Diagnosis

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.

 

 

 

No ordinary lump

This was no ordinary lump. I know ordinary. Ordinary is the lump I have in my right breast. I found it ten years ago. It too was examined but found to be a fibroadenoma. Harmless. Oval. Slippery. Rubbery. Almost friendly.  The old lump is everything the new lump is not. The new lump is hard. Ragged. Fixed in place. The new lump feels like a shard of glass under the skin. Like a piece of emotional shrapnel that exploded out of my heart and slowly worked its way to the surface.

The doctors tell me it’s been there for eight to ten years. I try not to think about it but I do. What was I doing on that day ten years ago when the first cell went awry? Was I stressed? Did I have an argument with my father? Did I eat a pesticide-laden salad? Drink contaminated water? Breathe too much exhaust? I can’t help but wonder what weakness in my body invited this anomaly.

Ten years ago I was 28 years old. That’s the year I met Mary, quit my job, started freelancing. That’s the year I started feeling like I might know what I wanted in life. But, around that same time, something hatched.

When I think of the tumor, my mind sometimes wanders to the sacks of spider eggs in our basement. We have a basement typical of the Midwest–draped with gooey, wispy webs. Marking the center of each is a sack of eggs. Inside each sack are hundreds of baby spiders. I beg Mary to vacuum them up before they hatch, but she doesn’t want to. Who can blame her?

When I found out my tumor was invasive, I pictured one of those sacks. Ever growing. Pulsating with the life inside. At what point did the sack split open and the first miniature spiders march out? No doubt they sought light, air, food, new environs to set up their spider shops. Is my tumor the same way?

For ten years it’s been growing, hidden beyond the reach of my inquisitive fingers. Then, one day, a seam opened up and tumor cells went on the march. Each offspring seeking it’s own little corner of my body to set up housekeeping. How far have my spider babies traveled? What is their final destination? How can I get rid of them? It won’t be as easy as vacuuming. Of that I am sure.

Just the facts…

Because it’s been a little more than two weeks now, I’ve already yo-yo’ed through a million different emotions and stages of denial, depression, grieving, etc… But, before I go into any of that, I should fill in a couple of details.  (Just so you know, this blog won’t necessarily be in chronological order, but I’ll do my best to have it make sense.)

I found a lump at the top of my left breast on Sunday, January 18th. No, I wasn’t doing a self-breast exam. I’ve never been a fan of self-breast exams (more on that later). Instead, I noticed a soreness in my breast while I was lying on my stomach in bed. Curious, I rolled onto my back and felt around a bit. The only thing I noticed was a little tenderness at the site of a small mole. I chalked the pain up to the mole, thinking maybe my bra  had irritated it the day before. An hour or so later, in the shower, my attention was drawn to the area again, and this time I felt a lump. As it turned out, I could only feel the lump when I was standing up.

I called my doctor the next day. I saw her on Tuesday, January 20th. As expected, she felt it and said, “yep, you’ve got a lump.” Her nurse  made an appointment for me to get a mammo at Bloomington’s only imaging facility. The appointment was for February 2nd, nearly two weeks away. I slogged home through snow and ice, veggied out on inaugural coverage, and resigned myself to waiting 14 days to take the next step in the discovery process. Thank god my sister called. Always level-headed in an emergency,  she pointed out that waiting two weeks with a lump I could feel would be torturous. She encouraged me to call imaging centers in nearby towns. I took her advice, picked up the phone, and found a breast center in Indy where they could see me the following Monday.

On January 26th, I had a full day of  mammograms, ultrasounds, and biopsies. The radiologist obviously didn’t like what she saw but reassured me that it was probably nothing. More precisely, her exact words were “you’re not the right age for this.” Back at home, I looked up a couple of stats and found out that 80 percent of breast cancer cases happen in women over 50. And that, as a woman in my 30s, my risk of being diagnosed with breast cancer was 1 in 233. Of course, that was cold comfort because barely 48 hours later, at noon on January 29th, during what turned out to be Bloomington’s worst snow storm in 31 years, a very sweet woman from the breast center called to tell me that I had cancer.

First, An Apology

Before I dive into this, I need to clear the air. A confession: I’m guilty of blog bashing. I’ve been known to call blogging a stoopid waste of time, a self-indulgent navel-gazing activity. I’ve openly wondered why people—especially freelance writers—toil at their computers for gratis when they could be off doing something more pleasurable, like chewing glass. But cancer has shown me the light, and I’m sure it won’t be the first time.

Soon after my diagnosis (exactly two weeks ago today), I realized I couldn’t not write about it. Each morning I’d awaken to find a tidal wave of images and words had flooded my brain while I’d slept. Sloshing around in rubber boots, I’d gaze at the debris wondering where it came from. Last night’s sky didn’t look like rain. But then I’d  shrug and get to work sweeping the detritus into a tidy pile of strung-together sentences. Soon, I’d awaken with a fully written essay knocking around in my frontal lobe.

Of course, I have a lovely journal for such occasions, but then there is the desire of friends and family to keep abreast (so to speak) of my breast without being intrusive. (Thank you.) Couple that with my tendency to get tongue-tied the minute the phone rings, and you can see why I’m here. So, to quote Mr. Dreamy (Obama), I’m offering an apology to bloggers everywhere—I’m sorry. I screwed up. I made a mistake. Mea culpa.