Thursday, March 20, 2008

The Big C

I’ve had a lot of mammograms by now and I’m used to the routine. Strip to the waist, gown opening in the front, the chilly room, the cold machine that pokes you hard when you wrap your arm around it and stand as you are told, the attendant’s hands – thankfully warm – as they arrange your breast on the plate, pulling and piling every last centimetre of fatty tissue from beside and below, and then the pressure as the top plate is lowered, mashing and flattening until you cry uncle. If I concentrate on the pain from the sharp corner digging into my armpit, the flattening doesn’t bother me so much, and they get a “nice compression”.

Most of the time, the routine is the same. The attendant steps behind the safety screen, I hold my breath, whirr, whirr, click, click, change positions three more times, the pictures are clear and readable, I get dressed and go on my way. A week later, there’s a note in the mail with the word “normal” on it.

Once, there was a phone call. Doctor would like to order a sonogram. Nothing to worry about, just something he wants to check a little further to make sure. This test is not unpleasant – no pain and actually rather soothing. Three days later there’s another call. Don’t worry, these things show up all the time, and they’re usually completely benign. I don’t like that word, it implies that there is something else that it probably isn’t, but could be. I make an appointment to have a needle biopsy done in the doctor’s office.

I have a relaxant pill to take beforehand, and they give me a local to numb the test area. I’ve spent most of my life being needle-phobic and can’t watch, but it’s over quickly and I leave with a small round band-aid on the underside of my breast and a feeling of apprehension. I remove the band-aid a couple of days later, and a phone call from the doctor’s office removes my fears. Nothing to worry about.

I’d already had cancer. My standard stupid joke line is: I only have one kidney left, but I’m still full of piss and vinegar. I had been trying to lose a bit of weight and it was going so well. Then a friend and I went to the county fair and took a ride on the wild and whirling side. My innards bounced around like bumper cars and gave me pain; enough to send me to my MD – just for a checkup.

Do you ever think about just how medical tests and procedures were devised, and about the poor schmucks who were the very first on the table to be invaded and cut into and carved up and just plain HUMILIATED so doctors could see if and how the new thing worked? My first test was a barium enema, which is every bit as delightful as it sounds. First, you empty yourself out, and then they fill you up again and block the doorway. As I was lying on the table waiting for my close-up, admiring the roomful of sophisticated equipment, and with three radiologists completely focused on my lower regions, one of the doctors began massaging my abdomen with the back of a big wooden spoon. I started to giggle, and the doctors actually smiled. About that time, I was feeling incredible pressure, and I was reminded of a very silly joke that my mother had told me: “What is the difference between a saloon and an elephant’s fart? One is a barroom, and the other is a ba-RROOM.” I giggled more. They tell me that I was the only person who ever giggled all the way through this procedure. I wouldn’t tell them what I was laughing at. Embarrassing and uncomfortable as the test was, there was no pain involved and the results were negative. The aftereffects of the barium, however, were unpleasant and left a big “impact”.

My symptoms and I were referred to the best urologist in the area. He was a pioneer and expert in vasectomies, an old curmudgeon who treated me like a delicate piece of china. And made me laugh. I needed a sonogram of my kidney, and when that indicated an abnormality, he ordered an IVP – a series of sophisticated X-rays of the kidney when highlighted by an injected dye.

All of this was being done with haste, in between work and being a Mom, and I was a little dazed by it all, but thought, “I’m coping. I’m doing what’s needed and I’m coping.”
Then I got the phone call. A doctor I’d never heard of said that I was now his patient and that I was to be at the hospital in two days for a venagram. It would tell us whether or not the tumor they found extended up towards my heart - or something like that. I went numb, muttered good-bye and hung up.

I raced off to see my MD. He took me into his office, and while I cried, he apologized for the way it had been handled, told me about the new doctor and that I now actually had three doctors, and thoroughly explained my situation and the procedure. Somewhat calmed, I left, only to panic again 15 minutes later. I was too young, the test itself might kill me, I had a daughter in her early teens, I didn’t have a WILL! I drove to the office of an attorney that I knew and explained what I needed to his secretary. She said there was an appointment available early the next week and I burst into tears. After handing me a box of Kleenex, she gave me instructions on making my own holographic will and I went home and wrote.

All of the radiologists were wonderful, but especially the man who did the venagram. He was a huge teddy bear man, with beautiful twinkling blue eyes, and neat white beard, and a wonderful voice full of intelligence and thoughtful care. I thought then, and still do now, that if he had said to me, “I see we have something here that needs to come out, and as long as we have you here, why don’t I just do it now and get it over with?”, I might have answered, “Oh, good. Please do.” Such was the extent of my comfort and confidence levels with this man.

A good friend of mine was one of the main surgical nurses, and with her help, I chose my surgical team. Groggy as I was going in, and without my glasses, I wouldn’t have known if the Queen of England was hovering over me - except for the anesthesiologist, who is black, and I remember thinking, “Oh good, David is here.”

I “awoke” in the ICU, to the ministrations of the ICU night nurse - a man who sat by my bed, Q-tipped my cracked lips and soothed my head and spoke so gently and tenderly that I swore he was an actual angel. In my drugged state, I would have seen wings, except that I could barely open my eyes.

It was cancer, but they were very sure that it was contained, and that they had it all, so no follow-up radiation or chemotherapy was needed; just six-month checkups and chest X-rays for up to five years. For the first year after, it seemed as if every other paper or magazine that I read contained an article on renal cancer and how deadly it is if it metastasizes, and I was faithful with my exams for about four years, before deciding that, okay, that’s enough.

That’s a long time ago now, and I am officially a survivor - a very lucky one. It is possible to function very nicely with one good kidney, the cancer was caught just in time and before the cells began dispersing like dandelion fluff, and I didn’t need the punishing Hell of follow-up treatment. My waistline is now defined by a long, welted scar that runs half way around me (but I’m too old now to wear a bikini, anyway), and my head has never let go of the notion that if I lose weight, it means that I’m sick. That one stuck with me, as do the ten pounds that I really would like to dump.

I’m not going to mention the cost of health care in this country. That is another discussion. This is just a rather self-indulgent description of some of my experience – because I’ve never talked about this before. Some doctors are sons-of-bitches – I’ve met some and heard of more. Sometimes, it does happen that medical people are so intent on doing their job as thoroughly and as well as they can, and doing it in time, that they forget about the emotional human that surrounds the small body part they are focusing on. Overall, they did very well by me.


AmyLS said...

This was NOT self-indulgent. It was generous. I am in the middle of a frightening series of 'Lets just see' procedures, and it is unknown territory for me. Reading your experiences - especially your personal responses/reactions to what you experienced - makes me feel less alone. One of the worst things about scary medical stuff is the sense of isolation.
Bursting into tears at the lawyer's office... what a lonely, helpless moment that must have been. You are brave, and you have a great attitude. I'm so glad that you were lucky!
Thank you.

Anonymous said...

thank you for telling your story in such a straightforward and informative way.

Carol/Arcata, CA