Two down

On August 4th I met with an otolaryngologist to discuss the excision of the melanoma on my ear, and to discuss doing a sentinel lymph node biopsy to find out whether the cancer had yet spread beyond my ear. Dr. H surprised me by saying it didn't matter, clinically speaking, whether we did the SLN biopsy or not. He said if the melanoma had already spread beyond my ear, it wouldn't matter whether they found out immediately by doing the biopsy, or whether they found out in several months when the cancer would have grown enough to enlarge my lymph nodes and be found non-surgically. The survival statistics, he said, are the same.

"Really, it's completely up to you," he said. "Are you a person of faith?"

I may be a person of some faith, but I didn't feel calm about just waiting around for my lymph nodes to start bulging, so I scheduled the surgery anyway. I had it on August 20th. They removed a good chunk of my ear (repairing it to remain ear-shaped, though slightly smaller) and three nodes from my neck.

That was a Wednesday. At Dr. H's suggestion, I had taken the rest of the week off work to recover. Fortunately, this time the recovery was a breeze. They sent me home with codeine, and I faithfully took the recommended dosage all day Wednesday and into Thursday, but by midday Thursday I realized I wasn't feeling any discomfort at all, and stopped taking it. The incisions on my neck were slightly sore, but nothing like last time. So on Friday Mr. Thel and the doggie and I took a little drive down to the Green River Gorge just to get out of the house and see something pretty--and to try to take my mind off the fretting.

After a very long weekend of trying unsuccessfully not to worry, I got a lovely little pathology report emailed to me on Monday, August 25th, with the words "No evidence of malignancy" repeated three times, once for each sample.

There's been a lot of celebrating in the weeks since then.

Dr. H was exuberant in the follow-up appointment I had with him on the 26th. He said there was "virtually no chance" of it being a false negative result, based on their testing technique and the fact that they biopsied three separate lymph nodes. I'll have to go see him every 8 weeks for a year to monitor the site on my ear. He said, "We don't have any way to know whether this was kind of a random event, or whether this is your body's way of telling you that you've reached your limit of sun exposure, so I'd recommend getting a wide-brimmed hat and wearing it." Done. And I now carry a little tube of sunscreen with me everywhere I go, and am much more diligent about wearing it.

But all in all, that was pretty much the best outcome I could have hoped for, once diagnosed. As far as we know, I'm now in remission from melanoma.

Praise be.

Now they tell me!

The one that changes everything, in which nothing really changes

I mentioned in January that 2008 would be my tenth year free of cancer, although I then spectacularly neglected to share here the process of revisiting that ten-years-old experience. Honestly, I didn't even get around to reading all of my journals from that year. As the 10th anniversary of my final radiation treatment rolled around on July 17th, I began to feel a bit remiss for not better celebrating my remission. (That's not strictly true: I didn't know the exact date of my final treatment until I looked it up just now. I just knew it was toward the end of July.)

Now, though, I'm kind of glad I didn't already spend the first half of this year thinking about cancer.

Last Thursday I went in to have a dermatologist examine a suspicious mole on the tip of my right ear. She took a punch biopsy of the mole for testing, leaving me with two stitches. The dermatologist and her nurse both independently assured me that although I'd have a small notch in my ear, they'd do everything they could to minimize scarring. I appreciated their concern, but I think the existing scars at the base of my neck from my 1997 biopsies will sufficiently attract attention from any wee divot on my ear.

This morning the dermatologist called me to pass along the unfortunate news that my mole is a melanoma.

My attempts to talk seriously about this so far feel as awkward as trying to talk around a mouthful of saltines, all dust and garbles. So instead I made jokes about the bandage on my ear last week (I was going to make Mike Tyson jokes until someone brought up Van Gogh, which was much funnier) and poke fun at my own tendency to grin and laugh nervously when I'm given bad news (that dermatologist probably thinks I'm crazy, what with my frequent giggles in our conversation this morning: "I'm sure I'll be looking at your knowledgebase online right away, hee hee!"). A part of me is thoroughly, bitterly amused that I could manage to come down with a totally different kind of cancer after 10 years in remission from the first kind.

I started to write the following sentence: "The truth is, I feel_____." Trouble is, the word to fill in the blank changes at least hourly.

The truth is, I feel confident. Maybe this melanoma hasn't spread beyond the tip of my ear, and a little more surgery can be the end of it.

The truth is, I feel secretive. I don't want to tell anyone at work yet because I don't want people making assumptions about my capabilities.

The truth is, I feel angry. Two different cancers before 30? You're fucking kidding me, right?

The truth is, I feel defective. Nobody else in my immediate family has had cancer. Don't get me wrong, I'm glad they haven't, but, you know--I feel like the pimply-faced, crooked-toothed, tumor-ridden, malformed cuckoo in the nest.

The truth is, I feel hopeful. I have good friends, good family, good health (yes, except for the cancer), and a good job with health insurance.

The truth is, I feel balanced.

The truth is, I feel erratic.

My next appointment, to discuss upcoming surgery to remove the rest of the melanoma on my ear and to find and biopsy the sentinel lymph nodes, will be a week from today (sooner if they have a cancellation). Until then, I feel calm.

(Except for when I feel devastated.)

January 2, 2008 - Minus Ten

I had my second chemo treatment exactly ten years ago today--Friday, January 2, 1998. My parents had taken me to the first one, back on December 18. A girl named Michelle who'd lived on my floor the year before drove me to this second one. My doctor was extremely upbeat when he found out I'd never been sick after the first treatment.

"That's great! he kept saying, and told me that if one is going to be sick at all, one would be sick the first time. "So," he smiled, "if you didn't get sick at all the first time, I'd say that's a pretty good sign you probably won't get sick."

Two treatments in, I was beginning to be surprised that Having Cancer wasn't a continuously grueling ordeal every moment of every day. I was about to start the second quarter of my sophomore year at SPU, trying to maintain as many of my routines (school, work, campus volunteer activities) as I could and amazed that it looked surprisingly possible. With two down and ten to go, I was 17% done with chemo already.

More than anything, I was beginning to be humbly astounded at how many people were adamant about wanting to do what they could to help me. I've always tended to be a shy kind of person, standing on the sidelines dragging my toe awkwardly through the dust and assuming nobody likes me. So I was taken aback that so many people who were so much cooler, smarter, more popular, prettier, richer, more spiritual, and funnier than me--in my own true opinion--were genuinely enthusiastic about wanting to help me out.

I was also beginning to be flattered (and slightly uneasy) by the number of people who were already telling me I was inspirational, strong, and brave. Some had already started appropriating my cancer fight as a parable for whichever sermon or object lesson they happened to want to tell. At the time I remember being flattered and proud to be so recognized; but I remember a stirring of discomfort with that aspect of it, too.

And meanwhile I was secretly mourning that the boy I had a crush on had started dating someone else.

Looking Back

On November 26, 1997, I was diagnosed with Hodgkin's Disease, a form of lymphoma--cancer originating in the lymph system (I just learned from this article, just this very minute, that Paul Allen was treated for Hodgkin's in early 1983). I was 18 years old, a sophomore in college. After six months of chemo and a month of radiation treatment, it was declared to be in remission. Except for a short period the next fall when my oncologist worried that it was coming back (it wasn't), it's been in remission ever since.

I haven't written much about it here. But next summer it will have been in remission for ten years. More than a third of my life will have been lived post-cancer. I've been thinking about that a lot lately; it's part of the excuse reason for my planned train trip in the spring, and it turns out I've forgotten almost everything but the highlights--the date I was diagnosed, the number of treatments, things like that. I don't really want to wallow in the past, but I find myself wanting to revisit those months, to look back and remember what it was like not just to be diagnosed and to be declared in remission, but also to remember what it was like during my seventh chemo treatment, or at what point it was that I shaved my head, or how much more I worried about the boy I had a crush on in April than I did about my low white blood cell count.

This probably won't interest anyone but me, but I think for the next few months I'd like to post a weekly snippet about what I was doing during that time, ten years ago. I'd commit to posting diary excerpts from those days, except that I was 18 and most of my diary entries really were melodramatic accounts of my most recent interaction with whichever classmate I was swooning over that month. So if anything jumps out at me, I'll share it; otherwise it will just be a summary.

Why not start today, while I'm thinking of it, spending far too long browsing online info about lymphoma (I think some of this information has changed since I was obsessively researching it ten years ago), and flipping through old diaries and such?

Commemoration

List of things I hope to accomplish between now and next July, the tenth anniversary of the year I had the cancer:

- dye my hair blue
- buy one of these and spend a month crisscrossing the continent
- ride the 2008 STP
- get a tattoo to mark the ten years

Gee, when you string it all together in one place like that, it looks awfully dramatic. Still, you only live once. Time to step out of the rut I've been treading for the last few years.

If I remember right, after ten years they start whispering the word "cured" instead of "remission." So now instead of fretting about a relapse, I can start worrying about my increased risk of breast cancer due to all the radiation I absorbed ten years ago. I get to start having mammograms ten years earlier than all the rest of you!

Waiting for the Dawn

Take this soul, stranded in some skin and bones--
Take this soul and make it sing. *

November 26, 1997. The day before Thanksgiving. I am alone in my dorm room, sitting on the floor in an empty space surrounded by stacks of books and papers. I rest the old beige telephone on my lap and dial the surgeon's office carefully.

Hello, I'm calling for Dr. La Mancha? Yes, I can hold. Hi, yes, I'm still here. I'm calling for the results of my biopsy last Friday. Yes, he said he'd call me on Monday, but I didn't hear from him then, and he hasn't returned any of my messages...yes, I can hold. Hi, yes, here I am.

Dr. La Mancha is out of the office for the week. Another doctor is on the phone. Well, it is lymphoma; nodular sclerosing Hodgkin's Disease in fact, he says. Looks like stage 2A. You'll probably receive the standard treatment regimen--chemotherapy, probably four cycles or so. ABVD, I imagine, followed by several weeks of radiation therapy. We'll refer you over to Dr. Kaplan at the Tumor Institute, and you can set up an appointment with him next week or the week after. Okay? Okay.

My roommate has entered the room during this brief conversation. She glances at me and her face lights up. "I knew it would be okay!" she whispers, grinning. I realize my face is frozen in the polite smile I put on when the doctor began to speak, and quickly shake my head at her, relaxing my grimace into a frown. She bites her lip and sits down on her bed while I mechanically take notes as the doctor finishes. Nodular sclerosing Hodgkins 2a, I write. Chemo. ABVD. Radiation. Kaplan.

I still have that slip of paper in a scrapbook in my closet. "Chemo" is underlined twice.

The Automatic Bravery of a Cancer Patient, Exhibit A: My roommate being a nursing student, she all but pulls me to the nursing building to sit down and ask questions of her favorite nursing professor. The professor answers cautiously when I ask about the possibility of staying in school while I receive treatment, but admits it might be an option.

I am eighteen and have been in Seattle for barely one year. I stay in control of myself when the nursing professor is speaking, but every time I think about moving back home I start crying again. It seems childish to be more upset about this than I am about having cancer, I realize, but the tears keep coming.

I don't want to tell my parents this news. I imagine my mother sobbing. Oh, hell, will my father cry? Will they insist that I move home? What if I just don't tell them until after Thanksgiving?

But they already know about the biopsy, so they'll be waiting to hear something. And I'm a terrible liar. So I try the next best thing: I ask the nursing professor if she can call my parents to tell them, while my roommate and I are in the midst of our ten-hour drive home. I convince myself that this is a great idea--my parents can have a day to absorb the shock before I have to deal with their emotions, and the professor can answer the questions they will have.

Yes, I tell myself. This is a great idea. And she does it, too, calls them while I am on the freeway, inaccessible in the slow traffic jam that always oozes down I-5 the night before Thanksgiving.

I'm still a little ashamed of being that cowardly, I say.

Ah, you say, shrugging a little; but it was seven years ago, after all. You were just a kid.

I'm glad it's been seven years. It's not a cheerful anniversary, but I mark it every year.

Is it morbid that I can remember this date more easily than the date of my final radiation, my "remission date?"



*Yahweh, by U2, from "How to Dismantle an Atomic Bomb"