Saturday, November 8, 2008

The Hurricane

When I lived in the south, there were always hurricanes headed my way. I would hear of one coming and get into a mad flurry of preparations, hoping to be ready before it hit. Then it would hit and all hell would break loose and I would find out if I had been adequately prepared or not. Once it was gone, there would be a period of clean up and exhaustion at the amount of work to do. Eventually, it life would be back to normal, but reminders would be there- like the tree split in half or the house with the shiny new roof.

Getting a cancer diagnosis has been a little bit like a hurricane. I felt the lump, but didn't really know at first if this would be a hurricane that would hit me full force or if it would be one that would die off at sea before hitting land. It has hit me full force and I thought at first I didn't have adequate time to prepare, but really every life experience I have had up until this point has prepared me in different ways for this hurricane.

Writing has always helped to keep my sanity in tact so I will use this blog as a way to record the facts of what is happening, and my feelings about those facts.

The Facts and the Feelings:

On the Friday before Halloween I woke up on my stomach with my breasts feeling smashed. I got in the shower and my right breast was hurting. I thought about how long it had been since I'd done a breast exam and decided to do one. I felt a lump in my right breast. Years ago a nurse taught me how to do a self-exam using a rubber breast with a hard lump in it. She explained that if I found one on myself, it might feel like a hard pea. This one felt just like the rubber breast model. I got ready for the day, dropped the girls off at school, and called my doctor for an appointment for 3:30 that afternoon. All day long I fretted and worried and finally convinced myself that because I was feeling pain, it wasn't cancer and I must have been hit in the chest during my last soccer game. I reminded myself of all the things I had done right in my life to reduce my chances- having a child before 30, nursing for 4.5 years total, eating very healthy and making a point to eat cancer fighting foods, having a yearly mamogram. I reminded myself that I had just had a mamogram last July, and my doctor had examined my breasts then and I was ok. Still, I had the nagging thought of my mom's breast cancer diagnosis 3 years ago. At the doctor's office, he felt the lump too and scheduled a diagnostic mamogram and ultrasound for the next Tuesday.

On the Tuesday, I went to the Oregon Imaging Center and had a mamogram that did not show the lump. I then had an ultrasound that did show it. I was scheduled for a biopsy on Friday, Oct 31st right at the time that I had planned to be getting the girls ready for trick or treating.

The Biopsy: The biopsy was scary. I knew that I wanted someone with me. My experience as a childbirth instructor and doula has been that people are much more calm and peaceful when a support person is with them during medical types of things. I asked my alanon sponsor to come and she did. She was able to sit right next to me and hold my hand during the procedure. When I began picturing a needle going into the heart of my breast, I thought I would pass out and roll into my sponsor's lap. When I told her how much it sucked, she suggested I do a gratitude list in my head and she reminded me how fortunate it is that I live in a country where this procedure is readily available to me, and how fortunate it is that I have the means to have it paid for. Focusing on gratitude leaves little room for panic, so that is what I focused on. It worked until the needle hit a nerve and my nipple began throbbing. I began to cry and panic a bit because I didn't want the crying to make my chest move and I was having trouble holding it in. But, the doctor was able to stop then because he had enough samples (3 were taken). Off I went for a quick cup of tea, a trip to 7-11 for tylenol, then off to trick or treat with my kids. I had told the girls very simply and briefly what was happening and explained that I would need to take it easy trick or treating. The results were expected to come in sometime the next week, around Wed or Thur.

On Monday I took Kaycee to vision therapy and endured a huge melt-down in the car afterwards. I picked up Karina from her after school program, then got back to the car and saw a message on my phone from my doctor's office. The message said my results were in and I should come in that day. It was 4:30 and when I called back, they told me to be there by 5:15. I took the girls back to Creative Care and briefly explained that I was getting results back from the biopsy. Karina asked me if I had cancer as we were walking back in the door of the school. I tried to remain calm and reassuring on the outside.

On the drive there, I called my sponsor to talk, and she ended up driving to the doctor's office to meet me. I was so very, very grateful to not have to walk in there alone. All the movies, tv shows, and country songs I knew off that showed people getting their scary test results came back to me. In the doctor's office, I was told that I had breast cancer. My doctor kept talking, but I was in a spinning free fall up and out of my body. I looked down at myself and saw myself hunched over and crying and I looked lonely so I got back into my body and heard the rest of what the doctor was saying. I don't remember much, but I do remember him telling me that I wouldn't hear much of what he was saying, but that my sponsor would remember. The one thing I do remember is him telling me that right now my fear was huge and my information about the cancer was small. He said that as my amount of information increased, my fear would decrease. He said that my next step was to have a lumpectomy and he made a recommendation of a surgeon and said his office would schedule it. We left his office and had about 10 minutes to talk before I needed to get the girls.

On the drive to get the girls, I tried really hard to stuff the fear and feelings away, but wasn't really able to stop crying. When they saw my face, Karina was scared and asked if I had cancer. I hurried them out of there and she kept pestering me. I asked God to help me out, and on the way to the car I told them something- I don't recall what. I do remember emphasizing that it was something that I would have to have a doctor help me with, but that it would be ok. I know we went home and I fed them dinner and I don't remember anything about the rest of the night. I'm sure I called a few people, but I don't remember much.

My doctor made an appointment with me to see a surgeon on Thursday. On Tuesday I stayed home and stayed in bed most of the day. A friend took the day off of work and brought me food and kept me company. I called the VA clinic to see what my options were with VA support, and I got an appointment with my doctor there within two hours of my call. He spent about an hour with me, going over the results and talking about my options. I learned that I could receive all of my care for free at the Portland VA hospital.

On Wednesday, I called my patient navigator. This is a woman I met at the biopsy whose job it is to support and help people diagnosed with breast cancer. She is a survivor herself and is a resource person and has a nice, calming spirit. She met with me an hour after I called and shared some booklets with me and let me know that I had some choices to make about my treatment. She also gave me a bit of support in how to support my girls. She let me know that I could either go with my doctor's recommendation of the general surgeon, or I could pick my own person. She gave me a few names of doctor's that she thought I might like. Dr. Trezona was the one that sounded the best- he would do the surgery and as a cancer doctor would provide follow-up treatment. I called his office that afternoon and his soonest appointment was a week away. I pleaded a little with the receptionist, and she went to talk to him personally, then got back on the phone and told me I could come in the next morning at 9:00. I called my insurance company and they said they would pay for as many consultations as I wanted, so I decided to see both Dr. Trezona and the general surgeon. I also decided I would see a doctor at the Portland VA and then decide who to go with.

Thursday morning I went to Dr. Trezona and brought both my sponsor and my best friend (who is a nurse and who has worked with this doctor and knows him a bit). My support people took notes while he talked. I expected to be in there for about half an hour since he had squeezed me in. Instead, he talked to me for two hours. He very, very thoroughly explained my test results and my options. It turns out that not all of the testing from the biopsy was complete, so there were (and still are) unanswered questions about the aggressiveness and type of cancer I have. He explained that he recommended a lumpectomy, but he wanted me to have an MRI first so that he could see if there was more cancer than just the one lump, and if there was cancer in the other breast. He said that there is only one MRI machine that could do this in Eugene and that it would take a while for me to get an appointment and that would delay surgery a bit. After my two hours with him (and I think 20 pages of notes between my two support people), I waited while the receptionist called to make my MRI appointment. She told me that they could get me in in 15 minutes and that she would schedule my surgery for the next Thursday (Nov 13). In a daze, I rushed off to the MRI place. On the drive over, I called and canceled my afternoon appointment with the general surgeon and I called the VA to say I didn't want to go to Portland. I had decided to go with Dr. Trezona. I am relying on my spiritual intuition to guide my decisions and I had a very clear, very strong sense that I was in the right place with Dr. Trezona. Check out his website (and all the cool stuff his wife offers) and you will see why:

I found myself in scrubs in a waiting room, with my friend by my side. My sponsor came for a bit, then had to go. I was so grateful for my friend, who explained to me what would happen in the MRI. I found myself in a long white tube on my stomach trying not to move a muscle. I forgot how to breathe normally and kept alternating between shallow breaths and deep breaths. The helpful technician spoke to me through headphones and told me to breathe normally. I then discovered that its actually impossible to breathe normally on command when I'm in the middle of about to be freaking out. All I had to fall back on was my relaxation techniques from childbirth. My favorite one was imagining warm water slowly cascading over my head, down my neck and shoulders, all the way to my feet. After about 15 minutes, I was able to completely relax, in spite of the very loud sounds the machine was making- they reminded me of a construction site and I had to fight to keep images of heavy machinery mixing with my breasts out of my mind. When I opened my eyes, I could see into a mirror that reflected the view from the window, which was of tall trees with beautiful fall leaves on them. I tried the gratitude list again and I pictured each person in my life who is important to me on an individual leaf. As I looked at each leaf, I thought about each person in my life and their special qualities. I was amazed to discover that I know many, many amazing people (yes, each one of you who has access to this blog had your own leaf!) When the wind picked up, the leaves would dance about frantically, but the trunk of the tree was still. I imagined that I would be leaving my own leaf for a time and hanging out on the trunk. I imagined my special people moving about, taking care of me, and me resting on the trunk. I imagined a period of rest for myself for the winter, then in the spring I imagined myself on a beautiful, strong, green leaf. You know, I say I imagined all of this. That isn't exactly right- it was more like these images came to me and I just watched them. By the time the MRI was finished 40 minutes later, I was in a state of deep relaxation and my breathing was very deep and even. I got up from the MRI and felt like I was drugged- the same feeling I got once after a 10 mile road race. I am not a person who has ever been able to meditate before, but I imagine this might be what meditation is like.

Part of what has been so hard for me throughout all this is the extremes of emotion- intense peace and calm followed by intense fear and sorrow. It is exhausting.

I was expecting MRI results in a few days, but Dr. Trezona called a few hours later, just as I was driving to pick up the girls. I asked if I should pull over while we talked and he said yes and I about puked my stomach was so lurchy and nervous. The MRI showed more "highly suspicious areas" in both breasts- two next to the original lump, and two in the other breast. He said I needed another ultra-sound to pin-point these and that he would be taking out a bigger chunk during the lumpectomy and would need to do a biopsy on the left breast. He said that if the areas on the left breast didn't show up on the ultrasound, then I would need another MRI at which time a needle would be inserted to mark the spots. I got off the phone and off I went to pick up the girls. I couldn't pull myself together and asked a friend to bring us dinner and be with the girls for the evening. I went to bed and cried and cried.

The next day (which was yesterday- Nov 7th) I had a pre-surgery appointment in the morning that lasted 2 hours. I met with several different people, then had a chest xray. I took a break for lunch and attempted to go into work for a bit. That didn't work out so well as I couldn't stop crying and couldn't really concentrate.. I then went in for the ultra-sound. The areas on the right breast showed up, but not on the left.

I see Dr. Trezona again on Tuesday to talk about the revised plan for surgery and to hear about the rest of my results from the original biopsy. I don't know when or how this other MRI will happen.

It's Saturday now and I'm so relieved that I won't be getting any phone calls from any doctors until at least Monday. I am trying to rest and be peaceful this weekend. I am also going to try to get my house and my girls in order in preparation for the surgery.

I have gotten emails and phone calls of support and that has been so nice. I'm struggling quite a bit with wanting to isolate and knowing that I need to reach out to people. I feel so grateful that so many people are arranging for my basic needs to be met- food, care for the girls, and company for myself.

All the doctor's phone calls have left me a bit scared to answer my phone. The exhaustion of talking about it and the pull to isolate have prevented me from returning all my calls. I hope people will be patient with me and know that I will call back when I can.

That's all for now. The girls and I are going to Mt. Pisgah to climb trees.


Geek Knitter said...

Krista, my heart goes out to you and your girls in this tough time. Please know that I'll be thinking of you and sending you all the positive energy I can muster.


Denise said...

Stay strong; I'm thinking of you and your girls and sending you positive energy. Dr. Trezona is a great doctor; my mom is a breast cancer survivor and he did her surgery in '97...she still talks very positively about him.
Thinking of you,

Baby Baird said...

Thank you for sharing your story. I have been thinking about you. Take care of yourself.