Not Down Or Out

It could be worse. I might not be laughing.

Tag: Hysterectomy

Checking In

Back at the hospital

This morning I went for my six-month exam. Other than fatigue from having survived a swift move, I have been feeling well. In late February/early March. the daily, serious pains associated with radiation cystitis abruptly stopped. In June I determined that the other side-effects of cystitis–distress and incontinence–were well behind me. I stopped taking the Oxybutynin that had been prescribed for me. My bladder and bowel seem to have healed from the effects of chemotherapy and radiation.

I have had several “clean” pelvic exams and tests for cancer cells. My last scan was June of 2012. It showed no signs of cancer. In October it will be twenty-four months since my hysterectomy. In December it will be twenty-four months since treatment ended. I was thinking there would be a scan and blood tests, but there were no tests today.

My oncology team wants me to undergo surgery to correct a pre-hysterectomy hernia. The surgeon who originally diagnosed my cancer was going to repair it as part of my hysterectomy, but he ended up having someone else perform the surgery. That doctor did not touch the hernia. But it was in the way of his reaching my lymph nodes. As a result, no lymph nodes were tested–which explains why my chemotherapy and radiation treatments were “adjuvant.” They addressed risks unknown. I learned that the scans also can be confounded by the hernia, and that my radiation was more extensive because of the state of my “habilis.”

Everything looks good right now, but, if cancer were to return, everyone would feel better if things got “tidied up.” There’s no question but that I would like to get this addressed as well–EXCEPT–I do not have health insurance, I do not have the money to pay for this surgery, I am about to start school and cannot imagine undergoing surgery during “school time,” and the very thought of checking in to the hospital after my December 2011 experience there is out of the question unless it would save my life.

I am returning this week to teaching at the law school that terminated me the day of my hysterectomy. The law school is facing declining enrollments and has decided to cut the compensation paid to adjuncts, like myself, by 40%. At the same time, it has increased class size by 25%. The school has conducted its own internal investigation of my case and has cleared everyone involved of any breaches of university policies.

I suppose that means that the school would support my termination a second time if I underwent surgery–even if my surgeon said, “You can return to work next week.” That’s what the surgeon said last time.

The EEOC is examining my case now. I would like to wait for the results of that investigation before chancing fate on the subject of job security. As if an adjunct has any job security.

The Affordable Care Act will go into effect this fall. I would like to wait to see whether I can afford insurance when the new exchanges open in my state. I might have new options for treatment at a hospital that does not scare me.

The doctors think the charity that covered so much of my post-surgical care would agree to pay for this surgery if I appealed to it. That will take some time.

The doctors want me to go now for a mammogram. My cancer was estrogen-related. Some breast cancers are estrogen-related. So, I’ll do that. My maternal aunt died after more than a decade of dealing with breast cancer, so I will have the test.

My weight had dropped somewhat. My blood pressure was much better. I’m only taking a water pill for that. The doctors put off until my next check-up an ultrasound of my legs that might rule out varicose veins as the reason for my sometimes swollen right leg. No one else reacted when I mentioned the possibility of lymphoedema–which means nothing. I know that it could be the reason for my swelling from reading the excellent blog http://lymphnodetransplant.wordpress.com/. Check it out if you have unexplained swelling after surgery or other treatment that might have affected your lymph nodes’ ability to function.

I am seeing a GP in late September. I see the P.A. for another gynecological check-up in October. I can investigate my insurance/charity/surgical options between now and my next oncology appointment in February 2014.

I am feeling relieved to have gotten through this check-up, but my definition of “relief” has changed from “phew” to a sort of uneasy reduction of the alarm level from orange to yellow.

Photocredit: ripsaw-defence.co.uk

Photocredit: ripsaw-defence.co.uk

A lot can happen in six months. And I have some checking to do before checking in again with my oncology team.

Recalculating

Cars pull up and honk to see if I am leaving

Cars pull up and honk to see if I am leaving

I cannot stand those GPS systems with their ceaseless commentary on my driving. One of the increasingly appreciated advantages of being divorced is that no one complains about my driving. No one presses an invisible brake when I am slow to do the same. No one comments on my preference for a less well traveled route. No one exclaims when I choose to gun my little car and overtake another because its driver ticked me off.

When I travel with my sister Kathy she likes the instructions, the reassurance, the computer co-pilot. I think she would admit that my sense of direction is a little better than hers. As a result, the GPS system’s announcement that it is “recalculating” feels more like an expression of patience than the criticism I perceive it to be.

Today I finally went for the four month follow-up on my first thorough gynecological exam after hysterectomy, radiation, and chemotherapy. It has been twenty months since surgery.

I got up at 5 a.m. and left the house before 6 a.m. for my 8 a.m. appointment. I could not take it for granted that there would be a parking space at the hospital. This week I have taught five classes. I graded piles of papers. I reviewed resumes and spoke with students searching for jobs. I gave references for jobs and admission to the bar. I wrote recommendation letters. I spoke with attorneys for a prior client about an old matter. I was exhausted this morning, so exhausted that I climbed in the shower before I had bothered to turn on any lights.

I was lucky enough never to have acne, but this past week I have enough blemishes to warn passersby of impending doom. I am red! My joints ache. My blood pressure crept up. My tinnitus has been distracting when I want to empty my mind and concentrate on slow and steady breathing.

I got in the car and drove before I could focus on anything other than the need to get going. When I arrived at the hospital I was in time to get one of the last spaces. It was light out by then and I had to slouch in my seat because everyone who saw me tapped his or her horn to see if I was leaving.

There was no sense in getting out before 7 a.m. That’s when the elevators on the first floor open. I was afraid I would fall asleep so tried reading John Grisham’s The Racketeer, but it has been difficult for me to read fiction lately. I am going through a stage when the only things I feel are real.

When I entered the building it was like going back to your hometown after a long trip. I found everything old felt new. A police officer arriving late nearly mowed me over in the hall. The elevator lobby was under construction and I felt like the place was foreign rather than familiar. I rode the elevator to the second floor in the company of a red-dressed bird. This woman wore the tightest, brightest red blouse and capri pants. Over this she wore a pristinely white jacket. Atop her head she wore a curly black wig that cascaded in all directions. Wrapped around her head and across her forehead was a black and white polka-dotted scarf. The ends trailed down one side like she was singing back-up for the Jackson Five way back when. Beside her was a woman in a maxi dress with alternating horizontal stripes of orange and tan. The pumps matched. I kept wondering why I did not receive the memo because the colors were even more eye-popping than the women’s physical attributes. They were attention-getters, too.

In my navy blue shirt, navy blue pants, and navy blue slip-on shoes I felt invisible. I wanted to be invisible. I longed to be someplace else and to have more important things to do, but nothing was more pressing than this appointment.

Of course, I was the first patient present. The receptionist called me to the desk then told me to sit and wait because I was more than an hour early. It was after 7 a.m. and my appointment was at 8 a.m., but there was no point in arguing. She called me five minutes later when there was still no one there.

A nurse came out and brought me back to be weighed and have my blood pressure checked. One was down and the other was up. I explained that I was suffering from some “white jacket syndrome.” I learned that the physician’s assistant who last examined me was the only person present. I knew what this meant and tried not to panic.

I was shown to a room and sat for almost another hour before the P.A. came in.

I was the one who had to do some recalculating today. The exam still hurt, but my anxiety level was much lower. For one thing, as she took notes I had my clothes on. Last time I was led naked through the hallways twice and felt very vulnerable even before the P.A. decided to take my history while I sat half naked (the half that sat on the table was covered).

There was less info to share. The time went by faster. The P.A. could not predict anything without test results, but she let me know that she saw nothing that raised her concern. I hope that this is progress and that some of my fears will be eased when I return to see the P.A. in October.

I ended up driving out to my mom’s place and we spent the afternoon together. We took a ride to the Queen of Heaven cemetery in Hillside, Illinois. Back in the early 1990’s there was a local man (Joseph) who claimed to see the Virgin Mary there after he first saw her in Megjugorje. http://www.medjugorjeusa.org/; http://www.medjugorje.org. He visited the cemetery because he was directed to a cross near a three-trunked tree. http://www.catholicrevelations.org/PR/joseph%20reinholtz.htm. When my dad was alive, he took me and my mom there to see what was happening. In those days, Joseph would come and pray and see and speak with Mary while others crowded around him saying the rosary. People took interesting photos and rosaries turned gold.

One of my mom’s friends had a plain rosary turn gold. I have visited the location a number of times, including after my dad died. On the Christmas after my dad died, I took some Polaroid pictures of the plain wooden cross. The dark wood cross glowed gold on an overcast day while rain fell on me. I took the photos while I kneeled at the foot of the cross. Was it the flash bulb? Why was the effect not repeated in each photo taken from the same place at the same day and time?

I still have one of those photos and gave one to a former coworker who was quite devoutly religious. She also was dying at the time and said the photo gave her great comfort. I will try to find the photo album and scan a few of the remaining photos for this posting later. There are some others that make it appear that a door opened in the sky. I think the sun reflected off of the sides of the camera’s aperture. Nevertheless, they are cool to look at.

Photo taken June 14, 2013

Photo taken June 14, 2013

At any rate, the scene has changed since Joseph died. The cross was moved several years ago to an empty area of the cemetery. A parking lot was installed. The cross was set in the center of a blacktop area that people could not trample. No large group was gathered. A lone man walked the perimeter lost in prayer. Someone created a little shrine for a statue of Mary. The toes of Jesus’s feet have been touched so many times that the stain and sealer have worn away. Bare, white, and deteriorated wood is exposed. A couple people have left items. We said a prayer before leaving.

Photo taken June 14, 2013

Photo taken June 14, 2013

For my mom it was a let down. She was hoping to feel that energy that we last felt from the crowd when we visited there. It would have been a connection with my dad, whose birthday just passed and who we will remember this Sunday on Father’s Day.

But I had the opposite reaction. I put my hand on the cross and thanked God and Mary for helping me through the last two years of trials and treatments. I realize that others have experienced far worse than I have and want to keep this in perspective. But there were times when all I had to keep me going were faith, family, and friends. All I feel were gifts that helped me endure. And I felt as I touched that cross that a burden of fear and sorrow lifted from my shoulders.

I found myself recalculating.

New-Me

I attended a business/social event this past month at which I had to reintroduce myself to several people who have known me for years but had not seen me in some time. I recognized them as soon as I saw them. Their faces bore familiar landmarks that could not be dismissed even after as many as ten years had passed. The slope of a nose, the shape of a moustache, the slightly more deeply etched laughter lines, and the curve of a lower lip were recognizable from across the room.

When I approached these long ago colleagues each of them seemed at first uncertain about my identity. Eyebrows met in confusion. One head tilted a little to one side, as if trying to catch the lilt of a distant tune. Another turned his ear toward me, prompting me to say my name. One of them stuck out his hand even before he “placed” me. His smile just grew broader when I said my name.

I had not imagined that I might not be recognized. I have been to some of their homes. I have traveled with some of them for business reasons. I have worked with them. I have not forgotten them and they had not forgotten me. But they could not place me in the legion of people whom they have met, worked with, and known.

This is not the first time that I have been called upon to jog another’s memory of what I imagined was my unindelible place in it. It has been about 18 months since my diagnosis with cancer. I have had to reintroduce myself to some people who last saw me only one or two years ago. I recently waved to several former students and they looked at me without seeing me until I said my name. Then they smiled and admitted they had not recognized me.

I lost some, but never all, of my hair following my treatment with chemotherapy. It used to be dark blonde and cut in a chin length bob. It was that length, although sometimes lighter, nearly all of my life. When I was very young, my hair was very light in color. My dad called me “hayhead.” There were reddish highlights as I grew older. My Grandpa Kayo had those same red highlights in his moustache and beard, so I was quite comfortable with them. There were times when I lightened or brightened or even darkened my hair, but it was not all that radical a change after I stopped using “Sun In,” a hair lightener that combined lemon and sun to return me to my “hayhead” blonde coloring in my teens.

Since chemotherapy, I have worn my hair short and its color has faded to a brown. It has a wave that appeared after treatment and was not there before. I have traces of silver across the crown that are new and have been mistaken for “frosting.” So, yes, my hair is different.

I used to dislike these changes. I have become accustomed to them. My hair has never been softer to the touch. I wash it and do not worry about it. There is no need for cream rinse or gel or spray to manage it. I see Mariam to get it cut once a month. She snips it into a short cap and tries to talk me into teasing it with my fingers and a little gel into a spiky cap, but I cannot be bothered any longer to mess with what “nature” (if there is anything natural about chemotherapy) has given me. I no longer use a comb to regiment its strands. I run my fingers through it and forget it.

I have no idea what has happened to my several hair dryers or curling irons or rollers. I finally assembled all my barettes, headbands, scrunchies, clips, and other devices into a shoebox. I am thinking of mailing them off to my niece’s “tweenage” daughter on the theory that she might reinvent some use for them. They are vestiges of the old me for which New-Me has no use.

When my hair was falling out, sometimes a strand at a time, sometimes in small tufts that somehow avoided leaving me with bald spots, I learned to stop touching it at all. I started sleeping with a neck roll instead of a huge pillow. The roll supported my head without putting pressure on my hair. I still find strands of my former mane when I wear what I think of as my “chemotherapy” sweater. I detach them carefully because the hairs that remain have become entwined with the garment’s gray woolen strands. I set them aside or toss them in a handy trash receptacle. Little by little I have shed the old me.

This week a former student met with me to discuss her job search plans and she asked me what happened to my red hair. She spoke of the red wig I wore when my hair was quite thin but starting to return. I also had a red-gold wig and a very blonde wig that I never did wear out of the house. I don’t wear the wigs any longer. My hair may have changed, but it is back, and I still recall the day the wig fell off during a lecture and I had to grab it and plop it back on my head. I may be unfamiliar to some who have not seen me in awhile, but I am more comfortable in my own “skin” than in anything else.

I do not think I look all that different now that I wake each morning and look in the mirror at the New-Me every day. But this past week was a reminder that, even when it seems that nothing much has changed, what is happening in my life is making changes. My body is different. My hair has changed. My outlook reflects new concerns.

Many of the changes have nothing to do with cancer. I turned 56 in the last week. Age takes its own toll.

I read the blogs of many people who have been treated for cancer. Some of those people speak of their scars with horror, sadness, or misgiving. They have often experienced radical surgery that forever changes the landscape that was once familiar. My scar runs from side-to-side across my body, but I cannot any longer see it. Dr. D, the surgeon at Advocate Masonic Medical Center did such a superb job that the staples came out within five days after surgery. Long after the incision had healed I had difficulty feeling anything within several inches of the site. The nerves have reconnected and I am not feeling visibly scarred by surgery.

Not that treatment has left me physically unchanged. In addition to changes to my hair there are changes from radiation and chemotherapy that linger. There is pain. At times I have thought the pain had etched scars in my life far more disturbing than the scars visible on my body. It is not a good thing to have pain every day.

Ever since I decided to stop recording my pain level a few dozen times a day it has ceased to define the New-Me. It is there, but it is becoming like my missing hair dryers. I no longer feel the urge to snap at others when I am feeling pain. I have learned to unclench my jaw and let the pain radiate through and out of my body. When the pains are sharpest and seem to gouge into the core of my body, I wrap my arms around my own body and rock a little. If the pain is bad enough to make me cry, then I let the tears well up and tell myself that those tears will carry the pain right out of me. It comforts me to send a message of love to that part of me that seems foreign and wrong. And, luckily for me, my pain is not sustained. At this stage in my recovery, my pain is episodic. I believe that it will keep abating. That belief sustains New-Me.

I used to hate the strangeness of my post-treatment body to the point where I hated the smell of my own body. I really do not know if that sense of alienation has disappeared because chemicals have left my body and returned me to “normal” or if I have become more accepting of the changes that have taken place. I am relieved to have gotten past the feeling that I was a stranger to myself.

Soon I will get past the sense that I am a stranger to people who have known me. New-Me is someone I have come to know and like. She just takes a little “getting used to.”

Bruised (Part III)

I still don't know who chews on the hospital's chairs.

I still don’t know who chews on the hospital’s chairs.

I proceeded to the CareLink charity office and waited in line for a number so that I could reapply for charity status. There were not as many people waiting at 10:30 a.m. on a Friday morning. I was number 469 and the office was serving number 458.

I took a seat inside the interior waiting room and tried to grade papers, but I had trouble concentrating. I just stared at the pages and ended up proofreading for typos instead of doing any serious reading.

There were many people waiting in the twenty-seven available chairs, but there were empty chairs, too. Some people were in a militant mood. There were two adult women in long dresses with their hair concealed by elaborate headscarves. They had not obtained a number at the desk out in the lobby and had waited for some time. They wanted someone to serve them without a number. No matter how many times they tried to get served without a white ticket, the staff declined to serve them. Sometimes voices rose. I believe one of them finally went outside to get a number.

There were many people with numbers on green tickets. They needed someone to approve a discount or fee waiver on their prescriptions. This was bothering some of them. You have to go to the pharmacy to claim your drug (a task that can take an hour, two, or three), get a sheet of paper that shows the fee for the prescription, take that to the CareLink office, wait for approval of the fee waiver, then go back to the pharmacy to collect your meds. Some people pick up prescriptions in the same building as the charity office (people being released from the hospital or dropping off first-time prescriptions). Some people have to cross the street to the Fantus Clinic. It was cold outdoors and the winds were punishing. Some of the folks waiting were on crutches, in wheelchairs, or carrying luggage.

Only one employee was on hand to approve these waivers. Sometimes other employees came out to approve enough waivers to keep the crowd’s size under control. Then they went back to their cubicles to handle people with previously set appointments and people like me with handwritten white “tickets.” My “ticket” was a red ink number on a piece of white paper the size of a fortune from a fortune cookie. I kept tucking it into safe places and it kept coming loose. I think it was an omen, but I tend to ignore them. One man was incredibly “antsy.” He kept getting up and inquiring whether he could be next. The answer was no. He sat in a chair in front of an empty cubicle, rose, knocked the chair over, righted it, sat down again, studied his smartphone, eavesdropped on the meeting taking place in the next cubicle, studied his watch, observed a woman wearing a long down coat, carrying a rolling suitcase, talking to herself, coughing without covering her mouth, until she began watching him.

As I sat there I observed the crowd. There were a husband and wife with three young children. They had number 468. They sat beside me. They entertained those kids, including an infant, and you hardly heard a peep from them. There was a beautiful woman waiting with a younger woman who might have been her daughter. The older woman had very long brown hair worn in a long ponytail bound periodically with bands. There was a bun wrapped around the top of the ponytail. She had wrapped a silver cord around the base of the bun. The back of her cinnamon-colored winter coat was decorated with black leather medallions to which some other decorations were affixed. It looked like a design from a palace in some Moorish country. There were tiny black stones decorating her collar, too. She wore reading glasses down low on her nose. Her skin was so fair that her freckles looked like pieces of bronze. She was very angry that the wait was so long. I could not make out her words, but she scolded folks regularly. She sometimes got up and escorted her companion out to the first waiting room. Then they returned and continued waiting.

A man in a motorized wheelchair wheeled alongside me at one point. He wore an immense white and black fur hat like a hunter might wear, if he bagged some Siberian white tiger. Because he came up to my side I got a good look at it and believe it might have been real. He also wore a mink jacket with a fur-lined hood. It looked velvet soft and was the most incredible shade of brown. He was a big man, very tall, and, of course, bundled up. He had a lovely smile and lively eyes. His voice was cocoa with whipped cream and a cherry on top warm as he patted my arm and said in a very loud voice, “I just have to say that I am loving your haircut.”

“Thank you.”

“It is just a pleasure to get to look at.” He looked around the room, “No one else seems to have taken hair as seriously as you have. This is one of the best times of my day, let me tell you!”

I thanked him again. He motored away and I saw that, hanging from the back of his chair was one of those yellow and reflective tape vests that road workers wear. It read: “Watch Me For Safety.”

Of course, he proceeded to go to one of the cubicles to demand service. It was so startling to have him publicly compliment my hair one minute and then go batsh*t crazy on some poor charity representative. I thought they were going to call security as things escalated, but a woman with a forceful cloak of authority told him that his needs required special handling and he would be served immediately if he would head immediately to Room 1317. He left as fast as his motorized wheelchair could take him and did not return. As he approached the heavy metal doors to the lobby waiting area, he lifted one foot and kicked the thing open. I think everyone flinched because those doors have no windows and open out so newcomers are always on the other side of them trying to figure out whether to pull or push. No one got hit.

At 10:40 a.m. we were up to number 464. That was incredible. Of course, people started taking lunch breaks. So it slowed down. But breaks appeared to be very short. At 11:10 a.m. staff called 466 and 467. At 11:15 a.m. someone called 468. I was next.

It took sometime for my number to be called. The charity’s staff seemed to be enjoying a Friday moment. As people started getting a tiny bit unruly the staff started repeating certain comments in soft voices and the message began to work its way to where I sat like a game of Telephone.

“He says he’s been waitin’.”

“She says she’s got things to do.”

“He’s got a job to get to.”

In the end I was called. Based on my current income, which is actually lower than it was back in 2011, I qualified for a 25% discount on hospital services. What hurt me was the DePaul did not pay me for my fall paralegal classes in the last payroll period of December. Then it did not pay me for the first payroll period in January. It arbitrarily decided to change the customary schedule for paying “contracts” with people who it treats as employees for payroll purposes and independent contractors when it feels like it. So the most recent pay stub I had showed me as earning much more in one payroll period than I ordinarily do. I also taught a 12-week class in 8 weeks for another school during January. That upped my monthly pay over what it usually is.

I felt really bad for some reason. It was like DePaul took another swing at me, when it really did not mean to do that. An employer’s arbitrary altering of a pay schedule to suit its purposes is a regular event for many adjuncts.

I probably should have waited for a February pay stub showing only the halved fee paid for teaching Transactional Drafting. But I was not trying to “work the system.” I will just keep working on getting a quote for insurance from someone and hope I can cover 75% of the cost of the three doctors’ appointments, five blood tests, and pap test I already have had since the last week of January. I have 30 days to appeal the determination. Maybe my pay stubs will better reflect my circumstances in that time.

In any case, I won’t be scheduling any operations for this year. I have experienced enough “tinkering” in the last fifteen months. I am resourceful and still have people to call and options to explore. And I am feeling much better than I did when this experience began. I am still grateful for the doctor who diagnosed me. I am grateful to the excellent hospital, doctors, and professional staff who operated on me. I value the thoughtful care given by my oncologist and feel lucky to have had her wise advice in making decisions that will affect me for the rest of my life. I think my oncology nurses and the phlebotomist who helped me through chemotherapy were excellent people. I owe an immense debt of gratitude to the two charities that covered so many elements of my medical care. I am grateful to my county, its hospital, and all the excellent people I have encountered there for having resources for people like me.

I have family, friends, and faith that things will turn out well. And I still have my sense of humor.

I remain Not Down or Out.

Bruised (Part II)

My Friday appointment with a physician’s assistant (“P.A.”) in the Gynecology Department at the county hospital was a trial for which I knew I was unprepared. I was nervous about it and the P.A. kept deferring her examination to take a more complete medical history.

After what seemed like a very long time, the P.A. got up and helped me put my feet into the stirrups. She started to run warm water and explained that she would be rinsing the speculum so that it would not be cold when she used it. I was just about to lie back.

Then she changed her mind and decided to perform a general medical examination first.

She listened to my lungs, my heart, examined my breasts, examined my visible hernia, and palpated every place where lymph nodes may be found. Every once in a while I trembled, but I was able to arrest my fears with the certain knowledge that this examination could not possibly prove to be as bad as the last one.

At one point she discontinued her exam to go make more notes on the computer because I mentioned my aunt’s breast cancer. She scolded me so very kindly for leaving this out during the earlier discussion of medical history.

In the end, she did the exam. And it was not as bad as I imagined. Because I have been healing over the last fifteen months. I no longer have a raging bladder infection. My bowel is no longer newly burnt. According to my last CT it has become somewhat “hardened” by radiation. I figured everything else was going to be hardened, too, but there is some resilience left and some of it is emotional.

I will spare you the description except to say that some experiences are more disturbing because of how they are done and not because of what is done.

I felt (and still feel) that I was killed with kindness. I learned certain things about my post-surgical body that no one else explained to me in the last fifteen months. The P.A. commented throughout the exam. I’ll keep some of those lessons to myself. I did appreciate the information. I just found some aspects of the exam uncomfortable. I now wish that I had been more vocal about that. It was not something I could at the time articulate well.

It was not until Saturday that I could say much of anything about the entire experience. I kept asking myself if I had been overly sensitive. I kept replaying the kind words, the scolding tone, the repeated assurances that she treats all her patients like they were family,  and the seemingly intentional delay of the exam. I acknowledged that it was not the P.A. who walked me around the halls nearly naked. I was disappointed in myself for not asserting myself more forcefully. I was kicking myself for not having medical insurance and choices and living up to my own potential so that all of this could have been somehow avoided.

Tears started to leak from the corners of my eyes as the exam drew to a close. I wiped them away with a little embarrassment. It seemed important to the P.A. that I put in words that it had not been as bad as I imagined it would be–and it wasn’t bad the way I feared it would be. But I was so eager to get out of there.

She left me there in the stirrups while she went to find the never-to-be-seen Dr. Y. On her return she announced that he was satisfied with her report on my condition and did not feel the need to see me.

She helped me sit back up and told me that there were no visible signs of cancer’s return. Her practice is to not call if the tests done are negative. We discussed the fact that I don’t use text messages so, if she needs to report bad news, then she will call me and leave me a message telling me I need to come in to see her.

After that, she left me to dress, I cleaned up and tried to leave, but she was in the next room still typing notes on a computer. I went back to my examining room to wait for her to print out some papers for me.

She explained that I will need to have an internal examination every three months for three years, then every six months for two years, then every year. She told me how I should have my hernia fixed and that I should see the primary care physician soon.

Then she pulled out her candy bowl and asked me to choose a piece of candy. She explained that her brother loved candy. She offers some to all her patients. Some of them are diabetics and, particularly after the long wait in the clinic, their blood sugar is down and they are grateful for the treat. I could take as many pieces as I wanted. The bowl was filled with Mary-Janes (a very hard toffee that I haven’t seen in many years) but there were other things, too.

It all seemed very odd to me. After all of the kind comments and reminders about blood pressure, gallstones, diet, diabetes, cholesterol, and everything else, she offered me candy. I took a mini Baby Ruth and said, “I’m going to save this to remember you. See, there’s a little pocket here in my purse for it.”

We walked out to the nurses’ station and she explained that I could ask for her specifically on my return. Lots of people do that. I showed her the note I already had put in my open calendar. It was her name followed by the notation, “SO KIND.”

I have a headache today. I still feel unappreciative of the kindness and that bothers me a little because I have gotten so used to feeling grateful that it seems terrible to me that this seemingly nice woman has bothered me so much when she said the same sorts of things other medical professionals have without giving any offense.

When I spoke of the day with my mom on Saturday she recalled once reading that, in her lifetime, doctors would end up ruling the world. They would order all of us to eat certain things and not others. They would criticize our lifestyles and dictate to us about our behaviors and habits. “It’s come to pass,” she said.

I do these things in my professional life, too. I evaluate. I comment. I criticize. I compliment. I lecture. I intend to examine my own behaviors carefully and question my methodology. But first I need to get over the feeling that I have been bruised. No wounds were inflicted. It was such a subtle experience. It was SO KIND.

Bruised

I had an appointment with the gynecologist on Friday. It was my first “serious” examination since I underwent a hysterectomy in October of 2011. The only other time that anyone has examined me internally was in December of that year when I was in the emergency room for a rip-roaring bladder infection and the doctor wanted to take a “look-see.” At that time, it was less than three months after my surgery and a day after my twenty-fifth radiation session. If my bladder and bowel were burnt to a crisp by radiation, then the narrow length of flesh lying between them was still smouldering.

Back then they tattooed a big black “X” on my body and used it to line up their equipment. I know what that meant. My vagina was under direct attack. Back then I was glad that my mom had fled the ER before the doctor inserted his speculum because I screamed in pain. The last time I screamed like that I stood up in a theater and screamed because the alien had attached itself to a man’s face in the movie Alien.

I moaned and begged God for mercy during the aftermath of radiation when my bladder was racked with cramps and blood clots. I recall a long, keening sound coming out of me as two nurses struggled to insert a catheter into my body when nothing would pass through the urethra and I thought my bladder might explode under pressure. I have yelled while driving in my car. But, in that tiny bay in the ER, I screamed with so much fear and agony that I still cannot forget it.

So I was terrified at the prospect of another internal examination. I realized that I had time to heal. It could not possibly be as bad after a year of recovery. But fear is not always rational.

On Friday morning I got up at 5:00 a.m., showered, dressed, and headed out. It was cold outside–about 25 degrees outdoors. When I got to the hospital I sat in the car to wait for the elevators to open at 7:00 a.m. By the time I went inside I was frozen. But I forced myself to get moving because I told myself to face my fears and get over them.

I waited for the elevators to open. I was there so early that I had to wait for a nurse to open the doors to the waiting room. A receptionist greeted me and checked me right in. I was so tense and there was a young woman waiting there for an appointment with the Orthopedic Clinic. She suffered from a mental disability that prevented her from speaking in words. Instead, this young woman in her early twenties babbled. She shouted startling sounds. She ran around the waiting room. Her family was there to try to cajole her into staying in a seat. When she stood they tried to encircle her. They would pet her hair and shoulders as if she was a toddler. They comforted her when she cried. After she escaped their loving circle and curled up in a corner on the floor, a father figure huddled beside her with his arms around her.

I was thinking how doctors in the suburbs have a door for well children and another for sick children. What do such doctors do with healthy children with profound difficulty speaking? I have never seen a young adult in a public place with such a difficult-to-cajole personality. Her family’s love was so inspirational. One family member looked to be a younger sister. She wore white leggings and a white sweatshirt, like someone had pulled her from a cheerleading squad meeting. When the sister would run, this young woman bolted after her. It was like guarding in the NBA.

Young people’s dignity can be so fragile. This girl drew so many stares. I wondered what it must be like to be so visible when you felt awkward about what you were doing.

The same nurse who had so much trouble taking my blood pressure on Monday came out and we tried again. On the second try the machine worked. Again my blood pressure was uncharacteristically high. The nurse took me back to an examining room. She explained that the doctors were attending a “tumor” meeting and would be along shortly. Medical students would be the first to arrive. They would perform an internal examination. Then the doctor would stop by to meet me. It was cold in the examining room. She suggested I wait fifteen minutes before undressing and climbing up onto the examining table. There was a pad covering the step I would use to climb up. There was a paper gown to put on with the front open so that the medical student could examine my breasts for signs of cancer. There was a blue plastic blanket to spread over my lap while I waited.

She left me alone in the room. As always, I had papers to grade. But my nerves were getting the better of me. My teeth were chattering. My jaws ached from my efforts to clench them.

After fifteen minutes of waiting with my fears for company I undressed and climbed up onto the examining table to wait. I felt so vulnerable as I waited. This was going to happen. I wanted it to be over.  After another fifteen minutes the nurse came in and announced that I needed to move to another room. The paper gown was hardly adequate cover. It was open from throat to my knees. I needed the blue plastic sheet to shield the naughty bits of my body. I wore socks but no shoes. The nurse gathered some of my stuff, but not all of it. So I clutched my shoes and underwear, my paper gown, and my blue plastic sheet with nerveless fingers.

The nurse headed out into the hallway. I walked with the certainty that nothing was concealed. It was worse than when I walked around the Radiation Department with my cloth hospital gown caught up and my lower torso bared to the amusement of male patients. At least I was drugged with Benadryl that day.

The nurse instructed me to take a seat in another examining room until a third became available. “Don’t sit on the chair,” she cautioned. “Get that blue sheet beneath you so you don’t catch something.”

The cloth seat of the chair had a big black stain on it. I only had one free hand and it was holding that thin plastic sheet for dear life. Somehow I got it around my waist.

Several minutes later I followed the nurse back out into the hallway and down the hall to a third examining room. The effect that this had on my nerves was not pleasant. A slender woman in a white lab coat introduced herself to me while I held onto my clothes, shoes, purse, paper gown, and blue sheet. The nurse had set my book bag on the extra chair in the room. The physician’s assistant (“P.A.”) introduced herself and insisted on shaking my hand. To do that I had to let go of something. It was the last of my dignity.

“Get up on the examining table,” the woman instructed. “I’m going to get some information before we start. Then I’m going to examine you. Then I will present your case to Dr. Y. He may come in and meet you after that.”

Well, it was difficult to get up on that examining table when I was feeling a little demoralized. But I did my best. It was not good enough. She came over to direct me and we ended up tussling over the paper gown and the paper that covered the bottom of the examining table. The gown gave up the ghost. “Don’t worry about it,” she said. “As long as your posterior is on a covering so you don’t catch some infection.”

My feet did not quite touch the step after I was seated. I discussed the experience with Barb today. She said I should never have agreed to get naked before I met the doctor and felt comfortable. I think that would have been better than sitting there with only the blue sheet across my lap and the paper gown hanging from one shoulder. The rest of the torn paper gown was trapped beneath me.

I am direct. I said, “I have to tell you that I am terrified of having this exam today because the last time I had an internal exam it was too soon after surgery and radiation. It was so painful I screamed. I just want to get this over with.”

“You’re in the best of hands,” she assured me. “I’m very experienced at this and Dr. Y trusts me to handle matters. We’ll take good care of you.”

However, it turned out that the P.A., likes to get a thorough medical history. She started asking questions and checking for data on the computer. According to her there were no doctors’ notes to explain my history. I have watched as doctors entered notes, but no one asked as many questions as she did. I kept telling myself that she was being thorough. I was getting really good care. It was going to be okay. But the truth is that she was not easing my fears. I was becoming more nervous.

I was cold. My nose was starting to run. I had goosebumps on the red splotches that covered my limbs and torso. My back started to hurt. I thought my left foot was going numb.

When was my first period? When was my last? Had I been regular? Had I ever taken anything for that? How about hormone replacement therapy? What was the longest time I ever went between periods?

Had I ever had a child? A pregnancy? How did it end? Had I had a D&C?

How had my cancer been diagnosed? Did I have a biopsy? How much blood had I lost? How much blood did I take by transfusion? When was I admitted? When was my surgery? Who did the surgery? At what hospital was I treated? How did I end up at the county hospital? Who referred me to Dr. Y?

She asked about my surgery. What type of tumor was it? Size? Location? Secondary points of spread? Staging? Grade? Prognosis? Lymph node results?

What was my post-surgical experience? Had menopause begun within as few as 48 hours? How long did it last?

When did I start treatment? What was my treatment? Did I have external beam and/or internal radiation therapy? How did I respond?

She asked all the other questions one asks. She wanted to know about my medical history and the medical histories of my dad, mom, sister, and brother. “Do you know that you have gallstones?” she asked.

I nodded.

Thin as a rail this woman was, but she said to me in the heavyhanded manner of someone who enjoys being in charge, “We can’t have all the fatty fried foods we love so well, now can we?”

I resent the implication that being overweight makes me stupid, too. I don’t own a fryer. I have one small bottle of olive oil in my home. I doubt that I have touched it in nearly a year. I have been using the same tub of Smart Balance for more than a year. There’s a package of Snack Well cookies on my shelf that I bought last summer. There is not a french fry in my freezer.

“I see you had a recent blood test. Let’s see what we learned. Oh, I see your cholesterol is very good!” She turned to give me an encouraging look. It was difficult to be sure, but I started to get the impression that condescension was setting in. This was serious condescension. “Hmm, blood sugar safely normal. Surprising really.” She noted that my blood pressure was 160/95 twice that week.

“I am terrified of hearing the cancer is back and even more scared to be having this exam today,” I explained. “I just want to get it over.”

She ignored my nervousness. She had dozens of additional questions about my two medicines, my ongoing physical complaints, my weight, my height, the umbilical hernia that I have. My goosebumps had goosebumps.

In between bouts of questions she told me about herself, her brother who died of leukemia, how she started in brain research at University of Chicago, how she began handling trauma cases, and how she had gone from the brain to the reproductive organs (as if someone had flushed her life down the drain). Our birthdays are coming up. I am two years and four days older than she is. How the doctors were tough on her but helped her hone her skills.

Oh, even as I relive the experience my muscles are taut as bowstrings. I felt so vulnerable sitting there naked while she went on and on about her business. She was so cheerful. It was maddening. I was not myself.

Did I smoke? No. Did I drink? No. Not even a social drink? “No, I have had one sip of champagne for a friend’s birthday in the last three or four years.” She looked skeptical. Was there a problem with alcohol? No. What about prescription drugs? We again reviewed my two prescriptions. Marijuana? Other illegal drugs? No. She turned around to look at me. “I have to ask. You’re sure it’s nothing?”

“Nothing,” I answered. “I am a law professor. I wouldn’t dream of it.”

“Hmm.” She went on to explain that there was big bowl of candy on a piece of paper towel beneath her desk because her brother liked candy. This is how she keeps his memory alive. She keeps candy around.

She decided to refer me to a primary care doctor to discuss my high blood pressure, which she described as “out of control.” She decided to refer me to a surgeon to have my hernia repaired.

I never asked for these services. I just wanted to get the tests over with.

“Married or single?” she asked.

“Divorced.”

“Ever been a victim of domestic violence?”

“No,” I answered. She turned to look at me like she thought I was hiding something. “Really?”

“Really,” I was trying to get my mojo back, but the tension was not easing. “Both of us were lawyers,” I commented. “We abused each other legally.” It was a joke.

“Did you have any of the following?” She started with STD’s.

I said, “I’ve been abstinent since 1986.”

“That’s twenty-five years,” she commented as she clacked at her keyboard.

“More. Long enough to have avoided all those issues,” I said. “The only thing I’ve ever had to contend with is the cancer.”

I had been sitting there for half an hour and we had not started the examination. I wanted to demand we get it over with, but fifteen months of waiting for doctors’ care has taught me patience. And I was still so conscious of being naked. And I thought I was doing an adequate job of using my words. And I was afraid of the moment when she would insert the speculum. The suspense was unravelling my sense of self.

I met a woman while I was in law school who reminded me of the P.A. She was in my study group. She volunteered at a local animal shelter. She used to take in animals to nurse them back to health. We only met at her home once because it was unnerving to see all the sick birds and other animals roaming about the house. The other thing that made us uneasy was that she spoke so often about euthanizing animals that could not be placed with families.

I don’t know the P.A. well enough to say she is a sadist masquerading as a healer. But we did not get to the examination until she was good and ready. That is only one of three reasons why, after I got home that afternoon, I took two showers and went to bed for the rest of the afternoon. (Part II in the next installment).

All That and the Brooklyn Bridge

Last week was the first time in ten months that my life did not run at full throttle. I taught an online class. I attempted to attend a faculty meeting until I was turned away by four downtown parking garages and returned home. Those were my only serious commitments for the week. My average week has included teaching as many as five classes. In addition to those ongoing commitments, I hemorrhaged until I had depleted two-thirds of the hemoglobin required for healthy life. I was diagnosed with uterine cancer. I underwent major surgery, chemotherapy, and radiation. I spent two weeks in the hospital. I went through menopause.

Cancer–something buried in the middle of everything else I did–was just something on my weekly “to do” list:

1. Prepare five sets of lecture notes.

2. Grade 60-100 papers.

3. Grade about 20 exams.

4. Get treated for cancer.

5. Spend Saturday with Mom.

After all of these months, I finally sat down and thought about all that I experienced.

I read my blog entries from beginning to end. I went through my in and out boxes in my email account and moved all the cancer-related messages to a cancer folder. Then I took out the several journals that I kept over the last ten months. I skimmed them. Then I flipped through my calendar to read the entries for doctor’s appointments and treatments. I opened up my linen closet and tossed out every nightgown, towel, and sheet that bore stains from my uncontrolled bleeding prior to surgery, the orange medicine I took in December to alleviate bladder pain, several months of painful gastric and intestinal distress, and the bloody radiation burns I had around my hips from December to March. I put my wigs back in their boxes. I threw out all of the hair products that I used to use and have not touched since October. I started trying on my pre-October wardrobe and figured out how many items were too large to be worn again. I put them in bags that I plan to contribute to charity.

I emptied my camera and took a roll of film to Walgreens to get it developed. I transferred the few digital photos that I took during the last year into a folder. I stared for almost thirty minutes at a photo of blood clots that I had passed from my bladder in early December. They were so large that I found myself thinking that the photo appeared to have been “photo-shopped.” It was not.

I sat in front of my lighted 10-X magnification mirror and studied my new hair, brown, sprinkled with silver, short, wavy, and standing up all over the place. I evaluated the longer length of my eyelashes and my eyebrows. I studied the sparse white hairs on my arms. I determined that the calluses that formed on the tops of my feet and the backs of my hand during anemia and chemotherapy were all gone. I examined the ridges on my fingernails that mark the period when I was receiving chemotherapy.

I went to the full length mirror and studied my completely healed and nearly invisible hysterectomy scar. I have not looked at it in so many months that I cannot recall when it changed from red to white. If I did not know it was there, I would not be able to find it. I cannot even feel it with my finger tip. I studied the hernia that I did not know I had before October, which has become prominent after surgery and weight loss. I realized that I am still sort of numb at the top of my left thigh because some of the nerves around my incision site have not yet repaired themselves.

I opened up my freezer and resolved to eat in one week all of the vegetables I bought and could no longer eat once I hit that rough third week of radiation when my digestive tract felt burned. I uncovered a baggie filled with health bars that my friend Tracey made for me in early November. I ate one without feeling like its Chia, pumpkin, and other seeds would tear my intestines to shreds. By this time next week they will be gone. I finally used up the last of the paper towels and toilet paper that I bought from Peapod in December when I could no longer carry supplies up my back steps because I was physically exhausted. I moved the last two twelve-packs of ginger ale from the front closet to the refrigerator. That’s what I used to drink when I was a little nauseated after chemotherapy. It has no caffeine that might irritate my bladder.

After taking stock of the events as they relate to my home and my body, I felt tension like a twisted rubber band running from my ears to the back of my neck. The tension was not alleviated by letting go of so many items. It ratcheted up appreciably. I felt nauseated, as if I had consumed Thanksgiving and Christmas dinners at one seating and then swallowed a bottle of seltzer. Everything that I had been absorbing without digesting from the time I was told I had cancer until now seemed swollen and expanding.

I cleaned my desktop off. I last did that in September 2011. I filed away all the receipts, notes, and address changes that I had accumulated. I moved to the floor more than one hundred magazines and books that I had marked for articles, assignments, lectures, and books I plan to write. They are now in piles so that I may systematically go through them before consigning them to bookshelves, storage, or trash. I made a list of people to contact because I never got around to answering Christmas cards, birthday cards, or other updates all year if they came from people who did not know about my “health crisis.” I read every last get well card that I received one more time before discarding them.

After I did that, I sat hunched over my desk because my body had become so taut with tension that I could no longer hold my head up. I felt as if my joints were made of glass and the effort it would take to get up and move might shatter them. I was “Tin Man” stiff with unreleased anxiety.

My eyebrows hurt. My cheekbones hurt. The sides of my nose hurt. Every prior effort to force my lips into a smile when I was asked how I was doing felt like it had been performed in reverse. My jaws hurt as though I had been chewing gum all day. I felt the weight of my own prior cheerfulness descend upon me like an avalanche or a crashing wave.

It’s only been about a week since I stopped racing around, but my primary reaction to the entire experience is that I am not the same person any longer. I could not figure out how to put these changes into words that would make sense of my experience.

My cousin Susie called yesterday. She doesn’t call herself Susie since she became an adult, but she will always be Susie for me. She has a way of getting me to open up about how I’m feeling that is better than therapy. All she has to say in her loving and measured way is, “How are you?” I start singing like a canary.

I still am not sure how I feel except that I sense that I am on the verge of a new wave of change and I want to measure how far I have come before I move on to the next place. In the last few weeks I have encountered two psychics that have told me that come October 2012 my professional life will be changing. I have heard recently from ten people who have ideas for new projects that we can work on together. I start new classes in another month. Two people have told me that I must do more to help others who have cancer or do not have health insurance. No one tells me what to do. I make that decision, but people are trying.

As I heard from Barb and Kathy during the day, the process of assessing the last year’s events continued. Nevertheless, by the end of the day on Sunday I was so stiff with tension that my toes were clenched like I wore a new pair of flip-flops for a run up the stairs at the U.S. Capitol building.

When I climbed into bed I felt older and more uncomfortable than I had since my hospitalization in December. It was like I had worked out with Jillian Michaels from Biggest Loser. I was physically and emotionally whipped. I stayed in bed for four hours and got up when the clock said 4:00 a.m. and I could not recall whether I had managed to sleep at all.

I now sit at my desk before my laptop and I am no closer to figuring out what has happened to me than I was yesterday. This past week I read Mary Pipher’s Writing to Change the World at 83 (Riverhead Books 2006), in which she wrote:

The writer Craig Vetter once remarked, “The Brooklyn Bridge was built by a guy who had a term paper to write.”

Maybe the last week’s efforts were nothing more than, and just as exhausting as, the construction of the Brooklyn Bridge, effort undertaken to delay moving forward. This is what I do know. I do not now have cancer. I want to live. I have important things to do. There are people I want to know better. I am grateful for all of the blessings in my life. Maybe that’s all there is to know.

You Can’t Get There From Here

Many years ago I drove a van to a college debate tournament in my capacity as assistant debate coach. We were lost and stopped for directions. The local passerby, when asked for directions to the highway, answered, “You can’t get there from here.” At the time, I was charmed by the notion that you could not reach a place on a road from a road. Later in life, my mom and I visited a coastal town in Alaska while on a cruise. The town boasted about ten miles of road that connected homes to ten bars and as many churches. When a fellow passenger asked how to drive to another nearby coastal town, the answer was the same. “You can’t get there from here.” One had to take a seaplane or boat to visit the nearest town. Many years later, I met a naturopath and told him that I felt that I had become a dying organism and I wanted to make some changes in my life that would transform me to a living organism with new goals and direction. He gave me the same answer. In his view, life was lived some place along two axes: horizontal life was unfulfilled. Vertical life had momentum and held the promise of new growth. He believed that a life misspent in horizontal endeavor needed to retrace its path to inception before it could pursue upward flight–a cosmic “do over” if you will. Through a series of “corrections” administered in his office, he did set me on a course to new growth. Now I find myself about to finish cancer treatment, and I wonder if, once again, it will seem all but impossible to move from where I am.

My doctor says that I will need to undergo tests every three months for many years. The doctors will look for cancer markers in my blood. They will perform scans of my body to search for masses. I will be examined for a recurrence of cancer in some new organ (as the cancer that was found in me has already been removed as part of my hysterectomy).

How can you ever put this disease behind you when, in as little as three months, it might recur? My cancer buddy Wanda was operated on in April and found to have a new mass in October. I have never lived in a state of fear before. I cannot imagine that this experience will be taken in stride. Whenever in life I have faced something awful, I have first asked myself what is the worst case scenario? If I can imagine myself handling it, then I have been reassured that I can handle it.

The idea of a recurrence shakes my self-confidence because I began my current odyssey with some sense of my own limitless potential for recovery. Now I come close to finishing a course of treatment that has taught me that I am not as strong as I thought. I began treatment feeling very well. I will complete it with a new humility. In five weeks, my treatment has broken down many of my body’s systems. I bleed from my nose, bladder, rectum, and skin every day. I experience pain during daily body functions that is so severe that I cry out in terror and pain many times a day. I have felt my intestinal tract throb with pain and, in doing so, cause so much more pain that I feared I might pass out. When I urinate I gnash my teeth and wail. It has been all but impossible to sit, to stand, and to lie down. I have never slept much, but lately I sleep two or fewer hours in some days. I have lost more than forty pounds and forced myself to eat and drink. I have showered once a week instead of every day because my skin flinches under this watery assault.

Life has become a condition I must encounter through a vast membrane of painful nerve endings. I no longer am secure that I can handle the worst case scenario. If this is what it is like to treat cancer, then how I can face cancer again?

There are things I can do. I can change my diet and eat what is described in literature as an alkaline diet. The literature says that cancer cannot thrive in an alkaline environment. I can oxygenate my blood by eating raw foods. Some say cancer thrives in an environment of cooked meals. Even as I say this I wince. A new discipline to run my life–not my definition of moving forward.

I can return to working out. I have a pulley system of weights that I can use as soon as I feel a little better. I don’t mind doing this. But I have never been the sort of person who feels the endorphins. Where is the joy in a life of cautious measurement of risk?

I think the best way to get where I want to go might be to pursue a path that focuses instead on the following:

1.    I need to connect with others through faith, family, and frienship. There is no question but that these have gotten me this far. I have a life filled with people I love who love me. My bonds with them are deeper still after they have helped me through this trial. I need to honor these connections and keep them strong.

2.   I need a pet. There are studies that a pet can extend life. I want to share my daily life with a creature that I love and who loves me. I want to be reminded every day that life is a series of interconnections that give life texture and meaning.

3.   I need to laugh every day. An antidote to fear is humor. I intend to find something to laugh about, especially me. Cheryl has become so serious that she needs laughter to give her life a less grave tone.

4.   I need to volunteer. I do not simply mean to contribute my time to a cause, but to stand up and be counted upon to speak out when something is wrong. If I am a bystander, then I am not engaged. I want to be fully engaged in my own life.

5.   I need to pursue my passions. I have not undergone this hell to do things that do not matter to me. Whatever I do I must do it with my heart.

6.  I need to be grateful. Many people have saved my life. I have counted my blessings and they are numerous. I will not forget that at my darkest hour there were people who filled that darkness with light.

I am sure that I will add to this list as I undertake recovery. But I believe it is possible to get there from here. I am counting on it.

The Cutting Room Table

My doctor chose to have a surgical oncologist perform my hysterectomy. The surgeon taught a pair of female surgeons. The three of them came for rounds several days before my surgery. At the time, I continued to receive transfusions of blood. My hemoglobin at admission was 3.7. A normal reading would be 12-16. The reading had to rise to 10 before my surgery. While blood dripped into veins so parched that they collapsed when tapped, my blood pressure cuff operated every fifteen minutes. My blood pressure had been sky high ever since the diagnosis. I kept insisting that my blood pressure was normal when I was not facing cancer and major surgery. No one believed me.

In anticipation of a CT scan scheduled for that afternoon, I was instructed to drink two glasses of icy cold contrast medium. The milky white fluid was tasteless but filled with iodine–a substance some find irritating. I had consumed one Big Gulp-sized dose and had a second at the ready when the surgeon approached, held out his hand, and identified himself.

The surgeon took my hand and gave it a firm shake. I reciprocated, forgetting for the moment that I was tethered to a blood pack. An entire cup of contrast medium and ice chips splashed down my torso and pooled in my lap.  My teeth chattered helplessly from the chill.

The surgeon did not acknowledge my discomfort. He asked me to climb into my bed and let him examine my stomach. The young doctors reached for paper towels. I lifted the wet hospital gown and let the remaining liquid run onto the floor. While the surgeon watched, I backed up to the bed and hitched my behind up onto it. I managed to lie on my back even though needles lodged into veins at my wrist prevented me from leaning on my right fist or grasping the bed’s railing as I reclined. I dragged the wet gown up to my waist to bare my stomach for his examination. I was cold, sticky, and miserable.

“We’ll perform an abdominal procedure rather than a laparoscopic one,” he announced. I knew this might slow my recovery. “We’ll enter at the bikini line.” Never having worn a bikini, I was not comforted by his choice of entry points. This would be a painful incision that would leave a long scar. I had never undergone major surgery before. I was still whole.

I shut my eyes and tried to imagine myself someplace else. Cold liquid dripped over my stomach and down onto the bed.

One of the young doctors helped me to sit up and rang for the nurse. I stepped down from the bed and into a puddle of the splattered medium. The surgeon looked down at the mess and addressed me formally, “I am . . . sorry that I . . . that you spilled that drink on yourself.”

I closed my eyes again, then opened them, and smiled broadly. “I was just excited at the prospect of meeting you.”

The surgeon frowned.

The two female doctors lowered their heads to conceal broad smiles.

The hospital moved me to another floor and room after my CT scan. A technician arrived before I had settled into my new space. It was time for my echocardiogram. There was something oddly gratifying about watching my heart pulse on a black and white screen. The technician’s fascination with the organ was evident. He searched and searched for a defect and appeared to find none. Yet another test was passed.

Cholesterol – normal. Thyroid – normal. Blood pressure – normal. Chest x-ray – normal. Abdominal and chest CT – normal. Electrocardiogram – normal. Diabetes – no. Hemoglobin – still an issue, but rising. That left cancer. No big deal, right?

I underwent surgery on Friday, October 7, 2011. Thursday was a long night. I made a list of my blessings and the many “angels” in my life. In particular, I was grateful for my friend Barb. She had been to visit me every day since I was admitted to the hospital. I had seen a priest and accepted the last rites. I had informed my family that I had a Do Not Resuscitate order in place in the event that my heart stopped during surgery. I was certain that there was an afterlife, but afraid that if I were to die my mother would never get over it. She had already buried my father and her parents. Her sister had recurrent breast cancer. I was grateful that my sister and brother had flown in to support our mom during my hospitalization.

The emptying of my intestines prior to surgery began after lunch and continued throughout the night. I felt certain I watched my life pass before my eyes with every flush. The fact that the nursing staff would not allow me to walk to the bathroom without assistance meant that someone observed every painful moment. In the hour before surgery I started to bleed yet again. Bright red blood spread across the sheets of my hospital bed like evidence at a crime scene.

An orderly wheeled me to the OR. I was frightened, but there was no alternative to surgery. This was cancer. It was unpredictable. It was dangerous. At that moment it held the surgeon’s knife at my throat. I had to go on with the operation or (I imagined) face what could be a painful death. I was tired of the uncontrolled hemorrhaging that I had been experiencing, particularly the hemorrhaging that had brought me to a doctor’s office earlier in the week. I had to undergo the surgery.

The OR staging area was lit with natural light. My three surgeons, dressed in pristine scrubs, sat in a row with their smart phones out. In the corner, a group of young orthopedic surgeons boasted about procedures they had recently seen. They were somewhat cocky, somewhat vulgar. I was glad to have the classier team waiting for me to be prepped for surgery.

The anesthesiologist came from an Eastern European country. She was dissatisfied with everything about me. “Do you have sleep apnea?” she asked. I shook my head. “Because if you do, then your heart could stop when the surgeon lowers your head and raises your lower limbs.”

She studied my arms which were bruised and swollen from transfusions, I.V.s, blood tests, and constant squeezing from a blood pressure cuff. “You are a hard stick,” she accused. “We will have to keep your arm straight out to one side during surgery,” she complained.

She found a place to lodge a port for her medications. I could feel the invasion to the base of my teeth. She tipped my head below my shoulders, asked me to open my mouth, and studied my throat for signs of a blocked airway. Yet another test passed. It appeared that my only “complaints” were slightly elevated blood pressure, slightly elevated triglycerides, and uterine cancer.

A surgical nurse asked me to tell her my name and my birthdate. She checked each of the products that had been ordered for me: antibiotics, anesthesia, blood, and painkillers.

Moments later I was moved to the OR. Surgeons and anesthesiologists gathered around me. The attending anesthesiologist introduced himself. I could not recall a time in my life when doctors had ever been so polite while maintaining so much emotional distance. I had not shaken so many hands in twenty or more years of practicing law. We all knew each others’ names, but very little else about each other. Yet I trusted them with my life. I have never had to trust anyone as much as I had to trust them.

The attending anesthesiologist started the medicine flowing. My eyes closed instantly and I entered into my first sound sleep since having been admitted to the hospital. It was nothing like falling asleep. There was no counting back from 100. There was a moment of clarity and then dreamless darkness.

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