Monday, November 09, 2009

Some of you are new readers, some are friends, family and colleagues. I’ve been writing about my Breast Cancer journey for nearly two years now. Thinking that my Breast Cancer babbling was a finite thing. I mean, Schwartz (see Cast of Characters) calculated my recurrence chance at eight percent. I’ve always been at the top of my class, so perhaps I should’ve seen it coming. After being diagnosed with Stage II, high-grade, infiltrating, ductal cell carcinoma on Dec. 4, 2007, I tested positive for the BRCA1 genetic anomaly. Aka, I had one of the “Breast Cancer genes” that statistically indicated that at 32 years old, doing anything short of a bilateral mastectomy and chemo, the Cancer would likely come back fast and furious. After dumping El Schmucko—the negligent surgeon who performed a lumpectomy and before the biopsy results informed Mom and Dana that it was “nothing,”—and the first, dour-verging-on-bitchy oncologist we consulted with, I went on Sloan-Kettering’s Web site. I scrolled through the masthead of its breast oncologists.

At the very top of the list is Dr. Larry Norton, the Anna Wintour of Breast Cancer, I knew I had to get in to see him; my family and friends were hopeful I’d get the mastectomy and do the chemo. Prophylactically. I think I went through the five stages of grief in about two weeks. I’ve always been an overachiever. An impatient one at that. After the initial, ‘I’m-single-I don’t-want-my-fucking-breasts-cut-off” stage, I began to come around. ‘Oh, fuck it,’ I thought, ‘I hate my saggy, 34C stretch-marked boobs anyway.’ My family and I put out our feelers—we needed to get in to see Norton ASAP. Within a day or two, I was in. There is no doubt in my mind—no doubt whatsoever—that being extremely well-connected was an integral part of my wellness. I make no bones about it—I’m just lucky that way.

The four of us piled in to Norton’s office in the winter of 2008. Mom, Dad and Brother, who handed me a sacred red string from some holy place in India. I’d only seen dad cry once in my life; at his father’s funeral nearly 20 years ago. I sat down across from Norton, still wearing my gloves while paging through a magazine.

“Why are you wearing your gloves?” he asked.

“Germs. I’m a germaphobe. And all these ‘please wash your hands signs are freaking me out even more.”

“You don’t need to worry about germs on things like paper,” he said bemusedly. “It’s mainly surfaces that absorb human heat—metal, glass,” etc.

“Ha! See why I don’t ride the subway,” I gloated to my Brother, finally vindicated.

In that hour consult, Norton elucidated all the muck and jargon that other doctors had thrown at us. This man knew his shit. There’s indeed a reason he’s been at the top of the masthead for years. There’s a reason why his patients go on to donate billions to the Sloan Breast Center. Yes, billions. His patient list—a Jewish Social Register; The Forbes List.

I asked him the question I always ask doctors—penetrate their AMA guard and force them to see me as Stephanie Green, not patient number whatever.

“If I were your daughter, what would you tell me to do?”

“I would tell you that the safest option would be to have the mastectomy and the chemo.”

“Okay then. Done. Let’s lop ‘em off and put ‘em back on. Who is the best oncologist in Miami?”

“I trained Michael Schwartz [at Sloan].” Schwartz’s name had also come up in our research.

“Done. He’s my guy.”

We headed to Bergdorf’s and the jeweler.

After I got back to Miami Beach, I was never alone for one minute of any of my treatments, consults or procedures. My family came down in planned out rotations. Mom and Dana at nearly every chemo, Dad when he didn’t have a trial or something going on, Brother flying in from NY for the mastectomy and what would turn out to be my worst chemo treatment yet. After seeing Schwartz and gathering my “team,” (also see Cast of Characters), I gutted my insides. Had “jet fuel,” as Dr. Laura calls it, pumped into my system for four months, Herceptin infusions for one year, had inflatable balloons inside my hollow chest for months, had aureolas and nipples constructed from a skin graft by Rosenbaum, lost all my hair—in short engaged in every possible Breast Cancer treatment as a safeguard against a potential, deadly recurrence.

Cut to 20 months later. Hair back thick and gorge as ever, assisted by Oribe and Momotaro. My oncological gyno, McHottie, aka Jacob Tangir, felt an enlarged node on my neck. On October 5, mom, Lynn (see Characters) and I were back in Schwartz’s office. I could read his face instantly—he’d only ever given me good news.

“It’s a malignancy. The Cancer is back.”

Last night, I was sitting on my couch replaying that day in my head and I started cackling with laughter. There we were again, in Schwartz’s office, mom and Lynn in their matching Jimmy Choos (unplanned), me on three Xannies and Schwartz. And as soon as he said It Was Back, three high-maintenance women hysterically bawling, his head swiveling from one to the other. Any other man would’ve run for the hills. But Schwartz knew us; he could take the three coiffed, bejeweled (in our ‘every day’ jewelry) women throwing an emotional hissy.

“But—eight percent! You said eight percent. I don’t understand. Are you surprised?” I think it was the only time I’d ever harbored any resentful-esque feelings toward one of my docs.

But Schwartz was pretty fucking shocked. He’d reached out to Norton after palpating the enlarged node, before Mesko had even shot me with the biopsy gun. Hell, I’ve never been ‘normal,’ why should Cancer be any different? After the PET scan, he was relieved to tell us that it had only come back in the neck nodes and the nodes behind my sternum. Yup, behind our sternums lurk potentially deadly nodes. Fun! Immediately I was started on oral chemo. Eleven horse pills a day with minimal side-effects and no hair loss. I never wanted to wear my $4k, couture wig by Ralf again. Nobody was fucking with my Oribe. Fuck you, Cancer.

After another agonizing month of waiting, this time to see whether the Chemo Cocktail was working, Mom arrived on Friday for our 1 p.m. appointment with Schwartz. When she walked in to my apartment, after her typical bat-out-of-hell-drive from Jax—‘wake up at 5 a.m. be to Steph’s by 11 if I go, 90 mph and have a good book on CD,—the first thing I noticed were her shoes. I’m very superstitious. She was wearing the cursed Choos.

“Take those shoes off!” I screeched and retreated from her like she had the H1N1. “Take them off! You can’t wear those!”

“What, why? What’s wrong they match?!”

“Those are the shoes you and Lynn were wearing when I was re-diagnosed! Hurry, take them off!”

“Okay, okay! I need some sandals or flats then!”

I ran into my closet and began projectile vomiting shoes. Gold brocade Manolo flats.

“Those don’t match!”

I didn’t feel like having the old ‘gold is a neutral’ argument with her—I had my own Talismen-guided wardrobe to consider.

I threw black and white Jack Rogers out at her.

“Ok, well, you’re going to be introduced to Jack Rogers Mom. Seventy-five bucks, available in every color combo under the sun and comfortable.”

The Wiccan Health Spell candle I’d received from my friend at the New York Post was burning, I’d said the chant, and had my Talismen on. Hermès cuff Mom and Dad bought me on the post-It Hasn’t Spread Bal Harbour jaunt; holy red string from India; pendant from India that circulated the Subcontinent with both Michael and Hemley; an Indian ring from Hemley; and mom’s black patent Louboutins. Which really held no spiritual value except for the fact that they are the only Louboutins that have ever fit my wide, chubby feet. I briefly thought about taking off my Tank watch, for Acupuncturist had taken it off the night before so as not to inhibit my Chi, but I didn’t quite go that far. You have to draw the line around crazy at some point.

Off we went to the hospital, again. I barely let mom speak because she’s so Pollyanna that I see nearly everything she says a jinx with regards to the Cancer. Christ, I was on two Xannies and still wired. Blood work was drawn. I asked to see Schwartz stat so that I could film what he said, as mom’s note-taking skills were not that of a trained journalist. He determined that the cocktail seemed to be doing its job—the CBC showed that my body was tolerating the Xeloda and Tykerb well. I was slightly disconcerted that the CA 15-3 tumor-marking blood work was not ready. That’s always been the guague of whether treatment is working. Yet, as your body’s levels of whatever spike when you start chemo, that test won’t be accurate for another month. However, he felt the lump and liked the way it felt. Ooh la la! He took out a tape measure. Ha! The only reason I hadn’t done that is because I couldn’t find mine. He took a Bic and drew a circle around the lump. It’d shrunk by .4 cm in a month. Sweet.

“Ah, medical technology. I love it.”

I was used to this blend of high and low culture in medicine. Rosenbaum had used the remnants of a roll of surgical tape to trace the size of my aureolas he would create. They turned out perfectly. Genetic vaccines, PARP inhibitors, new and improved Breast Cancer drugs developing at warp speed—and tape measures.

It was once again, “the best news we could hope for.”

Shit, I started writing this as an intro to the transcription of my check-up interview with Schwartz and it’s turned into this 1,500 word essay. Oy. Haven’t even checked email or changed out of my PJs. But I’ve already taken nine horse pills!

I’ll transcribe the tape later. I suppose I should start my Saturday.