Part Forty-Six: More and Less

            Having successfully made the forty-mile drive from Bartlesville to Owasso, my first stop was at Sprouts, the grocery store I love.  My cart held only two items when a lightning bolt of pain struck my lower back.  Suddenly I could barely walk.  Excruciating jabs and stabs accompanied every step.  I was determined to pick up the items on my list; after all, I had 45 minutes until my doctor’s appointment.

            I took mincing steps and frequent stops in the attempt to dampen the pain.  I adapted and shortened the shopping process accordingly:  no stooping for bottom shelves and no random browsing.  Fortunately, somewhere between the bakery (I never even try to resist buying those yummy flax muffins) and the check-out, the pain dimmed down.

            It’s a good thing it did because I got to Bailey Medical Center a little late and had a hard time finding the sleep clinic.  Twenty minutes before I had been barely limping along, and now I was walking at full pace.  But arrive there I did, and as it turned out, filling out the last bit of paperwork took longer than it did the doctor to decide he would refer me for a sleep study.  From there I drove home, my lower back complaining about the gas pedal and brakes--and relaxing when the cruise control was on. 

            It is true that I over-exerted myself that morning:  I sorted out and straightened up my shoes, bagging up the ones I have not worn for a year or more.  That involved a lot of bending, which I guess was not such a good idea.  But I am supposed to be exercising more, and cleaning up the closet floor felt like exercising.  Diet and exercise, my primary care physician said at my check-up last week when the finger prick blood test revealed I am borderline diabetic.   

It’s looking like self-care and medical appointments will continue to keep me busy now that the end of cancer treatment is within view:  Eat less (count those carbs), walk more, see a specialist regarding my spine, do a sleep study, and start radiation therapy sometime soon.  In addition, make appointments for what got delayed during cancer treatment:  dental check-up, eye exam, and colonoscopy.  See my oncologist and radiologist next week, my surgeon in six weeks, and my primary care physician in three months. 

And in the meantime, no more bending, lots of walking, and less muffin-eating.

           

            

Part Forty-Five: Cancer in Three Tenses

            The other day I found myself talking about cancer in past tense.  It surprised me.

            Yes, cancer is past tense in a significant way:  a squeaky clean pathology report showing no evidence of cancer.  None in my breast and none in my lymph nodes.  The chemotherapy did its job.  It may be more accurate to say that the chemotherapy was so successful because of many people’s prayers.  God heard and answered those prayers.  I am grateful.

            Yet, cancer is still present tense in a significant way because radiation is the next step in the cancer treatment protocol.  About six weeks of radiation, five days a week is the standard.  The blessing is that I will receive those treatments right here in Bartlesville.

            In some ways, cancer will continue to be both past tense and present tense in the future.  I have some scars to prove it, though I don’t plan to show them off!   There are also lingering effects from the chemotherapy, such as my increased memory glitches and occasional peripheral neuropathy.  My hair is growing in gray:  believe it or not, I’m excited about that!  However, the white chin hairs I discovered looking in the bathroom mirror last night are not nearly as exciting, and I wonder if my eyebrows will ever look the same.  The sole lymph node removed in surgery gives me a slight chance of developing lymphedema (persistent swelling) in my right arm.  And the radiation . . . well, I hope it will leave nothing but a memory.

            There are larger, more important impacts that I hope never dissipate.  A deeper experience of “the peace that passes understanding.”  A new understanding of what people with cancer go through, a new compassion for their suffering, and a new appreciation of their courage.  More gratitude and joy in things that can easily be taken for granted, such as getting out of the house, taking a short walk, driving my car.  I don’t ever want to forget that all of life, even the insignificant moments, is precious.  I want to be thankful always for what I have and never begrudge what I do not have.

            What I am most grateful for is that God knows what the future holds.  In the last six months I’ve learned, more than ever before, that I can put my trust in Him.  No matter what.

Part Forty-Four: Complete Response

            Today (November 22) is another landmark day, a pre-Thanksgiving Tuesday I will celebrate for years to come.  It is the day I received the two best words a breast cancer patient can receive from her surgeon:  complete response.

            Complete response means that the pathology report from last week’s lumpectomy and sentinel node biopsy was negative.  In other words, I am cancer-free!  All that remains is radiation.

“Wait a minute,” you say.  “Why do radiation when you are cancer-free?”  That has been my question for months.  I was sure that if I was declared cancer-free I would never consent to radiation.  Today, I asked Dr. Smith what would happen if I did not do radiation.  She knelt down beside me and said, “Without radiation, the risk for cancer recurrence in your breast is thirty percent.  With radiation, the risk for recurrence is fifteen percent.  Why stop treatment now when you have all the hardest parts behind you?”  Her facts, the solemnity of her tone, and the look of compassion and concern on her face sealed the subject for me.  Besides being a highly skilled surgeon, she is an incredibly compassionate woman who is invested in the well-being of her patients.  She wants the best for me, and she has the knowledge and experience that give her words great weight.

            Thus, I am saying yes instead of no.  

Part Forty-Three: From Worst to Best

            I was prepared for the worst.

            And only now do I realize why:  Because of being so sick all summer from the “red devil” chemotherapy.  Because of the pneumonia that landed me in ICU over Labor Day Weekend.  Because of the peripheral neuropathy from the Taxol.  It’s been a rough road.

            I was supposed to be rejoicing over the death and disappearance of my tumor.  And I was, except that I was having such a hard time with the neuropathy.  And then the week before surgery, I was struggling emotionally with the information about lymphedema and physically with severe joint pain from being off my anti-inflammatory medication. 

            I read up on lumpectomy recovery and also remembered recovering from my dislocated shoulder in 2004.  I was prepared to be helpless and in lots of pain.  Thankfully, oh so thankfully, that is not what happened.

            But let me go back to the day of surgery for a moment.  My daughter drove me to Hillcrest, and we settled in to wait in the pre-op area.  The pale purple disposable hospital gown and dark purple slipper-socks cheered me (I mean, who doesn’t like purple?).  The IV insertion in the back of my left hand was surprisingly painless.  The nurses were very nice.  My surgeon, Dr. LaNette Smith, came to check on me and to ask if I had any questions.  Naturally, I could not think of a single one.  Then she surprised me by asking, “Would you like me to pray with you?”  She and Dana and I joined hands, and Dr. Smith prayed.  How her presence and prayer comforted me!

            After some more waiting, a nurse escorted me into the surgery room.  The anesthesiologist put a mask over my nose, and I expectantly waited to get sleepy.  I didn’t.  I was sure to keep my eyes open as a signal that I was awake, and then the next thing I remembered was waking up in the recovery room. 

            The surgery was both brief and successful.  The only difficulty was getting me intubated, but my throat doesn’t even hurt.  Dr. Smith took out the tissue where the tumor had been as well as a single lymph node.  The most uncomfortable part after surgery was how tight the binder was. 

            Recovery this week has been a bit of a lark.  I am more comfortable, physically speaking, than I have been in weeks.  My arthritic joints are rejoicing with the return of Celebrex.  The discomfort from the incisions is well managed by Tylenol #3.  I’m hanging out at my house with daily visits from church choir members and Bible Study Fellowship friends who signed up to check in on me when my daughter could not.  (I’m not yet ready to face the probability of a grandchild bumping into my sore spots.) 

            Next week I hope to receive the pathology report at my post-op appointment.  Naturally, I’m hoping for the best. 

            

Part Forty-Two: No Matter What

            I meant to blog last week.  Really, I did.  But I felt so bogged down by American politics that I didn’t.  I spent lots of time reading news articles, trolling Facebook, and using fact-checking websites.  The mudslinging on social media and in the press depressed me.  Silently disagreeing with my family and many friends--and, evidently, most of Oklahoma--about the presidential race depressed me more.  I stood with Christian leaders such as Max Lucado concerning their opposition to Donald.  I voted for Hillary.

            But America has made her decision now, and it is time to move on.  Today I am especially grateful that my lumpectomy is this month instead of in January.  If president-elect Trump does what he has promised concerning the Affordable Care Act, I won’t be able to afford insurance for 2017.  It seems ironic that a presidential election could well be the deciding factor concerning whether I receive radiation treatments in the new year or not.

            But let’s stop thinking about presidents and policies.  I’d like to go back to my little world of triple negative breast cancer, wildly successful chemotherapy, and next week’s surgery.  Last week the peripheral neuropathy began to lift a little.  It’s not 24/7 anymore.  I get breaks from it for minutes or hours at a time now.  That is a very big blessing.

            On Monday, I followed doctor’s orders to stop taking Celebrex, which is an anti-inflammatory medication that keeps much of my arthritis and fibromyalgia pain at bay.  Let’s just say that my joints and my muscles are complaining loudly every minute of the day.

            On Monday, I also had my pre-op appointment followed by a lymphedema specialist appointment, both at Hillcrest where my outpatient surgery will be.  I came away with a plastic hospital bag filled with copies of completed forms, pamphlets, pages of information, and pre-surgery cleaning wipes.

            Not having had much experience with surgery, I had no idea how extensive a pre-op would be:  filling out forms, answering questions about my medical history, listening to the nurse’s pre-surgery instructions, having an appointment made for December with a sleep specialist because I am high risk for sleep apnea, and having an EKG and a chest X-ray. 

            Then Alice (my neighbor who provided transportation) and I had just enough time to eat lunch in the hospital cafeteria. (It was far better than the food I ate as a patient back in September.)  From there, we went over to the third floor of the Women’s Center where I met with the lymphedema specialist.  That’s where my education really began.

            I learned that the rest of my life will be spent in prevention of and/or dealing with lymphedema.  My right arm has been the favored one for many years due to ulnar neuropathy, tendinitis, and the lingering results of a shoulder dislocation.  I get to favor my arm even more now, protecting it from cuts, scratches, bug bites, and heavy lifting.  No more heavy purses dangling from my right shoulder.  No more blood pressure cuffs or blood draws from my right arm.  Careful surveillance of the right upper quadrant of my body for any swelling, and immediate reporting of such to my breast surgeon.  I learned that stage one lymphedema is when swelling is short-lived, and that is where you want to stop it with appropriate treatments.  You see, lymphedema is progressive, and once you go past stage one there is no return.  At stage two (continual swelling), you must wear a compression sleeve pretty much all the time.  Thus, it is important to prevent lymphedema from ever progressing.  The best thing, of course, is to try your hardest to prevent the lymphedema from ever beginning.

            So please forgive me if I am a little overwhelmed right now.  I’m trying to do a few things around the house to prepare for recovery from surgery, and at the rate I can work, they will not all get done.  I’m in constant pain now with the prospect of post-op pain to follow.  At least the post-op pain will be in different places: the incisions in my breast and armpit.  And I’m wondering how much medical stuff I can cram into December while I still have 100% coverage.

            Last night’s Bible Study Fellowship lesson was from John 6.  The feeding of the five thousand reminded me of Jesus’ compassion and generosity.  I could relate to the raging storm on the Sea of Galilee, the disciples in the boat struggling with the waves, and their terror when they saw Jesus walking toward them on the water.  I’ve been in the storm of cancer for almost six months now, for the most part sustained by “the peace that passes understanding,” but sometimes stricken with terror.  “Don’t be afraid,” said Jesus to his disciples.  “Don’t be afraid,” he says to me.  I don’t want to be afraid.  I want to trust him completely all the time, no matter what. 

           

            

Part Forty-One: There is a Bell

            Across from the scheduling desk at OCSRI-Tulsa, there is a bell mounted on the wall with instructions next to it.  Upon completion of chemotherapy treatments, one is supposed to ring the bell three times. 

            Mona reminded me of the bell after my appointment with Dr. Moussa.  He gladly accepted my report about Wednesday’s visit with Dr. Smith, signed me out of chemotherapy on the computer, listened to my concerns about neuropathy, took a quick look at the new sore and swelling on my left arm, diagnosed it as cellulitis, and prescribed an antibiotic.  He looked at the calendar on the wall and entered in the computer an appointment with him for December 12, one month after my surgery.  He shook my hand and said he would send a nurse right in to take my port needle out from the blood draw for the usual lab work before my appointment.  Less than a minute later, the sliding door opened, and there he was with a nurse he had snagged in the hallway.  With a big grin, he joked, “Here is the nurse.  She’s never taken out a port needle before, but you can be her guinea pig.”  Naturally, she was an expert.  As we all left the exam room a couple minutes later, the technician who took my vital signs and entered my information on the computer gave me a big hug and a “congratulations.” 

            What a wonderful feeling it was to head straight back down to the first floor instead of down the hall to the chemo treatment room.  When we got to the bell, I asked Mona to take my picture before I rang it three times.  What I did not expect was the applause.  I turned to see the scheduling staff and various patients clapping for all they were worth.  The end of chemotherapy suddenly felt real as this host of strangers celebrated with me.

            A surprise was yet to come.  One of the schedulers led us over to the cafeteria area, which just gained a Starbucks about a week ago, and informed me that I would get a free coffee.  I decided on an iced caramel macchiato.  The barista told me the back story:  last week, a woman who had just finished chemotherapy had ordered a coffee, saying she was celebrating.  A moment later, the bell rang, and the barista realized that person had just finished chemotherapy.  She decided then and there that she would pay for a free drink for each bell ringer. 

            Funny how ringing a bell sealed the moment for me.  I am officially done with chemotherapy.  Today (Friday, October 28) I rang the bell on the hardest four months of my life.  Thanks be to God!

Part Forty: Two Words

            Today I saw my breast surgeon.  I told her about the neuropathy I’ve been dealing with for the past 2 ½ weeks despite the 25% reduction of my October 14^th chemotherapy, and the cancellation of my October 21^st chemotherapy.  She said, “Let’s take a look.”

            I looked over at the small screen as she started the ultrasound even though I can never decipher the images.  All I saw today were some white streaks.  She scanned back and forth multiple times before she said two miraculous words: “It’s gone.” 

            The words “Thank you, God!” burst out of my mouth.

            And then we talked.  She is sure my oncologist, whom I will see on Friday, will agree with stopping the chemotherapy and moving straight on to surgery, which she put on her schedule for November 14^th. 

            To be honest, I never expected this.  I hoped that the tumor would be smaller.  It never occurred to me that it would be gone.  The lumpectomy will remove the tissue where the tumor was as well as the sentinel node.  Then we will wait on the pathology report, and then we will discuss radiation therapy.

            In the meantime, this most excellent news is still settling in.  Maybe the more people I tell, the more it will seem real.  I will add three words of my own, three words I will repeat many times over each and every day: “Thank you, Jesus!”