Life has settled into a groove. I swallow Tomoxifen in the evening and hope that it does its job of preventing estrogen from binding to the cells in my breast and causing another cancer. My breast is still swollen and despite reassurance from Sigal that the swelling is due to the radiation, the fear that there are other, more sinister, causes is ever present, occasionally leading to a minor anxiety attack. Its dimensions apropos the other, hopefully healthy, one reminds me that we should be careful what we wish for - I'd always wanted to be more buxom but my hope extended to both breasts sharing equal proportions; the devil is no doubt enjoying a prolonged snigger at my lopsidedness.
The hot flashes are still a major annoyance. Last month, I had an appointment with a gynecological endocrinologist with an unpronounceable name (Dr. Zlotsover. try it out loud) who prescribed a natural, over-the-counter remedy based on black cohosh. Black cohosh apparently improves the functionality of Tomoxifen and recoups bone mass lost as a result of taking Tomoxifen, However, according to several reputable sites I found on the internet, the jury is out on black cohosh - not only are there conflicting conclusions from the many clinical trials, but it might actually be contraindicated in breast cancer patients (http://ods.od.nih.gov/factsheets/BlackCohosh.asp). Apart from that, it doesn't seem to be helping - there are days when I feel that the flashes are less frequent and less intense but the next day, they're back, with increased vigor. However, it takes about six to eight weeks for the black cohosh to do the job, so I'll give it the benefit of the doubt.
In my quest for optimal health (having been so cruelly deprived of the illusion that that's what I had all these years the cancer was surreptitiously growing inside me), I've begun paying more attention to what I put on my body, not just in it. I've recently discovered a supermarket close to my office that sells organic vegetables and fruit alongside non-organic produce as well as rows of spices and herbs that claim health-inducing properties, every type of pasta on the planet, freshly-made bread with whole grains, goat's milk ice-cream, a soup bar, and so on and so on. The ambiance is rustic as establishments emphasising health tend to be, although the effect is somewhat marred by containers of Osem chicken soup powder at the entrance to the store. At the back, there is a shop selling all manner of toiletries that purportedly contain no harmful properties and were not tested on animals. In fact, the range of lotions, moisturizers, shampoos, conditioners, deoderants, etc. is overwhelming, as indeed are the prices. But who wouldn't hand over a few more shekels to promote good health!
The question is, does it? The market is cashing in on the current obsession with good health. (There's a furniture store near my office called Green Furniture, as if to deny that their furniture is depleting the rain forests. On the other hand, the proprietor's family name could well be Green.) How much of it is a scam? Do we assume that the labels on products are telling all the truth? Is the literature telling us to avoid products with sodium lauryl sulfate, propylene glycol and petrolatum based on substantiated proof that these substances, even if they don’t cause cancer, are harmful to our bodies in other ways? Is the absence of harmful ingredients from the packaging sufficient indication that the listed ingredients are indeed good for you, or at least, will not cause you any harm? How is a simple consumer with no training in pharmaceuticals or chemistry supposed to make intelligent decisions?
The sales assistants project an air of knowledge about their products and are seemingly sincere in their belief that the products are not harmful but that's what they have been trained to do. Notwithstanding the sincerity of the manufacturers and sales staff, the possibility that some substance hitherto believed to be harmless could become toxic in combination with other substances cannot be precluded. These questions might seem obsessional but I find it hard to accept the superiority of a product, a food or a belief just because people with persuasive skills tell me to.
In spite of the questions and doubts, I've decided to to err on the side of conventional wisdom and buy the toxin-free products gradually, choosing those that suit me, and phasing out those containing ingredients identified as harmful. And if these products are indeed all they are purported to be, I hope that my current habit of mixing them - such as the healthy, pomegranate-smelling shampoo with the unhealthy conditioner, and vice versa - will not cost me any brownie points.
The Cancer Notebook by Julia Chiappetta provides a pretty full breakdown of which cosmetic ingredients to avoid - in fact, it contains quite a lot of useful information; highly recommended.
Scepticism also describes my approach to what I put in my body. Every morning, Nachum and I down a glass of green magma, a bright-green powder smelling of grass, mixed with water (http://www.greenfoods.com/products/green_magma.html). Based on barley grass, this tasteless mixture lays claim to promoting good health by supporting cardiovascular function and supplying the body with a generous dollop of antioxidants. Efforts to locate independent research on the efficacy of green magma proved fruitless but I was directed to http://www.greenfoods.com/news/#1 by the manufacturers of Green Foods. My conclusion was that so long as it does no harm, the worst that can happen is that it does no good. In the meantime, I wrote to Sloan Kettering to ask if they had ever conducted research on green magma, but apart from an auto-generated acknowledgement, I have not yet heard from them.
I have begun to eat with abandon and in the last few months, have gained around seven kgs, which makes me feel clumsy and uncomfortable. Having eaten according to the rules for so long and yet falling foul of cancer, I have thrown caution to the winds and, although our fridge now contains goats' dairy products, I have eaten cows' dairy products that were high in fat, aware that dairy foods cause mucus in the body and that cancer cells thrive on mucus. I have eaten cookies and cakes, aware that cancer cells thrive on refined sugars. On the other hand, Nachum has been making me a weekly portion of soup of carrots, yams and squash because I was advised to eat orange food.
In the battery of tests scheduled over the next few weeks, I've included a dietician to help me streamline my eating habits. She will no doubt dispense advice based on current conventional wisdom.
Tuesday, December 25, 2007
Saturday, November 10, 2007
Panic
It’s a known condition of human nature that we appreciate what we have only when we’re faced with losing it. I’ve spent so much time bemoaning the lack of well-being that characterized my life BC (before cancer) that I failed to notice a gradual process whereby a facsimile of that well-being was developing in its place.
And then, that was shattered.
I’d become aware that my bra was pressing against my flesh, especially on the left side, but put it down to having put on weight. During the week, however, I realized that my breast was swollen. I remembered it had swelled during radiation but I’d had a vague notion that it had settled down to its normal dimensions some time over the last two months, since completing therapy. But now, my breast obtruded whenever my left arm brushed against my side, a situation that was not reflected on my right side. By the time I became agitated enough to call Hannah, my old companion, the churning stomach, was back.
Hannah told me to contact the surgeon. She said that the swelling could be due to the radiation, but it scared me that she could entertain any other possibility. (It’s unclear to me why she suggested I contact the surgeon instead of Dr. Sarid, my oncologist. She said that she didn’t know Sarid’s schedule for Wednesday, when he would be at the hospital, but I still wonder why she couldn’t have made an emergency appointment for me.)
Genuinely alarmed now, I tried to contact Dr. Sigal Librant and left a message on her voicemail. Next I made an emergency appointment to see her on Thursday afternoon (made possible by Nachum running to the doctor to obtain an emergency referral).
By the afternoon, I had calmed down. I’d surfed the net and spoken to Sally, my granddaughters’ former nanny, whose young daughter is a cancer survivor. It seemed that even months after radiation therapy, the breast can remain swollen. My problem was that I couldn’t remember if it had ever returned to its original smaller proportions.
I remained relatively calm until Wednesday evening when I noticed small black spots on the aureole around my nipple. Thursday morning, I ran a search for inflammatory breast cancer or IBC and what I read sent me into an unprecedented realm of panic (http://www.mayoclinic.com/health/inflammatory-breast-cancer/DS00632). My symptoms met some of those of IBC, although they could just as well be related to the effects of radiation. IBC is rated as Stage 3B or Stage 4 if it has metastasized, and survival rates are low. I believed with my whole being that the fight was over and that I was now facing death.
We reached the clinic early and when Sigal arrived, she told me that she’d heard my voicemail message only that afternoon. She examined me, told me the swelling was indeed due to the radiation but that I had one of the best recoveries she’d seen, that the black spots were pigmentation, also from the radiation, and that I certainly was not suffering from IBC.
I wondered, and still wonder, why I wasn’t immediately lifted out of my sense of doom by a feeling of relief. I think it’s because I’d given up. I had cried with uncontrolled hysteria, I’d screamed with fright at the horror of imminent death, I'd rued the time I hadn’t spent feeling grateful for my life as a cancer survivor. Mentally, I had gone to the brink of the abyss and it took a while to step away from it. How fragile my ability to cope with it all is and how wonderful life is when I can.
The next day I drank in the beauty of the world, and was back to complaining to Nachum, dispenser of indispensable TLC during that horrible period, about his driving.
And then, that was shattered.
I’d become aware that my bra was pressing against my flesh, especially on the left side, but put it down to having put on weight. During the week, however, I realized that my breast was swollen. I remembered it had swelled during radiation but I’d had a vague notion that it had settled down to its normal dimensions some time over the last two months, since completing therapy. But now, my breast obtruded whenever my left arm brushed against my side, a situation that was not reflected on my right side. By the time I became agitated enough to call Hannah, my old companion, the churning stomach, was back.
Hannah told me to contact the surgeon. She said that the swelling could be due to the radiation, but it scared me that she could entertain any other possibility. (It’s unclear to me why she suggested I contact the surgeon instead of Dr. Sarid, my oncologist. She said that she didn’t know Sarid’s schedule for Wednesday, when he would be at the hospital, but I still wonder why she couldn’t have made an emergency appointment for me.)
Genuinely alarmed now, I tried to contact Dr. Sigal Librant and left a message on her voicemail. Next I made an emergency appointment to see her on Thursday afternoon (made possible by Nachum running to the doctor to obtain an emergency referral).
By the afternoon, I had calmed down. I’d surfed the net and spoken to Sally, my granddaughters’ former nanny, whose young daughter is a cancer survivor. It seemed that even months after radiation therapy, the breast can remain swollen. My problem was that I couldn’t remember if it had ever returned to its original smaller proportions.
I remained relatively calm until Wednesday evening when I noticed small black spots on the aureole around my nipple. Thursday morning, I ran a search for inflammatory breast cancer or IBC and what I read sent me into an unprecedented realm of panic (http://www.mayoclinic.com/health/inflammatory-breast-cancer/DS00632). My symptoms met some of those of IBC, although they could just as well be related to the effects of radiation. IBC is rated as Stage 3B or Stage 4 if it has metastasized, and survival rates are low. I believed with my whole being that the fight was over and that I was now facing death.
We reached the clinic early and when Sigal arrived, she told me that she’d heard my voicemail message only that afternoon. She examined me, told me the swelling was indeed due to the radiation but that I had one of the best recoveries she’d seen, that the black spots were pigmentation, also from the radiation, and that I certainly was not suffering from IBC.
I wondered, and still wonder, why I wasn’t immediately lifted out of my sense of doom by a feeling of relief. I think it’s because I’d given up. I had cried with uncontrolled hysteria, I’d screamed with fright at the horror of imminent death, I'd rued the time I hadn’t spent feeling grateful for my life as a cancer survivor. Mentally, I had gone to the brink of the abyss and it took a while to step away from it. How fragile my ability to cope with it all is and how wonderful life is when I can.
The next day I drank in the beauty of the world, and was back to complaining to Nachum, dispenser of indispensable TLC during that horrible period, about his driving.
Sunday, November 4, 2007
How Am I Physically?
I'm tired. I don't know if I'm tired because radiation destroyed some of my cells and my body has to work overtime to recreate them, or I'm tired because we're in a transitional season and I'm working long hours. Everything becomes cancer-centric even when a connection to it is farfetched.
I sometimes forget that I still have limited use of my left arm. This is the arm from whose armpit 15 lymph nodes were extracted and although I'm getting some sensation back - for example, I can feel myself applying deoderant - an area of my upper arm is still numb. Sometimes, such as when I stab my electronic card at the parking entrance at work, I overreach and then my arm hurts. I've been told not to lift anything heavy in this arm, including weights. For the rest of my life, blood tests, injections and anything involving the active use of an arm and its contents must be done from my right arm. I wonder how much more time will pass before I get full feeling back.
I've put on weight. Initially, I put on weight because I tend to overeat but I should've been smart and lost a few kilos before beginning the Tomoxifen. Now my jeans pinch around the waist and the thighs. I don't know if there's any point in even trying to diet.
I have hot flushes. When I stopped taking HRT, I began to get a few hot flushes a day. They didn't last more than a minute or two and were more or less bearable, even those that left a faint line of sweat on my upper lip. It was, after all, summer and there were times when I didn't know if I was having a flush or it was just damned hot. A hot flush, for those who have never had one, begins in the depths of the body and spreads itself all over while concomitantly increasing in intensity. It has been referred to as 'cooking from the inside'. I think their frequency has increased since I began to take Tomoxifen - a spot check over the last four hours shows I was getting one every hour on the hour for the first three and the fourth one a mere 50 minutes later. If it gets worse than this I'll be dressing for summer in the depths of winter.
I sometimes forget that I still have limited use of my left arm. This is the arm from whose armpit 15 lymph nodes were extracted and although I'm getting some sensation back - for example, I can feel myself applying deoderant - an area of my upper arm is still numb. Sometimes, such as when I stab my electronic card at the parking entrance at work, I overreach and then my arm hurts. I've been told not to lift anything heavy in this arm, including weights. For the rest of my life, blood tests, injections and anything involving the active use of an arm and its contents must be done from my right arm. I wonder how much more time will pass before I get full feeling back.
I've put on weight. Initially, I put on weight because I tend to overeat but I should've been smart and lost a few kilos before beginning the Tomoxifen. Now my jeans pinch around the waist and the thighs. I don't know if there's any point in even trying to diet.
I have hot flushes. When I stopped taking HRT, I began to get a few hot flushes a day. They didn't last more than a minute or two and were more or less bearable, even those that left a faint line of sweat on my upper lip. It was, after all, summer and there were times when I didn't know if I was having a flush or it was just damned hot. A hot flush, for those who have never had one, begins in the depths of the body and spreads itself all over while concomitantly increasing in intensity. It has been referred to as 'cooking from the inside'. I think their frequency has increased since I began to take Tomoxifen - a spot check over the last four hours shows I was getting one every hour on the hour for the first three and the fourth one a mere 50 minutes later. If it gets worse than this I'll be dressing for summer in the depths of winter.
Friday, November 2, 2007
Musings
I have been a hypochondriac since childhood. Whatever ghastly illness of the week I was suffering from, the inevitable panic was sometimes allayed by a visit to a doctor, where more often than not I felt like an idiot, or it just dissipated with time as I found that I had no real symptoms and I was still alive. As I matured, I found that although I was still apt to take on board the most rare and deadly disease possible, I was far more sanguine about my state of health. In fact, I suspect there was an element of 'it can't happen to me', because until then, it hadn't.
Now I find that, in common with almost every cancer patient I know, anything that is even slightly awry is cause for panic. A little over a month ago I watched with horror the appearance and daily growth of a mole-like object on my leg. It started as a small, white bump that morphed from a pale pink to a darkish brown. I was convinced that my body was breaking out in melanomas but people who should know what a melanoma looks like put my mind at rest. The mole or whatever it was, darkened, hardened and has since disappeared. But this is the way it is - an unexpected twinge where there had never been a twinge before, a bout of gas, fatigue, a pimple, all become the focus of a fear that my cancer is manifesting itself in a new and dangerous way.
Art of Living
I'd been looking forward to this course, which was conducted within the framework of research, and was open to anyone who had contracted breast cancer within the last five years. Art of Living appears to be an international organization - launched by one Sri Sri Ravi Shenkar - with the usual claims of reducing stress, increasing awareness, and promoting better health, energy, personal and global peace. A number of courses on its effect on cancer patients was concurrently underway in
The course I attended consisted of 16 women, the trainer, Dafna, and two additional women whose presence was not totally clear - I think they were there to help us perform the exercises or tend to someone in case of distress. The women were of all ages, some shockingly young, from different walks of life. Our common denominator was that we had all suffered breast cancer, ranging from the minimally treated for early stage cancer (one woman's lump had been only 0.5 cm., less than half the size of mine) to those who'd gone through the hell of chemotherapy. One young woman revealed she'd had a recurrence.
Following the initial meeting, I was struck by the impact of that seemingly innocuous statement - we'd all had breast cancer. My diagnosis and ensuing treatment had been so very dramatic and I have been totally focused on my feelings, my treatment, my health care practitioners. As I have moved through the process to recovery, I have immersed myself in learning about the disease and its remedies, exchanging stories with women who shared the process with me, and riding the emotional roller coaster of trauma, fear, panic, despair and acceptance. It had been, it still is, a very personal, intense and all-encompassing experience.
The 16 women assembled in the room with the Indian ambiance and yoga mats, could have been anyone you see in street, the mall, driving to work - and yet, each and every one of us has lived through the same drama. It's almost surreal to contemplate that we all experienced the same gamut of emotions; the anxiety punctuated with intermittent hope waiting for results, the horror, fear, panic, despair and tears on receiving the devastating diagnosis, the bewilderment of submitting our bodies to the various machines, the resilience needed to confront the fear.
The course was exhausting. We filled out forms, learned to breathe in different rhythms (we learned to recognise each rhythm by its Sanskrit name), we looked into each other's eyes, we informed each other when we arrived on the planet and how long we intend to stay here, sang a song to an alien god, shared our feelings, and thankfully lay down on the mats to sleep as soon as we could complete the requisite breathing exercise. We drank a lot of water. Strangely, the subject of cancer was almost a stranger in the room, rarely becoming a topic of our interchanges.
I asked Dafna what happens physiologically when we breathe in different rhythms. Surely there is a purpose in taking long, drawn breaths as compared to short, panty ones. She insists it cleans the system, but cannot say how or why. Whenever I ask questions such as these, a common response is Why do I want to know. Seems to me a more relevant question would be, why would I not want to know.
Hiatus
The period between the cessation of treatment and my appointment with the oncologist was, despite predictions to the contrary, almost tranquil. With no treatments to undergo and no medication to remind me of what I'd had, I was almost able to enjoy the illusion that life was returning to normal.
I returned to work on October 16, after Rosh HaShana. I approached the day with a sense of heaviness, resenting the need to fling myself back into the pressure of a profession that I'm becoming increasingly less enthusiastic about. Although I work in a small company, most of my colleagues don't seem to know about my cancer and just assumed I'd been off on a carefree vacation for three weeks. By Monday, I was feeling better about being back, the workload not being particularly onerous. My boss, who had shown patience and understanding while I was undergoing treatment, seemed to expect me pick up where I'd left off pre-cancer as if I'd suffered nothing more than a particularly nasty bout of flu that had now passed. The CEO, who'd regaled with me with horror stories of the cancer experiences of a close friend of his, told me that he'd almost called to convince me not to take time off during the radiation treatments, for my sake, he averred, not the company's. I told him that the emotional as well as the physical effort of traveling daily to the hospital had taken its toll and I had been correct in taking the time off. All in all, my employers have been supportive and considerate.
I'd contacted the 1 in 9 organization a few weeks earlier and the very sympathetic and knowledgeable volunteer I'd spoken to had told me that many women have an emotional crisis during the month-long period between the end of treatment and their next visit to the doctor. I remember the period between learning I wouldn't have to undergo chemotherapy and beginning my radiation treatments as being emotionally difficult because for the first time since receiving the devastating news of my cancer, I was faced with downtime - no test results to wait for, no appointments to keep, just timeout for contemplation. The lack of action forced me to confront my mortality and go to the next stage emotionally, Now, during this longer, one-month hiatus, I found, unlike that earlier time, I began the day with a smile, which I more or less maintained until flaking out in front of the TV at around 9.00 in the evening, waking up around 11.00 in time to go to bed.
Medication Begins
I've allowed a whole month to go by without updating this blog, not because nothing happened in October, but because I didn't have the time or the mental energy to sit down and write it.
At 10.10 am on 10 / 10, I had my third appointment with Dr. Sarid, my oncologist and, as expected, he prescribed Tomoxifen.
At 10.10 am on 10 / 10, I had my third appointment with Dr. Sarid, my oncologist and, as expected, he prescribed Tomoxifen.
Tomixifen is the medication of choice for hormonal-receptor positive cancer treatment. It received FDA approval in 1978 and its role is to block estrogen from binding to its receptors in the breast. There are some unpleasant and even life-threatening side-effects and I was curious to know why I wasn't being given Arimidex, which the informative lady at the 1 in 9 organization had told me is generally prescribed for post-menopausal women, such as myself. Arimidex is an aromatase inhibitor that prevents the conversion of steroids produced by the adrenal gland into estrogen and it has its own set of unpleasant but not necessarily life-threatening side-effects; however, it is thought to be superior to Tomoxifen in terms of preventing recurrence.
Dr. Sarid explained that Arimidex is very expensive and is not included in the basket of services in the first two and a half years of recovery from cancer. If I survive the first two and half years, I can expect to then be prescribed Arimidex, always presuming that it won't have been dropped entirely by then. Regardless of the cost, I wanted to know which medication was more likely to keep me alive. He said that in some cases, when the cancer was more advanced than mine, he recommends that the patient undertake the burden of paying for Arimidex. He seemed so convinced that I am going to survive that he was almost dismissive in asserting that Tomixifen is good enough for me. He wasn't receptive to the idea that I seek a second opinion, which the 1 in 9 lady had recommended. I managed to ask a few more questions before deferring to the feeling that I was taking up time he should be spending on other patients. I am now on a schedule of 3-monthly checkups. Perhaps at my appointment in January, I'll be able to ask another few questions. Prior to that, I'll need to have a blood test, a mammogram, ultra sound and check my bone mass.
Friday, September 28, 2007
Self-Pity or What?
I've become aware of a new phenomenon. Occasionally, and not preceded by any particular thought or event, my throat fills and my eyes well with unshed tears. Is this self-pity? Or perhaps it's a rush of gratitude that I discovered my cancer at an early stage and have a good chance of surviving it.
The tears don't fall and the moment passes.
The tears don't fall and the moment passes.
Wednesday, September 26, 2007
No More Therapy
Last Thursday (September 20), I had my fourth and final session with Liron the psychologist. Although the sessions were slated to continue for three months, I could only agree with Liron that my anxiety was mainly under control and that the turmoil I’d felt that had caused me to seek psychological help in the first place was settling into broad acceptance of my fate. I guess there are patients who are unable to ‘hold’ their anxiety - as Liron put it, cupping his hands to indicate how anxiety metaphorically nestles - as well as I seem to be doing and therefore need his services more than I do. Also, if my fears and anxiety threaten to overwhelm me, I have several other options. In October, I’ll be beginning a yoga course called the Art of Living which has been adapted especially for breast cancer patients. (I understand that the difference between this course and the standard one is that we breathe more!) I’ve also made contact with the 1 in 9 organization and hopefully will be joining a support group very soon. I meditate and once a month have a session with Eran.
So the opportunity to plumb the depths of my sub-conscious and discover if there is anything there that contributed to my cancer is unavailable for now. Clearly, if I knew what thoughts and perceptions I have buried there, they would no longer be in my sub-conscious. I do think that the theory of flooding the mind with positive messages (I will survive, I am unique, and so on) to neutralize any sub-conscious negativity is seriously flawed. Any messages of this type would set up residence in my conscious mind rather than dislodge the contents of my unconscious mind.
But what if my sub-conscious is harboring massively positive, life affirming thoughts? I remember one afternoon in the waiting area for Accelerator 4 how one young woman was describing how her treatment was extended because the machine broke down so often and the thought that immediately leapt into my mind was, Well, that won’t happen to me! Of course it did, the very next day, and it hadn’t been repaired in time for my treatment the day after either. However faulty they might be, why would I want to expel such perceptions from my sub-conscious where all they are doing is making me happy and optimistic?
So the opportunity to plumb the depths of my sub-conscious and discover if there is anything there that contributed to my cancer is unavailable for now. Clearly, if I knew what thoughts and perceptions I have buried there, they would no longer be in my sub-conscious. I do think that the theory of flooding the mind with positive messages (I will survive, I am unique, and so on) to neutralize any sub-conscious negativity is seriously flawed. Any messages of this type would set up residence in my conscious mind rather than dislodge the contents of my unconscious mind.
But what if my sub-conscious is harboring massively positive, life affirming thoughts? I remember one afternoon in the waiting area for Accelerator 4 how one young woman was describing how her treatment was extended because the machine broke down so often and the thought that immediately leapt into my mind was, Well, that won’t happen to me! Of course it did, the very next day, and it hadn’t been repaired in time for my treatment the day after either. However faulty they might be, why would I want to expel such perceptions from my sub-conscious where all they are doing is making me happy and optimistic?
Wednesday, September 12, 2007
No More Radiation
Today I had my final radiation treatment. Out of a set of eight booster treatments, three had to be deferred because of a breakdown in the accelerator, bringing my last treatment right up to erev Rosh HaShana, a fitting start to the new year. Any cancer cells lurking anywhere in the vicinity of my breast should have been thoroughly nuked and expunged after the 33 treatments, leaving me, it is hoped, completely cancer-free. That’s the plan.
The angry-looking redness of my breast has now morphed into a rather nice tan color, with only slight redness around the scar, under which the lump, the original cause of all this trouble, was located. I was lucky that, unlike some women, I suffered no pain, no blistering or burns.
My next appointment with the oncologist is on October 10. On Sunday evening, on my first day back at work, I’ll be attending a meeting of participants in a yoga course for breast cancer patients called Art of Living.
The angry-looking redness of my breast has now morphed into a rather nice tan color, with only slight redness around the scar, under which the lump, the original cause of all this trouble, was located. I was lucky that, unlike some women, I suffered no pain, no blistering or burns.
My next appointment with the oncologist is on October 10. On Sunday evening, on my first day back at work, I’ll be attending a meeting of participants in a yoga course for breast cancer patients called Art of Living.
Friday, September 7, 2007
Why?
Why? This is the question I’ve asked since my diagnosis was confirmed. Not a plaintive ‘why me,’ but a practical question with tangible answers that can help identify the cause so that I can do or not do whatever it was so that it won’t happen again.
Is it the food I eat, the air I breathe, the electromagnetic emissions from computer, cell phone and remote control units I absorb? Does the plastic from the bottle leach into the water I drink; do the toxins in my deodorant, shampoo, conditioner and make-up silently attack my cells? Is it pressure from the tuck in my bath towel that I wrap around my body?
Is it due to a traumatic experience from childhood? Is there something I need to ‘get off my chest’? Do I have a range of negative thoughts which sent my cells on a frenzied journey of malformation? Am I not loved enough or do I not love enough? Am I subconsciously depressed, repressed and stressed?
I believed I had my life under control, that I was treating my body, mind and soul well and that I would be repaid with continued good health. I haven’t smoked for 22 years, I eat vegetables and fruit, fowl and fish, and have abjured eating the flesh of antibiotic and hormonally-fed cows for at least four years. We do not own a microwave oven. I exercised. I meditated. I worked and exercised my brain. I enjoyed fulfilling relationships. I rarely suppressed an opinion but exercised restraint—well, mostly—within the boundaries of acceptable social intercourse. I felt empowered, untrammeled by the insecurities of past years and was willing the remaining years before retirement to pass quickly so I’d could begin to really enjoy myself. Not since I was a teenager did I want time to move so fast. In short, my life was a perfect picture book example of the healthy lifestyle that self-help advocates urge us to adopt after contracting cancer! What irony. Clearly, it wasn’t enough to combat the risk factors...
I belong in quite a few high-risk groups: I am over 50; I have close blood relatives who contracted the disease; I began menstruating early, at the age of 11; and finally, I’d been taking HRT (hormone replacement therapy) for almost 11 years. For most of that time, the HRT was estrogen-based; in the last few years I took a non-estrogen-based therapy. However, cancer develops slowly over a long period, and in all likelihood the provenance of my cancer dates from those early years when all that concerned me was not to endure another hot flush. A combination of all these risk factors with HRT providing the clincher to cause all other risks to shrink and shrivel before it, seem to have outweighed the benefits of the healthy lifestyle that played by all the rules.
It’s been suggested that my cancer was inevitable and that my healthy lifestyle actually deferred the onset of cancer by many years. If this is the case, then I appear to have being doing everything right and all I need to do to live a long life free of cancer is to continue with more of the same - minus the HRT.
I have used various terms throughout this blog to describe myself in regard to living with cancer, most frequently as ‘cancer victim’. As the cancerous lump was scooped out of me by the surgeon, I am presumably cancer-free and all the subsequent treatments are designed to ensure that none of those pesky little cells remain in my body and that new cancerous ones will not develop. I think a more appropriate term is ‘cancer patient.’ ‘Patient’ implies endurance with an unavoidable process while ‘victim’ suggests bitterness.
I do not dismiss the body, mind, spirit connection. One of the women I meet during radiation treatments believes that stress from the Second Lebanon War precipitated the onset of her cancer. Conversely, my brother Tony defied predictions and lived for two and a half years following diagnosis instead of the year that the doctors gave him. I am convinced that my mother, who was almost completely blind, willed herself to die as she felt the increasing frailty of my brother when she hugged him, unable to face the death of yet another child.
If stress is the main factor in triggering cancer, I have never in my life undergone such intense stress as that emanating from contracting the disease itself.
Is it the food I eat, the air I breathe, the electromagnetic emissions from computer, cell phone and remote control units I absorb? Does the plastic from the bottle leach into the water I drink; do the toxins in my deodorant, shampoo, conditioner and make-up silently attack my cells? Is it pressure from the tuck in my bath towel that I wrap around my body?
Is it due to a traumatic experience from childhood? Is there something I need to ‘get off my chest’? Do I have a range of negative thoughts which sent my cells on a frenzied journey of malformation? Am I not loved enough or do I not love enough? Am I subconsciously depressed, repressed and stressed?
I believed I had my life under control, that I was treating my body, mind and soul well and that I would be repaid with continued good health. I haven’t smoked for 22 years, I eat vegetables and fruit, fowl and fish, and have abjured eating the flesh of antibiotic and hormonally-fed cows for at least four years. We do not own a microwave oven. I exercised. I meditated. I worked and exercised my brain. I enjoyed fulfilling relationships. I rarely suppressed an opinion but exercised restraint—well, mostly—within the boundaries of acceptable social intercourse. I felt empowered, untrammeled by the insecurities of past years and was willing the remaining years before retirement to pass quickly so I’d could begin to really enjoy myself. Not since I was a teenager did I want time to move so fast. In short, my life was a perfect picture book example of the healthy lifestyle that self-help advocates urge us to adopt after contracting cancer! What irony. Clearly, it wasn’t enough to combat the risk factors...
I belong in quite a few high-risk groups: I am over 50; I have close blood relatives who contracted the disease; I began menstruating early, at the age of 11; and finally, I’d been taking HRT (hormone replacement therapy) for almost 11 years. For most of that time, the HRT was estrogen-based; in the last few years I took a non-estrogen-based therapy. However, cancer develops slowly over a long period, and in all likelihood the provenance of my cancer dates from those early years when all that concerned me was not to endure another hot flush. A combination of all these risk factors with HRT providing the clincher to cause all other risks to shrink and shrivel before it, seem to have outweighed the benefits of the healthy lifestyle that played by all the rules.
It’s been suggested that my cancer was inevitable and that my healthy lifestyle actually deferred the onset of cancer by many years. If this is the case, then I appear to have being doing everything right and all I need to do to live a long life free of cancer is to continue with more of the same - minus the HRT.
I have used various terms throughout this blog to describe myself in regard to living with cancer, most frequently as ‘cancer victim’. As the cancerous lump was scooped out of me by the surgeon, I am presumably cancer-free and all the subsequent treatments are designed to ensure that none of those pesky little cells remain in my body and that new cancerous ones will not develop. I think a more appropriate term is ‘cancer patient.’ ‘Patient’ implies endurance with an unavoidable process while ‘victim’ suggests bitterness.
I do not dismiss the body, mind, spirit connection. One of the women I meet during radiation treatments believes that stress from the Second Lebanon War precipitated the onset of her cancer. Conversely, my brother Tony defied predictions and lived for two and a half years following diagnosis instead of the year that the doctors gave him. I am convinced that my mother, who was almost completely blind, willed herself to die as she felt the increasing frailty of my brother when she hugged him, unable to face the death of yet another child.
If stress is the main factor in triggering cancer, I have never in my life undergone such intense stress as that emanating from contracting the disease itself.
Coping
The internet is awash with advice and stratagems to prevent or cure cancer. Much of it is contradictory, unproven or unattributed. Serious sites, those that belong to or are endorsed by recognized institutions describe, inter alia, a range of clinical trials, the results of which frequently present conflicting evidence. The world of information, whether via the net, professionals in the field or the grapevine is a morass of confusion which no person who wishes to maintain a modicum of sanity can hope to fully navigate with inpunity.
From the beginning, I have tried to understand the facts of cancer and to find a path to follow that would best ensure my continued survival. Some of the questions I ask either have no answers or have answers I would need a degree in medicine or biology to begin to understand.
However, there was no doubt in my mind that I would entrust myself to the medical establishment and conventional treatment. Whatever the shortcomings of modern medicine and the fact that much about cancer remains mysterious, new information about the disease and innovations in treatment are constantly evolving and survival rates of cancer patients are increasing.
There are myriad alternative treatments out there on the internet, ranging from the practical to the mystical to the crackpot. Although I investigate and might even adopt an approach here and there, none of these treatments are subject to the intense and objective research of medical science. They therefore remain unproven and any examples of their purported success are anecdotal, unsupported by accepted norms of scientific research.
Whether I gravitated towards technical writing due to my almost obsessive need to understand the fundaments of any given issue or the profession simply honed my skill in doing so, my coping strategy has been to dissipate the fog that suffused me when I first received my diagnosis. Educating myself with solid data about the disease and the treatments I undergo promotes a semblance of control. I try to be methodical, but digressions, especially on the internet, are so tempting. Nonetheless, developing additional strategies to play a supporting role in my treatment is an ongoing process as their effectivity is tested over time.
I am still at a crossroads in terms of my eating habits. I find myself skipping from one nutrition authority to another, with no clear idea of what to adopt and what to eschew. In the meantime, I’m trying to maintain what is referred to as a well-balanced diet, and to eat plenty of salad greens and vegetables, limited but varied fruits and plenty of protein; to shun cow’s dairy products; reduce dairy and sugar intake. Some websites recommend eating only wholewheat products while others prohibit eating wheat at all. It’s very confusing.
I aim to introduce more harmony into my life. When going to work each day became a burden halfway through my radiation treatments, I decided to take a break until they were finished and felt an immediate lightness. In November, I will attend an Art of Living course, a yoga workshop specifically designed for breast cancer patients. I also spend more time meditating than in the past. This morning I tried a visualization exercise whereby bright, white little muscle-men killer cells hunted down ugly little bilious-green cancer cells and found a couple of them copulating behind a lobule. Unfortunately, the buzzer rang indicating the meditation session was over before the muscle-men could pulverize the bad guys. And I took Eran’s advice to cease double-checking the equipment and interrogating the technicians and instead had a conversation with God during my radiation treatments. It was actually very liberating but I’m relieved that the conversation remained one-sided.
I have been very gratified by the number of people who have offered to include me in their prayers. The intensity of the warmth I experience each time a request for my mother’s name is made must, at the very least, be equal to the efficacy of the act itself.
As for repressed childhood traumas and suppressed memories, well, they’re repressed and suppressed so I guess they’ll continue to remain unidentified until they present themselves in some recognizable form.
Caring people with the best of intentions need to draw on deep resources of sensitivity when offering suggestions, and recognize that we cancer patients are emotionally vulnerable. Sometimes it takes a while to find the path that is right for us but in the end, we adopt coping strategies that are based on our personal choice and inclinations, in the same way that we reach decisions regarding our religious beliefs or the way we style our hair. New insights and open discussion are stimulating, but there is a thin line between giving supportive advice and invalidating another person’s choices, for some, arrived at through painful and time-consuming enquiry. Confidence in our coping strategies can be fragile and their invalidation can cause us uncertainty and stress.
One of the best articles I’ve read on the web touches on this point: Being Positive
From the beginning, I have tried to understand the facts of cancer and to find a path to follow that would best ensure my continued survival. Some of the questions I ask either have no answers or have answers I would need a degree in medicine or biology to begin to understand.
However, there was no doubt in my mind that I would entrust myself to the medical establishment and conventional treatment. Whatever the shortcomings of modern medicine and the fact that much about cancer remains mysterious, new information about the disease and innovations in treatment are constantly evolving and survival rates of cancer patients are increasing.
There are myriad alternative treatments out there on the internet, ranging from the practical to the mystical to the crackpot. Although I investigate and might even adopt an approach here and there, none of these treatments are subject to the intense and objective research of medical science. They therefore remain unproven and any examples of their purported success are anecdotal, unsupported by accepted norms of scientific research.
Whether I gravitated towards technical writing due to my almost obsessive need to understand the fundaments of any given issue or the profession simply honed my skill in doing so, my coping strategy has been to dissipate the fog that suffused me when I first received my diagnosis. Educating myself with solid data about the disease and the treatments I undergo promotes a semblance of control. I try to be methodical, but digressions, especially on the internet, are so tempting. Nonetheless, developing additional strategies to play a supporting role in my treatment is an ongoing process as their effectivity is tested over time.
I am still at a crossroads in terms of my eating habits. I find myself skipping from one nutrition authority to another, with no clear idea of what to adopt and what to eschew. In the meantime, I’m trying to maintain what is referred to as a well-balanced diet, and to eat plenty of salad greens and vegetables, limited but varied fruits and plenty of protein; to shun cow’s dairy products; reduce dairy and sugar intake. Some websites recommend eating only wholewheat products while others prohibit eating wheat at all. It’s very confusing.
I aim to introduce more harmony into my life. When going to work each day became a burden halfway through my radiation treatments, I decided to take a break until they were finished and felt an immediate lightness. In November, I will attend an Art of Living course, a yoga workshop specifically designed for breast cancer patients. I also spend more time meditating than in the past. This morning I tried a visualization exercise whereby bright, white little muscle-men killer cells hunted down ugly little bilious-green cancer cells and found a couple of them copulating behind a lobule. Unfortunately, the buzzer rang indicating the meditation session was over before the muscle-men could pulverize the bad guys. And I took Eran’s advice to cease double-checking the equipment and interrogating the technicians and instead had a conversation with God during my radiation treatments. It was actually very liberating but I’m relieved that the conversation remained one-sided.
I have been very gratified by the number of people who have offered to include me in their prayers. The intensity of the warmth I experience each time a request for my mother’s name is made must, at the very least, be equal to the efficacy of the act itself.
As for repressed childhood traumas and suppressed memories, well, they’re repressed and suppressed so I guess they’ll continue to remain unidentified until they present themselves in some recognizable form.
Caring people with the best of intentions need to draw on deep resources of sensitivity when offering suggestions, and recognize that we cancer patients are emotionally vulnerable. Sometimes it takes a while to find the path that is right for us but in the end, we adopt coping strategies that are based on our personal choice and inclinations, in the same way that we reach decisions regarding our religious beliefs or the way we style our hair. New insights and open discussion are stimulating, but there is a thin line between giving supportive advice and invalidating another person’s choices, for some, arrived at through painful and time-consuming enquiry. Confidence in our coping strategies can be fragile and their invalidation can cause us uncertainty and stress.
One of the best articles I’ve read on the web touches on this point: Being Positive
My Sister Jo
Jo (Josephine) was my elder sister. She died in 1985 at the age of 47 after the breast cancer she contracted three years earlier had metastasized to her bones and other parts of her body. When I think of what happened to her, I am gripped by fear because I am afraid it will happen to me. The way I’ve chosen to cope with this is to try to furnish myself with as much information as possible about her cancer and the procedures and treatment she would have undergone in 1982 in the hope that I will discover why she died and why, 22 years later I won’t. There is no-one alive today that I am aware of who has any information about her, not even where she was hospitalized.
There’s not much I remember about her cancer. At the time, the word inspired such fear (it still does, but the subject is discussed so much more and there is such a glut of information about it that the word loses some of the mystique of earlier times), I had no idea what to ask or even how to digest what she’d told me.
I knew nothing about her illness until the day I received a letter from her informing me that she’d had an operation and that the tumor had been encapsulated. She described how for six months, she had to cover her breast and not allow it to get wet when taking a bath. When I visited England some time later, I remember her telling me that she was going into early menopause and that her breasts were becoming very large. I remember my mother mentioning it in worried tones.
At the time, our family doctor told me that an encapsulated tumor presented the best chance for survival and when I asked why in that case Jo had died, she theorized that a cell must have escaped. From the little information I have, it seems likely that Jo too underwent radiation treatment and that she was also taking hormonal treatment, probably Tomoxifen—which I will be taking in another month.
My questions focus on the differences in knowledge about the disease and the efficacy of diagnoses and different treatments in 1982 and 2007. Although there is no way of ever finding out, I wonder if an errant cell escaped and metastasized or did Jo have a recurrence which remained unidentified? This question is as imperative today as it was then.
I would assume that laboratory techniques for analyzing tumors in 1982 were less sophisticated than they are today. What would they not have known then that they regularly test for today?
I don’t have to avoid wetting the radiated area, on the contrary, I’m supposed to smother it in creams. How do radiation treatments differ in the last 22 years? What radiation treatment is it likely she received?
Have the components of Tomoxifen improved over the last 22 years or has it remained essentially the same?
Were lymph nodes automatically removed in the case of an encapsulated tumor? Is it possible that hers were not removed and that the cancer had already migrated to her lymph nodes?
According to a document published by the Breast Cancer Campaign called The History of Breast Cancer, the gene HER2/neu and its role in aggressive breast cancers had been discovered in the 1980s, although it’s not clear during which part of the decade and whether its discovery impacted in any way on my sister’s treatment.
Locating hospital records from 1982 is problematic. So far, I’ve learned that she was not hospitalized in St. Mary’s or St. George’s. I’m still waiting to hear from the Royal Marsden.
Jo was my senior by nine years. She didn’t take much notice of me when I was a child but we began to establish a rapport around about the time I was 12 and she was 21, or, more precisely, when I began to exhibit an interest in boys and make-up. She was fun, her wit made me laugh, she was tall and elegant and always seemed so confident. If any facet of her personality stands out, it was her sense of humor.
She chose not to die in a hospital. I arrived too late to find her alive at the home of her friend Sylvia, who, with incredible charity and compassion, had lent her home to Jo in her last days. Sylvia told me how she broke the news to Jo that her situation was terminal but she refused to accept it, saying she would go kicking and screaming. When Sylvia suggested that Jo call her place of work, she declined, saying, What if they take away my car and then they find a cure!
I often think how Jo would have enjoyed the world of advanced communications we live in today, how she would have been amongst the first to take advantage of the internet. She was an artist, though she claimed she wasn’t a very good one because our parents tried to force her, a left-hander, to use her right hand. Instead of art, she built a career in public relations and at the time of her death was doing PR for a firm producing 5.5 in floppy disks. She never had children of her own but was a perfect aunt to my three kids and my brother Tony’s son, Jonathan.
Jo’s death left me shocked. It dispelled any notion I might have had that death didn’t exist, at least, not in my family. And inevitably, the reality of her death brought into question my own mortality. For years, her lifestyle was the talisman I conjured to rationalize why I would not suffer her fate. She smoked, she’d never given birth, she ate mainly unhealthy restaurant or pre-packaged meals, she’d been on birth control pills for over 15 years. I’d given up smoking, I’d had three children, I ate healthy home-cooked meals and I used an IUD.
How smug I was! Today, in order to avoid smugness, I fall foul of the other side of the coin which is fear of meeting the same fate.
About nine months before she died, Jo and I had an argument as a result of some miscommunication. I remember writing a long letter to her explaining exactly why she was wrong and I was right and then I threw it away. But I was surprised, and not a little distressed, that for the first time, Jo didn’t send David a birthday card. At the time, I thought it was because she was still angry with me. Now I realize that it was more likely an oversight and that it was not in her nature to be spiteful to a child because of differences with his mother. When I returned home to Israel after her funeral, I found an anniversary card from her in which she wrote that I should expect a letter from her soon. Of course, there never was a letter from her ever again.
There’s not much I remember about her cancer. At the time, the word inspired such fear (it still does, but the subject is discussed so much more and there is such a glut of information about it that the word loses some of the mystique of earlier times), I had no idea what to ask or even how to digest what she’d told me.
I knew nothing about her illness until the day I received a letter from her informing me that she’d had an operation and that the tumor had been encapsulated. She described how for six months, she had to cover her breast and not allow it to get wet when taking a bath. When I visited England some time later, I remember her telling me that she was going into early menopause and that her breasts were becoming very large. I remember my mother mentioning it in worried tones.
At the time, our family doctor told me that an encapsulated tumor presented the best chance for survival and when I asked why in that case Jo had died, she theorized that a cell must have escaped. From the little information I have, it seems likely that Jo too underwent radiation treatment and that she was also taking hormonal treatment, probably Tomoxifen—which I will be taking in another month.
My questions focus on the differences in knowledge about the disease and the efficacy of diagnoses and different treatments in 1982 and 2007. Although there is no way of ever finding out, I wonder if an errant cell escaped and metastasized or did Jo have a recurrence which remained unidentified? This question is as imperative today as it was then.
I would assume that laboratory techniques for analyzing tumors in 1982 were less sophisticated than they are today. What would they not have known then that they regularly test for today?
I don’t have to avoid wetting the radiated area, on the contrary, I’m supposed to smother it in creams. How do radiation treatments differ in the last 22 years? What radiation treatment is it likely she received?
Have the components of Tomoxifen improved over the last 22 years or has it remained essentially the same?
Were lymph nodes automatically removed in the case of an encapsulated tumor? Is it possible that hers were not removed and that the cancer had already migrated to her lymph nodes?
According to a document published by the Breast Cancer Campaign called The History of Breast Cancer, the gene HER2/neu and its role in aggressive breast cancers had been discovered in the 1980s, although it’s not clear during which part of the decade and whether its discovery impacted in any way on my sister’s treatment.
Locating hospital records from 1982 is problematic. So far, I’ve learned that she was not hospitalized in St. Mary’s or St. George’s. I’m still waiting to hear from the Royal Marsden.
Jo was my senior by nine years. She didn’t take much notice of me when I was a child but we began to establish a rapport around about the time I was 12 and she was 21, or, more precisely, when I began to exhibit an interest in boys and make-up. She was fun, her wit made me laugh, she was tall and elegant and always seemed so confident. If any facet of her personality stands out, it was her sense of humor.
She chose not to die in a hospital. I arrived too late to find her alive at the home of her friend Sylvia, who, with incredible charity and compassion, had lent her home to Jo in her last days. Sylvia told me how she broke the news to Jo that her situation was terminal but she refused to accept it, saying she would go kicking and screaming. When Sylvia suggested that Jo call her place of work, she declined, saying, What if they take away my car and then they find a cure!
I often think how Jo would have enjoyed the world of advanced communications we live in today, how she would have been amongst the first to take advantage of the internet. She was an artist, though she claimed she wasn’t a very good one because our parents tried to force her, a left-hander, to use her right hand. Instead of art, she built a career in public relations and at the time of her death was doing PR for a firm producing 5.5 in floppy disks. She never had children of her own but was a perfect aunt to my three kids and my brother Tony’s son, Jonathan.
Jo’s death left me shocked. It dispelled any notion I might have had that death didn’t exist, at least, not in my family. And inevitably, the reality of her death brought into question my own mortality. For years, her lifestyle was the talisman I conjured to rationalize why I would not suffer her fate. She smoked, she’d never given birth, she ate mainly unhealthy restaurant or pre-packaged meals, she’d been on birth control pills for over 15 years. I’d given up smoking, I’d had three children, I ate healthy home-cooked meals and I used an IUD.
How smug I was! Today, in order to avoid smugness, I fall foul of the other side of the coin which is fear of meeting the same fate.
About nine months before she died, Jo and I had an argument as a result of some miscommunication. I remember writing a long letter to her explaining exactly why she was wrong and I was right and then I threw it away. But I was surprised, and not a little distressed, that for the first time, Jo didn’t send David a birthday card. At the time, I thought it was because she was still angry with me. Now I realize that it was more likely an oversight and that it was not in her nature to be spiteful to a child because of differences with his mother. When I returned home to Israel after her funeral, I found an anniversary card from her in which she wrote that I should expect a letter from her soon. Of course, there never was a letter from her ever again.
My Brother Tony
Tony was older than me by seven years. Our relationship was not particularly close but, like Jo, he made me laugh. He’d been married twice, had one son and at the time of his death, was in a close relationship with his live-in girlfriend. He was a partner in a firm of solicitors and had been an extraordinarily successful musician since his teens. He played keyboard, saxophone (alto and contralto) and clarinet.
As with Jo, I knew nothing about his cancer until I received a letter from him with the bad news. Later, visiting the UK, he described how one day he’d felt a hardness in his side and had been pleased because he’d spent some time working out and he thought it was having a effect. A few weeks later, he peed blood and soon after was diagnosed with very advanced cancer of the kidney.
Like Jo, Tony refused to acknowledge that he was dying, continuing to go to work everyday and lead an otherwise normal life. This superhuman determination is probably what led to Tony surviving at least a year and a half beyond the year the doctors' had predicted. The last time I spoke to him was about a fortnight before he died. It was clear that the cancer had already metastasized to his lungs as he tried to fit as many words as possible into each exhaled breath. He was looking forward to the new millenium but died a mere 16 days before it.
A few weeks before my own cancer diagnosis, I’d thought how ironic it was that I, the bratty little sister, living in a country beset by the dangers of war and terrorism, was still alive while my sister and brother were not.
As with Jo, I knew nothing about his cancer until I received a letter from him with the bad news. Later, visiting the UK, he described how one day he’d felt a hardness in his side and had been pleased because he’d spent some time working out and he thought it was having a effect. A few weeks later, he peed blood and soon after was diagnosed with very advanced cancer of the kidney.
Like Jo, Tony refused to acknowledge that he was dying, continuing to go to work everyday and lead an otherwise normal life. This superhuman determination is probably what led to Tony surviving at least a year and a half beyond the year the doctors' had predicted. The last time I spoke to him was about a fortnight before he died. It was clear that the cancer had already metastasized to his lungs as he tried to fit as many words as possible into each exhaled breath. He was looking forward to the new millenium but died a mere 16 days before it.
A few weeks before my own cancer diagnosis, I’d thought how ironic it was that I, the bratty little sister, living in a country beset by the dangers of war and terrorism, was still alive while my sister and brother were not.
Wednesday, September 5, 2007
Booster Days
I’ve completed the 25 radiation treatments and started a series of eight booster treatments. The boosters are carried out in Accelerator 4 and differ from the treatments I had in Accelerator 2 in a number of ways. First of all, the ray is electronic and directly targets the location of my erstwhile lump, instead of photon, which, if I understood the explanation correctly, bores deep and spreads in the area until it meets the resistance of the inner contours of my breast. Secondly, instead of the reflection of interlocking red guidelines on my body, a yellowish light is beamed directly on to my scar and there is only one, 20+-second blast, instead of two. And most significantly, the radiation team in Accelerator 4 seems to favor a more upbeat background music than their colleagues in Accelerator 2, who preferred the gentler rhythms of Julio Iglesias and Beethoven; I need to remind myself to remain still and not to twitch in time to the music.
A small coterie of women, with whom I compared lump size and respective treatments, has migrated with me from Accelerator 2 to Accelerator 4 where we continue to wish each other luck.
My breast looks like it’s been left out in the sun too long. It’s red and patchy and I faithfully apply the creams that the nurse, Rahel, recommends—so far there’s no discomfort or blistering. It’s also larger than its twin, although I accept that the lack of symmetry is discernible only to myself. I tire easily and disconcertingly, tend to drop off while watching movies that, now that I’ve taken a break from work, I have the time to watch.
I view everything through the prism of my emotions. I’m quick to tears and feelings of anger and frustration. The slightest aggravation or disappointment can trigger any one or all of these emotions. When my first appointment in Accelerator 4 was cancelled due to a malfunction, I felt so let down I could barely resist the impulse to burst into tears and stamp my foot. My daily treatments, while a pain in the ass, bestow a sense of being cared for. They also serve as a framework within which I function as if my life were normal and any deviation from it disproportionately undermines my ability to cope. A cancelled appointment is equivalent to a loose thread that threatens to unravel the fabric of my life.
The hospital allocates three months for therapy and I have had three sessions to date. My psychologist’s mission is to help me regain the well-being I had before my diagnosis and to combat my fear that I meet the same fate as my sister.
Between them—the doctors and radiation technicians, Liron the psychologist and Eran, my mediatation guide—I would seem to have body, mind and spirit covered.
A small coterie of women, with whom I compared lump size and respective treatments, has migrated with me from Accelerator 2 to Accelerator 4 where we continue to wish each other luck.
My breast looks like it’s been left out in the sun too long. It’s red and patchy and I faithfully apply the creams that the nurse, Rahel, recommends—so far there’s no discomfort or blistering. It’s also larger than its twin, although I accept that the lack of symmetry is discernible only to myself. I tire easily and disconcertingly, tend to drop off while watching movies that, now that I’ve taken a break from work, I have the time to watch.
I view everything through the prism of my emotions. I’m quick to tears and feelings of anger and frustration. The slightest aggravation or disappointment can trigger any one or all of these emotions. When my first appointment in Accelerator 4 was cancelled due to a malfunction, I felt so let down I could barely resist the impulse to burst into tears and stamp my foot. My daily treatments, while a pain in the ass, bestow a sense of being cared for. They also serve as a framework within which I function as if my life were normal and any deviation from it disproportionately undermines my ability to cope. A cancelled appointment is equivalent to a loose thread that threatens to unravel the fabric of my life.
The hospital allocates three months for therapy and I have had three sessions to date. My psychologist’s mission is to help me regain the well-being I had before my diagnosis and to combat my fear that I meet the same fate as my sister.
Between them—the doctors and radiation technicians, Liron the psychologist and Eran, my mediatation guide—I would seem to have body, mind and spirit covered.
Saturday, August 11, 2007
Radiation Therapy: The Routine
From Sunday to Thursday, I leave work around 2.45 and drive to Rambam. As my appointment is after 3.00, I can park for free in the employee’s parking lot - the guards at the gate now recognise me and don’t bother asking for the letter confirming the appointment. I no longer lose my way to the Oncology department and my card with its magnetic strip is ready at hand to pass under the scanner when I arrive.
I then round the corner and take a seat in the waiting area and wait, freezing from the excessive air-conditioning. There seems to be a regular turnover of patients waiting for treatment but some have become familiar faces: the Russian guy with the baseball cap, whose treatment now seems to precede mine; the young and always animated Asian boy, whose brightly colored head covering would indicate that he’s undergone chemo; the youngish Arab woman with a passing resemblance to Sandra Bullock; the woman whose baby doll, blond and curly hairstyle appears incongruent with her heavily-lined and overly made-up face, perhaps yet another victim of hair fallout from chemotherapy.
When my name is called, I am buzzed through one of the double doors and I make my way to the technicians’ station, where I hand over my magnetic card. I go into one of the changing rooms, remove my top and bra, take a dusty-pink robe that matches the dusty-pink doors - probably coincidentally - and then lock the door behind me. By this time, the technicians have swiped my card to display my details on the PC screen. The details include the photo that was so mysteriously taken of me when I underwent radiation planning.
The radiation room is usually dark when I emerge from the changing room, indicating that the previous patient has not yet completed treatment. When he or she appears, we sometimes exchange smiles of camaraderie. Lately, this has been Dmitri, the guy with the baseball cap, who does not acknowledge the camaraderie of a shared experience.
By the time I enter the room, the table has been adjusted to accommodate my specifics. The reclining head/arm rest is put in position and the bar where my bottom comes to rest is placed at 8. If I were shorter or taller, the bar would be adjusted accordingly. All this is done to ensure that I lie in exactly the same position at every treatment. A paper sheet is placed on the table and I climb on to it and raise my arms above my head until they’re resting more or less comfortably in the arm rests. A technician dabs my breast with a black marker, and begins to raise the table. Music plays in the background.
The machine, which I now know is called an accelerator, begins to whir. The gantry, or arm which supports the disc-shaped plate through which the radiation is beamed, cranks and groans into position on the right side of my body. I stare up at the red interlocking lines on the ceiling which are mirrored precisely across my breasts. There are a few more whirs and a few whizzes, and then the radiation spurts, during which time I remain very, very still to avoid the beam hitting vulnerable parts of my body. Inevitably, I'm conscious of an overwhelming need to scratch my nose, but I don't dare and the feeling passes. The radiation burst is anything between 20 to 26 seconds. The gantry then cranks and groans its way over to my left side, whizzes for a few seconds, then there’s another burst of radiation lasting from 19 to 22 seconds. When it’s over, I don’t move, never quite sure if it’s safe to do so, until the technician comes back into the room to lower the table and release me.
During the 13 treatments, I think I’ve been attended to by the full complement of eight or more oncological radiation technicians, who mix and match their partnerships on any one day. That is, one day, the young, blonde girl might be teamed with with older, thickset man, who is teamed the next day with the technician with wild red hair and heavy bright blue eye makeup. They are generally pleasant, more often than not ready to answer my questions, though some express surprise at my interest. Sometimes I get the feeling that they’ve been primed to indulge the nosy British woman, to just answer her questions and maybe she’ll shut up.
Each patient is assigned what is called a radiation dose rate, which accounts for the variation in seconds in each treatment. The dose rate is measured in units of 100 to comprise a minute - the dose remains constant but might be delivered at different speeds due to concurrent activity on the network. Radiation delivery seems to function pretty much in the same way that information is delivered over internet networks. The monitor above me registers the number of time units it took to deliver my dose and it usually hovers around 55 / 46.
The dabs of black marker are made by technicians whose eyesight is challenged to find the marks that were tatooed on my body during the simulation and planning sessions. The beams are directed to optimally miss my heart and as much of my lung as possible. Apparently, it’s impossible to avoid the lung completely and the beam encroaches about a centimeter into it. However, I was told that up to two and half centimeters is permitted without any threat of undue damage.
After a few treatments, radiation of my left side was interrupted by the taking of an X-Ray to check that my coordinates, defined during the simulation and planning sessions, were correct. Apparently, they were, and I’m grateful that my anxiety that the beam is not always as precise as it should be were allayed.
Basically, radiation treatment can be compared to being micro-waved whereby the nuking begins in the center and spreads outward. After 13 treatments, my breast has assumed a rosy hue. I’ve been told to expect that it will redden and swell, burn and blister like any lump of meat placed in a micro-wave oven, but so far, apart from its rosiness, I don’t see much difference between the two breasts. I apply a cooling cream both morning and evening in the hope that doing so will preclude - or at least retard - burning. As for the swelling, do I buy a bra with larger cups and stuff the non-radiated side with cotton wool? Reminds me too much of puberty!
I retrieve my card, smile at the next patient on the reverse path to the treatment room, dressed like me in the dusky pink gown. I get dressed, and, no longer mistaking the storeroom door for the exit, leave. The whole process, from the time I first swipe my card to announce my arrival to the time I reach the parking lot, takes about half an hour. The rest of the day is mine.
I then round the corner and take a seat in the waiting area and wait, freezing from the excessive air-conditioning. There seems to be a regular turnover of patients waiting for treatment but some have become familiar faces: the Russian guy with the baseball cap, whose treatment now seems to precede mine; the young and always animated Asian boy, whose brightly colored head covering would indicate that he’s undergone chemo; the youngish Arab woman with a passing resemblance to Sandra Bullock; the woman whose baby doll, blond and curly hairstyle appears incongruent with her heavily-lined and overly made-up face, perhaps yet another victim of hair fallout from chemotherapy.
When my name is called, I am buzzed through one of the double doors and I make my way to the technicians’ station, where I hand over my magnetic card. I go into one of the changing rooms, remove my top and bra, take a dusty-pink robe that matches the dusty-pink doors - probably coincidentally - and then lock the door behind me. By this time, the technicians have swiped my card to display my details on the PC screen. The details include the photo that was so mysteriously taken of me when I underwent radiation planning.
The radiation room is usually dark when I emerge from the changing room, indicating that the previous patient has not yet completed treatment. When he or she appears, we sometimes exchange smiles of camaraderie. Lately, this has been Dmitri, the guy with the baseball cap, who does not acknowledge the camaraderie of a shared experience.
By the time I enter the room, the table has been adjusted to accommodate my specifics. The reclining head/arm rest is put in position and the bar where my bottom comes to rest is placed at 8. If I were shorter or taller, the bar would be adjusted accordingly. All this is done to ensure that I lie in exactly the same position at every treatment. A paper sheet is placed on the table and I climb on to it and raise my arms above my head until they’re resting more or less comfortably in the arm rests. A technician dabs my breast with a black marker, and begins to raise the table. Music plays in the background.
The machine, which I now know is called an accelerator, begins to whir. The gantry, or arm which supports the disc-shaped plate through which the radiation is beamed, cranks and groans into position on the right side of my body. I stare up at the red interlocking lines on the ceiling which are mirrored precisely across my breasts. There are a few more whirs and a few whizzes, and then the radiation spurts, during which time I remain very, very still to avoid the beam hitting vulnerable parts of my body. Inevitably, I'm conscious of an overwhelming need to scratch my nose, but I don't dare and the feeling passes. The radiation burst is anything between 20 to 26 seconds. The gantry then cranks and groans its way over to my left side, whizzes for a few seconds, then there’s another burst of radiation lasting from 19 to 22 seconds. When it’s over, I don’t move, never quite sure if it’s safe to do so, until the technician comes back into the room to lower the table and release me.
During the 13 treatments, I think I’ve been attended to by the full complement of eight or more oncological radiation technicians, who mix and match their partnerships on any one day. That is, one day, the young, blonde girl might be teamed with with older, thickset man, who is teamed the next day with the technician with wild red hair and heavy bright blue eye makeup. They are generally pleasant, more often than not ready to answer my questions, though some express surprise at my interest. Sometimes I get the feeling that they’ve been primed to indulge the nosy British woman, to just answer her questions and maybe she’ll shut up.
Each patient is assigned what is called a radiation dose rate, which accounts for the variation in seconds in each treatment. The dose rate is measured in units of 100 to comprise a minute - the dose remains constant but might be delivered at different speeds due to concurrent activity on the network. Radiation delivery seems to function pretty much in the same way that information is delivered over internet networks. The monitor above me registers the number of time units it took to deliver my dose and it usually hovers around 55 / 46.
The dabs of black marker are made by technicians whose eyesight is challenged to find the marks that were tatooed on my body during the simulation and planning sessions. The beams are directed to optimally miss my heart and as much of my lung as possible. Apparently, it’s impossible to avoid the lung completely and the beam encroaches about a centimeter into it. However, I was told that up to two and half centimeters is permitted without any threat of undue damage.
After a few treatments, radiation of my left side was interrupted by the taking of an X-Ray to check that my coordinates, defined during the simulation and planning sessions, were correct. Apparently, they were, and I’m grateful that my anxiety that the beam is not always as precise as it should be were allayed.
Basically, radiation treatment can be compared to being micro-waved whereby the nuking begins in the center and spreads outward. After 13 treatments, my breast has assumed a rosy hue. I’ve been told to expect that it will redden and swell, burn and blister like any lump of meat placed in a micro-wave oven, but so far, apart from its rosiness, I don’t see much difference between the two breasts. I apply a cooling cream both morning and evening in the hope that doing so will preclude - or at least retard - burning. As for the swelling, do I buy a bra with larger cups and stuff the non-radiated side with cotton wool? Reminds me too much of puberty!
I retrieve my card, smile at the next patient on the reverse path to the treatment room, dressed like me in the dusky pink gown. I get dressed, and, no longer mistaking the storeroom door for the exit, leave. The whole process, from the time I first swipe my card to announce my arrival to the time I reach the parking lot, takes about half an hour. The rest of the day is mine.
August 11, 2007: My Father’s Death (July 25, 07)
It’s almost a month since I last blogged and I have now had 12 radiation treatments. The first one was on July 22 and since then, the formalities, the procedure itself, and all other aspects of this treatment have become a way of life.
En route to the hospital on July 25, the day of my fourth treatment, I received a phone call from my nephew Jonathan to say that my father had been taken to hospital and that his death appeared to be imminent. As I was at the beginning stage of my treatment, Dr. Sarid agreed that I could travel to England for the funeral.
My relationship with my father was complex and the effect of his death has increased the turmoil that cancer introduced into my life. However, this blog is not the place to examine the implications of his death on my life other than to say that with the passing of my father, I am the sole survivor of the family I grew up in, the one that provided security for me as a child. This fact adds to my general sense of precariousness now that I too, like my siblings, am a victim of cancer.
Sunday, July 22, 2007
Radiation Treatment Begins
The atmosphere was different today - more pleasant, kinder. The secretary showed me how to pass a card under a sensor to announce to the radiation technicians that I'd arrived. While I waited for them to call me, Alison, the radiation nurse I'd met a few weeks ago, passed by, chatted for a bit with me and Gabi, then went to see how long it would be before I was called.
The same two technicians greeted me with broad smiles and explained exactly what they were going to do and how long it would take. Again I lay on the table, arms raised, and again I experienced the illusion of heavy machinery moving towards me when in fact, I moved toward it, suspended once again above the floor. I was zapped from one direction and then zapped from the other. Strangely, the angle of the circular platter that was presumably the zapping agent, seemed to point at my right breast, rather than the left. Once I'd been lowered and could move again, I asked why it appeared that the wrong breast was in the line of fire. The technician said that the instrument was precisely aligned in order to minimize contact with my lung. That took me aback a little - I knew that they try to avoid the heart, but I didn't realize that my lung was going to be, even minimally, affected.
The whole exercise took about 10 minutes and was much less onerous that the two previous sessions. As my appointments are in the afternoon, we were able to park in the employees car park for free and within half an hour of arriving, left the hospital.
I have my first appointment with a psychologist, scheduled for July 31. Yay!
The same two technicians greeted me with broad smiles and explained exactly what they were going to do and how long it would take. Again I lay on the table, arms raised, and again I experienced the illusion of heavy machinery moving towards me when in fact, I moved toward it, suspended once again above the floor. I was zapped from one direction and then zapped from the other. Strangely, the angle of the circular platter that was presumably the zapping agent, seemed to point at my right breast, rather than the left. Once I'd been lowered and could move again, I asked why it appeared that the wrong breast was in the line of fire. The technician said that the instrument was precisely aligned in order to minimize contact with my lung. That took me aback a little - I knew that they try to avoid the heart, but I didn't realize that my lung was going to be, even minimally, affected.
The whole exercise took about 10 minutes and was much less onerous that the two previous sessions. As my appointments are in the afternoon, we were able to park in the employees car park for free and within half an hour of arriving, left the hospital.
I have my first appointment with a psychologist, scheduled for July 31. Yay!
Saturday, July 21, 2007
July 19, 07. Whatta Day!
Eating Right
Mirit the dietician confirmed Liora’s claim to nutritionist bilbul (confusion). The rule of thumb for a healthy diet seems to be to eat as many non-processed foods as possible (or as few processed foods that is feasible), and to reduce quantities of dairy and sugar-laden products. Tuna should hail from the ocean where there is less mercury begriming the waters. As glucose in fruit is natural and takes longer to be absorbed, I should continue to eat about three fruits a day. To all my questions, such as the hormonal and antibiotic content of cattle feed, she gave the equivalent of a verbal shrug; research into what we consume is so dynamic it’s beyond a mere dietician to know more than a mere cancer patient. I cannot in any way fault her attitude - she could only dispense information that has been proven today in the knowledge that it might be disproven tomorrow.
I won’t be making many changes to my diet - for years I’ve followed what could be deemed an essentially healthy regime with occasional forays into the high-fat cheese and cake departments. Before cancer, I frequently mentally patted myself on the back for my adherence to good eating habits, regarding it an adequate talisman against such horrendous diseases as, well, cancer. In fact, a few weeks before my diagnoses, there was a report on how eschewing beef can reduce the risk of cancer. I haven’t eaten beef for years - I originally stopped eating it because of Mad Cow’s disease, but once the crisis was over, I was never even tempted to start eating it again. I’ve also considered giving up chicken considering what is probably put into their feed to say nothing of the unsavory way chickens are bred. I was amazed, therefore, when Mirit said I should be eating red meat, beef, three times a week, in order to maintain B12, folic acid and iron levels. I’ll have a blood test to determine if I have any deficiencies and then make a decision.
For years I have eaten several almonds daily based on something I read over 30 years ago. Edward Cayce, aka the Sleeping Prophet, was an illiterate man with no medical training whatsover, who claimed that while in a deep sleep, his psyche travelled around the body of what he referred to as an entity and located whatever was awry in that body. He would then prescribe some herbal remedy, from which, according to the book, the entity recovered. Cayce claimed that three almonds a day would protect against cancer.
Incidentally, Cayce also claimed that our planet would not end with a big bang of a nuclear explosion but would whimper to an end through ever-increasing occurrences of drought, famine, pestilence, floods, volcanic eruptions and earthquakes, all due to increased pollution. And that was in the 1940s.
Hmm! He was wrong about the almonds!
I showed Mirit a list of suggested natural remedies from the internet. This particular article, although well written and seemingly authentic had no attribution, nor was there any official endorsement from a research or medical facility. Articles such as these cause me no small amount of turmoil because they induce guilty feelings. If imbibing, smearing or swallowing one or many of these items would ensure my continued survival, then I am clearly not acting in my best interests by ignoring the advice. On the other hand, these very same items, taken in incorrect, or even recommended, proportions or in conjunction with other preparations, could in fact be injurious to health. Medicine Man Tea and Blue Green Algae will have to wait until I’ve exhausted other, recognized, options.
What Do You Have To Do To Get A Psychologist Around Here?
The day took on a Pythonesque twist. The week before, I’d asked Liora the social worker to arrange for me to consult a dietician and a psychologist. Mirit had phoned a few days later but as no psychologist had yet contacted me, I called Liora to remind her. She gave me a phone number she said I could call to make an appointment. As soon as I’d taken my leave of Mirit, I called the number but I got an answering machine inviting me to leave a message for one of three doctors.
As I was already in the hospital, I thought it would be a good idea to go along to the department and try to make an appointment directly with a secretary or nurse. No-one in Reception knew where the Psychology department was so Nachum and I went over to Information.
The clerk behind the window didn’t know where the Psychology department was either, and, noting my meaningful glance at the sign above her head proclaiming Information in Hebrew, English and Arabic, protested that she didn’t know everything that happened in the hospital. She went to ask the ‘girls’ but they didn’t know where the Psychology department was either and, clearly feeling that she had made a supreme effort, indicated that my query had been dealt with to the maximum of her ability and would I now just go away.
The deputy manager of the Reception department came out of her office to see what the altercation was about and invited us into her office. She tried to help by calling a few numbers, the upshot of which had us running back to Oncology to look for Room 31 where we would find Shlomit, a social worker who apparently was responsible for psychology appointments. Room 31 turned out to be a room containing a doctor and a patient who appeared justifiably disgruntled at being interrupted so we followed the signposts to Social Workers and found Shlomit’s office (Room 30) just as Hannah emerged from it. We told her that we were trying to locate the Psychology department and that Anat in Reception had sent us to Shlomit. She went off to find out some more details and a few minutes later, a dismayed Liora appeared in front of us, puzzled as why I would want to consult Shlomit about something she and I had discussed at length only a week earlier.
It seems there are only three psychologists attached to the Oncology department on a part time basis and they are usually not available to answer a phone. At Liora’s suggestion, I phoned again and left a message, which I probably should have done in the first place. But if no-one had contacted me after Liora passed on my request a week ago, how will leaving a message now make a difference?
One can go nuts trying to get an appointment with a psychologist around here.
Radiotherapy Planning
At 3.00, I returned to Rambam for radiotherapy planning. When I entered the room, a technician pointed a digital camera at me and took a picture of me. It is something I am wont to do in social situations but I felt that under these circumstances, a friendly explanation would have been in order.
I was told to remove my top and bra - behind the curtain naturally - and then lie down on the table, arms raised and resting in the grooves of the bright red blocks. When I queried what was about to unfold I was told that they were going to ‘apply the simulation’, referring to the simulation I had undergone on June 20. I was under the impression that this would take only a few minutes and, thinking they were done, started to get down from the table. This was clearly a mistake as the two technicians told me to lie back, keep still and breathe deeply - this was going to take 20 minutes.
The room grew dark. I was lying under a sort of giant, 2-pronged propeller with a massive circular platter above me and a square one to my right. The circular platter appeared to move towards me and hovered at about half a meter above me. It whirred a few times as the technicians shouted out numbers at each other. Inexplicably, the table I was lying on occasionally shuddered. Lying as I was, stretched out with arms above my head staring at the ceiling, I could make out very little in my peripheral vision. At some point, the circular platter revolved to the left and the square platter appeared in my line of vision on the right. Suddenly, one of the technicians applied something to my breast and I raised my head, only to quickly lower it when she shouted at me. She repeated her action and the second technician laid something that felt like a cord on my body. I had a sensation of being captive to a bunch of lunatic aliens. I was aware only of bobbing heads somewhere in the periphery of my vision as, mystifyingly, the technicians, appeared to be going about their tasks on or about my body while seated on very low chairs.
About 15 minutes into this activity, one of the technicians told me that Dr. Bernstein (the radio therapist) was going to mark a place on the scar on my breast and in a voice reminiscent of a drum roll, announced that Dr. Bernstein had entered the room. Totally misunderstanding, I lowered my arms and began to sit up. Again I was told - brusquely - to lie down and Dr. Bernstein, who was barely visible in my peripheral vision, made a mark on my scar, also seemingly from a sitting position.
By this time, even my right arm, which, unlike my left one, had not undergone an operation in the recent past, was feeling the strain of being in a constantly raised position. The circular and square platters continued to whir into action interchangeably and I was reaching the point where I’d had enough.
The whirring stopped, the lights went on and I discovered that the table on which I lay was raised a few meters from the floor, which explains why I’d only been able to make out the tops of heads from my prone position. Well, here was a lesson is perception - I had been sure that the circular platter had moved towards me when in fact, the table, had moved towards the platter. How lucky I had been that in my enthusiasm in greeting Dr. Bernstein I hadn’t leaped from the table to what would have been the floor, very far below.
This unpleasant session ended when, after lowering the table (!), I berated the technician for not informing me what they were doing while they were doing it. She asked if I meant that they should have pointed out that... and then she sarcastically reeled off a litany of activities they had performed on or about my body. I waited patiently for her to finish and said, ‘Yes, the answer is yes.’
Generally speaking, the higher up the scale the practitioner, the more the patient is treated with courtesy and given some explanation of what, why and how something is being done to them. Perhaps it is merely a matter of training in which case, radiation technicians need to be better taught to understand that the bodies lying on their tables belong to human beings with curiosity and fears, all of which could be allayed if they were to relate in a friendly manner.
Mirit the dietician confirmed Liora’s claim to nutritionist bilbul (confusion). The rule of thumb for a healthy diet seems to be to eat as many non-processed foods as possible (or as few processed foods that is feasible), and to reduce quantities of dairy and sugar-laden products. Tuna should hail from the ocean where there is less mercury begriming the waters. As glucose in fruit is natural and takes longer to be absorbed, I should continue to eat about three fruits a day. To all my questions, such as the hormonal and antibiotic content of cattle feed, she gave the equivalent of a verbal shrug; research into what we consume is so dynamic it’s beyond a mere dietician to know more than a mere cancer patient. I cannot in any way fault her attitude - she could only dispense information that has been proven today in the knowledge that it might be disproven tomorrow.
I won’t be making many changes to my diet - for years I’ve followed what could be deemed an essentially healthy regime with occasional forays into the high-fat cheese and cake departments. Before cancer, I frequently mentally patted myself on the back for my adherence to good eating habits, regarding it an adequate talisman against such horrendous diseases as, well, cancer. In fact, a few weeks before my diagnoses, there was a report on how eschewing beef can reduce the risk of cancer. I haven’t eaten beef for years - I originally stopped eating it because of Mad Cow’s disease, but once the crisis was over, I was never even tempted to start eating it again. I’ve also considered giving up chicken considering what is probably put into their feed to say nothing of the unsavory way chickens are bred. I was amazed, therefore, when Mirit said I should be eating red meat, beef, three times a week, in order to maintain B12, folic acid and iron levels. I’ll have a blood test to determine if I have any deficiencies and then make a decision.
For years I have eaten several almonds daily based on something I read over 30 years ago. Edward Cayce, aka the Sleeping Prophet, was an illiterate man with no medical training whatsover, who claimed that while in a deep sleep, his psyche travelled around the body of what he referred to as an entity and located whatever was awry in that body. He would then prescribe some herbal remedy, from which, according to the book, the entity recovered. Cayce claimed that three almonds a day would protect against cancer.
Incidentally, Cayce also claimed that our planet would not end with a big bang of a nuclear explosion but would whimper to an end through ever-increasing occurrences of drought, famine, pestilence, floods, volcanic eruptions and earthquakes, all due to increased pollution. And that was in the 1940s.
Hmm! He was wrong about the almonds!
I showed Mirit a list of suggested natural remedies from the internet. This particular article, although well written and seemingly authentic had no attribution, nor was there any official endorsement from a research or medical facility. Articles such as these cause me no small amount of turmoil because they induce guilty feelings. If imbibing, smearing or swallowing one or many of these items would ensure my continued survival, then I am clearly not acting in my best interests by ignoring the advice. On the other hand, these very same items, taken in incorrect, or even recommended, proportions or in conjunction with other preparations, could in fact be injurious to health. Medicine Man Tea and Blue Green Algae will have to wait until I’ve exhausted other, recognized, options.
_____________________________________________________
What Do You Have To Do To Get A Psychologist Around Here?
The day took on a Pythonesque twist. The week before, I’d asked Liora the social worker to arrange for me to consult a dietician and a psychologist. Mirit had phoned a few days later but as no psychologist had yet contacted me, I called Liora to remind her. She gave me a phone number she said I could call to make an appointment. As soon as I’d taken my leave of Mirit, I called the number but I got an answering machine inviting me to leave a message for one of three doctors.
As I was already in the hospital, I thought it would be a good idea to go along to the department and try to make an appointment directly with a secretary or nurse. No-one in Reception knew where the Psychology department was so Nachum and I went over to Information.
The clerk behind the window didn’t know where the Psychology department was either, and, noting my meaningful glance at the sign above her head proclaiming Information in Hebrew, English and Arabic, protested that she didn’t know everything that happened in the hospital. She went to ask the ‘girls’ but they didn’t know where the Psychology department was either and, clearly feeling that she had made a supreme effort, indicated that my query had been dealt with to the maximum of her ability and would I now just go away.
The deputy manager of the Reception department came out of her office to see what the altercation was about and invited us into her office. She tried to help by calling a few numbers, the upshot of which had us running back to Oncology to look for Room 31 where we would find Shlomit, a social worker who apparently was responsible for psychology appointments. Room 31 turned out to be a room containing a doctor and a patient who appeared justifiably disgruntled at being interrupted so we followed the signposts to Social Workers and found Shlomit’s office (Room 30) just as Hannah emerged from it. We told her that we were trying to locate the Psychology department and that Anat in Reception had sent us to Shlomit. She went off to find out some more details and a few minutes later, a dismayed Liora appeared in front of us, puzzled as why I would want to consult Shlomit about something she and I had discussed at length only a week earlier.
It seems there are only three psychologists attached to the Oncology department on a part time basis and they are usually not available to answer a phone. At Liora’s suggestion, I phoned again and left a message, which I probably should have done in the first place. But if no-one had contacted me after Liora passed on my request a week ago, how will leaving a message now make a difference?
One can go nuts trying to get an appointment with a psychologist around here.
_____________________________________________________
Radiotherapy Planning
At 3.00, I returned to Rambam for radiotherapy planning. When I entered the room, a technician pointed a digital camera at me and took a picture of me. It is something I am wont to do in social situations but I felt that under these circumstances, a friendly explanation would have been in order.
I was told to remove my top and bra - behind the curtain naturally - and then lie down on the table, arms raised and resting in the grooves of the bright red blocks. When I queried what was about to unfold I was told that they were going to ‘apply the simulation’, referring to the simulation I had undergone on June 20. I was under the impression that this would take only a few minutes and, thinking they were done, started to get down from the table. This was clearly a mistake as the two technicians told me to lie back, keep still and breathe deeply - this was going to take 20 minutes.
The room grew dark. I was lying under a sort of giant, 2-pronged propeller with a massive circular platter above me and a square one to my right. The circular platter appeared to move towards me and hovered at about half a meter above me. It whirred a few times as the technicians shouted out numbers at each other. Inexplicably, the table I was lying on occasionally shuddered. Lying as I was, stretched out with arms above my head staring at the ceiling, I could make out very little in my peripheral vision. At some point, the circular platter revolved to the left and the square platter appeared in my line of vision on the right. Suddenly, one of the technicians applied something to my breast and I raised my head, only to quickly lower it when she shouted at me. She repeated her action and the second technician laid something that felt like a cord on my body. I had a sensation of being captive to a bunch of lunatic aliens. I was aware only of bobbing heads somewhere in the periphery of my vision as, mystifyingly, the technicians, appeared to be going about their tasks on or about my body while seated on very low chairs.
About 15 minutes into this activity, one of the technicians told me that Dr. Bernstein (the radio therapist) was going to mark a place on the scar on my breast and in a voice reminiscent of a drum roll, announced that Dr. Bernstein had entered the room. Totally misunderstanding, I lowered my arms and began to sit up. Again I was told - brusquely - to lie down and Dr. Bernstein, who was barely visible in my peripheral vision, made a mark on my scar, also seemingly from a sitting position.
By this time, even my right arm, which, unlike my left one, had not undergone an operation in the recent past, was feeling the strain of being in a constantly raised position. The circular and square platters continued to whir into action interchangeably and I was reaching the point where I’d had enough.
The whirring stopped, the lights went on and I discovered that the table on which I lay was raised a few meters from the floor, which explains why I’d only been able to make out the tops of heads from my prone position. Well, here was a lesson is perception - I had been sure that the circular platter had moved towards me when in fact, the table, had moved towards the platter. How lucky I had been that in my enthusiasm in greeting Dr. Bernstein I hadn’t leaped from the table to what would have been the floor, very far below.
This unpleasant session ended when, after lowering the table (!), I berated the technician for not informing me what they were doing while they were doing it. She asked if I meant that they should have pointed out that... and then she sarcastically reeled off a litany of activities they had performed on or about my body. I waited patiently for her to finish and said, ‘Yes, the answer is yes.’
Generally speaking, the higher up the scale the practitioner, the more the patient is treated with courtesy and given some explanation of what, why and how something is being done to them. Perhaps it is merely a matter of training in which case, radiation technicians need to be better taught to understand that the bodies lying on their tables belong to human beings with curiosity and fears, all of which could be allayed if they were to relate in a friendly manner.
Friday, July 13, 2007
My New Oncologist
OK, I’ve been around, I know the drill. It’s usually done when I first enter the room - but there have been times when I was already prone, ready and waiting. Sometimes I manage to sit for a while, talk for a bit, but the end, I get up and remove my top and bra. I move over to the bed, lie down and raise my arms above my head. My breasts, both of them, are then prodded, poked, pounded and pummeled and - not to be too P-centrically alliterative - jabbed, joggled and jiggled. The whole routine is then repeated with me in a sitting position. Then the prodder who did the jiggling smiles and says, OK, everything’s OK and I get dressed again.
I’m not sure what they expect to find. It was only a short while ago that the cancerous lump was removed from one such breast. Do they expect it to come back for a return visit?
It's Thursday, July 12, and before keeping my appointment with Dr. Sarid, I met Liora the social worker. Since discovering the lump in what seems like eons ago, my life has been dominated by operations and waiting, usually tensely, for the results of various tests. Now all the labs are in, and the final piece in the jigsaw of my cancer is in place; there is no more action, just the reality of a dividing line between my life before cancer and my life after cancer. There are times when this realization plays havoc with my sense of well-being.
I want, I told Liora, a psychologist. I want to be able to pour out my emotional meanderings and find my way back to equilibrium. (Note: Even with access to a dictionary, there was no way I would be able to express that sentence in Hebrew. What I actually said was far more mundane, a linguistic compromise, if you will, but the message was the same.) Liora asked me if I had lost my appetite (no, if only!) and if I had sleeping problems, either oversleeping or under-sleeping (again no, so long as she didn’t count losing consciousness for about 20 minutes every evening in front of the TV as oversleeping). She concluded that I was not depressed, but that I was sad. That was a relief, because for a moment I was afraid that I would be denied a psychologist if I were judged insufficiently miserable.
I also asked her for access to a dietician or nutritionist because I am very, no extremely confused about what to eat and what not to eat. Tofu, for example - who hasn’t felt noble at eating tofu? They are now telling us that the phytoestrogens in tofu, instead of being beneficial, could well be a contributory factor to breast cancer. Furthermore, last week on Channel 10, there was a report on green, leafy vegetables, such as petrosilia (parsley) and cusbara (coriandar) - those we’re exhorted to eat for good health and to keep cancer at bay - and how they are saturated in carcinogenic substances. As if that weren’t enough, Liora told me that she attended a lecture where the role of organically grown produce in promoting health was impugned. Apparently, the very substance which destroys worms and other produce gnawing mites could be injurious to our health. The nutritionists themselves are very confused, said Liora. However, one concept that appears to be more or less universally acknowledged is that cancer cells love sugar: (http://www.webmd.com/breast-cancer/news/20070710/meat-sweets-boost-breast-cancer-risk). I don’t envisage cutting down on my sugar intake as a major hardship.
I got off to a rather shaky start with Dr. Sarid when he asked for my test results and I had nothing to give him. Nachum and I had gone to his secretary’s booth to confirm the time of the appointment but she wasn’t there and after waiting for about five minutes, we left because I was afraid we were late. I was dismayed and began to protest that I had no idea why he didn’t have my test results, that I wasn’t responsible for or even cognisant of administrative practices in the hospital. He calmed me down, told me that he was happy to tend to me because I was the mother of a colleague and that I should remember to bring all the documents next time. He also told me that if I continue to respond to him in that way, he'd be afraid to say anything to me, so I shut up. There was an element of warmth in him which had been lacking in Dr. F that I found compelling. I left his room feeling satisfied with my team of health care specialists.
I begin radiation treatment on July 22 at 3.55. There will be 33 treatments in all, every day, five days a week. I can expect to feel fatigued and weak as the treatments progress. On the way out of the hospital, I popped in to Steimatzky's and bought three books.
Friday, morning shower: After my breasts have been poked, pummeled and joggled, and have received a clean bill of health, I have no qualms applying moisturizing lotion to my body. I reckon if the doctors are satisfied, the possibility that I might chance on something untoward is pretty low. During intervals between breast jiggling, I tend to be reluctant to use the lotion because that is what triggered this whole drama - and there are some places I do not want to revisit.
I’m not sure what they expect to find. It was only a short while ago that the cancerous lump was removed from one such breast. Do they expect it to come back for a return visit?
_____________________________________________
It's Thursday, July 12, and before keeping my appointment with Dr. Sarid, I met Liora the social worker. Since discovering the lump in what seems like eons ago, my life has been dominated by operations and waiting, usually tensely, for the results of various tests. Now all the labs are in, and the final piece in the jigsaw of my cancer is in place; there is no more action, just the reality of a dividing line between my life before cancer and my life after cancer. There are times when this realization plays havoc with my sense of well-being.
I want, I told Liora, a psychologist. I want to be able to pour out my emotional meanderings and find my way back to equilibrium. (Note: Even with access to a dictionary, there was no way I would be able to express that sentence in Hebrew. What I actually said was far more mundane, a linguistic compromise, if you will, but the message was the same.) Liora asked me if I had lost my appetite (no, if only!) and if I had sleeping problems, either oversleeping or under-sleeping (again no, so long as she didn’t count losing consciousness for about 20 minutes every evening in front of the TV as oversleeping). She concluded that I was not depressed, but that I was sad. That was a relief, because for a moment I was afraid that I would be denied a psychologist if I were judged insufficiently miserable.
I also asked her for access to a dietician or nutritionist because I am very, no extremely confused about what to eat and what not to eat. Tofu, for example - who hasn’t felt noble at eating tofu? They are now telling us that the phytoestrogens in tofu, instead of being beneficial, could well be a contributory factor to breast cancer. Furthermore, last week on Channel 10, there was a report on green, leafy vegetables, such as petrosilia (parsley) and cusbara (coriandar) - those we’re exhorted to eat for good health and to keep cancer at bay - and how they are saturated in carcinogenic substances. As if that weren’t enough, Liora told me that she attended a lecture where the role of organically grown produce in promoting health was impugned. Apparently, the very substance which destroys worms and other produce gnawing mites could be injurious to our health. The nutritionists themselves are very confused, said Liora. However, one concept that appears to be more or less universally acknowledged is that cancer cells love sugar: (http://www.webmd.com/breast-cancer/news/20070710/meat-sweets-boost-breast-cancer-risk). I don’t envisage cutting down on my sugar intake as a major hardship.
I got off to a rather shaky start with Dr. Sarid when he asked for my test results and I had nothing to give him. Nachum and I had gone to his secretary’s booth to confirm the time of the appointment but she wasn’t there and after waiting for about five minutes, we left because I was afraid we were late. I was dismayed and began to protest that I had no idea why he didn’t have my test results, that I wasn’t responsible for or even cognisant of administrative practices in the hospital. He calmed me down, told me that he was happy to tend to me because I was the mother of a colleague and that I should remember to bring all the documents next time. He also told me that if I continue to respond to him in that way, he'd be afraid to say anything to me, so I shut up. There was an element of warmth in him which had been lacking in Dr. F that I found compelling. I left his room feeling satisfied with my team of health care specialists.
I begin radiation treatment on July 22 at 3.55. There will be 33 treatments in all, every day, five days a week. I can expect to feel fatigued and weak as the treatments progress. On the way out of the hospital, I popped in to Steimatzky's and bought three books.
Friday, morning shower: After my breasts have been poked, pummeled and joggled, and have received a clean bill of health, I have no qualms applying moisturizing lotion to my body. I reckon if the doctors are satisfied, the possibility that I might chance on something untoward is pretty low. During intervals between breast jiggling, I tend to be reluctant to use the lotion because that is what triggered this whole drama - and there are some places I do not want to revisit.
Thursday, July 5, 2007
New Oncologist, Life Returning to Normal (well, almost)
Gabi took my file to Dr. Sarid, who has agreed to be my oncologist. I have my first meeting with him on Thursday, July 12, and in the meantime, I'm waiting to be invited for my first radiation treatment, which should happen around the end of July, beginning of August.
Now that my immediate future is less of an enigma, the first thing I need to do it cut my hair, something I avoided doing for no rational reason other than a vague idea that there wasn't much point if it was all going to fall out anyway.
With everything falling neatly into place, it's a little disconcerting to find that my latent hypochondria has gone into overdrive. One would think that once the disease you've most dreaded actually strikes, there would be some relaxation in hypochondriac angst.
Unfortunately, that doesn't seem to be the case. I've been anxiously examining my eyes to make sure the whites are not yellow, indicating the presence of liver cancer. The other day, I had an irritating cough and I dreamed I had lung cancer. The next day, my throat hurt and I lost my voice, so now I'm worrying I have throat cancer. Yesterday morning, I had a sudden pain in a small area of my head and felt a little dizzy - no prizes for guessing what kind of cancer I'm thinking of.
I think it's time to go back to exercising. When I left the hospital, I'd lost 3 kg., the only bright spot in the whole experience, and although I've gained back about 2 kg., the fat seems to have redistributed and my clothes are feeling tight on me. Another reason for returning to exercise class is that it would be good preparation for the radiation, which can leave patients feeling tired and weak. It's time for me to start rebuilding my strength.
Now that my immediate future is less of an enigma, the first thing I need to do it cut my hair, something I avoided doing for no rational reason other than a vague idea that there wasn't much point if it was all going to fall out anyway.
With everything falling neatly into place, it's a little disconcerting to find that my latent hypochondria has gone into overdrive. One would think that once the disease you've most dreaded actually strikes, there would be some relaxation in hypochondriac angst.
Unfortunately, that doesn't seem to be the case. I've been anxiously examining my eyes to make sure the whites are not yellow, indicating the presence of liver cancer. The other day, I had an irritating cough and I dreamed I had lung cancer. The next day, my throat hurt and I lost my voice, so now I'm worrying I have throat cancer. Yesterday morning, I had a sudden pain in a small area of my head and felt a little dizzy - no prizes for guessing what kind of cancer I'm thinking of.
I think it's time to go back to exercising. When I left the hospital, I'd lost 3 kg., the only bright spot in the whole experience, and although I've gained back about 2 kg., the fat seems to have redistributed and my clothes are feeling tight on me. Another reason for returning to exercise class is that it would be good preparation for the radiation, which can leave patients feeling tired and weak. It's time for me to start rebuilding my strength.
Tuesday, July 3, 2007
July 3, 07. The Oncotype Results
NO CHEMO.
Yay! My oncotest result was 8: "Patients with a Recurrence Score of 8 in the clinical validation study had an Average Rate of Distant Recurrence at 10 years of 6%" is what it said in the page Gabi faxed me from Oncology this morning. That means that something in the sliver of malignant material sent to Oncotype suggests that 10 years from now, I will have a 6% chance of recurrence - undergoing chemo would reduce that to 4%, which is considered insignificant.
Being in doctor limboland had made me anxious that my results from Oncotype would arrive and nobody would inform me, so I'd called Teva early in the morning to find out when I could expect the answer. The answer arrived this morning and it was faxed to Dr. F, I was told by the Anglo lady who answered. She refused to tell me what the results were and told me to contact Dr. F directly.
I spoke to Gabi who was getting ready to leave the paggia (premature baby unit) and she told me she'd go over to Oncology to pick up the fax. It would take her about 10 minutes. Next I called Hannah, who was in the clinic. As the clinic is housed in a separate building from the hospital itself, it would take her too about 10 minutes to reach Oncology and pick up the fax.
I paced up and down waiting for Gabi and Hannah to converge on the Oncology ward and call me with the results. 10 minutes came and went, 15 minutes, I paced, I sat, I got up and paced, my heart pounding, my palms sweaty. Finally, the phone rang and Gabi told me the good news. The relief sent a bolt of energy coursing through my body.
Dr. F invited Gabi into her room and explained to her the significance of the result and told her she'd be happy to explain it to me. Is she really impervious to the trauma she'd caused me just over a week ago? Is she being arrogant or simply defensive in failing to acknowledge her oversight? I cannot begin to fathom her behavior.
I need an oncologist I can depend on. Hopefully, that will be taken care of in the next few days.
Yay! My oncotest result was 8: "Patients with a Recurrence Score of 8 in the clinical validation study had an Average Rate of Distant Recurrence at 10 years of 6%" is what it said in the page Gabi faxed me from Oncology this morning. That means that something in the sliver of malignant material sent to Oncotype suggests that 10 years from now, I will have a 6% chance of recurrence - undergoing chemo would reduce that to 4%, which is considered insignificant.
_____________________________________________________
Being in doctor limboland had made me anxious that my results from Oncotype would arrive and nobody would inform me, so I'd called Teva early in the morning to find out when I could expect the answer. The answer arrived this morning and it was faxed to Dr. F, I was told by the Anglo lady who answered. She refused to tell me what the results were and told me to contact Dr. F directly.
I spoke to Gabi who was getting ready to leave the paggia (premature baby unit) and she told me she'd go over to Oncology to pick up the fax. It would take her about 10 minutes. Next I called Hannah, who was in the clinic. As the clinic is housed in a separate building from the hospital itself, it would take her too about 10 minutes to reach Oncology and pick up the fax.
I paced up and down waiting for Gabi and Hannah to converge on the Oncology ward and call me with the results. 10 minutes came and went, 15 minutes, I paced, I sat, I got up and paced, my heart pounding, my palms sweaty. Finally, the phone rang and Gabi told me the good news. The relief sent a bolt of energy coursing through my body.
Dr. F invited Gabi into her room and explained to her the significance of the result and told her she'd be happy to explain it to me. Is she really impervious to the trauma she'd caused me just over a week ago? Is she being arrogant or simply defensive in failing to acknowledge her oversight? I cannot begin to fathom her behavior.
I need an oncologist I can depend on. Hopefully, that will be taken care of in the next few days.
Tuesday, June 12, 2007
April 24, 07. In the Beginning…
Due to the fact that I began writing the 'story so far', in a Word file, there's an inconsistency in the chronology of the blog links for June. First of all, all the entries in June have two dates: June 12 - the day on which I transferred the contents of my Word file to the blog - and the date that the event actually occurred. Because I'd set up the blog to show the newest item first, I had to upload the last item first in order to present events in the order they occurred. That explains why the Older Posts link actually leads to a newer post.
The easiest way to go through the items in their order of occurrence is to use the links in the Blog Archive on the left side of the page. The last link for June (June 11 to end-June) contains a number of events occurring on different days.
From July onwards, the first item describes the latest development - and clicking Older Posts will actually display a previous post.
I never self-examine. Whenever I ventured to do so, I inevitably found an errant bump - and endured the consequent tension until it was pronounced meaningless. I gave myself over completely to the apparati and doctors to identify the lumps and bumps in my body and to reach decisions on their significance. In February, my annual mammogram failed to turn up any aberration - out of mind until July, I thought, when it's time for the surgeon's physical exam.
On the morning of
Family and close friends know that I am the only one of my siblings to reach the age of 60. My sister Jo died from breast cancer in 1985 at the too-young age of 47. My brother Tony died from kidney cancer in December, 1999. He was four months short of his 60th birthday. Although genetic testing showed that I do not carry any known breast cancer genes, the spectre of cancer hovers over me like the sword of Damocles and I have maintained a strict schedule of mammogram testing followed six months later by a manual check for the last 15 years or so. At the end of each round, I would take a moment to register relief - and then continue with my life. The morning I found the lump, I went cold and my stomach churned with fear.
May 2, 07. Well, What a Relief
The following day, I made an emergency appointment with a surgeon. Dr. Agbaria pummeled, manipulated and poked my breasts, paying particular attention to the lump, and then pronounced me healthy. He explained that a cancerous tumor does not have well-defined edges and does not move around - and my lump was well-defined and was very mobile. I cried tears of relief. To be absolutely sure, he told me to make an appointment for an ultra sound.
I made the appointment for a week later and practically skipped back to work. The heaviness of the last two days lifted and I smiled at the world.
May 4, 07. The Results
*Nachum drove to the Herzliya Medical Center to pick up the results of the ultra sound I’d had two days earlier, while I stayed home to prepare for our weekend at Jacob's Ladder (an Anglo music festival for ageing hippies and progeny). I waited for him to call me and tell me that everything was OK, to put a final period to the whole unpleasant and frightening experience. In fact, I was so confident that it would turn out to be nothing; I'd gone ahead with my plans for setting up a Swinging 60s group and written a script in which I'd referred to the lump as being nothing more insidious than a cyst.
I was in for a shock. I heard the words, 'It's not good news' and that the lump was possibly malignant.
Angry! I was enraged - I went from room to room, yelling and cursing. Sitting on the bed, suddenly deflated, I began to cry. And then, amazingly, I picked up the paper and went on reading. It's probably some stupid mistake, I thought. The doctor who looked at the pictures wasn't wearing her glasses, or entered a comment meant for someone else.
Nonetheless, a pall spread over our fun weekend.
*Nachum is my husband.
May 6, 07. Up Again,,,
Sunday, I was back at the clinic for another emergency appointment. Dr. Rosenblatt looked at the ultra sound pictures and examined the lump. 'I would've sent you away and told you to come back in three months time,' he said. He couldn't fathom why the doctor who checked the ultra sound pictures thought my lump was suspicious but because he admired her professionalism, he took her recommendation seriously and referred me to an oncological surgeon.
Life on an emotional roller coaster. I'd been down, I'd been up, then down again - and now, I was almost afraid to hope.
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