Several months ago, I was sitting on the exam table in the breast cancer center, wearing one of those very fashionable gowns you get to wear in doctor's offices, holding it together so as as not to flash my chest at my surgeon (a guy who had operated on my breast twice before and, therefore, has probably seen me more doped-up and drooling than anyone else, and yet, I was still embarassed to be topless in front of him), when he suddenly stopped laughing at some stupid joke that I had just told him and said, "Darcie, cancer is not fun-ny," as though I didn't already know this (eye roll). "'We shouldn't be laughing."
For the past 21 months (who's counting?), since I was 28, I've had stage IV, metastatic breast cancer, which, if you don't know, is (unfortunately) the incurable kind. Statistically speaking, breast cancer is especially "not good" if you're stage IV from diagnosis, and if you've had lung involvement since diagnoses, both of which I have, so, yeah, I guess if anyone knows that "cancer is not fun-ny," it's me.
I do, however, love my surgeon. He spoiled me so much as a patient, in fact, that all other doctors pale in comparison. If only I could have started out with a really bad doctor, then the other doctors would seem really good comparatively.
Oh wait, I did.
My very first surgeon misdiagonsed the lump in my breast as benign (fancy word for not cancer), when it was, in fact, cancer. I guess she thought that since I was so young (I was 27) that I couldn't have cancer. Although, I have to admit that she was diligent enough to biopsy the lump, which is more than I can say about some doctors. Apparently, the biopsy needle didn't quite work and missed the cancerous parts. Thus, the misdiagnosis. Think of sticking a little needle into a golf ball made of swiss cheese. The needle might miss the holes in the swiss cheese and only hit the solid parts, right? That's kind of what happened during my needle biopsy. I remember asking her, "Are you sure? It's really not cancer?" and she had said, "No." "Well, what is it, then?" I remember thinking to myself, but didn't ask and instead, returned to work, happy as a clam, thinking that I was home free. Six months after the biopsy, I received a little post card in the mail reminding me to come in for a check up. I taped that post card to my work computer and ignored it for two more months (this, of course, I would later regret).
When I finally called the breast center to make a follow-up appointment, now 8 months (but who's counting?) since the needle biopsy, the first surgeon was no longer at the practice. So, I made an appointment (luckily!) with breast surgeon number two. I didn't find out that I had cancer until the lump had almost doubled in size and spread throughout all lobes of my lungs and through the lymph nodes surrounding my lungs. The cancer was found by my second surgeon during an excisional biopsy that occurred right before my husband's 29th birthday. I remember the timing because we had to schedule his birthday dinner early, before my surgery, so that I could be there. Pictures from his birthday party are the some of the last pictures of me with long hair, albeit, with bad bangs.
So, I suppose I am fortunate to have found my second breast surgeon, even thoough he has spoiled me with his great bedside manner. One of the most impressionable things he said to me during my first appointment with him was, "let's get that thing out of there." He measured the lump using an ultrasound machine and his own guestimation, comparing his measurement (4 cm) with the previous surgeon's measurement (2 cm) written in my chart, and so, I think, even during that first examination, he knew something was wrong. I however, still didn't think that I had cancer. The thought had crossed my mind, but had only lingered there, dancing around covered in happy, pink ribbons, for a moment. ("Well, what is it, then?" I had thought, just 8 months ago.) I was so happy that he was taking the lump seriously and that he was willing to remove it that I simply nodded, "uh-huh" and asked him how quickly he could schedule the surgery. "As soon as you want to schedule it," he said.
"Let's get that thing out of there." He was talking about what he would later refer to as my "ugly," old-lady-cancer, lump. What can I say? I have mucinous carcinoma, a breast cancer that's very rare in young women (thus, an "old-lady" cancer) and is apparently "ugly" because it's, well, made from mucous. Gross, right? Yes, I know.
My surgeon's a good doctor because he has great bedside manner, which makes up in part for the fact that he's a general surgeon and not a breast cancer specialist. In addition to operating on breasts, he also performs hyrnea surgeries. He always responds to my emails within 24 hours, even when they include random questions, like, "What part of my breast are you removing?," "Give me a 5 minute lesson on breast anatomy," and my favorite, "Will I still be able to breastfeed after surgery?" and offers to perform surgery according to his patient's schedules, even if it means working the day before Christmas. He wore a NASCAR cap to my first surgery and a tacky snowman tie to my second. Granted, it was around the holidays, but a you have to admit that a snowman tie is probably not a fashion statement that you'd like to make. I'm not sure which was worse, my chic outfit consisting of a pre-op gown so new and stiff that it could stand upright, without a patient inside, or his tie.
I also like my surgeon because he told me that I could shower after surgery as soon as I wanted to, saying that if he got to shower, I should be able to, too. If you know anything at all about me, you know that I like to be clean and have probably never gone more than a day without showering since I was a kid, so I liked his "hygeine" philosophy. I've heard too many horror stories of patients who were told not to shower after surgery and I was probably just as nervous about not being able to shower as I was about the surgery itself. Of course, even with my surgeon's okay to shower, I still duct taped saran wrap to my chest before my first post-op shower, because I was afraid of getting my incision wet. That was before I knew that they made special bandages for this purpose. They sell them at CVS for $5 each and they are worth every penny. They are the fancy version of saran-wrap-duct-taped-to-the-place-you-used-to-call-your-breast, with the added bonus that they do not leave a large, irritated red rectangle of skin on your chest after you remove them, quickly, as though there are just a tiny little band-aid.
Several surgeries into our doctor-patient relationship, I was sitting on the exam table in the exam room in my silly white and blue polka dot gown talking to my breast surgeon. After two surgeries, 4 rounds of chemo and a bunch of other "stuff," I found another lump in my breast. Some would call this a recurrence, although I do not, as the cancer never "went away" in the first place. During a check-up, my oncologist told me she didn't think this new lump was cancer, or if it was, it wouldn't matter at this point, as I already had cancer in my lungs and that they don't recomend surgically removing breast cancer lumps from stage IV patients, yada, yada, yada. Of course, I didn't believe her, and so I made an appointment with my beloved breast surgeon, who had once told me that he thought I would be okay. I might have to do some awful treatments, but I would be okay.
My surgeon and I were laughing about some stupid joke that I told him during an otherwise awkward medical appointment. I hadn't seen him since my hair had fallen out during chemo and was sporting my new pixy hairstyle. He told me that I looked great, asked me how I was doing, and if I was having any medical issues. I responded with my typical, "Nope. I'm perfectly healthy, except for the fact that I have cancer. Ha, ha, ha." Now, I know that isn't really funny, but, he is a gentleman, so he pretended to laugh at my joke.
Then, he suddenly got very serious and said, "We shouldn't be laughing, Darcie. Cancer is not funny." I stopped laughing and looked at him for a second and got serious, too, frowned and said, "No, it's not funny, but I think it's important to have a sense of humor about it." He was quiet for a second and then, went on to explain my treatment options. I could have a needle biopsy, but I was worried about the whole needle probing a golf ball of swiss cheese thing again. If the biopsy came back negative, I knew I wouldn't trust the results. I would just think that they had "missed" the cancer. My other option was to have an excisional biopsy. I surprised my surgeon, I think, by saying, "take it out." Maybe it's not valid to want surgery so that you don't have to feel a lump of potential cancer right under your skin, but I think that was ultimately the motivating factor. I might have cancer in my lungs, but I couldn't feel those lumps with my hand. I had been considering having my ovaries removed as part of my treatment, so I figured I would have both surgeries done at the same time, a kind of "two for one" special.
"Will I be able to breast feed?" Ha. That was a silly question.
My surgeon and I continued our typical banter, because although we both knew that cancer is not funny (it is afterall, slowly killing me, or so I've been told,) he explained how if I opted for a mastectomy, I didn't have enough fat to reconstruct my breast from stomach tissue. Then, he offered up his own belly fat (pinching his middle), saying that he would be happy to make a fat donation. If only you could actually transplant belly fat from a slightly overweight, middle-aged, over-worked breast surgeon to a 29-year-old woman with breast cancer. Ah, the things you wish for in cancer world.
He told me his assistant would call me to schedule the surgery. It was late November.
"You like to have surgery around the holidays, don't you?" he said, and then, "If anyone took a look at both of us, they would think I'm the one with cancer."
His thinning hair was messy, sticking straight up, that day, as though he had quickly pulled off his surgeon's cap after surgery and walked across the street from the hospital to the clinic to see patients. He had half moons of blue under his eyes and yes, he did have a little more belly fat than he should.
I grabbed my middle, jokingly, and said, "Maybe if I eat enough over the holidays, I'll be able to grow enough fat for a breast."
Actually, I didn't say that. I just took the phone number and said that it was a good thing that my office was closed from Christmas through New Years. It would give me some extra time to recover after the surgery.
In short, although I never have and never will think that cancer is funny, I know that life is oftentimes funny, and if I have to live my life with this stupid cancer hanging out, I figure I might as well get some laughs out of it while I can. So, I'm going to use this blog to tell my story of cancer, not through a lens of doom-and-gloom or through that awful pink-ribbony chear that is oftetimes (sadly) associated with breast cancer, but somewhere in between. Because, if you know anything about me (next to the fact that I like to shower a lot) it's that I like to tell stories that only I think are funny, even if no one is listening.
