Acid Trip – Part 2: Rapid diagnosis

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Thursday: I got an ultrasound on Edward Street during the lunch break from jury duty. I mentioned to the technician that I was leaving on Sunday for Oakland, for a week. I was scheduled to present a paper at Diversity Rx, a national conference on quality healthcare for diverse populations.

She stopped scanning for a few seconds.  “You have to wait for the results. You may not be going anywhere.”  With that statement, my heart skipped a beat.

After the scan, the technician left the room with my chart and brought it to the radiologist, asking that my case be reviewed next.

At the end of the day, I left through the back door of the courthouse and saw, for the first time, Eldon Garnet’s 2012 sculpture of a lion and a lamb sitting on a level plank.  The plank is perfectly balanced on the tip of a pyramid bearing a quotation I know by heart from the Charter of Rights and Freedoms of Canada: “Every individual is equal before and under the law and has the right to the equal protection and equal benefit of the law without discrimination.”

Funny, I thought.  Cancer does not discriminate either.  Rich, poor, healthy, unhealthy, fit, couch potato, loved, unloved.  No one is spared for good behaviour.  Or for any behavior.

I called my Community Health Centre (CHC).  They had already received the results.

Friday: I was at the CHC when they opened to get the news in person: I needed a biopsy.  I saw Nghi, the same nurse practitioner I’d seen earlier in the week, and another nurse practitioner, Rosie, whom I’ve known for 15 years. She said she knew how anxious I must be, not knowing.

Thinking about what the ultrasound technologist had said, I asked Nghi and Rosie if delaying the diagnosis for a week would impact outcomes, and they assured me it wouldn’t.

I connected with a friend and colleague at the Princess Margaret Cancer Centre and managed to get a referral to the Rapid Diagnostic Breast Clinic. Rapidly.  An appointment was booked for the morning after my return from Oakland.

It helps to be a staff member at University Health Network when you need any kind of care.

On March 18, at the Rapid Diagnostic Breast Clinic, I first met with Sandy, a nurse practitioner, who explained the sequence of the day.

She also asked if I had an Eastern European Jewish background.  I was taken aback.  Is she asking because of my name?  “Yes,” I answered, wondering why that would be relevant.  Sandy told me about the BRCA gene that is carried by some people with an Ashkenazi background, which means an increased risk for breast and ovarian cancer in women, and prostate cancer in men.  She encouraged me to get tested.

The mammogram and ultrasound were repeated before the biopsy.  When it was all over, I was told to come back in four hours for the results, which is nothing short of revolutionary. Thanks to a $12.5 million donation from Emmanuelle Gattuso and family, women can get biopsy results same day.

I live downtown.  I went home.  I poured a glass of Prosecco and drew a bath, with Epsom salt and lavender oil.

Before I climbed into the claw foot tub, I already knew.

I knew because of the technician’s urgency to have my results expedited.  And because Rosie had probably seen enough mammogram and ultrasound reports to know when someone is about to be diagnosed.

As I soaked and sipped Prosecco, I listened to music that my daughter had loaded on my phone.  Each song seemed to speak directly to my state of mind and circumstances. I had a few short hours before hearing my diagnosis, and I had every intention of enjoying the liminal stage of waiting for the results.

The fact is, I have so much to be grateful for, and I had documentation.  About 18 months before the lump, I started a gratitude journal. I wrote about things big and small, moments and experiences, gestures and what I called “gifts from the universe.”

Hardly a day went by that I didn’t shake my head at how fortunate I was.  I felt like Julie Andrews in The Sound of Music, when she sings “I must have done something good.”

I’ve always considered myself lucky because I was born into a North American, middle class family with parents who loved me and told me I was capable of accomplishing anything I set my mind to. I would always have a roof over my head, access to clean water and didn’t have to worry about where my next meal was coming from. My work is fascinating and rewarding. My extraordinary children, Emily (23) and Solomon (16), are happy and healthy.  I have an amazingly loving family, and I love and am loved by friends who feel like family.  My romantic life could fill novels.

In short, life was better than I had ever dreamed it could be.

With my body immersed in hot water up to my neck, blissed out on the music and my last moments of ignorance, I thought, “I have to take some bad with the good.”

Back at Princess Margaret, this time accompanied by a close friend, Sandy met with me first to tell me the tumour tested positive.

I wasn’t surprised. “I figured it would be,” I said.  Sandy asked if I needed a minute, but I didn’t.  I said I was okay and asked what my options were.

Although I could choose a mastectomy and immediate reconstruction, she said they recommend a lumpectomy.  I asked her what stage it was, and she said, “Probably stage I or II.”  Sounded good to me. Early stage, easy to treat.

My friend, who had known about the lump since shortly after the discovery, was very sober after Sandy left the exam room.  “Are you ok?” she asked.

“Yeah, I’m ok,” I said, and meant it.  I was completely relieved at dodging the mastectomy.

When David McCready, my breast surgeon and head of the Breast Program at Princess Margaret Cancer Centre, came into the room, he examined my left breast matter-of-factly.  It could have been an apple at a greengrocer’s. He reiterated information that Sandy had given us and recommended a lumpectomy.  Breast-conserving surgery and radiation had the same outcomes as mastectomy.

“I’m so glad I get to keep my breast,” I told him. “I like having two.”

I asked about prognosis, but David said he doesn’t like to get into the “numbers game.”  Everyone is different.  At Princess Margaret, he explained, they practice evidence-based medicine and give “maximum treatment and expect the best outcomes.”

He left and two nurses came in to obtain my consent for the lumpectomy and sentinel node biopsy.  We started talking about surgery dates.  I opened my agenda to the page where you can see the entire year.  I had diligently highlight my away dates over the next few months.

The nurses looked at the page and then looked at me, with supportive and knowing smiles.  “You’re going to have to cancel your plans.  You have to put your health first.”

Yeah, right.  As if cancer could keep me from the maiden voyage of the Norwegian Breakaway, following the same course as the Titanic, with my daughter and our dear friends, or a presentation at a World Health Organization conference in Sweden.

A decision to cancel such singular events would just be feeding my own fear.  What if I never had the chance to do these things again?

I closed my book and said nothing.

Breast Cancer: How Your Mind Can Help Your Body

6 thoughts on “Acid Trip – Part 2: Rapid diagnosis

  1. Michelle Gariepy

    Elizabeth, I just learned about your story today, from UHN’s intranet posting. I thought you were off on a secondment in another country and living the high life. You are courageous to share your story – thanks for your honesty – I was alternating between tears and laughter. Best wishes to you and your family.

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