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.
Zero decisions.
Breathe.
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This made me laugh, tear, and shake with frustration. I'm in no place to say anything about right or wrong, but there's only one super awesome beautiful you.
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