Tuesday, December 29, 2009

Another Day, Another Diagnosis

These past seven days in New York have been pretty fucking insane, all in good ways—until today. My appt with Larry Norton at Sloan Kettering (aka Anna Wintour of Breast Cancer) was beyond mind-boggling. Like, I think he just possibly saved my life or issued what to me feels like if not a death sentence, then a death of the quality of my life sentence. Here we go again, people.

Prior to my two-hour stint at the new Four-Seasons-
esque Sloan Kettering Breast Cancer Center on East 66th Street, one block away from my former apartment, I had a lovely lunch with Mel at Bergdorf's, who looks fabulous as ever. Fun girl talk and not many Cancer thoughts. Shopping around a bit helped. Wasn't even so nervous about seeing Norton, but popped a Xannie for good measure on the 7th floor.

Though we (my parents and brother also in tow) had to wait for a while and we really cut it close with my flight (I'm in
LGA right now), but we made it and he spent an hour-plus with us.

First, his nurse
practitioner did a more thorough exam of my lymph nodes than Schwartz ever does. She only felt three, which is what we knew. No new ones that she could tell. Withing a few seconds, the nurse did a more thorough exam of me than Schwartz does. Yeah, I'm a little pissed at Schwartz at the moment, though I love the guy to death.

Here's the thing—I assumed (I know, I should know better than to assume anything in the Cancer Game) that because Schwartz was trained by Norton, and they conferred upon my case, that Schwartz would automatically stick to Norton's protocol.

Well, I had everything sent up from Schwartz to Norton except the actual slides, which I suppose was my bad because it may be Mesko who has them or even pathology at Sinai. The second bad omen re. Schwartz was the fact that the nurse told me—right off the bat—that they prefer one week on, one week off with the Xeloda. Schwartz has me on the most common regiment—two weeks on, one week off. Apparent-fucking-ly, not only does the shorter cycle decrease the side-effects, but it may indeed work more effectively on the Cancer cells. Are you FUCKING kidding me?

Schwartz NEVER even presented that as an option. Yeah, so my burning feet that kept me holed up at home writhing in foot pain during Art Basel? Schwartz never suggested what Norton did. After the nurse
pract. did the physical, she, Norton and his nurse Karen, conferred and then Norton came in.

"We have a plane to catch, so do we have enough time?"

"Well, jeez guys, if you're going to fly in for a day in the middle of winter at least make the appointment in the morning. I want to talk!"

"No, no, I will miss the plane for you. Talk."

A.) He needs the slides of the tumor; may want the whole node removed for further testing. (Schwartz did not recommend that. God I'm fucking
pissed at him right now.)

B.) He felt some enlarged nodes in the soft tissue under my arm, using a technique that again, Schwartz has never done. He actually taught the nurse
pract how to do it on me. The man never stops teaching.

C.)
Herceptin infusions are more effective/"better" than Tykerb. Polar opposite of Schwartz's assertion that Tykerb is a "super Herceptin."

D.)
There's a possibility that this is not even Breast Cancer. This is not a good thing. This is a frightening, in the words of Gary, standing on the mountain facing death, about to fall off thing.

"The nodes don't really feel to me like Breast Cancer."

What. The. Fuck.
Fuckity fuck fuck?

"What?
What? What do you mean?"

"I'm not saying it's definitely a different kind of Cancer, but I think there's a possibility, that this isn't even breast Cancer at all. It's unusual for it to come back in these areas. Usually it's in the organs. That's why I need to see the slides [from orig diagnosis in 2007 and recurrence date this October]."

"
What?" I pretty much have my head on his desk at this point. Weren't it for the Xanax, I would've been crying. I could not wrap my head around this. "What kind of Cancer? I don't understand."

"Let's not get ahead of ourselves, but your HER2 NU number originally was five; now it's two, which is borderline." [HER2 NU relates to hormones and what kind of treatment best suits you, e.g. why I had
Herceptin].

"Jesus."

"Do you smoke?"

"I mean a little in college."

Dad: "She smokes pot!"

"Stop smoking the pot."

"I vaporize? Still?"

Get this shit fellow weed lovers:
It's not just the smoke—it's the fucking THC. THC interferes with Cancer treatment. It hinders the efficacy. It fucks with your hormones. Meaning: I can't eat it, I can't vaporize.

I can no longer be a proud pothead. What the hell am I gonna do in South Beach now? Ugh.

"Yeah," he says to all of us. "In Vermont and California these patients go in, they buy all the vaporizers—they all smoke it. So much so that the hospitals stopped checking for marijuana in
tox screens cause everyone in the hospitals in those states is high. All the time"

"Jesus."

"So yeah, sorry, but stop eating it and smoking it."

"Okay. I'll stop."

What else? Well, let's all keep our fingers-crossed that this IS Breast Cancer. (Time to say those prayers/cast spells/light candles/send good vibes my way again please.) Yes, pray for breast cancer.

"What other kind of Cancer could it be? I mean, Jesus."

Look, I know I have a lot of religious Christian readers, but here's the deal. Us Jews say Jesus. A LOT. We just do. So, I'm sorry if it offends, but you'll just have to get used to it. In a room full of
Heebs, which natch Norton is, saying 'Jesus' is basically like saying 'wow.' We mean no offense.

Anyway: "You're jumping
waaay ahead. First I need to see the path slides to make sure it's Breast Ca. There's a slight probability it's not."

"But, what kind, like lymphoma?"

"Maybe."

"Oh Jesus. Chemo?
Herceptin infusions? God, I don't want another port."

"Okay, I'm going to say something to you that is as important as any other part of Cancer treatment. I see people—actors, royalty, heads of state, dignitaries, you name it. The richest, most powerful people in the world. They come in and tell me, 'I don't want to lose my hair. I don't want a port. I don't want this, I don't want that.' These people are used to controlling the world. They tell me they don’t want chemo or this or that. I tell them what I think would save their lives. And let me tell you, lawyers are the worst
[looks at dad] are you a lawyer?”


“Yeah,” says Dad cracking up.


“For some reason, they just can’t relinquish control. But you’re not all bad. I’m having dinner with a lawyer tonight and he’s a very good person.”


Lolol. Is he not the funniest??


“A lot of these people leave and never speak to me again. So listen to me; I’m only telling you this cause I know you want to know. I’m telling you this because you just said you don’t want a port again; you don’t want Herceptin infusions; don’t want to lose your hair.


I’m telling you this because I tell it like it is [indicating that I’m the same] and I know you want to live.


But you can’t say things like 'I don't want this, I don't want that' to a lot of doctors—they’ll take that cue, know what you don't want, and offer you something else. That ‘something else’ may not save your life."


“I, uh, wow. Isn’t that completely unethical? For a doctor to know that a treatment that the patient doesn’t necessarily want is the one that will save their lives? Who does want this? I didn’t want chemo and a mastectomy, but I listened to you.”


“Well, it’s not an ethical thing. It’s more of a medical issue. The doctor should give you all the options, yes.


“Wow. That’s insane.”


That’s why Farrah Fawcett and Dominick Dunne went to Germany, I thought immediately. And their treatments didn’t work. As you know, Dominick Dunne was one of my favorite writers. He died the same day Oribe did my hair, August 21. I was speaking of Dominick today with someone, as I’m reading his final novel, which, unfortunately was not the book he’d hoped to write before his death. That black widow bitch Lily Safra who was beyond a shadow of a doubt somehow involved in her husband Edmond’s death in Monte Carlo and got away scott free. He was never able to write that book. So his final book, while entertaining, was more an amalgamation of his collected observations over his career.


And now—I’m on the plane back to Jax—I just finished the book. And stumbled upon this passage at the end. Dominick wouldn’t have seen Dr. Norton, but likely his doctor in New York was the best of the best a la Norton.


From Too Much Money:


“The party’s off. . . . I’m pretty sick. I just returned from a trip to the Dominican Republic, where I had a stem cell treatment, and now I’m going off to a clinic in Bavaria. I’d rather pursue those options than the chemo I’m being offered here. I have high hopes.”


He died within a few months. Seriously, is it only me that these fortuitous, portentous events happen to? I got the message from Norton; Dominick, wherever you are, in addition to being one of my literary role models, you’ve put some fire under my belly to stay alive.


No, I don’t want to wear the wig again. Yes, I hate this. Yes, it’s unfair. Yes, I’ll be crying in public, like I am now on a fucking Delta flight. No, I don’t want to gain weight, have a port again, enter the awful chemo ward, be radiated or whatever I need to do should this not be Breast Ca—please, god, let it be Breast Cancer—but I do want to live, for now anyway.


Saturday was a very fruitful career day for me. Saturday I was on a high. I’m now the Fashion Editor at Heeb. I’ll be writing a weekly Web column for them, as well as beefing up fashion coverage, attending the shows—everything I’ve always wanted. I then went to see my mentor, the editor in chief of ESPN magazine. He gave me the pep talk of a lifetime. Insisting that I email him my book now to read. Told me he’s proud of me—coming from a former professor who’s watched my writing grow over nearly ten years—that means the world to me.


But given that my life seems to consist of extreme ups and downs, I’m hoping hard that I can keep the up part, and NOT be plagued by the down. So yes, pray that I have merely Breast Cancer. That’s right—I want this to be Breast Cancer. Please, please, please, let me just have the Breast Cancer. I’m a pro by now and my dukes are still up. I just wish I knew exactly what the enemy is.