Latest News

The latest in Regge's series of Endless Mountains ghost stories is available on Amazon:

The Boy in the Toy Room: An Endless Mountains Ghost Story

Nora is haunted. She's haunted by the past, haunted by the future, and haunted by the boy in the toy room. Wanting desperately to fall back in love with her husband, Nora moves back to the country to work on building their dream home. Building dreams isn't easy, though: she'll have to fend off a drunken ex, contend with an interfering mother-in-law, and try to keep a battered rental house from falling down around her.

Meanwhile, someone has been breaking into the house, and her daughter's imaginary friend, the boy in the toy room, seems to be trying to burn the place down. While the men around her rage and bluster, it's Nora's job to hold things together and keep her daughter safe, whatever the cost. 

 

And don't forget Waking Up Dead: An Endless Mountains Ghost Story

If Deidra Shay had known she was dead, she might have made other choices -- but she didn't. When her best friend, Jesse, finds her body and is pulled away screaming and crying, Deidra follows her home and all hell breaks loose! Friends and family are pulled into a maze of love and sex, revenge and redemption as Jesse and Deidra struggle to figure out how to go on living after waking up dead. 

This is romance, a testimony to friendship, and one answer to what life might be like beyond the grave for both the person moving on and the people left behind.

Blog Index
The journal that this archive was targeting has been deleted. Please update your configuration.
Navigation

Old And Still Evolving

photo by Angela Episale

Someone once told me that, "To live is to dream; to dream is to live." As I get older people I've been young with and dreamed dreams with are falling, one by one, into a state of perpetual stillness. Dreams are scoffed at and put into "when I was young" and "before I knew better" categories. This is the blog of someone who hopes to never know better. It's the rambling of someone who should know who they are by now, and doesn't -- someone who is still evolving. 

 

Entries in CANCER (2)

Thursday
Aug102017

THE SURGEON AND BIOPSY

The Breast Cancer Experience 2

Regge Episale

 

            Mike went with me to my first appointment. I’m glad he did. There was a lot to talk about and a second person is good. Two heads are better than one. The Breast Center in Scranton is easy to find. Go across the bridge and turn right on Penn Ave. Parking in Scranton is annoying, just like in Harrisburg, but there were plenty of spaces. It costs twenty-five cents for ten minutes, and I’ve never been there less than two hours, so bring lots of quarters if you ever have to visit.

            The waiting room is clean, bright, and well decorated. There are magazines, toys (although I’ve never seen children there) and a TV. Everyone is friendly and upbeat. I handed the receptionist my medical reports and disk, and she handed me a stack of papers to complete: medical history, family history, personal history, etc. I guess it’s good I had a long wait because there was a lot to fill out. Finally a nurse called me in for the basic things: blood pressure, temperature, weight. She apologized for the wait and said that Dr. Kelley is often late but that is a good thing since she always gives each patient as much time as they need. “Her patients love her. They feel she’s worth the wait.” Truthfully, I didn’t mind. The entire atmosphere was comfortable and every person who dealt with me gave me their full attention.

            Dr. Kelley herself was sixty-two years old, upbeat, warm, smart, attractive and relaxed. She teaches surgery at the new medical school in Scranton and has spent her entire career working with breast cancer. Her credentials are impeccable. She reviewed my medical history and was impressed with the long list of cancers in my family. I didn’t have information about my father’s family, and since then I’ve learned that cousins on that side have a history of breast cancer but even without that information, there was plenty to discuss. Dr. Kelley never talks down to people, does talk about the evolution of the study of breast cancer and all of the time is checking, looking, and sharing information.  

            She explained that she didn’t feel I needed a bilateral 3D mammogram because the ultrasound and MRI provided by Endless Mountains Health Systems were excellent and I have a breast density of II. On a scale of I through IV, with IV being very dense and hard to see through, mine are fairly transparent. (That’s information provided in your mammogram report and you should ask your doctor about it. It’s important. Dense breasts can hide things.)

            At the end of the exam she told me the next step was a biopsy. My heart sank. I expected to be sent somewhere else and given another appointment, and that wasn’t the direct route I had in mind. “I’d do it right now if I could,” I told her. “How long before it can be done?”

            She looked surprised and happy. “I can do it right now if you are willing.”

            “Here?”

            “Yes.”

            I was thrilled. She then told me that when she offers to do the biopsy immediately, many women say no, they aren’t ready, make another appointment for a week away, and run. I, on the other hand, just wanted to move forward. Cancer is cancer, time is of the essence, and the sooner things got moving, the better.  

            I was taken into a small operating room where I disrobed. Mike didn’t feel that he needed to be with me, and the doctor said there wasn’t room for him anyway, which was true. There was a sink, a cupboard, an ultra sound machine, an operating table, and just enough room for the doctor and technician to stand, one on each side of me.

            When the nurse tried to get the tumor on the ultra sound machine, she couldn’t find it and had to ask me where it was. That made two technicians who had trouble locating the lump and I felt better about not recognizing it sooner myself. It was far back under the arm, really in the location of the lymph nodes.

            I had heard stories about the pain of biopsies and had had a kidney biopsy in the past that really hurt, so was prepared for an unpleasant experience. I was right and wrong about that. Doctor Kelley used some kind of pain killer to deaden the area, and that worked fairly well although it didn’t deaden the discomfort completely. Dr. Kelley warned me that the needle sounded like a drill and some patients thought it must be old fashioned but it’s not.

            They turned the ultra sound screen toward me so the doctor and I could both see it. It was fascinating. I saw the tumor and saw the biopsy needle go in. It’s hard to explain it exactly. The biopsy needle isn’t thin like a needle you get a shot with. It is larger so it can collect tissue samples. The doctor had to push a little and on the ultra sound I could see my tissue resist before the needle got through. It didn’t feel good, but it wasn’t really bad. There was a whirring sound, more like a dentist drill maybe or a small compressor, and I could see a small vertical line twist as the suction picked up a piece of the tumor. She took nine samples. We’re talking about nine samples of a 12 mm area. It was hard to believe there could be anything left. I joked with her that the tumor was so small, she might as well remove the whole thing while she was in there. She laughed but said that no, she wasn’t allowed to do that.

            When Dr. Kelley withdrew the needle, she said, “Yep, this looks like cancer tissue. We’ll wait for the report, but that’s what it looks like.” I wanted to see the sample, see what a cancer tissue looked like, but she covered it and handed it to the technician. I guess some people get squeamish. I would like to have seen it.

            A bandage was applied and I was told not to stress the site, not to use my arm for heavy lifting or moving, and then was given a detailed list of instructions. The nurse and doctor joked with Mike about sweeping and mopping, and how to do it. A return appointment was set for a week later at 4:15 p.m. so we would be the last appointment of the day. Dr. Kelley explained that if the results were positive, she wanted us to have all the time we needed to ask questions and get an idea of what to expect. “Bring your cooler of beer, a bottle of wine,” she joked. “You might want to stay awhile.” She then walked us out, chatting as if we were old friends. She has a knack for that.

            It was time to wait.

            I was surprised on the ride home to realize I felt drained and tired. Sometimes I have a strong blocking mechanism that fails to let my emotions register. I guess that was one of those times.

            I can’t remember how many days it took to get the results. I remember getting a call from Dr. Kelley’s office, or maybe I had to call them. I do remember them asking how I was feeling after the biopsy. They then asked me if someone was with me, and if I had a place to sit down. I laughed. “I don’t need someone with me, and I am sitting. It’s positive, right? You can tell me.”

            “Yes. Dr. Kelley will go over it with you at your appointment. Are you sure you’re alright? Do you have any questions for me?” I didn’t. “I’m so sorry, but you’re in good hands.”

            I wasn’t upset or alarmed. I felt like I’d known the results for weeks. I just wanted to get the tumor out. I was glad when the dressing came off of the biopsy site. The tape left an ugly red scar that doctors mistook for the surgical site later on. I wonder if that scar is going to last longer than my scar from the other, deeper incision. 

 

 

 

Wednesday
Aug092017

WHAT'S WRONG WITH ME? 

My Breast Cancer Experience 1

Regge Episale

 

             At Christmas of 2016, I didn’t feel right. I had been under a lot of stress physically and emotionally, but that wasn’t really new for me. I usually rise to any occasion with a can-do attitude and take on any giant. December was different. I was tired, every little arthritis spot in my body was screaming to the point of being disabling, and I couldn’t think straight. I forgot things. I repeated myself. I didn’t remember what other people had said. I am not a person who struggles with anxiety, depression, or impatience, but I was struggling with all three. And I was tired. My energizer bunny was out of batteries. Something wasn’t right.

            “You drink too much.”

            “You’re worried about money.”

            “You’re getting older; it’s time to slow down.”

            “Mom, I’m worried about you.”

            I was worried about me, too. I wouldn’t remember exactly when it began if I hadn’t trusted my doctor. We have a twenty-year relationship and he knows I’m not a hypochondriac. He knows that if I tell him something is wrong, then something is wrong. The previous summer I had had a stress test, a scan of my carotid artery, and a biopsy of a nodule on my thyroid. All were good, so those were ruled out. He went looking.

            The first test was a CT scan of my lungs and spine. “It’s probably your thoracic outlet syndrome, but let’s make sure. I don’t want to assume and miss something important.” I do have thoracic outlet syndrome and arthritis in my neck, but there were no growths, no separations, and no signs of something new. He gave me an arthritis medicine and an appointment for my yearly checkup in April. The medicine made me sick so I upped my Aleve for daytime, increased my alcohol for sleep, and went on.

            One thing I questioned. My temperature, which is always around 97.6, was suddenly consistently higher: 98.4 – 98.8. Sometimes it was even 99. That was a low-grade temp for me. There was no explanation. I had swollen glands in my neck and under my arm and figured they had something to do with the fever. I thought I had some kind of virus or infection trying to take over and my body was fighting it off. That would explain the fatigue.

             Spring means concerts and plays and recitals, so I spent more time traveling back and forth from Montrose to Harrisburg. I spent less and less time going out with friends when at home. My memory continued to betray me. After one night of teenagers stealing a bottle of vodka and a friend becoming obnoxious and belligerent, Angela and I decided neither of us would drink anymore and there would be no liquor in her house. It helped her to focus; it helped me to recognize that the pain was real and intense. It also escalated my anxiety. I realized that my thoughts were too dark, my body was too tired, and my sleep was broken and not restful. I would wake up thinking about what I had to do, toss and turn trying to get comfortable, and something new started: I had night sweats.

            Anyone who knows me knows that I am never warm enough. I wear sweatshirts and jeans when others are in T-shirts and shorts. I have only one wardrobe: a winter wardrobe. Now, I found myself drenched in sweat, changing my clothes in the middle of the night, and feeling more and more tired. I went through menopause over twenty years ago and haven’t had hot-flashes since but even when I did, I didn’t have night sweats.  And my thoughts became darker and darker.

            Angela planned a Florida vacation for us at Easter. When she called me all excited to tell me the plans, I felt exhausted just thinking about it but I didn’t want to spoil it for her. We drove to a wonderful place on the beach and I tried to hide how tired I was. And then we drank too much. Poor Gabe got under my skin and I got mad at him, much to Angela’s shock and dismay. I went into a total drunken rant about how everything was so horrible in my life, how I felt used and misused and exhausted and angry. My sister came to rescue me but in truth, she was really rescuing Angela and the kids. She told me what I had said, how much I had had to drink. I tried to tell her that there was more to the problem. Something was wrong with my brain. By drinking, I had given her and everyone else a good reason to discount that fear deep in my head, but I knew. I knew it wasn’t like me to even have those thoughts, drunk or not. I knew I couldn’t drink as long as those thoughts were buried inside there somewhere. I quit again, but it didn’t help my brain.

             I accidentally took Angela’s car keys home with me. I must have returned them the next time I visited, but I didn’t remember that. Two weeks later I visited again. Before going, I searched my house, my purse, the hook I had put them on for safe keeping, my car, and everywhere I could think of. When I got to Angela’s, I told her I had lost the keys. She laughed and showed me where I had put them on a hook at her house the last time, making a point of telling her where they were. I didn’t remember any of it. At another point Angela said, “I’m worried, Mom. You aren’t yourself. You forget a lot.”

            I started having numb spots in my head. I would be driving and the entire back of my skull would go numb. Sometimes my face would go numb. Sometimes I was afraid to keep driving but would, just to get to where I was going. My yearly checkup was only a couple of weeks away, but I called my doctor again. He did an MRI of my brain and ordered my annual mammogram. “Arthritis and stress will cause those symptoms, but let’s be sure.”

            I did some in-depth research, this time not reading about cancer, but rather reading reports on each symptom. Every single symptom had at least one clinical study relating it to cancer of one kind or another. I messaged Angela: Look at this. Fatigue, depression, anxiety, fever, night sweats, personality changes, brain fog. It makes me hope I do have cancer so they can fix it.

            By the time I went for my mammogram, I knew that that swollen gland was really a small lump, and I knew that every single symptom I had could be attributed to some kind of cancer. I was grateful for all of those tests run over the past year because I could already rule out some of the scarier things. My biggest fear was the results of the MRI, but recent clinical studies show that what doctors once considered chemo-brain-fog can actually be cancer-brain-fog. They believe it is due to proteins that a tumor puts out. I was hopeful that I wasn’t crazy, but I wanted to see that report.

             The letter saying the mammogram was questionable didn’t surprise me. I watched the ultrasound and when the tech had trouble finding the tumor I was able to show her exactly where it was. I watched as she measured, studied the shape, and knew I was looking at a tumor: a small one, but a tumor. That didn’t surprise me, either. I’d done the research.

            I feel a little sorry for Dr. Dana. He walked into the office with the test results, put them on his desk and said, “The MRI is good, but you won’t like the ultrasound.”

            “Oh, I know. I have a tumor. May I see the MRI?”

            He handed it to me. “It’s very good,” he said.   

            “It says there is central and bifrontal cortical atrophy!”

            “Mild borderline atrophy appropriate for your age.”

            “I don’t care if it’s appropriate. I don’t like it!”

             “You don’t even have sinus problems. This is a perfect MRI. I want to talk about the ultra sound.”

            “I understand. There’s a tumor.”

             His voice raised slightly, “You know we’re talking about cancer, right?”

            “I know that. I can live without a breast. I can’t live without a brain.”

            The ultrasound didn’t mince words. “Small irregular shadowing highly suspicious 12 mm lesion in the axillary aspect of the left breast, corresponding to a small mammographic irregular density at this location; this is most likely a small malignancy and tissue sampling is highly recommended.” I needed a biopsy to be sure, but in all likely hood, this was cancer.

             Dr. Dana seemed frustrated and impatient. He sat at the desk. “I’m referring you to the Breast Center in Scranton.”

            “Not Lourdes or Robert Packer?”

            “This is the Breast Center. It’s all they do. They are the best.”

            “Okay. But I want the fastest appointment I can get. If they can’t get me in, I want you to check with the other two.”

            “I’ll put that in the notes. See?” He turned the screen toward me so I could see the instructions that said that if I couldn’t get in right away, the referral desk should check with Lourdes and Robert Packer. “I’ll have you in within a week.”

            And I was.

            I had a lump under my arm. It was so close to my glands that I honestly didn’t think it was a lump; I thought it was a swollen gland. It wasn’t until it didn’t go away that I recognized what it might mean. Also, as women we are taught to look for dimpling of the skin, nipple discharge, discoloration, a change in breast size or shape, or a lump (although most of us have changes in old breasts, and if you never had a lump, it isn’t easy to recognize early on). I had only one symptom of breast cancer: a small lump under my arm. I had many other symptoms I didn’t know about: brain-fog, night sweats, personality change, anxiety, depression, low-grade fever, and increased joint pain. Many things cause those. In my case, they were caused by a very small, very new cancer. I could have missed it. I am grateful for that annual mammogram and the habit of examining my own breast. I am grateful for the internet where I can find a lot of nonsense, but where I can also find actual clinical studies. I am grateful I have the ability to read those studies. I am grateful for a doctor who listens and talks to me. I guess I am just grateful in general.