Wednesday, June 29, 2011

Life Preserver



Great is your compassion, O LORD; preserve my life, according to your judgments.
Psalm 119:156, Book of Common Prayer

            I had a mini-meltdown in the kitchen this morning, which only served to remind me how much energy it takes to keep my emotional hatches battened down the rest of the time. Last night when I got home from work, there was one message telling me that surgery Friday was backed up half an hour. That meant I could sleep a bit later, but also meant that I had to change plans with my driver. The details of arranging things for surgery are niggling annoyances. 
            And then there was the other call, from someone in my gynecologic oncologist’s office, who left no message except her name and phone call.
            It was too late to call back. I convinced myself that it had to be a schedule change, with no relationship to the CATscan I’d had last week. I remembered the time a nurse in his office had called to say the doctor wanted to talk to me. I nearly died of fright. At least, I told myself, it wasn’t himself calling. I didn’t want to learn that my surgery had to be postponed altogether because something bigger and badder was going on in my abdominal cavity. Or to find out—and of course this had to be it—that the pain in my hips in the morning had nothing to do with aging and everything to do with end stage bone cancer.
            When the office opened, I called, but the woman who called wasn’t in and the nurse who answered didn’t know why that woman had called. She confirmed the date and time of my appointment and gave me the woman’s voice mail. I left a message, and she called back within a few minutes.
            Nurses, hospital staff, and even doctors are all human. She was calling merely to find out if I had kept my appointment with the bladder guy. She didn’t see the note that my gyn onc had already called to talk to him, not until that very minute on the phone with me. I could connect the dots—the tumors the bladder guy is removing on Friday showed up on the CATscan, and my gyn onc was making sure everyone knew they were there. Sometimes I love him for his attention to detail; sometimes I wish he’d take a vacation, be a little less dedicated.
            I asked this woman to put a note in my file saying I lived alone and had an active imagination and that all future calls were to be specific. The HIPPA privacy rules mean that no detailed messages are left, unless I make it clear that I want such things. She apologized profusely; I told her my heart rate was returning to normal.
            I took a lot of deep breaths and got on with my morning routine. At the healing service at church, my priest spoke of how we don’t need to go it alone, a sermon just for me. I went forward to be anointed and prayed for; the other women hugged me and assured me of prayers. But all day, my body has been upset. It had faced news of a recurrence of the dangerous cancer, even if the news was fabricated in my own mind, and it wasn’t happy.
            Instead, I was thrown the life preserver of God’s loving compassion, mediated through good people around me. I don’t suppose it’s a coincidence that all this occurred on a morning when I was already headed to church. If it had been bad news, there would have been people to help me through it. I am not alone.

Monday, June 27, 2011

The Reality of Surgery



I know I’m headed to surgery, have known it for weeks. But it gets a little more real when I have to stop taking my fish oil and Vitamin E supplements a week before the event, a date I’ve reached. Any anti-inflammatory OTC meds are verboten as well, but I don’t keep a stock of “pain relievers.” I’ve learned to live with a bit of pain and to treat it with fresh air and walks, with massage, reiki, and acupuncture.
My pre-surgical instructions, along with the usual ban on eating or drinking after midnight the night before surgery, also call for stopping over-the-counter herbal supplements. That means, I suppose, no cinnamon (to regulate blood sugar) or red yeast rice (to help with my tending-toward-high blood pressure). I’m a little confused about this, so am taking a week off from all the vitamins and supplements I take.
But I really know I’m going to surgery when I start dreaming about it, as I did recently. In that dream, surgery was canceled, though I showed up, which is when I found out that my doctor had decided to deal with the tumors in his office, one per visit, one visit per week. This would stretch my dealings with him to seven or eight weeks, which angered me in the dream. Not because he’s a bad guy, but because of what it would cost.
Maybe that was the crux of the issue. I’ve received estimated bills for his services, as well as bills for the last two office visits. I do have insurance, albeit with a high deductible I’ll be able to meet. I still have a 20 percent co-pay, however, and that gets pricey. Bye-bye summer vacation.
That’s what I resent—along with the lack of ever being free of the disease— the feeling of being unable to count on discretionary funds again. They will all go to the good people keeping me alive.
Last night I ran into a nice man I rarely see, and the first thing he said was, “I haven’t seen you in awhile. Did you beat the cancer?”
I try not to be bitter, but I heard myself say, “You don’t beat cancer. It beats you.” I truly believe that, not only because I’ve had so many friends die of it, but also because it’s a wearing-out disease. Having cancer places an enormous emotional stress on us, and it’s not easy to share that burden. Our loved ones have their own burdens of “What if I lost her/him?” or “How can I help?” We don’t want to talk to strangers about it. Most people who haven’t had cancer don’t really get what it means. So we join support groups or go to counseling or seek spiritual direction, all of which can help. But in the reality of Dream Time, we know the reality that surgery is coming soon.




Sunday, June 26, 2011

Lying About It


 For behold, you look for truth deep within me, and will make me understand wisdom secretly.
Psalm 51:7, Book of Common Prayer

I lied my way through church this morning. I figure when people ask, “How are you?” it’s just a social thing. Unless people already know what’s going on, the expected answer is, “Fine, and you?” I rationalize that it might be different if I were—God forbid—on chemo and bald again, but very few people at church even know about the second cancer, much less that Friday will be my fifth surgery for it.
That I attended church all during chemo reflects no special virtue on my part. I’m wired for religion, always have been. There’s strength in church, just by being in a building where prayer has been offered for more than a century. There’s beauty in the words of the liturgy and the hymns. Which is why I went this morning, when my body told me to stay home and listen to the rain on the roof. I went for purely selfish reasons—I wanted to sing (though I didn’t feel like it), and I wanted the strength of the gathered community, however ignorant I’ve kept most of its members about my upcoming surgery.
I’m not sorry I went, just sorry that I felt fragile and distracted throughout the service. My surgeon has told me he doubts I’d need a temporary bag after this surgery, but it’s hard to believe him, given that I’ve had one after each of the previous ones. I was thinking about what I could wear to church next week that would hide the bag I may not have. One of the children has taken to wearing a bunch of plastic bracelets on his right arm, and I thought about bringing him my ovarian cancer one. And I thought about the plastic band a nurse will slip on my wrist in five days, and how much I hate that band, the sign of my membership in the company of the unwell. One dear woman touched me lightly on the back when she passed my pew going up for Eucharist, and her gesture nearly undid me.
The closing hymn included the words attributed to Francis of Assisi, “All you that pain and sorrow bear, praise God and cast on him your care.” I lost it on that line—not, thankfully, with the immense sobs of which I am capable, but some tears trickled down my face. I wasn’t in physical pain, but I was bearing sorrow, for myself and for friends undergoing various difficulties right now.
There are teenagers in my church who love me. It’s a humbling thing. I adore them, and the fact that they come and sit with me after the service to tell me about their lives, just beginning to open, and to hug me. The problem is that they’re not stupid. One asked, “Are you all right?” Another came up, looked at my face, and wanted to know, “Why are you sad?” I gave them both the same half-truth, “Good music does this to me.” Absolutely true, just not the whole truth. I was sorry I had to lie and that I’m not as good at it as I would like to be. As we waited in the line to shake the rector’s hand, one of the young mothers in the church asked how I was. I told her I was fine, apparently believing in the idea of protecting the women and the children.
I left as soon as I could after that. There didn’t seem to be any point in hanging around to enjoy fellowship at coffee hour and tell any more lies.

Friday, June 24, 2011

Hidden Blessings

   
“For your hidden blessings, and for all you have in store for us . . . ”
fragment of a prayer of thanksgiving

Finding a spot in the parking deck at the hospital takes longer than getting an EKG does. (The technician was unable to explain why it’s an EKG when there’s no k in electrocardiogram.) Not willing to waste 40 miles of gasoline and time, I headed over to see “my nurses,” who took care of me during chemo.
            Perhaps you’ve seen that Sally Field movie Soapdish, in which she plays an actress no longer as popular as she once had been. When her character is depressed, her friend takes her to a mall and stages an “aren’t you ----?” The character is then mobbed and her spirits lift. The closest I get to that kind of celebrity is going to the gynecology/oncology office. I’m a wonder—a woman who hasn’t recurred in four years, who isn’t back in treatment. The nurses fuss over me and compliment me (I think it’s mostly because I have hair and some color in my cheeks). I got hugs and kisses and encouragement about the surgery next week.
            More blessings: the downtown farmers’ market was open and had fresh spinach and Yukon gold potatoes. I decided to blow off more time and to reward myself for being very good at the EKG/blood draw/urine sample session. I took back roads home, checking on the corn, much of which will be “knee-high by the Fourth of July” despite the late planting. I got to see a white-tailed deer wandering in the corn, and what may have been the largest farm vehicle I’ve ever beheld hogging the road.
The twists and turns of back roads slowed me down enough to notice two small white dogs in a yard and a robin bathing in a puddle. And yes, I stopped for ice cream at a soft-serve place, and detoured a block to drive one of my favorite streets, listening to Beethoven’s Egmont Overture and to Renee Fleming singing Mozart.
It’s true: I’m behind on my project, and if I took seriously my last rant about not having time for medical procedures, I’d have come straight home and gotten to work. And missed the hidden blessings.


Thursday, June 23, 2011

Time is Money

  My times are in your hand; deliver me from the hand of my enemies and persecutors.
Psalm 31:15

            “I don’t have time for this!” is the cry of my heart. It’s not just that I have surgery next week, but all the things that have to be done prior to that event. Now I’ve been told to get an EKG. I’ve managed to escape one for a few surgeries, but apparently have crossed some threshold. So tomorrow I will drive 20 miles one way to my nearest hospital-I-trust for the pre-surg testing: EKG, blood work, and a urine sample, just in case I have a bad heart or an infection and don’t know it.
            “I’m fine! We don’t need to do this!” I want to tell them all, but having a cancer growing in me for perhaps five years before it presented symptoms (which my gynecologic oncologist thinks is the case for my ovarian cancer) shakes my confidence that I know what’s going on with my body. I know that the medical people have my best interests in mind—and that they also want to avoid lawsuits or the embarrassment of having me die on the table from some unsuspected heart condition.
            It’s the little things, always. I’ve been on the phone to get pre-registered for my CATscan related to the first cancer, for the surgery for my second cancer, and for the EKG, just this morning. A phone call takes less time than going in to the hospital or imaging center, but it breaks my concentration. As a freelance writer, I am nearly always trying to concentrate on something—this morning, I am way out of my league, trying to plan revisions for a piece on the International Space Station. Now, instead of getting back to work, I’m ranting on the page.
            It will all work out. I “lose” tomorrow morning to an EKG, but my editors aren’t calling for my arrest. I haven’t been able to walk in the woods, one of my preferred methods of maintaining my balance; I’ve not felt that I had time, and it’s been storming for days here. Walking would help.
“All shall be well,” Julian of Norwich says. I expect them to find nothing on the EKG, and nothing on the CATscan, and nothing to indicate an infection that would mean rescheduling surgery. I need to stop carping about the time and expense of all these tests and procedures and give thanks that modern medicine has kept me alive this long. I’ll get right on that, as soon as I have time.

Tuesday, June 21, 2011

Refusing Comfort



I cry aloud to God, aloud to God, that he may hear me. In the day of my trouble I seek the Lord; in the night my hand is stretched out without wearying; my soul refuses to be comforted.
Psalm 77: 1, 2 New Revised Standard Version

Not to be offered comfort is one thing, but to refuse it is entirely another. By the end of this psalm, the writer manages to crawl out of the Slough of Despond. Still, the writer does so by referring only to long-ago history of the people, not to any present comfort.
I’ve read this verse many times over the years, but this morning it stopped me completely and sent me looking at other versions. None of them offers a cheerful variation.
Only once do I recall trying to refuse comfort: when my father died. I was living a thousand miles from my parents, in my third year of teaching, all of 24 years old. The call came during first period—the school secretary came to get me out of class. I went into shock mode, staying dry-eyed and making plans until third period, when my seniors demanded to know what was going on. One of them moved to hold me, and I protested, “Don’t, Buck, I’ll cry.” But he held me and I did cry, aware that the girls in the class were crying with and for me. It’s a holy memory for me, and the last comfort I permitted in that city. I had too much vested in my image. When I returned a week later, I was “fine.”
Many of us have images to maintain. We’re the parent, who has to stay strong or the kids will get scared. We’re the spouse, trying to be strong for the beloved going through treatment. We’re the son or daughter suddenly called on to parent a parent in chemo. We’re the person who’s always had it together and can’t let down, fearing we will “flow in grief,” as Shakespeare put it.
And so we’re fine. Even in the chemo room. I watched one day as a woman admitted to chest pains and was whisked into emergency so fast it made me dizzy. When her husband stopped in later, he told the nurse, “You don’t see her at home, when she cries. It’s really hard for her, but she tries to put up a brave front here.”
Many of us did. We were ridiculously cheerful, cracking up the chemo nurse with jokes and antics. I saw a woman come in from work wearing a stylish wig, nylons and heels. I heard a woman facing recurrence say, “Well, I’ve had three good years.” And after my only chemo room meltdown, I’ve joined their ranks. I lie at church and tell people I’m fine, two weeks away from another outpatient surgery for my “nuisance” cancer. Why bother them, when this has become my way of living?
I need to think about whether this is my way of refusing comfort.

Monday, June 20, 2011

Buddying up to Barium



Her name is Sandy. For nearly five years she’s been bringing me warm blankets and wrapping me up in them while I sit in the imaging center’s waiting room, and today I finally learned her name. Leeanne I know—she’s the one who actually does the radiation work. And Kelly, who does the intake and works with me on how I’m going to pay for this procedure that we’re calling The Last CATscan. I let them all know that it needed to be clear, showing nothing except the small bladder tumors we already know are there.
            On the drive over, hungry and thirsty, I saw a bright yellow finch fly across Hilltop Road, and I took it as a good omen. But that wasn’t the case. I didn’t anticipate being put in a different waiting room—you’d think it wouldn’t matter, but I’ve always been in the same waiting room, the one with the clock so I could gauge how close I was to meeting my time goals. (One sips barium over about an hour and a half before the machine experience; one does not gulp.) I didn’t expect that the barium would upset my empty tummy and intensify the “What? No caffeine this morning?” headache, but it did. I also couldn’t foresee that having the IV line put in my right arm would hurt, despite my “excellent” veins, nor that the contrast dye going into that arm would be even more painful—these things had never happened before. Leeanne flushed the line with saline again, and decided that the pain was due to holding my arm above my head, as instructed; she put my arm down flat on the table, which helped, and then chafed my cold hands while the dye went into my system.
            I think my body is done with it all, the way it was done near the end of chemo, when the nurses had trouble finding a good vein. I love these women for their care of me and professionally kind manner. I’m grateful for whomever figured out the new formula for barium that tastes like water instead of powdered chalk. I love going in and asking questions, learning new things; for example, 98.2 percent of the energy it takes for an X-ray is expended in heat; only 1.8 percent goes toward making the image, which is why the room is sweltering by the end of the day. But I am truly praying that this scan is clear and the last one I will need.

Friday, June 17, 2011

Seeking Comfort


Let your loving-kindness be my comfort, as you have promised to your servant.
Psalm 119:76

Sometimes, none of my tricks designed to make me content or comforted help. Yes, it’s true, I’m among the privileged—I woke up this morning, and could get out of bed and make my own breakfast. Not everyone can do that. I can still enjoy the taste of food, the morning’s chill breeze, and that’s a gift.
But as my friends know, there are times I need a “There, there, poor baby,” and this is one of them. With a CATscan and surgery coming up in the next few weeks, and now a cat who’s been foolish enough to get hurt and is unhappy about being asked to remain inside until his paw heals, I’m not coping very well. My acupuncturist told me that before my recent treatment, I was “depleted.” When she finished, I was “full,” but I don’t feel all that much different.
The truth is, I’ve never liked being around sick people, and now I am one. Not sick with oozing sores like the lepers Jesus touched, and not confined to bed, but clearly not among the well-with-no-cares, as I was for decades.
“No one understands like Jesus,” one of the songs from my past proclaims. Jesus must be my comfort, especially when I don’t tell people the full truth about what’s going on in my life. People are not nearly as intuitive as I’d like them to be. I look well enough, no gaping wound like my cat has, so how are they to know if I don’t tell them?
The truth is, I get tired of talking about cancer, the “gift” I never wanted that keeps on giving. I will never be completely well again—that “whole-souled wellness” as a college professor once translated shalom is not mine any more. I need to think about this. If he was right, there’s no reason my soul shouldn’t be whole, even if my body keeps making tumors.

Later
            I think it’s the playwright Tina Howe, in the introduction to one of her works, who talks about the fierce love of old women. In any case, I got a dose of that fierce love from the women—some of them with daughters my age—I see on Wednesday mornings. I used to quilt with them, but now that I’ve taken on a part-time job, I show up in time for the healing eucharist service and chat briefly before I go to work. The quilts are better for it.
            I told them about the surgery, and they were full of motherly coddling, crying “No fair!”, hugging me tightly, and promising prayer. I’d forgotten that Jesus mediates his comfort through others.

Monday, June 13, 2011

Being Valiant


With God we will do valiant deeds, and he shall tread our enemies under foot.
Psalm 108:13, Book of Common Prayer

            When the psalmist wrote of valiant deeds, no doubt the allusion was to courageous deeds during battle—after an initial call to praise God, the psalm turns in verse 7 to beating the war drums. But there are many kinds of valor, most of them not considered worthy of medals. Even those of us who, like the Wizard of Oz’s Cowardly Lion, display “conspicuous bravery” against our own wicked witches, will seldom be recognized for doing so.
            At one point during chemo, I remember telling a friend I was considering going under the bed and staying there. “Just take your journal with you,” she advised, knowing that I process my life on the page or the computer screen, equally white and blank. So here I am, trying to muster up the courage to get on with my life.
            It’s been much, much worse than facing several medical procedures over the next few weeks. Now that barium tastes like water instead of powdered chalk, a CATscan is almost nothing, if you don’t mind being radioactive for a while. (At least it doesn’t hurt.) Outpatient surgery is better than inpatient surgery. I have not one but two friends who’ve offered transportation, and a third with a spare room I can occupy during the 24-hour window after surgery. I have no reason to suspect my gynecologic oncologist will give me bad news at next month’s follow-up visit. But somehow the cumulative effect of all these events on the horizon have me feeling as if my head is going to explode.
            I suppose a large part of the problem is that I’m not clear about how I want others to handle all this. If outpatient surgery once a year to deal with the “nuisance cancer” that keeps cropping up is my new normal, then it should fall into the category of no big deal. I don’t need to broadcast it at church, get my name on the prayer list, or expect flowers to be delivered after the procedure. “Twenty minutes tops,” my doctor says it will take him, a far cry from the projected four-hour surgery that became six hours to remove the first cancer cells. Or even the cystoscopy that became surgery and an overnight stay in the hospital. On the other hand, it is surgery, with anesthesia, neither of which, as an education nurse told me before the first one, is supposed to happen to a body. If this one is typical, I’ll feel off for a week—not exactly ill or in pain, just not quite right and not terribly excited about food. This is hardly grounds for taking up residence among the dust bunnies under the bed, or a desire to keen, but I’m experiencing both.
            This ambivalence can create tension in my relationships. Yesterday when a friend—who hasn’t been told about these forthcoming medical events—asked me how I was, I said, “Overwhelmed,” and kept walking. He, of course, was supposed to follow me and ascertain the nature of my difficulty, but I’d erected the force field to repel others. He could probably sense he’d have his nose bitten off for his trouble, and let it drop. It took much of the day to shake it off, and apparently I’ve not yet done so.
I don’t like being this way. I’ve yet to figure out, five years after my first symptoms, how to do cancer. Just getting up in the morning and making it through the day, without doing emotional harm to myself or anyone else, is the only valiant deed I can manage.


Sunday, June 12, 2011

CATscan


You’ve no doubt heard the joke about the (literal) lab report and cat scan, but this morning I saw a funny photo of a cat sitting on a CATscan machine, held in place by a guy in a white lab coat. I smiled, and then I thought, That’s a GE scanner, like the one at the center I go to. This familiarity with machinery I barely knew existed five years ago dismays me.
I may be a bit extra sensitive right now, because I need to call the doctor’s office and schedule my next CATscan; I have to wait until we’re within a month of the next check-up—the center doesn’t schedule out as far as the doctor does. And invariably I have to remind the nurses to call the imaging center, and generally have to change the appointment they make, because someone doesn’t listen to what I’m saying about where or what time. This is known as being your own advocate or just one more thing to deal with.
This is an important scan, and there’s not one thing I can do to change the outcome, beyond eating my Swiss chard and spinach, taking my supplements—which may not have any effect at all. My gynecologic oncologist has said if this one is clear, it will be the last one; from here on out, we will rely only on blood work and exams. I always want a clear report, of course, but it would be lovely not to have any more radiation coursing through me. Much as I adore the warm blankets that are wrapped around me during my two hours of drinking barium—and grateful as I am that barium no longer tastes like chalk—I’ll give it up gladly.
This time I have a new question in terms of timing: is it better to have a scan before or after outpatient surgery? Only twelve days separate my surgery to remove one cancer’s tumors and the appointment for the other cancer, before which I need the CATscan and blood work. Poor planning, but between my freelance project with a tight deadline and his surgery schedule, it was the best I could do. I’ll have to let you know.

Wednesday, June 8, 2011

Those Who Would Condemn


I will give great thanks to the LORD with my mouth; in the midst of the multitude will I praise him; because he stands at the right hand of the needy, to save his life from those who would condemn him.
Ps. 109: 29, 30 Book of Common Prayer


“What did I do wrong?”
Those were the first words a friend of mine spoke after being told she had ovarian cancer. A conscientious woman, she’d faithfully had mammograms and watched her weight. She’d even had two children, unconsciously lowering her risk of ovarian cancer, according to some researchers. Because she didn’t follow up on a strange bloating she experienced, I heard her say, “I blame myself” for not catching the disease at an earlier, more treatable stage.
Sadly, there are people who will condemn us, behind our backs if not to our faces, for our cancers.
“If he hadn’t smoked like a chimney all those years . . . . ”
“She’s got such a temper and is a Type A, and we all know . . . . ”
“He knew something was wrong and he waited too long . . . . ”
“Well, what can you expect? She missed her mammogram and . . . . ”
The truth is, while we do know some common carcinogens, nobody really understands why one chronic smoker gets lung cancer and so does a person who never smoked, whose parents and spouse never smoked. Nor do we understand what causes the body to stop fighting all the mutant cells we all carry and to allow cancer to grow. Condemning a person for having cancer is adding insult to injury.
And yet, we do it to ourselves. Sometimes the needy person and the one who would condemn are the same person. Sometimes, God needs to save us from ourselves.
I struggle with this during every recurrence. I should have lost weight. I shouldn’t cheat on my celiac regimen. If only I had . . . .
Just for today, I need to be aware of God at my right hand, not condemning me, worthy of praise.

Thursday, June 2, 2011

Check-up



Whenever I am afraid, I will trust in you.
Psalm 56:3

I am afraid, as my dreams show. Not quite full-blown nightmares, they are projections of what I fear will happen at my six-month bladder cancer check-up. In last night’s dream, a nurse did a pre-exam and found cancer, plus my organs were all twisted and in the wrong positions. I think these dreams make it possible for me to get through my days without keening and wailing in fear and dread, but they don’t make for a restful night.
            One of three things will happen. It’s possible there’s no recurrence—that happened the last time, but I don’t trust it, because it was the first time in three years. I feel fine, have no symptoms, but then I never did. It’s possible that in six months, tumors have sprouted and grown to gargantuan proportions, making surgery the only option. I know what that means: outpatient surgery, followed by a bag for a week to let the bladder heal. As one might expect, I feel pretty awful with the bag, and worry about it leaking and slipping down my leg, because I don’t manage those elastic straps very well. Or there could be small tumors, which my doctor would “fulgurate” in the office. It sounds like fumigate, but it’s really a synonym for cauterize. As in, burn. He’s assured me that most patients tolerate the pain pretty well. I have a high tolerance for pain, but still.
            I am going alone, because it’s easier. If I feel okay after the exam, I’ve got shopping to do in a part of town I rarely visit, where there are health food stores with items I need. And if I feel bad, I don’t have to make anyone else feel bad. I don’t have to try to put on a good face, or minimize the shock of bad news. I don’t have to chatter on the drive there. I lose human sympathy and a friendly face, someone to celebrate with after hearing good news. But I’ve been going to doctors for almost five years now, have had seven or eight surgeries, and I feel I should save my friends’ graciousness for when I really need them. This suggests I’m afraid their goodness is exhaustible, when they’ve shown me over and over that it is not. So perhaps it’s just my hubris. I’ll let you know.

Later
I was wrong. There’s a fourth option: number of small tumors—the usual non-invasive, Stage 1 kind—too many to fulgurate in the office. We’re scheduling the surgery.
I’m not happy, even though I dreaded the pain of being awake during an office procedure. Surgery is costly; anesthesia is a nuisance. I tell myself that having outpatient surgery once a year is much preferable to multiple recurrences of the ovarian cancer. That’s true, but I still wish I didn’t have to do this.