My Peach Pit

"Tori, I don't want to tell you this but your results came back positive for cancer."
Cancer. Gulp. Don't panic, I thought.
Cancer...........Gulp.
Now what? "We need to get you scheduled for a Breast MRI as soon as possible..." [And a pet scan, and a biopsy.....radiation.....chemo......] "I'll turn you over to Vicky, my nurse so we can get that going...."
Don't panic......Did he really just tell me I have cancer?
It all started when I found a lump in my armpit about the size of a peach pit while I was at my daughter's soccer practice. It was hard and when I pushed on it, it didn't hurt. It was a Friday. I called my Primary Care Physician immediately but I knew he would not be in. Instead, I settled for the only available appointment in 3 hours with one of the Nurse Practitioners. She was condescending. "It's just a little 'ol inflamed node. Probably nothing to worry about." She ordered the mammogram and ultrasound anyway and a CBC to prove that my elevated white cell count would in fact support her findings. She did a full breast exam. She found nothing. 3 days later, my mammogram was negative, the CBC was normal (no systemic infection), and the radiologist couldn't make hide nor tail of the thing in my armpit. I made an appointment with my OB/GYN. After reviewing the mammogram and the ultrasound, she too, was of the camp that it was an inflamed node.
"but the CBC is negative," I told her, (indicating no systemic inflammation).
She did a full breast exam and again, found nothing but fibrous tissue. I've always had fibrous tissue which makes self exam difficult. She referred me to the surgeon, but before she did, she told me to wait a couple weeks. "See if it goes down in size. These things usually resolve on their own."
But after two weeks, the lump was still there. It moved but never hurt. It was hard and felt exactly like a peach pit. My armpit had an actual pit. There's irony for you. A few days later my Primary Physician called. He said he got the results of the ultrasound and that I needed to go see Dr. L, my first choice of surgeons. Luckily, it was my OB/GYN's first choice as well. I now had two referrals to the surgeon. It just so happens that he was also my first choice. He's pretty great. So two weeks later, I was in his office. He found my lump strange. Why such a big lump in the armpit and nothing palpable on a breast exam?
My thoughts drifted to the early mornings when my mother would drive me to early training. I was an alpine ski racer. She did the hard duty of getting me to physical conditioning training at 6 in the morning twice a week. However, the drive was 10-15 minutes from home and she would traditionally smoke all the way there. After 15 years of breathing her secondhand smoke, I was convinced that I now had lung cancer with metastasis to my lymph nodes. Lung cancer is the number one cancer of all of them. It's hideous and awful.
"Whaddya say we stick a needle in it?" Dr. L was suggesting a fine needle biopsy of my arm- Pit. It was the reason I was there.
"Let's do it." I said.
Four days later he was on the phone with the news.
Don't Panic I thought. Airway. Breathe. Years of ER nursing have taught me that panic is ineffective and not part of the algorithm that starts with the ABC's.....Airway, Breathing, Circulation.
I have been a registered nurse for 12 years. 10 of those years, I spent in the emergency department. I loved it there. Eventually, the 12-hour shifts were hard to do once I had kids. I took a position in the cardiac cath lab for two years, but the cath lab got busy and they wanted more of me than I was already spread too thin to give. I decided to give Oncology a try. For the last year, I have been immersing myself in learning about cancer, chemotherapy and how best to treat my patients. Just when things started getting interesting, I got cancer.
Dr. L's nurse called me back. " I have an appointment for a breast MRI on the 27th (9 days from now). Will that work for you?"
"Uh, no, I want one tomorrow."
"I thought you might say that. I'll call you back"
Two days after my conversation with Dr. L, I found myself face down in an MRI scanner. Let the games begin. For the next week, I would be subjected to every diagnostic test known to man. The MRI was loud and my nerves were rattled. Knowing I had Cancer, I was secretly hoping it was breast cancer since it's the most treatable. The MRI was a lesson in finding calm in chaos. My brain was racing with what-ifs while the knocking sound of the MRI tried to rattle me. I focused on my breathing until the radiology tech said, "Hold your breath please." I vowed that if I ever had to repeat that test, Valium would be a prerequisite.
From MRI, I would then go to Nuclear Medicine for a Pet Scan. The Pet Scan is a diagnostic exam where they inject a person with radioactive sugar. Cancer LOVES sugar. It absorbs it as fast as it can. This test had to be done another day because you have to fast for 6 hours and can't eat any sugar for the prior 24 hour period. Then, they inject you with the radioactive sugar. After letting it marinate for about an hour, I was moved to the nuclear medicine scanner and CT scanner. Here, they scan your entire body. The Nuclear Medicine scan picks up the location of the radioactive sugar while the CT scanner scans the image with respect to where it is in the human body. It's genius really. It's a long test but not nearly as bad as the MRI. It's relaxing, relatively quiet and the radioactive sugar doesn't do any harm. Plus, the Pet Scan tech had a little more personality, which is always helpful. Usually, they do the biospy of the breast and then send you for Pet Scan. However, with the timing, this worked out pretty well. I was off to my biopsy immediately afterward.
Dr. N. was very nice. First, the Ultrasound tech did an ultrasound of my breast. There they were, Tumor 1 and tumor 2, 1.7 and 1.5 centimeters respectively. Then, as I watched on ultrasound, Dr. N stuck a needle that resembled one of those automatic fire starters right into my breast and ultimately the tumor. I wanted it to scream, but I heard nothing. The needle was huge. Of course, I felt nothing because Dr. N was clearly very skilled at this procedure. He answered many of my questions and when they were done, I got a nifty little pink ice pack to tuck into my bra. It wasn't anything like the horror stories my patients told me. It was really quite easy. However, after being a human test subject with the prospect of Cancer being somewhere in my body, I was feeling like a lab rat.
Days later, my husband and I sat in Dr. L's office. The results of all 3 tests were in. I have (at least) stage II Metastatic Breast Cancer. The hormone results of the biopsy weren't quite back but based on size and spread, I was at least stage II. The pathology would grade and stage my cancer further but that took time. Time was now of the essence and we discussed lumpectomy vs. modified radical mastectomy. I was very pragmatic. I put my nurse hat on and discussed it like I discussed any other patient. We went through options, risks, benefits, etc. It was very obvious that the modified radical mastectomy with nodal dissection would be the answer.
My husband's face was pale. He didn't say much.
We would schedule the surgery for the following week. Too many weeks had passed and Cancer was just sitting in my body, growing and spreading. I needed it out. The chances for recurrence supposedly go down with full removal of the breast. Besides, I'm an A cup at best. Once they took out 3cm diameter of tissue, there was not going to be much left anyway and I wanted either a full, round-shaped breast or nothing, not some hunk of tissue that hung off my chest as an attempt to retain my feminine identity.
In a short time, I went from having my whole life in front of me, to being a cancer patient and scheduling the removal of my left breast. It was surreal. We didn't tell anyone. Primarily because we don't want the kids to worry. With a friend losing her battle with brain cancer and another friend battling Multiple Myeloma, my daughters equate the word cancer with death and loss. For as long as I can, I want to keep them cancer free, because for the rest of their lives, their Mom will have Cancer. They will find out soon enough. 2 extra months of a cancer-free childhood is a big deal. Let them live everyday as if Mom is going to live forever. For now, my husband and I are processing it as best as we can, doing what needs to be done and trying to get through to the final plan. I don't think losing my left breast will affect me. I don't tie my identity to my breasts nor do they enhance who I am. And given my small size, I'll bet no one even notices. Who knows how I will feel. I didn't miss my femur when they sawed it off and replaced it but then again, I'm not looking at the missing end everyday either. I'm more lamenting the fact that I will not be able to kayak anymore this season. Apparently, there's some rehab that follows and I won't be able to get in the river for awhile. Now, that is worth crying about. My friend's wedding is this weekend in Park City.I will see many old friends there and presume that there will be many happy reunions. It's probably a bad time to bring this up. I think I'll keep it to myself for awhile. Feels more manageable. As a self-proclaimed control freak, i was comfortable with keeping things under wraps. I was not naive enough to think that soon enough this would soon spiral out of control.