Wonderlust

Paola and Lucas Recovering

2007-06-24T19:51:00.000-07:00

I just talked to Paola. She is doing better although she overdid the walking yesterday and is now sore. She's still in pain from the raw wounds caused by removing the tape. Also, she's still anxious to see what her "new body" looks like, but it is still too early to tell because she's still swollen from surgery. That said, it sounds like she's doing pretty well. Lucas is likewise on the mend, having had to go to the animal hospital for two bowel obstructions. Lucas is now home again.

All clear to contact Paola

2007-06-22T12:17:00.000-07:00

Hello all,

Paola is feeling better today. Lucas is ill. I did not get an update on Rosie.

If you would like to call Paola, feel free! If you would like to visit Paola, please call her first and see if she's up for it.

Drs are pleased with their handiwork

2007-06-21T12:59:00.000-07:00

Paola and her mom spent this morning at the hospital for a post-op check-up. The doctors are pleased with Paola's recovery thus far. They removed the dressing and the drain - a good step forward but a painful one, given the conjunction of delicate flesh and stubborn tape. Paola was in pain from the surgery and is now in further pain from the tape removal process; nevertheless, she has been able to eat and take limited walks, so she is in far, far better condition than after the previous surgery! For a month she will need to wear a tight bodysuit-like contraption. Hopefully she'll be able to get some stitches removed in a week. So, all in all, things look good. She is still not up for phone calls or visits yet. Maybe tomorrow - I'll let you know.

At home

2007-06-20T11:30:00.001-07:00

I just spoke with Paola's mom. Paola is at home and had a good night, but she is still in pain. Tomorrow she goes back to the doctor for a check-up.

Heading home

2007-06-19T15:33:00.000-07:00

Paola has been discharged, and her mom is taking her home. Paola is tired, in pain, and generally not feeling fabulous. Once Paola tells me she's up for visitors or talking on the phone I'll let you know but for now, please let her rest. If you feel compelled to do something for Paola, send her a card or a note - she'll enjoy seeing them while she's recooperating.

Still at the hospital

2007-06-19T10:05:00.000-07:00

I just spoke with Paola. She is still at the hospital but is likely to be discharged today. She has not yet seen her surgeon. The hospital would not allow Paola's mom to stay there last night. Paola is in pain but is able to eat - she had just finished a bagel when I called.

To the recovery room

2007-06-19T03:42:00.000-07:00

Paola's mom called me at 10:19 PM EST (June 18th) to report that Paola was awake and had been transfered from the recovery room to room G10.

Out of surgery

2007-06-18T17:23:00.000-07:00

I just got a call from Paola's mom. Paola's out of surgery and headed to the recovery room. She'll stay in the hospital tonight, and Paola's mom will remain there as well.

Headed into surgery

2007-06-18T12:51:00.000-07:00

Paola just called - she's headed into surgery now.

I'm not afraid, Part 2

2007-06-18T11:56:00.000-07:00

Paola and I just spoke. She's at the hospital, sitting in the ambulatory surgery waiting room. Continuing her tradition she declared for the record "I'm not afraid! I'm not afraid!"

Surgery Round Two

2007-06-18T10:51:00.000-07:00

As you all likely know, Paola's scheduled for her second round of surgery today. This surgery will focus on breast reconstruction. I am in New York, so I'm facing the challenge of trying to stay up-to-date -- and keep y'all updated -- from afar. Paola's mom, the wonderful Rosie, is with Paola.

Paola's surgery is scheduled for 1:30 PM today. Once I know anything, I'll post it to the blog.

Allie's back!

2007-06-16T10:37:00.001-07:00

Just checking in - I'll be updating things while Paola's undergoing this next round of surgery.

Bringing the Blog back to Life

2007-06-12T13:47:00.000-07:00

Despite my best wishes I found it very hard to blog throughout the later part of surgery recovery, chemotherapy and radiation. Instead I sent updates out to friends via email at intervals updating everyone on latest news. Though I do hope to resume blogging at some point soon, I want to share these emails here, clumsily fast forwarding the blog and bringing you all up to date on my treatment and recovery.

Here's a time line of my treatment for reference:

Double mastectomy and initial breast reconstruction: 16 August 2006

Estimated surgery time: 10 hrs. Actual surgery time: 20 hrs.
Lymph nodes removed from breast and left axila
Stage III cancer diagnosed
Estimated that without operation, I would have died by February of 2007
Food prepared by Joey's kitchen team is delivered daily starting 24 August.

Chemotherapy--8 sessions every other week: 1 Oct 2006 - 9 Jan 2007

Lost my hair by 15th of October; shaved my head 21 Oct 2006
Lost eyelashes, eyebrows, and pretty much every other hair strand (except in my legs) by the Holidays
Couldn't eat any raw vegetables, everything tasted like metal, survived on cheese, pasta and other bland foods including ice cream
Gained 20 lbs and made Oncologist upset when I complained about it
Immune system completely shot, couldn't fly, attend concerts, crowded restaurants, or theaters for the duration (though I cheated a bit and went to the mall and movies on occasion).
Spent 4 months essential on house arrest. Friends and colleagues delivered lunch, movies, helped around the house and stayed overnight when needed.
Took 5 weeks of recovery time before Radiation started

Radiation Therapy--25 daily treatments (excluding weekends): 5 March - 6 April

Severe internal pain, skin rash, and fatigue
Due to radiation angle, permanent damage to left lung leaves lingering dry cough
Heart tissue is safeguarded
Took 8 weeks of recovery to allow skin to heal prior to second reconstructive surgery

Breast Reconstruction Part II: 18 June 2007

Estimated surgery time: 4 hrs. Actual surgery time: we'll see, I'm expecting 5-6 hrs.
Scar tissue will be removed and breasts reshaped.

Breast Reconstruction Part III: TBA

And now, the emails. Please see following posts.

Radioactive Update (2 April 2007)

2007-06-12T13:43:00.000-07:00

Dear All,

I hope you have all been well these past few months, and the beginning of a New Year has brought the changes you had hoped for on New Year's Eve. Even if your resolve to stick to your resolutions has been lackluster, you still have ¾ of the year to make them all come true…including the weight loss! (You know who you are…)

As Passover, Easter, and Pagan Spring Fertility and Renewal festivals approach, I wanted to take this opportunity to wish you all a wonderfully blooming time and give you a little update on things here.

Though chemotherapy officially ended on January 9^th, some side-effects remained; most notably my total lack of hair and the weight gain. As I have mentioned before, chemo drugs completely obliterated the flora in my intestinal track forcing me to eat very bland and starchy foods for the duration of treatment. I guess the steroids I took to withstand the pain didn't help either as they made me very puffy. In the end, this translated into a 20 lb (~9 kilo) gain...@#$%&!

Once chemo ended, my body completely hairless, immune system destroyed (AND trying to fight the flu), I headed for a restorative sojourn to the beach and spent some much needed time with family. I was happy to soak up the sun, disconnect from the world, swim, sunbathe, meditate and read. It took me some three weeks to start feeling better, but after much sleep and surf, I felt like a person again. I finally went for walks and started eating more normally—especially vegetables, fruits, and other raw foods including sushi. (Yay!)

The steroid puffiness faded soon after my energy started to slowly return, but there was no sign of new hair still. Even worse, the waves knocked out every last lash and eyebrow which made my eyes sting violently without any protection against the acidic mix of sun block and saltwater. On the upside, I was incredibly aerodynamic in the water; which aided my first few attempts to swim. Gleefully my stomach muscles engaged and I was able to swim for the first time in over 8 months. I was terrified my torso would just sink like a log and I'd never do another triathlon again. I didn't get very far, mind you—given my weaken state, diminished range of motion in my arms, and the salt water in my eyes—still, my stomach HELD UP!!! One triathlon sport down, two to go.

A steady fruit and fresh vegetable diet also kick started the slim down, but it's been a painfully slow process. My body is a little whacked; some weeks I am up, some down. It seems no matter what I eat or do, I can't get the weight to stabilize. My doctors keep telling me I have to be patient and let my body heal itself slowly. Intellectually this makes perfect sense, but emotionally the weight gain simply added insult to injury, and it hurts.

Upon my return in late February the docs checked everything out and deemed me ready for nuking. I have never been this excited about radioactive isotopes! It's totally spacey, and duly complicated. You see, this stuff can kill you, so they need to make sure that only the cancerous parts are nuked, and at the right levels too, lest the treatment give me MORE cancer…crazy science! But how does one prevent adverse effects? Sadly, one doesn't…only prayer (and potent drinks to induce denial) can possibly account for all the unknowns. Still, glowing in the dark is much better than being dead, so I agreed and on we went.

First there are tons of x-rays from every angle to pinpoint the specific field to be nuked. I guess this also serves to give the body an early taste of radiation. Then comes the simulation. This generally involves you laying down semi-naked for hours, and hours on a gooey platform that eventually retains the contours of your body. I am so glad they told me how long the test would last BEFORE we started and I COULDN'T move AT ALL…no wait, that's the one detail they left out! The simulation, then, doubled as a test for my bladder capacity and control. Turns out I can hold it for over 3 hours without moving—and you thought my talents were relegated exclusively to the classroom!

Aside from the near-bladder explosion, the "test run" went very well. They determined the coordinates to align me with the machine and promptly tattooed markers on my body. These would then be used every day for 30 treatments to assure we were nuking the exact same area. Why is this important? Well, we wouldn't want to further damage any surrounding tissue, like for instance, the heart and lungs. Unfortunately, part of having been an athlete for years is powerful (namely big) lungs. Though they tried their best, and were able to avoid radiating the heart, they couldn't avoid nuking part of my left lung. Thankfully this will only mean a constant cough I may never be able to shake. Fun! And thus the nuking commenced on a Thursday morning promptly at 8am. I pleaded for a more humane time, but sadly other pesky cancer patients had taken the good slots! Alas, the nice tech promised me 10 am nukings after the first 10 treatments. (Score!)

If this treatment had a warning label, it'd read something like this: Extreme hazardous materials. Use only under insufferably overqualified adult supervision and confined to a vault-like room with foot thick steel reinforced walls and doors. Upon administration be sure that all non-cancerous personnel leave the premises to avoid exposure. Extreme hazard if subject moves even a millimeter during administration. Subject may experience extreme fatigue, dizziness, claustrophobia, muscle spasms, sunburn-like symptoms including itching, scaling, severe rash, cracked skin and intense pain. Subject may also experience electricity-like pain emanating from affected area and radiating along limbs and nerve-endings. Finally, treatment may cause cancer at margins of radiated field, and may in no way prevent further recurrence in areas outside the said field. Treatment may be given only once with an acceptable level of risk to deem it "safe." Subject, though mildly radioactive, does not glow in the dark; is not dangerous to babies, puppies, small rodents (including tiny doggies) or plants; subject cannot power her own house, or perform any cool party tricks.

On the positive column, radiation does in no way impede hair growth. My overachieving follicles (did you really expect anything less?) are so ahead of schedule they'd managed to fold time, as a mere 8 weeks after the end of chemotherapy I had TWO rows of eyelashes and full eyebrows that once again required grooming. My hair started growing in inconsistent patches about 4 weeks after chemo. After much shaving to strengthen the lint that first appeared atop my head, growth has finally stabilized and now covers the entire head evenly for a soft brush feel at about ¼" inch (~0.5 cm). Another cancerous joy is the guess-what-color-and-texture-your-new-hair-will-be game. At the moment my once medium ashy brown has turned into deep charcoal black. As for the texture, given that the hair is not sticking straight up, it may indeed be a bit curled rather than its original straight self. Most patients tell me I should be happy it's black rather than entirely gray—which is the other popular option.

And thus the past few months have gone between recovery and radiation. My first blood test some 6 weeks after chemotherapy showed that my immune system is back to normal and firing on all cylinders. The doctors were also pleased to see that all blood particles are regenerating normally, which amounts to an amazingly fast systemic recovery. I am currently at the very tail end of radiation and the conclusion of the cancer-fighting battles that started on 16 August with the tumors' removal. We'll know if the war is won in about 12 months though. In order to improve my survival chances by 50% I'll have to make it to 4^th April 2008 without remission. Thereafter, my chances of survival will increase by 12.5% for every year I make it without cancer for 4 years. This will bring me to 5 years of remission upon which my overall chance of dying from cancer will diminish from 100% to a mere 30%. Simply put: if I make it to 5 years and I am still in remission, there's a 70% chance that I'll become the rocking old (and all around cool) broad I know I can be.

So what now? In the long term: wait and live. In the short term: visit with family and friends, and retreat again to give my body a chance to heal in preparation for a second round of surgeries. In June & July I will undergo two more surgeries to finish out the girls and assure that all pesky cancer cells are vanished. I am yet to fully discuss the complete follow-up plan with my docs, but they assure me I will be under intense observation for the first (and most critical) 12 months. But no fear, as I have mentioned to so many of you, cancer will not kill me…I've decided this and it will be so.

Though I remain steadfastly positive, I am tired; actually physically, emotionally and spiritually exhausted. Being sick and generally incapacitated for this long has been a test of will I hope never to endure again. This prolonged house arrest and inactivity have been incredibly hard on my spirit. I want nothing more than to be training as the triathlon seasons gets underway, I miss my work colleagues, and friends, and want to finally stop being in pain. And though I know these side-effects are temporary and inevitable, I still long for my body to allow me to do the things I enjoy. But, as my dad says: "La luz de 'alante es la que alumbra" (The light ahead illuminates the path); so I march onwards undeterred, though at times frustrated, to the light.

I want to thank everyone who through their actions have made my treatment bearable and my recovery possible. May you continue to turn your words into deeds, and never speak in vain.

Until June…Lots of love as always,
Paola

PS: If you made it this far, thanks for indulging my very, very long update…Chag Same'ach Pesach! Peace to your home and joy to your heart.

Chemo update and Happy New Year (29 Dec 2006)

2007-06-12T13:40:00.000-07:00

Dearest All,

As 2006 draws to a close I want to take this opportunity to tell you a bit about what's been going on here and bring you a little holiday cheer…ok, who am I kidding, this is a cancer update! (But one with a happy ending so far)

As many of you have pointed out, the blog continues to show wet pictures of Lucas since September. I know this is cruel and unusual, not just to the poor creature, but to many of you; sadly I really have no good excuse other than "I've been having a little chemo"…hasn't gotten me out of any speeding tickets, but hopefully will allay your fury and get me out of Jury duty in Santa Clara County—got summoned this week! For now, this update will have to suffice until I am able to finish and upload a more comprehensive narrative detailing the joys of Cancer treatment.

Speaking of silver linings, one of the most remarkable things about this process has been the opportunity to learn how to receive and appreciate help, and experience first hand, what amazing people I am surrounded with. As many of you may know, I had a double mastectomy in August and by the end of September my mother had already gone home. I started chemo on October 2^nd and have since relied entirely on a vast network of friends in the Bay Area to get me through it.

My colleagues and friends at Google have dutifully delivered lovingly prepared meals by the kitchen staff every day since August and through all of chemo. I should mention that some of them have waited months in line to make such deliveries as apparently I've become a hot excuse to get out of meetings :) Others have offered themselves and their parents to drive me to and from chemo infusions and follow-up doctors' visits. Some have volunteered to spend key nights with me each chemo cycle to make sure I have someone in the house should I need help, medical attention, water, a laugh or just some company. The Gray's Anatomy viewing club has been a roaring success offering up weekly McDreamy-Steamy sessions and even an excuse for a chocolate fest when the ban on cocoa products was finally lifted by the docs on Nov. 16^th.

Little things from weekly cards with encouraging messages and hilarious tag lines, to a brand new pill box that actually fits all the supplements I'm on, a free subscription to NetFlix, weekly help with my garbage and recycling, Lucas bathing, head shaving in solidarity, unending errand running—especially to get Pedialyte and other bland foods, and finally, endless rides to various places and gatherings have made these last few months bearable and in some cases even enjoyable. I have been overwhelmed and immeasurably thankful for the vast show of support and love I've received. But most importantly, while learning to receive unconditional help gracefully, I have also had brazenly honest and profound conversations with many of these people, and have gotten to know them in a way I think our normal day-to-day circumstances never allowed before. Somehow, cancer destroyed a wall around us and allowed all of us to be real in a way I've seldom experienced before, but have the joy to embrace daily now.

But not everything has been rosy—just in case you thought this was turning into a Hallmark moment. Cancer treatment in general, and chemo in particular, can be summed up as a tedious and repetitive test of one's will to endure pain, discomfort and, unexpected and profoundly disconcerting side effects, with the hope that you'll be rid of every last evil cell and come out the other side alive.

I have lost my hair pretty much everywhere, including inside of my nose which irritates my sinuses and has thrown me into a permanent state of sneezing, YET I am still shaving my legs! I know, this proves that g-d cannot possibly be a woman, I'm most disappointed. On the up-side, I have managed to keep most of my eyebrows and about 30% of my eyelashes. Since chemo kills all rapidly dividing cells in your body—cancerous or not—I have also lost all the lining in my mouth and stomach rendering me almost incapable of digesting a raw vegetable or any kind of spiced food without great pain and other unspeakable side effects that I'll spear you. As a consequence, I have lived on a very bland and starch/dairy laden diet that has made me GAIN rather than lose weight on chemo. Yes, you heard it, I managed to PLUMP up…I complained to the doc and he almost killed me as this is a very desirable outcome—except when you are the one logging the outcome poundage around…sigh.

The first set of chemo drugs made me nauseous 24-7, but thankfully the latest set simply give me lots of pain and hot-flashes. Yes ladies, if you've ever made fun of your mom, aunt, grandma, or random stranger reaching for anything in sight to fan herself, please say a little prayer to yourselves that you'll actually have to wait until menopause to experience your body's amazing ability to make you think you are going to actually combust, and then make you sweat uncontrollably. The more chemo I get, the more often hot-flashes come, and of late they've been happening mostly in the middle of the night, which happily interrupt my sleep regularly. Oh how I wish there was a better way to target and kill only cancer cells in the body instead of putting patients through all this hell—it's like using a nuclear blast to kill a mosquito, it also obliterates and contaminates everything within a 500 mile radius.

The good news is that chemo is almost done. I have just completed my 7^th infusion and on January 9^th will go in for the last one. After that, I will take some time to retreat and heal in preparation for 6 weeks of daily radiation. Following the nuke fest, two more surgeries await. But I am taking this one step at a time, one day at a time. Chemo battle is almost over, and I am halfway through the Cancer war with relatively few casualties—unless you count hair strands individually. I have been lucky to have the support of my friends, family and work to allow me to take the time I need to heal. My body has taken a beating, but my spirit remains strong. Mostly, I've learned to appreciate the present more, as it's become increasingly clear to me that's all we really have.

I want to thank all of you for your support—whatever shape it's taken—and wish you the kind of love and encouragement I've felt this year to overcome any challenges you may face in 2007. Remember to look around and recognized how loved you are, tell others how much you love them, go out there, kick ass, and go for what you REALLY want—life's too short not to play hard!

Lots of love, health and happiness in the New Year!

Many hugs,
Paola

Back Online: First email after Surgery (11 Sept 2006)

2007-06-12T13:37:00.000-07:00

Dearest all,

I apologize for the long silence, but rest assured that all your messages, flowers, gifts, encouragement and thoughts have not only been received, but have been an integral part of my recovery. As I have already told so many of you, knowing that you are thinking of me--and sending positive energy and love my way—has carried me through the tough days and allowed me to enjoy the good ones a bit more.

I had been waiting to feel "good" before resuming my blogging duties, but then I realized two things: a) This might be a LONG while and b) "Good" is a very relative term these days. So after my writing hiatus I wanted to take this opportunity to give a quick update and once again point you to the blog. Though I may not be able to write every day, I hope to blog at least once a week—comments on posts and the wonderlust group/forum are ALWAYS welcome.

The past few weeks since my release from the hospital have been marked with small triumphs and occasional setbacks, for an overall positive balance on the recovery front. The docs are happy and want me to push a bit harder on the physical activity—which is very painful. Mom is cautious and wants me to cut down on pain meds—since they are narcotic and generally bad for you—but this diminishes my ability to increase physical activity. So it's a balancing act every day between my doctors' orders and my caretaker's wishes.

I should also mention here that mom doesn't really believe in western medicines and thinks them all generally poisonous to the body. My docs have never heard of any of the homeopathic remedies and herbal treatments mom has so laboriously researched. So I try to take the best of both worlds and I'm happy to report that some of mom's treatments—though they generally taste like ass—have been quite effective and haven't really interfered with the course of the "traditional" medicines.

Still, I am unwilling at this point to go to an all raw diet mainly consisting of sprouted cereals (it is as gross as it sounds), no dairy or starches, and go to bed at 9 pm(!) each night. I have, however, conceded on the refined sugars—drastic reduction of pretty much everything that's yummy—and moderate to actually non-existing simple starches in my diet. In addition to mom's mission to get me to fight cancer through a rabbit's dream diet and a monk's lifestyle, the docs have summarily prohibited any caffeine containing food, especially CHOCOLATE!!!! I know, this is torture! Oh, did I mention I can't drink either? Yeah. So I guess I am closer to the monk and the bunny than my normal self…

But I am taking it all in stride and immensely enjoying the time with my mom—though admittedly frustrating at times. She has given herself over to my care with the outmost love and devotion, to the point that I have to push her to take better care of herself. Like a good Latina/Jewish/Italian mama, she is very protective of me and wants to make sure that nothing in my surroundings will cause me harm. This has translated into a manic cleaning frenzy that never seems to end, including endless loads of laundry--if something touches the floor it must be immediately washed in piping hot water! I am afraid she is single handedly diminishing the fresh water supply for the whole of the Bay Area.

The most concerning of her wellness strategies for me is her firm belief that Lucas is somehow radioactive, and I shouldn't AT ALL come in contact with him. At first she advocated for having him (and all his belongings) deported from the house for an indeterminate (I believe "forever" was her goal) period of time. After a long and tearful negotiation I agreed to not hold him or in any way cradle him and stay completely clear of him, his toys, food, and living space. In turn, mom agreed that if he spent the majority of his time in the backyard and was only allowed in the house a brief period of time in the evenings—completely away from me, of course—his contamination would be properly contained and thus I could be saved from its ill effects. She then made it her mission to disinfect and thoroughly wash absolutely everything the dog has ever come in contact with. I still have to restrain her desire to bathe the poor animal on a daily basis.

Lucas, in turn, thinks that *I* am radioactive and begrudgedly (but obediently) stays clear of my bed and person. He still gets his kicks, however, using his big brown eyes and batting tail to guilt mom into long petting sessions and extended belly rubs. Mom, I believe, has secretly fallen in love with the little guy, and though she maintains her resolve to keep him (and his supremely infectious doggy dirt) away from me, she seems to thoroughly enjoy being the ONLY person in the house permitted to pet the monster. Conspiracy perhaps?

And so the days roll in intervals dictated by the meds schedule and are colored by mom and Lucas' antics. There has also been quite a bit of chanting, candle and incense burning, heartfelt talks and some tearful arguments. Mom is settling into her role with gusto and I am trying to be a good patient. It's a tough road to travel, but we are marching on and leaning on the help of so many to make it through. Mostly, I am thankful to be so loved and to have so many of you by my side.

For those of you who are in the Bay Area and would like to come and visit, I'd love to see you. So please give me a call 650-xxx-xxxx (don't just stop by pls!) and we can coordinate a time that works—generally evenings after work are a good time :) I will let you know in as much advance as I can if I am not feeling well and can't see you, but as you well know, I am a social butterfly and hardly miss an opportunity to hang (unless I am REALLY, REALLY sick!)

For the rest of you, I've loved receiving and reading your cards and smelling the lovely flowers you've all sent. I have tacked all cards to a board Rob & Allie created for me, so they are my inspiration every time I wake up, feel down, or just need to refuel my courage cell. Thanks so very much (and keeop them coming if you are so inspired)!!!!

Catch you all in blog!

Lots of love,
Paola

I am finally well enough to bathe Lucas

2006-09-22T00:22:00.000-07:00

I know, I know, many of you must be thinking "why on earth would you want to be well enough to scrub the dirty monster!" Granted, the whole bathing a water-hating-I-rather-die-than-have-you-shampoo-my-hair- little-mongrel-doggie-monster does have its down sides: from the tangled poop (don't ask) to the tangled twigs in his butt (really get a short haired dog), down to the struggle to get him to stop curling into a tight ball when I am trying to dry his hair; but it's the commonness of it that's beautiful. For the first time in a over a month I was able to hold my dog and painstakingly extract pieces of my garden from his hair. I spent the time to free him of all tangles and even styled him to perfection.

A few weeks back the idea of standing for more than a few minutes, lifting my arms, or even lifting Lucas was unthinkable. Today I used my arms without pain, bent down without effort, stood up without hesitation, and spent precious time taking care of my constant companion. It was also a relief to see that he still hates his bath...it brings a sense of normalcy to my life; perhaps even a sense of peace and hope that things will once again be as they were before (if not better).

And now for you enjoyment and Lucas eternal embarrassment, here are some pictures of my wet, shampooed, and blow-dryered doggie. (Lucas, please forgive me for sharing these with the world!)

This is sooo humiliating, are you actually taking a picture of this?!?!?!?

Oooooh, not the close up!!!!

For peat's sake, get it over with already!

I get older & live to see my 32nd birthday!

2006-09-21T18:26:00.000-07:00

Mom and I pose at Buca Di Bepo in Palo Alto where a few friends gathered to wish me a happy birthday. Hair: Rossie (mom); Wardrobe: Nordstrom (also Mom); Make-up: Bare Essentials medium tones (Paola); Sexy Lipstick: Channel Rouge Allure collection (you guessed it, mom!).

Jeremiah, Michelle and Matt (wearing hat) pose for the camera. Note that Michelle is man-wiched by the tall athletic triathletes ...hmmm!!!

From front right to back: Jordan, Christina, Evan, and Mongoose. I'll post more pictures when Evan sends the rest...I ran out of battery after this shot!

A Few Lessons in Clarity

2006-09-19T01:25:00.000-07:00

Unfortunately these, though chronologically recounted, span back to the hospital stay. I hope their potential for amusement will excuse my tardiness in reporting them.

> Will my stitches really explode?

One of the first things I remember amidst the morphine haze was the chief plastics resident--a very stern and cold former Israeli soldier--telling me that I had to be EXTREMELY careful with my stomach stitches as the skin was pulled quite taut and they could explode. Perhaps it was the fact that I failed to realize in our first encounter that he is a *RESIDENT* ("chief" non-withstanding) or perhaps the fact that I was high (though legally) at the time, but I took the man literally. He was particularly concerned about sudden movements or spasms including laughing, coughing, and most importantly vomiting.

Since I wasn't in a mood to laugh, nobody with any kind of cold-like germ was allowed within a mile of me, and I really rather dislike vomiting (plus I was on an all-IV diet), I really thought the explosion could be avoided all-together. Then night fell and the morphene's nausea monster reared its ugly head: I "projectiled" all night holding a pillow tight against my stomach waiting for the moment when everything (literally) would just come undone.

After a miserable night spent in fear, asking the nurse, mom and pretty much anyone around to please check the stitches, and a talk with my actual surgeon the following morning, my very real fears of a total abdominal explosion were set aside. "In the physical universe we inhabit there is no way that coughing, laughing, or even puking would un-do surgical stitches...where did you get that from?" my surgeon asked with a bewildered look on his face as though I had been recently lobotomized. Allie and I were happy to tell him his chief resident had been the culprit. The surgeon chucked it off to a misunderstanding, but I am happy to report his resident was gentle, clear, and not at all hyperbolic with me there-after :)

LESSON: Take everything residents say with a grain of salt; they mean well, but really, they don't have a clue how to talk to patients...yet. Hurray for teaching hospitals!

> How poisonous is Chocolate, really?

Apparently one of the key rules of cancer is no sugar, no coffee, no chocolate and clearly NO FUN! Though the surgery was fairly traumatizing given the complete reconstruction of my torso, I have to say the announcement that I was to turn into a monk was far more shocking.

"Ok, I get the no smoking, and the coffee bit, after all that stuff will give you cancer...oops (smile)! But chocolate? Seriously...CHOCOLATE?"
"Well, it also has caffeine"
"But how much, really"
"Enough to be a problem"
"What if I promise to eat only the really watered down kind? No Godiva for me, just Hersheys?"
Amused laughter
"The Soda, coffee, cigarettes and drastic reduction in sugar I can do...but you have to give me SOMETHING here"
"You have pain killers..." (mischievous smile)
"Point well taken. But still no chocolate. How long?"
"A while"
"Could you be more specific? In cosmic terms 100 yrs is a while, 1 year a mere thought"
"A short while"
"I don't mean to be a pain, but surely you understand I must retain at least one vice--I don't even have a boyfriend--throw me a bone here"
"How long can you go"
"How long do I need to go"
"I'd be happy with 6 months"
"Would you be content with 3?"
"I can live with that"
"Thankfully so can I"
"Deal"

LESSON: A "while" is not a medical term so you shouldn't let your doctors dupe you with it...the art of negotiation (even if for vices) is a key to post-surgical (and life) survival. Oh wait...I still can't drink, smoke, have coffee or sweets...damn!

> *ALWAYS* ask for clarification when doctors talk about pain "management"

I was reminded recently of a saying my high school AP history teacher used to say: "Never assume anything, as it makes an 'ass' out of of 'u' and 'me' (ass-u-me)". That is PRECISELY how I felt when I went to my oncologist last week.

As part of our conversation to get chemo set up, he asked me if I was off the pain medication.
"No", I said, "I am pretty consistently in pain, so am still popping pills daily."
"What?!?!?" -- He looked at me as though I had just run over his puppy several times with a ginormous SUV covered in "I Love Bush" stickers.
"Well" I continued trying to figure out what was so horrifying about the situation "It hasn't been a month since my surgery; I'd assumed that given the extent of the carnage, I'd be in a lot of pain. No?"
"Ok, so let me get this straight. You have been in pain, all the time, since the surgery"
"Correct"
"So what do the pain killers do?"
"They make it so that I don't want to cry 24-7, but merely whimper"
"Let me explain something to you. The whole point of pain 'management' is to NEVER be in pain so long as you are taking pain medication."
"Excuse me?"
"Yes. For your pain to be properly 'managed' your pain must be eliminated, rather than ameliorated by the medication. Your pain is not managed, it's merely tempered."
"Well, how nice."--I said remembering so many long nights wishing I still had the morphine-- "I wish someone would have told me this 4 weeks ago when I left the hospital!!!!"
"They didn't?"
"Not in those terms; they gave me the prescription and said this would help 'manage' the pain. And indeed my pain has been 'manageable', though never quite gone and sometimes quite excrutiating."
He hung his head low and peered at me over his glasses with a look of pity I keep getting from my doctors. "I am sorry to hear that. You should have never been in pain this whole time. Let's make sure this doesn't happen again; would you like stronger drugs since your current pain killers are not doing the job?"
"Absolutely!"

LESSON: Always ask your doctors what they mean by "manage", actually ask them what they mean by anything they say. Perhaps we should advocate for medical schools to teach vernacular in addition to medicaleese. Perhaps hospitals should also make translator services and/or dictionaries available?

Relese Notes > Paola 2.0 > Engage...

2006-09-14T02:13:00.000-07:00

Hello?
Anyone there?
Testing 1, 2, 3...

Announcer: After the lovely photographic interlude, we'd like to resume our blog already in progress... Introducing the New, Improved (and still stain resistant) Paola 2.0

Thank you, thank you very much! It's lovely to see all of you again, carefully scanning the words and trying hard not to laugh at a cancer blog. But really, it's ok to laugh; it's much better for you than crying.

Before I get started in earnest I'd like to thank the lovely Allie -- APPLAUSE PLEASE -- for keeping the narrative going with heartfelt honesty and wit. I hope she'll jump in from time to time and share some more of her wisdom with us.

And now, for the main event: The unveiling of Paola 2.0 (no worries people, this will be strictly PG)

Key version improvements:

> Cancer tumors --yes there were TWO--successfully removed (yay!)

> 18 hrs+ of surgery yielded two perfectly healthy new bobbies--the twin girls are thriving alongside their proud new mama.

> Tummy tuck complete...at last flat stomach (bonus!)

Some fun facts:

> When Paola got to the recovery room, after having been on a respirator tube for close to 20 hrs, she wouldn't SHUT UP! How atypical, don't you think?

> Paola lost 14 lbs in the surgery. Who would have thought?

> Paola offered some interesting (and tri-lingual) comedy relief to family, friends and medical personnel with excited (and sometimes angry) morphine-induced hallucinations. I wish someone would have taped the German one :)

> The scar across her belly looks like a perfect smiley face--how cheerful!

> Though close to 19 hrs in length, her surgery DID NOT break the Stanford Hospital record--bummer.

> Most of the nurses and the surgical team were convinced that Allie and Paola were gay partners. We received many compliments on how cute a couple we made and how dedicated and loving Allie was. Though we were both extremely flattered, we had to tell them Allie's husband Mark may not want to share her with me :)

But seriously, it's a miracle of science and a gift of love that I am alive. The entire surgical team worked to exhaustion to construct this new, cancer free body for me. Then, incredibly dedicated nurses, docs and PAs worked tirelessly alongside Mom and Allie to get me through the hospital stay.

Following that, my friends and colleagues have delivered food, gifts, flowers, hope and love to keep me going at home. Mom has been amazingly graceful and strong, and completely dedicated to my care. Even Lucas has pitched in by steering clear of me as instructed by mom.

I am humbled, honored and immensely thankful to have such an incredible network of people looking after me. I can truly say that without your care I may not be here today. So rest assured that version 2.0 will be stronger, and even more kick ass than Paola Classic.

But this is just the beginning--and what a triumphant one! The road ahead is still hard, so let's start walking...shall we?

Rosie feeds us

2006-09-10T05:34:00.000-07:00

My apologies to Rosie, Paola's beautiful mom, that I took such a bad photo of her. Here she is, making sure that Paola and I are fed.

new photo - Paola's wheels

2006-09-10T05:24:00.000-07:00

Hi all, I don't know if Paola's still using this or not but I'm just getting around to downloading some photos from when I was in CA. This snazzy contraption is her wheeled walker, which conveniently could serve as a seat when the need arose.

Paola's doing wonderfully

2006-08-28T18:45:00.000-07:00

Hello all,

This is my official last post. I'm headed to the airport shortly, but I wanted to update everyone that Paola's doing GREAT. She had a doctor's appointment this morning, we ran various errands, and then she, her mom, and I ate lunch out at a restaurant.

Paola reports that she is still in pain but has energy. She's definitely enjoying hearing from those of y'all who have been calling. I don't think she's been on the internet today (it's been a busy day), but she has LOVED seeing comments on her blog, so keep it up!

Paola has not been sleeping well on her lift chair so she's rented a hospital bed, which will be delivered tomorrow morning. She's really looking forward to that bed!

Thanks to everyone who has helped Paola (and, by extension, me) out in the last few weeks. Matt L., Michele T., Rob L., and Liz W. have been especially wonderful - thank you very much. Thanks also to the providers of food.

Despite the fact that the last few weeks have been rough, I've enjoyed spending time with Paola, and I've had fun meeting her friends. I also had a great time reacquainting myself with Paola's mom and brother and with Rob L. I even managed to learn approximately 2 words of Spanish! (Quite a feat, as anyone who knows my linguistic capabilities will attest...)

In closing, Paola, you are growing stronger and healthier every day. It has been inspiring to watch you tackling adversity. You've pushed yourself hard, and your rapid recovery is testimony to your willpower. Take it day by day and know that your strength will carry you, not only through this, but also through chemotherapy and anything else that life throws at you. It has been a honor to be with you during this period of your life.

Best wishes,
allie

Headed home

2006-08-27T12:18:00.000-07:00

Paola said she was too dirty and icky for a "leaving the hospital" shot, so this is all you get. Paola's mom is driving (white car) Paola home from Stanford hospital.

"I'm not afraid"

2006-08-27T12:12:00.000-07:00

Paola is being wheeled into the operating room, not to emerge for hours and hours. As she's being taken away, she's yelling back at Michele and me: "I'm not afraid! I can't believe I'm not afraid, but I'm not. I'm not afraid!" (I have to attribute this outburst of euphoria to the drugs but what do I know...)

Paola and the anesthesiology resident

2006-08-27T12:06:00.000-07:00

He of the painful IV insertion. He's pretty happy; Paola is too (of course, he'd just given her drugs). This is mere seconds before she got rolled into the operating room.

Lucas missed Paola when she was in the hospital

2006-08-27T11:54:00.000-07:00

Photo credit: Fishstik2 (aka Rob Lojek)

Weekend update

2006-08-27T11:33:00.000-07:00

Well, Paola is definitely on the road to recovery! This morning she and I took a long (well, for someone on a walker) walk. She's been able to take quasi-showers, and she's eating like a champ. She's been able to reduce her pain meds from every 4 hours to every 6, which means less waking up in the night to take medicine.

Yesterday she and her mom went to the ER because there was some drainage from one of the incisions, but the doctors told them that everything was fine. She's still regaining her strength, and she's still in pain, but she's doing great.

Paola is now answering her own cell phone so feel free to call her. Please don't drop by the house unannounced, but I'm sure Paola would love visitors. Just call her and see if there's a time that she'd be up for a visit.

I finally figured out how to post photos yesterday, so check them out. More to come! Also - as I'm sure many of y'all figured out - your comments weren't posting to the blog. Apparently the comments were in limbo waiting for the blog moderator (Paola) to "allow" them. Anyway, she got online the other day and did that, so the comments are finally showing up. I couldn't see them any sooner than y'all could, so I'm sorry that I didn't respond to the comments.

FYI, I'm returning to NYC Monday (tomorrow) night, so my days of blogging are about through. Once Paola's arms don't hurt her as much, she'll be able to resume blogging herself.

Pre-surgery photo

2006-08-26T23:49:00.000-07:00

Photo - night before surgery

2006-08-26T23:39:00.000-07:00

Paola and her friend Emily after Thai food...

Privacy at last

2006-08-25T20:55:00.000-07:00

After spending the last week plus with people around her every minute of the day, Paola got the gift of privacy today. She stayed home alone while her mom and I went to the medical supply store to survey the selection of chairs and beds. (Paola rented a reclining/lift chair, but she's finding it a little less comfortable than she'd hoped.)

Paola slept fairly well last night, and she's eating normally (though she can't have any caffeine). She took three walks outside today. She's still in pain but is doing much better.

Paola's home!

2006-08-24T13:31:00.000-07:00

Hello all,

Paola left the hospital precisely at 11:00 AM this morning. She's home now catching up on missed episodes of "Entourage." Between her new TV (a birthday gift), her snazzy rental rolling walker, and her reclining/elevating chair, she's pretty happy.

Paola's still in pain and still has limited motion (particularly in the arms), but she's doing much, much better. Nonetheless, she requests no visitors until next week. If you'd like to stop by and see her, please call ahead and schedule a time to visit.

I'm sorry that I wasn't able to return every phone call. Both my phone and Paola's were ringing pretty constantly for a few days! Please know that if I didn't call you back I did let Paola know that you called (or, if you left a message, I passed it on.)

[By the way, I'm not sure how much longer I'll be doing these updates - I assume Paola will be back on the computer sooner or later.]

Another good day and tomorrow: discharge!

2006-08-23T21:37:00.000-07:00

Hello all,

Well, today marked one full week in the hospital for Paola. She's much, much better than she has been. She's down to two drains (she'll come home with those) and is able to get in and out of bed, use the restroom, sit in a chair for hours, and, most excitingly, walk the hospital hallways. She's still in pain, but she's completely off IV meds. Yesterday she had her long anticipated grilled cheese sandwich (only half). Today she finished off the grilled cheese, had yogurt, had applesauce, and then had salmon for dinner.

There was so much going on today Paola didn't have time to get a bath or a shampoo, but I bet her mom will take care of that this evening. Paola's REALLY looking forward to being able to wash her hair, so I think that's high on the to-do list once she arrives home. (She's going to be discharged around 11 AM tomorrow.) Her nurse and I warned her that she's going to be exhausted by the trip home. As such, I'm not sure that the shampoo will happen right away, but maybe Friday will work.

That's the news. To those individuals competing in the Canadian Ironman, Paola wishes you well, and so do I.

A very good day

2006-08-22T21:59:00.000-07:00

There's not much to add from my earlier post. Paola walked from her room to the nurses' station and back three times today; she ate yogurt and drank juice; she remained clearheaded the majority of the day. She's off IV meds entirely. She had two more drains removed, but the doctors say she'll likely still have some drains in when she is discharged. We had an excellent nurse, Laura, today. We were delighted not to have the nurse from hell today; she wasn't on the unit today (maybe she got fired!) I gave Paola a bath and washed her hair. She felt well enough to deal with her own hair and gave herself a ponytail.

That's the latest...

Good news all around

2006-08-22T13:16:00.000-07:00

Hello all,

Paola is doing fantastic. Her doctors are thinking that she may be discharged Thursday. Sorry, but she's decided that she'd rather not have visitors until she gets home. Even when she gets home, she's going to be in pain for a while so I think she may not be up for visitors immediately. Please schedule your visit rather than just dropping by!

In other good news, she managed to walk from her room to the nurses' station and back. (I'd tell you how far this is but I'm horrible with distances. It was a good way though.)

She's supposed to be switched this afternoon to all oral meds so she'll be free once again of her IV pole.

Paola will have a busy schedule of doctors appointments in the weeks ahead. At this time, I am planning on returning to New York around Tuesday of next week. Paola's mother will remain here for a few weeks. I envision that Paola and her mom may be grateful if anyone can help by making grocery runs or Target runs or maybe helping get Paola to and from doctor's appointments. (Paola's mom can drive Paola's car, but Paola may need to be in a wheelchair at first, so an extra pair of hands might be useful. I don't know, I'm just speculating.)

That's it for now; I'll write again when I have news. By the way, for those of you who have been frustrated in your attempts to comment on these posts: it seems that Paola has to allow each comment individually and - as she hasn't been on a computer at all - she hasn't been able to do this. Please just comment in the forum section of the blog. She's very much looking forward to seeing all of your comments when she is able to get on her computer again! By the way, the offer still stands that if you drop cards or small items by her house her mom and I will bring them to her.

Also FYI, Paola's brother left today. Raff, if you're reading this when you get home, thanks so much for EVERYTHING. We'll miss you.

An eventful day

2006-08-21T22:35:00.000-07:00

Today Paola moved to a new unit. We are both regretting the move -- for all that we know it is a sign that she is getting better -- because now she’s just one of many patients and the nurses are less able to give her individualized attention.

I wrote “less able” in a conscious attempt to be charitable. The first nurse she had on the new unit was HORRIBLE. It wasn’t merely that she didn’t seem 100% competent; it was that she was rude. Nurse X (name changed to protect the unpleasant) was one of those health care workers who refuse to believe that a patient – or a patient’s companion – might actually know what medications the patient has received (or needs to receive), what angle of bed is most comfortable, etc. She shared her “philosophy” -- which was basically that only wimps need medicine -- with us. While I agree with her that one should strive to get off the meds, it seems that if you just had major surgery and are in pain, you ought avail yourself of available pain-relieving agents. But I digress…

Paola reports that she had a good night. When I arrived this morning, she was sound asleep and didn’t even realize I was in the room for hours. Paola’s nurse let her sleep as long as he could, but he had orders to move her to the new unit so eventually he woke her up and then we formed a merry band – Paola prone on a stretcher, a nurse and I bearing Paola’s collection of gifts through the hallways.

Paola’s new room – in unit C2 – has – yes – cell phone reception. Unbelievable! It’s a private room with a nice view; she’s happy with it. As I’ve previously mentioned, the first nurse we had to deal with was terrible. The second nurse seemed unfriendly at first - I think Nurse X had told her that we were “difficult.” Anyway, she warmed up to us over time and appeared to be a very good nurse. Too bad nurses work in shifts. I’m just praying that we can avoid Nurse X tomorrow. [Especially since she directly ignored or contradicted doctor’s offers re Paola’s care and whenever this was brought to her attention felt the need to remind all present that she’d been a nurse for 31 years. (I wonder if she’d been a GOOD nurse for any of those years????)]

Paola is off IV fluids and is responsible for keeping herself hydrated. She’s been cleared to eat whatever food she wants except anything with caffeine (coffee, chocolate, soda). She still doesn’t have much of an appetite so today she contented herself with jello, a little soup, juice, and some applesauce. Her big accomplishments of the day were: getting out of bed and sitting in a chair, walking from her bed to the door of her room and back several times, and walking to the restroom and using the real toilet. Her evening nurse (the competent one) was not impressed – her plan was to have Paola walking the hallway corridors tonight. Paola is very determined to do absolutely everything she’s told to do, so I assume she will actually walk the corridors tonight. That said, when I left her this evening, she was in a lot of pain.

Have I mentioned the issue of Paola’s mother’s bed? The first two nights that she was here, Paola’s mother stayed overnight at the hospital. Despite numerous requests, the nursing staff was unable to find her something on which to sleep. The third night, I warned Paola’s night nurse (a very competent individual) that he might have an additional patient if he couldn’t procure something on which Paola’s exhausted mother could sleep. Accordingly, he found a kind of reclining chair (think: giving blood), which we wheeled into Paola’s room.

Today, when moving units, I asked if we would be able to keep the reclining chair and was told that we would. However, later in the afternoon another nurse came and took it away, despite our protests. Pleas to the incompetent nurse to find a replacement chair (or cot) went unheeded. Pleas to every individual who seemed possibly able to help likewise went unheeded. However one marvelous nurse’s aide took pity on our plight and brought us a cot, which we greeted with much joy.

I think that’s the day’s news. Sorry this posting was so delayed. Unfortunately, the new room still has no internet, and the one time I made it to the cafeteria, I couldn’t get a signal.

Good night, and please pray that we can avoid Nurse X tomorrow!

A good day

2006-08-20T23:05:00.000-07:00

Today was a good day for Paola. As I mentioned earlier, she’s off oxygen and the dressing was removed from her abdominal incision. Her fever is gone. She’s still receiving pain meds, but only by request. She’s still receiving prophylactic antibiotics and anti-nausea medication, as well as IV hydration fluids. This evening she began eating again. One of the doctors told Paola that she could eat anything (meaning, anything the dietary department sends her). Paola misunderstood and thought that she could have ANYTHING. She asked her mom and brother to bring her a grilled cheese sandwich. Sorry Paola, for now it’s jello!

The biggest news is that Paola’s moving around. She sat in a chair 3.5 hours this morning, and she sat in the chair again another 2 hours while I was with her. She’s in bed now, but prior to that she walked around the room a little bit. She’s sitting up, getting out of bed, walking, and getting back into bed largely on her own power. She’s not at all wobbly – these motions hurt her, but she can do them. She’s also using the bedside toilet.

In addition to being in pain, Paola feels gross. It will be a while longer until she can take a real shower or bath. In the meantime, I gave her a sponge bath today, and I washed her hair. She also got to brush her teeth for the first time since before surgery, and she put her nose ring back in. So, all in all, it was a good day. If she has a good night tonight, she might be ready to start receiving visitors. I'll let you know. If you do plan to visit, please be aware that room for flowers, etc., is extremely limited. Thanks,
allie

So far, so good

2006-08-20T13:00:00.000-07:00

So far today things have been much better than yesterday. Paola is off oxygen, and the doctor took the dressing off her abdominal incision. She's still in pain but is coherent and able to talk. She is able to get out of bed to use a bedside toilet. Our goal today is to walk.

A day that ended better than it began

2006-08-19T22:18:00.000-07:00

So, as I previously mentioned, Paola spent last night throwing up repeatedly. This, along with the resulting lack of sleep, left her feeling not too hot today. She was very drowsy the majority of the day. Sometime in the early afternoon, she felt nauseous again. This was a false alarm, but it left her troubled and unhappy.

The day had good news too. For one, Paola's off morphine. She is still on pain medications but only by request.

Most of the good news came after 4pm. She got out of bed (largely under her own power, same as yesterday) and sat in a chair for two hours. This is really important for many, many reasons, and it was very encouraging. She got back into bed largely under her own power as well. The unit was understaffed (a recurring issue) so no nurse was available to give Paola a sponge bath in the afternoon [she'd declined when offered one in the morning], so her mom and I gave her a sponge bath and Paola's mom "washed" Paola's hair. (The hospital has these cool hairnets that have shampoo inside of them. If a patient can't wash his/her hair, one of these hairnets can be pulled over the hair and the shampoo can be rubbed in via a massaging motion. Then, the hairnet is removed, the hair is towel dried and combed. Result: clean hair.)

Perhaps the best news of the day was that Paola's night nurse, Jack, (who she and her mom think is FANTASTIC) managed to locate a reclining chair. We've been asking for a cot or a reclining chair for days as Paola's mom has been spending the nights at the hospital in utter misery. Paola's mom's discomfort has been upsetting Paola so getting this chair was a really good thing for both of them.

I think that's all the news. Let's cross our fingers for an uneventful night so that both Paola and her mom can get some rest.

Bye,
allie

A rough night

2006-08-19T12:20:00.000-07:00

Paola had a rough night last night due to vomiting. The doctors checked her stitches - nothing seems to have been harmed. She's sleeping now. The goal for the day is to get up into a chair again. If all goes well, the additional goal is maybe to start walking.

As you can probably guess, she still doesn't want visitors. Sorry for the bad news.

bye,
allie

A big day!

2006-08-18T22:13:00.000-07:00

All,

Paola is continuing to improve. As of this evening, she still thinks she isn't ready for visits or phone calls, but there is lots of good news to report. First, Paola added chicken broth to her diet of jello and so-called "Italian desert" (i.e., slurpee). Secondly, and more importantly, she stood up today and was able to transfer into a chair. Getting into the chair was quite painful, but she did a very good job, and she stayed in the chair for at least 1.5 hours, maybe 2 hours. Then, she got back into bed with only moderate assistance. The doctors said she absolutely had to get up and sit in the chair today, so she met the goal. I think tomorrow's goal is to start walking again.

Only slightly less exciting was Paola's other big accomplishment of the day -- sleeping. While I was with her, Paola managed to get an hour of relatively undisturbed sleep, which she really needs. It's hard to sleep in a hospital - people come in and out of your room, your equipment beeps, the equipment from other rooms beeps, and your loving friends and family keep telling you to do things ("Take deep breaths") or asking you questions ("Do you want some water?"). Paola hadn't gotten much in the way of non-artifically induced sleep, so it was really good to see her take a nap.

That's the news here. As you can see, it was a big day. Tomorrow promises to be another one so stay tuned.

all charged up

2006-08-18T13:32:00.000-07:00

Hello again,

I'm getting ready to head back to Paola's room post-lunch but am writing again because I forgot to inform everyone that the missing charger for Paola's cell phone turned up. As such, I have in my possession her cell phone, its charger, my cell phone, its charger, my laptop, and its charger. We're all charged up, so no worries about calling...

allie

nap time

2006-08-18T13:22:00.000-07:00

Hi, nothing new to report, I just thought I'd hop online because I'm in the cafeteria having lunch. It's nap time for Paola. Everything is fine here.

bye,
allie

argh part 2

2006-08-18T12:03:00.000-07:00

Ok, I finally got something to post! To expand on my previous update, Paola's been eating jello and drinking clear liquids since yesterday evening. She still has a fever, but the doctor I spoke with wasn't worried.

You are welcome to send non-edible items to her (Unit G2S, Stanford Hospital) or, if you like, you can drop small items off at the house and we can bring them to her when we come to the hospital.

That's the news, more later, assuming of course, that Stanford's shitty wireless internet lets me post...

allie

argh

2006-08-18T12:00:00.000-07:00

I have written this update twice now, and the damned internet keeps cutting off before it gets posted...

Paola is still recovering. She is coherent and conversational, but in pain and sore. She still asks for no visitors. You are welcome to call me on her cell phone or mine, but she's not up for talking yet.

Posting this now before anything happens to it...
allie

Still recovering

2006-08-18T11:54:00.001-07:00

Hello all,

This is Allie, here at the hospital. Paola is coherent and conversational, but still in pain and sore. Once again, she asks for no visitors. Feel free to call me on her cell phone or mine if you like, but she's not up for talking on the phone yet. Yesterday evening she was given permission to eat jello and to drink clear liquids, so she's been doing so. She still has a fever, but the doctor I spoke with is not worried.

You are welcome to send things to her (Unit G2S, Stanford Hospital). If you like, you can drop off cards or other small things at her house, and we can bring them to her when we come.

That's the news. More later.

Still recovering

2006-08-18T11:54:00.000-07:00

Brief posting

2006-08-17T22:47:00.000-07:00

All,

I'm too tired to really write so just briefly (I'll post again tomorrow):

* Paola's doing well. She's still drowsy from the anesthesia, and she's in pain. To control the pain, she's taking lots of morphine. She has a fever, which none of her doctors find alarming or surprising. She's on a broad-spectrum antibiotic just to make sure that nothing is infected.

* Paola has requested that nobody call her or visit tomorrow. When she feels ready for visitors, I'll pass along the word.

* She got to see her mom and brother today. Her mom is spending the night tonight.

* Paola's seen her surgeons, and they are pleased with her recovery.

* Paola has been allowed to start taking clear liquids. She was very excited about this, as she'd been mighty thirsty.

More later (i.e.. tomorrow). Goodnight!
allie

Doing fine

2006-08-17T15:37:00.000-07:00

All,

Sorry for the long delay in updating the blog. Paola is in pain but otherwise doing very well. Her mom is currently with her, and she is in a private room with nurses and machines monitoring her. She has requested people not try to contact her yet. As before, feel free to contact me (either on my phone or hers) but please beware that reception is not good.

Flowers are ok, though space in her room is limited. Her room number is GS201. She still can have nothing to eat or drink, so please no food-type stuff. We are hoping to start her on water this evening.

She's on high levels of morphine to make her more comfortable, and her throat is still sore but she's able to converse with her mom. She's still quite drowsy and will dose off during conversation. She's still working through the anesthesia -- after all, she had almost 19 hours of surgery.

The plastic surgeon stopped by to admire his handiwork and was pleased. From what her mom and I have seen, the new breasts look great! Michele (Paola's friend who has been AWESOME, deciphering medicalese, keeping us company, etc.) warns us all that once the swelling goes down, things will look different, but so far, so good.

That's the scoop. More once there is something new to pass on.

Allie

good news

2006-08-17T04:19:00.000-07:00

All,

Paola is out of surgery. I saw her after an hour or so in the recovery room (so, a little after 3 AM). She was very groggy but knew who I was and asked about her family. Her throat hurt a lot, so talking was difficult. Also, the nurses told me that the pain medications they were going to give her would make her sleep.

The doctors told me that she was stable and had been throughout the whole surgery. The plastic surgeon assured me that the long time on anesthesia was not worrisome.

When I left the hospital (i.e., was told to go home), they still did not know what room she would be in tomorrow, so I have no landline contact information for her at this time. Even if I did, I would discourage calling her (except maybe later in the day/evening) because her throat will be so sore. Her cell phone is almost dead, so tomorrow I need to find the charger for it - it's not where I thought we put it. My cell phone is recharging now, and I'll have it with me tomorrow. We will likely be in a part of the building with bad reception again though. (For y'all who live here or who are affiliated with Stanford, I urge you to tell Stanford that their cell phone issue is unacceptable.) I will update this blog as more information emerges HOWEVER I am signing off completely at this time in order to get a few hours of sleep.
good night,
allie

never ending day

2006-08-17T02:02:00.000-07:00

All,

I spoke with Paola's reconstructive surgeon around 12:45 AM. Everything is very good. She is still not out of surgery, but should be soonish.

Paola's mom and brother are in CA, but are at Paola's house, hopefully sleeping. Thank you Matt for getting them from the airport.

To those of you who are texting me, I'm so sorry but I don't know how to text. Furthermore -- except for when I run to the cafeteria to access the internet -- I've been moved to a new area of the hospital where my cell phone has absolutely no reception. Paola's phone has limited reception. Both are low on batteries.

In essence, Paola's doing well. She still needs to get out of surgery, spend an hour or so in the recovery room, and then move to the special unit. Nobody has been able to tell me yet when she'll be able to receive visitors. I have been unable to learn if there's a landline phone in the room. So please, have patience with me! I'll notify you as soon as I know things.

Thanks everyone for being so concerned.
allie

Sorry I'm not computer literate

2006-08-16T22:37:00.000-07:00

All, sorry I messed up on my latest posting. I can't fix it, so it will have to stay as is for a while. Sorry...
allie

A very long day, part five

2006-08-16T22:31:00.001-07:00

All,

The latest estimate is that Paola's surgery will not be over until midnight or later. I have been reassured that there is no problem and she is doing fine. I do not know what the delay is.

Allie

A very long day, part four

2006-08-16T22:31:00.000-07:00

a very long day, part three

2006-08-16T20:00:00.000-07:00

Dear all,

A surgical nurse just informed me that Paola's surgery should be over around 10 PM. I'll post at least once more tonight, once the surgery is completed.

Due to heavy call volume, my phone is almost dead. Unfortunately, I didn't think to bring a charger today. Thus, please call me on Paola's phone should you wish to contact me. Also, if you call, please take pity on me and tell me who you are. Please remember that I don't know a lot of you!

Thanks,
allie

A very long day, Part II

2006-08-16T14:39:00.000-07:00

Hello all,

I spoke with Dr. Dirbas about 30 minutes ago. He says that Paola is doing well. The removal portion of the operation is complete. The reconstruction is ongoing and will be for quite a while longer.

Updates on other things:

* Paola's mother and brother are arriving in San Francisco tonight. Matt Lindner will take care of getting them.

* Post-surgery, post-recovery room, Paola will be in a special unit, which is kind of like an intensive care unit. This apparently is standard operating procedure, because they want to keep an eye on people who just had such extensive surgery.

*Both Paola's phone and mine have extremely bad reception in certain areas of the hospital. Please do not be upset if you call and the call is not answered. If you leave a message, I'll try to call you back as soon as I notice there's a new message.

* In this special unit, there will likely be restrictions on number of visitors, visiting hours, etc. As soon as I find out, I will let you know.

* Pre-surgery, Paola was told that she was going to feel bad post-surgery. She may not want visitors right away. Furthermore, because she is on a breathing tube during the operation, she was told that her throat was going to be painful after surgery. This may lead her to not want to talk on the phone right away. I know everyone wants to get in touch with Paola, and as soon as I hear from her or from her doctors that she ready to have visitors or talk on the phone, I promise I'll let you know. Given the cell phone situation, I'll also try to find out if there's a landline she can get calls on (in the special unit, she may not have a room). I'll pass any information I have on as soon as I can, and, if you need more, you can try to reach me on my cell phone or on Paola's. In the meantime, I strongly discourage anyone from trying to visit or call her tonight or tomorrow morning, at very least.

Thanks to everyone who's called today, offering help in so many ways. I really appreciate it and your support for Paola.

A very long day

2006-08-16T09:24:00.000-07:00

** Disclaimer - Paola's in surgery now. I have no news to report; the following is just a recounting of the morning's events. I'll update the blog as soon as I have news. Allie **

The alarm clocks went off at 4:20 AM. We both turned off our alarm clocks; however, it quickly became apparent that Paola had gone back to sleep. I was reluctant to wake her -- after all, today didn't promise to be fun -- but we had to be at the hospital at 5:30 AM. Attempting to wake her gently, I stood in her doorway and called her name repeatedly, but my attempts were useless. In fact, as if to drown me out, Paola began snoring loudly. I had to shake her awake. As she stared at me sleepily, I reminded her that we needed to go to the hospital and she couldn't drink anything.

Yesterday, Paola's breast was injected with a radioactive dye that allowed the technician to take images of her nearby lymph nodes. Bearing these images, her medical proxy forms and lots of other random stuff, we headed out the door at 5:00 AM. I drove, and Paola navigated while simultaneously talking on the phone with her family, then Google folk in Dublin, and then some office that officially placed her on disability. We got to the hospital a few minutes before 5:30. Unable to find the parking lot where we'd been instructed to park, we raced around campus, parking in a different garage. We got to where we were supposed to be only a few minutes late. Paola checked in and then took another call while I passed the time with the only magazine in sight - Ladies' Home Journal. The cover story sang the praises of plaid wool.

After a short wait, a nurse called Paola's name, and she took Paola away. A few minutes later, she got me and took me to Paola. Paola was reclining on a hospital gurney dressed in the normal (inadequate) hospital gown, but she had on little socks to keep her feet warm, and the nurses tucked blankets around her. A whir of medical personnel came and went, asking questions, the most common of which was if she had any allergies.

An anesthesiology resident introduced himself to us and set about asking even more questions, including, yes, if Paola had any allergies. A nurse stopped by, asked which breast was being operated upon, and upon hearing "both" wrote in marker on each of Paola's breasts the word "Yes." Around this point, Paola's friend Michele, who works at Stanford, showed up. The anesthesiology resident started an IV in Paola's left arm. She didn't enjoy this experience at all, especially given the size of the needle.

Paola's cubicle quickly filled to capacity with me, Michele, the anesthesiology resident, a plastic surgery resident, a general medicine resident, and two other individuals, who I think were chief residents. These last two were women, which pleased Paola, who was very happy that there would be females with her in the operating room.

In the midst of this, Paola's plastic surgeon showed up. Some of the people stepped out the cubicle, and Paola disrobed. The surgeon took some photos of her breasts. (Michele said this was for the before and after pictures.) Then, it was the surgeon's turn to write on Paola. The material that will make up Paola's reconstructed breasts is coming from her abdomen, so he spent a while there. First, he made a dot on either end of her pelvis, near the hipbones. Then, he drew a curving lines from one dot to the other, under her tummy. As a result, Paola had a smile across her body. Then, he drew a straighter line connecting the dots, turning the smile into an open mouth. At this point, his artistic renderings became far more abstract - vertical lines, horizontal lines, etc. Paola knew what I was thinking and teased me about not being able to take a photo and post it to this blog. (She said that I could "paint the picture with words," and that's what I'm attempting to do.)

Once the surgeon was through (and had photographed his handiwork), I put Paola's gown back on her, we hugged, and she got on the gurney. I took a photo, which I'll post, once I figure out how to do so. The anesthesiology resident gave Paola some drug - my guess was an anti-anxiety something or another. Paola stated that she wasn't scared and expressed surprise at how calm she felt. And that was it! Paola and her entourage headed down the hall toward the operating room.

After Paola's departure, Michele kindly guided me to the cafeteria and gave me a quick tour of the hospital before returning me to the waiting room. Around 8:30 I approached the desk and asked the nurse when she thought I might hear from Paola's cancer surgeon. (The surgery is being performed in two parts - the removal, then, following a break, the reconstruction.) As of that time, the surgery had not yet begun. She estimated that the surgeon might be ready to speak with me around 12:30 PM. It's only 10:20 AM now but my laptop battery is low so I'll end this post and go back to the waiting room. I'll write again once I have something to report.

The night before surgery

2006-08-16T00:13:00.000-07:00

Hello all, this is Allie making her debut on this blog. As I type, Paola is showering, hopefully savoring the experience, as we fear she may be limited to sponge baths for the next few days. Following the hospital's instructions, Paola has removed her jewelry and her nail polish.

Tomorrow we have to be at the hospital at 5:30 AM. At this moment it's a little past midnight, so you can see that we aren't getting much sleep tonight. Paola and I had a wonderful dinner (Thai) with one of her friends, Emily. It's been a busy day, full of errands and medical appointments and attempting to prepare for the next few days. Paola was pleased to find post-it notes with the pink ribbon (breast cancer awareness) logo on them at Office Depot. She stocked up!

Paola's phone has been ringing off the hook all day with well-wishers. (Or, I should say, people have been calling, but due to cell phone ghosties, the phone hasn't been ringing, so Paola kept finding new voicemails...) Her friend Grant dropped off a lovely and thoughtful gift. She's looking forward to hearing from everyone (and seeing those who are in the area) while in the hospital, although it's likely she won't be up for visitors tomorrow.

Paola's out of the shower, and she reports that she did enjoy it. Off to take a shower and head to bed as morning will arrive far too soon...

Following is Paola's email to friends and family on the eve of the operation:

Dearest all,

I apologize in advance as many of you already know much of this information. Still, I wanted to take one final pass at my ENTIRE contact list to assure that everyone's up to date. I should mention that this email is going to folks living all across the US and CANADA (go Camel!), the Middle East, Europe and South America. Between all of you, there are over 10 languages spoken and about that number of nationalities represented. Finally, you all rival the UN in your ethnic, racial, and religious diversity. How cool is that?

As I prepare for surgery in a few hours, I wanted to share with you all that I am single-mindedly dedicated to beating the *#&$*%*^ out of this cancer so I may resume my life as an all around kick-ass girl, triathlete and Googler. I have heard your fighting words, felt your supportive embraces, and continue to bask in your collective love; and though I know the road ahead is tough, I am tougher! Cancer ain't seen nothing yet!

If you have been keeping up with paolablog.blogspot.com, then you know that the surgery is scheduled for Wednesday 16 August, 7:30 am - 5:30 pm PST @ Stanford Hospital, in Palo Alto, California. Allie will do her best to blog something tomorrow telling you all how things went. Googlers and TNTers--you have your points of contacts to find out more details. If you are outside of these networks, the blog will be your best bet, but please know that *I* won't be able to type for at least on week--potentially much longer--and Allie will have limited access as she'll be by my side at the hospital. You may also call the following numbers directly (corrected from previous email) where they'll be able to tell you whether I am out of surgery or not. Unfortunately, that's the extent of what they can reveal due to U.S. patient privacy laws.

Stanford Hospital Ambulatory Surgery Center
Before 7pm: 650-498-4835
After 7 pm: 650-723-5163

I leave you tonight with the knowledge that I am most definitely loved, and the promise that I will put up the fight of my life starting tomorrow in that OR. I know that you will all be there with me along the way in my long recovery. So let's keep marching, together, and learn about ourselves and each other through this journey. Thanks for everything so far and see you on the other side of the anesthesia.

Lots of love,
Paola

To Boob or Not Two Boobs

2006-08-13T05:15:00.000-07:00

I have been thinking a lot about breasts lately. Ok, I know this doesn't distinguish me from guys, but I bet they never actually stop to ponder what these appendages actually represent. The truth is breasts have taken on much more than their mammary function, they represent femininity, sensuality, womanhood, and even sexuality. Breast are short hand for woman and everything that we are supposed to be--mother, lover, wet-dream, nourishment, tenderness, sustenance, life-giver, nurse. No wonder the "girls" fell ill under the pressure of their own iconography.

I must confess I had never had mixed feelings about my breasts until one fell ill with cancer. I had always been perfectly happy with them, though they have never actually defined me in any way--except perhaps as a Victory Secret junky. But when faced with a life or death decision, could I live without one? Either? Neither? One thing was clear: given the size of the tumor the left breast has to be removed in its entirety. What of the right one then? What's really at stake...just breasts or something deeper? How much of myself is wrapped in "the girls"?

Like the consummate pragmatists I went to the data first. For most things, with the exception of wisdom, youth is generally on your side. When it comes to cancer, however, youth is your undoing--it gives the cancer strength to reproduce and ample time to invade. The medical literature places a "normal" woman's chance of recurrence post-treatment at 0.5-1% change per year of life (as calculated according to approximate life expectancy). Ok, so what does all this mumbo-jumbo mean? Essentially that I have a 30-40% chance of cancer in the right breast (over the course of my life) should I decide to keep it. This, of course, is doubled if you are a BRCA 1 or BRCA 2 carrier. So depending on the genetics I have anywhere between 30% (best case) to 80% chance of a second cancer. I decided I'd wait for the genetic test results to make the final decision.

However, data only paints some of the picture. What about the possibility of breast feeding a future child? How comfortable am I with losing key erogenous zones? What are the physiological effects on my body and recovery? Never mind physical scars, how about emotional ones? What about my body image as a young single woman? Most importantly, what would allow me to sleep at night and prolong my peace of mind...in the loooong run? It seemed that most everyone around me was mostly focused on the very short term. But since I am not planning on dying young, I wanted to look well into the future and weight my options to make this impossible decision. As I worked through these scenarios and talked to survivors and doctors I started formulating my bottom line.

My friend Lisa helped solidify my initial thought that though being able to breast feed would be great, I'd first have to be ALIVE in order to give birth...so really, nursing was a minor detail at that point. Lisa also shared the less glamorous aspects of her experience. Given that, and the fact that generations of children have been successfully raised on formula, I eliminated this as a concern.

Now, what about intimacy? Many of the survivors I have been lucky to meet were graceful enough to open up about their post-mastectomy sex lives. In the immortal words of Joni Mitchell "you don't know what you got 'till it's gone;" thankfully these couples, who are living on borrowed time, have mostly strengthened their physical and emotional bond--reconstructed, implant or no breast...the fact that she's there at all is a gift in itself. The mere thread of losing a partner, then, is enough to appreciate her as a whole woman, rather than a sum of her parts. This set my mind at ease and gave me much insight into the kind of partner I hope to have once this ordeal is over. I know in my heart that this too will be my experience.

And so we come to the question of body image...every young woman's perennial torturer. It's hard enough negotiating a pudgy figure with the ultra-slender, curve-less, flat-stomached, toned, overly siliconed and botoxed ideal. Now I have to also figure out how to be a single girl with reconstructed breast? Isn't cancer torture enough? In truth, for its good parts and bad parts I have never really fully appreciated my body. I got my first wake up call when I blew out my knee and couldn't exercise for nearly a year. After a painful recovery I vowed never to spend another sunny Sunday laying on the coach. So I joined a triathlon team and learned to swim, bike, and run.

Now I realize how silly I have been--and how silly I am being to even add "body image" to my one boob/two boobs decision matrix. Any time that this body--whatever its shape--allows me to remain on the planet will be a gift, and one I will take full advantage of. I know mom is scared that no boy will want me after a radical double mastectomy/reconstruction. But if that is all they care about, then really, I am better off without them. So I am currently a recovering self-hater, and each day, though I am scared of the surgery's outcome, I tell my inner teenager, that whatever the result, I will be ALIVE--and THAT is my bottom line.

Once I came to this conclusion the genetic tests weren't back yet. There's a huge difference between 30% and 80%. Then I thought, 10 years ago women didn't have the luxury to find out their BRCA status; what if I take stock of my options and ignore genetics for a bit? How comfortable am I, truly, with a 30%-40% chance of cancer later on? What if 10 years from now they realize that while I wasn't a BRCA carrier there is some other mutant gene that only affects Miami-raised-half-Colombian-half-Cuban-brown-eyed girls? What then? Ok, so that's silly, but so is banking entirely on a single test. Truthfully, I realized that any chance of this happening again was far too high (and far too high a price to pay) to keep a breast. And so, I signed over the girls to the scalpel and medical research, and have decided to have both breasts removed and reconstructed. New boobs and a new lease on life...now it's up to me to learn to love my new body.

PS: The genetic tests came back yesterday and I am NEGATIVE. Still, I am peaceful with my decision.

PPS: I decide to have a good-bye party for my boobs. Here are some pictures!

I cook Cuban food for everyone--but they have to help if they want to eat!

Everyone gathers before eating to hear me officially say good-bye to the ladies. Many boys offer to give the twins a proper good-bye, others demand that the girls make a personal appearance. With all decorum and solemnity I tell them to go to hell.

And finally, we eat a boob-shaped cake to drown our sorrow in luscious sugary goodness.

Scheduling a Surgery: Almost as Fun as the Spanish Inquisition!

2006-08-12T16:05:00.000-07:00

So, remember how helpful the Stanford Cancer Center folks were when I tried to book a second opinion consult with Dr. Dirbas? Well, that same commitment to complete incompetence delayed my surgery by a couple of weeks and nearly derailed the whole process. It went something like this:

> Thursday 27 Jul: I meet with Dr. Gurtner, agree that we are going to perform a DIEP flap, possibly bilateral--but will wait for genetic testing to come back to make final decision. I immediately follow up with Gurtner's surgery scheduler who'll get in touch with Dirba's scheduler to see if we can have the surgery the week of August 7. Oh, they have to find an OR for 10 hrs too.

> Friday 28 Jul - Wednesday 2 Aug: I call and leave many messages for Dr. Dirbas and Dr. Gurtner's scheduling staff. I finally get a call back from Dr. Dirbas' office; apparently the same woman with whom I had my little "second opinion" conversation is on the case. Really? Exasperation + Sigh... After multiple phone calls I manage to convince her that I am NOT having a TRAM FLAP and that most likely both breasts will be reconstructed. She finally confirms that the surgeons have been scheduled for Friday the 18th and it's just a matter of getting the OR. I may not know for sure until the day before the surgery. GREAT!

> Thursday 3 Aug - Monday 7 Aug: Still non-committal answers about the actual final schedule, but I am assured that surgeons are confirmed and an OR will be found. Mom, Allie and Raff take the plunge and buy airplane tickets. Still no final date though.

> Wednesday 9 Aug: Hmmm...funny how I don't have pre-op appointments with either surgeon and I'm supposed to be in the OR next week. Don't they have to run tests? Don't I have to sign consents? I get on the phone. Dirbas' scheduler, who still isn't sure what the procedure will be despite me having told her repeatedly: *B I L A T E R A L* *D I E P* *F L A P*, finally confesses that there might be a problem. WHAT?!?!? Tickets have been bought, plans have been made...are you serious?

I call Gurtner scheduler. Turns out Gurtner was NEVER actually scheduled for the surgery and he is going on vacation on Friday the 18th. Gurtner scheduler actually HANDLES the situation, figures out what's happening, and gets me in for pre-op appointments (which Dirbas' staff refused to do without a "solid" date). I guess they were waiting for the Cancer Fairy to materialize herself, schedule the plastic surgeon and find an OR.

> Thursday 10 Aug: Gurtner walks into the pre-op appointment and apologizes for the situation. He had been looking for me on the schedule and was so surprised my surgery date wasn't set, he figured I'd gone with another surgeon. Meanwhile --I tell him--I thought he already had me booked. "What?" Exactly. He is very gracious and confesses he is new to Stanford and now that he understand the system's limitation he's going to work on it. "That is fabulous," I say, and I mean it honestly; "but what do we do about MY surgery?" "Well," he replies, "we move all small, non-urgent cases from Wednesday to Friday, and we operate you on Wednesday the 16th. I already took care of it." WOW! The SURGEON fixed the schedule!!!! That's unheard of, and really awesome. Had it not been for his intervention, I'd have to find another surgeon or wait an extra 3 weeks. Meanwhile, the tumor is nearly 6 cm now and encroaching on the axila (that's the armpit for non-medical personnel). Dr. Gurtner is my hero :)

To be fair, Dr. Dirbas was also apologetic and very irritated with the situation. I tried to politely tell him how incredibly useless his staff is, but really, I had to be diplomatic. He did follow up with some specific questions, and I was as frank as I possibly could without telling him outright that the stethoscope he was holding is probably smarter and far more capable than his current scheduler. I also couldn't tell him that she doesn't actually understand spoken language, that she doesn't listen to patients and that she lied to me. But I *DID* share the second opinion conversation--in broad strokes--and warned that had it not been for my absolute resolve to have him as my surgeon, I wouldn't have been seen in his clinic, at all, EVER. I finally did mention that this reflected poorly on him professionally, and though I didn't hold him personally responsible, it was a major problem. He never got defensive, but looked a bit troubled.

The most important thing, however, is that the surgery is finally set: Wednesday 16 August, 7:30 am PST, Stanford Hospital. My mom is still working on changing her ticket to arrive before the surgery, Allie gets here on the 14th and Raff most likely on the 16th. Sigh... and on we march.

Allie-b, and other stories of heroic friendship

2006-08-02T00:41:00.000-07:00

There are things you can't wait for others to know: your child took her first steps or said his first word, you've just gotten the transfer to the Fiji office, you've experienced excellent customer service at the DMV, or even more amazingly, you've just been told "I love you" and this time it's real. Sadly, finding the right time to tell your friends that you have breast cancer ranks somewhere between a triple root canal without anesthesia and pulling out your own toe nails with hot pliers. If I could schedule this, it'd go under NEVER.

But part of being strong is surrendering yourself to others when you need support. And though I had been stoic about the diagnosis and clinical in my approach, I started feeling the weight of my disease. So I compiled a contact list and went to it.

The first time I blurted out the words "I have breast cancer" I was standing in the middle of a parking lot listening to the steady flow of cars on the highway behind us, and a noisy group of teenagers three cars down. Next was a restaurant, then my car, a conference room, the gardens outside my office building, a street in the middle of the Inner Sunset, a softball field, various doctors' offices, an elementary school parking lot near my house, a cafe, the Target parking lot, my kitchen and my couch (and others I am sure I'm forgetting).

This had essentially become my personal cancer announcement tour of the Bay Area. Scenic vistas--did I mention the bank's parking lot?--private conversations shared in public spaces, shock, sighs, tears and some laughter...but mostly sorrow and disbelief followed by fighting words and love, sheer love. I gave into it, and took it all in--call by call, email after email, one conversation followed by hugs after the next. I must confess I didn't realize just how loved I am. And I wondered why that is. Why don't we tell these things to each other more often? Why does it take a deadly diagnosis to verbalize our feelings? There is no perfect time, just life and it's so easy to underestimate its speed.

It's hard to single out any one of these conversations, as they have all been joyous and painful in their own way; but I'd like to share Allie's response as an example of the caliber of friends who've become my extended family--and on whose shoulders I'll be carried to remission.

The first time I met Allie she was hurriedly carrying boxes up three flights of stairs to her room in Long Portal, Brown College UVA. It was September and naturally it was 100 million degrees with 110% humidity in Charlottesville just for move-in day. She was a spirited 3rd year (that means junior for all you non-wahoos), in charge of pretty much everything as far as I could tell.

We became fast friends after we discovered a mutual love for Annie DiFranco--which she played non-stop for approximately a WHOLE year--wine, and wacky outings like the time we dressed up as ninjas, crashed a party to sing happy birthday to some girl, and then almost got arrested at the 7-11 when we came through the door totting fake guns and face paint. Allie's also been witness to the total annihilation of a manual transmission--the thing literally fell out of the car--and Ganesha drinking milk. (Look, I couldn't make this stuff up even if I tried.)

To complete the picture I should mention that Allie has two master degrees, is currently pursuing a doctorate, spent two years in Africa for the Peace Corp, has an amazing sense of humor, loves cheese quesadillas, and basically lives on Coca-Cola Classic, bagels and pizza. She also started going out with her now husband at a party I threw :)

But enough background. I had tried to contact Allie for a week and after a couple of messages she wrote an email from Montana telling me she was on vacation. She could tell something was up, but I didn't want to ruin her cross-country traverse so I filled her in on my Dublin trip and convinced her there was no emergency, though I did ask her to call me when she got back to NYC. We played phone tag for a bit, and after a couple more messages Allie knew something was definitely up--after all, I NEVER call her at 9 am on a Saturday (my time).

I was hopelessly lost in the Inner Sunset when I looked down at the phone and saw Allie's name flash on the screen. Crap! I have to take this. I pulled over in the next street, parked the car in a red zone, and actually engaged in conversation after feeling for my phone under the seat where it fell after a sharp turn. Allie was thankfully still on the line. After I caught my breath, I laid the news on her...no preamble, I think I didn't even ask about her trip.

In true Allie fashion, she immediately went into emergency mode, asked key questions to assess the situation, offered me her (and her husband's) life savings, and wanted to get on the next plane to SFO. God I love that woman! Most importantly, she agreed to be my medical proxy and execute my medical wishes should something go wrong. I wasn't shocked. This was Allie, in her truest form...the same kick-ass girl I'd met in my dorm over 10 years earlier. I know she immediately got on the computer and pulled every last article, study, pamphlet, and footnote about California laws, my type of cancer and its treatment protocol.

And so the announcements went, each response amazing in its own way--especially from my inner circle. From flowers to cards, hugs, offers to shave their head and sperm donations for the necessary pre-chemotherapy embryo harvesting. What else could a girl ask for?

Note to self: never get cancer in July

2006-07-30T09:54:00.000-07:00

Once I settled the boob-removal, it was time to enter the reconstruction phase. I talked to Dr. Whang and she highly recommended Dr. White, and mentioned he is an artist--both in the OR and out, as he sculpts in his free time. This sounded incredibly promising, so I called the receptionist and got an appointment without having to play 20 questions. Fabulous!

Since they worked me into his schedule so quickly I barely had time to do my homework on reconstructive surgical options. I did read enough to learn that I much rather have a tram or DIEP flap in lieu of implants. I know, I know...this is all too complicated and kinda gross. Imagine how I feel. But here's the bottom line: If I had to go through all this surgery and long recovery I didn't want to have to be in the OR once and again over the course of my life. 40% of all women who get implants have them removed or re-adjusted within 5 years. Most require adjustments every 7 to 10 years depending on physical activity. This was the statistic that sold me on the tram--that and the fact that I'd get a tummy tuck AND new boobs, for free...can't beat that deal!

It was probably the HOTTEST day of the year when I made my way to Dr. White's office, notes and questions in hand. I generally make it a policy to meet and talk to doctors while clothed, and thankfully Dr. White and his staff obliged. Since I wasn't getting into a gown I had a bit more time to read the numerous plaques in the office: Two best of the Bay Area Doctors covers ('04-'05), and one Best Breast Reconstruction Surgeon (in the country!) 2001. Looking pretty good!

When Dr. White finally walked in he apologized for his sweaty shirt, and we talked about the abnormally hot weather for a bit. He was kind, had a great smile and a steady hand--all good things in a surgeon. I also liked this "bed side manner" as he took the time to talk to me about my options, including implants, just to make sure I understood there are some advantages despite my reservations.

I didn't even have to ask for pictures or past patients' names when he pre-emptively volunteered some names (and contact info!) so I could judge the results for myself. He also mentioned I should never have any problems getting in to see him as he'd be glad to squeeze me any time. Finally, he had OR privileges at Stanford and had worked with Dr. Dirbas before. All the pieces were fitting together.

Though I had a great feeling about Dr. White, I still wanted to talk to his patients, see the cosmetic results, and ask some key questions to finalize my decision. This is how I met Aletha. She not only returned my call immediately, but 24 hrs later I was sitting in her living room asking her all kinds of questions about her experience, Dr. White and the type of tram she'd had. She was so incredibly open and giving, and was even willing to show me the results or her reconstruction. She raved about Dr. White and gave me names of even more patients I could talk to. But I was sold, no need to shop around for more names. Dr. White it was!

Except, surgeons have to go on vacation some time. Sadly summer is generally that time. After talking to the schedulers for Dirbas, Whang and White we came to the conclusion that not even divine intervention could make the schedules work to allow a surgery (and appropriate time for post-operative care) before Dr. White's sabbatical. Back to square one. Poopy!

And so I started the search again, only this time my first question was: "Will you be on vacation any time during the month of July or August?" It seems like a VERY popular time to relax, especially if you are a highly qualified reconstructive plastic surgeon. Which really stinks when you have cancer in July. But fortunately, after many, many, phone calls and much background research (thank you Allie!) I settled on Dr. Gurtner. Thankfully not only was he NOT going on vacation, he could perform a DIEP flap which would conserve my stomach muscles intact, thus speeding up recovery and allowing me to continue my amateur triathlon career. YAY for microscopic surgery!

Now all we need is an open OR for a 10 hr. surgery that coincides with the times both surgeons, the anesthesiologist and the staff are neither in clinic, nor asleep. Easier said than done, even with 21 (yes...Twenty-ONE!) ORs to choose from. And you thought finding the surgeons was the tough part! I am still waiting on a final surgery date...sigh.

I get a second opinion

2006-07-30T01:27:00.000-07:00

Life is full of unexpected situations. Getting cancer at 31 is certainly one of them. But the most unexpected part of this journey has been the sheer amount of homework you need to do as a cancer patient. Since my diagnosis I have spent countless hours reading about my disease in an effort to more intelligently guide my treatment. Of course, the docs have the medical expertise, but not all docs are created equal...or so I am told. It's always best to vet your sources and get confirmation, so after speaking with Dr. Whang and at Dr. Schneider's urging, I looked to the Stanford Cancer Center to get a second opinion. This, incidently, could easily qualify as Chinese torture.

I zeroed in on one guy--Frederick Dirbas--rumored to be the cream of the crop as far as removing breasts go. Unfortunately, Dr. Dirbas' staff didn't take after their leader. Here's how the first call to his office went:

"Hi, I'm a breast cancer patient at the Palo Alto Medical Foundation (PAMF) and would like to set up an appointment with Dr. Dirbas for a second opinion."
"Dr. Dirbas works at the Stanford Cancer Center."
"Correct. Would it be possible for me to get an appointment?"
"If you are being seen at PAMF, why do you want to see Dr. Dirbas?"
"For a second opinion"
"But you are being seen at PAMF, that's where your doctors are"
"Yes. But I'd like Dr. Dirbas to review my case"
"Are you a patient at Stanford?"
"No. I just want a second opinion"
"I am still unclear as to why you need to see Dr. Dirbas"
OF course.

After several calls that sounded pretty much like this, and Dr. Schneider's intervention I was finally able to get an appointment 3 weeks later.

"THREE WEEKS?" I was flabbergasted.
"Yes, that's all I have available"
"Is there any way to move this up?"
"Everyone we see has cancer"

Well, that certainly put things into perspective. Not that I was trying to play the cancer card, but my special status was the norm here. Too many cases, too few specialists, and certainly too little time.

Fortunately, the universe has a way of making things work. After the first MRI they noticed there was a sizable tissue extension attached to the tumor. Dr. Whang wanted to test the tissue to learn whether the cancer had spread and to what extend. It turns out the only doctor in ALL OF STANFORD medical center who could perform this biopsy was out on vacation for another week. A week to receive the results would put me right against my visit with Dr. Dirbas. Without this last piece, Dr. Dirbas couldn't really review the case fully. The delay wasn't unnecessary after all.

After the second biopsy (which came back negative for cancer, by the way) and an entire afternoon spent PERSONALLY tracking down and delivering lab results, tissue samples, x-rays films and pathology reports to Stanford, I finally met with Dr. Dirbas. We talked at length about my particular kind of tumor, its location and the possible surgical outcomes given his plan for extraction. He also mentioned that given the size and location, he expects that the cancer has spread to the lymph nodes--crap! He has also apparently been to every single conference there is on the topic, so he talked liberally about the absolute latest findings on the standard of care. After this conversation and a quick check for a ring on his left hand (there was none) I realized this guy LIVES to work--perfect! I then asked if he'd like to remove my breast. He agreed...we had a moment.

The sisterhood of the cancerous boobs

2006-07-30T01:16:00.000-07:00

As many of you know, I have never been a "girly" girl. In fact this has always been a point of contention with my mother, who to this day, doesn't understand what the appeal of triathlons are. Our first conversation on the topic went something like this:
"Guess what mom, I've joined a triathlon team. I'm sooo excited!"
"Where? Are there single men?"
"Hmmm, didn't really ask. We are going to train all summer."
"Train? For what? What are you doing again?"
"TRI-A-THLON mom. Swim, bike, run to raise money for cancer research.
"Hmmm, wouldn't it be just simpler to write a check? You are going to grow muscles all over your legs again..."
Sigh...

It turns out my grandmother was a serious tom-boy too. I had heard stories of this pretty governor's daughter in early 20th century Colombia disguising as a boy so she could leave the house and play with the street kids. She routinely smashed her imported porcelain dolls and preferred climbing trees to mandatory charming school lessons. Apparently I had inherited her aversion to bows and all things pink and frilly. My biggest nightmare as a child was having mom buy me dresses that made me look like a meringue...a very fluffy, ribonny, pink meringue! So I'd accidentally-on-purpose stain, rip, or in any way damage these ribbony torture chambers to avoid having to wear them. I was successful only some of the time unfortunately. (Sorry mom! Please don't get mad now.)

My aversion to girliness was most explicitly manifested in my deep fascination with sports, particularly track. My mom, who still believes that it's not lady-like to sweat was horrified--and to her credit, incredibly supportive. She had already tried ballet, music lessons, and all sorts of other girl-appropriate activities to no avail. Unfortunately for her, standing in front of the mirror looking like a pink shower-gel puff repeating position 1, 2, 3, endlessly could never match the thrill I got out of running with the boys. Running was exciting and kick-ass; ballet was delicate, slow and soooooooo boring! My competitive nature just couldn't take it. I finally joined my school's track team and become a junior national champion. Mom understood and tolerated my passion, but never really *liked* it.

So what does this have to do with having breast cancer? Patience, people...patience. Given my dislike of all things girly including activities that most girls engage in, I grew up around boys: my brother, half-brothers, and tons of boy-cousins at home; lots of boys on the track team at school; and then a ratio of 10 boys : 1 girl at my high school. Though I had "girl-friends" as a little girl, it wasn't until college that I learned that other kick-ass non-frilly girls are out there. Needless to say I befriended many of them and they remain in my life to this day.

But despite this realization, I hadn't really understood the power of "sisterhood" until I was diagnosed a few weeks back. Counselors, survivors, doctors, nurses, friends of friends, and all others in-between have opened up their arms and souls to help me understand my breast cancer. Women I have nothing in common with, and whom I hardly know have opened their homes and given me invaluable advice. Some have even shown me their mastectomy scars or reconstructed boobs. It's been overwhelming and quite surprising to know that someone will instantly offer their hand once they hear the words: "I have breast cancer." It makes me think we should all be more like this, all the time. I, for the first time, feel like a "sister" and it's amazing.

Telling my mom is harder than having cancer

2006-07-26T18:12:00.001-07:00

For those of you who've had the privilege to experience my mom "live" this portion of the saga will not at all surprise you. Many of you only know her through my stories--and I must confess that though they are all absolutely real, I do, on occasion avail myself of hyperbole for effect. Having said that, I'd like to emphasize that what follows is as true an account as I can muster, that it is in no way exaggerated, and that no small animals (though many Kleenex) were harmed.

So you think that hearing the news that you have cancer is hard, right? But when you have the peculiar mix of over-protective-non-cooking-yet-exceedingly-maternal-Jewish-Italian mother I do, telling *her* becomes the actual challenge. The moment the words "cancer" came out of Dr. Schneider's mouth, my first thought was: "How do I tell mom without given her a heart attack?" Oh surely Paola is exaggerating. Normally I'd mean that metaphorically; in this case, I meant it quite literally. Let's examine the precedent.

My mom's version of handling an emergency--particularly anything involving her children and bleeding--ranges from screaming, crying, fainting to completely freaking out. I first learned this at the age of 12 when upon slashing my knee open in the shower I called for mom to come to my rescue. When she entered the bathroom and saw the blood geyser emanating from my leg and running down the drain she stopped breathing, brought her hands to her face, and sat on the toilet weeping.

At that point I realized not only that I was on my own with the bleeding and the piece of ceramic stuck in the wound, but that I also had to get my mother's breathing under control. So, I fished in the fleshy opening for the ceramic wedge while instructing mom to put her head between her knees. I then proceeded to wash the wound clean as I counted off her breathing intervals to avoid hyperventilation. I held the wound shut, reached for a towel, dried off and went to find a paper bag for her. Note to self: Mom--excellent business woman, lousy EMT.

Sadly, there's been no observable improvement over time. A mere three years ago, when my little brother Stefan got his head slashed open in a friendly game of street baseball, mom's reaction, once again, was to hyperventilate and totally FREAK OUT. This time two ambulances were called: one for Stefan, one for mom. He got stitches, she got Valium. I knew there was no getting around it, mom just can't handle any kind of harm to her children, no matter how slight. I was afraid my cancer announcement might actually kill her.

So, like a general going into battle I gathered intelligence and planned the attack. Step one, tell dad. As expected, his reaction was rational, collected, thoughtful and strategic: "Let's not tell your mom." Excellent choice dad, but she may wonder a) why I can't come home for Christmas b) may not buy the, "hey, it's the latest rage in California to shave your entire body, eyebrows and eye lashes included" excuse and c) may seriously consider physically harming you--or worse yet, instituting permanent silent treatment for both of us. "Good point. Can we wait until you know more?" Sure. How much more. "How about A LOT more."

A LOT more came the following week after my meeting with the surgeon, the oncologist, two MRI's and a second biopsy. Dad didn't agree. So I reminded him of point (c) above. It was 10:30 pm in Miami. He proposed we tell her the next morning. I convinced him this would unnecessarily prolong the number of hours he'd have to hear her cry. Once again, dad saw the wisdom in my strategy. If we tell her now, she'll have to go bed at some point, most likely within 2 hours. Tomorrow, she could potentially cry all day. I pumped him up like a boxer heading into the final round of a championship match: You can do this. Take the phone, go into the bedroom, get the kids to leave and call me back. "Ok."

30 minutes later I was beginning to lose my patience. How long does it take to send two teenagers with their own TVs, playstations, computers, PSPs, magazines, books, and phones to their own bedrooms? It's not like they'll be bored...Seriously! *Ring* Mom's caller ID flashed on my cell phone. I had been dreading this moment for two weeks, but I was ready:
"Halo"
Screaming
"Halo?"
Screaming followed by wailing.
Shit! He told her.
"Mom? Listen to me, breathe. Please breathe.
Whimper, scream, Kleenex, garbled, completely unintelligible Spanish
"Mom, please breathe. I can't understand what you are saying."
More garbled speech interrupted by wailing
"Mom, you have to come down. Please"
This went on (albeit completely in Spanish) for about 45 minutes. After she was able to regain her breath she was very angry I hadn't told her immediately upon leaning the diagnosis and barked angrily at dad and I:
"What are you hiding from me! Tell me! How bad is it. Tell me the truth"
So I did, and she sobbed, and listened, and I consoled her for another hour.
Then, something remarkable happened--complete silence.
"Mom, are you there? Are you ok? DAD! DAD!"
"I'm here" her voice heavy with sorrow, gravely from crying. She had finally stopped crying, but I could tell she was heartbroken--the future she'd envision for me vanished. The grandchildren she'd always wanted evaporated. All she could see was the painful road ahead. She knew our lives would never be the same and she mourned.

The revenge of the mutant Jewish genes

2006-07-24T18:24:00.000-07:00

Next stop, Dr. Leibowitz--medical oncologist extraordinare. To be honest, I really wanted my entire cancer team to be composed of girls. After all, they have boobs and they know the special relationship we have to the "ladies". However, perhaps a male prespective was also needed. So I decided to give Dr. L a try. (Additionally, his schedule was open and he came highly recommended!)

As a good little cancer patient I did my homework before going to our first meeting and had all kinds of hard-hitting questions ready for him. Example: What's your favorite color? Correct answer: pink. Ok, so that was just a compatibility question. But seriusly, I really wanted to give this guy a run for his money and let him know that I was in charge. I was pleasantly surprised when he opened our conversation with (and I quote) "I am here to lay out the numbers and give you my opinion, but I am not going to force you to do anything you don't want to do. The treatment course is entirely in your hands." I liked him immediately, a doc with 35 years of experience in medical oncology who'd actually LISTEN to me...beautiful!

With that, I started my interrogation:
"What can possibly cause a perfectly healthy 31 year old to get breast cancer?"
"A number of factors", he said in a very conforting paternal tone, his wide arms crossed, the reflection of the office lights on his bald head competing with his gregarious smile.
"Mostly we can attribute it to family history. Did you say your mom had cancer?"
"Actually my grandmother too, and my aunts, and cousins, and random other males on both sides of my family tree"
"I see"
"Were they all breast cancer?"
"For the ones with boobs, yes. The men were mostly liver. They drank a lot. We area happy bunch."
Subdued laughter.
"Have you considered genetic testing? It could definitely complete the picture and give us more information for your treatment plan."
"Most definitely. Do you want to draw blood now?"
"Hmmm...the nurses do that. But it's just a precaution; the marker genes are mostly prevalent in jewish families"
Smerk
"Hmmmm" I pointed my index fingers inward and made small circular motions at my head. "Guess what..."
"Really?" His eyes got really big.
Circular gesturing continued.
"REALLY?" He emphasized.
"Really. My ancestors were kicked out of Spain by Queen Isabel and promptly migrated to South America. Turns out the Spaniards had franchised the inquisition there too. My real last name is Brosntein--Sanmiguel is just the town they came from"
Laughter
"We are definitely testing you." At that point he quickly turned around and typed frantically on the terminal. Google poped up. A second later I was staring at a table indicating the likelihood I was a carrier of the cancer gene given my family history: 70%!
"Seriously?"
"Seriously"
And there it was. Apparently you don't need to be practicing--on in any way a believer--to take advantage of the many jewish gifts: hypocondria, razor sharp self-depricating humor, neurosis, wit, sarcasm, cooking prowess and mutant genes.

> More on the genetics of Breast & Ovarian Cancer

So, how bad is it? I talk to the surgeon.

2006-07-24T16:17:00.000-07:00

I must confess that the fourth of July holiday (Friday-Tuesday) wasn't nearly as interminable as I had predicted, given that my first appointment with the surgeon after my initial diagnosis was scheduled for July 5th. It actually gave me some much needed time to reflect and crystalize my bottom line. I walked into Dr. Whang's office with a clear perspective and a ton of questions.

So, how bad is it? "Well, it's certainly not good". She then proceeded to explain that the tumor is about 3.5 cm x 3.5 cm and it's tucked uncomfortably close to the axilary lymph nodes--AKA close enough to the arm pit to cause some serious harm, while still wedged within the breast tissue. A bit of a janus-faced tumor, if you would. Perhaps it had a difficult childhood and couldn't settle his identity entirely? Maybe it's going through therapy right now to find its inner-cancer.

At any rate Dr. Whang estimated that we are most likely looking at stage IIB if no cancer is found in the lymph nodes. If the little bastard cells collonized the armpit, then I get upgrade to stage III. Ok, so what does this mean? "Given your age, the tumor's size, and how fast it seems to be growing..this means we'll give you the most aggressive treatment we can." There really is no middle ground with me is there; not even my cancer could be mild. Danm it!

Since I am a triathlete in excellent health--cancer aside--and very strong, this means surgery to remove the tumor,3-6 months of the most aggressive chemotherapy possible, and maybe radiation and hormonone therapy after that. Before we do that, let's get at least two more MRIs (one for each girl), a chest X-ray, pregnancy test, and a whole lot of other blood work too. "Well, then. Who do I talk to about slowly poisoning my body?" Dr. Leibowitz.

> More on cancer staging.

Quality vs Quantity: A question of balance

2006-07-24T16:14:00.000-07:00

Once you know you have cancer, your view point shifts radically and time collapses into a shorter spectrum. The now, today and next week are prioritized more than you ever have. Tomorrow, next month, next year and 20 years from now are no longer a certainty but rather a goal. I guess this is the way time works for all of us, but it unfortunately takes a marshmellow-sized tumor in your left boob to force you to face the reality of time--your time--and prioritize accordingly.

I have been thinking about time a lot, and I have come to the conclusion that the quantity of time I can remain cancer free is not as important as the quality of my life during that time. This is not to say that I am not willing to go through hell to achieve cancer-free status, but simply to clarify that once I get to the promised land, I still need to be able to enjoy the things I love: triathlons, travel, drinking, eating, dancing, writing, adventure, friends and family.

Of course, there are side-effects I will willingly accept: loosing my hair, eyebrows, eyelashes, boobs and maybe even my ability to procreate. Cancer does and will leave its mark. The trick is to be able to fully re-engage while bearing these battle scars. I refuse to sit on the side lines. And I have told my doctors this. Whatever treatment they recommend must render me able to live, really LIVE--otherwise, I will happily pack my bag, laptop, camera and passport and go roam the world until I keel over.

From my perspective, a few years of fabulous far outweight a life time of blah.

What Now

2006-07-19T22:32:00.000-07:00

Though I have always done my best to live in the moment, our culture--and without a doubt my own ambition--have certainly gotten in the way. I can't even recount the number of weekends I have spent working, the dinners I cancelled to stay in the office, not to mention all the personal emails and phone calls I postponed--often indefinitely.

So what of all that time? I still don't know how I feel about that, but I know this: It's not too late! Even if I have yet to achieve my own standard: live wihout regret. Happily, while I do have some regrets, mine are mostly pretty minor. And perhaps that's the reason the shock of the diagnosis was swiftly followed by deep serenity--peace, even. That, and a call to action to take control of the situation and focus on the immediate, immediately!

To that end, I threw myself head first into research (I'd be an overachiving cancer patient!). With Jana (councelor from the cancer center), my Cancer handbook (Jana gave me my own copy now that I had joined the club!) and "Googles", I set off to put all my graduate school research skills to good use. I flipped and clicked, read and highlighted, and came to the conclusion that being a cancer patient takes a LOT of reading. Who knew there'd be this much homework?

Like a good academic I sought to determine my approach to this process, a theme if you would. I wanted to prepare for my first meeting with the surgeon immediately following the long 4th of July holiday weekend. I wanted to be clear in my heart about my wishes before learning the full extend of my particular cancer. At this point, all I knew was that I had non-differentiated, invasive ductal carcinoma. I also knew that statistically, due to my age, my cancer was aggressive and would progress very quickly. So I formulated my bottom line: Quality over Quantity.

28 June 2006: The Diagnosis

2006-07-19T21:57:00.000-07:00

So what do you do between a biopsy and the dreaded results call, you ask? My answer, Counting Crows concert and beer. Ok, so the concert didn't last 2 full days, but it's too boring to recount my daily routine (though I could actually dig up the Google menus for those days if you are really curious). It's also more fun than sharing how very painful it is to have your boob impailed with a large needle...did I mention it was hu-freaking-mongous? But I digress.

During my trip to Dublin--independent of the tumor which at the time had been diagnosed as a hormonal malfunction--I had a moment of clarity; I decided it was time to bring some much needed balance between life and work. In that spirit, I came home early that Wednesday to catch up on about three months worth of National Geographics (and, ok, some Rolling Stone too).

I ended up catching up with Charlotte and was chatting along on the phone when *beep*, call on the other line. Hmmm, who's calling me at 7pm from a private number? Click over. "Dr. Schneider here, the biopsy was positive; you have breast cancer." Uhhh? Excuse me? I'm 31 years old. I just completed the most difficult triathlon course in all of North America. I swim, I bike, I run. How is this possible? "I'm sorry"

I am confused. Shocked. Stupefied. I believe this is what an out of body experience feels like, except I wasn't floating anywhere. I was sitting on my couch, wearing my black and pink polka dotted pijama bottoms, staring at my fireplace. Frozen. *beep* Charlotte's still on the other line...what now?

Monday 26 June 2006: The Biopsy

2006-07-19T18:42:00.000-07:00

So it turns out that STAT doesn't mean squat in our medical system. It took over 5 days to get a "stand-by" appointment to maybe, perhaps, most likely but definitely not for sure get a huge needle inserted in my booby.

I got to the Palo Alto Medical Foundation at 7:30 am. Dutifully, like a good Googler in the middle of mid-year performance reviews I brought my laptop with me (Mary, I hope you are reading this part) and proceeded to gush over my collegues excellent performance over the last two quarters as I waited in a tiny room wearing scrubs. The nurses where very impressed by my set up: computer, headphones, ipod, phone and stylish water bottle. They were tempted to check email, I know it!

At around 11 they finally got around to me. I was lead to a room where they did a mamogram...not as painful as I thought, but it definitely feels funny to have a strange lady place your breast on a plate so it can be smooched nearly to death. Once they realized that yes, the lump was indeed not a figment of my imagination, we proceeded to the sonogram.

One of the interesting things about the sonogram (in addition to the warming gel...hmmm warming gel) is the cool imaging that allows you to see blood flow. My tumor actually was quite active in this department. Lots of blood flow, rivers of it--relatively speaking. I didn't realize that this was bad news--too busy looking at the screen like the computer geek I can be--until the radiologist came in and the tech said in a overly somber tone:"It has blood flow, look!" The radiologist's expression sank, she took my hand and asked me if she could please insert a ginormous needle in my boob. Now, I have been propositioned before, but this was too good to pass up. Dark room, scrubs, the dim light of the tumor's blood flow on the screen..."Let's do it!" I replied.

She was kind and got the procedure underway very quickly. She winced again when I told her I felt no pain as she scraped the top of the tumor in several directions to get multiple samples. I guess this is a bad sign. She reamined calm and assured my doctor would have the results within 3 days.

Friday 19 May 2006: The Journey Begins

2006-07-03T22:07:00.000-07:00

It was a normal morning when I thought "hmmm...that's odd; I don't remember having a huge solid mass in my breast." Alien abduction? Perhaps. In any case, I was catching a flight to Dublin for a business trip. After a quick stop by the Google Doctor (yes, we have a doctor on site), I got on the plane with assurances after a quick physical exam that it was probably hormones acting up. After all, nobody gets breast cancer at 31! Still, the Google Doc recommended I get it checked out if I could still feel it upon my return.

Fast forward 3 weeks, many Guinesses and a quick stop over in Italy to spend some time with the family. I land back in SFO after an epic journey:Florence-Rome (train), Rome-Dublin (plane), lost baggage (thank you Aer Lingus!), quick cab ride to Iza's, 5 hours sleep, cab ride back to airport with very animated Irish cabby who dropped F-bombs every 2 minutes, flight to Shannon, Ireland (luggage recovered), transcontinental flight to NYC Kennedy Airport, 2 hours and a bad bagel later, second transcontinental flight to SFO. Man, I almost didn't survive the journey...sadly my little stow-away cancerous friend made it all the way back to SF--rat!

Thankfully I had made an appointment with my family doctor from Dub, so got in to see her shortly after my return. Dr. Schneider wasn't happy with the physical exam and extensive cancer family history and ordered a lump biopsy STAT! (She literally said that. Ok, maybe not; but I've always wanted to use that term...)