Why?

One of the great spiritual questions of the universe. Why do things happen? Why do bad things happen? Why do bad things happen to good people? Why do bad things happen over and over and over again to the same really good people? It's not fair. It's a pisser. It's not character-building. It's not because some almighty someone thought we could handle it or had a grander purpose. It just sucks. There is no way to explain it away. This sentiment may offend some of you, which is not my intention. But it is MY sentiment and it is how I feel.

We found out today that my mom's lung cancer is inoperable. It's not untreatable, but it will most definitely be a long, tough fight involving chemotherapy and radiation. Mom's a fighter and she'll fight with everything she's got, but her life will be forever transformed. She always has been a fighter, in her proper, southern, ultra-polite down-home kind of way. She and my dad were fighters when their son Tommy, my brother, battled and lost his fight with cancer at the age of 3, nearly 44 years ago. They were fighters when my dad's brother Dick, battled and lost his fight with cancer many years ago. They were fighters when both of my grandfather and my mom's brother lost their battles with cancer. They were fighters individually as they defeated breast cancer and prostate cancer, respectively. They were fighters when I, their then-17-year-old daughter, fought and thankfully won my battle with cancer 25 years ago. They were fighters when my cousin Karen lost her battle with breast cancer at the age of 40.

When I was sick my mom and I would talk about how I was "building character." Well damnit, we've got enough character! In one of my last conversations with my cousin Karen, she said "What's up with our family and cancer? What's that about?" I don't know, Karen. I don't know.

Just five days ago, as my parents sat by my bedside awaiting my surgery, they were fighters, upbeat and positive and absolutely there for me. I love that they were here for me, and wish I could be there for them more than I can from 350 miles away. They've returned to Bodega Bay where they are this evening, just the two of them, alone with each other and their thoughts of what is to come. Please send your love and positive energy their way. My mom will tell her own story on http://www.carepages.com/. But we are so intertwined that her story is my my story and my story is her story. Such is the bond between mothers and daughters. I never thought we would be battling cancer together. What a sad, sad irony there is in that.

I continue to heal and take comfort in the love of my family and friends.

To Love and Be Loved

Yesterday I saw the plastic surgeon. He took out my surgical drains ... awesome and unbelievably painful at the same time. He then sat down and proceeded to voice all of the fine print about my procedure. As I mentioned yesterday there was some discrepancy between the plastic surgeon and the cancer surgeon regarding how much skin to remove. So my plastic surgeon reiterated that he had less skin to deal with than he had expected, and that because my chest had been irradiated, even 25 years ago, I was at a much higher risk for "problems" resulting from the tissue expansion. I asked what kind of problems and he indicated that wound healing could be much slower. At the same time he said, "If you were my wife I would have elected to do the exact same thing, I just want you to be aware of the risks." I was a little miffed that we hadn't had this conversation prior to the procedure but after really talking it through I wouldn't have done anything differently.

When I asked him what I should be concerned about he said a few things. One, previously radiated skin potentially heals much more slowly, so he wanted to wait for complete healing before beginning the expansion process. This could be as much as 2 - 3 months. Ugh. Before expansion we need the incision to be absolutely positively 100% healed.

Two, previously radiated skin may not have the elasticity needed to expand appropriately. My breast skin, however, looks very healthy and stretched very well when I was nursing all three of my daughters. We all took this as a good sign. Even the doctor. While I vividly remember horrible burns to my underarms (hence no shaving) during my radiation treatment, I don't remember any problems at all with my breast skin. They blocked out my lungs from the radiation and I think the breast skin was blocked out as part of the package, so I'm optimistic that all will be fine.

So what can I do to ensure the best results? Stay still ... sort of. There's a fine line between not wanting to stretch too much and being so sedentary that the recovery process drags on. I'm allowed to raise my arms high enough to feed myself, which I'm doing with great gusto. But I'm not allowed to raise them over my head or do anything that puts a strain on the sutures.

The doctor's going to follow me as a high risk case so I'll see him every week for the next few months. Next Tuesday he'll remove the dressing, which I'll await with great anticipation. I've got very sensitive skin and am not only reacting to the tape, but also am apparently allergic to one of the antibiotics they gave me as I've broken out in a rash all over. Because I can't lift my arms, and even if I wanted to it would hurt, I've had to enlist a team of scratchers. I remind myself of Balloo the bear in The Jungle Book when he says "I've got to find me a tree ..." and then he has a really good scratch. I've managed to identify my own forest of tree-like objects around the house. It's a good thing there aren't video cameras around!

My recovery has been tempered with the news that my mom does, in fact, have lung cancer. She'll know much more tomorrow about the treatment protocol and what happens next. The waiting has been excruciating so I'm thankful for her that at least some of the answers will be forthcoming tomorrow and she should emerge with a plan of attack. It was so wonderful to have both of my parents here as I went through the surgery. You're never too old to want your mommy and daddy, I suppose. It's both wonderful and sad that in times of family crisis you truly realize how important family is and become much more overt about expressing your love for the important people in your life. I encourage you all to say "I love you" to someone today ..., and please know that I love all of you ...

Ta Ta to the Tatas

The last 24 hours are a blur but I'm back home, on my big comfy couch, surrounded by my family, just like nothing happened. Of course there's the small fact that I no longer have breasts. Well at least not really. When I woke up and checked my bandages, I was surprised to see that with all of the "infrastructure" the surgeon put in to support my future implants there's really not much of a net loss ... at least at first glance. That's either sad, ironic, or just plain funny, but fortunately modern medicine will take care of that!


I know you've all heard that the surgery went well and my nodes were negative. My stay in the hospital was, in fact, less than 23 hours ... of my own choosing. While I've been nothing but ultra-impressed with the care I've received from Sharp Healthcare ... everyone's been just fabulous ... I had to complain about my roommate. She was elderly, very petite, and quiet as a mouse ... when she was awake. When she slept she snored louder than a grizzly bear! Thankfully the combination of earplugs and morphine allowed me to drift off in spite of the background noise. Yesterday morning when I awoke I really wanted to be at home. There was nothing they were doing there for me that I could't be doing at home, so I made the decision to check out as soon as they would let me.


One of my guardian angels, Jen (whom I met in a carwash ... more on that later) is here and has jumped right in to surrogate mom mode. I've got a bell by the bed, a baby monitor to hear my every request, and she's currently at "Bagels and Books" with the girls, reading at school. Last night we enjoyed a fabulous meal of tinga, painstakingly concocted by our dear friend Brenda. My parents were still here to enjoy it and there are plenty of leftovers. Jen arrived with enough food to fill the freezer as well, so we are set for some time.


As for how I'm feeling? Ouch. Not terrible pain but definitely painful. The incisions under my arms are the most bothersome because of where they are. I'm under instructions to not raise my arms any higher than needed to feed myself. Interesting that the general "cancer" surgeon told me I have no restrictions on movement, but the plastic surgeon said "don't move any higher than you can feed yourself." I guess he's in charge now.


Prior to going into surgery both surgeons were there, purple markers in hand, negotiating over where the incisions would be. The plastic surgeon started by drawing very small incision marks, but my general surgeon stuck to her guns and said "I'm getting the cancer out and all that goes with it ..." which meant she had to make a larger incision than the plastic surgeon would have preferred. It was important for her to not only take the tumourous tissue, but also the skin above it to ensure the margins were clear enough. Apparently the plastic surgeon was a bit "miffed" when he discovered what he had left to work with. I was out cold but grin now at the thought of these two very professional and competent doctors arguing over the state of my breasts while I was spread-eagled on the table.


I see the plastic surgeon this morning for follow-up. He indicated to Bill that because he had to deal with less skin than originally thought, we would likely wait 4 - 5 weeks before beginning the expansion process. This will allow the skin to heal and stretch in preparation for the next step.

As far as further cancer treatment, I'll see the oncologist on the 9th. By then all of the pathology reports will be in. Apparently they're going to slice and dice the tissue they removed to determine unequivocally what we're dealing with. Hormone receptors and all that jazz. Given the nodes were negative, it's quite possible that I will NOT have chemo ... I'm trying not to get my hopes up for that because I'm committed to taking the most aggressive path possible to ensure this disease doesn't come back, and isn't hiding somewhere right now. It only takes one cell. I learned that the hard way with my experience with Hodgkin's Disease 25 years ago. The initial treatment involved surgery and radiation to my upper body only. 18 months later I relapsed in my groin area, so there was a rebel cell somewhere ... So we'll see.

I can't say thank you enoug for all of the positive thoughts, prayers, and good wishes. I love you all!

Gold Medal Page

Hi there. Bill here. After a very long but successful day, Page is resting up in her hospital bed under heavy sedation. As eloquent as she is on most days of the week, I think under the circumstances it's best that I write on her behalf. This post's title "Gold Medal Page" is not intended the reflect the quality of my writing, but rather my lovely wife's tremendous bravery, gumption, and penchant for still thinking about trips to the tropics, even in the face of impending major surgery.

Let me just first say that the oncology surgeon had both sentinel lymph nodes tested (to determine if the cancer had potentially spread outside of the breasts) and both nodes tested negative. This is just exactly what we were hoping to hear. Not only does this mean that the cancer is almost certainly limited to Stage 1, it should also likely mean that she will not need chemotherapy. Hurray! We're all just ecstatic about it.

Page will be discharged tomorrow "in the pm." That could mean anything from noon to 5 pm. I'll touch base with the attending nurse in the morning and we'll see about the game plan. I was able to take the girls over to see her tonight, along with Page's folks. Since Sofia, Tess, & Rose have all to some degree been under the weather lately, they wore surgical masks while on Page's floor. Page is sharing a room so each girl went in to see her one by one. Page was fairly coherent at the time, so they had the chance to chat and see that mommy is okay. Each of them prepared a nice card for their mom. Sofia even created an award, through the use of her strong computer and writing skills, which was someting akin to the Tin Man being granted the heart that he already had. Page was noted for being a survivor and a tremendous mommy. Well there you have it.

I think it was a nice relief for her folks to be there as well. They are here until Wednesday. Of course we can all benefit from motherly and fatherly love, no matter what our age, and naturally parents always want to check-in on their little ones.

The response from all of our wonderful friends and family members has been nothing short of incredible. Thank you so much to all of you for your marvelous positive thoughts and prayers. Everyone keeps saying they want to do "something." By caring and sending us all of your positive energy and prayers, you are all doing some kinda thing.

Kind regards,

Bill

The Time is Upon Us

Well, it's almost here. I'm both thankful to be getting on with it and apprehensive about what's to come. Thank you SO MUCH to all who have called, emailed, sent cards, visited, or just sent good vibes. You're all so wonderful and I am truly blessed to have each and every one of you in my life. Bill will be updating this blog tomorrow evening with the results of the surgery and node biopsy, so stay tuned.

I would like to make a request. For any of you wanting to do something tangible to show your support, please consider making a donation in my name to the Susan G. Komen Breast Cancer 3 Day. My neighbor Arlene, who did the walk last year, signed up again after my diagnosis, and will be walking on my behalf. You can access her donation page at:

http://www.the3day.org/site/TR/Walk/SanDiegoEvent?px=1300746&pg=personal&fr_id=1187

I also have two former co-workers who are walking, Colleen and Amanda. You can find their pages at:

http://www.the3day.org/site/TR/Walk/SanDiegoEvent?px=1830429&pg=personal&fr_id=1187 for Colleen and

http://www.the3day.org/site/TR/Walk/SanDiegoEvent?px=1574801&pg=personal&fr_id=1187 for Amanda

Our friend Vaychan, who walked with me back in 2004, joined Bill and I in 2005, and has walked in every San Diego 3-Day since. You can access her page at

http://www.the3day.org/site/TR/Walk/SanDiegoEvent?px=1574801&pg=personal&fr_id=1187

Give to one ... give to all four! The cause is obviously important to me but even moreso for my daughters (and yours), in the hopes by the time they are adults breast cancer will be cured.

Thanks again to all of you. Will write more, probably lots more, in the days and weeks to come.

Damn That Damocles

There's a phenomenon known as the Sword of Damocles. It's the Greek equivalent of waiting for the other shoe to drop. It's something cancer survivors live with forever. Nearly 24 years after completing my treatment for Hodgkin's Disease, the fear still lives within. It was waning somewhat, as I would go perhaps days without thinking or fearing of cancer's return. Of course now it's back, probably for good. In some ways I welcome the return of the fear. It will help me to focus on the present, and live each day with awareness and attention to the important things in life. A dose of perspective is always a good thing.

In my case I think I always knew, deep down, that it was not a matter of if I got cancer again, but rather when. I've said to many that if what I'm going through now is the price for the last 24 years, including my three beautiful daughters, it's a very small price to pay and I would do it again in a heartbeat. My upper body received a lot of radiation ... more back then than they would prescribe today. They blocked out my lungs and my heart with lead, but because my breast tissue was developing at the time (I was 17), it was extra sensitive to the radiation exposure, hence my increased risk. The chemotherapy I had after I relapsed did a number on my heart ... serious enough that my oncologist changed my regimen after two cycles. The radiation has also caused a number of skin cancers ... basal cell carcinomas. I've had three removed so far, some from places where the sun doesn't shine so we know it was the radiation at work.

Fortunately for me and my new tatas the radiation didn't do too much skin damage. It can potentially damage skin to the point where the tissue expanders won't work because it's too leathery. In my case the doctor's confident that I'll stretch just fine. Woo hoo.

So the sword of Damocles once again hangs everpresent over my head. There's something oddly empowering about being in the throes of medical science. I know when I'm through this ordeal I will have been fully inspected from head to toe. That will provide peace of mind, as will the ongoing follow-up that, according to my oncologist, will happen consistently for the rest of my life.

Tommorrow is the day before my surgery. I'm anxious, I'm scared, and I can't wait to get on with it. My parents arrived today. It's wonderful to have them here, though bittersweet given my mom's situation. I'm so thankful that the universe made it possible for them to be here with me. I know it's important to both of us.

Tomorrow I'll spend the day organizing ... getting everything in place so that life in the Donovan household can go on as usual while I'm out of commission. I have an amazing network of friends who have arranged for around-the-clock care for me for the next week. I hope to get back into routine within the next couple of weeks. As a wise woman and friend said to me recently, I'm going to take it one day, one hour, one moment at a time.

Quick Update

I had my pre-op appointment yesterday with the surgeon. The good news? The roto-rootering of my right breast showed NO cancer on that side. Just fibrocystic stuff. After speaking with my doctor, however, I have elected to do the sentinel node biopsy on both sides to provide the peace of mind that we've searched everywhere for cancer and will treat according to what we find. As I learned with my first experience, it just takes one renegade cell to support a recurrence later.

The sentinel biopsy is more involved than I had thought. I'll go in Sunday for an injection of a radioactive tracer (wonder if I'll have an even more glowing personality at that point?). Monday morning I check in at 8 a.m. for "lots of pictures" to be sure the tracer's doing what it's supposed to do.

Surgery is scheduled for 11:30 and I'll have the dynamic duo of breast surgeon and plastic surgeon working together. They will inject some blue dye into the lymph system (while I'm snoozing) which will guide them right to the sentinel nodes on both sides (It will also make me pee green for a few days, apparently). Those will be removed and tested. If they show no evidence of cancer, we're done. If they show any evidence of cancer, they will remove additional axillary nodes on the appropriate side.

I'm relieved to know that after this ordeal we'll know pretty much exactly what we're dealing with. I asked the doctor what the chances are that there is cancer somewhere else in my body. "Practically zero," she said. I'll take it. We're just determining whether I'm Stage 1 or Stage 2, both with a 90%+ survival rate. Final stage will determine final course of treatment.

The surgery will take as long as 5 hours then I'll be in recovery for another hour or two. They still have me booked as an outpatient, which is shocking, but I've been assured that I'll spend at least one night in the hospital. Good thing cuz I'm really looking forward to that dose of morphine!

Someone will update this blog when I'm out of surgery to let all of you know what's going on. I'll likely wax philosophic over the weekend before the surgery so you'll hear from me again before Monday. Thank you Thank you Thank you for all of your thoughts, prayers, offers of help, support, jokes, etc. I'm the luckiest person on the planet to be surrounded by such an amazing group of family and friends.

Ciao!

The Picture of Health

Aren't we the classic American family? Don't I look healthy? Crazy, isn't it, that I've got a life-threatening illness? Go figure. I find myself living a very double life at the moment. I know I'm sick, but the world at large has no idea.

Take the guy at the gym. I've been trying to get to the gym to work through the stress and anxiety that are often stifling. When I'm there, I work out hard. I sweat. I tune out. I focus. I breathe. It helps.

I was on the recumbent bike, reading my book about breast cancer. This middle-aged guy looked at me and said "You must be a runner."

I say "Nope, bad knees," turning back to the paragraph about surgical drains.

"Oh," he responded. "I just noticed your shoes and strong legs. You seem really focused on working out."

"Oh, my shoes. Well I bought these to do the Breast Cancer 3-Day Walk a few years ago."

"You walked for three days?" he said, in disbelief.

"Yep. 60 miles."

"Without sleeping?"

"Well, no. We walked 20, then slept, then another 20, and so on."

"Why would you do that?"

At this point I was laughing inside ... wanting to jump up and push my book in his face. "Because women like me, who look healthy and strong, get breast cancer and it turns their lives completely upside down. It takes mothers from their children, wives from their spouses. That's why we walk."

But I didn't say that. It wasn't his fault that I was sick, or that I didn't look it. I didn't tell him that my six-year old daughter, when she learned I had cancer, wanted to stage her own walk through the neighborhood so that I would get better.

"It's a very fulfilling experience and it raises money for breast cancer research," I responded. Back to my book once again. Moving on to mastectomy bras. Whoopee.

On Tuesday morning I was face down in an MRI tube having a very uncomfortable biopsy done of my right breast. They had to scan me, numb me, poke me, then essentially roto-rooter seven biopsy samples. After the 45-minute procedure was done, I sat there chatting with the very nice radiologist as he held a gauze pad on my breast to stop the bleeding. He know what I had and what I was facing.

Three hours later I was presenting in front of a large homebuilding client in Orange County. "If you want to maximize the efficiency of your online advertising spend, your best bet is a combination of pay per click and rich media display advertising," I told the group of six.

Ouch. The anesthetic is wearing off and I feel like there's a knife in my breast. Oh no, what if it starts bleeding while I'm standing here? "And it's critical to determine what your measure of success will be. Are we looking for impressions? Conversions? Phone calls?"

Now I feel woozy, and no one in this room has any idea what's going on inside of me. Weird. I get through it and make my way home, where I collapse in bed.

The great irony of this disease is that not until they are working to heal me will I actually look sick. By this time on Monday my body will be forever transformed. While it can be restructured, and some would argue made even better than it is now, it will never be the same. If I have chemotherapy, I will not only feel sick from the poison that will fight the cancer, but I will look sick as my hair falls out and my white blood cell count drops. It could be months before I once again look healthy without the aid of makeup, wigs, and prosthetics.

But I will be healthy. I will feel healthy. I will look healthy. And I will once again where the badge of cancer survivor with honor and pride.

The note to self for today? Never assume that the way a person looks on the outside is any indication of what's really going on on the inside.

Lizards and Lamborghinis

Friendship. Especially girl-friendship. What an amazing, authentic, unconditional, unpredictable thing. Last night I met three dear friends for dinner. We've tried for the last several years to get together at least monthly, but were generally lucky if we made it quarterly. This time we set a record. I sent an email on Thursday. "I need my girlfriends before this all starts." Lo and behold everyone made it on Monday. There's that silver lining again ... Four hours, and two pitchers of margaritas later, we hugged in the parking lot. Bittersweet. What would I be like when I saw them again? Would it ever be the same?

Because this disease isn't picky and touches so many, my girlfriends knew some of what I was facing. Like the fact that I won't be able to lift my arms for a while. The restaurant was in a shopping center with a Ross and an Old Navy. They arrived with bags in hand. "What did ya get?" I asked. "Oh, we'll show you inside." Fully expecting to see cute clothes for one 10-year old son or another's 3-year old daughter I was truly stunned when they presented me with all of the bags. Full of zip-front comfy sweatsuits and button-front cute shirts for me to lounge in during my recovery.

There was also a necklace. A pale green leather strap with four discs on it ... each carrying a different word. Health. Patience. Joy. Live. ... Yeah. I'll take one of each, please.

And then there were the hand-knit scarves, made with love, all within two weeks. Four of them. All pink, yet distinctly different. Mine has small bead fringe sewn on the end. Tess's is fuzzy. Rosie's is fluffy. Sofie's is neither fluffy nor fuzzy nor frilly ... perfect for her. Mom's is classy, as it should be. All in the shape of the traditional pink ribbon. One for me. One for each of my girls. One for my mom. "A tangible expression of my support," the card said. More are on the way for each of the women at the table and a few others who are flanking me through this battle.

We talked a lot about breasts. "How big are you thinking?" "Are you and Bill going to have a going away party for them?" "What exactly is the reconstruction process?" "What kind of bra will you need as you're going through this?"

Then we got silly. We talked about my Del Mar plastic surgeon and the fact that my new bustline would be valued at somewhere in the neighborhood of $30,000. How crazy is that?

"I can't wait to take you to the Wizard of Bras," Jen said. "It's THE place to get fitted for a bra in all of Southern California. We'll make a day of it." Having not fully heard Jen, Carol responded, "The Lizard of What?" We laughed loud enough to turn heads.

We then mused that the cost of a bra there was probably $500 or more. "Well I wouldn't expect anything less to support my $30,000 boobs," I said. "You can't fill a Lamborghini at the Arco station," said Carol. "Yeah, that's what I'll say to Bill when he asks why I didn't just buy bras from Target like I usually do."

We laughed. Out loud. Belly laughs. For four hours.

Conversation turned serious here and there, but only for a little while. "You need to tell us what you need from us. Whatever it is."

"I need this." Friendship.

Un-Effen-Believable

Inconceivable. Incomprehensible. Un-f-in believable. There's no other way to describe it. Yesterday my mom was diagnosed with cancer. Either lung cancer or a metastasis of the breast cancer she had in 2000. The irony of our family situation is beyond comprehensible. I'm more than a little pissed off at the universe at the moment. What exactly am I supposed to "learn" from this? What "good" can possibly come out of this situation?"

The image at right was created by my dear friend and graphic designer extraordinairre. She shared the irony of the use of the term un-effen-believable as she had used it the very same day as I had. Thanks Denise!

We'll know more next week. Her treatment plan will vary depending on the final diagnosis. I won't say much more here ... I'll allow mom to tell her own story, but please keep her and my dad in the circle of those positive thoughts and prayers coming our way. Those who would like to stay abreast of mom's situation can visit the page my dad set up at http://www.carepages.com/carepages/LouiseMericle/updates/1667231 (you can set up an account to receive an email when there's an update). Those of you who know my parents, and especially those in Northern California, please do whatever you can to support them during this really shitty time (no other way to say it), especially since I am unable to be there at least in the immediate term.

As for me, I'm progressing toward my surgery date of 8/25. I went in for an ultrasound biopsy of the right breast on Thursday. The good news (I think) is that they couldn't see anything on ultrasound. They want to be sure whether there is cancer on that side so on Tuesday I'll have an MRI-guided biopsy. For those who've been in an MRI machine, I have NO idea how they're going to do that ... stay tuned. I lie in the machine face down with my boobs hanging down in two little spaces. The treatment plan will be the same either way, but if there is something on the right side they'll take a sentinel node from that side during the surgery. Even if they can't get it with the MRI I'd prefer they just take the node (means one more incision ... ) so we can know for sure. I'm being as aggressive as I possibly can with this thing.

I called the surgeon this week to find out how long I should plan on being out of work. "A month," she said. I laughed out loud. Really. "A month? I was thinking a week..." Her turn to laugh. "Well if you do that you'll be the first one."

A month. Wow. While every ounce of me wants to be back in the saddle right away, I've surrendered to the doctor's guidance and am planning to be off for a full month, returning part-time after that (dependent on the long-term plan, chemo or not, etc.). I can always return earlier if I feel like it. At the urging of many loved ones I've also instructed my company to turn off my email so I absolutely cannot access it ... at least for two weeks. That will be a first in ten years, but I know that any energy I do have needs to go to myself, my kids, and my parents.

Today we're having a professional family portrait done on the beach in Carlsbad. I've been wanting to do this for years but we just haven't gotten around to it. My diagnosis was the kick in the pants because I want a picture of the way we are, and the way I am, with boobs and hair intact. I know there will be many more pictures in the future but I also know in my heart that I, and we, will be forever changed.

Thought for the day:

"It is health that is real wealth and not pieces of gold and silver.”

~ Mahatma Gandhi

Savor.

Dimples are a Girl's Best Friend

I've done my self exams since I was 35. Once a month, according to instructions. Now it's no secret that I'm not exactly Dolly Parton-esque, so I always took comfort in the fact that if I couldn't feel anything, so there must not be anything there because there was literally no place to hide.

This, my 43rd year, has definitely brought noticeable changes to my body. Joints creak. Eyes squint. Weight is more stubborn. Arms are less firm. So when I looked in the mirror about two months ago and saw a small dimple on my left breast I thought, "Great, now I'm getting cellulite in my itty bitty breasts ... what's next?" I of course immediately did an self exam ... pushing, prodding, poking to find anything that felt lumpish. Nothing. "Maybe it will go away, I thought."

Then I proscratinated. Funny how that works. I knew I should get it checked out but kept thinking I'd wake up one day and it would be gone. There have been so many times when I got myself all worked up over something that ended up being nothing. I've perceived that doctors thought I was a hypochondriac. I've worked myself into a tizzy only to find it's something "perfectly normal." After a couple of weeks, I made the call and set the appointment. The doctor wasn't available so I was to see the nurse practitioner. When I got there for the appointment it had mysteriously disappeared from the schedule. "No big deal," I said. I'll just reschedule. So I rescheduled for the following week.

When "Dr. Phil," the nurse practitioner, entered the room, he said "So you're here today for a scary thing." Zing. "I wasn't scared until you said that," I replied. He found nothing upon exam, but consulted with my primary care physician and they both agreed we should be aggressive in finding out what was going on.

Next stop, a diagnostic mammogram. I have no idea how women with large breasts endure those things! Results were inconclusive. There was "something" that "didn't spread out quite right" so they sent me down the hall for an ultrasound. Just like when I was pregnant ... but not really. The tech took some ictures, left the room, came back, said he needed to take some more pictures. I was watching the screen, but really didn't know what I was looking at. There were these black spots. "That can't be good," I thought. But nothing was said.

The tech left and returned with Dr. Gurney (what a name!), the radiologist. "There are three nodules that we can't identify." That led to biopsy which led to my diagnosis.

Last week I had an MRI that showed "something small but suspicious" on my right breast. I'll have another biopsy tomorrow. My treatment plan won't change, but if the right breast turns out to have cancer in it then the doctor will take a lymph node from that side.

Bill and I marvel at the fact that, were it not for the dimple I would have gone about my business at least until my next mammogram, which is six months away. By then the cancer would be larger, and may have spread.

So my message to all of my girlfriends out there: Do your self exams. Question everything. Take charge of yourself and your health. There's so much riding on it.

The Silver Lining

So with every cloud, there's a silver lining. Since my first go-round with cancer, I've never had to shave my armpits ... the hair just doesn't grow. Every woman in the world would probably say that's a silver lining, right?

As word of my current situation gets out I'm getting a flood of support from around the world ... I admit it's wonderful to be so loved but also somewhat overwhelming as it makes this whole ordeal seem so much more real.

Yesterday I received the following from a dear friend who's wife is battling a brain tumour. He's about three months ahead of us in the experience and shared the following observations ... very insightful for both me and Bill:

While I don’t know the set up in your hospital, I have found that many waiting rooms are very bland and uncomfortable. However, very often the waiting rooms for Neurosurgery and other expensive treatments are quite plush and often have free coffee, as opposed to a pay coffee machine. In my case, I found a room that had a free espresso machine. Tell Bill to give his cell number to the nurse and then make his way to the nicer waiting rooms. I also found that crackers and cookies are commonplace in the better rooms. Of course he can do the same on follow-up visits.

Cell minutes. As more people call in to check on you, your cell minutes go quickly. Again, find a good waiting room, or even a “patient consultation room” that has a phone. Normally you can make outgoing calls. I let my calls go to voice mail then called them back on the hospital dime. It’s a nice service that the hospital provides, even if they don’t know it. Both of these tips work for your surgery and follow-up treatments.

Should you need to order food while you’re there, the patient gets all the food they want for free. However, if Bill sucks up to the nurse a bit, they may end up ordering you, Bill and the girls a nice lunch. I enjoyed a really nice stuffed shell pasta with a vodka red sauce, along with a Caesar salad and Izzie drink.

You will likely have some down time. This can be difficult since you won’t be feeling well and sometimes there isn’t anyone around. So, here’s my advice:
You can rent all of the seasons of Grey’s Anatomy on disk. While it may remind you of your situation, it’s a really compelling show. Sex and the City is normally a spirit lifter, or so I’m told. I’m a guy, so I really don’t know. The Wire and Generation Kill are outstanding HBO series’, but wait until you’re feeling better for those as you will likely have had your fill of drama.

Now, as to hooters. I’m sure you’ve been considering b and c cups. But as melons go, bigger is always better. You don’t need to go for knee shooters, but the extra expense you might find with having to purchase new undergarments will be well worth the decision to go with larger Bazoombas. According to your blog, going with D cup knockers may not be something you’re thinking about. As I am a male, I am passing along for your consideration that larger gazongas can make you feel more feminine and open doors. Quite literally, if the silicone hardens up you can just push open the door at Starbucks with those puppies and not have to bother with your hands which are likely carrying your purse and your Lord and Taylor bag.

LOL. I'm thinking there's an opportunity for spouses of cancer patients to write a heckuva guide book, don't you think?

No new news as of today ... still on track for surgery 8/25. Looking forward to a quiet weekend letting all of this sink in. thanks again to all of you, especially my dear friend with the dry wit for his invaluable perspective on the state of my Bazoombas.

There's a Pony in There Somewhere

The story is told of twin boys of five or six. Worried that the boys had developed extreme personalities -- one was a total pessimist, the other a total optimist -- their parents took them to a psychiatrist.

First the psychiatrist treated the pessimist. Trying to brighten his outlook, the psychiatrist took him to a room piled to the ceiling with brand-new toys. But instead of yelping with delight, the little boy burst into tears. "What's the matter?" the psychiatrist asked, baffled. "Don't you want to play with any of the toys?" "Yes," the little boy bawled, "but if I did I'd only break them."

Next the psychiatrist treated the optimist. Trying to dampen his out look, the psychiatrist took him to a room piled to the ceiling with horse manure. But instead of wrinkling his nose in disgust, the optimist emitted just the yelp of delight the psychiatrist had been hoping to hear from his brother, the pessimist. Then he clambered to the top of the pile, dropped to his knees, and began gleefully digging out scoop after scoop with his bare hands. "What do you think you're doing?" the psychiatrist asked, just as baffled by the optimist as he had been by the pessimist. "With all this manure," the little boy replied, beaming, "there must be a pony in here somewhere!"

This story has been the unofficial anthem of my journey with cancer and, by extension, the difficult medical experience of those I love and even those they love.

When I was diagnosed with Hodgkin's Disease in 1981, my mother's dear friend Stanley Sullivan sent me a small pewter pony, along with this story. That pony stood watch over me throughout that ordeal. When I was once again healthy, I began to share the pony. My best friend Jen had it with her while going through greuling infertility treatments. My cousin Karen had it with her as she fiercely battled, and ultimately lost, her battle with breast cancer. My mother had it with her through her breast cancer and subsequent health challenges. The original pony is now in Oregon, with a close family friend who continues to battle breast cancer, among other ailments. I have given ponies to friends facing tough times. By now there's a sizable herd of them, prancing across the prairies, both in this world and in the next.

Today, Jen gave me a pony. Small enough to be discreetly placed in a pocket or held in a hand wihle talking with doctors, or lying face-down on an MRI table (as I did yesterday - boy those things are loud!). Standing tall and proud, a shetland I think, all of 1-inch tall. I now feel prepared for the battle in front of me. I have my pony to help me navigate the uncertainties, rise above the dung, and charge into the sunset in search of a day beyond cancer.

Yee ha.

The Great Divide

Clinical Update: Had another very informative day. Saw the plastic surgeon and learned more about breast reconstruction than I ever thought I'd need to know. Surgery is now scheduled for August 25. All docs have assured me there's no risk in waiting a couple of weeks ... apparently breast cancer is a very slow growing evil thing. So, I've got a couple of weeks to get through the mountains of paperwork, make my final decisions about the first phase of treatment (one versus two, B-cup or C-cup . . .), and leave my office and clients in some state of organization.

Today I have an MRI to check my other breast and insure there's nothing suspicious on that side. Even if there is it simply means the doctor will take a lymph node from that side. Shouldn't change much else. Also a chest x-ray and EKG ... the final pre-op work-ups that need to be done. Then I can get back to living for a couple of weeks to get things in order. Unfortunatley this was the only MRI time they could fit me in and I had to give up my ticket to Phantom of the Opera with my friend Jen. Ah, priorities ...

I'll be in the hospital for 23 hours ... not 24, that would make me an inpatient and insurance says I have to be an outpatient. Apparently they've come a long way with mastectomy procedures and they can be an in-and-out thing. I will spend the night, and I'm sure will welcome at least one dose of morphine. The good news, though, is because the operation does not involve any bone or muscle, it's a very straightforward procedure. The reconstruction piece is actually far more involved. There are a couple of different ways to approach reconstruction: natural tissue reconstruction where they take skin and fat from somewhere else on your body, and implant reconstruction. I'm not a candidate for the natural tissue kind because I don't have enough tissue anywhere to spare ... I think that's a compliment??? So, implants it is. During the surgery the surgeon will do what's called a "skin saving mastectomy" ... saving as much of my skin as possible while still removing all of the suspect tissue. The plastic surgeon will be there and will insert skin expanders ... little balloons that will go between the chest wall and my skin. These will sit on top of a very expensive material ($11,000, I was told) that will lend support to my future bustline. The balloons will be gradually "inflated" with saline ... once a week ... until they are the size I want. At that point the plastic surgeon will replace the expanders with your basic implant and address the other "cosmetic" things associated ...

I must wax philosophic about the dramatic differences between the environment and patient population at the oncologist's office in Chula Vista, versus the plastic surgeon's office in La Jolla. While every doctor I've ever seen has sterile white exam rooms and hands me a paper gown, the plastic surgeon's exam room is painted a soft green, decorated with artwork and a large mirror, and they handed me a black satin gown. All of the women in the waiting room were very well endowed. The cute young things behind the desk, all of whom must receive free services as part of their benefit package, were clearly not used to dealing with "sick people." I questioned the insurance process and referrals. She said "so you haven't been here before?" I said, "No. On Monday I was diagnosed with breast cancer. This is the fourth doctor I've seen. I just want to be sure all of the referrals are moving ahead as they should." Her response: "Oh."

Word is clearly getting out and I so appreciate all of the phone calls, emails, and positive energy. It's overwhelming to be loved by so many. Please know I love you all too ...

A Good Day

Yesterday was a good day. Hard to believe I'm saying that after the news I received the day before. Nevertheless, it was a good day. We ended the day feeling much better than when we started.

It began with our appointment with the surgeon. Turns out she's only 10 days older than I am and has young children. Instant bond. I couldn't help thinking that under different circumstances had we met we would have hit it off greatly. I think we'll be friends when this is all done. Her news was good. The cancers are small. A physical exam does not indicate they've gone beyond the breast. That said, because of my history I'm not a candidate for radiation, and one of the cancer types, she believes, is a marker for much increased risk of a future cancer in the other breast. For these reasons, she is recommending a double mastectomy with reconstruction. At this point they're calling it a Stage 1 cancer, that's a good thing. They believe worst case would be if the lymph nodes were positive and then it would be Stage 2. Either way I'm looking at pretty good odds ... 95% and 90%. I'll take em.

Yesterday afternoon we met with the oncologist. A very different personality than the surgeon. 50-ish Iraqi graduate of the University of Baghdad with a wall full of American credentials. Very black and white ... "just the facts" kind of guy. Very optimistic. Two things he said that I remember: "What are we going to do with such a healthy girl?" and "Your prognosis is very good." He will not make a decision on chemotherapy until a few more tests are done and we know if the lymph nodes have joined the party or not. He is not a proponent of the double mastectomy but concurs that the cancerous breast needs to come off. His rationale is that, because I now have this diagnosis I will be closely followed for the rest of my life. Even if another cancer did arise on the other side, it would be caught early. So my decision is do I want to just deal with it now and have the peace of mind that I won't be putting myself or my family through this again ... I'm leaning in that direction but again weighing all options.

Today we meet with the plastic surgeon to understand all of my options regarding reconstruction. There are many and they all have different pros and cons in terms of all kinds of things ... most importantly recovery time and likelihood of success. Then there's the whole size issue :-) Tomorrow I have an MRI. By Friday they'll have all the info they need to finalize my treatment plan and schedule surgery.

So, I now take off my patient hat, put on my mom hat, get the kids to school, then head to work to get caught up on all kinds of things. It's a very busy time with much to do. I told my close peers at work yesterday and they were all really great. Will tell the team that reports to me today. Word definitely got out yesterday as the emails, text messages and phone calls started coming. Please keep em coming but be patient with a response. Tonight and tomorrow night are Back to School night. This weekend will hopefully be restful.

And so it begins

Today I was diagnosed with breast cancer. Infilltrating ductal carcinoma. I got the news from my doctor this morning while I was sitting in the middle of an executive meeting. With the words "There's cancer in there" a flood of emotions overtook me, many of which brought me crashing back to 1981 when my parents entered my room and said "You have cancer, but it's curable." The reaction was the same as well ... disbelief, fear, sadness, anger ... Yet the similarities ended there. The first time, I was 17 years old and selfish. I only had myself to worry about. I felt immortal and figured it was just another one of those things to get through. Mom shuttled me from doctor to doctor, I drove myself to radiation treatment. I stayed in college and flew home every three weeks for my chemo injection. I was cured.

More than 26 years later I'm happily married with three gorgeous daughters. The stakes are now very, very high and I'm now more worried about the people I love than about myself.

Bill is shell shocked. He hasn't been through this before though in our nearly 20 years together he's aware of the realities. We told the girls tonight. Rosie, 6, ran away in tears when she heard the words "This is about mommy." Tess, 9, after joking about the dreaded "family meeting," immediately said "You don't have cancer, do you?" When I responded "I can't say no, honey" she burst into tears and jumped into my arms. She said "Promise you'll be OK" over and over and was unwilling to accept any other outcome. Sofia, 10, was very stoic ... obviously just processing everything she had just heard. Unable to cry and mad at herself because of it. My parents were initially shocked but kicked right into their supportive, optimistic selves. While I was talking to my parents Sofie and Tess went upstairs to call their friends ... not to tell them, but to share that they were sad. Everyone had trouble getting to sleep. It's 3 a.m. and I still can't sleep.

Though the years have passed, the ironies are the same. Cancer doesn't hurt. I don't feel sick. Yet the treatment I'm facing will make me feel awful.

Tomorrow we see the surgeon. It's the next step. From here it's probably surgery, then radiation and chemotherapy. Lots of questions ... a very long list. My best friend Jen came over as soon as she heard the news and helped me make my list. The big question we all have is "what is my prognosis?" While I'm optimistic based on what I know today, the next few weeks will be dedicated to finding a definitive answer to that question.