Monday, Monday

Dottye Wodogaza

With a weekend to mull over things, Monday came just in time. And so did my "Breast Cancer Nurse Navigator," Dottye Wodogaza. A phone call at 9:00 A.M. from this peach of a Belle who clearly knows how to get where she wants and on her terms, told me I could finally relax and take the next steps. Never before was a title better suited as Dottye steered me through the maze of paperwork, and appointments, even providing me with reams of information about my particular cancer and its treatments, as well as a wealth of services available through Palmetto Health Richland, the University of South Carolina, and the American Cancer Society. Makes my first time around twenty years ago seem almost archaic. And she set me up with my first appointments.

http://www.palmettohealth.org/body.cfm?id=3380&oTopID=0

A note here: Following my first cancer and the divorce that followed, I lost my health insurance. Bad decision on my part to not ask my ex to continue to pay my premiums, but, of course I had not considered the uncovered expenses of cancer that would follow me for the coming 10 years, putting me into financial distress and forcing me to drop my coverage. As a result, I was never able to purchase insurance that would cover breast cancer as a pre-existing condition. Only in the past year with the Health Care Reform Act passed by Congress would I be able to get insurance. But at 62, I was nearing retirement age and a Medicare benefit at 66, so I hoped for the best. For the past 15 years or so, I have been depending on the Eau Claire Cooperative Health Center in my neighborhood for my medical care. There are many programs that have helped me get regular mammograms, a colonoscopy several years ago and gall bladder surgery in 2008.  Like so many people without insurance, I was doing the best I could to stay well. I had also quit smoking and gained almost 50 pounds! My doctors were not so concerned with the weight gain; better to be a non-smoker again.

Here's where Dottye really helped save the day. Dottye and I discussed insurance. She told me to go by the finance office and ask for a “Cervical and Breast Cancer Act Application.” This act, passed first in 2000 by Congress, provides women on Medicaid with treatment for breast and cervical cancer. The Obama Administration through its Health Reform Act of 2010 increased the scope of the law to allow people like me, not on Medicaid but of low income, to benefit from the program.  I could have cried. How I would be able to pay for all this was a nagging concern. Following my first surgery I often said, “Sometimes survival is worse than the disease.” Maybe this will bring a little piece of mind as I go through this process.

Doctors, Tests, ETC.

Dr. Nottingham

Like I said, Dottye set me up with several appointments. The first was with Dr Nottingham, my surgeon. A name you can't forget is equalled only by a cheerful, red-head who could well have stepped out of one of Chaucer's tales or Sherwood Forest. "So, what do you wanna do?" he asked. Like I know anything. "Off with their heads!" I cried. He laughed. I know he's a surgeon. He wouldn't be in the picture otherwise. Over the years, I have kept up with the literature. Had I known then what I know now, I would have had both breasts removed at the get-go. (And I wouldn't be sitting here today).

http://specialtyclinics.med.sc.edu/physlist/viewPhysician.asp?pID=81

I've been toying with the idea of reconstruction (which I didn't have following my first surgery), but will probably opt to go "topless." When I was in my 20s, my friends and I would joke that, if I ever had breast cancer, nobody would notice, Probably true. My size A cups have always been a smidge too small for my XL posterior. A "pear" indeed!

But there was more to Dr. Nottingham's visit than surgery. He told me that the tumor was larger than they wanted (which I already knew) and that I would go through chemotherapy before surgery in order to shrink the mass. My oncologist would determine the treatment and we would be back, probably after the first of the year, 2011.

There was one other rather startling thing Dr. Nottingham told me. He said that the doctors and staff at Palmetto Health Breast Center meet each week to discuss their cases. Every week, he told me, there are no less than TWENTY NEW CASES of breast cancer! That's at one of two primary cancer centers in the central midlands of South Carolina with a population of probably 600,000 people. That's more than 2,000 NEW cases of breast cancer every year or 1 in 300 people (men included) were diagnosed with breast cancer in the central midlands of South Carolina this year!

Though so much has changed in the treatment of breast cancer; so much emphasis has been put on "the cure," and so much public awareness of self-exams, "buddy calls" between friends, etc., the rate of cancer seems to be growing. Though early detection is also responsible for the numbers, we all have to know that environmental causes are so much more a factor.

Next up: More tests and reflections

I'm a Survivor, damnit!

So. Here I am. 62 years old, and for the second time in 20 years, I have been diagnosed with breast cancer. Invasive ductal carcinoma. Not the same cancer of my 40s. But just as annoying.


Though maybe not the subject of light dinner conversation or Facebook friends, I've considered that a somewhat regularly-occurring recounting of the experiences I'll be facing in the months ahead, may be of interest to others and will, hopefully, shed some light on one person's journey through this disease.

I have begun this blog late in my discovery. I was diagnosed on September 9, 2010 with the past few weeks becoming a blur of tests and scans and sticks and even one round of chemotherapy. But through this blog, I will catch the reader up with what has thus transpired and keep you abreast (pun intended) of my progress.

By the way. I am a survivor, damnit! I will kick cancer's butt again. And I will raise some issues that we might all consider in our fight for the "cure."


There is one caveat I'll mention here. The folks at blogspot asked me to note if the content of this site was of an "adult" nature. Pondering that for a minute, I decided to leave the site available to anyone who wants to follow. However, I might advise the reader that I may post some photos of surgery that may be uncomfortable to some, but are in no way intended to be salacious.

You ready? Let's go!

Day one and a little background.

I'm sure it was Labor Day weekend when I found the lump. There's been a reoccurring theme surrounding Labor Day weekend for me. I quit smoking around Labor Day in 2004. I had my first attack of gallstones over Labor Day in 2006. I stepped on a nest of yellow jackets that chased me across my yard before leaving welts on my feet and ankles over the Labor Day weekend in 2008. It's the time of year when the seasons remind you that the time of growth has passed; and the time to prepare for the winter is upon us. It's always been my "blue" time of year.

I'm good about checking for lumps and bumps in my sole surviving breast. Twenty years ago (January 2, 1990) I had my left breast removed due to a lobular form of the same cancer, so the single sister tends to get a little more attention.

I don't have health insurance. And, though mammograms are available to me at my local clinic, I guess I kinda let last year's exam get away from me... The scan in 2008 was clear. But last year was just hectic. And, my self-exams seemed to be normal. Yadayadayada...

In 1990 a very small (1 cm) lump was found by my physician during an annual checkup. That had also been a very stressful year for me. A failing marriage and a hurricane called Hugo combined to make the end of 1989 both traumatic and fateful. My doctor advised I get rid of the stress. By March of 1990 I had one less boob, and they removed by left breast as well.

Day Two (stay with me here)
Of course it wasn't the news I wanted to hear. I was too busy for this again. And, anyway, didn't the knot feel kind of lumpy and squishy? Surely it was really just an overgrown cyst. OK. Get out of that denial. IT IS WHAT IT IS. That's what my friend, Mae, said. And, as usual, Mae has a wisdom that I have always considered well worth considering. Once she told me all the men in my life were either dead or crazy. Though she claims she really doesn't remember saying that, she owns it. And it's the truth.

It is what it is. It's cancer, damnit. My doctor at the Eau Claire Cooperative Health Centers in Columbia, SC, Dr. Tonya Humpheys-Lewis, may have been more concerned than I with the diagnosis. After all, she is probably only in her 40s and, what do I know, is more compassionate than many and a real  "sister in arms," if you know what I mean. She needed to touch my shoulder when I came back in the office for some blood work; "I know you'll be fine," she offered. She was smitten with me. I'll get her out of that mood soon enough!

I was to hear from the doctor's office on Friday by noon with an appointment to see a surgeon. At 1:00 P.M., I hadn't heard anything, so I dropped by the office which is just around the corner from my office. Jeff, the receptionist, took my info and said a nurse would be out right away. 10 minutes turned into 30 and I'm no follower of patience. I walked out into the hallway and called my friend in the administrative offices.

Lucky for me, I publish a local newspaper. Not that big a thing, but with a readership of about 10,000 people in Columbia, SC. We're not commercial or anywhere near competitive with other local rags; just a neighborhood news sheet. Anyway, I've been following the progress of the Eau Claire Cooperative Health Centers for quite some time. They first opened in this low-income suburban community in 1981 to provide a "safety net" for an underserved population "in the spirit of the Good Samaritan" as described in their mission statement. Today, they have clinics all over the Midlands of South Carolina and continue to provide the same, compassionate care that's part of their mission. I'll talk more about ECCHC later, but here's a link to their site: http://www.ecchc.org/


Anyway, I called my friend, Dean, in the administrative offices at ECCHC to ask his advice while I waited and spoke, instead, to a colleague, Clantis. I had just met her a couple of weeks before when I had been in the office to talk about a dental program the cooperative was offering. She had helped me enroll. Never would I have imagined that I would be speaking to her about breast cancer, of all things!


Clantis could hear my distress. "Take a deep breath, Becky," she said. "It's going to be OK." I knew it would; I was just anxious to get to a surgeon and get this show on the road. I felt that someone at the clinic should have called me by now. It was, however, Friday afternoon, now. Doctor's offices are hard to reach. Referrals from a clinic are not taken as quickly as from other sources, I began to realize. OK. Patience. Clantis told me to find Andrena, the duty nurse. She would help me. After a couple more minutes of Clantis' calming voice, I was a grown-up again. 


I walked back into the waiting area to where Jeff usually sits behind the sliding glass window. There was a woman there now. As I approached I saw her nametag, "Andrena." "Are you the duty nurse?" I asked, almost with incredulity. "Why, yes," she answered with nearly the same surprise. "Clantis told me to find you," I blurted out with some kind of silly glee. Another sister in this tale, she promised me a return call as soon as an appointment had been made. OK. I'm good. It's Friday. Go home and chill.


I guess it was all I needed. Forget about it over the weekend. Monday will come soon enough.




Day Three
Maybe you've gathered by now that the progression of this blog is somewhat like the Creation story. One day is really not a 24-hour period, just a capsule of events that lead to the next.