Signs of Life (Ch. 8)

I have had a curious kind of Spring; topsy-turvy. Instead of new life growing in nature all around me, I found a lump in my breast and cancer growing within me. As I journeyed through the acceptance of my disease and the aggressive treatment I chose to undergo, my view of my future changed. Instead of assuming I would have decades to watch my kids grow up, I thought, “what if I don’t?!” and tried my best to be more loving and affectionate. Instead of waking up in the morning and wandering around in my pyjamas with my hair standing on end, I thought, “what if I lose this hair in a few months, and look shitty even if I try to look pretty?” and showered, styled my hair, and put on makeup. I looked at my enormous garden space and accepted that I would have times when I wouldn’t have the strength to dig in the dirt and pull the weeds. I begrudgingly admired the beautiful hanging baskets full of flowers that my furry man went out and chose (something I wanted to do desperately) because I knew if we waited until I was feeling up to it, the season might pass us by. All that time, I was waiting for the surgery incisions to heal, so I could meet the oncology team at the Cross Cancer Institute and forge ahead with the chemotherapy I was told I would need. All the while I wanted my body to heal quickly, I also wanted time to slow down before I had to head into a summer of unknown chemo side effects. There was nothing I dreaded more, now that I found out I could survive general anesthesia and Bodacious Ta-Ta Tuesday.

While I healed, we had follow-up visits in Edmonton, with my plastic surgeon. As the stitches on my breasts faded, and my transplanted tissue started to feel smoother and look as close to normal as I could hope for, and as my abdomen incision slowly closed, my doctor always asked the final question during our visits, “Do you have any questions or concerns?” And Markus would ask, “How soon can she travel?” Dr. Schembri’s eyes would crinkle as he smiled, and he would say, “If you promise to stay in your chair and not do any gymnastics while you are there, you should be just fine to go to your high school reunion.” We have been asking this question ever since we met him. The only high school reunion I would ever go to is not just for any old high school. The high school kids I always want to reunite with are from the Taipei American School. We were a tiny little school in Taiwan. Our experiences growing up there have cemented our friendships, and I am never quite as comfortable in my skin as I am when I am with a group of TAS graduates. This recent reunion was an idea that my friends Dacia and Kerri had come up with last year. Any time you bring a few TAS graduates together, anywhere in the world, we call it a reunion. Dacia planned the reunion at her parents’ B&B in Anacortes, Washington, a little spot of Heaven in the San Juan Islands. Through the winter, we put our heads together and had so much fun planning and chatting about it. When I got hit with Barnard in the Spring, I realized that surgery would probably take a huge bite out of my plans for the May reunion. One more shitty thing that I came to accept this Spring… Until Markus caught me reading the Facebook page for the Anacortes reunion wistfully, and told me, “We are going to get you there. This will be your reward for the surgery and kicking Barnard’s ass. You do your job and rest properly like the doctors order, and I PROMISE you we will get you to that reunion somehow. Being with your friends will be good for you. You’re going.” And that is where the Question came in during our visits with my surgeons, “How soon can she travel?” So ever since March, when I first met with the surgeons, we worked toward the May 24th goal of the Anacortes TAS Reunion. A better carrot, there never was. On May 24th, 1 week shy of the minimum 6 weeks recommended recuperation period, I hopped on an airplane in Edmonton and headed out to Anacortes. Missing only one piece of luggage, I met my best friend Duncan Hsu (I call him Punkin Poo and he calls me Poo Pest – my favourite nicknames from childhood) at the baggage carousel in Seattle, and spent the next 2 hours driving to Anacortes while catching up on the last 3 years we had missed together. Arriving on the sleepy little island of Anacortes, Dacia, Kerri, and my other friends tumbled out of the cozy little house, and their hugs took away all the residual pain of both the surgery and the worry of cancer. We spent the entire weekend laughing non-stop. There was crying, but only when it was time to say goodbye. My friend John made an announcement that he was going to join my CIBC Run For the Cure team, The Suepremes, and fundraise for the Canadian Breast Cancer Society. He passed around his hat and said that he would shave his head at the end of the weekend. He raised hundreds of dollars, and I did indeed shave his precious head at the end of Sunday evening. I had to catch an airport shuttle at 1:45 Monday morning, so I never went to sleep on Sunday. And when it was time to go, each friend hugged me and wished me well, knowing that I was flying home to meet with the oncologists in Edmonton, to face chemotherapy. Collectively, their love and support floated me out the door and up into the sky back to Canada.

When I landed in Edmonton on Monday afternoon, I took a taxi straight to Dr. Schembri’s office for another visit. He does a little victory dance every time he examines me and sees his precious babies, “They’re PERFECT! So PERFECT!” He told me that the sections on my abdominal incision would take some time to fully heal, as it was healing from the inside-out, but that I am indeed Wolverine, as Markus labeled me; my body is healing like a superhero. Knowing I was meeting with the Cross Cancer Institute the next day, to discuss chemo, he said to give him a call in 3-6 months and we could talk nipples. I can’t wait to make that call and get him on the line and say, “Hey there…let’s talk NIPPLES.” I don’t know anyone else who has ever made such a phone call. That one is going to give me a giggle, that’s for sure.

Markus and I rendezvous-ed at the Fairmont Hotel MacDonald later that afternoon, and we braced ourselves for our afternoon at the Cross Cancer Institute the following afternoon. Actually, I mostly just slept, having exhausted myself during my reunion weekend. On Tuesday, we dilly-dallied our morning away, and reluctantly made our way to University Avenue and the Cross Cancer Institute. In the parking garage, we passed ladies on their way back to their cars, scarves covering their heads. I couldn’t swallow past the lump in my throat. Markus grabbed my hand and squeezed it tightly and we slowly walked into the lower level of the institute. The very first department we passed was the Wig Department and the rooms where they conduct makeup and beauty tips for those undergoing chemotherapy. I resisted the urge to peek into the door, thinking I would get the chance to see plenty later…

Upstairs at the main registration area, we realized that we were over an hour early, but I stood in line and filled out the paperwork anyway. They made me a special red plastic I.D. card that I would need to bring to every appointment or treatment. I did not like that card. That card was my fear made tangible. I stuffed it into my purse, hoping it would get lost among the mess of receipts and lipstick that lived in there. Then, the registration lady gave me to a volunteer, who was told to bring me to my appointment area. As we walked through the centre, the volunteer pointed out the various areas to us; the lending library, the information department that would be very helpful with resources for families, the 2 cafeterias, the gift shop, the pharmacy, and the labs. The facility is huge. Finally, he deposited us into our waiting area, where a nurse had me fill out more paperwork and instructed me to change into a trusty hospital gown and robe. Then, we were shown into a room where we were told to wait for our different visitors.

Our first visitor was a heavily pregnant young nurse named Magdalene. I kid you not. For someone who has recently lost some of her faith in this unfair scuffle with cancer (if good things happen to good people, and I try my best to be good my whole life, how the Hell did I get cancer, EH?! Explain THAT one, God…), this was a little bit of a punch in the stomach. I had to take an extra breath to answer her questions, as my mind kept whispering, “Mary Magdalene was a best friend to someone who had so much more to suffer than you, Sue.” After Nurse Magdalene left, Markus and I made silent eye contact until our next visitor. She was a soft-spoken representative of the Cross Cancer Institute Tumour Bank. After all of my tumour was removed during the mastectomy, and the appropriate amount was sliced and sent to pathology, the leftover bits had the potential to be deposited into the Tumour Bank to be used for research in the fight against breast cancer. She was there to ask my permission to use the tumour for research, and to make the deposit official. As I signed the papers, I wondered, who ever would NOT give permission? If they could make some use of Barnard and somehow benefit future cancer patients, why on earth wouldn’t I sign? I just had to give a few tubes of blood to accompany Barnard to his future home in the Tumour Bank, and GOOD RIDDANCE to Barnard! That was a very cool feeling, knowing a bit of me was going to stay in the institute and perhaps help others.

Our final visitor was a Nurse Practitioner by the name of Margaret Ann Vlahadamis. She was very dry and stood over by a white board across the room from us. Markus took my hand, and we held our breath. With a very stern look on her face, NP Vlahadamis said, “First of all, before I write all the details and numbers on this board, let me tell you this: based on your tumour’s stage and grade, the oncology team has determined that you will need no radiation and no chemotherapy.”

no. chemotherapy.

There was a ringing in my ears, and I shook my head…what was she saying? Focusing on her lips, I could see her saying, “Breast cancer is fought with several different types of treatments. There is surgery, there is radiation, and there are many types of chemotherapy. You should know that your double mastectomy was a major treatment by itself. Your cancer was completely removed. The pathology revealed that it was a 1.4cm Stage 1, Grade 1 tumour; very slow growing. Your 3 sentinel nodes revealed no lymphatic spread, and during surgery it was found that there was no lymph vascular infiltration within your breasts. It is hormone receptive, but HER2 negative and not Triple Negative cancer. You were very fortunate to catch your cancer early, and for the next five years, you will only need to take one Tamoxifen pill each day. You will have 6 month wellness visits with your family doctor throughout that time, where you will be checked for possible metastasis of the breast cancer into other parts of your body. And that is all.”

Stunned, not believing this could possibly be true, I actually ARGUED with the poor woman. What about my extensive family history?! Won’t that increase my odds of recurrence? My cancer surgeon had warned me to expect chemo. How could it be that I’m all done, that there is nothing further to suffer through?!

After patiently explaining that my family history of breast cancer has nothing to do with the treatment of the breast cancer we removed – WHAT?! (they focus on treating the cancer they hold in their hands – on its characteristics, not on what my future could develop). That my cancer was removed completely by my mastectomy and the Tamoxifen would starve any microscopic bits that might be floating around in my body. That my family history of breast cancer would only be a concern for my ovaries and fallopian tubes down the line, and I would need to approach that outside of this visit. Only then, did she patiently say, “This is GOOD news…”

And only then did her words sink in. No chemo and I am done with the fear of Barnard. I turned to Markus with a lost look on my face; all my anxiety was still built up inside – where was I supposed to put it? Markus repeated what NP Vlahadamis said, “This is GOOD news…” I decided to stop fighting it. Even though I was SURE they were mistaken, that this was too good to be true, I decided to play along. I was confident someone would catch the mistake in a few days and call me with the corrected news and tell me to get myself into chemo…So I turned back to her and smiled and asked what I should do next. She told me to take my new prescription to their pharmacy, and she would be calling me in a few weeks to see how the side effects of Tamoxifen were treating me.

In a daze, I changed back to my regular clothes, and joined Markus in the hallway. We kept looking at each other in disbelief, then he would grab me and laugh out loud and cheer. In the pharmacy waiting room, he sat across from me and kept asking, “What shall we do to celebrate?!” We giggled and said, “I can’t believe it!” too many times before I looked around and realized I was surrounded by people who were suffering from cancer, waiting for their prescriptions, who didn’t have any good news for themselves. Sobered, we listened to the pharmacist explain about the many side effects of Tamoxifen (Hello, Menopause) and grinned when she politely whispered about “vaginal dryness and discomfort” and the various solutions for that. I can buy a fix for vaginal dryness on the shelves of my local pharmacy…can’t say the same for cancer, right?

Tamoxifen grasped in my hands, we retraced our steps to the car; past the cafeterias, past the information centre, past the lending library, and finally past the wig department. I touched my hair and murmured, “I’m keeping my hair…” Markus whooped and hugged me.

In the car, he told me that he was getting dozens of responses to his good news post to my friends on Facebook. He urged me to tell my friends and family right away; that everyone would be so relieved and happy for me. How could I tell him that I secretly could not believe the good news? What if I made the announcement, and I got a phone call the next day, crushing me with the opposite news? I flapped my hands and told him I would write it later. I couldn’t even call my own children to speak the words out loud; I was so scared I would jinx things. We bought a feast at the T&T asian supermarket, and brought it home to the kids. The whole family was giddy with the news, while I sat there quietly wondering. Late that night, I cautiously wrote about my day, sharing the news on Facebook, then sat back and waited for the phone call I was dreading. I put off writing in my blog, thinking I would make it officially good news if nobody called me with bad news in a few weeks.

This week, I got a phone call from a private caller. A voice sounding just like my best friend asked for me…so I yelled, “PUNKIN!!!” and there was a long pause…then, “Uh um, no, my name is John Mackey. I am a medical oncologist from the Cross Cancer Institute.” I swallowed my immediate panic, and laughed and explained about Duncan/Punkin and that his voice was an exact match. With a smile in his voice, John Mackey replied, “Well, if Duncan has the same voice as me, then he must have a very nice voice indeed, haha! I was asked by Doug Goss to review your pathology and double check that you are having the appropriate treatment…he said you are a family friend? I just need your verbal permission over the phone before I open your medical file and read it” Still panicked, I mumbled yes and waited…This was the phone call I was waiting for – finally someone realized that they messed up and my cancer wasn’t all gone and I would have to go to chemo after all and lose all my hair and get sick and be tired and maybe maybe I wouldn’t live as long as I wanted to… There was total silence as he read over my file. I think I held my breath the entire time. When he started to speak, I still couldn’t breathe. He said these magic words, “Sue, based on what I am reading, you can be sure that the cancer has been removed and is gone from your body. The Tamoxifen is precautionary – 5 years of starving any possible cancer that could have been missed on a microscopic level. You should feel confident that you are well. Now, let’s talk about your family history and what that speaks to.” I floated as we discussed genetic testing and I complained that testing positive would endanger future life insurance for me and my children. He paused and said, “Um. You have already had breast cancer. That horse is out of the barn. Life insurance companies will discriminate against you and your children because of that, regardless of the genetic testing results.” I had to laugh when I realized I had totally forgotten that I have breast cancer. It feels good to forget. By the end of the phone call, he had recommended I discuss prophylactic removal of my ovaries and fallopian tubes with my gynaecologist, and wondered if I was ok with that; with early onset menopause. I reassured him that I was done using my ovaries, that the Tamoxifen will imitate menopause for the next five years, and as my mom went through menopause early, I expected it was around the corner anyway. I thanked him for his time and hung up, posting the funny phone call on Facebook. Immediately, my friend Wendy, who lives in Edmonton and is wading through the cancer war like me and knows every doctor out there, posted, “Dr. Mackey is the best oncologist in Western Alberta. You are very lucky indeed!” Holy shit. So, another guardian angel has landed and now I have officially lost track of how many of them are in my life. How blessed am I.

Today, we went to pick up a friend from the hospital in Hinton, and took a little side trip to the garden centre in Canadian Tire. I chose new veggies to replace the ones that have been eaten by frost in our garden, new herbs, beautiful flowers, and seed potatoes. On the ride home, we listened as our friend told us how lucky she was that although she had fallen off of a 20 foot cliff while rappelling, she was wearing a helmet and managed to not break any bones. I shook my head in disbelief, and then I stopped myself. I need to stop this denying of good news. I told my friend that I was so happy that she was safe, and that I was amazed at what a great adventure she survived. How blessed was she!

After we brought our friend home, we settled into gardening. Markus worked on the flowers in the back yard, and I worked on planting pumpkins, tomatoes, beans, cucumbers, and cabbages in our vegetable patch. The sun shone down warm on my shoulders, my knees got dirty, and I sweated. Every spadeful of dirt I dug up was rich with pink wriggling earthworms, and every leaf on every plant glowed green with life. I sat back on my heels and looked around me. My topsy-turvy Spring was over. As I breathed in the warm fresh air, I realized that Summer was here, and I was surrounded by new life. I can dig in the dirt and pull weeds and let my hair get messy. I can plant the vegetables that I know I will harvest in the Fall. And I can look at those hanging pots of flowers that Markus chose, and I can see that hummingbirds have come, attracted to the colourful blooms. Ganbaru feels extra good in the sunshine!

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I’ve Got MacGyver, Paul Bunyon, and The Suepremes – Barnard Hasn’t Got a Chance (Ch.2)

Today, March 12th, my breasts and I met my surgeon in Edmonton. All I knew about the doctor in advance, was that the name was Dr. D.W. Olson. Images of characters from children’s television shows floated through my mind. I pictured Arthur the aardvark’s little sister D.W. (old PBS animated series), married to Nellie Oleson’s little brother Willie (from Little House on the Prairie), sporting a white coat and chopping off boobs. That, plus the warning from my Nurse Navigator (more on that later), had me a little bit nervous to meet the Knife. “Sue, I want you to brace yourself and not put too much store in the surgeon’s manner. Surgeons can sometimes come across as clinical and lacking empathy. But those characteristics are also the very same characteristics that make an excellent surgeon; they spend most of their time with you when you are unconscious, not chatting with you. If your questions are answered and you feel confident in the surgeon’s experience and explanation of all of your options, don’t let the bedside manner dictate whether or not you choose this one to be your doctor.” Needless to say, I was a fretting bundle of Useless during the drive.

It takes 4 hours to drive from Jasper to Edmonton, so Markus and I kissed the children goodbye and shivered into the car at 6 o’clock this morning. During the boring and seemingly endless drive, we had plenty of time to discuss what we hoped to achieve with this visit, and what questions to ask the doctor while we were in his office. Being in the early stages of my breast cancer journey, I have to be honest that Markus and I are also struggling a bit with our new roles. The furry man wants to be my best cheerleader, and take everything onto his own shoulders. I am much more practical, and I know that even superheroes can burn out unless they take a break or ask for help. These are early days – I want him to mellow out and save his energy for the hard days of clearing drain lines dangling out of my chest, and cooking and cleaning if I need to spend time as a chemo zombie. He thinks I should let go and let him take charge. I think he should reach out and ask a few people to bake some lasagnes when I go in for surgery down the line. Hess Tough vs. Treppenhauer Stubborn…much head butting and growling ensued. Markus is reading a very good book titled: Breast Cancer Husband; How to Help Your Wife (and Yourself) Through Diagnosis, Treatment, and Beyond. It has taught him invaluable things, like how to read pathology reports, how to write down everything the doctors say to me, and how to stay calm in the face of a frightened PMS-ing wife who seems to be losing her mind. Normally my furry man is the light in my life, keeping me smiling and laughing. This morning, his own worries plus my hen-pecking transformed him into Serious Markus. I hate Serious Markus because then we are BOTH grumpy. In the parking lot of the doctor’s office, I told him I don’t like Serious Markus; that I want my funny man back. He pointed a finger at me (I won’t say which one) and said, “Then stop BOSSING me, woman! Hess Tough sucks when it’s me that gets it. Trust me. I’m going to take care of you. I got this.” Message received; Hess Tough Torpedo Guns have been aimed elsewhere.

Enough soap opera; back to the Journey! A Nurse Navigator is the main angel in a special program that we have up here in Paradise (aka Canada). The Alberta Comprehensive Breast Care Program takes patients that are at high risk for cancer; patients like me that have discovered a lump, or had abnormal mammogram results. We are pulled out of the sometimes confusing mainstream of our national healthcare system, and fast-tracked toward the appropriate doctors, procedures, and cancer centres that we need, cutting to the front of the line of any waiting lists. If further tests come back negative, those patients are bid farewell are sent back to real world. The rest of us keep marching forward. When admitted into the program, we are each assigned a Nurse Navigator; our medical guardian angel/advocate. My personal angel’s name is Diana. She is a nurse, packed with ages of experience in the field of breast cancer treatment. She handles most of my appointments, calling me to tell me when and where, and how to get there. She spent what seemed like hours on the phone with me, as soon as I got home from hearing the worst 3 words I’ve heard in my life, last week, “You have cancer.” My family doctor is a moron and actually could NOT explain most of my pathology report, and “didn’t want to go out on a limb” to explain anything further to me, for fear he would be held liable if I misunderstood, blah blah blah, welcome to Jasper. So I had asked for a printout of my pathology report, took it home, and looked up every single word I didn’t understand, and then I called Diana. She confirmed what I had concluded, and in a very gentle voice, began to tell me about the road I would need to travel to reach wellness. She spoke for so long, reassuring me, sharing what resources this wonderful program had to offer, told me that she would be mailing me a big packet of information for me to read through, including a book to help my children cope with my new illness. She told me that I would be overwhelmed with information, and to write everything down. She told me to be careful about choosing websites to read about breast cancer, and she gave me a list of good sites to explore. On the spot, she booked me in to see a surgeon, and told me that she was there on the other end of the phone if I ever felt confused. And if she was ever away from her desk, she told me that her office was full of professionals ready to help; that there were therapists and social workers on-call if anyone in the family ever needed to talk to someone about how they are feeling throughout this time. How IS it that this beautiful country can create such a brilliant program to take special care of frightened, vulnerable women, without having to worry them about how they would manage to pay for everything? My Nurse Navigator told me, “Mental Health is just as important as Physical Health. Just treating the cancer with medicine would be pointless if, in the end, if you are an emotional and financial wreck. We treat the whole person.” Reason #437 to love Canada.

After the showdown in the parking lot, Markus and I entered the Meadowlark Health Centre in Edmonton. We were immediately greeted by a bevy of sweetly smiling receptionists. Markus and I looked at each other, our faces saying, “We’re not in Jasper, anymore, Toto.” We were 45 minutes early and thought we were in for an enormous wait (one is never seen earlier than 30 minutes past their scheduled appointment time in the Jasper clinic). I didn’t even have time to put down my purse, when a lovely lady came to collect me for a breast exam. I followed her down a long corridor to a private room, where I donned my lavender gown and waited for my aardvark surgeon. A knock on the door, and a perky young blonde with a ponytail entered, with a pimply teenager in tow. She introduced herself as Dr. Olson’s (I found out the spelling was different from Little House on the Prairie, bummer) Chief Resident. Her name is Dr. MacGyver. I kid you not. I’ve got MACGYVER on my team! And she introduced her skinny little sidekick as Mark, a medical student at University of Alberta. Yay, I get to flash my boobs to a crowd! After extensive questioning, MacGyver proceeded to palpate my breasts very carefully to confirm location of the tumour, etc. Then, she invited sidekick to join her from the edge of the room, where he was nervously nodding his head, and asked him to palpate my right breast to see if he could find the tumour on his own. I had to keep a straight face as he timidly reached out and poked at my boob like it was a bowl full of bad jello. Poor boy. Anything I can do to bring added education to the world, I am happy to do. Perhaps it was the first breast he had ever met, because as soon as he thought he’d found it, he jumped back to his wallflower position.

After the breast exam, MacGyver asked me if I had any questions from my pathology report, and I said that I am an American, so please forgive me, but I didn’t understand why my tumour was measured in millimetres, yet all literature about breast cancer discusses tumours in centimetres. She and Mark smiled at the ignorant American, and kindly explained that it was because my tumour was smaller than a centimetre. Well, duh. That shows you just how flustered I am these days. Then MacGyver started talking about hormone receptors, and I was like, “WAIT. Your pathology report doesn’t match my pathology report!” As if it could be possible to have an even lower opinion of my Jasper doctor, it turns out he only gave me HALF of my biopsy results. When I had asked about hormone receptive or not, or HER2 and triple negative, he flapped his hands at me and told me they would tell me that after my surgery, when they had removed the tumour and examined it further. One more medical lesson learned: DON’T BE A SHEEP!  So MacGyver told me that my tumour is estrogen receptive, which is well-treated with hormone suppressant chemo. Hello, Menopause. Then, MacGyver and Pimple Boy left to find the doctor.

After a few minutes alone, I heard a booming voice coming down the hall, “WHERE IS THE AMERICAN!” and a bearded lumberjack in glasses swept into the room, replete with plaid flannel shirt. He reached out his hand and said, “You must be the American! I’m Dr. Olson. So pleased to meet you! What on earth brought you to Northern Alberta?!” I explained about the furry German man and Fairmont, but that actually I’m only American on paper, having grown up all over the world. And he laughed, “AAAHH, a nomadic type – so I can’t even ask you where you’re from, eh? There goes my next conversation starter.” He blew my worries about cold, clinical, aardvark-Nellie-Olsen-sibling-surgeon right out of my mind. Tension melted out of my shoulders almost immediately.

After another breast exam, Dr. Olson (aka Paul Bunyon) went out to get my husband. I could hear them in the waiting room, Paul Bunyon calling out, “I’m looking for MARKUS! And upon meeting him, declaring, “So you’re a FAIRMONT man! Yes, your wife and I have been talking about you. She told me everything. Come this way!” He arranged us in the small exam room, “Sue, you’re the Queen,” (how did he KNOW?!)  “so you get the throne. Markus, you sit next to her. MacGyver, you sit in this chair. And Mark, you’re going to have to pretend to be the patient for the day and hop up on this exam table; UP you go.” Then he sat down on his stool, faced me, and said, “Ok. Now let’s get serious. We have much to discuss, and you have some decisions to make.” In the blink of an eye, Paul Bunyon turned into a doctor. He explained that there were many choices for an average woman in my shoes. Breast cancer starts in the milk ducts; most breast cancer stays in the ducts, just growing bigger. Mine is invasive, and has escaped from the duct it was born in, and has microscopically begun to get around in there. With a relatively small tumour, likely no cancer in the lymph nodes, many women just need a lumpectomy and radiation, and they may never have a recurrence of breast cancer for the rest of their lives. He explained that radiation is typically 5 minutes of focused X-rays, 5 days a week, for 5 weeks. There may be skin changes, there may be slight burning, there might be some fatigue, but it would be nothing like my mom’s radiation 30 years ago (she used to laugh about how one of her nai-nai’s had a very nice tan from the radiation). Then he said my situation was slightly different, with the family history of breast cancer. He said, “yours could have been a hereditary thing, or it might not be. You can take a genetic test, like Angelina Jolie did, but you also need to understand that currently, who ever takes it and gets positive results, will be refused life insurance applications forever, and their children will also never be able to qualify for life insurance. It will be permanently on the records. Those rules might change in the future, but that’s how it is for now.” Whoah. He followed that with other possible options for me. I could have a skin-preserving mastectomy on one side, with reconstruction to include an implant to match my “generous” other side. I asked about a bilateral mastectomy for my peace of mind. He said it could be done, but that would have to be my request. He said he could do that and preserve the nipples, and I asked “what about the odds of recurrence of cancer in the nipple, I heard it was a considerable risk?” He replied, “Well, true. The nipple is the front door; all the milk ducts and glands lead to that – it goes to reason that cancer might appear there in the future.” I said, “I could always get nipple tattoos…” (Look at me, wild woman thinking about tattoos!) and he pointed his fingers at me and said, “YES, you can. And there is nipple reconstruction too. You have LOTS of choices.” My mind spun as he offered even more on the breast treatment buffet table, the whole time my furry man scribbled furiously in our Journey Journal (we knew that we would forget 1/2 of what we were being told). Regarding reconstruction, there are fillers made of man-made materials (saline/silicone implants), and fillers made with Suzy Creamcheese-made materials (my own skin, muscle, and fat, from back, abdomen, butt, or inner thighs). During this discussion, he mentioned, “You have ptosis.” We looked blankly at him. He said very tactfully, “Well, when women have, er, generous breasts, over time, they tend to lose volume and they are not as perky as they used to be…” I was like, “OH! Yeah, after 3 kids, they are not at all what they used to be. That’s okay, they fed 3 children; they did their job.” And now I have a proper word to use when referring to my gravity-stricken breasts. “National Geographic boobs” is too much of a mouthful. I have ptosis. Sounds more mysterious.

Toward the end of our appointment, having weighed all the possibilities, I decided that I would opt for a bilateral mastectomy, with immediate reconstruction. Bracing myself for my doctor’s disapproval of what even my own sister has deemed an irrational decision, I was so grateful to hear him respond, “This is your choice. It is your body, it is your fight, and only you can decide this. There is something to be said about the breast cancer phobia that someone with extensive family history like yours might be feeling. It weighs heavily, and if this brings you peace of mind, that must be taken into account and respected. So skin-saving bilateral mastectomy with immediate reconstruction it IS!” He turned to Markus, pointed a finger, and said, “Write this down, Scribe. ‘Dr. Blair Mehling.’ I will set you up to meet him after you have a sentinel node biopsy.” If Dr. Olson is my lumberjack Paul Bunyon, then I suppose his plastic surgeon friend, Dr. Mehling, must be Babe the Big Blue Ox! Can’t wait to meet him…wonder if he will have horns…

A sentinel node is the very first lymph node that the nasty little cancer cells would bump into on their way out of the breasts, as they try to sneak into the rest of you. If there are cancer cells in that first lymph node (the sentinel…the lymph node on guard duty, get it?) then it shows the cancer is on the move; more lymph nodes need to be biopsied, and your adjuvant treatment (follow-up treatment to surgery; radiation, chemotherapy, etc) is adjusted to be more aggressive. The more information the doctors can glean from the sentinel node biopsy, or from any tissue with cancer for that matter, the better armed they will be in the fight. Before the operation, they will (brace yourself) inject a radioactive dye into my right nipple. Guys, hearing or reading that for a woman, brings a similar feeling to you reading about injecting radioactive dye into the little buddy in your pants. OW. Then, they will put me under general anaesthesia and use a Geiger-counter like a metal detector to probe into my armpit. The first lymph node to light up is the sentinel node. This good soldier node will be cut out and sent to a lab for analysis. If there is cancer, we will regroup. If there is no cancer, rejoice and full-steam ahead with our booby going-away party!

When I was first diagnosed, my friends and family quickly rose to my defence, with the collective battle cry, “You will kick cancer’s ass!” On my Facebook page, one day, my sweet furry man was commenting about that bastard cancer, and autocorrect oh-so-helpfully inserted “Barnard” instead. My cousin Gaby took it one step further and envisioned cancer as the stinky Parisienne pickpocket who tried to steal my iPhone while we were visiting the Eiffel Tower last year (a whole other story). Barnard the Parisienne has developed into a full-blown effigy who is after more than my iPhone. He wears a dirty beret and dangles a perpetually smoking cigarette between his decaying yellow teeth. My Facebook page now has a middle finger salute to Barnard, a toast to kicking Barnard’s ass, etc. Occasionally, someone who hasn’t been paying attention will comment, “Who the heck is Barnard?” Now y’all know. Barnard is goin’ DOWN.

So now the initial shock of discovery is over and it seems this journey is turning out to be more a race of endurance, rather than one of speed. I need to take my own advice that I gave to Markus this morning: calm down a little. I need to save my strength by not using it to panic. Be the turtle, not the hare. I would hate to run out of energy close to the finish line. Now I wait for April 3rd, to have my sentinel node removed. Between now and then, there should be less worry, and more living. There will be a thousand moments of joy; a thousand chances to smile or laugh. And I must be fully present to grab those moments and savour them. This journey is turning out to be adventurous, indeed, with colourful characters to meet all along the way. Diana the Nurse Navigator angel, MacGyver and sidekick Pimple Boy, Paul Bunyon, possibly Babe the Big Blue Ox Plastic Surgeon, and my parade of angels: my CIBC Run for the Cure team; 30+ strong women and men, coming together from Alberta and all over the world, to raise money for the Canadian Breast Cancer Society. I’m Suzy Creamcheese and they are The Suepremes. Say it, SAY IT: I’m a Chinese Diana Ross, baby! Our team would love to raise $9000 by October 5th, when we will come together and walk and run side by side. By that time, I hope to be healthy and well. Here’s the link if you’d like to help us collectively kick Barnard’s ASS: http://www.runforthecure.com/site/TR/RunfortheCureFY15/PrairiesNWT?px=3564263&pg=personal&fr_id=1851

I hope you enjoyed Chapter 2 of Follow the Breast Cancer Road. I expect many of you read, “BLAH BLAH BLAH MacGyver BLAH BLAH BLAH lumberjack BLAH BLAH BLAH National Geographic Boobs” and left this blog with your head spinning. Don’t worry. You and I, we have much in common. I am going through my days in a similar state. “Blah blah blah malignant blah blah blah absolute outcome blah blah blah wait 2 more weeks.” I want more “blah blah blah Mom I can burp the abc’s blah blah blah honey give me a kiss.” And flying monkeys; I want flying monkeys. If I have to be on this road, send out the flying monkeys…I already gave birth to the lollipop kids years ago.

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