Friday, December 7, 2012

How Do I Tell Them?

After I found out I had cancer I had the strangest feeling. I liken it to Alice falling down the rabbit hole. Conversations with acquaintances became stilted and distant. The simple question we ask strangers - How are you today? - turned into a stabbing reminder that I'd be lying if I answered with the expected "Fine. How are you?"

So I would say nothing and smile warily before looking away or babble on about the price of blackberries to the well-meaning cashier at my local grocery store.

Talking to family and close friends plunged me further. Who do I tell and when? In what order? Is this the conversation where I dissolve into tears and tell my mother, who lives across the country from me, that I have breast cancer? How can I tell her when she is only a week away from a hospital stay to replace her pacemaker?

Who I told first and the details of the telling are lost in a fog of smiles, hugs, tears, and dread. I did what I had to do and quickly wadded up the moments and threw them away like letters I never wanted to read again. But there are a few memories that will stay with me forever.

I took a good friend of six years aside after a meeting and told her my news. As her eyes welled with tears, I smiled and reassured her that I would be alright. After a few minutes where she stared at me, a little dazed, and I told her the details of my illness, she said, "If you need help drawing your eyebrows on please come to me. I'll make them look very natural."  I was overwhelmed with love for her.

Soon after, my husband and I flew home to Georgia for his high school reunion. We'd attended the same school, so I knew most, if not all, of the people at the dinner. Reunions are festive occasions where we dress to impress, condense the last twenty years of news into a two minute recitation, and pray that we can match the names from the past with aging faces and bodies. I couldn't figure out how to work in the news that the following month I'd start Chemotherapy. I wanted to have fun and laugh for real, not whip out my practiced smile say, "It's okay really. I'm going to be fine."

It helped to reconnect with old friends
 Most casual conversations don't recover from the "I have cancer" bombshell. Todd and I ended up sitting at a table with a classmate who is also a breast cancer survivor. She talked about her experience in casual terms that I just could not process. To be fair, she'd been well for many years and didn't know about my problem. As she talked I listened intently, hoping to glean some wisdom without breaking down and crying into my plate of  finger food. Before the night was over, I went to the bathroom seven times. I counted.

To my right is a sweet lady (one of Todd's classmates) who passed away from breast cancer this month.
In the bathroom, I cried a little, splashed water on my face, shook out my hands to release the frustration, and gave myself little pep talks. "You can do this. Go have fun." Still, an insidious voice rose from behind me to say, "What if this is the last time you see this group of friends? It could be, you know. You could die before the next reunion. It could happen."

Then I'd start the process (1 through 7) of crying, washing, shaking, and reassuring all over again.

I waited to tell my parents in person. It was on this same trip to Georgia. We sat in lawn chairs under the big oak tree, as we often do in the summer. I don't remember what I said. I just remember the look of devastation on their faces, my stiff smile, and my repeated reassurances that I'd be fine. I had to be strong for them. Their only child was seriously ill. They needed to lean on me.

Gold panning in Dahlonega served as distraction after telling my parents the news.

That's what I mean about the rabbit hole. All of my emotions, all of my responses, all of my reactions were twisted, upside down, big then suddenly small, absurd then miraculously sublime.

I wish I'd just said to everyone I met along the way, "Good evening. Hello. I have cancer." Then zipped my lip and let the world take care of itself.

I could have been Tig Notaro. "Hello. Good evening. I have cancer," is exactly what she said when she walked on stage to perform her comedy at Largo in Los Angeles back in August of this year. She'd recently found out that she had breast cancer. It seemed insincere to do her typical routine. Her jokes seemed trivial compared to the earthquakes going on in her personal life. So she let the audience in, let them feel her confusion as she worked through the problem on stage giving an impromptu performance. I think it's the most touching dialogue I've ever heard. It's well worth a listen. This American Life did a segment called What Doesn't Kill You that featured a portion of the live half-hour show.

Tig Notaro on stage.
I never want a do over on the cancer bombshell, but if it happens I want to be as brave and forthright as Tig. God bless her. She's told the press that her treatments are going well. Here's to long and happy lives for both of us, Ms. Notaro!

Thursday, November 15, 2012

The Healing Power of Pets

Three months elapsed between when I first noticed a problem with my breast and my cancer diagnosis.

April - Noticed my breast had changed shape...went to my gynecologist...had mammogram and breast son, Derrick, asks me to adopt a homeless, too many pets already.

May - First needle biopsy...negative unhappy, orders an MRI...Derrick begs me to take still unadopted kitten.

June - MRI suspicious...second needle biopsy....Derrick brings home kitten curled up in his backpack....I fall in love.

Dusty's first picture

July - Cancer diagnosis...sentinel node biopsy...kitten owns my heart.

Dusty fit right in with our two cats. They bathed and cuddled with her, treated her like they'd given birth to her..weird since they were both male. She took to me instantly, wanting to be held, always on my lap if I was sitting, always under my feet if I wasn't. At night she slept beneath the covers curled up against my stomach.  She seemed to know that I needed her as much as she needed me.

I think of her as my cancer kitty, a little gift from God. When I listened to her soft purr and stroked her fur I was reminded that everything would be okay and in time I would be well. During the months of Chemotherapy she gave me great comfort. By the end of the grueling treatments, I spent most of my days on the couch sleeping, watching movies, or crocheting while Dusty perched near me batting at or chewing the yarn ball.

Sometimes my other two cats paid a visit and I've have three warm bodies stretched over my legs and stomach.
Harry and Domino

Oh yes, we have a dog too, an Australian Cattle Dog. He'd check on me then go to his spot on the floor at the end of the couch.


As much as I loved my other animals, Dusty was special. She still follows me upstairs every night, meowing and purring until I settle down in the bed. She weasels her way under the covers and nibbles at my fingertips until she's bored. By the time Todd is in the bed and we are asleep, she's settled into her favorite spot near my feet.

When I see how much she's grown I'm reminded that two years have passed. I am well and she is part of the reason. Science has shown that caring for a pet is therapeutic for people with chronic illness. I didn't know it then, but when I'd pet Dusty or my other animals my body released oxytocin, the same hormone released when a woman breastfeeds her child. This helped me to feel relaxed and promoted a sense of peace and well-being.

Dusty all grown up

I found a wonderful article on NPR. In the audio interview, Rebecca Johnson, a nurse who heads the Research Center for Human/Animal Interaction at the University of Missouri College of Veterinary Medicine, says, "Oxytocin has some powerful effects for us in the body's ability to be in a state of readiness to heal, and also to grow new cells, so it predisposes us to an environment in our own bodies where we can  be healthier."

I certainly needed a boost to my body's ability to grow new cells. Thank you to my pets, especially my Dusty, for helping me in my time of need. It's a win/win situation for people with pets, even if neither of you are sick. Loving an animal who loves us back (unconditionally) is tremendously soothing. We can all benefit from that!

Here is a group of children from my hometown in Northeast Georgia performing a song promoting shelter pet adoption. Save a life. Take home some love.

Adopt a Shelter Pet
P.S. At the request of someone very important to me I must add one more picture and a footnote. Harry is no longer with us. He passed in January at the age of 10. Shortly after, my daughter, Natasha, adopted a kitten she named Fearless Leader. She is a welcome addition to our family.

Fearless Leader on the left

Monday, November 12, 2012

We Can Rebuild Her

(Insert breast cancer patient's name here), a woman barely alive. Gentleman, we can rebuild her. We have the technology. We have the capability to make the world's first prefabricated woman. (Insert name again) will be that woman. Better than she was before. Better. Bigger. Perkier.

Watch this clip before reading further:


I had a little fun rewriting the opening to one of my favorite television shows from the 1970's, The Six Million Dollar Man. That is how I felt during the conversations with my doctor about breast reconstruction. That's how I felt and still feel when I see or read interviews with celebrity women who've had cancer and opted for reconstruction following a mastectomy. Sometimes it's just too difficult to look at my true feelings about cancer. Jokes make it easier to take.

I remember one television interview, in particular, with a husband and wife. I won't name the show or the celebrity because that woman's journey belongs to her. Everyone handles it differently. Everyone's spouse handles the anguish differently too. Judging them would be wrong. They were muddling through the experience like the rest of us. But, since it was a national interview, I feel I can comment on it. The interviewer asked the smiling couple about the wife's upcoming mastectomy and reconstruction surgery.

Here's where it got personal for me.

The woman responded that even though she only had a very small, contained lump (stage 1 cancer, if I remember correctly) in one of her breasts she'd decided to have them both removed.

"So you are having both breasts removed to minimize your risk of having breast cancer again?" the interviewer asked.

She answered, "Yes, but mainly I'm having both removed so that I'll get better results with the reconstruction. I want the girls to match."

Her husband joined in, "We asked for big ones this time."

Everyone on the set laughed. I threw a pillow at my television.

I am very grateful for advances in medicine. Treatments, after care, and prevention are so much better than they were for our mothers and grandmothers. I'm not complaining about breast reconstruction and the normalcy it affords women like me. I am complaining about the media  and the way it sells and spins reconstruction to women who've had cancer. In my humble opinion, it's perverted. A very serious set of surgeries are presented as a fluff piece in People Magazine or on network talk shows. Let me explain. Bullet points should work nicely. The infuriating statements I've heard or read in the media are in bold.

1) It's a quick trip to the plastic surgeon to get your breasts back.  No. No. No. I chose a reconstruction method using a tissue expander and a silicone implant. There are many other ways. I've had 4 surgeries related to reconstruction and expect to have at least one more to complete the initial process and it doesn't end there for me. I opted to keep my right breast, so if I want "the girls to match", I'll need additional mastopexies about once every 5 to 10 years. I'm in my forties. Let's do the math. 6 more surgeries are coming down the pipe if I live to be eighty. I don't think I'll care about the my sagging breast when I'm eighty but if I did...well, there you are.

 This is not a quick and painless process. I had my first surgery almost two years ago. I'm not finished yet.

2) Let's get excited about having a clean slate ladies. Isn't it great that you can pick your new size. Want to be a DD? Go for it! No, it's not great and no, I'm not excited. The reason I'm faced with this choice is because I lost my breast to an invasive disease. I was perfectly happy with my body before I got sick. I'd keep my breast and it's sister if I could, thank you very much.

It's true that, once faced with the problem, I could go as large as my skin would allow or smaller than I used to be. The first step in reconstruction is the placement of a tissue expander to hold the shape of the breast mound. This expander is filled with saline. On subsequent doctor's visits the expander is injected with more liquid until the patient reaches just a little larger than the size they want to be. This gives the surgeon a bit extra to work with while shaping the new breast, a margin of error of sorts. The skin stretching is a painful process. For the next few months after the tissue expander placement I felt like an elephant was sitting on my chest. Stretching my torso too quickly was jarring and painful. When my body finally adjusted to the process, I liken it to each time the orthodontist tightened my braces.

What a woman has to remember if she decides to go larger than her natural size is that she has no breast tissue under her skin to soften the look of the implanted device. The only thing under her skin will be the silicone bag (unless she goes with another method). The larger she goes the harder her breast will feel, the more the bag will weigh down her skin, and there is no way to hide the contours of the implant with such a thin (skin) covering.

3) Lucky you! You'll have brand new breasts! No. I have a fake breast where my natural one used to be. It looks good for what it is but it is not a brand new breast. It's more like a Barbie boob glued onto my chest.

4) Just get them both off while your at it. You'll look better in the end. I didn't do this. I felt very strongly that a bilateral mastectomy was not for me. My cancer was contained to my right side and I tested negative for the BRCA1 and 2. I am at low risk of this or a new cancer returning. My plastic surgeon told me that many women choose prophylactic mastectomy even when they have a low risk for recurrence. It's easier for the surgeon to give the patient symmetry. He was only trying to help, but for the life of me, I can't understand why I would want to lose two body parts just so I can have a matching set of prostheses.

Very few natural women have perfectly matching, symmetrical breasts. I'm in good company.

5) No one will ever be able to tell you've had cancer. You will be as good as new. This is sort of true. With my shirt on I look the same as every other woman on the street. I like blending in again and only talking about my past illness when it suits me. 

If I take off my shirt, well, that's a different story. You would know I've had cancer. I have significant scarring, which is the norm for women like me. One side is extremely firm. The other isn't. The reconstructed breast has an odd shape. And this result is with a very talented, highly recommended surgeon.

End of bullet points. Moving on.

I'm alright with these imperfections and happy with my decision to have reconstruction with an implant. What I object to is glossed over, cutesy half-truths and misinformation fed to us by the media to make women feel better, like cancer is no big deal and recovery from breast cancer is all about regaining your female sexuality, not saving your life. That is why I called it perverted.

I am a grown woman who suffered from a life threatening illness. Having stage 3 cancer is as close to serious as it gets. I needed full disclosure about what lay ahead of me in order to make the best decisions for myself and my family.

Eureka! This is it. I understand why this upsets me so.

The media, in general, treats women with cancer like airhead, child-like creatures who can't handle the truth. They are turning us into happy warriors instead of giving us the tools to be strong, capable women. They candy-coat their conversations with famous cancer survivors, women we should be learning from if they are going public with their illnesses. Instead of using the interviews as teachable moments, the media laments over the loss of the famous woman's sex kitten status and rejoices that we will soon be able to gaze upon new, improved breasts when the happy warrior poses for future issues of Maxim.

The media says they are covering breast cancer but they aren't. They refuse to look the disease square in the eye. They distract women with tales of "Oh, it's not so bad. You'll get through it and be better for it!"

I like to think this media slight of hand is not malicious. I like to think it's because, as a society, we chat about breast cancer all the time, but we are uncomfortable (and sometimes incapable of) talking about women's breast health in a helpful, nonsexual  manner.

The links I've added are important to the context of this post. If you have the time and inclination, please click on a few to see what I mean.

Thursday, November 8, 2012

Let's Go Bald Together

A woman's hair is her crowning glory.

So when you lose it all to Chemotherapy where is your glory then? I found solace in two popular sayings. Beauty is in the eye of the beholder and the eyes are the windows to the soul. I was the kind of woman who enjoyed fixing (insert Southern accent here) my hair, learning new ways to braid, and the attention that being a blond afforded me. I did not enjoy the dumb blond jokes but I'd just laugh then kill the jokester with my brain (reference to Firefly).

My husband also had long, golden locks. His hair was part of his personality. He'd grown it out in college and kept it that way for over twenty years. I loved running my fingers through it, playing with it on long trips in the car, and burying my face in it while we slept. Just for the record. He doesn't like dumb blond jokes either and his brain is more powerful than mine.

Back when we first started dating

After we found out I needed chemotherapy, I sought advice from other cancer survivors at The Caring Place. They said, "Your hair will fall out within fourteen days of starting treatment." I thanked them for the information and thought, "Yeah, right. No one can pin point it that closely."

Just in case they were correct, I devised a plan. Before it came out in clumps, I'd go to my hair stylist and dear friend, Rocio. I would ask her to shave my head. This seemed much less traumatic than dealing with large clumps of shoulder length hair falling out in the shower. To my surprise, in an act of loving solidarity, Todd announced that he'd shave his head too. If I had the courage to be completely bald so did he.

I remember attempting to talk him out of it. He held fast. One thing about my husband, when he makes up his mind don't bother trying to change it, especially when it comes to loving me in the best way he knows how.

When we showed up at My Salon, Rocio's smile faded. I'd already told her of my plan when I visited her in August and we'd taken the first drastic step. I wanted to know what it felt like to have dark red tresses. Against her best judgement, Rocio colored my hair. If I didn't like it, so what? It would fall out soon anyway. So for a short time I pretended to be Jessica Rabbit.

The day came for the final step. Rocio hugged me and led me to her chair. She held the electric razor near my head then pulled it back. My beautiful Peruvian friend began to cry. "I can't do it. Let me do what I want. Come back when you can't take no more. I shave it then. Please."

I agreed. She trimmed and trimmed, leaving me with a very stylish, very short pixie cut. She felt better and it in a strange way I did too. It was as if she were the first on the scene of my car crash and wanted to help but felt paralyzed by the severity of my injuries. Afraid to perform CPR, she  offered the next best thing. A 911 call and some damn good hand holding until the ambulance arrived.

Rocio motioned for Todd to take my place in her chair. She asked one more time if he was sure. "It's going to be big change but you have nice shape head."

He assured her this minor step was nothing compared to what lay ahead of me. More importantly, he needed to show me that he was "all in". She proceeded to take it "all off". I've never loved him more.

A precious moment

Exactly fourteen days after my first Chemotherapy treatment, the majority of my hair fell out. Seeing my hands covered in short red hair was still traumatic but I imagine less so than it could have been. I went back to Rocio and she shaved my head. No tears. The time had come. She told me I had beautiful eyes and that I was lucky to have "Nice shape head too."

"When this is over, I work with your new hair. We make it gorgeous, huh?" She hugged me. Rocio always hugs me when I leave her salon.

I usually wore a scarf when I went out. I found many places to buy lovely scarves and bandannas. I learned fun ways to twist them. I only had one epic fail with my attempt at a turban. Yikes. Unfortunately our friend, Mickey has a picture or two on his camera. In my defense, I thought it looked good. Not.

At home I went au natural most of the time. My family didn't seem to care and the kids knew better than to say anything, even to joke about my shiny head, in front of Todd. He was and is my greatest fan. What more could a woman want?

He loved my bold look ( I do mean bold not bald) so much (at least, he made me believe he did) that two months after Chemo ended he urged me to put on a sexy dress and leave the scarf at home. He wanted to take me out for Valentine's Day and show the world what a gorgeous, strong woman he had as a partner.

Reminds me of Annie Lenox in the 80's

I thank him for that. Beauty is in the eye of the beholder. I'm very lucky to be with a man who, even when I was at my weakest, made me feel like the most beautiful woman in the world.

My hair grew back very slowly. Yours will grow back too. If you can, don't dwell on its loss and don't pine for it to come back. Instead, take the opportunity to start over. Your bald head is a clean slate, of sorts. Do your best to enjoy your new hair in all it's awkward stages. There will be many. Try new cuts, new colors, new styles. Hold your head high and smile if a stranger stares for a moment too long. It's okay. Your eyes will light up the room and they will see the real you.

This is Todd and I a few months ago with our daughter before prom. I'm still evolving, still playing with the new me.

Taken at the indoor garden at the Bellagio

I wish for you to have a Todd in your life to remind you that beauty (with or without hair) begins in your soul and radiates through your eyes for all the world to see....and they will see. I promise.

Wednesday, November 7, 2012

The Healing Arts - Alternative Therapies for Cancer

A stack of brochures sits on the counter in my breast surgeon's office among other information packets from the American Cancer Society and the Susan G. Komen Foundation. This brochure is actually a calendar folded in thirds. I am an information junkie so I grab one of everything available.

At home, I have a pink fabric bag filled with helpful goodies and more pamphlets from my oncologist's office. These trinkets feel like lame prizes for winning the cancer lottery. I put my new stack of papers into the bag and drop it at the foot of my bed. I'm not ready to own my illness. I don't want to be a pink warrior. F**k that. (excuse my language but sometimes f**k says it all.)

Days before my first chemotherapy appointment, I resentfully jerk the bag off the floor. Dumping the contents onto my bed, I sift through the pile.

A pink slinky. Really? Okay.

A pink ball to squeeze during the hundreds of times I am poked with a needle.

A pink bandanna to cover my soon-to-be-as-bald-as-a-baby's-bottom scalp.

A white rubber bracelet stamped with a pink ribbon. Date night jewelry maybe?

A pink folder bulging with information I am supposed to read before my first treatment. When I am finished reading them I will know enough about my disease, my financial obligation, my treatment plan, and the expected side effects to make me hyperventilate.

Lastly, I notice I have two of the calendars folded in thirds. My oncologist had thought it important enough to add to my goody bag. I open it and read the title. The Caring Place, September 2010 schedule. The blocks are filled with notations for jewelry and art classes, support groups, and yoga classes. There are times set aside for reflexology, reiki, massage, and healing touch sessions. What the heck is healing touch?

I immediately call The Caring Place to find out more about them and after a short conversation with a cheerful volunteer I am on the schedule for an hour with a reiki practitioner. This is new to me but so is everything else I have coming down the cancer pipe.

It turns out that The Caring Place is an oasis for people touched by cancer. It is somewhere I can go to meet people like me, find support, and professionals who volunteer their time to promoting my mental as well as my physical well being.

Having someone attempt to manipulate my body's energy field and align my Chakras seems a little woo woo but I am game. I'm not going to turn my back on anything that might contribute to my survival.

The energy inside the Caring Place is like the warmth of my mother's arms. The staff welcomes me as if I am an old friend. The director gives me a tour of the library filled with books to help me on this journey (and a large selection of novels too). She shows me the treatment rooms where the healing professionals will work on me and the large room where the yoga class meets.

One of the rooms is furnished in plush couches and chairs, soft lighting and muted colors. Sunlight streams in through the floor length windows. She tells me to wait here for my reiki session. I attempt to relax into the sofa cushions. I can't. My shoulders ache. My back aches. My head aches. For the first time since suspecting I might have cancer I take the time to feel the stress in my body. It's crushing.

A lovely, slight woman comes to retrieve me from the lounge. "Hello, I'm here to help you."

I struggle to hold back my tears. My emotions are so raw that kind words make me cry. She smiles and seeing my face, she doesn't say a word. She's one of those peaceful people who instinctively knows that less is more.

I lie back on her table. She places a blanket over my body. "Most people close their eyes during the session. It helps with relaxation and visualization. While I work on you, breathe deeply and see yourself as a whole and healthy individual."

I almost laugh. This is so out of my comfort zone but I do as she asks. I can feel the movement of her hands as they alternately hover over and wave across my body. I feel the warmth when she places her hands on my stomach. I feel heat building when she holds them just above my chest. Tears trickle down and pool in my ears, a reaction to the slow release of emotions I'd held in for so long.

The room is silent except for her rhythmic breathing. I feel safe and vulnerable at the same time. An hour passed in what felt like mere moments to me. She whispers, "Slowly open your eyes. Lay there as long as you like. You were very blocked. Take some time to let your emotions settle before you get up. I'll see you out front when you are ready."

She closes the door behind her and I sob. For a very long time I sob and it is freeing, regenerative, and healing. I need this as much or more than surgery and chemical compounds. Thank you. Thank you God for leading me to this place. And it's free. Thank you.

Saturday, November 3, 2012

A Port In Every Storm

"Looks like you are healing well from the biopsy. That's good." Dr. Spotts took my hand to help me sit up after the exam. Before I'm fully upright, she added, "You have cancer."

July 27, 2010. She dropped the bomb just like that.

The room started to spin. I held my breath. My husband's face slowly came into focus. My first thought was not about myself but about how sad for him that his wife had cancer. Before my first tear fell, the nurse put a tissue into my hand. Sharon was good at her job.

"You need chemotherapy. I'm sending you to an oncologist. She will devise a treatment plan," Dr. Spotts said this quickly. No breaks in her speech to ask a question or give a voice to my state of shock.

At the time, I'll admit, I thought she exhibited less than ideal bedside manner. It didn't take long to realize that she, too, was good at her job. Dr. Spotts knew I was headed for a meltdown and when that happened I wouldn't be able to digest anything she needed me to know. Todd, my husband, would be in the same shape. Get out the important parts. Deal with the tears. Keep moving forward. I had family and friends to help with my emotional state. She was in charge of keeping me alive. I admire her handling me this way.

The prospect of chemotherapy scared me most of all. I'd seen many movies about people with cancer. I knew how sick it would make me and how I'd wish that I wanted to die before it was over. Consenting to chemotherapy felt like giving a doctor permission to poison me, kill every good cell in my body, and turn me into a rag doll in the process.

Thank God there have been advances in treatment and the management of side effects related to chemotherapy. My experience was nothing like on the big screen in the same way that actual childbirth is nothing like it's depicted on film.

I completely turned myself over to my new oncologist. I trusted her and hung on every word she said. I followed every direction, except one. Dr. Allison explained that many, if not most, chemotherapy patients opt for a PICC line or port to be placed in their chest. That way the chemicals would be delivered without damage to my veins.

"But you have very good veins. You're young and otherwise healthy. I'll leave it up to you," she said.

"Let me try it without the port. Can I get one later if I change my mind?" I asked. It seemed so invasive to have a permanent catheter placed under the skin below my collarbone. And very scary to contemplate a cannula inside my right internal jugular vein for several months.

"Sure. It's your call." Dr. Allison typed instructions into her desktop computer and scheduled my return to begin Chemotherapy in a few weeks.

TAC Chemotherapy is one of the most caustic chemo cocktails on the market. It works, but in the process it burns up the small to medium-sized veins it passes through. After the nurse inserted an IV into my arm and flushed my vein with a little saline infusion it was time for the first drug. Adriamycin, sometimes called doxorubicin, is a bright red fluid injected very slowly into an IV by syringe.  It's administered this way because the nurse must control the speed by which the Adriamycin makes contact with my vein, monitor me for adverse reactions, and monitor the IV site to be sure the cannula is still in my vein and not leaking fluid (nicknamed The Red Devil) into my surrounding tissues.

I knew I might have made a bad decision when I turned down the PICC because immediately my right arm started to burn, not on fire burn, but bad enough to make me question my judgement. Three weeks later at my second treatment, it took the nurse three tries to find a viable vein for my IV. 

"Why don't you have a port?" she asked.

"I thought I'd try without it first," I answered, sheepishly.

"Ok. You've tried it. Now get one before I see you again."

Yes Ma'am, I thought (picture me saluting her).She was right. Having a PICC line or port inserted turned out not to be so bad after all. I was asleep during the procedure. The incision healed quickly. The port under my skin looked like a raised bubble on my chest but I didn't care. It was much preferable to further damaging the veins in my right arm.

So, don't be a hero. If your doctor offers you a PICC line or some other form of catheter port before chemotherapy my humble advice is DO IT. Save your veins. You'll need them for the rest of you life.

My arm a few days after a blood draw

Every time a nurse attempts to start an IV or a tech pokes me multiple times to draw blood, I am reminded about what a martyr I can be at times. From only two exposures to TAC therapy the best vein in my right side collapsed leaving behind a valley running up my arm. Imagine a dry river bed or a flattened plastic tube. That's my vein. And it, most likely, will never be any better. Don't let this be you.

The bruising got worse before it got better

In short, I stand firmly on the pro port side of the argument. If there is an argument to be had. Who knows? The only conflict might have been with myself.

Wednesday, October 31, 2012

A Little Guide To Life

My birthday is next Tuesday. Election Day! If you want to give me a gift go vote and then let me know about it.

I love birthday cards. Especially the ones from my parents. The cards always arrive in the mail a few days early. I like the anticipation of walking to the end of my driveway and peering inside the mailbox. You see, I've spent most of my adult life living far away from my family. They are in Georgia and I'm always somewhere else. So the card from my parents is like the birthday hug I'd get upon waking up when I was a little girl.

My parents are older now, 81 and 79. My mother is the card buyer in the family but things have changed. She stopped driving earlier this year. It's a chore to go to the store for anything. I understand completely and still, I yearn for the past when she was energetic and demanding (read with a whisper - she's still demanding).

My loving parents

When I tacked last year's birthday card on my kitchen wall it was in honor of all the birthdays my parents helped to make special. Forty-six of them, to be exact. Also, this particular card had a message I wanted to remember and two handwritten notes penned at the bottom. When I'm feeling down I look to the left of my kitchen sink and take a moment to read the beautiful, pale green card.

A Little Guide To Life
for a lovely daughter on her birthday

Be good to yourself. 
There are some things everyone deserves -
Love, respect, time to recharge.
Never settle for less.

Seek out your dreams.
Start small. Take it as it comes.
Even a butterfuly has to inch along
before getting its wings.

Listen to your heart.
Trust your gut.
If the way seems unclear,
look within you.

Let your voice be heard.
You have a story to tell and opinions that count.
And a different to make.

Stay curious.
Take every opportunity to learn.
Knowledge is a gift.
It will take you places.

Hold on to what's important.
Let worries go.
No matter how you look at it,
some things just don't make sense.
The way you choose to carry on
is that really matters.

And when you make a list of what you want in life,
make another list of what you've got.
Be sure to start with all the things
that make you a beautiful person.
There are so many.

I can imagine my mother brushing her hand along the card display at the drugstore, choosing one with a cute picture of a puppy, reading it, and finding it lacking she puts it back in the rack. She scours the cards until her eyes land on this one particular pale green card. It speaks to her and it's filled with the important advice she wants to pass on to her

I know it makes her sad, too, that the time has most likely passed for endlessly pacing the card aisle at the CVS near her house. It was also very sad and frightful for her to be so far away from me while I was so very ill. She doesn't fly anymore, but her and my father's love came to me in cards, phone calls, and notes scribbled on little scraps of paper.

The card is signed...
Hope you have a good birthday.
Wish we could be there to enjoy it with you.
Remember how much I love you.
With my love as always,

Have a good birthday.
Hope to see y'all soon.
Take good care.
Love you,
Daddy Rabbit

Daddy Rabbit...that's a story for another time.

This card is my gift to you. Print it out on colorful paper. Draw roses, daisies, and curlycues to frame the words. Tack it to the wall where you can see it every day. Remember that all this is true for you, too. No matter what you are going through today, these sentiments remain to carry you through. Smile and feel the hug.

Tuesday, October 30, 2012

That's Not Your Life Anymore

One year after Chemo

I'm down to seeing my oncologist once every six months, a welcome change from the almost weekly visits I'd become accustomed to. This changes our relationship. Meeting Dr. Allison now is like having lunch with a friend. I notice she's wearing new glasses and her hair color is slightly darker than back in April. She notices my shoes, a pair of Teva slip-ons easily dressed up with a skirt. I think it's cute she doesn't remember commenting on them several times before. It's clear Dr. Allison's taste has remained steady over the years. She's a woman who knows her what she likes. Picture this...We are sitting at a patio table. I'm toasting our successes with a fruity drink and dabbing the corner of my mouth with a linen napkin.

Reality check...We are in her gaily decorated office. Wizard of Oz memorabilia everywhere. I'm wearing a pink paper napkin and she's discussing how to tweak my pharmaceutical cocktail. It's okay though. Just like friends, we laugh and crack jokes about my ten pound weight gain. It's the holidays. They last from October to January. Ha, ha, ha.

Then it's straight into business mode.

I take five pills a day. That's five too many for me. I ask about eliminating Neurontin, a yellow capsule that helps stave off night sweats brought on by  the Tamoxifen I take and early onset menopause. Menopause at 44 years old, a gift (read with sarcasm) from four months of TAC Chemotherapy.

"I haven't had a problem in a long time. What do you think about dropping the Neurontin? I hate taking so many pills. Before I got cancer I hardly ever took a pill."

Dr. Allison rolls her eyes and waves her pen at me. "That's not your life anymore. Keep the Neurontin. Trust me. It's not that many pills. Just toss'em back in one mouthful."

She tells me to lie down and for the millionth time she examines my breasts, paying close attention to my left side--the side that had the audacity to grow a rather large finger-like tumor and forever change my life. This is the side I lost to a mastectomy and had reconstructed with a silicone implant. Two weeks ago my plastic surgeon attempted to sculpt a new nipple. Two headlights are better than one, so I've heard.

The process did not go so well. It's not Dr. Spann's fault. My plastic surgeon's skills are beyond compare. He's brought me this far with superior results. It's the fault of my radiated skin. See, after a round of radiation treatment the irradiated skin becomes taunt and less stretchy. Think back to my imaginary lunch date with Dr. Allison. I'm more of a linen napkin girl as opposed to a jersey knit sweater. My irradiated skin also has a difficult time healing, so any operation in that area carries the risk of failure.

Before my mastectomy, I scared myself sh**less with post-surgery pictures of breast cancer patients on the Internet. I came away with the solid belief that I'd never be even close to normal again. I've been lucky up to this point. I have a talented plastic surgeon and my skin recovered nicely from the deep burns of radiation. My reconstructed breast mound has a pleasing shape (alibeit, a little like a very firm grapefruit sitting high on my chest) and normal peachy skin tone.
Back to my exam where Dr. Allison is looking at my left breast, particularly the black, inky nub protected by a plastic shield.She sucks in her breath and says, " Yikes. So you're not going to try that again, I'm assuming."

Nipple failure. Constricted blood flow has caused half of my new nipple to die. For now, I am babying it with a slathering of triple antibiotic ointment, protection from accidental rubbing or bumping, and heartfelt prayers to God.

"Carol's sells stick on nipples. There a really nice option." She closes my shirt with a crinkle of paper and helps me sit up.

I tell her I'll think about it. On contemplation, a sticky, pliable, silicone nipple did seem the easiest way to solve my one headlight problem at the beach or on a cold, wintery date night with my husband. This might also be less traumatic than a skin graft from my intact, right side nipple or my labia (that one makes me cringe), as suggested by Dr. Spann. Another option is a very cool tattoo to disguise the nippleless area. Maybe a dragon lounging across my mastectomy scar.

I give Dr. Allison a hug and a smile as I leave the office but  her words play in my head. That's Not Your Life Anymore.

As if she'd poked me in the eye with her index finger, I was left with blurry, slightly off kilter vision. Honestly, it ruined my day.  After an evening of sulking, I have a better understanding of my reaction. I truly believed that one day soon I'd be the Lisa I was in the spring of 2010. I'd be that healthy, never say no, never take pills, vibrant, sexy-for-my-age woman again. She was coming back. I just had to keep moving forward to find her.

But that's not true. She is not me anymore. I am the post breast cancer me and I have to learn to love this me as much as I did the old me. I have to take my top off, look in the mirror at the mastopexy scar on my right breast and the mastectomy results on my left and say that I love me. Scars, black nub, everything. If I'm going to be me again I have to love what I see.

So I'm trying this affirmation:

This my life now and I am happy to have it.