Wednesday, July 31, 2013

One Year Ago

Annabel, August 2012, at the "Pi-wit Ship Pway-gwound" 

Same beautiful girl, same place, August 2013
This Friday night, the first Friday in August, a group of Brian’s alumni hockey players will come over to our house for a cookout. I’ll be on my way home from work when they arrive but somehow, Brian will have everything prepared, and I’ll walk into trays of delicious BBQ, a pot of homemade clam chowder, and a whole bunch of boys that my son thinks are superheroes.

We didn’t plan it this way, but it turns out that last year’s alumni cookout was the first Friday of August, too. Last year, that was August 3rd, and it was the night I first felt my tumor. For the record, I'm not feeling for any lumps this Friday; I'm just going to eat a lot of my husband's great cooking, enjoy some good company, and go to sleep. 

*  *  *

I’ve already written about finding the lump, and I don’t mean to bore you with the details again. But I do need to rehash some things for myself about last August. It’s kind of like a game of dodge ball -- I know these memories and emotions from one year ago are going to be fired at my head; I can either try to catch them and stay safe in the game or avoid them and eventually be knocked out.

When I first felt my tumor, I was worried. My hypochondriacal history, however, helped to ease my mind a bit because nothing else I had ever built up to be cancer had actually been that. Sure, it'd be a neat story if I had a unique feeling that this lump was different but I didn’t have any such thing. I just had a feeling that I should get it checked out to be sure; just like I had had swollen glands and calcium buildups examined before.

If left alone, I would have made an appointment a few weeks or a month down the road. But Brian (secretly) worries more than I do, and he insisted that I schedule an appointment as soon as I could.

On Monday morning, I called my doctor's office. My PCP was on vacation for the week, but another physician in her group could see me that Friday at two. I put it in my calendar, which usually made me feel better. Oddly enough, however, this time, it didn't. 

On Monday night, I started to worry more. I didn’t feel the tumor more than a few times because I hated the thought of what could be going on inside my body. I just kept wondering, Why would there be a lump on one side and not on the other?

I called my doctor's office back again on Tuesday morning. I told the secretary that I was worried about the lump in my breast and that I’d really like to come in sooner than Friday. She said they had a cancellation and I could come in that afternoon, at 2pm.  It just happened that there was a train home that would get me to the appointment perfectly on time.

Brian must have arranged for someone to watch the kids because he was with me at that 2pm appointment but the kids weren't. I remember lying on the exam table topless as the covering physician massaged my pathetic excuse for a boob. Does this hurt when I press on it? she asked bearing down on the lump.

Kind of, I answered.

Good, I’m pretty sure it’s just a cyst, she explained, It wouldn’t hurt if it were a tumor. Either I’m a total wimp or her textbook needs a footnote.

As soon as the doctor said cyst, I was fine. No cancer. No worries. This was just something to add to the list of worries-turned-fine; just like when I went in for a persistent headache and my doctor told me it was due to excessive teeth-grinding; just like when the suspected pulmonary embolism was a broken rib. I was going to be fine and I celebrated that for a minute or two amidst the embarrassment I felt for my overreaction. Then I just got inpatient and wanted to go home.

The PCP decided that she would send me for a mammogram and an ultrasound to confirm her assessment. What a waste of time and money, I thought. The doctor punched something into the computer and handed me a little card to take down to the radiology department. Reluctantly, I did.  

The guy at the radiology scheduling desk was new. He managed to schedule my mammogram with ease (for the very next day), but the ultrasound gave him some trouble. I was getting really antsy and I told him to not bother with the ultrasound. If they see anything in the mammogram, I'll book an ultrasound, I told him trying to push my rudeness back down to its hiding place. I was sure that the mammogram would confirm that the lump was a pesky little cyst but the scheduling guy was loyal to the rules like any good rookie and he told me that he had to schedule the two appointments together. 

Five or ten minutes later, with the help of his most unhelpful colleague, the scheduler had my ultrasound set for just after the mammogram. I thanked him and said I'd be there, even though I planned on ditching the second appointment.

I didn’t think about that lump for another minute after Brian and I walked out of the building holding hands.

The next morning, Brian took the kids to a little zoo just north of the Rhode Island border. He had asked me if I wanted him to come with me to the follow up appointments but I insisted that he not waste his time.

Being only 32 with no family history of cancer and no other risk factors, my August 8th mammogram was my first one. I remember undressing and putting my clothes in a little locker by the small internal waiting area. I remember being cold. But not scared.

Until last year, I thought mammograms were like ultrasounds -- performed with a wand on a patient lying down. I had no idea that a mammogram (or at least, my mammogram) was done standing up, or that it would involve propping my pancake of a boob up on a cold metal plate and pressing another plate down on it from the top. It was kind of like my boob was squished in the middle of a cold panini maker. Did it hurt? No, although I'm not saying it tickled. But it was quick and life-saving and I would strongly discourage anyone from scaring a woman into avoiding a mammogram.

As the rad tech (who I will call "Jean") repositioned my pancake and the hidden rotten blueberry between the panini plates, I started to feel like something may be wrong. I asked her if she saw anything bad. She hesitated and her answer was vague.  

When we were done, Jean told me to wait in the waiting room. I heard her talking to the radiologist (Dr. Berman) in his windowless office nearby. I could tell that Dr. Berman was showing her something on the image. And I heard him say that he wanted more pictures. 

Back to the plates we went. They felt so much colder the second time. No doubt, now I was scared. 

My memory of time for the rest of that day gets a bit fuzzy. I don't think it could have been more than 10 minutes before Jean came back to the small waiting room to retrieve me and whisper that Dr. Berman wanted to do the ultrasound right away. 

Dr. Berman told me that he saw cancer within minutes of placing the gooey wand on my chest. At the time, his language was completely foreign to me but I know now exactly what he saw and what he said -- invasive ductal carcinoma, as well as ductal carcinoma in situ (DCIS). The invasive part was the tumor. The DCIS was a four-inch-in-diameter growth of cancer that was still inside the ducts. 

Believe it or not, I can recall precisely the first thought that I had after Dr. Berman told me that he saw cancer -- If this is only breast cancer, I will beat this. At the time, I didn't understand that breast cancer that has reached the chest or the bones or the brain is still breast cancer. So what I meant in my own head was, If this hasn't spread, I will survive. 

I don't usually put too much weight on that gut instinct, especially because within seconds, I felt cancer all over my body. And I don't mean it to suggest that people can't beat cancer that has spread. Even then, I knew that people could beat cancer even after it had traveled to several parts of the body (OK, maybe Lance Armstrong was my only example, but I needed only one instance to know that it was possible). Still, in a few of my dark moments, I have returned to that very first reactionary thought and I have chosen to believe it. 

The next step was the biopsy, but before that, Dr. Berman had to gather some materials (or sneak in another patient, who knows). Jean gave me her office to call Brian. 

For some foolish reason, I thought I could tell him about Dr. Berman's pseudo-diagnosis without crying. But the moment I sent the words, He thinks he sees cancer, from my brain to my mouth, the tears came too. I was in shock, trying hard to stay standing on a ground that felt like it had fallen out from underneath me. 

I sat back down in my johnny in the small waiting area. At one point, I started crying again, and a young woman asked me if I had ever had a mammogram before. I could barely respond. I have a family history so I've gotten lots of them. It's not that scary, she explained trying to comfort me. 

Yeah, it's the hearing you have cancer part that's scary, I laughed and cried. She apologized, stunned. That was the first time, but definitely not the last time that I saw that holy-shit-shocked look. Later, I worried that I had been too flippant to a kind woman who was just trying to help. 

The biopsy part was just messy; literally. Dr. Berman numbed the area and then used some sort of device that made loud clicks and spit out tiny globs of some liquid (blood?) or solid (chest flesh?). It didn't hurt at all, but it was terrifying because I knew then and there that I wasn't going to be catching my train to work that day; I knew that my whole life was about to change. 

Dr. Berman tried to comfort me. Will I see my kids grow up? I asked him in order to induce him to say, Of course you will!

But he said something much more doctor-ly. This is very treatable now, he explained. Little did he know mine would even be curable! A few months ago, I went back to tell him that but he had already retired. I saw Jean and she started to cry when I told her I was doing really well. Her niece had just been diagnosed and clearly, she was having a lot of trouble processing that. I told her that her niece would do great. 

When Dr. Berman was done with the biopsy, he told me some vague timeline of events (which I didn't remember) and handed me a card with a phone number for new breast cancer patients. 

I got dressed, walked to my car, and called Mark to tell him I wouldn't be coming into the office. I told him why, and I felt so badly that I had to give him news that would upset him. 

Then, I drove home without turning on any music. I never do that.   

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