Life is cray cray here.

I haven’t written because things are changing so quickly. There has been no time to process and disseminate one issue before another arises. So please, forgive the length of this post as I try to catch up here.

When last we left our cancer-ridden heroine, I was contemplating the meaning of pain in the aftermath of my first lumpectomy. While boob-life has not been easy since, I’m happy to say that remains my most pain-ridden moment to date.

Every surgery/procedure has an epilogue called The Pathology Report. I’m learning quickly that the Path-Port is really the next-steps Bible for cancer, more so than any other lab report to come out of treatments, because it’s dealing with Bob & the Bobettes. The doctor cuts them out of me and the white-coated folks take over, aiming their microscopes and stains on B&B to learn more about these invaders. I like to think of the Path-Port as an alien autopsy, Hangar 51-style.

So the Path-Port from the first lumpectomy came in right after my last post, and it wasn’t good. Remember those margins I talked about? The doctors want clear (cancer-free) areas around the tumors that they cut out. Well, my margins were not clear and I needed to go in again. In fact my margins showed more small Bobettes that weren’t showing anywhere in all of the other tests and scans I’d had to that moment.

And this very point, that I had things growing in my boob that were not easily found, led to the second revelation of the now Dreaded Path-Port. If I had so many small satellite malignant tumors lurking and growing in the breast, it was still possible for one or more of them to spread to other parts of my body. These would still be too small to track (needle in a haystack-style) which would make them even more dangerous in the future. The only real option for ensuring that I would not have a problem with these potential “colonists” (my wonderful doctor’s word, not mine) would be to have chemotherapy.

Chemo is a blow. While I completely understood and agreed with the problem and solution, Stephen and I reeled with the news.

Chemo is what sick people get. Really sick people. Emotionally, I still hadn’t absorbed that I was really sick. I felt good, I couldn’t feel lumps and I was told and I believe (still) that I will be cured. So how could I be considered sick, with something as major, as deadly, as cancer?

And if I wasn’t really sick, there was nothing for me to be afraid of. That’s right folks, I had not felt any real fear during any of this. I had yet to be afraid.

Chemo stripped away my emotional innocence, and my arrogance, because I was now afraid. Very afraid.

Still my fear wasn’t coming from a fear of dying—they keep saying I will be fine­. My fear is of becoming so sick that I actually would feel like I had cancer. To me that’s the main side effect of chemotherapy—feeling like big crap. Big Crap. BIG, BIG CRAP.

(Not doing chemo when it was recommended was never an option. My maternal grandmother, my only female relative to have breast cancer, died from it because she opted NOT to have chemo or radiation after her mastectomy. She died two years later when it spread to her brain. Not pretty.)

On Sept. 2, Stephen, Samantha and I were back at the Aspen Surgery Center having a second lumpectomy, knowing that chemotherapy and radiation would be my protocol after. This surgery was much simpler, because the only good news from the Path-Port was that my two sentinel lymph nodes—which act as the primary conduit to spreading cancer throughout the body—were clean. So we didn’t need to take more lymph nodes, only go into the breast again for the margins. And I didn’t need to become the Borg again, because we weren’t working with a large main tumor, but with small Bobettes. No wires, no dyes, woohoo!!

I flew through that second surgery, and landed back at work and active the following week, thinking all was good. Yep. I was done with surgery. No worries at all. They got the Bobettes out of me. In fact, Dr. B basically performed a partial mastectomy this time to ensure that she had clear margins. (Stephen remembers her saying that she took a big chunk out of me this time because she didn’t want me on her table again—which we found very amusing and reassuring. None of us wanted me on her table again either.)

Samantha, Stephen and I attended Chemo School. Yes, that is what it’s called. We were told I’d be on a four three-week cycles of TC. TC is the cocktail they chose for me. I would have many other things to help me survive the chemo, like anti-nausea meds, steroids, Neulasta (to increase my white cell count to help fight of nasty bugs) and more. While the TC guarantees me losing my hair, it’s a good all-around chemo for us to use as a proactive measure. Twelve weeks and I should be able to work through most of those days.

We scheduled the start in early October, after the Simi Valley Relay for Life on Oct. 1 and 2, for which I had taken over as team captain for a friend who wouldn’t be there for the event. We were set and I was starting to do my research into surviving and thriving during chemo and using cold caps to save my hair. (More on that in a later post.) I was intent that I would be the best, most functional chemo patient possible.

I’d forgotten about the second Path-Port. Completely, totally forgotten. I was so focused on our next steps and planning as much as I could that when Dr. B called me last Thursday, I figured it was just a follow up.

Instead I found myself shaking and crying in an empty office with a dear, dear co-worker holding my hand while Dr. B went over Path-Port: The Sequel.

My margins were not clear. They found more microscopic tumors and cancer cells, and some slightly larger ones. This time I would need a mastectomy. They would need to take my breast. Take. My. Breast.

I couldn’t breathe. Here I thought I’d gotten around needing to lose my breast and two surgeries later it was bye-bye boob.

It’s a little hard to put solid words to such strong emotions, but I’m going to try and ask you to bear with me in this. And do know that I’m past needing reassurance about my womanhood, identity, usefulness of my boobs and all of those other things we hope will sound reassuring. I am okay at this point, but I had to process this all first, and that’s what you get here—my process, and it’s intimate.

(WARNING: THIS IS INTIMATE. IF THAT WILL BOTHER YOU OR IF YOU THINK YOU WILL KNOW ME BETTER THAN YOU WANT TO, THEN DON’T READ. BUT I PROMISED MYSELF TO BE HONEST HERE, SO…)

For some women, from what I’ve been told, their boobs are not necessarily an appreciated portion of their sexuality. (Yes, I’m finally venturing into the world of sex here.) That’s not the case for me. I have always appreciated the sensations that come with happy boobs. (My daughter is now running around in circles, clamping hands over her ears and screaming, “Stop talking now!” Okay, Dear. Enough said.) There is a very sad part of me that says losing one or both of my boobs is like a lower-version of castration. I am without those sensations forever more. That’s a loss. A very personal loss. One that I have NEVER heard anyone put words to. And I think we don’t talk about it because the bigger concern is living, and with the close second concern possibly being gracious, well-mannered ladies in the process. Obviously I agree with the first part (I am now afraid that I will die, just in case you were wondering when that emotion was going to final arrive) or I would not be moving forward. As for the second, judge me as you will.

But, I certainly don’t have to like it.

The other change that comes with Path-Port: Part Deux is with my chemo. Now that we’re seriously concerned because we really don’t know what the hell is happening in my boob, we need to get more aggressive with my chemo. What was 12 weeks total of TC will now likely become 8 weeks of AC (which I’m told could make me fetal-curl-crying-for-mommy) followed by 12 weeks of T. All of these acronyms and the order and combinations in which they appear are for specific chemo drugs. But I really hate science and I’m getting tired of my forced indoctrination, so I’ll let the very curious research these solo. It’s all very searchable on the Net.

Wrapping an overly long update here, I’ll say that my surgery is scheduled for next week. Chemo will start 3-4 weeks after. And radiation is still on the table. I will post later about reconstruction and options and what they all mean, but for now me, my family/friends and my doctors are committed to and confident with the approach of cutting the damn cancer out of me and poisoning what’s left. And at the end of it all, I will be okay. They still say this. I will live. I will thrive and I’ll have some perky new boobs to go with my renewed life. Amen.