Tuesday, January 30, 2007

Thought for the Day. No, for Life.

From Marianne Williamson (oft credited to Nelson Mandela, who used it in his inauguration speech):

"Our deepest fear is not that we are inadequate. Our deepest fear is that we are powerful beyond measure. It is our light, not our darkness that most frightens us. We ask ourselves, Who am I to be brilliant, gorgeous, talented, fabulous? Actually, who are you not to be? You are a child of God. Your playing small does not serve the world. There is nothing enlightened about shrinking so that other people won't feel insecure around you. We are all meant to shine, as children do. We were born to make manifest the glory of God that is within us. It's not just in some of us; it's in everyone. And as we let our own light shine, we unconsciously give other people permission to do the same. As we are liberated from our own fear, our presence automatically liberates others."

Read "God" as the Universe if you wish. Embrace your power. Shine.

Monday, January 29, 2007

The Long Winter

Ian and I are moving to New Zealand for a time. He’s accepted a job counting fish for an organization there, and I’m going to go and see what a dilettante can find to do when her husband, who’s been a student as long as she’s known him (minus 48 hours or so), suddenly becomes gainfully employed. I’m looking forward to it very much.

We’ll be living in Wellington, the capital city. The weather will be much like Seattle, although not quite so extreme (cooler in the summer, less bone-chilling in the winter, although pretty much just as damp year round). The latitude is more or less equivalent (although opposite) to Eureka, CA, but the proximity of Antarctica will keep us from getting too hot or, indeed, bored from lack of wind. The wind is significant enough that pilots have to have a special endorsement to land at the airport there. Yay.

In a stroke of genius on our part, we’ve managed to be friends with a brilliant person who’s living in Wellington right now, and blogging about it with great flair. We’re looking forward to making her show us around town in April when we arrive.

Yes, that’s right, we’re leaving Seattle on 15 April.

There are three challenges to this date, so, so soon, so rapidly approaching.

Challenge one is the Visa application process. The lovely and brilliant Chiara filled out the one-page on-line Working Holiday visa, and was accepted within two days. We, on the other hand, are filling out the standard 32-page work visa form. We each have to apply, even though I have no intention of working in any traditional sense. And, in fact, I could theoretically be denied a visa. Sixteen of the 32 pages are an exhaustive medical examination and report, and mine says I’ve had cancer. Recently. New Zealand, having socialized medicine, isn’t interested in new residents who are likely to put a huge burden on the medical system. It is also, naturally, not interested in people with TB, or HIV, or Hepatitis B, or syphilis, or people who need dialysis. We understand this. In a country of only four million people (and 60 million sheep), two more can have a significant effect. Fortunately, 98% of my medical form shows me to be the extravagantly healthy person I am, and since I will be, from now on, cancer-free, we’re not worried. And so we’re boldly forging ahead with our other two challenges (we’re not even giving a moment’s consideration to the possibility that our FBI records—yes, that’s right, we’ve been fingerprinted and everything—are anything but clean).

Challenge two is finishing a doctoral dissertation, which lies primarily with Ian, with encouragement and minor editing from me, as well as a willingness to take on Ian’s habitual household tasks.

Challenge three is cleansing our house of a combined 66 years’ worth of accumulated craps (both our parents have already bequeathed our childhood projects and stained math club T-shirts to our own long-term storage in our own basement). I’ve taken on this job, and have been surprised at how much I’ve wanted to cull. We were watching an episode of Seinfeld the other night and Jerry said something about people keeping books they’ve read, for example. “Why do you keep them?” he asked. “They’re like trophies. ‘Look what I’ve done!’” Bingo, I thought sheepishly. More evidence of how Seinfeld mirrors life. So, books, many many many of you, gone. The 26 matching glasses we bought at Goodwill for our New Year’s 2005 party, as well as the various unmatching glasses left over from years of collecting glassware? Gone. Any cooking apparatus with Teflon or an off-brand non-stick coating? Gone. Strange knick-knacks given to us by people who don’t know us quite well enough? Gone. Piles and piles of clothing that either 1) works best with two boobs or 2) I won’t want when we finally get summer again, 18 months after the last time? Gone.

Yes folks, that’s right. Since we’re moving to the southern hemisphere in April, in early, early spring, we’re going to miss the glorious Northwest summer. And we’re missing the evidently not too shabby Wellington summer right now. And we won’t actually get a summer until one year from now. Sigh. Although Ian’s right; I don’t like spring all that much, and I do like fall, so I’ll be trading one for the other pretty neatly. And, being that Ian’s job is not in the US, he’ll be getting about five weeks of vacation per year. And Fiji is very, very close.

Saturday, January 27, 2007

Accessory Boobs

I went to Nordstrom for my boob fittings yesterday, and it was a pretty enjoyable experience, actually. Mom came too, and took me out to lunch afterward at the Nordstrom cafĂ©. The first bra I was given to try on for size (34 B, for those interested in such things) was the classic granny bra, also the classic mastectomy bra. Enough said. But I gamely let the fitter put it on me, and indeed it seemed to age my upper torso by about 50 years. One nice thing about getting prostheses and mastectomy bras at Nordstrom is that they have an excellent alterations department, though, and “pocketing” is free on any bra in the store—meaning they’ll stitch in a pocket for my accessory boob (which keeps it from migrating my toward my throat throughout the day). So the fitter, about my age, looked at me and said, “Um. I’ll be back.”

When she returned, she had several bras that looked like something a 30-something would be comfortable wearing, as well as an awesome halter top bikini. I ultimately decided on something very similar to the bras I’ve worn before, two black and two beige, then I tried on the swim top.

I was suddenly very, very happy about the smallness of my remaining boob. For one thing, it’s not all that noticeable when I don’t stuff the right side of my bra (N.B.—I do recognize that it’s winter here, and I spend most of my time in thick sweaters and down jackets or vests. The one boob thing might be a tad more obvious in the summer . . . which is actually a good thing about our upcoming plans . . . more on those soon . . .). For another, my body isn’t totally out of balance (one of the reasons for wearing a prosthesis is to keep the body balanced—over time, even a small boob can cause muscle shortening and structural problems). For a third, my boobs are the size that fit entirely within the fabric part of the halter top—both my real boob, and my accessory boob.

I tried on the bottoms, too, a low-cut bikini with metal loops on the sides, but it was cold yesterday and I was wearing black long underwear under my skirt so I just took off the skirt and tried on the bikini over my long underwear. I had taken off my boots, too, but had orange knee-high socks with pink and blue polka dots on, pulled up over my long underwear. Hands on my hips, I looked like a superhero, but one or two clicks off from the paradigm. More like a sortahero.

I’d been referring to my upcoming prosthesis appointment as my trip to get press-on boobs; it turns out they do, in fact, make them. They’re very sticky, and have these strange bumps on them, like magnified gecko feet (or so I imagine, never having seen a gecko foot, although geckos stick pretty well to things). You have to wash them every night, though, and that is absolutely not something I can see myself doing. I don’t wear my contacts mostly because I have to clean them when I do wear them.

Anyway, it’s a bit soon to wear my real accessory boob (more healing is necessary), but I do have a lighter-weight foam one to play with in the meantime, which is also good for exercising because it doesn’t get so slippery as the silicone.

In all, a good day.

Monday, January 22, 2007

Path Report

Clean margins all around, although the one between the tumor and my chest wall was a very, very narrow 1 mm. Still, it was clean, and the narrowness was more due to the “geometry” of my small breast, as the surgeon put it, than anything bad about the cancer. So I’m continuing my non-invasive naturopathic/energetic/Neurolinkic protocols, my healthy eating, and starting my stretching program to get my flexibility back. It looks really cool—I’ll post a (tasteful) picture once the rest of the purple Sharpie has washed off.

Wednesday, January 17, 2007

The Worst Part

*NOTE: If you haven't checked in yet today, be sure to start two entries below with Wow Girl*

I got my drain out yesterday. To make sure the surgery site doesn’t fill up with fluid, at the end of the procedure the surgeon installs a bit of perforated tubing, about where an underwire sits if you’re wearing a bra (except under the skin), that exits the skin under the arm (held in place by a stitch) and ends in a flexible, transparent bulb. There’s a slight vacuum in the system, created when you squeeze the bulb to empty it, then cork it back up before letting go. This vacuum draws the fluid slowly out. The tubing can get clogged with blood clots, so you occasionally have to “milk” it, by pinching the tube up near the stitch with one hand (you don’t want to pull on that stitch!), and pinching and sliding the other hand down the length of the tube to the bulb. I only had one blood clot in the tube, which formed while I was still in the hospital. When I’d cleared it, a long, dark red worm lay coiled in the bottom of the bulb.

The bulb has been inconvenient, as you might imagine. It’s been pinned to my surgical bra, with the extra tubing taped to my side so I don’t accidentally pull at the stitch in some nocturnal flailing (fortunately, I sleep virtually without changing position all night long. And Ian, who is a flailer, is on my left side, so I was pretty safe). Since I’ve been wearing a huge flannel shirt that I bought in college at the height of grunge fashion, the bulb, coupled with some bandage padding, has done a pretty good job of simulating my boob, which wasn’t all that big to begin with (either 230 grams or 280. They told me, but I can’t remember.).

A good thing about me is that I still have lymph nodes under my right arm, and they have done a banner job of keeping the fluid running through my body. So actually, from the time I came home, I never went 24 hours with more than 20ml of fluid accumulating in the bulb, and the cut-off for getting the drain removed was 30ml in 24 hours. I briefly considered just leaving the drain in until my check-up with my surgeon on Thursday, but decided that it was enough of a bother that I’d rather just get it out. You see, not only was sleeping somewhat hazardous; showering was virtually impossible. Even with a handy invention called AquaGuard, which covered the stitch and the tubing exit, I still had the bulb to contend with. Ultimately, I tied it to a ribbon around my neck like a gory accessory for some underground cult. It worked . . . but I’m a little too mainstream to really appreciate all the nuances of such an adornment.

Something handy about the location of our house is that it’s within 10 minutes of every clinic and hospital I’ve been associated with since returning to Seattle in 2000, so when the nurse called me back yesterday morning as the snowstorm waned (Monday the clinic had been closed in honor of MLK), I was able to assure her that not only was I still interested in coming, but I actually could (the 4-Runner always appreciates the chance to show its stuff in the city).

The nurse, Cari, showed me into a room and seated me on the bed. I lifted my arm and she took a scissors to cut the stitch. I felt a touch of wooziness as she grabbed a tweezers and yanked out the last bit of nylon thread, and she asked if I needed to lie down for her to pull out the tube itself.

“No,” I said, “I’m fine.” Automatic response. My brain flitted back for an instant to the first day home, when I attempted to swab the stitch site with a Q-tip dipped in peroxide and water, and found myself immediately having to sit, light-headed, on the side of the tub before I pitched head-first in and made the entire operation moot. Something about a bit of surgical tubing coming out of my body really didn’t sit well with me. “Actually,” I said, “I do need to lie down.”

I lay back and lifted my arm over my head, and Cari said “Okay, this is only going to take 3 seconds, and it’s going to burn 1 2 3 and it’s out!”

“Aaaaaaauuugh!” I cried, as the tube, evidently become a red-hot, glass-sharded poker, ripped out of my chest and fluid started to leak down my side onto the pad I was lying on. In 6 days, my body had clearly already begun to incorporate the tube into itself, and it was loath to let it go. The thought of the procedure after two weeks instead of six days made my stomach turn, but I held it together and the burning eased within a minute.

Later, on the phone with my mother, I realized that the drain removal was by far the least comfortable part of the whole mastectomy process; in fact, the only part that was remotely uncomfortable.

But, as they say, no pain no gain. Glad we got that taken care of.

Narcotics: Not Really a Girl’s Best Friend

Four days after my surgery I felt more woozy, and had more vertigo, than on any of the previous days. I blame withdrawal, from the false god Oxycodone. Oxycodone comes to you in the depths of your discombobulation, offering an easy-going, pain-free existence, certainty about life, joy in all your gifts, and an ability to sleep at the drop of a hat. The price—an intensely satisfying voiding of the bowels—seems small and insignificant in the face of the benefits. And so, without question, even without pause, you pop the pills—two every three hours for the first 24, then two every four hours for the next 36, then one and a Tylenol, then another and a Tylenol, and then it suddenly occurs to you, looking in the mirror at your previously flat stomach that is now distended and taut, and appears to be carrying a 4-month-old fetus, that the price—an intensely satisfying voiding of the bowels, remember?—is in fact way too steep.

So I picked at the prunes my mother brought, sipped a bit of the grape juice, strolled casually around the neighborhood, and otherwise cavalierly assumed my body would do its job regardless. And then I cried, and then I took some over-the-counter Sennakot and had a good nights’ sleep, and then, ah blessed relief!

Just in case, I’m not even taking the Tylenol anymore.

Wow, Girl—It’s Been, Like, a Really Long Time

And measured in spiritual growth, in soul growth, in the growth of my gratitude for life, and my love for others and myself and this amazing, complex world we live in, it’s been much longer than that.

You last heard from me when I was in Idaho, enjoying yet another interlude of peace and quiet in one of my favorite places in the world. This particular visit the peace and quiet were much more critical than other visits, because one week prior to going, the day before the wedding of two of my dearest friends, I was diagnosed with a second recurrence of breast cancer. Or, yes, a third overall occurrence of breast cancer. It started in my right breast, again, same place it had started the previous two times. This particular time I seemed to have caught it early—a huge battery of tests (mammograms, ultrasounds, CTs, MRIs, PETs, biopsies, X-Rays, etc) confirmed that there were two tumors, but they were both contained tidily in my right breast.

You may remember from reading this entry that I was not going to truck with cancer anymore. And I meant it . . . but I meant it from a position of hopeful yearning, of bravado, but of no confidence. But how could I have had any confidence? I’d entirely given over responsibility for my health to my oncologist and Western medicine, and they , the authorities, don’t believe cancer can be cured, at least not with the tools they currently have. Certainly not with the chemical ones they used on me. So, within that framework, how could I possibly believe it?

Sure, I appeared to have a modicum of control over my health. I ate healthy foods, and exercised regularly, and lived, overall, a pretty clean life. And I’ve also always been strong—of body and of mind and of will—and I used my strong will to convince myself that my health, to a great extent, to the ultimate extent really, was out of my hands. I had convinced myself that, when I got cancer, it was a sign to give myself over to the care of others, and let them choose my path for me.

Well.

It doesn’t work that way.

Sometime last October, I started having anxiety attacks. Without knowing anything (in the must-be-measured-by-scientific-equipment-to-be-true way), I suddenly knew, on a cellular level, that something was wrong. My intuition, which had given me subtle signs over the years, stopped being subtle. “Listen to me!” it screamed, as I sobbed hysterically on the couch at my grandmother’s house, gasping for breath, my arms tingling and black spots swimming before my eyes. “Something is wrong, and you need to figure it out now!”

I began feverish self-examinations of my breast, and noticed changes. Is this particular lumpiness related to the return of my hormones? I asked my nurse. Because if not, than something is wrong. Can I get my mammogram next week instead of waiting two more weeks? Maybe, she said, maybe the changes are normal. You could try to talk to other survivors at Gilda’s Club. But no, we’re not going to change your mammogram appointment; we don’t want to enable hysterical behavior. You can talk to a clinic psychologist, though; he’s very nice.

He was very nice, and briefly helped. At my first appointment he seemed to listen. But at my next appointment, he didn’t. He spent the whole hour teaching me how to control my breathing to keep from falling into another anxiety attack, a technique that I demonstrated back to him in the first 5 minutes. Invisibility doesn’t solve problems, so I went to my third appointment only long enough to tell him that what I needed was something else.

When I finally had my mammogram, I immediately stopped being invisible to my Western medical doctors. Because, of course, what I had felt wasn’t normal, and there was now scientific evidence to prove it. I had ultrasounds as well, right after the mammograms, and the following week a biopsy that clinched the evidence. The cancer was back.

Somehow, even while railing at the Universe for making me go through this again, and feeling—despairing, even—that my life was coming to an end, a tiny, fierce part of me refused to believe that I couldn't be cured. And so I started to take back my life, my will, my spirit—or embrace those things fully for the first time ever—and I started to make decisions based on my intuition and not my desire to have someone else solve my problems.

I began to understand that we are each, individually, responsible for our own health and well-being . . . but that doesn’t mean we can’t seek assistance. In fact, we should seek assistance. We humans are community-oriented beings, and our communities are richly populated by people with myriad strengths, strengths we could not possibly embody all at once, all in one person. So I began to seek out assistance from all the richness around me. Here is the thing, though—intuition cannot be subsumed in a desire for someone to take care of you, no matter who you’re asking for assistance. A naturopath isn’t the answer any more than an oncologist is the answer. An energetic healer isn’t the answer any more than a Neurolink practitioner is the answer. All are the answer, and none are.

You, and what you know to be true about you, and what you believe to be right for you about the teachers you draw into your life, are the only answer for you.
What has been working for me is the following:
A naturopath who specializes in small doses of things and gentle physiological support (i.e. a liver detox that is so gentle you don't know it's happening; you just notice one day that you feel better)
A body worker who also does energy work
My friend the Witch Doctor (a Neurolink practitioner)
An energetic healer
Meditation, and gratitude for this brilliant, amazing life I've been blessed to lead, and learning to live without judging (others or myself)
And a breast surgeon.
(not to mention impressively open-minded friends and relatives, who have stood by my decisions faithfully from the beginning)

I had a total mastectomy on January 10th. It removed my right breast completely, including the nipple and areola (my cancer was intraductal, and all the ducts come out the nipple), the scar from my original lumpectomies, and the skin over the site of the current tumor. My remaining underarm lymph nodes were left intact, as was my left breast, which had never had cancer, even last time when it had spread all over my chest lymph nodes. I have opted not to do reconstruction. The thought of implanting silicone into myself makes me queasy, and one of the side-effects of being in excellent physical condition is that I don't have enough belly fat to transplant that (and inner thigh fat is, evidently, not used). Besides that, reconstruction involves several more surgeries.

And besides that, Amazons all cut off their right breasts.