At just the right time

I've posted before about how Jason and I love Council Collection week. It happens twice a year: everybody hauls their junk (furniture, old TVs, busted kids' toys, you name it!) out to the curbside and at some point during the week, big trucks come take it away.

But not before plenty of other folks come checking out the loot! In years past we've kind of made a date of it; cruising around, looking at our neighbors' cast-offs. Because we are ALL CLASS. This year though, we weren't looking for anything and didn't have any real interest in it. My heart just wasn't in it. But the Monday after my surgery, we took Grace on a quick trip to the park and spotted this desk on the way home.

I'd been tired by even that little outing, but spying it on the curbside, I perked right up! Life and spirit surged to the surface! My pulse quickened! My blood flowed with new energy and vigor! What wondrous place is this, with such free furniture in it!? It was time to carpe desk, er, diém!

It was just a few houses down from ours, and Jason hopped out to have a look. Perfect condition, the desktops opened and closed, and as they did I heard them cry softly, "Mama!"

"I'll drop you guys off and then come back," Jase said. "No! You have to get it now!! Before it gets away!" And because you don't argue with a convalescing bargain-hunter, he did.

And now, Ava and Nate sit there each afternoon and do their homework. Cutest thing. As I told Becky, free furniture really IS the best medicine.

How to have a lumpectomy, Part 2

Oh, but wait! You really should read Part 1 first!

So, secure in the knowledge that my sentinel node was mapped, I went back into the waiting room of the nuclear medicine department. A nurse mentioned that my surgery had been moved forward, and that instead of the 2+ hours that we thought we had left to wait, someone was coming now to collect my charts and take us up to pre-op. Oh! Oh.

This made me a little nervous...I had been thinking I'd more idle time on my hands for magazine reading. It felt a little like preparing for your scene in the third act and then finding out the director was skipping the second. You're on! But really, it was a good thing. Why delay it if you don't have to? Plus, I knew that it would be better for our families, anxiously waiting back in the States, where it was already creeping towards dinnertime.

We went back upstairs, I got back in my little bed with the warm blanket. A nice young guy came and wheeled me away, Jason following. Again, I felt silly being wheeled around, when I knew I could walk on my own. I suppose it's easier for the hospital staff, but it's like I wanted to get down and do some pushups, just to show I could.

And then it was all a flurry, really. The surgeon and team were whipping through their schedule for the day, and I was next. The anesthesiologist came over to meet me and ask me a bunch of questions, I signed forms, I put on a fetching paper cap to match my undies. And then the nurse asked if I was ready. Jason kissed me--and for the first time he looked a little forlorn. Standing there, holding my purse, with me being wheeled off. "Hey--go get a coffee," I said to him, "I know you've been dying for one! I'll see you soon."

I was wheeled to the little anteroom right outside the operating theatre. I could see my doctor in there, getting ready, and the anesthesiologist came over to put my IV in. There were a lot of people, and there was a hum of efficiency. I could hear music--it sounded like Johnny Cash--playing. "We usually have a little music going, is that alright with you?" he asked. I told him it was fine, after all, I wouldn't be awake to hear much of it. "Hey," I said, "Is everyone feeling good? Y'all had a healthy breakfast? Everybody happy?" "We're doing great," my surgeon said, "We could do this all day." "That's good to hear!" I said. I don't know why I felt the urge to, like, warm up the crowd. It's this thing I do--get all chatty when I'm nervous. Actually, I tend to get chatty whether I'm nervous or not. As if the burden to entertain is all on me? I'm surprised I didn't perform a stand-up routine. Thank God.

They brought me into the operating theatre, and I shimmied onto the operating table. Somebody gave me a shot of something. I remember wanting to stay awake a little longer. Not because I worried about being unconscious, but because I sort of enjoyed watching everyone work. That sounds totally bizarre now that I've written it down, but I noticed this same thing when I had the biopsy done. There's this part of you that's detached from the fact that all this is happening to you, and you're just interested in the process. I just wanted to look around for a bit.

Now, a technical sidenote, if you're interested. This is my understanding of the usual procedure for lumpectomies. Once the surgeon opens you up, he/she removes the sentinel node first. That's sent to pathology right away--to look for cancer cells. The aim is them to remove the tumor, with a sliver of healthy tissue on each side. This is called a "margin". There's no standard rule for how much of a margin to get--the idea is to get healthy tissue on either side so you know you've gotten the whole mass. My doctor told us he aims to get 1-2mm margins. Once the procedure is over, that's sent off for analysis, to ensure that the margins are clear--meaning cancer-free. If they're not, then they have to schedule another surgery to go back in.

Before the lumpectomy is complete, the initial result on the sentinel node is reported back. If it's cancer-free, as it was in my case, then that's all that is done. If the node had cancer cells, like it was with Becky, then the surgeon does what's called axillary dissection. This is when more lymph nodes are removed from your armpit for analysis. The number of nodes removed varies, but I was told it's usually between 2-9. This is of course more invasive and will require a surgical drain and a longer recovery time.

Anyway, the next thing I remember is the doctor calling my name, and me opening my eyes in recovery. He said something about no node involvement, and I murmured a response. Then he was gone, and I texted everyone. Then I opened my eyes again and realized...of course I hadn't texted everyone! I didn't have my phone. I'd dreamed that bit. So then I got confused if I'd actually talked to the doctor, or if I'd imagined the whole thing. Trippy!

Pretty quickly upon gaining consciousness, I felt a burny-throbby-scratchy pain on the side of my breast. It felt angry to me, in my hazy state of mind. A nurse came and asked me if I wanted some morphine. Um, duh? Sure! Why not? I'd say the pain was about a 7, on a scale of 1-10. But the nurse kept coming over and asking how my pain was, and kept topping off the morphine. So within about half an hour, I barely noticed it--maybe down to a 2. Another nurse came and asked me if I wanted to stay overnight--the doctor had said I could go home if I wanted to. I was so groggy, I was having a hard time making the decision. "You have young children, don't you?" she asked. Yes, I told her. "You should stay here tonight. It's better," she said firmly. Sometimes, it's really nice to have someone else tell you what to do. Yes, I said. I'll stay tonight.

And it was a good thing I did! I was very dizzy from the medication the rest of the day and into the evening. I couldn't lift my head without the room spinning. I guess all those drugs come at a price.

Recovery has been pretty smooth. I think I'm lucky...I only had one node removed, so I don't need a surgical drain, and my surgery was a lot less invasive than it could've been. The surgery was Friday; by Sunday I was up and about in the house. Doing laundry--seriously, what is wrong with me?

And Jason has been juicing. Juicing everything in sight and making me drink it. More on that later, my pretties. I have talked long enough, of boobs and boob-related issues.

How to have a lumpectomy, Part 1

Thursday evening, the night before my surgery, a nurse called from the hospital to give me my "arrival instructions". Basically, I had to be there by 7am, I had to have no food after midnight (just like a Gremlin!), and I couldn't drink any fluids after 4am. It's the no liquids part that made me nervous. Skipping breakfast and lunch isn't such a big deal, but what if I got thirrrssstyyy? No one likes dry mouth! Our friends Matt and Sarah were over; they'd come to make us dinner and then were gonna stay overnight to help with the kids the next day. Sarah is a nurse. "Are they pretty serious about that no-liquids thing?" I asked her. "Umm, yeah," she said. Blah blah anesthesia, blah blah aspirating into your lungs, whatever. Fine.

So I decided to wake up at 4 and drink a buncha water. Guys, this is tip number one: don't do that. Cause then you will immediately start thinking about the day ahead, and your brain will rev into full awake mode, and you will not be able to go back to sleep. And then shortly thereafter, you are really gonna need to pee. And after that. And, a little while after that.

We were model patients and arrived promptly at admissions at 7am. The room was already packed with people that presumably had surgeries scheduled for that day--most of them outpatient, or day surgeries, as that was where we were supposed to check in. I amused myself by looking around and playing "guess the procedure" for each person. Hmmm, tonsillectomy! Questionable mole! Prostate!

Then they called us over and checked us in. "And what procedure are you having today?" the clerk asked. Almost like a waitress, as if I'd been given a menu to select from. "I believe I'll start with some node mapping, please...and then the lumpectomy is looking pretty good to me today."

Eventually we got called back into what must be a staging area. I was weighed, I was given a gown and robe to change into, and as some of you saw on Becky's blog, I was given these.

Not even kidding, I thought it was for my hair at first. That would've been awkward. And to think, I'd already followed the proverbial advice to wear nice undies in case you ended up in the hospital! All for naught.

They assign you to a bed at this point, and a very sweet nurse came and tucked me in with a warm blanket. But the funny thing is, I didn't really want to lie in the bed. I feel fine, I kept thinking. That's been the surreal thing about this process. I am very healthy and feel great, but.

Then the nurse walked Jason and me down to Nuclear Medicine. (I cut a fine figure in my bathrobe and running shoes, don't you worry!) "Nuclear medicine" made me envision haz mat suits and test tubes and Russian scientists...but unfortch I didn't see any of that. It is here, my friends, that the "sentinel node mapping" takes place. And in case you ever need to understand what that is (and I hope you never do!) I'll tell you a little bit about what it's like. (But if you need, like, actual medical information, get thee to Google! I majored in Psychology.)

When surgeons remove a tumor from your breast, or perform a mastectomy, they also remove and test the sentinel lymph node for cancer cells. Your sentinel node is called such because it's the first node that any cancer cells would reach if they were spreading from the original site. To put it simply, if the cancer has spread in your body, it will almost certainly be in the sentinel node. So testing the node is a good indication of the stage of cancer you are dealing with.

Sentinel node mapping is how they find the right node. Ya got lotsa nodes, dontcha know. And the sentinel is not always the nearest in proximity to the tumor. And here is where the fun begins! After checking in, I was brought into an examination room and lay down on the table. The nurse chatted me up for a bit, then the doctor came in with four different needles. The needles are very small, and each contain about .2ml of radioactive solution. The process is this: the radioactive liquid is injected, some time goes by, then they X-ray the area to see where the fluid has traveled. The sentinel node "lights up" with the fluid. I've since read that there are different techniques in finding the sentinel, but this is what was done with me.

While I chose a strategic place on the ceiling to stare at, the doctor injected each syringe into different areas of the breast. Unfortunately, they can't use any kind of local anesthetic with this procedure--it effects how the fluid moves through the tissue. That was kind of a bummer to hear.

I've been told that each person experiences this differently--a lot depends on your pain tolerance as well as the way the nerves are arrayed in your breast. For me, it was about a 4 on a scale of 1 to 10. Not what I'd choose to do on a Friday morning, but not awful either. One of the shots hurt more than others, and the fluid stings a bit going in, but it was okay. Just okay. However, for someone with problems with needles, it would be good to have a hand to hold at this point.

After the needle part was over, the nurse put a bandage over the area and told me that I had to massage it for 10 minutes. This was very important, she said. I must massage it to get the fluid moving through the tissue so that the imaging could see what it needed to see. That was slightly awkward, but whatever! Just me alone in a doctor's office, massaging my boob. Like I've done so many other times.

Eventually, they came to get me and took me to this ginormous machine. It looked a bit like an MRI machine, where you lay on the mat and it slides you under the imaging stuff. These are all the technical terms, of course. Attached to the machine is what looks like a big panel, two of them, and the technician moved one down, down down, very close to my face. "Sorry," she said, "If you had bigger breasts we wouldn't have to get it this close." Lady, if I had a nickel for every time I've heard that one. (Sorry. I don't even know what that means.)

Then I had to lay very still for about 10 minutes. Don't even think about your nose itching, cause then it will and there's nothing you can do. Nooothiinngg! Then she adjusted the machine and I laid there for 10 more minutes, with the panel on the side. You might think this is enough radioactive imaging of your boob. But it isn't! Silly girl, what do you know? Then you go sit back in the waiting room and read magazines for half an hour. Then you go back in there and do it all again. Except this time they end with taking a 3-D picture. Just like Avatar! This time the machine and the panels move and spin around you slowly and it really is better to close your eyes. Cause that's a bit disconcerting. I'm not prone to claustrophobia, but if you are--best to just keep your eyes closed, cause the panels get pretty close to you.

At this point, the doctor came into the room, and referencing some incomprehensible blobs on the imaging screen, drew on my boob with a purple Sharpie. Radioactive fluid and million dollar equipment and it ends with markers.

I'm very proud to say that the technician told me it took much less time to map my sentinel node than normal. I smiled and said, "Well, let's be honest, that fluid didn't exactly have heaps of tissue to work through." She acknowledged the truth of this, but said it was mostly because I had massaged it so well. "We get some much older women in here who just aren't comfortable doing that," she said in a confidential tone, "It's a generational thing."

Ahem. I think that's a good place to stop for now.

Good is right!

Just a quickie quick post to check in. I am sitting here having morning tea at the hospital, then we'll head home. I was all set to go, then started to feel woozy again. The morphine and the anesthesia have done a number on me! So I decided to stay for cake. It's medically necessary.

Cake is natural, cake is good. Not everybody does it, but everybody should.

More later. You guys have heard the main news. I am so very thankful. The truth is, I know I'm in God's hands, but the news about a clean sentinel node is icing on the cake. (There's the cake again.)

Meanwhile, y'all continue to be awesome. Thank you for thinking, praying, reading, and caring about me. Should I ever be lucky enough to meet you in person, there will be some serious smooching going on. Or at least side-hugs, if that's more your thing.

Hmmm, judging by this post, I'm still pretty loopy. Better stop now and finish my tea. More later. Xxx

Good

Y'all! It's Becky, Amy's sister. Amy is doing great! They took her in for her lumpectomy a bit earlier than we expected, and were done a bit faster.

The post-op word was that her sentinel lymph node was clear. The so-called "sentinel node" is the first lymph node that would be reached by cancer cells traveling from a tumor. It's the node that raises the alarm. Sentinel, get it? So if the sentinel node is clear, that means the cancer cells haven't spread to the lymphatic system or haven't taken hold there.

So that is very, very good.

The surgeon also felt confident that he had taken out the entire tumor mass, though the pathologist will have to confirm that the margins are good. That will take a couple of days. But my experience from talking to surgeons is that they are pretty good at sizing up a situation, and if they say they are confident, they have good reason to be.

I am so relieved, I just can't even tell you.

A little while ago, Jason called me and said that Amy was groggy and had decided to spend the night in the hospital, but she wanted to speak to me. Matt and I both put our ears up to my phone. I talked to her and she sounded great. She seemed like she had just woken up from a nap, just normal. She said she had morphine and was okay.

So this news caused me to relax in places that I didn't even know were tense. And then I had two glasses of wine.

If you missed the pre-op photo session, take a look at my post from this afternoon.

So, to sum up: early indications are that the situation turned out as well as we could hope, and that her cancer really was caught at an early stage, earlier than mine. She will certainly have radiation, which is standard for a lumpectomy, but we don't know what, if anything, else.

But this is good, y'all. Thank you for your prayers, kind words, thoughts, vibes, white light (you know who you are). Even if we have never met, I see you. You are real to me, and to Amy. We appreciate you being out there.

Sleep well sister! I think I might call it a night.

It's only a day away.

Tomorrow is my surgery. Or depending when you're reading this, today. And you know what? I'm actually relieved. This waiting around thing is the pits. Let's just get in there and get 'er done.

Two days after we got that initial diagnosis, we decided to tell Ava and Nate what was going on. We knew we'd be on the phone a lot with family, and of course telling friends and church members here. So we didn't want them to overhear anything that would frighten them. They were both in the living room watching iCarly, so we asked them to pause it for a minute, that we had something to tell them.

Mom has some bad cells in her body, we told them. (They know, in a vague sense, what cells are.) She has to have surgery to take the bad cells out, or they will grow and could make her really sick. Nate started to look worried at this point, but then he started to get interested in the whole surgery thing. Would they put me to sleep? Would they cut me open? Would it hurt? After it was over, would I please tell him what it felt like? I could tell he was thinking, "This is gonna be pretty interesting."

I referenced Becky and her experience while we were talking, and Ava asked "So does this mean your hair is going to fall out?" Maybe, I told them. I told them I might have to take some medicine after the surgery. "You know how some medicine you take makes you better, but it can also make you feel sleepy, or can make your stomach hurt? This medicine is like that. It will help me get better, but it will also make my hair fall out." We told them we didn't know yet if I'd need to have that. They nodded, they were okay with that answer. Then, in talking about the surgery, I mentioned that the "bad cells" were in my boob. Nate gasped. "You mean they're gonna see YOUR BOOB?" Then he covered his mouth and started laughing. And then I knew they were okay. And then the iCarly episode was un-paused.

So, yeah they're gonna see my boob. As Rachel from Friends once said, "That's okay--I've got nice boobs." As far as the surgery goes, I'm not nervous--about the actual process, I mean. I'm not nervous about hospitals or afraid of needles. Of course, it's more the outcome I'm thinking about. The million dollar question: will the sentinel node have cancer cells in it, or not? If it does, that means we are in for a longer journey than I'm hoping for. If it does not, then I'll feel like I'm super fortunate. I'm trying not to think too far ahead at the moment.

And the strange thing is...I feel fine. I really do. I mean, I'm not happy about this, or excited. But the last 2 weeks have been more of a digging in of my heels and a squaring of my shoulders kinda thing. Like, okay if I have to do this then let's just do it. I was telling this today to a lady from the hospital who called to check on me. She identified herself as a "Breast Navigator", which... let's just stop for a moment and snicker like 13 year old boys at that job title. Cause it's up there. Way up there.

Anyway, her role is to basically help patients navigate through their treatment, answer questions and give information at each stage, as well as emotional support. She asked how I was doing and I told her. I shared that I was anticipating an emotional low after the surgery when things slow down a bit. Up till now, there have been appointments, phone calls, arrangements to make...not to mention the everyday stuff that comes with three little kids and pastoring a church. It's been easy to distract myself.

So we'll see how we go. I've given up obsessing over how I feel and wondering why I don't feel something else. This is working for me right now, so I'm gonna go with that.

My surgery isn't till early afternoon tomorrow, but I'm sure someone will check in here and let y'all know how everything went. Thank you for all your sweet comments, emails, and thoughts. You are the wind beneath my wings, guys! You are the real breast navigators in this story. And that's the truth.

xoxo

How is Jason doing?

In the last week and a half, several people have asked me how Jason is handling the diagnosis and all the questions, uncertainty, and well, just stuff that goes along with it. Of course, it's really early days, so I don't mean this to be a definitive description, it's just more a snapshot of what the last 10 days have been like. We have a road ahead of us, and we know that.

The day that all this unfolded; the day I got the diagnosis, I was on my own in the city. A good 45 minute drive away from him. I'd left that morning to go to what I thought was really just a cautious, responsible check into what would turn out to be nothing. There was no sense, in my mind, in trying to find someone to watch Grace at the last minute so that Jase could come with me. Plus, at the outset, I confess that I thought: "A day on my own in the city! I'll have this little appointment and then maybe I can go get a pedicure!"

So as the day went on and I realized that there was maybe something to this, and then that there was almost definitely something to this, I was sending him text messages every time I had a chance. That seems so anti-climactic, doesn't it? If this were a movie, that would so not be the way you tell your husband that you're having a biopsy and that things don't look good. Where's the drama? Where's the heartfelt expressions of love and support? This movie stinks!

It's just that there wasn't really time to call him, I was back and forth having tests, filling out forms, talking to people. Plus, it was a very quiet waiting room full of people that would've heard my every word. So we texted back and forth instead. But the thing is, Jason and I have been together for pretty much all of our adult lives. So I knew what he would say if I'd been able to call him. And he knows the same about me. So all that mushy heartfelt stuff was there, but it was subtext. In fact, this was a very pragmatic day, and most of our communications were, on the surface, conveying information.

In fact, once we did talk on the phone, after I'd finally talked to the doctor and paid the bill and gone out by the elevators--I don't even remember if I told him it was cancer. He already knew. And I knew that he knew.

My husband is an optimist. He really thinks that, most of the time, things are pretty darn swell. When I'm frustrated or discouraged about something, he is quick to debate me and demonstrate how, really, it's not that bad. (Which, I'm not gonna lie, is super-annoying sometimes!) He's also a doer. So, that first night, after I got home from the clinic, he read through the whole breast cancer book the clinic had given me. Then the next day, he was online, reading about cancer-fighting foods and complementary treatments, and alkalizing your body or some such. He knows I'm going to be fine, just knows it. Knows it better than I do. But he's also busying himself researching what we're gonna do from here on. How we'll eat differently, what kinds of food we'll buy, where we'll shop--all that stuff.

I'm not there yet. In fact, we had an argument the other day. I know, right? Who argues with a cancer patient?? I thought everybody was just supposed to be nice to me now. I mean, there ought to be some perks! Sheesh. It was the day I was trying to decide whether I'd have the lumpectomy or the mastectomy. Remember, I told y'all I was feeling pretty anxious and uncertain.

I called him over to the laptop. I was looking at statistics on local recurrence of cancer in patients who'd had lumpectomies. (Meaning, cancer returning to that breast.) I was saying I didn't know what to do. And he, being the optimist, started reassuring me about how it would be fine because in the future we are going to change how we do things, and that we were going to beat this and it wouldn't come back.

Well, that made me mad. See, you guys think I'm all sweet and positive all the time? I'm really not. I'm quite thorny, actually. I froze up when he said that, I was angry but I didn't really know why. So I snapped at him, he huffed, I puffed. You know how it goes. I said something snarky like, "I'm not gonna go to some health spa and slather my boob in quinoa paste! I'm not that person!" Even though I know that wasn't what he meant. I just wanted to say it.

It was only later, as we talked, cause he is like that--he always makes me talk and share, that I realized why I was upset. It's that I can't think that far ahead right now. I can't think past the surgery, really. And to me, I needed to make that decision--about what procedure to have, and thinking about how we were going to change our lifestyle in the future wasn't helping. In his mind, he was encouraging me that it was going to be okay, and in my mind he was saying my anxiety was silly.

Feelings. So annoying, am I right??

After that conversation, I told him to just go for it. Read everything, study up, file all this information away. I'm not ready to hear it right now, but I want him to do his thing. Because I know that later, I will be. It's not that I'm against all that stuff, I totally see the value in making lifestyle and diet changes! I just can't go there right now. It's too much for me.

Oops, I think I've made this post more about me than about Jason. To answer my original question...Jason is doing pretty good. At this stage, his plate is about as full as it can get. Things are very busy with the church, it's always full-on with the kids, he's thinking about me and looking after me too, and he was supposed to be completing his master's thesis at the end of this month. Woohoo! In fact, the other day he said to me, "I think I'm running at full capacity--I don't really think I could handle much more right now." Which is like a normal person saying, "OH GOD WE'RE ALL GOING TO DIE! DOES ANYONE ELSE SEE A BRIGHT LIGHT??"

So, I know he's feeling the strain. Geez, who wouldn't be? But I always admire this about him, and I wish I was like this: he is able to separate his emotions from what needs to be done. He just gets on with it, he does what he can do in a given day, and he moves on. Gag--so annoyingly healthy!

To sum up, I think I'm in pretty good hands. And, fine! I will try not to be so pissy with him.

The End.