7/29/08

Ten Things I Learned

Although it may be cliche, it's still true: In every challenge, lessons are derived. Here are a few of the things I learned during the past 10 months while detouring through the land of breast cancer.

1. I love to blog. This fact must be obvious to those who've been reading along. But this notion extends beyond the blogosphere. The real message is not to ignore or discount one's creative side. Don't wait until retirement, or when the kids are grown, or when the garage is cleaned to nurture your creative spirit. Whether it be writing, sketching, singing, playing an instrument, dancing or sewing, make time for it. The rewards are innumerable. (Along this line, my next blog is under development, but more on that later.)

2. People surprise you. You can never predict who will step into your life when you're in the midst of an ordeal. Without being asked, people whom you barely know will reach out in a particularly thoughtful way, and, from there, they will evolve into good friends. Conversely, others whom you counted on may not be up to the challenge.

3. Don't hesitate to connect with someone going through a bad patch. Some part of us wants to hold back and not risk the emotional fallout of talking to those who are bereaved, sick, or suffering in some way. But human contact is a good thing. Pick up the phone and dial. If people really don't want to interact, they just won't answer. But they will know that you made the effort. And that knowledge goes a long way on a bad day.

4. Ask your doctor if you have dense breasts. If so, find out what screening methods, beyond mammography, are available to you, because mammograms simply don't do a good enough job on dense tissue. No diagnostic tool can prevent cancer. But good screening can lead to early detection, which can help doctors treat cancer before it spreads. Given what I know now, I would have paid for annual breast MRIs, despite the prohibitive price tag. At the very least, I would have enrolled in the clinical trials for the Sonocine, which is a whole breast ultrasound. (You can find the link to Sonocine on the list to the right.) The most compelling evidence is this: I had a second smaller tumor, the size of a pea, in the same neighborhood as the peanut-sized growth that I discovered. This smaller lump was lying deeper in the tissue. Neither I, nor any of my doctors, could feel it, and it was not visible on my mammograms. However, the radiologist saw it on my MRI. Given its location, this little tumor could have kept growing unnoticed until it was quite large. I was fortunate, really, to have had a palpable growth close to the skin. So while MRI is very expensive, think about it if you have very dense breasts.

5. Find out what you can about your medical history. Ask older relatives about how their parents and grandparents died. Should you face a cancer diagnosis, doctors want as much genetic information as you can give them.

6. Do your research and know the facts of your condition. Doctors seem to respect this. If you can talk intelligently about your treatment, you and your doctors will have a more meaningful dialogue and you'll feel better about the decisions that everyone makes.

7. Chemo was not as bad as I feared. The best advice I heard from my oncologist was not to make assumptions about how chemo would affect me. He was right, because I fared much better than I imagined I would.

8. Fitness matters. But not for the reasons you think. There is no magic bullet that prevents serious illness. Eating broccoli and running six miles a day are no guarantee of immunity. However, should illness strike, being in excellent physical shape helps to overcome the rigors of surgery, chemo, radiation, or whatever the treatment happens to be. If you get sick, you want to be strong in order to fight back.

9. Enroll in the best health insurance plan that you can reasonably afford. If your develop a major illness, you want the freedom to select the best doctors and facilities.

10. You're stronger than you think and your loved ones are, too. You wonder how you will cope, should you develop a serious health problem.,or how your spouse or kids will manage. While the whole experience is scary, everyone will fall in line and do what needs to be done. I don't have enough distance on this experience yet to be certain, but I expect that a battlefield mentality takes over. You just move through whatever the next task is. Fretting and worry consume valuable energy that is needed elsewhere. My best advice is to check those emotions at the door and stay focused on the remedies.

My last treatment is tomorrow!!!! The next blog is getting underway. Stay tuned.

7/21/08

Power To You

Walking along the corridor of the hospital the other day, I saw another patient who I'd exchanged glances or half-smiles with, although we'd never spoken.

This woman was walking a little ahead of me, but as I was moving at a much faster clip, I quickly caught up with her. I expected that we would share the usual greeting -- or non-greeting, really -- and I would continue on my way. But as I passed by her, she turned to me and said, "I've been wanting to talk to you." So I slowed my pace to match hers, and said, "Yes?"

She surprised me by revealing that she had been watching me and wished that she, too, could leave the house with her head uncovered. At the moment, she was wearing a bucket hat, and I remembered that she always wore a hat or a wig. Cancer-related hair loss is so devastating, it was no surprise that this woman needed shoring up. I assured her that before long, her hair would come back and her hat days would be well behind her.

"Do you want to see my hair?" she said. Then, in the middle of hospital hallway, she lifted off her hat and uncovered her head, which was encased in the black netting that football players wear under their helmets. Next, she began to peel off the netting. I expected to see a combination of bald spots and patchy growth. To my surprise, this woman's dark gray hair was much longer than mine. She had more than an inch of perfectly fine hair all over her scalp.

I was dumbfounded, and stammered, "You have lots of hair. You don't need to cover it up." She demurred, although I'm not sure why. But by initiating a hallway conversation and showing me what was under her hat, she was clearly reaching out for support. I suspected that she wanted a push toward the next step.

My family and friends know that I love to offer solutions. If they present me with a quandary, they will get my ideas on the best fix, whether or not they actually want to hear them. So seizing a chance to hold forth, I suggested the following remedy: Put on some make-up, and do one errand with your head uncovered -- the post office, the bank, the supermarket, whatever. Just take on one errand and, after that, assess whether you still need the hat or the wig.

She didn't sign on to this idea, but she didn't say, "No," either. As the conversation ended, and I turned to go, she called after me. With her fist raised and clenched, she said, "Power to you." Puzzled by this whole encounter, I walked to the car thinking about all of the ways in which we trip ourselves up and let inhibitions take charge.

This happened on Friday, and I saw her again this morning. I asked if, over the weekend, she had gone out bare-headed, and she said, "No." But today she appeared stronger and with more resolve. She told me that she was going to attempt a trip to the supermarket. "Good luck," I yelled as she walked away.

We'll see what happens. I have seven treatments left. I'll consider it a victory if within that time, this woman walks into the waiting room, head uncovered and newly empowered.

7/14/08

Box of Chocolates

Cancer treatments do eventually come to an end. Last week, Frank, another patient whose daily radiation treatment was scheduled close to mine, received his last dose.

I talked to Frank's wife, while he was with the technicians. She told me that Frank was so diminished by all of the attacks against his cancer, she wasn't sure he was aware that he was receiving his last treatment. Frank's tumor is located in his throat and is inoperable because of its proximity to the carotid artery. He finds it difficult to speak, and his wife stays close to his side. Nearly 80-years-old, Frank underwent chemo and radiation simultaneously. His wife said that he was so weak after his treatment the day before, the hospital staff transported him to their car in a wheelchair.

Frank returned to the waiting room after his last session, and he and his wife exchanged a few words before Frank left again to change into his street clothes. Frank's wife then reached into her totebag and pulled out a box of chocolates. At the same time, Bill, the ever-present hospital volunteer, walked into the room. Frank's wife stood up, presented Bill with the chocolates as a gift, and expressed her deep appreciation for all of his support.

The waiting room for radiation patients is tiny and intimate. I was sitting only a few feet away, and by chance, I was very much drawn into this private exchange. Bill was obviously touched by the gift, and Frank's wife was clearly grateful for whatever words of encouragement Bill had imparted during the preceding weeks.


In talking to Bill earlier, I had learned that he had cancer, himself, four years ago, so he brings a survivor's perspective to his conversations with patients. My guess is that he and Frank, men who are close in age, understood each other and formed a solid bond. By the time the chocolates had changed hands, everyone was misty-eyed, including me. Although it was only a token, the thank you gift to Bill -- and the emotions that accompanied it -- spoke loudly about giving and receiving and about our collective need to lean on each other.

I don't know what Frank's future will hold -- only that he has a strong network in his wife, four grown daughters and his grandchildren. Like Frank, my cancer treatments will also soon come to an end, but emerging from 10 months of medical care raises questions. Where will I find myself when the detour is over? In what ways will I have changed along the way?

7/6/08

Radiation Wisdom: Arrive Early and Borrow From Bossie

This weekend marked the half-way point in my radiation treatments. Aside from causing a little tiredness, the treatments are more of a recurring episode in my daily routine than anything else. Every weekday, I drive 15 minutes to the hospital, always with the goal of arriving promptly for my 10:10 a.m. slot. If I can be gowned and seated in the waiting room by then, I'm usually on my way back to the parking lot by 10:25 a.m. If I arrive a little late, however, I'm likely to wait 20 minutes for my turn.

Another patient, Frank, who is in his seventies, is scheduled five minutes after me, but his treatment lasts much longer than mine. Frank and his wife always arrive early, which makes me the wild card for the technicians. Their daily quandry: Will Cathleen arrive on time this morning, so we can squeeze her in before Frank's treatment? Or should we just take Frank because he's gowned and ready to go 15 minutes ahead of schedule?

If I have to compete with people who are habitually early, I'll lose every time. Because I have window in which to start a project before I go to the hospital, I get drawn into that activity, and leave the house too late to allow for contingencies, such as lingering traffic from the morning commute, or the off ramp for the hospital being closed. Don't think I'm complaining here. Compared to the unpleasantness of chemo, radiation is a walk in the park. I just need to remember to bring a book -- or (is it possible?) get out the door a few minutes earlier.

While radiation is considerably easier on the patient, most people do suffer from its side effect of red and irritated skin. To counter this, doctors recommend a cream that carries the following language on the jar:

Directions for Use: Wash udder and teat parts thoroughly with clean water and soap before each milking to avoid contamination of milk. Apply to the udder after each milking, massaging into the skin.
Warning: Do not use on parts affected with cow pox.

Yes, this cream, called "Udderly Smooth," is for cows and is manufactured by Redex Industries in Salem, Ohio. But Udderly Smooth is no ordinary animal product. This little lotion has a whole life beyond the dairy farm. The company's website, http://www.uddercream.com/, has a subsection labeled "oncology," which discusses using the cream for skin problems associated with cancer treatments and diabetes. People also report using it to remove make-up, relieve sunburn, prevent skin cracking in winter, and alleviate chaffing when hiking and cycling. Even quilters praise the cream because it doesn't make their hands greasy, and thus cause stains on their fabrics. Best of all, a 12-ounce jar costs less than $5.00.


So, armed with an ample supply of cow cream, I have only 18 treatments to go. And that's udderly marvelous.