Friday, September 19, 2014

Outta dodge

I got some incredibly surprising news last night that brought me to the edge of undeserving.

Rewind to one week ago and I was marching into the breast imaging department at Vic Gen, feeling a bit cocky ahead of my ultrasound. My PET had revealed a suspicious area under my right arm and Dr. A has felt a thickening there all along.

I was cocky not because I thought it was nothing, but because I've gotten so good at self-talk that I had convinced myself, and everyone around me, that even if the ultrasound showed something and I had the area biopsied, that I was staying the course of my "watch & see" approach and would fight to keep that suspicious piece of shit so small it would never amount to anything in this life.

My nurse that day was lovely - motherly and funny and determined to make me feel comfortable in that room with a billion stories. I was immediately thrown back to 2010 when I had my first ultrasound and the tech kept going over and over the same area before calling a radiologist in to do a core biopsy and fine needle aspiration on the spot. I was all but shoved out of the room when it was over, with my shopping basket of clothes, reeling from the new experience.

When this one got going, it was relatively quick. Some back and forth, then a joke about taking an image of my implant, just to prove she felt me up in the right places. My nurse disappeared at this point to show the images to the Wizard of Radiologists, hidden in a back room somewhere, and I felt good.

As I lay on my left side, a rough towel thrown over me, the ultrasound jelly still on my skin and the nurse not back in the time I would expect her to be if it was really nothing, I started to fall apart.

I craned my neck around to study the images she had left on the screen, and sure enough, there was a long black oval, taunting me. Just when you thought you were out, McCart...

By the time the nurse came back in, I could tell she had someone with her and my tears fairly gushed out.

The fucking radiologist.

"We saw something, Mrs. McCart..." and then blah, blah, blah until I was crying quietly while she numbed my armpit, asked for a "spinal-sized needle" and proceeded to perform the very strange and fairly painful aspiration.

My nurse held tight to my hand the whole time and I held tight back. I didn't once look at the fucking radiologist. I didn't want to remember her stupid face or engage with her. She would not exist.

"We got a good sample, Mrs. McCart."

When it was over, the nurse hugged me, brought me a cup of tea and let me hang out on the bed until I calmed down. That made it all worse.

Six months of stress bit me hard in the ass all at once and my mind went right to dwelling on the asshole nature of metastatic cancer. The cells are different when they spread beyond the original site. They're more aggressive. They don't respond as easily to treatment. They'll screw your husband and steal your promotion, all with perfect hair and white teeth.

I knew that if the Taxol hadn't been able to eliminate this famous spot, then there wasn't much hope of eliminating it with anything else, and I knew I couldn't take more Taxol. There was just pure luck and me now, doing my best to keep it from growing.

"There are a lot of tears in this room," the nurse said. That was all I needed to hear to remind me I wasn't going to be like all those other bloody stories.

By the time I got home, I was zen again. I was determined to file this one away and do exactly what I've been doing, only more. I was hell-bent on not letting this become some depressing chapter in my fight. I got on with life.

Then last night around 7:30 pm, Dr. A called me at home and blew my mind.

"The biopsy was negative."

I think I made her say it a few times, and I asked a shit ton of questions about what else it could be (maybe an overactive lymph node, maybe fighting off an infection, maybe a shitty biopsy sample).

"I'd take it as very good news, Mrs. McCart."

Swoosh... Just like that, I'd won the lottery again. I get to start again. Like, really start again. And it kicks off with a trip to the home country...

Since I was knee-high to a grasshopper, I've loved travelling.

From anticipation to sorting through post-vacation photos, it's all 2-year old giddiness to me and this trip to Italy slapping us all across the face next Friday has dug itself even deeper into my psyche.

When I was rediagnosed, we had to cancel a big family vacation and I've been grappling with the fact that unlike J.Lo, my ass is no longer insurable. Cancel for any reason and I'm fucked.

And like any 2-year old who sees a cookie beyond her bowl of veggie mush, I could only think of the one thing I couldn't have for a very long time. No travel made me feel housebound, Islandbound, stuck. I hated it.

Then my work family, like any amazing family, decided to do something about that and gave me back the incredible gift of anticipation.

Over the past several months, beyond the scans and consults and chemo and endless needles, I've had this unreal joy of planning a trip. It was ridiculous, actually, to be looking ahead to a time of complete mystery to take my family far away. It's not what I'm inclined to do, but it grounded me in something completely outside of the shit of cancer and I'll never be able to tell you what that has meant to my motivation for getting the bad cells gone.

So we're making like my brilliant cancer cells and getting the fuck out of dodge.

A presto, i miei amici. Mi bere vino e mangiare formaggio in tutte le vostre onore!

Tuesday, September 9, 2014

The marriage

After the high of the PET scan results, I got another two great pieces of news that will ultimately lead me toward the next stage of my life: no radiation, no surgery.

Radiation was nixed because the PET scan results were so good and because if I radiated anyway, I could end up with a broken rib or a host of other nasty complications.

Surgery was nixed because the PET scan results were so good and because there's nothing left to resect.

I came into this whole dealio thinking I was a sure candidate for both of those steps, so to be removed from the list makes me feel like I lost the lead in a really bad play. I'm a bit miffed I wasn't selected, but the whole experience would have been a shitty one, so ultimately yay for me.

There's still the game of "what's under my armpit?" to play, so I get an ultrasound on Thursday that may or may not lead to a biopsy during the same visit. If the biopsy happens and there are cancerous cells behind door number three, the options are not cut and dry.

For once, Dr. A wants to be less aggressive.

She recommended that if it's cancer, she would prefer I take a "wait and see" approach rather than blast it with radiation or cut it out. Radiation leads me back to those nasty complications and surgery could leave me with two arms that have compromised lymph systems. It's been bad enough babying my left arm for the past four years, but an infection that nearly ended me in 2013 is a story I don't want to repeat.

I agreed with Dr. A on waiting things out, so no matter how the ultrasound on Thursday turns out, I'm moving into maintenance mode, or a marriage for life with il cancro.

Three years ago, when I came back to work after beating the c-word the first time, the question I heard the most was "did your doctor give you a clean bill of health?" At the time, I was a bit put off by the question. I was released from the care of the Agency after getting "clean margins" from my mastectomy, but there was never a conversation about the cancer being absolutely gone. I felt like a bit of a fraud, but I played the game for simplicity's sake.

"Yep, clean bill!" I would exclaim, because I'm not a social idiot or a debbie downer and most of these conversations were on the way to the bathroom or during a 60-second chat as I passed a cubicle.

Everyone wants a happy ending and beating cancer is undoubtedly inspirational. The real complexity of having it is hard to describe quickly and doesn't really fit on a poster.

Since then, a handful of friends have passed away from cancer far too soon, every one of them getting something like a clean bill of health from their doc at some point - either that exact phrase or something more medical-speak like "complete pathological response". Whatever they heard, I'm sure every one of them did the jig like I did after my PET scan, because it's fucking good news, and you thirst for that shit when you're going through treatment.

The truth is, once you get cancer, it's more like a rocky marriage than a bad boyfriend you kick out after you can't take it anymore. And that's hard to adjust to. I will have to manage this asshole for the rest of my life, like it or not. I still have more or less the same body, and whatever led those cancer cells to take over in the first place is still there. I can try to push them off as long as possible through a great diet, regular exercise and consistent meditation practice, but it will never go away completely.

This isn't sexy or inspirational. And I promise not to be depressing when you talk to me about this stuff as I roam the world again. Because I feel anything but depressed or defeated. I am over-the-moon about coming to the end of a giant hill, and there's really nothing that can push me off that high.

So I will continue to have Herceptin and Pertuzumab pumped into my veins every three weeks. I will likely go on some kind of brutal medicine to put me into early menopause and keep the estrogen at bay. I will continue to have scans at regular intervals to see if those asshole cells are still, after all the warnings, leaving their socks all over the bedroom floor again. But I'll also continue to be so badass, my cancer husband will have no choice but to be quiet and meek and so very regretful of the day he thought he could disrespect me twice.

It helps immensely having a real husband who is nothing like my cancer husband and has gone the distance with me over the past 12 years. He loves my wretched self despite everything I've put him through in the better or worse category.

"In that book which is my memory, on the first page of the chapter that is the day when I first met you, appear the words, 'Here begins a new life'." - Dante

Tuesday, September 2, 2014

Girl riding a horse

I made the trek to and fro Vancouver last week in one day for my PET scan, with the ferry on our side, a jaunt to Granville Island slipped in and a trip through old neighbourhoods to remind me once again how much I miss the city but not the bloody traffic.

They don't let you read or otherwise engage your eyes for the 45 minutes it takes for the sugar water cocktail to pump through your veins and attach to your cancer cells, and I remember my wait in April being excruciating. This time, I had five months of on and off again meditation practice in my arsenal, so I chilled with my third eye.

The scan itself is like the CT or MRI donut hole experience, but completely relaxing with the IV taken out; so much so that I drifted off for a moment and jerked awake when they were scanning my noggin. 

"You're almost free to go, Mrs. McCart, and you can drink and eat whatever you want now... vodka, gluten-free brownies, anything," the tech said. "We just have to check that your brain scan matches up with the CT you did back in the beginning."

This is when the stress I'd been holding off for weeks returned like a slap upside the head.

I had visions of the techs in the observation room pointing and gasping as they looked at my brain light up like a Christmas tree with giant, willow-tree rooted tumours.

"Holy shit, is this the same woman's brain from five months ago?! It CAN'T be! We need to be sure about this... Be cool... just tell her you have to do some administrative check so she doesn't panic. It's THE WORST when people ask you to give them hints about their results. Cancer patients are such jerks."

The next two days at home were torturous.

By Friday afternoon, I stationed myself at my dining room table, playdate central going on around me to keep my brain occupied, my landline and mobile phones on either side of me, volumes turned to max.

I finally called to leave a useless message with the Cancer Agency appointment desk to tell them I was promised results by week's end. PROMISED, you assholes!

Finally, after putting off Frances and her endless "braid my hair!" requests all day, at 5:30 pm, I resigned myself to having a fretful long weekend and left my position as watcher on the wall.

And of course... this is when the fucking phone rings.

The next five minutes I was in whirling dervish mode as I ran from my landline to my mobile to my carrier pigeon, trying to catch Dr. A as she tried to reach me. When we finally connected, I was swearing my head off and she was her usual nerdy self.

She read the report out word for word so I had to keep interjecting with "what does that mean?". The gist of it was that the scan showed no disease in any organs or my brain, no remaining disease in the original areas on my chest and collarbone and only one small "non-specific" area under my right arm, which was there before, is still categorized as "suspicious", and will be ultrasounded and likely biopsied soon.

Best. News. Ever.

"It's really quite good. I'm quite happy with the results," she said with perhaps a very small hint of a smile.

I hung up the phone, cried and made out with my boyfriend.

We've been giddy all weekend, deliberately ignoring the details of the next phase of treatment. I feel like the girl in my "Girl riding a horse" lino print I wept over and then bought from a local artist, Telma Bonet, when I was diagnosed in 2010.

The path in front of me feels open and endless.