Good problems

When I think of good problems to have, I think of things like, oh my gosh, we have too much ice cream and not enough room in the freezer.

This blanket is so soft and snuggly it's making it hard to get out of bed.

My pants are uncomfortable because I ate too much pie.

Ooh, the tea is too hot. I have to wait to drink it.

We have too many puppies. (Can you have too many puppies? I want a puppy.)

These are the things that spring to mind with good problems.

I don't know if you ever read, "Where'd You Go, Bernadette," but there's a part where one character calls the brain a "discounting mechanism"—discounting in that you get incrementally less excited about something new, or less upset about something terrible.

They said something about it being a survival mechanism. Humans cannot stay super excited about every new thing because then in the olden (prehistoric?) days you wouldn't process threats, or something like that.

So your brain makes sure it gets less and less shiny and exciting, or less calamitous, as time goes on.

I find this idea soothing. It makes sense to me.

You can get used to anything. 

Anything.

I have known this forever.

The problem is, it can give you a super fucked up worldview, and in the Venn diagram of life, your circle might not even have any overlap with most people's. You could just be your own adjacent circle.

Or anyway, it might feel like that. If you feel like you're always inside outside.

But just about anything can be normalized.

I'd known this for a long time, but hadn't thought about what our brains were doing. 

Discounting! If you act fast, you can have 30% of this emotion. Today only.

So on Monday, Nick went with me to my quarterly oncology checkup.

We passed the Pope, we walked across the walkway, we hung out all masked up in the very full  oncology waiting room.

Friends who'd had breast cancer told me that at first you thought and worried about it all the time. And then after a while, it becomes normal, and you just live. Which makes sense.

Because there are so many other things that require your focus in life. So what else are you going to do?

Anyway, I wanted Nick to come with me, because when I told him I didn't need him to accompany me to my annual visit with my breast surgeon, that's when she found the lump.

I'd rather he were with me than not.

Last time I saw the oncologist, so this time I was seeing Terri, the Nurse Practitioner. She's terrific. She asked me if I'd considered the new medication that she was under the impression the oncologist had suggested to me three months prior.

And I was all, maybe I was too sick to remember? Or maybe she didn't talk to us about it because she was so worried about me having pneumonia?

I couldn't remember any medication discussion, and neither could Nick.

So according to Terri, there's a medication that is not new, but it's newly available to a lower-risk group of people than before. Because I had lymph involvement, I now qualify. And so they wanted to know if I wanted to try.

I know that I had a .3 mm spot in the one lymph node they removed. I know this. And I know I didn't need chemo, and my scores were so good that radiation was optional, so after a second opinion, I decided not to.

Because there might be more in other lymph nodes, but there might not. And radiation has its own complications.

At first I worried about my decision all the time. And then, after a while, I just kind of stopped thinking about it.

I know the facts, but I don't feel them all the time. Sometimes I ruminate. Sometimes I what-if, particularly about my parents.

But I try not to do this, because it doesn't solve the past. It just hurts me now.

You have to live.

But suddenly, there I was, feeling the big anxiety feelings again.

This new medication would be in addition to, rather than replacing, my current medications, and would  further reduce the risk of recurrence.

The risks, because there are always risks, include liver injury and heart problems, so they monitor you carefully in the beginning.

So Nick and I were like, it seems like you think it's a good idea, even though it's adding another medication with possible side effects?

She said yes. If I couldn't tolerate it, then I'd just quit taking it. But no harm in trying.

It takes a while, because it comes from a specialty pharmacy, plus insurance has to approve it, and that is its own process.

So maybe I'd be starting it in the new year.

It felt like something huge, adding another medication. 

And I'm already on medication that makes my joints hurt, and it's aging my skin, and when I look in the mirror, some days I feel like I look like that actor who plays River Cartwright's grandfather. If you've watched Slow Horses.

Although a friend assured me I don't look like River Cartwright's grandfather.

But even if I do, that's just vanity. I want to be around for my kids.

So then I wouldn't want to not have tried, because what if I didn't try, and then down the road it comes back?

And then I'd be all, fuck a duck, I should have added that other medication.

Right?

This news felt so heavy.

Maybe it's because it's winter, or maybe I just got used to things being the way they are, whatever that might be.

We talked about it on the way home. Of course I should try it. Then no regrets.

Then, shortly after we got home, Terri called me. She'd spoken to the oncologist.

As it turns out, the oncologist hadn't offered it to me because I don't qualify. My risk of recurrence isn't high enough for this study. My tumor wasn't big enough in the first place. And I only had a micro-met. 

Metastasis, but super tiny, which they call a micro-met.

Like if you get introduced to someone, but only briefly. Steve? Oh, I micro-met him at a party last year. 

I was like, "Wait, so now I can't have this medication?"

She said, "You're too low risk. It's a good problem to have."

Which is, of course, true. Being too low risk is a good problem to have.

But then suddenly I felt like I had this amazing option taken away. Like, what if this was the solution, the thing that bumped me over into safety from a future problem I might not even have?

When, realistically speaking, it might've given me annoying side effects for three years and not made any difference.

You don't know until you know. Which I guess is true about everything.

But now it's been four days. And the discounting has begun happening. Monday felt like crisis. Tuesday less so. 

It's Friday, and I can talk about it in a more dispassionate way, because I just don't feel it so much.

And plus, now we are in the end-of-year-holidays-are-upon-us frenzy, and there are so many things to do. 

The tree us up, and that's a whole nother thing, and holiday sads do catch me unawares and wallop me every once in a while.

So actually, while I'm thinking about it, I would definitely take a coupon for a massive discount on those feelings.

Hallelujah "nothing concerning"

I put that in the title because I hate it when you click on a link thinking you're going to get the number of minutes to cook unsoaked beans in the Instant Pot, and then you have to scroll through many paragraphs of how the blogger backpacked through Albania.

I want to thank all my kind friends who offered words of love and support on FB, in messages, in texts, and on the blog. I'm tremendously grateful for my community. 

And my goodness, I'm so relieved.

At Georgetown, at least from the entrance we use, you have to pass the Pope and photographs of other figures of historical import to get to appointments. The Pope gets his own sort of corner, though, which I think you can see.

I had to turn right at the Pope for surgery. I go straight past him for my regular appointments.

When I sat on the table the radiologist asked if I had any questions. I got all teary and was like, "Well, I guess what I want to know is if it's more cancer."

I don't even know what other question I'd have.

I said, "My tumor was behind my left nipple, and this little bump is under my left nipple."

So it's not an insane leap to imagine both implants removed and going through chemo and radiation.

These are actually possible scenarios with a recurrence.

This is not like envisioning sliding down the inflatable slide onto the life raft, imagining sharks circling just because you hit the kind of turbulence that makes pilots use their stern voice when they tell you to fasten your seat belts.

I told the radiologist that my surgeon thought maybe it was fat necrosis, and he said he couldn't say what it was, but the appearance was consistent with fat necrosis. 

Mostly we talked about the Hinkley Hilton, which he calls the Reagan Hilton (while I don't call anything the Reagan anything), and the Air Florida flight that crashed into the 14th Street bridge (and which, oddly enough, the dad of my friend Debbie had crossed just in time). We lived in the US the first time during both those events.

I also learned that he was born in Georgetown Hospital after his parents immigrated from mainland China. 

I don't know if I should capitalize mainland?

Basically, the radiologist said he saw "nothing concerning" and he had me sign a paper saying he'd given me this information. 

I don't recall having to sign a paper before, but to be honest with you, the other day I couldn't remember the word for dresser. I was talking to Nick and India and I said, "It's like a table with drawers that you put your clothes in."

So maybe I always sign a paper?

The radiologist told me to follow up with my surgeon, and then told me that she'd have ordered a biopsy if she were particularly concerned.

I found that extremely comforting.

So I texted my surgeon to say he found nothing concerning and wants me to follow up with her, and she hearted my message.

I don't know how I would fare with dating in the age of texting and emojis.

I had a flip phone (ooh, and also that wonderful Nokia brick, if any of you remember that) when I was doing all that Internet dating, which only partially explains realizing en route to meet a guy for a Match date that I couldn't remember his name. I had no time to go home and log into my computer. We hadn't talked on the phone.

Anyway, when I checked out I asked if I should make an appointment and they said she'd contact me once she'd seen the scans if she wants me to do anything further.

Phew.

And at least I know that I will see the oncologist in under three months and my surgeon in six, so that's helpful.

But for now, whatever this is is "nothing concerning" and I will take that. 

If I learned anything from Nicole last year, it is to dress up to feel better. So the photo above is what I wore this morning.

It's fall, which is not my favorite, because of course it is a precursor to winter. But at least it's sweater and boot weather, and I love both of those things.

I cannot take my antidepressant in conjunction with my aromatase inhibitor because for whatever reason, it makes my hips hurt like holy hell.

So I need to get out in the sunshine, and use my full spectrum light, and eat well, and exercise, and do all the mental healthcare things.

I know all these things, and I need to do them all consistently.

Yesterday, though, yesterday I ate an entire box of palmiers from Costco, and if you go to Costco, you know they sell everything in packs of five million.

Often when I'm stressed I just don't eat. 

But yesterday I ate one palmier after the other after the other while watching Love is Blind (which Nicole thought was a show about blind people). 

I never watch TV during the daytime. I did laundry concurrently to mitigate daytime TV guilt.

Some days are just like that.

I think despite going to yoga I was basically holding my breath for 10 days. And now I need a big cry. 

I used to cry almost every day. If I felt it welling but not coming out, I'd watch the English Patient. Back then, I had more time to commit to sobbing over a beautifully filmed three-hour romance tragedy. And I knew which scenes were my triggers, if I were short on time.

But I haven't watched it in over a decade. Could I just skip to where he's carrying her to the cave? Would that still work?

I'm so incredibly thankful to currently be in the position to be wondering about this, rather than making all the appointments and plans I was terrified I'd have to start making.

And that's where I am today.

The lump

When Jordan was little, and we couldn't find something, I'd say, "Jordan, where is it?"

I'd shrug my shoulders and put my hands in the air like I just didn't know.

He'd mirror the gesture, looking at me very earnestly. He'd shake his head, and say, "It's SOMEWHERE!"

Which is always true.

Ever since my surgery last September, I've had a checkup with oncology every three months, and with my breast surgeon every six months.

About 10 days ago I had my one-year check with my surgeon.

My last oncology checkup was in September, when I was in the throes of pneumonia, and that's what the oncologist was most concerned about.

I don't have scans, because I have practically no breast tissue. Basically, I get felt up every three months.

Nick took me to the oncology check because I wasn't strong enough to go by myself. Otherwise I'd have gone alone.

I told Nick I didn't need him to come to the appointment with my surgeon, because all the checkups so far have been very routine. 

Everything feels fine, you look good, see you next time.

But of course, everything is fine until it isn't.

Because at this check, my surgeon found a lump.

She immediately said she thought it was nothing to be concerned about. "Fat necrosis" was most likely what it was. Very common, not a big deal.

She was all, "I don't want you to get all anxious. This is going to be nothing."

But of course I started crying. I started listing the choices I made, saying I should've made different ones. 

No, she said. I did everything I should do.

We were at the downtown building rather than the hospital, and she sent me to the radiologist upstairs to see if they could fit me in, because she could then just run up and take a look.

They don't do breasts on Fridays. 

It took me a bit of time to get an appointment. In the meantime, I've googled.

Fat necrosis is common after trauma like surgery. Fat cells die from lack of blood supply. They make a lump.

This makes a lot of sense.

But of course, I've catastrophized. I'm a catastrophizer.

And I work fast.

Way back in my singleness I'd go on first dates and by the time we'd had a glass of wine I'd mentally have married and divorced the guy.

So.

First thing Wendesday morning, I'm going for a scan.

It's either something, or it's nothing. 

I mean, it's something. 

It's just either something no big deal, tantamount to nothing, or it's a really big deal.

A shark smile in a yellow van

Two days ago I got this sweet message: I do so hope you are alright.  I miss you. Please come back.

I owe the writer such thanks.

Because I couldn’t have said what I needed to start writing again—because I missed this place, but didn't know where to start—but it was exactly what I needed.

In the summer in DC, when our doors swell with humidity, we have to give them an extra push or pull to open them.

I’m so grateful for that kind and gentle check-in. The lovely sentiment. 

I just realized that I’ve been sad, like desperately, scraped-raw sad, for coming up on a year. I’ve been some level of scared for nearly that long.

I haven’t been alright, though I look like it from the outside.

I just needed some help recognizing it.

I've said before that I so badly wanted to be back to normal.

Normal. Ha. But you know what I mean.

I only started really processing the magnitude of all of the everything quite recently.

Somehow the time between the night of May 2, when my mom fell, and this February was just so, I don’t know, frenzied is maybe the word.

Betty left us on May 15. Her days in the hospital were brutal. And I'm dreading Mother's Day. I don't think I'll celebrate it again.

Weeks after her death, I had a high school reunion to host. I couldn't cancel. Friends had bought international plane tickets. And it would feel so good to see everyone.

Which it did, of course it did. We remembered Betty and cried together. And laughed. And danced.

I had a houseful of friends staying. (Those same friends would return in September to surround me with love.)

And then a couple weeks later I drove the kids to Maine. And drove home. And got on a plane.

And flew for 25 hours to Bali, where I spent all day in yoga teacher training and also went out and sobbed in the rice paddy at least once a day.

Sometimes people noticed me leaving class, and someone would escort me, or quietly come sit with me. Sometimes talking, sometimes just sitting.

One lovely, lovely woman told me on the last day that she’d avoided me for much of the course because I just had so much strong emotion.

She didn’t say it was overwhelming, but I imagine it was. 

I imagine I was.

I remember not knowing I was intense until I was in my 30s, and someone told me and I was surprised.

So whatever I am in the moment, I think I am very much of it.

I went to Bali to escape. 

Yes, I was already signed up to do yoga teacher training. But mainly in that time, I desperately wanted to be away from our house. Away from the place my mom fell. Away from home where, everywhere I turned, there she used to be.

Grief streamed from my eyes. My mouth. My pores. I sweated grief. 

Grief surely swirled and crackled around me like static electricity.

If grief had a smell, I think it would be lightening. Apparently the smell is ozone, which is way less poetic but probably easier to rhyme.

Even when I was laughing—and we laughed a lot—the base note was grief.

I’ve said before that uproarious laughter and hysterical sobbing are millimeters, instants apart.

Two sides of the same coin. Maybe closer, even. The warp and weft of fabric.

I learned on the last day of training, and was embarrassed to know, that my classmates heard me sobbing in the rice paddy.

I cried so hard it physically hurt. I was so desperately sad, it didn’t even occur to me.

And then I came home. And then we got the kids, and went to family camp.

And then I had my biopsy, surely nothing, let’s just check.

And then I had cancer.

Suddenly, I went from I just have to get through my mom’s memorial service before I can breathe—before I can make plans, before I can resume life—to getting through her service, and then my operation, and then my recovery.

And then I’d be able to breathe. Plan. Resume.

Nicole, my god what would I have done without Nicole, came for two weeks to take care of me, as you know.

Nicole is a force of nature. Nicole is an event.

Then suddenly it was Thanksgiving. Then our family went to England for Christmas, to avoid the memories we hang on the tree and the sticky buns Betty is no longer here to make. The perfectly wrapped packages she’ll never wrap again. The stockings she was always excited to fill.

It was better, but grief still found us in Hyde Park. India and I hugged and cried while Nick and Jordan looked at the ducks.

But nothing stops. And I kept moving. 

And then Nicole came back, so Nick and I could go to the fancy event in Oxford. I’d never been in my life, then twice in a month.

So fun! So extravagant! So lovely!

Nick asked, and Nicole said she’d come take care of the kids if she could stay two weeks. And then Maude said, well, if Nicole’s coming, then I want to as well.

It was as wonderful as one might think. We chatted and we laughed and we wept. Maude brought starter from Denver and taught me how to make sourdough.

And then.

Then they left. And the house was very quiet.

Valentine’s Day, I think, is when I really started falling apart. But inwardly.

Inwardly apart. Apartedly inward.

Imploding?

We once went to a carefully orchestrated demolition. All these explosions were placed and timed such that the building would cave in on itself. It didn’t even seem violent. 

Emotionally like that.

Not that I didn’t cry regularly before then, because I did. But like a shark, I kept moving, moving, moving.

Water over the gills to keep breathing.

Apparently, this isn't every type of shark. I looked it up. So, hashtag notallsharks. The ones that need to do this are called obligate ram ventilators.

ANYway.

You can’t outrun yourself. I guess this is one of those lessons I seem to have to learn over and over.

I wasn’t seeing my therapist, because though I love her, it just felt too hard.

One of my yoga friends noticed. She looked me in the eye after class one day and said, “How are you?”

I started to explain about the physical, and she said, “No. You. How are you?”

I started to cry, right there in the gym. I was not fine. I was not remotely OK. In fact, I was barely even breathing. 

On the outside, I look strong. Healthy. Healed.

I’d been cut open and sewn up by world-class experts. At this point I have delicate scars. I’ve got high grade silicon implants that are my personal forever science experiment.

I think about how the rest of my body seems to be degrading at an accelerated pace, but these are fairly static. 

Like, one day I'll die, and my body will hollow, which I know firsthand happens. And still, barring previous calamity, I'll have these two youthful silicone shapes, pretending to be part of me.

You know me. I’ve long had anxieties about a whole lot of things. Mainly like plane crashes and raccoons and rabies and sink holes.

Somehow breast cancer was not on my fear list.

Also: the more I learn about neurodivergence, the more it explains my life. Not ever human picks one topic to obsess about endlessly until the next topic catches their eye.

But I digress. Because when do I not?

Suddenly there it was, top of my fear list, its own circle in the Venn diagram of my life. The bold heading of one of the now-myriad clubs to which I never wanted to belong. 

I picture my Venn diagram more like a chrysanthemum, because I like them. I don't care about the factuality.

So, I just had my six-month oncology checkup. I have my surgery checkup next week.

I thought they’d take blood, analyze the results, and be like, yep, you’re good, see ya in three months.

But it doesn’t work like that. They don’t know.

You just have to keep living and hoping for the best. There are no for sure answers.

Although I guess that’s really all of life.

The day of my checkup, I also had an infusion for my bones, because the medication I’m on can cause osteoporosis.

A common (78%, I googled) side effect of the infusion is feeling like you have the flu.

I taught a yoga class the next morning and thought maybe I was in the lucky 22%.

By that afternoon, I could barely walk.

And for a day and a half, I felt like hell. I knew I wasn’t sick, but I also couldn’t get out of bed.

It was reminiscent of post-surgery, which I’ve kind of forgotten, but which wasn’t that long ago, after all.

It’s surreal, honestly. For two weeks I had tubes coming out of my body, attached to silicone bags I had to empty every day. I know this is true. But I don’t remember it.

I couldn’t take care of my family. I couldn’t fully take care of myself.

In bed with the not-flu, I read a Louise Penny book. I intend to start using “tabarnac” as a swear.

But then, I also intend to swear less, and I can’t say that’s going well.

Tabarnac!

At this juncture, it feels like it’s been cold and rainy my entire life, though I know that’s a factual impossibility.

I took the photo above about a month ago. My hair was clean. I was wearing makeup. I liked my outfit. 

Ever since Nicole visited, donning something fabulous daily, if only to hang out and walk to CVS, I’ve had the goal of wearing real, non-gym friendly clothes every day.

I probably accomplish this about 50% of the time. Or maybe 25%? I am, after all, a person who asked for something to be mixed 60-30.

Not most of the past week, but today I'm wearing jeans. Jeans count as real.

Anyway, I’m here.

I’m not very alright, but probably more so than not. 60-30. Anyway, I believe I will be.

Love and hugs,

Lisa

Will it ever stop? Yo, I don't know!

I think, on the whole, that I have a pretty good fucking attitude.

I have my low moments, for sure.

Nick called earlier to say hi, and I'd just been upstairs in my mom's room. And so while I'd been sending him breezy texts, the moment he caught me, I was crying.

The thing is, I know I'm crying for me. For my kids. My mama, she's fine. It's those of us left behind who hurt.

So once I stopped taking Anastrozole last week, my life improved day by day.

By Saturday morning I was feeling good enough to put on this superhero outfit and head to a neighbor's for brunch in honer of a mom from our school who moved away years ago.

Before that I nipped over to the farmer's market, and I got the last Swiss chard.

The guy selling bread complimented me on my jacket, which I got on Facebook Marketplace. That place is a wonder. 

I don't even particularly like Swiss chard. It's just supposed to be really fucking good for you.

And I have a high tolerance for ingesting stuff that's good for you. Like, I can make myself eat or drink pretty much anything if I have to.

Anything not animal, I mean. Like, no blood pudding or tongue or calf heart or what-have-you. Although do those even fall in the category of good for you?

So last night I sauteed the Swiss chard, and Nick tried some, because he's trying to say yes to vegetables even though on the whole they make him want to burn the house down. He was like, "It tastes like not very much of anything."

I ate a whole bowl of it even though I totally agreed. 

He said, "Maybe in a smoothie?" Which reminded me of why I make the smoothies.

So now I have to go to the post office, and honestly, our nearest post office is staffed by one of the meanest humans around.

In the spring I was trying to do a return of the Fleabag jumpsuit that I'd bought for my high school reunion, but the size was wrong. So I wanted to pop it in the mail back to the UK, until I realized that mailing parcels to England costs a million dollars. 

Anyway, I will not bore you with the details, but the woman behind the counter was so incredibly mean. And then the shipping cost was crazy.

So after she told me the cost, I said, "I'm going to take this over to UPS. Where they're nice." And then I told her the actual definition of a word she'd been using loudly, repeatedly, and incorrectly.

I can't even remember it now. 

Did I need to do this? Of course not. But at the time, it felt necessary.

I don't care how smart you are or aren't, and I keep my mouth shut when people use words incorrectly. 

Unless you'are a giant strobelight bitchfaced bitch on wheels to me, apparently.

So I walked down the street to UPS and asked if it would cost a million dollars to mail something to the UK.

The guy laughed and was like, "Maybe?"

I said I'd just been at the Post Office up the street to mail it and the woman in there was so mean.

Another customer turned from the other counter and said, "Oh my god! That woman is so fucking mean!"

She had her own whole story. I've repeated this and multiple people in the neighborhood have agreed. Apparently, it is known.

Anyway, the UPS cost was prohibitive--like, more than the item had cost in the first place.

So now I know not to order from England. I was used to Boden, where you return it for free in the US.

Why why why is it so expensive to send stuff to the UK?

I think I'll post it on Marketplace.

In any case, I have to go. Even without the mean lady, the Post Office is one of my impossible tasks.

I tell people not to leave stuff at my house, because it will take me eighty-five years to mail it.

Oh my gosh. And I now! 

Now I have been instructed to restart Anastrozole, but they're also calling in a prescription for anti-nausea medication, because I told them I was scared to take it. 

I cannot handle the nausea. I just can't.

The nurse told me that the nurse practitioner said that nausea was a very unlikely side effect of Anastrozole, but they're happy to give me Zofran. But to be mindful if I'm taking it regularly.

Apparently Zofran can make you constipated. Several friends told me this.

But between nausea and constipation? No contest. 

(And they're welcome to tell me that it's a very rare side effect. OK. It's my very rare side effect.)

In fact, I don't think I'd choose nausea over any other kind of discomfort. I mean, certainly over like losing a limb or something.

But otherwise, I think it's top of my list of terrible bodily feelings.

Anyway, that's me and my great fucking attitude.

How are you today?

Greetings from the pit of despair

Four days ago, I started taking anastrazole, an aromatase inhibitor.

Totally different AI than is all over the news.

I feel like aromatase sounds like a police weapon. Like, "We aromatased him. He's still armed and violent, but now he smells like warm vanilla and amber."

Anyway, the oncologist had told me that the side effects of these drugs, which block estrogen so that any possible little breast cancer buddies have nothing to eat, are hot flashes, muscle and joint pain, and osteoporosis—although you get an infusion every six months to help with your bones.

I was like, oh, it'll be fine. I had all the hot flashes, so if I have a few more, they won't be that bad. And my hips already hurt, so I have that covered.

And I asked what I could do for those. (Like maybe was there a joint pain infusion, too?)

She said, "Exercise, especially yoga, is really helpful."

Oh. Yoga. I should try that.

I sleep with a fan blowing directly on me all the time. And my hips are screaming. Will this improve with time? I have to ask.

And now I have a headache all the time.

I've been thinking that surely I can't have a headache for five years...can I?

So I was kind of primed to fall into a pit of despair yesterday when I started reading in depth about invasive ductal carcinoma.

Prior to surgery I wasn't googling—Maude stayed up way too late and did that for me one night. She gave me the highlights of invasive lobular carcinoma.

I didn't know what lobules were before I was diagnosed. They're the glands that produce milk, and then the ducts carry the milk to the nipple.

It's the second most common kind of breast cancer. The most common kind is invasive ductal carcinoma.

When the breast surgeon drew the picture of the breasts to explain, the lobules looked kind of like broccoli. I had cancer in my broccoli.

So I knew that it was the second most common kind, and I knew from Maude that I was super duper lucky that the radiologist caught it so early. Because this kind grows in a linear sort of way, whereas the ductal kind causes a lump.

So this cancer of the broccoli is typically not caught until it's quite advanced and palpable.

Lucky lucky lucky.

Yesterday I started googling ILC and radiation to see what I could find.

Basically, thought it's the second most common kind, it hasn't been all that extensively researched. So when doctors are telling me they don't know the best thing to do, they really fucking don't know the best thing to do.

Also, it's more likely to recur than ductal. Typically years out, but sometimes sooner than five years. So maybe in a couple years or maybe in a lot. Also, this kind has more places it likes to go.

Because of it's particular characteristics, including being fed by estrogen and progesterone, it's well treated with endocrine therapy like AI. 

But! This kind also likes to become resistant to these therapies.

Fuckity fuck and more fuck.

This feels the opposite of lucky.

Why can't I be a normie?

So yesterday my OK/Terrible scale tipped all the way past terrible into a viscous pool of abject hopelessness.

I sat around looking at yoga clothing on my phone and trying to breathe deeply.

But the weird thing is, I'm well trained to look for the funny when things feel very bleak.

I think it must be training. Or maybe it's genetic.

I can't find the post, but somewhere in my archives is a story about visiting my dad in the hospital several weeks after a suicide attempt.

He'd been intubated for a while, then they made a hole in his throat for him to breathe, because they didn't know if his trachea had been crushed, and wouldn't know until the swelling subsided.

When he started talking again, it was in a whisper.

At one point, he had a roommate who only spoke Spanish. And he was waiting for the translator to come to help him communicate with the doctor.

I asked my dad if he wouldn't like to just translate for the guy. He shook his head.

And he whispered, "He's crazy."

This is just how it is.

There are always going to be funny things. Like, in an hour, the time changes. 

Sunday morning I'm going walking with a friend. She texted to confirm. "9 am? And remember, the clocks change tonight."

I thought about texting back that 9:00 would be 8:00, but then I didn't want to be confusing. And actually, the new 9:00 is actually 10:00.

This is the week I drive Nick particularly crazy.

So there's shit like this to fixate on, because the world still moves forward.

But the truth is also that it's very, very scary to think about. I think about pain, possible treatments and loss of function, and actual life or death.

I know that even when things are truly, brutally awful, I still more forward, one foot in front of the other. Even doing silly walks. It's just who I am.

So I know I can do hard things.

But why do I keep having to?

And when you're 15 feeling like there's nothing to figure out, well

The Oncotype results came back earlier than expected!

My score out of 100 is 15.

The medical oncologist called to tell me, and I could hear the smile in her voice. A score under 25, she'd said, would mean no chemo. So no chemo!

Happy happy dance!

My gosh, I needed this good news!

So then I spoke with my radiation oncologist, who said, yes, great news that my score, being under 18, does not automatically mean radiation! 

But we still might want to do radiation.

Oh.

She reminded me that it's a grey area, where there isn't much data. It's not clear what would be best.

Basically, it's up to me how to proceed.

Up. To. Me.

I decide? (ME??)

This gave me the same feeling I had when the midwife asked Nick if he'd like to catch the baby.

And I was all, "No! What does he know? I want someone who knows what they're doing to catch my baby!"

I mean, this was the man they'd recently sent to stand up near my head because he made fun of me for pooping on the delivery table. 

They were all, "You don't get to stand down here anymore."

I told this to Leigh today when we spoke about the results and how I need to decide what I am going to do. She loves math and statistics, so I texted her the numbers that my doctor went through with me.

My chance of recurrence is 5–10%
Radiation reduces this to 2–5%

However.

Possibility of damage to heart is 1% or less
Possibility of damage to lungs is 1–3%

Also, radiation will shrink and harden the implant on that side, although to what extent varies person to person. And the surrounding tissue will tighten, possibly to an uncomfortable or painful extent. Or not.

This could mean more surgery. Or not.

It can also cause lymphedema and cording. This happened to a good friend of mine.

But might not happen to me. Bodies react differently.

So when I told Leigh the parameters for the Oncotype test, and how it's for my specific and very common type of breast cancer, she totally understood and tried to explain how they'd use data sets and modeling to be able to predict outcomes with a high degree of accuracy. You could hear the enthusiasm in her voice.

Then we talked about how 5% doesn't seem high...but 10% does.

So then I said, "But there's also this 1% chance of heart damage. So if you minus the 1 from the 5–10, it's more like 4–9..."

And she said, "Let me stop you there. Because that is definitely not how the numbers work."

"Oh."

"Yeah. You don't get to stand down there anymore."

Good thing I'm a writer and not a nuclear scientist.

She's so unusual

When my surgeon's nurse practitioner gave us the update last week, I held my tears until she left, and then sobbed on Nick.

I'd been given the choice of mastectomy, or lumpectomy with radiation. I chose mastectomy.

This was supposed to be straightforward. Mastectomy would fix it.

But as it turns out, I'm unusual.

My surgeon came in and said this was completely unexpected. My tumor was so tiny, in the middle of my breast. And caught so early. 

In surgery, they typically remove 1-5 lymph nodes, two on average. With me, she removed only one lymph node, which looked fine. 

Until oncology examined it. 

At which point they found a tiny—.3mm—point three, not three, millimeters not centimeters, bit of cancer. Like, a pinprick worth.

A pinprick of cotton candy would be one thing. A pinprick of cancer is still cancer.

It's one lymph node. But she only took one. Because typically with tiny tumors, caught early, there is no spread.

One. So it's 1/1 that's positive. Not 1/2 or 1/3. Just one. 

So, like 100% of the ones they removed.

Fuck.

She said, started to say, "Your case is so interesti..." She caught herself. 

I'm sure it is interesting, scientifically speaking. I didn't begrudge her the finding it interesting, though I myself do not. I find it traumatic.

"Your case is unusual. You're an outlier. I'm going to be taking your case to the cancer conference on Tuesday."

I've heard other doctors refer to it as the "tumor board"—which my friend Brian said sounds like the worst kind of charcuterie platter ever. 

Come over! We'll have a nice pinot noir and a tumor board!

If I were under 50, I'd be getting chemotherapy as a matter of course. But I'm not.  There is the possibility of radiation. But the benefits may not outway the risks.

I'm in a grey area. I've heard this over and over.

Twenty positive lymph nodes, and it would be one very clear course. None would be another.

However.

This is unusual.

Some years ago my mom told me that shortly after we moved to the US and I was starting college and my brother was starting high school, he brother asked my mom if she thought he'd ever have a normal childhood.

We'd just moved from India. Our dad had recently attempted suicide for the second time.

And she said no. That ship had sailed.

My dad was mad at her for dashing my brother's hopes of normalcy.

Which, I think we can all admit, is hilarious.

In college, I tried so hard to blend. I was surrounded by people who looked like me, and I felt nothing like them.

I never really did blend, but as I got older, normal ceased to be a goal. Far from it. As India likes to say, "Who wants to be a normie?"

Not me. Except right now.

They sent the tumor off to Oncotype, which analyzes the genetics of the tumor, which are different than one's own genetics, and you get back a statistical analysis. 

They give you a score, which says how likely it is to recur somewhere else in the body.

Hopefully that comes back next week and gives them some guidance.

She also set me up with CT and bone scans. 

Which I was supposed to get today. 

But because American health care is dictated by for-profit, parasitic insurance companies who have yet to approve these scans, the NP canceled the the scans so I wouldn't be stuck with a huge bill. 

A CT scan with contrast can approach $7,000. With no guarantee of reimbursement.

We paid $650 out of pocked for a necessary but not-yet-approved MRI, which insurance approved days later. We are awaiting reimbursement.

I've been up and down, but honestly, on the whole I'm pretty good.

Some days I have to force myself to have a good fucking attitude. I make myself count my blessings.

But a lot of days, I just do. I'm grateful for so many people, so many things. Physically, ever day is better than the day before. This has been the case since day two.

Like I said before, I'm healing really well. I can raise my arms up close to my ears. Not quite as close as I usually can, like in warrior one, but close. They want me doing this, so my scar tissue doesn't restrict me.

I keep asking them if I can do yoga yet, and they say no, not yet. But can I hang from a bar? Also no. Go upside down on the inversion table? What? No.

They don't get those particular questions all the time.

Not from the normies, anyway.

Goody bags for vampires

Just to let you know, this post is about replacement boobs and drain tubes. So if this icks you, which is understandable, stop now.

Because there's even a photo with tubes and collection bags, which I put down at the very bottom of the post so nobody stumbles on it accidentally.

You've been warned.  

So. 

Eighteen days ago, I had a double mastectomy with immediate reconstruction. They removed 98% of my breast tissue, and once the breast surgeon was finished, the plastic surgeon put in two gummy silicone implants.

They also put in two drain tubes--one for each breast. I've spoken with three women, all of whom had two per breast, so four tubes, and four drain bags.

My tubes exited my body via a small hole on each side near my ribs, and then drained down into attached bags that collected the fluid. My drain bags were hand-grenade shaped clear silicone containers.

The good thing about these is that you don't have fluid buildup inside your body. It drains out. The danger is infection, as you have two holes in your skin being held open by tubes, plus these two tubes that start well inside you. 

So before you open the grenades, you wash your hands. You clean the open-close thingies (there is a word for this but I'm still pretty vague post-anesthesia) with alcohol before closing them.

The tubes are long, which is why you have clips for the drain bags. Otherwise they'd dangle and pull and bug.

I was instructed to empty them twice a day into a measuring cup, and then record how much liquid I was draining per side. You also have to "strip" the tubes--meaning you squeeze them from top to bottom to make sure they didn't clog.

After, you'd squeeze all the air out of each grenade to create a vacuum, and seal them up again.

The first night Nick emptied them for me. I couldn't imagine doing it, ever. But at that point I couldn't really imagine standing up unassisted, so.

By the next day, it was fine. Open, pour, measure, disinfect, squeeze, close. Weird, but fine. 

And then I'd stand there with a cup of blood thinking how bright red it was and looking at how much to write down. In the beginning it was 60 ml if I added up both sides.

Every time I did this, I felt like watching Twilight. Even though I was well into Buffy, as planned.

It took me a while to realize why.

And on a side bar, the plastic surgery nurse practitioner, whose name is Tammy, told me that her husband, who is from Spain, learned English watching Buffy. She was all, "Real people don't talk like that."

This is true. Real people don't talk like that. Also, Team Angel forever.

Now, if you're a person who picked at scabs as a kid, or if you popped pimples, then you may understand that stripping the tubes could become oddly compelling. Trying to get every last bit out of the tubes and into the container.

So these tubes, or anyway, mine, started on top of the implant, curved around the side, and exited my body over by my ribs. 

I didn't know this until my one-week appointment with plastic surgery. Or rather, I didn't think about where they started. Just where they ended.

The nurse who put me in the room told me to take everything off my top and put on the gown.

And I was like, "Even THE BRA?"

She said, "You haven't removed the bra yet?"

Oh, hell no.

I'd been wearing the recovery bra since surgery. When they sent you home in a recovery bra, they tell you you have to wear one 23 hours/day for 4-6 weeks.

Since I couldn't get the surgery or drain sites wet, and I hadn't made the jaunty trash-bag top they'd said I could use to keep that part dry, I was just bathing myself in pieces, using hospital wipes for my top half and leaving the bra untouched. 

I didn't want to see it, or touch it, or even give it much detailed thought, if I'm being honest.

The nurse said I could leave it, and Tammy would help me.

When Tammy, came in, she was delighted with my range of motion, my ability to move, my overall whatever.

Maude and I met Tammy at my first appointment. This time I introduced her to Nick and Nicole.

Tammy opened the bra to discover I'd also left all the pads that had been inserted as cushoins post-surgery. I was wondering why they'd included so many abdominal pads along with collection cups and alcohol wipes.

Because my bra was stuffed full of them.

Tammy very pleased with the way my surgical scars were healing.

A+ in healing! Same pleased feeling I get when my dentist tells me it's clear I've been flossing.

She said, "Do you want to see them?"

I looked down and the first thing I saw was two dark, curved ridges poking up under my skin. I think I squeaked.

Tammy said, "Those are just your drain tubes." 

Horror show. They looked black, but I assume that they were dark red, as the tubes themselves were clear plastic.

"Agh! It's like Guinea worm!"

Then I looked at the Tammy. "Do you know Guinea worm?"

I was all ready to explain Guinea worm, and how once they've reached maturity in your body you see them just under the skin...and then they make a hole and burst out and you have to slowly wind them around a twig or pencil or something until they're out.

But she said, "I do. I'll get a stick."

Tremendously impressed.

So I couldn't look, but Nick and Nicole and Tammy, none of whom were grossed out by the tubes, all examined them and agreed that they looked terrific.

Even at home after that I couldn't look. Every parasite I've ever had was intestinal.

We returned last week and Tammy took out my drain tubes and pronounced me fine to take a full shower.

Now I can look at them, but they're still weird.

She assured me that the weird dents from the tubes would smooth out. And in fact, I should not rush out and spend money on a nice bra for the next six months, as there's still swelling and shifting and what have you.

The best way I can think of to describe how they currently feel is abraded. Like maybe I dragged back and forth across gravel for like an hour.

Which I have not done.

And which would still be better than having Guinea worm.

Let me explain...No, there is too much. Let me sum up.

India and I take turns saying, "I miss Nicole!"

India will add, "Whyyyyyy does she have to live in Texas? Why can't she live here?"

We would like everyone we adore to live right next door.

So before I tell you about Nicole, I feel like I need to tell you about Nicole.

After I got diagnosed, Nicole offered to come and take care of me. She reiterated this offer the weekend of my mom's memorial service, 10 days before my surgery.

She'd nursed her own mother through this, and Nick had to be away for five days for work not long after my surgery.

I took her up on the very kind offer.

Nicole and I met in high school in New Delhi.

We both arrived shortly before school started. She was two grades ahead, and she was gorgeous and fabulous and so charismatic.

Really, really smart, but could came across as a party girl. And did. Not. Care. What people thought. 

This kind of confidence is so attractive.

She wore a bandanna around  her head (this was the 80s, friends) and I started copying her. Because she was so fucking cool.

What I didn't know was that she'd been in a terrible car accident, and among other traumas, had had a head injury. She was covering up surgery.

Anyway, we sat together in French, and we lived near each other, and would often walk the 2.5 miles home from school together.

My sophomore year, we were both cheerleaders. I still miss those pom-poms.

Nicole graduated and went back to Texas, and we lost touch. Until a school reunion a couple decades later, where we picked up exactly where we left off.

Which is to say, happy to revel in ridiculous goofiness, content to chat endlessly about clothing, shoes,  and jewelry, and open to discussing anything and everything.

If no longer able to form a cheer pyramid.

She still has a southern accent, and both of us speak really quickly. Which doesn't have anything to do with anything. 

Until it does.

Nicole has this flawless, enviable skin, and dark hair and eyes, and she's always had eyelashes that a camel would kill for. 

If she were in a Disney movie, she'd be an Angelina Jolie-type Maleficent, but also little birds would be sewing her clothing and bunnies would do her dishes. Children would follow her joyfully down the cobbled path.

India and Maude's daughter absolutely adore her. She's a celebrity to them.

Because she's cool and she's FUN.

After our reconnection, Nicole started visiting annually. She'd come for a week, and we'd all have such a good time together.

When Jordan was in Kindergarten, he would sit on the floor of her room very quietly until she woke up, and then he'd ask her to play LEGO with him.

That year, she volunteered to come with us on his class field trip to the zoo.

It was unseasonably hot, and chaperoning small children at the zoo is stressy (what if I lose someone else's child?), tedious (yes, yay, you can count to 500! Overandoverandover!), and exhausting. Exactly the kind of activity that makes me want to throw gin, ibuprofen, and coffee in a blender as soon as I get home and collapse on the sofa.

Nicole maintained a Very Good Attitude, whereas I...did not.

Anyway, one summer after a reunion party, a friend offered to give several of us a ride home. Nicole and another friend and I were lined up to get into the back of the car.

The way we were positioned, Nicole would be in the middle. 

She turned to me and asked if I'd mind sitting in the middle. She said—or rather, what I heard her say was—"I can't sit in the middle because of my crotch scent."

And I was all, well, July in DC is really hot. And Nicole is wearing a short dress. This kind of thing happens.

Naturally, I was happy to sit in the middle. Probably best for all involved.

Somehow, a year or more later, we figured out that what she actually said was, "I can't sit in the middle because of my CAR ACCIDENT."

Truly, I have no idea how the subject arose. But I was all, car accident! CAR ACCIDENT!

And she was all, "You thought I was talking about vaginal odor, and you didn't even blink!"

Listen. 

If you're my ride or die and you call me to tell me you've just killed your husband or some such, I won't ask why. I'll just remind you that I'm strong and my car is large enough to hold a body. 

And that, my friends, is Nicole.

'Tis but a scratch! Day zero: Surgery

I woke up from surgery thinking, "Oh, absolutely not."

No, nope, no thank you. 

We arrived at 5:30 in the morning for 7:30 surgery. First of the day! I'd fasted, and I'd showered twice with the anti-bacterial soap, and I had the button-down PJ top and stretchy pants. 

I was ready.

When the plastic surgeon drew a Sharpie line down the middle of my chest, and then little marks like eyelashes above each breast, I was all, "ARE YOU GOING TO CUT ME IN ALL THOSE PLACES?"

And he was like, "I'm not doing open heart surgery!"

In fact, I have two small slits under each breast. I haven't looked. although I understand from the professionals and loved ones who accompanied me that they're healing very well. 

Me, I'm still freaked out by the drain tubes. But that's a whole nother post.

The eyelash lines were where my boobs used to start, and marked the upper edge where my fake-o ones would be. 

And are now. Weird? Yes.

I poke and squeeze them gently, because they're right there, attached to my body but not really mine.

I mean, yes, they're mine, but I wonder if they'll ever feel normal.

Maybe I'll just walk around for the rest of my life with two comfort boobs attached to the front of me.

I remember meeting all the doctors and residents beforehand, and saying goodbye to Nick, and telling him that I loved him, that it would be fine.

The last thing pre-op thing I remember is being wheeled into the OR with the IV in my arm and the jaunty cap covering my hair. 

And then hours later I was gently awakened. When I very much did not want to be.

They were all, it's over, and now you can wake up, and when you feel better, you can go home. 

As if.

I went back to sleep.

During my C-section, I was awake, if totally loopy and kind of thinking I was Jesus for the way they had my arms straight out from my sides like a cross. When they awakened me from the delightful post-colonoscopy propofol sleep, I was all snuggled up on my side feeling the coziest happy ever.

This time felt more like being stabbed through a demonic vortex and waking up a hell dimension.

Or maybe like if a hippopotamus trampled you but you lived through it, and then someone offered you apple juice.

These people, these persistent medical professionals, they really wanted me to be awake. They wanted me to drink something.

They'd led me sleep a little more and then wake me up and ask me if I'd like some water or ginger ale or juice.

They were relentless. 

No thank you. OK, fine. I'll have this little cup of water with the big pill. And can I please sleep some more in this terribly uncomfortable chair?

"OK. We'll let you sleep a little more,"

Thankyouthankyouthankyou.

And then mere milliseconds later, there they were, waking me up again. "Lisa? From 0–5, how is your pain?"

"Five."

They'd tell me the doctor wanted it under three, if I recall correctly, before they could let me go. So they'd leave me for a bit.

And then again with the, "Where's your pain, from 0–5?"

"Five."

I wasn't angling for the huge, heavy-duty painkillers that I know make doctors nervous. (Thanks, Sackler family, for our painkiller addiction epidemic.) They just add nausea to my pain.

And I'm not a pain complainer. 

I didn't even make a huge fuss when the nurses realized they had forgotten to connect my IV pain meds after my C-section, and just kept telling me to push the button.

And all I kept saying I am pushing, but it really hurts.

Push the button, my ass.

It was five, and I was sticking to it.

If I'd had any wherewithal or sense of humor, I'd have said that this one went to 11.

Bring me a tiny Stonehenge!

Instead, they insisted on waking me up and asking, and I continued saying five. It was five, and five, and five.

They gave me some more IV something painkilling, and more Tylenol, even though I was all, Tylenol doesn't work on me.

Tylenol is bullshit. I stand by this.

They wanted me below Pain 5 and they were very nice. Since my inclination is to always make the other person more comfortable, if I'd been more lucid, I might've been all, "Oh, I think it's at 4 now."

However.

They kept leaving me to sleep and then returning and finally after we'd played the Under Five game 370 times, they said the doctor said I could go home with five.

I...won?

Then I went to another recovery area, and Nick was with me. The nurse there took out one IV but left the other in just in case I fell and hit my head while I was trying to get dressed.

I was both impressed with her practicality and slightly alarmed.

She showed us how to empty my drains, and explained a bunch of stuff that she told me I would not remember, which was absolutely accurate.

And then Nick got the car and they wheeled me out to him, just about 11 hours after we'd arrived that morning.

I remember thinking there was no way I could actually step up into the passenger seat, but then I did. No way I could climb all those stairs to our back door. But we inched up, with Nick behind me, hands on my waist.

They said I could take ibuprofen at home, and I was all, oh, thank god. 

I really just wanted a cup of hot tea. 

I'd had to fast completely since midnight—no more than a sip of water with medication!—and I understand the very real danger of aspiration, plus I'm a rule follower for rules that make sense, so I adhered.

But I couldn't bear the idea of ginger ale or juice. And my throat hurt from the intubation, so I declined the graham crackers or cookies, though I do like a Lorna Doone.

I desperately wanted hot, sweet, milk tea. Tea of my childhood, tea that fixes so many things.

Nick made a cup for me, but then I was too tired to drink it. 

He brought up homemade soup from friends. And I was too tired.

Hours later he came up to find me kneeling at my bedside table, because it was the right height to not have to lift anything, drinking tepid tea and slurping room temperature soup from the tipped bowl.

They were amazing.

Nick helped me to the bathroom and emptied my drains, which, if you've not had surgery that requires the surgeons to leave drain tubes inside that drain out into containers, it's as weird as it sounds.

They send you home in a compression bra, which you have to wear constantly the first two weeks.

They very kindly gave me an extra. These bras, which incidentally are pink, they have plastic loops (also pink) attached so you can clip on the drain bags so they don't just hang. They're thoughtfully designed.

I mean, if you enjoy dangling things from your bra, that is.

15 years: the silicone anniversary

Dear Nick,

When the hospital assigned me a surgery date and time two weeks after my consult, I was relieved.

Then I realized that it was our wedding anniversary!

And then I did math, and realized it was our 15th anniversary! Fifteen seems quite like a lot, doesn't it?

I can't remember if we promised each other sickness and health til death us do part. 

Probably? We went simple but fairly traditional.

Although in truth I didn't actually think about it that way until I really thought about it.

Yes, it's true that I no longer joke about stabbing you in front of you, because it upsets you, but you know I don't fully trust women who don't admit to occasionally feeling this way.

But most of the time I go through life with the approach that you and I will be together until one of us is no longer here in corporal form.

I just didn't think we'd be confronted with more than your deviated septum and Achilles heel business for quite some time to come.

Breast cancer was definitely not on my Bingo card. (I shot the clerk?)

At least neither of us are terribly sentimental about our wedding anniversary. I loved our wedding so much, you'd think I'd be into the anniversary.

I don't think we've ever exchanged gifts for it, have we? Not even a wee vacuum cleaner or bread knife. (I do love my birthday bread knife. Such a good one.)

Still, it seems auspicious, if surgery can be considered so, to do something life-saving on a big anniversary.

A friend recently asked if you were a breast man, and I was like, maybe he'd like to be? But if that were a top priority for a person, I wouldn't be the woman for them.

Still, when I decided to get implants, you did sneak in that the only regret you'd ever heard from friends who'd had implants was that they should've gone bigger.

At which point I was like, "Maude is coming to the plastic surgeon appointment with me."

I'd be lying if I said I wasn't nervous, because it's a big surgery. And I've never had general anesthesia. I've never been intubated.

I saw my dad intubated plenty of times, but those were always under emergency circumstances.

I love my surgeon, and I feel confident that it will go fine. But still.

India asked if I was scared, and I said that what I'm most scared of is not being able to do things for myself. The hospital is amazing, and the surgeons are fantastic.

I asked her what she was scared of, and first she said she was afraid of me losing a boob. I told her that was the whole point. But I'm getting new ones!

She's scared of something going wrong. She's scared of losing me.

I told her that's not going to happen. Because it's not.

Me, I'm scared of not being able to take care of myself. 

Pain sucks, but I can handle it. We're getting Hulu so I can binge Buffy.

But I am so used to doing all of the everything.

My only frame of reference for surgery is my C-section, the recovery from which was horrendous. But since this one does not involve the severing of my abdominal muscles, and because I won't also have a new baby to care for, this should be less traumatic.

Still, and obviously, this is not how I'd choose to spend our anniversary.

In high school, when we did the play Our Town, our parents wept. I played Emily, the female lead, and of course, I thought it was our stellar acting abilities making them cry.

But now I understand that we were just too young to really get it. Adults, who'd lived through so much more than we had, who'd experienced time going by too fast, who'd lost loved ones, felt the message. 

In the last act, Emily, who has died young, has the opportunity to go back for a day and visit loved ones, so she can move on from the living. And she wants to pick a special day. 

The advice she's given is, "Choose the least important day in your life. It will be important enough."

It's easy, for me at least, to find our daily lives prosaic. Sometimes I long for adventure. Something to shake things up.

But then something comes along and shakes things up.

And reminds me that I like the safety and comfort of routine.

I so wish this 15th anniversary could just be a normal day, where you make me tea in the morning, and we text each other our Wordle scores, and you come home late and walk Wanda for the night, and then we sit on the couch and watch an episode of Midsomer Murders with our running commentary.

Instead, we'll be arriving at the hospital at 5:30 am, and I'll be in surgery at 7:30.

When I asked my breast surgeon in the consult if it would take a long time to get on her schedule, she gestured at my chest and said, "Your breasts are very small. It'll take an hour. I can fit this surgery in easily."

Like, with my small boobs, we could squeeze this all in between a Starbucks run and a manicure!

And in fact, my total surgery is 150 minutes. Then a couple hours in the recovery room, and then home. Where you can wait on me hand and foot. Hurrah!

Happy silicone anniversary, sweetie!

Love,

Lisa

Isn't it rich? Are we a pair?

When I told my dear friend Leigh I had breast cancer, and was considering mastectomy with immediate reconstruction, she said, "You get the booby prize!"

She'd gotten in touch about the flowers for my mom's memorial. And I had to be all, oh, hey, I love dahlias and also: I've got a wee touch of the cancer. 

We cried together and then she brought up the booby prize.

You can see why we're friends.

Let me not pretend that I haven't sobbed my guts out, because I've cried so hard I've hyperventilated and retched and nearly fainted.

But apart from that kind of sobbing, so often it's laugh or cry. Two sides of the same coin.

At least, that's what I think.

We did a meditation exercise in yoga teacher training where we had to stare into a partner's eyes and send them loving energy.

I was partnered with this kind, beautiful, truly luminescent young woman. We both started laughing. It started small, and built and built. We shook with laughter. We laughed, and laughed. 

Quietly, not in a disrespectful way.

We kept trying to stop, and then one of us would start laughing again, triggering the other. I had tears of grief streaming down my face at the same time.

It's one of the best, most cathartic experiences I've ever had.

So.

Maude went with me to the plastic surgery appointment.

My breast surgeon got me a last-minute appointment, and Maude and I decided to walk. Since it was a couple miles, I needed to wear sneakers.

It was a beautiful morning, and I put on a pair of bright turquoise capri pants. I think they might've been normal pants when purchased, but my mom lopped them off to capris. Which is a shame, because the color is fabulous, but the length is a little weird. I wear them anyway.

So I donned them, and decided to add new white running shoes with turquoise soles and orange details.

I looked in the mirror, and with these particular pants, they looked like clown shoes.

I turned to Nick. "Do I look like a clown?"

"Yes. Those pants are weird."

And I was all, I *have* to wear a good outfit. At least on the bottom.

Meeting a plastic surgeon is akin to meeting a new hairdresser, really.

I've known my lovely hairdresser so long it doesn't matter what I turn up in, although when I have time, I do try to dress cute, because she appreciates it.

But meeting a new one, I'd try to look like a person who fits the hair I want to have. You know?

So I was running around the house all, "I have to look normal! I can't look like a clown! What if I end up with clown boobs?"

And Maude was all, "Ooh, maybe they could honk when you squeeze them!" 

You might imagine that we went into the appointment in this mindset.

The nurse practitioner complimented Maude on her hair, which is currently blue and aqua. Very mermaidy.

She said though I thought I knew what I wanted, I could change my mind back and forth. She said, "You didn't choose to get cancer. But you get to choose what happens to your body."

This was so empowering.

We discussed implant sizes. I said I'd like to have what I had before two babies sucked the life out of my boobs. And I'd like them up where they used to be.

The plastic surgeon proffered an implant in my proposed size.

Maude put a hand on her breast and held the implant to compare sizing. It seemed totally reasonable.

It was very malleable. Nice and comfortable. It's the gummy kind. I thought it might feel like a gummy bear, but it's much softer.

Obviously, there was more to the appointment. These are the highlights.

When I asked the surgeon if I could take it home, he seemed surprised. "You want to take this with you?"

"Could I, please?"

"Well, you can't take this one, but I can get you another one..."

"That would be great!"

So he left and returned with a bigger, slightly less malleable one that I could take home. He said, "This is different, but you can have it. You really want to take it?"

I said, "Oh, yes! Thank you!" And popped it in my bag before he could change his mind.

Because who would take back an already-bagged boob?

It's nice to hold. Calming You can smoosh it, turn it over. Like a fidget thingy.

I had a house filled with guests last weekend for my mom's memorial service. 

We chatted and passed the implant around.

Sometimes I tuck it into my sweatshirt pocked and carry it around. Kind of like how men play with their whatevers when they're just sitting around.

Hashtag not all men? Because it's true that my sample size is not huge.

But realizing this made me think that if I were a guy, maybe I'd sit around with my hand in my pants while watching TV, too.

It's my emotional support boob.

Although it is true that in the immortal words of Rob Base, it takes two to make a thing go right.

Ever since I got my breast cancer diagnosis, I keep thinking of Ralph Macchio in My Cousin Vinny. 

"I shot the clerk? I shot the clerk?"

I mean, it's been 13 days since the radiologist told me I have breast cancer.

He walked through the details with Nick and me. The oncology addendum gives specific details of said cancer. 

I've now met with two breast surgeons and a plastic surgeon. I've had an MRI.

Still, regularly, I am all, "I have breast cancer?"

Today I turned to Maude all, "Can you fucking believe I have cancer?"

I shot the clerk? 

I already had the practice of going into Rock Creek Park with the kids and yelling. We started doing this in Covid. 

I need to take Maude so we can have a big bellow-fest.

Yesterday morning I asked Nick what he thought I should wear for my breast surgeon consultations.

I did this because when he has something important, I'm always all, "What are you going to wear?"

And he always says something like, "A suit. And a shirt. A tie. And shoes."

So I asked, and he was like, "Something breezy."

I love it when he plays along.

Also: Georgetown breast cancer center gives you a lovely waffle-fabric robe to put on.

Also also: when I told the surgeon about the T-Rex arms post-surgery, she was like, "We most certainly do NOT want you completely immobile! You can get frozen shoulder!"

Which I said was a relief, because I'd been worrying that maybe I wouldn't be able to wipe my own bottom.

She assured me this would not be the case.

Today I had an MRI. My doctor ordered it September 1, the day after I got my diagnosis, and I made the appointment that very day.

So, 12 days ago. And still, as of right before my appointment, my insurance hadn't approved it.

Because, they said, they'd only gotten the request yesterday, and they need 72 hours to review and approve. So they might not cover it.

I didn't ask them why they're a relentless bag of dicks. 

I know why. In America, the only entity that benefits from our private health insurance industry is the health insurance industry.

But I wasn't going to not get the MRI, because it's fucking cancer. And it's the next piece of information my surgeon needs.

So I put it on the credit card, and hopefully they'll reimburse us.

Health care professionals keep telling me to lower my stress level, relax, etc. Everyone except the insurance industry, which is like, let's ratchet up your anxiety at a vulnerable time.

I was nervous about the MRI and also really wondering what would happen, because they said I couldn't eat or drink anything for two hours ahead. Nothing. No water, nothing.

And I was like, they're not putting me under, are they? They'd have said.

But then the morning was hectic and Maude and I rushed from the plastic surgery consult to the MRI appointment and I wouldn't have had time to ingest anything in the two hour window anyway.

I will have to blog about the plastic surgeon appointment. Maybe tomorrow. 

He let me take an implant sample home. It's quite soothing.

At the MRI place they asked me in the paperwork and then again in person if I was claustrophobic and I said no. 

But they asked so many times that I was like, AM I?

Kind of like when you say a word over and over and then you're like, is that even a real word?

Maybe I'm claustrophobic? (I shot the clerk?)

Reader, I am not.

The tech running the machine was lovely, and truly, the whole thing was easy.

The only thing I regret was the music.

Despite the provided earplugs and noise muting headphones, there was still a tremendous amount of noise.

I didn't realize it would be like this.

She asked if I would like some music, and gave me a choice, and I immediately thought of my go-to and said, "How about 80s?" 

But then I was face down, boobs dangling in this big space tube with the clanking and clonking of the machine.

And layered on top was, "I wanna rock right now! I'm Rob Base and I came to get down!"

So if you have to do this, I might go for soothing classical.

I shot the clerk?

Wake me up when September ends

Dear Mama,

When I was a kid and I had a nightmare, I'd crawl in on your side of the bed. 

I'd wake you up and whisper, "I had a bad dream."

You would always pull back the covers, and I'd snuggle under, safely tucked in against you, shielded by your arm. (The same arm you'd fling in front of me when you braked the car suddenly. Vestigial behavior from pre-seatbelt days.)

That particular feeling of safety, of being ensconced in protective maternal love, love that requests nothing in return, is one I crave so badly right now.

Today is your birthday, and ordinarily, your birthday post would be about you.

This date has loomed large since you left us. Birthdays hurt.

And it's not that I don't miss you, because my gosh, I do. I occasionally smell you as I pass through a room. I cry. 

It's not that I don't think about you and all the things I love about you.

It's just that in the most brutal year of my life, a year I could not imagine getting worse, it somehow did.

I've been diagnosed with breast cancer. 

Because I needed one more club to be in: dead dads, suicide loss survivors, dead moms...

I fully intend to be in the breast cancer survivors club down the road. Right now I'm in the havers club.

The lucky/awful thing is, it's a very popular club. There are lots and lots of incredible women in it. Loving, fabulous women who are generous with time and information.

But still. It's scary. And devastating. 

I don't yet know all the details for necessarily treatment, but I know I'll be having surgery.

I just keep thinking, I need my mama. I really, really need my mama.

You'd hug me and kiss me. Make me food, bring me drinks and snacks, pick up my medication. You'd comfort and love on and distract the kids.

But more important than physical assistance--and I know at some point I will need a tremendous amount--you'd just be here. 

You'd worry about me and love me and wish you could make it all better.

You'd mother me.

Since reaching adulthood, I've not needed maternal comfort more.

I have Nick, of course, and he's going to take good care of me. I have the kids, who are loving and terrific.

You wouldn't believe how much they grew over the summer, both physically and emotionally. Jordan towers over me, and India is almost as tall as I am.

They've become so competent and, while not totally self-sufficient, really heading in that direction.

Who'd have thought we'd be able to make a grocery list and either one of them could run up to the store?

India was concerned about choosing radishes when I sent her yesterday, and I said just to make sure they didn't look like the poor unfortunate souls in The Little Mermaid.

And then she chose nice ones and I made salad.

I've told them both the news, and assured them that I'll be OK. Jordan asked, and I said yes. I will be find.

I'm trying to normalize conversation around it, because we're going to be living with me in treatment for some intense period of time.

Honestly, I don't know what's going to happen. I have consults with surgeons the week after this coming on. 

I'd decided in January that if that biopsy showed cancer, I'd go the most extreme and have a double mastectomy.

Eliminate the potential constant fear of it happening on the other side. Although now that I'm researching, I don't know if that's the approach that makes the most sense.

Obviously, I have to talk to the doctors about risk and benefits to that approach.

Maude told me that a friend of hers took this approach, and for some period of time after surgery, you're restricted from using your arm and chest muscles.

"So," she said, "you basically have arms like a T-Rex for a while."

Which sounds extremely inconvenient. T-Rexes couldn't do anything with those stupid little arms. 

And they didn't even have to wear pants. Or use their hands to eat.

I guess I could hold a sippy bottle in one arm. I have one that's tall enough to hold in my hand wtih my elbow tucked to my ribs, and I can still drink out of the straw.

I just tried.

It's helpful for me to focus on things like that. And I'd rather the kids focus on ridiculous image of me having T-Rex arms than focus on fear of losing me.

I'll feel better once I know what the deal is, and what I need to do.

I know too well that even in huge trauma, I put one foot in front of the other and plod forward. 

What else can I do?

It sucks, it super sucks. But I fortunately have such a loving, generous community. I have recommendations for great doctors.

And the week of my appointments, Maude will already be here. Thank god. And so many friends will be coming for your celebration of life.

It's going to be a party filled with people you love. I've encouraged people to dress joyfully and wear hats. We'll have beautiful music and gorgeous flowers.

I sure wish you could be there.

Happy birthday, mama.

Love,

Lisa