Death and Dying - at Midlife

I was out of sorts yesterday. Just felt meh-ish, after a several week period in which I was up-and-at-em. Am I crashing, I thought. Oh no, oh woe. But then I did what I have learned to do at such times (at least when I can remember) and that is to just accept that I'm feeling meh-ish. And know that it too will pass. While I was working at achieving this pseudo-Zen state--and wishing, really, that I could have a Stepford button installed in my brain because who needs to feel meh-ish even if you know it will pass--I realized the source of my state of mind. The day before my friend M called to tell me that our friend Sharon was dying.

I saw Sharon when I was in LA a couple of weeks ago. It was a reunion of sorts of our book club and Sharon, who hadn't been feeling at all well, particularly wanted to come. She needed to see her friends. The group of us hung out as we have done so many times in the past, and we talked, really talked, 'checking in' with each other as only women who have history together can do. My check-in was to relate not only the ghastly year I've had, but also the much more promising one that seems now to be taking place.

Sharon checked in with her medical report. The doctor saw a spot on her lung and said it was probably sarcoidosis. Or maybe lung cancer. Sharon wasn't buying that diagnosis; she much preferred the sarcoidosis, which is an immune system disease that is rarely fatal. She would do what she has always done (sometimes with disasterous results, it must be said) and trust totally in Alternative non-Western medicine. She was refusing the steroids that would be prescribed for the sarcoidosis and she was refusing the second CAT scan that would rule out cancer. But oh, she was so tired, and so weak, and so very very depressed. The doctor wanted her to go on anti-depressants and until now, she had refused them as well. But we, her girl friends (some of whom were loaded up on Prozac and Effexor themselves) urged her to reconsider. Think of the mind-body connection, Sharon, we told her. How can you hope to get well without your full emotional strength. And she finally agreed. When I hugged her goodbye, it was with the knowledge that she too would soon be loaded up on Effexor and feeling 100% in just a matter of time.

I don't think she ever got that prescription filled. The next day I'm told she was so weak that her sister came to take her to the doctor. She had the second CAT scan. Stage IV lung cancer; metastasized already to her bones. She died yesterday, just three weeks after I last saw her. When M called to tell me, I thought, Aha--the meh-ish feeling made much more sense than I had originally thought.

I've reached the age when I'm starting to lose my friends, all of whom are midlife women. Not that cancer doesn't take young people as well, but I am suddenly aware of how vulnerable we all are to the ultimate breakdowns in the body. How vulnerable I am. And it makes me feel--well, very vulnerable.

Plastic Surgery: yes, no, and if not now, then when?

Aaryn Belfer's got an article in the San Diego City Beat in which she takes apart a new picture book for kids called My Beautiful Mommy. It was written by a plastic surgeon in order to help, he assures us, the children of his patients get used to mommy's new nose or belly or tits (I think he's a tad gentler in the book). I'm not going to name the good doctor because I don't want him to get more attention than he's already bought with (I'll bet) some megabucks PR firm. If you want to know more, go read Aaryn's article, which is one and at the same time funny and mad and incisive, in other words just the kind of writing I love.

Susan Myrland turned me onto Aaryn's article because she "wanted my opinion." I started to email a response to her, but I got wound up and wired and thought--whoa! plastic surgery, is this not the very thing for MidLifeBloggers? I had a selection of titles for this post. Cosmetic Surgery: Kindness? Cure? or Cruelty? But the c/k sound seemed a bit more alliteration that even I was willing to go for. Then I thought Plastic Surgery: Kindest Cut, or Cruelest? That was marginally better, but it really didn't sum up my thoughts. The title I've used above does just that.

One can't have spent as much time living in Los Angeles as I have without being exposed to a variety of what we euphemistically call Work. Some of it wasn't bad, and some of it was pig-shit dreadful. The Work that was good--well, that, like the cheerful American tourist, just passed on by without notice. Okay, there is one case where I visited a friend of mine post-face lift and to thig day, I wonder if her surgeon just wrapped her in bandages and told her she'd had surgery. Twentyfour hours after the lift, I couldn't see a thing except that with the full head bandages, she looked, as she put it, like a Q-tip. So, while I have never had Work Done myself, as we say euphemistically, I certainly can say my opinion is "informed" by visual sightings of the good, the bad and the truly awful.

Why haven't I had Work Done? That facelift that my friend, the Qtip, had was $20,000--and that was just the doctor's charge, never mind what the suite at the Four Seasons Recovery Unit cost her. So bottom line is really the bottom line; I just don't have the spare thousands. If I did, would I do it? I'm not sure. The idea of having the skin on my face peeled back, flayed actually, is sort of scary. Sort of--hah!

As I write this, I'm realizing that my reasons for not having plastic surgery are mostly to do with fear that I would be the dreaded After example. I'm scared shitless to let someone mess around with my face, I don't care how many letters after his name he has. And so I tell myself that I'm proud to wear my wrinkles and sags and bags and dips and brown spots and--oh my god, I am so depressing myself. I've earned every one of these little fuckers: yada yada yada, fill in the Jamie Lee Curtis tape.

So what about some less INVASIVE procedure? Well, there's Botox. I would have Botox except that, drat it, I don't need it. My forehead has no wrinkles; it's as smooth as a baby's bottom, etc. etc. etc. I do have some crow's feet and I could get Botox shot in them, but really, they're not sufficiently bad, or maybe I just wear my hair hanging over my eyes and I can't see them.

No, the procedure I would have is something to eradicate those marionette lines that have now taken over my lower jaw. I'd like some Restylane pumped into them, not too much, just enough so that they're not so deep. I've noticed that when I look in the mirror and smile, they ease up nicely. And I find myself trying to remember to smile in repose. Except I fear that too much of that and people will wonder 'what the fuck is she smiling at?' I've got a big wedding in New York that I'm going to at the end of June. I'm thinking I'll make a doctor's appointment about the end of May. Or maybe I'll just smile at the wedding. Depends on where I am on the Adventure-O-Meter this month.

So the answer to your question, Susan, is: I'm not sure. I don't have a philosophical or moral or ethical problem with plastic surgery. I don't think it's a denial of aging; nor do I blame our youth-obsessed yada yada society. Frankly, we live where and how we do, and my feeling is we've got to deal with life as it best suits us. Not someone else. Us. Me. Jane.

And you?

Crossposted at MidLifeBloggers

Where do you stand on the HPV vaccine issue?

In January, NPR's Rough Cuts ran a podcast on HPV and the vaccine. Back then, everyone had only good things to say about the topic. It was, it seemed, the Second Coming of vaccines, right up there with Salk and Sabin. But the whole ad campaign made me queasy. There have been too many "wonder drugs" touted in the past decade or so that have, with use, turned out to be less-than-wonderful if not outright dangerous. When I heard yet another pro-Gardisal program on NPR, I wrote this response, which was published on Rough Cuts web site.

I'm confused/concerned/suspicious (?) that this flood of information about HPV and its relationship to cancer has come out with and is tied to Merck's campaign for their vaccine. It may be coincidence, circumstance or fortuitous, but I have been ignoring most of the "bumpf" on this topic as just another example of the drug companies' creativity and immorality with regard to marketing their products. The only reason I am paying attention this time is because I respect you, Michel [Martin], and NPR. Still, I would like to hear some medical testimony, pro and (especially) con, before I buy into what right now seems to be the latest scare tactic aimed at women's sexuality. Here are questions I would like to have answered:

1. Why has this taken so long to come to light -- given the incredible amount of energy that women have expended on behalf of their health issues?

2. What research (besides Merck's own) is being cited?

3. Who did that study which resulted in the shocking statistic (re: sexually active women and HPV)? What kind of a study was it? What were the numbers? What were the demographics of the study andhttp://beta.blogger.com/img/gl.quote.gif
insert blockquote the control group?

4. Is there anyone who is denying the veracity of this study and/or the need for the vaccine? Who are they? What are their claims?

5. Both of your guests are African-American, and you mention the prevalence among Black women. Is this coincidence? Or are Black women more vulnerable?

I could go on ... I've been a radio reporter, so I understand the vagaries of tape and time. But this story right now is too loosey-goosey for my liking.

Sent by Jane Gassner | 5:48 PM ET | 01-05-2007

Since I wrote that, Merck has pulled back on the advertising, but the controversy over the vaccine goes on. I certainly don't want to be put in the same pot as those who are against it for religious or moral reasons. But I still can't help feeling that the hoo-hah around the vaccine is--I don't know--a bit too loud. Is it that this is the first vaccine for cancer that's been found so let's shout it from the rooftops? Or that we're having some very sad, slow newsdays these past months?

I suppose the bottom line is: Would I vaccinate my daughter? I don't know. Okay, I don't have a daughter, so there aren't any stakes there. But I do have a pre-pubescent niece: am I going to lobby her parents to have her vaccinated? I don't know. Why am I having such a negative response to the vaccine issue? I don't know.

What do you think?

Bronchitis...

That's what I have, according to the doctor I saw yesterday. She was wearing fake leopard-skin pants, so I'm not sure I should trust her.

Here are my symptoms: a chest full of shit, which rattles when disturbed; EEEXXTTTRRREEEMMMEEE fatigue. I told her, "I've haven't felt this exhausted since I had brain surgery" which caused her to whip around and finally direct her attention from the computer screen to MEEEEEEEEEEEEEEEEEEEE. Satisfied with my explanation--oh, a mere aneurysm--she went back to the computer and tap-tap-tapped in the prescriptions which went directly to the drug store, without even a by-your-leave or mother-may-I to me.

This is medicine by computer and those I bow to none in my love of geek gear, I think it sucks. It enables efficiency while disabling patient care. I feel a major rant about this coming on, but right now, I'm too TTTIIRREEDDD.