How Do You Spell Relief?

Relief is not spelled R-O-L-A-I-D-S, as those of a certain age would naturally reply.  This morning, relief was spelled L-U-M-P-E-C-T-O-M-Y.

My date with the Dutchman answered some pressing questions, notably:

• biopsy three told us nothing we didn’t already know – i.e. I don’t have an invasive flavour of cancer – so, I get to skip the sentinel node biopsy, chemo and (best of all) another attempt at an MRI
• Mum’s breast cancer has no bearing on my own condition, so I get to skip genetic testing for the BRAC-1 and -2 business
• mastectomy is too aggressive for the cancer I have (yep, I asked the tough question), so I get to keep the booby

I fairly skipped out of the hospital.  Knowing exactly what I have, and how we’re going to deal with it, makes the planner in me very happy.  It lets me make checklists and critical paths, and exercise my control freak muscles.

This afternoon, relief was spelled P-U-B-L-I-C.  The emotional strain of keeping secrets is over, at long last.  (Except for Dad. I still won’t tell him ‘til after surgery.)  Now I can plan my next appointments, organize my winter work schedule, and take phone calls without having to speak in code.  It turns out, I wasn’t cut out to be James Bond.

Ups and Downs on the Cancer Coaster

The Dutchman’s assistant called, yesterday, with a fist full of information. First – and most fabulous – a surgery date: January 26. Sooner than I’d expected, which is dynamite. And more than two weeks in advance of my planned Olympic departure, which is even better.

Second – and far less exciting – an order for another biopsy. ANOTHER biopsy. A THIRD fucking biopsy.  Four months in on Monday, and they're still sticking pins in my breast-shaped voodoo doll.  If the strategy is to perform a lumpectomy five cores at a time, they’re on the right track. I thought we’d done all of that we needed to, but this go-round they’re apparently looking for evidence of invasive cancer (i.e. something other than DCIS). If it’s found, my surgery will be adjusted to include a sentinel lymph node biopsy (http://www.cancer.gov/cancertopics/factsheet/therapy/sentinel-node-biopsy), in order to determine whether the cancer has spread. My third date with The Dutchman is set for January 7; no dinner and a movie, just biopsy results and a confirmed plan for surgery.

So, back on the table, but this time at Princess Margaret Hospital. I’ve now sampled the biopsy suites at three facilities: PMH wins, hands down. They were able to squeeze me in (pardon the mammographic pun) today, rather than make me wait ‘til the new year. I hated that idea, yesterday, but now, on the other side of the procedure and a lousy night’s sleep, I’m glad it’s over.

Third – and most annoying – I’ll be scheduled for a do-over on the dreaded MRI. But, this time, I’ll go armed with a sedative. Crap, I hope it’s a strong one.

More Tests I Can't Study For

Second verse, same as the first.  Another ultrasound (warm gel, this time -- you can always tell the finer establishments by their upgraded amenities), and another biopsy.  I had expected this biopsy to be done during a mammogram -- kind of a catch and release program -- but it was done under ultrasound, just like the last one.

It seems pretty evident that there's lots to look at under the magic wand -- other than the obvious, I mean.  And I'm told I'll be scheduled for an MRI to follow.  My research indicates that's all about lymph nodes;  it's hard to know whether they saw something they'd like to follow up on, or whether that's all about ruling things out.  Naturally, the docs (two radiologists, this time -- both broads) and technicians (only one of those) won't have a meaningful conversation with you.  When I asked what they were looking at so intently, the response was that they were deciding on the optimal location for the biopsy.  I refrained from a "well, duh" response, as the doc was the one with the needle in hand!

On the upside, they got what they were looking for;  there are definitely microcalcifications in the samples, this go-round. They put a rush on the analysis in the hope that The Dutchman will receive the results by the 17th -- our second date.  If that doesn't happen, I imagine there won't be much to talk about.  I hate those awkward silences.

So, I'm now the proud owner of two identical adjacent puncture wounds in my right boob. If I didn't know better, I'd think I was part of a soft core version of the Twilight saga.

Tom Petty is a Prophet

The waiting really is the hardest part.
http://www.youtube.com/watch?v=GLCJEYLIBQY

The first time I waited, I didn’t even know I was doing it. After my annual physical in the summer, I was sent for a regular (AKA screening) mammogram on August 27. Been there, done that. I remember thinking how lucky I am to have large breasts, as the process is only uncomfortable for me, not painful, as it can be for smaller-breasted women. In was in and out, and never gave it another thought.

When I got the call from my doc to request a magnification mammogram and ultrasound, I wasn’t freaked. I just went back and started over. This time, just the right side: two views. September 28.

I knew it was microcalcifications they were looking at, and I saw the film on the light board while the technician was out of the room. A yellow grease pencil had drawn an untidy box around the cells in question. A constellation of tiny white specs. Not a lump. And not uncommon. Only 15% of occurrences turn out to be malignant. Pretty good odds, I thought. Don’t worry, ‘til there’s cause.

Then off to the ultrasound. I’ve had those, too: cold gel and the magic wand. Not the magic wand at the airport (the one that picks up the underwires and the rivets in your jeans), but a wand nonetheless. You always know when the technicians have found what they want to look at, as they go over and over and over it again. And when your technician elects to call a friend, it’s hard to disguise that there’s something going on. I think it’s fair to say that when health professionals tell you not to be concerned, it’s time to get your worry on. But, who’s got time for that? Two days after my second tit sandwich in a month, I flew off to Turkey with instructions for the doc to call me as soon as the results came back.

Ya know, it doesn’t matter how busy you are – and I was some busy in Istanbul – when you’re waiting for a phone call that’s taking its own sweet time, the clock seems to slow down, and the calendar pages don’t turn as quickly as they usually do. You’d think with the men in my recent life, I’d be better at accepting that: apparently not. But the call did come, and with it the news that I was to be scheduled for a biopsy. Shit.

After a week away, and another week after I got home, I was back at the lab naked from the waist up. This time with a South African – Christiaan Barnard of the boobs – making small talk with a swab in one hand and a needle in the other. It was never among my fantasies to hear a man with his hand on my breast say, “And now you’ll feel a little prick”, but I digress. After four or five cores (it’s hard to keep track when you’re trying not to think about the needle in your breast), the little prick left and I wobbled off to tape an ice pack inside my bra and head back to work like nothing had happened.

Two weeks ‘til the results. Shit, again.

This afternoon -- two weeks and two days later -- my doc reviewed the pathologist’s report with me. It turns out the biopsy didn’t pick up any of the microcalcifications, so the next step is either another biopsy – stereotactic, this time, so they’ll be sure to get what they came for – or an excision, which amounts to a lumpectomy. Either way, I’ll know once and for all if the atypical cells are benign or malignant. But in the meantime – until the consultation with the next in my parade of doctors (set for November 26)– more waiting.

Sing it, Tom.