The Backstory (Part 2)

December 18, 2006: We've waited, endlessly it seems, for the results of the biopsy. I haven't told my family this is going on because, well, I thought it might come out okay in the end and I didn't want to worry them needlessly. Although I tell friends (who are massively supportive), it is still hard.

I make the mistake of calling mid-afternoon to find out if they have the results. Apparently, they do but they can't tell me. I have to wait for the doctor to call and she is away for a conference. They say she might call as she's been checking for messages regularly. I know she will if she can, since she is really really good. Still, when I hang up the phone (I'm at work), I'm pretty darn cranky. Okay, angry. How come they get to know about MY body but I don't?! Hmph.

Joey (who's back from Indiana U for the holidays) and Mike and I go to Ra for dinner. We love sushi and they have great chocolate martinis. We sit down and my phone rings. I can see that it's not a number I recognize, so I'm pretty sure it's my doctor. It is. While Joey and Mike are ordering drinks and food, I'm learning that I have cancer again. Not a recurrence but a new cancer in the other tata. I have to say I pretty much expected this (I think you sort of know somehow) plus I don't want to stress Joey, so I'm on auto-pilot - asking what's next, being matter-of-fact. She asks who my surgeon was last time (whom I loved) so I request him again and she says she'll call me with an appointment time with him. Unless he says otherwise, she says I can wait through the holidays. Mike reaches over and takes my hand, as he and Joey can tell through my end of the conversation what the verdict was. When I hang up, I feel almost too sick too want any food or drink. Mike and Joey both say, "Get your martini". Who I am to argue? Joey, ever the optimist, says "It could be worse" and of course he is right. I get the drink, we eat lots of sushi, and the night is good.

Later, I call my family and now I have to tell them point-blank. My mom and dad, my sisters - all really upset now. Even later, Mike and I process it alone and it's scary all over again and perhaps even worse. Time Number Two. What are my chances now?

January 2, 2007: Mike and I are pretty good at distracting ourselves so we enjoy the holidays. Despite weather delays, my sister Cathy gets here from Denver for Christmas albeit three harrowing days late. Still, there's always the thoughts that come up just when I get into bed at night (and I know Mike isn't sleeping well either) and they can keep me up indefinitely. But a new day is always there and that's a good thing. Today we meet the surgeon. Unfortunately, it's a long wait today. My appointment is at 8:30 but an hour later and we've yet to be called back. Finally, we get called back and they put us in a room that is clearly not a patient room but some kind of closet. Right next to the bathroom where we can hear EVERYTHING that happens there. Also, there's only one chair. VERY depressing so we play word games on my cell phone to keep us distracted.

My doctor comes in. After a few minutes of chit chat to recall us from 6 and a half years ago, he holds up four fingers. I don't know what this means. He says "your hair; it didn't use to look like that?". "Ah", I say. "Nope; this is the post-bald look". He then says what I knew he would say and I was trying to prepare myself for. I need to choose between a lumpectomy and a bilateral mastectomy - the latter because now I've had cancer in both my tatas. I can't decide then and there. He gives me stats; we try to work our way around them. The bottom line is that with either procedure the survival rate is the same. With the mastectomy the risk of recurrence goes down 7%. Neither way is there any guarantee. There are no stats on my situation, which is what are the chances of a new cancer just like this one? No one knows. I worry about mastectomy, I worry that lumpectomy isn't enough, I worry that screening for new cancers won't catch future ones soon enough. I worry about reconstruction and silicone, I worry about my job - my students, my classes, tenure, I worry about my family. The doctor and his resident hold my hand, rub my back and tell me they need my help. They can't make this decision for me. It has to be me. I get a little teary. I just don't know.

The doctor discovers I haven't had a CT scan yet (which checks for metastasis to the lungs and liver) and gives me a week to get that and to decide. As he leaves, he holds his hand above my head - clearly wanting to run his hand over the top of my hair. This makes me smile and, of course, I let him.

Back out in the waiting room, we collect my sister Cathy, who nearly finished an entire 500 piece jigsaw puzzle while we were with the doctor. We fill her in when we get to the car and she and Mike both ask what I would like to do. Coffee Bus this time; you gotta love the power of the bean :0)

January 5, 2007: This is turning out to be one of the worst weeks ever. I don't sleep well; neither does Mike. I buy a lot of cancer books at Border's (all published within the last 2 years) but I avoid looking at them. I talk to my Mom, my sisters, to Mike and a few friends. I don't know what to do. I think I should do a mastectomy but it scares me. A former patient of my surgeon's calls me. Says she has had one and reconstruction. She's really nice but I still don't know what to do. She tells me "knowledge is power" and so I call my oncologist and the plastic surgeon. I get an appointment with the plastic surgeon but not until after I have to see my oncological surgeon again. Well, he'll have to wait if I think it's necessary. There are ways to be in control here.

Today is the CT day. Another needle stick, which doesn't go very well. They have to use the vein under my left wrist (the right arm is out because I have lymphedema there). That's the "last resort" vein, as the CT tech later says. It hurts the whole time, especially when they push the contrast through. Of course, it's temporary and Mike (KISA), takes me to breakfast and a scrapbooking store afterwards. My "all about me" treats. He's wonderful.

A few days later, my best-neighbor-ever calls and for the first time I say aloud, "I think I'm going to have a mastectomy". I tell her it's the first time I've said that aloud. She says I should say it. See how it makes me feel. Okay, it makes me feel sick and terrified.

That night, two nights before my next doctor's visit, I read after Mike has gone to bed. I'm up until 11:30 AM, which is late for me, reading all the relevant parts of the books I bought. When I'm done, I'm starting to think that a lumpectomy isn't a cop-out. Breast cancer treatment has come a long way in the last 20-30 years and mastectomy is not necessarily the only way to go any more. One book strongly advocates breast conservation as a first step unless a woman is in any of five particular situations - none of them are me.

Next day, I talk to Mike. We make a pros/cons list and a list of questions to ask. At this point, we are leaning towards lumpectomy. Mike says this way we don't burn any bridges. Once your tatas are gone, there's no going back. My most persistent thought is that there is no guarantee that a cancer won't reoccur even with a mastectomy; this is scary and also sobering. It makes me more cautious about heading straight for the more invasive surgery because it doesn't actually seem to offer the protection you might think it does. I also begin to think: imagine you have a mastectomy, but there are cancer cells still lurking. With no tatas to travel into, where does the cancer go? Somewhere scarier like my liver? My bones? I know this is ridiculous and not supported by the science (survival rates are the same with either procedure) but I can't help thinking it.

January 10, 2007: My oncologist calls to check in with me (I've been trying to reach her with questions). She has the results of the CT scan and reads them to me over the phone. There are changes in the right lung, probably due to the radiation I had last time. She says "but metastasis can't be ruled out". I feel sick. She says we'll do a PET scan and that should be more definitive. She emphasizes that the report reads changes are most likely due to radiation and that the wording about metastasis is merely a caution. She says she'll try to touch base with us tomorrow when we're waiting to see the surgeon. I feel myself weaken about the lumpectomy. When I hear the word metastasis, I'm thinking, "Take those tatas off!" I eat chocolate after this conversation.

Later we go out to dinner with our friend Andrew. Mike opts to break his "no fat" rule and gets a steak. Even though I'm not fond of steak, it suddenly sounds good. We all get steak, eat yummy veggies and potatoes, talk. We discover that Andrew is actually sick but dragged himself out to cheer us up. People are so good to us; we're very lucky.