I’m running out of pain medication, so I decide to pay my doctor a visit again. When I walk into the clinic shortly after they open, the receptionist looks up with a smile on her face. When she sees me, her face falls.
“No emergency today,” I say. “I just need to talk to Dr. Nowak about my painkiller prescription.”
“Ok,” she says gently. “Have a seat. I’ll let her know you’re here.”
I can feel the tumor in my jaw. It’s slight, but it’s there, a bit like Kleenex stuffed between my lip and my gum. Part of it might be swelling from the tooth extraction. Some mornings, it doesn’t even hurt. Sometimes the Ativan is enough to keep the pain away. But sometimes, it hurts like a bitch. I’ve tried a variety of pain meds. Sometimes 400mg ibuprofen and a Tylenol is enough to deal with it, but sometimes it isn’t.
Rather than dancing the dance of “how much pain is this ramping up to in an hour?” I’ve started regularly taking two Tylenol-3 and one prescription 600mg ibuprofen. When it doesn’t hurt, I don’t worry as much, so the painkillers are as much for my mental health as my physical.
I’ve been subsisting on the small amounts the periodontist and then oral surgeon doled out, but I need to get a steady prescription. Otherwise, I try to ration and rationalize whether I should take them or not. More to stress about. I don’t need that.
The resident assisting Dr. Nowak calls me into a room.
We saw her a couple times so far with the twins. She seems like a bit of an airhead. The first time we saw her, it took her over an hour to do the checkup with the babies. That, in and of itself, isn’t horrible—she is still learning, after all—except I forgot a nipple for their bottle and they were screaming hungry by the end.
The biggest problem was that every time I asked her a question, it looked like she was visualizing a textbook in her head and reading out of it for the answer. After she was done, Dr. Nowak came in and changed almost every instruction she gave us regarding Calliope’s skin rash and Morrigan’s issues with withholding poop (which is a whole other story, sigh).
The last time we were in for their monthly appointment, I explained how I was waiting for results from the jaw biopsy. Today, I assume the resident has been informed of my results, so I start talking to her like she knows.
But she’s asking questions that I’m hoping she has the answers to. “So you’ve been referred to Princess Margaret?”
“Yes, well,” I say, “I’m waiting to hear back from you guys on whether I’m in with the Rapid Breast Clinic, but the oral surgeon has referred me to the head and neck division.”
She types something into the computer. “And what are you here for today?”
“I need painkillers.” I briefly describe my experimentation and how I’ve decided what works for me.
“OK, I will give you a prescription for 100 Tylenol-3 and, hmmm, let’s see… 65 ibuprofen.” She’s doing some math in her head that I can’t follow. I take one ibuprofen and two Tylenol-3 three times a day. So I need twice as many Tylenol-3 as ibuprofen. But I don’t argue. She seems easily confused.
She finished typing and leans forward. “So did you hear back about the biopsy of your jaw?”
I blink at her. I am at a loss. This is like how I have to explain to people that, No, they didn’t fucking catch it early; it metastasized. My mother on the phone while I was waiting between my mammogram and my ultrasound, for instance. My entire life, she’s been so damn focused on trying to keep me from feeling pain that she minimizes and belittles what I’m saying and makes it so much worse because I have to argue with my lived experience versus whatever candy-covered world she would prefer everyone live in. It’s exhausting.
But she’s not the only one who’s tried to assert it was caught early. Telling people that no, they didn’t, is worse than when I needed to educate people about how twin pregnancies are much more taxing than singleton pregnancies—that it’s normal to be exhausted throughout and nearly unable to walk toward the end. Having to explain just how bad my cancer is seems a betrayal. It’s bad, ok? It’s fucking bad. THANK YOU FOR REMINDING ME. I ALMOST MANAGED TO FORGET FOR ZERO POINT THREE SECONDS.
“That’s how they found the breast cancer,” I say. “The biopsy came back as breast.”
The resident looks even more confused. She types some more things into the computer.
We finish up, she gives me the prescriptions, and I leave. As I’m walking through the parking lot, I hear my name. It’s her, calling me back. “Dr. Nowak wants to see you!”
Sure. OK. Is that good?
I go back into the room. Dr. Nowak comes in, gives me another hug. “Sorry,” she says. “I didn’t even know she was seeing you. Usually I meet with her before she sees patients to get her up to speed on things.”
“Yes,” I say. “She seemed rather… confused.”
Dr. Nowak looks at the prescription she gave me. “A hundred Tylenol-3? They’re never going to fill this!” She takes it and starts typing into the computer. She mumbles something about controlled substances.
At least it’s not just me who thinks this resident is clueless.
She updates my prescriptions, and we talk about the CT scan. “I have your bone scan results back,” she says.
My heart seizes up. Good thing I took an Ativan. “What do they say?”
“Hmm,” she says. “It looks like there are two spots of note. But the thing is, these results would indicate arthritis, the way they’re showing up on the scan. They’re glowing just a little, not a lot, and it’s at the joints. But because of your… condition… they’re saying they need further follow-up. Otherwise, they would diagnose them as arthritis.”
“Where are they?”
“One’s your shoulder.” Ah, vindicated… or not. I don’t want arthritis in my shoulder. “The other is your lower back.” She tells me which vertebrae, but the information floats into one ear and out the other. It’s near where the MRI two years ago showed my bulging discs. “Also, it’s showing a light glow all the way down your spine. Arthritis. That’s what I would presume it is.”
“I’m young for arthritis,” I say. “Is there anything to be done for it?”
She shakes her head, frowning. “Unfortunately, no. Pain medication. That’s it.”
Good news / bad news indeed.
I’m both relieved and dismayed. If I make it through this, I’m going to have to deal with arthritis for the rest of my life. Some of the worry that I’m going to die lifts away. “You don’t have the CT scan, do you?”
“No, they’ll have it when you see the oncologist.”
That’s it, then; that’s all for today. It’s not anywhere else in my bones. And, as Meghan said, breast cancer prefers bone over organs. Once they cut out the tumors and nuke the ever-living fuck out of me, it’ll be gone.
The rope holding the sword hanging over my head thickens. It’s still there—it could fall—but it’s no longer one thin strand. I can breathe easier. I can rest easier. I can…
Now what? What the fuck do I do now?
Wait, I guess. The appointment with the oncologist is on the 15th.