Posts Tagged ‘heart tests’

Even though I was hung-up at the crossroads, the pace picked up a bit after seeing the oncologist. Dr. Hershman had spread a map out across her desk (figuratively speaking) with a variety of treatment tracks each with varying degrees of difficulty and I had to pick one. There was a chemo track for Stage 1 & 2 lymph node positive that involved A/C (Adriamycin Citoxan) in which hair loss was a given, then radiation and hormone therapy. Another chemo track with a slight curve that I recall had the apt initials FU (5-FU Fluoroucil) which involved more doses over a longer period of time and less or no hair loss, then radiation and hormone therapy. Another chemo track called T/C (Taxotere Cytoxan) with a steep incline that required a strong engine because TC was reportedly hard on the heart and the immune system, then radiation and hormone therapy. Or, an express track of only radiation and hormone treatments. So, before I could link arms with the scarecrow to ease on down a chosen road, I had research to do — I needed to submit to the prescribed medical tests, and to turn an eager ear to the stories on the wind.

The track I wanted – the express track – was always an available choice, but in order to get blessings from my western practitioners, I had to, or, rather, my tumors had to score well on the oncotype dx test. This test required little physical exertion on my part other than to give consent to further biopsy the tumors and to be prepared to battle insurance carriers for coverage. The oncotype dx was expensive ($10K) plus it had heretofore been prescribed only for lymph node negative breast cancer. Since I was lymph node-positive, Dr. Hershman felt the insurance company might balk. But, she endorsed the test anyway because the cancer in my lymph node was but a speck, and the oncotype dx was cutting edge and on the brink of branching out to early stage lymph node positive, and, she said, Genomic Health, Inc. offers other forms of financial assistance. Above all else, she felt the test was valuable. The lab examines twenty-one different genes in the breast tumor tissue to determine the aggressiveness of the cancer thereby informing of the likelihood of return, and the benefits of chemo. She said, “The oncotype dx tells the story of the tumors.”

“YES,” I said, “I want this. Stories are essential. I believe that stories are our best teachers.”

Yes, I consented with my fingers crossed while shouting silent prayers for financial coverage. As it happened, the insurance company did balk but a Genomic Health representative assured me that there would be an insurance process of denial and resubmission that they would handle, and that I need not worry about money (powerful healing words). The tumor specimens were delivered to the lab, the results would be ready in roughly a month. All I had to do was wait.

Meanwhile, the good Dr. Hershman prescribed a heart test to determine whether my engine was fit for the T/C track.

My fierce, right-angled, rebellion fills up an entire journal page – TC chemo is hard on the heart and tough on the immune system – Why? would I opt for that??

And yet, I went for the test because I was only gathering information, plus I was curious about my heart. I’d been so focused on worldly stress – finances, career and academic disappointments – that I’d lost sight of my passions. I wasn’t sure how hard my heart was beating anymore.

This is the report in my brown suede medical journal on the day after the test:

The learning is exciting. All teaches me: the fear, the friends, the intricate weave of the drama. Like moving to a foreign land, my every sense is on alert (in the hospital) to find my way.

The echocardiogram experience was interesting. It was essentially a sonogram of the heart. I think of the blips on the graph on the screen, the pixilated blob deflating and inflating, the whoosh squoosh sounds of what I was informed was the rushing of blood through the valves, and I am awestruck by the life force.

I said to the pretty technician, “It’s more fun to see a baby on that screen.” Then reneged. “But I guess it’s equally great to see that it (my heart) is pulsing.”

[This is not in my journal: part of the reason I reneged was that there was more story behind that comment than I cared to share with a chilly echocardiogram tech. In 1996, a black hole on a sonogram screen informed Reade and me that our first pregnancy had spontaneously terminated. That was one of only two times that I’ve witnessed my husband cry. Then, almost a year later, a squirmy little being with a heart as loud as a stomping T-Rex appeared on another sonogram screen, and my hardened heart began to beat again that day. I relived that moment during the echocardiogram, and, in a flash, had a lump lesson revealed on to me – I love my baby, true, and now I love me too.]

Back to the journal entry re: my pulsing heart:

Yeah. It’s amazing to be made aware that there are parts of me – vast & powerful & highly energized parts of me – that are alive without me (my talking mind) directing them to beat, breath, and so on. There’s so much more of me than my thoughts.

The tech by the way was more than pretty. She was a light-skinned, dark Spanish beauty, an Earth goddess – very solid and capable – and way too serious. Maybe she sees hearts everyday and so she doesn’t marvel at the life force? Maybe her heart aches for someone? Maybe she protects her heart and just does her job while she’s in her blue uniform and responsible for taking pictures of every chamber and valve?

Every time I go to the hospital I meet such courageous and kind people. I’ve been loving the people at Columbia Pres. just loving them.

Joanne the adorable and extremely sweet echocardiogram receptionist, secretary, defender of the pre-certs. She was able to soothe my soul after some insurance referral agitations, thereby stilling my heart before the test. Then there was the hilarious elderly Jewish lady, apparently a regular on the floor, who spoke Spanish rather than Hebrew because “Oy, Hebrew is so hard it should be left for the Rabbis.” Then there was another elderly lady that lost her way to the sitting room. I pointed her in the right direction and she squeezed my elbow with such force – a vehement thank you – that I felt she had inoculated me with ultra good vibes.

There are so many heartthrob stories in wheelchairs and on gurneys in the lobby, on crutches or toting oxygen tanks on the elevator, wearing uniforms, or smiling behind the reception desks. I am so touched by the kindness and the courage of patients and staff – the hospital has shown me that my heart is beating before I even took the test.

(to be cont.)

In awe,



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