Asymmetry, Grief and Love

When I look at my naked body in the mirror, I cry.

For days, I’ve been trying to write this post, but I can’t seem to get past that first line. Where do I start? How do I attempt to unravel the layers of emotion that have formed over these past couple of weeks since my second surgery?

Let me start with some facts: The surgery successfully addressed what turned out to be a seroma, not a hematoma. (As far as I understand, the main difference between the two is that a seroma is essentially a collection of clear fluid whereas a hematoma involves blood. Both can apparently lead to Dolly Parton sized breasts.)

Recovery was, as expected, quicker and easier with this surgery than with my mastectomy. I was up and about after the first week. Unfortunately, because of the seroma, I needed a drain. If you’ve never had a drain, trust me, you don’t want one. I forgot to take a picture of my own drain, so I scrolled the internet to give those who’ve never seen one an image of what I walked around with for the last couple of weeks (and for three weeks after my first surgery).

drainMy drain was attached to my bra with a safety pin not this nifty looking eyelet. The long tube that disappears under the bra is inserted into the skin. Then, every day, I (and by “I” I mean Josh, because he usually did it) got to empty and measure the fluid like this (though my fluid was less blood red and more serus):

empty drain

Today was a good day because, after two weeks, I finally got the damn thing out, which means I no longer have to walk around with a plastic tube and container attached to my body, collecting fluid from my wound. Bulky and gross and a great way to feel like a sick person.

As for what else I hoped to accomplish with this unexpected surgery—symmetry and a regained level of comfort in my body—that did not come to fruition. My reconstructed breast (and nipple) is now noticeably smaller than my healthy breast. That, coupled with the physical scars, makes me… well, it makes me cry. I feel ravaged, ugly, older than my years (the post-chemo gray hair isn’t helping); and every time I look in the mirror, I am reminded of what I’ve lost and what I’ve been through and what lurks on the horizon as my new, biggest fear (recurrence, metastasis, telling my children I have a cancer again, missing out on all the things I don’t want to miss in their lives).

But here is the amazing thing: Despite all this— the disappointment, the self-consciousness, the crying, the fear—I generally feel happy.

Growing up, when I was having a hard time about something, my mom would say, “Go somewhere else on the canvas.” Meaning life is like a giant canvas, with, say, one group of friends in one little corner, an aspect of work in another, a particular family member somewhere else, an aching back up top, cancer down below; and that whatever the pieces of our lives might be, there are, for most of us, many of them. When one piece of the canvas bogs us down, it doesn’t mean the entire canvas has to go down with it; we can move our attention elsewhere. For the most part, this is easier said then done for me, but by some miracle, the grief I feel these days in my moments of crying is confined to those moments of crying.

canvas

This morning, I crawled into bed after my follow-up with my surgeon and had another tear-fest. I cried for all the reasons I’ve shared, and because I now need to decide whether I’m going to have yet another surgery, purely elective this time, to achieve some symmetry. There is no rush to this decision, but it weighs on me with the same guilt and shame that weighed on me when I had to decide about reconstruction. I feel ashamed by the thought of choosing a surgery I don’t need to “fix” something I don’t like about my body. Why stop with my reconstructed breast? Why not suck some of the fat out of the saddlebags I’ve always wished away? Why not erase the bags under my eyes? Tighten up my knees, which I’ve always found a bit saggy? Certainly these are choices that many people make, but they are not choices I ever thought I would make. Yet here I am considering what feels like a similar kind of choice, and it weighs on me. I would never, ever begrudge another woman for choosing reconstruction after enduring the traumatic loss of a breast, but I am struggling to find that same compassion and understanding for myself.

Time to go somewhere else on the canvas. I think I’ll linger for awhile in the fact that I am more in love with Josh than ever before, and that to feel that way after 15 years is incredible. Josh, who lies down with me in the middle of the day and tells me, while I cry, that he wants me to feel whatever I’m feeling, but then to remind myself that we will get through this, one foot in front of the next, just like we’ve gotten through everything else. Josh who sings to me, “You are beautiful, in every single way;” and who, after this latest surgery, wouldn’t let me off the couch for days after I felt like I could once again help with the kids and the house; and who is patiently waiting for me to watch Big Love and then read side-by-side in bed like the wonderfully old married couple we are.

heart love

Pathology Report, Birthdays, Doctors I Adore, and Breast Cancer Be Damned

I realize that a couple of posts ago I wrote about needing radiation without explaining why, which I will attempt to do now. The good news is that the results of my post-surgery pathology report are positive (or so I understand—after getting a medical run-down of the report, I did need to ask, “So, is that good news or bad?”).

As far as the doctors know, they removed whatever cancer remained—and what remained was much smaller than what the MRI showed pre-chemo, meaning I responded well to the chemo. They got “good margins,” meaning there was a good buffer of cancer-free tissue surrounding the extracted, cancerous tissue, reducing concerns about any lingering cancer cells being left behind. There was no cancer in my lymph nodes. There was, however, scarring in one of my lymph nodes, which is a sign that there might have been cancer there before the chemo eradicated it. Which is both good news and bad: good, of course, that the cancer has been eradicated; bad because knowing it might have been in one of my lymph nodes was the tipping point for needing radiation. (Though my understanding now—which was not my understanding in October when Josh and I first met with the radiation oncologist—is that radiation likely would have been recommended regardless, because of how young I am and how wide-spread the cancer was throughout my left breast.) The radiation is meant to kill any free-floating cancer cells that might remain.

What else is going on this week? Pretty much I alternate between tears and rage; bed and couch (or a doctor’s office).

My baby girl (who isn’t a baby anymore) turns 7 on Saturday, and I always make a big deal out of birthdays. But this year, it looks like I won’t be able to pull off very much. On Tuesday night, I was slammed with pain like I hadn’t felt since the hours just after my surgery. As careful as I thought I was being, apparently I overdid it. So I’m back on more or less total bed rest. I must have slept for 20 hours yesterday, all doped up again on pain meds. I’m feeling better physically today but terrified about doing too much and hence 1) postponing my healing even more and 2) missing out altogether on Sophie’s birthday celebrations.

I can’t say that the increased pain, bed rest and narcotics have done much to improve my emotional state.

I saw my oncologist, Dr. Katz, on Tuesday, who is starting me on my 10 years of Tamoxfin. Maybe it won’t be a big deal at all. Or maybe it’ll give me massive mood swings and hot flashes to top off all the other joys of the last seven months.

When I asked about our next appointment, she said she’d see me again in about 3 months. “Three months?!” I exclaimed, with great disappointment. (I would rather 3 weeks. Or 3 days.) I really like Dr. Katz. She is smart and direct and patient and kind and makes me feel like I am not only in the best of hands, but that I am a real-life human being about whom she genuinely cares. I actually look forward to seeing her, which is a big deal, because I can’t think of when else I’ve looked forward to going to the doctor.

Though I might be looking forward to seeing Dr. Parikh, my plastic surgeon, tomorrow. (I say “might” only because I’m pretty sure he’s going to tell me he can’t take out my surgical drain yet, which brings me back to the tears, rage, couch and bed.) I like him as much as I like Dr. Katz: a lot. The first time I met him, he blew apart all my stereotypes about plastic surgeons. He, too, is kind and patient and humane on top of very smart and very good at his job. What ultimately put me at ease about my surgery was knowing he would be in the room with me. (Which is to say nothing at all negative about the surgeon who performed my mastectomy. He, too, struck me as surprisingly kind and gentle for a surgeon—there I am exposing my stereotypes again—and he apparently did an excellent job. I would recommend him (Dr. Arenas) in a heartbeat. But I only met him once, briefly, whereas I met with, emailed with, even ran into Dr. Parikh often; which is why his presence, like Dr. Katz’s, feels like a safe place for me to land these days.)

ImageMy bed is a safe place to land, as well, but I sure am getting sick of it. Why this didn’t happen during chemo, I don’t know. Why I traveled through the first 6 months of treatment feeling more or less okay (and sometimes even strangely wonderful) emotionally, and am now hitting a wall, hard, I don’t know. But that I am: hitting a wall, hard. I am sick of the inside of my house. Sick of being so unavailable to my kids. Sick of feeling crappy. Sick, sick, sick of breast cancer. (Thanks, Greg, for the “screw cancer” poster.)