One-year smashogram, and I become a guinea pig

                Tomorrow is Ash Wednesday. It was a year ago on Ash Wednesday that I was diagnosed with breast cancer. There are different schools of thought on when you celebrate your “cancerversary.” Some people go with the day they were diagnosed, and others go with the day they went into remission. Personally, I don’t have a feel for when that was, the day we actually got rid of the last bad cells. It could have been last August, when I had surgery, or some time in October or November, when we did the radiation to clean up the stragglers. So I’ve decided I am instead going to celebrate my survivorship from the day I was first told I had cancer, which was March 9, 2011.

                Today, I celebrated nearing the one-year-survivor mark by having my one-year smashogram. It was clean! Yay! And it was only half the pain it used to be, since there is only one boob left to smash.

                Today’s mammogram and sonogram were hugely different than last year’s. A year ago, at the sonogram, the minute I knew I had cancer came while I was watching the radiology technician’s face. I saw the look on her face and started shaking. She was not allowed to tell me anything, but I could see she was trying not to cry. She put her hand on my arm and said, “I wish I could tell you what you want to hear.” The mammogram film was horrific; to this day, not even my husband has seen it.

                Well, no such drama today! I was in and out of there with no hoopla. The staff radiologist said they saw nothing dodgy, and they would see me in a year.

                Today was also another milestone in my cancer journey. I officially began participating in a large research project aimed at discovering whether the diabetes drug Metformin can help prevent a recurrence of breast cancer. I am probably going to explain this wrong in some way, but the gist is:  there is very good reason to suspect that women who take Metformin are less likely to have a recurrence of breast cancer than women who don’t. They think that the drug messes with your hormones in a way that breast cancer doesn’t like. Now they have to demonstrate this effect in a scientifically acceptable way. So, thousands of women like me, who have had breast cancer, are being recruited to take this diabetes drug for five years. They give half of us the real thing and half of us a placebo. Then they watch us like hawks to see whose breast cancer recurs.

                They had to do all sorts of blood tests on me to make sure I was eligible for the study. They had to weigh and measure me and ask me a lot of questions. I also had to sign and initial many pages of legal baloney. We did all this last week. I had to have another stupid pregnancy test! That’s just as ridiculous as it was the last time they made me have one, the day of my mastectomy. As I keep telling them, I had my tubes tied nine years ago and I’m menopausal. Definitely, unconditionally, not pregnant, and I’d be happy to sign a legal document to that effect. But the medical system in America is truly driven by lawyers, and they are covering their legal asses. It makes me sad to think that the breast-cancer-research money raised by millions of people running their 5k races and doing their three-day walks is going to pay for pregnancy tests for people like me who aren’t pregnant, but there it is.

                The study seems to be trying to cover its legal ass in other ways, too. They wanted permission to test me for the BRCA genes, but refused outright to let me know the results of the test. I said no way. I told them if they wanted to do genetic testing on my genes, the least they could do is let me know the results, because I have a daughter to whom the results could be very important. They still said no. I am sure they don’t want to be held liable for counseling and such for people who turn out to have the bad genes. In the end, I refused permission for the genetic testing.

                Today, I got my Costco-sized giant bottle of the “study drug” pills. I hope I got the real Metformin and not the placebo. My oncologist said the biggest side effect I could expect is not being hungry and maybe losing a few pounds. Well, sign me up! However, the nurses involved with the study say the biggest side effect is likely to be “G.I. issues.” I suspect I did get the real thing, and not the placebo, because the first pill did sort of upset my stomach, and I doubt a sugar pill would do that.

                In other news, I can report that the cancer magazines at the breast imaging center at Sibley Hospital are as old and lame as the ones everywhere else. This one had ads for organic hair tonics for people like me, whose hair has fallen out from chemo and isn’t coming back the way it should. Have I mentioned that I am STILL looking pretty mangy? There are big old bald patches on the back of my head. I was supposed to have hair by now. In fact, my oncologist alarmed me last week by commenting on the thinness of my hair, which used to be pretty darn thick, and asking me if there were any genes for baldness in my family?

                “What does THAT mean?” I asked him. “You said my hair would be coming back! Should I start freaking out now?”

                He chuckles nervously and says we should give it more time, and of course I shouldn’t be freaking out, and some people’s hair takes longer to grow back than others’, blah blah blah. But clearly he is really thinking, yep, you might want to start freaking out now. Even so, I can’t see me as a consumer of organic hair tonic.

                There were other ads in that cancer magazine for lots of other products I am never going to buy. There were several ads touting cruises for breast cancer “thrivers.” Not my cup of tea for a whole bunch of reasons. I am not a boat person anyway, but even if I were, locking myself on a boat and hearing nothing but cancerspeak and seeing nothing but pink for a whole week is not something I would ever do for fun.

                There was also an ad for a machine you can buy for your own kitchen to blend wheatgrass for shots and smoothies, which we are told are the sort of thing “thrivers” consume. Well, I personally did a shot of wheatgrass once, in a crunchy Seattle café. I will not be doing it again. Doing a shot of wheatgrass is like kissing a horse, only not as nice. Drinking a wheatgrass smoothie would be like chewing someone else’s cud. No, thank you. Give me a nice Scotch, if you really want me to thrive.

                And you know, even if I were going to do wheatgrass shots, I could probably whizz the wheatgrass in the food processor I already have, eh? I don’t need another separate device, I’m pretty sure, even if the damn thing is pink.

                Speaking of useless pink items, we came across another one, the worst one we’ve found so far. It is a pink handgun called the “Hope” edition, which is being marketed by a gun company called Discount Gun Sales. Supposedly some of the proceeds are going to the Seattle branch of the Susan G. Komen Foundation. Well, good for them! I am sure their P.R. folks have nothing to do this week other than deflect press inquiries on pink guns. I must remember to check if the N.R.A. offers any classes to empower gun-toting breast-cancer thrivers like myself. And somebody out there must be marketing a pink deer rifle…That is something a girl could actually use!

               

               

Probably way too much information about plastic surgery

                I have a friend who, at Urban BBQ in Sandy Spring, introduced me to a delicious drink called a Buttered Nipple. It is a shot of Bailey’s Irish Cream and a shot of butterscotch liqueur. Some people put vodka or Kahlua in there, too. It is very, very tasty. But it’s hard to keep a straight face while you’re asking for one. So my friend, who doesn’t like saying the word “nipple” to total strangers, asks for a “buttered body part” instead, and the drink tastes just as good. That is neither here nor  there; what I am trying to say is, if that friend is reading this, she had better stop now, because I’ma say the word “nipple” lots and lots here, and the word “boob” lots more. Just saying.

                I’m about to embark on some serious plastic surgery here in Montgomery County, Maryland, which is the 12^th-most-wealthy county in America, according to the US Census Bureau. This means that the waiting room at the plastic surgery center is quite a cultural experience, for me. There is an abundance of tasteful, white furniture and tasteful, spare flower arrangements mostly featuring orchids.  The office staff (are they nurses?) are trendily dressed. Lots of black. No green medical scrubs here.

                The clientele breaks down into two distinct groups:  those who are here to get their parts tucked or lifted or filled with spackle, and those who are here to get their parts replaced. I’m gonna generalize wildly now. Most of the patients here belong in the first category, and these are mostly slim, blond, well-heeled and very attractive women who are not wearing cowboy boots. I believe some of them have purses that cost as much as my car is worth. The people in the second category are not nearly so MoCo. They tend to be bald and overweight and at least one of them is wearing cowboy boots.

                There is almost nothing to read in this waiting room, which makes me cranky. Everyone is using electronic devices, instead. There is one Cosmopolitan magazine. At least there are no cancer magazines here.

                I am happy to report that the sex tips in the Cosmo are no more helpful than the ones in the cancer magazines at Sibley Hospital, but they are funnier. Compare and contrast:

                --Cancer magazine sex tips:

                                1) Try not to do it while actually puking, which is unattractive.

                                2) Try to do it before your chemo, not after. See #1.

                                3) If your body has become hideous for any reason, try to find a way to do it with your clothes partially on, or at least keep the lights off, for God’s sake.

                --Cosmo sex tips:

                                1) Do it on the clothes dryer. (Cosmo did not address who was going to clear out the skanky soccer and bike stuff that’s piled up on there, which is a real turn-on, or how you were going to disappear the children while you got off on the clothes dryer.)

                                2) Do it with your clothes on like the characters in True Blood. See #3 above. If either your body has become hideous or you’ve become a vampire, apparently, clothing can help.

                                3) Do it dressed up as that girl from Sailor Moon.

By this point I was snickering and scaring the contingent of blond, attractive persons. That was satisfying in its own way, but, really, you have to admit, that is a pretty lame sex tip. I don’t think John would ever dress up as Sailor Moon, anyway. Happily, they called me to the exam room at this point.

                There was even less reading material in there, no Cosmo, no cancer magazines, not even a Golf Digest. There was nothing at all except brochures for the various kinds of plastic surgery you could get done around here. Well, those were educational.

                Have I mentioned I am from Montana, and from the wrong side of the tracks, at that? MoCo-style plastic surgery was never on my radar screen before. Hell, I am nearly 50 years old and I have never had a manicure or a pedicure. That stuff is for painted city women or persons from New Jersey. Of course, I have read about manicures and face lifts and liposuction. But arm lifts? I thought that was something you did at the gym. I am reading this brochure about arm lifts and thinking, damn, I didn’t have to do all those miserable bench presses and biceps curls and such. These painted city women might be onto something. I am wondering if I can talk my doctor into doing a couple of those arm lifts while she’s already got me knocked out in the operating room for my boob remodeling.

                No such luck. We are here to talk business. When I first met with the plastic surgeon, last spring, I was far too sick from the chemotherapy to even think about a boob job. Well, I’m not sick anymore and I am ready to do whatever it takes to make the boobs look presentable again. We have four major plastic-surgery objectives. Sadly, none of them involve arm lifts or liposuction:

                1) Swap out the “tissue expander” for a good old-fashioned breast implant on the robo-boob. It will feel more like a real boob and less like a curling stone after that happens.

                2) Make the poor old regular boob on the other side look like it belongs to the same human as the robo-boob. When we’re done, the robo-boob should be roughly the same size and shape and time zone as the other one. By the way, there is no good word for that “other” one.  “Real boob? “Remaining” boob?  “Surviving” boob? “Conventional” boob? (But the opposite of “conventional” is either “organic” or “nuclear,” depending on your age and mind frame. What is the opposite of “robotic?”)

                3) Detail the robo-boob.

                Specifically, we mean sticking a nipple on there. Well, that will require another, separate surgery. 

                “Why?” I ask. “Why can’t we do that all at once, while I’m already drugged up like a darted lion on some Animal Planet show?”

                Well, we theoretically could, but it turns out that whether you have a boob lift or a boob reduction on the conventional boob, in your effort to make it match the size of the nuclear boob, either way, it’s a little unpredictable where the nipple ends up. You want to let that conventional nipple settle down some, post-surgery, before you go monkeying around trying to install a nipple on the other side. Otherwise, those nipples could end up pointing two completely different directions, like they’d been put on there by Picasso in his Cubist period, or maybe by Salvador Dali. And we don’t want that!

                4) Get a tattoo! I get to have my own tattoo artist! Now my daughter is going to be jealous AND call me a hypocrite! There is a woman, in Rockville, bless her heart, who started out as a regular tattoo artist but has since specialized and now spends her days using the magic of tattoo ink to make the areola, or the front bull’s eye, of your synthetic boob, the same general color as the front of your conventional boob. Maybe I can I talk her into drawing something special, like a butterfly or a spider or a Harley, on there was well. She probably charges extra for that.

                

            One thing I am bummed about is that it is all going to take longer than I had thought. I had thought I would have all this boob remodeling done during the summer. But apparently we might not even start it until September. As it turns out, all the stupid cancer surgery and radiation causes your robo-boob to shrink, and mine is still shrinking. We don’t want to try to match the conventional boob to the nuclear one until it’s done shrinking, or we could end up with two different sized breasts, and that would look wonky.

                The other thing that is a mild bummer is, we don’t know if we are talking a boob lift or a boob reduction on the conventional side. How do we decide?  Not only do we need to see how much the nuclear boob shrinks; we also have to see how much weight I’ve lost by then. I am supposed to try to get myself to vaguely the weight I plan to stay at, BEFORE we do the plastic surgery. The reason is is, an implant doesn’t gain or lose weight, but a standard non-nuclear human boob does. So, if I plan on losing a bunch of weight—and my doctors have informed me I should plan on that, because the fatter I am the more likely the cancer is to return—I should lose the weight now. Otherwise, again, I might find myself with two different sized boobs, and that would be unacceptable.

                Damn.

                So not only do I need to lose a bunch of weight to get down to the weight that my doctors say will maximize my chance of not dying; I also have to do it before I get my boob upgrade, or the girls could turn out wonky.  Today I looked in the mirror and threw my shoulders back and inaugurated my newly-urgent weight-loss program by eating a big hunk of dark Godiva chocolate. It is heart-healthy! I am skipping the Buttered Nipple, for now. But when this whole drawn-out plastic surgery adventure is done, by maybe next Christmas, I swear, the Buttered Nipples are on me.

               

Bitterroots and checkups

This is a bitterroot. It was one of the staple foods of a lot of Native Americans, and it was eaten by Lewis & Clark. It is the state flower of Montana, and my nominee for new symbol for Easter, death and rebirth, and such. 

I bought this plant, and one other, at a farmer's market last July in my hometown, Missoula, Montana, where I had gone to visit my mom. I had been looking for bitterroot plants for years, and had never found any until that day. Years ago, I had ordered some online from a grower in Oregon, but they all died. Anyway, the guy at the farmers' market in Missoula had two plants left, and I bought them both. It was only the second time I'd ever seen live bitterroots in person. The first time was a million years ago, in high school, when my church youth group went on a hayride in the North Hills and we caught the bitterroot bloom. They were everywhere. The ground was pink. I suspect the spot where we saw them that day has now been plowed up and turned into a housing development. But I know they still find bitterroots in the wild and some people are propagating them, because you can find vendors at powwows who sell the roots for throat medicine for the singers. 

Well, I carefully packed my two little plants in a big plastic container, cuddled them in bubble wrap, and nestled them carefully in the overhead bin on my flight back from Montana to Maryland. They made it through the flight, and bloomed happily on my kitchen counter for a couple weeks. Then they absolutely withered. They just crumbled and disappeared. I don't know if it was too much water, or too much air conditioning, or too much humidity, or what. They rotted away. August in Washington, DC, is nothing like August in Montana. Something was not to their liking, that's for sure. I felt awful for murdering the only two living bitterroots I had seen in thirty-five years. I could not bear to throw them out, so I just put the pots in the garage. At least I had photographed them while they were blooming.

Well. I went out to the garage the other day to look for something, and hunting among the junk on the shelves out there, I came across the pots of the two poor dead bitterroots. But they weren't dead!   They completely had come back. They have lots of new little bitterroot leaves. I hadn't killed them. They had just died back temporarily because that's what bitterroots do.  That's how they get through winter.

I now have two very happy little bitterroot plants on my front step. I do believe they are fixing to bloom again. I am renewed.

Why did I go through that whole long story? Because they remind me of me.

I saw a photo of myself a couple days ago that was taken that same week in July. I looked God-awful. My whole self was red and swollen, no hair, no eyelashes, puffy face, the whole deal. I looked like death warmed over. I must have scared my mom:

That was pretty close to rock bottom for me. I wish I could express how much better I am feeling now. Here's what I look like these days:

Today, Ground Hog Day, I had my first big post-cancer checkup with my surgeon, Dr. Colette Magnant. She is the person in charge of the team of doctors who are saving my life. She is also the director of than the Breast Cancer Program at Sibley Memorial Hospital in Washington, DC.

I aced my exam. Dr. Magnant proclaimed my non-robo-boob “Perfect!” (In the medical sense, of course; in the aesthetic sense, this breast is a whole different size, shape, texture, and latitude than the robo-boob. But we will be fixing those issues next summer, God willing, via the magic of plastic surgery). For now, we are just grateful to have one functional, healthy breast and no sign of cancer anywhere. John was there, too, and we both thought that Dr. Magnant seemed genuinely happy with how it’s going.

And she does think my hair will come back.  Right now, it is disappointingly sparse and sketchy. It looks okay in front, but there are big bald patches in back, like a newborn baby who was born with a lot of hair but wore it off the back of the head by too much sleeping. Yes, I’m still pretty funny-looking. And my eyebrows, which were so dark and bushy that I was teased about it for oh, thirty-five years, also have bald patches that I have to color in with an eyebrow pencil.

 I have been afraid that this patchy hair I’ve got now is as much as I’m going to get, and that my hair would never look normal again. After all, it’s almost seven months since I finished chemotherapy. I had been told not to expect to feel normal until maybe January. But Dr. Magnant says it can take a year to get over the effects of chemo, which could take us to the middle of next July or August, before things really get back to normal. Ouch. I was hoping to look better much sooner than July! This baldness thing was funny for a while. It’s not so funny anymore.

So it goes. She also says my eyes, which have been very dry and irritated, will also continue to gradually get better. I should have asked her if the brain cells would continue to gradually get better, too, but I forgot.

 Overall, Dr. Magnant seemed very pleased by the progress I’ve made. She asked me how I’m feeling, and I told her I am feeling so good I’m scaring people. Which is true. I am now to the point where I’m doing five miles on the treadmill or the elliptical machine, several times a week, and nasty workouts with my relentless trainer, too. I am pestering people to go dancing with me. I said aloud, in front of witnesses, that I might run a 10k, which is something I’ve never done, even when I was young and healthy. I’ve begun dragging John to concerts and such. We went to see Steve Earle in Annapolis last week. He was awesome. We had a couple drinks. We stayed out until nearly midnight. On a school night! If I keep improving from now until July, I am going to be feeling better than a girl probably should.

It's nice to be a happy cancer statistic for a change. It's been a roller-coaster week for cancer among my family and friends. My neighbor's mom died of cancer on Monday. On Tuesday, a friend learned she has a probable recurrence of ovarian cancer. On Wednesday, my brother, a colon cancer survivor, spent the whole day having tests which turned out, happily, to show that he is not having a recurrence right now. Great news! And then there was my good report today. While I am glad for my brother and me, I know some of you out there are coping with much worse news. We are thinking of you, hoping that like us, even if you die back, you live to bloom again.

Dr. Magnant and me