hello, friends. how have you been?

technically, i am writing this at the beginning of Week 51 of Cancer Land. the past seven weeks or so have been mostly uneventful; just chugging along in this mess of 2020. Week 44 included another zoladex injection, and Week 45 involved a fourth of july camping weekend of epically humid and sweltering proportions. (the continuing hot flashes did not help).

Week 46 brought an unpleasantly abrupt end to covered visits with my physical therapist, due to faulty verbal guidance from my insurance company. fortunately, this rehabilitation office also provides occupational therapy, which can also help with my current arm and shoulder issues (aside from the lymphedema), and which my insurance covers for an equal amount of visits as physical therapy. as it turns out, my occupational therapist has walked a similar path to my own (breast cancer, chemo, surgery, radiation, lymphedema), so we have plenty to talk about. on another level, there is plenty to NOT have to talk about; experiences that we both already understand, no explanations needed. it is curiously comforting. at this point, i am basically part of the scenery at this office, as i've been going there since april. given the isolation of the pandemic, andy gets somewhat jealous as i leave for therapy appointments. "you get to see your friends today?"

the most exciting thing that happened in Week 47 was that i got the air conditioning in my car recharged. BLESSED RELIEF. Week 48 was a four-month checkup with dr. h., my surgeon. no visitors allowed, so andy joined via telephone. i cracked up inwardly again as she confirmed how great my scar looks. again, she's not WRONG, and i'm happy to let her admire her handiwork. we talked port removal and breast reconstruction, among other follow-up topics. "so, have you been exercising?" "oh, of course! i've been working on all of the physical therapy arm exercises at home." dr. h., confused but kind, paused and looked at me like the idiot i am. "no, i mean... like, getting your heart rate up. exercising, working out." "oh! yeah, no, not really." she didn't seem to think that walking downstairs from my office to the kitchen counted as exercise, so i guess i need to step up and increase the neighborhood walks.

the week ended on a less than ideal note when a tractor-trailer tried to turn onto our street that friday afternoon, accidentally dragging down a power line and evidently uprooting the pole right along with it. all the neighbors were out; it was a sight to behold. the afternoon and early evening came and went; lots of AEP trucks, but still no power. of course, it was approximately a zillion degrees, so we eventually busted out two dozen LED tealight candles from the wedding and filled up the queen-sized air mattress for some "camping" in the basement, where it was blessedly cool. the power kicked on around 3am, though by that time, the pumps in our fish ponds had been out for at least twelve hours in the heat of the day. so that's the story of how a semi-truck driver indirectly killed two of our goldfish.

during Week 49, i had appointments on four out of five weekdays. monday and wednesday: regularly scheduled occupational therapy. tuesday was a follow-up CT scan, located at the imaging center on the second floor of the oncologist's office building. i had never been upstairs before, but found the elevator, made my way up, and settled in for some heavy drinking. the nurse brought in my 1.5 liters of contrast water (i went with flavored this time - crystal light raspberry), along with the usual instructions, and some bad news. "so, the CT scanner is currently down. but we're hoping it will be fixed by your scheduled scan time!" i wasn't too worried, as i had at least an hour and a half of water chugging ahead of me, though i was definitely not optimistic. as it turns out, neither was the technician who walked through about an hour later. just as i was downing the last of my contrast water, the nurse broke the official news to those of us who were busy hydrating: no CT scanner fix today. sad face. but they had arranged for us to get our scans immediately at riverside/bing, about a five minute drive, so off we all (separately) went. this is where i had my PET/CT scan in september, so the office was not unfamiliar. during check-in, the nurse asked if i had a port. i raised my eyebrow and answered yes. the first time i had a CT scan, they didn't access my port -- because i didn't have one yet. it hadn't occurred to me that it would be used for this scan, so i hadn't applied any numbing cream to the area. i was fairly unhappy about this, as i had never used my port without any numbing cream, and no one had thought to tell me it would be used for the contrast injection. but, again, i wasn't too worried... after all i have been through, what's a little needle stick? (says the girl who had never even had an IV placed before last september). but still, i was irritated, because it could easily have been avoided. anyway, i drank a little more flavored contrast water (lemonade flavor this time), as i waited for a nurse to access my port. it was unpleasant, but not terrible. (the needle, not the water). then it was into the CT scan. i laid down on the table, and the very perky and extroverted nurse covered my lower body with a standard hospital blanket. then he had me shimmy my shorts down to my knees to make sure no metal would show up on the scan. he reminded me that when they inject the additional CT contrast through my port, it would feel warm, and it often makes people feel like they are peeing their pants. i noted that having your shorts down to your knees surely doesn't help reduce that sensation. anyway, they slid me back and forth through the CT donut, as i held my breath at the appropriate times throughout. the last scan was done after getting the contrast injection through my port: warm peeing feeling, one last slide through, one last breath hold, and i was done.

two days later, on thursday, my last appointment of the week was with my oncologist. after we were checked in by a new and rather confused receptionist, the first activity of the visit was a blood draw (through my port, and i DID apply numbing cream that morning). next up was the office visit with dr. m., which is really why i am writing. she confirmed the medical gobbledy-gook of the CT scan results i had received in my chart on wednesday: nothing new or progressing was found on the scans. cancer-free, in remission, whatever you want to call it. i prefer 'no evidence of disease' (NED, for short)... very happy to welcome my new friend NED. as a side note, the results noted that many of my internal organs were "unremarkable". under normal circumstances, i would be offended, but in this context, i am happy to be "unremarkable". we also discussed starting exemestane, the daily hormone therapy pill, to keep my level of estrogen (cancer food) down. (notes from the future: after a week on exemestane, i have not yet noticed any side effects). we discussed the removal of my port. i inquired, with raised eyebrow, "what are the chances i would be needing one in the next year or two?", trying to get her thoughts on my chance of cancer recurrence. dr. m. shook her head without a second thought. nope. no reason to keep it. well, if she's confident, then i'm confident... i will return to dr. h's office at some point to remove the port.

i will continue to see dr. m. every twelve weeks or so for the foreseeable future. but other than an upcoming mammogram (has it really been almost a year since this all started?), and a bone density scan in a few weeks, it seems like any future scans will just be on an as-needed basis, in the event that dr. m. or i notice anything weird going on. no more blood draws needed, but i will continue to return every four weeks for a zoladex injection (which also keeps my estrogen levels down, in a different way than the daily exemestane does). this will basically be the way of life for awhile (five to ten years?), unless we decide to give my ovaries a permanent, surgical farewell. it's more or less the ideal, hoped-for ending to nearly a full year of medical madness and appointments. i'm thankful for all of my medical providers, and for all of you, as i land safely across the shore from Cancer Land. new endings, new beginnings. let's do this.