Waiting for my PET scan

The big day is finally here. Pet scan day! What is a Pet scan you ask? A pet scan is a nuclear metabolic scan. Typical protocol goes something like this. You check in

They check your blood sugar to make sure it is below 200. Then they have you wait an hour to let the glucose spread through your body to your now starving cells. (You had to fast for this). Then yiu go through a machine that scans you from your head to your knees kind of like a CT scan, but more claustrophobic. The scan itself takes about 20 minutes. It looks for what’s called hot spots. These hit spots are areas of increased uptake of that glucose and increased metabolic activity. Since we know that cancer cells are rocking it out with devious metabolic workup more than your normal cells, those hot spots are likely to be areas of cancer. These results let you know at a cellular level where you are really starting from before you start chemo . It is usually a prerequisite to have a Pet scan before being able to participate in any clinical trials as well. Even though I have been waiting for this scan for what seems like forever, now that the day is here the reality of it is kind of hitting me like a ton of bricks. It didn’t help that I barely slept last night and woke up feeling 80 years old either. I am usually not the guest of honor at a pity party but oh man I almost threw one this morning….lol. Oh well. Time to put my party hat away. Time to dive in. I’ll let ya know how it turns out.

Dr. Katz

Takin it easy is not the same thing as being a prisoner.

Oh man am I having trouble with that distinction lately! First of all, limitations have never really been my jam to say the least. I have been a patient more than I care to admit in my lifetime. You know, multiple surgeries, medical emergencies, accidents, time off work, the whole nine yards. I am usually the one who is walking the halls just hours after emergency surgery. I am not a stay tied down kind of person. Now that the universe decided that cancer with chemo plus a pandemic was a good idea, I am looking at a whole lot more than just some temporary limitations. There is no way around it. I feel like I am looking at house arrest for months. Let’s face it, I will be immunosuppressed, on top of having cancer, in the midst of an ongoing pandemic. I can’t afford to take chances so I need to suck it up.

Yes, I exaggerated. I won’t exactly be on house arrest. I am going to work when I can. I will need to leave the house for doctor appointments. I just won’t be going out of my way to go out to dinner or take unnecessary risks. I probably won’t be doing any hospital procedures either. It’s just being smart. To be honest, it won’t be that different from what is going on now, except for the fact that the chemo I will be on shoves me from the mild risk category to the top of the highest risk category when it comes to death from infection and Covid. Yippee! This is not the kind of line that I wanted to cut to the front of.

In my rational moments, it all makes sense. There is no point in fighting hard to dodge the cancer bullet if I am just going to open myself up to the Covid one. That would be ridiculous. The restrictions are in place to help keep me safe and see this thing through to the end. I choose to follow them. I know that. And, it’s not as if there isn’t enough Netflix to go around to entertain me.

There are other things that I worry about though. Yes, believe it or not I worry about being bored, even though I am working on a book, a podcast, a blog and I try to post daily updates. I worry about having too much time to think which runs the risk of being counterproductive and focused on worrying with nothing to distract me. I worry about resenting my family and friends as the pandemic restrictions lift and life resumes again while I watch vicariously through a proverbial window. I worry about being consumed with guilt from letting people down. I realize that everyone is being tremendously understanding now, but everybody has their limits. See! I wouldn’t have so much time to overthink all of this unless I was on restrictions!…lol

Oh who am I kidding? No one really has to enforce my restrictions. My body takes care of that nicely. I never know which version of me is going to lift her head off the pillow in the morning: the one that is raring to go for several hours or the one that gets short of breath after about three steps and has to sit back down. It is a real Wheel of Fortune going on around here and I am definitely not the big winner the majority of the time. I am kidding myself to think that I could really change that even if I wanted to right now. It is what it is. The only real choice that I get to have control over is my attitude and my willingness to accept the advice of my doctors. I have to realize that this is not their first rodeo and that they do actually know what’s best based on experience, knowledge, and training. Like I am always saying, I need to be a team player in my healthcare. If coach says I need to sit on the bench for a bit, well then I better just sit.

Dr. Katz

The Best 35 Minutes Ever!

So, this one Saturday pre chemo I woke up feeling like a champ!  I had slept a full ten hours…..without interruption!  Holy Crap!  I didn’t even feel like I had cancer!  I had energy!  I wanted to go kick some ass somewhere!  I did a little dance.  I told everybody in the house that I was ready to go.  I sat down to breakfast 35 minutes later, smiling ear to ear.  And then, without warning, it all started melting away.  I felt the slow spread of heat and fatigue wash over me.  I started getting short of breath and achy.  I couldn’t speak in full sentences without taking a breath.  Within a few minutes, my cancer symptoms had swept back in, enveloping me in that blanket of sick that I had just swore I had shucked off for the day.  Here I was again, the lymphoma patient, set up for yet another day on the couch.  Awe man!  One of the hardest parts too is watching my husband’s temporarily hopeful facial expression slowly fade into a sad little empathetic smile that I have come to know so frequently.  This is, my friends, just the way it is.  There is a level of unpredictability about this whole thing that is never easy to reconcile, much less accept.  Welp, I guess it’s time to dig out the remote again and settle in for some more Netflix. It is what it is. That’s fine. I’ll rest for now, plotting what amazing things I could do in that next 35 minutes! This is just one of the smaller battles Cancer. You can have this one. I’m saving myself for the real one. Cue mic drop.

Dr. Katz

Don’t treat me like a china doll!….unless I ask you to…lol

Just remember before you read this…..it is for fun only.

Yup. It’s started already. One little diagnosis of cancer and everyone thinks you are immediately transformed into a broken china doll that can’t do anything for herself. I swear to God even the dogs treat me differently. Frannie is constantly looking at me with a weird sort of sad, worried expression on her furry face. She is stuck to me like velcro at all times and watches my every move. She doesn’t even rudely jump on top of me anymore. She just sort of slinks up on the couch and gingerly slides in next to me. Hmm. Interesting. They say that cancer makes you smell differently to a dog. So, maybe someday when my cancer stink is not as strong she will go back to jumping on me all the time and being ridiculous. Wait? Do I really want that?

My family makes me alert them to the possibility that I may actually want to bathe or go to the bathroom by myself, in case I should fall or something. However, to be fair, I did splat on the floor a time or two before so I really have to give them that one. Ok. Ok. They also don’t want me lifting, pushing or pulling anything….ever! But then they aren’t available when something needs to be lifted pushed or pulled. Ugh! What choice does a girl have? This is why Christmas decorations will be up until 2022. I am sure of it.

Now these same folks that want to treat you like a fragile little thing also don’t seem to mind when you sneakily did something that works to their advantage, like make them a gourmet dinner because you literally had nothing else to do! But, that’s only human I guess. Who doesn’t like good food?

Now, don’t get me wrong. It’s not all bad being let out of certain things. For example, watching everybody load the horses into the trailer themselves and pack everything while I just lounged in the car? Pretty fantastic. Not having to be the one to actually drive everybody everywhere and sometimes I just get to ride along? Also not complainin. If only I could pick and choose tho! It would be great to be able to decide on the spot when I want to be waited on hand and foot versus when I want to tear around like Wonder Woman. Just sayin. I completely get that there are things that I simply cannot do at times. Sometimes I am so weak and tired that I feel like the energy was sucked out of me with a funnel. These are the times that I desperately need help and I thank God for my amazing army. Then, other times I want to grumble and do what I want anyway because I am feeling resentful and frustrated at the limitations. The bottom line is, I just need to learn to be patient with my peeps and with myself. They are all trying to help and they are definitely better at it than I am at helping myself. For now, all I can tell you is that I’ll work on it. Have an amazing day!

Dr. Katz

Suckin the Life Outta Ya

Man this cancer thing is already kind of ridiculous, and I haven’t even started treatment. From the moment I found out, I firmly positioned myself in full bad-ass stance, made long term grandiose plans and capriciously swore that nothing would hold me down or stop me from caring for other people and patients. I was cocky. I was confident. I thought that it would help me beat this thing.

So, that was like….so last two weeks. Now let me tell you about what I actually should have done or learned…lol When I first learned that I had cancer, I had people telling me everything from reminding me how I need to slow down to I could work full time with this no problem with no pauses! Well of course I gravitated toward the full throttle advice! Who wouldn’t? I didn’t cancel patients right away. I started writing my book. I started a new podcast. I recruited my army, once I finally let the cat out of the bag. I cried for about two seconds and then I was ready to go! I was not done yet! Screw you cancer! You’re not the boss of me! Sound familiar? Anyone else been there? It doesn’t last too long does it?

Here is what I should have realized and learned. The first thing to realize when you are told you have cancer is that it has been around a lot longer than you thought. You need to add a couple of years in some cases to the time of diagnosis. Whaaat?! A couple of years?! That sucker has been sneaking around in my body for a couple of years? What the hell?! What that means is by the time you are diagnosed, it has been around long enough to give you symptoms. This means that the path from feeling normal to shitty has been significantly shortened before you even get the chance to process the fact that you have cancer in the first place. How rude!

Second, I should have realized that now is the time to plan carefully, anticipate and CONSERVE energy, not burn it all up before you even start. This is the time to try to be realistic, without guilt, about what you will be able to do and not do. This is my biggest challenge. Instead of just relaxing, I spend way too much time feeling guilty on what I am missing out on and who I am letting down. I am fixated on the fact that I am dropping the ball. Ugh! I went from feeling good to crappy in about a week. Now I walk across the room or just sit and promptly get short of breath, depending on the day. I have fatigue that is so intense that it literally comes out of no where and sucks the life out of you to the point that even breathing seems like too much effort. I am told that this is common with lymphoma since it is a condition that has a lot more inflammation associated with it. Therefore, your body requires a ton of excess energy and calories to try to fight it off. It makes sense I guess. My point is, that I waste time when I feel good trying to accomplish a million things until the next time I don’t feel good. I am not good at resting. How will this benefit me? It won’t. It will only make it tougher and take me longer to get better.

Last but not least, I should have realized that I have to let people help me! They are doing it because they want to, not because I am making them. I need to stop trying to do everything myself. I need to stop confusing accepting help with some weird acknowledgement of failure or weakness. What is my problem? I still don’t know…lol All I can promise is that I will work on it, because I intend to see this thing all the way through. Wish me luck!

Dr. Katz

” The Good Kind” of lymphoma

Today’s the day. Today I go for excisional biopsy of the lymph nodes around my neck so they can study it and determine if I have ” the good kind” of lymphoma, Hodgkins, or the aggressive kind, diffuse large B Cell Non-Hodgkins. Good kind? Bad kind? I am just not sure what to root for here. Isn’t all cancer “the bad kind?” My doctor also told me with a smile that he has never lost a patient with Hodgkins. Awesome! But wait! What about Non-Hodgkins patients? He meant to be reassuring. Instead of taking that as good news, I immediately panicked that he had somehow over bragged to the universe and karmic retribution had to be on it’s way.

Sorry, I couldn’t help a bit of sarcasm there. I know what the doctors mean. One kind has really high cure rates and one not so high and tougher to get through. Yes. Of course I understand. However, it is tough for a patient to embrace the clinical perspective right after hearing a diagnosis. Sometimes they just need a minute to try to start processing before they are able to realize whether they are actually “luckier ” than they thought or not. The moment you hear the words “we think you have cancer”, everything kind of stops. No other words have a chance to register. That dirty C word just hammers in your ears like an obnoxious bell and your mind starts racing. You need to just let it sit a minute before you start comparing stats and trying to tell them how to think about it. I know this first hand. I do it too as a doctor. I am always trying to temper my need to tell a patient that it’s not so bad and flood them with good statistics to reassure them with their need to just sit a second and take in what I said first.

Bad news is never easy to deliver, even when a patient is expecting it. I don’t really think that there is one best way to do it. I tend to vary my presentation depending on my knowledge of the patient and what I think they can handle. I was expecting this news, based on everything that I knew, but I still wasn’t instantly ready to prioritize and tier the possible types of cancer and how one was better than the other. I just needed to take in the fact that I could have cancer. That was as far as my mind could go at the moment. For me as a physician, if I know that I have to deliver bad news, I deliver the news and then I am quiet for a minute. I deliberately try to let the patient be the first one to start the next part of the conversation. I have just told them something that may soon launch them into a life-changing scenario in which they have little control. I figure that the least thing I can do is let them have control over how the conversation goes in the next few minutes. If I let them speak first before bombarding them with statistics or trying to mold how they should perceive the news, I can more clearly gauge how to tell them more and what to tell them. I think that it is really important to let them at least take control of this initial conversation. It may be the only decision that they get to concretely make for awhile. Sometimes I can’t reassure them right away. Sometimes they just aren’t ready. They are scared, angry, and confused. Sometimes you have to let them be for a minute.

I think it is tougher for my doctors to let me be for a minute. They know that I am a physician too and they figure that I can handle all the stats and details. They care almost too much because they know me. They know that I can understand the information. They know that I am interested in being my own advocate. I get all that, but sometimes it is a little too much. This time, I am the patient. I am not in charge, although I am trying to act like I am. I am putting on a brave, calm, collected face. Sometimes I think I am doing that more for others than for myself. I don’t feel very calm and collected when I am sitting in my bathtub, overreading about lymphoma and trying to give myself an anxiety attack…lol. I want to be Wonder Woman, but right now, I am just me, Laura Katz, the patient. I am waiting for news just like everybody else. I am waiting to see how my life is going to change. That will have to be good enough.

Dr. Katz

Don’t wait till yer dyin to love deeper.

How does that Tim McGraw song go? The guy found out he was dying and decided to love deeper and speak sweeter? Now that there was hardly any time left? That song makes me cry every time I hear it, not just because the guy is dying, but because of all the time he obviously wasted when he could have been savoring life, everything and everyone around him.

Let me tell you first hand that I am being worked up for lymphoma right now. One possible type is very treatable and the other is far more aggressive and tricky. Either way, I am in for a fight and, like with any possible cancer diagnosis, there is a possibility that I won’t make it. It’s just the reality of the situation. However, I know one thing for sure: I have tried to live my life to the fullest and love the deepest since the day I was born. I have always tried to put myself out there. I have tried new things. I have been kind. I have always let my family know that they are my true love and my whole heart. Do I have some regrets? Sure. Everybody does. Are there some things that I would have done differently? Of course. I have had a shit ton of tragedy and obstacles too and I have learned from all of it. But, no matter what, I know that I have had a life well-lived so far and that I am going to continue to head in that direction. I am so grateful for that. I can’t imagine feeling like I have to cram an entire life’s worth of experiences and savoring into a couple of months because I wasted it all before that point. It’s an impossible task. My advice is take it all in now! Savor everything now! Send love out to the universe now! Don’t kid yourself and hold back thinking that you’ll always have plenty of time. Tomorrow is never guaranteed for any of us.

Dr. Katz

How a Doctor Does Cancer

Welp, it is finally my turn. I just got diagnosed with cancer and suddenly I am in the same boat as thousands of other women that I have helped over the years. What the hell? How did this happen? What did I do wrong? I started off feeling weirdly vindicated and relieved, since I knew something was off for awhile and just couldn’t put my finger on it. I am sure that sounds strange to say out loud but I am sure that some of you know what I mean. You know your own body. You know when something is wrong. Sometimes you just feel it. Or, in my case, sometimes you know too much and overthink it and then chastise yourself that you are being a hypochondriac and dismiss it. It’s like what every medical student and resident goes through. As soon as you learn about a new disease, you swear that you have it if you even have one of the symptoms. It gets kind of ridiculous if I am being honest.

Anyway, moving on…..now I actually have the diagnosis of cancer. It is not in my head. I can no longer brush off symptoms. It’s real. It’s time to buck up and embrace it and kick it’s ass! I have quite the road ahead with chemo, radiation and who knows what else. I have an impending “hair do over” to look forward to. But you know, maybe it will actually come back thicker and nicer? It could happen. Fingers crossed.

I have a lot to do in the coming months. When I hear people say that my first thoughts go to my family, my employees and my patients. Ever the overachiever, my plan is to care for all of them, while kicking cancer’s ass and just zoom along like nothing ever happened. But, as the last few days and extra hospital admits have shown me, I have it all wrong just a bit. I actually need to back up and reprioritize a little. By that I mean, I need to be better about looking after myself. I need to recognize the fact that “gasp” I may have a few limitations coming up. What?! Not me! I need to realize that I can no longer travel at the speed of light 24 hours a day. Sometimes I have to stop. Sometimes I will have to work from home or not at all. The last thing I need to do is set myself up for failure. That won’t help me or anyone else. I also have to learn how to say no. Dear God that is not an easy one.

Now, don’t misunderstand. I am not about to stop being me. As we speak, I am sitting at home working on this blog and mapping out my sixth chapter in my book about lymphoma and I have plans to donate any proceeds to lymphoma research when this is all done. I do not intend to shrivel up in a corner and disappear or anything. I just have to listen to my body and slow down when I need to.

So, the bottom line is that I plan on beating this thing……and helping patients along the way. I have been a patient more times than I care to think about in my short 51 years and each time I have been able to use my first hand experience to help patients and others. I will slow down when I need to. I will follow my own advice and the advice of my doctors but cancer, you better stand up and take notice! It’s your turn to be afraid! I am gonna turn the tables on you and use you to actually help even more people! Hah! Whaddya think of that?