Farewell symmetricalness! It was a great run.

103 degrees today. One-oh-three. Record-shattering temperatures. 103 would feel like 120 degrees for the rest of the country only because just like when it snows, Seattle is completely ill-equipped to handle this heat. We're having a heat wave, but we're also on a 3-month drought, breaking records from the late 1800's. This morning on KEXP two djs were talking about why it's not actually that hot when you compare this to the midwest or other places with hot summers, but again, it's because this city is not built for heat. John Richards said, "I don't even own a fan!" and Kevin Cole rebutted, "I don't even own shorts!" Forget air conditioning, no one has it and they've even designated public libraries as cool-safety-spots.

Everyone is asking how I feel about tomorrow's surgery. Besides that I cannot wait for this to finally be getting-it-on, the forecast for tomorrow is 100 degrees I am looking at this as 8-hours of crankin' hospital AC bliss. It's 91 outside as I write this at 10:30pm, and the inside of my house is finally cooling down to a balmy 87. I can't WAIT to be in that hospital tomorrow.

So, I thought this would be a great day to go for a run. Something has happened to my brain since having to focus on Lump. It's like I cannot handle any other brain activity. Bad decisions are made. Things get lost. Cell phones get dropped. Daily. (Ok, that has always happened to me I confess, but the frequency is definitely on the rise...) Last week before Sarah's wedding I showed up a day late for my hair appointment (but at the correct hour! I haven't totally lost it!) I saw this sign on a light pole around the corner from my house. I could completely relate. I feel I'm coming dangerously close to being in this person's shoes:


I had dinner Monday night with my friend Dr. Sanders who was giving me all kinds of medical and emotional advice. He told me he was taking me out to boost me up for the surgery and emphasized how important it is to eat like crazy before an operation. Why?, I asked. It gives you energy to fight the stress on the body, fills up your fat reserves, gets you through the long haul. "Imagine going in there all depleted?" Right. You don't have to tell me twice. I ate almost an entire giant eggplant stuffed with fava beans, pinenuts, and rabbit. And I have been on a eating spree since. (When the heat isn't suppressing a singular desire for only cold yogurt and blueberries.) With all this feeding, I woke up this morning craving a run. I haven't had time in the past few days nor has the heat been particularly inspiring. But this is it. I'm not sure how long it will be before they'll let me run again, so I felt I had to go.

Here are a few of the bad decisions. That I decided to go on a run in the first place. That I picked my 7-mile route instead of a shorter one. That it goes inland, instead of out along Puget Sound where it is far cooler from the cold salt water. And oh yeah, that of all the days before this one, today was going to break 100. (Good decision: I brought a water bottle for maybe the first time in my life.)

Half-way through the run I started recalling Sanders, "Imagine going in there all depleted?" Oops. That may be the very thing I was doing. At one point in the full sun I had sweat pouring off my elbows, like a gutter. The bandana on my head was doing nothing with perspiration control, it was so soaked I could have washed a car with it. I finally set up a system telling myself to run where there was sun and walk when there was shade. So now I know, that for a tree-hugging city, Seattle has surprisingly not so many trees. When sun comes, we want it. Well, we asked for it and are sure getting it in spades this year. I clung to shadows like a cat walking the perimeter of a lawn. I also realized how hilly my run is. So, even more than a run/walk, it was more like a run/mosey. And the whole time I was nervous I was jacking up my surgery tomorrow. I just. Wanted. To get. Home.

I did, but my normally 1 hour 15 min run went 40 minutes longer than usual -- which under normal conditions I could have run another 4 miles in that time. After grubbing around looking for these hydration tablets I bought on a whim once, I drank 64 oz of water with like 4 of those tablets fizzing away. Then kerplunked into an ice-cold bath. I swear you could hear sizzle and see steam. I submerged my head and turned off the icy faucet with my toe while still underwater. I didn't want to come up. My fingers were fingerling potato swollen. I get why they are named that. My face like a beet. My face turns red when I run in the winter, in the rain. I'd passed a guy struggling with energy to mow his lawn, but he took a long look at me and reached for his cell phone by instinct, I know he was contemplating calling 911 for a young woman having a heart attack from running like an idiot in the mid-day sun.

But other than that little self-imposed stupidness, I feel great. I've been spending the last two weeks getting ready for tomorrow. Making follow-up appointments. Deep cleaning. Paying bills, balancing checkbook. Doing yard work between heat spells. Replacing gunky 4-year-old makeup so I can try to pretend I look ok on pain medication. Food shopping. Laundry. Finding housemates for downstairs. Exercise. But not a lot of sleep.

Last night my amazing friend Monika came over. She works in HR for the King County Public Library system and deals with health insurance every day. We went through mounds of overwhelming (to me) paperwork, matching up statements with bills, checking all the charges, red-flagging weirdness. We got piles sorted out and organized into a thick 3-ring binder. She also told me to not open or pay any bills for the next two weeks. Just stick them all in an envelope and she'll come over and we'll go through all of them together. I can sleep tonight just knowing that is finally under control, I can't even describe the relief. She's Polish and speaks English fluently as a second language. She also speaks fluent Health Insurance and I will be forever indebted to her.

I have to get up at 4am. I need to check in at Overlake Hospital at 5:30 and go to the Nuclear Medicine Department to get some radioactive goo shot into my right boob which will be carried up into my armpit by lymphnodes so they can test them for cancer too. They cut into your armpit during the lumpectomy to do that. It's called a Sentinal Node Biopsy. After that I head down to surgery and let the lumpectomy begin! They also do a couple of other tests to see if the cancer has left the breast and invaded your system (so I will know about chemo after this.) It is supposed to be 1 1/2 -2 hours of operating and then I'm not clear how long I stay there. I think a few hours. It will be outpatient surgery and I will be kicked out of AC Eden at some point tomorrow.

Last night I went to bed with total delight. I had all the lights off, crawled in to read for a few minutes, clicked on the light and saw a ladybug on the wall next to my good-luck charms! Extra extra good stuff! There's two little figurines given to me by the wonderful Txell (pron, "Che") who was given them to her for a surgery she had this year. One of them is this flat, polished, carved, white stone in the shape of a female body. I press her right breast with my index finger every night for good luck.

The third object I have was given to me by my little 9-year-old friend, Ophelia. One day April pulled up in her mini-van as I was walking down the street and she yelled out the window, "Jenny! Ophelia has something she'd like to give you!" It was a fresh four-leafed clover. "Ophelia finds them all the time and she said to me, 'You know Mommy, Jenny needs this one a lot more than I do.' " I am not sure what is more astounding, the fairly deep understanding that little Ophelia has for a very adult situation... or the fact that she finds these four-leafed clovers all the time. I am SO jealous! I'm always on the look out for them and never find any. I pressed it between tracing paper and it joined the figurines. And last night the ladybug flew in for the party. Tomorrow my chest will be forever altered, but I know I am going to be ok.

Crawling Out of the Information Quagmire

WHEW. That was a crazy long bit of too much. I've moved back to my house, I'm still unpacking, our Argentinian, long-time friend Alejandro Gee has moved in as a roommate upstairs (into what Hogarth calls "The Tango Palace"), and John & Amity our best friends downstairs have bought a house and are moving (sniff... sniff...sniffsniffsnifffffffff) the beginning of August so we are on the search for new tenants. And I've been to another billion appointments and struggling with: which surgery and which surgeon to pick. And I have. YEY.

Please don't get me wrong: I know I am SO lucky to have options. But I never envisioned my process being this way. And I did not foresee how unbelievably stressful this decision would be (and still is). I am not comfortable deciding the fate of my body. Which doesn't make sense because isn't that the ultimate luxury in medicine, to make your own choices?

I originally went to Surgeon #1 and thought I'd leave that meeting with her telling me exactly what my surgery would be. Wooo-weeee, was I ever wrong. Instead I left there totally exhausted and confused after she said I could pick what I wanted to do (again: this is GOOD!). Surgeon #2 (at a completely different hospital system) said the same. #3 said he would definitely NOT do a mastectomy because of the lump's closeness to my pectoral muscle, he felt he could not get good enough "margins" (they want to cut a minimum distance away from the tumor to ensure they got a good clearance of the cancer cells) and he would not cut into the muscle. Therefore I would need to do lumpectomy with radiation because with mastectomy I most likely wouldn't get radiation and therefore there would be too much risk of cancer cells left behind near the muscle. So I was set on lumpectomy for sure. I went back to surgeon #1 and she concurred. Deep breath...

...Then I saw a plastic surgeon to see what he thought. He told me to choose #2 as my surgeon since I liked him best and then he went through all the reasons why a mastectomy could have better cosmetic results for me so I could be aware. And -- oh great, yet another option! -- I could start with a lumpectomy, see how it turns out, and if it's terrible aesthetic results, go back in for a second surgery and get a mastectomy.

Now I have no idea what to do except... I know I want Surgeon #2. I went back to #2 and he said he would cut into the muscle and it wouldn't be a big deal, thereby putting mastectomy back out as an option. In the end he told me to go see a counselor about trying to pick which surgery, since all surgeries will cure the oncological problem. The rest was aesthetics, process, and lifestyle decisions that I need to make... and only me. I did see a counselor. But actually what really helped was meeting a radiation oncologist who was so completely fabulous. She reinforced my feeling that I should do what the plastic surgeon said: start with the lumpectomy and see how it goes from there.

Somewhere around seeing that plastic surgeon is when serious headaches started disabling me and I began having really big problems with words. Like "please shut down the rainbow" means "could you lower the volume on the radio, please." Names of people -- HA! Unless you're a doctor I forget them. I don't care I've known you forever and you're my sister, you're still sometimes What'sHerFace. And a really weird side effect: I cannot remember how to efficiently drive from point A to B anywhere around Seattle. My mind-maps are blown to bits. And I stare off in space with exhaustion. Please wipe up my drool if you see any. Ever try to learn another language in a crash-course, immersion kind of way? It's a lot like that.

And I am HEALTHY. I do not understand what people do when they don't feel well and have to do hospital things. This is why I pray to the Great Chemo Gods that I won't have to go through that. I am terrified of chemo. I digress. As I was saying, this is all just mental and emotional exhaustion. No meds yet, no nothing. Just a severe case of being super overwhelmed with information and indecision.

Lumpectomy vs. Mastectomy
So here was the problem. Appointment after appointment, tons of reading material, talking with breast cancer survivors... all of this information kept getting revealed and I still never liked the choices. They all sucked. But which sucks the least? Who knows. Breast cancer is different for every woman so it's hard to know who's profile you match the closest too. In the end it's really your own personal decision (when you have choices...). These were my options.

Lumpectomy (this is verrrrry basic):
-Tumor is removed but because of the breast tissue left behind you HAVE to do radiation to make sure you kill off cancer cells left in the tissue
-Radiation treatments for me would be Mon-Fri everyday for 6 1/2 weeks (10 minute appointments but a 20-minute drive each way.)
-Because you are basically getting burned, radiation toughens up the skin and tissue making it almost impossible to get reconstructive surgery (picture bacon, but this happens microscopically)
-You have a slightly higher rate of breast cancer returning because there is breast tissue left behind
-There is a 1-3% chance that sometime later in life you could develop a totally different type of cancer from the radiation -- and these are usually not curable cancers
-Radiation can hit and damage other parts of your chest cavity, heart and lungs
-Sometimes your breast can shrink a full size (Hello! I'm already A-ish...)
-Where my tumor is and the skin that will be removed could make one nipple higher than the other, mmmhhmm... lopsided
-Where the tumor was removed it could look like a big chunk is missing. Up to 30% of my breast could be removed, and I might be deformed, certainly no longer symmetrical. I might tell people I wrestle alligators for a living.
-Or everything could look great. That's the problem with this, you just don't know the visual outcome, till the outcome
-BUT... I would still have MY breast and it would have sensation and continue to live and be a body part
-I keep forgetting to ask if I can get a tattoo where the skin has been radiated. Something is definitely going there when this is over...

Mastectomy (again, super basic, broad statements):
-Remove all breast tissue
-Depending on the tumor location, this usually means the nipple is removed as well
-Later, with WAY-better-than-Frankenstein reconstructive surgery, a fake nipple is made and tattooed on
-GOOD: I most likely would not have to do radiation (since lump and all tissue have been removed)
-SO, you can get great reconstructive surgery. But it is not like a regular boob-job. Those the implants go under breast tissue and muscle and there is still sensation. With a mastectomy it's just implant and then skin. My friend's mom said her implants are "lumpy, a little mushy."
-There is little to no sensation in the entire mastectomy area, which can also continue up into the armpit. It feels numb.
-My other breast would get a normal boob-job implant to match
-I'd have the mastectomy surgery, then two months later they put in these bags that stretch out the skin, then two months after that they put the final implants in (some plastic surgeons put those stretchers in at the time of mastectomy surgery; mine won't because he doesn't like the risk of infection). A six month dealio.
-Also GOOD: it would decrease the chance of breast cancer returning some (since there isn't tissue for it to return to)

This is like 6 weeks of information and opinions about my particular lump boiled down to some basics that leaves out a whole lot, but you get the gist. It seems so odd that all of the doctors are so brilliant and yet all have slightly different opinions and takes on information. (Like the radiation oncologist doesn't think my breast will shrink that much.)

Halfway through I took the option of double-mastectomy totally off the table. I'm only going to deal with the one breast with problems at this time. The other one right now is healthy and I'll just go with that. Also, a 4th option was thrown into the mix. Because of my tumor location it is possible to do a nipple-sparing mastectomy. They leave your nipple but remove everything else. Again, breast cancer reoccurance is slightly higher because a nipple is breast tissue and you are leaving it behind. The nipple is dead though. It does not react to anything like temperature and it too is completely numb like the rest of the breast. And it might not take after the surgery and could die off. However, I liked this psychological option as I was COMPLETELY freaked out about losing it entirely.

For some people there might be factors that guide them clearly in one direction or the other. I'm in the group of the clearly undecided. My strategy for a long time was that as long as I didn't decide, then there wasn't a decision, and therefore no surgery could be scheduled, and this all wouldn't be happening. Lalalalalalalaalalalalllaaaaaaa. (I'm learning the true meaning of denial.) Well, the clock is certainly nipping that theory in the bud.

This is where Super Lisa comes in. Whenever I see a picture of Lisa I see an imaginary caption underneath that quotes what Rob once said, "Lisa might be the smartest person we know." And Dr. Rob Crampton, PhD has a lot of smart people in his life. I know, right? -- Wouldn't you bring her along too??? Well, that's a good enough resume for me, and poor, poor Lisa got recruited into my world of nuttiness. She met my oncologist, plastic surgeon, surgeon #2, and the radiation oncologist. She also got in on the film-losing-escapade. One day she said, "I don't know how you aren't all googly-eyed at the end of these days" ...since she was all googly-eyed too. Oh, which I am by the way (see drool comment above). You can't help it.

This is how awesome Lisa is with helping me sort out all this information. Every time I drop her off from one of these insane appointments we decompress all our new facts. Somewhere along the line she decided we needed a decision tree before our heads popped off. Look what she made me. This isn't finished, it is in Phase 1 of production:


She also typed up the notes she took at our appointments. Have I mentioned enough that I have the most amazing friends? I am one lucky dog. Here is Lisa. She's super beautiful (and single too. All my single girlfriends get a free promotion when starring on this site.) We had a great time doing a jigsaw puzzle waiting for one of my always-seem-to-be-delayed appointments. Note to hospitals: I would have happily waited hours for the appointment with that puzzle. In fact, it was hard to pry us away once Lisa found the LAST edge piece. Yes!

Lisa, possibly the smartest person we know

Soooooo.... Surgery D-Day is Thursday, July 30th. Julie What'sHerFace, my sister, is coming up from Portland to stay with me and take me to Overlake Hospital. They'll cut out the lump and send it out for tests. They'll test all six sides of it and make sure there are enough healthy cells surrounding all of it (those pesky "margins.") If they cleared the margins enough, then I'm done for now. If not, I need to go back in a week later and either get more breast removed, or just go for the whole enchilada mastectomy thing.

If the lump tests ok, then I go to the plastic surgeon. Using a needle he will aspirate the fluid that fills up the lump's hole. (The fluid is the body's way of trying to heal and makes everything look puffy and nice post-surgery -- but it will get zapped away with the radiation. Kind of like when you see a souffle in the oven and then it totally collapses later on.) With the fluid gone, we can better see what my breast will look like after radiation treatment. At this point (ok, check the Decision Tree now) I can decide if it looks good to me and 3-4 weeks later start radiation ... OR if I feel like a deformed freak, I'll skip the radiation and sign up for a nipple-sparing mastectomy so I have a shot at reconstruction.

Basically we know all that we are going to know until after surgery. During surgery they put a blue dye or some radioactive gunk in your breast and it sends it up into your armpit and shows the surgeon where your lymphnodes are. He cuts into your armpit and removes some of these nodes. This is the Sentinal Node Biopsy. They test them right then and there. If they are positive, then they go for removing more nodes. If negative, then it looks like the cancer is pretty local in your breast. But they get sent out for further, better tests as well.

At surgery is also when they can tell what stage your cancer is officially at. They also can tell if there are tentacles to your tumor and if they are spreading beyond the breast. They also do another test that I forget the name of. That's for the oncologist, so they'll know better what your deal is as far as the cancer being in your system or just localized. So, it's not until after surgery that I'll know if I need chemotherapy or not.

But we're not going to talk about that, because I am not going to have that, in my mind. But if it happens, I'll have a lot to deal with then, but right now I have other things to worry about, I'm not putting my energy into the possibility of chemo. Like, I'm not sure what shoes I'm wearing to my friend Sarah's wedding on the 25th. (Can't wait, can't wait, can't wait for that!)

My lump is slow growing, non-aggressive, well-behaving (if there is such a thing) cancer. Most women my age have cancers that are akin to a Bonnie & Clyde rampage, shootin up the country-side, robbing banks, spraying bullets, balls-out, taking no mercy. My cancer appears to be like the 70-year old woman fed up with her nasty husband and sprinkles arsenic every night on his meatloaf. So, chemo is hopefully unlikely, but not ruled out... till after surgery. I'm so sick of hearing with everything, "We'll know better after the surgery..." Aye yi yi...

All I know is that I will sleep better after this surgery... oh wait, that's right! For two weeks you can't sleep on that side of your body and it's really painful. Will someone tell me what's the good part of having (early-detected) breast cancer? Oh yeah... you get to live. Alrighty, I'll take it. YEY!

Forever Young

Yesterday was my birthday. This spring I was realllllly dreading it. 38, okay. Turning 39 -- seems so much... closer to ... 40. And when you feel like you're 28, how does this math compute? But there is nothing like having breast cancer at 39 that makes you feel super duper, like, totally young. I don't know where I've been in breast cancer education, but I had no idea that it was something you usually get after 50. And I did not know that usually when you have it at a young age, it's not pretty. It's probably very aggressive and rampant. This is one time I do not mind being a freak.

I love it every time a doctor or someone says, "You're sooooo young to have breast cancer..." I've never had so old a birthday and think it is so young! And, as one doctor told me, every birthday from here on out will all the more special.

So this is how it went: found lump myself, saw primary care Dr. Woo the next day, got signed up for a mammogram two weeks later at Ballard Swedish Hospital on Friday May 29. Mammogram actually came back normal, but there was obviously a lump there, so they went on and did an ultrasound. The lump showed up on that imaging. Now they had to determine if it was benign or cancerous. To do that they sent me to the other side of town to Cherry Hill Swedish that same day for a biopsy. My biopsy was ultrasound guided, meaning they used that to see where to stick the needle in (your lump area is locally anesthetized). They stick that in and pull out core samples of the lump that get sent to a lab to see if it is cancerous. The doctor had a hard time getting those because my lump kept moving around.

The results came back much quicker then they said they would -- Monday afternoon, June 1st. That's when I got the lovely phone call with the fabulous news. One of the only things the nurse could tell me from the biopsy about this new cancer stuff in me was that the lump had scored a 3 out of 9 on the Bloom-Richardson test. They grade it in three categories, so the lowest you can possibly get is a 3. These categories grade the tumor: things like its shape, aggressiveness, how much the cancer cells look like their counterpart normal cells, etc.

One surgeon told me that usually when women as young as me come in they almost always score a 9 out of 9. And of all her patients, she usually only sees one to two 3's walk through the door a year. So, in a way it seems I have the hormones more like a 70-year-old. I am, as another surgeon said, "really, really strange..." I will most gladly take strange, thank you very much.

I mention all of this because I've had shared with me quite often the very, very kind words of people's experiences that, for example, their mom had breast cancer and all they did was remove the lump and she was good to go, so don't worry about it, you'll be fine, no big whoop. This can be many (older) women's experiences, thank goodness. And while my inner 70-year-old and I may actually be a little similar in their lower-impact experience, most young women with breast cancer are not facing a simple journey. The 9 out of 9 is not a place I'd want to be. I would like to share this as I had no idea either, that while it is less common to get breast cancer younger, it is usually a much more aggressive and potentially very devastating cancer. Thought I'd throw that out there.

So, as my birthday wrapped up the first 30 days of this lump that's change my life, I still haven't had much time to reflect. It has been CRAZY. No one tells you that for the first month or so, your life is going to be completely insane. A million doctor appointments, that run into other appointments, meeting surgeons, 2nd opinions, 3rd opinions, oncologist, radiation oncologists, radiologist, genetic counselor, social worker, plastic surgeon, lab work, tests, blood drawn, MRI, nutrition counseling, mental counseling, 4,000 new cancer-related vocab words and test name acronyms, lost films, information total overload. Not to mention if you've been given options for surgery (how super great!) like me... you have to make some really major decisions. Soon. (And then there's the rest of your life that you hate to put on hold. Did I mention I ran a half-marathon last weekend and moved? Help me.)

I look back at my notebook and see all these things I wrote down June 3rd, when my naturopath gave me the 2-hour lowdown of what the process was going to be -- and how now I understand all that was once jibberish. No one tells you that your cancer is going to be a FULL-TIME job the first month, and really, good luck trying to work. And if someone told you what it will be like, you won't believe them anyway.

I hardly remember last week. I had so many appointments and I was trying to fit in work here and there. One day I said, "Tomorrow I will definitely be in for two hours," thinking this was an entirely attainable goal. Nope. At 3pm when I was finished with my second half-a-day appointment, I needed to get my films to bring with me for when I see the to second-opinion surgeon. Apparently no one could find them, and I spent the next two hours trying to track them down. It's like dealing with the government. So much for going back to work. And so much for not being exhausted. (Note: one thing I have learned -- keep your films in your possession at all times. Never give them to nobody, no matter how nice, trustworthy, organized, or official they may look. Nobody.)

The next day I had to use my lunch hour to pick up the copy of my mammogram that they were reprinting back in Ballard... because they still could not locate my films. It wasn't ready when they said it would be, so I decided to run over to this tiny but awesome take-out place, Green Go Food, while I waited for them. I walked in the door and asked some questions about their yummy yum yum super yummy menu. This little kid off to the side (in fact if you click on the Green go link you can see a picture of him) started showing me his airplane toy. "Oh, cool," I said. "Did you get it on a flight somewhere?" "No, I got it at the airplane store." I decide this kid is a-ok.

I'm bleary-eyed I'm SO insanely exhausted from the week and it's only Wednesday, lunchtime, but I really don't mind his incessant airplane talk. His smooshie-cute parents are in the kitchen, his mom yells, "Cypress. Please let the lady eat her food." The plane flashes red which he insists are the engines blowing up and he has to put them out. Over and over. All these mishaps. "That plane has got a lot problems," I comment. "I know," says Cypress. "It just keeps catching on fire."

I like his exploding plane play. Finally he comes over and climbs up on the stool next to me to show me yet another feature of the plane. Then he says:

Are you my friend Cooper's mom?
No, I am not.
Are you sure?
Yes, I'm sure. I'm not a mom.
Are you a grandmother?
(oh, thanks kid!) Nope. You have to be a mom first before that.
Well, you look like Cooper's mom. You remind me of her.

pause

Why aren't you a mom?

pause
pause
pause

pause
pause

He stares at me with blue eyes and blond hair. I stare back at him with mine. For what feels like 10 minutes. My stomach hurts for a second. Why didn't I tell this kid to scram when I had the chance?

That's a good question. I don't know. It just never happened. I guess I never got around to it.
Why not?
It's ... complicated. But... I would like to be a mom. I'd like to have a nice, fun little boy like you to talk with. This triggers something in him. I think he thought I thought he was a baby.
He jumps up and shows me his fingers. "Hey! I'm FOUR!"
Wow! Does that mean you go to kindergarten next year?
Yup... in the fall... when the leaves drop to the ground. He makes a graceful gesture as he says this, his hands and fingers making slow, tiny movements of leaves falling off trees and landing. Is this kid a mini-poet or what?
And by then...maybe I'll be FIVE! He totally cracks himself up with this and smacks his face with the whole palm of his hand.
When's your birthday? Do you know it?
February 3rd. It always has the same name every year: February 3rd... it never changes. When is your birthday?
Well, hey! My birthday happens to be next Tuesday!
Which Tuesday?
Today's Wednesday. (I count my fingers) Then Thursday, Friday, Saturday, Sunday, Monday...Tuesday. Six days.

His face totally changes with enlightenment.
Heyyyyy. I know. I should get you balloons. And I should make you a cake!
Ohhhhhhhh my gosh. Huh. What a wonderful thought! Thank you for thinking of me!

Dad walks by.
Hey, Dad -- can we get her balloons and make a cake for her birthday Tuesday?

ADULT WORLD ENTERS.
"Ahhhhhhhhhhh... I don't know how we can do that..."
But it's her birthday. Cypress looks back at me incredulously with palms up, face like Johnny Trav in Saturday Night Fever reading, "Wha? Wha's the problem here??"

I decide it's time for me to take off, relieve Cypress's poor dad from signing up to personally cater my birthday, and hope that stupid mammogram film is finally ready. I still can't stop thinking about Cypress though, and how at his age anything really is possible. Cypress thinks it's completely realistic to schedule balloons and a make a cake for a perfect stranger. I swear I will try to think of a few things that could be possible too.

MRI at the MoMA

Yesterday we were at the surgeon candidate #1. Here I am before I am completely exhausted by information and the idea that I need to figure out what I want out of life. I wore my Jamie Kreitman (Magda's friend) bunny shirt that Mags gave me few years ago. It's got this big, soft, fluffy cottontail sewn on it. I thought I could fool the surgeon that this was my lump. She didn't go for it. I'm telling you, she's smarty-pants.

(Oh, and Magda, this is the first time wearing it in years. The bunny tail was dangling by a single thread after an outrageously crazy night at a gay dance club a few years ago. Apparently gay men cannot get enough of bunnies with diamond necklaces and white fluffy orbs and that little cotton ball was completely mangled and nearly ripped off by the end of the very long night. Dozens-- I mean dozens -- of guys yanked that thing. Just did my mending.) Anyway, I want to show some happy pics at the beginning of this process -- to remember when all this might take a turn for the rough and tumble.


Now for today. Here is my good friend Txell (pronouced "Che".) Txell is from Barcelona. She is beautiful and funny and a great storyteller (and single -- just throwing that out there). She is also a teacher and has the summer off. Txell offered to drive me to appointments. Today I broke down and asked her for a ride to my MRI and I am so glad. We had fun and she entertained me through my tiredness and annoyance with the medical system.

Look her, so good -- trying to acommodate my photo request while still keeping her eyes on the road!

Ok, now, here's more like it, I'm starting to get more patient-y looking, right? No bunny shirts allowed in the MRI today. The Super Nice Lady (I am meeting way too many people, I'm losing track of their names...) handed me and said, "Here's a pair of drawstring pants. And an obscenely large robe that should open from the front." She was not kidding. I felt like I was unpacking my tent for camping. It wrapped around me twice. SNLady added, "...and you need to take out any clips in that hair too." (I love "that" hair. HA!) I had to get down on the floor for this. I had six of them in my crazy hair. (Warning: SAD INTERLUDE. I am absolutely terrified of them telling me I need chemo, for many obvious reasons. My hair can be my nemesis. But who will I be if I lose it? Ok, not thinking about it because, again, I do not know yet so I won't worry about it yet...please go back to the light-hearted parts, Jenny... like:) Txell laughed hard and said, "You know, you look like a medical geisha right now." We giggled and giggled.


Long story short, they'd changed up my MRI time to later without telling me so now I am frantically trying to call Bastyr to let them know I will be late for my 3pm. This is how I function these days. My 3-ring binder of info is never farther then two feet from me at all times. Can you see my little black book? That's where I write down notes of what's said at every appointment. See the cover and the first two pages, they are already covered in taped-in business cards of all the people I need to see or have seen. I'm frantically trying to call but they are nicely trying to grab me to put the IV in. Che grabs the phone, tells me not to worry. After the MRI is over she tells me that the appointment will take a full hour, so we will miss it, and she rescheduled me for next Tuesday at 11am because she could tell from the business cards that I had an appt. that day at 1pm, giving me time to eat lunch and get there. I told her that she was just promoted after one day from chauffer to Personal Assistant. What do you do without friends? I don't understand.



The MRI Lady told me to undo my front and "lie on your stomach, put yer ladies in those cup holders, face goes there like when you get a massage, and put your arms over your head." I think I may call my boobs "my ladies" from now on. I've actually never heard that before.

I lie down, face down, ladies in position, big wad of cold medical equipment pressing into my gut and get ready to not move for 20 minutes. I ask her what if I have to sneeze? She says, "Welllllll... don't. I mean try not to, but if you do, it will all go bad and we'll have to do it all again." Ugh.

"Ok, here we go!" she says behind me and gives a big push. I open my eyes into the face-thing and I'm zooming forward and can see everything coming at me. I pretend I'm in the space shuttle and I'm launching. All of sudden she's on the other side, in front of me and waving. "Can you hear me?" I have earplugs in like I'm at a music show. "Isn't that mirror cool? It looks like you're driving this thing, right?" It is kind of cool. I'm physically looking down at the floor but the mirror makes you see straight ahead. I can see my hands in front of me (which I have in loose fists in an effort to keep them warm for 2o minutes) and everything going on at that end of the tube, didn't feel claustrophobic at all. She did say I could wiggle them (and only them) when my arms go to sleep, but I'm too afraid to mess this up.

Then the freaky loud sounds begin. I'm trying not to move so my breathing gets deep, and the more my breathing gets deep the more afraid of moving I'm getting so the breathing gets deeper and more I think I'm moving my body. On top of this I can feel the gunk that she said I probably wouldn't even notice start flooding my arm through the IV. It feels like someone is injecting cold Kool-Aid into my blood and it's going into my forearm and up past my elbow to my upper arm.

This is getting so mental and I do NOT want to do this again, I need to do something. So I stop pretending I'm with NASA and I start listening to all the crazy loud sounds. I now decide that I am at the MoMA, and I'm checking out a sound artist's experimental work. I ask myself questions like, "How does this art make you feel?" "What do you think the artist's intention was with this piece?" "Why do you think he chose the medium of sound?" Dozens of these funny art questions that I say to myself, but I use Laurie Anderson's voice, which soothes me. I guess I must have done this for most of the 20 minutes. I'm mulling over that this guy is like an 8-trick sound pony when I start hearing a man's voice saying very quickly over and over "singsingsingsingsingsingsingsingsingsingsingsingsingsingsingsingsingsing..." while in stereo right is a bass "wahwahwahwahwahwahwahwahwahwahwahwahwahwahwah..." and like four other sounds go off and the whole thing is shaking a little more than ever. I decide I'm pulling this guy's NEA grant when MRI Lady says, "And that's it! It's all over!" I'm so happy. My arms are half asleep, I'm groggy from getting so relaxed and spaced out in the MRI MoMa, I climb off this thing and almost fall over, terrified of this stupid IV that is still jammed in my arm.

MRI Lady says, "So, guess what? We just took about 1300 photos of your breasts. I bet The Girls have never gotten so much attention before!" The Girls. I might put this woman in Txell's car and call this the best medical day ever. All I can say is, "Well, I guess you'll know them better than I ever will." We talk more as I get oriented and she's saying something about, "Yeah, well when I was in there for 45 minutes yesterday blah, blah, blah..." I have to interject, "Wait -- do you go in here for fun??" She laughs and says no, they were doing a test and "all they need is a warm body, and I'm like hell yeah I'll lie down anywhere for 45 minutes!"

I get dressed and Txell walks me down their Stanley Kubrick space age, curved, vaulted, lit neon white hallway*, gives me a big hug and we head home. I love my friends.

*I can see that part of this $4,000 (or something like that) MRI (of which I pay 30%!) must get converted into their interior decorating. Maybe.

Behind the 8 ball

It's 10:30pm and I think I recognize what denial might be. I have to meet the surgeon in less than 12 hours tomorrow and I have NOT:

-Filled out my "New Patient" paperwork
-Read Chapter 17 on surgery options in Dr. Susan Love's Breast Book that my sister Julie assigned to me. (She's driving up from Portland after work tonight to go to the 9:30am appointment with me. She is going to be so annoyed with me.... she also told me to:)
-Make a list of the supplements I'm taking and
-Print out the list she forwarded me of "10 Questions to Ask the Breast Cancer Surgeon" and
-Make a list of questions of my own

And that would be: no, no, nope, nope, and...not yet. Ok. yes, clearly this is big time denial. But I will get right on it after I finish this post, I promise! For reals.

Anyway, FARRRRRRR more interesting to me is this envelope I received from the Breast Cancer Center with my thick wad of New Patient paperwork to fill out:

Have you EVER seen anyone use this handwriting device before???

Instead of doing the above boring lists of stuff, I have been sitting here mulling over this envelope address for a good long time. Who writes like this? And carefully spells out "Washington" like it's 1943? I'm fascinated with this person. (Doris, can I get an analysis here?) I imagine her neatly writing this out, adding the little devil tails as a final touch, and her saying in her day-dreamy head,

"Dear Jenny Joyce... so sorry to hear about your lump. I wonder what you look like? I think you look like this (see below photo). Love, The Swedish Breast Care Center Admin.
ps. Can we be pen-pals?"

ripped off the web from sticker giant.com

And you know what? I think I'm going to start imagining I do look like this. In fact, I may want to come back from surgery looking like her. You people won't even recognize me! I'm starting over! Or maybe I'll get this tattoo. Except without the "Bad Luck." Maybe "Marginally Ok Luck" or "Good Luck Overall, Just Some Big 8-Ball Problems Right Now".

I haven't done the above list because I'm nervous. Dr. Claire Buchanan is going to be the first person who really gives me some big straight poop on this deal. And it's also like an interview, the whole time I'll be wondering, "Of all the people in this whole wide world, are you the one I'm going to trust with my life?" Ugh. I'm looking up other doctors for second opinions because that is what you are supposed to do. Dr. Claire is who Swedish Health System assigned me. Tomorrow she'll do some tests (not sure what) and will look at my films from the mammogram, ultrasounds, and biopsy and we'll discuss surgery options. And dates I presume.

So far I've just been absorbing. One minute someone tells me I'll probably get a lumpectomy and some radiation and I'll be fine. Yesterday our friend's wife who's a pathologist said it could be a double-mastectomy because of my age. I don't let myself get excited when I hear potentially great scenarios... and I don't freak out when I hear the bad ones either. Because right now I just don't know, so freaking out isn't going to do me much good. But tomorrow I will be getting my first real-deal opinion. Yikes. It does make me nervous. Suddenly this lump is getting serious with me. (But it doesn't know that I'm about to get serious with IT. Uh huh, that's right.)

Ok. Out of denial, into the paperwork. But a part of me can't stop thinking about the "Bad Luck" tattoo. Both my breasts may be behind 8-balls, but I'm going to think about the protective, powerful black cat watching over her instead.

Frequently Asked Questions

-Did you find the lump or your did your doctor?
I did, May 17th. We'd just had our neighborhood parade and a great bbq afterward. I was taking a bath later that night, sitting up, and I was sooooo happy I was literally splashing and singing something like "Rubber Ducky" when I went to move soap suds from my neck down to my armpit and on the way my hand went: **bump bump** -- over some crazy huge lump. I yelled out loud to the shampoo bottle, "Wait...seriously... WTF is THAT ???" The shampoo bottle blinked and said, "Wow. I really don't know..."

I calmed myself down and went over what Dr. Woo had told me the year before when I sheepishly admitted for the umpteenth annual exam (same conversation every year), "No, I have NOT been doing self-exams, what is it that I'm looking for again?" And then he always says, "Something the size of a pea, and hard." This wasn't like that. It just felt like a cyst. Or something swollen. I wasn't worried. Sort of.

-What size is it? What does it feel like? Where is it? Can I touch it? Does it hurt?
I don't have an exact size of it yet. I can't remember if that happens when I meet the surgeon, or when I get an MRI. And I'm not sure if they measure the whole thing or just the cancerous part. To me the mass feels about the size of a large apricot pit. It feels like that too, but if you made it slightly gummi-like. But it changes. It gets really big, then sometimes it seems small, sometimes it feels hard other times it feels swollen.

It's on the top part of my right breast, closer to my neck or heart than my armpit, which apparently is good. The closer to the arm, the more chance of lymph node problems I think. See photo.

Right here.
And I'm holding onto my hat so it doesn't blow away.

Yes, please ask me to feel it. I want to educate people what it may feel like. Nope, it doesn't hurt. And I feel fantastic. Still running 6-8 mile runs a few times a week and in great spirits. But that's the hard part. I feel SO healthy and yet I've got this stupid bump hanging on me like a monkey on my back. Except he's on my boob.

-What was the diagnosis?
So far they are calling it an infiltrating ductal carcenoma. Welcome to my non-medical world where I'm on an insane learning curve of lingo and acronyms and so much information coming at me from so many different people my head is going to pop off.

Anyhoo, from what I understand --and could be completely wrong-- it sounds like a bunch of cells blob together and form a neat little mass. And this state is called 'in situ'? I think I have this somewhat right. My cancer is in milk ducts and it's gone from in situ to starting to hang out a little bit on the inside of these tubes and on the outside. Hence the 'infiltrating' and the 'ductal'. Anyhow, this is what they've determined so far from just the initial mammogram and the ultrasounds and all the stuff that happens with the biopsy. So who knows, this could change.

-So, wait, go back to the bathtub again
Oh yeah. So I calmed down thinking there weren't any hard peas to be found and as always I very easily talked myself out of any kind of worry that anything was wrong (this is how I ended up with a staff infection in the past) but some reasonable tiny part of the back of my brain was a bit shaken and got me over to the phone to leave a message for Dr. Woo at 11:30pm to please try and fit me in the next day, Monday May 18th. I had bad sleep and weird dreams. Awoke to his office at the Swedish Clinic calling me at 7:15am saying they had time at 10. Good.

Well, Woo thought there was definitely some cyst-like thing there and I shouldn't get worried because he couldn't feel anything hard...but... "we need to get this looked at and confirmed. You know, just to make sure." (Wait. That step wasn't supposed to happen. He signed me up for a mammogram. Um, ok. I was supposed to be dismissed like the last time I came to him with a mystery lump four years ago and he said it was nothing and to go home.) Oh, and they only do Fridays at the Ballard Swedish Hospital and this coming one was booked. I have to wait two weeks. Argh!

Friday May 29th, I have an 8:30am mammogram appointment, so excited to get this over with and have a day off. It's hot, I want to go swimming!

I'll speed this up: paperwork, paperwork, gown, leave pants and shoes on, go by machine, get squished, mushed, pinched, vice-griped, don't move, and if we see something not quite right we'll do an ultrasound. Go in little cold room, wait...wait...wait... Uh, Jenny, we'd like to do an ultrasound. Lie down, cold chair, cold gel, lots of talk about on the screen, I'd like a picture of that... and that... and that... ok, go change and meet the doctor in the waiting area. Well, we definitely found something but the only way we'll know if it's cancerous or not is to get a biopsy. It's Friday, is there anyway you can do this as soon as possible, like Monday or Tuesday? (Me: Ummmmmmmmm, what's happening? Where's the part where we all laugh that it's just a cyst and we did all this silly testing for nothing. Let's go home and see you after 40 when you are supposed to start having mammograms. Ho ho ho ho ha! Oh and wait -- my parents are coming Monday... how is this all going to work??)

In the meantime the doctor runs away. Nurse is talking to me about stuff I cannot even remember. Doctor comes back, sits me down and starts saying that if I can get up to First Hill Swedish Hospital across town and sit it the waiting room for a couple of hours, she spoke to her colleage up there whom she loves, trusts and is the best, she'll try to fit me in for a biopsy today. The results can take up to four business days so she'd rather have me get it in before the weekend. Oh yeah, and you CANNOT go swimming. (First of many notes to self right then and there: this process is really annoying and inconvenient.)

I am driving up there and I'm like "WHAT is going on here? This is crazy over-reacting!" This is getting long so I will leave out most of the details of some amazing events during this same day like when two couples in two pick up trucks drove up and asked me if I wanted the abandoned dryer in my backyard... and let's just say that by the end of this interaction the women said they were Prayer Warriors, honked their partners to stop driving away and the four of them deliver a pentacostal-like prayer in the alley for me ending in hugs and tears all around. They said the dryer was going to keep me from having bad cancer and drove away. My Dryer Angel. And then after my biopsy I met Brenda, this colorfully patterned and bedecked older black woman (man? transgender? I really could not precisely tell you) with a giant hat, silver teeth and a wheeled-walker, she (?) and I had a fantastic 15-minute talk in about a 30-yard stop-n-stroll together ending with her placing her giant warm hand on my shoulder and delivering a long, loud prayer of hope and love for me in front of First Hill Swedish Hospital's parking garage.

At this point I knew I might possibly be screwed. I hadn't even gotten back the results of the biopsy and beautiful strangers were already praying for me.

The biopsy results did not take four business days. I had it done late Friday afternoon and they called me Monday June 1 with the news at 3pm. It was so soon I wasn't ready for it. And at that very moment my parents were somewhere in the sky on a plane flying out, a trip they randomly planned a couple of months before. Hi Mom and Dad! Guess what's new?! Oy. But perfect of course. They were here, such great support and my mom could go to a couple of long appointments with me and get the big low-down which I am so, so, SO thankful for. I can't imagine relaying that all by phone... with a 3-hour time difference. And no facial expressions.

-Mammograms, ultrasounds, biopsies -- do you have insurance?!
YES thank goodness. I have been paying through the nose for a plan that was canceled a couple of years ago. They weren't making $ on it so they gave it the boot to newcomers. Instead they have been punishing me with a premium of $327/month. OUCH. I meant to look into cheaper plans because why am I paying for this when I am so ridiculously healthy? And really, I was in perfect health (I thought) before ol' lumpty dumpty showed up. Please please please, have someone who might understand look over your insurance and see what is actually covered. It looks like even with this great insurance I will still have to pay $10-15k out of pocket. But it sure beats $100,000 to $200,000... **whew**

-So what happens next?
In the past two weeks I've been tested, poked, prodded, blood work, peed in a bottle for 24-hours, pelvic exams, informational appointments. And I didn't know how hormonally tied breast cancer is. You need to get this test done on the 23rd day of your cycle, MRI on days 5-7, pee in the bottle day whatever...

This is why I feel like this lump is just a big annoyance. It's seriously cramping my summer style. It's been BEAUTIFUL in Seattle this year, we're on day 25 without rain! It's not fair! And now it's tests, appointments, vitamins, supplements, phone calls, all of this information to know and remember. COME ON!!! Anyway, that's what I've been up to since June 1st.

**************
Anyway, I meet with a surgeon on Wednesday June 17 and I think I will maybe know the size and we'll definitely discuss surgery options (um, because she's the surgeon. I'm getting so tired writing this so late...) Right now it sounds like the two basic ideas are (1) lumpectomy with radiation, maybe chemo (I think chemo is unlikely) and (2) mastectomy and none of that other stuff. And then little variations of these possibilities.

I got back two important test results (ER+ and PR+ tests and HER2neu test -- I won't go into it all because it's boring and I'm confused anyway) -- BUT... they came back as really good results indicating that it's a slow-growing, less aggressive cancer which is GOOD NEWS! Apparently breast cancer in young women is usually very aggressive and they were pleased to see this unusual result. Yeyyyyy!

**************

I am sure that you are as sick of hearing about this stupid lump as I am by now. If all this gives you any insight into my foggy brain of information overload. But I have to say this: I AM SO LUCKY. I'm lucky I have small breasts and found this lump two months before when my next annual exam would have been, I'm lucky that I have someone helping and guiding me through this entire process (more on this Angel-on-Earth later), lucky my parents and sister were here the first week of this, lucky my sister works in a hospital (= interpreter of medical info), Lucky that this is breast cancer. There's no way I will die from this and there are so many more horrible things that can happen to your health. All I can complain about is missing a couple of days of swimming.

But most of all, I am so lucky to have so many friends and family with so much amazing support and love and help and good vibes and good recipes and good stories and jokes. It makes this lump almost fun! (I just say that to keep myself from getting faklempt...)

Seriously, I love you all.

(And future entries will not be this long winded...)

Um, yeah. This should be fun!

Seriously? As if this year hasn't been crazy enough, now I have freakin cancer? So, oh well. What can I do but go through this, like anything else?

I'm doing this blog not because I want to blab on about poor, poor me (sooooooo not me...) but because I can already feel the mental energy being sucked from brain over this new life development. And I am also beginning to be super rude about returning phone calls and keeping up with email. So I'm throwing this space out there for anyone who'd like to know how I'm doing or what I'm thinking about these days with all of this. Stop in and say howdy once in a while to this cowgirl out in the pasture ropin' in this stupid lump.