Monthly Archives: May 2013

Hot diggity!

Standard

Wow. I didn’t expect to be giddy with relief after the surgeon’s appointment today. Like Cinderella at the ball. Or Dorothy home in Kansas.

The three page birth plan is back in force. There will likely be no chemo. And probably no radiation. My hair won’t fall out and my skin won’t peel off. I won’t feel like I’m dying in the midst of “treatment.” Nobody batted an eye at my request for skin-sparing bilateral simple mastectomies and immediate reconstruction (the first steps of it, anyhow). The incisions are small, and the procedures will be done by folks I trust. All my externals will be left as they are–maybe even with some sensation. My friend Michelle just messaged me about the “awesome new rack” I’ll get for my troubles. LOL. I’ll be happy with just short of normal.

All the arcane testing done on my cells says they haven’t gone nearly as awry as “invasive” breast cancer implies. Chemo won’t work on “non-HER-2 expressors.” Or those with a “low Ki-67 proliferative rate.” Am I the only living woman with an urge to thank an under-acheiving cancer mutation? Mom viewed my decision to become a nurse as evidence of mediocrity. Well, hoo-yah!

We shall see. The above changes if it turns out some pesky cancer snuck into my lymph nodes. That will be determined with surgery and could require radiation. But by then I’ll have the expanders-soon-to-be-implants (yay silicone), and there’ll be no going back.

…I got to reading that last sentence, and realize there are friends and patients I know who’ve had a terrible time with aggressive cancers and all the misery chemo implies, as well as postoperative complications that require going back to the beginning and starting all over again. In the face of all that, my giddiness may well feel selfish and downright insensitive. I apologize. I’m enjoying the moment, though, and trust you don’t begrudge me that.

Late night thoughts…

Standard

Lewis Thomas had his, prompted by Mahler’s 9th Symphony. And I’ve got mine, though none so lofty. Mine are like: Geez–nobody looked up Amazon (previous post). Everybody’s so freaked by the damned disease that they’re going to go through life thinking Amazon mostly means

  • an online bookstore
  • a river in South America
  • a big green parrot in South America
  • mythical female warriors who lopped off a breast the better to draw a bow

Actually, if you remembered the last one from 8th grade history, you’re close to being right. Amazon translates “without breasts” from the Greek. I only know this because I’m freaked by the damned disease too, and that piece of trivia came up early in my internet wanderings. I have no idea why it seems important tonight.

My dear friend took me to lunch yesterday. She’s so emotionally intelligent, anyone lucky enough to be her patient is really lucky. She asks things like, “what do you want to have happen?” and “what scares you?” Like she’s not afraid to hear the answers. Like if I don’t know, maybe she’s got some ideas. Or maybe not. But that’s ok, because at least she thought to ask the questions.

On the other hand, I already told folks at the office that I’m not into the whole “cancer journey” thing.

“So how’s YOUR journey going?”

My darling dad, a very private man, was mortified when an enthusiastic greeter at a center for alternative medicine grasped his hands and insisted on defining this “journey” for him. He was supposed to emerge changed: “different, yet somehow better” than before cancer. Actually, he was dying. He knew it, and he hated it. As was his right. As is mine, should it come to that.

And nobody’s shaving any heads. I’ve been put on notice by my friend Pam that she’s sure as hell not gonna be bald just because I get that way. I still have a niggling hope that I won’t be. My dad used a cold cap during chemo infusions, though his oncologist scoffed. But he kept his hair. A friend who was a cancer nurse introduced the idea, said she’d seen great success with it among patients at Cedars Sinai. Well, I’m wildly enthusiastic about the possibility of keeping some hair, even if the evidence-based-medicine Grinch won’t support it.

Oh.

Please.

There will be no talk of making plaster casts. None whatsoever. Pregnant bellies are fine in this medium. Old boobs are not.

Now we are Amazon (look it up).

Standard

Guess I had my meltdown earlier this week, before any actual diagnosis. Am just kind of dull right now. Stayed home from work Tuesday and nursed the biopsied breast. Like any good patient ignored medical advice and got in the bathtub–what the hell, right? Dripped pissed-off tears into my lavender bubblebath and sort of got over it, but really wished I didn’t know what I knew. In a fit of solidarity the radiologist showed me the films. It was patently obvious with fancier imaging that what couldn’t be seen on mammogram was right where they thought it would be. Dunno how he found it in the first place. The regular mammogram looked pretty regular to me.

So yesterday one of my partners gave me the news. I’m so sorry to have burdened her with that (she looked more miserable than I felt), but I decided to have the breast center CC the report to our office. Through long experience I know the much-vaunted primary care system isn’t going to call me any time soon. No word from that quarter until last night. A sotto-vocce reading of the report by a minion who wasn’t comfortable doing it. Wonder how she’d have handled it if I was a layperson and she thought I didn’t know the words?

“Invasive ductal carcinoma…features of LCIS and DCIS.”

I’d be more optimistic about what they didn’t find (a really “aggressive” cancer) if there hadn’t been a another biopsy yesterday. This one, sampling calcifications further out, was also positive. So my fantasy of joining Angelina Jolie for a subcutaneous mastectomy and immediate reconstruction flutters to the floor. Sorta like the three-page birth plan. If I’m smart, I’ll take my patient Jamie’s advice (she’s nearly due with her first baby), and “just show up” for the event, leaving the rest to the professionals. Well, I’ll try, anyhow.

Not what I thought it would be…

Standard

So I thought I’d be posting about midwife stuff.

Instead, I’m bawling into a wad of Kleenex after the second of what’s going to be a whole series of breast biopsies. Not that this is anything new. I’ve had cysts aspirated and densities sampled, and ultrasounds and mammograms–all in excess of the usual surveillance undertaken by good girls. Hey, I’m in the business. I don’t believe in the talismanic properties of medical tests, but I do them anyway.

This time seems different. Had the mammogram and got called back for more. Nothing unusual about that; it happens every time. I don’t even bring my husband these days. Then I was told I needed a fine needle aspiration. Still not alarming. But it must not be too fine a needle, as the radiologist left behind a titanium marker shaped like the stupid pink breast cancer bow. I didn’t get a vote, he just showed me the pictures and there it was: bow marks the spot.

Sitting with a cold pack on biopsy site. You can see how upset my dog, Buddy, is. There are angels among us, I tell you.

Sitting with a cold pack on biopsy site. You can see how upset my dog, Buddy, is. There are angels among us, I tell you.

Only it didn’t. Missed it by an inch. The Area Of Interest is deep, so I get invited to do a stereotactic biopsy. This one’s like being in a weird sex film–I’m face down, utterly helpless, boob dangling though a hole with people I can’t see sticking needles in it. And my husband’s in the next room (ok, I chickened out and brought him this time). There’s nobody to hold my hand. The technologist presses on my back, but I get the feeling it’s more about keeping me still than for comfort. It’s embarrassing because because I can’t breathe when I’m on my stomach. I’m snuffling and snorting, trying to keep the table dry, and they think I’m losing it–which I mostly only do in private.

So this time the marker’s in the right place. I don’t notice if it’s shaped like a bow or a bunny or what, because I’m riveted to the screen. Dunno why we bother with mammograms when there’s this kind of imaging. It clearly shows a mass. Not the “density” they’ve been whispering about, but a real mass. The radiologist calls it “very concerning.” It has spiky edges. The crablike kind that gives cancer its name.

Nobody says cancer yet (and if they keep not saying cancer I’m gonna be really embarrassed about this meltdown), but they want me back for another stereotactic hoo-haw the day after tomorrow. This time to sample smaller bright spots around the big spot. Everybody’s being very kind, very attentive, very professional. And I’d sooner stick my head in a toilet than step through their doors again. But guess what? I’ll be there Thursday morning, bright and early. Leaving the bells at home.

Empowered Blogger