February 2009

Radiation Roulette

Another day, another morning spent in a waiting room flipping through an old issue of People. I assure myself this visit will be a breeze—no clueless surgeon telling me I may already be Stage 4, no needles jabbing into a “suspiciously swollen” lymph node, no jaunty pink ribbons of sisterhood. I’m here for a simple pre-surgical chest x-ray. But nothing is as simple as it seems these days. And, as I hear the technician’s monotone instructions–take a deep breath, hold it, let it go–I can’t help but wonder if this is where it all began.

I was 13 years old when our family doctor ran his finger down my spine and announced to my mother that I had scoliosis. I knew the word all too well. Like my peers, I gobbled up every book by Judy Blume, including Deenie the ode to the adolescent angst of scoliosis. The tears began to roll the minute I hit the parking lot.

How many x rays are too many? No one knows, but the orthopedists who mapped my wayward spine seemed to think nothing of ordering them in abundance. Strangely enough, even then, I feared the radiation might damage my ovaries and breasts. How on earth, at age 13, I suspected that radiation was bad news for my budding reproductive system, I’ll never know. (Blume? Was it you?) On the day my anxiety boiled over I mustered the courage to ask the x-ray technician for something to hold in front of my ovaries. I can still picture the quizzical tilt of her head, the you’ve-got-to-be-kidding-me expression on her face. Without looking at me, she handed over a small plate of some kind. I took my best 13-year-old guess and held it beneath my navel. Deep breath. Hold it. Let it go.

Of course, one can’t re-examine every choice. (Maybe I should have held the plate in front of my breasts?) But that doesn’t keep my brain from wandering off to pan the stream of my past for carcinogens. What’s maddening about breast cancer is that I’ll never know what tipped me over the edge. The place I go looking for answers isn’t rational, but I like to visit it anyway. I peruse the statistics, run my fingertips over the risk factors. I find bizarre comfort in the unavoidable ones, such as early menses, but my gut lurches when I seize upon something questionable, something avoidable, like one too many x rays.

As someone who writes about women’s health for a living, I knew my history of radiation exposure put me at a higher risk of breast cancer but I didn’t know by how much. Was I naïve to think I could mitigate that risk by eating a vegetarian diet, staying fit, buying organic? I told myself a few x-rays wouldn’t raise my risk substantially. After all, it was just a little scoliosis; it wasn’t like I was in Hiroshima when the bomb dropped.

Then, on a flight to DC two weeks ago, I opened Dr. Susan Love’s Breast Book. While browsing the chapter on breast cancer risk factors, my eyes snagged on two sentences: “…there are other studies confirming the existence of radiation-induced breast cancer. One showed an increase in the disease among women with scoliosis who had a lot of x rays to monitor their backs during puberty…these studies show that the danger is from exposure to moderate doses of radiation.” Shit.

I’ve spent the past twenty-five years trying to make peace with what happened to my back. Trying to understand how an otherwise healthy young girl with a mild curve ended up in an operating room where surgeons carved a 13-inch incision, deflated a lung, took out a rib, removed a couple vertebrae, and rebuilt her lumbar spine out of metal rods and screws. One week in the ICU. Two weeks in the hospital. Three months flat in bed in a full body brace. Six months in a half-brace. Twenty-five years of thinking—was it worth it? Maybe I finally have my answer.

And that’s how I found myself at 9:15 this morning face to face with yet another x-ray machine. Breasts innocently awaiting another blast of radiation.

This time I didn’t bother to ask about protection; obviously, it’s beside the point.

By this time next week, they will be gone.

Deep breath. Hold it. Let it go.

 

 

 

‘Cause One is the Loneliest Number

Because breast implants freak me out on every level and because I’m too thin (wow, did I really just write “too thin?” see, cancer is good for your self-esteem) for a TRAM flap–that’s when a plastic surgeon cuts a thick slab’o fat from your caboose (or elsewhere) and slaps it onto your chest –I found myself left with two stellar options: uniboob vs. no boobs.

Let’s talk about the singleton. I know plenty of women do and more power to ’em, but I just can’t image going solo. For starters, the asymmetry would drive me bonkers. A dozen years of non-stop yoga has left me freakishly in-tune with my body. What does that mean? Trust me, it’s not as fun as it sounds. Basically, my brain is constantly calibrating my body’s position, checking to see if things are centered, and gauging whether or not I’m using both sides evenly. (Yes, vacuuming is a bitch.) But before you judge me freakier than I really am, you should know that such hyper-awareness was borne of necessity. It’s my way of micro-managing the aches and pains of scoliosis.

Because my back curves in umpteen different directions, every day is a fruitless search for center. Until last month, my messed-up back was my “thing.” ‘Cause everyone needs to have one sucks-to-be-you health thing, right? Except me. Now I have two. Shit. Well, the point is that my obsession with symmetry means you won’t see me rocking the uniboob.

Oh, and before you talk to me about a prosthesis, keep in mind that handstands are vital to my sense of well being. Think about it. Fake boob. Tiny yoga top. Upside down. It ain’t pretty.

The Kitty Cure

What do self-respecting lesbians do in the face of a crisis? Get a cat of course. Yup, last week we adopted a 6-month-old kitten at the animal shelter where I volunteer as an adoption counselor. His name is Bindi. (Yes, I know, so many lesbian clichés in such a short little paragraph. Have I mentioned I teach yoga and drive a Subaru?)

 

bindi2

One Week and Counting

I’m scheduled for a double mastectomy a week from today: Tuesday, March 3rd.

I’m guessing some of you might be asking yourself: how does a self-described indecisive person make up her mind? isn’t a double mastectomy a little drastic?  but my [insert name of sister/neighbor/friend here] had a boob-sparing lumpectomy…why in the world would catherine choose to cut off her breasts? Here’s the scoop on how I came to decide on the big “double M.”

To know me is to know that I am a small-breasted woman. I love my breasts. I love all breasts. What I didn’t love was the mental image of what my itty-bitty titty would look like after half of it was scooped out and the other half was nuked for six weeks. Aside from the potential side effects of radiation, such as bone-numbing fatigue, scarring, skin texture changes, and, in some cases, cancer (just what I need), I didn’t like what I saw. I envisioned something between a prune and a raisin–an unseemly picture the plastic surgeon did not contest.

What he did do was offer to slice a muscle from my back (or abs), thread it up into the cavity that was my breast, and wrap it around a nice, new implant, like a bow on a present. He presented this idea with a wink and a smile, like I was crazy not to jump at the chance.

Okay, let’s get this straight. I’m supposed to sacrifice muscle for a nipple-less lump of half flesh, half silicone (oh, and by the way, that implant will need to be replaced every 10 years). Hey dude, I’ve worked way too hard for those muscles for you to carve them up and rearrange them into boob-like shapes. Not to mention, I’d rather use my muscles for rock climbing and handstands. Um, thanks but no thanks. I’m going to need all the strength in every one of those muscles to get me through this and whatever else comes my way.  

To be continued…

So Many Decisions…

My diagnostic Happy Meal contained several prizes. Some have yet to reveal themselves (chemo or no? only the lymphnodes know). Others are in the guise of a puzzle–each frustrating piece shape-shifting on the fly according to my answers to a series of mind-blowing questions: lumpectomy or mastectomy? single or double? fake boobs or flat chested?

Have I mentioned that I’m an incredibly indecisive person? As someone regularly beset by buyer’s remorse, the magnitude of this decision is unnerving. Just last month the biggest decision on my plate was whether or not to buy an espresso machine. Now, seemingly out of thin air, I’m asked to decide whether or not I’d like to keep my breasts. They gave me approximately two weeks to decide. How kind.