Sanguine, Mostly You…

Sanguine, Mostly

You seem so calm.

My doctor says this to me, when I call her
two days after diagnosis, ready
with lists of oncologists to consider,
my calendar open. Lets get this thing done.

She sounds almost worried that I
do not sound more worried, that perhaps
the truth hasnt sunk in. I rush
to reassure her that I have my weepy
moments. Im just action-oriented;
I like to make plans and follow through.
I am more ready than she is.

The waiting is the hardest,
more than one person has said.
I doubt thats true, but it is certainly
maddening. I may procrastinate
unpleasant e-mail, tedious grading,
but when the truly terrible looms,
Id rather dive in, headfirst.

The Greeks divided us by humour:
the excitable were choleric and melancholic;
the calm, phlegmatic and sanguine.

I am steadiest in the morning, when
I can do research with a clear head,
take calls, make plans. I am even
calm enough to reassure the people
who love me, many of whom possess
a more mercurial temperament.

I am glad to do that for them, to
make small jokes, laugh it off.
Then evening arrives, and the weight
of the day descends, with all its petty
frustrations and greater fears.
Then I take to my bed, curl around
the drowsy dog, pull the covers high.

You may just sail through this,
my doctor says. Maybe. Maybe not.

Cancer log 6: I know…

Cancer log 6:

I know there's been a flurry of these; it'll slow down soon. Pent-up energy from needing to be quiet for a bit. I'm about to go get on a plane and may be mostly offline for the next few days at a baby shower (babies, yay!), but wanted to do a quick recap of today's MRI.

So, this was not quite as much fun as I'd hoped. At first, it was straightforward enough -- strip to socks and undies, put on a robe. Wait around 'till she was ready for me. I found myself somewhat anxious, for no good reason. And then she reminded me that I was getting an MRI with contrast, which meant needle poking -- she had to put an IV line in for the contrast dye. Ugh. I did a bunch of IVs during the pregnancy, and I can't say I loved them (although sometimes, when they were giving me fluids, they did actually make me feel better). The MRI nurse was not so great at inserting it, so there was a good minute of stinging poking about -- I've had way better. Ah well.

Afterwards, I felt a bit shaky -- I get dizzy sometimes when I do blood draws and other needle stick things, and have even fainted a few times. I've gotten better at managing it so as not to faint -- lots of deep breathing really helps, and thanks again to my advisor Katie Coles who ran into me in the halls before my doctoral exams, where I was panicking, and quickly talked me through deep breathing; it has been useful many a time since. Still, I felt kind of woozy when I lay down. I figured I'd being lying down for forty-five minutes, though, so I should recover quickly.

Instead, I felt cold and shaky for quite a while. The process of getting into the machine was less than dignified; after putting in your ear plugs, you have to basically crawl up onto a bed and then lie down with your breasts hanging down through holes in the bed. Then there's a fair bit of readjusting to try to get as comfortable as possible (because you're really not supposed to move for the next forty-five minutes, or you'll get blurry images), and the tech moves your breasts around a bunch and wedges them into fixed place. You slide into the machine, and if you're claustrophobic, I'd recommend just keeping your eyes closed.

Eventually, I warmed up -- not sure why. I got drowsy inside the machine, because I didn't sleep well last night, but actual sleep was impossible because there were frequent loud noises -- and they varied, so it wasn't as if you could get used to the pattern of them. It felt like being inside a huge old school copy machine, actually. A piece of the machinery, and a faulty one at that. You're the thing causing the jam.

In retrospect, I wished I'd asked her if I could move other bits of me. Would wiggling my toes be okay? What about my fingers? Could there be stretching breaks, so I wouldn't get pins-and-needles? It's all mild discomfort, but it was annoying. And perhaps because I was at a not-very-high-end hospital (I have HMO insurance), there was no music playing, which really seems like a bad choice. It would have helped a LOT to have music in the background to focus on.

So, woozy from start to finish, and cold, and a stinging hand (she found a vein in my wrist eventually). MRI -- not the most fun ever. But also not actually horrible or anything. I won't be eager to repeat it again, but I'm enough of an experience junkie to be moderately okay with having gone through it once.

Results next week, and hopefully actual staging. Onward.

Cancer log 5: It’s…

Cancer log 5: It's funny, the things that help. Friends and family, of course, are all the comfort and support that you'd expect. But my two professions are writing and teaching, and I have to tell you, I've been living with this potential illness for several days now, waiting for results, waiting until it was appropriate to inform the family, and it has been really hard keeping quiet online about it.

Some people, I know, prefer to be private, and obviously, whatever gets you through, you do that. But for me, I take refuge in the two things I know how to do, the two things that might even help somebody else. I process by writing (sometimes in a form that's explicitly educational, sometimes not), and I gain comfort from sharing the writing. When I work to make the experience make sense to others, in poetry or prose, it helps it make sense to me too.

Perhaps this is why I started blogging, almost twenty years ago. Did you know that my blog is the third oldest continuous blog on the internet? #themoreyouknow! Blogging has helped me so much over the years, and it would be nothing without the readers. I tried keeping private diaries a few times, but they always fizzled out. This blog, this Facebook, these various forms of speaking -- they've been my therapy, my tool for introspection, my community.

Thanks for listening, people.

Cancer log 4: So, some…

Cancer log 4: So, some people close to me were hit hard by this news -- my immediate family, of course, and also close friends. People further out have also been affected, some of them more emotionally than others. I am doing okay generally, so far, and I haven't had any trouble with any comments on my wall or in e-mail or anything. But some parts are likely going to be rougher on me, and rougher on those immediately supporting me, and so I take this opportunity to bring you the excellent Ring Theory of Kvetching, which is useful in so many of life's difficult situations. I found this framework very helpful to me, personally. Use it wisely.

Cancer log 3: Note,…

Cancer Log, 3: Note, one may be slightly more emotionally susceptible to tearjerker tv than usual. Of course, when watching an episode titled, "All I Could Do Was Cry," I probably shouldn't have been surprised to find tears running down my face for five solid minutes. Damn you, Grey's Anatomy. Shonda Rhimes really knows how to yank those emotional heartstrings. (The catharsis is probably good for me; I was raised a New Englander, and we tend towards the overly-stoic.)

Day After…

Day After Diagnosis

Barbara Walters asked, But what would you do
if the doctor only gave you six months to live?
Asimov answered, Type faster.

The urge is to write ALL THE BOOKS. Some may be
too ambitious. The epic science fiction series,
the fantasy trilogy, the huge, tangled memoir
on love and nationalism and writing and sex.

Even the cookbook revision may be too
strenuous  will the body still be able to endure
hours chopping onions, ginger, garlic?
The scent alone may be too much. Strange
to contemplate  food no longer a comfort.

Yet surely the poetry, domestic & small,
will be manageable. When first writing
as a broken-hearted student, it was poetry
that emerged, words that wouldnt speak
out loud, weeping their way across the page,
sometimes raging. Catharsis and consolation.

My partner asks, if time is limited,
which book is most urgent? What hasnt
been said yet? Time is always limited,
and so far, everything known well enough
to say, has been said. Thats something.

But time is not yet over, and every day,
more small truths emerge in the silences.

Asimov was right. As long as fingers
and mind function, there will be writing 
as much as the body can stand. There will
be poems, but there will also be books.

Cancer log 2: I find…

Cancer Log, 2:

I find it scary not knowing what's coming. I learned yesterday that a friend of mine in her 60s hasn't had a mammogram at all yet, which startled me, and made me wonder how many women I knew were avoiding them because they didn't want to know, or because they thought it would be painful. I'm certainly immensely glad I went for mine, and I wanted to take a few minutes to walk you through the mammogram, ultrasound, and biopsy, just in case that helps put anyone's mind at ease. Gentlemen, pay attention too -- you may one day want to help support a woman through this. (Men can get breast cancer too, of course, but I don't think they currently do mammograms; someone correct me if I'm wrong.)

The day of your routine screening mammogram, you need about an hour or a bit more set aside. The procedure won't take that long, but there's paperwork and waiting and such. Dress in two pieces; you get to keep your pants and shoes on for this one. They'll have you take off your top and bra and give you a robe that closes in the front. When it's your turn, you go into the room, where there's a big machine with large heavy plates. The tech puts little stickers on your nipples, with metal markers -- that makes it clear on the scan where the nipples are. She'll have you take the robe half off, slipping your arm out of the sleeve, and I could never decide if I appreciated the other half of the robe being left on, for some faint illusion of modesty / protection, or if it just felt silly. The tech will have you step forward, and she'll manipulate your breast to the right position on the plate, shifting you as necessary. She may want you to hold onto a bar for steadiness / position. Then comes the squishing, and yes, this bit does hurt. It's mostly discomfort, but as the plates compress, there might be a few seconds of actual pain. In my experience, it's not nearly as bad as, say, stubbing a toe, but your mileage may vary. But it's over quickly -- you hold your breath and try to stay still for the few seconds needed, and then you can breathe again and it's over. They'll do this several times, maybe three on each breast, and then you're done. The first few times I did mammograms, they found nothing, and just told me to come back a year later.

If there's a suspicious result, they'll have you come back for a more thorough version (diagnostic mammogram). More images, more squishing, same level of discomfort. In my case, that same day, after the radiologist viewed the images, they asked me to stay on for an ultrasound, so I'd allocate more like two hours or so for this process. There's a fair bit of intermittent waiting, so you might want to bring a book, or headphones and music. I was a bit too anxious to read, it turned out, but the internet was nicely distracting.

The ultrasound is painless; I did a lot of them during my pregnancies (because I had uterine fibroids that they wanted to keep an eye on), so I was familiar with them. You lie on a bed (again, pants on, with the robe), and they put gel on your breast, and then move the wand across the breast, pressing gently. That's pretty much it; they do that for a while, taking pictures. Again, consult with the radiologist, who might do more imaging if she wants more pictures somewhere. Then they clean you up and you can get dressed.

They had me come back in on a different day for the biopsy. Allocate an hour and a half or so. Pants on, robe on top. You lie down in the bed, and the radiologist comes at you with a long needle. This is the part at which I stopped watching -- I was gazing at the ceiling for the rest of it. I chatted with her about her kids, which was nicely distracting. The first needle delivers anesthetic, and it feels just like the one that does that at the dentist -- initial prick, a bit of stinging for a minute or two. That's the worst of it, and it's not bad. Then the biopsy itself a few minutes later -- I didn't see the device, but it sounds like a staple gun. You'll feel pressure with each snap of the biopsy needle, but it shouldn't hurt. I did find it all somewhat unnerving. The biopsy part takes about ten to fifteen minutes, I think.

That's it -- then it's just rewarding yourself with chocolate (or your treat of choice), waiting for the results, and reminding yourself that 7 out of 10 times they do a breast biopsy, it comes back negative. Likely, you'll be fine.

When You Have Breast…

When You Have Breast Cancer

Friends rush in for overdue
mammograms, even the ones who were
resisting going at all,
afraid of what theyd find.

Husbands are kinder to their wives,
hold them tight at night,
seeing a future without them.

It can make you cranky;
this should be about you,
but now its also about them.

You let it go.

May something good come of this 
more check-ups and kisses.
We should all be kinder to ourselves,
to each other.

Diagnosis The first…


The first needle is long, but no worse than the dentists,
a small prick in an unaccustomed place. Rat-tat!
Rat-tat! The biopsy sounds like the beat of a distant
drum, or, more sharply, a staple-gun, extracting
rather than inserting. Two days later, the breast
still aches and the results are in. Surprising. She
was so young. Is. Is, of course. At forty-three,
on the young side for this, but not outside the bounds.

The last lump we were sure was cancer:
benign uterine fibroids, only fertility-threatening.
Spurring a spiral of panic, months of weeping
about children not yet had. Perhaps responsible
for our finally having children at all. The pointed
impetus, the reminder that we dont actually have
all the time in the world. The odds are with us,
this time. Only one out of twenty wont make it.
We have been lucky so far. Rat-tat. Rat-tat.


Cancer Log, 1

So, I had a routine mammogram a few weeks ago; they found a suspicious mass and had me come back for a more thorough screening mammogram. They followed it up that same day with an ultrasound, and soon after, with a biopsy. The biopsy found breast cancer.

The prognosis is quite hopeful, we think. Nothing is certain yet  were waiting on some hormone results and an upcoming MRI on Friday, so that the oncologists can do their assessment. Im meeting with them next week, at which point I should learn definitively what stage its at.

But that said, my best guess, based on what we know so far, is that its early stage 2. Thats very good, as these things go. That group now has a 95% five-year survival rate. (Thats a confusing phrase  it means that after five years, theyre still fine, and many of those people go on to live a long life afterwards, and even eventually die from things that arent cancer.)

And as friends have pointed out to me, in that 5% who dont make it, there are people who are already sick with other things, who may have compromised immune systems, who have other factors like alcoholism and drug addiction, who may be non-compliant with their medications, etc. and so on. So the odds are likely even better; there has been a tremendous amount of research into breast cancer, and they have gotten very good at treating it lately.

That said, it is, of course, a bit stunning. I fully expected the biopsy results to come back negative; I am somewhat young for this, and we have no history of cancer in our family, as far as I know. The next several months are likely to be somewhat rough, although I dont know yet what my specific protocol will entail. Probably lumpectomy and radiation, possibly more radical surgery and/or chemo.

I have a truly tremendous support network, a family full of knowledgeable doctors, and my department is being terrific about this as well. I plan to continue teaching every day I feel well enough to, and theyll bring in people to cover when I cant. My plan is pretty much to go on as close to normal as possible. Ive been through three major surgeries already (two c-sections, one breast reduction, which, incidentally, should have nothing to do with the development of cancer), and I already know that my body tends to heal well and quickly from surgery. We're in fine financial shape, with good insurance coverage. My life is in a very stable and happy place generally, and I have so many strong factors in my favor  it feels a bit weird to say this, but I cant think of anyone I know in a better position to deal with this.

I plan to write about this, probably a lot, and be very transparent about the process. One great thing about being an artist is that when terrible things happen to you, you have a little voice in the back of your head saying, Well, at least this will be good for my art! The main way Ive dealt with every difficult thing in my life is by writing about it, so I dont see any reason to stop now. I dont think the conversations going to be all-cancer, all the time; among other things, Im still deeply involved in the SF novel Im writing.

Okay, I think thats about it. If you have questions, do feel free to ask, but I may not get to the answers for a while, or possibly, not at all. Ive been telling close friends and family, and one thing Ive found is that it does take time and energy to respond properly to well wishes. If I dont get back to you, please know that your thoughts are read and appreciated. Thanks, folks.