Friday, September 14, 2007

My Story

In May 2005, months before I had turned 31 years old, I was working as a medical assistant in a not-for- profit clinic. I had moved to Dallas from San Diego the previous December to be with my dad who had terminal renal cell carcinoma. He past away in January and I decided to stay in Texas, near my family, for a while. I took the job at the clinic because I really loved the doctors that worked there- they really viewed their position as doctors as a means to serve society- and needed work, but mostly because I felt they were doing good things and I needed to be out of the house, keeping myself busy, not wallowing in grief.
The job did not offer insurance, but I did not plan on staying there long-term, so I wasn't worried about it. The doctors really took care of their nurses, though, and one day, while showing a nurse friend my pedicure, I asked a doc to take a look at a mole on my toe. The mole had been there my whole life, and had within the last year started to bleed. It sat square near the top of my smallest toe, but I was a runner, and ran about 25 miles a week, so I always assumed it was just irritated from that. Dr. Daya told me to go across the street to a dermatologist friend of his to have it removed. The derma took a look at it and said it was probably nothing to worry about, but needed to come off. It was perfectly symmetrical, had clear borders and normal color. I asked how much the lab fees would be because I was paying cash and not making great money. I also asked if it could be sent diagnostic lab I was familiar with, simply because I knew their prices. He said we would work it out but insisted on using a laboratory which specialized in derma cases. They gave me the number to an automated system and said the lab results would be ready in a week. I didn't think much of it.
A week later the doctor I was working for, Dr. Daya, called me into an exam room. I was a little freaked because the only reason I could conceive of him wanting to talk to me one-on-one was because I had done something wrong and was going to be in trouble. He was looking at the floor and very solemn, and told me he was sorry to be the one to tell me, but that I had cancer. "Nodular malignant melanoma," he said, "a very aggressive form of skin cancer." He said I needed to get immediate care or that I was in danger of dieing.

A month after the diagnosis, I finally found someone to who would see me even if I didn't have insurance. It took weeks of begging and searching and networking, but we finally found Dr. Beitch and Dr. Venkatessan. So, here's the short version:
May 2005- Diagnosed at Stage II.
June 2005- I went to an outpatient hospital and had the skin and some of the flesh around my toe removed, a skin graft taken from my thigh, and 3 lymph nodes from my groin to determine if the cancer had spread. Two weeks later the results came in that the borders around the skin left on my foot were positive for melanoma as well as 1 of the 3 lymph nodes. Now considered Stage IIIc.
July 2005- I had my smallest toe, part of my foot, and all 16 lymph nodes from my groin removed in outpatient surgery.
Outpatient surgery is no fun, especially if there is abdominal surgery involved. The incision started about half way down my thigh, crossed over just above my hip, and stopped about 3 inches above the hip bone. They also removed my little pinky toe and a small part of my foot at the same time. It was, how do you say?, intensely painful, especially since I didn't have insurance at the time and had to do a "day surgery," which basically meant that after I came to, I had to get the hee-haw outta there. That meant getting out of the bed and into a wheelchair, out of the wheelchair and into a car, out of the car and walking into the house. Ouch. Yes, there were pain meds, but nothing really prepares you for walking (or should I say attempting to walk? more like dragging myself on crutches) just hours after they staple (87 staples, by the way) you shut. A full 10 on the one-to-ten pain scale. I didn't even know that pain like that could exist. Forget childbirth, if that's what it's like.
August 2005- I began high dose Interferon in a hospital. Interferon is a biological therapy/ immunotherapy for high risk patients. The treatment is a little dangerous and has pretty serious side effects so it required 5 day hospital stays for 4 weeks.
September 2005- The treatment lowers your ability to fight infection,
and in early Sept I discovered that my leg was red and tender, and I had 102 fever. I had contracted a staph infection and had to stay another 3 weeks in the hospital fighting that.
October 2005- I was sent home and Rxed low dose Interferon to be self administed by injection for the next 11 months. I would be very sick and unable to work. Off and on through the year I was sick, jaudiced, and had heart palpitations and trouble remaining ambulatory. Spent some of the time in a wheel chair.
October 2006- Finished the treatments, but the treatment had caused a condition similiar to chronic fatigue syndrome. Spent a full year and a half combating those symptoms.
June 2007- Routine PET scan showed an inflamed inguinal node which doctors were concerned was melanoma. Node was removed but no evidence of disease found.
Present- The majority of the symptoms from Interferon have subsided. Currently NED (no evidence of disease.)

There is no remission for melanoma, because there is no cure, and, essentially, it's going to come back. There isn't even really a treatment for it. Even Interferon, which I took for a year, is rarely Rxed anymore because the results are so iffy (only a 6%-20% chance of staving off disease) and the side effects are so horrendous. Interleukin 2 (or IL-2) is also a treatment option, but has about the same results and even worse on the side effect side. I prefer quality of life to doing a treatment like that again. According to the American Cancer Society and most of the doctors I've seen over the last 3 years (and there have been a lot!) my chance of living to 2010 ranges from around 27% to around 52% and my chance of living to 2015 ranges from around 22% to around 37%. But, to quote Fight Club, "On a long enough timeline, the survival rate for everyone drops to zero." In a way, I'm lucky because at least I'm not going to work some shit job that I hate in the hopes of one day, after retirement or something, enjoying life. I enjoy it now. I live as fully as I can. And it's a good life.
There are some very hopeful treatments for melanoma in clinical trials now, such as vaccines. But until some kind of effective treatment comes out, I am not getting regular scans. My oncologist kinda said, "What's the point? There's no treatment anyway." and I agree. If I get scans every 6 months, I'll be a nervous wreck until the next one. So, I'm taking it as it is.
I'm hopeful about the future. But more importantly, I love the present. It's all we have, anyway.

Thursday, September 13, 2007

How to eat fried schoolchildren

Sorry it's been so long since my last update. As you know now, the school year can be a bit hectic.

Having said that, I need to make sure that I make this clear too: your 2nd year teaching out weighs your first by about a million percent. I know, I know, mathematically that's not possible. But I'm telling you, I'm not exaggerating. I sleep at night, my room is organized, the kids actually get to enjoy the class because it's not so strained and new to me. So far, too, the goals I set for myself in the classroom have been attainable, and that's making the class better, too.

Not that there aren't "challenges" (the teacher word for problems) this year. I have a good group of really sweet kids, most of which still think members of the opposite sex are yucky, which I personally love. So cute to see them so young, and it makes my job SO much easier if we don't have love affairs going on. But never fear, by spring these guys will be jumping through their skin to see what it's like to kiss behind the gym after school. Ah, young love.

I've also had an opportunity to get to know my fellow teachers this year and- believe it or not- make FRIENDS. Remember those? The ones back before the chemo days, the ones you got to know at work and just vented to and were there to be vented to? Yes, those. Good God, what a difference it makes to be able feel comfortable enough in your own skin to just laugh and talk to someone like you used to. And to be able to hear other people in your same situation feeling the same way as you. These girls I've gotten to know have made my life a lot easier this year. Not to mention happy hour.

My one goal this year that I've failed miserably at is working out 3 days a week. I've pretty consistently worked out 2, and I always do it once, but this is it truly not good enough. Let's face it, people, I officially hate my body. And I'm an equal opportunity hater. I hate my legs, I hate my butt, I hate my back, but most of all I hate my front. I can't remember the last time I was so disgusted with myself. While I was on chemo, I always told myself that it was a temporary situation, and that I had no control over what was happening. But now, good Lord, it's been 2 years and I'm still struggling to get back into shape. Can I really blame this on chemo still? Me thinks not.

That's it for me. Tune in next week for the full on breakdown of every inch of my cottage cheesy bottom.

Tuesday, September 04, 2007


Just really feel the need to tell you about my day today.

Started out, technically, last night at 1 a.m. when I still couldn't sleep, after laying there 2 hours, b/c I was thinking about all I needed to do this week. It's a short week, which is awesome, but also means I missing out on a full instructional day. So much to do!
Awake by 5:10 and at school by 6:00, and if you think teachers have it easy, just think about the line of teachers that were at the door trying to get in, trying to get a jump on the day. But everyone was laughing and smiling, giving each other a hard time- "What are you people doing here so early?"
But 7, I'd had breakfast, made copies, and was ready for the first lesson of the day- place value. If you haven't pulled teeth lately, just let me tell you, it's a lot like teaching place value. But with place value there's a lot more blood and screaming.
7:30 a.m.- time to serve breakfast, take roll, collect beginning of the school year paperwork (all 11 forms per student), distribute (again) the paperwork that wasn't filled in correctly or that hasn't come close to being turned in yet, take breakfast roll, put the remaining breakfast in a specifically marked bag, put the breakfast trash in a specific trash bag, say the pledges (including the new, deranged, Texas pledge), and get a math warm-up in the works. Then do the other attendance, and send in the completed forms, each one complete with it's own specific set of instructions- (green sheets in order of student id#, pink sheets in alphabetical order, blue sheets by date of birth, etc.). Then the principal does a random walk-thru ("Ms. Lee, why are you not in the midst of your place value instruction?") Give out table points to the quietest, most attentive table and individual points to those dedicated to their task and helping their neighbor without giving answers. Okay, time to teach now.
So, my new goal this year is to not do more than 15 minutes of instruction at a time, considering the average 11 year old brain is already stretched pretty thin by 15 minutes of instruction. In the midst of those 15 minutes, there are 2 interruptions- one to remind me to sell school t-shirts, and the other to let me know we need more family members signed up in the PTA. Back to instruction, and the kids are starting to get it. This year, a lot more hands-on, a lot more interactive instruction, a lot more "forming their own theories" about numbers. And it seems to be working. 15 minutes are up and so we play place value bingo for the prize of one gooey brain, for which the majority of the class is willing to give up a major organ. 2 games and they're still begging for more, and I can't believe my ears. Finally I have to give out homework, just to make sure everyone can apply this stuff on paper. Did I mention I have a kindergarten level kid in my class, for which I've had to modify and come up with lessons that look the same, but really are 4 grade levels lower? Also I have one student from South America who's parents refuse to put him in bi-lingual classes, so I've had to translate enough parts of the lesson so that he is learning English, but still able to fallow along. It seems, by the look of the homework, only about 10% (around 3) are really not getting it. This is about average. It's 9:30, and time to teach the other class math now. Start all that over.
It's 11:10, and time for PE. Two kids having a little anxiety about going, and I've got to figure out why. One is obviously being bullied, but I have no idea by who. This is the PI piece of my job, and I've got to get to the bottom of it quick. The other, I finally figure out, doesn't want to go because of headaches. The headaches are caused by vision problems, and the parents don't have the money for glasses. I know this because I saw the application for free lunch- six people in the household on an income of $300 a week. They make so little because probably illegal, and they make it under the table. These families come here so their kids can get a decent education, but the problem is the gangs fill these low income neighborhoods. My bully, she's being hasseled by older kids in her apartment complex, and they all wear red. We wonder why she bullies others- because she feels so powerless outside of the classroom. And my poor vision kid, he'll get the glasses he needs but it'll be 4 weeks easily. So, I'm off to the counselor's office, who is good. Last year, the counselor just tried to avoid all the paperwork, so she did nothing. At least she's gone. 45 minutes of paperwork to get some intervention on the bully. I pick up the paperwork for the glasses on the way back, and will have to get to it later. Time to pick up the kids. We go back to the classroom and read a few pages of the Ron Clark book. The kids eat it up, they really want to explore character development and they say please and thank you in the lunchroom, a phenomenon that does not go unnoticed. Same thing happened last year, and the lunch ladies love it! I have 2 minutes for a Lean Cuisine while I fill out the paperwork for low-cost glasses. Pick up the kids, and now back to the classroom for science, a lesson on the scientific method. You thought place value was bad. Luckily, we're doing a "swing bear pendulum" experiment that makes it come to life, and the reward of a gummy bear at the end of the lesson gets everybody working hard. More individual points and table points, and I'm amazed how hard these kids work for a little recognition. 15 minutes of recess as a reward, but the winners vote and tell me they'd rather eat lunch with me than go outside. :) I'm all warm inside, and feel blessed by such good kids being in my life. The bell rings, and the real work begins, getting ready for tomorrow and the rest of the week. 3 teachers come in and cry between 3 and 5, because their class is so low and the pressure is so high. I remember this from last year- good grief, I had no idea how to deal. This year, I'm much more able to roll with the punches. Still a struggle, though. Copies and laminating for the activities this week, but the copier shuts down mid copy. Third time since school started that this has happened. I'm amazed that the teachers never complain. A grumble or 2, but no serious bitching. I go down and try to help destress another new teacher, and we laugh it off with stories from the day. It's 8 o'clock, and I know my hard work tonight will allow me to leave by 5 probably the rest of the week. I should go work out, but need to be able to sleep. I gotta start leaving earlier, but I love the satisfaction I'm getting from my job and from the kids. But I miss Bobby, too. It's all a toss-up, you try to balance. I get a text message on the way home, a kid from last year who tells me middle school is "fly." I'm happy that last year I lasted, even though it almost killed me. And then I get to see Bobby, the best part of my day.
Time for bed!


I'm Too Young For This!