Thursday, April 1, 2010 8:06 PM, CDT
April 1, 2010
Is it a coincidence that this journal begins on the day of foolery? Was I foolish not getting checked out sooner? Am I foolish to not fear the future? I don’t know. I’m conflicted about it all. All I know is I have been diagnosed with breast cancer and have a tough journey ahead. For my daughter, sisters, nieces and all the women in my life I am determined to document my journey. At the risk of being foolish or embarrassed I will write. I will be real. I will not hold back.
The journey begins with a doctor’s visit and a suspicion that something wasn’t quite right. Although I was in denial – not me – in private I worried about a slight shadow in the low curve of my right breast. The shadow emphasized a dimple, an indentation that only presented itself as I raised my arms to apply underarm deodorant. Not one to gaze at myself in the mirror I do not know exactly how long this vague indicator originally presented itself, I can admit (out loud) that it has been at least 2 months and probably 3 or 4 months. I really thought I was too young to be worried about it. I’m under 60 and in good health, have small breasts and didn’t feel anything under the shadow. No pain, no obvious lump, only a shadow.
I haven’t been fastidious about self exams, but I do do them when I think of it. I’ve tried to understand or imprint in my head the layers of lumps, ridges, soft spots in there but I have to admit, it all felt odd. So the least I could do is compare both sides and try to identify changes. I didn’t. I didn’t recognize the change until that shadow. I haven’t been getting annual mammograms. I didn’t practice good judgment or what I preached. I couldn’t even admit to myself that I was WAAAY past due for an exam. And in spite of the fact that Mom and Jackie had breast cancer, I STILL didn’t think it could be me, or did I? Maybe I knew and wasn’t ready to face it. Foolery indeed.
The Mammogram:
Less than two weeks ago I was scheduled for a mammogram. I really hate mammograms. With small (and what I’ve been told were dense) breast the challenge to fit them on the flat platform to be pressed and captured between the plates is uncomfortable and less than pleasant. My experience was not what I expected.
First the facility is really nice. The staff extremely pleasant and not overly sugary. I was on time, I was seen expeditiously with a professional warmth with just the right amount of detachment to assure me I needn’t be embarrassed in my gown. Silly that I would be asked to alternate the action of slipping my arm out of the sleeve while the gown hung on the other side just slightly covering the other breast. But I mimicked the professional detachment and obliged to partake in the illusion. The deed done I returned to my tastefully appointed dressing area, dressed, reapplied my lip gloss and left with a thank you and a smile not expecting (really??) to see these nice people for at least another year. The desk attendant let me know the results will be sent to my doctor.
The Results:
So I went home and proud that I did what I needed to do.
Two days later I received the call from the doctor’s office that there was a dense (there is that word again) area that the radiologist wanted to exam closer and I was scheduled for a follow up appointment the next day.
A new technician met me, respectfully went over the process. She did see the shadow and identified the area of concern – said she could feel it. I could only believe that she had much more experience with breast lumps. She pressed down with a finger to see if I had any soreness. I didn’t. She took her pictures and again I returned to the dressing area, but this time not so confident.
I wasn’t fearful. Why? I was more concerned about my lack of concern. Who am I to think even at this stage I will get favorable news. Boy, isn’t denial amazing?
This time the doctor called and said the radiologist (who is this guy?) recommends a sonogram. So it is scheduled and I meet with the nurse navigator who explains the process and assures me that it will be a quick and simple office procedure. It was. Very nice. Instead of the TV version where cold gel is applied the gel was warm. The sonogram technician was very nice and very professional and pregnant. After a review is was decided a biopsy was in order. It was scheduled for the next day. I’m glad I took the day off.
1. Mamogram
2. Compression mammogram
3. Sonogram
4. Biopsey – needle biopsy/Sonogram
Oh the Pain, the pain.
Please don’t let anyone tell you a biopsy doesn’t hurt. Don’t believe them when they say “you’ll feel a little prick and some pressure” LITTLE PRICK!!! Good grief. Little Prick!!! - Hell, I scared the doctor and the technician when I yelped in pain.
Imagine a cold soldering iron drilled into your breast – no problem. Then the switch from off to on with instant red hot heat – the burning pain starts as a single point of pain that blossoms like a flower, spreading slow with a unique definition. I knew exactly where it was and where it traveled. Now multiple by three. Three samples. It was supposed to be four, but the doctor and technician took pity on me and elected to stop at three. They were good samples. Thank God. With care and sympathy the doctor assured me that this was unusual (must be because my small breast are do “Dense”).
The issue is this. The area, about 1 inch in size-phase 2, is close to my chest wall. There was extra caution to not puncture my lung with the biopsy needle. The needle was navigated from the side, but the lanicane just didn’t get there. So yes, it hurt like hell. So what. A sign of life. I got over it.
Learning to sleep:
So Tom and I left the doctor’s office thinking, yes, this wasn’t so bad (in spite of the pain). We went to lunch. Enjoyed sushi while I worked the chop sticks with my left hand, protecting my right side. I was now packing a cute little circular ice pack in my bra. After lunch I wanted to complete my kitchen make-over (inspired by Lynn) and pick up a few items at Harry & Davids. Sure…I was just fine. No problem. The ice pack melted, the breast calmed down, I wanted to be happy, just pick up a few items to make black bean soup and some trivets to decorate the kitchen walls . What was I thinking? The doctor said I should take it easy for a few days, not do any cleaning, cooking etc… for 24 hours. The only thing I complied with was the no showering for 24 hours.
So that evening I practiced sleeping. I am a BIG flopper. I flop all night. I don’t just roll over I flip the covers up in the air propel my body up and twist with the goal of landing in a new position just as the covers land. I haven’t perfected it yet. I’m asleep these things take years. Most of the time I wake up with the sheets twisted sideways, two or three pillows thrown across the room and the nicely folder covers from the closet in a heap in the corner. Don’t ask. It is so bad I have to sleep in another room from Tom or else he wouldn’t ever get any sleep.
So lying in bed wearing my bra (doctors orders) and panties (not orderd) I practiced sleeping without the flip and the flop. I worried what it was going to be like if I had to protect my chest area, avoid the pain. I still had the bandages on from the days adventure. I practiced not rolling on my side, not lying on my stomach, not twisting. I lied straight face while I lied (to myself). I couldn’t do it. I managed to keep the flipping to a minimum but I did roll and change position many times. That is when the worry set in. At night learning to sleep.
Okay, long story short:
Okay, long story short. I got the call the following Tuesday at work (the biopsy was Thursday). The biopsy was positive for cancer. The doctor gave me the information over the phone. I was thankful he didn’t make me wait for an appointment or a letter in the mail. He was apologetic, appropriately somber and I found myself assuring him it was okay. I would be scheduled for an appointment with a surgeon, an oncologist, etc. etc. etc. Wheels in motion.
I called Tom and Jackie. I wanted to wait until I had my treatment plan before calling anyone else. It’s simpler and less dramatic if you can say … "and this is what I’m going to do about it." This is me being practical. I’m still at work. I decide to tell my boss. She is supportive and even more calm and practical than me. Okay, she says, you just do what you have to do.
I called Bailey. I had to leave a message. She called back that evening and was calm, supportive and amazingly non-panicky. A real chip off the ‘ol block. She is facing her own adventure with abnormal paps and a recent biopsy. “I enjoy being a girl”
Berkeley is spelled with 3 e’s:
Tom and I went to see the surgeon, Dr. Kho. Meticulously she reviewed my pathology, treatment options and we looked at the computer images of my breast; fondled the hardware that transports chemicals into the bloodstream; agreed that a good course of action would be a few months of chemo therapy first to shrink the tumor, then (if all goes well-why should things change now??) surgery to remove the tumor, a lumpectomy or partial mastectomy., followed by radiation. Tom and I have every confidence that this surgeon knows her stuff. She has her undergraduate degree from Berkeley, Asian with kind eyes, is about 13 years old and very cute. Everything you want in a surgeon. Before we left her office the oncologist concurred over the phone. Not that she was cute, but the treatment plan was a good one. I was a good candidate for this type of treatment. So we left knowing that someone would contact us in a few days to schedule an MRI; I needed some additional lab work done and have a chest X-ray.
The official pathology: Infiltrating carcinoma with mixed ductal and lobular features. (I have features, don’t you just love features?)
Surgery a go-go:
Surgery to implant a port for the chemo and biopsy the right lymph nodes is scheduled for April 16th. Dr. Kho is very busy and that was her next available surgery date. My biggest concern is whether or not I would be in good enough shape to travel south for mom’s memorial. Everyone I spoke with knows now our family history and are working to assure I can without a problem. Hmmmm will the port be detected at the airport?
The Navigator:
I have a nurse navigator. Tom and I visited her right after our appointment with Dr. Kho. She brought out the diagrams and dioramas, packets of pink literature, models of half breasts and pamphlets. She and Tom bonded. I think they would have gone out for a cocktail if I hadn’t been there. Pink Champaign or something. I’m glad he has a new friend; I think he is going to need a navigator.
Pillow talk:
It is my plan to keep working as much as I can. I’ve taken the week following the implant surgery off for recovery so I can be in tip-top shape on the 24the and give me time to plan for future treatment (in other words, laundry and house cleaning). I will actually see the oncologist the Monday following. Then let the games begin. I do not know anything beyond this. It is my plan to forge ahead one day at a time and maintain an as positive attitude as possible. I will probably work some days from home or partial days as the treatment allows. A few people at work already know and we have had a few good laughs about baldness and me being a grumpy old lady. Plans being what they are, plans…I expect some interesting side trips and diversions. Think I will need a new pillow, no not to cry on. Just planning ahead for those long nights learning to sleep.
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