Monday, February 9, 2009

2/9/2009: The Nightmares

Submerged in cool water the sheer white gown clung to my skin. My long black ringlets danced in front of my face. My ears filled with water and buzzed calmly giving silence to everything around me. I looked to the surface of the water where I saw angels and demons circling vigorously above. I released all of the air from my mouth watching the tiny bubbles dance quickly toward the light. I closed my eyes and was peaceful.

Opening my eyes I was engulfed in the darkness of my room. I waited a couple of seconds, and then gasped for air. My dreams were becoming more vivid and I knew this meant that things were about to change significantly. I noticed a severe pain in my left breast. Sitting on my bathroom floor I held my knees to my chest and rocked myself back and forth. I was dizzy and nauseous from anxiety. I knew something was wrong. How could I get sick the day before my biopsy?

Within a couple of hours I was admitted to Reston Hospital and was started on a series of antibiotics through my IV. That evening my plastic surgeon, Dr. Gottlieb came to see me. She reviewed a couple of options for surgery. It only took a couple of minutes and I told Wendy to remove my implant and not replace it. My mother looked at me wide-eyed and reiterated what the surgery meant. I nodded with a knot in my throat and said, "I know -- I will lose my breast." I asked Dr. Gottlieb to also remove the scar tissue and lymph node on my right side while she had me under anesthesia. I figured it made sense to just get it all over with at once.

The infectious disease doctors noticed a murmur in my heart beat and so following surgery I had an echogram done. I cannot even stomach explaining this test even now. It was truly excruciating since they had to rub and push against the crater that was now my left breast. The doctors were worried that the infection had moved to my heart. Luckily they reported back that my heart was "so incredibly strong." My parents burst into tears hearing the news.

My body was not so lucky though when it came to the infection. The tests found that I had a bacteria much like an intestinal infection (urinary track infection) in my breast. I asked my oncologist if this meant that I touched my vagina then my boob. He laughed and said no, but that it was good to see I hadn't lost my sense of humor. I then proceeded to tell everyone who entered my room that my vagina had made me sick. Stupid vagina! Additionally, the tests found that I had a contaminant infection in my mediport. I am now on a series of strong antibiotics for the next couple of weeks to bring my body back to life.

Dr. Gottlieb removed two areas of scar tissue from my right armpit area. I have a teeny incision about an inch long that itches like crazy! My doctors believe that the smaller piece of scar tissue is what was reported as a "questionable lymph node" on my PETscan. Both pieces of scar tissue were dissected and tested. NO CANCER WAS FOUND. I am elated. I will be tested again in a couple of months once my body has bounced back from this surgery and the inflammation has gone down. I will have check-ups every three months to ensure that I remain cancer free.

I was in the hospital four days and despite the cancer-free news, endless love and support of friends and family and the compassion of my nurses and doctors there was a looming sadness for the loss of my left breast. My last day in the hospital, Dr. Gottlieb arrived to my room to check my incisions and remove my drainage tube. She was bandaging me back up and the tears started rolling down my face. She sat on the edge of my bed. I said, "I know I am cancer-free and that I should be so happy, but I am consumed with the loss of my breast." Dr. Gottlieb said, "Jennifer, I am reconstructing one of my patients breasts this month and she is 50 – vanity is real no matter the age. It doesn't matter if you are 27 or 50 – you are a woman and you have lost something that defines you physically in that way. Don't be ashamed for feeling the way you do … you are entitled. And believe me that every woman working on this floor who has been changing your bandages, administering your medicine, or checking your vitals aches seeing what you are going through." It will be two to three months before I will have surgery to reconstruct my left breast. This will entail taking skin, tissue and muscle from my back or stomach to create a new flap for my breast and putting in a new implant. The good news is that the new skin will respond much better than the radiated skin, it will be done by swimsuit season … and I will be able to upgrade.

Leaving the hospital my nurses cried and hugged me. Many of them remember me from my other stays. Like Dr. Gottlieb had described, I saw the pain in their eyes -- they ached for me. Perhaps they were happy it wasn't them or imagined themselves or their daughters in my place. Regardless, I just hope I made an impact. Once I arrived home I unpacked my things.

Dr. Gottlieb had left two pink Victoria Secret bags in my hospital room. One bag contained prosthetic inserts for my bra. They other bag … two sets of beautiful lingerie and Godiva chocolates. As a woman, Dr. Gottlieb also understood the pain and the loss I was experiencing. She is a class act. I was moved to tears by her kindness and compassion.

Despite my pain, I am not ready to stay submerged in the cool waters of my subconscious. As long as my heart is strong, my spirit is vibrant and my vagina is kept clean, I will continue to fight. Keep circling angels and demons above the thin surface that currently separates us ... for my work here is not done.

Monday, February 2, 2009

2/2/2009: New Lump

I unbuttoned my blouse, took his hand and slipped it under my bra. I guided his fingers to the lump and said, "What the f&%k is that?" His eyes got bigger as he started pressing on the lump and pinching it between his fingers. "It feels like it is sitting on your rib. I'm going to need you to undress and put on a robe so I can examine you," said my oncologist, Dr. Heyer. He left the room and I crumbled into the chair. My jaw clenched with the onset of an anxiety attack and I could feel my heart surging out of control.

I was in the oncology office for my second to last Herceptin treatment and had not intended to talk to Dr. Heyer about my new found lump until I saw him in the hallway speaking to his assistant. I passed by making idle chit chat with the nurses and doctors. They all marveled at my thick black locks and gave me lots of loving hugs. They had all experienced my journey and were elated to see me healthy. Dr. Heyer must have noticed that I was acting different. He said, "Do you need to talk to me?" as he walked toward the conference room. I said, "Yes, but I need you to feel me up." He said, "Oh – then we'll need an exam room." (Is everyone just so used to my inappropriate comments that they just ignore them now?)

Dr. Heyer pulled my gown open and moved my implant away from the lump to ensure that it wasn't just the edge of the implant. He said, "This doesn't feel like a tumor, Jennifer. This feels like scar tissue or part of the implant. I can move it around. Talk to Wendy [my plastic surgeon] on Monday and have her look at it." He left the room and the tears ran down my face. Thank God I don't have cancer again.

Today I went to see Dr. Gottlieb (my plastic surgeon) to have my stitches removed from my left breast. I took her hand as I had Dr. Heyer's and laid it on the lump next to my right breast. She looked at me concerned. "I think we should biopsy this. With you, we'd rather be safe then sorry." I was shocked. I told her about my recent PETscan and her office called over to get the results. At the same time Dr. Gottlieb called my surgeon, Dr. Mason to get a second opinion on the biopsy.

"I have your PETscan results and I want to go over them with you. I am not good at reading these things, so I need for you not to freak out when I tell you what it says." I was numb and staring blankly at Dr. Gottlieb. Her lips were moving but all I could hear was the high-pitched horn of a truck running me over. "… newly enlarged right axillary lymph node measuring 13mm with abnormal FDG uptake with SUV of 2.6 is suspicious …" WTF was happening? I have cancer again … but on the other side??? But I did everything right, even giving up my right breast to prevent this. How did this test know that I drove an SUV? How could this happen twice to the same person???

I heard nothing else she told me besides the fact that I have to have a biopsy on Thursday morning in Arlington to test both the mystery lump (which everyone thinks is scar tissue) and now my "newly enlarged right axillary lymph node measuring 13mm." Walking alone to my car at Reston Hospital I called my mother. "I have bad news and I have bad news. The lump needs to be biopsied and I think I have cancer again." Silence. How many times must my family bend before we eventually break?

Dr. Heyer called me to review the report. I was in a meeting with my team at work and scrambled, stumbling over a chair to exit the room quickly. My voice shook on the phone with him while my throat tightened to keep me from bursting into tears. "Did you see the report? What is going on? I did everything right. How could I have cancer again? What do I do?" He waited patiently for me to get out everything that had built up for the last two hours.

He explained that he hadn't received the actual images yet (just the written report) so he doesn't exactly know what we are dealing with. He said that this lymph node had an SUV of 2.6 and my previous tumors had an SUV of 17 and 18, so this one is not 100 percent identifiable as cancer. He said it is very possible that the lymph node is simply inflamed from the surgeries I have had and that he isn't convinced that it is cancer. I told him how confused I was due to the fact that I never had cancer on my right side. He said that cancer is always a possibility for me but that he finds it highly unlikely. Even so, it needs to be tested so that we know for certain.

Thursday I will have my biopsy …