Getting Over Myself

Every week is a chapter complete with conflict, climax and conclusion. This week I’ve felt truly at physical odds with cancer for the first time. Since June when those words, “You have breast cancer” reached my ears, it’s been more of an emotional and even abstract dilemma.  There was talk about treatment; talk about surgery and what it all meant but it was still academic.

The surgery and immediate aftermath were surreal. I came through great and had virtually no pain in the week following. That’s not to say I wasn’t uncomfortable. It was terribly uncomfortable but there was no throbbing pain. I didn’t need to take the Vicadin (I still can’t take the Vicadin). There were no humiliating calls for help in the bathroom or while dressing. I got up each day and received the wonderful outpouring of love from friends and family in the form of food, calls, cards, flowers and visits. It was a tangible sense of reaping what I’ve tried to sow. That part felt so wonderful, I almost forgot about my dilemma.

I became lulled into the notion that I would soon be “back to normal.” My normal is about 65 mph seven days a week. I’m never without an agenda and mission. 

At almost two-weeks out I took on a full day of activities, not full throttle but somewhat normal. By 10:00 PM that night I felt devastated. It was a tired that rivals that of new motherhood and the pain arrived. It awoke me around 1:00 AM. As a child when I couldn’t sleep, I counted sheep. In early adulthood I would watch vapid TV programming or even walk dark streets trying to wear myself out. I know and fear insomnia. It surely must be an element of hell. Now, I count blessings on the rare occasions when sleep evades me, like last week when the pain came. I finally drifted back off about the time I got around to thanking God for things like the chickens.  

With the pain this week, which has developed a habit of showing up around 4:00 PM and intensifying until I finally give up around 10:00 PM, came a familiar taunting voice. It’s the one that questions everything I’ve done or left undone and plants doubt, discouragement and disappointment about the past and future.

The voice was “loaded for bear.” Earlier in the week I’d gone to see the oncologist. He gave me good news about my diagnosis and made chemotherapy sound like a spa treatment. The radiologist was not so reassuring. He’d talked in a language only doctors know, but he seemed to be indicating that all might not be so peachy. I blew it off.

The next day he called me at home, again speaking Greek, but he used a word that I did understand - re-incision. 

Two days later (the day I ended up hitting the wall), I went for my follow-up with the surgeon. He comes in all smiles. I’m all business. “Before I hug you, please tell me that Dr. Murray, while an esteemed colleague, is pedantic when it comes to reading pathology reports. Speak mere mortal to me and tell me he’s wrong.”

He smoothed his beard while flipping through the pathology pages. “No, Murray’s right. From a text book stand point we should open you back up. I can do it under local right now. We’ll have you out of here in an hour.”

The silence that accompanies the aftermath of a loud explosion surrounded me.  I felt the blood pulsing through my veins and all three “incisions” were suddenly alive, as if the stitches were going to burst open.

My brain kicked in finally in all it’s brilliance. “So, you are talking about reopening this wound on my chest?”

“Sure, we’ll just take a little more, get those text book margins. It’ll take me 15 minutes.”

He reads me like a text book: “But, if you don’t wanna do it, you don’t have to. I mean it’s something like 2.5 percent... (I’m only hearing the sound adults in Charlie Brown’s world make).

We talked some more and then there was the long silence where he waited patiently about 60 seconds for me to make a decision. The Jeopardy music played in my mind.

“No.”

And that was my final answer. But, if it does come back - there will be no choices. 

I came home from “chemotherapy school” the other day with out all the handouts. Later, when the pharmacist handed me literally a bag of medications and a book filled with possible side effects, I told him to keep the book. He was already rattled from me grilling him about generics and where they were made. I said, “I don’t do drugs well, especially ones made in China.”

I don’t want my brain to know that the steroid could make me look like a jack-o-lantern or that the other drugs cause constipation, anal seepage, night tremors, psoriasis, ring worm, economic recession... 

I’m not making it up. I honestly don’t tolerate any sort of drug well. I was sick for 9 months during my pregnancy. I can’t ride in the back set of a car. I tried to explain all of this to the oncologist. He nodded and said, “You need to take all of this just like I’m telling you to or you’ll get in a hole and it will take me a long time to pull you out.”

That night I took the drug for nerve pain. It helped and I was okay. No tingling of the extremities, blood clots or sleep apnea so far.

The conclusion of each chapter seems to be about me “getting over myself.” 

I have to get over how much time this will take, get over feeling taken out of even the dug out for this season, get over my fear of medications i.e. being old and weak, get over my difficulty asking for help, get over a sense of being worthless if not producing something, anything for God’s sake. 

Maybe as a therapy for getting the full use of my arm back, I’ll revive that annoying practice of catching stacks of pennies off the forearm, like Fonzie used to do, and get in the Guinness Book of World Records.

Romans 5: 3-5

...we also glory in our sufferings, because we know that suffering produces perseverance; 4 perseverance, character; and character, hope. 5 And hope does not put us to shame, because God’s love has been poured out into our hearts through the Holy Spirit, who has been given to us.

Preparing for What's Next

It was a week yesterday since Dr. Ed Levine removed a 2 centimeter tumor from my chest. It was triple negative, ductal carcinoma, highly aggressive. Things have gone really well. I walked Tuesday morning in the vineyard and it felt very empowering, even though I only did six laps. I worked most of the day and by that night felt exhausted.

My spirit remains positive. I refuse to think anything other than thoughts about healing and being better than I was before this all started.

Today I spent several hours with an incredible oncologist – Dr. Gus Magrinat; a self-described obsessive compulsive radiologist – Dr. Bob Murray; and my very dear friend, conservative role-model, financial planner and angel – Jackie Wieland (she’s the total package).

Lots of news and information today; thankfully, Jackie took notes:

1. My cancer is stage 1. None of my lymph nodes held traces of cancer. The “margins” were clean. There are no signs it metastasized. According to Magrinat, I was unusual in that I had 6 sentinel lymph nodes. Most people only have 1 or 2. Those along with 4 regular nodes, that happened to be hanging around too close for separation, came out.  Learn more about this practice:    Sentinel Lymph Node Biopsy: What Breast Cancer Patients Need to Know 

2. Chemotherapy will give me an 83 percent chance of not experiencing a reoccurrence of breast cancer versus a 70 percent chance without it. “Chemo is your friend,” Dr. Magrinat said. 

I’m trying to believe that. I will start the process on September 6 and finish December 20 for a total of 6 treatments combined with as many immune system building shots here at Wesley Long in Greensboro. I have the option of joining a randomized NSABP study. These studies have done a lot to improve cancer treatment drugs. Should I do it or not? 

Did you Know – Breast cancer spread to another part of the body is still breast cancer. If cancer forms on my knee, it means doctors will find cancerous breast tissue on the knee. So breast cancer does not become knee cancer if it spreads. I had no idea.

3. Dr. Murray broke the news that for my age and cancer type we gotta go the long route. That means 6 or more weeks of radiation 5 days a week. 

So, it looks like this whole interruption will carry on till February, which is exactly what Dr. Levine predicted. 

Only those who share my innate love/hate with time will empathize with the contortions my brain was doing around the amount of time this will take and how little work might get done for the next 6 months. I was mildly hyperventilating the whole time. I mean how can I justify taking up space on the planet if I mainly lie on a couch either sleeping or ingesting drugs via a “port”?

Near the end of the very detailed and amazingly layman-like short-course on breast cancer, Dr. Magrinat casually said, “you will never be the same again after this.”

It was the first time during all of these appointments and procedures that my eyes welled up publicly with tears. He quickly leaned forward speaking and indicating toward a box of Kleenex, “You’ll be completely healed. I mean spiritually and emotionally – you’ll never be the same.”

I knew what he meant already.

He went on to use this analogy: “It’s like I’m sending you to Iraq to be in combat. When your tour is over, you’ll have to reintegrate into civilian life, but you’ll be different.”

I’m already in Iraq. The Blackhawk dropped me off on June 20. My platoon is awesome. The Sergeants and Corporals are top notch; the best we have to offer. The General is, well the General. I’m still mostly in the way, trying not to screw this up; do my job and get back in one piece.

And, to add some spice to the mix over the weekend I, with help from many of you, decided to put Maggie into private school. She’s been on the waiting list at Caldwell Academy for two years. In April they assured me there was no way she’d ever get in due to demand. 

About 3 weeks ago I got a call: “we have a spot; do you want to be considered?”

I authorized the “background check” for Maggie. On Thursday, that’s two-days after my surgery and three days prior to public school starting, I get a call: “Ms. Harper, we’re so sorry but the school will not respond to our fax, call or emails requesting her records. Her teachers have not responded either to our requests for the student evaluation form. If you want her to be considered for this slot, you’ll have to get the records here yourself by tomorrow.”

It’s a long story, but God parted my Red Sea on this without mistake. I sat down and made a list of all the barriers and reasons why this could not work in the 11^th hour. I prayed: “God, I can’t deal with any confusion right now. If this is your will, make it abundantly clear.”

By Saturday night, all concerns were dealt with. Maggie is still pretty ticked off that I made an executive decision on her but she’s agreed to give it a shot with a good attitude – we have some differences of opinion regarding how long that shot should take.

I asked the other night on a scale of 1 – 10, with 1 being she wants to strangle me and 10 being she sees how much I love her and that this will turn out for her good – where she stood. “About a four, Mom,” she replied.

How do you tell an 11 year old that this opportunity is absolutely golden? I guess it’s a bit like telling the combat infantry soldier that if you’re going through hell keep going and on the other side of hell is healing; perhaps a new life of sorts.

Post Surgery

Once again, I’m overcome with appreciation for the love and attention you’ve given me. I can’t put into words the way I’ve felt since Tuesday morning. If you’ve ever personally experienced a sense that God was near you, that’s the feeling I’ve had all week. Much of the time it’s been delivered through the voices, hands and just smiles of others; some strangers; some not.

If you have reached out to me in anyway, know that it has been like an important brick in the building of a foundation. It’s the foundation from which I’m growing stronger, healing and preparing for what’s next in my life. I’ve not yet responded to all, but know that I heard or felt you and it made a difference.

I was in surgery for about 2 hours. The OR was full of people. They were all laughing, joking the way people do when they are enjoying themselves. The last thing I remember was Dr. Levine telling the origins of “slipping a Mickey.” He’s originally from Chicago. Someone had joked that they were going to “slip me a Mickey now.”

I started it prior to going in by making them all promise not to take a kidney or anything for the black market. I needed levity as I signed and resigned forms and even my own body leading up to the event.

Since we all learned during the “health care debate” two years ago that many doctors take extra organs or perform unnecessary surgeries to fraud insurance, the hospital has a policy now that both patient and doctor sign with a pen all incision sites.

Yes, I have Dr. Ed Levine’s initials on my breast now. There are no extra incisions.

The other miraculous thing is that in spite of having three incisions, I’ve had zero pain. There’s certainly discomfort but no pain. I’ve been able to get up, dress, walk and do all necessary things.

Next week holds further pathology results and my first visit with “the best” oncologist. During surgery Levine removed the tumor and six lymph nodes. I’m told all went well and that losing only six lymph nodes is a good sign. 

Please keep sending me your good thoughts and lifting up those prayers. I’ve only crossed the first mountain. There are more ahead.

For those who wondered, the book was called Healing Wellness by Kenneth and Gloria Copeland. I continue to read and recite key verses each day such as Psalm 103: 1 -5, Isaiah 53: 4 -5, Jeremiah 30:17, Romans 8:13, James 4: 7 – 10, John 10:10. We all have some place that needs healing. I encourage you to find out for yourself how eager the Lord is to heal you too.

Our health care is great and people want to help

I have felt so much love this week. Thank you so much for the outreach in every form. It means a lot, more than I can express. 

I’ve gotten exactly what I needed this last 7 days to make this first big decision. From talking to those on the other side of this, those in the middle and most of all, my friend Leslie’s (who I just met in April playing tennis) husband who is an oncology pharmaceutical rep. Chemo was my biggest fear of all and he completely helped me see another side.

I did exhale a bit today after my second visit with Dr. Levine and another very handsome radiologist. As a teaching hospital, they crowd the room with residents but I didn’t feel at all put out by this because each of them came across as very sincere and professional. Let’s face it no one gets into medicine for the money or glamour any more. I have a feeling I’ll be doing more research and writing on health care and the impending changes proposed within the law passed last year.

I’ve been fortunate to not need the American health care system very much. But, from my experience this last month in both hospitals, we are blessed with a dedication and standard of care that simply must be protected and advocated for. 

Before I leave the health care industry, I must say too that so far my insurance carrier – Humana -  has been great.  When I first called about finding a facility “in-network” to get the mammogram, I spoke to a very nice woman. She was very helpful and gave me her extension. I call her regularly with updates and ask lots of questions. She’s been very reassuring that everything my doctor orders will be covered and I’ve learned that Humana offers services I was not even aware of like 24 hour on-call nurses for any concerns and discounts on alternative therapies. Stay tuned on this because the bills have not started to come in as of yet but that dread I had about insurance has passed. 

Here’s the break down of what I know as of today:

• Blood work and x-rays looked great. No additional cancer or problems detected at this point. Thank you, God!
• I’ll go in for a lumpectomy on Tuesday, August 9 at 8AM. I should be home by 2PM that day. Within a couple days, I can do basically whatever I feel like doing, including driving. There’s still a chance that more not good stuff can be found during surgery which could change the outcomes. For example, if the pathology is not good on the area surrounding the tumor more surgery could be required. If the “sentinel” lymph node is sick, then perhaps all the lymph nodes (up to 16, I think) can be taken which has implications for healing and later treatments. The “sentinel” is a lymph node close to the breast that is the conduit of sorts for escaped cancer cells. If that one is sick, it tattles on the cancer telling the doctors that more treatment is needed.
• A lumpectomy does require extended treatment to get the odds of reoccurrence down. I’ll do many months of chemotherapy following surgery and once that’s done at least one month of 5-day-week radiation. 
• For now I’ve asked for what I want and given him permission to do what he needs to do. I asked about getting a nose job and my eyes lifted during surgery, he said that was pushing it, but did tell me he would feel comfortable having his sister take the same course I’ve chosen. 

I think this first step will go smooth. The hell for me is going to be the many months of continued treatment and not being at full capacity – not knowing what future full capacity will look like. I’m going to have to make peace with time. I’m such a freak about time. I never expected to live past 30. Then Maggie was born at 33. Then I got to come home at 40. It all feels like borrowed time and I still have such a long list of things I really, really want to accomplish.

It’s like my Aunt Carolyn said, “You’re gonna have to get over a lot, including worrying about everybody else.”

I think this is permission to be selfish. It could get good to me and I’ll start expecting special treatment from now on. Maybe one of those really nice looking Jewish doctors is single? That’s probably pushing it already.

I’ve got to close with the rest of the tree story. Two weeks ago half of my big oak tree came crashing down. When I went out to see it in the faint morning light, I felt like the spirit of God spoke to me about pruning big but not killing the tree or me. This week my Dad and his friend Bill came and cleaned much of it up. Then a father and son team – the Michaux’s (I swear they look like direct descendants of Van Gough) – came and did the rest, including felling a very tall and leaning dead pine tree right outside my bedroom window.  Now that it’s all cleaned up, there’s all this fresh light coming into our yard and front windows. It feels good, open and new in a weird sort of way. 

Let’s hope that’s a good omen and that the oak lives. I’ve told God that if that tree dies he’s really ruined a great witness. 

Thanks again for the offers of help, support and prayers. I will continue to need all of that in the coming months. The hardest part still lies ahead.

Sharing the News

I’ve been dreaming for a long time about sending an email to friends and family with great news about some milestone reached in my life. This is not that email. It’s bad news at this point for me, but I know that it can and will be used for my good. I have learned recently that I have breast cancer.

If you are on this list, it’s because I trust you. I was surprised at how long the list really is because I find trusting people with myself very difficult. So, there’s already a blessing that in four short years my list of friends has literally more than doubled.

I don’t know much about what’s going to happen at this point (see the detail below). The journey has only just begun and promises to be quite long. I do have to make what feels like a very large decision this week and that’s whether to go with a lumpectomy or full mastectomy, perhaps even double – why just get one new breast after all?

Maggie does not know yet. She’s still in CO. I do not feel safe at all letting this information get to CO. I will be very careful until this is all over to not let the information get to Dave. I just don’t want any unnecessary stress. I don’t want added stress or fear for Maggie either. She’s my biggest concern next to simply surviving this. I want her life to remain as unscathed as possible. There’s my clients too that need to continue finding me prompt and indispensible. Losing my ability to be financially stable and take care of Maggie and I would be the most devastating thing of all. I’ve worked extremely hard since about age 15 to be financially independent.

As a matter of fact, I don’t want to share the information widely at all. I don’t like to talk about it much because I’m just not an openly emotional person. I’m a ridiculously optimistic person with crazy dreams in spite of no real indications they’ll come to pass. Yet, I still keeping working at it and believing. I don’t want people feeling sorry for me or treating me with kid gloves. I want your prayers and certainly information if you have access to something or someone helpful. If you live nearby, I’ll sure appreciate food for Maggie once the dreaded chemotherapy begins – I’m told this is not an option despite being more scared about that than anything else about the process. 

Among you are varying degrees of faith in God and I respect that. You’ll be hearing me talk regularly about how God is at work in this. I’ll do so to record and remind myself that God has not forgotten about me. I’ll continue to believe he works all things for the good of those who love him because otherwise the rest of my faith is meaningless. The unshakeable belief I’ve come to in the last eight years or so has been hard won after years of searching under every rock just to be sure, after in large part losing my marriage over it.  I don’t eat anything with a spoon offered by another. I have to find out first hand everything the hard way. If you’re still wondering yourself, I can tell you from not one but many first hand experiences – there is a God and he’s very personal. Perhaps what happens to me will heighten your own awareness of the fact that he’s looking for you.  My personal mission for the last five plus years has been to influence growth and the knowledge of God within people. Here’s another chance, I guess.

My first talk with him about this pointed out that I’ve been praying for proverbial bread for a very long time and that this feels a lot like a snake.  

Yet, since the day I left the doctor’s office numb with this news, I’ve been blown away by the “chance” meetings and recent connections that are already proving helpful. Exactly one week after receiving this news I lay in bed willing myself to consciousness from dreams of evil doctors and large brown spiders in my bed. A distinct sound brought me fully awake. A tree had just fallen. I went outside and by a very faint predawn light could see that an enormous arm of a very large oak tree had split right off.  It took out a smaller magnolia tree and a couple Adirondack chairs but otherwise lay gracefully across a wide expanse of our yard.

I stared at the jagged wound left by the weight of the breaking arm but noted that the big, towering tree was otherwise just fine. A voice in my spirit that I know to be God, because the words are always way simpler and wiser than anything I ever say, said, “Sometimes I have to prune a lot but you’re going to live.”

I didn’t think there was anything else left to prune, but here we go.

What I know:

•       Invasive ductal carcinoma. Triple negative. 2 cm tumor, right breast. High grade III. Aggressive growing. Tumor 

                 anywhere from 3 to 8 years growing.

•       I lymph node tested negative - good news.

•       Surgery will be soon at Wake Forest Baptist Health – Dr. Ed Levine, Chief of Surgical Oncology. Raved over by 

                 all who know anything about this stuff. Performed surgery on my doctor 12 years ago.

•       Next appointment is July 8 to meet oncologist, radiologist, plastic surgeon and get results of further blood work        

                and chest x-ray.

•       Choice to make right away is whether to go with a lumpectomy (requires radiation and chemotherapy with a 10 to 15 percent chance of reoccurrence) or mastectomy (requires chemotherapy only). Then there’s decisions about reconstruction or not, etc.

•       Surgery projected next 2 to 3 weeks. Depending on what I decide, no overnight in hospital to several days. Chemotherapy 4 to 6 months.