It's the Little Things

I know that I've told you about post-surgical drains. And about sponge baths necessitated by the prohibition against showering for several days after surgery.

But I don't think I've mentioned one of the other indignities that goes along with surgery—at least with surgery in the general vicinity of one's armpit: no shaving and no deodorant.

Let me say right up front that I realize that some people prefer not to shave or wear deodorant, and that is fine (provided they don't straphang next to me on the subway in, say, mid-August). If you prefer the natural state—unshorn and otherwise unmediated—that's just great. You have my full support.

I, on the other hand, prefer the hairless, fresh-smelling—one might say inconspicuous—variety of underarm, and that means I've been suffering with the other kind—on the left side, anyway—for quite some time. My first surgery (this time around) was December 14. Today is February 28. By my count, that's 76 consecutive days of averting both my eyes and nose.

It therefore gives me great pleasure to report that there will not be a Day 77.

I saw my fantabulous surgeon today and got the green light to return my much maligned left armpit to its former glory. A little axillary makeover is now on the agenda for tomorrow.

And there was much rejoicing in Knowerville.

For Those Keeping Score at Home

I spent the day going through stacks of medical bills and EOBs (aka "explanations of benefits," aka insurance statements), trying to figure out what we owe, what we need to submit for reimbursement, etc.

I had to make a spreadsheet just to keep it all straight.

So far (with lots of treatment and office visits yet to come), the grand total of medical expenses for both cancer treatment and IVF—billed either to us or directly to our insurance providers—is $53,178.52.

Gulp.

I've still got a lot to do before I can figure out how much of that is coming out of our pockets. Meanwhile, it's already clear that I need to go through the statements with the diligence of a forensic accountant to make sure the bills are getting processed properly. For instance, there are three separate statements for "allergy testing," which I've never had. One of them is from a provider I've never been to.

There's also a statement showing that a claim for acupuncture was rejected because I didn't have a referral. It's true that I didn't have a referral. I also never had acupuncture.

I'm sure the fun is just beginning.

That's More Like It

I've stopped sneezing.

My tissue usage has dropped precipitously.

I haven't taken any Tylenol in the last two days.

In short, I feel fine.

Good, even.

So good that Zach and I went to the movies last night and then out for a bite to eat. And today I met a few classmates (hi, Danielle and Emily and Shira!) for brunch in the Village.

My stupid canker sore is pretty much gone, and my digestive system is back in whack. I am eating with abandon. (Well, with as much abandon as a super-picky eater can ever muster.)

I've got four more days to go before Chemo #2, and I plan to make the most of them. This is, after all, Week 3 (aka "the good week"). This is the week I'm supposed to generally feel fabulous [insert obvious caveats here].

And, in fact, I do.

Just thought you should know.

Why Egg-retrieval Day Is Like a Spa Day (Sort Of)

Spa Day: You arrive, check in with a very friendly woman at the front desk, and are given a little goody bag (a bottle of water, a pair of disposable flip flops, possibly a robe) and a plastic bracelet.

Egg-retrieval Day: You arrive, check in with a very friendly woman at the front desk, and are given a little goody bag (drawstring pajama bottoms, a gown, and a robe—all in coordinated cotton patterns—and a pair of disposable socks) and a hospital bracelet.

Spa Day: You get your own locker for the day. (The key is on the plastic bracelet.)

Egg-retrieval Day: You get your own dressing room. (But no key.)

Spa Day: You change into your robe and wait in a very pleasant waiting room with all of the other robe-clad women until your masseuse/facialist/reflexologist/wrap specialist calls your name.

Egg-retrieval Day: You change into your pajama bottoms, gown, and robe and wait in a very pleasant waiting room with all of the other pajama-bottom/gown/robe-clad women and all of their husbands/partners/sperm donors (until the husbands/partners/sperm donors are summoned to the Room of Porn).

Spa Day: The waiting room has excellent magazines, ice water with lemon slices, and various semi-healthy snacks.

Egg-retrieval Day: The waiting room has excellent magazines and vending machines not too far away for the husbands/partners/sperm donors who are allowed to eat and drink (you, of course, have been fasting since midnight).

Spa Day: Your masseuse/facialist/reflexologist/wrap specialist retrieves you from the waiting room and escorts you to a monochromatic room. At the center is a raised table with a pillow and a white sheet or blanket.

Egg-retrieval Day: Your nurse retrieves you from the waiting room and escorts you to a monochromatic room. At the center is a raised table with a pillow and a white sheet or blanket. (And, um, a pair of stirrups suspended overhead.)

Spa Day: Your masseuse/facialist/reflexologist/wrap specialist has you slip off your robe and slide under the sheet or blanket. You close your eyes, relax, and possibly fall asleep while she starts your treatment.

Egg-retrieval Day: Your nurse has you slip off your robe and pajama bottoms and slide under the sheet or blanket (and, yes, put your feet in the stirrups). You close your eyes and fall asleep while the anesthesiologist starts your IV.

Spa Day: You wake up after your massage/facial/reflexology/wrap, put your robe back on, and go back to the waiting room or locker room feeling, perhaps, a little zonked. You have a glass of ice water with lemon slices to perk yourself up.

Egg-retrieval Day: You wake up—eventually—in the recovery room, feeling incredibly zonked. You have several juice boxes and many packets of Ritz crackers to perk yourself up while your husband/partner/sperm donor waits patiently for you to regain lucidity.

Spa Day: On the way out, you experience a moment of sticker shock when presented with the bill, which includes the extra minutes/masque/scrub you agreed to in your massage/facial/reflexology/wrap-induced stupor.

Egg-retrieval Day: Several weeks later, you experience many moments of sticker shock when, after receiving your credit-card statements (including charges for the hospital visit and doctors' fees), you receive several lab bills totaling $1,337.20.

See? I'm not completely crazy.

(Incompletely crazy, perhaps.)

Which Way the Wind Blows

To oversimplify things, here's the basic deal with chemo:

1. Day 1: I have treatment.


2. Remainder of Week 1: Most acute side effects hit.


3. Week 2: Most acute side effects pass, others may arise. White blood counts drop, putting me at risk for infections.


4. Week 3: White blood counts bounce back. I generally feel fabulous (relatively speaking), right in time to start all over again.

That was the pattern last time, anyway, and it's what I was told to expect this time around. Usually the first three-week cycle is a relatively good predictor for the ones to follow, with the caveat that some side effects—like fatigue—may be cumulative. And, of course, there are no guarantees. ("Past performance is not necessarily indicative of future results.")

So what do I mean by acute side effects? Nausea (no—hooray!), fatigue (yes), bad taste in my mouth (yes), fuzzy-headedness (in spades), tingling in my hands and feet (not so far, but it happened last time), hot flashes and other menopausal symptoms (ditto), muscle and joint pain (ditto), mouth sores (yes), digestive-tract issues (big time), hair loss (any day/week now), finger- and toenails that get soft or brittle or discolored or fall out (no), changes in appetite (yes), nosebleeds from dried-out nasal passages (two so far), and, well, there are probably others, but that's enough for now.

The side effects come and go, and it occurred to me the other day that they're a lot like weather fronts. One will blow in, stick around for a few days, and leave. Another will linger. A third will barely register. I'm trying to pay attention to them so I'll have some idea what to expect during the next three-week cycle, and the four after that.

The problem, of course, is that I can't predict anything this time around, so every day is a surprise.

Imagine, if you will, a world in which meteorologists didn't exist. You'd have no Weather Channel, no forecasts in the newspaper or on the radio or on TV, no Farmer's Almanac (and no Punxsutawney Phil) to guide you. You'd wake up in the morning and there might be two feet of snow on the ground, or it might be 60 degrees outside, or there might be a windstorm (all of these things happened here in New York last week). You wouldn't be able to plan in advance when to replace your roof, or wash your car, or head up to Vermont for a weekend of skiing. You wouldn't be able to organize a barbecue or a picnic or a camping trip ahead of time (OK, if you were hard-core, you'd probably plan the camping trip no matter what).

You wouldn't know when to finally put your winter clothes away and break out the shorts. You wouldn't know when to pull the storm windows out and put the screens in. You wouldn't even know whether to grab an umbrella as you walked out the door.

Maybe you are one of those carefree creatures who likes that kind of uncertainty. Maybe you thrive on not knowing what each day will bring. Maybe you are a genuine free spirit, perfectly attuned to the mysteries of the universe.

Maybe you and I have absolutely nothing in common.

Because I, on the other hand, crave order in my life. I like to know what to expect, and when to expect it. I like to make plans and hate to break them because something came up at the last minute. (This does not mean that I am a total control freak. I like to do things spur-of-the-moment. I can be spontaneous. I can play things by ear. Just not everything, all the time.)

So it's hard for me to live in a perpetual state of limbo, waiting to see how I feel each day—each hour, sometimes—before figuring out what I can do, where I can go, whom I can see. I hate having to append "depending on how I feel" to pretty much every sentence I utter or write. I hate the fact that my calendar—the old-fashioned, paper kind—is full of scribbled-out appointments and events. It drives me crazy that I can't buy tickets to the theater—or to a movie—with any degree of certainty that I'll be able to make it to—or through—the show.

Today, Zach and I were supposed to drive up to Phoenicia to meet with a contractor, check in on the house, and maybe sit by the fire and relax for a couple of hours. Just a day trip—nothing too ambitious. But I haven't been up there in almost two months, and I was looking forward to a little dose of serenity. And a pretty drive with great car tunes on the iPod. And a look at the space where our kitchen used to be (it's been ripped out to the studs). And maybe even a stop at Woodbury Commons to pick out new towels for our new purple bathroom. All very pedestrian, but incredibly appealing to me.

And then I woke up this morning with a cold. I was coughing earlier in the week, and yesterday I started sneezing. Today I'm congested, and my nose is running. Nothing life-threatening—nothing that would even have kept me home from work a year ago—but enough that I knew I had to call my doctor's office and check in. So I did.

Which is why I'm sitting here, on the couch, in my pajamas instead of showered and dressed and halfway to the Catskills, having one of those great car talks with Zach while one of his custom playlists keeps us company.

Rest, drink lots of fluids, and don't go too far—those are my orders. And Phoenicia is too far. So Zach is heading up alone, due back in time for dinner. And I will be communing with my couch (again), sitting by the TV instead of the fire.

In the grand scheme of things, it's not a big deal. The house isn't going anywhere, and we can make the trip together another day. The only question, as always, is when.

Gratuitous Bagel Post

Just want you to know that it isn't all cancer, all the time, 24/7 around here. Sometimes we like to forget about it for a while.

So, continuing my now-hallowed tradition of non-sequiturs in this blog, I thought I'd share with you the latest of my attempts at breadmaking.

Every few months I like to try to master new stuff in the kitchen. Last year I went through a grilled pizza phase and a cupcake phase. The year before that it was saganaki and homemade ice cream (not at the same time). I started in on breadmaking last summer, and have managed to pull off several baguettes, a couple of peasant loaves, and one batch of dinner rolls.

Today, I tried my hand at bagels. Something to make you all hungry if you're reading this Friday morning.



Brunch anyone?

Getting Ready

So I'm going to be bald. Again.

Yup.

Now that I have the first round of chemo behind me, I'm pretty much just waiting for my hair to fall out. Last time around, I was on a chemo drug that was highly predictable, and I was told that my hair would fall out 16 days after the first treatment. And it happened right on schedule, on that very day.

When I woke up that morning, there was a bunch of hair on my pillow—not a big clump, but dozens of individual hairs. Then, when I ran my fingers through my hair, long strands just came out.

It felt like a scene from a Stephen King novel or something—very creepy.

Not wanting to star in my own horror film, I decided to take control of the situation: I was going to beat baldness to the punch. So I went to see Dave, Zach's brilliant hair stylist (and mine ever since), and got a buzz-cut.

For a couple of days, I looked a lot like a Marine. (Minus the uniform. And the gun. And the six-pack abs.)

Every morning, I took long showers and shampooed my hair several times.

Lather. Rinse. Repeat. Repeat. Repeat.

Every time I rinsed, more hair would come out. But because it was already so short, it was much less traumatic. By the time it was all out a couple of days later, I was used to the idea.

This time around, the drugs aren't so predictable. My oncologist estimated that it would take 3-6 weeks for my hair to fall out, and that's a pretty broad range. I'm 12 days in at this point, so we could be talking about next week or another month from now.

Meanwhile, my hair was getting longer and longer, thicker and thicker. Why pay for a haircut, I thought, if it was all going to fall out anyway? But then I realized that if I didn't get it cut, the change would be especially dramatic, and maybe especially upsetting. (Ever since it first grew back in late 2001, I'd been keeping my hair pretty short. Now that I had put off a haircut for a couple of months, it was longer than it had been in years.)

So last week, I got it cut. Short. Very short. Very gamine. If you've seen a picture of Natalie Portman lately, you know what I mean.

I had had it this short for a long time, and it was kind of nice to go back to a familiar look. It had been my post-bald look, and I guess now it's my pre-bald look, too. For another 9-30 days, anyway. . . .

It's Official

I'm a drain on the economy.

Actually, I'm on medical leave. But "drain on the economy" has a much better ring to it, don't you think?

Can't wait to use it at cocktail parties.

In the meantime, I'm laying in a big supply of bon bons to keep me occupied during the coming months.

Oh, and I'm going to sign up for thumb-twiddling lessons.

(It's important to have something to fall back on.)

Home Alone

I have been left unsupervised.

Shhh.

Don't tell.

Actually, I'm not doing anything exciting at all.

Ordered in Chinese, watched some TV, went through the two-foot-high pile of mail.

Ran the dishwasher.

Fed the cats.

Thrilling, right?

Well, yeah.

'cause Zach is out of town.

He's down in Baltimore, having a little family reunion and seeing his mom in a show. And not, for the first night in something like 10 weeks, taking care of me.

I'm doing that all by myself.

And even though he is exceptional at it—much better than I am—it's good to know that he doesn't have to do it all the time.

(That autonomy thing works both ways, you see.)

Earth to Jody

Hello again.

Remember me?

Indefatigable over here?

The one with the big can-do attitude?

The one with the orange panties?

Wait.

I haven't told you about the orange panties, have I?

Digression

Last time around, toward the beginning of the whole I've-got-cancer-now-what? phase, I was getting dressed one day and happened to catch myself in the mirror. At that moment, all I had on was a pair of tangerine-colored bikini underwear. For some reason—no I can't explain it—this seemed to give me great fortitude. I got a steely look in my eye, stared myself down in the mirror, and said—very much out loud—"F*** you, cancer! I'm wearing orange panties!!!!"

Because, as everyone knows, cancer is easily scared off by sprightly undergarments.

(You knew that, right?)

Well, somehow this became my twisted little battle cry. And those orange panties became my talisman. I wore them to every round of chemo and to all of my big follow-up tests. Even if nobody else (besides Zach) knew about them, they somehow made a difference to me. And yes, I still have them. Wore them to chemo last Friday, in fact.

End of Digression

So anyway, here I am with my orange panties, thinking I can just do the whole I-have-cancer thing on the side, while I'm, you know, out there reporting and writing my stories and making my deadlines and graduating right on time.

Because I've got the orange panties, right? So what's two surgeries and IVF and physical therapy and a freaking port and a few sessions of chemo and 18-1/2 credits and, um, hourlong commutes back and forth to pretty much everything?

No problem. Under control. We're on it, my orange panties and I.

And until about two days ago, we were.

Then the truck hit me.

And by truck, of course, I mean the cumulative insanity of a single week in which we had egg-retrieval day (spa comparison still forthcoming), port-placement day, and first-chemo day. I am quite sure that by the end of the day on Friday, my body was the equivalent of a toxic-waste dump—it just took a few extra days for the various pollutants to make their full effects felt.

But after some initial shyness, boy did they put on a show. Great special effects and everything.

Total exhaustion? Check.

Drug-induced stupor? Check.

Complete personality transformation? Check.

It's a very good thing nobody gave me the keys to heavy machinery. Or asked me to do long division. Or gave me important papers to sign.

The term "not in my right mind" doesn't begin to describe it—I was just non-functional. Couldn't think straight and certainly couldn't speak intelligently.

It was similar to last time around—I felt like someone had stolen half my IQ points and WOULDN'T GIVE THEM BACK. I was impaired, and I knew that I was impaired, but I couldn't do anything about it. If you've ever tried to wake yourself from a dream but couldn't, you might have a small sense of what it was like.

And in the midst of all that fog, I had a very important moment of clarity. It happened sometime early Wednesday morning. I had gotten up around 6AM in order to make a 10AM deadline. I had 750 words to write, and I was starting from scratch.

Two hours later, my word count had maxed out at 13.

First it dawned on me that there was no way I could make my deadline. Then I had the moment of clarity.

I realized that it was just not possible for me to continue with school this semester and graduate on time, as I had hoped and planned.

(You probably just turned to yourself and said, "Duh." And you're right. Duh. But for whatever reason, this rather obvious conclusion managed to elude me all this time. So, yes, you were right all along. But I'm glad you let me figure it out for myself. It's this thing called autonomy, and it's really important.)

The funny thing is that, in the end, I really wasn't upset about it. I was relieved, in fact. Disappointed, of course, but mostly relieved.

So now I'm working out all of the details—talking to my professors and deciding whether to take a leave of absence or continue as a part-time student this semester. There is a lot to be figured out, and whatever I do is going to take some getting used to. But it's the right thing, and I'll be much better off in the end.

In fact, I'm much better off already.

Radio Silence.

We know. It's been quiet around here. Too quiet.

The fact is, the roof has been caving in. Literally. We had major leak in the top floor apartment during the snowstorm. It was dripping down the living room light fixture; which is, you know, bad.

So I got the roof shoveled off, then dried, and today had it repaired. The spring-like weather was a blessing, and the repair crew were sensational.

Totally bushed now, but pleased with the outcome.

More soon. Promise.

How I'm Feeling

Ancient.
Infirm.
Unable to concentrate.
Unable to get comfortable.
Unable to bathe without a chaperone.

Relieved.
Happy to have treatment underway.
Glad to have made it to class today.
Gladder to have made it home in one piece.

Weak.
Impatient.
Unable to write complete sentences.
Doubtful that I'll make tomorrow's deadline.
Astounded that I made today's.

Defiant.
Depressed.
Overwhelmed.
Hopeful.
Unrealistic.

Frustrated.
Overdue for a vacation.
Indebted to everyone.

Delinquent.
Muted.
Fuzzy-headed.
Overtired.
Uninspired.

Grateful.
Human.
Sub-human.
Semi-human.
Protozoan.

Unrecognizable.
Indefatigable.

All of the above.

Tougher day today

Was it the snow?

Was it the slog slog slog to get to physical therapy up at Sinai (which is four trains away, and a two-hour roundtrip)?

The pressures of the magazine class assignment?

"Coming down" from the steroids?

The chemo kicking in late? (Or perhaps I should say "early", since Jody's blood counts should theoretically drop next weekend, not now.)

Whatever it was, Jody was a bit of a wreck today. Worn thin, and nerves rattled and kinda zonked. Of course, the weather didn't help (did I mention the snow?); on the bright side, the rest of the week is supposed to be nicer.

Jodes worked intensely on schoolwork all morning and into the early afternoon. We had a late lunch together, and then headed to the Upper East Side so she could keep her appointment for rehab on her left axilla. This is the area under the armpit where her two surgeries were in December and January. The therapist is helping Jody improve her range of motion in her shoulder and also spends time massaging out some of the scar tissue that has accumulated.

Even before the appointment, Jody was flagging a bit. The commute up there was horrible, and the PT always takes something out of her. As her session was wrapping up, she was on fumes. We made a pit stop at her support group across the street just to revive a bit; that helped, as did ducking into Starbucks for a quick coffee (me) and chocolate milk (her). But by the time we'd made it back to Brooklyn, we were both just spent. We put our heads down for a quick nap, which turned into something longer. I snoozed for about 40 minutes; Jody was out for 2-1/2 hours. After a late dinner, she tried to work some more, but there was just no energy there. Around 11:00 she gave up and resolved to get up early to start fresh in the morning.

We'll have to wait to see whether this happens every time, or if it was just the culmination of a lot of factors today. To paraphrase what I said on Friday: we've been so driven for so long, kind of running at top speed, that we haven't had a chance to pull back; now that we're finally slackening the pace a bit, I think the last two months are catching up to us.

But that's to be expected, no? As I learned firsthand when my father was ill last year, there will be good days and bad days. Guaranteed. You just have to accept that as part of the package. Today pretty much sucked, but it could have been a lot worse.

And to quote Katy Scarlett O'Hara Hamilton Kennedy Butler, "Tomorrow is another day"...

Nineteen point five inches

That's the measurement in the depths of our backyard. Apparently this is the second heaviest snowfall in NYC's history, although I feel as though I've seen worse than this a few times.

(click the pic to see a larger version)

UPDATE: It's now the heaviest snowfall ever to hit NYC.

Just So You Know . . .

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They make our day, every day.

So thank you, thank you, thank you.

It Worked!

Other than opening my eyes a few fleeting times during the night, I slept straight through for seven whole hours and woke up feeling pretty damn good.

Of course, I'm due for another dose of steroids in about an hour. . . .

The snow is still coming down, and it's really peaceful—the only sound I hear right now is Zach's shovel on the sidewalk outside. I've got plenty of work to do (still hoping to graduate on time if at all possible), the Olympics are on, and Zach has stocked up on lots of good food, starting with the makings of homemade cornmeal pancakes and bacon for a hearty Sunday breakfast.

Should be a good day.

The Day After

Author's Note: All times approximate based on my drug-induced recollections. This is not A Million Little Pieces. I don't just make stuff up. I do, however, employ very obvious pseudonyms (try finding My Fantabulous Surgeon in the white pages) and the occasional hyperbole because THAT'S HOW I TALK.

OK, end of James Frey-induced rant.

12:30AM: Go to bed after having taken appropriate medications and drinking equivalent of eight glasses of water. (Chemo acts on its targets very quickly, but you don't really want it hanging around after that, so you've got to flush the stuff out of your system as soon as possible. Warning—do not read rest of parenthetical if easily grossed out: Back in 2001, I was on a very potent, very toxic chemo drug called Adriamycin that is bright orangey-red in color. Aside from killing cancer cells and making your hair fall out, guess what it does? Causes you to pee in TECHNICOLOR ORANGE. The down side was that it was really freaky to pee in technicolor. The up side was that it was easy to tell when the stuff was out of my system. By then I'd drunk so much water that I was peeing absolutely clear. OK, end of gross-out.)

Still feeling good despite midly bad taste in mouth and tiniest of headaches. Had a good appetite for dinner and a yummy dessert. (If it's Girl Scout cookie-time near you, I highly recommend a couple of crushed frozen Thin Mints atop Ben & Jerry's Organic Vanilla ice cream. To quote my friend Dan (hi, Dan!): de-lish!)

4:00AM: Wake up. Pee. (That was eight glasses of water, remember?) Try to fall back asleep. Fail.

(One of my appropriate medications is a steroid that prevents allergic reactions and swelling but also has several undesirable side effects—sleeplessness, to name one. Plus I had taken a nearly five-hour-long Benadryl-induced nap during treatment. The Benadryl also prevents allergic reactions. And, as you may remember from the egg-retrieval day, I am highly drug-sensitive. So glad I brought all that reading material along with me yesterday. )

4:35AM: Give up on sleep. Move to couch. (We live in a studio, so this basically means walking around the bed to the designated "living room area." Work on laptop in the dark. Try not to wake Zach (a mere seven paces away).

6:00AM: Try to decide whether I'm nauseated or not. (I am sparing you a pedantic discussion of the difference between nauseous and nauseated. No need to thank me.) Doesn't seem like a tough call, but lack of sleep always makes me feel a little sick to my stomach when I first wake up, and then it passes within about an hour. Am due to take anti-nausea drug #1 sometime this morning (and again tomorrow morning), so I decide to take it now. Anti-nausea drug #2 remains on deck. Pee again.

6:10AM: Go back to bed. Wish I could curl up on one side or the other, but no dice. Still sore from surgery on the left and from new titanium accoutrement on the right (even without all the IV tubing). Lie on back, thinking of Gregor Samsa. Fall asleep.

7:30AM: Wide awake. Pee again, then move back to couch. Still can't tell if I'm nauseated. This really shouldn't be that hard. Try drinking some water and eating a few Ritz crackers. Feed the cats before they start meowing incessantly. (Zach still blissfully asleep.)

8:00AM: Cell phone vibrates back on my side of bed. A doctor, perhaps? Someone from the cancer center calling to make sure I'm OK? No. A wrong number.

Zach now awake.

8:30AM: I decide that hunger and nausea probably can't co-exist. I try my luck with a bowl of cereal and a banana. So far, so good.

We start hearing a weird noise emanating from the basement.

Please do NOT let it be the boiler. (There is a blizzard forecast for tonight.)

Zach investigates and confirms that it is the boiler. We give thanks for our 24/7 service contract.

(It's not the first time a major snowstorm inspired the boiler to give out. In fact, the last time it happened like this: We stay up late on a Friday, prepping for our holiday party the next night. Blizzard begins. Zach wakes up in the middle of the night in excruciating abdominal pain. I call 911 for the first time in my life. Ambulance comes. We ride to the hospital in the snow. We cancel party. I come home 14 hours later. Zach stays another three days and eventually has to have surgery a few months later. Blizzard continues. I shovel snow and spread salt. I freeze party food. Boiler dies. I'm so cold and tired I don't notice until the next day. Other boilers all over town die in solidarity. Service calls backed up almost 24 hours. I call a car service and go to Home Depot at 10PM on a Sunday and buy three space heaters—one for each apartment—as back-up. Boiler is fixed Monday morning. Space heaters save the day—um, night—until then.)

We put in a service call. The weird noise gets weirder and louder. Zach shuts off the boiler.

10:00AM: Service guy arrives, checks out boiler, needs a part. Promises to return.

Still not sure if I'm nauseated. Still hungry. Still have a minor headache. Still awake.

10:22AM: Doorbell rings. Service guy returns!

10:30AM: Zach makes me a yummy breakfast smoothie. I take my morning dose of steroids (guaranteed to keep me awake and hungry).

11:00AM: Boiler is fixed! I am back to work on a story due on Wednesday (impressed, aren't you?). I am even planning a fun pre-blizzard interview this afternoon. Hurrah! Now if I can only will myself back to sleep for a nap in between. . . .

1:30PM: No nap, but lots of good interview prep. Zach is making me a sandwich so I can have a picnic lunch in the car en route to the interview.

5:00PM: Back from fun interview, still feeling good. Snow has been falling for about an hour and is beginning to stick. Two close college pals are on their way into town—one from LA, the other from PA—and I'll get to see them tonight. Between the snow and the chemo, it looked likely that we'd have to cancel, but we've managed to salvage our plans. We're bagging dinner at a fancy restaurant downtown and are relocating the festivities to far-from-fancy Brooklyn.

12:30AM: Back from yummy dinner at Thai restaurant with Zach, college pals (hi, Linda and Lisa!), and upstairs neighbor (hi, Bill!), followed by yummy dessert and vociferous political debate at nearby Italian panini restaurant. It's the first normal Saturday night that Zach and I can remember having in two months. Good friends, good food, atmospheric snowfall, an excuse to enjoy our neighborhood—what else could we need?

I'm still feeling good and hope that I have worn myself out enough to overcome the steroids (second dose taken five hours ago) and sleep through the night. If not, there's Benadryl in the house. . . .

Day One

Chemotherapy # 1 was today. It went really well.

Four years ago, when Jody endured nearly six months of chemo (Adriamycin, Cytoxan and Taxol, administered intravenously over the course of 5-6 hours every three weeks, for a total of 8 sessions), she escaped relatively unscathed. She lost her hair, and she had some neuropathy (tingling in the extremities); she also usually had a little fatigue the weekend after the treatment. But given the horrors we'd imagined, it was really quite manageable.

So this time around, we haven't been too fazed by the looming prospect of chemo. Between the two surgeries, the ten thousand doctors' consultations and the IVF circus, we've had enough on our plate. Chemo was the one semi-known quantity. It's just been hovering quietly out there on the horizon—a small speck, growing imperceptibly over the weeks, and whoops! you turn around and it's at the door. C-Day. Day One.

We've had our sights set on this day for a while, almost impatient to get moving with it. The sooner you start the chemo, the sooner you're killing the disease and (of course) the sooner you get to stop. Plus, as I said, it's a semi-known quantity. We've reasoned to ourselves: it went well last time, some of the drugs are similar, so we expect it to go well this time until we're proven wrong.

Still.

Being back in the cancer center and actually having the two lines flushed in Jody's newly-implanted port was a bit overwhelming, for both of us. Now that C-day had officially arrived, we were caught off guard. By what? By the massiveness of this whole undertaking, I guess. I haven't had a chance to poll Jody (she's asleep next me as I type this, while Herceptin dripdripdrips into her chest). But you know if you've ever been through a really traumatic event that you steel yourself to cope with it, for as long as it takes. Then one day, you feel like you can let up a bit, relax just a bit. You untense your muscles and take your first real deep breath in weeks, and suddenly you're sobbing uncontrollably. Where in the hell did that come from?

I think the familiarity of the chemo process actually permitted us to relax in a way. And finally—looking at tubes and IV machines and bags of fluid with big warnings on them—it hit us both that as optimistic as we feel, as gung-ho as we are to kick the crap out of this thing, we're still dealing with, you know, chemotherapy. Jody is going to have to trash her body quite a bit over the next several weeks.

That having been said, I repeat that it went well. (It's later now, and we're home.)

After today's treatment (which was Carboplatin, Herceptin, and Taxotere), as far as we know, there has been no hair loss (may be total, but usually reversible), no decreased hearing in high frequency and voice ranges, no loss of balance, no mouth ulcers, no unusual taste (okay, we've actually had that now), no sore throat, no lung damage, no changes in heartbeat, no heart failure (we're pretty sure of that one), no constipation, no intestinal ulcers, no nausea, no vomiting, no diarrhea, no burning with urination, no bleeding into urine, no kidney damage, no hot flashes, no elevation of blood sugar, no tingling in the fingers, toes or extremities, no pain in the jaw, no muscle weakness, no irritability, no depression, no confusion, no foot drop, no lowering of blood counts including hemoglobin and possibly requiring transfusion, no lowering of white blood counts leading to increased susceptibility to infection, including life-threatening infection requiring hospitalization and antibiotics, no lowering of platelets leading to increased susceptibility to easy bruising and severe bleeding, requiring platelet transfusion, no hardening of the veins in the area of the injection and the veins above this site, no ulcer formation or discomfort in the region of intravenous drug injection.

In short, despite being presented with a dazzling array of potential side effects from Jody's treatment, we got out of Dodge in good shape. Of course, some of these things may have happened without us knowing about them, or they may come in time. But by and large (knock on wood), today was pretty smooth sailing.

We'll keep you posted on any side effects that show up in the future.

Editor's note

Two quick things:

1. Blogger has been having some technical problems lately, so posts may be delayed while they work out their drama.


2. The "la-la land" link in the post below has been fixed.

More soon.

Sailing into harbour.

Where souls do couch on flowers, we’ll hand in hand,
And with our sprightly port make the ghosts gaze.

— William Shakespeare, Antony and Cleopatra: IV, xiv

We now have our "sprightly port". Or to be more precise, Jody has hers.

She's been outfitted with a Deltec PORT-A-CATH® II Dual-lumen, Low Profile™ System with PolyFlow® Polyurethane Catheter. Despite my encouragement, however, she opted not to get the chrome rims on it.

You'd think, since she was successfully stuck ten days in a row for IVF, that Jody has veins of steel and that putting in an IV "only" every three weeks would be a cakewalk. Unfortunately, that leaves out the chemo factor: the drugs she'll be receiving will weaken her veins, making successive sticks harder and harder. And because she'll be having chemo for 3-1/2 months, and Herceptin for a full year, she'll need something to make the process easier and more reliable. Hence the port.

I took the liberty of sketching a brief diagram of her while she was in recovery today:

Okay, I confess. That illustration was actually poached from this page, which goes into some detail about the port's benefits and how it works.

Jody has some pain in her shoulder, but is basically fine. She was actually back in classes at Columbia later today! (She's pretty conked out now though). Some notes on the day:

• Jody, after spending two-plus hours on Monday in la-la land following her egg retrieval, decided to be more firm with today's anesthesiologist about starting her on a small dose. He was a great guy, and happily complied with her request, noting that she certainly should know her own body by now and since she's the one going through all the crap, it's only fair she get to call some of the shots. The result of the lower dose: Jody was completely alert and downright chatty not ten minutes after her procedure ended. It's nice when the doctors actually let the patients take part in their caregiving.


• I made a joke about Jody getting stopped at airports while she has the port implanted, but the attendant simply shook his head, grinned, and said, "Nope. Titanium". Pretty neat, huh?


• I drank scotch with an acting buddy and Simon Russell Beale last night. This item has nothing to do with the port insertion (other than the fact that I was a running quite a bit slower than usual this morning). But you know, it was still pretty cool. :)

Tomorrow marks Day One of Jody's chemo/Herceptin regimen. That means roughly a year from now (if the planets align properly) we'll be celebrating her last Herceptin dose and, once again, putting this all behind us. So put a mark in your calendar for a whopping party with us in early February '07!

Editor's note: Blogger was down last night, so this first appeared on the site Friday morning, but it's dated for Thursday evening because that's when I wrote it.

Mind Over Matter

Twelve hours from now I will have a new accoutrement. This one's even better than the surgical drain.

First I'll be sedated, and then, about an hour later, I'll wake up with this thing—a port—implanted under my skin, somewhere in the vicinity of my right bra strap.

It's for my own good, blah blah blah.

It'll be a direct line to a major blood supply, blah blah blah.

It means no more excavating to find a vein in my arm, blah blah blah.

After a while I won't even notice it, blah blah blah.

OK, but I'm still going to have this thing. Implanted. Under my skin. For a year.

Have I mentioned that I'm squeamish?

No, really.

My new mantra:

I will not freak out about the port.
I will not freak out about the port.
I will not freak out about the port.

Success. Success.

The world is unsure, uneven, unpredictable. And the path that the Jodes and I have been on is especially so. There are no guarantees, and you take the hand that you are dealt. Etc.

A few weeks ago, when we were discussing our IVF potential in the present for the first time (as opposed to "something we'll need to discuss in the future") and realizing what hurdles we faced, we tried to temper our expectations. Jody hadn't had a regular period in five years. There was a possibility her ovaries were non-functioning from the first chemo. We were warned that the odds were such that we mightn't have any kind of success. At all.

We did the shots and the bloodwork diligently and quietly hoped something would come of it all. We watched the ultrasounds each day, as follicles appeared, grew, shifted, ghostlike across the monitor. What would it mean in the end?

In the end it meant two successfully fertilized eggs, two now-frozen embryos, two potential future little Knowers.

There are still no guarantees. Surrogate parenting is an iffy thing in and of itself: not all implanted embryos result in births. But now we have a couple of shots at having our own children, and that's two more than we had before.

(Cut to the two of us beaming at each other.)

Resting Comfortably

Just a quick post to say that everything went smoothly today, although I was extra-groggy in the recovery room.

I told the anesthesiologist that a little goes a long way with me (same is true for alcohol). For a procedure that was supposed to take only 5-7 minutes, I'm pretty sure she could just have whispered the word "anesthesia" in my ear, but no dice.

This made for lots of fun for Zach, who had to listen to me repeating myself over and over in some weird cross between Groundhog Day and Memento.

I have other strange observations to share—like why egg-retrieval day seemed kind of like a spa day (note the use of "kind of")—but those will have to wait for another post. I'm supposed to be resting. . . .

36 Hours to Go

We got the call this evening: Monday is going to be egg-retrieval day. Hooray!

Zach (or as I now call him, the Sperminator) and I are absolutely thrilled.

After tonight, NO MORE SHOTS!

After tomorrow, NO MORE DAILY BLOODWORK AND PELVIC ULTRASOUNDS!

After Monday, NO MORE EARLY-MORNING COMMUTES!

The last shot, of Ovidrel, given at precisely 11:20PM tonight, sets us up for retrieval exactly 36 hours later. Sometime on Tuesday, we'll get a call telling us the results: how many eggs were retrieved, how many were fertilized, and how many embryos were frozen.

So root for us on Monday—for lots of healthy, mature eggs and lots of microscopic Olympians on our 101-million-strong swim team.

The Cancer Card

Jody doesn't tend to get maudlin about her disease or wrap herself in its mantel to gain favor.

True, we would often joke about it around the apartment four years ago—such as this laffer:

Me: Hey, when you get a chance, could you unload the dishwasher?

Jody: (whiny, tantrum voice) I have cancer!

...or, this old chestnut:

Me: I've cooked for the last three weeks. Wanna take a turn?

Jody: (whiny, tantrum voice) I have cancer!

But for the most part, Jody never played the "cancer card". Only when she was really ragged from the chemo did she ever miss a day at work, skip a date, or retreat from the world in general.

(Okay, there was that one time she just used it to get out of social plans she had absolutely no interest in, but that wasn't with you, I promise.) :)

I've always admired this stoicism in her: it would be far, far too easy to let cancer be a crutch; a kind of blanket immunity from anything you didn't want to deal with. Jody's threshold for using it as an excuse is (typically for her) stratospheric.

My threshold, apparently, not so much.

Today, I played the cancer card. Tricky, huh?

We decided to drive to the Upper East Side this morning for our IVF appointments (instead of taking the subway). Jody was to have bloodwork and an ultrasound, followed by our consultation with a radiation oncologist at MSKCC.

It was pouring out when I dropped her at the clinic and proceeded to look for a parking spot. And look. And look. And........wait.

An oil truck made a delivery on the street in front of me. A full ten minutes sitting behind it. The rain falling heavier. Jody's time in the clinic progressing. I wasn't so worried about the bloodwork, but I wanted to be there for the ultrasound because her actual doctor was performing it (instead of an attending), and he'd give us a good idea as to where we stood.

Up the streets and down the streets I crawled in rush-hour traffic, in buckets of rain, looking for a spot, any spot, for my tiny car, which will fit in most of them. And then... disaster.

I turned onto an avenue where, across the street, a large, long roll-off container truck was preparing to back-and-turn across the four lanes of traffic between us to get into a construction site. A flagman waved me down to stop so that the truck could pass in front of me. But I was running late, and besides, there was no other traffic on the street for three blocks south of us, and as soon as I'd passed them by, they'd have had plenty of time to make the maneuver. Yet here was the flagman, waving me down anyway.

"Screw this," I said under my breath, and zipped past him and the truck both, in a matter of seconds (see, they really took more time stopping me than they would have just letting me through!)

Wrong move. Immediately a police van pulls up behind me, lights-a-flashin'. A burly, angry cop hops out, taps his flashlight on the window (and I thought they only did that in the movies!)

I roll the window down and he shouts at me (think heavy Brooklyn accent), "When a flagman tells you to stop for your safety, I suggest you stop!"

I'm totally busted, and I'm out of time. It's been half an hour since I dropped Jody off. Who knows what's going on up there? (As it turned out, Jody was getting reamed by an inexperienced phlebotomist, but that's her story for another day). I was not going to let this asshole read me the riot act. Even if he was just doing his job.

So....I pulled out the cancer card.

And the actor card, while I was at it.

"I'm sorry I didn't stop, but my wife and I have an appointment with her RADIATION ONCOLOGIST, and I've been trying to park the car for twenty minutes!", I protested, My Lip Trembling.

Cop: (insistent) "I'm sorry to hear that, but let me see your license and registration!"

"Here they are. I dropped my wife off half an hour ago. We're figuring out the best way to proceed with her CANCER TREATMENT," I said, My Voice Choking Up.

Cop: (calmer) Allright, allright. Which doctor are you seeing? (Like he was going to verify this.)

"B***** M*****! (the doctor's name)" I shot back immediately, "at the Sloan-Kettering CANCER CENTER", Tears Welling Around My Eyes, and Composure Hanging By a Thread.

The officer veritably jogged back to the van (I've never seen that before), hopped in, took oh, about 30 seconds to look at my stuff, then jogged back again.

Cop: (soothingly, now!) Okay, but next time, if the flagman says stop, you STOP.

"Yes sir, thank you sir!", Relieved Smile Spreading Across My Face.

And good luck to you both!

+++++

I know, I know. Shameless. But as soon as I pulled away, I found the only parking spot I'd passed all morning, and as I was getting out of the car, my cell rang with Jody on the other end imploring me to get up to the clinic. I won't argue that the ends justified the means, but the fact was, I really needed to get up to her, and I did what I had to do.

I won't make a habit of it.

Switch to low-beams!

(Disclaimer: This post is about sperm. If that's TMI for you then you should probably just come back another day.)

A very brief post for you all about my experience on Monday (Zach here).

I had to go in for a semen analysis. Why let Jody have all the embarassing procedures, right?

Regarding my visit to produce a sample, let me just say:

1. It was fine. Not as bad as I'd expected (although a little blush-inducing when I checked in with the perky 27ish female receptionist).


2. The comfy chair and magazines in my little room were appreciated. The 80-kilowatt non-dimmable fluorescent lights were not.

Got word back today on the results. To quote the nurse, I have excellent sperm. Specifically:

• There were over 101 million of the buggers in the sample I gave (they generally want to see at least 20 million). I like the extra 1 million over 100. Feels like insurance or something.


• 57.5 % of them were moving with rapid progression. I guess the other 42,925,000 of them were tuckered out.


• Only 10 percent of my sperm were abnormally shaped! (Well within the preferred 5-14% range.) Woohoo!

Recipe for a Meltdown

Ingredients

2 sticks (stomach)
2 small pills
4-1/2 hours sleep
1 6AM deadline
1 10AM deadline
1 5PM deadline
1 dead car battery 1 $1,000 car repair
1 rush-hour subway ride
1 overflowing waiting room
1 stick (arm)
1 pelvic ultrasound (internal)

Directions

1. Mix first three ingredients in one 39-year-old body. Let stand overnight.


2. Layer next three ingredients on top, balancing carefully.


3. Combine next three ingredients. Monitor pressure build-up.


4. Add next ingredient, taking care not to spill.


5. Wait to add last ingredient. Repeat. Repeat. Repeat. Repeat. Repeat. Repeat. Repeat. Repeat. Repeat. Repeat. Repeat. Repeat.

Your results may vary.