Tuesday, December 18, 2012

Calcification Tribulation

Yesterday morning I had my yearly mammogram, which was administered by a large woman whose sleeves were a dazzling brilliant violet. I sat in the waiting room afterward for a time and was called back for two more pictures. I asked if the first ones had not been clear, but the technician said they had been clear and that the radiologist just wanted more pictures, so this was in effect an immediate follow-up, with one of the pictures being quite painful, as with last year’s follow-up mammogram, which was one of the most disagreeable parts of the entire thing.

I sat in the waiting room again and after a bit was instructed to get dressed and wait to meet with a nurse. While I was sitting near the reception desk waiting to speak with the nurse, I saw the technician looking at me through a glass panel with what appeared to be naked pity.

I met with Sarah G., the same person who gave me the news last year that I had cancer, and she told me that there were calcifications seen in my six-month mammogram in June, but they were thought to be near the tumor site and not of it. However, the calcifications have changed since June and now a biopsy is needed, which is scheduled for Thursday, one year to the day from my lumpectomy.

I rode my bike downtown to have lunch at Ananda Fuara and sat over my dal and naan with tears dripping down my face, feeling wholeheartedly sorry for myself. I pictured C. walking around after I’m gone, which seemed very unfair: why does he get to live and I have to die? Of course, everyone will die. It’s not a special punishment reserved for the few. But 50 seemed way too young until I thought again of the children in Newtown. I guess if 20 six-year-olds can die, 50 is not too young at all. I consulted my Grandma Lee in heaven, who assured me everything would be all right. However, upon being pressed, she allowed that that didn’t necessarily mean I wasn’t going to die.

I’d scheduled my mammogram and one-year visits with my surgeon and radiation oncologist on the same day so I could just take the whole day off work and do all three appointments, so after lunch, I rode back to the medical campus and saw Dr. P., my surgeon. He already had my mammogram results and before he came into the examination room, I could hear him on the phone discussing my case with the radiologist. When Dr. P. joined me, he said that last year there were calcifications besides the cancerous ones, but of the kind they don’t worry about because they are always benign. But now there are calcifications that need to be checked as they couldn’t be made to “layer,” meaning they don’t appear to be in fluid. Evidently, if they are in fluid, they are not of concern. He said that what was seen today could be scar tissue, which can be not present at six months after surgery but present at 12 months, and it could also be that the calcifications were in fluid that has drained away. He said there are many possible explanations. I was not at all reassured.

Next I rode across town yet again to see my radiation oncologist, who said that three times lately there has been an abnormal mammogram that a biopsy showed to be not a problem—what looks worrisome could simply be benign changes in the breast due to the surgery or the radiation treatment. Because I had intraoperative radiation with my lumpectomy, if the biopsy shows DCIS again, I could choose a lumpectomy and external radiation this time, whereas if I’d had external radiation last year, and then had a recurrence (which I might be having), I’d have to have a mastectomy. If I’m having a recurrence, I can still choose a mastectomy, and if it’s invasive cancer this time instead of DCIS, likely I’d have to have chemotherapy.

I suppose there is no age at which death is welcome. Even if I were 99, the age my Aunt Mary was when she died, I still wouldn’t be excited about it
(though my Aunt Mary said she was pretty much ready to go). I thought about something Phillip Moffitt said when I was on retreat this year: “Something doesn’t have to last forever to have worked.” (He was referring to my relationship with C.)

Having learned from last year’s experience, this time I told many fewer people about the mammogram results. I very much appreciated all the support, but I ended up having to update 20 or so people every time something else happened.

Not long ago, I was telling Deborah that, when I think about it, I find it highly disconcerting that there is anything at all instead of nothing, and prefer to avoid pondering the matter—it makes me feel like I’m going crazy—though it is comforting that there are scientists who purport to be able to explain it. I think she said, “But isn’t it great that all this stuff is here?” I wasn’t in that mood at the time, but lately I have been: how miraculous that out of nothing should have come a purple marker! And this letter opener with a handle shaped like a giraffe’s head! And five trillion cars and paneer makhani and quite a bit of other stuff.

That feeling of marveling at creation was fitting nicely with my exuberance about having gotten a job. Life seemed wholly remarkable and enjoyable. Even when bad things occurred, I was thinking with a certain kind of delight, “Wow! I didn’t know this was going to happen. How amazing!” Howie sometimes uses the Sanskrit word “emaho” to express this joyful sense of wonder.

Since yesterday’s bad news, however, I have felt sad, scared and alone. I also am starting to not be so sure about my new job. It’s starting to look like once you learn it, that’s that, unlike my old job, which stretched my brain all the time. And I work in an atmosphere where the sole motivation for getting out of bed for most people can only be money, which was also true in my old job, but I think is even more the case in this department, and so, based on the evidence of one rather imperious phone call I received in error from another company employee, I decided that I’ve landed in a sea of jerks, though I will say that doesn’t seem to be true of my own team at all, thank goodness. My peers and manager seem entirely pleasant and relaxed, so further investigation is warranted.

In any event, I can hardly quit now, though I did tell myself that if it turns out I can actually buy my own health insurance one of these days, once the next round of medical attention is over, I have permission to quit this job and find something that brings more joy. I know finding a job while already working isn’t feasible, since it was pretty much impossible even while not working.
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