Scar Tissue

Aren’t we done here? I’m one thousand one hundred ninety-eight days post lumpectomy (believe me, you’d count too), and by the looks of things I’m breezing along—religiously scheduling and attending annual mammograms and scans, daily popping my treatment pill, going to New York and whining, wining and dining with my breast friends (aka breasties), and even raising money on a cancer walk. By all accounts, I am evolving into an unremarkable cancer patient. Scratch that. Survivor. I’ve done the rose smelling, looking forward to things, looking back trying to flatten the bumpy reality of this ride, and done my damnedest to remove the cancer distraction, survive, and get back to the work of evolving.

I’m doing all the things. Taking the daily ten-year pill (Anastrazole) to block estrogen from feeding any mf-ers who dare sidle back up to the table for a meal. The twice a year insanely expensive (thank God for insurance) Prolia injections, which for half the year halt my bone sloughing activities so I can climb out of osteoporosis, which I can thank aforementioned ten-year pill for. So far my spine has graduated into osteopenia and hopefully the hips will study hard and make the grade too. And then there are those mammograms we women all loathe, but the highly uncomfortable smush we must enlist.

A friend who also didn’t sign up for this sistership remarked about the surprising fear you get when there is something new. You spiral all over again hyperventilating over endless frantic Google searches. Some fear is healthy and helpful because it enables you to react quickly if you need to (fight or flight) but being an expert anxious overthinker who can slide into panic mode on a moment’s notice is not.

Take Tuesday, for example. I’d been noticing some swelling on my left side where all the hell had broken loose in late 2019, and it seemed the asymmetry was subtly increasing. I don’t need symmetry, but I do need consistency. Once cancer enters the scene, change, the only constant, is above all not welcome. Since my annual MRI was the next day, I slipped into an exceptionally nasty rabbit hole, you know the one where you start bawling those sad guttural notes and realize you won’t have the chance to finish several important projects you finally had the guts to start, but which you’ve only just begun. You’ve drifted back to that island alone, back on the torn raft, and once again you can’t bring yourself to glance back at the shore where you’ve left everyone going about their enviable ordinary lives which, from your vantage point, look sparkly, exceptional even.

You replay all your decisions. Why didn’t I just get a double mastectomy and be rid of this troublesome attention-seeking tissue, which per my doctor wasn’t a better option since lumpectomy+radiation = mastectomy when it comes to outcomes. You lament all the things you never stepped up to do because you let self-doubt win out. You won’t get to see that beautiful blue paint you picked out for the house you’re renovating, whose renovation has been at a standstill for three months, or live to see the day the new upstairs toilet is plumbed down the hall from your bedroom so you can stop sleepwalking the 22 stairs down to the bathroom in the far corner of the house. Your empathetic cat jumps on your lap and looks into your teary eyes trying his best to calm you, stretching his 16-lb body over your chest, his sweet, adoring attempt at a hug. Bo, my lovebug. You appreciate it, but it’s still your problem and yours alone. That’s the lone journey that is cancer.

I broke down to my breast friends in a sad teary video unlike any I’ve left. Historically I’ve been the optimistic one, you could say annoyingly cheerful even, and letting this other woman run amok and star in her own video was a risk I was willing to take. Someone needed to join me on this ride back out to sea. The response came in sweet videos from these ladies who get it.

The MRI was as they always are. Expensive, a lesson in patience and stillness, and as always, I can’t understand why those socks they give you with your gown aren’t donated to people who could use a pair of socks, any pair especially these which are warm and have treads. I’ve asked and they’re thrown away. Maybe I will live long enough to spearhead a hospital sock campaign to gather them all up and distribute them to the sockless? Each time I request classical music to accompany the MRI’s knocking/phone off the hook/discotheque soundtrack, and because so far it’s worked, why switch music and tempt fate? Afterward the technician said they usually read them quickly, so I figured maybe end of day I’d hear something.

The nurse practitioner I’d called at my breast surgeon’s office returned my call and they could see me in a few hours at 1pm. I wanted them to feel firsthand this swollen asymmetry and maybe an ultrasound would show something an MRI couldn’t? I stopped to pick up coffee and ran into a friend, the same one who’s walked to radiation with me a few times and who’s mostly up to speed on things. Her simple, “How are you?” brought forth from me an abbreviated non-teary-eyed version of my plight, that I was sandwiching an errand between scan appointments. It all felt rather healthy, despite the great unknown I still faced, and thankfully the conversation moved on to lots of other areas like kids, work, house renovation.

“Your tissue is folding around your scars and pulling up causing the puffiness. See where this is?” the nurse practitioner asked. I don’t see anything unusual here.” The tears, thousands of which were still collected behind my eyes from the day before, broke free and this poor woman had unwittingly found herself in a scene. I started hugging her and it was clear she was not a big hugger, but with no choice, did it anyway. I must have hugged her two more times groveling with my, “You don’t understand how crazy this makes me” excuse for carrying on. She added that radiation is the gift that keeps on giving, resulting in dramatic tissue changes that don’t necessarily settle over time. A few more hopeful nods from her and she got the hell out of dodge, and I got dressed, but not before leaving my breasties a video.

With mask pulled off my face to reveal the full red puffiness of my tear-stained checks, I left an update to the tune of “The nurse practitioner thinks it’s okay and the ultrasound looks normal; it’s just my tissue is pulled and puffed up.” Released from prison, I moved quickly through the elevators and parking deck, reaching my husband with my get out of jail card news and then left my sister a voicemail, which was barely audible through the endless supply of tears I’m now able to produce on command. The breast friends fired back multiple videos of relief which gave me a place to land. It’s much more fun to skip out of jail if you’ve got folks cheering on your escape since they too have been incarcerated.

In her video, one of my friends mentioned how fear of recurrence for her is almost worse than the actual initial diagnosis, which I wholeheartedly agree with. We now know too much and with this new knowledge, our mind is an even far more dangerous place to be. She shared the analogy she’d read about (https://at.tumblr.com/somehedgehog/cancer-the-mountain-lion-in-your-fridge/1d3nsa19vdc0) of having had cancer being compared to having a mountain lion in your fridge. It’s there. You can hide it. You can live with it because it’s in the fringe, but sometimes you open it and are reminded that it’s always going to be there.

Home to find an email with MyChart MRI breast w/ and w/o contrast results somewhat inconclusive:

Finding 1: Area in the left breast appears benign.
Finding 2: Area in the left breast requires additional evaluation. Additional mammographic images are recommended. A possible ultrasound may be warranted following the mammographic views. Recommend diagnostic evaluation with mammogram and possible ultrasound for left breast swelling.

More calls to doctor to see what they make of MRI and ultrasound findings when seen together, and the surgeon suggested a diagnostic mammogram. When pressed, the PA admitted additional evaluation can result when the patient is voicing a new complaint, aka me, and they take it seriously. I’m glad I can’t seem to keep my mouth shut because I want that comfy place with more eyes on me. I want my file to be stamped “free to go” until the next crisis, ahem scan, happens.

On March 8, I’ll be back at the cancer center for a diagnostic mammogram and ultrasound, and I’ll get same-day results, which my PA expects will be fine. After that, I will begin weekly breast lymphatic massage therapy, a healthy drive up to Roswell where whomever is assigned my high maintenance breast will manually redistribute the tissue and I’ll be more comfortable. Whatever it takes, sign me up.

I started physical therapy to restore range of motion in my shoulder and arm, left tight and knotty from a recent lumpectomy and radiation. Being able to reach behind and scratch my back easily and pain-free is a new goal, as is securing a bra clasp. Over a year since surgery and nearly that long since treatment, you’d think by now the healing would be all done, but seems the tightness has only increased. The tissue under my arm feels like fabric sewn with too tight stitches and all we need is a seam ripper to break through and pull the threads loose.

You’d think by now the healing would be all done.

Like you do when telling an infant’s age, I used to talk in months – I’m three months post chemo, six months since radiation, etc. – but thankfully now I can talk in years since all this started up in late 2019. My surgery and treatments have graduated out of their infant stage and into a toddler stage, with tantrums arising as this little blocked lymphatic circulation mess I must now clean up.

The physical therapy office is close by, convenient and calm — nothing like my last PT experience several years ago where the incongruously L O U D radio was routinely tuned to the unholiest of trinities – The BeeGees / Gerry Rafferty / Air Supply – and my physical therapist’s brash order-me-around style certainly didn’t fit my idea of a first-string player you’d pick for your healing team. Last week at my initial session, I was assigned an Emory student, a no-nonsense tucked-in clean-shaven guy who, after moving me through several stations working my arm and shoulder, moved into a deep tissue shoulder massage miraculously landing on all the tight unyielding spots which, albeit stubbornly, gave way. I left with a sheet of homework exercises, most of which I completed except the one involving a Theraband. Surely I own a Theraband, but, alas, where is it? Still haven’t brought myself to enter a Target or Walmart since the pandemic began, so opted against purchasing. I know, Amazon.

At today’s session I worked with a petite young lovely woman who moved me through various stretching and strengthening stations. The therapists toggle between several patients, like busy chefs minding multiple burners, careful to tenderly sauté and not let a rolling boil erupt or a pan sit unattended and burn. They move between patients rolling their laptops around on wheeled lectern style desks.

I might have blurted out to my therapist that the roving desk setup she maneuvers reminded me of the SNL skit with Melissa McCarthy playing Sean Spicer rolling her podium on the streets of New York. She humored me with an amused/mortified smile, probably not so happy she got assigned the clown who wants to inject humor into all of it, breaking up the calm focused room she and her colleagues have cultivated. I joked now she won’t be able to shake this visual and she smiled again realizing the truth of that unfortunate circumstance.

This weekend we went for a Sunday drive, winding through various parts of Atlanta — Edgewood, Inman Park, Poncey-Highlands. Other than looking at house paint colors for inspiration, my primary goal was to score a canelé, a small striated cylindrical French pastry flavored with rum and vanilla with a soft and tender custard center and dark caramelized crust, which I found at Ponce City Market’s Saint-Germain bakery. I’m working on not consuming much sugar, but occasionally the urge is real, and I’m increasing trying to locate something exceptionally good vs the first filler sugar I can get my hands on. By the looks of things in the Food Hall, but for the masks covering most people’s faces, you’d never know we’re in a pandemic. Throngs of loud-talking particle-spreading people filled the hall, the din of noise so visual and loud I nearly abandoned the much-anticipated sugar errand. I got myself a canelé and Joe a palmier, his favorite, plus a coffee éclair and raspberry and passion fruit mousse little round cake for later. We nibbled on the canelé and palmier and meandered through neighborhoods studying houses’ paint colors from our car for our some-day repaint.

Driving through Edgewood, I noticed a ramshackle of a church with a sign out front and the message, “Your Grief is Valid.” We live in a world full of dichotomy – help is on the way with stimulus checks about to drop into accounts and Covid vaccines increasingly common, yet still there are long lines for those waiting for a bag of food to feed their family and scores of people pre- and post-Covid cloaked in a stuck-on heaviness they can’t shake. Last week, the TV networks broadcast highlights looking back on the full year since Covid was proclaimed a global pandemic. How do you bundle so much loss into a news segment? It was admittedly well done, but so sad, too. Smiling faces now gone leaving behind families who don’t know where to begin to climb out of their despair. Exhausted doctors and nurses, their virtues extolled, in search of a reset or second wind or both.

Your grief is valid.

We each heal in our own time. And time, for the most part, heals all things. But for those of us stuck in the middle between our hurt and our healing, and with a pandemic thrown in the mix, every morning can feel like Groundhog Day, a familiar rotation without much hopeful change in sight. Circling back to the church sign, your grief IS valid, despite however fresh or old, and the way you move through it is your choice. But until you feel well on your way, please don’t stoically go it alone or hide until your best self magically shows up. Because we all know things don’t quite work out that way. Instead, walk with someone, grab a coffee or a canelé and take some time together, comparing notes, taking notes, or soaking in the simple and reliable beauty outside. One day when you aren’t looking, you will feel it, a little less heavy and moving forward with a slight change that happened, when things starting looking brighter, sharper and you saw a shiny glint of hope in the distance. Try and break up the days, infuse them with connection. Sure, physical therapy can mechanically do it, but being together also melts scar tissue, and is what opens up space for all kinds of goodness.

Tag: Scar Tissue

The Gift That Keeps On Giving