Back in the Mammo Again

Yesterday I went for my annual mammogram and my semi-annual appointment with the surgeon. The mammo technician was on a word diet, I believe. I think she had only a certain number of words to use that day. She called me by last name, and issued me curt instructions s about where to stand and when to breathe and when to not-breathe. The plates really hurt my breast, but I didn't mind. The machines at the Mammogram Factory, where I used to go, didn't hurt my breasts much, and also didn't reveal my cancer until it had reached stage 2. I asked to have a radiologist and not a fellow talk to me about the results. I got a middle-aged woman I'd never seen before. She explained that I had calcifications and they'd been benign in the past, and hadn't changed much, and were probably benign. But she recommended I have another mammo in six months. I told her that when I was first diagnosed, I had a bad experience with the fellow, who hadn't called me when she said she would, and then when she did call, just said, It's positive, and seemed very cold. The radiologist looked in her records to see who that fellow was, said she was now out of state, and that she was sorry. She added that some patients might not even know what positive meant, they might have thought that it meant good news. She said she didn't like having people receive the news over the phone because you don't know where they are, and that it's really bad when you give the news to an elderly woman who's alone. I asked what training the fellows get, and said that they should get better training, and she said the best thing is to give feedback, that's the only way they know if anything's wrong. I guess I should have said something at the time, but there was so much else going on. I was still teary about this. I hated that cold blonde fellow.

And I know that she was nervous, and aloof-seeming because she was nervous, and also seemed defensive, because she wanted to prove she was a Real Doctor while the patients were thinking she wasn't real and bona fide yet. And maybe it didn't help that she was pretty and blonde and maybe all her life had been trying to convince people that she really was smart. I think now I would be able to tell people they had cancer, but I wouldn't have been able to when I was younger. Why should some 25-year-old know how to do it? I think the radiologists make the fellows do it because they don't want to. At a conference in Iowa this spring I heard a med student (widow of a man who died of cancer in his 20s) talk about how her fellow med students would giggle when they were role-playing delivering bad news. And she didn't want to chide them and tell them that it wasn't a laughing matter, she just let it go. I think the radiologists need to train the fellows how to talk to patients. What makes this tricky is that you have to be secure if you're going to address the patient without pretense, and the teaching docs can't teach security, they can only encourage it. If you're secure then you don't have to be absorbed in proving your expertise. You can pay attention to the needs of your patient.

I do want to find out how they're trained to tell patients they have cancer. There's is a humanities center connected with Fancy Hospital, and I know it's well-regarded, but I haven't met any of the people there. I shall.

The House

The house is three blocks west and one block north of my condo. It is more than 100 years old. It has original (we think) trim and floors. There is a French man living there right now. He has two children who are in France with their grandparents for the summer. His wife is already working in Manhattan. (Today I just heard about someone in Manhattan so rich that he has a back yard.) The house was on the market since October and sixty people walked through before we made an offer. Four people lived in a space that we will occupy. Though we want it to accommodate guests, including L's two children and their entourages. The For Sale sign out front still doesn't say "under contract." Our walk-through is Monday morning and then noon is the closing and then we run back to weed and pull down ivy. I picture us running through the empty house, too, shouting, It's ours! It's ours!

Property is theft, my friend D reminds me.

But from whom? From the great C0mmon Good? On the one hand, it is preposterous to think of "owning" anything, since we're going to die. But on the other hand, can everything be shared? Theoretically, yes. My friend R used to live in a commune in Germany. You would sleep in whatever bed was available at night and take whatever clothing fit the next morning. If you don't have all your things with you, if you don't have things, then you're not carrying your history around with you, at least on the outside. You're not dragging around your heirlooms and inheritances. Your DNA does that quite well enough on its own. We are supposed to buy and buy, first because of Sept. 11, and now, to stimulate the sluggish economy. To own more and more. The more each person has, the more there is to separate one person from another, to divide us as we individuate by our possessions. The more there is to use to build walls around each of us, to label everything, Mine mine mine.

The Mad Weeder Strikes Again

I was indifferent to gardens in my 20s and 30s. I started appreciating them in my 40s. L loves wildflowers and wildflower walks and he has a front yard with columbine (including a hybrid created by his aunt), hens and chicks from his mother's Downstate yard, irises, poppies from his mother, hibiscus, ajuga groundcover, lilies of the valley (see photo at right), vinca and other plants I'm forgetting. In back he has cacti, false Solomon's seal, asparagus, chives, green onions, yucca, day lilies and gingham girls. He has lilac, honeysuckle and forsythia bushes. All this he will leave when he sells his house this or next year, though he will dig up some of the plants for our new place. We started taking rocks from his front yard to put in our yard. We put them in the trunk of his car and then when we got here we weren't sure what to do with them. I would've just let them sit in the trunk for the next week (We close on the house--see photo--June 30). But he didn't want to drive around with rocks in his trunk. So we put them in my storage area.

This morning I went to Michael McColly's yoga class. I recommend it. What's good is the he talks about breathing and clearing your mind and paying attention to your body. It was odd, though, to be taking a class from someone I know, and to have his familiar voice telling us what to do with our bodies and breathing. My mind buzzed around, as always. The only time I've ever been about to truly concentrate and focus is when I took yoga at the Alliance Francaise. When the teaching was in French, I had to really listen. Alas, the class wasn't always in French. The teacher would let in people who barely knew how to say Bonjour, and then she'd repeat everything in English. That's why I no longer take yoga at the Alliance. When it was an all-French experience, it was like being in a trance, wrapped in a haze of foreign language, and the haze made it feel like you were in a different place.

The yoga room was warm, because for some inexplicable reason, the heat had gone on earlier. I was hot and slightly dizzy. Perhaps the dizziness is caused by gabapentin, which I'm taking to help with the hot flashes. So what should I take for the dizziness?

Yesterday L and I bought flowers in Indiana and today I planted them in two big pots out front. We decided to put them in pots so people wouldn't trample them. Someone walked on some columbine (brought from his yard to mine) and killed it recently. Now I'm afraid that people will pick the flowers because they don't have to bend down to touch them. We shall see. We have cosmos in the middle, and around them I put snapdragons, begonias, and something that looks like impatiens but isn't. At the checkout counter yesterday I noticed special pink garden gloves for sale. With each sale, money goes to Susan G. Komen [foundation] for the Cure--at least $100,000. Both L and I looked at the gloves disparagingly, though I have to admit that $100,000 going to the Komen foundation is better than zero dollars going to the Komen foundation. But I'd rather have $100K going for research on the causes of cancer.

After yoga I walked along Broadway, where there were huge round planters holding flowers in various stages of health. Some pansies were dried up. There were weeds in all the planters and as I walked along on my way to Metropolis Coffee Company and back, I pulled weeds. I love to pull weeds. I love when all their roots (see dandelion taproot on left) come up, clean, like a thorn pulled out of a paw. It is so satisfying. Once last year I had a computer mishap and I was so upset I went in the front yard and pulled weeds. It helped. I used to squeeze the blackheads on my father's back and carefully put them on Kleenex so he could see them, dark on one end and light on the other. That was satisfying, too. You'd think I'd love to clean and would be obsessive about it, but I'm not.

As soon as we close on the house, we're going to hurry to it and start yanking out weeds and pulling off the ivy from the sides. We've already surreptitiously pulled a few lamb's quarters from around the tree in front.

Dem Bones

Today I went to Fancy Hospital to get a baseline of my bone density. I wanted to see if I have the beginnings of osteoporosis, which stooped my grandmother and has shrunk my mother a little. I am post-menopausal, which is when you start losing density. (Cancer led to chemo, which caused early menopause, which can be bad for your bones, and cancer also led to the prescribing of tamoxifen, which, praise be, seems to be good for your bones.) L asked what the difference is between post-menopausal and plain menopausal. I asked that of R, the New Oncologist's physician's assistant, and she said--they're the same thing.

So I'm in menopause and also past it. Time warps.

The woman who scanned me was bright and cheery and had a hardcover copy of The Audacity of Hope in her little scanning room. (This election is the best soap opera ever, she said. Nothing's been watched as closely on TV except Roots.) She said the scan was the easiest test I'd ever take. All I had to do was lie down and let the scan scan me. This scanner-person used to do mammography, which she liked, except when adult children brought in their 95-year-old mothers who didn't know what was going on, and thus would start screaming when their breasts were smooshed between the plates. She said in this job, where people don't disrobe or store their accessories anywhere, she's encountered little old ladies with wads of cash stored in their bosoms and guns stashed in their pockets. (One gun per lady.) They don't believe in banks or credit cards and say they're not going to be victims, she said.

My mother believes in banks and credit cards, though not ATM machines. She has never carried a gun, though in Texas, you can carry concealed weapons if you have a license. (You can buy a semi-automatic assault weapon without a license.). She exercises with a group of other ladies in her building, and they use free weights. She also walks in the nearby shopping mall on a longstanding route that's about two miles long. She calls her exercise class her medicine that's not in a bottle.

Today I didn't go to the little park district gym, so I walked home from Fancy Hospital, which I think is about five miles. I window-shopped and stopped a few times. It was easy and the weather was perfect, about 70, and I stopped for vegetarian empanadas for tomorrow and I ran into a student I'd been thinking of checking in with about a class she's teaching. I also saw two attractive beagles and a very shiny black short-haired dachshund, so it was quite satisfying.

I have told L that when I die I'll come back as a dachshund, and he'll have to ask, Is that you, S? and I'll say yes by barking three times. I drill him on this every so often. We haven't figured out what he'll do next. He's allergic to dander.

The Non-Anxiety Dream

I know it's boring to hear other people's dreams, but wait. For years and years I've had anxiety dreams about going back to the Miami Herald and not knowing what to do: I don't have a place to sit, I don't know what department I'm in and I can't get the hang of putting a story together. Last night I had a non-anxiety dream about being back at the Herald, and in the dream I thought, This is different from my dreams. I was going to write about Miamians who were nostalgic for the town before it became hip. I was thinking of calling the phenomenon "Miami Blight"; it sounded almost right since the reinvigorating of Miami started with Miami Vice, which city fathers were skittish and worried about allowing to be filmed in their fair city.

The editors (in the dream) said they needed more on Broward and Palm Beach counties. I remember my first few days there (in real life), in 1983, when the features editor said, Just drive around and I did, all over, and I got the idea for my first story on South Beach, which was full of retired needle-trade workers sitting on porches in their rocking chairs. I wrote about old feet. I spent time observing in a podiatrist's office. The highlight was an old Italian lady who came in, triumphant, showing the doctor her corns, which she'd cut off and put in a plastic bag.

Losing My Mind

Pieces of my mind are loosening, falling. I could not think of the name of my cousin's eldest child tonight. I was emailing all the relatives to see if they wanted the coffee table and a painting that I have that were my grandparents' and I couldn't remember his name. I kept seeing his face. I knew his brothers' names and I couldn't think of his. I looked at the family email address and I could tell that it was based on the three boys' names and that it started with J. I said to L, name some names that start with J and then he did and I remembered. Jonathan. How could I forget?

Yesterday I was telling someone that I was a grandmother, that L's son married a woman with a child, and then I drank with my students (one drink, a black and tan) and three hours later I was about to say to the same person, I'm a grandmother. I thought it to myself, of saying it to her, and then I realized I'd said it earlier. But what if I hadn't realized it?

Today in my writing group we were asking one another questions and I said, No one asked me a question, then T reminded me she had just asked me a question. That's why I was answering it, why I had been talking. How could I forget?

There is chemo brain, it is real, we know because it was in the New York Times. I am too young to be senile. I forget words. I say posy instead of peony because I know the word is there, out there in the world, but I can't think of it. I slow my speech because then I have more time to find the words. I see them up there, ahead in the distance, like my cousin's face. Floating just beyond my reach. How will I be able to teach if I can't find words at the end of the sentence?

I just read the NYT article again and I see that tamoxifen can make it worse. I'm taking fish pills, they're supposed to help. I think about meditation. I think about taking a meditation class. When I was drinking my black and tan I said I had decided to take an improv class but I'd forgotten that I'd decided to and my student (my student who is 20 years younger and who does not have chemo brain) laughed in a bemused way and asked, How can you forget what you decided?

Black Cohosh

is not recommended for people taking Tamoxifen or people who are susceptible to breast cancer. That doesn't sound right. Can you have a tendency toward cancer? Mebbe so. But the physician's asst. who works with the oncologist suggested gabapentin , which seems like the Swiss army knife of prescription drugs: it does everything. Slices, dices, files your fingernails, cures bipolar and epilepsy, alleviates pain, helps with numbness (which is why I'd taken it before, after Taxol), shines your shoes and washes your dishes. Which may be why the company that makes it was sued fby the Dept. of Justice for marketing it as a cure-all. When I took it before, I got cotton mouth, which I don't have. Yet.

I was spooked by the Severe Yoga Incident and didn't go back to the park district on Thursday to work out. I got back on the horse on Friday and went to the park district's dingy little gym and treadmilled and did weights. For a while in autumn an old guy with a foreign accent would sit on the seat of the leg-strengthening machine, reading the Sun-Times and asking what certain words meant. I haven't seen him for a while. A lot of people come in with their Ipods inserted and don't say anything to anybody.

Meanwhile, Iowa is under water. So difficult to believe. And sad.

Zee Blood

I feel I should write about the guy on the L who told me he slept through 9-11 (at his desk, and had to be evacuated by the Illinois secretary of state); and the guy who was offered the job as the head of No Child Left Behind, and refused it, but not before pilfering 100 pages of Cheney's stationery to amuse himself with; and my realization that no one sells bedspreads anymore, just duvets and coverlets and dust ruffles--but what moves me to write is my blood. Which does not move as quickly as it should. It is sluggish. In yoga yesterday after doing a complicated bend up to the side and put your arm through your leg to meet your hand on the other side, we rested. And when I rested I felt that my skin was on fire and had a severe hot flash and I got scared and I felt like crying. I don't know if it was because of the pain or because of the fear. I never know that. I think it was at first because of the pain. I couldn't stay lying down )even as I write that I don't know exactly what I mean, but I know I couldn't) so I sat up and drooped my head and tried to breathe, which was somewhat uncomfortable because my asthma and allergies were acting up. L was supposed to meet me after class and I sat outside on a step waiting, with my head bent over. I called him and he had gone half a mile north by mistake, but I felt I couldn't get up and meet him. I had to keep sitting. Some friends from the class offered to give me a ride, which was very nice. Finally L showed up and we talked then walked to Tac Quick for dinner. I felt somewhat lightheaded and began to feel better.

I had had a big hot flash last week in yoga, but I thought it was bad because I hadn't brought water. This time I had plenty of water during and after class. I emailed my hematologist and called her today and she said she didn't think it was my blood disease, because my blood showed it had thinned out last time it was checked. Today my head feels filled with blood, the way it does after you bend over, and my ears are red. She said I could come in and get my red blood count checked if I didn't feel better. The thing is, the possibility of getting hit by this again feels dangerous, but I asked her, and she said it wasn't. I'm used to, by now, sweating at the drop of a hat, sweating when I do the least bit of exercise, and I don't want my fear to keep me from exercising. Today I've been all teary because I'm afraid. Afraid of what? Afraid of the dizzy and light-headed and on-fire feeling. Afraid of feeling the nest-of-mettles again (O please don't throw me in the briar patch! I mean it!) Afraid of death. Because it seems a precurser to dying. To Death. It felt like death cooled over. A prelude. My father died of an aneurysm that burst while he was shopping for clothes. He had a terrible headache that morning. I don't have a terrible headache. My doctor has told me what a blood clot might feel like. I don't feel that. I'm feeling all the things that everyone expected me to feel when I was diagnosed with breast cancer, but didn't feel. (Just typed "blood cancer" by mistake. Hmm.) I'm feeling, Why me? Why this stupid extra blood-making? And of course it blends into my lifelong asthma, caused in part by exertion. To have something wrong with your blood is to have something wrong with your most vital and essential body-self.

I called the Bouncy Shrink and left a message to see if I could get on Black Cohosh again. It interferes with something else I'm taking, but I'm hoping she can taper me off that and substitute something else.

Bloody Good News

I heard today from the hematologist's physician's assistant (sounds redundant or at least like three people are involved) that my red-blood-cell count is now in normal range, so I don't have to get any more blood siphoned off for a while. I'll need to get my blood checked again at the end of the month. The condition I have is polycythemia vera. The hematologist said it's not from chemo, but who knows? It might be. It's a rare disease and so not studied much. It seems to me that if the chemo drug Adriamycin, which I was given, can lead to leukemia, and that PV can turn into leukemia, then chemo could cause PV. Or is that a logical fallacy?

At the same time I had my blood checked for red blood cells, I got it checked for Vitamin D level. I'd read about a study that links low Vitamin D levels with breast cancer recurrence. The oncologist's physician's assistant said that she was going to the conference where she would hear a presentation by the team from Mt. Sinai Hospital in Toronto that did the study. The tricky thing is that having high levels of D can be harmful, too. As Aristotle said, Everything in moderation.

Is it possible to have excess in moderation?

The odd thing is I'm looking all this up and it doesn't seem connected to me. It feels so abstract. Even the breast cancer feels like it happened to me but at a distance. Does this mean I haven't accepted that I had it? Have I been keeping up a wall of denial all this time? That doesn't seem possible. Or is it that I don't feel sick so I can't believe that cancer is lurking in me?