Girl Detective (cancer edition)

2003 version of the relaunched Trixie,
properly dressed for the usual October
breast cancer awareness activities.

As a young girl, I loved "girl detective" stories.

Before I could read (or read well), my dad used to read Nancy Drew stories to me, it was our thing.  We probably went through 30-40 of those books, and loved them all, no matter how far fetched they may have been.  The very first chapter book I read myself?  A Nancy Drew mystery, of course, one that transported me over the course of a summer from real life 1970's Iowa to fictionalized 1960's Hawaii through an action packed mystery that--no surprise here!--the Titian-haired Nancy solved with her usual blend of pluck and cleverness.

Later I devoured the Trixie Belden stories after finding a 1977 reissued copy of The Secret of the Mansion at a local bookstore.  I loved those books (plus the Trixie Belden paper doll set I felt lucky to find in those pre-internet days) and was delighted to find the series reissued in 2003, just in time to begin reading them to my daughter.  Unfortunately, I guess they didn't sell well enough for most modern girls, because the 2000's versions didn't go past book 14 or 15 out of the original 39.  But still, my daughter and her best friend loved them and, between my old collection from the 80's, interlibrary loan, and her friend's Ebay treasures, they were able to enjoy the whole series as part of their very Trixie and Honey like friendship (typing that, it occurs to me that those names are really better suited to gun molls than amateur detectives, but obviously no one thought to check with me before naming them).

In between those 2 notable mystery series, I, of course, read all sorts of other mystery books aimed at young girls that featured teen "girl detectives" and the crazy villainous criminals they each had the bad luck to run into over and over (and over and over and over...) again.

It's probably not surprising, then, that somewhere inside my brain, there's still this urge to solve a mystery, even when faced with things I have zero actual knowledge about.   Last week I had another bone scan and another CT scan.  I'll get results next week.  In between is a 7 day long wait that is practically tailor-made for attempted mystery solving.

The creator of the Trixie Belden
mysteries also wrote some of the
Cherry Ames nursing mysteries.
In retrospect, I probably should
have focused more on those.

The CT scan does not make a good mystery.  For that one I just drink a lot of barium, get contrast injected into my arm, and wait for results with no indication at all of what they may be or what that might mean--aside, of course, from my usual failing attempts to "read" the technologists' expressions and find "meaning" in whatever happened to be the workflow patterns for that day (is that pause meaningful?  did they have me raise my arms above my head last time, and if not, why not?  what does that IV removal technique all say about the cancer in my bones!?!).  You'll notice, I didn't say I don't try to solve the CT scan mystery, I only said that it doesn't make a good mystery--not nearly enough clues (although I suspect Nancy would have figured it out, owing to her particular talent for knowing just what to ask and combining that with her skills at everything including, doubtless, skill as an amateur radiologist).

The bone scan, unlike the CT, has so many clues, if only I knew just what to look for!  For that one, the radioactive tracer works its way into my bones and then a  detector picks up each little gamma ray to form a dot on the study.  The isotope gets absorbed more where there is damage or healing, such as that caused by cancer in the bones.  The thing with the bone scan, though, is that, when turned on, the monitor in the scan room shows the dots in real time where I can view them!  And after the usual views, the technologist sends the images to the radiologist (who is, one hopes, an actual professional and not an extremely talented amateur like Nancy Drew), and the radiologist may ask for additional views where things look interesting.  How's that for clues falling right into my lap?

Last time I had a bone scan (June) the monitor was off, which was very unsatisfying.  But the one before that, in January while we were still working to diagnose the bone mets, I could very clearly see the hot spots taking shape.  When you hear about a PET or bone scan "lighting up like Christmas tree," that's what they mean--lots and lots of little rays clustering in different areas to form extra bright spots on the image.  And in January, I watched my hips, a rib, and a spot on my skull, all shine brightly, well before the rest of my bones had even taken shape.  What I didn't see clearly at the time were the spots on my femur and neck bone, but I guess that's why they let actual radiologists have a look and don't rely on me.

But this time?  I didn't notice all the hot areas glowing more than the rest of my bones.  My entire spine and the base of my skull looked pretty darn bright, which was scary until I googled and saw that that's how they look on many of normal scans, and maybe still something on my ribs?  Not sure what that glow was.  But what I don't know, unfortunately, is whether this lack of glow is a sign of good news, or just a matter of me not knowing a darn thing about reading diagnostic imaging?  Is it a sign that the cancer is, for now, slowing down?  Or is it like the spots I didn't notice in January, just a sign that there are spots I still didn't notice while lying on a scanner bed looking at a screen across the room out of the corner of my eye (yes, I know Nancy would have been able to make that work, but she could fill in for professional ballerinas and was a certified scuba diver, so there are actually a lot of things she and I don't have in common)?

I do realize I'm not going to be able to diagnose myself, plus there's a reason why the law dictates resolution for radiologist's monitors and it's the same reason why real radiologists have years more training than the zero I have, plus real radiologists will presumably also look at images from the CT scan instead of just relying on behavioral cues.  

I know that, in reality, I don't really know anything at all.  Well, anything except this: when I left the bone scan room in January, I knew I was in trouble.  I knew before my oncologist called me that what I had glimpsed wasn't good.  But now, even though I understand that the news could still be bad, despite knowing that at stage IV, good news is never a permanent state, right now, I still have reason to hope that the Faslodex, Xgeva, and Lupron are still doing what we hoped they would and I have hope that we will not have burned through those options just yet. 

Unfortunately, just like the tension-filled cliff hanger chapter endings in all the good "girl detective" books, I'm going to have to leave you (and me, too) hanging until I find out results next week.  When your dealing with amateur "girl detectives," isn't that always the way?

______________

*My High School guidance counselor, upon hearing that I planned to study physics in college, replied, "Oh, you want to be a lady physicist?"  That irritated me because what I really planned on doing was being a physicist.  Being a lady was unrelated.  In light of that irritation, I probably need to state clearly that I know full well Trixie and Honey would have just called themselves "detectives."  Although, Nancy, doubtless, was well above such quibbles herself.

2 years, by the numbers

George Bellows - Stag at Sharkey's

Today marks the 2 year anniversary from my first (stage III) cancer diagnosis--go me!  In honor of this occasion, besides patting myself on the back just for being here, I've decided to do a "by the numbers" of the past 2 years of medical things.

In the past 2 years there have been:

• 420 days between ending active treatment for stage III and being officially diagnosed with stage IV
• 394 days wearing my lymphedema glove and sleeve (I usually don't have trouble as long as I wear them, so it looks like my hand and arm have problems but it's not really so bad at all)
• 393 days on Tamoxifen 
• 220 days of full or partial baldness
• 116 days between first appointment about the hip pain to stage IV diagnosis (time included multiple types of scans, several appointments and a biopsy)
• 46 days of radiation therapy (28 to the mastectomy site in 2012, 18 of 20 to the hip this time around)
• 8 doses of chemo (given over 16 weeks)
• 8 tasty pastries because my husband bought them for us during each and every chemo
• 8 injections of Neulasta (to increase white blood cells the day after chemo, and a huge thank you to my in-laws who picked me up and drove me to 7 of the 8, only missing the one that coincided with their grandson's out of town wedding.  Zero is the number of in-law jokes you'll ever hear from me because mine are the good kind of in-laws)
• 7 days in the hospital
• 5 surgical procedures (bilateral mastectomy with immediate reconstruction, port in, unrelated to cancer kidney stone that they blasted and took out through a hole in my back--some girls have all the luck!, port out, reconstruction revision)
• 5 kinds of pain killers (strangely enough, some work better for different kinds of pain than others, who knew?)
• 4 CT scans (not including the radiation oncology planning or the CT guided biopsy, because enough is enough, and besides, if you aren't drinking barium smoothies, it probably doesn't count)
• 4 cancer pathology reports (1 for each biopsy, 1 from the surgical sample, 1 from Dana Farber)
• 4 Faslodex injections (but given 2 at each appointment)
• 3 MRIs (breast, brain, spine)
• 3 flu shots (much less time consuming than those MRIs)
• 2 genes not found to be mutated (those BRCA1 and 2 genes you sometimes read about)
• 2 PET-CT scans
• 2 cancer diagnoses (stage III and stage IV, same cancer, though)
• 2 clinical trials (actually enrolled, 2 more that didn't pan out) 
• 2 Xgeva injections
• 2 X-Ray studies (I think one or both of those studies was more than one view, but I'm not going to quibble)
• 1 biopsy (this is the bone biopsy for the IV diagnosis, the core needle ones for the stage III were, of course, before that diagnosis)
• 1 echocardiogram
• 1 wig
• 1 ER visit
• 1 bone scan
• 1 Lupron injection
• and definitely more appointments than I care to count

But, on the other hand, worth noting that over the same 2 years there have been:

• 1 school play
• 1 first house for my stepson and daugher-in-law
• 1 well deserved promotion for my stepdaughter
• 1 new grill for my husband and the will to use it often
• 2 birthdays for me
• 2 birthdays for my husband
• 2 birthdays each for my daughter, stepkids, daughter-in-law
• 2 wedding anniversaries
• 2 summer gardens
• 2 Christmases
• 2 Easters
• 2 of every other holiday big and small
• 2.5 youth sports seasons
• 3 visits from my out of town stepson, including 2 surprise visits because these kids are awesome that way
• 731 days of being alive 

Because I am still here and that is 2 years (and counting) where cancer doesn't get to win.

Take that, stupid cancer, take that.

Peeking out at the world

Andrew Wyeth - Christina's World

Well, I had my appointment for biopsy results  and discussing next steps (and I had my second opinion, too).  Even though the news was not unexpected, it kind of knocked the wind out of me.

I am now a stage IV cancer patient.

Sigh.

It's weird because I went into the appointment fully expecting this.  It's been a slow build up of clues from the pain, to the continuing and worsening pain, to the not ruling it out bone scan, to the highly suggestive of cancer PET-CT, to the fact that they wanted to biopsy, to the fact that no one called me quickly with a good report from that biopsy (usually bad news gets the quick calls, but in a case like this with an appointment upcoming, I would have expected a quick call for good news not bad).

I knew what my oncologist would say before my husband and I even entered the room and still it shook me.  Shook me hard.

I'm not an out of control kind of person, I cry at very sad or very happy stories, pictures, commercials, but I'm good in a crisis.  And I was my very in control self.

True to form, I listened to my oncologist, took notes, and asked questions.  I talked with the clinical trial coordinator about the exit kit for the clinical trial I was on but am no longer eligible to continue now that I have metastatic disease, and got some information about a new clinical trial just opening up.  I chatted about the weather and my not-so-easy veins with the technologist who drew my blood, and sat calmly going over a side effect list with the nurse who gave me my first dose of Xgeva (an injected medicine that makes it harder for the cancer to continue to eat away at my bones).

I think, outwardly, I really pulled it off.

But, the truth is, it's a damn good thing I took notes because I don't remember a whole lot about those conversations.  My oncologist called me yesterday to see if I had any questions about the new trial for stage IV patients that she thinks I would be a good fit for.  I had read the materials after the appointment and thought I had a handle on it (and was leaning against it), but on the call (a week after the appointment) she (very patiently) explained why all the things I had thought the study materials had said weren't actually what they had said.  She was kind enough to say several times that she could see how it was confusing, but the thing is I reread the materials last night and they were pretty darn clear (and sound like something I do want to be part of).  The problem wasn't them, it was me.  I swear I thought I was functioning mentally, but clearly there were some serious gaps.

My mind doesn't seem to want to deal with this at all, and I've become at once obsessed with reading all about this and at the same time pathologically afraid of dealing with it.

I've told people about the cancer only when I felt I really had to tell them or risk making things worse by my ongoing silence.  I've avoided Facebook, forums, and the telephone.  As you may have noticed, I've been keeping away from my blog.

I wonder if this part would have been easier if I had been more emotional from the start?  Maybe I would have gotten it all out and been ready much sooner to move on and adjust to my new identity as the new stage IV me?

The good news is I'm starting to feel more together.  Look, I'm even blogging!  I've been telling myself and the people who love me how many people with bone mets can go on like this for decades, but now I'm actually starting to hold that message in my own heart, as well.

I don't know what the future holds, but for the moment, I'm starting to be willing to just keep my head down and keep trying while I wait to see.  I believe just like this stage IV diagnosis was a slow build up of multiple results that more and more strongly suggested the outcome, that when my cancer evolves around first one treatment then another and another, there will be time to understand that fact before the full reality of what it means actually happens.

It may end up differently, but I just can't see a way to make life work and do the things I need and want to do if I'm constantly telling myself that the end is neigh.  Especially because there's a decent chance it won't be (see what I just did there?).

For now, I'm banking on having some years to go and hoping science will come up with new treatments faster than my particular cancer comes up with ways around them.  And beyond that, I realize that none of us ever get to live forever, but I'd really like to be here long enough to see a cure so I can damn well die later of something completely different.

So do not worry about tomorrow; for tomorrow will care for itself. 

Each day has enough trouble of its own.  Matthew 6:34

Damn. Just damn.

Chagall - Bridges Over the River Siene

I'm not sure I can put down very well what I'm feeling right now.  I've gotten some really bad news.

Because I don't really feel up to that much, I'm going to start by just putting in some of what I posted on my favorite bc forum the other day:

Turns out my bone scan lit up and (after a snowstorm reschedule) I had a PET-CT and my onc tells me it looks like I have mets in my pelvis.  They're scheduling a bone biopsy, so I guess it's not a sure thing until then, but my onc seemed to feel it was very unlikely to be anything but mets, given the PET results and the history.

She tells me the good news is that my organs look clear, so that's the best sort of mets to have, but clearly mets are still not the best news to get.  

It's so strange, on the one hand I've been worrying about this for so long, especially since I started developing pain in my hip, that it almost feels good not to worry about it, if that makes any sense at all.  And on the other hand, it kind of ticks me off--I got mammograms, I keep healthy habits, eat berries and cruciferous veggies, take my tamoxifen like a champ--so this complete failure of cause and effect working the way I want it to makes me angry.  Useless to be angry, I know, but sometimes it feels good anyway.

I would appreciate any prayers and good healing thoughts anyone wants to send my way.  And I'm absolutely wishing you all continued good health and no more cancer ever!

So yeah.  I'm sort of in limbo, but it seems like the outer circles of the inferno are well within shouting distance (stupid Dante reference, wouldn't my AP English teacher be proud?).  There's a part of me that's holding out hope for some miraculous miracle of benign biopsy, but most of me feels like that's pretty stupid.

I was doing ok with things this morning, but I'm back to feeling really sad and gloomy this evening.  My emotions seem to come and go really quickly right now.  Also, weirdly enough, I'm finding that even when I don't feel like I'm feeling anything, physically I find myself feeling shivery or stomach achy or all sorts of tense.  I guess it's going to be a wild ride getting a handle on this one.

I keep telling everyone who I share this with (not many people, I'm so not ready to be not only "cancer girl" but "'terminal' cancer girl."  damn it.) that people can and do live decades with bone mets.  I know it's true, and sometimes I really do feel like that will be me, too, but there's still another part of me that's sitting in the corner, rolling her eyes, and saying, "yeah.  right.  got a bridge in brooklyn to sell ya, too." (turns out my grumpy subconscious doesn't like capitalization.  who knew?).

Thing is, I know that could be me, I could go with no evidence of disease for decades and decades and then sometime between now and 2025 they could come up with an actual cure and I could live to be the grumpy old lady shaking my fist at you, willfully neglecting to use capital letters, and muttering swear words under my breath.  It could happen.

But I feel like I've lost a little innocence.  I mean, I didn't argue, I didn't slack, I showed up on time for all my appointments, sat patiently through all that chemo, lay there bare chested and beamed with radiation day after day after damn stupid day.  I ate healthy food, exercised until I was told to try resting my stupid hip, and took that tamoxifen every.  single. day.  Because I wanted to be here for my family and was willing to do whatever it took.  I know it was still the best thing to do because it gave me the best chance possible, but having tried and (probably) failed, I know whatever else they try could also fail.  Because, ask me how I know.

(But the first person who want to take my story as proof that conventional treatments don't work had better take off running, because I don't have time for that crap and I'm not interested in your stupid theories.  I usually feel really uncomfortable being blunt like that and usually avoid it, but today I don't care.)

I'm sure at some point, I'll get my act together, stop acting more emo than the emo kids, and charge forward for all I'm worth.  And I'll probably read this later and wonder what the heck I was thinking.  And also I'll become obsessive about proper capitalization.  But that point isn't now.

So right now, I'm beginning this adventure by obsessively trying to mentally get out of being on this adventure.  And writing to try and obsessively find a little place of peace.

The Lord gives strength to his people;

    the Lord blesses his people with peace. 

Psalm 29:11

How I danced with the red devil and shot mustard gas through my veins.

Sounds kind of poetic, doesn't it?  Poetic and a little hardcore.  I like that.

Like many, many stage III breast cancer patients, I was given a chemotherapy regime of dose dense Adriamycin and Cytoxan for 4 doses over 8 weeks, followed by Taxol for 4 doses over 8 more weeks.
 

Marc Chagall's "The Dance"

Adriamycin is red and strong and, according to multiple sites on the internet, is sometimes called "The Red Devil"--not that anyone in the cancer center ever called it that in my hearing, of course, because that would be rude--but for each infusion of it I watched them hook the red bag to the IV in my port and watched the Kool Aid punch red liquid flow through the tubing and into my body.  Later that day, the same red had made its way around my body and remained red as it made its way through my kidneys and out of my system.

Cytoxan, on the other hand, doesn't need a hardcore nickname.  It isn't mustard gas exactly (a little poetic license on my part) but it's a nitrogen mustard akylating agent and a close cousin to the chemical warfare agent.

These, as I mentioned, are followed up by taxol, which for many people is the easier part of the ACT chemo with fewer harsh side effects.  For me, it actually seemed a bit harder--taxol is when I finally lost the last of my lashes and brows and dealt with the worst bone pain and neuropathy, expressed as both numbness and as a relentless, prickly pain.

Dose dense means that the doses are given closely together (without being deadly, of course) and this feat is accomplished with the help of a variety of anti-nausea agents and another drug called Neulasta which requires a second visit 24 hours after the chemo infusion but is required to increase production of white blood cells killed off by the chemo.  Not that the white blood cells ever got to normal-person numbers, but the Neulasta helps you get enough white blood cells together in your body to continue with the chemo.  The goal of dose dense scheduling is to keep hitting the cancer cells hard and deny them time to recover between infusions.  It's the chemo equivalent of a constant seige.


For me, the particular chemo I would have was discussed after my surgery, during a visit with my oncologist.  Before surgery, my cancer team had thought, based on the MRI (and possibly some of the other scans I'd had--I'm not really sure anymore) that I would probably be stage II, with a decent chance of avoiding chemo altogeter.  Immediately after surgery I knew they had found a lot of cancer in the lymph nodes, but I guess I didn't put 2 and 2 together because it wasn't until that appointment that I finally understood I was now stage IIIa.  I am proud that at that appointment I held back my tears and I was able to keep it all together enough to talk about the most important thing at the moment: where we were going to go from there.

I had, of course, learned enough about the different stages before that appointment to know the general trends in odds and stages, but it wasn't until after I'd finished with chemo that I finally asked my oncologist about how that related to me.  Weird, I know, but at the time I figured no matter what the odds were, for me it's just binary--either I'm alive or I'm dead and odds don't change that.  Now I care more about the odds, and at times I cling to them like a cross, but when it was all new and I was just trying to get from one day to another, I didn't see any reason to bother asking.  I knew stage III was not good news and when she said we really needed to hit the cancer very aggressively, and she recommended dose dense ACT chemo, even with it's side effects, I was all in.

As I understand it, until they develop something new, dose dense ACT chemo is the most aggressive chemo they give for breast cancer, equalled in aggression by some other 3rd generation regimens but, as the phrase goes, never surpassed.  It's also extremely common for stage III her2- breast cancer, so I have a lot of sisters in this.

Side effects can include heart damage and permanent neuropathy, so it isn't given without a good reason, but lots of cancer that's already spread through the lymphatic system counts as a good reason.

I remain grateful to have had this kind of chemo in our bag of tricks to throw at this.  My cancer was a nasty, aggressive kind, fast moving and mean, and I needed something heavy to throw at it, but it was hardly fun, because, well, because chemo.

But at the same time, now that it's over, in a lot of ways I enjoy being able to say I did that and made it through.  It makes me feel like a badass punk kid who you better not mess with because I eat barbed wire for breakfast and spit nails for lunch.  And, coming from a place where cancer seriously messed with my body and tried to take my life, I feel like I can probably give myself permission to indulge my inner "don't mess with me" from time to time.

I like to think my stage III sisters and I are a hardcore bunch, and, to me, that has a lot to do with having to learn to live with lots of fear and uncertainty, having to adjust to viewing victory as a moment on the road that may or may not be a lasting endpoint, having to understand about not enjoying the luxury of giving "quality of life" more weight than therapeutic benefit.  Maybe that's not the case for all of us at stage III, and I won't even try to speak for other stages, but from my experience and experience on my favorite cancer forum, I think it's something a lot of us do struggle with and feel pushes us just a step or two outside the usual circle of breast cancer patients.

I'm really not trying to diminish the battle of other women who were lucky enough to have been an earlier stage.  Heck, I thought I was one myself and it was still a fight.  I understand that even stage I and II can metastasize and, despite better odds, it's still scary.  Plus, I know I am very fortunate not to be working out stage IV issues right now.

The odd thing is, I've been rewriting this post a number of times trying desperately to say what I want to say without sounding like I'm not appreciating the struggles of other women at other stages and places.  But at the same time, I wonder why I can't say just say, "we took on something that was damn hard and we fought our way through.  Other people did other things, but we were here and we did this."  We've been through a lot to have this chance at life.  And right now I'm not in a mood to downplay that.

I've said before (and I meant it) that I'm not brave, just stubborn, but I'm also strong.  I mean that, too, I know I'm strong.  I danced with the red devil and shot mustard gas through my veins, and I'm still here to tell the tale.  You don't want to mess with me.

And now for something completely different....

This post is not about how I found out I had cancer.

I was planning on putting those posts together in order, getting it all down and sort of setting the stage for how I got to where I am today.  But honestly?  Even this much later, it's hard to revisit.

I feel like it's important to get it all down for my own reference as those early days get smaller and smaller in my rear view mirror, but also in the off chance that someone else is going through it who happens upon my blog and can benefit from my story.

But as I get closer to those early days of diagnosis up to surgery, the more I want to once again make it all go away.

I guess the good news is, with time and my doctors, I did make it all go away (ha!).  Those days are, fortunately, a year and a half behind me now.  And, while at the time I wasn't entirely sure I'd ever have another day where I didn't feel that creeping, clawing shadow of panic in the pit of my stomach lurking around all of the time, I'm happy to report that it's mostly a memory.

Strangely enough, even the times I've been afraid the cancer beast was back and I'd be fighting stage IV, there's been panic, but not the same deep-seated fear that I felt when I first found out.  I know I could still surprise myself, but I think maybe I've been on this cancer train long enough to get used to it, long enough to know there's a lot of stuff to throw at the monster before you're completely out of ammo, and long enough to know that I have allies who are ready and willing to help me get through what I need to get through (in no particular order: my family, my friends, my God, my church, my doctors).

And, even though I don't want to think about it, that means even helping me get through an ending that comes much sooner than I'd like it to.

But, yeah, that would suck, so I hope it doesn't work out that way!

So, like I said, going back in time is hard, and I'm taking a little break from it for now.  Life right now is very good.  I'm feeling well, loving my daughter, stepkids, and husband, living like a totally normal person, and only occasionally worrying about the cancer making an encore appearance.

I wish I could go back and tell myself that it would get to be this way again, but the best I can do is tell myself now, and, if you, my reader, happen to be in the beginning of this journey, tell you: there will be days where breathe and sleep and laugh like normal again, whole weeks where you don't worry about leaving your family to fend for themselves without you, long stretches where you don't look at everything you see through the lens of wondering if you'll live long enough to see how it ends, and even times when you will procrastinate and waste time doing silly stuff (or even stupid stuff) without feeling like you're blowing what little time you have.

I probably wouldn't have believed me if I could go back and tell myself that, but I swear it, it's all true.

How I discovered I was growing cancer, part 2

So on my last post I left off with a scheduled diagnostic mammo and ultrasound.  God bless the wonderful woman in scheduling who lead the charge to get me in for the imaging and follow-up with a (now "my") breast surgeon all on one day within 3 days of my gyn appointment.

The mammo was fairly uninteresting from a patient point of view, but the ultrasound was where I started to understand what was really going on.    

My lump barely showed on the US, the technologist (wonderful calm and caring woman) could feel the lumps but had to do some work to image the shadowy difference on the US.

I think the procedures are probably a little different from facility to facility, but where I receive my care the radiologist came in at the end of the US exam to look at the results, talk to the ultrasonographer, and talk to me.

Now, radiologists a lot of times get a reputation as being something akin to cave-dwellers.  Diagnostic imaging has changed the face of medicine and radiologists--those are the doctors who read images, the techs who take them are radiologic (or MRI or CT or whatever) technologists--oftentimes spend their day in dimly-lit rooms looking at images and never having to speak to a single patient.  The reputation is more or less based on the kind of person who would think that was a great way to spend a day.

Fortunately for me, there are some who seem to go into the specialty for other reasons, or at least can make a successful switch to patient interaction mode when need be.

I was lucky to have the kind with good people skills.

So, she comes into the room and talks with me and the ultrasonographer.  She tells me there were calcifications on the mammogram that were worrying her.  I said something like, "so they're not cysts?"  and she said they were not.

Honestly, it wasn't what she said but how she said it that really hit me.  Later, between that visit and the results of my biopsy, my mom tried to tell me I was worrying for nothing because she googled it and lots of people have calcificatitons (I believe she was going for sort of advanced technique in, "there, there, it's not so bad,").  All I can say was the radiologist's tone and serious face made it pretty clear that these were not the kind of calcifications that usually mean nothing.  And the "not cysts" statement had an underlying unspoken, "No way in heck are these just cysts" lurking somewhere just beneath it.

So that's when I began to understand I could be in some serious trouble.

A few hours after the ultrasound, I saw the breast surgeon for the first time--my breast surgeon is great at talking with people, great at explaining things, great at making you feel comfortable, like my radiologist he goes against type--he talked a bit about the imaging reports and mentioned that they didn't image like most cancer but they were still suggestive.

"Suggestive of...?" I asked.

"Of cancer," he clarified.

Ok, I really did know the entire day was more or less centered around looking for cancer, but it just seemed so otherworldly, I couldn't quite make my brain fill it in without hearing it flat out.

So, as he suggested, we scheduled a biopsy a few days later, at the end of the week, and a follow-up with him in the middle of the next week.  Since you've seen the title of my blog and are, no doubt, more than smart enough to put two and two together, you probably already know how that biopsy worked out for me.

How I discovered I was growing cancer in my breast, part 1

I found it accidently.  It was a total fluke and I can only think it was a gift from God that lead my hand to brush one of the lumps when it did.

I had just gotten back from a spur of the moment fabulous vacation to Colonial Williamsburg with my daughter--my husband and I decided she and I should take the opportunity to do this because time moves so fast and in a few years she would be in high school and a few after that she'd be out the door.  We were thinking about needing to take the opportunity to spend time together while we could.

Who knew that would be so prophetic?

On our last evening at Williamsburg my daughter danced in the rain.

So there I was changing clothes, and for whatever reason my hand just brushed against this lump.  I don't have any history of breast cancer or even much history of other cancer in my family, so it didn't really occur to me to panic.  My entire thought process was more like, "What the hell is that?"

So felt the lump and around the lump and felt another lump on another part of the same breast.  I thought it was weird, but I wasn't worried, because I was healthy and young and had had a clean mammogram 6 months before (my very first (and last) screening mammogram ever, I was just 41 so I was just at the start of my recommended mammo age)--besides what were the odds?

I googled it and decided I should probably wait until after my next period to see what happened, apparently cysts come and go with hormones that way.   But 2 weeks later the lumps were still there.

So, at my husbands urging I made an appointment with the nurse practitioner at my gyn's office.  I really wasn't that concerned--as my mother-in-law would say, I was too green to burn.  I actually thought about putting it off and seeing what the lumps did--I'd recently had a work up for ovarian  pain that turned up nothing (although after my cancer diagnosis I found out what was really causing that pain--a singularly massive kidney stone, but that's another story for another day), and I wasn't eager to continue feeling like I was always worrying about things that didn't show up anywhere.

The nurse practitioner felt the lumps and said she didn't think they were anything to worry about but scheduled me for a diagnostic mammogram and ultrasound a couple of days later, to be sure.

Still I was thinking no big deal.  I was unhappy to have to get another mammogram, and felt like I was probably wasting a lot of people's time, and, as Alfred E. Neuman would say, "What? Me worry?"

Yep, I was definitely too green to burn.