Pathology report II

You know you're in trouble when your oncologist says, somewhat frantically, "I don't know what to do; I need some help!" Of course, my oncologist talks this way all the time, so I've kind of become used to it, as you'll know if you've read my story about the last time I went through this. She's been looked pretty ragged, actually, so maybe the job is getting to her. She was happy to hear I'll be seeing two orthopedists soon, because she's reluctant to start treatment and then be told that I need emergency back surgery. I told her I'd rather treat the cancer first than the back pain (even though we don't know that the cancer isn't causing the back pain), but she asked how I could get through chemo if I can't even sit up. She seems very hesitant about radiation, seemingly because of the likelihood of lymphedema if they fry my armpit. But she looked me in the eye and stressed how serious it would be if the cancer returns in that location.

So after going around in circles like this, we decided to get ready for chemo, which is a "systemic" treatment (it would attack cancer cells throughout my body -- hey, typo fans, I originally typed "attach" instead of "attack"), rather than radiation (which is a local treatment, and we're not sure yet which locale needs it). Depending on what the orthopedists tell me, I will start chemo in the first week of March. I'm set up to get something called a MUGA scan, which will determine whether my heart can withstand the drug family anthracycline.

And I've asked to get a Porta-Cath rather than that damned PICC line I had last time. The doc said the Porta-Cath is safer, although the other day a nurse told me the opposite. Both are used to keep a vein continuously open so that they don't have to jab my lousy veins every time they administer the drugs (the doc is recommending a "dose-dense" regime that will take four months). The PICC line leaves an apparatus hanging out of your arm that is a royal pain, and it has to be flushed every day with blood thinner (I learned to do it myself last time after a couple of months of daily nurse visits). The Porta-Cath is inserted just under the skin in your upper chest wall and leaves a scar but requires less maintenance. The PICC line gets infected quite easily, I know from experience; I don't think the Porta-Cath is as susceptible (I could be wrong), but the nurse told me that because its terminus is closer to your heart, infections are more deadly. Still, I think I'm going to chance it.

I told the oncologist how crappy my ribs feel just under my breasts -- a kind of pressure on my diaphragm that burns and makes my stomach feel sick -- and pointed out that that could be caused by my sagging spine, according to what I've read. She shook her head and said it was also a symptom of bone metastasis. But she did make some encouraging noises about stopping the cancer in its tracks with the chemo.

Pollyanna moments:

• After I succumbed to weepiness for an hour or so last night, I was casting around for things to make me laugh, and I watched a goofy guy movie, Harold and Kumar Go to White Castle. It was pretty stupid, but I did split a gut during the scene in which the guys steal the punks' vehicle, are shocked to discover that the tough guys' mixed tape in the deck contains all soft-rock girlie music, but gradually get sucked into singing along exuberantly to "Hold On" by Wilson Phillips.
• I also got a huge chuckle out of an email joke my brother sent me that compared a dog's diary to a cat's (the dog simply listed his activities with glee -- "2:00 p.m. Played in the yard! My favorite thing! 3:00 p.m. Wagged my tail! My favorite thing!" -- while the cat composed a long, paranoid disquisition on his captivity that was worthy of Conrad Black).
• I hosted my book club on Thursday night and spent most of the evening on my back; couldn't even eat my meal at the table without lying down every few minutes. It is kind of weird that some of the women in my club who are older than my mother -- fit as fiddles and running from theatre rehearsal to environmental-movement meeting to volunteer activity -- cleaned up my kitchen while I and another member my age, who is adjusting to late-onset Type 1 diabetes and fibromyalgia, lounged in my living room talking about assistive-devices insurance, long-term disability and painkillers. Health is the luck of the draw in some cases, and our older members have had their share of bad times; it's great to see that bouncing back is possible. Anyway, the Pollyanna moment was being surrounded by these great women who've been meeting monthly for 16 years. They're such a source of strength to me.