of a true cancer-free recovery. Keep a record of everything and don’t be afraid to build your own shield of protection.
Lesson Four –Develop a personal mantra and use it to replace any negative thought that squeezes its way into your head. This can be a single word, a phrase, a short song, whatever works for YOU to replace the negative with the positive. Remember, your brain can only process one thought at a time. Don’t waste your brainpower on the negatives!
Chapter Four
The Diagnosis and Prognosis
“Worry is a misuse of the imagination.” — Unknown Author
On Thursday, October 11, 2001, I was scheduled to meet with Dr. B to discuss the test results. I had my “pinky swear” friend, Mary, to accompany me for a variety of reasons. First, for moral support, second, I felt that maybe her perspective would offer a different interpretation of what the doctor was saying, and third to ask any questions she could think of that I might have missed. Keep in mind, this can be a very trying time and although we think of a thousand things to say before we get there, sometimes our minds just go blank when we arrive in the office.
My appointment was not until 1:00 in the afternoon, and I can tell you that the morning seemed to last forever. I had purposely scheduled a long meeting at work so that I knew my mind would be occupied elsewhere for at least a little time while I waited for the “moment of truth”.
At the appointed time we arrived in the doctor’s office, camera in hand, and clown noses in my bag. I already realized that this meeting would not be all cheery and sweet, so I brought the noses along as a supportive measure. I wasn’t sure who needed it more, the doctor, or me! I didn’t know him very well, but I knew I wasn’t going to be the usual patient – I had already hired members of my Humor Team, but more about that later!!!
I didn’t think I was really nervous until I had to wait for Dr. B to arrive in the room. It took almost 25 minutes, but that 25 minutes may as well have been 250! I was in the examining room by myself, until Mary was summoned and I think I looked at every square inch of the room. I lay down, I sat up, I counted the number of tongue depressors in the canister (16 if you would like to know). I was really working up the nerve bunnies when Dr. B arrived. I told him I had someone with me and the camera, so please don’t say anything yet. I was so afraid of missing something really important in the exchange.
He laughed and said, “Okay, okay, just let me take a look at you for a minute.” Ahh, that was so sweet, well, it was until I realized he meant the bandage covering my left breast!! Of course I knew that was what he meant, remember, it was stressful waiting!! (Looking back, the whole scene was almost surreal and like something from a comedy film. Hmmm, a film of my life – I wonder who they would get to play me? Maybe I can check with Dolly Parton, as she is one of my favorites! There might have to be a few, or at least a couple (wink-wink) costume adjustments needed, but she would be able to play the role very well!!
He said everything looked good and he asked the nurse to go summon Mary and that he would be right back. Closer to the moment of truth – hurry up, let’s get on with it!! When everyone was seated, camera rolling, he began. For the next 36 minutes (one of the advantages of having it taped – it has a timer), he calmly and thoroughly told me the diagnosis and answered every question I had. If your doctor does not do this, tell him or her that you really need to have the opportunity to talk and ask questions, and most importantly, have them answered to YOUR satisfaction. Make sure your doctor explains everything, and in language YOU can understand. If you don’t know the definition of the terms he or she uses – don’t stop asking questions until you do. No matter how minor you think the questions are, remember, this is YOUR body and YOUR life.
I knew Dr. B was very busy, and I didn’t want to waste his time, but we were talking about my LIFE. I wasn’t just a patient, but a real live person who had a cancer growing in her breast. I needed to know what was going on and I needed to know now. There was never one second that I felt Dr. B was rushing me, or his responses (another part of my thankful list!).
My diagnosis was a 2cm invasive carcinoma in the left breast located directly under the nipple. In some books, there would be a series of technical jargon from this point, but I believe the technical information can be covered in books written by better authorities on the matter.
One of the best things Dr. B did for me was to take the booklet, “Breast Cancer Treatment Guidelines for Patients”, a very informative publication by the American Cancer Society and the National Comprehensive Cancer Network, off the shelf and highlight everything pertinent in the book as we were discussing it. This was extremely helpful as the book contained a decision tree – the kind that says, “if this is the case, then here are your options – if this other is the case, then these are your options, etc.” The technical information was something I could then read and re-read, look up, study, and understand when I was able to think clearer.
Not only did he “mark up” the book, but he also drew diagrams on flipcharts, in different colors for clearer explanation (little did I know then what kind of artist he was, but I found out later some of his true talents - but more on that with surgery two!).
There were a lot of choices thrown at me from a lumpectomy to mastectomy to reconstruction (insert scream and pulling at hair image), and there were decisions that had to be made. These are the type of decisions that only you can make, and I strongly affirm the idea that we need to be educated about the options available. In many cases, there are many options. My emotions were very high, but in the end I felt good (and still do to this day) about my choice of decisions.
Basically, since the cancer was directly under my nipple, for me the decisions started with either a lumpectomy (in this case, also known as a partial mastectomy) or a total mastectomy (removal of the entire breast) and whether or not I wanted reconstruction done. In most cases, a lumpectomy does not require the removal of the nipple and areola area, but since this was directly where the cancer was located; it would be required in my case. Dr. B explained that there weren’t any guarantees. Even if I had a bilateral total mastectomy (both breasts removed), this still would not guarantee that the cancer would never come back. We had a long discussion about the options since my cancer was in the nipple area, and it was small enough at 2 cm, that I opted for the partial mastectomy, which is essentially the same as a lumpectomy, except that I was losing a definitive part of the breast. I asked him that all important question, “If I were your mother…” He laughed and said I was way too young to be his mother, but if I were his sister or wife (shoot – he’s married and has 4 kids – oh, well, he is still easy on the eyes!), yes, this would be the surgery he would recommend.
Okay, then. One of the things I really dislike in life is indecision. I don’t always make the right decision, although I did in this matter, but being a “fence sitter” makes me crazy. I would rather make the decision and move on than sit there dangling my feet off the fence!
I believe that Dr. B is a fantastic doctor and I did and do trust him with my life. When I asked him once why he chose this particular focus, he told me that there was so much controversy in the field of breast cancer, and it was always changing with new updates in medicine. I think that is what keeps it interesting for him. As we learn more and more, we can make better decisions. When I was diagnosed, he told me there would be some decisions to make, and he could advise me, but I was the only one who could ultimately make the decisions. I know some people do not want this option, and would rather just say to the doctor, “Do whatever you think is the best thing”, and others who refuse to do anything and let nature take its course.
