Attitude is everything

Some days feel like much longer than the usual 24 hours. Today was one of those days, and it's not even over yet!

Early this morning Rachel Whalen, the Breast Care Coordinator at Kaiser in Oakland, called me to say that Kelly O'Neal had to operate today and all her appointments were being rescheduled. I asked Rachel if I could see someone else just to get the complete biopsy results, but she did even better - I met Veronica Shim (not Dr. Shim: although she is a well-trained surgeon specializing in breast cancer, she prefers to be addressed as Veronica) this morning instead.

Veronica is very nice, extremely aggressive and I like her a lot, so I'll stay with her. She told me that I have Stage III ductal carcinoma. The lump under my arm had cells drawn from it, and we were informed 20 minutes later that it was also positive for cancer. No need to do a sentinal node biopsy now.

Here's the plan as it stands today, but this could change based on further test results: I will be scheduled for a CT scan and a bone scan (which cannot be done on the same day), blood work was done today, and I will be seen by a genetic counselor who will review my chart and decide if I should be tested for the genetic marker for breast cancer. Veronica felt certain I'd be accepted for this test at Kaiser, but if not I will find out anyway, I'll just have to pay for it.

The genetic test results take a month to find out - now that's gonna be the longest month in history for me. The results will drive the surgery - if I am positive for the marker then both breasts as well as both ovaries will be removed. Why? Because statistically there's a significant risk of cancer recurring in the opposite breast and ovaries. I am a candidate for the following reasons: I am 100% Ashkenazi Jew, I am under 50 with breast cancer, and the estrogen/progesterone receptor test and her2neu test were both negative. I can choose reconstructive surgery to happen at the same time, and I'm headed in that direction, I think.

Obviously the genetic marker positive result will also drive testing for my sister, Sheila, and for other close relatives.

OK, so because the genetic test results take a month, chemo will be started asap. I have a 10 am appointment with Dr. Michael Russin, an oncologist in Walnut Creek, on Thursday 11/3, and at that time I'll find out more about my chemo. Rachel said I should expect my hair to fall out, so if Dr. Russin agrees with that I'll be shaving my head very soon.

Ooh, I don't like to think about no hair. My hair has been such a big thing for me all my life. I know it will grow back . . . but damn, no hair doesn't look good on any average-looking woman. I understand that how I look has nothing to do with anything, but . . .

Chemo will take about 4 months I think, and then the decision about the surgery will have been made and we will proceed with that.

The CT scan and bone scan results might be scary, but I'm prepared.

Look, this is how I think about it: It may be an unpleasant year, and that's putting it mildly, but I will survive. Me and Gloria Gaynor - remember that song?

I am not asking about statistics, I don't want to know them so you won't see any statistics here. I am one strong broad, dammit, and cancer should be scared.

I may be able to continue working through the chemo, but Rachel said everyone's reaction to chemo is different, there's no way to know ahead of time, and not to make long-range plans about work until I've got more info.

I am also seeing Kathy Weston, the therapist who works with breast cancer patients, on Thursday afternoon. She and I will discuss therapy options for me and for my boys.

Sometimes I feel like there's a barrier between me and the world, that I can't see my surroundings at all, I'm too self-absorbed to notice. And at other times I'm hyper-aware. I am trying very hard to stay fully present when I'm with Avi and Heshy, to see their confusion, worry and pain. I am delighted to report that they seem to be taking it in stride. Pray that their strength, as well as mine, continues.

Bring on the hats and scarves, ladies. Only the ones that can cover my whole head where the hair will soon be gone. Trippy, I must take pictures.