Thursday, November 8, 2012

We're all dying

I started out on this journey banging my head on the floor about my test results, and jamming my brain full of very detailed (and often irrelevant) information, and jumping up and down to try to find out anything- anything- that would give me some sort of firm handle on what was going to happen to me. Whether I was going to die, and if so, how soon. And how could I stop it? Because dammit, it just didn't feel right to die just yet.

I was in a bit of a state, actually. As is usual, of course, for those who've just had a cancer diagnosis. It was my beautiful GP, Dr Rosie, who suggested to me in her usual quietly humorous way that it wouldn't be a great idea to get so preoccupied with my test results that I walked out onto the road and got hit by a bus.

That is a basic truth; none of us really knows when we're going to die, unless we have a terminal prognosis, a set of handcuffs keeping us in a safe place and a doctor with an excellent handle on probabilities within the specific field. Even then, there are people who defy the odds or succumb to a sudden complication.

I remembered that conversation today, when the Bear and I were having a bit of a deep and meaningful which turned into a comedy show (as our conversations often do). Our relationship was built on empathy and laughter, and so it remains; we soar from arguing to giggling, from philosophy to farce.

"After all," I said, "we're all dying really. It's not just me. I just happened to get a signpost."

"A tree could fall on me today at work," he replied, as he wandered around on his way out the door to the cattle property, still looking for his beloved pocket knife that's been missing since last week. I'm not the only one with Cancer McFlurry brains around here.

"And I could be hit by a bus," I said.

At which point he started to guffaw.

"You'd have to be fucking stupid to get hit by the bus on this road," he chortled.

"And deaf," I giggled. "You can hear it coming about two kilometres away."

But after he'd given up on the pocket knife (again) and finally left for work, I figured that actually, that's a perfectly workable analogy. We're all dying, but I can hear the bus coming.

Most of you can't. Yet.


Dr Goodguy rang me this morning to answer a list of questions as long as his arm which I'd emailed to him earlier in the week, still in the throes of my irrational quest for certainty.

"I talk a lot faster than I type," he said, and I suspect he was laughing. "Is it okay if we do it this way?"

So he spent about twenty minutes sorting me out, again. Poor chap. No, there's no need at this stage for a double mastectomy; too traumatic, and no indications that it's a priority. Yes, docking my ovaries at a later stage would be a good idea; and yes, he could do that.

Yes, chemo could start three or four weeks after surgery, as long as I'd healed up to his satisfaction. Yes, here were the names of the two oncologists he'd referred me to; I'd get sent to the first one with an appointment available, unless I had a preference (I didn't).

No, inserting an expander into the chest at the time of mastectomy was a dodgy idea. (An expander is like a balloon which can be embedded in the chest, then gradually inflated with salt water to stretch the tissue till you have a breast-like mound again.) Radiation therapy might cause the expander to be pushed into a weird shape by scar tissue. And the effect of the radiation on the tissue would likely make stretching it a really, really risky process.


I really am going to miss having a cleavage. As I joked with some friends the other day, instead I'm going to have a leavage. Because that's what they'll leave behind.

More like the White Cliffs of Dover than the Grand Canyon.

So it comes down to chopping a bit of muscle or fat off some other part of my body and recreating a breast-like mound from that, unless I cope miraculously with the rads. Please pray for a miracle. I really, really want to avoid more major surgery here. Not to mention that the trouble with graft surgery is pain in two different locations.

Probably, in my case, the whole thing would be a pain in the butt.  Literally.


The other bit of news was about the rest of the pathology from my doomed mammoplasty. It probably won't mean much to you unless you've been to Cancerland yourself, but I'll try to explain.

Tumours can be 'fed' by hormones, so they test the hormone receptor status of the tumour. The Freeloader has been found to have an appetite for oestrogen. (Mmm, yum yum, female hormones!) He's what's called 'oestrogen positive'.

So that means we can starve the little bastard. It's another tool in our toolbox- shutting off the oestrogen supply. I can swallow hormone tablets for about five years, to ruin his party. Dr Goodguy can whip out the ovaries later on, to stop them drip-feeding any new gatecrashers.

Look out, Freeloader! The pantry is shut!

The other bit of good news was that the Freeloader is NOT one of the nasty HER2 positive ones. They're the aggressive, fast-moving tumours that don't respond to hormone therapy. Being HER2 negative gives us all a bit of breathing space.


So maybe I woke up in tears this morning, looking down at my poor chest that's about to be turned into a speed hump with ditch. Maybe the next six to twelve months will be pretty unpleasant, and not what we had planned. Certainly I'm going to lose all my beautiful hair.

But at least if you hear the bus coming, you can try to step off the road.

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