A Month Out

Today marks one month since my mastectomy.

Today I did the following things for the first time in a month:

1. Put on a bra. I know that may seem amazing, but really I just haven't wanted any part of the bra situation.

2. Put on eye makeup.

The thing is, apparently it takes one month for me to forget how to apply eye makeup. Over thirty years to finally learn and then one month to forget. I had to settle for a drowsy raccoon look.

I had not forgotten about the bra.

PET Sounds

I had a full-body CT/PET scan this morning. And what did you do, busy bee? 'Cause I do more lying motionless before 9 am than most people do all day.

There was no reason for this scan except that my doctor wanted to establish a baseline. And I think that they bought the machine.

The good thing about a PET scan is that they let you wear your own clothes for it. So I didn't even change out of the ten year-old fleece pants I'd slept in. I don't want no scrubs.

The bad thing about a PET scan is kind of everything else. Or nothing really bad happens, it all just takes a while. Compared to mammography, which involves standing around topless for free, PET is almost restful. The only weird part is that, after you're all checked in, and they've given you an injection of the radioactive stuff through your IV, they want you to sit and relax for an hour, but you're not allowed to read. That's right. You have to sit in your own little room, in a comfy chair, and let the radioactive sugar work its way through your system, going to be metabolized wherever things are getting metabolized. Apparently reading would involve using your arm muscles and your eyes and whatever part of your brain you use to read, though I told the guy that the book I'd brought doesn't actually involve my brain. If you are using those areas, they would take up the sugar and light up on the PET scan instead of letting the sugar go to possible areas of interest, like cancer cells.

Like, I guess if you sat in the PET thingie doing a bicep curl with a heavy weight, the PET camera would be able to see nothing but your arm. Or that's how I understand it. Please now confer upon me an honorary Doctorate in Nuclear Medicine.

So I said, "What if I don't hold the book and instead put it on my lap?" And he still said no. And Matt couldn't come in there and read to me. But I could listen to something. So they tucked me into the magical chair of relaxing and gave me a blanket, and then I fired up the "This American Life" app on my iPhone and started listening to a show from couple weeks back about a hedge fund. I made it through about ten minutes of that and then it was sleepy time. I paused the playback, worrying that I was using too many muscles to do it, and dozed a little bit.

Did I mention that this whole PET camera was not actually in the hospital? But was in fact in a big truck pulled up behind the hospital? We were up at the satellite hospital near our house, not the big serious hospital downtown, so they have this roving PET camera that's there only two days a week. Like the Bookmobile. Or, as Matt said, the Girls Gone Wild bus.

Yeah, so I was resting in the bookmobile until they were ready for me, then they made me get up and walk to the bathroom, and I'm all, what was the point of all that muscle relaxation if I'm hoofing it to the toilet before hopping into the camera? But what do I know? And one of the techs was playing solitaire on one of the computer monitors. I said, "Solitaire, really?" And he said, "Well, ya gotta do something."

So I got to lie on my back for the scan, which was good, and the PET machine is really quiet. MUCH quieter than an MRI, which sounds like lawnmowers having sex really close to your head. And it was only twenty minutes, really. So nothing much to complain about.

I just lay there willing every part of my body to score awesome on the test. You know what I mean. If you're someone who has made an identity or even a career out of doing well in testing situations, it's hard not to want to earn gold stars in medical screening too. And then it turns out that your body parts are just average, or even worse. (Yes, I'm talking about you, former boob.) Like, if someone would just give me my A+ in being a patient now, and have it certified by the proper authorities, I could relax. So could we do that please?

And now also I would like a hot dog and a cosmo.

My White Jeans Make Their Debut

Of course I waited until after Easter like any decent Southern woman, but then I had a lot going on with the whole post-op recovery thing and I didn't bust out my white jeans until today. This not-so-great phone pic was snapped at the furniture store. The jeans performed just fine, though as you can see they are "distressed"--whatever. The fact that I had on pink underwear, which I realized only after I was fully dressed, did not deter me from sallying forth.

Oh, and why were we at a furniture store? Well you may know that slipcover-tucking accounts for about 80 percent of the metabolic energy consumed by my body. I decided that I do not have to live this way. Life is short and all. So I bought two new couches. That is not one of them. I got two of the JC Penney knock-offs of the Pottery Barn Basic slipcovered sofas. You can see 'em here. I know, JC Penney! They have furniture! I haven't been in that place in ages, but these couches have gotten good reviews and they really look just like the PB ones, for much less dough. I went to actually flop on them before making my decision. The flopping was good, so I went for it. I got the "natural" color.

I think that my life is about to improve dramatically because of this move. And in the time I recoup from the tucking and retucking, I may brush up on my reading French or sequence the human genome, who knows.

Hair Today

Whew, where were we? Oh yes, with me on my first day of chemotherapy, high on steroids, and in love with everyone. That was sort of awesome. I was a real Dexy's Midnight Runner. Wednesday night my sister got to town, so of course we went to Target and closed the place up. As we were leaving, I shouted, "Shut her down!" And they turned off the lights. Then we took my mom to a tequila bar, just for one drink. That was our absolute limit. We stuck to it, and as we left these guys smiled at us and said, "Don't get into any trouble, ladies," and I thought, "Dude, you have no idea what kind of trouble I represent. Just my uninsurability alone would keep you busy many a long, long night."

So then, the bad news: couldn't stay on the steroids forever.

And now, the good news: I have yet to feel really bad or nauseated from the chemo. That is, I know, a great boon. I'm hoping my luck holds. I mean, it's Sunday night, I had that infusion on Wednesday, it seems like I should have been upchucky by now? On Friday afternoon, feeling cautiously optimistic, I said, "Why don't we just head up to to the mountain house for the weekend?" Others packed and drove. I took a pharmacopoeia of meds with me, just in case, and lots of reading material. Now we're back and we had a lovely time.

Saturday morning I woke up early and felt a little. . .unsure. Then I remembered that Ativan wants to be my new best friend, and I took a half tab. Then I took another half tab Saturday evening. And that's been my schedule. It's got me feeling a little flat, but not really sedated either. No queasies! So I'm going to stick with this plan for a few days.

Lots coming up this week, including some physiotherapy for my arm, which has decided to give me no end of botheration in the last week. Details, whatever. I have a crack support team arrayed to take me to appointments, laugh at my jokes, and watch "Arrested Development" with me on Netflix. (Amy wanted me to say that she needs to be blogging too, but she's in my kitchen making her trademark sticky chicken.)

Oh, and the whole real point of this post was to tell you about telling Laura about my possible (probable? certain?) hair loss. Last Tuesday night, the day before my first chemo infusion, before anyone arrived, we were sitting in the sun room and she brought up an old friend of hers from preschool days. She said, "Remember how Faith had really short hair, like a boy?" I thought that she had heard me discussing the hair issue and that this might be her way of bringing it up. So I jumped in.

I said, "Well, you know how now I have to go a few times and get extra medicine for the tumor they took out of me, to make sure it doesn't come back?" I reminded her what a side effect is, and I said, "One of the side effects of this medicine they'll give me is that it can make some or all of my hair fall out."

Her mouth fell open. Absolute shock. She said, "You're going to be bald?!?" I said, "Well, maybe, yes, but not forever, and not all at once. I will have some scarves and hats to wear, and if all my hair falls out, I'll get a wig to wear until it grows back." She didn't look upset, exactly, but I realized that she'd had no idea and this was totally new information to her. I added, "You know, it's not that big a deal, it is a bummer but the hair will grow back." And I watched her. I think that, much more than when I told her about the surgery, this was a moment when her feelings could have gone either way, and it was all down to how I was reacting to it.

I just repeated myself a little: "When and if it happens, it is not going to seem like such a big deal. I'll just get myself a wig and wear it." I could tell she was still processing.

And here is a big parenting lesson that I learn over and over: when you are telling something new, surprising, or big to your kids, and they stop asking questions, stop talking. They are at a saturation point and they need to work on what you've said. Don't answer any further questions that they aren't asking, just clam up and wait.

Then she said, "Hey, I think you shouldn't tell Hank this is going to happen, and then when he sees you with no hair, he'll be so surprised!" And she laughed. I took that attempt at levity as her desire to close down the conversation for the moment, so I said something like, "Whoa, that might be too much of a surprise for him."

Then we went along with what we were doing, but when Mom and Dad came in a little later, Laura rushed to the door and said, "My mom is going to be bald!" She wanted to be the first to tell. And since then we've talked it over a few different times, with talk of wigs and whether or not she can get one too. I think she and I will both be fine with the whole thing. I'm sure you'll hear more about this later, gators.

As of today the hair is hanging in there. I am really enjoying it, truly.

And here's Amy and her niece up at the mountains. I hope y'all had lovely weekends. Sorry I'm all like, "me me me and what about me some more?" I need to get around and get properly caught up on what y'all are doing. xoxox-B

Y'all! I Almost Forgot!

Just got home from my first chemotherapy treatment and it was long but fine and blah blah blah, but guess what?

Today Suburban Matron is two! I started blogging on April 21, 2008. Thus making it the longest-running hobby (or is reading a hobby? or old boyfriends?) that I've ever undertaken, and the most wonderfully satisfying.

Last year, I did a big year retrospective post, navel gazing at my first year of blogging and picking out my favorite post from each month. I totally want to do that but there is this whole boob business, and the wifi was broken at the chemo place, so I didn't get to liveblog it. Maybe I will still pick out my fave posts. I swear I have forgotten some of the stuff I've written. Anything y'all particularly remember?

Anyway, I got home from the doctor's office just now and found a lovely bouquet of flowers from the lovely Michele in my house. Her husband, if you read her blog, is said to be a great horticulturalist and now I have the proof. Gorgeous. You want those two on your team, people.

The treatment took about forty forevers. Yet somehow I only managed to read one In Touch magazine (terrible) and start a Country Living (note: empty frames hung on the wall are not art, or have we discussed this already?), and I chatted with my neighbor and ate half a sandwich that Matt brought me. Nothing hurt and nothing was uncomfortable. I don't feel sick, but I am so full of anti-nausea meds that I could probably win Fear Factor right now.

Also, and maybe you can tell from this post, I started yesterday on this drug called dexamethasone, which I take for three days before and after treatment. It is a steroid and it is designed to tamp down any allergic reactions I might have to the chemo, but mostly if makes me feel totally amazeballs and like Miss Chatty McChatpants. The nurses told me it would do this. They said, "It will give you a lot of energy. A lot." And I was like, "Duh, in the same way that they should make entire airplanes out of that stuff the black recorder box is made of, because that sucker always survives the crash, why don't you give me this wonder drug for the entire course of treatment?" And the nurse blinked and was like, "Are you already on something right now?" Then she said a bunch of stuff about how it is bad to take steroids all the time and Matt chimed in that it would shrink my testicles. So only three days of this miracle pill at the beginning of each cycle.

Last night Mom and Dad got in and they said, "Wow, you do seem peppy." But I'm always pretty talkative, so I didn't believe that the dex had really kicked in. Then, then: My brother Dave had called and said, hey, call me after mom and dad get in and we'll discuss my coming down there while Amy is in town. I was like, okay dude. So later the parents arrive and I'm all, let's call Dave. So we did, and we talked to him for about three minutes. That was all the time we needed to agree, yes, come down next weekend, goodbye.

Then about thirty minutes went by and I thought, "Oh, we need to call Dave to talk about his coming down." So I rang him and it went to voice mail. "Darn," I thought. About ten more minutes went by. I thought, "Hmm, I'll try Dave again because we need to talk about him coming down." This time his phone seemed to be turned off. I thought that was weird since he was expecting my call. I complained to Mom and Dad. They were like, "Um, okay . . . yeah we talked to him not an hour ago. You spoke to him. You. With your voice."

I had totally forgotten that because I had moved down along the river of life since then. And Dave had turned off his phone because it was 11:30 and he actually works for a living.

After that, anytime my hand would stray towards my iPhone, Mom or Dad would say, "Don't call Dave!" So that could be the drugs.

After that, as I chatted everyone into weariness, I said, "Next cycle we are having a party the night before treatment, because we are wasting this. I am killing this room and it is all wasted." They nodded blearily. Are you nodding blearily right about now?

Ooh, so Amy is on her way here from the airport. I will update you on all things, including the talk with Laura I had about my chemo treatment and side effects and hair. That was interesting and another parenting-learning moment for me.

I love you guys and it is not the pharmaceuticals talking!

Heaven Help the Mister Who Comes between Me and My Sister

(You know that song? From some old movie but I can't remember.)

Amy and I just had one of those text message exchanges where it's supposed to seem like we're joking, but really what we are saying is just the absolute truth. It was this:

Amy: At the Sydney airport. The countdown begins!

Me: OMG, I can't believe it. I better straighten up around here!

Amy: For real, I like things really neat.

The funny part, to me, is that when I said I'd straighten up, it was supposed to seem like a joke, because I'm starting chemotherapy in the morning and maybe I could just chill on the couch, watch "Lost," and not worry about the state of the house, and I would expect someone to read that text and think I was therefore joking about the cleaning up, but in truth I WILL straighten up before she gets here, even though I will act like I didn't really do much.

The other funny thing is that Amy DOES like things really neat and is being perfectly honest, even though she is also trying to sound deadpan and is, on some textual level, joking. Yet I know that if she walks into my messy house, she would understand but she would also clean it before she could relax.

So, you know, sisters.

It will take her twenty four hours to get to the ATL. I am so, so glad she is coming and grateful that it is possible for her to be here. She has a post up today about how, when you get to travel without kids, a 13 hour flight seems like a spa weekend. Believe it, childless people. Hear me now and believe me later.

But what her post does not tell you is that this sister weaned her baby early to come on this trip. Grace is ten months old and I know Amy was going to nurse her for a full year like she did the others. Amy could have brought Grace and we encouraged her to do so--I thought it was way, way too much to ask the mother of an infant to leave her for two weeks--but she thought she could be of more help if she were here solo, with no kids of her own to care for. So she weaned her--she started a few weeks ago and it has all gone fine from what I hear. Then she marshaled her tribe (God help you if you don't have a tribe) her husband, friends, neighbors, and her mother-in-law--who is crossing the Pacific in the other direction to go help with Amy's kids--and she is on her way right now. So complicated! Such a web of generosity and help.

She sent me a few more texts from the airport that made me think it has been so long since Amy traveled without kids that she didn't remember airports have gift shops. She was like, "There are books here. And a buttload of t-shirts!"

We are a go for chemo to start in the morning, bright and early. It will take hours and Matt will be with me. Meanwhile, in a different part of town, Hank's school is having its annual Trike-a-thon, which I was supposed to help organize before all this boob stuff came up. No fear, my mom and dad will be there to represent the family and cheer Hank on. Oh and Laura has her Girls on the Lam running club and swim team tomorrow, but it's all covered.

Speaking of tribe, my neighbors have stepped up with the meals. Stepped It UP. Or well, Frenemy only brought a store-bought pie, but she tries. (Okay I'm doing that thing where I seem like I'm joking but I'm telling the absolute truth? She does try and the pie was yummy and it got eaten, you betcha.)

Thanks so much for all your comments and lovin', guys. So tomorrow, the first session of chemo takes forever. Maybe I will live-blog it! 'Cause I have whole bunch more random crap to say. As usual. xoxo-B

They Don't Deal in Guarantees

(Advance apologies for the high level of oncological details in this post. There will not be a test.)

We had the first meeting with my medical oncologist last Monday, after the episode with the squirrel. She seems to be from the same bright and super competent sorority as my surgeon. Multiple people have told me she is the absolute best in Atlanta, and so far I'm willing to believe it.

At this point I want an expert to take me by the shoulders, look deeply into my eyes, and say, "Yes, you are going to be completely 100% fine. You are going to beat this, have no recurrence, and live until the age of 102, when you will die peacefully from having eaten too much risotto." Nobody will quite tell me that I'm definitely going to live to see my children grow old. I no longer ask because it starts to seem impolite.

That said, it was encouraging to meet with the oncologist and learn that she stages this cancer as a IIA. For any of you cancer nerds out there, here is some more info (the rest of you can skip to the next paragraph): Stage IIA, multiple foci with largest area of infiltrating ductal carcinoma 9mm, one lymph node involved, strongly estrogen and progesterone-receptor positive, not her-2 overexpressing, a high cell proliferation rate as indicated by a Ki-67 measurement of 32%.

So that up there is what they took out of me. The oncologist liked the small size of the largest tumor, she liked the strong hormone receptivities, and she did not like the high cell proliferation rate. She said this cancer is "a mixed bag." Small but potentially nasty. She also said, "Thank God we got to that early, because it would have been several years before anyone made you get a mammogram and by then you would have been screwed." Those might not have been her exact words, but that was the gist.

I was confused by the whole tumor-size issue, because the surgeon had said I had a 4-5cm mass. Apparently that was a mass of ductal carcinoma in situ (the kind that stays put in the tubes), which she wanted to get out, and the parts the oncologist was more worried about were the littler bits that were starting to grow up, get rowdy, and move out of the house.

So, stage IIA. That puts me in a very pleasant bracket with a 92% five-year survival rate. I am happy to be there. But even though that 9mm tumor and that bad lymph node are sitting in jars downtown, and they can't hurt me anymore, the doctor is of course worried about what they might have gotten up to before they were taken out. She had a lot of metaphors involving trains and buses. The lymphatic system was the train line and you know where all the stations are. Blood circulation is the bus system and who knows where it goes. There were more metaphors. But the point is that we now have to do something to round up any cells that may have hopped a bus and be in there riding around, and that something is chemotherapy.

On metaphor: if you read this blog you know that I am a word person and that words matter to me. We live our lives in language. If you have a complicated thing wrong with you, or if you are just interested, I highly recommend the book How Doctors Thinkby Jerome Groopman. It talks about doctor-patient communication--Groopman says that although a doctor's tools are medical, she meets her patients in language and language is the first tool. As a patient, you must use language to be your own advocate, to help your doctor avoid certain cognitive pitfalls (that the rest of the book about), and to get better care. You do it by active listening and by asking questions. Ask questions to find out stuff you don't know, or to clarify stuff that isn't clear, but also ask questions that make the doctor say what she thinks in several different ways. If something seems tacit in what the doctor is saying, ask a question that makes it explicit. I tend to ask lots of questions that start, "So you are saying that. . ." or "What would be an argument against [what you just said]," or "What would be another way of saying what you just said?" It is kind of exhausting.

But we learn. Every time we meet with another person, we get a slightly different window onto this whole complex disease process. The surgeon's view and the oncologist's were quite different. We left our surgical consult thinking, "OMG, this is a whole mastectomy with a large mass and there are two funny-looking nodes." Then came the surgery with its news of only the sentinel node involved and clear margins. Then we left the oncologist's office thinking, "Okay, she told us that one node is not 'falling off a cliff' and it's an early stage cancer and we're just trying to hold down the odds of a recurrence. I am going to make it out of this."

Probably with no hair, but I'm going to make it out.

A lot of the question right now seems to be how aggressive to be with the chemo. A nurse said to me, "It's funny--the better the prognosis, the more aggressive the treatment." The onc said she "agonized" over whether to do a so-called "dose dense" regimen where I get chemo with adriamycin every two weeks, or a different regimen that is only every three weeks. She doesn't like how aggressive that small tumor seems. She is also trying to weigh the risks associated with the dose dense drug--risks of cardiac damage, secondary leukemia, and who knows--because I have to use this body for many more decades. She decided on the conventional every-three-week course. She said that in her training, they called adriamycin "the red death." So, not getting that is good, I think? She also said that in her experience, young mothers were willing to "call in airstrikes on themselves" if it meant guaranteeing they'd be around for their children. I guess the dose-dense adriamycin would be that airstrike, and I told her I would do it if she thought it best. But she went with the other thing, four to six cycles of Taxotere/Cytoxan.

I know, details. So get this, I am starting this on Wednesday. As in, in four days. What the HECKS? I thought we were, you know, just talking this stuff over. But, um, no, I actually have to do all this crap. We had a meeting with the nurses yesterday about what to expect and side effects and all that. I am sure you'll be hearing more about this, but now I will bring an end to the longest and most poorly-structured blog post in these United States.

But I am serious when I say that everything is fine. I told Matt last night, "Is it weird that I feel really happy?" Not weird I guess. I am not happy about the hair issue but we can talk about it later.

I'm happy because I got my second surgical drain out yesterday and there were no rodents involved. Phew. And Amy is coming! Wednesday!

Why Don't We Talk about Me Some More

When last we checked in on my physical condition, I was griping to anyone who would listen about these two surgical drains I had in. Yesterday we went down to the plastic surgeon's office, toting the log sheet of drain data that Matt has been meticulously keeping. My hopes were high. The nice physician's assistant took our log sheet and studied their output. Then she said only one drain would be coming out, but the good news was that it was "the big one." I think it was called the big one because from the way it felt when she pulled that tube out, there was a squirrel on the end of it. You know I like to keep it light here at SubMat, so please forgive me when I say that it hurt like an absolute motherfuck.

I had saved my last percocet for this event. That was in the top twenty smartest things I have ever done.

Matt held my hand, of course, and as he pointed out later, the PA did not warn me, "This is going to hurt," but when they give you that "Take a deep breath and then let it out" line, I know what they mean is, "Yeah, this is going to hurt." So I took a deep breath and let it out, and out, and I got afraid that I would run out of exhalation before she finished pulling and I did not know what I would do then. But then she was finished. And it felt so good that she was finished that I was actually happy. Pain is weird, y'all. She says the other one is "the little one" and in a couple days, it will be "a cinch" to take out. So I've got that going for me.

I told her that I just wasn't sure if it was normal for me to be in such constant discomfort and pain at the site where the little tube comes out. She said my skin did look irritated, "as though it really doesn't like that," and that I must be extra sensitive. Just like the Princess and the Pea. I'm a real princess, y'all!

Then today I saw a picture of Heidi Montag in a magazine, looking all Barbie beautiful, and the caption reminded us that she had ten plastic surgeries more or less simultaneously. And I thought, "That girl needs a doctor who will put down the knife and fix her brain. A really good doctor."

Twenty minutes after my drains/exhale/tube-pulling/squirrel/massive endorphin release experience, Matt and I had our first sit-down with my medical oncologist. That was a good meeting and there is more to tell. But I will spare your blog-strained eyes and tell you tomorrow. It is time for the horizontal mambo. By which I mean I am going to sleep. xoxo-B