Equity, and my *only* surgery

My surgery went better than I had hoped on Friday, the 20th. I had completed my pre-screening at the hospital the day before: two blood tests, a urine sample, and a chest x-ray.

My report time for the procedure wasn't until 11:00 am, so I had plenty of time to not eat or drink anything in preparation. Normally this would have bothered me, but my nerves must have helped me ignore my thirst and hunger. When I checked in at surgical services, I was sent back over to the imaging lab. Wasn't I just here? Deja vu! Third time's the charm I guess. This time I was lead to a room with a a curtain and bed in the back of the room. The nurse and tech explained that the radiologist would be inserting the radioactive dye used to perform the sentinel node biopsy. Oh boy. I had hear that sometimes this procedure is done through the areola, and that it can be very painful. I took advantage of the opportunity to ask the nurse. She told me it just depends where the cancer is at, and that the pain felt varies from patient to patient. Super reassuring. The radiologist comes in, and gives me a small shot from the outside of my breast. He explains this procedure has gone through a lot of changes in the last couple of years, that yes, some patients find it painful or experience a burning sensation, but that most find its pain similar to that of a lidocaine shot. Sure enough, it is no big deal for me.

I'm so relieved, that my nervous joking goes beyond my normal comfort level - the nurse tells me I can turn the hospital gown around, with the opening in the back so that it is less revealing. I say "what if I want to show them off while they're still real?" She says "everybody has their own way of coping with this situation, I even know some women have "revealing" parties after their surgeries." I blush at the thought that I was joking and she thought I was serious! I try to assure her I was joking, and then curiosity gets the best of me and I ask about the revealing parties. Yeah. Sorry guys, that is just not the way I'm going to handle having falsies! Later on as we are preparing for surgery the nurse flips through my chart with a confused look on her face. "Do you have any allergies?" She asks me. I smile and say "Nope. I'm perfectly healthy other than the cancer."

She keeps rapidly flipping through pages and says "I can't seem to find the record of your prior surgeries..." to which I reply "That's because this is my only surgery." "You've never had another surgery?" "Nope. I've never been placed under general anesthesia before. I don't plan on doing it again, either." The plastic surgeon comes in with a marker to draw lovely curves on my skin so that they will make sure to put my fake breasts in the right places. I'm glad it's so technical. ;) He is very optimistic, and tells me his cancer patients often look better than before they started. Then he laughs self-deprecatingly, and says "Maybe I shouldn't over-promise!" His nurse reminds me that this procedure today is not about looks. She stumbles around it a bit, and I catch on that she's concerned I might think I will come out of the operation with normal looking breasts. I try to reassure her and be funny - "You mean, I'm going to have a double mastectomy, and I'm going to look like I've had a double mastectomy, with the beginnings of reconstruction. Okay. Yup, got it!" I smile at her so she'll know I'm not being crazy positive because I have unrealistic expectations!

My memory is pretty spotty after they wheel me toward the operating room. Retrograde amnesia, my hubby reminds me, is one of the side-effects of general anesthesia. But, I do remember most of the recovery room. It was pretty funny. Apparently I inherited the "talk it up and share lots of jokes in the recovery room" gene from both of my parents. Their stories are far more humorous than mine. I woke up to the plastic surgeon telling me the procedure was over, and it went great. I must have recognized his voice, because I certainly don't remember seeing him. Several silly minutes later I was in my hospital room. It was strange to be back with my family members and have them know more about the surgery than I did, but I am grateful the docs and nurses kept them informed. All of the five lymph nodes they removed looked clean. Dr. T. reminds me they have a 90 % correct track record on this in the OR. Amazing! I wake up pretty sore, and soon discover that oxycodone is my new best friend. One night I try just taking one pill, instead of the two I am allowed, and I wake up in pain. The nurse offers me some morphine until the second pill arrives and then has time to take effect. "Huh," I tell her "I didn't realize I had a headache. But nothing else changed." Turns out the morphine was nearly unnoticeable! Oh, yeah, and the blue dye they gave me during the operation to help identify my sentinel lymph node turned my urine the same color as lime green jell-o!

Lime Jell-O will make me giggle for a long time!

That was freaking awesome! I spent a lot of time sleeping and visiting with amazing nurses, techs, housekeeping staff, dietary staff, and family and friends. All in all it was like a vacation where you're woken up several times a night to check your vital signs and where you need help getting to the restroom. Oh. That doesn't sound much like a vacation, does it? Good thing they sent me home a couple of days later! I spent as much time as I could sharing my testimony with people. It seemed really, really important that they hear about these really cool faith-building experiences I kept having. I'm not sure many of them 'got' what I was trying to communicate. Maybe I'll do a better job sharing here.
Thursday night I had another profound spiritual experience. As most of you are aware, I belong to The Church of Jesus Christ of Latter-Day Saints. I'm a Mormon. Like most Christian religions, we believe in "the laying on of hands" as mentioned in Hebrews 6:2, or perhaps a better example is when Christ's disciples "anointed with oil many that were sick, and healed them" in Mark 6:13. Anointing and healing through the power of God is mentioned in many places throughout both Old and New Testaments. I've had practitioners of other faiths lay their hands upon me and bless me in Jesus' name. I've also been anointed and blessed through the Preisthood power by members of my church. I have faith that miraculous healings occur through the power of God (and through our faith) even in modern times.

While I knew this kind of healing was not part of God's will for me during this trial, I also have faith that He might have other, more important blessings to bestow, so I asked for such a blessing the night before I went into surgery. As my father placed the oil on my head, I felt a little surreal moment, and said "I feel like we just barely did this. Would you guys mind if we switched it up tonight, and Shane anoints me and my dad gives the blessing?" To be honest, it had only been a week and a half since my last blessing, so we really had just barely done it. "Whatever you want!" They both say, and promptly trade jobs. So. My dad gives me this incredible blessing. My mom and husband are listening. My dad does his best with interpreting what the spirit gives him to say, which apparently includes blessing me with equity. And telling me about the equity I am being blessed with. And what I will do with the equity I am being blessed with. As the blessing closes in Jesus' name, I say "Wow. I'm not sure I know how to react to that." My mom shakes her head and lets it drop into her hand as she says my dad's name with her "what were you thinking?" tone. He starts to apologize to me - "I'm sorry babe, I know that blessing didn't make a lot of sense..." and I stop them both and tell them "NO. That's just it. It made perfect sense TO ME. I know you it didn't make any sense to you. That's why I don't know how to react. That blessing was to me, the words were meant for me, and I understood what Heavenly Father needed me to hear." Then I got to share some pretty amazing things with them, and clearly, I am not sharing all of these things on my public blog, but let me tell you about this one. Equity. When that word came out of my father's mouth during my blessing it was like someone else was talking to me. When he expounded on the equity I was being blessed with, and what I am destined to do with that equity - I'm telling you. It was divine. What my spouse and parents didn't know was that I have been studying the health economics of breast cancer for my English class. During my brief examination of the articles I'm considering using for my research project I became a little bothered by some of the moral implications of the studies. Since I want to become a health economist, it's kind of a big deal that I not have moral reservations regarding what I want to do with my life, you know? So, during my study I decide I'm going to tackle a rather hairy aspect of the research. The two objectives of health economics are efficiency and equity. I'm going to examine the equity side of the issue, and try to hold health economics accountable to these objectives. The two objectives are almost mutually exclusive. This is why it is so critical that both objectives be acknowledged and promoted. One without the other will not lead us to optimal health care knowledge. It's massive. It's just this huge thing to me, and it's all wrapped up in this giant process of me deciding what I want to be when I grow up and how I will make a significant contribution to the world. And there it is. In my blessing before my double mastectomy. I am blessed with equity. And I KNOW.

This is inspired. It is not a coincidence. Our language is beautiful and complex, but a word like equity doesn't randomly show up in a blessing for health. I just can't seem to communicate how cool this is to people. It's profound. God spoke to me, and He made it obvious that it was coming from Him. I mean - I know He's there. I know He loves each and every one of His children. Sometimes it just feels like "but there are so many of us..." or "but He's so busy..." or a million other ways in which we discount the enormous magnitude of His belief in us! That word - equity - it was not my father's word. He didn't know what he was talking about. My mother was almost disappointed in the blessing because I wasn't blessed with the things that you would expect to hear in a pre-operation blessing. But I was blessed with what I needed. And I was told what I needed to hear. And whether you know what "equity" or "efficiency" or "economics" mean, I think you can recognize that this was not an average experience. There is a grand design. God loves us. He loves me. He loves you. 

Plumbing the depths of my selfishness

     This may be the weirdest post you've ever read. But that's okay, because it's mostly for me, and, since this post is all about me and my selfishness, I figure that's appropriate. Just to be clear: as I ramble about my feelings, impressions, and lessons, I am NOT preaching to you about how your life should be, about why you should change, or anything remotely resembling those things. Caveat over - spotlight back on me.
   

We are all selfish by nature. Learning to live without being completely self-absorbed is so rarely accomplished, we usually refer to people who have achieved it (even temporarily) as saints or prophets. As a deeply spiritual and religious person, I have been trying my entire life to develop a less selfish perception of the world. Let's just take a look for a moment at how well I've done:
     1. As the oldest of eight children it is all about me. If a sibling makes a mistake it is because I have not set a good enough example. If a sibling achieves success it is because my parents raised us right. Oh, yeah, and I set a good example.
     2. As a student it is all about me. I want to have both the top grade, and be the teachers' favorite. If there is an award or recognition to be had, I want it. If this means running against a friend for a student council position for which she is more qualified, then I will run and win.
     3. As a wife I want people to know just how much I have sacrificed for my husband. His success is due to my support and hard work.
     4. As a artist of sorts (whether as an author, on stage, in the orchestra pit, or behind the piano) I must give nothing less than my best performance. I strive for the lead roles and solos. The more my name is printed, the better.
     5. As a mother I must be conscientious about my children's needs, wants, and milestones. Like my siblings, their mistakes are my mistakes, their triumphs are mine also. I am the center of their universe because I am MOM.
     Are you sick yet? This is just the tip of the proverbial iceberg people! I'm not saying I haven't chosen to be selfless at times. Brief times. Not so long ago, if you had asked me "Are you a selfish person?" I would have responded with a "No, at least, I try hard not to be." How naive I was. I truly believed that I had made progress throughout my life on becoming less self-absorbed. I am now chagrined at what I had deemed 'progress'. This next part is very difficult to share, because it is close to my heart.

     The day I found out I had cancer I spent some time in prayer and meditation.

I had a very specific impression come to me. It was not my own thought, it came from somewhere else. Since I recognized this immediately, I also knew its source. Fortunately, despite the multiple screw-ups in my life, I have at least successfully learned to identify the Holy Spirit! The thought was something like this: "IF you wanted to be healed (and had enough faith to be healed) through a priesthood blessing/miracle, that is a choice you may make. However, if you want to fulfill God's will for you, this trial has been sent to you not for your own growth and understanding, but on someone else's behalf." Now, sometimes the spirit speaks in words, but sometimes it speaks in impressions. This one was kind of a combination. The part about this trial being for someone else had a deep meaning to it that was not communicable through words. It was powerful. It was also like a conversation, because I knew that I had the faith to be healed, and could request a miracle, but I also told my Father in Heaven that I primarily wanted to accomplish HIS will.
     Anyway, time passes and I tell people I have cancer and they tell me repeatedly how: positive I am, brave I am, inspirational I am, strong I am, etc. etc. But all I can think when I hear these things is "But this trial isn't about ME. It's for the benefit of someone else," and this leads me to examine my reactions to some of the other trials I've had in life. Some have been excruciating. The strength and courage and positivity I had to exhibit were inspirational as far as the way in which I approached the trial: SELFISHLY. Completely absorbed in myself, and my trial.
     I asked all the normal questions with these trials: DEAR GOD,

WHY ME? WHY? WHY? WHY? Please remove this trial from MY life. This trial is hard! It hurts! I know you want to refine me in your fire, but isn't there another way? WHY?
     I'm sure most of us are very familiar with these questions.
     So, here I am, diagnosed with cancer. I experience no "denial phase". I haven't yet experienced an "anger phase" and I'm hoping I won't (though it may come as a result of hormones, and if it does, I expect it to be short-lived). Because this time, this trial, my focus has been removed from MYSELF. I'm sure there are those who may read this post and not understand my faith, and they may say "her 'impression'  is a form of denial," but I testify that it was of divine origin. It has taken me weeks now to process the experience and even get this close to explaining it - but you better believe I didn't do it justice.

Now if that's not a miracle, I don't know what one is. This is new ground for me! A trial given to me, for which I am not concerned with the whys, and the normal rebellious attitude. I have embraced this trial. I've heard brothers and sisters in Jesus Christ try to explain the tremendous blessing that trials are to our life, but I've never so fully embraced and welcomed a trial before. This is what is seriously throwing other people off as they try to sympathize and empathize with me. It is why they are worried about how I'm handling it, because I clearly "must be in denial," or "it just hasn't hit her yet," or "she's just putting on a brave front". It's dramatically different than those situations. So different, I struggle explaining it to people.

      A friend of the family came over to speak with us one night. She shared a story she had read in a book. She couldn't remember the name of the book, if you recognize it please share in the comments! The story went like this: One day a woman entered the church's restroom to see a young mother with her baby. The baby had suffered severe burns to its hands from touching the glass covering a gas fireplace. Part of the recovery process for this little one required the mother to stretch the tender, healing skin grafts every hour. This caused terrible pain for the baby, but without it, the skin would not grow and learn to be pliable, and the child's dexterity would be severely limited for the rest of the child's life. This mother had to put her baby through excruciating pain to help it. The author used it as an analogy to our Father in Heaven. He stretches us through trials and tribulations. It hurts, but it is for our own good.

   

 This story reminded me of when my oldest suffered severe burns and required skin grafts when she was two years old. I can remember wishing with every fiber of my being that as her mother I could take her pain upon myself. If that act is what my current trial - my cancer - is accomplishing, I volunteer with all my heart. I will embrace it, and make people sick with my positive attitude. If it is accomplishing God's will, and helping someone else, I will gladly give up my selfish attitude and support His plan.

The Cry Fest

Yup. It happened. We all knew it would. I woke up Friday morning with a dull ache in my left breast. It wasn't in my head! My cancer was causing me pain. Mild pain, mind you, but I could FEEL it. <shivers> I was up early, because I have so much to do, but despite my best efforts, my littlest was pushing all my buttons, and we left late for my regular yoga class. Again. My little one did not want to go into the gym's daycare - which is unusual for her. I knew I needed yoga. It may be the last time I do it before my surgery.

I tell her "Listen. You can either hug me and hold me and have an angry mommy, or you can let me go to yoga, and I will hug you and hold you after and be a happy mommy. You choose. Happy mommy or angry mommy." She cheered "Happy Mommy!" and ran into the daycare as happy as could be. We had a substitute teacher in yoga. She was great, but a different instructor can really mess with your practice, even if they're good. I couldn't help but gripe in my head a little. I wanted the workout I had expected! Still, we got to the end of class, the Shivasana that everybody loves where you lie in Corpse pose on the floor and try to relax completely. Everything is fine for the first 5 minutes, but the last few are a different story. I begin to weep. As we come out of our shivasana I attempt to 'hide' my tears by engaging in a few more stretches. The tears don't stop. Then my friend asks "Are you okay?" So I tell her, "I think I'm really emotional from all the stress. I'm okay. I'm going to be okay, but I think I just need to cry." She invites me to the steam room, where she allows me a good cry, and says super supportive things. I tell her "I just want IT OUT. I just want them to CUT IT OUT of me all ready!" You get the idea. And no, those capital letters aren't just emphasis like I normally use them, they're the actual yelling kind of capital letters. Those things are handy after all! So, on our way out of the gym, my friend takes her necklace off and puts it around my neck. It says "BE BRAVE".

I ask if I can return it to her when I'm done with it. I don't love accepting things from people. She says "Pass it on to someone else who needs it. Someone gave it to me." I'm hoping to learn more about the necklace's history. Anyway, part of why I was so stressed was because I was trying to get ready to leave town for the weekend.

My dad's parents

My grandparents left their home in a trust fund for their children to use. We only get the opportunity to visit it rarely, but it is in a very rural location. It reminds me of being a child, and of my deceased grandparents. It feels secluded, and free. I love it when we get to spend a few days there. My children love it too - maybe even more than I do! I knew as I began this process that a weekend away together before my operation would probably be a good idea. The hard part was trying to get enough done to go! I thought about all I had to do as I drove home. I knew I could call someone over to help me, but I also felt like the time when I really need that is still coming. I said a little prayer, and went to the Junior High to check my oldest out of school. I made sure she was going to be okay with missing the rest of her classes, and then explained my emotional state to her. I told her I just needed to be with her, and have her help, if that was okay. She was thrilled. She got a little bit done, and I got a lot done. We left on our trip two hours late, but it was okay.We had a great time in my grandparents' home. I got lots of homework done, and the kids got lots of playing done. It was exactly what we needed, and we may go back for spring break.

My parents and grandparents

I'm so grateful for my parents, and my grandparents, and their legacy. I drew strength from having a retreat with my parents in the home of my grandparents, and returned ready to sprint to the first mile marker in this journey. Two more days. Today, and tomorrow, and I will be in a world of pain and drug induced lack of pain accompanied by drowsiness. BUT, the cancer? It'll will be GONE. I can't wait!

When life gives you lemons...

     I got to meet with my plastic surgeon today. It was an interesting experience because with the proliferation of plastic surgery, especially in popular media, it was something I knew I had some false preconceptions about. Also, I never really pictured myself as a plastic surgeon's patient. I sat in the waiting area thinking. "I'm really here, about to have a consult with a plastic surgeon about a huge alteration to my body. This is so weird!" My adorable man was able to come with me to the appointment; although he is still in training for his job, the training today was an introduction to the work environment where he has all ready been employed on two other occasions. <snore> "Uh, my wife has breast cancer and is meeting with the plastic surgeon for the first time today. Do you think I could skip the unit orientation?" Yeah. Not a problem.

Aw, isn't he adorable?! He's not very happy that I use the word adorable...

     Anyway, last night I got to sit down with a breast cancer survivor and really ask some personal questions. She was a little concerned that I was thinking I want a bilateral mastectomy. She is about ten years post a (single) mastectomy, and just wanted to make sure I understood what the procedure would mean for me: for my recuperation, for my psyche, for my intimacy with my husband, for my physical health, and for my life, my future. You get the idea. It was fantastic to be able to ask specific questions and see where her journey has taken her ten years later. She was a little younger than I am when she was diagnosed, and still had a one year old in the home. It was tough. If I'm experiencing denial in the whole process of "you've got cancer" it's in accepting that this surgery is considered major surgery, which indicates significant recovery time.

I decided to curl my hair while I still can!

Yup, I'm kind of struggling with that. I'm not the best patient in this regard because I tend to push myself a little too hard, and then pay for it when I'm recuperating. I understand this about myself, and yet I feel helpless to prevent it from happening. I know when it comes down to it I will make this mistake during the healing process, and yet that knowledge will not prevent it from happening.
     Then on my way to my appointment I receive a text from my mom detailing how long her friends' recovery was. It does NOT sound like something I can handle with grace. I feel like "if it takes that long I am going to be ANGRY." My mother also wants to know that I'm not alone, because her friend tells her the day she met with the plastic surgeon is the day it all became real to her - the day it hit her. So, there I am in this office I had never imagined being in, a little psyched out by these concerns.

Contoured implants

Shane, being a rather large 'child' went straight to the sample implants and started playing with them. Okay, I admit, not playing, but curiously examining them. I found a brochure about some of the options, and it was quite informative. I had no idea what implants are available, or why they may or may not use a particular style of implant. The doc will recommend a type to me based off of my body's appearance as I recover.

Round implant

I had looked up the plastic surgeon's website, and spent some time reading about him and his patients' endorsements of him. I anticipated that I would enjoy meeting him. I was not disappointed. He spent most of the appointment asking sincere questions about Shane and I. About Shane's residency hopes, about my educational goals, and other 'getting-to-know-you' type things. It felt like if we had met under other circumstances we could have had a fun double date with him and his wife (I have to assume about his wife, his website mentions her so I know she exists, but he didn't refer to her, of course).

     He examines me, records measurements, discusses the possibility of nipple conservation (something I have very mixed feelings about,) and takes the infamous 'before' pictures. I try to flex my abs because I've worked hard on them! I doubt it will make a difference in the pictures, but I just couldn't help myself! We discuss a little bit about the size of my future implants. (That sentence is so weird. It's like when I say "my cancer.") The doc asks if I want to, ahem, increase my size modestly. I tell him "maybe a little, but I'm talking a little." He asks if I want a specific (common) cup-size. I say maybe the next size down... closer to the size I was before nursing four children. Shane asks him about flap procedures where they remove muscle and tissue from another part of your body to help create a more natural breast. The doc says "She's not a candidate, there's not enough on her body to use for that." I take it as a compliment. Just over a year ago it might have been a different story, but I've been hitting the gym 5-8 times a week for a year, and while I have lost some weight, I've lost awesome clothing sizes! I'm pretty buff (for me) right now. I also think this is another way in which God has prepared me for this trial; at least being physically fit should speed my recovery, which is the next thing I ask the Doctor about.
     I've read and heard some horror stories about recovery. The doc reassures me. He anticipates my recovery should be between two and three weeks. He will place one drainage tube on each side. I can drive when I can manage my pain without narcotics. Shane asks how long the procedure will take. It depends on the surgical schedule that day, but if they can work it out, both the general surgeon and the plastic surgeon may be able to work on me concurrently. Dr. Tittensor can perform the left side mastectomy while he performs the right (prophylactic or preventative) mastectomy. Then he will complete the reconstruction, and the procedure time can run about two and half hours. If it doesn't work out this way, and Dr. T performs bilateral mastectomy (both sides by herself) and then he comes in and does the reconstruction, the procedure will likely be more than five hours. Wow! That's a significant difference. Join me in praying that their schedules work out!

     If you feel awkward about reading about my nipples you can skip this paragraph. They offer "reconstructive" procedures, tattoos, and sometimes they can save your nipple based on how close the cancer is to it. My cancer is close, and not close at the same time. Dr. T. and the plastic surgeon are a little uncertain about whether it might be an option or not. Dr. T. will have to make the determination during the surgery. I'm not sure how I feel about these options. I may wait until a few weeks after the surgery to decide what I want. It feels odd to me, I have such strong opinions on wanting a mastectomy, that the ambivalence I feel regarding this decision leaves me feeling like there's a vacuum in my decision making processes. I can imagine a variety of circumstances, and none of them make me feel more comfortable than the others.

     We discuss size again. The expanders that I will come home from the operation with are little silicone bags with a port that features a magnet. The magnet guides a needle for a syringe which enables them to slowly increase the size of the expander: I will visit the office about every week and a half and they will inject saline into the expander, giving my skin time to s-t-r-e-t-c-h. This continues until I feel comfortable with their size. Then, they know how much saline is in the expanders, and pick the appropriate implant based off of that information. Then I will have an outpatient surgery to replace the expanders with the implants. As an additional note, if the pathology reports from my surgery indicate the cancer was starting to spread I will have chemotherapy with the expanders, prior to receiving the implants. Since chemo wouldn't start until 6-8 weeks post-op, that would mean I would have the expanders for quite some time.
     The good news about all of this is that the mastectomy results in loss of sensation. As in my chest will basically be numb. The expanders don't hurt, but they feel very tight, especially as the skin stretches over them. The injections don't really hurt. The surgery doesn't hurt like the first one. It's all about the positives, right? Along those lines is the reason for the title of this post. One of my best friends posted on Facebook about how sad she was about my cancer, and asked her FB friends for prayers on my behalf. Her brother (whom I have met) responded by saying "When life gives you lemons, trade them for melons..." It totally cracked me up, and I've used it a few times to lighten the mood when discussing my cancer. I especially love how lemons and melons are anagrams, 'cause I'm a nerd. Shane says we're going to put it on a plaque for me. Yeah, that's exactly what I can picture hanging in my office!
     On our way home, the nurse calls from Dr. T's office with the results from my MRI. They're a 'grab bag' of pros and cons. There appears to be a spot of concern that could be a 'satellite' of the cancer. Am I sure I want a mastectomy? Because if I want a lumpectomy they will have to biopsy this second site, and the Dr. will likely try to talk me into a mastectomy. I confirm that I definitely want a mastectomy! The tumor measured 1.17 cm at it's longest on the ultrasound. It measures 1.5 INCHES on the MRI. It's either growing crazy fast, or the increased sensitivity of the MRI revealed it to be much larger than the ultrasound showed. There is NO indication of cancer in my right breast. My lymph nodes look great. Like I said, a total grab bag! I ask about the hormone receptor part of my biopsy's pathology report. Different cancers can be 'fed' by hormones... and stuff... and the type of receptors your cancer has (or doesn't have) determines a lot about your treatment. My results should have been in last week, but as the nurse reviewed my file, she realized the test was never ordered! She ordered it before calling me, and those results should be available in a couple of days. I thanked her because I've been anxiously awaiting those results!

Happy colors, I guess these 'jammies will work.

     After I dropped Shane back off at work I stopped at Kmart. I've read I will need front-closure sports bras, pajamas, and shirts to wear during my recovery since they will be much easier to put on. Amazingly, Kmart has this cute and modest front closure night gown in my size! I figure I'll shop on the internet a bit, and there's a store I've been trying to get to here in town that sells special bras etc. for breast cancer and breast surgery patients that I will check out. Since we haven't budgeted for these kinds of expenditures, I discussed how we will need to file our taxes soon with Shane. We really need to pay down some credit card debt, but maybe a hundred dollars will go a long way in helping me feel semi-normal during my recovery.
     I have so many ideas for additional posts, but I am ready for bed tonight, so y'all will have to be patient until I have time again. Considering the amount of homework I want to get done BEFORE I have a bilateral mastectomy, that might not be for a while! Of course, as I have mentioned before, this blog also helps me in coping with all of this, so I reserve the right to surprise myself. :)

Surgery Consult, MRI, Birthday Party

     Okay. So, just so y'all know that I'm totally human - I woke up this morning and wasn't quite all the way awake, but definitely I wasn't asleep either. You know what I'm talking about. Anyway, I entered full-consciousness with the thought that I need to write a letter for Shane's next wife. I mulled it over for a couple of hours before telling him about it. (I went to Zumba, pumped some iron, and picked up a birthday cake.) Bless his heart, he said something to the effect of "Don't worry about it. You're just facing your own mortality. You're going to be just fine." It wasn't just the way he said it, either, it was his nonchalant tone that comforted me and reassured me. He validated my fear by telling me about some of his thoughts, and the unease left me.
     Anyway, I know some of you want to hear more detailed information about the cancer stuff. If that's not you, you can skip the rest of this post. :)

     Dr. Tittensor spent a great deal of time with us (me, Shane, my mother, and Shane's mother) on Thursday. The nurse took my history, including our family's cancer history, and the Doc performed a quick ultrasound and exam. "Oh, yep, there's the cancer." It's pretty obvious when you're small-chested. Then she asked if I would like a genetic panel performed. If your insurance covers all but $375 (or less) of the test, it automatically goes through, so they just need to be sure you can handle a $375 bill if it shows up. Yikes. That's a lot for us, but, Mom is there and I look to her and she nods yes. I know if we can't cover it, she will help. I feel that this test is important, and Shane was impressed by how extensive it is. There is more than a little cancer in the family, and my results may help my siblings, of which there are seven, not to mention their children (and mine) as well. After my blood is drawn, Dr. Tittensor comes back in to discuss my treatment options. She has an outline-format information sheet to take with me, and she explains step by step the options and associated risks. After I tell her I'm pretty sure I want a mastectomy, but am uncertain how I feel about the other side, she recommends I meet with the plastic surgeon. She says most of her patients feel confident in their decision after meeting with him, whether they change their minds to a lumpectomy, or a double mastectomy. I am all ready feeling like I want a double mastectomy, but I hope Tuesday as I meet the plastic surgeon that I will feel confident in my decision!
     Then, she recommends an MRI. It is scheduled for the next day, which is also my youngest's third birthday. I scramble to find babysitting, and think "I really need to get organized about who is willing to help with my kids before this process gets worse!" Many, many sweet friends have immediately volunteered to help with the kids when they hear about my cancer. I think they all can imagine themselves in my shoes, and I am so grateful for their offers. My MRI is the same time as one of my classes, but the professor furnished us with the times she teaches other sections, so I call my mother-in-law and stick her with the kids while I attend early, and then she comes with me to the MRI. She (or someone she knows) had a bad reaction to the contrast in an MRI once, and doesn't want me there alone. I am grateful for her company, even if I leave too late to get to my appointment on time, and then drive us to the wrong hospital. She knew better, too, and tried to tell me! But, they are a little behind at the right hospital, so no harm done. My technologist is bubbly and friendly. I change into hospital pants and gown(s). I start by putting on the pants backward, and laugh at myself as I turn them around. When I'm all dressed she inserts an IV (I hate IVs, but she did a great job) and takes me to the machine. It has a special attachment for a breast MRI. I'm going to try and find a picture, because words will not do it justice!

Yep. That pic paints a pretty accurate picture. A raised platform to lay on with two holes in it for you to hang out. Super fun, and super comfortable! <sarcasm!> "Don't lift your head at any point during the scans or in between the scans, even if you have to talk to me." Instructs the technologist because if you lift your head it moves your ... assets. I practice pranayama (deep breathing) and meditate during the exam. I break meditating a few times to respond to the technologist over the intercom, so she knows I'm not asleep. She tells me what to expect for the length of each scan throughout the exam, and especially lets me know when the contrast is dispensed into my IV. I really appreciated the warning! It wasn't bad, but it was cold running into my arm, and made the rest of my body feel funny-warm as it made its way through my systems. I wish I had my phone with me to take a picture of the red mark the cradle left on my head and chest. No, I wouldn't have taken a picture of my bare chest, good grief people! But, the red mark extended high enough on my chest I could have taken a pic with a low shirt on and you would be able to see it. I laughed pretty well at myself when I looked in the mirror in the changing room! I asked the tech for a copy of my images for my husband. She gave me the disclaimer "It's unlikely you will know what you're looking at..." and I remind her he's been through medical school, and assure her that he will want to see them. She tells me "We expect a certain variation in the images due to breathing, but yours hardly moved at all. At times I was worried you weren't breathing any longer!" I explain about yoga, and think "I'm glad I responded vocally to her prompts over the intercom a few times so she knew I was fine!" All said and done, I was in the machine for just about thirty minutes. It was loud, but they provide earplugs. The images are beautiful, but no, I won't be posting those either! 

     I come home from the MRI and decide we need to have a party for my youngest, so I call on two of her friends and invite them to come over tomorrow at 2. I head to Costco and buy paper plates, bowls, cups, utensils, and gasp at the cost, but I know they will cut down on work and stress over the next month or so. Our Relief Society President brings us pizzas and visits with me, then I have to take care of the eleven year old's ingrown toenail which includes buying more epsom salts, so we take the youngest to Wal-Mart and let her pick out a present. She decides she wants Doctor dress up clothes. I am tickled. None of the other kids really expressed an interest in dressing up or playing Doctor, even though their daddy's life has revolved around it. The party was super cute, and both of our guests' mothers volunteer to babysit for my appointment Tuesday.

     Then, a dear friend I haven't seen in years came and took me to Aveda salon in Provo for pedicures, and to Cubby's afterward! I picked pink polish for breast cancer awareness. I love that my toenails will be pretty in the hospital, and the catch-up session with my friend was priceless. I also cried just a little bit because it was so kind of her, and I felt so pampered. I've also been trying to remember to invite women I know to feel my lump, so they know what to look for in their own breast exams. It's not awkward since mine is located just under my shirt line by about an inch - my bra doesn't even cover it. This may be just one way something good will come from my experience. 

Something like intuition...

     In my communications with people regarding my cancer I’ve had a difficult time explaining the source of my calm demeanor. Yes, it is related to spirituality, but it’s not just the result of faith. I feel like I have been prepared for this trial. This post will make an attempt to clarify what I’ve felt and experienced, but I also know it will fall short of truly communicating my experience. I’ve used the word “premonition” to describe it a few times, knowing that it doesn’t quite fit. I checked the thesaurus, and none of the words fit. What I’m feeling lies somewhere in between premonition, discernment, inspiration, and intuition.

     For as long as I can remember, when I have heard about someone having breast cancer I have thought “That could be me.” I understand this response is familiar among women, after all, breast cancer is the most common cancer women develop. My thoughts would often take me beyond that initial connection. I would question “If it were me, what would I do? How would I react? How would I feel?” Many of my speculations were dependent on my age, but in general I came to the same conclusion. I would want a mastectomy. This line of thought has occurred many times throughout my life, but it’s not the only thing that has prepared me.

   

 I do Yoga. I love it. I’ve never been very coordinated. The rest of my sisters took dance and gymnastics lessons. I went home crying from my first lesson in each, and my second and third lesson in gymnastics, and most of my swimming lessons to boot! That’s part of why I’m a musician, the coordination involved in the piano, the violin, and the viola is much more specific! Still, I’ve always wanted to be coordinated, and I love to dance for pleasure. I’ve worked hard to learn dances for stage performances, and I love aerobic dance (which means Zumba right now). Still, yoga does something special for me beyond the physical. My sister introduced it to me after Shane joined the Air Force, and we practiced it together while he was gone to basic training. It helped me to center, and taught me something I’d been frustrated with my entire life – how to increase flexibility and balance! I did my research paper in my Aerobics Teaching class on Hatha Yoga, and spent many hours reading about it. Part of practicing yoga is listening to your body, not pushing it. Understanding your body, and working with it, not against it. Many times the pose you find most difficult or most uncomfortable is the pose your body needs the most. Triangle pose was this way for me in the beginning, but throughout the last several years of medical school induced stress it’s become Upward Dog that I know I need. I’ve even burst into tears in the pose, and it frequently makes me feel like crying. Knowing that triangle pose is linked to sinuses and that I frequently have sinus issues, I wondered “Why is upward dog causing this emotional reaction?” So, I looked into it, and read about how, along with Camel pose and a few others, “heart opening” poses can do just that – open the heart! I also read that this feeling is often experienced in women who have breast cancer. I thought, “Well, I’m under stress, so it’s likely an emotional reaction to the stress,” but, I also had that little question, “Could it be breast cancer? What would I do if it was?” And still, there are other ways in which heaven has prepared me.

     While living in Georgia, I found an ‘anomaly’ in my breast. I had Shane examine it. He pronounced it likely the result of fibrous tissue change and advised me to wait a couple of weeks and see if it went away. It did. Still, it gave me plenty of impetus for my speculation regarding my personal reaction to a cancer diagnosis.

     While on Facebook a year or two ago I read a post about the possible link of Aluminum in anti-perspirants with breast cancer. Now, let’s agree, a ton of stuff gets posted to Facebook like this, and in general it gets placed in the “EVERYTHING CAUSES CANCER” folder in my brain. That folder like, never gets opened, because I’m naturally a worry-wart and would worry myself to death if I believed every piece of medical advice and opinion on Facebook!!! Still, this one struck me, and I stopped using my anti-perspirant and bought a Tom’s of Maine deodorant that same day. I can’t explain why it was suddenly so urgent to me, and, truly, it was an unusual way for me to respond to that kind of Facebook post. Go figure!

     We moved to Spanish Fork in 2012. It was an insanely difficult move. It very nearly broke me, in more ways than one. The ward (church group) we attend features a meeting for women called Relief Society. One of the women is called through Preisthood power to be the president of the organization. Ours had just finished her battle with breast cancer about the time we moved in (I think). I was so impressed by her positive attitude regarding her experience. I loved the way she carried herself in a way that radiates peace. She exhibited humility and confidence sans shame. Humility should be without shame, in fact, they should be mutually exclusive, but somehow in our human nature we sometimes confuse humility with a combination of other attributes. Humility is among the most difficult spiritual attributes to attain – at least in MY opinion. I was inspired by her openness, by her faith, by her humility. More than inspired, I felt a connection to her, despite the fact that I wasn’t present for her tribulations. My speculation regarding how I would respond to a cancer diagnosis suddenly had a role model.

     Now, these are just the few examples that are foremost in my mind as I reflect on why I feel so prepared. Some would call them coincidences, but to me they are a testimony of God’s guiding hands being a constant part of my life. And now, maybe… hopefully… those of you who have taken the time to read this have a better understanding of why I am handling it “so well” and with such a “positive attitude”. I have more to say regarding the spiritual nature of my journey, but for now, this is sufficient.

     For anyone who does not follow Facebook, my MRI is tomorrow, my appointment with the plastic surgeon is on Tuesday, and my surgery is scheduled for February 18^th. I plan on having my left breast removed, but am going to hold off on deciding anything about the right one until I meet with the plastic surgeon. I’ll keep you updated. I also learned that my cancer is both Stage 2 and Grade 2.

Thanks again to everyone for the support and prayers!!! 

I'm sorry to say it's Cancer

     I went back to school in August. I had been told in a preisthood blessing I would know when the time was right, and on August 15th I decided the time was right. I had ten days to complete the application process before classes began at Utah Valley University, where I will get an associate's degree to take with me wherever we (hopefully) move to.

 Due to the differences between BYU and UVU, I had to take a generic college health class. I didn't love it. I kept trying to make the questions more complicated than they were, and even my lovely husband who has been through medical school would disagree and nitpick them with me. Regardless, I came to the chapter on sexual health which included a tidbit on self breast exams. Did you know they are no longer recommending that all women do them monthly? I was shocked. But, it was a good reminder, it had been a couple months since I had done one on my left side because I had (in a moment of brilliant, dazzling klutziness) a rather large bruise. (I had somehow managed to walk into the corner of the car door. I told you, brilliant, dazzling klutziness!) So, I do the self-exam and... what is that? That is definitely a "lump"! I wait until bedtime and ask Shane to examine it. "Huh. It's feels like fibrous tissue change, or possibly a cyst. It's hard, and it's free moving, both good signs. Why don't you wait a couple of weeks and it should go away. If it doesn't, make an appointment."

     Thanksgiving, finals, the flu, Christmas, New Year's, school starts, the time flew by, and I realize "It's been a while since I've checked! Oh, great. It's still there." I call and make an appointment a week away. Our family Doc is in our ward. In the Bishopric. He's a fantastic guy, and though I know most women would feel awkward seeing someone they know personally for a breast exam, I am confident in his abilities. No kidding, he says verbatim what Shane had told me, except "since it's all ready been several weeks, let's schedule an ultrasound. It's probably a fibrous cyst, which is easy to verify on ultrasound, and it would be a good idea to check and make sure." A few days later within 2 seconds of the ultrasound wand being in place I hear "Oh. That is NOT a cyst. You definitely have a lump honey. You're going to need a biopsy. It has irregular borders and calcifications." Great. I call my 5 sisters and let them know what's going on, so that just in case it IS cancer, they've had a little bit of warning.

     At this point I start talking with my husband about possibilities. Since traumatic injury can sometimes create ossification (a little bit of tissue changing to bone) I hope that maybe, just maybe, that massive bruise that I tried to forget the moment it happened (due to my super-human ability to be a klutz) was the cause of that kind of tissue change. It's in the same spot, after all. Of course, my hubby doesn't remember me ever having a bruise. "Maybe I'm making-up running into a car door with my chest because the alternatives are scary?" I think. Then, while visiting with my mother about the biopsy she says "Well, you DID have that great big bruise there." Validation! Ha!
     Since the hospital where I will receive the biopsy has a particular policy about the way these things go I have to get a mammogram before I can have a biopsy. My appointment is on January 22nd. I take my mother-in-law with me since she's available and HAS NEVER HAD A MAMMOGRAM. She's getting close to 60. It is my moral duty to convince her to get one. We review the results, (Oh, look! There's a spot of concern on your mammogram. You think? It looks worse on the ultrasound!) and move to the ultrasound room. The surgeon comes to do the biopsy and asks "You haven't had any aspirin within the last five days, have you?" Dang it. Stupid headache on Civil Right's Day from waking up at the crack of dawn to go to the temple. I took Excedrin, which contains aspirin. I have to reschedule the biopsy for the following Tuesday, the 27th. It hurts a little. They numb with lidocaine, and I can watch the needle on the ultrasound as it shoots through the mass. I didn't feel much of the first and third samples, but for some reason the second sample makes me deeply uncomfortable. I don't experience a ton of pain, but I take a massive nap after the procedure, and skip my Zumba class the next night.

    I should have the results within 72 hours. I get them in 48. Poor Doc, giving a patient he knows suck-y news. "Your results are in. I'm sorry to say it's cancer." I take notes on what he starts saying because I know if I don't, I won't remember any of the words. Invasive Ductal Carcinoma (IDC). Because it measures over one centimeter at its longest, it is considered stage 2. He refers me to a surgeon whom he highly recommends. She's the same one who helped our Relief Society President with her breast cancer the year before we joined the ward. My visiting teachers from church are in the room with me when I take the phone call. I take a moment to consider how I want to deal with the news. I excuse myself to tell my husband before I tell them. "Babe, that was the Doctor. It's cancer." I tell him loud enough I know they will hear. I commit to my decision. I will be upfront and honest and unashamed. I will tell people, even if it hurts. I will accept that this is a trial I have been selected to be blessed with. Yay. I have tons of work and homework to do, but I don't want my family finding out 'later rather than sooner', and definitely not through the grapevine. I spend roughly four precious homework and work-from-home-work hours on the phone explaining my results with 14 of them. The rest will have to hear from their spouses, or my mother-in-law. Heaven bless her. She's dealt with cancer in a child before, and she's prone to weeping, so I know that was not a pleasant task. Even more difficult than losing the hours of time is comforting and reassuring people who try not to cry. I decide to share my news on Facebook in bed after 11 at night. I ask them (my FB friends) to forgive me for not being ready to cry over it, and for excusing myself or laughing it off if they need to cry over it. I write some prose: 

     Diagnosis

I glimpse the edges of my mortality,

Their horizons wink at me.

My soul reflects their colors;

A spectacular juxtaposition

Of elusive hues which have no names.

My work is yet unfinished,

My journey incomplete.

The twilight beckons,

The mystery entices.

I am an agent of my crossing

And time remains my friend.

I begin fielding responses from friends online. Everyone is super supportive, and I hear how positive I am handling it over, and over, and over, and over. My family is concerned because I'm unemotional. They say "It just hasn't hit you yet," but I think about my little attempt at poetry and my self-reflection and say "No, it has. I'm just okay with it. I have a really peaceful feeling about all of this." Then I have to tell my professors. Why is it so much easier to tell the women? I can't drop classes - we've already spent some of my student loans. The amount of juggling I will be doing in the near future boggles my mind, so I decide not to think about it for now.

     My appointment with the surgeon is on Thursday at 2:30 pm. Shane started a new (old) job yesterday, and is in training for two weeks. I seriously thought they would not allow him to leave early, but he told me tonight that they have no problem with him joining me. I'm relieved he will be by my side, and both of our moms are coming too. I've heard amazing things about my surgeon, and am excited to meet her. My automatic reaction is that I want my whole breast removed. I dread chemotherapy, but understand it is likely necessary. I wanted to have another child. We have no money. We live in my parents' basement with two bedrooms and four kids. We've worked our butts off, and sacrificed nearly everything we could to get my husband through medical school. Residency has eluded him. The loans are massive. The match isn't until March, and the odds are downright scary. Forgive me for thinking this way, but the cancer seems like the easy trial right now. I keep telling people that I am grateful because at least it's a common cancer that is treatable and I live in the United States. We can't afford health insurance, but we are covered by Medicaid. I cringe at what that means for the Doctors who will be treating me, but am grateful - so profoundly grateful - for the coverage.