WANTED: YOU!

Periodically I comb through Dr. Susan Love's Army of Women current research projects to find a few broad-based studies that are easy for people to participate in. My goal is to entice you to get involved in one. (Or two!) Taking a simple online survey doesn't take much of your time, it doesn't cost a dime, and it has the potential to help a great many people.

Of course, you can also donate money to a respectable organization that is putting its dollars directly into breast cancer research — and lord knows we need that, too — but guess what all researchers need even more than moola?

Study participants! Women with breast cancer! People like you and me! Lots and lots of them!

There is power in them thar numbers. Put it to good use by checking out one of the studies below. (If you don't remember if you have participated in any of them before, no worries; just click on the Yes! Sign me up! button on each study page. If you get a "According to our records, you have already submitted an RSVP for that project. Thanks!" Well, then, thanks! 

(PS: KNOW SOMEONE WHO MAY QUALIFY FOR ONE OF THE STUDIES BELOW? PAY IT FORWARD AND FORWARD THIS POST. PLEASE!)

• Boston University's Phase 2 study of the Variations in Health Needs of BC Survivors needs 600 women within the U.S.A. to take part in a telephone survey. The research team will assess the health and well-being of women who have any of the following: recurrent breast cancer, metastatic breast cancer, a recent diagnosis of breast cancer, an additional invasive cancer diagnosis, or you are currently undergoing treatment. The information gathered from this study will be used to develop programs and services for women with breast cancer.
• UCLA's Latina Breast Cancer Initiative is looking for 150 Latina/Hispanic women in the U.S.A. who have been diagnosed with breast cancer for the first time — at any stage — within the past 12 months. This telephone survey is in English or Spanish (your choice) and will look at the psychological impact of breast cancer.
• Washington University School of Medicine's The Breast Cancer Risk in Young Women Study (which I first blogged about here) is looking for a total of 5,000 women across the U.S.A. and CANADA who were diagnosed with invasive breast cancer — at any stage — at age 40 or younger. It doesn't matter how old you are now. It also doesn't matter what stage of treatment you are currently in. All you need to do is submit a blood sample, which can be drawn at your next doctor's appointment. You will be sent a kit that includes shipping materials and all of the documentation your doctor requires to draw and ship your blood to the research staff. There will be no cost to you and you don't have to handle anything icky.
• The University of Louisville Brown Cancer Center's The Breast Cancer, Uterine Cancer, and YOU Study (which I first blogged about here) is an online survey for U.S.A. participants that looks at whether a woman who has been diagnosed with breast cancer at any age or stage (including LCIS and DCIS) is at higher risk for developing uterine cancer.

ENGAGING INTUITION

"You have to leave the city of your comfort

and go into the wilderness of your intuition."

—Alan Alda

(photo ©2012 TheBigCandMe)

HIGH-PROTEIN FOODS FOR HEALING

Since protein promotes proper healing, it's important to eat enough of it — that means 100 grams a day if you are actively healing. That may seem like a lot, so to help you do that, I've compiled a list of my favorite high-protein foods along with the number of grams of protein each serving contains. (I buy organic whenever possible.)

NOTE: I did not include protein shakes in my list because most of them contain soy protein, and consuming soy can be really tricky when you have cancer. I cut out all processed soy from my diet due to my hormone-positive breast cancer, but soy beans in their natural state (i.e., edamame in the shell) are safe to eat on occasion (per my oncologist) and are a good source of protein. 

For more on the soy-in-your-food debate, see breastcancer.org's article here. For my go-to list of healing protein, see below.

RENN'S TOP 10 HIGH PROTEIN FOODS

• 4 oz. chicken breast: 25 grams protein

• 8 oz. plain nonfat Greek yogurt: 23 grams protein

• 3 oz. solid white albacore tuna (packed in water): 20 grams

• 4 oz. lowfat cottage cheese: 15 grams protein

• 2 oz. raw almonds: 12 grams protein

• 4 oz. edamame* (soy beans): 11 grams protein

• 2 tablespoons crunchy peanut butter: 8 grams protein

• 1 stick light string cheese: 8 grams protein

• 4 oz. cooked black beans: 7 grams protein

• 1 large hardboiled egg: 6 grams protein

DELAYED HEALING

Alas, I do not have much room in my brain to fully ponder the notion of not going to the Cancer Center for 180 days. Why? Because my beautiful new incision (read about that here) is not healing again. (Warning: There will be pictures involved.)

Trouble starts up again: The telltale yellow spots.

Three small yellow/green spots (not infection, but excess collagen which is interfering with my body's ability to close my skin) develop along my right incision line. I continue to keep it sterile and covered with antibiotic ointment and Xeroform and plenty of gauze (which I have to change every few hours, because the fluid my body is producing is leaking through the spots in my incision. Kind of like having a bad period, but continuously).

I keep Dr. C.’s office informed, and I monitor my progress (or lack thereof) by photographing my incision line each morning. I also rest more by taking a long nap every afternoon.

Can I just say how hard it is to try and lose weight when I have to eat more food rather than less? Dr. C. told me that healing "is not the time to restrict calories." And getting in 100 grams of protein a day — protein promotes healing — means eating every three hours. (See my Top 10 List.) I can’t lift anything using my right arm because the incision is still healing. No pulling, no pushing, no carrying with that arm. No upper body exercise aside from gentle stretching. Walking is fine, as is the elliptical (but no arms).

I still feel semi-exhausted most days. Though I realize I've been under anesthesia twice in the past month (4 ½ hours total), in my mind I feel like I should have more energy. The old me is having a hard time accepting the new me.

Three spots converging to become one.

And I continue to document my progress with my digital camera. I highly suggest this practice.

After several weeks, I notice my revised incision is not healing properly. The yellowish green spots have merged, colliding to become one larger spot. Dr. C. doesn't like the look of it. He wants to "debride" (i.e., clean up) the unhealed area and re-suture my incision line. Again.

I'm pleased he’s taking the precautionary road and we are dealing with this surgically (my other choice: continue to take a "wait and see" approach while continuing to use a special “debriding” ointment, but that doesn't seem to be helping), but I’m not happy about having a 3rd surgery.

Quarter-sized spot

The spot grows to become the size of a quarter (see photo at right). So five and a half weeks after my last incision revision (and 8 weeks after my bilateral mastectomy), I am wheeled for a 3rd time back into the operating room. The staff is familiar to me now. They recognize me. “Oh, I remember you!” (Nothing like being famous in the OR.)

Dr. C. debrides the area and re-sutures the skin. (And yes I'm loosing a little skin each time he does this.) He removes another 50 cc's of saline from the right tissue expander, reducing the pressure further in an attempt to get it to heal.

My right tissue expander is now less than half the size of the left. Yes I am very lopsided and that makes it difficult to disguise in clothes. (As if having coconut shells on my chest weren't enough, mine seep and are different sizes! Oh the joy!) I buy a heavily padded bra that I wear to give the illusion of a normal shape. (Just don’t hug me.) But most days I live in my surgical compression vest — which I still must wear 24/7.

Newly debrided, re-sutured incision

My new incision, however, looks beautiful (see image at right)! I am told to focus on getting back to life: keeping up my protein intake, walking, trying not to do too much around the house (I have to force myself to limit movement of my right arm so I don't put undue pressure on the new stitches). My energy is coming back despite having 5+ hours of anesthesia in two months. I’m back to hiking twice a week.

But as all things in the world of cancer, nothing ever goes as planned. Several weeks pass and again, the tell-tale spots. (What a sinking feeling that is.) The spots are small, and do not advance as quickly as in the past, which is good (and I make note of), but still, it's hard to ignore the fact that this incision does not want to heal. (My other side? Completely fine, still.)

With spots come seepage. It's almost like my incision is weeping along with me. The seepage seems to be tied directly to how active I am. If I work at the computer and then take a nap, it doesn’t leak; if I take a hike, make a salad or drive to the grocery store, it does leak. How much of a prison can I live in? I vacillate between doing nothing for days on end, and trying to be normal (save from using my right arm). And still I leak. Labs show no sign of infection, BTW.

I am a patient woman, more patient than most, but WTF? Seriously, I am so over this. There have to be other women out there who are struggling with these healing issues too. Sure enough, I head online and start a thread within the BC group for tissue expander problems (aka “delayed healing”). Once I connect with others in my situation, I feel far less alone, knowing these ladies "get" the frustration I am wallowing in. Some had infections that prevented their healing; some had allergic reactions; some experienced rejection of the expander (their body viewed it as a foreign object); some had an expander that sprung a leak (it happens!); others had thin skin due to radiation or surgery — the latter of which we believe is the cause for my troubles. My surgeon scrapped as much tissue out of my affected breast as possible during my mastectomy (I told him I didn’t want any tissue left for bad cells to move into so get it out, please — and he did). But now there doesn't seem to be enough circulation in the thin skin that surrounds my incision.

Dime-sized hole in my incision.

Despite the exercise, the protein, the non-use of my arm, the naps and my (generally) sunny disposition, my incision doesn't heal. The main spot widens to the size of a dime. (Better than a quarter! See photo at left.)

Office stitches

I know I can heal this if Dr. C. reinforces the center of the spot — so he gives me a four blue stitches (in his office this time, no anesthesia, and yes I was scared).

I have been wearing my surgical compression vest and changing my gauze dressing for 5 long months. I can do it a little longer.

Husband and I decide to take a short trip to Las Vegas to celebrate our anniversary and take my mind off my healing. It works; I am able to completely forget I have cancer (seriously!) and I feel like the old me. It was fabulous.

Except when it wasn't. We were walking a lot, so, natch, the seepage increased. (We went to a show one night, and I was seeping so much I had to stuff a washcloth in my big bra to safeguard against leakage.)

The "What happens in Vegas, stays in Vegas" addage apparently doesn't hold true for me. I make an appointment with Dr. C. to discuss said seepage. He removes my pretty plastic stitches and says the incision looks great, but is concerned that the incision is not sealed. He explains that because my skin is so thin, any buildup of fluid will exit at my weakest point.

We are bandaging the wound differently for the next few weeks to see if it heals any differently.

Then we start talking about Las Vegas. (Funny, I don't remember telling him I was going.) I say it was great to get away. He asks how we liked the Wynn. What? How does he know we stayed at the Wynn? I look at him, perplexed. He keeps going. “You were on the 60th floor, right?” Whoa. What? "How do you know that?" I ask. He laughs and says he saw my husband and me get on the elevator just as he and his wife were getting off. He called out to us but then the elevator doors closed.
He figured I didn’t recognize him in his pool shorts. (He would be correct; I usually see him in a suit.) I added that had I seen him, though, I would have told him I had a washcloth stuffed in my bra! We had a good laugh.

When I tell Husband the story, he laughs too, then has a vague recollection of a guy in a straw hat, waving at us from an elevator. Small world, isn't it?

CALLING ALL U.S. BC PEEPS!

Here's a quick survey for any woman in the U.S. who has ever been diagnosed with breast cancer. This survey looks at the risk between breast and uterine cancers.

Props to Dr. Susan Love's Army of Women for the heads up about this study from the University of Louisville Brown Cancer Center. And if you aren't already an AOW member, register here; it's free, and there are lots of studies to peruse that you may be eligible for.

Your participation really can make a difference in the development of future treatments for women with breast and other cancers.

(Courtesy Army of Women)

DO I NEED CHEMO?

In my quest for catharsis, I'm finally picking up where I left off (on the heels of my delayed healing issues). Here's what happened next on my breast cancer journey:

I'm sitting in the lobby of the cancer center, waiting to see Dr. D., my oncologist. I will soon learn four crucial pieces of information:

1) My BRCA test results
2) My Stage
3) My Oncotype Dx score
4) Whether or not I need chemo

Husband is with me. In a moment of tenderness, he asks if I am OK. "I can handle anything Dr. D. has to tell me." Husband is as surprised to hear me say this as I am! In the months since my diagnosis, I have researched, read, lived and breathed breast cancer. I’ve been in touch online with countless women with a similar diagnosis. And it's because of these women that I am able to sit in this waiting room and feel a solid wall of strength supporting me. These ladies have my back. I'm really not afraid. Which is a pretty darn good way to walk into an oncology appointment.

Dr. D. is a man of few words. He looks me straight in the eye and answers every one of my questions.

1) I am BRCA1 and BRCA2 negative. That means I do not carry the gene mutation responsible for some breast and ovarian cancers. Whew!

2) I am Stage 1B. Because my tumor was 3.2 centimeters, it pushed me from Stage 1A (where the size limit is 2 cm) to Stage 1B. Still, it's great news; I am over the moon! Waiting for that number affected me on such a deep level that I don't even think I was fully aware of it. I just know that in that moment, I feel relief for the first time since I was told I had clear lymph nodes.

3) My Oncotype score is 16. That means I have a 10% risk of distant recurrence — and puts me at the high end of the low-risk group. There are 3 risk groups: low, middle, and high. If my number fell anywhere in the high-risk group, I would be given chemo; if it fell anywhere in the middle group, chemo would definitely be weighed as an option; but because my number fell in the low-risk group (albeit the high end of the low-risk group), studies have shown that chemo may do more harm than good.

4) I don't need chemo. Given my age (52), low tumor grade (1), low cancer stage (1B), perimenopausal status, and bilateral mastectomy, Dr. D. says that statistically there is no benefit to giving me chemo.  WOW.

I had an intuitive feeling about this; I have felt all along that chemo would do my body irreparable harm. Hearing Dr. D. tell me I don’t need chemo is a huge, huge relief. (Not to mention that it validates my intuition.) Husband is visibly relieved.

5) I don't need radiation. Even though I had a double mastectomy, I might still have needed rads had my tumor been closer to the surface of my skin; but it thankfully was not. (Another major plus.)

This is all good news. So why don't I feel better?

Dr. D. hands me a prescription for Tamoxifen, a hormone blocker I'll be taking for five years before switching to a post-menopausal hormone blocker for another five. Then he adds, "See you in six months."

Say WHAT? Don’t I need to be monitored more often than every six months? How will I know if the Tamoxifen is working? Am I supposed to be checking myself? How do I do that? I don't understand! Wasn't I just diagnosed? I need more hand-holding. I'm not ready to let go just yet.

I leave Dr. D.’s office feeling completely untethered. And not in a good way.

It takes me a good long while to process and allow myself to fully feel the power of Dr. D.'s words. I have been suppressing so many fearful and negative emotions since my journey began that when I hear good news, my reaction is still one of denial. Crazy, isn't it?

THE WAY THE WORLD IS MADE

(© Copyright Rennasus 2012)

"All life is interrelated. We are caught in an inescapable network of mutuality; tied in a single garment of destiny. Whatever affects one directly, affects all indirectly. Strangely enough, I can never be what I ought to be until you are what you ought to be. You can never be what you ought to be until I am what I ought to be. This is the way the world is made."

—Martin Luther King, Jr.

LINDA IN LAS VEGAS

(Courtesy Youtube/Linda in Las Vegas)

If you haven't yet seen this video, check out the awesome and uber-courageous "Linda in Las Vegas" as she tells the world exactly what breast cancer is — and what it is not.

The Youtube video is just 4 minutes and 25 seconds long; I urge you to see it through to the end. Linda is a former Komen supporter who reveals not just her thoughts about having BC, but her scars. And her inner strength too. (In spades.)

Bravo, Linda!

(PS Thanks to Marilee for discovering this!)

SPOKE TOO SOON

Another heroine has fallen... Susan Neiber (aka WhyMommy) of Toddler Planet fame passed away today from a rare and aggressive form of inflammatory breast cancer. She leaves behind a family that includes two small children. She was a scientist for NASA.

I discovered Susan's blog just a couple of weeks ago... January 22, 2012, to be exact; it turned out to be her last post; for me, it was her first. I was only just beginning to "know" her. An article about her blog ran in The Washington Post online on January 24, 2012. And today she is gone.

Rest in peace, Susan.

FALLEN HEROES

When I started blogging about breast cancer 10 months ago, the world wide web opened up and extended her loving arms around me. I came in contact with (and was embraced by) a great many people fighting this disease — all writing about it with humor, with bravado, with insight. I knew, statistically speaking, that some of these lovely bloggers that I "follow" would one day stop blogging.

Not because they had writers block (though that certainly happens); and not because there was a dearth of things to blog about (the Komen controversy alone could fuel us the rest of our days). Nope. I knew they would stop blogging because they would pass away.

This morning, I read that Rachel from The Cancer Culture Chronicles died at the age of 41 from metastatic breast cancer. She had a tenacious wit and a marvelous sense of humor. She wrote a guest blog for Breast Cancer Action in December; her last blog post was just a couple of short weeks ago.

And now she's gone. You can read the amazing story of her life here.

I created a "We'll Never Forget" section on my blog. It wasn't my idea. I'd seen it done by other bloggers. I just never wanted to have to do it. But I have one now. It's a place our fallen angels can now rest in the blogosphere.

Rachel was not the first to fall silent.

Cheryl, of Indigo Dreaming blogging fame, passed away in mid-January. Cheryl lived in Australia and battled secondary breast cancer and was also a very brave and upbeat gal; you can read about her story here and also here. (Thanks, Alli and Julie.)

But the first to die, for me, was Lynn — age 50, who passed from metastatic breast cancer on December 29, 2011. Lynn's husband was the blogger in the family, and he wrote (and continues to write) with great heart and compassion about his experience as caregiver of a BC patient. He is now a husband without a wife; a father of two children who are now without a mother. You can find Lynn's story (and that of her husband and family) here.

I wish my list didn't exist. A virtual graveyard is not what I had in mind when I stepped into the design section of Blogger. But it is a brutal reality of breast cancer.

So what can we do about it? Stay educated about cancer. Live a clean life. Donate time (or funds) to organizations that you have vetted and are confident will make the most of your donation.

And keep laughing. Find the humor in life. That's something Lynn and Rachel did in spades.

Rest in peace, pretty ladies.

PULLING THE PLUG ON PINK

The general public has finally kicked Komen off their pink pedestal.

Last week, I blogged about the brouhaha brewing in the breast cancer community over the commercialization of Komen. I also mentioned the Canadian documentary about Komen called Pink Ribbons, Inc., that is making its debut today — the same day the pink dust has settled following Komen's Planned Parenthood firestorm. (It also happens to be the one-year anniversary of my bilateral mastectomy, or my "surgiversary," as I like to call it — but I digress.)

That's what I call a tipping point. Because for the first time, everyone everywhere can glimpse a Komen that can no longer hide behind its frilly pink curtains.

As you know, Komen partners with a gazillion companies, lending their name to a ton of products, all sold under the pink umbrella. As a consumer, I buy a yogurt (not organic, BTW) with a pink ribbon on it, thinking I'm doing good — only to later learn I must mail the lid back to the yogurt company before they make a contribution to Komen. The yogurt company makes money off of me, and then donates a few cents of said made money to Komen, getting a tax break in return. Sweet deal all around. The kicker, though: Many companies place a ceiling on how much moola they donate, so even though you buy a "pink" product, no money may go to Komen at all if said company has met its donation quota. That is a bummer.

But don't feel too bad for Komen. They earn mega money regardless, though just $650,000 was earmarked for screening exams for low-income women over at Planned Parenthood. And for that there is an uproar... and political pressure... which caused Komen to cave but then they rescind and say they'll continue to fund some PP breast screening programs (for fear of losing liberal dollars). At least for now. Even though breast cancer is an equal-opportunity employer.

Oy, I have a headache.

I don't know about you, but I think the time has come for the charity that is raking in the biggest bucks (ahem, Komen) to use that fat leather wallet not just for good, but to make good. Finding breast cancer is the first step, but it's not the only step. It's what comes after finding breast cancer that is most troubling. Komen, we really need your money to go all in towards research that figures out why we are getting breast cancer in the first place. Why is it so epidemic? Why is it striking younger and younger women? Why, with all this "awareness," are people still so in the dark about the disease? We also really need your money to find better treatments for those who already have BC (including our metastatic sisters, please; for more on blogger Katherine's opinion on that, see her post here).

What we don't need is more "awareness." We don't need more pink marches with people raising money that goes towards funding more pink marches. We are all too aware, Komen. The awareness baton has been passed. It's time to pull the plug on pink — and get to work.

And on that note, I leave you with an image I captured as I hiked up a new hill this afternoon to celebrate my one-year surgiversary.

I purposefully choose a different path to the top today; I hope Komen does, too. Because actions speak louder than pink.

TICKLED PINK

Out of the blogosphere comes the most exciting stuff: Caroline, one of my awesome fellow BC bloggers, recently posted about a documentary entitled Pink Ribbons Inc. The film had its debut at the Toronto Film Festival last year, and opens in Canadian theaters on February 3, 2012.

That just happens to be the one-year anniversary of my bilateral mastectomy. My how time flies. I couldn't pass up an opportunity to reflect on this coincidence.

(Courtesy National Film Board of Canada)

What's cool about this movie is that it is about the very brouhaha that erupted in October among breast cancer bloggers. I am relatively new to this whole cancer dance, so I was unaware how timely our ranting and raving really was (see my post on The Hunt for Pink October here). Turns out, Anti-Pink Ribbon Fever has been brewing for a long time... long enough ago for this savvy little film to be conceived, birthed — and premiered.

Here is the trailer. See what you think. I hope it turns the tide in a sea of pink. I also hope it makes it to a theatre near you. And me!

PS For more on the origins of the pink ribbon, Think Before You Pink has an entire page devoted to its history here.

HORMONE SURVEY

Calling all Arimidex, Aromasin, Femara and Tamoxifen takers! Dr. Susan Love's Army of Women needs YOU for a short online survey.

The requirements:
1) You are female
2) You have been diagnosed with breast cancer
3) You are currently taking (or have taken in the past 12 months) Arimidex, Aromasin, Femara or Tamoxifen
4) You live in the United States

The goal of this research study (a joint project of the University of California/Los Angeles and the Dana-Farber Cancer Institute in Boston) is to better understand your feelings, physical symptoms and behaviors as they relate to your taking endocrine therapy for breast cancer.

It is simple, takes little time (I completed it in 15 minutes), is anonymous, and a great way for your voice to be heard. Log on here for more information and to sign up to take the survey.

My thanks to fellow blogger (and Army of Women leader extraordinaire) AnneMarie over at chemo-brain.blogspot.com for the head's up about this survey!  ;-)

THE RUBIES

In the spirit of a new year (and inspired by my blogging pal Marie's thought-provoking queries), I want to open 2012 with a question. Anyone reading this post has either been diagnosed with cancer or knows someone who has. It doesn't matter if you are in the former or the latter group; our collective world is shattered and splintered by The Big C.

But among the fallout and the rubble of cancer come The Rubies — the people who keep us grounded, or safe, or sane, or distracted, or engaged during all the rolling ruckus.

The Rubies are there at the right time, in the right place, and we have the foresight to recognize them as the rare gems they truly are.

As a person dodging the minefield of cancer, I am fortunate to have many Rubies. And without the internet I would never have "met" the majority of them. I count among my Rubies the courageous cancer bloggers who are telling their tale with honesty and humor and bravado. They paint a deeper, fuller, more complex and truthful picture of cancer in all its crazy colors — and we all can benefit from their wisdom. I feel stronger and less alone in my struggles because of them. And so I say thank you to the women and men of the blogosphere.

I also am lucky to have Rubies in the form of a group of women I met online at BCO. We are seven in total, and range in age from 27 to 53. We all were diagnosed with breast cancer at the end of 2010. Five out of seven of us had bilateral mastectomies; one had a single mastectomy; one had a lumpectomy. Three had chemotherapy; five are on Tamoxifen. No one lives near the other (though some ladies did manage to meet in 2011) and I have yet to meet these fair maidens myself, but we "talk" every day. They are my lifeline, my sanity, and my strength. And so to my six Rubies, I say thank you for always being there. I couldn't do this journey without you.

But getting back to you, dear reader: Who was/is your Ruby when you were dealing with The Big C in your life?

CATHARSIS

I started this blog back in April as a cathartic way for me to deal with The Big C. I wasn't writing for anyone in particular; I wasn't writing to keep friends or family updated. (Few people even knew I had started a blog.) My goal all along was to simply tell my tale in all it's gory glory, and eventually sync up my story to my life in "real time" by year's end.

Well, that hasn't happened. In part because I am distracted; in part because I am tired. But mostly because I am a very slow writer.

Me on my favorite hiking trail. (Copyright © 2011 The Big C and Me)

I debated whether to fast-forward to what is happening right now. Or write the Reader's Digest version of "The Big C and Me." But that would involve skimming over certain road blocks and challenges, which wouldn't be fair (or truthful) to you — or to me.

So my goal for 2012 is to continue to unravel the details of my cancer experience as it happened (vs. as it is happening). And on that you have my word. Albeit a very slow one.

Happy New Year!

HAPPY CANCERVERSARY!

I have really been dreading this day. 

All last week (the past few weeks, really), I have been marking each day by saying to myself, At this time LAST year, you still were naive to what was about to change your life. On this date a year ago, you had a mammogram but you weren't worried. On this day, you had a biopsy but you were still in the fog of denial.

Then yesterday landed. The 70th anniversary of the bombing of Pearl Harbor. Historic for two reasons: It also happens to be the anniversary of my father's death....

LAND OF CONFUSION

Anyone who has ever traveled down cancer's long and crappy road has spent time in the Land of Confusion. Lots and lots of time.

I stumbled upon a perfect visual depiction of this crazy cancer land, and thought I'd share it.

There is a sweet website called theydrawandtravel.com, where artists the world over submit map illustrations of their travels; that's how I discovered this simply awesome drawing, simply entitled "State of Confusion" by artist Deer Prudence from Berlin, Germany.

It is the ideal metaphor for cancer.

After all, who among us hasn't stepped off The Beaten Path, fallen Out of Range, not seen The Woods for the Trees, gotten lost in the Sands of Time, wadded in Fake Lake, crossed the Plain Impossible, visited Villain Village, landed Somewhere Else, swam for our lives in Sea Me, tried in vain to Sea You, felt like an Ugly Fish, nearly drown on Cape Rain, fallen down Cave In, made (or been the butt of) Shallow Jokes or pitched a tent in Underwater City?

We all have. Cancer or no cancer, we can all relate.

Deer Prudence (and They Draw and Travel), you hit a home run with this one! Though you may have intended it to be a guide on how to get lost, you have in fact put into images what so many of us that deal with cancer feel. You are a Source of Inspiration, for sure. Your illustration is plain, pure, unbridled perfection!

(Copyright ©2011 TheyDrawAndTravel.com)

HOUSTON, WE HAVE A PROBLEM

I'm at a follow-up with my plastic surgeon, Dr. C. Unfortunately, he's not 100 percent happy (his words) with the way my right incision is healing. He used the term "delayed healing." It's worse on the right (cancer side) than the left. My skin is red on that side and looks bruised. I have surgical tape on both incisions, but beneath the tape a dark area is visible. Dr. C. cautions me to pay close attention to this area, because if it gets any darker, that means my skin is dying.

Necrosis? Oh, joy.

I'm to use Xeroform as a wound dressing. But first I apply Bactroban (an Rx antibiotic ointment), which I then top with a strip of Xeroform, which I then top with gauze which I then tape to my skin. I’m to continue to wear my compression vest 24/7. (Confession: It’s become a rather comforting contraption.) And if my incision doesn't decide to heal, Dr. C. will decide whether to surgically reduce the pressure in the tissue expander by removing some saline. Super duper!

And as if all that weren’t enough, Dr. C. is leaving the country in four days — for three weeks. Yikes.

I get home from the doctor, pull out my digital camera and start shooting close-up images of my incisions. I do this each morning. Husband finds it odd. I tell him it’s the only way we can be objective; from day to day things look fine, but if you compare Day 1 to Day 3, well, you can see a difference. (Note to all surgery patients: Photograph your healing journey.)

A few days go by. After my shower one morning, I inspect the wound. I don’t like the look of it. More redness, more darkness at the incision line (under the surgical tape). I take more pictures.

My dear friend M. comes over for lunch. But I'm in a bad mood — definitely not like me when I am spending time with friends — and I can’t seem to shake it. M. asks why I’m feeling unsettled, then encourages me to call my doctor. It’s 1 PM on a Friday afternoon. What are the chances I’m going to reach anyone? But lo and behold, Dr. C.’s nurse answers the phone, and I lay my worry out there like a blanket on a fire. But she is not alarmed. The redness I'm experiencing sounds normal, she says. She’ll mention to Dr. C. — who happens to still be in the office. Psyche.

I hang up and feel good that I’ve taken action. Yet something is still nagging at me. Finally, a light bulb goes off: Email Dr. C. a few photos so he can see exactly what I’m talking about! (This also saves me a trip to his office, not that I could get in on a Friday. Just sayin'.) I call the nurse back and tell her to check the JPegs I just emailed. If I don’t hear back from her today, she says, that means Dr. C. thinks things look fine and I should keep up with the Xeroform program until he returns from overseas.

OK! Now I can finally relax. I enjoy the rest of my lunch with M. and she leaves in the late afternoon.  No call from Dr. C.  I take a nice, long nap, then rummage through the refrigerator for something to eat.

While I am downstairs, my cell phone rings upstairs. I don't hear it. By the time I realize I have a message, it's 7:30 PM.

Guess who. Yup.

Dr. C. apologizes for messing up my weekend, but he wants me to meet him at the hospital tomorrow morning — yes, Saturday morning — at 5 AM. He has secured a surgical room for what he is calling a “minor intervention surgery.”

I don’t have time to think, to worry, to even wrap my head around the fact that I am about to have another surgery just 16 days after my bilateral mastectomy. (Cancer: The gift that keeps on giving.)

Husband and I go to bed early, get up at 3:45 AM and drive to the hospital in the dark. I’m prepped and wheeled into surgery by 7:30 AM. Luckily my anesthesiologist hand-tailors an Rx cocktail (along with a patch behind my ear) so that when I came to, I am alert and not dizzy or nauseous, and am able to go home 90 minutes later. (So not like last time.) I am also not in any pain.

Turns out too much pressure on my tissue expander was causing my skin not to heal. I have necrosis on the top of my incision, but there is also a spot that is necrotic under the skin as well — and that is the dangerous part. If we don't fix it now, I run the risk of losing the expander and starting over again. So Dr. C. removes 50 cc's from my right expander (originally filled to 400 cc's), debrides my wound and re-sutures my skin.

I feel like I dodged a big, necrotic bullet, and am proud of myself for staying on top of this, for diligently taking photos of myself, for coming up with the idea to email them to the nurse, and for trusting my gut throughout. This surgery wouldn’t have happened otherwise. (Listen to your instincts, my friends, even if it means calling your physician on a Friday afternoon and having surgery on a Saturday.)

The following day, just 30 hours post-surgery, I show up at a party to meet our neighbor’s first grandson. People are surprised, even shocked, to see me; they tell me how great I look, that they can't believe I just had another surgery. Me either. Even though I am light-headed and have very low energy, it still feels good to get out among the living. I even forget about my pressurized chest for a couple of hours.

The next few days are hazy. I feel woozy, but we manage to take in a matinee. (Again, a sense of normalcy I desperately need.) And yes I'm still watching these incisions like a hawk. Snapping pictures every day, oh yeah. And applying my ever-trusty Bactroban and Xeroform.

But my smile belies how I'm really feeling: blah, depressed, unfocused. What does going through all this cancer %$#@ and subsequent complications mean? What's the point? I feel like there is something I am yet to do, something bigger, but I don’t know what it is.

Three weeks post mastectomy, one week post second surgery, and I wish I could say I have some energy back, but nowhere close. I have discomfort and pressure on my chest 24/7, feel like there's fog in my head, have a headache that comes and goes. Internally, I think I'm still 30 years old, so am expecting my body to bounce right back. Then I remember I'm really 52. So I need to cut myself some slack. I need to become more patient — a virtue with which I will become very well acquainted in the coming months.