This morning I had my first post-treatment check-up with the breast surgeon. I will be alternating appointments between my breast surgeon and my oncologist so that I see one of them every three months for the foreseeable future. I haven’t asked recently when that will switch over to six months, and so on, because right now every three months seems pretty comforting. I’ll want that safety net there for a good long time before I walk the tightrope with only the cold, hard, popcorn strewn floor below, thank you very much.
Many people have asked me “what’s next” now that surgery (other than phase two of reconstruction a/k/a my tit exchange as one friend so aptly put it), chemo and radiation are finished. This is their gentle way of asking what can be done to make sure that I am okay and that the cancer has not come back.
People are often surprised to learn that these doctors visits will be composed mainly of a physical check-up and questions about how I am feeling. Scans are not always routinely performed on patients who did not have a lot of positive lymph nodes at the time of surgery and even when scans are done they do not tend to change outcomes.
Having thought about it I am not too keen on getting scanned and thus subjected to even more radiation on a regular basis. Some cancer survivors find scans comforting, but from what I’ve learned from my doctors, I might actually find them anxiety producing. Time will tell.
Blood tests are sometimes performed at the check-ups to test for tumour markers, etc. but the results can apparently be confusing. So again, the main tools used are the physical exam and talking to the patient. Old school.
That brings me back to this morning’s check-up. My surgeon examined me and said that my skin looked very good after radiation. He then palpated the skin around my expanders (my temporary, saline implants) and under my arms and finally did an ultrasound to see how the expanders were lying under the skin and whether and to what extent there was inflammation following my treatments. All looked good.
Following this, I showed my surgeon a small cyst on my right arm (people who have found lumps on their bodies that turned out to be cancer do NOT like to find random lumps on themselves) which he dismissed as a typical subcutaneous cyst, which probably predated my cancer. For good measure I had him look at a small, dark mole, which one dermatologist had insisted I biopsy immediately but which a second opinion had determined to be “nothing sinister.” He concurred with the latter opinion and said we could watch it.
Once I was out of questions about lumps, bumps and marks I figured I would get his input on the big picture. “Is there anything else I should be doing?” I asked. Now, I have already asked four oncologists their opinions about such things, given the morass of extreme cancer diets and information out there claiming that one has to do this, that and the other thing to stay healthy.
My surgeon knows how I am. In other words, he knows that I eat a relatively healthy diet, that I exercise regularly and that I am not planning to gain weight. And his answer was basically “nope.”
This is a relief because I hadn’t planned on going macrobiotic or anything. If I even tried to do that I might become psychotic, which could be a more serious health issue than cancer, or extremely bitchy and irritable, which could be a serious health risk to others around me. Or just a plain ole insufferable bore, which many people who embrace extreme diets and such are (sorry if you are one of them and you are offended but the great majority of people really don’t give a shit that you ate only kelp and green tea today).
While I was at it I polled him about alcohol consumption, especially considering a recent study I read indicating that as few as TWO drinks a week can increase the risk of estrogen-positive breast cancers. I really hate studies like that. I mean, two fucking drinks? Good grief. Not that I was a big boozer before all of this, but I do enjoy a nice glass of wine for crying out loud.
He said that it was very hard to separate alcohol consumption in those studies from other factors and that in the grand scheme of things he wasn’t too concerned about an increased risk if one didn’t drink excessively.
It all boils down to what my London oncologist said to me one day. “You have to live your life.” And you do. You can beat yourself up about every minute thing or you can get on with it and be reasonable and once in a while indulge. Isn’t that what makes life enjoyable on some level?
Therefore, when I got home this afternoon I took the last of the chocolate chip cookie dough (homemade gimme some credit) out of the fridge and baked up a sheet of cookies. My older daughter had a play date over so it was a good excuse.
“Okay, each child may have two cookies,” I said. Then when they weren’t looking I shoved four of them into my mouth in rapid succession. After a dinner of seared chicken breast, rice, mushrooms, roasted broccoli and purple cauliflower, which I swear tastes better precisely because it is purple — or at least that is what I told the kids when I said they couldn’t have any more cookies after dinner if they didn’t eat it all — and “one unit” of white wine, I ate two more cookies.
Following the sixth cookie I stopped, held my stomach and assessed how I felt. “Oh boy. I think I ate one too many cookies,” I told my five-year-old.
Without missing a beat, she responded, “I think I ate one too many cauliflowers.”
Ain’t life beautiful?
