some neck pain, as if I'd been under a lot of stress and my shoulders were trying to conjoin with my ears. I didn't think much of it, other than to wonder what was going on.

On Saturday, I was sitting in my La-Z-Bum chair, playing Scrabble on my laptop. All the sudden I had an intense chest pain that radiated up both sides of my neck and into my lower jaw. I called the consulting nurse and she told me to get my ass to Urgent Care, which I did, thanks to my husband.

After a few hours, they determined that I had not had a heart attack, and there were no blood clots roaming recklessly around my body.

Then on Monday, in an innocent move at a park, I scraped my knee as bad as I ever did when I was little, and injured my ribs on the side of my body that I'd had cancer, surgery and treatment. The next day my chest hurt like crazy. I called the consulting nurse again and she said I'd probably bruised or cracked my ribs. On Thursday, it hurt so bad I called the consulting nurse again. She advised me to come in and see someone because the injury happened on the same side as the cancer, etc. 

So, I left work and went in. The Nurse Practitioner examined me and had me have a chest x-ray. The x-ray showed no cracks, but did show quite a few staples in my body from the cancer surgery.

I had no idea. I said "Hunh."

Isn't this the kind of thing my surgeon would have indicated were left me? In doing some googling on the topic, apparently it's not unusual to leave clips in after surgery, and it's not unusual for patients to be surprised when they find out later they have surgical clips in their bodies.

The NP told me the staples may have been wrenched during my fall, and that may be what's causing the pain. 

WTF?

Here's a photo of what breast cancer surgery "clips" look like. It's not my x-ray. Mine shows a lot more in a straight line.

The radiologist's report on my x-ray said "There are surgical clips in the left breast and left axilla." "Axilla" sounds like an animal on the Serengeti, something with horns that runs fast.

I'm ready for my close-up, Mr. DeMille

Next week Group Health is going to come by the house to film me at home, in the yard, in my studio, riding my bike. 

When I was going through treatment for cancer, I enrolled in a study to research the effects of having access to a "nurse navigator." What this meant was an oncology RN called me once a week to chat about how I was doing, answer questions, assess symptoms, etc. It was a wonderful resource and I was fortunate enough to have a great nurse.

I saw my Oncologist every few weeks, but our relationship wasn't chatty. He was full of information, but wasn't particularly comforting. My nurse navigator gave me great comfort.

So, in the few years since the study, Group Health has decided to make the nurse navigator study a real program, and I was asked if I could be interviewed about my experience, and filmed.

Heck, yeah.

The video producer wants to film me in my studio, making jewelry. So, this morning the spouse and I spent a few hours cleaning the basement because my studio's down there. 

Between cleaning and hot flashes, it's a three-shower day.

Two procedures in one day and my groinicological area feels like Napoleon and his army trampled through

About a month ago I noticed a little spotting. I told my GP, who had me come in for an exam. The hormone-blocking medication I'm on, Tamoxifen, causes the endometrius to thicken, and can potentially cause cancer of the endometrius. So, any sign of blood and they want to get all inside my parts.

She didn't see any blood, but did see signs of genital warts, something I picked up when (as my husband says) I was perky. She thought they were maybe causing the spotting, but wanted me to have a transvaginal ultrasound. Fine. I'd had those before.

I drank a quart of water two hours before the ultrasound. Silly me, I drank it an hour before I got on the bus, not taking into account the other hour of travel and waiting in the reception area. By the time I was taken back to radiology, I was having to dance to keep my bladder in check. And of course, the tech was pressing the ultrasound doo-hicky all over my belly, as if my bladder wasn't about to burst.

They couldn't see the the endometrium too well because of a large and decaying fibroid, so they wanted a biopsy of my endometrium. The head of Group Health's OB/GYN did the biopsy. She was great. The procedure was uncomfortable. I'm pretty sure the extra-large speculum she used was made by the same person who made the Jaws of Life. She dilated my cervix and threaded in some tool that sliced and grabbed bits of tissue.

The lab results showed what they think are "necrotic polyps". What the fuck. What's up with all these things in my uterus that aren't supposed to be there?

They wanted to be sure they were necrotic, which means there's no blood flow, which means they're probably not cancerous or pre-cancerous. To do this, they needed to do another transvaginal ultrasound. I thought it was going to be like the last one. It was not. Yesterday, right before the procedure, I learned that a radiologist was going to inflate the endometrium with saline water, to get a better look at the polyps. Holy crap! Then he said he was going to use a balloon to block the cervix, so the saline water wouldn't leak out during the ultrasound. When I heard "balloon", I thought of this. Actually, it was like fishing line. It was nothing like a balloon. It felt odd. I could feel things moving in parts of me that I ought not. I experienced a little cramping, but nothing like the menstrual cramps I used to have.

The radiologist told me that if he was not successful at seeing around the fibroid to see the polyps, he might have to stop the procedure to drag an OB/GYN into the room. This person, he said, would put a clamp on my cervix and I stopped listening.

When it was over, the radiologist showed me some of the images. He'd point at things and tell me what I was seeing. I'd nod my head and make approving noises, but I didn't know what the hell he was talking about or what he was seeing. 

A few hours later, I had my second procedure of the day. This one was to remove and biopsy genital warts. It was the second time I saw Jane Dimer and I think she's the best physician I've ever had. She asked me about the morning's procedure, told me what the report showed, told me what she was going to do, and when she was done, talked about next steps. Her pace was measured and considerate of me. She told me something that no one else has in the 2.5 years since I was diagnosed with cancer; that my immune system remains compromised because of the cancer and its treatment. 

She told me that the ultrasound images from the morning showed that enough saline had been in my uterus to float the polyps, which for some reason was a good sign.

Throughout the past 2.5 years, when I first went back in for a follow-up ultrasound and mammogram because my annual mammogram had indicated something was wrong in my left breast, through yesterday, I've been struck with the information conundrum of being a patient being treated for a deadly disease. I've seen a number of medical professionals, and each one has given me different information. Being under-informed  I often made assumptions based on the information I received, and my assumptions were often wrong.

Why didn't the radiologist in the morning mention that my polyps floated? It seemed to me, when Dr. Dimer told me about it, that it was a big deal. I imagined that when he was reviewing the images with his peers, he might have said "Look! Her polyps floated!", and they all would have clapped their hands in response to this happy news. All I remember him telling me was that it was hard to see what he wanted to see because of the monstrous fibroid I have in my uterus, which has become friendly with an unknown number of polyps that float.

The exam table prior to the procedure

She had me get on the exam table, put my feet in the stirrups and looked for what she wanted to biopsy. It was a little rough. I'm not used to someone trying to stretch parts of my groinological area in order to get a better look at whatever's going on there.

She showed the nurse what she was going after. She then explained to me that she was going to numb the area with two topical agents and then inject the labia and surrounding area with another, stronger numbing agent. She did this, and while she was gentle, it was unnerving, no pun intended. She told me she was going to use a tool that both took samples and cauterized the wound, and that the nurse was going to use a suction device to remove the smoke. That was hard to hear. I did indeed smell burning flesh when she was going at it. The nurse put an adhesive pad on my leg and she said it was the ground for the tool the doctor was using. It was like a big EKG sticky.

It didn't take too long to get the samples. It didn't hurt. Both tools she and the nurse used made noises that distracted me from thinking about what she was doing down there. When they put their tools aside, Dr. Dimer said she was going to stitch me up. I have stitches on my labia. In a normal world, I would never have had cause to write that.

She said she wanted to see me in four weeks, and that they may need to do a more robust biopsy of the polyps. I have no idea what that means and I'm not going to think about it.

The exam table after the procedure

I left the hospital with my husband and my sutured labia. 

In which she learns that cancer is like an annoying friend she can't shake...

I saw my Oncologist a few weeks ago for my regular check-in/check-up. He said I'm doing well enough to come in every six months, instead of every three. It's a kind of graduation.

I talked to him about hot flashes caused by the Tamoxifen. I've been taking Tamoxifen for over two years. Amazing to think I've been having these hot attacks so long. He suggested I change to the post-menopausal hormone-blocking meds. I asked him about side effects, and he said "You're at higher risk for osteoporosis. Let's do a bone density scan."

The scan results show I have osteopenia, the red-headed stepchild of osteoporosis. 

Great.

At what point do symptoms stop being a result of cancer and treatment and start becoming a result of aging?

Cancer sucks

Yesterday I ran into a coworker who I haven't seen for a while. I had heard that her husband had cancer and was stopping treatment. He died a few weeks ago.

As I was talking with her, I thought "This is what a new widow looks like." She looked okay. She was struggling, but she looked okay. She said someone gave her a pin that says "Cancer Sucks", and that truer words were never spoken.

Four months ago a friend and former lover stopped treatment for cancer and died. I'm just now accepting that this larger than life person is gone.

Another coworker's cancer is back. Those of us at work who've been out with our cancer all know about her situation, and the effect of the cancer returning rippled through this small but tight-knit group.

A good and old friend who had cancer 22 years ago called a few days ago to tell me it's back, in her stomach and metastasized to her lungs and liver. She's in the midst of diagnosis and is in shock.

Cancer sucks.