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Got My First Tattoo Today

June 5, 2023 by Jaci Dawn

I wish my son was here for me to tell. He would get a kick out of my first tattoo even though it is really not impressive. I have four tiny dots (about the size of a . ) on my torso tattooed with India ink. They are there so when I go in for radiation treatment, the radiologist will know where to point the lasers.

Backing up. I do have to have five days of radiation even though I am technically “cured” of breast cancer. The radiation is to ensure that no stray cancer cells were left behind (“leave no cell behind!”) and reduce my chances of ever having a tumor again. I’m cool with that. I am thrilled that I won’t have to endure chemotherapy. Radiation is just a road bump.

Last week, I met with the radiology oncologist who explained everything to me and gave me my options (I had three). Given the small size of the cancer, I chose the least invasive radiation plan which is streaming the radiation only on the site where the cancer was. No whole breast radiation, and not three weeks of it. I consented to the tattoos.

Today, I went in for a “sim” test on the CT Scan (Sim=simulation). They need to figure out the best position for the cancer patient to be in to maximize the radiation and to protect the heart and lungs. Radiation is good for you, but it is also very bad for you. Fortunately, my cancer was on the left side and that already helps protect the heart. I imagined this process would take some time as the tech figured out the best position for me to lie in and I also expected that position to be a bit uncomfortable. It was neither.

The first position worked, and it was not an uncomfortable one. I may get a bit of a neck cramp at the end of the first radiation treatment. I think the process took ten minutes, including the placement of the tattoos. Those dots will never be as fancy as my son’s tattoos or those of my beloved daughter-in-love, but at least I can brag that I have them. Can’t show you them (probably can’t even find them), but… I have them.

This short process was followed up by a consult with one of the radiology nurses who schooled me in how this is all going to work: side effects (minimal), checking in, consult with the radiology oncologist part way through, skin care, where to go, and so on.

It got dicey then. I had to fill out this form dealing with my emotions and mental outlook (I swear it is really good!) and under one heading was the question: “Are you dealing with the loss of a loved one?”

UM. YES. And then I had to tell my story to an incredibly empathetic radiology nurse who kept asking sympathetic questions and crying. To say it ripped my heart to shreds is to put it very mildly. I kept trying to tell her that going through cancer was nothing… but hitting that wall of loss still echoes in my heart. She hugged me when I left the office, but I sat in the car afterward and tried to collect myself. I came home and just sat in the garden, trying not to feel anything.

I really don’t want anyone’s sympathy. But- BOOM! – a stranger asks and then loses it over the tragedy of MY life. I don’t want to minimize my hurt by saying, “Others have it much harder” BUT … my life isn’t tragic. There have been tragedies and I may never fully recover from them. I will say my son’s name every day (and my sister’s, and my mother’s, and my father’s, but especially my son’s name). I am not who I was 2.5 years ago. The world shifted.

Even so, I wanted to write about my cancer journey with humor and funny anecdotes. It isn’t the end of the world. Even if it was a more severe cancer, it wouldn’t be the end of the world for me. This is just an obstacle in the road.

After all this is over, maybe I will get a real tattoo. Something that speaks of joy and living life to the fullest in honor of my son.

I thought the worst of today would be figuring out my position on a hard table with half my clothes off in a room of strangers, but that’s pretty darn minor. The hardest was trying not to lose it in front of an Empath who truly understood my pain. The hardest was reliving those frantic hours between December 10 and December 12, 2020. But I got my first tattoo.

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Breast Cancer Follow Up

May 24, 2023 by Jaci Dawn

I had my post-op appointment today and it went screamingly well – except for a couple bumps. I write this because so many women have no clue what they are getting into when it comes to breast cancer (I am one). The general stuff is thrown out there, but there’s the up close and personal stuff that doesn’t seem to be talked about.

#1. They don’t even talk about radiation treatment until 4-5 weeks AFTER the surgery. I jumped on that one, in part because I received a strange phone message from the “body oncologist’s assistant” asking when did I start the letrozole (femarole)(estrogen blocker). I hadn’t started it because it states I should *not* start it until after radiation. I tried calling back but she didn’t return my call and I (wrongly) assumed I wouldn’t have radiation. I will bring that up to the body oncologist when I see him in two weeks. Follow up is important.

#2. I won’t know how much radiation or how long until I meet the radiologist next week on the first of June. I did tell my oncologist surgeon that as long as it doesn’t interfere with my road trip in late July to see my grandchildren, I’m pretty cool with whatever happens. She gave me a very long and heartfelt hug over the loss of our son two+ years ago and the fact I haven’t seen all these kids together since then. It’s an important road trip.

#3. I got my results today. The cancer was 1.5cm, which is about the size of a dime, not the .8cm they thought it was. Still in the Stage 1 zone, and they got it all. I am, for all purposes, “cured”. Radiation is a second layer of protection to prevent further development as is the hormone blocker I will be on for the next five years. I remain among the very lucky.

I don’t know how this will affect my other summer plans. I may have to change things up a bit but I won’t know until next week. Radiation could be one week or it could take several weeks. I have plans the first week of July as well as the last week, but I will sacrifice that first week if I have to (sorry to my friend with whom I have made plans) BUT I may not have to. It’s all a waiting game.

#4 No one tells you how much of a waiting game cancer is.

I am healing well. In a week, I will be able to lift 5#+. That means gardening, building that retainer wall, and hauling things to the thrift store in order to declutter. BUT I don’t have an inkling as to how radiation will affect those plans. Square one: wait and see.

In summary: don’t jump the gun and don’t expect the worst. So far, it has all been the best possible outcomes (aside from actually having cancer in the first place) but I have been jumping the gun much too often. Breathe, Jaci, breathe. Patience.

What I DO know and celebrate is this: NO CHEMOTHERAPY. And that is a huge bonus.

On a side note, while I was at the oncologist’s office setting up appointments today, we fell into a discussion on perfumes. I won’t bore you with how we got to that conversation, but I feel it is important to note the context. I don’t wear perfume most of the time. When I do, I wear very little: you would have to be intimate with me to smell what I do wear. I do this because I have been in and out of doctor’s and dermatologist offices: people have serious reactions to perfumes, including anaphylactic seizures. Deodorants, hair spray, shampoo, and perfume can all be triggers. I know the people on the allergic side of this equation. We (the scheduler, the assistant nurse, and myself) all agreed this is a huge issue and it is ignored by so many people in the public sector.

I once worked for an employer who came straight to work from the shower, doused in after-shave, body wash, and cologne. I’m not allergic, but he reeked of a sweet perfume. TOO MUCH. You are not supposed to be able to smell yourself. Perfume or cologne should be sprayed into the air and you wave your arm/write under the descending droplets, capturing just a hint of the scent. That’s it. No more. And use unscented deodorant, please. It’s important to the person next to you.

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Let’s Talk Garden!

May 22, 2023 by Jaci Dawn

We went from a cold and drizzly April to a dry and sunny May. The garden has “popped” as they say. Flowers galore. The daffodils faded and the grape hyacinth followed them closely, then the blue and white hyacinths. The heat came on and the peonies reached for the heavens. The heat turned down and the peonies are hanging on to their blooms: blood-red, deep magenta, salmon pink, cotton candy pink, yellow, and white. Bomb peonies, doubles, triples, and tree peonies. Now the irises are clamoring for their time in the limelight: purple, blue-and-white, purple-and-yellow, yellow. Dutch, wild natives, Japanese, and flag. Out front, the geraniums and Solomon’s seal are in full array of pink and white and green.

The tiny flowers as well are in their glory. The native forget-me-nots and the commercial ones, the inside-out flowers, the bishop’s weed, and the poached egg flowers (meadow foam) are all on display. The native camassia has bloomed and faded now. Heucheras, or coral bells, wave their tiny fronds of mini blooms in the breeze, along with the fringe cups. Speedwells have blossomed and faded along with the sweet woodruff.

Pushing up from the ground to make the next display are the sages: pineapple and Jerusalem, as well as the phloxes, the Peruvian lilies, the crocosmia, the Shasta daisies, cornflowers, bachelor buttons, and dahlias. Then will come the milkweeds and the evening primroses with the scattered sunflowers. The four roses out front have swollen buds while the rhododendrons are finishing off their array of colors. The heavy scent of the lilacs has already faded with the memory of their color. The orange daylilies will put on a show in just about a month. The Rose of Sharon has greened out and will soon bloom with reddish-purple blossoms.

If I am fortunate, the mock orange with blossom this year. I am fortunate: there are eleven spikes of flowers in the bear grass clumps. The hostas will take their turn as well as the lilies: Easter lilies and Martha Washington white lilies. The honeysuckle is striving for its place in the glory of bloom.

There are few bumblebees, and this concerns us: the giant solitary ones are house hunting but the littler ones we have are scarce. But the tiny ground dwelling bees and the mason bees have been plentiful, and we have noticed honeybees here and there. The paper wasps have returned home – they are important pollinators. We always have a plethora of tiny, winged pollinators on hand, from hover flies to yellow jackets.

Birds. The crows built their nest just to the south of our fence. We’re certain they will fledge any day and our hope is that the little ones will not end up on the street below the nest or in our yard where the dog might find them. The juncos that nested on the ground beneath a peony have raised one fledgling. It now can make short flights and avoid the dog easily. The lesser goldfinches are building a second nest for the next brood of babies. We haven’t seen the wrens for a while but have heard them: hopefully they also raised some new babies. The secretive spotted towhee comes in daily for a bath in one of the many baths for birds.

This season of flowers and warm days is my favorite time of year: Spring into Summer in the Pacific Northwest. I ache to be on knee pads with my hands deep in the wormy soil, pulling weeds and coaxing new flowers out of the loam – one more week of being careful after surgery and I will be back at it. I will plant some annuals before then: my usual petunias and pansies need to be purchased and planted in baskets. My fuchsias over-wintered and I have planted nasturtium seeds in the hopes of watching those pretty (edible) flowers will soon grace my yard.

There are issues that need to be addressed: brown spot, aphids, black spot, fungus in the soil, bushes that are half-dead and hanging on that need to be pruned and babied back to life and moving plants from one area to another to better facilitate their needs. I will be doing that in June.

Don is prepping the vegetable garden for the rototiller. We need to build a retaining wall around two sides of that garden (I bought the stones in February of 2022). The apples need to be protected from flies and worms (we have special nylon “socks” for that). The crazy grapevine is bursting with little green blossoms that portend a great harvest later in the summer (I share liberally with birds and with the neighbor whose fence helps prop up my vines). Sadly, I lost my “blackcap” raspberry in 2022 and that needs replaced this year – I live for my raspberries!

OH! Did I mention my strawberries? No, I did not but I will now: I have two urns full and an accidental little strawberry patch by the A-Frame (where we hang bird feeders out front). LOTS of berries are coming on! Sweet Hood strawberries, the best in the world. I just need to keep the slugs at bay.

<SIGH>

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Mother’s Day Recovery

May 16, 2023 by Jaci Dawn

I am almost a week out post-surgery. There isn’t anything to write about as my memory begins to fade and events become jumbled together. The recovery is worse than the surgery. Waiting is worse than surgery. Surgery is sometimes all about waiting.

The highlights of the event include needles, blue dye contrast, bruising, and a little swelling. And waiting.

The odd thing about waiting is that once things start happening, they happen in a whirlwind of motion until – abruptly – it is all over. You get sent home for another round of waiting: waiting for the pathology report and waiting for the three week recovery time to get past so you can lift five pounds again.

This has all been a pain in the behinder for me. I hate waiting. I hate waiting in waiting rooms, on hospital beds, and on time to pass. I am a useless appendage when I can’t be up and doing things – and I *want* to be doing some things. Certain things. Things like pulling the weeds out of my flower beds before they reach three feet in height, bloom, and go to seed. Things like planting more flowers in my garden beds. Going to the grocery store alone! Doing anything but light duty.

It has been unseasonably hot for this area. One day, it was ten degrees below normal and raining. The next day – BOOM! – it’s in the nineties (Fahrenheit) and the ground is turning to hard clay before your eyes. I love me some hot summer days, but not days when I can’t haul hoses or watering cans (five pounds!) around to water thirsty plants. I also like to become acclimatized to sudden death summer. (And it isn’t even summer!)

So I am waiting. Sitting in a lounge chair, sipping water or beer and doing nothing except watching weeds grow faster than the flowers and unable to do anything about it.

WHINE.

I know, I know: you feel this deep empathy for me, a great sorrow at my plight. I appreciate that. Once I post this, I will get back to that lounging and wining (er- whining) and you can feel even more deep sympathy for me. Poor Jaci.

Enough of that. There was a little tracker injected into my breast last Wednesday. Needles. The tracker helped the surgeon find the lump and was removed with the lump. That was two needles: one for the lidocaine and one for the tracker. Thursday, the blue dye contrast was injected into my breast. No lidocaine but two hurts: the initial poke followed by the sting of the dye. Needles.

After surgery, my pee turned Smurf blue. My breast was Smurf blue (except where it was bruised violet-blue). The blue lasted around eight hours. The bruise is still violet-blue, but now has tinges of yellow along the edges. The colors are all very brilliant and spring-like.

That’s it. We’re still waiting on pathology (which will determine if there is more to this story or not) but in the meantime… I’m going to go sit in the shade, read a book, and watch my peonies bloom. It’s my waiting game. I know you feel sorry for me. 😊

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I Chased the DDT Truck

May 7, 2023 by Jaci Dawn

We have had an unseasonably cold April. And a lot of rain. Last year, April was dry, so – you get what you get in the Pacific Northwest. But it is screwing with my gardening.

I lost several bushes over the winter. That makes me sad. My French lavender bit the dust, the curry plant is hanging on by a thread, and my purple wallflower is half alive. I lost some transplants as well, but I haven’t looked at my plots for the garden to know exactly which plants died. I can only tell by the remnants of the plant they were and go, “SIGH.”

It has been difficult to get ahead of the grass and weeds due to the cold rains. However, I have but one flower bed left to dig the grass out of as of tonight. The grass is a foot tall, but I’ve conquered all the other beds so far – so good. Have I ever mentioned how much I despise grass? I’m certain I have. I could replace lawn with wildflowers and ground cover if it weren’t such a daunting project on a 100×100’ lot.

I skipped the big Garden Palooza on the first of April: too soon, too rainy, and so much cancer information going on in my brain. We did, however, make the Clackamas County Spring Garden Fair this past weekend. I only found two pots of anything I wanted but my husband found starts for his tomatoes and peppers. We still need to do a Portland Nursery trip, but I think we’ll skip the annual drive south to Corvallis and assorted nurseries this year. Inflation and health concerns (actually, medical bills concerns).

That doesn’t mean I haven’t been busy! I moved three columbines (Aquilegia) to new locations. They were blocking out my poached egg plants (Limnanthes Douglasii). Last fall, I also moved some of my geraniums and coral bells (huecheras) (those are coming along nicely in their new locations). I still need to thin out the geraniums and huecheras in the front!

Friday there was a post on a local garden group on Facebook for free plants. I scored pink phlox, purple monkshood, and two toad lilies (one of which I gave to a friend). Saturday, I purchased two small pots of bunchberries (Cornus canadensis). Today, I planted most of them in the shade border along the fence. The monkshood prefers full sun and will go into a planter that I can move around out front (it’s toxic, so can’t be where the dog can get to it).

The paper wasps are back and setting up home in the little blue ceramic house they have lived in for the past five years. The native ground nesting bees, wasps, and hover flies have all hatched. Mason bees have hatched and laid eggs. The darling six year old next door tried to give us a humongous slug today (we politely declined).

The crows are nesting in the fir tree immediately adjacent to our property and are quite demanding of peanuts and other treats now that the eggs have hatched. A pair of Bewick’s wrens have nested in the wood pile (they once nested in the garage – not a great idea!). A pair of Dark-eyed Juncos have chosen to nest on the ground amongst the grape hyacinth and peonies that are in the fenced off portion of the flower garden (where the dog can’t reach them). Those have hatched as well. The Lesser goldfinches are nesting nearby somewhere and eating me out of thistle seed.

We missed the arrival of the Turkey Vultures due to the inclement weather (normally around March 15), but the bald eagles have not disappointed us.

Bald eagles. Daily. Three or four. Daily. I remember when we drove them close to extinction. I am 66 and that was 55 years ago. I have never seen them like I am seeing them now, five decades since we sprayed DDT to kill mosquitoes on every road, every stream, every town, every suburb, and every child. I am one of those children.

The DDT truck would come through our neighborhood, and we would run out into the street to follow in the fog of pesticides silently screaming “Hallelujah” as mosquitoes died on our freshly coated skin. We’d beg off from baths and showers in the hopes that the residual poison would continue to protect us for days to come. Meanwhile, we killed fish and fish-eating birds – some to near extinction. 56 years later, we get to see bald eagles soar overhead, a symbol of recovery and survival.I should have had cancer ages ago.

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Don’t Look at Me Like That

May 7, 2023 by Jaci Dawn

This is not That. Whatever your experience with breast cancer (or any other deadly cancer) this is not that.

I have been trying to make fun of this entire experience, but I’m coming up short when people give me That Look that says they feel terribly sorry that I am even going through this. Please, please, please, don’t look at me like that. In the memory of all the friends we have lost to cancer, don’t look at me like that. I don’t have the kind of cancer that is going to kill me in five years or less.

I started writing about it because this is novel to me, having a firm diagnosis on something. The irony of making the appointment and having the procedure done is not lost on me: I abhor mammograms. I don’t particularly believe in them. And after decades of having something “off” in my body but no one can figure out what it is, suddenly I have something “off” and everyone freaks out. (Maybe not everyone.) There was the mystery of the bleeding kidney (unsolved) and the mystery of the sudden blood clot in my left leg (also unsolved). Tests, C-T scans, biopsies, stress tests, and so on – all with no results.

Indeed, the MRI I recently had reported NO anomalies. The cancer in my left breast is undetectable by MRI, only by mammogram. The irony.

I am basically healthy, aside from year-long “seasonal” allergies and the Covid weight gain of 25#.

Reading the test results and discovering that a carcinoma was growing inside my body was more of a surprise and an immediate feeling of, “OH. BOTHER” than it was terrifying. I mean, seriously, OH. BOTHER.

I won’t lie: the novelty has lost some of its shine as I have gone to appointments and had procedures done. The oncology staff puts on a great show of cheerfulness but underneath their smiles runs a current of “I’m so sorry you are having to go through this” sympathy. My pharmacist looked at the prescriptions I had to fill for my post-operative care and suddenly turned empathetic and sad. “When is the surgery?”

This is not Stage 4. This is not metastatic. This is not Stage 3 or even Stage 2.  This is the simplest form of Stage 1 breast cancer. There is nothing in my history to suggest otherwise and nothing in my blood work to indicate otherwise. They aren’t even talking about chemotherapy (thank the good Lord!).

This is more of a “Whew! Dodged that old bullet, didn’t I?” cancer. More of a “When can we get done with surgery and recovery so I can go back to gardening because this is the month of May” kind of cancer. This is an Oh. Bother. Cancer.

We have a Game Plan. By “we” I mean this sudden influx of extremely compassionate staff and oncologists who are now in charge of my upcoming and ongoing care.

May 10 – ultrasound with contrast to see which lymph node the milk ducts feed into. This is “new”: they used to remove all the lymph nodes in the affected armpit but they discovered milk ducts (where breast cancer usually starts) only feed into one lymph node.

May 11 – lumpectomy to remove a carcinoma that is scarcely 3/8” (0.8cm). See attached photo. I get to go home the same day.

I will be under long term care as any cancer survivor will attest to. This is something I did not know I would have to go through. It’s more of an “Oh, Bother.” Five years of hormone blocking therapy. Yay. What little estrogen my post-menopausal body still produces will be entirely cut off.

Under good news: there will most likely be no radiation treatment and definitely no chemotherapy unless this go completely sideways on Thursday and the tumor is larger than they could see in the mammogram (highly unlikely since the MRI couldn’t see it at all).

Under bad news: no estrogen for five years. More hot flashes (not a bad thing in my world of being constantly cold). Most likely a full beard within a week of therapy (I already have to deal with whiskers every four or five days, so – yay). Twice a year visits to an oncologist to track my progress. Twice a year mammograms (!!) for the foreseeable future.* No magical weight loss due to chemo or radiation (DARN!).

*This, boys and girls, is why we go to have a mammogram done once a year or so – to avoid the bi-yearly squash by highly trained sadists.

To summarize: I am not scared, worried, fearful, or otherwise emotionally attached to the upcoming surgery and procedures. I just want it over. And I don’t want your sympathy. (I’m merely writing about it for the laughs.)

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The Dog is Worse Than the MRI

April 30, 2023 by Jaci Dawn

My little Breast Cancer saga continued this morning: I had an MRI scheduled at 9:30 in the morning at a nearby hospital. Not my local hospital because they don’t have an MRI machine, but a sister hospital within a 20-minute drive. We arrived early, of course, because it was a Sunday morning and there was no traffic.  We wasted ten minutes sitting in the car and trying to count how many Eastern Fox squirrels were in the adjacent trees and shrubbery. I quit counting at ten. That’s a lot of squirrels in a small area.

Checked in at 9:25 and sat down to wait for the tech. Oh, I had about three minutes’ worth of additional paperwork to fill out: “Where does it hurt?” It doesn’t. “Place an ‘x’ on the body part to be scanned” (That was easy). And so on.

Another patient wandered in for an ultrasound. His nurse came and picked him up after about fifteen minutes. Meanwhile, the clock ticked. Trust me, this was the WORST part of the morning: waiting for a full 45 minutes before my tech showed up to usher me back to the machinery. Tick…tick…tick…

The tech was very out-going and so made up for the long wait. The second worst part of the morning (actually, pretty low on the scale of worst to best) was the insertion of the IV.

Wait. I forgot to mention that our eighty-pound beast of a dog jumped on the bed at 6:30AM, firmly landing on my outstretched leg. He heaved himself up onto the bed and subsequently stepped on that same spot before I could withdraw my leg. I have the bruises to prove it. Darn dog!

That was more painful than the IV.

Technology has come a long way since the last time I had an MRI. Back then, the machine was a long tube and my biggest fear was that they would stick me inside that tunnel and forget about me (or the power would go out and they wouldn’t be able to get me back out). Fortunately, I was only having my left knew scanned and got to sit outside the tunnel with just my legs inserted. (I had a torn meniscus at the time.)

Now the machine looks like an oversized CT Scan machine. Open on both ends and not nearly large enough to swallow a human being whole, much less strand them due to forgetfulness or a power outage. WHEW. I declined any sedative at that point: it couldn’t possibly cause me to have a claustrophobic anxiety attack.

Rather, the positioning of the body was the most distasteful part. On my stomach, breasts positioned just so, and hard plastic digging into my sternum with my ribs crushed below. I was certain I would bruise after 25 minutes of that torture, but – alas – it wasn’t that much torture and I endured. And I didn’t bruise. Only where the dog walked on me earlier in the morning.

The tech gave me headphones with music cranked up at front row concert, like at least 85 decibels (probably not that much, but it was pretty loud). I soon learned why the music was so loud: the MRI machine is LOUDER.

Bang! Clang! Alarm! Beep! Boop! Whistle! Vibrate (that actually felt kind of nice). I decided the best way to pass time was to count how many songs played. If a song is three minutes long (standard radio play time back in the day) that it would take 8 songs for 25 minutes to pass. Apparently, songs can run longer in this day and age because I only reached 5 and a half songs before it was over.

When I had ten minutes to go, the tech came on the little radio and told me he was sending the contrast into my system. I half expected to feel something, although he had earlier assured me that the contrast he uses is not the same contrast they use for kidney function: the stuff that makes you feel like you just wet your panties. His contrast, according to his words, is “more Vanilla than that”.

Despite the warning from my drinking friend last Saturday, waiting for the contrast was not horrid. I felt nothing. I heard a lot: whirring, gears grinding, some more beeps and boops and whistles. Some day they will invent an MRI machine that is as silent as a CT-scan machine. Won’t that be amazing?

We left the hospital at 11:00AM and headed to the local food cart pod for breakfast, then across the street for a couple beers with dear friends. By 2:30PM, I realized that all the noise of the day – the MRI, the crowded brew pub, and the loud 80’s MTV music playlist – had worn my sensitivities to too much noise down to a frazzled level of “I just need to go home and be quiet”. Kind of like the night my brother dragged me to some nightmare Casino/kids play area in Reno with greasy cheese pizza and his grandchildren running amok (not ill-behaved, mind you, just bouncing off the walls in the kids playing area with thirty thousand other children) and I crawled into bed later with my Introvert HSP ears ringing.

In summary, the breast cancer screening by MRI is uncomfortable and noisy, but the biggest pain of the day was when Ruger stepped on me and woke me from a dead sleep with a stabbing pain in my lower right leg. And left me with bruises. And the worst part was the 45 minute waiting in a hospital lounge where there was only one other patient, and he only waited fifteen minutes.

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Blessed. I am Blessed.

April 23, 2023 by Jaci Dawn

My last post was about breast cancer biopsy (the bruising is completely gone now). I told my brother that I wasn’t surprised by the outcome because doctors have “tells” in their speech and mannerisms. I am, however, disappointed in that I am now a statistic. A lucky one, at that.

Had I not been referred for a bone density scan, I would not have called the radiology lab at the local hospital. Had I not called, I could easily have ignored the referral for a mammogram. I still could have ignored that referral but I decided to just go with it despite my previous painful experiences. I still don’t know what the bone density scan showed, but I sure as heck know what the mammogram revealed and the subsequent needle-poking of the biopsy proved.

Emotions tend to run high at the mere hint of the word, “cancer”. I’ve had several basal cell carcinomas removed from my face and a couple pre-cancerous lesions. Nobody freaks about that although those areas were much larger than the carcinoma discovered in my left breast. It’s so tiny, it can’t be felt by a routine self-exam. It’s considered an “invasive carcinoma” which merely means that it has invaded my breast tissue.

The word “metastatic” was not written in the report nor has it been mentioned by anyone. So, calm down everyone: it’s tiny. It most likely has not moved into the lymph nodes. All my markers are good. I’m not freaked out.

I’m irritated at the timing, worried about how friends and family have reacted, and not real thrilled with all the upcoming tests and surgery and follow-up, especially (irritation) during the height of garden season. my list of questions for the oncologist had more to do with the timeline of care and recovery than “Am I going to die? Will it recur? How scary is this?!” I still have no definitive answers on the timeline, but there is an outline of a game plan, and it does NOT involve chemotherapy, mastectomy, or even a whole lot of radiation.

The number of friends, family, and acquaintances I know who have already been down this road have been diagnosed with Stage 3 or 4 cancers, some metastatic and some highly aggressive. the living ones (sadly, I have lost friends, acquaintances, and family to this scourge) have either told their stories publicly or I have known them well enough to have watched them endure the weeks and months and even years of recovery. We all know those stories. I think that is where the fear comes in.

The doctors I have spoken to have gone out of their way to be kind and considerate. My own PCP (Julia) left a voice message that if I “needed to talk…” she would be there. The oncologists office was cheerful and upbeat in a true effort to make the whole process less frightening for cancer patients. Everywhere I have turned so far, it seems like I am being handled with kid gloves, as if my emotions are going to just spiral out of control.

I was referred to CompassOncology which has several offices in the Portland Metro area, the closest of which is 20 miles away, right off of I-5, and very reminiscent of my commute for at least 10 years. My oncologist is a Dr. D who is tiny, funny, sincere, and caring. She’s also very thorough. And she’s on vacation all this coming week.

Which is OK because I have to have an MRI a week from today. A mammogram only catches 50% of cancers. An MRI catches 97%. They want to know if the mammogram caught the entire picture of what is happening in my body and only the MRI can do that. My husband and support person whispered, “If that’s the case, why don’t they just do a routine MRI for breast cancer?” (Answer: insurance companies don’t want to have to write off that expense.) He also offered to take me to breakfast after the MRI even though I might be a bit loopy (I’m claustrophobic and will need a little sedative to get into that tube face down for 20 minutes).

Check that: MRI on April 30.

I also need to see a hematologist. This is because I had a DVT (blood clot) in my left leg a year ago and there was no obvious reason. No surgery, no bumps to the leg, nothing out of the normal and my blood pressure and heart beat all tested out relatively normal. this came as no surprise to me: Julia had mentioned it last year saying that we could rule out a clotting disorder if I saw a hematologist. We need to rule out a clotting disorder before I go into surgery.

The fun part about this upcoming appointment is that it is at 4PM. I’ll be driving home in high traffic. It’s OK, I’ve done this commute before, too many times to count. I told my husband he is not allowed to come with because I don’t want him to be in the car with me when traffic comes to a dead stop. And starts again. And stops again. he’s not good company in heavy traffic.

I do know the surgery will most likely be a simple lumpectomy and that one lymph node under my left arm will be removed for testing. I was advised Saturday by a cancer survivor that the injection of dye into the breast is the worst of it that no one tells you about. So yay for implanting that bit of knowledge into my nervous system.

Telling friends and family has been … interesting. A lot of “I’m so sorry you are going through this” comments and virtual hugs. I don’t want anyone to feel sorry for me. I am going to be okay. Two friends broke down and cried. But I still made summer plans with one of them. My family… Well, my brother made jokes (I love that guy). I know they are all there for me, if I need them. But I am still making summer plans with some of them. I’ve heard privately from other dear friends, encouraging me. All the same people who reached out when our son died.

This has been a lot more serious than I intended it to be. I was planning on making jokes all the way through. I’m not far enough into the process to make this journey humorous, but – trust me – I will find a way.

The photos I am using were sent to me by a very dear friend shortly after my last post. She said they were the first images she saw after she read (and deciphered) my last post. They are of the Oregon Coast. They are proof that I am blessed. Very blessed.

Please do not feel sorry for me. This is just a little stumbling block. I’m in good spirits. I’m hopeful. I am grounded.

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This is Only Going to Hurt a Little Bit

April 14, 2023 by Jaci Dawn

Liar, Liar, Pants on Fire!

Today was Biopsy Day. I’m recording this, not because I am afraid I will be diagnosed with the dreaded breast cancer, but because I think women should know. And men who are married to women or in a relationship with a woman or have a woman in their life that they care dearly about.

First, they did a second ultrasound so they could mark my left breast for the incision. Promised me that I would be injected with lidocaine and that would be the worst of it. I know all about lidocaine and the pain of that injection. Definitely was not looking forward to that injection. I have been to the dentist too many times in my life to even think it wouldn’t be painless (and dentists use lidocaine’s cousin, novocaine). Besides, all of this entails a very large needle inserted into my body.

I do not do needles. I close my eyes at the dentist’s office and I turn my head when they draw blood at the doctor’s office. I cringe when I get a vaccination. The only Vax I ever got that didn’t hurt was Covid #1 and Covid #2. True story. I didn’t even bleed either time which befuddled the paramedic giving them out who was ready to put a bandage on the injection site. No blood, no mark.

Otherwise I bruise and turn purple. It’s just a fact. You mention the word “bruise” in a medical office and my skin immediately turns purple.

They mentioned the word “bruise” today. I haven’t been able to peek under the bandage, but I’m pretty certain I turned purple.

All the prep went well, we were on schedule, the radiologist was a pleasant person, and then came the big needle. Oh – did I mention the ultrasound imaging was right in front of my face so I could watch the needle being inserted into the fattty tissue? And that I don’t do needles? There it was, in front of my nose, long and silvery, and then came the sting of lidocaine. And more. And more.

I neglected to advise the radiologist that I usually need extra novocaine when I have the dentist work on a cavity in my teeth. OOPS.

That first biopsy was a searing fire-hit needle into my breast and beyond. My eyes watered. I almost cried out. I certainly gripped the handles of the guerny. DAMN! So – more lidocaine. But not enough. SHIT! More lidocaine. Third times the charm.

BUT – during the pre-biopsy ultrasound, they discovered another “suspicious” mass they wanted to biopsy. “Not a real concern, but we’d have to monitor it every six months…” and my brain screamed: you mean the smash-smash-smoosh-smoosh EVERY SIX MONTHS?!” Nope, nope, nope. I just went over fifteen years since the last one and now I’m being subjected to more torture. NO. Biopsy the bastard.

So the first needle went in and it stung like a bee sting. I lied and said I felt nothing. JUST GET IT OVER. The second needle hit my nerves like a yellow jacket with purpose. My breast will never be the same. The third shot… well, the numbing medication went into effect and I felt nothing. Heavy sigh.

But- but, but, but – they aren’t finished yet. Because now there is a “light pressure” mammogram on the plate to make certain the little metal markers inserted are where they need to be.

Oh, did I fail to mention that part? They insert little metal markers with cute little names into the position of the suspicious mass so they know what they biopsied. Site A gets one marker and site B gets another marker. They are different shapes. Site A has an oval marker and site B has what they names “infinity” but it isn’t actually an infinity symbol. Someone flunked math. It’s more of a corkscrew and I would have named it the “Wine Marker”.

The light pressure mammogram was exactly that: at least they didn’t lie about that. But I had to wait with a little sticky ice pack on my breast while the radiologist reviewed my files. Can’t risk swelling.

I am home now. Ice on every 20 minutes and off every 20 minutes. I can feel the incision and the path of the needles through my fatty tissue. Can’t remove the bloody bandages for 76 hours. No lifting, no planting flowers in the garden during these exceptionally warm April days, and sit still. I’m excited.

I get the results in two to three business days (Tuesday or Wednesday next week). I’m leaning toward they will be benign and all this hoopla will be for nothing because that is my medical history: all panic in the foreground and nothing to worry about after the tests are done. I hope this for every woman (or man) who has to undergo this kind of scrutiny/injections/biopsies.

I will post updates next week. Until then, scrunch up your battle face and do the mammogram. ‘Kay?

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The Dreaded Smash-Smash-Smush-Smush

April 10, 2023 by Jaci Dawn

If you don’t know what that is, you are most likely a male of the homo sapiens. It is a sadistic medical procedure women put up with (at least some women do) annually or every other year. I did it twice in my mid to late thirties. That was, um… a while ago. Quite a few grandchildren ago. I mean, I raised my kids, saw them grow up and start their own lives after that last mammogram in the 1900’s. Yes, that is correct: back in the 1900’s. Like a century ago. Last century, anyway.

(I hear my son making some snarky comment about my age and my close relationship to Moses. Damn, I miss that kid’s snark.)

I have dodged every mere suggestion of a repeat of that last Smash-Smash-Smush-Smush because that was *exactly* what it was. The tech was a sadist. I only went in for that second one because the first tech was kind and gentle and didn’t attempt to smash my 32A breasts to nothing. The second tech didn’t care anything about my pain. She screwed the plates down hard and taut and then took her sweet time taking the images while I bit my tongue. I swore I would never – NEVER – endure pain like that again unless I was somehow placed in an internement camp and set up for torture.

I am not unsympathetic to breast cancer survivors. I know a few and have known a few who survived for a few years. But I had tiny little bumps on my chest and they were easy enough to do a routine, monthly, self exam. No cancer history that I know of in my immediate family. And a healthy respect for Erma Bombeck’s description of the procedure. Erma was a breast cancer survivor and knew what she was writing about when she described a mammogram in detail. Do yourself a favor and “google” “Erma Bombeck Breast Cancer.”

Erma was far funnier than I can aspire to be.

I know a group of women in my prayer circle who refuse to do the procedure. They dodge it as skillfully as an athlete in a dodge-ball game. Me, I’m more the kid who gets hit with the ball and leaves the game with a big bruise on my belly from the impact. Still, I managed to dodge that ball for a couple of decades. I just forgot I had a referral.

I had enough other medical issues to deal with that seemed much more important. A bleeding kidney that turned out to be nothing at all and which suddenly ceased bleeding after three years of medical tests and questions and procedures. Some skin cancer that had to be scraped off. A broken foot that revealed I have thin bones and needed to go onto medication to try to rebuild the bone and strengthen my skeleton. A little this, a little that. Always something that turned out to be nothing at all or something highly treatable. Last year’s heart scare (which was probably more about a broken heart than any actual physical issue). High blood pressure which is currently under control. A wounded rotator cuff that just sucked eight weeks of my life into physical therapy.

Okay, the PT wasn’t all that bad. I started with a shoulder so frozen that I couldn’t raise my arm over my head and I graduated eight weeks later with almost full motion restored. I still have a lot of exercising to do, but I reached my personal goals of being able to life and reach and GARDEN (if only the rain gods would relent and allow me to get my fingernails dirty).

My Primary care Giver (PCP) is a wonderful person. She has four children, same as my daughter: three boys, one girl. She sets me up with referrals that I don’t always follow through on and forget about until we meet the following year: “Mammogram? Oh, gee. I didn’t do that.” But she got me this year.

I have to have bone density tests every couple of years in follow up to that painful instep break I managed to do to myself a number of years ago. I fractured two metatarsal bones in my right foot by slamming my foot into a bed post in the dark. I climbed into bed and cried until I fell asleep. Only when I woke up and needed to get up and pee did I know how badly I’d mangled my foot. The pain was not pretty. Let me give birth to a ten pound baby before I have to step on a broken foot again. (For the record, I did give birth to a ten pound plus baby and it really was *not* as painful as trying to put weight on a broken foot.)

Besides, the baby had certain rewards that came with his birth. A broken foot only precludes you from jury duty, driving a car, and running a marathon. The baby came with a certain sense of snark, sticky fingers, and a penchant for making me laugh whenever I was angry at him.

I saw my PCP in January. She ran the usual tests and we talked about the usual things (“have you had a mammogram recently?” “Nope.”) and she sent out some referrals. One was to physical therapy and two were to the local hospital for imaging. I figured I could do the bone density test and sneak away without a mammogram yet again. Score!

It didn’t work out that way. I called the hospital to set up the bone scan, but the bone scan is done in the same department as mammograms and the scheduler had both referrals in front of her. I wasn’t prepared with a good excuse so allowed her to schedule both tests on the same day, just 30 minutes apart. I thought I might buy a bottle of wine in celebration after – or I could hope that the sadist was an anomaly and I’d get a sympathetic tech like my first mammogram tech. Worth a hope, anyway.

The bone scan was easy. I still have a lot of work to do to rebuild bone density.

I have gained a lot of weight during retirement/Covid. My breasts are no longer mere 34A, but are more 36B. Fat has its benefits. Muffin tops are not something to be proud of, but that’s where I am in this stage of life. I even had to hold some of my fat out of the mammogram. Literally. I’m 25 pounds over what I used to be and it’s all settled on my waist and above. It used to settle in my butt. I don’t know which I prefer. Well, I do: I prefer to be 25 pounds lighter than I am now.

Probably too much information, but I am at a stage in life where I really don’t give a flying flip. This is what women go through: body shaming, fat shaming, breast shaming, butt shaming. Age rounds our faces and adds wrinkles. We lose our upper arm strength and musculature. We get thinning hair. Unwanted whiskers grow on our chins and out of our moles. (I understand men go through similar physical changes. I can’t speak to that. I am not unsympathetic.) Sometimes we get benefits: I no longer grow hair under my arms or on my legs. I haven’t needed to shave in a decade. Benefit.

The mammogram tech was very kind and gentle. Everything went painlessly. Then I got the results: asymmetry in one breast. Well, no surprise: my breasts have always been asymmetrical. One larger and the other smaller, and neither one lines up like my eyebrows or my ears. It’s like the angels who worked to create my body didn’t communicate. It’s probably why I make weird sculptures. What is perfect and symmetrical, anyway? Nothing of Nature.

Here’s the kicker: if you don’t have regular mammograms, your old results “disappear” after ten or so years. There’s no “baseline” anymore. The techs don’t know what your mammograms looked like before. It has been a lot more than ten years for me, so – no “baseline” for comparison. I could tell them that dense breasts are my baseline, but they don’t have that data. That data died during Y2K. Just kidding – it was probably still available for a few years after that supposed “crash” of the Interwebs. But it definitely died in the mid 2010’s. They need you to come back in to establish a “baseline” for the results.

Another Smash-Smash-Smush-Smush. And this one was not as nice as the former. I will say that the tech today was not a sadist. She tried very hard to not put me in pain and she hurried to take the images so I wouldn’t scream in pain while she did it. Then she ushered me to the ultrasound tech. My poor bruised breast complained as the tech ran the ultrasound over the smashed and bruised flesh of the breast in question. I practiced breathing techniques and meditation.

The result is a .5 x .5 x .8mm “something” in breast that has never had anything show up on a mammogram. At least not 20 years ago. But it is there now. I have to go back for a biopsy.

I am a little surprised: nothing ever amounts to anything for me, medically speaking. The radiologist said it was probably a very recent growth given the size. I find myself running through “worst case scenarios” and none of them are that bad. But it is certainly a wake up call to myself and my group of friends who are mammogram deniers. Maybe we should test at least every five years and insist that the tech be extra gentle with our tender bosoms.

And a note to mammogram techs: a little empathy goes a long way. I will probably never forgive that —tech— from years ago. She was a sadist.

I am not particularly worried. It’s just another thing the 2020’s has thrown at me. Another irritation as of this writing. If it is something, it is still another irritation. But – perhaps – i should not be so cavalier about mammograms. I owe my breast cancer surviving friends and relatives an apology for poo-poo-ing this sadistic procedure. The medical industry owes us a better way to examine breasts.

End of the story: I have a biopsy on Friday. No results until next week. I have daily plans next week that I will not renege on.

Until I know…

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