Many of you, I have spoken to, many I have not. On Monday of this past week, I was diagnosed with the earliest stages of breast cancer. And this blog entry today is going to cover it all. So, be warned, if you don’t like to hear the word “boob”, then this isn’t the right read for you. It’s as much therapy as for me in writing as it is an explanation of everything that has happened to me in order to tell my friends and family across the globe. It’s kind of rambling, it might contain typos (woe is me!), it doesn’t flow as well as I would like it to, I might repeat myself (I have had a few conversations this week of which I did not remember until the next day), and I cannot be held accountable for the amount of chocolate that I eat during this whole ordeal. That last sentence I just put in to make myself feel better. I wish I could call you all personally, but I just can’t. I realize that I am not the Queen of England, but I do have a whole heck of a lot of folks who care about me out there who want to know what’s going on. So, this is for you!
Early last week, I decided to go to see my doctor regarding some tenderness under my right arm. She decided because we were supposed to be leaving for El Salvador in just over four weeks, that I should have an MRI. She recommended an MRI on both breasts to be sure that we were in the clear due to my family history of breast cancer. I scheduled the MRI and two days later, I was lying in a freezing cold MRI machine having the procedure done. I didn’t realize how loud, uncomfortable, long, and freaking cold it would be. Bring your blanket if you ever have to have an MRI!
However, I didn’t think anything of it. Sure, I would have an MRI, but of course, I didn’t have cancer, right? Well, only a few hours later the doctor who did the MRI called me and said that in fact, they did have some areas of concern in both breasts and I should most certainly have an immediate double biopsy. Huh? So, the next morning, there I was again, having yet another MRI, then a double biopsy, then another shorter MRI, and finally a “gentle” mammogram. Gentle my ass! First of all, just the thought of the biopsy needle was enough to make me nervous and I am not even afraid of shots. Heck, I was a Peace Corps volunteer in Sub-Saharan-I can’t be! And then I had to have it done on both sides. Oiyvey. A piercing, stinging sensation in my breasts was no fun at all. I thought I was doing all right until after I was done, I realized that I was trembling all over and I could not stop. Even my legs were shaking. In fact, my doctor was worried that I was going to pass out, I was so white in the face and my body was shaking so badly. I think, in the end, it was just my emotions and adrenalin getting the best of me. I really thought I was fine, but clearly, my body thought otherwise. As for the mammogram, it was just as squishy and squashy as I had remembered my first mammogram to be, (only a few months prior, of which I got an all-clear at the time) and that one was most certainly not right after a double biopsy. I tried to take my mind off the pain while the technician was pushing and prodding on my still-numb-but-very-sore-boobs. The first thought that came to mind was Kim Kardashian. Not sure why. Maybe big boobs and no brain? This is what my mind thought for the next 3 minutes-Kim Kardashian, George Clooney, chocolate chip ice cream sandwiches, Reece’s Pieces, and Belgian Hoegaarten beer. In that order. Anything to get my mind off my boobs.
And then, suddenly, I was all done and on my way. Literally about 30 minutes after. Biopsy results 24-72 hours later, they informed me. I shot out to my car, ran home, picked up Rem and Z, and then drove over to the Foreign Service Institute where Sacha is working to get a tetanus and typhoid shot and to get Remi’s second Rabies shot. Yeah, I had two crappy shots right after my lovely morning at Fairfax Radiology. And poor Rootie Bootie had a mean old rabies shot.
Again, I didn’t think anything would come out of the biopsies. I thought for sure that they would come up with nothing. The first two days, Thursday and Friday, my head was spinning. I didn’t have time to think about things really. I decided not to tell anyone because I didn’t want to worry anyone. Perhaps I also didn’t want to worry myself. But by Saturday and Sunday, time started to drag. I had decided by Sunday night to call the doctor’s office Monday at about 11:30 am. By 9:45 am on Monday, I had had enough and I called. When they put me through to the doctor, she sideswiped me and said, “Oh, I actually got your test results about 20 minutes ago and have them right in front of me.” Say what??? I don’t think I was quite prepared for that comment even though I was waiting for it, you know? Felt like I almost had to pee my pants.
So. The doctor told me I have the earliest stage of breast cancer in my left breast. Stage Zero. Which sounds a bit odd to me, but this whole process has been very surreal. And the right breast is of concern for the future because of the three + masses, as well as my family history and my “young” age for being diagnosed with breast cancer. Without the MRI, they would have never known anything was wrong and as my doctor put it, the cancer in my left breast would have become invasive in the next couple years. And then I would have been in a much more dangerous position. If I had been overseas, I probably wouldn’t have gone to see the doctor. Too much trouble, especially in a non-Western post. So, I am in fact, very lucky. I guess it’s the best news of the worst case. I am not sure why I decided to be so proactive, but in the end, it might have saved my life. At the least, it saved me from a much more aggressive cancer. Of course, I am not doing the happy dance here, but whew, I sure did dodge a bullet, so to speak.
How did I react to all this initially? I had two kids running around me (Z and Rem) pretending they were My Little Ponies being chased by a monster, I couldn’t get ahold of Sacha for a couple hours, and I had only told a couple good friends about the whole ordeal because again, I hadn’t wanted to scare anyone prematurely. Because I thought I didn’t have cancer! It was a crazy few hours, to say the least. I actually decided to take out the recycling a few minutes later because I guess I was perhaps trying to forget what had just been told to me on the phone. I hadn’t told my parents yet because my Mum was having a colonoscopy 36 hours later and I didn’t want to worry her. I hadn’t told my sister because it was just all a little too much to take. So I blubbered away on the phone with my doctor and she very kindly talked to me for a good 30 minutes before we hung up. Then, I spent the better part of the next 72 hours on the phone with doctors, insurance, State Department Medical, friends and family. Keep in mind that we were supposed to leave for El Salvador just four weeks from now. I am supposed to be thinking about packing out our belongings to air freight, plane ride with us (suitcases and carry-ons, stroller, car seats), and stuff we are leaving here in the DC area (cold weather clothes, stuff we have acquired here but we don’t need in Latin America). Not to mention our car was already slated to be shipped and we were supposed to move out of our apartment and be on a plane to Miami and then El Salvador on July 8th. It’s a fine dance of organization and preparation and if one thing goes wrong, then everything is set off. And one thing most certainly did go wrong. Obviously, our departure date has been pushed back for at least 1-3 months. I am anxious that the folks who are reviewing our medical status may decide to keep us here in the DC area, which is NOT part of my plan. I just want to get to El Salvador and get my children and family settled. However, now, I have to wait.
By Tuesday of this week, I had seen both of my doctors again, talked to several other doctors and had been told the options for my sort of case-either a lumpectomy and radiation or a single or double mastectomy. I decided, in the end, to opt for the double mastectomy at the advice of my doctors and several other women who have similar cases to mine. I am “young” for having breast cancer, and the chances of it coming back with a lumpectomy and radiation are greater because of my age. My family history-my Mum had breast cancer (she’s a 15+ year survivor) and my great-aunt also had breast cancer, so there is the family history. And frankly, I don’t want this to be something that I have to worry about every 6 months to a year. I don’t want to always have to wonder if this disease will come back. I am still relatively young and I don’t want to live my life wondering. And lastly, our lifestyle is a factor-we live and travel all over the globe. I rarely ever see the same doctor regularly and I do not want this worry to be a part of my life. I don’t want to put my trust in physicians that I do not know to be sure that this cancer isn’t going to come back. I want to stomp it out once and for all. Once I have the surgery, the doctor will be able to see if there is any invasive cancer that they missed and also they will do a biopsy of my lymph nodes to be sure that nothing has spread. They will do this because the lymph nodes were in fact, where I felt the tenderness in the first place. And an ultrasound that he did today didn’t come up with anything besides seeing that they are enlarged. The enlargement could be for any reason-I might have had a slight infection or virus or maybe I just have big ol’ lymph nodes. He saw no cause for worry there, but of course wants to be as proactive as possible during and after my surgery. He and the oncologist will coordinate to see if there is any need for radiation post-op, but at this point, the breast surgeon does not think this will be necessary. Finger’s crossed. Nor does he think that I will need Tamoxafin, which is the hormone drug that many women (including my mother) have to take post-operation for several years. I was grateful for this news. Tamoxafin can cause the early on-set of menopause. For a woman, it’s hard to hear that menopause might come sooner than expected. I already feel like I am going to be a bit of an alien with fake boobs, I don’t also want to feel any less of a woman because I am forced into menopause in my late 30’s (I can still say that because I am 39, ha ha) due to a drug. It’s actually quite an emotional thought. Not that I wanted to have more children. Sachie is convinced he wants to have #4, and well, I am not so convinced! In fact, I was quite sure I did not want to have more children. Well, throw a diagnosis of breast cancer into the mix and maybe it’s my emotions getting the best of me, but I keep crying at the thought of NOT having more children now. So you KNOW I must be going batty, right?!?! If I think of myself with four little nuts trailing behind me, I start to get dizzy. And queasy. But the thought of not being able to have more children due to this whole scenario is also enough to make me feel weak. I know that I am SO blessed to have my three girls. I am grateful every day for Mia, Zoë, and Remi. And my adoring (heheh) husband. All kidding aside, I think of couples or folks who are struggling to have one and here I have three gorgeous children? Again, I am so truly grateful for what I have.
So, where do I stand now? I saw a plastic surgeon on Wednesday, a genetic screening specialist yesterday, and a breast surgeon this morning. The plastic surgeon was one of those scenes where you go, “Wait a minute, am I really here?” He was lovely, really. But I just couldn’t help looking at all the perfect-looking staff women and their perfect little bodies and thinking, “I am not supposed to be here”. Even the doctor himself looked like Dr. 90210. And although he was reassuring and kind and everything you would hope for in a doctor, when I was looking at all the photos of post-op boobies, it made me cry. I complain about my boobs, yes. They annoy the shit out of me, to be honest. Breast-feeding three babies kind of sucked the life out of them. (‘Scuze my language but I think I have a right.) But they were MINE. And these new things, well, they aren’t going to be mine. It’s tough to think about. The whole process is also a lot more time-consuming and clearly painful than I thought it would be. Not that I didn’t know it would be painful. I just kind of thought that voilà, the reconstructive surgery leaves you with your new boobs, DONE. I just had no idea that they use something called an “expander” that essentially stretches you out over a period of 2-4 weeks with temporary implants. Aiyaiyai. Sounds like a medieval torture device. Then, you go into a “hold period” for two months until you go back into the hospital for an out-patient procedure where they put in the permanent implants. The recovery for this takes about a week and apparently, I can be cleared to fly to El Salvador by my doctors during the “holding period” while I am waiting the two months for the permanent implants. Apparently, I can also go scuba diving if I want to. Not that I want to. But the doctor said it would be okay. Now to convince the State Department Medical Department that I can also be cleared to fly. That might be a whole different story. I laughed when the doctor told me that in certain cases, they can actually take tissue from your stomach and “make” a breast for you. However, I don’t have a lot of stomach fat. Darn it all! The results are apparently a lot more realistic and natural. At that point, I wondered aloud if he could take it from my ass. (I didn’t use the word “ass”, I think I said “behind”, to be polite. But I was thinking ass.) But! Ha ha. Big sigh here-he said they actually can do it but they usually don’t because it leaves a big scar on your tush. Um, yeah, NO thank you.
The genetic screening test was yesterday, as I said. They want to be sure that I am not a carrier of the breast cancer gene, which if it came back positive, would put my girls, my sister, and her daughter at 50% chance of getting breast cancer. It is unlikely that I am a carrier, but of course, I want to know just in case. Man, technology now is incredible, I must say. It’s a DNA test, so I had a mouth swab complete with minty fresh mouth wash. Not too invasive and much better than another needle. The results will be back in a couple weeks and whatever the results are, they won’t affect the decision to have the surgery.
This morning, I drove yet another 20 or so miles in another direction to see the breast surgeon. I am getting to know Northern Virginia! For over an hour, the doctor talked me through the whole process, answering questions and going over every bit of information that had been given to me over the past four days. Surgery will be about four hours and I will stay overnight in hospital. They get me up and moving right after surgery and into physical therapy, but I will be unable to drive for about two weeks. I go home with drains in my chest and have to be careful of infection. I won’t be able to lift anything or anyone for several weeks. Dr. Vargas was wonderful-so warm and very patient. I wrote everything down because I am afraid I might miss something. I still cried because again, it’s all a bit too much to handle in just a few days. Then, at the end of the appointment, the nurse gave me a pink bag filled with “helpful” information. As soon as I saw that bag, I felt a little sick. Who wants a bag that’s a clear reminder of cancer? Not to seem ungrateful, but I just didn’t want the bag.
I was thinking they would also get me in for surgery earlier than later. At least, that’s the impression that I was given from the start. So, I was a bit shocked to hear that my surgery isn’t scheduled now until June 28th. The problem is that both the plastic surgeon and the breast surgeon have to be free for the operation and both of their schedules are extremely tight. They are the best of both in the area, of course they are busy. But June 28th? That’s three weeks from now. They are trying to see if there is any other way they can squeeze it in, but for now, that’s the date. My parents fly in from the UK on June 12th and they leave on the 27th. The day before my scheduled surgery. Talk about bad timing. I had another moment, shall we say, on the phone with the scheduling nurse after hearing this. I just cried. Yet again. And I believe I alarmed her because Dr. Vargas called me personally a few minutes later to say that they are doing everything they can to push my appointment forward. Again, I am grateful. Terrified, but grateful.
Let’s see, so all in all, I have cried a LOT, laughed a lot (the thought of big boobs on me?!?), had many hugs from my husband, little nuts, family (virtually), and friends. Sachie is actually having a bit of a hard time with the news, but I keep telling him that I will be back to nagging him in no time after my operation, ha ha. Not to worry there! I am so grateful for the many phone calls and messages I have already had from those of you who know. The offers of help with the girls, or just the well-wishes and prayers of my dear friends and family. I am trying to wrap my head around the idea that early last week, I had no idea of anything being wrong and now, I am scheduled for a bi-lateral (double) mastectomy on June 28th and I am going to leave the hospital without the breasts with which I was born. That’s a hard pill to swallow. As much as I joked about my boobs and the fact that I went from a size C cup to a size A cup after I nursed my three girls, I never thought it would end like this. I joked about a boob job but I never wanted this scenario! And the surgery itself. Again, I am not one to shy away from needles or hospitals, but this is totally different. Major surgery for about four hours. Yikes. Makes me need to pee again.
So, I gave the pink bag to Zoë. I don’t want it. I actually shoved it into my other bag leaving the doctor’s office because I didn’t want anyone to see it as I was walking out of there. Kind of wanted to forget about it for a while and just head back to my car and sing along to the radio as I drove home and battled traffic along I66. So that’s what I did. And I ate two chocolate chip cookie ice cream sandwiches when I got home. Because I kind of felt like I deserved it today.