One Step Back; Two Steps Forward

Fourteen months ago Image

I have a background in the natural sciences: botany, ornithology, Lepidoptera. When I travel I carry binoculars or loupe, field guides for flowers, trees, birds, bugs, shells, whatever I need. This background and what I imagine I have learned from it all affects my thinking and reasoning.

So when the lump was ‘found’ (Yeah, like it was something I had lost or misplaced) I had two choices: needle biopsy or excisional biopsy. In my mind the thought of punching a hole in a tumor was frightening: create an opening in an object that is relatively encapsulated so in the following days – weeks cells could leak out. I don’t think so. So when the surgeon asked I was adamant that we go with excisional and get the damned thing OUT. As in Lady Macbeth OUT! DAMN IT! OUT! Thus a simple procedure that would not require a general anesthetic became a big deal. I was ready!

Within a week my surgery was scheduled. After pre-op I was wheeled down to what felt like the basement of the hospital and just as cold as hell. Before surgery a specialist had to use a sonogram to find my tumor and insert a wire in, on, above, or below it. I could never actually figure out what was going on. Until much later, when I realized the whispered conversation between the doc and her aide was because she saw two tumors instead of the expected one.

Ssshhhhh! Don’t tell THE PATIENT!

Finally I get rolled back upstairs for the actual procedure. As in excise that bastard right out of me. ALL of it. Every last bit.  Somehow that did not happen. I don’t know if it was because there were two tumors instead of the expected one, the wire wasn’t just right, whatever the reason an edge of one of the tumors got left behind. Heavy sigh.

Except I don’t know about any of this for another week. Not until I go back to the surgeon to hear the test results: Her2 and estrogen positive, invasive ductal carcinoma AND an edge of one of the tumors seems to be missing, as in IT IS STILL INSIDE OF ME. Damn! Exactly what I didn’t want to have happen. And it will be at least three weeks before the lumpectomy is done. Yeah, right. Three weeks with the remains of a sliced tumor leaking into my lymph system. I just cannot seem to get a break here.

Finally, I am back in the hospital for the lumpectomy. It’s starting to feel comfortable as I begin to recognize nurses and they me. Pre-op completed I am wheeled back down to the basement. I never realized how cold, physically chilling, hospitals are. Especially down in the bowels where nuclear radiation labs are relegated. I lay there shivering. Was it that cold? Or stone cold fear? I was piled with warmed blankets. You know, those hospital kind of blankets that are so thin they keep them folded in half so if you move something gets exposed. Like your ass. And no matter how many are lying atop you it never seems enough. Sigh.

Back to the radiation procedure: Two lab techs get me positioned on the table, just so. Between physically moving and shifting me around and mechanically adjusting the table, it takes a few minutes. Then the older of the two talked me through what was going to happen during the procedure, that the doc would come in and explain everything, yada, yada, yada. He was nice. He then extracts my arm from the hospital gown and places it above my head, telling me it will have to stay like this until all is done. Now my breast is still covered and my arm is slowly turning blue in the chilly air. Then, moments before the doc walks in, they must have known by their “doc-dar” sense that he was fast approaching, my gown is folded back exposing the lucky lady. This makes me think we are going to get right down to business. I can see the sterile tray with everything on it that will be needed. Wrong!

I look over to the door and said doctor walks up to me looking like the Indian version of Doogie Howser, only shorter. Without actually looking at my face, he then proceeds to yammer on about what will happen, THE NEEDLE, inserted, again and again and again, injecting the radioactive material all around my nipple. They will then give it an hour for my lymph system to absorb and from there it will move into the “sentinel” nodes in the breast. It takes him at least 20 minutes to tell me all of this. He is basically talking over my exposed breast. He cannot look at ME, like I am a person, with a brain, feelings, and… Hey! A PULSE! I am not one of those cadavers you vivisected in medical school, thank you very much.

But more importantly was that really necessary? Would allowing me a modicum of modesty for a few minutes longer been that big of a deal? How time-consuming would it have really been to expose my breast after his exposition, when he has two aides at his beck and call and it would have taken one of them, oh, 1.5 seconds to fold back my gown? At that point I was so humiliated and uncomfortable by the time the procedure began that tears were streaming down the sides of my face. And I am pretty sure he did NOT notice since he never made eye contact with me. Gee, thanks doc for being such a swell guy. Like this whole ordeal isn’t bad enough let’s make it a little worse.

The silver lining was the older tech. He was SO sweet and solicitous afterwards. At least he acknowledge my pain. As soon as Doogie Howser left he immediately asked if the doctor had hurt me. So I explained how I felt, and if being completely humiliated was painful, then yes, he had hurt me. He was so sympathetic and suggested I complain to hospital administration because he couldn’t really do anything about the doc’s lack of bedside manners. But considering what was going to happen next, it rather fell to the wayside.

Back upstairs and into the OR. By the time they whip out a handy-dandy Geiger counter like gizmo to find those sentinel nodes I am sedated. Thank God. They found two. They are immediately sliced, diced, stained, and put on a slide in the OR for a pathologist to examine. Thumbs up, no tumor cells thus no more invasive surgery to remove more lymph nodes. Thumbs down, well you get the picture: straight to the armpit and what is called the axillary pad is removed and those nodes are examined as before. My sentinel nodes had cancer cells as well as five of the seven axillary nodes.

Heavy, heavy sigh. So I get the full package: lumpectomy, port implanted, axillary pad removed, and drain installed. What all of this adds up to is that I end up being really sore, on both sides and especially under the one armpit. Oh, and there is nerve damage from removing the axillary pad. As I was told, “the nerve wasn’t cut, but I did have to pull on it quite a bit.”

I ask, “Gee, Doctor, how long is this numbness going to last?” (Mind you it starts across my scapula, runs under my armpit up to my breast AND includes the upper back side of my arm.)

“At least eighteen months, maybe longer,” she cheerily replies.

I have to sit on my hands. They are beginning to reach for her throat on their own accord.

I then ask if she will prescribe a compounded, injectable  version of Vitamin B-12, methylcobalamin, that helps to rebuild damaged nerve tissue.

I love doctors. If they have no idea what you are talking about they cannot admit it. They just ignore you and change the subject. So that is what she did. It was as if I hadn’t said anything.

In the end, my oncologist, who also happens to be from India, prescribed it for me. In fact she was so impressed with what I shared about the B-12 that she now takes it, sublingually for tingling in her hands and sends it to her mother back in India for the same problem. And they have both found relief using it.

Needless to say I love my oncologist. I think because she is from India that culturally she has been exposed to more alternative medicines and approaches to healing (yoga, herbal remedies, acupuncture, etc.) So after I started seeing my acupuncturist, who is also a herbalist, and brought in my list of herbs she was prescribing to help me fight the cancer and counteract the side affects of chemo, my oncologist was right on board with all of it. In fact she knew about some of the herbs I was taking and wanted information about others that were new to her. She also shared that she wanted to learn acupuncture techniques to help her patients alleviate their pain.

Net result: Yes, I was angry that the initial biopsy did not go as planned. But once my team of doctors, beyond the surgeon, and oncology nurses got into the game I couldn’t have asked for a better group of women to get me through the next year.





4 responses to “One Step Back; Two Steps Forward

  1. An Indian Dougie Howser lol. Sorry it unfolded like that for you. It must be really numbing for practitioners to do this every day. I couldn’t help think, when laying in the same way, exposed, and inside the nuclear reactor post acid burning and cold, what a miserable job it would be. Testing people for cancer. There aren’t many who do it well with a bit of humanity. My GP gave me the results of biopsy results/ultrasound/mammogram which was done at my local hospital. This is common practice here, go back to GP for results of preliminary tests. Then surgeons for anything they do. Lets face it, no-one is comfortable with looking cancer in the eye. I still haven’t heard from some family members and my GP looked like he was about to laugh when he told me.

  2. Lisey, On reflection I couldn’t disagree with you more. My Doogie made this career choice over many other options he had before him in medical school. Is it really so hard to be compassionate and considerate? Nor was it a matter of giving me bad news, since that had already been delivered weeks ago. All he had to do was perform a rote procedure that he’s probably done so many times he could do it in his sleep. All I needed from him was his acceptance of my humanity and respect. It calls to mind a scene from Jane Austin’s Pride and Prejudice between Elizabeth Bennett, Col. Fitzwilliam, and Mr. Darcy:

    “Perhaps,’ said Darcy, ‘I should have judged better, had I sought an introduction, but I am ill qualified to recommend myself to strangers.’

    ‘Shall we ask your cousin the reason of this?’ said Elizabeth, still addressing Colonel Fitzwilliam. ‘Shall we ask him why a man of sense and education, and who has lived in the world, is ill qualified to recommend himself to strangers?’

    ‘I can answer your question,’ said Fitzwilliam, ‘without applying to him. It is because he will not give himself the trouble.’

    ‘I certainly have not the talent which some people possess,’ said Darcy, ‘of conversing easily with those I have never seen before. I cannot catch their tone of conversation, or appear interested in their concerns, as I often see done.’

    ‘My fingers,’ said Elizabeth, ‘do not move over this instrument in the masterly manner which I see so many women’s do. They have not the same force or rapidity, and do not produce the same expression. But then I have always supposed it to be my own fault — because I would not take the trouble of practicing. It is not that I do not believe my fingers as capable as any other woman’s of superior execution.’

    Thus, I believe my Doogie was very much of the mindset “to not give himself the trouble.” My point is he has to interact with people. He may be an introvert or extremely shy or a real-life Doogie, but that does not excuse his insensitive behavior given his education and intellect. He had to learn so much to get to his present position, he should continue the process and learn how to be human and develop an acceptable bedside manner.

    I know this is possible because I have other doctor’s who are very compassionate. My OB/GYN admitted to me years ago that he learned how to be a good doctor during his residency (30+ years ago) by moonlighting at the local Women’s Health Clinic. He observed the nurses and midwives and LEARNED from them how to talk to the patients and pick up from their cues what the women needed. This all happened because of his compassionate nature. If a doctor lacks this he should at least learn how to fake it in such a way to hide his true nature from his patients. Or find a profession where he doesn’t have to interact with the living.

    I was saddened when you first posted about your GP smiling/laughing as he gave you the news. After all I have been through in the past year I would have called him on that. It’s his job. You are not supposed to be comforting him because he’s uncomfortable. Is it because we are women? Are we supposed to step up and mother every Tom, Dick and Harry whenever the situation arises?? Had you been a man he was speaking with would it have been different? I think this is why I always try to choose primarily female doctors every chance I get. My GYN isn’t but I have know him for ever and he is wonderful as mentioned earlier. And my chiropractor is male. Both of these two men have wonderful strong wives, so maybe that is why they are sensitive health care professionals. I find the woman are more sensitive and in tune with what you are experiencing as a woman, mother, wife, daughter, etc.

    My middle daughter is a licensed massage therapist. You know what she loves? Working with terminally ill people, especially children. Talk about depressing, but she’s good at it because she can make someone feel like they are being cared for, through her hands and presence. She cannot cure them, but she can acknowledge them, their suffering, and be present for them. And all of it done without speaking a word.

    That’s what some of these doctor’s don’t get. And that is what pisses me off. And if I ever am in that situation again, or for a friend or family member, I refuse to let my fear or ignorance stop me from addressing their rude behavior or arrogance. If I have to pay out the nose anyways, I am damned well sure I want to get my money’s worth out of the SOB. LOL!

    As you can see, I AM STILL dealing with anger issues! I won’t apologize to you for the rant. You are a woman. And as women, we are stronger than many give us credit for. Which is also why I know you will do well through your upcoming trial. You are in my prayers and thoughts, ~D.

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