The Cancer Chronicles

It's fuzzy. You know, I really don't remember the first time I noticed it. Looking back, it seems like one day there was nothing, and then there was this lump. Of course I didn't think anything of it. The company I was working for at the time, had a wonderful benefit for executives above a certain grade level. It was an annual physical at the Executive Health Group's Life Extension Institute. I remember going to their offices for the first time in November 1996. Marble floors, walls wainscoted in rich deep woods. Very posh. After changing in the women's locker room, I was asked to wait in the lounge, which contained plush sofas, large-screen TV's, and a great spread of breakfast and lunch foods. I'm starving, but can't eat until after the blood tests. This is so cool, I think to myself. I'm seated with a bunch of graying, old, white-guy executives' you know, the cigar-chomping bunch. I felt only slightly out of place, which as a 31-year old, female executive standing only five feet tall, was a feeling I've come to get used to!

My report was good. I'm in good health. I wonder why I never feel 100% healthy. There's always something.. a headache here, stomach problems there, fleeting pain over there. There's the usual stuff about my high-risk lifestyle, smoke too much, drink in moderation, wear seat belts. I read the report again, trying to find something wrong with me.

Well, the report says I'm perfectly fine. As it is written, let it be so.

Flash forward to June 1997. I went to visit my OB/GYN, Dr. FreckleFace. I can't remember if there was a particular complaint or if it was just a check up. Knowing my habit of disregard for preventive maintenance, I'm pretty sure there was a specific complaint. I remember telling her, oh yeah, I've got this thing in my breast, but I don't know what it is. Do you think I should go for a mammogram? She felt the lump and said the words that I wanted to hear. You probably have fibrocystic breasts, you don't need a mammogram until you're 40. I wouldn't worry about it, you're too young for breast cancer.

Good. Of course I'm too young for breast cancer, what a ridiculous concept! Sheesh! I left there, no doubt not giving it a second thought. Months go by, and it's time for my annual physical again at Executive Health Group. Same ritual, same marble, same rich dark wood, same cigar chompers. They took blood, heart rate, checked my eyesight and hearing, tested me for color blindness, ekg, all the thorough tests they are known for at this fine establishment.

When I finally go in for consultation with the doctor, we talk about my general history, and I mention, almost as an aside: By the way, I've got this huge lump in my breast, and my doctor won't send me for a mammogram because I'm too young. What do you think? I watched her eyes as she examined my breast. I could see her look turn to one of surprise and her hands went back over the lump as if to verify what she felt wasn't her imagination.

Pretty big, huh? I said cavalierly, like the girl with the most cake. She said, I want you to have a mammogram. NOW. I'm sure it's nothing, but I'd rather be sure. The nurse whisked me off to the room with the mammography equipment. Of course, I had no conception of what a mammogram was or looked like or felt like. I was still just a kid, you know. There was something about being in this room that felt like a rite of passage to me. I guess I've always felt that my life experience was well beyond my chronological age, and this was just one more thing that made me feel somehow wise beyond my years.

Yippee. I'm a woman now. Again.

Just a few months earlier, during a gynecological exam, my doctor told me, I think I feel something in your uterus, it's probably just a fibroid? Although you're a bit young to have fibroids? they're common to women in the forties and fifties. Once again, I am a fast-tracking overachiever. She sent me off for a sonogram, which confirmed her suspicion. I had two uterine fibroids, and one apparently was quite large. But it's nothing. Don't worry about it, I was told.

OK by me. Man, did that feel awful! Just take my poor defenseless little boob and squish it down between two hydraulically powered plates! Yow! Twice on the right, twice on the left. The technician takes the films, tells me to wait. Minutes pass like hours. You know, I'm a very busy woman, I simply MUST get back to work, I think in my own self-important head. After all, this was the Executive's Life Extension Institute. Don't they know time is money? Excuse me, I've got deadlines.

She comes back, with one of those expressions meant to make you feel at ease. No big deal, but I need to take a few more shots. I think she said something about the film being bad, but whatever, I figured this was standard operating procedure. Remember, I had no frame of reference for this sort of thing.

When the radiologist came back in with the technician, I figured, oh-oh, what's this all about - they're double-teaming me! She told me the mammogram looked negative. For God's sake, of course it's negative. I may always have some needling little thing bothering me, but I'll never have anything really serious, that's my destiny. When my report comes back three weeks later, once again, I'm the picture of health. OK, so maybe I put on a few or ten pounds in the past year, and there's that lifestyle moderation junk again. There's a passing reference to the lump in my breast, and a recommendation that I follow up with a sonogram.

Onward I go back to my work. I'm in the process of helping my company start up a new profit center, developing conferences for senior level executives on the latest and hottest business topics. It's extremely successful, and I'm loving it, and feeling really charged up about what I do for a living. I just got a nice promotion heading up the area. Months pass, and whenever I roll over in bed and feel the kumquat under my right breast, I think vaguely, oh yeah?I really need to call my gynecologist and schedule that sonogram. Then I drift off to sleep.

I remember mentioning to a colleague, yeah I've got to get to the doctor about this lump. She angrily told me not to let stuff like that go without checking. Health is too important. She was a mother of three, and devout family woman, who had her priority shift in life long ago. I think she knew I was a workaholic, and I discounted her message like all the rest. "Yeah, yeah, I'll get around to it." My priorities were still, shall we say, 'less evolved'.

So I finally did call Dr. FreckleFace for an appointment. Of course it was some other complaint that sent me to her, rather than this growing kumquat in my breast. My period had been about a week late, which for me was pretty unusual. Instead of my period, I was overcome by stabbing pains in the left side of my abdomen. I went straight on to the Internet for symptom diagnosis?ectopic pregnancy? Oh, that would really suck, I thought.

So I got to see my doctor, and of course guess what comes as she's examining me? Yes, the blood. Isn't that always the way? By the time you take time off from work to get an appointment, and drag yourself all the way to their office?you're cured. What a waste of time, this health stuff! Oh well, at least I can talk to her about starting the pill again, the scare of pregnancy was enough to get me motivated.

She wouldn't give me a prescription because of the fibroids. There was obviously an overload of estrogen in my body, and birth control pills would only make the problem worse. Little did I know at the time how much of an estrogen overload there really was!

She said the pain was probably a cyst that had erupted, and I didn't get my period because the cyst was blocking the flow. Don't worry, all women have cysts on their ovaries. More joys of being a girl! Again as an afterthought I told her. By the way, when I went for my annual physical back in December, they sent me for a mammogram, and strongly recommended I get a sonogram for this weird lump in my breast. Can you send me over? She seemed surprised for some reason.

She sent me over to a well-regarded radiology group on the Upper East Side of Manhattan. Yeah, I had to take more time off from work. No one else seemed to care about this other than me. They bring me into a room, where this young, kind of goofy doctor with wild hair rubs white Vaseline-like goop on both my breasts. As he approaches the kumquat he says, there it is, and rolls the sonogram wand back and forth over it for a while. I remember thinking, he seems so awkward, is this guy in training? He leaves the room and comes back with an older, more sedate colleague. They talk a foreign medical language to one another and nod their heads in collusion.

I'd like to take some more films, let's get you into the mammogram room. Here we go again?more hydraulics. Suddenly, it feels as if everyone seems to be acting differently toward me. The less than courteous nurse, who showed me to the first exam room was now leading me by the arm. Come with me, honey, she said with a doe-eyed look of concern on her face.

More films, they leave, they return. We need to take some spot film of the area, in order to isolate the view, he says. Sure, whatever. Starting to feel a bit like someone's science experiment, I think: I really need to get back to the office soon, I've been here for over two hours now. They paste these cool little "X-Spot" stickers with b-b's in the middle onto the lump in my right breast, and a smaller lump in my left breast. (Until the day we moved out of Grosvenor House, I had them stuck onto my refrigerator, as a reminder, and because I thought they were so cool.)

The doctor comes back in, looking less awkward, and very serious as he puts the developed film up on the light box. He circles a white area on the film and tells me that this is an "area of suspicion" and he would like to biopsy it right away. I try to drink in whatever it was he was saying but all I could think of were my hypochondriac mother's words the night before. "Don't let them do ANYTHING to you!" She seemed to get very angry when I told her I was going to the doctor because of a lump in my breast. If you've got a lump, you need to see MY doctor. I'm sure it was out of fear and concern, but it sure didn't come across that way.

For one of the few times in my life, I obeyed instead of rebelling. I told the doctor: no thank you, I won't be having a biopsy today. He protested with urgency, but I held my (and mom's) ground: "Don't let them do ANYTHING to you". He left frustrated, and came back: Dr. FreckleFace is on the phone, and she'd like to speak with you.

My gynecologist's voice at the other end of the phone sounded stern and questioning: Randi, Dr. WildHair thinks that there's an area that looks suspicious, and in order to be sure it's nothing, he really needs to perform what's called a core needle biopsy. He'll insert a small needle into the lump and pull out some tissue, to see what it is. It won't hurt, and its best to do it right away. I told her, that today was out of the question, but I'd be more than happy to come back on Friday, when I have more time. Looking back, I know they both knew right then and there that it was a malignant tumor.

Of course, I really just needed time to comprehend what was happening to me. It was starting to feel a little surreal. I needed time to do what my analytic mind does best: research this "core needle biopsy" thing, and really get my brain around what it was all about.

Both doctors agreed to let me leave without the biopsy, if I promised to come back on Friday and have it done - which I did. Dr. WildHair personally escorted me to the front desk to schedule the appointment. Suddenly, all of the Puerto Rican girls behind the front desk magically transformed from ornery New York City chicks who hate their jobs into sweet, compassionate girls looking at me with doe eyes and calling me honey and sweetie.

Whatever.

I research core needle biopsy on the Internet, and up pops an article actually written by the young, awkward Dr. WildHair. Wow, credibility. I learn more about the process, and begin feeling more at ease with the procedure. My mom tells me I was right not to let them do anything to me, I must cancel the Friday appointment and that she will schedule an appointment with HER doctor -- at the breast center of Good Samaritan, way out in West Islip, Long Island. Living in Manhattan, home of the best doctors in the world, the thought of going out to Long Island for healthcare held very little appeal. Clearly, I was her baby, and she felt the need to take control of my well being. I can't really fault her for that, it is her job. Or more accurately, it was her job.

Now it's mine.

So Friday rolls around, and back I go to the Upper East Side. They let Andrew come into the room with me. The biopsy didn't take all that long. They injected a needle containing a local anaesthetic into my breast to numb the area. The sonogram wand is waved over the lump, in order to accurately pinpont where the needle needs to be inserted. Next thing I know, I hear this loud "SNAP"! The core needle looks like some sort of toy gun contraption, and when the trigger is pulled, a little needle shoots out into the lump collecting tissue samples and shoots back in just as quickly.

The tissue sample sits in a vial of clear fluid on the countertop, and a strange fascination prompted me to look at it. What is this weird thing inside of me? This limp, gray "thing" floating around in the jar was my Alien. It's gross perhaps, but it doesn't look all that menacing. That was pretty easy. The end. That should be the end of my hanging out in doctor's offices for a while!

When I hear Dr. FreckleFace's voice on the other end of the phone, I think I knew. She wanted to see me in her office at 11am Monday morning.

I spent the weekend trying not to think too much about what was happening to me. I really believed that I was one of those charmed life people whose luck would always have them teetering on the brink of crisis, but nothing bad would actually ever materialize. A sixth sense told me that my luck was running out. But then again, talking myself into worst case scenarios was a technique I had learned to protect myself from situations like these. If I think the worst, how relieved and pleasantly surprised I would be when the news wasn't as bad as I'd thought.

Andrew goes off to work, and I stay at home whiling away the time until the appointment. I spread some strawberry jam over my English muffin, and choke it down past the butterflies in my stomach. Eating isn't terribly appealing, so I chain smoke instead, lighting next cigarette off the one just finished. Just as I finished the last drag, Andrew walked in to pick me up, and it was time to go. I haven't had a cigarette since that day, and strangely enough, I haven't missed it.

We join the new mothers in Dr. FreckleFace's waiting room, thinking to myself, how nice it must be to have a newborn baby. I intuitively felt the irony: There was new life all around me, but I was about to brush with death first hand, all at the ripe old age of 32.

I am an overachiever. When they called my name, I stood up and gave Andrew a kiss. Dr. FreckleFace asked: Is this your husband? Maybe he should come with us. I smiled at her as Andrew and I sat down at her desk. She did not smile back.

The lab results are back and I'm afraid its not good news. You have breast cancer. Suddenly, I was up on the ceiling looking down at the three of us in the office. OK, so what does this mean? What do I do next?

I've taken the liberty to set up an appointment with a doctor at NYU for you. He's a top breast surgeon, and he'll examine you and suggest the best course of action. I'm really sorry. The look on her face told me that this was the part of her job that she really hated.

OK, thanks, Doc. We left there, and I honestly don't remember all that much about what I was thinking or feeling. I'm pretty sure I was numb, and switched onto autopilot, where I spent the next several months. We walked from Dr. FreckleFace's office at 30th between 1st and 2nd, to NYU at 38th and 1st. Entering the hospital, the sight of a young bald woman walking very slowly and deliberately in our direction makes my stomach turn. Oh my God! THAT's a cancer patient!! That's what's going to happen to me?

Sorrow.

In Dr. OldDude's office, we waited for what seemed like an eternity. He was an older gentleman, balding with pale white hair. He examined me for about 10 seconds and said, Get dressed and meet me in my office. Andrew was already waiting there. I pulled out a pad and pencil, because somewhere I had heard that it was a good idea to write down what the doctor was saying, since you may not be in the best frame of mind to really hear.

I scribbled: Cancer?tumor?surgery?

"PUT THAT AWAY!!" His voice boomed. "Look me in the eye while I'm talking to you!" Whoa, I thought, but I'm just trying to make sure that I understand everything that you're telling me. "I don't want to talk to the top of your head, I want to look you as I'm explaining your options." Suddenly, instead of a young woman who's just had the pleasure of being told she has cancer, I felt like a schoolgirl, whose Daddy just yelled at her for misbehaving.

Here's what I heard:

"You'll need a lumpectomy.While the tumor is about 2½ centimeters already it's just small enough to spare your breast.

"You can choose to have a mastectomy, but lumpectomy with radiation should be fine.

"You'll have a slight cosmetic disfiguration, a sunken hole where the lump was.

"You may also need chemotherapy. "We'll need to get a baseline bone scan to make sure the cancer hasn't spread.

"I can do the surgery on Wednesday,the nurse will handle the scheduling and pre-operative tests. "Goodbye."

Uh?Wednesday? That's a bit soon, isn't it? What about a second opinion?

"With cancer, you need to move quickly. The next availability is next Wednesday, but I already have four surgeries that day. Thursday morning, then. You can get a second, third or fourth opinion if you like, but they'll all tell exactly what I've told you. I've seen thousands of these cases."

OK, ummm, thanks, bye. Ummm, nice meeting you?

To the nurse, I was also just another cancer on the assembly line. She recited the drill as if I was the one millionth customer:
 
"Here's all the forms you'll need to fill out. "Bring them with you on themorning of the surgery. "Your bone scan will be scheduled for tomorrow. "

"Don't eat or drink anything past midnight, the hospital will call you to confirm everything. "Goodbye."

Holy cow! What just happened in there? The experience officially catapulted me onto auto pilot! There was no way in hell I was going back to see THAT guy ever again, let alone trusting him to perform major surgery on the pristine temple that is my body!

End of Part One of the Saga?.more to come, eventually, when I can get around to it!