Separating the Saucer Section(s)

(Hey, if it made me smile, then it's going as today's blog entry title. For those who have never watched Star Trek, just wait, there's going to be a movie musical reference in a bit.)

It's 6 a.m. I've been up since 5 and slept somewhere from 11 p.m. to 1 a.m., and then 2:30 a.m. to 5. Washed about a gazillion times with the special soap (die germs!) and am pretty much good to go when we're actually leaving, which is 6:30.

I've got my "Rod call/text list" ready, my "stay at the hospital" bag ready, my "stuff Rod will have to carry all morning until I go into surgery" (aka the "distraction") bag ready (ipad, iphone, headseat, charger, sudoku book, Hebrew grammar workbook pages, glasses........)

Am I ready? Eh. As I'll ever be, I guess. Got prescription lidocaine cream slathered all up and down my left arm (for the notorious IV insertion ordeal) which means I've got plastic wrap covering me from elbow to fingers. (If you deprive it of oxygen, it works better. To hold it all together, I put a latex glove on my left hand and threw on one of Rod's work shirts (pink plaid.) So now I'm really warm but not worrying about that particular pain will totally be worth it. And I look kind of funny.

The other place I've put the cream is where (I'm guessing) the four injections will go for the sentinel node tracer material. The injections have to be done about an hour before the surgery because.... well, I'm a little fuzzy on the details but I know it has something to do with how Dr. McIntosh finds the sentinel node when she gets into surgery. This area, too, is covered in plastic wrap, held in place by my camisole. But since that will have to be wiped off by Dr. D'Amico when he draws on me at about 7:10, I hope it has time to get to work and stays in effect until 9.

Yesterday on Facebook I posted a status that said I was determined to enjoy my birthday by using Scarlett O'Hara's famous line, "Tomorrow is another day." Then late last night I was reading my "Ten Minutes of Torah" that I get via email each day. The portion this week is about how daughters of a father who has died without male heirs are given their inheritance by God, and the rabbi who is writing compares the whole situation to the O'Hara girls inheriting Tara. Coincidence? Probably.

But in one my favorite all-time movies, "Hello Dolly", Barbara Streisand asks her dead husband for a sign that she should marry Horace VanDergelder and Horace says something like, "Money is like manure. It's no good unless it's spread around helping young things to grow." And of course, that was the exact line her husband has been fond of saying. So she had her sign.

Is "Gone With the Wind" my sign? I kinda hope not, since it is not one of those movies I would watch over and over.

But if the doctors have got my front today, I know you all have got my back.

Love,
Rebecca

Thinking and thinking

I had two kind of (maybe) oddball realizations this week.

First, about the pink: I've always liked pink, but within the past couple of weeks I've gone kind of pink-aholic. When I chose a color of polish for my pre-surgery pedicure - (tastefully) hot pink. My new summer bag - big time pink flowers. I now own a pink mouse for my laptop, a pink notebook cover, pink shoes, pink nightgowns, a pink blog page, a pink robe, pink highlighter, pink heart-shaped Post-Its, pink paper clips, not to mention the four pink bracelets I am wearing. (There were 3, but darling Joan & Iris gifted me with a beautiful pink crystal bracelet with beads spelling out "faith" and a breast cancer ribbon and "hope" charm.)

Do I really love pink that much because people compliment me when I'm wearing it? Maybe. (Doesn't explain the office supplies, though.) Am I buying pink because it's the quintessential "girlie" color and I'm needing to compensate for what feels like the imminent loss of a feature that makes me a "girl?" Hmmmmm...

I'd like to not dwell on that, but trying to ignore the fact that this is a loss is like trying to ignore the fact that somewhere in my "house" is one of those trick buckets of water balanced on a partially open door. Eventually, and when I don't expect it, something is going to go 'splat' on me and I'd like to have an umbrella (and no cracks about a smile being my umbrella - I hear some of you thinking.) Or a poncho. Or a hat. Preferably a pink hat.

Second, there's this rather odd feeling that the closer I get to Monday, the more surreal this whole business seems. As I left my last (for a while) wonderfully soothing chiropractor appointment this afternoon, it just came upon me. I'm torn between wanting it to last (it's kind of nice there in "it's-not-really-happening-land) and wanting to be fully present in my present, so to speak. I don't know if this happens to others in my situation, but it's a very weird thing to be experiencing.

Also in the news this week: Dr. McIntosh's office called my cell at 8 a.m. Wednesday to say that the insurance company had approved the plastic surgeon and would cover his part of the surgery. YAY! And, I had a more pleasant conversation with another nurse from the insurance company yesterday. I was extremely polite, and I could tell she was trying really hard to be helpful. She did not attempt to "educate" me about anything (said I sounded like I had good support around me and was as well prepared as I could be,) and said she'd check in with me next Wednesday or Thursday to see how I was doing.

But first, I've got my dad coming in tomorrow and a birthday to celebrate on Sunday. Good thing the pre-surgery ban on food and drink doesn't start until midnight the night before!

Trying a Patient's Patience

Here it is Father's Day, June 20. One week into the "no Advil" and one day until the special soap begins:) Three more chiropractor appointments (chances to get my back so I can sleep on it comfortably.) Six days 'til my dad gets here.

Rod and I called our fathers, and when I spoke to my dad the conversation (as it inevitably does) turned to the surgery - with me completely ranting about an encounter with the health insurance company, and that led me to think more about my patience (or recent noticeable lack thereof.)

Friday, about 5:45 p.m.: I get a call from a woman who says she is calling to "help" me with my health insurance. She doesn't identify herself in any other way. So far, she sounds a lot like the people who call to "help" me with my mortgage rate. And she asked for "Becky," the nickname that NOBODY who knows anything about me would EVER call me; certainly not what someone who has never met me would call me. Who starts with a nickname just to get chummy? I'll tell you who - people who call Rod and ask for Tom because his full first name is Thomas. Guess what? They never get to talk to him.

So, here I am, driving with Ari to the synagogue for a barbecue and family service, and already this woman has me wound up. But, I agree to speak with her and after she asks me for my birthday and zip code, I ask(nicely) to know exactly which company she is calling from. Satisfied with her answer, I proceed to have to explain to HER what my medical history is and how I got to my current situation.

Turns out she is an oncology nurse who is calling to "help" me - and that word is in quotes yet again because so far, (and I'm telling you now that by the time we hung up,) that word has NO place in a description of our conversation. Through all the years since 2006, every person working in oncology has been wonderful - understanding and patient. And the first thing they all say is either "How are you doing?" or "Is there anything I can help you with?"

Somehow she managed to tell me that a) my hospital is not in-network (untrue - any rube with an internet connection could look that up easily and find out that my hospital is, indeed, in-network) and b) that her understanding of the gap exception rule is that it is only applicable if there is no suitable doctor within a 30-mile radius. (Visions of a pile of disappearing cash and/or a doctor who says at the last minute that he can't do the surgery arise in my head.) And, she wants to know who Rod spoke with to get his information from.

Now we've arrived at the synagogue, I'm inwardly furious with this woman for not only NOT helping, but starting a conversation about something that would seem to be decidely not her purview and putting me in such a tizzy that can only be described as "a state." I saw Rod had already arrived and handed him the phone, but that evening it was all I could think about, even through speaking with some nice prospective members and the lovely outdoor service.

Her last words to me were "Why don't you call me next week? I'd like to educate you a little about chemotherapy." If we had been face to face, she should have stepped away; that's how angry I was.

My last words to her were "I have an oncologist, and we won't know what will happen with that until after we have all the testing done after the surgery." This is better than my evil (and fortunately for both of us, silent) twin's response: "Educate? Really? I'm sorry, is there no other place that would let you work for them? Because you're just adding to the stereotype of insensitive, ignorant health insurance employees." Maybe even with my actual response I might have sounded kind of snotty, but if she was calling to be my case manager and help me through some of this, she should have been a little more sensitive, especially for a first call. And I resented that it felt like she hadn't actually been listening to me. I spent all that time explaining my medical history (using the appropriate vocabulary even)and she still spoke to me like she knew everything and I knew nothing. The word "imperious" comes to mind.

After I replayed the conversation in my head a few times I thought that maybe I could have been more patient with her. (After all, she was, in theory, trying to assist me. She was just really terrible at it. And I guess she had no idea that when I said I only had 10 minutes, I really only had 10 minutes.)

Frankly, I could be a lot more patient with everyone at this point. For the past few weeks I have been impatient with family, co-workers, friends, and the world in general. I don't even know if my situation gives me permission to be that way, but I appreciate all of you putting up with me.

(You know it's bad when I've started joking that the anesthesia will at least insure I get 3 to 4 hours of uninterrupted sleep!)

It will be better soon.

Sign Here, Initial There

Just got home from visiting both surgeons' offices and signing too many forms to count. Plus I had my pre-admission bloodwork and EKG. If both of those results are as they should be, I guess I'm cleared for surgery.

We didn't see the plastic surgeon himself today, just his office manager who handles all the forms and gave me my pre- (special soap) and post-operative prescriptions. Valium to control muscle spasms to aid in healing, an antibiotic to ward off infection, a heavy-duty painkiller "just in case," and something for nausea following anesthesia (also, "just in case".) I asked her how it was coming with the insurance company, and she said "they're" working on it. (Who is "they?" I don't know.)

We did, however, meet with the breast surgeon personally, and she was all about making sure we knew what was going to happen. She even drew us one of her classic diagrams, some of which I save the way Sardi's collects caricatures of famous people on their walls - except these are all sketches of breasts and procedures to be done to them. (On the other hand, I've never come off looking good in caricatures, so maybe this is better.) She told me that maybe 3 1/2 hours for the surgery - not too bad, right?

The tricky timing bit is that Dr. D'Amico wants me at his office that morning to draw his reconstruction guidelines, but I'm supposed to be at the hospital at 7 a.m., and he doesn't want to do this part at 6:30, and he doesn't want to come to the hospital to do it. So Dr. McIntosh said I don't have to be at the hospital until 7:30, and Dr. D'Amico is expecting me at 7:10. Either way, it's early, but it's okay because I figure the earlier we get all this stuff over with, the better the chance my surgery could start on time, and we can get this thing over with. That would be loverly.

She gave me a prescription for a numbing cream so that I can slather it all over where I think the IV will be - historically they have a tough time getting the IV in (if the nurse/phlebotomy person is not so good at it, it hurts while it's being inserted) and so it usually ends up on the back of my hand, which hurts going in AND anytime it moves AND creates a huge bruise which lasts for a couple of weeks.

In addition, I try to put the cream in the general area where the injections will go for the sentinel node biopsy. About an hour before the surgery the radiology department injects a radioactive substance in four spots that (I think) act as a tracer for the surgeon to find which node (and hopefully it will be only one) to take out to send up to the lab right away. This also means that once I get checked in and change and have my IV put in, they have to take me over to the other building (thankfully, connected to the main building) for the injections, and then back to the surgery area.

So I travel in a wheelchair in my hospital gown and little hospital-issued socks (not warm at all,) with Rod, all my stuff, all his stuff, a blanket to cover my legs, the IV hanging, and an orderly pushing me along. Having gone through this part back in 2006, I can look back and think it was kind of funny. But, I wish everything could happen in the same spot. This time around, I'm going to ask to wear my own robe and slippers at least! (If they're piloting me around the hospital, through the lobby and all the hallways, they can't really argue that my robe isn't sterile, right?)

I had left my nails with polish on so that I could show both doctors what I was talking about - and got official, in-person permission to have "nice" nails for the big event. Why this is so incredibly important to me, I'm not sure, but I think it has something to do with control, not how pretty I want to look in the hospital. As with the shampoo as opposed to the antibacterial soap, it's about what I can do MY way, in the face of all of the "have to" things that make the surgery more real.

Meanwhile, a few nights ago I dreamed that I was having my leg amputated, and even though I remember being upset about it, I did not wake up shaking with my heart racing. Does this mean I'm growing to accept my own decision to have body parts "amputated?" I hope so. With all the doctors and nurses trying to make sure I have no questions, so far no one has offered some kind of loss counseling.

On the more pleasant side of things, last Saturday night all of us went to Dave and Buster's to play, and had dinner at a place called Fire and Ice, which was new to us, but a really neat and pretty tasty experience, and not as expensive as I had expected.

While we were at the mall, Rod suggested I "check" at the Apple store to see if they had the iPads in stock there. As it turns out, they had the exact one I had ordered (which was coming, in theory, very close to the end of the month.) He further suggested I find out if I could cancel the order, and just get one then and there. Yes, and yes - and it's VERY cool:) Rod even gave me my birthday present of a year's 3G service right then and there, over two weeks before my birthday! Now, there's a great guy - but you knew that already.

This morning Dr. McIntosh's nurse Pat asked me how I was doing and I started to tear up a bit, but I said that eventually I was going to be fine, right? And she said "right." To loosely quote a friend of a friend, I thought I was used to the idea that not everything I walk on will be smooth, but some days I feel like this road is a long and bumpy one.

Things to Look Back on - and Forward To

The week went by in a blur of - hmmm, I'd have to look at a calendar to list everything. And a lot of it was fun at the time, especially the shopping therapy at Pearl Paint (thanks to Elyssa - what a wonderful place!) and then on to Kohl's to find the perfect button-up-the-front pink flowered shirt for coming home from the hospital.

A very cool and rare sighting from home - my dad is coming to visit the Saturday before the surgery, and my sister-in-law and niece are coming with him to visit with her sister, who lives here in Oakland, right near us. They're all coming on the train, and going home that Tuesday. I joked with Dad that he was just staying long enough to be sure I had survived, and he laughed and said "that's right!" Those who don't know us too well would be horrified, but that's the way we talk. Underneath we're very soft and squishy sentimental folk.

Also during last week my birthday present to myself was ordered - an iPad. Although I had hoped it would come sooner, God's cosmic joke (in the form of Apple's shipping department) has dictated that it probably won't arrive until closer to my actual birthday, a far-too-close-for-comfort 4 days before the surgery. Plus, being a "want what I want when I want it" kind of gal living in an age of instant gratification..............well, you get the drift.

Sometime midweek each surgeon's office (because I couldn't remember which one's paperwork said "no nail polish" and needed someone to tell me why not) called to tell me that yes, it is ok to wear nail polish, as long as there are no acrylics underneath. I have gels, thanks to Jane(!) so it turns out a nice manicure before the surgery will at least be something pleasant to do to get ready, along with the special antibacterial soap washing and no eating or drinking (not even water) after midnight the night before.

The synagogue itself is pretty quiet right now, which is great, since my own little end of the hallway is busy with movement - books and papers going everywhere while we count what we have and decide what we need. Thank goodness Rachel is there with me. We made a list of all the work she is going to do over the summer, with or without me there, and she filled a whole lined pad! Granted, it was one of those little half-sized ones, but still, I never realized how much we do to get really, really ready.

The paradox (or is it a dichotomy?) of the calendar for me is that while I am just desperately impatient for Ari to be done with school, live through his finals, and just be able to stop struggling with things for a while, I am pretty patient about waiting for the surgery. There is so much I want to get done first!

This morning Rod & I drove down to West Orange for a one of our dance "family" child's Bat Mitzvah (Hi Ann & Stan - D. was great.) It was Conservative, so it started at 9 a.m. but she didn't start participating for real until around 11 a.m. We got there about 10:30 and it was different from what we're used to, but the same enough that we could make comparisons to our own services along the way. As we arrived they were into the 2nd or 3rd Torah reading, and I automatically started translating in my head. I actually could do quite a bit; Then they went on to a section with a bunch of names and numbers and parts of animals (all kinds of organs and such) because they were talking about sacrifice, and I lost track, but I had it for a while!

We sat with some of our other friends - it was good to hug everyone, most of whom we last saw at New Year's. We ducked out before the service was over and were in the car by about 12:30. The trip home should have been a little over half an hour. Nope. Trailer and its truck turned over in the middle of Route 287 and we didn't get home until around 2 p.m. Oy.

So we had plenty of time to check in with Ari, who Alex had driven to the youth group election/Chinese Food/Laser Tag end of year blowout. He was running, with a friend, to be the liaison to the junior youth group kids, and the boys didn't win. I felt bad because I knew he would have done a good job, and now there are no boys, er, young men, on the board at all. The girls who won are terrific, and I like them a lot, but as I take off my virtual synagogue hat and put on my virtual mom hat, I just felt bad. Probably he doesn't, and I'm sure it'll all be fine.

This afternoon we're going to meet Ari at the synagogue to pick him up from his youth group mall fun, then turn back around and go to the mall for Alex's "you had an awesome sophomore year in college" Dave and Buster's family outing.

Andrew will come over after he's done at work and join us for dinner and some gaming, and with any luck I'm going to go back to concentrating on NOT concentrating on anything for a few hours except enjoying being with Rod and the boys.

Q&A (the Tip of that Iceberg)

Monday I started to tackle my "questions" list that I had composed over the weekend based on all the dreaded paperwork reading that Rod had done (I am so grateful.) It was easier to have him pass me things to sign - I didn't really have to read them closely. Rod gave me a summary of what each one contained, and he made it much less scary. And he guided me through making my list of questions. Once it was down on paper, also not quite so scary.

The beginning of the question answering - not so bad. Dr. McIntosh's nurse Pat was really helpful:

Do I have to be there at 7 a.m., really? no, we have time to scoot over to Dr. D'Amico's office first to get marked up for his part of the surgery, then check in at 8 a.m. Special radioactive injections for the sentinel node biopsy at 9, surgery at 10. (Just writing that made my heart go flippity-flop.)

What should I bring? Robe, slippers, warm socks (my necessity), toiletries, phone, charger (how modern are we?)

What about all the pre-testing that some of the paperwork is asking for? Nope. Just the two that I already booked for the 16th, bloodwork and a heart thing (I can never remember if it's EEG or EKG - it's just sticky things and a graph output of some kind.)

What about this washing exclusively with a special prescription soap for some days before? I'm trying to explain that my hair will be gross if I don't wash it with my shampoo and use conditioner. Not my hair, silly (she didn't say "silly" but I heard it) just my body. It's to try to kill as much bacteria as possible before the surgery. Duh.

Similarly, a nice call to Dr. D'Amico's office:

What about the second "follow-up" consultation, AND the special appointment with the nurse (who's only in on Tuesday and Thursday) to sign the paperwork? Already had the consultation, and not necessary. We can simply drop off the paperwork I signed after we do the hospital stuff on the 16th. (Dr. D'Amico's office is across the street from the hospital; he's the chief of plastic surgery there.) At the same time, I can pick up prescriptions for all the stuff I'll need right after the surgery, like valium (used to stop muscle spasms, not for my sanity) and the aforementioned special soap.

Note here that this simply dropping off stuff is a good thing. I try to stay out of the doctors' offices, and the hospital, as much as possible; although I know it doesn't actually change anything, it FEELS less awful. For the same reason, when I go for exams, I usually dress so that I don't have to take lots of time to change, put clothes in the teeny locker, etc. I spend a little less time there and the act of removing tons of my own clothes to put on the the gown and robe is just mentally harder. So if Stacy and Clinton from "What Not to Wear" were to show up at one of these visits, they'd be properly horrified by gray sweat pants, Crocs, and a camisole top covered by my favorite zippy sweatshirt! Easy off, easy on, easy to get the heck out of there.

Monday I also started to try dealing with the insurance company on my own. By the time I had spoken to the 3rd department in a row, I had gotten nowhere fast and they had already denied the fee for the initial consultation. Plus, one of the papers I have to deliver on the 16th is something I signed saying we would "guarantee" that the doc receives his fee (somewhere over $35,00) no matter what happens with the insurance company. I'm sure everyone has dealt with things like this, and I'll bet you all have your own insurance horror stories, whether they be about property damage or your health, but boy oh boy this was quite the frustrating hour or so on the phone. (Can't imagine how that will show up on the cellular bill!)

The bottom line was that I needed to have Dr. D'Amico's office call the insurance co. to acquire something called "gap exceptions" for all their work, since there is technically a "gap" in the coverage that allows us to use an out-of-network doctor. (This gap thing is actually good news, believe it or not.)

Yesterday I spoke to Dr. D'Amico's wonderful manager, Marie, who has answered all my questions so far. (I'm not sure I've actually met any of his nurses yet?) She said "Please don't worry about this; we will take care of it. You have other things to think about."

All well and good - but before I said good-bye I told her that I hoped we would know more about this before I hand in my signed "I promise you will be paid all that money" form next week. We shall see.

The one thing both Pat and Marie said was, "keep writing down your questions and bring them in when you come next week." Nice change from the not-so-good old days when the doctor (usually a man) said "do this" and you did it, no questions asked, and you just worried. I feel like I'm eliminating some of the worry, and I appreciate that they want me to feel less anxious and are willing to take the time to help it happen.

Between my lists for work, my lists for home, and my lists for the surgery, I should just carry around a whole stock of Post-It notes. Oh, wait a minute......:-p

On a Technical Note...........

A few people who have become "followers" (sounds a little cult-ish to me, but if that's the terminology, then that's the terminology) have written to ask for the link again. So, I guess I missed that you have to give people a way to actually get notification that you have posted a new blog entry.

Ari muttered something to me about "RSS feeds" way back when I started, but I have no idea what he's talking about. In the meantime, I found a "widget" that presumably will do this. So, if you click on the right-hand side of the page in a very nicely decorated (again, not my choice but pre-made by the developer) box under the Followers box, you should be able to enter your email address and you will get a message when I write a new entry.

I have tested this, and it does seem to work, and most importantly, they emphasize that they DO NOT SEND an email unless I write a new entry. So I'm hoping this solves things for a few of you, I thank you again for reading, and if you have problems with this particular widget then let me know and I'll disable it and try to figure out something else.

See now, I have successfully taken my mind off breast cancer and surgery and chemotherapy for a whole 15 minutes or so. Nice!