The Xanax worked great. I slept easily the night before the surgery, even though I was nervous about the next day. And I was relatively calm in the morning. Even though my fear wanted me to refuse to walk into the surgery center, my feet kept moving me forward. Once I had been admitted and they had gotten my IV in, they let MG, E, and C come back and wait with me for the surgeon. (Again, this was pre-COVID. I miss those days when the patient could have their support people with them during these difficult moments.)
This was my first surgery ever. I was afraid of the possible diagnosis, but what was most upsetting was being on a gurney. It reminded me of my Mom’s crisis that summer; I think for my sister and for me, and that was upsetting. It was scary laying there on that gurney, not really knowing what this was going to be like, and having to put my life in the hands of the medical staff, when my mother had almost died in another hospital not that long ago.
We didn’t have much time to dwell on that before the anesthesiologist came with a syringe of Valium, and after that, I really wasn’t nervous or upset at all. (Since that day, I have known that whenever I am facing a procedure or surgery, I just have to stay calm until they come with the “happy juice” and then I know that it will be smooth sailing from there.) Then they came and wheeled me into the operating room, which was cold and filled with equipment and nurses and my surgeon. Before I knew it, I was out.
Then, for some reason, I woke up. At first, I had no idea where I was. All I could see was blue, which was a surgical drape that they had hanging in front of my face. I think they do this to keep the surgical field sterile, but it also kept me from seeing what the surgeon was doing. I was crying when I woke up, which I have learned is how I react to most anesthesia when I’m waking up. I called for MG, who obviously wasn’t there, and then I called for the surgeon. She answered me. I said I wanted to see her, and she said she was busy, and that I needed to try to calm down. Another moment that is funny looking back on it. Then the anesthesiologist said that I could look at him, and I turned my head to look at him, and the next thing I knew I was waking up in the post-op room. Crying again and asking for MG, with the nurse assuring me that I would see her soon.
Soon I was awake enough to understand where I was and to remember why MG wasn’t with me. Then the nurse moved me to the recovery room, where MG, E and C came in to wait with me until I was ready to go home. First, I had to successfully drink ginger ale and eat some toast. Then, my sister had bought me this teddy bear in the gift shop, which came with a container of peanut M&Ms, and I ate all of them. So the staff agreed I was ready at go home. They won’t let you leave until you pee first, and are able to walk to and from the bathroom without passing out. Then they let me get dressed, which is when I noticed how sore my breast was from the surgery. They gave me more pain medicine, I rested for a few minutes, they brought me a wheelchair, and it was time to go home. MG went to get the car, the nurse wheeled me down to the entrance, and we were on our way home.
As we were leaving, I gave the teddy bear to this young woman who was in the recovery room with her one year old son. He had just had back surgery, not the first of his young life. He had a while to wait before they would let her take him home, and he was getting restless, so I thought he could use the distraction of the new teddy bear.
Recovery from this surgery was more painful and took longer than recovery from the biopsy. The incision was near my left armpit, and I had to wear these front-zip sports bras, which I could get on and off without raising my arms over my head. I could only wear button-down shirts, which was fine, since it was still summer. The bras fit pretty snugly to provide compression, but even so, when I was sitting up or standing, the weight of my breast made the incision hurt. Also, my skin had a pretty painful reaction to the surgical tape that was holding the bandage in place. Every time we changed the bandage, we could see that the rash was getting worse. Eventually, my skin started coming off with the adhesive, which hurt. This reaction to medical tape got worse with every surgery I had after this, so now medical adhesive is always on my list of allergies.
The first time we changed the bandage, I saw the incision and the stitches and got really queasy. I was afraid to even touch it. MG was not queasy at all, thank God, so she had me look away and changed the bandage for me. Over the next few days, it got a little easier for me to look at the incision, probably because it got less bloody and bruised, but I never really got used to it. Bathing after breast surgery was a little difficult, but not too bad; at least, not after a simple biopsy like this one. (Which didn’t feel simple at the time, believe me, but in comparison with my later experiences, it really was.) I had to use a mild, anti-bacterial body wash, and my surgeon told me not to let the water hit the incision directly. At first, the incision was sealed in a waterproof bandage, like plastic. But once that bandage started coming off, we started having to tape fresh, non-stick gauze over it every day. It had to be non-stick, so it wouldn’t pull on the stitches. When I showered, I would lather up my shoulders and neck, and then stand with my back to the shower, so that the lather would rinse down the incision, cleaning it but not letting the water hit it directly.
After about a week, we went in to have the stitches taken out. I was nervous, assuming it would hurt. However, other than a little tug feeling when she snipped the knots on the threads, I didn’t feel anything. After the stitches were out, I could shower like normal.
Getting the stitches out was easier than expected, but hearing the results of the biopsy was not. Dr. G told us that inside the precancerous tissue they found a very small malignancy (tumor), less than a centimeter across, and that I had what they call ductal carcinoma in situ (DCIS)[1], or non-invasive breast cancer. In other words, the breast cancer had not yet escaped its original site in the milk duct nor begun invading the tissue surrounding the original tumor. At first, though, all I heard was the word “cancer.” All I could feel for the first few minutes was the fear that comes with hearing that word. “Am I going to die?” That was the first thing I thought of. Cancer. How could I have cancer? I felt fine. We hadn’t found a lump, I had no symptoms, nothing. We had been talking about the odds being in my favor at every step of this process, but here I was, with a diagnosis of breast cancer. I felt numb, in shock.
Dr. G thought she had gotten the whole tumor out, but she needed to go back in and make sure they had clear margins[2]around the tumor site. This news was almost more upsetting to me than hearing the “C” word. I didn’t want to have another surgery; I was just getting over the last one. Plus, we had reservations for a long weekend in Provincetown, and I didn’t want to cancel it. The surgeon assured us that the second surgery would go just as smoothly as they first, and that we could wait until after our vacation. She said that I would need to meet with an oncologist to talk about treatment options, which would probably include radiation therapy. So we scheduled the next surgery for after our trip, and she gave us a referral to an oncologist. And then MG and I were supposed to go back to work.
You have breast cancer, but you have to go back to work. How do you do the that? How could it be true that I had breast cancer? I felt fine. There was never any lump; the image on the mammogram was just microscopic specks. I saw them myself. How could they be cancer? I couldn’t just go back to work. Instead, we decided to have lunch at the Friendly’s in our neighborhood. We had met at the doctor’s office, so I had to drive myself to the restaurant. Somehow I got there. While I was waiting for MG, I was trying to wrap my mind around this new identity: “breast cancer survivor.” What did that mean? Was I a survivor if I was never sick? What would radiation therapy be like? How could I prepare myself for something I could not even imagine?
More importantly, how could I go back to a job that felt meaningless to me now that I knew I was vulnerable to something like cancer? I didn’t want to die… ever… and have my tombstone read “she wished she’d done something useful with her life.” Back in 2001, I had spent 6 months being unemployed, and MG and I had talked about my going to graduate school for my master’s degree in social work. At the time, the idea of returning to school was intimidating: What if I wasn’t any good at it? What would our lives be like without my income? What if I didn’t like the new career after spending all that money getting the degree? I was just too afraid of so much change, so I didn’t look into it. I just kept looking for another job in my field until I found one. But that day, the day I was told I had breast cancer, I decided that it was time to take the leap. So, for the next few months, while I was going through treatment, I was also applying to graduate school. It felt good to be taking charge of my life in one area when my health felt so out of my own control.
We often hear people refer to cancer as a kind of “wake up call” in their life. It could be about their career, as DCIS was for me, it could be about their relationships, or about how they take care of themselves. There’s just something about being confronted with your own mortality that gives you pause, makes you take stock of your life, inspires you to change those things that don’t work. Unless it doesn’t, which is perfectly fine!
“Life is too short” – we hear that a lot. When you have cancer, life can suddenly feel so short you don’t want to waste any more time doing anything that doesn’t feed your soul or make you happy. This is why some people call cancer “the great motivator.” It's also why some people talk about looking for the “silver lining” of cancer, or even worse, tell you that you should find a silver lining in your own cancer. They talk about the “power of positive thinking,” the importance of having the “right attitude.” What IS the right attitude? Really, nobody has any right to expect any particular attitude from you. We shouldn’t put that kind of pressure on ourselves, let alone on anyone else. If you feel positive at any point during diagnosis and treatment, that’s great. If something positive comes out of your experience, I am happy for you. I also know, from my own experience and the experience of countless other cancer patients that I have known, that even if embrace the idea that a positive attitude will help, even if we find positive moments, we can also have some negative moments along the way. We have pain, we have fear, we get angry, we get frustrated and impatient. We grieve our losses. We ask “why me?” We get sick of people saying “you look great” when we hate the way we look in the mirror. Those moments don’t mean we aren’t being positive. We can be positive and still have negative feelings. Don’t let anyone tell you otherwise.
[1] Ductal carcinoma in situ (DCIS) is often considered the earliest form of breast cancer, or stage 0. In DCIS, abnormal cells multiply and form a growth within a milk duct of your breast. DCIS is noninvasive, meaning it hasn't spread out of the milk duct to invade other parts of the breast. DCIS is usually found during mammogram screenings, but it can be difficult to detect. Because of increased screening with mammograms, the rate at which DCIS is diagnosed has increased dramatically in recent years. While DCIS isn't life-threatening, it does require treatment to prevent the condition from becoming invasive. Most women with DCIS are effectively treated with breast-conserving surgery and radiation (http://www.mayoclinic.com).
[2] Clear margins mean that the edges of the tissue around the tumor are free of cancer cells. If the margins are clear, all the cancer had been removed (http://www.breastcancer.org/symptoms/diagnosis/margins.jsp)
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