A Tale of Two Biopsies

I must break down and accept I’m like most people. Memories of “firsts” are strategically filed in my mind, instantly accessible. They are there forever etched in the brain: first boyfriend, first date, first kiss. You get the picture. One “first” that I’m discussing today is unfortunately far from the loin-trembling variety. It’s my very first biopsy.

My first biopsy happened at the turn of the century.  OMG!  That sounds so yesteryear! The year was 1998. As President and CEO of the engineering company that I had founded 15 years back, I had the world by the ears. I had broken barriers and earned bragging rights as a female engineer and a by-the-bootstrap entrepreneur. I was so riding high that I did not notice my neck had been bulging. I could not possibly notice it because each time I looked at the mirror, I got stuck on my face sans make-up, carefully searching for lines that might be appearing without my permission. Satisfied, I’d move on to other more pressing business. It was only after a friend gave me a recent snap shot of me that I noticed how big the base of my neck had bulged, like a frog holding its breath. I was so upset I confronted my mother. Bless her soul in her eternal resting place.  At that time, she had lived with me, my husband – the first in the widowhood series – and my growing son for 21 years. Wasn’t that marvelous? Yes, specially considering we had only invited her for dinner.  Actually we all had a great time with the arrangement. But I did blame her for not letting me know about my fat neck.  At breakfast time in front of my son and my husband, I asked Mother, How long have I had this neck?  She replied, As far as I know, after I gave birth to you, I noticed  your neck connected your head to your shoulders.  And we all cracked up.

Fortuitously, a retired anesthesiologist opened a walk-in medical practice half a mile from the office building that my company occupied. The name of his business was…ta da…”Walk-In Doctor.” After lunch one day, I walked in and met the good doctor.  You have goiter! The first words came tumbling right out of his mouth.  Right off the bat I liked the doctor.  Aside from not being too tall, which is number one qualification for waiters and doctors in my book, he also knew my problem without first asking me my problem.  I invited him, Tell me about it.  He replied, You need to see an Endoctrinologist (“Dr Endo”).  That was long before the start of my relationship with Dr Google.  All I knew those days was that people with goiter lacked iodine in their diet.  I did not believe my body was short of iodine, considering all the “bagoong” (Philippine fermented shrimp fry) that I had been consuming since time immemorial.  

I remember Dr Endo massaging my swollen neck, then having X-ray pictures taken of it.  I thought he was going to propose surgery.  But no!  He said this exactly: I’m going to stick a needle in your neck and draw some stuff so we’ll know what’s in there.  A needle perpendicular to my throat! It sounded horrible.  He scheduled the drilling in two weeks.  

If I had been Ms Worrywart, the two-week wait and imagination of a sharp instrument drilling through my neck would have been torturous.  Fortunately, there were more pressing things occupying my head:  projects to chase, payroll to cover, receivables to collect, string bikini figure to maintain. 

Time came for the mining for the stuff in my neck.  Then a few days to wait for the result.  Looking back,  they were just normal days in my busy calendar.

I remember I was preparing to call it a day when Dr Endo phoned me the result.  There was a smile in his voice.  Good news! He exclaimed.  The stuff in your neck is not cancerous.  We’ll schedule the surgery to remove your goiter.  All I could say to him was, Really!  I kept the reason for the shock to myself.  Truth was, it had not occurred to me that cancer was a consideration.  My head was so buried in the sand I was dense in most life matters.  But for sure density had its advantages.  I did not know I was supposed to be worried.

The parathyroidectomy – surgical removal of one or more of a human’s 4 parathyroids –  proceeded uneventfully.  A couple of days later, I was walking around with a normal-sized neck except for a bandage over the surgery area, like over a slit throat.  When friends asked me, What happened to your neck?  I always deadpanned, I was in a bar room brawl and the only one left standing!  I just loved to impress.

The second biopsy brought about by a cough that did not seem to quit in 2012 told a much different story.  I was 14 years older and a retired contented pensioner with nary a thing to worry about – no more employees, no more staring at the ceiling hoping money will drop to meet the payroll.  With my business closed for good at the time of my choosing, there was no more concern about losing my professional engineering license which totally defined me.  My head emerged from the sand!  Suddenly I noticed things around me.  I realized the stark difference between Republicans and Democrats!  I noticed deep purple lipsticks.  I read about famous people being diagnosed with lung cancer.  That was when I suspected the biopsy material scraped from my left lung could spell trouble and cause me to be afraid.  Very afraid. 

I just did the best I could to deal with the situation at hand.  I sought knowledge.  I forged an alliance with Dr Google and together we softened the blow from the fear of the unknown.  Knowledge is power.  It repels fear and can help in fighting any situation.

And always, there’s time for lightening up.

Happy dance!

My Seventh Cancerversary

OMG.  Seventh Cancerversary!  What happened?

Well, I was supposed to keel over dead 8 months after my diagnosis of Stage 4 non-small cell adenocarcinoma lung cancer in August of 2012.  But no!  I celebrated my 1st cancerversary, 2nd cancerversary, 3rd cancerversary….. you get the drift.

Everything started in April 2012.  The late Octo, the second in the widowhood series, and I had been married for 4 years, quietly minding our own business in a retirement resort in South Orange County, California when catastrophe came knocking at the door of our existence.   An unproductive cough started harassing me.  I blamed spring pollen, the Los Angeles smog wandering to our paradise, and the red grease floating on the Mexican menudo.  I fought the cough.  I took antihistamines, stayed indoors, and carefully degreased my menudo.  But the nasty cough did not seem to quit.  I wasn’t coughing 24/7 per se; just several times during the day enough to ruin my composure.  

As fate would have it, a New Mexico judge summoned me to return to Albuquerque and perform a jury duty, or else.  Coming from a judge, the Or-Else option sent me shaking in my Z-Coils, so Octo and I drove off.  While I was in Albuquerque, I thought I might as well visit my Physician’s Assistant (PA) whom I had not seen in 2 years.  And I did.

How’ve you been? Asked the tall pretty 40ish Anglo woman.  Sitting across from me, the table covered her long legs that, when standing, normally set her head towering over me.  I told her about the jury duty and the dry cough that wouldn’t go away.  Otherwise my health is pretty damned good, I bragged.  I’m a feisty heifer.   She stood up, went around her desk, and did the stethoscope motions on my chest and back then took me to another room for me to pose for X-ray pictures of my chest.  

While waiting for the X-ray images to develop, we chatted about milestones: my move to CA and her upcoming move and gig as PA in Pennsylvania.  Soon she walked to the other room and presumably studied the X-ray pictures.

Celia, did you travel outside the US recently?  She asked as she was ambling back into her office.  I answered, No, why?  She seemed perturbed.  She said she was hoping I had visited some poor third world country where I might have picked up some nasty stuff.  I don’t like the looks of your lung X-ray, she responded.

My heart dropped!  What’s so wrong with my lungs? What nasty stuff could I have picked up that landed in my lungs?  I asked her to show me the X-ray image but she ignored me.  

It would be August when I’d see the detailed picture of my lungs after a CT scan, a PET scan, and a final diagnosis of non-small cell lung cancer of the adenocarcinoma variety.  The Pulmonologist to whom PA referred me for further action turned on the computer monitor and showed an enlarged picture of my lungs.  The image resembled the Milky Way: against a dark background, tons of tiny white spots too numerous to count.  A 3cm x 3cm x 2cm malignant nodule occupied the bottom lobe of the left lung. No human lungs should look like those, declared Dr Diplomacy, a handsome Jamaican dude – imagine a dark young George Clooney.  Thank you, I acknowledged his comment.  I have always been proud of myself for being different.  At that point, after days of a tremendous amount of consultations with Dr Google, I had already come to terms with having lung cancer.  By the end of August 2012,  I had come eyeball to eyeball with Mr Mortality.  In 8 months I was ready for him  to transport me to the other side of the Pearly Gates to join Elizabeth Taylor and Farrah Fawcett among other beauties.  

But surprise!  After 100 days of taking Tarceva, my first line treatment, the wonder drug gobbled 80% of the malignant nodule!  Of course it hadn’t been easy.  The horrible side effects of Tarceva drove me nuts, especially the watery explosive diarrhea.  Those were the days of my life when my navigation prowess was put to the test.  Wherever I went, I quickly, without delay, established the coordinates of the nearest restroom in the vicinity as soon as I entered a facility.   Whew!  Obviously I succeeded.  I survived my 20 months on Tarceva without any accident for me to write in painful detail.  Other torturous side effects included finger-in-the-electric-socket spiked hair and skin problems.  But the mutant long eyelashes more than made up for their torment.  The sexy long lashes gave my eyes the come-hither look so I batted them shamelessly.

For my second treatment, I qualified to participate in the CO-1686 Clinical Trial, which  gave my cancerous nodule 34 months of stability in 3 different teaching hospital settings.  It was after the first 4 months when hyperglycemia, the drug’s major side effect hit me.  Dr C, the world renown oncologist, told me, You either have cancer or type 1 diabetes.  Diabetes we can control.   The clinical trial hot shots prescribed Metformin to control the raging high blood sugar, but Metformin in high doses unleashed its own nasty side effect:  loss of appetite.

Loss of appetite was the saddest event in my cancer journey, so far.  Food that entered my mouth turned my stomach and sent my face hanging over the commode.  Even in restaurants, colorful photos of ham, sausage and sunny-side-up eggs repulsed me.  Eating had been my favorite hobby and its absence left a gaping hole in my existence.  I thought I’d never smile again.  But not for long!  It gave me back my string bikini figure!  Thank goodness for small favors. 

Medical marijuana (MMJ) appetite drops re-awakened my desire for food.   A never user, it was my first time for MMJ.  Octo, a never-user like me, for the first time sat near anybody about to use MMJ.  We both were clueless exactly what was supposed to happen.  So, in the dining room, when I took the first few drops,  he watched me very intently, prepared to wrestle me to the floor in case I got out of control!

And now on my 7th Cancerversary, I’m on the 30th month on Tagrisso, my third treatment.  I thought it has given me zero side effects but when I posted an update about my ingrown toenails and the podiatrist, readers who are also Tagrisso users informed me through email and social media that Tagrisso caused their ingrown toenails.  Hmmm….Learn something new everyday, that’s my mantra.  

Lung cancer diagnosis led me to research, knowledge acquisition, and blogging.  Learning was my catharsis during those early dark days when I knew zip about lung cancer.  Knowledge empowered me.  Sharing the knowledge and hope with other cancer patients and caregivers is my purpose. 

Let me be clear here.  I  have no delusions of eternal health.  Pragmatic is the word.  With each cancerversary celebration I become more accepting that sooner or later – preferably later –  I’d croak just like everybody else with or without cancer.  Meanwhile, I’ll keep filling my cup.

Happy dance!

The Prize for Pain and Suffering

The author models the fateful coat she was wearing at the car-vs-pedestrian collision







 

 

On March 20, 2019, I finally received the financial settlement check  for the collision of  the left  shoulder of my 112-pound body with a man’s moving car at a busy intersection in South Orange County California.  The accident happened December 26, 2017.  What a prize for 15 months of pain and suffering! 

Two versions of that car-versus-pedestrian conflict tumbled from the lips of caring individuals who never saw the accident. 

BT, my significant other, told our pool buddies: Celia was tossed 80 feet up in the air before her face hit the pavement near the curb.  Amazingly, she sashayed out of the accident scene like a model in Ru Paul’s fashion show!

PF, a retired engineer colleague of mine during our Albuquerque city hall days and now a researcher of mysterious sex habits of northwestern migratory birds, gave a more pragmatic interpretation of the accident.  He texted me: You were only hit by a car mirror!

Fortunately, the official report submitted for record by the accident investigator told the real story.  In summary: Car Driver hit Pedestrian’s left shoulder; Pedestrian landed on the pavement two lanes away; Driver, Pedestrian, and two on-site Witnesses gave corroborating statements; Pedestrian complained of pain; Driver admitted fault. 

Let’s get it from the horse’s mouth, the audience clamors!

Now that I have the beans in my hot little hands, I can tell my pain-and-suffering story without fear my words will be used against me in court.  My slightly detailed car-versus-pedestrian accident story is in the post titled “Dusting Myself Again.” 

What the accident investigator failed to include in his accident report was what I was wearing at the scene.  The fact: I was wearing a black quilted floor-length winter coat so bulky it looked and felt like a sleeping bag.  Nobody wears that thick coat in Southern Orange County California’s 65-degree winter weather, friends often tell me.  I say, Hey, I was born and raised in the tropics.  Anything under 100 degrees Fahrenheit is cold.  Anyway, I swear the coat helped my fragile body to avoid serious injury by bouncing it from one traffic lane to another.

So at the scene of the accident, a 30-something Emergency Medical Technician  (EMT) cleaned the bleeding contusion on my forehead and plastered  something over it.  I became curious how big the wound was.  Finding no mirror on the street sign post, I worriedly asked the EMT, How do I look?  The handsome young man mustered all the sincerity he could in his voice and gazed into my eyes,  You look beautiful!  He gave the right answer.  I wanted to ask him but fought the feeling, Do you dig older women? Soon the ambulance came and transported me to the trauma hospital. 

At the trauma hospital, the X-ray image revealed a hairline crack on my left shoulder.   The Emergency Room (ER) doctor relegated my left arm to a sling, gave me painkillers and sent me home late that night after observing and assuming no head injury.

We need to get you a personal injury lawyer, declared BT on the way to my minimalist manor.  He might as well had wasted his breathing to the four winds.  My exit from the accident scene practically whole so shocked me that nothing else mattered. 

The following morning, my aching bruised body talked to me, Plan for treatment NOW!  My body and I have this thing going.  We listen to each other.  I contacted my Primary Care Physician (PCP) and asked him to refer me to an orthopedist to continue the care started by the ER doctor.  PCP was thrilled.  Referring me to a specialist highlights his day.  He obtained the insurance company’s approval for me to see Dr Butu-Buto (Dr BB), a fictitious name for the orthopedist surgeon. 

Dr BB agreed with the ER doctor’s finding of the hairline crack on the shoulder, that it’d heal eventually and I’d regain my range of motion with the help of some physical therapy (PT) and time.   He sent me to my insurance-approved PT place, where starting January 2018, a PT assistant supervised me while I did some lame arm bending exercises.

A week later,  I received an introduction phone call from Atty O’Dear (Irish name changed to protect everybody) the personal injury lawyer to whom BT’s buddy, a retired high-powered lawyer, referred me.  O’Dear’s voice was that of a young, powerful, authoritative dude,  a  fight-to-the-ends-of-the-earth kind of voice.  According to buddy, O’Dear represented the wife of  buddy’s associate in a personal injury lawsuit.  She had stubbed her big toe in a Las Vegas resort pool and O’Dear got her a six-figure settlement award.   What’s not to like about O’Dear already!

To get a second opinion on O’Dear, I consulted my other colleague, Atty Google.  He knows EVERYTHING legal EVERYWHERE.  I have a sneaky suspicion he is related to the good medical doctor Dr Google. 

I liked the site to which Atty Google sent me.  O’Dear’s website showed recent settlements for car-versus-pedestrian accidents at $200,000 or $250,000.  The other cases include car versus car, supermarket slip and fall, and bicycle versus auto.  They yielded 6- and 7-figure settlement awards.  I drooled at the possibilities!  I imagined taking my immediate family members and their mates on an all-expenses paid river cruise.

No questions asked, I agreed to be O’Dear’s warrior client.  A fighter client for a fighter lawyer!  We signed the contingency agreement of 2/3 – 1/3 split.  Payment for the medical bills would come from my 2/3.

I never met the guy.  We communicated by text through the year and email or  phone in the last 3 months.  I texted him photos of my black-and-blue arms and legs and a picture of my face with the contusion.  I texted him photos of PT updates, letters and some bills from medical services suppliers.  He acknowledged each text and thanked me right away. 

To supplement the 45-minute PT every other day at the wellness clinic that caters to Medicare patients, I also did the same lame exercises at home.   In between actions, I learned as much as I could about how financial settlement checks for accident pain and suffering are determined.  Why not?  I have time, I’m retired, living the dream, enjoying no tension with my pension.

My good friend Atty Google said settlement award check equals actual medical bills paid 100% plus cost of pain and suffering.  Pain-and-suffering cost equals actual medical bills multiplied by 3, 4, or 5, depending on the injuries and the victim’s age and state of health, the victim’s lost earnings and potential future, etc.  I thought, wow, my medical bills are small. I am retired.  No amount of multiplication and calculation could result in six figures.  No wonder O’Dear asked me if I had a headache after seeing the picture of the contusion on my forehead.  He was thinking brain scan. He also suggested surgery for my shoulder.   While the procedures would definitely jack up the medical bills, I refused both.  Been there done that on brain scans and I really had no pain that would justify surgery or brain scan.   My major reason against the brain scan:  I did not want to discover stuff that might be quietly minding their own business inside my skull, like advanced signs of Alzheimer or metastases.  Let sleeping dogs lie!

Near the end of March 2018, after 2 months of PT, the PT doctor examined my progress.  Using a special protractor, she measured the angles of my range of motion.  Your left shoulder progress is not where it should be at this time, she said almost irritated, then declared with finality: I have to release you.  I was taken aback.  I said, Maybe you should give me more rigorous workouts, not exercises for old people.  She responded, Based on my experience you should have an MRI of your left shoulder to make sure there are no damaged soft tissues that X-rays don’t show.  Sometimes soft tissue damages are discovered after the insurance payment is settled.  OMG I better get an MRI!

Dr BB did not want to requisition an MRI but Dr PCP was gung ho about another referral.  Dr BB would have not been my choice, he said.  I’ll refer you to Dr Lim (fictitious name), a Chinese general orthopedist.  His practice is focused on sports injuries.  I secretly did a “Yes!” with my fist.  BT’s account of the 80-foot aerial somersault qualified me to be Dr Lim’s patient.

Dr Lim read the release report of PT doctor.  He asked me, How much pain do you have now, scale of 10?  I answered, I actually have no pain unless I try to move my arm beyond its present range of motion.  He gave me a cortisone shot on my left shoulder, a prescription for an MRI, and a referral to a PT doctor specialized in sports injuries. 

Within 48 hours the cortisone shot relaxed my shoulders.  The range of motion improved.  

The MRI report said the image showed soft tissue damage caused by trauma, not wear and tear.  The hairline crack was healing.  Indeed the MRI was justified.

The sports PT doctor attended to me personally.  First he asked, How much pain do you have now, scale of 10?  I gave the same answer: No pain except when I try to move the left arm beyond the current range of motion.  He commented, You will have pain  because that’s what we will do: slowly increase the range of motion.  He poked his pointer finger deep into my left armpit as if searching for a culprit.  I felt no pain.  When he raised my left arm to the point where I screamed in pain, he stopped.  The PT doctor’s work lasted for 20 minutes.  The other 40 minutes consisted of back massage by an assistant who used her  finger knuckles for pressure, routine exercises for my left arm, machine exercises for both arms, and icing of the left shoulder.  The drill went on two days a week.  I supplemented it with daily exercises at home including a pulling the pulley I bought and had installed behind the bedroom door.  I also bought a professional-grade cold-pack thingy to use at home in case there was pain.  I ended up not taking it out of the packaging because I felt no pain.  Looking back, I wonder if there was really no pain or if I have acquired a high threshold for pain over the years after clumsy slip-and-fall accidents, natural childbirth, hysterectomy, gum surgery, parathyroid removal, and facial shingles, etc.  Those just cover physical pain.  Emotional pain is a whole other list.

The search for knowledge on the mechanics of pain-and-suffering financial settlement continued.  I pored over Atty Google’s blogs by other lawyers trying to grab a share of the lucrative business.  Atty Google said that healing of shoulder injury takes time but it is not good to drag it over a year because it could backfire.

By September 2018, the tightness of my scapula had decreased.  I could dance with my arms flapping all over except to the fullest range of motion.  A second MRI attested to the  improvement and a third one showed it had stabilized.  Dr Lim declared,  It will never go back to 100% range of motion.  I declared that day was my exit-visit day.

On October 1, 2019  I bade goodbye to my sports PT friends.  I texted O’Dear about the milestone.

Surprisingly, O’Dear did not respond to my text.  It was so unlike him.   I told referrer buddy about it.  Oh, he said, O’Dear has a couple of big cases.  Blood-and-guts cases.  I guess mine was small potatoes; it could wait.

November 2019 came and still no word from O’Dear.  I texted him again.  This time he responded promptly, Call tomorrow when I’ll be in town.  He did not say where he was, I did not ask.   The following morning I phoned him and ask him the status of my case.  He replied, Email me the list of the health providers that provided you services.  I was hacked off. I said, I have been texting everything to you – bills, letters, receipts, reports.  He answered, text is different.  Email is more official.  I sighed.  I get it, I said.  You’re putting me to work, buying a little time.  He laughed nervously.  

Fortunately I had everything in “Accident File.”  I emailed O’Dear the list: ambulance, trauma hospital, imaging hospital, orthopedic doctors, PT’s, etc.  I allowed him a few days to contact the parties.

Thanksgiving week 2018 came.  My left arm had no problem pulling the cold meat off the carcass of a turkey my Son the Sculptor had roasted for the big dinner the day before.  He asked when the insurance settlement was going to happen.  I answered, next week.  The phrase Next Week was repeated many more times after that day.

On January 7, 2019, I emailed O’Dear:  I was hoping we’d have settled by now.  It’s been over a year.  I don’t want this case to linger much longer.  He emailed back:  I have everything I need now.  I should have something for you next week. 

In the days that followed, I received form letters from my insurance company and its subcontractors.  They said based on CA law, insurance companies must provide medical care “on credit” for the insured who is injured in an accident.  They wanted their money from any settlement.  They said if you have a lawyer, give us the name and submit your signed agreement.  I simply forwarded the paperwork to O’Dear.

It was now February 2019 and still no word from O’Dear.  Call him, nudged BT.  Or if you want, we’ll drive to his office in LA and just surprise him.  Nah, I responded.  He gets 1/3, he knows what he’s doing. 

In mid-March 2019, I decided to call O’Dear’s paralegal.  What’s going on with my case?  I asked.  She answered, Oh, oh, let me give you to O’Dear.  He’s here.

The conversation between O’Dear and me went like this:

He: (whispering) Hi Celia! How are you?  

I wondered, Why is he whispering, so sheepish? What happened to the fighter’s voice?

Me:  I’m fine.  What’s new with the settlement deal?

He: (whispering) Does your insurance coverage include uninsured motorist?

My blood curdled. 

Me: (voice raising) I gave up driving years ago.  That’s why I was walking when the car hit me.  The man who hit me – is he uninsured? Are you telling me this after a year and 2 months?

He:  (whispering) He is insured but only for $100,000.  The insurance is willing to give the whole thing nothing more. 

Me: What are the options?

He:  (whispering) One, If you have uninsured motorist insurance we can go after your insurance for additional money.  Two, we go to court but our split becomes 60%-40%.  I’ll spend money the opposing party will spend money.  Then it’s up to the jury.

I knew no jury would feel sorry for me unless I was all bandaged up and carried into the courtroom by two burly men.  Or shuffle into the courtroom with great difficulty on crutches.  But I was hit on the shoulders not the legs.   

Me:  How about the medical bills?

Him:  I’ll negotiate them down.  Way down.

According to Atty Google, on contingency cases, lawyers do negotiate medical bills down.  Insurance companies don’t want to take chances.  Certainly, 10% of something right away looks better than 100% of nothing any time.

Me:  When will I get the check?

He: (obviously with a smile) Tomorrow!

Wow that soon! 

I think, what happened was, O’Dear didn’t investigate early on the driver’s insurance details.  Had I known, I would have stopped after the first MRI.  He was probably scared I’d sue him for negligence. 

A couple of days later I received the check and signed the release papers.

It’s over now.  My left shoulder has no pain.  There’s mulla that wasn’t there before.  Still, I’d rather that the accident never happened. The settlement couldn’t have been better and the alternative definitely would have been disastrous.  

Live.  Learn.  Laugh.  

Happy dance!!

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Revisiting the Podiatrist

 

Since our first meeting, I have been seeing my podiatrist Dr Paa every 3 weeks to have him sculpt the two stubborn calluses near my big toe.  My pesky bunion causes the regular medical visit, which is mutually beneficial.  The benefit for me: I save myself from back strain when I don’t have to bring my face down to my right foot; or from cramp when I don’t have to bring my right foot up to my face.  In addition, my good compadre Medicare pays for the procedure.  The benefit for Dr Paa:  He has a commanding view of my foot from his armchair and in less than half a minute, he completes a lucrative billable job.  Plus, if he happens to be one of the 60% of the podiatrists who, according to my unreliable sources, have a kinky thing for big toes,  he also gets some jollies.  So every 3 weeks, Dr Paa and I go through the same routine, which is swift, in and out under 10 minutes.  Done deal.  We part, both happy.

In my latest visit, however, nothing was routine.  A soon as I entered Dr Paa’s office, I announced with a broad grin, Do I have a new job for you!  And what is that? he asked.  I answered, Ingrown big toe nail!  His eyes glistened with excitement:  That’s my specialty!  I muttered to myself, You don’t say! Could there be truth to the 60% rumor?

Prior to that visit, the only clue I had about ingrown toenails was from years ago when an employee of mine told me about an ingrown toenail for which she had to get emergency treatment that past weekend.  I feigned sympathy but in the back of my head, she was just distracting me.  Now after experiencing an ingrown toenail myself, I can safely say it is very painful indeed especially if it’s infected.  Even the the weight of a bed sheet feels like a ton of bricks bearing on the poor toe.  I secretly apologize to my unsuspecting ex-employee for my having been a cold-heart, inconsiderate, but otherwise wonderful and awesome human being.  I feel better now.

Back to Dr Paa.  He studied my right foot on his low working table, his eyes focused on the big toe.  On the table was a small canister of freezing spray, a special longer-than-usual shiny toenail clipper, a bottle of antibiotic, and a couple of individually wrapped band-aids.  When he aimed the the spray on my big toe, I commented, That was infected yesterday but I took care of it.  He seemed annoyed, as if I had encroached on a  possession of his.  How did you do that? He looked at me eyeball to eyeball.  I replied, I followed Dr Google’s advice to soak my foot in warm water with vinegar.  He lightened up.  Yes, he agreed.  That will draw out the infection.  I felt better, remembering the ball of dried pus that had emerged from the affected nail in the morning.

Snip. Went the clipper.  In a few seconds, the whole procedure was over.  My big toe felt relieved of painful pressure.   Dr Paa went short of beating his chest proudly for his accomplishment.  I gave him more reason to be proud.  I asked him why I was having ingrown toenails, something I had never had before.  Blame the aging process, he suggested.  Nail becomes harder, skin gets thinner, yada, yada.  I know, I assured him, who’s no spring chicken himself.  Aging is not for amateurs.  

Two weeks later I was back again in front for the same procedure on the other side of the right big toe.  After the successful operation, he quipped, How about that! You have two problems and they were on the same big toe.   I guess I was supposed to celebrate the circumstance.

I was so pleased with Dr Paa’s work that I went on and phoned my Son the Sculptor and shared my experience.  I told him he should not have to suffer from the pain of ingrown big toe nail.  Go straight to a podiatrist, I advised.  That’s what podiatrists do.  At the end, I asked, Have you ever had ingrown big toe nail?  Yes, he answered, when I was a teenager.  Really? What happened? I asked in quick succession.  He answered, You did surgery on it.  OMG! I couldn’t remember that event but knowing me, it was quite conceivable that I did it.  Noticing my big silence, he pushed some more: Blood all over! Then I knew he was putting me me on, trying to get even with me.  I had told him years ago how lucky he was.  I suffered from postpartum depression  after he was born and could have put him in the microwave oven. 

Happy dance, Happy Toes!

 

 

 

CT Scan Results

The day after CT Scan Day was anti-climactic. I thought it’d be a week before I’d find out the results so I began drafting two masterpiece blog posts in my smart phone:  A, if all’s clear; and B, if something is new an/or something grew.  It was tough.  I did not want to sound too triumphant if A and too hacked off or too cool if B.  I was carefully tiptoeing the lines.   I fancy myself as the prima ballerina of the written word.  Imagining myself an awesome dancer is the best I can do after failing miserably in my youth while prancing between two bamboo poles of the Philippine dance called “tinikling.

Suddenly my cell phone beeped a text notification.  It was from Onc Dr Smiley’s office!  It said your health record has new medical terms.  My interpretation: The CT scan report is available at the Patient Portal and I can read all about it if I follow the link.  Before I could drill on the link, the cell phone rang.  The caller ID indicated Dr Smiley’s office.  I thought, Wow.  There’s a sense of urgency.  I hope he’s not sending over an ambulance.  I need some time to put clothes on. 

I decided to answer the phone.  The caller identified herself as Dr Smiley’s nurse.  She said he had asked her to call me and give me the news:  everything stable, see you in 8 months.  

There we have it.  Tagrisso rocks!

 

CT Scan! CT Scan!

February 25, 2019 at the Imaging Center in South Orange County, California. Have you had a CT scan before? asked the 20-something Asian woman technician as she covered my legs with a warm blanket. It was probably the 23rd or the 25th time, I don’t remember which, I had to answer the question from the 23rd or the 25th different technician. There seems to be a quick turnover in that line of work. I imagine the technicians get bored.  If they only knew what the patients go through. And boredom is hardly it.  

My answer, of course, to her question was:  Yes, yes, I’ve had tons of CT scans over the last 7 years and I blurted out a thunderous laugh.  I enjoy startling upwardly mobile employees.  They are so vulnerable, especially to a very relaxed me.  Hey, there’s no tension when there’s pension.  That’s the mantra in our retirement resort.

As Techie jabbed the needle into my wrist vein where the dye contrast fluid would enter and give me the warm feeling of wanting to go potty,  I recounted to her my very first CT scan, the one that led to the discovery of the 3cm x 3cm x 2cm malignant tumor on the lower lobe of my left lung.  How can I ever forget the measurements?  If the third dimension had been 3cm instead of 2,  the tumor would have been perfect, like the dice on the crap table.  I told her about the misgivings I had before, during, and after the CT scan and all the way to the fateful reading of findings with my Physician’s Assistant (PA) who had ordered the CT scan.  Days later, my very first oncologist gave me the 8-months-to live prognosis.  It was August 2012.  Yes, I confess.  I did experience scanxiety.  Big time.

I consider it my solemn responsibility to gauge a technician’s suitability for a kind of work that she would do through her adult life.  I noticed Techie was awfully quiet.  She had a faraway look in her eyes.  She probably regretted ever asking me the question. Any question.  The only answer she expected to hear was probably a cursory yes or no.   Or she had thoughts of chicken drumsticks barbecuing, dancing in her head.

Time came for Techie’s final instructions before my horizontal trip through the CT scan machine tunnel.  First, I had to shut up.  Soon the CT scan motion started.  As my body was traveling slowly through the CT scan contraption, my mind took me to the second  CT scan –  the one taken after 100 days of treatment by the drug Tarceva in various dosages.  Yes, various doses but please don’t follow my example of messing with dosages.  Talk to your onc.  I’m a dangerous role model.  

I recalled no anxiety on that second CT scan, only curiosity.  I guess at that point, I was resigned to the proposition that in the approaching April 2013 – the 8th month in the prognosis –  I’d be joining Whitney Houston and Dick Clark in the rowdy section inside the Pearly Gates. 

Whew! Got the unforgettable drama out from my chest.  Thank you for reading up to this point.  Now we move on to the result of the latest CT scan, which produced zero scanxiety like all the others beyond the maiden one. 

I must say that one week before the CT scan at hand, one-man-band-onc Dr Smiley instructed me to take a blood test to check my CEA numbers prior to my physical examinations.  I asked him, Do those numbers really mean anything?  Yes! He assured me.  They sure do.  I did not argue with him because I was clueless about CEA numbers.  In my past life I was a professional civil engineer who designed sewers, making sure they flowed downhill.  So I asked Dr Google what CEA stands for.  My knowledgeable  colleague answered: CEA (CarcinoEmbryonic Antigen) is a protein found in many types of cells but associated with tumors and the developing fetus.  The main use of CEA is as a tumor marker.  Lung cancer is among the common cancers that elevate CEA.  If the CEA is high before treatment, it should fall to normal after successful therapy.  He would have gone on and on but he noticed that I was beginning to nod.  He surmised I got the drift already.

During the physical examinations, Dr Smiley informed me the blood test results showed my CEA numbers are normal.  Then he went through his routine motions.  In search for swollen lymph nodes, he kneaded my neck, jabbed his fingers into my armpits, and massaged my belly in all directions.  Everything is good, the good doctor said.  Now we’ll see what the CT scan next week will reveal.

The next week that Dr Smiley referred to is now.   I’ve just dressed up after that CT scan and ready for my cabbie to pick me up and drive me home.   I’ll post the result as soon as I have it.

Meanwhile, ask me any questions.  I might have the answer.  Otherwise I’ll get it for you.

Hair Loss

It’s All on the Head

When it seemed like I was already carefree – lung cancer stable, bladder unremarkable, bunion under control – I got this wild-haired notion to grow my hair and recapture my long-lost youth. Time came when the hair was long enough to be pulled away from my face and neck and fashioned into a tiny Asian bun. I got all excited! I made a mad dash to the dollar store and bought the smallest black banana clip that matched my dyed ebony hair. The project was going great guns! Or so I thought.

One day while towel drying my hair after a shower, I noticed a clump of tresses on my fingertips. The same thing happened in the days that followed. I was aghast. I had visions of my head becoming as smooth and as shiny as a billiard ball.

True to character, I immediately blamed my falling hair to cancer. Of course, what else would I blame? Cancer has always been my go-to guy in the blame game.

Tarceva came to mind. When I was on Tarceva 7 years ago, that wonder drug devoured 80% of the malignant tumor in the bottom of my left lung within 100 days. Awesome! But it’s side effect transformed my hair into the equivalent of steel wool. I formed a theory about the situation at hand: Maybe Tarceva’s bad effect on my hair is now in the roots. I agree, the theory is rather farfetched. Tagrisso came next. Could the hair loss be a side effect of Tagrisso and is just now manifesting itself after 2 years? Hey, the hyperglycemia side effect of the clinical trial drug CO-1686 showed up on me after 4 months. Okay, 24 months is a stretch. Unconvinced by the theories of the blame game, I dug deep into my memory bank.

The hairy experience brought back hair loss memories from my late husband Tom, the first in the widowhood series. Baldness ran among the males in Tom’s family. His youngest brother’s head became as smooth and as shiny as a bowling bowl shortly after age 20, according to my late mother-in-law, who had a proclivity for high drama. Tom, proud of his head full of dishwater blond hair at 40, thought he had already beaten the baldness odds so when he noticed substantial strands of hair caught on his comb, he immediately saw his primary care physician, who in turn, referred him to a specialist. The specialist curled his eyebrows and nodded slowly as he indulged Tom’s recitation of his hair loss blues. Then came the specialist’s turn to speak. He gave Tom the name of the hair loss malady, the Greek word “Alopekia.” Bald-headed Jesus! Exclaimed Tom, an irreverent ex-seminarian. What does that word mean? The good specialist doctor deadpanned and said, It means you’re losing your hair.

The memory of Tom’s hair loss diagnosis failed to satisfy my curiosity so I visited my alma mater Google University to find more authoritative pronouncements. Sure enough! All sorts of hair loss information from causes to prevention to state-of-the-art treatment popped up. Now we are talking! I selected a couple of sensible informational items on preventing or treating hair loss. Here they are:

LASER COMBS. I had never heard of laser combs but they are state of the art. In fact the laser comb is the only hair loss treatment to have received Food and Drug Administration (FDA) approval. A study found a significant increase in hair density in men after 26 weeks of applying a laser comb across the scalp 3 times a week. Something about the antioxidant effect of the laser on hair follicles make the improvement happen.

I rushed to the online stores to check the laser combs out. I found they are shaped like headbands and cost anywhere from $300 to $1000. What hair-raising prices! The ad photographs show men and women modelling the laser combs.

AVOID HAIRSTYLES THAT PULL THE HAIR AWAY FROM THE FACE. Say what? That was exactly what I wanted to do – pull my hair away from my face – to gently erase the fine wrinkles on my face. Which brings back another set of hair memories. When I was around 4 or 5 years old, I disliked combing my hair for no special reason except that I was able to have things my way. One day my grandmother caught me, doused coconut oil on my scalp, untangled my hair, pulled them in a pony tail, and tied it with a strip of rag. It was so tight it took me a while to blink my eyes. Henceforth my grandmother and I switched to the staring mode.

I have begun the long-hair project abandonment. I’ll just keep the fine hair short and loose and let it all hang out.

Happy dance!