My Great Breast Cancer Adventure

Excellent Resource Page

Here's a cancer resource page that's very good if you're interested in doing your own research re: best ways to design/find a treatment protocol that's right for you, get the best help possible, understand how to wend your way through the maze of information, etc. etc.

You Can Start Anywhere

    The dream had swept Lenore away into honeyed elixirs of paradox, trays of erotic oyster canapés. But it couldn't happen in real life. She would fix something simple for breakfast. She got out of bed and reached for her bathrobe.
    "Would you like a cup of coffee?" she said.
    "Sure, that'd be good."
    As she scooped the dark french roast out of the bag, she heard his footsteps coming toward the kitchen from the bedroom. The next door neighbor's chicken began to make a racket, clucking and baaking up a storm. Suddenly she remembered the cinnamon and overripe bananas. He walked in, put his arms around her waist, gave her a light kiss on the top of her soon-to-be-bald head.
    They drifted over the coffee for a while, keeping the torment of hospitals and needles at bay a little while longer. They were all alone together in the middle of a beautiful city. He took excellent care of her. Sometimes the truth seemed so small, a speck at the bottom of a canyon, she could pretend it wasn’t there.
    "What kind of eggs do you want?" he asked, tears collecting for later behind his gray-green eyes.
    She couldn't think what to answer, couldn't make the dream disappear, saw the rest of her life spent in ambivalence, a limbo of pros versus cons, risks versus benefits, survival versus quality of life. "Scrambled," she finally said.

    That night before dinner, she sat shimmering with the radiance of her cellular imbalance, accepting of the fact that she was not, nor had she ever been, an easy-going person. Her upper lip twitched. She was forever aware that words, beloved though they were to her, could betray.
    Oh forget it, she said to herself. You have to cook. You have a whole new life now. Everything shook, inside and out, but yes, it was so. She should be content with warm but brief conversations. It was essential that she ask for more from herself.
    Evenings, alone in the house, she streamed and compressed, made herself impervious to the darts of pain that twinged through her breast. Crouching inside the vivid reds, ambers, purples and peach, she was the only one who understood what she had chosen to put on her walls over the years, or why. Or was she? Or did she?
    Oh no, never, not that, not you, she had thought, but deep down she'd known better. You were given that which you most feared, up to the point where you could handle it, whatever that meant. She wasn't sure.
    "What does that mean?" she had said to doctor after doctor, interrupting them, annoying them, cutting into their precious time.
    Now, working quickly and efficiently, the wisdom rising in her, she kept to silence.
   
    He had walked in with a bag of groceries and now stood at the stove, getting the rice and beans going. She stood unmoving in the center of the kitchen, thinking, Should I have a drink? Tea or wine? Should I allow myself a glass of wine?
    "What are you thinking?" he said. "Is something the matter?"
    "I'm thinking about what to drink. Wine or tea. That's all."
    She didn't say, "I'm thinking about how to proceed for the rest of forever. I'm thinking about what blood type I am, what a thin line we walk. I'm wondering why the nerves in my arm are acting up again, sending those streaks of pain down toward my hand. I'm thinking about the blood in my veins, and about the body of god — is it well-toned? Does she work out at least three times a week? Is her immune system functioning optimally?"
    "Ah," he said as he opened the refrigerator door and took out a beer. Warmth, companionship. Life was trotting along from Tuesday to Wednesday.
    She considered her drink options. Crowds of doctors gathered at the edge of her brain to listen in. She was drowning in tea but couldn't give up her fear of doing the wrong thing, feeding sugar to the gobbling invader. Nevertheless, she poured herself a glass of chardonnay to have with the fish.
    "Same old recipe with a new twist. It came out pretty good," he said. "I like the chili peppers in the diced tomatoes. Don't you?" He grinned a boyish grin.
    She wanted to blurt out that her left arm was still numb and hurting, three months after the biopsy. It seemed to be getting worse again, in fact. What awful new side effect was on the horizon? But sometimes you had to choose restraint, in one mode or another. She got up from her chair, walked around the table, put her hand on his head and stroked his hair. "Yes," she said with a laugh, "I do. It's delicious."
   
    Later, after the dishes were done and the day was about to disintegrate once more, she stopped laughing, sank back against the refrigerator.
    "What is it?" he said. His face appealed to her. His hazel eyes, his russet hair. She wanted the house empty, but would miss his quiet and generous soul.
    If it had been otherwise — if she hadn't wanted what wasn't needed, hadn't been so well acquainted with the night, hadn't found so much beauty in the chaos — then maybe...maybe... maybe what? It was a moot point.
    "It's okay, " he said. "Tell me. You can start anywhere."

For the Science-Minded Among You

New Drug Points Up Problems in Developing Cancer Cures

 

By GARDINER HARRIS

 

 

WASHINGTON, Dec. 20 - Despite promising discoveries and multibillion-dollar investments, cancer research is quietly undergoing a crisis. Federal drug regulators will soon announce several initiatives that they hope will help salvage the field. Few drugs are being marketed, and most of those that have been introduced are enormously expensive and provide few of the benefits that patients expect. Officials of the Food and Drug Administration suggest that the failures may result from an obsolete testing system.

 

There is growing evidence that X-rays, long the standard, may not accurately assess a patient's disease. The drug agency is creating collaborations to develop imaging, blood and other tests that better signal the progression of cancer.

 

"We need to develop cancer drugs differently," the chief operating officer of the agency, Dr. Janet Woodcock, said in an interview. "The tools we have to develop these treatments are not what we need in cancer."

 

On Tuesday, the agency approved Nexavar, a drug that officials described as "a major advance" in treating kidney cancer.

 

That action demonstrates the global confusion surrounding cancer. The manufacturer of Nexavar, Ba yer, used X-rays to determine that the drug doubled the time, to 167 days from 84, before tumors grew substantially in number or size, a finding called "progression-free survival."

 

Officials of the drug agency found the findings so compelling that they urged Bayer to stop the trial early and give Nexavar to subjects who had been taking placebos.

 

European regulators, on the other hand, wanted the trial to continue because they wanted Bayer to prove that Nexavar actually extended lives, a finding that would have taken many more months to establish, a deputy commissioner of the drug agency, Dr. Scott Gottlieb, said Tuesday in an interview.

 

"Nexavar is a good example of how we have developed better science around the development process itself that not only enables t hese drugs to come to market but to come to market more quickly," Dr. Gottlieb said.

 

Much work remains to be done, he said, adding: "The crux of the crisis in oncology is that for years we have developed tremendous scientific advances in looking at how cancer develops, and that's not being translated into practical solutions that are benefiting patients at the pace you would expect. Look at what the government and all the drug companies are spending, and yet drugs are not reaching the market."

 

Groups of cancer patients say they, too, want better ways to measure success against cancer.

 

"That doesn't mean we want drugs pushed through faster," the president of the National Breast Cancer Coalition, Frances M. Visco, said. "It means we want better science, meaningful endpoints and drugs that have less toxicity and actually prolong survival."

 

There have been successes in oncology besides Nexavar, of course. Platinum-based drugs have mostl y ended deaths from testicular cancer. Tamoxifen and Herceptin have saved thousands of women from breast cancer. And early screening has helped push down death rates.

 

Researchers are not alone in their failures. Drug makers are in the midst of a dry spell that threatens the foundations of the industry. After peaking in 1996 at 53, the number of new drug approvals has steadily declined. This year, it is unlikely to exceed 17.

 

Although every field has suffered, cancer has had the greatest chasm between hope and reality. One in 20 prospective cancer cures used in human tests reaches the market, the worst record of any medical category. Among those that gained approval in the last 20 years, fewer than one in five have been shown to extend lives, life extensions usually measured in weeks or months, not years.

 

True cancer cures are still exceptionally rare. Medicines have been approved for colorectal cancer. Patients who take every one of the high-tech drugs has to spend, on average, $250,000, suffer serious side effects and gain, on average, months of life, according to studies.

 

Drug companies have been promising for years that gene-hunting techniques would yield targeted nontoxic therapies that melt cancer, but few cancer medicines fit that profile.

 

"There are all these myths having to do with cancer drugs," Dr. Steven Hirschfeld, an F.D.A. medical officer with expertise in cancer, said. "That they're very targeted, when in fact all these drugs have multiple targets. That they're nontoxic, when in fact the latest ones have their own set of side effects. And that they're cures, when they are not."

 

Nexavar, for instance, seems to affect a variety of crucial molecules involved in powering can cer cells, but its real effects are uncertain. It can cause rashes, diarrhea and increases in blood pressure, although drug agency officials said it was far less toxic than previous therapies.

 

The disappointing track record in cancer has mostly resulted, of course, because it is not one disease, but hundreds, whose progression is governed by a dizzying array of genetic and environmental factors that are just beginning to be understood.

 

Drug agency officials are increasingly concerned that failures with cancer may result because the science of human testing, called drug development, has not advanced as rapidly as the understanding of the biology of cancer. "My concern is that these novel drugs being discovered will bump up against an aging development process that can't adapt as quickly," Dr. Gottlieb said.

 

The agency will soon release a report that lists more than 12 research areas that it will address to try to improve clinical trials. Among the efforts is a search for new ways to measure cancer progression.

 

For decades, X-rays have been the principal means for researchers to judge whether a cancer drug works. If tumors appear to shrink or stop growing after therapy, the drug is thought to be working.

 

There is growing evidence that tumor size may not matter much. Small tumors can sometimes be as deadly as large tumors. That discovery has unmoored drug development. Researchers could track which patients live or die. But trials that measure life expectancy often take years and tens of millions of dollars to complete. Researchers and companies would dearly love an interim measure akin to cholesterol or blood pressure readings.

 

The anxiety over measuring success in trials has led drug regulators around the world to try to provide guidance to companies. By coincidence, the Food and Drug Administration and drug regulators in Europe and Japan all released papers over the summer on cancer drug measurements.

 

"But I think it's more instructive what these documents didn't say," Dr. Hirschfeld said.

 

None endorsed any one measurement, he noted.

 

For Nexavar, the drug agency accepted X-ray measures because the changes were so dramatic, said Dr. Richard Pazdur, director of the oncology office.

 

The agency also encourages tests of new imaging equipment. Officials are hopeful about research into positron emission tomography, or PET scans. The scans show not only a tumor's size, but also its vigor.

 

The drug agency is also setting up collaborations with the National Cancer Institute, the Centers for Medicaid and Medicare Services, and other groups to pursue other technologies, blood tests and genetic screens.

 

In the end, though, the search for new ways to measure cancer may not be successful, said Dr. Susan S. Ellenberg, the associate dean for clinical research at the University of Pennsylvania School of Medicine, who spent much of her career at the drug agency and the cancer institute.

 

Dr. Woodcock said success was vital.

 

"The science is at a point where we shouldn't let this opportunity escape us," he said. "There are ways to figure this out, and it's not like I'm some wild-eyed idealist. I'm the F.D.A., for heaven's sake. This is going to happen."

Divine Honey Treasure

I've fallen in love with another man, who I call my sweet Honey Man.  Jack already knows about it, because he was with me when Cupid's arrow struck, and he could see that I was goner the second it hit.

All I did was ask Honey Man a question: "Can you explain to me why honey is better than sugar? I mean, doesn't it all just break down into the same old glucose, in the end?' He looked at me like I was crazy, but it was a gentle look, a startled but kindly look.  Then he began to explain things to me about honey, while also giving me lots of tastes of this and that on little white plastic dip sticks.
Marshall's "Haunted Honey"

But what he had to say went well beyond the amber jars of multi-flavored, flowery honeys. He took me and Jack on a lovely introductory stroll through the healthy and HEALING world of bee pollen, as well as something called Royal Jelly and something else called propolis.

My dear little Honey Man was probably in his late 60s or 70s, white-haired, short and slight. He was wearing an old, comfortable looking cardigan sweater. I think his eyes might have been a soft pale blue, or if they weren't blue, they emanated the essence of blue — clear sky blue, warm pond blue. We found him at the Allemany Farmer's Market this morning at 7:30 a.m.

At one point in our fifteen-minute discussion, Honey Man handed me an old, red, well-weathered and thumbed book all about the wondrous healing properties of propolis. He also gave us three informational sheets, one about Royal Jelly ("a miracle food"), one about propolis ("natural medicine from the beehive"), and one about "Honey Royal," (a potent combination of raw honey, bee pollen, Royal jelly and propolis - take a quarter of a teaspoon per day!). I had the feeling that Honey Man wouldn't have given us any of this information if I hadn't asked him that first question. He wasn't at all the pushy salesman type, but rather a gentle and generous soul, with a wealth of information to impart, but only to those who cared to inquire.

Call me Lucy Goosey, but as Honey Man talked to me, I had the distinct feeling that he knew much more about me than I had told him. I think he intuited something - I think he sensed my illness, maybe not my breast cancer per se, but maybe the fact that I have a disease, and that because of this disease, my questions were arising from a deeper place than mere passing curiosity. I found myself thinking "longtime closet psychic who probably would never call himself a psychic."

We left the farmer's market carrying bags filled with beautifully dark green celery, red chard, brussel sprouts, lettuce, a small package of propolis, and a tiny jar of Honey Royal. As we walked up and over the hill toward home, surrounded by all the picturesque Bernal houses, I felt infused with the spirit of my Honey Man, and of magical San Francisco in general. The early morning air was crisp, cool and sunny. We could feel our leg muscles working. And we were together, walking side by side. (Jack said to me, only a few minutes later, as we were on our way to Bayshore Blvd. to buy fresh crab for Christmas Eve dinner, "This month is our fourth year anniversary, Janie.").) And I felt happy, just plain happy.

When I got home I looked up propolis on the AnnieAppleseed site, and elsewhere on the Internet.

"Honey is not a product," began one of the informational sheets that Honey Man gave us, "but a mystic Universe! Its reaches are beyond description."

Holiday Saliva Test

Functional Adrenal Stress Profile, #201: This profile is intended to evaluate an individual's ability to adapt to environmental, mental, emotional, and physiological stressors.

Your kit includes:

• Test Submittal Form
• 4 Capped Collection Vials
• 1 Biohazard Bag
• 1 White Return Specimen Box
• 1 Fed Ex Mailer

Patient Instruction Guide:

On the Day of Saliva Collection:

DO NOT drink coffee, tea or caffeine drinks
DO NOT take any sublingual (under-the-tongue) products
DO NOT eat or drink anything except water for 1 hour before the collection
DO NOT brush or floss your teeth for 1 hour before collection

1. Collect your saliva during the following 4 time periods

• morning, between 6 a.m - 8 am
• noon hour, between 12 pm and 1 pm
• late afternoon, between 4 pm and 5 pm
• nighttime, between 10 pm and 12 am

2. Label the plastic-capped vials with the stickers that are included. Complete the requested information before applying.
3. Before collecting each sample, rinse your mouth with cold water and wait 2 minutes before expressing saliva. If necessary, you may chew sugarless gum to stimulate salivation. DO NOT fill vials with throat clearings.
4. Fill vials a minimum of 3 ml, excluding foam. Cap vials tightly and insert into biohazard bag.

Place the bag into the white return specimen box with the completed submittal form. Be sure to include the test submittal form. Be certain to provide payment for shipping or postage. The specimen must arrive at the laboratory within 7 days of collection. It is recommended that you use a carrier with guaranteed 2 or 3 day shipping. Have a Merry Christmas and a Happy New Year.

Serendipitous Rain Walk

Okay, so I had to go up to Quest Diagnostic Labs at UCSF on Parnassus this morning, for a couple of blood tests (so many tests, tests coming out my ears). After the tests, I decided to walk down to 9th Avenue and put a few Writing Salon flyers and cards out and about. As I was just about to reach the corner of Judah and 9th Avenue, I passed the Overland Book Company used bookstore. I had known there was an Overland Book Co. on Webster Street near Union, but didn't realize they had another store on Judah. Since Overland is owned and run by an old friend of mine, Beau Beausoleil, I poked my head in to see if he was there. (I say he's an old friend, and he is - as in the kind of old friend you haven't seen in Forever. In this case, I'd say it had been a good ten years since I'd seen Beau, who I originally met back in the late 70s when I worked at Small Press Traffic bookstore when it was located on 24th Street in Noe Valley. Beau walked into the store one Sunday morning, nobody else was there, we started talking, and that was that.)

Anyway, there he was, sitting behind the counter of what looked to be a lovely, spacious, airy store. I walked in and over to the counter, said "Hi Beau!" and waited for him to respond. He looked at me blankly. I mean a total blank. "It's Jane," I said. Oy. Of course I wondered if I had really aged that dramatically in the last ten years. But "we" decided it was just that I'd had very long and much darker hair the last time he saw me. I also wore contacts back then, but today I was wearing dark brown framed glasses. And yeah yeah yeah, I was ten years older.

No matter, though. We fell right back into our old rapport of yore, and I, being me, wasted no time with small talk, instead launching right into the nitty gritty —  telling him all about my current breast cancer hoopla. He told me some of his nitty gritty life stuff, too. It was a good exchange, not only personally but professionally. Beau gave me a copy of his latest book of poems, Concealed In Language (his ninth book) and also told me about the Sausalito jazz radio show he now hosts, Brilliant Corners, a fun and eccentric mix of poetry and jazz. And I talked Beau into including a quarterly spot for Writing Salon students and teachers in his upcoming Overland Books literary reading series. I didn't really have to "talk" him into it; he was in the middle of planning it, and was happy to work The Writing Salon into his not-yet-finalized program - so long as I can come up with a solid written proposal.

For years I've been wanting to start holding Writing Salon readings in bookstores and cafes around the city, but it takes time and energy to find the right places, contact the right people, and really do all you have to do to make these events happen. Lots of organizing and planning is involved. So... my idea kept simmering on the back burner but never made it to the front burner.

If I hadn't had to go to UC Parnassus for the blood tests, and if I hadn't then decided to walk around putting up Writing Salon flyers in order to get more exercise (a new post-cancer resolution), I wouldn't have stumbled upon Beau's store, which, as it turns out, has only been on Judah Street for a year, and I wouldn't have hatched this new plan to hold a few Writing Salon readings there next year.

Funny how these things come about sometimes, isn't it?

Best of all, I had a glorious walk in the rain. I had no umbrella or hat, and my glasses got totally blurred, but I wasn't cold, and it felt delicious to get soaked from head to toe.

I recommend Beau's radio show from last night. It's a podcast (link above). His intro is very funny.

Addendum to Three Oncologists

Lenore has left for the day, so it's only me now, and I'm posting again because I want to do at least one UPBEAT post about doctors. (I'm a Libra, always striving for balance). So... let me set the record straight by saying that I haven't been unhappy with ALL the doctors I've met since my breast cancer diagnosis in September. Like today, for example.  The phone conversation I had with Dr. Gary Ross, just an hour ago, was amazing. It was the kind of conversation that I fantasize being able to have with every doctor.

I had called and left a message saying that I needed to ask a question. Gary himself - not his receptionist, not his nurse - called me back. And when I said, "Do you have two more minutes?" he replied, "Of course." And when the two minutes were up and the conversation was clearly not over, he let it continue. We actually engaged in a bonified discussion about my case (or I should say, a second discussion, following up on the first appointment that I had with him last week). I told him about my most recent concerns that have come up again, only within the last couple of days, regarding the fact that every doctor I talk to gives me different, conflicting advice about estrogen/hormone replacement therapy in relation to breast cancer.

One day I'm told to go off HRT completely because staying on it could make my cancer grow faster. The next day I'm told to stay on it because going off it could make my cancer grow faster. I kid you not. Respected professionals are telling me COMPLETELY different things, and each one of them is adamant and confident that their way is the right way. Who do I listen to? Who do I trust? How do I proceed?

Dr. Ross actually ADDRESSED my concerns (as has Dr. Mark Renneker, my wonderful consultant and advocate). He didn't ignore or dismiss them. In fact, he asked me for the names and phone numbers of three other doctors I've seen, so that he can talk to them all, compare notes, get information about recent studies, and try to help me figure out how the hell to make an intelligent decision when I'm being bombarded by controversy.

He listened. He responded. He commented. He suggested. He advised. He gave me additional information. And he was THERE for me. Focused on me. Attentive to me. Courteous to me. Respectful of me. When I hung up the phone I felt the renewal of hope that I so desperately need. I felt that someone was in my court. This is a feeling that comes and goes, depending (not totally, but to a great extent) on which doctor I've most recently come into contact with.

Thanks, Dr. Ross, for being remarkably different from most of your peers - in a good way.

Three Oncologists

Lenore didn't understand her doctors, their reluctance to inform her of all her options. She knew they were well-meaning souls for the most part. No, they were more than that. They were often times admirable — hard workers striving to save lives, courageous men and women working in the face of a medical system that held them back, roped them in, and, in the end, would corrupt them. After all, they were only human, not the gods that too many people wanted them to be.

She thought of each of the three oncologists she had seen so far, and tried to imagine each of them as her next door neighbor — just a regular person. Dressed in baggy shorts, a tee shirt, and floppy old shoes. She had been several years older than two of them, and around the same age as the third. Her life experience was as valuable as each of theirs, wasn't it? Her wisdom, her intuition, her mind, her opinions, her assessments, her questions — were all just as valid, just as meaningful, just as necessary to the process of her healing. Doctors were not gods. They were people. Fallible people.

What if she were to get to know these three oncologists in an "everyday" context, when they weren't in the examining room with her? What if she talked to them every day over the fence, about weeds in the yard, sprinkler systems, broken dryers, taking out the trash, the next block party, the last divorce, the wayward child?

She had met three people, three strangers, who held the title of Doctor. Some people were extraordinary people — wise, brilliant, visionaries, geniuses. Some doctors were extraordinary people - wise, brilliant, visionaries, geniuses. But only a few. Not all. Never all.

Doctors could be wrong. They could be screwed up. In addition to being admirable and courageous and giving, they could be exhausted, overworked, distracted, arrogant, patronizing, egotistical, sloppy, careless, inconsiderate, rude, narrow-minded, sad, hurting, jilted, grieving, and angry.

They could also be confused. About their jobs. About their ethics. About their patients. About their treatments.

It was looking like she would have to meet many more than three, in order to find the right one. She took a deep breath. Then another. And another.

Here's a very nice cancer

Here's a very nice cancer blog:  A Woman of Many Parts. I love the design and colors. And the writing too, actually. From an interesting and gutsy woman with a great name: Minerva.
 

Apoptosis

Sunday morning. Lenore turned on the dishwasher, got back in bed, opened the book, laid the book down, stroked the cat, listened to the sounds of December. She wondered about her pineal gland — was it really her third eye? She wondered about the china dishes. Should she have set the dishwasher cycle to gentle rather than normal? Could she bring her pineal gland back to optimal functioning? Would that make her psychic —  or at least more spiritual? Should she call Jack, ask him if he wanted to take a morning walk? Were they going to the dump this afternoon? What about the party? What about the groceries? What about apoptosis?

Yesterday she had gone walking and had sipped a cup of decaffeinated coffee as she walked. Up a hill. What a good little cancer girl. Today she would add to her To-Do List: 1) Make appt. with Dr. Rosenberg, 2) Make appointment for MRI, 3) Do the saliva test, 4) Make appointment for the blood tests, 5) Go to acupuncture, 6) File the medical papers all over the living room floor, 7) Phone consultation with Dr. Renneker. Ask him about the iodine test. Ask him about low-dose Tamoxifen. Ask him about alternatives to Tamoxifen. Tell him that Dr. Lewis still hasn't given you the order for the tumor marker test, even though you asked her for it nine days ago.

She hadn't been making her bed of late. Bad girl. While out walking yesterday she had bought a new brown jacket. Should she go to the Christmas party tonight? It was so far away. Would it be worth the long drive? Would she know anyone there? She could wear the new green top she had bought when she bought the jacket — a good girl/bad girl splurge. Decisions decisions.

She got up to make more tea. The heater thermostat wasn't working again, and the house was freezing cold. She began to layer herself. You had to exercise. Walking was good. Walking was a different kind of thinking. Sometimes she wanted to walk forever, walk and walk and walk and never stop walking. She was almost out of melatonin. It ran out fast when you took seven pills a night. A pharmacological dose. A cancer-fighting dose.

She made herself an apple smoothie with soy milk and whey powder. Her fingers were freezing cold. You couldn't see the half moons on the nails of her third fingers. This was a sign, she had recently read, that her body lacked oxygen. She needed to work on regaining the half moons. She needed to make them come back.

Inside Out

Lenore slipped out of bed, picked her day up off the floor, and put it on inside out. The label at the nape of her neck read, in plain, bold lettering: CANCER GIRL. She made her way to the kitchen, turned on the burner under the tea kettle, and reached for the dark brown glass dropper bottle filled with a Chinese herbal tincture. Four droppersful, three times a day, in hot water.

While waiting for the water to boil, she took her enzyme pills (one hour before meals or two hours after). Her upper arm was still numb and sore, three months after the removal of the malignant lump and lymph nodes. The pills would help to heal the nerve, scar and tissue damage.

When the tea kettle whistled, she poured the water into her rose colored, hand-glazed pink cup and lifted it to her lips. The urine-testing kit that would measure her iodine levels sat on the kitchen table, waiting for her to decipher its instructions. The blood and saliva kits were still in the large wire bin she had designated to hold all the medical papers until she could get them filed into the as-yet unlabeled folders. After drinking her medicinal tea, she ate her whole grain oat cereal with blueberries, soymilk and ground flaxseeds, followed by a cup of fresh orange juice loaded with a scoop of vanilla-flavored whey powder which would, she had been told, break down into a powerful antioxidant known as glutathione. Her knowledge of medicines and science was growing.

Yesterday she had learned the difference between a "pharmaceutical" and  "pharmacological" dose. Last night she had taken a pharmcological dose of melatonin. Her breast cancer, she now knew, would not be at all happy about that shift in her body chemistry. Today she would begin taking the steps to get an MRI followed by a blood test that would measure her CA15-3 and CA27/29 tumor markers. Greta cat, curled into a ball at the end of the couch, snored a tiny whistle of a snore.

Lugging her fondest memories of sugar into the drowsy afternoon, Lenore was pleased to note that life itself had become more mouth-watering than a chocolate brownie or a bowl of apple cobbler with ice cream on top. When Thursday's mail dropped through the slot, she was thinking about all the foods in the world that were unacceptably hydrogenated. Olive oil was not forbidden to her, however. Coconut oil was okay too. So much had changed. Vegetables were stampeding to the forefront, shoving her beloved eggs and cheese into oblivion. Fruits were demanding her attention, insisting she say goodbye to and cookies and croissants. Whole grains, nuts and raisins had elbowed their way in, shoving the Pugliese, baguettes and pizzas aside.

The view from the window behind her kitchen stove, however, showed the same, beautifully-never-the-same sky as always.

Uncracked Codes

My Wednesday thus far (as of 1:11 p.m.) has been spent:

1) Trying unsuccessfully to solve a Quark "file not found" and "cannot find required volume or folder" errors (error codes -43 and -35) that have prevented me from making any new Writing Salon flyers for the upcoming Winter Session. I had planned to edit and then print out several hundred new flyers by tomorrow at 3 p.m., when the flyer distribution service is supposed to pick them up. Instead I have been laboring to figure out why none of my Quark files can be found or saved. I've sought help, but so far no one has been able to come up with a solution (or they haven't called me back).

2) On the phone with Dennis and Sally, who work at HealthNet, my beloved insurance company. I've been trying to get HealthNet to reprocess all my claims. This morning, I was working on just one particular claim, which HealthNet tells me they cannot process because it came in to them with the wrong code (code V76.12). They told me to call UCSF Medical Center and ask them to re-send the bill with a different code. I called UCSF and spoke to Debbie and Rebecca, who spoke to her supervisor as well. They told me that code V76.12 was correct, and that I needed to call HealthNet back and tell them this. I called HealthNet back and told them this. To no avail. It has taken me only a minute to write this paragraph, but I have been on the phone with HealthNet and UCSF for the last two hours straight. Is the claim being re-processed? No. Someone will call me back. (Where have I heard that before?)

So here's what I'm going to do next:

Get dressed. Walk to the Good Life Grocery to buy cottage cheese to mix with my flaxseed oil, because this is the one diet change that has been proven to make a huge difference fighting cancer. I know it sounds dumb, but if you do your research, it stops sounding dumb. I'll also get some more vegetables.

After that, who knows? Maybe I'll sign up for tap dance lessons. Oh, but wait. I almost forgot. Didn't I once do something called writing? Not just blogging, but other kinds of writing. Yeah. I did. Maybe I will do it again someday, after cracking all the mystery codes and eating my flax-filled cottage cheese.

Duh

Gee, what a surprise.

Somebody in My Corner

Last Thursday night I had my first consultation with Dr. Mark Renneker (thanks to the recommendation of Dr. Jeff Draisin at California Pacific Medical Center's integrative medicine clinic). Here are a few of the introductory paragraphs of the 22-page packet that Dr. Renneker sent to me prior to our first consultation:

I provide help to people in medical situations who may not be getting the complete help, information, or treatments they need.  I'm good at resolving such dilemmas; I seek to put you fully in charge of your case.  I do this through an uncommon consultation method, one that is wholly patient-centered and patient-directed.  It involves advocacy, personalized medical research, and communicating with you (and family members, if you so designate) each step of the way. 

(1) I will be happy to consider helping any person (or family), regardless of where in the country they live, type of health problem, or ability to pay (I charge on a sliding scale).

(2) I will be a physician in your corner, your own personal consultant, researcher, and advocate, working to help you gain the information and authority you need to be in complete charge of your case.  I will not be assuming your care, nor will I be treating you, but I will help you find and receive the best possible treatments.

(3)  I practice what I call "optimistic medicine."  No matter how desperate or hopeless a situation may appear, there are always new things to try.  And I'm willing to put in whatever time and work it takes to find, evaluate, and help implement new approaches. 

(4) I am a board-certified, university-affiliated family physician with a broad training in virtually all fields of medicine.  I have special expertise in cancer, inner-city medicine, preventive medicine, behavioral medicine, geriatrics, sports medicine, consultative medicine, integrative medicine (combining traditional/conservative medicine with alternative/complementary approaches), physician education, physician behavior, family therapy, medical communication and information (including informatics and telephone medicine), medical and general writing, patient education, and patient advocacy.

If only every person who needs this kind of help could find a Dr. Mark Renneker. Sadly, there aren't many Mark Rennekers in this world. Not yet anyway. He's forging new ground, braving wilderness territory. And I was fortunate enough to find my way to him.

Mark made many suggestions during our first consultation - suggestions directly related to helping me figure out my treatment options. He also helped alleviate my fear that I wasn't moving fast enough. There's no one correct "fast enough." Every case is individual. In my case, starting chemo on Nov. 10th would have been TOO fast. Knowing what I now know, I think it would have been disastrous.

One suggestion Mark made was that I go to see Dr. Gary Ross, a GP with an office one minute away from Union Square. He said Gary could help me sort through my problems re: Return of the Dreaded Menopause symptoms. He's a GP who knows a whole lot more about menopause than your average doctor. He's also a GP who is open to and knowledgeable about both conventional and alternative medicines.

Why, you may wonder, is she focusing on menopause symptoms when she has breast cancer to deal with? Where are her priorities? Well, I'm juggling a lot of different balls. And indirectly, dealing with the menopause symptoms IS a way of dealing with breast cancer, because if menopause is turning me into a miserable, sleep-deprived, cognitively disabled peeing machine who has half a dozen hot flashes every hour, day and night, how can I possibly cope with all the decisions that have to be made re: breast cancer treatments?

So. That's what I did yesterday. Went to see Dr. Gary Ross. Did I like him? A resounding yes. Finding Dr. Ross was like finding an old-fashioned (but at the same time cutting edge) small town doctor practicing smack dab in the heart of downtown San Francisco. I liked him because he's open to both conventional and alternative medicines — open and knowledgeable. It was a breathtaking relief to meet him, after all my disappointing encounters with "cookie cutter"  doctors.

I celebrated by buying a lovely new bra at Aricie, thanks to Julie Oxendale. I also bought some fishnet stockings!  In addition, I came home with a saliva test kit, a special blood test kit, an iodine test kit, a glutathione test kit, and a warm memory of spending the day with my friend Kerry, who not only took me to lunch at a Café Claude (where I had a most delicious and healthy beet salad) but also accompanied me to my appointment with Dr. Ross.

After the appointment, we went to a cafe and talked about Kerry's impending trip to Antartica in February, which will be followed by a trip to Borneo in March! We also talked a lot about men, of course (the oddities of trying to communicate with them). Our conversation went on for almost three hours actually, so as you can imagine, we covered a lot of territory. As we were about to leave, Kerry said, "I have to tell you that I don't believe in that 'let's KILL the cancer' mentality." I could see that she was a little worried that she might have said something that would offend me.

I reassured her that I don't believe in it either. Now that I've had more time to think about it, I don't see cancer as an evil enemy. Cancer is just a word. It's a label that has been attached to something that I prefer to think of as "a state of imbalance" in my body. A state of imbalance that is unique to me and me alone. Nobody else in the universe has the exact same state of imbalance that I do.

I'm not planning to do guided imagery where I imagine machine guns killing off the cancer cells, or Good Monsters gobbling them up, or tidal waves sweeping them away.

My body has gotten out of balance, that's all. I'm not minimizing the severity of this imbalance. I'm just saying that I'm not going to get mad at my body (or at myself) because it exists. I'm just going to do my best to regain a better, healthier state of equilibrium. If I die in the process, then at least I'll die while honoring and revering my body/mind/spirit. I'm not at war with my own body. I'm working toward creating a state of greater peace within it.

Meditation

Tall telephone poles, sea salt, Lenore was taking the short route to China. She rushed through her chores and then headed out on an imaginary freighter, taking her loom with her. Strand by strand she alternated between the warp of information and the weft of intuition. Her breast ached as she wove. Looking out over the ocean, her eyes were both desperate and clear.

The wind carried the scent of omega-3 fish oils. The sky dilated as the shore shrank. Lenore inhaled deeply. The boat turned into a sidewalk, the loom turned into a meditation. It was a Sunday morning. Sunlight streamed in over the vitamin bottles on the counter next to the blender. China was merely a story structured around a plot that contained many needles, herbal tinctures, beginnings and endings. The wind of qi gong began to blow in great twists of unbridled energy.

China or not, she had to find the adaptor cord for her laptop. Where had it gone to? She couldn't find it anywhere, not in the box, not on the shelf, not in the trunk or the bottom of the rolling file cabinet. Maybe she needed a new spiritual practice, something that would help her get better at searching for lost objects, say, a heart meditation that would alleviate her impatience, help her find the fruitful side of her snarling, nipping anger.

Where was the adaptor cord? She didn't know, couldn't answer that question. Things happened, got lost. She was not much of meditator, but even so, she had to ask herself, Was there some other way of seeing things, something deeply hidden in the obvious?

She looked for the adaptor cord behind the drapes, in the drawer, under the coffee table. It had to be somewhere. She couldn't find it. She couldn't answer the question. She couldn't say where she went in the dead of night, she didn't know if dead people turned into angels, she wasn't at all certain that the naming of a disease had any usefulness.

Maybe she needed to buy a plant, or repot the old one on the kitchen table. Would this qualify as a meditation? What made for a good meditation? Would it be cheating to search for a spiritual practice solely for the purpose of locating a lost adaptor?

Wait a minute. Nevermind. There it was. Under the bed. Exactly where it had always been.

Soil Analysis

The doctors are confusing me again with their conflicting words of advice re: how to make my treatment decisions.  I've spared you all the nitty gritty, behind-the-scenes details of my last few weeks of dogged researching, compiling, filing, assessing, questioning, weighing. Suffice it to say that I'm tired out by all my attempts to make heads or tails out of this tangled web of information that yields no definitive or easy answers. The clock is ticking louder and louder with each passing day, and I know I have to make decisions. One minute, the statistics frighten me so much that I'm ready to dive into a vat of andriamycin and taxol TONIGHT. The next minute, I see right through the illusion of statistics, and know that this decision I'm trying to make isn't about death. It's about who I am and how I want to live my life. It's about following the path that feels right to me on an intuitive, spiritual, emotional level — not just an intellectual level.

Time to go. Here's an appropo quote I like:

". . . Some years ago I served on the dissertation committee of a woman in the Midwest, who was studying spontaneous remission of cancer. Among the people who answered her ad in the paper asking for people who thought they may have had an unusual experience of healing was a farmer who had done exceptionally well despite a dire prognosis. On the phone one evening, she told me about him. She felt his outsome was related to his attitude. "He didn't take it on," she said.

Confused, I asked her if he had denied that he had cancer. No, she said, he had not. He had just taken the same attitude toward his physician's prognosis that he took toward the words of the government soil experts who analyzed his fields. As they were educated men, he respected them and listened carefully as they showed him the findings of their tests and told him that the corn would not grow in this field. He valued their opinions. But, as he told my student, "A lot of the time the corn grows anyway." — Naomi Remen (from her book, Kitchen Table Wisdom: Stories that Heal)

Focusing

I know that many of my breast cancer posts will not interest everyone. But this is the primary focus of my life right now. I'm at the very beginning of what will be a new lifelong path  - living with cancer. Looking back over the last long four months, with hindsight, I would not have done ANYTHING the same. Every step of the way, from needle aspirations to surgeries to doctors' appointments and consultations, I would have done things differently. I'm not saying I think I did EVERYthing wrong - just that, had I been more informed, I would have done everything BETTER, more carefully. I would have been more proactive. I would have been less intimidated and more self-educated. For example: I would have told my breast surgeon to NOT do the standard breast massage that (I now know) can increase chances of metastasis. But at the time, I had no idea that there was ANYTHING I could "choose" when it came time for surgery.

So. Live and learn.  I am now examining every single potential step BEFORE I take that step. This morning I found another self-help "aid" in the form of  an interview with Madeleen Herreshoff, who is head of an organization called CanHelp.com. (Lynne Farrow, the head of breastcancerchoices.org, recommended that I check out Madeleen's website.) I'm seriously thinking of using her report and referral service to help me figure out not only my treatment program, but how to find "integrative medicine" practioners who I like, respect and trust. I now know that there's nobody out there who will totally create and oversee my treatment program. I'm going to have get involved in it on every level. It's going to mean a total lifestyle change.

Geez louise.

Find Out Your Options!

Here's a disturbing excerpt from one of the FAQ pages at breastcancerchoices.org:

After being screened for breast cancer, a suspicious lump has been found.  How is the lump biopsied?

Primarily, there are three ways to biopsy a suspicious lump:(1) fine needle biopsy  (FNA), (2) large gauge needle (core) biopsy,  and (3) excisional biopsy during
which the whole lump is surgically removed.

I have just had a mammogram and my doctor sees a suspicious mass in my breast.  My doctor has suggested a needle biopsy.  Is there any downside to this procedure?

Background: Needle biopsies pierce the suspicious breast mass to draw out tissue for analysis.  Some researchers fear these procedures may spread (or seed) the cancer, causing something called "needle track metastasis." Others feel this possibility is not a significant concern or that the immune system, surgery and/or radiation that follows will clean up the area. Each individual must review the information that is presented in this BIOPSY section with her doctor and decide for herself whether or not to undergo these procedures.

Hot News: In June 2004, the results of the bombshell Hansen study, "Manipulation of The Primary Breast Tumor and The Incidence of Sentinel Node Metastases From Invasive Breast Cancer," were published in the American Medical Association's prestigious journal, Archives of Surgery, revealing that patients undergoing fine needle biopsies were 50% more likely to have micrometastases spread to the sentinel lymph node than those patients having the entire tumor removed for biopsy.

The implication of this discovery is that a woman without lymph node involvement, who would have been staged at a low level, now will be staged higher, her disease considered more advanced, and more aggressive treatment might be recommended.

Over the years, several researchers have voiced serious reservations about routine needle biopsies, but they were mostly ignored by their colleagues. Hansen's research team cited their predecessors, and  the research path leads back several decades. It's hard to understand why The Archives of Surgery study, which embodies all of these reservations about needle biopsies, didn't make the front page of the New York Times.

Cancer authority Ralph Moss comments in his February 6th, 2005 Moss Reports
Newsletter:

"Imagine the outrage these patients will feel when they learn that many of these sentinel node metastases were caused not by the natural progression of their disease but directly by the actions of well-intentioned (but ill informed) doctors. Imagine, further, what will happen when patients find out that questions have been raised about the safety and advisability of needle biopsies for a number of years by some of the finest minds in oncology. Imagine the disruption of the smooth functioning of the "cancer industry" when patients start demanding less invasive ways of diagnosing tumors.  And imagine the class action lawsuits."

The article goes on and becomes even more interesting/distressing.

How this affected me personally: I had not one but two needle biopsies. The first one was done almost three years ago. The other was done almost four months ago. No one - not the doctors at Mt. Zion breast care clinic, and not the breast cancer surgeon who ultimately did my lumpectomy - EVER told me that there was any risk involved. EVER. Nor was I told that I had any other options.

And yes, I ended up with a positive lymph node. Would this have been the case if someone had told me that I had other biopsy options that might have been safer? It's too late now. For me. But I hope someone else reads this and benefits from it. Bottom line: Never assume you are being told all that you need to know. Never never never. You have to ask questions every single step of the way. Don't let any doctor or medical "system" intimidate you into thinking that you don't have that right, or into feeling that you're being stupid to ask the question. No question is stupid. One right question could literally save your life.

All That Was Needed

The leaf on the tree above Lenore's head trembled with. . .with what?  Fear? Joy? A sprinkling of rain? A ripple of wind? An inappropriate burst of laughter? All that was needed, she decided, was a sense of each leaf's infinite possibility (although a dishwasher and a set of double French doors leading out to a country garden with an automated sprinkler system would also be helpful).

She had been observing herself stepping from mystery to mystery even while inundated in the statistical logic of medical science. Her goal for the afternoon was simple: to walk along the cold December street, up to the top of Bernal Hill, impervious to the roar of the pharmaceutical industry's massive engine. A leaf lullabyed itself down onto the sidewalk. She picked it up, held its fragile face in her palm. The leaf smiled up at her muted question, gently but firmly refusing to discuss her prognosis.

Fuhget about Stuhtistics!

Here's but a brief excerpt from the inspiring introductory letter that Ralph Moss sends out to people who are buying one of his world-renowned "Moss Reports." It's well worth reading in its entirety.

"...the various diagnostic categories of cancer are man-made constructs that mask the uniqueness of each individual's condition. Each person's cancer is only similar to, but not identical with, that of any other person with the "same" diagnosis. A medical philosopher once wrote: "Diagnosis is a system of more-or-less accurate guessing, in which the end-point achieved is a name. These names applied to disease come to assume the importance of specific entities, whereas they are for the most part no more than insecure and temporary conceptions. (Lewis, T. Reflections upon medical education. Lancet 1944;1:619-621)

In 'War and Peace,' the great novelist Leo Tolstoy wrote of the character Natasha's illness, "Every living person has his own peculiar, personal, novel complicated disease unknown to medicine - not a disease of the lungs, liver, skin, heart and so on, mentioned in  medical books, but a disease consisting of one of the innumerable combinations of maladies of those organs." He added that "this simple reflection can never occur to doctors (just as a sorcerer cannot entertain the idea that he is unable to work magic spells) because  it is the work of their life to undertake the cure of disease, because  it is for that that they are paid, and on that they have wasted the best years of their life" (ch. 16). So, forget about statistics! Defy the odds! Work in a joyful way to heal yourself, body, mind, and spirit. . . ."

I read this letter only a few minutes ago, shortly after midnight when I was feeling panicky  after having read a couple of 5-year "prognoses" for women in my "category." I've just spent several weeks working to alter my perception and understanding of this disease, trying to see it with a more holistic vision - but when I read this prognosis (on a couple of different, perfectly reputable Internet sites), I was overcome with a gigantic rush of fear (literally; it swept through my whole body, and all I could see were these words: invasive ductal, invasive lobular, infiltration, distant metastases, blah blah blah....the stuff of nightmares), and I felt myself sliding backward into the black pit.

So I decided to close my laptop lid, get into bed, and try to read something that would lift my spirits and help me feel more hopeful again. That's when I remembered that someone had advised me to read Ralph Moss's intro letter. Boy did I need that. I think this man is a brilliant innovator, researcher, and crusader for all people with cancer. He's a rare voice of wisdom,  compassion and action. And he can write beautifully too! My hero.

What Is it We Want?

I've spent the last few weeks immersed in the dehumanizing scientific jargon of western medicine (statistics and percentages, graphs and charts - all designed to tell me the relative and absolute chances of recurrence and/or survival in five years, ten years, twenty years —survival not for me in particular - not for Jane Underwood - but for "some woman" in my age range, who fits into a group of women who have similar diagnoses to mine. In the world of conventional Western medicine, I don't have a name, I am not unique; I am merely a generalization based on a bunch of randomized, clinical trials.

I've been searching for a different, more holistic and humane perspective on illness AND on wellness. A perspective that seems RIGHT to me, a perspective that doesn't make me fall asleep (or perhaps I should say lie awake) every night thinking, This feels wrong, so utterly wrong. 

Yesterday, in anticipation of my acupuncture appointment today, I was reading Efrem Korngold and Harriet Bienfield's book, Between Heaven and Earth - A Guide to Chinese Medicine. As I am often wont to do with nonfiction books, I was skipping around.  Therefore, although I haven't yet read the whole book, I've already read the ending, which I loved:

What is it we want? To fully experience our aliveness. To feel in our bodies a streaming, like the rush of a river over stones. To be awake, alert, and responsive in our limbs and sensitive in our fingertips to the textures we touch; to be infused with our own whispering current of wind; to feel as if our outer and inner reality is congruent and that our efforts are rewarded by a sense of satisfaction. We carve out our own identity and possess our own purpose, and yet we also yearn to shed the isolation we feel within the envelope of our skin. We desire union. We aspire to have our private lives nestle within the valley of a public world that we can affirm. We long to feel connected with each other. Like the woods that harbor wild creatures, creekbeds, and fertile pastures that rest upon a mound of earth that spreads into a vast range of mountains and plains—we want to feel a part of a community that spills into and becomes part of a larger universe. We want to be able to embrace and be embraced. We want to live the life of our bodies and want our bodies to fully permit us to live our lives.

Chinese medicine is a beginning.

Chinese medicine offers a perspective that makes sense to me intellectually, emotionally, and spiritually. I don't think my spirit could survive a long-term, intensive foray into the mechanistic and warlike world of chemo, radiation and tamoxifen. It goes too deeply against my grain (I'm the woman who chose to do a homebirth rather than go to a hospital. I couldn't bear the thought of having that sacred experience in such an alien environment. I wanted to have the last word in how it all went down. And I did. I gave birth to my son while lying on an old mustard yellow couch, in the little back porch room off the kitchen, without drugs. My labor lasted 28 hours. I had a midwife, and we were ready to race to the hospital if need be. But the need never arose. I did the whole thing my own way, as every woman should be able to do.)

Figuring out how I want to experience the process of dealing with (treating) breast cancer is no different than when I had to figure out how I wanted to experience the process of giving birth. I have to listen to my deepest, innermost voice - even if that voice is urging me to take the road less travelled.

This isn't to say I'm eschewing all conventional treatments. I've already had two surgeries; that's Western medicine. And I might do Tamoxifen or Arimidex; that's also Western medicine. But I seriously doubt I'll do ALL of them; the price I'd have to pay would be too great.

A New Online Publication!

Okay, so I've been spending my Saturday morning trying to come up with a name for an online publication that I want to create, one that will feature the work of Writing Salon students and teachers. This has long been a back-burner dream of mine, but I could never seem to get around to making it happen. I was always too busy doing the "daily grind" duties that befall every small business owner who can't figure out how to pay for even one part-time employee.

This morning, however, I have refused to go that daily grind route. The tedious job of updating the Writing Salon mailing list will just have to wait. If it doesn't get done and the Writing Salon classes don't fill up as a result, and the whole business falls apart, so be it. At least I will have come up with a name for an online publication.

So. As I was working on thinking about a possible name for this possible publication, I had an inspiring thought that made me want to do my daily 12-minute write. In the process of doing my write, I came up with a phrase I wanted to use: "molecular transmogrification" (I wanted to know if molecular transmogrification could help a person walk through a wall, say, if the door was locked and you really really wanted to get into the room on the other side of the wall). But I wasn't sure if transmogrification was even really a word, or what it meant exactly, or if it could be molecular. So I did a Google search for "molecular transmogrification" and lo and behold, many links popped up. Wow. Where to begin?

And then I saw it: Dr. Toast's Amazing World of Toast. I had forgotten all about Dr. Toast's site, which I stumbled across quite by accident, once upon a time long ago, and grew quite fond of for several minutes.

Why had Dr. Toast's site come up when I typed in "molecular transmogrification?" I checked it out. Ha ha ha. Then I went into the kitchen and made two delicious pieces of wheatberry toast with peanut butter, flax seed oil and a smidgen of blackstrap molasses smeared on top. Yum.

My Daily Write:

In a minute, just a minute, soon, not now but soon Lenore would make up her mind about how and when to fight, she would sleep a full night, take a long walk, recall what she forgot, and remember how to feel desire. She would be her old self again.

She listened to the rain pouring down, car tires swooshing by on the wet asphalt, and was surprised when she also heard the heater turn itself on. Her living room thermostat had been working only intermittently lately. This morning she was plenty hot without it, though, thanks to her newly prescribed cancer-fighting regimen of Estrogen Deprivation. The hot flashes had come back, as had the insomnia, along with the need to pee every hour or two, day and night, night and day.

It was 6 a.m., she'd been up since three, and she had to teach a class that evening. By 7 p.m. she would be only half awake, a simmering shell of herself. It wouldn't have been as bad if she didn't have to work, didn't have to think, didn't have to relate to any other human being or group of human beings. . . if she could just sit like a stone, waiting for the inevitable cotton brain to kick in.

In a minute, just a minute, soon, not now but soon she would find a way to muster a better flow of chi, tap into her reserves of optimism and wisdom, and do something about that broken thermostat. Soon the heat that was eating her up would fade, and she'd make a cup of leafy green tea, or maybe she'd rebel, brew coffee, allow free radicals to rule the day.

When the heat came back like a wave of lava under her skin, she could always run out into the chill November rain. Stand on the sidewalk. Lay herself down on the cool wet cement. Maybe then she'd be able to sleep.

In a minute, just a minute, soon, not now but soon they'd find the key. To the door. The door that led to a cure. Until then, Lenore would keep looking for other ways to enter. Windows left unlatched. A secret passageway opening into the back of the armoire. Malleable sheetrock. The rearrangement of atoms, molecular transmogrification.

In case you don't know what cotton brain is, it's one of the symptoms of menopause wherein the woman feels as if Her Brain is Made of Cotton Balls. Highly unpleasant cotton balls. A huge blobby vague stupid lobotomizing wad of cotton balls. 

I looked for a link that would define cotton brain, and I came across this delightful post. Although it's not a description of menopause-induced cotton brain, it'll do just fine. Made me laugh. I might even go back to Odessa Street again some time. It's written by a 25-year-old woman, originally from the Midwest, who has been living in Paris for the last five years. She's a kick.