ADIEU, OLD FRIENDS

I've been talking about my 60th birthday celebrations which included a party at a kosher Russian restaurant in Queens (man, do those Russians know how to have a good time!), a dinner with friends in Jerusalem, and a dance party in Melbourne last week. But there was something else I did, not exactly celebratory, spurred by my turning 60.

I had my ovaries removed.

I'm not Angelina Jolie, and that won't make headlines. But the reason that I had my hardworking little girlies removed was that I was increasingly afraid that they would go rogue on me. My maternal grandmother was 55 when she died of ovarian cancer; I never knew her. My mother was just 66 when she died of ovarian cancer; my older kids hardly knew her, the younger ones never knew her at all. And here was I, smack in the middle. It's called 'the hot decade'.

About 8 years ago, when genetic testing started, I decided to have the test to see if I had the BRCA1 or 2 genetic aberration. It was done at the Peter Mac (cancer hospital in Melbourne) Familial Cancer Centre, and I have to say that getting my patient appointment card to a cancer hospital already had me sweating a bit.

I made the appointment on advice of a colleague who is a Gynaecological Oncologist, who, when I disclosed my family history in a sort of inappropriate social situation (umm...at my Shabbos table where he was a guest), sort of drew himself upright in his chair and told me to get tested asap.

They have this whole way of doing things there at the Peter Mac. First they told me to go away and think about having the test, and all that it means, and how it might affect my medical and health insurance. And then I had to schlep back and do the test which I had wanted to do at the previous visit. And then they said to come back with a support person when they gave me the results. They also said that they would try to find the 'tumour blocks'- i.e. tissue samples, which would have been taken from my mother 25 years earlier when she was operated on (and diagnosed at the time of surgery; it was a big shock for everyone, surgeon included. He thought he was repairing an umbilical hernia). Since the operation had been done in a different hospital which had since been relocated, I didn't like their chances too much, and in fact they couldn't find them.
So I brought my husband with me when they called me in to give me the results. We were sat in a bleak little room with a box of tissues on the table. The ladies who came in and out of the room, asking us how were were, were very nice and solicitous, which actually made me more anxious. And then the doctor came into the room and, in a roundabout way, which kept me guessing right to the end, informed me that I did not have the BRCA mutation.
Well! The relief! But Doctor Circumspect wasn't smiling; because they did not have the genetic material from either my mother or, of course, my grandmother, they didn't know their BRCA status, so they couldn't actually tell me what my chances were of getting ovarian cancer. And in fact, most cases of ovarian cancer occur in people with normal genes. It's just that if you have the BRCA mutation, your chances of getting cancer are extremely high. (And then my usually slightly more sensitive husband said that we could exhume my mother and thus obtain a DNA sample. Mr Practical. Mr Only Trying To Help. Just..NO.)
So it was really back to square one for me. I sought advice from several doctors and a medical ethicist, and although there was a good case to having the op, it was not really something I wanted to do at that time.

Why not? Mainly because I am a big chicken when it comes to surgery. Stuff goes wrong.
Also, who has time for this? I was busy with kids' weddings and babies and travelling and and and.
And then, maybe my ovaries were still useful! I wasn't having hot flushes etc, but my blood tests did show that I was menopausal. But maybe I was running on empty! The motor was working well enough, why rip out the Oestrogen fuel tank?
And my OB GYN of many years was very keen to do a total hysterectomy, with the kind of insouciance that male surgeons often have. I mean, that uterus isn't doing anything anymore, why not just take out everything.
Poor old uterus. She never did a wrong thing in her life. Never a minute's trouble. I never even had a period pain my whole life. Never bled when she wasn't supposed to. When I wanted to conceive, I did. When I didn't, I didn't. My pregnancies were uneventful, my deliveries uncomplicated. And for all the years of faithful service, you want to just whip her out? She's an innocent bystander! It just seemed wrong. OK, maybe there were some auxiliary lady issues, like a bit of a prolapse here and there, but really, nothing that bothered me. Everything was well worn, but had worn well, so to speak. So, no thanks. Oh, but technically it's simpler to just do a full clearance, and repair this and that and yada yada; and then another GYN started talking about robotic surgery and multiple staged this and that, and FORGETABOUTIT. Not going to. Freaked out.

So for the last 10 years or more, I have been having pelvic ultrasounds and keeping an eye on the ovaries. That's all you can really do. There is no precancerous detection, as there is in breast cancer. Any change means cancer. And although annual ultrasounds sound like a good idea, in fact, ovarian cancer can go from go to whoa in as little as three months. So what's the good of that. Blood test (Ca 125) is non-specific, and I had those too, for all they're worth. And that's the state of the nation, folks. This is why you should buy a ribbon on Ovarian Cancer Awareness Day, because there needs to be more research done, looking for a pre-cancerous marker that would then make screening possible. Right now there is nothing.

So as the years went by, the anxiety mounted. I passed the age that my grandmother died. It felt like a milestone. And as I approached the age that my mother became sick, I felt that it was time to take action. After the last scan, I spoke to the GYN who did it and he heard me out, about the ovaries and the uterus and the prolapse and the robotic surgery and how I just did not know what to do. So he asked, 'What is bothering you the most?' and I answered, 'The fear of ovarian cancer.' So he said, 'Just have the ovaries out and see how you go.' So simple.

Because when you have the ovaries (and tubes) removed, the risk of ovarian cancer is pretty much zero.
And suddenly I knew what to do, and I made the appointment with the original GYN who told me to do it nearly 10 years earlier. After a couple of months' wait, laparoscopic removal, overnight stay in hospital, take it easy for a couple of weeks, no worries. Pain was minimal, took some Panadol; 4 tiny little cuts on my tummy, healed up. On the 3rd day post op, I saw a patient. On the 9th day, I went to an ACDC concert (Amazing BTW).  On the 13th day, danced like a fiend at my 60th. After 2 weeks, back at water aerobics. (Not looking forward to going back to gym, I have been enjoying getting up later than 6am. But.)
So BH it all went well, the pathology results were fine, and I feel exactly the same.

I was afraid of feeling castrated, gonad-less, less of a woman, blah blah. Nothing like it. I'm glad that I can cross off that potential cause of death from my list.

I'd better not be hit by a bus. The irony would be too much.

SIXTY

So the 60th birthday celebrations are coming to a close. Last night was the party, along with a good friend, who also turned 60 not long ago; our kids put it all together. It was also the last night of Chanukah, so we were all burning with full light, to strain a metaphor. There was a DJ. I danced. Today I cannot move. But it was worth it.

Here's the speech I made; my brief was to be funny and I think I was. Well, people were laughing anyway, and I hope it was with me and not at me.

I still can't believe I'm this old.

BEN SHISHIM LE ZIKNO

In Pirkei Avot, 'Ethics of the Fathers', there is a reference to the arc of life and what is expected at various ages:

5- LeMikrah, 10- LeMishna, 13- LeMitzvah, 15- LeGemarah,

18- LeChuppah, 20- Lirdof- ie pursuit of a livelihood

30- Koach- full strength

40- Binah- Understanding

50-Eitzah- Ability to give advice!

60 - Zikno. OLD. Over the hill.

ZIKNO. Age. Comprised of 4 letters, Zayin, Kuf, Nun, Heh, which forms a neat acrostic:

Ziftzin - Sighing

Krechtsen- Groaning

Nissen- Sneezing

Hissen- Coughing

70- Seivo – ripe old age

80-Gevurah – Great strength; Because 'getting old ain’t for sissies'.

Goes downhill from there.

BUT I note that this is all BEN and not BAS. SO could it be it only applies to MEN? Huh?

3 things happen with aging:

ONE, your memory isn’t so good.

I forget the other 2 things.

It’s good that women over 50 don’t have babies, they would put them down somewhere and forget where.

SCIENTIFIC FACT: Brain cells come, and brain cells go, but fat cells live forever.

Time may be a great healer, but it’s a lousy beautician.

When you go through menopause, they say you are going through the change of life. The change. But they don’t tell you what you’re changing into – in my case, my dad.(Stroke bristly jaw of nana whiskers) But like a hot, itchy, mental version.

Age doesn’t always bring wisdom: sometimes, age comes alone.

THINGS I HAVE LEARNED: WORDS OF WISDOM-RULES OF AGING *

Never, under any circumstances, take a sleeping pill and a laxative on the same night.

Never pass up a toilet; never waste an erection; never trust a fart.

Never lick a steak knife

Never say anything to a woman that even remotely suggests that you think she is pregnant unless you can see an actual baby emerging from her at that moment.

Do not confuse your career with your life

There is a very fine line between ‘hobby’ and ‘mental illness’

People who want to share their religious views with you almost never want you to share yours with them.

No matter what happens, somebody will find a way to take it too seriously.

When trouble arises and things look bad, there is always one individual who perceives a solution and is willing to take command. Very often, this person is crazy.

The most destructive force in the universe is gossip.

A person who is nice to you, but rude to the waiter, is not a nice person. (THIS NEVER FAILS, pay attention.)

Your friends love you anyway.

Here are  few more:

1.

Most things don’t matter.

Stuff that you think really matters usually doesn’t. You can work yourself into sickness worrying about things that, in the long term, are unimportant. Anyone planned a wedding?

What IS important: Being kind and being a mensch.

2.

Nobody is thinking about you.

You are certain that everyone spends half their day talking about you or discussing your weight or denigrating your work. But really, NOBODY is thinking about you. They are thinking about themselves, just like you.

(I wish I could tell this to self-conscious young women, especially about their looks. They are all beautiful. Youth is beautiful. Joy is beautiful.)

3.

There comes a time in life when you have to stop trying to strengthen your weaknesses. It’s ok with kids, you see some gaps and you try to help things along, or it might work on the sport field, but not in life. In life, in maturity, if you attempt to strengthen a weakness, you will get weaker. BUT if you keep playing to your strengths, people will not notice you have weaknesses. Don’t believe me. Take singing lessons. But it’s true.

4.

Give honest, frank and open criticism to nobody, ever.

Someone, friend, relative, workmate, employee, whatever, has behavior or character flaws evident to all but themselves. You think that an honest, frank, pull-no-punches conversation will show them the error of their ways. They will see the light at once! And be forever grateful for your kindness and candor and courage. Better still! They will reform their ways, their lives will be redeemed and improved and they will owe all that you candid, courageous you.

FORGET ABOUT IT. Don’t do it. Who here likes to be criticized?

This relates to my previous point: Nobody is thinking about you, UNLESS you tell them about their faults. Then you can be sure they are thinking of you. They are thinking of killing you.

On that note:

Nobody cares if you can’t dance well. Just get up and dance anyway.

Friends, family, thank you for coming tonight to this celebration.

At my age, I know how much easier it is to stay home. Not to mention how much more enjoyable, as a rule. I love when things get cancelled and I can just stay home. I’m sure I’m not the only one. So thank you all for making the effort.

Thank you to the young ‘uns (Maaryasha, Nechama, Rosa- sorry if I forgot anyone, my memory isn’t so good) for organizing this and not letting it fizzle into a couple of 60 year olds being overwhelmed by the thought of being that old, and hiding under a blanket while soothing ourselves with chocolate (Just me, then).

Thank you to Ralph and Tilly for giving their home for the party, I really appreciate the work involved. I hope nothing got too trashed, guests included.

Last but not least, thank you to my loving husband for always being there, for his support and forbearance and being an all-around good guy (WHO IS NEVER RUDE TO WAITERS BTW)

And finally- people rarely remember what you say in a speech. But they sure remember if you took too long to say it.

I conclude! With-

A TOAST:

TO PUTTING THE ‘SEXY’ BACK INTO SEXAGENARIAN!

May the light of this last night of Chanukah stay with you all throughout the year.

LECHAIM

* Although I wish that all these points were original, I did in fact scour the internet and came up with these. Some are from Dave Barry, and the 4 points are from Roger Rosenblatt’s ‘Rules of Aging’. The line about ‘change of life’ was from American comedian Mrs. Hughes. (Link above.)