Goodbye Girls

When I showed up at the clinic for my annual exam in October of 2008, in a fortuitous twist of fate, the doctor assigned to me was a friend. During the exam she suggested a mammogram to check out an enlarged lymph node. Had it been some random doc...I probably would have procrastinated...but, maybe because it was her, I called to set up the appointment as soon as I got to the car.  

On October 17, I had my digital mammogram.  The lymph node was just a lymph node...but there was something on the other side. They did a biopsy the same day, and that didn't exactly go well as someone miscalculated the settings on the computer-operated biopsy machine and overshot the target with the needle (not fun). At least I got some "Breast Cancer Awareness Month" cookies and a pink robe as a parting gift.

Thus began a crazy whirlwind.

With no insurance and no regular doctor, I found myself at the mercy of the hospital. Biopsy results were delayed and the tension built…finally, on October 28, the doctor called to give me the news over the phone "you have cancer, come in tomorrow at 9".  

We were still in a state of shock when we showed up the next morning. The doctor, who must have failed the kindness portion of his training, handed me a book called "Be a Survivor" before he even said "hello." He then proceeded to try to convince me that we had to move fast and should try to do the surgery as soon as possible. The problem was that I would be leaving in about a week for my Fall show trip...five weeks on the road. He claimed that I would be fine doing that trip right after surgery. Fortunately, his schedule could not fit me in.

The phone calls started. What about a doctor in Tennessee or DC where I was heading? I made an appointment with a woman doctor in Nashville where my Mom and many other family members live and we hit the road early. The doc in Nashville greeted me with "Well, the good news is you'll be permanently perky." I must have looked stunned (maybe more like "mildly irritated") because she went on to cheerfully explain that they begin the reconstruction during the surgery to remove the cancer. Long story short...she wasn't going to work out either.  

At my Fall art shows, my artist friends were my saving grace. My way through things that are too hard to think about is to laugh...and laugh we did. Ray was going to carve me balsa wood boobs, and a sculptor friend offered to make me a bronze set. A dear friend who had had successful reconstruction shared her story and offered to let me feel hers if I wanted (words that came out right as Ray happened to walk by and brought on another round of giggles).  

Meanwhile I was wrestling with some big decisions. There was no indication of cancer on the right side and the tumor was relatively small. The doctors all said the best thing was to do a lumpectomy, followed by chemo and radiation. Option two, a mastectomy and probably no radiation/chemo. They offered assorted recommendations for reconstruction, most started the process during the initial surgery...but there would be more surgeries, either way. The thought of chemo flat out terrified me and there was still the problem of no insurance. Reconstruction had no appeal, nor did the idea of being "lopsided" or dealing with a prosthetic. With no insurance, minimizing cost had to be considered as well. 

In the end, I went against the advice of all the doctors and chose a bilateral mastectomy without reconstruction. I made this decision for several reasons. First, I have never seen myself as a fake boob kind of girl and I could not imagine putting my body through more surgeries than necessary just to fill a bra (those things are annoying anyway). Second, I was hoping to get through this without having to do chemo or radiation. Third...with no insurance, and no chance that I would ever get insurance after this...it just seemed the logical thing to be done with it all and not have to worry in the future, if possible. A friend recommended a surgeon in Helena and appointments were made.

On December 11, I said goodbye to the girls. Just before surgery, the doctor asked "are you sure you want to go this route?" Without hesitation, I said "Yes...and could you give me lightning bolt scars?"  (she didn't).  

More news came at the first follow-up visit: The doctor said "You made the right decision. Turns out there was a second tumor that had missed by all the mammograms, MRIs and doctors." Fortunately, they just happened to get it all in the surgery but, because the margins were a little close, I would have to do radiation.

"Buddha Bear"
(Inspired by one of the bears I watched
during radiation)

Radiation was not the monster I thought it would be. The doctors said the effects would be cumulative and that I would get more and more exhausted over the ten to twelve weeks it would take. Thing was...it was Spring and my favorite time to see bears in the Park. So, for most of the last seven weeks of radiation, I would get up at 2:30-3 AM and drive a couple of hours to Yellowstone to watch and photograph bears, wolves, etc. I would schedule my radiation appointment as late as possible every day and to make the daily 4-4:30 slot in Bozeman, I would have to be leaving YNP by 2 PM.  After radiation, it was another 40 minutes drive home to rest. Then I would do it all again the next day. Weekends were spent entirely in the Park. Where other women in the waiting room would talk about how all they could do was go home afterward and sit around and cry...I would come bouncing into the hospital telling stories and showing photos of the bears and wolves I had seen.

In the end...it was a combination of luck, pragmatism, common sense, trusting my gut and a tendency to be vanity-challenged that saved my ass, even if nothing could be done for the tits. Even finding myself single again, I have no regrets about the decisions I made. Being flat-chested really isn't so bad…in fact, I'd have to say it has some distinct advantages.  

What amazed me over the course of this process was how important saving the breast (or rebuilding it) was to the vast majority of the people I spoke with.  Someone told me of a friend who chose to try to save her breasts and wound up with another round of cancer that killed her…she left two small children behind.  It is a sad reflection on our society that so much import is put on something of, really, so little consequence.  How sad to think of all the women who have lost their lives to keep their breasts…or lost their partners because they didn't. I remember reading over and again about so many women who would look at themselves in the mirror post-surgery (if they even COULD look) and cry because they felt "less" than a woman without breasts. That never happened with me for some reason…from the first time I faced that mirror the day after surgery, what comes to my mind has always been "well, it is what it is". I don't feel a sense of loss or like "less" of a woman…just very fortunate to be alive.

November 2012 ()

Ironically, in 2002-2003 I did a huge solo painting project  that benefitted breast cancer research, though I had no connection to breast cancer.  

Weirder still was this: when the doctor explained how long I had probably had the cancer based on the size of the tumor, it turned out that the cancer most likely started WHILE I was doing the "48x48" project.  

Guess you could say that no good deed goes unpunished...OR you could look at it like I do:  

In a way, cancer was a gift. Though I would NEVER choose that path (or wish it on anyone)...in so many ways my life is far better for having had cancer. My life is far more valuable to me and far richer...and I will never have to buy or wear a bra again!!

(By the way, I am NOT single again because of my decision regarding my breasts. Ray not only stuck through it all, he was my rock and incredibly supportive of every choice made..especially that one.
We were just different people on different paths...)