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Saturday, June 6, 2009

Cancer-Free....What now???? (Blog 20)

On Wednesday, March 18th I woke up feeling as nervous as I was on Thursday, September 11th. Surprisingly, my final doctor’s appointment had stirred up as much anxiety as my diagnosis day—presumably because, like before, I still didn’t know what was to be expected. We sat in the waiting room for twenty minutes, Mom casually flipping through a magazine while I tapped my foot compulsively on the floor. Looking around, I realized that this place, once a sanctum of ominous news, had strangely become a haven for support, safety, and love. Even though I would routinely come to CCCST anxiously anticipating the ritual of being poked with needles and injected with poison, the compassion I felt from my nurses and Dr. Wilks always seemed to overshadow the torment they ruthlessly bestowed upon me. I realized that I was starting to miss this place already, despite the fact that I have loathed the very idea of chemo for months.

After having my blood drawn for labs and vitals taken, Dr. Wilks bound into the exam room with boisterous enthusiasm. “SARAH!!!” She sang. Then, eyeing the x-ray films I hand-carried to the appointment, she smiled and said, “I already know…..Your films look really good and everything looks almost normal!” She said that my lungs were healing from the pneumonia, my blood work looked good--except for the ever-present anemia--and she is certain that the spots remaining in my chest are indicative of scar tissue and not any remaining malignancies. Mom asked: “Does that mean, in your opinion, she’s cancer-free?” Dr. Wilks nodded and said, “We were borderline with her on the radiation anyway, but we’re not going to do it now that her lungs are so compromised. I’m confident, though, that she’ll do just fine without it.” She turned to me and said, “You’ve been through enough as it is! I’d say you’re cancer free!” Mom reached over in an awkward side-by-side, tearful tight embrace as I stared straight ahead, somehow stunned by the news. I was expecting it but then again, can one ever prepare themselves??? I took it all in, completely shocked, as the other two individuals—whom I loved dearly—celebrated. Dr. Wilks then launched into her remission speech, preempting it with, “I’m going to try not to cry but I just might…………” (AWWWWWW……she feels the same way I do!) Wilksie told me what to expect, physically, over the next few weeks and gave me tips on building up my strength. She said to discontinue all cancer-related medications and gave me a general idea of the outlook for the next few years. I’ll have scans every three months for the first year, then six-month scans for the second, and yearly scans thereafter. Since I’m now more susceptible to recurrent lymphoma, leukemia, and breast cancer, she’ll monitor me closely for those cancers, but she is confident that I am cancer-free for life. “I can’t believe I won’t get to see you again for three months though!” she said, echoing my sentiments (she took the words out of my mouth). I was already going through Wilks withdrawals and the very thought of not seeing my nurses for so long was impossible! “Well, let’s make it six weeks. Why don’t you come back for blood work so I can monitor your anemia…” wink wink, nudge nudge. Side note: Now that my 2009 insurance plan has reached its catastrophic coverage limit (meaning that now everything is covered at 100% instead of 80%), I’m more than happy to have an excuse to see my hero.

During our appointment Dr. Wilks mentioned something interesting. She said that it is normal, if not completely expected, for those declared cancer-free to struggle emotionally with their new status. Mom and I looked at each other with a knowing glance, as I had conveyed to her that I was grappling with that very concept but had felt such immense guilt that I didn’t think I’d have the courage to outwardly express it. Part of the problem is that, instead of getting the ceremonial send-off from the nurses and celebrating over drinks, dinner and hugs on remission day (and, who are we kidding?....the rest of the week if not the entire month of March), I was put in the hospital. After getting out, I was still too weak to partake in any festivities and, furthermore, we didn’t have a definitive cancer-free declaration from her anyway. My status was left ambiguous and, combined with the idea that I almost died from pneumonia and was subsequently recovering from its effects, I didn’t care enough to worry about it. But now….Now she was telling me that it was all behind me while I was left trying to make sense of it. So yesterday I had cancer and today I don’t? Yesterday I took ten medications and today I take none? Yesterday my world revolved around appointments and side effects and today I’m no longer a prisoner to this disease? I told Dr. Wilks that I was absolutely struggling with depression and was very ashamed at not expressing the extreme enthusiasm expected of me at being healthy again—particularly in a boisterous, public outcry. In turn, she said that such evocation is common. “It doesn’t mean that you’re not grateful and relieved, it just means that you’re trying to make sense of this big transition.” She explained that patients grieve for missing the safety and security of the nurses and doctors at their clinics and that, as much as they loathe it, they have become so accustomed to the routine of endless appointments that an open calendar seems so ominous, so uncertain. Furthermore, the repetitive pattern of chemo followed by illness and recovery has become an expectation. “I KNOW!” I exclaimed, exhaling with relief. “I mean, I’m looking for a job now that I can actually HOLD one, but I honestly don’t know what I’m going to do with myself now that I’m better. I’d normally just resume what my life was like before I was diagnosed but I honestly can’t remember it.”
Mom added, “I was telling Sarah that too. Now that she’s better I’m not quite sure what to do with myself. My life was centered around going to San Antonio every other week, if not more frequently, and I try to remember what I did with my time before all of this. I just don’t know. It seems like it’s always been this way.”

Dr. Wilks nodded and encouraged me to take it slow, but to get involved with things I was used to before but haven’t been able to participate in during treatment such as casual dinners with friends, book club, and my young professional society. She also suggested that I have a party to celebrate: “Something to commemorate the occasion and make it official,” she said. I’m already on it! With the help of my dear friend Nancy, I will be throwing a REMISSION EXTRAVAGANZA soon!!! This, of course, is the follow-up to my “Screw Cancer” party, aptly named my “I Just Screwed Cancer” party. I’m nothing if not classy.

After my appointment I strolled down the hallway to the infusion room so I could say goodbye to the nurses. Upon seeing me they each grabbed a bubble gun, gathered around me, and inundated me with soapy bubbles while cheering and clapping. Nurse Shannon announced to the room that I had officially completed chemo and was CANCER-FREE, and the full house of patients and clinicians applauded for me. Then Nurse Maxine presented me with a certificate declaring me a chemotherapy graduate. Mom cried, the nurses cried, everyone cried but me as I stood there happily dazed, not sure how to take it all in (admittedly, the bubbles helped). The most memorable moment of all was when Maxine called out, “You WON!” and I realized that yes, I did win. I fought an evil demon that tried with all its mighty power to kill me and I emerged the victor. I may not have wielded a sword or shield, but I still fought like hell and it paid off. I WON!!! Yes, indeed.

After scheduling my six-week appointment, Mom and I got back in the car and headed straight to Rockport. The last time we took that drive was just before Christmas following a particularly bad chemo. Only days after that drive, I had found myself in severe Neualasta-induced bone pain that required heavy narcotic painkillers. This time, I was tired but didn’t mind the inconvenience in the least since I knew that each day would only get better after this final chemo pattern took its course. Furthermore, my blood counts were so good that I didn’t need Neulasta and my hair was growing in, albeit in a cartoonish sort of way. The one glaring negative was that the high dose of Bactrim antibiotics that I was on since Day 1 in the hospital had taken effect on my body (it’s amazing that anything affects me anymore!) and I was experiencing serious nausea and vomiting every morning. That drive was no different. Although my nausea was delayed, I instead threw up a considerable amount of nastiness into a towel midway to Rockport. The funny thing was that puking had become such a routine part of my life that I simply paused my conversation with Mom, heaved into the towel a few times, and resumed my part of the discussion. Neither of us blinked. Saaaaaad. Aside from the nausea, the Bactrim gave me thrush (yet again) and, just like last time, I knew I’d have to manage the inconvenience with lots of ice water and no spicy foods (a cruel form of torture, if not near impossibility, in South Texas).

I accomplished little more than resting and reading on Thursday through Saturday, wondering when my energy was supposed to return and waiting for its magical re-emergence. Turns out, my fairy godmother and her magic wand were nowhere to be found. Bitch. I realize that, on one hand, I wasn’t doing much to facilitate it, but on the other hand, I seemingly wasn’t rebounding at all to the extent that one would expect after a flu or virus. I was waiting for that gradual daily strengthening to transpire, and I eventually complained to a fellow Hodgkins survivor that I wasn’t getting back to normal yet. “You do realize,” she said, recounting what her oncologist told her and which eventually proved true with her experience, “that it will take about a year to get back to 100%, right?” No, I did not. She further theorized that, while it took six months of toxic poison to cure me, it will take at least that length of time of biological healing to make me feel normal again. Okay, stated like THAT, maybe it makes some sense…..Hmph.

Remembering this sentiment, I pressed further. Dr. Wilks had told me to start off by walking 20-30 minutes at least three times a week and doing “bed weights,” or lifting my legs with ankle weights and doing basic arm curls with two-pound dumbbells while watching TV or reading. Logically, it makes perfect sense, yet realistically, I wonder how she expects that to happen. “Later,” she instructed, “you’ll want to invest in a treadmill or elliptical machine.” Riiiiiight….. I thought. I’m lucky if my lungs afford me the ability to walk from the car to the clinic door without collapsing, yet explaining that to others was a moot point. At any rate, I already had the weights and planned to implement them along with some yoga and walking as soon as I returned home. But, I theorized, I’m not home yet so I’ll just pull the covers over my head and rest a little while…

I spent the next few days reveling in my Rockport seaside laziness. On Saturday, Mom and I went to the Rockport marina to visit Gary while he was working on the boat he captains. This is such a different world from the one I’ve known as its commerce relies heavily on the boating, fishing, and vacationing community. Gary is a world-class fisherman and boat captain and is thus connected with people I would normally never know and in a world I will never understand but will gladly visit for an escape from my own reality. Picture this: We pull up to the marina/restaurant parking lot that is adjacent to high dollar condos and surrounded by palm trees. Lizards and seagulls abound and scurry as we approach. It is a beautiful, sunny, 80 degree March day and we walk along the docks while commenting on the boats of varying sizes--small fishing boats and large yachts alike--and the people who are there for varying purposes. Some are managing the vessels--just like Gary--as others are boarding their wee multi-million-dollar investments. Mom talked to Gary while he manhandled an outrigger and I sat at a picnic table watching the boats drift in and out of the marina, overhearing the stories of who these intriguing people are and what they do. “That’s a neurologist from San Antonio. He’s got three mistresses,” a stranger informs me and “There’s the real estate agent from Corpus. He’s worth billions.” Recession? What recession????....I digress. Anyway, there I was, propping myself up on a picnic table in khaki capris and a navy shirt wearing my bright, paisley scarf and big Hollywood starlet sunglasses, taking in the sun and relishing the breeze. Life doesn’t get any better.

Later that afternoon, Mom and I took a neighborhood walk and I was able to successfully amble the 1/5 mile without losing my breath or passing out. This gave me pause and allowed me to reflect on what I’ve been through and what I can look forward to that I ABSOLUTEY won’t miss from my cancer experience. For my own therapeutic indulgence and your reading pleasure:

Sarah’s list of SHITTY SIDE EFFECTS TO WHICH SHE BIDS GOOD RIDDANCE

Hair loss: The q-ball in me insists that the implications here are obvious
Fatigue: This ranged from the inability to run errands to the inability to get out of bed
Sleeplessness: Despite the aforementioned fatigue, I was unable to stay asleep past 4:00 AM and, even then, only with the aid of prescription sleep aids. This is commonly due to both chemo and steroids, of which I was on both.
Going Stir Crazy: This was a serious problem. Days 1-4 post-chemo I was typically exhausted but climbing the walls. I wanted more than anything to take naps and go to bed early, but the specific chemo regimen I was on rendered that impossible. Instead, I would take Xanax and wait for the calming effects to soothe me, whereupon I would read and pass the time until 5:00 PM, the first socially-appropriate time for wine consumption. In turn, the wine would make me feel wonderfully normal again and, for about five hours each night, I could see a glimpse of my old self
Insatiable Food Cravings: ….Particularly BBQ, Pizza, and Hamburgers. Odd, since I never craved meat before yet I was a sweets freak prior to cancer. During treatment I could totally live without chocolate.
Nausea and Vomiting: Daily spells of both colorful upchucks AND unproductive heaves
Skin Problems:
Insanely dry skin, leading to…………
Itching, causing severe………
Bruising, scarring, and discoloration all over my body, namely my chest (near my mediport), and on my thighs, stomach, and arms. I still wonder today whether they’ll ever go away. Mom recently bought me Mederma so we shall see….
Amenorrhea: ‘Nuff said: Welcome to the land of Geriatrics.
Mouth sores/thrush/cold sores: This was an ongoing problem. I contracted a serious case of thrush twice; once in October and again at the very end of chemo. While Nystatin helped with pain control, it was still a major problem when trying to eat, drink, or talk.
Excessive Bleeding: Cutting myself shaving was a bitch.
Neulasta:
The bone pain I experienced from this “wonder drug” was unbelievable!!! I have never felt more distress in my life (all three times) and cannot adequately express the bone-crushing misery that I (one of 26% of Neulasta consumers) endured. Furthermore, upon receiving my clinic bill I laughed wholeheartedly that said Neulasta retails for over $7,000 per dose. What the F does it contain….holy water? Thank God for catastrophic coverage at 100%. Neulasta for Sarah = $0.
Prednisone/Other Steroids:
They may work wonders on some people but I experienced only hunger, weight gain, and irritability. Awesome. My doctor told me to discontinue the Pred while I was in the hospital and, ceremonially, I dumped the horse pills into the waste bin and happily ditched my daily dose. After 12 extra pounds, I didn’t have to be asked twice! I may not ever be the size 4 I was in college, but I WILL get back down to my fighting weight….
Blood Counts:
I clearly did not have an accurate grasp on my blood counts and therefore decided to graph my numbers. This may have something to do with the fact that I love charts and graphs and consider myself a Microsoft Excel nerd. Or just a general nerd.


-Omitted for formatting purposes-

On Sunday I went on a date with a local Rockport boy. Awwww…..all of you say. Yet, although I would love to report that I was wooed by the local country boy thing, I can only say that it just wasn’t there. I had a great dinner and decent conversation and, despite the undeniable fact that I wore a scarf and was experiencing a very precarious cancer recovery and that those things did not bother him (a very noble quality), I just couldn’t commit to a second date. Don’t think of me as hardcore and difficult….just realize that, cancer or no cancer, I’m still a girl with high expectations.

We hosted a thank-you dinner on Tuesday night and I was delighted to entertain my surrogate mothers as a pathetic attempt to compensate them for their help during my illness. We invited Susan and Rufus (who took Lola for me while I was hospitalized), Jackie and Charlie, and Sandal (another cancer patient who has supported me through my journey). Four of the five guests made it as Sandal was in a Corpus Christi ICU unexpectedly dealing with her own illness. Plates of salad, bread, Gary’s awesome spaghetti, and strawberry shortcake later (not to mention the wine and champagne toasts), I felt blessed that our guests of honor came but saddened that Sandal was so sick. It was bittersweet.

Mom and I returned to San Antonio on Wednesday. That night, as per tradition, we hit County Line for some amazing Texas BBQ and live music. Before going to the restaurant Mom and I had stopped by the mail center to discover that even more people had contributed to my medical bills. We were both overwhelmed with emotion and thankful for everyone’s generosity. Plus, the BBQ, fries, and margaritas were VERY healing. I felt both soothed and regenerated with every bite and sip.

We hit our favorite brunch spot on Thursday morning (do we do an inordinate amount of eating?). Magnolia Pancake Haus has the BEST pancakes ever. Mom is a world-class connoisseur and can testify that, right up there with Cracker Barrel, they are pretty damn awesome (please put this on your list if you visit!). The weather was horrible and Mom had a mission to get home for some previously RSVP’d events. With the excuse of waiting out the rain and wind, we hung around and watched TV and held out for the all-clear on the news. At 2:00, Mom took off and I was left alone indefinitely in San Antonio for the first time in over six months. What on Earth was I to do now that I was completely on my own?

All joking aside, I felt lost. No one had called since I was pronounced in remission yet I was suddenly thrust back into my former environment, minus the safety of the friends, family, love, and support I experienced during my illness. I suddenly wondered who I was without LLS or CCCST. It occurred to me that I was now officially a different person. I was a Cancer Survivor. I was In Remission. I was All Better. When given the all-clear you are told that you are not yet cured until you hit the seven-year mark, but I felt as though others had written me off: She’s not doing chemo anymore. She’s fine now. She doesn’t need us. Time to move on to the next cause….. Terrible thoughts, I know, but that’s where my mind went. The next few days were hard; very hard. I had a Master’s degree but no job, health but no hair and no energy, support but no one around…. It was a bona fide conundrum and I was a walking oxymoron. To cope I spent a lot of time sleeping, drinking wine at night (NOT before 5:00 I say!), and pondering the next steps of my life.

Luckily, I didn’t have much time to contemplate. On Tuesday, March 31, I interviewed for a Practice Administrator position with a large endocrinology group in San Antonio. This came about when my friend Steven turned down the opportunity seeing as he was happily employed with a cardiothoracic group in town. Instead, he referred them to me and I reluctantly agreed to take their call. “Steven,” I said. “If they want YOU, they won’t want me. You have several years of experience running a subspecialty group; I have one year running a headache clinic.” He told me to let them review my resume and see what conclusion they come to; if they interview me it will, at the very least, be great experience. I couldn’t argue with that logic and agreed to patiently wait for a call. While I was in Rockport, the Nurse Manager, Mickey, called to schedule an interview and I accepted it, by this time decidedly excited for the interview practice opportunity.

On Tuesday I gussied myself up in a skirt suit, silk shell, jewelry, heels, and Veronica the Wig. I was HOT. The interview with Mickey, the Nurse Manager, went well and the subsequent interview with both practice owners/MDs (though there are 7 providers in the office) was similarly decent. I adamantly insisted to the doctors that no, I have not had experience with THIS and No, I was not able to do THAT. Thanks for the practice, folks, I’ll be seeing ya….. I thought with complete sincerity and appreciation. “We’ll be in touch,” the Nurse Manager said. Grateful for the opportunity, I left with my head held high, ready to continue the job search but now armed with a little more oomph in that I had just been interviewed by an impressive, prestigious group. Nice. But as much as I wanted to admit that it didn’t matter…..DAMN……that job sounded fantastic. The docs were great, the staff was efficient, the practice was well-established, and the benefits were enviable. I. Wanted. That. Job. My thick skin and iron shield attempted to protect me from those feelings and I managed to whisk them aside, certain that I could feign indifference while searching for something better. Something lesser. Something more…well….me.

A full week of cleaning, People’s Court, Lola walks, errands, and daily 2 PM naps later, I got a phone call from Mickey: “They’d like to see you back on Tuesday.” Huh??? Did they not hear me when I explained how unqualified I am??? “It’s looking real good Sarah,” she added as I furrowed my brow and wondered what they possibly saw in me. Instead, I smiled, nodded, and tried to maintain my composure as she verified my proposed start date. When we finished the call I dialed Mom, squealing into the phone: “I’m….so…..EXCITED!” I told her about the second interview and added that I felt it was going to happen. “I told her I could start on the 13th and she wrote it down!”

I hosted another Girls’ Night just days before my big interview. Nancy, Heidi, and I ate salad, lasagna, and garlic bread, and drank copious amounts of wine as we discussed our usual wildly inappropriate topics. I worried about what would happen if I didn’t get the job (and, despite my previous optimism, chances are that I wouldn’t land the gig given my lack of experience….) and they talked about their respective child and husband issues. Good counseling session all around.

The following Tuesday, in the grand tradition of the likes of other divas like Anne Boleyn, I reluctantly marched to my own beheading (AKA: the Final Interview. Okay, so I’m completely obsessed with British history—particularly The Tudors—and some may call me an Anglophile, but I make no excuses for my preoccupation with medieval monarchy). Mickey welcomed me back to the office and I played the game of Selling Oneself. She asked me where I saw myself in five years. She asked me who my hero is. She asked me how I relieve stress. I wanted to laugh at each question—not out of disrespect but out of sheer enjoyment….finally, something I can answer. I may furnish an idiotic response but these qualitative questions typically result in reasonably intelligent verbiage, particularly given my recent experiences with Life and Death. Mickey took me to Dr. Becker’s office and Dr. Uy promptly arrived. As he sat down, Dr. Becker asked how I was doing and then followed with, “Well, we think we want to offer you the job.” Ummm……Okay... . I thought, taken aback by the immediate offer.
“Are you aware that I am a recent cancer survivor?” I asked. When they shook their heads no, I told them that I had just conquered Hodgkins Disease, was finished with chemo, and expected to be forever cancer-free. They seemed indifferent about it and asked questions like, “So who was your oncologist?” and “How are your blood counts?” Typical doctor queries. Once again, I could answer these questions. I felt certain that my history would not affect how they regarded me and my professional background. I nodded idiotically as Dr. Becker discussed the pay, benefits, and expectations. I nodded and sputtered incoherently while they recalled the details of the position, shook my hand, and walked me to the door. “You said you can start on the 13th, right?” “Uh-huh,” I nodded. “Great, see you then!”

Excited and overwhelmed, I confidently walked out of the office searching for my cell phone in my purse. I have to call Mom….And Judy…..And Nancy……And so many other people. I exited the building (within the perimeter of--and associated with--the local hospital) and began walking through the two parking lots toward my car. My feet gradually became heavier and I wondered if my shoes were fastened correctly. With a quick glance downward confirming this and, upon determining that all appendages were also attached adequately, I kept walking. I grasped the concrete rail yet I walked. I looked around me with paranoia yet I walked.

Heavy….heavy…….HEAVY………H…E….A….V…..Y. Suddenly, my calves couldn’t support my feet anymore. I lost balance. My ankles twisted in my fabulous strappy, pointy-toed, stiletto heels. I waffled. I wavered. I fell.

SMASH!!!

With little warning I was on the pavement in a puddle of humiliation. People rushed toward me and asked if I was okay. “Yeah….yeah….I’m fine,” I said, trying to regain composure. The strangers helped me up as I attempted to find my balance. “I lost my footing. I was undergoing chemo for six months and now I’m trying to play in the real world,” I explained with a laugh. The strangers smiled apologetically and insisted on helping me up. As I thanked them and obliviously continued my pursuit toward the car, more hands and feet rushed toward me and I was suddenly aware that I was once again unbalanced. Just before my cheek met the ground, the environment around me started reeling and I was well aware that I had lost composure and fallen. I tried to indiscreetly help myself up. Instead, flocks of people rushed over and offered an arm, a hand, a ride home. Humiliating though it was, I was grateful for the help. Two strangers held me up as we walked toward my car. Upon approaching it, a police officer materialized and offered to call a squad car to take me home. “We can get your car home some other way, Ma’am,” the officer stated. I insisted that my fall was a result of a musculature problem, not neurological. In other words: I had the mental capacity to drive. Each of the three helpers monitored me as I removed my fabulous, killer heels and shifted my car into reverse. I’m convinced that they watched me drive down the street and onto I-35 toward home. I called the cancer clinic (with my earpiece properly inserted, thank you—I friggin’ HATE when people hold their cell phones to their ears when they drive!!!), and told the nurses about the incident. Within seconds they called me back and said that Dr. Wilks INSISTS I come right over in case this is indicative of serious nerve damage, blood count problems, or anything else. I called Mom and told her that I was on my way to CCCST because I walked out of my interview and collapsed and people came over and the helped me to my car and a cop rushed to me and it was really embarrassing and……and…..and……” But what about the JOB???” she asked.
“Oh, I was hired. I start next Monday,” I panted.
“YOU DID??? That is so great!!!”
“Yeah, I’m excited. So anyway. This was totally awful. I can’t believe it just happened and I’m horrified!!!”
“BACK TO THE JOB!!!”
And so our conversation was bipolar in that I focused on the shameful thing that happened and she continued to steer me toward the positive: I am now gainfully employed by a long withstanding specialty practice that knows about my illness and is totally fine with it. Wowza! One caveat: I had to return the next day to learn the payroll system (notoriously problematic according to my sources) while the interim Administrator is still available before entering into full-fledged retirement. I hear that once retirement is achieved, contacting these people is like Mission: Impossible. Better jump while I can.

The phlebotomist at the clinic drew blood and Dr. Wilks said that everything looked relatively decent. Not super yet, but not alarming either. We both agreed that I probably experienced a collapse caused by muscle atrophy since I spent the past three or so months in bed, save a few daily trips to the fridge, potty, and nearest plot of grass to service Lola’s needs. Dr. Wilks thinks that wearing fierce, wickedly awesome pointy-toed, ankle strap stilletos was probably an idiotic idea seeing as, in the last three months, I was usually barefoot save for a few hours wearing slippers or slip-on tennis shoes. Come to think of it, those heels were probably a bit ambitious but then the fashionista in me usually wins out over my internal 88-year old (and yet, I had exactly 7 shiny, silver strands on my head before my hair was destroyed by chemo; Methinks if it grows back representative of the my inner octogenarian, I will gladly pursue the Nice ‘N Easy route toward aging…) Dr. Wilks continued her explanation that part of the problem was likely, albeit indirectly, neurological as well in that had I stayed on the ground the first time until the moment passed and my body had a chance to fully recover, I probably would have regained my composure and been fine. Instead, in my haste to get the hell out of there I rushed it and collapsed again…..and then again. The message never had a chance to connect from my legs to my brain before I attempted to apply pressure. Dr. Wilks told me to lightly lift leg and arm weights as I begin the basic tasks of standing, walking, and engaging in the outside world once I start my new job.

After all of that excitement, I never had a chance to get nervous about the next day’s lofty training agenda. For the first time in an eternity (for over an hour at a time, anyway), I put on real pants—those made without spandex, elastic, or denim reinforcement—and a shirt that had actual buttons. I arrived at the office a good 30 minutes before Barbara (the interim administrator) and took that time to meet the staff again. As I was greeting someone in the hallway, a tall, commanding figure dressed in polyester, orthopedic shoes, and a white bouffant hairdo (yes, this was a ‘DO), march toward me. Still in interview mode, I flashed her a smile and stuck out my hand. “Hiiiiii, you must be Barbara. Thank you SO MUCH for coming by to help me out!!!” I gushed.
“Yes, I am. I’ll be in the office,” she muttered and continued walking. I looked at Mickey and she glanced away, seemingly reluctant to make eye contact. “I’ll let you get to it,” she said and quickly disappeared.

The next four hours were nothing short of awful. Cruella De Vil was patronizing, sarcastic, and rude and refused to be of any help. She made it clear that she hates this job so much and was PISSED OFF when the practice asked her to do this teeny, tiny little favor of training the newbie. She told me that she wishes me good luck (“because you’re gonna need it,”) and that everyone on staff is inept and crooked (“that one steals,” and “that one lies.”) During her diatribes, staff members would start to walk into the office, stop short when they saw her (did that girl’s shoes just screech and emit smoke as she skidded to a stop???) and quickly back out muttering something about coming back later. Within the first two hours it became comical and, instead of stressing, I started to find humor in both her bitchiness and the staff’s fear alike. Wow. This is an interesting social experiment based on the dynamics of fearful employees and the fear-mongering boss. Or Wicked Witch of the West. Or Cruella. Take your pick. I learned nothing that day but I did have a mini-therapy session with myself. I thought: if this is the act I’m following I’m set. I may not be the most experienced Suit on the block, but I’m nice and I’m ethical. In my world that means I’m already ahead.

The next day I filled my prescription from Dr. Wilks by hitting Target and Stein Mart on the hunt for flats (she had ordered me to forego heels for “AT LEAST A YEAR, SARAH”) and I, in turn, found some perfectly hideous Grandma shoes. Who knew ugly could be so comfortable??? While waiting in line at the register, my cousin Taryn called to check in after hearing about the Unfortunate Parking Lot Incident. As I was telling her that it was all due to chemo-induced, fatigue-induced-atrophy, about twenty heads turned around and I was actually surprised! Since finishing chemo seven weeks prior, being discharged from the hospital five weeks ago, and having Wilksie declare me cancer-free for three weeks, I was shocked to find that I was no longer used to constantly being on display as a Cancer Patient. At this moment I realized that I was in the process of Moving On. Not quite sure how to process it, I was neither happy nor sad…..perhaps complacent. Furthermore, I began my intensive cleaning spree later that afternoon. Whereas before I might have convinced myself that I was simply preparing for my shiny new life as a professional woman with a fabulous job, Freud might have suggested that I was ceremonially scrubbing away the icky cancer germs.

The next day I sacrificed my final unemployed weekday for the insanity of having my prescriptions refilled at Wal-Mart. More notably, I opted out of wearing a head covering: Neither hat nor scarf nor wig. Most people looked at my scruffy head with disinterest (later, I also realized that wearing minimal makeup, yoga pants, and t-shirt MAY have impressed upon the general public that I was….say…..”masculine”) whereas others saw my prescription bag and Livestrong bracelet and registered a look of combined clarity and pity.

After a weekend of chores, organizing, filing, paying bills, cleaning, cleaning, and more cleaning, I felt somewhat prepared for work on Monday. In fact, I reported for duty at 8:00 a.m. and made it through an entire day without collapsing. All day I waffled between two different emotions/scenarios. First, I recalled starting my first Administrator job over a year ago. I had developed the flu just before Christmas and was diagnosed with full-blown Influenza B in late December. That meant that I had the emerge-slowly-but-linger-for-weeks version (as opposed to A, which reportedly hits fast and diminishes as quickly as it comes). I had called my new boss (the head Doc) on New Year’s Eve and told her, with despair and a croaky-froggy throat, that I was probably too sick to start work on January 2nd. Upon hearing my voice she immediately agreed and was obviously more worried about me than about my start date. I celebrated my 29th birthday sleeping in bed, and reported for work the following Monday, January 8th. Yet, despite sleeping for days—if not weeks—I was barely standing after lunch on that first day. Finally, at 2:00, Dr. Holt convinced me to go home. This continued through the week and I was finally able to last the full workday the following week. Yet, on April 13th, 2009, I looked at the clock a few times only to find that it was already 10:00, noon, 3:00, and 5:12. I drove home pleasantly exhausted and mentally challenged, wondering what the hell I was doing but excited about the possibilities. More importantly: I faired better on my first workday post-cancer 2009 than I did post-flu 2008. That just plain rocks.

As the week progressed in my new role, my staff started to feel comfortable enough with me to ask questions (I was clearly not Mean Barbara and they could therefore attempt to converse with me without fear of being fired). They all wanted to know what I did before this job and I always answered that I managed another clinic. Later that week, as I pulled a chair up to the table in the break room and engaged the girls in lunchtime conversation, they pressed further and I relented. I explained that I did my undergrad at TCU, worked in Dallas for three years, did my graduate studies at Texas State, my residency at University Hospital, and then started working for the Headache Institute…..pause….gulp. “Iwasdiagnosedwithcancerandtookseveralmonthstogothroughchemoandrecover, and then I was hired here….” . This obviously elicited many responses and I answered the rapid-fire questions as they came—particularly regarding the truth about my unchanging hairdo….I was, afterall, sporting Veronica the Wig everyday). By the end of the week the entire office knew and I felt confident that I had handled it appropriately. While I had decided to NOT make it knowledgeable by public announcement, it was also no longer a secret. To this day I can say that I handled it correctly for me: Those who asked me directly got a straight response but I also allowed for word to spread on its own without my shoving it down people’s throats. In other words: this is me but it’s not ME. I informed the staff that I would periodically be gone for appointments, to which they all nodded solemnly and performed cheesy gestures like thumbs up and pumping their fists in the air. I was just waiting for them to start quietly and slowly chant “Sarah……..Sarah.....Sarah....SA-RAH…SARAH..SARAH!!!!” in the spirit of the movie “Rudy.”

That weekend was very much a repeat of its predecessor. I had no idea how tired I was until I was allowed to sleep in on Saturday morning. I lazed around in bed until Lola forced me to get up and walk her. When I returned, I poured my coffee and, instead of sitting in the living room and watching HGTV, returned to bed (to watch HGTV, of course). This continued throughout the entire day save periodic bathroom interludes. I told myself that my weekly chores could wait until after coffee….wait, after lunch….perhaps when the sun starts to go down……blah blah blah. Finally, I resigned myself to the realization that I wouldn’t get anything productive done until Sunday. As delighted as I was to put aside all responsibilities for the day and embrace the silence, I realized that it was just that: silent. Still, no one was calling, no one was texting to check in, no one was sending cards in the mail, and very few people were e-mailing. My Facebook activity was suddenly nil (of course that was mostly my fault but try to convince me of that in my sudden state of self-pity). Still, I drew from my conversation with Dr. Wilks and the LLS support group: People don’t intend to be mean. They actually mean well and their heart is in the right place when they assume that I am now no longer needing them. They are simply giving me my much-deserved space. They are respecting my privacy and wishing the best for me. What they do not realize, however, is that I expect nothing more than their mere presence (in whatever form) to remind me that, even without cancer, I am still worthy of their time. I couldn’t help but wonder if I was just a project. Now that I’m fixed, are they on to the next assignment?

Through my third week of work I stayed busy and thought very little of my former life as Cancer Patient. I was too busy negotiating managed care contracts, purchasing equipment for the clinic, performing cost analyses of medical supplies, counseling wayward employees, and researching the new Red Flag Rules that the FTC idiotically decided applies to healthcare. In short: I would frequently get home and crash. My evenings consisted of changing clothes, walking and feeding Lola, drinking wine, making dinner, reading, and going to bed. L-O-S-E-R. In my free time I was able to obsess about the fact that my chemo scars (physical, not emotional) from scratching my dry, irritated, poisoned skin have not gone away. In fact, they have not faded in the slightest. I recall wearing a cap-sleeve sweater one day when the violent brown streaks on my arms were visible. I didn’t notice--nor did I even think about--my scars when I got dressed. Furthermore, I obviously must have seen them in the bathroom mirror but have grown so accustomed to those ghastly marks over the last seven months that they didn’t register with me at all. When in public, however, I became self-conscious, suddenly aware of something that hadn’t bothered me before. That day, at least four people recoiled in horror when they laid saucer-sized eyes on my upper arms. “WHAT HAPPENED????” I made light of it by telling them that “chemo’s a bitch” and they laughed it off, but we both parted ways a little skeeved. Awk-ward, I would mouth to myself. Still, if I were to cover all of my scars I might as well move to Afghanistan where I hear burkas are all the rage. To make matters worse, my steroid weight is gone but my chemo weight is not: I still have ten pounds to lose until I get back to a comfortable “me” weight. As annoyed as I am about having to wear Spanx under my pants, I’m still not resorting to the extreme measures of Sarah from days gone by. I’ve spent too much time feeling awful and I refuse to make myself feel that way voluntarily a la starvation and vomiting. And, while scars and extra weight are already salt-in-the-wound offensive enough, the worst was yet to come. One day as I was putting on my makeup in my ultra-illuminated, mega-magnified makeup mirror, I noticed something horrifying: Tiny, fine black hairs sprouting from my undereye area. I can say with absolute certainty that they were NOT there before. The blood drained from my face and I lost all sensation in my extremities as I took in this new development. Shortly thereafter I googled this bizarre symptom and found that it is a result of severe chemo-induced hormone changes. While undergoing treatment, most women are basically thrust into menopause. When treatment is ceased, hormones are understandably out of whack and sometimes shift into overdrive. This is apparently the case with yours truly. As I was reading this scientific literary delicacy, I felt the wind knocked out of me as I happened upon the portion that said it “may or may not stabilize.” Oh. My. God. Am I going to have to have annual prostate exams soon? Will my uterus shrivel up and expel or…..worse yet……will my future child have to purchase bras AND boxers? More on this mini-tantrum later.

On Monday, April 20th I went to Dr. Deal’s office for a second pulmonary function test. The first PFT happened just before Christmas—midway through treatment---to see if the chemo had significantly damaged my lungs (reparably or irreparably). It hadn’t, but they like to conduct a post-chemo PFT after it’s all over. Moreover, I had just battled a very serious and rare case of pneumonia which alone can cause long-term damage. While eyeing the computer screen during my appointment, the tech indicated that things appeared decent on her end (good ‘nuff for me) and asked why I was getting the test at all. I explained the cancer, the chemo, the pneumonia and hospitalization, etc. and she told me that Dr. Deal would have LOVED to see me again—particularly looking so well—but he’s not in at the moment. I have to admit that, given professional attire, makeup, and Veronica, I am miraculously able to fool ‘em all. Of course, like most specialists, he’s arranged his schedule so that he doesn’t have to work on Friday afternoons or Monday mornings. I say that tongue-in-cheek because I know they work ridiculous hours all the time. Most patients get irritated when they can’t get an appointment during those slots but with clinic hours, hospital rounds and procedures, documentation, and dictation, doctors end up working well beyond the standard 40 hours. Double it and you’re in the ballpark.

As I was leaving Dr. Deal’s building, I noticed another suite’s door with Dr. Wood’s name. WHA??? My pulmonologist and infectious disease doc in the same building, on the same floor, next door to each other??? I walked in and asked if Dr. Wood was in. The receptionist shot me a withering stare and said that no, he’s not in clinic on Monday mornings. I explained the situation and she instantly brightened and asked my name. I told her and she said, “I remember you! I made your chart! Wow….I remember that you weren’t doing well at all. He would always say that he’s going to see his cancer patient at the hospital.” I was inspired to whip out my cell phone given that, at one point during the most serious time of my hospitalization, Mom had taken a mobile photo of me. Now folks, let’s do an exercise: Picture glam Sarah (come on…just go with it). Now, remove the hair. Remove the makeup. Add a cast of chalky white paleness to the face and hollow circles around the eyes. Add glasses. Add oxygen mask. Add hospital gown. Just for effect, insert in background tangles of wires, tubes, and monitors. There you have the Sarah that Dr. Deal, Dr. Woods, Dr. McCutie, and all the nurses knew. Classic. I showed this photo to the tech and she gasped….. “is this YOU??? Oh my god!!!” (Picture her glancing back and forth multiple times)….He would LOVE to see you now!!!”

As I walked to my car I called Mickey at the office. She informed me that the accountant, who comes once a month--as well as Mean Barbara--had commandeered my office to close out the months’ end books (Nancy) and do payroll (Barbara). She laughed and told me to stay away….not only was the space limited but everyone was at risk of suffering B’s wrath these days. Instead, I decided to meander across the street to the hospital where I was treated. I wanted to say hi to my nurses and perhaps talk to the financial counselor there. I wasn’t due back to the office until lunch time and it was only 11:00, so I might as well make it useful.

When I entered the hospital I made a beeline for the oncology unit just past the welcome desk and to the right down a long hallway. You know you’re there when you see cancer support group posters, “I’m an Oncology Nurse” ads for open positions (it’s a highly specialized form of nursing and very hard to fill), and handwritten signs on patient doors such as “NPO” and “Patient Receiving Chemo.” I felt strangely at home. Yet, as I happened upon the nursing station at the far end of the hall, I recognized NO ONE. “Ummmm….Is Irene here?” I asked. “She’s up in Oncology,” the nurse responded, then informed me—upon seen my crestfallen expression--that the cancer unit was moved to the second floor but that Irene no longer worked here. WHA???? Too…..many…..changes.

I took the elevator upstairs (yeah, my energy still SUCKED) and stepped off to face a huge, open, U-shaped nurse’s station and, standing smack in the center of it, Dr. Wood. I approached and grinned like an idiot. He looked at me and nervously looked away a few times until I reached him (help me…someone???, he seemed to be telepathically pleading). The nurse asked what I needed and I basically ignored her and said, “Ummm…..Dr. Wood?”
“Yes…?”
“You probably don’t remember me but I was your patient a month ago??? I am Dr. Wilks’s lymphoma patient and had pneumonia? Yeah, so I was here for over a week and you treated me? Ummm…My mom was there the entire time……???”
“Oh riiiight! You have hair…I didn’t recognize you!”
“Well….hair, color in my face, and real clothes so, yeah, I’d hope you wouldn’t recognize me.”
“Yes, you were in really bad shape. I remember that. I was worried about you.”
“Awwww…..well, you basically saved my life,” I said with complete honesty. He was the sole individual charged with determining what I had and how to fix it. The other doctors—my oncologist and pulmonologist—were incidental at that time.
Shortly after our encounter (which, I should mention, was very healing as it brought me some sort of closure) I was told that the hospital underwent “major changes” and that most people from the first floor are gone. Major bummer.
As I was walking down the interminably long hallway of the first floor toward the exit, I saw a familiar bald head with wire-rimmed glasses.
“Dr. Deal!” I called like an idiot. At the revolving door, he stopped and looked at me politely, yet impatiently. “Yes?” he asked with a half-irritated smile.
“You may not remember me but I was your patient here a month ago. I was in oncology…..? Dr. Wilks’s patient….? Pneumonia…?”
“OH RIGHT!!! I didn’t recognize you with hair! You look great!”

We chatted a few minutes about my Lymphoma, my new job, and my lungs, and then he said, “Well, since I know you look this good now I should give you David’s number.” Folks, you may recall that “David’ is Dr. McCutie and I was his biggest fan. Oh who am I kidding….I was his indentured servant. Dr. Deal and I both laughed it off—he apparently meaning it as a joke and I feigning carelessness while in actuality experienced an arrhythmia—and we parted ways. As I walked out of the main entrance my legs started to feel heavy. My shoes were suddenly clunky and I was mysteriously seven years old playing in my mom’s heels. Oh….Shit. I realized immediately that my legs were giving out and cursed my self-diagnosis earlier that morning that I was strong enough to wear high heels. What are the odds? I asked. Lighting doesn’t strike twice!!! I found the nearest concrete bench, sat down, and frantically removed my heels. Sophistication be damned….I shall walk and drive barefoot! So, while I did not collapse again, I did humbly accept that Dr. Wilks knows better than I and that perhaps I am not ready to jump into big girl world just yet. Baby steps…..

So regardless of what could/would happen with Dr. McCutie and my dating life, I was on Cloud Nine. I returned to the office feeling renewed after having seen my former doctors and feeling like the final chapter in my scary book was closed. As usual, pharmaceutical reps had brought a gourmet lunch (and I’m not kidding when I say that most bring 2 different salads, 2-3 main dishes, a few sides, bread, dessert, and an assortment of drinks----sheesh!) and finished out the week feeling like I was possibly GETTING IT…..as in, I was feeling slightly less idiotic, slightly more capable, and that hiring me was not a huge mistake. Ay Que Bueno!!

Friday the 24th was San Antonio’s annual holiday Battle of the Flowers. Every year San Antonio celebrates Fiesta, which is a two-week long celebration of “our Mexican heritage.” You may have noticed that I am NOT Latina, yet as a resident of this fine city, I am privy to their advantages. Last year, my staff members warned me that Fiesta brings out the crazy in people. Not only does the city turn itself upside-down for the occasion, but people plan their lives around it. Example: Mickey took off the final week of Fiesta to attend each event and subsequently recover the next day. What I am telling you non-San Antonians is that it is quite the affair and that residents are die-hard about it. Make no mistake or risk your life.

At any rate, as per usual on the day of Battle of the Flowers, the staff was more chipper than usual, the doctors were mysteriously absent, and (with my permission), attire was reduced to jeans, solid colored shirt, and lab coat. Yes, I know….I rock as a boss. While everyone chattered about their afternoon and evening plans, I fantasized about sleep. Indeed, I spent that Friday afternoon and weekend hibernating. I accomplished nothing and it was fabulous.

On Wednesday, April 29th I had a follow-up appointment with Dr. Wilks to “monitor the anemia.” In reality, we had decided that neither of us could go three months without seeing each other and she, knowing I had met my insurance deductible and everything was fully paid for, suggested I come back to “check in.” Although I was hesitant to take off of work AGAIN after starting my fabulous new job only weeks before, I couldn’t wait to see General Wilksie. Knowing I’d go to work straight from the clinic, I laid Veronica in the passenger seat to hang out while I wore a wide-brimmed canvas hat to my appointment. After signing in, I sat down at an empty bank of chairs. Shortly after settling into a texting marathon with various friends, an elderly woman walked in and sat down two seats away from me. We smiled at each other and she struck up a conversation with me…something about me being “prissy,” (I was wearing my typical uniform of slacks, jacket, funky jewelry, and heels) and I thanked her.
“You don’t see many people HERE all dressed up,” she said.
“I’m going to work after this,” I replied, delighted to even say those words knowing that--just one month before--my future and career were uncertain. The two of us talked about our cancers, our hair loss, medications, and—eventually—the crazy San Antonio drivers. Just as I was feeling really connected with this woman, a younger version of her walked in and sat down between us. Without even looking at me, she told her mom, “I suppose I shouldn’t be surprised to look in the car next to me and see a WIG!” I laughed and said, “THAT’S MY CAR! A green SUV, right?” The entire lobby—30 or so people—erupted in laughter and we all started sharing stories of wigs, driving bald, and other oddities that only other cancer survivors can appreciate. When my name was called, I was sorry to leave the newly bonded group but eager to get this nonsense over with. Seriously…I will not miss the incessant, sadistic needles.

Since a new clinic rule mandated that all port accesses had to come from the chemo room (AKA the nurses station), I opted to head that way instead of having them stick my arm. I paid good money for this metal device and, dammit, I WILL utilize it. My veins may have come with the entire bodily package but my port is worth thousands.

The nurses hugged me, tore off my hat, and demanded to feel my fuzzy head. While waiting for my turn and lounging in a wonderfully relaxing pleather chemo chair, I whipped out a copy of my “I SCREWED CANCER” E-vite. I invited all of the nurses and most of them committed to being there. Then, as I was scanning the room and talking to the other nurses, I noticed a new face. A familiar face. Someone I could not place. It suddenly hit me and I—freakishly and seemingly without warning--called out: “Ummm….hi. Did you used to work across the street at the hospital?” The woman turned to me and said, “Yes I did,” shooting me a noticeable look of why and who are you??? I reminded her that she was my main nurse…..I was in oncology for pneumonia…..I had a bronchoscopy and my mom was with me nearly 24/7…… and….and WAIT! I have a photo! Just as she was starting to remember me, she saw the cell phone picture and smiled widely. “I remember you! You were in Suite 130 at the very end of the hall. You were really, really sick.” We chatted some more and she drew my blood. Within thirty minutes I was sent on my way, but not without boo-hooing over the fact that my NURSES were boo-hooing at my recovery. I love those women dearly.

When I saw Dr. Wilks, we hugged and laughed and smiled as she reiterated that I was doing GREAT. I gave her another copy of the E-vite but got the distinct impression that, although we are close, she does not see patients socially. I totally respect that and didn’t expect for her to agree to attend, nor did I push it. More than anything, it was a courtesy invite. Then, I got down to business…to the important stuff….to the serious business….to the abnormal hair growth. She immediately suppressed a laugh and then giggled. I insisted that she tell me what’s so funny and she raised her index finger in a “hang on…one sec” gesture. Funny, really funny. She said that she teases me because she feels so close to me but yes, it is hormonal. It may go away, it may stay the same, or it may get worse. Only time will tell but that, occasionally, some of “her girls” experience hormone changes. Ummm…..Ya think??? Then she commented that a later trip to an endocrinologist may be in order but to give it some time. Odd, since I work for the biggest and best endo group in town yet I refuse to let them view me as another case. I am not a patient, I’m their Administrator. I did not have cancer, I have always been perfectly healthy. I knew I had a CT scan in five weeks and a results appointment in six weeks. As I said goodbye, I thanked her. I told her that I owe my life to her—that she saved my life. “I didn’t save your life, God did,” she said, smiling sheepishly.
“But only with your help,” I said. She responded by saying something I was absolutely not expecting: “You have been such an inspiration to me since the day you walked through the door. I have always felt close to you and that I could learn from you. You have taught me so much.” WHAAAA????? We exchanged our “You mean so much to me” and “What will I do without you?” sentiments. I was actually choked up. We talked some more, said goodbye, and I walked toward the scheduling desk to make arrangements for my 3-month CT scan. She stayed behind to record her chart notes and, as I saw her walk out of the exam room (only a few feet away from scheduling), I called out a goodbye. “Bye! She called. “I love you!”
“I love you too!” I called. The people around us were understandably bewildered.

I returned to work with a huge boost. I was doing great, I saw people who loved and cared about me, and I was returning to an incredible job. Things were awesome.

The next night (Thursday), I was texting my friend Jeff when I mentioned (somewhat joking) that I owe my cancer to meeting a cutie: I had a crush on one of my doctors. Jeff, a psychiatrist, called me out on it within seconds. He asked: “You mean Dr. Marks???” “HOW DID YOU KNOW?” I countered, somewhat defiant and totally shocked.
“You blogged about him. Or, rather: How many young, single pulmonologists are in San Antonio?” Good point. With my permission, Jeff texted McCutie and invited him to my upcoming party. Within seconds he received a response: “I’ll be there!”
They decided to discuss details later and I was thrilled.

Mom came into town that Friday. She sells an upscale clothing line that is only presented in homes. The samples (estimated at $50,000 per show) needed to be transferred to another consultant who lives in my area—also a great excuse for Mom to visit and for us to hang out. We decided to indulge our Indian food fetish by stuffing our faces with Naan, curry, yogurt sauce, and other middle-eastern delights. Afterward, we were pleasantly fattened enough to decide to browse the nearby shoe and handbag store selling cheap knockoffs. The girls who appeared to be employed by the store were sitting at the back with plates of food on their laps. They were friendly but decidedly inattentive to their customers’ needs. I suppose we were imposing upon their fried chicken dinner. Yet, one of them made eye contact with me and said, “GIRL, THAT IS CUUUUUTE!”
“What’s that?” I asked, confused.
“Your hair! Who cut it? My cousin Shanita would love it.”
“Oh…” I said, laughing. “This isn’t a hair CUT, it’s massive hair GROWTH. I lost my hair from chemo and it’s growing back.
“For real?” She asked. “It looks like you had it done that way.”

Okay, let me back up. This is exactly what I was fearing. Mom convinced me to go fuzzy-headed (no longer can I clam baldness, thank you) because “it looks just darling.” To be clear, my head resembles a brown cotton ball that has been flattened on the top. Sexy. I had explained to Mom that I didn’t WANT it to look darling. This hairdo was not a conscious decision and I certainly didn’t want people thinking that. I mean, what would people think???? We went around in circles arguing the “I-don’t-want-people-to-assume-I-asked-for-this” vs. the “Who-the-hell-cares-you-look-adorable” viewpoints. Finally, I agreed that a few hours of head covering liberation was worth a few stares.

Now you can see why I was a little skeeved.

That night, I hadn’t heard from my LOVAH so I texted Jeff who, in turn, encouraged me to text Dr. McCutiePants. After much mutual discussion, he convinced me to just GET IT OVER WITH. Feeling invincible after conquering cancer and wearing my lesbionic haircut out in public, I did just that. Within seconds, Cuters responded that he would “definitely” be there, what could he bring? What time should he come???? I was riding sky high.

On Saturday morning, Mom and I lazily drank our coffee on the porch and watched the news. True to my OCD nature, I spent the day doing my weekly chores (laundry, dishes, taking out the trash, ironing, etc.) before getting ready for the Big Night. May 2nd was my Remission Party at Nancy’s absolutely gorgeous home in Stone Oak. Aunt Leigh Anne, Uncle Barry, and my cousins had driven in from Houston and rented a motel room nearby for the occasion. It was an awesome night. Friends from the health care sector, book club, grad school, and random other places showed up and drank wine/beer/champagne, ate good food, and listened to tunes. The house was incredible (killer party home, folks!) and the flow was amazing. Thank you, thank you, thank you to Nancy and Brian Rosenberg. It was perfect.

I know what you’re wondering: What about McCutie? No, he did not show up. Drunk on wine, I sidled up to Jeff and asked, “WHERE is your friend?” He shrugged his shoulders and said, “Have you heard from him? I talked to him at 2 this afternoon and he was coming.” I should have felt deflated but I didn’t. Oh well…..those who love me are here… right here, right now. I enjoyed the rest of the night and relaxed, realizing that my LOVAH is not coming. He is probably an asshole. He is probably a player. BUMMER!!!

Strangely, I woke up on Sunday feeling slightly depressed. Mom and I went to breakfast and I revealed my latest neurosis that I was sad. She reassured me that I was SUPPOSED to feel that way in that I had just experienced another momentous occasion. I acknowledged that this is part of the process and decided to work through it that day. Alcohol + Adieus = Blahs. I also experienced tremendous guilt over not expressing my gratitude toward Mom at the party for her unconditional love and support. I absolutely know that she does not expect it, nor does she want it, yet I realized that she deserved some kind of public recognition. In that, I failed. After a trip to Target, a long nap, a huge salad with lots of healing folate, and an order placed to 1-800-Flowers, I was in a much healthier place by Monday morning. Another chapter of my book was closed and I was ready to move on.

Now that I’m cancer free, stay tuned to my latest news. Thanks for being supportive!!!

Tuesday, March 17, 2009

Hospital Fun (Blog 19)

Hospital Fun

I staggered into Northeast Baptist Hospital on Wednesday, February 25th with complete trepidation. The admissions representative commented, as I was nervously filling out intake paperwork and Mom was parking the car, that she always feels bad for cancer patients. “I could tell you had cancer right away when I looked at you; I saw your papers and said ‘Yep! She’s going to oncology.’” “Uhhh yeah, thanks,” I muttered, not quite sure how to take that. And here I thought I was having a decent aesthetics day….

I was taken to room 130 on the oncology unit (all private suites, thank GOD), asked to change into a gown, and immediately given a pitcher of water and instructions on how to operate the bed and call button. It was all so surreal. I realize that most people reading this have experienced this by now, but I hadn’t and was dumbstruck at the idea of having to go into the hospital on—quite literally--my LAST day of treatment. Such is my effing luck. I was admitted at 11:00 AM and, save a series of blood tests, Mom and I were basically left alone. Given the effect of Tylenol, my vitals were somewhat normal--as good as can be expected for a cancer patient, anyway--and the doctors were thus not that concerned with me: I was more of an observation patient than a critical patient. The Infectious Disease doctor, a wonderful man named Dr. Wood, visited me later in the afternoon. He basically called me a mystery: I had pneumonia but they weren’t sure what kind and, until they could discern if it was viral, fungal, bacterial, or otherwise, they were going to put me on high doses of five different IV antibiotics. A few minutes later, a Respiratory Therapist (RT) came to my room to administer a breathing treatment and then ask me to hock sputum into a cup (very ladylike, I know). To that, I explained that my cough was dry and that nothing was coming up but, as per her instructions, she insisted that I make a valiant effort. I would later learn that the first run proved fruitless based on the lab results: Not enough “juicy” sputum to draw a conclusion. Gag.

That afternoon a gorgeous bouquet of flowers arrived from Rene’ and Randy. Not only did they brighten my room, but everyone who entered my creepy lair commented on how lovely they were. Rene’ said that she insisted on a PINK vase and if they didn’t have a PINK vase, they needed to find one. Indeed, it was bright fuchsia. Given my lack of hair, makeup, and jewelry, I appreciated the touch of femininity, so I send my sincerest thanks to the couple I like to call R-squared. Mom left on Wednesday night just before I was served what my friend and former college roommate, Lissa, has coined “Chicken Fried Meatloaf.” I texted her that I had no idea whether I was eating chicken fried steak or meatloaf (and, let me tell you, I am NOT exaggerating; I don’t have expectations beyond the ability to identify what I’m eating as evidenced by the fact that I actually like airplane food). The mystery meat was completely inedible and it lent full credibility to the old joke that hospital food sucks. It does.
Posing with Rene's flowers


The pulmonologist referred by Dr. Wilks arrived around 6:30 when I was eating “dinner” (the jury’s still out as to whether or not it was edible). Dr. Deal said that I was looking okay but that a bronchoscopy may be necessary before I leave in order to get a definitive diagnosis. “It’s somewhat invasive, though, so we’ll only do it if you don’t respond to treatment between now and then.” He clarified that, while my temperature may have dissipated, my cough was clearly getting worse.

Later that night, I was awakened no less than four times for my vitals (temperature, blood pressure, pulse oxygenation) and to change out my IV antibiotics. I tallied only a few hours of precious sleep and was exhausted the next morning.

Hospital Day 2: Thursday, February 26, 2009
I still managed to feel pretty good on Thursday—able to shower and brush my teeth in the bathroom without assistance--and an admissions department rep came to my room to give me discharge plans (Do you have someplace to go?  Do you have someone staying with you for a few nights?). Even though they didn’t have a specific diagnosis, I was stable and my temperature had remained normal, though my cough was still problematic. All signs were pointing toward going home tomorrow and I couldn’t be happier. Family friends Jackie and Charlie Wright sent a beautiful bouquet of bright red tulips that could almost be mistaken for roses and, along with Rene’s flowers, I couldn’t help but feel loved and supported. My room, at that point, was definitely, unmistakably, a GIRL’S room.

Earlier in the day on Thursday, I was told that the on-call oncologist covering for Dr. Wilks had ordered two units of blood to raise my ridiculously low red cell count. I waited patiently for awhile, then realized that, as the night progressed, the later the blood arrived would directly affect my quality of sleep as clinical staff would have to awake me every few hours to check my stats and change the blood bags. I should clarify that, at this point, I was freaking exhausted. You get very little sleep in a hospital and, combined with a debilitating cough, it’s safe to say that I was getting absolutely none. The blood was ordered at 2:00 pm but wasn’t delivered until close to 8:00 that night. Both transfusions would take four hours each which, after one sleepless night, seemed cruel and agonizing that I’d be awakened at midnight and 4 AM. Additionally, vitals are taken every four hours but they were not on the same schedule as the blood bank, so I knew I’d be awakened at 2:00 and 6:00 AM for those. In the wee hours of the morning, as scheduled, the Certified Nursing Assistant (CNA) wheeled the mobile vitals machine into my room and informed me that I had a fever of 102.0. My pillow and hospital gown were damp with sweat so, on one hand, I wasn’t exactly surprised but, on another, I was shocked since I was on so many IV antibiotics. My coughing fits grew worse and Becky, the CNA, was unfortunate enough to witness one of them. She took my pulse ox on a whim and found that it was 77. Note: A pulse oximeter is a medical device that clamps onto a finger and measures the level of oxygen saturation in blood; blood delivers oxygen to the cells and, with a low pulse ox, organ function declines. I thought that 77 was a passing grade (C’s make degrees, baby), but my nursing team was all aflutter fetching a nasal cannula and hooking me up to O2. “We don’t like it fall below 90,” she explained. Every point beyond that is even more dangerous, so my pulse ox was no bueno. Then again, my incessant coughing and gasping for air wasn’t exactly a sign of thriving health. I felt so much relief from the oxygen that I didn’t mind in the least the irritation of two prongs infiltrating my nostrils.

And yet, I couldn’t sleep that night even after getting O2. Robert, one of the nurses, brought me a book of paintings illustrated by cancer patients depicting their experiences with chemo and radiation. I flipped through it for another two hours (long after home decorating shows on HGTV were replaced with infomercials), and eventually got an estimated three hours of sleep. At some point, a horrific coughing spell during the night necessitated that the nasal cannula be replaced with an actual oxygen mask after they determined that the prongs were not delivering enough precious O2.

Hospital Day 3: Friday, February 27th, 2009
At the inhumane hour of 8:00 AM, I was awakened by a transporter with a wheelchair: “Your doctor ordered chest x-rays. Hop on!” Despite the fact that I was…….ohhhhh, gee, I don’t know….. IN A HOSPITAL BED, they seemed oblivious to the fact that I felt awful: nauseated, exhausted, and chilled. Once in the radiology suite I couldn’t lift myself out of the wheelchair so they managed to take the x-rays with me sitting down--in my wheelchair--in the radiology department--although the “take a deep breath” portion of the show was not gonna happen. I explained to them that I had pneumonia and that doing so was impossible, so they worked with whatever lung capacity remained. To hell with accuracy.

I returned to see my breakfast tray awaiting me and the odor of eggs permeating my room. “Please get this out of my sight,” I said, shooing it away with a wave of my hand, diva-fashion. “Are you nauseous?” The nurse asked. “VERY,” I emphasized wincing with a subconscious gag reflex.

After the x-ray, still early in the morning, I called mom’s cell and demanded to know: “WHERE THE HELL ARE YOU? I NEED TO PEE!!  She replied that she was almost here but not close enough for my immediate needs, so I resigned myself to pushing the nurse call button. I summoned Ann and asked her to help me get out of bed as I was now too weak to do so on my own without falling.
“You need a potty chair,” she stated. I stared at her blankly, uncomprehendingly.  “What?.....No!....I mean, are you sure? Because, see, I can use a regular toilet with help” I mock-asserted with desperation.
“Nope, we need to put a potty chair by your bed. You’re too weak and we don’t want you falling.” She returned with a white plastic monstrosity: a veritable dignity-sapping piece of equipment that I deigned to use, especially given the fact that I didn’t think this day would come for another 55 years. I was humiliated, but it clarified just how sick I really was.
Not minutes after using the ill-be-spoken potty chair, Mom arrived just in time for Dr. Wood to stop by (and since doctors were taught in med school to wait approximately one-half second between knocking and entry, I was lucky to have escaped an audience for my potty chair debut). He told me that they still didn’t have a conclusive diagnosis (“the sputum wasn’t sufficient”) but that, disturbingly, my potassium level had plummeted. I asked whether or not that would have any correlation with the pneumonia; he shook his head no and said that it was another issue altogether. I’d be getting two bags of potassium between courses of antibiotics. In fact, I was already aware that potassium helps to regulate heart rate and hydration, so I was suddenly paranoid that my heart was now defective. Dr. Wood also mentioned that I may be moved up to the Progressive Care Unit (PCU) for closer observation and more thorough care if I failed to get better in the next day or so. It also happened to be one step away from the dreaded ICU…. I was terrified.
“Mama, if I go to the PCU I’m not coming out of here alive. I just know it,” I said, trying not to cry.
“Baby, I’m not going to let anything happen to you,” she responded with a decidedly stiff upper lip and white-knuckle grip on my bed rails. “But, this is where your attitude comes in. You MUST be POSITIVE. You have to be STRONG through this,” she exclaimed while grabbing my left hand. “You are a fighter. I raised a FIGHTER! And if there’s ever a time you aren’t strong enough to fight for yourself, you know I will fight for you, because that’s what mothers do.”  I’ll never forget that strength and resolve in her voice….she very consciously forced me to rally.
Later that day, I learned that Dr. Deal was out of town for the weekend and that he had turned my care over to Dr. Marks. Marks entered my room and told me that, based on the fever and worsening cough, they’d be doing the aforementioned bronchoscopy at around 4:00 that afternoon. This day just keeps getting effing better. 
“Delightful!” I exclaimed after he told me that he’d be giving me “sleepy meds” and “forget meds” but that I would essentially be awake and alert the entire time. “Are you as excited as I am?!” I asked him with mock enthusiasm.
The infamous Six Flags dude
"I'm ALWAYS ready,” he said (with maybe a little too much enthusiasm?).
Muy Bien, I thought. Preparedness is most definitely a good trait when inserting a tube down someone’s nose or mouth. It is also somewhat sexy….. That last sentiment startled me as I suddenly realized that he was young, good looking, and not wearing a wedding band. I was besotted…..and fuzzy-headed in a cartoon-esque sort of way…..and wearing a cloth gown sans makeup……and, the final touch, wearing my glasses which, against my bald head and propped atop the oxygen mask, makes me look like the dancing old man on the Six Flags commercials or some kind of alien aviator. Yeah…….. I didn’t have a chance. The nurse later explained that I was NPO (no food or drink) all day until after my bronch. At that very moment my appetite was returning so the nurse quickly fetched me a pudding and banana and told me to eat up and THEN go NPO after scarfing it down STAT. I’ve never been so grateful for vanilla Jell-O pudding in my life, particularly midday.

Dr. Wood came by and reinforced that they’re still trying to diagnose my condition. An RT would be arriving again to take another sputum sample (“Try to get a good one this time”) but, for now, I would be at the mercy of the hospital for awhile. “You mean I’m not going to go home tonight or tomorrow?” I asked, helplessly. He nearly laughed and said, “I’d plan on staying through the weekend, if not the entire week.” I felt deflated. I absolutely could NOT spend another night in this place: I was sleep-deprived and depressed and SICK of being poked and prodded. A part of me thought I’d undergo this routine procedure, then recover for an hour and be released home with my mom. Soooooo…..yeah, I guess not.
“Is she going to be okay?” My mom asked with a detectable waiver in her voice. Dr. Wood raised his eyebrows and responded, “I certainly hope so. Let’s just take one day at a time and see what the tests show.” Ouch.
 Later that day, the RT attempted to take yet another sputum sample, but part deux was also unsuccessful. Later I will learn that one of the hallmarks of my illness is dry cough with no sputum. Imagine that!
Sarah as characterized by: No hair or makeup but WITH glasses, oxygen mask, hospital gown, hospital bed and a whole lotta chutzpa.


At 3:00, a full hour before the procedure, a transporter arrived with a wheelchair. I was taken into an Endoscopy room where I was privy to the preparation process of laying out the instruments, positioning me on the bed, and making sure the larger equipment was set out and operating correctly. In my nervous state, the nurse was annoying me with idle chit-chat and Mom was really effing pissing me off with gentle head strokes--such was my atrocious mood (anyone who knows me well knows that I love it when someone strokes my hair….er, bald head). I told Mom to BACK OFF (Hey Mom: sorry about that by the way) and in doing so managed to simultaneously convey that same message to the uber-verbose nurse. They promptly left me alone to stew in my apprehension.
When the doctor arrived and my Mom was excused to the waiting room I asked him a question that had been bothering me all day: “Dr. Marks, how are you able to do the procedure when any movement whatsoever sets me off into a long, awful coughing spell?” I further explained that simply moving my head an inch in either direction would trigger a fit (which, in turn, would make my pulse ox drop quite drastically), so I was dubious that he could successfully administer the procedure. “Essentially, you’re the kind of patient we do these on. I’m not worried,” he responded. I then heard him tell the nurse, “no, I like to go through the throat, not the nose,” and….without warning, an overwhelming calming and numbing sensation overcame me and I realized that I was being sedated. Wowza, this is some good stuff… Okay……YES….
Bronchoscope

I was in Recovery. Mom was at my left side and the nurse was a few feet away. I squinted to see Dr. Marks charting at the nearby counter in front of me, but twisted completely around in his chair as he looked in my direction with furrowed brow and obvious concern as I coughed uncontrollably on the gurney. I learned later that it was well after 6:00 PM and I was still coming out of my drug-induced stupor, despite being out of Endo for over an hour.
“They said you did really well,” Mom said.
“What does that mean?” I sputtered.
“You didn’t fight him and they were able to collect a sample. They didn’t get to do a biopsy because you were coughing too much—they were afraid you’d start bleeding--but that’s okay! They got what they needed.”
At 6:30 I was finally able to return to room 130 where my dinner was awaiting me. I ate a few bites, then pushed it away and fell back to sleep, frequently waking myself with mumbles and groans. I had no idea what was on my tray that night, and still don’t know; It was clearly undesired (and most likely undesirable). Whenever I did let out a loud, random “mfffffnnnnn,” I would inadvertently open my eyes to glimpse Mom staring at me from the recliner as she assessed my physical state, making sure that I wasn’t in pain. I remember repeatedly being so embarrassed that I’d made such a loud noise and would squeak out an apology but, I could almost swear, she grinned and actually chortled when she realized that I was totally high and having a trippy dream. This nonsensical mumbling resumed all night (make strange noise, awake, apologize, fall sleep….repeat). It is no surprise that I felt less than rested on Saturday. I doubt Mom did either. However, she had firmly decided to spend the night on Friday, opting instead to go home to briefly care for Lola in the evening and again early the next morning but otherwise staying with me at the hospital. She had refused to leave my side and slept in the bedside recliner with her head propped against the edge of the headrest and her feet resting on the foot of my bed, contortionist style. As with the two previous nights, I was awakened frequently for blood draws, breathing treatments administered every four hours, IV changes, and vitals. I kept asking Mom if I could request for a cot for her, but she refused, saying, “This way I can be close to you and see you at all times. I can’t be this close to you in a bed.” Only a mother…

Hospital Day 4: Saturday, February 28, 2009
Mom left at 8:00 AM to walk Lola and, during that time, Dr. Wood made his rounds. He told me that they now know what I have: Acute Atypical Pneumocystis—typically found in patients with full-blown AIDS (yes, I was tested and no, I don’t have it thankyouverymuch), and that he would be discontinuing certain antibiotics and resuming others. “This is really good news,” he said. “We’re on the right track.” Yet, after two full bags of potassium my level was not yet adequate, so I would be getting a third bag. Subtle Rene’ said that, for encouragement, she tried to track down a stripper in a banana costume. She ultimately couldn’t arrange it because, apparently, bananas aren’t sexy. Thanks for your efforts, R: I’m sure my blood pressure would have also drastically improved.

My pulmonologist’s on-call partner was also on-call that day, and thus their THIRD partner arrived and carefully examined my lungs. “You had a really difficult bronch,” he said, then explained that I had apparently coughed the entire time and Dr. Marks had asked him to keep a close eye on me. “You almost had to go on a ventilator,” he remarked. Later, Mom explained (assuming I was in a better state to accept this) that, while I DID cough incessantly, thus preventing him from collecting a tissue sample, I was a very obedient patient. That is no surprise: I aim to please. I have absolutely no recollection of the procedure but I was apparently awake, alert, and able to converse. So bizarre! The “forget meds” are called a truth serum in that the part of the brain that conceives of lies is temporarily disengaged. Shut down. Closed for business. The patient can only tell the truth and, knowing this, I wondered if I had professed my sudden, temporary infatuation for the doctor. I’m not ashamed. Let the truth be known; I wanted to sexually molest him. I also find it amusing that, along with the anesthesiologist and surgeon who did my mediport surgery, as well as Dr. Wilks during my bone marrow aspiration, the assisting nurse for the bronch told my Mom that I kept rousing during the procedure and she had to give me more and more sedation. “If I had that much they’d have to resuscitate me!” she said. Once again I stipulate: I am not a cheap date.

Hospital Day 5: Sunday, March 1, 2009
As planned, Mom left early on Sunday to take care of Lola. When she returned to my room she informed me of something AWESOME: She saw perverted Elvis (newcomers please see previous posts regarding Elvis’s “personal stimulation” in the infusion room at my doctor’s office). Elvis is apparently a problem child—not only to Cancer Care Centers of South Texas but to NE Baptist Oncology as well. While he was hooked to an IV and loitering in the hallways, Mom once witnessed a nurse shaking an index finger at him and exclaiming with intense exasperation, “GET BACK IN YOUR ROOM!” 
Later that day, my nurse came in to change my IV. “Is Elvis here?” Mom asked. “What?” she asked, startled and apparently caught off-guard. I intervened: “I’m a patient at the cancer treatment center across the freeway. Is there someone named Elvis here?” With a heavy sigh, she nodded, rolling her eyes. We laughed, remembering that Elvis gave us quite the show during chemo. Apparently, our rebellious friend had become a public disturbance. “He’s here all the time,” the nurse said, dismayed.

Mom returned to my apartment to collect Lola and Lola Accessories in preparation for transport. Family friends decided that the best way they could help us would be to make the three-hour drive from Rockport to San Antonio and take Lola so that Mom could stay with me at the hospital without worrying. I was still incredibly sick that nothing mattered to me at that time, yet Mom was so grateful that she cried when Susan offered to take my beloved Little Lola off her hands. Much later that afternoon, x-ray came to my room (I was no longer deemed fit for intra-hospital travel) and everyone cleared out as my lungs posed for their glamour shots. That night, since Lola was sent off in her doggie seatbelt, food and toys in tow, Mom was able to relax in the hospital recliner to watch Desperate Housewives. A heartfelt thank-you to Susan and Sandal for their enormous generosity.

I felt terrible that night and, minutes after Mom and I turned off the TV to go to sleep, I heard a whirrrrrrr outside. Shortly thereafter, the room suddenly became unusually warm and I realized that the hospital lost power but that the generator had kicked in. Luckily, the medical equipment (oxygen, IV monitor, pulse ox, etc.) was connected to said generator. Mom looked out the window and noticed that the entire opposite hospital wing, block, and freeway lights were completely dark. Within a short time the room became stuffy and my difficulty with breathing was exacerbated. I complained that my nose was so stuffed up that I had to breathe through my mouth in this thick heat but, with the humidity, even that was challenging: Once again, I felt like I was breathing through a straw. “I can bring you a fan,” the CNA suggested brightly. I, in my horrid mood, said, “That’s just going to make it WORSE! I’m already congested and the dry air will only aggravate it” (I stopped just short of adding, “duh.”) I insisted that she call in a decongestant and, since the on-call oncologist with a less-than-stellar bedside manner was expected to answer the phone, the poor CNA delayed for an hour. I begged her in the wee hours of the morning and she finally acquiesced--because I was, well, a bitch. The doctor prescribed Benadryl and Tessalon cough pearls, which directly affect the lungs and not the central nervous system as does Codeine (I’m highly allergic to codeine and will vomit profusely if ingested). With the aid of medication and an oxygen mask (in use at all times except when I was eating, during they would replace the mask with a nasal cannula), I finally experienced a few precious hours of relief before being awakened for my morning stats.

Hospital Day 6: Monday, March 2, 2009
I woke up on Monday feeling somewhat decent. After determining the cause of my illness, the right antibiotics were identified and, placebo effect or not, I felt confident in my recovery. Dr. Wilks was back in town and made a much-needed appearance (I love that woman!). She told me to “Get used to this place” and “make it your home…..put up some pictures and get comfortable.” In other words, the antibiotics would take effect in time, but that I was here for at least a week. Saddened to hear that, the day was unremarkable and, that night, the nurses offered to move me to a different room with a pull-out bed and more space. We couldn’t resist and were soon transferred to 123. The benefit of the room’s—well--roominess was undeniable but the disadvantage was also clear: Room 130 had overlooked the physician parking lot and I could therefore keep an eye on who came and went, stalker style (and by that point I had started to know who drove what), while room 123 offered a view of a fake garden area and the side of another building. Still, Mama Jackie was able to stretch out at night and I felt less claustrophobic.

Hospital Day 7: Tuesday, March 3, 2009 
Dr. Wood arrived on Tuesday morning and told me that I was responding so well to the antibiotics (as evidenced by the convenient, nightly 3:00 AM blood draw results), that he wanted to talk about discharging me on Thursday or Friday. Seeing as I was fully reliant on oxygen, I was somewhat surprised that he thought I was ready. “You’re getting stronger and we’ll send you home with portable oxygen,” he explained, also reiterating that the worst place for a sick person to be—given the risk of hospital-acquired illness—was, in fact, a hospital. I already knew this, given my education and background in healthcare administration (the textbooks called it “iatrogenic illness,” actually), but--oy vey  was I leery. Scared, even. My friend Iris visited me with yellow tulips and a gift bag assembled by her toddler son (everything, including the pencil, slinky, eraser, and rubber ball, had a smiley face on it: It was clearly a theme bag. Look out, Lizzie Grubman, PR guru to the stars, you’ve got some competition). As uplifting as it was, I could still accurately be described as down. This was shocking to me. I spent a week lamenting my hospitalization--mentally tabulating the inevitable, extravagant bill I was racking up hour-by-hour, considering all the things I should be doing with my time to find a job, and secretly cursing all those who prevented me from getting more than 4 hours of collective sleep a night. Where was this sudden, surprising depression surfacing from? Although I responded the way one is supposed to when one’s captors announce impending release: “Oh that’s GREAT!,” I was actually very scared. Later that evening, stuffing a portable O2 tank in the back pocket of my wheelchair, Mom took me outside to a courtyard area for some fresh air which made me feel so much better seeing as I hadn’t been outside in six days, and I began to think that perhaps I was ready to go home. Or maybe that was the Ativan talking.

Hospital Day 8: Wednesday, March 4, 2009
On Wednesday I woke up and decided that I didn’t need to use my potty chair anymore. I had had enough humiliation during the last few days in asking Mom to retrieve toilet paper and stand guard as I perched on the makeshift commode only inches from my hospital bed. In complete defiance, I hobbled out of bed without anyone’s help and used the real toilet on my own (but was not allowed to close the bathroom door…hmph). Minutes later, Dr. Marks, my most recent crush, arrived and Mom showed him (as she did the other docs and nurses) a picture of me taken just before my diagnosis: “This is what she really looks like.” He looked at it and said with (if I’m not mistaken) disbelief and incredulity, “This is YOU?” I nodded, and he said, “Well, I recognize that smile. She’s always smiling. Always.” I felt all warm and fuzzy inside. Furthermore, not only did I accomplish the amazing feat of going to the bathroom unattended, but Mom wheeled me outside for almost an hour so that I could breathe fresh air yet again, but this time off the mask and on the nasal cannula for my venture. During that time I managed a long conversation with my friend Theresa which only heightened my spirits as I realized that I was, indeed, physically becoming capable of going home soon. The potty chair remained in my room as a “just in case,” but I didn’t have to use it. When Dr. Wilks arrived that afternoon and said that I would be due to go home on Thursday, I informed her that Dr. Wood indicated Friday as the likely day. “We don’t like to discharge on Friday because, if something goes wrong, you wouldn’t be able to reach me.” At that point, I’d decided that that was totally fine with me…….I’d choose my feather bed and real food over the hospital any day. The best news was that I no longer needed constant O2. For the most part, the nasal cannula (which was a firm downgrade that morning from the mask), lay at my bedside as I learned to breathe normal air unassisted again. Later in the afternoon, I was wheeled down the hall for an echocardiogram just to make sure that the potassium drop wasn’t an indication of heart damage.

Hospital Day 9:  Thursday, March 5, 2009--Discharge Day
On Thursday morning, I woke up prepared to go home after having a decent night of sleep with only one coughing spell and no oxygen (the nurses also tend to leave you alone when you’re doing well and about to leave. When snoozing peacefully, the nice ones will forego vitals in favor of saving a limb). Mom took me outside on another long O2-assisted wheelchair venture. The nurse delivered discharge paperwork and informed me that I was only to go home if I agreed to home-based oxygen. Of course I did, and the Praxair representative came to my hospital room to show me how to work the portable oxygen unit, lest I decide to stop breathing on the way home (understandable as they are accustomed to working with COPD and Emphysema patients). I felt confident that I didn’t need constant surveillance, but that was part of the discharge agreement and I was certainly in no position to argue.

I got home at 2:00 and the O2 people arrived around 4:00. They set up the large oxygen machine and showed me how it operates. Eventually that night, I did need the nasal cannula after a coughing fit. I felt mildly ashamed (given my smug attitude insisting that oxygen was soooo passe), but was nevertheless grateful that it was there. I used it sparingly on Friday through Sunday although I did little more than lay in bed, pant, and wonder if my lungs would ever feel normal again. I guess I wasn’t as healed as I thought even though the doctors insisting that my recovery could take as long as two months. Crazy thought that the experts know what they’re doing…..

On Friday I woke up motivated to get better after a much-needed comfortable night of sleep. Mom and I took a short walk and I made sure to manage light activity whenever possible. After some basic stretching and a second light walk, I only needed a small amount of O2. This set the tone for an uneventful weekend.

Yet I was relieved on Monday to still have my oxygen. After the laborious task of showering, my breathing became shallow and I started coughing uncontrollably. I basically spent the day in bed resting as my hardcore oral antibiotics took effect. I ran some light errands with Mom on Tuesday, then took a long nap. I woke up with the desire for a glass of wine (a huge indication of the Return of Sarah and of general health—the early stages, anyway) and found that I FINALLY no longer needed oxygen. The large, imposing plastic box encasing the vital gas became an eyesore in my bedroom, particularly with the extra-long nasal cannula looped on the floor and across my bed. I called Praxair to have them discontinue my O2. “We have to contact your primary care doctor first,” the rep explained. They called back on Wednesday and said that, as per protocol, my doctor required an overnight pulse ox reading sans oxygen assistance before they were permitted to pick it up. If my pulse ox remained steady, as transmitted from the small portable machine to the Praxair office and eventually faxed to my doctor, they would pick it up on Friday. They don’t like to see a pulse ox fall below 90 (and 85 sets off an annoying alarm that I was absolutely, annoyingly used to from the hospital). A man delivered a portable pulse-ox monitor that day and, happily, mine remained steady at 96 that night. On Friday the rep retrieved the machine but told me that the oxygen tanks themselves would likely be picked up next week.

The weekend was dreadfully boring. Mama Jackie struggled through the concept of “doing nothing” as I gladly appointed the couch (and, later in the afternoon, my bed) my haven. We did manage to take another short walk in an effort to exercise my compromised lungs but that was about all the energy that was able to exert that day.

I had a follow-up x-ray for the pneumonia on Monday and they gave me the films to take to my Wednesday oncology appointment. On the way home, I used my professionally trained eye (or not so much) to assess the images. I won’t have confirmation until Wednesday, but I could see small white spots standing out against the gray background of my chest. Is that cancer or scar tissue? They still didn’t know and, most likely, won’t know until we “watch & wait” what my three and six month scans show. No growth = scar tissue; growth = bad news.

Wednesday is my follow-up appointment with Dr. Wilks and then we’re going to Rockport so that Mom can resume her normal life and I can get a change of scenery. I may be doing the same thing there as I would at home (sleep), but at least I can breathe in the saltwater air while doing so. At the clinic I’m so hoping to hear that, despite the spots that remain in my chest, and despite the fact that the radiation oncologist wanted to go through with radiation but now they refuse to screw around with my chest/lungs, I’ll have a somewhat definitive statement of being cancer-free. I may not really know until my first scan in June, but a positive send-off would be much appreciated!