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.

ISLE OF DENIAL

Immediately after my breast cancer diagnosis in December 2010, I become stuck in the “Making-Medical-Appointments-Around-the-Holidays” mire. Unable to get in to see any physicians until early January, I have no choice but to get back on the train to nowhere. And so my husband and I decide not to tell anyone (aside from my two girlfriends) about my diagnosis. Friends and family will just ask lots of questions and we won’t have any answers. Better to wait until we know more. Besides, we don’t want to wreck everyone’s Christmas. Bad enough we have to wreck our own. We'll just keep it all a secret.

I had never spent a holiday on the Isle of Denial before. It wasn’t so bad; kind of like a honeymoon phase. I tell myself there will be plenty of time to deal with everything cancer-related soon enough. So I wrap presents and bake cookies and decorate the Christmas tree just like every year. But I’m not sleeping well. I get up at 3AM, listen for the rain and make Peppermint Pinwheels. Then I study the biomarkers in my pathology report, looking to make molehills out of mountains.

But what I oddly don’t do is any further research, which is not like me. My head seems firmly stuck in the sand. I don’t investigate the findings on my pathology report beyond what I already know to be true: I have IDC (invasive ductal carcinoma); it’s ER/PR+ 95% (estrogen and progesterone receptor positive, meaning the cancer is being fed by my hormones, so taking the premenopausal drug Tamoxifen will suppress this estrogen and interfere with it's ability to stimulate the growth of breast cancer cells); I am HER-2 negative (good because HER-2 positive cancers tend to be more aggressive). And my Nottingham Score — a common tumor grading system — is 5 out of 9. These stats simply confirm what my Dr. S. has already told me: that my cancer is likely slow growing. So I really don’t think about “it” that much. I try to continue to forget “it.” 

And I try to find some semblance of peace on the merry 'ole Isle of Denial.

(See New Year and Ditching Control for what happens next.)

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