Two posts in one day! It’s like I’m sitting around recovering from surgery with nothing to do…
But I do have some really excellent news to share. The Carneys stopped by and Francis made me his world famous dry martini! So yep, I’ve had my first post-surgery drink!! Woo-hoo!!! Oh, and the doctor called and said the “margins were clean”–which means they got the whole tumor and I’m through with surgery. Cheers again!! Drinks for all my friends!

And here’s how the rest of my day went:
Yeah, Seamus is exhausted because he hates delivery people and they kept showing up with flowers. He spent the day chasing them off. He’s wiped out from this.

Flowers are from mom & Ted (top left), The board of Alternatives to Domestic Violence (top right) and the board, staff and volunteers of the Riverside Humane Society. I thought they were just happy I took a leave of absence from their boards for a few months, but they genuinely seemed to be wishing me a speedy recovery!

I also was able to shower and semi style my hair today. No one is happier about this than I am…well, except Chris. I’m pretty sure he’s happy about that.

So Friday was a pretty good day, all in all. And a special thanks to another support team:

My assistant Michelle, on the left, and paralegal Laureen (on the right, but you probably figured that out), kept my office going all week. At least I think they did. But they were wearing the pink ribbon pins and “Together We Can” solidarity bracelets all week, so what could possibly have gone wrong?? It’s all fine, I’m sure it’s fine. It’s fine. I was only gone 3 1/2 days. I’m sure I still have a law practice. Of course I do. It’s fine. I’m good.
Martini anyone?

Wow, sorry about that long post yesterday. Apparently I needed to vent all that. And now you probably need some of my Vicodin just from trying to read it. I’ll see if I can be more precise. Or funnier. Or just less gory.

When we last met, I was just about to go into surgery…well, surgery day. We were up at 5:30 and while there is no point to make-up and dressing nicely, I did shower and do my hair (since I wouldn’t be able to do either for another 48 hours) and I donned the pink sweat-sort-of-suit. We dutifully reported in to the surgery center at 7 a.m. So did about 173 other people. Wow. And apparently it was half-off surgery for children day because they were lined up out the door. And crying. Children cry when confronted with surgery. I cry when confronted with 7a.m. and no Starbucks. It was not a pretty, nor quiet, scene.

After they one by one took pretty much everbody else back to surgery and Chris and I were still stashed in the corner (shaking, crying and promising we’d never, ever have children), I had to remind the front desk lady that I was expected down in nuclear medicine at 7:30 (it was 7:35). She said “for what?” Ummmm…aren’t you guys supposed to know that? I kid you not, I got the “I’m new at this” response. Eventually a nurse came and got me and then another nurse took us down to nuclear medicine. Which is every bit as scary as it sounds. So scary they stash it away at the bottom of the ‘North tower’ and you have to take a secret elevator to get there. You’ll know you are there by the arctic temperatures that accost you upon entry.

Two other things happened when we entered. A lab coat wearing man, we’ll call him Larry (because that was his name) entered and the receptionist said “we have a such-and-such brain serious major procedure today” (I’m paraphrasing) and he said “Really? I haven’t done one of those in 20 years.” Comforting huh? Please god, do not let me find out my brain is in my right breast.

Also in the waiting room was a somewhat swarthy looking man in his early 40s, unshaved and wearing a leather jacket and boots, and next to him was a woman who looked like “mom”–just not his mom. Mom like Mrs. Cunningham, or June Cleaver, or any of those moms who did not have swarthy looking sons. They took swarthy back into the treatment rooms and five minutes later a tech comes out and says to mom “Mrs. Jones? Your son-in-law would like you to be with him for the procedure.” Mom smiled sweetly (and knowingly) and got up and went back. Really? Who does that? His mother in law??? And where was his wife? I’m really hoping this had nothing to do with his prostate.

Then it was my turn and oh yeah, Chris came back with me. We were greeted by “not in 20 years” Larry. Larry was quite chipper (he likes inflicting pain, it’s just obvious) and he says to me, “So you understand why you’re here and what we’re doing?” I, who haven’t had Starbucks, said “um, yeah, kinda…I just know it’s painless.” And he laughed at me. Full on laughed in my face. I stopped dead in my tracks. He said “Oh, come on. It’s four injections. It’s going to hurt. There’s going to be pain.” BWAHHAHAHAH!! Thanks, Larry. This was the part where they were injecting radioactive material into my breast to find the sentinel node. I don’t know how I got the rest of the way down the hall into the treatment room. Once there I was happy to find that Larry the Ass was not the doctor. Larry is not even a doctor. The doctor was a young woman (of course she was young), Dr. Tabib, and far, far kinder.

I will describe what was about to happen by medical terms, courtesy of John Link, M.D. and his book “Breast Cancer Survival Manual” (which I read cover to cover yesterday):

“Doctors use the radioactive tracer as follows: They inject it in and around the cancerous area (or under the nipple) at the time of the initial cancer surgery. …In the operating room using a portable Geiger counter known as a gamma probe, the surgical team identifies the first draining node and removes it following the removal of the primary cancer. The pathologist then analyzes the node using a technique called frozen sectioning. He freezes the node by using liquid nitrogen and then cuts the tissue into thin slices and views them under the microscope. If he sees no cancer, no further surgery is performed.”

So, I had four injections around the cancerous area. And I guess, again, where mine is located is somewhat fortunate for these parts. 3 out of 4 of the injections weren’t really much. But the one closest to the nipple…yeah, um… ow. Not off the charts, and certainly tolerable, but Ow. Enough to make me bite my lip. Did I mention that Larry is an ass?

Then we had two hours to kill while the radioactive material is finding its way through my breast (no, I couldn’t feel anything) before I was to return for “pictures.” We chose not to hang out in the arctic zone. Instead we delivered my health care directive and HIPAA release to patient services (I’m still being a lawyer) and then sat in a sunny window reading. I was reading David Sedaris’s “When You Are Engulfed in Flames” and Chris was reading “Then we Came to the End.” Perhaps we should have thought about our selections ahead of time.

We returned to nucler medicine and waited for “pictures.” At least they gave us blankets this time. When they came to take me back this time there were other patients around–they do bone and brain scans and all sorts of “man you are really sick” stuff, and again, I’m squeamish. There was an old guy on a gurney in the hallway asleep (please god, he was just sleeping) who was just skin and bones, with his mouth open and his body contorted. Yeah, that eliminates any possible feeling bad for myself I could have mustered. (And why do they always leave someone on a gurney in the hallway??)

The “pictures” turned out to be not as simple as you would think. I was picturing a quick little x-ray and I”m gone. Not so fast. Again, I had to lay down and then this panel comes down on top of me (they ask again “are you at all claustrophobic?” so that gives you an idea how close the panel gets). And they take two “pictures” that take five minutes each. The tech points out on the screen what they are doing. So I turned my head to see the screen. As I’m waiting out the five minutes I noticed that there were actually 3 screens. The one he pointed to, a much bigger one in the middle and then one in my periphery vision that I can barely see. But the big one in the middle, while difficult to see, is scary looking. It’s got a lot of red, some yellow, some pink, and a big ol’ scary looking jagged-edge black spot in the middle. Wow. I’ve seen lots of scary pictures of my cancer but that one was the worst. Probably because of the red everywhere, and it was obviously extremely close up since they were looking for a little tiny lymph node, but that one was freaking me out a little. I kept trying to figure out where this famous lymph node was on the screen amidst all that pulsating blood. Finally I decided I just couldn’t look at that screen anymore and I went back to the perfectly harmless looking black and white screen he had told me to look at. It had a nice little countdown clock on it too and that helped.

Eventually, the pictures were done and he said “good job. We found the node. I’m just going to mark it on you.” Which they do. He drew on my underarm to pinpoint the node for the surgeon. Then they said I could sit up , so I did. And there in front of me was the scary, frightening, big computer screen….with a beautiful red, yellow and pink sunset and the black silhouette of a palm tree sticking up in the middle of it. The words “Polynesian Spa Music” were written across the top. But in my defense, I couldn’t see that from my position under the panel!! (Louise, if you are reading this–you have to be reminded of the glass dancing booths at this point). It’s possible I was nervous. But Chris got a big kick out of my story when I came back out. I blame Larry.

Seriously, squint sideways at this…. you can see cancer can’t you??

Alright, back up to surgery we went. With my pictures in hand and a notebook full of medical info on me (which the nurse gave to Chris originally and made him swear under penalty of death he would return to her when we got back to the surgery center). Oh, and I had to go in a wheelchair…because of the whole “I see cancer in the sunset” thing, I’m sure.

Surgery is a giant blur to me. I remember this much: the anesthesia nurse was Steve and he was very kind and good at what he does (and was the first voice I heard when I woke up, which also let me know I was still in the surgery center and not in the hospital, which meant good news on the lymph node thing, at least in my mind). The other anesthesia nurse (apparently there to supervise Steve) was an attractive woman with a really cute, colorful surgical hat–until I noticed it was images of coffee and said “latte” “coffee” and other such words all over it, which is just cruel to me in my then state. She was concerned I might rip it off her head when the anesthesia kicked in and I lost the last two inhibitions I had left. Apparently, I did not. But I don’t know because I never saw her or her hat again.

Oh, and the infamous blue dye shot straight to the nipple? Yeah, I had it, but I don’t remember it. Dr. Karam assures me that I felt it because I “tried to help”–which is to say I tried to knock it away. And I was out of it. It’s just crazy that they do that to some women without anesthesia. Other things to note–the blue is not indigo blue. I thought it would be like ink. It’s not. It’s more of a dark turquoise color. Sort of pretty. Just not, you know, for a breast. It’s already faded away however. I think. There may be something there under the bandages, but I can’t tell at this point.

So that was surgery day. You know the rest of surgery/ recovery day (or can scroll way, way, way down or click on the Archives for the “A Very Big Breast Day” posting to read it). Now we just wait to hear if Dr. Karam got clean margins around the tumor (i.e. no cancer cells at the edges, which means he got it all and no further surgery is necessary).

I go back to see Dr. Karam next week and at the same time will meet with a medical oncologist about the chemotherapy and treatment options. I’ve now heard and read enough to know that my best chance of not having a recurrence of cancer is indeed the chemo and radiation. My kind of cancer and my “test” scores indicate a high chance of recurrence (I have no idea the actual percentage–my own guess from the reading is 20-25%; I assume they’ll tell me this in the next meeting). So even if Dr. Karam got all of this tumor, there is still the chance that there are some dastardly cancer cells still on the loose and ready to wreak havoc. They must be stopped.

Today I’m going to enjoy a leisurely day off. There will be sleeping, reading, and probably a phone call or twenty. Or maybe I’ll start planning our Christmas/ Jimmy Buffet’s birthday trip to Maui now. Since, you know, I’ve got tropical sunsets on my mind…. Aloha.

(That’s actually a Pacman frog…I humor myself. Keep reading…you’ll get it!!)

Now that I’m back home and resting comfortably in a recliner by the fire with my highly inspirational beagle Seamus nearby, I can perhaps report in more precisely on the medical stuff. I have been told on several occasions throughout this now month-long breast cancer journey that I am a “good” patient. Or that I did “great.” Or some such thing. That makes me laugh, and I’m sure it makes every member of my family laugh or at least go “Huh?” Of everyone in my family I am by far the most squeamish. My dad’s a doctor, my brother is a regional vice president of a medical equipment manufacturer, my sister is an OR nurse, and the rest have no trouble with gore. Me? I can’t even watch medical shows on TV or the fakest of the fake horror flicks, because I simply cannot see blood. And the thought of stitches about makes me pass out.

Despite this, it seems, I’ve been long trained to be a “good” patient. My father once took out stitches in my hand on the dining room table, to the delight of the other neighborhood children. And then there is the infamous childhood story when my family was on a cross-country motorhome trip and I fell off a ladder and broke my arm in South Dakota. We made it to Las Vegas, Nevada before my parents decided it was in fact broken. Here is the point where my father would like for me to mention that he did put my arm in a sling and even after we arrived back in California (what no hospitals in Nevada back then??) and the arm was examined, it still was only placed in a sling. No cast was necessary. I’m a good patient after all. Oh, and my mother would like me to point out that she knew it was broken in South Dakota. I just don’t know why that’s better?! I’d just like to point out that there are three states between South Dakota and Nevada. Big states. And we were driving. So yeah. I’m a good patient; I don’t complain much. I also don’t cry a lot. I have yet to cry over this whole cancer thing–except the night of the actual diagnosis, but that was because as I was telling Chris the diagnosis his sister called to tell him the family dog had to be put down that evening (RIP Chloe!). Now that made me cry. (And no, Chris did not say “Oh yeah? well Teresa has cancer!” We waited a respectable five or six days). And the surprising thing is, I’m getting less squeamish as time goes on with this. I’m finding the medical aspects sort of fascinating. So for those of you who might actually be more squeamish than me, you may want to skip over this. And I’ll break this up into the various stages/ procedures so you can just skip to the good parts, however you determine “good.”

THE DIAGNOSIS

On December 23, 2008 my primary care doctor calls and says “highly suspicious of malignancy.” And he wants the lump out. Not just a biopsy. Excise the lump. That feels a lot like “You have cancer,” but it isn’t. Because I still had hope (and a friend who was told “you have ovarian cancer” and she didn’t). My actual diagnosis day is January 12th. I messed up the poll–January 13th was my MRI day to see if it had spread any further, but actually Dr. Karam had called me on January 12th to tell me it was in fact cancer. And he confirms for me that’s the day considered my “diagnosis day.” So January 12, 2009 is the day that will live in infamy. My D-Day.

How does that feel? Well, I kept thinking about that folklore (science-lore?) that says if you throw a frog in a pot of boiling water it will jump out immediately, but if you set it in the water and slowly turn up the heat it will stay there even up to boiling (please don’t try this at home or anywhere else!!). The “highly suspicous” conversation was like being thrown into the boiling water–all I wanted to do was jump out. Instead, I talked to a few people, I went about my regular life (I didn’t tell anyone so as not to ruin anybody’s holidays and to keep my mind off things) and then had a doctor’s appointment with a calm doctor who said “you don’t know it’s malignant until you have the biopsy.” So I got out of the pot in a manner of speaking. Let me also mention here that if you ever feel a lump or have a suspcious mammogram and they are telling you “85% of these turn out to be nothing”–they are probably right. I’ve heard that experience from lots of women and lots of men who were trying to calm me (or themselves) about the situation. Trust me though, I never heard that from any medical personnel dealing with me during this time. I could tell to a person, from absolutely everyone’s reaction (from the PA who first saw me, to mammogram technician, the ultrasound technician, my primary care physician, the Riverside surgeon, and everyone one at UCLA–I think the parking attendant knew!) that they thought “cancer.” I got “95% chance this IS cancer.” Not the “85% are nothing” response. So if you get that one, you are not a frog and there is no boiling water around.

Then there was the debacle of getting health care in Riverside over the holidays. Let me be clear here–the problem here may not be the quality of care, it’s quite simply that we don’t have enough doctors “out here.” And that’s just crazy. (Come on, UCR Medical Center!! Can’t arrive soon enough.) The earliest we could get a biopsy scheduled in Riverside was January 16th. Nearly a month after my first doctor’s appointment. That would have been a month of “highly suspcious” and “but you never know.” Carry on.

My nemesis became the ditzy Brenda from the surgeon’s office who was supposed to be scheduling my biopsy but couldn’t stop drinking eggnog long enough to read the “Stat” written on my file and kept forgetting to call me or the imaging place that was supposed to handle the biopsy. Oopsy.

That’s when it felt like I was back in the pot and the heat was being turned up. But in a good, albeit weird, way. When I was stuck in the Riverside health hell, my feeling was “oh hell no. Not cancer. I can not have cancer.” Then Stacey helped me find my way over to UCLA and Dr. Karam and my attitude moved to, “okay fine, it’s probably cancer, but no way am I having a masectomy.” And that becomes, “okay, well I can handle that. I can be Christina Applegate and her ‘I’ll have cute boobies in my 90′s’ attitude. But no chemo. I can’t handle chemo.” And eventually, as Dr. Good Karma slowly, politely, humorously (yes humorously), but quite clearly turned up the heat, it became “Okay, let’s just get on with this. I can handle whatever it is. The dog lived. And so will I.” I’ve come to think of the diagnosis process, lengthy though it is, as helpful to the mental adjustment. For me, anyway. So, keep that in mind as I explain, in what turned out to be this really, really lengthy blog posting, what one goes through to get the diagnosis of “Breast Cancer. Right breast, 10 o’clock.”

THE MANY TESTS (December 19, 2008 to January 5, 2009)

Let’s see…first it was a mammogram (Dec. 19th), of course (remember, I found the lump myself). That occured on a Friday. Then the following Monday (the 22nd) I went in for an ultrasound of the right breast. Yes, I watched the screen and yes, I was pretty sure it was cancer. Then I watched the face of the tech and yeah, you kinda know. They can’t say anything of course, but they can become a lot more solicitous. Then came the call from the doctor (the 23rd), then came a Christmas Eve spent trying to get a meeting with a surgeon scheduled in a town where clearly healthcare is closed for the holidays. Right, the folks at WalMart have to work but health care workes? Eh, call after the 1st of the year. I also had to drive over to the Breast Imaging Center to pick up my own “films” to take them to wherever my doctor might be able to get an appointment for me, whenever that might occur…because the films are old fashioned films and not on computer disk so that can’t simply be transferred by the click of a mouse.

Then we went to Christmas Eve dinner with Chris’s family. Of course we did. That’s usually a place that makes me quite nervous. But talk about perspective! I was fine. And I had wine. And not that Chris’s mom knew (although she is a breast cancer survivor herself) but she gave me a really beautiful, really comfortable mocha-colored wrap that is extremely soft and has been wrapped around me for much of the last month, and a little Coach purse that turns out to be the perfect size for the items I can have with me at the hospital (and perfect for Chris to be able to stash in the backpack he’s been carrying around for both of us).

Finally, on December 30th Chris and I went to meet with a surgeon in Corona. In a place that looked like Mother Teresa would have come to visit the dying there but no one else would or had since her passing. We almost bolted, but for the fear that we’d have to wait until 2011 for another appointment with another surgeon in Riverside. The surgeon was great. Very calming. And a woman (ruining forever Chris’s two-women fantasy when she did my breast exam; it’s just not what he had in mind at all. At all.). But alas, she turned me over to the heartless twit that was her scheduler and not remotely helpful. By January 5th (6 days and countless calls–mostly by me– later; not exactly “stat”) they had my biopsy scheduled for January 16th. The biopsy is what tells you whether you have cancer or not. You know, a month after you find the lump!My frustration turned to rage and I then turned to Stacey (who likes my rages and humors me and then helps me), who turned me to UCLA. But I do keep wondering–I’m self-employed, articulate, assertive and have several contacts in the medical field (yes, I used some of them); I could take the time and could afford to do a lot of the footwork myself and had friends who could and did help. What on earth do women who don’t have all of the above do???

THE BIOPSY (January 6 to 9)

Lunch with Stacey was January 6th. She had her UCLA doctor email me within an hour. Email! Within an hour! An actual doctor! No Brenda-bimbette involved! Stacey’s doctor (who had never so much as met me) not only referred me to the great and good Dr. Karam, but called and had them hold an appointment for two days later. I spent January 7th driving to no less than 5 different medical offices in Riverside (and one in Corona because the twit Brenda sent me to the wrong location first) picking up all of my various records to hand carry them to Dr. Karam. January 8th Chris and I drive to UCLA. Dr. Karam reviews my films (the July 23, 2008 mammogram showing nothing, and the December mammogram and ultrasound showing holy hell) and says “walks like a duck, quacks like a duck” and then immediately goes downstairs to radiology to try to get my biopsy scheduled ASAP. It’s scheduled for the next morning. ASAP/ Stat obviously mean different things in different counties.

As mentioned, the biopsy is how they can tell for certain whether it’s cancer. That morning (January 9) we arrived at 9:30 and they did another ultrasound. My radiologist was a resident by the name of Dr. Koo and she too was about oh, 19 years old? Dr. Karam stopped by and told me he was scheduling the MRI as well. If it turned out not to be cancer, we could cancel the MRI (and this makes so so much sense, but is not, I have learned, how things are done in Riverside). I did then finally say “you seem to only be talking about this being cancer; I assume you know already that it’s cancer.” And he said, “I”m 95% certain it’s cancer.” The radiologist could be heard letting her breath out. Clearly she also could tell it was cancer but couldn’t say anything. When Dr. Karam left, Dr. Koo launched into the “survival rates are really high when you catch it this early” routine. And thanks, but “survival”?? Honestly, it hadn’t occured to me that there was any other option!! I still refuse any other option. Oh and Dr. Koo said “Your doctor seems really young.” This still cracks me up! Hi pot? Meet Kettle.

The biopsy is an interesting procedure. Again though, I was well trained. You have to lay still for about 30 to 40 minutes while they insert a needle and a little thingy that was best described (for we older folks) as a “Pac Man” that goes in and extracts little chunks out of the tumor (3 to 5; naturally, they needed five from mine). My tumor, as we all know, was at 10 o’clock, and way on the side. Thus for the radiologist fellow Dr. Overstreet (another woman!) to get to it, I had to lay on my side but with my top half twisted back and my arm moved even further back. This is remarkably similar to the position one assumes for certain chiropractic adjustments….which I’ve been getting since I was oh, five or six years old. Now, the needle that goes into the breast to numb it for the biopsy…not a lot can train you for that. It stings. But then it goes away. So all in all, not too bad.

Post-biopsy they actually did another mammogram. And if you think a normal mammogram is painful, try it after Pac-Man has attacked your breast! Let’s just say there was bleeding. And while Dr. Koo bandaged me up again we had the Harvard (where she went) v. Princeton (where Chris went) discussion. UC Santa Barbara (where I went) wins!!! (hey, I’m the one with cancer). Then I was sent home with ice paks and steri-strips and all was well. I even stopped by the office, until they kicked me out. The bruise on my poor boobie lasted almost two weeks. But that was just the beginning of the blue period.

CANCER FOR REAL/ The MRI (January 12 and 13, 2009).

After “the call” where “it is what I thought it was” there really is a lot that goes on. Turns out there are all sorts of breast cancers and all sorts of factors that weigh into the treatment plan. My particular cancer is not, unfortunately, “in situ.” Meaning it isn’t just situated in the duct. And it’s got highly invasive tendencies. On the Bloom Richardson scale of 1 to 9 with 9 being the most invasive…mine’s a 9. (Not a time you want to be a 9!!). In fact, my pathology report (from the biopsy) says this about all the various factors:

Invasive ductal carcinoma, poorly differentiated
Modified Bloom and Richardson score 9 of 9 (I’m a chronic over-achiever!! that’s not on the report; that’s strictly gratuitous on my part)
Tubule formation: 3
Nuclear pleomorphism: 3
Mitosis: 3
In-situ component: not identified
Lymphvascular invasion: not identified
Microcalcifications: not indentified
Breast biomarkers/FISH: pendingMost of that was good, well…except the whole cancer part. The bad ones were the 9 and later when the pending FISH came back. They look for cancers that are “hormone receptive”–if they are the patient can be treated with anti-hormone medication (granted, this medication goes on for five years, but it’s not chemo). My particular cancer was 0% receptive. 0%. Don’t waste your hormone medication on me! (I’m probably not supposed to be, but I’m kinda glad I won’t be taking medication for 5 years; chemo or not).

Next up was the MRI. This basically gives a good look at how large the tumor is and whether there are cancerous cells detected anywhere else–like in the lymph nodes. My MRI was January 13th and afterwards Chris and I went to dinner and met with our LA Writers Group. The MRI was, for me, not a big deal. Yeah, it’s difficult to lay still for that long and it’s a tight space and really loud, but for all the test does, it’s just not that bad. Unless you are claustrophobic and then, well, yeah. It’s gonna suck. I planned the blog during mine. My biggest issue was that the tech told me “no deep breaths. If you need to take a deep breath do it now. No deep breaths when you are in.” Which pretty much guaranteed that all I could think about was taking a deep breath!! Don’t think about purple. Stop it! No Purple. Do not picture the color purple. NO!! Purple is death!! Stop it!! (now let me know when you stop thinking about the color PURPLE. See, there you go again! Purple.).

By about 5pm that evening, Dr. Karam called to tell me the MRI was beautiful. No signs the cancer was anywhere other than where we already knew it was. But it was closer to 2cm than the 1.5 that had been earlier estimated.

THE TREATMENT PLAN (January 15, 2009)

This was basically a meeting with Dr. Karam to discuss his recommendations and “sign me up” for the lumpectomy. I think this is reasonably well detailed in an earlier post so we’ll just say, the heat is turning up but I’m still not jumping. Oh, and purple. Stop thinking about purple.

HEALTH CLEARANCE FOR SURGERY (January 20, 2009)
I had to return to Riverside healthcare to get a medical clearance for surgery from my primary care doctor on January 20th. I had to wait 4o minutes to get in and they asked me for the $20 co-pay. Neither of these things have occured at UCLA. I passed. All clear for surgery.

LAB RAT-NESS (The research study; January 27, 2009)

As I mentioned, I was asked to participate in a research study. Here’s the description of the study, straight from the materials they gave me:

“Between December 1997 and October 2008, a total of 98 subjects were enrolled in a study at UCLA examining patients with malignant and benign breast cancers, and healthy women. An additional 30 subjects will be enrolled at UCLA over the next year. This additional research has been funded by the US Army Medical Research and Material Command.”

[The army!! who knew! And I think I'm number 13 of the additional 30 they are trying for.]

“It is hoped that this investigation will result in a new technique to image benign and suspicious areas in the breast. This clinical research project is designed to learn if MR imaging/spectroscopy (MRI/MRS) is a reliable anatomical and biochemical tool for identifying breast cancers… The outcome of this study will help the researchers in developing a better diagnostic tool for breast cancer…”

I’m going to scan in and post the whole description, for those of you who are interested, because it’s really kind of fascinating. Basically, for those who get the “85% of these turn out to be benign” talk when a lump or spot on a mammogram is discovered, this MRI Spectroscopy may one day be the option instead of a biopsy. Much, much less invasive. No Pac Man. No bruising. Just time alone in a tube. For an hour. Okay, yeah, it got uncomfortable and I was pretty fidgety for the last 10 minutes. But the actual test “in the future” won’t be that long.

Scott and Sherrie (my physicists! the researchers) did tell us they were having a hard time getting volunteers for the research and they weren’t anywhere near the numbers the wanted for the “malignant tumor” test sample. And they did seem awfully thankful. Apparently, some women are upset with a cancer diagnosis (note to self: you are not normal!!) and can’t handle another doctor’s appointment or the timing is just too difficult to work out (you have to be a lab rat before your surgery of course). I can understand that. It just didn’t occur to me to say no. In fact, it helped to think I was helping science and future patients the night before my surgery. Kind of getting out of my own drama. And then of course many people can’t handle the MRI tube. And this time, I did notice how really small the space was. I tried to turn my head from one side to the next and hit the roof. Oops. But I”m glad I did it and I’m going to follow their research (or, I’m going to make my dad and my sister follow it, since I may not understand it!). I was after all, lucky lab rat #13.

That brings us up to surgery day and my trip to the surgery center, the nuclear medicine department, two hours of roaming the medical center while blue dye roamed my breast, back to the surgery center for pre-op check-in, back to nuclear medicine, back to the surgery center, into the operating room (or so I’m told), and finally the recovery room–which you’ve heard about. It was all about Roger. I think however this post is long enough. Nuclear medicine can wait. Probably until 3a.m this morning, since I can only sleep on my back and after a few hours my back begins to spasm. But I am not complaining! I’m a good patient. A really good patient. Oh, and have you stopped thinking about purple yet?

THUMBS UP!!! Surgery went as well as it possibly could have. That’s Dr. Good Karma (and Hands!) giving the thumbs-up post-surgery (also holding the Jaboulet 2005 Parallele 45 Cote du Rhone we gave him as a thank you for all his good care). He located the sentinel node, removed it successfully and voila! The report came back that it was cancer free. Woo-hoo!!! So the lumpectomy proceeded and by 1:30 I was waking up (I remember absolutely nothing of the surgery–which is how I hoped it would happen).

Took a little while to get recovered enough to leave the recovery room and the guy next to me seemed to be taking priority (well, to be fair to the nurses, the dude was demanding priority!). Chris and I spent a couple of hours listening (no matter how hard we tried not to) to a rather loud and extensive diatribe from next-curtain-over patitent Roger about how unfair it was that they wouldn’t let him leave until he peed and he couldn’t pee (I’ll spare you the details but clearly his surgery was “down there”); that was followed by the many things that “normally” make him pee and his demands for the same (to wit: walking, the elevator in their home, coffee, and running water). So while I quietly lay there counting the moments until Starbucks was possible, the nurses offered this guy everything from cranberry juice to apple juice (eventually he asked them to mix the two!!) to coffee while he strolled up and down the room in his high fashion gown discussing his urinary progress!!! But then my incision started to ooze and well, that got the nurses attention. Apparently I bleed a lot. That’s mostly what my delay was–took awhile to get the incisions (yep, two–one for the lymph node and one for the cancer that is no more) to stop bleeding. And ironically, I really needed to use the little girls room (and yes, it was blue. Tidy-Bowl blue!)

Eventually we were released. I’m sure Chris was as relieved as I was since I at least got a nap and he, poor baby, was up at 5:30 a.m. with me and roaming hospital waiting rooms for the day (except for a nice break when Emily picked him up for lunch–thanks Emily!). My plans for Starbucks however were foiled by the stairs between me and the Starbucks in the hospital. I wasn’t up for that. I tried to settle for a Dr. Pepper and chicken noodle soup at the cafeteria, but quickly found myself in the bathroom almost, but not quite, well…getting nauseous. So the Dr. Pepper was slowly sipped and the saltine crackers were savored. Not really up to the standards we had set last night, but I really needed to get rid of the “no caffeine in 24 hours” headache.

Finally, back at the hotel at last, I took off my cute pink hoodie and….well, let’s just say the incision was oozing again (saturated is the word they use. TMI?). We may not be seeing that pink hoodie again. Chris to the rescue though. He got the ice pack in place, put me to bed (I zonked out. Best nap in a long time), called Dr. Karam and about an hour later Dr. Karam showed up in our hotel room! He fixed me up, changed out everything, gave me a full report on the surgery (all good!) and rode off into the sunset (with his wine–the picture was taken in the hotel room. Yep, he does house calls too!!).

All is good now. I haven’t even had to take the Vicodin. Tylenol seems to be working fine. Chris gave up Lost for Sex and the City reruns, we’ve had a room service dinner and I’m back to my delusion of a long weekend away at a great hotel. Oh, and cancer has left the boobie!!

Thanks for all the well wishes and thoughts and prayers, and calls and emails and Facebook comments, and blog comments… it was nice to see when I got back to the room. Tomorrow I’ll tell you more about the medical parts. I have plenty o’ stories! Did you know there are a lot of sick people in a medical center??

I survived my research MRI Spectroscopy and all they gave me was this lovely hospital gown! Well, that’s not entirely true. Scott (on the left, in case you are wildly confused) also gave some good restaurant recommendations and there’s a check in the mail for $75. No, really. They promised. And here’s how it went– we arrived exactly on time (Chris really knows his way around this part of LA, I’ve got to hand it to him) and found our way back to the corner where MRI Research is stashed. The photo is of the physicists conducting the research (and yeah, I know, I think that brings the average age of the medical professionals I’ve seen down to like, 16.). That’s Scott Lipnick on the left and Sherrie Lin on the right. And the lab rat in the middle. They were great and I don’t think I did so bad myself (although, I was starting to fidget there at the end).

I spent close to an hour in the little MRI tube. And it got littler and littler as time went on. But there was the humorous intermission when the good and wise and ever-so-steady-handed Dr. Karam made a surprise appearance and talked to me mid-Spectropscopy over the intercom system. Apparently the rest of the time he talked to Chris about France and wine. Hey!! I’m stuck in a tube here, people!! Eventually they remembered me and let me out. Then I was able to observe lovely images of the girls and the obnoxious (but not so terribly huge looking) spots on the right twin. I was also able to learn more about the research they are conducting–all good stuff that in the future should eliminate a lot of unnecessary biopsies for women. I will report in more on that later, because it is indeed fascinating stuff. But the most important fact of all was that I was research subject number….13. Of course I was!! And then Scott valiantly tried to stumble through some distorted reason for why I might not be #13, but said the word “malignant” about 142 times…which really reduces any effect being number 12 or 14 rather than 13 might possibly have had! Again though, there were good restaurant recommendations.

We just didn’t take them. We went back to the hotel and had my last supper….well, last meal for 18 hours or so. We went to West at the top of our hotel overlooking Sunset Blvd. Very, very good. So, last meal…. frisee salad (mmmmmm poached egg on wilted frissee with lardon and croutons that were more like brioche), 12 oz bone-in filet with gorgonzola butter and truffle fries. And there was wine. Because it was half-off Tuesday! Wine bottles were half off! It’s like they knew we were coming. Did I mention I’m enjoying my surgery long-weekend? We’ll see how tomorrow goes but all looks good for now.

Oh, and I know you are all as concerned as I am about this…turns out I remembered I do in fact own a sort-of sweat suit outfit thing (it pains me to even type that!) and it’s PINK!!! So don’t worry–I will be in a pink Jones New York “sweats” outfit for my surgery appearance. Well, until I’m in a paper dress with comfy, thick socks (thanks for the tip Stacey!). Fingers crossed, I’ll be posting again in 24 hours! Tomorrow–cancer does NOT win!!

We have arrived at the Angeleno hotel and I must say, it’s adding to my delusion that I am on a nice long vacation weekend with Chris! Great hotel. And they put us on the Getty side, not the freeway side, which is (or at least will be) super helpful. The feathertop bed looks fabulous as well. See, total vacation! (surgery extra).

Michelle (my assistant) emailed me a photo of flowers that arrived at the office for me…just right after I left. Sweet clients! And yes, great assistant. Here’s how I’m enjoying the flowers:

That’s right–I’m enjoying them “virtually” and sharing them with you (my two faithful readers).

As we checked in the desk clerk asked if we wanted dinner reservations at the restaurant up top (Italian steak house…I could probably have a fettuccine in a rich cream sauce!). It was tempting for a “last meal.” But clearly I cannot think that far ahead. I didn’t pack anything remotely dinner-date like to wear. Dang. Room service it is. Just as soon as the lab rat experience is over. Oh, and the researchers called as we were driving in. Apparently I’m to look for a “young man and a young woman” Scott and…hmmm…Susan was it? They are the folks conducting the research. They are physicists. Wow. Add that to the list of professionals I’ve seen in January. I’ll see if I can talk them into pictures too. I wonder if they’ll be wearing pink?

In just about 24 hours I will be at UCLA Medical Center in the nuclear medicine department getting a radioactive seed shot into me. And I’m not even on Star Trek (although I will be playing the bald chick in a real life movie soon enough). Yep, surgery day is almost here and that’s the first part of the great search for the “sentinel node” (hey, now I’m in a Tom Clancy novel…with breasts). But first things first, tonight I’m a lab rat participating in the research MRI with Spectroscopy.

Chris and I are headed into LA this afternoon. Thanks for all the suggestions for where to stay. Apparently there are two choices in Westwood. The “we’re completely booked” hotel and “you can’t even afford to ask about our rates” hotel. But I have CANCER!!! Alright, it’s early to whip out the “Cancer Wins” card, so I held it. We found a room at the Angeleno Hotel which is owned by the Joie de Vivre boutique hotel chain. And that just cracks me up. It’s that round building right near the 405 that used to be a Holiday Inn? Three things caused us to overlook that “right by the freeway” part: room service and feather-top mattresses, and well, they had a room available. So rather than driving in the LA traffic we’ll be sitting right above it (please, crazy fates, way above it if you could; thank you) Tuesday and Wednesday night. Surgery is Wednesday.

If all goes as expected, I’ll be home Thursday afternoon. If all goes really well, there will be blogging again immediately post-lab rat and post-surgery (Wednesday night? Hmmm. Can she do it??). For now though, life as a normal person goes on for a few more hours and I must head into work! My clients need me. (This is what I tell myself. Humor me).

Saturday Chris and I decided we’d just go do something other than work or doctor’s appointments or talking to people about cancer or thinking about cancer. That required getting out of town. We went into LA (a surprising choice, all things considered, but our car drives there automatically now) to the Los Angeles Art Show at the Convention Center. No, I know what you’re thinking, and there was no velvet, no Elvis, and no mass-produced oil paintings of ships, children, flowers and sunsets. Yeah, I know, we were disappointed too!! This was a show that featured 125 galleries from around the world (and none with regular spots at the swap-meet). Anyway, it worked. We got to walk around for almost four hours just being normal people (really really normal actually, as the “art world” is as odd and eccentric as the Hollywood world). No one knew and no one cared about my breast cancer. Including me!! And just to hit that point home, in just about the last row we walked down there was Brad Garett perusing the art with a surprisingly normal looking woman. He didn’t even so much as glance at my cancer breast! Brad Garrett doesn’t care that I have cancer. God bless him! (and yeah, he really is super tall. Even I thought so. But, to find that photo for your viewing pleasure I Googled him. His bio says 6′ 8 1/2″. Now once you hit 6’8″, really, what’s the point of adding that 1/2″? Is he also 49 1/3 years old now?).

After that we went to Pizzaioli (yes, scene of the extremely delicious crime that was the fettuccine in Gorgonzola cream sauce). They knew just how to make me feel perfectly comfortable. It involved wine, calamari, wine, the aforementioned fettucine, wine, wine and as it turned out…a roomfull of bald people to start my adjustment! (Okay that’s me with Mimi DeGrezia–daughter of the owners, Tom & Kris, but note all the folks in the background. Coincidence?? I think not.)

Support Group #2: The DeGrezia Family:
Thanks guys!

Yeah, more insomnia. This is fun. I am steadfastly ignoring that I was up at three in the morning when I had fettuccine alfredo (and wine), and now I’m up at 4a.m. after having fettuccine in a Gorgonzola cream sauce (and wine). This is pure coincidence.

But it is also giving me a chance to read your comments here and on Facebook and in emails. Perhaps I was a bit strident in my directions on the “care and feeding” of “cancer person.” Perhaps. But it’s working! Here is what may be my favorite response to date:

“…[I] was led to your blog which made me cry and laugh and cry. But I am glad I found it because I would have said something foolish to the effect of ‘my grandma beat it and you’ll beat the odds too.’ But that’s not what you said you need, you need numbers tipped to your side and she is just taking away from your chances. The bitch!

So here goes (remember, I am Holly’s child and with that comes her sense of humor)

‘I am so sorry, especially because the ten people I have met with breast cancer have all died.’

I hope that helps to put the numbers back on your side again! And if you need anything at all, just ask. Especially chef services, I’ll whore Brein out to you and Chris any time!

That’s from Roryann Clements. And it’s my favorite for two reasons: 1) it’s damn funny, and 2) she and her husband Brein are the owners of my favorite Riverside restaurant Omakase, so I’m all over that chef services offer!! (He is unlikely to prepare fettuccine in any kind of cream sauce, so I’m okay there).

And then there is my least favorite response to date. Both of my parents (who have agreed on precisely two things ever in life–one resulted in me and the other resulted in my brother) suggested that I should tell my ex-husband about the breast cancer. So I did. And three days or so later, here’s the email I got in return. Get the tissues ready:

Okay, now wad up the tissue and throw it at the computer screen!! I promise you that is the entire response. I spent ten years of my life with this man! Clearly he has been beseiged with emails from ex-wives recently diagnosed with life threatening illnesses and he was forced to develop a form response so he could just hit “send” as necessary. But I’m not bitter. I understand. He was raised to think emotions are like dirty underwear–you don’t display them. I know deep down though he’s worried. He’s worried I won’t be able to pay my medical bills and this will damage his credit report since I still have his last name.

Oh good, I feel better now. And it’s 5:15a.m. and I can hear that in the other room Chris is now wide awake and watching TV. Poor baby. This is going to be a long 8 months.