"I'm Fine"

Breast cancer? Really? Because I haven't been through enough yet?

My first mammogram quickly became my second, then two ultrasounds. A week later, I had a biopsy and needle aspiration. On July 26, I had a lumpectomy and sentinel node biopsy. My lymph nodes are clear, but the small lump turned out to be microinvasive. As in, invasive cancer rather than precancerous as initially suspected. The tiny level of microinvasion puts me into a whole other class of treatments.

I'm currently awaiting the results of the BRCA 1 and 2 genetic test. I've seen the surgeon more times than I can count. Had my first appointment with the oncologist a couple of days ago. The gist of that appointment was that if the test is positive, bilateral mastectomy is probably my best choice. If not, radiation. And either way, at least 5 years of tamoxifen with its laundry list of potentially horrible side effects.

Did I mention I'm still recovering from surgery? It wasn't nearly as bad as my 3 c-sections, but having an incision right along where your bra strap hits is pretty awful. Wear just the wrong thing and by the end of the day, you're rubbed raw. And you can't move your arm around too much or it gets sore and swollen pretty much all the way around from your front to your back. So I haven't exercised much until this week. When I saw the surgeon a week after surgery, she asked when I'd return to work. My response: Um, I was supposed to take time off other than the day of the surgery?

I'm tired. Tired because my body is healing and because my mind is overwhelmed. As another woman put it, in addition to everything you're already doing, you also have to be "cancer patient," thinking about what to do next, researching treatments, diagnoses, etc.

Dr. Susan Love is a cancer researcher who last year was diagnosed with leukemia. She wrote a blog post describing why she doesn't like to be called a survivor. Her main point is that survivors have lived through something, something that is over. Cancer isn't ever over. It can come back, it can get worse, and it can kill you years after you thought you'd "survived" it.

Yesterday my surgeon said something about how tough it is to make decisions under pressure. This, however, is something I'm more than familiar with. As a friend put it, it sucks to be an expert on so many tragic things. I can talk to a parent whose lost a child and really understand, and now to other cancer patients. I would love to stop being the expert on tragedies. The experience does help in some ways. I know not to make decisions when I'm not thinking clearly and I'm very good at recognizing when I'm not/can't.

This is different than losing my daughter in so many ways. In that case, while we had to make a lot of decisions initially (memorial services, selling house, etc.) eventually all that was left was living with the grief. There are obviously things that make that worse, like her friends all starting first grade this year. But I don't have to make decisions anymore. Breast cancer, on the other hand, could require a series of decisions over the rest of my life. And ugh, I hate making decisions. After my daughter died, I tried not to make any because I questioned my judgment.

And the decisions I'm making now are like the worst type of gambling ever. The doctors rattle off one statistic after another, none of which applies EXACTLY to anyone, and you have to throw them all together in some sort of grotesque shaker so you can roll the dice. Out comes my choice and then I see what I win or lose.

I'm fine. When someone asks how you are, is that what you say? Most of us do. It seems though, that my parents and in-laws (perhaps as a result of their age?) have started being more honest. How are you? "Well, I had surgery for my gallstones and it didn't go quite right and I have to go back..." Not really what people expect to hear. I'm honest with my friends, those who I've kept updated about my treatment. I'll tell them now that I'm tired, wish I didn't have to deal with this. But usually, I say, I'm fine. I suppose it's my way of not overwhelming myself or anyone else with reality.