"You like snakes?"

     It’s 7:30 p.m. on the day of surgery and I’m feeling good. The nausea from the anesthesiology is behind me. I’m no longer groggy. My urine, blue all day thanks to the dye injected in my lymph nodes, has softened to a lovely green.

     My left breast, the one I’ve been mad at since Spring Break, has altered. The nipple is still there – hence the nipple-sparing technique -- but I can feel the edges of a foreign object underneath. It’s the tissue expander. It feels like a miniature deflated kiddie pool and its placement is high on the chest.

     My breast is about half the size it was. In short, I am a 50-something woman on the right and an 11-year-old on the left. After healing, over time, this will change as Dr. Popowich fills the tissue expander to “the desired size.”  

   The kids and Ron just left after spending the afternoon watching my mouth flap open and me doze. (He took a picture, which I’m not posting.) It’s a bit after 8 p.m. The view from my window is of the west hills. One of the nurses had pointed it out earlier, but I couldn’t appreciate it then. It is a beautiful view.

    I’ll  just pretend I’m in a hotel. 

    Room service brought me a ginger ale and jello.  Lime. I haven’t had green jello since I was a kid. Definitely the best I’ve ever had. I’m hungry. Haven't eaten for over 24 hours. I make sure my breakfast is ordered.

     “Chopped” is on TV. My daughter turned on the set before they left. The remote control is easy. One remote to call the nurse, hit the lights, and control the TV. A dozen buttons or so, that’s all. I’d like one this simple at home.

     I missed the "Chopped" basket ingredients because my mind is elsewhere. 

     Nothing was found in the four lymph nodes taken at the time of surgery, but the official pathology report comes on Thursday. I get to wait.

   A nurse checks my vital signs. I don’t have my contacts in; I can’t read anyone’s nametag.

     “You like snakes?” she asks, pointing to the purple and black stuffed creature in my window.  

   “Well, not really, but my kids got that at the gift sh…”

    “A boa constrictor almost killed my sister,” she says. She motions with her hands how the snake was strangling the life out of her sister, who was a young adult at the time. “I’m from the Philippines,” she adds and her eyes grow wide. “One almost got me too. I was in the rice fields. I was only 11 years old when I saw that boa rear its ugly head.” She holds her hand limp and moves her fingers upwards slowly, mimicking the triangular head.  “It was getting ready to go for me. So I call for my brother. He comes to the rescue and kills it with a machete.”

     “Wow,” I say.

     “Chopped” is still on. One of the chefs has cut her finger. She frantically pulls on layers of plastic gloves.

     The nurse looks at my snake.  “I still hate snakes,” she says with a shudder and walks out the door.

     Tomorrow I go home.

     Thursday I'll get good news. 

Relinquishing Control

     This was my ordeal, exactly one week ago: 

  

     I wake, feeling a tad of congestion that started the night before. I wonder if it’s nerves. I practice deep breathing on the 15-minute drive to the hospital. We arrive at check-in early: 5:25 a.m. Third in line, I stand behind the guy in PJ bottoms and slippers, wondering what he’s having done and how old he is? He has cropped grayish-brown hair; he could be 40, 50 or 55. Is he my age? His wife seems young. Does he have cancer too? I can’t tell. At the head of the line, a couple kids mull around a woman, clearly their mom. I wonder who’s having the surgery? Is it the energized boy ducking under the belt barricade?
     Check-in amounts to initialing three boxes that match three brochures, something I’ve done dozens of times. We sit, then follow a nurse to a waiting room. Three other parties are already there. I choose a spot as far away from each of the others as possible. The first person called is old and frail. She has a hard time getting up and walking when her name is called. I breathe deep. Feel fortunate. At 6 a.m., my name is called. We go to Short Stay where a ginger-haired nurse shows me my bed. I don’t catch her name or anyone’s name. The next hour and a half flies. 
      Close the curtain. Strip. Gown ties in front. What’s your name? Birthdate? What are you having done today? Do you have an advanced directive? She takes my temperature, listens to my lungs. Reads my blood pressure. It’s high, 155/75, which frustrates me. I’m already doing a bad job. The nurse disappears and I grumble to Ron about white coat syndrome. Deep breathe. The nurse is back, preparing the IV, eyeing the plump vein on the back of my hand. I point to my wrist bump and say no IV at my hand or wrist; I advocate for the vessel they used last chemo, the one on the inside of my arm. She says she can’t see it. I hold my ground. She adds heat. It’s pale but works perfectly.
     I mention that when I came in for the livery biopsy, they ended up prepping me and getting me on the table ready for the biopsy, then they couldn’t see it clearly enough and opted against it. “Hey, maybe that will happen today,” I said. I was joking.
     “That’s not going to happen today,” the nurse said.

      Someone interrupts and informs my nurse she wrote the bed number wrong. My surgeon pops her head into my berth. “I checked your bed and thought ‘oh, no, she’s not here.’” Dr. Garreau is amiable and energetic. She asks how I’m doing.

     
     “I’m ready for you to do your thing,” I say. We chat. I mention apprehension about anesthesia. She says the anesthesia folks will be in soon. She says spinal blockers are an option; they inject the blocker on each side of my spine which helps with pain control in the chest area. I’m not so sure. She says I don’t have to have it. Before leaving, she asks, “Any questions about the surgery?”
     I pause, then motion with my hand. “So you’ll slit here…”
     She motions a lateral cut from the left side of the breast to the center. “I cut here and then hollow you out.”  That’s all the detail I need. She talks about the sentinel node removal.
     “Okay,” I say. I sign the permission slip for the surgery.
     The nurse brings me antibacterial wipes and has me wash each side of my chest for a full minute. She says they’ll repeat the procedure in surgery with orange wipes. She’s back and the anesthetist arrives.
     She introduces herself. I don’t remember her name. She describes risks of anesthesia. She asks for consent and I sign.
     The anesthesiologist arrives. I describe nausea from anesthesia in the past. Ask her about the blocker Dr. Garreau mentioned. She goes through the process and risks. Describes the 12-18 hour benefit for pain control. I opt against it. At some point, I’m offered Valium. I say yes. I’m a little tense.
     Surgical nurses arrive and introduce themselves. They’re peppy and warm. The surgical intern arrives and introduces herself. The plastic surgeon, Dr. Popowich, arrives, gets on one knee and draws on my breast with a purple marker. He leaves and others swarm in; they don’t seem to introduce themselves anymore. A woman at my feet wraps compressors around each of my legs; they’re like massaging bubble wrap. She doesn’t tell me what she’s doing; I have to ask. The wraps feel like shackles. I feel panic and start deep breathing again. At my left, a woman dots me with what appear to bits of tape. “This is an EKG,” she says. “I feel surrounded here,” I say with an awkward chuckle. “Oh, does it feel like you have no control?” she says in a jovial tone. “Yes,” I say. It seems we have rapport. But she’s done as quickly as she started. “That’s it?” I ask. “Yes,” she says. “How was it?” “Everything’s good,” she says, and darts off. Suddenly I’m being wheeled down the hall. We enter the surgery room. It’s lights and stainless steel. “Is this the surgery room?” I ask. “Yes,” I hear. 
     And the next thing I hear is: “Surgery’s over,” and I’m being wheeled into recovery. Good news follows almost as quickly.

Focusing the sky

     We went to Sisters, Ore., over the fourth. I didn’t book early enough to get a spot at one of the 'cool' resorts so we stayed at The Ponderosa Best Western, which had llamas to pet and a fragrant pine forest around its perimeter. The room was restful, furnished with rustic pine furniture and comfy beds. In the morning, the maids decluttered our space.
     It was sunny and warm, but not too hot. The nights (unlike in Portland this past week) were devoid of fireworks, which I considered a plus. We strolled the town and looked at quilts, swam, hiked and filled our lungs with the smell of pine. All in all, it was a peaceful get-away. We came back to Portland Saturday night, which gave me time to become untethered.
     There’s such a thing as too much time to ponder.
     There is such a thing as wanting to control that which we cannot control.

     On Sunday, I needed to conquer our bedroom. I wanted it clean. Not just clean, but deeply clean, a spring-clean kind of clean from the depths of the closets to the back of the drawers. I wanted a calm space like the hotel room with nothing extra, no books or mementos gathering dust, a healing space for my return from the hospital after surgery. 

   The problem was I couldn’t move. Through monosyllables, I tried to explain to Ron that I needed his help. He seemed puzzled at first but quickly dove in to help. He led with the big picture cleaning, which took him an hour, while I concentrated on organizing details. The task gave me a day’s worth of focus, made me happy and inspired one daughter to do the same with our kitchen.

     Today I feel better. Rested. More prepared somehow. 
     And right now, I’m pondering what to do with my next 10 to 12 hours. Because perhaps this is energy I shouldn't waste.

Count down and around

     It’s been interesting to see the stats on this blog. I’ve had readers from every continent except Africa. This encourages me to share information that others going through a similar journey might find helpful. Consider passing on the link if you find something worth sharing (or if you know someone in Africa). 

     I thought I could write about this journey honestly and without self-editing because it’s not like I’m baring family secrets as many nonfiction writers do.  The act of writing this blog is more about baring me.
     Still, unless one is a hermit, others are always involved. And there are places I won’t go.  For example, I won’t go into detail about my kids and how they’re handling or not handling my situation. Perhaps that’s a story for sometime down the road. Maybe it’s theirs to tell.
     I will tell you my writing energy has waned as I await the Ordeal that is eight days out. My focus is off.  I suppose this speaks to the emotional part of this journey.  That and the distractions. 

     The lengthy call from the pre-admissions nurse yesterday was one of those distractions. She covered medical history, drugs, pre-surgery instructions, including detailed shower, linen and clothing steps. She peppered me with queries. Are you feeling sick?  Have you been around anyone with a contagious disease? Have you or a family member ever had a blood clot in your leg? Will you allow a blood transfusion in the event of an emergency? Do you want a chaplain to speak with you the morning of? Are you feeling suicidal?  Have you ever reacted to anesthesia?
     No. No. No. No. No. No. Yes.
     I can tell you about the surgery specifics. How I will have a nipple-sparing mastectomy on my left breast. This, as I understand it, is a nifty and advanced procedure. After, I’ll have a cleanly deflated breast. The plastic surgeon will follow during the same surgery session and insert a tissue expander under my chest wall. I’ll have drains for a few days near the incision line. Over the coming months, the expander will be filled on an outpatient basis. When the expansion is complete, it’s replaced with a permanent implant in an hour-long procedure. If adjustments need to be made to my right side, it’s done later.
     If that felt like TMI (too much information) I can tell you that’s the abbreviated version. It happens next Tuesday. I go home on Wednesday.  I’m looking forward to getting this behind me.    

Dragon Power

     My friend George Ivan Smith promised to make me an angel bread sculpture in a few months to celebrate the end point of my Hero's Journey. But to tide me over, he made me this dragon. He delivered it warm, fresh from the oven and insisted it was made to eat. While I don't generally eat art, I ingested this beast with butter and jam. I feel the fire in my belly and I'm ready for battle because of it. (My kids helped me indulge after getting quite a chuckle when they spotted it resting on our counter.) 

      Here's a poem by Jack Prelutsky (from an accompanying book George lent me) that speaks to this moment in time, and perhaps says a little something about positive thinking.  

If you don't believe in dragons, 
It is curiously true
That the dragons you disparage
Choose to not believe in you.

Ingesting Sunshine

     When I visited my internist to have my blood pressure checked, she asked what medications I was taking.

     “Nothing,” I said.  I’d stopped the daily aspirin and the fish oil to avoid any bleeding issues during surgery. While I was at it, I halted everything including my daily Calcium and Vitamin D.

     "You should be taking Vitamin D,” she said.

     So I restarted my daily Vitamin D supplements and remembered why I started taking them in the first place. I was woefully deficient in Vitamin D, like many of us in Oregon. We simply can’t count on luscious sunny days like today. And if you don’t get enough Vitamin D naturally through the sun, you need to load up on salmon, tuna, sole, milk, eggs, mushrooms or beef liver! -- or take supplements.

    
     Research supports the benefits of Vitamin D supplements for a number of reasons.  Here are a few recent findings:

     In one study, kids getting Vitamin D supplements showed a 47 percent lowered risk of cavities. (Nutrition Reviews.)

     In another, healthy adults taking 800 IU of Vitamin D supplements per day experienced lowered blood pressure. The top number fell by 10 points on average after a year and the bottom BP number fell by four points. Vitamin D was also responsible for lowering heart rate from 74 to 70 beats per minute. (Nutritional Influences on Bone Health) 

     Low Vitamin D levels impact pregnant women. In 31 studies of pregnant women with Vitamin D levels less than 30 ng/ml, there was an increased risk of developing a complication such as preeclampsia or gestational diabetes.

      Low Vitamin D levels have also been linked to increased incidence of suicide. One study showed that people with the lowest levels of Vitamin D, less than 15 ng/ml, were roughly twice as likely to commit suicide as people with Vitamin D ranging from 17 to 41 ng/ml. (PLOS One). 
     What’s more, researchers suggest that Vitamin D curbs the growth of cancerous cells.  A report presented at the latest meeting of the American Association for Cancer Research (AACR) showed a link between increased Vitamin D intake and reduced breast cancer. It found Vitamin D to lower the risk of developing breast cancer by up to 50 percent.
     Not everyone is as certain. The National Cancer Institute says claims of Vitamin D’s cancer fighting benefits are inconclusive and unclear. 
     The bottom line is: sunshine makes you feel good. And from my vantage point, Vitamin D’s the next best thing. Mine come in adult gummies.

Teachable moments

     Teaching at the community college feels like important work. Students bare their souls on the page and I listen and respond. Most students are in their 20s, but this past term I had ‘kids’ ranging from a 16-year-old high schooler to a 60-something retiree.
     Each night class, we sit in a circle and share; personalities range from anxious to theatrical, inhibited to cocky, sweet to angry.
     Each session, there are surprises on the page and in the room. By night end, my mind is nimbler, my knowledge of diverse lives expanded and my understanding of the Millennial generation richer.
     The last class of the term, we go around the circle and share inspirations: a quote, book, movie, musician, artist or idea. This term, I toyed with the idea of sharing my personal story, reiterating the points I’d reached on “The Hero’s Journey.” This would be a good review of the story model we talked about the first night of class, and not just a review, but a working tool of one positive way to cope with the obstacles life will undoubtedly throw your way.  

     Monday night’s class came and went; I opted against being a downer with my story of breast cancer. Besides, no one knew I wore a wig. Why ruin the illusion now?
     On Wednesday, I had a surgeon appointment and mentioned I was toying with the idea of sharing my chemo, my hair loss, the obstacles I’d reached so far on “The Hero’s Journey” with my class that night.
     “They’ll probably say, ‘Sucks for you!’” she said.
     We laughed.
     Wednesday night came and, again, the timing didn’t feel right to go into my personal story. But a day later, I recapped my tale via the 12 elements of “The Hero’s Journey” and sent an e-mail to my Wednesday night class.
     Five students responded with e-mailed notes. One student, Larry, gave me permission to share his story.
     The funny thing is Larry probably didn’t need to hear about a good story model to apply to life’s struggles. To share the power of “The Hero’s Journey” with someone like Larry is hammering home a coping mechanism to someone who’s already spent a lifetime soldiering through obstacles.
     Larry is a good decade older than most of the community college students. He struggled with ADHD and dyslexia as a kid. He hated English teachers and never learned to read until his mid-twenties when he finally taught himself. He’s struggled with writing ever since, working on bringing to life the stories he ‘composed’ in his mind while growing up on fishing boats in Alaska. He attributes a kind and patient writing instructor at one of the community college campuses as honoring his story-telling ability and making a difference in the way he viewed his writing.
     Distractions continue to plague Larry and this past term was particularly difficult. For starters, he had a hefty workload and then he had to move. For much of the term, he lived in two places to accommodate bus travel to school.
     Despite his personal challenges, Larry wrote me a three-page letter in response to my email. Here’s an excerpt:
     “Your letter made me realize how many of my obstacles were trivial. We all have a space where we keep our troubles. No matter how big our troubles are, that space is the same size. Each of us takes our troubles and expands them to fill that space. We say to ourselves 'look at all I am going through. No one is enduring my tribulations.'
     “The reality is most of us expand the difficulties we experience to fit our space for our troubles, never thinking some people have to deflate their troubles to fit into that space. Your story is a testimony of how little all of our problems really were during last term…
     “…I hope that very soon you will be back like the rest of us having to inflate your troubles to fill your trouble space. Better yet after this storm passes may that space be so big you can never fill it.” 
     His letter made me cry. It also made me remember why I like teaching so much: I learn as much from students as they do from me.