Comedy of Broken Pieces

Enough already! The past week has been one problem after another as my body breaks down from the strain of cancer treatment. It’s like the classic example of the driver, breathing a sigh of relief as they near home after a long drive, and then, minutes from home, they get into a car accident.

I was breathing that sigh of relief near the end of radiation, ready to be at home with a new chance at life. I am more than ready to done with doctors and hospitals and all things cancer. My body tells me otherwise. The effects of treatment keep popping up to remind me that I can’t move forward as if nothing happened. It is going to take more time and effort than that.

Monday I met with a specialist to try to find a solution for recurrent UTIs, which are exacerbated by chemotherapy-induced menopause. Tuesday was my final day of radiation, a milestone worth celebrating, to be sure. I brought a dozen donuts to St. Luke’s radiation oncology department. It was a lovely day, and I was thrilled to be done with the 7 weeks of daily trips to St. Luke’s. There were plenty of hugs and high fives. My skin seemed to be over the worst of the burns, and I was starting to heal, feeling like I was nearing the end of the long road.  I received a wonderful bottle of wine from a friend, so there was further celebration that evening.

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Wednesday I had a follow-up with the medical oncologist. Everything was looking good. Fatigue was my only complaint, yet initial blood work was showing improvements over the dropping numbers caused by chemotherapy. There were more congratulations and hugs. I donated my hats and scarves further symbolizing the end of that chapter. On my way out the door, beaming and ready to ride my motorcycle home on a beautiful fall day, the nurse stopped me and said she needed to talk to me…

Back into an exam room I went. The nurse came in to inform me that my blood work showed an elevated level of troponin, an enzyme that is released when there is damage to the heart. It is found in people who are having heart attacks. It also can occur if radiation stresses or damages the heart. So, having told me this and asking if I had any chest pain or shortness of breath, they sent me on my way with instructions to rush to the ER if I experienced any symptoms of a heart attack. NOT a reassuring thought as I strapped on my helmet and climbed onto my motorcycle for the ride home. I felt every beat of my heart on that trip.

As everything else on this road, the “not knowing” period is the worst part. Left without details, my imagination takes over and fills in the knowledge gap with worst case scenarios. In my mind, I beat cancer but surely would need a heart transplant or other extreme measure to survive the effects of the cancer treatment. The cardiologist called and I was scheduled for a heart echo-cardiogram on Friday. I do not like Friday tests. They usually mean I get stuck, waiting with my imagination, until Monday to hear the results. Thankfully, I got the call Friday afternoon assuring me that my heart was stable. Phew.
NOW, certainly I was done with hospitals and doctors for awhile. I looked forward to the upcoming weekend and a visit from a dear friend, Rania, and her boyfriend. I also was anticipating a possible road trip with my boyfriend with excitement. But (since it wouldn’t be November with orthopedic surgery) on Thursday, I had a recurrence of a sharp pain in my knee. I had already seen the surgeon for the knee pain earlier in the month and had x-rays and an exam. The next step was to have an MRI. I scheduled it and went on with RICE (Rest, Ice, Compression and Elevation), and went forward with fun plans for the weekend.

riding

I spent a wonderful weekend with friends, reminiscing, riding motorcycles, eating out and toasting the end of cancer treatment. Then Sunday night, the neuropathy that was finally almost gone from my left foot, came back with a vengeance. By Monday morning, my left foot was terribly swollen and painful, making it difficult to walk. I scrambled around to try to see the orthopedic surgeon asap and attempted to move the MRI date up. The surgeon didn’t want to see me until he had the MRI results in, but I did eventually get the MRI rescheduled and a new appointment to see the doctor.

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Now it is Tuesday morning, the day of the MRI. I am able to put a little more weight on my foot, but I’m still limping quite a bit. I called around to make sure nothing implanted in my body contained metal (a no-no in MRI machines). The chemo port checked out MRI safe, the IUD also was okay. Then I spoke with the surgeon’s nurse about the tissue expanders (as I affectionately call them – boob placeholders). Tissue expanders have a metal port in them which the doctor uses a magnetic on to locate the port when injecting saline. NOT MRI safe…

The beautiful weather we had all weekend left with a drastic cold front yesterday, I struggle to walk without pain, I can’t have an MRI to determine the cause of my knee pain, I’m exhausted, disheartened, and my boyfriend is leaving tomorrow for a two week trip that I had hoped to accompany him on. I’ve had better days. I am ready to move forward, get my health back, get in shape, yet, here I sit, looking around at broken pieces.

Wholey Moley

Wholey Moley

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By wholey, I mean my whole body. By moley, I mean moles. What I’m getting at is that my whole body has always had a lot of moles. Being a fair skinned woman who loves the feel of the sun, I’ve always needed to watch my moles carefully for changes. I’ve always been advised to go for an annual check by a dermatologist to make sure none of them are turning cancerous. In the past, there have been a few I have had removed which tested as “pre-cancerous”. Well, as we all know, time flies faster as we age, and life gets busy. “Annual” usually ends up meaning every 3 or 4 years or so, when I remember that I’m overdue for the annual check. Prompted by my medical oncologist who expressed that I had FLM (funny looking moles), I went in yesterday for a consultation. I learned a few interesting things from my new dermatologist. In fact, I’m glad my medical oncologist referred me to this dermatologist, because I learned more in the 20 minutes in his office than I had known about skin cancer all my life, despite trying to inform myself over the years.

The first question I asked was, “does that fact that I just went through chemotherapy mean that any cancerous changes in my moles would have been destroyed by the chemo?” Surely, that seems logical, but the answer was counter to what I would have suspected. He said that the since the chemo weakens the immune system, thus making it harder for the body to fight things on its own, skin cancers actually tend to “come to light” during chemo. So due to the weakened immune system, skin cancers can actually grow and change more during chemotherapy.

Years ago, when I first started watching my moles for changes, I was told that I had Dysplastic Nevi (atypical moles) syndrome. Basically, anyone with a lot of large, irregular moles is at a higher risk of developing Melanoma. What I learned yesterday is that if someone with more than 6 large, irregular moles also has one immediate family member with melanoma, their risk increases to 50%. If they have two immediate family members, the risk is 100% that they will develop a melanoma. Wow!

Another thing I learned is that skin cancers don’t always appear on the parts of the body that have been exposed to the sun. Many times people miss deadly melanomas because they can appear on the bottom of the feet, in between toes and on butts, where, I can assure you, the sun has not shone (on me, anyway…)

Also, another important lesson I learned is that skin cancers don’t always appear as changing moles. In fact, most of the melanomas found on people with atypical moles arise from normal skin and not an atypical mole. The first thing the dermatologist found yesterday was a scaly patch just above my eyebrow ( a common place for skin cancers) that I did not even know existed. Sure enough, after he brought my attention to it, I could definitely feel it. This patch could have progressed to cancer without my awareness. A blast from his cryosurgery device froze that patch off in about 10 seconds. Such an easy way to halt cancer in its tracks.  Especially in comparison to the year-long battle I’m in the midst of against breast cancer.

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I learned that size does matter…when discussing moles. We all know the ABCDEs of melanoma, right? (A) Asymmetrical moles with irregular (B) borders and uneven or varied (C) color, over a certain (D) diameter that are (E) evolving can be trouble. I had some moles that fit the ABC, but were under 6mm in diameter (D), so the doctor said we didn’t even need to consider these smaller moles.

The last, and most useful thing I learned in yesterday’s informative consultation was that, much like the importance of keeping on track with my annual mammograms and breast cancer screenings (which I might not have done religiously), it is very important for me to keep up with my annual skin cancer screening. I made next year’s appointment on my way out of the office yesterday. Cuz I’ll be damned if I’m going to allow another cancer go unchecked in my lifetime…