Category Archives: Breast Cancer

Spam spam spam spam…

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My blog has been up for what, two weeks, and the bloody spammers have found me.

When I initially set up the blog, I read that spammers could clog up one’s site with “comments” on posts. I even thought I had set up a nifty software plugin to deal with the issue prophylactically, should they ever find me. But apparently I forgot to activate it (until just now).

So for the last few days I have been filtering some pretty dumb crap on ole killingitblog. I’ve been marking such crap as spam one comment at a time. Not very technologically advanced and about as much fun and effective as swatting flies one at a time with a month-old ham on the counter and the back door wide open.

Well here’s a little bit of advice for all you spammers out there who thought it was a good idea to post comments on my website, which in case you hadn’t noticed, is about breast cancer and shit:

(1) If you tell me that my blog is “one of the best you have ever seen” and that you will “subscribe to it if I will try your pills” it sounds a little disingenuous, dontcha think? What are you, eight?

(2) I am not interested in buying Viagra, whether you ask me in English or in Flemish, whether you spell it with a capital or a lowercase “v.” I do not have a penis, and if I did it would not have erectile dysfunction. Rather, it would be a sizeable, virile, killing it machine. Naturally.

(3) Despite the fact that numerous surgeries are in my future, none of these surgeries involves a sex change or otherwise getting a penis. So I do not need any Viagra. Are you getting this, you daft prick?

(4) I do not need to “get my girlfriend back” so you can stop posting dumb comments on my site as well, thanks very much. If you read anything I have written you might clue into the fact that my female issues, although quite plentiful, don’t involve a long-lost lesbian love. Or getting her back. Although that might spice up my “journey” and increase readership.

Now LOOK: if you have a question to ask me, even if it is just a “yo how r u” or “where u at,” or you have some feedback on an issue (“you swear too much”) or a correction to offer (“your science is all wrong”), please do post a comment on my site. Comments are nifty and I so enjoy sifting through them when they are legit.

But you spammers beware, or I’ll go all honey badger on your ass.

That’s all I have to say about that.

 

 

Breast Cancer for Dummies Part Deux

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Because I started my blog in the midst of chemotherapy, rather than at the beginning of my story, I have jumped around quite a lot. This has turned out fine, because — at least in my experience — life is rarely linear. However, I do feel that it is time to continue with the story of how I ended up here, five out of eight chemos in, fighting breast cancer. This leads me to the second instalment of Breast Cancer for Dummies.

As I mentioned in my first post on this topic, “Breast Cancer for Dummies Part I,” I am not a doctor, nor do I have any expertise on this subject other than what I have learned along the way in dealing with my own disease. Nevertheless, I believe that you will find the following useful if you ever wanted to know more about breast cancer without reading a text-book, or if you are just curious to know how I got to this point. If this grabs you then you should start with Part I above if you haven’t already read it, or maybe give it a skim to refresh your recollection if you have read it. Conversely, if you find this all too technical and “involved,” fear not. More silly posts about this, that and the other thing are forthcoming. And I won’t be offended if you skip this one.

Moving right along…

Where did I leave off? Ah, yes. I took you through finding my lump, having imaging, getting biopsies and initial diagnosis. So here we are in the first week of January 2012 and we have, in the right breast, multifocal, ER+, PR+, HER2-, Grade II Ductal Carcinoma in Situ (DCIS) and Invasive Ductal Carcinoma (IDC) with no apparent lymphovascular invasion. The biopsies reveal at least two tumours, oriented radially, each appearing to measure under a centimetre.

Oh, and I won’t make you take a multiple choice quiz this time because I know you were upset about that in Part I and it made you have flashbacks from the SAT or whatever torturous British or [insert appropriate nationality] exams you had to take. I don’t want you breaking out into a cold sweat and shorting out your computer, tablet or smart phone. Isn’t that nice of me?

Anyhoo, when we left off I had just been diagnosed with breast cancer. What then? The first order of business with cancer like mine was to see a breast surgeon. When I was told this it sort of took me aback. What about an oncologist? What about “the whole picture?” Well, how it works is, they like to get the tumour(s) out of you first and then they figure out the whole picture. So breast surgeon it is. He looks at the pathology from your biopsies and your imagining and recommends what kind of surgery you need. This becomes step one in the big “killing it” game plan.

I found that putting in place the game plan was a big deal. Once I began to do so, I started feeling a hell of a lot more in control, because I knew what step one was. This was instrumental in moving beyond the initial shock of “how can I have cancer?!” and “why me?!” and all of that unproductive Nancy Kerrigan-esque jazz. No one likes a whiner.

Now, if you read my first post, “Halfway Through Chemo… How Did I Get Here?” you may recall that having spoken to Beth, my plastics/breast reconstruction surgeon buddy, I had already begun to wrap my head around removing the entire breast (maybe both) even before I had my diagnosis. Beth had seen and heard about a number of women who had opted for lumpectomies and then ended up with a recurrence in the same breast and thus a mastectomy anyhow. She had also seen women who had opted for a single mastectomy who ended up back under the knife for mastectomy number two after a recurrence in the “healthy” breast.

That being said, the most common surgery for breast cancer remains lumpectomy. With lumpectomy, the tumour is removed and then generally the patient is given radiotherapy to reduce the risk of a local recurrence in case any cancer cells remain at or near the site. Sometimes more surgery is required after the pathologist examines the removed “lump,” which you can think of as a cube of tissue, each side of which is rubbed with ink to determine whether there are “clean” or “dirty” margins. This is not an exact science, but the gist is that the surgeon wants to get a clear margin around the tumour so that dirty a/k/a cancer cells are not left in the patient.

So there I was, back in London, armed with my initial pathology. And I needed a breast surgeon.

One of the greatest sources of stress we faced was figuring out whether we were going to be comfortable doing my surgery and any additional (if any) treatment in London, having lived here for exactly five months, or whether we felt we needed to haul ass back to the US. So after we made some enquiries about the best and the brightest — hee hee! I almost wrote “the breast and the bightest,” — I started calling around. I went totally honey badger on the situation. (By the way if you still do not know what the honey badger is, I am going to get a little annoyed at you. So please watch Randall’s YouTube video linked above and get caught up.) I managed to secure two appointments with London-based breast surgeons on very short notice. A good sign.

Days later I saw the first guy. He was both a breast and reconstruction surgeon. He recommended based on my pathology and imaging that I have a mastectomy in the right breast and monitor the left breast. He ordered an MRI to try to get a better sense of the locations and sizes of my tumours.

Three days later, I saw the second surgeon. He also did both breast surgery and reconstruction and concurred that I needed a mastectomy. That the cancer was multifocal warranted removing all the breast tissue. I was comfortable with this and frankly relieved that both surgeons recommended the course of action I had already envisioned based on my conversations with Beth. I thought about the healthy left breast. I had been told that in the UK, many surgeons are loath to do a risk-reducing mastectomy when the unaffected breast can be “monitored” going forward, as surgeon no. 1 recommended.

I have to say, I didn’t like the idea of that. I did not ever want to deal with this again. Plus, I figured at the end of the day if I was going to lose one boob I might as well just do them both. One boob, two boobs, whatever. Just kill it.

I pushed the second surgeon on it. “If I were your sister, would you advise me to remove the other breast?” His head nodded an emphatic “yes” before “breast” even left my lips. His eyes never left mine as he said the word. Okay, this was my guy. He was honest and straightforward and aggressive. That was what I needed, wanted. So I decided I would have them both done. By him. Step one of the game plan firmly in place. Check one box. Kill it.

I know. This post is kind of heavy, not as much fun as the beer fermenting in the bathroom or wearing leopard print to chemo. But you have to take the bitter with the sweet, my friend. It is part and parcel of the whole picture and I want you to understand where I am and where I was.

And did I mention there is a silver lining? When you do a bilateral mastectomy, you do tend to have an easier time getting a more symmetrical cosmetic result. So that was a plus in my mind right there. No cancer and matching boobs. Good show!

Step two was a visit to a reconstruction surgeon. Now, as I mentioned, some breast surgeons (these are the folks who do lumpectomies and mastectomies — their job is to remove the cancer) do their own reconstructions and are “oncoplastic” (onco being cancer and plastic, well, duh…).  But there are some pretty tricky reconstruction procedures to choose from these days, and many breast surgeons do not dabble in some of the more involved techniques.

I was told I could have an immediate reconstruction following skin-sparing bilateral mastectomies, which means that they were going to give me new (temporary) boobs right away after removing all of my breast tissue, but keeping as much of my own skin as possible. That way you look down and see your own skin. It’s just what’s inside that’s all new.

This is quite a departure from a radical mastectomy, which for years was all that was available to women, leaving them with a scar from armpit to midline. Of course, some patients today still require a radical mastectomy, depending on the extent of their cancer. Yet for many of these women, a delayed reconstruction remains a possibility. I was simply fortunate enough to be a candidate for instant gratification. An immediate boob swap, as it were.

But what kind of boob swap?

I went to see the breast recon guru so that I could consider all the possibilities. This guy is known not only for his excellent breast reconstructions but for his fabulous boob jobs to the stars. Aim high, I always say. I liked him immediately. He was gentle and kind and sympathetic, and I felt comfortable in his hands (literally — I mean all modesty goes out the window with this, people). I stripped and he felt me up. And then he pinched my tummy and my bottom and the inside of my thigh. Why? He was weighing his options. There are some pretty amazing microvascular surgeries they can do now where they take a bit of tissue from your abdomen, inner thigh or rear-end and make a boob out of it. Really. The benefit of these surgeries, although they do involve a site scar and require a long recovery period, is that the reconstructed boob can last indefinitely if all goes well. This is because it is made of your own tissue and fat, so it looks and acts more like a natural boob, which is — as we all know — mostly fat.

He didn’t pinch me for long, however, before it became clear that these fancy procedures were not an option for me. Not enough extra tissue, he said. I hadn’t eaten enough fries (chips if you are a limey). In a way I was relieved. It was sort of nice to be told that I was too thin for that option (aw shucks). Also, then I didn’t have to decide whether I wanted to deal with a seven-hour surgery that would require months of recovery while trying to take care of a five-year-old and a seven-year-old.

Now don’t get me wrong, the autologous tissue flap, as these things are called, is an excellent and desirable option. If done well and pulled off without complications it yields a more natural breast and can last forever. But it is a big deal. And there just wasn’t enough fat on me to do it so that was that.

Implants it is, he said. Okay. Do it up.

Have you ever seen a silicone implant? Most of them are shaped like M&Ms. They are symmetrical. But being in Europe has its advantages. Here, they have been using “shaped” implants for well over ten years, implants that are still in clinical trial in the United States. These are also known as gummy-bear or 410 implants and are made from cohesive silicone that is less liquid-y than the traditional silicone implant (thus the comparison to a gummy bear, though I wouldn’t want to eat one). These implants are interesting for breast reconstructions because they are shaped more like a natural breast, with a slope and a projection. That is, they are flatter at the top and rounder and fuller at the bottom. More boob-like.

Well, thanks to a friend of mine whose two buddies recently had breast cancer in the US and whose surgeon happened to be participating in the clinical trial, I knew about the gummy-bear implants. I asked the recon guru. Yes, he said. He liked them and would use them on me. But first I would get saline expanders (basically temporary implants that are inflated with salt water) in order to make a nice pocket for the permanent silicone implants. Getting them primed for boob swap number two later on down the line. Patience is a virtue…

By the way did you hear about that son of a bitch in France who sold all those implants made out of industrial grade silicone? I cannot even tell you what I want to do to him but I think you can imagine. It involves a honey badger.

Okay then, step two in place: reconstruction. I had started to assemble my dream team. And they would work together, the breast surgeon doing the mastectomy on one side with the reconstruction surgeon following on his heels, and then onto the other side.

But we need to back up. There was another order of business to address. This was the sentinel node biopsy. Before beginning the mastectomies, the breast surgeon would remove one or more lymph nodes from under my right arm to find out if they contained any cancer cells. The sentinel nodes are like the guardsmen lymph nodes — the first line of defence. A technician locates them by injecting you with a radio isotope near the tumour and then tracking to which lymph nodes that isotope drains. X marks the spot and the breast surgeon removes this node(s) at the beginning of surgery so that it can be tested for cancer cells, often while the patient is on the table. If cancer cells are found, the surgeon will perform an axillary lymph node dissection (ALND), which is when they remove a number of other (or all) the lymph nodes.

The long and short of it is that you don’t want to find cancer cells in your lymph nodes, because it means that the cancer has started to spread. You can still kill it of course, but it isn’t what you want. If they find cancer in your sentinel nodes, they remove more nodes to see how many of them contain cancer cells. And all of this factors into your treatment plan. Whether you will need chemotherapy to seek and destroy any cancer cells floating around in other parts of your body/bloodstream and/or radiation to kill any cancer cells that are hanging out at or near the site from which the tumour was removed.

The night before the surgery I slept well. Really, I did. I was calm and ready to get on with it. D-Day was February 7 and I had waited about a month after diagnosis for my surgery. Although this sounds scary, I was assured by doctors on two continents that unless you have a very aggressive form of cancer, waiting a month or even two should not make a difference because breast cancer is slow-growing.

Still, the waiting was not easy. Indeed, it was the hardest part. This is because you cannot progress with the next step of your game plan until after the tumours are removed during surgery and then analysed by the pathologists. So you wait, and noodle and try not to be too mental. I dealt with it by going to the gym a lot, which you know if you read “Work It Out.”

The morning of the surgery, my husband took me to the hospital, to be joined later by my mother who had stayed at home to see the girls off to school. Once I was in my room, each surgeon came to see me, separately. Each explained what he was going to do and the recon guru marked up my boobs with a permanent marker and took pictures. Again — all modesty out the window. I smiled for the camera. A little while after that, I waved to Bill and they wheeled me out of the room. The anaesthesiologist had me out in about 20 seconds.

I woke up to my name being called. “Emily… Emily.” I blinked, had no idea where I was. I snapped back into focus. “The node, was it negative?” I asked. The nurse didn’t know. “The node…” I said. The anaesthesiologist rounded the corner and confirmed: the node had been negative. I exhaled. So they hadn’t removed any other nodes. All had gone according to plan.

Shortly thereafter, they wheeled me back into my room. I started ordering my poor husband around immediately, telling him to send an email to everyone that all had gone well and I was fine. I had killed it.

But alas. I still had to wait for my final pathology report. And that is why cancer is such a BITCH. Because just when you think you have won one battle, it sucker punches you right in the face.

I went into the hospital on a Tuesday. On Saturday morning, (still in the hospital) the breast surgeon came to see me. I was happy to see him. We chatted briefly before he got that serious look that doctors get and told me he had some pathology results. Bill was still at home with the girls.

“Were there any surprises?” I asked. “Yes,” he said. I got my notebook. Sat down.

They say that when you get difficult news, you should always have someone with you because you only absorb about 20% of what you are told. I’d like to give myself credit for about 80%, but it is harder when you aren’t prepared.

The breast surgeon said that there were three things we had not expected:

(1) The tumours were larger than the imaging had indicated, because one area of what appeared to be discrete little spots were actually interconnected and therefore counted as one tumour. That one measured 30 mm or 3 cm. The other one was about 14 mm. Shit.

(2) Although the sentinel nodes were clear, two other tiny nodes that happened to come out as part of the mastectomy revealed “micrometastases,” which are bits of tumour that are 0.2 mm to 2 mm in size. These nodes needed to be further analysed to determine whether the cancer cells were in fact that tiny, and therefore less significant, or whether they were bigger and posed more of a threat. If “macrometastases” were found, they might eventually have to go in and do that axillary dissection.

In any event, (1) + (2) = chemotherapy for me. This was not easy news to digest. But I kept writing, determined to take intelligible notes so that I could make sense of it all later.

And he wasn’t finished.

(3) Even though I had had all of my breast tissue removed (the whole point of the mastectomy), the margins of the tissue removed in the right breast were not great. Tumour was “present” at the margins, meaning in my case that it had abutted the natural barriers of my chest wall, posteriorly, and my skin, anteriorly. Therefore, he thought, I needed radiation, something we had been about 85% sure I wasn’t going to face.

That Saturday was rough. And it marked the beginning of yet another waiting period.

But the next bit of news we got was good. A week later, we saw the oncologist and he confirmed that the nodes had only micrometastases. Micro mets used to be undetectable but modern technology has allowed us to find these tiny cells. Some doctors treat the presence of micro mets no differently than finding nothing in the nodes (i.e., they treat such a patient as “node negative”). My doctors, although very encouraged by this news, did feel that the presence of the micro mets plus the size of the tumours warranted a more aggressive stance on both chemotherapy and radiation, tipping the scales in favour of both. Part of this had to do with my age. They tend to be more aggressive with breast cancer when you are young.

When I asked the breast surgeon why there might have been tiny deposits of cancer in these random nodes that “happened” to come out with the mastectomy but not in my sentinel nodes, he indicated that when one has cancer there are probably micro mets present somewhere. It happens. And this does not mean that they will ever grow into tumours. Or that you have a bigger metastasis elsewhere. But it still blows your mind.

And that is how I ended up where I am today, five treatments in. Counting down to June 7, five short weeks from now. My last chemo.

Two weeks after that I will begin radiation, five days a week for five weeks (my, that’s a lot of fives). Whew.

If you got through all of that I commend you. It sure as hell pooped me out.

Day-Glo Orange Surprise

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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

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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

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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

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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

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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

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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

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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

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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.