Thankful for Good Friends and Good Food Today

U.S. Thanksgiving happened to fall on a Japanese holiday this year, so the kids were out of school for the day. An American friend a few stations away offered to host a Thanksgiving get-together at her house so I took the younger two children (J has mid-terms tomorrow and needed some quiet time and M had other social plans), a big bowl of mashed potatoes and a smaller bowl of Japanese pumpkin to enjoy the day. Other multicultural familes brought homemade cranberry sauce, coffee cakes, pumpkin cheese cake, salad with feta cheese, and really good wine. The hostess procured and prepared the turkey, made stuffing and baked a pecan pie. It was all delicious but now I want to order a case or so of the Australian Shiraz that was so smooth. Mmmmmm, antioxidants are good for me, right?

The relaxing day was just what I needed after the first half of the week, which was a little busy. I resolved my problem of having to be in two places at once by calling my new oncologist to confirm that he had all the data he needed for my next consultation and learning that the cell samples hadn't arrived yet. That meant I would have no reason to truck all the way downtown and rush back to check S out of his hospital so it made the day a little less hectic. The strategy meeting has been rescheduled for 9 a.m. on the 6th of December (2 days after I go there for an ultrasound of my head to confirm the absence of cancer there and, hopefully, the presence of some form of brain) so I get to take the early morning trains with six million other people. I think I'll wear a disposable mask.

S has an appointment on the 4th of December too, to discuss treatment now that the tests have been completed. He wasn't too confident of the doctors' style while they tested him; he thought they were bumbling more than they should have been indicating that they were unfamiliar with the process. From his description, it sounds like they gave him a spinal tap but they may have just been injecting the contrast for the imaging. He's sure they've permanently damaged the nerves in his lower back when they should have been working higher up. He did admit to feeling much better when he returned to his own futon some of his discomfort is most likely from his general dislike of hospitals. He was well enough to take J out for sushi for lunch today and hold a study session at our classroom for the students who have tests tomorrow. Whew.


The Plan for Now

I packed a bag for S and he will go for his three day stay for the tests he needs and make any decisions about surgery or second opinions after that. What a relief! He filled me in on what his students are doing so I can take over his classes tomorrow, Tuesday and Wednesday so I guess I'd better get working on fixing some easy dinners for the kids for those nights. Fortunately J will be home right after school all week so I don't have to worry about her coming home in the dark while I'm not home.

I'll go with him tomorrow to make sure he gets checked in and ask a few questions.

More on S

Well, the MRI showed that his spinal cord is compressed in his fourth vertebra (C4) and the doctors say he should go stay for two nights for a CT scan with contrast and other tests to determine how they should surgically proceed at a later one month hospital visit. The administration called today to say they had a bed for him from Monday morning and he is scheduled now. The only problem is that he says he has never heard of the university to which the hospital belongs (he only acknowledges the top 3 universities in Japan and the rest are all inconsequential to him) and is suddenly considering cancelling because they might mess up and they looked terribly young to have a medical license...

This could go two ways:

1. He'll go to one of the two central Tokyo university hospitals which actually list themselves as having spinal cord specialists within their orthopedic departments (Tokyo U. or Keio U.)

2. He'll go to a local chiropractor or acupuncturist to see if they have any better advice.

If he refuses to go for the inpatient check-up nearby, I'm going to push for the hospital I found that is staffed mainly by Keio U. doctors and specialists. He is a Keio graduate so he can't complain about the dubious qualifications and it's easier to get to by train (on the way to the cancer center in fact).

If he needs to be in the hospital for a month, we may have to hire our top student to teach a few classes because I know I can't teach 7 afternoons and nights a week and still feed the kids. The student came over today and has indicated the times he will be able to fill in for S so it looks like we can manage.

I've been writing a list of questions I'd ask if it were my neck on the block but S is convinced it's an old sports injury and not congenitally narrow or arthitically induced so he may not ask. I doubt that he'll let me go with him to speak with the doctor, but I'll print out the questions anyway and see if it makes a difference. Maybe I can figure out a way to e-mail them to the doctor...


S Breaks Down and Submits to Medical Exam

S asked me "Where can I get a scan?" yesterday, making it sound like he wanted to scan some document or photo. "What's wrong with the scanner at the classroom?" I ask, to which he shakes his head and I suddenly understand that he actually has decided to do something about his increasingly numb hands and arms. I quickly pulled out a list of hospitals near here that have MRI and CT scan equipment and are within cycling distance. One hospital website even showed the number of surgeries in a year for neurological problems with the number of neck surgeries specified (500 total, 35 neck). I had written it all in the Chinese characters that I found on the various websites and he was impressed enough to choose one and go for a check up. Hooray!

He came home in a neck brace with a schedule of MRI scans, physical treatment and further exams. I think he was probably waiting for me to finish up with my treatment so he could have a turn but has finally understood that he'll never get a turn if he continues to think that we have to take turns taking care of our health. I hope that he will refrain from Sunday softball for a while until he understands what is causing his trouble.


The Consultation

I stopped downstairs at 9:15 to pick up my survivor neighbor and we walked to catch the train downtown where we got on the subway to the National Cancer Center. We arrived at 10:30, half an hour before our appointments, so she would have time to give her pre-consultation blood sample. It was very crowded though and there was a 50 minute wait in the blood test area where we met one of her friends who had arrived about 10 minutes before we did and was also waiting her turn for the needle.

The doctor called the first women while she was off giving blood so my neighbor went into the examining room first with a "She's off giving blood so you can see me now instead." So he brought her records up and they had a talk while I waited outside for the other woman to come back to let her know that her turn had arrived. He saw the other woman next while my neighbor went off to give blood. Both women are basically visiting to check that their cancer hasn't advanced and get their blood work so they can plan their diets for the next couple of weeks or months until their next appointments.

Then it was my turn to meet the infamous Dr. Fujiwara. I'd been expecting a 60ish guy but he was only about my age or a little more. He offered to write the notes about our consultation in English (they always write in duplicate and give a carbon copy to the patient), but I need them in Japanese for Shigemi so I thanked him and asked for Japanese.

He told me that they are still waiting for a sample of my tumor from two years ago to arrive from Kyorin so they can re-dye and re-do the cell work to confirm the lab results before outlining a specific course of action. He did say though, that from last month's CT scan results he could see several "shadows" ranging from a few millimeters to 2 centimeters (in my left lung) and that further treatment is necessary. The CT scan showed that other organs are all healthy and the bone scan confirmed that there are no metastases to my bones. The electrocardiogram and heart ultrasound showed I have a strong and healthy heart.

Basically, he needs to reconfirm the cell work on the original tumor before he recommends the next step. He looked me in the eye and explained that at this stage, when breast cancer recurs, there is no cure and that all treatment is geared towards living a quality life with cancer. My neighbor told him indignantly that Kyorin hadn't even taken a sample of cells from my lungs but he concurred with my Kyorin doctor that a lung biopsy would be more trouble than it's worth as the CT scan clearly showed the breast cancers metastases.

I mentioned my concerns of possible genetic tendency to blood clotting (Factor V Leiden) and he immediately looked at my bloodwork from last month and confirmed that the platelet count was a little high and that he would check for Factor V Leiden next time to see how it might effect my treatment options. He suggested basically the same thing as my Kyorin guy; induce menopause and prescribe anti-estrogens or aromatase inhibitors and constant vigilance. Then if that doesn't keep the shadows in check, the next step would be Herceptin alone or Herceptin with more chemotherapy, probably Taxol or Navelbine.

I'll get a head ultra sound and then an ultrasound of the radiated area sometime in the next couple of months as well as having my veins in my legs, especially the leg that had the clots last year, tested.

We three survivors finished at about 1:00 p.m. when we proceeded to a nearby restaurant where we met another survivor friend for a delicately presented Japanese 10 course lunch. The other women are inspiring and deserve their own posts sometime.

One had lungs mets and was told that she'd exhausted treatment options and should contact a hospice. She went home and dug up her garden to plant vegetables and started eating only genmai, the vegetables she grew and tofu products and gave up coffee, chocolate, dairy products, fish and meat. Eight years later, she goes for check-ups every 3 months and is doing fine. She doesn't mind a little fish now and then, so I think that she enjoyed lunch today as an occasional treat. She handed me a bag of genmai and black rice cooked with beans and packed into balls (rice balls are sort of the Japanese version of sandwiches; a convenient finger food) and some dried radish and freeze dried tofu to make for dinner tonight so I could try her diet. I told her how I had considered genmai (brown rice) capability when buying our most recent rice cooker but that I hadn't managed to convert the family from white rice yet. She said I should go ahead and cook a batch and freeze portions for myself and let the rest of the family eat whatever rice they like.

The other woman is a retired genome researcher but will be going to London next year to work again upon invitation by a genome research lab there. She asked to see my CT scan results and was sympathetically worried for me.

The kids are begging for computer time so I won't delve into the sensory pleasure that lunch turned out to be but it was certainly worth a trip downtown and a morning in the hospital for...