Tuesday, November 13, 2012

Day 873: Questions to Ask Your Oncologist

I suppose it is some kind of measure of success that I didn't feel like writing about my visit with the oncologist last week. I am down to visits every six months, providing there are no problems. So the next time I see him will be shortly after my next mammogram, on May 7, three days after my three year cancerversary. I can only assume that day will bring me good news, because to do anything else might make me lose my mind.

I was a little nervous before this visit, but not overly so, since I knew he would just ask me questions and feel me up for a while. And we all know that my TNBC is fairly unlikely to recur locally (in the breast), so that's nothing but a fun little dance, really. And so the day of the appointment, I got up extra early and was one of the first in line at my local polling place. I voted in my fifth presidential election, remembering how much I wanted to vote back in 1992. Maybe I should have done like Willow in that Buffy the Vampire Slayer episode and gotten myself a fake ID for that purpose back in the day. But I digress.

I voted quickly, got back home, sent Gabe over to vote, made the kids breakfast, and left the house once he returned. I took an early train so that I could walk the two or so miles to the doctor's office from the train and work some of my nerves out. I feel like such an old-timer at this place, not in the sense of being OLD but in the sense of how rote my behaviors are, like I do this every day. Get visitor's badge, get off elevator, ignore people who are trying to direct me, walk past everyone who is confused in the maze, check in, prepare for an eternal wait for the doctor.

But life is always throwing curveballs in my direction.

I had barely sat down when the male nurse came to take me back to the room. I didn't even have time to look at the newspaper. He took my vitals, and I found out that I am, in fact, really healthy, as usual. I started undressing "from the waist up" before he had even left and he seemed surprised, as if modesty still existed in the breast cancer ward, and I prepared to wait. Again.

And again, it didn't happen. The doctor came in, himself--no physician's assistant this time--about two minutes later. I couldn't hide my surprise. That was fast! I said. He attempted a smile, shook my hand, said It's good to see you.

Oh, how we lie. How we stretch the truth.

He asked me how I had been doing. I said I felt great and reminded him of the breathing issues I had over the summer. I told him they had subsided, but that they came back every month, seemingly with my cycles. Maybe it's water retention?

He frowned at me. That would be an odd reason, he said.

Oh, but baby, isn't everything?

He said they usually didn't get concerned if symptoms eased. I said I had refused the chest x-ray. Much to my astonishment, he agreed with that decision. That's a slippery slope. We might find some little thing and then put you through a bunch of tests for nothing. That happens all the time.

All the while, I was surprised that he remembered everything about this situation from four months ago, even though I had never discussed it with him directly. He remembered the results of my tests and could rattle off which tests I had done without looking at my chart. He asked me if I had any aches or pains. He manipulated me as always and felt my breasts, concentrating on the right side where Gabe thought he felt something, and then he said this:

Your heart and lungs sound normal. As for your breasts, I don't feel anything that shouldn't be there. The rest of you looks great. Do you have any questions?

And I sat there, wondering how this encounter could mean so much and yet last less than five minutes. My main question was about whether or not to take a taxi back to the office. A million other questions swirled around in my brain:

Well I've had these weird pains off and on in my tailbone and my ankle. Should I worry about cancer? Am I just getting old? Is it actually possible that I will get old and my body will start to feel the effects of that aging process just like everyone else? Or am I just, you know, DOOMED?

Why do I have these weird food cravings post chemo? I was always a "sweet" person, not a "salty" person. And yet here I am, thinking about pickles and red onions all day, things I never even LIKED for the first 35 years of my life, and then I wonder if these are normal cravings or dear God am I pregnant or something but wait how could I be pregnant when the only man I have sex with recently got a vasectomy?

And about sex, it's so awesome now, I am like a teenager again, my cycles are like clockwork every 25 days and I have every pubescent PMS symptom in the book, and do you think I will have to go back to that horrible menopause stuff, with the hot flashes and sexual dysfunction and everything else, anytime soon? Is there any way to just MAKE THAT STOP so it never happens to me again? Because look Doc that shit was just DEPRESSING. I don't care how "lucky" I am supposed to feel about everything. I would like to stop time right here right now with how my body feels and works and I know I can't do that, and why can't I do that?

Is it normal for a woman who really didn't drink before breast cancer to have a sudden love for Knob Creek Kentucky bourbon? To get to the end of a day, no matter how boring or stressful or fun and think about capping it all off with that burn on my lips, that booze that somehow just dribbles a bit out of your mouth whether you want it to or not, that feeling of warm haziness? Am I going to hell for this or tempting fate or what? Are the breast cancer gods just aghast, wondering how I skipped over beer and wine and went straight for the heavy stuff when I was supposed to just be living a clean and perfect life, like the one I basically lived before that didn't help me any with this cancer shit?

Is two and a half years enough? When will we ever know how this is really going to turn out? When can I tell my family to stop worrying? When can I stop writing a blog about cancer?

What about PARP inhibitors? What about the fact that yeah I had breast cancer, but PSYCH, not really, because triple negative breast cancer is hardly like breast cancer at all, so maybe all that treatment I took that kicked my ass and put me at risk for long term health ailments was for nothing? How about these clinical trials? I mean I know it's too late for me, but hey doc, do you think there's some real hope for TNBC on the horizon?

All of these thoughts were enough to make my head nearly explode. So I took a deep breath and asked him:

Do I have to come back here?

And he laughed. Of course you do. I will see you in six months. Enjoy your holidays.

And he left. I got dressed, checked out, called my husband, hailed a taxi. Got out of the taxi in bad traffic several blocks from my office, got myself a coffee--the good stuff, Intellegentsia, of course--and went to work. I made the appointments for six months from now for the bilateral mammogram, surgeon visit, oncologist visit. I thought about what it would mean to have made it three years. I thought about how different life can get in a few months, days, how life can just open up before you or seem to close in on you, and you never know what to expect. I thought about all this, and more than a week later, I wrote something about it.

Now I will go back to living in the months between, living in that real space, much like one of my favorite quotes from an obituary about how life and the places where we live it is like the blink of an eye:

She liked to live in the blink.


  1. Happy. This made me happy and sad and smile and get a little misty as I sit in the waiting room for my daughter's gymnastics class....

  2. In 1992 I also was keen on acquiring a fake ID to vote. I suppose that makes us nerds of a feather! As for this election day, I'll never forget the foreboding when I they wouldn't let me vote. Then I broke my iPhone screen when I finally found the correct polling place. Knowing your oncologist visit was happening I was wrought with trepidation... but then you called and told me, in that understated way, that everything was fine. I cannot recall feeling such relief!