Saturday, August 13, 2011

Hair Today

After a week of steadily being on the mend, it was time for another outpatient appointment. The full cast of Planet of the Apes was at work that afternoon in the registration office, using intermittent mis-asjas and ahh-soos and oo-hoos and continuously inhaled jahs. They finally decided that yes, the name on my identification card did in some way resemble the name printed on my cordial invitation to receive chemotherapy. I was granted passage.

A full minute later I was already out of the outpatient chemo room. They had already taken the blood sample. I would have to wait an hour, but meanwhile, since Dr. X from last week was now on vacation, it was time to visit Dr. Y. So I went.

“You have cancer,” Dr. Y informed me.
—Yes, I’ve become more aware of that lately, I tried to bite my tongue.
“So you know what kind you have? And the treatment?”
I explained that I already had an oncologist, one whom I trusted, in Tallinn, and that I’d already completed a five-day session of chemo.
“Then why are you here?” she almost seemed on the verge of annoyance.
—I live in Tartu. My Tallinn oncologist said I could do the outpatient sessions here.
“You don’t need them. It’s just bleomycin. You can skip them entirely,” she repeated the words of Dr. X the previous week.
—I’m very sorry, but I disagree. She has an excellent reputation, my Tallinn doctor. She makes the decisions, I just get the treatment here.
“Yes, you can get treated here, but here you are my patient, and I make decisions,” Dr. Y stated. “You also don’t need the surgery.”
—Umm, this is very odd, I have to be honest. Please look at it from my point of view. I’m getting conflicting advice from three different doctors. Is this not unusual in your opinion?
“Your bloodwork is not ready yet. Come back in a few minutes.”

So I went back to the corridor and waited. Five minutes later, another door opened and I was called in. A tough-as-nails older woman—very polite nonetheless—introduced herself as Dr. Z.
“You have cancer,” Dr. Z informed me.
—Yes, several people have told me that, so it must be true. I was having trouble biting my tongue. What happened, I continued, to Dr. Y?
“She’s on vacation.”
—But I just saw her five minutes ago.
“Yes, and now she’s on vacation. You cannot have treatment today, your leucocytes are too low.”
—What? What does that mean?
“Go home, just rest for another week. This is common,” she tried to reassure me.
—Is there anything I can do? Anything I can eat to speed this up? I want to get better, I want to do anything I can possibly do to adhere to my original schedule.

I was beginning to see my Holland and Belgium trip fading…

“No, there is nothing you can do but rest. Your leucocytes are at one point oh. They should be at least one point five.”
—Do I need to take any special precautions?
“No.”
—Can I ask your advice? You are the fourth oncologist I’ve talked to now. What do you think about my surgery? And the bleomycin in general?
“You don’t need it. Any of it. Just cisplatin and etoposide,” she emphasized.
—But how can you be so sure? Why did an entire “consilium” unanimously agree on this course of treatment, including surgery?
“I don’t know what they’re thinking. I can call your oncologist if you want.”
—She’s on vacation.
“I know. Just a moment.” And she called. No answer. “She’s not answering.” And she frowned in disappointment.
—I wouldn’t answer either if I were on vacation.
“Hmph.”
—Alright, so I come back next week and speak to you then? What time?
“Come at the same time, but talk to Dr. XY. I will be on vacation.”
—Seriously? Another oncologist? Is it really a good idea for everyone to be gone at the same time?
“He can handle it. He’s very experienced,” Dr. Z affirmed.

I looked up Dr. XY. Started practicing last year.

***

That night was my eleventh anniversary with Mrs. Mingus. As mentioned on my restaurant review blog, we ate at Kapriis. We later moved to a new vinothèque on Rüütli Street in Tartu called Vein ja Vine. Vein means wine, not the blood vessel. Vine means buzz, not wine or the plant. It was pretty cool. There were no tables or chairs, but a waiter named Kristjan was watching for potential customers and quickly and politely sat us around a stool he brought to temporarily house our carafe of red wine that was automatically served to us.

My Tallinn oncologist said I could have a vodka cocktail on our anniversary. Avoid beer and wine. Dr. Z, whom I’d spoken to that day, said beer and wine was fine, but just try to keep it down to just a few, like three or four. I had a couple beers at dinner. All they had was Saku (so my first alcohol in a month tasted like lake water…hey, I’m used to good Tartu beer!).

After about fourteen people joined our table—all friends and family celebrating our anniversary with us, as is our custom—I had another two glasses of wine. Even after a big dinner, I felt rather drunk. I knew it was a bad idea for me to drink, but I did it anyhow. The way I understood it, drinking during chemo is just bad for the immune system and liver, if taken to excesses and frequently. This one time, this one last time, wouldn’t hurt.

I felt a bug in my hair. I had long, curly brown hair. When I reached for it and pulled it out, several hairs came as well. It had begun. Not in huge clumps like you see on television, but more than the expected one or two. I pulled from another part of my head. Same thing. I pulled again, I couldn’t stop. I wasn’t panicking, but I felt a bit depressed. Mrs. Mingus and some of the guests figured out what was happening. She leaned over to me, “Not here, not now. Do you want to go?” I told her no, I just wouldn’t touch it again. But I would like to go relatively soon anyhow, as I was pretty drunk. From four drinks.

By instinct, I went into funny mode. I started telling ball jokes. The table roared with laughter. “Good thing I’m not a general, because half my army was dishonorably discharged!” or “My favorite food is the deviled egg.” or Mrs. Mingus’s personal favorite, “Finally, my wife likes tea-bagging!”

The next day, it was quite clear my hair was falling out. From my chest, from my groin (Brasil Brasil!!!), a bit from my arms and legs, and of course my head and beard. I told Little Mingus I wanted her help in cutting my hair. She got serious, somehow understood the gravity of the situation, and nodded her head. She cut it all off, down to the last centimeter. Littlest Mingus stood by and watched. “Daddy, why are you cutting your hair off?”
—Because I don’t want it anymore.

When it was all done, I went over it with hair clippers and left it all at about a millimetre.

Mingus Two-Point-Oh.

5 comments:

Anonymous said...

Hi Mingus! I think your blog is the best blog I have ever read. I admire you for keeping your sense of humour at this difficult time. You are really talented at writing. I wish you good luck in your battle with cancer! I am sure you will be the winner!

Mingus said...

Thank you, that really means a lot to me!

danny said...

Very few people would have presence of mind to be as incisive as you are in dealing with doctors. A serious suggestion is to become a patient's advocate when you get well. Accompany patients to their briefings and conversations with doctors, and so forth.

Justin F said...

I know they say Americans work too hard and never take vacation, but seems like the doctors' vacation schedule is really cutting into your treatment. It's no surprise they are all taking it in July/August since that's the best weather -- but why are they all allowed to take it at once?

One thing I recall reading regarding the recent Norway tragedy is that the team who normally operated the police helicopter that could have quickly responded to the island were all on vacation that week.

Anonymous said...

I think u are one very strong person and u got wonderful and supporting family and i believe u get better soon.