Long story short, I don't have any apparent metastatic disease! That means almost certainly no chemo; just surgery. On October 28, I will have a simple mastectomy on the left side only and immediate reconstruction using what's called the DIEP flap (or, if necessary, the MS-2 TRAM flap) procedure.
Read on, if you want the long story long! (It's pretty long!)
Cancer makes you busy, I'm remembering. Between the follow-up mammogram that led to diagnosis and my last consultation that will happen a week from Monday, I will have had 16 appointments and procedures in five weeks! There's the mammogram, the normal accompanying appointment with my breast surgeon, the biopsy, the first post-diagnosis consultation with my breast surgeon, a chest and abdomen CT, a bone scan, a breast MRI, a brain MRI, a first consultation with the plastic surgeons, two appointments with a social worker (one by phone), a second consultation with the breast surgeon, a second consultation with the plastic surgeon, and pre-op blood work, EKG, and consultation with an anesthesia nurse. Then there's the talking with people and the researching options and the deciding about options and the simple processing of the fact that this is happening. Again. It is a lot.
I have let it become rather all consuming, and I realized the other day that I have been judging myself for that in a way that I did not very often the first time. Some people in my position stick with their schedules, their lives, their routines. Some people have to. Some people find it comforting and others just don't want anyone to know that something this disruptive is going on. I have the opposite reaction. Hold everything! Back up, back off, relax, reevaluate...wait to see what the long-term implications will be.
The waiting between diagnosis and knowing how bad it is or isn't really is the hardest part. Even though I take the idea of having cancer better than some, the time where you're waiting around to find out whether secondary brain cancer will explain your fogginess, forgetfulness, fatigue, recent headaches, and unexplained vertigo is not the easiest. It doesn't help that a cancer diagnosis makes you remember all these little symptoms that didn't add up before--or does it make you reinterpret your memories into a problem that isn't really there? I am at my most paranoid during this lag time.
Managing this, as you can imagine, can be challenging, and I haven't been as adept at it as I was before. (I now take my neurological symptoms, by the way, as largely the result of hormone suppression therapy, possibly some latent chemo effects, along with the usual culprits of diet and dehydration.) Part of the reason I have had to put my life on hold is that my work is intellectual and my mind is distracted. Other ways of keeping busy, physical or mindless entertainments, are easier to handle. Ideally, a lot of time should be spent just finding peace, which also doesn't get work done. And lately, as I said, I've been worried about that more than I should be, thinking that a "stronger person" would be able to focus on work or get more done in a day. I have to remind myself that there are different kinds of strength and that it's also okay not to be strong all the time. Once I told a friend going through her own difficult time the most useful thing I could think of, "There is no right way to deal with something like this," and I have to remember that this applies to me as well. Aren't you ever surprised at how hard it can be to be nice to yourself? So I'm trying to treat myself as I would treat a friend--or how friends treat me! It's usually a much kinder, more forgiving narrative.
To make things more fun, while you're waiting, you have some decisions to make. For me, the first decision was whether to have a unilateral or a bilateral mastectomy. The second decision was whether to have reconstruction and, if so, when and what kind. No small matter, all around.
On the first question, I ultimately decided that I did not want a prophylactic mastectomy--that is, the removal of the right breast for protective reasons, even though there is no apparent disease. My oncologist said that if she were me, she would. Her concern is my age. The longer I live, the bigger my risk of recurrence, and wouldn't I just like to never do this again? My surgeon was less convinced that the statistics mandated the recommendation of a double mastectomy, although women certainly get them and she would do it if that were what I wanted. As someone not apparently genetically predisposed (I've had all the possible genetic testing), my chances of getting cancer on the opposite side are 5.5% in five years and 6.8% in ten years. They keep going up; we don't really know how much.
I thought about it, and I did wonder whether my recurrence had changed my attitude that led me to get a lumpectomy in the first place: I wanted to treat the cancer I had, not the cancer I might have in the future. We see where that got me. And people who deal with patients going through this all the time asked me certain questions to help me decide on my priorities: If you don't get the mastectomy and you do get cancer, will you be upset with yourself? Do you find follow-up imaging extremely stressful? Do you think about recurrence all the time? Is treatment so traumatic you never want to do it again? I had to answer no on all counts. Although recurrence has been difficult, it's not insurmountable, and as I go about my daily life I am not going to be obsessed with it. For me, the thought of the bilateral mastectomy brought about a great sense of loss. I would always wonder whether it was truly necessary. If I need that in the future, I will have had more years with my healthy body parts intact--and who knows what medical advances may have come about by then? Besides, mastectomy doesn't bring your chance of getting breast cancer to zero. It comes down to 1-3%, but it's not zero. That's a lot of body modification without any guarantee. What affects survival rates is the stage of the cancer, so as long as we catch it early--if it happens at all--I should be just fine.
On the second question, I had a nice long conversation with the plastic surgeons about my options, which boil down to implants or this other procedure, where they use fat, skin, and blood supply from elsewhere on your body. I remember learning the first time I went through this that breast implants are secured behind the chest muscles, which I hadn't realized (though it made more sense once I thought about it--put them in front and gravity will take right over!). Also, I remember thinking that using my own tissue seemed more like me than implants, and after learning a lot more about the way each method works, I'm still of that opinion.
Implants have the benefit of requiring a much easier surgery. Right after the mastectomy, they slip a spacer under your pecs and you're done. But the overall process is longer, because you then gradually pump the spacer up with saline, a little each week or so, and when you've gotten where you want to be, you wait at least two months while the tissue relaxes and forgets about it. Then one more quick, outpatient surgery to swap spacer for implant. The devices themselves have come a long way. We have anatomical options now, rather than just the giant M&M shape. Even so, keep in mind the difference between reconstruction and cosmetic implants--in the latter situation, you are primarily bolstering what's already there but for reconstruction there's nothing to soften the profile of the implant. Now they have techniques, though, to feather a bit of your own fat around the top to create a more natural slope. They are much nicer, then, than they used to be. It is still a foreign object, which can lead to trouble including a higher risk of infection. And you will be dealing with one static side and one aging side (unless you decide to get both done, which is possible).
Flap procedures have the benefit of using your own tissue, leaving something that gains and loses weight with you, sags with age--all that glorious stuff. You can use the fat around your lats or your belly. For me, it will be the belly. They cut quite an oval out of you, from hip to hip and from over your belly button to your lower abdomen. Then they chase the blood supply for that tissue down past your abdominal muscles, either by moving muscle out of the way or, if there are several delicate blood vessels instead of a nice strong one, taking a small square of muscle about the size of a postage stamp. Then they rebuild you. It is a much longer upfront investment--adding 4-5 hours to the mastectomy surgery per side and requiring a day in ICU and four to five days in the hospital. The ICU time is so that your blood supply to the new situation can be closely monitored and fixed very quickly if there is a problem. Vascular surgery is, obviously, much more complicated, involving a microscope and everything! It's really quite remarkable that they can even do it. It's more to recover from, but then you are done. And there is the added bonus of a tummy tuck of sorts, although with a big scar usually higher than normal.
Both surgeries require about four weeks of recovery, with the flap procedure just being a bit more painful in the beginning. Afterwards, we'll see if the pathology report tells us anything interesting that we don't already know about this occurrence. I assume, and my surgeon agrees, that there was the kernel of DCIS probably already present a little forward of my first lumpectomy site, which we didn't know was there because we couldn't see it. That has since grown and burst its boundaries; now we know it's there. This does mean that if I had chosen a mastectomy to begin with I wouldn't likely be facing this situation now. I still don't regret my decision to try the lumpectomy, which further supports my decision now to only get the mastectomy on the affected side.
I appreciate every word and email and call and text of support that I have received. I haven't gotten back to everyone, and I'm quite sorry about that. I was touched that you wrote and you will hear from me hopefully sooner rather than later. I am incredibly lucky to know so many wonderful people and to be so loved in this sometimes difficult world.
Be kind to each other, but especially to yourselves!
Saturday, October 18, 2014
Friday, September 19, 2014
Second time's the charm
It is with a heavy and once again hopeful heart that I tell those of you who don't already know: I have been re-diagnosed with breast cancer.
On my most recent followup mammogram, on Thursday, September 11, they found microcalcifications of a sort and in a formation that were concerning. These could result from fat necrosis from the trauma of surgery, they told me, or they could be evidence of the return of cancer. The usual timeline for surgery-related calcifications is 1-2 years, of recurrence 3-5 years. It had been two years and 9 months since my surgery, almost to the day, making it difficult to tell where I was likely to fall. They ordered a biopsy for Monday.
I was nervous about this procedure, which was guided by mammogram rather than by ultrasound. If you just imagine the concept of a mammogram you can understand why the idea of poking me with things while I hung out in this machine was not exciting. I had also had a difficult time the last time they did anything remotely similar, which was when they were placing the markers that tell the surgeon where to go, right before my first surgery. As it turned out, though, with the glorious modern invention of lidocane and the fact that you lie down for this instead of sitting, it was not that bad at all.
I wasn't sure how much to worry about the results, but I had the feeling they would not be good. The range of possibility for malignancy was very wide--a useless 5-95%--but with my history and the looks I was getting around the clinic, I was not surprised when I got the call.
What they found was the presence of ductal carcinoma in situ (DCIS), the localized cancer that they had discovered under what had once been my invasive disease when I had my first surgery, along with a very small segment--just 2mm--of invasive ductal carcinoma (IDC).
Because of the presence of invasive disease, they will be doing the battery of staging tests that they did the first time: MRI and CT at least. All to see whether there is evidence of invasive disease elsewhere, especially in the other breast (what they found is on the left, as it was before) and in the place my lymph nodes used to be, since I had it there already, but also bones and other places breast cancer is mostly likely to do its dirty deed. As was the case last time, this waiting period is the hardest part, although I am optimistic that we are dealing with a localized recurrence. It was obviously an early catch. That will all happen in the next couple of weeks.
If they find nothing in the way of other cancer, and my little smidge of invasive disease is it, then I most likely won't have chemo. I am going to have surgery no matter what, probably in October, and it will be a mastectomy of at least the left side and possibly a bilateral. I am no longer eligible for lumpectomy on the affected breast, because lumpectomy is paired with radiation and I can't have radiation again there. There is a threshold beyond which they are just giving you different cancer, so that's a one time deal. The pathology report from surgery will also go into the question of whether I will have chemo, as will whether or not this is a recurrence, which is most likely, or another process, which they will be able to tell when the more detailed analysis of the biopsy come in.
I plan to write more later about the impact of this and how I am dealing with it, but for now I just need to get the word out. There are several people who should have heard this from me in person who haven't. I'm sorry. I can only hope that you understand and forgive me.
As you can imagine, this is an emotional time but also a practical one, because that's how I am. I will get over whatever treatment takes, eventually, as long as it works. So none of this third time's a charm BS. A second time is more than enough, thank you. Though some people do deal with it over and over and many still go on to live long lives, so anything is possible.
People often wonder what to say in these situations. Anything you say is fine--I'm not easily offended! :) And not saying anything about it is perfectly acceptable, too. Some of you are probably already wondering if there's anything you can do, and I'm grateful for your kindness. Patience and good cheer are all I need for now. Those of you who saw me through this last time know I have both of those things in droves, but a little extra can't hurt. Also, you can hug someone for me! Anyone will do, and pets totally count. And remember that life is short. Eat delicious food, smell a flower, feel the breeze, go to a show, take on that hobby! It's fine to have the long view, but you can still enjoy today.
xxoo
On my most recent followup mammogram, on Thursday, September 11, they found microcalcifications of a sort and in a formation that were concerning. These could result from fat necrosis from the trauma of surgery, they told me, or they could be evidence of the return of cancer. The usual timeline for surgery-related calcifications is 1-2 years, of recurrence 3-5 years. It had been two years and 9 months since my surgery, almost to the day, making it difficult to tell where I was likely to fall. They ordered a biopsy for Monday.
I was nervous about this procedure, which was guided by mammogram rather than by ultrasound. If you just imagine the concept of a mammogram you can understand why the idea of poking me with things while I hung out in this machine was not exciting. I had also had a difficult time the last time they did anything remotely similar, which was when they were placing the markers that tell the surgeon where to go, right before my first surgery. As it turned out, though, with the glorious modern invention of lidocane and the fact that you lie down for this instead of sitting, it was not that bad at all.
I wasn't sure how much to worry about the results, but I had the feeling they would not be good. The range of possibility for malignancy was very wide--a useless 5-95%--but with my history and the looks I was getting around the clinic, I was not surprised when I got the call.
What they found was the presence of ductal carcinoma in situ (DCIS), the localized cancer that they had discovered under what had once been my invasive disease when I had my first surgery, along with a very small segment--just 2mm--of invasive ductal carcinoma (IDC).
Because of the presence of invasive disease, they will be doing the battery of staging tests that they did the first time: MRI and CT at least. All to see whether there is evidence of invasive disease elsewhere, especially in the other breast (what they found is on the left, as it was before) and in the place my lymph nodes used to be, since I had it there already, but also bones and other places breast cancer is mostly likely to do its dirty deed. As was the case last time, this waiting period is the hardest part, although I am optimistic that we are dealing with a localized recurrence. It was obviously an early catch. That will all happen in the next couple of weeks.
If they find nothing in the way of other cancer, and my little smidge of invasive disease is it, then I most likely won't have chemo. I am going to have surgery no matter what, probably in October, and it will be a mastectomy of at least the left side and possibly a bilateral. I am no longer eligible for lumpectomy on the affected breast, because lumpectomy is paired with radiation and I can't have radiation again there. There is a threshold beyond which they are just giving you different cancer, so that's a one time deal. The pathology report from surgery will also go into the question of whether I will have chemo, as will whether or not this is a recurrence, which is most likely, or another process, which they will be able to tell when the more detailed analysis of the biopsy come in.
I plan to write more later about the impact of this and how I am dealing with it, but for now I just need to get the word out. There are several people who should have heard this from me in person who haven't. I'm sorry. I can only hope that you understand and forgive me.
As you can imagine, this is an emotional time but also a practical one, because that's how I am. I will get over whatever treatment takes, eventually, as long as it works. So none of this third time's a charm BS. A second time is more than enough, thank you. Though some people do deal with it over and over and many still go on to live long lives, so anything is possible.
People often wonder what to say in these situations. Anything you say is fine--I'm not easily offended! :) And not saying anything about it is perfectly acceptable, too. Some of you are probably already wondering if there's anything you can do, and I'm grateful for your kindness. Patience and good cheer are all I need for now. Those of you who saw me through this last time know I have both of those things in droves, but a little extra can't hurt. Also, you can hug someone for me! Anyone will do, and pets totally count. And remember that life is short. Eat delicious food, smell a flower, feel the breeze, go to a show, take on that hobby! It's fine to have the long view, but you can still enjoy today.
xxoo
Tuesday, January 8, 2013
Acceptance is not resignation
So I had cancer. What's a girl supposed to do with that?
Part of me in the very early days was thinking, "Fight, fight, fight!" That's normal enough. War is a nearly ubiquitous metaphor in circumstances where human beings see a problem to be solved. The war on drugs. The war on terror. We fight corruption. We fight disease, too.
It has a definite appeal: the impression of organization, resistance, action, empowerment. And some things are worth fighting for, I suppose. Naturally when I was diagnosed I wanted to feel like there was something I could do, that my doctors could do, to conquer (see, there it is again) this thing threatening my body--my life!
But war is a rather sorry way to solve a problem. Decidedly unpleasant. Usually ineffective. Itself a harbinger, if not of doom, at least of unintended consequences. And another part of me was thinking, "This stress is going to kill you!" (I have a morbid sense of humor.) I didn't want to be amped up all the time by a drive to stay on the offensive. Maintaining the "fight" end of the fight or flight response for an extended period of time, even if just conceptually, seemed exhausting and, in the end, probably counter-productive. I thought I should really take a deep breath and relax.
On the other hand, I didn't want a quiet outlook in the face of something so dire to become, or seem to the universe or to my immune system, a kind of surrender to the disease, a resignation to whatever it had in store for me. I didn't want to give up the fight. "Give up the fight." Sure sounds like "surrender" to me...
And so I struggled for a while with how to manage my fighting spirit while I worried about remaining calm (which, I can tell you, is not the same thing as remaining calm). Then one day, the simple revelation reconciled these two impulses:
Acceptance is not resignation.
It was obvious once I thought of it, as these things often are. The best thing I could do was get out of my body's way and give it what it needed so that it could do its job properly. If equanimity is good for the immune system, as it seems to be, then paradoxically the best way to fight is not to fight.
The less obvious idea that makes the first one possible is that acceptance of the present moment is exactly that, and no more. It makes no assumptions about the future of any kind, good or bad. It is not a resignation. On the contrary, and again paradoxically, it is a kind of empowerment--a way to face what is difficult (or anything else) without expectations and thus with the utmost clarity.
This was where I found my strength, even before I realized it. This is how I sat, after mammogram and ultrasound led to waiting for a biopsy, without panic, somehow. I just waited. People around me acted like I should be worried, which I remember I found a little oppressive. They were, of course, just being kind. But I took a deep breath--a lot of them, actually--and waited. I wasn't in denial, although I worried about that at first. It was just what needed to be done. It needed to be done if the results were negative, and it definitely needed to be done if the results were positive. You can't fight what you can't see. (Ahem.)
So not long after that, when I was in that between-time after diagnosis and before treatment--by far the hardest part of that six months for me--I realized that the situation was really the same. I had cancer. I needed treatment. And I was going to get it. There wasn't anything else to do about it. That *was* what there was to do about it.
This saved me from so much fantasizing about the future. Thoughts about the obvious worst-case scenario started to feel ridiculous, which isn't to say I never had them. But I started to see how silly and unnecessary it was to upset myself over something that wasn't happening now and I had no particular reason to believe would happen anytime soon. Sure, having cancer is risky; so's driving a car, and I do that all the time! Thoughts about the best-case were better, of course, but were still tinged with the fear of having my hopes disappointed. It was all fantasy and it was all a potentially harmful distraction from what really needed attention--my actual well-being in the here and now. So I set about focusing on what was right in front of me, as much as I could.
I realize that this might sound incredible to some. There is a certain nose-to-the-grindstone practicality to how I got through this ordeal that I know stems in part from my personality, and everyone is different. But I don't think that anyone who knows me would say that I was calm about cancer because I'm wired that way. I'm not naturally equanimous. Practical, yes. Equanimous, no. Especially about myself. I've been working on the ignore-something-until-you-panic-and-then-cry-about-it habit for years. So if I could manage to operate this way in a crisis, surely there's a message of hope in there for others.
Now, for my next trick: Apply all this strength and awesomeness I didn't know I had to my normal life! Ready? ... Ready? ... No, really, any second now! I think it's going to work...
Part of me in the very early days was thinking, "Fight, fight, fight!" That's normal enough. War is a nearly ubiquitous metaphor in circumstances where human beings see a problem to be solved. The war on drugs. The war on terror. We fight corruption. We fight disease, too.
It has a definite appeal: the impression of organization, resistance, action, empowerment. And some things are worth fighting for, I suppose. Naturally when I was diagnosed I wanted to feel like there was something I could do, that my doctors could do, to conquer (see, there it is again) this thing threatening my body--my life!
But war is a rather sorry way to solve a problem. Decidedly unpleasant. Usually ineffective. Itself a harbinger, if not of doom, at least of unintended consequences. And another part of me was thinking, "This stress is going to kill you!" (I have a morbid sense of humor.) I didn't want to be amped up all the time by a drive to stay on the offensive. Maintaining the "fight" end of the fight or flight response for an extended period of time, even if just conceptually, seemed exhausting and, in the end, probably counter-productive. I thought I should really take a deep breath and relax.
On the other hand, I didn't want a quiet outlook in the face of something so dire to become, or seem to the universe or to my immune system, a kind of surrender to the disease, a resignation to whatever it had in store for me. I didn't want to give up the fight. "Give up the fight." Sure sounds like "surrender" to me...
And so I struggled for a while with how to manage my fighting spirit while I worried about remaining calm (which, I can tell you, is not the same thing as remaining calm). Then one day, the simple revelation reconciled these two impulses:
Acceptance is not resignation.
It was obvious once I thought of it, as these things often are. The best thing I could do was get out of my body's way and give it what it needed so that it could do its job properly. If equanimity is good for the immune system, as it seems to be, then paradoxically the best way to fight is not to fight.
The less obvious idea that makes the first one possible is that acceptance of the present moment is exactly that, and no more. It makes no assumptions about the future of any kind, good or bad. It is not a resignation. On the contrary, and again paradoxically, it is a kind of empowerment--a way to face what is difficult (or anything else) without expectations and thus with the utmost clarity.
This was where I found my strength, even before I realized it. This is how I sat, after mammogram and ultrasound led to waiting for a biopsy, without panic, somehow. I just waited. People around me acted like I should be worried, which I remember I found a little oppressive. They were, of course, just being kind. But I took a deep breath--a lot of them, actually--and waited. I wasn't in denial, although I worried about that at first. It was just what needed to be done. It needed to be done if the results were negative, and it definitely needed to be done if the results were positive. You can't fight what you can't see. (Ahem.)
So not long after that, when I was in that between-time after diagnosis and before treatment--by far the hardest part of that six months for me--I realized that the situation was really the same. I had cancer. I needed treatment. And I was going to get it. There wasn't anything else to do about it. That *was* what there was to do about it.
This saved me from so much fantasizing about the future. Thoughts about the obvious worst-case scenario started to feel ridiculous, which isn't to say I never had them. But I started to see how silly and unnecessary it was to upset myself over something that wasn't happening now and I had no particular reason to believe would happen anytime soon. Sure, having cancer is risky; so's driving a car, and I do that all the time! Thoughts about the best-case were better, of course, but were still tinged with the fear of having my hopes disappointed. It was all fantasy and it was all a potentially harmful distraction from what really needed attention--my actual well-being in the here and now. So I set about focusing on what was right in front of me, as much as I could.
I realize that this might sound incredible to some. There is a certain nose-to-the-grindstone practicality to how I got through this ordeal that I know stems in part from my personality, and everyone is different. But I don't think that anyone who knows me would say that I was calm about cancer because I'm wired that way. I'm not naturally equanimous. Practical, yes. Equanimous, no. Especially about myself. I've been working on the ignore-something-until-you-panic-and-then-cry-about-it habit for years. So if I could manage to operate this way in a crisis, surely there's a message of hope in there for others.
Now, for my next trick: Apply all this strength and awesomeness I didn't know I had to my normal life! Ready? ... Ready? ... No, really, any second now! I think it's going to work...
Tuesday, September 25, 2012
The price of dedication
There is one story of heretofore uncharacteristic dedication to running that I accidentally left out of my last post. As it happens, though, that particular little gem developed into an incident that deserves a story all its own.
The day I got my port out, which was August 10, was a Friday. Obviously I wasn't going to be going to the 4-miler training on Saturday morning with a fresh incision, so I dutifully decided to do my Saturday run on Friday morning.
I was allowed no food after 6am that day, and I wasn't due to the hospital until noon. I knew I'd be hungry enough without the running. So I actually got up at 5:30am so I could have breakfast, so I could run 3.5 miles with appropriate calories on board. This blows my mind. But it's true! I did that.
Then, after a very hungry morning and an uneventful procedure, I am making a bathroom trip while we wait for wheelchair that will deliver me to the car and I notice a little scab on my thigh that looks like it's been grazed so it's just attached by one edge. I try to pull it off and I can't. I try again, and again. But then I decide that I'm not very coordinated at the moment, on account of the drugs they give you, which are very effective at making you not care that they are doing things you would normally find disturbing. I think of food and a nap. The scab can wait.
Come Sunday morning, which, mind, is two days later, I rediscover said scab and again attempt to pull it off. But it doesn't come. And it doesn't come. And then I think... That is not the same color as it was on Friday... And I think it's moving.......
It's a good thing Mom was here. I come out and say, Will you see if this is a tick, and if it is don't tell me? And she looks. And she pulls, And she looks up close and says, I'm not saying anything, and heads to the trash.
Ew. It seems that on my little 3.5 mile adventure, which went down the river trail a ways, I picked up a friend. I wonder what its experience was of those incredible drugs? Well, that's fine. I had a tick for a few days and didn't what it was--apparently I was not only uncoordinated but unobservant. I suppose that's to be expected.
But a week to the day after the tick was removed, I wake up with a very round spot about the size of a dime around the bite. Uh oh. And come Monday morning, I'm picking up antibiotics for Lyme disease. Lyme disease! The only tick I've ever had, and Lyme disease?! Are you kidding me?
Nope, not kidding. But on the bright side, because I knew I had a tick, and I knew it was attached for 72 hours, and I could see the rash start (which didn't look like a bulls-eye until it started healing, but they don't all), we could treat it immediately and I didn't experience the flu-like symptoms or any of the crazy complications that happen to people when it takes a long time to figure out what's going on.
It was too early to test the blood for antibodies, but based on the story and the symptom, and the prevalence of Lyme around here, it is not at all unlikely. It would explain why the week before was the first time since early summer that I felt very compelled to nap and unable to finish planned errands. Still, I feel silly saying that I had Lyme disease, since I didn't really suffer from it and recently a friend of mine really did. But it's just such a kicker to, well, the cancer. Like I needed that. It gets to be funny, because it wasn't serious. And it's another opportunity to be grateful for how fortunate I am even in my misfortune.
I still haven't made it back to the river...
The day I got my port out, which was August 10, was a Friday. Obviously I wasn't going to be going to the 4-miler training on Saturday morning with a fresh incision, so I dutifully decided to do my Saturday run on Friday morning.
I was allowed no food after 6am that day, and I wasn't due to the hospital until noon. I knew I'd be hungry enough without the running. So I actually got up at 5:30am so I could have breakfast, so I could run 3.5 miles with appropriate calories on board. This blows my mind. But it's true! I did that.
Then, after a very hungry morning and an uneventful procedure, I am making a bathroom trip while we wait for wheelchair that will deliver me to the car and I notice a little scab on my thigh that looks like it's been grazed so it's just attached by one edge. I try to pull it off and I can't. I try again, and again. But then I decide that I'm not very coordinated at the moment, on account of the drugs they give you, which are very effective at making you not care that they are doing things you would normally find disturbing. I think of food and a nap. The scab can wait.
Come Sunday morning, which, mind, is two days later, I rediscover said scab and again attempt to pull it off. But it doesn't come. And it doesn't come. And then I think... That is not the same color as it was on Friday... And I think it's moving.......
It's a good thing Mom was here. I come out and say, Will you see if this is a tick, and if it is don't tell me? And she looks. And she pulls, And she looks up close and says, I'm not saying anything, and heads to the trash.
Ew. It seems that on my little 3.5 mile adventure, which went down the river trail a ways, I picked up a friend. I wonder what its experience was of those incredible drugs? Well, that's fine. I had a tick for a few days and didn't what it was--apparently I was not only uncoordinated but unobservant. I suppose that's to be expected.
But a week to the day after the tick was removed, I wake up with a very round spot about the size of a dime around the bite. Uh oh. And come Monday morning, I'm picking up antibiotics for Lyme disease. Lyme disease! The only tick I've ever had, and Lyme disease?! Are you kidding me?
Nope, not kidding. But on the bright side, because I knew I had a tick, and I knew it was attached for 72 hours, and I could see the rash start (which didn't look like a bulls-eye until it started healing, but they don't all), we could treat it immediately and I didn't experience the flu-like symptoms or any of the crazy complications that happen to people when it takes a long time to figure out what's going on.
It was too early to test the blood for antibodies, but based on the story and the symptom, and the prevalence of Lyme around here, it is not at all unlikely. It would explain why the week before was the first time since early summer that I felt very compelled to nap and unable to finish planned errands. Still, I feel silly saying that I had Lyme disease, since I didn't really suffer from it and recently a friend of mine really did. But it's just such a kicker to, well, the cancer. Like I needed that. It gets to be funny, because it wasn't serious. And it's another opportunity to be grateful for how fortunate I am even in my misfortune.
I still haven't made it back to the river...
Friday, August 17, 2012
The Charlottesville Women's 4-Miler
I have gotten up at 5:45am and driven across town to make 6:30am weekday runs--I don't do that any more, but I do go on my own, just out my front door, usually sometime between 7 and 8:30am. I have gotten up hungover at 6:30am on a Saturday to make a training day--the running itself was surprisingly pleasant, but leaning over to stretch out was woozy business. I have run twice on vacation--letting my running shoes take up valuable real estate in my suitcase and once making my dad find me a spot on the beach in San Diego and then wait 45 minutes for me to do my thing. Since June 16, I have run three days a week without fail--except that one day that dad and I rode bikes along the Pacific coastline for twice ten miles.
I started at a 16:50 mile, at our first time trial. I am now running, by my own calculation, about a 13:15. Still slow as dirt, but I care less about speed (though improvement always feels good) than about controlling my pace so that I can run the whole whatever, which I do in true neurotic fashion by using a heart rate monitor to keep my heart rate in a reasonable range. I'm getting better at doing that without the monitor, actually. I'm comfortable between 70-85% of maximum; over 92% and breathing gets painful. I am up to about 10 miles a week. Tomorrow is our first shot at four miles--a dry run of the race called a "fun run". I am dubious of this description, but still willing.
I cannot say that I love it. The race is what gets me out the door many times, making me wonder when the next one should be. And, man, this place is hilly. But I don't hate it, either. I like the personal challenge and sense of accomplishment. I like the feeling of conveying myself across the earth, my feet hitting the ground, the air in my lungs. I like doing something that I know is so good for me, and I think about that a lot while I'm doing it. I try not to use the time to mull over my problems or plan my day. My running time, like my yoga time and, not often enough, my sitting time, is time for peace of mind and attention to body. On a lower note, the fact that hormone-blocking Tamoxifen has killed my metabolism...well, that's also motivating.
And so, the race has come a long way in its first purpose: getting me off the couch, out of the house, and healthy. But I also signed up for this particular race so that I might give something back to the UVA Breast Care Program, which has been nothing short of amazing. The money raised by this race does all kinds of wonderful things, some of which have been of direct benefit to me.
When I was diagnosed, I got a huge gift basket and an equally huge binder of material explaining breast cancer and cancer treatment, all of which were supplied by 4-miler funds. Those same funds allowed the massage therapist at the cancer center, whose services I am lucky enough to have access to for as long as I am here to access them, to attend a course specifically on breast massage for breast cancer patients, which addresses scarring and reintegration with the body after the trauma of surgery. Another thing the race has paid for, which has nothing to do with me but I just think is awesome, is a mobile mammogram unit--a bus that drives to the medically underserved areas of Virginia and provides free and low-cost mammograms to women who otherwise wouldn't get them. How great is that? And there is so much more.
I have had so much help for the past 13+ months that it is hard to ask for more. But that's my problem. I know that many of you will be happy for the opportunity to contribute. And so I humbly ask that each of you consider sponsoring me for the race, if you are able. Any amount, however small, would be put to good use. Here is the link:
You'll click the "make a donation" box, then choose the option to sponsor a runner and look me up by last name. If you have any problems or the desperate desire to support the USPS, please let me know. You can also read more about the race, the programs thus supported, etc. And the doctor in the picture there? That's my oncologist. She's fantastic.
Thank you in advance for your generosity. The race is September 1--there's only two weeks left, so don't wait!
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