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AN OPEN LETTER TO MY PATIENT ON THE DAY OF HER MASTECTOMY

October 16, 2013

Hello, Dear.

Today is the day. I am a member of the surgical team who will take care of you -- the team that will remove your breast to treat the cancer that has tried to make a home in your body. We all have our role today, and the world would see yours to be the "patient."

I see it as something more: a powerful gift to us.

Because you remind us why we do what we do.

Today will feel sterile and scary. And I am sorry for that.

I wish there were a better way. Today we will ask you to take all your clothes off and put in their place a gown. Women before you have worn it. Women after you will wear it. Be sure to ask for warm blankets, because we always have plenty. We will ask of you your blood type, your medical history, your allergies. We will ask you to lie down in a bed that's foreign to you. We will have to poke you so that we can start an IV.

You will meet many nurses, doctors, and hospital employees. We will write down important things for you to know. Your surgeon will see you soon. He will have to mark the breast we are having to remove today.

We will take you into the Operating Room -- a room only few have seen. There will be bright lights, lots of metal, instruments that you've never seen, and we will be dressed in gowns, gloves, and masks. Over our masks, we hope you can see our eyes reassuring you as you go off to sleep.

Today is the day you will have to say goodbye to a part of your body, a part of yourself.

Your breast has felt the warmth of a lover's caress, has fed your child with life-sustaining milk and connection. You have many memories stored in your breast, stories none of us today know about. Somehow I wish I knew them.

And yet. Here we are. We must do our rituals. We must scrub our arms and hands with alcohol so that we can fight off infection before we start. We don our gowns, our gloves, our masks. We must drape your body in blue.

You are exposed. And unconscious. And it must be difficult to trust. I honor you, Dear One.

My job is to help your surgeon take away the cancer. I get a bird's eye view of the process. The surgery begins and I feel your warm skin through my gloves. I wonder what stories you already have and the ones that are yet to come.

We carefully remove your breast. It never gets easy to see or to do. You must know this. It never feels natural, it never feels cavalier. It feels sacred to me. Every. Single. Time.

I look down and see your pectoralis major --- the big muscle behind your breast. A source of strength. It is beautiful and shiny. Sometimes it contracts a little bit while we work. Sometimes the muscle is bright red and young. Sometimes the muscle is faded a little. But it is always strong. I like to gently touch it withmy fingers. Because I feel your strength there.

We must send your breast away now. It officially leaves your body. I always feel an ache in my gut in that moment. There is no way for you to fully prepare for this day, Dear One.

I like to think that your body is already healing, as we close the incision we had to make.

Sewing your skin back together feels like I'm helping a little. But I know it's actually all youdoing the work. Even as you sleep, Dear One.

We will put a bandage on your incision. We will wake you up. We will tell you everything went well. But the road is just beginning for you.

I saw you today.

You are beautiful.

You are strong.

Thank you for entrusting me and my colleagues with your most intimate moments. I am honored to be a witness to this phase of your life.

Because now the healing begins. Now the grief is in full force. Now your breast is gone and in its place is a memory.

I watch you as you wake up. And I want to make it all go away. I can't. Today your body underwent a transformation. And today our team took care of your body. I hope we took care of your heart, too.

There is nothing we can say or do to make it go away. But please know that I care. We care.Behind our masks and gowns are heavy hearts and sometimes tears.

Yours are a gift today. Because you remind us of human resilience. You remind us of strength. You remind us of trust.

I saw you today.

You are beautiful.

You are strong.

I will not forget.

---Niki, your Nurse Practitioner First Assistant on the Surgical Team

Buddha Belly

I can see my belly! Which blocks the view of my feet! Dang! My boobs used to block that view looking down. My figure is disfigured! I'm shaped weird. I actually don't miss my boobs, but I sure would like to get rid of this buddha belly. Unfortunately, the belly stores fat as "energy". . . . . and I don't have a lot of energy!

Hot flashes, hair loss, joint/bone/muscle pain, FATIGUE, unusual sweating and temperature changes, nausea, dizziness, anxiety, mood swings (it's hard to explain, but they just slap me suddenly into a funk) and trouble sleeping. These are all side affects of the darn meds I'm on. Fibromyalgia and hypothyroidism kicked my health to the curb a couple years before crappy cancer came along. The meds for those caused weight gain. Now, I'm dealing with all the side affects of the multiple drugs I'm on and I'm shaped like Pooh. See the flat chest and round belly? Yep, that's me! POOH!

My biggest complaint so far is the extreme fatigue. Yes, my joints hurt and I have frequent temperature changes along with restless nights and all the other affects. But I just don't want to be this deep down, bone weary, TIRED for 5 years! Is it the hormone treatment or lack of estrogen? Who knows. All I want to do is sleep, but I usually cannot. I fight anxiety to almost the point of an attack. I hate being around a lot of people. I'd rather just stay home all the time, but I force myself to get back into the world and "show up." It's not easy. And some days I just can't.

I've made a five year commitment. . . . . and it kinda fills me with rage just a tiny bit. I don't want to think (worry) about crappy cancer for the next 5+ years, but I will every time I take that tiny pill.

In the meantime, I'm trying to stay busy so I don't just sit or lay down and do nothing. Staying busy, along with a healthier diet, gives me hope that the buddha belly will somewhat level out. I'm turning 60 this year, and the metabolism is slowing down. My health has deteriorated more than I'd like at this age.

I can't believe how much my life has changed. I'm not the same person I was before crappy cancer. In many ways, I'm more thankful, thoughtful, kinder, and more appreciative. More spiritual. In other ways, I'm more sad, depressed, scared, and just . . . . .different! I look different and I feel different. I'm a survivor and I'm different. But, hey, I'm alive. Buddha belly and all!

Sugar Shakedown

…..sigh…this coming from the woman who loves sweets, and in fact craves sweets, and an occasional glass of wine.

The fact is, alcohol is a known cause of cancers of the mouth, throat (pharynx), voice box (larynx), esophagus, liver, colon, rectum, and breast. It may also increase risk of cancer of the pancreas. It is not known exactly HOW drinking alcohol leads to cancer, but there is a definite link. Researchers from the Boston University School of Medicine and Boston University School of Public Health have shown that alcohol is a major contributor to cancer deaths. These findings, published in the April 2013 issue of the American Journal of Public Health, show that alcohol is a carcinogen, even when consumed in small amounts. Therefore reducing or eliminating alcohol consumption is an important cancer prevention strategy.

Two simple facts: alcohol and sodas are high in sugar or artificial sweeteners, and they contain zero nutrients. It is a known fact that cancer LOVES sugar! Cancer cells consume anywhere from ten to fifty times more glucose than normal cells do! So in fact, when you feed your body sugar, you are actually feeding cancer cells. . . . . kinda makes you want to give up sweets, huh?

Excess soda can also lead to weight gain, which is another risk factor for cancer. If you think that switching to diet soda is better, think again. Diet soda drinkers have twice the amount of obesity than the general population. Artificial sweeteners are no better than sugar. In fact, they are toxic. They are up to 100 times sweeter than real sugar, which blunts the taste of nature’s sugar, such as that found in fruit. They also increase the craving for sugar since the brain has receptors designed for sugar that do not accept the artificial substitute. Don’t be fooled by drinks that tout “all natural flavors”, since these natural flavors are actually Monosodium Glutamate (MSG) in disguise! MSG is a neurotoxin that is hidden in many foods, under many different labels, including “natural flavors”. While there is no direct link between MSG and cancer, it has been linked to brain lesions, neuro-endocrine disorders, and neuro-degenerative disease, such as Parkinson’s and Alzheimer’s.

Sugar suppresses a key immune response known as phagocytosis – the Pac-Man effect of the immune system. Consuming 10 teaspoons of sugar can cause about a 50% reduction in phagocytosis. If you consider the sugar in your cereal, the syrup on your waffles and pancakes, the sugar added to your morning coffee or tea, the sugar in cold beverages like iced tea or lemonade, the HFCS in prepared foods, salad dressing and ketchup, and of course sugary snacks and desserts, you can see how easy it is to suppress your immune systems significantly.

Not only the amount of sugar, but also the frequency of ingesting sugar is relevant to immune function. In one study, research subjects were found to have nearly a 38% decrease in phagocytosis one hour after ingesting a moderate amount of sugar. Two hours later, the immune system was suppressed 44%; immune function did not recover completely for a full five hours. So, it lowers your immune system, which a cancer patient does NOT need!

When sugar in any form is consumed, the pancreas releases insulin. Breast tissue, for example, contains insulin receptors, and insulin is a powerful stimulant of cell growth. One group of Australian researchers concluded that high levels of insulin and insulin-like growth factor (IGF) may actually be causative of cancers of the breast, prostate, endometrium and pancreas. A broad study conducted in 21 countries in Europe, North America and Asia concluded that sugar intake is a strong risk factor contributing to higher breast cancer rates, particularly in older women. A four-year study at the National Institute of Public Health and Environmental Protection in the Netherlands compared 111 biliary tract cancer patients with 480 healthy controls. Sugar intake was associated with more than double the cancer risk!!!

And here's another thing: Humans are the only mammals on the planet who consume the milk of another mammal! We are not baby cows and our bodies were not designed to drink a beverage that nature intended to make calves gain hundreds of pounds in a matter of months! Whether or not dairy causes or promotes cancer is still open to debate. The fact is, factory farms inject their cattle with a substance called IGF-1, which has been linked to cancer. In addition, in order to keep them producing milk, cows are also injected with estrogen, which we know feeds hormonal cancers, such as breast cancer. Since the type of cancer that I had was estrogen fed, I'm supposed to avoid dairy like the plague! So, those late night bowls of cereal are just a memory.

Scientists have found that sugar is addictive and stimulates the same pleasure centers of the brain as cocaine or heroin. Just like those hard-core drugs, getting off sugar leads to withdrawal and cravings, requiring an actual detox process to wean a body from.

So basically, I'm addicted. Sugar is my drug and I'm having a very difficult time giving it up. I crave it! I want to remain cancer free, and I really want to cut out the sugar as much as possible, but I fail miserably. The craving becomes too great and I cheat. Sugar Shakedown. . . . . . It's a process.

What have I Become?

I have not become more reasonable, less stubborn, less angry, or more patient.

Stubbornness, anger, and impatience are my biggest personality flaws, and they have just been exacerbated by cancer. Especially impatience. Somewhere deep inside me, I'm scared about the amount of time I have left. I value time. It has become precious. There's not enough. Crappy cancer stole some of it. It continues to steal time as I recover and go through treatment.

I'm different. On the outside and the inside. My figure is distorted. My personality is distorted. It seems I've developed new flaws, and old flaws have reared their ugly heads. What have I become?

I've always been brave, string willed, never shy or afraid of crowds. I've always been a leader. Now, I'm content to stay home. Crowds make me nervous. I'm experiencing anxiety. I'm told cancer patients get PTSD but I feel that's too strong a description and totally unfair to our soldiers. . . . . and yet, I'm not the same. What have I become?

Crappy cancer is forever a black cloud hanging over me. Blood tests every three months, lots of doctor visits, treatments, scans and more for at least the next five years. Will it come back? Probably. Breast cancer usually does. The battle never ends.

How we go into this battle with crappy cancer is as individual as we are. There is no right or wrong, proper or improper way. If you run in with a cape and a sword screaming war cries, and it works for you, it's the right way. If you walk in boldly being led by God and a bible, or a rosary and holy oil in your pocket; if it works for you, it is the right way. If you must be dragged into the fight with knees knocking, tears streaming and heart racing, but it gets you through, it is the right way. The pink cancer warrior suit comes in one size fits all! How we slay crappy cancer doesn't matter, as long as we slay. Right?

I have found that each day can bring about a change in my emotional response. It's a roller coaster. Sometimes all I can do is roll with the emotional tide. Some days I just survive the day. Some days I soar bravely with my cancer, and sometimes I am face down in my tears, but my suit is still as pink as it was the day I put it on and decided to fight.

Ponder with me the many emotional responses through crappy breast cancer:

Denial and Shock - "This can't be true." "How did this happen? "

Anger, Rage - "This isn't fair." "I never took hormones."

Stress and Depression - "I don't have time to deal with this." "I feel so sad." "How bad is it?"

Grief and Fear - "I'm not ready to die." "I'm going to lose part of my body." "What if it's spread?"

Acceptance, Adjustment - "Okay, it's true. I've got breast cancer, but I don't have to like it." "Let's just do this and get these boobs off NOW."

Fight and Hope - "I'm going to be brave and beat this!" "I'm going to research and understand every bit of this crap."

Concern about disfigurement – "After surgery, what will I look like?" "What will happen to my sex life?" "How will my clothes fit?"

Fear of the unknown – "What happens next?" "What treatment will I get?" "How long will it take to recover?"

Worry about side effects – "I don't like what I'm reading and hearing." "How is this going to affect my quality of life?"

Anxiety - "How do I know if the therapy works?" "What if it comes back?"

Family Concerns - "How is this affecting my family?" "Will my daughter's get this too?" "I don't want to scare my grand-kids."

Fear of Recurrence - "Will my cancer return?" "Will it spread?" "Is that pain I'm feeling or just a pulled muscle, or could it be my cancer has returned? Where will it come back at?" "How will I know?"

Feeling Vulnerable - "How do I guard my health and what do I need to change to take better care of myself?" "What if I do something that causes it to come back or spread?"

Fear of Continued Pain - "My chest is sore." "I'm exhausted." "Will I ever feel normal again?"

Fear of Death - "My family needs me. I'm not prepared for this."

Yep. Crappy cancer has taken me through all these emotions several times. I'm tired. So tired. I want off this roller coaster ride, but it just got started. I don't like what I've become. I miss the old me. . . . . The confident gal before crappy cancer changed her.

What have I become? Well, for now, I'm still evolving. It's my 3 month cancer-versary since my boobs were whacked off. So, I'll give myself a break. It's too soon to know what I'll become.

I am NOT a Cryer!

I hate to cry and I seldom do. I've always been tough and able to deal with things in a very stressful world. I've always had a stressful job, worked long hours, volunteered a lot, and I just DO. NOT. CRY.

But now, I find tears running down my cheeks quite often. Commercials, Lifetime movies. . . . LIFE!
I'm overly emotional about the tiniest things. Mood swings are out of control. I hate it! Suck it up, Buttercup, and get a grip! Cried several times on Christmas day.

I am having some weird side affects too with no explanation. Chills to the point of my teeth rattling with NO fever, then, 30 seconds later dripping in sweat. I cannot sleep. I barely doze on and off and start my days off totally exhausted. My nights are awful with very little sleep. I can only sleep on my side for a short period of time because my sides and underarms still hurt.

I've never been nervous or anxious. Now, I get a little scared just leaving the house. I don't want to become a recluse, but I'm just perfectly content to stay home. It has become a security blanket of sorts. . . . . a way to avoid anything happening outside my immediate world and family. I'm simply not the same person. At all. Stupid crappy cancer. . . . . I blame you for all of this!

Therapy begins: Fight or Flight

Here we go....therapy begins and I'm hesitant. Not scared or nervous, just doubtful. Aremidex is what they are discussing putting me on because I'm post menopausal. The side effects are frightening to read but that's true of any medication. However, my survival rate is a whopping 93.5%! Don't you just love it when they give you statistics? I'm a number now.

More labs and tests tomorrow to see if I need chemo. Total waste of time because I'm not taking it. (A 2.1% cure rate isn't high enough to my way of thinking.) I've basically been in 'fight or flight' mode since my diagnosis and just when I think I'm pulling myself out of it and coming back to my "new normal" something else is thrown at me.

These crappy meds cause depression and mood swings. Really? Like I haven't already been there, done that! Sleep deprivation. . . . makes me laugh! I haven't slept well in 2 months! Weight gain is another to look forward to, as though my fibromyalgia meds and hypothyroid haven't already put 30 pounds on me.

I could go on and on but these are the ones that most women experience on this drug. And I'm supposed to take it for 5 years! WOOHOO! Crappy cancer just won't let me live my life. It's like a little black cloud over my head at all times . . . . Always reminding me.

I'm still experiencing tenderness in my pits and sides which make it difficult to sleep or do anything physical. My scar is healing beautifully so THERE'S a bright spot in this journey!

Warning! Warning! Warning! ⚠

PICTURE to follow below. 👇

My tattoo artist has artwork for me to look at and take measurements. I'm excited beyond words to see what he's come up with for me to look and feel feminine again. It's the one thing I have to look forward to!

And of course I'll post pics of the process!

I pray daily for all the pink sisters out there going thru this crappy cancer journey. You are not alone. My strength is from my Savior who walks with me and often carries me. My wonderful husband who continues to kiss the scars and tells me I'm beautiful is a constant source of strength and encouragement to me. Don't ever give up, and do what's right for you; for there is no "one size fits all" when it comes to crappy cancer.

P.S. Dry skin I hate you too! (just another symptom of crappy cancer)

Beware: Grumpy Old Woman

It's NOT because I'm a woman! (That is a disclaimer for all the men reading this) It's because of the cancer, surgery, recovery and treatment. I've been having huge mood swings similar to PMS. (Some might say worse) One minute I'm happy and the next I'm crabby and rude. I'm also having anxiety and that's a new experience! I couldn't decide if it was because I wasn't getting any sleep, from constant pain, or perhaps a hormonal change from the crappy cancer.

I was afraid I was alienating myself from my loved ones, and hated the way it was making me feel. My precious husband just keeps sticking with me, assuring me of his love no matter what.

After opening up to my support group and doctor, I'm told this is normal. Every single woman I talked to was having the same issue! Great! At least I'm not alone and losing my delightful personality! :)

It's a journey that's not too pleasant with many different side affects. PTSD is not uncommon among cancer patients. I wouldn't go that far, but I was reassured it would get better. I feel like I need to wear a sign around my neck warning people: "This isn't who I am. It's only temporary. "

One woman told me her son made her a sign to hang on her door: "Beware of Grumpy Old Woman." She took that well!

So if I bite your head off or show annoyance, please bear with me and remember it's the crappy cancer and the treatment that's screwing with my body and mind. I'm trying to be cautiously aware of my snippiness. Crappy cancer, I hate you!

It's Weird

I can't explain it. I can't tell you why. But as I was taking a shower last night, I'm soaping up my chest and it just sorta hits me: Dang! My boobs are gone! Yeah, yeah, I know. . . . .they've been gone now for 8 weeks and this isn't the first time I've showered! There's just moments when it seems surreal, or maybe unreal?

There are times when I stand in front of the mirror and just stare at myself to get used to what I look like. The scar isn't bad at all. It's just a different look without the boobs. It's a different feel too. It feels weird. It looks weird.

I'm still a bit sore and tender. I still hug my heart shaped pillow to my chest at night and can't lay on my side for very long. There seems to be some sore spots where the drains were. It hurts to lift my arms above my head and I feel "tight" as though I'm going to pull something if I stretch out. It's not at all comfortable. It's weird.

Now gals, it really is freeing not to wear a bra; not to pull up those straps constantly slipping off my shoulders. I even experimented the other day by putting on a bra and my "fake boobs" which felt even weirder. I felt conspicuous. . . . . just not normal and don't know when it will ever feel normal again. It's weird.

I've become somewhat of a recluse, enjoying my time at home wrapping Christmas gifts and spending time with family as I recover. I haven't gone back to church yet; and although I miss my class and Tom's lessons, I'm scared. I almost have a panic attack just thinking about how overwhelming it will be. All the hugs will hurt. "How are you" will be answered with the standard "I'm fine." The men will do their best NOT to look at my flat chest. The women will tell me I look great. (I really don't understand this comment. They just whacked off my boobs. My face, hair, and the rest of me all look the same. Did I not look great before?) I know, it's weird, right?

I'm just weird. I'm having weird thoughts. Weird emotions that are all over the place. Is only been 8 weeks. Maybe I'm expecting too much. I want to feel normal. . . . . Well, my "new normal" whatever that is. It's weird.