Bone Marrow Biopsy - Caught on Camera

I have started to document my journey into Cancerland on film, and decided to record the notorious bone marrow biopsy and aspirate. The video is divided into two parts, and reflects my second fabulous experience with this procedure, which took place earlier today.

Part I



Part II



This blog is also posted on Planet Cancer.

Putting All My Eggs in One Test Tube

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After a week of giving myself multiple injections that by all accounts made me look like a heroin addict, the grand finale of my fertility treatments was finally upon me. As I had done every day this past week, I visited the fertility clinic and was requested to, how does one put this delicately, spread for bread. However on this particular morning, the doctor was no longer simply monitoring the growth of my eggs. Today, he would be the gynecological equivalent of the Easter Bunny and collect as many little eggs as possible through my bulging ovarian baskets.

Thankfully, I chose to undergo the procedure under general anaesthesia, since there is something about poking fourty odd holes in my ovaries while awake that just doesn't sit right with me. My hubbie calmed me before the procedure and fed me chicken soup after it was done. Of course it was a big day for him too, and he valiantly performed on demand to produce his noble contribution to the cause. Despite the fact that these embryos have found their start as test tube babies, there is still something magical about the process and we both felt an undeniable sense of glee and awe at the reality of what was going one. These little guys (or gals) are just cells sitting on a shelf for now, but they could one day be our future children, waiting until the right time to make their entrance into this world.

It's My Parody and I'll Cry if I Want to

Lying down spread-eagled, clothes slumped haphazardly over a chair, brimming with hormones and ready for a large object to be inserted into your nether regions may sound like a perfectly delightful, deliciously lustful way to start a 31st birthday. But when you are lying on your back in that most compromising position in a sterile doctor's office, your feet inelegantly splayed in stirrups, and the object in question is an ultrasound device designed to assess how your eggs are growing, you don't exactly feel like Bringing Sexy Back. Nor are you, at that very moment, particularly into doing it like they do on the Discovery Channel. But you do feel a lot like an animal. Like a fish that has been pumped with hormones to produce enough caviar to feed a small country. Or like a chicken injected with drugs to generate extra, extra large eggs. Or like a cow given a boost of chemicals to enhance its milk supply. You get the point.

And when the plan is to have your eggs fertilized and then frozen until you are in remission from a relapse for Hodgkin's Disease, assuming remission is even achieved, the ultimate goal of these fertility treatments, which is to produce a Baby-Gap clad bouncing bundle of joy, feels virtually unattainable and almost ethereal.

Between getting cancer and worrying about related fertility issues, and now having what by all accounts appears to be a relapse, things have not exactly been looking up for me. To make matters worse, on this particular visit to the McGill fertility clinic, I was flying solo, since my hubbie had a meeting back in Toronto and had to miss my appointment. Having no desire for my doting parents to accompany me to the exam (I have my pride...), I went to the clinic alone.


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To top things off, it was my birthday. As I lay down with my loins spread open, the doctor carefully measuring the size of my follicles (the sacks that contain eggs) on the computer screen, making vague attempts to engage in polite chatter, I made the decision that this year, I was going to have a non-birthday. Because most of my thirtieth year had been spent in hospitals enduring mildly unpleasant to downright painful procedures, and feeling like a toxic waste site (and one that is, moreover, dangerously back-up) from all the chemotherapy and radiation and anti-nausea medication, I concluded that this year would simply have to be a re-do, at least from an emotional perspective. Like a major tax write off, my 30th year would simply be wiped out and I would have another go at it.

At the end of my appointment (which had been interrupted by a fire alarm), I asked if the doctor who had been following me would be available for the final "collection", the procedure where the eggs are all sucked out through a small needle aspirate. The day of collection is timed to precision based on the exact point when the eggs reach maturity but before ovulation, and for me, that day would fall on a Saturday. The doctor explained that he would be away that day, so a colleague who was on call would perform the procedure.

I left the hospital, simultaneously inflated with dozens of ripening eggs and deflated by the final blow I had received, that some unknown doctor was now going to be responsible for sucking out my potential future children. As I walked down the hospital hill towards the street, the icy February chill numbing my fingers, the daily fertility injections causing me to feel at times totally erratic, and at times strangely erotic, I did the only sensible thing to be done under the circumstances: have a good long cry and wallow in self-pity.

Back in May, 2007, tests were well underway to determine the cause of the mysterious lump on my neck. I spent weeks looking like the Michelin Man with a huge bandage plastered on my neck from my biopsy, and went through a round of fertility treatments once the diagnosis had been established and chemotherapy was imminent. Now, nine months later, I have another ominous lump on my neck and the test results do not look good. It must be some cosmic joke that I am getting these lumps at the right intervals but in the wrong places - how much nicer it would be if they had only been larger and on my tummy...

So I have found myself going through another round of fertility treatments in order to gather some more eggs before receiving the aggressive chemotherapy it is expected that I will need, and about to embark on another surgical adventure to remove the brand new node from my neck. This whole thing feels a lot like Groundhog Day anyway, so why not just have another go at being 30?

Back to Work: The Cancer Vacation is Over

Yes, it's been a while since my last post. As they say, no news is good news. The holidays came and went, and involved staying at my husband's family cottage along with about 25 other people, including seven children under the age of eight. (Like clockwork, a new critter has been born into the family each year for the past seven years). Then there were two dogs, one of which perpetually had drool icicles hanging down his jaws. Whenever the dog would shake his head vigorously, in the way that dogs do, the stretchy saliva would haphazardly land on a stairwell or on the water cooler. Add to the mix some mice and throw in the stomach flu, and you have yourself a party.

I returned to work on Thursday, January 3rd, after barely recovering from the stomach flu that I had managed to dodge until New Years day. Between chemo and the stomach virus, I now consider myself an expert in puke. There are many different types and styles of puking, which vary based on the individual but also the cause. The stomach flu, for instance, can involve some truly impressive projectile vomiting, whereas chemo vomiting is more controlled. If you aim for the toilet, it all gets in.

But enough about that. Work is going well. It was inevitably awkward to return after a six month hiatus, and on my first day back I stayed close to my office, a little anxious to stray too far away from my home base. By the second day things already began to feel normal again. I received the usual array of odd comments. During a brief encounter in the washroom, a partner on my floor said: "I haven't seen you around in a while, guess you've been hiding in your office!" Then there were those who gave me the old bait and switch, the bait being a sympathetic call asking how I am, and the switch being the part where they ask me to work on a new deal. The best was the frantic call I received on Friday at 4:30 p.m. about a new deal that needed all documentation prepared for Monday morning.

The bottom line is that most people are self-interested. When you return to work after having something like cancer, expect very little sympathy. Your doctor may want you to take it easy for the first few weeks just to ease back into things, but in practice if you say no to too many things, you are bound to stir up some discontent.

That being said, several people took me out for lunch to welcome me back to the firm, and others dropped by just to see how I was doing. Overall it is good to be back, because it means that things are getting back to normal.

And the Holiday Parties Begin...

Even though I have not yet returned to work, I decided to make an appearance at my firm's holiday party. It was an opportunity to catch up with colleagues and watch the articling students perform their highly anticipated skits for the evening's entertainment, and it all seemed like a peachy idea until the day before the event, when butterflies began to take up permanent residence in my belly.

You see, unlike other work events that I had attended while on leave, the holiday party included more than just the lawyers. Pretty much everyone at the firm attends the event, from law clerks, to assistants, to kitchen staff. The holiday party is in fact more of an annual staff appreciation evening, where nine-to-fivers and overtime employees are thanked profusely for putting up with the demands of quirky, workaholic lawyers.

While I had already made numerous wigged appearances in front of my fellow lawyers, this would be my grand debut as a blond in front of the staff. Admittedly, this may sound a little self-centered - who really cares if I show up, and why does the colour of my hair even matter? The world does not revolve around me, whether or not I have been on a six-month cancer vacation. And why would the staff take particular interest in the arrival of a chronically absent mid-level associate?

When you work in a law firm, you quickly find out that it is the assistants who carefully cultivate and fuel a sophisticated system of gossip that rivals the London Underground in its vastness and complexity. If you want to know which lawyer is having marriage troubles, who is leaving the firm to work with a competitor, or who is expecting, you simply need to tap into the Network of Assistants who Gossip (NAG).

Lawyers would probably want to gossip as well, but they don't, mainly for lack of time. Plus they are isolated in their offices, working independently most of the day (and night) and often remaining at their desk during lunch. This frequent isolation and intense focus on work is why a number of lawyers at my firm actually have no idea that I am on leave (and this includes lawyers who work in my department), despite the fact that I have not stepped foot into the office for six months, and that a jet setting colleague from the New York office uses my Toronto office so often he practically has squatting rights.

Unlike lawyers, the assistants work in open-concept cubicles in the company of others, a veritable breeding ground for gossip, and every day at noon they meet in Ikea style lunchrooms where they can disseminate all the latest firm news. So perhaps now you can appreciate the anxiety that was building up inside of me during the hours preceding the holiday party, where I would make my entrance in a voluminous wig (to cover up my pathetic wispy hair) and in a high necked blazer (to hide my gross radiated skin), the Schadenfreude practically palpable among the assistants.

As luck would have it, on the day of the event, I was having an undisputed good wig day. You may initially assume that a wig will always pretty much look the same because, well, it's a wig. While synthetic hair isn't quite as unruly as natural hair, wigs still vary considerably in how they will look on a given day. Some days, they just have too much volume and you look like you are stuck in an episode of Dallas. Other days, they are a mess of static flyaways. But once in a while, they can actually look pretty decent. And on the day of the holiday party, I looked like I had just stepped out of a salon sporting real, actual, honest-to-good fake highlights and a great blow-out. In a world of bottled blonds, hair extensions and Jessica Simpson hairpieces, natural hair is a relative term and wiggies like me are just a little further down (okay, way down) on the spectrum, especially on a good wig day.

So the moment was finally upon me and I ventured into the Royal York hotel, past various other corporate parties until I found the right one. As planned, I arrived just as cocktails were winding down and dinner was about to begin, wearing my carefully selected BCBG Christian Jacket, which not only managed to have flair and remain professional, it also had the distinct advantage of having a collar high enough to cover up my peeling skin.

As soon as I entered the cocktail room, I bumped into colleagues and the conversation was neither stilted nor awkward. There are a cluster of lawyers who follow-up with me regularly to chart my progress, and it was good to see them.

I gradually made my way into the reception and to my pre-assigned table, which consisted of a semi-circle of assistants, facing a semi-circle of lawyers. It was clear that the hour-and-a-half of cocktails had gotten the party started. One assistant, sitting directly opposite me, shouted from across the table that it was good to see me, and when was I going to return from my leave. Well, anyone at the table who might not have been aware of my questionable status now certainly knew. I politely replied that the plan was to be back in January, and then attempted to divert the attention away by complementing her on how well her necklace matched her blouse, which seemed to do the trick.

The remainder of the evening went relatively smoothly. There was the odd employee or too who exclaimed, "Where have you been!" - to which my cheeky reply is always, "Where have YOU been?" One computer tech person, after asking how long I have been married and hearing my reply of four years, seemed absolutely flabbergasted and asked "And you don't have kids?" I chose not to promptly disintegrate into a spiral of depression and instead gritted my teeth and excused myself. To his credit, he is a nice guy and did try to recover by saying, "waiting to become partner, are you?"

By the end of the evening, it was clear that NAG was in full effect, since all the assistants who said good-bye added that they would see me in January when I was back at work. Which led to some puzzled looks from the lawyers who asked if I had been away. To which I replied that I was just hanging out for a bit and would be back soon.

Wigs Can Fall Into Toilets - And other perils of an afternoon out after chemo

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Life can get a little more complicated when you've had cancer and prefer that passing pedestrians were none the wiser. Simple things, like an afternoon of shopping and exercising, now take cunning, skill, determination and balance.

The afternoon might proceed as follows: Walk into stores blasting "All I Want for Christmas Is You". Try on belted dresses, frilly tops and cropped jackets in search of the perfect outfit for upcoming holiday parties. After slipping on each outfit, carefully reposition wig. Exit fitting room, since store strategy is to place mirrors outside of stalls so that salespeople can walk up to patrons and gush over how perfectly the garment fits while thinking how dreadful it really looks.

Complete shopping experience without any luck and continue on to gym. Walk into said institution, step into locker room and dart straight for the bathroom. Remove wig, tuck into gym back, and retrieve pink and grey bandanna, carefully chosen to coordinate with pink and grey Lululemon ensemble. Gently comb out pathetic wispy hair that survived chemo onto forehead and tuck behind ear to try and create illusion of boundless tresses. Check hair in tiny makeup mirror. Ensure that top is zippered all the way up to the neck to hide spectacularly unappealing, or more accurately, unapeeling, skin from radiation burn. Exit bathroom stall. Attend class.

Following class, repeat steps in reverse, carefully balancing wig, bag and bandanna in tiny cubicle and gracefully catching wig just before it falls into public toilet bowl and floats there like a dead rat, mocking all Herculean efforts to appear normal. Place pageboy cap back on top of wig so that blond hair becomes less conspicuous relative to mousy brown hair seen peeking out of bandanna. Leave gym and walk home.

All I want for Christmas is hair! And all I want for Chanukah is health.

What Does it Mean to be Sick?

When I was diagnosed with Hodgkin's Disease, there were a lot of things that I wanted to learn. In addition to educating myself about the disease, I wanted to understand more about what it meant to be sick in general, and to have cancer in particular. There is a whole language associated with having cancer that reveals how emotionally charged and socially constructed it is. You hear about someone's "battle" with cancer. The person who has it is admired for being "strong" and never complaining and "fighting" through it and is often considered a "survivor" whether or not they survived and whether or not they are cured.

I was already beginning to feel the stigma associated with having a disease like cancer. One or two well-intentioned family members advised that I keep very quiet about my diagnosis and that I should limit the number of people who I told. In their view, there just wasn't any need for colleagues or acquaintances who didn’t really care about you to find out and to start gossiping. There was a concern that these people would then see me only as the one dimensional "sick person" rather than as "Andrea".

When it comes to cancer, there is just such a range of perspectives and beliefs. Some people, whether consciously or unconsciously, even feel that reading an article or seeing a movie about someone who is sick could bring on bad luck, or that cancer is somehow contagious and that you might "catch" some terrible disease by being around someone who has it. This is sometimes called magical thinking. I for one have skipped reading obituaries due to a very irrational fear that they would somehow result in bad luck. (So much for that theory...)

There is certainly a tremendous, raw sense of fear, partly rational, and partly irrational, that a great number of people associate with the disease. Cancer is associated with many scary things, like chemotherapy and hair loss. Oh yes, and death.

So I set out to learn about different perspectives on what it means to be sick. As it turns out, there is a whole area of anthropology devoted to this very topic, referred to as medical anthropology. I went to various McGill libraries and loaded up on textbooks and papers, which I found to be interesting although perhaps a little too dry and scientific at times.

I next turned to bookstores and always beelined for the cancer section. I wanted to read about people's experiences with cancer in order to try and contextualize my disease. I read Dr. Marla Shapiro's candid account of her battle with breast cancer in Life in the Balance . I read John Robert McFarlanes touching, even charming stories of how cancer has changed him in his book, Now that I Have Cancer I Am Whole.

I also tried to prepare myself for what lay ahead and to gain a better medical perspective on cancer.
My all time favourite book in this category was, without a doubt, Chemotherapy and Radiation for Dummies. I also read Cancer is a Word, Not a Sentence: A Practical Guide to Help You Through The First Few Weeks . The main thing that I got out of this book is that "cancer" is a misnomer. In fact, there are disparate kinds of cancers and they are each vastly different diseases. Lumping them all together is like lumping all viral infections together, from the common cold to HIV. If "infection" were a term as loaded as cancer, then it would be hard to cope with hearing that you had an “infection”, even when all you have is a cold.

I do think that the author, Dr. Robert Buckman, makes a valuable point. But at the same time, there really is something concrete that binds together most cancers, and that is how they are treated. There is a real bond you share with others who have gone through chemotherapy or radiation. And so, there is a veritable culture that has developed around cancer. There are sub-cultures for survivors, and for their family members, for children, young adults, and for women. The list goes on. And then there is the culture of cancer that has permeated society as a whole. There are pink ribbons and yellow bracelets and runs for cures and enumerable charitable foundations.

From time to time, I planted myself in a little corner of the cancer self-help section of Chapters and Indigo and read excerpts of many other books, for as long as I could in a single sitting until a dutiful bookstores employee asked me, as politely as possible, to stand up as I was not permitted to read on the floor. (How annoying is it that there are so few chairs in bookstores? But I guess that's the whole point - they aren't libraries).

Along my literary journey, I learned so many interesting perspectives. I encountered the feminist photographer Jo Spence, who used phototherapy (literally using photography to heal) to document her experiences as a patient with breast cancer. Some of her views were a little too extreme for me, but the point is that she presented her disease as a social experience.

I watched the documentary, Crazy Sexy Cancer, about a young woman, Kris Carr, who is diagnosed with an incurable type of Stage 4 cancer, and as she notes, there is no stage 5. Kris sets out on a journey into alternative medicine, and discovers various treatments, some helpful, some counterproductive, and some plain wacky. She meets fellow survivors along the way, including Glamour editor Erin Zammett Ruddy, who has leukemia but was able to control it by taking a drug called Gleevec. She makes the difficult decision to go off the drug in order to get pregnant, and we find out from her blog that she ultimately gave birth to a gorgeous baby boy. But lightening struck twice when Erin's sister Melissa was also diagnosed with a blood disorder - Hodgkin's. I had read about Melissa's story before the documentary came out and we actually exchanged a few emails when I consulted her about radiation. She was incredibly compassionate and responsive.

I also went to an amazing young adult cancer support group in Montreal, and in our sessions have cried but have also laughed very hard. I approached the first session with a great deal of trepidation and uncertainty (what would these people be like…? Oh yes, I was one of them…), but since then have felt tremendous warmth and camaraderie from the group.

So, what does it mean to be sick? What does it mean to have cancer? It means a lot of different things to a lot of different people. It means that life is fragile. It means sleepless nights. It means pain and it means that wounds heal. It means that life is not always fair, and that you sometimes end up in a club that you didn't ask to be a part of. It means summoning inner strength and courage and discovering there are reserves of it deep within. It means that some people care and some don't. It means get well cards and telephone calls and packages and lunch dates. It means love and fear and compassion and reaching out. It means finding what you need from the most unexpected people and places, and being able to give in the most unexpected ways. It means hope and faith. It means that we are all going to die and it can mean a new lease on life. It means treatment and support and self-healing. It means acceptance and it means fighting back. Perhaps it comes closest to being a microcosm of life, of experiencing life in its most concentrated form with all of its ups and downs and lows and highs.