My new reality
What’s it like waiting for a breast cancer diagnosis when you don’t feel sick? Think surprise rain shower on a sunny day. The doctor gives me my breast cancer diagnosis, and I realized that I’d just spent my last cancer-free moment . I’m part of a new reality.
It’s like being the victim of drive-by violence
This is part 1 of my cancer drive-by. Like all random drive-by violence, the damage can vary from a dented fender or a bullet hole in the garage door to a senseless and innocent death. Mine was more like the garage door damage. A little body work covered the scar where my breast has a slight dent from surgery and was discolored by radiation. Tamoxifen or arimidex oral chemo will now be part of my morning ritual for five to ten years. But I’m lucky, considering.
A Missed Mammogram
I had skipped a year on my annual mammogram. Doctor H. discovered that while she was giving me a pre-trip checkup a few days before I was leaving on a week-long canoe trip on the US-Canadian boundary waters (BWCA) with parents from my Eagle Scout son’s former Boy Scout troop.
I had originally scheduled this appointment to take care of an arthritic left pointer finger that might flare up after days of paddling and portaging. We squeezed the mammo in right after my check up. A day later, my husband and I left for Ely, Minnesota to spend Labor Day week 2013 without beds, showers, toilets, dry clothes, or wine. So apprehensive about how I would handle pooping in the woods, I watched a YouTube tutorial on how to use a boundary waters latrine. I didn’t even give a thought to the mammo.
Off the grid for six days
I’d spent six glorious days on the water, in the wilderness and without my cellphone. When we returned to the outfitter’s dock, I wanted to extend the vacation a little longer so I refused to turn on my phone. We celebrated our canoe adventure survival with a crew dinner at the Grand Ely lodge.
We had eaten very well on the trek thanks to our expedition leader’s love of camp out cooking. He had freeze dried everything, down to sriracha sauce. But even with his wilderness cooking skills, we were all still hungry for what we were couldn’t dehydrate. Red wine, cocktails, fresh salad with chunky blue cheese dressing, fried fish, cloth napkins, and limitless fresh-tasting water.
A Hint of trouble
While at Grand Ely lodge, my phone snagged a cell tower and started down loading all the messages I missed during the days on the water. My doctor had left six messages. I began to suspect those messages are not billing questions or an “everything looks good” call back. Here in Minnesota, sitting at a long table with my canoe crew, freshly showered, fed and slightly buzzed, I refused to give up my last night here to any disturbing news from back home. I would listen to the messages in the van back to the airport tomorrow.
One call would not have concerned me
If my doctor had gotten through to me on the first call, I would not have been too worried. About twenty years ago, I had a questionable mammogram and saw an oncologist every six months for a couple of years. Calcifications can be cancer markers and I had them throughout both breasts but the calcifications never changed locations, size or appeared to be massing together for criminal purposes. Maybe these common, pepper-like grains were causing my clinic to do another check as I got older.
Hanging on to ignorance a little longer
My brain did raise a bit of an alarm at five additional messages from the clinicians and nurses trying to catch me to schedule another look. Still, I could not talk to anyone there until Monday morning, two days from now. I had a four-hour drive back to the airport in the back seat of the van, where I would sleep while the rest of the crew shared trip stories.
“I could really have cancer.” That was my first thought after I connected with the clinic on Monday morning. The nurse told me to come in early that next morning for an ultrasound scan of the suspicious area.
The other women’s cancer
I sat in the radiology waiting room, with the other women who were trying to stay warm. All of us were wearing the kind of gown that all women know “opens to the front.” In the periphery, I heard a few of the other women talking about “their cancer” as if were an unruly pet, like a troublesome cat who regularly hung its ass outside of the litter box.
Some were in the middle of treatment, others had been newly diagnosed and were waiting to see how they would tackle their malignancy. One lovely black woman in her late 60’s was down the road with her treatment. I do not remember what she said to the woman next to her but the black woman radiated a calmness that confused me since she HAD CANCER!
This time was different
When the technician call me for my ultrasound, I knew the drill but this felt different from the other times I had been on that table. For one thing, the nurse laid her hand on my knee in a gesture of comfort. The technician told me “good luck” after it was over. “I could really have cancer,” slipped into my mind every so often for the rest of the day.
That night, when I tried to go to sleep, the blip became a an on-going buzz. “I could really have cancer. This could be one of my last cancer-free nights.” Mercifully, I heard back from the clinic quickly. They needed another test, an ultrasound assisted biopsy. Also, I’d see an oncologist surgeon on the same day just in case.
Talking to the first surgeon
The surgeon saw me around 10 o’clock in the morning. He put the first ultra sound images on the light box and explained that the jagged edges of a pea-sized mass had caught the radiologist’s attention when she reviewed my original mammogram. It also looked like there were some shadows in my lymph glands that should be checked.
What are the options if it is cancer?
“If it turns out to be cancer, what’s the prognosis?” I asked. I could not imagine how many times he had had to answer that question in his career. This was my first time to need an answer to the question so that’s all that mattered to me.
“It’s small so prognosis could be really good. If it has not spread into the lymph nodes, then a lumpectomy and some chemo or radiation as insurance against a re-occurrence. You wouldn’t be slowed down much during treatment,” he said.
“And if there’s cancer in my lymph glands?” I asked. “Then probably a mastectomy. Definitely, a more extensive surgery so there would be some trauma to some of your muscles in your upper arm. You look like you work out so you would probably have to modify your routine for a couple of months. Again, it is small and it if is cancer, we have it early. You’ll have a great prognosis,” he assured me.
Waiting on to have the biopsy
It was now about 10:45 in the morning. My biopsy was not scheduled until 2:30p. The surgeon’s nurse hurried things on a bit by telling the radiology department that the doctor needed the test right away. It was rescheduled for around 1p so I only had two hours to wait. My house was only 15 minutes from the clinic but I did not want to go there.
I drove into the wealthy neighborhood that surrounds the clinic. West University is upscale but homey, not like Houston’s River Oaks where the old and new money compete to build the biggest mansions on the largest spreads. West U has some new homes and old trees. The remaining houses from the 1930’s are either extensively remodeled or inhabited by old people who don’t want to leave their lifelong home but don’t have much left after their high property taxes.
Learning to say the c-word
There are a couple of shady pocket parks sprinkled throughout West U where landscape and construction workers take a break at noon. It was a little early for their lunch visits so I took over a bench, looked at my emails and called the office. I was working on a project at Univision with Kath and wanted to check in.
I like working with Kath, her style and her directness, but we were getting to know each other. Before we got down to business, she asked how my appointment went. “I think I’ve got cancer,” I said and I started to cry. I had not said it aloud to anyone until right then and it felt funny claiming “my cancer”. Kath did not know what to say.
I would not have either, if the roles were reversed. I moved the conversation to the project to gain control of my emotions but we both knew I wouldn’t be heavily involved past this point, at least not for the foreseeable future.
Back on the ultrasound table
At 1 o’clock, I was back on the ultrasound table. The doctor doing the biopsy was someone whose name had appeared on most of my mammogram reports going back a decade. I wondered if she caught it because she is so familiar with everyone’s breast pictures.
An ultrasound assisted biopsy grabs a piece of the tumor with a spring loaded needle. Dr. R gave me warning right before the needle took a bite. It is a loud, sharp sound and each bite jars you slightly. A little uncomfortable but not bad. There was a bit of a hard shell around part of the mass and the doctor had to have a second go at a couple of areas but it was all over quickly.
Every knew but me
Everyone in the ultrasound room but me knew this was a malignancy. You could feel their certainty and their awareness of my dawning intuition.
The surgeon tried to reach me in the early afternoon on Wednesday. I missed his first two calls because I was out doing a presentation to one of my bigger clients. The preparation for that presentation allowed me to compartmentalize my health concern for a little while. I called back as soon as I returned to the office and saw the 713-442 prefix which meant a clinic call.
It’s official – I have cancer
I was only on hold a few minutes when the surgeon came on. How many times had he given a woman this news? “I’m sorry but the mass is malignant. Stage one invasive so I recommend we proceed with treatment quickly. There is some good news. It doesn’t look like there is anything to worry about with the lymph nodes.”
A hint of calmness
I expected to be devastated when the cancer was confirmed but a little of the calmness I had felt emanating from the black woman I met in the radiology waiting room started to seep in. I was going to cry, first alone and then every time I had to tell someone close that I now had cancer. It was hard to witness their disbelief and then fear that, if it was happening to me, it could happen to them. But now I had firm diagnosis, which was the first step towards treatment and recovery. It was time to throw myself into how to navigate this new direction.