One of my favorite ways to shock people is to tell them I have five tattoos. Jaws drop. "You don't seem the type," they say. Well, I may be fibbing, just a little. I do have five tattoos, but they are barely noticeable, because they are only tiny blue dots, which served as markers when I received radiation treatments back in 1999. (Or, when I was partying like it was 1999, I decided to get some tattoos.) There is one on my chin, one on each shoulder, one where my collar bones meet, and one on my sternum. (For the record, that is *almost* the sign of the cross. Pastoring has been in the cards for me for some time now.) I used to joke that if I ever had to get a mastectomy, I could say, "Yeah, I have a boob job, and five tattoos, too!" and then I'd really see the jaws drop!
Ok, so now I'm getting a mastectomy, and that thought was still sort of in my head. But what really brought it to the point it is now, which I'm about to tell you, is the process of nipple reconstruction. Yes, they do that, too! If a mastectomied (<-- not a real word) woman wants to look like she has nipples, which is important to some women, they can go back a few months after the initial surgery and sort of pucker up some skin, and then tattoo an areola around it to make it the right color. Cool, huh?
I feel no particular need to create a fake nipple, though. What's the point? The only people who would ever see it are me and Michael, and neither of us care. It won't be able to feel anything, as all the nerves will be cut. So I put the tattooed nipple idea out of my head.
But then I thought, why tattoo a nipple? If I'm gonna get a tattoo, why not something cool and meaningful? Then I got excited. As a bonus, it won't even hurt because I will have lost all feeling in my breast - I oughta get something good out of that! Michael had been talking all along about getting a tattoo on his chest on the same side I have to have removed (he said this to me the afternoon last summer when I told him about the first biopsy - "If you have to get a mastectomy, I will get a tattoo in the same place!"). We could be buddy tattoos, and go at the same time! Maybe a wedding gift for each other? So many possibilities!
So then the question became: what tattoo should I get? It was my uncle John who suggested what should have been obvious: a sunflower.
Michael and I have chosen sunflowers as our wedding flower. It started off because we both love them, they are bright and happy and not as often used in weddings, so it would be different. My mom also does a unit in her kindergarten class about sunflowers, and she is fairly obsessed with them and collects sunflower things. It is obligatory in my family to point out any and all sunflowers you may see from the road (best done while pointing and wiggling fingers in the general direction of the sighting... those of you who know my mom will understand). As we started doing some research, we found some other facts about sunflowers that sealed the deal. Here are some:
* They are named after the sun, a life-giving force.
* They turn their faces to the sun, the light.
* They are tall and remind us to keep looking up and standing tall.
* They offer nourishing food.
* They symbolize long life, strength, happiness, health, and hope, especially for those who walk with cancer. (One wedding website suggested they are a good wedding flower that can honor a loved one who has battled cancer - well, duh!)
* Their petals reach out, reminding us to do the same.
Now who can read all that and not say, "Girl, you tattoo a sunflower nipple on that boob right away!" Right??
Obviously I'll have to wait until I'm fully healed - 2-3 months. But even as someone who never had any desire to get a tattoo - I'm totally stoked about the idea. Now to find the perfect image, and the perfect tattoo artist... (Do you think insurance would cover this?)
Here's a start... something not too cute and cartoon-y, sort of vintage and a little realistic. (I don't even know what to look for in a good tattoo design!!)
Tension is high. Jesus and his disciples
are sharing the Passover meal, when Jesus surprises them by insisting that he
wash their feet, and then further insists that they all do the same for each
other. As they puzzle over this, Jesus announces that one of them will betray
him – he knows that it is Judas, whose feet has he just washed. As Jesus hands
Judas a piece of bread, he tells Judas to do quickly what he must do, and Judas
leaves the room, into the night, to turn Jesus in to the authorities. The other
eleven disciples stay behind, confused. We know how the story goes after this –
thanks to Judas, Jesus gets arrested, then his faithful friend Peter denies
ever knowing Jesus, and Jesus is beaten and hung on a cross to die.
Such
a difficult night that was – and how remarkable that it was in the midst of all
that betrayal, tension, denial, confusion, suffering, and death that Jesus
offers these words that we hear today: “I give you a new commandment, that
you love one another. Just as I have loved you, you also should love one
another. By this everyone will know that you are my disciples, if you have love
for one another.” It is a
lofty command in the best of circumstances, but how much more so in the midst
of drama, tension, and heartache! And yet because of that difficult context we
come to understand that commandment more truly. “Love one another” is not a
romantic mandate, nor a suggestion to merely “be nice” or to tolerate each
other, nor to love only those who love you back. Only moments before offering
this command, Jesus has washed the feet of Judas the betrayer, even as he knew
what Judas would do. He tells Peter to love, even as he knows Peter will deny
even knowing him in his hour of need. And Jesus himself is about to go forth
and die for a world that has in many ways rejected him, all to show the world
the love of the Father. Suddenly, in Jesus’ mouth, loving one another becomes
not a nice, fun, warm occasion with lots of hugs and smiles, but rather, a
self-sacrificing act which puts the well-being of others before your own. Love
one another as Christ has loved you.
And
this sort of love, Jesus says, is how people will know you are followers of
Christ. Not by our doctrines or our dogmas, not by our creeds or our diligence
in Bible study, not by our church buildings, or the clothes we wear, or our
family values. By our love. By the way we treat one another – even, and especially, in the
midst of the dark and difficult times that life offers us.
Sometimes
we do all right, sometimes not so much. This command can seem an impossible
task at times – in part because it is difficult to know just what Christ-like
love looks like in today’s world. It’s not too often that we have the
opportunity to die on a cross to save humanity, for example. So what does it
look like to love others as Christ has loved us? As I’ve been reflecting on
that question this week, I’ve kept my eyes open for some good love stories, and
also some not-love stories, and I certainly have found some of both – times
when people have gone out of their way to care for another’s needs, and also
times when people have found it difficult to love someone, because of
disagreements, or because of the difficulty of forgiveness, or because of disappointment.
Listen to some of these stories. See if you might find yourself in them, but
also listen to where you might find Christ in them.
Okay,
first story: although this is several years old now, it seemed timely given
recent events. Following the Oklahoma City bombing in 1995, there were over 680
people injured and 169 killed. People rightfully wanted to see justice come for
those families, and Timothy McVeigh was to be executed. But one victim’s father
preached forgiveness instead of vengeance. While the families of the other 168
victims were hoping to see McVeigh’s execution televised, hoping it would bring
them closure and healing, Bud Welch, whose daughter was killed, was crusading
in the U.S. Congress and around America saying, “There is no healing from
killing people.” A difficult message to
preach for someone whose daughter has just been killed by this monster. You’ve
likely heard other stories of extraordinary forgiveness like this – the Amish
community who reached out to the family of a school shooter comes to mind. What
extraordinary love, to reach out of their own pain and loss, and offer
forgiveness and comfort to the one who hurt them.
The
next story is a bit more personal. As I have been navigating another journey
through breast cancer, I have talked with many women and heard their stories.
In a recent group discussion, we were talking about people in our lives who
have been either over-bearing on the one hand, or uncaring on the other, as we
endure the disease and treatments. Several women had been hurt by what they
called “bolters” – friends they had stood beside in their hour of need, but now
that the roles were reversed, these alleged friends were nowhere to be found.
Some felt the need, as a result, to cut these friends out of their lives.
Friendship goes both ways – I was there for you, so you ought to be here for
me, and if you’re not, then bye-bye. Perhaps you have found yourself in a
similar position, when people you thought were your friends were not there when
you needed them. How did you respond? It’s a tough call – especially when we
are rightly trying to care for ourselves, and surround ourselves with positive,
loving energy. Out with the bad, in with the good. I wouldn’t have blamed the
man Jesus at all if he had decided to cut his betraying, denying friends out of
his life – after all that he had done for them, and all that he was going to do
for them, they shouldn’t have treated him that way! But Christ-like love is not
tit for tat. How satisfying it is to give back what people deserve – good or
bad! “You scratch my back, I’ll scratch yours” is so reasonable. You love me,
and I’ll love you makes perfect sense. How much more difficult it is to love
even when you don’t appear to be getting anything in return. And really, how much
more Christ-like.
Suzanne Guthrie offers our last story: “Not long ago,”
she writes, “I was driving to a meeting in an unfamiliar town on a rainy
Saturday morning. I stopped at a red light and noticed some kind of protest
happening on the street corner – a group of people wearing sandwich boards with
huge lettering. Some signs said, ‘Stop Abortion,’ while others read,
‘Pro-choice’ – both interspersed with harsher messages. These passionately
opposing individuals stood amidst one another, laughing and talking and
drinking steaming coffee in the cold rain. Nearby, two people wearing opposing
signs embraced. Ah, I thought, see how they love one another.” [Christian
Century, May 2, 2001] Some of the
hardest people of all for us to love are the people we disagree with.
Especially if the issue is very important to us – it is hard to maintain
respectful conversation if we feel our deeply held values are being challenged.
It becomes easy to place ideals in a higher, more important position than we
place people.
For a while, you may remember, those What Would
Jesus Do bracelets were really
popular. It’s a worthwhile question, but even a better one is, What – or Who –
Would Jesus Love? If we are called to love one another as Jesus loves us, then
we can start with knowing whom to
love. So let’s look at the first story – do we love the victim’s families? Do
we love Bud Welch, the forgiving father of a victim? Do we love Timothy
McVeigh? And in the second story – do we love those friends who help us when we
are sick? Do we love our friends by helping when they need us? And the friends
whom we helped, but who were nowhere to be seen when we needed it? And in this
last story: do we agree with those with whom we agree? Do we look at those who
believe differently about important issues – and I mean the big issues, like
abortion, gay marriage, gun laws, taxes, immigration, health care reform – do
we look at people on the opposite side of those issues and love them? And the
bigger question: how do we love them?
My favorite part of Suzanne Guthrie’s telling of that
last story is not so much that people on both sides of the issue were talking,
but that she catches two people with opposite signs embrace. She likens it to
the “new heaven” described in today’s reading from Revelation. She writes,
“Here is the holy city adorned as a bride for her husband. A new heaven, a new
earth, breaking forth through the rain, hidden as a sign on the street corner.
See how they love one another passionately enough to embrace this moment of
reconciliation and still more passionately to continue their opposing struggles
on behalf of others.” You don’t have to agree with someone to love them, see?
You don’t even have to like someone to love them. Jesus probably wasn’t too
pleased with his betraying, denying friends on that night that he offered this
commandment – yet he never stopped loving them. So loving someone as Jesus
loves us, you see, doesn’t mean liking their actions. But it does mean seeing
them as children of God who are worthy of God’s love, children of God for whom
Jesus died and rose again, for whom God through Christ conquered death so that
we all could live with God in eternal life. To love one another with this love
is more powerful than disagreement, more powerful than disappointment, more
powerful than the difficulty of forgiveness – indeed to love someone with God’s
love is more powerful than anything else on earth.
Let us pray. God our Father, you have loved us with
a love more powerful than anything else we know. Help us to see all people
through your eyes: as your children who are worthy of love. In the name of the
Father, and the Son, and the Holy Spirit. Amen.
I have had a couple days of that wonderful post-decision state - a couple days to let it sink in, and worry that I'm suddenly going to say, "What was I thinking??" Thankfully, the post-decision freak-out hasn't happened. I continue to have peace about the decision.
How can that be, so suddenly, after all that agonizing? I have thought about that, and wanted to share my thoughts with you.
First of all, I find it interesting and consoling that the decision I finally rested on was almost identical to what Michael and I both left Dr. Skinner's offer feeling at our first appointment after I was diagnosed. I didn't really realize that until after I had come back to it and made it official. That's a good sign that it is right - it was my first gut feeling, and my last gut feeling.
I talked with a friend and mentor about Ignatian spirituality's approach to decision making. One of the ways to come to a decision is to look at the least appealing option, and sit with it and pray about it for several days. See how it feels. Imagine how you would explain it to someone else. Consider how you feel at each point of its outcome. I'm not very familiar with Ignatian spirituality, but it seems this is what I was doing! I made my way through several options, sitting with each one and discerning how it made me feel. In the end, I needed someone else to suggest an idea I had already sat with to see how I would really react to the idea! Dr. Skinner's suggestion got me out of myself and consequently (and counter-intuitively) helped me realize how I really felt.
Sort of along those lines, I've also thought a lot about Dr. Skinner's comment that I need to feel peace about my decision. I've thought a lot about what peace feels like. I thought about how I felt waking up after my lumpectomy last fall. I thought, "It's done. The cancer is gone. I'm good, and life can go on." Peace and relief. Now, when I imagine waking up after another lumpectomy, I imagine thinking, "That cancer is gone, but I feel unsatisfied and anxious." Cancer is gone, but the fear remains. Is there other cancer already there somewhere? Is there cancer starting to grow? No peace. When I imagine waking up after a bilateral mastectomy, I feel sad and anxious, and I imagine I would cry. I feel loss, and no joy. The feeling of grief over losing both breasts is greater than the feeling of joy over no cancer. No peace.
When I imagine waking up after a single mastectomy, one breast gone and one breast still healthy, I feel sad but relieved, a bit scared and grumpy, but ultimately, I have a sense of acceptance. "The cancer is gone, and so is most of the fear." I think that is the key to peace. Peace doesn't mean happiness. Rather, it is acceptance - not resignation, but positive acceptance. My life is not how it was, nor how I want it to be, but it is still life, and I accept the loss that had to happen to let me keep that life. A cancerous breast that keeps making more cancer is not life-giving or life-enhancing. On the other hand, a breast that is healthy and could feed our children someday IS life-giving. So when we are able to choose life, I'd say acceptance - and hence, peace - follows close behind.
19I call heaven and earth to witness against you today that I have set before you life and death, blessings and curses. Choose life so that you and your descendants may live,20loving theLordyour God, obeying him, and holding fast to him; for that means life to you and length of days, so that you may live... (Deuteronomy 30:19-20)
It's done. The decision is made, I called the doctor's office, they called back, and the date is set. I will have a unilateral left mastectomy with immediate implant reconstruction at 7:30am on Tuesday, May 14.
Whew.
Today has been an interesting emotional cocktail of relief, nausea, anxiety, calm, and focus. (I wish it tasted more like the Fresca, cranberry and vodka cocktail my friend made me last night... Thanks Jenny!) When I called my mom, she said, "I hear anxiety in your voice." Why wouldn't you? I said. It doesn't matter when this happens; the fact is I'm going to go to sleep that morning and wake up without a boob. (This struck my mom as funny, which I guess it sort of is, when you phrase it that way!) But I'm trying to focus less on the Date of Doom, and more on the things that need to get done before that. Now I can do what I do best: PLAN. I immediately wrote emails to my church councils, my bishop, the other families in church who are affected (like those of the girls I was supposed to confirm on May 19, Pentecost), etc. Now we can line up supply preachers, and set meetings as needed. Personally, I can prepare myself. I got a book someone recommended called The Breast Reconstruction Guidebook. Among other things, it gives you a list of things you should do four weeks before, two weeks before, the week of, the night before, the day of. Already I missed the four week mark, so I'm starting now on those things. They include making sure I eat healthy food (so much for the pizza last night...), get plenty of exercise, etc. So last night instead of driving the mile and a half to my friend's house, I put on my running shoes and ran there. Today I dragged Klaus on a run (he was unimpressed; hence it was a short run). I almost put him in the house and kept running - suddenly I have all this energy! Other things I have to look forward to on the list include: pamper myself with a manicure/pedicure, consider waxing my armpits and legs because I won't be able to shave for a few weeks after surgery (would not have thought of that!), buy clothing that buttons in the front because I won't be able to lift my arms... It's a very practical guide.
I told my council and staff in my email that they should ask me to do anything they want, because busy work is my friend right now. It gives me something to do, to take my attention from the inevitable. (I also added that they should ask much but actually expect little from me!) That is what I'm doing right now. This is my current coping mechanism. Eventually I'll get to the more emotional piece - I already have gone through a lot of that. For now, it is very therapeutic to be able to plan stuff.
One thing I want to plan is a Boobie Funeral. Lefty needs a proper goodbye. Even though we're not parting ways on very good terms, I don't want our last words to be angry words. I was likening this today to a bad break-up I had a few years back. Even though I knew the guy needed to go, I was so enmeshed with him when we finally broke up that even though it was I who made the final decision to break up, I was absolutely devastated. Even as I hated the guy's guts, I also was still desperately in love with him, and felt very attached. I knew he had to go - that I had to cut him out of my life, if you will - but I couldn't bear the thought of it. I'm having very similar feelings about Ol' Lefty. We've had some good times, she and I, and in the end I'll be sad to see her go, but we both know it is for the best in the long run. (I'm listening to my Farewell to Boobs playlist right now and Lady Gaga's "Bad Romance" just came on. How appropriate!) I'd like to reflect more on that, but perhaps in a different post. I have a lot going on in my head right now, and I'm trying to keep it organized. (Again: planner at work!)
In this post, I wanted to reflect on the Boobie Funeral idea. This may sound morbid to anyone who isn't a pastor, but I actually love funerals, and I think most pastors would agree. The reason is that in the Christian faith, funerals are not a time to dwell on death. They are a time to remember the deceased, of course, and to celebrate their life, but ultimately the purpose of a Christian funeral is to celebrate that an earthly death is actually a birth - a rebirth, an entrance into eternal life, a life basking in the perpetual light of God. Now, I'm not going to go so far as to say that my boob is going to enter God's eternal glory on May 14 - let's not be ridiculous. (It seems worth mentioning at this point that the very first funeral I ever did was for a parakeet named Daisy.) But the consolation that out of death comes life - that resurrection idea that is the basis of Christian faith, as demonstrated on Easter morning - THAT is something I can get on board with, even for a boob.
As I bid farewell and godspeed to my boob, I am also welcoming something much greater than boobs back into my life: health. I loved the way that Dr. Skinner talked about this. She said that although this is big and scary, it should also be joyful, because when I wake up after surgery, I won't just be boob-free. I will be cancer free. And that is indeed joyful. That is indeed life.
So, I'm having a funeral for my boob. Sometime during that weekend before. If you come, bring a food to share that reminds you of boobs. (Obviously there will be gummy bears, even though that part of reconstruction doesn't come until later.) If you have ideas for how to throw a helluva boob funeral, please leave them in the comments below. Thanks for the help!
Yesterday was quite a day of appointments. After my appointment with Dr. Skinner in the morning, I had counseling at noon. (That felt great - I had barely sat down when I started dumping on her everything going on in my life!) Then in the afternoon, I met with the plastic surgeon again, which was a very clarifying appointment.
We continue to really like Dr. Langstein. He is down to earth, honest, confident, yet humble. One of our favorite moments was when we were talking about the kind of reconstruction where you tunnel tissue from your belly to your breast (yes, they do!), and he said, "If you ever wanted that, I would defer to my colleague. That's a young man's game. I'm in my mid-fifties - I'm not interested in doing an 8-hour surgery anymore!" Fair enough!
Other favorite moments: when I was asking about how my breasts would age if I had one real breast and one implant, he said, "All women have uneven breasts. I know women who are two different cup sizes. You're in the God business - and you know that we can't do better than God. A natural breast is always going to be the best. And if God's breasts are uneven, then we can't expect to do better than that." Can't argue with that! (You see what I mean about humility?) Later, when I was asking about recovery time, he said something about, "if you owned your own business..." and I said, "God owns my business." And the resident piped up, "Really, he owns ours, too." Cute.
Okay, enough chit-chat - on to the actual substance of the appointment. First question was, had he looked at my radiation records, and did he still believe I was a candidate for implants? He said from the records it seemed that I had not had full mantle radiation - both he and Dr. Skinner described it more like a left-facing L than the T that is usual for mantle radiation. And even at that, the dose was low. He said my skin looked great, and if I hadn't told him I'd had radiation, he wouldn't know. It doesn't look like it had been burned (though believe me - it was! And radiation burns are no fun at all!). So he was confident that my skin would likely do well even with implants. Coming from someone who is known for telling people everything that could go wrong, I believe I can trust this. He said, "I'm just making up numbers here, but say you have a 75-80% chance that the skin will be just fine. Great. If not, we may see that on the operating table. If not there, then we will see within just a few days, in which case I could take you right back in and do the latissimus flap, and you'd still have plenty of time to heal before your wedding." Great! So implant reconstruction does indeed seem like a good option.
Next question: I asked about this other kind of reconstruction a friend of mine had, where they take tissue from the thigh. I said, "I'm not sure you do this kind, but what do you know about it?" He said, "I do that." Huh? He said, "There's another surgeon in town who fancies himself as the only guy in town who does it. That's not true. He's just the only guy that wants to. He is likely to push that procedure because he believes it is a good one. I don't like doing it because it is a tough recovery." Then he said, "I don't think you'd be a good candidate for that anyway. Stand up, let me look at your thighs." I will tell you right now that you need a healthy self esteem to let a doctor tell you where you are fat enough to make a boob. That, or you are quickly humbled by the process. He pinched my inner thigh through my jeans (!) and said, "See? Not enough fat. It's all muscle." He turned to the resident: "See? No fat." ("Soccer thighs," I explained.) He said again, "You don't have enough back fat, belly fat, or thigh fat to make two breasts. Maybe one. But the only place you have enough is" - he hesitated - "your back side," and he pointed to his butt. Baby! Got! Back! (I suddenly have this urge to rewrite the lyrics of Sir Mix-a-lot's famous and controversial hit, adding this perk to his list of reasons he likes big butts and he cannot lie.) But (<--ha), this is a very difficult surgery to recover from, and not really an option I want to consider. Fact is, I'm not fat enough to create a new boob out of my own tissue.
Okay, so then I told him about the different options we have: 1) lumpectomy now, decide later; 2) unilateral now, hope for the best on the right and see how it goes; 3) bilateral now, and be done with it. He said from his perspective, he would take the lumpectomy now option off the table. Any time you add another incision in the breast, it makes his job more difficult - more scar tissue and less skin. Great point! I hadn't thought of that. He also said he wouldn't do the bilateral now. The right side is at lower risk, and I could likely safely save it for the things I've dreamed of. And heck, who knows - maybe after I have a couple kids, I will have enough belly fat to do a tummy tuck and turn it into boobs. :) Especially if I'm not ready for it right now, don't do it. And after I am done with child-bearing, assuming nothing has happened on the right, I can get "fixed up" and evened out, if that is important to me. That option was already where I was leaning going into the appointment, so it was good to hear him say that, especially since he was the one who earlier had told me, "When I'm looking at Hodgkin's survivors, I'm usually looking at a bilateral." Things change. And what a different reaction from when Dr. Skinner suggested doing a lumpectomy now and put off decision, where I immediately felt bad about the possibility! Much better to have a positive reaction.
As for recovery, he indicated that it wouldn't be as bad as I imagined. Assuming all goes well, he thought four weeks would be plenty to recover. He said even two or three, saying, "You'll still have drains, but you can go to work with drains." Um, I think not. I think I'll just go ahead and wait at least until the drains are out! I'll still plan for at least four weeks. He doesn't give a lifting weight-limit - he said it is more about mobility. "As long as you can move your arm to do something, I say you can do it." Especially with just doing the one side, I'll still have use of my right arm from the beginning, which will make recovery easier. He thought I'd be pretty out of it for a week or so, but after two weeks I'd be feeling pretty good. All good things! The surgery itself won't even take too long - maybe 4-5 hours. His part is only about an hour. "The time we have spent talking together in the office is already more than we will spend together in the operating room," he said.
So it looks like the decision is: single mastectomy with implant reconstruction. He will put an expandable saline implant in and expand it most of the way, and I'll probably have to go in once more a week or two later and get it expanded the rest of the way. Then I'll be good to go through the wedding, and at some point, if I want, I can swap those out for a silicone (gummy bear!) implant, which is a superior product that offers a more natural look. But what I get will be fine for my purposes. (I asked about wearing a swimming suit this summer, and he said, "You're putting a lot of pressure on the plastic surgeon, now!" I assured him I'm talking about a fairly conservative swimming suit, so not to worry! No string bikinis for me!)
So now I have to decide if that is my final answer, and call the doctor to get it on the schedule! Call now, or let it percolate? (By now, it has already percolated quite a while...) If I call now, it is done and I can put it out of my head and focus. If I don't, I may very well flip-flop again. But I feel fairly confident about this decision, and feel the pros outweigh the cons, especially since it has the endorsement of my surgeons. So I should probably call...
It must be hard to be someone in my inner circle right now - or, given how open I have been with this journey, any of my circles - what with all the flip-flopping I have been doing throughout this process. If you read this blog with any regularity, you're probably tired of my jumping all over the place with what I plan to do.
I assure you, it has been much harder on me.
This morning we saw Dr. Skinner, for whom I am again extremely grateful. Michael and I came in, both of us exhausted from all the emotions we have felt about any number of things - breast cancer and everything else that it brings up in a person and a couple dealing with it. Michael and I have had several emotional conversations in the past days as we have tried to sort all of this out, and this morning we were not as chipper as we normally are. Surely Dr. Skinner (and everyone else) could see that we were a bit gray. I gave her the low down on everywhere we have been in the past two weeks of trying to make a decision. She listened carefully and sympathetically. I spoke about how my head thinks it knows the right decision (bilateral mastectomy), but my heart is having a hard time getting on board, as it is not as easily swayed by logic. As I spoke about giving up breast-feeding, I started to cry. She made tissues available. As I continued to talk, I grew more and more emotional, and at one point she said, "Now I'm going to need one of these," and took a tissue to wipe her own eyes. (You see why I love her? She also held my hand for part of the conversation, and as she left, she said, "Go with God." So grateful. As a side note, there is another nurse there whom we love - we actually love everyone there, but she and I connected during one of my early biopsies because it was her job to talk to me through it and keep me calm, and we ended up talking a lot about faith. She is pure gold. Before we left today, she gave me a beautifully wrapped gift. "Open it later," she said. I'm not very good at waiting, so I opened it in the car. It's a thing to set on a table or a bookshelf that says, "If God brings you to it, He will bring you through it." Cue waterworks again. So thoughtful - I was totally touched.)
We also ran by Dr. Skinner the idea to "punt" - to do a lumpectomy now and worry about a mastectomy later. I admit that even as I brought it up I was feeling less certain about it, for various reasons. One is that my parents would have a very hard time coming in the fall - they could come for the surgery, but not stay for any extended period. One is that while it would take away the immediate threat, it only took 6 months after my first lumpectomy for cancer to develop again. Because I know what could happen and indeed what has happened before, having a lumpectomy only takes away the current threat, but very little of the fear when it comes right down to it. Still, Dr. Skinner thought that was a reasonable option, to allow me/us to enjoy the other exciting things in our lives right now and deal with the stress of mastectomy later. But would I enjoy it? Or would I feel like I'm racing the clock, quickly trying to have a good time, all the while knowing that the cancer clock is ticking. I hate to bring up the time bomb analogy after last week's events, but it feels a little like that - my breast ticking away, and I know that this cancer bomb is going to go off, but not how bad the damage will be when it does. Maybe DCIS again, maybe something worse.
As all this ran through my head, and as we talked with Dr. Skinner (and also spent some time simply sitting in silence), I continued to cry, despite my best efforts to hold it together. I finally just looked desperately at her and said, "What should I do?" Somewhat to my surprise, she thought for a moment and said, "I think you should do the lumpectomy. A lumpectomy is a non-decision, it just postpones the decision and gives you more time. You need to be at peace with whatever decision you make, and you're clearly not there yet. So give yourself some more time. Enjoy your wedding, and deal with this later."
Sounds like exactly what I would want to hear, right? But for some reason, it wasn't. It made me feel anxious. I found myself wanting to explain all the reasons I didn't like that option. Would I have had the same reaction to anything she said? Maybe. She's absolutely right that I need to feel at peace about my decision, and I didn't feel at all at peace going into that office this morning - which is why I was surprised to hear my adamant response that I was 100% ready to get rid of my left breast. "Get it off. I want it gone as soon as possible." Even as the words came out of my mouth, I thought, "Whoa, I didn't realize I felt that way." The words continued to ring in my head. Suddenly, for all of its benefits - and it does make perfect sense, both logically and emotionally, and has my surgeon's stamp of approval - doing a lumpectomy now seems completely inadequate, and where yesterday the idea made me feel calm, today it makes me feel angry. Like it's masquerading as a treatment but is really just trying to make me feel safe, when I know full well that there is probably already cancer trying to grow somewhere else in that breast. Get it off! Suddenly, after hearing so many women say this and totally not getting it (feeling precisely the opposite, in fact), now I totally get it. I feel anger toward my left breast, the breast that betrayed me, and I want it out of my life. Again, I'm thinking about Carole King's, "It's Too Late":
There'll be good times again for me and you, But we just can't stay together, don't you feel it, too? Still, I'm glad for what we had, and how I once loved you
It's too late, boobie. It's too late. ... I just can't fake it.
So once again, I'm faced with these decisions, and I told Dr. Skinner I'd let her know by next week:
1) Lumpectomy now to take off the pressure, and think more about this and what I want to do. Possible pro is being able to enjoy what exciting things are going on in other parts of my life (though as I wondered above - will I enjoy, knowing the inevitable is coming? am I just prolonging the pain?). Gives me time to come to a place "at peace" with my decision, talk to another plastic surgeon about different options, etc. On the other hand, even as "punting" give us more time, it also drags it out, not only for me and my closest family and friends, but two congregations and a bunch of colleagues who are at the ready to help me however they can, and are as eager for me to be past this as I am. Waiting may give me more time, but it is hard on all of them.
2) Unilateral mastectomy now. I know it has to go, and I want it to go. Get it off so I can actually find that place of peace where I'm not worried there is still something growing in there. I had prepared myself for that this spring, as had my family and my congregations, so let's get it done. I still have one breast for all the things I want a breast for. On the other hand, I don't have the time to investigate another option for reconstruction, so I risk just doing what is easiest, and not doing what is best. I also run the risk (albeit less) of developing breast cancer in the right side as well down the road, and having to go through all of this all over again.
3) Bilateral now. Eliminate all the risks, and move forward with my life with this weight off my chest (yes, I still have my sense of humor), without breast cancer hanging over my head (or technically, under my shoulders), without having to keep doing closer surveillance, and knowing that when I do have children, although I won't be able to breast feed them I will be able to pick them up and love on them and know that I will be around for them (at least as far as breast cancer is concerned) for the long haul. Down side is that while I'm almost ready for this, I'm not quite. I don't have that peace about it. I don't have the anger at my right breast that makes me say, "Get it off!" I've never had any anger or lyrics of break-up songs toward my right breast. I could make myself ready, but... it would feel like rushing it.
Three good options. Three bad options. One distressed, confused, stressed, angry, sad... but surviving woman with breast cancer.
It's been a rough 24 hours living in the pressure cooker that is our lives right now. On Sunday, after two worship services and a choir concert, I came home absolutely exhausted and eager to talk to Michael about some things that were on my heart and mind. He wasn't able to come over and I was unable to move... and I completely lost it. Very unlike me. I found myself thrust back in the anger stage of grief. Suddenly, after all this wonderful processing I had done, and everyone's kind comments about how well I'm handling this and my great attitude... I could not bear the thought of it anymore, and I sat on my couch and wept (and Klaus licked up my deliciously salty tears). In the midst of my uncharacteristic break-down, Michael asked, "What do you need me to do?" and I thought about it, and finally replied: "Make me not have breast cancer anymore." If only he could. After another cry-fest as I was trying to fall asleep, I finally did sleep, and woke up with puffy eyes, but ready to face the new day. Off I went to work, where my mortgage originator called me. We've been trying to finish getting pre-qualified for a mortgage, and I was eager to get some questions answered. She needed a few more documents from me. Okay, no problem. I asked what we would qualify for... and she quoted something much less than we had expected based on online calculators. Oh dear. (After the initial shock of this, I realized that with the money we can contribute from our savings, it's not really all that much less after all... but still less.) Then I mentioned that we were thinking about getting legally hitched before the surgery, but we wouldn't be living together yet. Was that okay? "If you get married before the house is purchased, you won't qualify for first home club anymore." Oh dear again. With our combined salaries, we make too much to qualify for the $7500 grant. We have to be all done buying a house by our wedding on Aug. 3 if we want that grant money. Read: the pre-wedding is off. And I lost it again, right there on the phone with the mortgage originator. Poor girl, probably thought I was crying over the stress of buying a house. I wanted to explain to her that I'm not usually like this, that I usually keep my chin up and can handle things like this, that it wasn't so much the house as it was that every carefully laid plan we made seems to be backfiring, and I was getting really tired of my hopes and dreams being compromised. She tried to console me, saying that it's usually about a 60-90 day process from offer to ownership, so we should be fine, since we'll be making an offer on a house in the next week or two. The next week or two??? We only just found out that we have been looking at the wrong houses! We have a few showings set up for this week, but what if we don't like them? And did I mention in addition to finding a house, we both also work full time, are planning a wedding, and are preparing for what is an extremely emotional and life-changing surgery?!? (Like I said: pressure cooker.) I texted Michael what was going on, and he immediately leapt into action. (As he said later, "Those were problems I could fix!") He sent me several lovely houses that are in our new price range. He said and did all the right things. I thought he was going to break down like I had, but instead he stepped up and my heart just beamed with gratitude. What a man. Last night, we finally got a chance to talk in person. He came in saying, "I have an idea." There's just so much big stuff in our lives right now - we were handling the house-hunting and wedding just fine, but a major and emotional surgery is a lot to throw in that bucket! So we looked at what could lessen the pressure. The house piece could, and we could rent like most newlyweds... but then we lose the grant if we get married, and since we suddenly also qualify for much less than we thought we would, that $7500 is looking pretty great right about now. Shame to throw away free money. So then, pushing the wedding back could also allow us to push the house purchase back... but for one thing, we don't want to. The wedding isn't causing us all that much stress (hooray for our mutual desire to keep things as simple as possible!), and having to cancel and move everything and reschedule AGAIN would be much more stress at this point. Pushing the surgery back until later isn't an option... ...until we realized it actually is. One of the options we had was for Dr. Skinner to do another lumpectomy, and get the cancer out. Then I can do the mastectomy in the fall - after we are wedded homeowners, and hopefully fairly unpacked and settled into our new home. There are several pros to this: * It takes off a load of pressure and allows us to fully appreciate and enjoy these other two very exciting events. * Because the mastectomy would happen outside of the pressure cooker, I would be in a better position to go into it more calmly, and focus on healing instead of trying to do wedding planning and house-hunting/purchasing while I'm also trying to heal and process everything that just happened to my body. * Similarly, I would have more time to prepare myself for it emotionally and medically. Because I feel this pressure to schedule it soon to get the cancer out, I'm only getting two opinions from plastic surgeons (I know some women who got nine!). I know there is another very renowned plastic surgeon in town who does another kind of procedure I may be a candidate for. (Dr. Langstein doesn't do it.) One of my more emotional reactions to mastectomy/reconstruction is knowing I will have something foreign in my body for the rest of my life, as well as the various risks and upkeep that go with them. He does a reconstruction using tissue from the thigh - and I've always felt that my thighs are one of my best endowed body parts! I'm not sure that I would do this, but it feels a bit irresponsible not to look into it, and I think if I didn't I would always wonder why I didn't at least ask about that. This is a pretty huge decision not to check out every option. So putting off the surgery until fall would allow me time to do this. * Michael and I would be married legitimately, under God and the law, in the church, and living together when the surgery happens. This helps with family medical leave for Michael, but also in case something happens (which it won't), he will actually mean something to the law, and have rights he wouldn't have as a mere fiance. * Michael's vacation time starts over in July, so he'd have plenty of days available. There are also some cons, of course: * Medically, this isn't the preferred route. It seemed silly to put my body through an additional surgery for the sake of having real boobs for the wedding (when fake boobs would fill the dress just fine), but it seems much more reasonable given all the other things going on. Still, now we are looking at one major in-patient surgery and two out-patient surgeries in a year (lumpectomy and swapping out the expanders for implants), plus the two I had last fall! Part of me wants to just get it done and be done already (even as there is another part of me that loves the idea of putting this on the back burner for now). * It's not as easy a time of year to manage. September is Michael's busiest month at work, it is much less feasible for my mom to come out for an extended time since school will just have started, and who knows what dad's class schedule might be. Michael is going back to school in the fall (though it is all online classes, so he would still be home), and my church program year is starting up again. If we push it out too late, it means I'm coming back to work right as Advent starts, which is not a great time to ease my way back in! Though of course I could plan ahead to have someone else do Advent programming, or we can combine with another church or something like that. There are ways to make that work. So... We're letting this idea sit today and will ask Dr. Skinner what she thinks at our appointment tomorrow morning, and of course Dr. Langstein in the afternoon as well. Never a dull moment, huh?
Acts 9:36-43, Psalm 23, Rev. 7:9-17, John 10:22-30
This
was one of the weeks that it is hard to be a preacher. On Monday, a tragic
bombing at a beloved sporting event kills three and injures or maims nearly 200
innocent spectators. The same day, poisoned letters are sent to the president
and other government officials. The next day, attempts to reform gun laws to
make it more difficult for dangerous people to get their hands on deadly
weapons get defeated in the Senate, bringing up tears and more pain for the
families of victims of last year’s devastating shootings. Just when you try to
wrap your head around all that, and how the Word of God might speak to it, the
news Thursday morning brings forth another tragedy, a sudden explosion in a
little community outside Waco, Texas, again killing several, injuring over 100,
and devastating this close-knit little town. Lest we forget about Monday, a
violent manhunt for the bombing suspects puts Boston in lock-down for a day.
Violence, destruction, danger, disappointment. These are concerns for many in
the world every day, and often to a much larger extent than we experience in
America, yet for so many events to hit so close to home in so short a time
makes us realize our own vulnerability much more poignantly. We sang at the
beginning of worship the Kyrie, which means, “Lord, have mercy,” and indeed
that is our prayer this week: “Lord, have mercy!
With
all that’s happened in the past week, and the past several months, the texts
assigned for today seem in some ways a cruel irony, with all their talk of
comfort and God’s promise to be with us in dark valleys, and hearing the voice
of Jesus and following it. Comfort? Where is that? And Jesus’ voice? Who could
hear it over the sound of explosions and gunshots and people crying out?
But
then again, each of our texts, from the very well-known 23rd Psalm,
to the lesser known passages we hear from Acts and Revelation, do offer a word
of comfort, if we are prepared to hear it. But hearing it is the key - see
Jesus’ words in John: “My sheep hear my voice. I know them, and they follow me.”
It is sometimes very hard to hear Jesus’ voice, the voice of our Good Shepherd,
especially in the bustle of day-to-day life, and especially in the midst of tragedy, isn’t it? So how
and where do we hear it? Sometimes in silence, or prayer, sometimes in the
words of a friend… and most concretely, we hear it in Scripture. In our new
member class last week we were talking about the doctrine of the Word, and what
it means that we call the Bible “holy.” It is not the book itself that is holy,
but rather, what it points to, what it portrays. And what, or rather who, does
it portray? … Jesus! Sometimes obviously so, like in the Gospels. Sometimes
less directly. But any time you read the Bible, you can think, “What is Jesus
telling me in this passage? Where do I hear Jesus’ voice here?”
So
let’s ask that question today: what is Jesus’ voice saying to us this morning
in our other readings? What do we hear? What might Jesus be saying to us this
week? Let’s go through each reading, and you pull out your bulletins so you can
follow along with each text.
Start with Acts, and the touching story
of Tabitha, or Dorcas. We hear a lot of stories in the Bible about healings,
and even multiple of people being brought back to life. But this one is
especially tender. We know that Tabitha was devoted to acts of charity and good
works, and she is in fact the only woman in the Bible to be explicitly called a
disciple. When they call Peter there after she has died, did you notice what
everyone, all the widows gathered there, are doing? … They are telling stories
about Tabitha! The widows are showing the tunics she had made for them, some of the most vulnerable people in
society. Tabitha had cared for them, and in the wake of her death, they
remember her for her love, for her commitment to service. It’s not unlike what
we do when people die today, is it? One of the great blessings of being a
pastor is planning funerals with people, and hearing all the wonderful stories
about their deceased loved one. Suddenly, there in my office, the deceased
comes alive again in a new way, as people laugh and smile and remember. In the
story from Acts, Peter comes and brings Tabitha physically back to life, an
action by which many come to believe, but we can see that she was already alive
– she was alive by means of her remembered ministry to the vulnerable in
society.
What
does the voice of Jesus say to us in this tender interaction? What do you hear?
What I hear is that the love you show to the weak and vulnerable matters.
Perhaps it was a small task for Tabitha to make those tunics, but to these
widows, it meant everything. We have no way to know what one small act we
perform in the name of Christ might mean to someone else. I was so touched in
the stories about the Boston Marathon bombing to hear about people running toward the chaos, about runners who, after
running 26 miles, kept running two more miles to the hospital to give blood,
about strangers comforting strangers in their pain. Perhaps such bravery and
tenderness felt natural in the moment to those folks, but I’m sure for the
recipients of their care, those actions meant everything to them. That is what
I hear the voice of Jesus saying in this passage: the love you show to others
matters deeply.
Our
second reading is from Revelation… which I admit is a difficult book to get a
hold of at times, with its strange imagery and symbolism. So let’s break it
down a bit. The first part is one unit, the main point of which is that God is
all-powerful, and always wins. “The Lamb” refers to Jesus, because he
sacrificed his life for us as lambs were often sacrificial animals. Because of
what Jesus did, God is worthy to be praised. So all these people are gathered
to worship God and the Lamb, singing praise to in a loud voice because of all
that God has done for us. Then in the second part you get this shift, this
question and answer piece, and it is here that I start to hear the voice of
Jesus speaking to us this week. These gathered, says the elder, are those who
have come out of the “big ordeal” – a great tribulation, a struggle. And what
is the promise at the other end? See there in those last two verses: “They will
hunger no more, and thirst no more; the sun will not strike them, nor any
scorching heat; for the Lamb at the center of the throne will be their
shepherd, and he will guide them to springs of the water of life, and God will
wipe away every tear from their eyes.” Beautiful! A promise, that through your
struggles, whatever they may be: Jesus the Lamb will be your shepherd, guiding
you not toward vengeance, or violence, or anger – though certainly all of those
might be natural inclinations – but rather, toward water, toward life. Even as we feel anger and sadness about
our current ordeal, whatever it may be, Jesus promises to lead us, and to wipe
away our tears.
And
that brings us of course to the 23rd Psalm, one of the best-loved
passages in all of Scripture. The voice of Jesus can be heard in so many ways
in this Psalm: the promise to lead us and provide for us everything we need,
even to the point that our “cup runneth over” with goodness; the promise to be
with us in our darkest valleys, whatever and whenever they may be; the
persistent promise of comfort and protection. The part where I most distinctly
hear Jesus’ voice, at least this time around, is in the last verse: “surely
goodness and mercy shall follow me.” That word that is translated here as
“follow” is more often translated as “pursue,” and except for this one instance,
it refers to enemies – as in, my enemies pursue me. It sounds relentless,
doesn’t it? Enemies, dangers, violence, destruction, unfairness, anger – these
things do seem to pursue us at times, catching us at every turn. But even as
these evils pursue… so does that goodness and mercy of the Lord, keeping pace
and in the end, beating out the darkness and leading us into the light. Surely
goodness and mercy shall pursue me all the days of my life, never leaving me
alone, never leaving me to fend for myself, never leaving me to wipe my own
tears.
Because
of mercy and goodness’s endless pursuit of us and our lives, all those other
things Jesus’ voice says become possible: we are able, with Tabitha, to live
lives that show our faith and dedication to a God of love; we are able, with
those gathered at the throne of the Lamb, to trust that God will lead us to
safety from pain and toward waters of life, and will wipe away our tears; and
we are able, with the Psalmist, to believe that with God as our shepherd, we do
indeed have all that we need.
Let us pray. God our Good Shepherd, you speak to us when
we are in dark valleys, as well as when we are by still waters. Help us always
to hear your voice and not only to hear it, but also to believe it. In the name
of the Father, and the Son, and the Holy Spirit. Amen.
Like so many, I have been thinking a lot about what a crazy week this has been on the news. What a lot of tragedy in so short a time. On Tuesday we had a text study with local clergy (a sermon prep opportunity), and Boston was on our minds (this was before everything else happened!). Several people pointed out that while this is sad and terrible and not to be minimized, in our own grief we may lose sight of the fact that for people in other parts of the world, this sort of daily tragedy - and much worse - is the norm, not the exception. As one friend put it, for a little girl in Palestine, every day could be a bomb-riddled marathon. My hope is that such tragedy so close to home causes us not to gaze more deeply into our own belly buttons, but rather that it helps us remember and pray for those who do deal with this sort of thing daily.
But whether or not that happens, the fact is: while their story is important, so is mine. It is important to me because it is my story. A bombing at a beloved sporting event does make me realize my own fragility and vulnerability. It makes me sad for those directly affected, and it makes me appreciate my many blessings.
I have thought about this especially in relation to my own personal trauma (which now seems so much less bad). In a lot of ways, my situation sucks, plain and simple. It's not fair. It's maddening, it's sad, it's frustrating, it's discouraging. But I find myself thinking: at the end of the day, it's not so bad. I don't have stage IV aggressive breast cancer, and what I do have will be gone soon and my life will be spared and I will go on, breast cancer free. I hear about other people deciding whether or not to go off treatments because their quality of life is so bad that life isn't worth living like this.... while I'm trying to decide which form of breast reconstruction I will have my good health insurance cover. There are people who have been on disability for years trying to fight this dreadful disease, and with a family at home to care for... while I am stressing about taking six weeks off from work to recover from surgery, while my dear husband-to-be and loving parents drop everything to dote on me, and two congregations and wonderful colleagues and friends surround me with love and casseroles. Woe is me, huh?!
But just as it is tempting but not altogether appropriate to minimize what has happened in this country in this past week simply because someone else has it worse, it is also not appropriate to minimize my own story. Because it, too, is important, and it is my story. It is a struggle for me, in its own ways. It is a struggle for my loved ones. It makes me cry. It makes them cry. It makes me hurt. It makes them hurt. And so it is an important story, that elicits important feelings, and no less so than anyone else.
I remember in CPE (clinical pastoral education - a.k.a. chaplaincy internship), one thing we learned was not to give a tissue to someone who is crying. As soon as you hand over the Kleenex, you are saying, "Wipe up those tears. No need to cry." No, there IS a need to cry! Feel what you need to feel! There is no illegitimate feeling. Cry about nothing if you have to. But get out whatever emotion needs to get out. So if I want to cry over an unsightly scar, I will, even as someone else cries over a decision to go off treatment. And if I want to cry over losing my breasts before I've had a chance to breast-feed my children, while someone else cries that an IV kind of hurts, then great. All of those tears are exactly where and how they should be.
(As a side note, the song I'm listening to just had the lyric, "Do you realize that happiness makes you cry?" Yes, I do! I cry then, too!)
I had this idea to create a playlist of songs that would help me get through the various aspects of having mastectomy - body image, general health, inspiration, empowerment, compassion, still feeling like a woman, strength... you get the idea. I know a pretty good amount of music, but I thought if I put the question out to Facebook, I might get some songs I didn't know before, in genres with which I'm not as familiar. I also put the question out to an online community of young women with breast cancer that I've connected with. I got lots of input, and came up with a two-hour playlist of 39 songs, pretty much not cutting anything people offered (unless I couldn't find it on Spotify) because even if I didn't like it, if it had been helpful to someone else, maybe it would helpful to me, too. I'm now listening through it for the first time, and so far so good! I have included it below for your own enjoyment, if you so choose.
Farewell to Boobs Playlist
(For some reason, 8 random songs are not included in this link. Why? This is my first Spotify playlist, so if anyone has any ideas, let me know. They do appear on the Spotify list, just not the link.)
1. I Will Survive (Gloria Gaynor)
2. Man! I Feel Like a Woman (Shania Twain)
3. The Hardest Part (Coldplay)
4. Everybody Hurts (R.E.M.)
5. Blackbird (Sarah McLachlan)
6. Extraordinary Machine (Fiona Apple)
7. Bad Romance (Lady Gaga)
8. It's Too Late (Carole King) --> aka "It's Too Late, Boobie!"
9. New Shoes (Paolo Nutini)
10. I'm Gone, I'm Going (Lesley Roy)
11. Baby Got Back (In the Style of Sir Mix-a-lot) (Done Again)
12. Short Skirt/Long Jacket (Cake)
13. Leave the Pieces (The Wreckers)
14. Beautiful (Carole King)
15. Do You Realize?? (The Flaming Lips)
16. Beautiful Dawn (Wailin' Jennys)
17. As Cool as I Am (Dar Williams)
18. Grey Street (Dave Matthews Band)
19. Brick House (Commondores)
20. Brown Eyed Girl (Van Morrison)
21. All That You Have Is Your Soul (Tracy Chapman)
22. Moving (John Fullbright)
23. Don't Stop (Fleetwood Mac)
24. If I Can Dream (Elvis Presley)
25. One Day You Will (Lady Antebellum)
26. Stronger (What Doesn't Kill You) (Kelly Clarkson)
27. How Could Anyone (Shaina Noll)
28. Touch of Grey (Grateful Dead)
29. World Without Tears (Lucinda Williams)
30. Keep Breathing (Ingrid Michaelson)
31. Titanium -feat. Sia (David Guetta)
32. Lose Yourself (Eminem)
33. The Guy that Says Goodbye to You is Out of His Mind (Griffin House)
34. No One (Alicia Keys)
35. Just the Way You Are (Bruno Mars)
36. Sex and Reruns (Matt Duke)
37. Don't Stop My Now (Queen)
38. I Run for Life (Melissa Etheridge)
39. I'm Every Woman (Whitney Houston)
Ok, I admit it: it is hard to focus on, well, pretty much anything. Someone said to me on Sunday, "I can't believe you are still able to work. You have so much on your mind!" I shrugged it off, like, "Meh, I feel fine, no biggie." To some extent, I have been able to compartmentalize this and put it aside when I need to... but as time goes on and the inevitable draws closer, this is getting harder and harder. Perhaps the difference is that on Sunday, I still had a next step in place: I would see the plastic surgeon on Monday. That went well, and now... what? I don't have a next step. Or, the next step is to actually to have this surgery. That's way scarier and far more permanent than the plastic surgeon's office.
As a result, I have been completely unfocused for three days. I totally flaked on a meeting this week, something I rarely do. Just completely forgot. I have no motivation. I feel utterly unsettled. I don't even have a surgery date for goodness' sake! Would a date have a calming effect, or be more anxiety-provoking? If I had a date on the calendar, it becomes more real... anxiety. On the other hand, if I had a date, I could at least plan the other things in my life... calming.
My trip to the plastic surgeon was great in many ways. It opened up a lot more options for me. This also makes things more complicated, though. Suddenly, where I had pretty much made my decision - left mastectomy with latissimus reconstruction - now I don't know what to do. Should I do both breasts? Are implants right for me? Has the plastic surgeon had a chance to look at my radiation records? If so, does he stand by what he said before? If I get implants, how will this affect my life? Where is the resolve I used to have that I could do without reconstruction - why is this suddenly so much more important than it was? (Answer: because now it is real. Still, it makes me feel a little shallow. For someone as self-assured as I usually am, I just don't know that I can be a no-breasted woman. I want to be the kind of woman who is fine with that. And I guess I probably am. I just don't feel like it right now.) And nothing else can happen until I make this decision, and of course I'm the only one who can make it. Darn that! I hate decisions like that!
As I mentioned previously, my parents made some very compelling arguments for getting bilateral mastectomies right now and being done with it. Of course they have their daughter's health and longevity in mind - but don't we all? Arguments included things like: Michael and I would be able to start our marriage with this burden lifted from us forever, I wouldn't have to worry about the difficulty of close surveillance while pregnant/breast-feeding, I wouldn't have to worry about this popping up again while I'm either pregnant or have an infant who wants to be held (and I can't because I'm not supposed to lift things), I wouldn't have to worry about having to take another lengthy medical leave and enduring another surgery, I could give my full and healthy life to Michael in marriage, and celebrate at our wedding not only our marriage but also the joy of life... and oh yeah, the big one: I wouldn't have to worry about getting breast cancer again. As Dr. Skinner said, so far my cancers have presented themselves early, but I might not continue to be so lucky next time around. As Michael pointed out, we haven't had luck with rolling the dice so far.
So what's stopping me from doing the bilateral and being done with this forever? Breast-feeding. That's the biggie. How long have I dreamed of that moment when I first feed my child from my own breast! I get choked up to imagine it. Some of my dear, thoughtful friends have written to me with their own stories of dashed dreams of breast-feeding, assuring me their children turned out healthy and beautiful anyway. The possibility of breast-feeding can be taken away for any number of reasons, of course, and the fact that I'm dealing with radiated breasts to begin with probably wouldn't help my chances any. But to give up both breasts right now... is to give up the the chance even to find out.
So what do I do? What do I do?? And once I decide on unilateral or bilateral, what kind of reconstruction? Well, at this point, the answer is: ask people about their experience (which is the one thing I can actually focus on), and make more appointments. I have scheduled appointments with both Dr. Skinner and Dr. Langstein for one week from today. I'll come up with more questions to ask, and then I guess we'll set a date. As much as I long for the certainty and settled-ness that comes with having a date down, the thought of this makes me anxious. Though perhaps no more anxious than knowing there is cancer growing inside me. Again. (This story is getting so old.)
First off: Went to the plastic surgeon this morning, the chief of plastic surgery. It was such a better experience than last time, I can't even begin to tell you.
Second: I'm fickle. Every day I feel differently. Now I am considering doing both breasts right now. More on that later. I hate feeling differently every day. Dah!
Third: This is a bizarre procedure, no matter how you cut it. (<-- Get it? Cut it? Like a surgeon?)
Now, to elaborate:
Dr. Langstein walked in and introduced himself and got both our names, clearly knew some things about us and our lives ("Oh, I heard there was a fiance!") and one of the first things he did was say, "What questions do you have? How can I help you?" One hundred billion gazillion times better impression than the last dude, in the first 30 seconds. Then it got better: he explained what he would want/need to do in terms of an exam, and said, "Then we'll let you change out of the gown and into your clothes while we have a conversation." Hallelujah! This little bit of dignity really made all the difference, not to mention it was cold in there, so this allowed me actually to be physically comfortable during a difficult conversation, instead of shivering in an ill-fitting gown. So, we were off to a good start.
Other things we liked: he indulged our silly jokes by at least pretending to laugh, if not actually laughing. He said several times things to the effect of, "I'd like this to be question guided - you're clearly smart people, so tell me what you need to know." He said at one point in explaining what he meant by "high risk": "Well, this is plastic surgery. It's not life or death." Very honest that while this is a worthwhile and important field, it is not going to make or break my life. It was humble, and we didn't feel at all like he was trying to sell us something. Rather, he said that one thing he hopes to do in his work is help erase the painful memory of breast cancer, so when people look in the mirror each day, they aren't reminded of that difficult time. A noble goal!
Then, if you can believe it, it got even better. In my spiel telling him what we already knew and what we were thinking, I mentioned both that the previous doctor did not think he could do latissimus reconstruction on both sides at once, and that implants weren't possible due to my previous radiation. Dr. Langstein said, "Oh, I could do both sides at once. That's not a problem." He also said I may actually be a candidate for implants after all, which makes everything so much easier. He said he would have to look carefully at my radiation records ("That'll be my homework," he said), but he expected since it was a lower dose, and more focused than it would have been if I'd had breast radiation (as opposed to something designed to hit deeper in my chest), it might not be a problem. And if it was, we would be able to see this fairly early on - maybe even on the operating table, because they could see that the skin would lack elasticity, but for sure within a couple weeks we would see signs of it not working. So if that happened, latissimus would still be an option; I could just go back and fix it if my skin wasn't doing what it needed to do. So, while he said he doesn't usually recommend different options because it is such a personal decision, he would prioritize implants over latissimus, mostly for simplicity at the moment and in recovery. Much less trauma for the body. But if that doesn't work, he can do latissimus no problem.
There are various pros and cons for each option, of course. Pros of latissimus: I would not need expanders, which I've heard are very painful. They would use all my own skin (more on donor skin in a minute), and there would be more of organic me in there. The immediate con is that it is a tougher recovering, and it leaves me with several significant scars. There is the weirdness I mentioned before about the back muscle having to figure out how to be a boob now, and the quirks that go with that. The muscle atrophies and the breast changes shape - although maybe that wouldn't be so pronounced with me because I would also have an implant in there. (There's not enough back fat to make me the same size I am now with just my own tissue - I'm either too busty or too skinny. Who would have imagined THAT would be a problem in my life??). And this seems dumb to consider, but with such a surgery on my back, the sensation on my back would be all wacky (ultra sensitive, or no feeling at all), and having your back rubbed is one of life's sweetest little pleasures. My parents used to put me to bed like that, rubbing my back while they sang a lullaby. I would hate to lose that sweet sensation, especially since I will soon be marrying a live-in back rubber!
Implants' major pro is their simplicity, and their technology is always improving and the surgeon is able to get a pretty good shape with them. My recovery time would be less, too. Silly, but: I would have perpetually perky boobs, even into old age. Cons are that they might not "take" for me (this was the "high risk" conversation, but high risk for plastic surgery is not the same as high risk for, say, pregnancy, or heart disease, or heck, breast cancer!). I would probably need expanders, and then possibly another, outpatient surgery to have the saline expanders swapped out for more permanent implants, probably after the wedding sometime. Implants, whether saline or silicone, are long term but not permanent. I would have to get an MRI every few years to make sure they are not leaking. There's no external signal that they might be leaking - no "maintenance needed" light like on my Honda, no, "time to go to the Boobie-Lube" guideline. (<--credit to Michael for that one... we giggled quite a long time about that.) He said generally they last about 10 years before they start leaking, though he's seen them last 30, and if/when that happens, I go in for a half hour surgery and have the leaky boob implant replaced. Sort of tedious, but again, I will have implants either way, so it seems trips to the Booby-Lube are my fate if I want reconstruction.
The other option that a lot of women use is tissue from their stomach. In case you wondered: I do not have enough tummy for two boobs. Maybe one, but that would be pushing it. (I said to Michael, "I think he just called me skinny!") How many boobs do you have in your tummy? You should find out - this makes great party conversation. (Again I say: this procedure is BIZARRE. I said this to the doc, and he said, "I know! And yet, people do it!") The other thing about anything with my tummy is it might affect child-bearing. He said they generally don't recommend any sort of abdominal surgery for women wanting to bear children. So that's out.
Another word about implants, since that seems to be the better option overall, if it is indeed possible. They will expand me as much as possible at the time of surgery (just stop and picture that for a minute, and for a laugh, imagine it with brightly colored balloons, maybe even animal balloons). They do this with saline (sorry, no animal balloons in real life) filled bags (actually, he did use the word balloon), and you can add more saline into them to expand more over time, presumably through a port. With one kind of saline implants they can then leave them in there, no more surgery required. With the other kind, they don't have to expand me as far, but then do a surgery to replace the saline with silicone, otherwise known as - get this - gummy bear material!! Cue song: "Gummi bears! Bouncing here and there and everywhere!" Cannot get over this. Michael asked if they come in different flavors. (Nope, no strawberry boobs.) I'm trying not to make this decision based on a funny name... but come on!!
I dare you to watch that without laughing. This could be my new theme song.
I'm so distracted by this, even now, that I can't remember what I was writing. Where were we? Oh yeah, my gummi bear boobs. I mentioned donor cadaver skin before. Yeah, sounds gross. It's this amazing technology where they use the dermis from cadavers to sort of supplement my own skin, since they will have to cut away some of my skin (the nipple and areola) for the mastectomy. (Nipple-sparing surgery is sometimes a possibility, but it is a little risky, and with radiated skin, he wasn't comfortable with it for me. It's just too delicate, and without enough blood supply, the nipple can die and... well I'll just leave it at that.) So they use this cadaver dermis to patch it up, I guess, and over time, my own skin grows over it. Weird, right?! I don't have to use that, but I admit it sounds freaky-cool. I'm sure my dear fiance is doing more research about it right now - he was pretty intrigued by the prospect.
Okay, so after all of the jokes and giggles, the fact is: I have some big decisions to make, and fast, cuz I want this cancer out of me. With this new possibility of implants, and reconstruction on both sides at once, I am suddenly entertaining the idea of doing bilateral mastectomies. My parents weighed in on this with some pretty compelling arguments, and Dr. Langstein also said when he's dealing with Hodgkin's survivors, he's usually expecting to do a bilateral - although again he said he would need to check out my radiation records and see what I actually had done before he could say anything definitively. There are many pros to having both done at once, not the least of which is not having to worry about breast cancer anymore. And the one major con, of course, is giving up my dream of breast-feeding, which I want to do emotionally and for the health of my children. Can I let that go? I don't know. Lots of thinking to do, in not a lot of time. And so we continue.
This is definitely an example of one of those sermons you preach to yourself. Basically, it is my internal dialogue this week, as much personal reflection as it is sermon, truly a "life meets ministry" sermon.
Easter 3C
Acts 9:1-6, Psalm 30
Christ is risen! Christ is risen
indeed!
Today
we hear the story of Paul’s conversion – from Saul to Paul, from persecutor of
the church to promoter of the church. Such a great story: this guy who was the
greatest enemy of the church, “breathing threats and murder against the
disciples of the Lord,” and as he is actively trying to tear down the church
this blazing light from heaven knocks him down and blinds him and calls him
out. Friends have to lead a confused and sightless Saul into town where he
encounters Ananias who has been told by the Lord that he must talk to this
enemy of Christ. Ananias does as he is told, explaining to Saul what had
happened to him on the road, and then this great line: “something like scales
fells from Saul’s eyes, and his sight was restored.” And Saul was baptized, and
began proclaiming the good news of Christ, and eventually became Paul, the guy we know and love who wrote much of the New
Testament.
There
are so many cool parts of this story… but I admit that when I read it, I often
feel a little jealous! I sort of wish I had such a cool and dramatic conversion
story, something that would draw people in, make them say, “Wow, if something
like that could happen to her, maybe this God and this faith are worth
considering.” Instead, my story is, “I was born into a pastor’s family and went
to church every single week, sometimes twice, for my whole life, then I majored
in religion, then I was a missionary, then I went to seminary, now I’m a pastor
and will have my own pastor’s kids someday.” It’s not a very compelling story.
No flashing light from heaven, no sudden “a-ha!” moment, no scales falling from
my eyes and sudden enlightenment. Even my call to ministry story is more
logical than mystical: I started thinking that maybe I could be a pastor, and
then I applied to seminary. For someone like me who loves a good story, it’s
kind of a bummer.
But
maybe I do have a good conversion story, and in order to find it, we need to
broaden our understanding of what conversion is. Paul’s story sets the bar
pretty high as far as how he actually become a Christian… but the thing about
becoming a Christian is that it is not a once and done sort of deal. You don’t
suddenly get baptized, confess Christ, and then you live a life of devout and
unwavering discipleship and nothing ever goes wrong and everything in life is
hunky-dory because you are a Christian. By no means! Conversion is something we
might do every day of our lives, as we face our various travails and
challenges, frequently turning this way and that before finally turning back
toward God. We are constantly converting! And so I think that the conversion
story in our readings today that might better suit many of us and our
day-to-day conversions, comes not from Paul, but from the Psalm.
I
remember the first time I really noticed Psalm 30. It was while I was living in
Slovakia. I’d been there about a month, and had just arrived in my village –
after spending the first month there with the other Americans in my group, I
was now all alone in this tiny village. I was desperately homesick, and
doubting that I should be there at all, and I spent a lot of time crying. In an
effort to cultivate a spiritual discipline, I started reading through several
Psalms each day. Although I had never before written in a Bible, when I got to
Psalm 30, I started underlining and putting exclamation marks in the margins.
“Weeping spends the night, but joy comes in the morning.” Yes! “You have turned
my wailing into dancing.” Please, Lord! Though the Psalm spoke in past tense, I
understood this as my prayer, that this would soon become my own past tense.
Joy would come in the morning. My
wailing would be turned to
dancing!
I
had a similar experience this week in my office. It has not been an easy week
for me, as many of you know, with many big health decisions to be made. I was
grumpy on Monday morning, to say the least. As is my custom in sermon
preparation, I read the texts assigned for today aloud to myself in my office…
and by the end of the Psalm, I was weeping. Once again, I knew: God would turn my wailing into dancing, and would clothe me with joy. God would convert my heart and bring me through this trial,
just as God had done so many times before. And indeed this marked a turning
point for me – I suddenly became very aware of the blessings God was putting in
my path, from the surprising kindness of strangers, to old friends
reconnecting, to a deeper sense of gratitude for the abundant gifts I have in
this life. They had all been there all along, but it was not until my heart was
converted that I was able to see them.
It’s
a different sort of conversion that the Psalmist sings. It’s not the same as
Paul’s conversion on the road to Damascus, but it is a conversion, nonetheless.
A conversion from frustration and confusion to understanding and acceptance.
From darkness, to enlightenment. From doubt and despair to hope and
fulfillment.
Such
conversions tend to happen when we are not prepared, right? Or perhaps more
accurately, when we are prepared for something else than what life throws us.
Such conversions blindside us, knocking us down when we least expect it: when a
job is lost, or an illness diagnosed, or a relationship broken, or a loved one
taken from us. We put such careful plans in place, have so many hopes for our
lives and our futures, and then BAM, everything changes. We find ourselves,
with the Psalmist, “down in the pit.” We are sad, confused, angry. We may not even
have the words to pray at all, certainly not to praise any God that would let
this happen!
This
is when conversion is possible. Saul was knocked down, blinded, confused,
approached by a stranger who told him the will of the Lord, and suddenly, he
saw. Something like scales fell from his eyes, and he saw and understood how
the Lord would work in him. He was converted, from hate and despair to love and
purpose.
And
that is a story we see in our
lives all the time. In today’s Psalm, the Psalmist begins in praise, in joy, on
solid ground. He writes, “While I felt secure, I
said, I shall never be disturbed. You, LORD, with your favor, made me as strong
as the mountains.” That’s a wonderful place to be, but it is not the place of
one who is ready to grow and be transformed, is it? It is not until we are
knocked down, maybe even blinded like Saul was on that road to Damascus, that
we suddenly become aware of our need – our need for God, our need for
conversion and transformation. I have a colleague who said it very well: “being
happy is great and all, but happiness doesn’t have a whole lot to do with
transformation.”
And
transformation, conversion, is what this faith is all about. Yes, Paul’s
dramatic conversion story that day on the road to Damascus is a wonderful story
about becoming a Christian, but conversion and transformation didn’t finish on
that road. It also didn’t start on that road. The transformation of life as we
know it started on that Sunday morning at early dawn when some women discovered
that God could transform death into everlasting life, that fear and sadness
could be converted into love and joy – indeed that wailing could and would be transformed into dancing.
This
happened on that Easter morning, it happened on the road to Damascus, and it
happens still in our day-to-day lives. This is the promise of the resurrection:
that God will continually bring life out of death, and transform our wailing
into dancing. I had a profound experience of that this week, and I’m sure you
have had similar experiences: times when
you found yourself in darkness and in pain, and were confronted with light,
healing, and direction. Times when you suffered, when “weeping spent the
night,” but when you turned toward God, “joy came in the morning.” That
conversion – that is the power of our God.
Let
us pray. Transforming God, we sometimes find ourselves weeping and wailing
through the night, unable to understand or accept our circumstances. Help us to
trust that your promise to us is to turn our death into life, our mourning into
joy, and our wailing into dancing. In the name of the Father, and the Son, and
the Holy Spirit. Amen.
