Mammograms and Menopause…

Boy howdy, did I have a good time today.  Should probably be illegal, and yet it’s required by the conscientious medical provider I have, to the point of getting actual mail, not only e-mail reminders.  I think the last time I got real mail from my doc, it was an order referring me to an oncologist because my entire blood count was next to nothing, beginning the odyssey of leukemia survival.  So, they scare the crap out of me to let me know it was time for the annual (or so they’d prefer) boob compressing.  It’s an exam undoubtedly devised by a man who never thought that there could come a time when a very ornery, hormonal, fed-up menopausal woman somewhere in the medical invention universe would come up with a testicle crushing machine to ID nut cancer.  If my personal physician wasn’t female, I’d probably find some internet conspiracy theories to make myself feel better about blowing off said mammogram.  But she is, so I went.

The first time I had a mammogram was about eight or nine years ago. I’d heard horrible things about the girls  being smashed so flat, they needed spatulas to scrape them off of the table thingie when the exam was over.   It had been compared to the labor pains of the woman’s northern hemisphere.  I went in terrified of having my boobs stretched and pressed so harshly that I’d need to roll them up in those old pink foam rollers to get them to stay in my bra afterwards.  But I went.  I followed all instructions to a tee, including the ‘no deodorant’ rule.  My first thought was that the technician would be wearing a gas mask, but not the case.  And the exam began…

Eh.  Not a big deal.  Yeah, so I wouldn’t want to be holed up in those positions for any longer, but it wasn’t horrific.  I’d survived, and the girls weren’t bruised or misshapen. Still faced different directions. Back to baseline.    There was, however, a problem.  I tend to be somewhat intolerant of nonporous surfaces, and I sweat when in contact with them.  I’m also very heat intolerant, so I sweat just thinking about being slightly warmish.  My boobs also inherited this condition.  The first one let go of the table without much fanfare.  Peeled ‘er off, and tucked ‘er back in the backwards ugly-gown.  The second one?  Nope.  Did. Not. Want. To. Go. Home.  She was flattened down, and gripping with a suction I didn’t know was possible from a boob.  She put some octopi to shame that day.  I had horrific images flashing in my head about finally getting her loose, only to have the recoil  slap up against my forehead, refusing to move.  I’d have to drive home with a boob over my left eye, hoping like crazy that I didn’t get pulled over for ANY reason.   The sweat would be creating humidity in the car that would make driving hazardous. Ferns would grow.  Finally, I got it loose, and hunched over as I ran into the dressing room, hoping I’d been able to dislodge it without the tech getting any glimpse of the power struggle going on from a stubborn ‘limp’ tit on her table.  I wasn’t letting that boob get any ‘lift’ from air as I moved, lest she go airborne, and become too unruly to shove back into my bra.  Scary having something seemingly operating independently of the rest of me 😮

I had another one the winter after I finished chemo for leukemia (APL). Once I got the OK, I had every crevice and loose bit of tissue  tested for any and all types of weirdness.  I wanted to know I was starting with a clean slate.  And so I did- and all came out OK.

Then, came today.  I had a routine oncology appointment today (is that an oxymoron?  ‘Routine’ and ‘oncology’ lumped together?) , so I scheduled the mammogram for after that.  That meant no deodorant for the oncology appointment (but I did mist the back of my shirt  with a bit of body spray).  Menopause has done some odd things with body odors.  I hadn’t anticipated that when it all started, but have come to understand that I smell really, really bad if I’m not layered up with whatever non-toxic odor neutralizers I can find.  I’ve been tempted to stuff dryer sheets in my bra.  As it is, when I get a whiff of my pits- which are connected to a sedentary body, creating no extra odor due to healthy activity- I  dash off (well, I limp, so ‘dashing’ probably isn’t accurate) to do a wipe down with witch hazel, as well as a moderate scrub with some old cheap washcloths with some texture to them.  A layer of non-toxic baby powder is also a good thing.  This is all when I’m at home, alone, with nobody to witness the tragedy of menopausal pits.

Anyway, I got through the oncology appointment and went to the mammogram appointment, and got in early, since it seems Tuesdays in Cancerville are fairly sedate, and I overestimated the time between appointments.  But, the boob squishing department was at a lull, and I got right in over there. Did I mention that the handicapped parking is down about 16 steps?  Anyway,  I was escorted to the changing room,  given the ugly-gown to change into, and then made my way to the exam room, where the tech had some questions.  Thus far, the pit stench wasn’t horrible.  Not my finest, but I didn’t think I’d kill anyone.  On to the exam.

As soon as my right (the first one done) arm was raised, the green mist appeared.  I was suddenly reminded of roadkill along the backroads of Texas in July, about two days after impact.  Buzzards were circling, and flies could be seen in cloud form.   I smelled like decomposition 😮    Oy.  Those poor techs.  Menopause was making me smell like a dead opossum. Or skunk. With a witness.   I was horrified.  I laughed it off, and the tech just said she didn’t smell anything.  That must be part of the job application- must pass one of two of the following:  outstanding liar or absolutely no sense of smell.  The woman today seemed trustworthy enough, so my guess is that the part of her brain that interprets smell was blown out at close range in a terrible crossbow accident that left her otherwise unharmed.

I got out of there, and made it home so I could get the Brillo pads out after my pits.  I got my appointment clothes off (still emitting a slight green fog), and got my natural deodorant.  I thought about applying it with a spackling knife, but decided that might be a little too looney.  I’m not the queen of persnickety hygiene, but I try not to be a community health hazard.  At home, it’s just me and the dog most of the time (and she seems quite happy, no matter how much I’m mortified by the changes of menopause).   I like it that way, with few exceptions.   I just hope that when this whole process of ovarian retirement is over, I go back to being just a little whiffy when it’s hot out.  NOT being so toxic that I need to wear hazmat signs when I leave home.

My condolences to the mammo-tech.

Cancer’s New Normal

When I was going through the initial induction chemotherapy after being told I had AML/subtype M-3 or APL (acute promyelocytic leukemia), I just sort of went with the flow. My emotions were blunted- partly from fatigue, and partly from not really having the time to wrap my head around the idea of cancer before chemo started.  I was admitted from the ER after having some shortness of breath, and didn’t leave for 6 weeks.  I did have some warning that something was wrong, but I didn’t know what until I was admitted to the hospital oncology floor, and the bone marrow biopsy was done.  It was a whirlwind of life changing forever.  And yet, I’m very lucky.

I’ve written about Jeannie Hayes (the local NBC affiliate anchorwoman) who had 2 days between diagnosis and death. This week a friend of mine had a nephew who was OK on Thanksgiving, felt a little bad over the weekend, and then went from the local ER to being life-flighted to a children’s hospital; he was in a coma by the time he got there…and died the next morning. He was 11 years old.  The information I’ve got tells me it is the same thing… APL.  Nobody had a chance to even get used to the idea of cancer before they were making funeral arrangements.  That’s two families (and their friends) who had their lives changed forever from a disease they barely had time to learn how to pronounce.  Two people in the last month who died within 2 days of diagnosis, from the same thing that I survived.  It’s shaken me up a bit…. I feel so badly for those families, especially since APL is one of the most curable leukemias if its caught early enough.  Mine was caught purely by ‘accident’ with annual diabetic lab work.  I had no symptoms telling me to get checked out.

I never spent much time before now looking at how fortunate I really am.  It was simply what was happening, and I had to deal with it. But now, I’m gaining a whole different perspective on what very easily could have been the end of me.  The average survival from the onset of the disease and death (for those who are undiagnosed/untreated) is about a month.  Many people are diagnosed during autopsy. It’s that fast.  I didn’t get in to see an oncologist for 2 weeks after that bad lab work, and that was because someone else cancelled- I had originally been put off for over a month. I’d seen my lab work. I knew I needed to get seen, so I had my doc make a call and get me in sooner.  Then there was the delay of another week for the bone marrow biopsy.  I didn’t make it that long before I went to the ER with breathing problems.

My chemo lasted for a total of 19 months, with the IV stuff in the hospital, IV stuff (arsenic) as an outpatient on telemetry in the oncology unit, and then a year of ATRA  (all trans retinoic acid- think jacked up vitamin A), methotrexate, and M6 mercaptopurine- all pills. They have all had effects that have lasted longer than actually taking them.  My blood sugars are just now getting back into some decent range (I’ve been off of all chemo for 14 months). My weight is horrible (I gained a lot). And my skin is still kind of weird. BUT, I’ve been in remission since the end of induction.  NO relapses.  I’ve had a few annoying things (shingles, infected bug bites on my face- or that’s the guess, etc) that delayed things a few times. The muscle and joint pain towards the end of the year on oral meds was pretty brutal, but if it meant I’d survive, I could put up with it.  I actually got out of the whole thing fairly unscathed.

Now comes the rest of my life, when any little bump in the road health-wise has my cancer radar spinning like an EF-5 tornado.  I’ve got a bunch of other things going on with my health, so I’m never sure when I should pay attention to something, or when it’s just my life as I know it with a little hiccup. Last spring, I had a mammogram, MRI of my brain, colonoscopy, upper endoscopy (EGD), skin exam and biopsy, and yearly (ha !!) girly exams.  They all came out fine, for which I’m very thankful.  I’m waiting to feel relieved and like I’m really going to be OK for the long haul.  The official ‘5-year mark’ doesn’t hit until April of 2015.

And I’m not sure that’s going to make me feel really in the clear.  I watched my mom have bilateral mastectomies (separate surgeries), a lung resection, and brain tumor removed- and then chemo and radiation. The radiation to the brain left her with dementia for most of the 17 years she lived without additional cancer.  Every time, they said they ‘got it all’… is that even possible to say with complete certainty?  I don’t mean to sound like a total buzz kill for those doing well- not at all.  I’m a nurse. I’ve taken care of metastatic cancer patients, and seen them go through hell.  I just need to work out in my own head when to have things checked out.  And how to feel it’s OK to expect a future (disabled as I was before the leukemia).  And when to relax a bit.

I don’t have anything that’s bugging me in a suspicious way- I’ve just never dealt with the cancer to begin with. I put on a smile, drove myself to every one of 50 doses of arsenic, and the weekend Neupogen/Neulasta shots (to boost white cells), showed up for my appointments on my own (even the bone marrow biopsies- drove myself home 20 minutes after they were done), and never really thought about how close I came to being six feet under.  I absolutely understand that my prognosis is excellent. My most recent genetic marker studies were perfect. NO sign of the translocation of chromosomes 15 and 17.  I’ve been rearranged back into the right genetic sequence (how weird is that? !).  I’m a survivor.  I’m doing well- I get it… and I understand cancer isn’t a predictable disease.  I feel a sense of responsibility to have my apartment set up as simply as possible, clear out some clutter, and be prepared for anything that I can, to ensure that I can live independently as long as possible.  That may be another 30 years with nothing else mucking things up.  That’s the ‘plan’…but cancer doesn’t respect plans.

This all sounds so much more depressing than I really feel- to me it’s just reality.  I need to be as prepared as I can be, while not being tied to a diagnosis that has pretty well been treated. Relapse can still happen, but my new oncologist is checking genetic markers often.  He encourages patients to get things checked out if there’s any question.  He ‘gets’ the emotional component of having the ‘big C’ and knowing that it’s a mind warp for a while.

The news anchor and now the 11 year old have opened my eyes up to how blessed I am to still be here to even be a bit freaked out by their deaths.  I can’t imagine the pain their families’ are going through. No warning.  My prayers go out to them.

I need to figure out how to live better within my physical limitations. I’m still very fortunate.  Now just to stop being a bit scared.  A lot.