Gross Anatomy

So it turns out when you have cancer for the second time, are recovering from a mastectomy, getting used to a partially filled expander wedged between layers of your pectoralis muscle, injecting yourself with three fertility medications a night, you are so bloated you can't button, let alone zip, your jeans or bend over comfortably without risk of ovarian torsion, and your estradiol level is 1,715 pg/mL, that from time to time, you may not feel like yourself, let's say you might even feel irritable. 

Yesterday when this wave of irritability engulfed me, David said I had every right to feel that way and then suggested that I break something. 

I replied, "I already broke our glass pitcher last night when I was trying to do the dishes!"

He responded, "I don't think breaking something by accident yesterday really counts."

Instead I did aggressive one-armed yard work that did not involve bending over.  I squatted to pick up stuffed innards of destroyed dog toys and plucked every dead leaf off every rose bush and vegetable plant in our yard. 

The wave of irritability washed away and I went back to just feeling bloated with a sore chest, meaning feeling quite excellent.  Over the past two weeks I decided to set a new baseline for my body.  Otherwise you just classify yourself as feeling not good everyday and that is depressing and also, quite dull.



This is a big week. 

David is going back to full time work after his summer break from Vocational Skills Tutoring at Santa Rosa Junior College for young adults with intellectual disabilities.  He has been teaching the summer cross country course for the past couple weeks but now he is going back to doing both jobs at the same time.   Our original plan for our mutual summer break was to rent a small RV and drive up to Canada with our dogs.  Obviously this didn't happen but we made the best of it and managed to have lots of laughs during this ordeal.  There is entertainment everywhere.  David has been skilled at always helping me see it, or in many cases, making the entertainment.  Thanks David.

Today, the UCSF breast tumor board is meeting to discuss my case and come to a collective recommendation about the rest of my cancer treatment.  I thought about whether or not I should attend to listen in, a privilege often offered to doctor-patients, but I decided not to.  I want them to be frank with eachother.  For the non-medical foks reading this: see the picture to the right to see what a tumor board meeting looks like.  I recall as a medical student having no idea what the heck a tumor board was when I was told to show up at one and do a 20 minute patient presentation in front of 15 doctors who are national experts in their field during my first week of clinical rotations.  Although at the time I was less than pleased with the task I was assigned, tumor boards are actually a fantastic enterprise.  Cancer pathologists (doctors who looks at tissue samples and cells under the microscope and actually diagnose and describe the qualities of the cancer) and a whole team of medical, surgical, and radiation oncologists meet and review all imaging, tissue slides, and the medical history of a patient with a complex cancer situation.  They discuss various treatment options in detail and come to a consensus.  I am grateful they are providing me with this service and am curious what they will recommend.  One part of my treatment, shutting down my ovaries and taking anti-estrogen treatment for a total of five years, is a slam dunk.  However I anticipate that another aspect of my treatment, traditional chemotherapy or not, and if so, what agents and for how long, is going to be controversial and a heated discussion. 

Tuesday morning I get my eggs harvested at UCSF.  The other medical term for this procedure is "egg retrieval," which I dislike because it infers the eggs are not actually mine.  I am sticking with "egg harvest" for now but Lynne and I are brainstorming a better term.  Please email with suggestions. 

Wednesday morning I will meet with my UCSF medical oncologist to hear what transpired at Monday's tumor board meeting.

Per WI Katie's recommendation, after this double whammy, I will reward myself by seeing the new Will Ferrell movie, The Campaign.  I would rather go on a vacation to Bali, but the whole egg harvest thing was pricey, even with the UCSF cancer discount.  Will Ferrell is a close second.  He is reliably hilarious.  Bali will have to wait.

A final note:
I have the best friends, family, and colleagues in the world.  Thanks for your emails, cards, meals, thoughtful gifts and unending love and healing energy you have sent my way.  You continue to make a big difference in my well-being.  Thank you!