Medical Update
The first (and hopefully last) surgery went really well. I’m healing well. I’m resting a lot in between people dropping off soup and flowers and getting around the “no hugging” dictat by sidling up to me and giving me a little nuzzle on my left side. Many of you would make good cats. You’re ungovernable.
Pending lab tests will tell me if The Beastie has been totally vanquished from my breast, and if it has had the temerity to spread to my lymph nodes, some of which were also removed for testing.
I will have more information on that on May 1st, where I meet with my ninja surgeon for a follow-up visit. As I mentioned before, I had the good luck to be paired with Dr. Alina Mateo, who is the head of the Integrated Breast Center at Pennsylvania Hospital and who looks as though she cannot possibly be old enough to hold that post, which is one of the reasons I find her so impressive. Girlfriend is a badass. (People often underestimate my niece Kaelyn because she’s tiny and pretty and blonde, but she’s about to go to Duke on a full ride to get a PhD in bio-medical engineering. Take that, stereotypes).
Dr. Mateo has already recommended radiation and likely hormone therapy. To recap on that, the radiation would start in June, after a bunch of tests and consultations with an oncology team in May. Once they’ve ordered it, I’ll go to the hospital every day for a month or so and they’ll fry me up. Hormone therapy would mean taking a drug that lowers my estrogen levels, because my cancer is estrogen and progesterone receptive, i.e., it might feed The Beastie.
If they didn’t get all the cancer, I’ll have another surgery. If it has spread to my lymph nodes, they will make me do chemotherapy.
If, if, if.
I, of course, believe it’s all gone, because humans have all kinds of ways of coping and deluding themselves and so, based mostly on my own wishes, I’m behaving as if my security squad has removed the offending guest from the party.
One big fact in favor of my wishes: While in the past, one in three women needed to go back for additional surgeries to remove all the cancer, my chances are greater they got everything because UPenn is one of the hospitals in the region that is using a newish (FDA-approved in 2017) technology called a Savi Scout, that replaces the traditional wire method they have used in the past.
In the Before Times, like when my cousin had this same surgery over a decade ago, the day of your surgery, the first thing they’d do is make you do yet another freaking mammogram (official medical code AFM), during which they would place a thin wire from the outside of your breast to the tumor site. Once it’s in, it sticks out of you, they tape it down, and then you can’t move your arm because that might cause the wire to move and make the surgeon miss. You might have to be like that for a few hours before they can do the surgery.
For me, the Monday before the Thursday surgery, I went over for pre-admission testing and—AFM.
While in the vice grip of that infernal machine, they numbed me up, stuck another needle into the site of the tumor, and then inserted a “Savi Scout” which is a little radioactive device the size of a grain of rice, right into the center of the mass. You can’t feel it and you can move normally. It can stay there for months if it needs to.
When they turn it on like a little satellite the day of surgery, it starts emitting little beeps, and so the surgeon has multiple ways to know where the exact mass is, and to spare as much healthy tissue as possible while still slaying The Beastie. In addition to increasing accuracy, it makes the day a lot less long as well: I showed up at the hospital at 8:45, and was taking a nap in my own bed by 4:30 that day, which is amazing when it comes to resting and letting your body do its thing.
So, part of the reason I’m healing really well, taking no baddie-daddie pain meds (opioids are the devil and I avoid them as such—not today Satan!) is that they were able to prep with a less invasive and painful maker, hyper focus on the mass site, and just get in and get out with as much accuracy as possible.
And so to modern medicine and my special forces team—Huzzah.
One change from what I told you before: they didn’t go through my nipple, as she had predicted.
Dr. Mateo went through a 2-inch incision under my armpit, because she said she could better hear that little scout device beeping at her from that side. It’s tiny, but it’s the boss (remind you of anyone?)
The wound is healing well. If I put my arm in my jean pocket, I can go for a little walk because it makes a protective tent for the incision site, which also allows me to make Alanis Morrisette jokes in my head while I take in some spring air. (Here’s a link for those of you don’t remember the 90s.)
On the Odd Emotional Aspects of Your Body Trying to Kill You
You guys know that I’m not crier.
I don’t get rattled easily. I have naturally low blood pressure. I don’t compare myself with other people often, which has great emotional and psychological benefits.
I had a colleague tell me once that if I were up to my knees in crocodiles, the first thing I would do is make a list (true). I was once gifted a tee-shirt from another colleague that simply said, “My data has headers.” (Don’t worry if you didn’t get that last joke, not everyone loves excel sheets).
I am, in some ways, incredibly good at compartmentalization, or some version of the Serenity Prayer—as I get older I’m better at distinguishing what I have control over and what I don’t.
My cousin, who had the same procedure I did but many years ago, told me that the best advice she could give me was to just let everyone do their jobs, and that’s what I’ve been trying to do. One by one, the staff do their thing… security, admissions, escorts, vitals, radiation oncologist, anesthesiologists, surgeon, orderlies, recovery room… it’s a lot of people. And often they will lean in and say something like, “I’m a survivor myself—17 years. You’re going to be okay,” or “You’re in good hands. Don’t worry too much. We’ll take care of you.”
That said, I remember watching a Frida Khalo biopic that detailed all her physical struggles (she had dozens of surgeries to correct injuries she sustained in a bus accident and also suffered from polio as a child, and possibly spina bifida). One line really stuck with me, in which she referred to “this Judas of a body.”
This Judas of a body. What a great line.
There is a little feeling of that here for me: my own body has gotten a little uppity. Cancer is like a badly-behaved house guest peeking in drawers and cabinets and deciding to take up an uninvited residence in places like the milk-producing lobules in your breast and then spreading out all over like they own the place—rude. Just rude. (Speaking of uninvited and murderous house guests, I’ve also just watched Ripley during recovery. It’s a slow start, but beautifully shot in an old-school Italian-cinema way, so if you need a slow burn with pretty vistas, it’s for you. I will watch anything in which I get to indulge in house porn, especially if it’s of the historic variety, which is also why I enjoyed The Gentleman. There’s been a lot of Netflix over here, friends.)
And so I’ve been trying to just be as normal as possible, because I haven't felt sick, and my doctors know what they’re doing, and I have great support. I’ve been working on the spring issue of Root Quarterly, doing my volunteer board work at FAIR, doing my freelance work, starting seeds and planting the garden, practicing my cello and violin, tearing up my kitchen. Avoiding anything that isn’t that. Just letting it go.
I’ve also been updating friends and relatives, going to doctor’s appointments, getting AFM after AFM, undergoing a truly unpleasant breast MRI, submitting to genetic counseling and testing and talking with insurance companies and, well, it’s frankly been a lot when I look back at it all.
During this time, my cat was also really sick. It turns out he had diabetes and needed insulin shots twice a day. The only time I really cried was that day in the vet. I barely knew yet what was going on with me and I broke down as she was explaining what was going on with him. The vet turned into one of those “wha wha wha wha” teachers on Charlie Brown: She was talking, but I wasn’t hearing her because I was imagining trying to chase him around the house with a needle while I was recovering from surgery. He’s done me the service of going quickly into remission and doing his job as an emotional support animal.
That was the day I knew I wasn’t okay, even if outwardly I was putting on a good show of it.
The Tuesday before my surgery, I went out schmoozing at the open house at the amazing new offices of free-speech powerhouse the Foundation for Individual Rights and Expression, at it for 25 years, and ate all the sushi and drank all the bubbly and talked to the amazing staff and didn’t think about The Beastie.
In a further, grand gesture of compartmentalization, gliding along on the magic carpet of the Serenity Prayer, the Wednesday night before the surgery I went to dinner with my partner Walter and then asked to go to a real movie theater and we watched Civil War.
You should watch it. It’s hard to watch. Whether it’s your own body or your own countrymen turning against you, it’s a tough betrayal. I’m glad I saw it, and may go see it again—you follow war reporters who are chasing their story and getting closer and closer to the front lines, and none of it seems implausible, and it reminds you of how important real journalists are (I’m making a distinction here between actual journalists and the adderall-addled progressive millennials who never leave Brooklyn and on the other side the right-wing whackos who mess up most of our news by staying in their own tiny little bubbles). I’ve been volunteering for the last three years with the political depolarization nonprofit Braver Angels (shout out to my fellow BA volunteers), and we’re working on keeping our worst instincts at bay and proving we can coexist with people who disagree with us.
About halfway through the movie, as I was watching Americans try to kill each other and not even really knowing why, I was overwhelmed by the fact that the following day I was going to be put under and someone was going to slice into my body. I hate body horror. I don’t even like looking at bodies that have too many tattoos or piercings. It freaks me out.
So: Do not go see Civil War the day before you have surgery. This is my advice to you. Go see Sasquatch Sunset or something.
Obviously, I’m feeling well enough to type this out to you today. Tomorrow, I will get back to finishing the spring issue, which marks our five-year anniversary (!), of Root Quarterly. The theme is Goldilocks—a story of yet another unwelcome and badly behaved house guest. It’s a story that’s following me around.
Next week, I’ll start answering other emails and getting back to mostly normal until we find out about the lab tests, and figuring out when radiation starts. Fingers crossed that little Savi Scout did its job and this Judas of a body will come to heel as long as I treat myself well.
About You
Lovely texts and emails and phone messages have been coming in. Neighbors and friends have been popping by and I’ve been sleeping in-between visits with the aforementioned briefly-diabetic cat and really truly trying to lay low. My friend Michelle takes the award for best card (so perfect, Michelle). Thanks to you all, the fridge and freezer are filled with food. Root Quarterly subscriptions and donations are ringing through every day (keep ‘em coming folks… it’s paying for my treatment). There are flowers all over the house—sunflowers, bleeding hearts, gerber daisies, lilies, and gorgeous peonies.
I even got a Canna Lily root to plant from one of my fellow gardeners and neighbors. I started some flower seeds on Saturday in a little tray. And as my mother always says—there are no unhappy gardeners. When she walks by a house with lots of flowers outside, she says, “Happy people live there.”
We are only gruff sometimes when someone messes with our territory. We will not shoot at you, but we may insist that you watch carefully where you’re treading or suffer the business end of our hoe along with a wild-eyed stare. We’re trying to repair the world over here.
See you after May 1st.
Love,
Heather
“Ways You Can Help” is on the main Brouhaha Page.