Friday, August 13, 2010

I Fall, I Blossom, I Rise

I work up early this morning.  6 am something.  I'm not a morning person.  I only like morning from the other side, the wee small hours as they say, the ones you devour like a guilty pleasure.  I work up early, and remembered nobody was going to lovingly be sticking my port today.

My arm looks like hell, all bruised and bloodied, and don't even think about moving it much.  Sheesh.  That's nothin.  Big deal.  My port is gone.  Hallelujah.  Hallelujah.

This chicklet is portless.  Ha.  She gives a ninja kick, kicking that port Hell back to Hell.

I catnapped a bit more here and there, got ready for my 9 a.m. appointment with my girls and the gift of chemo (tanky Buffalo Soldier Kimberly).  Can I tell you something?  As much as I hate that chemo, as much as I hate sitting in that chair and why, it often seems like a small price to pay for the fabulous company that waits me.  Really.  Really.

I think I am going to need to volunteer or something at the Cancer Center.  I can't live without these women.

I decided to wear the Jennifer Aniston wig today.  I figured what the hell, if I get too hot, I'll just pull the damn thing off.  What, like they've never seen a bald lady?

I was feeling pretty damned good, in my hair and shades.

Cancer sexy.  This is what it looks like.

Well the gang was all there, love em bad, and they all wanted to see my bullet hole.  Here it is Ladies.

Kitty shook her head.  I don't think any of em have seen anything like it, or heard of anybody's body trying to push a port out.  Vonda was peeking too.  And M, dang, I can't remember the code name I gave for M, was it Mariah?  and Krissy, cute little bug Krissy.  She liked the wig, a lot, Kitty said it was sassy.

Sassy.  I like that.  I told her wait till you see the red one.

Have I mentioned, yeah I did, right up there, how strange it is, to go through this stuff, and yet love all these people taking care of me?  Taking care of me with such affection and tenderness and humor, funny funny laughing my ass off humor.  How blessed I was to be sent here.  How blessed.

Sure was easy getting my chemo in the PICC.  No stick.  Yippee coyote.  Just open a little valve and there you go! Yippee.  Funny though, I used to get hot, now I cover all up with a blanket.  I get cold cold.  Tuck me in.

I was scheduled to see The Good Witch around 10:15, so it wasn't long before Vonda came to get me.  Have I explained how all of that works?  Vonda is one of the nurses that works in the exam room part of the office.  She comes and gets me on days I will be seeing the Good Witch, takes my temperature, blood pressure and weight, and gets my chart all ready, puts me in an exam room and I wait for The Lady that Flies, the Good Witch.

Krissy is very new to the Center and works as a floater wherever they need her.

Kitty is a chemo nurse, my chemo nurse, and Mariah is like her back up.  She helps Kitty do all the sidework to take care of me.  In my world, we call that a backwaiter, and it's a very important job.  Kitty is the only one to handle my port and give me the chemo love.

The exam rooms are in the middle of the building, and down the hall and turn right, you walk past the doctor's private offices and then into the back side of the building where all the chemo torture and magic happens.

I was still plugged in when Vonda came to get me, so we just wheeled my IV bag on wheels to the exam room.

The Good Witch was running like a clock, I didn't wait long.

I showed her my bullet hole, and I showed her a photograph I had Husband take of what the port looked like right before the surgeon took it out.  We talked a bit about that, and she was concerned about what the scar left behind would look like and that its in a very visible place.  She said the plastic surgeon would take care of all that during my reconstruction.  I hope so, I sure don't want a protruding olive for a scar.  Right now, the edges of the hole are so far apart I can't even imagine them closing together, but I know they will.  The bottom of the hole is healing and getting shallower.

I had a list of questions for The Good Witch, first about Tamoxifen, the drug I will be on for approximately five years after chemo.  This is the one to make sure I am fully in menopause and producing no more estrogen.  I told her about all the brutal reactions I've been reading women on the message boards talk about.  She said the reality is, this is menopause.  She has used Tamoxifen on her patients for years, and most of them are able to tolerate it, and find different ways to relieve menopausal symptoms.  I guess I will be exploring that.  I asked her about the test that shows how well you metabolize Tamoxifen.  Its called a CYP2D6.  There are alternatives to Tamoxifen but it is considered at the top of the list for dramatically lowering the risk of recurrence in hormone positive people like me.  I guess we will cross those bridges when we get there.

I also talked to her about my consideration of a double mastectomy or BLM (bilateral mastectomy).  We've discussed this before, but each time, I feel as if we go a bit deeper into the pro's and con's of this very personal decision.  I asked her if I will be receiving the BRCA test, the genetic test that shows if you have the markers or pre-disposition to breast cancer.  She explained that although it is helpful in early decision making for patients with small tumors or breast cancer history in their family, the size of my tumor pretty much trumped her need for the BRCA.  It would not have changed her treatment plan for me.  She agreed though it may help me make the decision about whether or not to keep Mopsy.  If I do find out I have the genetic marker for breast cancer, I think this will make the decision clearer.

In my meeting with the Good Witch today, I felt as though we had a new level of candor regarding the statistical reality of my diagnosis.  She explained that when a patient is first diagnosed, it is so overwhelming and there is so much information to process, she gives the info as the patient is ready to absorb it.  As our discussions shift from chemo to my survivorship, she is becoming more candid about my diagnosis.  Don't misunderstand, I don't feel she has been holding anything back from me, just very wise in gradually educating me about the big picture.

She explained that as my cancer was presented to her, when I first walked in the door, a 5cm tumor is big, and greatly enhances my risk for a future recurrence.  As we've discussed, lobular is also more likely to occur in the other breast.  Ductal is usually contained to one breast before it spreads to a new place, if it does.  She has explained with lobular the breasts are more like a field, and the field has been compromised.  When I walked in the door, my tumor size and all other factors considered, statistically means I could have a 50-60% higher rate of recurrence.

That is why she gave me everything she's got, so to speak.  Five months of heavy duty chemo even before my surgery.  The primary goal, to reduce the tumor size in Flopsy, but mostly, to kill cancer any place else in my body.  I am really beginning to understand for the first time, the weight of my particular diagnosis, and that it's not really about Flopsy or Mopsy.  It's about my life.

Now don't get all freaky on me Midge :)

These are statistics.  They don't necessarily equate what will happen to me, it's just what could happen.

Another layer.  Another layer of acceptance.  Another layer of letting go of getting all caught up about my boobies or my hair.  Another dose of reality about my life and that I want to live.  To be a sassy old lady.

The Good Witch is happy my plastic surgeon appointment is coming up soon, but I feel as if she was reminding me that is about a cosmetic result, not my overall survivorship.  These are all things I was ready to hear.

and not.

We talked about a few more things, of which my chemo brain can't remember, but I do know, I have the best Lady for the job.  Not just the technical part of the job, but a partner on this path.  I can't say enough about her.  What a gift to have her as my healer.

I wheeled back to my chemo room to finish up, and sure loved all the hugs and kisses that always come my way from the Ladies.  I love you all so much.  So much.

It wasn't long before I was finished, gave all my hugs goodbye.  I stopped at the front desk to chat with the lovely Lady Brown Sugar Grace to have her make my next Good Witch appointment.  The Good Witch came up front to tell Lady Grace something about another patient, and gave me a quick pat on the shoulder as she spoke.  We went a layer deeper today.

I came home exhausted.  Robin sure is cute, you won't believe how his curly hair has grown out.  He is in the home stretch of the long long summer ending.  I went to lay down and chill out for awhile, till I got a text that the Cowgirl was in labor with those twin girls.

Holy crap.  It ended up being a false alarm but yikes.  I got all decadron panicky.  Everything is ok though.

Robin got ready to go to his buddy's house for a sleepover.  The doorbell rang.  It was a package for me.  I drove Robin to his friend's and had the house alone for a few hours before Husband got home.

I was thinking about everything, absorbing this path.  I felt myself falling, having a moment of vulnerability thinking about the worst case scenario.

Damn I don't want to be martyred by this fucking cancer.  Damn.

I decided to open the package, the return address was the American Cancer Society office in Fairfield, where Kimberly is.  Now just so there is no confusion, this is not the same Kimberly I wrote about a couple nights ago.  My Buffalo Soldier.  This Kimberly is the one who gave me the courage to get the red wig, and is one of a few angel "Kim's" on my path, like Emily's Mama and Miss Kim.

Ok, so I open the package.  There is a card inside.  The front says "Your treatments... tough.  Your spirit... tougher."  When you open the card it says "Your courage... inspiring."  The card was from Kimberly.  She wrote a quote.

"We never know how good we are until we are called to rise."  Emily Dickinson

Then she said "Dearest Debbie" and wrote a lovely letter about the Relay ceremony and looked for me there, but read my blog about that night and the surgeon and all.  In the box were some presents.  A little sparkly gadget with the pink Breast Cancer ribbon that you attach to your purse and attach your keys to.  A beautiful silver angel ornament with these words on her wing.

"Courage is not the towering oak that sees storms come and go; it is the fragile blossom that opens in the snow.  Alice Mackenzie Swaim"

And two new hats knitted by her Mama, the pink one I looked at when I got my wig but was too shy to take, and a new one, a PURPLE ONE!!!  She put a post-it in there  - "You can ROCK the purple.  Survivor."  Survivor was underlined.

I held these things in my hands and I bawled, and re-read "until we are called to rise."  I sat in my favorite chair and bawled about all the scary stuff, and for all the love.

I walked a path today, I saw the valley, and I was alone and scared and allowed myself to see the what-ifs.  I thought about my Buffalo Soldier Kimberly, and how she was sent to me, to fortify me and maybe reinforce my commitment to my sacred life, in case I do have a recurrence.

and then, on the very same path, a package arrived, right on time for me, from another angel whose Mama makes hats for cancer patients.

Then I was rising.

Accepting my calling.

See me rise?

And I blossomed too,

fragile little flower in the snow,

I blossomed.

I started writing a new song tonight.  Just the beginning of a melody and a few words.  Maybe I will play it for you sometime.  When it's done.

Today with a little help from all my angels, I blossom in the valley, and I rise.

I hear my calling.

I answer.

Yes.

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