On loss and gain

Yesterday was the last of the first half of my chemo treatments. In two weeks I start with Taxol. Nausea is not as big a problem with that drug. As I sit here battling the queasiness that's been my daily companion for two months, that sounds like really good news! The bad news is that there is a high risk of allergic reaction. That means you take steroids beforehand and then they titer the drug into you over 4 hours, watching carefully for any reaction. If you feel anything odd at all, they intervene by pumping other drugs into your system to combat the allergic response. If it's really bad, they stop the drug, but I get the feeling it has to be pretty bad.

Russian Roulette with anaphylactic shock. Anyone want to do it for me? It sounds both terrifying and stressful. It makes it my job to monitor myself and report to them. Call it too close, and I get pumped with bad stuff that makes me jittery, unable to sleep, and God knows what else. Call it loose and I'm toying with serious allergic reaction. Ever read a description of what anaphylaxis actually is in your body? Don't.

After 4 treatments like that, with two weeks in between as usual, the chemo phase should be over. With great fortune, forever. Those of you praying for me, and I know there are lots, that's what we are aiming for!

After that, I will have a mastectomy, probably just one, or maybe two, depending on the recommendation. I haven't really looked into the data on this and it depends on what they know about the likelihood that this cancer is already hiding in the other breast. No sign of that, but we can't see single cells yet. Since we know it's in my lymph system, the cat is out of the bag and the likelihood of cancer cells lurking pretty much anywhere is high. If the chemo and my immune system don't kill them, they will pop up one day. Unclear whether chopping additional parts off makes a big difference. Modern thinking about cancer is that it's a systemic, not a tumor disease. The underlying conditions that allowed it to occur and the body's lack of adequate response have to be addressed. But we know very little about either.

This aside, there is that one mastectomy to face. And what a thing that is. I've been thinking of the harrowing scene in The Pawnbroker, where the victim of Nazi medical torture realizes they are removing a piece of his hip. And it is this, more than the agony of everything done to him so far, that breaks him. The permanence of it, the knowing that this is something that will never heal, that they are succeeding in taking away a part of him and never giving it back, that breaks his will and his heart.

I draw no parallel between the two situations, except the profound psychological impact of permanent bodily loss. For me, there is the possibility of reconstruction, about which I hear decidedly mixed things, from it's great and you end up with "the boobs everyone wants" (actual quote from survivor friend of friend), to "wish I hadn't done it." (actual quote from survivor sister of friend). Sigh...

But that doesn't change the initial grief of letting go of a familiar and, if not essential (I've never been one to build my self-worth on my boobs - never had such great ones to build it on, so that was easy!) body part that hurts. And I'm not without vanity (for sure!). I've never been a great beauty or head-turner, but I know Idid fairly well in the genetic lottery, thanks to my lovely mom and handsome dad. There have always been people in my life, especially those who not limited to media-driven ideals of attractiveness, who have called me beautiful, and I like it. Who wouldn't? But it is something we trade in life, currency paid for the privilege of time. Cancer just makes the choice more stark, and more deliberate.

Temporary baldness, circles under the eyes, older looking skin are the first wages paid, the first obvious reminders of the ultimate equation. Now, Botox and liposuction have never been my plan. My concessions tithe cultural obsession with looking young include hair color and oil of Olay Regenerist. Not t say there won't be more of this ilk, but I'm basically planning to age gracefully.

But mastectomy raises the bar pretty massively. It's not a normal event, like wrinkles and sagging, something we all face, it's a special choice. Like chewing off a trapped limb, the conscious decision that your survival, your life, your future, is worth more than this thing you once thought was yours, is a "part of you" has to be faced.

So I'm starting to mourn for my lovely left breast, which will no longer be mine. I honor it for the tough duty it survived, stretch-marked and weary, from two pregnancies and feeding two babies. I will miss its easy, swelling, cleavage, found only recently when my breasts followed a family pattern of growing in my forties. I will miss it as one of a matched set that reconstruction, were I to choose it, won't fully replace.

What I hope, is that its absence will serve as a reminder, a small war monument embedded just above my heart; like all monuments, a deliberate act of storytelling that creates meaning behind the suffering. I hope the scars, or even a fake boob, will help remind me of the value I placed upon my own life. It will call to my attention daily to the priority I gave to more birthdays, more graduations, more people coached, taught, changed by my efforts, more people sung to, more beauty created, more writing done, more friends and family given my love. It is a gift, this monument to my choice.

So I say "bring it on," grief, pain, scars and all. And I will learn to love the lessons, so hard-won; on letting go, moving on, embracing life, maybe more than I ever appreciated that mammary gland of mine. A fitting honor for a pretty nice breast that didn't get half this much attention during its lifetime, wouldn't you say? LOL!

Colleen