Reframe

I feel like a new person today. Finally last night Michael and I got a chance to just be together, alone, and talk about how we are feeling about all this. Just being able to say things aloud to each other, put them on the table so we can deal with them and move forward, feels like a weight has been lifted. We've not come to any conclusions, but I at least feel more equipped to reason through the different options without dissolving into uncontrollable tears. Big steps in the right direction.

Here's the other thing I've found. I feel equipped today to be able to re-frame things so that they sounds like I am (we are) in charge. Yesterday, cancer and Tamoxifen were dictating our life, a life we were extremely excited about that had just been shattered. Today, I'm dictating it, within some bounds that were previously not there. (But you know me, I like structure!) As my radiation oncologist said, I am the captain of the ship. So for example, if we decide that I will take Tamoxifen for two years, then go off it to have some babies, then go back on, that's no longer, "We can't start a family right away." It becomes, "We already are a family, Michael and I. A two-person family. For the first couple years of our marriage, let's just get used to what it is like to be married. Let's get really good at being married, let's strengthen our partnership, let's equip ourselves to have the best partnership we can so that we can then be the best parents we can be. During that time, I'll take this drug that will help save my life. Then, we'll add to our two-person family and become a three- or four-person family, and won't that be a joy!" In fact, maybe this is God's underhanded little way of showing us down a path that will ultimately make our lives as spouses and as parents even richer. God only knows!

Yet another blessing. (Isn't this wonderful? Yesterday I saw not one sliver of silver, and today, two!) Some couples get married without having any clue how they will manage those Really Big, Tough Things that come up in life. You know, things like major illnesses and bumps in the road to family planning. Not so with Michael and Johanna! We have done it (er, are doing it)! We have had to say to each other countless times, "We will get through this. We will do this together. I'll hold you when you need me, you hold me when I need you, and we'll hold each other or turn to our many family and friends when we don't have the strength ourselves. And God will hold us all the way through. However we do this, we will do this!" We will enter our marriage with a wisdom deeper than many newlyweds have. Though I don't like the path that produced that, I suppose even for that, I'm grateful.

Monkey-wrench

Okay, I admit it: it is getting harder and harder to stay perky and positive through this thing. And maybe I shouldn't write this post yet, as it may be too full of raw emotion, but, well, you've been with me so far, so maybe you won't mind if I just bare my soul even more than is usual for me (this is saying something!).

I met with the medical oncologist yesterday. She was very nice, but more reserved than other doctors I've had so far. (By this I mostly mean she didn't laugh at as many of my jokes, Oh, it hurts!) She is a preacher's kid, too, which I went ahead and took as a good omen. My parents are in town, which is great, and they were able to come with me. Michael had to be at work. It was "just like old times," going to the oncologist with my parents - except, as they pointed out, this time I had to do all the paperwork myself and they didn't even have to co-sign!

The doctor started by laying out the treatment plan possibilities. I could do surgery, as discussed. I could do radiation, as discussed. And/or I could do Tamoxifen, "hormone therapy," which we would discuss. Radiation, she said, she would take off the table. The risks are too great, and especially given the high risk of this returning (given other indicators), I don't want to risk not being able to have successful surgery in the future (like a mastectomy). Ok, good, that's where I was headed already. So surgery it is. But, she said, she would also really urge me to take the Tamoxifen. Here's the scoop on on Tamoxifen: It is a drug I would take for 5 years, and serves as a preventative for estrogen-fed cancers like mine. It would in fact cut my risk of recurrence by about 50%. It is an estrogen blocker, so side effects would be similar to what I would experience in menopause (hot flashes, short-term memory problems...). More significantly, I can't get pregnant while I'm on it. Or rather, I could get pregnant, but the risk of birth defects is very high, so I'd need some heavy-duty, non-hormone birth control for the next 5 years. Well, this puts a bit of a damper on the whole starting-a-family thing that Michael and I were hoping to get busy with on July 20, 2013. Not great. I can deal with having a scarred breast. I can deal with having to breastfeed on just one side. I can deal with knowing that I am at extremely high risk of this returning and I can even deal with the possibility that I may have to have a mastectomy in my 30s. But this latest bit is not something I'm having an easy time with.

Now, there are some other options. I can, of course, not do it. Not that I'll choose to do that, but it is nice to remind myself now and then that I have this power, that I am in charge of my own body and health. Another, more feasible option is that I can take Tamoxifen for a couple years, go off it to have some babies, then go back on for 3-5 more years. It's not the norm (neither is having breast cancer at 29), but it is a possible and the doc thought very workable option, given my particular situation, especially because pregnancy can, in itself, be protective against breast cancer. That is, having been pregnant lowers one's risk for breast cancer, because breast tissue then matures fully and stops changing quite so much. Another option is, we could adopt children. Or, we could get hitched tomorrow and start a family right now! (I'm only partly kidding - this has occurred to us as a reasonable option, and Michael's been saying all along he'd marry me tomorrow if I said I would!)

I know that this isn't the end of the world. But in some ways, it feels a little like it is, in that it is challenging my understanding of my life purpose. My whole life, I have dreamed about being a wife and mother. I have always considered wife-hood and motherhood to be my primary vocation, and now I am feeling very frustrated that just when I finally am planning to get married and start a family, my body has rebelled against the idea, and all these roadblocks and detour signs have been thrown up. Why now? Even my other vocation, as a pastor - I'm a year into my ministry, it's going well, and then I get smacked with cancer again? How is that affirming of my following your call to serve your church, God, huh?? What am I supposed to make of this??

When I started this thing, I had a couple concerns, given that it was clear this cancer would not take my life: 1) maintaining the ability to breastfeed, and 2) to some extent, my vanity - wanting to still look as "normal" as possible. I didn't expect that my ability to stay on my life track as far as timing for starting a family would be affected. Maybe I was just in denial about that, because I did know Tamoxifen was a possibility from early on. At this point, even being able to breastfeed or not seems so insignificant compared to having to wait 5 more years to start a family. At this point, I would gladly give that up. Funny how perspective changes. (Just kidding - it's not funny at all.)

I'm an emotional wreck. Please pray for the wisdom to make the right decision. Thank you.

Sermon: Kneeling for healing (Oct. 14, 2012)

Mark 10:17-31

         There once was a rich young man. He was a really good guy – the kind of guy you’d bring home to meet the parents. He went to church, he did nice things for people, he was smart, self-reflective, handsome… He had a good job, one that already paid him quite well, but also had lots of room for climbing the ladder. He was able to live comfortably and even put some money away. This man was definitely in a good place in his life. And on top of all that, he had always been the kind of guy who does the right thing. You know the type? He never said mean things about people, he was loyal to friends and family, he never took credit for things that weren’t his, he never lied or cheated, and he was very good to his parents. This guy was one good egg.

         And yet, something felt off. I mean, here he was – a good job, a good family, a good life all-in-all, but he still felt this sense of dis-ease. You know how you get that feeling? Like even though you think you’re doing everything right, something just isn’t in place?

         He thought about this a lot. And then one day, a well-known spiritual leader came to town. As he heard people talking about this leader, the source of his dis-ease occurred to him: he wondered, for all the good that he did here on earth, what was it all for? What was the point? What comes next?

         And so off he went in search of this leader. And when he found him, the young man fell to his knees, suddenly certain that this teacher could tell him what he needed to know. “Good Teacher!” he said. “What must I do to inherit eternal life?” The teacher told him to keep the commandments. Feeling somewhat affirmed, but still lacking what he needed most, the man replied that he already did this, and always had. The teacher gave him a curious look, a loving look, as if he saw deeply into the man’s soul. It is only when one truly loves you that one can truly know you, and the young man did feel wholly known by this teacher. But the next words the teacher said were difficult: “You lack one thing; go, sell what you own, and give the money to the poor, and you will have treasure in heaven; then come, follow me.” The poor, rich young man was shocked. Sell everything? All that he had worked so hard for? His future? Everything?

         His dis-ease had been diagnosed. The teacher had offered him a treatment, a way to find that which was missing in his life. Though he could see the good that would come from the change, the treatment seemed too much. He couldn’t bear it. And he went away grieving. …

The experience of the rich young man in our Gospel lesson this morning is not so unfamiliar to us. How often have we come to Jesus with a feeling of dis-ease in our hearts, and asked for treatment, only to find the treatment too difficult to bear. Maybe we are overweight and under-exercised, and, knowing we should be good stewards of our bodies, we try to eat better and exercise more. But the lifestyle change is too much. We cannot bear to give up chocolate, or our favorite TV show. We go away grieving. Or, we are facing a cancer or other disease, and the doctor says, “It needs to come out to save your life.” But the thought of losing a thyroid, a uterus, an appendage… seems too much for us, even if it is what will save our life. We go away grieving. Or we have a friend who has turned destructive. She keeps us from growing closer to God. But this person has been our friend for so many years, and we can’t imagine life without her. We know we need to leave the relationship, but it is unimaginable. We go away grieving.

There are so many ways we feel dis-ease in our lives, even as we try to live life the best we can. What dis-ease do you experience? What brings you to kneel at Jesus’ feet and ask for help… and how often have you found that the treatment for the dis-ease is too difficult to comprehend?

As we often do at this time of year, we are beginning today to think intentionally about stewardship. We often associate stewardship with giving money. That is a part of it, for sure, because where we put our money says a lot about what we value. It is often said that if you want to see what is most important to you, you should look at your bank statement, and see where your money goes. But much more than a conversation about money and our “many possessions,” stewardship is about being good managers – or stewards – of all that God has given us. This of course includes money. But it also includes everything else we have. Luther articulates it well in his interpretation of the first article of the Apostles’ Creed in the Small Catechism. He says: “I believe that God has created me and all that exists. God has given me and still preserves my body and soul: eyes, ears, and all limbs and senses; reason and all mental faculties. In addition, God daily and abundantly provides shoes and clothing, food and drink, house and home, spouse and children, fields, livestock, and all property – along with all necessities and nourishment for this body and life. God protects me against all danger and shields and preserves me from all evil. God does all this out of pure, fatherly, and divine mercy, without any merit or worthiness of mine at all! For all of this I owe it to God to thank and praise, serve and obey him. This is most certainly true.” Wow. That’s quite a lot that God has provided for us, from shoes and clothing to protection from evil, and all just because God loves us, not because we did anything to deserve it.

Framed this way, it’s remarkable to imagine that the rich young man was so shocked and grieved at the thought of giving up the bounty God had provided him – giving it to the poor, no less, who had far less than he did! It had only been given to him out of grace, anyway. It never did truly belong to him, did it?

And yet, it is hard. We know that, with the rich man. Of course it is hard. I mean sure, it would be great to give not 10%, but 100% of my income away, if it weren’t for having to pay for those pesky things like food, clothing, rent, student loans, oh, and dinner out now and then, and this fabulous new jacket, and a trip once in a while to visit someplace interesting.

Yeah, we’re not so unlike the rich man. We all have things we’ve come to believe are rightfully ours. I earned this. This is my money. This is my time and I will spend it how I want. And how quickly these possessions then turn around to possess us. We cannot imagine our lives without them. Who we are gets so entangled with what we have, we find it hard to imagine that we can be who we are without these things. Such dependency on our possessions may or may not immediately cause that sense of dis-ease in our hearts that the rich man felt. But when Jesus suggests that the way we can grow closer to God and inherit eternal life is to give all these things away and follow him, this does indeed seem a shocking impossibility, difficult to ignore! It is giving up too much – our selves, our time, and our possessions!

And for mortals, for you and me, it is a shocking impossibility. But not for God. For God, all things are possible, Jesus tells us, if we but trust in God! Because at the end of the day, it is not our things that define us. Our true definition comes in our baptism, when we are showered with water in the name of the Father, the Son, and the Holy Spirit, and called, “child of God.” It comes in words of forgiveness. It comes in those words, “Given for you.”

What is it that keeps you from embracing that identity God gives you? What have you allowed to define you? When you come to Jesus and kneel before him in need of wholeness, what is his response? What words of grace does he offer you? Who are you when that happens?

Let us pray. Merciful God, we come and kneel before you, aware of our dis-ease, asking for your help. Guide us in knowing what you would have us give: our selves, our time, and our possessions. As we learn to rely more wholly on you and your grace, give us the confidence we need to trust that your providence never fails. In the name of the Father, and the Son, and the Holy Spirit. Amen.

I feel so special... (radiation oncologist)

Lo, finally I know something more, and that something is that I have some decisions to make. I met with the radiation oncologist today - Dr. Hong Zhang, a very sweet, compassionate, and energetic Asian woman. For the first time today, I went to Highland Hospital, which, while a part of the University of Rochester system (aka same as Strong), is a new facility to me. Michael and I both found our way there, and had good interactions with people from the start.

The first person we met with was the nurse. Then the physicians assistent, who did an exam on me. Then they sent in Dr. Zhang. All three women were very excited about Michael and me getting married, and Dr. Zhang couldn't stop saying how cute we were together. :) On our way out at the end, the nurse and PA said, "Hey, we want invitations to the wedding!" Cute.

So Dr. Zhang went into detail about what was discussed at the Tumor Board on Monday. They had pictures of my insides up on the wall, my records in front of them, etc. She said my treatment for Hodgkin's was very good - I was a part of a trial that included much lower doses of radiation, so she was pleasantly surprised by that. (Apparently this low dose, though not normal in 1999, is getting to be the norm now. I helped!) First she laid out what is standard, which we already knew: a patient with my diagnosis (DCIS) would have a lumpectomy followed by radiation. The purpose of the radiation is to catch any  remaining cells, thus decreasing the chance of reoccurence. (It does not decrease the risk of secondary cancers, however, which is why I'm in this situation!) There are different ways she could do radiation, and would do her best to avoid my heart.

But, there are a couple things that make me special (well, I hope more than a couple!). One, I'm young, pre-childbearing. And two, my medical history. That said, the board came up with two options for me, both of which they all felt would be medically feasible and successful:

Option 1: I have a re-excission surgery. Although they had healthy margins around what was taken out the first time, 80% of the time when the same cancer returns, it is within one centimeter of what was there before. So Dr. Skinner would go in and get a centimeter worth. Since the part with the 3mm margin (the closest one) was close to the edge (my skin), she'd probably just take out as far as she could until she got to skin. Then they would watch me extremely closely over the next several years.

Pro: I wouldn't have to have radiation again. I have the opportunity, should this return, to get a mastectomy, or even another lumpectomy. I would probably find breast-feeding more successful.
Con: This isn't the standard, which always feels a little scary. All the risks associated with surgery. Already my breast size has changed noticeably, so this would add to that. (Vanity, vanity, all is vanity.)

Option 2: I have radiation. Again, there are different ways to do this, including coming in only for 2 weeks, twice a day, and receive higher doses.

Pro: Avoid surgery and possible breast deformation. It IS the standard, and has a high success rate for wiping it out. It's what I had already prepared myself for.
Con: If this does return someday, surgery is made more complicated by the radiation - a mastectomy may not be possible. While my breast shape would be maintained, the function not so much - they usually discourage breast-feeding from a radiated breast (plus it probably won't perform anyway).

So, lots to think about. Michael had to run off to a meeting right after this, so we haven't had a chance to process together, nor have I talked to my parents or friends. On Monday I will meet with the medical oncologist for the first time, and my parents will actually be with me for that (!). We can discuss this at that appointment, as well as the possibility of taking Tamoxifen, which is an estrogen blocker and preventative, but I would be unable to get pregnant while on it. The usual amount of time to be on it is 5 years, which doesn't really jibe with my life plan to start a family as soon as possible. I'll be interested to hear what the med onc has to say about this.

Whew, that's a lot. Feeling a little overwhelmed. I'm glad I have the day off tomorrow to think about it.

Sermon: God Doesn't Break Promises (Oct. 7, 2012)

Mark 10:2-16

            As you well know, I have had a lot of pretty big things going on in my life lately, some more pleasant than others. But, now that my surgery is done and was successful, and I have a few weeks off now to recover before the next steps begin, I can turn my attention to something much more fun. That’s right: I have wedding head! Michael and I will have engagement photos taken this week, we’ve been looking at some possible venues, we have settled on a date – July 20^th in California and a couple weeks after that we’ll have a celebration here in Rochester – and I’m getting excited to look at dresses, choose flowers, all that fun stuff. How easy it is to get swept up in all of the excitement of starting a new chapter, a new life with the one I love!

            You know, I can’t help but notice how frequently the lectionary, the set of assigned texts for each week, aligns with whatever else happens to be going on in life. So just as I’m preparing to put on my blushing bride hat and get down to wedding planning, we’re faced with this difficult text with Jesus’ words on marriage and divorce. Well, I’ll tell you one thing: it has definitely given me a reason to do a lot of reading this week on the spiritual aspects of this marriage covenant that Michael and I are going to enter in… 286 days (!).

            And we do consider it a spiritual covenant. Marriage wasn’t always that, of course, and that is clear in the Pharisees’ challenge to Jesus in our Gospel reading. Aiming to test him, they ask him a very legalistic question about marriage – because that’s largely how marriage was understood in the first century. It was a legal engagement, a matter of property transference. And honestly, it was a pretty unjust one, and Jesus’ first purpose is to point that out. Up to this point, the woman had been given to the man as a piece of property, and according to what Moses had commanded, a man could dismiss that woman for any reason ranging from infidelity to simply not liking her cooking. One rabbinical source says that burning the man’s toast could be reason enough for dismissal, or divorce. Boy, in that case, I’d be on the street in a hurry! For the woman, of course, such a dismissal would be devastating, because by then, she is damaged goods. She must endure familial and public disgrace, potentially severe economic hardship, and limited future prospects for her and her children. In short, in the case of a divorce, she becomes among the very weakest members of society. Not such a good system – and no wonder Jesus spoke against it! One could very easily and rightly interpret this text as one about justice for the weak, which is confirmed by Jesus’ immediately following reference to children, another weak segment of society. “Care for the weakest among you,” Jesus urges his followers in today’s Gospel!

            While this is a fine reading of this text, and an accepted one, to leave it at that would miss an opportunity to really talk about this thing, divorce, that has caused so much pain for so many people, including many of us here, who have been hurt by an experience with divorce, whether our own, or our parents, or a dear friend or family member. And it is not the legal aspect that is painful, is it? Much more than who gets the house or even who gets custody over the kids, the deep and lasting concern for us today is the spiritual and emotional impact of the experience, the brokenness and perhaps shame we feel, the pain we must endure.

            Jesus is also concerned about that spiritual brokenness. Notice how when the Pharisees ask him their legalistic question, Jesus turns it into a spiritual one, referring to the text from Genesis that we also heard this morning – the one about the creation of Eve, and the subsequent partnership that ensued between Adam and Eve. What is the reason God creates Eve? Is it so she can make babies? Is it so she can burn Adam’s toast, or not? No, it is because it is not good for the man to be alone. It is because Adam needed a helper, a partner in life. And when God takes a part of Adam’s flesh to make the woman, Adam realizes that this person is a part of him, “bone of my bone and flesh of my flesh.” They are one flesh, one body that nothing can separate.

            That sounds a lot like our relationship with God, doesn’t it? See, that is what happens in our baptism, when God, the Father, Son and Holy Spirit, brings us into the dance of the Trinity, the relationship of the One-in-Three and Three-in-One, and makes us a part of the one Body of Christ. In our baptism, God makes a covenant with us, just as God has made covenants with God’s people all throughout time. God makes a promise, a covenant, a vow, to be with us always, to the end of the earth, to love us always, to forgive us always. God promises in our baptism to have and hold us, for better, for worse, for richer, for poorer, in sickness and in health. This is God’s promise.

            So the gift of the marriage covenant, in this way, is one deeply profound way for us to experience in an earthly relationship the covenant that God has made with us. In marriage, we make a promise to someone, to have them and hold them, for better, for worse, in sickness and health, for richer for poorer, until death parts us. And in making that promise to another, we have the chance to more deeply understand what a Big Deal it is that God makes that promise to us! Because while I am not yet able to speak from personal experience on this matter, I’ve heard tell that for all the wonderful aspects of marriage, it can also be really, super hard.

But God wants that sort of depth of relationship for us. Covenant is God’s intention for humanity. That is made very clear throughout the witness of the Old Testament, starting with what we heard in Genesis a moment ago. “It is not good for the man to be alone,” God observes, and so provides a companion, a relationship, for that first man. That is what God wants for us: for us not to be alone, and for us to be in relationship with one another.

            Marriage isn’t the only way to experience God’s desire for relationship and community, of course. We may experience it in our families of origin, or with our own spouses, children, nieces, or nephews. We may experience it through friendship. We certainly experience it here in the church. As I said before, God assured us of that in our baptism, and we experience it every time we come forward to this table, like grains of wheat once scattered on a hill, now come together to become one bread. Whatever way you look at it, our God is one who desires community.

            And so our God is grieved when that community, or relationship, or covenant is broken – when there is conflict in the church, when families refuse to speak, when marriages fall apart. Just like God is grieved when our relationship with God is broken. And we do have a history of breaking God’s covenant! You can read all about that throughout the Old Testament, not to mention the entire history of Christianity since that babe was born in Bethlehem. We fallen human beings are not all that great at keeping covenants. Relationships are a great gift, and marriage can be one of the greatest gifts of all, but they can also be terribly hard to maintain. They can turn destructive, even dangerous. Sometimes they do need to end, so that we can better nurture our relationship with God and with God’s people. Covenants do get broken.

            But here’s the good news: even as we endure the pain that accompanies a broken relationship, we can rest secure in knowing that even when our covenants fail, God’s never does. When we fail at our vows, God’s gracious vow to keep us in this holy family called the church will still stand, will still hold us upright. And while breaking the covenant of marriage, or any covenant, is not God’s intention for us, it is also not unforgivable. Despite whatever brokenness we manage to participate in, God’s grace always manages to wiggle its way into the cracks and work a new thing. Our sin, our shortcomings, our propensity to see other’s faults before recognizing our own… none of that is too big for our God, who promises us in our baptism, and every day since then, and every time we come to this table, that we are beautiful, loved, and forgiven children of God, and nothing can ever change that. Thanks be to God!

            In the name of the Father, and the Son, and the Holy Spirit. Amen.

Past, present, future

When Michael first proposed to me, I yelled at him. "You weren't supposed to do this this weekend! I said I couldn't make any major life decisions right now!" (But then I said yes, of course.) When I told my parents, they said, "I thought you weren't going to make any major life decisions right now." Yeah, I did say that. That was really wise and responsible of me to say. Focus on your health, Johanna. One major life event at a time. Don't stress yourself out.

But timing for important things is so seldom what you expect it to be. And here is what I've noticed. Even though I have never thought I would die from this cancer (not even remotely - it's 100% treatable for goodness' sake!), there is always, associated with "the C-word," this sense of, "My life is over." At least, my life as I know it. I will never go back to a time without these scars, these risk factors, these fears... (though also these relationships, and this wisdom. It's not all bad!) My life will indeed never be the same, in an even bigger way than normal.

So in the midst of all that "my life is over" stuff, what a blessing it has turned out to be to have something else in my life that is all about my future. My positive future. My exciting future. My positive, exciting future with someone I adore. I don't only have strenuous treatments, quarterly check-ups at the doctor for the next three years, and the fairly decent possibility of this coming back sometime in the next 20 years to look forward to. I also have pretty dresses, grand celebrations, promise-making, family starting, and a wonderful life of partnership to look forward to. That's definitely something to get out of bed for in the morning!

Post-op appointment, and more unknowns

It seems like every time I learn something about what's happening inside my body, more unknowns pop up!

But first, let me say that I had my post-op appointment today and I would say I got an A on it (if they gave grades, that is). I met with the nurse practitioner, since Dr. Skinner is out of town this week. Mercifully, she delved right into the pathology, so now I know a little more about the cancer that was in me. Read on, and you will know, too!

The amount they took out was much smaller than I was told - only .6 centimeters. (Radius? Diameter? I don't know.) The cancer-free margins all around were big enough that no more surgery is needed. The diagnosis has changed from straight up DCIS (ductal carcinoma in situ) to mammary carcinoma in situ, because there is some lobular CIS mixed in there. Lobular CIS is not actually full blown cancer, though it could presumably develop into such. Either way, the "in situ" piece means that it has not broken through the wall. It is all contained in the milk ducts and is not invasive. Good news! The stage (how extensive the tumor is) is technically zero, and the grade (how aggressive it is) is 1/2 (3 is the worst). (Stage 1 and 2 have to do with the size of the tumor, stage 3 is in the nodes, and stage 4 is in another organ.) The cancer is estrogen receptive, so it is sensitive to hormones. I could take something like Tamoxifen, an estrogen blocker, as a preventative, but I can't get pregnant on it, which is definitely on my to-do list after next summer. I think there are some other options available, though, for drugs.

As for the surgery site itself, there is no swelling (though the incision from the week before still has some fluid). It has no bruising and is healing really well, despite being unsightly. (Between this new scar, the scar from my site select procedure on Sept. 17, and my old scar from my port-a-cath in 1999, which is just under my boob, I like to call it, "Franken-boob." Michael told me I shouldn't put my boob down like that. What can I say, I process things through humor. It's sort of an endearing name, no?)

So that's all the good stuff. Here's the more complicated stuff. I finally brought myself to do some reading, and have read in multiple places that people who have had radiation to the chest previously should not have radiation to the same spot again. Well, that would be me. The nurse practitioner did not feel comfortable addressing that concern herself, but said it would be discussed at the Tumor Board on Monday. (I don't know why, but the name "tumor board" strikes me as funny. Anyone else?) The radiation, while scary since it is what triggered this bout in the first place, actually increases the survival rate, because it catches any stray cancer cells that surgery might have missed. Is it worth the risk either way? Dunno yet.

The other thing is that I hoped to get this all done before Christmas, both for financial (insurance) and professional reasons. We are already pushing it. But then the medical and radiation oncologists that Dr. Skinner normally refers to can't see me for a consultation until Oct 31 or later, which really pushes it out. So we have set up appointments with a couple oncologists at partner hospitals, and I will meet with them in a couple weeks. I'm grateful they were able to get me in. But I feel a little uneasy because, although I have heard only good things about all the breast care centers around here, I was feeling really good about my care at Strong, and about what people had told me about the doctors at Strong that I would be working with. So I'm trying to sort through that and shift my thinking, and convince myself that it wasn't a mistake to push being done by the end of the year.

The other thing that threw me for a loop was that when the scheduling girl called to tell me what she'd set up, she said, "You'll meet with Dr. Marcia Krebs to discuss chemotherapy." I quickly corrected her, saying chemo was never one of the options for me. But she said it was a consultation for the next steps, and chemo was one possibility. Did she get her signals crossed? Or is chemo a possibility if I can't, in fact, have radiation again? The receptionist, of course, wouldn't know. I had really settled into imagining that radiation would be next, and now, again, I have to shift my thinking. I will do whatever it takes, of course. But between this and the doctor shift, I'm feeling a little unevenness of the ground beneath me.

All in all, though, a good appointment. And I might just get all week next week with no doctor's appointments! Huzzah!