VEGAS MELTDOWN

To put you in the mindset: I'm in Las Vegas with my two BFFs for a rhythmic gymnastics meet (the daughter of one of my BFFs competes). I am nervous about my upcoming lumpectomy, so this weekend is a welcome distraction. The first rhythmic event is tonight, and we're all really excited. After breakfast, we spend the day walking around The Strip and end our outing at Serendipity, where we wait 45 long minutes for their famous (and fabulous!) frozen hot chocolate. 

We return to our hotel to shower and change. And since I am the official "makeup artist" today, I also apply eyeshadow and lipstick and sparkles to my friend's daughter's pretty face. In the adjoining room, I hear my cell phone beeping. It's now 5:30 PM on a Friday night and my surgeon, Dr. A., has left a voicemail. This is very odd. I've got 10 minutes before we have to leave for the competition. I rush to call him back.

Good news/bad news. He has presented my case before the hospital's tumor board and has called to tell me the consensus is in: I need an MRI of both breasts before I can have surgery. And that's not all. Due to the location of the cancerous mass, my nipple must go. Which means more than half my breast must also go. Which means I likely will need a mastectomy — not the lumpectomy I am scheduled for in five days.

Dr. A. and I had previously discussed this very possibility at our last appointment, and I told him then that if I wind up requiring a mastectomy, I want a bilateral. Remove 'um both, remove as much future worry as possible. And give me some matching, reconstructed boobs. Now he agrees this is the best plan of attack, but the MRI will tell us precisely what we should do. So I need to get that scheduled. In the meantime, will cancel next week's surgery.

My head is swimming. My BFF knocks on the door to say we have to leave. I plead for five more minutes. (I realize this makes the kid potentially late, but I don't know what else to do.)

Dr. A. also adds that I need to see a plastic surgeon for a consultation. Can he recommend anyone? I ask. He gives me two names. But something doesn't feel right. I pause, then say, "If this was your wife, who would you send her to?"

"Does your health insurance let you go out of network?" Yes. "Then if it was my wife, I would send her to Dr. C. He's an artist. We've worked together before. I'll call and tell him about your case, but you give him a call on Monday." 

In the span of 15 minutes, I've gone from mentally preparing for a lumpectomy to probably needing a double mastectomy and a plastic surgeon. This is way too much to process.

Yet my little entourage awaits. So I swallow my fear, force back the tears and step into the hotel elevator. I smile at our little gymnast, but my BFFs can see there's trouble in my eyes. Somehow, we get through the next hour talking about routines and hula hoops on the way to the meet before leaving her with her coach and teammates. We have exactly one hour before the festivities begin. One hour to cry over my beer and dissect my need for a bilateral mastectomy in a nearby pub.

The next day is spent in a stifling hot, noisy gymnasium watching dozens and dozens of  girls perform complicated floor routines to very repetitive music. We are sitting in a crowd of parents and children — certainly not an environment where I can break down the way I need to. I probably should have stayed at the hotel and ditched the meet, but the thought doesn't occur to me until I'm already inside the crowded gym. Besides, it feels better to be surrounded by my friends than be alone with my thoughts. So I suppress my emotions and put on my  "everything's OK" game face. But everything is so not OK.

But eventually I crack. It happens before the final event. I have a hot flash and feel like I'm about to implode from the heat. I can't find enough air to breath, and can no longer hold "it" in. I leave the gym abruptly, wade through the throng of spectators and slip outside where the air feels cool. And I start walking. I pass a playground with seating, but there are kids playing, and I can't deal with their screams. It is I who wants to scream. 

I wander over to a senior center next door and sit down on a cold bench. I'm finally alone — and so numb and overwhelmed I can't even cry. I just sit there and stare into space. 

I needed this weekend away with my best pals before I head into surgery. And if I had waited until Monday to return the surgeon's call, I might well have had the carefree time I was envisioning. But once that fateful call was answered, all bets were off; I lost emotional control. And the road trip quickly morphed into an exceedingly stressful, solitary nightmare on wheels. I call my husband. I just want to come home.

PRE-OP ROAD TRIP

My datebook tells me I have a lot to do today before I head to Las Vegas tonight. I wish I could say I am taking a trip to take my mind off my upcoming surgery (while that is a side benefit, it's not the real reason I am going). Instead, I am accompanying two BFFs and one BFF daughter, the latter of which is competing in an athletic event in Vegas. And a road trip sounds soooo good right about now.

          First things first, though. I pick up my car, which has been in the shop due to a broken automatic-window-control thingy. Then I stop by the dentist to cement a crown and get my teeth cleaned. For some unknown reason, I decide to tell the hygenist I have breast cancer and of course I start to cry. (And no, I really didn't see that one coming!)

          Next up: my pre-op appointment with my internist, Dr. S., in preparation for my January 19th lumpectomy. But he is not in today. Instead, I see a doctor I've never seen before. She greets me in 3-inch heels and carries a folder with the pathology report from my biopsy in her hands. She glances down at it and says (quite casually), "So, you'll be having chemo then?"

          Me: "WHAT?"
          Daffy Doc continues: "I see you are estrogen negative."
          Me: "No, I'm not! I'm estrogen and progesterone positive — I'm HER2 negative!"
          DD: "Oh, I must have read that wrong." Pause. 
          DD (again): "I see your BRCA test is negative."
          Me: "WHAT? That can't be back yet. It's too soon. Are you sure?"
          DD: "Well, that's what Dr. S. typed it in here. Why would he type it in if it wasn't in?"

Now my blood pressure is on the rise. She asks me a few real questions (not inane assumptive statements) and then a nurse comes in to draw my blood and run an EKG. I'm handed a referral for a chest Xray (which I have to get at another location on the other side of town). On my way out, I ask the nurse at the front desk for a copy of my BRCA results. Guess what? They can't find them. The nurse that drew my blood pipes in: "I haven't seen any BRCA test results come in yet." Really? How surprising.

          I wish medical professionals would be a tad more sensitive; these tests, these stats, are a VERY big deal. And when my info is treated nonchalantly like this, it makes me feel whittled down to a bare nub of a patient — just a number on a chart that can easily be misread. Not on my watch. This is MY life we're talking about!

          I look at my cell phone and realize I have barely enough time to get the chest Xray and then get home to make dinner before my BFFs arrive. We have a quick bite, hop in the car and steer it towards the freeway. We laugh, we joke, we sing, we break a tail light.  BFFs are great!

          We roll into Vegas exhausted, and plop down onto our big, comfy pillow-top beds. Oh yeah, this is exactly what I need.

DR. A. & DR. J.

I have a second appointment with a surgeon at the cancer center. I walk in and immediately feel I don’t belong. There are old people everywhere; patients waiting with adult children or grandchildren or young “nurses.” Only one other couple looks to be around my age; her husband is filling out her forms. She looks anxious. First timer. Just like me.

My husband and I wait an hour; Dr. A. finally enters the examining room just as my cell phone rings. It's my mom. I haven't told her I have cancer yet. I tell her I can’t talk. Now I’m spooked. (She has exceptional intuition, my mother.) 

Dr. A. patiently explains the procedure he will do for me to remove my cancerous mass: a lumpectomy. He'll also be doing a sentinel node biopsy to determine if my cancer has moved into my lymphatic system. Breast cancer spreads via the lymph nodes; during surgery, a blue dye is injected near the cancerous tumor, and the sentinel, or first, lymph node that takes up the dye is removed and examined under a microscope. If the sentinel node tests positive, that means my cancer has spread and Dr. A. will take out additional lymph nodes. And that also means I’ll need chemo. (Note to self: If my right arm hurts upon awakening from surgery, it's not good news.)

Since I have family history (my sister had breast cancer at the age of 31), Dr. A. asks if I have had a BRCA — the DNA test that analyzes mutations in a pair of genes responsible for some breast cancers. Yes, I tell him, and I should hear back in a few weeks. He is pleased but stresses that I shouldn’t wait until I get the BRCA results back; I should schedule the surgery as soon as I can, to "get it out of there." He’s right. It's been more than three months since I had the "bad" mammogram. I need to get it out of there.

Dr. A. has answered my dozens of questions patiently, thoughtfully. I trust him and want him to be my surgeon. I talk to one of his nurses about setting up a date for my lumpectomy.  She explains they need approval from my insurance company before I can be put on the schedule and this could take a couple of weeks. I leave not knowing exactly when surgery will be, but happy to at least have a plan. Having a plan means having control.

After our consult, a social worker asks if have any questions for her. Uh, how do I know what I’ll need emotionally when I haven’t gone through anything but anxiety yet? My BP is good upon arrival (125/75); but I can only imagine what it is now. I take her card.

On our way out, we run into a physician that my husband knows very well. This is awkward. Dr. J. is one of the doctors who treated my husband’s late wife for breast cancer. So there is a lot of history here. Since I have taken such great pains to keep my diagnosis from everyone, I am absolutely terror-stricken that my news will now be leaked — and not by me. 

But we try and play it cool, my husband and I. Dr. J asks us twice: How is everything, how is the family? We nod fine, fine. But it is obvious things are not fine. Pause. My husband fesses up: "We’re here because she has breast cancer." I quickly add, "and we haven’t told anyone yet.” Then the tears come. Dr. J. tells me not to worry, he won't say a word. Doctors are supposed to keep these things secret, right? Yet I know in my heart of hearts he will go home tonight and tell his wife that my poor husband now has had two wives with breast cancer.

By the time we get into the fresh air my head is pounding and I am starving. We head to a deli for a bite to eat. 

On the drive over, I call my mother but avoid talking about where I just was. (I will tell her soon enough, just not on the phone.) My husband and I sit down in a booth at the back of the restaurant, and I order cabbage soup and half a corned beef sandwich. My husband puts his hand on mine, a tender gesture. I pull away. "Don’t!" I snap at him. "I’ll start crying and I don’t want to lose it right now!" I hold it together but do a lot of staring off into space during lunch.

We get home at 3 PM. I put on my pajamas, close the blinds, crawl into bed with my dogs and watch House Hunters for 2 hours. Then I fell deeply asleep.

This is getting real now. 

My time is no longer free. 

I fear this cancer has spread. 

I don’t want to lose my hair. 

I can handle pain but I’m getting afraid. 

I tell myself to be glad for moments of happiness and fun and clear thinking — they help offset the ugliness that I know will bring me down if I'm not balanced.

I’m trying very hard to level the playing field.

(See Operation Wigout for the next installment.)