Tuesday, April 30, 2013

What You Do When You Want Out? You Smile.

I wrote this about 10am on 4/23/13 and then the bottom the following day, after finding out the biopsy showed cells that appear to be cancer.  I've debated publishing it, because it's raw.  But it's also honest.  It's long.  Tread lightly with this one, ok?


I was 27 the year my Mom turned 48 and was diagnosed with breast cancer.  I remember it well because it was her actual birthday.  After she and my Dad told my sister and I, things get fuzzy about what happened and when.  But I do remember her telling me that since her Grandma was diagnosed by 48 and that her Mom was diagnosed at 48, she had been convinced that she would get it by the time she was 48.  I wondered how you live your life thinking that without it coloring your whole world.

In March of 2009, we found out that my Mom's BRCA genetic test was negative.  But I didn't feel relieved.  It's as though I felt like I too would have cancer and I just wanted to get it all over with.  Pete and I have had conversations about breast cancer several times.  It's not something that I think about daily, but I do think about it often.

In December 2011 my mammogram was abnormal.  I had never been called back and I'm not going to lie, I cried.  I was scared that I'd go to that appointment and some doctor would tell me I had cancer.  I went alone because Pete had to work.  After additional mammogram images, it was determined that I had little sacs that were nothing to worry about.  I was relieved.  But it brought up all the same feelings again.  The what its and the what is my plan thoughts.

I had my yearly mammogram 4/18/13.  I went, had the images done and was back to work in less than 30 minutes.  And then I promptly forgot about it when I didn't get a call the next day to come back in.

Monday morning I got to work, did some computer work and dropped some things off for coworkers.  One of them has a dog that is dying and I made a bunch of treats for him.  When I got back to my office I had a message from my doctor.  I called and again was told that there was abnormalities.  So I chose to go back in that afternoon for the additional mammogram images.  When I left work I closed my computer down and shut my door like I wasn't coming back, even though I should have had more than enough time to get back to work and continue my day. 

I texted Pete along the way and told him I was going back in for images.  He asked if I wanted him there and I told him that I didn't need him.  I was more worried about the fact that he was temporary and needed to be at work.  Besides, I had done this before and I assumed that I'd be getting a call back more often, the older I got.  In fact I asked the scheduler if I should be going to the local breast center instead of to the local clinic?  She didn't know, and told me to ask at the breast center.

Along the drive, I thought about the process I had been through before and how each step went.  I thought again about my Mom and how, unknowingly, we had planned a surprise birthday party for her on her birthday the year she found out.  I still regret that.  I knew there was something wrong that night, but she never let on.  I thought about how scared I had been the last time I got a call back, but that it turned into nothing.

When I got to the breast center, I changed.  And just like I had taken an Instagram photo the first mamo, I took one again.  I planned to share it and hope that I prompt someone else to get checked and prevent or catch cancer.  I sat, shirtless and braless in a short pink smock with other ladies waiting on a tech to come get me for the images.

My tech was named Kim.  Very friendly woman, about my age.  I always wonder how you decide that you want to fondle (for lack of a better word), other woman's breasts for a living.  I suppose that people always wonder why I'd want to work with criminals.  I went into the room and sat down while she verified information and we talked.  I asked about going there for initial mammograms and she told me if I was more comfortable there, to certainly do that.  I remember thinking that they were going to be checking the same sacs as last time and asked to verify that.

That's when my heart sank.  She told me that they were looking at another spot and it was irregular cells this time, not a sac.  It was in the same area as the sacs, but a different reason.  My breathing got shallower and I flushed with heat but took a deep breath and stood up.  She manipulated my breast in the machine and took the images.  Afterwards she sat me in another more private waiting area and took the images to the radiologist to view.  This was just like the last time and something inside me calmed down, thinking that the tech viewed something that made her think it was all ok.

About 10 minutes had past of me reading the various magazines and the tech came in to take me to a consultation room.  That's when I knew it had gotten more serious.  I wanted to cry, but knew if I started, I'd never stop.  I wondered if the people there thought I was unfeeling?  I put a smile on and waited.  I shook my leg, crossed and uncrossed them and bounced while waiting.  There was a phone and I wanted to call Pete, but by the time I made up my mind up to do so, the nurse and doctor were in with me.

There was a spot and they needed to do a biopsy.  My mind was spinning, spinning and I was frantic inside, but smiled on the outside.  I wanted to call my Mom so she could guide me thought this but didn't want to worry her.  I wanted Pete to hold my hand and tell me everything would be ok.  I didn't want to do this anymore.  I wanted to be at work or at home or anywhere else.  I wanted to cry out and let the tears fall, but just couldn't.  I wanted to leave, but knew I had to stay.

The radiologist and I talked about my Mom's BRCA results.  About how they believe that it's genetic, but haven't found the gene yet.  About how they told my sister and I to be aggressive should cancer show up.  She suggested that I see a geneticist myself to chart out my risk and have a letter sent to my insurance to get not only yearly mammograms, but yearly MRIs.  But all of this is in the event that my biopsy is negative.  If it's positive, I'll need to make other decisions.

I signed the consent forms and got the after instructions and who to send the results to.  And when they took me to the waiting area again, I ran into the locker room, locked the door and texted Pete something about having a biopsy mammo and being worried.  It was a combination of autocorrect bad and bad typing that lead him to not understand it.  I texted back "It might be cancer," irritated that he didn't understand and locked my phone back up.  I instantly regretted it and wished I could take it back.  It's not a fair thing to do to him and texting is not the way to learn that your wife might have cancer, when your Mom died of cancer.

I got into the procedure room and found a table with a hole in the middle where my breast would hang through.  It was uncomfortably hard and almost funnel-like so your back was bent the whole time and your ribs rest on hard plastic.  I got up and laid down and realized that my head would be turned from them during the procedure.  I don't know if that is good or bad.  I like to see what is going on and choose to close my eyes if I want.  But there was no other way to do this.

I laid there while they positioned me and tears started forming in my eyes.  I quickly thought of something else, but I can't remember what.  If I started crying, I'd never stop.  The procedure lasted about 25 minutes.  One nurse rubbed my back while it was happening and told me that I was doing great.  One played classical music to relax me.  I think now that if I have to do this again, I need to schedule on a different day and have a valium. My anxiety skyrockets just thinking about it all. 

They compressed my breast and took some images to find a good path to the area.  Mine was on the outside of the breast, near the chest wall.  And when I heard that, my mind raced back to my Mom.  This is/was sounding exactly like her process.  Hers was on the chest wall and small.  Breathe.  Just breathe.  After finding a path, they washed the area and the radiologist came in.  She sent searing shots of litocaine into my breast to numb it up.  They took additional images to make sure that the injections hadn't moved the area.  Then they started.

A machine that sounded like a sewing machine started up.  The nurse came around so I could see her and started talking to me softly and reassuring me.  Reassuring a 43 year old like I was 5.  Telling me to breathe and relax as best I could.  But it hurt.  Even with the numbing agent I could feel intense pressure and it was painful to have a long tube inserted to grab out tissue.  That's when I noticed that I was shaking.  I was trying to hold so still so that it wouldn't have to be repeated, but all my muscles were starting to revolt, almost mockingly.  After they got the samples, they had to image those to make sure that they got the right cells.  Then they imaged my breast again and stick in a tiny marker to mark the area they collected from.

When they told me I could roll over to my back I was shaking and cold and couldn't stop.  One nurse was holding pressure on my breast to stop the bleeding.  The other got me juice so the sugar would help with the adrenaline.  After about 5 minutes of pressure, she dressed the area and put a compression bandage over it and I sat up.  I was still shaking and they got me drinking more juice.  I felt like a kid sitting there drinking from a juice box and it was strange given that I had just had a biopsy. 

After a few minutes they walked me to the waiting area and had me keep drinking the juice and try to relax.  Then Kim, the tech, had me go back into a a room to do some more images on my breast for comparison.  Do you know that a regular mammogram places about 15-20 pounds of pressure on your breast?  I do.  I also know that the pressure isn't a good thing on a sore breast.

When I was done I walked to the locker room and got partially dressed and sat down.  I was still cold and slightly shaky.  I walked out of the center and got in my suv to drive home.  I guess my instincts to close down my office before I left were right.  I called and had to leave a message for Pete because he was busy.  I don't remember much of the drive home, other than I was cold.  Pete called when I was almost there and asked if I was ok and silent tears ran down my face.  I told him I just wanted to get home.

I laid in bed, in the dark room with the dog cuddled to my midsection.  Stroking his hair calmed me down.  I watched mindless TV that I can't remember and kissed Pete when he crawled into bed with me.  I explained the procedure to him and he was silent.  I can't say for sure, but I think he felt like he had no control and like he was living his Mom's life all over again.  His Mom died at 42 of ovarian cancer after a 3 year battle.  He asked me what I wanted to do if it was positive, if it was cancer.  I told him that I wanted a double mastectomy with reconstruction, but was unsure that insurance would pay for that and I'd have to wait and see.  It was like reliving my Mom's experience all over again, only from the inside out this time.  We spent the evening in bed, tried to act like everything was normal and went to bed holding hands. 

This morning I got up while Pete was at the gym, determined to go to work.  Sitting at home would get me nowhere and I needed to keep my mind occupied.  I took off the compression bandage and got into the shower.  Halfway through the steri strips were coming off and I remember thinking that I didn't want to do this anymore.  Out of the shower I looked at the area and it was bleeding pretty badly.  I took tissues and placed my hand over it compress and stop the bleeding.  It was, is sore.  The ribs around it are sore. 

Compressing and looking at it I tried to imagine my chest without my breasts.  I tried to imagine would it would be like with a large lump out of my breast.  I tried to imagine if it would be painful after surgery and how I'd cope.  I tried to imagine everything about it, if the result was cancer.  It never entered my mind that it wasn't.  I think that's a self preservation thing, not imagining the best.  Prepare for the worst and be pleasantly surprised when it's not.

Pete looked at it after it stopped bleeding and told me I'd have a big bruise.  He asked me how I felt and I wanted to scream at him that I didn't want to do this anymore, that I wanted out of the situation.  But I didn't.  He told me all he wanted to do was hold me, but he was afraid of hurting me.  I realized that I wanted him to hold me too and that it was ok to lean on him.  So we laid in bed holding each other, quiet.  It calmed me.  Again, I wanted to cry, but knew that if I started I'd never stop.  After a while he kissed me and we got up to finish getting ready for work.

So I'm sitting here, at my desk, waiting for results.  My right breast hurts and typing makes it hurt worse.  I'd having issues with reoccurring shoulder pain because I'm again holding my shoulder differently because my breast hurts.  My head hurts with the anxiety of a headache and holding my jaw tense.  I keep looking at the clock, waiting to see if I'll get the news at 11am or 4pm when results are delivered to the breast center. 

Waiting.

2/24/13

It appears as though it's cancer.  Past of me keeps saying that I want off this path.  The other part is relieved that it's cancer so that I can go through it all and be done.  I called Pete yesterday after I got the news.  He was the one who pointed out that I was holding back from my Mom, just like she holds back from us.  He told me I should tell her so I told him I was leaving work to go see her.

The way over there I had to hold back tears a couple of times.  I kept breathing deep and trying to hold it in.  If I started crying, I'd never stop.  When I got there, she had been calling me and the phone happened to ring just as I parked in their driveway - it freaked me out.  It made my adrenaline flow hard, as though she sensed something.  But she was calling to see if Pete could help with something.  So I went in, sat down and started talking.  It's awkward to blurt out that you have cancer.  It's not gotten easier in the last 24 hours and I don't know that it ever would.

I think phrasing it in the guise of needing her help in choosing a surgeon put her into her former occupation of a medical scheduler and took some emotional pressure off her.  She immediately went into gear making calls and finding out who to go to.  We found a surgeon and I made an appointment. 

In the mean time my Dad came home and I was trying to find a way to move the conversation back to tell him and there is just no way to do this gracefully.  So I finally told him that I had a biopsy that showed cancerous cells.  He immediately teared up and tried to hide it.  He walked out of the room to compose himself.  There is something in you that accepts your parents or grandparents having cancer.  It's not easy, not at all what I'm saying.  But it's almost a natural progression of things.  To hear your child say cancer must be extremally hard. 

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