mixed...

 " Well some things don't ever get settled.  You just make a place for them.  Learn to let them sit there with you , side by side with the good."  Oxygen, by Carol Wiley Cassella

The temperature yesterday read -23, but with a 15-20 mile an hour wind, the wind chill factor made it feel like -55.  Honestly, anything getting below zero is just plain cold.  -55? Is when cold becomes just painful to experience.

But it doesn't hold us back.  While Minnesota Governor Dayton did close schools on Monday, my need to go to the clinic for a physical therapy assessment couldn't be put off.

My session went well.  Linda, the PT, determined that I have both lymphedema, (swelling in my upper arm and down in my fingers and knuckles) and cording which starts underneath my arm where the radiation of the lymph node took place, and travels down to my knuckles.  Its a tight feeling within my arm, and it feels like a "cord" that is tight and tender at the same time.  Its uncomfortable, but not painful.  

So Linda showed me some exercises to do.  She also fitted me for a compression sleeve, and glove.  They take some getting used to.  And what we don't know?  Is how I will respond to treatment.  

Afterwards, I walked from the PT building through the skyway over to the main clinic and got my blood work done.  As cold as it is, I love seeing the sun shining and the crisp and sharp look the cold brings to everything. 

My lungs don't necessarily respond well to the frigid temps, but I pay them as little attention as I can.  

As I am sitting and waiting for my turn, a friendly face appears before mine.  The woman says "Are you Vicky?"  "You spoke at the Health conference right?"  "I met you there and I read your blog."  "Can I just give you a hug?"  I'm swept up in her big hug and listening as she continues.  "I've had the surgery and I just wanted you to know its good.  I am doing well.  You'll do great."  She says such kind things, and before I can ask anything more about her, she is gone, leaving me sitting there smiling."  I'm so caught off guard at being recognized, I never adequately recover.

Today the temp was a mere -15 when we left for Roger Maris.  As I chatted with Cathi the receptionist about the upcoming Pink concert, my pager was already vibrating in my hand.

It was a new nurse who took me back today.  She told me to forgive her, it wasn't her usual job, she was only filling in.  But she had been told by the other nurses "Oh its Vicky?  She is so easy, you'll be fine."

I laughed and sent up a quick prayer, "okay, lets make this one easy too please."

Dr. Panwalkar made a hurried entrance.  

He asked a few quick things and then smiled and asked about our holiday.  

"Well…" and I launch into the trip to the ER, the bleeding, the tests, the wondering, the worrying.  He looks completely surprised.  He listens to me and says, "well lets just get those ovaries out then."  I'll call the OB and talk to him.

In my mind, I am already trying to decide how to tell Dr. P. The doctor I saw wasn't overly optimistic about me having a good benefit from having my ovaries out.  Statistically, it doesn't improve my overall survival. And the risks of surgery are greater because I am a cancer patient. He wouldn't really recommend me doing this surgery at all.  It had been so hard to listen to him tell me this.  I know Dr. P  would not recommend having them out if there weren't a true benefit.  Yet I am stymied in convincing the OB otherwise.  Besides...

Do I want to have a surgery done by someone who isn't confident its the right choice for me?  

But first, we have to tackle the news I've been waiting for...

Dr. Panwalkar turns the computer screen to me to go over my scans.  "Your brain scan is good. Nothing new."

I'm relieved.  And yet, I know in the way he has said it, the next thing he says will not be as good.

Oh how I know him… more so in the lapses, and lulls then the words themselves.

Your ct scan, however, shows 2 new spots.  

Ahh. There it is.  The NED wrecker.  He is just a fading glimmer on the horizon now.

Your tumor markers have also slightly risen up out of the normal range now.

He then proceeds to show me on the scans.  I admit to him I've started up with a bit of a cough again.  And the cold and how it hurts.  And… well, I've certainly wondered.  

"So lets stop the Tykerb," he says, smiling.

I'm somewhat relieved and yet surprisingly saddened too.  

His eyebrows raise and he says, "Is this not what you have waited for?"

"It is," I say, "but part of me feels like, better the devil you know, than the one you don't."

So what is next?

Its then that Dr. P gets paged.  And he reads the first message and doesn't respond right away.  Then, almost instantly a second one comes, and this time he excuses himself and leaves.  

He is gone for awhile.  Rick and I sit and chit chat idly.  

He suddenly reappears.  But he is visibly different.  Subdued.  Serious.  Is that sadness I am seeing?  Rick says later he read it as sadness.  Whatever it was, whatever he just did or found out, wasn't good.

We're more quiet now and my mind rehearses the question I need to ask him, as he goes to examine me.  

Afterwards, he is again quiet.  He is both a million miles away, but observant and still with me.  He also knows me too well.  "What it is you are thinking about?" He asks.

And then the whole story about the OB and how I feel tumbles out.  

"Can I see a different OB?"

He quietly muses, "yes, I just don't know any of them.  Its hard to ask them to do something on short notice for you when you have never met them." 

We discuss a few options and then he comes up with his own idea of who he can ask.

We conclude with the plan of finding the right OB and getting the ovaries out. Then recovering, and then he suggests a hormonal treatment, Aromasin, to see if we can get the tumors to respond to that.  

"We have some time to try and see if it will work, and if not, we can consider other things later."

He walks me to the infusion center, his hand rubs a circular motion on my back as he pats me and then offers a quiet good bye.