Mauled by a Student Nurse



Alert readers will recall that Cancer Bitch has a rare blood disease that borders on cancer. It becomes cancer when plaintiffs' lawyers go after the people who allegedly caused it in their clients. Otherwise it's pre-cancerous. It appears mostly in men over 60, so she doesn't know what she did to get it, besides having a certain JAK2 gene mutation. The condition is called polycythemia vera and those that have it have too many platelets and red blood cells. One of the symptoms of the disease is itchy skin, especially after a hot shower.

Cancer Bitch has not taken a hot shower in years because of this. She has taken very quick warm showers and jump-in-jump-out baths because she wants to avoid hot water. In the past few weeks, she's been itchy all the time, and it ranges from regular old dry itchy skin to just-like-the-time-she-kneeled-on-the-ant-hill: itchy and painful pins and needles. It seemed for a while that benedryl could tackle the itch, but then it seemed it could not. Friday she itched and scratched during dinner. Saturday she was itchy and uncomfortable and on the way home from grading papers, she whimpered and cried in the privacy of her car. She couldn't tell if she was weeping because her skin hurt so much and she felt feverish, or because she felt, It will always be thus, why do I deserve this? She never asked, Y Me? about the cancer, but she was asking it about PV. She could understand how Spalding Gray killed himself because he couldn't relieve physical pain. She didn't know, either if she was scared and panicky because she'd run out of Effexor for a day and half, and didn't know what is fear caused by pain and what is fear caused by fear of pain.

She stopped at the drug store to pick up the Effexor and she asked the pharmacist if there was anything stronger than OTC cortisone cream. The pharmacist said her doctor could prescribe cortisone. And Cancer Bitch thought how terrible and impossible it would be to take cortisone for the rest of her life; it would dissolve her bones and maybe make her crazy, out of one's tree, as Stanley Elkin once put it.
She became Scarlett O'Hara asking, What is to become of us?, us being herself and her rare blood condition.

It was early evening and she was still weepy when she arrived home and her husband L said Why not call your hematologist? She was too choked up to do it so he called and left a message with a real live person to leave a message with the hematologist on call. Soon a hematology Fellow called the Cancer Bitch residence and said, Your itchiness may be due to a higher platelet count, so before I prescribe something you should go to the ER and get your blood count. So that is why Cancer Bitch and consort spent four-and-a-half hours in the Fancy ER. During which time a student nurse chased after a vein in the crook in Cancer Bitch's elbow, digging into it, really, and that is why Cancer Bitch yelled out, Shit, shit! when she has never before cursed or yelled out anything during any procedure ever before involving a needle in pursuit of a vein. L said that she would have a bruise the next day, and it was so: it's fuchsia and about three inches across and one inch high.

The blood was drawn and then it was examined and then it was told to Cancer Bitch that her platelet count was high, and then the ER doctor prescribed a lovely drug called Atarax, which STOPS THE ITCHING.

The question is, Why didn't Cancer Bitch's hematologist recommend this before? She will find out Wednesday, at her next appointment.

Meanwhile, Tuesday she is getting her womb opened up slightly so the gyne can examine her cervical cells to see if the abnormal cells she gathered for a biopsy are widespread and to see if there's a polyp still hiding in there. When the doctor described the procedure to her Monday, Cancer Bitch said, Is it a D & C? and the doctor said Yes, it's a D & C. D & C always sounded so mysterious, as if it were a cover-up for an abortion. It does take place sometimes after an abortion. But not in this case. In this case the doctor is probing for secrets of the womb, wanting to know if any cells have started down the road to becoming cancerous. Cervical cancer, we read, is slow-growing and it's one of the easiest cancers to treat. Taking tamoxifen can lead to cervical cancer, which is why the Cancer Bitch and her doctor are so wary.

Then Wednesday is the appointment with the hematologist who wants to put her on a pill that could eventually lead to leukemia, just like the condition itself, polycythemia vera, might.

Might might might. May. Quien sabe?

Media coverage in two time zones




Cancer Bitch has been in the news lately:

Grand Rapids Press, March 15, 2009

Time Out Chicago, March 19-25, 2009

Good-bye, Grand Rapids


Cancer Bitch has returned from Grand Rapids, the town where Gerald Ford is still a hero. She had many adventures there. Among them:
She found that her friend B, who invited her to Aquinas College (after she asked him to), is more nature-phobic than she is. She did not know that that was possible. She is a Fresh Air Fiend in comparison. Unlike B, she can identify common flowers and and likes bugs and worms. She especially likes to watch the beetle family. B does not. He considers nature to be dangerous partly because there are bugs. She became self-conscious about pointing out flora and fauna to B because she thought that he would think that she did not deserve her nature-fearing credentials. Cancer Bitch is mostly afraid of nature because it gives her asthma. Also, it bores her and makes her feel empty and that the universe has no meaning.
B and Cancer Bitch, therefore, walked around looking at Italianate and Romanesque buildings downtown. They also visited the outside of the only Frank Lloyd Wright building in GR. It is owned by Steelcase, one of the furniture manufacturers in town. Herman Miller is HQed there, which explains the Aeron chairs in the Writing Department meeting room at Grand Valley State University. Wright built the house for Meyer May. Cancer Bitch read the historic marker in front of the house: This house was built in 1908-1909 for local clothier Meyer S. May and his wife, Sophie Amberg. Frank Lloyd Wright designed the house in the Prairie style. It was his first major commission in Michigan. May was the son of Abraham May, founder of A. May and Sons clothing store. In 1906, Meyer became president of the store, which was the first in the nation to display clothes on Batts hangers. Meyer May lived here until his death in 1936. The house was used as a private residence until 1985. In 1986, Steelcase Incorporated began the complete restoration of the house, its interior and grounds. Meyer. Bing. Amberg. Bing bing. Son of Abraham. Bing bing. Clothier. Bing bing bing. Sophie. Bing. Her Jew-dar had sprung into action. She wanted to mention this to B but she was embarrassed at how Jew-centric she is. Though on GR campuses there seemed to be a dearth of Jews, so that being Jewish was odd enough to make Jews an *interesting, exotic* minority. As a Jewish student told her: I don't want to be exotic.
The question is, of course, what are Batts hangers and why are they important enough to be mentioned in a historical marker? And a corollary: Was May so unremarkable that his second most famous purchase was hangers for his store?
Batts, Inc., in Zeeland, MI, made wooden hangers until that division was bought out in 1999. So May bought local.

Coattails


I have been trying to figure out for the last week and half why we want to get our pictures taken with the famous. We're projecting a false image to the world; this is a person we got to stand next to us for a millisecond and he already forgot who were were before the flash went off.

My friend M says it has to do with power. He has an ex-alderman friend whose office was littered with pictures of him next to Democratic luminaries. My little cousin M has a picture of himself and Obama from an early fundraiser. We went to a dinner honoring longtime activist Quentin Young on his 85th birthday. L's labor union bought a table and it was right next to the luminary table: Quentin, Gov. Pat Quinn, Congressmen Danny Davis and John Conyers. At one point I said to my photographer friend M: Take a picture of me with the governor.

Why did I want that? My immediate reason was to send a picture to my mother to impress her: I'm in the same place at the same time as someone you've seen on TV. Therefore.... It's the therefore that keeps tripping me up. Am I therefore important? Noteworthy? Immortal? In the know?

As it turned out, Quinn left right before dessert, so M couldn't take his picture. A few days later we had dinner with the Youngs at Greek Islands and ran into the governor again. We shook hands.

That's what politicans do; they shake hands and kiss babies. The are ingratiating. They reach out. They press the flesh. It's as if they have to touch their constituents to assure one another that they're real. I am somebody because I got my picture taken with somebody. I am a traveler because I got my picture taken in front of the Eiffel Tower/Notre Dame/Leaning Tower of Pisa/Mt. Rushmore. In that case we may be creating proof: I was there. And we're creating a memento. But deep down, are we also hoping that some of the celebrity of the Grand Canyon or Hollywood Hills will rub off on us? Syllogism: Mount Vernon is important. I was at Mount Vernon, therefore I am important.

If I had a picture of myself with Obama, I would be saying: I agree with him. I endorse him. We approve of one another. We're a mutual admiration society. Or: he approves of me. The leader of the free world is on my wavelength. We were in the same space at the same time. We connected.

There seems to be something so pathetic about this. We did not really connect. We do not know one another. We don't toss around political notions. He took a picture with a voter, that's what politicians do. All a photo with Obama would prove is that we wanted to have a photo taken with him.

The picture above is of an Illinois Congressional candidate named John Laesch, who sought and obtained Quinn's endorsement when Quinn was merely lieutenant governor. Noam Chomsky also endorsed him, though they weren't shot side by side. But Laesch and Quinn are on the same plane, the same page, in the same room at the same time. A visual is quickest in conveying a message. Pat approves of John. The associative principle: If you like Pat, you'll like John. More people recognize Pat, therefore it's good for him to appear with lesser-knowns because that raises their cache. He can do that for them. The familiar next to the unfamiliar.

Can I taste your fame? Can I take it? You're not using it all right now.

***
L said the other night, Pat Quinn is such a decent guy. They're going to crush him.

Grand Rapids, the West Coast of Michigan


(The photo to the left is not from Grand Rapids.)

I am in Grand Rapids, home of the Gerald Ford airport, which doesn't bother me half as much as the George H. W. Bush airport in Houston. I came by car with my student A, who is an alum of Grand Valley State University, and will be reading along with me there Tuesday night. If you are ever in Grand Rapids, you must go to downtown because there are lovely, pleasing brick 19th- and 20th-century buildings. That is, you must go downtown if you like old buildings. There are a number of "ghosts," those faint vestiges of painted advertisements on old buildings.

We went to dinner at San Chez Bistro and Cafe, a tapas restaurant (which brought tapas to Western Michigan) that has tall indoor columns covered with mosaics. They were done by Jose Narezo, a local artist who exhibited internationally. He died in December.

Cancer.

His paintings are all around the restaurant too.

But it is the mosaics, or *are* the mosaics that I wanted to stay and stay and look at. We went to Chartres some years ago and the cathedral was nice and everything, and the famous British guy gave the tour, and the stained glass was impressive, though I wished I'd had binoculars, and L was enchanted, but then we took a city bus to Maison Picassiette, and that thrilled me utterly. I remember the whoosh of happiness I felt just being there.


The man covered every surface of his house and property with pieces of tile and glass:

If I'd found good pictures of Narezo's columns, I would have posted them here.

If I'd found good pictures of downtown historic buildings in GR, I would have posted them here.

At GVSU, students are protesting police brutality after a sheriff's deputy shot a GVSU student in the chest while they were about to execute a search warrant. The student is hospitalized.

In Line


(On Line, for you East Coasters.)

I stopped at the Large Pharmacy to pick up two prescriptions before I leave town on Monday for the first stop, Grand Rapids, on Cancer Bitch's World Tour. I was in a hurry and there were three people in front of me. I arrived at the end of the line from the left while someone else arrived from the right. She was gracious and said I could go first. Since people were coming over in about 20 minutes, I accepted. She and her friend were talking about the grandfather of one of them. He's 88, widowed and went to a dance place. The announcer welcomed him, and two women asked him to dance. He took both of them out to dinner. His social life is better than mine, said the one who was his granddaughter. He and his wife had been in the competitive square dance circuit.

In elementary school was had square dance lessons every Friday in something called Rhythms for some reason. I remember the boys' sweaty palms and them holding on too tightly and jerking or pushing with their arms. I recall that we had a dance when we finished sixth grade and some kids didn't participate because they were Baptist. They couldn't play cards, either.

I paid a king's ransom for Wellbutrin XL because the insurance company hasn't accepted that the generic doesn't work. Believe me, it doesn't. My autumn was quite autumnal because of this.

Grand Rapids is known for Gerald Ford and Amway. I will be staying in the Amway Grand Plaza Hotel for two nights. On the third I get to stay in an old house that used to be a college president's residence.

The photo above is of the groundbreaking for the building where I'll be reading on Thursday.

**
I am up at this ungodly hour because I have been wrassling with the ungodly National Endowment for the Arts fellowship application. It was designed to frustrate the prose writers of America and lead us further into despair. You have to submit the application online unless you can prove you live 30 miles away from internet service. Thus the application instructions contain such gems as this: "If it appears that your submission is not being successfully transmitted to Grants.gov (e.g., you do not receive a confirmation screen), it is possible that your application actually was submitted.... An application may not be submitted successfully for a number of reasons, such as heavy usage on the Grants.gov system or security settings on your computer or your firewall." The government is trying to make the writers of this country go stark raving mad.

Local public service announcements


Saturday, March 14, Loyola Water Tower Campus: Ethical Journalism in a Digital World, brought to you by the Chicago Headline Club and Poynter Institute. $5 for students and $25 for nonmembers. All details here.

Golan’s Moving and Storage Inc. will pick up your cell phones, printers, cartridges, scanners, hard drives, and old light bulbs for free and bring them to the City of Chicago Computer Recycling Facility during the weeks of March 23rd and April 20th.
No TVS, a/cs, dehumidifiers. No more than 5 items will be picked up from a single location Cook County only. To set this up, email recycle@golansmoving.com.

Inspired by Thoreau (above), my former student Steve Jordan has led some students at Mundelein High School on a quest for voluntary simplicity. Use the internet to see them on TV talking about plans to give up the internet.

Anne Basye, another former student, has published a journal about her similar quest.

Good news about ovarian cancer?



A study shows that the CA-125 blood test and ultrasounds can help diagnose ovarian cancer in post-menopausal (which is the same as menopausal) women before it has metastasized. Ovarian cancer, you may recall, is what Gilda Radner died of. It's called the whisper disease because the symptoms are so subtle: bloating, pelvic or abdominal pain, feeling full quickly, frequent urination.

The study isn't final and there's a caveat: However, the results so far leave two major issues unsettled: what the ideal method of screening is and whether finding ovarian cancer early will actually help women live longer,Katherine Hobson reports in the US News & World Report.

Women who have an average risk of getting ovarian cancer don't need to be tested, according to the American Cancer Society.

I read Gilda Radner's memoir almost 20 years ago and I remember how painful it was to read her blaming herself for the cancer--having to do with an eating disorder, I think. For all we know, she could have had a gene mutation that led to the cancer. I hate blaming the victim. For example, I read that stress and "low social support" can help ovarian and other cancers along. A study shows this. What is stress? It's the release of norepinephrine and epinephrine. Stress can be measured. The effect of stress hormones on cancer cells can be measured. I do not like this. I've been trying to remain calm for the last two weeks. I say to myself, I am calm. It works some of the time. But I get agitated easily. When I got my last mammogram, in January, I was in a waiting room for women who had had breast cancer. One woman who was my age, thin and Romanian with designer eyeglasses, said that after breast cancer she had changed her whole life--eating better, eliminating stress. Cancer as a wakeup call: You must change your life, as Rilke told us in another setting. In a museum, upon seeing a torso of Apollo. Changing is the most difficult thing a person can do. I eat more vegetables, I think; that's how I explain my lowered cholesterol. I want to be a morning person. I want not to have things bother me. I want to be calm and relaxed without taking my assortment of pills: Effexor, Buspar (generic), Wellbutrin XL. I want my asthma to go away. Yoga has helped people with asthma, my now-retired yoga teacher J used to say but I don't feel that it's changed mine much. I've been at it for maybe eight years. I want to get up with the sun and exercise every day. I want to not do things at the last minute. I want to clean my desk. I want to be organized. I want to live a long time.

The young Rilke, we are told, had writer's block, and was counseled by the much-older Rodin to go to the Paris zoo and look "until you capture the essence of the animal." Rodin's motto: travailler, toujours travailler. Work, always work. Work will save you. (That comes perilously close to Arbeit macht frei.)

We have lost much of the physicality associated with writing. Everyone sits at a computer now, not just the writer. There are no quills, no sand (to help dry the ink), no inkwells, no blotting paper, no typewriting that must be stopped at a certain hour so it won't disturb the neighboring tenants. Technology is changing, always changing, and we keep up with it or not. I want to stop it. I want to burn all the Kindles and iPods and iPhones because I don't understand them. Stop them all, like Faust wanting to burn his books. But we've come too far.

Faust doesn't look so happy:

Results


hysteroscopy photos, San Francisco Women's Healthcare, Inc.

So I called the doctor again and left a plaintive message with the assistant, saying I didn't know if I had cancer and would like to know before the weekend. The doctor called back and said the pathologist was gone on Thursday and so that's why she didn't call me. She found evidence of a uterine polyp that she wants to remove and she found cells in the cervix that were dysplasic. Dysplasia is pre-cancerous, but there are several steps, she said, between dysplasia and cancer. (See http://www.womenshealthchannel.com/cervicaldysplasia/index.shtml) There were just two minute clusters of abnormal cells, she said. The thing to do about dysplasia, she said, is to keep monitoring the cells.

Thus, she will do a Pap smear soon to check out the cervical cells. Then she will go on a mission to find the rest of the polyp, via uterine hysteroscopy . That takes place in the hospital, under sedation, but I will be awake and can watch the procedure on a screen, which is very interesting she said.

Which makes me think we should re-examine the term "navel gazer." I suppose that's as far inward as men could imagine looking at themselves.

(And so it has come to this, toward the end of the first decade of the 21st century, where we write about our dysplasia for all the world to see.)


severe dysplasia, not mine

The Unringing Phone


They say they're going to call, in a week, on Thursday. So on Thursday you wait. You don't have to wait at home anymore like people did for most of the 20th century, you take your cell with you and take your waiting with you. On Thursday afternoon you leave a message with a machine. Then you leave a message with a person. Then it's Friday and you call again and leave a message with a person. The weekend is coming up, after all.

The new gyne sounded so sincere when she said she'd call. Today's first message-taker said she'd seen my file on the doctor's desk. The next message-taker said she'd give the doctor a message to call me. And, of course, only the doctor is allowed to tell the patient the biopsy results.

If she'd not going to call me, why doesn't she delegate?

Maybe by not calling she thinks she's conveying the message that the biopsy showed nothing, just as she figured. Up until Thursday I wasn't anxious to hear. Because I knew she would call on Thursday.

Her office closes in 45 minutes.

On the other other hand...

...the blood test showed that my cholesterol is a slender 133, down about 50 points from last year. I have been eating more vegetables, but still I was surprised. And after being surprised, I became quite quite proud of the number. I'm working it in to as many conversations as I can: O, the percentage of voters who turned out in yesterday's special Congressional election? Speaking of numbers, did you know that my cholesterol is...


And I got a good review from Bookslut, which called my book "far more selfless than most illness memoirs. Its eyes rove outward more than almost anything else I’ve read in the genre.... It is a sort of black planet she flies over like a pilot, unable to reach down but guided by small, scattered tribal fires of compassion.... The book is funny, damned funny. Much more Rabelais and Woody Allen than Homer." (See the rest of Richard Wirick's review at: http://www.bookslut.com/nonfiction/2009_02_014148.php

Again, the link function isn't working so well on this here blogger thing.


And my candidate and friend, Tom Geoghegan, referred to once or twice in this blog as T, one of the intellectuals who not only subscribes to but also reads The New York Review of Books, did not win the Democratic primary yesterday, for Rahm Emanuel's vacated seat.

Despite my cavassing of strangers and haranguing of friends. I guess Washington's not ready for another smart, skinny, book-writing Harvard lawyer from Chicago. And I guess it's back to the margins for me: Obama was the first candidate I ever worked for who actually WON. I thought maybe that meant that the mainstream had moved over to my way of thinking. Guess not.

More from the Annals of Polycythemia Vera


L's office brings in people to test our blood every year in a "wellness screening." I have polycythemia vera, that in layman's terms means I have too many platelets. (I want to link to earlier posts about PV but the linker isn't working. See 2/20/08, 3/9/08, 6/2/08, 2/1/09.) I sent my results to my hematologist yesterday and today she said that since my platelet counts are still high, despite my therapeutic phlebotomies (I go to the blood bank and they remove a pint and throw it away) that she wants to talk about prescribing hydroxyurea to lower the count. Wikipedia tells us that it's "used in hematological malignancies, specifically polycythemia vera and essential thrombocytosis." Whether my PV is cancer or not depends on whom you talk to. The delightful thing about hydroxyurea is that it prevents leukemia and also can cause it. It gets you coming and going. Side effects include "drowsiness, nausea, vomiting and diarrhea, constipation, mucositis, anorexia, stomatitis, bone marrow toxicity (which may take 7-21 days to recover after the drug has been discontinued), alopecia (hair loss), skin changes, abnormal liver enzymes, creatinine and blood urea nitrogen." For the moment I'm not upset, just scared about adding this new drug to my large bouquet of strong medicines. Will I have to take more drugs to combat the side effects of hydroxyurea?

The FDA tells us that the drug is good for ovarian cancer. I wonder if you can use it pre-emptively. Would that be the silver lining in this cloud? Likewise, what if people took chemo and they didn't have cancer? I suppose the chemo would kill off any cancer cells swimming below the radar. But it wouldn't keep you from getting cancer later.

Mayo tells us we should wear disposable gloves when handling the tablet or capsule. After all, this is a substance that can turn your nails black, cause hallucinations, and as I said, bring on leukemia--even years after you've stopped taking the medicine. It can lower your white blood cell count, so make you more susceptible to infection.

On the other hand, it can cause weight loss.

The thing about polycythemia vera, or at least my version of it, is that the symptoms are ridiculous. I have tiny red dots on my skin and I get very itchy from being in hot water or even from the deep massage I'm getting for my Achilles tendonitis or even just out of the blue. It also gives me red cheeks so I look robust and healthy, like I've spent all day skating around the frozen-over dikes with Hans Brinker.

I felt fine before I was diagnosed with cancer two years ago, and I feel fine now and I keep thinking of Ann Patchett's book, Truth & Beauty, where she quotes Lucy Greely saying that her cancer made her feel special. It's ridiculous now to feel special when one out of every eight or nine US women has a breast malignancy. But there's this Thanatos-loving part of me, or melodrama-loving part, that feels sort of hopeful about the possible endometrial cancer. And I don't mean hopeful as in, It's probably nothing. It's like this dark hopefulness, like an attraction to the edge of a chasm. As in, O, I'm even more special because I might have a different kind of cancer.

What kind of person thinks this? Do I feel another cancer is inevitable, so that it's a relief when I think of finally being hit by a second one? Then I don't have to worry about the second hit. If you're dying, you don't have to worry about dying, because you're already doing it. When I was younger I felt so guilty for being alive because I knew that if I didn't have asthma medicine I would be a goner. And I knew I was privileged to have the asthma medicine, and later a breathing machine, because there were people everywhere who weren't getting care. And maybe they were dying and maybe not, and it seemed like my real fate was to die. To be dead. (This is why I've been in therapy since the Nixon administration.) It helped that my parents paid for a machine like mine that they donated to the hospital. I went to summer camp for three years and hated it because I couldn't breathe but I didn't tell my parents, I think because I didn't want to disappoint them. There was something deeply wrong with me, I couldn't exist with and in Nature, even though it should have been... so natural. Nature could kill me, and now my own nature, my blood, has turned against me. Has thickened against itself.

We are finite beings. Is that so hard to fathom? Yes. Because we have been here our whole lives. The world could not have existed before we were born.