Been There, Done That...and I Can Do It Again

The old sparkle was beginning to chase the fear from Karen’s eyes and a high level of barely-contained energy made her appear poised for something to happen. Now, three months after breast sparing surgery to remove a tiny, B-B size lump in her left breast, Karen was ready to begin radiation therapy...finally.

"The first few weeks A.C. -- you know, that’s after cancer -- I was struggling to take charge of my body. I am not accustomed to inactivity, and I wanted to go on the offensive against this invader. I wanted the cancer out of my body...NOW," the peace officer explained. "When a fluid retention problem set in following the lumpectomy surgery, the radiation therapy had to be put on hold, and the waiting was really making me anxious."

"Under normal circumstances, I would have had a moment or two of frustration and gotten on with it. Now, however, my mind started working against me. I thought, ‘the reason it’s not healing is that there’s more cancer in there...’ So now, not only was I scared about a new assault, but I couldn’t do anything about fighting the cancer we already knew about. The days passed and then weeks, and fear and frustration were running neck and neck in a race to consume my waking thoughts."

Karen is very candid about her growing dependence on her surgeon and his assistant for reassurance. "I would have to get my ‘fix,’ as I began to call it. I don’t know how many people are lucky enough to have this kind of extraordinary bond with their doctor. But being able to talk candidly with Dr. Leggett and his team sustained me from one visit to the next. Intuitively, they knew what I needed during this waiting time, and they gave it to me -- sometimes in encouraging words...sometimes in a gentle touch. I would go away with renewed confidence that everything would be all right."

The weeks dragged on. They were aggressively treating the fluid problem and a home nurse came daily to remove the "packing" in Karen’s breast and then repack it. Finally, after the surgeon reopened and closed the incision, the healing was complete and radiation therapy could begin. 

"In looking back over the past few months, I know that I have become increasingly better grounded. I realize now that my ‘journey’ hasn’t been unique...it just felt that way at the beginning. One of the things that has helped me through this evolution was attending a series of breast cancer education programs offered by the Breast Center at Houston Northwest Medical Center’s Women’s Atrium. I wasn’t ready at first; in fact I was almost downright recalcitrant. But I’m not by nature an isolationist," Karen said emphatically, "I tend to draw energy from people around me...family, friends and the people I work with. Now, of course, I’m glad I got up off my apathy and attended the evening meeting. It was like a lightbulb going on...I WAS NOT ALONE. Here, sitting all around me, were people who were going through similar experiences; being haunted by the same worries, alternately confident and scared about the ultimate outcome, and hoping it would all just be over with."

(Staff and physicians of The Women’s Diagnostic Center")

"When a woman finds a lump in her breast," explained Ellen Moore (no relation), director of the Women’s Diagnostic Center which is dedicated to women’s imaging, "she wants to find out at once. And, if a diagnosis of breast cancer is confirmed, she wants to be assured of receiving the best care possible. We have weekly interdisciplinary pretreatment planning conferences where physicians from different specialties involved in breast cancer treatment collaborate to discuss and plan the best, individualized treatment plan for each patient."

Twice a year, the Women’s Diagnostic Center offers a breast cancer educational series for the community that gives in-depth information about the disease and its treatments. "In this series, patients can learn about what happened to them, and why," Ellen explained, "and, when they are ready, we also have a monthly support group, Care, Share and be Aware!"

"One of the more startling revelations that occurred," Karen continued, "was the realization that hey, I’m lucky. There are others who have not been as fortunate as I was to find it early when there was the best chance of a cure. Strange...to think of having breast cancer as being lucky, but at last I was back in control, taking the initiative against the disease and fighting back by learning more about the enemy."

Just before starting radiation therapy, Karen’s radiologists suggested that, because her lump had been so obscure, she undergo a new ultrasound to make sure there was nothing else there, "just in case." She said that the ultrasound was especially thorough.

"When Dr. Stephen Rose pointed out an area that looked a little ‘suspicious’ I was almost amazed at how calm I was. My first thought was that I wasn’t surprised...so maybe there was something there, after all."

"Now -- try to follow this -- contradictory thoughts were whirling around in my brain, struggling for control. ‘See, I told you so...there’s something wrong.’ and ‘There’s nothing else there...I’m sure of it, the doctors are sure of it.’ But then, here it was, a shadow...a gray area. Was it or wasn’t it? De ja vu all over again, as Yogie Bera would say. Biopsy time again. Could I take it? Yes, of course I could. Been there, done that...and I could do it again."

Knowing what to expect this time, Karen sailed through the fine needle biopsy (clear) and the core biopsy (also negative). She went home feeling great after just the results of the fine needle biopsy and was even more relieved on Monday when the other results were OK, too.

"During these three months after the diagnosis," Karen reflected, "after going over and over my decision to have a lumpectomy instead of a mastectomy, I am confident that I made the right choice. My relationship with the professionals who were providing my treatment and therapy was growing more comfortable every visit. The fact that they questioned test results and reviewed and challenged each other’s decisions became a strange source of comfort to me. Each was staking his or her reputation on me. They wanted me to survive; they wanted to do exactly the right thing given the circumstances. I reveled in the fact that they weren’t ‘yes-men’ saying only what I wanted to hear. To them, I’m not simply ‘the breast,’ I’m Karen -- someone with needs and wants and fears just like they have. It dawned on me again that I was lucky; no, more than that...I was blessed to have them as partners in my care. In fact, I almost felt compelled to tell others that if they didn’t have this same kind of support from their doctors, to go find it." 

While Karen was recovering after the surgery, a radio-therapy body-mold was created for her out of plaster that would position her for the radiation sessions. Then, with the incision healed and therapy imminent, Karen lay on her back in her "cradle" while the radio-therapists lined her up and marked her breast where the beams would go, and instructed her through a therapy simulation.

"It was like learning personal care all over again," Karen smiled, "only this time I had to un-learn things I’ve done almost all my life, like putting on deodorant, shaving under my arm and wearing a bra. Now, don’t laugh...it’s not funny. I took their advice and began wearing a white T-shirt to protect my clothing in case the markings rubbed off and learned how to use cornstarch as an anti-perspirant. It’s amazing how flexible you can be when your eyes are on the target and you’re focused on reaching a goal."

"I feel so good about the support and encouragement I’m getting from the people who have read about me on Your Family’s Health. I actually feel like I’m doing something to help other women overcome their fears about having a mammogram or doing a breast self exam. After all, if I hadn’t found my cancer early, I shudder to think it would still be growing inside me. My friends are telling me that, because of what they read about me, they are getting their mammograms and doing their exams. If telling my story helps just one women save her own life, I will be satisfied."

"Mother’s Day this year really was special for me. Except for missing my son Keith and his wife, Robyn, who live in San Francisco and couldn’t be with us, it was truly wonderful to feel good, to be with Phil, Leanne and Matthew, Janet and Richard, as well as their delightful daughters Madison and Remington."

"You know, when things get tough, it’s my granddaughters who have the most calming effect on me. They are my one true grounding force. When I am with them, I just forget about everything else," Karen said. "I have told them I have cancer, they have taken a peek at all the funny blue lines on my chest, and they know this is something that we are all concerned about. They accept what I’ve told them, and don’t let me wallow in it. And, on a very different level, looking at them reminds me of everything I have to live for."

"After the denial and the anger and yes, the fear, I am feeling more in control than out of control. I’m sleeping better. I know that one of the reasons cancer patients are so vulnerable to emotional upheavals during the first few weeks is that even if you can get to sleep, the first second that you turn over or one eye opens, it comes screaming back at you: I HAVE CANCER, NONONONONO. It sneaks unbidden into your waking thoughts, draining you, immobilizing you. It isn’t long before the tiny cracks in your composure appear and your smiles don’t quite reach your eyes. You don’t dare cry because how would you ever stop? And then, ever so subtly at first, it begins to get better. Somehow you get the strength to put modesty aside and deal with what you would consider invasions of privacy if they weren’t designed to help save your life."

"You have a whole new perspective of what’s important and the day to day challenges just sort of fall into place. I’m facing 5 weeks and 3 days of radiation treatments, once a day, five days a week. The first one wasn’t bad at all, but I know there may be some side effects...this is not, after all, a day in the park. I’m listening to my body more carefully now. I’m open to new ideas, and maybe I will make some changes to my diet. But, overall, I’m approaching this next phase with determination and confidence. I feel good and I will beat this."