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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.
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
