INTUITION

A question that comes up often when people first hear about my diagnosis is, "Did you know?" What they really mean is, did my gut tell me? Yes and no. My gut knew; it was my head that didn't. To wit:

1. When I'm called in for a second mammogram to get more compression views, I think nothing of it. Yet, subconsciously, I know there is more going on than just "dense tissue."
2. When the ultrasound technician tells me I need a biopsy, I don't ask her any questions, though she gives me plenty of opportunity to do so. I make the appointment but don't tell my husband.
3. When I have a core needle biopsy, I tell myself the procedure will simply show what benign breast tissue really looks like.

The evidence is adding up — yet I don't do the math.

Then one night I have a dream. In it, I'm telling both my parents that I have breast cancer. And I'm very sad because I realize that my father — who passed away three years ago — will never know that I have it. 

I awaken with a haunting feeling.

It was only after my diagnosis that I recall my dream and acknowledge how wise the subconscious mind is. It always knows.

Next up: Dr. A and Dr. J.

CANCER CLUB (Part II)

Biopsy day arrives. The radiologist is right. It doesn't hurt! She takes four separate tissue samples using a large core needle that makes a clicking sound each time it captures my flesh. She comments on how relaxed I am, that I'm "in the zone." Wait a minute. Am I supposed to be "in the zone"? Why am I IN THE ZONE? As I lay on the exam table, I begin to realize this whole thing may be a bit more serious than I have allowed myself to believe. So I formulate a few questions to ask the radiologist when she returns to the room.

But she never does. 

Instead, the technician hands me an ice pack which I am to use 20 minutes on, 20 minutes off. She also mentions that I will be hearing the pathology results directly from my primary care physician — not the imaging center. I know this is code for "I'm sorry you are about to go out of your mind with worry while you wait days and days and days until you finally get your results but please don't call us, we can't tell you anything." Suddenly I am scared.

I decide to share my concern with two close friends, one on the east coast, one on the west. Both listen and calm me and tell me they are sure it is nothing at all. We make a pact, the three of us: No news is good news. “I'll call only if it's bad news," I say.

That evening, when my husband comes home from work, he finds me lying on the couch watching TV,  a thick scarf loosely draped around my neck to hide the ice pack still inside my bra. He suspects nothing. (I figure if this turns ugly, there will be plenty of time to tell him something.)

But I'm starting to act weird. I jump when the phone rings. I don't feel comfortable keeping this from him just to save him the worry. So the night before I find out my fate, I share my little secret. He is nonreactive, yet concerned. He says he is glad I waited to tell him. And it would have been OK too if I had waited until I actually knew. (Do I know my husband or what?)  

As expected, it takes days before the phone finally rings. My primary physician, Dr. S., is a very friendly, upbeat man, and I'm certain I'll hear it in the tone of his voice if the results are not what I am expecting. So I am thrilled when I pick up the phone and find his joyful voice on the other end.

Him: "Well, I have your test results!" 

Me: "Yea! I am so glad."  I slide my relieved body into the kitchen chair.

Him: "Unfortunately, it IS cancer." 

Me (long pause): "I was not expecting that."  Uh, wow.

He starts to rattle off preliminary findings as the hair on the back of my neck stands up. My face becomes flush. My hand shakes as I jot down the few words I manage to hear through the verbal assault that is pummeling my brain.

"Invasive ductal carcinoma." (It's the most common type of breast cancer; that's a good thing because the medical community has a lot of experience treating it.)

"Well differentiated." (Sounds bad, but generally means slow growing, so that's also good.) 

"Not a tumor." (It's a mass that looks like breast tissue but has cancer cells in it. That's also good. Still, I can't help but think of Arnold in Kindergarten Cop... It's not a tuma!)

"One inch in size." That's just an estimate. I will need a lumpectomy and a lymph node biopsy to know for sure what we are dealing with. 

I don't remember anything else, except telling Dr. S. that we can talk more about all this tomorrow — because, odd as it may seem, I had an appointment for a general checkup with him the very next morning. An appointment I made three months ago. Before any of this started.

Do do do do. Do do do do. (See Curtain of Dread to continue with my story.)

RELATED POSTS

• Cancer Club (Part I)
• Telling Hubby 
• Isle of Denial

CANCER CLUB (Part I)

I am an official, card-carrying member of the Cancer Club. I unwittingly applied for membership on October 1, 2010 and was formally accepted on December 8, 2010. Here is how my story begins.

During my annual mammography exam in October 2010, the techs (one experienced, one trainee) tell me they need extra views of my right breast. This is generally not a good sign, but I don't ask questions; I have dense breasts and I know this makes it hard to get a clear reading. Or perhaps this is simply an exercise for the trainee; maybe she didn't get a good image the first go-round. I submit to the extra views. I get dressed, go home and get on with my life. 

One week later,  I receive a letter from the imaging center with good news: My test results are normal! Wow. Really? Whew!

Fast-forward a few weeks to early November 2010. A second letter arrives in the mail. Upon further review, the letter states, a "subtle architectural distortion" is noticed between my 2009 and 2010 mammograms and "given family history" (my sister had breast cancer ), an ultrasound is recommended. 

Hmmm. So if I didn't have family history, would this "subtle architectural distortion" simply be overlooked? (This is a scary thought — since more than 75 percent of breast cancers are found in women with no family history.) In fact, I come to learn that a woman's risk of breast cancer approximately doubles if she has a first-degree relative (a mother, sister or daughter) who has been diagnosed with breast cancer. Yikes.

I set up the ultrasound appointment immediately. Then I do a self-exam to see what they are talking about. BINGO! I feel a quarter-sized lump in my left breast. I recall the extra views they took during my October mammogram — this must be why. Still, for whatever reason, I am not worried. In fact, I don't even mention it to my husband. I just go in for the ultrasound.

While I'm laying on the table waiting for the procedure to begin, I tell the tech about the lump in my left breast. She says the ultrasound is for my right breast. Huh? But what about this lump here? I ask. She rolls the ultrasound wand over my left lump and assures me it is a simple cyst. She then turns her attention to imaging my right breast. 

As I wait at the edge of the chair in my little blue gown, the tech goes out to find the radiologist. The room is cold, and dimly lit. I wait a very, very, very long time. While I wait, another woman enters the room, hands me a heavy packet stuffed with pamphlets about breast cancer and says in a sheepishly cheerful tone, "There's really a lot of good information in here!" Of course I find this extremely odd; no one has mentioned anything to me other than the fact that I have dense breasts. So I listen to the voice of reason inside my head that tells me everyone is likely receiving this literature because October is Breast Cancer Awareness month. (Even though I know it is now November.)

After about 40 minutes of waiting, I poke my head outside the room and ask a passing nurse if they have forgotten about me. The tech comes in to say they are still waiting for the radiologist. I am obviously in denial because I don’t ask any further questions. 

Finally, the tech returns. She tells me that I need to have a biopsy of the area in question. It’s a simple procedure, she explains, and my breast will be numb so I won’t feel any pain. She then very casually mentions that I can return in two days to have my biopsy done. Two days? Two DAYS? Why do I need to come back in TWO DAYS? I don't actually say this, but she can see the terror in my eyes. No one has mentioned the words cancer or malignancy. 

Deep inside I realize something is up but my denial is stronger.

"Oh, you can wait until Monday if that's more convenient for you." Why yes, waiting is definitely more convenient for me. So I make an appointment for a week from today — Monday. I’m certain this will give me enough time to wrap my head around this biopsy business. And so I go home. And I do not tell my husband. (To find out what happens next, see Cancer Club Part II.)


RELATED POSTS:

• Cancer Club Part II

• Curtain of Dread

• Isle of Denial