Friday, May 14, 2010

The Good Witch, First Glitch and Hawkeye Pierce

So let me tell you about my oncologist.

I am scheduled for my first appointment with her two days after receiving my diagnosis. Husband and I are waiting in the exam room after I've been weighed in and blood pressure taken. I am looking down when the door opens and the first thing I see are two fabulous shoes walking into the room; snake embossed slate gray pointed toe pumps with a little tassel. At least a three inch heel. Legs like a racehorse. Tight pencil skirt. Flouncy silk blouse with a loose bow. Hair all loose and wispy in a sexy updo. Pearl drop earrings. Pearls around her neck.

Well hello diva. Meet diva.

Wow. I was not expecting a hot vivacious attractive woman to walk in, full of encouragement, humor and dripping confidence. My kind of girl. We hit it off right away.

Fairly soon into our discussion, she knew I had been doing my homework and was very impressed with what I already knew and what I was asking her. It was almost a three hour meeting. One on one. I never once felt rushed or patronized or as if she was distracted. I had her complete attention and interest. Wow. Was this how doctoring was back in the day? She is a pleasure to be around.

It felt great. Absolutely great.

Early on she said let's get right into the technical stuff because I know you can handle it and want it. Lets go over all your reports. So we did. One by one starting with the mammogram. Then the ultrasound. Then the biopsy. She copied my pathology report for me and we went over it carefully. "Here, I know you are going to want this, so I made one for you so you wouldn't take my copy" she said with a smile.

My tumor? Approx 5 cm. Troublesome. The grade? Grade 2 or Medium. These cancerous cells are still trying to act like normal breast cells. They have not completely turned to the dark side in aggressive cancer production like Grade 3 or High.

Good News? My cancer is hormone receptor positive. That means estrogen feeds my cancer. No more estrogen for me. They will be turning that off for me and throwing me and the boys in this house into menopause. Also, many of the great new cancer drugs are for hormone receptive cancer.

2nd bit of good news. I am Her2 negative. Her2 is a protein that when it is positive in the cells makes for an aggressive fast growing cancer. There is a new medicine to treat it, which you have to take for five years. I dodged that bullet.

General good news? All other systems are healthy for me. I am strong spirited. I have a great group of people that really love me.

Oh yeah, I forgot one. The proliferation rate inside my tumor is 50%. That's how fast it's dividing and growing more of THEM. 50%, like a grade in math is terrible but this is a good terrible. Out toward the edge of my tumor the proliferation rate is only 20%, an even worse great, if you know what I mean. My ki-67 numbers looked pretty good. If those numbers had been high, it is a marker for the cancer's recurrence which in that case would be likely. I was feeling very hopeful about those numbers, hoping it was an indication that the cancer would not be in my lymph node.

Now I am Dorothy on this journey. I have my Glinda the Good Witch, with all her magical powers and potions. I can't wait till we get to the part where I click my pink flip flops and she says:

And think to yourself -- "There's no place
like home; there's no place like home;
there's no place like home."


So the good witch sends me on my way, down the pink brick road. Next stop? To meet my surgeon.

Hawkeye Pierce.

He's a good looking man, tall with a sultry radio voice. But scruffy. Very scruffy. He needs an Oprah makeover and he'd probably come out looking fairly guapo.

He introduces himself and gets right down to business. He is a nice man with not a whole lot of bedside manner. He is all business and to the point. When he starts talking about the possible mastectomy for flopsy, and even after reconstruction she won't be a "sex organ" and no nipple, just basically something to fill up my bra cup...

Wait a minute there Buster, you are talking about Flopsy. My Flopsy. Ok, ok, I know you are just trying to give it to me straight but ease up a little man. What if it was your wife's Flopsy?

My meeting with him is fairly brief. I liked him. He's not all touchy feely, but he has a way about him, you sense he cares about you. Hell, he's a man. A different kind of man. A surgeon. He reminded me of Hawkeye, his scruffy hair, his five o'clock shadow, the way he walks into a room. Not arrogant but the man has swagger.

Surgeons must be very careful
When they take the knife!
Underneath their fine incisions
Stirs the culprit--life!
EMILY DICKINSON,


"Ok so let's get this show on the road. Let's put your chemo port in and do a sentinel node biopsy. How bout next week?"

Sure doc. It's a date.

My cancer has this thing about Wednesdays. Wednesday April 7, mammogram. Wednesday April 14, biopsy. Wednesday, April 21, told my inner circle about my diagnosis. Wednesday May 5, biopsy and implant port.

My second biopsy was to take out the sentinel or first lymph node. The lymph nodes are part of the lymphatic system in the body, a fluid system that parallels the bloodstream. The lymph nodes are throughout your body and are interconnected throughout your body. It's important to know if cancer cells have spread into the lymph nodes. If it has, the future risk is higher that the cancer will spread to other parts of the body.

The other part of my surgery was to install my Power Port. Yeah, see what I'm sayin, I always knew I was a girl super hero. Finally somebody is giving me some gadgets and gizmos. Yeah baby. Give me da cool shit.

Huh? My chemo port is my stairway to chemo hell? Here's how it works. Instead of having to give me an IV every single time, they will implant a port inside my chest that has a soft tube that runs all the way to a vein in my heart. I saw a picture of one, it looks like a little lego inside me. When I go for my chemo treatment, they will hang an IV bag that is connected to a long tube and at the end of that is another lego with a needle in it. I will lay in a chair and they will plug the needle lego into the lego inside my chest. Sounds like fun huh? I love legos.

Happy Cinco De Mayo Surgery Day!!! Woo hoo. I asked my anesthesiologist to give me top shelf tequila.

"With or without salt" she asks.

Oh baby I love you. Now before I go any further, how am I getting all the hot chick doctors? My anesthesiologist looked like the blonde character Sarah on the "Chuck" show. Dang girl. You are gorgeous and kind and gentle with a virgin Mary medal hanging around your neck. And tall and thin you bitch! You got it goin on and you're a doctor. Damn girl, I'm scared a you. Then she seals the deal with this line.

"Honey I am going to give you stuff that is way way better than top shelf."

I think I have a girl crush. She tells me she will back be later when the surgeon and operating room are ready for me. I look at her with doe eyes.

Next stop, special effects, nuclear medicine baby. I am on my way to becoming a weapon of mass destruction. A real one George Bush.

A radiologist or nuclear medicine specialist will inject a weak radioactive dye (technetium-labeled sulfur colloid), or a blue dye (isosulfan blue), or a combination of both, into the tumor site. This can be painful, so you may be given a choice of whether or not to have an injection of numbing medication first. Since injecting the dyes can take longer than a flu shot usually does, you might like to seriously consider asking for the numbing medication, if it is not offered.
Once injected, the dyes need some time to travel from your tumor site to your lymph nodes. You will spend some time in a nearby waiting room, so bring along some reading material or music. -From the About com breast cancer site.


I have done my homework. I am ready. I have the book I am reading about Grace Kelly. I have my ipod nano with all my tunes like Van Morrison, Into the Mystic; Autumn in New York, Frank Sinatra; Maxwell, Pretty Wings; and a recent edition from the honorable Senator from Illinois, the theme from the movie "A Man and A Woman."

da ba da ba da da ba da ba da

The radiologist greets me. He has a nice face, like a Buddhist Monk. He explains what he is going to do. Four shots around my nipple filled with the sulfur dye and the blue dye. He asks me if I'm ready.

"Well, um, I read on line that this will be painful so I need my numbing creme or a Spa Martini. You're going to give me somethin, right? I read it online. You might like to seriously consider asking for the numbing medication.

Give me my numbing medication. Give it to me now. Wah. Wah. Wah. Damn if only I had that Power Port installed and at the ready. Damn.

He smiles at me like

a) he is getting a real kick out of me and I have studied up;
b) I'm just plain cute;
c) my boobs are out. Duh.

"Well, I can give you four shots to numb your breast, and those will hurt just as much going in as the four shots I am going to give you with the dye. So you choose. Eight shots or four?"

Harry Callahan: I know what you're thinking. "Did he fire six shots or only five?" Well, to tell you the truth, in all this excitement I kind of lost track myself. But being as this is a .44 Magnum, the most powerful handgun in the world, and would blow your head clean off, you've got to ask yourself one question: Do I feel lucky? Well, do ya, punk?

The blonde brain punk says "I'll take four shots doc."

He smiles. "Ok get ready, here comes the first one."

I hear Flopsy squeal like a little bunny caught in Mr. McGregor's net.

He talks as he finishes his evil work. "Once the dye is in you we will take some pictures and you will be on your way. There now, one more to go." He pats me. "You are done Debbie. Oh, and one more thing, the blue dye will appear on your breast, from the inside out. You will be peeing blue until it's gone."

I spend the next two hours inside a tube with no breathing room, no wiggle room, and half the time holding this big lead rock on top of my boob to block the injection site and just get a picture of the far left of my left boob. I am late for my date with a scruffy surgeon.

What the hell? Come on now. I have been very patient and very pleasant, but I am mad as hell and not going to take it anymore. When do I get to read my book, and listen to my songs, and when is somethin ever gonna go like all my research said it would? Dang.

Assumption is the mother of all screw-ups.
- Wethern's Law


So to make a really long story short? I finished the surgery. Told everybody afterward when the concerned messages starting coming in asking how was I doing. I am the coyote. After the roadrunner goes beep beep and the coyote falls off the cliff, then the acme crate hits him, and then the acme semi-truck runs over him.

I made it though. And the bonus? My beautiful Avatar blue breast. It is just beautiful, like some nude body art. I like my blue boob. And my pee color, oh look at that. I don't have to buy those blue dye things for the toilet anymore and can I take that to the Home Depot paint department and get a match? It's perfect for my beachy living room.

Now I am finally getting somewhere and will start chemo the day after Mother's Day.

Two days after surgery I found out that xrays taken after surgery of my port after it was sealed up showed that there might be a problem. I wasn't going to chemo. I was scheduled for a "vapogram" to access my port, shoot some dye in it, and take a look at her.

My first glitch? No. Tell me no she whines. Maybe everything will be fine. The only good thing, Dr. Zen would perform the test.

Those smart they people also say a journey of a thousand miles begins with the first step, but come on, come on, let me get on this pink brick road, hand in hand with the Good Witch from Ohio dressed better than the Sex In the City girls, waving her magic wand and potions and sprinkles all over me.

Let me get on this road.

Somebody please, is anybody listening, let me get on this road.

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