Return of the Bitch

Cancer Bitch has returned from her Midwestern tour, which began with a midnight ride to Iowa City and then continued with a daytime (mostly) ride to Ripon (pronounced RIPn), Wisconsin, where her visit was announced in the local paper as well as in the larger one in nearby Fond du Lac. Now she is home and complaining. Her hips hurt. A little. She thought a few weeks ago it was from doing lunges but now she believes (having quit doing daily lunges as part of her daily yoga, which she also quit) it has to do with long-term side effects of Terrible Taxol. Her knees hurt a little, too. She has sent a message to the oncology nutritionist and will report on her findings.

In Iowa City, besides her official business at the NonfictioNow conference, she met with old Red (or Pink) friends from the Iowa Socialist Party, S and R. S is a longtime temporary worker in the Iowa City public library, and his house with R is filled with library discards. It is filled with many other books and papers and with cats. There are also more than 50 boxes of tea. There's a little cancer corner, and from there she was offered a number of items. She took Rose Kushner's "Breast Cancer: A Personal History and Investigative Report," which Kushner wrote partly because she couldn't find any books about breast cancer. How times have changed in 30 years, and partly because of Kushner's ground-breaking book. On the one hand, it's sad that the library discarded Kushner's book, but on the other, it must mean that many other books on breast cancer are in the library and seem more relevant to the librarians and patrons.

Kushner was a member of the Ashkenazim (European) Jewish folk, and she died in 1990, of breast cancer that metastasized.

Your Cancer Bitch is way behind in everything because of her trips, and she leaves Thursday for a nearby university, where she will lead a workshop on writing about your cancer. All fun and games, tra-la.

READ MORE - Return of the Bitch

Taxol

Hmm. Now the University of Michigan has found that certain women with estrogen-positive breast tumors were not helped by the nasty chemo drug Taxol. These women had tumors that did not express a protein called HER-2. This is a crude rendering of the findings, which you can read about here.

What does this mean for Cancer Bitch? That's always the question, isn't it? Otherwise, she would be Cancer Sweet-One. Cancer Bitch just looked at her pathology report and read the notes she took at the first meeting with the oncologist, and saw that she was borderline HER-2 negative. So she sort of expressed the protein. The Michigan study found that "women whose tumors were HER-2-negative and estrogen-receptor-positive had no additional benefit from" Taxol. Which, as loyal readers may remember, was the drug that made my bones ache, and after that, the stuff that was supposed to help the ache flung me into the valley of despair.

To further complicate matters, I didn't have one of the drugs in the usual chemo triumverate of ACT (Adriamycin, Cytoxan, Taxol) because it was feared that C might be dangerous because of my blood disorder. (High platelet count, in layperson's terms.) Which reminds me of the story of the little old Jewish lady who went to her first live theater performance. She saw the lead actor fall to his death on stage and she jumped up and shouted, Give him chicken soup! Her embarrassed, American-born son tries to explain acting to her and at the same time to shush her, and she insists, undaunted: It couldn't hoit!

So I guess that's the notion when it comes to giving Taxol to Cancer Bitches whose HER-2 status is borderline.

Where does that leave you, dear reader, if you happen to have had cancer that fed on estrogen and that didn't express (secrete?) HER-2? Ask your oncologist, says the article in Science Daily. Don't jump to conclusions, say the scientists, based on our conclusions.

READ MORE - Taxol

Taxol: Once More, with Feeling

I had my second round or session or infusion of Taxol on Monday, with chemo escort S. I received three medical responses to my report of "bone pain" from the first session. First was the unfamiliar self-identified "nurse who works with Dr. --" who bounced into the exam room and checked my breathing and breasts. I told her about the pain and she said to try Aleve or ibuprofen. Next was the oncologist (who also checked my breasts and breathing), who told me I could also try Advil, and if that didn't work, to call the office, even on the weekend, and I could get a prescription for a steroid to help. Third, was L the Platonic Ideal of Oncology Nursing. She's the one we ran into when we went to eat at Caliente a couple of months ago. The first time I talked to her, on the phone, she sounded like she was meeting the friend of cherished friend. She is always friendly and seems genuinely glad to see me and whoever's in my entourage.When we first talked about small mouth sores I was getting, she wrote me out a prescription for this vile pink mouthwash mix that I ended up getting filled last time around. When I told her about the bone pain, she asked what number it was from 1-10. I said 3, but that I felt like crying. She laughed and said it sounded more like 10, and she wrote me a prescription for the short-term corticosteroid (dexamethasone), to take prophylactically. I went to the drug store last night. As I was giving the paper to the clerk, I noticed that L had written 2006. I said to the tech, It's got the wrong year. I can change it. She said, aghast: You can change it? (It must be a felony. Maybe even suggesting it is a felony.) She asked the pharmacist if she could fill it, and she said OK. I said, I didn't even have cancer a year ago. (The prescriber was an oncologist.) That, my bald head and the crispness of the prescription must have convinced them.

Last night was the first July 3 we've spent in Chicago together that we didn't go downtown to the fireworks. L (husband, not nurse) thought that being surrounded by a million people wouldn't be the best thing for a Cancer Bitch with a depressed immune system. We rode bikes, looking at houses and condos we're pretending to be interested in, then went to a new branch of a Mexican restaurant around the corner, even though we'd bought all kinds of organic produce Monday night. The guacamole was good, the chips were oily. At home, we spent about 10 minutes on the roof looking at the top edges of the fireworks behind the Hancock Building. The rain drove us in. In the middle of the night I threw up.

I woke up this morning with slight joint pain, took the steroid and went back to sleep. Now the pain or discomfort is gone. (That's the $64,000 question: What is the line between pain and discomfort?) When I mentally scan myself for bone pain I wonder if that's what the cancer feels like when it sneaks back inside you.

READ MORE - Taxol: Once More, with Feeling

Taking Taxol/I feel petty, oh, so petty

What can I say about chemotherapy that hasn't already been said, in a million pop songs? That's a line from an essay by Marjorie Gross. I don't know what chemo-poison she was referring to. The chemotherapy agent of the hour, of my hour of discontent, is Taxol. Sounds like toxic. It seems like toxic. A drug that's injected in your veins that makes your bones hurt. Not like when you were little and your mother would mention offhand to your doctor you felt "growing pains." No, this is an ache in the joints and along the bones, that seems maybe it's not so bad, it's not acute, but it's there. Deep and unrelieved, and it makes you cry during yoga when you bury your head for child's pose. Because it doesn't seem like it should hurt so much. And you cry partly because you suspect you're exaggerating the hurt, and partly because of the hurt itself. And you look the same on the outside as you did the day before, when it didn't hurt, when all you had was apprehension about the possibility of this bone pain. But it's real, and it's from the wiping out of red blood cells, and it's there in the pink oncology binder, in black and white, under "side effects." And the nurse told you about it, that it might happen. It's the subtlety of it, as cruel as meangirl gossip, almost not-there, but there. And in your teeth, making them feel loose, and in your gums and a sharp sore on the side of your tongue, and an ache in your back, and you feel it in your endometrium, like a bad cramp, though there aren't bones there.
***
After yoga Friday I drove downtown to pick up L so we could meet V for dinner in the South Loop. When he got in the car to take my place (I hate driving) I was crying and we pulled to the corner and I told him I felt so bad. I had picked up a magazine at the park district where I do yoga, so I'd have something to read while L put me on the L to go back home, and he went on to dinner with V. He took me home and called V to cancel. I was so pathetic, so grateful that he was driving me home. He had planned to go on to Gary after dinner. He has a house there. We stopped at Blockbuster and got four DVDs: Curb Your Enthusiasm, first season; Sex and the City, second season; The Truth About Cats and Dogs and Sweet Home Alabama. At home I settled on the couch and he unloaded the dishwasher and did other household chores while I watched Sex and the City, which he can't stand but gets sucked into anyway. I took acetaminophen, which he said I should have been taking instead of ibuprofen. And lo and behold, it was the pain-reliever of choice in the pink oncology department binder from Fancy Hospital. I felt better and also whiny and self-indulgent. Friday he asked me what number the pain was, from 1-10, and I said 3, thinking that 3 sounds very small. Like nothing.

Now it's Sunday evening and what I've done this weekend is Nothing, meaning watched the videos and read some and slept. And wrote a pissy letter to the editor about the whitewashing of Nicaraguan history in the Travel section of the paper. I did what dogs do, which is lie around and nap and then get up and sleep. If dogs read, I'd be the perfect dog. L is in Gary right now. This weekend he has told me on the phone and in person that I'm silly to feel guilty for doing nothing, aka Taking Care of Myself. I was invited to a BBQ, which I've skipped, and was supposed to go to a Muslim festival to help publicize a Muslim-Jewish poetry anthology I'm helping put together. You have cancer! he tells me, and I say, Supposedly the cancer is gone, but he counters that I'm going through cancer treatment, and what I'm feeling is because of that treatment. Which is true. The bone-pain has lessened much, and I'm wondering if what I felt is what it's like when the cancer returns and it's in your bones. And that scares me. The fact of it returning to my bones scares me.

The pain is down to 1, or 0 in some places. The side of my tongue is still sore despite using this special chemo mouthwash cocktail I got at the pharmacy for $31, and oral analgesic ointment. There are so many pains a person could have, so many acute pains. The world is awash in suffering. Would I get used to it if I always felt the way I did on Friday? Would I want to kill myself? Once when I ran out of BuSpar tablets I felt so upset, so weepy and full of self-loathing, that I thought if I felt that way all the time I would kill myself. I was taking the generic for BuSpar and concluded it didn't work for me. But now I take the generic all the time because our new insurance plan won't pay for the name brand. What is the lesson of that?
***
Last night I dreamed I was looking for job postings at the WRU Press office to pass on to our grad students, and I took off my dress to do it, because that was the protocol. I thought. But I was wrong. And I felt embarrassed to be there, that I didn't belong there, and put my dress back on, and went to look for more job postings in the journalism department, and looked for my mail box there, but it wasn't there. I didn't belong. I didn't belong anywhere, even though WRU Press had published my first book (in the dream and in real life). In real life, too, my faculty mail box disappeared from the journalism department many years ago, because I had started teaching non-credit instead of credit journalism classes, and the Decider of Mail Boxes had decided I didn't deserve a box. Though there were lots of empty boxes. I eventually got hold of an empty cardboard box and put it on top of the mail boxes, with my name on it. That was taken away and then I got another box and labeled it ETAOIN SHRDLU, which is an old journalism (nonsense) phrase from the days of Linotype. I told a good friend about all this a few years after and he told me how terrible I was. He used the word asshole, which was the first and only time (I think) anyone has called me that, to my face. When he said that I felt I'd been petty and immature. It is unwise in academia to be petty and immature unless you have tenure.

But hey, he, the Decider, started it. And he removed the ETAOIN SHRDLU box, too. And I needed a box, dear readers, because I was teaching a for-credit undergraduate interdisciplinary class that met in a residential college I didn't have a key to. The students needed a place to drop off and pick up papers. We ended up using a student mail box (down the hall from my erstwhile one) and that worked out fine. OK, you can argue that the journalism department didn't owe me a box for the use of liberal arts students, but it would have been a nice courtesy, wouldn't it? And I did receive mail there occasionally.

I still have a mail box problem. I'm a part-time, year-round employee at WRU but my mail box downtown is removed during the quarters I'm not teaching downtown. I have tried repeatedly to change this, but the person who makes and inserts the mail box labels goes by a book of faculty names she gets every quarter and that's that. There's a separate area for full-time, year-round employee mail boxes, but it just so happens that there is no space there for an extra box. The assistant dean tried to intervene once but he couldn't get me a box. Sometimes I make my own mail box label and feel like an illegal squatter and wonder if the mail sorters will ignore it because the label isn't like the others.

This non-box-ness makes me feel disappeared. I try not to think about it. I had a permanent box in the suburban WRU mail room for about a year then one quarter it too disappeared. It was easy to get another label there and it was clear it was an oversight. Thank goodness.

Until I had these real estate crises, I used to think the comic strip Dilbert was ridiculous and unrealistic.

READ MORE - Taking Taxol/I feel petty, oh, so petty

The tongue,

said the endodontist this morning, is a very curious animal.

This is true. It has its own obsessions and compulsions. The tooth (number 13, third from the left, on top, next to the molars), had broken off after phase one of his root canal. Part of the remaining tooth had formed a point, which my tongue kept touching and feeling until I had a sore on it. The mild endodontist shaved off the point and will finish with the root canal next week. Then I'll get a crown from the dentist. I don't know why he didn't do the rooting out of the canal and the filling of it in one fell swoop. I should ask. I also don't know why he works downtown only on Tuesdays.

He told me his brother is an oncologist in Washington State who had cancer in his tonsils and directed his own treatment.

The cancer cell has its compulsions and obsessions. We are told: "Normal" cells stop dividing when they come into contact with like cells, a mechanism known as contact inhibition. Cancerous cells lose this ability. The cancer cell does not get the social cues. It cannot read the faces of the other cells. It does not know when to stop reproducing iteself, when to stop telling that story one more time about its cross-country trip in a beat-up station wagon. Because of this we need to ingest poison to stop the cancer cell, and in so doing, the toxin stops other harmless and helpful cells in their tracks. The faster the cells are dividing, the more likely it is that chemotherapy will kill the cells, causing the tumor to shrink. They also induce cell suicide (self-death or apoptosis).

Cancer cells are uninhibited. They put our lampshades on their heads and run through public fountains. But these same frolicking, out-of-control cancer cells are trying to kill us. In defense, we try to induce suicide. Can you blame us?

Today was chemo Round 5, the first dose of Taxol, which is derived from the Pacific yew. We have some kind of yew bushes out front, which we prune. I don't know what kind they are. Taxol is preserved with a chemical called cremo-something, which a few people are allergic to. The nurses told me that a reaction is rare, but they laid out epinephrine and benadryl on the table nearby just in case. They'd already given me some benadryl in the drip. Reactions include feeling very hot or having constricted breathing. It happens in the first few minutes.

After a few minutes on the drip I felt blood rush to my head and ears and they were hot hot hot, and there was a heavy foot on my chest and it was hard to breathe. I reported this calmly because they’d said they were prepared. They took me off the Taxol and gave me more benadryl and put oxygen cannula in my nostrils. I felt better. Then a few minutes later I had what felt like menstrual cramps, and a nurse gave me a heat pack. The cramps went away in about ten minutes.

Was this anaphylactic shock? I asked. No, said the nurse, it was anaphylaxis. Which, from what I read, is serious and life-threatening. But not shock.

So it may not end with a whimper, or a bang, but with a closing up.

*****

Waiting for the L (train, not husband) today to go to Fancy Hospital I saw a guy in a very dark suit, white shirt, red tie with diagonal red and white stripes. Something odd about his outfit--so very severe, formal and self-conscious. He had opened a black leather folder to reveal a list, handwritten on yellow legal paper. Tell about... Tell about your… I presumed they were interview questions he was going over. His outfit was too perfect and plain. He did not seem proud of his suit. It was not ill-fitting but didn't seem tailor-made, either. Who wears white shirts any more, and who wears a black suit when it’s 80 degrees? I don’t see many people in suits on the L, but that’s because I don’t ride much during rush hour, especially in the morning. Tom Wolfe says he wears a white suit because he’s not trying to fit in. He used to try to dress like his interview subjects but he couldn’t look authentic. So he decided to look out of place. If you use that line of reasoning, then a person interviewing for a job shouldn’t look like an employee because he’s an outsider. Perhaps it is right and proper that he should dress differently from them as a sign of respect and a nod to the artificiality of the interview process. At the same time, he wants to communicate the message that he’d fit in. He wants the interviewers to imagine him working with them. When they offer him the job they should grab his jacket and fling it across the room and tell him to loosen his tie, roll up his sleeves and tear up his practice questions.

If he is smart, he will keep the list of questions.

READ MORE - The tongue,