Breast Surgeon

11/15

Today I met with the breast surgeon

My amazing friend came with, and we decided to make a day of it, so treated ourselves to VIP (amazing Korean food 🙂 for lunch. We had found and printed a bunch of questions from breastcancer.org to ask the different specialists who would become my cancer care providers. We wanted to be prepared. We had been listening to podcasts and searched for unknown knowledge that would soon become our common, and read through the questions during lunch. Truth is, I didn’t even look at those questions at the appointment.

Cancer during COVID, so they wouldn’t even let my friend into the waiting room. She had to walk the hospital halls instead (what irony!). So in I go alone. I had filled out all the initial paperwork ahead of time (always a good idea as you are stressed out about being there and can’t think straight enough to fill it out day of), so I got to get naked, don a robe and wait.

At first, the surgeon seemed attentive, but dispassionate. I wasn’t quite sure what to think. She didn’t ask about my sob story and she didn’t really give me any time to digress or to explain my unstable mental and emotional states. What’s up with that???

The surgeon didn’t coddle or pity me. She didn’t let me digress into depression. What she did do was stick to the science and thoroughly explained my diagnosis. I was given a highlighter and we went over the pathology report line by line marking everything I needed to know clearly. She then presented an action plan for treatment and pushed it forward into motion.

She focused on the facts, not the feelings. On reflection, I believe she did this because she realized that I couldn’t focus on anything else. She knew what I was experiencing was more than overwhelming. The most successful patient outcomes are from those who focus on staying both mentally and physically healthy and fit. She reminded me who I was (a single mum of an amazing teenage girl who needs me), and what I did (personal trainer and group fitness instructor), and what I was made of (grit and strength). And she told me I could do this, and I knew I had to, because there was no other choice.

I was told about this incredible woman/cancer survivor warrior, Kikkan Randall. Check out the awesome public vlog of her cancer journey here:

https://www.kikkan.com/

I find it awesome and inspiring that such an amazing person had gone through this before me.  She went from being a gold medal athlete to a giving a platinum performance through cancer treatment, smiling all the way. At first I was astounded. Still am. Kikkan is a rock star. She’s even more than that. I FB messaged her some questions when I found out I actually went to the same high school as her, and she was so kind and caring in her responses back.

I then asked the surgeon my question of how/when I developed the cancer and she explained to me that the tumor cells grow exponentially. When you find a lump it doesn’t mean that the cancer just showed up overnight, it’s more like cell division has reached a point where you can actually feel a mass that’s already been there for quite some time. Cancer growth is rate dependent, and there are many factors that can effect the rate: your age, tumor grade (what it looks like), receptor status, type, etc. So a cancer you can feel actually got started with a single cell that divided over 5 years ago. Where was I 5 years ago???

I heard the dreaded words: “We will start with the chemo.” At this point I had researched treatment plans but had no idea (because I had no specialist providers yet) what was going to take place. Would I have radiation, chemotherapy, or mastectomy. Could I be having the cancer cocktail of all three? Researching online shows you there are lots of different types of treatment and all involve different things.  I was hoping to maybe avoid chemo, at this point. Anything but chemo. Everything I have ever found or heard about chemo sucks. I’ve never ran across anyone or any site that says chemotherapy is awesome! I actually found lots of cases of people who managed to avoid chemotherapy, but I didn’t know if this would apply to me. I had this sneaky foreboding that since I was winning it on all fronts of losing recently, I was cocktail lucky. Girl can hope though, right?

When I asked about the possibility of not doing chemo she gave me the “only if you want to die” look. Oh. Radiotherapy? That’s definitely on the table for after surgery. Double Oh. So then I got up enough nerve to ask about mastectomy… no answers. No one wants to give you answers you definitely don’t want to hear. Let’s wait and see.

I did not want to wait and see. I just wanted to know. Knowledge is definitely power, especially when it comes to what plays out for your future; and I don’t know how to not know. How do you not know?

Okay, so what does this mean for now? I told her about my fears for the future. How can I teach going through chemo? Chemo basically kills all your cells as they are dividing in attempt to kill the cancer cells. Over and over again. How would I be able to train anyone or in anything after frying my body to bits? How do I live if my job is physical exercise and chemo makes you too tired to move?

Her look of incomprehension astounded me. She told me, quite matter-of-factly, that there was nothing I couldn’t continue to do as long as I felt up to doing it. She then mentioned Kikkan again and how she was able to bike to treatment and back and train everyday. And while I am totally all about Kikkan, I looked back at the surgeon in disbelief.

I don’t get paid to train! Well, I kind of do, as I get paid to work but no work, no pay! In that moment, reality started to sink in a bit further, and I realized who I am not. I am no survivor. I am not just a label. And I most definitely am not a cancer warrior. I’m no trophy winner, have no sponsorships, no medical team, no fan club. It’s just me, and I definitely don’t want in for this race.

Up goes the blood pressure and so I automatically jump to just wanting to know when this would END. I do so well with goals. Short goals, long goals, any goal. Give me something. Anything? Even before I got started I needed to know when it would just be over–No comment.

Okay so how about timelines? Can you give me a timeline? I wanted to know when/if to send for help to care for my dd and her schooling. I wanted to know when treatment would be starting, when surgery was, and again, when this would end. I got no dates, no times, no answers. I was reminded to take one step at a time. I HATE taking things one step at a time! Breathe.

When I asked her about getting a second opinion there was no hesitation. She gave me the names of some other surgeons was completely confident that they would come up with the same treatment plan as she. I asked her if I should go back to Boston and Dana Farber. She explained while they might be a prestigious cancer center, she reminded me about the beauty of Alaskans. People aren’t here because they have to be. She reminded me that the same resources and caliber of professionals were available here as elsewhere. People with the same level of expertise, but choose to live life differently, same as me.

What she did offer was her experience and expertise. And to schedule my first surgery. First surgery??? I had no idea I needed more than one! She then offered to personally put in my chemo port. What’s a chemo port? She showed me.

A chemo port is a plastic device about the size of a quarter, with a tube that goes into your vein to your heart. It’s put under the skin into your chest so that your blood can be drawn and IV meds distributed more easily. She said it was more efficient than using PICC lines in the arm. And then I freak. “A what in my chest, with a tube to the vein in my heart???” Total tune out, total zone out, no comprehension. No plastic in my chest. Oh, no way. Deep Breath.

She had someone come in to take a picture of my boobs for the files. With my back up against the wall and my upper body all exposed, I started wondering what it felt like to have your picture taken when you are about to be convicted to be on death row.

A myriad of medical checking, prodding, and tumor measuring ensued. She then did something special that showed me her heart. She explained to me why she offered to put in my port. While it’s simple enough a procedure for any surgeon to do, she asked if they would do it in the correct place. Most surgeons would put it in your chest, somewhere under your clavicle, in an easily accessed location where you’d have a visible scar, for the whole world to see. You could be at the grocery store one day just trying to check out and some curious person might randomly ask you about your scar. You might not want to explain. She then showed me where she’d put the port in on my chest. Under my bra line. She showed me where my skin lightened and where it was covered up. She then told me that this journey was my story. Mine to keep or mine to disclose however, whenever, and to whomever I chose. Or not.

So I chose her. I knew then that she was the right surgeon for me. I thanked her for everything and told her how grateful I was that she was available to be my surgeon. She gave me her A team, adding on a wicked smart oncologist for expertise. She told me about how she was looking forward to seeing me this yearly event she held for cancer survivors, and watching how my personal training business would flourish, in spite of it all. I breathed a little sigh of relief knowing that I had her in my boat.

And then she touched my hair. My long, flowing, purple tinted hair, and and said you know it will all grow back, right?

Questions to Ask Your Breast Surgeon

https://www.breastcancer.org/treatment/surgery/expectations/questions