Once the diagnosis came life took off in fast forward and while it was all really happening, it really was an out of body experience. My medical chart and appointments went from a small file folder to a binder's worth...thank God for digitization LOL! (tribute to my nerd copier industry humor :) . I hope you guys will remember what my friend Silver Fox Cindy told me at the beginning of all the procedures...that the medical team has to send me to all of them to put together the very complex puzzle of my treatment plan. And with each procedure the puzzle became more and more clear.
The Contrast CAT Scan
The CAT Scan can help doctors find cancer and show things like a tumor’s shape and size. and it really is a painless process. I think the hardest part was drinking the contrast liquid and then waiting the hour, it's just boring really. I was also really scared still at the time and going to the hospital, getting the bracelet on my arm, having to say out loud to the technician why I was there...those were tough too. The CAT Scan was the first time that I said out loud that I had breast cancer, and of course I cried when I said it...there was a lot of crying in those weeks. But the process of the CAT scan is just fascinating, I actually thought the machine would be much bigger, but it's basically a big donut. Once I downed the contrast liquid and wait the hour required I was escorted back to undress from the waist up and sport the lovely gown, this time though I got to sport 2! One forward facing and one backwards, no idea why but at that point I didn't even care, but I did think it was interesting. And then the tech had me just lay down on a table, that's pretty much all I had to do. They gave me an IV so that they could inject me with the contrast dye after the initial scan. Laying there, as effortless as it is, let me tell you -- it's mentally exhausting. The table I was laying on moves back and forth through the big donut, a big voice from the sky told me when to hold my breath, when to exhale and there's lots of clicking noises. The first scan of the head, chest and pelvis are done in about 15 minutes. Then the dye is injected and while it is painless, it's so weird. I could feel the coolness of it as it went into my arm, then I could taste metal in my mouth, then it legit felt like I was pissing my pants! It doesn't last long but it is definitely weird. And after the dye goes in, they scan again. I can't tell you how much I prayed laying there. The CAT scan looks for the spreading of the cancer, I knew that if it was somewhere else, this scan would see it and I was absolutlely terrified. I remember leaving there and feeling exhausted, it was another very quiet ride home where I had pretty much convinced myself that the cancer was everywhere and I needed to write my will and figure out what to do with my kids. It's crazy now as I think back on it, but seriously at the time it was very real.
The Bone Scan
The Bone Scan can help doctors find tumors and see how much the cancer has spread in the body, it wasn't too different from the CAT Scan. Alex and I had to go to Temple for this one, it's about an hour north of Austin and the drive was pretty good for us. The Bone Scan is a Nuclear Medicine scan and Temple was the closest one that could get me in. I had talked to a couple of my friends about what to expect so I felt pretty prepared. This procedure was also a contrast imaging process but luckily I didn't have to drink the liquid this time. We got checked in and taken back to get an IV, the tech injected what they call a tracer into me and then told me to come back in 3 hours....surprise day date! We knew the appointment was 4 hours long but we didn't realize we didn't have to stay at the hospital for that time so we ventured out and had a nice lunch with the sweetest southern waitress. While we were eating we overheard her talking to the table behind us and while I won't force my faith down anyone's throat here, I will say that there is no question in my mind that God placed that waitress in my life that day. She was telling the table behind us about how she and her family had a reunion recently and that it was the first time that they had all been together in years but they had recently had a tragic family event and survived it so they made a point to get together just for the sake of being together. She didn't say what it was, she just went into a testimony about how much more she appreciated life now. Her words were like a message from God's lips to my ears. She was so full of gratitude, hope and love and it spoke directly to my heart. I felt so much comfort and inspiration from her, it's such a trip how sometimes people have an impact on your life without even knowing. Once we finished our lunch we headed back to the hospital for the scan. And a scan is exactly what it was, I was basically a piece of paper on a copy machine, I just laid there while the scanner passed over me oh so slowly. I told a couple of my work friends that based on the speed of the scan it traslated to pretty much a Toshiba or a Kyocera...too slow to be a Canon (another copy industry chucle for my copier nerds out there:) The table is pretty narrow though and once I was on it I was pretty surprised by how close they lifted me to the scanner, the thing was just inches away from my face so I closed my eyes because it gave me a little anxiety.
I could hear it slowly moving over my body and I actually drifted off to sleep this time, the tech had to wake me up when it was over! LOL, it was actually somewhat relaxing, another pleasant suprise :) . But the mental game was in full swing when I walked out of there too. Looking back on it, I wish I had been mentally stronger. The stress that I put myself and Alex through was unworthy. At the time I thought I was preparing myself for the worst...but I forgot to hope for the best. Maybe I didn't forget...maybe I didn't allow myself hope because I was afraid of the hurt I would feel if it came back bad. Alex is the complete opposite, he was so optimistic. So optimistic that sometimes it made me mad because I felt like it was naive. There was a definite stress on our relationship during all of this, I was downright irrational. I know now it was fear, but that didn't make it any less discouraging for Alex. Again, looking back I wish I had practiced more control, I wish I had coped much better. To say my judgement was clouded is the understatement of the century, my mind was constantly running 100mph and my irrationality was a testament to that.
The MRI
The MRI uses radio waves and strong magnets to make detailed pictures of the inside of the breast. it is often used in women who already have been diagnosed with breast cancer, to help measure the size of the cancer, look for other tumors in the breast, and to check for tumors in the opposite breast. Once it came time for my MRI I was pretty worn out. The appointments were back to back and the mental game had worn me out. Nevertheless, it had to be done and Mama Mia, the breast cancer MRI is SO weird! So different! This was another contrast procedure and it was similar to the CAT scan, I got my IV all set up and put on the gown, just one this time. There was a 2 person team doing the MRI, one to set me up and one to run whatever they do behind the glass. And the setup is a PROCESS! I thought I knew what an MRI was and what the machine looked like but I was off base. The MRI for a breast cancer patient looks so different. I was laid face down on a table that had cutouts for boobs! Your boobs literally just hang out! The process is a little painful though, once I got my girls in the cutout holes I had to rest my ribcage on this partition to hold me in the position they needed me in to get the image and it is uncomfortable. The angle of my body was awkward and it's really important to hold still during the whole process so it wasn't real pleasant. Once I got all situated they put earplugs and headphones on me to protect my ears from the noises of the machine. And what a massive machine it is! The space is super tight, I am not claustrophobic luckily but it was still a little nerve wracking to be in such a tight space. I just closed my eyes to try and relax myself and not freak out and I did OK. The process is very loud, there is a lot of clicking and rotating and I could even feel a little pain in my breasts while it was happening but I was able to make it through.
The techs did the first round of imaging, then injected the contrast dye. It was the exact same as the CAT scan, cool feeling in my arm, metal in my mouth, sensation of peeing my pants....I was a pro at that point. But the mental game wasn't as intense this time, I think mostly because of the noises and the awkward position of my body. It was important to me for them to get good images so I was super focused on being still and holding my breath when they told me to. But the ride home was similar to before, I was self diagnosing the worst and shut down again. I think back on those rides to and from procedures and how it must have felt for Alex. I tend to shut down and internalize when I'm scared and I wonder what that must have felt like for him. He does his best to show support and offer encouraging words and I just wasn't receptive at the time. I can't imagine that it wasn't discouraging for him, this was all new to him as well and I do have some regret that I wasn't more inclusive. Along the way I have learned that cancer doesn't just happen to the person diagnosed with it. It happens to everyone that loves that person. The fear, shock, anger, even the appointments...they happen to those closest to us too. I see that now but I don't feel confident that I saw it at the beginning of all of this. My team and especially Alex went through a lot, if not all, of the emotions I went through when we got the diagnosis and if I could do it over again I would be much more aware of that.
The Echocardiogram
You know, I thought the Echo would be the easiest of the procedures. Again, I thought I knew what to expect and I was close but the breast cancer echo is a little different. My mom and Alex both took me to this one and the process started out as I expected. My doctor told me that the chemotherapy for patients my age is aggressive. She explained to me that cancer tends to grow faster the younger you are so she wanted to attack it strongly and the Echocardiogram is needed to make sure my heart is strong enough to handle it. The tech starts off by instructing me to get into the gown undressed from the waist up, it still trips me out how many strangers have seen and touched my boobs in the last month and I'm not even a single girl, LOL! But again, this tech was super nice and so competent and informative much like all of the rest of my medical team at Scott & White. She put Electrocardiogram sensor stickers and some gel on my chest then used a microphone-like instrument to create images of different locations and structures of the heart. She took pictures from all different angles and this time I could feel pain when she rolled over my lympy nodes, I could tell they were more swollen then before and it made me feel a bit panicky. She was having some trouble getting clear images so guess what we got to do next? MORE CONSTRAST DYE! The IV, the dye injection...cool, metal, pee. I had it down to a science.
There's an app for that!
Technology is so damn cool. Gone are the days of having to wait for having to go see your doctor to get test results, there's literally an app for that! Scott & White's Cancer Center is just incredible, I have a nurse navigator that makes communicating so easy and she really does advocate for me when I need it. She had me download the digital chart app and that thing has been my best friggin friend!
As soon as test results are available I get a text and can access results and my whole chart right on my phone. The results are there, notes from my doctor explaining the results, my appointment schedule, my financials (sidebar..cancer is SO EXPENSIVE, it's like the biggest ripoff in the world!), literally everything I need to know is right at my fingertips through my phone, it's so convenient and has been a lifesaver for us. That app gave me my first and many more victories. As I had already self-diagnosed with terminal cancer spread to every organ and bone in my body..the app sent me texts and published results that turned out to all be fan-fucking-tastic!! Every procedure was a victory..every single one! The CAT scan results told me that the cancer was isolated to my left breast and 3 lymph nodes, not in any organs! VICTORY #1! The Bone Scan results told me that there was no cancer in my bones, VICTORY #2! The MRI results told me that there was no cancer in my right breast and while my tumor had grown and a couple more lymph nodes looked swollen, it was still isolated to my left breast, VICTORY #3! The echo told me that my heart is STRONG AS SHIT, VICTORY #4! BRING ON THAT CHEMO, MY HEART CAN HANDLE IT!
You know, celebrating these victories is critical. Getting a cancer diagnosis, having a medical team assigned to save your life and make sure you live for many, many years, having so many procedures, racking up thousands and thousands of dollars in medical costs in just a matter of weeks, all of that is so overwhelming and can and did put a black cloud over my head. It impacted my whole attitude and I fought some real dark and depressing times in those weeks. My nurse navigator and social worker talked to me pretty extensively about celebrating my victories and I did. I didn't take them for granted, I know that not every cancer patient is blessed with positive results from these tests and I felt really lucky to have been received such good news with each one. I shared them with my family and friends through text and I allowed myself to actually feel happy for the first time in a while. And oddly, I felt excited that my puzzle was complete. My medical team knew my body inside out, every crevice, every single piece of me head to toe. It gave me a sense of security, my prognosis looked promising and I was and am determined to be part of the 76% survival rate. I am going to be cured, I am going to live a long life and I have a whole new appreciation for life and the incredible people in my life, much like my angel waitress from Temple <3
