WANDA, CHRISTINA AND ME

One of the many benefits (OK, I threw in the word 'many' for affect) of having breast cancer is that I am thrust into a world I would never have been interested in before... the wonderful world of breast cancer bloggers. These women (and a few men) are fighting the good fight and writing about it every step of the way. They may not all be professional writers — but they could be. They are witty and wise wordsmiths; their blogs, a pleasure to read. The discourse that arises on the screen is often cutting edge, and unlike anything you are going to read anywhere else.

To wit: This morning I read a fabulous post by blogger Katherine over at ihatebreastcancer discussing the announcement by the amazing Wanda Sykes on Monday that she was diagnosed with DCIS (ductal carcinoma in situ). Wanda is one of the funniest comics out there, and this news is devastating.

Wanda talked about her breast cancer publicly for the first time on "The Ellen DeGeneres Show" and shared how her cancer was discovered — while undergoing breast reduction surgery, of all things. Though her cancer was caught early (Stage 0), she opted for bilateral mastectomy due to her family history; as Wanda explained, "Cancer is cancer." This is true. But then she went on to say the words that have the breast cancer blogosphere buzzing: "Because now I have zero chance of having breast cancer." And Ellen agreed. But that would not be true. (The zero chance part, that is.)

(Courtesy Warner Bros.)

I'm joining blogger Katherine in being "Cliff Clavin"-esque here because Wanda and Ellen's comments eerily remind me of Andrea Mitchell's comments earlier in September when Andrea was also diagnosed. Andrea stated, "This disease [breast cancer] can be completely curable if you find it at the right time."

Here's the real deal: Whether they have a lumpectomy — a la Andrea Mitchell and Sheryl Crow — or bilateral mastectomy like Wanda Sykes, Christina Applegate and me (gotta throw myself in here, since this is the only time I'll be able to mention my name along with theirs and have it make sense!), when people in the media say they are "cured," they do us all a grave (pardon the pun) disservice because it simply isn't factual. It just isn't true. And it gives people false hope — not just the patients that breast cancer afflicts, but the friends and family of BC'ers too. Catch breast cancer in its early stages and your chances of staying cancer-free are certainly high — but they are never 100%. Ever.

What Wanda, Christina and I (and so many of my BC buddies) bravely did by getting bilateral mastectomies (though our cancers were found in just one breast) is still considered controversial. But that is not the point of this post.

Instead, I want to address the issue of why public figures feel the need to downplay a cancer diagnosis.

I'm pretty sure I know why they do it: Because they are afraid they won't be hired again unless they say they are "cured."

Would it be better if Wanda had said, "Yes, I found my breast cancer early and yes, I had both my breasts removed and yes, my cancer can still come back at any time and kill me"? Abso-f-ing-lutely.

But I also understand why she didn't say that. Part of it is the natural desire we all have to believe we are cured. I get that. But the other part is just as important: She has to worry about her (and her family's) financial future. Just as we all do. Just as we all don't walk straight into our bosses offices and announce that yes, we have breast cancer and yes, we might die. Because if we did, we probably wouldn't be getting that next promotion. That next opportunity. That next big gig. And so we downplay. To ease others' fears — and to ease our own.

It's a gnarly little line that people in the public eye must walk in order to save face. And we already know which side they are gonna take. The side they must: They have to save themselves first. After all (and this isn't the first time I have said this and it certainly won't be the last): They are only human. And trying to keep everything as normal as possible for as long as possible. (Can anyone relate?)

So I'm gonna cut Wanda a wide swath of slack. But I'm also gonna make sure I talk about all this. It is up to us (the "foot soldiers," as the Army of Women calls us) to get the word out and not be under any illusions that bilateral mastectomy is "the cure." Not trying to be a Debbie Downer here; just Renn the Realist.

Maybe at some point down the line, a high-profile personality will pick up a bullhorn when they are first diagnosed with cancer and tell it like it really is. But until that day happens, I'm not gonna hold my breath. I'm just gonna blog about it.

HEALING AND DEALING

There is a phenomenon that happens post-surgery, when you’re back at home and cozy in your jammies, trying to heal and deal with your new self-image (whatever that may be, depending upon how severe your surgery). In the case of mastectomy, it presents itself as a layer of hiding. Make that multi-layers of hiding. And this hiding has little to do with whether or not you have started the reconstruction process.

The first layer of hiding is from myself — and any mirrors that may reflect back to me an image I’m not yet ready to behold. I steer clear of all reflective surfaces for the time being.

Next there is hiding from my husband, lest he find me newly unattractive. I feel the need to spare him — and myself — from this moment for as long as possible. This second layer of hiding is easily handled, on the surface, at least, by donning a bathrobe selected for just such a non-veiling (vs. unveiling) occasion. In my case, that would be putting on the pale green robe my husband purchased (unbeknownst to me) while we were vacationing in the Oregon wine country last fall. A trip that will forever be sandwiched between “The Mammogram” and “The 'Come Back' Letter." Imagine my surprise when I found said robe beneath the tree on Christmas morning! That was divine. But it will always be remembered as the Christmas that came after “The Biopsy,” after “The Call,” before "The Surgery."

But wait, there's more: Post-cancer surgery offers up a third layer of hiding, wrapped in the form of friends and/or family — yup, the very people who are your lifeline, your safety net, your thread back to the jacket of normalcy you wore before cancer unraveled everything. They phone or text or email or drop by in an ebb and flow of checking in, checking up, and checking out. It’s all good — except when it’s not.

• The “checking in” part is great! I can handle that easy enough by text or email.

• The “checking up” chats I leave to my husband. Those require more verbal acuity than I have the energy to muster at the moment.

• It’s the “checking outs” that are the most difficult to decipher —and to deal with. I’m not talking about the “eyeball” type of checking out you might expect when people first glance at a newly deflated chest. (That is another post for another time.) I’m talking about complete checkouts of the unexpected and puzzling variety. As in: The calls that never come. The cards that are never mailed. The flowers that don't get delivered.

Don't get me wrong; I am grateful — very grateful — for the kindness shown to (and showered upon) me during these dark and dismal days. But allow me a moment if you will. Complete Checkouts are the people who can’t deal with your cancer — or your vulnerability. They don’t know what to say. They don't know what to do. And so they do nothing — mistakenly thinking that no contact is good contact — or at least better than awkward contact. 

But they would be wrong. Because reaching out in whatever way is comfortable for you means so much to me! Aside from making me (and every person I know who has gone through the BC experience — and it happens to the majority of us) feel ignored and unloved during one of the most challenging times of my life (and let's not even draw the correlation between cancer and death, another subject that renders people silent), here's the really troubling part: Complete Checkouts turn out to be the people you least expect. And they are stealth.

And that, folks, is the dirty little secret of a cancer diagnosis.

Complete Checkouts can make a girl feel like doing a little checking out of her own. (Not in a “I want to die” kind of way, just in a “go away” kind of way.) So that's what I do. Within the plush folds of my velvety robe, I find my safe harbor and my escape. It’s my own Amazing Technicolor Dreamcoat. I slip it on and slip back into the land of yesterday, when my boobs weren’t called foobs and I didn't look like a cross between Barbie and the game Operation.

Still healing and dealing and hiding over here. This could take a while.

ARMY OF WOMEN

Thanks to Dr. Susan Love's Research Foundation and the amazing Army of Women, there are oodles of ongoing opportunities to participate in cutting-edge research. I'm highlighting a few noninvasive studies for you to consider participating in if you meet eligibility requirements. There is even one listed here for ladies who don't have cancer. Click the links below for more details. (These studies are time-sensitive, so if interested, get in touch right away. If they're not right for you but for someone you know: share, share, share!) 

DCIS AND BRCA STUDY If you've been diagnosed with DCIS, have a known BRCA mutation, and are over age 20, this research study may be for you. The best part: They are recruiting women from all over the world. 

ENERGY STUDY The "Exercise and Nutrition to Enhance Recovery and Good Health for You" (ENERGY) study will analyze the effects of diet and exercise on overweight breast cancer survivors. Women must live near the following locations: San Diego, CA; St. Louis, MO; Birmingham, AL; and Denver, CO. 
HOT FLASH STUDY The "Interventions for Relief of Menopausal Symptoms: A 3-by-2 Factorial Design Examining Yoga, Exercise, and Omega-3 Supplementation" study needs women near Seattle, WA — cancer NOT required! — who are between the ages of 40 and 62, peri- or postmenopausal, suffer from hot flashes and not on Tamoxifen or other hormone treatment.

JEWELS IN OUR GENES STUDY aims to understand if there are undiscovered genes unique to African Americans that may predict early breast cancer risk. The "Jewels in Our Genes" study is looking for black women over age 18 who have been diagnosed with breast cancer and reside anywhere in the USA. 

MEDITATION STUDY If you live near Los Angeles, CA, and were diagnosed with breast cancer after 2001 but before age 50, you may be eligible to participate in a "Mindfulness Meditation-Based Intervention for Younger Breast Cancer Survivors" study.

YOGA STUDY The "Yoga for Breast Cancer Survivors: Effects on Fatigue, Immune Function, and Mood" study needs ladies who live near Columbus, OH, for a research project studying the effects of yoga on (you guessed it) fatigue, immune function and mood.
YOUNG BREAST CANCER STUDY The purpose of the "Breast Cancer Risk in Young Women" study is to learn what role genetic factors may play in the development of breast cancer in younger women. Currently recruiting 5,000 females diagnosed with invasive breast cancer at age 40 or younger who live anywhere in Canada or the United States.

(© Army of Women )

DOUBLE DIPPING

Coming home from a bilateral mastectomy is an event — not of the red-carpet, Oscar-worthy variety, but an event none-the-less. I was happy just to smell fresh air, see the sun, sit in traffic. I was going home.

And that's when the party got into full swing. No guests yet (just our two furry barking machines). And yup, a few pretty floral arrangements. But what I was most stoked about were all the accoutrements on my bedside table (see Step No. 5 for post-surgery boudoir table tips). Snacking in bed? Never do it, but bring it on! Watching TV while the sun is still out and I’m still under the covers? (Yeah, baby!) Pain medication? (Par-tay!) Remote control all to myself? YES! Husband feeding me because I can’t use my arms or bear any weight? (OK, that one didn’t actually happen.) But it was a comical side show just getting me in the bed (forget about getting me out of it to use the bathroom). I’m tired just thinking about it.

Lucky girl that I am, Husband has taken two weeks off from work to take care of me. He’s even placed a bell on the nightstand should I need anything. I rang it once. He didn't hear it. Well. It's. The. Thought. Right?

What I remember most about those first few days home were all the odd sensations. I felt supremely uncomfortable. Frustrated. Sweaty. And smelly. And I can’t take a shower until my drains come out. Have I mentioned my lovely drains? Allow me to paint the picture again ('cause they're just so dang much fun). I’ve got four thick-like-a-straw tubes hanging off me, and they each connect to a bulb into which fluid drains. I preemptively bought a Marsupial pouch belt (see Step No. 7), which was an awesome solution: I tuck two bulbs into one soft terrycloth pocket, two bulbs into the other, and my pain pack in the pouch in the middle. (Bought four pouches but only use three on the belt). Oh what a sight. (See purty picture above.)

Husband has been tasked with emptying said drains and measuring their fluid outtake. Actually, he volunteered. (I think.) He’s normally a little squeamish but is handling the drains with surprising aplomb. I won’t go into further detail because, quite frankly, they are icky and gross and I’d rather not relive it. You can thank me now.

Am I in pain? Yes, but mainly because of the drains. They are poking out of my sides. They hurt more than the mastectomy (my pain pouch is working its magic there). I guess the worst part of it all, so far, is the pressure I feel, which can only be described as this: Imagine having two coconut shells (sans the hairy stuff) wired to your chest wall. Then imagine being engulfed in gauze and zipped into a very [un]sexy compression vest. And then wrapped up some more in a fat ace bandage. It's freakin' weird.

(Copyright ©2011 Rennasus)

Because of (or despite) all this, and because I am a good and compliant patient, I take my meds right on the button. And since I am married to a pharmacist, that means he has the pill deal covered. He delivers my capsules and tablets bedside (though I like to imagine it more as poolside), with a glass of water, exactly at the time I need to take them.

But he neglects to tell me ahead of time that this is The Plan.

Now normally upon awakening, I do what I always do: I take a Synthroid tablet. Which is exactly what I do my first morning home. (Remember, I am unaware of The Plan.) Husband hears me stirring and comes in right away to check how I'm feeling. I don't even see him counting out pills; but he folds a few into my hand and gives me a glass of water. I notice there are some different pills in the pile (pain meds and Colace and such) than I normally take. Unfortunately, I don't notice that there also is a Synthroid tablet. In my post-anesthesia brain fog, one plus one only equals one.

So. Yup. Took a double dose of Synthroid. That is not recommended. By the time I realize I've taken mine and his, it's too late. I do have a bit of an emotional meltdown thinking I've just tried to kill myself, but Husband assures me that I will not die from taking two. (I may feel a little warm and fidgety, however. And he would be correct.)

I spend the remainder of the day in a hot flash haze, wearing washcloths dipped in ice water as scarves. And yes, I felt revved. But I also slept a lot. By evening, my double-dipping had worn off.

I stopped worrying about taking my meds after that. Decided I would leave that up to the professional. I just relaxed and became [a] patient.

HIKING MAKES ME HAPPY

(Copyright ©2011 TheBigCandMe)

"The trail has taught me much. I know now of the varied voices of the coyote — the wizard of the mesas. I know the solemn call of herons and the mocking cry of the loon. I remember a hundred lovely lakes, and recall the fragrant breath of pine and fir and cedar and poplar trees. The trail has strung upon it, as upon a thread of silk, opalescent dawns and saffron sunsets. It has given me blessed release from care and worry and the troubled thinking of our modern day. It has been a return to the primitive and the peaceful.  Whenever the pressure of our complex city life thins my blood and benumbs my brain, I seek relief in the trail; and when I hear the coyote wailing to the yellow dawn, my cares fall from me — I am happy." 
–Hamlin Garland (1860-1940), from "Hitting the Trail," McClure's Magazine, February 1899

(Copyright ©2011 TheBigCandMe)

Hiking makes me happy too. The trails are where I go to find and make my peace with "The Big C." Coyotes and saffron sunsets? You bet. Deer and dogs and bunnies too. I love 'um all.

HOW TO SURVIVE AN MRI

Before deciding on my mastectomy, I needed an MRI. I'd had a couple of them in the past: one for my left knee, after I abused it running a marathon; and one for my head, following a run-in with a log cabin while mountain biking in British Columbia. But I digress.

The point is, I remember feeling really claustrophic during both prior MRIs. With the teeming anxiety I was already experiencing with my cancer diagnosis, the last thing I needed was to feel trapped like a caged you-name-the-animal in a big 'ole clicking machine. So I tricked myself into thinking I was somewhere else.

You, too, can survive an MRI — or any other uncomfortable procedure (blood draw, chemo, dentist visit, surgery prep, whatever procedure you are afraid of) — while feeling calm and cool and even fairly collected. I've got it down to five simple steps.

1. Breath deeply while you're waiting, after changing into that cute little gown, and then while waiting some more. Don't let your mind wander into the worry zone. All will be OK.
2. Don't be overly ambitious when you walk into the MRI room. Keep your eyes and mind focused on walking towards the machine. Try not to think of anything else in that moment. Do not look around the room. Stay focused on walking towards the machine.
3. Lay down as instructed and close your eyes immediately. This is key. Get comfortable. Listen to the tech's instructions, but whatever you do, don't open your eyes. Wear an eye mask without metal in it (if they'll let you). Or tie a bandana around you as a blindfold (that way there's less pressure to keep your eyes shut).
4. Think about your favorite place that is relaxing and joyful to you. For me, it's being at the top of a hill I regularly hike to. I imagine how it feels to stand, feet firmly planted on the ground, arms stretched out to touch the wind. I notice the sun and how warm it feels dancing across my face. With the cool breeze comes the fragrance of eucalyptus. I listen for the sound of birds and hawks in the wind. What's cool is that while you are imagining the details of your favorite place, the MRI will commence. Whatever you do, no matter how many times they ask you to move or flip over, no matter how many times they reposition the machine, keep your eyes shut! Focus on your breathing; it should be slow and rhythmic as you relax into whatever pleasant experience your mind is conjuring up for you. (I used a similar technique as a pre-surgery meditation here.) 
5. Now sing a song. In your head. This helps counteract the banging and clanking of the MRI machine. Pretend you're in your favorite place and sing to the wind (or the audience, depending). Sing it over and over and over again. With your eyes closed. Before you know it, the tech will be telling you it's over — the MRI, that is. Remember: If you can't see that you are closed in, you can tell your mind you're anywhere.

(Copyright ©2011 TheBigCandMe.blogspot.com)

HEADING HOME

BREAST CANCER LESSON NO. 213: Don’t let your husband go home the first night you’re in the hospital.

Such is how my evening begins.

After enjoying the requisite post-surgical strawberry jello and juice, my husband heads home to feed the dogs and get some rest. It’s 8:00 PM when he kisses me goodbye, saying only that he’ll see me early the next morning. (We neglect to clarify what “early” means.)

My chest is bound up like a Geisha’s feet, and I have four plastic tubes the thickness of straws sticking out of me — two on either side. The tubes are a foot in length; at the end of each tube is a plastic bulb about 4 inches long x 2 inches wide into which fluid drains from my incisions. A nurse comes in periodically to empty them; they fill up fast the first day. It’s gross and smelly.

I also have a pain pack that automatically releases medication through two very thin tubes under my chest. So I have four tubes, four bulbs and one tennis ball-sized pain pouch hanging off of me. (Anyone wanna dance?)

As a fresh-from-surgery patient, I must rely on the nursing staff to help me do everything. (Thank goodness I have a catheter.) What makes this more difficult is that a nurse, in her infinite wisdom and attempt at kindness, has closed my door so I can get some sleep. There is a visitor’s lounge a few doors down from my room, and in the middle of the night, it turns into Comedy Central. Every graveyard-shift employee is stopping by — laughing, eating, chatting on cell phones… a real hootinanny. (At least  that's what my codeine-fueled brain is imagining, anyway.)

My closed door also means I am now isolated. I can’t catch anyone’s attention as they walk by. So my night goes something like this: pain, nurse button, pain meds, BP, drains drained, nap, noise, awaken, lights, thirsty, can’t reach, pillows slip, can’t correct, itchy, can’t scratch, too hot, blanket off, too cold, blanket still off; nurse button, wait, wait, wait. Repeat.

The night nurse's aide — definitely not in the running for Miss Congeniality — is very busy and not very worried about me. I must look like I'm doing well. Her English is also not great. She doesn’t understand what I mean when I say I need her to scooch me back up in the bed. (I can’t use my arms, so it is impossible to move myself; and I’ve slid so far down the bed that my feet are starting to dangle off the bottom.) She is in and out in a flurry. (Again, this is how my brain-on-pain-meds is perceiving it.) I fall asleep with the comforting thought that soon, my husband and sister will be here to help.

Morning comes, as does my breakfast — the first solid food I’ve had in more than 30 hours. I gobble it down. No idea what it was. But my sister should be here soon. I haven’t seen her since before surgery; my husband sent her (and my mom) home when I was having trouble coming out of anesthesia. She’s an early riser so I expect her to walk through the door any minute now.

Breakfast is over. My water and cell phone are nearby. It’s 7:30 AM — too early to call anyone. I watch some television and doze off. I wake up at 9:00 AM and call my husband. He just got up. He says he’ll be here in an hour. I'm bummed. I feel like I've been waiting for him for forever.

That’s when I notice the sign taped to my door: “No BP on left arm.” What? That’s wrong! It’s supposed to be no BP on RIGHT arm! (Because I had lymph nodes removed from my right arm, I can't have my blood pressure taken on the right side.) Oh... so that’s why I had to keep correcting the nurse last night every time she came in and went for my right arm....

These are the details I focus on to pass the time.

The clock says 10:00 AM. I call my sister. Turns out she was intentionally not coming to the hospital this morning to give me time with my husband. Huh? She says she thought my husband spent the night in the hospital with me. I never said that. I ask her to stop by after lunch because hubby will be here any minute. (BC Lesson No. 214: Always ask exactly when someone is coming back before they leave.)

Nearly 11:00 AM now and still no husband. You can guess what I do next. Yup. The tears flow like a swollen stream after the rain.

And of course that is precisely when he walks in. Oh, am I cranky. I can’t do anything for myself! The night nurse couldn’t understand English! There was a party next door! I was completely miserable and hardly slept all night! I couldn't reach anything myself. I couldn't scoot myself up! I couldn't move my pillows! Blah, blah, blah! I pepper him with complaints rather than compliments. But he fluffs my pillow and flips it over to the cool side for me anyway. He gets me my pain meds and some ice water. He fixes the lousy sign on my door. And I start to relax just a little.

My sister arrives. I take my first walk down the hall, notice the visitor’s lounge and put two-and-two together. (So it wasn't just my imagination on drugs!) . My surgeon also stops by to see how I’m faring and is happy with my progress.

That evening, after my husband and sister go home, an absolute angel of a nurse on the graveyard shift appears. She is sweet, she is kind, and she is compassionate. She makes sure I have everything I need and never makes me feel like I am asking too much. She stops by often. She is like a dream compared to the night nurse before her. I actually sleep.

Morning No. 2 dawns, and my BFF arrives at 6:30AM. YAY! I called her yesterday about the mix-up with my husband and sister; thankfully she is an early riser and offered to come visit. After breakfast, we take a stroll down the hall. I’m in a purple robe trailing my IV bag on a hook. We go real slow. I feel weak but I know I need to move. As we round the bend, I see Dr. C., my plastic surgeon, leaning against the counter at the nurse’s station. He’s dressed in street clothes. 

“That’s your plastic surgeon?” my BFF asks. I think she is surprised I haven't mentioned the cuteness factor. (She later tells me she would be happy to accompany me to my plastic surgery appointments; she's only half joking.)

Dr. C. walks us back to my room, says I'm doing great and that I can go home. HOME! Yippee! He wants to see me in his office in three days for a follow up, when he’ll remove my drains and pain pack, but for now he is pleased with my reconstruction so far and even offers to show me how I look before I leave the hospital.

Oh no. I’m not ready for that. I want to stay wrapped up in the safety of my bandages a little while longer, thank you very much. I want the “big reveal” to happen in the comfort of home.

WATERWORKS

My room is ready. (Wish it were overlooking a tranquil sea instead of in a hospital, but I'll take what I can get.) After 4 ½ hours of surgery and five hours in recovery, a room without a view sounds pretty darn good right about now. At least it's private.

A male nurse arrives to take me upstairs (what floor, I couldn’t tell you). Despite my post-surgery brain fog, I find it a little odd that he's the only one assisting in my transfer (besides my husband, that is). As I’m wheeled backwards into the elevator, I suddenly feel emotional. I close my eyes and let the tears roll silently down the sides of my cheeks.

Then BAM! The magnitude of the moment finally hits me. Just. Like. That. Up until surgery, I've been able to focus on a single thing at a time, placing one foot in front of the other. I had tunnel vision, and I liked it. But with surgery now complete, I'm left to face my new reality. And I have absolutely no idea what that looks or feels like.

We reach my room and I'm still quietly crying. Like a leaking faucet. Can't turn the waterworks off. (This time I don't even try.) The lone male nurse raises my gurney so it’s the same height as my hospital bed. Then he asks me to move myself over. Yup, you heard me right — he is not planning to slide me over using a sheet, he is asking me to move my fat fanny from the gurney onto the bed. Myself. After I just had major surgery. 

I can’t. How do I do that without using my arms or pulling on my chest? Why can’t someone else help? Where are the other nurses? Why is he asking my husband to spot him? Are they really that short-staffed?

I'm not sure how much of the above I actually verbalize (parts, but definitely not all). And there stands my fabulous husband, encouraging me to "just slide over," saying it’ll take a few seconds and then it will be done. I glare at him. Whose side is he on here? But I haven't the energy to fight. He's right. It will only take a few seconds, but why should I have to...? Before I can even finish my martyr-lovin' thought, I do a one-two-three shimmy off the gurney and onto the bed (with their help), crying the entire time. In part because I’m in pain, natch, but mostly because I’m a freakin' emotional mess. Yet this doesn't seem to faze the nurse, nor my husband. Huh?

I'm caught so off-guard by the wall of rage that is building inside me that I cannot hold it back. (Kinda like retching in the recovery room.) My feelings are overripe. Oh no. Lower your lids, this ain't gonna be pretty.

“Don’t you people understand what I’ve just been through?!” I scream the words, surprising even myself with my ferocity. (The male nurse spins the gurney out of the room so fast I think he left tread marks.) My husband looks startled. He’s never heard me lose my cool like this before. N-e-v-e-r. But the raging isn’t over. 

“I just had my breasts cut off!" I continue screaming (and don't care who hears me — so unlike me). "Don’t you get it? Do you know how hard this is?” My voice is horse. 

All the raw, suppressed emotion of the past two months shoots out of me like loose gunshot, hitting anything and everything in its angry path — in this case, my poor husband.

“You're a very strong woman,” he says calmly. “You’ve been so strong through all of this.” 

Lest he think I don't know it, I take the opportunity to tell him. "I am strong!" I yell back. Then, with more than a trace of vulnerability: "But I can't be strong anymore." I'm sitting in a heap of sheets. He leans in to give me a hug (not easy to do given the IV and the pillows and the bandages and my semi-reclined position). 

I wish I could say that releasing my emotions made everything better, but that would be a lie. The pain — physical, mental, emotional — has only just begun.

RETCH & RECOVER

I hear a woman’s voice. She’s calling my name. Everything else is like peach fuzz. I try to bring her into focus but I’m laying on a gurney. In a room much like the pre-operative one, with a nurse’s station directly in front of me. Have I even had surgery yet? I’m confused. Thoughts float around in my head as though lodged in thick, groggy soup. A nurse types something into a computer to the left of my bed. She asks how I’m feeling; she takes my blood pressure. I try to force my eyes open, but a familiar sensation interrupts this task. The nurse quickly grabs a pink kidney-shaped basin. Afterwards, I close my eyes. The room spins. Another tidal wave hits. The pink basin remains at my side.

It seems I’m having trouble coming out of anesthesia. I’m aware — acutely — of how tightly wrapped my chest is. I’m snapped inside an oversized, papery purple gown with white bear paw prints running across it. An ace bandage and a whole lot of gauze compresses my new chest, which is now comprised of two temporary tissue expanders beneath my pectoral muscles (since all my breast tissue on both sides has been removed). Dr. C. has filled each expander with 400ccs of saline. The purpose is two-fold: to hold the space left by my now-departed breasts while I heal completely, and to give me a semblance of a chest, so I am not flat-chested after surgery. Both help with healing — the former with my physical healing; the latter with my emotional. In a few months, after the expanders are filled a bit more with saline, I will have a second surgery to remove them and put in permanent silicone implants. 

But for now, somewhere in the cobweb-like recesses of my brain, I remember to check under my right arm to see if it hurts. (Pain means lymph nodes were removed.) Because I can't reach under there, I focus my thoughts on my armpit. But I feel nothing. Yay! Turns out I’m just numb. Dang. I string enough words together to ask the nurse Is there cancer in my nodes? Her response disappoints. “I don’t know, honey. You have to ask the doctor.”

For the next couple of hours, I slip in and out of sleep between bouts of nausea. I can’t have water yet, so my throat is achingly dry. I start to shiver, and a hose is quickly attached to my pretty purple gown. Warm air swooshes all around me, enveloping me, and for a brief moment, I feel peaceful, even cozy. But it’s a momentary respite; my tummy is unrelenting. I'm given Zofran but it does nothing.

I can feel time passing. I fall into an automatic, Lamaze type of breathing — short, quick, rhythmic breaths in an attempt to tame my pain. In actuality, it just gives me something to focus on besides the nightmare I seem to have woken up in. And that’s OK. I’ll take the distraction.

Speaking of distractions, where is my husband? I look around; he’s not here. He’s never been here. Seems the nurses haven’t brought him in to see me yet. OMG. That means he’s been sitting in the waiting room the entire day with my mother and sister. Waiting. Worrying.

I open my mouth but can manage to eek out only two words: “My husband.” The nurse nearby ignores me. So I repeat myself. Still nothing. Oh. I’m only talking inside my own head! I focus hard on saying the words out loud; this time she hears me, and nods OK.

And like in a dream, when I reopen my eyes, my husband is standing beside me. It’s obvious I’ve been going through a terrible time; I look limp and pale as a noodle. (He later tells me that upon seeing me, he went back out to the waiting room and sent my mom and sister home, rather than have them see me like this. Good call.) 

My husband asks the nurse what meds I’ve been given so far, then suggests Ativan, an anti-anxiety medication that also has an anti-nausea effect. My surgeon, Dr. A., agrees with him, saying, “Good idea. Let’s try it.” Within minutes, the room stops spinning. My husband explains to me why: Nausea begins in the brain, not the stomach — which is why the Ativan works.

My husband the hero pharmacist strikes again.

My surgery has taken 4 ½ hours. I’ve been in the recovery room an additional five. We arrived this morning in the dark; it is now dusk.

(Copyright ©2011 Rennasus)

But what about my nodes? They removed several. All were negative. While we won’t know exactly what we’re dealing with until the pathology report comes back in a few days, both surgeons say there were no surprises. They got clean nodes and clean margins. This is as good as it gets. We are happy, despite all the day's drama.

I finally made it to the other side.

SURGERY DAZE

We’ve been up since 4:15 AM, Husband and I, and by 6 AM I’m laying comfortably in a bed on the second floor of the hospital, with an IV taped to the top of my hand (and yes, it hurt going in). My surgery is scheduled to begin in 90 minutes.

I feel very relaxed, considering. For the past four nights before bed, I have been listening to a meditation CD provided by Blue Shield (believe it or not) specifically designed to calm my pre-surgery jitters. It’s working. I employ the visualization techniques I’ve learned as I lay still —  in between the mind-numbing, repetitious medical questioning that’s been going on since I arrived this morning. 

Every person I encounter asks the same questions. What medications are you currently taking? Have you had any surgeries in the past? What are you allergic to? This gets annoying. Really annoying. It messes with my "relaxed" mindset. So I ask: Why the barrage of queries over and over and over again?

“Patients forget to tell us vital information,” the nurse explains. “And sometimes the info you give us gets entered incorrectly into the computer." Oh. So asking each time ensures everything is accurate? "Yes." OK, I get it. This labyrinth of cross checking and questioning is ultimately for my own good. But I don't have to like it. (This surgery is for my own good too; that doesn't mean I have to like that either.)

My anesthesiologist introduces himself. I let him know that Demerol and I are definitely not simpatico (it makes me terribly nauseous and dizzy). He says they don’t use Demerol anymore, but makes note of it anyway.

Finally, I’m wheeled down to a prep area on the surgical floor, where my husband and I wait in a large square queue of sorts with a dozen other patients having surgery this morning. All that is separating us is a thin curtain (like in an emergency room). You can’t see through the curtain, but you sure can hear through it! My hubby and I amuse ourselves by listening to the litany of complaints and problems and conversations on either side of our curtain.

My surgeon, Dr. A., stops by; he’s dressed in his blue scrubs. I make sure he knows how important it is that he take all of my breast tissue, on both sides. (The point in my choosing a bilateral mastectomy is to reduce my recurrence risk as much as possible; I don't want any tissue left behind that could house stray cancer cells.) He tells me not to worry. I like him and I trust him. He reminds me he is doing the sentinel node biopsy — he'll inject a blue dye near my tumor. The first (or sentinel) lymph node that absorbs the dye is removed and examined for cancer cells. If cancer is found, more nodes will be removed. If no cancer is found in the sentinel node, he likely won't remove any others. (In the not-so-distant past, women undergoing mastectomy were stripped of dozens of their lymph nodes, putting a heavier burden on the ones remaining and increasing the risk of complications like lymphedema.)

Major mental note to self: If I wake up from anesthesia and feel pain under my arm, my cancer has probably spread. (Little do I know that I won't be able to even feel my underarm; it will be completely numb — as will my entire chest and part of my back. Maybe for forever.)

As I am filing this shattering thought away, The Prince of Surgery (AKA my plastic surgeon, Dr. C.) arrives. It’s 7 AM and he’s wearing a dark blue suit, a crisp white shirt and a perfectly knotted tie. My initial reaction is to tell him how fabulous he looks. But I’ve got something else I need to get off of my, umm, chest.

  

I want to go a little bigger.

I know my breast cancer sistahs will howl with laughter when they read this; they are the only ones who can truly understand the phenomenon we have dubbed “boob greed.” But I need Dr. C. to know, in case going just "a little bit bigger” will alter what he is about to do right now. He assures me it will not. “There is plenty of time for that later,” he says. “Today, let’s get the cancer out and the tissue expanders in.” 

And on that note, he pulls out his black Sharpe and proceeds to mark up my entire upper torso, tracing the outline of my boobs and marking their position in great detail. When he's done, I look like a grade school art project gone haywire. (Makes me wish I had my camera.)

Dr. C. leaves my bedside and my anesthesiologist reappears. It's time. I kiss my hubby goodbye with tears in my eyes and leave him standing alone in the hallway as they whisk me away on my soon-to-be magic carpet ride.

But I’m not feeling it — the happy juice, I mean. I am completely, 100% lucid. I make idol chitchat with the nurse guiding my gurney as he makes a sharp left and then an immediate right, wheeling me straight into the operating room.

It’s bright, and very cold. A nurse asks me to slide myself off the gurney and onto the (quite narrow, I might add) operating table. This isn’t easy to do, especially since my arm is attached to an IV; then I realize they haven’t yet given me the “juice” — or they wouldn’t be asking me to “scooch.”

They place my arms on narrow extenders that swing out from the sides of the operating table. I close my eyes and visualize myself standing at the top of the hill where I love to hike. I breath deeply. I can hear voices around me. Then all falls silent.

NORDSTROM RACK

So what are you supposed to wear after a mastectomy? You can’t raise your arms over your head, so pullover tops are out; that means zip-up or button-down shirts are in. Most of the shirts in my closet are body-hugging pullovers with a lower neckline. (I never noticed that before. Funny, the things that pop up when your boobs are getting lopped off.)

I figure I'd better stock up on a few easy-on/off shirts. You know, just a couple of things to make me look presentable post-surgery. (As much as I’d like to wear my bathrobe to my plastic surgery appointments, I don’t think my husband will let me out of the house in it  — even though it’s the spa robe he bought me for Christmas, in the most dreamy shade of pale sage green.)

(copyright 2011 TheBigCandMe)

And so begins My Shopping Spree from Hell.

Since there's no need to spend a ton of cha-ching on these interim clothes, and because I still want to look quasi-cute, I head over to Nordstrom Rack. I comb through the store with all the determination of a tried-and-true shopper in search of a sale, leaving an audible trail of hanger click-click-clicks in my wake. I focus specifically on shirts and sweaters with buttons, snaps and clasps — though patterns, ruffles and layered materials also come into play. My strategy? Find anything that will distract the casual roaming eye from the fact that my chest is literally under construction.

The shirt selection is actually better than I anticipate, and this strikes a pleasurable (and familiar) chord in my psyche. There really is nothing quite like retail therapy. I’m rather enjoying my little shopping foray. I find myself falling — ever-so-slowly — into a kind of hypnotic trance as I sift through the sales racks. And it's taking my mind off my surgery. Eventually I look down and see an enormous pile of colorful shirts in my cart. Wait. What just happened here? I check the clock on my cell phone. I’ve been in this store for almost 2 hours. Whoa. 

I notice a dull headache coming on, probably because I haven't been drinking any water. My throat feels scratchy and dry. I hear a baby start to cry. Then a woman arguing with her teenage daughter. The noise level is crescendoing. The air feels stiflingly warm. I rummage through my cart and return just about everything I've taken painstaking time to select. I hang my returns in the general vicinity of where I found them and decide to keep seven items. I rush to the checkout and am floored to see there's a long line. Man, I really need to get out of here. 

My eyes start darting around the store, as if looking for a fire exit. A ringing cell phone startles me; a woman answers, talking rapidly in a language I don’t even recognize. I feel a swell of anger building up and just then, the clerk shouts out, "Next!" She smiles. I ignore her (though I do help her take my garments off their hangers).

  

I pay for the purchase, cram my credit card back into my wallet, grab the bag and make a fast dash for the door. Once outside and away from the crowd, I begin to feel like I can breath again. But I notice the air is still hot and heavy. I open my car door, roll down the windows, slide into the seat and start the engine. And then it hits me.


I am on the verge of having a panic attack. 

This realization floods my eyes with tears. But why so much anxiety? Why am I crying? Is it because I wasted too much time shopping when I should be doing the 100 other things I need to get done before my surgery? Or is it because I spent too much money on clothes I don’t really like, didn't even try on and will probably need to return because they won't fit or will look hokey or matronly or just plain dull?

It literally takes the entire 15-minute car ride home for me to realize what's really going on.

I’ve just been on my first Mastectomy Shopping Spree, buying tangible items to disguise the fact that in less than 48 hours, I will no longer have breasts. Dayum. If that’s not cause for a panic attack, I don't know what is. (The fact that I chose Nordstrom Rack to purchase shirts for my lack of a rack? Well, that's just good old-fashioned irony.)

GET THIS PARTY STARTED!

One morning, just days before my surgery, I am sitting in my BFF’s kitchen. But this is no ordinary catch-up, chill-out visit. It’s much more personal, educational, important — dare I even say enlightening.

BFF has invited her friend "E." to join us for coffee. E. is a breast cancer survivor. She had a bilateral mastectomy and reconstruction — the same surgeries I am about to have. The entire process, from soup-to-nuts, start-to-finish, took her nearly two years.

That is a very long time.

I’ve known E. for awhile; we see each other at holiday and birthday parties (she and BFF have kids close in age). But I have never had a conversation with E. about breast cancer. Not that I didn’t have an opportunity; I saw her several times while she was undergoing reconstruction, and although I always made a point of asking how she was doing, she always made a point of saying she was fine. I never got the vibe that she wanted to talk about “it” — particularly at a party. And since E. makes a sinfully delicious dirty martini (complete with huge, juicy olives stuffed with bleu cheese), she would always then say, “Want a drink?”

It was soon after my diagnosis (in the same phone call, if I recall) that BFF suggested I call E. But I never felt comfortable picking up the phone; not exactly sure why. Maybe it was because E. never seemed open to discussing BC. Maybe it was because I didn’t know her very well. Or maybe it was because I was the one uncomfortable about opening up. (When my plastic surgeon’s office gave me the cellphone numbers of two women who recently completed their reconstruction with him, did I call them? Nope.) I guess I was afraid to hear all the details — the good, the bad, and the very, very ugly.

But as my surgery date creeps closer, I begin to crave face time with someone who has walked this path ahead of me. I want to benefit from their hindsight. Thankfully, during one of my repeated rants in the midst of all this cancer crap, my BFF had heard me loud and clear and took action, just in the nick of time.

So here we sit, we three women, and now I can’t stop talking to E. about breast cancer! I ask her everything I can possibly think of regarding pre- and post-mastectomy surgery and recovery. My notebook is crammed with questions, from the most mundane (if I can’t bear any weight on my arms, how am I supposed to drag myself out of bed in the middle of the night to use the bathroom?) to the more technical (what size were your tissue expanders? Did your surgeon use a biologic?), to the absolutely, utterly personal (are those [surgeon-created] fipples? Wow!). 

E. answers every one of my probing queries. And slowly but surely, my pre-surgery jitters begin their final fadeout.

The highlight of my meet-and-greet that will forever be seared into my brain is the fact that E. shows me her boobs. Yup, she shows me the money, honey. And they look freakin’ fantastic!  Here's the thing: When a woman is about to undergo the removal of two of her most cherished (and visible) body parts, finding another woman who looks just like she hopes to one day is nothing short of inspiring. Seeing how splendidly medical science can piece us back together (after using their many weapons of mass destruction in the OR to tear us apart) is not just reassuring, it’s downright life affirming. It makes me realize I will get through this. I will look whole again. If E. can do it, so can I.

So after explaining her entire reconstruction to me in great detail (including her complications, which I obviously have blocked out because I can’t for the life of me recall what they are), she casually reveals her "booby" prizes: two symmetrical, incredibly natural-looking, 36DD “foobs.” And they are amazing.

I have been so focused on the deconstruction part of my journey that I haven’t really thought all that much about my reconstruction, even though it is occurring at the same time, on the same table. Today, in the safety of BFF's kitchen, I allow myself to go there. Not only does the experience with E. help soften the mental blow of my mastectomies, but it forces me to truly face what I am about to go through. 

(Copyright ©2011 Rennasus)

These two hours, spent over a cup of hot joe with a woman I hardly know while she shares her most intimate details with me, are not just a bonding moment or a necessary evil or even a way for me to face my internal music; it's all of those things. But more importantly, these two hours are about the sheer force and monumental power of sharing a life-altering experience with another human being who knows exactly what I am feeling, fearing and denying.

And it is this moment that makes me finally ready to climb aboard that hospital gurney and get this party started. Surgery, here I come!