Third Time's a Charm?

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

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

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. 

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

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

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

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

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).