Connecting

Today I finally, finally got to see the rheumatologist, a lovely man who was as kind as could be. At the end of my two hours there, after the exam and the bloodwork and the urine sample and the X-ray of my hands, he sat with me in his office to go over everything. That's when he told me that his own daughter had had breast cancer in her early thirties, but that she's fine now, almost 15 years later. She gave birth to his grandson eight years ago.

I love hearing stories like that.

I got the impression that he would have been lovely and kind no matter what, but I think he was extra-sweet because of his daughter. That happens to me a lot. I'll meet someone, and he or she will be particularly solicitous. Or just completely unfazed by my baldness (or post-baldness). Then I'll find out that there's a sibling or parent or child or friend or spouse or some other cancer veteran in the person's life, and I know the source of the tender spot.

Perhaps you've been extra-sweet to a stranger sometime recently. Or perhaps you will be, sometime soon. It's really nice when it happens to me.

I also get stopped on the street, on the subway, in stores and restaurants—pretty much anywhere—by fellow cancer veterans. They spot me right away and strike up a conversation, then confess their own history. They want to know how I'm doing, and they want to reassure me that I'll get through it, that I'll have long hair again and resume my normal life. Now, of course, I nod and smile, because I know all of that is true. Because I've been where they are now—years removed from surgery and chemo and eyelash stubble and trusty baseball caps—and I know that I'll be there again.

Sometimes I tell them that this is my second go-round, that I know that there is an end in sight. Sometimes I just stick with the nod and the smile, because telling them my story means raising the specter of a cancer sequel in their minds, and that's not what they bargained for when they patiently kept looking my way, waiting to catch my eye so that they could make a small overture of friendship and solidarity.

Weaning

Today I had what was very possibly my penultimate session of physical therapy.

My therapist thinks I'm about ready to be kicked to the curb, and I think she's probably right. I've gotten a lot of mobility back in my arm, thanks to her relentless attacks on my very stubborn scar tissue, and now it's pretty much up to me to keep up the good work by massaging and stretching and exercising every day.

So far, I've been pretty diligent, although the massaging has fallen somewhat by the wayside ever since the joints in my hands decided to revolt.

I actually like the stretching and exercise regimen—it's one of the few proactive, tangible things I can do to promote my own health. I don't think I'm burning enough calories to threaten the residual flab, but it's a start.

My physical therapist is going on vacation for the next two weeks, so I'm on my own until September 20. If I can stay in the groove during that time, she's going to discharge me when she gets back.

I'm looking forward to getting those five hours (including commuting time) back every week. So you'll forgive me if I sign off now—I've got a date with a bright yellow elastic band.

Random Updates

1. The insurance snafu has been resolved.


2. The Naproxen Rx has been filled.


3. Most of my joints are a little better.


4. My fingers are a little worse.


5. My eyebrows are nearly back to normal.


6. I now have eyelash stubble.


7. My hair is desperately in need of edging. Right now, I have the beginnings of peyos (sp?).


8. I'm hoping that mousy brown is not my new color, but that's what I've got so far.


9. One of my toenails fell off tonight.


10. I have gone two days without Juicy Fruit.

Round and Round We Go

The latest theory, supported by anecdotal evidence from a couple of other breast cancer veterans, is that perhaps my joint pain is the result of an abrupt drop in estrogen—in my case, the kind that accompanies acute-onset menopause, which is what you get as a parting gift along with your oophorectomy. (Try finding that in an Oscar-nominee basket!)

It definitely makes more sense time-wise: the pain hit exactly a month after the oophorectomy, compared with five and a half months after I started on Herceptin.

I ran the theory by my physical therapist yesterday. It was new to her, but she said she'd ask around. MOSWO is out of the country, so I'll talk to him about it when he gets back. And I'll see what the rheumatologist has to say when I meet him on Thursday.

Meanwhile, the nurse-practitioner who works with MOSWO suggested that I move on from Motrin to Naproxen, a prescription-strength anti-inflammatory that may be more effective. She called in the Rx on Thursday, and Zach and I headed to the pharmacy on Friday morning to pick it up.

Not so fast.

According to the pharmacist, both of my insurance companies denied coverage.

Not for the Naproxen.

For me.

<sigh>

See, a few months back, during the whole Emend fiasco, I used up the annual prescription-drug benefit provided by my primary insurance, the one I have through Columbia. Fortunately, I also have secondary insurance through Zach and one of his unions (thank you, SAG!), and that, too, has a prescription-drug benefit. So when I maxed out the first prescription-drug benefit, the second one automatically kicked in.

The two insurance plans are on different "plan years." The Columbia insurance runs according the academic year, and the SAG insurance runs according to the calendar year. And it's actually a little more complicated than that. Most Columbia students start classes after Labor Day, so their insurance plan runs from September 1-August 31. At the J-school, however, classes start in August, so J-school students have a separate plan that runs from August 1-July 31.

This all matters because even though I'm currently on medical leave, I was able (through a COBRA-like process) to extend my Columbia insurance so that I'll have it, uninterrupted, during my time away from school and then again when I return for the spring semester. It will finally end next July 31.

See, the word "uninterrupted" is key.

When the pharmacist told me that the Columbia's prescription-drug folks said I wouldn't be covered until September 1, I knew exactly what the problem was: they didn't see the asterisk next to my name, or the footnote below that said "Alert! Alert! This is a J-school student. Her coverage starts on August 1!! DO NOT MESS THIS UP!!"

But I couldn't figure out why the SAG insurance refused to cover the prescription, especially because, according to them, my coverage ended the very day before. It made no sense whatsoever.

Until Zach called and discovered that the SAG insurance folks had just—the very day before—received a form from us, telling them that my Columbia coverage had (so we thought) kicked back in. That meant that they didn't have to cover my prescriptions, since my primary insurance was supposed to be doing that.

Meanwhile, I called Columbia and left a message for the very top university official in charge of student health insurance—the one who handled my extension. Had I been a student at any one of the university's other schools, the extension would have been a very simple transaction—fill out a form, write a check, go on my merry way.

But, because the J-school has its own separate plan, things were not so easy. Turns out I'm the first J-school student to want to extend her coverage while on medical leave. Ever. This meant that the very top university official had to negotiate a whole separate contract with the insurance company, and that took time. A couple of months, in fact. And those couple of months ended—surprise!—right before the July 31 cut-off date for my regular coverage.

So even though a new form was created, and I filled it out immediately and hand-delivered it to the university—along with not one, but two separate checks—and even though things seemed fine for the first three weeks (during which I had several sessions of PT plus another round of Herceptin), there was the inevitable snag along my merry way.

The very top university official checked with the folks at my primary insurance company, and they confirmed that my coverage was indeed uninterrupted.

But, um, the folks at their pharmacy management division must have missed the memo.

In theory, all of that is being straightened out. And I did get a "sorry for the mix-up" message from the very top university official. But I still don't have the prescription, because by the time I got the message, the pharmacy was closed. And then we headed upstate before it reopened the following morning.

So I'm still taking the Motrin. And still hobbling down stairs and across rooms.

Bite Me

Today's mail brought with it a letter from MCS Claim Services, Inc. on behalf of the cancer center where I spend a lot of my time (and my insurance companies' money).

It says, in part:

"We have been retained by the hospital to collect from you the above balance due. Please send payment for the full balance due to our office."

MCS is clearly a top-flight operation. I imagine that they are the premier debt-collection agency on the planet.

They are so premier that they printed their letter on a dot-matrix printer. These are exceedingly rare—veritable collector's items—owned by only the most discriminating businesspeople in the world. I imagine that MCS purchased its dot-matrix printer at auction, using the millions of dollars they have garnered through their efficient debt-collection techniques.

These techniques are so efficient that it took only 20 days for their letter to travel from one spot on the land mass known as Long Island (their offices in the county of Nassau) to another (my home in the county of Kings), a total distance of 29.8 miles. Those folks at MCS are smart, too! They not only tracked down my current address (after, I assume, spending hours combing through the two or three Knower entries in the phone book)—they also found my previous address. In fact, they used both on their letter—the street name from my current address and the city and zip from the last place we lived.

I bet the mail carriers just love the folks over at MCS for keeping them on their toes and making their job FUN! I'm sure those clever collectors at MCS can't remember the last time they stumped a mail carrier with a nonexistent address, but they keep trying! Sounds like a winning premise for a new reality show to me!

Now I realize that the cancer center has shelled out well over $100,000 in medical care for little ol' me, and I can imagine that they might be a little irritated at not getting reimbursed right on time. You know how slow those pesky insurance companies can be! So I can completely understand why they would want to engage the services of an industry leader like MCS to promptly recoup some of their substantial investment in my good health. And I can also see why it would make economic sense to do that right away, instead of sticking with the old-economy practice of first sending me a bill.

Because I'll tell you right now, if the cancer center had written and asked me to settle up for the $24.30 that MCS is now asking me to pay, I would have filed the lawsuit first and asked questions later.

Tortured Metaphors (Well, Similes) for How I Feel

1. Like a car that has raced through a torrential rain to get its owner to the airport on time, only to be left in the parking lot with its lights still on, slowly draining the battery.


2. Like the charater in Saving Private Ryan whose helmet stops a bullet during the landing at Normandy and who then, after taking the helmet off and staring at it in disbelief, gets hit in the head by a second bullet.


3. Like the athlete who waits four more years, finally makes the Olympic team, and then gets sidelined with an injury.


4. Like Nancy on thirtysomething, who can't fathom how Gary could possibly have been killed in a traffic pileup while on his way to visit her at the hospital to celebrate her unlikely triumph over ovarian cancer.


5. Like Charlie Brown, after the hundredth time Lucy snatches the football away a split second before he kicks it.

I said they were tortured.

Woe Is Me

It started slowly.

Friends would ask how I was feeling, and I'd hesitate.

My supply of reflexive "Great!"s had run out, and I hadn't even noticed the needle dipping down toward Empty.

I was stuck, not knowing what to say because I didn't know how to describe the way I felt: Frustrated that my body hurt more now than during chemo or after any of the four surgeries I'd been through in the past eight months. Indignant that when I was finally starting to look well, with the promise of hair and brows and lashes, I was truly feeling ill. Unnerved that we hadn't figured out why my joints had suddenly—and it was sudden—begun to balk at the most basic of bodily demands. Drained of the energy it took not only to walk short distances but simply to get through the day—to summon the will to focus my concentration away from the persistent dull aches that accompanied every waking hour.

I usually ended up mumbling a halfhearted "Okay." Or "Not bad." Or two other equally unconvincing syllables.

I think that was my first clue that I was heading—or hobbling—toward a place where physical pain becomes emotional pain.

If you asked me how I'm feeling today, I'd have another two-syllable response:

"Depressed."

It's still halfhearted, by definition.

Unfortunately, though, it's completely convincing.

Maybe I Should Count My Blessings

The complete list of reported adverse reactions to Herceptin:

• abdominal pain


• acute respiratory distress syndrome


• anaphylactic shock


• anaphylactoid reactions


• anemia


• angioedema


• anorexia


• antibody formation


• arthralgia


• asthenia


• bronchospasm


• cardiomyopathy


• chills


• cough


• diarrhea


• dizziness


• dyspnea


• edema


• fever


• headache


• heart failure


• hypotension


• hypoxia


• infection


• insomnia


• leukopenia


• myocardial infarction


• nausea/vomiting


• neuritis


• neutropenia


• pericardial effusion


• peripheral edema


• peripheral neuropathy


• pharyngitis


• pleural effusion


• pneumonitis


• pulmonary edema


• pulmonary fibrosis


• rash


• respiratory depression


• rhinitis


• sinus tachycardia


• sinusitis


• stroke


• syncope


• thrombosis


• urticaria


• wheezing

The Latest Theory

I was at the cancer center this morning for my tri-weekly dose of Herceptin, the relatively new, relatively miraculous drug. One of the nice things about Herceptin is that, unlike traditional chemotherapy, it doesn't have those nasty, day-to-day side effects. It doesn't make your hair fall out, or cause you to puke, or wreak havoc with your digestive tract. A friend of mine, who took it for a year, memorably described it as "bland."

OK, it can cause cardiac toxicity, but that's both rare and reversible. (That's why I have MuGA scans every three to four months—to make sure my heart is a-pumping as it should be.)

Anyway, the nurse who treated me this morning asked how I was doing, and I told her that the joint pain was still keeping me company. I told her that I'd tested negative for Lyme disease, and for whatever tests one can do for lupus, and that my next step was to see a rheumatologist in a couple of weeks. She thought about it for a minute and then said something like, "You know, I think Herceptin has been reported to cause joint pain in a small number of cases."

She went off to look it up and came back a little while later with a printout in her hand. Sure enough, she was right. Down at the bottom of a two-page description of the drug was a paragraph that began, "Other adverse reactions . . . include arthralgia. . . ."

Arthralgia is the fancy medical name for joint pain.

In some ways, it would make more sense for Herceptin to be the culprit—unlike the deer tick, it has come into regular contact with my bloodstream for the past six months.

But that's just it—I've been taking it for six months. And the symptoms didn't start until three or four weeks ago.

I honestly have no idea what to think at this point.

Maybe Not the Best Sales Pitch

The last time I was bald, five years ago, I walked by a panhandler on a street corner on the Upper West Side of Manhattan.

"Sir, can you spare some change?" he called out.

It took me a second to realize that he was talking to me.

It took him longer to realize that I wasn't a sir.

Let's just say he didn't profit from the experience.

Fast-forward to today. I was on my way home and was standing on a subway platform, waiting for a train. I walked over to the newsstand to buy a pack of gum. (In lieu of Yankee Doodles, I now have inexplicable cravings for Juicy Fruit. I'm planning to go cold turkey. Soon.)

As I walked up to the candy rack, I heard a voice behind me say something like, "Hey, man, can you spare 75 cents?"

I didn't pay any attention because a) the voice was behind me, and b) I am not a man.

It turned out, however, that the guy was, in fact, talking to me.

I know I'm bald and all, but really. Is it that hard to discern my gender?

Did I mention that I was wearing a dress?

Process of Elimination

Well, the Lyme disease test came back negative.

So did whatever they test for to see if you have lupus. Or to see if you might have lupus. (It's not a clear-cut diagnostic process.)

So now I'm back to waiting to see the rheumatologist, which won't happen for another two weeks.

So much for pinning my hopes on a deer tick.

Unreliable little buggers.

We're Walking, We're Walking

At the moment, my feet are rebelling. It's as if they think they are walking on hot coals or in very high heels, so slow and staccato are their movements. This morning, at least, walking from the couch to the bathroom is a serious undertaking. Later in the day, when they've stretched out a bit, I'll be able to take a long stroll, but for now, I'm not planning any major treks.

My dear friend Linda, on the other hand, is gearing up for exactly that—a major trek. She has been training for the Philadelphia Breast Cancer 3-Day, a 60-mile walk benefitting the Susan G. Komen Breast Cancer Foundation and the National Philanthropic Trust Breast Cancer Fund. Sixty miles is a looooong walk, the equivalent of 1,200 city blocks here in the Big Apple.

Linda has been one of my closest friends for the past 20 years, and she is walking in my honor, which is an amazing and humbling thing. To participate in the walk, you have to raise a minimum of $2,200, and she's already done that, nearly two months before the actual event. But she's set a personal fundraising goal of $5,000, and I have no doubt that she'll reach that as well.

If you'd like to support Linda and her enviably nimble feet, you can do that here. And if you'd like to send her some words of encouragement, let me know, and I'll shoot you her e-mail address.

I'll keep you posted on her progress and, of course, on mine.

What I Should Have Said

There was a new security guard at the Health Services building on Friday. And this time by "security guard" I mean 18-year-old, iPod-wearing, bored-out-of-her-skull undergrad. Or friend of undergrad. Or something.

Once again, I got the I-know-you're-trying-to-get-away-with-something-even-if-I-can't-tell-what-it-is vibe when I asked to for access to the elevator.

Let's just say that the ensuing exchange was somewhat less productive than the one I had a couple of weeks ago. This one featured the 18-year-old accusing me of giving her attitude.

Maybe I did.

Maybe I didn't.

It matters not. In the end, I rode the elevator. But here's what I should have said:

Scenario I
Me: Hi. I need to take the elevator up to Health Services.

Absurdly Empowered Teen Security Guard: You're not in a wheelchair or anything.

Me: And you're not in a uniform and don't look like you could defend a pint of ice cream from a motivated four-year-old, but I'm playing along and treating you like a security guard, aren't I?

Scenario II
Me: Hi. I need to take the elevator up to Health Services.

Absurdly Empowered Teen Security Guard: You need the elevator?

Me: Wait, you must be a philosophy major. Hmm. Do I need the elevator? If you mean "need" in the sense that you need earphones and a slack-jawed expression in order to make it through the day, why then yes. Yes, I do.

Scenario III
Me: Hi. I need to take the elevator up to Health Services.

Absurdly Empowered Teen Security Guard: Why do you need the elevator?

Me: I haven't been to an amusement park all summer, and I really want to go on a ride.

Scenario IV
Me: Hi. I need to take the elevator up to Health Services.

Absurdly Empowered Teen Security Guard: Yeah, right. I don't think so.

Me: Pleeeease?? See, this is a preposterously plotted action film, and the only way I will be able to pull off the big heist is to overpower the unwitting Health Services nurse who unlocks the elevator so that I can grab the key and then take her hostage when I make my daring escape. Of course, if you'd like to be my hostage instead. . . .

Scenario V
Me: Hi. I need to take the elevator up to Health Services.

Absurdly Empowered Teen Security Guard: Can't you just take the stairs?

Me: Sure, if that's easier. You're going to carry me up the two flights, right?

Prolonged Suspense

The rheumatologist can't see me for another three weeks.

To get a jump on things, I'm going up to the student health center tomorrow to get screened for Lyme disease. If that's what I've got, at least I'll be able to start the antibiotics that much sooner.

At this point, I'm almost hoping that some wayward tick found its way onto my skin—I like things that have a) an explanation and b) a cure.

I think it's unlikely, though. I don't remember getting bitten. I haven't seen any sign of a bull's-eye rash. And if I had a fever, it eluded me completely. Maybe it was camouflaged by my hot flashes. . . .

Today, in addition to my joint pain, I've got some serious soreness around my left shoulder blade, where my physical therapist did some major manipulation yesterday. She said it might feel a bit "tenderized" afterward. Well, you can pretty much throw me on the grill at this point.

I should be pretty tasty. After all, I've got those extra 10 pounds of residual flab working for me these days. And it's all about the marbling, right?

One Step Forward . . .

I'm about to get about five extra hours every week.

For the past couple of months, minus time off for surgery and recuperation—not to mention vacation—I've been going to physical therapy twice a week. The PT place is, like most of my medical destinations, not near anything and not particularly easy to get to. So I have to commute almost an hour each way for a 30-minute appointment.

It's absolutely been worth each and every trip, but the inefficiency of it all definitely bugs me—the inconvenience-to-benefit ratio is way too high. For that reason, I wasn't exactly broken-hearted today when my physical therapist told me that she thinks I'm nearly ready to leave the nest. Come Labor Day, and possibly sooner, I will be able to fill those slots with other, preferably more enjoyable—or at least more lucrative—activities.

But before I start spending time I don't yet have, it looks like I'll be adding another partner to my medical dance card. I checked in with MOSWO (my oh-so-wonderful oncologist, lest ye forget) today, even though I'm not due to see him for another month. He'd asked me to keep him posted on my joint pain, which we'd concluded was a late-breaking side effect of one of my chemo drugs, so I gave him a brief update.

Turns out that the persistence of this particular symptom is "out of the realm of the usual," which means that he thinks it's worth ruling out other potential causes, like Lyme disease. Oh, and lupus.

Yeah, I was un-psyched about those possibilities, too.

But I'm going to tread very carefully on the road to conclusions—no jumping for me, even if my joints were up to it. First stop is a visit to a rheumatologist.

Perhaps I'll get lucky and have an easy commute this time around.

Missing Pieces

During my junior year in college, a friend who had submatriculated to the dental school convinced me and a couple of other pushovers to volunteer as guinea pigs at the university's dental clinic. The first-year dental students had to recruit their own patients for a three-week session on preventive dentristy, and she had offered to arm-twist some of her undergrad pals for the folks who didn't have any prospects of their own. She promised that we'd be taken out to dinner as a thank you for showing up at 8AM on three consecutive Fridays—a chore that, as lazy college students, we felt required hazard pay.

I still feel bad for the guy who got stuck with me as his patient. In the first place, he was so nervous that his hands literally shook while inside my mouth. All he was doing was demonstrating proper flossing technique—there was no way he could hurt me—but he was an absolute wreck.

It didn't help that the next assignment was to do a kind of random audit of the patient's teeth. He was given a diagram of the mouth with several specific teeth designated for examination. Out of 32, I think he was supposed to examine something like six or eight. Unfortunately for him, I didn't have at least three of the designated teeth. I'd never gotten wisdom teeth (which explains a lot), and I had inherited an absence of another two teeth on top from one side of the family and two on the bottom from the other. So instead of a full 32, I had 24. He was so flustered by this that I thought he might drop out of school then and there.

I was reminded of the hapless dental student this morning as I was heading to the gynecologist's office for my semi-annual check-up because, well, I no longer have some of the parts that she would typically examine: no ovaries, no left breast. Fortunately, she's not a first-year medical student, so this didn't throw her.

I did wonder, momentarily, whether I'd get some sort of discount on the cost of an office visit since the exam would be, by definition, somewhat abbreviated.

A couple of years ago, when I was getting one of my first one-side-only mammograms, I asked whether I'd be charged half of the typical fee. It seemed only right, since the technician and radiologist were doing only half the work and using only half the film.

Not surprisingly, the billing person didn't see it that way.

It was neither the first nor last time that my application of logic to a given medical situation was met with a blank stare.

Followed, of course, by a not-remotely-blank bill.

Personal Regrowth

My eyebrows are starting to come back, for which I am quite grateful. The less I have to mess around with an eyebrow pencil, the better for everyone.

At the moment, however, they look a bit like misplaced stubble.

Just one more bodily oddity in a long parade.

Useless

I'm sitting on what currently passes for a couch at our place in Phoenicia, watching Zach lug in 10 boxes of blue ceramic tiles from the car. Each box weighs 74 lbs.

The tiles are lovely and will, someday soon, comprise the floor in our nascent kitchen.

At the moment, however, they are dead weight.

Last night, I watched Zach load them from our apartment in Brooklyn into the car. If you've ever watched Olympic weightlifting, you may have seen an event known as the "clean and jerk," in which the weightlifter first snatches the barbell from the floor and holds it in a crouching position before propelling herself or himself into a standing position with the barbell overhead. Zach wasn't lifting the tiles overhead, but in every other respect he was doing the clean and jerk. Oh, and then walking each 74-lb. box out of the apartment and onto the street before finally loading it into the car.

The thing about Olympic weightlifting, though, is that the athletes only lift one barbell at a time, not 10 in a row. And they don't have to walk around with them, either. So you can imagine that this was a rather tiring exercise for Zach. One that he's had to repeat just 12 hours later so that we can use the car for other things on this trip.

I, of course, cannot help.

I, of course, cannot lift things.

Between the recent abdominal surgery (hernia alert!), the string of breast/axilla surgeries (lymphedema alert!), and the resulting ban on exercise (muscle atrophy alert!), I am pretty much useless.

I cannot overstate how maddening it is to be unable to pull my weight, as it were. On our vacation, Zach had to lift my carry-on-sized suitcase into the overhead compartment, carry it on and off the rental-car shuttle buses, and take it in and out of the rental car itself.

I have done a ton of business travel, and carrying my own bag has always been a point of pride. Had always been a point of pride, I guess.

It's not just suitcases or 74-lb. boxes of tile, either. It's grocery bags (unless they are filled with paper towels or potato chips). It's the 5-gallon bottles that go with our water cooler. And the extra boxes of cat litter we keep in the basement. It's the other end of a couch or bookcase whenever we decide to rearrange the furniture. It's firewood up in Phoenicia. And my bag of golf clubs, for whenever I'm allowed to play (er, attempt to learn) again. It's the platters we use when we entertain. And the four other storage boxes on top of the one I really need to get into. It's the bottom of our queen-size mattress when I'm trying to tuck the sheets in. It's the cat carrier, avec cat, when we have to go to the vet.

In short, it is the rare day that passes without my having to abandon a task, or ask for help, or take a chance and try to do it myself when I know that I really shouldn't.

Zach doesn't mind, of course. He's happy to lift and carry whenever I need him to.

But I mind.

I'd like to have carried some of those boxes of tile.

Or at least held up one end as we carried them together.

Just to Be Clear

The cholesterol story from yesterday's post happened nearly five years ago, after the last go-round with chemo.

So what's my cholesterol figure today?

Good question.

I'm overdue to have it checked, but I'm going to wait a little longer.

Until, perhaps, I have shed some of the residual flab (which I should probably rename residual Yankee Doodles).

Or have worked my way up to something more than five minutes on the elliptical trainer.

It could be a while. . . .

Moist Heat

For the last couple of days, my knees have been much better. I can go from sitting to standing in one quick motion, without the intermediate stop in suspended animation. They still feel creaky when I go up or down stairs, but it's still been a rather dramatic improvement.

I don't think it's attributable to the Motrin, which I have been taking mainly at night.

I'm wondering whether this very stubborn heat wave has anything to do with it. After all, I've been out and about quite a bit, and during those times, it's felt very much like I was swathed in wet washcloths with heating pads on top. Not the cool comfort I would have preferred, but maybe the hot, humid air has actually done some good.

Again, stranger things have happened.

I've struggled with my cholesterol for a long while now—probably close to 10 years—and my total has surged as high as 282, mainly due to high triglycerides. I actually have lots of good cholesterol and not too much bad cholesterol, relatively speaking, but those pesky sugars have wreaked havoc on my numbers. And while I didn't regress to Yankee Doodle-eating the last time I went through chemo, I assure you that my diet back then was not exactly sugar-free.

So I held off on getting my cholesterol monitored until well after I'd finished chemo—and radiation, too, just to play it safe. And I girded myself to hear a figure that would lead inexorably to a lecture by my doctor, followed by a prescription for one of those cholesterol-lowering drugs that I'd successfully avoided thus far.

But when I called for my lab results, I was told that everything was normal.

I assured the doctor that he had overlooked something on the lab report and suggested that he double-check the cholesterol numbers.

Nope, he said. They were fine. My total was a perfectly safe 169.

I was stunned. Without making any effort at all, I had succeeded in dropping my cholesterol figure by more than 100 points.

It made absolutely no sense.

And then I wondered whether the chemo might have something to do with it. After all, the stuff was toxic. Maybe in addition to killing cancer cells it also attacked sugar molecules and fat cells.

I became convinced of it. How else to explain this remarkable turn of events?

And then my doctor disabused me of the theory once and for all.

If chemo could dramatically reduce a person's cholesterol, he said, don't you think the drug companies would have entire ad campaigns touting it as a feature of the treatment?

He had a point.

One Small Piece of Advice

If you haven't had the pleasure of a mammogram, you may not know that the first thing they tell you when you schedule the appointment is that you can't wear deodorant or powder on the day of the test. That's because both have a tendency to show up on the films as little white specks, which look a lot like microcalcifications (aka tiny calcium deposits), which can be an indication of cancer (or of a precancerous condition).

So to avoid a false positive, you play it safe and go in for the test with armpits au naturel.

I used to have my mammograms in the spring, between March and May. This year, for various reasons (like I was busy being poisoned all spring and couldn't fit anything else into my schedule), I didn't have the test until yesterday.

And what was yesterday?

Just the kick-off to this week's heat wave.

So I had the great pleasure of leaving my house in the middle of the day, walking five blocks in the heat, and then heading underground, where I got to wait on a toasty subway platform before boarding the blissfully air-conditioned train to ride a total of one stop before getting off and waiting on another toasty platform before boarding a second, equally blissfully air-conditioned train, riding another six stops, climbing two flights of stairs, and walking most of an avenue to the cancer center.

By the time I arrived, blissfully air-conditioned trains notwithstanding, you can be sure that my skin had pretty much liquefied.

And that any natural sweetness you might think I possess had long before succumbed to, shall we say, something much riper.

Of course, now that I have shifted to midsummer mammograms, I'm pretty much stuck with this scenario from here on out. Maybe next year, I'll wear some kind of warning sign for the benefit of my fellow straphangers.

Meanwhile, I offer this suggestion to those of you who a) have breasts and b) have not yet been initiated into the wonderful world of mammograms:

When it's time to make your first appointment, shoot for January.