The Power of a Week
You all. You ALL! A week ago I was furiously typing away all my frustrations concerning six weeks of radiation I wasn't prepared for. Now a mere seven days later the path has taken a different course, and it's one I'm most thankful for. God winks, guys. He is always looking out for us.
I met with my oncologist again today and the upcoming surgery plan was the main focus of our conversation. I was scheduled to meet with my surgeon on April 16 for my surgery consult, but that will no longer happen. He is in a high-risk category for COVID-19 based on his age and has elected to take himself out of any upcoming surgeries to reduce his risk. When I initially heard this my heart sank because he is incredibly well respected in the breast cancer surgery world, and I always knew I would be in good hands with him.
My oncologist then went on to say that they have been instructed to continue to do lumpectomies and mastectomies as what were originally laid out in patients' treatment plans. However, reconstruction can NOT be done at this point in time due to a lack of supplies and putting patients at unnecessary risk of infection. Now, reconstruction isn't even an option for me until spring or summer of 2021.
Needless to say, my heart sank. She got done saying all of that and I said, "So that means I'm going to be flat for an entire year and have to, like, wear boob prosthetics to look like I'm still a woman?"
She said yes.
And my head said no.
But then she said, "You do have an option we haven't discussed, and I don't think you'd be interested in it based on your desire for the double mastectomy, but I still want to tell you about it."
I had no idea I was about to get the sunshine rays of Jesus put on me.
O: Since your tumors are so small, a lumpectomy is an option. This dramatically improves your cosmetic results and you will still have your breast tissue. Since your genetic testing came back negative, I feel comfortable recommending this to you. I will still order a breast MRI and mammogram for you annually, and we'll stagger them, so you'll be getting checked every six months.
M: (I was surprised by this information, but still skeptical) Ok. But if I do a lumpectomy, doesn't that allow the cancer a chance to grow back? Recurrence with a lumpectomy vs. mastectomy - what's the data on that?
O: Back in the 1970s and 1980s, women who had a breast cancer diagnosis were given radical mastectomies where breast tissue, lymph nodes, and muscles were all removed. Truly, women were disfigured. Dr. Bernard Fisher conducted a study that randomized women into three groups: lumpectomy only, lumpectomy with radiation, and mastectomy. There was no difference in recurrence rates in the lumpectomy with radiation vs. the mastectomy groups. Lumpectomy on its own did not fare well. You will be in no greater danger if you elect to do a lumpectomy with radiation instead of the mastectomy.
M: Even with it being triple negative?
O: Correct.
M: What are the recurrence rates for triple negative again?
O: 10%-20%. So not terrible.
M: (I begin to feel that lump that forms in the back of your throat when you need to cry, but don't want to.) This is a huge relief. I had no idea the double mastectomy wasn't going to put me in a "better" prognosis/recurrence category. I honestly never even considered a lumpectomy for that reason.
Then I paused...and went on to say, "It just amazes me how society has this assumption that a breast cancer diagnosis is a shortcut for a boob job. If a diabetic had to have their foot amputated because they had a wound that wouldn't heal NO ONE would say, 'Awesome! Maybe you can get a foot with the toenails already painted so you won't have to worry about getting pedicures anymore!'
**digression from our conversation**
Right? Right. Because that is idiotic thinking. Someone is getting their foot amputated. They're not going to give a shit about their toenail color at that moment.
It's the same thing with a mastectomy. You all, it's not a boob job. If I have one request, it's that you STOP saying to breast cancer patients, "Well at least you get a new set of boobs out of it!" This is not a timeshare presentation where the salesperson threw in an extra week of vacation to our already overpriced deal we've fallen for. It is literally the removal of your breasts. Like, all parts of them - the nipple, areola, and breast skin. Your souvenir is an awesome scar across your flat chest. And I hadn't planned to only have a mastectomy on one breast - it was going to be both. So pause for a second and consider the visual I would have in the mirror every morning when I got dressed and every evening when I went to bed. If you're a visual learner, here's an informative video for more info on mastectomies: https://www.nationalbreastcancer.org/mastectomy
Reconstruction can often be done in the same surgery as the mastectomy, but with COVID-19 that would need to wait for an additional year. Once again, consider the visual I would see every morning and evening. I know that sounds vain, but I have not adequately expressed my anxiety over the double mastectomy. It completely scares me. I am not obsessed with my boobs. But when I think about how they fed my children and are what make me feel feminine, the thought of losing them messes with my mind.
**back to the conversation**
O: (laughing) You're right. I have seen several reconstruction surgeries; some are better than others. Some patients come in here and you can hardly tell they've had a surgery...and then everyone comments on how great the patient looks. However, you doctor, nurse, husband, or friend can tell you that you LOOK great. But do you feel great? Do you have the same sensation you had before? No. And ultimately you need to do what makes you the happiest mentally.
M: (eyes are welling up with tears, voice cracks) I have honestly had so much anxiety over the surgery. I just want to look like me. The chemo never worried me. Radiation doesn't scare me. But looking in a mirror every day for the rest of my life and seeing a version of myself I never asked for is not something I can voluntarily choose to do.
I'll spare the rest of the conversation, but in a nutshell the lumpectomy is an OUTPATIENT procedure (YAY!!) and the recovery time is drastically less than a bilateral mastectomy. I will be able to drive! I will be able to sleep in my bed, not a recliner! I will have little scars, not a flat chest! I won't have implants! I will be able to use my arms! I will be able to gain back weeks of my summer I envisioned being spent on painkillers holed up in my house!
I know I gave the marathon analogy last week; I still feel like I'm on the marathon, but today's appointment was the equivalent of a water station and a better pair of shoes.
Also, the main tumor could not easily be found today. After a lot of digging, she eventually found it. It's currently less than half a centimeter. Praise Jesus!
On my way home after chemo, I was listening to "It Is Well" by Bethel Music & Kristene DiMarco, and I just cried.
"And far be it from me to not believe
Even when my eyes can't see
And this mountain that's in front of me
Will be thrown into the midst of the sea
And through it all, through it all
My eyes are on You
And through it all, through it all
It is well
And through it all, through it all
My eyes are on You
And it is well
So let go my soul and trust in Him
The waves and wind still know His name"
It IS well. It has always been well. Ideal? No. Perfect? Absolutely not. But this entire journey has been well with me. I mean that.
But think about it - think about how much slower our daily lives are now. We're not rushing from one thing to another, completely missing the small God winks throughout the day.
Others are begging for time to slow down. People are critically ill. Marriages are ending. Deadlines are looming. People are looking at clocks wishing the seconds wouldn't go by quite so fast.
I think this is the human condition. We want the opposite of what we currently have. We were all too busy two weeks ago. Now many of us don't know what to do with all this extra time on our hands. When do we get back to the center point of contentment?
Cancer has taught me that time is something we all try to control, yet none of us can. Six months ago I was working full time, running my boys to sports practices, and drowning in laundry and dinner prep. I was completely missing the meaning of being a mom with a husband and two young boys. My tasks trumped my intentionality in connecting with others, especially my family. Time felt like a stopwatch that was tracking my tangible successes each day.
Along this journey, some days time looks like a full day in bed resting. And I've gotten to a point where I have accepted that.
Other days, time looks like a big home cooked breakfast and a Peloton workout.
It might be an uninterrupted conversation with Jeff over a variety of topics.
It can be an afternoon on the driveway watching Reid ride his scooter and Lincoln shooting his basketball.
The point is that my time is now devoted to being intentional and not manically flitting from one action item to another on a list that never ends. There is no fulfillment in living that way.
My biggest prayer for when active treatment is over is that I remind myself to try and stay in the center point of contentment as much as possible. Will I stray? Absolutely. But being aware of it is the first step in living that way.
I sure hate cancer. Nothing about it has been enjoyable. However, I'm not going to go through this journey without finding the blessings in the bad. And for that, I am most grateful.
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