Six Months

Exactly six months ago at this time, I was just awakening into post-mastectomy reality, which was confusing because a giant, colorful unicorn was bobbing blithely around the foot of my hospital bed.

Six months. The longest, shortest six months.

The first two months were a roller coaster of events but there was one main objective: recovery. It was emotional and painful and scary, yet somehow I remained chipper. I had a good routine and amazing support. I rocked recovery. I was even able to make it to a girls’ cruise just after the two month mark, and introduce the new boobs to the world.

But, I hit a wall. Then I slid into a pit. It was a delayed low that I did not expect. I was having a hard time accepting my reconstructed chest, in all its imperfectly perky glory, and spent a lot of mental energy fantasizing about explantation. I procrastinated on starting Tamoxifen, naturally, and so that was just ramping up its rude blockade of my perfectly good estrogen. My antidepressant had recently been changed. And I got a raging sinus infection that had me down for weeks. So, it was hard to tell which aspect of life was to blame for my funk, but it didn’t matter. I descended into a zombie-like state of existence.

It is only natural that the people who were so present when cancer burst onto the scene, faded back into the patterns of their own busy lives. It would have been awkward if they hadn’t. My feelings were not hurt, but some days were very lonely. My wounds were fully healed. I was physically back to “normal.” I was even back at boot camp, the one thing I thankfully kept constant. It’s not like I could call someone up and say, “I’m too depressed to get the laundry done.” Except I could have, and I should have, although I’m not sure I had yet articulated that in my own head. I definitely didn’t feel like I should be depressed. I had the best possible breast cancer outcome. What was my problem? Husband tried his hardest to give me space and yet gently press me on, oh, speaking to him about what I was thinking and feeling, all while keeping the house afloat.

About a month and a half ago, someone in an online cancer support group asked for words of wisdom as she was preparing for her mastectomy. My go-to advice is to take the pain pills on a SCHEDULE for the first three to four days but then be fully, pharmacologically prepared for the consequent intestinal gridlock. However, this particular time, I unloaded about the state of my psychological affairs, eventually making the sage proclamation, to my fellow breast cancer recipient, to give herself grace. That any reaction, at any point in the process, regardless of her results and outcome, should be permitted and validated. I’d like to say that it was an epiphany and that I walked away granting myself that same grace I so easily recommended, but things are better than they were.

In May, I was healthy and strong enough to participate in my first Susan G. Komen Race for the Cure as a survivor. Over the few months prior, I avoided thinking about it, still experiencing some level of denial and imposter syndrome, unsure about how I felt about the very word “survivor.” But my Burn Boot Camp family rallied a team and I decided to do it. The day of the race was hot and humid. The five kilometers felt like ten, but my running buddy stayed by my side and another friend and trainer pushed me through the final stretch with the perfect encouragement and support as I attempted a sprint to the finish line. At a few points, when I felt like stopping, I tried to conjure a Hallmark-Channel-worthy mental montage of all my obstacles since diagnosis and how I navigated them, complete with Billie Joe Armstrong and his acoustic guitar serenading that unpredictable time of my life… except, it was hot, like I said, and it turns out I had to put all my attention to breathing and putting one foot in front of the other. Which was, of course, the perfect metaphor. I’ll just keep doing that.

“So take the photographs and still frames in your mind, Hang it on a shelf in good health and good time…” Green Day, Nimrod, 1997

 

MRI with and without Existentialism

Nothing is straight forward after being diagnosed with cancer. Exhibit A: The tummy ache that revealed a mass in my spine.

My husband informed me that it would be pretty inconsiderate not to disclose up front that everything is fine. I’m fine. My new posse of sketchy lumps and masses (introduced by name below) have all been deemed, by my village of radiologic experts, benign. But I invite you to remain seated with your seatbelt fastened, keep your arms and legs inside inside at all times, and take a lap on the roller coaster that was my most recent medical scare.

A little over 2 weeks ago I started having a tummy ache. Right upper quadrant (RUQ) pain, as it is specifically noted in the medical world. Pain up under my right ribs that got worse when I took a deep breath. I’m a doctor. I’m reasonably intelligent. There are only so many things that RUQ pain can be, gallstones being the most common. While it didn’t quite fit the profile, it made the most sense to me and to my primary doctor and the sharp medical student working with him. The normal next step in this situation is an ultrasound of that part of the abdomen to look at the gallbladder and liver. By this point, as is the case with a statistically significant portion of all new medical problems (citation needed), it was late Friday afternoon, meaning nothing at all would happen for the next 3 days. So I called a doctor friend who has his very own, high-tech ultrasound probe that plugs directly into his iPhone. My Friday evening consisted of getting my pasty, soft RUQ prodded and imaged by my friend, at my request, on his living room couch, chatting with his wife who is my good friend, while witnessing their three year old daughter experience a whoopie cushion for the first time. Fun times. Until those ultrasound waves resonated off of a liver mass. Meet Phil.

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Phil. The fuzzy, grey, doughnut-shaped liver mass as seen on ultrasound.

In short, instead of an ill-timed but totally-benign gallstone, I had a biggish liver mass. And even though my breast cancer was stage 1A, meaning NO SPREAD, not even to one lymph node, a liver mass is at least mildly concerning. I passed this along to my doctor and by some medical and administrative miracle, I was able to finagle my way into an MRI that next Monday.

I have had two MRIs in the past. One was of my hip which revealed “degenerative changes” instead of a stress fracture from my 10K training program. (Doctor: I’ve got good news and bad news… you do not have a running injury, but basically your hip is old. Me: Rude.) And the other was of my brain, which showed nothing at all, proving that my swimmy vision was just my very first migraine aura at age 37, and not a brain tumor or aneurysm or anything else of any concern. I’ve been crammed into that tiny tunnel and experienced the mysterious noises and vibrations, the anxiety of trying to hold perfectly still for almost an hour. It’s a mental challenge for even the least claustrophobic among us. (For the truly claustrophobic, there is medication.) But add to that the threat of metastatic cancer and it became a breeding ground for emotions and musings so broad that I’m still re-experiencing them weeks later, all set to the soundtrack of a music genre of my choosing, pumped in through magnet-immune cords and headphones. When they asked me for my selection, I considered Imogen Heap (my go-to zen vibe) and, in a moment of fleeting angst, Green Day (but what good is angry punk rock if I can’t yell-sing along at the top of my lungs?). Knowing I couldn’t possibly sound less cool to the hipster MR tech, I went with, and I quote, light classical. But I know what I like, and I did not want Wagner in the mix.

In I went, to the tune of Antonio Vivaldi’s Four Seasons. As the machine powered up, so did my mind.

I imagined each of the uncountable protons in my body spinning, spinning in their respective magnetic fields, straightening up like obedient children in the giant magnet of the MRI, then dancing, dancing to the radio frequency pulses of the machine.

I wondered how it was possible to manipulate the most infinitesimal unit of our physical existence and not come out the other side inexorably altered.

I pictured Phil, perhaps silently plotting an epic battle inside my body, or more likely, smugly benign, sitting in on some sort of a silent protest of my sanity.

I pretended I was an enigmatic, badass galactic traveler preparing for deep sleep in a sleek pod, or mid-takeoff in a cush one-woman spaceship, or spinning dangerously in an interdimensional vessel to make contact with other life forms… basically all the Hollywood sci fi heroines I could come up with.

I imagined, for the first time, my family scattering my ashes off a silently bobbing sailboat somewhere in Manchioneel Bay in the Caribbean.

I wondered what the geographic coordinates are for Manchioneel Bay and thought about how that would be a cool tattoo and how I should hurry up and get one before I die.

I pictured my four year old daughter as a teenager, an adult, maybe a mother, an activist, a problem solver, a force for good in the world.

I wished peace for my husband and love, all the love.

I pondered how surprisingly synchronous the disconcerting pulses of my magnetic cocoon were with Vivaldi’s orchestral Summer thunderstorms.

And then they pulled me out.

  *   *   *   *

Phil was just one of FOUR liver masses. Meet his cronies, Herb, Hugh, and Orville. They all appear to be BENIGN tangles of blood vessels, called hemangiomas, as was predicted by my braintrust of radiologists. But amongst the shenanigans inside my liver, Jean Luc was discovered, quiet and solitary in my 11th thoracic vertebra (one little bone in the middle of my spine). I had to wait two more days to get a bone scan, during which time, only after I fled a coffee shop crying one morning, I fully re-entered Denialville. My brain had stressed out one too many times and shut itself right down. I went through a period like this shortly after my original diagnosis. I was forgetful and spacey (not in an enigmatically badass way) and laughed too loudly at inappropriate times, but I was also creepily unconcerned. Three cheers for built-in coping mechanisms. It allowed me to focus on things that really mattered, like making 28 vegan heart shaped pancakes the morning before C’s breakfast-themed preschool Valentine’s Day Party, a task I fully brought upon myself. (Fun mental image time: me, unkempt, lacking the technical acumen for such an endeavor, frantically mixing and flipping, right up until 8:55 am, throwing a parka over my grease-splattered PJs, and baby-wiping crusty batter and yesterday’s smeared mascara off my face at the red lights I hit on the short commute, C totally unaware, belting out the latest seasonal iteration of Baby Shark from her carseat.) After that romp, a shower and an hour in the scanner with a warm blanket was actually a pretty nice little Valentine’s Day treat. But even more so, of course, was the news I received just a few hours later that Jean Luc was a total dud, not showing up AT ALL on the scan, which was 100% good news. (Most likely another hemangioma, I’m told.)

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My magnum opus.

Meanwhile, my tummy ache resolved. And like my racing heart from a few weeks prior, there is no tidy explanation. But I’ve been injected with contrast and a radioactive materials, and scanned and zapped from stem to stern in a radiographic goose chase that should leave me relieved that there are no more, at this time, malignant lumps inside of me. Which is good, because I am running out of names.

 

The Pits

So many weird things are discussed and planned before having your boobs chopped off. I’m thankful for the support groups I’ve found my way into, and for family and friends who have lovingly and extensively researched the matter, because I’m out in left field right now, and I need help. It makes sense that my neck will feel tight after surgery and that a fuzzy, lavender-scented, bunny-shaped neck pillow that can be heated or cooled will feel fantastic. Big body wedge/pillow for the bed? Sounds amazing. I sleep on my side and stomach which is obviously a no-go post-op. My sister amazonned me both a fuzzy neck bunny and a medical grade wedge, because I certainly didn’t think of any of that. I was fretting about my daughter, who turns four just days after my surgery, and in stepped my bestie Harmony, who found a winter break day camp at the YMCA and called to reserve her a spot. (Harmony just left after spending a week with me, away from her family, two weeks before Christmas. She will get her own blog post at some point because she did oh-so-much more than set up child care!) Oh yeah, I’ll have four surgical drains dangling from my chest and I haven’t given an ounce of mental energy to a solution to that, but my mom personally experienced this and came up with her own drain hack involving fashionable scarves (naturally) which she will bring and style for me.

But the most humorously perplexing issue by far has been… my PITS. That’s right. My armpits. I haaaate armpit hair. I shave daily. It itches me if I don’t. I feel dirty even when I’m not if I have any growth whatsoever. And Harmony brought to my attention that I should address this prior to surgery after which I am not allowed to lift my arms for THREE WEEKS. Simple solution: a wax. No hair for three weeks. Perfect. Or so I thought. Apparently one has to have one to two weeks of hair growth before getting a wax. I had a pre-surgery long weekend getaway at the beach with my husband and I wasn’t going to be anything other than clean shaven as I was taking my girls out for their last hurrah in a bikini… which of course had to be excessively photo-documented. (Take a moment to imagine me, usually selfie-averse, awkwardly taking pictures of my chest from every angle on the beach. Yep. I was that person. But selfies are a practiced skill and I am just not up to par.)

The Pits
Exhibit A (Who blinks while taking her own photo?!)

There was still time thankfully and I began the arduous growing-out process. And let’s just say that I don’t have cute, fluffy, popstar pit hair which was having a moment a few years ago (or is it still?). Think less euro-chic, more lumberjack. At boot camp, I felt the need to explain my pit-uation to everyone in my immediate vicinity which of course lead to a lot of breast cancer oversharing and sweaty hugs.

Ten days in, I could take it no longer and made the executive decision that it was time to make the waxing appointment. I was so excited. But just before I hit “complete” on my online booking, I paused. I hadn’t taken any time to consider the downsides of waxing. I quickly consulted one of my online support groups for guidance and my reservations were validated. I have never waxed anything before so I have no idea how my skin will react. It could be fine, but I could also come down with anything from mild irritation to a flesh-eating bacterial infection. Lymph nodes will be removed from my armpit during surgery, flesh-eating bacteria of the pits would be, well, the pits. So, I scrapped that idea and immediately shaved simultaneously bemoaning the needless ten days of axillary annoyance and the fact that I would, in fact, have to deal with itchy, hairy pits on top of having my boobs chopped off. RUDE FOREVER!!!

As has happened in a few other instances, I took this disproportionately badly. Like almost as badly as the diagnosis itself. My brain is all confused about what and how much to feel about anything these days. But, if I do end up needing chemo and/or radiation (this is still unknown and will not be known until after surgery), I suppose losing all my pit hair would be the the one perk. Gotta take those where I can get them!

So, my last day to shave my pits will be Monday December 17. In the surgical world, time is measured by the number days after the operation. (“Post op day 1” etc.) I shall amuse myself by measuring time in no-shave days. Christmas will be no-shave day 8. Oh what fun!

Whatever, Vladimir

I received a package in the mail from the nurse manager of the breast center where I was diagnosed with breast cancer four days ago. (Wow, still smarts a little to say that.) It is a book called “Be a Survivor” by Vladimir Lange, MD. Now, I don’t know Vladimir. He might be a lovely person, but he can step aside. Really? They couldn’t find a medically, emotionally, and experientially qualified WOMAN to write (and title) this road map to my new disease and how to survive it??? RUDE. Also rude for anyone to remind me so blatantly that I do, in fact, have breast cancer. I was doing just fine in Denialville with my delightful breakfasts of Ghirardelli dark chocolates.

Also enclosed in the package was a flier for a local breast cancer support group. The nurse had mentioned this previously in a phone call so I was expecting it. But combined with Vladimir and his bossy directive, I started to feel panicky. Too real, too real, alert alert alert! I left my cranky daughter with my tired husband and sped to my new boot camp gym with a winded sensation that felt like I was already doing godforsaken burpees. On the precipice of my first genuine meltdown, I collected myself and forced myself to go inside.

*  * *  * *

Side bar: Fitness and I have a tricky relationship. It’s on-again-off-again really. I have gained and lost the same 10-20 pounds since adolescence and have a pretty rotten self image. I’ve tried and successfully completed a variety workout programs, complete with transformation pictures to prove it. But they always come to an end and then I struggle to maintain a normal healthy lifestyle. I have two different Instagram fitness accounts that I never actually posted in because the pendulum swung back the other way before I felt lean/sculpted/satisfied enough to make the big reveal. Healthy. Eventually, I became fed up with the “fitstagram” collective, and armed with the great wisdom imparted by motherhood and my mid-30s, I tried to start a new humor blog about health and self acceptance no matter your appearance. But that didn’t get off the ground either because it wasn’t genuine — I did not accept myself. I really only wanted to humor-shame fitness obsessed people to make myself feel better. Yeah. Embarrassing. But insightful? (Hindsightful?) So over the last six months, I found myself descending into a pit of self-loathing about my appearance, about the fact that all my pants were too tight, that everything seemed to jiggle, but additionally, that I cared so much! I just wanted to be normal and happy and active and healthy and secure! I wanted to model all that for my daughter so she wouldn’t grow up with the same crazy that I have! Clearly this was cause for more of the emotional eating that started all of this in the first place. And that is when I found Burn Boot Camp. (This is not an ad. Well it sort of is, but no one is paying me!)

I signed up for a 30-day free trial, which started October 1 at their grand opening in my town. It was extremely challenging but interesting, and I had never done anything quite like it. There is a community there that is supportive and motivating. It took almost four entire weeks to see or feel any sort of progress (probably because of my chronic-dieting-related geriatric metabolism), and I spent a significant portion of that time hobbling around with muscle-related soreness. However, just before the cutoff to sign a contract with “founders” rates, I noticed some gratifying improvements. I didn’t magically look bikini-competition-ready, but I could hold a plank a little longer, lift a little bit heavier, and while the metrics only changed a little, the psychological lift of accomplishment and sisterhood had me energized and hooked. So I signed the contract on October 30. Literally the very same day that Bob showed his ugly face on a mammogram and ultrasound.

The point is that running off to boot camp is not some subtle humble brag… restrain your eye rolling. Or not. Gym selfies annoy me as much as the next non-fitness-model, but who knows, I might post some one day because I HAVE CANCER AND I CAN DO WHAT I WANT. But that place is sort of my sanctuary right now and part of my journey … OK, I hear how that sounds;  eye rolls permitted.

*  * *  *

Exercise proved beneficial for my psyche. It no longer felt like a tunnel of doom was closing in around me. I’m super glad that I made myself go to the gym. Hopefully, I will remember to turn to it in the future, rather than full-on ostrich my head in the sand with stress and anxiety, as I often do. But I did come home, shove Vladimir and his platitudes under a pile of papers, and eat chocolate for dinner. And I’m fine with that, too.