"What if?" The most insidious phrase in all of the English language has been popping up in my brain with annoying regularity over the past week and a half. Like some sort of whack-a-mole game, every time it pops up, I try to bash it down, but more often than not, I miss. It pops up at the times I least want it there - when I am putting my five year old to sleep, his plump little arms wrapped around my neck, a wet kiss planted on my cheek or when I am resting my head on my husband's chest - the kids finally asleep, a moment for us to just breathe, instead of running man to man defense on three constant motion boys. It doesn't pop up when I am running around, doing a million things, it pops up at those moments I treasure the most - the moments when I realize how much I really have to lose.
If you've read my earlier blog entries, you know that I had a cancer scare two months ago and that my dog, Sadie, has been battling cancer for those same two months. She is doing amazingly well and is now in remission, thankfully. I didn't mention in my previous blogs that while I was waiting to hear about Sadie's second biopsy, I was waiting to hear about my biopsy too - a second cancer scare, just weeks after the first. Both results were great - Sadie's cancer was gone and my biopsy was benign - the problem was decidedly non-life threatening. I was so happy to put that chapter behind us - that awful stretch of cold, dark winter when I really didn't know what the spring would hold. Burying our dog, illness for me - I just didn't know.
Of course, as soon as you are sure things are looking up, life often throws you a new curve ball. Getting into pajamas after a long day, tired as could be, my breast suddenly hurt, really hurt - in just one spot. I never do breast self exams, but I felt the area, pressing slightly, and there it was - a discernible lump. Pea size, solid, immovable. Definitely tender. That's a good thing, I told myself and proceeded to do what anyone in the Internet age does when faced with a health concern - I googled "Does breast cancer hurt?" Apparently, breast cancer can hurt - in it's advanced stages. I told myself that with regular mammograms, the chances that I had advanced breast cancer were slim. (Of course in my head, my grandmother's voice admonished, "Don't give yourself a kinehora*!") I also found though, that inflammatory breast cancer does hurt, and progresses at an alarming rate. I was stressed and exhausted and spinning things out to the worst possible scenario, a terrible habit of mine. I was going to just snap my laptop shut at that point. Googling was not providing reassurance, as I had hoped, but was simply fanning the flames of my anxiety.
Google won, though and I visited one more site - a blog written by a woman who had the same experience: breast pain, felt a lump, needed to have a mammo and sono and then, well I couldn't find the follow up. Maybe she had cancer and just couldn't deal with it, so she never wrote the follow up or maybe it was nothing and she just didn't bother to bring it up again. Either way, reading it convinced me that I should share this experience, that I wasn't being a melodramatic crybaby to find this whole thing unsettling. If someone else thought it was a blogworthy subject, that was good enough for me. It's an important tool to warn women to take breast pain seriously. Plus, I think most of the women reading this will have either gone through a biopsy or will know someone who has.
I didn't put the symbolic pen to paper for quite a while, though. After booking my mammogram and sonogram for the following week, I really forgot all about the lump. I was doing what needed to be done and worrying wasn't going to change anything. As an extra measure, I made an appointment for a Halo test - my doctor had been pushing me to get one for two years. It's like a pap smear for your boobs. After making and canceling an appointment a few months before, I decided it was time.
Let me tell you - the sweater puppies had a tough two days. The Halo test sounds all gentle and benign - invoking images of angels and Beyonce. It is more like something on loan from Guantanamo Bay. I will spare you the details, but if they have breast pumps in hell, they will be similar to this machine. But, and this is a big but - I am glad I did it. And I urge other women to do it, as well. It ferrets out abnormal cells that a mammo and sono might miss. It doesn't replace those tests though, so the next day I found myself being pancaked by those cold, hard plates. But honestly, compared to the Halo, it was a walk in the park. The mammo looked normal, so off I went confidently into the sono room. If the mammo didn't find anything, how bad could the sono be?
The radiologist did the sonogram himself and when he squinted at the screen and asked the technician, "Have we biopsied her yet?" it was a bit disconcerting. I answered for her, "No, you haven't. I was told about three years ago that I might need a biopsy, but then I received a letter stating that everything looked benign and I should just come back in six months." My mind reeled with the possibility that the letter was sent to me in error, that I should have had a biopsy then and that, however improbable, every test that I'd had since then missed the original problem, which now was three years more advanced than it would have been.
A check of my records indicated that it was a new lump - the one I had felt a week earlier. Ironically, when I tried to find the lump right before my mammogram, so the technician could place a sticker on it, I really couldn't. I put the sticker where I thought it was and told the tech that maybe it was just a cyclical thing. It wasn't. It was a 9mm "complex mass." 9mm sounds so ominous. Like there's a locked and loaded weapon residing in my breast. The doctor assured me that it wasn't overly large - only pea sized, but even a pea sized mass is disconcerting, especially when the doctor says you need a biopsy (and others, well meaning as they are, say things like, "That's big!" and "That's not tiny! My lump was smaller than that.").
The "what ifs" started on the car ride home. What if it's cancer? What if I have to tell the kids I have cancer? I don't even like to take antibiotics, what if I need chemo? I had to get it all out before walking in the house. I have to admit, there was even a shallow "what if" or two. Like most women, I have had a love/hate relationship with my breasts. When I was an "early bloomer," I hated the attention they brought me. My nickname was Dolly Parton and I walked around with hunched over shoulders. In my twenties, they seemed just right for my frame and by my thirties, they disappointed me. After three pregnancies and three years of breastfeeding, they were somewhat deflated. Then, a miraculous thing happened - after years of being underweight, I gained five pounds as I entered my forties and they perked right back up again. My formerly comfy B cup bras left me sore, with angry red imprints. A few weeks ago I went to Target and bought an armload of 34Cs. (I know it's not Victoria's Secret, but I bought five at Target for the amount I would have spent on one at VS. And, they really are quite nice.) I am kind of ashamed about that completely shallow “what if”. What if I lose my breasts when I'm finally filling out C cups? Come on. So many women lose their breasts and end up with better ones, end up alive - the most important thing. Look at Christina Applegate - she maintains that she'll have the "best boobs in the nursing home." And you know what, she's right.
That shallow "what if" is, arguably, the easiest one to contemplate. I'd miss my C cups, but I can certainly live without them. The others (radiation, chemo or worse) - not so easy. I tried to put everything out of my mind, but it was hard. Understandably, my mother and sisters were worried and called, giving me support and advice - which forced me to face facts and take action, when I would have preferred to just forget about it until my appointment. Of course, this was a good thing - I ended up switching to a much better radiologist, one specializing in women. If I kept my head in the sand, I would have stayed with the radiologist that had a receptionist explain the test to me (in five minutes), instead of switching to one that had a nurse speak with me about the test for forty minutes. (More importantly, this new radiologist is doing a core biopsy - more invasive - but also more accurate than the fine needle biopsy my old doctor planned to try first and she noticed a second spot she wants to check.) Unfortunately, my family is full of cancer experts. My mother, sister, father, grandmother and aunts all had cancer. All but my grandmother beat it and my grandmother's cancer was so advanced, that she only had a week to live when the doctor discovered it. We are a family of survivors, to be sure, but worriers as well. I have at times felt like a ticking time bomb thanks to my family history.
Even with all this weighing on me, I was still fairly calm, despite the "what ifs?" Most of the time, I was too busy to think about it. But then I discovered that due to a communication mishap, I was actually six months late for my mammogram. I had booked my appointment this year, assuming that I was right on time. When I picked up my films from last year to bring to my new radiologist, I glanced at the report sent to my doctor. I felt physically sick, reading the closing line, "Continued clinical and mammographic vigilance is advised, including bilateral mammogram studies in 8/09." The only letter I had received advised me to get my annual mammogram.
The "what ifs" came crashing back down. What if the 9mm mass was just 3 or 6mm last summer? What if it is something terrible? At first I was furious, blaming the radiologist, my doctor, swearing a lawsuit, but my righteous indignation crumpled when I learned that I had screwed up. Last year’s check was only partial - my full mammogram was in September 2008 and I was due back in August. I really should have known that. I know I am my own worst enemy - over thinking everything and blaming myself. As the biopsy draws closer though, I am really trying to just forget about it. There isn't anything I can do - no amount of magical thinking will change the verdict. In a way it's not all bad - the fear has taught me to appreciate what I have - from my boobs to my family. I feel like shaking my fist, yelling, "Lesson learned. Good enough. I get it. Appreciate what I have."
And, I do appreciate what I have. Really. While I was writing this, Aidan came over to me, wrapped those little arms around my neck, kissed me on the cheek and said, "You're the best mom. You will be my mom forever and ever and ever, right?" I answered, "Yes, of course, I'll be your mom forever and ever."
"And ever," he finished for me. Then, he added, "Even when I'm 49, you'll still be my mom - right?" I hugged him close and overwhelmed by my love for him, said, "Yes, even when you are 49, I will still be your mom." Kinehora*. Knock on wood. Fingers crossed and all those other things that chase away the evil eye. He hugged me again and I tried my best to chase away the "what ifs," as well.
*Kinehora n : A curse in reverse. A colleague says with best intentions; "Looks like you're going to get a promotion, Jack." Kinehora! You quickly cover his mouth, for to utter such a thing is to ensure it will never happen - source: the Yiddish dictionary
Oops - did I say "my lump was smaller than that". Sorry. Actually first one was 9mm and 2nd was was 4mm. I liked the article. Sorry you had to have a biopsy. Hope you're feeling better . . .
Posted by: Shari Goldberg | 02/18/2010 at 09:16 PM
It WASN'T you!!! OMG - I am so sorry if you thought it was. You never told me how big the lumps were. I told you what I was going to say about you ;-) I was also going to write, "My friend, Shari, battled breast cancer with humor and grace and beat it! I am lucky to have her as a role model, while going through this biopsy, no matter the outcome."
Posted by: Stephanie Kepke | 02/18/2010 at 09:34 PM
OK, here's my follow up: one word - benign. I wanted to let readers who happened to stumble upon this blog know the result of my biopsy for two reasons - the most important being that if you are going through the same thing, it's good to know about happy endings! Another reason is simple human curiosity. As I mentioned in this post, I read a blog about the very same thing, but there was no follow up - no happy or sad ending. I wanted to know what happened to that woman. This post is still getting hits, weeks after being published (thankfully!), and now you know how it ends - happily :-)
Posted by: Stephanie Kepke | 03/02/2010 at 10:14 AM