Fast Forward

I think every girl should get a pedicure before surgery. Let's face it: you won't be wearing anything at all while the doctors work on you, so you might as well dress up your toes. Mine were an iridescent blue-green that reminded me of peacocks. I had a white flower with dashes of hot pink and black and a tiny rhinestone on each big toe. No Jimmy Choo shoes, but I would say my toes had a little extra something going on.
     I guess I'm getting ahead of myself, though. I'll admit that things went awfully fast, and I don't think I've caught my breath at all yet - but let me back up a bit. Mike and I drove home from Morro Bay on the last Sunday of Spring Break. We spent the Saturday after hearing the news pretending that we hadn't heard anything. Sunday was a long drive home and a full work week to start immediately on Monday. My doctor had told me she would send the surgeon she recommended an email asking for an appointment on my behalf. We expected something later in the week. I had a morning class, co-taught with a friend, and attended that. I got back to my desk to a message from the surgeon's office: could we make an appointment that afternoon? Yikes. Mike wasn't even on campus and so would have to meet me there.
     When I got to the office, Mike was already there. I filled out all that irritating standard paperwork that makes you wonder what the point of it is. They already know my phone number because they called me. The system is the same as for my medical oncologist, so it's perfectly well available already. It makes me grind my teeth. I remember during Cancer #2 writing in silly things just to see if they noticed, something to do with a daily intake of chocolate. No one ever said a word.
     The new surgeon impressed us both as being utterly brilliant but also as someone trying very hard to have a comforting bedside manner that isn't the norm for her - as if she read a manual on how to do it and was determined to make it work. To me, it made her even stiffer, but that was okay. She didn't need to hold my hand or hug me; she just needed to be good at her job. And I truly do think she has a good heart. She reviewed the pathology from the biopsy with us and basically said she just didn't think a lumpectomy was on the table this time. She said that if I opted for anything other than a bilateral mastectomy, she would worry about me. My cases have always been what they now call "triple negative", which has to do with various tumor markers they check in the pathology. Triple negative cancers are typically much more aggressive, fast-growing, and don't respond to hormone therapy. Lucky me. I'm also BRCA1, which means it's in my genes to get cancer. She had an analogy she used that I still remember. She said it's like when you type text on a computer. If you make a mistake, you can hit the backspace key and fix the mistake. But DNA doesn't work that way. The DNA that carries the BRCA1 mutation in my body is just going to continue to replicate the mistake. No backspace key for me.
     Also, all of my cancers have been what they call "new primaries". This means that they are not metastasis from previous cancers but brand new ones - and different types every time. The surgeon said the only way to minimize the effect of the BRCA1 mutation is to take away the breasts. They can't control anything but that. And, no, it's not a guarantee even if you do it. The cancer can show up in the scars. But the risks become much much lower if you take away the tissue where that mutation likes to show up. Okey dokey, then. Didn't seem like much of a choice to me. My only choice was whether to put new ones on when they take the old ones away. Oh, and whether I was willing to allow the tissue (that would be my breasts) to be used for research purposes. I signed a bunch of papers agreeing to that. After all, I wouldn't be needing them anymore. Someone else might as well get some use out of them.
     The appointment to talk to a plastic surgeon was set for Friday with the promise of surgery the next week or the week after that. I felt like I'd been hit by a semi and was lying flattened on the road, just like Wile E. Coyote, except he always bounced right back up. The ride home, with Mike and I in separate cars, was the longest one of my life. I just kept thinking: "I just want to get home; please just let me get home." Did I mention that the surgeon's office is clear on the opposite side of the city from where we live? It was a long long drive, alone, and I had no idea how Mike might be doing.
     Just the other day, many compliments later, I finally removed the nail polish from my pedicure. It occurred to me that I might have kept it on so long because it represented the time BEFORE: before Cancer #3, before my chest became as flat as a man's, before I took a step that would launch me into a different way of thinking about my body and my life. As I removed the polish, I felt like I was removing pieces of myself.