We're on the plane to Phoenix to go have surgery to correct my stupid fractured ribs that are stupidly poking my ventricle, and maybe correct the carinatum that was created from the excavatum procedure and it all feels a little secondary right now.
And at the same time, I have the stupidest and most fixable of cancers, and have not a damned thing to whine about.
I got a coworker fighting the REAL fight with a cancer like an octopus of doom in her boob, and she's getting chemo. Which is poison. I'm a nurse, and I'm not supposed to say that, because it's poison that saves people's lives and I know that, too. I also know it's fucking poison. I don't know how to help her, other than to hug her and text her sometimes that she's awesome.
And I probably won't need it. Chemo, that is.
The standard treatment for DCIS is lumpectomy, with or without radiation, or mastectomy. With either option, possibly the drug tamoxifen for at least ten years.
Thank ALL the gods about the likely-no-chemo thing. (I haven't talked to any of them lately. Maybe I should. Maybe Isis is up on the latest research on DCIS, I shouldn't dismiss out of hand that she's hasn't got an opinion on these things.) (I should ask.)
Yeah. It's fuckin cancer.
….
I've been expecting a diagnosis of breast cancer for 13 years, since my mom was diagnosed at age 53. She had DCIS, too, mildly invasive but at a lower grade than me. Have never been pregnant, much less breast-fed. Was on oral birth control for a solid 20 years, and then switched to an IUD with the (much smaller dose, but still present) hormone release. At age 44 and 3/4, I am a recipe for breast cancer.
Oh. I've been learning cancerspeak. It's another language. Let me help translate.
I explained it to Chase last night, and I'm partly making this up maybe. But maybe not and maybe this makes sense and is correct....or correct-ish. I have ductal carcinoma in situ (DCIS). Ductal is obvious...it's in the ducts of the breast. From which milk would emerge, if you've done that sort of having-a-baby thing (which I have not). Carcinoma is obvious....-oma is some type of tumor thing that doesn't belong there. In situ means in place. So. DCIS means cancer of the ducts that emerged from there and is sitting there.
I told Chase, who likes science, and had biology, to look at it on an X-Y axis of seriousness. Invasiveness is one of the axes....mine is not invasive, as far as they know right now. Yay for me. My mother's was mildly invasive.
Another axis is the “mitoticness” of it....which may not be a word, but he understood. Mitosis is the process through which cells divide, and the degree of this is graded. Mine is a high grade, so my little cancer fucker cells are breeding like fucking rabbits. They need to die. Now. So this is bad. Or, maybe, more accurately: less good.
DCIS is still the best breast cancer to have.
Yay. Me. Woo....?
I have THINGs to DO and this cancer shit is REALLY inconfuckingveniencing me. Sorry. I dropped a lot of F-bombs after my biopsy too. I kept apologizing, but I couldn't seem to stop it. Angie was my radiology tech and she was the awesomest person ever. Then Asmet helped me with coordinating the biopsy, and she was completely awesome, too. The two of them were there for my biopsy, with Dr. Amy. I really did have the A team, literally and figuratively. I couldn't have asked for better people to take care of me.
Mark is taking care of me, too. He is worried. He doesn't know cancerspeak either. This stupid crap is new to both of us. We'd rather be doing something else.
When I'm unconscious for THIS surgery tomorrow, I am going to let him have the books I got from amazon.com. (Of COURSE I got books from amazon.com. I met the Fedex guy at the door, twenty minutes before we left for the airport. Only because I want the patient's-eye view before I start going to town in PubMed. I love that I have free and easy access to PubMed because of my job.) One was a funny cancer book, the other is not. I read the unfunny one until I can't, and then I switch to the funny one until I can't and flip back and forth.
So. I'm okay. I am deeply grateful for the people in my life. My mother-in-law called today. My father-in-law (who just got home from France) called yesterday. My colleagues have been fantastic. I am a lucky bastard. I am really happy with all my UCH doctors. My PCP called an hour after I got off the phone with the pathologist, and asked me to come see her for my mental health. I suppose I could take that as, "Michelle, you are either now, or about to become, a complete emotional wreck and you need to be medicated for your looming DSM-V diagnosis." But I didn't. I think it was kind. I think she cares.
The weird thing (or, not weird) is that if I hadn't had the pectus surgery, this little shit of cancer would probably not have been found, because it was living...squatting without paying rent, or cleaning up after itself....in the medial aspect of my right breast, deeper into the tissue. Completely inaccessible to a mammogram last year. Little fucker.
Sorry about all the swearing. Just, you know. I am learning that cancer makes you swear...a lot more than you typically do
So.....yay? That I had this surgery....and I got infected and found out via CT scan that I had a bone poking my ventricle....? And then I felt a lump in my left, and got my annual mammogram “with diagnostics” right before this SECOND big surgery of the year and it would not have been found if they hadn't popped my sternum up. I mean....yay, right?
When Mark, Chase and I were talking about it the other night...(god, was that only last night?)....we concluded that it was sort of a good series of possibly not-accidents.
Fucking cancer.
Next Wednesday, the day after we fly home from the OTHER Biggest Medical Thing To Happen To Michelle This Year, we go meet a multidisciplinary team: a surgical oncologist, a medical oncologist (read: chemo person), and radiation oncologist, plus a genetic counselor “because I'm young.” (What this means isn't really clear to me. They'll be testing my genes to see how likely I am to have horrible cancer, I think. I think we've already ascertained that I have failed the genetic and lifestyle combination crapshoot, so the purpose of this is not clear to me.)
I was talking to Erin, the Breast Center nurse, and said, “I just want this shit out. Like, now. I'm already gonna be on FMLA....how far out are you scheduling lumpectomies and mastectomies? Because I will do it next week if you'll let me.” She said 1 – 2 weeks for lumpectomy, 2 – 4 for mastectomy. She asked, “If you're sure that you want a mastectomy, we could also have you see a plastic surgeon....?”
That threw me off, because I hadn't even thought about that yet. Breast reconstruction. Oh yeah. Women do that. I thought about it some, and left her a voicemail that sure, I would meet that person if she could arrange it because I would be open to hearing what he or she has to say.
I have written elsewhere in this blog how I have felt about a boob job for me. It's a sore point because some physicians erroneously believe that pectus repair is about body image issues. There is literature out there that discusses body image and pectus. Fine. It's a valid area of research. Some of us aren't doing this because kids are mean. Some of us are doing this because we can't fucking breathe and we have tachyarrhythmias. If I'd wanted a boob job, I would have gotten one a long time ago. I did not want one.
I don't care what any other woman does with her body; it's her business. But ever since I was 18 years old, and that nurse practitioner, at my very first visit to Planned Parenthood, told me to go see a plastic surgeon....I have kept my body the way I am as a somewhat-unconscious hell-with-you to people who judge others based on their appearance.
My breasts were always significantly uneven because of the cavernous divot in my chest. Yes, I was self-conscious as a teenager, but what teenage girl isn't self conscious about her body? My good friend and hairdresser, Katie, has Eyebrow Issues...in the sense she's very conscious of them looking nice, and evenly spaced and....whatever else people judge eyebrow criteria on. Because she's beautiful and perfect, inside and out, and the only thing the mean girls in her Catholic school could come up with to make fun of her were her....eyebrows. Even the most beautiful of people don't like something about their appearance. And chances are outstanding, you don't notice it. Unless you're a jerk.
Girls and boys are mean. Alan Cox once made fun of me in the library in 7th grade about shooting a duck and its “tits flying off it's body,” but that would never happen to me because I had none. (Are you reading this, Alan? I love you, man, but, you were a mean kid in 7th grade.)
I look like what I look like. If it's not good enough for other people, not pretty enough, not hourglass enough, dude, totally your loss. My wonky right breast has never ever been a problem for any man lucky enough to see it up close and personal. It never got in the way of ...any of my social activities. Go pound sand, insensitive nurse practitioner who thinks 18 year old girls should get boob jobs. You are wrong.
I got a tattoo over my right breast about ten or fifteen years ago...long ago enough that the once-black ink is turning to that payne's grey that older tattoos have. I didn't think consciously about where I place it (because, honestly, a little inebriated at the time). But I didn't want the tattoo anywhere else. It was the body part I wanted....decorated? Offset? Feng-shui-ed?. In a permanent way. I'm not sure I have the right word for that. If there's a German word that means to place a piece of art next to something that reflects kindly and aesthetically shines onto something else that the art is near....that's what I mean. (German has a vast vocabulary for ephemeral and yet hyper-specific things.) (Maybe there's a Mandarin word for that, too.)
At the time, my thinking was not that complex about it.
And so....they are offering me to make my breasts look...”normal.” With silicone and stuff. I think. Women feel strongly about this one way or the other, and I don't know what to feel.
If you're thinking I'm putting the cart before the horse and that maybe they won't take my breast off....it's because I've been obsessively thinking about cancer for a whole five days. And I'm an efficient thinker.
I'm at a very high risk for not only getting diagnosed with cancer (which I have, at age 44), but having it recur. Something like within five years, I could be doing this crap again. And having it be worse. And worse means chemo, which is a fate some people choose to die in lieu of doing. I may not have strong feelings about breast reconstruction yet, but I had strong feelings about chemo even before I watched my mother suffer through it.
No breast tissue, no breast cancer. No breast cancer, no chemo. Bada-bing. Yes, I could get colon cancer or lung cancer or cancer of my pinky toe or whatever, but I eat broccoli, don't smoke, and I get up and move and the whole point of this surgery this year was to go back to exercising like I used to....because when I can breathe, I like getting up and moving. I drink red wine moderately enough that my liver function tests say it's okay to keep drinking and don't eat anything with eyeballs. I do not skydive. I brush my teeth and floss. People like me shouldn't get cancer. Dammit. Nobody should get cancer. It's a stupid thing to get.
They may want to radiate me, which is complicated because I have metal bars in my chest. Yes, I've already told Dr. J. I got a call from Kelly today that Dr. J is strongly considering NOT fixing the carinatum I now have because she doesn't want to put more metal in my chest if radiation is a thing that may happen. I want her to fix the carinatum, though. We'll discuss it tomorrow morning.
So I have a lot of decisions. I'm a decisive person, generally, but these are not easy.
I think we might be circling Phoenix airport. We seem to be gently descending. We have to go get the car, get to the hotel, and I have to take a hibiclens bath/shower/something. And we have to get up at four thirty in the morning to go to the hospital so I can have a surgery that has nothing to do with this little fucker cancer in my right boob.
So. I have to go think about something else now.
And at the same time, I have the stupidest and most fixable of cancers, and have not a damned thing to whine about.
I got a coworker fighting the REAL fight with a cancer like an octopus of doom in her boob, and she's getting chemo. Which is poison. I'm a nurse, and I'm not supposed to say that, because it's poison that saves people's lives and I know that, too. I also know it's fucking poison. I don't know how to help her, other than to hug her and text her sometimes that she's awesome.
And I probably won't need it. Chemo, that is.
The standard treatment for DCIS is lumpectomy, with or without radiation, or mastectomy. With either option, possibly the drug tamoxifen for at least ten years.
Thank ALL the gods about the likely-no-chemo thing. (I haven't talked to any of them lately. Maybe I should. Maybe Isis is up on the latest research on DCIS, I shouldn't dismiss out of hand that she's hasn't got an opinion on these things.) (I should ask.)
Yeah. It's fuckin cancer.
….
I've been expecting a diagnosis of breast cancer for 13 years, since my mom was diagnosed at age 53. She had DCIS, too, mildly invasive but at a lower grade than me. Have never been pregnant, much less breast-fed. Was on oral birth control for a solid 20 years, and then switched to an IUD with the (much smaller dose, but still present) hormone release. At age 44 and 3/4, I am a recipe for breast cancer.
Oh. I've been learning cancerspeak. It's another language. Let me help translate.
I explained it to Chase last night, and I'm partly making this up maybe. But maybe not and maybe this makes sense and is correct....or correct-ish. I have ductal carcinoma in situ (DCIS). Ductal is obvious...it's in the ducts of the breast. From which milk would emerge, if you've done that sort of having-a-baby thing (which I have not). Carcinoma is obvious....-oma is some type of tumor thing that doesn't belong there. In situ means in place. So. DCIS means cancer of the ducts that emerged from there and is sitting there.
I told Chase, who likes science, and had biology, to look at it on an X-Y axis of seriousness. Invasiveness is one of the axes....mine is not invasive, as far as they know right now. Yay for me. My mother's was mildly invasive.
Another axis is the “mitoticness” of it....which may not be a word, but he understood. Mitosis is the process through which cells divide, and the degree of this is graded. Mine is a high grade, so my little cancer fucker cells are breeding like fucking rabbits. They need to die. Now. So this is bad. Or, maybe, more accurately: less good.
DCIS is still the best breast cancer to have.
Yay. Me. Woo....?
I have THINGs to DO and this cancer shit is REALLY inconfuckingveniencing me. Sorry. I dropped a lot of F-bombs after my biopsy too. I kept apologizing, but I couldn't seem to stop it. Angie was my radiology tech and she was the awesomest person ever. Then Asmet helped me with coordinating the biopsy, and she was completely awesome, too. The two of them were there for my biopsy, with Dr. Amy. I really did have the A team, literally and figuratively. I couldn't have asked for better people to take care of me.
Mark is taking care of me, too. He is worried. He doesn't know cancerspeak either. This stupid crap is new to both of us. We'd rather be doing something else.
When I'm unconscious for THIS surgery tomorrow, I am going to let him have the books I got from amazon.com. (Of COURSE I got books from amazon.com. I met the Fedex guy at the door, twenty minutes before we left for the airport. Only because I want the patient's-eye view before I start going to town in PubMed. I love that I have free and easy access to PubMed because of my job.) One was a funny cancer book, the other is not. I read the unfunny one until I can't, and then I switch to the funny one until I can't and flip back and forth.
So. I'm okay. I am deeply grateful for the people in my life. My mother-in-law called today. My father-in-law (who just got home from France) called yesterday. My colleagues have been fantastic. I am a lucky bastard. I am really happy with all my UCH doctors. My PCP called an hour after I got off the phone with the pathologist, and asked me to come see her for my mental health. I suppose I could take that as, "Michelle, you are either now, or about to become, a complete emotional wreck and you need to be medicated for your looming DSM-V diagnosis." But I didn't. I think it was kind. I think she cares.
The weird thing (or, not weird) is that if I hadn't had the pectus surgery, this little shit of cancer would probably not have been found, because it was living...squatting without paying rent, or cleaning up after itself....in the medial aspect of my right breast, deeper into the tissue. Completely inaccessible to a mammogram last year. Little fucker.
Sorry about all the swearing. Just, you know. I am learning that cancer makes you swear...a lot more than you typically do
So.....yay? That I had this surgery....and I got infected and found out via CT scan that I had a bone poking my ventricle....? And then I felt a lump in my left, and got my annual mammogram “with diagnostics” right before this SECOND big surgery of the year and it would not have been found if they hadn't popped my sternum up. I mean....yay, right?
When Mark, Chase and I were talking about it the other night...(god, was that only last night?)....we concluded that it was sort of a good series of possibly not-accidents.
Fucking cancer.
Next Wednesday, the day after we fly home from the OTHER Biggest Medical Thing To Happen To Michelle This Year, we go meet a multidisciplinary team: a surgical oncologist, a medical oncologist (read: chemo person), and radiation oncologist, plus a genetic counselor “because I'm young.” (What this means isn't really clear to me. They'll be testing my genes to see how likely I am to have horrible cancer, I think. I think we've already ascertained that I have failed the genetic and lifestyle combination crapshoot, so the purpose of this is not clear to me.)
I was talking to Erin, the Breast Center nurse, and said, “I just want this shit out. Like, now. I'm already gonna be on FMLA....how far out are you scheduling lumpectomies and mastectomies? Because I will do it next week if you'll let me.” She said 1 – 2 weeks for lumpectomy, 2 – 4 for mastectomy. She asked, “If you're sure that you want a mastectomy, we could also have you see a plastic surgeon....?”
That threw me off, because I hadn't even thought about that yet. Breast reconstruction. Oh yeah. Women do that. I thought about it some, and left her a voicemail that sure, I would meet that person if she could arrange it because I would be open to hearing what he or she has to say.
I have written elsewhere in this blog how I have felt about a boob job for me. It's a sore point because some physicians erroneously believe that pectus repair is about body image issues. There is literature out there that discusses body image and pectus. Fine. It's a valid area of research. Some of us aren't doing this because kids are mean. Some of us are doing this because we can't fucking breathe and we have tachyarrhythmias. If I'd wanted a boob job, I would have gotten one a long time ago. I did not want one.
I don't care what any other woman does with her body; it's her business. But ever since I was 18 years old, and that nurse practitioner, at my very first visit to Planned Parenthood, told me to go see a plastic surgeon....I have kept my body the way I am as a somewhat-unconscious hell-with-you to people who judge others based on their appearance.
My breasts were always significantly uneven because of the cavernous divot in my chest. Yes, I was self-conscious as a teenager, but what teenage girl isn't self conscious about her body? My good friend and hairdresser, Katie, has Eyebrow Issues...in the sense she's very conscious of them looking nice, and evenly spaced and....whatever else people judge eyebrow criteria on. Because she's beautiful and perfect, inside and out, and the only thing the mean girls in her Catholic school could come up with to make fun of her were her....eyebrows. Even the most beautiful of people don't like something about their appearance. And chances are outstanding, you don't notice it. Unless you're a jerk.
Girls and boys are mean. Alan Cox once made fun of me in the library in 7th grade about shooting a duck and its “tits flying off it's body,” but that would never happen to me because I had none. (Are you reading this, Alan? I love you, man, but, you were a mean kid in 7th grade.)
I look like what I look like. If it's not good enough for other people, not pretty enough, not hourglass enough, dude, totally your loss. My wonky right breast has never ever been a problem for any man lucky enough to see it up close and personal. It never got in the way of ...any of my social activities. Go pound sand, insensitive nurse practitioner who thinks 18 year old girls should get boob jobs. You are wrong.
I got a tattoo over my right breast about ten or fifteen years ago...long ago enough that the once-black ink is turning to that payne's grey that older tattoos have. I didn't think consciously about where I place it (because, honestly, a little inebriated at the time). But I didn't want the tattoo anywhere else. It was the body part I wanted....decorated? Offset? Feng-shui-ed?. In a permanent way. I'm not sure I have the right word for that. If there's a German word that means to place a piece of art next to something that reflects kindly and aesthetically shines onto something else that the art is near....that's what I mean. (German has a vast vocabulary for ephemeral and yet hyper-specific things.) (Maybe there's a Mandarin word for that, too.)
At the time, my thinking was not that complex about it.
And so....they are offering me to make my breasts look...”normal.” With silicone and stuff. I think. Women feel strongly about this one way or the other, and I don't know what to feel.
If you're thinking I'm putting the cart before the horse and that maybe they won't take my breast off....it's because I've been obsessively thinking about cancer for a whole five days. And I'm an efficient thinker.
I'm at a very high risk for not only getting diagnosed with cancer (which I have, at age 44), but having it recur. Something like within five years, I could be doing this crap again. And having it be worse. And worse means chemo, which is a fate some people choose to die in lieu of doing. I may not have strong feelings about breast reconstruction yet, but I had strong feelings about chemo even before I watched my mother suffer through it.
No breast tissue, no breast cancer. No breast cancer, no chemo. Bada-bing. Yes, I could get colon cancer or lung cancer or cancer of my pinky toe or whatever, but I eat broccoli, don't smoke, and I get up and move and the whole point of this surgery this year was to go back to exercising like I used to....because when I can breathe, I like getting up and moving. I drink red wine moderately enough that my liver function tests say it's okay to keep drinking and don't eat anything with eyeballs. I do not skydive. I brush my teeth and floss. People like me shouldn't get cancer. Dammit. Nobody should get cancer. It's a stupid thing to get.
They may want to radiate me, which is complicated because I have metal bars in my chest. Yes, I've already told Dr. J. I got a call from Kelly today that Dr. J is strongly considering NOT fixing the carinatum I now have because she doesn't want to put more metal in my chest if radiation is a thing that may happen. I want her to fix the carinatum, though. We'll discuss it tomorrow morning.
So I have a lot of decisions. I'm a decisive person, generally, but these are not easy.
I think we might be circling Phoenix airport. We seem to be gently descending. We have to go get the car, get to the hotel, and I have to take a hibiclens bath/shower/something. And we have to get up at four thirty in the morning to go to the hospital so I can have a surgery that has nothing to do with this little fucker cancer in my right boob.
So. I have to go think about something else now.