A boob in my pocket

Wow—time sure flies when you’re... um... recovering from surgery. I can’t say that’s been much fun, but it’s nice to have it behind me. Note: Some of this post includes me talking about my breasts, so if that’s TMI or makes some of you uncomfortable, you don’t have to read any further.

A few weeks ago I posted a link to an NPR story about a book that NPR reporter Madhulika Sikka wrote about her experiences with breast cancer: A Breast Cancer Alphabet. It is a wonderful book, which I highly recommend if you’d like some insights into someone else’s experiences with this disease and its treatments. Reading her book made me gasp and cry with connection and understanding—so many of her experiences mirror my own, from the confusion and craziness of diagnosis, to her desire (and my own) to dismantle dominant assumptions of how people might deal with it all. The one place that I find my experience to be quite different from hers is the emotional impact of mastectomy. Don’t get me wrong—this has been an emotional roller coaster. However, the source of my difficulties dealing with the surgery are, I think, different from hers. She discusses the emotional toll of losing a part of her anatomy that is emblematic of womanhood. I get that, particularly for women who, unlike myself, are well-endowed in the chest region.

But for me, the difficulties have stemmed more from the physical imposition of the surgery—having lymph drain bags hanging from my side for 10 days; the limited range of motion in my right arm; having a compression wrap around my arm to prevent lymphedema; and of course, the pain. It just plain hurts, whether it’s arm pain, soreness at the incision site, or even phantom boob pain—a pain that feels as if it’s in a part of my body that is no longer there. This has been emotionally difficult, but less due to the change in my figure (which is not that significant given that I’ve always been fairly flat chested), but more to the limitations in my movement, particularly my ability to exercise. I figure it can only get better from here, though, which brings me to prosthetics!

In another month or so I will get measured and fitted for a new boob—a silicone prosthetic to match my left side. You’d be amazed at how many choices there are in terms of material, shape, size, drape, color, etc. It makes buying a drink at Starbucks seem simple. For the time being, however, I am using a basic generic breast form; a starter boob, really. It's a relatively inexpensive mail order thing made with micro-beads inside a nude-colored triangular piece of fabric. It is very lightweight and similar in size to my left breast, but I must say that it aches having it on my chest, as I am not yet fully recovered from surgery. This is not a problem much of the time—I just go about my day not wearing it, but when I go out I do tend to wear it.  On occasion I’ve found myself discretely trying to rearrange things, and even removing it all together. Sometimes this is easy. Last weekend we went to see the film Divergent, and in the dark theater it was no trouble to just reach in, yank it out, and stuff it in my pocket. But while I’m not a shy person, I stopped short of doing that in the middle of a College committee meeting at work today. Instead, I just dealt with the dull ache. I’m assuming that as time passes it will improve, but in the meantime, if you see me at work or walking down the street with a boob in my pocket, you’ll now know why.

It’s just me, cancer free

Today I had my first follow-up appointment with the surgical oncologist, and my pathology report just came in. The doctor prefaced the results by saying, “This is as good as we could have hoped for.” The pathology showed no cancer in the lymph nodes, none at one of the tumor sites, and “residual poorly differentiated invasive ductal carcinoma” at the other tumor site. It measured .8 x .7 cm, and 6 mm “from the deep margin” (which I believe means margin from the chest wall). The doctor is extremely pleased by this report, and he said that I should feel as if I “just won an Olympic medal.”

Have I mentioned that I like to be thorough? Well, I do. I am supposed to be in a very celebratory mood right now, but I must confess that my joy is somewhat measured. I had hoped to be in the 45% of people whose tumors disappear all together. I mentioned that to the doctor, and he said, “Well, it all but has disappeared.” Okay. But this thoroughness-loving get-the-job-done perfectionist wanted more! I wanted it all the way gone. *Sigh* Of course, as I’m writing this, I am reminded that it is all gone now, thanks to the surgery. I am now essentially cancer free, and if that isn’t something to celebrate, I don’t know what is! Regardless of the fact that there was residual tumor, it and the “demon boob” (as my friend called it) are both gone, and that teeny bit of residual cancer was removed with a nice wide margin around it.

Despite these excellent results, I still get my remaining treatments under the rationale that they will serve as “insurance” against any undetected rogue cells floating around my body. In other words, the course of chemo coming up in April and May is not intended to kill any tumors because I now have no tumors to kill. Rather, it is meant to clean up any remaining microscopic bits that may have survived the first course of chemo and the surgery. Same thing with the radiation that I’ll be getting in the summer.

Beyond the path report, I am healing well from surgery. I am mostly off narcotics now, and the swelling is receding. It’s funny. I am now cancer free, but never have I looked more like a cancer patient: No hair, missing a boob, a big scar across my chest, my right arm wrapped up to prevent lymphedema, lymph drain bags hanging from my body. Oh well. While all of that is clearly a pain in the ass (the drain bags, in particular) it doesn’t bother me too much, as most of it is temporary. And no, I don’t miss my right breast. At first I thought I might. Last Thursday, before surgery, I wished it good riddance, and I meant it. However, I was unsure how I would actually feel after the fact. But, honestly, looking at myself in the mirror and seeing it gone does not feel weird. In fact, it feels oddly normal. Having cancer and knowing that I had tumors right there in my breast felt much weirder and scarier to me. So while I probably don’t look like myself to those around me, I feel like myself. This is not a “new, cancer-free me” talking, or even a partially boobless me. It is just me; cancer free.

Post surgery report

Hey Everyone, Craig here.

Just letting you know the surgery went very well (according to the doctor) and Lara is doing great--a little groggy with Norco and Ambien but overall doing well.  She gets to have her arm and chest wrapped in a compression bandage for a while which can be a bit uncomfortable at times. Hopefully she'll be home tomorrow night if all goes according to plan.

Right breast is apparently in some biohazard bin on the 2nd floor--good riddance.

A goodbye letter to my right breast

Dear Right Breast,

You and I, we’ve been together a long time. What’s it been now? Forty-five years? The memories swirl through my mind: Our first bra, nursing the kids, and a zillion other escapades that need not be detailed here... Good times.

But over the past few years you’ve changed. You became unstable and unreliable, making it difficult to discern your true intentions. A sore lump here, a mysterious “calcification” there (or was it DCIS? I’m still not sure). I stopped counting the number of mammograms and sonograms you drove me to, not to mention the tears and anxiety. And things really took a dive this year, when you went rogue on me. Let’s be honest: We both know you’ve been trying to kill me. But cancer? Seriously? And as if that wasn’t enough, you had to drag the nodes into this. Was that really necessary? I’ve always known you were dense, but this is pure desperation.

So it’s over, Right Breast. You’ve had your fun. While I will continue to enjoy life’s treasures for many years to come, tomorrow you’ll meet your brutal end, filled with medical dissection and testing in a cold sterile lab before being discarded for eternity. And you’ll get nothing from me; no sympathy, and no more tears. All I have left for you are five words: Happy Amputation Day. Ta ta!

Lara

MRI results, moving on to surgery

Actually, this post might be better titled "chemo results," as the MRI I had last week was meant to help us see the results of my first course of chemotherapy. But whatever we decide to call it, the results are wonderful: Nothing detectable shows up at all in either my lymph nodes or at the site where the largest tumor was. N-O-T-H-I-N-G. At the site of the smaller tumor, something that measures 2mm appears; however, it is not well defined. Could it be residual tumor? Yes. However, it could also be scar tissue or DCIS (ductal carcinoma in situ, a non-invasive form of cancer). If it's the latter, it was likely there before the invasive cancer grew and was just not previously detected or biopsied. It is impossible to tell for sure what it is by just looking at the MRI, and so we'll have to wait until about a week post surgery to find out the pathology of that tiny little mass that is in there. Either way, it is TEENY and will come out with the rest of my breast and lymph nodes in a couple of days. So, I am thrilled with these results! *SLAP! SLAP SLAP SLAP!!!* Can we get a collective WOOT WOOT! from the crowd?

Some of you might be asking yourselves what my oncologist was actually feeling at the site of the largest tumor last week if the MRI shows nothing there. When she had me feel there a week ago, I couldn't feel anything, but she said she could and I figure she's got a lot more practice and skill at feeling lumps in peoples' breasts than I do! So, today she said she might have just been feeling normal densities in the breast, and I do have dense breasts. (Sorry if this is TMI. It's amazing how a breast cancer diagnosis can make someone perfectly comfortable talking candidly about one's breasts, both in private face-to-face conversations and in the blogosphere. Breast breast breast breast breast!) Anyway, I am still holding out hope of being in the 45% who go into a remission after just the 12 week course of chemo.

So my thoughts have turned to this Friday's surgery. Several friends have asked me how I'm feeling about it, and because my feelings are all over the place, it's a difficult question to answer. However, I'm so grateful for those who have asked, as I think it's something I've needed to talk about more than I have been. I'm really not worried about the surgery itself. I've been under general anesthesia before (and it's great, by the way). All along I've said that I'm not bothered by losing a breast. I mean, let's be honest: It is trying to kill me. I have no desire or need at this point to have reconstructive surgery because I just have not viewed my breast as a significant part or contributor to who I am as a person. Also, I'm not a very good candidate for reconstruction or implants. And yet, I have felt very anxious in the past couple of weeks leading up to the surgery. I think that's because regardless of the emotional and physical significance, or lack thereof, that I place on my breast and it's removal, this is still unknown territory. I simply cannot say how I will feel after it's done. I anticipate feeling better; relieved and with a concrete knowledge of what I currently can only vaguely imagine: The absence of a body part that has always been present, at least since puberty. And that's the thing. I still don't know, and so this falls under the frustrating and scary categories in which we file so many things in our lives and in our imaginations: THINGS I CAN'T CONTROL and THINGS I CAN'T YET KNOW. And that's not easy for catastrophist control freaks like me. :-)