And People Wonder Why I'm Not a Big Drinker

I'm wearing the orange panties, so you know what that means: I had a Herceptin treatment today.

The treatment itself is not a big deal, but right before the nurse hangs the drug and starts the IV, I have to down a Benadryl and two Tylenols to ward off any possible reaction.

Those three little over-the-counter pills might as well be general anesthesia given how quickly they render me unconscious. And that was before I took the first of my daily doses of anti-inflammatories.

Apparently Zach called in the aftermath of all of this, but I was in such a stupor that I have no recollection of the conversation.

I am going to have to plan better next time. At the very least, I should have been wearing a lampshade.

No Cape, Just a White Coat and a Heart

Today's superhero is the doctor who shared her Diet Coke with my dad. It wasn't his exact brand (the caffeine-free variety), but it didn't matter.

What matters is that she knew that a swig of Diet Coke meant the world to him.

That it wasn't going to kill him.

And that a small kindness and a willingness to break a senseless rule can be as important to a patient's recovery as all the surgical skill on the planet.

Strike That

My dad's still in the hospital.

He was on the verge of being discharged when someone noticed that his white count was elevated. So close to a clean getaway. . . .

Other patients are routinely sent home with white counts at the same level, but the doctors are being extra-cautious with him. They don't want a reunion anytime soon, and they were afraid that if they let him go today, he might boomerang right back if his count continued to climb.

Now we're looking at Thursday.

On the positive side, he had graduated to slightly thinner thickened liquids by dinnertime. And his nurse today, the aptly named Jewel, used a combination of trickery, sweet-talking, and good old-fashioned saleswomanship to get him to eat a half-dozen bites of meat loaf and mashed potatoes. And I'm talking about hospital food, not stuff we brought in from a local restaurant.

If she ever gets tired of nursing, this woman has a real future in politics.

I'm Paraphrasing Here

Sometime this morning my dad received a visit from a social worker—or an occupational therapist or a nurse or some other member of the hospital staff—who asked him a bunch of questions in anticipation of his discharge from the hospital and transfer to a rehabilitation center, which we hope will happen tomorrow.

I have no idea what the questions were, but at least one of his responses was deemed noteworthy enough to be recorded in his chart, where it was discovered later in the day by one of the many doctors on his team. Based on the expression on her face when she read it aloud, I'm guessing that most of her patients indulge in the kind of word-mincing that my father has never fancied.

I didn't have the presence of mind to write it down verbatim, but it went something like this:

"I'm 80 years old. I just want to go home and sit in my chair and watch television and drink Diet Coke. Is that too much to ask?"

No, Dad. No, it's not.

And the first round's on me.

5767

This year, for the first time in my life—as least as far back as I can remember—I didn't spend Rosh Hashanah in synagogue. It feels strange to have missed services after all these years.

I like the enforced opportunity to reflect back on the past year and look ahead to the new one. Nothing was stopping me from doing that, of course, but I missed the ritual that usually accompanies it. And I missed the comfort of repeating that ritual year in and year out.

I'm not a deeply religious person. Actually, I'm not really religious at all. But I do cling to many of the customs of the religion in which I was raised, and I continue to find beauty in the words and melodies I learned as a child, attending services in the synagogue that my parents co-founded more than three decades ago.

This year has been an especially hard one, bookended by my grandmother's death and my dad's surgery, with my own medical odyssey in between. Perhaps it is fitting, then, that my parents and I spent this Rosh Hashanah in a hospital instead of in a synagogue. And as wistful as I am about missing the rituals I cherish, I can only be grateful to have started another year in the company of the two people who gave me life and taught me to how to live it.

Shana tovah, Mom and Dad. A happy and, above all, a healthy year to you and to all.

Progress

My father left the cardiac intensive-care unit yesterday and is now in a "step-down" unit down the hall. Visiting hours are much less restricted, and we are allowed to bring in outside food in the hopes of tempting him with something other than the mysterious offerings from the hospital kitchen.

Still no beverages, though, other than bizarre "thickened liquids" that have the consistency of honey. This has not deterred my dad, who begs every doctor, nurse, technician, companion, orderly, and visitor he sees to bring him a Diet Coke. If the folks over at the Coca-Cola Company are in need of a new spokesman for their caffeine-free diet line, I'm pretty sure he'd work cheap: just a few free cases a month and he'd be very happy.

More Company for Satan

Other nominees for that special place in hell:

1. The guy who escorted my dad from the waiting room to the operating room for his OPEN-HEART SURGERY and reeked of cigarettes. At 7:15AM.


2. The guy walking toward the hospital, exhaling a cloud of smoke. While in surgical scrubs.

And my personal favorite:


3. The woman smoking outside a nearby CANCER CENTER. Wearing a white coat emblazoned with the CANCER CENTER's insignia.

5 Signs That My Dad is Feeling Better

1. Before we arrived for visiting hours, he'd already made the trip (with lots of help) from bed to chair and had eaten both applesauce and Jell-o.


2. Despite being in ICU, he told us more than once that he's ready to go home.


3. He asked for 28 Diet Cokes. Not 27. Not 29. Twenty-eight.


4. He turned his nose up at the various purées he was served at lunch and dinner—chicken, beef, carrots, peas, and potatoes—but he ate three dishes of pudding with no trouble at all.


5. When we left, he was tuning into the Yankees game.

Into and Out of the Woods

Fourteen years ago—four months before Zach and I were married—my dad underwent quadruple-bypass surgery. If you haven't been through open-heart surgery, either as patient or next of kin, you may not fully appreciate what an awful and amazing thing it is, a simultaneous assault and rescue operation.

Everything about it is grueling: the cracking of the chest, the hours in the O.R., the constant post-op ministering and monitoring, the time spent on a ventilator, the abject exhaustion, and the long, slow recovery that begins in the ICU and ends months later, when the simple act of eating a meal or taking a shower no longer requires a compensatory nap, when the 8-inch incision has become a scar, when dancing at your daughter's wedding is no longer a goal but reality.

If you've been through the trauma of open-heart surgery—if you've had great violence done to the core of your physical being and come out the other side—you imagine that life will give you some kind of bye after that. You believe that there is some measure of justice in the cosmos and that double jeopardy doesn't exist.

You don't expect that 14 years later you will have to go through the whole thing again because, although those four bypasses are still going strong, two leaky valves have suddenly compromised your entire cardiac plumbing system.

Last Friday, my dad went once more unto the breach and under the knife. After 10 long hours in surgery, he has two brand-new valves to go with those four bypasses. And after four long days on a ventilator—the machine that sustained and tormented him for an interminable week last time around—he was liberated early this morning.

He is still in intensive care, and the path to recovery will be a protracted one, but my mother and sister and I have all exhaled.

And so, finally, has he.

Not Feeling the Love

In the last 24 hours, one or both of our cats have:

• bitten the hand that pets them;


• crapped on our kitchen floor, despite the fact that their litter box sits less than 10 feet away and had just been scooped;


• meowed at me insistently until I got out of bed and gave them breakfast (thus encountering the kitchen's new floor treatment);


• shed little white tufts of hair all over the apartment.

But am I bitter?

Yes.

Eye of the Beholder

I have been complaining for the last little while (not here, but in conversations with friends and family) that my new hair—at least so far—is a dull, mousy-brown color.

I know full well that post-chemo, hair can change both color and texture, and I also know (so save your comments) that there is an entire hair-color industry out there, and that I could, with my half-inch locks, become a blonde or a redhead or anything else I might fancy in about eight minutes flat.

But I'm not so much the hair-coloring type (not, tipping my hat to Seinfeld, that there's anything wrong with that), so I was kind of hoping to return to the good old dark brown of yore. And, as I said, the term "mousy" is what's been on my tongue of late.

Dave, the delightful guy who cuts (or at least shapes) my hair, has a much more flattering—or at least charitable—way with words. When he greeted me this afternoon, he said something like, Wow—your hair is coming back with a vengeance, and it's this great champagne color!

Cheers!

Officially Unbald

I gave up hat-wearing a week or two ago. I've got enough hair now that I don't worry about scaring small children when I walk down the street. I'm even going to see my hair stylist tomorrow, not so much to get it cut as to have it shaped (his term).

It's probably still a bit premature, but I've got some longer, wispier strands that stick out above my ears, at the back of my neck, and on top of my head, and I think having them trimmed will give me a look that's more yes-my-hair-is-intentionally-super-short instead of oops-I-had-an-unfortunate-encounter-with-a-Flowbee.

At least I hope so.

Where I Was

Five years ago today, I was three days away from my eighth and last (or so I thought) round of chemo. That made it Week 3, which meant that I was feeling pretty good.

It was a gorgeous day, with an improbably blue sky. I had an early-morning follow-up appointment with my plastic surgeon, and I had taken the bus across town to her office. By 8:45 a.m., I was sitting in an exam room, waiting for her to come in.

I had long ago given up on wearing a gown at the surgeon's office. It seemed ridiculous to put it on, only to take it off the second she walked in. Months before, I'd asked her if the gown was for my benefit or hers. I think she was surprised by the question, but I meant it in earnest. For all I knew, she was shy and needed the gown to provide the fiction of privacy between us.

She wasn't shy. It was for my benefit, she told me.

I told her that since half the free world had seen my breasts at that point, and the other half had examined them, any modesty I'd had was long gone. By then, wearing a gown felt like an exercise in futility—it did nothing for me and just created extra laundry for somebody else.

So I used to sit on the examining table, naked from the waist up, waiting for her to walk in. I'd kill time by reading a magazine or the newspaper, so I actually looked like a sight gag you'd see in a slapstick comedy, as if the magazine or paper had been strategically placed to titillate (yes, I know) without triggering an R rating.

And there I sat, indecently attired, reading I can't remember what. Music from a local station was, as usual, being piped into the room through a speaker in the wall. I don't know what song was playing—I was focused on whatever I was reading, and the music didn't register. But after a few minutes, the song became an agitated voice as the earliest reports of the first plane started coming in.

The enormity of the situation wasn't clear at first. I don't remember exactly what the announcer said, but I had the impression that a small plane had gone off course and hit the building—not a good thing, of course, but not a cataclysm, and certainly nothing sinister.

I remember what happened in those next few minutes and hours, but not the exact order: reports of a second plane and of another striking the Pentagon, hastily throwing my clothes back on and walking purposefully out to the reception area, seeing the receptionist panic because her fiancé was—or might have been—in one of the towers, hearing that the bridges and tunnels were closed to traffic, calling Zach and telling him to turn on the television, hearing the surgeon tell of a woman in New Jersey who called to say that she was coming in for her nose job or face lift or tummy tuck no matter what, being examined by the doctor after all, learning that the receptionist had reached her fiancé as I walked out the door, getting onto the crosstown bus and realizing that some people had not yet heard what had happened, stopping on my way home to pick up provisions because I didn't know what else to do or how long we might be instructed to stay at home, calling the office and finding out that a colleague's brother was at a meeting at Windows on the World that morning, walking into our apartment and hearing for the first time that the planes were hijacked jets with hundreds of passengers on board and that the first tower had fallen and being completely unable to comprehend the horror of it all, clutching Zach in desperation, trying to call my parents and sister to assure them that we were safe, sending out a mass e-mail with the subject line "we are OK,"and watching it all unfold on television for hours and hours on end.

Three days later, I called the cancer center to see if I should still come in for my last chemo treatment. I had heard on the news that the main hospital was designated as a trauma center for those injured in the attacks, and I thought that they might have shut down all of the non-emergency operations.

I was wrong—the center was open, and I was told to come in as scheduled.

MOSWO told me that on that Tuesday morning, they'd had dozens of doctors and nurses and gurneys all lined up to receive the wounded, but there were hardly any patients to treat. People had gotten out of the buildings in time, or they hadn't. There was really no in between.

In Which I Hope Very Much Not to Tempt Fate

I don't want to speak too soon.

And I definitely don't want to jinx anything.

But after 10 days on a higher dose of Naproxen, my joints seem to be, at least marginally, (I'm writing this now in a whisper) better.

Not great.

Not good.

Not even decent.

But maybe, possibly, just a little bit less bad.

(This conversation never happened.)

A Special Place in Hell

Fair warning: I am now going to pick on a total stranger.

I have no idea who this man is.

I don't know if he works at the cancer center, was visiting a patient at the cancer center, just made a delivery to the cancer center, just used the bathrooms or the vending machines or the water cooler at the cancer center, jumped out of a cake for someone at the cancer center, was trying to proselytize unsuspecting patients at the cancer center, or what.

I cannot tell you why, on a perfectly lovely Friday afternoon, he was sitting on the steps right outside of the cancer center.

And smoking.

The man was sitting OUTSIDE A CANCER CENTER, puffing on a cigarette.

Is it really necessary to have "No Smoking" signs OUTSIDE A CANCER CENTER???

Is it not just understood that one should refrain from POLLUTING THE AIR WITH CARCINOGENS if not everywhere, then, at the very least, OUTSIDE A CANCER CENTER?

I wonder what this guy does the other days of the week.

Hmm.

Maybe on Saturdays he smokes crack while leaning up against a rehab facility.

He probably follows that up by scoring some heroin outside a methadone clinic on Sunday.

If it's Monday, he must be polishing off a pint of Ben & Jerry's outside the local Weight Watchers meeting.

On Tuesdays, I bet you can find him in the cafeteria of a nearby elementary school, working his way through a bag of peanuts.

I'm sure he sucks down Pixy Stix on Wednesdays, comfortably seated outside the headquarters of the Juvenile Diabetes Research Foundation.

He probably spends Thursdays drinking out of a brown paper bag in the corner of a church basement, waiting for the AA meeting to start.

Then Friday comes, and he buys himself a pack of Marlboros, heads back over to the cancer center, plops himself down on the steps, and lights up.

Maybe he moves out of the way when the guy with the oxygen tank passes by.

Maybe he doesn't.

Departures and Arrivals

I am flying solo today.

Zach left this morning for Los Angeles, where he will be spending a chunk of time this fall, trying to capitalize on his recent career momentum.

We've done the long-distance thing before (five times before, if my count is right), and we are actually pretty good at it. In the words of the immortal Tim Gunn, we just make it work.

Still, Zach's absence is palpable, and our place is that much less a home when he's not here to inhabit the space and endow it with his idiosyncratic style of life.

But sometimes the universe comes to the rescue, bearing gifts that seem to bring the world back into balance. And that's what happened today.

A few hours ago, I was in the kitchen—unequivocally Zach's domain—trying (and failing) to recreate a dish he makes that I absolutely love. In the midst of my culinary fumblings, the phone rang, bringing the most wonderful news from Zach's brother, Cyrus.

Just before one o'clock this afternoon—the same time Zach's flight was departing for LAX—a new little Knower came into the world. Cyrus and his wife, Caroline, now have three beautiful children: Benjamin, Madeleine, and our newborn nephew.

His name is Zachary.

The First Day of the Next Five Years of My Life

You may recall that the whole reason I had my ovaries out was to enable me to benefit from a relatively new class of drugs called aromatase inhibitors, which help to block estrogen but only work in the postmenopausal setting. (I love being a setting. If someone would just supply a few dramatis personae, we could put on a play!)

Things may change, but the current standard of care is to take aromatase inhibitors for five years.

So the plan was:

1. Have ovaries out.


2. Recuperate.


3. Start aromatase inhibitor.

Pretty simple, right? (OK, so having surgery is not exactly simple. But the plan was fairly basic.)

Of course, in practice the plan became:

1. Have ovaries out.


2. Recuperate.


3. Go on fabulous Pacific Northwest trip to celebrate incredibly handsome husband's quinquennial birthday.


4. Get hit upside the hands, knees, and feet with debilitating joint pain.


5. Spend six weeks trying to wait out/treat/find the cause of joint pain.


6. Start aromatase inhibitor.

Step #5 of the new and not remotely improved plan was added because, well, aromatase inhibitors have their own happy list of side effects, and those include—wouldn't you know it?—joint pain.

<sigh>

MOSWO didn't think I should start the aromatase inhibitor while I was still hobbling around, mainly because hobbling might start to seem like a fond memory if the new drug ended up attacking my joints as assiduously as it did my free-floating estrogen. (It would also introduce another variable into my body's already fraught ecosystem, potentially making it even harder to determine the cause of my troubles.)

So we waited, hoping that the pain would resolve, or that it would be traced to something easily treatable, like Lyme disease.

We all know how well that turned out.

When I found out last week that my joints were likely rebelling against the sudden crackdown on estrogen trafficking, I asked the lovely and kind rheumatologist what he thought about the whole situation.

He didn't hesitate.

Start the aromatase inhibitor right away, he said. Cancer is the main concern, and we've got to come out with our guns blazing. Hit it with everything we've got. [Fill in your favorite battlefield cliché here.]

And the joint pain?

D-14. (My term, of course. Not his.)

In theory, the pain is self-limited, which is another way of saying that it should resolve on its own, without intervention.

That's a good thing, of course, except that self-limited is not necessarily synonymous with short-lived. And, well, short-lived would be nice.

Would have been nice. After six weeks, I think "short" no longer applies.

In any event, I saw MOSWO yesterday, and he concurred with the rheumatologist. (He also concurred with the cancer center's complementary and alternative medicine practitioner, who came to see me the last time I was in for a Herceptin treatment and suggested that I try acupuncture. Stay tuned.)

So I filled the prescription this morning (no insurance issues, I'm happy to report) and popped my first pill today.

Just 1,824 to go.

How to Piss Me Off in 6 Easy Steps: A Guide for MuGA Scan Technicians

1. Call me Judy.


2. Stay in the room and stare at me while I change into a gown.


3. After staring at me, ask me why I am tense.


4. Tell me to lie perfectly still and then neglect to ask how I'm doing or give me the opportunity to move or stretch in between the three separate scans, so that I am immobilized—with my arms held above my head—for 30 minutes.


5. After waiting until I have fallen asleep to loudly announce that the test is finished, look directly into my startled eyes and say, "Oh, did I wake you?"


6. Send me on my way, leaving three of the electrodes stuck to my chest.

Cold Turkey

It's not definitive—the lab results are still pending—but the lovely and kind rheumatologist's best guess ("If someone put a gun to my head and I had to give a diagnosis right now . . . .") is that I'm going through estrogen withdrawal.

I didn't even know one could be an estrogen addict.

Heroin? Crack? Alcohol? Tobacco? Gambling? Foreign oil?

Yup. Sure. Absolutely. Yes. Of course. You betcha.

But estrogen?

It's like some sort of bad joke.

Do I have to go to meetings now?

"Hi, I'm Jody, and I'm an estrogen addict."

Is there a 12-step program for people like me?

Why haven't I heard of this before? Where are all of the magazine covers sporting headlines like, "Exclusive! Confessions of an Estrogen Junkie" over photos of disgraced celebrities?

Where are the infomercials hawking herbal supplements guaranteed to decrease estrogen cravings?

Why hasn't Big Pharma come up with an estrogen patch?

How come I haven't heard anything about the rise in estrogen-related crimes?

Or seen the latest public-service announcements? ("This is your brain." Ssssizzle. "This is your brain on estrogen.")

Where are all of the athletes being disqualified for estrogen doping?

The fashion industry must have gotten wind of this by now.

Just you wait.

There will be "estrogen chic" all over the runways this fall.

You'll be able to tell because instead of hobbling down the catwalk in orthopedic shoes, the models will be sauntering down in four-inch, architecturally engineered stilettos, wearing what will look to the untrained eye like vapid expressions but will actually be a classic sign of estrogen-fueled euphoria.

You heard it here first.