Completely Benign

Those are the magic words we heard at the surgeon's office this morning.

Not that we were expecting anything untoward in the pathology report from my salpingo-oophorectomy. After all, it was a prophylactic procedure.

But hey, we've been burned before.

In fact, late last night, when Zach got home from work, it dawned on me that the burning tends to happen when I unthinkingly go to a doctor's appointment by myself.

And Zach wasn't supposed to come with me this morning. He was supposed to be doing one of the Zillion Things That Must Be Done If We Are Ever to Have a Kitchen in Phoenicia.

But then I remembered the correlation between bad news and unaccompanied visits to doctors' offices. And I asked him to come.

I'm not the superstitious type, usually.

But this time around, I really, really didn't want to chance it.

Top-to-bottom Update

1. It's not obvious to the naked eye, but the hair on my head is making a comeback. It's very fine and very fair so far—reminiscent of a baby duck. Zach noticed it first. He was doing that thing people do when they can't resist the tactile sensation that near-baldness provides: he was rubbing my head like a genie's lamp. I don't know if he made a wish, but he definitely scooped the competition (that would be me) with the news that my scalp is showing signs of life.


2. My eyebrows seem to have completed their round of layoffs. Had I been consulted, I would have voted to purge the hairs below my arches, but they weren't nearly so systematic. Still, the results aren't awful. (They're actually not all that noticeable, actually.) But I'm still peeved about the whole thing. It's like a late hit in football—there should be some sort of penalty, I think.


3. I was right. The belly-button steri-strips fell off first. OK, I did help them . . . a little. But they definitely would have fallen off first even if I hadn't—the ones on the other three incisions haven't budged.


4. I'm still relying exclusively on drawstring pants, but I am hopeful that I may return to the world of buttons and zippers before too long.


5. I am down about five pounds from my recent all-time-high. I'm hoping that the other 10 will bid me a gradual farewell once I get the all-clear to exercise once again.


6. There's really nothing to say about my legs or feet except that my attempt at a do-it-yourself, pre-op pedicure was thwarted slightly by the fact that I unwittingly purchased a polish that is not remotely age-appropriate. It looks OK in the bottle, but on my toes it has that shimmery-pale-pink-fairy-princess thing going on. It will look darling on my adorable 7- and 4-year-old nieces, to whom I plan to bequeath it the next time they visit.

Post-op Post

1. I think I have finally deflated. Well, at least mostly. I can't tell if the remainder is residual carbon dioxide or residual flab.


2. My post-op, post-chemo appetite is pretty much back to normal. No Yankee Doodles. No Yankee Doodle cravings, even. And I'm no longer ravenous all the livelong day. I hope this bodes well for the residual flab.


3. Drawstring pants are my life. My four incisions are strategically placed to nix any chance of wearing a normal waistband (belly button), a low-rise waistband (hips), or a super-low-rise waistband (bikini line). Not that I'd be caught dead in super-low-rise pants, mind you.


4. If I had to dress like a functioning member of society instead of a slug-butt, empire-waist dresses would be my life.


5. I can, once again, bend over. No more grand pliés whenever something slips out of my hands.


6. I recently noticed that my incisions aren't quite symmetrical, and this kind of bugs me. I guess it won't matter if the scars are tiny or camouflaged, but I was kind of expecting my bottom incision to be centered along my belly button. (It isn't.) And I figured the two side scars would be at the same exact latitude. (They're not.) So instead of a nice, neat parallelogram, I'll be walking around with a quadrilateral for the rest of my life.


7. I moved back to the couch last night. I started out here because I couldn't get in or out of bed without help, so I slept propped up on a bunch of pillows. I had moved back to the bed a couple of nights ago, but I haven't been able to sleep on my side yet, and I was waking up with lower-back pain as a result. I don't really have lower-front pain anymore, so I don't see any reason to encourage my back to act up.


8. My steri-strips are hanging on. Until Monday, they were covered with gauze and some kind of cellophane-type adhesive bandage that looked like a cross between a clear mailing label and a small piece of Saran wrap. My money is on the belly-button steri-strips to fall off first.


9. I didn't notice this until the Saran-like bandage came off, but I've got four pinprick punctures or incisions around my belly button. (There may also be one or two others under the steri-strips.) It looks like a couple of vampires paid me a visit during the surgery. That or aliens.


10. This really was a breeze, pain-wise. I didn't even fill the prescription for Tylenol with codeine, and I didn't dip into the Vicodin I have lying around from one of the other surgeries. I took a couple of doses of Extra-strength Tylenol and one Aleve on the day of the surgery, but I haven't needed anything since. Except maybe ice cream.

D-14

Years ago, when Zach was in college, he was (shocking, I know) in a theater group. Each year, you'll be impressed to know, this particular group created an original musical comedy, performed it on campus, and then took it on a national tour over the winter break.

The tour traveled to various cities in which the alumni population could be counted on to a) buy tickets and b) house the undergrads who were involved in the production. It was run on a small budget, and everyone—performers included—was expected to pitch in on the less-than-glamorous backstage effort, from loading in the equipment to managing the props to striking the sets after the show.

College kids will be college kids, of course, and much of this backstage activity was accompanied by four-letter words and other offhand epithets uttered in the midst of the hectic communal effort to, quite literally, get the show on the road. But given the presence of the all-important alums, not to mention the occasional parent-of-a-kid-in-the-show, the proclivity toward profanity had to be, well, re-channeled.

So one year, the clever co-eds came up with a lexicon that translated nearly every possible show-related epithet into a neat, adult-friendly, and socially acceptable alphanumeric code. And every year after that (continuing to this day, I'm sure), the lexicon was one of the many things handed out to the group on the very first day on the tour bus.

I've never actually seen the lexicon, but I learned about it early on in my time with Zach. I must have complained about something, but I can't possibly remember what.

His response?

"D-14." (Or maybe, "D-14!")

My response?

"Huh?" (Proof that I am ever articulate.)

Then he said:

"D-14." (Or maybe, "D-14!!!")

Then I said the only thing possible:

"What the hell does D-14 mean???"

I got a full-on explanation, not only of D-14, but of the entire system. And as of that day, a good decade-plus ago, "D-14" has been part of our own private lexicon. (I actually don't know what any of the other codes are, but I think they go from A to F, with plenty of sub-parts for each lettered category. Zach assures me that the complete list is in one of the many boxes in our basement—no doubt labeled "Memorabilia," as so many are—but I haven't gone a-searching.)

So what does "D-14" mean, you ask?

It's pretty simple: "Suck it up and deal."

And why am I telling you about it now?

Because over the weekend I got it on good authority that there's absolutely nothing I can do to hasten the deflation of my abdomen. The carbon monoxide (not nitrous oxide—I was wrong) is going to dissipate in its own sweet time. And it's starting to, finally. I no longer look like my due date is just a few months off. (And don't think that the irony of looking pregnant immediately following the surgery that made it a physical impossibility to get that way has been lost on me.)

I'm still, well, aerated. Not to mention irritated.

But, as I said to Zach, it's basically a D-14 situtation.

Which means, of course, that it's no different from the rest of this whole experience.

Post-surgical Glee

The surgery was a breeze.

A cakewalk.

Easy-peasy.

No big whoop.

You get the idea.

We rode to the hospital in our ragtop, a 1988 VW Cabriolet convertible, with the top down. Might as well start the party early, I thought.

No traffic, just brilliant sunlight reflecting off the East River as we headed north on the FDR.

No screw-ups with my name when we registered.

Everyone was very nice.

We even got a vibrating beeper, like they give out at Outback Steakhouse, to let us know when it was our turn to give all the usual insurance info, etc. This led to many jokes in which Zach affected his best Crocodile Dundee impression. Trust me, they were hilarious.

Then I was whisked off to change into a gown and robe and those attractive non-slip socks, have my vitals checked, and give a urine sample. I'm usually pretty coordinated, but this time I managed to pee all over my hand in the process.

When I came back, little cup of pee in hand (but no longer on hand), Zach was waiting for me in lucky Exam Room 13. He tried to take my picture with his Treo (aka his new toy), but I gave him the death glare, and that was that.

I was unaccountably giddy, but that's pretty much how I've been before all of my surgeries. Not sure why. I wasn't faking it, either. I think I was just glad to be getting the show on the road.

A few minutes later an escort came by to take me to the next stop on the pre-op tour. Zach and I said our goodbyes, to each other and to my ovaries. He gave me a big kiss on the abdomen, and we saluted their heroic performance back in February.

Then off I went, along with another, much less giddy, patient. Our escort was walking in slow motion, or so it seemed. I couldn't tell if this was for our benefit or just her maximum speed. But it was better to trudge behind her than to ride in a wheelchair, so I didn't mind.

After another short wait, I met my O.R. nurse, the assisting surgeon, and the anesthesiologist. I gave my medical history a few more times, verified my name and D.O.B. again and again and again, signed the consent form, and gave my speech to the anesthesiologist about my drug allergies and general drug sensitivity and the off-limitness of my left arm. I got a good vibe from her, so I figured everything would go smoothly. Then the lead surgeon came in and asked me a couple of last-minute questions before the anesthesiologist and I walked down to the O.R.

Operating rooms are generally kept at meat locker-like temperatures, so I was grateful for the surgical cap on my head and the warm blankets they piled on top of me. By then I'd literally disrobed, but I still had the attractive gown on. (The orange panties, lest you think I forgot to wear them, were back with the rest of my clothes and shoes and baseball cap, in a plastic "Patient Belongings" bag somewhere.)

Speaking of the surgical cap, it was one of those puffy kinds that look vaguely like a shower cap but are made of some paper-like substance. On the way to the O.R., we passed a dispenser of these fashion accessories, and now I know that they are called bouffant surgical caps. Try Googling if you don't believe me.

While I was waiting to be knocked out, someone strapped my legs to the table (think heroine tied to railroad tracks and you'll have a pretty accurate visual). Turns out they sometimes have to tilt the operating table to one side or the other for better access and, well, they don't want the patient going overboard right in the middle of things. Someone else put those lovely inflatable sleeves (think water wings, but longer) on my legs to prevent blood clots. It's a good thing I wasn't having second thoughts about the surgery because at this point, I was pretty well trapped.

I remember three other things before going under. First, the clock on the wall was the most blatant example I'd seen so far of drug-company swag. Forget retractable ballpoint pens and colorful notepads, ladies and gentleman. Mere child's play! We now have anti-depressant-branded timepieces for your operating rooms! Is this some sort of subliminal advertising for the patients? Are people waking up after surgery and asking for a dose to go with their apple juice and graham crackers??

Second, I, word freak that I am, had been thinking about the origin of salpingo. As in salpingo-oophorectomy, which was the name of the procedure I was having. (It refers to the Fallopian-tube part of the proceedings.) So I asked the assisting surgeon. (Word freak that I am, I know that there must be an official—or at least better—name for this person. It would be second chair, if we were talking about trial lawyers, but I doubt that it's second scalpel. Although that does have a nice ring to it. . . .) He thought it meant "snakes." Which kind of made sense but also kind of weirded me out. (Turns out it's from the Greek and means trumpet or tuba, which makes less sense but at least is more lyrical.)

Third, the anesthesiologist numbed my arm before starting the IV, which I thought was very considerate. No one's ever done that for me before. She did that and then shot me up with Versed, the precursor to the heavy-duty drugs. "Just chills you ever so slightly," in the immortal, and perhaps misquoted, words of Joan Cusack in "Working Girl." Well, maybe more than "ever so slightly" in my case, because that's the last thing I remember. No mask, no counting backward from 100 by sevens, no nothing until I woke up in the recovery room.

I was there for a while and apparently received a visit from the surgeon, of which I have absolutely no memory.

Then it was goodbye IV, hello wheelchair for the ride to the place-without-a-name-that-they-take-you-to-before-you-get-to-go-home. There I was reunited with both Zach and my clothes. It's also where I discovered my post-surgical accoutrement: a belted sanitary napkin, right out of the 1960s. Or some other prehistoric decade. It was far superior to the dreaded surgical drain but still not exactly welcome.

Oh, and I also have four little incisions, arranged in a diamond-like cluster starting with my belly button, then going out toward my hips, then back to my lower pelvis. They must have shaved me for that bottom one, but you can hardly tell. (I did say that the hair loss was near-complete, didn't I?)

The only real issue I'm having is that because the surgery was done laparascopically, they filled my abdomen with nitrous oxide or some other kind of gas first (the better to see your insides, my dear), and, well, they don't exactly deflate you when they're done. So I'm walking around with the distended belly of a pregnant woman and burping like a truck driver. It's a very attractive combo.

Other than that, the pain has been minimal. I didn't fill the Rx for Tylenol with codeine or dip into the leftover Vicodin I have lying around. I took some Extra-strength Tylenol and one Aleve yesterday but nothing so far today.

I haven't yet had my first real dinner, but only because I filled up on a bunch of snacks yesterday—Zach's homemade guacamole, some yummy bread and cheese, and the best minty-lime cooler known to woman.

It's going to be a quiet day today. Zach booked a job earlier this week and is out shooting it today, and I am just hanging out.

And burping.

All Went Well

Jody is home, the surgery was a complete success. Not much more than that for now, but we're happy to have it behind us.

More soon. :)

The Suckfest Continues (continued)

Well, better late than never.

The surgery is first thing tomorrow morning.

First thing as in we have to be there no later than 6:30AM.

Which means I should be going to bed right about now if I want to get a decent night's sleep.

Fat chance.

It's probably better to be sleep-deprived, anyway. That way I'll be too tired to hear my stomach growling.

For the past 12 hours, I've been subsisting on water, ginger ale, and Jell-O. And after midnight, I get to have bupkus until after the surgery.

But that's by no means the worst part of the pre-op suckfest.

I've had to spend the better part of the day [APPETITE SPOILER ALERT!] inducing diarrhea.

There are two main ways to do that, and I've had the keen pleasure of having to do both, thank you very much. By comparison, the SST was a delight.

So I've been spending the afternoon in close proximity to porcelain, watching lots and lots of TNT programming. Because, well, they know drama.

And I don't get enough of that in my own life, so I have to use a remote control to fulfill that need.

Actually, to be honest, the anticipation of the pre-op suckfest was actually worse than the suckfest itself.

See, a couple of years ago, I had to have a colonoscopy (one of the many things that fall under the category of "Oh, you've had breast cancer, so now you need to do this"). And, as those colonoscopy veterans among you know all too well, you have to be [EUPHEMISM ALERT!] thoroughly cleaned out beforehand. And the process is pretty similar to what I had to go through today, starting with having to drink this exceedingly revolting sludge.

Only last time, I had to drink two or three bottles of the stuff. (This time I only had to drink one.)

And guess what?

It made me vomit.

Fourteen rounds of chemo didn't make me vomit, but this stuff did. So you can imagine how bad it is. (Or maybe you know firsthand. So sorry.)

Needless to say, I had a horrendous time of it before the colonoscopy. So I was expecting the same thing to happen today.

But it didn't.

For one thing, there was no vomiting. My oncologist suggested that I pop an anti-nausea pill beforehand, and I'm sure that helped. Plus I'd heard that the stuff goes down easier if you mix it with ginger ale and pour it over crushed ice, so I did. Of course, it still made me gag—despite being camouflaged as some kind of perverted take on the cocktail. And I pretty much had a meltdown when the bottle of ginger ale exploded all over me and the kitchen in the process.

But I got it down. (Even though Zach had to cheer me on from the dry sidelines by the time I got to the last couple of ounces.)

And eight hours of TNT has helped to dull the memory.

I'm about to go for nine.

Last Supper

After breakfast tomorrow, I'm going to be restricted to clear liquids until the surgery on Thursday. And who knows how quickly after that I'm going to get back to my normal (OK, abnormal) eating habits? So I probably should have spent some time figuring out what to have for dinner tonight—something satisfying and maybe even a bit indulgent.

But did I do that?

No.

I was working steadily from a little after 3PM to 8PM on the dot, and by the time I focused on dinner it was already a quarter to nine.

Oh, and Zach is working nights at the moment, so a delicious home-cooked meal was not in the cards.

I probably would have special-ordered Absolut penne from our neighborhood Italian restaurant (it's no longer on the menu, but we're regulars, so we get special privileges), but I hadn't had any real protein today, so I figured I should try to rectify that.

I went through our entire collection of takeout menus and was completely uninspired.

So I ended up getting a burrito.

It was fine, but I'm not exactly going to remember it longingly when I show up at the hospital at 6AM on Thursday, ravenously hungry after nearly 24 hours without solid food.

I'm going to try to make up for it on the other end, once I get my appetite back and feel like I can eat anything I want (two entirely different phenomena).

I have no idea what it'll be, but I can tell you this much: whatever I have is not going to come in a plastic bag and be transported by bicycle to my front door.

Virtual Doppelgangers, Too

So much for being unique. Or at least original.

Besides the other Jody Rosens roaming around the planet (or, actually, the city), there are at least two other blogs out there under the banner of "Once More Unto the Breach":

http://stephesblog.blogs.com/my_weblog/

http://www.oncemore.co.uk/

At least nobody will confuse them with this one.

<sigh>

The Name Game

I'm back in physical therapy again, although this time it's at a different place with a different therapist for a different reason.

Because I'm such a prime candidate for lymphedema, MOSWO (aka my oh-so-wonderful oncologist) suggested that I see a lymphedema specialist to make sure that I'm doing everything possible on the prevention front.

Between the time we had this conversation and the time I called to make an appointment, I started to have a hard time getting my wedding and engagement rings off my finger. Unlike many (most?) people, I take my rings off every night, so I could tell right away that my ring finger was a little swollen.

This was not a good sign.

This was very likely an early indication that lymphedema had struck, if only slightly.

I spent the next week or so obsessively looking at my arms in the mirror, trying to discern whether the left one looked bigger than the right.

It didn't, at least to me. Or to Zach. (And let's just say that it was not exactly a self-confidence-boosting experience to be staring at my triceps, which have lost all muscle tone over the past few months and, if viewed alone, would likely lead one to think that they belonged to a woman approximately twice my age. But, as usual, I digress.)

In addition to the swollen finger(s), it also seemed to me that the sleeves of my short-sleeved shirts fit a little tighter on the left. Ditto my bra straps.

So I was both eager and anxious (which—as the punctilious grammarian in me feels the need to point out—are not, in fact, synonymous, despite common usage) to see the aforementioned lymphedema specialist.

Easier said than done.

I called for an appointment.

I faxed over the prescription, along with my name, rank, and serial number (aka name, date of birth, Social Security number, address, phone numbers, and insurance information).

I waited for a call back.

I gave up waiting and called to follow up.

I was asked for more information—dates and types of surgery, dates of radiation treatment.

I gave it.

I waited for a call back.

I gave up waiting and called to follow up.

I was told that they had no record of me.

I spelled my name slowly. "Knower. With a 'K.' K-N-O-W-E-R."

They found me.

They passed my file along to The Woman Who Deals With Insurance Companies.

I waited for a call back.

I actually got a call back.

The Woman Who Deals With Insurance Companies told me that I needed to get a referral and bring it with me to my first appointment. She told me that my co-pay would be $10. She told me that in a day or two, I'd get a call from the scheduling people to set up my first appointment.

I waited for a call from the scheduling people.

I gave up waiting and called to follow up.

I was told that they had no record of me.

I restrained myself.

I explained that they did, in fact, have a record of me. And that I knew this because I had been asked to give additional medical information. And because The Woman Who Deals With Insurance Companies had called me and told me that I had cleared all of the administrative hurdles and could now get an actual appointment.

The person I spoke with tried to find me "in the system" but failed. She hypothesized that The Woman Who Deals With Insurance Companies must have entered my name wrong, which meant I'd need to follow up with her. She transferred my call, but The Woman Who Deals With Insurance Companies did not answer.

I left a message.

I waited for a call back.

I gave up waiting and called to follow up.

I left a second message.

I waited for a call back.

I gave up waiting and called the people I had spoken to in the first place, after I had faxed over my prescription.

I explained that I was in that hellish place known as Bureaucratic Limbo, and I begged for help.

The very nice woman I spoke with found me in about two seconds flat.

Turns out I was "in the system" under Rosen.

I'm so glad that I took pains to write "Knower, Jody Rosen" under "Name" when I sent in my name, rank, and serial number. (I did that to avoid having my name recorded as Jody Rosen-Knower, which happens all the time.)

The very nice (and smart) woman I spoke with suggested that we check the rest of my records to make sure that there were no other errors. Good thinking! She rattled off all the fields, and everything sounded fine until she got to my secondary insurance.

"You're covered by your husband's plan?" she asked.

"Yes," I said.

"And his name is Zachary Rosen?"

Um, no.

I'm so glad that I took pains to write "Zachary S. Knower" under "Secondary Insurance" when I sent in my name, rank, and serial number.

OK then.

The very nice and smart woman said that she would correct Zach's name, but that she'd have to get someone in Medical Records to correct mine—she couldn't do it herself.

Fine, fine, fine. Can I please just make an appointment already??

I get back on the phone with the scheduler, I explain that she can find me (for now) under "Rosen," and I set up my first appointment for the following Wednesday.

Wednesday comes, and I arrive at the appointed place at the appointed hour, and I go to the registration desk, and I give my name.

I am met with a blank stare.

"Look under 'Rosen,'" I say.

She does, and there I am. I explain the problem, and she listens politely. Then she takes my insurance cards and gives me a bunch of forms to fill out, which I do. Starting with my name.

I return the completed forms, and she gives me a "pass" to take into the next room, where I will meet my physical therapist. I look at the pass, and it's made out to "Jody Rosen."

So I explain, once again, that that's not my name (anymore). And she apologizes, and gives me a new slip.

I take the new slip into the next room and hand it to the receptionist, who, of course, cannot find me "in the system."

So I explain. Again.

And then I sit down to wait. Moments later, my physical therapist walks into the waiting room and calls out, "Jody Rosen?"

So I explain. Again.

And then we have a very productive session. [Turns out that my left arm isn't swollen after all. Turns out that it's actually smaller than my right arm. (She measured.) I'm right-handed, so that's as it should be. In any event, it's not clear why my rings don't fit, but it has been hot and humid, and, well, I do weigh more than I have in my entire life.]

Before the session ends, I happen to catch sight of the label on the file she'd been holding. "Jody Nan Rosen," it says.

OK, now we're getting somewhere.

Because I most certainly did not write "Nan" anywhere on the sheet I faxed over or on the forms I was given to fill out.

Because I haven't used "Nan" since I got married 13 years ago, when I dropped it in favor of "Rosen" as my middle name.

But this particular rehab center just happens to be affiliated with the hospital in which I was born. And back then, my name was—and remained for 26 years and one day—Jody Nan Rosen.

It only took me three more tries to get it fixed.

I can't wait to see what my insurance companies make of all of this.

See, I happen to know that there are at least two other Jody Rosens in New York City, one of whom is a guy.

Maybe one of them will get my first couple of PT bills.

Somehow, that would actually make sense.

Now??

For whatever reason, my eyebrows have started to molt.

This is really pissing me off.

Week 4!

I'm writing from the cancer center, where I'm about to get my first Herceptin-only treatment. Unlike chemo, Herceptin does not have any of those annoying day-to-day side effects you've been reading so much about. So my hair will finally start to grow back, and I won't have that nasty layer of paste on my tongue anymore, and the toxic waste dump is, well, no longer toxic.

But perhaps best of all, my blood counts will not be affected, and that means I no longer have to view the world through a Week 1/Week 2/Week 3 construct.

Oh, and I can eat and drink(!) whatever I want, without worrying about having a compromised immune system. Hello, Caesar salad! Hello, cookie-dough ice cream! Hello, wine and spirits!

Well, maybe not hello just yet.

'cause the first thing they do when you arrive at the treatment center is put you on a scale.

And let's just say that all those Yankee Doodles (and all those other easy-to-digest-but-super-unhealthy foodstuffs) have really added up. . . .

IOU

I haven't forgotten that I promised to tell the rest of the story about next week's surgery.

It's just that there's a lot to tell, and I want to do it justice.

And this week has been busier than most—in part because I'm trying to cram a lot in before I go under the knife—and that means I've been short on the time and mental energy I need to write about the surgery.

But I can say that the back-to-back pelvic ultrasounds (transabdominal and transvaginal) went fine—other than the fact that they were preceded by two hours in the waiting room. And that for most of those two hours, my fellow waiting-room denizens included one certifiable lunatic. And not the quiet kind, either.

It seems to be my week to be plagued by poorly behaved strangers.

Last night, my friend Elizabeth (hi, Elizabeth!) and I went to a reading at the New York Public Library. Note the words "reading" and "Library." The people sitting behind us apparently didn't, because they were just yapping away through the introductions. Kudos to Elizabeth for turning around and saying, in the most matter-of-fact way possible, "Are you going to talk the entire time?" She said it in the same tone of voice in which you might ask, "Is that seat taken?" As a silencing mechanism, it was very effective.

Then tonight, Zach and I went to the theater for the first time in forever, only to be stuck sitting in front of a very drunk woman and her enabler-husband (or date or paid escort—I couldn't tell for sure). She lurched into me several times, spilled her drink at least once, and audibly murmured along with the proceedings onstage during the entire first act. Then she practically took a header on her way to the bathroom (or maybe back to the bar) a few minutes before intermission.

By that point, steam was very nearly shooting out of our ears, so we resorted to extreme measures. I was tempted to turn around, remove my hat in righteous indignation, and, in an appropriately melodramatic tone, say something like, "You know, I don't get out very often, so I'd really appreciate it if you would SHUT UP and stop ruining our evening."

Instead, we ratted her out to the house manager. (Since she and her companion spent intermission at the bar, it was easy to point them out from the safety and comfort of our seats.) The house manager pulled her aside when she came back, and she and the husband/date/escort spent the remaining minute or so (before the second act began) dissecting the grievous injury she'd been done by virtue of this talking-to. But she did behave after that.

Well, mostly.

The Suckfest Continues

In just a few short hours, I am heading off for one of my all-time favorite tests: the pelvic ultrasound. Not the kind you see on TV—usually done on a very pregnant woman—where they slather that goo on your lower abdomen and look through your body with a device that looks kind of like an old-fashioned electric razor but is actually a transducer.

Actually, I'm having that test, too. It's just not my all-time favorite.

That distinction falls to the transvaginal pelvic ultrasound. This is the little slice of torture in which the doctor or technician looks inside your body with a specially shaped transducer that looks nothing like an old-fashioned electric razor. What is looks like, in fact, is an old-fashioned vibrator.

I am pleased to report that it does not, however, vibrate. (Others who have been down this road might be displeased about this, I realize.)

The first time I had this test, several years ago, the technician explained everything very carefully so I'd know what to expect. When she got to the part about the specially shaped transducer (SST) and how it would feel when she inserted it, she said something to the effect of, "It's just like a tampon."

Ahem.

It is most definitely not just like a tampon.

Unless, of course, your body is on the same scale as, say, King Kong.

What makes the SST even more appealing (impossible, you say?) is that before it is put to use, it is dressed in a condom and then slathered with that same goo.

Trust me when I say that no amount of guided imaging or meditation or small talk with the technician can distract you from the presence of the SST.

Especially when the technician has to manipulate it so that he or she can see your innards from various angles. Soooo comfortable!

Just so you know that I am not being a big baby about the whole thing, I had to have transvaginal ultrasounds every single day for about a week during our round of IVF.

But that was four whole months ago, and, well, I haven't missed them.

This time around, I'm having the ultrasound done as a precursor to surgery. Back in January, I wrote about the cool new estrogen-blocking drugs called aromatase inhibitors that I will start taking now that I am done with chemo. I also wrote about the fact that while those drugs are great at blocking estrogen, there is a critical caveat to their power: like Superman with kryptonite, aromatase inhibitors are powerless in the face of the subset of estrogen that is produced by the ovaries. That means, in superhero-speak, that I have to neutralize my ovaries in order for the wonder drugs to work.

So next Thursday, I will go in for what should be a short outpatient procedure, done laparascopically, to remove both my ovaries and my Fallopian tubes.

There's more to the story, of course, and I promise to tell it.

Just as soon as I get back from my date with the SST.

More Fun with Medical Bills (and the People Who Send Them)

A few more victories from this week's foray into my stack of medical bills and insurance statements:

• A bill for $87.90 for the balance due on my super-attractive lymphedema sleeve: My physical therapist had told me that the cost of the sleeve should be covered 100% under the terms of the Women's Health and Cancer Rights Act of 1998, so I was surprised to get a bill at all. The total cost of the sleeve was $293.00 (and no, it isn't trimmed in precious gems), so the insurance company had only paid 70% of the price. Which is, you know, less than 100%.
  
  So I call the insurance company. And the very nice guy who answered the phone tells me that the claim was paid at the out-of-network rate. I'm surprised to hear this, too, and think that perhaps lymphedema sleeves are so esoteric that there are very few manufacturers and that possibly none of them are in my network. And I float this theory by the very nice guy, who dismisses it—very nicely, of course—out of hand.
  
  So I ask him how I would go about finding an in-network provider, because I'm told that if I start having to wear the sleeve a lot (while I exercise, for example—which I aspire to do again someday), I should really get a second one and alternate between the two. So the nice guy does a quick search of his online directory, and he says, in a still-nice-but-sort-of-"told you so" kind of way, "There are 33 in-network providers in Brooklyn alone."
  
  But just when I'm starting to feel defeated, he makes the kind of noise you might make if you had accidentally inhaled a fly. Or if you had to retract your "told you so" tone of voice. Turns out that he was scanning the list of the 33 in-network providers in Brooklyn and discovered that my provider was on it. Hee hee hee. So now they're going to re-process the claim, which means that I will only be responsible for a $10.00 co-pay.
  
  Next!


• A bill for $500.00 for a surgical consultation: I called my insurance company, and they had just received the claim from the surgeon's office on Tuesday. (That would be the dreaded 6/6/06, but I'm not going to focus on that.) It'll take them 2-3 weeks to process the claim, so I can just sit tight for now.
  
  I love bills that translate to "We haven't been paid by your insurance company yet, so we're going to bill you in the hopes that you might actually send us a check more quickly than they will. But we promise that once we do get paid by your insurance company, we will make sure to reimburse you for any overpayment. And, in the meantime, we will not for one second enjoy earning interest on your money."


• A bill for $650.00 for a radiation oncology consultation: These folks submitted the claim to my old insurance company—the one I haven't been covered by since last August. Good thing Zach and I spent an eternity filling out new forms when we were there in January. Somehow, though, they had the information for my secondary insurance, which didn't kick in until January 1, so they must have looked at the forms long enough to get that right. In any event, they are now going to send the bill to the right place, after which I can submit any remaining balance to my secondary insurance. The way I calculate it, those two things alone mean I won't see a bill again until maybe sometime in August.


• A bill for $274.56 for the anesthesiologist who did such a heroic job during my port surgery: This bill was actually for $1,120.00—$274.56 is just the balance remaining after my primary insurance paid its share (or what it deemed to be its share). I called to find out whether the remainder had been submitted to my secondary insurance, and the friendly guy I spoke to said that the claim had actually been re-submitted to my primary insurance and was currently "in review." (That's code for "OK, we'll take another look at it because, yeah, we do screw things up a good percentage of the time, so you might get lucky this time around.") Once they hear back, they'll submit any remaining balance to my secondary insurance.
  
  OK, fair enough. But my favorite part of the conversation was when the friendly guy told me that I could have ignored the bill in the first place.
  
  "It's just computer-generated," he said. As if HAL had reanimated itself and started sending out rogue medical bills to unsuspecting cancer patients.
  
  Oooh—spooky.

So if you're still keeping track at home, that's $1,512.46 in bills that I received but did not, in fact, have to pay. (Of course, there's another $400.00 that I do have to pay, but still.)

Gulp

Bolstered by the return of my energy and by yesterday's modest triumph, I once again donned my green eyeshade and tackled my ever-growing stack of medical bills and insurance statements (not to mention the ever-growing spreadsheet that I use to keep track of the ever-growing stack).

So, from today's edition of Forensic Accounting for Dummies, a few scary figures:

• Retail cost of my first round of chemo: $40,245.50.


• Total amount reimbursed by my insurance company: $11,194.87. (Don't worry—I didn't have to pay the difference.)


• Retail cost of my second round of chemo: $37,138.50.


• Total amount reimbursed by my insurance company: $27,853.88.

Can I explain why there is a $3,107.00 difference between Rounds 1 and 2?

No.

The only thing I can think of is that my dosage of Benadryl was halved after Round 1. But I can't imagine that trimming the dosage of something that's available over the counter could account for that kind of discrepancy.

Then again, I am attempting to apply logic to the situation, and, well, that's just a pointless exercise where these things are concerned.

I also can't explain why my insurance company reimbursed so much less of the cost of Round 1 (especially since the cancer center charged more than for Round 2).

Is it possible that we hapless cancer patients aren't the only ones who have to deal with maddening deductibles?

Nah.

Who ever heard of a $29,050.63 deductible, even for a big institution like a hospital? (And yes, I am doing the math in my head. I told you I was feeling like my old self again.)

OK, last scary figure (for now):

• Our total out-of-pocket costs to date (including IVF): $16,474.09.

Fun with the Folks in Accounts Receivable

Remember that day back in April when I got a check for $744.31 in the mail and couldn't figure out why?

Well, we figured it would be foolish to actually deposit the check unless we knew for sure that it was, you know, not a hoax.

So we called.

And we asked.

And were told that, in fact, it was not a hoax.

And that we could, in fact, deposit the check.

And that no one would try to take it away from us.

You can see where this is going, right?

A bit more background: The nice man at the hospital explained to us that the check was for the $784.31 hospital fee that we had paid on egg-retrieval day, minus $40.00. Turns out that my insurance company paid the hospital all but $40.00 of its fee, which is why it refunded the difference to us.

OK. Makes sense. (Except for the part where the insurance company sends the money to the hospital instead of to us, but we didn't quibble.)

So we deposited the check.

Then, a few weeks ago, we got a bill from the hospital for the forty bucks. (I confess that I did not leap to pay this bill.)

And a week later, we got another bill from the hospital, this time for $784.31. (Good thing I hadn't leapt.)

And tonight I got a call from the hospital about the $784.31.

What did I do?

I said, in my friendliest, most credulous voice, "I'm so glad you called." (How often do you think the folks in billing departments hear that?)

Then, in the nicest possible tone of voice, I related the chain of events and explained that I wasn't about to part with seven hundred-plus dollars when I had no confidence whatsoever that I actually owed it.

What did he do?

He put me on hold.

He stared at his computer screen.

He came back on the line.

He stared at his computer screen some more.

And then he agreed that I didn't owe $784.31.

And said that I owed only $40.00.

And told me that he'd send me a bill to that effect.

I reminded him that I already had a bill for $40.00.

Plus the one for $784.31.

He said, "This will be the FINAL bill."

"Promise?" (OK, I was laying it on a bit thick. But can you really blame me?)

"I promise," he said.

So I'll wait for the second $40.00 bill.

And then I'll call back and convince them that I don't owe that either.

(Because, in fact, I don't.)

Moving Right Along

I hope my sister and brother-in-law don't mind me telling this story. (If this post suddenly disappears later this week, however, you'll know why.) I also hope I get it mostly right.

There are two things you need to know:

1) My brother-in-law is a pretty low-key guy. He has a wicked sense of humor, but he's pretty quiet about it, so it often takes you by surprise.

2) Like lots of moms, the main thing my sister wants on Mother's Day is to be able to sleep in and then shirk her usual domestic responsibilities for the rest of the day. She wants to be, in the inimitable words of my friend Lisa, a complete slug-butt. And so, on the second Sunday in May, that's pretty much what happens: my brother-in-law and their two highly adorable, spectacularly beautiful daughters (ages 7 and 4) give her a well deserved break.

So here's the story:

A couple of years ago, my sister woke up on the morning after a typical Mother's Day. Her husband had already headed out for the day, but he had left her a note. It said:

Mother's Day is over. Get back to work.

I don't know who laughed harder: my sister, or every person she ever told the story to. I still crack up every time I think about it.

Why am I telling you this?

Because I had it in mind today—the first day in four months that I've felt like my old self again. Not 100%—yet—but pretty damn close. My energy is back, and I'm ready to use it.

If my brother-in-law were here, I imagine that he might have left me a slightly different note this morning:

Chemo is over. Get back to work.

And actually, that's exactly what I plan to do.

Starting tomorrow, I'm going to be doing some part-time editing work for my old firm. I'm really looking forward to getting started and to getting some structure back in my life.

And, of course, to getting paid.

Little Slice of Normal

Last night, Zach and I took a walk through our neighborhood, popped into the new cheese shop that opened around the block (danger, Will Robinson!), and tried a new spot for dinner. We had really yummy food, marred only by the fact that we were eating outside—aka the place the smokers would come periodically to get their fix, sending odoriferous carcinogens wafting our way. But again, the food was really yummy, and the company was grand. Then we walked back, picking up, in our South Park-inspired lingo, a little desserty-poof along the way. About a block from home, we ran into our neighborhood fishmonger and his girlfriend on the street and had a nice little chat with them. And then we came home, settled in on the couch, dug into our respective desserty-poofs, turned on the TiVo, and watched the last two episodes of Top Chef, to which we had become addicted this season.

It was nothing special and nothing fancy, just a low-key, perfectly lovely evening—the kind we used to have all the time.

In other words, it was bliss.

For Whatever Ails You

If you're sitting at home on a Friday night, waiting for your stomach to right itself, waiting for the humidity to pass and the rain to stop, bleary-eyed from sorting through medical bills and insurance statements, and lacking the company of your Incredibly Handsome Husband (who is out of town for the evening), you can't do much better than to happen upon a showing of Footloose on TV.

How can you beat the ear-candy soundtrack, the montage sequence of Chris Penn's dance lessons, the game of chicken played on tractors, and, of course, Kevin Bacon's gravity-defying hair?

You just can't.

I'm Baaack (I Think)

These are the last waning hours of Week 1, and I have to say that I'm feeling pretty good. (Okay, my stomach is kind of flipping out, and has been for the last day or so, but that's really just a minor inconvenience at this point.)

After spending nearly two full days in the house upstate, and nearly another two full days not venturing beyond our property line here in Brooklyn, I actually forsook the couch (and its outdoor equivalent, the hammock) and spent the whole day out and about.

No naps for me!

No weird low gear!

No masquerading as a mute introvert because I didn't have the energy to interact with actual people!

I even knitted sixteen rows of my soon-to-be scarf! And read more than half of today's paper!

For tomorrow, I've got an actual to-do list started.

Watch out, world!