Wednesday, December 9, 2009

Plastics Make It Possible

Nearly healed from surgery at long last. Days after I wrote my last post, I grew another infection. Fever, chills, rashes at my incision sites. We’re all walking bacteria farms, but I appear to be an entire continent. Out of the four surgeries I’ve had in my life, three earned me a painful infection. My doctor’s take? “Maybe you should be done having surgeries.” Sobering. That fat graft from my thighs to build perfect breasts is looking a little dicey at this point.

My friend Jeanne sent me an interesting article about how breast cancer is getting a lot of attention on the back end (mammograms, insurance) when we should be doing more on the front end. The chemicals leaching out of microwaved plastic containers, cups washed in the dishwasher on high temps, hormones in meat, PCB runoff? As another cancer survivor says in her memoir, we’re victims of an ongoing environmental disaster.

I don’t want to be a victim. I don’t want to be seen that way. And I don’t want to be some Chicken Little either. But I can’t help but be concerned about the health of my children and staying around long enough to watch them graduate. Some days it seems everywhere I turn there are poisons.

This is all old news to some. I’m certainly not the first person to wring their hands. And it must be said that plastic saved my life and improved it. Catheters. Syringes. Implants. And so I am complicit. My pomegranate elixir comes in a plastic bottle, as does our milk and oftentimes the orange juice. The largest container of recycling in our house is filled with plastics. Why are we collecting this stuff, only to turn it back into the same problem?

Sunday, November 15, 2009

Laparoscopic Assisted Vaginal Hysterectomy

Prepare to click away dear reader if you don’t want to know the ins and outs. But before you go, first let me tell you this. The next time you are a patient, remember to take as much control of your care as possible. It doesn’t mean be difficult, but rather challenge your doctors, ask for the outcome you wish to see. More often than not, they like the break in monotony. I told my plastic surgeon I didn’t want to be pumped up visit after visit to have big breasts, only then was I given a simpler option. I asked my OB surgeon if it was possible that I could avoid the six-inch incision through my belly muscles and he said he would try laparoscopy first. They prepared the OR for both options. Even the drugs that they give you can be altered. Most health-care programs are very open to customizing your treatment, you just have to speak up.

The Procedure
Approximate time: 2 hours

There are three primary ways to have a hysterectomy: through the big honking incision (total hyst), through abdomen laparoscopy or through vaginal laparoscopy. In my case, my surgeon performed a modified version of vaginal laparoscopy. After two enemas and the intake procedure, I was fitted with an IV, a mask to put me out (last I remembered of course) and then a breathing tube. They inserted a catheter after that to keep my bladder emptying and ease recovery if they went for the total hysterectomy. On the operating table they slanted my body slightly head down so that my other organs would slide up into my upper torso (lovely image, isn’t it?). They also inserted air into my belly so they could move their cameras around in there. The metal instruments they put into each incision also have a cauterizing/cutting tool to do the work. If you Google the procedure, you will see plenty of photos of just how it is done. I had to stop midway through one video but hope to return to it when I can’t actually feel the remnants of alien probes rifling around in there.

Once they took a gander they discovered that the Zoladex shots had temporarily shrunk my fibroid so they would be able to perform the less invasive procedure. The Zoladex had also closed down much of the blood flow to that area so that made the work even easier. The doc was quite pleased. He said my ovaries looked all healthy and pert (lil devils).

He did manage to take my cervix and some of my uterus out through my vagina (pried open with gleaming metal handles called retractors, ouch), but because I’ve never had children my vagina was not lax enough to handle much more so he had to essentially take apart ¾ of my uterus and extract it through an additional incision in my belly. Still, the difference between the laparoscopy and the total hysterectomy is worlds apart when it comes to recovery.

I woke up with some acute pain that the nurses got a handle on in post-op while a few beds down a man lay mewling in agony. Poor guy, that hurt more than anything. Once in my room, the nurses were frustrated because I kept forgetting to use my morphine drip and didn’t want two pills at a time. I guess, after my last surgery, I was expecting full-on agony and it just wasn’t there. I was certainly terrified going into this, but by the time they pulled the catheter out I was like, “Is that all you got?!” I suppose after contracting a staph infection during my last adventure I should be more hesitant to bang the drum but seriously. I feel pretty good. The worst pain I’ve felt so far is the hangover migraine that the morphine left behind.

My procedure started at 7:30 on Thursday and I went home noon on Friday. It's Sunday. And here I sit jabbering away at 90% Ladiectomy with two healthy ovaries and a chemically induced menopause and the sort of discomfort one suspects might be alleviated with a 12-pack of Activa yogurt. And let me tell you what you may already guess: I am so happy to be alive, flashing hot and cold, that I could just cry.

In the image above, the incisions. The bruise is from my Zoladex shot. I will tell my grandchildren this is all from my adventures in the French foreign legion.

Monday, November 9, 2009

Something Borrowed to Carry Me Through

Don't know what's left to say about being deconstructed over the course of a year. So I'm posting work from my friend Mary Logue, mystery novelist and poet extraordinaire. She always sums it up neat and clean and beautiful at the same time.


When you reach the longest day,
first day of summer and perfect,
the air clear and dry,
the wind making all the flowers

nod at you again and again,
when you reach this perfect day,
do you wonder which of all
the days you’ve lived through
was the apex of your life?

As the sun circles farther south,
do you begin to slide? Do you worry,
knowing you will never be here again?

Or do you give up and lie like a dog
happy on the swing in the porch,
your belly exposed and vulnerable
to all the days that will come?

—from Hand Work

(You can of course purchase most of Mary’s work at Amazon or request it at your local bookstore.)

Thursday, October 29, 2009

Ramble On

Almost as soon as I spewed out that last post, my energy picked up and my outlook brightened. Perhaps I had turned a corner with my cold/flu thing, perhaps I experienced an out-gassing of hormones or perhaps the very act of writing was a sort of sloughing off the bad juju.

Anyway, I feel good. But that post remains for anyone to see and assume I’m in tatters. I guess if I want to honestly document this process I can’t delete it. Just more proof of how sideswiped we are by changes to our delicate physiology and that we need to feel a sense of purpose in life if we’re going to make it through.

Working on getting strong again for this next surgery. Going off the tamoxifen for a few weeks to prevent blood clots. My excorcism hysterectomy is November 12th and the doctors want to make sure I’m good to go.

You know what’s weird? When you stop getting your period. I suppose if you’ve been pregnant this does not seem weird but on some visceral level I keep waiting for it to come. There is a twinge I guess. Sort of like losing my 34Ds. They were kind of a nuisance, but they were my nuisance, you know? I wonder what I would have said a year ago if someone had said, hey, you can stop having a period, make your breasts smaller and firmer, lose weight, get free narcotics and all you have to do is look into the abyss.

Bet I would have said, hells yeah, sign me up!

Tuesday, October 27, 2009

Cloudy With A Chance Of Shoes

Last week I was up in the middle of the night, tossing blankets, stripping off my shirt and distancing myself from the various heat sources in our bed, and I began to think how un-depressed I was, how the other shoe had not dropped. We were dealing with my medical issues, had absolutely no work, living in a house filled with dust and exhaust from basement construction, the weather had gone all cloudy and cold, and yet I didn’t have an overwhelming sense of dread. I realized that I had had more anxiety at 32 than I do at 42. As if, once you’ve made peace with the big anvil falling out of the sky, all the other stuff is totally maneuverable.

Then I woke up with chills and a sore throat and one of those sand papery coughs. A week on, I’m still exhausted, I go to bed early and can’t truly wake up until mid-morning. I feel so useless and I absolutely hate that it falls exactly in line with the medical predictions. I don’t want to be depressed. It’s not my bag really. But I do feel as if I’ve lost the plot of whatever story I was supposed to be living. My family makes it better. They’ve been very understanding even though I’m essentially a part of the furniture, like a threadbare ottoman with a missing leg. I had only an inkling before this of how important hormones were. They are a lot of what drives us to keep reaching for those youthful aspirations however feeble. And I don’t mean to say that after menopause (or manopause) that we’re all somehow directionless. But that a gradual process is more like a door opening than one slamming shut.

Talk of menopause makes people uncomfortable. Something we shouldn’t discuss, or if we do, we shouldn’t speculate and say something unfeminist. And that’s fine. Women don’t want to be devalued after they pass childbearing age. Men find it icky and mysterious. My friend Mary G. says the whole concept of labeling menopause is silly and a way to subjugate women. Like, it’s not that big of a deal and she’s probably right for many of those who transition naturally. But the brain fog I’m in right now is making it difficult to even blog correctly. (My apologizes for that.)

What is the positive? What can the reader pull from this murk? Well, other than being thankful for the relative normality you may be experiencing as you read this, I guess that it's possible to wade through the fire without ENORMOUS incident. And that even in this mess of a year there is so much to marvel at. Yes the pills and shots are putting me through my paces. But without medical science, I would have never met Cheryl. She would have already been dead seven years from thyroid cancer. There would be no Cameron and Madeline, no duplex to house our little family and our business, no relationship with Cheryl's family and soon there would be no me.

But still we persist.

Saturday, October 10, 2009

Putting Out A Fire with Salt Water

Big Ass Needle and I had our second date on Thursday. We met in the “big comfy” chemo chair this time. There was a man in the adjoining room, receiving his chemo, watching a baseball game. I gazed out the window at the eclectically manicured Cancer Center gardens, imagining all those who had sat in this chair before and received something more toxic. It didn’t hurt as much this time, the nurse gave the lidocaine plenty of time to work. She explained that the Zoladex is a tiny tablet, that’s why the needle is the diameter of a swizzle stick and also why last month I could feel a little bump under the skin. Anyway, I didn’t bruise or start bawling and decided I would be all right this time. Maybe my ovaries had already gone to sleep and this month was going to be about leveling out.

So on Friday I decided I wasn’t sore or anything and went on a bike ride. I mean, it was going to turn cold and it might be one of the last good days, right?

I’m not sure if it’s the hormone loss or just the season winding down but my rides lack aggression. Really having to tell myself to get out of the saddle and sprint. There’s less joy at the apex of a climb and my heart feels non-committal in my chest. I keep trying to tell myself it’s all in my head, that I’m just being suggestible from all the stuff I’ve read. It was a GOOD ride all in all. I’m still very strong (always am by the end of the year) and I even took the dogs on their walk when I got back. After that I was hungry and clammy. So I wolfed down some dark chocolate and cranked on the hot water for a shower. (One of the results of my surgery is my implants don't hold heat like real breasts and I don't have a lot of fat up there for insulation.)

After I got dressed, I realized my ovaries weren’t done with me yet. See, Zoladex tells your pituitary gland to stop talking to the ovaries. And so by the second day, they start getting uppity. The ride and the shower was bound to exacerbate the symptoms. A throb in my belly came on, like this horizontal bar of heat and tenderness. My face turned red and in the middle of dinner, I just started crying into my soup. But I wasn't exactly sad and even began laughing in the middle of it.

It might seem depressing on the outside. It isn't. The hot flashes are easily dealt with by layering my clothes. I'm experiencing an amazing transition—one that induces reverence and awe for the human body. It really does feel like it’s all going up in a blaze of glory.

Of course, such hyperbole could be the out-rush of estrogen and testosterone as they leave the building.

Of all my lady parts left scattered about like so much roadkill, I would be sad to see my ovaries go. My Oncologist and my OB surgeon are at odds on this. The Onc wants them gone. The OB says I’ll need their residual effects. I can totally understand the two viewpoints. The Onc is only concerned about cancer returning. The surgeon comes from a place that sees surgery as the cure. He probably thinks I was cured the day they took my breasts. Why hurt my quality of life? And of course the Internet is all over the place.

I want to keep them. Just one last party favor from a time when I was powerfully driven by the force of Mother Nature. But am I playing with fire? Even after all that we have been through in this house, I often forget my diagnosis. And I don’t foresee ever having cancer again. Is that the human capacity to live or just willful ignorance?

Tuesday, September 15, 2009

Thank You, May I Have Another

Today I had an appointment with the OB who delivered our twins (as well as removed a humungo fibroid first so that Cheryl could carry those twins). His focus is generally fertility but we trust him and he’s a crack surgeon. He’s conducted over 600 procedures since our last visit.

After much discussion and an in depth exam, we decided on a hysterectomy in November. The Zoladex may shrink the fibroid up to 20% but once I go off the shots, it will likely grow larger than it was originally. And if I just have the fibroid removed, my uterus will grow more to replace it! According to the doctor, if you do not want to have babies, there is no reason to hold onto your uterus. And I feel the fibroid's presence now, every moment. The doctor said at this size it's like being 3 months pregnant. My friends are probably tired of me making pee stops every time we go out. So any hesitance I should have at this point would be more about the surgery itself and recovery.

Not so with the ovaries. Gotta keep them. I don’t really want these bruises once a month for the next five years, but looks like I have no choice.

The OB said we really shouldn’t remove my ovaries unless I have the gene that indicated risk. I don’t. And I need them even after menopause, to keep my bones strong, my heart healthy, my libido cooking and my emotions stable.

In some ways, this next surgery is the least of my worries. The doctor said that after my next shot my hormones will have hit rock bottom and that some women hate it so much they don’t want to keep it up. He’s a real ray of sunshine that guy, but he’s honest and I like to know worst case scenarios.

Today I feel pretty good, bones a little achy, but I'm happy to be alive. What a year this has turned out to be. So many famous people leaving this world that the snarkier blogs are calling it The Summer of Death. The healthcare debate is the latest subject to reinforce this country’s divides. Young soldiers are still giving their lives every week in a far away country.

We’re all tested along the way. My first was being gay. Can’t say I rode that one out of the gate very smoothly. When Cheryl came along, I showed marginal improvements. By the time we had kids, I was reasonably equipped to be a normal human being. And now cancer has awarded a badge of authority I probably don’t deserve. I have received so many cards and well-wishes from people I had no idea even thought about me anymore. It’s really amazing. I hate to admit it, but I may have finally grown up.

I now believe that a life fully lived is our shot at triumph over tragedy. No matter what portion has been taken from you, you must not hide. You must go out and live it.

Thursday, September 10, 2009

Estrogen! The Musical

So, I’ve been on the Tamoxifen for a few weeks now and am starting to see the effects. Headaches aren’t that bad but I am a little weepy. It’s as if a yearning John Barry soundtrack is playing in the background. Anything will set me off. Oliver caught a cicada today and tortured it. Waaaaaa! Kids pick up that playdough, or I'll, I'll, waaaaa!

Also, my fibroid is beginning to radiate a constant pain now. A child’s elbow, a dog’s paw—it feels like a punch in the gut every time I get poked in the abdomen. My oncologist told me today that my fibroid is only a centimeter smaller than my uterus and sitting on top of it, so I should probably consider surgery. The Zoladex shot I got today might lessen that but I wont see any results for a while.

I thought the Zoladex shot was going to be a quick shot in the butt or arm. But it is more like the core biopsies in that they lay you back, numb you up with Lidocane before they use the “big ass needle,” as my nurse called it. The difference is it goes in the belly instead of the boob. Ouch. Once a month. Sigh. At least it’s not chemo, right?

Anyway, I walked out of the cancer center, tears streaming down my face, looking like I just got a fatal diagnosis. What an idiot. Suppose it’s kind of good to cry sometimes; it flushes the system. Plus I’m not just crying over sad things, but good things too. (The hibiscus blossomed again, waaaaa!) It’s weird. I never cried a ton before. It’s like the lady parts are going out with as much drama as possible.

According to the onco, it’s really going to kick in now with the shots. Hot flashes apparently.

Maybe I can keep the family warm this winter and we'll save on energy bills.

Thursday, August 13, 2009

Breaking: Leo Keeps Mane

Okay, bad news first. I got a friggin’ staph infection from my surgery. So my doc switched me to malaria grade antibiotics to kill that. Ick.

But the good news is my Oncotype results show that #1: My cancer recurrence is slim. And #2: It probably would have been resistant to chemo anyway. So no chemotherapy! Who-hoo! I fell into a category below even the shaggy grey area and would have only gained a couple percentage points for a cure by taking chemo.

Where does that leave me? Well, I have a bottle of Tamoxifen sitting in front of me, for when my staph infection subsides. I will be on that five years. I also will be receiving a shot once a month of Zoladex (for the same amount of time) to suppress my ovaries. My oncologist says that these two treatments have much the same effectiveness for my cancer as chemo does in other non-estrogen cancers.

I have an appointment with a geneticist to determine if I have the BRCA gene that indicates ovarian cancer risk. And an appointment with my OB-GYN to determine if I need a hysterectomy. The whole she-bang could be taken at once and I would stop the Zoladex shots. But I won't know for a month or so. And really, do I want another trip into a staph-riddled hospital?

We're not exactly dancing around, because there are still a few twists and turns, side effects etc. But it is entirely likely the worst is behind us. And that counts for A LOT.

Wednesday, August 12, 2009

No Better Time Than Now

There's no point in waiting until I'm cured to start banging the drum about cancer awareness, prevention and research funding. The American Cancer Society has all the details and it isn't always about forking over cash. Sometimes it's about volunteering. Which means a Web site or two in Carbon Creative's future.

There's another cause bears mentioning and that's becoming a donor. At this point in my life, I already owe two people a great debt—two people I'll never know who made it possible for me to have a strong knee again and brand new breasts. Our friend Stephanie can attest to such gifts. Her cousin was recently killed in the war. It was a devastating blow to many people. But the upside is his heart has given a Chicago woman a chance at life.

So please 'pay it forward' for me and become a tissue and blood donor, because at the moment nobody wants my "stuff".

Excellence in Parenting

Madeline has been behaving oddly. It coincides with my illness and the start of kindergarten so we assume either one or both are the cause. About a month ago she began confessing all the possible things she'd done wrong.

"Hun, I got paint on my pants." or "Hun, I dropped a booger on the floor."

At first it was sweet. And we thanked her for telling us. Then it became a little wearisome.

"Hon, I just spit out my pepper." and "Hun, I forgot to brush my back teeth."

It came to the point that confession was the only conversation she could have with us. So then we began to ignore it, trying not to fuel it. But that caused an escalation: purposefully doing things wrong and suggesting things she might do wrong in the future.

"Hun, I touched my ———— in public."

We knew it was a quest for attention but we weren't sure why she felt she wasn't getting attention. Perhaps it as a quest for control, because my illness and kindergarten are losses of control. But she just learned how to ride a bike and we hoped that being able to master that would give her a sense of control. We began asking her just to tell us what she'd done right. It was getting to the point where Cameron could not be heard over all her "sins".

This morning they were getting ready for summer class when Madeline said, "Hon, I breathed into a plastic bag."

Well, I had no choice. I had to whip out an Aesop's fable. So I proceeded to mangle that story of the boy who cried wolf. You should have seen our babies, eyes bulging, as I told them about little Emo (only name I could think of at the moment) who kept telling his dad he saw a wolf that wasn't there. But when I got to the end, I remembered why we never tell them old fables.

Madeline's eyes were all glossy. "Did the wolf eat him?"

"Um, well, I think it just scared him."

"I think it ate him." Cam nodded.

"No, it probably just scratched him."

"Do you think it bit him, Momma?"

"Oh, I don't know! The point is there's a moral to this story. And what do you think it is MADELINE???"

"That we should never, EVER, mess with wolves."

Monday, August 10, 2009

Dangerous Curves

Been trying to live my life again, the way it used to be. Playing slowly-moving-target to the kids' waterballoons and scanning the art fair for free junk. On Thursday night, Cheryl and I hung out with the guys. On Saturday night, we hung out with the gals. Yesterday, I got to ride 26 glorious miles.

'Course, this illness thing keeps wanting to tussle. Over the past few days, a section of my scar has become inflamed. My left breast is stinging in odd areas, nowhere near the scar. Last night all I could imagine was the cancer was back. Something they missed. Because that does happen. Or maybe some new cancer, like the inflammatory type, which is the most gnarly of the gnarly buggers and presents like an infection. Then my mind begins a subconscious march through all the things I need to be, and be doing. Be a better mom, be a better wife, better friend, make amends. Become a saint essentially, which doesn't look good on me; makes me look fat. It's wrong to go there, I know. But I’m a little suggestible when everything is not 100% fine. So this morning we headed back to to the plastic surgeon, who was a little stumped by it. He did a culture and put me on antibiotics.

There are other reminders, all around, disturbing as Betty Davis in Whatever happened to Baby Jane: "But you are Blanche, you are in that chair!"

While we were all talking on Saturday night I realized our friends Mel, Nancy and their daughter Ivy had stopped by after my surgery. Ivy entertained the kids; Madeline had lent her one of her Eeyore stuffed animals. This was all news to me. Somehow, in my percoset/ativan/post-anesthesia haze I lost the event. Certainly, I was there sprawled on the recliner, but not in spirit apparently.

Last night, I saw an old clip from a show Cheryl "forced" me to watch, The L Word, about all these women who were friends and lovers and full-time drama queens. I had forgotten there were some characters that didn’t make it to the end of the series. None of these women represented our lives very much anyway, so to try and somehow match yourself to a personality type was like trying to dress in the petite ensemble of a manikin at Ultimo. But secretly I wished I could squeeze into the character of Shane, the rascally lothario (lotharia?). Then seeing that clip last night, I realized I must be Dana the dorky one who got cancer. Feh.

We find out the results of the tumor test on Thursday, which will determine my chemo protocol. I will also find out the results of today's culture.

I am so over this cancer business. I wish it was over me.

Wednesday, August 5, 2009

And Now For Something Completely Different

DISPATCHER: Metro 911, what's the address of the emergency?

WOMAN: I'm locked in my car, my battery's shut down—

DISPATCHER: You're locked in your car.

WOMAN: Yes, I can't . . . my power's shut down on my car.


WOMAN: And I'm starting to hyperventilate. I'm starting to freak out!

DISPATCHER: Now ma'am, you think your battery died?

WOMAN: Yeahhhhh.

DISPATCHER: So, okay, and you tried the handle, right? It won't let you out that way?

WOMAN: No, ma'am, it won't let me do anything, and I'm—

DISPATCHER: Can you, did you, can you actually see the top of your lock? You now, on the door, can you see what it's . . .

WOMAN: No, it's . . . Oh, my gosh.

DISPATCHER: Yeah, just pull it up, baby.


WOMAN: Okay, I'm embarrassed.

DISPATCHER: You can get out now, right?

WOMAN: I'm out. Thank you. I am so embarrassed.

DISPATCHER: That's okay. All right.

—courtesy of Amy, Lauren and Drew

Tuesday, August 4, 2009

It's Not About The Bike

Re-read the first part of Lance Armstrong’s memoir last night. I had picked it up a few years back when I was racing and hoped to somehow absorb his skills (negligible results, by the way). This time I was more interested in his battle with cancer, which involved an orchiectomy (testicle removal), brain surgery, high doses of chemo and another painful surgery to remove his chemo pump. That he won multiple Tour de France titles after a 25% survival rate and all that punishment leaves even the most agnostic among us muttering the world “miracle.”

He says something very interesting about his belief in survival:

"Without belief, we would be left with nothing but an overwhelming doom, every single day . . . I knew now why people fear cancer: because it is a slow and inevitable death, it is the very definition of cynicism and loss of spirit. So I believed."

And that is a truism found in just about every cancer patient. An immediacy in everything. To believe or disbelieve. You aren't asked to choose. You are forced.

It’s interesting how that book turns out, with him walking into the sunset with his wife Kristin and new baby. As if cancer would make him live happily ever after. Well, nearly a decade on, he and Kristin are divorced. He has run through a string of high-profile relationships and is back in Europe trying to regain his former glories. Did he lose sight of cancer’s “gift”? Did he see through life’s BS and decide to just live for himself? Is life just too long to live it selflessly every single day? (And do I read the Enquirer too much?) We may never know if he took performance-enhancing drugs. He may have just been super-human. But he’s clearly still mortal like the rest of us. Phew.

Where Lance really shines, where he has managed to put his world-class ego to good works is in the Livestrong foundation. Not just raising awareness and funds for testicular cancer, but all cancers. When I am cured (see how positive I can be?), I probably owe him some percentage of my recovery.

These are our gods here on earth. Brash and flawed and always redeemable. Every time I get on my bike, I pretend that I am coming back. And I can thank Lance for that.

Well, Lance and that 70s movie Breaking Away.

Tuesday, July 28, 2009

Stacked Crooked, But Now I'm On My Way

It’s clear now that I made the right decision to go with immediate reconstruction. (BTW, this WHOLE post will be about boobs, so look away if you hate boobs) I can still wear most of my shirts and see some shape and know that others see that too, even if my friends know how I got it. Is that the way it should be? Should we give so much importantce to breast size? Future generations will probably find us quite ridiculous, but our urge to define and judge others is bred deep within and goes far back into our past. It’s a hard habit to break. And I guess I just wasn't ready to be declassified.

Would it have been easier to wrap up the mastectomy and be done with it? Short term, oh yes. Those first few weeks were rough. It felt SO wrong to have a foreign object stuffed under my muscle. And yet the worst pain already seems distant. Yeah, I still have discomfort and things I can't accomplish. Days I push too hard because I forget there’s a healing process still going on in there. But for the most part, this new set-up rocks. These abbreviated breasts feel pretty real. Okay, better than real—firm and without lumps.

Had another follow-up with my plastic surgeon yesterday and asked why my left side was smaller. After blanching a little at the slight to his surgical prowess, he said the mastectomy surgeon took more from the tumor side to be safe. Also, my chest overall has shrunk a bit since surgery because the swelling has reduced. My left side now has this indentation between my sternum and the implant. There’s just no fat there. And because they took so much, it’s different from the right (well, to someone who keeps looking at her chest in the mirror every two seconds). It really shouldn't bother me, because I was lopsided before surgery. Why do I need perfect symmetry?

Anyway, I showed him how I can now move my breasts independently by tensing my pecs like a sailor (all I need is a hula girl tattoo, low cut top, a cup for donations and Carbon has another wage earner). He seemed nonplussed by this skill. Would that exercise help, I asked. Not really, no. Anyway, he did give me some options.

First, more massage. Sigh. Oh, so now I need to massage them up and over and NOT down. Got it. Then he said he could put a larger implant in. Um, NO! Then—THEN—he said he could lipo some fat from OTHER AREAS and lay it in over the indentation. It was all I could do not to hop in his lap right then and there and lay a gentle kiss on his forehead.

I do recognize this entire ordeal has failed to stifle my vanity. But how convenient is it that I have just such a fat donation site located in my upper thighs?


Monday, July 27, 2009

On Hormone Therapy

After chemo, I will need to go on Tamoxifen for five years to shut down the baby maker. However, the drug brings its own set of side effects and risks that aren’t too swell. The most immediate being that Tamoxifen increases uterine lining, making the fibroid I have now grow another head or arms or possibly uterine cancer. So I might be looking at a hysterectomy somewhere after chemo and before Tamoxifen. My mom had one at my age because of a grapefruit-sized fibroid, and I have history on the other side of my family for uterine cancer, so it wouldn’t be a surprise.

I’ve also got those other two ner’ do wells, my ovaries, to consider. I need to see a geneticist to determine if my breast cancer is pals with ovarian cancer and if so I may need to have my ovaries removed. I’m not hot on that, because losing your ovaries can effect your heart. So I'd like to stop short of the full Ladiectomy.

I also asked my Oncologist about clinical trials because there is always some new therapy being tested. But it’s a crapshoot. You get entered into this pool. For example: 33% women get the new therapy, 33% get the traditional, 33% get a placebo. And well, it would suck to get the less effective treatment ’cause it’s your life we’re talking about. But there you go.

Meanwhile, we had a great weekend. Party in Uptown, camping up north. The kids had a blast. We played Ghost in the Graveyard at twilight in a big open field. Running felt great. We were all screaming and laughing in terror. The next day it was naps for the adults and over-tired tears from the kids.

Good times.

Thursday, July 23, 2009

Hurricane Downgraded to Category I

Six months ago, if you had told me I had Stage I breast cancer there would have been a gnashing of teeth, a rending of garments. But today, when my oncologist confirmed my prognosis as a Stage I out of IV (4 means spread to other organs), I was actually pleased.

Together with my oncologist, Cheryl and I visited and entered my information. Tumor size, receptor types, age, health, etc. And it spat out charts showing likelihood of me kicking the bucket. Appears I’m 90% likely to survive the next ten years. 9% for cancer getting me and 1% for me walking into a manhole or something. Sounds pretty good to me. Then we looked at the long-term charts for recurrence if I took no further treatment, chemo alone, hormone therapy alone, chemo plus hormone therapy (my eyes crossed while Cheryl actually absorbed the information). As you might imagine, chemo plus hormone therapy has the most gains. I have a 25% recurrence potential if I do nothing and 8% chance if I do chemo with hormone therapy.

Then my oncologist admitted there is still a slim chance I won't need chemo. The problem is my staging falls in a shaggy gray area. Both tumors were below a key size limit, earning me a stage I, but the larger was moderately aggressive. I may already have been cured with surgery or some gnarly buggers just might have escaped. They would probably be slow growing but if they land in my brain, lungs, bone marrow, liver, etc. then they are incurable and, while treatable nowadays, are considered chronic and life-threatening. Geh.

So I gave the go ahead today for a test called Oncotype DX. They send my tumor(s) off to a lab and test the DNA for two things: the chance of recurrence and whether my cancer will respond to chemo. If I fall in the low recurrence, low response to chemo, I will likely just be facing hormone therapy (which I’ll explain in another post). But I may end up in Oncotype's gray area too and in that case my doctor votes for chemo.

It seems there’s a little misinformation on their part, a little misunderstanding on ours. The breast center said I would be facing chemo a month out of surgery but the cancer center now says two months. And why couldn’t they have sent my tumor off to the lab right after surgery? Why are we looking at a rinky-dink computer screen now, couldn’t they have reviewed all this sooner?

Anyhoo, the good news is I have another reprieve. And, even when that’s over, I might not have to have chemo. But then again, I probably will. Or not.

So, cheers!

(edited because I had all my numbers messed up)

Wednesday, July 22, 2009

On Your Left

Vicodin withdrawal has left me itchy and restless. And actually that’s a good thing. I don’t need near as much sleep and I’m actually getting work done.

I took off on my ’89 chrome Robinson BMX this afternoon and headed down the Greenway trail to see if my pecs could handle it. No problemo! Rode up this beautiful bridge.

I had on an old, baggy T and, boy, was the wind through it sublime. Wept like a little baby, some kinda desperate joy I guess. Have no idea why I think I look dorkier on a 3-wheel recumbent than a bike that was made for a kid. But it sure felt good.

My legs just want to spin. My heart wants to rev. My lungs want to rake in big gulps of air. And my brain? It wants me to sail down hills and struggle up climbs, to balance along the white line that divides the pedestrian path from the bikes. This is how I have healed in the past. Perhaps this is how I’ll survive. I hope biking isn’t taken from me. I’d go nuts.

My friend, Rebecca, sent me an interesting article about Post Traumatic Growth in cancer patients, and how positive thinking/action can affect the outcome, extending life for longer than those who simply give up. I also read a book by a woman who was from the other camp, a sort of anti-pink-ribbon-cancer-is-a-gift mentality.

Guess I’m somewhere in the middle. It’s generally easier to be positive, because my cancer appears controllable. But I’m not kidding myself. There are just some things beyond our grasp and ability. And frankly, this gift is kinda lame, albeit non-refundable. Sometimes I can’t help but get down when I try to lift or reach for something that was so doable before. This leads to the problematic: “Must be positive, growing new cancers with negative thinking—Aughhhhhh!” Which is of course ridiculous.

Tomorrow we’re off to the cancer center to see what’s in my chemo sweepstakes package. Will post as soon as I can.

Monday, July 20, 2009

Blogging for Dollars

Yes, it's true. I have officially allowed ads on my blog. I'm not sure what the ethical ramifications are of exploiting ones breast cancer for profit. Guess we'll have to see what sorts of ads pop up. The proper thing would be to donate all funds to defeating cancer. But first I need to defeat my own and contribute to Carbon manor's coffers.

Please commenters, let me know if the ads become annoying and I will take them down.

Thursday, July 16, 2009

Did I Give Myself Cancer?

(Okay, I did say that I wasn’t going to post anything until next week. But I just drank a lot of coffee. So...)

Just about every patient tortures themselves with the above question. It’s very silly on one level, as the deed (if there was one) is done. And too, because many cancers defy the “why” question. But the diagnosis does shock introspection into you like one of those freaky movie close-ups where the camera pulls in on your stunned face and the background stretches out all wonky. Everyone, at some point in their life, wonders about what will kill them, when and how. And cancer, the ol’ joker, is happy to pop out from behind a tree and say, Hey! Might be me!

So here I am, tramping down the well-worn path of clichés all cancer peeps travel. And currently I’m researching causes as well as prevention. Here are some breast cancer risks; I’ve blundered into most of them:

• Did not bear children or had children later than twenties
• Did not breastfeed
• Took birth control pills (for endometriosis, for those of you confused)
• Ate a lot of beef, pork, cured meats, charbroiled meat
• Smoked and drank alcohol
• Wore tight bras
• Frequent periods
• Family history
• Exposure to pesticides

I still don’t think I would have given birth knowing that I would get cancer if I didn’t. But I probably would have stepped up to the plate if Cheryl could not have had the kids. When it comes to breastfeeding, I have to konk myself on the head for that one. We had twins after all! I could have done lactation, but did not opt to do it cause it kinda wigged me out. Grow. Up. Jeez. My periods are frequent too. Chemo will put an end to that.

Okay, I did smoke off and on in my twenties. But, it was cool, and everyone else was doing it, and—dumb-de-dumb-dumb-dumb. As for alcohol, studies show it is jet fuel for estrogen-based cancers. And I do loves me some cheap chardonnay. Oh, how I will miss my two-buck chuck. I stopped eating truckloads of fatty hoofed creatures a while ago, but apparently (like sun damage), junk you consumed in your youth adds up.

The bra thing is still being argued. 34D isn’t ginormous but it is a hassle when you’re not a big boned gal. I strapped those babies down in a sports bra every chance I got, even to bed, in hopes that it would somehow firm them up. But some doctors say that your boobs need to go all free-range so that your lymph glands can clear, plus the muscles will grow stronger that way. Who knows?

There is a smattering of cancers on both sides of my large extended family, but only a couple breast cancers later in life. Still, it does not mean that I don’t have the breast cancer gene. My mother had children at a young age but I’m still keeping an eye on her!

Pesticides? C’mon, we live in the Midwest! Still, it’s organic products as much as possible from here on out.

Don’t get me wrong. I’m not “blaming the victim” in some depressive state. I’m simply waking up to a few things. Probably what everyone has to do before they move on. Basically, risky behavior can trigger cell changes if your DNA is prone to it. Clearly, mine was. How many stories have we heard of smokestack alchoholics living into their nineties? Conversely, how many times have we seen athletes’ or vegetarians’ lives snuffed out inexplicably. Right now, I’m focused on awareness of what my family is putting in their bodies. This week has been a good week and I will be able to go into chemo in a very healthy state.

And finally, let me clear something up. The 1 in 7 women thing? I recently learned that is over the course of a 90 YEAR LIFESPAN. The younger you are, the less your risk.

• From birth to age 39, your risk is 1 in 229.
• From age 40 to 59, your risk is 1 in 24.
• From age 60 to 79, your risk is 1 in 13.

The 1 in 7 number is used to facilitate mammograms. For good reason. But there are other cancers that arguably need as much if not more attention than breast cancer does.

But that’s a whole nother post.

Defying Gravity (sans broomstick, black dress and green skin)

Item #1: No vicodin today!
Miraculously without a 12-step program. Yet.

Item #2: Entire dentist office now alerted to my boob drama
I am shameless in my quest for attention. Admittedly, I needed that cleaning to have bacteria removed before chemo, but since they were asking …

Item #3: Tri-cycle! Tri-cycle!
Cher chaperoned me on a bike ride today on Rita’s three-wheeler recumbent. Smirks from other riders abounded. Just wait until I’m bald, smirkers, then you’ll see.

Item #4: Bras officially rendered moot
I ran for the first time since surgery today. Had to high tail it across the street from the dentist office, because I had crossed against the light (take that death!), and you know what? My new boobs DID—NOT—MOVE. I cannot express what a strange feeling that was. There must have been a jostle of some sort, because they’re not made of concrete, but I certainly didn’t detect it. Wow. Just wow. The possibilities ARE ENDLESS! Hrmph. So sure, I’ll wear your requisite decorative triangles to the beach, dear oppressive patriarchal society, but they are only there for show, so nananana boo boo.

Friday, July 10, 2009

Blue Skies in the Eye of Hurricane Claudia

Though my mind’s floating on pharmaceuticals and my chest is strung tighter than a Stradivarius, most of me is up and running just fine.

Our homelife seems to have righted itself. Not too many chores piling up or calls from friends left unanswered. Cheryl’s stress is lessening a bit. The dogs scamper and play throughout the house and yard, then come to nest on my lap. Sometimes I sit on the kitchen floor with the kids and make Playdough sculptures or read Spongebob comics. Recovery means I can leisurely enjoy my family with the heightened longview of Jimmy Stewart in It’s A Wonderful Life. If there is a gift in this stupid disease, this is surely the greatest portion.

So enough with the navel-gazing for just now. It’s really not very effective anyway. Got some extra fireworks to light, actual social engagements to make and work projects I need my pre-chemo brain for. Unless something earth-shaking occurs, Ladiectomy is powering down until I meet with the oncologist on the 23rd.

Peace out.

Wednesday, July 8, 2009


So I dodged a needle aspiration at yesterday’s plastic surgeon appointment. During the exam, I kept my big trap shut, eyes wandering the room, while the doc assessed the amount of swelling. No sense volunteering, right? Cheryl was in on it too, knowing how freaked I was at getting a needle inserted into an already painful area. Still, I’d prepared for the appointment with a percoset and ativan and was pretty much in love with the world, so it probably wouldn’t have fazed me.

Dr. Deangelis thought it all looked normal. We discussed how I was feeling about my new chest rather than the specifics of pain. Because you can cancel most of the pain with a prescription. He said I need to be able to feel my new breasts, literally embracing them. And I have to admit, I just wanted them numb until they were miraculously healed. Like somehow, one day, I’d just wake up to normality and move on.

No, the doc said, what you really need to do is massage them.

Erm. Wha?

Yeah, apparently I need to get in touch with them. And the “ickiest” areas need to be touched first. No masseuse, or partner, or man-on-the-street can do it for me. He said women recover faster when they accept and embrace this new part of themselves.

Sounded a little hippy-dippy at first. But here I am, padding around the house, cupping these incredibly firm lumps on my chest. I’m already so conspicuous about it that someday you might see me in the mall or on the sidewalk, clasping my chest and mumbling affirmations.

I also asked the doc for a less powerful drug. Something better than OTC but less numbing than percoset. So he sent me home with some vicodin.

And then I got the mail today, opened up the latest New York magazine to this article.

Jeez! I need to get this chest-palpation show on the road before I become some drug-addled, liver-shriveled nutter.

Monday, July 6, 2009

“It’s Always Somethin”

Gildna Radner really knew a thing or two, didn’t she?

Just when I thought this new chest was done making trouble I had to go and overexert myself. The nurse who removed my drains said not to go out and ride my bike. Fine, right? She said nothing about a little light yard work, fireworks administration and a trip to Chino Latino.

This morning I had to face the fact that my chest is swollen more than it should be, more painful than OTC meds can touch. The rubberband that is my pectoral muscle is not happy with me. So it’s back to percoset and back to bed. My body will absorb some of the lymph fluid but not enough, so I’m probably looking at another needle tomorrow during my post-op visit with the plastic surgeon.

Brings new meaning to the utterance, “Swell.”

I think someone needs to put a straight jacket on me. It could serve multiple purposes. I just want to get out in the wonderful weather and be a part of life before they hit me with the A-bomb. This must be the part where they said cancer would be life-changing. My entire summer is being rewritten. Hell, a lot of summers are getting re-written because of me.

We watched Into The Wild last night. It’s the story a young man, estranged from his family, who runs off to Alaska to live a life away from the hypocrisy that we all know is too rampant in our modern society. He does fall in love with nature but eventually finds that nothing can be fully enjoyed alone.

I certainly did not need this movie to remind me of the naiveté of my twenties or that I should never go walking into the woods unequipped. But it did remind me that holding onto hurt, holding onto resentment is a cancer that can kill you slow like starvation. That letting go isn’t a one time thing. Letting go has to happen every day, like letting your clothes slip from your body, taking a shower or brushing your teeth before bed. And like so many other things I’m experiencing right now, even letting go requires assistance.

Inhale. Relax. Exhale.

Thursday, July 2, 2009


One of the annoying aspects of a mastectomy are the drains. And long after you’re up and about and pretending to be fine, they simply hang around waiting to be emptied. A mixture of blood and serum must exit the surgery site, otherwise it would be catastrophic.

My first encounter with the drain was in the hospital, still high on anesthesia so much that the atmosphere was green and spotted. I stood all wobbly, greasy-haired, staring into the mirror, daring myself to look at the area above my bandages. At first, I thought the silicon implant was out of place or defective. A raised six-inch bump ran across my chest, just two inches below my clavicle. Cheryl had seen it too but neither of us mentioned it, not wanting to scare the other. Eventually the plastic surgeon told us that was a section of tubing for the drain.

It’s no fun to empty these things. And I applaud the women who’ve done it alone. I opted for my trusty assistant naturally. Twice a day, I lay prostrate while Cheryl held the tube and ran her pinched fingertips down along the line to remove any clots. The suction created a dull ache inside my chest and made me feel like aliens were coming to life. Then she emptied the clear bladders into measuring canisters and wrote down the progress.

We did have some luck in all this—because I’m relatively thin (and had lost 9 lbs since diagnosis)—I wasn’t draining the amount of fluids a larger woman would. Instead of the regular two weeks of drains, I had next to no output at the end of week one.

So today, after one endless week of pain and mind-numbing drugs and digestive agony (the likes of which I’ve never felt before and hope not to experience on chemo), a nurse quickly and decisively slipped the drains from my chest. I took a deep breath and on exhale she pulled one tube out. Then the next. It was temporarily painful but an immediate release.

For the first time, I faced my new chest in the mirror. I won’t lie to you. It made me sad for what my body has so far endured, but hopeful for a new way. As I sit here typing, I am free of tubes and straps and gauze and tape with a tight ache that cautions patience.

It is taking time to process all that we’ve been through this past week. But I think I’m back now and ready to write. And ready to catch up on what’s going on out there in the real world with my friends and family.

No strings attached.

Wednesday, July 1, 2009

Better Days

Michele had another rough night but she is feeling better this afternoon. Thanks for all of your kind words and laughs. We told the painter/mace story to her parents today. Michele laughed so hard that it hurt. Thanks a lot Todd!

She still doesn't feel up to blogging so I thought I would fill in a few details. Michele had a couple of drains attached after the surgery. She will provide more detail when she posts but they are very uncomfortable and at times painful. I have to clear the tubes and then empty them twice a day. I have been tempted to record the sound she makes during this process. It is really heart breaking. She sounds like an injured animal. She has an appointment with the surgeon tomorrow and we are hoping they will remove them. I'm imagining the process to remove them will not be pleasant (there appears to be more than a foot of tubing inside her on each side) but having them out will be a relief.

We still have a few weeks before we meet with the oncologist . They want her to heal before talking about what comes next. The waiting is a little difficult. I know I'd like to know what to expect and when to expect it. When they said the cancer was not in her lymph nodes I was hoping that she may not require chemo but Judy (her case manager/nurse) said with two different types of invasive cancer we shouldn't get our hopes up.

Michele will be back to blogging soon. Thanks for all of your thoughts and support!

Monday, June 29, 2009

A rough couple of days

Michele isn't feeling great. She doesn't really feel up to blogging but I wanted to keep all of you informed on her progress. The last couple of days have been filled with fever and queasiness. Her healing is right on schedule. I changed her dressing today and everything looked great. She's a bit emotionally discouraged though.

I need your help. I've been trying to make her laugh but apparently she doesn't find me funny right now. That may not bode well for all of you (because I am very funny) but any attempts at humor on your part would be greatly appreciated.

Whatcha got???

Saturday, June 27, 2009

Two Wolves and a Lincoln Continental

By now it’s probably clear that I’m a fan of the metaphor. It can be annoying, I know, but it’s how I often make sense of things.

Last night I had a dream that I was walking on a snow covered path in the rural area I used to live. Two small grey wolves had picked up my scent and were pacing me. When I turned to them, they lunged. The teeth of one wolf grazed my neck. I reached out for both of them with my hands and they bit onto me. We clamped onto each other and wrestled in the snow. I didn’t want to kill them, but I knew they would kill me if I didn’t. So I bit back. And I killed them.

Wow, how obvious was that?

This is clearly me worrying that my two miniature pinchers are going to walk all over my chest. Heh. Heh.

I can’t write too much right now, but suffice it to say there is much to discuss. Cheryl was overjoyed by the results we got from the pathology report. For me it was like nearly being hit by a car. I’m not quite ready to celebrate because I can still see the taillights. Guess I need to catch my breath. Let my heartbeat return to normal.

I’ll be back soon.

Friday, June 26, 2009


Michele came home today. It was a stressful day with many highs and lows. When we received the pathology report we were both floored. It confirmed that she really dodged a speeding bullet. I will let her explain more when she feels up to posting but long story short, both of her breasts were filled with two different types of cells that are known to develop into breast cancer. Had they not found the second cancer and had Michele opted for a lumpectomy, the nurse predicted she would have developed another cancer in the next twelve months. I feel very lucky. Catching that second very hard to find cancer put into motion decisions that likely saved Michele's life. Lots to think about and be thankful for.

Thursday, June 25, 2009


Michele has mentioned the irony of walking into the hospital feeling healthy to get a life saving treatment that makes you feel awful. She went from easily speeding through her 16 mile bike loop to finding a walk to the nurses station exhausting. She's having a good day, feeling the pain but staying on top of it. She's tired, but feeling positive and appreciative that the cancer was caught before it reached her lymph nodes. Cam and Mads visited today. They entertained the masses by asking tough questions about her surgery in the honest way that only a five year old can.

Wednesday, June 24, 2009

Good News

Michele is still in surgery but I just spoke to her surgeon. They took out two sentinel lymph nodes and both looked clear. We will have full results on Friday but she said that doesn't tend to change. This means they did not remove the rest of her lymph nodes (one of her biggest fears), no radiation (another big fear) and the cancer does not look like it spread to other areas of her body (the third big fear).

Cancer sucks, double mastectomies suck. There is much comfort in knowing things don't suck as much as they could!

Happy Juice

The surgery is underway. It is going to be longer than we expected, probably four to five hours. Michele was very tense but she did manage to find humor in the fact that she will come out of the surgery blue. Apparently not a very attractive shade of blue from the dye they use to test her lymph nodes.

Michele is a happy and unusually positive person. The drugs they give her seem to really magnify that. When I took her home from having her wisdom teeth pulled, I found her in the recovery area with two thumbs in the air and a big drooly smile telling the dental assistant what a great time it had been. On the way home after her knee surgery she decided she was thinking Arbys. I can't stress enough what a huge mistake that was. I got a glimpse of that nuttiness before they took her to the operating room. We are counting on all of you to help make sure she is laughing (and making us laugh) soon!

Hold Back the Rain

Feels like there’s a storm on the other side of this day. Gotta let go of Cheryl’s hand and walk into it. I’m not too proud to admit this “warrior” is oscillating between resignation and terror at the hours, weeks and months ahead.

A team of doctors will soon take the first (and most important) action to save me. You can’t get out of such an experience without being humbled to your core. We are all brought low in so many ways.

Whatever strength I have to rise up again comes from a sense of love and connection to a family, a community and a world that I’m not ready to leave. A million thanks to everyone for the thoughtful calls, emails and comments.

Let’s do this.

Tuesday, June 23, 2009

In Sickness and In Health

My rock through all this is of course Cheryl. She’s been at every appointment since that first biopsy. There is a definite upside to co-dependency.

The downsides are times like that first weekend after the diagnosis—two cold, rainy days of us contemplating the end of all we’ve built together and our poor kids. What a wonderful reprieve it was the following Monday when we discovered that my lymph nodes appeared to be in pretty good shape. And that my cancer was driven by estrogen and therefore more controllable.

Cheryl and I have never exchanged vows before a congregation. No white gowns, no flowers, no choice of steak or chicken. DJ or live band? Gift registry at Macy’s or Bloomingdales? Nope. A wedding is certainly a gorgeous and thrilling event. A marriage, however, is a plot between two very stubborn people. It takes years of good times and bad times to make you strong enough to endure the big stuff. I don’t know what I would do without this woman. She’s amazing.

Somewhere in my youth or childhood,
I must have done something good.

(and you know you’re pretty far gone when you’re quoting Rodgers and Hammerstein)

Monday, June 22, 2009

C is for . . . Claudia

Just realized I switch to second person when writing about things I haven’t quite got my head around: “If you want nipples, they will fashion them for you...” And when it’s something I don't want to face without Cheryl it becomes first person plural: “Friday we meet with a plastic surgeon...”

Along those same lines of mini-denial, I let the doctors and staff call me by my first name. They read my chart or insurance card and I never correct them. So it’s Claudia going through this, not Michele.

C is also for coping.

Friday, June 19, 2009

Rummaging Around For Some Grace

Lots of odds and ends. The most important news is my surgery, scheduled for Wednesday. And with that, I must drop all worry about my lymph nodes, the big unknown. Time to let it go.

We visited with the oncologist yesterday and that went well. It was tough to tour the oncology wing of the cancer center still with breasts and hair, and nod to those in various stages of their chemo process. The doctor assured us: my treatment will be specifically geared to my results, history, genetics, etc., not just some boilerplate dosage.

Last night I read a dozen or so survivor stories and they ran the gamut. Everything from women who had a small lump removed with no chemo and a little radiation to women who had suffered for a decade with the most dangerous, aggressive breast cancer. Every story was positive, every woman making the most of her time on earth.

This morning we met with the plastic surgeon and he also assuaged some concerns. I told him that I don’t need to be busty, I just don’t want to be concave. I really hated the idea of repeat visits to be “pumped up.” His eyes lit at the challenge and he told us about an alternative: immediate reconstruction. It will provide me small but presentable breasts and doesn’t require chest expanders or additional surgery. 90% of my decision was ‘the beach factor,’ when passersby might look at me in a swimsuit and balk. I’m reasonably sure my friends and family understand that I don’t need to be a 34D anymore.

This weekend will be about getting things in order—a balance of cleaning, organization and relaxing with my family.

Peace to all.


After the mastectomy, the plastic surgeon opens a pocket behind my pectoral muscle. Instead of inserting expanders, he will sever the muscle and reattach it to tissue called Alloderm to provide immediate expansion. Then he will insert the actual breast implant and sew me up. All done.

So what’s the catch? I won’t be big breasted anymore. And, well, Alloderm, scares people. It is donor tissue that has been cleansed (probably irradiated) of cells that might cause rejection. It actually carries less risk and discomfort than the more popular expansion technique.

Why am I not freaked out by having a stranger’s tissue connected to mine? Because I already have a donor’s achilles tendon (allograft) in my knee. I got over the creep-out factor a couple years ago. In fact, I’m incredibly thankful. My post-op knee works better than it ever did, the muscles on it are noticeably larger than my right.

So. Soon I will be comprised of three people!

Which I will conveniently use to explain mood swings.

Wednesday, June 17, 2009

Rays of Light

Forgot to mention: My chest x-ray and blood work looked good.

Also, the HER2 results on my primary lump came back negative. If the result had come back as HER2 positive it would indicate a cancer that tends to grow and spread faster.

So those results are looking good.


Back from reconvening with my surgeon since yesterday’s news. Looks like a double mastectomy. Paraphrasing her, “Clearly, your breasts want to make cancer, it’s probably just a matter of time before you develop another cancer in one or both.” So the choice has been made for me, it’s no longer a question of possibly sparing my breasts. And, imagine, if I had not had that follow-up ultrasound and biopsy, I would have had a lumpectomy, only to find another cancer in a year’s time.

I’m not quite sure why I’m not collapsed in a blubbering heap yet, like you see on a Lifetime movie. I am certainly frightened of the coming pain. And sad that an identifier of “who Michele is” will soon be gone. I did try to get along with these breasts. Thought we had an understanding: I support you, you don’t get in the way too much. But when they want to kill you—well, that tends to sour the partnership. And so I guess I’m ready to drop that weight from my shoulders.

Tomorrow, a consult with my oncologist to discuss my case. She won’t be staging me or anything, but they know we have a lot of questions and want to get the ball rolling.

Friday, we meet with a plastic surgeon. His schedule has to line-up with the mastectomy surgeon. So we need to heavily lean on him to fit us in. I REALLY want to do this next week; those lymph nodes are always in the back of my mind (the CIA should use this waiting game as a torture technique).

So the latest thing we need to get our heads around is reconstruction. I’m not all that crazy about it, frankly. It just seems so unnecessary in the grand scheme of things. And yet, I feel this enormous pressure from society to at least have some facsimile of breasts, even if they’re just Barbie boobs. It’s seems such a crazy thing to consider when you’re simply trying to stay alive.


After the mastectomy, and the check for lymph node involvement (with possible dissection), the plastic surgeon comes to the table and adds two saline-filled bladders behind my pectoral muscles.

Over a few (depending upon desired size) office visits, they inject more saline into the bladders to slowly stretch the pectoral muscles and skin (they will have taken much of my breast skin and nipple, leaving very little excess).

When you reach the desired size, they sedate you again and insert the implants behind the muscle (unlike a natural breast which is fatty on the front side of the muscle). If you want nipples, they can fashion them from your skin and then tattoo on areola.

If I understand correctly, this is where the actress Christina Applegate is at in her cancer journey.

Tuesday, June 16, 2009

Latest Results

Got the results of yesterday's biopsy ahead of schedule.

It appears I have a whole 'nother kind of cancer. Lobular. Good news is this lump is smaller and less aggressive than my first lump (ductile). Plus it is in the same quadrant, meaning they might both be taken at once in a lumpectomy.

However (there's always a however), lobular cancers tend to develop in both breasts, meaning my right might develop one eventually.

And so I say, ARGH, simply ARGH.

At least the show is on the road now. I meet with the surgeon tomorrow. Oncologist on Thursday. My facilitator, Judy, says I might want to meet with a plastic surgeon. How's that for a subtle hint?

Have mercy.

Monday, June 15, 2009

Also Makes a Handy Pincushion

Had a lovely weekend, taking care of odds and ends, hanging with the peeps, getting strong. We’re in a much better place here at Carbon manor. Cheryl and I are slowly clueing the kids in on what’s ahead. We want them to be able to ask questions but we also don’t want to overwhelm them. They start kindergarten this fall and it needs to be as stress-free as possible. Madeline was concerned kids would make fun of them because of my bald head. It takes you aback at first, their awareness and honesty. But why should we censor that? It's exactly what I would have wondered at her age! Guess they will be shaped by this too, just no getting round it.

My biopsy went fine today. Finally had the guts to look at the device. I was imagining a giant pneumatic staple gun, but it’s really just a hollow needle, larger than normal but probably smaller than an amniocentesis needle (how do those women do it? poor things). The needle is long but they only go in an inch or two. They insert tiny metal markers too, so they can track the lumps. I’ve got four in now. Shrapnel.

Although my breast looks like a battlefield on which we’re firing the opening shots, I feel extremely vital. How lucky am I to have, not only my otherwise good health, but my wonderful friends and family who are working to keep me sane and making me feel loved? Everyone deserves this fringe benefit. I see the women who come to the clinic alone, looking a little rough around the edges and I just want to sit and talk with them. Future calling? We’ll see.

So. Another warm summer day. A few more cuts and bruises. Results on Wednesday.

Thursday, June 11, 2009

Meanwhile, Along the Winding Path . . .

Back from the follow-up ultrasound. As they had warned me (many times), the ‘problem’ with an MRI is that it really lights up all manner of concerns. Ultimately this is a good thing because you need to find everything.

My right breast remains clear, which is good if I’m aiming for lumpectomy. My left breast, which already contains the cancer, does have other areas they want to biopsy. But there is still hope. Two very small lumps that they suspect might be cancer are very close to the primary lump, and so they can probably get all that in the lumpectomy. There is an additional lump in another quadrant however, and if that turns out to be cancerous, I’m looking at a definite mastectomy. The radiologist suspects that it is benign but wants to be double sure. So again, there is still hope for a lumpectomy if that’s what I decide.

Monday I will have the three more sets of core biopsies. Wednesday I will find out the results. I also had blood work done today and a chest X-Ray so the results of those should be coming.

I should say too that while all this testing and waiting is agonizing, I don’t have the kind of cancer that requires immediate care. Some women take their month long European vacation before getting treatment. Of course, they are complete lunatics in my opinion, but the doctors do send them off with a smile.

So another weekend without definitives. But as Cheryl just reminded me, all good stories require tension and suspense. So tune in next week for another exciting episode of As The Magnetic Resonance Imager Turns!

Wednesday, June 10, 2009

Door Number One? Or Door Number Two?

Radiation Therapy consult today at the cancer center. And so finally everything is clear. As mud. Each time I try to sit down to blog, I start going off on a tangent. If it takes several consults to understand this stuff, how could I possibly bottom line it here?

The primary conversation here at Carbon manor is lumpectomy vs. full mastectomy. It’s probably just a distraction from larger fears, but there you have it.

Initially, I was thinking “get them off me yesterday!” but now I’m less certain.

It's true that if I keep my breasts, I’m faced with MRIs every year for the rest of my life. But there is actually no danger in an MRI. My breasts are dense and nearly impossible to read with a physical exam plus mammogram but a MRI with ultrasound is really effective. Plus now I have a baseline. I might even be able to skip the mammograms since they don’t work.

But what are the chances of developing a new breast cancer? Well, because they’ve determined my cancer is estrogen/progesterone fueled, it is pretty ‘good’. Part of my treatment will be to trigger menopause and shut down this rattletrap reproductive system that had nothing better to do than manufacture fibroids on my uterus and gnarly buggers in my breasts and make me a big crank once a month. With that treatment alone I’m already reducing the chance that another one will pop up. So that’s a mark in favor of keeping them.

From what I can discern, you have a mastectomy for two main reasons. Either you have multiple tumors and it’s just easier to take the whole thing. Or you are attempting to prevent future cancers and the anxiety/hassle that comes with it. A mastectomy doesn’t really protect me from the cancer I have now. It’s the lump removal, chemo and radiation that kills the current cancer. When they take a breast, they can’t get every single breast cell and in rare situations, it can return in the form of a rash or bump. Cancer's a real joker.

Mixed up in all this are vanity and gender concerns plus a plethora of pain fears—subconscious issues thrust to the forefront usually at oh, say, 2:15 a.m.. It's already changing me. Rapidly. When I come through this, I will no longer be who I was just a month ago. And I hope, as when Cam and Mads came into my life, it makes me a better person.

So today, I’m thinking I might try to live with the sword of Damocles above my head, as we all do, mine’s just shaped like boobs.

Tomorrow, I’ll be one step closer to a decision. An ultrasound to rule out multiple tumors.

Monday, June 8, 2009

Alrighty Then ...

I'll try to make this brief and post in more detail as I process the information. But what I'm looking at for sure is:

to remove 2.1 cm (level 2-3 out of 3) invasive ductile carcinoma
Chemotherapy protocol to destroy any cells that may be elsewhere in my body
Radiation on the breast to destroy any cells that may have migrated in the breast

On friday, I have one more ultrasound to confirm regions found on MRI are not cancerous. If it is still inconclusive, they will do another needle core biopsy on Monday. If by chance those are cancerous I will have a mastectomy. And if I need that, I will most likely opt for a double mastectomy.

This isn't a full prognosis, they won't be able to stage my cancer until after surgery. I'll try to describe some of this stuff over the next few days, weeks, months, but my head is spinning at the moment. I'm mostly just happy to know that my lymph nodes feel normal and I ain't gonna die anytime soon (what a weekend!). So what's really crucial to know here is that this a very average breast cancer situation. Women go through this all the time and survive. It's gonna be a b!tch, but, we all got sumthin.

Here's an interesting factoid: my clinic does 200 mammograms a week. Out of those, 10 find breast cancer. If you are over 40 and/or have a family history, please make an appointment for screening today.

Sunday, June 7, 2009

Into the Tube

I already had an MRI for my knee a couple years ago, and while it was disturbingly loud, the anxiety was misplaced. They’re really no big deal if you can ride out the noise and claustrophobia. That one was only over my lower body anyway. So, when Judy told me I would need one because my breasts were so dense that a mammogram and even ultrasound were not enough, I was like hey, whatever, let’s do this NOW.

Cheryl and I headed out on the Friday night of my diagnosis to the hospital. They were backed up at the end of the day so we waited an hour and then the nurse said, “It will be a just a little bit longer and then we’ll get you set up with the IV.”

Wait. What? I turned to Cheryl, “Did you know about this?” because she does seem to know about everything, like it was some surprise party they were all planning.

Apparently, they are concerned that the lump(s) have blood flow to them. So they insert a dye into your bloodstream to light up the works. This and the presence of other gnarly buggers is what they will be looking for. I think it means the difference between lumpectomy and mastectomy plus chemo or radiation. But don’t quote me on that because I ain’t going anywhere near Google right now. So, they put in the IV needle (shunt?) without the fluids yet. And of course, it didn’t really hurt that much. Then I entered the MRI room where three young women were listening to M.I.A. and all very perky and sweet.

With a breast MRI you lay stomach down, on a sliding tray, with your breasts suspended through two holes. Your head is on a cushion that has a hole in it and you’re staring at a plastic randomness. They put some headphones on me and I asked for talk radio. But the noise inside an MRI is really too loud to hear anything else. They gave me a rubber plunger to squeeze if I freaked out, then slid me into the dimly lit tube and cranked her up.

It’s really a cool contraption if you think about it, taking thousands of pictures of your body to create a 3D image. It’s like being inserted into a dancefloor speaker and forced to listen to electronica for twenty minutes. When your nerves are a little frayed, it's a slap in the face. In fact, it made me mad. In a good way, like, we are going to kick ass! (Which is actually what I feel like when I listen to electronica.) Halfway through, they inserted the dye, which cooled me down but not so much that I shivered. I made sure not to move too much, but you have to breathe and I kept wondering if that was making my boobs rise and fall too much. Apparently not, because they shut it down and let me out.

I'd have to say the most pain I felt that night was the girls trying to rip the IV tape off my arm. What’s up with the super-glue adhesive?


Saturday, June 6, 2009

Needle Core Biopsy

I listed those three words as my least favorite a few days ago on Facebook, still cavalier, still in denial. The least I had to worry about was a needle. Here I'd always thought of myself as a keen observer of the world around me and the people I know. But I'm myopic to what's going on at close range. It isn't until I get some time and distance before I realize what I said, or was said to me or the true meaning of the looks on people's faces.

The intake nurse and ultrasound technician started off a little brusque. Not mean, but clinical, you know, professional. When the tech brought up the lump on the monitor and the radiologist took the first core, everything changed. The three women in the room became like family, their voices softened and they asked a thousand questions about my dogs, which I gladly answered. The intake nurse handled my dressing with compassion and some kidding around. Both she and the tech ushered me out the doors and into the lobby, bantering back and forth like we were all old friends.

Only my partner Cheryl saw this as bad sign. She didn't mention it until yesterday, after the core tests came back.


If you have a mammogram (not really painful, just uncomfortable) that shows an abnormality, the radiologist will order an ultrasound (which is not painful at all). If the lump looks strange then, the radiologist will order the biopsy. 4 out of 5 are normal.

This very non-invasive biopsy is basically an ultrasound tech finding the lump again. Then a radiologist numbs the site with lidocane. She targets the lump on screen with the core needle and it happens fast. I jumped a little because of the pressure and the sound which makes a snap like a staple gun. The core itself resembles a half inch long strip of dental floss.

They took five from my lump. I felt no pain at all. In fact, I barely felt the original needle. I have some tenderness on that breast and a little bruising. It's easy to look in the mirror and start the pity party. What will it look like in a few months? Will I have bigger problems to worry about?

Bring on the next procedure. This is what it takes to save a life.

Friday, June 5, 2009

Let's do this. GRRRR!

Today, Judy (lovely woman) from the Breast Center called to let me know I have invasive ductile carcinoma.

My friend Laura says I should journal it. So, here goes.
Want to walk down the path with me?


Needle Core Biopsy
All fun and games until the radiologist looks at the screen.

My First Breast MRI
Sounds like Fatboy Slim at a berzillion decibels.

The Prognosis
Find out when I do.