Yesterday was my one month check-up with the dashing Dr. C., my surgeon. I was looking forward to this, as I was determined to pin him down on the question that seems to get talked around every time, including with my oncologist: if I don't have a mastectomy, how much more likely am I to die of breast cancer?
Thinking about it since I saw Dr. L, the oncologist, I realized that we had discussed odds of recurrence. Of course, this is salient too: no one wants to go through the wicked uncertainty and discomforts of the experience I just had, even if the results are, happily, a good prognosis. But the more important, the crucial question is simpler and razor-sharp: am I risking death by not having a mastectomy, and if so, by what odds?
Funny how difficult it was to put this question into the clearest and most direct phrasing. While I waited two and a half hours to get into the examining room (he was "backed up", as the receptionists say, which conjures constipation more than crowding), I tried out different versions till I settled on the one above. Meanwhile, patients all around me were tapping their feet, buttonholing staff, and generally in a bad mood about the interminable wait, especially one elderly Russian lady who had originally had a later appointment and had been shifted to a much earlier one, only to be taken an hour after the original time. As for me, I'm an old hand at this, so I know you have to come armed with very long books -- fortunately, I never run out of those I'm supposed to be reading for my job as college professor.
Dr. C. looked worn, and I felt for him: it was dark by the time I saw him, most of the staff had gone home, and there I was with my questions. First he looked at the breast in question, and he was pleased with himself: "It looks as good as any reconstructed breast would," he remarked with innocent pride; I felt like Galatea. "I have a question for you, and I'm going to be blunt," I said when he was done. "Go right ahead," he said generously. After all that mulling over phrasing, you'd think I would have gotten it right. But I only got half the question out when he interrupted me to say that yes, mastectomy is the standard procedure, and the radiologist I'm going to see will probably tell me the same thing as Dr. L, but he thinks it's okay to save the breast. I mentioned statistics for survival versus reccurence, but his answer was confusing, and he was in such a rush (poor man, I don't blame him) that there was no time to parse it out.
Basically what he seemed to say was that my chance of getting a life-threatening cancer (i.e. one that has advanced too far to "cure") is less after this surgery than it was eleven years ago, because this was DCIS. If I do get one, and the chances are low (I could not seem to get him to say how low, and I tried), it would be from the original cancer, not this one. On the other hand, the rate of recurrence from this one could be as high as 10-20% (!), though not life-threatening recurrence. If that happened, mastectomy would be necessary. In sum, he seemed to claim that studies did NOT show a survival advantage from mastectomy in my case, though it would have a recurrence advantage. And meanwhile, I get to keep my breast, such as it is.
And just to complicate matters, even mastectomy would not reduce the risk of either recurrence or survival to zero. Welcome to the wonderful world of cancer.
Which brings me to the question in the title: at what price do I get to have two more-or-less matching breasts? On what scales am I supposed to weigh all this? It's like playing poker for your house, your job, your life, while unable to see all your cards.
On the one hand, there are the odds, which is to say the studies and the statistics they proffer from which the odds are derived, that imply the risk is worth taking. Get into the car, book that trip, cross that street...it will probably be okay, so why not? On the other, there is the worth of that breast...a globule of soft fat (with some scar tissue thrown in and no nipple, in my case) that evens out the bra, the shirt, the bathing suit, the nightie. Why risk anything at all for this hunk of stuff? What's it worth?
I don't know, right now. That's the truth. I'm waiting for March 18th, when I finally get to see the radiologist. Maybe that will shed some clearer light on all this. I hope so. Because I'm flying blind.
Tuesday, February 22, 2011
Tuesday, February 15, 2011
Doctor, Doctor, Give Me the News
In a perfect world, when there's something wrong, an expert is there to diagnose it and fix it: and so in medicine, A (illness) leads to B (diagnosis) leads to C (cure). I suspect we all have that in our heads somewhere; it's just a question of finding the right doctor, like finding the right person to marry.
My dear old-world mother, who revered doctors as much as any self-respecting Jewish immigrant, would relate in reverent tones, "And she's seeing a big shot on Park Avenue". We never saw Big Shots, Park Ave or otherwise, because there was no money. We saw sweet Dr. Leban, who had wire-rimmed glasses, never asked questions, and came to our house to deliver a "shot" in the butt to anyone lying on the living room couch with the flu, for which he was paid in cash. Before she could afford that, she took subways and buses to Coney Island Hospital on a regular basis to treat my older brother's asthma in the Emergency Room, as so many poor people still do today.
But I was socially and economically mobile, as she intended me to be, and when I was a married lady with a child in my late twenties, I acquired an actual doctor on Park Avenue. It's not that we had a lot of money; my husband was a lowly Assistant Professor at a public university, and I was a graduate student. But I'd suffered from a misdiagnosis (in an Emergency Room) of an ectopic pregnancy and had to have emergency surgery to save my life. Afterward, the idea was to get nothing-but-the-best, and so I found myself a patient of Dr. Z, a portly (to put it nicely), chain-smoking OB-GYN with a lavish office and a long wait to get in to see him. Dr. Z. had an excellent rep -- yes, a Big Shot -- and you could tell he was beloved by his patients because pretty photos of the babies he delivered adorned the walls of his waiting room, along with gushing letters along the lines of "Dr. Z, we love you JUST BECAUSE YOU'RE YOU!" My friend DK will testify that I'm not making this up.
Anyway, when I entered my forties, an odd thing happened: unexpectedly, my periods stopped coming regularly, and then, at age 44 or so, not at all. It seemed too early for menopause, but that's what it was, apparently. Dr. Z. said not to worry; he had just the thing. All I had to do was take this prescription for HRT -- hormone replacement therapy, a combination of estrogen and progesterone -- and I would not only avoid the symptoms of menopause (none of which I actually had), but it would be good for me in every way. I remember something about prevention of heart disease and dementia, not to mention looking and feeling young till I was 120 or thereabouts.
Cut to age 53, when I'd been taking this little pill daily for nine years. That's when I was diagnosed with breast cancer, and before I knew it, it was all over the paper: major studies had shown that taking HRT for more than five years was definitely correlated with a higher risk of breast cancer (it's now known to be even worse than that). I had an estrogen-positive tumor, too, meaning this cancer was fed by estrogen. This was appalling, but how could I be mad at Dr. Z? It wasn't his fault, right? That was the wisdom of the day. However, I remember that while I was taking HRT, an aunt once told me her female doctor, who tended to be skeptical about pharmacology, advised her not to take HRT and she had done without it. I remember thinking this was wacky; Dr. Z. was, after all...a Big Shot. On Park Avenue.
The reason I'm thinking about this is that The New York Times ran an article the other day about a new study showing that lymph node resection does not prolong survival for breast cancer patients. Oh. No kidding. Really? Because eleven years ago, when I had my first surgery for invasive cancer, the sentinel node (the one nearest the tumor and thus most likely to be malignant if any are) was removed and found cancerous. So I had another surgery, excising more tissue, and also had twenty or so more lymph nodes taken from under my arm, hunting for the supposedly all-important number of malignant nodes that would tell us about my prognosis. There were no more, so the flesh cut from my underarm and the numbness in the area that makes it a torment to scratch an itch there were for nothing (actually I was very lucky not to get lymphedema, possibly thanks to the skill of the famous Dr. C, my once and future surgeon).
So now you tell me that this wasn't necessary. It didn't prolong my life. It didn't do much at all, except cause more pain after surgery and a deformity in my underarm.
Plus Dr. Leban's shot of antibiotic (though for all I know, it could have been saline) almost certainly didn't help us get over the flu.
This does not raise my level of faith, hope and trust in the medical field, dear reader. I suppose that is the way medicine works, yes. Except that there is a class action suit against the pharmaceutical company that produced the drug I took, because, according to a lawyer who works exclusively on the suit, the drug company suppressed evidence of a suspected estrogen-cancer link long before the study that exposed it. I won't see any of the money, though, if the suit is successful, because I didn't learn about it until it was too late to sue. Put that in your pipe and smoke it. Or rather, don't smoke at all, unless you trust what the tobacco companies were telling you.
My dear old-world mother, who revered doctors as much as any self-respecting Jewish immigrant, would relate in reverent tones, "And she's seeing a big shot on Park Avenue". We never saw Big Shots, Park Ave or otherwise, because there was no money. We saw sweet Dr. Leban, who had wire-rimmed glasses, never asked questions, and came to our house to deliver a "shot" in the butt to anyone lying on the living room couch with the flu, for which he was paid in cash. Before she could afford that, she took subways and buses to Coney Island Hospital on a regular basis to treat my older brother's asthma in the Emergency Room, as so many poor people still do today.
But I was socially and economically mobile, as she intended me to be, and when I was a married lady with a child in my late twenties, I acquired an actual doctor on Park Avenue. It's not that we had a lot of money; my husband was a lowly Assistant Professor at a public university, and I was a graduate student. But I'd suffered from a misdiagnosis (in an Emergency Room) of an ectopic pregnancy and had to have emergency surgery to save my life. Afterward, the idea was to get nothing-but-the-best, and so I found myself a patient of Dr. Z, a portly (to put it nicely), chain-smoking OB-GYN with a lavish office and a long wait to get in to see him. Dr. Z. had an excellent rep -- yes, a Big Shot -- and you could tell he was beloved by his patients because pretty photos of the babies he delivered adorned the walls of his waiting room, along with gushing letters along the lines of "Dr. Z, we love you JUST BECAUSE YOU'RE YOU!" My friend DK will testify that I'm not making this up.
Anyway, when I entered my forties, an odd thing happened: unexpectedly, my periods stopped coming regularly, and then, at age 44 or so, not at all. It seemed too early for menopause, but that's what it was, apparently. Dr. Z. said not to worry; he had just the thing. All I had to do was take this prescription for HRT -- hormone replacement therapy, a combination of estrogen and progesterone -- and I would not only avoid the symptoms of menopause (none of which I actually had), but it would be good for me in every way. I remember something about prevention of heart disease and dementia, not to mention looking and feeling young till I was 120 or thereabouts.
Cut to age 53, when I'd been taking this little pill daily for nine years. That's when I was diagnosed with breast cancer, and before I knew it, it was all over the paper: major studies had shown that taking HRT for more than five years was definitely correlated with a higher risk of breast cancer (it's now known to be even worse than that). I had an estrogen-positive tumor, too, meaning this cancer was fed by estrogen. This was appalling, but how could I be mad at Dr. Z? It wasn't his fault, right? That was the wisdom of the day. However, I remember that while I was taking HRT, an aunt once told me her female doctor, who tended to be skeptical about pharmacology, advised her not to take HRT and she had done without it. I remember thinking this was wacky; Dr. Z. was, after all...a Big Shot. On Park Avenue.
The reason I'm thinking about this is that The New York Times ran an article the other day about a new study showing that lymph node resection does not prolong survival for breast cancer patients. Oh. No kidding. Really? Because eleven years ago, when I had my first surgery for invasive cancer, the sentinel node (the one nearest the tumor and thus most likely to be malignant if any are) was removed and found cancerous. So I had another surgery, excising more tissue, and also had twenty or so more lymph nodes taken from under my arm, hunting for the supposedly all-important number of malignant nodes that would tell us about my prognosis. There were no more, so the flesh cut from my underarm and the numbness in the area that makes it a torment to scratch an itch there were for nothing (actually I was very lucky not to get lymphedema, possibly thanks to the skill of the famous Dr. C, my once and future surgeon).
So now you tell me that this wasn't necessary. It didn't prolong my life. It didn't do much at all, except cause more pain after surgery and a deformity in my underarm.
Plus Dr. Leban's shot of antibiotic (though for all I know, it could have been saline) almost certainly didn't help us get over the flu.
This does not raise my level of faith, hope and trust in the medical field, dear reader. I suppose that is the way medicine works, yes. Except that there is a class action suit against the pharmaceutical company that produced the drug I took, because, according to a lawyer who works exclusively on the suit, the drug company suppressed evidence of a suspected estrogen-cancer link long before the study that exposed it. I won't see any of the money, though, if the suit is successful, because I didn't learn about it until it was too late to sue. Put that in your pipe and smoke it. Or rather, don't smoke at all, unless you trust what the tobacco companies were telling you.
Thursday, February 10, 2011
Gratifying, Frustrating
I was glad to see my old oncologist, Dr. L, today, partly because I really like her, and partly because I had many questions that my surgeon either didn't want to or cannot answer.
And I did get some answers and learned one or two interesting new facts, which was gratifying. But I didn't find out what I most wanted to know, which was frustrating (yes, thus the title). And there was an awkward moment at which I teared up and she actually apologized for what she'd said. More about that in a moment. First, the answers:
1. Was this a recurrence or a new cancer? Supposedly an recurrence is more dangerous because it means the original cancer cells haven't been eradicated, so I'd like to know. The surgeon was quite vague and seemed uninterested in the question; Dr. L, on the other hand, appeared to give two contradictory answers at different points. First she said that my original invasive cancer eleven years ago had been estrogen-positive, and that recurrences of estrogen-positive tumors tend to peak twice (as opposed to estrgoen-negative ones): the first peak is 2-4 years after, the second around ten years. "So I'm right on the second peak?" I said, amazed because I had never heard this nugget of info before (why? did no one want to tell me to avoid alarming me?). "Yes", she said. So that implies recurrence, right? But later she said it wasn't a recurrence, because it was DCIS rather than invasive, and apparently the surgery, chemo and radiation did wipe out the original invasive cancer. This is confusing. Is the 11 year gap from diagnosis just a coincidence?
2. Why were the mammogram and the MRI just after the diagnosis of Paget's both normal, when the path report showed DCIS? Answer: Because I didn't have enough DCIS to show up on the imaging. "After all, the amount you had was minimal," she said. It WAS? No one had told me that, not even the surgeon. I read the path report, and the word "minimal" isn't on there. "No," she said, "But it says 'a few foci of DCIS found', and that means it's not extensive." So that's good, going on great. But you'd think I would have been told that before.
3. What about the dread "dirty margin"? Dr L said I didn't actually have a "dirty" margin, which means cancer found ON the margin of the excision. I didn't know that either. What I had was a close margin, half a millimeter from the incision. Is that as good as a greater margin? No. The bigger the better. But it doesn't necessarily mean an automatic re-excision either. It's a judgement call, as so much else in cancer treatment seems to be. She did add that the path report says only "one of five slides shows DCIS .5 mm from the margin" -- I'd read that but didn't know that one of five is not considered much at all. What do I know?
4. Hormone treatment: shouldn't I go back on it, given that I was diagnosed with the Paget's one year after finishing my course of estrogen inhibiting drugs? Hmm, she said. Hard to say, she said. There's a study being done now about extending hormone treatment for women like you, but we won't have the results for three years. And if it does no good, you run the risk of osteoporosis, higher cholesterol, and possible heart damage for no reason. So she will consult with other oncologists and get back to me in a few days with their collective decision. Apparently majority rules. Another judgement call.
5. Radiation: this isn't up to her. There's no question that radiation prevents further recurrences after lumpectomies, but the standard is not to re-radiate an already treated breast. "The breast tissue usually can't withstand it at the levels needed to eradicate cancer," she said. Nevertheless, I'm to see the radiologist in about a month: she said the one my surgeon recommended is their best expert on this, so that's nice.
6. My prognosis: this is where we ran into trouble..my tearing up, her apology. She repeated several times that the "cure rate" for DCIS is 98%, which is wonderful, but then added that this is after lumpectomy and radiation -- in other words, for first timers..."So if you can't do radiation, you should rethink getting a mastectomy, because that's the gold standard." NOW? I thought. I'm just beginning to come out on the other side of this surgery, which after all was minimal compared to mastectomy (not to mention breast reconstruction, which I hear is even more painful). Am I going to up the ante now? She saw that I was getting upset, and quickly apologized: "Wait, I misspoke," she said, "Decisions about surgery have to be made in consultation with the surgeon. That's not my call. It's just that it's the gold standard."
Ah, the gold standard! Who wouldn't want the gold standard? Why take silver or bronze medals when you can Go for the Gold? The feeling that I am being cowardly because I hate surgery and want to look normal is distressing; the idea of risk, even a small risk, is dismaying. On the other hand, I really, really don't want a mastectomy right now. I don't like making this decision myself, but I also don't know that I trust Dr. L. OR Dr. C. (the surgeon) or anyone to make the right choice. It all seems so much a matter of luck, a cost-benefit analysis based on unknowns. This is the weird and frustrating part. The answer to every question seems to be "hard to say".
And I did get some answers and learned one or two interesting new facts, which was gratifying. But I didn't find out what I most wanted to know, which was frustrating (yes, thus the title). And there was an awkward moment at which I teared up and she actually apologized for what she'd said. More about that in a moment. First, the answers:
1. Was this a recurrence or a new cancer? Supposedly an recurrence is more dangerous because it means the original cancer cells haven't been eradicated, so I'd like to know. The surgeon was quite vague and seemed uninterested in the question; Dr. L, on the other hand, appeared to give two contradictory answers at different points. First she said that my original invasive cancer eleven years ago had been estrogen-positive, and that recurrences of estrogen-positive tumors tend to peak twice (as opposed to estrgoen-negative ones): the first peak is 2-4 years after, the second around ten years. "So I'm right on the second peak?" I said, amazed because I had never heard this nugget of info before (why? did no one want to tell me to avoid alarming me?). "Yes", she said. So that implies recurrence, right? But later she said it wasn't a recurrence, because it was DCIS rather than invasive, and apparently the surgery, chemo and radiation did wipe out the original invasive cancer. This is confusing. Is the 11 year gap from diagnosis just a coincidence?
2. Why were the mammogram and the MRI just after the diagnosis of Paget's both normal, when the path report showed DCIS? Answer: Because I didn't have enough DCIS to show up on the imaging. "After all, the amount you had was minimal," she said. It WAS? No one had told me that, not even the surgeon. I read the path report, and the word "minimal" isn't on there. "No," she said, "But it says 'a few foci of DCIS found', and that means it's not extensive." So that's good, going on great. But you'd think I would have been told that before.
3. What about the dread "dirty margin"? Dr L said I didn't actually have a "dirty" margin, which means cancer found ON the margin of the excision. I didn't know that either. What I had was a close margin, half a millimeter from the incision. Is that as good as a greater margin? No. The bigger the better. But it doesn't necessarily mean an automatic re-excision either. It's a judgement call, as so much else in cancer treatment seems to be. She did add that the path report says only "one of five slides shows DCIS .5 mm from the margin" -- I'd read that but didn't know that one of five is not considered much at all. What do I know?
4. Hormone treatment: shouldn't I go back on it, given that I was diagnosed with the Paget's one year after finishing my course of estrogen inhibiting drugs? Hmm, she said. Hard to say, she said. There's a study being done now about extending hormone treatment for women like you, but we won't have the results for three years. And if it does no good, you run the risk of osteoporosis, higher cholesterol, and possible heart damage for no reason. So she will consult with other oncologists and get back to me in a few days with their collective decision. Apparently majority rules. Another judgement call.
5. Radiation: this isn't up to her. There's no question that radiation prevents further recurrences after lumpectomies, but the standard is not to re-radiate an already treated breast. "The breast tissue usually can't withstand it at the levels needed to eradicate cancer," she said. Nevertheless, I'm to see the radiologist in about a month: she said the one my surgeon recommended is their best expert on this, so that's nice.
6. My prognosis: this is where we ran into trouble..my tearing up, her apology. She repeated several times that the "cure rate" for DCIS is 98%, which is wonderful, but then added that this is after lumpectomy and radiation -- in other words, for first timers..."So if you can't do radiation, you should rethink getting a mastectomy, because that's the gold standard." NOW? I thought. I'm just beginning to come out on the other side of this surgery, which after all was minimal compared to mastectomy (not to mention breast reconstruction, which I hear is even more painful). Am I going to up the ante now? She saw that I was getting upset, and quickly apologized: "Wait, I misspoke," she said, "Decisions about surgery have to be made in consultation with the surgeon. That's not my call. It's just that it's the gold standard."
Ah, the gold standard! Who wouldn't want the gold standard? Why take silver or bronze medals when you can Go for the Gold? The feeling that I am being cowardly because I hate surgery and want to look normal is distressing; the idea of risk, even a small risk, is dismaying. On the other hand, I really, really don't want a mastectomy right now. I don't like making this decision myself, but I also don't know that I trust Dr. L. OR Dr. C. (the surgeon) or anyone to make the right choice. It all seems so much a matter of luck, a cost-benefit analysis based on unknowns. This is the weird and frustrating part. The answer to every question seems to be "hard to say".
Wednesday, February 9, 2011
There's Nothing Like the Right Bra, Baby
It should be a song. Because just as all men are not alike, and all boobs are not alike, some bras just make you look and feel better than others.
It's not only small vs. large-breasted women, though; it's women who have been through the cancer mill and come out with one or more boobs that don't look the way they did...and yes, the way they should, in some boob-utopia of the mind. I've been twisting and turning in that mill-of-the-mind for weeks now, waiting and hoping that the poor beaten-up boob will return to "normal" or some semblance of it, and slowly realizing -- not. It's not what it used to be, and probably never will be, and I'd better get used to it, and I'd better be grateful for however long I get to hang on to it (so to speak) at all, and do what I can.
As soon as I returned to work, I went back to wearing my bras. But it was a disaster unless I wore the loosest, maternity-like sweater and crossed my arms a lot. This made me so sad I obsessed about it during a few sleepless nights. Would I have to ditch my entire wardrobe,really? And no more cleavage, ever again?
Then one day I idly found a chat room on breastcancer.org and cyber-spoke to the ladies who happened to be on at the same time. I don't much like real-time chat, but they were great, a true example of people who help each other for the sheer comfort and pleasure of doing so. My thought at the time was that I would buy inserts (like falsies) to put on one side, and didn't know where to get them. The Ladies Online immediately gave me a link, and I bought some. But when they came, they didn't look the way I hoped, and they didn't help with the discomfort I felt when I wore my usual underwire bras. I think it was my daughter A. who advised me to go to a bra fitting store and get a special bra instead.
I was reluctant but willing to try, dreading the process and the results. No one had seen the breast naked except for medical personnel, and I didn't look forward to awkwardness and suppressed embarrassment. So I rehearsed what I'd say when I went into the Town Shop: "I'd like someone to help with fitting a bra, but I have a special situation. I had breast surgery recently." Oddly, I never got to the second sentence, because at the sound of "special situation," a young woman was called from where she was lurking at the back. I told her the deal and she just said sweetly, "OK, let's see." I took off the bulky sweater and bra, and then I knew she'd seen it and probably a lot worse many times before. "Wait here," she said cheerfully, and then came back with just the right bra. It wasn't a mastectomy bra or a modified regular bra, just an actual bra that doesn't have underwire to cut into my incision..instead it has double stitching and support and is shaped in such a way that when it's on, it's really not possible to tell that anything is different -- unless you're staring directly at my boobs, in which case why are you?
I could have kissed her. She was so unimpressed with my freakishness that I felt less freakish. And when I left the store she had also provided me with a lighter and looser version for sleeping (at least till I heal). Plus they weren't very expensive, as I'd expected. And since then I've worn just about any damn thing I feel like. So there. Thank you, Imperturbable Young Lady from the Town Shop, and thanks to the wonder we call The Bra.
Tomorrow is my important first visit with my old oncologist, Dr. L.
It's not only small vs. large-breasted women, though; it's women who have been through the cancer mill and come out with one or more boobs that don't look the way they did...and yes, the way they should, in some boob-utopia of the mind. I've been twisting and turning in that mill-of-the-mind for weeks now, waiting and hoping that the poor beaten-up boob will return to "normal" or some semblance of it, and slowly realizing -- not. It's not what it used to be, and probably never will be, and I'd better get used to it, and I'd better be grateful for however long I get to hang on to it (so to speak) at all, and do what I can.
As soon as I returned to work, I went back to wearing my bras. But it was a disaster unless I wore the loosest, maternity-like sweater and crossed my arms a lot. This made me so sad I obsessed about it during a few sleepless nights. Would I have to ditch my entire wardrobe,really? And no more cleavage, ever again?
Then one day I idly found a chat room on breastcancer.org and cyber-spoke to the ladies who happened to be on at the same time. I don't much like real-time chat, but they were great, a true example of people who help each other for the sheer comfort and pleasure of doing so. My thought at the time was that I would buy inserts (like falsies) to put on one side, and didn't know where to get them. The Ladies Online immediately gave me a link, and I bought some. But when they came, they didn't look the way I hoped, and they didn't help with the discomfort I felt when I wore my usual underwire bras. I think it was my daughter A. who advised me to go to a bra fitting store and get a special bra instead.
I was reluctant but willing to try, dreading the process and the results. No one had seen the breast naked except for medical personnel, and I didn't look forward to awkwardness and suppressed embarrassment. So I rehearsed what I'd say when I went into the Town Shop: "I'd like someone to help with fitting a bra, but I have a special situation. I had breast surgery recently." Oddly, I never got to the second sentence, because at the sound of "special situation," a young woman was called from where she was lurking at the back. I told her the deal and she just said sweetly, "OK, let's see." I took off the bulky sweater and bra, and then I knew she'd seen it and probably a lot worse many times before. "Wait here," she said cheerfully, and then came back with just the right bra. It wasn't a mastectomy bra or a modified regular bra, just an actual bra that doesn't have underwire to cut into my incision..instead it has double stitching and support and is shaped in such a way that when it's on, it's really not possible to tell that anything is different -- unless you're staring directly at my boobs, in which case why are you?
I could have kissed her. She was so unimpressed with my freakishness that I felt less freakish. And when I left the store she had also provided me with a lighter and looser version for sleeping (at least till I heal). Plus they weren't very expensive, as I'd expected. And since then I've worn just about any damn thing I feel like. So there. Thank you, Imperturbable Young Lady from the Town Shop, and thanks to the wonder we call The Bra.
Tomorrow is my important first visit with my old oncologist, Dr. L.
Friday, February 4, 2011
Telling
Rereading the last post, I'm aware that I am feeling quite a bit better than when I wrote that five days ago (probably if I weren't, I would have posted more here!). There's no question that work is a wonderful antidote to these feelings: I'm busy as a bee, and it feels great to be up and about, surrounded by people, doing what I feel I'm good at, and making decent money by doing it.
An odd question has come up: whom do I tell about the cancer and to whom do I pretend that nothing has happened? Now that the first level of family, friends, and key superiors at work know (the latter in case I had to take time off), it seems odd to answer the innocent (and usually meaningless) question, "How was your vacation?" I'm constantly tempted to say, "Fine, if you don't count surgery for breast cancer." You can't just say "Lousy", because then you're expected to provide an explanation. So either I tell them the truth, or I say, "Okay, thanks, and yours?". I've never been able to say things I don't mean with ease, so the bland social response feels uncomfortable to me. But at this point telling Tom, Dick and Harry what happened also feels uncomfortable...like I'm begging for sympathy. And what can they say? "Oh, I'm so sorry." "Yeah, thank you..." I'd reply. Not satisfying to me, and probably embarrassing to them. This is probably why I told almost no one at work when my mother died years ago. I'm weird that way: either oversharing or undersharing compared to other people.
Still in a distressing amount of physical discomfort, hard to describe. There are occasional flashes of pain in the breast, but that's not the problem. It's more like a constant, tight, heavy, stinging feeling that I can't forget about and that's not relieved with OTC medication or ice or heat. Maybe it will go away, but it hasn't changed that much in a couple of weeks.
This Thurs. I have an important appointment to see my old oncologist, Dr. L. (randomly, she may be the only black female oncologist on the staff). I have lots of questions for her: WTF? is pretty much the first one. Why didn't the MRI pick up the DCIS and the extent of it? is the second. Does this mean that even MRIs don't see all that's in there, that there could be a lot more that the surgery didn't get? Then I definitely want to know what she thinks about the surgeon's decision not to operate further in spite of the "dirty" margin. And the question of radiation, and the possibility of further hormone treatment...and so on. I should take a tape recorder with me. Maybe a human one.
An odd question has come up: whom do I tell about the cancer and to whom do I pretend that nothing has happened? Now that the first level of family, friends, and key superiors at work know (the latter in case I had to take time off), it seems odd to answer the innocent (and usually meaningless) question, "How was your vacation?" I'm constantly tempted to say, "Fine, if you don't count surgery for breast cancer." You can't just say "Lousy", because then you're expected to provide an explanation. So either I tell them the truth, or I say, "Okay, thanks, and yours?". I've never been able to say things I don't mean with ease, so the bland social response feels uncomfortable to me. But at this point telling Tom, Dick and Harry what happened also feels uncomfortable...like I'm begging for sympathy. And what can they say? "Oh, I'm so sorry." "Yeah, thank you..." I'd reply. Not satisfying to me, and probably embarrassing to them. This is probably why I told almost no one at work when my mother died years ago. I'm weird that way: either oversharing or undersharing compared to other people.
Still in a distressing amount of physical discomfort, hard to describe. There are occasional flashes of pain in the breast, but that's not the problem. It's more like a constant, tight, heavy, stinging feeling that I can't forget about and that's not relieved with OTC medication or ice or heat. Maybe it will go away, but it hasn't changed that much in a couple of weeks.
This Thurs. I have an important appointment to see my old oncologist, Dr. L. (randomly, she may be the only black female oncologist on the staff). I have lots of questions for her: WTF? is pretty much the first one. Why didn't the MRI pick up the DCIS and the extent of it? is the second. Does this mean that even MRIs don't see all that's in there, that there could be a lot more that the surgery didn't get? Then I definitely want to know what she thinks about the surgeon's decision not to operate further in spite of the "dirty" margin. And the question of radiation, and the possibility of further hormone treatment...and so on. I should take a tape recorder with me. Maybe a human one.
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