Where's your wife?

Cancer Bitch recommends that you do not ask this question. She has asked it twice in the last 2 years and it was awkward in the first case. So why did she ask it again? She is a slow learner.

In spring or summer of 2007, she greeted one of her husband's co-workers at a fundraiser by asking where his wife was. He said, I don't know, and Cancer Bitch quickly understood that something was amiss. She asked her husband L, Why didn't you tell me? and he said he'd just found out himself. L is never the bearer of good gossip; he doesn't ask enough questions. The co-worker and wife are still separated.

At the Kol Nidre service at the hippie congregation, the rabbi asked everyone to introduce themselves to their neighbors. The man in front of her turned and they realized they knew one another. One of Cancer Bitch's pre-Prozac boyfriends (read: angst-ridden relationship) was friends with this man, M, and Cancer Bitch would always talk to the wife L when they ran into one another. Cancer Bitch remembered the wife describing how she photocopied her dissertation at her husband's office and sent out copies of the manuscript to agent after agent. Or was it publisher after publisher? And it was published. L sang in Hebrew and Yiddish and had red-frame glasses and a New York accent. Her husband told C Bitch: She passed away. Four months ago.

After services M said that a year ago she'd had a seizure while singing in California and they'd found out that she had lung cancer that had gone to her brain.
She returned early to Chicago so she could sing on Yom Kippur with the hippies. She died at home, her sons sniging to her till the end.

Cncer Bitch had not heard, obviously. The family took out a paid notice in the New York Times, but not in the local papers. There is too much cancer-dying these days. There was L above; and K's wife E, who also had lung cancer; and the wife of another old boyfriend, after five cancer-free years; and her friend P's cousin is dying of ovarian cancer. There are heart problems and neurological damage and it seems that absolutely everyone is getting dental implants. This is middle age and it is only the beginning of the body's decline. Cancer Bitch has finally begun calling herself middle aged. For years and years she'd considered her mother to be middle-aged, but now that her mother is 81, she has to face facts. Sunday in Evanston Cancer Bitch walked past a house on Chicago Avenue north of Dempster and as always, remembered the time in 1980 when she went there to see about renting a room, and the guy there said that a cute Southern girl with a great accent was there first and he couldn't resist. She told this to her husband who said loyally, You were a cute Southern girl. She thinks about the Southern girl every time she passes the house but Sunday was the first time the memory was accompanied by a strong swoop of sadness: the passage of time. She thought of herself in her early 20s with her whole life ahead of her. The sadness of losing that feeling of potential. She doesn't regret her choices, except her many hours of wasting time, but she is no longer young, no longer just becoming, that's the point. Yeah yeah, there was Grandma Moses who started painting late in life, but there was also Mary McMarthy who told Cancer Bitch (in an interview in Florida) that people in their sixties and older couldn't write novels any more. She was referring to herself.

C Bitch has a novel in a file cabinet in the other room and in her computer and needs to gear gear up to revise and rework it.

The Passive Cancer Patient

She said, Did you ask your oncologist what she thought about the calcifications?
I said, No, I forgot.
Then I thought better of it and thought maybe I had asked. I said, I think I did. I keep forgetting about it.
She said, It seems you either are at zero, not worrying at all, or way up here, thinking about dying. You need to be able to tolerate a 3, to do what you need to do.
She said, It takes energy for you to forget about it, because you're not really forgetting, it's in the back of your mind.
She told me how she went to four doctors who all said she didn't have cancer. The breast surgeon told her she was a hysterical female.
She waited a month or two and finally insisted on surgery and of course it was malignant.
She reported the doctor to the board of whatever, but there were no consequences.
The form the Breast Experts gave me in June and December and in June again said "calcifications that are probably benign." The radiologist in December said I could have an MRI if I wanted but warned me about false positives.
Now, she said cancer begins as calcifications, if it bothers you, you need to do something about it. She said, It's labor-intensive for them to read MRIs, that's why they don't like to do them. And: it's labor-intensive to do a biopsy using ultrasound and they don't make much profit from it. She said Fancy Hospital was on the TV news because they had a backlog of mammogram patients and they didn't have enough radiologists though they promised to get more.
A local TV station reported earlier this month that at Fancy Hospital, women have to wait between 8 months and a year to schedule a mammogram. ABC7 checked with six other hospitals in the area and all were able to schedule a mammogram within a few weeks.
Fancy says that there's a shortage of radiologists.
But it seems to be restricted to only one block in the city.
Calcifications can be malignant--they don't turn malignant, they can begin that way. "Probably benign" can mean that there's an 80-98 percent chance that they're benign. MSN reports: Please note that some specialists may prefer additional testing (breast MRI, biopsy, etc.) while others may be more conservative. A lot has to do with your personal or family breast health history.
I still think the calcifications are not cancerous. But I don't know for sure. I emailed my surgeon's nurse and asked for an MRI. She wrote back today and said that she sent over the order, that I should call the MRI division and make an appointment, that it would take a few days to get precertification, but that insurance might not pay for it.
Because it's elective, I suppose. But it's not like I'm doing it for vanity. And it's odd--usually the doctors prescribe extensive tests to CYA.
There's a blog written by The Assertive Cancer Patient.
This is not that.

Talking to a stone

I am the stone. I've heard over and over that exercise is important in keeping breast cancer from coming back. I even have an exercise book especially for bc survivors. I haven't looked at it for months and months. But I keep getting emails from our rowing coach, J, about exercise and breast cancer and on the ROW website she has links to articles that extoll the value of exercise in keeping metastasis at bay. Finally it sunk in. Monday I went to rowing practice, and Tuesday and tonight I rowed at the YMCA. I also rowed last week. I know I should cross-train but I like doing one thing over and over and over. (That must be why I created a workshop called The Joy, Joy, Joy of Repetition.) Just about everybody there except me has an iPod. I look at the TV when I'm sitting back up and leaning back. I watched part of The Office last night, and when it was over I switched it to the PBS station. Uh oh. PBS didn't have closed captioning. But I was already strapped into the rowing machine so I just watched people's mouths move. They were talking about Milton Bradley, the out-of-control Cub and I could presume what they were saying. I am interested in him because of his name. You know, like the board-game company.
Tonight I watched the Nature Channel on Colony Collapse Disorder. I learned that in Sichuan in China, where a pesticide has wiped out the bee population, people do the pollination. It's very labor-intensive, as you might imagine, and involves sticks with feathers on the ends.

One solution to the disorder is to bring in Africanized bees that are resistant to CCD. But those bees are aggressive and who knows what they might do? or what a hybrid bee would be like?
We should all be as busy as bees, and develop our own waggle dances. Or just pull back and forth, back and forth to get our heart rates up.
Alas, it appears that bees don't listen, either. New research shows that bees observing the dance often ignore it.
I need 150 minutes of exercise a week to be called moderately fit. So far I've had about 75, not counting yoga, and it's only Wednesday.

[The increasingly rare bee suit]

What's on my food?

I found a new-ish (launched this summer) website that tells you what pesticides you're ingesting with each piece of fruit or vegetable. Kind of; it tells you what was on a sampling of foods in 2007, and what damage those pesticides can do. It's part of the Pesticide Action Network. (Oh no, does that mean we gotta do something and not just complain??)


Swedish researchers found that eating foods that were high in acrylamide did not cause breast cancer. To wit: During a mean follow-up of 17.4 years, a total of 2,952 incident cases of breast cancer were diagnosed in the cohort. In multivariate analyses controlling for breast cancer risk factors, no statistically significant association was observed between long-term acrylamide intake (assessed at baseline and in 1997) and the risk of breast cancer, overall or by estrogen receptor (ER) and progesterone receptor (PR) status.
Interestingly, in looking through media reports about acrylamide, I've found many hostile responses in the Comments sections, some calling the info "junk science." How valid are the accusations? Who knows? But it seems that some researchers consider the substance to be a danger.

Hello, Sweet; Good-bye, Crunchy

First the sweet: A pot of bright tomato-red-orange lilies appeared in one of our flower beds yesterday. It seems new, since the tag is still on it, and we plan to plant it. Our across-the-street neighbor denied any knowledge of it. Did someone receive the plant and give it to us because they assumed we'd give it a good home? Someone once told me of a Dutch Jew who had to leave a hiding place (all during the Nazi occupation, but you knew that) and walked through a neighborhood and rang the bell on a stranger's house. The Jew asked the stranger to hide him/her and the stranger did, but asked, Why did you pick my house? The Jewish person said: Because your roses look so well-tended.

There is no real moral to this story because some horrible people have beautiful gardens. But still a nice story.
Then the crunchy; farewell to crunchy, crispy, roasted, well-done, crackly and blackened. I've heard for years about the dangers of charred food. Now here's a new twist, today's Tribune tells us. If you cook high-carbohydrate food at high temperatures, a substance called acrylamide is formed. When rats eat it, they develop tumors and neurological problems. The Swedes have been concerned about this since 2002, when its food administration reported on high levels of acrylamide in high-carb foods, and a link between acrylamide and cancer in lab rats.
The California Office of Environmental Health Hazard Assessment tells us that it's possibly carcinogenic to humans.
The bad news is that you can't just eschew french fries and go about your merry way. According to the Office and the FDA, reports the Trib, of 100,000 people who ingested coffee once every three days in their whole lives, one person would develop cancer from acrylamide. Pie, pizza, breads, popcorn and sweet potatoes are also culprits. So are potato chips.

In 2005, the state of California sued chip makers Heinz, Frito-Lay, Kettle Foods Inc., and Lance Inc. for not having warning labels on their bags. A year ago, the companies settled out of court by paying $3 million in fines. They also pledged to cut down the amount of acrylamide in the next three years.
The Trib advises: Think golden yellow instead of golden brown, pre-sock potatoes in water, don't store them in the fridge, trim bread crusts, toast lightly
, and eat fewer processed foods and a balanced diet with lots of grains and fruits and vegetables.
As always: be a vegan or vegan-ish, avoid processed foods. At least chocolate wasn't on the list.

Eat, drink, be merry and quick & get health insurance

The New York Times reported today on a study by the American Institute for Cancer Research. Conclusion: Women can cut their risk of breast cancer by almost half if they stay lean, exercise at least 30 minutes every day, breast-feed, and limit alcohol to one serving a day.
Not shocking by any means, just common sense, but because this is a study of many studies (about lifestyle), it has numbers behind it. Many numbers. It's the largest study of its type ever conducted, according to the Institute. The AICR's director of research estimates that nearly 40 percent of breast cancer cases could be prevented if women followed this prescription.
In other words, the AICR is blaming the victim. Sorta. It's so much easier to document what a person does than to figure out how exposure to pesticides and pollution contribute to tumors. Which is my theme song. But in the meantime, the AICR recommends a diet of vegetables, fruits, whole grains, beans. There was no mention that I could see of the difference between organic and conventional foodstuffs.
The AICR reported on another study that shows that pessimists and women with "cynical hostility" had a higher incidence of heart disease and cancer, and they died earlier than the optimists. Black women who were hostile were more likely to die of cancer.
I want to make fun of this report because I have a lot invested in pessimism. I also want to point out that there's a difference between hostility and negativity and I think cynicism can be a sign of intelligence. It can also be a sign of stupidity and paranoia.
How did the researchers spot the cynics? Besides hearing their frequent snorts of derision, the researchers "administered" a questionnaire, which I think means they read statements to the women and asked if they agreed or disagreed. Or it might mean that the women answered on paper. Sample statements: "In unclear times, I usually expect the best"; "If something can go wrong for me, it will." Cynical hostility was measured by reactions to to such statements as: "I have often had to take orders from someone who did not know as much as I did," and "It is safer to trust nobody."
These were post-menopausal women, mind you. Wouldn't you expect that women in their 50s and beyond would have a history of being under-employed?
It turned out that optimists lived in the western United States, had more education and money, health insurance, and attend religious services. They were less likely to have diabetes, hypertension, high cholesterol, or depressive symptoms.
Well wouldn't you be hostile if you were lacking in education and income, were jobless, didn't have health insurance and had diabetes or were depressed?
So you could say that having health insurance makes you healthier and happier.
I am cynically hostile to this report, which does not bode well for me.
At the top of this post is a photo of a skeptical woman, which is not quite the same as cynical, but will have to do.

On a scale of one to ten...

That's what they always ask you: Where is your pain on a scale of one to ten?
The question, of course, is, what's ten? I imagine ten to be Joan of Arc at the stake. A man being hanged. Amputation without anesthesia or even a bullet. I don't know ten. I don't ever want to know ten. And if ten is supposed to be the worst pain I've ever felt, what use is that? How can every patient's ten be the same?
The better scale is the FPS-R (Faces Pain Scale-Revised).

When Nurse L was trying to assess my Taxol-induced bone pain, I said it was a three. Then I described the pain to her and she said it sounded like ten. Again: compared to what?
Cruel and unusual, J mused when he was 12 and in the hospital for the sarcoma that eventually killed him. Unusual punishment, he said--they could put you in a room filled with butterflies. That's unusual.
And what's worse than a root canal is a dental implant, which I am in the middle of experiencing. On Thursday the periodontist pulled out the remains of tooth #19 (penultimate molar on the left side) in two pieces, and then drilled a hole in my jawbone and stuck a post inside.
Later the dentist will connect another post to the top of the internal post and then fashion a crown around it.

Meanwhile, my bone is supposed to welcome the new foreign body into my skeletal system. It will become part of me, by osmosis. (Not really, but by ossification.)

The periodontist gave me a prescription for 18 tablets of 600 mg ibuprofen (one refill allowed) and yes, 14 antibiotic capsules, a strange one I've never heard of: Clindamycin. It's a turquoise bullet. The last day my jaw has ached. How much? Sometimes in the whimper stage. That's the only way I can calibrate pain. First there's Complaining then Whining then Whimpering then the Fuck! stage and then Crying, though saying Fuck! and crying can come upon you at the same time. Then there's Weeping. Even in yoga I've felt that Fuck!/near-crying pain in my hips when we do variations of the lunge or runner's pose.
I had decided to call the periodontist and tell him about my pain. I would also have to tell him about the disappearance of the thread he used to make stitches. The thread was loose last night and then (as dumb as it sounds) I chewed on it until it broke and now there is no thread. It was supposed to dissolve.
I had decided to break out the codeine but after ibuprofen I'm back in Complaint only.
Elaine Scarry wrote about pain. I read some of her book, The Body in Pain, several years ago. From a quick look at reviews and summaries on line: She says that it is so very difficult to describe pain, that pain leads to destruction that "unmakes" the world.
The opposite of creative, generative. Pain is negative proliferation, creation turning in on itself, crabbed, deformed. Pain sounds a lot like cancer, like evil, the void taking over.
Pain, as Snoopy once said, hurts.
L's mother wouldn't take her pain pills at first. Then she did.
Our friend B had a hernia operation then came here a few days later. This was in spring. He wouldn't take pain medicine because he wanted to feel how strong the pain was.
I'm as curious as the next person but after I feel pain I want to get rid of it. Now. The ibuprofen dulls the ache some, but there's still the underlying pain. How much? Does it distract me? Yes. But then I'm easily distractable. Is it making me complain or whimper? In between. Maybe I will try the codeine tonight, left over from some other procedure. We do have well-stocked shelves of medicine, we have much to offer in the way of relief. And we will not be too proud to use them.
Meanwhile, my itching is starting up again, a side effect of my polycythemia vera, my blood disease. Sometimes the itching is mostly burning and it so painful and inremitting that I feel despair. Which is not a stage of pain, but something altogether different. And now I will take an Atarax and the itching will fade and disappear and I will go to sleep.

Cancer has left the family...

downtown Litchpatch

...as far as we know. My mother-in-law's melanoma was removed from her leg, skin was grafted over it, and there's no damn cancer in her lymph notes. She's walking around and changing the dressing herself, which is good because her sister and brother-in-law are leaving today, and L left after a week, and I made a cameo appearance.
In all, we quintupled the Jewish population of Litchfield, IL, aka Litchpatch.

Sonia's Antibiotic

My mother is a subset of the category of Typical Jewish Mother--she's elegant and tasteful, The Jewish Jackie Kennedy, my cousin has called her for decades. She's as anxious and fearful as the stereotype, or more so, but she relays her doubts not in a whining, gratey New York voice, but in an olderish-but-not-creaky Southern Lady accent. The accent is not Deep South, and not light, but more medium Texas drawl. She has lived in only two places her whole life--Dallas (smaller, more snobby about its culture) and Houston (where she moved as a bride, and found you didn't have to wear white gloves as often).

The last person I met with a whiny-New York voice was a German with at least one American parent. So you can never rush to judgments with accents.

I was talking on the phone with my mother, who had just returned from a sibling arts-outing to Marfa, Texas, and I mentioned that I had a dental implant, my first, coming up later that day. She's had her troubles with implants, including one that made a side of her face swell up. The reason for mine is that a root-canaled crown fell off about a month ago and so the remains of the tooth (a shallow, uneven ring coming out of the gum like a worn-down wall) must be pulled, for about $300, of which my insurance will pay a portion. Then the periodontist will insert a metal cylinder into the jawbone, which will grow around the implant. Insurance will not pay for any of that, which is of course the more expensive part.
Our conversation ends. Then she calls back: She forgot to tell me [again, imagine the voice of a Southern Jewish Lady Mother] about Sonia's antibiotic. Sonia is her friend who had a lumpectomy many years ago and lymphoma recently. Sonia (or S) finished chemo about a month ago, about the same time that her husband died. S just went to the dentist for a cleaning and was chided in the office for not pre-medicating. The message is that I need to take an antibiotic before my dental surgery in order to avoid infection. I told my mother that I didn't need an antibiotic. When I was accused of having a mitral valve prolapse, I used to pre-medicate, but then some other doctor along the line asserted that I didn't have the prolapse. I reminded my mother that I didn't take an antibiotic before my root canal when I was going through chemo, that no one ever told me I needed an antibiotic before a dental appointment--not the dentist, not the oncologist. Undaunted, she said, Check it out. I said OK, which she knows is noncommittal.

She calls that night to see how the procedure went. I tell her that the surgery was postponed (because it happens to be true) because when I got to the periodontal office, the receptionist said my appointment wasn't on the office calendar. She said, We wondered why you were on the doctor's calendar, but not the other calendar. She wondered? If she wondered so much, why didn't she call me? The periodontal office person said she was on the brink of calling my dentist. Which, neatly enough, is how my family works, through indirection: If A is upset with B, A will automatically turn to C to discuss it, and maybe C will pass B's words along to A. I asked the receptionist about antibiotics and she said they weren't necessary. I tell this to my mother. But S's doctor..., my mother says; but everyone I talked to..., my mother says. She doesn't see that I am not the same as 80-something S, that my breast cancer is not S's. My mother was accidentally prescient about one piece of medical advice. Before I had cancer, when I was just your average gal with lumpy breasts from fibrocystic disease, my mother told me that S's doctor told her she shouldn't have soy, and therefore I shouldn't. I said no one had told me I shouldn't have soy, that my knots weren't cancerous, that there was no reason to do as S did.
And then I was diagnosed with estrogen-munching cancer, and my oncologist told me to avoid soy because it resembles estrogen.

A few months ago S sent me an article from the New York Times about eating to outwit cancer. I was skeptical of it because the author of the article asserted that cancer feeds on sugar, and no one had told me that. But then I mentioned this to an expert who said, yes, sugar causes inflammation which can lead to cancer. So score one for the Southern Jewish Mothers of Houston.

My surgery is planned for tomorrow, and I will not be taking an antibiotic beforehand. When I was in third grade or so, we had to write about intangible gifts, and I blazed forward and wrote many little essays about these gifts, and by the time I got to the fourth or fifth one, I was writing about the gift of worry. Worry (A), my mother (B) and I (C) go back a long way. Or maybe worry is (B), which my mother transmits, or worry is the medium through which other messages are conveyed. It is complicated.

My cousin (by marriage) D has created the term negative R--- attitude, to describe the fear and caution that my mother's family (the family R) carries in its genes. Forty years ago, my grandfather R told my cousin (the one who later married D), that he would pay for her undergraduate education if she would only opt for the University of Texas instead of the dangerous radical Northern school, the University of Wisconsin, where she was bent on going, and did in fact attend and graduate from. And she went to graduate school in New York City, and lived in Boston, before finally returning to Texas, with D. Luckily, her mother had married a man who was not afflicted with NRA and who calmly allowed his children to venture hither and yon. And yes, Madison was radical in those days and when anti-war activists bombed the physics building, a researcher died and four others were injured. NRA can sniff out danger. The problem is the bar is set very, very low.
Accents can be misleading. Last week a downtown panhandler threatened an 80-year-old Chicagoan with a knife before the cops shot him. I heard the older man on the radio and he said fest instead of fast, sounding to me like a guy with a Yiddish accent, like someone who came here straight from Ye Olde Shtetl. It turned out that the man left France at age 25 and his last name sounds Armenian, not Jewish. Many years ago my friend P wrote to me from college in New York about a conversation with a little old man with a Yiddish accent, and noted that there are fewer and fewer of these people and accents who are around. Which was true then, and true now, though now and then you hear a Soviet emigre with that accent. I'm not talking about a Slavic accent, but one spoken by someone whose first language was Yiddish. Which has been dying out, we've been told, for at least 100 years.