19. OCTOBER BREAST CANCER AWARENESS MONTH- Ramblings

WARNING: This edition is rambling thoughts. Read with caution.

It is October.  And on October 21 it was Five Months since my breasts became a memory.  Double mastectomy took them.  And yes, October is Breast Cancer Awareness Month.  Rest assured, I am aware.

I went to the Pink Soiree to kick-off the Breast Cancer Awareness  month. Some knew my story.  Some did not.  Some didn’t want to hear the story.  And a few had the look  “I am here to support the cause only—I don’t want to catch what you had.”  Ok, that was an exaggeration.  Besides you cannot catch cancer.  Can you?  I am not sure on that as the genetic testing said I did not have the BRACCA genes. 

In addition to this month of October, I see Pink drinks in every bar I go to . . . .ok. . . .one bar. . . .but it is close to home.

 So what was the roller coaster ride that was the first five months?

At first, it was amazing to me that when you receive the diagnosis, how many women came  out of the woodwork saying:  “I had breast cancer.”  “I Had a lumpectomy.”   “I don’t have my boobs, lost them years ago.”  Each one ready to share their experiences and offer help.  And some shared their words of wisdom:

Just think, maybe you can get that two piece bathing suit half price.

Well, you won’t have that income from Playboy anymore.

Reconstruction—you can have a 44DDDD

At least now, when you drop food it won’t land on your shirt it will go straight to your lap harder to see with the table in front of you.

How will you hold up your towel?

Just think –you will lose weight

When you have that MRI—it is LOUD!  Take music.

Lets get the friends together and have drinks fun and frolic. . .oh yes, can you drink?       (as if that is a question)

Oh, and by the way, if you need anything—an ear, a walk, food, a friend, call me.  

There is also the reality.

We wanted more children, but I could not because of the medication I was on afterwards. (This was not a problem for me—had a hysterectomy many years ago.)

The waiting is the worst.  YES it was! Waiting for results.  Waiting in the waiting room of the numerous doctor visits. Waiting for the drains to be removed. Waiting for the Lab results after the surgery. WAITING WAITING WAITING

Don’t let your brain race into the dark zone  ruminating over every little thing such as  when you get a blister on your toe and you think has the cancer returned?

At each meeting with the surgeon, oncologist, nurse, tech, consult, test, results, --take someone with you. Your mind is reeling, you need someone to take notes and listen.  (It turns out these people are always welcome—and asked if they have questions as well)

              The MRI was loud. And I cried the entire time.

              The drains were the worst part the first few days after surgery.

Just one step at a time—you can do it!

There will be drains. You will have a class on how to empty them.

Take Showers –they are good.

Is it ok if you are tired to ask people not to visit right how? Or to say, I am tired and need to rest? OF COURSE! You are healing!  Honesty is important.

Oh, and by the way, if you need anything—an ear, a walk, food, a friend, call me. 

You may have noticed a theme: If you need anything call me.  That has become my mantra. If you need anything, call me. I pay it forward.  What these strong ladies. . .these heroes – have taught me in five months is YOU ARE NOT ALONE.  

Yes, I had a great Post Op visit, no chemo, no radiation. No pills.  I still tire easily.  Three months after surgery, I took a cross county trip—Pennsylvania to California—to assist my baby as she relocated.  One stop--We were in Arizona exploring a cave that gave its description:  Five steps up, 122 steps down. 

The cave was beautiful. The Navajo Tour Guide great.  Instead of returning the way we came (It was flat) The 5  steps  up  turned out to be large rocks pretty steep to get out of the cave.  Ok, I can do that.   There were little rocks to hold an balance. 

Now to get to the 122 steps down. That  turned out to be a 1 mile walk up hill in sand to get to the iron walkfor the final steeper climb to the top of the hill and the 122 iron steps down the side of the hill—in 104 degree desert heat.  I did make it to the iron walkway that took you the final few feet up to the crest of the hill to the walkway across to the 122 steps.  My daughter staying with me and asking if I was ok.  We were way behind the group.  A couple who were on the walkway, turned and saw us below.  Turned out they were a doctor and nurse from Virginia on vacation.   They came to my rescue.

DOC  “Are you ok?  Do you need water? Do you have water?” 

ME: Yes—back in the bus. 

DOC: Let’s stand here and you take some slow breathes, and we will help you back. You do not walk much? This was too hard for you?

ME: “I used to walk a lot. But about two months ago I had a double mastectomy and just started returning to normal life.”

DOC: “Why the hell are you  here? Are you nuts?”   

The couple remained with me down the steps and to the bus. I thanked them profusely—and still do.   Yes, I am nuts. Just ask my family and friends.  

So in the last few months, I pay it forward. Women,  some I know and some I do not, have come into my circle, have heard about me.   I offer: if you need anything—an ear, a walk, food, a friend, call me.    They have.

And Yes,  it is OCTOBER--  BREAST CANCER AWARENSS MONTH!

Get the Mammogram!  Early detection can save lives.  It’s the easiest thing you can do each year. Your family,  friends and more love you.

18. It Starts with WHY

A friend of mine has his own blog. The most recent one stands out to me:  WHY.

I have read the book— “IT STARTS WITH WHY.”  And it is true, everything does start with the question WHY? And more importantly. WHY ME????

• Why do I care about this?

• What do I already know about it?

• What do I need to learn or add to my knowledge?

• What do I know is not true about this?

It is easy to answer the first question. Why do I care about breast cancer? I was diagnosed with breast cancer, I HAVE IT! I saw what my mother went through, and I am the same age she was when hers was diagnosed. And now like her, I am minus two breasts.

What I knew about it was what I had seen in others. I saw my mother when she came out of surgery, looking so pale, eyes closed. I sat with her till she was awake and took the first few steps post-surgery. I heard her murmur, “I am glad your daddy could not see me like this.”

I watched her go through chemo, losing her hair, getting a wig she hated to wear, and not wearing the bra which replaced that which she had lost. In an effort to take her out to dinner, we watched as she threw up her meal on the table of the restaurant.  She was horrified. We were not and cleaned her and the table. Noone around us were upset and one woman offered assistance. My mother just wanted to leave. What I saw was what I knew about breast cancer. That, and getting a mammogram.

So, what did I learn? I learned much more than I ever thought I would. I learned about lab tests, blood tests, radiological tests, genetics, pre- and post-surgical needs, how to drain a JP drain easily, and all the options at your fingertips. Options such as bra inserts, plastic surgery, knitted inserts and emotional support. I learned about margins, and my favorite new term, the Sentinel Node. I see the lymph system now as the guards to my health, Alsa, I see them as the revolutionary guard with tricorn hat and muzzleloader, but a guard none-the-less.

Most of all, I learned about people. Friends and family who come together to help you. A smile, call, a text, a meal, flowers, ice cream and the occasional bottle of wine.

I also learned about how many people have been touched by breast cancer. No, I do not mean people who have a mother, daughter, aunt, cousin, or friend—and men too. I mean people who came forward and said,” I had breast cancer, I am X years free.”  “I had a lumpectomy.”  I had one/two breast removed, “   

These women told me their stories, from start to today. They provided insight and advice. They offered suggestions and ideas on many things you might take for granted, such as: How to take a shower with drains hanging from you, ways to prop yourself to sleep the most comfortably, and clothing to wear.

Many gave advice to keep communication open especially with your spouse and significant other, after all they are in the same boat as you. Much of the advice is practical, but needs to be said, like, listen to your body, when you are tired, rest. If you are not in the mood for visitors, tell them that. Believe it or not, people do understand and will not take offense.   

What do I know that is not true about this—about breast cancer? I did not know men can get breast cancer too. And, it is growing among men. I learned that radiation, chemo, and pills, may or may not be needed. For me, they got it all. I do not need any of it. I did not know the worry does not end when your breasts are removed. Back pain, strange bruising, a new freckle, is it the start of a new type of cancer?

Most of all, I did not know how friends and family would come together like they did to care for me. It was overwhelming at times. And yet, I could be honest and let them know how I was feeling.

SO, it starts with WHY.

Get the Mammogram! WHY? Early detection can save lives—YOURS.

WHY: your family, friends, and more love you.

WHY: Well, that is one question you will have to answer.

17. The Pronoun Intake Question

I have not placed pronouns next to my name as I have seen many have done. Being of the older generation, I just assumed (and we know what that means) the pronouns you use were evident by how I look and my name. Worse yet, I get confused when they use a plural pronoun with a singular verb. I was reading a bio one day and I had to read it aloud to myself in order to understand the article at all.

As I entered the hospital on B-Day (breast Day) I gave the perfunctory Medicare answers.  And then they threw in a new question.  “What pronoun would you like to be referred as?”  I was taken aback. And I was not sure how to answer that question.

First, you must learn about me. Turns out, I am a Cisgender, or simply cis, an adjective that describes a person whose gender identity aligns with the sex they were assigned at birth.. And after much rumination over this conundrum of pronouns, i have found mine. But before i reveal, there is another thought—another conundrum.

From what I have researched, the pronoun is to help learn about the individual. It is an indication that you understand that gender expression does not equal gender identity. So that means, you're not judging people just based on the way they look and making assumptions! Isn’t that what we always do? We base our assumptions on what we see—red, white, black, handicapped. I am not saying it is right— it is wrong to judge a book by its cover.

Alas, I was wrong. It turns out knowing each other's pronouns helps you be sure you have accurate information about another person. In any social situation, it is important to learn about the other person—your client, customer, friend and family.

Getting back to the pronoun, and accurate information.  When in any social situation, heaven forbid, I will ask you your name. In fact, I make sure I repeat that name a few times in the conversation (a tip to help you remember, and when you are old as I, that is important.) And, in great networking fashion, I would ask interesting questions like, “What inspired you to become (FILL IN JOB)?” or “What is your routine at that job in the morning?”

Add to these questions, that while I am with you, well, I will refer to you as You and Your name. If you are identifying with what is not on your birth certificate and have changed your name, I am not the birth certificate police or check your drivers license . I guess the problem does arise if you have a “generic name” like a skit years ago on SNL- where the character was named Pat. But even so, when I am with you —YOU will be the pronoun I will use. If I am talking about you (another heaven forbid) I will use your name so the one with whom I am talking  knows exactly who am talking about (got it?).

And how many pronouns should you answer when asked? Is it "she/her" or "they/them" rather than just "she" or "they"? I understand that different iterations reflect that pronouns change based on how they're used in a sentence. And the "he/him" format is actually shorter than the previously common "he/him/his" format. But wait, what used to be all three, now got down to two. Wouldn’t it be easier to shorten to just one pronoun? I guess time will tell.

So here is the answer to the question:  What are your pronouns to be used.  I have always believed that to create change, it starts with the individual. The I— the I has the idea, the concept, and the will to go through whatever it takes to make change. I also learned it is important to be yourself—in writing, in life, in social situations. You must love yourself. So my first pronoun is I.

Once that “I” has begun the impetus to make change, then lets face it, you need a WE..  We need to do it together. We need to fight for the rights, we need to lead the charge. I cannot do it alone, it takes a WE. And by working together, we can get it done. We can make change.

Let us not forget— US! When “I” meets “WE”,  together we become US. ONE ENTITY. ONE working together. The I, the We and the US —and if we need to shorten it to one pronoun when asked, WE. I'm all for using pronouns in the right place at the right time. Whether you're talking to a friend or making a statement, using the appropriate pronouns can make all the difference. When used properly, pronouns can make conversations flow like poetry. So why not embrace the power of pronouns?

Life's too short for over-complicated grammar and over complicated relationships. But let’s review the pronouns.

I- I have breast cancer. US- I am with you to remind you that Early Detection WORKS! WE: Together, all of us, can spread the word on EARLY DETECTION and maybe— WE can find a cure.

Meanwhile- just call me Barb

16. Emotional or Practical: Friends Come in Different Sizes

People who need people
Are the luckiest people in the world
We're children, needing other children
And yet letting a grown-up pride
Hide all the need inside
Acting more like children than children

(People from Broadway Musical “Funny Girl”)

I was drawn to the song People from the Broadway musical, “Funny Girl.”  It was also released by Barbra Streisand in 1964 as a single.  Yes I am old.  And yes, I was ready to hide all the need inside.

I did meet Barbra once on the steps of the Plaza Hotel.  All I could say was, “My name was Barbara too, but different spelling.”  I am sure it was a life changing moment for her.

Anyway, back to people. When you hear the words,  “You have cancer” the world stops spinning.  I heard a dear friend who heard those words, simply said, “Oh, damn.”  The feelings ran the gamut, Anger,  Fear of the Future, Depression. You can read more at D-A-B-D-A. Please do!

While the decision of what avenues to take boils down to Emotional versus Medical, the friends you have come in two forms:  Emotional or Practical.  And, many can be both!  The Emotional variety of friend you can call or be with them in person, and they watch you cry, laugh, and really good ones, offer you wine. You tell them –well everything. The Practical variety offer rides to the appointments, ideas for the new jewelry you will need to wear, and many, survivors themselves, insights to the future, sharing stories of their journey.  Some friends are old and familiar and others are new to the entourage—or is it a posse like in the old west ready to hunt down the bad guy?  Bottom line, they are people who without I would not be where I am today.

The Emotional Support People come in many forms:  Family, Friends, Pastors (Plural as this diagnosis came at a time when my familiar pastor resigned and an Interim was taking up the slack), my medical team, and my new friends, cancer survivors who reached out to share stories and a much needed ear.  Let’s face it. I am on a new path in my life. A path that surprised me as I had retired months before. Since my retirement party, I have had a hip replacement and now bilateral mastectomy.  I thought retirement meant travel and no more 9-5, a misnomer for me as I was self-employed and worked weird hours to raise my family. I did have former clients reach out, which was an ego boost as well.

Once they learned of my plight, they came out of the woodwork, each one an angel in disguise. As the Type A that I am (Type Anus as my hubby calls it) I started with research.  As I poured through the endless links of Google, the fear filled the pit of my stomach. I went to the portal and asked a few questions.  Immediately the response, “Stop Googling!”  I stopped. Further more, I support this suggestion—STOP GOOGLING!

The medical team, the foremost authority, was easily available via email, phone and portal.  Best of all, they answered within minutes. The one exception, the drain removal team, as they only do that Monday through Friday and I reached my threshold Friday night so I needed to wait the weekend. No problem, it just assured with every drain that weekend, my the drains were getting lighter. They did call first thing Monday morning and I went in.

The Medical Team key people were the Doctor, of course, the Nurse Navigator in charge of navigating the entire experience and the frontline to the doctor, the nurses, techs, and admins as well as the entire hospital staff some we do not see and many who show themselves until the day of surgery—anesthesia and radiology. Each one ready to help and serve. Each one asking if there are questions, needs, and of course—a blanket.

The Medical Team started with homework. Who would have thought I had to study.  I received a three ring binder outlining meetings and phone, pre op procedures, calendar of surgery preparations, day before and day of instruction, post surgery instructions, resource support groups, emergency contacts and most important, how to reach the Breast Center.  In addition, a text book on cancer, with a bookmark on DCIS cancer—my specialty.

I read the text book first. The DCIS cancer was just a short chapter, thank goodness. It took a few days to start the three ring binder.  My head was not into it.  When I did, I did start filling out and noting items for the future doctor appointments.  True confessions, I made the notes and brought the binder to each appointment,  I relied on my family to ask questions, as my mind seemed to leave me.

Family. WOW!  You need emotional support, so do they.  My husband was a rock, learning the medical trade from care after the hip and now care for cancer.  We did talk. Sometimes it was overnight, alone in bed at 3 am till sunrise.  We have been known to do this throughout our 40 plus years of marriage.  Now it was a regular appointment.  Communication. A key.  

Then my girls. They had their own communication system of texts, conference calls, and google docs to keep each other in touch. They did their own research and brought questions to the table, taking notes at each appointment. When the day came, they kept in touch all day even though two were miles away on business trips.  It was my request, as the surgery was mid week with a chance of overnight, may as well come in the weekend. Which selfishly, meant they would be devoted to me and my beckoned call, and not working. 

The Baby, the nurse.  She took the brunt, as she was living with us. She was there at the first diagnosis and I am sure she held back her move until I got the all clear.  She looked forward to the weekend after the surgery when the other two and spouses –or is it spices plural—arrived to help out and see if mom was still kicking.  She also took drain duty, cooked meals, cleaned, and helped with this blog—setting it up and editing. When she edited she was surprised and in one case, said she was sorry.  You can be the judge as to which entry.

The Middle Daughter , the researcher. When she told her boss the situation, and her boss was a nurse, the boss indicated her mom had the same thing. I soon had a call from that mom (more about that later).  It was Middle who found what I would need post surgery—from special shirts to drain-wear. The Researcher bar none.

The Oldest, the voice of reason and parttime cook.  I say parttime cook, as her husband seemed to be the main cook, but let us not split hairs. She was the organizer, watcher, and drill sergeant, supervising all work done on my behalf over her sisters.  She shopped for food, read and noted my special instructions, then let the Baby perform them. She has always been the leader of the pack.  She also took charge of her dad, taking him, as the put it, yard sailing and doing father/daughter trips to keep him occupied—a feat in itself. And it was good for Dad.

Friends. As a long time ago girls scout, we sang, “Make new friends but keep the old. Some are silver and the others gold.”  Well the old friends and new friends are golden.

Old Friends, those who know you well. These people took me to appointments for special procedure they deemed I should not go alone to, took me out for breakfast, lunch, dinner and happy hours, dropped off food and sweets, lent an ear, sent flowers to cheer my day (it did look like a flower shop in my living room) and one friend not only supplied a happy hour with appetizers, sent pints of ice cream to enjoy during recuperation, although I was not sure if that was for me as much as my husband.

New Friends, the cancer survivors. As my plight became national news, old friends told their friends, who were cancer survivors. They would call and ergo, I made new friends.  These people shared their story with me. From how to take a shower after surgery, little exercises to take to help your arms, what to expect, each one had a drain story. Most of all, they talked about their experience, about how to take control of your life. From lumpectomies to bilateral and single mastectomies, they shared their life journey, the pros and cons of reconstruction, where to get a prosthetic bra, and where to get free bra inserts from the Knocker Knitters (A great organization that knits bra inserts so you can use your soon to be retired bra. They are free and good for swimming too).

The Pastors, to hedge my bets. My diagnosis came at a time when I was on council and our pastor of many years resigned.. I did keep old pastor in the loop, texting and getting responses, after all, he was part of our life from confirmation classes and performing the marriage ceremony for two of the three girls. The new pastor, hearing of my plight from old pastor, was truly a rock.  He called to check in on me.  Best of all, he arrived at the hospital before I did and shared stories and a prayer.  During my recuperation, he brought communion. Ok, he did spill the blood of Christ, but no one is perfect.

Getting emotional and practical support is important for your well-being. No one should face breast cancer alone. And, it may be hard to ask for help when you need it. Your family and friends may want to help, but may not know how. That is when you put on your big girl panties(or if you are part of the male population that has breast cancer-whatever you wear) and tell or ask.

There are also many support groups.  I have not gone to the support groups. I have been in contact with the PA Breast Cancer Coalition who sent a wonderful box of goodies—free I might add. If you are in PA, get to them! For me, this blog has been a great release.  Many have told me to make it a book.  Maybe I shall.

I still come back to:  GET THE MAMMOGRAM. Early detection can save lives—YOURS—and make it easier on your family,  friends and more!  It is Emotional and Medical time.  It is an Emotional and Practical time.

13. The Hospital Stay

I think the actual surgery was three hours and then post op.  When I awoke, I really did not know what time it was or how long I was in the post op.  What I do know is that I was in my room after 4 pm.  The doctor said it would be an overnight stay. Longer if there were complications. 

Three items would dictate the situation:  Ability to Pee, Move (Walk, take food myself, etc.) and healthy vitals (no temperature, bleeding, etic).  Within a few hours, I did accomplish all three.  So all that was left was to survive the night.

Surviving the night would be harder than you think.  There is no rest in the hospital. Someone is always coming in.  And you would think, after being put to sleep and a variety of anti-pain meds, sleep would be easy. 

First came the nurse(s).  Editors Note:  I give these men and women kudos. They work hard and as far as I can tell, work 12-hour shifts. These shifts are staggered so there is coverage to every patient—like me—get the care they need. I really think COVID has something to do with these strange hours.  To say I had great nursing care—I did, but I cannot attribute it to any one nurse. Many different nurses came in throughout the time I was a captured audience—and I did get GREAT care.

To start, the first nurse came in and took my vitals, added some massage mechanism to my legs (to prevent blood clots) and asked if I would like a snack. (Since I had not eaten since 6 pm the night before, that sounded like a good idea).  Graham crackers, cranberry juice and a turkey sandwich was ordered. I had no concept of time, and thought it was after 5:30.  She soon brought the repast I had ordered, and I ate the graham crackers and cranberry juice and asked for more juice. I was very thirsty, and my throat felt a little sore. In fact, my voice sounded weird.  Turns out they put a tube to breathe down my throat and it irritated the lining. These symptoms remained for a few more days.

I had only taken a few bites of my sandwich and gave it to my husband who finished it. Just then my dinner arrive—turkey, mashed potatoes and broccoli.  I could not eat it. The graham crackers filled me.  My husband ate that too.

The Baby, hubby and I were then left alone for a little while.  They told me the doctor visited them after the operation in the waiting room and said I had come through with flying colors.  Even the evasive Sentinel Lymph node, in her opinion, felt healthy, the pathology tests will provide more information and they wouldn’t be ready for a week (turned out to be two).   As we relaxed, another nurse came in.

The instructions were simple: Here is how the bed moves, here is the TV remote buttons, and if you need to go to the bathroom, here is the call button as you need to be escorted by the nurse. No getting out of bed on your own.  At this point, the nurse went to a big dry erase board and wrote down the names of the team who would be assisting me overnight.  As I did not have my glasses on, that was for naught.  Would you like your arms propped with pillows? YES! The result was very comfortable—and would be used for weeks after. In fact, as I right this, weeks later, propping feels great!

The nurse then took the vitals, checked my incisions, and started to scan the many QR codes on my wrist.  It was then she realized the Nuke Med bracelet was still on. “I need to take that off, is that OK?”  Sure.  “It is also time for Tylenol, and you can have an Advil in between, The doctor has not ordered any Oxi (DARN!) and we will only ask should you really need it. Otherwise, it is the combination. So let me know how your pain is from 1-10.”  I took Tylenol.  Remember, take it as the dosage and timing is outlined.  Do not try to be a hero and go without. That is my motto given to me by friends in the medical field and was reiterated by this nurse as well.

“We need to do your drains. We need to milk the tube into the drain, empty each drain into the measuring cup, and note the total amounts.”  Great- my caregivers are here and need a lesson as well.  They all gathered around my now missing chest and had a lesson.  As a graduation gift for learning, the nurse gave the students—hubby and Baby—a set of measuring cups marked with L and R.  It was the best gift we could have gotten as my glass measuring cups at home only did tablespoons and cups, these were marked in Milliliters.

My husband, devoted to me through hip replacement and now breast removal, looked very tired. It was around 8:30 and he had been at the hospital with the baby for 13 plus hours—longer than the nursing staff.  I asked/told them to go home.  Tomorrow, the doctor said she would be in early, so I am going home! (Think Positive)

Family on their way home, I turned on the TV.  After the long day, around 10 pm I decided, turn off the TV and let’s get some sleep.   I slept 1.5 hours, when the nurse came in for Vitals.  Lights on, another set of pills, milking the drains and measuring, she warned me of a return visit at 3pm for another dose, and then 4AM for  vitals etc. It was then I asked if could go to the Bathroom.  OK she said, give her a moment, and she will return, DO NOT get out of bed on my own. 

She left and returned immediately. Helping me up, we went to the bathroom down the hall.  Here you go. Do your thing, then press the nurse call button, and the nurse will come get you.  Here is where we went our separate ways.  The toilet had the red call button next to it. There was no way I was going to have her wipe me and get me two feet to the sink to wash my hands. So, I did it myself.  Please note—there are railings all around, so if I did feel wobbly, the railing was in easy reach.  I did my business and opened the door where the nurse was waiting.  She was not happy—and expressed her reasons.  OK, Me Bad. I felt good.  I needed to do things on my own or I would be here extra time.  We made a truce, and she escorted me back to the bed. 

Hooked to the leg massagers, lights out in my room, the multi-level parking garage was outside my picture window. The blinds were fully open.  The cars, probably with the ever-changing staff as this went on all night, would shine their headlights into my room. I could watch as they wound their way down to the first floor and escape.   I could not get back to sleep.  By 4:30 I did start to get sleepy, a new shift of nurses arrived and introduced themselves since I was awake. This nurse asked if I wanted the blinds shut. With the sun starting to rise, I agreed.  

I dozed a little bit and was awoken again at 7AM by my Breast Doctor.  Glad to see her and get a report straight from her did ease my mind. Everything looked good and I went through well. Vitals looked good, incisions, drains, I met all the criteria—pee, walk, ate, moved—and she will complete the paperwork for my freedom.

I immediately called home.  I am free!  No rush though as they will be bringing me breakfast and I still have to be released from the variety of tubes and massagers.   My family said they would be at the hospital around 9:30.  

As I relaxed again, the pills came, and now another set of doctors and nurses—Anesthesia, the anesthesia research gal, the Breast Resident, and finally, my breakfast. You know how they make fun of hospital food?  Dinner was great—my breakfast, not so much. Even the woman who delivered the meal, after I said something about the eggs.  She agreed.  Then apologized.  I told her not too.   

I began to take stock of what I needed to take home. I loved the large water bottle. My L and R plastic measuring cups, which I learned was for Urine measurement as well, and one bed pad that could be used for the grand dog.  My family had arrived.  Ready to go?  No not yet. Still waiting for the nurse to remove my shackles and provide the release care information and paperwork.  

The nurse came in to milk the drains. We are still working on the release forms.  By the end of the morning, the family decided they would go to the café and get something to eat.  It turns out, nubby loved the food in the café and with the enclosed outside patio area, it had a nice ambience.  The price of food, how good it was, and the ambience made him invite us all to eat at the hospital as the café never appeared full and since we lived in a tourist area where restaurants are overflowing  Memorial Day through Labor Day, this might make a great alternative when we want to wat out.  We shall see.

They left.  My lunch arrived, an Italian meal of stuffed shells.  Not too bad.  Again I relaxed. The family returned.  And finally, the nurse with instructions, paperwork and removing the IV port and the leg items.  She then asked the family if they wanted to help me get dressed. The nurse would go and call for Transportation. It was protocol that I take a wheelchair. I could not walk out on my own.  My husband volunteered. Soon I was sitting on the edge of the bed, waiting for transport.

Transport soon arrived and loaded me and my suitcase on the chair.  As this was a busy time, they knew of a short cut that would make for an uncongested hallway and faster. We made it to the Valet parking lot and awaited our car.

We left the hospital at 3 p.m. 

15. The Post Op Visit

The drains were out on a Monday.  The Post Op visit was scheduled for that Friday.  Another trip to the hospital.  Another reason for the caregivers to change their schedules to come with me.  It is ok.  They wanted to come.

Since the Pre Op visit, the doctor was pretty clear that no chemo would be needed.  However, radiation and some pill to be taken for 5 years was still in the cards.  Everything was pretty dependent on the pathology report.  So for the three weeks since surgery, thoughts and prayers were on the Sentinel Nodes hoping they did their job protecting the rest of the body, the cells did not do anything for the 100 days,  the margins in the removal area were good.

The thought came to me.  Check that portal!  They always post the results. I got in, and immediately read the report. I did not understand a lot of what I read, but I did see one word throughout the document. NEGATIVE.  I started to cry. 

The Baby and Husband sitting next to me looked at me.  NEGATIVE I said.  That is a good thing—right?  We all prayed that it was so. That the other words concurred with the negative.

Luckily I have friends who are in the medical field—maybe  not  in breast cancer –but can read the hieroglyphics. They agreed it looked good but cautioned to wait till it came from the horse’s mouth—my breast care doctor. (Well hores mouth may sound mean. . . blunt, that was me saying that and truth-I LOVE my breast care doctor and team.)

We arrived at the Breast Center and the caregivers found a seat at the opposite end of the room while I registered.  I  answered again. . .the mandatory Medicare questions and signed the docs that spelled out that I would be liable for all payments. Hey, when your health is concerned, blank check it is.  All in order,  I took my seat.

As I sat with the Baby and Hubby, I watched the women arrive. All somber.  All quiet.  One group, looked the same as mine, husband, daughter and a woman.   The woman was wearing  a belted wrap that went around her upper body. Interesting as it had loops that looked like an area for a seatbelt. Wow, I have not seen that in my internet search.  I had my small pillows, now thrown on the dashboard, that fit under the seatbelt.  I was getting used to them.

Before I could look at her cushion vest, the nurse called us in.

Hey, a friendly face--the Drain Removal nurse. I mentioned that as well as asked if the table was fixed yet. She laughed and said it was.    We went in to the room and she handed me the gown.  I turned my back to the family who had already seated, and put it on. I still was not ready for them to see anything.  Stupid idea I know as we were in a small room and I am sure the octor would ask to see me.  

The nurse began to ask a few questions, any pain? Have I been getting out? What is my activity level. Blood pressure and temp. (Pressure a little high, but it always is at doctor visits)  Doctor will be in soon.

She did arrive quickly.  I think as the waiting room was filling it would be a busy day.  Reason again to schedule those first in the morning appointments. 

Sitting down, she immediately began the interrogation.  How are we today? How are we feeling? Any Pain?

ME: No, only using Tylenol as needed, and I have not needed it.  I wouldn’t mind some oxi tho—Just kidding.  (I have learned that Doctors do not laugh, I keep trying,  but even I admit that was a lame attempt)

DOC: Let me take a look and see how you are doing.

Here is where I tried to angle myself as not to shock or make my family wince or see the mutilation that had just occurred on this body.  Arms stretched out to make a tent, I did see Baby strain to see and I tried with no avail to turn away more, however doctor was by then removing the sterile strips and examining.  I was trapped. 

DOC: Everything looks great. You are healing well.   You may close the shirt. Have I called you with the results? 

ME:  No, no call.  I did look. Not that I understood them. But I did see the word NEGATIVE.  

Came my response as I brought my body safely back inside the shirt.  

EDITORIAL COMMENT:  Should these medical portals be filled with Lab results etc. before the main provider has had a chance to read them and talk to the patient?  Think about it. A non medical anxious patient, looks at the results before the doctor has a chance to review?  What if the words were POSITIVE?   Could not these portals have a prompt that allows the doctor to release the portal information after a meeting with the patient?  Would the doctor be inundated with portal questions and have more work?  PLUS, there is now a movement to charge for these portal questions after all, they are working.  Think about it. . . .

She brought out a print out of the results and her pen.  What I love about this Doctor, she draws, underlines, circles, and writes down what she says for emphasis. There are many pages. . .Left breast. Right breast,  Left Nodes, Right Nodes.  In each differing paragraph, she circled the word negative.

For the Right and Left Breasts:  Negative and Margins 2 Plus MM—excellent.  Next to each breast paragraphs  that was circled and underlined a big 0 with the slash thru it.

For the Nodes:  Left Nodes 1 Taken.  Negative.  Right Nodes, 7 taken, 6 negative.  Next to each Node paragraphs  that was circled and underlined a big 0 with the slash thru it.

And then with a flourish for the finish:  She wrote:  Radiation:  0.   Chemo: 0.  AND, big 0- No follow up pills for 5 years.

I cried—happy tears this time.  And she added this tidbit for the no pills.  My chance of re-occurring is 2%.  Taking the pills would only lower it to 1%. Save some money.  Hey I’ll put it towards the bills I just said I would pay for if no reimbursements were made.   And I am getting this report framed.

WOW!  What can one say for all that great news. Were there any questions?

Well, let us remember Nuke Med. And the difficulty.  She and the radiologist reviewed and determined in the future; all Nuke Med procedures will occur the day before.  No day of appointments. (Hey I am a trend setter)  It was nothing that my breasts did.  The cancer in the ducts did not deter.  The Dense-ness the word that appeared on every mammogram I ever had—Dense Breasts.  All of this has nothing to do with it.   

Could the doctor tell anything from the breasts when they were removed. NO.   Only if there was a BIG tumor, and to be honest, if that was found, well. . .what can you say.  

Could you tell by the Sentinel Lymph nodes?  Well they did feel healthy—and she did the squeeze motion with her thumb and forefinger. But again, you cannot tell until pathology reports.

She went back to the breasts. 

DOC: My Team did have a discussion after your surgery.  We all think that your breasts were the heaviest we ever removed.  I bet your back feels better.

We all laughed.

ME:  I have  a confession as well.  The Day of Surgery I weighed myself.  I also weighed myself the day a got home.  Weight Down: 6 Pounds.  Question: What else can we remove from me?

So there you have it. No Radiation.  No Chemo.  No Pills.  The past 6 weeks went by.  We made the deadline of mastectomy before June.  The DISC remained at stage 0.  A Family call was made to the girls as we walked back to the car. We all celebrated by Phone. 

Back at home: My text messages lit up.  A bottle of champagne purchased. Glasses raised. 

REMEMBER:  MAMMOGRAMS MEAN EARLY DETECTION.  And what a difference 100 days makes.

Is it in the Genes?

Amidst all the Doctor visits and procedures that required a trip to the local hospital, the Breast Doctor asked if there was interest in Genetic Testing. If I was, she would write and send the referral. She added that with my history, my mom had breast cancer, it might be prudent.

Ironically, I had the opportunity to have genetic testing in the late 1980s, which I mentioned.  The reason, I had waited till mid 30s to start a family.  The OB GYN said that due to my Advanced Maternal Age, I might want to do it.  I declined then.

Why did I decline in the 80s??  When he said  Advanced Maternal Age. I laughed.  My mom was 40 when she had me and 43 when she had my brother.  My grandparents seemed old when they had multiple children.

I did not decline now. I have three girls.  They were anxious to know. I am sure testing changed in the past 30 plus years.

With the Genetic Testing, the plus was the it required two meetings--the introduction/interview meeting and the second results appointment –both handled by TeleMed.  The one required trip was to the Lab for the blood test.  The first appointment, the Interview, was made and came with one bit of advice. . . .do not fill in any information you really did not know. 

Before the interview, the Genetic Counselor sent out a form to complete with a rough family tree-fathers side and mothers and my siblings.  Each side you required a relationship, age, age at death, and reason for death. My parents, both deceased, were from large families. My dad raised on the farm was near the youngest of his siblings and my mom the eldest. Bottom line, on my dad’s side, my cousins were the age of most parents, aunts and uncles.  They were dead as well. My mom’s side I was a little more familiar.

In addition to my family, the sister in law had genetic testing when she developed breast cancer. The result was negative for the Cancer gene—and breast cancer gene. I sent her genetic testing  to the Counselor as well.

I could complete my own siblings, spouses, children.  The rest of the form was pretty sketchy except for knowing they were aunts, uncles, on both sides.   I did send my siblings for any information they may have had.  My elder brother did have more answers.

Now remember, my parents were older when they had me, and they were from multiple siblings.  My dad had two brothers who lived fairly old –mid 70s—and died of lung cancer.  Yes, they were smokers—heavy.  They also spent their early 20s in the trenches of France in WWI, so mustard gas could have played a role.  The other surprise was to discover my mom had an older brother. He died in early 20s, in WWII in Italy.

Closer to home, I had a nephew who passed away young, drug overdose.  My father died of Leukemia, brought on by the medicine he was on for another illness.  My mom, had breast cancer, cervical cancer, and heart attack.

After submitting the forms, the Genetic Counselor established the TeleMed appointment.  At the appointed time, we reviewed my background. He then explained the next steps. He was going to send to my local lab of choice wither the local hospital or my doctors office and they would take a few vials of blood.  The vials are then mailed to the Lab for results, which should take about two weeks.

Interesting fact:   The blood tests were not sent to 23 and Me—I asked.  Only 5 major medical facilities in the United States perform the Genetic tests.  Thus the two week time lapse. 

I opted for the hospital trip on a Saturday morning. I figured early Saturday morning (Lab was open 6a-2p) would be a quick trip.  It was not.  Even early there was a line—maybe not as long as a Monday through Friday, but many patients were there.

The required box for the test was at the front desk.  Inside was more paperwork to sign off on that would be enclosed in the box with the vial and sent away.  After completing the required name, age, DOB, and Medicare questions, I was sent to a seat in the waiting room, where HGTV network was playing a house remodel. What else?

Called into the Lab, the tech took my blood. And I was through in minutes.  I called the family and said I would meet them for breakfast.

A few weeks later, the Genetic Counselor called.  The results:  No Breast cancer Gene or any other anomalies. He would send the results to me. Plus, with the history, he would suggest a baseline mammogram for each daughter at age 35.  The results and suggestion was immediately sent to the girls.

SO what caused the breast cancer?  I lived through Three Mile Island. I worked later at the Island. The deodorant I used? I had trouble breastfeeding one child.

Well, you cannot make yourself crazy trying to figure out why you are one of the Lucky 20% after the Strictly precautionary.

What you can do:  Get that Mammogram. Early detection can save lives.  Yours.

No. 12: THE DAY OF…

I realized that I have not written the steps in the order that they have occurred. While the events are true, they may not have happened in that exact flow. The names have also been changed to protect the innocent.

At least a week before the scheduled day of surgery, I achieved acceptance—the final stage in the grieving process. My thoughts for that week were simple, "Let's get 'er done."

Unlike the hip replacement a mere five months before, preparing for the breast removal did not seem as comprehensive. Some items are:

Stop any vitamins and supplements as well as ibuprofen the week before. Tylenol is approved. If you are on meds, stop taking blood thinners, which for me was my small baby aspirin. I can continue to take the cholesterol and blood pressure meds. SAME FOR BOTH SURGERIES.

Five days before the hip, however, they provided an antibacterial soap that you washed with every night. The first night you changed your bed sheets and every night after that use clean towels and clean pajamas. ONLY FOR HIP SURGERY. I did have some leftover antibacterial soap from the hip. It hit me the day of, so I did shower with it that morning.

Day Before surgery: For the hip, Take 1000 mg of Tylenol at 9 AM, 3 PM and 9 PM in an effort to give pain relief a head start. DAMN, I realized that the day of Breast Surgery on the way to the hospital. Why didn't I follow the Hip Surgery Playbook???

No food after Midnight. And Clear liquids—black coffee included—up to an hour before you report to the hospital.

One item did remain the same for both surgeries. The numerous calls you get scheduling procedures, the calls checking in on you and confirming what you need to do, and the ever-popular day before surgery when you get the times for arrival and your final surgical time.

For the breast surgery, that announcement came fairly early the morning before. Since surgery was on a Tuesday, it was Monday morning, a great way to start the week. The nurse was pleasant, "You will be arriving at the hospital at 7:30 am main entrance and go to the Admissions Desk. Here you will get signed in so that OR will know that you are there. Then 7:45 am report to Nuclear Medicine for the procedure to locate the Sentinel Lymph Node—the node that holds my fate in its hands. Surgery around 11 AM."

Actually, I slept pretty well the night before surgery. I was up early to shower with the aforementioned anti-bacterial soap. Hospitals today are concerned with infection, so I decided to help alleviate that concern. I also wanted to say Good Bye to the Girls. I looked at them and gave myself one more breast exam. I still did not feel anything. Why am I going through this? Is it too late to say NO?

I had already packed my bag. I was wearing what I would need anyway. I went braless—wouldn't need that. My shirt was one of those new ones with the inside pockets for the drains that would be added to my body. All I had to pack was slippers and clean underwear. (My mother was an ER nurse and you would be surprised to hear her stories of the people that come in with dirty, holey underwear. Whenever I travel, I make sure all underwear is clean and whole. For this, I purchased new.) I also had my three-ring binder, wallet with my ID and Insurances, my Kindle, and a magazine to read. None of which, except for the ID and insurances, turned out to be needed.

We arrived at the hospital right on time. As my family took a seat in the waiting area, I checked in. As the perfunctory questions were asked, a new question appeared! What pronoun would you like? I said IT. Then recanted and said She Her Me I Us. Really, call me my name. But that is fodder for another topic.

She put on my identity bracelet emblazoned with name, DOB and a variety of QR codes that would be my record of all charges. She said I was ready to go.

"I have to report to Nuclear Medicine, where is that?"

"Oh, That is different! I need to print out your records and you take them with you. These you will give to the OR when you report. I will also have a slip of paper to tell you where to go." I am sure she really did want to tell me where to go.

Papers in hand, I read the slip. We went down the main hall and turned right at the statue. Go to elevator and take it to the basement. My entourage and I proceeded.

Off the elevator, we reported to the admission desk of Nuclear Medicine. "Oh, your minister is here and is in the waiting room." Wow, he beat me there! Another ID bracelet was added to the same wrist and we went to the waiting room and the minister. It was a comfort to have the minister there. We talked and prayed. When the tech came to get me, he left and I went with the tech, the family remained behind.

At Nuclear Medicine, I was given the waist up, open in the front gown information and they left while I prepared. When they returned they explained what would happen in the 45-minute procedure. I would be given a shot to numb the breasts and then a dye of some radioactive substance will be injected into the nipple. They will then put me inside a camera to see where this juice flows to which lymph node on each side. They are the Sentinel nodes. I love that name—the frontline soldier who protects the body. It is also the one we prayed for to be clear of cancer and hoped it did not allow any cancer through its defense and into the rest of my body.

Getting up on the table, lying down, arms raised behind my head, I did not watch as they injected either the numbing agent or the material. I was rolled under the camera. And then it began. Nothing.

After what seemed like a long time, the tech asked me to start massaging my breasts. Cross your arms and rub. Keep it up. It actually felt good to let my arms at my side for that time. They tried again. The radiologist came in. Looked and disappeared. The tech and a variety of people came in and were talking behind the glass.

Two hours later, the radiologist returned. "When is your surgery?" 11 AM I replied. "Ok this is what you are going to do. We are going to get you off the table and I want you to walk around, exercise your arms like you are rowing a boat. Flap your arms like a bird. Do a few jumping jacks, keep your arms moving. We will do this for 20 minutes. Then you'll go back on the table. We will also bring your family in to be with you. They have been in the waiting room for two hours. Is that ok?"

The family arrived, and laughed that I was rowing and jumping around. I explained the stuff was not flowing—and they need to get it moving. As everyone was smiling at me—the family and behind the glass, the radiologist returned. "The OR is waiting for you, we are going to see if this worked and get you up there."

Back on the table and slid under the camera, it must have worked, as the radiologist made some marks on my chest and said "Done! Get yourself together and we will call transport to get you up to the OR."

As soon as I was dressed, we went to the waiting room. Within minutes, no transport person came. It was the OR supervisor, a nice young man, who said, "Everyone is waiting upstairs, and we couldn't wait for transport, so I am here to take you. Can you walk?" YES. "Good as there were no wheelchairs available."

So we walked, into elevators, up floors, down long halls and arrived at the OR admission. With the papers given to me at the Front desk, I handed them to the woman behind the counter who was just about to say, take a seat, when she said "Oh My this is the woman they have been waiting for!" The OR supervisor said, "I can take her, I know where she is going."

At this point, only my husband could be with me. The OR supervisor told Baby where she needed to go and that Dad would follow her soon. She gave me a hug, left. We proceeded down the hall, and it wasn't hard to see which Pre-Op bay I was going to as they were all standing there waiting—Nurse, CRNA, Anesthesiologist, Doctor and who knows maybe the janitor too.

"We are happy to see you—OR has been ready for an hour." Cannot say I am happy to be here, but I am ready too. They gave me the gown and wipes. Take off all clothes and wipe yourself down arms, legs, chest, no privates, gown open to the back. WHAT? Not the front? No, I do not know why. They may have said why, but all was happening so fast now.

When I was ready and on the bed, the curtain was opened and everyone was ready with paperwork. Sign here, Date here. I am the Doctor. I am the anesthesiologist. I am the Anesthesiologist for the research program you signed up for, I am your anesthesiology nurse and I think a regular nurse too. I do not know why, but when I signed the papers, I put the wrong date. Not only the wrong date, the wrong year. The nurse caught it. I said I would mark it like a bank check, initials and correct. They opted to put a label over the date.

Everyone left except for me, hubby and the nurse. "Everyone is waiting for you. Husband you go as far as the elevator and give her a kiss." We did. And husband said to the nurse, "Do your Best." She said she would.

Down the hallway, the nurse said now which room is it. I answered, This one. How did I know? It said Allergies: Latex and Penicillin. That is me.

We went into the OR and the Doctor and the assistants were ready. I moved myself onto the operating table. The doctor and I said a few pleasantries and the mask was put on my face. No counting down from 100? No just breathe. "Do your best" I said.

I woke up in Post-Op. Who knows how much later.

No. 11: Good Days & Bad Days

To think I have something in common with royalty. To be clear, I am not a royal watcher. However, the news is filled with King Charles and Princess Kate and their battles with the Big C. Kate and I had the diagnosis at the same time. While hers—and I agree as a PR person she has her right to keep it to family—is kept under wraps, she is battling with chemo. I chose not to keep mine a secret: Breast Cancer. Also, I have good news—No radiation. No Chemo. No Pills for five years. I pray that the princess and every survivor have good news soon.

That is not to say I did not have bad days. The mind is tricky and loves to play games. For instance, I do a body check:

1. Is my urine clear? If not, does that mean the cancer has spread and now I have Kidney Cancer?

2. Is that a new bruise on my leg? Where did it come from? Google says it's a sign of leukemia? NOTE: Every doctor I have had in the past 6 months says do not go to Google with medical questions—a GREAT TIP—someday I will follow it.

3. I stubbed my toe and it is bleeding profusely. What does that mean?

I still have trouble looking at myself in the mirror. I keep my eyes cast down in the bathroom mirror and up in the shower so I do not have to look. Then other days I think, hey, this is the new norm... move on. I can hear my mother, "Pull yourself up by the bootstraps, stop feeling sorry for yourself."

But then I put on a shirt that I used to love and it looks—well—I truly cannot describe it except to say I take it off and throw it into the back of the closet. I look for a front-button very loose fitting shirt—a shirt that flows, in essence—a tent. I have come to realize that I am built like a triangle—not the pear shape I used to have.

Body image. It does play a huge role in a woman's life. As someone who always was overweight—even after hundreds of diets and losing the same 10 pounds over and over, my body image was never good.

I take that back. In 2001, I did Weight Watchers group meetings and lost 50 pounds—I looked and felt great. On the day I lost the 50 during the weigh-in, the leader's phone rang and she said, "Our country is under attack so I am ending the meeting. God bless us, and hopefully we will be back next week." I went home and sat on the gazebo on a clear blue sky day in September. I decided that if someone wanted to kill us—me—that badly, who am I to deprive myself of brownies, mac and cheese, and wine? I gained half of it back.

I look at this old body. There is a 5-month-old scar on the left leg where a new hip was added. And now, a healing incision that seems to go across my chest that is now concave with a breastbone that I never knew I had before. I show very little to my husband—or anyone. In fact, after years of never locking the bathroom door because the kids always seemed to need me, I lock it now. Why? Because one day after this mind-altering surgery, my husband came in and asked a question and then later, the Baby came in to ask if I wanted to go to breakfast. I tried to grab for a towel, but it was too late.

At the post-op visit, the doctor needed to remove the sterile strips and wanted to see how I was healing. With the gown opened to the front, I kept my arms straight and angled so that the Baby and my husband could not see what the Doctor saw. That did not work too well. They wanted to make sure I was healing correctly too.

A few years ago, and I am not sure of the details, a religious sect made plans to pack a suitcase, go to the mountaintop, and wait for a ship or something to take them away to a new life. When I heard that, I laughed. Why? I would not pack my same clothes. I would go purchase a new wardrobe and exchange my size 16 clothes for Size 2. If I am going to get a new body—let's make it Great!

So there are days that are bad. I am sad that my family has to go through worry. I am sad that they have to see my body in this shape. I am sad that they have to care for me and maybe change schedules. I am sad I am a burden.

But then, I take stock of all that is good. This family has come together and been even closer watching out for me—and my husband. We have great friends who also have shared their own gifts from cooking, cleaning, and listening. So yeah, there are bad days. But like the Princess, the good days are the ones to realize the positive people and works in your life and move forward doing the things that make you happy.

No. 10: JP Drains & The New Jewelry

With a mastectomy, be ready for changes. Not only in your body but with the clothes you wear and the new jewelry that comes with it.

The JP drains are two plastic grenade-shaped containers attached to your chest through a length of tubing. This tubing is sewn to your chest. Two or three times a day, you empty these drains by milking the tubes and emptying the plastic container into a measuring cup. You must record the amount of each drain separately—left and right side. Once the fluid measures less than 30 ml on each side for two days, you can then have them removed. My breast doctor noted that it takes 10-14 days to achieve that goal. "The first week, it is new; the second week, it is an annoyance."

My drains started at approximately 65 ml right and 50 ml left. In the three-ring binder that was my bible, I had the sheets to record the numbers. In reading about the drains prior to surgery, I realized we would need some new jewelry and clothes. Since you cannot raise your arms over your head, front-button shirts were needed. Then, you need a way to keep the drains from A) flopping around and B) staying in place so they do not pull out.

I hit the internet and searched. I found shirts that buttoned down the front AND had inside pockets to hold the drain and a little snap that helped the tubes remain in place. Loved it and bought six short-sleeved shirts and one tank top. I wore them even when sleeping.

Sleeping posed another challenge. Luckily, having had hip replacement five months before, I learned how to sleep on my back, propped on pillows. And now, I had to do the same again. The shirts helped keep the drains in place.

I also found lanyards that one could wear around your neck. The lanyards, however, also required a safety pin to hold the drain to the lanyard. Where I lived, there were no safety pins for sale!

The shower, which was now required as you are not supposed to soak in water, offered another challenge. Since the lanyards needed safety pins and I had none, my daughter, who had talked to her boss, found a lanyard that worked great. Picture a belt and attached to each end is a beer koozie. The drains fit nicely in the beer koozie, and you just placed the belt around your neck.

I never realized how many knobs—door knobs, drawer knobs, water spigots, ends of towel rods—are in a bathroom. All of which could be the reason a tube could be yanked off your body. Brushing your teeth became a challenge so I would not have the tube get caught on the drawer. The Bible Binder did say if a tube got pulled out, no problem, just call and it will be fixed. Accidents happen.

Luckily, being careful was job one. I had no tubes pulled out, although I did have one near miss. It was a doozy and completely unexpected. I had bent down to pick up my pants after peeing, and the tube wrapped around my pants button. AUGH! I stopped just in time.

Then there was the emptying of the drains. It wasn't necessary, but I made it a two-person job. I would hold the tube closest to my chest, then let my caregiver (daughter or husband) milk the tube to the drain and then empty the drain. I kept holding the upper end so that there was a fail-safe in case the tube got accidentally pulled.

There was one day, when the Baby was in charge of the milking duties, that an unruly blood clot had made a nest in the tube. To her credit, no blood clot was too big or unruly to get past her. It may have taken a few extra minutes, but she had success. Until it dropped into the bottom of the waiting Left boob cup. And there it was. A clot that looked like a bloody salamander, lying prostrate on the bottom of the measuring cup. Baby-1, Salamander Blood Clot-0. The winner of the battle took the required measurement, ran to the bathroom to empty the cup, then gagged. "Dad can do the next drain time."

For ease and safety, the caregiver wore rubber gloves, and to make the tube easier to milk, we used alcohol wipes that made the tube slippery. We also had gauze for any leaks, especially when the tubes are removed, and a squeeze ball to help the circulation.

It was exactly 10 days that I reached the two-day goal of 15 left and 25 right. Sadly, that second day, last milk before bed happened on a Friday night. Because a nurse would remove the tubes, and it was not an emergency, I waited until Monday.

But first, Sunday afternoon, I called the Breast Nurses station and left a message so that I would be first in the queue on Monday morning when they opened at 8 AM. My message noted my anxiousness and excitement.

The next day at 8:01 am, the nurse called. "You can come in immediately or make an appointment." No question! I will come in immediately. We were there by 8:30, and after signing in, the nurse came to get me.

As I rushed across the room, she said, "You don't have to run." Yes, I do, I want these out. She laughed and said, "You are the one that left the message." YEP!

In the room, she left while I got ready—ok... Take off shirt, put on gown open to front. She started to raise the bed. It didn't move. She pushed more buttons, no movement. She unplugged and replugged. Nothing moved. I saw another plug on the floor. It was the plug to the bed. But even that plug did not work. I was beginning to think that I was bad luck in the hospital.

"Let's move to another room." We did. I got ready. She said, "Take a deep breath and let it out." I did. She looked at me. Side A—Done. I did not feel a thing. Now Side B, do the same. AAAUUUUGGGHHH That one hurt. It was done in a second...but hurt. She had me remain lying down for a few minutes.

Bandage added to each side. The instructions were simple. Change the bandage after each shower. Make sure the area is dry.

And that was it. Drains out. I felt free.

No. 09: The Caregivers

CAREGIVER: The person who provides any emotional or practical support.

I am one of the lucky ones. I have a great network of friends who provided support of all kinds. I was taken out to dinner, happy hours, lunches, given flowers, ice cream, home-cooked meals, or simply an ear to listen. They were all kind and supportive. They offered CARE.

The major caregivers were, best of all, my family – my husband and daughters. They came together and became the caregivers I needed 24/7.

The Husband, Significant Other, Partner

A good friend, confidant, and guide gave me this sage advice: SHARE YOUR FEELINGS with your husband. In her story, she did not. It was not until years later when she had good news of being cancer-free that she saw her husband cry.

My husband and I cried together when the diagnosis was confirmed. We had not told the girls until after the biopsy.

When the diagnosis came through, he was the first one I wanted to tell. Alas, I was at a friend's home, my writing partner, when the call came. He was the one who sat and listened to me until I had composed myself enough to drive home. I appreciated that my friend was there, and even though there were some tears, he was WFH. He was there for me. In fact, he has been texting and praying for me since the beginning. Prayers do work!

My husband was my rock. Following the sage advice, we talked. We talked about moods—his and mine. He made me feel cared for—shopping, cooking, listening, and emptying the drains that were attached to me. He urged me to walk and walked with me even down around the cul-de-sac of our street. He kept me active. Exercise is a good way to heal. He also reminded me to listen to my body and if I was tired, rest.

He also gave me space. I urged him to get out and do things that he wanted/needed to do. Ironically, as close as we were, I still had difficulty letting him see me for many, many days. I would dress in our walk-in closet or in the bathroom. He also had to adapt to my moods—which changed at the drop of a hat.

As I went through the grieving process of losing a major body part—a part society has magnified—I realized he was grieving too. Not the loss of my body parts; he reminded me that he did not marry me for my breasts. He was grieving for me—the changes I was going through. He loved to remind me that I was a Type A... which to him meant Type Anus. And we would laugh.

And that was the crux of our relationship. Together we reflected on what made life meaningful—our girls, family, and friends. And we would laugh together. Communicate. Laugh. Love.

The Grown Children

We have three grown children—all girls. They immediately became involved. They also determined the roles they would play. Scribe. Research. Scheduler. Support.

These three girls were in constant communication with each other from the day they learned about the biopsy. They planned a trip away from home for me prior to surgery. One or two would come to doctor appointments and take notes, then add them to the created Google Drive set up to keep all informed. Also, texting was occurring as the doctor spoke. Constant communication.

They also did research on their own. All let their employers know what was happening in the family. Through that, one daughter discovered her boss's mother had breast cancer and learned what questions to ask and what items might be needed. Online research, notes, questions, and texts were continually exchanged between the three.

The day of surgery was mid-week, and two-thirds of the daughters were on business trips. I requested that they keep their work schedule and commitments that week. I would be in the hospital anyway, and if there were complications, the stay would be extended. I would not need help until I got home. It worked out that I only needed a one-night stay. By the weekend, all were home. I loved the full house. And all were able to work from home as they had told their work.

More than that, I loved being waited on. Cooking, cleaning, shopping, drain duty. Snacks, drinks, all were delivered to me. Of course, one daughter declared herself the emotional support, sitting with mom while we both watched the others work. I will not point out who was who. Except to say, the Baby was the one who did the most drain duty, especially since she was living at home and the other two were visiting.

The house was quiet when the older two left. The Baby was left to take up the slack. She did. Drains. Cooking. Post-Op Visit. And working at her demanding job at the same time. She has delayed her move to California until she knew mom was okay. And, on the plus side for mom, we will be taking a cross-country trip—just her and me—to make the move.

No. 08: D A B D A

Psych 101 in college years ago, DABDA was my way of remembering the five stages of grief: Denial. Anger. Bargaining. Depression. Acceptance.

With my diagnosis of Breast Cancer, I went through these stages—twice. Once before the surgery and then after the surgery. I am probably still in the Depression stage (it's been three weeks since B-Day). I find myself crying when I hear my favorite songs from my youth. Luckily, it only lasts as long as the song—which I normally play when I am in the shower or in my car—so no one is the wiser.

What were these stages? While I had the first Mammogram, I felt good going into the Breast Center. I had no signs, regular mammograms, and I gave myself breast exams once a month—or 6-8 weeks. I was happy. Life was good. I had retired. The new Hip was functioning. My golf game was set to take off—once I had a few months of hip recovery. And I was planning to start retirement travel. I was free. And then came the report: Radiologists found something concerning.

DENIAL BEGINS: The second Magnified mammogram was scheduled—strictly precautionary. It was enough to call for the Biopsy. The biopsy came next, with an 80% chance of it all ok. It was not. Miss 20% here then was sent for an MRI to make sure nothing was missed. Guess What. Another suspicious area was discovered.

REPLACED BY ANGER: Why is this happening? All along the way, it was just—precautionary, then you have an 80% chance—until the diagnosis was—you have cancer. Then I was really angry. Angry at myself—what did I do wrong? I did see a few months ago one breast was a little larger than the other. But—no one has perfect symmetry, so why worry about that? I did breastfeed. Did I do that too long? (I stopped when they had teeth, if they have teeth, time to be real) Did I not breastfeed enough? Was it from my mother—Oh yes, MOTHER. Mother-daughter relationships are tough enough as they are. My mother had breast cancer, a mastectomy. I was a primary caregiver. She kept crying, "I am glad your father did not see me like this." I look like her. And, if you trust my husband, I sound like her. I am built like her. I am the same age as she was when she had it. Anger swelled.

Then there were all the procedures. Procedures where the loving nurses kept rubbing my arm—reassuring me all was ok. Please do not touch me. Can't you see, we need to get these procedures done? Make me well. Make me whole. I knew they meant well, and it was part of nursing. I did keep my mouth shut and let them do their thing.

BARGAINING: Between each procedure, I cannot say I bargained. I did not feel I had many chips left to bargain. Ironically, the past few months had been full of surgeries. First came a hip replacement. Within three weeks, the incision developed an infection; back to the OR we went to clean and repair as an outpatient. The Bone doctor admitted it could have been done in the exam room, but protocol made it necessary to get an OR. Maybe I could exchange 2 breasts for a right hip. Nice bargain, I knew what to expect with hips. We had just gone through that. My Bone doctor said I was heading for another hip replacement anyway in a few years. What else can I give in return for breasts? I took a body survey.

THE DEPRESSION: People—friends—are loaded with great intentions. People who heard what was happening offered so much help. Taking me to lunch or dinners or my personal favorite—Happy Hour. Everyone offered help in any way. (What way? I am losing a part of my body??) Some who were survivors offered a variety of tips. Many simply texted each day asking how I was doing and they are praying and thinking of me. It got to be too much, to be honest. I only looked at texts certain hours of the day. Some friends told their friends who had mastectomies, and I received calls of support from strangers. While it was great to know people are there to support you and they care about you, I did have to put on a happy face. I kept seeing the ad for some drug with the woman holding a smiley face in front of her own. That was what it was like. Depression, mixed with guilt, as I wanted to tell each one to stop and leave me alone for a little. I must have been showing depression because once I said something at dinner and a good friend said, "I am giving you one more day to feel sorry for yourself, and I do not want to hear anything more."

Wake up call. I began to appreciate all the calls, the texts, the offer of help. And some of the best coping mechanisms—journal your thoughts. Talk to good friends. There are support groups you can call or attend in person. What my friend said did come with a bit of truth. I was a little mad, but she had gone through the same thing—once lumpectomy, one mastectomy... alone.

I realized the die is cast. Onward with the surgery. And, sure, I will cry, but I promised myself only in the shower or car. No one around. We are ready for...

ACCEPTANCE. The surgery was not for two weeks. A Special Mother's Day weekend was planned by the girls. My Pre-Op included happy hour and dinner on the rooftop of a nearby town. And you know, I planned to live each day to its fullest. I/We, whomever I was with, we all had fun. We talked openly. It was inevitable to have the mastectomy. It was the wait. But I accepted what was coming—and really thought, Let us Move On! I did not realize my family was going through the same kind of process until one day, at breakfast.

One of my Boob Buddies, a survivor herself, had brought me a coffee mug, pink and emblazoned with "survivor." My daughter, as I drank my coffee, got mad. "Why are you using that mug? It's too early. You do not know anything yet. Put it away." I had accepted. I told her simply, "I am a survivor. Let us remember that." It calmed her down. And having me say it out loud did help me and her.

The second set of DABDA came after the surgery. I do not think it was as bad—or lasted as long—as the first round. DEPRESSION—yes. It took me three days to even look at my body. I was supposed to take a shower 48 hours after surgery at home. I stretched it to 72 hours. And I really did not fully look—I glanced. When it came to the wonderful JP Drains that had to be emptied 2-3 times a day, I held my shirt closed above my stomach while my assistants (husband and daughter) drained the contents. Then while they measured, I closed myself up again, hoping they did not see much of the sterile strips, the drains, and the caved chest. For a few days, I only glanced at my chest in the mirror. I was careful to wear a robe in the bathroom in case someone came in... plus it added protection to the drains. I never realized how many drawer knobs and door knobs and spigots in a shower that tubes could catch.

I think I really only did depression and acceptance in the last round after surgery.

I have reached acceptance. Let's face it. The hard part is now over. It is time to live.

No. 07: The Diagnosis

One Regular Mammogram - Check,

One Magnified Mammogram - Check,

Two Biopsies (One on each side) - Check, and Double-Check

One MRI - Check

One MRI Biopsy Scheduled - Check TBD

It was now time to meet the Breast Doctor/Surgeon. It was recommended to mark your calendar for at least 2 hours as the Nurse Navigator, who meets you first, will review the binder that explores the journey you are about to undertake. The second hour with the Doctor entails a breast exam, a review of the results of all procedures, and the options before you.

By now, the family, my center of support, was completely on board. The daughters, who have their own text messaging communication set up, had decided that someone would always be with me to listen and take notes. The baby, who currenlty lives with us and WFH, I thought would be the main contact. Surprisingly, since the oldest was on a business trip, the group had decided that two of the three would be my ears.

My entourage established: husband, middle daughter, and the baby, will attend with me. We arrived at the hospital in plenty of time. The two daughters armed with their laptops. And as it turned out, had designated duties which you will learn about later.

As we crossed the parking lot, my husband took my hand. I looked at him, and he was crying. I stopped short, yanking his arm back.

ME: NO! You cannot go into this building crying. If you are crying, you stay in the car. This place is difficult enough as it is—as you will see. I have promised myself I will not cry, nor will you.

The girls looked shocked—and also snickered—as their Dad was known to cry at the drop of a hat—when they took the train home or many of the smallest of family events, including giving the dinner blessing.

ME: Women will be inside facing all sorts of challenges, and some of them may be crying. I am warning you. I do not want that. (Yes, I am a hard ass, but I am not one to cry in public. The shower always, public NOT)

Wiping his face, hubby agreed, and we proceeded inside. The entourage took seats on the couch while I registered. Oh yes, the same questions, Insurances, Medicare, and yes, I will pay if no one else does. I then took my seat to the side of the couch facing the other loveseat, family lined up to my right.

Sitting on the loveseat directly across from me was a woman, red-rimmed eyes, staring at her phone although she was not swiping left or right. Actually, she was mostly staring at the floor. I looked at my family. All three saw the same thing.

The girls decided to discuss the travails of work and opened laptops. My husband looked at me, then the woman, and back to me. I smiled at him and gave a little nod. No need to say anything, we were in agreement. I watched the TV. The woman was soon called into the inner sanctum.

The next nurse that came into the room called my name. We all stood at the same time, which at that time of day, took away half of the waiting room. The nurse laughed. "You have a crew with you. I will need more chairs in the conference room."

The conference room was smaller than an exam room considering it had a table and 4 chairs. The nurse grabbed a rolling chair from the registration area and brought it in. The girls and I took a seat at the table with the nurse, and hubby, taking the rolling chair, sat to my side.

The Nurse Navigator brought out a thick, three-ring binder. "I am your nurse navigator. Any questions at any time, I will be your conduit. Here is my card with email and phones, and feel free to use any method at any time to reach out to me. This binder will be your guide as well. It is broken into various areas." She started to thumb through the tabs from support groups and pre-op protocols to PowerPoint outlines of self-care, operation day, and post-op information. The tabs were many. She took a few minutes. "The binder will be your guide. And do call or email if questions. I am not on the portal, but I will get to the doctor any questions and concerns as soon as I read or hear them."

Next, she brought out a book. A textbook. The complete book of Breast Cancer. This book describes all the various types of cancer. She already had the pages marked that pertain to me. "This shows you a healthy breast duct. Here is a duct with cancer—In Situ. The cancer is contained in the duct. And this is one where the cancer has invaded and broken through the duct. According to your report, you are still contained in the duct—thus makes it Stage 0. One side is Grade 1, and the other is Grade 2. There are three grades. The higher the number, the more concern. Did you know a cell grows and divides every 100 days? You will be able to read all about it as you will have this book as well. This book will also be your guide."

In my mind, upon learning the 100 days, I began to think... So, 100 days, were all these tests done at Day 99 or day 2? We have now expended a month of tests... did they split? Are we resetting the clock to 0, or are we done with the first round and are now on the second 100 days?

My thoughts were interrupted. "The doctor will go over in more detail. I will let her know you are ready."

MEDICAL vs. EMOTIONAL

The nurse left, and soon the Doctor entered. "Well, we have a full room. Who do I have the pleasure of speaking with today? I assume you are the husband, as you are the only male here."

I must say, the doctor put everyone at ease. And then she looked at me and said, "Mom, we are going to another room to have a breast exam. We will be right back."

The Nurse Navigator awaited outside, escorting us down the hall into an exam room. I was given the perfunctory half gown, and they left while I prepared. OK, thought: If you are going to open your shirt to the world anyway, what is the purpose of leaving while you take the top off for privacy? Just askin'.

When they returned, it was for a breast exam. Both Doctor and Nurse said at the same time, "The left is bigger than the right." Confession, I did notice that a few months ago and thought nothing of it.

Then I was placed on the bed, and the doctor did a manual breast exam. The doctor asked a few questions: "Is that the entire family here to listen?"

ME: NO, there is a third, the oldest. She is at work in NYC.

DOC: I guess she will have to get the report from her sisters.

ME: NO, she already is in the loop. They have been keeping in touch with her since we entered. One daughter—the middle—is typing notes, and the baby is texting her sister. They are connected.

DOC: You have a great family. (I DO!) What does the one in NYC do? (For privacy, I will not answer here, just to say that there was a child of those in the room who I would soon discover was graduating and who could apply for a job there when I send the link)

Finally, while she did her thing, she ended with, "I do not feel anything."

ME: I do them regularly myself in the shower, I never felt anything. That is why I am so shocked that we are coming this far.

DOC: We shall discuss with the others. Let's go back to the room. Get dressed and come on out.

Again with the privacy thing to dress and undress.

Back at the conference room, the entourage looked anxious as we entered. I smiled. They kinda smiled. The Doctor took her seat at the head of the table.

The results of each test were reviewed—in order—as to how we got here. And then it started, what was happening deep inside me. The DCIS—Ductal Carcinoma In Situ. It's in the duct. She drew a healthy circle with circles inside. Then a circle with stuff in it. And then added arrows—if they invaded the rest of the breast. Our stage is 0 as all indications were it was contained in the duct. The levels are one for the Left side and two levels for the right, meaning 1- low level, 2- intermediate; we have not reached the high level. That is good.

Now let us look at the hormone receptors. It was here that I listened but did not really comprehend because the word hormone kept being repeated. My brain went to two things: One, we need to do the drinking game. Every time she said Hormone, DRINK. My other thought was the old joke: How do you make a hormone? Answer: Refuse to pay her.

The next step was all the options.

THE LUMPECTOMY: Taking pen to paper on the flip side of the paper where she drew ducts, we now were getting drawings of breasts. Place a reflector (before surgery), locate the lump. At surgery, remove the lump. Biopsy of the sentinel node. I really tuned out for the sentinel node. You inject the nipple. You are numbed, of course. You still have mammograms. You will have regular exams and take medications. You will have the drains as well. Need to note that because your MRI had a suspicious area, we need to do an MRI Biopsy for further study. That has been scheduled for you; HOWEVER, you will not need it should you opt for the Mastectomy, as the breast will be entirely removed.

Which brings us to... the bottom half of the page.

THE MASTECTOMY: Both breasts removed (or one if that is your diagnosis). Lymph nodes will be removed. NOTE: you will go to Nuclear Medicine for a procedure to identify them, and they will be biopsied and pathologized (my word). AGAIN—you will have to read later about that experience. You will have the drains, JP Drains that you need to empty 2-3 times a day. And keep a record. She turned to that page in the 3-ring binder. There were 20 pages, each with 4 weeks on each page. Ok, I did need two pages—one left and one right. And if I opted for one of the reconstructions, I may have 2-4 more. That reconstruction takes fat and muscle from your stomach area—hey—added bonus. But 20 pages of 4 weeks each?? Would I need this many pages??? OMG!! But she continued.

Also, we need to know about reconstruction. The plastic surgeon will be standing by in the OR with the Breast doctor ready to begin the process. Now I can make this various ways. One, just have it set that in the future you get reconstruction. Otherwise, the plastic surgeon will start the implant process. You will need a consult with them first. Once you decide, of course.

For the lumpectomy, we perform the procedure as an outpatient. For the mastectomy, it will be an overnight stay, longer if you do not fulfill the requirements: Pee. Eat. Walk. And the walk means able to do things on your own. I had a hip replacement 5 months before, CAN DO!

Now for your particular case, Chemo is off the table. But Radiation and a pill for 5 years may be in your future. You will have regular exams. We will not know until we get inside and get the pathology report.

We also offer Genetic Counseling. With your history of your mother having breast cancer—at the same age as you, and then cervical cancer later, I would strongly suggest it. It would help your daughters to know. And with the history of Mom and Grandmother, I would say they should get the baseline mammogram when they are 35. And Insurance pays for the testing. It does take a few weeks after the blood test. Then they will meet with you for the report. They send you a fact sheet to complete as best you can with history of your family. Ages, deaths, reasons for deaths. Fill it out as best you can. We shall let them know if you are interested.

Any questions? Well, luckily my entourage had done research and asked many pointed questions which she answered promptly. I must confess, having my kids there as my ears in all the meetings, I was glad because I had none. I am the type that says let's get it done and cross each bridge as you get there. In the Medical Profession, that does not seem to be the case. They want to cross specific bridges. Plus, the way my brain works, or does not work, I just kept thinking weird thoughts. The doctor answered each query and was impressed with the questions these research Project Managers had.

Part of the research was that the Middle daughter's boss's mother had gone through the same cancer diagnosis and was cancer-free for a few years. The Baby (and Me) knew someone who went through breast cancer starting with a lumpectomy, followed a few years later with a double mastectomy (ok Bilateral) and reconstruction. Both were armed with questions to ask and some that were added once the procedures were explained.

The Doctor returned her attention to me. "I am not going to ask what your decisions are now. This decision is a MEDICAL vs EMOTIONAL decision. I want you to take your time, take a few days, and let us know then. Read the books, talk with your family, whatever you need to do to make your decision. Then let us know."

I already knew what I wanted. Genetics. Mastectomy. NO reconstruction.

I will take a few days to make the decision.

No. 06: The Plastic Society

The decision was made. So I thought.

1) Genetic Testing

2) Double Mastectomy (aka Bilateral)

3) No reconstruction

The email was sent bright and early in the morning. The response was fast.

The doctor will schedule your mastectomy; however, you must talk to the plastic surgery department first. We want to make sure that you understand all the options before you make any decisions. Well, I thought I had. And after research and discovering the Knocker Knitters, well, that club of people who knit so creatively, who could resist?

Appointment made, my entourage of Baby Daughter, Husband, and I arrived right on time to the appointed office. Even though it was early, the waiting room was full. I saw the poster, "PLEASE TREAT OUR STAFF WITH RESPECT," but did not fully read it.

What we did read to pass the time was the poster on HIPAA – two large posters with 11-point type. We had the waiting room trying each other's glasses to see if the poster could be read from locations around the room. It did pass the time.

Soon, we were called back to our appointed exam room. The nurse was perky and friendly. As she tossed the hospital gown at me, she then realized she did not have enough chairs to accommodate my posse, so went in search of an extra chair.

Returning with a chair in hand, she proceeded to provide instructions. Take everything off from the waist up and put on the gown—open to the front. Status quo. Nothing new here. Then she added, the Plastic Surgeon has requested before pictures. So she would be returning with a camera to take them. But do not worry, they will be taken from the neck down, indicating with her hand below her chin. She continued, these photos would only be seen by the Plastic Surgeon, the breast surgeon, your regular physician, and possibly a few residents as this is a teaching hospital before being stored in a secured site. No other person will see them.

ME: "So you won't be sending them to the Inquirer?"

The question was answered with a blank stare. "I will go get the camera now." She left.

The change of clothes—or lack thereof, went fast, leaving me time to read the poster. The poster that was plastered on every wall from lobby to waiting room, to hallway to exam room.

PLEASE TREAT OUR STAFF WITH RESPECT

I could read the paragraph underneath. Belligerent and abusive language, and physical abuse of nurses and staff would not be tolerated, and a call to the police will occur. You can be arrested and charges filed.

Hmmm. As one on the Speakers Circuit touting Sales and Marketing, it caught me by surprise. A favorite analogy to sales was this: Imagine yourself sitting in the exam room half-naked (such as I am now). You are antsy. You just want to see the doc, get the clean bill of health, pay the bill, and leave. The doctor enters, medical file in hand. He glances at you, then takes a moment to look at the file in his hand, lifting papers, frowning, then slowly inhales. A long quiet "Hmmmmmm" emerges from his lips. He looks at you, frown unchanged. You went from "OK, I am ready to get dressed and pay the bill" to "Doc, here is a blank check. Make me well." That is an outline for sales; you have a sick client, you diagnose and make them better. Best of all, you have the blank check in your pocket.

I digress. As I read the poster aloud to my posse, I made the comment, "Can you imagine what the wanted poster would look like?"

My daughter replied, "Just think what the lineup would look like."

As laughter erupted with tears streaming down my cheeks, the nurse returned, looked at us, and proceeded to take the photos, no questions asked about the eruption of laughter.

The Plastic Surgery PA entered next. Again with limited chairs, the photo-taking nurse left the room, giving the floor to the new attendee. Now, I am not going to be critical, but when explaining options and procedures, it would be best to have it in a linear format. This person (agreed with by the Baby when we left) was all over the board. She did provide a pamphlet we could take with us and review—which was very helpful. You do have a few options for reconstruction:

(PLEASE NOTE THESE ARE VAGUE AND NOT TO BE USED FOR YOUR OWN DIAGNOSIS)

1. Option 1: The Saline/Silicone Insert. There are two types—one filled with saline solution, the other silicone. An expander with a metal nipple is inserted into the cavity where the aforementioned breast was. It looks like a flat sippy cup. Each week, you would return to the hospital for an injection of saline water that will expand this cup. It would be located with a magnet that would search out the metal nipple. Once found, a needle is inserted, and the saline would pump up the expander a few mm each week until we reach the desired size requested. (At this point, she looked at me and my husband—again, my mind went to another area). Once the desired size is reached, another operation is scheduled, and the inserts replace the expanders.

2. Option 2: The Stomach Body Fat Replacement: A few weeks after healing, you return to the operating room, and the plastic surgeon removes fat and muscle from the stomach area and meticulously replaces the area with a mesh screen to hold you together. You are then reopened at the breast site, and the items are sewn into the area. The left side of the stomach items goes to the right breast and vice versa. You will have the drains in both areas to take care of when you are released. Plus, this is another major surgery, so the recovery time is longer. She did have a drawing that a surgeon gave her once that I took a photo of, showing the triangular breast cut. You need to flip the stomach items around so the veins and items can be sewn in.

Reconstruction can actually happen any time—it is just easier to plan and have it started the day of the mastectomy. The breast surgeon, if it is for later, will not stretch your skin as tight to leave room for expansion. And it is a bonus to start immediately. No matter which you choose, you will have surgery on the same area as the mastectomy.

There was more about hospital visits, care—you will have mammograms. And the inserts last approximately 10 years and might be replaced (if medically necessary). And you need to watch for leaks, which is another regular visit to check on them.

I know this is not the complete story; it is just how I heard it. Again, it is an EMOTIONAL vs. MEDICAL decision.

As for me - Plastic surgery consult completed. All options reviewed. The decision remained: Genetic Counseling. Bilateral Mastectomy. No reconstruction surgery.

No. 05: The Mammary Memory of the MRI

Things were happening fast. An MRI was scheduled within days. I never had an MRI. It seemed innocuous enough. Within days, I received a thick packet of papers stuffed into a #10 envelope. Ok, I am in marketing, and when you have a professional office, i.e., a hospital, send you an envelope with photocopies and a handwritten address, you might have second thoughts. Luckily, in the scheme of things happening, I let it pass.

I reviewed the papers. Pretty much the top sheet was what to do and expect for the MRI. No metal jewelry, and let them know of other items that might be on your body. Well, I had a new hip replacement just 4 months before. Even though it is titanium, I dutifully took the card out of my wallet and wrote down on the sheet all the particulars of the new hip. I created my own file and also downloaded all the history to date for that wonderful portal.

The day before the MRI, one of my golf gals (GG) and dear friend called. "Hey, when is that MRI time you told us about?"

Me: "Tomorrow at 1 PM."

GG: "Ok, I'll pick you up at 12:15 unless you want lunch or coffee; it can be earlier."

Me: "You do not have to. They said I can drive; no drugs are used in this procedure. And I am retired. You still work. Every day is Sunday to me. I do not want to put you out."

GG: "Don't be stupid. No, you should not be alone during this. I will take you. See you tomorrow." (Click)

My GG arrived right on time as she said. As we drove to the hospital, she told me that with all her procedures that she has had, she knows what it is like. And besides, being on the other side—waiting—might be fun. And she had her laptop; she could still work.

We arrived and went to the Breast Center. The wonderful woman at the desk looked me up and said, "You need to go to the Radiology MRI dept., not here. Just go out the door to your right, and it is at the end of the hall."

GG and I walked out, and there, big as life, was a sign that said MRI. Oh well. To say sometimes I am not with it during this ordeal may just be an understatement.

At the MRI welcome desk, I was checked in. After answering the insurance and wonderful Medicare questions for the umpteenth time, I took my seat.

The waiting room here was not as active as the breast center. My GG and I just talked about her business and had a few laughs—quiet laughs—this is a waiting room in a hospital, remember.

I was soon called. For once, I could leave my purse and jacket with someone; I did not have to carry stuff with me. The nurse took me to another small room where, again, I was going to change into a hospital gown, opened to the front. Then place your items in a locker, and come out the door and stand.

The change was quick, and items stowed. When I came out the door, the nurse was waiting.

"Name, DOB, check. Any metal items on you?" "No. Check." "Any items in your body?" "Oh yes, my hip," and I presented the sheet I had kept with me emblazoned with the date of the operation and details of the hip.

"You are thorough. Luckily, the hip will be a non-issue. Come stand over here on the pad and slowly turn around. We will double-check your body."

As I did as I was told, the machine, the nurse, and I had the same reaction. My glasses! They had metal frames and put everyone—machine and human—in a frenzy. Handing them off, I continued with spinning in the hall.

Next stop was an alcove with computers and another tech, with a large window that looked into a room with a big tube—the MRI.

Tech: "Name, DOB. Have you had an MRI?"

Me: "No. Am I going to be injected with anything?"

Tech: "No. We will just position you face down on the table; your breasts will be positioned through a hole in the table."

Me: "Oh, like the biopsy table. But without the lift."

Tech (just looking at me with no reaction): "And we will slide you into the MRI, and you will just lay there. We have music for you to listen to—OH, and are you scared of being in a confined space?"

Me: "No. Not that I know of..."

Tech: "And the procedure will last approximately 45 minutes. Ready?"

Me: "Yes. Let's get this going."

The nurse and the Tech escorted me into the room. I took off my shoes, and they assisted me onto the table. I really did not need help; I guess they took pity on this old woman. Plus, they told me there is a big glass picture window, and many people walking through the alcove.

Let me tell you, giving birth to three girls, a teaching hospital, and now this... modesty is not in your vocabulary at this point.

Positioning my face onto a pillow area similar to a massage bed, then centering my breasts in the hole, the two went to work. Tugging and pulling and adjusting, the girls were finally in place.

Tech: "Do you want a blanket?"

Me, thinking I am really tired of being asked this, just said, "Yes." I have decided to just take what is offered as they will hound you. The nurse went and got it. Actually, the blanket was nice; they keep them in a warmer, and it was quite comfortable.

Tech: "Did you want music? What would you like to listen to?"

Me: "I think 70s—maybe Billy Joel?"

Tech went and retrieved some earbuds and fitted them on my ears. "How is that?"

Me: "Great."

Tech: "Ok, we are ready to go."

Since all I could see was the floor, I assume I was in the tunnel. And then it began. After a few bars of a song, the MRI machine kicked in. And no music was ever heard.

That is, until the machine was slowing down, I assume coming to the end of this ordeal. It was then I heard the song playing. And I said, "Oh my God."

I was not aware that the people behind the glass could hear you. A voice came out of the air: "Are you OK?"

"Yes."

"We will be in in a moment, and we will help you get off the table."

The two arrived and began to take the blanket and help me get the girls out of the hole and sit up.

Me: "Did you see anything?"

Tech: "The results are sent to the Doctor, and you should hear very soon," ignoring my question. "Why did you react—what was the 'Oh my God'? We thought you were in trouble."

Me: "I guess you were not listening to the music you were playing for me."

Tech: "No. What was it?"

Me: "'Another One Bites the Dust.'"

I laughed. Seeing me laugh, the other two laughed too.

When I got to the waiting room, my GG was waiting.

GG: "How'd it go?"

Me: "It was loud."

GG: "Did they play music? They always asked me what I wanted to hear, although you couldn't hear it."

Me: "Yeah, asking for music is for naught. But let me tell you the song that was playing when the machine got quiet..."

No. 04: In the 80% or the 20%?

Have you ever watched your car be put up on a lift and the mechanics work feverishly underneath the car's carriage? Well, that is the biopsy.

Arriving early for the appointed date and time, I made sure I sat in the waiting room in a way that I did not have to look at anyone. I was not crying; I promised myself that I will not do that. Plus, it was 80-20. Actually, I do not cry at funerals either. I think it stems from watching the funeral of John F. Kennedy and the stoic persona of his wife Jackie and children. I was young and impressionable, and it made an impression. I digress.

You know the drill about the clothes. I will skip that. The nurse came and took me to another room and had me sit while they prepared the table and computers. The nurse was explaining to me what was about to happen while they worked.

1- I would get on the table face down, with my breast placed in the hole to dangle beneath. Which side would I like to do first as they will be done separately? (I opted for left)

2- Once on the table, they will be manipulating the breast to the best angles.

3- I will then feel a pinch as they will administer a local lidocaine or some such anesthetic to numb the breast.

4- They will then cut and do the procedure; you should not feel anything. (We can pray)

I was led up a stepping stool and placed face down. Moving my arm above my head, one doctor and one nurse placed me and started reciting numbers. A third person stayed at my side and kept patting my arm. "Would you like a blanket?" "No," I said. "I am good."

The other two then proceeded to pull, then pinch. I am not sure what was happening. The nurse kept patting my arm and talking about current events and our hometown. I could not see her as she was on the opposite side of where my head was turned.

From underneath came a voice, "Let me know if you feel this." I did. Not sure what that meant, or what they did, but I then felt nothing. Staying still, I just kept looking at the wall and feeling the reassuring pat. Soon side one was complete.

"You will take a break right now as we prepare the second side." The Doctor left as the other two cleaned and wiped everything down for the second side. I had to ask, "It's just me, same germs, why do you have to clean everything?" The answer: "Protocol."

Once clean, the second side was ready to be prepared. With the right arm above my head and two working underneath, I looked face to face with the nurse, who was standing and continued to pat my arm and again asked if I wanted a blanket. Again, No. I just wanted the entire procedure to be completed. Let us not waste time searching for a blanket.

The numbers again were yelled across the room to the Doctor, and then she said she would start with the pinch. "OK, let's get 'er done." This time when asked to say something if I felt something, all was good. Nothing was felt.

The ordeal over, I sat up and realized I was almost to the ceiling.

"Don't move, stay where you are," came the command. I wasn't going to move anyway; I was just trying to get comfortable. Holding the gown around my torso, I was asked if I wanted anything: a drink, juice, soda, water. I opted for water.

The nurse went to get the water. The other sat with me and proceeded to take blood pressure. It seems my blood pressure was high when I came in. Of course it was high. It is high every time I visit a doctor and now even more so. Luckily now, it was down. I dutifully drank my water.

The radiologist returned and reviewed what was about to happen. The biopsy went smoothly, and it will take a few days to get results. The doctor will call you and let you know. These procedures are precautionary. 80% are benign. Remember that.

And so the first wait began. 80%—not bad odds. We can do this!

No. 03: Strictly Precautionary

So the mammogram that was turned into a second—a magnified mammogram or a sonogram. When I heard "suspicious area found," it became hard to follow. I did hear they found a problem in both breasts and "we want to see more." When I did not hear from anyone in what I thought was a 24-hour period, I went through the portal to my regular doc.

To the credit of my regular physician, she emailed me through the portal and reiterated, "I made the referral, and please be assured this is strictly precautionary."

They did call within the hour, and the appointment was made. And so I returned a few days later.

Now, when you go to the second, "Strictly precautionary mammogram," you realize more of the surroundings. Your senses are on overdrive. As I sat there and watched, I decided the waiting room of any breast cancer center was the saddest place on earth. Women sat there pretending to read their phones; however, if you looked closer, you see the red-rimmed eyes and, although they are staring at their phones "reading," no one is swiping. No telltale finger movement.

The first woman I noticed sat across from me, and she did just that. She stared at her phone like she was reading, but made no movement. As each nurse came out from the inner sanctum ready to call the next name, she looked up with those large red-rimmed eyes—tentative—and I noticed her shaking hand. OK, true confession, I too looked up, although no red-rimmed eyes or shaking hands, waiting for my fateful name. When her name was finally called, she fumbled around for her purse and papers, dropping her phone. The nurse, in a quiet voice and bending to help, told her, "No rush, take your time, all is well." The two left the room.

Next came the woman coming from the inner sanctum. Fairly young—at least younger than me, maybe in her 40s, but I am guessing—in a wheelchair, pushed by a nurse. This woman had tears streaming down her face, which she tried to conceal behind a big tote bag, wiping her eyes. Her friend, who must have been behind me, came rushing around my chair and immediately knelt in front of her. The nurse, woman, and friend whispered a short conversation before I distinctly heard, "I will go get the car." The nurse nodded, and her friend said a quiet, "Thank you." The three left.

The third woman to come out was leaning on two nurses. I heard her say, "I do not have a ride here, I did not think I needed one. I need to make a call, and my phone is almost dead." She was led to a chair. The two nurses sat on either side. The woman requested a Kleenex, and one nurse went to retrieve one and, I assume, make the needed call. But before I could see how this play turned out, it was then my name was called.

As we went down the corridor, I was ready to turn into the all too familiar area from years of mammograms. "Oh, we are not going this way; we have another area you will be going to." I was taken down to the farthest corridor, one with offices on one side, the other with smaller changing rooms, between which had another smaller waiting room.

After the perfunctory "Take off everything from the waist up and gown open to the front. Then come to the waiting room, and I will come to get you" message, she left. I did as I was told and went to sit in the second waiting room.

SIDE NOTE: I have been in numerous waiting rooms now between a new hip and breast cancer. I have one question: "Why on these television monitors do they always play either the Weather Channel or Home and Garden Network?"

As I watched a couple select the new kitchen material for the house, the tech came to retrieve me.

We went into a smaller room. This room was a challenge because between the "magnified mammogram machine," the protective glassed computer area, a chair and table with cleaning supplies, plus the tech and the tech in training (TIT!), we had a small dance together as we maneuvered around to get the breast at the direct angle and position they wanted. I was hit in the nose a few times, met with many apologies, but the hit on the nose really does not compare to the breast being squished and pulled as we played a little version of musical chairs as we tried to get my breast placed. I was at the disadvantage as I could not move too much.

As the tech was doing double duty—training and me—she did a great job. We even had a few laughs. I even offered to help in the future, as I felt trained as well.

Both sides done, I was instructed to return to the room, dress, and go to the waiting room. The radiologist would read the magnified mammogram right away. I did as I was told.

Within minutes of returning to the smaller waiting room, I was escorted to the office of the radiologist. Sitting in front of a computer with two large monitors, featuring the enlarged version of my breasts, the radiologist went straight to business.

"We do not like what we see—here and here," she said, pointing to various areas on both right and left monitors. I stared. I think she offered more explanation, but to the life of me, I cannot remember what she said. Except her last words: "We want to do a biopsy and learn more. Please do not worry; 80% of the time, it is nothing to worry about. We want to get this as soon as possible, though. So, we will look at the calendar and schedule it now."

Hmm, no "they will call you in 24 hours"; we are scheduling it now. And 80% vs. 20%—I like those odds. The nurse escorted me to the waiting room. When she returned a few minutes later, she said, "Depending on your schedule, we can do the biopsy in two weeks on a Friday, but you will have to go to another satellite hospital 45 minutes away, or you can wait till Monday and return to ours, 5 minutes away." What's a weekend anyway, not to mention convenience. So I opted for the Monday close to home. Which, by the way, was April Fool's Day.

Appointment made, the nurse returned to walk me to the door. We got to the T intersection—one way you can leave through the waiting room. The other was the "back way," the route established when Covid protocols were in place. I opted for the latter, not because I was scared, but it was familiar to me. The nurse, however, took it that I wanted to escape. Placing a reassuring hand on my shoulder, she quietly said, "Everything will be alright, I know it will, and remember, 80-20."

Good odds. And so the next step was in play—The Biopsy.

AGAIN—Ladies, get that mammogram. Early detection does save lives.

No. 01: The Best Mammogram Ever

The call to the Breast Center to schedule a mammogram went easily enough. As a self-employed woman, I can create my own schedule. I always asked for the first available. And the first in the morning.

The reason for the first in the morning is to get the tech when they are fresh, and you are at the front of the day—not beholden to a delayed schedule and forced to sit in the waiting room for an hour. Please note there are signs that say, for a wait longer than 30 minutes, please see the front desk.

This day started great. I arrived 15 minutes before the allotted time. Checked in. Reviewed the clipboard with the health questionnaire and quickly took a seat and completed the form. All was good. It was not long before the tech came out, announced my name, and took me back to the changing room.

After the perfunctory rules: You did not have any creams or deodorant on. Take off shirt and bra and put on this shirt; keep the opening to the front. After years of this, I simply smiled. When you are ready, come through this door to the mammogram room.

I did as I was told and soon came into the room. The Tech asked me to take a seat; she was still booting up the computer. As I took my seat, the fire alarm went off.

"We need to leave," the tech said. "Tie the front together. Follow me."

We were soon outside standing under the front door awning. A security guard soon came and requested us to move farther out to the curb. No one was to be allowed back into the building until an inspection was completed. They had to be ready in case the fire truck came.

It was early spring, so it was a little cold outside. My little cover was really not enough. The tech, who remained by my side, kept rubbing my arm, telling me we will soon be back inside. It took 30-45 minutes before that would happen. (Remember, this is one reason I asked for the first appointment; just think of the person who came later!)

Back inside, we returned to the mammogram chamber. "At least the computer should be booted up by now," said the tech. "Let's get this going."

Untying the shirt, I looked down. "Boy, I was cold," breaking the ice... so to speak.

The tech hurriedly prepared my right breast. Pulling, tugging, squishing. Once she had it where she wanted it, she retreated behind the wall. "OK, hold your breath."

The machine started on its path around the breast... and stopped at the top.

"Oh my, what happened," said the tech as she immediately was at my side, and pushed a button on the floor that immediately released the trapped organ.

"You tell me, I am just standing here."

The tech pushed a few more buttons, then said, "Take a seat, I need to reboot the machine, this might take a moment."

I dutifully sat down. And waited. Within moments, the machine returned to its original position, and the tech asked, "Ready to try this again?"

"Sure," and I placed my glasses on the side table and took my position.

The mammogram went smoothly—this time. Since I had already told them I would wait for results, I asked if I may change my mind and get a phone call—since we had already expended two hours. The Tech said no problem.

I went into the little room, removed the gown, and got dressed. Placing my garment into the bin, I left the hospital and reached my car. Only to realize, I had left my glasses in the exam room. I turned around and went back. As I stood at the welcome desk trying to explain I had left my glasses, the woman asked me if I knew which room it was. Just as I said yes, my tech emerged from the inner bowels of the hospital, my glasses in hand.

What a day. I told her to have an awesome day... we smiled at each other. Best mammogram ever.

P.S. - I DO RECOMMEND MAMMOGRAMS... EARLY SCREENING.

No. 02: The Mammogram That Was

Ok, so the Mammogram, which should have been in the fall, was postponed by me. I had decided with a hip replacement and numerous doctor visits, x-rays, MRIs, and thick books of instruction, it would not hurt to not get the mammogram for a few months.

The hip replacement went well. Within weeks, walking and golfing returned, and PT ended. It was time for the regular Well check-up. Blood taken, reports submitted. I dutifully sat in front of my provider. Weight down. Blood work looked great—not even pre-diabetic—blood work looked great!

But wait, where is the mammogram? "You have not had one for a year. Let us get one scheduled."

And so it began.

The morning started like any other. Shower, brush teeth, dry hair, and do not apply deodorant. The mammogram appointment was first thing in the morning, 7 AM, and deodorant was forbidden. No problem, will add it later.

Arriving 15 minutes before the allotted time, the registration area was empty, except for me and the team behind the desk. As I am of the Senior age, I got to answer all those wonderful Medicare questions... questions that are asked all the time. Did you know you cannot give a blanket response? They are required to say the entire script. More about that later.

The forms completed, a seat was taken to wait for the name to be called. As I watched, saying a silent prayer, it was not a long wait (another reason to be the first one—or near the earliest time available).

As we made our way down the hall, the tech started the dissertation... go into the room, remove everything from the waist up, and gown opened to the front. The tasks performed, I opened the door to the room.

The tech was ready. Step up to the bar! As she lifted, tugged, and pulled the breast onto the platter, we exchanged pleasantries. What can you talk about as they work around you? What's a great girl like you doing in a place like this? My go-to questions are how did you select this profession and do you come here often?

As she smiled and went behind the glass wall, she said, hold your breath. The machine made its round about my trapped organ. It then released, and I could stand back.

Time for round 2! As she moved the second mammary into place, she moved the machine a bit, hitting me in the face. "Oops, sorry. Didn't realize how close you were." No problem... just finishing what you are doing so we can end this torture.

Stepping behind the glass, the hum of the machine began and the command to hold your breath. Task complete.

"OK, you are done—the radiologist will read the scans, and if there is a problem, you will get a call within the next 24 hours. If nothing, you will get a letter in the mail—or you can check the portal. If you want to use the deodorant, there is an aerosol can in the dressing room for you." Obviously, breast cancer results pale in comparison to the aerosol can and our environment.

Within a few hours, a call came. "We found a problem, and we need to do another mammogram-sonogram—not sure which, I only heard they found a problem... you will get a call in the next 24 hours to schedule."

So at hour 20, I emailed my regular doctor as I had not received a call. No worries, the order had been put in... and it is strictly precautionary. Please do not worry.

Strictly precautionary. Please do not worry. Is that possible? I kept that information to myself. The call to schedule an appointment came; it was made next week.

I AM A Big girl. I can handle this.