October 28th, 2008: A good end to a long life: my boyfriend Lorenzo’s father passed away yesterday afternoon at age 92. It’s been a dance for the past few weeks with Lorenzo, balancing time given to his father’s illness and my own health issues. I would say that we’ve danced very well together. May his father be free from suffering.
More forward motion today toward the start of treatment. Appointments have been booked for a central line to be installed in my upper chest, and, perhaps the same day—election day!—I may check into the hospital for my first five-day round of chemo. It will depend on whether there is a bed available.
Over the past weeks, I’ve slowly realized that I have been living with this tumor for a long time, at least two years by my body memory. An insidious feature of pelvic sarcoma is that you don’t know you have it. It feels like a weird sciatica or a sore butt or a painful hip, etc. depending on where it’s located. Even after my hip replacement—which was needed, very definitely—I have the same ache in my hip and pelvis. It’s been strange to go through the surgery with all my hope to easing the pain, only to confront the real pain. Now that the sarcoma tumor board and the melanoma tumor board have had a chance to review the tests, images, biopsies and scans, I am very anxious to begin treatment. I feel like this cancer has had a very long life, and in recent days I’ve actively talking with it about leaving. I tell it that I can’t continue to be a host to its growth. We all want to live, but my cancer will have to go somewhere else to find longer life.
My end-of-day reward to self: a trip to my healing center and the anticipation of tonight’s healer: Animal? Vegetable? Mineral?
Wednesday, October 29, 2008
Tuesday, October 28, 2008
October 28th, 2008: Today, after first hearing his name on September 23rd, I got to meet Dr. Thierry Jahan. The visit started off well and improved from there. By the time we left an hour and a half later, both Eileen and I were buzzing with purpose and plans. I had imagined Dr. Jahan as being somewhat severe. In fact, there was a lot of laughter and delight during the visit. Surprising, considering the content of our talk. First, he talked about pain management and suggested a basic principle: take medication sooner rather than later. Then, he walked me through the next few weeks. First, I’ll get a central line installed for the chemo and other fluids that will be part of the treatment. Then, I’ll check into the Parnassus UCSF hospital for five days. During my time there, I’ll get rounds of Ifosfamide for two hours a day for four days. Also Doxorubicin. Find out more about these drugs on Google.
I will loose all my hair. “I’ve always known that I would never be bald,” I said. “Wrong again.” “Yes,” Dr. Jahan agreed, “you will be bald. But unlike me, your hair will grow back,” and he rubbed his shining crown. The day after chemo, I’ll get an infusion of Nulesta or Neuprogen which stimulates the growth of white blood cells. Then, three weeks of rest. Then, another week of the same regimen as above. At timely intervals, I’ll be scanned and the tumor growth will be compared to the baselines that have already been measured.
Unlike the hip replacement, I don’t know what to imagine about my time between chemotherapy treatments. I don’t know how much fatigue I’ll feel. I don’t know how I’ll deal with nausea and the constellation of food and weight issues. However, I do know that I’ll need help. Over the past two months, people have consistently asked, “What can I do?” Up until now, there really hasn’t been much to do. My support has been about enjoying visits from people; sitting in my living room and drinking tea. Currently, my plan is to organize a support group of people who are able to help out with practical things like grocery shopping. But there are also forms of support that vault over physical distance.
Take, for example, chemotherapy. To me, chemo is the opposite of how I live most of the time. Normally I eat the healthiest, most appetizing food to nourish my body. With chemo, I am swallowing poison to kill toxic tissues. That’s a lot of negatives. I know that a chemo ritual would be helpful to me. This ritual would involve welcoming the chemo into my self, thanking it for its aggressive behavior, being grateful that it can distinguish cancer cells and end their lives. Also, the ritual would include telling the cancer that it can’t find a long-term home in me. Anyone in this circle of people would be welcome to send a one liner, a mantra, a motto that could be incorporated into the chemo ritual. And, when the time arrives to open the drip line and have the fluid move into my bloodstream, I would welcome it with the words that have been aggregated from many friends.
I will loose all my hair. “I’ve always known that I would never be bald,” I said. “Wrong again.” “Yes,” Dr. Jahan agreed, “you will be bald. But unlike me, your hair will grow back,” and he rubbed his shining crown. The day after chemo, I’ll get an infusion of Nulesta or Neuprogen which stimulates the growth of white blood cells. Then, three weeks of rest. Then, another week of the same regimen as above. At timely intervals, I’ll be scanned and the tumor growth will be compared to the baselines that have already been measured.
Unlike the hip replacement, I don’t know what to imagine about my time between chemotherapy treatments. I don’t know how much fatigue I’ll feel. I don’t know how I’ll deal with nausea and the constellation of food and weight issues. However, I do know that I’ll need help. Over the past two months, people have consistently asked, “What can I do?” Up until now, there really hasn’t been much to do. My support has been about enjoying visits from people; sitting in my living room and drinking tea. Currently, my plan is to organize a support group of people who are able to help out with practical things like grocery shopping. But there are also forms of support that vault over physical distance.
Take, for example, chemotherapy. To me, chemo is the opposite of how I live most of the time. Normally I eat the healthiest, most appetizing food to nourish my body. With chemo, I am swallowing poison to kill toxic tissues. That’s a lot of negatives. I know that a chemo ritual would be helpful to me. This ritual would involve welcoming the chemo into my self, thanking it for its aggressive behavior, being grateful that it can distinguish cancer cells and end their lives. Also, the ritual would include telling the cancer that it can’t find a long-term home in me. Anyone in this circle of people would be welcome to send a one liner, a mantra, a motto that could be incorporated into the chemo ritual. And, when the time arrives to open the drip line and have the fluid move into my bloodstream, I would welcome it with the words that have been aggregated from many friends.
Monday, October 27, 2008
October 27th, 2008: Eileen Lemus and I showed up for my appointment with Dr. Daud this morning at UCSF. He told us that NONE of the pathology tests done on the biopsy tissue confirm that I have a melanoma. This means we are back to the original diagnosis of a sarcoma. I have to say, I felt punched. I had gone to clinic expecting to hear that I had melanoma tumors and that chemo could start very soon. I’m always amazed at how quickly I adjust to a diagnosis, and then, when it is altered, I shift again. But my adjustments aren’t immediate, they require some time. At this juncture, I asked Dr. Daud how much time I could expect to live if the proposed treatments don’t work. Would I have five months? Eight? “Oh, I would say at least a year,” he ventured. We agreed that these figures were not informed guesses since there are so many variables. Also, I am committed to receiving treatment with the goal of lengthening my life. A bright note in the meeting; the MRI brain scan I had on Friday showed clean pictures. No brain tumors! Since I am no longer a patient with melanoma, Dr. Daud and I said goodbye to each other. I have to say, I’ll miss him. There’s a sweetness and clarity about the guy that I found, well, healing.
This also means that I will meet—finally—with Dr. Jahan the sarcoma guru tomorrow in the late afternoon. We talked briefly with his physician assistant and she said that at this point, the plan is to start some seriously strong chemo, so strong that it requires hospitalization. Not sure when that will start, but I am hoping to work out a schedule at tomorrow’s meeting. I continue to be grateful that this strangely zig-zaging diagnosis did prevent me from having a major surgical intervention at the beginning of treatment. I think that would have hastened my death.
Emails and phone messages have indicated a strong interest among Healthy Geo readers about the imaginary healing spot I’ve created. Last Friday, I received two other visits. The first was from a plant, a sage green sphere with the structure of mistletoe. It said, telepathically, that it understood the branching structure of growth and that it had arrived to dissolve the metastasized cancers at various sites in my body. The second visit was from a vulture who explained that it could ingest highly toxic flesh and metabolize it with no ill effects. That said, the vulture painlessly slit open my lower abdomen with a claw and proceeded with amazing grace and delicacy to eat the pelvic tumor. There wasn’t a moment of discomfort or revulsion, rather, I felt very cared for by a master surgeon. With a nudge from its beak, my incision was closed, and it flew off into the sky. Interesting to note that even though tumor hasn’t been accurately identified, there are already forces at work to end the cancerous growths.
This also means that I will meet—finally—with Dr. Jahan the sarcoma guru tomorrow in the late afternoon. We talked briefly with his physician assistant and she said that at this point, the plan is to start some seriously strong chemo, so strong that it requires hospitalization. Not sure when that will start, but I am hoping to work out a schedule at tomorrow’s meeting. I continue to be grateful that this strangely zig-zaging diagnosis did prevent me from having a major surgical intervention at the beginning of treatment. I think that would have hastened my death.
Emails and phone messages have indicated a strong interest among Healthy Geo readers about the imaginary healing spot I’ve created. Last Friday, I received two other visits. The first was from a plant, a sage green sphere with the structure of mistletoe. It said, telepathically, that it understood the branching structure of growth and that it had arrived to dissolve the metastasized cancers at various sites in my body. The second visit was from a vulture who explained that it could ingest highly toxic flesh and metabolize it with no ill effects. That said, the vulture painlessly slit open my lower abdomen with a claw and proceeded with amazing grace and delicacy to eat the pelvic tumor. There wasn’t a moment of discomfort or revulsion, rather, I felt very cared for by a master surgeon. With a nudge from its beak, my incision was closed, and it flew off into the sky. Interesting to note that even though tumor hasn’t been accurately identified, there are already forces at work to end the cancerous growths.
Thursday, October 23, 2008
October 23rd, 2008: This blog has focused on my medical events, because that’s what people asked about over and over. They wanted to know how I was feeling and what was my health status? I ask those questions myself when I’m talking with someone who’s ill. But during this week of medical lull, I’m realizing that there are many places that I go daily that are very much about how I’ve responded to having cancer, although they aren’t specifically medical.
One of those places is a healing center that I’ve built for myself. You won’t find it on Aerial Google, but I imagine it to be somewhere on the “Lost Coast” in Humboldt County. The home overlooks the ocean, and, I’m happy to report that the weather is almost always fabulous. To enter the property, I walk up to a large redwood and step through into a protected reality. Then, it’s a quick walk to the house. So far, I’ve spent very little time indoors. Usually, I head for the courtyard. First, I disrobe and slide into a tub lined with turquoise pebbles. The water washes away the goo of the day. I dry off and settle myself on a chaise of white marble that’s been shaped and polished so the surface feels soft. I relax. Through my feet, I can look across the shallow garden to a gate. Presently, there will be a knock on the gate. When I hear the knock, I ask, “Are you here to help heal me? Only healers may enter.” So far, the response has always been, “Yes. I am here to help heal you.” The door opens, and the healer enters. They take many forms: human, plant, animal, or sometimes it’s a spirit in a wind or aroma. Some days more than one healer appears, although they usually do their work one at a time.
Today, for example, I worked with a man from the Amazon basin named Huatil (pronounced: Hua-teal).He was very energetic and initially curious about the garden but immediately set to work carving a wooden replica of my pelvic cancer. He rubbed the wood model with a greenish paste from his hip pouch and waved it in the air so that the paste started to dry. Then, Huatil built a fire on a large river rock in the garden and slowly turned the carving over the flames as if he was searing meat. After a bit, he placed the wooden replica onto the flames, banked the fires with sawdust and poked at the burning piece until there was just a pile of embers. Finally, he brushed the embers into a sack, tied the sack with a string, smiled and, job complete, left through the garden gate.
One of those places is a healing center that I’ve built for myself. You won’t find it on Aerial Google, but I imagine it to be somewhere on the “Lost Coast” in Humboldt County. The home overlooks the ocean, and, I’m happy to report that the weather is almost always fabulous. To enter the property, I walk up to a large redwood and step through into a protected reality. Then, it’s a quick walk to the house. So far, I’ve spent very little time indoors. Usually, I head for the courtyard. First, I disrobe and slide into a tub lined with turquoise pebbles. The water washes away the goo of the day. I dry off and settle myself on a chaise of white marble that’s been shaped and polished so the surface feels soft. I relax. Through my feet, I can look across the shallow garden to a gate. Presently, there will be a knock on the gate. When I hear the knock, I ask, “Are you here to help heal me? Only healers may enter.” So far, the response has always been, “Yes. I am here to help heal you.” The door opens, and the healer enters. They take many forms: human, plant, animal, or sometimes it’s a spirit in a wind or aroma. Some days more than one healer appears, although they usually do their work one at a time.
Today, for example, I worked with a man from the Amazon basin named Huatil (pronounced: Hua-teal).He was very energetic and initially curious about the garden but immediately set to work carving a wooden replica of my pelvic cancer. He rubbed the wood model with a greenish paste from his hip pouch and waved it in the air so that the paste started to dry. Then, Huatil built a fire on a large river rock in the garden and slowly turned the carving over the flames as if he was searing meat. After a bit, he placed the wooden replica onto the flames, banked the fires with sawdust and poked at the burning piece until there was just a pile of embers. Finally, he brushed the embers into a sack, tied the sack with a string, smiled and, job complete, left through the garden gate.
October 22nd, 2008: In the past few weeks, I’ve noticed a shift in my interests, especially food and music. I used to spend a lot of time anticipating and enjoying meals, regardless of whether I was cooking for myself or dining out. In the months prior to my surgery, I’d been going to lunch once a week at Boulette’s Larder in the Ferry Plaza food cathedral. The nuances and concentrated flavors in Amaryll Schwertner’s cuisine took my palate to a whole new level of refinement. I had never apprenticed myself to a kitchen before this, and the rewards were awesome. Since the surgery, I can still taste, but I have very little interest in pursuing flavors. True, my diet has changed dramatically: no sugar, no white bread, lots of fresh vegetables, especially green. As for music, the presence of opera in my daily life has evaporated. I can hear but I don’t listen. These days opera requires a level of concentration that I find very difficult to muster. Before, I felt no effort; my capabilities had been honed for decades. Along with the lack of desire is the lack of memory of desire. I not only don’t put on Figaro or Don Carlo, I forget that I own those recordings.
Now I have a new pleasure that happens when I’m talking with friends. If I were to name the dominant memory of my post-surgery weeks, I would say, “Telling people I love them.” My previous boyfriend Chester used to say to me, “Wow, you sure are gushy.” Meaning that I would tell people directly that I loved them and how much our friendship it meant to me. I’d reply, “Hey, when my friends started dying in the late 80’s and early 90’s, they’d tell me that they loved me. I learned to say that I loved them too. Then I started telling that to a lot of my friends, regardless of their health status.” In the past weeks, during phone calls, I’ll go through my current health bulletin and listen to what my friends’ are up to, and when there’s an opening I’ll jump in to tell people how much I care for them. How much I’ve learned from knowing them. How much I appreciate some sweetness or talent or special trait that is uniquely theirs. To me, that’s the center of the phone call. When I say those words, my body and feelings and memory lights up with the joy of knowing that person. It's a feeling that I want to prolong. And often, they respond with a warmth and perception that’s gratifying to hear.
Now I have a new pleasure that happens when I’m talking with friends. If I were to name the dominant memory of my post-surgery weeks, I would say, “Telling people I love them.” My previous boyfriend Chester used to say to me, “Wow, you sure are gushy.” Meaning that I would tell people directly that I loved them and how much our friendship it meant to me. I’d reply, “Hey, when my friends started dying in the late 80’s and early 90’s, they’d tell me that they loved me. I learned to say that I loved them too. Then I started telling that to a lot of my friends, regardless of their health status.” In the past weeks, during phone calls, I’ll go through my current health bulletin and listen to what my friends’ are up to, and when there’s an opening I’ll jump in to tell people how much I care for them. How much I’ve learned from knowing them. How much I appreciate some sweetness or talent or special trait that is uniquely theirs. To me, that’s the center of the phone call. When I say those words, my body and feelings and memory lights up with the joy of knowing that person. It's a feeling that I want to prolong. And often, they respond with a warmth and perception that’s gratifying to hear.
Wednesday, October 22, 2008
October 20th, 2008: Back to the UCSF cancer clinic this morning, and into my first meeting with Dr. Daud who specializes in melanoma treatment. For the first time, I was on my own this morning. After many visits, I think it’s best to have an extra set of eyes and ears, but I also have a good history of staying in my body while taking notes and talking with the doctors. Dr. Daud started by asking about my previous melanoma excisions done by dermatologists on an out-patient basis, first in 1997 and again in 2004. Since my margins were clean after the melanomas were removed, there was no follow-up radiation or chemo at either time. Then, Dr. Daud called Dr. Christman who had performed the 2004 melanoma removal. He found that she had sent the tissue samples to the UCSF pathology lab for healthy verification. It’s likely that the samples as well as the history of the removal—depth of tumor, etc.—were still on record at UCSF. Then, Dr. Daud promised to present my case to the melanoma tumor board that meets this very day. I’m also going to be presented at the sarcoma tumor board this Friday, Oct. 24th. All this attention is good.
Bottom line: it is still not certain what type of tumor I have. After Dr. O’Donnell’s open biopsy, the estimates lean toward melanoma. However, the biopsy results are still not back from the pathology lab. Given these unknowns, Dr. Daud moved forward and said, “Let’s suppose that what you have is a melanoma. We can talk about types of treatment.” So that’s what we did. He started by talking about the Immunological drugs, such as Interluekon 2 which is quite toxic and requires a stay in the Intensive Care Unit (ICU) during administration. Then, there are the chemotherapy drugs, some of which have been used for up to 30 years. Newer chemo drugs are also available, and they may be used in combination to maximize effectiveness. The caution is that two chemo drugs used together also multiplies the side-affects. Additionally, there are clinical trials that Dr. Daud participates in and I may qualify of one of those. These are experimental protocols testing new drugs or new combinations of known drugs. Point being, there are several treatment options.
It seems that there are genetic variants between melanomas that occur on the head and neck and melanomas that grow on the back (and possibly others as well that didn’t apply to our discussion). My melanomas were both on the upper back and these tumors are characterized by the presence of BRAF inhibitors. Check this out for yourself on Google.
So, what’s the plan? Dr. Daud’s strategy is to first verify that this is a melanoma. If yes, then we can start me, say, early next week on a chemo combination that has a good probability of being effective. Baring a violent allergic reaction (something that isn’t a part of my medical history) I would complete the six to eight week course of treatment. Scans would monitor whether the tumors are responding or not. If the tumors don’t substantially decrease in size, then we proceed to the next drug regimen. All of these courses of treatment have their own pitfalls with fatigue, nausea, and the lurid list of chemo side effects. If this is not a melanoma, then I move back to the sarcoma side of the house and consult with Dr. Jahan who was initially recommended ages ago (four weeks, actually).
The effectiveness of these programs is surprisingly low. Some drugs have 15 to 20% effectiveness. Others are as high as 20 to 30%. That was hard to hear since those seem like very low odds. However, Dr. Daud reminded me, each time you enter a new program, you increment your chances of effective treatment. So, two treatments, one 15% and one 25% equals a 40% chance of finding something that works. Of course this is not exact math, but you get the idea.
At the end of the interview we discussed time. “You don’t have a lot of time,” Dr. Daud cautioned. It has already been eight weeks since the tumor was discovered and the cancer has grown at several sites during that time. Eight weeks is approximately one treatment cycle. I can’t recover that time. So the urgency is to identify what I have and get me started on a drug treatment most likely to be effective.
Two things I liked about this guy. First, he has deep experience with melanoma clinical trials so he’s a cutting edge guy. Second, he had broken his leg while roller blading, so he likes to be out there sailing through the air.
Bottom line: it is still not certain what type of tumor I have. After Dr. O’Donnell’s open biopsy, the estimates lean toward melanoma. However, the biopsy results are still not back from the pathology lab. Given these unknowns, Dr. Daud moved forward and said, “Let’s suppose that what you have is a melanoma. We can talk about types of treatment.” So that’s what we did. He started by talking about the Immunological drugs, such as Interluekon 2 which is quite toxic and requires a stay in the Intensive Care Unit (ICU) during administration. Then, there are the chemotherapy drugs, some of which have been used for up to 30 years. Newer chemo drugs are also available, and they may be used in combination to maximize effectiveness. The caution is that two chemo drugs used together also multiplies the side-affects. Additionally, there are clinical trials that Dr. Daud participates in and I may qualify of one of those. These are experimental protocols testing new drugs or new combinations of known drugs. Point being, there are several treatment options.
It seems that there are genetic variants between melanomas that occur on the head and neck and melanomas that grow on the back (and possibly others as well that didn’t apply to our discussion). My melanomas were both on the upper back and these tumors are characterized by the presence of BRAF inhibitors. Check this out for yourself on Google.
So, what’s the plan? Dr. Daud’s strategy is to first verify that this is a melanoma. If yes, then we can start me, say, early next week on a chemo combination that has a good probability of being effective. Baring a violent allergic reaction (something that isn’t a part of my medical history) I would complete the six to eight week course of treatment. Scans would monitor whether the tumors are responding or not. If the tumors don’t substantially decrease in size, then we proceed to the next drug regimen. All of these courses of treatment have their own pitfalls with fatigue, nausea, and the lurid list of chemo side effects. If this is not a melanoma, then I move back to the sarcoma side of the house and consult with Dr. Jahan who was initially recommended ages ago (four weeks, actually).
The effectiveness of these programs is surprisingly low. Some drugs have 15 to 20% effectiveness. Others are as high as 20 to 30%. That was hard to hear since those seem like very low odds. However, Dr. Daud reminded me, each time you enter a new program, you increment your chances of effective treatment. So, two treatments, one 15% and one 25% equals a 40% chance of finding something that works. Of course this is not exact math, but you get the idea.
At the end of the interview we discussed time. “You don’t have a lot of time,” Dr. Daud cautioned. It has already been eight weeks since the tumor was discovered and the cancer has grown at several sites during that time. Eight weeks is approximately one treatment cycle. I can’t recover that time. So the urgency is to identify what I have and get me started on a drug treatment most likely to be effective.
Two things I liked about this guy. First, he has deep experience with melanoma clinical trials so he’s a cutting edge guy. Second, he had broken his leg while roller blading, so he likes to be out there sailing through the air.
October 17th, 2008: My first normal day this week. I simply got up and went to work. Imagine! But once at work, I took a deep breath and met with my boss, Michael Wong, about my health issues. What a wonderful, supportive guy. His sole consideration was how to lighten my work so that I wouldn’t have to stress about not being able to deliver my assignments. I felt valued and cherished. This is my third contract at PG&E and it has been very healing for me to be associated with this particular group and to have worked on the assignments that I’ve been offered. It’s been creative and fun beyond all my previous experience at the utility.
On the way home, my cell phone rang a lot. First, Eileen Lemus called, then a person who I didn’t know and couldn’t understand over the chaos of the mid-afternoon bus ride. I returned their calls once I arrived home. The unknown guy turned out to be a clinic scheduler for Dr. Daud, a melanoma oncologist. Since I’d been working with sarcoma oncologists, it was clear that something had shifted. I’d been referred to Dr. Daud by Dr. O’Donnell who performed my open biopsy. We agreed to a clinic appointment, and I’ll meet the Dr. at 9:30 on Monday morning. Then, I talked to Eileen who explained that Dr. O’Donnell had called her after the biopsy and given her a thorough review of his findings during surgery. As soon as he made a slight incision in my abdomen and encountered the tumor, he recognized a melanoma, not a sarcoma. I had been misdiagnosed by the pathology labs at CPMC and UCSF. He took tissue samples and closed me up. Then, he talked to Dr. Daud about getting me into his practice. During the rest of the conversation, Eileen told me what she knew about melanoma treatments, how they can rely heavily or exclusively on chemo. After gearing up for a surgery, it turns out that I may not have one. Rather, the preferred treatment will be a tailored chemotherapy designed to take out the lesions on the liver, lungs and hopefully the pelvic growths. This is a major change of plans. And we won’t consider the path not taken: a deep pelvic surgery with metastasizing nodes on the lungs and liver.
By late in the afternoon, I was explaining this remarkable change of diagnosis to Wendy Ostrow. She brought a gift of Grandma Bessie’s cabbage rolls in roasted tomato sauce perfected with a drop of balsamic and noodle kugel; Passover food to celebrate the delivery through the Red Sea of a misdiagnosis.
On the way home, my cell phone rang a lot. First, Eileen Lemus called, then a person who I didn’t know and couldn’t understand over the chaos of the mid-afternoon bus ride. I returned their calls once I arrived home. The unknown guy turned out to be a clinic scheduler for Dr. Daud, a melanoma oncologist. Since I’d been working with sarcoma oncologists, it was clear that something had shifted. I’d been referred to Dr. Daud by Dr. O’Donnell who performed my open biopsy. We agreed to a clinic appointment, and I’ll meet the Dr. at 9:30 on Monday morning. Then, I talked to Eileen who explained that Dr. O’Donnell had called her after the biopsy and given her a thorough review of his findings during surgery. As soon as he made a slight incision in my abdomen and encountered the tumor, he recognized a melanoma, not a sarcoma. I had been misdiagnosed by the pathology labs at CPMC and UCSF. He took tissue samples and closed me up. Then, he talked to Dr. Daud about getting me into his practice. During the rest of the conversation, Eileen told me what she knew about melanoma treatments, how they can rely heavily or exclusively on chemo. After gearing up for a surgery, it turns out that I may not have one. Rather, the preferred treatment will be a tailored chemotherapy designed to take out the lesions on the liver, lungs and hopefully the pelvic growths. This is a major change of plans. And we won’t consider the path not taken: a deep pelvic surgery with metastasizing nodes on the lungs and liver.
By late in the afternoon, I was explaining this remarkable change of diagnosis to Wendy Ostrow. She brought a gift of Grandma Bessie’s cabbage rolls in roasted tomato sauce perfected with a drop of balsamic and noodle kugel; Passover food to celebrate the delivery through the Red Sea of a misdiagnosis.
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