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Tuesday, February 15, 2011

I will bloom where I'm planted.

I recently took a class at the Foreign Service Institute which dealt with some of the issues that foreign service spouses (EFMs) have to face.  One of the most memorable quotes I heard was from an EFM who's husband had been in the Foreign Service for over twenty years.  When asked how she dealt with moving to a different country every two to three years, she said, "I bloom where I'm planted."  I've been thinking a lot about "Home".  I began my first blog post talking about my house in Corrales and leaving home.  Then a wrote about our "home for now" which was our apartment in Arlington.  When I was diagnosed with cancer I wanted to go "Home" to New Mexico for treatment... and I did.  Bob went on to Germany to set up our apartment.  I am staying with my Mom and Dad in the house that I grew up in.  I'm sleeping in the room that was mine as a teenager.  The funny thing is that I don't feel like I'm at home.  Why wouldn't I feel at home in my own childhood home?  Last week I drove up to Durango to visit my daughter, Tasha, and her boy friend, Thomas.  I had a wonderful time there and it was so great to luxuriate in Tasha's company and I was very comfortable in their new house but I didn't feel at home there either.  While both my parents home and my daughters home are filled with people whom I love, those are not places where I feel "planted".  I was feeling a little low one day recently and said as much to my Mom.  "What's on your mind?" she asked.  "I want to go Home." I responded.  What!?  What I meant was that I want to go to Germany!  My home is a location where I've never been before.  In Frankfurt, Germany, in an apartment of which I've only seen photos and one Skype tour, there is my home waiting for me.  I will be at home when I get there because there, with Bob, I will be planted.

Breast Cancer:
I haven't yet called myself a cancer survivor. I was only diagnosed less than a month ago and the cancer has already been surgically removed from my body. I haven't said that I'm cancer free. I have yet to go through radiation treatment to make sure that any cancer cells that might be left over from the tumor will be eradicated and that tumor won't regrow. I am now in another statistical category. I've had cancer so my chances of getting a new cancer are higher than those who have never had cancer. I'll do a five year oral med treatment to search and destroy any cancer cells lurking in my body. I'll be as vigilant as ever with my mammograms but now they will seem less than routine and more anxiety provoking. I've heard that cancer changes some people forever. I guess I can see that. The diagnosis certainly was a jolt. I peered at my own mortality in a way that I never have before. But I don't want the changes in me to be that I am now all about being a survivor. I am not Breast Cancer. I never felt sick. The surgery was akin to serious dental work. I'm very, very lucky that my treatment, when it's all done, will have been so easy to "survive" that the word "survive" really shouldn't be used. The changes in me are more about a shift in priorities and living in the moment. It is time to change "one day" into "today". You never know what is going to come along and totally change the course of your life and what you intended to do one day is no longer possible.

I've always been able to find the bright side of almost any situation. Something really wonderful that has come out of the timing of my cancer diagnosis is that I have been able to come to live with my Mom and Dad for several weeks. This was a gift of time in their company that none of us would have planned but all of us really wanted. I was also able to go visit Tasha and Thomas in their new house. I wouldn't have been able to do that until I don't know when. I now have absolutely no reservations about leaving New Mexico and going to Germany. Before this time in New Mexico I was anxious about going but now I just can't wait to go.

The good news:
I visited my oncologist on Monday. She came into the exam room grinning and said, "I love it when I get to deliver good news." My pathology reports from the surgery show that they got clean margins around the cancer and that the lymph nodes were cancer free. We talked about what she recommends for treatment; Full breast radiation, follow up medication; Tamoxofin and me going to Germany for treatment. She fully supports me going and says that I should be able to get top notch treatment there. She would fax my records off by the end of the day to all of the appropriate people so that I can be approved to join Bob. I will leave on this coming Friday and arrive Saturday morning, hopefully after a good night sleep on the plane. I still have some challenges ahead regarding cancer but it feels like the worst of it is behind me. I am very grateful to be so lucky and so very happy to be going home.

Saturday, February 5, 2011

Post Op.

It's Saturday the 5th of February. Two days post surgery. I've waited until the narcotics have worn off to write. They told me not to sign any legal documents for at least 24 hours after surgery and I think blogging under the influence would be dangerous too.

It has been a record breaking cold spell in New Mexico this week. Many towns are out of natural gas and people are huddling under electric blankets and around electric heaters to keep warm. The governer has called a state of emergency. The morning of surgery I rolled out of bed at 6:00 am and it was 10 below 0 out. My sister had agreed to drive me to the hospital in her lovely SUV. When she went out her garage door was frozen shut. She did manage to get it open and Mom, Dad Heidi and I were on our way by 6:30. We wanted to give ourselves plenty of time to get to my 7:30 appointment because the roads had been so bad. It only took us 1/2 hour to get to the radiology office for a pre-op procedure. The staff was just arriving when we showed up and they weren't really open yet but they let us come in and hang out in the waiting room until they were ready for business. After the procedure we all piled back into the car (with seat heaters that were like a day at the spa) and drove to the hospital. There was very little about the experience that was unpleasant. Drugs helped me not feel the pain of what I went through so what my impressions is that there were flocks of sweet gentle women fluttering around me asking questions, taking my blood pressure, patting me and reassuring me. One of them apparently injected happy medicine into my IV. The last thing I remember was thinking, "This is kind of like a roller coaster. I love roller coasters!"

They performed a lumpectomy and removed one sentinel lymph node. I'm very fortunate that we caught it early and it was small. Here's were I get on my soap box about regular mammograms. Getting regular mammograms has undoubtedly saved my life. My cancer was buried underneath my breast tissue and I may never have felt it myself until it was really big. So, ladies, get your regular mammograms!!!! If it's been a year or more, call Monday and schedule it!!! (OK, stepping off of my soap box.) I was so happy after surgery. For one thing, it was behind me but also the medication made me very agreeable. I was up all day after surgery talking and talking and having a wonderful time. It felt good to be numb to the reality of my situation for a day and I knew that my incision was hurting but I just didn't care.

We were instructed to tend to my incision every hour. The first night I was snug in my bed in a drug dazed state and my wonderful Mom and Dad came in every hour on the hour and tended to me. They were like soft sweet silver angles hovering over me all night. None of us really got any quality sleep but it's a really nice memory for me to have in my library. I have been getting lots of phone calls, emails and notes on face book as well as comments on my last blog, with love and support. I can't tell you how grateful I am.

Today the anesthesia has worn off and I'm not taking the narcotic pain meds so the euphoria has dwindled. I'm very happy to have surgery behind me and I'm anxious to find out the results of the pathology reports. That will determine what treatment will come next. I may dodge a bullet and avoid Chemo but that remains to be seen. I will have radiation. This will all unfold over the next two weeks.

Wednesday, February 2, 2011

The best laid plans of mice and men...

It was to be our last Weekend in DC.  The movers came to the apartment and packed most of what belongings we had here into boxes and took them away.  Hopefully we would see them soon in Frankfurt.  Bob finished up the last of his training and I'd been getting the last of the administrative tasks and doctor/dentist appointments taken care of... a slight snag, I got a call after my annual mammogram to come back in so that they could take another look.  I couldn't get in until the Thursday before we were to leave on Tuesday.  This was nothing to worry about.  I'd been called back before and it was nothing.  But I had to do it just like dental work.   It would feel good to get all of this stuff out of the way.  Ok.  The mammo call back had me a little freaked out but there was no sense in expecting the worst. Positive thinking is the only way to get through in the face of something scary like that.

Bob went with me to the call back which was a mammogram and an Ultrasound.  Women over 40 really must get a mammogram once a year and we're all pretty glad that it's not more frequent.  It's not the worst thing I've been through but it's not exactly pleasant and I wasn't very happy having to do it twice in a month.  The ultrasound wasn't bad though, sort of like a breast massage!  My very competent radiologist, Dr. Lu, spent a lot of time looking and looking.  At the end of the appointment she said that she thought everything was fine.  Yay!  We left and went out to dinner.  I had forgotten my phone so it was a fairly quiet, very pleasant evening.  Not that I get a ton of calls but someone inevitably calls during dinner.  When we got home there were two messages on my cell phone.  "This is Dr. Lu.  You just left my office and I think I want you to come back if you can turn around.  I just want to have one more look."  then "It's Dr. Lu again.  Call me."  Oh crap!  I called her on her home phone number which she had left:  "I was looking at your scans again as I was dictating and I'd like you to get a biopsy on this little spot.  I really can't decide if it has more to it than it did on your last mammo."  We had told her about the up coming trip so she called her office and got an appointment for me the next day at noon.  Needle biopsy.  That sounds kind of awful and serious.  But really, it would be nothing.  We just have to make sure it's nothing before we go off on our big adventure in Europe.  I was a little sore when it was over but at least it was over.  Unfortunately we wouldn't get the results until Monday or Tuesday!  The day we were to leave!  The Doctor was great and put a rush on the order.  Bob and I had a wonderful weekend.  All of our stuff was gone and all of our training was over with.  We acted like tourists all weekend.  I refused to let this little scare put a damper on our imminent departure.  I decided to write a blog about what had been up since my last blog but I wouldn't write about the abnormal mammogram.  It was going to end up being nothing and no one would be the wiser.

Monday morning I went to the dentist as planned and then met Bob at the Newseum in DC.  If you ever have the chance you really must go.  It was moving and interesting.  If you like 3-D movies, there's a great one there about the impact of the news on our history.  It was a great day and we were both in a great mood coming home.  "I'm not worried about the biopsy." I said.  "What are the chances of your mother and your wife being diagnosed with breast cancer in one year?  That wouldn't happen!"  Bob said that he felt the same.  That wouldn't happen to us.  4:00 pm on our way home Dr. Pulosky called on my cell phone.  "Do you have a minute to talk?" She asked.  "Sure." I said settling down on a bench in the mall attached to our apartment building.  She started to talk and I could feel her circling what she was going to have to say:  "I'm afraid it's not good news."  After that she talked and I listened but I still don't really know what she said.  "What did she say?" Asked Bob who was waiting on the bench next to me.  "I have Breast Cancer."  I said.  My first thought upon hearing my voice echo in my head was, "I might die from this." We were in the middle of this stupid underground mall and I had breast Cancer.  I started to cry.  Not the kind of crying that feels good to let it out and you will feel better when you're done, but a panicked "I don't know what to do to make it better.  I always know how to make things better and I don't have the equipment to make this better!" kind of cry.  I couldn't breath right.  I don't really remember walking back to the apartment except that we ran into our sweet neighbor, Tim, coming out of his apartment to walk is dog.  He saw I was crying but I wasn't ready to tell anyone yet; to say it out loud again.  I was trying to pretend I was OK.  Bob saved me and told him that we had just received troubling family news.  I'm sorry I didn't say proper goodbyes to someone who had been a good neighbor.

When we got into the apartment, and I couldn't recount what the doctor had said, Bob called her back and got the details. It was small, 5 mm. It is a ductal carcinoma and it is invasive.  I should get in touch with a breast surgeon and an oncologist.  She could recommend some great Doctors that she works with and she was sure that there would be great Cancer care in Germany if we decided to continue on our trip.

"Denial is a great place to be." my friend Jo said.  "I'm still in denial and I'm over a year post cancer treatment."  I was in denial to a point when I got the phone call about the call back mammography, but not so much that I hadn't thought about and mentioned the "What if."  I had told Bob that if, God forbid, I had Cancer, I would go back to New Mexico for treatment so that I would have the support of our family and friends.  If we went ahead to Germany, I would be alone a lot as he would be at work and I really didn't want to be alone with this. I also wanted to make sure that language wasn't an issue for me.  I felt that dealing with Cancer in english would be challenging enough.  It took Bob a few minutes to realize that that was about to be our reality.  I wasn't going to Germany.  I didn't really have to think about it because I had thought about it already when my head was clear and when I wasn't paralyzed with fear.  The next big decision was, what was Bob to do?  Should he come home with me? Would his job be in jeopardy if he did? Should he go to Germany?  Would we wish that he had come with me if he did? We finally decided to wait until morning and call the State Department and let them know what was going on.  Our flight wasn't until 4:00 pm the next day and that would give us plenty of time to figure out what to do.  That gave us an opportunity to call our parents and my kids.  It's hard for me to write about it.  It was so difficult.  Each person had a different reaction.  Everyone was shocked of course but one cried, one got really quiet and a couple of them asked a lot of questions.  The big unasked question: What does this mean and are you going to die.  I told them all, "I'm not going to die!" Next I wrote an email to all of the friends and family members who's addresses I had telling them.  It didn't take me long to realize that if I didn't get it all written down and sent out that I would have to tell the same story over and over and relive it a little each time.  I wanted support so I really wanted everyone to know.

In keeping with our great impression of the Foreign Service, Bob's employers were stellar in their response to our situation:  Of course Bob should take all the time he needed to be with me and fly back to New Mexico.  There would be not problem with him coming to his job later. They also let us know that they would have med-evacuated me home for treatment so going to Germany for treatment really wasn't an option.  After thinking about how things would be in New Mexico with me and doctors visits and what Bob would be doing there, I decided that it would be better for Bob to go to Germany, get settled and if and when big scary things started to happen, he would fly home.  I knew that there would be a lot of time with nothing to do with regard to my cancer and we would spend that time wishing he was at work.  We both took the van ride to the airport that we had arranged but we said goodbye at Bob's gate.  As we hugged and kissed goodbye, the sadness of how our great adventure together was being hijacked by this Cancer overcame both of us and we sobbed.  He boarded his plane to NY to be followed by a flight to Frankfurt.  I waited another hour for my flight to Albuquerque.  By the end of the day I was in the loving embrace of my family in Corrales.

The next morning the phone started to ring.  The outpouring of love and support from my friends and family was amazing.  I am really touched and feel lucky.  Since we now have friends working in embassies and consulates all over the world I am being included in peoples prayers around the globe. I feel the love and it makes me strong.  I couldn't believe how many people could give me advice from first hand experience.  It wasn't long before I had a doctor lined up and a series of appointments made.  I got in with Dr. McAneny, oncologist, and her amazing group at the Cancer Center of New Mexico.  She recommended Dr. Smith for Breast surgery and her office is incredible as well.  I've been poked and prodded, scanned and examined.  I now know more about what's going on in my body than I ever thought I would.  With no stone left unturned I'm set for the next step: Surgery.

I am typing this blog on the eve of my surgery.  Until they actually do the surgery and send tissue samples to the pathology lab, we won't know what comes next.  At this point we know that I'll have a lumpectomy.  This will surely be followed by radiation and there is a chance of Chemotherapy. (It sounds like a weather report.)  If things go well, it will be nothing more than a bad storm.