Thursday, December 9, 2010

Lassoed and Tattooed

Once again – a full week later – we are on the fifth floor of the William Osler Health Centre, Brampton Civic Hospital.
This doctor is a young, friendly man whose first name is Jasper, which for some reason makes me want to burst into hysterical laughter. He exudes energy, confidence and efficiency, unlike the oncology doctor. He’s a radiation oncologist.
I’m also attended to by his radiation nurse, who gives me piles of paper and booklets to read. She’s kind and informative, but it’s still uncomfortable receiving a pamphlet that roars out, “Radiation Therapy: A Guide for People with Cancer”.
The list of people now involved in my life seems endless: surgeon, surgical oncologist, medical oncologist, radiation oncologist, nurse, therapist, physicist, cast and mould staff, technicians, pathologists, radiologist. There are others I can see if I want: psychiatrist, dietician, social worker…
Once again I fill out papers asking about my past, my relatives, my drinking habits, my drugs (including recreational) and my sex life. This is probably all going on YouTube soon.
Dr. Jasper says the radiation is dependent upon my individual measurements. The bigger the area, the more sessions you must have. It doesn’t matter that the bad blasted thing was only tiny wee; it’s a Jane Mansfield scale.
He opens my top, takes one look, feels around a bit, and tells me I will have to undergo the maximum number.
Thirty of them. Six weeks’ worth.
We tell him we're booked for Mexico on January 12 and he’s pretty much aghast. First of all, he thinks our chances of getting the radiation completed are very slim. Secondly, if we did get it done in time, I’d be leaving right after treatments, and that’s when there could be reactions – after the build-up of radiation in the body, on the skin. He doesn’t think being in Mexico in the sun, possible bacteria in the water, chlorine in the pool, was a very good idea. He doesn’t want me to go. He says it nicely, but then he adds that I could always have a full mastectomy and then I’d be done.
Vince asks if we can wait until after Mexico, and then it bursts out of my lips: “No, I’d be too scared to postpone it that long.” I was unaware of feeling this way, but am irrationally annoyed with Vince that he didn’t know how I felt. In any case, Jasper vetoes that too.
The doctor leaves the room for a bit and Vince and I talk. “Maybe I should get the mastectomy,” I say. “When everyone asks why I had to have more surgery, we can just say that I gave up a boob to go to Mexico.”
Vince says, “Why don’t you get both of them taken off and we’ll go to Europe?”
Then we laugh, because of course the idea is that absurd.
Dr. Jasper writes us a letter for the insurance company, sets up the planning session at Credit Valley Hospital, and tells me he’ll see me there on his review day.
What I learn is this: cancer is a designer disease. Every single person is different, although there are commonalities in the type of cancer. (I think of Monty Python’s Life of Brian, when he lectures, “We’re all individuals!” and one person pipes up, “But I’m not.” I really want to say I’m not.)
Treatment is all based on your very special profile, your own body, your shapes. No wonder so many people have to be involved.
In my case, the estrogen-positive type of cancer is extremely common. The radiation treatments don’t target a cancer cell for shrinking or eliminating: the cancer is gone. But because I am estrogen sensitive, the other cells might just be thinking of going off course. The radiation is going to slap them back into behaving.
We get a call the day after our visit to Dr. Jasper, summoned to Credit Valley that very Friday morning. The planning session is a simulation of what’s going to happen. They’re going to make a bunch of images, do some measuring, and tattoo the area to be radiated. The tattoos provide a kind of map, an outline, which the radiation will target, so nothing will be radiated that doesn’t need it. In my case, the target is my whole right breast.
Friday arrives cloudy, damp-cold and windy.
First, we can’t find a parking spot. We circle around and around until we’re high in the air and some spaces show up. Second, we walk in the wrong door and have to circle around inside the hospital too. Third, we approach the wrong desk and have to be redirected. Worse, it’s in the basement, dark and cave-like in comparison to the fifth floor of William Osler, where the rooms are large and windowed.
We sit on a couple of plastic chairs and I pretend to read my Kindle. I have brought my binder with all the papers the radiation nurse gave me, as though I am going through an exam that has questions at the end. I want them to know they can just get this over with; I’m ready.
Two radiation therapists come out – one who speaks very accented English and the other a student – they tell me their names but they don’t register.
They take us into a little room, pull in two more chairs, and we sit knee to knee. They repeat everything that I have read in the binder. They tell me that I will be asked for my birth date every single time – at the desk, at the waiting room, inside the treatment room. Get used to it, they smile.
Vince asks questions.
I am tense and irritated. Get this over with.
Six weeks of this. Every day.
I put the nightgown on – one backwards, one forwards. Then we sit on plastic chairs again. A woman, who has lost her hair and wears a jaunty hat, smiles at me. I can barely muster one back. A very thin man shivers in the corner.
Get this over with.
Finally they call me into the simulation room. There are four of them, all young and slim. I feel enormous.
They ask me to repeat my birth date.
They take off one of the gowns, lay it on a narrow table, and tell me to lie on top of it. I climb up awkwardly, my arms flailing as I try to be graceful, and drop into a lying position. At first I try to keep my knees bent, to be more comfortable, but then they put something under my legs and I am able to stretch out. My right arm stretches out above my head, placed in some type of molded holder, and they open the right side of my gown.
I look down at my poor breast, sort of sunken and discoloured, and I ask her if I should’ve had her removed after all. Does she really want to be bombarded with this radiation stuff? Would she rather have been replaced with something artificial? Suddenly I realize that I am talking to my body part (silently though thank god) and wonder who is the boob here.
The four technicians begin to measure, calling numbers back and forth, drawing bull’s eyes on my skin. Once they have a range, they slide me into the simulator to see if the map is accurate.
They tell me to keep my chin up and that they will be back in a few minutes.
That’s when I nearly choke from the effort of keeping back the tears. I feel a huge, heaving sob in my chest, tears ready to spill. I want to simply collapse and cry my head off. I feel terribly sorry for myself – for my aging body, my distorted breast (once my pride and joy, indisputably the most cherished part of my vanity). How the hell did I get here? I want to shout.
There is only one way I can prevent the pity party from erupting: I picture my daughter’s face. I think of the beautiful tattoo on her gorgeous skin. I think of the softness of her hand in mine, of her voice urging me to keep writing, of her lusty laugh. The tears begin to subside.
I keep my eyes shut and picture my children (by birth and by love), one by one, my grandchildren, my husband. The sob in my chest dissipates for now.
The technicians return, ask me to sit up (which of course I do without any grace at all), pull me this way and that, re-write on my skin, and slide me inside the simulator again.
Next, they start the tattoos: a ring of freckles all the way around my breast. Tiny little dots, a permanent reminder.
When I am released, they give us the date for the first real treatment: December 15. Will we get the full schedule then? They are vague, but I get the impression that they’ll give us all the dates. I need those dates to regain a sense of control over my life.
I am silent and irritated. I feel guilty as hell, scold myself as we shuffle back to the car in the sky. Look at that poor woman, see this skeletal person – you are a lucky bastard. How on earth can you feel sorry for yourself? What a wimp. Pissed off because you can’t go on your trip. Big deal. There will be other trips, other years – you are so damn lucky.
Vince has to go out for the afternoon and evening, so I sulk alone, which is a good thing. I watch television for hours, rearrange furniture, play word games, pet the cats, talk to myself. By the time I am ready for bed, I feel much better. I’m still not ready to write it all down, though.
It actually takes a few days to shake the feeling. It takes friends, family, Christmas-is-coming activities, plans, a few chat sessions with my grandsons. Finally I forgive myself for feeling sad and grumpy. I allow a few tears to fall on my husband’s broad shoulders, and he understands perfectly.
Then I get up and live and laugh again. Grateful again.
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