Weather Report

Gahh!! Once again, for about the kajillionth time this winter, the skies dumped a load of snow on our city. I shoveled the wet stuff as quickly as I could, pausing to reflect that I had a lot more energy than when I was on radiation. I talked to my sister-in-law yesterday, and she mentioned that I seemed to have dropped cancer as a topic in this blog. I have neglected to tie up the loose ends of my treatment, the more aggressive part of which ended a little over a month ago.

I had my first post-radiation appointment with the oncologist on February 14. While I was in the waiting room, I noticed a man sitting across from me. He wasn't a kid, but was obviously younger than me, dressed in business casual and checking the messages on his cell. Maybe he was waiting for an elderly parent? We kept casting glances at each other and finally struck up conversation about the complimentary beverages. "I didn't discover the coffee until my seventh chemo," I told him. "Oh, did you finish treatment? I'm just starting."

Brian had just been diagnosed with Hodgkin's lymphoma. He was taking a shower when he discovered a lump near his collar bone. "I guess we caught it early; it hasn't traveled below my pelvis." Hodgkin's lymphoma, a cancer of the lymphocytes, or white blood cells, has a cure rate of over 90 percent. "It's the cancer you want to get..." he said, adding "...though I'm sick of hearing healthy people tell me that." Brian is only 38, and was just starting a second career when this hit. We exchanged cards, promising to keep in touch.

Dr. T., the resident working with my oncologist Dr. C., was the first to see me. I secretly hoped that Brian had the same oncology team, because her appearance would have brightened the mood of any heterosexual male. Dr. T. is HOT, as in Gray's Anatomy hot, and on Valentine's Day, she kicked it up a notch: wine-colored wrap dress, boots and fishnet stockings. "You look cute," she said to me, taking in my outfit. "So do YOU!" I answered. "Everyone has commented on my appearance today. They keep asking me if I'm going out tonight." Was she? "No. This is my only chance to look pretty today." And give male cancer patients heart-attacks.

Dr. C. came in after a few minutes. We discussed my post-radiation treatment. "I'm going to put you on Tamoxifen for a year," she said. She explained that since Tamoxifen was only effective at blocking the action of estrogen, most of which is produced by the ovaries, it wasn't ideal for post-menopausal cancer patients. "We'll test your hormone levels in a year to confirm that you're really in menopause." If confirmed, then I'll switch to an aromatase inhibitor, a drug which is believed to be more effective with menopausal women. "Tamoxifen increases your chance of developing cervical cancer, but the risk is very small. It most likely will increase the incidence of hot flashes. But, nobody has ever died of a hot flash." True, but I could kill someone while I'm having one.

So, I'm taking an anti-cancer drug, and will see the oncologist once every three months. In addition to physical check-ups, I need to order a mammogram for May, and also meet with my surgeon again. The rest of my body, neglected for a year, is overdue for a tune-up. I might as well get used to doctors' offices.

Chinatown

"Feel OK?" Dr. F. asked. I did feel OK, but tried to remain as motionless as possible. I was bristling with acupuncture needles: feet, shins, knees, stomach (upper and lower), hands, ears, and a jaunty single right between my eyebrows.
He positioned a warming lamp over my feet and closed the door, leaving me alone in the darkened treatment room. Chinese music came from some distant part of the office, barely audible.

My first experiment with non-western medicine arose out of desperation. After several weeks of early morning hot flashes, I was almost demented from lack of a good night's rest. Already a little fogged by chemo, my brain wasn't up to handling sleep deprivation. The parking lot incident at the dentist's office was the final straw. As I walked toward my car, I was covered in confusion. A green Escort--that's it, all right. But what door was I supposed to unlock? I opened the nearest one and sat down. It was the front passenger seat. When I saw the steering wheel on the other side, I laughed. Still, it was unnerving.

Research indicates that acupuncture is mildly beneficial in reducing the severity of hot flashes. An acquaintance gave me the number of Dr. F, a traditional Chinese medicine doctor. She said he had worked wonders with her husband's chronic sinusitis. I was willing to give anything--anything but Effexor--a try.

Dr. F, a slim man with silver hair, works out of a grim little second-floor office in Chinatown. The dented waiting room divider is decorated with a silk diploma banner from a Chinese college, and a calendar depicting cartoon zodiac animals dancing in some kind of frenzy. After I arrived, Dr. F started a medical history, and the briefest of examinations. He timed my pulse, and then asked to see my tongue. He scrutinized it pleasantly, and jotted some notes. He asked about my liver function, and recommended I get a blood test. "Chinese herbs maybe too strong now for your liver." At least, that's what I think he said. Dr. F has a pronounced accent. It took a while for me to understand his question about my "white blood cell" count, which I gamely tried to repeat back to him. Wide brood sole? Wait blue sew?

After he had taken my history, Dr. F led me back to the treatment room, past metal shelves stacked with bins of wonderful-smelling herbs. After sterilizing the entry sites, he began to insert the needles, which looked nearly as fine as human hair. I glanced down and saw him deftly poking one into the meat below my thumb. It was absolutely painless. Four needles, the ones on my abdomen and knees, were attached to electrodes. Dr. F adjusted the current until I felt a tiny jumping sensation at each point. The whole thing took about half an hour. Afterwards, I felt mildly invigorated. Perhaps a placebo effect, but a nice one.

After I left Dr. F's office, I went to a nearby bakery and bought a "dry pork bun," expecting it to be filled with barbecued pork. I was suddenly famished, and my mouth watered as I bit into it. I discovered that its primary ingredient was mayonnaise. I ate it, anyway.

Photo: like, totally

Chemo 5/8

This was a botched shot, but a rather sublime one. I think I was having a hot flash as well, just to add to the ordinary spit-and-shine polish.

To friends and family who listened to me talk, and sometimes cry, over the phone last week, love and thanks. I was really low, and you helped bring me up. L & E, thanks especially for sharing the details of your own experiences with me. Knowing someone else was strong enough to get through that helped me feel a little stronger, myself.

The hot flashes have reduced in number and intensity, and (knock on wood), I seem to have regained control of my pelvic muscles. I won't have to add Depends to my shopping list any time soon, thank god. I talked to the nurse about it, and she was mystified. She suggested a prescription for Effexor, an antidepressant used off-label to treat hot flashes. Such a trade-off: the side effects of Effexor vs. the side-effects of my violent hormone fluctuations. I declined, for now.

Today was the first chemo with a new drug, Taxotere, On the plus side, it won't damage my heart, like Adriamycin, and I don't have to take steroids or antinausea meds. On the down side, it can cause peripheral neuropathy, i.e. nerve damage in the fingers and toes. Numbness is a common side-effect; severe reactions to the drug include nail loss and residual pain. I did my research this time, and found a study in France where subjects who wore frozen medical gel gloves during treatment experienced minimal neuropathy.

You guessed it: I brought a cooler full of frozen gel pacs and gripped them during my therapy. Nurse L let me do it, although she clearly thought I was a little nuts. It was, uh..uncomfortable, to say the least. But, I just shelled out nearly $200 on private guitar lessons. If freezing my hands for two hours every two weeks keeps me playing, it was worth it.

Funny Post

Ha...gotcha! Have you ever noticed how women are encouraged to joke about menopause? Oye, the hot flashes! Cue laugh track.

Yesterday, I had at least twenty separate hot flashes, and none of them have been funny. Each one seemed to wash away a little bit more of me, like the surf carving away a sand castle. This morning I cried out to my husband as the worse one hit, a nearly indescribable combination of fire and ice, followed up by nausea and abdominal cramps. He stroked my soaking wet head as I trembled and wept.

I'm being turned into a eunuch. In my pelvis, there's a deadness. The flush of estrogen from my body also brings geriatric problems, like sometimes peeing myself when I cough or sneeze. I cried the last time it happened, as much from nostalgia as humiliation. I was a normal woman a little while ago...remember what that was like?

A friend naively asked, "can't you do hormone replacement therapy?" If you haven't gotten that memo, doctors no longer recommend estrogen replacement for menopausal women, especially those with estrogen-receptor sensitive breast cancer, such as myself. Instead, we are instructed to take tamoxifen, a drug that blocks estrogen. Kill the woman to save the person: that's the prevailing theory. Tamoxifen is carcinogenic in itself; taking it doubles the chance of endometrial cancer. I've haunted countless listservs looking for information from cancer survivors, and those taking tamoxifen uniformly complain of non-stop hot flashes, loss of libido, anorgasmia (inability to have an orgasm) and other problems associated with low estrogen. The term "castrated" is often used by women to describe their symptoms.

Anyway, a co-worker told me how she liked the way I mix up the content in my blog: funny combined with "sad, struggly stuff." I'm afraid my funny bone is estrogen-receptor sensitive, just like my cancer, and the sad, struggly stuff is what's left for now.

"Normal"

How am I doing? Thanks so much for asking. I very often feel mildly lousy, sort of like having a touch of the flu, but without clear end in sight. I often have the urge to lie down. I told my officemate that he should not be alarmed to see my feet sticking out from under my desk; I was most probably just taking an impromptu break. On chemo weeks, I take a four-day course of steroids. These make me hyperactive and sometimes weepy and little paranoid. During my third chemo cycle, I upset a friend a great deal by accusing him of ignoring me, which he was not. The steroids also have added seven pounds, mostly around my middle.

Also on chemo week, I develop a sore throat, and sometimes cold sores and tenderness in my gums. I am constipated, a condition that completely and excessively reverses itself the next week. You see, the chemotherapy drugs target rapidly-dividing cells throughout the body, including those in the intestines. My spleen...I'm getting used to my spleen. The swelling is brief, and hardly bothers me any longer.

I am getting shiny bald. The hair loss includes all of my body hair, although I have, to my chagrin, had to shave my legs earlier this week. And, I wouldn't pay for my brazilian bikini wax--entirely too haphazard. Eyebrows still intact, but for how long? My skin heals very slowly, and I'm using bandaids to cover even minor blemishes and cuts.

I had my last period of my life, I believe, about three weeks ago. It arrived a week after the previous one had just finished. When a hot flashes hit, I feel like a human can of Sterno--I envision a nearly invisible blue-white flame is shooting out of the top of my head. If you are a smoker and need a light, just touch your ciggy to my scalp. It's a shame to waste all that heat.

The tumor does seem to be shrinking, and my breast is gently collapsing as it recedes. It's now easy to see how much tissue was eaten up by the thing. I wonder if I'll ever be able to look at myself in the mirror and feel "normal" again.

I don't feel very womanly, that's for sure. Even the little man outside the laundromat who muttered "chiquita" (cute), at me yesterday, couldn't raise my spirits. Perhaps I should view this as a form of chemical satori, or a crucible, where my sexuality is burned off, like dross. I just wish I knew who or what I will be when this is over.