Monday, February 12, 2007
Confusion sets in
We went to Plain Hospital today. We waited more than two hours in the modest (white and gray cherry blossom wallpaper, two real and one artifical plant, dun-colored industrial carpet, easy-going reception staff) office of the Much-Recommended Surgeon. Part of the reason for the delay was his caseload and part was my lack of all the proper reports from Fancy Hospital. It took phone calls and faxes to get them. Finally we saw him and he said virtually the same thing that the Fancy surgeon had said: Need a mastectomy on the left, up to me what to do with the right. He would support me if I wanted a prophylactic mastectomy or if I wanted to leave it alone (which I want to do). One thing he said that was different from Dr. Fancy was that he would remove a whole level of lymph nodes under my arm. He said he doesn't do sentinal node biopsy, which is a way of isolating the node most likely to have cancer, removing it and sending it to pathology to see if it's malignant. This preliminary check happens while you're still on the table. The node gets a more thorough analysis later, one that takes three to four days. The problem with this, he said, is if the node is found to be negative at first, but then, after more analysis, it's shown to be positive, the surgeon will have to go in *again* and take out more nodes. He'd rather take out the first level of nodes and feel around to the second level while he's in there, and can see if the second level looks suspicious. The problem with taking out those nodes is you can get swelling in your arm. I was confused and when we got home I called W, who was one of the people who had recommended him. She said he and another surgeon did a sentinel node biopsy on her, but reminded me that she had Stage Zero cancer and I probably have Stage 2. L is sure that the surgeon said he doesn't do sentinel node biopsies, not just that he wouldn't recommend one for me. I consulted The Bible aka Dr. Susan Love's Breast Book, and it seems that a sentinel node biopsy is the thing to do, unless a surgeon isn't skilled in it. She also warns: "If you have two lumps that are in different places in the breast, the sentinel nodes may be in two parts of your armpit and the procedure won't work."
But Dr. Fancy didn't say anything about my lumps precluding a sentinel node biopsy. I will have to ask her.
I don't want to ask her. I don't want to do more research. I don't want to do any of this work. I don't want to try to understand about different kinds of receptors and look at cut-away drawings of ducts and lobules and vessels. I don't want to read about steroid antiestrogens and aromatase inhibitors and GNRH agents. I don't but there's no choice. I also don't want to curl up and ignore all this while the cancer grows and spins through my bloodstream and lymphatic system. I told L tonight that I was upset and he said, Finally!
February 13, 2007
Hail to Tricky Dickie
Today I had a lump in my throat most of the day. That is what I call anxiety. That is what I felt throughout high school and college and after, during two dozen years of talk talk talk therapy and insight therapy and diving-down-deep-intoto-your feelings therapy and transactional analysis (I'm OK, you're OK--remember that?), and vitamin-nutrient therapy and take-aloe-vera-capsules therapy and a no-fermented foods regime, and no refined sugars and no alcohol and acupunture and little drops of allergens to put under my tongue with a needle-less syringe, and feminist/not-so feminist therapy, and finally the thing that got rid of the lump was Prozac.
I didn't meet L until I'd been on Prozac six months. I tell him he's never seen me in my feral state. He's seen enough of my moodiness so that he gets the idea. He says. Once, years ago, an aquaintance wondered aloud why it was that so many people, especially women, need these pills to get through their lives, much less their days. She thought that the social environment was the culprit. Her view is feminist, and Marxist, both lenses that I like to use, but I don't think the patriarchy is putting the lump in my throat. I wish I could blame it for that. I can blame it for my non-participation in sports--that, and asthma. The patriarchy kept women from moving freely for centuries. We didn't get a semblance of sports equality until the passage of Title IX during the administration of Richard Nixon, of all people. One easy explanation for my tension and anxiety is the continual persecution of the Jews. But not all Jews are as troubled and worried and tense and anxious as I am. I have an overdeveloped "flight" (as in fight or flight or freeze) response, which may have been a boon, from Neandertal time onward through pogroms. How devious Mother Nature is, though, to have given excessive "flight" to a person who gets asthma when she runs. Mother Nature makes Trickie Dickie look like... a third-rate burglar.
L says the anxiety is from, well, you know: two words, first starts with a b, second with a c.