Curve ball!

The plan yesterday was just to go in and make a decision about what treatment option I'd follow, once we'd received the last of the test results. Connie came with me, which immediately put the consultant at ease. (Why should him being at ease matter, you ask. Well, would YOU want your cancer surgeon to be nervous and uncomfortable around you?)

We hunkered down in the little chairs across from his desk, me fully expecting him to tell me that the cancer was everywhere, that the pain in my chest was a sign that I was doomeddoomed, and in fact I really shouldn't go back to school now because I may pop my clogs at any second. Plan for the worst, I reckon.
(There is a certain perversity and truth here- whenever I think all will be well, something seems to be waiting around a corner to kick me in the shin. My knee op, for example: I reckoned I was just going in to get some cartilage removed, and they informed me I've got the knees of a 65 year old. Well she can bloody well have them back, I don't want them! No more impact sports, no more trekking, knee replacements within ten years... And there I was thinking I'd be running again in a couple weeks. More fool, me.)

But you don't care about that: where was I? Ah, yes. Doomeddoomed.

So he starts by saying that it hasn't metastasised. Oh? Great! It isn't in my lungs or liver or heart- which is fabulous.

So the next step is...?

Dr- However,  we noticed something about your uterus.
P- Eerrrr, riiiiiight. What did you notice?
Dr- The lining seems to be very thick.
P- And it isn't supposed to be?

He then asks a whole series of questions that would, if he were speaking to me in a bar, have got him popped in the nose, and tells me that I need to see the gynecologist for another ultrasound before we decide what the next step will be. He once again outlines those possible next steps, and indicates that whichever treatment I choose, the main part of it will last six months. He tells me that my cancer has responded positively to the hormones they had tested out on it- aw, isn't that lovely- and that means that they will be using hepceptin as part of the therapy. He may have said 'pepceptin', of course. His English is pretty good, but his accent is still strong. And he may still think that I am Russian.
He also said that they will be inducing the menopause. I was not happy about that.

Connie: But that's all part of the treatment.
P: But I'm going to be working with your team, Connie, and I am going to be a heinous COW during the menopause.
Connie: (eye roll)

I asked about how severe the side effects of the chemo are likely to be. I want to be well enough to go into work whenever possible, and after conversation with my friend and former colleague Deb, remembered that she'd been able to come back to school occasionally and had become hopeful. The doctor eyed me up speculatively:

Dr- You seem like the sort that will be ok. Let me ask, though: you have a child?
P- Yes, a 17 year old.
Dr- Did you suffer from morning sickness when you were pregnant with her?

Now, let me exit the dialogue for a second, here. 'Suffer' is too small a word. It is woefully inadequate. It is so feeble when it comes to describing just how very sick I was when I was pregnant that I am generally forced to ring bells and bang drums and wave my arms around when I describe it just to make sure that the gravity of my morning sickness is understood fully. I knew every pullover spot on the 25 mile journey down the A140 between Norwich and Diss so well that I could have found them blindfolded. My students were so used to me bolting from the room, green-faced, that they barely looked up from their desks with an 'Oh, are you back then, Miss?' on my return. I had blood vessels burst in my eyes from the force of my retching, gentle readers. I started being ill at six weeks, and did not stop fully until week 37.

P- Yes.

Dr- Ah. No, then, you are going to have a bad time.
P- Bugger.

While I didn't fully understand the correlation between my morning sickness and my likely response to the chemo, I knew that I was able to work while I was pregnant. It just wasn't much fun. I was now expecting severe sickness, strange milk cravings, and an aversion to the soup aisle at the supermarket. I was hoping to avoid the indigestion, bloating, and stretch marks that make my hips look like a relief map of Africa. Connie clarified that the two were not going to be the SAME, just that my illness during pregnancy was an indicator that my body was not likely to respond... gently, shall we say, to the chemo.

So, all this being dispensed with, and an instruction to see the gynecologist and then let Dr Cho know the path forward, I let Connie help me with registering at the desk, and waved her off back to work.

And then I waited in the crowded reception room (Why do so many Korean women get cancer?) in the stifling heat (Why can't they turn on the air conditioning?) on the plastic covered chair (Why did I wear jeans that will show the sweat when I stand up?) for about an hour.

Now, this is the time for the reader warnings. I do not especially like graphic descriptions of medical procedures, especially those related to women's parts, but in the interest of a good story, I plan to proceed into the gynecologist's office with you in tow. If you would rather turn away and not follow, this is the time to depart. You have been warned.

The consultant, another man, was slight and angular with glasses resting halfway down his nose as he peered at me over the top of them. He asked me a few cursory questions about previous operations, most of which I answered badly- I need some time to remember these things, so inevitably recall something long after the conversation has moved on: 'Oh, yes, hang on- there was the frontal lobotomy in 1976!' (That never happened. I wrote it for effect) He then directed me around the curtain for disrobing and flowery cotton skirt putting-on. I do not want to think about how many other people had been wearing that skirt.

He was kinder than many men who have examined my wotsits. He at least apologised for the discomfort he was about to cause. I have had some examinations where the doctor has dashed in, had a good root around, and then run from the room without any conversation at all. On one such occasion, about 19 years ago, the nurse walked in afterwards to find me sitting on the edge of the bed, visibly shaken:
Nurse: What's the matter, love?
P: Who was that man?
Nurse: You mean the doctor?
P: Oh, he was the doctor?? He never said...
Nurse: (tight-lipped) Just excuse me one moment...

Several minutes and a few raised voices later, the man came back and sheepishly introduced himself.

So, even though this consultant technically never told me his name, he was positively polite by many standards.
He performed a physical examination first, and then reached for the camera. Please - PLEASE- imagine this like a light saber. It was not precisely like a light saber- it looked much more like an implement one would generally find in a naughty shop and about which I should have absolutely no knowledge, so it is much better if you imagine it like a light saber. He wielded it like one, of that I am sure. It swooped and swung around in there as if he were gripped in an epic space battle.

VVVVV! Swoop.
VVVVVVV! Swish.
'Ah, the force is strong in this one...'
Yes, go ahead and indulge yourself in that image. It is not wholly inaccurate.

I was allowed then to reassemble my dignity before sitting back down across from him. In the tradition of Korean medical practitioners, he was direct:

Dr- You have a seven centimetre tumour on your uterus.
P- Bugger.

He then qualified the whole thing by saying that it had appeared on the PET CT scan because of the radiation, which is what got their attention and meant that it could be cancerous. I was not taking chances with conditionals any more, having learned my lesson with the other doctor:

P- What do you mean, 'could'?
He replied that it has a one in four chance. I actually sighed with relief.
Dr- (confused) But that is not good news, really.
P- Honey, the other one IS cancer. This one has a 75% chance of NOT being cancer. That is actually good news after my last two weeks.

Good news or not, he says it must come out. Not prepared to mess around with biopsy nonsense, he wants to take the whole thing out. When I say the whole thing, I mean the whole uterus. In addition to the chemo and the operation on my breast, he wants to do a hysterectomy. 

P: Bugger.