BRCA Is My 4 Letter Word

Why Pursue BRCA Testing

2010-12-30T11:38:00.000-05:00

Have a close relative who has battled breast or ovarian cancer? If so, you may want to check into being tested for the BRCA gene. It's a no-brainer. See August 1, 2008 posting.

Great News for BRCA Gene Testing!

2010-12-29T21:38:00.000-05:00

New legislation helps with BRCA gene testing. See Nov. 3 posting.

Life as it should be lived

2010-03-13T15:50:00.001-05:00

When you've stared death in the face twice before the age of 50, you get a few things in order.

One of the chief realizations through my battle with cancer is the brevity of life (no big shock there, I know) and the importance of living out your dreams, if possible, rather than putting them off for "one day" that never comes.

Despite depleting my life savings account, I'm embarking on my dream of taking my two nieces (ages 15 and 22) to Paris. Since they were little girls, I've talked about taking them to Paris, even using this as a ploy to get one of them to expand her culinary tastes beyond, "eew, yuck, gross."

So, with map and credit card and a French-American dictionary in hand--and a suitcase packed with nothing but black--we leave today for a week in Gay Paree, exploring the touristy sites, visiting the local markets and eating nonstop.

It's a dream-come-true for me. I hope to give my nieces a memory for a lifetime. I'm so mindful in light of cancer that what's important to me are people and experiences - and I want to fill my time with those two things.

Au revoir.

OCS: The Fate of Women

2010-03-12T06:35:00.000-05:00

A friend handed me, "Younger Next Year for Women: Live Strong, Fit, and Sexy - Until You're 80 and Beyond" by Chris Crowley and Henry Lodge.

Although the title was off-putting, the subject matter caught my eye, since the authors talk about aging well for the "next third" of our lives (i.e., midlife until we die). In addition to proper nutrition and connecting socially, the key to aging well is exercise and, in particular, a strong core--which we all know by now.

But, it was another topic that caught my eye. Women are particularly vulnerable to developing a frightening, debilitating and destructive condition, and I'm afraid it has already happened to me. It's OCS. Old Crone Syndrome.

Yep. After menopause, with all our raging hormones, we turn into easily irritated, rough, tough, cranky, demanding old women. I find myself snapping back more quickly than I mean to...wanting to throttle people over the least mishap...losing patience over the simplest things, and coming across more harshly in general. Linda Blair has nothing on me. Where's a Catholic priest when you need him?

There's no cure for OCS, except to be cognizant of your less than gracious state of being -- hopefully, before you lambaste the flippant sales clerk, or the texting teenage driver, or the entire world who is getting on your last nerve.

It's a daily struggle for me, I have to admit, but at least I'm good at apologizing for my behavior.

Fighting My Own Windmills

2010-03-11T18:42:00.001-05:00

I've decided the life of a cancer survivor is similar to Don Quixote. Except his world was far more logical than our healthcare system.

After being blown off by my surgeon's office, who refused to give me a referral to see a physical therapist--silly me, for wanting to build back cut muscles, tissues, tendons and ligaments--I pursued the quest of finding a PT on my own (and on my own dollar, since insurance will only cover a referral).

You will find throughout the entire cancer process that it's completely up to you if you want anything done.

I looked for a great physical therapist who was also trained in pilades, since for us reconstruction girls, it's all about rebuilding our core.

I found the best in Jessica Locar, who, by the way, is opening her own business at the end of this month: STABILITY (www.stabilityatlanta.com). Stability offers physical therapy, occupational therapy, massage therapy, and pilades and yoga instruction--both one-one-one sessions and classes.

After 2 years of being out of whack physically, I am proof-positive that your core rules your life. Without core strength, you fall off balance easily (hence, why all my friends over 55 years old have fallen and broken wrists and ankles), and there are no muscles to hold in your organs in your abdominal area (hence, the pregnancy look even when your ovaries are missing).

Jessica had the brilliant idea to ask for my medical records - which every patient should have on hand - so she could review all that had happened to me. They revealed, of course, the removal of part of my abdominal muscles. Voila! The answer to why I'm in such a miserable situation.

As I've said in many of my blogs (rants), it takes a long time and a lot of work to build back your abdominal muscles, so the sooner you start, the better

My favorite new toy is a foam roller (I bought from Amazon.com), which is essential a hard styrofoam log the length of your spinal column. It's so terrific because you can work your abdominal muscles simply by lying down on the roller. That's it. Apparently, you are using your abs just to be able to keep from falling off. There are also some stretches and exercises you can do while on the roller.

My less favorite toy is the pair of flex bands because they require me to use chest and back muscles that I'd rather keep dormant. Although I think Jessica is great, I have found she has this sadistic streak in her that actually expects me to work hard, even when it's uncomfortable. Whining doesn't help. I also got these torture tools at Amazon.com.

If you're in Atlanta, check out Stability, and I'll see you in foam roller class!

Two Year Mark

2010-03-03T18:46:00.002-05:00

I know why they call it the Terrible Two's. I recently marked 2 years post-surgery and find myself constantly throwing tantrums like a toddler.

Even after all this time, I'm still building back my life physically, emotionally and mentally.

Physically...I'm trying to build abdominal muscles and stretch tissues that are too tight because they were cut.

So, MY ADVICE before you go under the chopping block: get details in writing from your surgeon and then go see a physical therapist, your new best friend. Because this surgery affects your entire core, from top to bottom: muscles, tissue, ligaments.

My recommendation after surgery: Get a doctor's referral to a physical therapist, who specializes in pilades.

In addition, you'll need to do the following:

* Pilades (for core)

* Yoga for flexibility.

* Weight training to build muscle strength.

* Water aerobics and swimming for all the above.

* Lots of martinis for everyone who has to put up with your mood swings.

See you at the gym.

To Dream the Impossible Dream of Getting a Physical Therapist

2010-02-03T19:27:00.002-05:00

The question I am asking myself at this moment, is who do I have to sleep with in order to get a referral to a physical therapist?

This is rhetorical, of course, since I am crazy about my husband, but after my conversation with my surgeon's office today, I am quite dumbfounded by their refusal to get me a referral for a physical therapist.

I was talking with Glenda in the business office, my first mistake. As I've said before, people who work in the office -- not the medical professionals -- could give a rip about whether you live or die, and let you know it.

This month marks 2 years since my major surgery, and over the course of these 2 years, I have worked out diligently to rebuild muscles, tissues, ligaments and other body parts that were cut during the double mastectomy/hysterectomy/reconstruction. I've done yoga, pilades, weight training, water aerobics, boxing--even worked out with a personal trainer--and I'm STILL having major issues due to weak muscles.

"Just why do you need a referral to a PT?" Glenda asked. Well....let me see. Because I've been ripped apart from limb to limb, maybe? She told me that my surgeon doesn't give referrals -- that I would need to get one from my primary care physician.

Let me get this straight: my surgeon is the one who cut me open and stitched me back up -- not my PCP. My surgeon works with breast cancer patients all the time, not my PCP. So....wouldn't the logical person to refer me to a PT be the one who caused this condition in the first place? It was obviously too much for Glenda's little brain to comprehend.

On top of that, I asked for a letter of necessity for a professional tattoo artist, who specializes in medical tattooting for breast cancer patients. Women I know who used the nurse at my surgeon's office to tattoo hated the results. It was like she used neon ink.

Glenda would hear none of it. She was very defensive and said there was no way I could be able to choose who I wanted to permanently tattoo me. The gall I had to make my own choice!

I don't wish people harm...really, I don't. But I do wish people empathy. And it's obvious that Glenda has never had breast cancer, so she has no clue what it's like to be cut apart and put back together and figure the rest out. She doesn't know what it's like to fall over while walking because you have zero balance because you have weak abdominal muscles...or struggle to put on pantyhose...or struggle to do thousands of the things you were able to do pre-surgery that now are difficult--if not impossible --to do post-surgery.

She doesn't know what it's like to have to build your life back. Because all Glenda cares about is a paycheck...not a patient.

So, tomorrow, I will get on the phone and call my PCP and ask for a referral to a PT and a medical letter of necessity for tattooing...and hope that my PCP has more empathy - and intelligence -- than Glenda.

Why Do the Heathen Rage?

2010-02-01T07:39:00.005-05:00

Why do the heathen rage? I'll tell you why. Because they're going through menopause.

BRCA surgery includes an abdominal hysterectomy, since ovarian cancer is one of the dangers of those who carry this gene mutation.

And going through major surgery for breast and ovarian cancer--and then, getting thrown into menopause on top of it all--is more than a girl can stand.

What's more, breast cancer survivors, unlike other women, can't take hormone replacement therapy to relieve the symptoms of menopause...not that I was planning on taking them anyway since there are too many controversial issues surrounding them. However, it leaves one with few options to cope.

As my oncologist said to me recently, "It's like you've been thrown into a deep well and you have to dig you way out." Maybe she said hell rather than well.

I can't help but think that major surgery--with all the cutting of body parts, and heavy doses of anesthesia and drugs, and overall stress on your body--contributes to the harsher reality of menopause.

Symptoms include electric shocks pummeling my body sporadically--like a mugger attacking me off guard--and negative emotional surges (rage). The combination of these two things, alone, qualify me for combat.

Other symptoms: crying over bad 70s tunes and even more pathetic commercials...distraction and forgetfulness (no brain)...and the propensity to be irritated easily by the mundane things of life.

The solution? I've become more fanatical about healthy eating habits and increased my exercise routine. I rest and try to reduce the To Do list to lessen stress in my life. There seems to be a major correlation between stress and hormonal surges.

And, then, there's "alternative (complementary) medicine." Although it seemed like voodoo, I decided to try the Chinese herbal medicine route. After knowing a few women who swore by it, I was desperate enough to try. First of all, I was amazed at how extremely normal this herbal guy was. I was expecting someone who looked like Jerry Garcia, but he was clean cut, wearing khakis and loafers. Even more, he had an easy-going, low-key, engaging personality. He even had a sense of humor.

He listened to my litany of woes, and ordered me a concoction of herbs. I was highly skeptical when the package arrived at my house a couple of weeks later. But after gulping down a few capsules, the hormonal surges subsided. Really.

The herbs are listed on the side of the container, so it's no secret what they are. Frankly, though, I don't care if the capsules contained dirt. I would take them because they work. I know this because I quit taking them a couple of months ago. I was feeling okay, and figured the worse of the symptoms were over. Wrong and wrong again.

All it took was a little stress added to my life and the surges reappeared. And it wasn't pretty. I ransacked my bathroom cabinet and came up with one container of the capsules with only a week's worth remaining. I immediately popped them in my mouth and presto! The Nightmare on Elm Street within me disappeared.

So, I made an appointment with the herbal medicine guy again to get back on track. My plan for getting out of this well during menopause is to take the herbs and apologize constantly to everyone who has to suffer through this with me.

Recovering Surgi-holics

2010-01-25T01:41:00.001-05:00

It's been since early December, after my final phase of reconstruction surgery, when I last blogged. Who has time to blog, I ask, when you're focused on getting back on your feet?

With all the dialogue about BRCA testing and whether to have surgery or not, little is said about life after surgery. At least, that's been my experience and that of others I've talked to.You get a lot of information going into surgery, but not coming out. Long-term issues are not addressed.

Yet, the consequences of having your abdomen cut from top to bottom are enormous and long-term. I recall my discussion with the breast cancer survivor who was also a physical therapist and her shock when she realized breast cancer patients aren't referred to a PT after surgery.

Physical therapy is critical because you emerge with a totally different body with multiple challenges, and you spend an amazing amount of time and effort trying to get back to "normal."

That's why most of my blog postings now concentrate on long-term recovery from surgery--because this is the part of the BRCA experience that's the least talked about but has tremendous implications about your quality of life going forward.

A Lesson on Healing

2009-12-11T13:57:00.000-05:00

Today, I ventured out for my first official errand since surgery...a trip to the farmer's market. The market is a real treat since it carries all sorts of organic produce, wild Alaskan salmon, exotic spices and freshly baked breads, among other things.

Following doctor's orders to "ease back into things" and the "no lifting over 10 pounds" rule, my goal was to make a quick trip, buy only a few items and return home safe and sound.

Walking into the market was like entering a Christmas wonderland. Colors and textures and aromas. Oh, my! Flaming red beets and orange turban squash and purple potatoes and rich green brussel sprouts.

Yes, I stayed too long, bought too much and wore myself out. And, I discovered an interesting fact: healthy food weighs a lot.

I Should Have Chosen Scotch

2009-12-11T13:35:00.000-05:00

Nicholas Kristof, one of my favorite columnists, had a column in the New York Times called "Cancer from the Kitchen?" regarding contaminants in our everyday lives and their link to breast cancer...such as certain plastics.

So, all this time, when I was consuming gallons upon gallons of water from those nifty, convenient plastic bottles, I would have been better served sticking my head in the toilet like my dog.

Not too long ago, my dad showed me an article about high consumption of grapefruit juice (red, in particular) and increased breast cancer risk. Since I had been consuming grapefruit juice like it was an elixir of love, I immediately stopped. And all this time I was drinking juice, it would have been safer drinking scotch...at least from a cancer perspective. Except that there's a correlation between alcohol and breast cancer.

A girl just can't win.

The Way of Love

2009-12-11T06:34:00.121-05:00

In his book, The Five Love Languages, Gary Chapman spells out the different ways we express and want to receive love: Words of Affirmation (You're wonderful!), Quality Time (Up for a drive in the country?), Physical Touch (Well, yeah...), Receiving Gifts (Americans specialize in this)...and Acts of Service.

Although we can appreciate each of these expressions, there tends to be one that speaks to us most, in which we deeply feel loved. Unfortunately for my husband, I feel most loved by Acts of Service. If only I could be bought off with a ring. But, no, I prefer him hauling barrels of compost to my garden beds each spring, which he loathes.

I bring this up because during the cancer treatment process--or, I should say ordeal--people have been amazing in showering me with love. I've received cards and books and warm pajamas. I've been sent dozens of cards with touching sentiments. People have told me how special I am and how I've impacted their lives. All of these things have greatly moved me.

In addition to these gifts, the Acts of Service have carried me through the most difficult times, and I can't emphasize enough how vital it is to have people lend a hand -- and be able to accept their generosity graciously.

I've pretty much been on the giving end of the equation, in which I was control, I was the strong one, I was capable. I suspect this is true for most breast cancer patients.

Being on the other side, in which I was the vulnerable one, the weak one, the dependent one...well, that was hard to accept. And a lot of that has to do with pride. It's hard to admit to yourself that you're not the all powerful, invincible super-woman you thought. You're mortal like the rest.

Once again, during this last surgery, I had friends who took the time, trouble and effort to sit at the hospital during surgery, drive me places, bring me homemade soup, walk my dog, run my errands...lend a hand anyway they could. Of course, my husband and my parents were there for me along the way. But having friends to give them some relief was an enormous gift. They are the super-women.

Throughout my experience with cancer, I've learned many things, but one of the most crucial lessons is this: you simply can't get through cancer without the love of others.

Reconstruction, Rebuilding, Rebooting

2009-12-10T20:53:00.003-05:00

It's over! I went through my final surgery and have been resting and healing this past week.

Looking back over this process, I ask myself--based on what I know now -- was reconstruction worth it? For the most part, I would say yes.

I love the results of what my surgeon did. I think about how terrified I was upon hearing the words, "double mastectomy." All I could envision was being butchered. I never would have dreamed I could go through this and end up with a body that, frankly, I liked better than when I began.

However, I would tell anyone who is considering reconstruction that you have to be physically and emotionally up to it, because it's a long haul, requiring a lot of work and patience.

I've been frustrated in having to accept my limitations. I've been exhausted, not having the same stamina as I did before. I've had to dedicate long hours to rebuilding muscle that was cut. My abdominal muscles swell when I put too much pressure on that area, which can make clothes extremely uncomfortable. And when I'm stretching or doing some sort of exercise, my muscles can cramp, which is painful. You have to think of it like rebuilding Dresden...one stone at a time.

It's far more involved than you realize going into it. But worth it? Yes, you could say that. But, I understand now why some women don't choose the reconstruction route. It's hard. There's no right answer, but what feels right to you.

So, now that surgery is behind me, I will be taking it easy over the next six weeks -- no strenuous activity -- and then back to exercise...and then tattooing. The fun never ends.

The Mammogram Debate

2009-12-06T18:08:00.002-05:00

The latest news being hotly debated is about moving the recommended age of women to begin mammograms from 40 to 50.

I know statistics show that for the most part, it's not as necessary until women reach their fifties (and there are those cynics who think radiologists are fighting this because it would affect their income).

While I'm no medical expert, but from a survivor's point of view--and one who was diagnosed at 41--it concerns me since cancer grows faster in younger women due to their higher levels of estrogen. So, the earlier cancer is diagnosed in younger women, the better to catch it before it spreads.

It also seems like there are more and more younger women (pre-menopause) who are being diagnosed with the disease. Statistics don't back me up on this, I know -- rather, it's only from my personal experience. But almost every woman I know who has -- or had --breast cancer, was diagnosed before 50. Maybe I'm just hanging out with the wrong crowd.

Hopefully, this issue will be discussed and debated more before they raise the age for a mammogram to be covered by insurance. We don't need one more thing to discourage women from screening for cancer.

Don't Worry, Be Happy

2009-12-05T13:39:00.001-05:00

As a breast cancer survivor and BRCA-gene carrier, I appreciate Barbara Ehrenreich for acknowledging the “Think Positive!” attitude pervasive in the cancer world.

Although most people were exceptional when I went through chemotherapy, there were also well-meaning, but misguided, “positive energy” advisers. The “Be happy and you’ll be cured” superstition is all too common in cancer dialogue, which doesn’t allow space for patients to truly grieve or acknowledge their fear, pain and anger.

Thank goodness for support groups that allow people to be real in the mist of the unknown.

Speaking of Hair...

2009-12-04T12:38:00.004-05:00

With all this focus on the cosmetic side of reconstruction, a girl can't go too long without bringing up the number 1 topic when it comes to our appearance...hair, of course.

This past year, when gray strands started comingling with my brown ones, I decided it was time to stop the henna and take on serious coloring. However, permanent and semi-permanent hair dyes converted my hair's texture into straw, with strands floating above my head despite every product I tried to control it.

Finally, a coworker put me in touch with a stylist who was a breast cancer survivor and used only non-toxic, organic products. I immediately made an appointment and discovered EcoColors hair color.

Voila! The color is rich and natural and my hair's texture is soft and glossy. And, I feel better knowing I'm not infusing my scalp with toxic dyes. Ask your stylist to try them.

I've Cast My Vote

2009-12-02T13:05:00.074-05:00

I've made my decision and I'm going for it!

I was finally converted after my pre-op appointment last week, when I met with my surgeon's PA. I've found that physician's assistants tend to have better bedside manner than many doctors, since they take more time to answer questions and connect with the patient.

And, I especially liked this P.A., who is female and my age, and just obsessive about working out. So, she could relate to my concerns about laying off intense exercise and our love/hate relationship with lunges and squats.

She also calmed my fears about general anesthesia, which I wanted to avoid (Twilight doesn't only refer to vampires, you know). But with my exercise-induced asthma, she said anesthesia would actually be "safer" since they would have more control over my breathing...or lack thereof.

And, then she posed the question - why would I go through 2/3 of reconstruction and quit before completing it? Well, now that she put it that way... A quitter I am not, so, I signed up for another adventure in surgery land.

On a side note: My husband, who is a healthcare consultant, says the influx of female physicians during our generation has been one of the most positive changes in healthcare, since he believes women are particularly gifted in patient care.

I've been thinking about why I've been so hesitant about this surgery when I seemed to sail through my previous ones, which were far more involved and dangerous.

But with previous surgeries, the choice was between cancer and surgery. Given those two options, there was no question: a scalpel and anesthesia seemed far preferable than cancer.

But this time, the choice is between living with my body "as-is" versus cosmetic surgery...so, now, surgery is the tougher option.

Even so, I choose surgery. However, this is it! No more! Unless, of course, my plastic surgeon sees anything else that needs tweaking while I'm under the knife...

Soliciting Surgery Opinions

2009-11-20T18:33:00.055-05:00

I continue to seek opinions as to whether or not to have this minor surgery, and it's split half "do" and half "don't."

Today, I received this advice from my friend, Anne, who is always wise and witty --

"Sounds like you’ve gotten lots of advice, so what if I add my 2 cents. Here’s my only question—does how it look or feel bother you? Honest answer (not to me, to yourself.). If it does at all, don’t try to talk yourself into thinking you’ll rise above it and get over it. You won’t. You’re too vain. (Remember, you drive all the way outside the perimeter to get facials.) And it’s only going to get more timely and costly for all our improvement/ maintenance items as we age…So, unless it HONESTLY doesn’t bother you, I’d go ahead and do it."

I was fine about not having surgery until she brought up my vanity. Now, I may have to reconsider.

Third Time's a Charm?

2009-11-17T18:17:00.030-05:00

To cut, or not to cut. That is the question.

After last year's odyssey of reconstruction surgery, I am faced with the option of a final phase. Because I had radiation during cancer treatment years ago, one breast healed differently than the other. That was to be expected, I was told.

The difference in size and shape is not significant, nor is it painful. It's just somewhat irritating and there is noticeable scar tissue.

Of course, my surgeon is all for another surgery to "tweak" everything and make me perfect. Ah, to be perfect...such a temptation!

It may be "minor to him," since it's outpatient and the procedure takes only 30 minutes. But anytime I go under the knife and it involves general anesthesia -- not to mention needles, bloodwork, EKGs, drugs, the risk of infection and those nasty drains -- it's major to me.

If they told me that I had cancer again, I'd go rushing to my surgeon's office in a flash. But, it's cosmetic. Non-life-threatening. Optional.

Do I really want to subject my body to more anesthesia and cutting and discomfort and healing time? I've been committed all year long to exercise classes to build up muscle strength and flexibility that were lost during my surgery last year.

Surgery requires you to lay off intense exercise -- only walking -- for 6 weeks afterwards. Don't know that I want to stop my workouts after I've made such progress.

I've asked everyone's opion (short of the people I pass on the street). Surgery or not? My husband says no, that I look great and have been through enough surgery to last a lifetime. Amen to that. Mom votes yes, since I'm still relatively young and have health insurance. I might change my mind down the road and then I'll be older (riskier) and may not have insurance coverage. My friend, a former plastic surgery nurse, agrees with my husband that my body has been through enough. Other friends have said to do it and get it over with so I won't have to worry about it any more.

This is what I lie awake at night and think about. But I don't have that many nights left since my surgery is scheduled in two weeks. So, to keep my date with the surgeon or cancel. That is the question. Then, there's the possibity of perfection...

The Thrill of It All

2009-10-20T10:00:00.000-04:00

I see no need to ever ride a roller coaster again. Nor try bungy-jumping, skydiving or rappelling. No extreme sport can equal the death-defying thrill of being a cancer survivor.

UP...you have cancer...DOWN...treatment arrested it...UP...you have the BRCA gene...DOWN...surgery will prevent reccurence...UP...there's a questionable area on your MRI scan...DOWN...the followup MRI shows no cancer growth...UP...your blood test shows elevated markers...DOWN...your blood test is normal again.

It's the roller coaster hell of WHAT IF? that happens with every checkup, every blood test and every scan.

Having to face the inevitable can be Good...you take nothing for granted and, hopefully, live each day to its fullest...and Bad...you worry that your life may be cut off sooner than later.

After all the up's and down's of my ride with cancer, and I'd like to take a breather for a while. Yesterday, I found out my markers were within normal range again. Hurrah! When I received the good news at the doctor's office, I broke down and cried.

Waiting over a week for results of my latest blood test put me on edge. Okay, over the edge. On the surface, I thought I was doing fine, but my husband and parents noticed I was even more wired than normal. Which says a lot, since I'm Type-A.

I didn't tell them for the better part of a week, but finally relented when I kept snapping at everyone over the weekend.  Mom told me that harboring all this anxiety and not sharing my fears with others only makes it worse. Talking about it with a few safe people can help get me through rough emotional times like these.

Agreed. But, the question is, do you drag your loved ones onto the roller coaster with you since it's a continual ride for the rest of your life? This has been my dilema since being first diagnosed.  Why put my husband and parents through unnecessary worrying?

On the other hand, does "protecting them" by not allowing them to live through this experience really help them and me?

I don't know.  And until I resolve this issue, I can't promise that I'll handle it differently the next time.

The Quest for Less Stress

2009-10-09T09:11:00.000-04:00

I hate when someone tells me not to be stressed or I'll get cancer. That sends me over the edge, since they're saying that if cancer returns, then I'm to blame. Just what a cancer survivor needs -- Guilt. And saying that to a Type-A, high-strung personality is pretty much telling me to change who I am. Or change my life.

To eliminate stress in my life, I would need to (1.) quit my job, (2.) end my friendships, (3.) ignore my husband and family, (4.) stop driving altogether, (5.) cancel my New York Times subscription, (6.) stay in bed all day. Essentially, quit living.

In the past month, alone, I have battled floods (which involved digging a trench in lightning while killing a snake with a shovel)...talking my husband out of climbing onto his elderly parents' roof in a torrential downpour with a chainsaw to remove a tree that crashed onto the house (Husband+Storm+Chainsaw=Emergency Room), leaving me frantically racing around to find a capable contractor to do it at the last second (thank you, Joe!)...two wedding weekends...birthday celebrations...training new staff at work...dealing with a contractor repairing our house from flood damage...fixing computer problems and refrigerator and stovetop malfunctions...worrying about an uncle with a heart problem in the hospital...counseling a newly diagnosed breast cancer patient...figuring out our financial future. You get the point.

And THEN, I get a call from my oncologist who tells me that I have elevated "markers" (indicating a possibility of cancer cell growth) from my visit a week ago...and you tell me NOT to be STRESSED?!

I ask you: What NORMAL human being wouldn't be stressed by all that? We all live crazy lives and then ADD CANCER to the mix and, PRESTO!, you have my life.

So, off I went to the oncologist's office yesterday for more lab work (big needle in little veins drawing lots of blood).

And now, the waiting game begins. One week until I find out the results. And you tell me to not be stressed.

Surgeons Lie

2009-09-01T18:06:00.002-04:00

In case I haven't told you this before, surgeons lie.

It's true. They minimize the pain and emphasize the fabulous end result. And leave out a few details.

My first breast surgeon told me the scar would be so tiny that I could walk buck naked down the French Riviera and no one would suspect I had a lumpectomy. He was wrong, of course...not that being naked on the Riviera was ever a goal of mine.

The surgeon who performed my hysterectomy told me that "it was his best cut ever." Wrong again. I've sliced raw chuck roast at a better angle. He should have taken the knife skills cooking class with me.

My reconstruction surgeon said my "new" stomach would be flat as the wall. Maybe. I'll let you know after I complete 15 years of boot camp.

I guess surgeons think that if they appeal to your vanity, you'll gladly go under the knife. Frankly, saving my life was incentive enough for me. They could skip the false promises. But apparently they didn't trust I'd be that level-headed.

So, I'm here to tell you BRCA carriers: Get the surgery. Go under the knife. And know that you're taking the right step in helping prevent cancer's appearance or reccurence. But don't bank on being naked on the French Riviera.

Beauty & the Beast of Breast Cancer

2009-08-15T22:12:00.001-04:00

In today’s celebrity-obsessed culture, women are pummeled with the message that to be loved and happy, they must possess beauty and physical perfection.

It’s hard enough for the average person not to succumb to this pressure, but how much more for women battling cancer.

Breast cancer treatment can assault a woman's femininity, sexuality and attractiveness.

I asked my friend, Virginia Apperson, how to deal with this. I figured she was the best person to turn to since she's a Jungian psychoanalyst and author of the book, “The Presence of the Feminine in Film."

“We’re a superficial culture that sets certain requirements as to what is beautiful—especially for women—and if we don’t fall into these standards, we don’t feel like we have value,” she said.

"But the irony is that it’s out of suffering and illness that we deepen ourselves and discover aspects of ourselves that are more genuine than striving for outer perfection."

The reality is, there’s nothing pretty or easy about cancer treatment. However, in the midst of it, there are choices as to how to endure, she pointed out.

Virginia said you pretty much have to put on blinders and 'start living in another ‘universe’ (how Jungian). In other words, find a place where not being perfect is acceptable.

"Surround yourself with others who can commiserate with your issues, and can acknowledge what you’re going through and grieve with you," she advised. That can be found with friends, support groups, or with a therapist or a pastor.

She also suggested expressing your feelings in "physical form"-- as she put it-- through writing or art.

“We’ve so sanitized our world and been told not to have bad feelings. But, the hope is, if you confront the despair and express it, it ceases to have power over you.”

Instead, she said, it could give you a deeper understanding of who you are and what's important to you.

Another tip - avoid magazines and TV programs that emphasize beauty and glamor. There's nothing worse than picking up a copy of Vogue with a cover of an emaciated teenager airbrushed to perfection.

Virginia encourages women to seek inspiration from role models in literature and film "who allow their inner self to be valued"--"characters who have the fierceness to say, ‘I’m not playing along!’ "

A good example is the movie, "Cold Mountain." Ruby -- who is plainly in need of a makeover--displays "a life force that’s unstoppable,” as Virginia describes it. Ruby is paired with Ada, who although is beautiful, finds that beauty won't keep her alive. Ada learns how to be strong through Ruby and Ruby learns how to dress better through Ada, which all leads to a somewhat happy ending.

So toss out your latest copy of People and watch an old Betty Davis movie instead. After all, Betty was not the beauty that many starlets of her time were, but she outshone and outlasted them all.

Breast Cancer Makes You Fat

2009-08-14T16:13:00.002-04:00

It's bad enough one has to suffer through cancer, but to add insult to injury, it can make you fat.

Jill Binkley, a physical therapist and breast cancer survivor, explains why.

Jill founded TurningPoint Women's Healthcare (http://www.myturningpoint.org/), a comprehensive rehabilitation program for breast cancer patients. It provides physical and massage therapy, as well as nutrition and exercise counseling.

“About 60 percent of women with breast cancer gain weight, which most women don’t expect…in fact, they assume they’ll lose weight,” she says.

But, due to metabolic and chemical changes from chemotherapy--plus, menopause kicking in -- the scale tips toward the upward direction for most women. Add a sizable dose of steroids to help the medicine go down and you're looking at a new dress size (or two).

A solid nutritional plan and regular exercise program -- 40 minutes per day 4-5 days per week--can help stave off unwanted pounds.

This is not only good for your wardrobe, but for your health as well--since weight gain is a risk factor for developing lymphedema and cancer recurrence.

Dragon Boat

2009-08-12T19:43:00.006-04:00

I obviously need to get out more. I had never heard of a dragon boat, much less dragon boat racing. But to my surprise, it's quite the rage, especially among breast cancer survivors.

Rowing, in general, is the perfect exercise for the area that's been marred and scarred by surgery since it builds and strengthens chest-arm-back muscles. In addition to fitness, the dragon boat brings survivors together for fun, camaraderie and an enhanced body image.

Besides rowing for fitness, dragon boat teams participate in races to raise money for breast cancer research. So grab an oar, smear on some sunscreen and hit the water. It could benefit your life and others. (www.myturningpoint.org/DragonBoatAtlanta).

Benefits of PT and MT

2009-08-12T19:24:00.010-04:00

I recently discovered a new organization aimed at helping breast cancer survivors recover from treatment.

TurningPoint Women's Healthcare (http://www.myturningpoint.org/) is a comprehensive rehabilitation program that offers physical therapy, massage therapy, exercise and nutritional advice and professional counseling.

It was founded by Jill Binkley, based on her experience as a professional physical therapist and breast cancer survivor.

“Anyone recovering from knee surgery is automatically sent to rehab afterwards,, but this isn't the case for breast cancer patients,” she says.

Binkley cites numerous problems resulting from breast cancer treatment, including limited range of motion, lack of strength and flexibility, and pain caused by scarring and swelling of tissues.

“Anywhere from 30 to 50 percent of survivors up to four years post-op have shoulder, breast/chest wall pain, as well as pain in the donor site from reconstruction,” she explains. “Overcoming pain and physical limitations can help women resume their normal activities."

Getting your body "back to normal" after all it's been through and helping you resume your life can also help ease feelings of anger, hopelessness, powerlessness and frustration that your body isn't the same as before treatment. And we all know what that feels like.

Physical therapy and massage therapy can help with range of motion issues and pain control.

Plus, massage has an additional benefit, she points out: “There are several strong studies that show massage during and after treatment increases the immune system function."

As if we really needed an excuse to get a massage...

Tip for the Lash & Brow-Deprived

2009-08-07T17:10:00.007-04:00

I've discovered the Viagra for breast cancer survivors...Latisse. It's the product Brooke Shields pushes, although I don't know why since she's always had brows the size of catepillars.

But for those of us who lost our brows and eyelashes during chemo and they didn't grow back fully afterwards...well, it's one of the best presents a girl can get.

I started using it a couple of months ago (it takes 12 weeks to achieve the full effect) and can tell a dramatic difference! Alas, now I have one less thing to whine about.

The Real Thieves

2009-06-01T18:02:00.000-04:00

Our fast-paced and chaotic way of living--with traffic and telemarketers and texters and twitters--along with the stress of the economy and the total uncertainty of what the future holds has gotten to me lately. You could say, I've been on edge.

Then, this weekend, Mom told me that her neighbor--who is my age with a 14-year-old daughter--is on her 3rd round of chemo for breast cancer. What she has gone through over the past year, and continues to go through in fighting this disease, floors me. I don't know that I would have her resiliency to endure so much for so long.

I was quickly reminded of how I felt when I was diagnosed as Stage 3 over eight years ago, before I began treatment, and wondering if I would be alive a year later. I remember that all my daily irritations and problems and worries fell away. They simply didn't matter. They lost their power. Only living mattered.

And when my frustrations and bad attitudes vanished, I became intensely aware of the beauty and wonder of life. I realized--as so many cancer survivors do--that focusing on all the negatives distract you from the richness of all that's good in the world. They rob you from living.

I love how the priest in Les Miserables answers people who question his decision to not bolt his door at night to prevent robbers from entering. He responds that it's not thieves who steal silver that we should fear. Rather, it's the darkness of our souls that truly robs us of all that's valuable.

So, I am once again reminded of how precious life is--despite it's constant disappointments and challenges. And in today's environment, there are many. But it's amazing how gratitude can instantly reverse your viewpoint.

The Truth Behind Cancer Studies

2009-05-21T18:43:00.001-04:00

I typically get an eye-roll from my oncologist whenever I present her with a ripped out newspaper article about a just-released study announcing new cancer findings.

With all the health news accessible these days, you'd think we'd be medical experts. But, in reality, the opposite is true because so much information that's reported is confusing and even incorrect.

How do you know which studies are valid? The starting point is understanding how health-related research is conducted, so I tapped my trusty source, Greg Orloff, who teaches the cancer of biology at Emory University in Atlanta, and has an award winning website about cancer (cancerquest.org).

"There's always an element of sensationalism in the media because that's how they sell their publications," Orloff says. "Consumers need to be able to interpret a study so they can factor this information into their decision-making."

He suggests the following to determine a study's validity:

1. Determine the study's purpose. Orloff says it's expensive to follow 20,000 people over 20 years.

"As a result, researchers attempt to extract as much information from a study as possible and then use the findings for multiple purposes."

A study may be designed to find out one piece of information (whether smoking increases the risk of lung cancer), but other researchers can re-analyze the same data asking different questions and come up with additional conclusions (smoking causes an increase in heart attacks).
"You need to look at the information collected and make sure that researchers are isolating the information you're interested in from other study conclusions. This is difficult to accomplish -- it's hard to analyze one single thing because humans are complex. It could be something other than what's being studied that's contributing to the outcome."
For example, let's say you're looking at the effect exercise has on breast cancer. You conduct a study involving 2,000 people and look at those who exercise 5 times a week, those who exercise 1-3 times a week, and those who don't exercise at all.
Then, you observe the rate of breast cancer occurrence over time. You may find that those who exercised 5times a week had fewer occurrences of breast cancer than those who didn't exercise at all.
But what do you think the chances are that people who exercise a lot also have a healthier diet than those who don't? So another factor -- diet, which is not what the study is about - may play a role in the study's results.
It's a matter of asking the right questions about the study.
2. Look at how the study was designed and conducted. To interpret the findings of a health-related study, consumers need to understand the nature of research and what it entails. Consider the following questions when giving credence to a study:
* How reliable is the information gathered from the participants? People can make mistakes (or not tell the truth) in recalling lifestyle choices and their family health history. This can affect a study's outcome.

* How many people did the study involve? The larger the study, the more credible the information. If the study was not conducted on a large enough population, then you should hold off making a conclusion.

* What was the length of time it was conducted? The results will differ significantly from a 5-year study versus a 20-year one.

"Often, evidence is derived from the preliminary stage -- such as 3 years into a 20-year study -- which can be misinterpreted and hyped by the press, eager to report the latest news. A longer study is better at providing the actual outcome."

* Who participated in the study? Socioeconomic and cultural variations between one population and another can impact results. A study should represent the larger population in order for researchers to make a general, relevant statement. But this is difficult to achieve.

"The challenge is how do you randomly select a population to study? Let's say you decide to study people living near a major college campus. But the problem is that a better-educated, higher-income population lives in that area, and that means they make very different lifestyle choices (such as more visits to the doctor) versus the average population. This is just one factor that will produce a bias in the study's results."

* Who conducted the study and what was their motivation? Is it to convince you to buy their product?

3. Know the difference between "correlation" and "causation."

Correlation -- is an association between two things. For example: Men who exercise have fewer incidents of colon cancer. But is it because they exercise, or that they are eating a better diet? The association between exercise and lack of colon cancer is real, but is exercise actually causing these positive results?

Causation--is a factor that leads to a specific outcome, such as smoking causes lung cancer. You can get lung cancer for other reasons, but scientists have proved that mutagens in smoking do cause lung cancer.

People often misuse those terms and misinterpret results, making a conclusion because they assume causation and correlation are the same.

4. Are studies conducted on animals relevant? Since human studies are difficult and expensive, animal studies can be beneficial since researchers know the genetics and can completely control behavior (how much daylight exposure they receive, diet, hours of sleep).

"For want of a better model system, animals are valuable," says Orloff. "People tend to dismiss animal studies, but researchers can still observe the effects of a particular treatment, which could be applicable to humans.

"At the same time, if a treatment works in an animal model, it may or may not work in humans because we're genetically designed differently."

With animal models, you need to ask if the doses that researchers are giving a reasonable amount.

5. Understand the statistics. "Studies ultimately come down to statistics, and most often, reporters and readers don't understand what those statistics mean. Statistics exist for any study with credibility.

"So, if you are interested in pursing a lifestyle change based on a study, you need to know the numbers that support the findings - is it statistically significant?"

Medical journals are a good place to find a study's statistics.

"And even if you can't interpret the data, the more information you can access, the better you are armed to ask the right questions of professionals (your doctor), who can give you the best answers."

So, despite the eye-roll, it's a good idea to check with your doctor regarding information you find in the media. They are the best source about what's true and false.

Cancer 101

2009-05-20T08:39:00.038-04:00

Every day, it seems, I get an email from a well-meaning friend about a new cancer study concerning grapefruit juice, PET bottles, red meat...the list is endless. Or, a news article saying that mammograms and self-examination are a waste of effort.

Since I've recently received my umpteenth email about another presumable cancer-causer, I thought it was time to feature an interview I had with Dr. Gregg Orloff. Orloff teaches the biology of cancer at Emory University in Atlanta, and has developed an award-winning website that explains the biology of cancer: http://www.cancerquest.org/.

"Of all the environmental and behavioral factors that have been investigated for cancer, only a few have shown a clear link," Orloff says.

"It's difficult to make hard conclusions about certain activities and their impact on cancer because studies to-date haven't involved a large enough population or haven't been conducted for a long enough time period to offer anything definite. The data simply doesn't exist at this point."

Still, research has uncovered enough implications between particular behaviors and increased risk that it's worth paying attention to how lifestyle choices impact our health, he says. But in order to understand how behavior and cancer are related, we first need to know what causes cancer to form.

The Basics
"Cancer is ultimately a result of DNA damage," explains Orloff.

"We know that cancer is derived from a single defective cell that has multiplied. It occurs when a cell strikes out on its own, resulting in unregulated cell growth. These abnormal cells pile up on each other and form masses, which are commonly known as tumors."

Why does a normal cell strike out in the first place? What causes it to become cancerous?

It happens when a particular set oif genes in a cell are altered by mutagens. And, this is where lifestyle behaviors may play a role in cancer. Mutagens enter the human body by means of inhaling, ingesting and absorbing.

They derive from:
* Chemicals in the diet -- For example, charred meat from grilling (the burning process) can cause the formation of chemicals that are thought to be mutagenic.

* Infectious agents -- A problem can occur when a virus actively alters the cells. For example, cervical cancer may result after infection with the Human Papilloma Virus...a viral infection.

* Chronic infections - Cancer can result in response to an infectino. For example, hepatitis has been associated with liver cancer. When cells are killed by infection, they need to be replaced constantly, so there are high amounts of cell division occurring in these tissues. In addition, the body's immune response to fight infection is producing chemicals that can cause mutations.

* Chemicals in the envioronment -- These can be absorbed or inhaled, such as smog and industrial waste.

In other words, every time you expose your body to a cancer risk -- eating buned meat, inhaling cigarette smoke or absorbing coal tar -- mutagens enter your body. And chemicals that are mutagenic can cause DNA damage.

The Luck Factor
If we all take in mutagens, then why does one person develop cancer over someone else?

"In order for a single, normal cell to turn into a cancer cell, it must acquire five to six different changes from mutagens. So, it's a cumulative effect," says Orloff. "Two people can be exposed to the same mutagen, but in one person, the cell dies or remains the same, while the other perosn acquires a mutation in an important gene and develops cancer.

"That's why you see some people smoke their entire lives and not get cancer, and others who 'do all the right things' develop cancer. Luck plays a big role as to who gets cancer and who doesn't. "

In the Genes
There are genetic components to cancer, as well.

"A person can inherit defective genes -- such as BRCA1--which by itself doesn't necessarily cause cancer," Orloff adds. "But a defective gene can increase your chances that some important key genes will be affected by a mutation, giving you a higher risk for cancer."

Another genetic factor that can impact whether one person develops cancer versus another is possessing better DNA repair genes, which respond to DNA changes differently.

In addition, the way your body processes toxins can affect your chances of getting cancer. For example, the liver has enzymes to process and eliminate toxins -- making them soluble so they can be excreted. But this detoxification process can convert a chemical into a mutagen.

Consequently, two people may be exposed to the same risks, but their bodies may process toxins differently.

Risky Business
Whatever your body's genetic makeup, DNA can be damaged by certain behaviors.

The following factors are known to have an associated risk of cancer because of their mutagenic properties:

* Smoking -- Full of mutagens, smotking as well as second-hand smoke is connected to almost all cancers.

* Sun damage -- UV rays are mutagenic and have been proven to cause skin cancer.

* Diet & obesity -- Obesity carries an increase risk of breast and colon cancers. Certain diets can alter the level of growth factors and nutrients (protiens, lipids, sugars) in the blood, which, in turn, can stimulate normal cells to become cancerous, or cause existing cancer cells to grow.

* Alcohol -- Particularly a risk factor for breast, colon and esophageal cancers, alcohol is toxic and must be detoxified, causing stress on the body. The detoxification process can cause DNA damage.

* Medications -- Certain drugs can potentially cause a problem. For example, female children of women who took DES (now outlawed) while pregnant have higher incidences of cervical and uterine cancer.

Healthy Choices
On the other hand, there appear to be certain behaviors that may help reduce your risk of cancer:

* Exercise - In some studies, exercise has been shown to have positive beneficial effects on breast and colon cancer. The benefits of exercise may be due to a wide variety of effects, ranging from enhanced immune system function to increased GI motility.

* Diet -- Overall, a well-balanced diet with fruits, vegetables and nuts is beneficial. Specifically, foods that contain antioxidants (such as leafy green and cruciferous vegetables) have cancer fighting possibilities.

This is because our bodies produce oxygen radicals, which are highly reactive molecules in cells that act as mutagens and can cause DNA damage. Antioxidants act as interceptor missiles, neutralizing oxygen radicals before they affect DNA.

In addition, studies have indicated that Vitamin D, selenium and calcium might potentially prevent or limit cancer growth.

"None of these things, alone, offers a huge reduction in cancer risk," warns Orloff. "But we know enough from studies to advise people to take care of their body."

The Bottom Line
"There's no holy grail in that if you do this set of behaviors, you won't get cancer," says Orloff. "All you can do is limit your risks.

"It's like avoiding a car accident," he says. "You can limit your risks by wearing a seat belt, not driving late at night, and not driving while talking on the cell phone. But all these things still can't guarantee that you won't get killed in a car accident."

"The same goes for cancer. Individuals have to decide what risks they want to live with."

Off Balance

2009-05-19T21:33:00.005-04:00

After breast reconstruction, I found myself falling over easily...and often. In fact, I lost my balance so much that I feared I had developed a brain tumor. Not that I obsess...

It wasn't until I heard about other women with breast reconstruction who also experienced the loss of balance after surgery. I finally surmised that because we had our core muscles cut, we no longer have the abdominal strength to balance us.

Therefore, if you're slipping and falling frequently, fret not. Instead, sign up for a strength training class to build back your core. Since I've been working out with my personal trainer -- who, incidentally had me hauling concrete blocks and stepping up and down on a bus stop post last week -- I realize I've been stumbling less.

It's painful, but it will keep you from injury in the long run. So, go find some concrete blocks and start moving.

Resiliency

2009-05-19T20:28:00.027-04:00

I was slogging through rush-hour traffic in Atlanta the other night while listening to Terry Gross with"All Things Considered" interviewing Elizabeth Edwards about her just-released book, "Resilience."

At the interview's end, Gross asked Edwards how she defined resiliency. Edwards' answer was so profound that I practically drove off the road trying to write it down. Since I haven't purchased her book yet, I will paraphrase what Edwards said:

"Resiliency is accepting the new reality of your life after loss-- and live it fully -- rather than long for the past and what it held."

If ever there was a quote for cancer survivors, this is it. I don't know about you, but sometimes I am wistful of life before cancer -- without all the surgery scars and missing pieces...when I was stronger and more flexible...when I had eyebrows (sigh)...when I could remember every detail (before chemo deleted my brain)...when I was innocent and naive, thinking I was invincible and immortal.

I don't obsess about these things, but every now and then, I get frustrated trying to be the "old me." And that person doesn't exist.

The new reality is an older, scarred, wiser woman who knows first-hand the body's limitations and the eventual result of death.

On the other hand, she also knows she has more courage in the face of fear than she ever imagined. That she doesn't take a single day of life -- or a single relationship -- for granted. That every day counts. Every interaction. Every choice. Every action. It all matters.

She also knows that she is loved far more than she ever realized. She knows that pain and suffering produce depth and insight. She understands what's truly important and what needs to be discarded or not taken so seriously.

Life after cancer is my new reality. I can never run away from or ignore what has happened to me. I can't go back and recapture my youthful self.

But, as Edwards points out, resiliency is the ability to "live fully" in your new life. That takes on a different meaning for each cancer survivor. For me, it's accepting my physical limitations, while at the same time, appreciating that I have a better grasp of what is true and valuable.

Advice from A Fitness Expert

2009-04-28T16:33:00.012-04:00

This is an email my fitness instructor sent me recently:

"I met someone today in my bodywork class. She wanted ideas to rebuild her abs, since she was cut for breast cancer surgery and reconstruction.

This is the third person I've come across in a similar predicament, so I am planning to do some intensive research on exercise for women who have had breast cancer.

I hate to see breast cancer survivors frustrated with their bodies, when everyone seems amazed by how far you have come , medical teams happy with the results...you seem to be the only ones left with a feeling of unfinished business...and indeed it's not over for you.

You have a different body, you are and you are not the same person. You need to assess these changes and how slowly they will be part of you from now on. You need to work with these changes that you may not quite understand or even know about.

Your battle is not over, and everybody has left.

I believe strongly into the amazing ability of the body to heal repair and adapt, but also in the power and relation the mind has on this process.

Your will and courage is your victory. We, as instructors, need to wake up to this specific growing demand and try to work together with the health professionals to assure not only recovery, but long term health , happiness...and fitness!

Women who have had breast cancer need to work specifically on core, abs and upper body strength--which seems to be the 2 areas of most changes and trauma...psychologically, physically and physiologically.

See you in class!"

Helene Villinger

AFAA Certified Personal Fitness Instructor

http://fitnessislife.tripod.com/

When Rubbish Happens-Part 2

2009-04-01T08:31:00.023-04:00

Recent layoffs among several people I know have prompted responses from well-wishers, telling the newly unemployed they'll "be in a better place" one day and "when one door shuts, another opens"...blah, blah, blah.

While I believe these statements can be true, there's a catch. It's up to you to open the next door to get to a better place. It doesn't automatically open. This pertains to jobs, or cancer, or any other disappointment in life.

Some people I know responded to their layoff by aggressively applying for jobs, networking, heading to the gym and keeping a positive attitude--which ultimately lead them to their dream job. Others headed to the bar, sat on their backsides and decided to be bitter.

A friend shared his fear of wasting his life due to working long hours and not having a Hemingway-like adventure every weekend. While I don't endorse workaholics or couch potatoes, it's not a job or lack of fun that wastes a life.

Rather, it's wallowing in anger, depression, fear and bitterness in response to life's challenges. Instead of moving forward with courage, you become paralyzed in your grief.

Life CAN be better when bad things happen to good people if you rise to the occasion. It's becomes better because it changes you -- you grow up, get a new perspective, learn to handle problems. Tough times can deepen you, pulling you out of your self-centered, self-absorbed, childish, all-about-me context.

And becoming a deeper, less selfish person is what allows you to live a richer, more fulfilling life.

Changing for the better is earned the hard way--the way we all try to avoid--through pain and suffering. But in the long run--by plowing ahead with courage--you can look back and say, "I'm in a better place because this happened."

When Rubbish Happens-Part 1

2009-04-01T08:18:00.035-04:00

A friend, who is younger than I, is now in hospice, dying of cancer. It has not escaped my notice that I've survived cancer for the time being, while she did not. This begs the question--why her and not me? Why did she get the death sentence while I was spared?

This has always been a tricky question that arises when life throws you a curve ball (or in the case of cancer, when life throws you a grenade). I don't claim to have the answer. But I do know, that as modern day Americans, we've come to expect a Disney ending to tragic things of life. And it's just not so.

Why did I get life over others in my condition? It's not because I'm exceptional, or that God loves me more, or that prayers for me outweighed prayers for others. I've known far better and nicer people--with much greater faith--to experience an early death while I lived. You have to wonder why.

After pondering this over time, here's what I hold to be true: "To whom much is given, much is required."

My writer-counselor friend, Sue, wrote a poem, "The Scarecrow” in which she points out that our life experiences "make our stuffing deep, rich and available for God’s use, whenever and however He decides to scatter it."

So, until the day comes when I'm in hospice, I'm in a strategic position to be a blessing to others. After all, it's what's required.

1 Year Later

2009-03-30T14:05:00.038-04:00

It's been a year since my double mastectomy, oophorectomy & reconstruction (phase 1), so time for a progress report.

My reconstruction surgeon said my right breast needed some "tweaking" since it's smaller than my left. The reason for the size discrepency is I had radiation in my right breast during cancer treatment years ago. Tissue in a "radiated breast" responds differently to surgery than a non-nuked breast. Translation: I need a larger implant.

Tip: If you must undergo radiation, ask your doctor how it will affect your breasts long-term. It's good to know for a variety of reasons.

Surgery to exchange an implant is an outpatient procedure (yaay!), but nevertheless involves anesthesia, tests, needles, blood, drains (%&#*!), nausea, and no exercise except walking for 6 weeks.

Right now, I'm not up for all the pain (from needle jabs) and suffering (from lack of food) this surgery calls for. So, like Scarlett, I'm going to think about it another day.

A small breast is no big deal. What is a big deal is that my stomach is still expanded like Demi Moore on the cover of Vanity Fair. (And that's the only similarity between my body and her pregnant one.)

I ask--what happened to "your stomach will be flat as this wall," as my surgeon swore?

Instead, after a year of surgery, when I was sliced in half, my abdomen has a small "pooch" like I'm in my first trimester.

What they don't tell you is that all the cutting and stitching of your abdominal muscles causes them to expand whenever you place any pressure on that area. Exercise, lifting & moving objects, gardening, housework...and myriad other daily activities can cause your stomach to swell. Swell, isn't it?

And, an expanded abdomen = no clothes with a fitted waist=forget summer fashions and swimsuits.

No one forwarned me that I needed to invest in maternity clothes after this procedure. From the way my surgeon talked, I was going to be a runway model at 50. (Tip: surgeons lie.)

Therefore, I enlisted the help of my French water aerobics instructor, who is also a kickboxing intructor and personal trainer.

My surgeon endorsed my decision, saying that building my core muscles were key to getting a flat stomach. NOW he tells me.

So, last Saturday at 7:30 AM, I am in Helene's basement (aka, the torture chamber) punching boxing bags, throwing weighted balls, jumping rope, doing pushups...and then going outside in the freezing rain and sprinting up the hill in her front yard. Alas, what we do for vanity.

It was then that I discovered a critical insight -- I have no muscle strength. ZERO.

After a year of surgery in which most of the time I wasn't allowed to do any exercises except walk, my body weakened overall.

This means a long, hard road before me with lots of Saturday morning sprints up Helene's hill.

But I'm up for the challenge. After all--for all the pain and suffering that Helene inflicts, it doesn't involve needles and anesthesia and lack of food.

Embracing Calm & Chaos

2009-03-27T17:23:00.010-04:00

The call interrupted my dinner preparations, and my world immediately switched from a relaxing Sunday evening with my husband to a sleepless night of fear and agony.

My usually stoic younger brother was sobbing on the other end of the line, as he told me that my 14-year-old niece had fallen 21 feet off a ski lift. She was skiing in West Virginia with her mother for the first few days of spring break before coming to Atlanta to spend the remaining time with me. All that changed with one poor decision.

My brother was at home when he got the news. Consequently, he was receiving sporadic information from the hospital. He knew that my niece’s spleen and kidney had been lacerated, but it wasn’t confirmed whether she had suffered spinal cord or other critical injuries. I envisioned my precious niece in a wheelchair for the rest of her life, and it was unbearable.

My niece was conscious when I called ICU after I got off the phone with my brother. “Aunt Julie, I want you to come see me.” That’s all it took, and I was determined to go to her--whether her parents wanted me around or not.

Adding to the drama, my older brother (who is a pilot) flew both my younger brother and me the next morning through fog and rain to West Virginia--worrying my mother because her three children were traveling in the same small plane in inclement weather.

Fast forward to the end of the week, after spending my vacation sleeping in a recliner and eating hospital cafeteria food (is it me, or do I always seem to be spending my vacations in hospitals?) and my niece is back home. No spinal cord injury and the spleen and kidney are healing just fine. Her judgment is another matter…

I must say, this put a damper on my resolve to reduce anxiety in my life. I was so proud of myself for not panicking every time the phone rang, thinking it would bring bad news. Didn’t my niece realize this when she refused to put down the bar on her chairlift?! (According to 14-year-olds, it’s not cool to have the bar down.)

Life has a way of messing up our best laid plans.

So far this year, I’ve attended the funerals of my favorite aunt, one of my breast cancer mentors and a friend’s mother (who died of cancer). My brother has been experiencing chest pains, and my forever strong dad has suffered dizzy spells and exhaustion. I’ve also mourned a coworker with liver cancer who got the news she would not recover. I could go on, but I realize that everyone has sadness and tough situations to deal with.

While in the hospital, I read C.S. Lewis’ spiritual autobiography, “Surprised by Joy." He mentions a friend who believed in not running from pain, fear, loss and trouble, but rather, experiencing all of life to its fullest -- even the negative aspects.

When we avoid pain at all costs, we end up creating fake lives of distractions and shallowness and emptiness. He points out that even pain and rough times can offer a kind of richness…because it’s all part of the human experience.

He writes: "Jenkin seemed to be able to enjoy everything; even ugliness. I learned from him that we should attempt a total surrender to whatever atmosphere was offering itself at the moment..on a dismal day to find the most dismal and dripping wood, on a windy day to seek the windiest ridge...There was a serious determination to rub one's nose in the very quiddity of each thing--to rejoice in its being (so magnificently) what it was."

Fear doesn't add anything to our experience because it's not real -- there's nothing tangible about it that transforms you (like grief and pain) or enlightens you (like coming to terms with your faults). All it does is cast you into an altered state.

Not that I’m welcoming bad news, but it struck me that maybe I need to celebrate the joys of everyday and also, live through the painful moments I try so hard to avoid. Maybe it’s better in the long run to experience it all.

All the Rage

2009-03-27T12:22:00.005-04:00

I took a break from blogging over the past few weeks and, instead, spent time thinking about all the anxiety and frustration that cancer has introduced to my life.

I finally hit a wall after listening to umpteen “experts” providing dire cancer predictions if I did the least thing wrong. My oncologist wants me to avoid soy. My nutritionist said red meat and dairy are cancer-producers. I’m told that exercising 40 minutes every day reduces cancer’s recurrence—so, get moving! And in the news recently, there’s a study linking alcohol to breast cancer. And, on and on it goes. It seems like everything is off-limits, including rest.

All this has brought up anger about how much I've had to alter my lifestyle over the past decade regarding things that bring me pleasure, such as:

· Gardening: Dirt + Overwork= Lymphedema
· Wine: 1 glass of Pinot Noir = Breast cancer
· Gourmet cooking: No Meat + Dairy + Soy = Limited Menu Options.
· Eating: Processed/packaged Foods = Soy=Cancer; Sugar products = Cancer Risk.

Even CHOCOLATE contains soy!

This leaves me with nuts, grains, beans, fruits and vegetables. Now, I’m all over these food choices – in fact, they’ve always been a mainstay of my diet. But to constantly hear that putting a spoonful of yogurt in my mouth, or buttering my French bread will cause my early demise…well, that puts me over the edge.

I've cut back on everything -- obeying everyone's "orders" and "rules" for my life. I eat mostly vegetarian meals and fish; organic produce. Drink gallons of water. Avoid desserts and never touch fast food or junk food. I take vitamins and exercise daily...I'm the ultimate "good girl."

While I enjoy a healthy lifestyle, I'd prefer that it be my choice rather than a requirement in order to live.

So, how does one attempt to live a calmer, less stressful life when she has all these hysterics coming after her!

My feeling is-- if I have to give up everything that brings me joy in order to stay alive, what's the point of living? (This is a rhetorical question -- I'm not contemplating dying).

This is a challenge for a lifelong Romantic, who tries to create rich experiences whenever and wherever possible.

My fantasy is to run an organic farm & vineyard along with a gourmet restaurant in the countryside. I'd be outdoors, working the land, cooking great food, connecting with people. But gardening, meat, cheese, wine—they’re all off limits! So, find another dream?

This begs the question: “What would JC do?!” (Julia Child, that is!) She’d eat a slab of meat, followed by a stiff drink. She ate (lots) and drank (lots) and was a breast cancer survivor and lived until 92. To that, I say, “Bon Appetite!”

Another Survivor's Viewpoint

2009-03-02T12:35:00.013-05:00

The following post is by a friend, who battled lung cancer last year.

While My Shoes collected Dust . . .

Anyone who knows me knows I have an intense love of shoes…some would call it a shoe fetish.

I like to think of them as essential items of clothing--as necessary as blouses, sweaters, dresses or pants. The difference is women’s shoes are a strong expression of an individual’s personality in a way that clothes don’t always equal. (Don’t get me wrong, I love clothes, too.) So, I shopped the shoe departments anywhere I could, regardless of whether there was a great sale or not.

I recently discovered something my husband had said was pitifully true—my shoes had collected dust!

Neatly arranged in our spacious walk-in closet, my shoes sat two by two with a fine layer of visible dust on all of them. That’s when the full impact of it hit me--the “it” being the unexpected and intense ordeal of my year-long battle with cancer, including months in the hospital and then months at home recovering baby-step by baby-step.

My journey isn’t about my shoes, but they are indeed a metaphor for leaving the way of life as I knew it.

I’ve learned a lot of wonderful and surprising things along the way about myself, my husband, our families, friends and the human spirit. While the shoes in a closet might get dusty, human kindness, care, concern and love never do.

I’ve discovered that everything I’d been taught about what was important in life is true. Not that I didn’t believe it, but I hadn’t “lived” it so completely before. You believe that accidents and/or complications from illnesses are something that happens to other people…certainly, not to you or the ones you love.

Well, guess what? Not true. And if you’re the “one” it happens to, to say that you question everything you’ve ever learned about life is an understatement.

On my first trip to a mall (shoe department), when I tried on a great pair of edgy flats in a metallic color, my husband voted them out and insisted I buy the red ones. Red flats? Red wasn’t me. But when a stranger who was trying on shoes next to me agreed with my husband, I ended up buying both pairs.

New shoes mean you have new places to go and new things to do. They signified my return to life as I knew it when the concerns of the day were mundane ones. There’s one big difference though: nothing will ever be mundane again. Nothing.

When you realize that all of us take much of our lives for granted, that realization takes you to a different place. I wanted to put up billboards asking people to take a long, slow look at their lives. But, if I had seen such a billboard, would I have paid attention to it? Probably not. So, what’s my point? To inhale life deeply, joyfully and slowly.

This Spring, I’m going to put on those red shoes and let them take me into my new future. I won’t have any preconceived expectations about what it’ll be or where it’ll take me. I’ll smile at things that used to make me frown and embrace problems that used to make me run. I now know what “the bottom” looks like--and it isn’t pretty. It comes unexpectedly and, like a roller coaster, when it comes, you’d better hold on for dear life.

All of us know that in times of trouble you find out who stands with you, beside you and for you. You also find out who doesn’t. Finding out who doesn’t, was one of the many things that for a long time, I wished I hadn’t learned. But, I came to understand that finding out who you can’t count on is of equal importance as finding out whom you can.

And, while that may sound negative, it isn’t. It gives one the freedom to weed your personal garden and focus on new plantings. You view your commitment to friends in a new light, and you find yourself promising to nurture and care for them with the better understanding you have now. True friendship takes on such a different meaning.

You realize you are walking in new shoes on a different journey--and it’s a second chance. After all, how many people gain a lifetime of experiences ---- both good and bad---- in a single year’s time?

I incessantly asked the questions: “Why me? Why now? Why this?” And, it’s taken more time that I care to admit, but finally, I discovered the reason for this experience isn’t what’s important.

I started to look at all of the things I hadn’t lost as opposed to what I had.

I had to look at what I faced now, and found myself looking at a big, open blank book. One that was waiting to be filled with steps of the journey: stories, drawings, sketches, jokes, diary entries and/or anything that came to mind or came along. You’d think that it would be very exciting for a creative person like me but it was not only daunting, it was downright frightening.

I’d always had a script for my life and I’d followed it to the last detail. What do you do without your script? No one told me that my story might need a major rewrite midway through.

Realizing that fact left me suffering from the ultimate creative block. I couldn’t focus or concentrate on the very things that used to propel me forward, so how on earth was I supposed to develop that new script?

Where you do start and how do you begin? I figured a good place to start was to make a list of what I had deemed important. Next, to reflect on how my life had changed. Then, I created a second list, detailing what mattered now. That would require some serious soul-searching.

I spent long hours thinking about what I used to value. First, was my good health. Well, so much for that.

Next was my career. I had a successful one by all measures, and one I worked very hard to develop. I’d never thought about leaving my career. Now, I could scratch that off the list as well.

Tackling my second list, I realized the most important thing on both lists was my husband. Next, was the amazing support we had around us. We had no concept of how many people would come to our side. It was mind-boggling. My husband and I found out this past year that we’re only as strong as the people in our lives.

Another important discovery through my illness was the wonderful new people who came into our lives—people we’d never have met any other way and now are like family to us.

It taught me that you never know who’s looking up to you for whatever reason. Your attitude and actions can have such an impact and, often, you don’t even know it. The thoughtfulness and laughter they brought was infectious and helped heal us. They showed us by example how you can help to restore life to the living.

One of our favorite phrases now is it was one of the worst ways in the world to meet some of the most wonderful people.

I also thought about my second “career.” What shoes did its journey call for? As I began to heal physically, I became impatient over the next phase of my life. As I’d always done, I felt the urgency for a new script right away. Right now and right here. I expected myself to come up with instant answers. Wouldn’t it be convenient if life worked like that? But, a life journey takes planning, time and work, so I knew no instant answers were available.

I wish I could tell you how this new journey will unfold, but I can’t even tell myself. What I do know is that day in the shoe department, when I purchased not only the metallic pair—but the red ones as well—was a turning point for me. To try something new. And I’m going to make sure my new shoes don’t collect any dust.

A Survivor's Advice

2009-03-02T12:32:00.002-05:00

Julie:
After reading your blog, I want to tell you that thoughts of death hover for a long time after cancer/surgery, etc.

After my mastectomy, I had visions of my own funeral forever it seemed -- whenever anything would remind me of my vulnerability -- and there are lots of reminders out there.

Your last blog spoke to me and brought that all back. I want to encourage you that it does pass, so, hooray for stepping off the bandwagon for awhile.

It takes more courage to say no to things than to say yes for those of us raised as people-pleasers and blessed with talents that make that possible.

Your Friend

What I'm Giving Up for Lent

2009-03-02T12:15:00.009-05:00

I’ve realized that I’ve been following the “live today since I may not have tomorrow” creed these days. This has translated into me cramming a year’s worth of life into each day. To be honest, I've always lived this way -- going “90 to nothing” and then collapsing. But now that I've had cancer and the constant threat of death hovering over, I’ve accelerated this mindset & lifestyle to burn-out.

My vulnerability of wanting to be loved (make that adored) and significant are what drive me to exhaustion. I try to be the perfect daughter, niece, wife, friend, coworker. Can't say that I actually achieve that, but, boy, do I try!

So, I’ve taken my minister’s sermon yesterday to heart. While others are giving up addictions like chocolate, or bad habits like texting while driving, I've decided to give up my calendar.

For the next 40 days, I'm going to live each day at a time rather than pencil in activities and commitments for two months out. I'm going to spend time in my wilderness with God – reading, journaling, meditating…having my spirit refreshed & renewed. By the way, my minister pointed out that “Lent” means “spring.” I never knew that!

It’s not to say that I won’t get together with friends, but it does mean that I’m not going to make a single commitment in advance. I don’t intend this to be my way of operating from now on – but just for Lent, I’m going to slow down, not overcommit, and listen to His voice instead of all my fears.

L'chayim

2009-02-03T18:22:00.062-05:00

It's no surprise that I'm a wee bit tense these days. After surgery last year, when they found precancerous cells on my fallopian tube and the possibility ovarian cancer lingering over me until the second operation proved otherwise...followed by an "ambiguous MRI of my leg bone in December"--well, a girl can only endure so much waiting and wondering before she cracks.

Friends and family have noticed that I'm a little more "on edge," a little quicker to anger, more easily startled. But they don't know the extent of my anxiety, which is more like a volcano waiting to explode. On the surface, I've resumed my everyday activities. But underneath a facade of normalcy, fear is brewing and spewing. Thoughts of death hover over me--mine and everyone I care about.

As a friend pointed out, I've faced death at a much younger age than the general population. Most people don't come to terms with their mortality until late in life. I think about death all the time.

Last week, for instance, my water aerobics didn't show up for two classes, which was unlike her. The gym didn't know what had happened to her...so I envisioned some catastrophe befalling her or one of her children.

When I finally tracked her down, I discovered she had been sick, and had, indeed, called the gym--the person she had spoken to didn't pass along her message.

I think about how my mind races to the worst-case scenario whenever something is out of the ordinary. I'm waiting for the next bomb to go off.

When I shared this with a friend who is Jewish, she referred to the Hebrew expression, "L'chayim" -- to life.

She said that although it's important to be outward-focused, it's also critical to take care of ourselves. She asked how I spent my time off from work-- if I did anything fun and relaxing...if I took time for myself. She said that part of the healing process is engaging in activity that brings us joy. I needed to lighten up, loosen up and have some fun. In fact, play, darn it!

So, I've decided to volunteer at a community garden this spring. I need to spend time outdoors with things that are alive and growing. I need to connect to the beauty and wonder and richness of the world. I need to celebrate life. L'chayim.

Loss of a Survivor

2009-02-02T19:45:00.013-05:00

My mom lost a close, childhood friend the other day. This group of 12 women--who named themselves the "Sunshine Girls"--had been friends since high school. Some even from elementary school days.

They've supported one another throughout the years--hosting wedding and baby showers for daughters, celebrating birthdays and anniversaries, attending funerals of family members. They were there for each other through sickness, heartbreak and loss. They celebrated joys & triumphs.

Whenever they gathered, they rekindled their sense of humor and girlhood spirit. They vacationed at the beach each year, and took many roadtrips as well. There were always hints of wild times and scandalous conversations -- never to be shared with children and husbands. ("What goes on at the beach, stays at the beach.")

Their friendships spanned a longer period of time than husbands or children. Their bond was closer than family.

JoAnn Scott meant a lot to me, not only because she had been part of my life as a "Sunshine Girl" since I was a child, but also, as an adult, she was a breast cancer survivor who served as my advisor.

When I was first diagnosed eight years ago, she participated in a breast cancer walk in my honor. She reached out to my hurting and scared mother and gave her support. Fast-forward several years later, and JoAnn was on the scene again, advising me on surgery options for my mastectomies and reconstruction. She was honest, forthright and caring. She always had a smile and a laugh...a lighthearted spirit who loved life and people.

I mention this because I think of this culture in which we worship fame and celebrity, but have bought into a lie. Because it's the common, everyday people we know who make the most dramatic impact on our lives. JoAnn Scott was one of the people who made a difference for me.

The other thing that struck me about her death--besides being the first of the Sunshine Girls to die--is that she didn't die of breast cancer...but from a blood clot.

I think that, as cancer survivors, we get obsessed about dying of cancer. Although this is certainly a reality, we may not die of cancer at all--but from something entirely different. And all that worrying about cancer reoccurrence may be for naught. I might be hit by a bus instead.

All to say, JoAnn Scott played a huge role for me. I learned from her in life--all about breast cancer--and, I learned from her in death--that I can't obsess about cancer.

Therefore, I need to live as JoAnn lived -- with a bright, vibrant spirit that affected everyone she came into contact with. God bless her.

Crash Landing

2009-01-28T22:08:00.008-05:00

I couldn't help but notice that after US Air 1549 recently crash-landed on the Hudson--and everyone on board survived--one passenger responded by praying and thanking God. Another passenger went to a hotel lobby and ordered a martini.

I can understand how they both felt. After getting news yesterday that my follow-up MRI was normal (i.e., no sign of cancer growing in my bone marrow!), I was torn between praise & thanksgiving...and heading to a bar. I did say a prayer of thanksgiving...and then took my dog for a walk.

Not since my first diagnosis of cancer--when everything was an unknown about my chances for survival--have I felt this close to death. When cancer hits the bone, that's bad news. I thought I had come through so much last year, with all the surgery and my close call in beating ovarian cancer. And, then, to find a mysterious mark on my leg in December--that's when I realized I could never fully escape cancer hovering over me. It's a fact of my life forever.

So many thoughts coursed through me during this month-long waiting period for the 2nd MRI to see if the area had changed, signifying if there was cancer. I thought about my short time on earth and how scary facing death is. I thought about how 50 years have flown by...and how I can never recapture the years I took for granted. I thought about how I wanted every day and every relationship to matter. I even found myself angry at people in my life who are acting petty right now. What a ridiculous waste of time.

Somehow, my latest potential bout with cancer has made me more serious about the time I have left. And although I escaped bad news this go-around, I know that as a human being, I will eventually face my end on earth.

But until then, I'm going to keep praying...and have a martini.

Cancer Doesn't Mean Carte Blanch

2009-01-10T21:34:00.002-05:00

I'd like to take a moment and turn into your Sunday School teacher, since we all need a lecture now and then.

Picture me pointing my finger and raising my eyebrows--and my voice--and taking on an admonishing tone. Because this is what I'd like to say:

Although cancer can be cruel, heartbreaking and devastating, and can rip you apart physically, emotionally and spiritually...

And although cancer makes you face challenges you never envisioned, and can get the best of us when we're feeling weak and vulnerable...

And although the world may not be as caring and comforting as you need it to be at the time...

And although you have to endure many rough days, tough decisions, scary thoughts and lonely nights...

Cancer does not give any of us the right to act anyway we want to. In other words, it doesn't give us permission to be a jerk.

Now, I --above all people--have my moments. Trust me. I can be gnarly and irritated. Irrational and outspoken. Demanding and downright difficult. But, typically, I come around to realizing that I'm on the wrong side, and try to apologize and make amends for those times when I'm less than angelic.

But, I've also known people who are cancer survivors --or continue to battle cancer long-term--who seem to feel that having cancer somehow gives them carte blanch to treat everyone like dirt. And it doesn't.

Despite the rotten behavior you sometimes run into, I've found that most of the time, people go out of their way to show compassion and kindness to us who are suffering from cancer. As a matter of fact, I've experienced people going overboard to extend love and help.

At the same time, I also know people with cancer, who think they have an excuse to lash out at the world. To be intentionally hurtful and mean-spirited.

But they are confusing cancer with another disease entirely...one with a completely different cure.

Tattoos for Ta Ta's

2009-01-02T13:47:00.001-05:00

January, 2009--As my body continues to heal, and I've decided to keep my breast size the same (although this could change)...what's next?

Tattooing! And you thought that was only for Gen-X'rs.

Among us girls with mastectomies, a tattoo is the finishing touch in giving us a realistic appearance. First, you have to let all the scarring heal (meaning, no red marks) before you can begin the tattoo process.

My initial research provided me with this tip: avoid the plastic surgeon's nurse and opt for a professional permanent makeup artist.

Why? Most likely, a nurse doesn't get the cosmetic training as a permanent makeup artist...so more often than not, you don't get the color you want. (Also, depending on your insurance plan, my doctor's office was twice as expensive.)

Of course, I'm fortunate because I know an excellent permanent makeup artist--which is not to be confused with a regular tattoo place, in which they use synthetic dyes. A permanent makeup artist typically uses natural dyes and applies the tattoo with their hand, rather than a machine, for a more authentic look.

In addition to cosmetic tattoos (such as eyebrows, eyeliner, lipstick and even blush), many permanent makeup artists specialize in medical tattooing as well -- it's worthwhile to find out if they do and see photos of their work.

I discovered Cheryl Rosenblum, owner of Permanent Makeup of Atlanta (www.permanentmakeupofatlanta.com) when I finished chemotherapy and my eyebrows didn't fully come back.

After spending several frustrating months applying makeup to my brow line, I heard about Cheryl and paid her a visit. She showed me a portfolio of her clients who needed all sorts of medical tattooing (mainly covering up scars and filling in bald spots).

She not only filled in my brows, but my eyeliner as well. It looks natural--which is good, since I've never cared to look like a clown. (The jury is still out, however, on whether I've actually been a clown or not.)

I talked about my next tattoos with Cheryl, who said she often has to redo breast tattoos from doctors' offices.

So, when my scars heal, I'll head to Cheryl, and share anything else I learn.

Christmas Present

2008-12-24T23:40:00.000-05:00

It's Christmas Eve and I just received a wonderful and unexpected gift!

It didn't come wrapped underneath my tree, but rather, in a voice message.

Blue Cross Blue Shield of Georgia called and let me know they were, in fact, going to cover my bill for genetic testing IN FULL!

Thank you, Blue Cross Blue Shield!

Yes, Virginia, there are caring health insurers after all!

Resolution! (other than the New Year's kind)

2008-12-18T12:05:00.013-05:00

It's almost Christmas and I've encountered an angel. It's true!

Myriad Labs resolved my bill--they adjusted my balance to zero! Zip! Nothing!

Dear Ms Auton,

Thank you for your assistance in the appeal process. However, Myriad will stand by the quote that Blue Cross Blue Shield of GA gave us prior to the test. In your case, they quoted 100% coverage. If they do in fact deny your appeal, please forward that denial to Myriad and your account will be adjusted to $0.

If you have further questions, please don't hesitate to ask.

Sincerely, Patient Accounts
Myriad Genetic Laboratories

It's time like these in which you want to reach through the phone and kiss somebody!

So, my advice for all you breast cancer survivors whom I've been encouraging to get genetic testing: Make sure you get IN WRITING your insurance company's commitment to pay 100% of the service rendered.

Get it documented. Save the documentation. Get it signed in blood...that's what it takes for insurance companies to honor their word these days.

I've been told that insurers bank on most of us not challenging and fighting their lack of coverage. They figure we're too overwhelmed with other things...like our health.

Although it takes precious moments out of your life, staying on top of insurance companies' payments is critical. I've already spent thousands of dollars out of pocket on cancer, when I could have been vacationing in Alcapulco.

I told Myriad that although they erased my bill, I would continue pursuing payment from BCBS. It's only right that I help. Therefore, BCBS has not heard the last from me.

My next step is taking this to our HR benefits person, since we just renewed our BCBS contract for 2009. What BCBS doesn't know is that my company has a personal interest in breast cancer, and BRCA testing--since we're mostly female employees and the majority of our customers are women, as well.

Just like John Paul Jones, I have just begun to fight!

Take That!

2008-12-18T11:42:00.012-05:00

It's not even New Year's, and I've already broken one of my New Year's resolutions. (#3--Show grace and kindness to everyone.)

I was less than gracious to the insurance company's customer service reps, who put me on hold for infinity, and found myriad (as in Myriad Lab) excuses as to why they couldn't and wouldn't pay my bill in full.

My friend, Pam, told me (as I was venting during our walk) that I needed to add a disclaimer to my "be nice to the world" resolution--exempting anyone who is "petty/vile/self-centered/manipulative."

That category needs to be dealt with swiftly and forcefully, without a trace of charm and sweetness. No siree.

If I had only known about the "disclaimer rule," I could have kept all my previous resolutions in years' past.

Memo to Myriad

2008-12-17T16:11:00.004-05:00

My new best friend, Erica, the genetics counselor, read my blog entry and noted my frustration.

Her advice: Talk to Myriad! She said they dealt with this sort of slimy insurance thing all the time. (My word, "slimy," not hers.)

So, I dashed off a memo to Myriad...

To Whom It May Concern: Attached is the correspondence I received from Blue Cross Blue Shield of Georgia, denying my appeal.

I talked with a BCBS customer rep, who told me that you have to produce evidence that they agreed to pay 100%. She said that although they authorized paying the “billed amount for the services,” this apparently does not necessarily mean they will pay 100% unless you have a separate document saying so.

This must be insurance lingo, because “paying the billed amount” = 100% to my way of rational thinking.

Therefore, I wanted to see if you, indeed, have yet another document that states you received authorization from BCBS to receive 100% payment.

Thank you for looking into this matter.

The Case of the Missing Authorization

2008-12-17T13:56:00.010-05:00

I've suddenly become Nancy Drew...tracking down the mysterious document, authorizing 100% coverage.

What would Nancy do? She'd jump on the case immediately. Contact the genetics lab. Contact the genetics counselor.

And friends wonder why I don't return their calls in a timely fashion. As Nancy would tell you, there's no time for chit chat, when you're hot on a case.

When Insurance Doesn't Pay (as Promised)

2008-12-17T12:40:00.016-05:00

So, here I am, sitting on eternal hold with my health insurance company, BlueCross BlueShield of Georgia, and listening to the taped message featuring cheesey Christmas music and a perky woman's voice letting customers know how much BCBS cares about us and is there to help. Hmmmm...

"We're looking forward to assisting you!" I'm not sure they want to hear from me today.

I just received a letter from BCBS stating they were denying my appeal to fully cover genetic testing at Myriad Labs--to the tune of $1,000--even though I had produced a letter on BCBS letterhead and signed by William Tatum, MD, Medical Management, BCBS: "We have approved your request to receive care as described above."

Yet, now, BCBS will not accept this document. Go figure.

I've been speaking with Veronica in customer service, who can't answer my question of why I've been denied coverage when I have a letter in-hand stating otherwise. Because Veronica is perplexed, she puts me on hold to find a supervisor.

10 minutes later..."Your call will be answered shortly! Thank you for holding!"

My plan of action, therefore, is to get tough. I'll stay on hold all day, if need be. I'll take this to the top of the insurance company. I'll write an editorial. I'll call every day. I will get this resolved.

20 minutes later..."We do respect your time! Please continue to hold. We will be with you as soon as possible."

It's amazing what you learn when you've been put on hold with your health insurer. I now won't eat too many sweets during the holidays due to diabetes risk...Cold season is here, and antibiotics are not an effective treatment since colds are caused by viruses--rather, drink plenty of fluids, get rest and use an over-the counter cold medicine, if needed...Several ways to reduce getting the flu include wash my hands and cover my mouth/nose when coughing; avoid people with flu-like symptoms; stay home if I don't feel well...Wearing heavy backpacks may injure your child's spine. Limit loads to 10-20% of your child's body weight....Keep fitness goals during the holidays by playing holiday music while working out!

30 minutes later..."We hope the New Year brings happiness and health!"

I'm wondering if they are starting to forget about me. Maybe this is another tactic to avoid paying -- keep me on hold forever so they'll never have to address my proof of a signed document by them.

At this point, I've been on hold for over a half hour and I've heard the recording about the cold season for the 50th time; therefore, I think I shall call them back...

My next call produces Mindy in customer service. She reviewed my information and said that although BCBS agreed to pay for the billed amount of the services, unless there was prior authorization saying they would pay 100%, they would only pay 70%.

Am I missing something here?! They agreed to cover the billed amount on my document, and now they are telling me that I needed to have some additional, special authorization for them to cover 100%. Of course, neither the lab nor I were aware of this. Somehow, I figured "paying the full bill" meant "100%", but then again, I don't know insurance lingo.

Mindy puts me on hold again, and I'm thrust back to "Deck the Halls" and "We appreciate you holding" message while she seeks further information.

I've now been on the phone with her for 15 minutes (for a grand total of 45 minutes)...

Mindy returns and, yep, I not only missed my appeals window of 180 days from the claim (in February)--although I didn't hear the first word about it until October (doesn't matter, said Mindy)...but also, the document I have in hand that states full coverage is negated by the fact that apparently I don't have yet another document saying they will pay 100% coverage.

Consequently, I must go back to my genetics counselor and the genetics lab to see if they can produce the required additional authorization.

No problem. I had nothing better to do anyway today.

2009 Resolutions

2008-12-15T23:04:00.028-05:00

New Year's is a little over 2 weeks away, so I've been thinking about next year and what tweaks and adjustments I want to make.

There's something about turning 50 this year--coupled with being a BRCA-carrying, two-time cancer survivor with a recent MRI exposing a "suspicious spot" on my leg bone--which makes me think seriously about how my days are numbered. I realize that I've not only lived over half my life at this point, but, also, that I can't necessarily count on living a long life since I've battled cancer twice. Yes, I'm aware that none of us knows how long we have, but cancer makes you more aware of this little fact.

So, peering into 2009 and beyond, here's what I want for my life:

ONE. I want every day to matter; every interaction with others to matter. I don't have time to waste. A day to waste. A relationship with another human being to waste. I want every moment to be lived, every connection with another person to bring life and meaning. This means changing my Tasmanian Devil-like behavior in which I buzz through life in a whirlwind of activity.

I've been thinking about this a lot lately. Take last weekend, for example. On Saturday morning, we had a security system installed. It was supposed to take only a couple of hours, but I happened to ask the young guy installing the system about his family, and as a result, my husband and I ended up doing marriage counseling with the installer for over an hour. It threw us off our schedule for the rest of the day, but he seemed so eager, so desperate, for advice.

After he left, I rushed off to visit with a former coworker, who had almost died this past year from complications from cancer surgery. Instead of my usual Saturday of errands and chores, I simply focused on spending time with her. And, it was time well spent. We reflected on where we've been with cancer and how life is precious--sharing in a way that only people who've been to hell and back can relate.

On Sunday, we baked Christmas cookies with two teenage brothers (yes--teenagers!) because for some odd reason, we are considered cool and hip enough for them to want to hang out with us. Two teenage guys=flour and cookie dough all over the kitchen floor and every utensil used. Yet, despite the mess that had to be cleaned up, I loved the laughter and they loved the attention.

As I reflect on this past weekend, I didn't accomplish a lot in terms of house & yard projects. Yet, I feel like I connected in a powerful way with others. And that makes me think that my life counts. That I can provide love and hope and joy to others, and that's really all I want for my life.

TWO. I want to stop living in fear. In addition to the economic calamity that pervades everyone's life at the moment, I'm scared that cancer will be discovered in me again and my life will be cut short. And, at the same time, I'm sick of worrying

I want to walk into the future with courage...accepting whatever comes my way. Dealing with life's challenges with power, rather than being the helpless victim. I'm tired of being the scared little mouse, scurrying to hide in a hole somewhere. I want to face life head-on. Of course, that doesn't mean that I won't have my meltdowns, pity parties and moments of angst. But after that, I want to get up, dust myself off, and move forward with boldness...tackling what life has in store for me.

THREE. I want to extend grace to others, being more forgiving and patient, more giving and kind--which will be a major challenge, since I'm often gnashing my teeth in frustration with the world in general. But, so many people have forgiven me for my mishaps and offenses, and extended grace and love and kindness when I needed it most...and I realize what a gift that is.

So, these are my goals for 2009 -- to embrace life more fully and powerfully than ever before, knowing that each day counts. To live with purpose and not waste a day with childish attitudes and ridiculous actions.

Other than these goals, the only other thing I want for 2009 is a great dye job. After all, if you're going to have a new boob job, you have to have great hair.

A Gift to Myself

2008-11-29T15:50:00.006-05:00

What does a girl do when she's facing a potential crisis involving a dubious spot on her MRI? She gets a face lift.

You heard me. A face lift. But not the kind involving a scalpel...I've played with way too many knives this year. I'm talking about a non-surgical face lift. Yes, there is such a thing.

This procedure uses micro-current technology, which stimulates & energizes cells in your muscles. A "wand" is traced over your face at varying levels of electricity to strengthen and tighten your muscles, giving you a natural lift.

In case you think this is some witch doctor sort of thing, you should know that this technology has been used for years among physical therapists.

Of course, I only trust my friend, Chrissy, owner of About Face Skin Care (www.aboutfaceskin.com), to conduct this procedure since she's a former plastics nurse. Now, she runs a successful skin care business in which the products and services are only available through medical personnel.

It takes a dozen times for you to reap the full benefits of this technology, and I'm not quite half-way. However, I'm already seeing an improvement in my reflection. I figure, if my attitude doesn't improve while I wait for the next MRI, at least my appearance will.

My New Companion

2008-11-26T16:48:00.014-05:00

I arrived home this afternoon to find a message waiting for me from the bone cancer specialist who had viewed my MRI.

He said the MRI "wasn't specific for anything, although it would be a good idea for me to come back in 8 weeks for another MRI to evaluate for any changes."

Don't you love doctor-speak? But, after all these years, I've gotten pretty good on deciphering it: They can't say for sure it's not cancer. "Evaluating for any changes in 8weeks" means, "We want to see if that area grows."

However, I have decided not to respond with Fear...Instead, I've moved on to Panic.

It makes sense that the word "panic" derives from the mythological god, Pan, the creepy little creature who roamed the countryside. With horns, cloven feet and a tail (inspiring Christian images of Satan), even his mother ran away at the sight of him.

One description says, "His unseen presence aroused feelings of panic in men passing through the remote, lonely places of the wilds." This captures how I feel right at the moment. I'm in the wilderness with an eerie unseen presence hovering about me.

I decided to not tell my husband about the MRI. Or my parents. I've seen the toll that cancer and my BRCA surgery took on them this year. And, they can't do a thing but stand helplessly by, worrying about someone they love. Why drag them to hell and back if this turns out to be nothing?

So, I worry--rather, I panic--alone.

If you have or have had cancer, you understand this roller coaster ride. Every test has the potential to expose something bad. And with MRI technology, I've been told that often "too much" shows up on film, adding to the confusion. Much of the "extra stuff" is nothing at all. But, then, as we cancer people can attest, the strange thing they see on an x-ray can turn out to be something with a very nasty name.

So, Pan has entered my life for the time being...but I'm not telling my husband. Although I'm sure Pan will expose himself one way or another in the next 8 weeks as I wait for the second MRI.

Sizing Up the Situation

2008-11-26T15:00:00.003-05:00

I've had so much plastic surgery at this point that when I die, I won't be buried or cremated. I'll be recycled.

This was my thought after meeting with my reconstruction surgeon, who felt like my breasts needed to be a tad bigger...just a tad. He said it would look better for my tall frame. But, he left the decision up to me...which is good since I'm the one buying the lingerie.

Of course, my husband, Gary, was no help. He agreed with the surgeon, and described his preference by cupping his hands in front of him at arms' length. Funny.

But, he also said the choice was up to me. Thank you. (I'd like to point out, by the way, that my female friends say my breasts are a normal size...but, that's what I get when I have two men weighing in this matter.)

So, I choose small (excuse me, normal) because I've known too many women who have chosen breast reduction and feeling "free" for the first time in their lives. Well, I'm feel free now...why be encumbered?

My surgeon advised me to think about it over the next couple of months...since I might change my mind. Okay. But, I wouldn't bet on it.

Putting Myself Together Again

2008-11-26T10:29:00.017-05:00

Now that I'm five months out from two massive surgeries involving lots of moving parts, I'm feeling the after-effects these days. Somehow I went into surgery fairly young (okay, middle-aged) and came out of OR 30 years later.

I'm sore, stiff and achey all over. If you're a Baby Boomer, you might remember the Samsonite commercial from years ago. It showed a gorilla throwing around a piece of Samsonite luggage in his cage, demonstrating that it was impossible to break open. I suspect that's what the surgeons did to me. I think they also beat me with a wrench...kind of like I've seen mechanics do when they're peering under the hood of a car. At least it feels that way.

And, with all the slicing and dicing of my muscles, my posture now resembles one of the early stages of man you see on the evolution chart.

Then, there's my fragile emotions. I thought I was handling everything just fine --facing the fact that I'm a BRCA gene carrier, undergoing the knife, discovering I had fallopian tube cancer growing inside me. My emotions have been pretty even keel. That is, until something goes awry.

For example, a couple of weeks ago, I received a call at work from a friend's father. She had not shown up for her flight, which had left over 2 hours earlier. She didn't answer her cell phone and no one could reach her. This was highly unlike her, especially since she was speaking at a major conference. I'll skip all the details, but her parent's concern became my panic, as I spent the following hour trying to track down every place she could be. The only thought that came to me during that time was that she was in a wreck on the side of the road, and I'd be going to her funeral that weekend.

Her father called two hours later, saying she had been booked on an earlier flight than expected and was all right. I hung up the phone. And burst out crying.

I react like that whenever anything out-of-the-norm happens--I envision death and destruction and devastation. In other words, I'm not the way I used to be. Physically, or emotionally. So, this is my time to put the pieces of my life back together. That's what you do after surgery.

Physically, I'm doing water aerobics classes and pilades to stretch my body. I'm taking Vitamins B, C & D. I drink cod liver oil each morning. My diet and lifestyle habits have always been Jack LaLanne-approved, but I've stepped it up. I'm paying even more attention to nutrition, as I now consume mostly dried beans, nuts, seeds, grains, vegetables and fruit, and minimize meat & dairy. I eat as much fish as Flipper, and try to buy organic and fresh food whenever I can. I exam each package label like Sherlock Holmes, looking for the dual villains of hydrogenated soybean oil and high fructose corn syrup. And, I continue to drink the same amount of water that travels over Niagra Falls daily.

As for my nerves, I'm spending time processing my thoughts with friends, taking long walks in nature, journaling, connecting to others, praying. I know it will take time for me to reclaim my former life in which my body moves more freely and my mind responds in a calm and collected manner.

But, then again, that may be expecting too much. After all, as a poster child for type-A personality, I've never responded in a calm and collected manner my entire life.

The Waiting Game

2008-11-26T10:17:00.004-05:00

Some people have created masterpieces in the same amount of time I've spent in doctors' waiting rooms. I'm sure I could have written a best-seller if I had spent that time at the computer rather than in the waiting room.

But, here I sit once again. For 2 hours. I even made a 7:30 AM appointment. You would think that would get me into an exam room fairly quickly. Instead, I watched an entire waiting room full of patients -- and I'm sure a few people from off the street -- get called into exam rooms before me. So, I sit...and wait.

Cancer treatment is one that requires long waits. You can expect to wait between 1 to 2 hours before seeting a physician or getting a test. I remember the waiting time for radiation was the worst. It averaged 2 to 2 1/2 hours each visit.

So, my advice is to come prepared: bring a book, magazines, journal and/or a friend to talk to. That's what I do. Now, if I just would bring my laptop, then I could pop out a best-seller one of these days.

Fear Is Another 4-letter Word

2008-11-25T15:13:00.020-05:00

The Exorcist was the last horror movie I've seen since high school. I decided after watching Linda Blair throw up, scary movies were not for me. After all, life is scary enough without adding make-believe to it.

But, isn't that what we do with fear? We create worst-case scenarios in our minds...and most don't ever come to pass. Yet, we live with these torturous thoughts plaguing us for much of our lives.

These days, especially, you can't get away from bad news--from Wall Street tanking to company layoffs to war in Iraq and terrorism hovering. And then there's cancer. What's a girl to do?

I need an angel to appear and say, "Fear Not!" But, then again, if an angel appeared, I'd freak out.

My fears and worries have worn me out. So, just for today, I'm going to take a deep breath, and put my faith where my angst is, and focus on my life at-hand, rather than all the scary, awful potential things that could happen. Because many scary, awful things have already happened in my life, and I have survived.

The reason I have endured many scary, awful things is because they are real -- and humans are designed to handle reality. Fear is not reality. It's a possibility that may never happen. And humans weren't designed to live with "what if?" but rather "what is."

I need to live with what is real and true. And what's true for today is that I'm alive and life is good for millions of reasons. That's what I need to focus on -- being grateful for all that I have been given, rather than worry about what might be. Because choosing worry over gratitude is a waste of life.

I've Never Learned to Limbo

2008-11-24T22:41:00.011-05:00

I think I could live in practically any state...except for the state of Limbo.

However, despite my best efforts, I'm constantly being dragged there against my will. As a cancer survivor, you're often dangling between 2 possibilities -- do I have it, or do I not? Only time will tell.

After missing yet another call from the orthopedist, I aggressively tracked him down the next day--with the same determination as if he were an escaped convict--for an explanation of my MRI report. But his answer was disappointing. He didn't know. He advised me to have the report faxed to my oncologist for her to weigh in on this "mystery spot" on my leg bone.

Visions of my leg being sawed off raced before me. All I could think of was how everyone had said I was so brave to have this preemptive BRCA surgery, and I how told them that I could easily give up body parts -- like boobs & ovaries -- any day over losing something really important...like a leg. And now, here I am.

Cancer can cause one to become a drama queen--which I rightly have been crowned. There are some days in which it's simply impossible to be rational and calm. And this is one of them...or several of them, as far as I'm concerned. The worry that I have cancer in my leg bone hovers over me. I feel like Fay Wray in King Kong's grasp. That cancer has a grip on me and won't let me go, and I'm as weak and helpless as Fay Wray (without the movie star billing).

Cancer is like a terrorist. You never know when it's going to strike. So, you have to learn to live with this uncertainty. But try telling a control freak that.

After I ordered the MRI report to be faxed, I followed up with my oncologist's office. Again, no return call on Friday. Which gave me ALL weekend long to obsess.

I left another message this morning. No return call this afternoon. Finally, at the end of the day, my frazzled nerves won over my logical brain, and I took the matter into my hands. I called my oncologist's cell phone. I apologized for calling, but explained that I just needed to know, going forward, whether I should buy 1 pair of shoes, or a single shoe. Okay, so I wasn't quite that sarcastic, but it was something along those lines.

Tonight, she called me back from her home. I decided that although neither she nor I are Catholic, I'm still nominating her for sainthood...right up there Mother Teresa.

She told me that she wasn't overly worried about the report, but wanted to see me next week and have me bring the MRI...so she could explore this matter further. (In layman's terms, it's still not resolved.)

Limbo, like King Kong, just won't release me from its grip.

Stretching and Retching

2008-11-20T21:47:00.020-05:00

I recently redeemed my friend's gift of two one-on-one sessions with a pilades instructor. It was her treat because of all my surgeries this year. How kind, I thought.

But now, after my first session, I am questioning this friendship...perhaps I've ticked her off in the past and this is her way of getting me back. Or, maybe we were never friends to begin with.

It felt somewhat like the torture rack--you know, the one that yanked Braveheart William Wallace from limb to limb...until he died. I was pulled in every direction except for the one that offered comfort.

Even the "pilades machine" resembles a torture rack. See dictionary: The rack is a torture device that consists of an oblong rectangular frame, slightly raised from the ground, with a roller at one, or both, ends, having at one end a fixed bar to which the legs were fastened, and at the other a movable bar to which the hands were tied. The victim's feet are fastened to one roller, and the wrists are chained to the other.

Yep. That was what I was on, all right.

It's amazing I survived. Not only did I survive, I signed up for her next session. Call me stupid. You can also call me a hunched over old woman. Because that's what I am after I've been cut from limb to limb.

With a double mastectomy and reconstruction, your abdominal muscles have been severed and sewn back together. As you heal, you will tend to give into poor posture, hunching over because you're muscles are weak and tight. Stretching is critical in restoring your body to a normal stance.

I thought I was healing just fine. That I was stretching and building strength. At least that was my illusion until I took a pilades class. It exposed my pathetic state. I cannot do a sit-up. Or, much else, it seems.

Jessica, my instructor, rubbed her hands together in glee. Torture is her specialty. She tasked me to do the impossible. Everything appeared so easy when she demonstrated it. Alas, it was not so simple. I realized how desperately tight and weak I am, and how desperately I need this.

It appears that pilades is a perfect therapy after breast cancer surgery. Or, maybe it's another type of therapy I need instead...the one involving my head.

The Waiting Game

2008-11-20T20:42:00.001-05:00

I thought after high school, I wouldn't ever have to sit by the phone waiting for a guy to call me. (Obviously, I was in high school ages ago.) But, here I sit -- once again -- anxiously waiting and wondering when the call will come in and what news it will bring.

This is the life of cancer survivors. We're always waiting for the results of a test. For answers to our concerns. For help when we need it. And we typically have to endure hours and hours -- sometimes days -- agonizing over a call.

I cannot begin to count the number of messages I've received from doctors' offices at 5 o'clock on a Friday, saying they have the results to my test...but, I'll have to wait until Monday since the office is now closed. Click. There is a special place in hell for these doctors.

If only they understood the torture they put us through in keeping us in limbo. Would it kill them to give me their cell phone? Just this once?

I am currently dealing with this situation as I wait for the orthopedic doctor to call me. Yes, orthopedist, not oncologist. Trust me, I do know the difference.

I had an MRI the other day, which revealed a torn meniscus in the back of my knee. This explains why I remained standing while the rest of the yoga class of 20-somethings squatted to the floor.

A simple surgery will fix it -- as if I didn't have enough surgery this year, why not go for more? But, the MRI revealed something else. Something that concerned the physician. There was a strange mass in my bone.

He assured me this wasn't unusual. I told him that I was a cancer survivor. He paused. Well, it could be a result of the chemo I had had years ago. Still, to be on the safe side, he asked me to call him a few days later -- which was today -- so he would have the full report.

So, I called. He wasn't available. Surprise! I left my office number and was assured he'd call me. I stayed glued to my desk all day. Until I had to run down the hall...just for a moment. When I returned 3 seconds later, there was a message light blinking on my phone. He called.

The message said: "I have the results, but I don't want to leave a personal message on your office phone, so I'll call you tomorrow." I immediately called his office back, but alas, he had "just walked out the door a few seconds before I called." He was unavailable until tomorrow.

So, now I wait. Again. I wait with my future up in the air. Do I have cancer in my bone? Or is it something else, something benign?

Let me describe for you, the typical mental exercise I go through when I find myself in this situation:

Cancer is back. It's spread to my bone. I'm going to die. I'm going to lose my leg. Please, dear God, don't let me die. And let me keep my leg. Deep breath.

You don't know it's cancer until you get the results, so calm down. I update my will, mentally. I reflect on how I'm living my life, spending my time. Am I living it wisely? Deep breath.

It's probably not cancer. He said it could be fat deposits, or damage from chemo. He's seen this before. Am I up-to-date with my tithe? Is there anyone I need to forgive? Is there unfinished business I need to attend to?

This mental exercise goes on sporadically as I go on with living life...not allowing my thoughts and fears to consume me.

Then, finally, mental exhaustion takes over. You have to come to terms with this latest potential crisis.

So, now after feeling like I got kicked in the stomach because of a suspicious marking on my x-ray, I take a deep breath and realize that also, once again, I will face whatever news I receive with as much courage as I can muster. Knowing that we don't live forever. Knowing that I've lived longer than so many people less fortunate. Realizing that I might be okay after all.

But I won't know that for sure. Until I get the call.

Great News for BRCA Gene Testing!

2008-11-03T17:57:00.002-05:00

Mean gene

BRCA is a four-letter word

By Laura Raines

Pulse editor

Sunday, October 19, 2008

Julie Auton is a breast cancer survivor. When she was first diagnosed seven years ago, doctors had no idea why she developed cancer at 42.

She exercised frequently, drank plenty of water and ate right. As her friends told her, “If Julie the health nut got cancer, there’s no hope for the rest of us.”

After surviving a bout with breast cancer, Julie Auton started a blog to share her experiences with the BRCA gene.

Now Auton knows that her cancer is hereditary. She’s quick to tell people that BRCA genes — the genetic mutation that makes some women more susceptible to breast and other cancers — is her four-letter word. She’s also tells them that more people need to be aware of BRCA genes and what they mean.

“My mother was diagnosed with Stage 0 breast cancer after 65, and my grandmother had breast cancer at 67, but since both were post-menopausal, my doctor, a national expert, didn’t think my cancer was hereditary eight years ago,” said Auton, executive director of apparel marketing at AmericasMart Atlanta.

During a followup visit in 2007, her doctor, who had read more research on heredity and breast cancer, suggested that Auton get tested for the BRCA gene. Worried about how the results might affect her insurance coverage and the cost — the test runs around $3,000 — Auton ignored the suggestion.

“But then I mentioned it to my gynecologist… and her immediate response was, ‘You need to do it,’ ” she said. “She told me that not only was I running the risk of another breast cancer, but that my risk of ovarian cancer was also high. She explained that there’s no early screening test for ovarian cancer, that it’s deadly and that I didn’t want it.”

Change of heart

Still Auton waited until a suspicious mammogram and other symptoms changed her mind about the test. Auton saw a genetics counselor, who took information about her family tree and health history, and determined that she was a candidate for testing.

Auton learned that most insurance companies will pay for the test — especially for breast cancer survivors — as well as prophylactic surgeries, because the cost is still less than that of cancer treatments.

“The lab doesn’t report the results to your insurance carrier unless you ask them to cover the cost,” she said. “It takes three to four weeks to get results, because my counselor told me that sifting through your DNA looking for a mutation was like sifting through a jigsaw puzzle with 16,000 pieces.”

Auton’s test came back positive for the BRCA gene, leaving her with some tough decisions to make. Auton encouraged her mother to get tested and the results were negative, meaning that the gene came from her father’s side of the family.

“If one family member has been tested, others can be tested for $300, because the lab knows where to look,” Auton said. “Just because a relative had it doesn’t mean you will, but for $300 wouldn’t you want the peace of mind of knowing?”

Auton decided to have surgery. In February, she had a double mastectomy and had her her ovaries and her fallopian tubes removed. A plastic surgeon also began breast reconstruction.

“They didn’t do a hysterectomy because it was simply too much surgery at one time,” Auton said.

‘A lucky woman’

After a slow and painful recovery, Auton thought she was through the worst, but tests revealed precancerous cells in her fallopian tubes.

“He told me he was taking me to [Las] Vegas, because I was a lucky woman,” Auton said.

She didn’t feel lucky.

“But he explained that if I had put the surgery off, this cancer would have been invasive in six months and the results would not have been good,” she said.

A hysterectomy and pelvic wash three months later showed no signs of cancer. With a reduced risk of breast and ovarian cancer, Auton is grateful to have recently turned 50 — and for the two doctors who saved her life by urging her to get tested.

“They’re finding out much more about the genetic link, and if you had breast cancer years ago, your doctors may have a different opinion now. Ask,” Auton said. “There just isn’t as much information out there about BRCA as there should be.”

Auton does her part to spread the word about the BRCA gene. While sequestered after her first surgery, e-mail was Auton’s lifeline but it became overwhelming to keep up with her friends individually. A friend suggested that she start a blog so friends could keep up with her progress.

“It started off as a personal journal, a way to vent about cancer and surgery, but then friends began sending it to people they knew who had cancer, because they said it was informative,” she said. “When I realized I could express my personal emotions, tell people what I’ve learned, and help educate them about BRCA — a blog was born.”

New law protects against genetic bias

Thanks to a new law, cancer patients and people who are high risks for cancer and other diseases no longer have to fear discrimination if they undergo genetic testing.

On May 21, President Bush signed into law the Genetic Information Nondiscrimination Act (GINA), which protects people from genetic discrimination by health insurers or employers.

Many patients, like Julie Auton, have wondered what would happen to their health insurance or to their jobs if they test positive for a genetic anomaly that could cause disease. GINA eliminates that worry and allows people to reap the benefits of genetic testing.

According to John D. Kemp, executive director and general counsel for the U.S. Business Leadership Network, genetic information is invaluable.

It can help doctors diagnose and treat illnesses. Researchers can create more-effective drugs, and patients can better manage their health.

But fear that the information would be misused has kept some patients out of genetic testing and clinical

trials.

GINA prohibits health insurance companies from basing eligibility determinations or adjusting premiums on the basis of an individual’s genetic information.

“Insurance companies cannot request, require or purchase the results of genetic tests, and they are prohibited from disclosing personal genetic information,” Kemp wrote.

Employers are prohibited from firing, refusing to hire, or otherwise discriminating with respect to compensation, terms, conditions or privileges of employment.

To learn more, visit Coalition for Genetic Fairness.

Chlorine is My Preferred Perfume

2008-11-01T18:19:00.002-04:00

I've discovered the Fountain of Youth. It's the pool at my gym.

Swimming is excellent for repairing damaged muscles, tendons, ligaments and broken bones. The water provides a safe buffer, so you can't overextend yourself, and it lessens the impact. (Forget step class, please!)

Whether you are undergoing chemo, or recuperating from surgery, take a dip in the pool as soon as you can. Freestyle swimming is the best, according to a swimming instructor I once interviewed. But, any stroke will do, especially (no pun intended) the breast stroke.

With all my surgeries this year, the only exercise I was allowed was walking. No swimming for 6 weeks. (Of course, this was during the long, hot summer in the South. Did I mention we were also enduring a severe drought?) But, this was due to bacteria in the pool as to why I couldn't stick my tippy-toe in the water.

So, I walked...and walked...and walked...and walked. Advice: Never tell an obsessive-compulsive, Type A person that the only activity they can engage in is walking. I logged 1,000 miles during my recovery time. So, naturally, I developed "planter faciatis" (from over-walking and tearing ligaments in my feet). Fortunately, the timing was perfect because I was given permission to enter the pool again!

But swimming the first few laps terrified me. When you're cut in half and sewn back together, your abdomen doesn't stretch or extend as far as it used to. I could barely move my arms without feeling like I was being pulled from limb to limb, like Braveheart. Furthermore, with all the anesthesia I had had, breathing became difficult, if not impossible.

I swam like a 80 year old woman. I take that back...a 90 year old woman, since the 80-year-olds passed me in the pool.

Then one day, I had limited time to swim and the darned##$%#@$@$@$@ water aerobics class was scheduled at the best time for me to swim my laps. I must tell you that I've loathed the water aerobics classes since I began swimming for exercise 15 years ago.

They evict innocent swimmers trying to do their laps and take over the pool with their class, which consists of really bad disco music and a bunch of out-of-shape ladies bobbing up and down for an hour.

I have resented them for years. I've even complained to the gym management, trying to persuade them to eliminate the class...swimming laps was much better for them anyway, I argued. But to no avail.

So, back to the Saturday in which the only time I could exercise was 9 a.m., but that was the water aerobics class. Defeated, I decided it might be better to "join them, if I couldn't beat them."

I showed up for class. The instructor kicked my butt.

What manner of torture was this?! I was shocked to discover I couldn't keep up with her. She was brutal. She made us run laps down the pool, and then in reverse -- against the current of 20 women. It reminded me of those nightmares in which someone is chasing you and you are running in slow motion.

She made me kick until my legs were numb. She made me to leg extensions in which I couldn't touch the pool floor. She had us pull weights underwater, which was agonizing. Who was this bionic woman instructor?!

I found out. She was the gym's kickboxing instructor, who took on the water aerobics class. And by the way, there's no disco music. She doesn't like music so we can hear her yelling at us.

I've now become addicted to water aerobics, and it's given me strength, endurance, balance and flexibility.

All to say is it's time to yank out that old swimsuit you have hiding in the closet and head to your nearest pool. There, you'll discover the Fountain of Youth.

My New Role Model

2008-10-25T13:21:00.006-04:00

At this point, I'm advising/encouraging several women with breast cancer, who have been directed to me. Breast cancer, it seems, has become a communicable disease.

None of them "want to inconvenience me"--some even apologize for "interrupting" whatever I'm doing with their call. It must be a woman thing. They are so used to giving to everyone else and aren't used to asking for help themselves. It reminds me of when I was in their position and so appreciative of the women who dropped everything to answer my questions and point me in the right direction.

So, I reassure these women: You can't inconvenience me...because it's not an inconvenience. Being there for someone else is the least I can do after the masses of people who reached out to me. They provided a lifeline. And now, I want to extend a lifeline to these women.

Every one of them has the same concerns: facing the possibility of an earlier death than they expected...worrying about finding the right doctor...getting the best advice...being overwhelmed at sifting through all the information and opinions...dealing with anger about doctors' offices for not returning calls...worrying about how their kids are holding up...fearing everything.

My advice is always this: Be proactive. Aggressive. Pester them until you get the answers or help you need. Anything to be heard. With this disease, you can't be passive or shy. You can't simply sit along the sidelines and patiently wait. You have to take matters into your hands. You have to take your life into your hands.

I'm not suggesting you storm the Bastille and take no prisoners, but I can assure you that you can be--and should be--diligent in getting the answers to your satisfaction. Some of the women I've been talking to have told me about doctors who were dismissive with their questions...when you're dealing with your body being mutilated by a knife, there's no reason for anyone to be dismissive. Or, surgeons who seemed irritated and impatient, as if this woman was taking up too much of their time. Then, I advise them to seek a second opinion. Not that they may get a different answer, but you need to be 100% comfortable with the physician you are entrusting your life to. And that includes the physician's office staff, and how well that's run. Believe me, you can be more assertive with doctors -- I promise you, their egos can take it.

It's time we all adopt a new role model...and her name ain't Dorothy.

The Hobby of Cancer Patients

2008-10-22T20:59:00.022-04:00

People ask me how I spend my spare time. Well, while others are pursuing interests such as tennis or tango, I deal with insurance claims.

It's not the hobby I would have naturally chosen -- I was thinking more along the lines of painting classes or learning Greek -- but, since I was first diagnosed with cancer seven years ago, I have become preoccupied with resolving claims between my health insurance company and the provider - whether it's the doctor's office, hospital, lab, physical therapist, pharmacy...you name it.

First, I want to say that for the most part, I've been extremely impressed with my insurance company, Blue Cross/Blue Shield. Not only have they covered almost every claim, but they have also provided exceptional customer service. They have been pleasant and helpful...even going above and beyond to explain things and work through issues. Most of the time, it's been the physicians' offices who were unorganized and unprofessional...and down-right irritating at times. Of course, how many doctors do you know who went to business school? And yet, most of them are CEOs of their practices.

The cost associated with all my cancer has been staggering when you add it all up -- between the chemo and surgery and radiation (which I'm told is far more expensive than the previous two combined), the drugs and the billions of tests they put you through. The amount of money that has been spent on me could have paid off the debt of a third world country.

But now, I am stuck with a bill that I'm quite baffled about. I received a letter the other day from Myriad Labs, who stated that of the $3,000 for testing they conducted, my insurance company paid a little over $2,000 -- leaving me with the remaining balance of almost $1,000 -- even though BCBS had originally agreed to covering it in full.

When I called BCBS, my customer service rep explained to me that because Myriad was "out of network" for my policy, they would only cover 100% if it was an in-network lab. But, Myriad is the ONLY lab in the U.S. that conducts this test -- so I had NO choice in the matter. They were the only option for me to learn I had the BRCA gene, I pointed out.

Doesn't matter, I was told.

I don't get it. BCBS covered all my surgery -- plus, all the tests, doctors' visits, medications, etc -- because I was a breast cancer survivor & BRCA gene carrier and, yet, they won't pay for the lab that found I was a BRCA gene carrier in the first place.

Go figure.

I learned this after being on the phone for 30 minutes with BCBS today. My next step is filing an appeal and stating my case as to why they should cover this cost in full. Another day, another phone call.

Maybe one day, I'll have time to learn how to knit.

Giving 101

2008-10-13T18:51:00.022-04:00

There is woman who works in accounting at my company. I've always liked her because she wasn't your stereotypical accountant (zero personality...no sense of humor...easily irritated by stupid questions from people like me). She was warm and friendly and helpful. She didn't roll her eyes when I filled out spreadsheets incorrectly.

We bonded over my tutorial in Accounting 101. During this time, she and her husband had their first child.

Fast forward 5 or so years, and we ran into each other a few days ago. I immediately recognized the "chemo look." The hairless scalp. The neatly tied head scarf. I was shocked to discover she had cancer.

She's incredibly optimistic. She said she's in good hands with her physicians. She has been on my mind ever since. I'm praying for her, but I want to do something tangible -- like grab hold of her and heal her. This is where we all feel so powerless...when we see someone suffering and can't do anything....and yet we can.

Here is my tutorial in "Giving 101" --

#1 - Care.
#2 - Pray.
#3 - Help...running errands, babysitting, bringing meals, driving them to the doctor's appointment...the list is endless.
#4 - Give...to cancer research.

The month of October has become as synonymous with breast cancer--and as a result, cancer in general--as it has with Halloween. The pink ribbon is as well known as the jack-o-lantern. And because of the enormous effort in raising awareness --and funds -- for cancer research, our lives are benefiting.

This past weekend, my company and our customers participated in a huge fundraiser benefiting the American Cancer Society. Called Order the Cure, it was the brainchild of a man who is beating his dire prostate cancer diagnosis due to advanced treatment now available.

We banded together to sign up participants and "decorated" our building with colored balloons, representing all cancers -- pink for women's, blue for men's, yellow for kids', red for "all other cancers." Participants called and emailed us -- "Sign me up for Order the Cure! I'm a 10 year survivor...our coworker has just been diagnosed with breast cancer...my mother (brother, daughter, sister, best friend, husband) is going through cancer treatment right now..."

A sharp young woman named Michelle with the American Cancer Society pulled together an army of volunteers who came out in force to help. We printed t-shirts and bought hot pink pens, and produced stickers that said "I Ordered the Cure!"

Stories began trickling in. One participant asked her customers to write the name of loved ones on a colored card, which she taped to her doorway. At the end of the fundraiser, she will be sending all the cards with the names to prayer groups. Another participant found checks made out for $1,500 and $3,000 in their donation jar. People were genuinely enthusiastic to pray and help and give. The final numbers are not in yet, but I know we raised thousands of dollars for cancer research.

In a few weeks, a member of my staff will be participating in a separate fundraiser -- the 3 day breast cancer walk totaling 60 miles. She's raised over $3,000 in donations and is walking in my honor. Another example of giving.

So, in addition to caring and helping and giving, I'm also praying that my coworker will have every reason to be optimistic. That she, too, will be cured of cancer so she can go back to doing "mom things" and continue to tutor people like me in basic accounting principles.

Memories...Of the Way I Was

2008-10-08T12:40:00.013-04:00

In Gabrielle Garcia Marquez's book "100 Years of Solitude," he writes about a town in which all the citizens catch a disease in which the side-effect is memory loss. He must have been writing about menopause.

My memory has vanished due to the abrupt loss of estrogen resulting from my hysterectomy. A friend commisserated with me: "Instead of getting a hysterectomy, I think I got a lobotomy." She went on to say that her sister is so frustrated by her lack of memory that she's rethinking taking a vacation anywhere. She figures, why bother spending all that money when she'd forget it all six months later?

I know how she feels. I can't remember from one moment to the next. I have to write every thing down, or the thought will evaporate. I mix up the names of close friends. I misread emails and recipes. My cooking has become suspect...

Yesterday, I washed my face, applied makeup, brushed my teeth and began getting dressed for work...when I realized that I hadn't showered. All of this would be funny, except that on the drive to work, blue flashing lights caught my eye on the expressway. In a split second, the car in front of me slammed on their brakes and I had to swerve -- barely avoiding an accident -- all because I had gotten distracted.

So, now my scattered brain has gone from being mildly amusing and somewhat irritating to very scary. Friends have offered their advice -- supplements, websites, books. So much to read, so much to retain mentally.

I ask my staff to be patient with me. This group of twenty-somethings does their best to tolerate my forgetfulness, but their estrogen-filled bodies can't relate. I remember when I used to have a quick mind like they have now. This must be one of the passages in life I must adapt to. At least I can trade experience, maturity and wisdom of age for detail, multi-tasking and clarity of youth.
I guess it's time for me to switch from my natural brunette color and dye my hair blond since that typifies my state of mind from now on.

The Big "L"

2008-09-17T21:37:00.009-04:00

Tonight is the last night of my 40s...funny how the 40s seem so youthful now.

Of course, being a Baby Boomer, I will always claim being young at heart versus the alternative. However, I can't dodge the fact that I'm moving into another decade -- and one that is without a doubt middle-age. This was verified by the AARP card I received in the mail, as we all do on this particular birthday.

A friend said not think of it as turning "50," but rather turning "L." I didn't understand what she meant -- did she mean think of it as "hell"?

"No...don't you get it?" she asked. "L is the Roman numeral for 50." So, I guess I'm "L" instead of 50.

Although I'm having to get my mind around this new decade/stage in life and crossing over to "the other side," of the aged, at the same time, I celebrate that I've reached this far in life. I'm grateful to be alive after all I went through this year - so, when you look at it that way, I think 50 is pretty cool.

It occurred to me that I've been given 3 chances at life when the odds were against me:

* Birth -- My mother was pregnant with me just 2 months after she delivered my older brother, making us Irish twins. Talk about being a "mistake," the story is told of the night Mom announced her news to Dad. It was pouring down rain and Mom & Dad were driving up the mountain in Birmingham, iwith a newborn baby crying in the car. Dad was unemployed since he had just gotten out of the military-- meaning, no money + no health insurance + 3 mouths to feed. The car died as they were going up the hill, and Mom picked that decisive moment to tell Dad that she was pregnant with me. Dad recalls how he put his head on the steering wheel and cried. Of course, I've been a blessing ever since...

* Surviving breast cancer at 42. Despite my annual gynecologist visit and mammogram not showing any trace of cancer, my monthly self-exam told me otherwise there was a problem. Because I pushed and pursued further testing after finding a lump, I saved my life.

* Surviving fallopian cancer at 49. Pursuing BRCA testing and being proactive about preventative surgeries this year resulted in finding pre-cancerous cells on my fallopian tubes, which would have ultimately killed me since I would never have known they existed until it was too late.

When I think about these incidences, I feel like there is a reason I've been spared...that there must be a purpose and meaning to my life. And tapping into that purpose - which, I believe, is being there and caring for people who are in pain, in a deep and caring way -- is how I plan to live out the rest of my life.

Happy Birthday to me.

Mentoring 101

2008-08-28T13:09:00.000-04:00

I have become a mentor for two women I know, who were recently diagnosed with breast cancer. My heart broke each time I received the news of their diagnosis, and all I could think of was wanting to alleviate their fear and hurt. I've been there.

Both are outstanding women, who live remarkable lives. They have interesting jobs and are terrific moms. I hate this for them.

I'm also extremely touched they turned to me for help, comfort, advice. With this topic, it's impossible to avoid the personal and vulnerable in discussions. You get down to brass tacks and dirty details.

This gut-level honesty establishes a tight-knit bond quickly and powerfully. Because we're talking life and death here. (Okay, so we're also talking beauty tips...)

We discuss our mortality. We share our frustration about our predicament: what did I do to get this?...why won't the nurse call me back?...what if treatment fails? We talk about solutions to combat the side-effects of chemo and dealing with well-meaning people who do the wrong thing. Most of all, we commiserate.

I feel the weight of responsibility in not wanting to let them down. Being a mentor, you want to make sure you are doing everything you can.

But, this is where I need to be reminded of my own advice. When a friend asked what I found most helpful while undergoing cancer treatment, I told her it was every single thing people did to let me know they cared, that I mattered and that I wasn't ALONE. Feeling like everyone is living full, glorious lives while you are on the sidelines fighting a disease and missing out on everything. This is a daily struggle. When people take part in your ordeal, you are reminded that you're not on the outside...others are with you every step of the way.

I think of Jan Bilthouse, in particular. Jan, who is owner of The Bilthouse apparel boutique in Buckhead, is a breast cancer survivor and extremely involved in fundraising and mentoring for breast cancer. When I heard I carried the BRCA gene--which meant a double mastectomy--I immediately thought of Jan, who had already dealt with this. I left a message with an employee at her shop the day before Thanksgiving, and explained the reason for my call. It seemed like just a few minutes later, my phone rang. It was Jan, driving her family on the way out of town for the holiday. She responded to my call for help right then and there. It was exactly what I needed.

I hope the women I'm reaching out to will be on "the other side" of treatment soon, with a new perspective and appreciation for their lives and the knowledge that they do, in fact, matter.

Mom & The Blog

2008-08-21T21:12:00.000-04:00

Well, the word is out. Mom has read my blog and, of course, she remembers details differently. I knew she would. She pointed out the facts I got wrong and gave another point of view about certain incidences I wrote about. I told her to start her own blog.

But, mostly, she said it appeared, as she read my blog, that all she & Dad did throughout my ordeal was 'let me rest in their easy chair." So, let me set the facts straight on this one: They were amazing.

Mom & Dad have been my support throughout my bout with breast cancer and, more recently, my BRCA testing and surgery.

From the very beginning, they have played a critical role. They were the ones who showed up at the doctor's office the day I found out I had breast cancer seven years ago. Gary was at work because I was assured by the doctor's office that they wouldn't find anything conclusive that day, so it wasn't necessary for him to be there. I sent Gary off to work that morning and he naively went. But, Mom & Dad, with their experience in caring for others over the years, knew someone should be there with me...just in case. And they were right. I was diagnosed that day, and needed them to carry me out of the doctor's office and take me home in my state of shock.

Throughout my cancer treatment, they provided food, ran errands, took me to doctors' appointments and screenings, and sat with me during all the long waits. They offered to help in any way they could. They even paid for my "chemo wig" -- with a $1,000 price tag that was not covered by health insurance at the time.

During the years following my treatment, they called for an update every single time I had a follow up doctor's appointment or mammogram.

And, this year, during all the BRCA testing and surgery, once again, they drove me to appointments, ran errands, researched information I needed, fixed food, cared for me during recovery from surgery...and let me rest in their easy chair.

Christina Applegate

2008-08-20T21:37:00.001-04:00

The actress, Christina Applegate, has been in the news recently about having breast cancer at a young age, testing positive for the BRCA gene and undergoing a double mastectomy. In her interviews, she showed bravery and a sense of humor (saying she would have great-looking breasts in the nursing home compared to all the sagging women).

Two things I noted about this incidence. One, is how I see my parents still being affected by the stress they endured this year, worrying about their daughter having the BRCA gene and undergoing all the surgery. Mom stayed glued to the morning new shows when Christina was interviewed. Then, Mom responded by doing something she had never done before -- she posted an email on one of the national network station's site, saying that since Christina was carrying the BRCA gene, she needed to watch out for ovarian cancer as well, which was never mentioned in discussions about BRCA. For Mom to post an email to a national site told me that BRCA was still top of mind for her.

And, Mom is right. My oncologist told me during my recent visit that of her BRCA patients who have undergone the propylactic (preventative) surgeries, that 100 % -- repeat, every single one of us -- had pre-cancerous cells on the EXACT same spot on our fallopian tubes. One 100% of us. That tells you something -- that the BRCA gene is far more insidious than just breast cancer, and women need to take a hard look at the possibility of having ovarian cancer as well if they carry this gene.

The second thing that struck me with the Christina Applegate interview is her claiming to be "cured of cancer." I love her optimism and her spirit. I'm hoping she will never experience cancer again. However, the statement is false, since once cancer is in your body, you can't guarantee that there aren't other cancer cells lingering somewhere that chemo or radiation or surgery didn't eliminate.

So, although I had a double mastectomy and hysterectomy and reduced my chances significantly of developing cancer again...there's still that remote possibility there will be a stray cell that can develop into full-blown cancer. That's why I will never be able to take estrogen or consume soy products -- since estrogen/soy "feeds" cancer cells.

I am glad, however, that Christina Applegate appeared in public and shared her story -- who knows how many young women took note and began questioning their chances of carrying the BRCA gene. After being immersed in the world of BRCA this past year, I'm discovering the enormous lack of information about this gene among the breast cancer community -- especially among breast cancer survivors who are strong candidates for testing (those who developed the disease before menopause)...and especially among survivors with daughters.

A simple test could provide worlds of information that could not only save your life, but your daughter's as well.

Why Pursue BRCA Testing

2008-08-01T07:10:00.001-04:00

Several books have popped up recently about women who discovered they carried the BRCA gene and their resulting decisions.

One woman in her thirties had a double mastectomy, but held off on a hysterectomy until she had children. The other author decided to do nothing since she felt there were more issues around early menopause, and didn't want to subject herself to all that surgery.

HERE'S WHY I PURSUED TESTING & ACTION:

I was advised to undergo BRCA testing, since I was diagnosed with breast cancer at 42 years old. Diagnosis at an early age (pre-menopause) is an indicator that you may carry the BRCA gene.

BRCA testing is often covered by health insurance, especially if you have already had breast cancer. Or, if you prefer, you can pay for it yourself ($3,000) so that your insurance company doesn't know.

NOTE: Myriad Genetics Lab does not report results to your insurance company (it's completely confidential), so the only way this will go on your insurance record is if you have your insurer pay for it.

The BRCA gene has implications for other family members. If it's confirmed you carry the gene mutation, then other females in your family may be at risk. The male can be a carrier (my dad passed the gene to me) and may be at risk for early prostate cancer. However, the higher risk for developing cancer is among females.

Just because your family carries the gene mutation doesn't mean that you will inherit it. My sister-in-law's mother, aunts and grandmother all carried the BRCA gene and it wasn't passed along to her.

Once you are diagnosed with the nightmare of breast cancer and endure all the treatment, you never want to go through that experience again. If you haven't had breast cancer, but are at high risk, you need to think long and hard about keeping yourself at risk.

A scarier diagnosis is ovarian cancer since it's extremely hard to detect in early stages and is very aggressive and invasive. In fact, it's most often found when it's hard to effectively treat.

I can't say this enough: Because I took immediate action -- even when my doctors thought I had more time before committing to surgery -- they found fallopian cancer in its initial stages (pre-cancerous, non-invasive cells). This was a shock to all, including my surgeons. After this discovery, I was told that had I postponed surgery just 6 months later, I would have been in trouble. It was a miracle I had surgery when I did.

Many breast cancer survivors I've talked to who were also diagnosed at an early age have not pursued BRCA testing since they don't know enough about it and don't think it applies to them. However, when I was diagnosed with breast cancer 7 years ago, I was told by medical experts that my cancer was not linked to heredity. Seven years and tons of medical research later, it's a different story. In other words, check it out. Information may have altered since your original diagnosis.

What I didn't realize was how significantly reconstruction surgery has developed over the years. I can honestly say that my body looks better now than before surgery. While it's not a recommended diet plan by any means, if you have to go through all the trauma of surgery, this is to assure you that there's a strong chance you'll come out of it reducing your risk of developing cancer AND with a new body as a consolation prize. This may sound shallow in light of cancer and death, but is a real concern among women (to have their body massacred) and why many don't pursue taking action.

All to say, I recommend anyone who thinks they might carry the BRCA gene to talk with their physician. If you haven't had cancer, talk with your gynecologist. If you have had cancer, discuss with your oncologist. It could save your life.

Determining My Fate

2008-07-31T22:14:00.006-04:00

I met with my oncologist this morning for the first time since all my surgeries were completed and pathology report in. Since they had discovered "fallopian cancer" (although it was precancerous cells, it's still considered cancer), I waited for Dr. Kay to determine whether I had to face another bout of chemo or not. My future was in her hands.

With cancer, your future is always in the oncologist's hands. Period. Not the surgeons. Not the radiologists. Solely, the oncologist. Remember that.

First, I would like to point out that after umpteen times I had to starve myself before tests and surgery, and all the times I went without sustenance following surgery, and all the times I released my food via mouth (if you know what I mean) and all the time I wasn't hungry...I STILL DID NOT LOSE A SINGLE POUND THROUGH THIS ENTIRE ORDEAL!!! You would think that an ovary or two would weigh something...

So, that got me off in a bad mood this morning at the doctor's office. Then, there was over a 2-hour wait...

Finally, when I saw Dr. Kay, I was--as the saying goes--"fit to be tied." However, my frustration over my weight and wait eased substantially when I remembered that this woman, alone, had saved my life. If she had not pushed for BRCA testing, I would have been walking around with fallopian tube cancer developing...and would never have known it. And it would not have had a happy ending. I thanked her for saving my life a 2nd time. She smiled.

She told me that of all her BRCA patients, 100 percent (yes, every single one of us) had cancer developing on the exact spot on our fallopian tubes! I'm sure they will be looking more closely at that phenomenon in the future.

She also said that since I'm still only 7 years out from my breast cancer, I would still need to see her every 6 months for a blood test -- plus, an annual chest x-ray, bone density scan and an MRI for my breasts (since mammogram is no longer necessary) and a blood test for ovarian cancer (for the cells in that area).

I'm still susceptible for cancer developing in my body because of my original cancer -- plus, BRCA carriers are more vulnerable towards other types of cancer besides breast & ovarian, such as pancreatic (oh, goody).

Although this was disheartening news, on the upside, Dr. Kay said my chances of developing breast or ovarian cancer were 5 percent - significantly low.

It's a good news, bad news sort of thing. I've beaten cancer and an early death twice, as I turn 50 this year. At the same time, cancer will always be a phantom hovering over me.

But, I can accept that as my fate. I know I am mortal and I will die of something eventually. And, I'm truly grateful for being able to live this long.

And, for the time being, I don't have to face chemo again. Now, that is reason enough to pop the champagne cork -- except that champagne has calories and now I must concentrate on moving the scales in the opposite direction.

Wine & Whine

2008-07-14T17:53:00.003-04:00

About once a month, I meet with a couple of friends, and we vent and rant about what's on our minds. We're a safe outlet to share our fears and frustrations about all that the issues we're facing in midlife. Since we cluster around food & drink and talk nonstop into the night, we thought it was fitting to call our gathering, "Wine & Whine." While some find value in book clubs, we find meaning in whining.

Naturally, all conversations are strictly private, so I won't share any details. However, the one common denominator is how much we've all endured by the time we've reached the age we are now. Our journey has not always led us down a yellow brick road to the Emerald City where all wishes are granted. We are no longer wide-eyed, innocent Dorothy's, who triumph over the Wicked Witch. Life is a little more complicated than that.

I will tell you that since Gary & I have been married (8 years), we have navigated through financial hits, career crises, elderly parents with debilitating illnesses, extended family concerns...and then there's cancer added to the mix. (Not to mention Atlanta traffic, but that's another rant altogether.)

It's all we've been able to do to keep our heads above water.

So, as much as I celebrate the good news of being "cancer free" now, I'm waiting for the next trauma to deal with...you could say my nerves are shot.

They call this Post Traumatic Stress Disorder (PTSD), which, like Wine & Whine, is a perfect descriptor.

After I came home from my second surgery, a friend gave me "In An Instant" by Lee Woodruff. Lee is the wife of ABC news anchor, Bob Woodruff, who suffered a critical brain injury from an explosive device while reporting the war in Iraq.

Her book totally engaged me, as I read with interest and empathy. Although Bob's head injury was severe, Lee had endured many tragedies in adulthood: She had lost a child, uprooted multiple times during her marriage, discovered one of her daughters was deaf, had a sister with a brain tumor and faced the possibility, herself, of having cancer.

She writes: "The more trauma a person has been through, the more they have seen, the worse the PTSD is. The cumulative effect appears to make the person much more susceptible."

She goes on to share how the horrific experience with her husband's slow recovery affected her: "I had morphed from a confident wife and parent into a woman fearful of everything, especially of my kids getting hurt...I saw potential head injuries everywhere. Even driving my car felt scary now. All I ever seemed to say as a mother was, 'Don't do that, stop it, be careful there.' I had become a coiled spring, waiting for the next injury or accident."

She admits, after the crisis was over and her husband was on the road to recovery: "A tiny part of me keeps waiting for a shoe to drop, for something bad to happen. When Bob doesn't answer me from another room after a few beats, I walk in to check on him. When he doesn't return from the store in a reasonable time, I make a call. These are my battle scars."

Amen, Sister! Can I ever relate! When I finished cancer treatment and began resuming a "normal life" again, I worried constantly about those I loved dying. I worried that Gary would have a car wreck on the way to the office, or his plane would crash on a business trip. (I even left his messages on voice-mail until he arrived safely home, in case that was the last time I heard his voice.)

If I had trouble reaching my parents, I imagined they were lying on the floor suffering a heart attack. Death had become a real possibility, and I realized we were all hanging onto life by a thread -- that any of us could be taken out at any moment. I didn't rest.

Although I've calmed down a little bit, I'm still on edge when it comes to my loved ones' safety. And, from time to time, I picture scenarios of potential future problems, so I can devise a plan of action -- just in case.

The one thing that helps calm me is knowing deep down that I can rise to a challenge and all that it entails. I know this because of my experience with cancer and facing my own mortality. I'm stronger than I ever realized.

Lee Woodruff makes a great point in view of her sufferings: "The moments that define us, that strip us down to raw bone and cartilage and build us back up: they are the tough ones. They are the stories of grief or tragedy, stories tinged with sadness and sorrow...I believe how we attack those curve balls is the stuff of life; they count just as much as the good times...

"And so, we have to choose to laugh and to keep smiling. We have to hope that there is always something better around the corner. We doubt our ability to rise to meet hardship, and we do everything in our power to avoid it. We have to dig down, to believe unfailingly in the ability of the human spirit to triumph in ways we didn't think possible. To make the choice to be resilient, ultimately to bounce back, is to make the choice to be grateful, as grateful as possible for the cards you've been dealt."

I might have to invite Lee Woodruff to join our Wine & Whine group.

Caring for Mom

2008-07-11T09:11:00.001-04:00

Breast cancer, as you can imagine, isn't just a disease of the victim. It affects everyone who is connected to your life, especially your family.

Of course, my husband was greatly impacted, and obsessively worried about losing me.

But the toll on my parents is what broke my heart. What do you do when your child is sick and you can't make her better? Parents think they're supposed to cure all ills and remove all pain, and when they can't, it's torture. This was the case with my parents as I observed their grief and fear over me.

Right after it was discovered that I carried the BRCA gene, Mom & Dad were over at my house for Christmas Eve dinner. Mom was acting strange, so I pulled her aside and asked to speak to her in private.

She broke down hugged me tightly: "This shouldn't be happening to you...I'm the one who should die first, not you!"

Well, first of all, no one was talking about dying...at least, yet. I was researching surgery options at that point, not caskets and funeral arrangements.

But, I understood what she was saying. She was terrified of losing me...and all mothers take a solemn oath before they deliver their first child that they'll do everything in their power to make sure their children outlive them. That's just the way it should be, according to moms everywhere. Unfortunately, that's not always the way it turns out.

I tried to comfort her, but I knew the only thing that would reassure her would be for me to sail through these surgeries and reduce my chances of getting cancer in the future.

I realized more deeply how much my mom was suffering when she shared with me a heartbreaking email she had sent the prayer group at her church. In her anguish, she wrote:

"Julie stopped over tonight to tell us about her latest report. I can't believe she has been inundated with cancer like she has. Fortunately, the surgery was done in the nick of time since they found pre-cancerous, non-invasive cells in the tissue of the fallopian tubes. She says this was "good news" but they need to remove the uterus in 3 months down the road. I only hope this will protect her from any future cancer but who knows if it will or not?

It is very upsetting to me having brought her into this world, but now the damage has been done."

A beautiful response came from the prayer group leader, who knew the vulnerability of being a mom:

"We are keeping Julie our prayers. God, who began a good work in her, will continue it until the day He comes again! Through her healing, we will all be blessed. Hang in there. God is in control."

To my great relief, I wasn't the only one who had spectacular friends. So did Mom. Amazing, dynamic friends--with years and years of care-taking experience as moms and grandmothers.

One of Mom's best friends drove up from a beach vacation in Florida -- over a 7-hour trip--to make sure she was with Mom during my first surgery. She brought with her homemade soup and muffins. (During my second surgery, the same friend was at the hospital again with freshly baked cookies for my husband. She has earned sainthood, as far as my husband is concerned.)

Mom also received a flood of cards, calls, emails and offers to bring me food. In fact, Mom had more correspondence about my cancer than I did...which was fine with me.

When we heard the good news about my pathology report, Mom received over 50 email responses from friends and well-wishers.

People's generosity carried Mom & Dad through this nightmare than no parent should have to face--and for that, I am indebted to all the people who took time to place a call...or write a note...or say an encouraging word...or give my parents a big hug. These simple acts go a long way in getting us through the tough times in life. And when you think about it, they are actually the mightiest acts of all.

A Minor Setback

2008-07-09T18:11:00.001-04:00

It had to happen. I was on the track toward healing when my incision tore. Yikes. Okay, so I admit I might have been overdoing it. After all, they don't want you sitting around all day because of blood clots...so what's a girl supposed to do, I ask?

But there's nothing like a hole in your abdomen to get your attention. You'd think I would have learned after my previous scare when I thought I'd caused a hernia the day after I came home from the hospital. But noooooo. Type A's don't easily grasp the concept of "slowing down to let your body heal"

It typically takes a set-back, like hernias and ripped incisions to make us take a situation seriously.

Although it may not be obvious, the body is wounded internally after such intense surgery and rearranging and requires rest and tender care.

Now if only I could remember that...

A Survivor's Purpose

2008-07-02T11:22:00.002-04:00

I recognized her instantly. The pale, delicate complexion. The carefully wrapped headscarf. The vibrant, magenta hat the completed her outfit. She was easily identifiable. A chemo patient.

I was browsing through the bookstore when I spotted her making a purchase. Something about her demeanor tugged at me to go over and say something encouraging, like, "I've been there. You'll get through it."

But I didn't. What if I offended her by being presumptuous? What if she possessed a reserved, guarded personality that didn't freely bear her soul to others? Who was I, a stranger, to approach her and delve into her personal life? Instead, I stood silently in the background, while eavesdropping at the same time.

"How are you today?" asked the saleswoman, as she rung up the purchase and placed it in a bag.

The lady with the magenta hat shook her head forcefully. "Not well," she replied, suppressing a sob. She quickly paid for her item, grabbed her package and bolted from the store. People near the counter looked at each other silently as the door slammed. Their expressions conveyed heartfelt anguish.

I stood there ashamed. Here was an obvious cancer patient, experiencing a bad day--just like the ones that had engulfed me--and I did nothing to help. I resolved then and there, despite any awkwardness on my part, I would reach out to others like her in the future. As a survivor, it was my duty.

How many times during my own battle with cancer did I feel exasperated and discouraged, scared and angry? Days when I was embarrassed to be seen in public. Days when I was fed up with all the shots and the perpetually foul taste in my mouth. Days when treatment seemed like a never-ending process. Days when I wondered if I was going to live.

Despite their compassionate intentions, friends couldn't fully relate. People were either horrified if I made a joke about my condition, or they put me on a pedestal for enduring it all. But, I wasn't a hero; I was a mere mortal with authentic feelings.

My savior came in the form of a woman I knew who was a lung cancer survivor. Since Dee had previously walked in my steps, she knew the treacherous terrain by heart. On our long walks together, we discussed our fears and frustrations associated with cancer. She validated the imperfect thoughts I shared.

Although an impressive support network exists for cancer patients, it was an up-close, personal connection that helped me through the particularly rough spots.

This is true for all the curve balls life throws us. We need those who have already lived through our painful experience. No one else can fully comprehend the questions, fears and anger like another sufferer...whatever the particular situation. It takes one to know one.

My lowest point emotionally during treatment coincided with a dinner invitation from Dee and her husband. That day, I looked and felt horrible, and wanted to cancel. Nothing my precious husband could say convinced me to change my mind. At the last second, though, I decided to go since I would be spending time, after all, with Dee.

She answered the door looking splendid--chic haircut, stylish outfit, enviable figure--compared to me in all my frumpiness and baldness and bloating. As soon as we sat down in her living room, Dee asked matter-of-factly how I was.

"Fine," I replied, masking my misery.

Gary--who never speaks for me--intervened. He told Dee the truth, that I was having a really tough day. I was so grateful for him speaking the words I couldn't voice.

Without a word, Dee got up and left the room. We sat there in silence. A few moments, she returned with a photo album. She squeezed in between Gary and me on the sofa and flipped the album to the first page.

There she was in living color -- bald, pallid skin, grimacing at the camera. Photo after photo documented her experience with cancer. They say a picture is worth a thousand words. By giving me an intimate glimpse of her struggle, I felt understood and restored.

Now, I realize it's my turn to stand in the gap for others in need.

So when I'm approached to provide information or encouragement for someone who has been diagnosed, I realize that hanging out along the sidelines in silence is no longer an option.

Banner Day

2008-06-30T15:06:00.006-04:00

This is where the Halleluiah chorus from Handel's "Messiah" comes in. Ready?
HALLELUIAH! HALLELUIAH!
HALLELUIAH...HALLELUIAH...
HALL-EEE-LUIAH!

My pathology report came back "clean." No cancer. Zip. Zero. I left the doctor's examining room and walked into the waiting area, where Gary was sitting. I smiled and told him the news. He got up from his chair, hugged me tightly, and broke down crying in front of everyone.

We walked out to the elevator lobby and hugged and cried some more. The news marked the end of a 7-year odyssey of living with cancer, and then living with the threat of another cancer developing. To end this chapter of my life seems surreal. I've gotten used to all the tests and doctor appointments and anxiety that accompanied it, waiting for the next cancer diagnosis. How do you return to "normal" life after all this? I'm not sure you ever do. Especially when your primary care physicians are oncologists. That's when you know you'll always be in a different category. But that's okay.

The first person I called to tell the good news was my mom, however, the phone conversation ended abruptly since I was crying so hard, I couldn't complete a sentence. With all the stress this disease has wrought on my life and Gary's, I think the people it's hit the hardest have been my parents.

I've heard the one death you never overcome is the death of your child. A parent always thinks they will die first, since that's the natural order of things. They also believe, erroneously, that they have the power to protect their child...no matter what age. I've watched the toll all of this has had on my parents, and it's been painful to watch their pain, their helplessness.

I recall last Christmas, when Mom pulled me aside and begged me, "Don't die before I do. I couldn't live if you did." Tears ran down her face. " This should be happening to me, not you. I've lived a full life, but you're too young." What do you do with that? How do you respond? I wanted to take away her agony and guilt and fear, but I was just as helpless as she was with my BRCA diagnosis. The only thing I knew to do was to take action.

And, that's my biggest advice for women who've had breast cancer or suspect they are a candidate for the BRCA gene. Take action.

Taking action has been the critical element in this entire cancer drama:

* It was because I conducted a breast self-exam that I found my lump. Even 2 mammograms two weeks later did not reveal a mass.

* It was because I forced the issue that I got further testing. And further testing revealed aggressive cancer.

* It was because I took action in selecting the very best healthcare professionals I could that I believe I got the best treatment for breast cancer.

* It was because I pursued BRCA testing last fall -- even when I had been told 7 years previously that my cancer wasn't hereditary -- that I discovered I carried the gene mutation.

* It was because I was so determined to deal with this "sooner than later" and get a double mastectomy and full hysterectomy to decrease my chances of future breast and ovarian cancer that they found pre-cancerous cells in my fallopian tubes as early as they did. Six months later, they told me, would have been a different story altogether.

Why do I tell you this? It's not because I'm such a noble person for taking action. Far from it. My natural inclination is toward procrastination. In fact, it's one of my specialities. And, I'm also not saying that taking action always gives you the perfect fairy tale ending. You may lose the battle with cancer because it's a nasty, hateful, deadly opponent that strikes witout warning, despite your best efforts.

But, your best defense is to do something. NOW. Not tomorrow. I've realized that Now can make the difference between life and death. I hope I can take this advice into other areas of my life. Wouldn't it make such a difference if I took action with all the zillions of other things I need and want to do...one day?

While sitting on the examining table, waiting FOREVER for the doctor to come in and tell me my pathology results, I prayed. I don't pray for "miracle cures" as much as I pray for courage to accept what God is leading me into and grace to walk into the future with love and compassion and gratitude instead of bitterness and self-pity and anger.

I then began praying for all the people who have cared so much and done so much for me during this entire ordeal. All the love, hugs, tears, phone calls, cards, emails, gifts, meals, car rides, doctor appointment buddies...it's so much. I've been placed on countless prayer lists in churches and small groups throughout several states.

My friends and my entire family have given enormously and sacrificially, and I feel greatly indebted. I want to be there for others in the same way people have been there for me during my darkest times. This experience has allowed me to see the power of us ministering to each other in the simple, daily routines of life. Maybe this is the most profound thing I've learned from cancer.

Other than it's nice to not be bald.

Campfire of the Vanities

2008-06-29T09:02:00.002-04:00

You would think with a life-threatening diagnosis before me that I would be focused on the higher things in life. But, I must point out as a Southern Belle, shallowness and vanity are part of my birthright.

So while the unknown pathology results loom before me, I realize I can't do anything about staving off cancer and must bravely face the outcome. You learn when you have cancer, you simply must accept what comes your way and rise to the occasion and deal with it. Monday, I will see my surgeon who will deliver the verdict. Yes, I'm nervous to know what my future holds...but meanwhile, I have other things to obsess over.

Such as cellulite. This has been a recent fixation of mine, examining every inch of my body for lumpiness. After breast cancer treatment 7 years ago, my obsession was eyebrows -- or lack thereof. Just so you know, I had beautiful dark eyebrows, which didn't return after chemo.

None of my friends could understand my irritation; however, most of them are blondes. (Which makes me think I should re-examine my choices in friends.) I, on the otherhand, have dark hair and dark eyes, so eyebrows dramatically define your face. Think Brooke Shields.

After much whining and gnashing of teeth, I located an excellent "permanent makeup" (tatoo) artist, who crafted some exquisite brows for me.

With cancer and chemo, it's a full-time job maintaining your appearance. The loss of hair. The scarring from surgery. The lymphedema ballooning your arm at inconvenient periods. What's a girl to do, I ask you?!

Now, I know you're thinking I'm being silly and shallow in light of what's facing me. But, those traits are also what maintain your normalcy throughout a period that is anything but normal. Why can't cancer patients be as trite as everyone else?

Years ago, during my chemo days, a coworker asked how I was doing, and I replied that I was fine except for losing those darn eyebrows.

She looked at me in horror over my admission. She grabbed both my arms: "Be grateful for life!" she lectured.

Now, there's a concept! I wasn't thinking about being grateful. I left this interaction feeling guilty, but irritated that I got slapped down for being honest.

Then, I was walking with my "cancer mentor" and mentioned my anger about my browless condition.

"I know exactly how you feel!" she exclaimed. "I hated that part of chemo, too." Honesty is the best medicine.

So, while people in my situation face the reality of death (instead of some vague concept that may happen in the distant future), it's nice to know I can still take part in the same daily dramas that those without cancer relish in.

After all, Southern Belles are known for our dramatic flair as well.

Of Books and Boobs

2008-06-28T15:57:00.003-04:00

Now that I’m at home and having to be “calm and quiet,” I’m getting back into my reading routine. Plowing through books is what got me through my last recovery, so I decided to do the same this time. In case you’re wondering, I've read:

* Julia Child’s autobiography (interesting, but she tried to make her husband sound more outstanding than he was).
* "Animal, Vegetable, Miracle" by Barbara Kingsolver (which explains the downside of high-fructose corn syrup & soy products and the upside of eating locally grown food).
* "Three Cups of Tea” (about a guy I’d never marry since his idea of saving money was to live in his car).
* “A Thousand Splendid Suns” (the reason I lecture younger women not to take their rights for granted).
* F. Scott Fitzgerald's "This Side of Paradise" (enjoyable now that there's no English teacher quizzing me).
* "Blue Shoe” by Anne Lamotte (a realistic portrait of living out your faith).

But, there are two I'd like to provide a book review, since they struck me more emotionally.

The first is the national best-seller, “Eat, Pray, Love.”

It’s about a young, rich, successful blonde from New York City who leaves her husband and decides to find herself and God. So, with a hefty book advance, she decides to find herself and God in Italy, India and Bali. If she had only stopped with Italy, where she writes about food.

Her book goes rapidly downhill when she trots over to India to search for God while having servants from the lower castes take care of her every need. You can’t help but note that everyone else at the Ashram is a wealthy Westerner with loads of freedom and time on their hands. It's interesting that the author didn’t look for God in the slums of Calcutta...

Once she finds God and the meaning of life, her last leg of her personal journey takes her to Bali, to “find balance”. (Well, that’s a shocker.) She recovers balance by having yet more low-wage servants in an economically deprived country take care of her garden and cook for her while she reads and eats and hangs out all day….kind of like I’m doing now without the book advance.

And, then, she engages in a frenetic, nonstop sexual union with an adoring Brazilian who tells her how beautiful she is and how perfect her body is. (Yet another similarity to my life...)

So, when my friend, Laura, handed me “The Hidden Life” about a well-to-do homemaker named Betty Skinner, who suffered a nervous breakdown and spent time reading and praying and meditating to regain her life…well, I was a little suspicious and very cynical.

“Here we go again,” I thought to myself in my hospital room. “A Christian version of ‘Eat, Pray, Love’.” But since Laura went out of her way to get me this book, and since she has more depth than practically anyone I know, I decided to read it. Plus, when someone gives you a book, they’re going to ask you if you’ve read it and you can't lie.

I know this because not too long ago, my friend, Anne, went to a fundraiser featuring a celebrity author and shoved everyone standing in line out of the way so she could secure the last autograph copy of the book for me.

However, I let my mom read it first, and then forgot about it until Anne asked what I thought about the book, and I could tell she was seriously disappointed that I had not read it.

So, here I was again, faced with another book a friend gave me, and I couldn't let another friend down.

It started out like a nice, Christian-y kind of book, which I loathe, even though I’m a Christian. (But just because you’re a Christian doesn’t mean you have to be subjected to cutesy, Christian-y writing for the rest of your life…there are other ways believers can sacrifice.) Anyway, it started getting on my nerves, but I kept plugging at it…mainly to not disappoint Laura, but also because I was stuck alone in the hospital room with nothing else to read and I was bored.

And then, after a few chapters, I was captivated. What made this book so completely different than what I expected is that it perfectly explained how our journey with God—including all the pain and suffering—is what ultimately leads us to our authentic self, and a life of purpose and meaning.

For example --

“A tremendous paradox will be revealed to us…by embracing suffering and allowing it to do its work of breaking through the protective walls we have constructed around our hearts, we become more vulnerable and honest. This moves us to a deeper understanding of our shared brokenness, opening us to compassion and changing our focus from ourselves to the needs and hurts of others...”

“The more we submit to and participate in the mystery of this purifying work, we experience the sense that everything –even our darkest pain – is held in Divine love…”

“Our unique expression is crucial to God’s design for the healing of the world...”

Written by a clinical psychologist who was mentored by Betty Skinner, the book gives a spiritual perspective from both the author and Skinner’s personal journal about the process of transformation. A wonderful example the book cites is a flying trapeze.

To choose life, we have to let go of old ways. We must be willing to let go of the bar we’re clinging to—what’s safe and known, but not necessarily what’s best for our lives—in order to grab onto the next bar. But between the bars, there’s “a never-never land of empty air” where you’re vulnerable and not in control –and don’t even understand—and this is where most of us lose courage. “So we live out our lives clinging to the same old bar.”

All to say, it was a powerful and moving book which has made me think a lot about my current fears about cancer and my future and everything else in the world I obsess about. And all fear does is drain me of my vitality and the ability to love others fully because I’m so caught up in myself.

I plan to use this time of physical recovery to reflect & journal and apply some of these book’s concepts to my life.

Maybe after I finish this reflective time, I will be a kinder and gentler person…and I won’t write nasty things about books like “Eat, Pray, Love.” Then, again, I’m seeking transformation…not perfection.

MY Vagina Monologue...Or, Menopause Ain't No Musical

2008-06-27T15:41:00.000-04:00

After coming home from the hospital, I have been shocked at the difference in how I feel this time around versus my first surgery. Yes, I know the previous surgery was massive, but all my doctors forewarned me that I was still undertaking quite a bit this time as well. Therefore, it was important to rest and give my body time to heal. With this said, they added that I wasn’t supposed to stay in bed, but rather, move around constantly to avoid blood clots.

Now, I ask you: What do you do all day if you’re not allowed to lift, pull, push or do anything, but you have to keep active? Do, but don’t Overdo.

During my last recovery period, my energy level was zero since every ounce of energy was directed toward my healing. I was expecting the same this time.

Instead, I turned intoLady Macbeth--pacing the house during the night, unable to sleep. I’m completely hyper. To offset this excessive energy, I walked over 3 miles my first day home. This didn’t relax me, so the next day, I walked almost 4 miles and then did some things around the house. This didn’t lessen my energy level, so I asked Gary to take me to a consignment store to buy a desk. This is shocking since I hate shopping, but when you’re high-strung, you’re also obsessive. As my mind raced during the middle of the night, I thought how nice it would be to have a writing desk… and I couldn’t rest until I got one. Even then, I didn’t relax.

Finally, the next morning, after pulling down a storm shutter, running up a flight of steps (a big no no) and pushing a large chair out of the way, I experienced a pain in my abdomen around my incision. Horror! What if I gave myself a hernia? Hernia =another operation=panic.

Fortunately, I was scheduled for a follow-up visit with one of my surgeons that afternoon. Fear made me sit tight until then. Once I showed my doctor the area in question, he assured me that I didn’t have a hernia. Now that I wasn’t terrified, I accused him of sneaking steroids in my IV during my hospital stay.

“You told me that I was going to be exhausted after all this!” I cried.

“You were supposed to be,” he replied.

“Well, I’m not!” I cried. “Furthermore, you tell me to not overdo it, but you don’t realize that for a Type A person, you have to be very specific-- since my definition of overdoing it is radically different than other people’s definition!”

He smirked. “I know nothing about Type A people,” he said. This from a man who performs 7 reconstructive surgeries a day, helicopters to work and races horses on the weekend to relax.
He sent me home without outlining any specific boundaries but reminded me to take it easy. The hernia scare was enough to alter my behavior.

So, now I’m home trying to be calm and quiet, reading and identifying the birds in my back yard which flock to my bird feeder. I’m still walking several miles each morning—which I’m allowed to do, and it helps.

Apparently, my surge of energy is hormonal…since they have now, in effect, removed any organ related to estrogen. In other words, I’m stuck with this overabundance of energy and verve.
This is not the only side-effect of my immediate menopause. And despite what they say, it ain’t no musical.

First, let me say that I’ve had the fortunate opportunity, unlike most women, to go through menopause twice. Yes, you heard me correctly…twice. Two times. Dos. Deux. You get the point.
Chemotherapy puts you into menopause since it shuts down your ovaries, so when I went through breast cancer treatment 7 years ago, I underwent menopause as well. Of course, when you have chemo coursing through your veins, you hardly notice menopausal symptoms since you feel miserable and yucky anyway. I was told that since I was 42 at the time, I would probably stay in menopause after treatment. But nooooo. So, here I am, having to go through this physical adjustment…again.

However, except for a few minor inconveniences, it’s not as awful as I feared. I remember my mom and her friends talking about menopause driving them crazy—enough to want to stand up and scream during the church service (and not being Pentecostal.)

I don’t feel crazy...and I assure you that Gary would tell me in a heartbeat if I were.

I do experience hot flashes, but they are simply waves of heat that rush over me throughout the day & night, but it’s not like I’m turning red and dripping sweat like I’ve seen some women do.

The only other symptom related to this new stage of womanhood is that I’m emotional.
Now, this may seem like nothing to you, but you have to understand that for a daughter of a Marine (a trained killer, as he likes to explain), I’ve rarely cried. In fact, I’m so much like my dad that Gary says being married to me is like being married to my father “in drag.”

But with my current hormone imbalance, I’m reduced to tears over reading about Dante. The other day, I heard a Barry Manilow song from the 70s and boo-hooed. Pathetic.

Gary is shocked over my behavior. After 8 years of marriage, he’s seen me cry maybe once. Now, it’s a daily ritual. And, I don’t just shed tears…I bawl and howl. I’m like Holly Hunter during the opening scene in “Broadcast News” in which she sits in a motel room and forces herself to cry to overcome stress. Gary is not quite certain what to do with it all.

I must confess that before this last surgery, I made a visit to a Chinese herbal medicine man who mixed up a potion to soften my hot flashes (among my other imbalances). However, I’m not allowed to take herbal supplements, yet…I must wait a few weeks out from surgery, according to my “regular” doctors. Therefore, I’ll hold off for now. But in a few weeks, I will uncork my Chinese herbal potion and voila! We’ll see what the results will be.

Otherwise, Gary is in for a long summer. A really, really long summer.

Getting My Money's Worth

2008-06-25T15:33:00.001-04:00

It’s been a week since surgery and my body is healing day by day. That’s the miracle of life: the body’s amazing ability to heal over time. What’s not a miracle are the 2 drains dangling from my sides. When I saw my reconstruction surgeon during my follow-up appointment, I pointed my finger at him and declared, “Liar, liar, liar! You knew perfectly well that I’d be carrying these drains home with me from the hospital! You just didn’t want to admit it so you wouldn’t have to hear me whine!” He laughed.

I'm glad he sees the humor in this. From my point of view, drains are a drag…literally.

Meanwhile, my body is taking shape and my boobs are bigger than I expected…or necessarily wanted. I’ve always been a small boob kind of girl. Gary, on the other hand, is thrilled. “Well, finally, I get something out of all of this!” Men…

My new boobs are going to take some getting used to, I can tell you that. The more important issue, however, is that my butt is still too big. You see, a natural outcome of opting for this massive reconstruction surgery is that they end up lipo-ing your hips in the process. This is in order to even out your midsection after they remove tissue and replant it in your boobs. Frankly, if I had known I was going to get a butt-job out of this, I would have rushed to have had a double-mastectomy 20 years ago, whether I needed it or not.

Even so, I didn’t get my money’s worth when it came to butt removal. My surgeon was way too conservative on that end (no pun intended) and concentrated more on my boobs—despite my constant pestering otherwise. You know the adage: “You can never be too rich or too thin?” Well, for me, it’s “You can never have a small enough butt.”

Right before surgery, when I’m in the pre-op area, my surgeon entered with his magic marker and began drawing circles all over my abdomen of where he was going to slice and dice and cut and chop. (This included a staple that I pointed out he had left inside me during my last surgery. “Oh, yeah, we’ll get that,” he replied casually.) Anyway, when he began drawing eensy-teensy circles around my hip area, I stopped him dead in his tracks. “No, no, no! This will not do!” I told him. I pointed to my buxom derriere and said, “It needs to be sucked out of here!”

He didn’t budge. “You don’t want to do that,” he said. Of course, I do, silly man. “No, you don’t.” He was adamant. “It will make you sag if I pull fat from there.” Soooooooo, what’s the problem with that? Let’s see…sagging butt versus big butt. There’s no question about what a butt-obsessed person would choose.

I reached for the magic marker to jerk it out of his hands and we got into a wrestling match, practically fighting each other to the floor. He won, of course. They always do when they knock you out with anesthesia.

So, now I have bigger boobs and an ever-so-slightly smaller butt. This is what I’m stuck with forever since I hope to never darken the door of an operating room ever again. Therefore, I must take comfort in what my dad has always said: “There’s nothing worse than a woman without an ass.”

The Great Escape

2008-06-20T15:36:00.000-04:00

It’s my third day after surgery and I’m ready to break out of this joint. Hospitals are like prisons, when you think about it. You have no control over your life and have to follow everyone’s orders. You’re fed institutional meals. You wear unfashionable garb that looks like all the other inmates. Consequently, I’ve even been on my best behavior, hoping for an early release. But no such luck. Alas, it’s time to make a bribe.

As indelicate as this subject may be, I must point out that you aren’t released until you pass gas. Yes, you heard right. It’s not the sort of thing Southern girls like me have been encouraged to do. So, now when you have all these nurses telling you that you’re staying in the slammer until the gas is passed, you get another perspective on this matter. They want to make sure that after the anesthesia from surgery closed down your intestinal system that it’s back in working order.

Even then, passing gas is not enough. Oh, no. Then, you have to graduate from clear liquids to a soft food diet to see how you’ll react before they release you. So, now I’m waiting for lunch, which will be something along the lines of pudding and mashed potatoes, when actually, I want to eat a horse. The greatest challenge once I get home will be to not stuff my mouth with everything in sight since I haven’t had solid food for almost a week.

I have to admit that this go-around, though, I have much more energy and less pain than my first surgery. I’m restless and have been strolling the hallways, pulling along my IV stand – kind of like a toddler pulling his wagon behind him. Back and forth I go along the same corridor, trying to avoid running into all the medical personnel with their machines. Walking makes you feel significantly better. I learned this the last time. Moving around and exercising produces endorphins, which is far more effective in pain relief than any medication.

A draining experience
I’m also waiting for my doctor to give the go-ahead for my drains to be pulled since these are two souvenirs I’d rather not take home from my luxurious hospital stay. Which reminds me that I never fully revealed the details of drains from my last surgery. This surgery, I have 2, whereas last surgery, I had 6. They hang from you like teats on a mother cow, filling up constantly with fluid that needs to be released from your body. Once the fluid fills the drain, the weight pulls on the tubing that is wound up inside your abdomen and extends out through a hole in your skin. Lovely, isn’t it? You need to empty your drains every few hours and measure the amount and not lie about it. You’re tempted to cheat because the less fluid you record, the quicker the doctor will remove the drains.

After my first surgery, I had 6 drains in my abdomen for 2 weeks. Unfortunately, the trendy fashion designers have not taken into consideration drains when they are creating their spring line. Alas, I have good ol’, reliable Target for my recovery wear—which includes stretchy yoga pants and knit tops. Drains are not appetizing, so you want to keep them hidden from small children and those with delicate stomachs. And, if you have a sensitive stomach, you’re out of luck, baby.

After a week of drains extending from you like snakes coming out of some mythical creature, they start irritating you. They itch and are cumbersome, and you want them out. Each time I got a drained removed, it was an enormous relief--despite the process of pulling them…which I will explain.

They do not administer any pain reliever when pulling your drain. You simply lean back on the examining table, take in a really deep breath and blow out hard, like you’re delivering a baby. As you do this, the nurse jerks out the long plastic tubing that has been wrapped up snuggly inside of you. I was shocked at how long some of these cords extended. No wonder I was so uncomfortable carrying around all that plastic inside of me. Removing the drains finally enabled me to stand up straight and move with more flexibility. You get a new lease on life! There is a tomorrow! Okay, you get the point. So, that’s why I’m impatiently waiting for the doctor to order my 2 drains out before I leave the hospital…otherwise, I’ll have them over the weekend. Joy.

Another thing I notice is that after all this surgery, my boobs look smaller than ever and my butt looks bigger than ever, so I’m wondering if they confused my surgery with someone else and gave them my boobs. That would be my luck.

B-Day (Boob Day)

2008-06-17T06:00:00.002-04:00

In 30 minutes, I leave for the hospital for my 2nd operation -- a hysterectomy and final reconstruction. Most importantly, but what I've not focused on these past 2 weeks when I learned I had to undergo surgery again so soon, is the chance they may find cancer in my abdomen. From my experience with living with cancer, I don't dwell on "what if." Doing so drives you crazy with worry and destroys the joy of the day. "What if" may never happen. And if it does, then you deal with it when you know for sure. It's interesting that I've applied this theory to other aspects of my life. Although I'm not worry free about jobs and finances and my future, I don't dwell on worse-case-scenario, but know that I will somehow muster the strength to face life's challenges.This surgery has me more unnerved than the last...because I know what to expect. My memory is too strong. I explained to a friend who had recently given birth, "It's like having a baby and then delivering again 3 months later." You need to give your body a chance to heal physically, but more important, emotionally. I remember too well my last hospital stay and recovery time. Now that I'm feeling healthy and strong, it's hard to subject myself to being cut up and starting the healing process over. It reminds me of when I was going through chemo. I had had several chemo treatments before my lumpectomy -- so they could see if the chemo drugs were working on my tumor. Surgery provided a wonderful break for a month. And then, I had to start back on chemo...and that killed me. I had gotten used to feeling great, only to have to gear up again for a few more bouts of the nasty stuff.My thoughts about my faith have also fluxated during this time, going from holding God at a distance, to being moved by something said or something read. My friend, Sue, wrote a devotional book for women in mid-life, and I've found this extremely comforting. One night (as with most nights), I was unable to sleep, tossing and turning and fixating on my surgery. I tried praying and my mind raced. I tried reading the Bible and couldn't concentrate. So I picked up Sue's book.She began with the story of her living her dream life in a small town in Pennsylvania with her growing family, when her husband got a job offer in Atlanta...where she didn't want to go. After a while of struggle, she realized that "God had a different plan for my life than the one I would have chosen."She sums up her decision to move from her comfort zone with this: "We dream big when we are little. Unsettling as it may be, God dreams bigger."Her words and insights have comforted me and moved me. I've been carried by her and two other women, who I met years ago when we formed a writers' critique group to share our personal work. Life's craziness dissolved our regular writers' meeting, but grew us into an amazing, deep group of friends. In fact, Sue, Casey & Laura are meeting Gary & me at the hospital this morning to hold me hand and pray for me, and to be on-hand for Gary.So, now I end my blog for a few days as I head off. The next entry will be after surgery, after the first few days in the hospital, after the heavy drugs wear off. And then, I can move on with my life.

God is in the Details

2008-06-11T18:43:00.002-04:00

I've heard that God is in the details. Well, I confess that these days, I not only don't see Him in the details, but also in the enormity of life's challenges. Big or small, I don't see Him at all.

I was simply having "one of those days" today. You know what I mean...you've experienced them, too. Everything went wrong. Everyone got on my last nerve. I questioned God's judgment in creating humanity. Yes, one of those days.

It started with my husband backing out of accompanying me to the gym. Now, I know this may sound silly, but I'm constantly harping on him to exercise for health reasons rather than listen to him whine about his middle-age body. Plus, I wanted the companionship. But, he blew me off and I felt insignificant...that he didn't want to spend time with me. Have I become an "old shoe" after 8 years of marriage?

I headed to the post office, where I was the only customer...let me say this again, the only customer. Yet, I had to wait because the postal employee decided it was more important to bring out passport applications than wait on me...like, I'm assuming, he's expecting a rush on overseas travel in the midst of the shrinking dollar and the astronomical cost of fuel. Another employee finally waited on me, while Mr. Passport practically jumped over the counter to help his friend who had just walked in the door. Call me chopped liver.

After my postal experience, I went for a swim in which I struggled to breath the entire time and my legs cramped in the pool. It was a less than enjoyable workout. After that, I went to our new vet's office to pick up Riley's records and rabies tags they forgot to give us. I'll save you the boring specifics and just say that every interaction we have had with this vet has been a nightmare..they don't even use a computer. I waited 20 minutes for our file...until it was dicovered that the teenage tatooed receptionist with 9 inch fingernails didn't bother to write our name on our file, so she couldn't find it. I took my dog's records and told them we wouldn't be back. Ever.

My nerves were on edge by the time I got home and tried in vain to reach someone at the business office at the hospital to pay out-of-pocket expenses for my surgery. I had previously left 3 messages and this time, I kept being cut off by their computerized answering service. I finally gave up, realizing that if they wanted to be paid badly enough, they'd contact me.

Next, I had my over-the-phone surgery assessment, in which I disclosed that I suspected I have sleep apnea (since I quit breathing during the night and wake up gasping for breath). My admission about this stalled my pre-op tests until Monday, the day before surgery -- which messed up my plans for today.

Then, I was off to my two surgeons' offices for pre-surgery consultations -- this is where you sign your life away after they tell you that having surgery puts you at risk for paralysis and brain damage and death. After the day I was having, that didn't sound so bad.

During my doctor visits, I found out that I'm also getting my apendix removed (surprise!) and I will, in fact, have drains again in my breasts. Oh, happy day.

I love my doctors and their assistants, and trust my life (and brain and non-paralyzed body parts) to them. However, no matter what questions I pose, I can never quite pin them down in giving me the full scoop as to what to fully expect. Surgery, frankly, is a matter of trust. I don't even know my boob size. "You'll love it," said my reconstruction surgeon. What does that mean? Will I look like Marilyn Monroe or Twiggy?! I have no idea.

On my way home, I stopped by my favorite neighborhood farmer's market, only to discover from other customers that a home invasion had just occurred in the area. The cul-de-sac was roped off with police tape; police cars and a fire truck were parked along the street; and detectives with guard dogs were combing the area. Just what I needed....a suspect on the loose in our neighborhood to top the day.

At this point, I was ready for a glass of wine or a double-dose of prosac...or both. I was also thinking of filling my pain medicine perscriptions early and taking heavy doses of percoset.

And then, while I was wrapping up my purchases, a teenage girl with her dad passed by me and walked out the door. Suddenly, the girl came back inside and said to me, "This may sound really weird, but I have to tell you that you're beautiful." I was stunned. Here I was -- no makeup, "goggle eyes" from swimming earlier, with my naturally kinky-curly hair pulled back since I didn't bother to style it. I was feeling old and worn out and well, less than attractive in a chopped up body. And, then, a young girl tells me that I am beautiful.

It's not that I need to hear those words for my ego. It's the fact of her kindness...her reaching out and saying something nice to a stranger. If only she knew all I was facing and how her words softened my day. And I realized that none of us fully know what another person is going through...and how much our words may provide comfort and encouragement and relief that is desperately needed.

I arrived at home, only to find my husband in a t-shirt and gym shorts with a flushed face. He had returned from a walk...exercising in the heat...because he knew how much it meant to me. And just for a moment, I saw God in the details.

Bypassing the Mid-Life Crisis

2008-06-01T11:05:00.000-04:00

Cancer survivors have a different way of viewing things. I see it in daily interactions at work, with friends...even with strangers who cross my path.

This realization came back to me recently with my husband. Gary had an incredible assignment overseas, which crumbled at the last minute due to circumstances beyond his control. Devastated about the sudden turn of events, it was the last straw for Gary. The international assignment had potential to catapult him from the frustrating reality of his daily life to an over-the-top experience.

You could say that Gary is in the midst of a mid-life crisis, which I see many of my friends -- both male and female -- battling these days. But, I have to admit: I simply can't relate. Since I've had cancer and have lived with the threat of an early death hanging over my head for 7 years, I've skipped over the mid-life crisis phase and moved directly to "glad to be alive" on the Monopoly board. Gary, on the other hand, has gone directly to jail...do not pass Go; do not collect $200.

While Gary is mourning the loss of an adventure and struggles to find joy in the everyday, I'm drinking in every second of life. In fact, I can't seem to get enough.

Last weekend, we went to the Georgia coast to visit my older brother's family and my aunt & uncle before my next surgery. The first night, we took a walk through a stretch of marsh on Jekyll Island to reach a stretch of beach that was deserted except for pelicans and seagulls socializing along the water's edge. I wanted to linger for a while, soaking in the sea smells and sounds. Gary seemed impatient and antsy...ready to head back and start making dinner.

The next morning, we rode bikes along a path, which transported us into scrubby wilderness depicting the land of Marjorie Kinnon Rawlings--of palm trees and palmettos and pines lining a road strewn with decaying leaves and pinestraw. Live oaks dripping with Spanish moss hovered over us, while hawks circled the sky and alligators studied us with their beady eyes projecting from a pond.

I was euphoric. Gary was sweating. He shared my enthusiasm for our bike ride for about 5 minutes before he was ready to go back to air-conditioning.

That's when I realized we're in different places in our lives at this point. It's not that my attitude is better. He is rightly grieving all the change--and loss--in his life, while I'm celebrating every moment gained--because I'm unsure of what's ahead for me.

And, I realize, that during this time of our unique & distinct fears and frustrations over what we face separately, we need to extend extra compassion toward one another...trying to understand life through each others' eyes...their worries and concerns -- not dismissing them as silly or shallow.

However, for my part, I'm glad to have skipped over the mid-life crisis phase...it's the least compensation I should get for being catapulted into menopause.

Food for Thought

2008-05-10T16:29:00.000-04:00

There's a bottle of cod liver oil on the top shelf of my refrigerator, and I take a swig -- straight from the bottle -- each morning. Gary finds this ghastly and refuses to kiss me. But I believe in the healing power of God & cod, so it's my daily drink.

I have always possessed somewhat suspect eating habits, which Gary has gotten used to over the years. But, from time to time, I can still push him over the edge of his tolerance level.

A few months ago, we were in North Georgia and stopped at an art gallery. While Gary was buying me a hand-crafted necklace at the check-out counter, I noticed a bag of "gourmet organic spiced dog biscuits" for sale. The owner of the shop explained that a local woman starting selling them once she discovered her dogs were crazy about them.

So, for $6.50 -- a king's ransom -- I bought a package for our Irish terrier, Riley, who was waiting in the car. Once we got back to the car, I broke off a piece, but my picky pup stuck his nose up in the air.

Along the ride home, I discovered the ingredients included all sorts of organic flours and spices. I never could tell which ingredient qualified them for being just for dogs, so I decided to try one.

They were, in fact, excellent, and I finished off the entire package. Gary was so appalled, he almost drove off the road.

I share this story for two reasons. One is to defend myself in the face of my "natural" food friends who think I gave myself cancer...I would challenge them to line up my diet against theirs any day. The other reason for this story is to emphasize the importance of accepting the food that others bring you while you're recovering. My husband was especially appreciative since my friends have saved him from all sorts of witches brews I would have concocted.

As a final note, I want to add that since the dog biscut episode, I have not been sniffing anyone's butt, and Gary tells me that my breath is much fresher.

Why I Am Grateful

2008-05-08T16:23:00.000-04:00

I know that many who heard I was having to undergo a double mastectomy and hysterectomy (actually, it was only an oophorectomy -- ovaries only -- as if that really makes any difference when you're having stuff pulled out of you) were a bit freaked out. Women, especially, have cringed in horror and thought, "Thank goodness that's not me!" I know this because that's what I thought whenever I encountered a woman who had breast cancer and had to undergo a mastectomy.

When I was diagnosed 7 years ago, I "escaped" having my breasts removed, and only had chemo and a lumpectomy. Whew! I was so relieved. And when I read an article last summer about a young woman with the BRCA gene who chose preemptive surgery, I was thankful that I didn't have to make that choice...until my oncologist asked that I be tested. Damn her.

So, here I am with my body cut up and rearranged and not quite ready for bikini season, but I can honestly tell you that it's okay. And, here's why:

First, I'm alive. When you're sitting in umpteen doctors' offices and mammography centers and chemo rooms, you come across others with breast cancer who have received a death sentence. And you wonder, why them? Why not me? How did I get lucky to live and they didn't? And they have small children they're leaving behind and they're only 35 years old, and that's too young to die. So, you're so grateful to get to live -- even if it's for just a little bit longer -- that you simply don't care what they cut out of you.

Second, with breast cancer, your connected to a community of some of the most amazing, inspiring women you'll ever know. Among this network, you find women who treat having a mastectomy like getting a manicure -- they're just that strong. So, you end up wanting to be as strong and cool as they are. And, if you're not as strong--that's okay, too. They help hold you up. You're never left alone with this disease; there's plenty of support out there.

And then, there's Roberta. She is the caretaker of Gary's mom. Roberta left Liberia years ago because of the devastating civil war. I asked her if she missed home and, of course, she said yes. She began sharing wonderful stories about life among her family and her village. But, soldiers came in and killed many family members and friends.

"I used to cry and cry all the time," she told me. "And then one day, I said to myself, "Roberta, you must be strong.' So, I quit crying and moved on."

If that wasn't enough to humble me, there was one other incident that put what I've been going through into perspective.

When I was nearing the end of chemotherapy 7 years ago, I was sitting in my oncologist's office complaining. Actually, I was trying to convince her to cut off treatment early because I was sick of it all--the baldness, the constant metallic taste in my mouth, a body bloated from steroids and a 20 pound weight gain. My good attitude up to that point was crumbling and I was frustrated and irritated. But she refused.

This occurred on September 10th, 2001. The next day, I watched TV footage of bodies falling from the top of the Twin Towers onto the street below, and I realized that I would gladly chose baldness, steroids, weight gain surgery, radiation and anything else associated with cancer treatment over having to make a choice as to whether to jump out of a 100+ story building or die in a fire.

It hit me that my life was a piece of cake...the life of a princess...compared to the hardships and heartbreak of so many others. And if they can endure, then by, God, so can I. And that's why I am grateful.

Another Point of View

2008-05-06T09:12:00.002-04:00

Jules-

Do you feel like your body is letting you down? Think of it as how strong you are to be able to fight off cancer as well as you have. And, you have to recognize cancer as an indiscriminate predator, and some victims are in better shape to fight it off.

You are one of those people who has taken great care of yourself with regular exercise and a very healthy diet, so you have done everything to arm yourself for any battle you must enter.

And God forbid, if it does come to it....you know i am your girl for chemo sessions! i admire you so much and love you even more. tammy

The Blame Game

2008-05-05T13:39:00.001-04:00

Now that I'm facing the possibility that cancer is swimming around in my abdomen, I can't help but feel like I'm to blame somehow for igniting my BRCA gene. Was it because I didn't have kids? Lived in smoggy Atlanta? Drank diet Coke? All of the above?!

We love to blame ourselves. One of my doctors gave me some brilliant advice when I was first diagnosed with breast cancer: He said women often try to figure out what they "did wrong" to cause cancer...that if they could pinpoint a certain negative behavior, then they could have control over their body--and ultimately, their destiny.

But this is wishful thinking. Although there are lifestyle behaviors that enhance (or attack) our health, it's more complex as to why cancer forms. (See http://www.cancerquest.org/, an award-winning site developed by an Emory University professor who teaches the biology of cancer. His wife also is a breast cancer survivor.)

In fact, most of the people I know who have had some form of cancer have had the following in common: avid exercisers, healthy diets (vegetarian, wholegrain eaters, vitamin takers), water drinkers, non-smokers, juicers...and followers of all the Girl & Boy Scout rules.

When I was diagnosed with breast cancer, my friends freaked out, saying that if I, Miss Health Nut, developed cancer, there was no hope for them. They were, in turn, junk food eaters, lax exercisers, recovering smokers and didn't follow all the Scouts rules. Yet, their checkups so far have turned up cancer-free, thankfully.

All to say is that you only have so much control over your body. Still, since I've had cancer, many well-meaning individuals (some friends, some strangers) have offered their advice as to "why I caused my cancer." This, I would like to point out, is not helpful. When you receive a terrifying diagnosis, the last thing you need is a prude shaking her finger at you, telling you that if only you had eaten wheat grass, you could have avoided cancer.

You also get a lot of advice about treatment -- if you take supplements, eat a raw food diet, practice yoga and meditate, then you will be cured! I've heard of women who refused chemotherapy in preferrance to an "all natural" treatment. I want to tell them that death is all natural. But I hold my tongue, knowing that everyone has the right to decide how they want to approach cancer.

Having said this, I recently received an email from a friend who believes I gave myself cancer and dispensed advice as to why I'm finding myself (possibly) in the same boat after 7 years of being cancer-free.

Frustrated and somewhat paranoid, I forwarded her email to a two-time breast cancer survivor who is also a healthcare writer for her thoughts on the matter. Is the fact that I might have cancer again the result of my bad behavior? Was it because I drank that second glass of wine on October 28th four years ago?!! I had to know.

Here's how my wise friends responded:

Hi Julie,
Count me as one of your friends who eats red meat, drinks wine, and has not given up sugar. I do try and make better choices and eat more fruits and vegetables. I eat an apple almost every day.

I believe what I read about nutrition having an important part in keeping us healthy. I try to eat more antioxidants, tomatoes, blueberries, brocolli, etc. I don't think it hurts, but I don't think it's the perfect answer, just like chemo or radiation aren't the perfect answer.

The body is an amazing thing, and I believe works to cure itself if you give it a chance. Sometimes it needs a boost from medicine, so I'm glad for all the advances they have made. I also think that stress and emotions have an awful lot to do with cancer and other illnesses.

Several years before I got cancer the first time were very stressful with sickness of family and other events, and I was feeling scared and hopeless, so for me, the best thing I can do is to find healthy ways to relieve stress, like journaling, praying, walking, talking with friends and asking God to handle things I don't know how to. What seems to help me more than what I eat or don't eat, is the food I put into my mind. It's a daily journey, but I do feel like I'm healthier now than I was ten years ago -- maybe not in body so much, as in mind.

And then, there's my friend, who is a lung cancer survivor, who handled her diagnosis this way: She stopped being a vegetarian and started eating meat.

My kind of girl.

Spiritual Insight

2008-05-04T09:24:00.000-04:00

There have been countless ways my friends have cared for me throughout this ordeal. Some have made incredible meals. Some have sent beautiful flowers or plush pajamas. Some have sat with me during boring doctors' appointments or been with my parents during my surgery. And then, there are my praying friends.

I am blessed with several friends who have a strong faith in God and live out their life with depth and meaning. They also pray, so I feel wrapped in safety and love.

When I found I carried the BRCA gene and was going to have to face all these surgeries and body alterations, Mike, a minister friend of mine, told me, "I'm going to bow before the altar of God every day and pray for you." You just can't top a gift like that when you're feeling scared and alone and vulnerable.

And, then when the pre-cancerous cells were found, which meant I would undergo more exploratory surgery for cancer, I received a flood of email encouragement.

My friend, Laura, wrote: "I believe with all my heart that God will provide, but how is the question. Waiting, and remaining calm, is never easy--at least not for me, and I don't think God expects it. He asks us to trust, to have faith, but He knows us well enough to know how hard that is. You are in the dark about the future. You are not alone and God has placed friends close by to remind you."

Sue said: "My first thoughts are that God loves you so deeply. I know you will inspire others to live life as fully as possible, to love and help one another, and to trust Him in all things."

Casey added: "God is on top of this surgery, in it and all around it...and He is passionately devoted to your well-being.

I loved Cheryl's quote, which she had found when she went through life-threatening surgery this past year: "I, who have created time -- and you -- can take it away...can return it to you again. It's not up to you. Therefore, believe you have all the time you will need. You do."

Karen said: "I want you to know, I'm praying ALL DAY tomorrow during your surgery and I'll pray even more specifically for you to be cancer-free! Now, I'll admit that God and I didn't quite see eye-to-eye when you first got cancer several years ago; still, I have utter peace that you don't have cancer again."

Finally, I have a friend who summed up her feelings this way: "Well, all I can say is DRAT. That's how I feel about you going through chemo again. I actually just wrote a four-letter word, but I remembered I'm in an edit bay for a religious client, and they have a filter on their email and I'm quite sure I would be reprimanded for using such language. So just imagine all the fabulous cuss words I'm using in my head."

We all need friends who pray...and cuss.

Round 2

2008-05-03T21:42:00.001-04:00

Well, I'm back for Round 2 and preparing myself for another pummeling. After checking in with my 3 Musketeers-- my regular oncologist, surgical oncologist and reconstruction surgeon -- it has been determined that I will undergo my next surgery in a matter of a few weeks.

The interesting thing is that my oncologist and my surgeon had differing points of view about next steps. My surgeon felt strongly that I had nothing to worry about and pondered whether to put me through another surgery. He said if I were 80, he wouldn't consider it at all. However, he didn't necessarily want to take the chance that something could surface down the road. Ultimately, though, he left the decision up to MOI as to whether to have another surgery...and if so, when.

My oncologist had a totally different take on the matter. I knew she would. The obsessive-compulsive, hyper-diligent, perfectionist, worrywart that she is. So, I knew I would defer to her no matter what irritating advice she would dispense since I trust her above all humanity. And irritating advice it was. She said the pre-cancerous cells that were found in my fallopian tube during the last surgery were more and more common among BRCA patients, so she encouraged me to have the exploratory surgery "the minute my body was deemed healed enough to undergo it again." Drat and double-drat.

I found this both interesting and disconcerting: Here I am a fairly educated, well-read person with a background in healthcare writing, married to someone who works in the healthcare field and with many friends involved in healthcare as well. As a result, I have received lots of information and advice every step of the way. So, making an intelligent decision about which doctor was correct and whose opinion I should follow seemed simple enough. But what about all the women who didn't have the connections I did? How does the average person make critical decisions about their health when they receive conflicting and confusing advice from medical professionals?

Like I said, I chose on the side of caution with my oncologist, so that if, in fact, they do find cancer again, I'd rather know now...since timing is everything with this disease. I didn't want to kick myself one day and say, "If only I had done something sooner."

So, here I am, facing my next surgery -- to remove my uterus, perform an abdominal "wash" (to remove fluid and test it for cancerous cells) and check lymph nodes. In addition, since I never seem to do anything half-way, I'm going to have the rest of my breast reconstruction at the same time. Just call me the Bionic woman.

Last night, I awoke at 3 a.m. with my mind racing back to images from my previous surgery in February. All the needles jammed into my arm, struggling to breathe on my own and feeling like I was suffocating, the sterile hospital room, the drugs, the dizziness, the nauseau, the pain, the anesthesia, the fear. I stayed awake for the remainder of the night reliving my miserable experience.

I was hoping to postpone this next surgery until fall -- to give my body ample time to physically heal, and my psyche time to separate myself from the trauma. In fact, I had decided upon my last blog posting to take time off and simply focus on life. I needed a break from thinking and worrying about surgery and doctors and cancer.

So, I chose to enjoy the spring, which was magical this year in Atlanta. Warm, cool, sunny, rainy, stormy, breezy, fragrant, vibrant. I visited an organic farm and ate dinner on the grounds. I went bird watching in Fernbank Forest. I visited my favorite nursery and bought flowers and herbs. I gardened and worked until dusk cleaning up the yard. I took long walks in my favorite park that features a lake with geese and curving paths along rolling hills. I went hiking in North Georgia to the top of Blood Mountain, passing irridescent green ferns and bright orange wild azaleas. I gazed at the full moon on a clear night. I signed up for a weekly fresh vegetable delivery from a CSA. I slept with the windows open so I could listen to the sounds of night and awaken to the calls of birds. I visited downtown Athens and shopped in boutiques and a used bookstore, and toured the state's botanical gardens. I caught up with my 94-year-0ld aunt and spent long evenings talking with friends. I drank wine with my parents on their deck. I popped popcorn and watched movies cuddled up with my husband.

It's so easy to love life. Cancer makes it easy. Because you realize how precious all the simple, day-to-day aspects are...and you don't take them for granted. I wanted to spend each moment this spring enjoying being alive and healthy--I wanted to savor this time.

However, this time is coming to an end...so let the whining begin as I dread being sliced & diced again.

I'm aggravated about being out of commission for another 6 weeks for recovery--meaning, no swimming, beach trips, bike rides, hikes and other summer fun.

Not to mention (again) that one of my best friends invited me to join her on a business trip to PARIS (free hotel for a week!). But, alas, she will be flirting with French men without me, while I will be having another rendezvous (naked, of course) with my 2 male surgeons. They are seeing way too much of me these days.

And, then, there's the chance they will FIND something and I'll have to undergo chemo. (This is where the music from "Jaws" comes in.)

I would like to restate that I voluntarily underwent BRCA surgery in February --being cut up in 10 million little pieces -- in order to avoid any chance of chemo. Now, I find out that in addition to being cut up into 10 million little pieces, I might ALSO have to endure chemo again...for 5 months...complete with metallic taste in my mouth, hair loss and steroids bloating my body.

Somehow, I have to get my head around the fact that I may be looking like Shrek again.

Recently, I came across an editorial cartoon I had clipped from a local newspaper years ago. It's an illustration of a woman hovering over her husband and the caption says:

"You wouldn't be so tense if your job produced something meaningful, the spectre of death wasn't stalking you, constant crushing debt didn't have you in a stranglehold, and the memory of your distant youth wasn't making a mockery of your present existance."

Well, that about sums me up at the moment.

A Draining Experience

2008-05-01T08:53:00.000-04:00

Remember the 1960s movie "Born Free," in which the theme song goes:

BORN FREE, as free as the wind blows,

as free as the grass grows

born free to follow your heart.

Well, you can substitute the words "DRAIN FREE"...

Once you get your SIX drains removed, you won't know what to do with yourself!

Great Expectations

2008-04-30T20:17:00.003-04:00

You could say that I underestimated the extent of my surgery and recovery. Just a little. The doctors tried to warn me, but I wouldn't listen.

The surgery would take 5 hours. Uh huh. It would push my body to its limits. Uh huh. I would need the full 6 weeks to recover. Blah, blah, blah. Their advice fell on deaf ears.

I told them that I would be power-walking 4 miles by the second week. They nodded their heads...Hmmmmm. Who were they to argue with Ms. Confident?

Okay. So, surgery kicked my butt. By week 2, I was lucky to be able to breathe and walk to the kitchen on my own.

How could this be? I've been an avid exerciser for 25 years. My diet would make any nutritionist proud. I sailed through chemo-surgery-radiation seven years prior. As long as I didn't have to go through chemo again, surely surgery would be a breeze.

What I couldn't comprehend was that healing takes energy. And all the energy that fed this hyper, Type A woman was redirected toward my healing process.

I had even made a "to-do" list that spanned 3 pages in my notebook. After all, I couldn't imagine sitting around with nothing to do for 6 weeks. All that I could accomplish during this time -- like renovate the house, re-landscape the yard and write the great American novel. Not to mention, provide a solution to world peace. I ended up accomplishing zero. Zero.

So, now you know. The greatest advice I can give anyone who undertakes this surgery is to be realistic and be prepared. Because I wasn't realistic, and I wasn't prepared. But my friends were.

My friend, Tammy, became the point person to assign all tasks. Friends signed up to bring me meals. Meals? I balked. I was a serious cook and was planning to go through my Bon Appetite cookbooks and try new recipes (in the midst of my home renovation, of course).

For the first week after surgery, I rejected all forms of nutrition. The pain medication, along with my nausea and exhaustion, removed any appetite. But after a week of not eating, all of the sudden, I found myself ravenous. My body ached for sustenance, and my friends showed up with home-cooked, over-the-top meals. I couldn't believe my appetite. I ate everything that moved. The dog hid from me.

I learned from the recovery period that your body craves the following: food, rest, pain management and exercise. It demands these things immediately and intensely, so you spend your time & attention taking care of those basic needs.

Even more, you need the help of others more than you realize, and it takes humility to be served. Ego, arrogance and pride can get in the way of accepting a gift. So, push yourself out of the way and accept the kindness of others. You might be surprised at the result. You will feel greatly loved and valued...and this aids, as well, in the healing process.

Every Day

2008-04-29T20:23:00.002-04:00

Every day, I think about life...and death. Every day.

There's not a day that goes by in which I don't look up at the sky and thank God for giving me another day of life. Each day, I drink in the surrounding world. Each day, I know what I want to accomplish. Each day, I determine who I want to connect with. I realize that each day is all I have. And that's when I think about death.

I'm more aware than ever these days of people who are sick or suffering or dying. I'm sure it's, in part, because I'm middle age that I'm more sensitive to how vulnerable we all are. Facing your own mortality also awakens you to death being imminent, and possible at any moment.

I wasn't always this way. I was a planner. I made elaborate goals and set time tables of reaching them in a year, 5 years, 10 years down the road. It was hard to concentrate on the present. I was too focused on the next trip, the next job, the next adventure. As a result, I reached many of my goals: Study photography! Climb Mt. Kilimanjaro! Secure that promotion!

Goals are fine. But they aren't necessarily the end-all, be-all. In fact, sometimes, they get in the way. They don't substitute for the daily routines and nuances that bring meaning and substance to who we are and our significance.

You know the question that gets asked in various circumstances -- whether it's a work retreat or a church sermon or a girls' getaway weekend -- what would you do if you had only one year to live?

Well, when you are truly faced with the reality of that question, you may be surprised at your answer. Given one year to live, I always thought I would take off and see all the exotic places around the world.

However, when I was diagnosed with Stage 3 cancer with no guarantee that treatment would save me, I received clarity quickly and powerfully. My day-to-day existence meant more than I had realized. Simple things like the wind moving through the trees. A hot mug of coffee first thing in the morning. Taking a leisure walk at sunset. Snapping butter beans on a screened-in porch on a summer afternoon. Wading in a cold, North Georgia trout stream. Receiving a hand-written letter.

Then, I thought of the people who enriched my life. I wanted to see my 6-year-old niece grow up and have an impact on her life. I wanted to build a solid marriage with my husband (we were newlyweds at the time). I wanted to experience an adult friendship with my parents and be there for them in their old age.

Recognizing what really mattered set me on a different course. Since cancer, I now take pleasure in the ordinary-- whether it's selecting basil at my favorite nursery, or going birdwatching with a teenager on a Saturday morning, or laughing with my 94-year-old great aunt on the phone.

If I reach another goal or fulfill a long-held dream, then yay-rah. But if I never step far away from my home or achieve anything noteworthy, I will still take joy in celebrating each day. Because connecting to the people I love and carrying out the tasks that make up daily life is enough for me.

One more thing. People ask if I'm mad at God for getting breast cancer. While I admit that cancer is an overwhelming ordeal with terrifying consequences, it's not like I'm the only one who's going to die and no one else is. I'm just more aware of my short life span on earth because I've had to face the reality of death sooner than later.

My friend, Casey, pointed out that every breath we take is a gift from God.

Hear Me Roar

2008-04-22T19:34:00.003-04:00

Once upon a time, there was a doormat. Everyone walked and stomped on top of her. But then she got breast cancer and had to fight for her life. This meant battling lots of snotty-nosed employees in hospitals, labs and doctors' offices. But along the journey, she found her voice and made it heard. And now she won't shut up. The End.

When you become a professional patient as I, you come into contact with all kinds of personnel in the medical field. What I've observed from my vast experience during these past 7 years -- which has included 4 major hospitals, more than 10 physicians' practices, and too many healthcare labs, pharmacies, insurance companies and parking lot attendees to count -- I'd like to pass along to you.

For the most part, doctors and nurses and other healthcare professionals show compassion toward patients. Every now and then, you come across a Witch Doctor, but all in all, I've been fortunate to be under the care of amazing people who love their work and are genuinely concerned about the patients they serve. That's why many say they entered the medical field in the first place -- because they wanted to spend their lives caring for others.

And then...there's another group who could care less about humanity. They are known as"office staff." They choose their line of work because it offers convenient hours or is close to home or provides benefits or assigns easy tasks that are not too taxing on the mind. Patient care is not their forte -- nor do they want it to be.

The reason I bring this to your attention is because it is often the office staff who ends up playing a critical role in your care -- as they control scheduling, passing along information, helping with insurance issues and keeping track of your medical records.

A doctor can be the best in his or her field, but if their office staff is incompetent, you've got a problem. A big problem.

When I first found a lump in my breast, I followed up with a mammogram 2 weeks later. Nothing out of the ordinary appeared on the mammogram, but because there was definitely a lump, I was told I needed ultrasound.

That required going through my physician's office for another referral and scheduling. The challenge was, I could never talk to my physician directly. He was too busy. The only person I had contact with was his office manager, who relayed my information back and forth between the doctor and me. I was so naive.

The office manager assured me that my doctor didn't think there was cause for concern, and the soonest she could schedule an ultrasound was 2 weeks later. When I pushed for an earlier date, she wouldn't budge.

Two weeks passed and I had the ultrasound, which showed a mass. Then, I was told I needed a biopsy. Back to my doctors' office, where I dealt with The Office Queen. Again, she was in charge of the referral for a surgeon. And, of course, the soonest the surgeon could see me was 2 weeks later. Another wait.

From the time I found my lump to the time it was biopsied and found to be malignant (stage 3, to be precise), it had been a time span of over 6 weeks.

You are probably wondering why I let this go on for so long and didn't demand better service. Like I said, I had never had to deal with doctors' offices and labs on this level before, so I didn't know what to expect. But when I was told that I had an "aggressive form of cancer" and that it had spread rapidly -- in a period of a few months -- I got angry. Very angry. There was no telling how much the 6-week wait cost me in terms of my cancer's advancement.

Anger brought out my voice. And, believe me, every office employee has heard it ever since. Don't get me wrong. There are some nice people out there. In fact, I am quick to speak up about those who go above and beyond by writing letters of praise to hospital CEOs and physicians. I've even sent cards and presents. Because when you are vulnerable, you are truly grateful for their help and kindness.

At the same time, I also don't accept mediocrity when it comes to my health. And that's what, most recently, Irene had to learn.

Irene was the executive assistant to one of my surgeons. She ran a tight office, I could tell. But she knew nothing about patient care. I discovered this the day of my pre-op, when my physician's orders had not arrived at the lab, resulting in confusion and problems that I won't go into. I called Irene to let her know about the mixup. She ripped into me.

At this point, I had not eaten or even had a sip of water for hours on end. I had had a lot of blood drawn. I was tired and nervous and extremely thirsty. Nasty Irene sent me completely over the edge. There I stood, bawling...in front of my mom, the nurses and an entire waiting room of strangers.

When I reached my surgeon's nurse and told her the situation, she immediately resolved it and conveyed her apologies. Something Irene could have easily done herself. Furthermore, I found out that Irene was mean to other patients...but their weren't speaking up and complaining.

Well, Irene. In journalism school, they say, "The editor always has the last word," and Irene didn't know who she was dealing with. I wrote a speech. I wrote a treatise. I wrote Beowolf II.

I told my surgeon that Irene was a disadvantage to his marvelous practice. That she shouldn't be working in a place that required patient contact. People like Irene should be working at a company that didn't care about customer service at all -- like an airline, for example. Anywhere, I said, but a doctors' office.

So, there, Irene! Take that!

Unfortunately, I wrote the letter before I found out that I was going to have to have a second operation...with the same surgeon. Which meant I would have to deal with Irene again.

Nevertheless, I will continue to speak up and speak out. So, watch out, Irene...and everyone else who messes with me. Because breast cancer teaches you to be appreciative, but also to roar when you need to.

The Real Cancer

2008-04-15T08:52:00.001-04:00

This morning I attempted to have a devotional and it was quite challenging reading the Bible on medication, I can tell you. I found myself reading the same verse over and over and as a result, something sank into me.

I was reading in I Peter about being "reborn," and while I know that so many people today make fun of the term"born again," it really is about the transformation of our being -- shedding the darkness that haunts us and allowing us to be free to be the person we were intrinsically made to be.

It hit me as I looked at my exterior right now and how my body has been all carved up to remove any possible traces of cancerous tissue. That's essentially what spiritual transformation is about -- carving out the cancerous stuff inside of us that holds us back from living our lives fully.

I hope that this experience will not be in vain for me - that while I'm relieved to have potentially bad tissue removed from the outside, I hope I will experience an inward transformation as well of removing the garbage I see on the inside.

Of course, I still cannot promise I won't have meltdowns from time to time. One can strive for only so much...