Coffee heat rising

Angst

If You’d Asked Me, I Would Have Told You…

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Water-saving, power-saving appliances are about as ecologically unfriendly and consumer-unfriendly as it is possible for a device to be.

P1030121How d’you like what came out of my washer this morning?

The new, fancy, water- and power-saving EXPENSIVE clothes washer creates a massive tangle if I have the chutzpah to put a shirt in with a pair of blue jeans. To avoid a huge wadded mess, I have to put anything that has a strap or a sleeve into a mesh bag.

Today that strategy didn’t work. The entire load of colored clothes came out in a single gigantic knot.

This annoyance is characteristic of the Samsung top-loading high-efficiency goddamn washing machine I bought a year or so ago. I’m told it’s characteristic of front-loaders, too.

Before Samsung (BS, appropriately enough), I could run a load of colored clothes through the old-fashioned top-loading actually functional Kenmore washer, hang the knit tops and cotton bluejeans on ordinary clothes hangers, and let them air-dry on a laundry-room rack. Now, to beat the wadded-in wrinkles out of them — after I’ve spent ten minutes untangling the mess — I have to run them through the dryer!

BS, I hardly ever used electric power to dry my clothes. Most of them dried, with no need for ironing, on clothes hangers that could be carried, once the laundry had air-dried, from the wash area to the closet. Now all the jeans and most of the shirts have to be run through a dryer, wasting electric power and running up the power bill.

A twenty-minute wash cycle has morphed into an hour and ten minutes.

One might avoid the knotting conundrum by washing all of one’s pants separately from all of one’s other clothing. Consider what this would do for you (or to you):

Now you would have to separate out every pair of pants from every other category of clothing. This would, at best, present you with four loads of laundry: colored pants, colored shirts and underwear, white & beige pants, white & beige underwear. Two 20-minute loads (one white, one colored) now convert to four one-hour-and-10-minute “high-efficiency” loads. Four hours and forty minutes to do a forty-minute laundry job! At least two of those loads — the ones including the pants, whose legs will knot together willy-nilly, will have to be run through the dryer whether you prefer to do so or not, to get rid of the knotted-in wrinkles. This more than doubles your water and energy use on the washer, and if you are one of those wily consumers who figured out that few clothes really have to go through a dryer, it increases your power bill accordingly.

It’s in the same category, isn’t it, as the water-saving toilet. You know, the one that supposedly needs 1/3 less water to flush than real toilets used to need, but that has to be flushed three times to get the stuff down. And the ugly fluorescent light bulbs that make everyone in the room look green, that dump mercury into the landfill (and all over your house if you drop one), and that give you a migraine whenever you turn them on.

Big-Brother-Knows-Best good intentions lead people to find workarounds with counterproductive consequences.

The high-efficiency clothes washer and the water-saving toilets are obvious cases in point.

Another one: we know that in 2015 the city probably will institute water rationing. From California’s experience, we know the strategy will be to tell people they will face fines  unless they cut water use, as measured by the present smart meters, to 60% of their prior use. Some folks, then, realize  they need to use about 40% more water than necessary now, so that when the cutbacks come, enough water will be available to keep their citrus trees, energy-saving shade trees, and vegetable gardens alive.

More immediately, though: Our dearly beloved paternal city has installed counter-intuitive roundabouts up and down the ’hood’s main north-south feeder street, and they’ve put infuriating, alignment-wrenching speed bumps along the east-west feeder street. The result? Pass-through traffic is diverted off the feeder streets onto smaller, once-sleepy neighborhood roads. In the few weeks since I found my way around the damn things, I’ve noticed that LOTS more drivers are joining me in the several routes that take us around the stupid speed bumps and the wreck-inviting traffic circles. (Ever had anyone try to pass you in a one-lane traffic circle? I have…)

Want to slow down the passers-through who don’t give a damn about our kids, our pets, or our old ladies trying to walk off a few pounds? Two easier, cheaper solutions: a) install traffic cameras; or b) station a nice, sturdy traffic cop in the neighborhood during rush hours.

Dogs, like humans, should eat real food.

That means actual balanced, unprocessed diets consisting of cooked meat, vegetables, fruits, and healthy starches — not the junk food humans normally eat these days.

Ruby the Corgi Pup has made the transition, at last, to a diet of full-blown real food. Shortly after losing the ultra-premium dog food, she lost the chronic diarrhea. And now, a few weeks after having made her escape?

Her fur is so shiny it practically glows in the dark. Her eyes are bright and clear. Her mood is happy, rambunctious, and funny. She radiates good health.

Cassie the Elderly Corgi, who has never been off real food since she entered my precincts, continues in good health. Her fur is rich and radiant; her eyes…yes, bright and clear. Her teeth, good. Her everything, healthy and strong. No vet has ever been able to find anything wrong with her.

The difference in the pup since I took her off the commercial dog food is incredible. Reminds me of what happened when I started feeding real food to the aged German shepherd and the aged greyhound, in response to the Late, Great Melamine Scare. The Gershep, who at the time was so advanced in decrepitude she could barely haul herself to her feet, suddenly was chasing her ball across the yard, something she hadn’t been able to manage for a year or more. Both dogs thrived on a diet of 1/2 cooked meat, 1/4 cooked vegetables, and 1/4 starch (such as sweet potatoes, rice, or oatmeal).

Folks. Dogs do best when fed a diet approximating a healthy, balanced human diet, less the onion, the garlic, the sugar, the salt, and the chocolate.

Commercial dog food is a huge scam.

This morning I threw out a half-dozen cans of ultra-premium dog food. At $2.60 per can plus tax, that came to a little over $17, directly into the garbage. That expensive commercial dog food made Ruby good and sick — she had projectile diarrhea for a good ten days, until I finally gave up and took her off the stuff.

Do you think it’s in the natural order of things that when you switch a dog from one food to another, it should get gastritis, manifested by diarrhea and possibly even vomiting?

Well, no, my friends: it is not. When a dog  becomes accustomed to eating real food, it can shift easily and with no ill effects from one type of protein to another, from one veggie or fruit to another, from one source of starch to another. Ruby has readily adjusted to the following:

chicken
hamburger (i.e., beef)
pork
sweet potato
rice
oatmeal
peas
carrots
winter squash
banana
blueberries

But moving from Castor and Pollux ultra-excellent canned dog food to Wellness ultra-excellent canned dog food gives her a violent case of the doggywobbles???? Excuse me? What IS wrong with this picture?

Welp, think about it. Dogs have lived with humans for some 15,000 years. Along about 1860 — about 157 years ago — some entrepreneurial human came up with the idea that doting pet owners could be persuaded that their “pet children” should be fed special pet food! This idea redounded to the vast profit of said entrepreneur, and to that of all the pet industry entrepreneurs who came after him.

Before this genius came up with a scheme to persuade us that nothing would do but what we must feed our animals special pet food, unrelated to anything we as humans would ever dream of eating (would you put a piece of dog kibble in your mouth?), dogs ate whatever people ate. Humans, who at the time did not overindulge in Big Macs, french fries, pizza, and soda, would put down whatever was left over from their own meals, or whatever offal they took out of the animals they hunted for sustenance. Over the millennia, dogs evolved to eat what humans eat.

In just 157 years, they have not un-evolved. Dogs still thrive on the kind of food you and I would thrive on, were we not presented with over-processed, over-sugared, over-salted junk food! We would thrive on it, too, if we could be persuaded to fire up the stove and cook our own food.

At $2.60 per 13-ounce can, a puppy that needs to be fed 2 1/3 cans per day racks up a much, much higher food bill than she does when her human goes out and buys some hamburger, pork, or chicken on sale (it’s a myth that pork is bad for dogs, BTW), a few sweet potatoes or a bag of oatmeal, and some frozen vegetables. It is far cheaper to cook your dog’s food than it is to feed comparable food out of a can or a refrigerated roll. And the results, in terms of your dog’s health, appearance, and temperament, are far superior.

And now for the Conspiracy Theory of the Day: Does it not strike you as odd that once a dog is acclimated to real food, it can switch readily from ingredient to ingredient with no distress, whereas a switch from Purina to Science Diet or from Castor & Pollux to Wellness will cause spasms of doggy diarrhea?

Odd, indeed. IMHO, the only reasonable explanation is that dog food manufacturers spike their product with ingredients that cause gastritis when the consumer switches abruptly from one brand to another. It is, in a word, a scheme to scare consumers into keeping their dogs on the given commercial brand they start with. Dog food is jiggered to make dogs sick when they’re switched from product to product.

Real food decidedly does not have that effect.

Way too often, veterinary bills are  inflated by unnecessary testing, unnecessary “wellness” exams, and unnecessary procedures.

Remember when your vet tried to get you to come in once a year for an annual pet exam? Well, they’re accelerating that: today when my vet’s assistant left me on hold to listen to the endlessly annoying, uneasy-making advertising tape, I was informed that he now wants customers to bring their pets in twice a year!

If you’ve been paying attention, you know that many of the vaccines we’ve been told our pets must have, over and over world without end, lest they die of some dread disease are truly unnecessary. Endless annual booster shots operate, at many veterinaries, as a tool to get you back in the door, where you can be subjected to the Big Upsell: persuaded that any number of unnecessary procedures, from expensive dental cleaning to daily medications that require expensive semi-annual blood tests to routine over-vaccination…to god only knows what. These procedures, many of which may be unnecessary, cost pet owners some very big bucks.

And while we’re on the subject, humans also are subjected to massive unnecessary medical examinations and testing.

I tire,  so let’s abbreviate:

The annual physical exam (thank god) is going out of style.

Annual physicals are unnecessary.

Unnecessary, we say.

Annual pelvic exams for women are unnecessary.

Routine physicals lead to invasive, dangerous, and unnecessary procedures, even among the one-percenters.

Routine screening tests lead to exorbitant unnecessary costs.

Studies show unnecessary tests rack up 40% of Medicare spending.

Do I regret allowing myself to be subjected to the “routine” mammogram that has sucked me into a mutilating surgery and an uncertain future? Maybe. Maybe not. From what I can tell, the extremely low-grade entity discovered in my boob may or may not morph into an invasive cancer. Apparently no one can tell. If I were six or eight years older, cutting open my breast and yanking this thing out would be a destructive, pointless, harmful exercise in futility — I would die of some other natural cause long before this thing could kill me, if it ever decided to spread around. But because I’m  not quite 70…it’s ambiguous.

Probably nothing would have happened if this thing had never been discovered.

On the other hand, getting rid of it may insure — provided that I’m not subjected to radiation therapy, which over time will elicit some unpleasant and possibly life-shortening side effects — that I’ll have a shot at a ripe old age.

Maybe.

Maybe not.

P1030120

 

Some Vacation…

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So, this damn cancer scare has converted what I’d planned to be the first extended break from work — about a month and a half — to one long hassle-filled headache, culminating of course in a surgery nightmare. Damnation. Not to say {whine!!!}.

Bright and early this morning someone from the Mayo called to inform me that they’ve scheduled me to spend the entire afternoon of next Monday at their facility halfway to freaking Payson getting poked, prodded, and re-X-rayed. (If I didn’t already have breast near-cancer, I would by now given the number of times my boobs have been exposed to X-radiation.) This will require me to drive home from the Mayo during the rush hour, a gawdawful prospect. I was supposed to take Ruby to the vet to leave her there overnight preparatory to spaying, but that will be out because I won’t get home before the vet’s office closes. So she’ll have to be delivered to his place at 8 a.m. sharp the next day, requiring yet another fun drive through rush-hour traffic.

This sounds like less hassle than it is. During the rush hour, you can’t turn left off the main north-south drag that serves our neighborhood. So, to get to the vet’s office, I have to wind my way through not one, not two, but three neighborhoods to reach a road that will allow me to turn east to get started on the long drive to the veterinarian. Because the middle class has largely vacated the central part of the city, except for a small millionaire’s row along North Central, all the infrastructure — including veterinarians and high-quality medical care — has moved out, too, following the dollars. To get your freaking hair styled, you have to drive halfway to Scottsdale. Same is true to get to a decent vet and a decent doctor. And of course Scottsdale is east — left — of here.

Cripes.

On the to-do list today is to update the will.

Several years ago, I went to a lawyer to have a will drawn up. After she charged me a hefty fee, I discovered she’d simply downloaded a form off the Internet and filled it in. Well, hell: I can do that.  Actually, what I plan to do is retype the thing and then get it witnessed and notarized by the same people who witnessed and notarized it for free the last time. Anyway, it’ll probably take a good 45 minutes to screw with retyping that.

Anyway, once it’s typed to disk, any future changes will be easy to make.

Then the dog: Ruby has to be spayed. She’s just about to reach the age when she could come into her first heat. Since my son will be here for a couple of days with his (formerly) male dog in tow, I can’t have Ruby emitting pheromones to drive Charley (and the rest of us) nuts. That happens next week, and god only knows how long I’ll have to nurse her along after that.

Then the money issue: The Mayo does not take Medicare assignment. This does not mean it doesn’t accept payment from Medicare. Sometimes it does. What it means is that they will not take direct electronic deposit of payments from Medicare, or, evidently, from your Medigap provider. What this means is that payment is remitted to you and then you have to pay the Mayo. But this payment comes in the form of a flurry of small checks, sent in envelopes that are indistinguishable from the usual junkmail these outfits deluge you with — EOBs and advertising and redundant or useless “information,” piles and piles and PILES of paper. So you have to rip open every envelope, search through the paper inside looking for checks, and then shlep the goddamn checks to the credit union.

I finally gave up trying to deposit the accursed checks electronically. The process is so slow and so buggy it’s often no faster than driving up way and Hell and gone to the westside, parking the car, walking into the lobby, standing in line, and forking the checks over to the cashier. A major project like breast surgery and all the ancillary testing and counseling and carrying on surrounding it is going to generate enough paper to fill an underground missile bunker. The amount of time consumed in dealing with all that paperwork and schlepping or e-depositing all those checks simply defies belief.

Presumably these people think that if you’re old you have nothing to do but waste your time at their behest.

Speaking of the money issue, one of the things I have to do today is get ahold of someone at the Mayo who can help to figure out what Medigap will cover and what it will not cover, so I can determine how much of my retirement savings I’m going to have to withdraw to pay for this misadventure. I would like, for a change, not to be blindsided by their incomprehensible billing.

Welp, things could be worse. One of my students, a young mother-to-be, missed the deadline to turn in her final paper because she was in the hospital getting surgery to divert urine out of her body. Her kidneys are shutting down. They’re planning to deliver the baby at 35 weeks and hope that will be long enough for the infant to develop adequately to survive OK. But…then what is not clear. We at least managed to get the paper in my hands by the crack of dawn this morning. This allowed me to get into the District’s system  before the grades I entered yesterday had officially been “accepted” — meaning I was able to change her final grade from a C to an A at 6:00 a.m., before my access to the final gradesheet was blocked.

Every time you think your own life is going to Hell on a skateboard, you meet someone else who’s riding a faster skateboard.
A lot faster.

 

Preparations…

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Hm. It’s possible that emergency surgery is better than planned surgery, in that you get to forgo all the stress of figuring out, in advance, how you’re going to cope. Instead, I’ve been spending hours in figuring out and putting in place preparations for every damnfool contingency that I know is going to come up, and then wondering what I’ve overlooked and what kinds of fiascos being unprepared for those will evince.

Some of these contingency preparations are things that we all should have in place, just as a matter of course. Others present themselves when a doctor says you’ll be out of commission for three days to two weeks and veterans of the proposed surgery say it may take two to three months to convalesce and up to a year to get back to normal.

Here’s what you get to think about when faced with a doctor’s pronouncement that you need surgery:

Medical:

Living Will. If you don’t have one, ya better get one. I do, and after I paid a lawyer a hefty fee to make one out for me, I learned she was using boilerplate that can be downloaded from the Internet. Google “living will” and the name of your state to pull this up. Download, customize, fill it in, and see to it that your representatives have copies and that all your doctors, hospitals, and other medical care institutions have copies.

Durable Health Care Power of Attorney. Your representative will need one of these to be able to make medical decisions for you, should you be too incapacitated to do so. It waives HIPPA restrictions so doctors can speak with the person about your condition.

Durable Mental Care Power of Attorney. This one allows your representative to obtain mental health care for you should you lose your marbles. This also waives HIPPA restrictions.

But while you’re filling out the endless forms at the doctor’s office, be sure you designate your representative as a person with whom information about your condition can be shared under the HIPPA laws.

Financial:

Will. Make out your will, long before the need for it becomes apparent. Get it witnessed and notarized. Be sure your heirs have copies, as well as your lawyer and financial advisors.

Investments. Designate a beneficiary for all of your investments. If you’ll be leaving money to more than one person or entity, then the beneficiary would be “the estate of [name].” If you have only one heir, then make that person the beneficiary. This will greatly simplify transfer of funds in the event of your demise.

Bank accounts. You can designate a beneficiary for a bank account, too. You also can make your representative — assuming he or she is responsible and can be trusted — a co-signer on your account. This makes it possible for her or him to pay your bills if you’re out of it but not quite dead yet. Or to cancel your auto-pays if you are dead. 😉

What will Medicare or insurance cover…and what not. I’m told there’s someone at the Mayo who can help figure this out given which policies I’ve got. Tomorrow I need to track that person down and make an appointment.

Durable power of attorney: Enable a trusted representative to handle your financial and other personal matters while you’re out of it.

Personal:

Pets. Decide who will care for your pets should you croak over or become too ill to care for them. Don’t assume that they will do so: ASK! Line up someone to take the livestock in the event of illness or final exit.

Funeral arrangements. You can make your own arrangements in advance. Be careful not to get ripped off. At the least, you can let your survivors know, in writing, how you would like to be disposed of and what kind of memorial, if any, you would like to have them put on for you.

House. Who will take care of your yard and houseplants? Does someone need to run interference with regular maintenance workers, such as a yard, pool, and cleaning services? Make arrangements for someone to handle these matters.

Though I’m not planning to croak over any time soon, I do feel like a Mac truck is bearing down on me. And the more I look around, the more things pop up needing to be done before I go into the hospital and get myself incapacitated for a period that may be anywhere from two or three days to two or three months. The number of things to set up or to cope with is amazing:

Pool: Hired a service to take care of the pool until such time as I’m able to do it again.

Cleaning: Hired a cleaning lady. May have her keep coming indefinitely, since I hate cleaning and she does a much better job than I do.

Dog: Holy shit. Realized that Ruby will be exactly 7 months old on the day they roll me into the OR, and very likely to come into heat shortly thereafter. She needs to be spayed! And there’s no way I’m going to be able to cope with dog surgery on top of my own surgery. Arranged, pending the vet’s approval, to have her fixed mid-July; she should be pretty well recovered by the time of my own procedure.

Plumbing: It’s likely to be a week or two before I can bathe. The shower in this house is essentially unusable. The previous owner installed very beautiful travertine on its three walls and lovely clear glass shower doors. His parting shot on the walk-through? “These travertine walls have to be stripped every six months and re-sealed.”

Uhmmmm…. Don’t think so, White Man!

So I’ve avoided using the shower as much as I can and instead actually bathe in the bathtub. When I do use the fancy (large!) shower stall, I have to clean and dry all three travertine walls from ceiling to floor(!) and then clean and dry the damn glass shower doors. And obviously, if I can’t raise my hand over my head, that task is going to present a bit of a problem. Meanwhile, I use the bathtub in the other bathroom as that: a bathtub. It has an elegant ceiling to floor decorative fabric curtain, and so is not designed to be used as a shower.

So I bought one of those spray heads on a metal hose that you can aim at specific parts of your body. That should make it possible to wash the stink off, anyway — bear in mind that it’s 110 degrees here, and by August it will be 110 and humid. The plumber just installed that (since I didn’t know if the old,  unused shower head was frozen on or what). Also got a plastic shower curtain, a 2nd shower rod, and shower curtain ring things. It’s going to hugely uglify the bathroom. But I guess it can be undone when all this is over.

Transportation: My son will drive me to and from the hospital — in theory, this is an outpatient procedure. But last night I got a package informing me that the day before the surgery, I have to traipse way to hell and gone to East Scottsdale for a preliminary procedure which may leave me not quite well enough to drive home. I can’t very well ask him to take yet another half-day off work. So I’ll have to find someone else to drive me out there on and back on the day before the surgery.

Someone to watch over you… And the reason I can’t ask him to take off more time is that he’s already taking off two days to take care of me and may be stuck with me over the weekend, too. There is, after all, a limit.

Dog2: Better have food and gear stocked in to feed the critters for as long as you’re unable to carry groceries into the house. If you cook your dog’s food, as I do, you’ll have to cook and freeze a couple weeks’ worth. Or more…

Food: Speaking of food, I’ll also have to get in enough chow, prepared or easy to cook, for myself.

I’m quite sure this doesn’t cover everything. What an unholy hassle!

Cancer? Not so much…

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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.

News of the Day…

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…Boob Department.

So, late, late late yesterday afternoon St. Joe’s called with the verdict on the biopsy: it’s cancer.

However, as cancers go, it’s far from the worst of all possible worlds. Their pathologist declared it a papillary carcinoma, which is a rare cancer that, in older women, is usually slow-growing. And in my case, both tumors are “encapsulated,” which means they’re closed off from spreading around with gay abandon.

If she’s correct, then as this kind of news goes, it’s actually fairly positive: According to the American Journal of Clinical Pathology “EPCs [encapsulated papillary carcinomas) are in situ carcinomas with an excellent prognosis and can be managed with local therapy with or without sentinel lymph node biopsy.”

That’s from a 2009 paper, so of course it’s a bit old. However, from what the radiologist said, the thinking must still be along these lines. She said they no longer yank out your lymph nodes — which, other than the disfiguration of your boob (which is hardly fatal), is the big issue with breast cancer, because it leaves you vulnerable to infection of even the tiniest little nick or paper cut.

Rummaging through the Hypochondriac’s Treasure Chest, we find a literature review in an open-access journal. Open access is less questionable in the hard sciences than it is in the humanities. As of 2014, this review of published research indicates “this form of cancer is usually low grade and rarely recurs. . . . Understanding the low-grade nature of this form of breast cancer allows treatment options to be less radical and safely omitted.” However, this same group of authors calls papillary breast cancer “diagnostically challenging” and remarks that if the tumor appears in conjunction with invasive cancer, that might not be great, especially if it occurs in a younger woman. However, I fortunately am old as the hills, and I’m told these things were quite small.

And finally, the Brits say, in a website dumbed down for the public, “Doctors usually treat papillary breast cancer with surgery. These cancers usually grow slowly, and don’t usually spread to the lymph glands or other parts of the body.”

So if I’m understanding what the woman said to me, it looks like the outlook is about as positive as it can get for a cancer diagnosis. I feel a great deal less frantic than I did while waiting for news…right now what I most want is just to get the surgery under way, get the damn things out of my boob, and move on.

My son is going to take the dogs for as long as I’m incapacitated. Suspecting this was coming up the pike, I’ve already hired a cleaning lady and lined up a pool guy. Cleaning lady has begun deconstructing my house — in addition to breaking the vacuum cleaner ($140!), she also quietly knocked the shower door off its track. Neighbor is coming over this evening to try to fix it. I just hate hiring cleaning help…honest to god, they do more damage than good! And then when they break things, they don’t tell you — they leave it for you to find out. Had a helluva time getting out of the shower stall this morning.

Let’s hope that’s not true of pool guys.

Tomorrow I’m meeting with a surgeon at the Mayo. I have no intention of letting St. Joseph’s cut me up, having damn near died there a few years ago. Besides, St. Joe’s Healthgrades ratings for patient safety are much lower that the Mayo’s and even lower than John C. Lincoln’s. JCL is located in the heart of a desperate slum, for hevvinsake, a few blocks from the headquarters of a dangerous meth gang. So…one wonders. At any rate, if I have to get radiation treatment and the Mayo doesn’t do that at its (relatively nearby) hospital on the 101, then I’ll have to get that done at JCL or St. Joe’s, since I can’t afford the gas to drive halfway to Payson five days a week for five to eight weeks.

So things appear to be as under control as they’re going to get. Unless, of course, the Mayo’s surgeon upsets the apple cart tomorrow…

Somethin’s gotta go…

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And I think it’s about to be this puppy…

Today or tomorrow, the biopsy report is supposed to come in. If it’s cancer, the first thing that’s gonna happen is Ruby is going straight back to the breeder. I certainly can’t care for her if I’ve got half my boob lopped off and am looking at weeks of irradiation and subsequent radiation sickness.

Even if it’s benign, I may have to return her. Mortal illness or no, we’re rapidly reaching the point here where I can’t take care of her.

She barfed all over the bed again last night. So at midnight I had to pull ALL the bedding off and remake the bed. This was after she’d had me up about once an hour from 10:00 forward.

Of course she went back in her crate at that point. Briefly. For the rest of the night, she was up about once every hour. I finally had to put her back on the bed to get her to settle down long enough to get 90 minutes’ or an hour’s worth of  uninterrupted rest.

I think her UTI is probably back, since I can’t find any new dog mounds in the yard, which means she’s not wanting to run out to squirt brown puddles on the ground. And what causes the barfing, I can’t imagine. This was SIX HOURS after she’d been fed. Normally, a dog’s food moves through its stomach quite fast. The entire digestive process takes six to eight hours. So she shouldn’t be woofing up virtually undigested food after six hours. Since the food does seem to be undigested, she actually may be regurgitating rather than vomiting, but if that’s the case, it’s mighty weird that the food would sit there without moving for all of six hours. In either case, it sounds like an expensive fix. Or a lifelong nightmare struggle.

{sigh} So. To add hassle on top of headache on top of worry, I’ll have to call the vet this morning and make an appointment so as to get in the door if I don’t have cancer (50-50 chance, we’re told), and then explain that if the biopsy results are positive, we’ll have to cancel because the puppy is going back where she came from. First thing, though — like right this minute — I’ve got to wash the sheets, blanket, and doggy throw.

In any event, the pup’s health issues are starting to drive  me crazy. I can’t deal with all this sh!t at once. Last night I didn’t read the stoont papers that came in — figure to read those while the students are in class today, since they’ll be in the computer commons putatively working on their 2500-word final papers (read “playing computer games, checking in at Twitter & FB, and surfing the Web”).

Even if the stress of the cancer scare goes away, come next Tuesday I’ll still have 62,500 words of drivel to read in a matter of maybe three days. Fortunately my associate will be back in town pretty quick, but since one invariably becomes sick after riding on airplanes and since she’ll be coming in from halfway around the world, it remains to be seen whether she’ll be in any shape to help out.