It's Been a Mad, Mad, Mad, Mad Week

Last weekend was lovely; on Friday, I went to dinner with some women from UTA (three I work with in the library and two English grad students), and on Saturday, Kyle and I went out with Suzanne and her partner, Julie, to a newish place (for Arlington) called Chuy's. It originated in Austin, and the Tex-Mex there is AWESOME. Kyle was super-excited (and if you know Kyle, you know that's rare) to get Hatch green chile sauce there. I spent about 4 hours Saturday and Sunday working on my subject guides (for work).

This week, as you may have gathered from my highly unoriginal post title, has been CRAZY. Monday was the first day of classes, so of course things at work have gone into high gear overnight. Meanwhile, I had to be out three afternoons in a row for doctor consults or other health-related stuff, grrrrrrr!

Monday: Met with Dr. Brian again, mainly just so we could go over all the scan results face to face and have all of our remaining questions answered. Here's what we asked and what she said:

Am I likely to have to have chemo? It depends on the pathology reports on the sentinel lymph node and the tumor itself; these reports should be back two days after surgery.

How long will I be in the hospital? Usually two nights, sometimes one less, sometimes one more; it all depends on how quickly I recover.

If lymph nodes are involved, does that mean another surgery? Yes, it would mean another surgery, probably after two weeks or so.

Does my cancer have hormone receptors? Yes.

What does that mean? And how will it be treated? It means that the cancer cells I have love estrogen; each cell has a little place in it for estrogen to come and set up house and make more baby cancer cells. I will be given a drug called Tamoxifen that fools the cancer cells. Basically, the drug mimics estrogen and thus blocks the actual estrogen in my body from moving in with the cancer and helping it to spread. I will be on Tamoxifen for the next five years, at least. You can read more about it here, if you wish.

We talked more about genetic testing for the BRCA abnormality, which I had refused at first (since I have no daughters, and my sisters are dead), but after I thought about it, I decided it might be worth considering. I do, after all, still have one breast that is unaffected. Dr. Brian told us that if I don't have the genetic abnormality, the likelihood that I will get cancer in the other breast is less than 10%. If I do have the abnormality, the chance goes up to 56% to 87%. Also, without the abnormality, chances of ovarian cancer are less than 2%; with it, they are 27% to 44%.

I have to ask Dr. Brian one last time whether she is absolutely sure about the necessity of a mastectomy, whether there is any chance for any other resolution. She says, of course, yes, she is sure, and no, there's nothing else to be done. Nothing effective and safe, anyway. So I tell her that we can go ahead and schedule it, as well as the reconstruction. My surgery will take place next Wednesday, September 2, starting at 9:15. The mastectomy will likely take around 75 minutes, and the placement of the tissue expander takes about the same amount of time; Dr. Brian and Dr. Heistein will come out after each of their jobs is done to let Kyle know how I am. I will be in recovery for about an hour, and then Kyle will be able to see me. I will tell him to be sure to post here as soon as possible after surgery so that you can know how I'm doing, too.

Tuesday: Meet with the genetic testing counselor, who is a physician's assistant for Dr. Krakow (the oncologist who is part of Dr. Brian's practice). She is very thorough, explaining in great detail what I posted above and much more, for about an hour. They then draw blood, which is sent off to a genetic testing lab. $3200 and two weeks later, I will know whether I have the BRCA abnormality.

Also meet again with Dr. Brian, briefly. I think I mentioned before that at the very beginning of all this mess, Dr. Rice found a lump in my right breast. Well, that was a cyst, and it's never bothered me before, but last week it really started hurting. So Dr. Brian aspirates it very quickly and painlessly; the only part that hurts is the shot to numb my breast. It's over in less than five minutes.

We then meet with Kelly, the patient facilitator, again. She is SO NICE! I ask her lots of questions. I thought I had asked all the questions I needed to ask the day before with Dr. Brian. But we came up with so many more. And although I'm still very scared, I feel like I understand better what's going to happen to me, which helps to alleviate the fear somewhat. If you are squeamish, you may want to skip the next parts.

GROSS SURGERY DESCRIPTION ALERT!

For my procedure, a simple, skin-saving mastectomy, Dr. Brian will make an incision all the way around my areola and remove the nipple (sob!!!), then remove all the actual breast tissue. I will have a horizontal closure right in the front of what used to be my breast, about 2-3 inches long. She will make another longish incision under my left armpit and will inject my lymph nodes with a blue dye. As soon as she sees the first node turn blue, she will know that's the sentinel node and will remove only that one for analysis. Dr. Heistein will come in and use a retractor to separate the muscles of my chest wall from my ribs, making a pocket for the tissue expander, which is kind of like a very tough balloon. He will not have to cut the muscles, however, and the muscles will hold the expander in place. There will be no external sutures, and the internal ones will dissolve. A long, flexible tube with holes in it will be placed under where my breast used to be. This tube will extend outside my body and will feed into a closed suction ball, which will collect the fluid that my body will naturally produce in reaction to the trauma. I will have to keep this drain for a week to 10 days, emptying the suction ball twice daily and measuring the amount of fluid so that the docs will know that my body is slowing production of it, which means I'm healing.

GROSS SURGERY DESCRIPTION OVER!

I'm told that afterward, there is really very little pain from the mastectomy. Most is from the tissue expander placement. Kelly says that many describe it as being like a charlie horse in your leg, very, very tight-muscle feeling, but in your chest, obviously. She didn't say how it felt to her. I will have a morphine pump for the first 24 hours or so after surgery. They will then wean me from that and get me on to oral pain meds and muscle relaxers. The only oral pain pill that I've ever been able to take that didn't make me vomit (violently and repeatedly) is Darvocet. Unfortunately, it's a pretty sucky-ass painkiller, nothing compared with, say, Percodan or Vicodin. Kelly says that if one Darvocet doesn't do it for me, maybe they will let me have two. I'm freaking out.

When I come home, I am not allowed to take a bath or a shower the whole time the drain is in. A week to 10 days. Kelly says I can have a sponge bath, and Kyle can wash my hair in the kitchen sink if we are very, very careful. But that's it. I'm not allowed to do anything at all. No laundry, no dishes, no housework of any kind. I can't lift my arms above my shoulders. We have to be extremely careful because if I'm woozy and start to fall and Kyle grabs my arms, he will likely rip open incisions.

Kelly spends about an hour going over and over all of this with us. She is extremely sympathetic when I start crying again; she explains that it is part of the grieving process. She asks us about 15 times if we have any more questions. We come up with a lot but finally can think of no more. In the small meeting room where we are, there is a box with a bunch of heart-shaped pillows in the corner. She tells me to pick one out; they give one to each patient to use as a cushion between her newly mastectomied chest and the seat belts of cars. She says it's also very nice to use right after surgery, to tuck under the arm that has the incision. I pick out a navy-blue pillow with a small cream-colored kind-of fleur de lys pattern. It has a note on it that says, "Made 4 U with LOVE by Hannah, Age 15." Kelly tells us that girls at a local church make them. I think to myself, I never thought I'd be the kind of person to receive a handmade, heart-shaped pillow from a 15-year-old, church-going girl named Hannah. Well, thank you, Hannah, wherever you are.

Wednesday: On Tuesday, I got a call from the hospital where my surgery will take place, kind of a pre-op interview about my health history. When they found out that I smoked for more than 20 years, they said I'd have to come in for an EKG. GRRRRRRR. OK, well, that one's my fault. So I had to take YET MORE time away from work to drive 22 miles north of my campus to Harris Methodist Southlake. It took me 30 minutes to get there, 15 minutes to get checked in, and about 15 seconds for the EKG, which was fine, of course. The hospital is really beautiful, looks more like a spa. I saw some photos of the patient rooms, and they look like hotel rooms. There will be a bed and lounge chair there for Kyle, and they have wi-fi, so Kyle can bring my laptop to amuse himself while he's watching over me. By the time I'm done at the hospital, it's 5:00, so I hit bad rush-hour traffic on the way home. I was going to go back to work for a while, but after sitting on 360 southbound for 20 minutes and going about 2 miles, I decide to get the hell out of there and head home.

So that's it. No more consults or scans or tests before Wednesday. I have the next week, well less now, to get done everything I need to do before I won't be able to do anything at all for a while. My days are filled with frantic, nervous action, punctuated by staring into space and thinking about HOW MUCH I DO NOT WANT TO DO ANY OF THIS. Sometimes those thoughts catch up with me and I cry. A lot. But not too often. I think my heart-shaped pillow and I are going to become very good friends.

Kathleen's 3-Day Walk Link

As I mentioned earlier, my friend Kathleen is doing the Komen 3-Day Walk again this year. She'll be walking 60 miles over those 3 days; that is a lot of walking! Well, it seems like it to me, the slug couch potato. So here is a link to her page; I will go ahead and actually paste it here rather than put it in the html code of this post so you can see the address, if you'd like to copy and paste it elsewhere (it resolves to a more complicated URL):

http://www.the3day.org/goto/kathleen

Thank you, Kathleen, for all you are doing! I feel so very lucky to have you on my side :).

More results, deconstruction, reconstruction

So Wednesday, I got the results from the breast MRI. Basically, it revealed nothing new. Which is good and bad. The good part is that it didn't show any signs of cancer in my right breast. The bad part is that it confirmed everything in my left breast but gave more detail: The tumor is the size that Dr. Brian thought it was (4 cm x 3.8 cm x 3 cm), and there are other details on the report, but I don't know what they mean. We have an appointment with Dr. Brian on Monday at 3:30, during which I'm going to ask her to explain all the med-speak.

My reaction kind of surprised me. I took it almost as hard as when I first learned I had cancer. I was really upset. I guess that completely unbeknownst to my conscious mind, in some small, dark corner of my head, I was still holding out hope that the mammograms were wrong, the biopsy was wrong, Dr. Brian was wrong. So this breast MRI is kind of like the death sentence for my left breast. I'm very sad about that. And I don't want to hear a single person say, "Oh, but at least your right breast is clear." That's like telling a mother who has lost a child, "Well, at least you still have your other child."

So we went to talk to the plastic surgeon yesterday afternoon about reconstructive surgery. It's much more complicated than I first understood. The type of reconstruction that Dr. Heistein (pronounced HIGH-steen) is recommending is called immediate two-stage reconstruction; you can read about it here. But I'll summarize: immediately after the mastectomy, Dr. Heistein would come in and make a pocket between my rib cage and the muscles of my chest wall. This is where the tissue expander would be placed. He would slowly fill it once a week for 8 weeks until it gets to the approximate size I want; with each time it gets filled, it would be painful, as would the initial placement of it because it is stretching very strong chest muscles. The filling of the expander could not take place while I'm on chemo, if I have to have it. So then around 4 to 6 months after the mastectomy, I'd have to have another surgery, with an incision just as large (he said he'd just cut through the mastectomy scar, in fact), to remove the expander (which is very rigid) and put in the actual implant. I'd probably need a week at home to recover from this surgery. Then way on down the road, I'd have to have the implant replaced in 10-15 years.

Oh, and he's saying that to make the right one match the left, I'd need to have at least a lift on the right, if not an implant. I saw pictures of some of his patients. He's correct; the ones who look the most balanced and natural are the ones who've had both breasts worked on. Though as long as I'm wearing a bra, they would probably look fine. It's just without that, they won't sit at the same level on my chest.

::sigh::

Having almost no experience with surgery in my life, I'm finding all this very difficult to comprehend or try to figure out. I've been under general anesthesia a few times but have never had to have an incision in my skin or my muscle for a surgical procedure, so I'm just at a complete loss as to how much this is going to hurt or how difficult the recuperation will be. I know I can talk to other people about it, but each person is so unique with her own level of strength and ability to bounce back, I really wonder how much it would reveal that would be helpful to me. Even though I've been assured by both surgeons that pain management will not be a problem, that's what I was told when I broke my wrist and was given Vicodin, which made me vomit for two days after I stopped taking it (I can't take codeine).

What it boils down to is that I know I have to have the mastectomy. I have no choice in that. So I will look abnormal after that if I don't have the reconstruction. But the reconstruction is my choice, and I think I will regret it if I don't do it. But it's scaring me. Bad. As I told a friend, I'm stuck between an awful place and an awfuller place. Kyle asked me which was which, and I'm thinking that the awful place is the reconstructive surgery, and the awfuller place is feeling that I will look abnormal/deformed.

Am. So. Exhausted.

This one will be very brief. I made it to the hospital in time, early in fact, and was for some reason highly bemused that they actually use a lead container to carry around radioactive injections. That was the first injection I got after they put in the IV. Then I had the breast MRI, for which I did indeed have to lie on my belly on a rig that had two holes for my breasts to hang through. AT LEAST it was set up like a massage table for one's head -- a nice cushioned hole so my head was facing down and not twisted sideways. And wow, an MRI is SO LOUD! Then I had the CT scan, very quick and painless. Last was the bone scan, just had to lie on my back and try to ignore the huge metal square thingie that was about an inch from my nose (to start with, at least, until the table I was on sort of fed me out from under it). None of the injections hurt, but now I understand what a couple of people were talking about when they said the one for the CT scan makes you feel "funny"; the tech doing that one warned me about it. He said it makes you warm all over, and some people feel like they are urinating, but they aren't. It's just a huge flush to your skin, ALL OVER, including the hoo-hah area :).

I was done much more quickly than I thought and so was able to be at work by 11:30, woo-hoo! I don't know that I accomplished much today because I was so tired, but at least I will only have to claim 2.5 hours of sick time.

And the good news -- finally, yes, some good news! The good news is that I had a call from a nurse at my surgeon's office this afternoon (much sooner than expected). She told me that my CT and bone scans were completely clear of disease and/or abnormalities! Now my lymph nodes could still be involved, and that would be bad, but at least there is no sign that the cancer has spread to my major organs or skeletal system. The nurse said that I should get a call from my surgeon tomorrow or the next day with the breast MRI results.

Everyone at the Baylor facility was really just so sweet. They could not have done more to make me feel comfortable, and they got me in and out very quickly. Here's the only sucky part: right after the nuclear med tech put in my IV, she commented that I sure had a lot of scans lined up. I told her I wanted to get them all done at once so I would not miss even more work time by having to commute back and forth three times. Then she says, "Oh, you do know we're open on Saturdays, right?"

AAAAARRRRRRGGGHHH!!!!!!!!

A Technical Note + Many Thanks + A Few Shout-Outs

I don't have much time to write tonight. I have to be in bed soon if I'm hoping to get anywhere near a decent night's sleep tonight since I have to be up at around 4:30 to be at the hospital by 6:30 for my day of scans. GAH!!! I AM SO SO SO NOT A MORNING PERSON!!!! I said that already, didn't I :)?

First: I am a blog n00blar (as we say in WoW), so I didn't have the RSS buttons set up at all on my blog until today. Many apologies. Mea culpa and all that shit. I looked over all the gadgets available today and added those I thought would be useful (search, RSS, etc.); let me know if anything's missing that you'd like to see.

Second: I have many, many thanks to give to all of you for making me feel so loved. I have tried as much as possible to thank each of you personally, but I've probably missed a couple of emails or FB comments. If that is the case, please accept my apologies and know that I have read and greatly appreciated each and every one of your comments. I honestly only have so many hours in the day, and obviously most of my time during the week is taken up with work, and I'm working extra hours as much as I can to build up comp time. On the weekends and weeknights, I try to spend time with Kyle or just on my own doing something that doesn't involve thinking about cancer. Like watching "Entourage" and "Mad Men" as I did last night for about four hours :). And don't even THINK about talking to me about what is going on currently with those shows! I'm always a season or two behind because I watch them on Netflix. If you send me a spoiler, I will have to hunt you down :P.

Third: There are a few people I want to single out. First, my sweet, dear, crazy husband has never been more supportive. Anything I have asked, he has done. I told him that I just have too much on my mind to keep deciding what to have for dinner and doing the cooking. He said he would do it. This from someone who has never cooked much at all (OK, that was partly my fault; I'm so obsessive-compulsive about doing stuff a certain way that he would always get upset with my telling him what to do and how to do it). I have come home to dinner waiting for me several nights now: chicken in a lovely white wine sauce last week and cottage pie tonight. And they were both AWESOME! Thank you, Kyle -- and Joy of Cooking :).

My boss and friend Suzanne could also not have been more supportive. She has sat and listened to me, worked with me to figure out the leave time (using a combination of vacation time, comp time, and sick time -- we are also looking at the sick leave pool that the UT System has), told me that my job is safe, and best of all, made me laugh. That is a HUGE load off my mind. She also, get this, told me that if I have to have chemo, she will shave her head in solidarity with me, lol! I'm not sure if she was joking, but I kind of think not :).

Two of my high school classmates that I have reconnected with on Facebook, Frankie and Alesia, have told me that they want to help after my surgery (or if I have to have chemo) by hiring a maid team or meal service or something else I may need. They want to organize other long-distance friends to help as well. Wow. Just wow. I haven't seen these women in almost 30 years; I'm just blown away. I don't know whether I will need anything like this, but the thought that it's there if I do is such a relief.

One of my friends from work did the Komen 3-Day Walk last year and has been planning on doing it this year, too. Last year, she walked in honor of her aunt, who is a breast cancer survivor. This year, as soon as she heard my news, she emailed me and told me that she'd like to walk in my honor as well. That was yet another point at which I cried. Her name is Kathleen Marquez Houston, and she will be walking 60 miles over three days to raise money for breast cancer research. I will post the link to her fund-raising page as soon as she has it up. My friend Jamie in Rochester Hills had planned on doing the walk this year but injured her foot/ankle; she still raised over $4,000 for Komen.

My in-laws (particularly Carol and Paul) have been incredibly supportive, offering to come and stay at the drop of a hat, should we need them. Their outpouring of love and messages of encouragement are overwhelming.

Again, I can't thank you all enough for your well wishes, support, friendship, and love. Such sweetness to come out of such adversity. If I have forgotten anything or left anyone out, I blame it on the Xanax that I took a half-hour ago. I'll post tomorrow post-scans if I have the energy.

A Force of Nature

Kyle and I went to meet my my surgeon, Dr. Mary Brian, for the first time last Monday. I didn't know anything about her other than what Dr. Rice had said: she's one of the best in the area, she's a breast surgery specialist, and the other doctors in her practice also specialize in breast care; the practice is the Breast Care Center of North Texas in Bedford (about 45 minutes north of my home). I had also heard from an OB/GYN friend of my supervisor's that she (the OB) would go there if she had gotten my diagnosis. Dr. Brian gave me a brief physical exam and looked at my mammograms and pathology report. We then met in her office for about 30 minutes, where she told me that her initial recommendation is mastectomy with reconstructive surgery. Wow, the good news just won't stop coming. Her reasoning seemed sound when she explained it, and she's very competent at communicating complex medical stuff. Since I have next to no knowledge of all this, I'm grateful to have a surgeon who can talk like a real person.

She tells me that I have a tumor that is probably 3-4 cm in diameter, and in order for her to go in and get all the affected tissue as well as another centimeter or so of healthy tissue all around, a lumpectomy probably won't be feasible. She also tells me that because the cancer has already grown outside of the milk duct where it started (i.e., the "invasive ductal carcinoma" part of my diagnosis mentioned in my last post), a mastectomy is the best option. She explains that they will take the sentinel lymph node out during surgery, and a pathologist will cut and examine it three different ways. If this lymph node is clean, then they all are clean because they all sort of line up after that one; that's why it's called the sentinel node. She also explained that the first step of reconstructive surgery can occur after the mastectomy, but frankly after I heard the "M" word, I think I got some stuff confused. I do know that a plastic surgeon will be handling that part of the surgery, should I decide to get it done. She tells me that she can't yet say with any certainty what stage I'm at or whether I will have to have chemo; they will know this when they test the lymph node. The next real shocker is that she says I'll have to take three weeks off work to recuperate. I just started my job in February; I don't have three weeks of sick leave. More on this later.

I am again crying, trying to get control. She waits patiently. Kyle asks lots of questions, and she answers them all very thoroughly. I have to say, I'm impressed. I really like this woman, despite the fact that she's telling me the worst medical news that I have ever received regarding my own health, well, outside of the cancer diagnosis. She tells me that she will know more if I have a breast MRI, bone scan, and CT scan; she will get an indication of whether the cancer has already spread outside my breast tissue. I agree that this sounds like a good plan. She also wants me to see a plastic surgeon; again, cool with me.

Next she has her nurse, who seems more like a patient facilitator, come and talk to us. Her name is Kelly, and she tells us that she's a 10-year breast cancer survivor; she also had a mastectomy, so she knows where my head is. Because I, of course, am still crying off and on. I tell her that I have very limited amounts of sick/vacation time, so I'd like to consolidate all these scans if possible. She says that's totally doable, and she will get approval from my insurance and have the imaging center at Baylor Irving call me. And you know what?? She did exactly what she said she would. She also tells me that Dr. Brian only works with three plastic surgeons, and one doesn't take my insurance; the other two are really competent and again, highly recommended. So we go with the closer of the two; he's in Fort Worth. Kyle and I are seeing him next Thursday.

So now I have an appointment for a breast MRI, a head-to-toe bone scan, and a torso CT scan for Tuesday morning at 6:30. Gah! I AM SO SO SO NOT A MORNING PERSON! This is going to take about 6 or 7 hours, I'm told. Oh, and more good news: the breast MRI is again the thing with the holes in the table, but this time they will be doing both. LOL! I did ask the woman at the imaging center whether they would have to be under compression, and she said no. Thank whatever gods there may be for that. I will have an IV and they will give me lots of injections of radioactive agents and dyes through it. I wonder whether I'll glow in the dark :)??

They ask me if I'm claustrophobic, which of course I am, so I'm freaking out a bit about the MRI, as well as all the rest of this stuff, and talked to my friend (and supervisor) Suzanne about it. She's like, "Have you ever taken Xanax?" Me: "Nope, but my dog has a prescription for it because of his storm phobia." Suzanne: "Call Dr. Rice." And then all kinds of stories about how well it works to alleviate anxiety. So I call Dr. Rice and tell her that I'm really nervous about the MRI because of my claustrophobia, and she's like,"Have you ever taken Xanax?" Hehehehe. I pick up my prescription on the way home Friday night; I haven't tried it yet. Supposedly it will help me sleep as well, which would be AWESOME! I have horrible insomnia, especially when I'm worried. Actually, I take that back. I just have horrible insomnia all the time.

Kyle and I have been talking a lot about what we think about Dr. Brian. Kyle's much less willing to trust than I am, not nearly as quickly anyway. So I ask Suzanne if her OB friend can elaborate on why she would go to Dr. Brian if she got my diagnosis. Suzanne forwards me the response from her friend, who wrote (in part): "Mary Brian is a force of nature. She is an excellent surgeon and trained in an era where women didn't become surgeons. She has no problem kicking people's ass for the benefit of her patients. She was a general surgeon for years with the good old boys then started doing only breast surgery. Most other mastectomies are done by general surgeons doing gallbladders, appendixes etc. She probably does about 12-15 surgeries a week...which is a lot." She wrote a bunch of other stuff about the other two doctors (a radiation oncologist and an oncologist) in the practice and how fabulous they are and how well they communicate with each other. I cry yet again when I get this note because I'm so relieved to hear that my surgeon is so highly regarded by another physician, and I really like the thought that I have a surgeon who can kick ass! I have never even thought about placing my life in a stranger's hands. I wonder what it feels like to be her? And I wonder whether this force of nature will be strong enough and smart enough to defeat the negative force of nature inside of me?

And so it begins....

I'm assuming that you are reading this post because you're a friend of mine on Facebook, or maybe you got an email from me, or maybe you play World of Warcraft with me. Maybe we've never met in person (I have many online-only friends) or maybe we haven't seen each other in 30 years. Whatever the case, welcome. I'm glad you're here. Feel free to read what you like, but don't feel that you have to leave a comment. And I will write when I feel like it, both emotionally and physically.

So let's get it out there. State it quickly, like tearing off a band-aid. I have breast cancer. Here's how I found out.

I just moved to Texas in February and, feeling very guilty that I hadn't seen a doctor since October 2006, finally made an appointment for a check-up with Dr. Laura Rice. She found a lump in my right breast during the physical exam and sent me for a diagnostic mammogram. So about a week later, I show up for the mammogram, fully expecting that they would also do an ultrasound on my right breast and tell me that it was a cyst. So the tech is doing the squishing-my-breast-until-my-eyes-water thing she has to do; she takes two shots of my right breast, then two of my left. She mumbles something about calcifications in my left breast and starts changing stuff on the mammogram machine. I'm like, "are we done?" Her: "No, I have to get some magnified shots of your left breast; you have calcifications." Me: "What's that?" Her: "They are normal in some women, but we need more views." More breast squishing, and then an ultrasound of my right breast, and guess what?? It IS a cyst. However, and isn't there always a however, I'm told that they need my films from my last mammogram. I make a call to Kyle (my husband) and ask him to please get me the number to my doc in Michigan, whom I call and after being transferred about five times, I finally talk to someone in the bowels of the Henry Ford Medical Center, who tells me I must fax a written request for those films. Get back to work and fax the letter. Now I wait. Nervous. Because I've been told that if my old films show calcifications, we are ALL GOOD -- that will mean they are normal for me. If not, it's biopsy city, baby.

Couple of days later, I get the call. No calcifications on my old films. Shit, shit, shit, shit. I schedule the biopsy. I'm told I will have to lie on my stomach on a table that has a hole in it for my breast to hang through. This sounds like so much fun! They will numb my breast then do a needle biopsy. OK, I can deal.

I show up, sit on the table, the tech asks some questions, then has me lie down as instructed. What I haven't been told is that my breast is not only hanging through this hole, but it has to be under compression the whole time. Argh! And she's having trouble getting me positioned properly so that she can take about 30 mammograms (well, it was probably more like 10), AND has to walk out a couple of time to get help. I'm like, "Hellloooo! Can you at least shut the door? Boob hanging through a hole here!" So basically, I have my boob through this hole, being pulled down and compressed, with my head twisted to the side and my shoulder and back all contorted for about 45 minutes. It got pretty damned uncomfortable. And needle? Forget that shit. It sounded like a gun going off when it went in (they do actually call it a gun) and then drilled into my breast with a sound like the grinding of a really slow dentist's drill. They put a titanium chip in where they took the sample as a marker. I wait for results.

Three days later, the radiologist who did the biopsy gives me the news: intermediate and high-grade ductal carcinoma in situ and invasive ductal carcinoma (grade 1 tumor). He recommends that I contact my primary care physician immediately for a referral to a surgeon. I've never talked to a surgeon before; I've never even had stitches. I call Kyle and tell him the news; I really don't remember his reaction. I think I was crying too hard to hear him.

I call my doctor, sobbing, of course (me, not her). She tells me about this fabulous surgeon who has a practice where everyone specializes in breast cancer. They do nothing but boobs. Period. Cool. So, I call, make an appointment. Go down and tell my boss, Suzanne, who has known about this since the mammogram. We're both kind of sitting there in shock, me wailing about how much I need my mom and sister, and how goddamned angry I am that they aren't around to help me through this. Thank my lucky stars I've got a boss who can sit and listen to me vent.

So that's how I found out. I have breast cancer. Cancer, the fourth astrological sign. I just read that on Wikipedia, where I also learned that "under the tropical zodiac, the Sun enters Cancer on the moment of summer solstice by definition, or roughly on June 22, leaving it around July 22." I think it's funny that Dr. Rice first felt that lump in my righ breast on July 22. Both funny-ha-ha and funny-weird.