I went in yesterday to the UCSF (real) mammogram office. After 5 years, it seems, they downgrade you to a lesser machine across the street on Sutter. The quality of the mammogram is evidently enough to just spot something, but not know what the heck it is, and for that, we need you to come back and get a (real) mammogram.
The Russian lady (that I have SPECIFICALLY asked to NOT have, EVER AGAIN) is so brutal and once you start screaming, she only tightens the machine one and a half more cranks…such that, a few years ago, I remember screaming early…NOW, she doesn’t release you right away (as other mammogram techs do.) Usually, they get the image, and hit the release button ASAP. But this one, she gets the image, tells you to breathe, waits a full 15-30 seconds until you scream again, or buckle at the knees.
I was afraid if I fainted from the pain that my left breast would be the only thing holding me up off the floor, it was squeezed THAT tightly.
I get dismissed, to wait in the post-waiting room…the same room where you leave your things in the little locker cubby, and wait for them to call you with the flimsy little robe on. A room full of women, in varying degrees of aging—the youngest I’ve seen could barely be 22, the oldest, well…they do get up there in age.
My Russian Sadist comes out to tell me that the “DoctR wld lk MR imges” So, from ONE more image, she says “FEW” as we’re heading back to her high-tech dungeon.
After putting the smaller paddle on (now it’s not the square dinner plate sized vise, it’s the spatula sized one that can generate more pressure—I took physics, bitch…I know what you’re doing) As she’s putting me into the machine (I’m not sure what hurts more, her groping hands and the tugging and pulling, or the machine) she says the doctor wanted more pressure—sure, why not?
After two images, she says to wait for the doctor to read them (“to see if she needs me to inflict more pain on you” is implied.)
So, the Radiologist (this is a 29 year old MD, usually) comes in to tell me that they saw some calcification, and takes about 10 minutes to explain that this could be, maybe, we think, sometimes due to FAT NECROSIS from injury, such as a surgical scar.
I’m numb, all day. I am thinking of the job I just resigned from, how I won’t qualify for disability should this be cancer again, how I can’t imagine going through all this again, how I probably should have gotten the mastectomy, but wait—if I had…would this be metastatic disease? Are the breasts a sort of canary in the coal mine of cancer? I get here and I’m subjected to this Russian pain monger and they think, maybe, possibly, sometimes, probably, likely it’s nothing to worry about.
For the first time, I look at her, and she says “oh, I was wondering if you were hearing me…”
I nod. I hear you—what I hear is you don’t know. What I hear is that you wanted to be a hero—to come in and tell me “it’s not cancer” (though, you didn’t) and you wanted to feed off my jubilance when I jump up and hug you, as if I had had cancer, and you took it away—right?
First, I’m a nurse, and I know how you MDs are—glory hungry. You’re all seeking validation for what heroes you are. In reality, you’re only following practice guidelines as all of us are; it’s just your job to give good and bad news.
What I heard was that I dodged a bullet—maybe, possibly, this time.
But, after all the emotional ups, downs, worry, not sleeping, making plans, saying goodbye to my life and husband in my mind, seeing him grow old alone over the span of 12 hours since you called me back to have more mammograms because there was something on my mammogram…the mental hell and back I’ve been to, and you want me to rejoice?
I’m aware that I’m still in a mine-field. And as with anything, it’s all in perspective. If I’m lucky enough to live long enough, I will be subjected to many similar sorts of “we think” “maybe” “possibly” couldbelikelyprobablies in the future.
Unless I start riding a motorcycle without a helmet, this is probably the way it’s going to go, until the maybeprobablies go away and it’s “I’m sorry” as it was with my mom.
Sometimes it sucks knowing so much.
You’re vacuuming, or whatever. The phone rings. “Something doesn’t look right in the mammogram you just had last week. The radiologist wants to do a diagnostic mammogram tomorrow. They see some calcifications in the left breast. It could be nothing” (but it could also be something, she doesn’t say).
"You’ll get an answer tomorrow, they will do the images, and you’ll wait for the result"
Like before. I know the drill.
Also, I know that they’ll likely say “hmm…better do a biopsy just in case.”
And I just resigned from a shit job.
I will be going thru the motions of living for the next 24 hours, while I contemplate the uncontemplatable.
Could it be? Again? Why me?
So much for dreaming about the lottery; now I dream something as simple as “please, let it be nothing.”
Not to worry, dear friends…I’m doing fine, healthwise…but my career, however…THAT appears to be on life support!
And so, here I am, dear friends. I have not written anything on this blog for ages, and though I started it to fill you all in on what was going on with me during treatment, I find it strangely apropos to continue writing here about what is going on now, with my career. Since, what started out as a health issue, has turned into quite the career ruiner. I’ve had quite a number of setbacks since my last entry here (thankfully, none of them are health-related) but I’ve had to accept a position at much, much lower rate of pay, (about half) and I have been reluctant to admit where.
When I was at the county, I had applied for a transfer to evening shift. I would have been able to come home at night and sleep with my husband, and wake up during the day, instead of laying awake all day, trying to sleep and then working all night, as I had been. My request had been approved when I found out about having cancer, and so all was put on hold.
When it came to the end of my year-long treatments, my boss (a woman of most mercurial tendencies) informed me that my “old shift” was still available.
My old shift? There had been a new grad (our unit secretary) whom had taken over my shift, and perhaps, I’m not sure, but perhaps the thought was to put her in the evening shift and “let me” return to my old night shift—11pm to 7 am. A horrible, terrible place to be.
The thought was so bad, it prompted me back to New York, to grad school, rather than return to work nights. (THAT bad, yes)
A very long story short—I left after a year (perhaps the subject of an entry, some other time, all to itself. If you’re ever bored enough to read it and I am bored enough to write it!)
Well, combine the year off with cancer, the year off at university, and then the year it took to find work…and three years does it make. Not favorable circumstances, or something which a hiring manager says “gosh! You’ve been away from critical care for nearly three years?! Yes, when can you start!?” In fact, the very opposite is true.
Initially, I was very honest. I told them about the cancer, the year at grad school…but gradually, I learned that I was saying too much—I stopped talking about cancer.
However, my mercurial old boss, she decided to talk about my medical leave in such a way as to make it sound like I had barely spent any time at the bedside at all, and thus, she soured more than one offer. And I found out about it, and had them dead to rights, so they had to rectify the situation in writing.
So, now, I’ve had to accept an offer at an ICU/CCU in the inland empire, where I used to attend college (the first time, for architecture.)
For fear of search bots finding me and my blog, and firing me over it, suffice to say it is a small community hospital where Bill and Ted might have had an excellent adventure. YOU know what I’m talking about ;)
So, here I am again, 14 years later. In order to get back into the critical care setting, I’ve had to come south. Very few people know this. Only my closest friends will be in on this news. I figure since I will be working 12 hour shifts, and can make my own schedule, that I can manage to head back to SF at least every week or every 10 days or so for 4-8 days at a time.
The plan: Work this for 6 months and get the hell back up north. Hopefully, by then, hiring managers won’t treat me like a leper because I’ve been away from critical care for so long. Having ICU/CCU back on my resume is better than saying I had to lower myself and take a telemetry job, at which I absolutely SUCKED. Four patients instead of two, and they were certainly more acute than the management cared to admit; they should have been considered Step down, and therefore only been assigned 3 to a nurse (fuck Kaiser.)
Anyway—those of you whom have been so kind and pestered with repeated reference requests, I want to thank you from the bottom of my heart. Without you I would STILL be trying to find work, competing with the 300+ nurses in SF that have recently been laid off from Seton and their hospital system (gah!)
I did get a few offers, and did settle (in every sense of the word) on this one, because it was closer to home and was more in line with what I wanted to put on my resume. I did get an offer from a hospital in Tacoma, but it was in the Neuro ICU and though it paid more, and the cost of living was less, I thought this was an easy 5-6 hour drive, or 1 hour flight home, and that won out in the end.
I love you guys, and if you are reading this, it’s because I do and wanted to fill you in on what’s going on now, and that without you, none of this will be possible.
I will be (I’m sure) bitching and moaning about the conditions at this excellent adventure hospital, and this is in no way any of your doing—I and I alone made the decision to come here (at half the rate of pay in San Francisco) because it was on the table, and of those offers on the table, it was the best suited to my needs.
Try to remember, as I will, as I have written on my bathroom mirror: All things are temporary, and this, too, shall pass.
It’s not all bad—I make my own schedule, the people I work with are a mixed bag, some nice, some will take some warming up to, but you know, that’s always the case. And, at least I’m back in the ICU/CCU setting.
I’ll keep you posted via this blog, if you’re interested :)
I noticed last month that I was getting increasingly bitter about all of this breast cancer stuff…like shockwaves from an earthquake a year ago, very odd.
It’s not that it’s hitting me in a delayed fashion, it’s that I’m noticing all the deficit I’m going thru now that was not here two years ago—this shitty hair, my worsening vision…yes, some of that is age, but it was acute in onset with the chemo.
Last month, I found myself griping about it over the phone with George—my biggest regret in life, I said, was having done the chemo at all…had I just done the lumpectomy, I’d still have my hair, I wouldn’t look as old as I do and therefore, would not be getting treated like I’m 65 years old by students that are really not all that much younger than me (there are a few here whom are half my age, but the majority are in their 30s) and I wouldn’t be struggling with these vision problems.
In any case, now I”m studying breast cancer. Funny, eh?
Surgical implications, types of mastecomies, treatment modalities, long term and short term medications…you don’t say? Hmmm, that’s very interesting. Ahhh.
Anyway, I thought it was interesting. Anger…two years out.
I’m just stressed out by the graduate school thing, no doubt.
So, I had been trying to get this cyst removed from my right ovary. during this break from school. It was discovered on an MRI during all that diagnostic stuff last year. Since the anesthesia program ramps up and I won’t get much of a chance to come home during the next two years, I knew it had to be now or never.
My worry was that it would start to tortion the ovary, and its blood supply, and I’d be in New York, and needing to have it out emergently…doubled over in pain and opened up wide for exploratory surgery, fearing an appendix rupture or something…and missing school, and having to make the whole year up again…and extra debt…oh the mind reels.
So, my Doc’s office called and said “can you come in today for pre-op and have the surgery tomorrow a.m. at seven?” What could I say but yes?
Before I knew it was at the hospital, getting admitted, having everyone trying to get an IV on me and failing (my arm looks all purple and only just now can I wiggle the fingers on my right hand for how bruised up it was. The anesthesiologist finally got it, though he was embarrased at how unelegant it was (bled everywhere.)
My gynecologist was awesome—he was at the foot of the bed when the anesthesiologist came to do the pre-op interview and told him he was in trouble. I just answered the anesthesiologist’s questions as he asked them, and then Dr. Rittenhouse stopped him and said, “I need to stop you and tell you why you’re in trouble…she’s an anesthesia resident at Columbia” and the anesthesiologist’s response was “so?”
He turned out to be quite good, told me he’d give me Midazolam and glycopyrrolate pre op and I said “oh…glyco pre-op?..huh…” and he said it was standard at that hospital. “I thought you give it with the neostigmine at the end,” and he said—“yeah, usually.” I also found out that we, in California, don’t really use Nitrous oxide where they’re teaching us a lot of that in NYC.
As I was being induced my doc had his hand on my shoulder, which I found oddly reassuring…I’m hoping now I didn’t say something ebarrassing like how hot he is—he really is gorgeous, like a young Richard Gere or Gerard Butler…The last bit of awarness I had was that the OR nurse asked the anesthesiologist if he wanted a baer hugger blanket and he said “I don’t see why you wouldn’t…why wouldn’t you use one?…what’s the question?” and I knew I was in good hands.
I was torn because she’s a fellow nurse, and he’s an MD talking down to her, but I was pleased that he was anesthesia and looking out for me. The perception I had of MDs being less patient-oriented and being more pathology oriented was debunked.
I woke up in PACU feeling like I had been kicked by a horse. I found out they found more than one cyst, and that they had discussed it for over 10 minutes what they should do, and finally, my Doc, figuring he knew me well enough over these last dozen years or so decided to take the whole ovary but leave me the left one, which was fine…since taking both would put me in premature menopause.
I can’t say I wasn’t a little sad to have lost an ovary—I wasn”t ready to wake up and hear that, but it could have been worse. I’m glad to have that overwith and now just recovery to get through. I’ve been on the couch for three days, playing the guitar, and goofing off, not much else. I still can’t cough or sneeze, or even clear my throat very well…it’s amazing how much you use your abominal muscles without knowing it!
Incisions—I have one in the belly button, and my belly button is stretched out to double it’s normal size…hoping that goes back to normal! and one incision on the right hip bone, and one just suprapubic, which will be covered once my hair grows back…ah, the OR gets crazy with the shaving, don’t they? So besides a small scar on my hip, it shouldn’t be too noticeable.
Of course, it feels like a hundred years before I’ll be able to do any real yoga, or run on a treadmill…still, at least now I don’t have to worry about doubling over in pain during residency and having to have surgery emergently in New York.
Thanks for all the well-wishes and support :)
Hope you guys are having a wonderful holiday season!
Yesterday was the 1 year anniversary of my first chemo infusion.
I thought about it a lot, as I sat in my Pharmacology of Anesthestics class. I would rather be sitting here, than there, I kept thinking.
I remember going to the infusion center and falling apart. I had held it together pretty well until that point. Diagnosis, finding the right oncologist and surgeon, talking about treatment modalities and outcomes, reading studies, etc. I think it was even remarked upon, to which I always answered “I’m a nurse; I’m in control.”
Until that day I had to show up and bare my arm. I’m a patient, and I’m helpless.
I imagine it must have been tough for George. I don’t think he has seen me in that state too often. My mom’s death, and this. Otherwise, I can lock it up when I have to.
The thing that irritated me was the false chipper “how are we doing today?!” from the first infusion nurse. “I have cancer, how the FUCK do you THINK I’m doing?” I said. I quickly appologized, but…I had to do a psych component for my nursing degree…didn’t you? You don’t approach someone with red-rimmed eyes, head hung low and trembling with the same tone as you would a kid standing in line at Disneyland!
I found this quite often in onocology. As if their false cheer was going to infect me and my mood. I KNOW what the reality is, I CAN’T be distracted by your cheeriness, what I’d really like is just some sincerety and sensitivity for how I FEEL. I try to make sure that I approach my patients this way. I don’t care if I’m having the worst, or the best fucking day of my life…they likely won’t be feeling the same way, and hey…I’m a NURSE, MY day doesn’t matter. If they WANT to be distracted by cheer, well, I can do that too, but I’m not going to cram my spoon full of sugar down anyone’s throat who doesn’t want it. I realize that some things have to just be “understood” and allowed to “be.”
So, how did I get on this tirade? Oh yeah…I was thinking about yesterday.
I even was reminded about it when I was at the grocery store looking for some type of snack that I could put in my book bag for those days when I can’t fit even the idea of a meal in edgewise. My eyes came to rest on a box of granola bars and I could feel the contents of my stomach rising up my esophagus and I thought I was going to lose it right there in the grocery store. Granola bars, and lots of water, were my pre-infusion meal. They tell you that it’s best to have some light meal in your stomach. Lance talked about a guy who ate two chicken ceaser salads because they were easiest to throw up later. People actually show up with bags of food, chinese take out, burgers, whatever…I couldn’t muster this.
But there I was, fighting the nausea at the thought of granola bars. Funny how one’s tastes change. The things I loved and craved are gone, (like sushi) and are now replaced with strange desires I refuse to give into (like cottage cheese on spaghetti. WTF? I can’t explain it…as a good Italian, I refuse to try it, but there are still nights where my mind will tell me to eat this.)
Also, I can never look at red jello again. The syringe full of adriamycin looks just like red jello before it’s congealed. Just thinking about it makes me queezy. If I ever need to barf on queue, I know what to think about.
Anyway, I was thinking about all the people whom are in those chairs now. I was hoping they could feel the “hang in there” vibe I was throwing their way. It does get better. Next year, you’ll be back to appreciating all the other things in your life that you once despised, like exams, taxes, paying bills… those things area all infinitely better than sitting in that infusion chair!
I had that horrible, terrifying Jurassic park dream again, in which I and a small group of people (at first…they dwindle down as the dream goes on) are the last survivors on earth after proliferation of large, fast, toothy beasts that take over as dominant species.
This time, the dream was a deja vu—or rather, I kept saying in the dream “last time, this and this happened. THIS time, let’s do this…” So, clearly…this isn’t a dream about a fear of reptiles, it’s about a fear of a recurrent cancer.
The ambulance bay sirens outside became screams in my dream, and I woke up after only a few hours of sleep. Had I been home, I would have wakened George, and poor thing, in his disoriented fatigue, he would listen to the dream, put his arm around me and say that the cancer isn’t going to come back, not ever. “How can you be so sure?” I always ask him. “I just know” he always says.
This recurring dream is new. I never dreamed it before cancer. Early in the cancer, I had a horrible dream (that I attributed to the toxic stuff they were pumping me full of) about robots and dinosaurs…it was a fight between technology and biology—can I dream in any more obvious metaphors?
In this dream, since I’m not in active treatment, there was no technology. There was a green and rolling hillside, and the landscape was dotted with fast moving dinosaurs. It was the landscape I imagine in “Watership Down”…the place Fiver is always describing, on a hill, with a view of everything surrounding it.
Anyway, this time, as I dreamed, I contemplated what survival would require, and mean. Eventually, I thought…we’re going to have to go outside and use the bathroom, gather food, and eventually, that food is going to run out. I contemplated running out there in the midst of all the velociraptors and Tyranosaurus Rex and just getting it over quickly. I woke up when I realized, in the dream, that I was prolonging the inevitable.
I used to like that movie—but now, after so many of these dreams, after it’s become a metaphor for what it’s like to live with cancer, I don’t think I’ll ever be able to watch it again.
and to think they made a ride like this? I can’t imagine wanting to go on it.