The Surgeon

So, I like this doctor. She is older than twelve. She introduced herself by her first name, which is important because if you are going to be handling my boobs we need to be on a first name basis. She threw a lot of big medical terms around that I never heard before, but basically said that there was nothing remarkable about my tumors (which is good even though I like to think that I am remarkable). She drew a lot of interesting pictures and diagrams on a piece of paper that explained all of my options and possibilities. That's my breast on the left circled in pink for those of you who have been dying to have a look.

So, I will be having a bilateral lumpectomy with sentinel lymph node biopsies. We talked about radiation after the surgery, the possibility of needed chemotherapy if the lymph nodes are not clear, and long term estrogen suppression medications. I will be having the surgery sometime in January, working around some dates so as not to interfere with her vacation plans. It will be outpatient surgery, done at McPherson Hospital (I will always call it McPherson). That's so close to home she might as well just come on up here to the farm and do it.

I am glad that I have the holidays to keep me busy. My son is coming home from Boston for Christmas. All of my kids and grandkids will be around. I have so much to be grateful for. Oh, and I got a certificate for a free massage in the packet with all of my cancer information. That almost makes it worth it.

Fragile

It's early Friday morning. I've been awake for a couple of hours, laying in bed thinking. I see the surgeon at 10:00. I feel like I am going for sentencing. Lumpectomy, mastectomy, radiation, chemotherapy. Not any of which I care to consider. I am being sentenced and I try to sort out, what was my crime? I stopped smoking forty years ago. I don't eat meat. I try to eat right (except for the Fritos.) I don't use antiperspirant or dye my hair. I do not let myself get stressed out over every little thing. Of course, I don't exercise enough and I am several (I won't say how many) pounds overweight. I let two years go by without a mammogram.

I have never had surgery or a broken bone. I did have my tonsils out when I was six, but I don't think we can really count that, the doctor didn't cut me open. It was no more than having a tooth pulled. I am coming up on fifty-nine years and do not take any medication for anything. So you can see how I have come to believe that I am invincible. I have watched others around me suffer from various ailments and thought "that can't happen to me because I don't (fill in the blank.) Well, that was just so much bullshit. Now I have joined the rest of the human race, my life is fragile and unpredictable.

And more will be revealed.

The Results

The biopsies were done on a Thursday, so I had the weekend to get through before I would hear the results. I did some Christmas shopping and went to another meeting. On Sunday evening I was wishing that the weekend could go on for a few more days. I was not looking forward to the phone call. I tried very hard to be positive, but really wanted to stay in that place of not knowing. The truth is, I was sure that the news would not be good.

On Monday morning, just as I was getting into the car to take my dad to a doctor’s appointment, my phone rang. When I saw the number on caller i.d. I thought, “crap, this is it.” I answered and it was the doctor who had done the biopsies. She asked if I was in a good place to talk. I told my dad that I was going back in the house to talk to the doctor.

“The biopsies were consistent with cancer,” she told me. Invasive Ductal Carcinoma, the most common form of breast cancer. The spot that I had been concerned about on the left breast was grade one, the one on the right was grade two. She explained that they are graded 1 – 3, 3 being the most aggressive. “You are going to be fine,” she assured me, “but you need to see a breast surgeon and get this taken care of right away.”

She gave me phone numbers to call for an appointment with a surgeon. I hung up the phone and went to find my husband. He held me in his arms while I cried uncontrollably.

My dad was still waiting in the car, so my husband threw on some clothes and went to take him to the doctor. I got on the phone and made an appointment with a surgeon for the following Friday. I called my children and friends who had been waiting to hear. I cried a lot. I screamed a little. It was about ten degrees outside and I thought about just going out to the back of our property and letting myself freeze to death. I hate to be cold, though. I know I would be back in the house in no time.

The thing that always happens when disaster strikes, for me anyway, is that the love and support of friends and family serve to lift me out of my despair. I have my few moments of insanity, then remember that I am not alone. People want to help, they cook and clean and hug, and tell me they love me. They remind me how strong I am and that I will get through this.

So now it’s Thursday afternoon, and I see the surgeon in the morning. I am trying to make a list of all of the things I want to ask. Someone from her office just called to remind me of the appointment, like I could forget about it.

I am scared shitless. 

The Biopsy

On biopsy day we had to be in Ann Arbor at 7:30 in the morning. The traffic on the freeway was crawling and I became anxious about being late for my appointment. We were 15 minutes late and they took me right in. I noticed a clock radio in the room so I asked the doctor if we could listen to NPR during the procedure. After numbing my breast the doctor made an incision and used a device that sounded like a stapler to extract tissue samples in two different places, one on each breast. She also did a needle aspiration of one area on the left breast. The whole thing took about an hour and a quarter. There were two technicians assisting the doctor, and we started talking about kids, grandkids, the elf on the shelf and the tooth fairy. Before we were done we were cracking up about the trials of parenthood. It was not as bad as I thought it might be.

I was given post procedure care instructions, along with two ice packs to put in my bra. This might have been okay in July, but not in December. I left the hospital with a list of breast surgeons, and called my ob/gyn to find out who she recommended.

Now to wait 2 – 4 business days for the results.

Mammogram and Ultrasound

I was fine until the day before the mammogram, and then I started freaking out a little. I guess because I wasn’t going to be able to ignore it any longer. I just couldn’t face the thought of telling my children or my dad if I had cancer. I didn’t think I could deal with one more thing after my daughters diagnosis, my dad’s stroke a couple of months prior, another daughter involved in a fatal car accident, and losing my uncle to cancer; all in a four year span. I was tired and afraid. I went to bed early and fell asleep with my husband’s arms around me. I woke up feeling refreshed and ready to face the day.

I checked in at the Women’s Health Center of St. Josephs Hospital in Ann Arbor. I was soon escorted back to the area where you remove everything from the waist up and put on a lovely pink patterned gown, fastening it in the front. Then I was instructed to sit in a waiting room with several other women in the same state of dress. We all sat with our magazines or smart phones, checking Facebook for the latest status update. I looked around and wondered which of these women were here for a routine exam and which were anticipating something more serious.

I was finally taken into a small dimly lit room for the mammogram. Are they trying to create an atmosphere? How about some candles and Yanni playing in the background? The technician had warm hands and tried to be kind as she carefully adjusted my breast between in the machine and then smashed the hell out of it, saying “hold your breath.” The mammography machine loomed over me and hummed with each adjustment of position. Eight different images were taken, then she told me to go back to the waiting room while the radiologist read them. She came back in a few minutes and said she needed to do a couple of more images. Great, I thought. Two more images of my right breast and back to the waiting room. “Why my right breast?” I thought. It’s the left I’m concerned about.

Finally the technician took me to another waiting area for the ultrasound. Another tech showed me into a small room and had me lay on a table with my gown open. She squirted some slimy gel on my right breast and began to scan it with the ultrasound wand. I watched the screen as she performed the test. She stopped in two different spots, took measurements and notes, and then went on to the left breast. I am astute enough to realize that those dark spots she was focusing on were the areas of concern. I asked her if someone would be looking at the scans and talking to me about them before I left. She said absolutely. When she was finished she left the room and came back in a few minutes with a young doctor, and I do mean young. I swear she was about twelve. She explained that she wanted to take another look at a couple of spots on the ultrasound, so I lay back down while she did that. She told me that I needed to have four spots biopsied, and explained how that would happen. She asked me if I had any questions. I started to cry and said “I don’t even know what to ask.” I wanted my husband to be there with me instead of in the waiting room reading some old issue of Womans Day. She asked if I knew of a breast surgeon, that she thought I would need one after the biopsy. Obviously she was not feeling positive about the outcome.

A biopsy was scheduled for the following week, but in the morning someone called and said they could see me in two days. I felt relieved that I did not have to wait so long, and worried because they felt they needed to get me in so soon.

The next day I was a sobbing mess. Every time I talked to someone I cried and cried, wanting to just lay down on the floor and kick and scream. Telling my kids was the hardest part. I didn’t want to worry them. My daughters all cried with me. My son took it like a guy, very stoic and matter of fact. My dad immediately started talking about what the dogs had done during the day.

In the following days I stayed busy doing things around the house, cleaning out the chicken coop and putting up Christmas decorations. I went to a movie with a dear friend, and I went to a twelve step meeting, where I have learned over and over again to stay in the moment and not to waste today worrying about tomorrow. 

Waiting

I was fifty eight when I first noticed the indentation in my left breast after showering one morning. “Hmmm, that’s interesting,” I thought. I felt around but didn’t find a lump. I forgot about it until my next shower and again let it flutter to the back of my mind. I wasn’t afraid. I had faced the most frightening thing in life two years before when my daughter was diagnosed with stage four synovial cell sarcoma. I ignored it for a few more days before I decided I should make an appointment with my ob/gyn. I was due for my regular exam anyway.

She looked me over and felt me up, then wrote an order for a diagnostic mammogram. Explaining that I would have my usual mammogram and then an ultrasound if it was deemed necessary, she told me I could get dressed. “Did you feel anything?” I asked. “No,” she said. I am not sure she would have told me if she had.

I scheduled the procedure; the earliest they could fit me in required a two week wait. I told my husband and asked him to go with me for the appointment. The waiting was not very hard; I stayed busy and only thought about it a couple of times a day. I called my best friend, who was a breast cancer survivor, and told her. She made me promise to call after my appointment and let her know what we found out.

My husband had a dream one night during those two weeks that I was having a heart attack and wouldn’t let him call 911. He could feel my heart beating like crazy and the numbers on his phone were all backwards. Then he realized that he had to call 119 to get help. The same night I had a dream that I hung sculptures of the Mad Hatter and the Jabberwocky on my living room wall. I am sure that both dreams have deep psychological implications.

Thelma & Louise

What the hell were we training them for?

I was the first girl in my sixth grade class to wear a bra, and I hated it. I was sure that everyone could see the straps through my clothes. My first bra had little flowers at the junction of the cups and shoulder straps; I yanked them off because they poked out the front of my shirt like two extra nipples poorly placed. My mother called it a “training” bra. What the hell were we training them for? The Mammary Olympics? The boys in my class took great pleasure in pulling the elastic back of my bra and letting it snap as they ran away laughing. As I said, I hated it.

In junior high, most of the girls had graduated from “training” bra to B, C or D cup. We kept our books close to our chest to avoid being grabbed by some adolescent sex crazed boys ( I won’t mention any names, but you all know who you are) in the hallways between classes. There was no such thing as “sexual harassment” in the 1960’s. We just tolerated it.

I’ve never quite figured out the fascination with breasts. Is it the fact that they are our first source of nourishment and comfort? Or maybe the first publicly visible sign of budding sexuality? Whatever it is, men and women alike are interested in them. Admit it, ladies, you look almost as often as men do, comparing them to your own or wondering “Are those things real?”

As an adult I stared calling my girls Thelma and Louise, after the movie characters. They were looking for trouble and usually managed to find it. Every guy I met wanted to get to know them, up close and personal. They mostly went away with their hopes dashed.

I nursed my four babies sitting in an old rocking chair, loving those middle of the night moments of joyous bonding with the lives I had created. I didn’t mind the sagging, the stretch marks, or leaky nipples. This is what breasts were designed for. I didn’t care that men stopped looking so shamelessly, or that I could not go braless because I actually needed a serious system to prop them up.

I started having regular mammograms after I turned forty. I looked forward to them like having a root canal. The man who invented that machine should have to have his testicles “grammed” on a yearly basis in the same sort of device. The indignity of slapping your boob onto a tray and having it smashed in a vice is quite unpleasant. The results were always unremarkable and I took it for granted that I could not get breast cancer. After all, the common thought when I was a young mother was that you had very little chance of getting breast cancer if you nursed your children. I had that covered. I thought I was safe.