Monday, April 30, 2007

May Day

Didn't see the double entendre (sp) in that until now.

May Day.

LOL.

We woke up so very early that morning last year. No need for an alarm clock. As scared as I was that morning, I was also thrilled beyond belief to have that stinkin' little cancer GONE from my body.

The day began with the usual check in. Only it wasn't usual then. I wasn't used to getting a hospital bracelet and filling out forms and sitting in a waiting room. I was used to being on the other side of the double doors. I had to change into one of those lovely hospital gowns, have an IV started and wait in a little pre-op cubicle instead of hanging out in scrubs, waiting for someone else to go through those steps.

The next stop on my tour that morning would be radiology. They took me back through the handy-dandy back corridor. A nice thing when you consider the lovely hospital gown I was wearing. The technician was a doll. She was cheery. Not overly so, but enough. She tried to convince me maybe it wasn't cancer. I think I actually said the words "Did you look at the mammogram?" (you can imagine my tone. LOL). As much as I would have loved that have been true, I knew there was no way.

The whole needle localization procedure was much more pleasant than I ever would have thought. I was anticipating much worse. Everyone in the room- the tech, nurse and radiologist, was a woman, so that helped. They were all quite interested in the fact that I am an ob/gyn, I think. Lots of chatting. By the time I left that room, I knew the medical history of every one in the room probably better than they knew mine! LOL. For anyone that hasn't had one of these, done, it was not terrible by any means. They did yet another mammogram (digital so it appeared on the computer screen immediately). Then, once I was positioned perfectly, I was given an injection of a local anesthetic. That was perhaps the worst part- the stinging from that was the worst pain I would have all day. And that wasn't outrageous- just like a bee sting or two or three. I did feel pressure from the needle being placed, but that was all. Once the position was confirmed (super quick with the digital mammo), I was bandaged up and taken back to my little cubicle.

The waiting was hard. They had sent Howie back to the waiting room, so I was in my cubicle waiting, all alone and without anything to read. At that point, I did not need to be alone. I needed to be with someone or have my book to read to keep my mind on something else. I needed a distraction. Any distraction.

The distraction eventually came in the form of the anesthesiologist. He came in and asked the standard questions. I was more than happy to comply. Anything to keep busy. The best moment came in the middle of the interview. He looks up and asks, "Do you have a sister who is an ob/gyn?" LOL! Seriously! This is what he asked! I said "Umm, Skip, IT'S ME!!" To be fair, it had been a good 3 years since I was an attending at that hospital and he had, at one time, cared for my sister in some capacity.

Eventually, someone realized I was back and brought Howie back to sit with me for a few very short minutes. I know I shed a few tears off and on, quietly, while we were back in that little cubicle. Anytime it felt too real, it made me tear up.

I suppose I am fortunate for this next part, because walking into an operating room is second nature for me. It's comfortable, almost relaxing. It's always familiar, even if it's an OR I've never seen before. It feels like home... until they ask you to climb ONTO the table! That's the part that is the oddest. I feel like a child playing make believe when I have to be the patient! This part does go very quickly though. I did climb onto the table (remember I am short so it is a climb). I remember the warmth of the pre-meds as they flowed into my arm. I remember Skip saying he was going to give me a mask with oxygen... and that's all. The next thing I knew, I was in the recovery room.

Recovery rooms are a funny place. Being a patient reminded me of this. I KNOW Susan said to me "It was a cancer and the sentinal node was negative." What's funny is that I have no memory of her saying this. I just know she said it. I had to ask the nurse if she really came and said that to me. LOL. The same nurse who told me to stop checking my own vital signs. Yup. It turns out that's one of the first things I do when I wake up in a recovery room. I check my vitals. LOL. I wonder if other people do this. Anyway, I am now exceeding conscious of what I tell patients in the recovery room, no matter how awake they seem.

Enough about that. I went home the same day. I still thought it was all going to be easy. On the bottom of my post-op instruction sheet from the breast surgeon was written something along the lines of how "this diagnosis may profoundly change your life." Something like that. I can't recall the exact words. I remember looking at those words and thinking to myself.. "No. Not me. This is going to be a little bump in the road that I will barely remember in a short time. The cancer is out. I'll have some radiation and then it will just be something in the past." I was so convinced it was all going to be simple. A year later, I know the truth.

Today, this cancer-versary day, is a bizarre day. An emotional day. I've already been teary and anxious. I've already been happy and at peace. I've already walked 3 miles, even singing and dancing part of the way (an advantage of walking on the canal tow path at 8 am when there's no one else around.. I do check before I sing. LOL). And it's still morning.

I do know one thing. I am ready to move on. They say it takes it about the same amount of time to recover as it did to get through treatment. So, let's get moving and get this recovery thing going!

The day before May 1st

So, here we are.

The day before May 1st.

The last day of April.

I don't have to turn to my journal to remember this day in 2006. I can hardly believe it's 2007. This last year flew by in a strange, telescoping time warp. There are huge chunks of time that I can't or don't choose to remember and others of which I remember every minute detail.

May 1 was a Monday last year. That Sunday was my niece's naming. We had never had one for Rachel, so we had the rabbi add on a little bit, more of a blessing, for Rachel as well. It was such a difficult day. I just wanted to say it aloud, but I couldn't. I knew the moment I did, it would become "the day Melissa told us she had cancer" instead of Hannah's naming. It was so much easier to pretend it wasn't happening. It wasn't real. Maybe I could wake up and find it was all a nightmare. The funny thing is, now, a year later, I wake up and sometimes do think maybe it was all a nightmare. And then something brushes against my chest and I see it but can't feel it. Or I catch a glimpse of myself in a mirror.

Looking back, the day wasn't too bad. At least, not until we dropped Rachel off afterwards. We had to be at the hospital at 6:45 am (funny how I can remember that detail) so she got to have a sleepover on a school night. Truly, this was the hardest part. The moment we drove down the street to the Sullivan's and Rachel got out of the car, was the moment it all became far too real. The next morning, I would become a cancer patient. I tear up just thinking about that moment. I remember how the air felt that afternoon, how blue the sky was, how pretty my little girl looked, and I remember the tears that flowed as soon as she closed the car door. It sounds so dramatic, but the moment the door closed, it felt like I was closing a chapter of my life. In reality, that chapter ended the day I had the diagnostic mammogram, but it felt like it ended at that moment.

So, tomorrow it will mark one full year. It gives me chills to think about it. So, I won't. :)

Thursday, April 26, 2007

Let's Pretend

I mentioned to a friend today that I am back in my "let's just pretend this never happened" mode. I am trying to get back in shape, ideally better than I was before. I'm slowly tackling my house, trying to get it back in shape, ideally better than it was before too! I'll settle for some semblance of shape, on both accounts. I'm letting my hair grow and grow and grow, despite nearly everyone else telling me I should keep it like this. Bit by bit, I'm working on making it look like all this never happened. I think it just might be the next step in recovery.

I just pulled out the calendar, which was sitting on the corner of my newly organized and somewhat de-cluttered desk (yesterday's project). Oddly enough, I had pulled the 2006 calendar instead of 2007. Out of curiousity, I took a peak. A year ago today, I was less than a week away from the first surgery, lumpectomy and sentinal node biopsy. I had already seen the breast surgeon and had already gone for pre-admission testing and pulmonary function testing, so the anesthesiologist wouldn't get uptight about my touch of asthma. There are all sorts of things listed on the calendar for that day and the following days- all non-cancer related. Several different dance rehearsals for Rachel, orthodontist appointment, etc. I remember running around like everything was just perfectly normal, knowing that nothing was normal at all. I didn't have time for cancer. I still don't.

Sunday, April 22, 2007

The Glass, Half Full

I don't believe I was born an optimist. I think I become one somewhere along the line. I don't know when, I just know that optimism is such a deeply ingrained part of my nature. On second thought, maybe I always have been an optimist. Just a realistic one, so sometimes I might just appear pessimistic, but it's only when there really is no hope. Some of the blog entries that were written on my darker days ended up with such positive responses. It amazed me that people would find something I didn't see or feel in those entries.

You'll notice that I said "darker" days. There are no blog entries from the darkest of days. Those are the days between when I had the mammogram and saw the breast surgeon. And again, the days between my first post-op visit and the realization that chemotherapy would be in my near future.

It's now a year from that first meeting with the breast surgeon. My first meeting as patient, that is. She had been my mentor for my 2 month elective in breast surgery, of all things, during my last year of residency.

I knew I was right about the diagnosis when I got the appointment. They received my mammo report on either Wednesday night or Thursday morning. First thing Thursday morning, there was a text message on my phone (not sure when it was sent) to call the office. She gave me an appointment for the very next day. My surgeon is a busy woman in a very busy practice. She triages appointments. Had she thought this was anything else other than cancer, my appointment would have been anywhere from days to weeks later.

You know it's never good news when the first thing that happens is the doctor walks into the room, gives you a hug and says "I'm so sorry." I probably could have left the room at that point. The diagnosis, albeit not official, was confirmed in that moment. I can still picture it. It was like a scene from a movie. I don't like that. You know how those movies end.

Back to my optimism. After that appointment, I focused on a few things. One was that she thought my nodes would be negative. I loved hearing that because it meant no chemo. Boy, would that one backfire. Small tumor, so lumpectomy is all that would be needed. I cut her off before she got more than a word or two into the mastectomy discussion. Looking back, I know I needed a lot more time to come to that decision. She was disappointed that I didn't bring anyone to that appointment. Yes, I went all alone. I knew what I had and thought I knew what I wanted. I wonder if I would have listened had she discussed a bilateral mastectomy at that opint.

The other concept that I clung to was that this was going to be stage 1 which has a 96% survival rate. I must have recited that number a million times. It became not just my favorite number in the whole world, but my own little mantra. 96% survival!

Of course, over time, I learned some of the above would not be so accurate. The tumor was grade 3 and a bit more aggressive than I had imagined. Funny, that I imagined my own tumor. I thought it should be well differentiated, moderately differentiated at worst. Didn't ever envision it would be poorly differentiated. I hate poorly differentiated tumors. They are bad news. They don't know how to behave like normal civilized cells. These are the tumors most likely to spread and cause havoc elsewhere.

Also, in my optimism, I completely ignored that the reported survival rates are just 5 year rates. I'll bet some of you didn't know that. A 96% survival rate is a beautiful thing. Don't get me wrong. But it doesn't mean as much as a 10 year or 20 year rate. It also lumps together a whole lot of disparate situations. A stage 1 tumor in a 60 year old woman is a different animal than a stage 1 tumor in a premenopausal woman. {sigh} I still like to ignore these things. 5 year survival is important, but it's not disease free survival either. Nor do these numbers look at recurrence. Nor do they look at something almost as bad, the chance of a new breast primary someday.

I do admit that once I had this appointment, it was a little bit easier to go on. I had a plan and a date. My surgery would be May 1. It could have been sooner, but I had to get in to see my internist for medical clearance. I also had to learn to say "I have cancer." Those words flow so easily now, but they were not only hard to say back then, they were hard to type. It made it real and I didn't want this to be real. It's a year later and now I say "I had cancer." And I still don't want it to be real. Sometimes, I even forget. Then, I catch a glimpse of myself in the mirror. I don't recognize this older woman with curly hair who looks back at me. And I certainly do not recognize this body. But, the forgetting is a good thing. A very good thing. It means that eventually, there will be longer and longer blocks of time when I forget this happened in my life. It means that Cancerville will be a place I used to live in. I won't be going back, not even for vacations! :P

Thursday, April 19, 2007

So.. a year ago today, I tried to carry on in "business as usual mode" as best I could. I was in limbo. Waiting for the radiology reports to be written. Waiting for a call back from the surgeon's office. Waiting for an uncertain future. These earliest days are the hardest part of the cancer journey. So much uncertainty. As a physician, I am all too familiar with this. So, I didn't tell. Very much not my normal nature, but I didn't want to scare everyone unnecessarily. I did tell a small group of online friends (hi pukesters), which includes one of the gang at my local scrapbook store, so they knew as well. Otherwise, it was just my husband and my sister.


Looking back, I wonder how I got through that day. No answers. No plan. No nothing. Just the knowledge that I had breast cancer. No idea if it had spread beyond the breast. No idea if that nagging pain in my hip was metastatic disease of just the result of having started a new exercise program a few weeks prior. Just an all around lousy time.
It was a Wednesday. I usually spent the third Wednesday of every month at my local scrapbooking store, Scrapbooking Moments in Time (SMIT) in Bound Brook, NJ. Dana had forwarned Pat, so it was a totally shock when I mentioned this in passing. Having the store as a place to go, a place made special by the people inside, gave me, once again, the escape I needed.
But, I can't go there today. As a result of the recent storm, it was under 6 feet of water, along with the rest of Main Street. There are photos at this link. SMIT is a special place. It's like Cheers, a place where everyone knows your name. It's only been a few days, but I already miss being able to pop in. So to Pat, Dana, and the gang.... you are in our thoughts and prayers!
In their honor, I thought it was time to share a little scrapbooking here again. :) Can't share my newest Boxer stuff until it's posted on their website, but I can start with the new papers from my other design team work, Scribble Scrabble. The third one is with papers from Sweetwater Express, but features my nephew, Marco, one of the most content babies I have ever seen.









Wednesday, April 18, 2007

A year ago today and other ramblings

As I watched the coverage of the tragedy at Virginia Tech, a screen came up with all sorts of tragic events that have occurred this week in history.

I had to agree.

April 18, 2006 was my D-Day.

Excerpts from my journal:

10:15 am :University Radiology
I walked in thinking this was no big deal. EVERYONE has repeat mammos and 80-90% of those are pretty meaningless. Still, I'm a tiny bit nervous sitting in the waiting area inside the office reserved for those "on deck" in the lovely paper gown.

The technician this time was as sweet as can be. If I could remember her name, I'd request her again (N.B. remember, this was written a year ago! LOL) I saw my screening mammo hanging on the screen and saw that red grease pen circle. It circled a tiny hyperechoic area. Not strongly hyperechoic, but enough to catch the radiologist's attention.

When she brought the next film back, I knew this wasn't a routine follow-up anymore. She took tighter and tighter compression films. As the plates get smaller, the pain gets higher! And people worry about a routine mamo!!! That's nothing!

The next film showed that the nodule (it was a nodule by then) was not round and did not have smooth edges. I knew it would have to come out. I shocked the technician when I said that aloud. She had no idea I was an MD. Apparently, they normally indicate this but no one asked and I didn't tell.

6 more films later, it was time for the ultrasound. The radiologist pronounced the nodule "suspicious." Suspicious? I knew it was breast cancer.

I was OK until I walked out of the building. I pulled on my sunglasses and then the tears began to flow. I called Howie and left a tearful message. I doubt he understood a word. I went to finish my errands. I filled the car with gas. While sitting at the pump (NB. This is NJ, someone else does the pumping), I called the insurance company to see if the breast surgeon I wanted was in the plan. Of course, they said no. They even said breast is not a specialty. I knew I wanted someone who ONLY does breast and that was that. (Kind of funny how quickly I moved into "action" mode. I stayed in that mode for months.)

I came home, got online and called the office I wanted to go to. Sure enough, she was in the plan!! I then called the radiology office to fax my results there, once they were available.

And then, I waited.


So, it's exactly a year ago today that I knew. It feels like a lifetime. I saw something scrapbook related recently that was asking about a moment that changed your life. My life changed in the moment I saw that spiculated little nodule on the screen. There was nothing else it could be. The rollercoaster ride that is cancer began. If you know me well, you know that I hate rollercoasters and don't ride them on purpose.

Of course, it's not all bad. I'm a survivor. It's the label I wear now and it defines me in many ways. Something I took away from the very first conversation I had with Dana, a survivor who's pretty much exactly a year ahead of me now one of my "bestest" friends on the planet, is that you'll quickly learn who your real friends are. It was amazing just how true that was. There are those that I thought were friends who rapidly disappeared from my life. Pretty amazing how quickly that happened. Others, from afar, some that I barely knew before this, who made sure to send an email or a card. Small gestures that I won't ever forget. There's also an incredible bond amongst my fellow cancer girls- the new friends I've made this year. Stef, who was diagnosed while I was finishing my active treatment and finally starting to come to terms with what having a disease that might kill you means (we got to do some of that together). Jaci, who's somewhat local.. we met to go shopping, grabbed a bite to eat and chatted for hours as if we had always known each other. Some of my other YSC friends and my chemogroup from breastcancer.org. Of course, I can't exclude my husband, who stood along side me, taking care of all the little details. I had to turn down food from the nurses at the hospital when I was first diagnosed because one of his first responses was to fill the fridge and the freezer. And there's my sister and my sister like friend, Patria, who rescued me several times this past year. I'm not good at the mushy stuff as a rule, and I'm sure there are others I should be naming, but you all mean the world to me and I couldn't wear the survivor label without you all. :)

Wednesday, April 11, 2007

The Long Awaited "TALE OF THE DEEP BLUE PEE"

Ahh yes...

I told you there would be lots of reminiscing in the coming weeks. We are now a year from when I had the first of my last mammograms. Last April was a nightmare. I clung to every little positive tidbit I was told and made those my mantra. When I look back now, I see how naively optomistic I was. Optomism is a good thing. A very good thing. I know it's what held me together back then.

In one of my early blog posts from when I finally went public last June, I promised to share the "Tale of the Deep Blue Pee." It's really the first of my "Tales from the Cancer Chronicles." Hmm.. maybe I'll write it all in a book someday. In the meantime, here's the tale direct from my private journal.


**************************************************************************************
A Funny Thing Happened on the Way to the
BATHROOM
or
the many colors of cancer
It goes like this.
You go to the hospital.
You have a needle localization (a mammogram with a wire placed into your tumor).
You go to the OR and go to sleep. While you are sleeping, blue dye is injected into your breast so the sentinal node, the most important lymph node, can be found. The dye stains your skin and can last a very long time (trust me.. it was still there when that breast was removed 4 months later). Might even be permanent.
Anyway, you wake up from all this and after being pumped up with fluids, you need to use the bathroom. You just had surgery, so a nurse helps you get to the bathroom.
You use the facilities, releasing VAST quantities of urine. You flush and notice the beautiful BLUE water. It is such a pretty color, just like the Carribean waters. You think "Hmmm.... someone must have just cleaned this bathroom. How nice!"
SERIOUSLY!!!
This is what I thought until the nurse said something about
BLUE URINE!!
Yes.
I am a physician.
Yes.
I did research before the surgery.
Yes.
I have even used this same dye on other people. But I use it to test urinary tract integrity so OF COURSE THE URINE IS BLUE!
How in all of this I never managed to hear about the BLUE urine is beyond me!!!!!!
Oh yes... it lasted for a few days too!

Sunday, April 08, 2007

Socks

I bought the socks I am wearing on my feet today last April.

There had been a little bit of recent stress because my husband had just learned he was going to be laid off. Aside from that, life was good.

I went for a routine mammogram in April 2006. I scheduled the appointment because we were uncertain about our health insurance status after the lay off, so we were trying to get in as much as possible. By the time I had my appointment, we learned dh would be moving to another group in the company, so there weren't any worries. I had already fit in my gyn appointment, a physical with my internist and Rachel's annual pediatrician visit. I had even already gone for my pelvic ultrasound. It did show that the cyst we'd been watching for years had grown quite a bit, but I decided to hold off and not have surgery. Too much living to do to take time out for a surgery for something I knew was benign. The mammogram was just the last little test left on my list. Life was definitely good.

I did not get any mammo results when I left the radiology office. Instead, a few days later, on Thursday afternoon before Good Friday, I received a letter that told me I needed to call for an appointment for more films. I tried my gyn's office. They did not have a report. I tried the radiology office, and they were closed for Good Friday. I had to wait until the Tuesday after Easter to make that call. Honestly, there was only a tiny little bit of an alarm in my brain and I tried to drown that out. After all, the numbers of women who are called back for additional films are extremely high. I figured it was just my turn.

So, I continued to live life, without fear.

I even went to Walmart. :P Don't know why I was in Walmart that day in April 2006. I'm sure I was there on a mission of some sort. All I recall is while pushing my cart to the checkout, I passed a small display of socks. Pink ribbon socks, with proceeds going to the Susan Komen Foundation. I remember it so vividly, I can probably count how many pairs of socks were in the display. At any other point, I doubt I would have given them a second look. But that day, I stopped. Fleetingly, the concept that I had breast cancer raced through my mind. I remember consciously shoving that thought right out of my brain, reminding myself that EVERYONE gets called back for repeat films. It's no big deal. Especially because a radiologist did not look at my films before I left. No big deal. *I* don't have breast cancer. I'm just going back for another film. So why am I stuck here, obsessed with looking at these &*^#&(%^#$ socks? Why can't I just walk by like everyone else?

I decided I would buy the socks. In memory of my aunt, in honor of my cousin, I would buy these socks with the pink ribbon logo on the ankle. I needed new socks anyway. I would wear them for others and perhaps to remember what some, but not me, would think of as a "close call." Close call.. reminds me of how a relative referred to my diagnosis as a "health scare." It's not a health scare when you actually have the disease. It's only a scare when you think you might, but it all turns out to be A-OK.

Those socks. They sat in my drawer for days. I wasn't sure about wearing them, but I would have to wear them eventually. I really did need new socks. It wasn't until the first surgery was actually scheduled that I wore them for the first time. It sounds like that was such a long time. We are talking about a time period of maybe 2 weeks. Time does funny things when your life changes. At this point, Rachel knew that something had been seen on my mammogram and I was going to have a little surgery to remove "the mass." She saw me take out my new socks to put on. It was then that it suddenly occurred to her, with wisdom beyond her then 9 years, that "the little mass" we had discussed a few days previous, almost just in passing, might be cancer. It was then she asked, with a hint of alarm in her voice, "Mommy, is that "mass" in your breast, a cancer?" {sigh} We run a pretty open household. At this point, I had already had the additional mammo films and we already knew I had cancer (yes.. without a biopsy.. both I and my surgeon knew). So, of course, I had to tell her. It still breaks my heart because I knew at that very moment, she was going to become someone different. She was going to be a little girl whose Mommy had breast cancer. At 9. Not at 29 or 39, like most who learn their mother has breast cancer. At 9. This would change who she was and who she would grow up to be. Not in a bad way, by any means. I'm sure I'll soon be posting a thread about my daughter, her huge heart and the little non-profit company she's created. This is just the sort of thing that changes you on some level and you don't ever get to go backwards and be the person you were before you knew.

So, now it's almost a year later. Those socks with the pink ribbon logo are a part of my normal wardrobe. Time really does telescope. The day when I bought those socks seems both so very far away and like yesterday.


A word of warning- I expect there to be a lot of reminiscing as my "cancer-iversay" approaches on May 1, the official day of my diagnosis.

Tuesday, April 03, 2007

The Lost Photo Saga, Take Two

They've been rescued and recovered!!!!

As I lamented in a post last month, we had a photo accident. All the photos I had taken since my camera came home from Nikon's ICU (intensive camera unit.. lol) were lost. I thought they had been burned on a CD (NOT), so I had reformatted my card and took pictures at my nephew's christening. A friend who owns recovery software offered to take a look. Not holding out much hope, I mailed the card across the continent. Sue worked her magic and lo and behold.... 299 images were recovered!!! The Disney trip and Rachel's birthday included!!!

{insert happy dance here} :D