2020 – Fork this!

Most people reading this are already over all the 2020 memes about what a forked up year this is, and how everyone wants to return their copy as it’s clearly defective.

April 1, 2020 I got a cancer diagnosis. Yes, I really wish it had been an April Fool’s joke.

In January I noticed I had an itchy spot on my left breast, located where the edge of a bra cup touches the strap. I thought it was perhaps that there was some latex in the bra itself that had somehow come uncovered and was causing me this discomfort, as I have a small latex allergy that causes contact dermatitis. There was no evidence of dermatitis, just this pervasive itch that seemingly had no source. So I scratched when it itched, and mostly ignored it.

Around the middle of March I noticed a sizeable lump in that location of my breast. When I say sizeable, I am talking about something the size of a golf ball, visibly standing out on my chest. It had not been there previously, and my first thought was, “who the hell punched my tit?”. My husband also noticed it, and said the same thing. There was no bruise, just this big bump on my boob. I thought perhaps it had to do with me wearing an underwire bra for the first time in months and that the bra had been a little tight, so maybe some lymph got stuck and I have an infected milk duct or something. I did hot compresses and the lump did go down, although it was still noticeable under the skin.

I saw the doctor for a follow up about my blood pressure medication shortly afterward, and finally said something to her. She called to see if I could go straight for an ultrasound instead of a mammogram. I waited two weeks, heard nothing until one Friday I got a call – could I come in that Monday for a diagnostic Mammogram and an ultrasound? Of course I could.

So Monday I had the mammogram and ultrasound – and they found not just a lump in my breast, but a lump in my armpit – which means a lymph node was involved. I was asked if I could come in the next day for a biopsy. Due to the Covid-19 virus they were trying to get people seen as quickly as possible before the hospital shut down that kind of testing. I agreed, and my husband sat in the waiting room as I was numbed and then sliced and tagged. I spent the rest of the week numbly waiting for the results. I knew I had another follow up with the doctor about my blood pressure, so I assumed that was when I would get the biopsy results.

On Monday, the day of my follow up visit, I received a call that the doctor had to postpone my visit until the next week and it would be a telehealth visit, as they were not seeing patients in the office unless they were ill. I cried, “I’m waiting on test results from last week’s biopsy. Could you please find out what’s going on?” The nurse said she would make some calls and someone would get back to me. Thirty minutes later I received a phone call from the Women’s health care center. I logged off my work phone, put myself on break, and went into an empty office and shut the door.

They were kind. They were thorough. There was a tumor found in my breast and in my lymph node. Would I be able to make an appointment the day after tomorrow to talk with the surgeon about the pathology report and what to do from there? I did. I hung up the phone and sobbed. It wasn’t an unexpected outcome, not really – my mother had breast cancer last year and her sister had had it the year before – so I had a gut feeling that it was cancer. Now I just had to find out how bad the cancer was, and how far it had spread.

My husband took the time off to be there for my appointment – and they wouldn’t let him in with me. He was told he could wait in the lobby, and we were allowed to phone conference him in.

My cancer was Stage 2, because it involved a lymph node. It was grade 2 because while it wasn’t an aggressive grower, it did grow some. I would need to meet with a medical oncologist and a radiation oncologist to begin a plan of treatment. The nurse asked me if I was able to do those appointments the next morning. I am amazed at how fast they were able to schedule these appointments for me, and I am forever grateful to Carm and Judy, my supervisors and biggest cheerleaders, who let me flex my schedule as much as possible to deal with this.

The meeting with the radiation oncologist was short. He explained what would happen, I explained that I burst into flame looking out a sunny window and he laughed. He said that’s not going to happen, you are going to be a little more tan on that side and I said that’s good because that’s my driver tan side anyway.

The medical oncologist is the person who oversees your chemotherapy. Mine explained in great detail exactly what was going on with the pathology report and why she was going to recommend the course of chemo treatment she had planned for me. It was a two-fold attack: first I would be getting dose-dense chemotherapy treatments every two weeks for four sessions; then I would receive a lower dose of a different drug every week for twelve weeks.

“Well, there goes MY summer,” I said.

“To be fair, I doubt anyone’s going to have a good summer this year.”

Once chemotherapy was done, I would have an MRI to see how much the tumor shrank, I would get four weeks off to recover from the chemo, and then I would have surgery.

And then she mentioned I would need to have a port catheter installed. She drew a picture and described how it worked. I stopped hearing her. All I could imagine was an image from the movie Dune where the Baron Harkonnen was watching a young blond boy in his chamber arrange flowers. He called the boy over, pulled on a plug installed in his chest, and the boy bled out all over him. This probably showed up on my face because the doctor asked me what was wrong, so I told her. She had no idea what I was talking about, but assured me it’s nothing like that and it was a perfectly safe procedure and much safer than using a straight IV for these drugs because they are really hard on the body.

My port procedure was scheduled for the following week – but first I needed to have a chest x-ray and an MRI to set the baseline for the tumor size.

Thank goodness my other doctor had already made me have an echocardiogram earlier in the year – that was one step we got to skip. My echo showed I have a good, strong heart with very little problems as far as stenosis – hardening of the valves.

I’ll skip the x-ray and MRI – it wasn’t all that difficult to deal with.

The day before my first chemo treatment I had the port catheter installed. A port catheter is a device that is inserted under the skin and into a vein, somewhere up near your collarbone and on the opposite side from where the tumor is. I explained to the nurse setting up the IV that I’m a hard stick, and they ended up having to use my wrist because my veins in my arm decided to desert me that day. The doctor who does the procedure came in to talk to me – apparently there were going to put me in twilight sleep so I was going to be able to feel a pushing sensation when they install the catheter. I told him my image from Dune. He’d seen the movie, and he laughed and said no, it’s nothing like that, and the nurse showed me again what it really looked like. It sort of looks like a little cap with a fine mesh plug on one side and two flexible tubes coming out of it. They explained they were going to leave the needle in for the infusion the next day. Of all the things that hurt, I think having to deal with that needle stuck in my chest was the worst.

The Chemo appointment itself wasn’t bad. Again, my husband was not allowed in with me, so I ended up sitting in the waiting room by myself. As it turned out, it wasn’t all alone – someone called my name and I looked up to see someone I knew from work sitting there. He was finishing up his rounds of treatments, and he sat and talked with me a few minutes until his name was called. I thanked him for that the next time I spoke with him, because just seeing a familiar face really made that day so much better than it could have been.

Chemo itself isn’t bad. They test your blood to make sure you have good red and white blood cell counts, they check your blood pressure to make sure it’s not too low or too high. They start with the anti-nausea drugs, then go to the chemo drugs. I get a little lunch while I’m there. They have popsicles and applesauce and snacks in case you get hungry.

The day after I get a shot of an immune booster to help build up my blood count. And then I go home and deal with side effects.

It’s a routine now. Day 1 is the day I get chemo. Days 2 through 6 I have increasingly crushing fatigue, peaking on day 4. I’m not talking “take a nap and you’ll feel better” tiredness. I’m talking “can’t both take a shower and get dressed without needing a serious sit down and rest for an hour” type of fatigue. Where I’m worried when I go down the stairs because my legs feel so tired I might just collapse.

Day 7 through 10 the fatigue begins to ease, but the mouth sores and nausea ramp up. I have drugs to deal with both. The other problem is I tend to get bad diarrhea if I am not careful about how much fat I am eating. It only takes one greasy meal to make my day miserable.

Day 11 through 14 are the good days. I have energy, the mouth sores are healing and I almost feel normal again. And then we start the cycle all over again.

So yeah. Holy Forking Shirtballs.