Last month I found my hands cupping my breasts, first the right and then the left. Hold on, now, just so we’re clear, this is not going to be one of those stories. This one’s different, but stay with me. They were unusually smooth, nothing like a few years ago, pre-menopause, when I used to do these self-exams, parsing through the mealy tissue with clockwise two finger circles. I have what’s termed “dense breasts” which I can only describe as the consistency of pea gravel you’d run through a Cuisinart, so turning over any potential bad stones often seemed next to impossible, and so I stopped but continued with annual mammograms..
Over the years I’ve been religious with all my health checkups, sometimes even calling the doctor early and reminding them it’s time for me to come in, and this year was no different, with a gyn annual visit in February that included a breast exam, and a mammogram in July. For that mammogram, I took my usual lucky seat next to the aquarium at the breast health center and once called, got it done. They called me back days later needing a “second look.” All you can think with a call back is holy shit. The days drag when you’re waiting for the “all clear” from MyChart and that coveted letter you get in the mail a week or so later, which you file to keep forever. I was cleared and declared “normal” and looked forward to another year’s stay of execution.
Fast forward to October when I was lying on my bed and for some reason I decided to feel both sides fully, almost marveling at their teardrop symmetry and softness, delicately balanced above my rib cage. All that pea gravel gone after menopause, this texture was silky smooth. Except, wait? Is that something on my left side? Hmmm. More rotations, more checking the other side. Yep, this is a little something, and I’ll be getting that checked, yet felt fine about it since the July all clear.
I called my doctor the next day and got in several days later. As I sat in the examining room in my paper flying nun gown, not nearly as adorable and carefree as Sally Field, I couldn’t help but wonder, wtf? My doctor felt it too, and looked a little puzzled, but reassured me it’s probably nothing, recalling July’s normal results.
Next on the agenda was another mammogram, this time 3-D, followed by an ultrasound scheduled that same day. As I checked in, the woman in reception, thrilled with her bouquet of pink pens for the taking, reminded me that I can keep the pen. I was reluctant, but she extended the pen toward me and smiled, waiting it out. My mind went to Seinfeld, in that fabulous episode when Jack insists to Jerry, “Take the pen!!!” I reluctantly took it and threw it in my purse hoping all that pinkness wouldn’t leak and coat my purse with its hot pink malignant ink.
I set off to change in their dressing room, passing the normal waiting area and was directed deeper in the facility, to a room with nicer snacks and cushier chairs, certainly not intending to, but most definitely amping up my anxiety. I refused to enjoy an apple juice or the Milano cookies because I was a regular in the first room and despite my assignment to this room, I wasn’t going to be joining this club.
The radiologist viewing my ultrasound asked me if I’d experienced trauma to my left breast, or else did I have diabetes? Both conditions can resemble a malignancy, and befuddled, I nodded no. Though I did fall at Bryant Park a few years back ice skating and cowered off the ice to heal only to go back on in a half hour and do it again. Skaters don’t just keep going when a fifty something woman falls; instead there’s this unspoken “old lady down” alert and they rush over and help you up and off the rink so the skating can continue without the distraction. And then there was last year when I was walking my dog on a perfectly fine fall afternoon and a ginormous acorn moved into my path. Down I went and off went the skin on my knees replaced with sticky bloody ovals on each knee cap, like a kid’s, but wrinkly.
The radiologist said her share of hmmm-s, and I’m concerned-s, and then I was scheduled for a biopsy in a few days. The biopsy radiologist was comforting and silky smooth, imagine Faith Hill in a lab coat, with a velvety voice to match. She walked me through all the steps, numbing your breast, placing a hollow needle inside and pulling out a sample of the tissue for testing. She said I’d be hearing a clicking which reminded me of an ear piercing gun. After it was done, they put a Steri-Strip on the incision and off I went.
It looks like I’m allergic to Steri-Strips or maybe it was the Lydocaine, but nevertheless, the next day I developed a rash covering the entire breast and even down a little below my ribs. Nothing itchy or painful, but just weird and slightly worrisome. After an interminable day or three (it’s all a blur), I got the call. You can never tell in your gyn’s voice because I’ll bet they all start out with “we got the results back on your biopsy and….”. I already know that front end of the sentence information because isn’t that the reason she is calling? Yet while extraneous, it affords the opportunity to gauge the tone of the news and predict what’s next. With each word, the tone became increasingly I’m sorry to have to tell you this.
After learning the news of what I’m dubbing my not benign situation while standing in a friend’s driveway, I returned home and a few hours later Faith Hill (remember, the pretty radiologist?) called me not realizing I already knew. We talked at length and her velvety calmness was the perfect salve. I asked her advice on loads of things and she said I should get a bilateral MRI (scanning both sides) and that I could mention her name when scheduling. The next morning first thing, I was on the phone using my Faith Hill get the MRI card. They said usually you meet with the surgeon and she suggests it and then you schedule the MRI, but they thought they could do it this way instead. I was meeting with the surgeon the next week and certainly wasn’t going to wait all those days to see her only to wait more for the MRI, so I hounded them a bit, ok a lot, to go ahead and schedule it in advance so the doctor would have everything in hand when we met. Besides, the not benigns were surely procreating inside me and they needed to stop their nonsense immediately.
A day or so later on a Friday afternoon I got a phone call and it was the hospital’s “patient navigator” on the line and she asked if she could help. First off, I was in denial that I was on this pink papered road and I certainly didn’t need a navigator, only further acknowledging this path was in fact before me. But she got me talking about my confusion with several MyChart biopsy results, about things like estrogen and progesterone receptors, and HER2, and labeling my not benign situation as invasive ductal. She explained there are some silver linings here. I am ER 100% positive which means that the pill you have to take for five or ten years is uniquely suited to my situation. This little bugger feeds on estrogen and only estrogen, so we can starve its sorry ass. The HER2 thing, which I don’t exactly understand yet, but which I learned is negative, she said is good news. As we kept talking, I liked her voice more and more. I hadn’t told many people and certainly hadn’t broken down. But I did here. For probably another half hour I sobbed and talked and sobbed some more and she listened and sent love over the phone. And that was everything. Afterward I had plans already in place to go see a play with friends, but after all the tears couldn’t imagine myself ready to leave in 20 minutes, but I did. I loved the play and the evening, but keeping this dark secret inside was hard, not to mention unsettling.
The MRI was bizarre. You lie face down on a table that has two big cutouts which line up with your breasts which hang down as if someone below on a stool would be milking you. Instead you are given a rubber oval thing to squeeze if you need anything (thank you, I’ll take a Shake Shake double cheeseburger, stat) as you are rolled into this machine, with earphones on because it’s loud. They said it would sound like a construction site, but for me it resembled a loud annoying sound of a phone off the hook which nobody had bothered to put back on. You do remember when phones came with curly cords? The attendant seemed proud that Piedmont could now offer me Sirius for my listening pleasure, and said I could choose my channel. I choose classical piano which paired nicely with phone off the hook.
Fast forward to I don’t know how many days later and my husband and I were at a breast center (btw Georgia Tech’s McCamish Pavillion could be a fine place to house a breast center – do a drive by, looked at its shape complete with nipple on top and see if you don’t know what I mean) in front of my surgeon. A top surgeon with a stellar reputation, she looked like a well-educated Janet Jackson in a lab coat, the pre-plastic surgery Janet. Her calmness worked well against my whatever you want to call it. She told me I was Stage 1 (or could be 2), and 1 cm in size, though the MRI shows it could be double that. Lots of potentially positive news followed by little doubts about whether it was as simple as it sounded. I pictured phone cords from all those off the hook phones tangled up in my breast, making seeing this evil bugger in this sea of density next to impossible. Still, teary eyed, I asked, “Is this eradicateable?” Surely that’s not a word, but after using it, I certainly didn’t admit I had a degree in English, and instead just whimpered softly repeating the question. She gave me a bit of a “well, duh” look, followed by a “yes”, which calmed me down. She said my lymph nodes in both the ultrasound and the MRI look small and unremarkable, which is what you want, and said after surgery we’d determine a course for treatment. She added if my pathology report indicates these not benigns have a low risk for returning, I will have radiation. High risk and they pull out the big guns, the cannons, the chemo. After all that, they put you on a pill for five or ten years, depending on pathology results. Piedmont is a badass.
With this diagnosis you get things. As if Elizabeth Warren herself designed this curriculum, there is a plan for everything. There is a nutritionist you can see, thanks to a grant, and I got in to see her immediately. For now, and maybe indefinitely, I’m gonna be a clean eater. And for now, a non-drinker. All the beige colors have left my plate and it’s bold peppers, carrots, kale and fish for me. A little chicken and some nuts too, but no dairy. Almond and oat milk are vying for space in my fridge and that 2% cow’s milk is shoved in back. I’m determined to feed this evil bugger everything it hates, everything that is anti-inflammatory. I’m certain I’ll have a slice of pizza or bowls of real (non chickpea) pasta now and then, because food is, after all, one of life’s greatest pleasures. I am eating well and it all tastes good. Before I went for a run the other day, while pulling on my jog bra, I said to these fellas, the not benigns, buckle up, we’re going for a ride! As I pounded the pavement, I pictured them shaking their heads asking wtf?, pissed off and running out of steam, as I filled my healthy lungs with air and pressed on. I’m loading up with all kinds of good ammo. I’m Will Ferrell, the elf throwing snowballs at this unwelcome mass. Here! Take this! Splat goes a red pepper. Can’t swim in all the almond milk, too bad, so sad! Thanks to another grant, there is a counselor to see, allowing ten free sessions, which I’m scheduling weekly. I’ve already been to two and cried through the first and after the second, she said I seem much better. It’s helping. There is genetic testing too, thanks to another grant, and they’ve drawn two vials and are testing 74 genes. So now I wait for that news. Knowledge will be power.
It’s been a mixed bag (no pun intended) of good and bad, these last three and a half weeks.
THE BAD: I worried every day to get to this day, the lumpectomy. I had to make umpteen appointments and be poked and prodded for biopsies, inserting clips in my breast to guide the surgeon, and then more fun with the IV at surgery and of course, the scalpel. And then I had to worry some more. I had to start telling people, because you can’t not, which made me scared to see their faces often scrunched with concern, as if they saw my future and now felt sorry for me. I had to imagine a potentially sunburnt breast from radiation and wonder would it be permanent?, or a bald head from chemo, and what kind of hair would grow back. And what will this medicine do to me other than block estrogen from getting to this breast, the chosen snack of the not benigns. I worried it’s a game of whack a mole, stamp out the trouble makers in the breast, only to discover them somewhere else. Rinse and repeat. I worried about worrying my family, my children in particular.
THE GOOD: I caught this myself, it’s early and it’s small, it’s eradicatable, and it’s clear someone is watching over me. For that, I am beyond grateful. My diet is squeaky clean, I am going to move more, and my body will be stronger for having gone through this. This is a wakeup call. A call for more calm and less worry, and I already feel the calm seeping into my cells. I may have been opened up today in surgery, but I am forever opened to breathing in all the good I’m finding and exhaling it over my friends and family, and over strangers too. After I finished rattling off my many questions in the recovery room to my nurse who had remained with me well past what is normal, I got dressed and was about to draw the curtain to get ready to leave. I heard a voice through the adjacent curtain say, “I’m glad you asked those questions. They helped me too. I’m over here next to you.” I said “hi” and opened my curtain to see who was next door. It was the lady who had been on the elevator with me this morning, our husbands both silent and ruminating on what was ahead for their wives, and she was lovely and about to be admitted to a room. She’d had a double massectomy as both breasts had been riddled with not benigns. I took her hand and squeezed it, and told her she would do great. She smiled and sent me the same good wishes. My exit wheelchair was waiting, but it was hard to leave her as we had this brand new connection, instantly filled with love and understanding. I cupped my hand around her cheek and reminded her again that all will be ok. She will do well as will I, and that moment will surely stay with us both.
I will hear from pathology in a week or so and know more about additional treatment, but for now, the not benigns have left the building, I’ve got my family by my side and friends who are in touch. I couldn’t ask for more. But actually there is one thing I need: Ladies, feel yourselves up like clockwork every month. Learn how they feel, even if they’re pea gravel, so if they change you will know. Also if you’re considered dense or even if you’re not, insist on a 3-D mammogram, even if your doctor whines that insurance might not cover it. Learn the cost and just do it, charge it if you have to. No one told me to do this kind and I’m certain if they had, this would have been caught even earlier when it was even smaller. I’m lucky in so many ways to have good insurance, a strong body and the boundless perseverance that I do.
And lastly, be kind to yourself. Really kind. Because the not benigns hate that. And more importantly, because you, my dear, are worth it. `