Some Bruising May Occur

(Note... Two things... One, this is very long because it covers about three weeks, so I'm sorry about that, and two, because my daughter is probably reading this, I really do NOT have cancer again. Promise. This is just about how you have to beat the dragon down once in a while. )


Right now there are more than 2.9 million breast cancer survivors in the United States. I'm sure they all go through something like this sooner or later...

---------------------------------------

After I was "done" with two rounds of surgery, chemo, and radiation, I was really only starting what sometimes feels like a never ending round of follow up visits.

I alternate between images, surgeon, and (chemo) oncologist. My radiation oncologist told me I could call him if I needed anything, but he didn't want to drag me in to see him too every six months. Now mind you, I still have pesky things like TEETH and flu shots to take care of. So every month I'm handing my insurance card to SOMEONE.

Six months ago after a mammogram, the doctor who reviewed the images spoke to me before I even left the appointment me to discuss some "findings" along one scar, saying they were probably calcification. As far as I could understand it, this just meant some hardened cells along the incision; the doctor's opinion was that they're most likely benign cells that aren't a recurrence of the tumor.

Of course, the gap between hearing and understanding was about two weeks, and asking my surgeon and her intern to explain it to me again. The recommendation at the time was "we'll watch it and do an MRI in six months." The "me" portion of "We" has been nervously looking at that scar for six months, probing it with my fingertips every now and then, thinking "And...?" Oh, I've been watching it. Mm hmm.

My chemo oncologist warned me, "sooner or later they will find something they want to biopsy. Don't get too upset. You're going to have 40 years of checkups. They're doing their job." So I liked the promise a bit more than the warning, but I remembered both.

The MRI took some five or six phone calls to schedule, mainly because I was trying to get it scheduled before I had the surgeon's script ordering the test, so that I could get it on the calendar of my friend who accompanies me to all of my imaging appointments.

----------------------------

Having an MRI is a rather drawn out affair. You have to affirm who you are, over and over, and promise that there are no rogue bits of metal in your body for the machinery to rip out, and pinkie swear that you're not allergic to the dye. Then you offer up an arm for the IV. (Ugh... One of my very least favorite things in the world; my left elbow feels like Swiss cheese some days.)

Then you lie face down on what SHOULD be the headrest of a massage table BUT - The Joke's OnYou, you're going to slide backwards into a big tube, wearing earplugs to confine you further, with your hands pinned awkwardly under your body. This is so they don't fall off the table, but your fingers unfortunately DO fall asleep eventually. Breathe. Don't panic.

You might sing songs to yourself - only in your head of course, because you can't HEAR, or move much, or cough, or anything like that. You may walk through the words of national anthem, and then try to think of everyone famous that you've ever seen perform that song. And then you think your way through another song, and another, trying to stay very calm so you can please just get this IV out and go home.

(I'm not sure why "I" became "You", but I'm sure a psychologist would just nod at me.)

----------------------------

I couldn't get any results immediately from the MRI, but I think in the back of my mind I knew they wouldn't call to say say "oh hai, it's all cool, see you in six months."

So it was only a dull ache when my phone rang, and I listened to someone tell me they wanted me to come in for an ultrasound to take a closer look at that scar to see if there was anything to biopsy. I made the appointment huddled covertly in an empty office, because I work in a trendy modern workspace which is more or less a giant conference table, and so I slip away when I get phone calls.

What sucked, and what made me cry just a few tears when I hung up, was that I was right about to go see my sister for a long weekend of kissing my cute baby nieces. It was something we planned just after my mother in law passed, and I had the plane tickets already, and I thought to myself, "I can't get a break. One weekend of just having fun and relaxing." This is why we can't have nice things, kids.

I went in to see my boss and said "um, that MRI didn't go so well." I was suddenly tearful, and weary. I don't want to do this again, I said to her.... Telling people, and making appointments for tests and procedures and explaining to my boss that yes I will be out AGAIN and oh hey don't forget the vacation I put in for last month...

-------------------------------------

So.... I went on my trip. I'm so glad I did. It would have been silly to waste the ticket, and I NEEDED to kiss those baby faces and eat cheesecake.

On the flight home I cried again, just for a few minutes, knowing that I had a lousy week ahead of me, and also knowing that my niece was running through her house calling my name, wanting to snuggle and watch her Monkey Show and eat my yummy Mac and Cheese with me, and not knowing when I can go to see her again. I wondered if the people around me thought I was afraid to fly, or if anyone even noticed my sniffles.

My second flight got delayed, and I didn't sleep well, and the next day spent a whopping two hours at work trying not to be sick, and then went home and slept for two hours and actually made it through the day. (so I was useless Wednesday after the phone call, out Thursday, Friday and Monday, and worked TWO hours Tuesday. I think I'm on track for employee of the month.)

--------------------------------

Tuesday's round of adventures started with an ultrasound. My friend was by my side in the waiting room, making me laugh through my tears. Partially because one staffer thought we were married...hey, it is NY State (yo, my wife is a beautiful black woman... sweet!)

The objective of the ultrasound was to try to locate the rogue cells and do another core needle biopsy. Oh, those are fun. I missed that staplegun sound, so close to my face. Not.

Unfortunately they couldn't see anything to try to biopsy. This is where I have to somehow understand why that's a BAD thing, and why we have to hunt down things that couldn't be seen in the ultrasound and hadn't changed since the last mammogram. But there's that whole I DON'T HAVE A MEDICAL DEGREE thing slapping me in the metaphorical face again.

The next person on staff that I spoke to was able to get me in for the MRI guided biopsy the Very. Next. Morning. Oh happy me. Now Wednesday was shot.

----------------------------

Not only was I dreading going back in the tube, I was trying to understand how they would actually biopsy me during an MRI.

Well, let me tell you, it's kind of cool -- because technology is amazing. Unless it's you ...and then it is wretched. Lie on your stomach/ ribcage on a lumpy table. (Even getting into position is hard when you have another IV, and you are trying to get your "side" to fall properly into the magic opening in the table where they will use square plates to compress it while you lie there, head forced to one side so that you are forced to spend your time staring at the IV inside your elbow. Joy. )

And if you caught the word "compress" ... Oh yes. A 40 minute semi-mammogram. (And the female techs tried over and over to get the plates right but finally had to ask me if the guys could come in to assist. Extra compression because the spot is high and to the side? of course. Modesty-ectomy, no charge.)

The plates have a grid, and that allows the doctor to place what we will vaguely refer to as a "tool" (you're welcome). I never did really figure out whether the doctor performing the biopsy was somehow UNDER the table or alongside. I'm not really sure I want to think about it much. (Don't google it until after you're done with the procedure. The tool is way scary looking. I'd rather gaze at my IV. )

All during the procedure two really sweet technicians held my hands and wiped away my tears and rubbed my back (... they also were in position to hold me down should I try to move...?)

The irony is that the lidocaine, which numbs tissues, hurts most of all. It BURNS going in. For most of the procedure I wasn't in actual pain, just uncomfortable. It did take a long time, so long that my shoulder cramped, and I was dizzy when I sat up, from barely breathing (resting on my rib cage and trying to keep still) and had to drink juice while I was thinking "if I EVEN pass out in this room..."

And even THEN you're not done. Nope! Another mammogram, to verify the placement of a tiny "clip" or titanium seed marking the biopsy site.

The doctor told me that she thinks it is probably fat necrosis, which sounds bad, but google tells me that it's fairly common after injury/ surgery and doesn't mean the cancer is back at all, but we have to wait for the biopsy results which will tell us for sure.

When all was said and done, I got some steri strips, a tiny pink ice pack. I also got written reminders to watch for signs of infection....and that some bruising may occur.

My bruise is now (a week later) red, purple, blue, yellow and green. And giant. But knock on wood, no infection.

Unfortunately as of this morning I also had no official biopsy results yet. After a week... One that my coworkers have enjoyed very much, no doubt. I have called offices and ASKED for the results, but all the nice woman on the phone could tell me is that they're back, but the dr is doing surgery yada yada someone will call me back. Then I got a computerized answering service and I dutifully recorded my name, birthdate, test results I'm asking for, and the number I would PLEASE like them to call back.

Roller coaster, anyone?

Finally this morning I thought to call a person in Dr C's office whose extension I still had in my phone. I left a voicemail before 8 am, pleading. Please see if you can get SOMEONE to call me back with my results.

All of a sudden, there was the doctor on my phone. "No cancer. It's scarring." I verbally hugged him over the phone, and felt 100 pounds lighter.

---------------------------------------

Right now there are more than 2.9 million breast cancer survivors in the United States.