July 14, 2010
It’s hard to know how to pass the time while you’re awaiting a phone call from your breast surgeon. You attempt to work, but it’s tough to stay focused. You try making light of the situation: “Maybe it wouldn’t be such a bad thing if it was cancer,” I remark to my fiancé, Peter. “New breasts!” (He looks unamused.) You try not touching the cherry-size lump in your right breast that caused the radiologist to exclaim she was “very worried” while she performed the biopsy.
And then you take a deep breath when the phone finally rings, at 7:28 p.m. “The biopsy is showing a cancerous growth,” the doctor says gently. Other words are said: invasive ductal carcinoma. Surgery. Chemo. Radiation. I’m a reporter, so I scribble down notes. When I get off the phone, Peter glances at the notes and immediately envelops me in a hug.
This will change everything. My health. My wedding plans. My hope to have a baby in the next few years. My financial stability. My hair. My body. I start dialing the most important people in my life—my parents, my three sisters, my best friends—to tell them the news. I make every one of them cry.
Peter and I wander around Miami in a daze. We’re here—in one of our favorite places, where we first vacationed together—to pick a wedding venue. (The trip was paid for before we got the cancer news, so we decided not to cancel it.) Normally I’m a nervous flier, but on the trip down I felt fearless, thinking: Go ahead, plane, crash. It sounded better than cancer treatment. I hate being poked and prodded. A few days ago, I wept as a nurse inserted an IV—just the first in a long series of sticks.
In South Beach, we sit with event planners and pretend to care whether the macadamia-crusted mahimahi can be served poolside. The rest of the time, we try to enjoy the ocean, the mojitos, and the desserts. But I can barely eat. Any day, I should receive the results of a scan that will show whether the cancer has spread beyond my breast to my liver or lungs, meaning it could be terminal. I watch my BlackBerry so obsessively that a pickpocket takes the opportunity to remove my wallet from my bag.
I’m not sleeping well. I’ve never been a morning person, but lately my eyes pop open at 6 a.m. I used to wake up thinking, Coffee. Now I think, Cancer.
Why didn’t I go to Paris/Ireland/Disney World when I had the chance? Why didn’t I buy that dress/bag/apartment? I just purchased 10-year rights to the URL of my name so I could create a website for my writing. Will my URL outlive me? I think about my two adorable nieces, ages 3 and 5, and calculate how old they’ll be if I die in two years. In five years. In eight.
On the third day of the trip, I get the results. Clear, except for the breast tumor. A giant sigh of relief, and another round of phone calls to the family.
Peter and I spend our last day in Florida with friends, swimming in Coral Gables. I’m able to have fun, but I feel a heaviness weighing on me. I’m scared to go back home to New York City, where my cancer treatment will soon begin.
Most big decisions in my life have come only after lengthy deliberation. Not so with cancer. The doctors laid out my options and gave me a week to make the call. Should I have a lumpectomy or a mastectomy? If I pick the latter, should I have just the right one taken off or, to be on the safe side, go for a bilateral mastectomy (meaning both breasts are removed)?
And I’m facing more tough choices. The first is whether I should take steps to preserve my fertility. Chemotherapy could make me infertile—and even if it doesn’t, I will need to take antihormonal drugs, because my cancer is fueled by estrogen and progesterone. So I’ll be 41 by the time I can safely bear children. But the process of extracting my eggs, fertilizing them, and storing the frozen embryos is expensive (about $9,000 out-of-pocket for one cycle, plus $1,000 a year for storage) and arduous (10 doctor visits, 30 needlesticks, and surgery to retrieve my eggs). I want the best chance of becoming a biological mother. So I decide: yes.
I struggle even more over which type of breast surgery to have. My sister Pam has called me every day since my diagnosis. When I explain why I’m leaning toward a lumpectomy over a mastectomy, she says, “I think that makes a lot of sense, and that’s the right decision.” She says the same thing when I ultimately choose to have a bilateral mastectomy instead of a lumpectomy. It’s the perfect response both times.
Before this diagnosis, Peter and I probably both assumed I’d live longer than he would. Women tend to outlive men; plus, he smoked a pack a day for 12 years. Still, Peter proposed to me thinking I was a healthy woman, able to have children, with a career, not to mention breasts and hair. I wonder out loud if going ahead with our marriage is fair to him.
Peter has no patience for this sort of talk. “What would you do if I were diagnosed with cancer?” he asks. I say I’d do everything I could to help him get through it. “And that’s what I’ll do,” he says. “What happens to you happens to us. If you’re going to die, you’re going to die married—to me!” We joke that as a widower, he’d get lots of sympathy sex. Humor helps us cope. But, quite honestly, the only thing that makes the idea of dying on him remotely tolerable is knowing we could have children. That’s why we are the proud parents of six frozen embryos.
In quieter moments, thoughts of death come unbidden. One day, lying in bed, I think about what I’ll wear to my funeral. I settle on my navy blue knit jacket with three-quarter sleeves and a Peter Pan collar. Very Jackie O. I think about my family’s grief and I start to choke up. And then I become exasperated: Am I really going to sit here and ruin my afternoon worrying about the (hopefully distant) future? I tell Peter about my daydream, and that jacket is henceforth known between us as my “burial jacket.” I feel uncomfortable every time I put it on.
Eight days ago, just before Peter’s 40th birthday, I had the bilateral mastectomy. (Some women might buy their fiancés a watch or a bottle of Scotch…I get my breasts removed. Happy birthday, honey!)
Today I receive the pathology results from the breast surgery. The experts looked at the tumor and the local lymph nodes to find out what kind of cancer was in there (aggressive or lazy, contained or widespread). My mom, Pam, and I are in the waiting room for a long time, while the sky turns black and rain slashes against the window. Thankfully, it isn’t an ominous sign. The cancer is a type that’s likely to respond to treatment, and only one lymph node is cancerous. Also, the tumor itself is smaller than it appears on the MRI and ultrasound. I am Stage 2B—“early breast cancer,” my surgeon says. Potentially curable. I practically kiss her. I might be alive in five years.
Right after surgery, I was left with small A cups. (Which on some level, I didn’t mind; I never liked being a big C.) Every week since, I’ve visited my plastic surgeon’s office for a “fill”—a process in which saline is injected into little pouches on each side of my chest, so my muscles and skin can expand and make room for the eventual implants. I feel like a teenager again, watching my boobs grow.
Before surgery, to cheer myself up, I’d imagine the strapless ensembles I’d finally be able to wear. I never realized that my old clothes would look awful on my new body. A deep V-neck dress (which I own in three colors) plunges toward my belly button. I look like I’ve melted.
During a weekend trip to see my old college roommate in Washington, D.C., I score a few new tops. I wear one out to a party that night and feel more self-conscious than I’ve ever been. I’m the only woman in this room who doesn’t have breasts, I think. I’m probably the only person here who’s ever had cancer. My pal’s acquaintances ask me, “What’s new?” I can’t help myself. I tell the truth (though I try to be cheerful about it): “Breast cancer! I’m starting chemotherapy soon!” Everyone looks sad and sympathetic. I am a total buzzkill.
I need to have eight chemo sessions over the course of four months. For the first infusion, my mother and Peter come along for support. He tries to lighten the mood with a joke about medical marijuana. (“Does the fiancé of the patient qualify for a prescription?”) Nobody laughs. My chemo nurse misses the first vein and the second. The lights start swimming and I pass out. (Note to nurse: Don’t tell a squeamish patient that her vein just “blew up.”) After I recover, in comes the resident “vein whisperer,” who deftly inserts my IV. The nurse returns to push in plungers of medicine the color of cherry Kool-Aid.
Afterward I wait to get pummeled with terrible side effects, but at first they’re not as bad as I had expected, thanks to medication. Mainly, I can’t bear to eat anything but white food (plain pasta, bagels with cream cheese). A few days later, I start to feel as if I’ve been beaten with a stick. Shortly after that, my hair begins to fall out.
I thought having fatigue, as the doctor referred to it, meant I’d be out like a light. Nope. In fact, actual sleep is elusive. Fatigue means curling up under a blanket without moving. For hours. My mind is usually racing, but my body is perfectly still. I’m finally ready to submit to the suggestion my mother has made, repeatedly, since my diagnosis: “Come home.” I’ve resisted so far and have steadfastly held on to my independence. But now seems like a good time to pay an extended visit.
Though the car ride from New York to my parents’ house in Allentown, Pennsylvania, is brutal—I fight nausea and my cat fights to claw her way out of her carrier the whole way—it’s nice to have them take care of me. When I arrive, my mother has beef stew, one of my favorite dishes, waiting. (For a few days each chemo cycle, I can eat foods with color.)
Peter and his mom and stepdad come for Thanksgiving. After the meal, Peter and I go upstairs to chat, and I start to break down. I’ve been getting through day by day but not really processing any of it, and some things are starting to hit me: Yes, I had my breasts cut off. At the moment, I am infertile. Oh, and I am bald. Peter comforts me. “You look good. Your wig even looks pretty good.” (At least he’s honest. The wig is OK, but it’s clearly not my hair, no matter how hard I try to embrace its Mad Men–esque style.)
Some might not appreciate having cancer treatment span the holidays, but I do. It’s easier to ignore that grim task when there’s mistletoe and holly everywhere. Except for making it back to New York for two chemo sessions and heading out once for Christmas shopping, I rarely leave my parents’ house.
I marvel about how infantilizing cancer has been. I’m bald like a baby. I live with my mom and dad; they give me money to buy Christmas presents. This would rankle me at any other time—I’ve supported myself completely since college—but now it doesn’t. I appreciate it, because I really feel a bit helpless.
January 21, 2011
I’m three-quarters of the way through chemotherapy, and I want to quit. I’m sick of having dead taste buds and painful fingers and toes. I can’t fasten jewelry, fold clothes, or open envelopes—it hurts too much.
I’m bald and blobby, bored and boring. I still eat nutritious food (smoothies, broccoli soup), though I’m not sure why I bother. I no longer believe that diet and healthy living can prevent cancer. Those are just stories we want to believe so we can feel safe. Now I think it’s just hopeful superstition: the way that, back in the olden days, people danced to bring rain.
It’s totally unfair. All those hours I spent at the gym. All that oatmeal.
My 36th birthday, a nice one. There’s an ice storm, and every branch and leaf is lined with crystal. I usually buy myself a small birthday present. This year I choose an eyebrow pencil. Mine have fallen out.
I’ve discovered online communities of breast cancer patients, and it’s soothing to be among comrades-in-arms. The war metaphor feels apt; we’ve been slashed, burned, and poisoned to keep our disease at bay. But I can’t summon fury toward my cancer, the way some do. It’s not as if I got food poisoning and can be mad at the street vendor who sold me a bad hot dog. It’s my own cells that have turned on me. A mechanical failure. I’m not angry at my cancer, just bewildered by it.
Tomorrow is my implant surgery. I am relatively undaunted by the prospect. All these medical procedures are almost becoming old hat.
I’ve developed a skin infection on my chest and a rash on my back, which turn out to be shingles—a reemergence of the dormant chicken pox virus, emboldened by a compromised immune system. This is a problem, especially since I’m due to start radiation in five days. I earn a three-day stay in what may be Manhattan’s priciest locale: the hospital.
Peter and my family know about the shingles, but my friends don’t. I can’t stand to be the recipient of more pity. For a while, I loved the cards, calls, and gifts, but I no longer want to be the person whose life makes everyone else’s seem blessed by comparison.
I’m starting to feel rebellious toward my doctors, too. On Easter Sunday, I sneak out of my hospital room, where I’ve been sequestered so I won’t pass along my pox, and go for a walk. It’s a gorgeous day.
My medical bills are nearly $50,000, and I get two or three statements every day. (I have mediocre insurance with high out-of-pocket costs.) I’ve been applying for relief to cancer-assistance foundations and to my doctors. So far, I’ve had some luck, but I still have staggeringly high bills. I can always file for bankruptcy, but I want to avoid doing that. The deciding factor will be whether I can get financial aid from the hospital where I’ve had my surgeries and chemo and where I’m starting radiation. After providing every conceivable scrap of financial information, I am denied. Some generous checks from loved ones—long since spent on those fertility treatments—made me look more flush than I am. I burst into tears. Everything about this is surreal. I’m broke and researching the rules for food stamps (yes! I qualify) with an Hermès scarf on my head (it’s a loaner).
I appeal the hospital’s decision, and six weeks later they overturn the denial and wipe out my charges. I still owe money, but a far more manageable amount. I feel more relieved than I have in ages.
My last radiation treatment! Now what? I’m exhausted. Friends and family want to celebrate. I want to stay home. I have an angry, itchy red radiation burn on my chest. I look like I’ve been grilled.
Apparently, some cancer patients have trouble adjusting to life after treatment, because they feel unsafe without the constant monitoring. I think I will love it.
It’s four days before my cancerversary, and I’m braiding my nieces’ hair in Michigan. Their mom, Stephanie, and I have brought them to spend time with our sister Kristy, who just had a baby.
I’m more aware of everything these days. Life is more intense—like a vibrant action movie with too-loud surround sound, full of suspense and heightened emotions. At one time, I would have dreaded two 10-hour car trips with a pair of tots. Now I see it as an adventure—traveling new routes, getting ice cream at rest stops, creating memories.
When I get back, Peter and I will pick up where we left off a year ago with wedding plans (me with less hair, new breasts, blown mind). We’ll set a new date for the ceremony. It will probably still be a destination affair, but I’m also planning a local gathering to thank everyone who showed me so much love during this cancer ordeal.
The effects of treatment are waning: The killer hot flashes from the chemo and the estrogen blocker tamoxifen have softened into warm waves. The fatigue is gradually letting up.
I may never again sleep as well as I did before cancer. I used to get eight hours solid; now I toss and turn all night. I never feel sleepy later on, though, which is kind of weird and kind of awesome. I’m walking and running a little. Recently I was rewarded with the appearance of a calf muscle. And I’m tiptoeing back to a normal work life.
I never forget that my breast cancer could return. For me, there is about a 25 percent chance. If it comes back, it may be fatal. But I don’t worry too much about that. I try to focus on my priorities instead—which have changed. Now they are: more cupcakes, more concerts, more beach vacations.
Before cancer, I sometimes felt incomplete, because I wasn’t married or a mom and I hadn’t written a masterpiece. But this last year has taught me that I don’t have to be those things. It’s enough that I’m a daughter, a sister, an aunt, and a cousin. A fiancée. A best friend. A cat owner. A neighbor. A colleague. What I am already is more than enough.