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Friday, February 5, 2016

Scanxiety or Opportunity?

I woke up this morning at 4:30am, wide awake, thinking what if instead of choosing to be filled with anxiety about my annual breast MRI, I instead take this opportunity to revisit my mortality and think about the quality of my life in the face of that mortality?  Similar to what you reflexively do when you are first diagnosed with cancer.  Except that now, you are NOT facing a horrifying diagnosis, you are just being forced to think about it a little, until you get the next all-clear.

Onondaga Lake March2012

It's been eight years since my bilateral mastectomy and reconstruction - January 30th 2008, and the completion of chemotherapy - April 30th 2008.  Every year I have a breast MRI, and every year it's a stressful experience.  There's the stress of having to face the possibility of recurrence, which on most normal days you can pretend isn't there. There's the stress of going through the scan, laying face down on that weird foam form, and how painful it can be, the feeling of the contrast as it enters your veins, the way the contrast in your body afterwards reminds you of the way that chemo felt in your body. And for me there's the additional stress of having trouble getting the IV in.  This year, it took 3 needle sticks - one by the tech in the crook of my elbow and the 2 other by the IV specialist in the middle of my forearm and finally, the one that worked, on the side of my wrist. I've had worse - 2 years ago it took 5 needle sticks; I felt like a pincushion.

The day of the test is always a rough day for me physically, but it's hard to separate that physical stuff from the emotional stuff. So I spend a day or two leading up to the test in a state of anxiety, as well as the week between the test and my follow up with my breast surgeon. Who, most likely, will say "all clear."  Of course, knowing that is the most likely outcome would not be causing me anxiety; instead, that anxiety comes from my fear of the other, less likely announcement. The one that, for whatever reason after all these years, is easier for me to imagine.  The "it's back" announcement.  After all, it's happened before. 

In 2007, what should have been a routine mammogram after 5 years of being free from my first breast cancer turned into a repeat of the diagnostic nightmare from 2002, only this time it was invasive cancer.  So that's always there, the possibility that it could happen again.

I have tried over the years to turn this annual scan into "my annual clean MRI" with mixed success. I think I have less anxiety in the days leading up to the test, but I'm still way more freaked out than I want to be. But this 4:30am wake-up was reality-shifting. What if this IS just an opportunity for me to remember what's really important about my life, what I love about it, what I want to change, what adventures I want to have, how satisfied am I with the work I am doing now, what is the quality of my relationships... lots of things to think about that I CAN do something about, rather than focusing on the one thing I canNOT do anything about. I can't know if cancer is in my body, and I can't predict what my surgeon will see in these MRI images. So how can I find a way to focus on something else?

So here's what I can say about my life. It's a great life.  I'm healthy and active, and have the good fortune of getting older. My wife is absolutely the best partner in the world for me. I'm so grateful that I found her when I did, and that she has been with me through all of the trials we have faced in the last 16 years.  Her family, my in-laws, are totally awesome. Her Dad is the best Dad you could ever hope for, and somehow I get to have his support and help. I am so grateful that I got to know her Mom as long as I did. Her siblings are really loving, caring people and completely hysterical at the same time. As are their spouses. And I love my nephews and niece - just the one - on that side of our family. Love watching them grow up, seeing the kind of young people they are becoming. As much as I love knowing and watching the nieces on my side of the family. My relationship with my youngest sister is supportive and encouraging for both of us. I have a good relationship with my older brother. I have great friends. I choose to focus my energy on the relationships that are positive in my life, which I have not always been able to do. I love my job, and the work I get to do in that job. I love the amount of choice I have in my work, and that I can make a decent living doing it. I enjoy the mutual respect between myself and the senior faculty in the institute. I am fortunate enough to have long-standing relationships with like-minded colleagues around the country, and the chance to travel to conferences multiple times a year where I get to interact with those colleagues.

It's all good. This year, we visited Nova Scotia for the first time. I still want to visit Alaska and New Zealand. And Ireland again, always Ireland again! I still dream about traveling around the country in an RV with my wife - although not in that off-the-grid way that braver women than I are living (you know who you are!).


Whatever may or may not have shown up on this scan, my life is good, and I choose to focus on that. And I will make that choice, as often as I need to, for the next 6 days until I can confirm the results of the scan.