OK, so my oncologist made a boo-boo.

He called me the morning after our meeting (at 6:55am to be exact) to apologize profusely and inform me that upon further review of my pathology report, he DOES recommend Tamoxifen. I was a little crestfallen, but it was what I expected all along, so there you go. I was also a bit wary because during our meeting, he gave me his personal philosophy on breast cancer:  that it is caused by prolonged use of hormone therapies, including birth control pills. Now, he is recommending that I take a pill every single day for the next five years?

I had my second oncologist consultation a couple days later. She vigorously recommended the same thing and was the first to give me NUMBERS to the risk: Five years on Tamoxifen CAN lead to an increase of 1 to 2% chance of uterine cancer. 1 to 2%? I thought it was something like 30%. I weighed the 1-2% uterine cancer against 6% invasive breast cancer recurrence (it could show up in the lung, liver, bones, anywhere…).

So I filled the prescription and am now taking the meds. So far, it does not seem like I have any side effects.  Because I’m back on a drain, I’m also taking horse pill antibiotics.  This process is a long one and I am trying to ignore the fact that I can feel the hard tissue expanders in my chest all the time. Occasionally, the pain wakes me in middle of the night and I have trouble going back to sleep. Maybe this is why I’ve been more emotional lately, crying at the drop of a hat again: lack of sleep.

I Googled “emotional stages of breast cancer” and got the following link:

http://breastcancer.about.com/od/lifeduringtreatment/ss/emotion_stages.htm

It’s all true. I am in the final stages of “grief”: acceptance and fight. Sometimes, I grapple with the hope part, because I’ve had setbacks at each stage.  The girls and hubby keep me happy. It’s all a process. This will take a long time, I just need to remember to enjoy all there is to enjoy in the meantime.

OK. I’m back. Here is a short and sweet history of my week:

Monday: Grocery shopping, clean house, pick mom up from airport. Ate nothing after 6pm.

Tuesday: 7am, pre-op stuff. No food or water or even gum. Shots in both breasts for dye to mark my sentinal nodes for biopsy. The Surgery. Post-Op: extremely groggy. Nauseous, not really good. Got up in middle of the night three times to use restroom, vomited copious amounts each time. Discovered my lymph nodes are clean – YAY!

Wednesday: Want to go home. Now. Badly. Had to wait until 5pm. Forced two bites of croissant and kept it down. Walked to the bathroom with the IV stand in one hand and my drain pack in the other. (For more on draining, check it out: http://breastcancer.about.com/od/reconstructivesurgery/p/surg_drains.htm). Dr. Bourne let me go grudgingly. Hubby looked doubtful. He tried to feed me salmon and chocolate cake. 48 hours since I ate something. Wouldn’t have the salmon, too dry.  🙂  Lots of kisses from kids and mom and sister who just arrived from California!  Went straight to bed with three vials of meds on the nightstand.

Thursday: Happy to wake up in my bed. Have to empty and measure drains regularly. Pin them to clothes. Be careful not to tug at them. Looked at the work. Almost fainted. Two tubes coming out of my ribs. Tightly bandaged chest. Needed to re-bandage, too tight!  My sister JoAnne washes my hair in the kitchen sink. Aaaaahhhhh! Feels so much better. By Thursday evening, feeling more like myself. Walked around, wrote a paper.  Started bleeding and went to the doctor. He applies pressure, changes bandages and says I might be able to remove the drains next week! “If you start bleeding like that again, just apply pressure.” I can also take a shower tomorrow! JoAnne picks girls up from summer school. We eat dinner and I crash. (By the way, my chest does not look like this picture. Dr. Shaun Parson did an outstanding job – the drains are on the sides of my body and much of my breast tissue was conserved).

Friday: Wrote two papers first thing in the morning, while drinking coffee. Heaven! Kisses to the girls. Received a steady flow of cakes, flowers, gift cards, get well cards, phone calls and emails. Where is my cell phone? Haven’t seen it since checking in at the hospital….My sister insists on taking pictures, as if I want to remember looking like this. Brother from California arrives with wife and daughter. Josie, Ava and Jae swim in the Hyatt Place swimming pool while Willey and I buy me a new cell phone. We all go out to eat at Hodori for lunch.

Saturday: Take Ava to dentist. She gets sealants. “She’ll need braces,” the dentist informs us. Great. Go home and watch “Samsoon,” an old Korean TV series my friend Grace sent to me by mail. Sister, mom and I are hooked! Sister leaves Saturday night. Brother comes to drive her to airport. It’s all too short, this family time. I decide to forego Vicodin and just take Ibuprofin instead.

Sunday: Happy Father’s Day! I wake up with my chest on fire. It feels like two people took a knife to it. Wait a minute…..they did! Willey takes the girls out while I work on three assignments for The Principalship class. This is the last week of my first summer session and I have many things due. Hoping I can take the drains out tomorrow, they are seriously cramping my style. I looped them on a necklace and feel like a cheap Flavor Fav imitator.

Tomorrow, I see my plastic surgeon and I hope I can get at least one drain removed. It’s disgusting, this plastic vial of blood and waste collects and you can’t get away from it. Every once in awhile, I feel a sharp jab at my ribs and it’s the tube, jutting out. It’s difficult to disguise.  Tuesday morning, I see my oncologist surgeon who will review the results of  pathology report. At that time, I will have a better idea of next steps: radiation, chemo, hormone therapy….not sure yet. I go back to my class Tuesday night.

I’m doing well. Of course, I have moments of anger. Why do I have to go through this? Why can’t I go to Hawaii this summer? Or Canada, Alaska, Austin, TX….anywhere but here, doing this.

But I can’t think that way.

Pity parties do no good. Plenty of very good people are going through much worse. I have to overcome this and overcome it well. My daughters are watching.

Surgery is scheduled for June 15th, exactly one week from now.

I find myself “nesting” as a friend mentioned. She had a medical condition too, congenital heart disease. We spoke of cleaning house, having enough food around for hubbies to zap warm, and so on.  Her story reminded me of how we are all so alike. We react the same way much of the time, it’s just that some of us get handed a bad card and the rest of us say, “How on earth do you handle it so well?”  For one, you would too. You have no choice but to “handle” it. And if you have kids, well, I don’t have to say anything else, do I? We do everything for our kids, our children make us better people.

So now I wait. Friends and family call to check in. They send me stuff to read:

They ask, “How are you doing?” “Fantastic, ask me in eight days!” I dread the recovery. I know, you fans of “The Secret” are trying to hush me right now, but let’s be realistic, shall we?  A radical mastectomy (both breasts for those of you who don’t know) and biopsies of BOTH armpit lymph nodes….it’s not going to be pretty. And I don’t rest well. I’m not a good patient. So mom, JoAnne and Willey, accept my apologies right now for the grumpiness you shall bear.

The surgeon informs me, I will be “Ace bandaged tightly” around the chest following surgery. I’ve asked my sister and daughters to wash my hair.  I’m getting waxed tomorrow. Why? JUST BECAUSE.  I am also getting a pedicure and manicure on Monday. JUST BECAUSE! You’d think I was preparing for a beauty pageant. Which brings me…

to the Plastic Surgeon’s office!

It’s like a spa. It’s housed within a medical building, but when you step into the office, you’re met with several square feet of granite before you make eye contact with the gorgeous receptionist (blue contact lenses, reconstructed breasts).  On a table sits a large, flat bowl of miniature chocolates and cookies, cold ice water with cut lemons await. The women who walk in and out do not resemble the women who walk in and out of the oncologist surgeon’s office. No, these women wear a smile, high heels … they push their babies in strollers, they have lean muscles observable through their Juicy sweatpants and they sport perfect hair.

Talking to the plastic surgeon is a bit like speaking with Santa Claus. Hello, you’ve been so good through this, the poking, the prodding, the cutting and the pain…..what size breasts would you like darling? It’s the gift or reward I have earned. At least, it feels that way. Christina Applegate still mourns her original breasts, “I had beautiful ones,” she recalls. Well, mine have been encased in very padded bras for almost three decades. This might not be so bad.

This summer holds more work for me than I anticipated. But that’s OK. Life happens.  I’ve got my trusty sidekick here, to keep me busy:

I finally told the girls about my cancer and impending treatment (surgery, reconstruction).

Here is how it went down:

Me: “Girls, remember how Auntie Kristin died of cancer?”

(Both girls nod yes)

“Well, when they found the cancer, she was in late stage 3, close to 4. When they find cancer at stage 4, it’s usually too late to do much. There are stages to cancer, 0, 1, 2, 3 and 4. If they find the cancer at 0, 1 or even 2 and sometimes 3, there are lots of things they can do to get rid of the cancer. Usually surgery is used to cut out the cancer and then sometimes you have to take medicine after wards.

They found cancer in my left breast. But it’s …”

Josie interrupts, big smile, “Stage 0!”

“Actually, Stage 1. But that’s good, I’m going to have surgery and they’re going to take it out.”
Ava: “When did you find out?”

“Last week.”

Ava: Why didn’t you tell us right away?

“I wanted to know the date of surgery before I told you.”

Both girls: “When is the surgery?”

“June 15th.”

Ava: How long will you be in the hospital?

“One night.”

Josie: But you’re going to look weird! It’s going to be wavy on your chest!

“They are going to put something in and I’m going to have even bigger boobs, isn’t that great?!”

Both girls: “Ew! Like what?”

“Mmmm plastic bags with salty water in them.”

Ava: They’re going to put Ziploc bags in your boobs!?

“Uh, kind of, something like that. It’s safe.”

Ava: Can we watch Spongebob now?

So there you have it.Clearly, they’re traumatized.

I’m still researching and looking at pictures of reconstruction. I see boobs everywhere. It’s always on my mind. I scar easily and I have hyper pigmentation big time. I am picturing myself post reconstruction and can’t help but see Jack Skellington’s girlfriend Sally in my mind.

The Biopsy was challenging: the wire localization should have taken 20 minutes, mine took an hour. I almost fainted at one point: the pushing of needles deep into my breast was faint-worthy. Add to that the paddles that squeezed my stabbed breast in place and having to take a deep breath and be still….ergh!  After surgery, my breast suddenly swelled up and became hard. Two hematomas were forming. More than a month later, I still have one hematoma, it is hard and rectangular, this breast is already foreign to me.

Five days after the biopsy, I learned the results.

The surgeon broke the news to me in a cold, clinical manner. “You have stage I breast cancer.” I felt my head spinning. Cancer? Me? The doctor spoke of two different kinds of cancer in my one breast: ductal carcinoma in situ and invasive cancer, the more serious one.  He recommended a mastectomy and reconstruction. I could do radiation and forego the mastectomy in a bid to save the breast, but he did not recommend that. “I wouldn’t wait more than three weeks before taking action.” He relayed the information to Willey, making eye contact with him, as I sat crying, the reality hitting me like a swarm of locusts. His words buzzed relentlessly, surrealistically.

I still had to go back to school for an evening event. I had spoken of the event all day to my 27 third grade students. I couldn’t be a no-show.  I wanted to feel normal so I washed my face and went to work, mingling with former students and their parents, talking to current students and parents and meeting (possible) future students and their parents. Oddly enough, I felt energized as I drove home. The next two weeks were tough. I cried without warning: at work, at home, at the grocery store. Three weeks later, I started to compartmentalize my fear and sadness: I cried only when taking a bath. While soaking, I looked down at my hardened, bruised breast with two scabs: one a smiley face, the other a frown. The entire breast was shiny and wrinkled, covered with a surgical glue in lieu of stitches, numb.

As far as cancer diagnoses goes, I am very, very lucky. At Stage I with microscopic cancer, I have several options and good odds to obliterate the cancer. Years ago, no one would have detected it this early because you can’t feel it at all. The new digital machines at EVDI caught it.

I received two more consultations before weighing my options: breast conservation? One mastectomy and no reconstruction? Bilateral (double) mastectomy and no reconstruction? One mastectomy with reconstruction? Bilateral mastectomy with reconstruction? And if I choose reconstruction, should I wait or do it immediately?  There is a 1% chance with each year that passes that the other breast will develop cancer (therefore, in 25 years, there is a 25% chance I would develop cancer in my right breast). I do not want to go down this road again in the future, if I can help it.  Many decisions to make: which surgeon, which plastic surgeon, whichprocedure to do….Mind boggling, given the fact that just a few weeks ago, my most serious decision was whether to get eyelash extensions or not!

The stages you hear about in cancer usually have to do with the size of the cancerous mass as well as the type. My case is on the serious side because one of my “masses” is the invasive kind. We know what invasive/invading means….and you can surgically remove it, but the chances of it recurring are extremely high. Hence, the recommendation for a mastectomy.At stage one, my cancers measured 4 mm and 5 mm. Stage 4 includes tumors 5 cm. in size.

Maybe if I was 80, I would simply opt for a bilateral mastectomy and be done with it. But, I am *relatively* young (Hey! I heard that!) and a bit vain, so I am opting to have reconstructive surgery, too.

It sounds rather obvious, but this brings the sense of mortality front and center. Don’t we all assume we will live to be at least 80? Faced with the chance that I may live just a few years….I had to reassess my life.

I am grateful I have:

• a new network of thriving breast cancer survivors;
• a career I love;
• a strong, loving husband, two beautiful children;
• wonderful, thoughtful, generous friends and a dedicated extended family.

Each day counts. I purchase more organic foods now and drink lots of green tea. I’m going to continue with my plan to complete my Principal’s certificate and MA in Education Administration. I see this new diagnosis like a triathlon. I have no desire to do a triathlon, but I know I can do it.