November’s Ultrasound

I had an ultrasound on 11/11/13.  Both John and Judi went with me.  It’s taken me a while to write about this scan because the experience was upsetting and because I wasn’t happy with the findings and needed time to process both issues.  (Oh yes, then there were the holidays, some travel, and then another health development…)

The procedure itself was upsetting because I felt the radiologic technologist violated professional boundaries with her comments and questions.  I’m over that now, but it took a lot of journaling and conversations with Judi and John to calm down.

After all, what really matters is what the R.T. found out and the radiologist on call verified:

Tumor #1 (The Fish), is now 37x27x33 mm (from June’s MRI measurement of 28x27x34 mm).  It looks more like a star than a fish now. This is the ductile tumor.

Tumor #2 (The Ghost), has also changed shape.  It’s almost completely spherical, and it’s 15 mm (from 9x8x11 in June).  It’s rounder than it’s earlier shape.  Up until this ultrasound, it had been stable in size and shape.  I wonder if the ghost busting got this lobular tumor to budge.

Tumor enlargement comes before the healing crisis, so I remained confident that I was on track for the cancer clearing phase of treatment.  There’s a pulse quality on the right wrist that indicates metastasis, and neither Brendan nor I have detected this quality.

When she called to follow up on this ultrasound, Kari (my surgeon) told me that she was worried about me but would continue to support my treatment plan.  I reminded her that Tumor #1 started out at 33 mm, so the net growth from March 2012 to November 2013 is approximately 4 mm.  Tumor #2 was 14 mm in March 2012 and is now only 1 mm larger.  We agreed that, given the slow growth overall, I could skip the March 2014 ultrasound and not measure again until the annual MRI in June, especially since my lymph nodes were still clear at the 2013 MRI.

In the meantime, I needed to deal with some persistent low back pain.

It Takes a Village

I really like the surgeon I put in charge of the biomedical part of my healing journey.  Kari Rosenkrantz is tall, gorgeous, unflappable, and funny, and she came highly recommended by people John and I respect.  My Pilates teacher, who had a lumpectomy and radiation a few years ago, shares my admiration.  Betsy thinks Kari is a rock star, and I agree, especially when she strides into the examination room wearing 4 inch high heels (I’m hoping never to know first hand if she operates wearing these shoes).

Kari has been supportive from the very first, expressing her respect for Chinese medicine even while freely admitting she has no knowledge of anyone using it as the primary treatment for breast cancer.  Her open mind seems to be a rarity in cancer care world.

I’m sure Kari knows that my complete recovery from cancer in the coming months will not end her career.  Although I am not the first person to take the Chinese medicine route to treat cancer, there are precious few of us compared to all the others who opt for surgery, radiation treatment, and/or chemotherapy.

Why is this?  Mostly because biomedical treatment of cancer seems to be the only option that doesn’t look like quackery–thanks in part, no doubt, to biomedicine’s focused campaign to discredit any practice that isn’t within its sphere of influence.  Maybe there is a conspiracy to squash the competition so that the cancer centers (and Big Pharma) can rake in the big bucks, but, if there is, it’s taking place at a very high level.  I’ve only experienced genuine concern and caring from the people I’ve dealt with at the cancer center.  They sincerely believe they offer the best and only hope for their cancer patients.  Still, I’m just one person opting out of the cancer center’s full array of services, so I pose no threat to anyone’s assumptions or jobs.

During the early weeks of this journey, as I underwent all kinds of diagnostic procedures, I also had a mandatory session with the cancer center’s social worker.  She laid out a menu of the center’s services, ranging from gasoline vouchers, wig fittings, lessons in tying up head scarves, make-up tips, art therapy, yoga/tai chi/meditation classes, financial assistance, psychological counseling…  Clearly, breast cancer patients at this center get excellent support at multiple levels.   Instead of feeling supported and cared for, though, I felt the hidden message was “girl, you’re in big trouble now.  We’re taking extra special care of you because your diagnosis is so very dire.”  A fear-mongering fist in a pink velvet glove.

When Jeffrey Yuen teaches about treating cancer with classical Chinese medicine, he warns his students that fear creates the greatest barriers to successful healing.

First come the practitioner’s fear:  Have I enough courage and confidence to keep the patient’s trust during all the phases of treatment, especially during the healing crisis?  Are my skills and training adequate?  What if I misinterpret the pulses and give the wrong treatment?  What if I miss something?  Will I harm this patient?  Will the family sue me?  Will the AMA or the American Cancer Society crush me?

The patient, too, has to overcome doubts and fears:  Is this the right choice?  Does this practitioner have the skills I need?  Can I sustain my confidence in my choices for as long as I need to?  How will I handle the final phase of treatment, when the tumors enlarge and possibly become painful, and the healing crisis may turn out to be prolonged and unpleasant?  Can I afford the time and money for weekly treatments and herbs, possibly for several years?

Even when the patient feels strongly that Chinese medicine is the best way to go, her friends and loved ones need to be convinced.   Few people have heard of successful cancer treatment using Chinese medicine, so there’s an understandable concern that the cancer patient is following an uncharted, unproven path.  It’s very difficult for patients to constantly defend their choices to spouses, parents, children and friends whose fears make them question the patients’ judgment.  Even casual acquaintances and total strangers feel free to tell cautionary tales of people dying of cancer for lack of “real” medical care.  Without very strong inner resources to resist the concerns of the people they care about, cancer patients often yield to their family and friends’ fears and switch to Western biomedical treatment.

In my case, no one can suggest that I am under the spell of a charismatic charlatan who has clouded my thinking or preyed on my ignorance.  I worked as a staff acupuncturist and herbalist for six years in a Boston AIDS clinic in the mid 1990’s, long before the so-called “cocktails” were around, and I know how effective this medicine was for our patients there.  My knowledge and experience tell me I’ve chosen what’s best for me.

When deciding where to get classical Chinese medical treatment, I picked the clinicians at Jade Mountain Wellness in Burlington over other qualified practitioners because I liked the idea of a team.  Brendan Kelly and his wife Liz Geran both took the same classes on cancer treatment that I had attended, and both were still studying Chinese herbalism, on a monthly basis, with Jeffrey Yuen.  Brendan happened to answer the phone the day I called for the first appointment–I would have been fine seeing Liz instead.  Because of the dearth of nearby colleagues trained in classical Chinese medicine to offer clinical supervision, I assumed that Brendan would consult with Jeffrey if need be.  At the very least, Brendan has Liz to help him with any private fears and doubts he might feel from time to time, and I imagine they share ideas and experiences (and class notes?).

My family and friends support me now.  In the early months I had to defend my choices to a few relatives and friends; I chose to stress Chinese medicine’s millenia of experience in treating “accumulations” and “fire toxins,” rather than make any case against biomedicine.  John and Judi have supported me completely from the beginning.  Whatever fears they may have they’ve kept to themselves.

John is a rock.  When last June’s MRI showed that one of my tumors had grown significantly, he didn’t hesitate a second before saying,”That’s great news!”  I have overheard John tell a couple of relatives that I wouldn’t be true to myself if I were to take any other path and that he respects that. John’s also an effective gatekeeper against those who feel compelled to share why they think I’m making a huge mistake.  I know this isn’t easy for him.  Even after 39 years of marriage, he still wants me around!  We have made plans to travel to far-flung places after he retires, and he’s optimistic about that, except occasionally during the wee hours of the night. His health, which has always been the exemplary health of an athlete, has started to suffer in response to his stress and worry.  Fortunately, he is able to reach out to others for sympathy and support when he needs it.  A few “breast cancer husbands” have taken him under their wings (those dear angelic guys!).  My children developed their own support networks.  It does take a village, if not a small city, to manage this disease!

Any kind of cancer treatment is hard.  Choosing the road less taken has special challenges.  In many ways, it would be easier to step back on the cancer center’s conveyor belt and let the biomedical experts take charge.  But surgery, radiation, and chemotherapy cannot alter the terrain that allowed the cancer to develop in the first place.  This cancer diagnosis has given me the opportunity and the responsibility to examine the unfinished business of my life, to discover where unhealed wounds exist that I need to touch and make whole, and to teach my heart how to truly sing.  I need peace and freedom to go inward as well as safety and guidance to process what I find.

My friends and loved ones give me sanctuary and listen to my ramblings without judgment.  They also feed me when I’m too tired to cook, give me things to laugh about when I get down, sometimes weed my gardens, and keep me supplied with great reads when I need to take a mental vacation from this work.  John provides the necessary financial support that gives me the luxury of time and acupuncture treatments and herbs (which are not covered by our health insurance–how ironic that the biomedicine route would be cheaper for us).  How lucky I am!  Thank you, all.

Results are in

I haven’t actually seen the MRI report, but Kari, my surgeon, emailed me the executive summary yesterday:  the smaller tumor remains the same size; the larger one, which was 21-23 mm in February, is now 34 mm (approximately its size at the time of diagnosis).  The lymph nodes all look normal.

I have to admit I had some moments of doubt when I got Kari’s email.  Of course.  But they really were just moments.  Doubt morphed into respect when I remembered that Brendan changed his treatment strategy about six weeks ago to precipitate this healing crisis because he judged, from my pulses and presentation, that I was strong enough to clear the Fire Toxins.  We were expecting the tumors to grow.  Still, having my Heart Vaporize the Phlegm (spontaneous remission) would have been so much easier (though less interesting, I suppose, as blog material).

Subjectively, I’ve known that The Fish is growing.  It’s now closer to the skin and seems much bigger than it was.  It does seem softer, though.  Biomedicine cannot measure the density of a tumor, just it’s size.

The smaller tumor, The Ghost, has remained fairly stable in size.  I can’t speak for its probable density, since I can’t palpate it.  I’ve been puzzling over why the treatments haven’t had the same impact on this tumor as they have on the The Fish.  After reviewing all my class notes, I think I now have the answer.

Last summer I attended Jeffrey Yuen’s annual retreat for his advanced students.  These retreats aren’t focused on one topic like his regular seminars.  Instead, he addresses concerns and questions that arise when experienced practitioners want to go deeper into their understanding of classical Chinese medicine.  One of the days was devoted to questions about the seldom used secondary acupuncture vessels known as the Divergent Channels.  Divergent Channel treatments focus on serious chronic diseases.  Divergent Channel treatments require nuanced pulse diagnostic and needling techniques that are difficult to master.  Since cancer is clearly a serious chronic disease, Jeffrey used me as the class’s case study.

In the course of interviewing me, taking my pulses, and working out a possible treatment strategy, Jeffrey talked to us about breast cancer in general.  He said that ductal tumors are problems of the jin-ye fluids, especially the ye (don’t worry about that) and are usually related to the Triple Heater and Small Intestine (Fire organs, the yang aspects of the yin Pericardium and Heart).  In his experience, these tumors resolve faster than lobular tumors, which he believes arise from Dampness and Phlegm, terrains that create the most stubborn pathological states.  The Fish is ductile, The Ghost is lobular.  That explains why one tumor is responding more quickly to the treatments than the other.

(A few months ago, for a different reason, I started a 100 day Daoist regimen for exorcising ghosts.  More on this later.)

Now that I have proof that the healing crisis is upon me, I need to adhere more closely to my diet, exercise (gotta get back to qigong), and detox bath regimens.   I don’t want to give those cancer cells any excuses to linger.  “Get off my plane!”

It looks like I might have to go through a second healing crisis down the road to clear the lobular tumor, unless my Heart can vaporize The Ghost’s Phlegm.  All things are possible!

Down the Rabbit Hole

Five months ago, on March 24th, while examining a bruise on my right breast (given to me–the bruise, that is–by my very large and playful and obviously undisciplined Rhodesian ridgeback), I felt a lump the size of a grape next to the bruise.  Surely this was a hematoma?  Yet the lump itself wasn’t discolored, and it seemed too rigid to be a mass of blood.  This was on a Saturday night.   On Sunday I got up early (I hadn’t slept much, anyway) to find and review my class notes on breast cancer.  I also considered, for sanity’s sake, that the lump could be benign.  Finally, I told John (my husband of 37 years) and Judi (my best friend) about my discovery.  Sunday was a long day for all of us.

My class notes (see Welcome page) reminded me that hormonal cancers express in life cycles of 7 years (for women) and 8 years (for men).  I am 63, at the beginning of my 9th life cycle, so no surprise there.  The notes outlined the typical etiology of the disease and discussed risk factors and symptoms that, in the main, described my case.  This increased my confidence that Chinese medicine has a handle on this disease.  (And yes, I did wonder how I’d managed to ignore warning bells during class.  And how I had not noticed a lump that large before?!  Ah, denial–so much more than a river in Egypt.)

By Monday I was ready to face, well, whatever.  First, a quick solo trip to my primary care provider’s office to see a nurse practitioner, who assured me the lump didn’t have to be cancer but got me an appointment right away at the hospital’s cancer center.  Judi, a fierce and loyal friend, then stepped onto the conveyer belt with me as I went from one end of the hospital to the other.  She took notes, asked great questions, and dared anyone to talk down to me (one resident tried, but he was no match for her).  The tour began with The Kind Nurse in Charge of Keeping You Calm and Focused While She Outlined What Would Happen Over the Next Few Days, then moved on to a series of diagnostic suites for mammography, ultrasound, biopsy, and MRI.   The radiologist pushed the pathologist to read the biopsy slides asap.  Before noon on Friday, the radiologist phoned to say I had two tumors, both malignant and invasive, one ductal and the other lobular.  It was quite a week.

The following Monday John and I went to the medical center for a second MRI (the “real one”–the first one being for research only).  We were turned away (the scheduling nurse had given me the wrong date–the only glitch so far) and told to return Tuesday evening.  After the MRI on Tuesday, I needed a break!  I had already signed up for a four-day class on Chinese medicine (not cancer related) in Asheville, NC, so I left Vermont and headed south Wednesday morning.

Back to the hospital on Monday, April 9, for a chest x-ray and blood test to determine whether the cancer had metastasized (happily, it hadn’t) before meeting with the surgeon.  First,the surgeon explained that she considered my cancer, due to the size of the larger lump, to be Stage II.  But she also thought that blood from the bruise may have seeped into the tumor, enlarging it enough to create a palpable mass (good dog!).  She recommended two lumpectomies and a sentinel node biopsy, followed by radiation treatment, and she could schedule the surgery for two days hence.  John was there and also took notes and asked questions.  The surgeon couldn’t have been more caring and patient with us.  Somehow she kept a straight face, not even sputtering in disbelief, when I explained I was going to Seattle in a few weeks to play with my grandson and would use the intervening time to (this just popped into my head unbidden) consult with my waterfall oracles.  I’d get back to her in a month about when or whether I was ready for surgery.

The next day I met with an acupuncturist in Burlington, VT who had attended the same cancer classes I had taken with Jeffrey Yuen.  I didn’t actually know him, but he had the credentials I was looking for.  When a waterfall oracle appeared to me, moments before this first appointment, I knew I’d found the right person for the job.  To be continued…