Friday, November 5, 2010

I Love Me More

I went to see the Wizard this morning, and wish I could have floated there in a hot air balloon.  When you have two drains coming out of your body, and a seat belt across two deflated sutured breasts, every bump and groove on the road, and braking in traffic, is brutal torture.

I thought I was going to be sick by the time we arrived.  I settled down in the waiting room of The Wizard's office.

Before I could click my heels three times, I was in the exam room, Husband delicately helping me remove clothing.  My little knit cap (Thank you Kimberly's Mama), my hoodie, a loose-fitting t-shirt over a tighter t-shirt that my drains were carefully pinned to.

Husband carefully unfolded the paper vest for me, and once in it, stepping up to climb on to the exam table took some major effort.

I sat and waited for The Wizard, legs dangling, drains dangling, looking out the exam room window from his office on the 6th floor.  I watched the fog weave itself between Victorians, church steeples and high rises on a typically cool San Francisco morning.

"Good morning" I could hear him say happily, before I could see The Wizard come from behind the door.

"Let's have a look here."

He got right to his business, opening up my paper vest, examining my drains, flattened breasts and bruised nipples.

"Ok, this right drain can definitely come out, and I'm going to need your help with this."

Oh geez.

"Go ahead and lay down" and helped me comply before I could decide whether I wanted to.  Then he put his gloves on and grabbed some small scissors.

"Now, what I need you to do is take a deep breath in, blow it out, then another deep breath in."

Aw geez, here we go.  Aw geez.

There have been moments over these six months, I must confess, I have wanted to jump off the exam table or the OR table or out of the chemo chair, and run as fast as I could to a waiting get away car, driven by one of you, with a trunk full of wine and Cowgirl Creamery Cheese.

"Go, Go, Go, Drive, Drive..."

You ever been to Cambria, California?  It is a magical hamlet on the Central California Coast, and there are all kinds of beautiful little Inn's and Bed and Breakfasts' alongside a rocky beach where you can really find moonstones.  Really.  I swear.

I closed my eyes and was walking on the beach.

"Ok deep breath in."  I knew what was coming.  "Deep breath in" is part A to part B, which is "Deep breath out" so he can pull that long tube out of my chest.  Deep breath back in again nobody has to ask you to do, you'll be doing it on your own while you whimper.

I reluctantly took a deep breath in.  What kind of idiot am I?  How much of this could I have avoided if I never took that deep breath in when they asked me to?  Dumb girl.

"Deep breath out."

Oh mommy.

I saw his arm yank hard over me like when you pull the cord to start a lawn mower, and the tube went flying.

I breathed in again, and out again and was panting a little when he said "You can breathe normally now."

Sometimes the things doctors say makes you want to laugh your ass off or spit.

"You can breath normally now."


Just when I start breathing normally, he starts pulling the pieces of tape off my sutures, all two hundred of them.  Ok, so maybe six pieces of tape under each breast and left arm pit.

Will some bunny please explain to me, if we can put a man on the moon, if we can invent things like post-its and jalapeno poppers, why haven't we invented tape that doesn't rip your skin off wounds that already hurt like hell?

My sweet Wizard wasn't finished.  Now he feels compelled to examine what's left of Flopsy and Mopsy, lifting up and looking underneath each one, examining each nipple, and the same under my arm.

I don't think I started breathing normally until we were back in the car later.

"Yes, let's be patient with the left side, and leave that drain in.  You keep an eye on it, and when it is draining 30 cc's or less in 24 hours, you call me, and you can come back in any day next week and I will take the other drain out."

"Ok, you can sit up now."

There was an awkward silence in the room as The Wizard sat on his stool and looked up at me, then over at Husband.  He knew what we wanted to hear.  Explain the pathology report.

He said he had only received a draft report so far, which had two brief lines about what was found.

Tumor size - 2.5 cm.
Cancer present in 4 out of 5 lymph nodes removed.

Definition of Neoadjuvant Chemotherapy
By S.F. Heron, eHow Contributor
Neoadjuvant chemotherapy is defined as treatment given to a patient to reduce tumor size before future operations or treatment procedures. such as radiation therapy. In some case, tumor size interferes with organs and prevents complete removal of a tumor. Once the tumor has shrunk in size, it can be operated on effectively.

In some cases, a patient presents with a tumor that far exceeds a reasonable size for an immediate operation.For example, some breast cancers invade the lobules of the breast, forming quite large tumors that require major tissue removal. Some oncologists choose to target the tumor initially with chemotherapy to reduce the tumor size. Reducing the tumor size makes surgery less invasive. Neoadjuvant therapy is commonly used as an initial step to treat inflammatory breast cancer.


The most obvious benefit of neoadjuvant chemotherapy lies in the reduction of tumor size. In the case of breast cancer, neoadjuvant chemotherapy can sometimes result in a lumpectomy rather than a full mastectomy. Reduction of the tumor mass and subsequently removal of less breast tissue is called breast-conservation surgery. This type of treatment plan considers both attacking the tumor aggressively and limiting necessary reconstructive surgery. Neoadjuvant chemotherapy also shows results immediately with a prescribed treatment plan. Doctors monitor tumor size closely, and evidence is immediate available of positive results with tumor reduction.

Clean Margins

Doctors also use neoadjuvant chemotherapy to address large tumors that bump into or encroach on nearby organs or tissues. When a doctor removes a tumor, he wants to allow a clean margin around the circumference of the tumor, which can be quite difficult, especially with large tumors. To obtain a clean margin, a surgeon must include some extra tissue beyond the tumor area to ensure removal of the entire tumor. Large tumors require so much removal of tissue that can be problematic for a doctor to ensure complete removal. By reducing tumor size, neoadjuvant therapy allows better success in achieving clean margins

The Wizard reminded me where I started out the first time I saw him.  At that time, his recommendation was a full mastectomy, far more invasive than what I received, which would have included the loss of my nipple.  He felt the chemo was a huge success, allowing him to achieve margins he was very happy with, and not have to take as many of my lymph nodes.

"I think I got all of it and I am very pleased with the result."

He talked about how I still had radiation to go, which should take care of any random cells that might still be lurking, which is also why he decided not to take more lymph nodes.

Listening to him talk, I realized how much chemo before surgery had accomplished for me, both in treating my cancer, and allowing me to later have a better cosmetic result.

He seemed so confident that soon enough this will all be behind me.  So confident.

I left there feeling so much better, about everything, and back up to speed on what the goal was.

On the way home, The Good Witch called.  It was great to hear her voice.  I told her about my appointment with the Wizard, and she was very pleased that I was feeling better.  Knowing me, she still went into a thorough explanation of the purpose of neoadjuvant chemo, how well my cancer had responded, all resulting in a dramatically improved surgical outcome.  She reminded me that the cancerous tissue was no longer in my body, but in a bucket in the operating room before being sent to pathology.

She asked me how I was feeling, mentally and physically.

I told her the biggest surprise over this last week since surgery, is the emancipation from Flopsy and Mopsy.

I told her that was like GRACE floating down from heaven and landing on me.  I never thought I would so easily embrace this new vision of my body.  Didn't cry one bit putting those big ol Double D bra's in the trash.  I'm done with that.

I loved you bunnies but let you go.  I love me more.

Seeing The Wizard, and talking to The Good Witch today, was just the breath in, breath out, I needed to start again.

Letting go of what is gone,
so I can be Grateful where I am.
Embrace where I am headed,
cause whether I like it or not,
I'm headed there.

Breathe In.

Breathe Out.

Keep going.

Start here.



Beneath the Eaves said...

So good to hear you are more confident after the doctors' visits. I have the word REPLY soldered between two pieces of glass hanging from a chain in my car. It is a daily reminder of YOUR words (paraphrased here) -in life it is my REPLY that matters to the lessons handed us. I view it each day and say a prayer for you. Thank you for continuing to share your "Reply". Hang in there.

Jill Nogales said...

The drain removal... I remember it so well. And you described it perfectly. Love your sense of humor. Glad you're feeling the GRACE.

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