Dispatch from Second Base

I've Moved!

2009-12-27T11:37:00.000-08:00

This is a change of address notice--I have moved my blog to http://secondbasedispatch.wordpress.com/
Thank you for visiting and I hope you will continue to visit.

I Had Breast Cancer and All I Got Were These New Implants

2009-12-15T06:30:00.000-08:00

The first anniversary of my second-stage reconstruction and augmentation was December 1st. Because I’m taking part in a 10-year study for silicone implants, I had a required follow-up visit with my plastic surgeon on Friday. The conversation was one you can never imagine having until you've been there--in addition to an overall progress report, we ended up chatting about how the girls line up (pretty darn well). I had to rate my overall satisfaction with the results and was able to truthfully say I am "definitely" pleased on the "definitely" to "not at all" scale of the form he had to fill out. I could tell he was pleased too, and he's a perfectionist (a great quality for a plastic surgeon to have). He said my overall results were excellent.

As part of the study, I have to fill out a questionnaire for each breast. And I get paid for it--$20 for the augmented one, and $100 for the follow-up visit and longer questionnaire for the mastectomy one.

I’m not sure how helpful my answers will be. Both questionnaires use a “Disagree strongly” to “Agree strongly” or 1 to 4 scale, and I always wish they were essay questions. It’s really hard to assign a numerical value to something like how attractive you feel. Does 3 mean I think I hold my own with the over-50 crowd but I’m no Michelle Pfeiffer? Does 2 mean I lack self-esteem?

Some of the questions/statements (“I feel worthless”) are clearly gauging mental health. Others border on trippy. I did the short questionnaire over the phone and may have tested the interviewer’s patience. At one point, she said,“Thinking about your breasts, how confident are you in social situations?” I replied, “I usually don’t think about my breasts in social situations.” I think I finally landed on 3 to mean “I’m not sure my breasts affect my confidence.” It reminded me of an old Saturday Night Live sketch. Gilda Radner was Annette Funicello in one of those 1960s beach movies, and introduced herself by saying,”Hi, I’m Annette and these are my breasts.”

I’m sure whoever designed the study knew what they were doing. But I still wish they were essay questions.

Yes, Virginia, You Need A Second Opinion

2009-12-08T15:37:00.000-08:00

When you’re diagnosed with cancer, certain things have become accepted practice. One is that you take someone to appointments with you because you’ll be too jacked up to process what the doctor says. Another is that you get a second opinion.

While I can vouch for both, I want to focus on the second opinion. I won’t go into all the reasons why it’s a good idea; you can find those through any number of resources. I want to explain why it made sense for me.

I assumed I’d get a second opinion when it was time to talk to an oncologist about treatment. But once I did, getting a second opinion felt urgent, because I didn’t like the recommendation or the way it was delivered.

I should back up the truck and explain that I was diagnosed with ductal carcinoma in situ, a very early stage cancer that is not invasive, although it can become invasive if not treated. It’s often successfully treated with a combination of breast-conserving surgery and radiation. I assumed I would be on this path until two surgeries didn’t get the desired results. Oncologist No. 1, after taking a family history, said, “I know you don’t want to hear this but I think you need a mastectomy.” I’ll spare you the details but the conversation went downhill from there. I felt like I had been sucker-punched.

On to the second opinion, who became my oncologist. The difference was night and day. The first doctor spent 20 minutes and was direct to the point of being blunt. The second one spent an hour and 20 minutes and said I had options, which was exactly what I needed to hear. He ended up making the same recommendation as the first doctor, but told me he would support me if I opted for radiation and surveillance. I chose the mastectomy and have no regrets.

An important thing to remember about second opinions is that even though their recommendations may be the same, you may find one doctor’s style suits you much better than another’s. You will spend a lot of time with him or her and you need to be comfortable. So get that second opinion and don’t worry about hurting anyone’s feelings. It’s your body, your life, and your choice.

Beauty, Bravery and Breast Cancer: The Scar Project

2009-11-30T19:37:00.000-08:00

I’m very lucky that my breast cancer waited to make an appearance until I was 52. I have a friend who was diagnosed in her 30s and is currently battling a stage four reoccurrence. When it was my turn to join the pink ribbon tribe, I remember wondering what it would have felt like to be diagnosed when I was Pam’s age. I’m grateful I had a 20-year reprieve.

Since then, I have met other valiant young women who were diagnosed in their 30s and even their 20s. Jessica Dietze is one of them. A mastectomy veteran at 23, she contacted me after one of the essays I wrote about my experience for the Omaha World-Herald, and we struck up an e-mail friendship.

For Jessica and so many others to go through breast cancer at such a young age is wrong on too many levels to count. But something beautiful has come from it, thanks to photographer David Jay and The Scar Project. Jessica volunteered to be photographed and flew to New York from Nebraska for a photo shoot. She learned about the project at breastcancer.org, where they put out a call for survivors under the age of 30. She said she wanted to take part to help show the young face of cancer.

The black and white images are arresting. The women look right at you, compelling you to look back. When I look at them, I see beauty and defiance, dignity and strength. I see young, vital, sensual women. Who happen to have scars, and wear them like a badge of honor. They are warriors, and they are beautiful.

Five Reasons I'm Thankful for Breast Cancer

2009-11-21T10:21:00.000-08:00

I would maintain that thanks are the highest form of thought, and that gratitude is happiness doubled by wonder.
-G.K. Chesterton

As Thanksgiving approaches and we start reflecting on what we’re thankful for, cancer is probably not real high on anyone’s list. But it is on mine, and here’s why.

It was caught early. My cancer hadn’t spread yet so I didn’t need chemotherapy. It was so early stage it wouldn’t have shown up in a self-exam, so I’m also very thankful for digital mammograms.

It gave me a lifelong appreciation of medical professionals. I’m lucky in that I have a wonderful family doctor I’ve seen for more than 15 years, but with mostly annual visits I never gave health care much thought. Getting breast cancer gave me a front-row seat to the medical profession, as my journey involved five surgeries and dozens of visits with a general surgeon, plastic surgeon and oncologist in addition to my doctor. I will always be grateful to them for their skill, humor and compassion. Their nurses and staff, and the hospital nurses who took care of me during my overnight stays, are also high on my gratitude list.

They’re perky. Probably the less said about this one the better; but suffice it to say my plastic surgeon is beyond gifted when it comes to reversing gravity’s effects.

It made me realize how much people care. This one is practically a cancer cliché but think about it. Clichés are trite because they’re overused, but perhaps they’re overused because they’re true. We go through so much of our lives caught up in our routines that we hardly notice the people we care for, and who care for us, until something like cancer happens. Finding yourself surrounded by so much love and care is both humbling and uplifting.

It gave me part of myself back. One of the obvious benefits of cancer is reconnecting with friends and family, but old loves like art and music may reappear in your life as well. In my case, I started writing poetry again. I hadn’t written or published anything for nearly 20 years and I really thought that part of my life was over. I’m so grateful to have it back and I hope I never lose it again.

But enough about me. How about you? What are you thankful for?

So We No Longer Need Mammograms--Oh, Really??

2009-11-17T04:58:00.000-08:00

I guess I should be thankful I'm over 50 and considered high risk, now that they're saying the harm in routine mammogram screenings outweighs the good. I still may be able to get a yearly mammogram. You may also--but good luck getting your insurance to pay for it if you're between 40 and 49 years old.

So far, I haven't seen anything that addresses whether this new study made a distinction between film mammograms and digital mammograms. My ductal carcinoma in situ was discovered on my first digital mammogram. I've read and heard from medical professionals that digital mammograms are more effective at catching early-stage cancers in dense breast tissue like mine, which has been identified as a risk factor. So are they saying digital mammograms don't help either? Or did they overlook them?

Because my breast cancer was caught before it became invasive, I did not need chemotherapy, which raises another question. What if a woman went without screening until her DCIS did become invasive, and had to go through a grueling chemo regimen that could have been avoided by -oh, I don't know--early detection by a mammogram? The rationale behind the new recommendations is that mammograms create more unnecessary testing and anxiety than they produce in life-saving benefits. But when DCIS is allowed to progress to the point of being invasive,wouldn't chemo qualify as both unnecessary and anxiety-inducing? Who's going to do a study to see if we see a spike in the numbers of women having chemo? How much does that cost in dollars and quality of life? Yet mammograms do more harm than good? Really??????

One more thing--they also stopped recommending self-exams. If mammograms don't work and self-exams don't work, what preventive options are we left with for this disease that is still killing a lot of women? Crossing our fingers and hoping for the best? Lighting a candle and praying to the supreme being of our choice?

If this evidence-based decision what we can expect from health-care reform, I'm not just confused, I'm worried. Ladies, talk to your doctors. And your House representatives. And your senators.

Does Breast Cancer Have Rules? Maybe.

2009-11-13T17:09:00.000-08:00

I'm hooked on the New York Times for a lot of reasons. I love their book and movie reviews and the work of some of their op-ed writers. Now that I've gotten up close and personal with breast cancer, I'm equally hooked on their health-care coverage. Dr. Pauline Chen is a surgeon and an amazing writer. Dana Jennings, who shares his journey with prostate cancer, is so good I have to stop and reread him. I've also become hooked on Tara Parker Pope's Well blog.

Earlier this week Well discussed a set of 10 rules for cancer. I related to just about all of them and you might too. They don't strike me so much as rules, which imply you must do something, but useful guidelines that can help you navigate the whirlwind of emotions, recommendations and treatment options that hits you after you've been diagnosed with cancer. I won't go into all of them here because I'm not interested in becoming a plagiarist. But I will touch on one that resonated with me--a cancer diagnosis is not an emergency. That doesn't mean you can stall indefinitely. But you can and should give yourself time to think, and to weigh your options. I remember the sense of urgency I felt to do something RIGHT NOW and I did leap into one thing without thinking--but that's a topic for another time.

The other thing I'm not going to do is point you to the Well blog, because it only included three of the rules. Instead, I'm including a link to the Web site of the woman who created them, Kathryn Gurland, because it has all 10. You may notice that it's a consulting Web site but don't be too quick to judge that this is someone trying to make a buck off cancer. She lost one sister to melanoma and another one to lung cancer and she knows whereof she speaks. God bless her for turning something so awful into something that I think will help a lot of women. Check them out and let me know if you agree.

http://www.cancerconsultants.com/a-survivor%E2%80%99s-compass/bout%2010%20Rules%20for%20Cancer.

Welcome to Dispatch from Second Base

2009-11-08T14:53:00.000-08:00

This is not a blog about baseball, although like the Annie Savoy character in Bull Durham, I believe in the church of baseball.

This is a blog about "second base" as in "Save Second Base," a.k.a., "Save the TaTas," a.k.a. breast cancer. It's not just about me, although it was my turn to get breast cancer in 2008 and I will use myself as a frame of reference. It's about everyone who's faced down the beast called breast cancer, whether it was you or someone you love. How it made you laugh or cry or pissed you off or gave you something back. How you navigate this journey because of your doctors and nurses and family and friends, or in some cases in spite of them. How you cope. How you help others cope.

I started this blog because of a series of essays I wrote for the Omaha World-Herald about my experience with breast cancer, and the response I got from readers. I realized I missed the conversations I was having with these women (and a few men). Their humor and bravery and encouragement were so uplifting I wanted to open it up to a wider stage. We all have a story to tell, and I want to keep the conversation going. So please let me know what you think and what you want to talk about. I don't want to be out here talking to myself.

And I wasn't kidding when I said I believe in the church of baseball. I took refuge at Haymarket Park in Lincoln, Neb. quite often last spring to watch the Nebraska Cornhuskers and forget about my medical appointments and surgeries. There are few places better to lose track of the outside world than a baseball park.

Let's get the conversation started--what worked for you? What helped you take a time out from cancer?