B-Day (Boob Day)

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

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

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

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

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

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

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.