Thursday, January 7, 2016

Checkups and check ins

Throughout my treatment, I've kept my head by focusing only on the steps directly ahead of me. It's the best way to prevent myself from running away with all of the what-ifs.

Make it through all of the pre-surgical assessments? Biopsies? MRI? EKG? Nuclear stress test? Echocardiogram? Check, check, check, check, check.

Surgery? Check.

Recover from surgery? Check.

Chemo? Check x 6.

Blood tests to check for toxicity? Check x 18.

Recover from the assault of chemo? Working on it, and feeling good about my progress.

It wasn't till this week, though, that I was in the position to think about the long term implications of cancer. I was scheduled for a follow up ultrasound on my right breast. 

You might remember that back in June, my pre-surgical MRI had indicated a potential issue that didn't show up on the mammogram set that had confirmed the mass I'd felt on the other side. A follow-up ultrasound a few days later confirmed the need for a biopsy. To say I wasn't happy is an understatement. In fact, for the first time since my diagnosis, I was downright angry, and scared. I was being such a good camper about the left breast, doing everything I was told to do, keeping a positive outlook, and fate was potentially giving me a double whammy. Intellectually I know that there's no fairness when it comes to matters of health, but... it wasn't fair. I couldn't find a single bit of humor -- not even grim humor -- about this potential for a second cancer, and when I can't find a way to laugh about something, it's pretty bad.

Fortunately, in one of the few examples of really speedy action through this entire escapade, my surgeon was able to fit me in for a biopsy the very next day. Results came back benign a few days later, with a recommendation for a re-scan in six months. I made the appointment and put it out of my mind. Why think (translation: worry) about something so far down the line?

That brings me to this week. Monday I went in for my once-every-three-weeks blood test, Herceptin infusion and chat with the medical onco. All's good, but she scheduled me for one of the recommended periodic echocardiograms to make sure the Herceptin isn't mucking with my heart. Lucky me, I got an appointment scheduled for the next day, also the same morning as the ultrasound. One stop stressing! Unfortunately, my nurse navigator/breast buddy didn't stop by during my infusion - I wanted to ask whether I'd see her if the ultrasound brought good news. Given that my only prior experience there was that I'd need a biopsy, I wanted to be prepared for the sight of her. I personally like her a lot, but, well, there are just certain times when she's the last person I want to see.

Everything was okay until the drive to the medical place on Tuesday morning. That's when I got a bit emotional. I can't even remember what song was playing on the radio, but the lyrics had added meaning. Something about mortality or some equally optimistic topic. I didn't break down in tears, but my eyes got a bit watery.

I wasn't worried about death as much as I didn't want to hear I'd have to go through this crap again. Another lumpectomy I can deal with, but chemo? No fucking way. And how would any potential new malignancy be managed in relation to my current treatment? And if it ended up being a stage 0 ductal carcinoma in situ (DCIS), would the docs want to be aggressive and yank it, or take the more conservative approach of checking back in six months, after I'm past radiation?

Before I could get too crazy, my frustratingly rational inner voice reminded me: nobody was going to be able to tell me anything before I got the ultrasound. Sometimes I really hate the fact that I stop myself before I really get raging.

One advantage of breast cancer: I got what suffices for frequent flyer perks in the imaging office. No forms to fill out, no wait in the cushy girls-only inner waiting room where everyone's wearing the same lovely mauve exam tunic. Right on time, the tech called my name and brought me directly to the exam room, where she gave me a moment to take off my shirt and bra and put on the tunic. 

I usually like to watch the screen during ultrasounds to see what the techs are looking at, but this time I didn't. The images aren't particularly clear, but the last time, I could see something unusual was there, and I got a bit worked up waiting for the news. I wanted none of that, and I didn't want to psych myself out. The tech was really great - after leaving the room for a few minutes to review the pictures, she returned and told me that everything looked okay. I'd get confirmation from my surgeon, but there didn't appear to be anything to worry about.  

Oh, happy day! Next step: the annual mammogram in May.

On my way out the door, I noticed my nurse navigator was in her office, so I stopped to say hi and share my good news. After congratulating me, she reminded me that this is my new normal. Staying healthy means vigilantly appearing at recommended intervals for tests that either confirm I'm cancer free or reveal something small we can nip in the bud. 

And, she observed, there's always the chance that my mind will do a number on me. Something totally unrelated could spawn neuroses that the cancer has returned, taken up residence somewhere else, you name it. It doesn't just happen to survivors; she told me she has moments where she's convinced that one of her own aches or pains is an early symptom of cancer. It's natural to feel that way - our neuroses can protect us as long as we get the issues checked out. I likened it to my experience with bedbugs: even after I'd eradicated them from my home, any little itch or bug bite brought fears they'd returned. 

The breast cancer survivors support group at the practice is a good place to talk about these things, she told me. These are folks who are a year out from diagnosis, and dealing with the aftermath. It sounds as if it might be a good thing for me, even though I've avoided going to the group with patients in active treatment.  

This is going to be a long haul, one that lasts for the rest of my life, hopefully many, many more years. The treatment may be the most intense part of the whole thing, but I'm coming to realize that it's just the first part. I have to get okay with the fact that I'll never be completely done with this.  

No comments:

Post a Comment