Cake Eater Chronicles

Random Observations For Friday April 27, 2007

I'm going to try to make myself useful by entertaining you all. Because God only knows I'm not doing a whole hell of a lot else right now.

Work with me here, people.

So, without further ado some bits and bobs for your amusement and edification...

• Longtime devoted Cake Eater readers will know that we take the Financial Times as our daily dead tree paper. This past Monday they redid the layout of the paper and it's been somewhat interesting this week to read it. I keep thinking my reading speed must have increased tremendously because I'm getting to the opinion section sooner, only to be reminded that, duh, they just moved it up a few pages. Apparently, I'm not the only one who's having issues with the new layout. One Mr. R.A. Parsons, Tempsford, Beds sent a most eloquent letter regarding the new, er, positioning of columnist Lucy Kellaway's regular Monday missive about work life.

  And I quote:

  "Sir, I preferred Lucy Kellaway horizontal."

• Just for the record, I still haven't puked. Yet.
• How sweet would it be to own this ride?
• I've decided that chemotherapy is this guy. He's doing his damndest to break me down, so that, ultimately, he can build me back up again, but damn, I really wish he'd lighten up a bit. Right about now, I'm feeling a wee bit like Mario Van Peebles after Gunny ripped out his earring. I do know, however, that it would be a mistake to call in Swede to try and stop him. Gunny would simply kick Swede in the nuts and that would be that. Waste of time, really.

  Now, I simply have to decide whether or not I like the mental image of millions of little Clint Eastwood heads running around my body, killing cells left and right, whilst muttering the words, "Boo Ya" in that gravelly voice of his.

  What say you, my devoted Cake Eater readers? Do you think Gunnery Sgt. Tom 'Gunny' Highway should be the official image of my chemotherapy?

  If not, who should be? We could have a contest or something.

• Though it slays me to give the tubby bastard anything, I fail to see where Alec Baldwin should have to apologize for chastising his daughter. Furthermore, this maxima mea culpa business is getting old. Kids can be cruel. No, parents shouldn't take out their frustrations on their children, particularly not when the source of said frustration is their other parent, but one can and should call a kid on it when they've stepped out of line. It does no one any favors to let them get away with it. I almost feel sorry for the guy. Almost.
• They warn you that chemo will cause your skin to be uber-sensitive to the sun, and they tell you to rush right out and buy a bottle of 45 sunblock to protect yourself. I realized they weren't kidding when I got sunburned last Friday, right after the chemo, in about fifteen minutes. No matter how pale I get (and believe me, I can get pretty darn pale) that doesn't happen. So, I've been slathering the sunscreen on all week long and whaddya know, just from doing my usual errands, I'm getting a pretty bitchin' tan.

  You see, it's about making the side effects work for you.

  Not like I'd really know, though. This is the only one that's worked in my favor.

• Luna Bars have the official Cake Eater Seal of Approval.

  Particularly the Dulce de Leche bars. Mmmmmmcaramelmmmmm.

• Spelling pet peeve that I'm seeing everywhere nowadays: it's capitol when you're referring to where the seat of government is located and it's capital when you're referring to start-up money, accumulated wealth, letters, an important principle or a crime that's punishable by death.

  Seriously, people. How hard is it to get this one right? All you need is to remember the opening credits of the now-defunct soap Capitol to spell this word correctly.

  And don't give me that disdainful look. You know you watched it.

  Honestly, if soap opera writers can spell it correctly, you can too!

• Right at this bleedin' moment, there is a pair of ducks in my yard, looking for a space to do their dirty deeds dirt cheap. I will repeat this for the third year running: The Cake Eater Pad's yard is not a duckie brothel! Move it along, already! Go to my neighbor's yard: she's a former hippie and no doubt she'd be cool with it. Take your duckie licentiousness elsewhere.

Ok, that should do it for now, my devoted Cake Eater readers. I'll check back in when I have the need to feel productive again.

Here We Go UPDATED

A brief snippet of conversation over two steaming bowls of Cream of Wheat, approximately twenty minutes ago:

The Husband: "Do you want some craisins for your Cream of Wheat?"

Me: "No, I don't want to puke up any little red things later on."

The Husband: "That's a bit morbid, but I see your point."

UPDATE 8:19 p.m. 4/20/07: Just for the record, no, I haven't thrown up.

Not once.

That was me being paranoid. They've got me on three different anti-nausea drugs, decadron, ativan, and compazine, and they seem to be doing the trick, even if they all have their own little side effects associated with them, like drowsiness, fatigue, and a complete loss of appetite, and in the case of the decadron (which I had to take at three different, specific, times yesterday, before this even started) a flushed face, anxiety and sleeplessness. (Yeah, so last night was a real joy, because I had to take it at ten and wake myself up at four in the freakin' morning to take another dose.) But I haven't puked. And the oncologist swears that I won't, provided I keep up with these medications over the next three days. My job, as the RN pointed out to me right now, was just to stay on top of the medication (i.e. don't wait until the symptoms show up and then take it) and to rest, and I should be fine by Tuesday, when most of the drugs will have worked their way through my system.

The chemo procedure itself was, well, pretty boring, on the whole. It took about five hours, all told, to receive the drugs via IV---and I received them in a very swank recliner, in a room full of about twenty-five other people, receiving their own chemo regimens, who all had their own swank recliners. It was sort of like day camp for sick people, but instead of doing arts and craft projects, we all watched tee vee, read, listened to iPods, or, in the case of the husband and myself, we played a game of travel Scrabble, wherein I kicked his bony little ass by about fifty points. (That's what happens when you get stuck with the 'Q' at the end, after having already been beaten into submission by a few triple word scores.) Fortunately, I didn't have any allergic reactions to the drugs, and tolerated them well, except for when they pushed a half-sized bag of the decadron into my system and I thought I was having an hour long hot flash, but, again, that's just a side effect of the drug and it was remedied by a cold washcloth to the back of my neck. I tolerated the three hour taxol drip well, but by the time the half-hour carboplatin drip was done, the last bag of the day, I wasn't feeling so well, sort of like I had the beginnings of a bad case of stomach flu. Fortunately, we were on our way home and in and out of Walgreens, with all of my prescriptions, in a shot. And, within fifteen minutes, I had compazine in my system and it started working immediately. Enough for me to take a long nap. Which felt good, considering I had very little sleep last night.

So, all in all, it's going better than I expected. Which is good, because I kind of low-balled my expectations, assuming the worst. What I now have to look forward to is being immuno-compromised by next weekend, possible anemia, potential decreased white cell count (furthering the problems with my immune system), complete hair loss within three weeks, and, perhaps, neuropathies in my hands and feet from the taxol. We'll just have to see how it all shakes out.

Just in time for my next chemo session, three weeks from today.

Good fun, no?

And, just remember, my devoted Cake Eater readers, I'm already cancer free.

I ask again: good fun, no?

What's that line about the cure being worse than the disease?

And, Robbo, craisins are simply dried cranberries. They look just like raisins. Except they're red.

Heh

The husband and I attended "Chemo Class" at the oncologist's office this morning. During class they give you the rundown on what will be happening to you during the treament, how you will feel afterwards and what the major side effects of chemo are. We toured the treatment room, we chatted about wearing jewelry during treatment (You shouldn't, just in case you're allergic to the chemo. They don't want to have to cut your rings off.), hair loss, skin and nail care, mouth care, infections, and, most importantly, nutrition. They then tell you that nutrition can be a major factor in how you feel, and that it can help control some of the adverse effects of chemo. The class was mainly a primer and they sent us home with a boatload of literature, neatly organized in its own expandable envelope. One little booklet from the U.S. Department of Health and Human Services, the National Institutes of Health and the National Cancer Institute, titled, "Eating Hints for Cancer Patients: Before, During and After Treatment," has some wonderfully helpful tips I'm sure we'll be using during all of this.

What I found interesting were the tips they gave in case you should lose weight and need to get your calorie count back up. They're simple, helpful tips to boost your count without having to eat more food---which might be an issue as appetite loss can be a problem. The last thing you want to have to do when you have no appetite is eat more. They include things like:

• switching to whole milk
• making fortified milk with whole milk and powdered milk
• add sour cream to cream soups
• folding unsweetened whipped cream into mashed potatoes (ed. heavy whipping cream has six grams of fat per tablespoon. Don't ask I how know this.)
• make hot chocolate with cream and add marshmallows
• melt cheese on top of casseroles, potatoes and vegetables
• add cheese to omelets and sandwiches
• use melted butter or margarine as a dip for seafoods, such as lobster, crab, scallops and shrimp
• stir melted butter into cream soups, sauces and gravies

I could go on, but I think you get the gist. What the cardiologist loathes, the oncologist loves.

Heh.

Ironic

I finally, finally find a product that controls my curly hair and now it's all going to fall out in approximately three weeks.

Go freakin' figure.

You just can't win if you've got curly hair. Really. It sucks trying to find something that tames the wild beast that is the mop on your head. And you try everything that comes down the pike. Believe you me, straight-haired people of the world, you'll never have the product problems I have had over the years. But I found something. And it works. It does what it says it's going to do. And you, who have had the ol' bait and switch pulled on you too many times to count when it comes to "frizz control" have a hard time believing it. And when you finally believe it, you jump for joy, secure in the knowledge that, unless the company goes bust, your hair worries are at an end for the time being.

Then, of course, because God enjoys a good laugh every now and again, you get cancer and have to have chemo. Which makes your curly hair fall out. And then the doctor tells you it may grow back in differently. The color may be different. The texture may be different.

At which point, if you've got my luck, you'll probably be stuck with a whole lot of product made to tame curly hair you no longer have. Probably.

Alanis Morrissette should write a song or something.

Your Cautionary Tale of the Day

Or, Why It's Generally Considered a Bad Idea to Chat With an Oncologist Whilst High on Percocet.

If you're interested, take the jump.

(Parts One and Two of the Neverending Ovarian Cancer/Hysterectomy saga can be found here and here.)

This is a graphic representation of what I normally look like. I look pretty level-headed, don't I? I'll cop to a slight obsession with my hair, simply because I just got a new haircut (with bangs!) that I really like and works well for me. I also have gotten hooked on some new product that really works on calming my Frieda-ish hair. I realize it's a pretty shitty drawing, but alas I never claimed to be the next DaVinci, so you'll have to deal with it because I sure as hell don't feel like having my photo taken right now.

This, however, is me on drugs.

They gave me a lot of drugs when I was in the hospital. A lot of drugs. As in listing them all out on the hospital bill took one entire sheet of 8 1/2" x 11" paper. As I was in pain at the time, I'm not arguing with the fact they gave them to me, but I have noticed how now, six weeks after the fact, I am much more with it than I was then. You really don't think you're out of it when you're on these drugs. Oh, you know you're not a hundred percent, but you feel like you're functioning, like you're close to normal, but really and truly, it is not true: your mental state is impaired. You're not firing on all six cylinders, but rather on three.

So, having your gynecologic oncologist show up a day after the surgery, while you're high on percocet, is not a good thing. You don't retain the majority of what they tell you. The conversation sounds a lot like this: "Blah blah blah genetic testing blah blah blah we'll know more about if it's spread when the pathology report comes back blah blah blah you're going to have to have chemo blah blah blah. You'll have six treatments blah blah blah. One in three people gets cancer blah blah blah. Don't worry about it now. You're going to have to deal with menopause. It hits three days after the ovaries are removed. Blah blah blah. I know Woodbury is a long commute for chemo, but I do it every day so it's not all that bad. Blah blah blah. Take care." And, poof, just like that, she was gone.

Somehow, she'd managed to morph into Keyser Soze in the blink of an eye. Whether Kobayashi picked her up in a Jag after our meeting, I'll never know.

Unfortunately, the husband wasn't in the room at the time she showed up or I'd have a more coherent account of what was said. He was downstairs, in the cafeteria, getting his dinner. He returned to the room about three minutes after she had left. "The oncologist was just here," I told him, still reeling from what she'd told me, but suddenly sure I wanted him to talk to her as well because he wasn't on drugs and would retain more of it. As he'd never met her, (nor had I until that moment) I had to give a description. "She should still be around. She's blonde, wearing a navy coat, glasses, and a fuzzy sweater. Go." As we'd been waiting around all day for her to show up and lay things out for us, he went and, thankfully, managed to intercept her before she rendezvoused with Kobayashi, and received the same schpiel she'd just given me.

So, we'd actually met the person responsible for dealing with my cancer. She was the new doctor, the one who would take over when I was finally finished healing up from the surgery. But before that could happen, we needed to find out the scope of the problem, and that meant waiting for the pathology report to come back. Somewhere in the bowels of the hospital, some unknown lab worker toiled over the samples they took of my ovaries, fallopian tubes, uterus, appendix, omentum, several adhesions, and, most importantly, my lymph nodes during the surgery and performed God only knows what sort of tests on them. This unknown technician would produce a report that would detail out, in scientific terms, where I was along the path this disease takes, and my doctors would pore over it to figure out what sort of treatment was needed. In the meanwhile I ate jello, walked the halls, and got dehydrated. Everyone else in my life, however, was waiting for the pathology report to come back and tell us if the cancer had spread...and they were worried. Very worried. Every morning either Dr. Pain or Dr. Cindy Lou Who would come in and the first words out of their mouths were whether or not the report had come in. The path report would tell the tale of whether the cancer had spread into my lymphatic system and was potentially still wreaking havoc in my body, even though the source of the all the trouble---my ovaries---was no longer present. It would be the deciding factor of how serious this was---and would be---and where my treatment would go from there. Everyone was busy holding their collective breath. Everyone except me, that is.

I know most people would be sitting on the edge of their seats at this stage of the game, unable to think about anything else. But me? Nope. I couldn't be bothered with fretting over it. Really. I couldn't. The only time I was reminded of its imminent arrival was when the doctor showed up every morning. When it was announced the report hadn't come back, well, then I made like a goldfish and it flew out the other ear. The rest of the time I concentrated on things like keeping my food down, dealing with my first tastes of menopause and learning how to fart all over again. One of the things I learned when the husband was still in his drinking days was how to compartmentalize my anxieties. How to shove them back until they were so far in the recesses of my consciousness that I didn't have to think about them unless I wanted to pull them out and obsess. I never realized how valuable a skill this is until after the report came back. Which it finally did, five days after my surgery. Dr. Cindy Lou Who showed up that morning and, with a large smile on her face, announced that my lymph nodes were clean. The cancer had not spread. This was a great relief to everyone, myself included. This meant, Dr. Cindy Lou Who told me, I'd still have to go through a round of chemo, to help boost my chances of survival, rather than to clean out any remaining cancer. But I could handle that, she assured me. I'd go bald, but I could just get some pretty scarves and large sunglasses and make like I was Lindsay Lohan. Because scarves around the head were fashionable with the startlets nowadays, weren't they?

Like I'd know.

That meant the next step was to get well, because in three weeks I'd be meeting with Dr. Fuzzy Sweater. And then we'd get down to business.

Three weeks pass, and on a sunny Monday morning we manage to dragoon a neighbor with some free time on her hands to drive us, who have no car, over to Woodbury, which is hell and gone from Cake Eater Land. It's a forty-five minute drive. Without traffic. We get there and we wait for her to appear.

And we wait.

And we wait.

An hour after our scheduled appointment, we have yet to see her. A nurse comes in and announces that there has been a mix-up and I was scheduled to see the nurse-practitioner---who doesn't ever work Mondays to begin with---thinking it was a simple post-op appointment, instead of a consultation with Dr. Fuzzy Sweater. But she was making time to see us anyway. Oh, really? How kind of her. We'll have to thank her for her benevolence. The husband, who has things to do with his day, was simmering at this stage, not least because it was he who set up the appointment and he knew the nurse was lying to us with this excuse. I wasn't really impressed with how the office was run beforehand and this only confirmed my suspicions that they were less than organized and wholly concerned with the wrong things. That this was an oncologist's office, where people have to wait around for appointments with a cancer doctor and are probably anxious about the meeting in the first place, didn't do a lot for my mental well-being. That I was still in the throes of recovery from serious abdominal surgery and sitting in a chair for an hour made me uncomfortable, well, that was just icing on the cake.

But she finally showed up---and promptly told us two things. First, that she was transferring me over to another oncologist in the same practice. We weren't unhappy about this because, well, driving to Woodbury to receive chemo would have sucked hard. The new guy's office is right across the street from the hospital where I was interned for seven days---and is a hop, skip and a bus ride from the Cake Eater Pad. This is good news. Second, she told us that she had decided I only needed three treatments of chemotherapy, rather than the six I'd been told originally. WOOHOO! The reason behind this, she stated, was that a study had come out recently declaring that there wasn't a large difference in the survival rates of those with my stage of cancer who had had three treatments instead of six. That meant, in the scheme of things, I'd be done with my chemo before the end of the summer, barring any complications. This, too, was good news. We then discussed things like why I can't start hormone replacement therapy just yet, bone density loss, what stage of ovarian cancer I'm at, the specifics of the chemotherapy treatment, what the side effects are, etc. We hade questions and she had answers. And when she was done, she wished us well and washed her hands of us. Her staff gave me the information about the appointment they'd made for me with the new oncologist and we were out of there.

The only problem with this scenario is that last week, when we finally met with the new oncologist, who we shall call Dr. Academic, disagreed with where Dr. Fuzzy Sweater staged my cancer. He said, as he walked into the room where we had been told to wait, "I'm going to throw you a curveball. I don't think you need chemo."

Huh?

Now, I can understand that most people would consider this to be good news. I, too, consider it to be good news. But I didn't act like that at the time. I felt like I'd been hit upside the head with a frozen mackerel. I have prepared myself for the eventuality of chemotherapy. I have prepared myself for the fact that it's going to suck, and suck hard. I have prepared myself for the fact I will go bald and I have asked my sister to start knitting hats for me to wear during this period. I have disabused people who, to try and cheer me up, told me I might not lose my hair after all, because they knew so and so who didn't. I have researched the drugs Dr. Fuzzy Sweater told me they would be giving me. I understand there will be side-effects and I have resigned myself to the process. I have worked hard on recovering from the surgery so I would have the best chances possible, but more so, I have worked my mind around to where it needed to be. I have gone from denial to acceptance and I am ready for what comes next. I have steeled my spine. It has taken me more than a month to get to this place and now you're telling me I DON'T need chemo? WHAT THE FUCK?

So, what you're undoubtedly realizing right now, my devoted Cake Eater readers, is that I don't have the most flexible of minds. I can't just accept a new reality at the drop of a hat. I have to work my way around it, poking and prodding it, to see what's what. Poking and prodding takes time. I must realize these things for myself, you can't just tell me what's what and trust that I'll take your word for it. This, I fully understand, my devoted Cake Eater readers, would mean I'd probably be one of the people first killed off in a disaster flick. Fortunately for me, though, life is not a disaster movie and I am not a disposable character. I have a whole week to digest what Dr. Academic told me and drew for me on a white board, like an earnest professor sure that a diagram will get the point across, because we have to wait for---wait for it---a new pathology report to clarify the situation.

In case you were wondering, I'm feeling every last second of the waiting this time around.

The upshot of the dilemma is this: Dr. Academic is disagreeing with the stage of ovarian cancer Dr. Fuzzy placed me in. She thinks I'm anywhere between a IC and a IIC, but she refused to specify further, but anything above and including a IC requires chemotherapy. Dr. Academic thinks I'm at a IB, which doesn't require chemo. He's read the original pathology report and he was at a loss to understand why Dr. Fuzzy decided I needed to come over to him to receive any chemo at all. Yet, he had the good sense to realize two things: one, that he wasn't at the surgery, so he didn't see what Dr. Fuzzy saw and, two, that I wasn't just going to take his word for it that I didn't need chemo, lest I thought he was being less than aggressive with my cancer treatment. As a result, he announced he was going to send all my stuff over to a gynecologic pathologist (who knew there were such doctors? I had no idea you could get that specialized.) to try and get a definitive answer regarding which stage I'm at. I would find out in a week if I needed to have chemo or not.

That week ends tomorrow.

Anybody got some percocet? I blew through mine already.