About KIBAdmin

Born in Houston, Texas May 12, 1972. Grew up mostly in northeast (Connecticut) went to Choate Rosemary Hall (1990), Georgetown University (BSL 1994) where I majored in French Literature and Harvard Law School (JD 1999). Law clerk 1999-2000 for federal judge in New Orleans. Worked as a corporate associate at a large NYC firm from 2000 to 2004 at which time moved to Boston area. Began design studies at the BAC in Boston in 2009. Currently living in London with husband, Bill (fellow HLS class of 1999) and two fabulous daughters, Isabel (7) and Charlotte (5).

Day-Glo Orange Surprise

A few weeks ago it was spring break here in sunny (ha) London. Everyone had big holidays planned. Trips to Mauritius, Dubai, Tenerife, the States. And here I was stuck with no plans except to have poison pumped into my veins. Fun times. Cue violin.

I decided that was unacceptable and with two weeks notice ordered my husband to book a suitable Easter vacation for the family within a two-hour radius of London in case I had a serious medical issue while away and had to be whisked back here.

Because he is wonderful (and because I have cancer and he listens to me a lot more now), he didn’t disappoint. He booked us in for a four-night stay in the Cotswolds at a fabulous Jacobean manse that had been a private home for 400 years until it was converted into a family friendly hotel in the late 1980s. It was about a 20-minute drive from Bath.

After deliberating we decided to take the train to Bath, neither of us having driven on the wrong side of the road (it is not the other side; it is the wrong side — deal with it), and rent a car from there to drive the short distance to the hotel. Actually as an aside we learned from our cabbie in Bath that the origin of driving on the left has to do with how people travelled in feudal times. Since most people were right-handed and held their weapons in that hand, it made sense to have one’s weapon on the passing side. Same with jousting and holding your lance in your right hand. Apparently Napoleon, who was left-handed, and thus made his entire army march on the right (poor buggers), was responsible for most of the rest of the world driving on the right. He really had a lot of chutzpah that Napoleon. If this subject interests you check out this link.

But I’m going to return to my story now.

So we packed our suitcases and set off for Paddington Station (yes, like the bear!). I have always enjoyed traveling by train. And this was a decent train with a clean bathroom. Bonus. I read The Hunger Games while the kids looked at books and chatted and then starting pesting until we relented and gave them our smart phones so they could play educational games like Angry Birds and Doodle Jump. What? Those are educational and stuff. Aren’t they?

The ride was painless. We got to the station, found a taxi and drove to the car rental place. We rented a car with a navigation system (key) and Toonces the Driving Cat (we call Bill that because of his tendency to hit stationary objects while driving and well just because he is Toonces, though he has never actually driven off a cliff… yet) took the wheel. I was a little concerned but not enough to kick up a big fuss and take the wheel myself. He did pretty well. I only cringed and shrieked about five times on the way that he was “awfully close to the left! Ahhhhhhhhh!” and needed to overcompensate on the right. He got mad at me for backseat driving even though (a) I was in the front passenger seat and (b) he practically took the driver’s side mirror off a parked lorry (that’s truck US folks) we whizzed past.

But overall he did great, even navigating several roundabouts (Brit speak for rotaries) without incident. I came up with some special driving music for him, which I think was from the Benny Hill Show. I just love Benny — he was such a perv. We reached the hotel. It was beautiful. I breathed in the country air, delighted and amazed that we had pulled off this trip, that we actually got to enjoy a real vacation, albeit brief, during this screwed-up time.

Our rooms were behind the main house on the second floor of a stone cottage. They had just been renovated and we were, in fact, the first guests to stay there since the renovations had been completed. That day. When we got to reception we were informed the rooms weren’t quite ready but that was reasonable because check-in time was three o’clock and it was only about one-thirty. So we left our bags in the car and had lunch in the main dining room. The food was surprisingly good.

At three we climbed up to our rooms. The place was old and there were odd quirks (yeah that is redundant) everywhere. For instance, the key hole to our suite was on the bottom of the door, so that you had to either lie on the ground or be partway down the stairs in order to open it. We nevertheless managed to get in. The rooms were lovely. All pristine and crisp and very British with twin upholstered headboards in the girls’ room and a wrought iron number in our very generous master bedroom. Fancy tub with sparkling stainless fittings. Groovy details like reclaimed wood door on bathroom that looked like it was from an antique barn. Just reeking with charm. And a splendid spring bouquet with an Easter greeting from Granny (that’s my moms) on the chest.

We felt very welcome. And there was a lot to do for everyone. Kids’ house with nice ladies to watch over little blighters crashing into each other with plastic ride-on toys or to assist older (and ah-hem more civilised) children with crafts and drawing. Wendy houses (read: play houses — origin from Peter Pan; house built around Wendy when she is shot by one of the Lost Boys) sprinkled here and there and a chicken coup, gardens, outdoor sports including cricket, football (soccer I mean) and croquet. There was also a spa with treatment rooms and an indoor swimming pool, an outdoor swimming pool (bit too cold for that though, sadly) and loads of gorgeous flowers, shrubberies (“We demand a sacrifice! . . . . We want… a shrubbery!”) and trees, including a marvellous ancient tree in the front that must have been there for at least a hundred years — probably longer. You getting the gist?

The main house was cozy, casual and charming. I felt perfectly at ease strolling into the sitting room, kicking off my clogs, plopping down on a leather sofa and reading my book by the fire. Random dogs abounded, including the resident dog, Peanut, a spaniel of some sort, I think, who had one of those unfortunate doggie tumours she was going to have to have removed (we were thus soul sisters from the get go, me and Peanut). All large tail-wagging guest dogs made a beeline for Bill and slobbered all over him, knowing as dogs do that he didn’t grow up with pets and was thus a desirable target. He was a good sport though, since none of them ate his biscuits.

At first there were only British families with young children. But on turnover day lots of nationalities showed up and I was hearing Italian, German, Portuguese French and Spanish and some Australian and Canadian accents. I think we were the only Yanks over the long weekend. Fine by me. I like to mix it up. Everyone had kids and there were lots of babies and some (very) pregnant ladies. I enjoyed being around the babies, even though it made me a little wistful.

Meals were a hoot. They had a deal where you could accompany your kids to early dinner (children’s “tea”) in the orangery (like a conservatory) and then later eat a civilised grown-ups’ dinner in the main dining room while the little ones watched a movie in the tv room or were monitored in our bedroom by a baby listening service. This was pretty great. Even if the baby listening service mightn’t clue in if the kids were juggling knives or popping my anti-nausea meds (don’t worry they were fine).

On the second evening of our stay Bill and I were having our adults’ meal while the kids watched a film down the hall. Although I had worn a scarf all day, I had decided that dressing for dinner would include Gabriella (see my earlier post, Armpit Wig, if you are stumped, and no, it isn’t what you think if you haven’t read it yet). I wonder if I confused the staff. Now she has hair, now she doesn’t, and vice-versa.  Hmmm. Anyhow, there I was, with my lovely dark bob, in a printed silk blouse and Joseph cigarette trousers (I mustn’t say “pants” bc it means underwear in England, tee hee) and flats, looking pretty normal. We had a romantic table in a prime spot and the moon was enormous that night, glowing through the branches of that great tree. I sipped a glass of champagne. Bill looked handsome in his Nantucket reds and striped shirt, representing for Massachusetts. All at once I noticed that we were not alone. A pleasant lady from reception was bending over our table, something about an issue with the room below us and could they just pop into our room to check the bathroom.

Oh dear. My first thought was that there had to be a water issue. But the woman was very calm and assured us it would be fine. I said yes of course pop away. When we finished dinner, collected the girls and returned to the room, two dudes and the nice lady were still up there checking things out.

Do you know anything about English plumbing? Well the English are not known for it. Sort of like the shortest book ever written being Italian naval victories. The gist was that during the very recent renovations a pipe had been disturbed and our sink was leaking into the floor and dripping into the bathroom below. “So what if you can’t fix it?” I said. “Well then you might not be able to use the sink,” one dude replied. I contemplated brushing my teeth  in the terlette or the bathtub for the next three days and was not amused. But it worked out fine and they said just to try to limit use and they could triage it until after the weekend when they would open the ceiling below and fix it properly. “Happy to oblige,” I assured.

By this time it was late, and well past the girls’ bed time. I was tired, which I always am toward the end of the day, and as much as I like Gabriella, I wanted her the f*ck off my hot itchy bald head. So no sooner did I bid the plumbers adieu and close the door, than I whipped off that wig and threw her on the bed. Twenty seconds later I had yanked off my shirt and trousers and was standing there in what can only be described as a day-glo orange lace bra and matching boy shorts, a recent purchase to make me feel less like a cancer patient and more young and fun and sexy and normal (well, sort of normal as it was fluorescent orange). 

I turned to my husband, and said in a South Boston accent,* “if they come back knockin’ now they’re gonna be in for a fuckin’ surprise.”

*If you’re from Nepal or something and aren’t familiar with that accent, go right out and rent Good Will Hunting and listen to Matt Damon and Ben Affleck (but not Robin Williams — who, although I dig him, did not have a good South Boston accent).

As it turns out they didn’t come back knockin’. But it would have been epic, no?

During our stay, we explored the Roman baths in Bath, drove completely out-of-the-way on nameless roads that stumped the navigation system to a microbrewery (which of course was closed because it was Good Friday). On the way though we saw rolling hills with yellow flowers and scores of spring lambs with their mommies. We visited Castle Combe, a medieval village where lots of movies, such as War Horse, have been filmed. Bill splashed about in the indoor pool with the girls and I got my toes polished since I wasn’t allowed to get in the pool (germs, ew). And we did a lot of chilling in the main house by the fire or in our room, reading, drinking tea and munching on lemon drizzle cake. It was a fabulous trip.

Although poor Bill was distraught when we were packing up the room on our last day, having discovered in the eleventh hour that there had been a ceramic jar filled with home-baked cookies on top of the dresser the whole time we were there.

But we’ll know for next time.  🙂

Top Ten Reasons Fighting Breast Cancer Isn’t All Bad

Reason No. 10:  No need to wax or shave.

Reason No. 9:  No bad hair days.

Reason No. 8:  Get to play the “C” card

Reason No. 7:  Can get away with shameless self-promotion

Reason No. 6:  Excessive self-grooming becomes “a medical necessity”

Reason No. 5:  Excessive retail therapy becomes “an emotional necessity”

Reason No. 4:  Wearing leopard print to chemo

Reason No. 3:  Get to find out who your real friends are

Reason No. 2:  Get away with posting pic of own ass on Facebook

And The No. 1 Reason Fighting Breast Cancer Isn’t All Bad:  Bigger tits in 60 seconds (come on you knew it was coming — read Boob Retrospective if you are mystified)

 

What I Wore To Chemo Today

My treasured friend Susan of 17 years came all the way from America to visit with me today. That visit happened to coincide with my first of four doses of Taxol (see my last post, Countdown, for details on that). Thus, our visit was conducted in the chemo treatment suite in white leather chairs. Susan is the director of the most prestigious public interest fellowships in the law, “a legal Peace Corps” as described by The Los Angeles Times.

Back in the days of good posture and (naturally) perky boobs (see Boob Retrospective — don’t you want to read it just for the title?), I was Susan’s legal assistant at the New York law firm that established the fellowships. We bonded immediately. She has too many qualities to list in the time I have before the fatigue hits me so just trust me on my compact description — she is HIGH QUALITY in every respect. But I do have to mention some specifics: she is both a philanthropist and a fashionista, has a wicked sense of humour, is not afraid to say “fuck,” is a hot ticket, is highly intelligent and has a true gift for friendship. And that just scratches the surface.

Anyhow, years ago, after I had left the firm and was a One L at Harvard Law School, Susan came to speak to the students about the fellowships. A Two L aspiring fellow had called her with some questions on the application process and Susan had told her to come to the talk and meet me (a built-in resource, having been through the process as Susan’s right-hand gal) so that I could help her and any other public interest students so-inclined.

Susan is very fashionable, but always very tasteful, and she had kindly bestowed upon me a number of designer suits that she no longer needed. She figured I would be wearing one at the meeting to please her and make a good impression on the students. Pale blue Armani, perhaps? Crimson Feraud?

Of course when she showed up I was sitting on the floor in a cheetah print mini dress I got at the ten-dollar store and knee-high boots. Oops.

So last night when I thought about seeing Susan after quite a long stretch of not having seen her, I realised that an appropriate ensemble was in order. I mean I didn’t want to embarrass her again and make her feel uncomfortable in the chemo suite, for Christ’s sake. She flew across an ocean. And to top it off I am bald now, which doesn’t help one’s appearance.

This morning I scoured my closet, keeping in mind that I had to allow decent access to my port site near my left axilla for blood draws and administration of chemo. I selected and then rejected several choices as inappropriate, but finally settled on the perfect kit (look it up, Americans, it’s Breeteesh). At this point of course I was late. So pathetic to be late to one’s own chemo. And to top it off the nifty phone apps I downloaded in order to get a taxi to show up at my door refused to work and the cabs and car services were all popping up with “unavailable in your area” messages. Unacceptable. And there was no “FU I have cancer come anyway” button.

At that point I had no choice and gulped down the rest of my flat white (like a latte but better), wiped the cinnamon from the corners of my mouth with the back of my hand, and dashed out the door to get to the tube. It was raining again and so I put on my silver wellies so I wouldn’t soil my outfit. I had not planned to be sloshing about — thought I’d be cabbing it door to door.  Grrr.

I dashed into the tube, which of course crawwwwwled along. Blasted Northern Line. When I finally reached my stop I catapulted myself onto the platform, ran (yes ran) up two escalators and flung myself outdoors to hail a taxi. I was still a good 15-minute walk from treatment. Luckily I found a cabbie right away. He dropped me off in front of the clinic (most people know it’s a cancer place) and then refused to make me pay for the fare. It was lovely, really, and I was touched if not a little surprised. I mean people get dropped off there all the time and I am sure they usually have to pay. It must have been the combination of my elegant attire and — oh — the fact that he knew I was a cancer patient.

So, I was about ten minutes late. Not fatal. But I was concerned about getting a good seat under the skylight. I practically jumped down the stair case and was scolded by a lady not to rush (good point — headline: “she makes it through four chemos only to hurl herself down a flight of stairs at chemo and end up a quadriplegic”).

The staff ushered me to a nice, sunny pod. I yanked off my wellies, hung my coat up and waited for my friend. I hoped that she would like my outfit. I did not want to let her down. Again.

A blond breath of fresh air in a red and gold silk scarf, persimmon sweater and chocolate trousers breezed through the door. Susan had arrived. She saw me. She smiled.

What? You were expecting Rene Lezard? Please, people.

Nothing says “cancer, kiss my ass,” like matching leopard print tops and tails.

We killed it today, Susan and I. Easiest bloody chemo I ever did.

Yippee ki-yay, motherfucker.

Countdown

Hi folks. It is always a little odd how much I enjoy the day before a chemo treatment. It approaches so quickly… and suddenly there it is. That normal Wednesday every two weeks before the Thursday festivities. Unfortunately the weather continues to suck here. It is cold, rainy and windy and not showing signs of improvement. And here I thought having chemo in the spring would be so lovely — sun on my bald head, showing off my bare legs with the latest in shorts. And so forth.

Anyhow, tomorrow I start the big countdown. For the first four chemo treatments I counted up. But those are over now. And I do believe that NASA would agree a countdown is more appropriate for the final four.

Whenever I go for chemo I try to get inside my head and get psyched up to do battle. If you are taking a drug that has bad side effects, you have to focus on the positive: namely, that the positive outweighs the negative and that this drug is exactly what you need even if it isn’t exactly what you want. So when I settle into my white leather chair tomorrow morning at 0900 London time and 45 minutes later my blood work comes back showing a fabulously high white blood cell count indicating “all systems go,” I will do my battle cry.

It goes a little something like this: “Die, motherfuckers.”

Sometimes I wonder if there is even anything bad in there left to kill. But just in case, we’re going in. And they will never see it coming. I feel almost sorry for them (not).

The really great news is that people say my “new” chemo drug, Taxol, is easier for many to take than my previous drugs (AC). But there are still some pesky side effects to watch out for. I read a laundry list of them once but it started to piss me off so I filed that information sheet and now I am starting to forget. But I do remember that they include joint, muscle and bone pain, tingling in the hands and feet, alopecia (I know I am already bald but I do still have eyebrows and lashes to worry about), nail changes, including discolouration and loss of nails (that sounds pleasant and attractive) and well, lots of other icky stuff. The queasiness isn’t supposed to be as bad and I am very excited about that because I get testy when anything interferes with my meals. I love food and I love to eat. And the thing that bummed me out about the first four treatments more than any other symptom was the combination of queasiness, metal mouth and taste bud changes.

What were we talking about? Oh yeah, the new drug, Taxol. Sorry I am tired and my writing today is rather random. I’m gonna go with it.

My cousin was on Taxol a long time ago when it was experimental and she said the joint pain was so bad she had to walk with a cane for a while. But that doesn’t scare me, because if I need a cane I will get a really badass one with a stainless steel skull on the top and a retractable knife in the base and I will go around clubbing people who make inappropriate comments and picking up trash on my street with the knife in order to beautify the neighbourhood (what you thought I would really stab someone? Come on I am not that mean and the riots are over — for now). She also still sometimes has residual tingling from nerve damage. That does make me a bit nervous, pun intended. Tee hee.

So to ward off these ill effects, today I visited the special doctor. The one who does complementary therapy. I had acupuncture, which helped enormously with my fourth and final AC treatment, and also some homeopathy. Phosphorous. I like the idea of that. The idea of sparks, of flames and of powerful energy banishing unwanted sensations. I am girl on fire, like Katniss in The Hunger Games. As I lay with the acupuncture needles in me, I imagined myself floating above the table, aglow with sparks. Invincible. Ready to do battle.

Ready to kill it.

Now don’t get all serious and depressed on me. Tomorrow I have a funny one planned. Promise.

Work It Out

I realised yesterday that I hadn’t been to the gym in a week. Lame. Could this be because I have been sitting on my bum writing blog posts every day for the last seven days? Yup.

Now don’t get me wrong. I am loving writing. I am loving having the blog. It is so energising, liberating, cathartic, cleansing, fun and different. And I plan to do it obsessively for the foreseeable future. But all this blogging is going to make for a flat ass and that simply won’t do. I need a nice juicy little behind to match my newbs (well, as much as I can have one without plastic surgery at age almost 40). Who says a cancer patient can’t have it goin’ on?

When we first moved to London in late July of 2011 I avoided working out for a few months. I had the usual excuses. “We just moved here.” “I have so much to do.” “I walk a lot so it doesn’t matter.” “I’m not sure where to join.” Blah blah blah. But all that was load of BS. Finally I investigated local gyms in October.

I did a blitz of the workout places in the hood.

The first place was the most convenient and by far the weirdest. It was a small neighbourhood gym about a six minute walk in amongst the lovely houses of Belsize Park, which is the only reason I can think of to justify the exorbitant membership fee. (No offence if you own this gym or you have worked out there since you were 12 — different strokes for different folks, people.) I walked in. The reception had a low ceiling and the first thing I saw was a cafe. Assaulted by the aroma of coffee and pastry. I don’t need to be smelling that shit when I am in workout mode.

I was taken on a tour. I cannot even describe the different rooms I went into, all on different levels and connected by various narrow stairways and hallways and doors and really just a labyrinth of British bizarreness. No way in hell I would have remembered what was where. And the cardio room, which I sort of remember, was totally 1980s and not my vibe. Even if I had been a good sport about the confusing interior I would certainly have fallen down the stairs at some point and injured myself. And the low ceilings and labyrinth thing and 80s mirrors made me feel like Alice in Wonderland on a bad acid trip. Not for me.

Then I tried the gym in the O2 centre, which had recently been purchased by Virgin. It was large and more Americanised than the little gym. It seemed to have a lot of decent equipment and a variety of classes. But I didn’t get a friendly vibe about the place — it was rather vanilla and commercial. The decisive factor really was that it was too far for me to walk to and I knew I would never haul my ass there, thus resulting in a colossal waste of funds and influx of self-inflicted guilt. Nope.

The third and final gym I checked out was a smallish place across from the Royal Free Hospital, which is an NHS hospital. This gym is housed in an old armoury and the downstairs used to be a shooting gallery. Are you thinking what I’m thinking? That’s right; I’m liking it already. And at this point I don’t even know I have cancer. The place has very high ceilings because the building is shaped like a barn. It is not shiny and new but it is clean, has a lot of good equipment and the staff is friendly. (In American staff is singular, people. I like to mix things up to keep you on your toes.)

And there is zero glitz factor. I will not be running into scathes of perfectly coiffed blonde mommies who have come to “glow” after the morning drop off. Thank God. Au contraire, there is a real diversity of people in this gym — different races and from very young to quite elderly and all sorts of physical types, folks with disabilities — you name it.

The manager explains that they are about to get a new German cardio/weight training circuit that will be centre stage. Each member who subscribes to this program will get a personalised chip card, which after an initial set-up, when stuck into each machine, will cause it to adjust automatically to your body. A cylinder of bubbling water in the middle of the circuit tells you when to change machines. Did I mention it also has pretty coloured lights that tint the water while you watch? Oooh ahhh. You are supposed to get a complete workout in only 35 minutes, the time it takes to complete two rounds on the circuit.

Well, folks, after hearing about this I’m sold. The Germans are efficient and know how to make shit and the circuit seems like the ticket for me. Oh, and I can walk to this gym in under ten minutes or take the bus and be there in five if I’m lazy or it’s hailing.

I start working out. The circuit is good. Within a couple weeks, I begin to see results. A couple weeks after that, I find my lump. I keep working out, taking a break only for Christmas holidays (you know what I did over vacay if you read my first post, Halfway Through Chemo… How Did I Get Here?). The day after my diagnosis, my husband plays hooky and we both go to the gym. I am a little fragile, but with him by my side and my body wrapped around those machines I hang tough.

Throughout the month of January, I kill it. Go to the gym and do that circuit regularly, and also throw in some yoga at an airy venue in Primrose Hill. I start to get sort of ripped. I feel strong and fit and powerful. Gearing up for war.

I decide to tell the gym staff about my diagnosis and impending surgery. (The poor manager is so shocked when I tell him he is speechless for about a minute.) The people I tell are super supportive and assure me that they will help me through it, making whatever adjustments are necessary to my training throughout the process.

My last workout is February 5, two days before surgery. It is a Sunday and I walk to the gym from Hampstead Heath where I have left the girls and Bill and two other families sledding and throwing snowballs. (What? That’s totally normal for London.) On the way I spot cute pyjamas and a bathrobe in a store window. I buy them so I can be fashionable while strutting up and down the hospital hallways. Then I go for that last workout. I kill it. I’m good. I’m in a good place.

No question that I recovered from surgery more quickly because of that German circuit. And even though I couldn’t pick up my kids much less carry a grocery bag for weeks after the surgery, I gradually recovered. Now I don’t even remember what I felt like two months ago. Because I am back there, killing it, bald as a cue ball and with my machines set to about half of what I was doing pre surgery.

But it don’t matter. I will keep going back. Through the chemo, through it all. Whenever I can. Because no fucking cancer is going to keep me from getting a little more bootylicious.

Are you still sitting there? Reading this?

Get off your ass and get to the gym. What’s your excuse?

 

Armpit Wig

If you read my last post, “Cold Cap: From Rapunzel to Rambo,” you will know that I shaved my head in early March after trying out a number of different hair lengths. Hard to believe that I have been bald for that long already. Harder still to believe that I will be bald for my fortieth birthday on May 12. Not exactly what I had in mind when I thought about “fabulous at forty.” I need me a Lady Gaga “do” right quick. After I post today maybe I’ll run out and buy a light pink bob with fringe (that’s Breeteesh for bangs).

Before chopping my hair for the first time after my surgery, I began to contemplate a wig. I figured I would wear scarves most of the time (which I do) but it is nice to have a back-up plan should one want hair.

I asked around. Everyone recommended synthetic hair. Human hair is very expensive and you have to style it (i.e. wash and condition it, blow it dry and then make it be-have, baby), whereas synthetic hair is low-maintenance, requires less washing and will snap back into shape as it dries naturally on its wig stand. You don’t want to blow-dry a synthetic wig. It might melt.

With both kinds there are limitations. But a good synthetic wig can look pretty realistic.

My wonderful, kind and generous friend Kate had flown over from the States to accompany me to my first chemo, after which I felt okay. So we decided to have a “fun with cancer” day and go wig shopping right after treatment and lunch.

We cabbed it to a tiny establishment in Kensington touted as the go-to place for chemo patients desirous of a wig. They had a good selection and a nice saleswoman helped me try on many different styles and colours.

What not to buy became clear pretty quickly. I have a rather small forehead, so a heavy fringe (you should know this word by now if you have been paying attention) didn’t suit me. Also a no-no was anything too dark as it washed me out — not a good look when one is a cancer patient.

I felt a little bit like Goldilocks on the first two tries, except that I wasn’t in a house of bears and I didn’t have curly gold locks and I wasn’t eating porridge. Nothing was quite right. I just wasn’t feeling it. Too short and helmet-y made me look like a soccer mom (not my thing, really). Too long dragged my face down and wasn’t practical. About chin length seemed to work well…

We finally appeared to strike gold, or rather copper, when I tried on a chin-length ginger (that’s Limey for red head) number with great movement. But when they pulled out the same wig in the nice rich brown colour I wanted, it was slightly shorter and sort of poufed out at the wrong place. Foiled again. At this point I had had enough and was starting to get frustrated. Also, I began to feel tired from the chemo and all the decision making. If you think that a trip to the department store to buy new skinny jeans is tiring try purchasing new hair after chemo. It’s really a bit draining.

So we packed it in and went home. Wigless.

The next morning I had more surgery to install a portacath into one of the major arteries in my chest so that chemo going forward could be administered via the port. This avoids damage to the veins in the arm, which can happen after repeated treatments, so lethal is the shit they pump into you. Following that I was too sore and tired to go wig shopping again anytime soon and the next day, Kate had to fly back. So there I was, still without a wig and on my own.

After a few days I felt better and was back at it. I went to a well-known major department store. They sold wigs and hairpieces in two places, on the ground floor and in their posh salon, upstairs. I decided after my initial disappointment and frustration to think outside the box and try some wigs that didn’t really resemble my real hair. Trying too hard to match it didn’t seem to be working out for a couple of reasons. For one, synthetic wigs are mostly straight, whereas my own hair is wavy. They had some wavy ones but they looked pretty 80s and were lame. Also, getting the same colour is an impossibility.

Anyhow, I decided I was approaching it wrong and needed to have more fun with the process. I tried on a platinum blonde Marilyn Monroe (it was pretty hot, actually). “Happy birthday, Mr. President…” I tried on a human hair brunette wig just for shits and giggles, but the hair was very thick — probably of Indian origin — and it just looked weird on me. I liked a dark red one, definitely a contender, even in the red, but not enough to buy it.

I have to admit I have always had a platonic crush on Ginger from Gilligan’s Island. She had great jugs and was such a tease (did the Professor ever get on that?). So something kept drawing me to the red ones.
But I wasn’t quite sure/ready so I noted the style number and went upstairs. When I got to the salon it was the wig lady’s day off so I tried on a couple half-heartedly, including a severe salt and pepper bob which made me look about 50, and another red number. Then I made an appointment with the wig specialist for the very next day.

That morning was a Thursday and I began the day with a visit to my plastic surgeon for a little instaboob (see the end of my blog entitled Boob Retrospective if that doesn’t make sense).  I returned to the store with my husband in tow. The wig lady was good. She was a stylist and had worked in the industry for years, including on fashion shoots, and then developed an interest in helping cancer patients with alopecia when her own mother was diagnosed. She sized me up and pulled out three or four styles she thought would suit me. I tried on yet another red number, shoulder length with light fringe and long layers. Great colour and movement, but not sure. Then she whipped out a very chic, chin-length deep brunette bob. I put it on. I posed. I became European. I became… Gabriella. I envisioned myself strolling down the street in Florence with a large Prada bag and a small dog, nodding to the men who were blowing kisses and whistling as I passed. Che bella

It was by far the best one I had tried on and, as the wig lady pointed out, it was “me” even if it wasn’t really me. My husband didn’t like it at first, but when I tried on some others and then reemerged with it he came around. So I bid him ciao and set about making my purchase. I got the works. Wig stand, special brush and Revlon shampoo and conditioner for synthetic hair. The wig lady took me downstairs to get the VAT off my purchase — I had to fill out a form that said I’d had a mastectomy and voilà, VAT-free wig. I ought to get something out of this, no?

To celebrate I bought some new make-up and by then I was so high I practically skipped out the door. On the tube I came up with a new MasterCard commercial to sum up my day:

Stylish new wig: £383
New NARS make-up: £85
Bigger tits in 60 seconds: Priceless

I went to the girls’ school to pick up Isabel and her pals and bring them to hip-hop class. I tried on Gabriella in the locker room at the hip-hop place and a friend snapped a pic.

That evening when I got home, I assembled the wig stand and opened the shiny box containing my new wig.

Something was not right.

What was that smell? I looked around the room, inhaled again. I sniffed my armpit. Nope, it was not I. I looked down at Gabriella. Could it be? No….

I picked her up, had a sniff. Oh, fuck. Gabriella smelled strongly of armpit. And not my armpit, mind you. Someone else’s armpit. Definitely female, due to the slight undertone of musky perfume. I frantically turned her around in my hands and inhaled every inch. The offending areas were the crown and down the right side.

The horror, the horror!

My mind was racing. “What the hell am I going to do?” I thought. I tried to think of a tactful way to phone the store and explain that my brand new wig smelled just like armpit, but not my armpit. To a British person. I considered saying nothing and washing Gabriella to see if the smell would come out. But what if I removed the tag and that didn’t work? Then they might accuse me of imparting the armpit smell myself. Maybe they would think I was into something kinky and was wearing the wig in the wrong place. I decided to sleep on it, my buzz from the day having been thoroughly killed.

The next morning I decided to come clean. I called the salon and thankfully reached the wig lady. “Er,” I stammered, “I have a sort of a strange issue that I need to discuss with you.” I explained that although I was thrilled with my purchase, I had gotten the wig home and noticed a peculiar odour emanating from it. I held my breath. “Oh bring it right in,” she responded. “I’ll take care of it.” Phew. She said she would either have it cleaned or get me a new wig, which might take over a week if it wasn’t in stock. I felt hot prickles go up my back as I recalled my experience at the first wig shop where the “same” wig did not fall the same way as the first one. I feared I might never see Gabriella again. And would have to start all over.

But that afternoon I took her back and handed her over. I left. Wigless again. I felt I had lost a good friend.

A week later I got the call. It was the wig lady. Gabriella was ready for pick up. She had gone back to headquarters and been washed and styled by their top stylist. I smiled.

The next day my friend, Susan, a terrific gal and a fellow Houstonian (I was born there), emailed with intentions of visiting that very store and did I need anything? I hesitated. “Well, actually,” I wrote, “my wig is ready to be picked up. But the thing is, you would have to smell it before you leave the store, you know, to make sure that it is really clean and fresh.” I bit my lip. Maybe this was too much to ask of a friend, even a very close friend. “I’ll do it,” she wrote. Hot damn.

She emailed once she had the goods in hand. “So, did you smell it?” I asked. “Oh yeah,” she wrote. “I smelled it so hard I probably got snot on it.” “As long as it is your snot,” I replied. “I’ll do a DNA swab when you get here.”

Now that, people, is a true friend. It just doesn’t get any better than that.

The doorbell rang. It was Susan. She handed Gabriella over. I lifted the lid and took a whiff. Fresh and clean and completely armpit-free.

So the morning after we shaved my head I put on Gabriella and left the house. I went to lunch, alone, at Le Pain Quotidien on Marylebone High Street. Leaving the house with a wig on and nothing under it for the first time was a strange experience. I kept having to remember to move my neck. “Oh God,” I thought. “Everyone knows. Everyone knows I am wearing a wig.” I tried to ignore these concerns and ordered. Then I struck up a conversation with a nice young couple who had a new baby. I reminisced about my girls when they were babies. “How old are they now?” The man asked. “Five and seven,” I said. “Oh you must have been really young when you had them,” he responded.

Dude, you just made my day. Made me feel like we can kill it, me and Gabriella together.

Cold Cap: From Rapunzel to Rambo

Once we know I need chemo, I meet with my oncologist for the second time. He’s an extremely personable and energetic Kiwi at one of the top places in London. He informs me that they have these “really great” cold caps that you can use throughout chemo to try and keep your hair. He looks at my thick wavy mane and determines I am an excellent candidate.

Afternoon tea at the Athenaeum

“Get yourself a bob,” he twangs. “With all that hair piled on top of your head the cold will never reach your scalp and it won’t work.”

Okay. So I decide to chop it. I had had long hair for well over ten years because the last time I cut it short was when I was a summer associate in Paris. I take the tube to my Hampstead hairdresser, waltz in and blurt out “hi I have cancer and need chemo so you have to chop off my hair.” Followed by a toothy smile.

He looks at me, pauses briefly, sighs and then sets to it. Very cool. No drama.

There is something liberating about cutting your hair and knowing that it won’t really matter if you aren’t thrilled with the results. You have to do it so you do it. And well, the ends were a little crunchy from years of highlighting and dyeing to conceal a generous sprinkling of salt in my pepper.

I emerge from the salon, the new me. Send pics around and everyone claims to like it — even prefer it — to my old hair (I hope later the same is said about my new vs. my old boobs but as we know from my last post that’s a tall order).  But I digress…

I consider the cold cap. How it works is: they put a plastic cap with below freezing liquid in it on your head and this reduces blood flow to the area which prevents the chemo from reaching the hair follicles. I am told best case scenario my hair will probably thin at least 20% even with the cold cap.

I conduct personal research.

Of my cancer buddies who tried it, each gave up after one or two tries because (a) it was excruciating to have a below freezing cap on your head for hours (shocker) and it gave them migraines and/or (b) the smell of the conditioner they slathered on to prevent the cap from sticking to the hair nauseated them (delightful).

Chemo for me consists of four doses of AC (doxorubicin a/k/a “the red devil” and cyclophosphamide) followed by four doses of Taxol, each given every two weeks on a dose dense regime. So sixteen weeks of treatment in all.

Here’s the catch: if the cold cap works and I retain a good amount of hair through the first half of treatment, I will have to switch to a weekly dose of Taxol for the second half and tack on four extra weeks. Why? Because Taxol when given biweekly is done on a slow drip over three hours and you cannot tolerate the cold cap for that long.

Then my friend Beth raises the possibility of a scalp metastasis if the chemo drugs do not reach the scalp. Shit.

I ask three top oncologists on two continents about this possibility. They say that scalp metastases are rare but it is a theoretical risk.

I do some math:

Freezing cold thing on my head (with loads of icky-smelling conditioner) + 12 weekly treatments vs. 4 biweekly for 2nd half of chemo + possibility hair will fall out anyway + possibility of not killing some little fucker hiding out in my scalp = NO WAY JOSE.

Sorry, but it just isn’t the honey badger way.

I inform my oncologist and the nurses at the chemo treatment suite that, no, in fact, I do not wish to try the cold cap. “Are you sure? You know your hair will fall out, don’t you?” Umm, yeah. I kinda got that. Thanks. I’m not putting that thing on my head. Fuggetaboutit.

It is just hair. It will grow back. And this way I get to go all GI Jane when it starts to fall out and maybe try out a mohawk, at least for a few minutes. Come on, you know you have always wanted to try the ‘hawk.

So I do my first chemo with my perky bob sans cold cap. The treatment suite is pretty swanky. One level under ground but cleverly designed with skylights so it is sunny (when there is sun in London) and nice white leather adjustable chaises longues. People bringing round tea and biscuits. Free wifi. It ain’t a bad place to be, really. If you have to be there. I feel like Dr. Evil in my own little underground lair (except with skylights).

A nice lady comes by who is visiting a friend having been through chemo herself. She has a cute short hair cut. “You should really cut your hair short before your next treatment,” she offers. “It’s easier if it isn’t so long when it starts to go.” I agree. I’ve been warned that when it starts to go, it goes FAST.  And I don’t want to be pulling out long pieces in the tub or walking down the street on a windy London day and have the bloke behind me get a mouthful. Ew.

So a couple weeks later, off I jaunt to Hampstead for new hairstyle numero dos.

This is the shortest lasting hair cut of my life. It lasts exactly five days. On the fifth day I shower and pull out about one quarter of my hair. I am prepared for it, as much as one can be, but still it is disconcerting. I make my husband come deal with it. He does, no questions asked.

The next night I rally the troops, sanitise the shaver my cancer buddy friend lent me, get the shears and get busy. I enlist the girls. Bill is skeptical about their involvement. “But that way it will be fun and silly.” I explain. “You can’t just have mommy show up with a shaved head.”

Although this may seem to represent great wisdom and creativity on my part, I have come to this conclusion after our five year old burst into tears following each of my new haircuts, shrieking “I HATE it! You look POOPY!” And proceeded to bawl and spit (seriously) and carry on. Luckily I have a good sense of humour and thought this was funny, especially when after an hour both times she came up and said I looked great.

I let Isabel take the first whack at it with the shears. No turning back. After a while I start to resemble a concentration camp victim. Bill and I don’t like that part much. So it is time to speed up the process and whip out the shaver. Strangely, I enjoy it. I feel powerful. I do feel like Demi Moore in GI Jane (except taller and I’m not getting paid millions). At Isabel’s suggestion, we do a mohawk.

After snapping a few pics for posterity we shave off the ‘hawk (my hair is falling out so quickly we kind of have to — otherwise I totally would have kept it for a while).  This is London, after all. No better place to be an anonymous nutter (that’s “crazy person” for you British English challenged).

And there we are. The cold cap can suck it. Because I am killing this look.

The best part? Charlotte comes up to me the next day and says “Mommy, bald is your best look.”

Boob Retrospective

The other night my husband turned to me and asked me if I ever miss my old boobs. My initial thought was to turn the question back on him and ask whether he missed my old boobs. But after a pause, I responded: “no, they were bad.” And I meant it.

I mean, I liked my boobs a lot before I found out one of them had cancer in it. Even though after two children they were not at their prime. (But they were still pretty good). After that I just sort of developed a surgeon’s mentality about them. Cut the bad shit out. Kill it. Please.

Hmmm. Let me reflect on my boobs. We had a long history. Well, sort of. It took them an awful long while to make an appearance. I went through puberty at 14 and didn’t have much to show in the way of boobs until then. By then I was a tall skinny kid without any curves and had suffered lots of jokes about anatomy throughout grammar school. “Hey, Emily, I’ve got a joke that’s so funny it’ll make your tits fall off. Oh, I see you’ve already heard it.” Hardee harrrrr harrrr. This really happened. I am not making it up.

I did not care for changing in the locker room for gym class. Most of the other girls had purchased bras (or desperately needed to) and had some hips going on (I didn’t — still don’t but that’s another story). I got impatient and finally went to a department store and bought a bra anyway. I found the thing about ten years later in the attic in a box of old clothes. It was white shiny polyester and about the size of a double eye patch. I remember when I bought it I showed it to my friend Beth and she remarked that it was baggy. This was true. Ouch.

In ninth grade they finally showed up. Overnight the commentary from the opposite sex went from banal remarks about their absence to “hey looking perky today.” In spite of myself I smiled shyly and blushed. Let’s face it; I was proud finally to have them and not going to pretend I was offended that someone noticed.

They were good. Smallish and neither too close together nor too far apart. A nice projection. And yes, perky.

Highschool was good. They were about a B-cup. They had some fans.

College, also good. I filled out a little more and was a solid C.

After college I worked as a legal assistant at a large New York law firm. I was known as bright and for my “posture.” I was able to wear dresses and tops without a bra and still look good. Not at the law firm! Geez!

They were good in law school. Of course I was still in my twenties… I bought a tight dress at Betsey Johnson in Manhattan after first year. A gal from Jersey trying on clothes too said “you have great boobs. Are they real?”

After law school I clerked for a judge in New Orleans. Her fast talking, animated and hilarious courtroom deputy at the time referred to my boobs in his Louisiana drawl as “the rack” and asked frequently after them as a surrogate for asking how I was. “Hey, Em. How’s the rack?” They were a nice D by then.

There was also the “decoy eye” incident, whereupon a man with strabismus entered the chambers and asked to speak to me about something procedural. I came out and talked to him for about ten minutes (during which it became clear that no one could help him because he was dumb as a post). After he had left, the judge’s assistant said that she had had to leave the room while we were speaking because she was so uncomfortable. I said “oh, yeah. I know what you mean. He was so dumb and I couldn’t help him understand…” She replied that no, in fact, she had been uncomfortable because he had been staring at my breasts the entire time we were speaking. “What?” I replied. “Are you sure? He was looking me in the eye the whole time.” Without missing a beat, the courtroom deputy chimed in “that was just the decoy eye.”

I wore a strapless dress to my wedding. It was fabulous. I purchased the white strapless bustier bra at a posh shop on the Upper East Side in Manhattan, had it altered to fit the rack just so and then sewed into my dress so there would be no wardrobe malfunction. And this was before that Janet Jackson incident.

During pregnancy, my boobs started creeping into scary letters of the alphabet, and when years later I unearthed the underwire bras I wore in the eighth and ninth months I was amazed at their size. They resembled two fabric salad bowls connected by a strip of material rather than the double eye patch I started with.

After the birth of our first child, I remarked that each boob was larger than the child’s head. Granted, she did have a small head. But still. I snapped a pic of myself holding my child with much of my boob strategically covered by one hand and sent it to a pregnant friend. She pinged back “I am SHOCKED. SHOCKED by the size of your boob.”

When I went to a postnatal yoga class about two weeks after giving birth, my adorable and tiny yoga instructor took one look at me and said “I see that your milk has come in.” Read: stay back or you might take me out with one of them things.

After giving birth to Isabel, a maternity nurse remarked that she thought “I was going to have quite a supply.” Indeed she was right. I nursed each of my babies for about a year and appeared to have enough leftover to feed several other children.

And after Charlotte was weened they were a little deflated but really still nice boobs. I was still able to wear some dresses and tops sans bra and look good.

So now I ask myself again: do I miss my old boobs?

I guess what I would say is that I think of them fondly. We had a good run.

Now when I watch television or a movie and there is nudity I don’t see breasts the same way I did before. I am more attuned to the shape, the projection, the way the breasts move or don’t move when the actress moves her body. When I take the tube (this is the London underground train for those who aren’t familiar) and a young lady with attractive boobs gets on I admire them more than I might have before. I try not to look for too long.

I miss softness and movement and that natural slope.

What I have now are my temporary boobs. Because I had immediate reconstruction after my bilateral mastectomies in early February, I have “place holders.” They are filled with saline and are making a nice pocket for my permanent silicone implants, which I will get, if all goes well, later this year. They look pretty good. Even in a bra you can’t tell. But they are hard and they do not move. I mean at all. I could jump off the top of a truck and the things wouldn’t budge.

But I do get to do something special. Every once in a while, I go into see my reconstruction surgeon and he expands them suckers with another 50 ccs of saline each. This takes a very little time. And I leave his office with bigger boobs. Instaboob. Bigger tits in 60 seconds. Think of the fortune that could be made if this service were available for normal women.

I am fembot hear me roar.

I get to try before I buy. The newbs will have more projection and softness and movement than my tempies even if they won’t be the real real thing. And they will never sag. I will be the hottest mama in the nursing home. Still killing it in a low-cut dress with no bra. Hooah.

 

 

Breast Cancer for Dummies Part I

You know, it’s funny. I didn’t know much about breast cancer before I had my battery of tests over Christmas holiday and started to go all hyper lawyer research on the subject. I suppose that isn’t unusual. Things move on and off one’s radar, but even with a relative or a friend going through something, there is a lot you don’t know. Until it affects you personally.

And unless you are a health care professional or you or a close relative or friend is going through breast cancer, or it simply interests you or it is for whatever reason your cause, you don’t need to know that much about it. However, I thought it might be interesting to put together a little primer on some basics for those people who want to have some clue but who aren’t ready to run out and buy Dr. Susan Love’s Breast Book, which is several inches thick. Very informative, but not exactly beach reading.

Forgive the personal slant.  I still don’t know that much about breast cancer that isn’t “my” type of cancer. And I refuse to use the “P” word — prognosis. So don’t you go running off and typing in this and that and trying to prognosticate me or anyone else based on bits of information you get along the way. Prognosis is very personal and as my oncologist said to me, a percentage based on years-old data about five-year survival rates isn’t going to tell us anything about YOU, the individual patient. Besides, we have already established that I am killing it.

Oh and before I start, let me disclaim: I am not a medical professional nor am I giving any medical advice. This is all just based on my own experience and knowledge and I haven’t vetted it with a doctor (or anyone else). It’s simply what I’ve picked up along the way. If you are a breast expert and you see anything here that does not appear correct please submit a comment and I shall fix it forthwith. And if you don’t want a primer on breast cancer feel free to skip today’s blog. It is longish and only has the occasional witty repartee.

Oh are you still there?

Right, so off we go now.

Actually wait, let’s start with a multiple choice quiz just for fun. Oh stop sweating; you LOVE multiple choice. Pretend you are reading Cosmo or GQ and it is a sex quiz. Juicy!

1. You are doing a breast self-exam in the shower. You feel something in your breast or axilla (that’s armpit for you Latin losers) that gives you pause, be it a hard bit or something sore or tender or something that just feels different or weird.

You should:

A) Not worry about it — it’s probably nothing.
B) Report the problem to your OB-GYN and set up an appointment.
C) A or B depending on what you feel.

Answer:  B

Don’t screw around. When I found my little barely palpable (doctors’ words) pea-sized lump (which turned out as you will learn to be a hell of a lot larger than a pea), it was not as hard as I thought it would be having felt “dummy” breasts with a “tumour” at both a conference for women’s health and at my OB’s office. Also, my lump was sore and tender and didn’t seem to stay in one place if I pushed at it (all of which I had read and heard — even from doctors — indicates that it probably isn’t cancer).

Just do it. And if you are nursing and think you just have mastitis or a clogged milk duct do not assume such. I have heard too many stories of women who found a lump while nursing a newborn and it turned out to be cancer.

So there you are with your lump and you go for your OB-GYN appointment. What next?  After your physical exam your doctor should order some imaging so the radiologists can look at the breast tissue up close and personal.

2.  Imaging used to look at breast tissue and to aid in detecting breast cancer includes:

A) Mammogram
B) Ultrasound
C) MRI
D) All of the above

Answer: D

Because I was 39 when I found my lump, I had not yet had a baseline mammogram, which generally start at 40 in the US. My OB-GYN ordered a mammogram and an ultrasound to check my breast. The mammogram revealed clusters of micro calcifications in my right breast, which CAN be indicative of cancerous activity (calcifications are not uncommon, and macro calcifications are generally ok — micro can be ok too but depends on how they are arranged). These are tiny and looked to me at best like flecks of white powder on the slide. What the mammogram did not see, however, was the tumours. Not even a little bit. The ultrasound following the mammogram revealed two masses which did turn out to be tumours. A later MRI (post-biopsy and diagnosis) revealed further suspicious areas that when analysed after surgery turned out to be interconnected bits of tumour.

Imaging is amazing but it has limitations. Mammos and ultrasounds don’t show everything and sometimes imaging, such as an MRI, can lead to false positives, or in other words, seeing things that aren’t really there. Other things that can feel like or show up as masses on imaging include cysts, fibroadenomas, bruises, mastitis and scar tissue.

Often after having imaging the patient is told to wait (and sweat and freak out and pee four times) while the images are examined and then further images are requested. This doesn’t mean you have cancer. But the waiting sucks either way.

Tip: if you have had imaging before, it can serve as a baseline to radiologists and technicians doing subsequent imaging. Make sure that the imaging centre has your old images and the dates thereof and doesn’t waste time pouring over a new thing that turns out to be something you had five years ago that hasn’t changed and is in fact fine. Don’t balk — you have to take the reins if you want good healthcare.

The radiologist will rate what they see on the images with a special scale (you don’t need to know the specifics). It may or may not warrant a biopsy. Sometimes if it doesn’t warrant a biopsy, but the doc has some concerns, she will suggest the patient return for follow-up imaging in some period of months (e.g. 3 or 6). Sometimes, however, a biopsy is warranted. These are performed in various ways, including a core needle biopsy, where they take a little “linguine” slice of the area of concern, or surgically under general anaesthesia, by removing the lump or suspicious portion of the breast. Needle biopsies can be guided by a special mammogram machine (stereotactic biopsy) or via ultrasound. The radiologist performing the biopsy uses the image to locate the area to be biopsied and takes her samples.

Sometimes the radiologist will insert titanium markers into the biopsy sites to let others know where she has been. Cool, huh? This can be helpful later on so they know where the suspicious areas were if they have trouble finding them later. And no, it won’t set off the metal detector at the airport or cause an MRI machine to start smoking. It’s titanium, not stainless steel, for crying out loud.

3. About 80% of all breast biopsies turn out NOT to be cancer.

A) True
B) False

Answer: A

This is helpful to know. It becomes less helpful when the fellow (I mean medical fellow, not chap — mine was a chick anyhow) tells you this and then the more experienced radiologist comes in and decides your mass “is definitely not a normal cyst” and refuses to put a percentage on whether your thing is cancer. Great…

Once the biopsies are performed, the samples are sent to histology to be reviewed by a pathologist. The pathologist will determine whether there are any cancer cells in the samples taken, what kind of cancer there is and what certain features of that cancer are.

Waiting for these results is not fun times. In fact, it was probably the worst week I have ever had in my life. But I still tried to party, since it was the holidays and all.

As I mentioned in my first post, at this point in the process it was clear to me that it was more likely than not (this is lawyer speak — embrace it it won’t be the last time I revert) that I had cancer. Some kind of cancer. This is when the temptation to scour the internet soars and you find yourself with your finger on the button… about to take the plunge into the black hole that is medical information available on the internet. This brings me to a very important question in our quiz:

4. You may have breast cancer. You do not know very much about the topic and are keen to learn more in order to be better informed, torture yourself and because you cannot help it. You should:

A) Get right on the internet and surf away with abandon.
B) Do not touch the internet. Instead, take a sleeping pill and get drunk.
C) Go to the book store and purchase a reputable book on breast cancer.
D) Some combination of the above.

Answer: This is a trick question. I cannot answer this one for you. Because it really depends on your personality. If you are an information person and a rational logical person you are unlikely to be satisfied by B. I wouldn’t recommend A to anyone, because not only is there a lot of crap on the internet, but because you will likely get overwhelmed and have difficulty processing what you find and deciding what is relevant/helpful and what is not at this early stage in the game. C seems a solid choice if you can force yourself to sit still and read a book on the topic. Had I to do it all over again I would choose D.

If you must do internet research, pick your websites carefully. Here are some ones that I have found helpful, but not without limitations: www.breastcancer.org; www.macmillan.org.uk. I advise you not to read a lot of personal posts by breast cancer survivors and current sufferers (except for my blog since I am brilliant, of course) because lots of people are dumbasses or totally mental or some combination thereof and you may just get confused or simply annoyed. No offence. But it’s the same thing with forums on anything else, such as the best carseat to select for your infant or whether a home tongue piercing is easily reversible.

Okay, I have offended some people. I am sorry. You may eventually take great comfort in participating in a forum about breast cancer, particularly if you find others who appear to have a similar diagnosis. My point is really this: IT IS TOO EARLY. Doing this now may just freak you out. You aren’t a member of the club yet. Wait and see. You can always find your internet forum cancer buddies later if need be.

At this point I did do some internet research. I quickly decided which sites appeared not to be full of crap and I tried to digest some basic information without going too far. I didn’t read a book about it for a long time. That came later. And of course I had Beth, my plastic surgeon/breast recon best childhood friend. Most people don’t have a Beth. She gave my husband and me a lot of information in the beginning and we knew we could trust her.

5. The following is by far the most common type of breast cancer diagnosed:

A) Ductal Carcinoma In Situ (DCIS)
B) Invasive Ductal Carcinoma (IDC)
C) Inflammatory Breast Cancer

Answer: B.  That’s right, about 80% of breast cancers are invasive ductal carcinomas.  Invasive cancer means that the cancer has spread to tissues surrounding the area where it started, in this case, in the milk ducts. DCIS is noninvasive but also starts in the milk ducts. It has not yet spread to the surrounding tissues in the breast.

I was diagnosed with multifocal DCIS and IDC. This is not uncommon. The areas of IDC started out as DCIS and then moved beyond the duct and thus became IDC. So both types were present. And I fall into the majority. I just love being like most people. Yay.

Once you find out what kind of cancer you have you also learn some things about how the cancer cells are behaving and how different they look from normal cells. This is called grading. As my OB-GYN put it, most cancers are at least a Grade II, which means “moderately differentiated.” The more icky they look and the less like normal properly-behaving cells, the higher the grade. Mine were Grade II. Misbehaving but not misbehaving as badly as they could be.

You also find out some other features from pathology, such as whether there is any lympho-vascular invasion present in the biopsy samples. This tells us whether those pesky cancer cells in the samples have gotten into the blood vessels and lymphatic system. My initial pathology report: mine have not. This is later re-examined after surgery when they remove more tissue and can test with more accuracy.

A third thing you will find out is whether the cancer cells biopsied are hormone receptor (oestrogen or progesterone) positive or negative, or positive or negative for expressing HER2 which is human epidermal growth factor receptor 2. Shut up you fellow Americans, that is how they spell oestrogen in the UK. Really.

Receptor statuses are indicated as such: ER+/-; PR+/- and HER2+/-. Your combination of receptor statuses will guide your doctors in how to treat effectively your cancer. For instance, if you are ER+, oestrogen from your body will make your cancer grow and you may receive hormone or endocrine therapy either to block your natural production of oestrogen or to introduce fake oestrogen into your body to trick the receptors on the cancer cells. These receptors will grab the decoy oestrogen and then die or become dormant. Ha, ha!

The results of my hormone and HER2 receptor status seems to take ages. It is the final piece of data that we receive from the biopsy. And they’re in: It is ER+/PR+/HER2-. This, all things considered, is a lovely combination and good for treatment purposes. Rather pathetically, I am elated at this news. One takes what one can get.

I will thus need endocrine therapy, which has proven very effective, as part of my treatment. Being HER2- means that I will not need a drug, such as Herceptin, to deal with that protein receptor. Some people have a combination called “triple negative,” which means that they are negative for all receptors. This kind of cancer is certainly treatable but tends to be more aggressive and will not respond to endocrine or hormone therapy. And there are other combinations as well. Some of these tend to be more or less likely depending on whether you have one of the breast cancer genes they can test for — but that is for Part Deux of Breast Cancer for Dummies.

So you see there are a lot of factors at play here, even at the very beginning of the story. All of these bits of information start to fit together and build a game plan as to how to treat the individual patient. How to kill your cancer.

Well that was a mouthful. I promise the next entry will be shorter and funnier and dirtier and sexier. But sometimes you need to take your medicine. Part Deux to follow at a later date. But not tomorrow. That took ages. I’m wiped.

Peace out.

A Chemo Haiku

I am tired so let’s make today’s short and sweet, shall we?

I like to think of chemotherapy as napalm for cancer. Because napalm conjures flamethrower warfare, however, perhaps Agent Orange is a more apt metaphor. Particularly since it was a defoliant.

Of course, that chemo nukes the patient is somewhat problematic, but I can handle it. Just get in there and kill any fast growing cell you find and be done with it. Death to the old bad cells. And, alas, to a lot of the old good cells. But lo, this brings me to today’s submission: a chemo haiku.

Chemotherapy
The ultimate spring cleaning
A new me will blossom

Thank you, Kate, for inspiring today’s blog with a picture of angelique tulips bursting forth. Now if only this crap, London weather would improve I might see some blossoming in my own garden in the near future.