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.

Posted by Kathy at April 9, 2007 02:14 PM | TrackBack