Here's how the book is helping them to cope with Mrs. Kossover's breast cancer:
בס''ד
י''ג באלול, התשע''ב
30 August, 2012
Copyright © R. Kossover, 2012
This "Note" will expand with time. As we deal with this, I'll add more entries. G-d willing, my wife will live a long life, and I can slowly forget about adding things to this Cancer Jurnal. But right now, I need to write. Just a brief note to clarify things for those of you reading OUTSIDE of Israel. A shekel is worth about 25 cents American. But Israeli wages are far lower than American wages - often a third of the amount. So a 6 shekel bus fare in Jerusalem is not merely $1.50. It is 6 shekels - which is a quarter to a fifth of what most folks make an hour here.
This all started when Adina got a letter from her health provider reminding her that she needed to get a mammogram. She made an appointment, and went on 31 July. It wasn't fun for her. Getting one's breasts smooshed in an exam is generally not fun, I guess. But she figured on getting the results she had alway gotten - normal - and she forgot about the whole thing. Then she got a call from the health provider telling her she needed a biopsy - something looked suspicious in the biopsy, what they referred to as "calcification". I translated that call for my wife and we set up an appointment for 8 August, 2012. For this I went with Adina. After all, it was surgery of a sort. My place is with her.
On 16 August, we got a call from the family doctor telling us that Adina had cancer. That was a Thursday, if I remember right. We managed to get an appointment for her the following Sunday with a surgeon. While he wa a nice guy, he didn't do breast surgeries anymore, and HE made an appointment for us with Dr. Oded Olsha, who had been recommended to us as an expert in the field, operating out of Sha'are Tzedeq Hospital Breast Care Institute in Jerusalem. That appointment was a Wednesday, on 22 August. At this point I have to mention that on the 20th, Sunday, we ran into Yocheved Golani, whom we knew from the Beit Canada Absorption Center when she would come to our "apartment" and plug in her computer to our wall and use our phone to check her e-mails. In trhe decade we've both been here, Yocheved has established herself as a health coach, and gave Adina a copy of her book, Its My Crisis and I'll Cry If I Need To, which is a workbook to help someone cope with a crisis. It has already helped Adina.
Wednesday the 22nd was a very busy day. First, we went to a clinic early in the morning so that Adina could have blood work done. Then we had some breakfast, and took the light rail to Sha'are Tzedeq to meet with Dr. Olsha at about noon. At that appointment he described in detail the problem Adina faces. She has a tumor about 1.3 centimeters long (a half inch) which looks like an oval and which infiltrates the ducts. From what he was able to determine, it was in its very beginning stages, called 1A, and the lymph nodes were, according the biopsy, clear. But treatment for the tumor is a whole process - not just a chop chop job where the junk yards gets a piece of scrap. A nurse was designated to coordinate Adina's care, which would NOT end with the surgery. In addition, we met with the person who would actually schedule the surgery. After spending some time at the hospital, we went to the health provider to pay for procedures that were to come the following Monday at Sha'are Tzedeq, a "pre-op" meeting to kind of vet the whole process and have additional tests. Afterwards we slowly wended our way towards the Geula neighborhood of Jerusalem, where Adina met with an oncologist.
The oncologist detailed the "day after" of the treatment process. About three weeks after the operation, called a resection, Adina was supposed to begin radiation therapy. Essentially the area around where the tumor had been would be flooded with X-rays for a five minute period each day for five days a week, Sunday through Thursday (which is the work week in Israel). This was to last for a 5 week period, which will be hard for me. Adina and I live in Ma'ale Levona, about 30 miles (50 kilometers) from Jerusalem, and for her to travel into town each day would cost NIS 37.20 a day. Multiply that out by 25 (the number of treatment days) and you wind up with the rather steep cost of NIS 930. When you consider how little we make, that 930 shekels is going to be a problem. So, we are working on ways to cut it down.
According to the oncologist, that is the easy route. If it turns out that the tumor is problematic, there will be chemotherapy as well, which will start sooner.
The next BIG step was the pre-op meeting on 27 August. We took the early bus into Jerusalem and bought our medicines for the month. Then we had a quick breakfast and took the light rail to Sha'are Tzedeq - we got there by 8:30, later than we had planned. This was the day when we were shuffled like peasants in a Russian government office. First we had to go to admissions to submit the forms that allowed us to be trtested at Sha'are Tzedeq, called a hitHayevút [התחייבות] in Hebrew. Then it was up to the fifth floor to meet with the surgeon, who detailed once again the operation. An additional detail, which we were not aware of, was added at this meeting. The surgeon was going to take out some one or more of the lymph nodes to assure (hopefully) that there would be no remaining cancer. After this brief meeting, we were shuffled to a waiting room and then called to meet with an anesthesiologist - who took details on Adina's health - and who asked her to stick out her tongue a number of times. Then we were told to go to the waiting room where a nurse finally called out Adina's name for an EKG. Then it was back to the waiting room to wait to be called in for another doctor to consult with us. All she did was to create a computer record of Adina on Sha'are Tzedeq's computer. However, in addition to all this, we would have to get a summary from our family doctor. That would mean a long trip to East Talpiot (in southern Jerusalem) where our family doctor is. Then we were given our file and told to find the coordinating nurse, talk with her, and then finally, to go for a chest X-ray. Before we left I called the family doctor and asked the secretary if she could have a summary prepared for us top fax to Sha'are Tzedeq.
The coordinating nurse and the chest X-ray were both on the 2nd floor of the hospital. It was nearly noon and we were hungry, but we tried to follow instructions and go to the coordinating nurse. We called her and got her voice mail. I left a message, and we waited - and waited. Finally, losing patience, I suggested we get Adina to the imaging center for the chest X-ray - which did not take too long. Then still holding this file in hand, I decided to go directly to the Breast Care Institute to hunt up the people we needed to see. It was my nose for finding things that got us finally to the Breast Care Institute. The coordinating nurse was out sick - but we had managed to find the young lady who will schedule the surgery, and we were ab le to leave our file with her.
After having lunch - a tuna sandwich that tasted like cat food - we both took the light rail in the general direction of down-town Jerusalem. My wife got off at the Central Bus station to return to Ma'ale Levona. I continued onward to the MaHane Yehuda Shouk (a huge market) so I could catch a bus going to East Talpiot.
In spite of all the time everything seemed to take, I managed to get the 5:25 bus to Ma'ale Levona. I was exhausted. Adina was sleeping when I got home.
The final chapter of this adventure - so far- is now the waiting for the actual operation. We got a call Wednesday that the operation would be next Monday (2 September). But then later in the day we were told that a woman whose case was very severe had bumped my wife from the queue - and that they would try for next Wednesday. And now, on the lip of the Shabbat, that is where we are. So, we'll see.
