*It*Was*All*Yellow*

December 13th, 2020

I have 2 days left with my breasts. It’s funny how your perception of yourself evolves over time and with different variables. I know I spent a great part of my youth wishing I had bigger boobs. Then, after I had children, I wished for my boobs to be even in size and less pancakey with nipples that pointed straight forward and slightly up, rather than one towards the ground, the other down and slightly to the right. At this moment (and most others since the first conversation with my cancer surgeon), I have never wanted my breasts just as they are more than I do now. With surgery impending, I am mourning a loss. A loss of what I’m used to. A loss of what fed my children (no matter how brief the time). A loss for a significant factor in the intimacy I have with my husband. A loss of sensation. A loss of something that has grown and changed with me through the years. Just a huge loss.

I’ll start from the beginning with my timeline thus far:

October 15th, 2020

Originally, my mammogram was scheduled for October 16th, but my work people were able to cover me while I went to the Breast Center at work. (Yes, I’m in Healthcare…. Registered Nurse, but my specialty is cardiac. In no way cancer). So, little did I know that this soon-to-be overwhelming journey would begin on my husband’s birthday— 40th to be exact, 1980s babies. I had just turned 40 fifteen days before which has become a running joke in our relationship, especially now that we’re getting older. (i.e. in 15 days, your back won’t let you get out of bed either). Anywho…. I decided to grow up and schedule all of my adulting appointments that I had been ignoring, some since COVID and some just because… why not? I scheduled my mammo, a new PCP (no doctor for me since I was in college) and my GYN appointment. After my mammo, I just went about my day. As a side note: I have been getting mammos since I was 34, about every 2 years. Several young people I knew or knew of had gotten breast cancer at an early age. As a closet and deeply swallowed hypochondriac, that freaked me out. (Plus the free rose, chocolate and mini-massage on Valentine’s day, when I normally go, hooked me). Anyways, as much as people talk about dreading mammograms, they are in no way an issue for me. They’re just necessary.

The following week, I got a phone call from the Breast Center Coordinator, that they wanted me to come back for a Diagnostic Mammogram because of a change detected on my screening mammogram. (What?? Why??) One of my co-workers had just had her mammo and had to go back for a follow-up as well. Hers came back as a lymph node, and she assured me that mine would be fine as well. (Okay, fine… I’ll buy that).

October 26th, 2020

It seemed like it took forever, both to get scheduled and for this appointment day to finally arrive. Although I always have underlying anxiety, I went into that appointment with a clear mind and my work-friend in my head, literally no thoughts about it all. The tech seemed nervous to me, not sure what to say and fumbly. I try my best to read people in situations, body language/facial expressions. Maybe she’s just anxious at work…. I know I am. It’s almost like putting on a show every day. I have to be extroverted and confident which literally drains me by the end of the day. The tech tried to show me on the previous mammogram what exactly it was they were looking at, but I could not follow. There was an area that looked like a spot to me, but not where she was pointing. So, from this I concluded that it had to be nothing, right?

We continued with the diagnostic mammogram, lots of different types of smooshers and in different angles. Super interesting. After that was over, she told me to wait again in the lobby and my results would be given to me before I left. (Ok, sure) I waited for about 10 minutes. From a door on the opposite side of the room, a thin, nice-looking man (my mom says this kinda stuff) and the mammo tech walked toward me with somber, business-type faces. He introduced himself as the radiologist. He sat directly in front of me, using all the clear body language indicators that this conversation was important. As I sat there listening to him, my mind seemed to be floating around in my head, like I wasn’t really there, or maybe I was just watching this evolve on TV. But, it wasn’t me he was really talking to…… what is he even saying?

An area of calcification……

We will schedule you for a biopsy……

We’d like to get you in as soon as possible…….

(Only snapshots…. that’s all I remember)

After I left that appointment, I sat in my car in the parking lot, as I do a lot of the time when I need to unwind. I immediately turned to my friend, Google, like most of us do (see link below). And what I read was overwhelming. But the word that bothered me the most? BIOPSY. That word means something. I deal with radiology patients at work. They come in for biopsies of their liver, lung, etc. They all KNOW that there is a problem and they come to us as a first step in how to DEAL with this problem. So, to me, that was a final word. Even though many women have biopsies that turn out to be nothing, in my hypochon brain, it was final. Driving home that day, as a person who doesn’t often cry and who tries to pretend like they have their shit together, I lost it. I was sobbing. I had already called my husband. We discussed it and decided that it is what it is, my current mantra. But, alone in my own head, with all the ping-ponging, the tears exploded. I pulled over in a National Fitness parking lot about 5 minutes from my house. I needed to get composure before I got home to my children. I called my little sister and word-vomited all this information that I had withheld from her in the assumption that all was going to be fine. And maybe it still would be, but in that moment, my world was crashing. She offered to drive in early from Nashville (in the middle of a move from D.C., she was basically homeless and trying to figure out her own life, but selflessly came to my side when I needed one of my longest, closest friends).

Hopefully it’s nothing. We’ll probably just do a repeat Mammo in 6 months (after reading my initial screening mammo)

https://www.breastcancer.org/symptoms/testing/types/mammograms/mamm_show/calcifications

October 27, 2020

First meeting with my new PCP.

Sorry to drop this bomb on you……. (she had already sent the order for the repeat Mammo without ever having met me which I was so thankful for).

Oh, well, now if that was me, I’d have that removed no matter what (after realizing the results of my diagnostic mammo were also resulted). Guuuuuuhhhhh. Deep down I knew she would be saying this to me.

A very thorough visit…. came away with some happy pills and help with a plan.

October 29th, 2020

Biopsy day. I definitely don’t wanna do it, but I’m not gonna tell anyone that. I wasn’t sure where the anxiety was coming from: fear of pain or fear of final results and what that could mean for me. Luckily, for me, pain is all relative. After the birth experience I had with my first son, Pete, I compare all levels of pain to that. Surely, a breast biopsy can’t hurt as bad having needles injected into your downstairs, being sewn back up on two separate occasions after discharge.

I cannot thank the staff of NKMC Breast Center enough for their care during my biopsy. I have been a nurse for 15 years and can recognize exceptional care when I see it. Unfortunately, I have seen the gamut of healthcare individuals which is always super disheartening. However, these ladies were all very informative, connective and calming during the difficult sections. Such a weird feeling to be laying prone with your boob hanging through a hole. Then to have needles for numbing and even bigger needles for taking some core samples for the biopsy. The tissue removed then has to be x-rayed to make sure they got a part of the calcifications that were found. While you’re waiting for the x-ray to be read, you are essentially laying there with a needle in your boob and instructed NOT TO MOVE. Another nurse came in to sit with me and chat while that needle was in place. (Nerve-wracking, sweating, blah). They placed a small clip in the area that the calcifications were located. The nurse who prepped me and was with me as I got ready to leave shared her story with me. She told me that she had 3 clips in one of her breasts and that there never was a problem. (Ok, yes, that sounds good…. we’ll go with that for me).

November 2, 2020

DCIS……. (phone call from Breast Center confirming Intra-Ductal Carcinoma in Situ.)

What is that? As I’ve said before, I am a cardiac nurse and have severe tunnel vision to that end.

At the most, you may have to have radiation……..

Where is my friend Google? (Diagram from American Cancer Society: Ductal Carcinoma in Situ (DCIS) (cancer.org)

Treatment for DCIS (komen.org) <——- Good info for DCIS (Source: www.komen.org)

November 5, 2020

First meeting with my cancer surgeon. (Originally, I was scheduled with a different surgeon. My manager was insistent that I go with my current choice…… so it helps to be a part of healthcare with people who have your back, make recommendations for you and keep you away from those with a bad reputation.)

I must say, being on the other side of medicine, you certainly have a different perspective. I consider myself to be highly observant (of facial features, repetitive body movements, idiosyncrasies specific to a person, body structures, mannerisms, etc.) And so with the mask requirements during this COVID time period, I feel an impediment to complete my normal analyzation of people to the fullest extent. I find it odd that someone who I have not, in my head, completely and fully met will be performing an important surgery on my body. In my own day-to-day at the hospital, I always found it odd that patients look completely different in hospital gowns versus street clothes, at times almost unrecognizable. Now, when I ask patients to lower their mask for a temperature check, the lower portion of the face can come as quite a surprise compared to my imagination.

All this to say, I didn’t enjoy that part of it as a patient, but I do quite enjoy my surgeon. She is certainly business, and I will come to know her as a true Type A personality in the future, but for now I am trusting of her.

Besides the appointment in which the radiologist told me that I needed to have a biopsy to figure things out, this first meeting was one of the hardest, if not THE hardest, for me to swallow. Before meeting her, I had already made the decision to have a bilateral mastectomy. I always knew this would be my choice. One of the most amazing women I have ever met, lost her battle with breast cancer after 3 separate diagnoses. Each diagnosis was about 10 years apart….. started with a lumpectomy, the next came back in the other breast and the third was metastatic. I put myself in her shoes…… every 10 years puts me at 60 when I die. Even though there are thousands of individual stories out there that start, climax, and resolve in any number of ways, her story, in my life, was the most poignant. She helped me to make my decision swiftly and resolutely. Although I am sad that the world is missing a gem such as her, I will be forever grateful that she courageously went through what she did in order to make my choice that much easier for me.

That was not the hard part, however. Losing breast tissue? No biggie……. Losing my nipple? I have anxiety on a normal day…. social-wise, performance-wise. I have the full-body sweating (not just the pits), voice-shaking, scrambling for words, flushing of the chest that spreads up my neck to my face, a “mood dot” on my forehead (which is some other medical mystery for another date), heart racing and tremors. But that day, and with those words, I blanked out. She was still talking, I know. There were flashes and words that I caught, but not many. Luckily my sister was there to listen and take notes. I remember staring straight forward and upwards at the door with the info tag for self-breast examinations hanging from the hook. All the many thoughts in my brain multiplied at that time and cycled through like flashes of all the bad outcomes I imagined in my head. No nipples? I can’t keep one without the other….. will that look weird…. 3D tattoos…. muscle reconstruction….. nothing? I seemed to come back in for a fleeting moment at the 3D tattoo comment. She pulled up an example on her phone which (unintentionally) was the wrong example for me. The photograph showed a newly created nipple that was tattooed in symmetry with the other breast and shaded to match, however the original nipple was still there and shaded to match the natural skin color, so that, to me, it looked more like a wart. I understood the concept, but in that moment, I was horrified and that lump crept right on up to my throat with the hot liquids not far behind. I could not imagine, at 40, that being my fate. It sounds so vain, considering the spectrum of disfigurements that are possible in the world, but in that moment, it was more than I could handle. (As a side note, this specific part of the story has been something I have been able to come back and find comedic relief in, in no way poking fun at anyone else’s outcomes, just the happenstance of the situation and my particular peculiarities.)

I do my best to keep my composure in all situations, outside closed doors at least. After I hugged my sister goodbye as she was leaving the hospital and I was returning to work, the enormity of that conversation and what it meant to me suddenly hit. The tears flooded (again)…. even the embarrassment of being caught sobbing (re: anxiety) couldn’t hold the tears at bay. I walked down the mostly empty halls, trying to pull it together on the 2 minute walk, when I ran into my closest co-worker. Blubbering. Snot in my mask. Blotched face. We hug, but she won’t let me do that for too long and I know its her way of telling me to buck up. It’s only a body part, it’s not you….. and at least you will still be alive. I have said I don’t want to be treated differently just because of this. I don’t want anyone to feel bad for me….. and that was her way of showing me that. That day and the biopsy scheduling day are the only two times I have cried (as of yet- I am finishing this post still two weeks out from surgery). “It is what it is” became my daily mantra after that…. what else can you do?

When I got out of work that day, I found a note on my windshield (flashback to high school). “LOVE YOU SISTER! You’ve got this!” She also knew that was a hard day for me. There were tears all around that day. But that’s enough of that.