Fa la la la Leo la la la Leo

This morning, I watched this NPR piece on Instagram explaining how over the past 2,000 years earth has shifted enough that the astrological signs we grew up with are inaccurate.

This is the new chart. If I weren't still a Leo, though barely, I'd reject it outright.

Anyway, in this new and questionable world, my mom was a Leo and my dad was a Virgo. I've always been super close to Cancers, Leos, and Virgos. But now my Cancer friends would suddenly be Geminis? Which I know nothing about.

I feel like everything I've believed is now thrown into question.

***

I cried and cried in acupuncture this morning.

It wasn't about the star chart. Just, whatever she unlocked opened a flood of emotion.

Like my acupuncturist turned off the light, closed the door, and I started sobbing. I couldn't really move, because you know, the needles. So I lay on my back and cried, tears pooling in my ears.

When I spoke to Nick afterwards, I told him acupuncture made me cry.

He laughed, and I said, "Why are you laughing?"

"She stabbed you with a whole bunch of needles. Of course you were crying."

***

I've been crying a lot. I don't even like Thanksgiving, but the holiday walloped me. 

'Tis the season.

After my mom died, I told the family that I wasn't doing Christmas. We were going away. And they could put up a tree and decorate if they wanted, but I wasn't going to.

I cannot bear the coziness of the tree with all the lights. I'm wrecked by the thought of all those sentimental ornaments.

I have so many memories of my mom in the red chair, enjoying the lights, cozying up with my kids.

My mom decorated gifts perfectly. Perfectly. And she was so happy to wrap for you. You could give her your gifts and she'd make them gorgeous, whimsical, lovely.

So I haven't done anything, and they haven't done anything, and it's been oddly liberating. 

We have a lone poinsettia from a crew fundraiser.

That's enough.

***

If you've ever been depressed, then this may resonate: sometimes you wonder if you're normal sad or not normal sad.

I'm sad, I'm very sad, but I'm quite sure I'm not depressed.

Like Peeta in the Hunger Games. Real or not real?

I think this is real sadness, profound grief.

Not that depression isn't real. But being depressed has, in the past, made me feel so sad when nothing calamitous had happened.

I don't feel hopeless. Just devastated.

Not every moment. 

But on the whole the holidays are brutal. There are so many memories swirling around.

There's a giant mama-shaped hole.

***

Which is not to say that all is darkness. We have joy!

We fly to London Friday night. 

A friend—in fact, multiple friends—pointed out that they have Christmas in the UK.

But I'm not trying to escape Christmas. I just didn't want Christmas at home.

None of our home traditions, no familiar decorations, no every-Christmas foods.

I remember my mom being unable to eat chocolate covered cherries after her sister died, because they were her favorite.

India wanted peppermint bark, because my mom bought scads of it every Christmas. She spent a small fortune on it.

I couldn't, I said. Maybe next year.

No North Dakota sticky buns. I've never  actually made them. 

Maybe next year. Maybe not.

***

Anyway, I'm just sitting around eating peanut butter banana toast.

Like the Leo I still am.

Survivorship clinic

A month or so ago, I got a message entitled SURVIVORSHIP.

Which was a little alarming.

At first I was afraid, I was petrified.

Ha.

This message was a notification for an appointment—now this afternoon—at the Survivorship Clinic.

Do I turn right at the Pope to get there? I don't know.

If you google, you'll find that lots of places have survivorship clinics.

Maybe the name doesn't bother other people? I feel like this is tantamount to calling it the Hanging On By Your Fingernails Clinic.

The image that pops into my mind is Rose on the door, Jack in the water.

Which leads me to that long-ago "Loser" song by Beck. Because I'm bad at lyrics, I used to think that "soy un perdedor" was "boy with his head on the door".

It makes no sense. I know. This is not a prerequisite for me liking a song. I mean, MacArthur Park is one of my favorites. 

Spring was never waiting for us, dear...

I think this is attributable to ADHD-brain associations. I don't know.

What I do know is that I could make this kind of association and Betty would be right there with me. Maude can be right there with me.

Nick every once in a while makes the leap and knows exactly what I'm talking about out of the blue, and when that happens, it makes him nervous.

Anyway, my understanding is it's about living forward after cancer treatment.

Why not call it Quality of Life Clinic? That's a nicer imagine than SURVIVORSHIP.

But back to Jack.

One of my goals is to do ice baths. I know they're trendy. But they're also really good for you.

Since I would rather be in 100 degree heat than cold, and since I can be cold at 70 degrees, Nick is highly skeptical. He asked if we might hold off on buying the ice tub for a bit, until I've somehow proven that I can do this.

Which is reasonable. Our house is littered with my half-projects.

Although I'm fairly intent on this one. I've begun ending my showers cold.

When I was in Peace Corps training, the family I lived with had said they had hot water, but they did not. 

There were these immersion heaters that you would attach to the shower to heat the water as it went through. If your water pressure was too high, cold shower. Too low, scalding. And I had friends who had one that shocked you every time you turned it on.

So a hot shower was kind of a gamble.

But anyway, my family did not have hot water. So I'd go for a run early every morning, and jump in the shower immediately after, to be able to bear the Andean cold water.

Which is to say, I'm capable of tolerating extremely cold water.

We're going to England for Christmas, and I jokingly suggested to my friend Fiona that maybe I could do a cold plunge in the Thames. Although that might be kind of sketch, like getting in the Potomac?

She was all, yes, dodgy, do NOT get in the Thames! 

Dodgy! Such a great English word. One I need to work into my vocabulary.

Anyway, I know I can do the cold plunge, and breathe calmly. I can definitely be cold.

It's just that so far, nobody I know has seen me prefer it.

But!

I'm strong and persistent. So I'll be hanging out in an icy bucket before you know it.

I'll be watching you all with the eye...of the tiger.

Crazy middle aged lady achievement unlocked

Oh my gosh. I just realized that I left you with constipation a long time ago and continued on my merry way.

I mean, merry if uncomfortably so.

That shit got resolved. No pun.

Also, I recently learned from a school mom friend that her brother passed away earlier this year. This year. This relentless, relentlessly terrible year. She said he used to say, "fuck that shit" and they shortened it to FTS. 

Her daughter made her an FTS bracelet.

I like this very much. 

FTS.

I don't know if you remember when people started using FTW, which stood for For The Win. Except that I thought it meant Fuck The World.

Which seemed quite extreme. And most of the time made no sense. Even after I looked it up, I would forget.

So I might read, "Homemade brownies FTW!" And be very confused.

I don't know if people use FTW anymore, which is a shame now that I know what it means. Although I guess it doesn't really matter, because I rarely use texting shorthand anyway.

The other night I asked Jordan if he used the word "rizz" as I'd recently learned that it was the Oxford word of 2023.

I said, "Do you say rizz?"

And he was like, "Absolutely not."

"Why not? When you totally have rizz?"

"Because it's stupid."

He hates conversations like this.

I was standing on a ladder trying to organize our cupboards at the time. 

We had two whole cupboards with glass doors devoted to vitamins and rubbing alcohol and Wanda's monthly meds and lord only knew what else.

Actually, I now know what else. A lot of expired kid cough syrup. Every pair of prescription glasses the kids have every had. Costco sized ibuprofen, Tylenol, and allergy meds. My mom's medications. A million bandaids.

Also, dropper bottles for use after swimming that I labeled "rubbing alcohol for ears" but which Nick added a B to, so they now say "rubbing alcohol for bears".

Anyway, I have been trying to figure out where to put all of these medicaments and such because it is space we need for actual kitchen things. And also, Wendy walked into our kitchen a couple weeks ago and was like WHAT THE FUCK with all the medication?

Medication FTW!

And I was like, she's right! Why do we have 54 gallons of hand sanitizer? And then I realized it's because we also have Covid rapid tests. That era still kind of dominates our cupboard.

So there I am, on this ladder, and I'm like, "So, apparently Timothee Chalamet said he has no rizz."

Except that I don't really watch TV, and I've mainly seen his name written, because he's not someone I give much thought to. And while I love words, I'm bad at celebrity names. Like, I used to confuse Kelsey Grammar and Gelsey Kirkland.

So I pronounced it Tee-mo-tay Shalamamalamalay  because I couldn't remember if he said his first name like Americans do, or how many syllables were in his last name.

And Jordan was like, "FIRST of all, it's Tim-o-thy Shall-a-may. And second of all, I don't use rizz because it's stupid."

And I was, all, "But he has the accent mark!" 

Then I turned off the overhead lights.

And then he was like, WHY are you doing that?

Because I'd found eye drops in the cupboard, which reminded me that I have dry eyes, and while I was thinking about it, I should put some drops in immediately. So I turned off the overhead lights so I wouldn't be starting directly into them at close range from the top of the ladder.

I said, "It'll just be for a second. I don't want to stare into the lights."

And he was all, "I don't care about the lights. It just seems like putting in eye drops at the top of the ladder is a very bad idea."

He had a point. As I had to lean back to drip the drops.

I told him that he was exactly right, and this was one of those ADHD no impulse control moments.

Nick doesn't know this—although I guess he didn't but does now—and behaviors like this are exactly the reason he believes he's a more competent human being. I know he thinks this. I don't even think he'll deny it.

Fortunately, I managed to drip in the drops without falling off the ladder. I climbed down, and turned the lights back on.

No rizz.

Namaste, Chalamalamalay!

FTW.

This time, baby, I'll be rabbit poops

This is going to be one of those scatological posts.

I remember the principal trainer for my group in Peace Corps, whose name was Prudence—Pru for short—talking to us about dehydration.

And on a side bar, I would really like an em-dash button on my keyboard. I always have to go googling and copying, because otherwise I just get the double dash, which I don't enjoy the look of, functional as it may be.

So Pru.

For the most part, I quite liked her.

But every once in a while she'd do somethings like try to force our van of tired selves to sing camp-type songs on the road back from a training exercise.

We were all adults in our 20s and 30s, and we wanted to sit quietly, or chat with the person sitting next to us.

We'd been busy all day. We didn't want to sing songs all the way home.

Another time, we had to write an essay or something. Pru wanted us all to sit quietly until everyone finished writing. Not to discuss. Just so she could dismiss us all together.

I asked why we couldn't just leave when we were done.

And she asked me if I was an only child.

So.

But I remember clearly this story she told us, which has stuck in my mind lo these many years.

She started out talking about a long bus trip. 

I was going to say "the thing about buses in Ecuador"—but there were many things. 

The most concerning issue was that you took it as a good sign when the brakes squealed, because then at least you knew they were working as you rounded tight curves on steep Andean roads carved just deeply enough into the side of the mountain for one lane of cars each direction.

Sometimes you'd sit and hold your breath as your driver and another met in opposing directions on a tight turn, and had to take turns backing up by inches so they could pass each other.

It was always more comforting to be on the inside of the turn in those situations.

I remember sitting by the window, looking at the 3,000-foot drop we'd plummet down if our driver backed up a wee bit too far.

The drivers always seemed pretty cavalier with the loud music and constant flirting with the girlfriend they brought along and such, but they must've been really, really skilled.

Anyway, the  other thing about these busses was that stopping for a bathroom break was at the whim of the bus driver. I remember begging, pleading with a drive to stop, just for 30 seconds, so I could pee on the side of the road next to the bus.

It's super weird to think of that here. You definitely couldn't do this with the Peter Pan bus on the New Jersey Turnpike.

But I've also never seen livestock or grain sacks on an American bus.

Aanyway, the safest thing to do for a 12-hour bus ride was not to drink water. Or drink a little but also eat salty snacks.

One of my fellow volunteers wound up with a kidney infection. Your body needs to be processing liquid.

So, in Pru's story, being a seasoned bus rider, our trainer had taken this no-water approach, and arrived home utterly exhausted. And then the next day she had these tiny rabbit poops.

Which wasn't surprising to talk about, because we talked about our poop all the time. Because nobody's bowel movements were normal. 

We got all kinds of parasites.

My exquisitely beautiful friend Neeta kept getting worms. The lesson she had to learn more than once was not to buy tripe from the street vendor. 

True fact. 

Me, I got giardia, and because it is a smell you never forget, I was able to correctly identify Jordan's case and insist the pediatrician get him tested.

IYKYK.

So back to Pru's story. The lesson of which was that dehydration, particularly at altitude, was dangerous.

And among the symptoms were exhaustion and rabbit poops.

Should this happen, you knew you needed to hydrate.

This was an excellent bit of teaching, at least for me, as it made a big impression and stuck with me way longer than any factual historical information ever has.

And every time that happens to me, I think of Pru.

Which is to say, Pru popped into my mind this morning.

The truth is, I was warned by multiple people that Zofran can make you constipated.

I had a telehealth visit with the oncology NP yesterday, who I really liked when I was talking to her directly. 

Because I'd been quite offended when the nurses reported her saying that it would be highly unusual to be nauseated on anastrozole. As if I couldn't be trusted to report my symptoms.

Or like she was saying I shouldn't be feeling the way I was in fact feeling.

When she repeated that yesterday, it was clearly in a caring manner. Like, they pretty much never have people with nausea to the point of needing medication.

The fact that I was taking Zofran more than once a day was concerning. I'm to message her on Monday about my symptoms to see if we need to change meds.

So, Zofran, she told me, they don't like you on it for long. It can make you constipated.

And I was all, ohh yeah. Checked that box already.

Because it happens to me whenever I travel, I thought I knew constipation. But this is industrial strength.

This particular flavor of constipation is resistant to Smooth Move tea, prune juice, gallons of water, raw carrots, lots of walking, yoga, and hot water with lemon first thing in the morning.

It's making me long for the days of foraging in the woods for poop sticks.

I have to say, though, I'm kind of impressed.

Me here at last on the ground/You in mid-air

Dear Mama,

Six months ago tonight, I held your hand for the last time. I kissed your forehead. Smoothed your hair, touched the crease between your eyebrows. I frown in the exact same way. 

Because you were mine, even though your heart was no longer beating, it felt OK to touch you. To hold your hand. To feel your fine, smooth skin.

I knew that once we left, I'd never have this opportunity again. I could talk to you, of course, but not touch you warm and still looking and feeling like my mother.

I saw your body again, twice, but you were far away.

***

That night, six months ago, Nick and I agreed that if the kids were already asleep when we got home from the hospital, we wouldn't wake them. We'd tell them tomorrow.

And then India heard the car and ran to open the back door.

She saw the bags and said, "WHY ARE YOU CARRYING NANA'S THINGS?"

And then I crumpled. And she crumpled into me.

***

There's a box of stuff we brought home from the hospital that I've been almost unable to touch.

Your glasses, your weekly planner, medications, things like that. 

There's even a page from an old calendar I'd made for you, a huge photo from our trip to Toronto years ago. I taped it to your wall to cheer you. One of the nice nurses moved it with your stuff and hung it on the wall in the ICU.

I've diminished the pile a little over time, removing things like hospital toiletries. It's the everyday objects like your padded eyeglass case, which you used all the time, that wreck me.

When you went into crisis, the staff had packed everything from your regular room into big plastic hospital bags, and in the 12 or so hours you were in the ICU, there was no reason to unpack anything. There was no time to settle in and look forward.

It made it easier, physically, to collect your things when it was time to go.

***

When I told one of my yoga friends, who is in his 70s, that I had breast cancer, he said, "It's a blessing your mom isn't here to worry about this."

Which frankly hadn't occurred to me.

But yes. This is one trauma you didn't have to live through.

I can see how it's a blessing. 

It just selfishly doesn't feel like one.

***

India's taller than me now. 

If you were still here, the kids would do to you what they do to me. They walk up and stand very very close. So I can be reminded of how much taller they are than me.

Now I'm the shortest one in the house. Except Wanda.

***

Yesterday I went to get my physical. 

The first question the nurse asked as he was updating my chart was, "Is your mother still alive?"

It caught me so off guard, I started to cry. I said no, that you'd died in May.

And he said he was sorry. His mom had died when he was 18, and losing his mom was the worst pain he'd ever been in. She's been gone 24 years, he said, and it still hurts.

We agreed that it hurts so much more than everything else either of us have lived through.

And then, because I'm me, we talked about his country and depression and stigma and his husband. He looked at my birthday and noted that I'm a Leo. Being a Virgo, he always clicks with Leos.

I told him you were a Virgo, and agreed.

He and his husband will probably end up invited to a Christmas dinner, if we ever host one again.

You know this. 

When he was putting all the little sticky things on for my EKG he said, "Wow! You're in amazing shape!"

I didn't tell him that I was the fittest person you knew.

***

We're going to England for Christmas. I told Nick and the kids in May that I wasn't doing Christmas this year. We have to go away.

I remember you saying that you never needed to worry, because your mom did all your worrying for you.

And I've never had to make things beautiful, because you did all of that for me. 

All the mantles with candles and pine cones and sparkles. You put everything together exquisitely. It was fancy but homey.

I loved it.

You wrapped packages perfectly. Not just with the paper crisp and even and the ends nicely folded under. Also with bows and ribbons and lovely little details.

They were just sumptuous and pretty.

I know how time works, and I know the problem with time is that it just takes so long. 

But being so familiar with grief, I know that at some point I'll be willing to pull out the wreaths you made, and decorate the tree with all the ornaments from childhood.

I'll take out your ribbon bag and go through your collection of wrapping paper.

Maybe I'll even make sticky buns.

But not this year.

*** 

I've been wearing some of your clothes.

Not your sweaters. That drawer still smells like you. I don't want that to dissipate.

When Maude was here, we went through your shoes, and she took some. She's been wearing your San Miguel de Allende cocktail combat boots. This brings both of us tremendous joy. 

I found an old bottle of Arpege on your dresser. It smells like the you of my childhood. Or actually, the you of my life until Dad died.

I walk around your rooms, opening your closets and drawers, telling you I miss you. I miss you I miss you I miss you. 

I stay until it hurts. Sometimes this is a minute, sometimes it's half an hour.

I'm slowly removing and giving away unsentimental clothing and objects.

You know, I took your creativity and sense of humor for granted. There are reminders on every wall, every door, really, everywhere.

You taped the kids' art to your walls. You used closet doors as inspiration boards.

New Yorker poetry and cartoons are sprinkled in.They're beautiful and funny in turn.

I wish we'd had more time.

***

At some point on the afternoon of your last day, though we didn't yet know it was your last day, it became apparent that you were never coming home. Even before you and I had the conversation where you said enough.

My friend Alexa, who didn't know how extreme the situation was, texted me to say that you were surrounded by loved ones. It was very crowded in your room.

They were all waiting for you.

***

I made the card above for your service, which was truly lovely. I'll write about it.

The back of the card has the lyrics for You Are My Sunshine.

On the day of the service, India looked at the cards closely, and pointed into your hair and said, "Mama! Look!"

I'd put your photo on a template, and missed the words Sample Text because your hair was so dark.

I told her Nana would think it was funny. Which is true. You would.

It's been six months, and I miss you. I love you and I miss you all the time. I just miss you.

Love, 

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?

Turn right at the Pope

That's what they said when I checked in for surgery. 

Go down the hall and turn right at the Pope. 

(Also, the dog has nothing to do with anything. I just think she looks really cute when she floofs her ears out.)

Anyway, if I turn into a deranged little old lady, you'll see me walking down the street muttering things like, "Anal sphincter." and "Turn right at the Pope." 

Actually, what am I waiting for?

Anyway, so this anastrozole journey has been a little piece of hell.

Nick and I were out on Sunday morning, and I suddenly had such tremendous nausea that we had to go home. It built and built until all I could do was lie in bed until it was time to go to sleep. With my bedside fan blasting on me, because good gracious, I could've roasted a chicken with my body heat.

Ew.

The same thing happened Monday. The morning was OK, and then by noon I started feeling bad, and by afternoon I was back in bed, absolutely walloped.

I'd somehow forgotten how terrible the early months of pregnancy were, and how I walked around like this all the time.

Isn't that weird? You're pregnant, and you feel like absolute crap, but you're also not yet telling anyone in case it doesn't work out.

So you're just trying to act natural when you want to throw up and/or sleep all the time and none of your clothes fit and your hormones are bananas. 

Anyway, the other day I was like, I'm not even getting a baby out of this.

But back to the issue at hand.

Since the oncologist had told me there were several options for these medications, I messaged the nurse to tell her what was going on, and asked if I could switch.

She called immediately for details, which I provided. I also told her that friends who've had breast cancer suggested an anti-nausea medication, as well as a medication that helps with hot flashes and joint pain. I said I could go whichever way they thought.

She said she'd talk to the NP and the doctor and get back to me.

I figured they'd be like, sure, no problem, we'll switch you or add other meds and call your pharmacy.

She replied saying the NP said that since I hadn't yet been taking the pills a week, it would be highly unusual to have these side effects already. She asked if I had a temperature. I should test for Covid and flu.

Which got my hackles all up. I AM highly unusual.

I took my temperature, which, as expected, was fine. I took a Covid test. Also negative. 

I reported both of these facts. I told them I did not have the flu. And that when I start a new medication, I get all of the wretched side effects, and I get them sooner than I'm told should be possible.

I also told her that I have a high pain tolerance, but no tolerance for nausea. 

(I mean, I wasn't asking for opioids or gold nuggets. I wanted the nausea to stop.)

So. In my reply, I proposed taking a couple days off and seeing how I felt.

What I didn't say was there was absolutely no way I was going to continue taking a pill that was making me so nauseated I couldn't eat or function.

She replied said that was reasonable, and suggested we check in on Monday.

I've still got nausea, but it's diminishing. Same with the hot flashes and joint pain.

Today my friend Kris told me that in France when you're pregnant they give you a suppository for nausea that works amazingly.

She was like, "You have to stick it in your butt, but it works great."

And I was all, "Honestly, I'd put just about anything in my butt if it meant getting rid of this nausea." And then I was like, "Well, no. You know I wouldn't."

But then I started thinking about what I'd be willing to do. Kind of like a terrible one-person game of Would You Rather?

And now I'm like, I should see if Nicole is still in Paris and if you can get anti-nausea suppositories over the counter.

Or maybe that would be under the counter?

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.

I don't think you're ready for this jelly

I assume at some point they'll seem normal, but right now the breast implants are akin to houseguests.

Like when I have very dear friends come to visit, and we're so close that I'm delighted that they're with us. And we spend tons and tons of time together, and it never gets tiresome.

Nicole was here two weeks, and I miss her so much.

Maude and I have lived together twice, and we can kind of function like extensions of each other. 

But they're not me. They have different needs and preferences. No matter how much we like and enjoy and are comfortable with each other, we're distinct people.

That's still how it is with these little guys.

In my appointment last week, Tammy told me that I could never use a hot compress on my torso again, because the silicone could heat to the point that it burned my tissue from inside, but I wouldn't know it.

Wow.

I told her that makes sense, actually, because now, if I drink cold water, my chest gets cold. And I was wondering if she knew if it would always be like this.

She said this was the first she'd heard someone mention it.

Now I'm wondering if it happens to other people, but they've just never mentioned it to her. Or if I'm just so unusual.

But then! Then it occurred to me that maybe I would have to refrain from getting really hot.

So I asked, "Does this mean I can never get in a sauna again?!"

(SOWna with the SOW pronounced like cow, in case you're wondering.)

And once again she said that nobody had ever asked her that question.

Nick felt the need to tell me that it's not like I get in a sauna every day or like ever, at which point I was able to reply quite smugly that a friend a block away has a sauna and she's invited me to sit in it any time I might like so ha!

Tammy reasoned that sauna would be fine, because your entire body is heating up. With a heating pad, the silicone could get extremely hot and burn you from inside. But in a sauna you'd be too uncomfortable first.

Basically, my spatulas and my boobs truly have a lot in common.

I got 99 problams but a (fake) boob ain't one (or two)

I have all kinds of things to tell you about my new boobs, but first I'd like to share two kinds of good news.

The definitive good news is that I had an appointment with Tammy, the NP I adore in plastic surgery. She pronounced me well healed, and said I could go back to normal life, including sleeping on my side and exercise. But really, to listen to my body.

I said, "Downward dog is OK?"

"Yes. Listen to your body."

"And headstands? Like, not today, but yes?"

"LISTEN TO YOUR BODY."

Nick said he'd encourage me to do this thing that everyone thinks I am not inclined to do.

I was going to go to yoga this morning, but I slept right through it. Look at me listening to my body and not the alarm!

After plastics, we minced on over to medical oncology. Actually, we did the opposite of mince. Because walking those hospital halls, I was reminded that Nick is a clompy walker.

"Are you always this clompy?"

"I'm not clompy."

"You're clomping."

I notice because I used to be a heavy heel strike walker. I still am if I'm not paying attention. 

Anyway, first we met with this very handsome fellow—and by fellow I mean like person doing a fellowship and just some guy. I mean, he was wearing a mask, but so maybe he has a weird mouth or bizarre choices in facial hair, but all other data points indicate handsomeness. And he was wearing this cute wool vest over his button down shirt.

Which reminds me—when we met with the radiation oncologist, one of her fellows was in normal clothes and Nick was all, "Where's your coat?"

And he said, "What?"

And Nick was like, "You know, your doctor coat!"

Nick was just teasing but the guy got a little flustered.

Although maybe he's new to breast surgery and women sitting around with boobs out?

Honestly, the oncology department was the first one that left me clothed the entire time. Now I walk into an exam room and reach to pull off my top.

It's like getting drunk in my 20s.

Anyway, I'd like to mention that all my doctors except my plastic surgeon are women. I quite love this fact.

I definitely wanted a female surgeon. There's a recent study indicating that they have better outcomes. This surprises me zero percent.

But good lord let me get to the point.

Nick and I both really liked the oncologist. She explained things so well and was patient with questions.

And here's what she said. 

First, she didn't feel like she could legitimately argue with insurance for the CT and bone scans, because my risk is so low. She doesn't see a need for them.

Also, with invasive lobular cancer, which is my kind, they do a special stain on the lymph node. The normal stain showed nothing, and then they do this extra special step.

(Who wants to be a normie?)

They didn't used to have this stain, just the regular one. And then this stain was developed, and they started using it for everyone, which led to overtreatment in some cases.

I do know from friends who had cancer decades ago that treatment used to be much more brutal. For example, they used to take out 20 ore more lymph nodes as a matter of course. Which led to lymphedema and I don't know what else.

They now treat more cautiously because they don't want to fuck you up for life if they don't have to.

Please understand that this is not verbatim, just my interpretation.

And the doctor said that the tumor board (with olives and prosciutto!) has representatives from every cancer specialty. These are the big brains at the top of their fields. This is what they do for a living. And none of them believe I'm high risk.

So.

The oncologist said that she is as certain as she can be without Oncotype results that I will not need chemotherapy. 

She explained that Oncotype has data on outcomes from all of these women with different kinds of breast cancer, and they use the genetics of your specific tumor and do fancy statistical analyses (again paraphrasing, and please know I failed probability and statistics--only class I've ever failed, and depression of course figured into it but also a severe cognitive inability to make letters stand for equations and also a lack of interest in how many red marbles there would be in a barrel of a million colored marbles).

Essecntially, for me what matters is after their analyses, they give you a number from 1-100. And a number under 25 means that for me, chemotherapy does not increase survivability.

It's weird to think in those terms. But chemo has all kinds of downsides that maybe aren't so worth it if going through it isn't likely to make you live longer.

The number for radiation is 18. I asked her why and she said it's just different analyses.

So sincerely and truly praying that my number is under 18.

I relayed this conversation to a dear friend of mine who had a different kind of cancer, and he said, and I quote, "The fact that she spoke about it at all is very encouraging news regarding chemo. Doctors find it uncomfortable confirming even the previous day's weather."

What I can tell you for certain is that it's been 80 degrees and delightful in DC lately. I mean, delightful in a global apocalyptic kind of way.

More on boobs soon. They're so weird.

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?