Eviction Notice - You Got Served!

Finally - surgery.  Lumpectomy, sentinal node biopsy, and port placement.  Having been through each of these procedures before (albeit at different times), I thought, Let's be practical - I've got a holiday off work, let's do this all at once and get it over with.  I'm literally "shivering with antici......pation", wanting so desperately to have answers to the myriad of questions that continue to grow each day.  So we schedule all three procedures for yesterday and, well.......I'm glad it's over with, but what was I thinking?  Thank god for Vernors and pharaceutical intervention.

I received word late last Friday that my insurance had approved genetic testing, so the first stop of our day (dubbed "The Tour of a Thousand Pokey Things")  was the oncology center for the blood draw.  Instead of utilizing the lab they took us back to the infusion center, "Chair 11" (which is designated by a large, glittery Vegas-like arrow hanging from the ceiling).  I remember this chair from previous visits as the location where Neulasta shots are delivered.  I hadn't been back to the infusion center since my last chemo almost four years ago, and was quickly reminded of The Smell - medicinal, salty, Heparin-y, icky, that smell you can taste in the back of your throat, the smell you still smell in your dreams and nightmares.  It's a scent unique to the infusion center, and for some reason I felt tiny tears spring to my eyes, but only for a moment.  Got no time fo' dat, not on a busy day like this.

I was in the infusion center, it seems, because the nurse thought I already had my port and planned to draw the necessary blood from that.  Alas I did not, but she quickly poked me with a butterfly and we were off to the hospital to check in.

(Damn the "nothing to eat or drink after midnight" rule; I desperately needed some gum or rum, or even a good run, to get that tasty smell out of the back of my throat...)

The outpatient surgery unit now requires the patient to use warm, sticky wipes to clean and prep the entire body to reduce infection.  Luckily, I got to give myself the sticky-wipey-sponge bath, but then I stand there naked and wet, freezing and sticky, waiting to dry off just a little bit before putting on my gown.  Which then sticks to me everywhere anyway.  I put it on backwards first - easier to tie in the front, I figure they'll want it open with Lucy more easily accessible.  Except that Ethel kept peeking out, jealous again the Lucy was getting all the attention and hoping someone would take notice of her too.  So I peel the gown off my less-sticky body and put it on properly, having Ken tie me all up the back.  As I slide back onto the hospital bed I notice a little pocket on the right-hand side and, looking down, see Ethel winking up at me.  Damn you, broad - you really don't want a piece of this shit...

And so the action of the day begins.  First stop is the radiology department for an ultrasound-guided wire placement.  The radiologist who performed my biopsy a couple of weeks ago is present to once again stick stuff in Lucy - this time an ultra-thin and super-long wire to pinpoint the exact location of the mass to be removed.  The surgeon asked for this wire placement to help him locate the mass.  Instead of making an incision directly above the mass (which would leave a visible scar near the center of my chest), he was going in at an odd angle from somewhere between the mass and my nipple (which is the area that will be removed during mastectomy, so ultimately no scar will remain).  A few numbing shots and the radiologist inserts a needle into Jabba (this time I watched on the ultrasound screen - which was both creepy and fascinating), then slides the wire into the needle, and into Jabba.  In, also, goes some blue dye to mark the location, and out comes the needle.  I look down to see about 6 inches of wire coming out of my breast.  WTF?  I think the puppy-dog fear in my eyes belied my concerns; the radiologist smiled and said, "Don't worry, we'll wrap it up for you."  And that he did - coiled it around his finger, laid it on my breast, then covered the entire area in a plastic bandage.  

That's handy.

The wire inserted, I am whisked down to mammography, to squish Lucy (with a WIRE inserted into her, no less) in all directions to ensure the wire is where it needs to be.  That fun is followed by a trip to nuclear medicine for the sentinal node injection - except this time, I'm being blessed with two injections.

I've had this injection before, and I know what's coming.  The needle poke itself isn't the hard part - that's the "bee sting" they warn you is coming.  "Now you'll feel a little burning", says the PA, as he injects the radioactive solution into my breast.  Except that it feels like molten lava trickling down the needle and into my breast.  Last time I had this injection I vaguely remember levitating off the table.  This time I burst into tears and cried out loud.  Before I even realized it I was begging the PA stop.  Bless his heart he said he couldn't stop, and I knew that, and I didn't really want HIM to stop, I just wanted the pain to stop.  In 10 seconds the injection was over, but the hot-poker fire of pain remains, and I cry for another minute as I compose myself to prepare for the next injection.  I cry again, I levitate slightly, and it's over and done with.  I apologize profusely, blubbering and embarrassed and angry and feeling so, so stupid.  The nurse - her nametag indicates she's a student, and I felt really bad she had to witness my inability to endure a little pain - pats my hand and says, "No need to apologize, we should be apologizing to you for hurting you!"  The PA is already long gone, no doubt frustrated with my lack of control (I know I am). 

After all this fun we make it back upstairs to pre-op.  In my absence someone's decided to give birth, and my anestheiologist is busy with the c-section.  My surgeon has his hands in someone else, so we wait patiently for our turn.  And then suddenly everyone's on our doorstep, making introductions, shaking hands, explaining procedures.  

I've had a cold for a couple of weeks and I decide at that moment to have a small coughing fit.  One doctor smirks, and says cancelling surgery now would be like cancelling a colonoscopy after all the prep.  She warns me about the possibility of pneumonia as they'll be intubating me, and makes me promise to see a doctor if my cough becomes "productive". (Sister, I've got a WIRE in Lucy and molten lava coursing over to my lymph nodes, so I'm pretty sure that we're going ahead with this surgery, m'kay?)  

Our surgeon lifts up the mammogram films to ensure the wire is placed properly, and says, "I don't see anything."

I pull down the top of my gown (which has never been properly rebuttoned after all this fun) and point to the wire coiled neatly on my breast.

No, he says, I see the wire.  But the tumor isn't on the film.

He shows it to me, and sure enough - there's the wire.  And there's the little clip the radiologist left in my during the previous biopsy.  They're both there, on the film, as though they're hanging in mid-air.  There's nothing on the mammogram to indicate there is any tumor or mass or growth or anything in my breast.

I look at him quizzically, cocking my head to one side, saying, "What the hell?"  He picks up the other film and holds it to the light, and we both squint to scrutinize it (it's my boob, I get to play doctor here).  "There," he says, pointing to a faint haze, just slightly darker that the surrounding breast tissue."  That must be it."  I squint a little harder, and it's there, but barely, not really, just maybe...  I ask if that's what it should look like and he says no.  I tell him we saw it on ultrasound, I know it's there.  He knows it is too, seems more curious than concerned.  I've got joy juice in me by that point so I really don't care.  Hopefully he follows the wire down the rabbit hole and finds Jabba at the other end.  I just kinda want to get this show on the road.

I vaguely remember being whisked to the surgical suite and sliding over to the operating table.  I'm fuzzy by now but I remember thinking the table felt vaguely crucifixion-like, as my arms lay on the arm boards sticking straight out from the table, using "seat belts" to strap my arms and legs to the table.  The mask covers my mouth and nose, I remember one, maybe two breaths...

...and then I'm waking up in post-op, covered in warm blankets with a canula up my nose and that little blue cap falling into my eyes.  The clock across the way says 3:05...blink-blink...now 3:30...the nurse is poking me to wake up, takes the canula off, then puts it back in, takes off my cap, now the clock says "moooooo....", wait, almost 4:00...

I get the pain-scale question, I'm fuzzy but it's a 5, although I want to say a 6 but I feel like I should say 4 but what the fuck let's just say 5, no 6, then the Fentanyl brings it down to a 3...

I get the lecture about staying ahead of the pain, and it's then that I realize my entire chest is covered in puffy gauzy bandages.  From my right shoulder over down to my left side.  Ken comes back and explains that everything went really well. 

Portia is back (I'm reported," I say to my nurse...who crinkles her nose in confusion...really?  Ported again?  Re-ported?  Reported?  Sounded funny in my head...).  

The surgeon was able to find two sentinal nodes and remove them.  No visible signs of cancer but they're off to pathology for closer inspection.  "She won't be happy," the surgeon tells Ken.  The nodes were far apart so there are two incisions, one under my arm, the other farther down.  And he's wrong - I'm ecstatic and would be even with more incisions.  There was a good chance we wouldn't find sentinal nodes due to previous radiation to that area, so I'm feeling grateful and very, very lucky.  Even if one or both of the nodes contain cancer, the chemo I'm about to start should knock out anything left floating around.  This also means I'm very unlikely to need a complete node dissection when I have a mastectomy later this year, which lessens my chance of lymphedema and other complications.

And the wire did its job - Dr. F was able to find the tumor, hiding under a layer of scar tissue, a corner of which had grown down into the cancer and was actually calcifying.  We now know the tumor was 1.5 cm, the size originally estimated.

Jabba has officially left the building.

The clock strikes 5:00, and Ken helps me dress so we can get outta Dodge.  He is with me through all of this, never leaving my side.  He's allowed to watch (again, from the corner) the wire localization; he walks with me through the halls and waits during the mammogram; he stands near me during the injection (and offers his hand for squeezing, although I fear I would break it) and watches the screen when they scan me, 15 minutes later, to ensure the radioactive material is moving through my breast.  He wipes my tears, strokes my head, kisses me gently.  I always say I can do this by myself, but I'm not-so-secretly glad that I have him with me every step of the way.  He holds me close and tells me he wishes it could be him.  And I - I am so glad it's me and not him.  Sometimes, I just don't have words to describe how very blessed I am.

We should have the answers we need later this week, and genetic test results should arrive some time next week.  My oncologist wants me to wait three weeks from surgery to heal, so my hope is to start chemo on March 8th.  Next steps are Chemo School (maybe I'll get lucky and flunk out...) and meeting with plastic surgeons.  Yes - getting back to Livin'.

But for now, yesterday is behind us, and tomorrow is another opportunity to find gratitude in the moment.  

Goodbye, Ned; Hello, Jabba

Those of us from Breastlandia are monitored closely for signs and symptoms of metastatic recurrence for the first two years.  Different kinds of breast cancer, however, have different long-term metastatic recurrence rates.  ER+ Invasive Ductal Carcinoma (or IDC) can recur years later; the first three to five years is critical for triple negative.  Her2+, Invasive Lobular, Luminal A or B subtypes - all have different ranges for metastatic recurrence.  This is why some of us aren't comfortable or just can't bring ourselves to say we're "cured" until, perhaps, we die of something else.  There is a shadow of looming recurrence, waiting for the other shoe to drop, hoping and praying that day never comes.

So once treatment was complete and my scans and bloodwork and exams were normal, my oncologist pronounced I had "No Evidence of Disease."

And so I started dating Ned.

Now, in my mind Ned looks like this, all hot and sexy and warrior-like, brandishing his sword to slay any rouge cancer cells circulating through my body, determined to fight back any chance of recurrence:

"Hey girl..."

I liked dating Ned.  Pretty sure Ken liked me dating Ned, too.  But alas, our relationship has come to an end.  If he had to leave, my hope is that Ned has moved on to another relationship - or, rather, a multitude of relationships - and that they last a lifetime.

And now I'm Hangin' with Jabba.  I was able to get a disc of my original ultrasound, where I caught my first sight of Jabba:

"Hey girl..."

Okay, so not really.  Here's the actual image from the ultrasound, with Jabba outlined for clarity:

See the resemblance?

On Monday, Jabba will be evicted - or, at least most of Jabba will be breaking up with Lucy (the end of another beautiful relationship).

It's been a long week of waiting for this surgery, which should give us the final pieces of my cancer puzzle.  We expect to learn the Her2 status within a few days that will determine the ultimate chemotherapy regimen.  We will also learn the true size of the tumor itself which will help us determine the stage.  The surgeon will attempt a sentinal node biopsy, injecting radioactive tracer prior to surgery to determine the first (or "sentinal") node the tracer travels to.  This node as well as several others will be removed and examine for cancer cells.  Previous radiation may make the node biopsy impossible; if so, we'll tackle that during surgery later this summer.  And lastly, I'll be reunited with Portia, the power port installed in my right chest area to allow for chemotheraphy delivery.

My bone scan on Wednesday revealed nothing exciting (except that I look like a skeleton under all my skin and muscle).  Monday's CT scan confirmed the size of the tumor and didn't reveal any obvious cancer in the lymph nodes under my arm.  Except for Jabba, things look pretty spectacular inside my insides.

Ned never shoulda left me.  I've got proof I'm just as beautiful on the inside as I am on the outside.

Shut up, Neitzsche

Every day I get a BrainyQuote delivered to my phone at 8:00 am.  It's a nice way to start my day, with words of inspiration from Ghandi, Dr. Seuss, or Chelsea Handler.  At the appointed time my phone *dinged* and there appeared the quote for Saturday:

"That which does not kill us, makes us stronger."

Seriously?  Shut it.

What doesn't kill us changes us.  We can't endure a life-threatening event without being forever changed.  Maybe we become stronger; maybe not.  Maybe it means a different appreciation for life, or love, or ourselves. Maybe we are just Changed, different, not the same.  It might take us a while to figure out what all of that means.  But not being strong does not make us weak.

Right now I don't want to be strong, I can't be strong, I'm simply not.

The first time we rode this roller coaster I was reasonably optimistic, felt strong and confident, was determined to "beat this" and go about my life.  This time, though, I'm still reeling from being blindsided by this new (??) diagnosis.  Four years.  Only four years.  And a new cancer - really, in the same place area as my previous cancer?  But without all the necessary information in front of me right now, it's easy for my mind to wander and wonder.  Is this a "new" diagnosis, or a recurrence of the previous cancer?  I don't yet have a stage - don't know the true size, don't know about lymph node involvement, don't know if it's set up shop anywhere else in my body.  I learned Wednesday that there was not enough tissue recovered during the biopsy to complete the testing for the third (and in some ways, most important) hormone receptor, the Her2neu.  So no treatment plan in place, and now surgery in a week to biopsy more tissue that will also include an attempt to map and biopsy my lymph nodes.  I may also have a port placed for chemo, but only once the size of the cancer is determined.  Unless the decision is mastectomy first, but only no port if the recommendation is a double mastectomy.

All of this information, that I don't have, it matters.  So frickin' stuck in "what if's" and "maybe's" instead of planning and moving forward.  The lack of control and knowledge is maddening and frustrating and exhausting.

I'm tired - really tired, and sad, and angry.  Anger like I've never felt before.  A sense of surrealism to everything I do right now:  folding laundry, driving, watching TV, chopping fruit.  All the energy has drained from my being, my soul, and disappeared.  I find myself forcing movement forward, feeling almost disconnected from my being.
And then...

Then there are moments of grace and beauty, where my heart feels like it is exploding with love and joy and happiness.  It's a feeling so profound that I think, I believe, it's the very essence of Life and Peace.  Ice skating with the grandkids I watch Luke, brave and determined, falling but getting right back up and trying again.  He pushes the skating "walker" forward a few feet then skates towards it, pushes it again, skates to catch it again.  Over and over, laughing with delight because he conquered something that an hour ago had him wobbly and clinging to the walker with a death grip of fear.  Nevaeh is skating on one foot, turning around, skating backwards, tripping and falling but up in an instant with a quick "oops!" and another attempt.  Their eyes shine with excitement and wonder and adventure, and for this one moment it's magical.  And every little thing falls away because all that ever matters is this.

I don't have energy to be strong right now, but moments like these make me want to at least try.

Second verse, same as the first...

It's been a long time since I've been here.  My last post was almost three years ago!!!  I haven't even been by to read or check for comments in over a year.  I'd started this blog to document my journey with breast cancer, and after treatment (and some scares), every day became another day of living without cancer.  In fact, life became beautiful and busy, filled with love and laughter and fun and excitement.  Weddings!!  Grandchildren!!  New jobs!!  Home improvements!!  Half marathon training!!  Travel!!  Yoga teaching!!  Hubby and family and friends...

You know - the stuff of normal life.

A couple of weeks ago was the fourth anniversary of my first chemo.  I was so busy Livin' that I actually forgot.  I remembered the next day, felt mildly nostalgic (and just a little naseous), and then the moment was over.  Move along...nothing to see here...

I had an appointment with my surgeon that Friday; I found another lump near the first area of cancer, but I'd had a cyst there a couple of years ago and we removed it and all was well.  My surgeon and oncologist continue to remind me - early stage, lots of tough treatment, go live your life and don't worry about recurrence, you'll be fine.  So I wasn't worried about the appointment with the surgeon, almost forgot, in fact, because I was so busy Livin'.

"So it's a cyst," I said to the surgeon (because I've been to medical school and I know these things).  "Let's poke it with a needle and be done with it."  He pushes it around, tries to pick it up, calls in another doctor.  They talk.  He shakes his head, sends me over to the hospital for an ultrasound.  The tech there takes her time and let's me watch the US screen; she's young and sweet and we talk about the weather and my daughter's recent wedding and what the HELL is that thing on the screen?  It looks like Jabba the Hut except a little uglier, all fat and jagged and dark and mean.  *click* there's one picture and *click* there's another and *blip* now we've got measurements of Jabba.  She wipes the gooey gel off Lucy and announces she'll "be right back."  

I lay there and think about my next long run - do I brave the cold and ice or just run the hamster-wheel track at the Y again (where 5 miles is 80 revolutions...oy...)  The tech returns with the radiologist in tow.  They whisper (by the way - that's just plain rude.  Secrets don't make friends...) and the doctor plops gooey gel on Lucy and does his own rolling search for Jabba......riiiiiight there.  And there.  And here's another view.  *click*  *measure*  And he announces he'll "be right back."

I'm a little slow sometimes, and just as it begins to dawn on me that perhaps this isn't just another cyst, the radiologist returns.  I hear words like, "solid mass" and "irregular borders" and "taller than wide" and "echogenic" and "shadowing", and he'd gone out to call my surgeon but the surgeon is in surgery so he calls the surgical suite to discuss this, and 

*boom*  There's that sinky, swaying feeling where all the air leaves your lungs and your head spins and your vision tunnels down to the lightswitch on the wall and words don't have meaning anymore and you can't really hear what's being said but the conversation goes on without you and the only thing that comes out of your mouth is

Fuck

Oops.  He smiles a sad sort of half-smile.  I tell him I've been down this road before so I ask, "Is it a 4 or a 5?"  He hesitates briefly, realizing I'm an edumacated cancer survivor and says, "I can't give it a 5 because that's a slam-dunk and I need a tissue sample, so I'm going to say 4c."

These numbers refer to the Birads rating system (Breast Imaging Reporting and Data System), which assigns numbers 0-6 to mammograms and ultrasounds as a means of standardizing reports and describing risk of breast cancer.  Anyone who's had a mammogram and received that letter in the mail may have seen the number, but it goes something like this:

0 = incomplete, more imaging needed

1 = negative findings

2 = benign findings

3 = probably benign (less than 2% chance of malignancy)

4 = suspicious (overall 20% - 35% chance of cancer, range of 2% - 95%)

In the 4 category are three sub-categories:

4a = low suspicion of malignancy (>2% - <10%)

4b = intermediate suspicion of malignancy (>10% - <50%)

4c = moderate concern, but not classic for malignancy (>50% - <95%)

5 = Highly suggestive of malignancy (95% chance of cancer)

6 = Known malignancy

He tells me he'll write the US report that weekend and fax it over to the surgeon so he has it first thing Monday morning.

And so the Long Weekend Wait begins (cue the violins...)

Ken and I - we Know, with that capital K of Knowing.  Been here before, Knowing before being told.  It's not reactionary, it's not catastrophizing - it's simply Knowing.  So we let it go for the weekend.  We run, have fun, go shopping, keep busy Livin'.

First thing Monday morning the phone rings - and doesn't stop.  The oncology NP calls to say they've seen the US report and wants to schedule a "planning meeting" with the Oncologist.  "But I don't have a diagnosis yet, what are we planning?"  She says they want to get the scans on the books, talk about next steps...  "But I don't have a diagnosis YET," I say again...  I leave her with the promise to call when I schedule my biopsy.  

The Oncologist's assistant calls to schedule an appointment (can't dodge that bullet apparently).

The surgeon's office calls to schedule the biopsy for Wednesday.  Then the hospital calls to pre-register for the biopsy.  Then another hospital staff calls to go over the biopsy procedure and pre-requirements.  "No bloodthinners for five days before the procedure...well, nevermind since we've only got two days.  Just don't take any Tylenol or aspirin or anything before then, okay?"

Okay.

The biopsy is an ultrasound-guided vacuum-assisted biopsy.  Let's just say that Lucy is numb from stem to stern; a small incision is made and a very large needle is inserted to take core tissue samples of the tumor, four in all.  They allow Ken to stay in the room and he watches (in fascination, of course) from the corner.  When it's over they insert a small titanium marker and then send me for a mammogram to ensure they can see the marker.

The oncology nurse navigator comes to visit before the mammogram.  We have a few minutes to talk about what all this means.  She lets me know they're level of concern is "up there".  We laughingly agree this sucks.  She tells us that it'll take at least two days for results - which likely means another Long Weekend Wait.  But since Ken and I already Know, we just get back to Livin'.

Ken reminds me later, however, that our GP has Saturday office hours, and so we pop in for a quick visit on Saturday morning.  And sure enough, the results are in.  No one smiles as they print and copy and stamp the report.  Oh well - we had a little bit of hope.

So all of these words, the telling of this super-long story, is to let you know that the biopsy is positive for breast cancer.  Not only is is positive, but it's also negative - as in, no estrogen receptors, no progesterone receptors, so it looks like this:

ER-, PR-

Okay, so now we freak out just a little.  This is not a recurrence of my previous cancer, which had estrogen receptors (ER+).  This is a new, completely different breast cancer.  But it's a new cancer exactly next to the place of my previous cancer.  It's been in there for a while - maybe through previous chemo and radiation (including targeted boosts to that very area).  WTF?

We're still waiting on another piece of important information - the results of the Her2neu testing.  That is the last of the three hormone receptors that completes the picture and tells us what treatment is necessary.  If the Her2 is negative, then I have Triple Negative (TN) breast cancer.  Being ER- means my cancer is not being driven or affected by estrogen, so Tamoxifen or other Aromatase inhibitors, which are significant and valuable treatment options in breast cancer, will not benefit me.  If the Her2 is positive, then I will need to add Herceptin and possibly Perjeta to my chemo regimine.  TN is often associated with a BRCA1 or BRCA 2 mutation, so I may finally get the genetic testing I'd asked for four years ago.

So there it is.  It really does kind of suck.  We don't have a treatment plan in place just yet.  Chemo, surgery, reconstruction - it'll all come together soon enough.

But for now, we take a few moments to absorb all this new, different, interesting and (yes) scary information.  And we keep on Livin'.

It's what I know how to do best now.  And I'll do it again soon, real soon.

Happy Chemoversary to me!

I don't post much anymore.  Two months since my last post, in fact.  Life is busy!  I finally completed my studies and graduated with my MSW.  I am actively looking for a job but still working part-time at the university, and enjoying a little bit of "free time" to do all the yard work I didn't have energy to do last year.  I'm running (sometimes) and yoga-ing (when I can) and soaking up the sun whenever possible.  Life has moved on, and so this blog has become kind of an after-thought - and that is GOOD!

And today - today is exciting!  Today is my Chemoversary - one year since my last chemo treatment.  A year ago today I introduced the Boob Fairy, all shiny pink tulle and satin.  I shocked the heck out of the infusion center staff, who admitted they'd never had anyone dress up to celebrate their final chemo treatment.

The original Boob Fairy

I can't understand why more people don't dress up and celebrate their final Dance with Toxins (especially when you can be all sparkly!)

Today, a year later, I am still recovering from the effects of those poisons.  And likely, I will live with pain and reduced heart function for...ever.  But the operative words here is "live with" - because that is what I'm doing (and doing well, I think!) - living.  Each and every day, as joyously and happily as possible.  I am still here, and intend to be for a very long time to come. 

So I am thankful for my short-lived affair with AC/T last year; because of them, I am still here today.  I am grateful for lessons learned, and for the opportunity to live (really LIVE!!) again.

Celebrate today!  Tell someone you love them; surprise someone with a hug.  Send an email or call someone and just say hi.  Think about someone you clash with and send them positive energy and love.  Do something kind for yourself; do something kind for a stranger.  Smile.  Make a funny face.  Make a child laugh.  Make yourself laugh.  Make love.  Make a choice to be happy - then BE happy!

I love you all - thank you for sharing this journey with me!

Rock On (or...my visit with the RO)

Another quarterly visit with yet another Cancer Professional.  This time is was the radiation oncologist (or, rather, everyone in the office but the actual doctor.  Now that I'm healthy I don't warrant a fully-professional visit).  Short version of the visit went something like this:

Me:  "How am I doing?"

Nurse:  "You've gained alot of weight.  Let's see what we can do about that.  Now put on this really ugly gown and wait for the PA."

Several toe-tapping minutes later...

Me:  "How am I doing?"

PA:  "Everything looks good.  But you've gained alot of weight.  Lose it.  See you in another nine months."

Aaaaannnddd...that was it.  Or something like that.  No tests or anything, although Lucy got a real good going-over (so did Ethel, but she's kinda over all the attention that Lucy has caused and so she wasn't particularly happy that morning).  Radiation has caused my skin and muscle and other tissue to shrink, so there is a great deal of associated of pain in my left shoulder and armpit - but no one seems terribly concerned about that.  Except me.  Cuz it hurts and limits my range of motion.  But on the flip side, no lumps, bumps or funny things to be concerned about, so it's another three months of dating NED for me!

I didn't expect much differently during this visit, because the RO doesn't order bloodwork or other scans (so there just isn't much for them to tell me).  But it's still good to see them, to have them see me, and to feel as though I'm not alone in this aftercare.

I've been emailing back and forth with my oncology NP, trying to gather more information about the genetics of my original cancer.  Knowledge is power, blah-blah-blah.  Reality is I want an assurance (or maybe that's a reassurance?) that I'm done with this beast.  Curse you, Cancer, for making me crazy (and fat.  Yes, you're the reason I'm fat.  Thank you).

After several back-and-forth emails, my favorite NP Dianne confirmed what Ken and I already knew, but didn't really want to hear - that my cancer is a molecular subtype known as Luminal B.

What does that mean?  Well, without trying to dissect lots of scholarly articles in this little tiny place (which no one really wants me to do), the easiest way to explain it is this:  It doesn't respond as well to chemo as, say, Luminal A might, and it tends to be aggressive.  In the end it explains why my Oncotype score was so high, and also why my PR status changed from positive (at pathology) to negative (thru Oncotype test). 

What does it mean in the long-term?  Who knows.  Might come back, might not.  Today, cancer is still my bitch.  Tomorrow, that might change.  But life is kinda like that, right?

Raising.......Arizona

One of the most profound movies of our time is Raising Arizona.  Not a week goes by that I don't find myself quoting the sage and philosophical words of H.I., Ed, Evelle, Gale, and the rest of the erudite crew. 

"There's what's right, and there's what's right, and never the twain shall meet."

"If a frog had wings, it wouldn't bump its ass a-hoppin'!"

"You know, I'm okay, you're okay, that's there what it is!"

"Son, you got a panty on your head."

But lately, I've been thinking about this insightful exchange, and how it perfectly illustrates what I'm feeling right now:

Gale (played beautifully and genuinely by John Goodman), as he busts into the rural bank:

"All right ya hayseeds, it's a stick-up!  Everybody freeze!  Everybody down on the ground!"

To which the old farmer replies:

"Well, which is it young feller?  You want I should freeze, or get down on the ground?  Mean to say, if'n I freeze, I can't rightly drop.  And if'n I drop, I'm-a gonna be in motion..."

Which is it gonna be?

I recognize that my inability to drop and be in motion has been my choice, my decision, perhaps even my desire.  Homeostasis is safe.  Venturing out into the world is scary.

I take my Tami and make my quarterly doctor visits and...for the most part I forget the last year.  Sometimes it still seems surreal.  Me - cancer?  Naw...must have been a really bad dream.  And for now it's easy to feel that way because reality creeps in only rarely (and only when I let it...or go looking for it).  Sometimes I'm almost sad to leave this all behind, and feel twinges of survivor's guilt when I look around and realize sisters have been lost along the way.  I want to move forward...but not really.

It's hard to explain because it often comes out as so much whining.  "Really, you're not over this yet?  Will you ever stop talking about it?  When do you become one of those cool cancer survivors who says, 'I'm cured!!!' and doesn't let it run her life anymore?"  You would think I'd want to run like hell from this experience and leave it behind like a bad relationship, when all I really want to do is gather it up and hold it close to me and protect it like a child.  Most days I'd rather freeze than be in motion.

Which isn't really an option, is it?  Because life moves forward whether I want it to or not.

The next few months are going to be busy and filled with lots of adventures - graduation, races, vacation, travel, family, a new job (I hope!) - so much motion!!  Spring is right around the corner (right...?) - a time of renewal and new life.  Last Spring I was in the midst of chemo and couldn't enjoy it; perhaps this year is my personal Spring, a chance for physical and spiritual renewal and an opportunity to adventure back out into the world.  Moving forward doesn't have to mean leaving behind; I think I need to get a good grasp on that concept.

Besides, even if I stand still, life will continue to go on around me.  Might as well drop and be in motion.