Funny about Money

The only thing necessary for the triumph of evil is for good men to do nothing. ―Edmund Burke

Cancer? Not so much…

Yesterday my son took off work to schlep out to the Mayo with me and hold my  hand as I entered the Land of Sickness. We were to meet with a high-powered surgeon to whom I was referred by my long-time doc and old friend, Tim Daley. After a brief wait, we were ushered into the catacombs.

You would not believe the difference between the way you’re dealt with at St. Joe’s and at the Mayo. First off, we were met by a nurse practitioner who handed me a whole book on breast cancer and a notebook filled with business cards & phone numbers of people to call at the Mayo, with all sorts of information, with what to expect, and on and on. She asked a bunch of questions, filled in forms, and moved on. Then a PA came in, did an exam and asked more questions.

And finally Her Royal Majesty arrived. And what an incredible lady that one is!!!

She also examined me, and she’d already read the pathologist’s reports and studied the mammogram. She was annoyed that St. Joe’s hadn’t done another mammogram after the biopsy to confirm that they’d placed the marker tags correctly, and said now that has to be done. Then she said the following:

At this point she believes these are ductal carcinomas in situ (DCIS). They are not exactly cancers; they are pre-cancers. She assessed them as “Stage 0,” about as close to harmless as they can get without being nonexistent.

Not all DCIS lesions develop into cancer, and if they do, they develop very slowly. They could turn into cancer in a year, two years, ten years, twenty…or maybe never. However, the problem is that ALL breast cancers start as DCIS. Because there’s no way (yet) for doctors to know which DCISes will become invasive cancers, which ones will just sit there, and which may even fade away, the wisest course of action is to have them removed by way of surgery. But that’s all that is necessary. And there’s no hurry.

The current standards for lumpectomy no longer require such a wide margin of healthy tissue to be removed around a DCIS, and so the procedure is relatively minor compared to what one would have expected in the past. Once removed, the things have to be examined by a pathologist, but if they are what she believes them to be, there will be no need for any other treatment. No radiation. No hormone treatments. No chemotherapy.

She thinks these critters have been in there for years — she explained in detail why she thinks so, based on the known growth rate of papillary carcinomas — and were simply not seen on earlier mammograms when my lush besoom was denser and the machinery was less sensitive.

She explained that radiation therapy is an option, but that it would reduce the already extremely low probability of a recurrence by about one or two percentage points. I asked her whether, if she were in this position, she would opt for radiation.

“No,” she said, “I wouldn’t have radiation. But then…that’s just me.”

Looked at her and thought, Lady, you are one hell of a lot smarter than me and you are staggeringly expert on this subject. If you’re not havin’ it, neither am I.

So I scheduled a lumpectomy for August 7. She said one should be up and about in a day or two and back in the swimming pool after two weeks.

How amazing is that?

And, we might add, how effin’ outrageous…

The radiologist at St Joe’s said to me, in reporting on the biopsy results over the telephone, “I’m sorry to have to tell you this, but it’s cancer.” Period. Evidently that was a slight exaggeration…

This was after I had been told, by another radiologist there, that there was a 50% chance those little lumps were cancer. So they had me prepped to believe I already have cancer, and then they delivered exactly that news.

In fact, they’re not benign…but neither are they actually cancer. Not yet, anyway. Nor are they going to become cancer in the very near future.

My friend KJG, on hearing this, remarked on the difference between the medical treatment you get in hospitals in affluent vs. not-so-affluent neighborhoods. Ain’t it the truth, apparently: few places get more affluent than northeast Scottsdale. And another friend remarked, after admitting to a skeptical turn of mind, on how much St. Joe’s stood to gain by corralling me into six or eight weeks of daily unnecessary radiation treatment.

Un-freaking-believable.

So it looks like a confluence of lucky events rescued me from a great deal of painful, pointless, and dangerous trauma:

  • Old Doc Daley moved from his mid-town practice to the Mayo shortly after the clinic opened in Scottsdale, all those years ago.
  • I managed to keep myself on the Mayo’s rolls after hitting Medicare age by sticking with him.
  • St. Joe’s ER damn near killed me with the crassest kind of neglect when I had appendicitis some years ago, and so I wouldn’t have surgery done at that hospital, not on a bet.
  • And past experience has convinced me that you should ALWAYS GET A SECOND OPINION before letting anybody do any kind of procedure on you or put you on some drug.

Always. Get. A. Second. Opinion.

Author: funny

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15 Comments

  1. That is great news! Yes, always get a second opinion.
    Also, I’d like to know the story about your ER experience at St. Joe’s. If you’ve already written about it, could you post a link to it?

    • Y’know, I think it happened before this blog came into being.

      Naturally, it was Christmas Eve when I developed appendicitis. I knew it was appendicitis because all the classic symptoms were there: pain in the lower right quadrant, fever, vomiting. And I’ll tellya, it HURT.

      I kept hoping it was something else — at the time I enjoyed chronically recurring, undiagnosed belly pain (which, interestingly, disappeared altogether and never returned after the appendectomy), and at first that’s what I thought it was. But by evening it had become abundantly clear that this was something on a different order.

      I asked my ex- to drive me down to the ER. He took me to St. Joe’s and left me off outside the door.

      When I went in I found the place JUST MOBBED. There was a flu epidemic going on, and every uninsured soul in South Phoenix (a very large low-SES district) and all their kids were parked in the ER waiting to see a doctor.

      I went up to the front desk to explain what the problem was. The woman gave me a fishy look and told me to take a seat. I vomited into the bucket I’d brought before I could turn away from the desk. She gave me an if-looks-could-kill glare.

      There was not a single place to sit down. The place was just FILTHY. The floor was so dirty I was afraid to sit on it, but I hurt so much I couldn’t stand up.

      Finally I was directed to a concrete bench outside and told I would be called if and when they ever got around to me. It was late December, it was after dark, and it was cold. It this point I hadn’t even been triaged — and never would be, as it developed.

      I sat down on the icy concrete next to a young woman who was having a miscarriage. She said she’d been there for four hours and, like me, hadn’t even seen a triage nurse. She had no coat, so I wrapped her in my jacket, because she was freezing.

      After I’d been there for four hours myself and still had not had anyone even take my temperature, I figured I’d rather die at home than on a concrete bench on the sidewalk in downtown Phoenix. So I called some friends and got them to come pick me up.

      The pain was just excruciating. Understand: I have a very high pain threshold, largely because I’ve enjoyed some interesting chronic pain most of my life. When my son was born, we didn’t get to the hospital until he was popping out because I thought labor was supposed to hurt more than your period. It doesn’t.

      So when I say I was in pain, I really WAS in pain.

      About 6 the next morning I called the Mayo. Their nurse practitioner on call returned my call and told me to call 911 and have them bring me to the Mayo hospital up on the 101 — about a 10-minute drive from here.

      I said I didn’t think they’d take me there. She said by law they’re required to take you where you ask to go.

      When the EMTs showed up, they said they were going to take me to St. Joe’s. I said I wouldn’t go back there and asked them to take me to the Mayo. They refused to do so. I sent them away.

      I could not drive myself. So now I called some other friends and asked if they would please pick me up and drive me to the Mayo’s ER. They were less than thrilled but the husband allowed himself to be talked into it.

      When I got there, they tossed me on a gurney and rolled me straight to surgery. It’s a bit of a blur, but I’m sure I was in the OR in less than an hour.

      By that time, I’d been suffering acute appendicitis for over 25 hours. Look up appendicitis in older adults to get a clue what that means. I was at extreme risk of serious, life-threatening complications.

      IMHO, the Mayo’s surgeons saved my life after St. Joe’s incompetent and ignorant ER staff put my life at risk.

      And that’s why I wouldn’t think of having surgery there.

  2. So relieved to hear this. Almost like a blip on the screen of life, right? But a scary interlude, nonetheless.

    August 7 will be here and gone in a flash. Hopefully you will have a quick and comfortable recovery. Life at the Funny Farm will resume, with a renewed vigor and gratitude, to be enjoyed to the fullest.

    Good news, and good for you for taking charge of your health care services!

  3. Sorry for the scare! Second opinions are worth it for this reason. Your life is so, so precious!

  4. Understanding that you didn’t want this episode of life to be minor, we who read you are happy, happy that it is not major.
    Also, we are secretly or not so secretly, hoping we/our families are as fortunate as you in physicians and hospitals.

    So glad to hear that you will still be able to enjoy the pool in the heat of summer and not have to rely on others for much or for long – and you have discovered how many people around you are in your corner and willing to help you out with the big things, including [which is nice] your son.

    Best wishes to you on Aug 7!!

    • LOL! It’s a happy medium, eh? Turns out not to be NOTHING, so the biopsy hassle & discomfort didn’t turn out to be, after all, for naught. But even tho it’s SOMEthing, it’s not the truly horrible something we all fear.

  5. Great news! Does this whole incident make you reexamine priortites, teaching, editing, things you actually enjoy …? Hope you can enjoy the summer to its fullest.

    • As soon as this course is over, I’ll have several weeks with no coursework to cope with at all, and then several weeks with only one online course to wrangle.

      This very day I wrote 8 1/2 paragraphs for chapter 5 in Book II of the Fire-Rider saga. But….

      This very moment I wrote “this very day” between interruptions. The INSTANT is sit my fanny on a chair, something interrupts. The phone rings. The dog pees on the floor right under my nose. The dog decides birdseed is a great delicacy and tries to stuff herself on it (the lid on the package of birdseed I bought at HD today was loose, and when I picked up this noon it fell off and half the container of birdseed dumped out all over the pati0…the broom did not get enough of it off the ground). The phone rings again. I say, “Come on over, ring the doorbell, and I’ll stumble out.” This causes the dogs to hallucinate the doorbell ringing and to fly into a barking frenzy. Get up (AGAIN), go to door, no one there. Come back in, sit down, barely make contact with the seat, and doorbell rings. Dog fly into a barking frenzy. And so on, to infinity.

      That’s why it’s unlikely that any more paragraphs will come into being today…

  6. Funny…You must be just “over the top”. To go from you’ve got cancer… to it’s pre-cancer and nothing to worry about….well you and your son must feel like you just hit the lottery! I will tell ya there is something about a very confident, knowlegeable and capable doctor that seems to make things better. I have had a couple of these in my life and it sounds like the gal at the Mayo is from the same mold. Happy for you and wish you well with the operation.

    • Well…of course one doesn’t know which doc is right. One can only hope the one with the most positive spin on the thing is the one who’s correct.

      Since I really don’t want to be subjected to radiation, I’m gonna take my chances on the Mayo doc.

  7. Congrats on your good news vis a vis the cancer.

    I can’t comment on your corgi blog, but want to caution that a diet of just meat and rice doesn’t contain enough calcium for growing puppies. Truly, pups have developed “soft” bones – and resultant fractures – being fed only meat and rice for too long. Think about adding in some calcium-rich vegetables, or a doggie vitamin, or just a plain old calcium supplement such as you’d take.

    • Yes, I know that’s true. I tried adding veggies today and it gave her diarrhea. Looks like she needs to be on the beef & rice for a few more days. If it appears she’s sensitive to one or more of the veggies in the Costco “Tuscan” mix I grind up for Cassie, then I’ll have to try adding one vegetable at a time (starting with peas, I guess, then carrots, then ???), so as to identify what agrees with her and what doesn’t.

      Luckily, she thinks pet vitamins are treats! The main thing is to find out whether the minerals in those come from ash, which will aggravate her urinary issues — so far I haven’t been able to tell.

  8. I am so happy for you and glad you got a second opinion. Thanks for sharing your experience.

  9. I kept meaning to tell you this but I am heartily relieved that if it must be cancer, it’s not horrible right at the outset. We’ve lost too many to late stage (late diagnosed) cancers over the years and wanted to hang onto you a little longer 🙂

  10. I’m very glad to hear that this ordeal has become much less scary! Like Anne, though, I am wondering if perhaps it’s time to stop doing all the things that make you miserable. You must have recouped most of your investment losses by now, so maybe it’s time to move them into something a bit safer and to spend down your assets while enjoying life?