Chemotherapy Leg Part 2

Today is my second chemotherapy treatment, where I am getting the drugs adriamycin and cytoxan. During the week between treatments, I had to have an iron infusion because I was anemic. The combination of the chemotherapy drugs and the iron left me profoundly fatigued and questioning the need for all this fuss. After all, the PET scan I was given before the treatment started showed that there was no cancer left in my body. But the oncologist was very emphatic about making sure there was nothing left that could potentially turn into more nasty cancer cells. So, I must endure 14 more of these treatments.

I've noticed a distinct chemo "culture" in the short time I've been receiving treatment. In each chair in the long, expansive room I spoke of last time, there is a story. Each person sitting in that chair is receiving treatment for some form of cancer, or possibly for a condition related to cancer. Many people brave the treatment by themselves; others bring friends and family members along for support. The room is like a giant Starbucks, with the nurses in the role of baristas, administering poisonous cocktails of medications to resigned patients. It's too bad a caramel macchiato or a soy vanilla latte can't cure what ails you; it would be a hell of a lot more enjoyable if coffee cured cancer, rather than the vile substances that make you feel like a half-dead slug. And that's on a good day.

Today, there is a woman sitting across from me who brought two friends with her. They are knitting, discussing literature, cooking, and a variety of other topics. Their conversation has been innocuous, and not in the least disruptive. I, on the other hand, brought my trusty laptop, but the hospital's WiFi service leaves much to be desired. I am managing to get a few words down, but streaming U.S. Open tennis matches is out of the question. Wireless Internet is a courtesy; the treatment I am getting will supposedly save my life. I keep repeating that to myself as I try to keep my brain functioning through all this.

Speaking of my brain, the case protecting it, otherwise known as my head, will soon be devoid of hair. As if on cue, clumps of it began falling out yesterday. Pretty soon, I will be bald, like so many other people I have seen. No wigs for me; many hats are in my future.

Nava

How Could This Happen?

I am one week removed from my first chemotherapy session, and the title to this post is something I asked myself on a few occasions during that time. I don't lament in the "why me?" sense, but more in the I-don't-have-a-genetic-predisposition-for-breast-cancer-so-how-could-this-happen? sense. Also, the line reminds me of one of my favorite episodes of The Sopranos. 

Logic tells me that nobody can provide a cogent answer to why I was diagnosed with breast cancer, but my sometimes irrational head wants to know what forces combined to create cancer cells in my body, and what I could have have done to prevent their formation. Were they caused by stress, lifestyle choices, bad decisions, geography? I'll never know. What I do know is that I have an image in my head of James Gandolfini as Tony Soprano sitting at the hospital bedside of his nephew Christoper after a couple of his imbecilic Paisans decided to use him for target practice, muttering, "How could this happen?" Viewers of the show know full well how it happened, but Tony, in his blind disregard for the lifestyle he leads, can't seem to figure it out.

When you submit yourself to chemotherapy, your choice of activities during treatment becomes somewhat limited. Thankfully, in this age of technology, I have access to countless television shows I can stream on my laptop while lying in bed. One of those shows is The Sopranos. I've seen every episode in the series numerous times, to the point where lines like the one I've quoted come to mind when certain situations crop up in my life. This wasn't the first time, and it sure as hell won't be the last.

Even if you're not undergoing chemotherapy, The Sopranos is always worth another look; especially if you've already binge-watched everything on Netflix and are experiencing withdrawal. The episode I'm talking about is "Full Leather Jacket", the eighth episode in the second season.

Nava

The Sad Reality, One Year Later*

 *I originally published this essay on May 15, 2013 on another blog I write. Little did I know that one year later, I would be in the same position.

Over the past few days, the Internet has been abuzz with Angelina Jolie's revelation that she had a preventative double mastectomy because she was at an 87 percent risk of developing breast cancer. Additionally, Ms. Jolie, according to sources, is planning on having her ovaries removed, because she is also at high-risk for developing ovarian cancer, the disease that her mother succumbed to at age 56. I commend Ms. Jolie for her proactive choices, particularly because she is a mother of six, but also because she made informed choices based on genetic testing. While we can never be sure of our fates, it is sometimes a good idea to not tempt that very fate by doing nothing.

Conversely, what Ms. Jolie has done is not an option for the vast majority of women. The BRCA1 and BRCA2 genetic testing she underwent costs more than $3,000, according to her New York Times op-ed essay. She did not mention whether or not the tests were covered by insurance, instead stating that those tests are an "obstacle" for many women in the United States. That obstacle is what I want to talk about.

Ms. Jolie has evolved since entering the public eye in the mid-90s. At first, she was the quintessential "wild child," but has since become a United Nations ambassador, and a dedicated humanitarian, who advocates for the populations of underdeveloped countries. She has adopted children from Vietnam, Cambodia, and Ethiopia. She has given birth to three biological children. She is an Oscar-winning actress, and an accomplished director. Oh, and let's not forget about Brad Pitt. But, what has she done to advocate for American women?

At first, you would think that American women do not need help from the likes of Angelina Jolie. But, the sad reality is, we do indeed. The United States might be the leader of the industrialized world, but we are sorely lacking when it comes to taking care of our health. While the women in the countries Ms. Jolie fights for have much less than we do, we are still woefully ill-informed, and dangerously unprotected when it comes to managing our health. That is something someone with a high profile needs to do something about.

It is very easy for celebrities, and people who are financially secure, to tell their stories about genetic testing, preventative mastectomies, and other procedures that will potentially save their lives. But, the sad reality is that the majority of the population in the United States does not have access to the same choices as the wealthy and influential. Why? Because those choices are not covered by your average health insurance policy. If a nondescript American woman in Ms. Jolie's position (a woman in her late 30s, married with children, and a history of breast and ovarian cancers in her family) wanted to make those same choices, you can bet that those choices would involve much greater financial hardship and sacrifice. It's all well and good to talk about it, but who is stepping up to the plate to do something about it? Yes, women in places like Haiti, Guatemala, Tanzania, and other parts of the world need help, but the sad reality is, so do women here in the world's richest nation.

It is very easy for me to sit here banging out blog entries to bring attention to this dilemma. But, the sad reality is, my influence does not stretch beyond a very small corner of the Internet. Someone like Angelina Jolie has a global voice; when she speaks, people pay attention. The same goes for other women who use their celebrity in ways that help people all over the world. Here in America, that help is forsaken, because it is assumed that we don't need it.

Here is what I would like to see happen: I would like Ms. Jolie, when she is fully recuperated from her surgeries, embark on a campaign to stop the healthcare insanity in this country. Someone needs to snap Congress out of its bipartisan bullshit behavior, as well as stop the insurance behemoths from denying coverage to women for the important procedures they need access to in order to protect their health. That is a monumental, almost insurmountable task, but it at least needs to be attempted. This country needs to learn to take care of its own, instead of indulging in rampant paranoia about having its rights compromised by the likes of "Obamacare." We need to stop paying astronomical insurance premiums for shitty coverage, and find some way to provide healthcare for each and every person in this country. Obamacare is imperfect; that is a given. So are the government healthcare plans in many other countries. But, the difference is, EVERYONE HAS ACCESS TO THEM. You don't have to live in fear of losing your insurance along with your job. And, from personal experience, I can tell you that is a great feeling. Unfortunately, that is something we know nothing of here in the U.S.

Since I returned to the U.S. from Canada, I have no health insurance. I have no access to the care I need, as a 46 year-old woman, to protect myself the way Angelina Jolie has done. As a freelance writer, I cannot afford to get a mammogram, let alone pay a visit to a general practitioner. Yes, as a Canadian citizen, I can still cross the border back into Canada to access healthcare, but why should I have to? Why should I have to leave the greatest country on earth to seek healthcare someplace else? Why should anyone? Why should it not be available to each and every person in this country? It's great that I am asking these questions, but really, who is listening to me?

There is much that needs fixing here in the U.S. and the healthcare system is one of the major broken cogs in American life. Hillary Clinton tried to fix it 20 years ago; Barack Obama is attempting to once again. Instead of working something out that will benefit everyone, politicians are crying Armageddon, while insurance companies are running scared, thinking that their multi-billion dollar policy scams might dwindle away to nothing. Pharmaceutical companies are terrified because they might not be able to charge $50 a pill for some of their best-selling drugs. Oh, the humanity. Yes, humanity is suffering because of all this.

I just re-read what I've written and noticed that I used the phrase "sad reality" a number of times. I thought about editing a few out, but I realized that from a health perspective, our reality is very sad. And that speaks volumes about what life in this country is really like. We might appear to be a shining city on a hill, but when you peel back the facade, most of us are really suffering. Some of us are even dying because we lack the wherewithal and the means to gain access to the lifesaving options people like Angelina Jolie have access to. We don't want to just hear about them; we want to use them as well.

Nava

Chemotherapy Leg Part 1

I am sitting in a very comfortable Naugahyde lounger in the hospital's medical oncology department. My nurse is about to begin "pushing" the first round of chemotherapy drugs into my system. Two jumbo syringes full of a cherry Kool Aid red-colored liquid will soon be coursing through my body, helping to eradicate any microscopic specs of cancer that might still be hiding. Then, it's on to a large intravenous bag of clear liquid that will take about half an hour to drip through the line.

It's fortunate that I am a freelance writer because chemotherapy and all the subsequent visits to the hospital are almost a full-time job. Having a bilateral mastectomy was quick work compared to everything that comes after. This is only my first treatment, so I'm thinking this will all be routine before too long.

It is hard to concentrate on writing about the experience; there is so much I want to say, but words are failing me. I'm too busy trying to eavesdrop on other patients in my immediate vicinity in this expansive room. Talk of alternative treatments and side effects; nurses bustling to and fro; family members wandering around looking both bored and shellshocked. It's a lot for the brain to take in, especially since I've never been here before.

My treatment is almost complete. I will remember the perfume one of the nurses has on, and likely associate its aroma with this experience going forward. The kind, concerned faces and their interest in my welfare are a comfort, as is knowing that I'm doing what is best for my health. It might not be pretty at the moment, but it will benefit me in the long run.

Coming up: How did I get here, and answers to other pressing questions. I am currently dealing with some mild fatigue and queasiness as time passes.

Nava

In Medias Res

Starting at the beginning is not always appropriate. When I went back to school, I was taught the term in medias res, which is Latin for "in the midst of things." Many authors are fond of starting their novels this way, and I think it's best to start off my blog in this manner, too.

My breast cancer diagnosis came during what is deemed "middle age." None of us knows exactly how long we are going to live, but the term generally refers to a person in his or her late 40s. It officially came one month and five days after my 47th birthday.

In the description of this blog, I described my breast cancer as a "journey." Where that journey will end is just as baffling as trying to figure out what age I will be when I die. What is certain is that I am a writer, and as a writer I am compelled to write about it, regardless of the outcome.

I hope you will accompany me on my journey. Like I said, it will be a different one, devoid of pink ribbons and the usual metaphors that correlate breast cancer with epic battles. Some journeys can be fraught with danger; others can be nothing but clear skies and calm waters. I don't know what kind of journey this is yet, but I know where I've come from.

Nava