Blue Breast: Second Surgery

ALERT: I know things now that I didn't know in 2005. For example, if I had known then what I know now, I probably would not have allowed them to do the sentinel node biopsy, or to take any of my lymph nodes, period. It's even possible that I might not have had the lumpectomy. So please keep this in mind when you read the post below, and do your research on lymph node removal and breast cancer; don't just assume that it's going to help you to have nodes biopsied or removed. You can start your research by going to breastcancerchoices.org.

A flashback to 2005:

The first surgery is over, the lump is out, and the diagnosis is in: Breast cancer. Stage two, invasive, intermediate grade, a mix of ductal and lobular. The good news is: The cancer has been excised. The not so good news is: I have to go back for a second surgery, to get a wider excision margin and also to see if any of the cancer infiltrated my nodes. The surgeon will inject a dye into my breast. The dye will travel along the glands that lead to the nodes. My breast and pee will turn blue for a day or two.

I can't seem to follow a straight line these days. I start out heading toward the doctor's office, then do a zig in the direction of death, followed by a zag in the direction of life. Finally I reach the hospital at the corner of Fulton and Shrader, with no idea how I got there.

But today I refuse to let the cancer confuse me. I choose to live with it, just the two of us, in truce. I press a cool damp rag over my burning eyes, and envision smooth Georgia O'Keefe hills rolling into sunsets, making love to deserts. My hand drops down over the side of the bed to touch my cat's silky ears, the texture of peace. What will the scar look like, I wonder? It will be my first major scar of note.

After the second surgery is over and, and my pee is no longer blue and scar number two has arrived, I congratulate myself on what a good nurse I've become: Pain pills taken, ice packs frozen, canned soup eaten, arm positioned at the proper elevation.

 

I ache all over, not only from the surgery but also from hunching over stacks of medical abstracts and mumbo jumbo scientific tomes. My mind is boggled from trying to find a "treatment path." My head may explode from too much pondering. Nevertheless, this cancer cannot be returned or exchanged, and I don't expect any manager or supervisor to make an exception just for me. Jack snores from his side of the bed, the football game muted now and moving on without him. I'm relieved that he didn't mention sex before he nodded off. I don't want anything to do with that right now, though I would sell my soul for a massage.

Jack was my angel before the surgery. I see him in a series of snapshots in my mind's eye: Jack driving me to the hospital. Jack holding my hand in the underground parking lot and through the too familiar corridors. Jack closing the stuck window in Room 309 as I begin to remove my clothes and don my hospital gown. Jack's large fingers fumbling to tie the back of the ridiculous gunnysack. Jack reading aloud from the paper, something about fire hydrants, as I fold my civilian clothes and slide them into the regulation plastic bag. Jack showing me how to lower and raise the hospital bed. Jack listening to my nervous chatter.

Yesterday I apologized to him for being so dull. I was wiped out, I said, from the ever-thickening plaque of surgery's residue followed by more uncertainty. Every word that dribbled out of my mouth was a bore. Jack laughed and said that a little dullness was a welcome relief after all the excitement I'd been handing him.

It's six p.m., our party guests will be arriving shortly, and my eyelids are already drooping. I'm on the verge of falling asleep while sitting up, just like a doddering old fogey. Soon my chin will be tapping my chest. I can't move my head around as easily anymore. My neck is stiff with embedded fear. It creaks and moans. Our Indian summer has crept beneath the bandages to bite at my wound. I fear that the wound is festering, but no, that is simply the way that fear likes to talk. In truth, the wound is healing. Healing and sweating and itching.

 

This has all been so unexpected. Of course, I never expected most of the things that happened or appeared in my life — the way Frank's poetic words, for example (such lovely wooden boats), kept me tied to him even after we'd been bitterly at war, not talking for months or years on end. Or our son's elegant physical prowess, the acrobatic feats that still make my heart burst out of the gate. Or the Hansel and Gretel cottage I found to live in after the eviction, with its story of Tania and Panos, newlyweds before I was born, their names inlaid into the living room's hardwood floor, their present a piece of my future. Or the premonitions I had, the ones that actually came true, proving to me how much more I knew than I would ever know. Even what I did expect rarely turned out to be the texture or color that I'd imagined. Raging rivers felt surprisingly dry to the touch. Angelic blue skies turned devilishly red in the blink of a wandering eye.

Another stabbing twinge pierces my chest. My breath roars up to the curb, as it does with every twinge, then quiets to an idle as I will myself to stop pressing the panic button. I try to focus on the good stuff. My son is doing fine, for example. In fact, he's amazing. And the evil health insurance company is reprocessing the claim that at first they refused to honor -- but this time I fought back and won. And I'm so lucky to have my Jack.

Our party is a birthday bash, in celebration of Jack's 50th and my 53rd. We asked every guest to wear a hat. Make it an interesting hat, we said in our invitation. A fun hat. A hat with a history, perhaps even a story.

Of course, I never wear hats unless it's raining or freezing. I own only one hat that has any stylish flair. It's a floppily wide-brimmed straw hat that I purchased before our trip to Death Valley two years ago. I wore it while trekking across sand dunes and trudging through the winding, twisty maze of river gullies. If I wear it to the party, I can tell our story about what made us decide to go to Death Valley. I could tell our guests about going to see 79-year-old Marta Beckett perform her vaudeville ballet routine at the Death Valley Junction Opera House. I can talk about Marta's raggedy tag, equally elderly boyfriend, Willet, and his gold sequined bowler hat, and about the peacock perched on top of a Death Valley Junction telephone pole at midnight, or about Marta's painting of the golden swan on the wall at the head of our hotel bed.

Question: Should I hide my cancer on the closet shelf, or display it on the mantle for all our guests to see? Wouldn't it be best to keep my pain a secret? Yes! But no, wouldn't that be a weird kind of lie? I get into the shower and peel off the bandages. The newest scar is swollen, jagged and red. My left arm aches and throbs beneath the numbness of severed nerves, forcing me to think about the cancer even though I would prefer amnesia.

 

We make it through the party. It's good to be with old friends, good to eat, drink and be merry. After everyone has gone home, wine glasses clutter the kitchen counter along with all the other celebratory fodder. Outside the window, tree limbs, mostly bare now, extend themselves toward a medicinal sky that lets loose a few fat drops of soothing rain. A leaf rocks itself back and forth, back and forth, down to the ground. Fragments of poetry, tucked into the cracks between then and now, emerge from their hiding places to comfort me.

I stand by the stove waiting for that hidden whistle to blast out from the tea kettle. Hidden is the operative word these days. There are hidden messages everywhere, hidden messages in the middle of the night, hidden messages in the future and the past, hidden messages in the length, the color of my hair.

Yesterday I spent hours on more research — weighing and re-weighing benefits versus risks, always that question of benefits versus risks. But cancer is impossible to decipher on so many levels, a maze of facts and clues that add up to a mystery that no one -- at least no one I've ever met -- has been able to fathom or solve.

It's unfair that one must go to such trouble to cut out the offending tumor, only to be left with the ongoing threat of  recurrence. Am I in store for another, bigger surgery down the line? Will there come a day when I have no choice but to let them lop off my breast? How hard will it be to decide? How much longer will I have before that happens, if it does? How much longer do I have, period? The unruly cells are driven to divide and grow, divide and grow, doing the best they can in order to survive, the same as me.

Comments

[Leigh Ann Starcevich]

What would you have done differently? (I'm working through your blog but wondering if I can get the bullet points!) Thanks for your posts -- I'm new on this journey.

[Breast recontsruction procedure]

Thank you for this exellent-written post. You are a very brave woman, and you've been through all of this and have a strong will and inspiration to live and to write! If I were you, I'd concider to make a book out of these posts:)
And if you would ever concider to go for a breast reconstruction procedure, please read this article: http://www.breastimplants.org/procedures/breast-reconstruction