Pregnant and diagnosed with cancer--not the end of the world?

CNN
reported this morning about women who survived chemo while pregnant and gave birth to healthy babies. Usually, it's simply a terrible accident of timing: The pregnancy has nothing to do with the cancer's emergence.

You might be thinking that higher hormone levels are causing cancer at this time, but CNN reports that studies show that pregnant women are more likely to have hormone-receptor negative tumors than hormone-receptor positive tumors--meaning they are not fed by pregnancy's higher levels of estrogen and progesterone.

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Anniversary & the Ritual Crushing of the Pills

On Jan. 16 a year ago, the radiologist at the Mammogram Factory was pretty grim as she looked at my ultrasound and told me I needed a core-needle biopsy. And so the fun began.

I decided that the best way to commemorate this event was to grind up the pills that I'd been issued for chemo side-effects. I mean, my understanding is that I can't have any more chemo, and if there were some kind of chemo for me in the future, I'm sure the drs would issue newerbetterstrongerlongerlasting pills to take.

The party couldn't start till 10 because I had class tonight. It's hard to get people to come to a party on a Wednesday night that begins at 10, especially when first advertised as providing no refreshments and lasting only 15 minutes. I loosened up but the damage was done. Only our loyal voisins de palier came (We know where they live) and we drank champagne, ate cheese and crackers and vegetable dumplings, and crushed the pills. L bought me flowers. That's L, above, crushing. My neighbor A wanted me to put the resulting powder in an urn. Or burn it. Or sell it on the street. I gathered the bits into a pill bottle and and put it in a gold mesh bag and I'm not sure what I'll do with it. I'll decide soon. I think it should stay enclosed so that it doesn't immediately contaminate the lake. My friend D sent me a study not long ago about fish containing Prozac because people excreted the drugs, which went into the water supply. Really, what's the harm? You end up with a little gentler fish and human population. And what's wrong with that??

My friend J is kind of nostalgic for the year she was diagnosed and treated, because she appreciated everything so much. I never had that quickening. At least not much. I don’t think my cancer was a blessing in disguise because it made me value life more, or friends or family more. Though friends and family came through in ways I hadn’t expected. Cancer didn’t cause me to bend more deeply to smell the flowers. It hasn’t made me deeper or wiser though I have become more aware of the manmade causes of the disease. The biggest change from the cancer is physical--my left breast is MIA.

All I can say for sure that I’ve learned is how to respond when someone has cancer. And I would prefer to have learned that second-hand.

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Waiting for the Tsunami

This is Day 3 after chemo, so the side effects are due to kick in: depression/anxiety and bone pain. But they haven't. I slept a lot today because I was feeling run down. And then rode my bike and got some work done tonight. But. The side effects aren't here yet. I'm taking medicine for the neuropathy (finger and toe numbness) but nothing for the bone pain. But it's not here. I'm waiting.

I can't feel the cancer, so the chemo and side effects take the place of the cancer. But not yet.

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Chemo Day

Just another chemo day today, seventh in a series of eight. In two weeks it will be over, everyone says, except that's not exactly true. The chemo will be over then. Then I'll take pills for 10 years. The chemo itself isn't so bad. I mean it's not great fun to spend six hours at the hospital, even if it's Fancy, but there are worse things. Like four days later when the bone pain and depression/weeping sets in for the next three days. But I hope to stave that off with heavy drugs--Tylenol w/ codeine, generic Ativan, and if necessary, I'll dip into my little stash of generic Valium. I will report on the results here. I still have some numbness in my fingertips and toes, though it gets better (which is less) each day. Nurse L said I can increase my dosage of pink anti-numbness capsules from one a day to two.

My friend G picked me up and took me to chemo. We got there about 20 minutes early and had to wait. The women who take blood from my port are always very nice and cheery and motherly. It doesn't hurt very much--and I think I have a low tolerance for pain. They spray "cold spray" on the site where the port is buried (upper right chest) to numb the skin. If any of you are considering getting cancer and having chemo, I would recommend having a port inserted into your body, even though it feels alien the first week or so and fills you with regrets. But the alien feeling does fall away. And now je ne regrette rien. At least about the port.

G had to leave at 3:30 and passed the baton to L. We watched part of Nicholas Nickleby from the selection of DVDs and video cassettes in the chemo ward. Nurse L brought them to us in what reminded me of a little red wagon. The movie was rather melodramatic, with good as Good and evil as Evil, so when the Taxol was finished being dripped into me, we decided it was not necessary to stay around and see the rest of it.

At one point I asked L to get me a blanket because I was cold, but by the time he found one, I'd had a hot flash and was sweating. As I told Nurse L, the hot flashes are the least of my problems. Feeling the void in the world is the worst, followed closely by bone pain and then weeping mixed with irritability.

I was very tired and so was L. We took the bus home. I sat next to an older woman with dyed brown-red hair who goes to Thailand once a year. On the other side was a Buddhist or Buddhist-file. The older woman's cat escaped yesterday and she was upset about it. At least he had claws so wouldn't be defenseless in the world. He doesn't have a tag, though, or a computer chip in his ear, so he'll have to find his way home himself. She put up Lost flyers but the rain wrecked them. She and the other woman talked about shih tzus and one of them said they were originally ratters in China. Didn't the Chinese have cats? I asked. I don't know, the Thailand traveler said, maybe they ate them.

L and I tried to figure out why people are more apt to talk to one another on buses than on L trains. Because buses are more contained, are more like a passenger car, are quieter? We don't know.

We had a very nice dinner at home: broiled salmon with garlic and paprika, steamed cauliflower mixed with curry paste and lemon juice and sauteed onions and garlic, and a little steamed kale. We didn't take a picture of our meal, as our cancer cousins in Marin do. But we could have. We have very nice plates in two patterns. Salmon has omega-3, which is supposed to help combat chemo brain. It's hard to figure out what's chemo brain and what's middle-age word-retrieval slowdown. G is on a committee to plan an international writing festival. I was suggesting she recommend ----Umberto? Humberto, the Uraguyan who wrote Voices of Time and was a big hit when he spoke at the Museum of Contemporary Art here. About 15 minutes later the name came to me: Eduardo Galeano. I don't know where Umberto came from. I also thought of the Polish-born French writer Agnes ____ . At home I found her trilogy: Le Grand Cahier, La Preuve and Le Troisieme Mensonge. Her name is Agota Kristof . I was close, but no cigar: she was born in Hungary and lives in Switzerland. I discovered her work when I asked a friend who teaches French to recommend of a book that wasn't too difficult. The three novels are simple but stunning in their depth and darkness, and twisty at the end.

Yesterday my friend J from Ohio was in town and we had brunch with her hosted by the rabbi (and his wife, who was the chef) who married us as well as J and her husband M. J graciously decorated my scrubbed and shaved head with curlicues, filigree, tiny peace signs and grape leaves and an easy-to-read U.S. out of Iraq in back. My head was quite the hit in Chemolandia today. J is a professional artist and did a lovely job. Most of it is henna, which is a greenish paste that dries black and eventually peels or falls off to reveal red-brown underneath. I try to keep the dark on as long as possible but it's so tempting to peel and pick. It's like fifth grade when everyone was pouring glue on her/his (mostly her) palms and pulling off the dried "skin." It's as satisfying as stomping on plastic bubble wrap. Not everybody appreciates that pleasant activity. Which is too bad.

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Chemo..

...is not as bad as advertised, said the legendary journalist Harry Golden Jr., back in the late '80s. I interviewed him for a magazine profile when he was dying of cancer. Of the throat? The magazine soon died, too. He was still working as a beat reporter in Harold Washington's City Hall. Working for the Sun-Times. Dean of the City Hall newsroom. His editor told me he never complained about his medical treatment, never let it interfere. My story was nominated for a journalism award and I invited him to go to the awards dinner with me, but he died before we could. He was that close to death. He was small with sharp features and laughed like this: hahhahhhahahahahhahahhahahahha.

So far I will have to say the same. For today at least. Chemo began with the installation of a port below my collarbone, in the jugular vein. It's an underground tube with a hole so that I won't have to be stuck time and again by the nurses. I hope it's the right choice. L has a friend at work who had trouble with her port. I wanted one because Cancer Vixen's drawing hand started getting numb from the chemo needles. And when I was in the hospital for surgery I had an IV in my hand and it hurt during and for two weeks after. I learned from a nurse that after constantly poking the inside of the elbow you might have no good veins left. So I hope this port is a port for the good.

Yesterday when a hospital person called to tell me to fast for 12 hours and such, I told her I wanted an attending ("real") doctor to do the surgery. She said to tell the people today. I did and they said, This is the first we've heard of it, we don't know if we can do it, the doctors spend a lot of time supervising... But I got a real doctor, a very nice one who rattled off information but had time to listen, too. When I thanked him for making the time, he demurred, that that's what he does. For the first time in Fancy Hospital, I encountered no apprentices! It was liberating! I realized I should have told the nurse who made the appointment for me that I wanted a real live doctor. What a crazy world when it's an imposition to get senior staff to do the work.

In the prep room there was a fake skylight on the ceiling, lit with a photograph of cherry blossoms. The little rooms to left and right had different photos. A nice touch.

The doctor said it would be like dental work, where you don't feel pain but you feel pressure. I felt nothing. Or don't remember feeling anything. It was quite Proustian--awake and dreaming at the same time--I remember talking about numbers in dreams. The nurse said I also talked about flying in dreams. That sounded right.

Next was the recovery room, where I recovered quickly and ate last night's leftovers from Red Light with alacrity. Green beans, basmati brown rice, kung pao tofu.

Then we were off to the 21st floor for the chemo. I thought it would be a room with three to five lounge chairs and ladies in varying stages of side effects. And then one day we would find out melodramatically why one person never came back. Instead, I was in a private room with a regular exam bed and a rocking chair, and the nurse gave me Ativan and some anti-nausea through the IV and then she "pushed in" the medicine, as she said, the Adriamycin in a syringe attached to the tube attached to the needle in the port. I couldn't feel much. I could see the Adriamaycin, which is red. Then more saline. Then it was over, after maybe 30 minutes.

We left with three prescriptions for pills to fight nausea. L and I picked them up later at the drug store. Two medicines are mandatory. One is optional. I asked the pharmacist if he knew anyone who went on chemo and didn't get nausea, and he just looked at me haplessly.

But I am hoping. I had some Indonesian ginger chews sent by a friend in Oakland and I am wearing the anti-motion-sickness wristband my sister sent me.

My sister also sent herself. She arrived yesterday afternoon and we sat around then walked around the neighborhood, finding a few crocuses. I showed her three-flat graystones that cost $1 million. Prices in Houston are much more modest. We had dinner with L's daughter for her birthday. It was the first time my step-daughter met her step-aunt.

My sister drove a borrowed car from the suburbs to pick me up this morning and we got to the Fancy Hospital parking lot in good time. She stayed with me as much as she was allowed to. She is very easy. I haven't spent much time with her alone, for years and years. She is cheerful, easily amused, calm and not irritable. She's a learning disabilities diagnostitian in a school and we talked about special ed and autistic kids. She's taking a class so she had to finish a paper for it, and fly home tomorrow to hand it in. We also talked about my mother, and about my sister's plans to hold both Passover seders at her house, for the first time ever. When my father was alive, he and I led the seders, using some feminist material I'd found in Ms.magazine. After he died in 1991, I led at least one family seder in Houston by myself every year, adding new tricks, checking out new haggadahs. I always thought the seders there couldn't go on without me. I think my constituents likened me to Castro. It seemed I would always be there, and never name a successor. This year I'm not going home; seems like too much coming on the heels of chemo. I will be a participant and not a leader in two seders here. We will see how it goes. I did warn my friend B that I would try to wrest control of the seder from him.

When I went to the Oriental Institute last week with a friend, I saw a display that said that there is no proof that the Jews were ever slaves in Egypt. Even the chancellor of the Jewish Theological Seminary says it ain't necessarily so. Ah, well. Then we can universalize the slavery experience. Or treat it as metaphor.

Meanwhile I keep asking myself if I'm nauseated. Like poking at a bruise and seeing if it really hurts. Right now, I'm OK. Let's hope.

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My First Hair Cut of 2007

Cancer Bitch went for her $60 hair cut Friday with trepidations and a ruler so that she could send 10 inches of hair to Locks of Love, though it’s a controversial outfit, as her friend from Iowa City pointed out in a comment. (In 2002, it supposedly gave out fewer than 200 wigs and collected hundreds of thousands of dollars.) She came back with a more sophisticated haircut as part of her Gradual Program. This will get her used to seeing her own face. Hairdressers always say this: Now you can see your face.
***
It was a one-person salon not far from my house, on a street with restaurants and houses and a liquor store. The owner has long Afro-Korean hair made up of little curly waves. It was tied back. She was very friendly and when I told her about my plan to cut my hair progressively shorter, she told me about her mother’s cervical cancer. Amazingly, she’d been treated well and successfully at the county hospital. She asked me if I was sure I’d lose all my hair, and I told her yes.

She did not approve of my triangle AKA umbrella cut, which I’ve had for many years. I never saw anything wrong with having hair that got progressively wider on its way to my shoulders. She also did not approve of my hair-around-my-face trim of a few weeks ago, which looks good when I put gel on it, which I hadn’t had time to do that day. I did it so that the hair around my face would curl. I told her I wanted today’s haircut, then a shorter all-around haircut, and then a Mohawk for a week. She wanted to make my hair very short, but I wasn’t ready for it. Her strategy was to make a diamond cut, which means that the hair would be wider on the sides than the bottom.

She measured the strands before she cut it and said to forget the ruler, she’d just give me a good cut. The pieces on the floor were about 4 inches long. So I’ll send a monetary instead of a 10-inch cuticle, cortex and medulla donation to one of the wig programs, for women or children. Once again, vanity triumphs. (I'm still not sure how effective any of the wig programs are. Locks of Love has been criticized, but now it's in the BBB's good graces. Wigs for Kids' finances weren't audited by a CPA. I can't find an evaluation for Beautiful Lengths.)

But back to the hair cut at hand. I think it looks good. It’s curly all over and you can see my face, which is rounder than I would like. At its longest, it's a few inches below my ears. I don't feel bad that this cut is only temporary. I’m going about this hair-cutting the way I have to. Losing all my hair at once would be too much of a shock. The hairdresser reminded me not to be lazy, and to put gel on my hair every day.

I am planning to get extra holes pierced in my ears so I can decorate myself when I’m bald. L doesn’t like multiple piercings, I found out today, after 11 years together. But he has no plans to try to stop me. He knows I have the cancer card.

I think I am burying the lede here: Chemo starts Monday, March 26, and hair is due to fall out 16 days later.

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Lesser of Two Evils

Tonight I walked to the Lesser of Two Evils chain bookstore and went wild in a Cancer-Bitchy way. I had a $50 gift card as part of payment/thank you for two workshops I did in a high school this fall. I was also paid by check and got a clock that had a plaque with my name on it. We couldn't get the clock to work so L pried off the plaque and we put the clock out by the Dumpster. I put the plaque on one of my file cabinets. At Lesser of Two Evils I bought Pink Ribbons, Inc: Breast Cancer and the Politics of Philanthropy by Samantha King (who teaches at Queen's University), Uplift: Secrets from the Sisterhood of Breast Cancer Survivors by Barbara Delinsky, and Cancer Made Me a Shallower Person: a Memoir in Comics by Miriam Engelberg. Got them all in the same section of the store. They cost me the whole card plus about $7. The one I wasn't sure about was Uplift, because it's a very lazy, randomly-arranged book. It's divided into chapters, and consists mostly of comments from women from all over the country. It's a very clever marketing ploy, because I'm sure all the contributors ordered books. I went through it in the store and thought a few of the snippets of info would be useful. Like tips on combatting chemo-induced nausea. Suggestions ranged from the very particular: "Morinda noni juice," blueberry muffins, chicken soup, Mexican food, Lorna Doones--to the obvious: crackers, hard candy, ginger ale. Someone also recommended "Chinese tea." I didn't know there was just one kind. I was also interested in reading about women's experiences with their hair falling out from chemo. I want to cut my hair now as a pre-emptive strike, but I'd really regret it if it turned out I was one of those people who *didn't* lose her hair from chemo. One woman talked about having a head-shaving party and inviting 15 women friends. That sounded like a good idea. I'm hoping to find other home-entertaining tips. It is a very corny book. Two chapter titles: Radiation: Soaking Up the Rays; Chemo and Hair: Mane Matters. If this sounds interesting to you, watch this space. I might end up giving the book away.

I've always worried about losing my hair to chemo. Just like I always thought I wouldn't get reconstruction, at least if I lost (is that the right word??) just one breast. (I'm reminded of the line from The Importance of Being Earnest: "Losing one parent is a misfortune; but losing both parents is plain carelessness.") I said even before I was afflicted by it that it seems that breast cancer is invitable, like gray hair and menopause. I swear I said this, way before I read it in Barbara Ehrenreich's essay, Welcome to Cancerland. You can find the essay on the Breast Cancer Action site.

I had a friend, a jokester, who used to open his wallet and ask if you wanted to see his pride and joy. Then he'd pull out a card with a picture of Pride floor wax and Joy dishwashing liquid. For many years my pride and joy has been right there on my head. In junior high I didn't appreciate my hair. It was "frizzy" and needed to be straightened chemically with Curl-Free, and then physically, by a process called "wrapping." The method was passed down by older female friends and relatives, like a folk custom,. You needed long bobby pins and a clean, empty orange juice can with both ends removed. After using shampoo and creme rinse (conditioner had not been invented), you would towel-dry your hair, of course, then comb out a section from the top of your head and wind it around the orange juice can, pinning it with the bobby pins. Then you would take the rest of your hair and wrap it around your head. The "theory"--yes, this process had a theory--was that the larger the roller you used, the straighter your hair would be. The juice can made for a very large roller. But the largest roller of all was your own head. We needed many bobby pins for this. Then after wrapping your head tightly you would sit under your hooded hair dryer and talk on the phone for the two hours it took your hair to dry. This is why we washed our hair only once a week.

I don't talk on the phone much to my friends now. E-mail seems to have replaced both long letters and long phone calls. I'd carpool with my friends, see them before and after school and during lunch, then at night talk to them on the phone. And then write them notes to give them the very next morning.

Somewhere in my 20s, probably when Cher's hair-do changed from curtain-straight to curly, my hair turned from high maintenance to low. Instead of complaining about my hair, I became vain about it. I was proud, though I had no right to be, that curliness and "body" were things that others strove for and that I achieved effortlessly. Strangers would ask me what I ate to get such thick hair. Women grooming themselves in bathrooms have complimented me on my waves and curls. On the other hand, when a college friend of mine brought me to her parents' for Christmas dinner, her very WASPy mother looked at me carefully and said slowly, Your hair scares me. My own mother has threatened, when I'm visiting her, to cut my hair in my sleep. My hair is what hers would look like if it were left to its own devices, which it isn't. Ever. L is always after me to cut it so he can see my face. So he will.

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