The Neighborhood Internist & An Embarrassment of Gynes

I went to my internist yesterday because L kept telling me I need antibiotics.* The chemo nurse thought I might, too, since I've had this cough and sore/dry throat for two weeks. She said I could still do chemo April 16 if I was on them. I don't know how long I've been going to this doctor. Maybe 10 years? I started going to her erstwhile partner, an older (than me) Belgian woman who B and S see. I didn't like her. I started crying in her office and she told me I was depressed, not anxious. I know I'm anxious. I don't have anything against depression, but that's not what I am; I don't feel there's a stigma with it. I've never had the classic signs of depression. Though I know I interchange the terms here in this blog. I thought it was arrogant of her to say abruptly and brusquely, You're depressed. So I went to the partner, who's Filipina, about my age, and who since moved to another office in the same building. Her staff speak Tagalog, so there's a mix of English and Tagalog in the office. Both arespoken quite muscially. There's always a wait. I was running late so I drove and parked at a meter. The appointment was at 11:45 and I got there about 10 minutes late. She saw me about an hour later. I worried about the meter but as I was contemplating going out to feed it, my name was called.

This doctor is always in a hurry but she's not so hard to reach by phone. She called me when she heard I had breast cancer and said she was praying for me. She didn't blink an eye at my cupping marks. She prescribed an antibiotic and said to call on Monday if I wasn't better, and she'd prescribe a steroid. Which I'd like to avoid since I had two courses of them in the late summer and fall and I think the chemo has steroids in the mix. And if so, shouldn't those steroids be helping my breathing?

Caveat: Now it gets personal. You may skip.
She did a Pap smear because I hadn't had one in 15 months. My periods have been so long that it was hard to schedule one. She found a polyp and said I needed it removed. She said I should also have an endometrial biopsy because of my long periods (which may be stopping because of the breastectomy and chemo). She said I needed to check with my gynecologist.

I do not know who my gynecologist is. I have a wonderful nurse practioner/midwife (Don't ask--I've never been pregnant) who hates the health care system and spends a lot of time in appointments and on the phone. But she can't remove polyps. She sent me before to a young gyne who removed a polyp and was going to remove my ovarian cyst and scrape away my fibroids but got freaked when I said I wanted to keep the ovary and just have the cyst cut out. She was afraid I'd be mad at her if she took the whole ovary out. So I went to a doctor she recommended, then I went to a doctor my friend A at Fancy recommended, and he did the surgery--removing both the ovary and salpingo (Fallopian tube, but salpingo sounds so much better). He said that fibroid surgery often doesn't work. (My cousin who has them has found this out the hard way.) This gyne is fine, though too good-looking to trust as a doctor (my irrational bias) and it takes fifteen layers of bureaucracy to get in touch with him. Both the nurse practioner and young gyne are easy to get a hold of. But neither is connected with Fancy Hospital. I guess I will call the Fancy one and see if I can get an appointment. I must add that my internist has been concerned about a lump on my former left breast for almost two years. She sent me to Saint Hospital to get an ultrasound about a year and a half ago and I was told it was nothing. She wanted me to get it checked out again this summer. Soon after I went to the male gyne and he told me it was nothing. It was nothing, if you consider that Stage 2a cancer is nothing...

I told L this afternoon that I'm breathing much better and he said in a deadpan voice, It must be the cupping.

Last night we dinner with our good friend V. She is our local friend V. We also have a Michigan friend V, who took the photos on this page. I was telling our Chicago V that an acupuncturist cupped me, and V kept saying, I don't believe you. Then she explained that she was thinking of cupping as it was practiced in the steel mills where she and L used to work. It's a prank I can't hear enough about for some reason. The workers would get a styrofoam cup and stick it in grease and then place it surreptitiously on top of the hard hat of a foreman. The foreman would wear this cup, looking ridiculous, until he figured it out. It's a variation of taping Kick Me on someone's back. It was very good to laugh and laugh over our very nice dinner of enchiladas and tamales. (I have become liberal or loose in Passover observance. I embrace my alleged Sephardic roots and eat corn, beans and rice, which they are allowed to eat on Pesach.)

Then I showed her my back and L said it was burned but V confirmed it was not. Though the polka dots are still red.

When I got back to my car after seeing the internist, the meter had run out and I had a ticket. I couldn't bear to look at it but I'm sure it'll cost more than the co-pay and antibiotics together.

*L claims he didn't keep telling me, that he told me once or twice.

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The Neighborhood Acupuncturist

I tried out a new acupuncturist yesterday, recommended by my friend G, who pens the greatly amusing but scarily accurate Whirled News Tonight. G sees this acupuncturist's mother in Chinatown.

The place is about a 10-minute walk away, in a half-basement office below a brick apartment building on Addison. The waiting room was a small and white with a bench with three square cushions on it, a few plants and big vase in the corner. X (his real first initial) greeted me by name from behind the counter. He looks about 30, with wire-rims and frequent smiles. It was windy and snowing very very slightly yesterday. He wore a blue shirt with vest. I had to wait about 20 minutes. I filled out a form and read through Health magazine, before I realized I'd brought The Jewish Book of Why with me. I didn't get through the introduction. I learned that Judaism has changed in each epoch. Which I suspected, but never articulated. While I was waiting a guy was leaving. I asked him what he thought of X and he said he was great, and that his mother is the country's best herbalist. (I guess her expertise could trickle down to us. He could consult his mother on intractable problems.)

He asked me many of the same questions that the Absentmind Acupuncturist had asked me, except he tooks notes by hand instead of on the computer, and looked in my eyes and seemed to be paying attention. I told him that immediately I was worried about my cough and sore throat. He looked at my tongue and asked how I was sleeping. (Hadn't gotten enough the night before.) He took my pulse and blood pressure. We talked. I lay on my back on the massage bed and he stuck me in my head and legs, telling me what he was doing as he did it. He brought a heat lamp to warm my feet. He turned off the light and gave me a button to push in case I needed anything. (I pressed it when the warmer got too hot.) Then he cupped me. I had seen this done once before, in Nicaragua. This is how he did it: I stomach and he lifted my shirt. He took a small glass cup that looked like it could hold a votive candle, then picked up scissors with a gauzy pad at the end, dipped the pad in alcohol, then (behind my back) lighted the gauze, put it in the cup for a moment, then put the cup on me. It felt like a suction cup. Uh, I guess it was. The smoke, he said, got rid of the oxygen. He had several cups and put them down my back. He left them on for a few minutes. When he took them off he said the circles on the right side were red, which meant I had more tension on that side. The cups were supposed to help my lungs, as I recall, but more indirectly than you would think. Cupping increases circulation and releases energy. He said that in summer people are less willing to be cupped, because it does leave marks.

He told me that he can help with chemo side effects. He didn't want to give me herbs because he said I already take a lot of medicine and he wants to use foods to heal. He also wants to wait to see how I respond. These are his recommendations, mostly to take care of the cold: Cut out dairy and sweets for two weeks, as well as other mucous causers: mango, pineapple, coconut, spinach, cherry, strawberries, berries; barbecued, grilled and deep-fried food; duck, lamb, seafood, cinnamon, pepper, salt. Have less: strong flavors, coffee, ginger, garlic, onion, broccoli, celery, cucumber. Cook those vegetables in ginger, because they have cold properties, and ginger has warm. (Yeah, I know, I'm supposed to have less ginger.) Do eat: seaweed, tangerines (not the same as oranges; tangerine peel is used in respiratory medicine), more vegetables, green and black tea. Soak feet in warm water before bed. He told me to have fresh ginger tea instead of boxed. To make it: cut and peel ginger the size of your thumb. Crush it. Boil in water two minutes.

Cooling foods cause nausea, he said, and hot ones cause headaches.

I didn't ask him why I could have seaweed, which is salty, and not salt. Maybe I didn't want to know. I put kombu in my soup last night. It's my second-favorite seaweed. My favorite is dulse. I'm just remembering a blind date in Miami; I remember finding out that dulse was this guy's favorite too. It seemed fated. He was a literature professor in Maine and his parents were Holocaust survivors. But he seemed to be too intent on us having a future (which he denied later). About four years later I went to New Orleans for the MLA convention and saw him at the airport. He was still very good-looking. I heard he quit teaching and is living in the country, with a partner and a kid. (I just looked him up on Google. He's teaching writing at Cornell.)

So. Flash-forward 20 years. Breast cancer. Acupuncture. I'll meet with the acupuncturist next week to tell him how it went. Today I woke up and I was more stuffed up and my throat hurt more. I thought of how my friend B went to him (must have been years ago, because B is in the wheelchair all the time now, and there are stairs leading to the office) and was worse the next day. How we rationalize; I'm thinking, Well, he stirred everything up and that's why I'm worse. I decided to call my regular doctor for an appointment. Got one for tomorrow. After two weeks, I might need an antibiotic. I called the chemo nurse and she said that it's OK to have any antibiotic. I told her about my bad headaches over the weekend and she said that it could be from one of the nausea medicines, though I took them only Tuesday and Wednesday. She said to wait till next time and see if it happens again.

Onward. Of course when I showed L my back last night he was horrified.

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