Dr Goodguy is surprised

I love my surgeon.

Oh, not the fluttery-pulsed, red-faced, squirmy-tummied sort of love. Not the sort of love that lives in a fantasy world of breathless anticipation. That would be silly. I may have identified as Monkey recently thanks to the hairdo, but I haven't resorted to gibbering yet.

No, I just mean that wonderfully safe feeling you get when you actually trust someone. You know they won't tell you any lies. You know they really care about what happens to you. You know they'll do their absolute best to make things go well for you.

That's Dr Goodguy. It's quite a while since I saw him last, but he welcomed me in for today's checkup with genuine warmth. I felt like he remembered me, and was pleased to see me. I felt like he gave a damn.

I'd been looking forward to my surgeon's appointment today, because Dr G makes me feel secure. If that little bit of swelling under my arm was something worrying, he'd find a gentle way to tell me and he'd know what to do about it. If I just had a mild case of cancerchondria, he wouldn't make me feel like a fool. He'd quietly check everything that needed to be checked, and he'd tell me everything I needed to know.

Every patient deserves a surgeon like Dr Goodguy. Especially if they're at emotional melting point. They should clone this fellow, I swear, and hand him out to every woman in the world who's suffered a lump of deadly tumour in her breast and a lump of chilling fear in her heart.

********************

I thought I'd been doing pretty well, emotionally speaking, since my tradie tears last week. My friend and fellow-environmentalist Sharyn read that last blog post, totally got it and suggested we hie ourselves to the coast forthwith and let the sea breeze blow the bullshit away.

Well, she didn't put it quite like that, but that's pretty much what she meant.

See, she's just about come out the other side of her own battle with the Freeloader. She's getting closer to that magic five year mark every day. But she understands how the Freeloader can wear you down, and she understands how nature can be a healer. I needed a kick upside the rear to get outside and let the natural world do its work on me, and she gently provided it.

We had a glorious afternoon. Look.

So I've been pretty chirpy since then, all the way to this morning when I turned on the shower to get ready for my trip to town... and the goddamned gas heater wouldn't light. The water spewing from the tap was stone, motherless cold.

I swore a few zillion times. As you do. Tried again, and again, and again.

Realised that I was just emptying the water tank for no good reason, and the clock was ticking.

Wrapped myself in a towel, thanking the Powers that Be that we'd had a few sunny days in a row. Ran outside freezing my tit off (yep, it was a nicely frosty morning) and changed the hot water back to solar heating.

Turned on the tap again.

And what did I get? Stone, motherless cold water for twenty seconds... and then no water at all.

?!

Normally something like that would provoke a flurry of my very best x-rated vocabulary, followed by a call to the plumber. This morning, it just made me cry.

Still not better. I still have a way to go.

******************

So I turned up to Dr Goodguy's office feeling a little under-groomed, having hastily dabbed the vital elements with freezing cold water and slapped on a face over the frostbite in the small window left to me before I needed to fly out the door. (Possibly on a broomstick. Did I mention that the Arimidex is giving me the most delightful blind pimples on my face? No? Pass me my cauldron and black cat.)

Brrr. I'd been counting on the shower to warm me up. I grabbed a warm hat from the back of the wardrobe, noted it needed a good brush-down and had a wonky brim, but shoved it on anyway; I just couldn't cope with the Megwig doing a boa constrictor impersonation on my skull today.

I hardly looked as I slapped my eyebrows on. They were probably crooked too. WTF. Who cares.

******************

Dr G didn't seem unduly disturbed by my unusually asymmetric appearance; he greeted me cheerily and gently grilled me on how I was feeling, before asking to see the bomb site.

As I lifted my left arm till it all but touched my ear to let him inspect his work, his eyebrows flew skywards.

"Wow, you've got great movement in that arm." His surprise was as palpable as my armpit.

So was mine; my eyebrows joined his on the ceiling.

"I can get it up there, but it's so tight- it really hurts."

He grinned.

"Yes, but you can do it. Some women can't get it further than this."

And did a creditable one-armed chicken impersonation.

"Getting it right up like that- that's really good."

I shut up about my arm then. 

Small mercies, Candy. Keep doing your bloody exercises.

The small hardened lump left him completely unperturbed.

"Scar tissue," he smiled. And went on, "It all looks great."

Checked the other side, as usual; nothing found. (Phew.)

Back to the desk we went.

"So what's on your shopping list today?" he chuckled, as I drew out a sheet of paper containing the usual barrage of questions. Useless for me to try to remember them; chemo brain has replaced anxiety as the thief of my usual orderly thought processes. If I don't write my questions down, I find myself paying upwards of $100 an hour to be a nodding dog smiling blankly at my specialists. And then I get home and wonder what the hell was that about, and what did he say anyway?

No, I've learned to prepare.

1. When can I get my port-a-cath out?

There's one school of thought that says you leave your port in. I mean, if you end up relapsing and needing more chemo, there's a bit of loop theory involved if you've had it whipped out the moment you got to the end of Round One. It's threaded all the way into the heart, you know. Not the most minor procedure, putting it in.

Relapse? ME?

Fuck that for a joke. It's coming out on September 6th.

Now, that port-a-cath has been wonderfully useful. One quick jab, and the chemo drugs were on their way without the nurses turning me into a voodoo doll. I've seen some terrific bruises and outstandingly mangled veins thanks to chemo, and none of them were on my arms.

But the party is over. I haven't the faintest intention of having more chemo, even if I do relapse. (Which feels extremely unlikely most of the time, I have to say.)

No, it's quality of life over quantity for me, and I am NOT going back to that particular banquet table for seconds. I've eaten enough 'nothing paste with metal sauce' (not to mention 'metal paste with nothing sauce') for one lifetime. I've had enough excruciating pain. The hair that's coming back is staying.

Goodbye, port.

2. When can I have a reconstruction, and what's the waiting list like for public hospital versus private, and what are the costs, and will you do the reduction of the other breast, and does that still count as part of my cancer treatment, and who would you refer me to, and...

That, of course, was about twenty questions in the end, but Dr G patiently answered them all.

The bottom line is that he is brick-walling my plea for a referral until next year, regardless of how well my body handled the radiotherapy.

"You really need to give your body a chance to recover," he reasoned. "It's been through such a lot."

Fair enough. My mind probably does, too.

Yes, it'll probably be expensive to get a plastic surgeon to make me a new left breast, and there could be a wait of a year just for an initial appointment if I go public. But Dr G can still do the reduction on the right breast afterwards, and that will be a no-gap procedure.

"I regard that part of the whole cancer treatment," he said. "You need symmetry."

Always thinking of the whole woman.

That made me feel a whole lot better. Not because of the money, but because he did such a good job when he did the first operation on my left breast. It wasn't just neat- it also left me with nipple sensation, despite the fact that the whole thing had been chopped out and relocated.

"No guarantee we'll get that result again," he smiled, and I realise that too. But knowing he's done it once, I like my chances better with him than with a stranger.

See, I've got a bit of a dilemma there. My Bear is a breast man. I told you that before. It would be better in some ways to leave that right breast alone.

BUT- and it's a big 'but'- there's no way the best plastics man in the world could make another F-cup to match it out of my surplus tissue. I'm no Skinny Minnie, but I most definitely don't have over a kilo of fat to spare on my tummy or back.

Or, for that matter, on my big butt.

So it's be lopsided (even if less lopsided) all my life, or mess with the other breast too. I'll be messing, and hoping to hit the jackpot a second time with nipple sensation.

I trust you, Dr Goodguy. I trust you to do your best.

******************

And that, really, was about it, till I see him on the table on September 6th.

"It's great to see you looking so well," he said as he ushered me out. Smiling, and looking me in the eye.

And you know, I bet he doesn't say that to all the girls.

Running on empty

When I was a little girl I had a peculiar stoicism which bewildered those whose job involved inflicting pain on me. I never cried, never even flinched at vaccination time; I looked at the needle, even, when I was having blood taken. And I endured countless drillings and the occasional extraction at the dentist without anaesthetic.

It's not that I didn't feel the pain. I did. But I wouldn't show it. I was one tough little cookie, and I was an expert at self-control. Mind over matter, and all that.

And then I grew up, and endured a childbirth that was a living hell. I can describe it in darkly comic terms now; imagine pushing a watermelon covered in razor blades through a piece of inch-and-a-half human polypipe, and you're getting a blurry picture of what I endured. But at the time it wasn't funny.

Something happened to my stoicism that day. It broke, and I've never been able to put it back together.

I don't look at needles any more. I have an injection before dental work. Put me in pain, and I scream for relief. One night of bone pain after that Neulasta injection was enough to send me crazy- remember?

Oh, I still have a strong mind. It just doesn't work on my pain threshold any more. And thanks to the Freeloader, I'm starting to see that pain tolerance isn't the only human limit that can be broken if you push it too far.

***********************

Really, I'm doing so well. Sure, I only have about two-thirds of a day of energy in me, but my fitness is probably the best it's ever been and my strength is slowly increasing.

I can help around the farm again. I can tidy the house a little without having to rest for the remainder of the day. I can go to town and achieve maybe three tasks of the five or six I really need to do, before I run out of puff and have to come home. And the other day I cycled 11 km without breaking into a sweat.

There was a time when carrying the heavy pots of water out to the veranda for turkey processing left me puffing and flat for hours, but now I take it in my stride. Last week I picked up a 20 kilo bag of concrete without difficulty- completely impossible a few months ago; when we needed a few more veranda posts for our extension, I was able to help carry the lengths of felled tree out of the forest and then lift that damn blocksplitter to thump some of the bark off.

Not all of it, mind you. The Bear did most of the work. But given that the blocksplitter was where this whole story started, I felt that I'd come full circle nevertheless, just through being able to try.

And it's not just what I can do that's improving. My hair is starting to look like maybe I meant it- maybe I just had a really radical haircut. I mean, Mia Farrow got away with the pixie look- why not me?

And my nails- well, the crappy, yellowed, flaking part is almost up to the top. Another month and I might be able to cut the gross-looking part right off at last, and feel like the poison is out of my system.


All of that has fooled me into thinking I'm nearly out of the woods. But here's the rub: while my physical strength is returning and I'm looking more 'normal' on the surface, my emotional strength is starting to crack.

*****************

For many women, the emotional fractures happen much earlier. They'll have a meltdown when they're diagnosed (completely appropriate, but I couldn't do it). Or they'll soldier through the diagnosis and chemo but suddenly fall apart before radiotherapy, like my Pink Sister Angie. (Me? No way. The occasional dummy spit, but no real breakdown.)

See, I've got form for emotional stoicism as well as the pain thing. I have a talent for low-level PTSD. I'm the one who copes brilliantly in a crisis, looks after everyone else, and then bursts into completely inappropriate tears a week later when everyone else has forgotten all about it.

But it's not working for me any more. My emotional tolerance is broken. The tiniest bit of stress, and I'm a cot case.

I mean, this last week is a perfect example. I'd finally got to the stage where I felt secure enough in my physical strength to actually plan an outing for today- lunch with the Bear at a favourite pub down at Maclean, on the river.

And then a tradesman working on the extension got his dates screwed up, and instead of coming Monday and Tuesday he was coming today. I would normally be mildly annoyed- wouldn't anyone?- but this time I was inappropriately furious. Angry words flew out of my mouth, soon to be replaced by tears of frustration. Even the Bear ended up crying.

I think he probably had a better handle on what was going on than I did. He certainly wasn't crying about a tardy tradie.

Eventually I resigned myself to rescheduling the lunch date. But when this morning dawned and the tradesman had messed his appointments up again and didn't turn up- and it was too late to go back to Plan A, because other much less exciting plans had been made in its place- suddenly a silly situation that I'd normally swear about a few times and then laugh off became something that knocked me down for the count.

Every time I tried to talk about it I started to cry. I realised I was being slightly ridiculous, but that didn't stop me melting down. And even as I was dripping all over the floor, I was thinking I can't go back to work like this. One little problem and I'll crack up. I'm not better yet. 

********************

The Bear isn't better yet, either. We're both running on empty. There's not a drop of emotional energy left in our tanks, and in him it expresses physically. First it was the gastric flu; this mega-fit man is never sick, but last week he was laid low.

And now he's lying beside me in an exhausted coma as I write this. He went to bed pretty much as soon as we got home from running a few chores in town, and he couldn't even get up for dinner.

He never refuses my cooking.

I'm scared that he's broken, too.

*******************

Maybe this is the breakdown we had to have. At least we're acknowledging to each other that we've got nothing in reserve. But where do we go from here?

Don't suggest therapy. I've had so much counselling in my life that I feel like I don't need it any more- I've got to a stage where I can cope with just about any personal crisis by talking myself through it. Surely that's exactly what this blog is about- talking myself through cancer.

But what happens when coping isn't the answer any more? What happens when the emotional tolerance hits zero?

I suspect the Bear will just hibernate his way through it. Sleep or beer are his answers to everything stressful. (Or, more often, beer and sleep.) It's not so simple for an over-thinker like me. If I let it all go when my emotional tolerance is broken, will I ever put the pieces back together? If I start crying, will I ever stop?

That's a stupid question. Of course I'll stop. The problem is being able to start. Cracking up over little things that aren't even the problem, like a tradesman who isn't here when he said he would be, is just a symptom. I need to crack up over the Freeloader who stole a year of my life, or over being chopped up and poisoned and burned alive, or over the constant threat hanging over my head for the rest of my life.

But I can't do it at will. I'm too used to keeping the wheels spinning.

Maybe there's someone out there who can teach me how not to cope.