The end of cleavage?

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Six months post-op

Six months post-op

My grandmother used to complain, regularly, as though it was a moral failing on my part, “You got nothing, just a pair of fried eggs!” A line that never failed to amuse when I repeated it to friends.  I still have a t-shirt with strategically-placed fried eggs that a friend painted for me.

That was before I had children.  My breasts (and ass) have puffed out since.  My dear friend, artist Harold Van Johnson, says I’m disproportionate. I’m thin with tits and a caboose, an hourglass figure I never expected in my youth.

I’ve enjoyed having a nice rack.  I like the attention.  I look good in clothes.  My tits have been painted, photographed and sculpted by artists.  I don’t think I’ve ever taken off my clothes without a reaction such as “Wow!” “Great tits!” or “Mamma-mia-bellissima-donna!” (all one word when uttered in an emotional state).

As I got older, I found the traditional underwire bra insufficient for my ageing torso.  I went to Victoria’s Secret and approached a young saleswoman: “I’m 42. Gravity is taking over.  I want my tits to be closer to heaven. If they can talk to god, even better.”

She laughed and told me to follow her.  She had just what I needed.

I entered the era of the push-up. Not the kind that adds an entire cup size–that’s just deceiving–but the molded cup with a little padding at the bottom, towards the outer edge, giving a significant oomph to the bosom.  Defying gravity.  Perfect.

And I rarely miss an opportunity to show them off.  I keep it conservative at work, but otherwise I’m in tight and/or low-cut tops and dresses.

My father car once complained, “Why is it that, whatever you’re wearing, I can see your bra?”

“My bras are expensive and beautiful.  I’m sharing the joy they bring me with the rest of the world.”

When offered the choice of a mastectomy or a lumpectomy, I didn’t have to think.  I wanted to preserve my left breast, knowing that it would look different than my right one.  Keeping my nipple was particularly important.

After the bandages came off, I was pleasantly surprised. Not bad! Yes, the lower left quadrant of my breast was missing a chunk of tissue, and my nipple pointed slightly laterally, but it was still a fine breast.

And to my great fortune, the padding in my bras from Victoria’s Secret (and Yamamay, an Italian chain) filled in precisely where my breast tissue had been removed.  In clothes, you can’t tell I’ve had surgery.

I recently hosted a party and wore a short, turtleneck dress.  After an hour or so I was roasting like a chicken.  I asked my daughter Emily, Should I change into something skimpier?

She responded, “You insisted on keeping your tits.  Now let’s see ’em!”

So all was jolly and fun until I started seeing a specialist in lymphatic drainage.  A result of my first breast surgery, I had developed lymphedema in my torso, specifically, in the area behind my left underarm. Lymphedema is a common side effect of breast surgery, and it can develop any time, soon after surgery or 20 years later.  It’s a lifetime risk, and it can be debilitating.

My specialist said I should be wearing a compression bra, and avoid underwire.

I am the most compliant patient on the planet, but there have been several moments when I’ve had to draw the line.  That is, I would rather die prematurely than change who I am and how I live my life.

The first time was at the Lymphedema Clinic at Princess Margaret Cancer Care.  As a staff member, I asked for a private session on Lymphedema Awareness.  It was a 45-minute slide presentation on all of the things I have to do (e.g., wear gloves to wash dishes, rub olive oil into my cuticles, slather lotion all over my body) or can’t do.

The clinician came to this slide with a drawing of a woman and a man in a hot tub, with a thick red diagonal slash across it.

“Avoid hot tubs and jacuzzis,” she said.  “Heat increases lymph fluid.”

I was quiet when she named all the other things I had no intention of doing (gloves, cuticles, lotion), but now I had to speak up.

“No jacuzzis?  I’m sorry.  Not only am I going to continue to enjoy hot tubs and jacuzzis, I will continue to seek out opportunities to enjoy them with a hot dude.” (Better yet, two hot dudes.)

couple-jacuzzi-spa

I had the same startled reaction with the compression bra.

(Important note: I rarely leave the house without looking as though I’m headed to a dinner party.  Make up, flashy outfit, cleavage.)

The specialist saw the fear on my face and gave it to me straight: “There is nothing sexy about compression bras, unfortunately. But Spanx makes some camisoles and tanks that work well.”  She also gave me a list of authorized compression garment fitters.

I went straight to the lingerie section of The Bay and purchased a couple of Spanx camisoles (which bind my breasts like Hilary Swank’s in Boys Don’t Cry) and a DKNY shape wear slip, knowing I would need to hire two men to get me into the garment.

I wore one of the Spanx camisoles that night, to attend the Ryan Driver Quintet’s CD launch, a collection of Emily’s father’s songs of heartbreak: The Stephen Parkinson Songbook.

It was a lovely event.  I saw a lot of people I hadn’t seen in a long time. However, my breasts were like two fried eggs. I felt self-conscious and anti-sexy.

The next shop I visited, the following Monday, was the compression garment fitter next to the hospital, .  It was a dreary lower level shop in the Ontario Power Generation building.  “Good morning,” I said to the two women at desks behind the counter. “I’m looking for a compression bra in black, low-cut, push up.”  They stared at me and said nothing.  “I’m kidding,” I said, even though I wasn’t. “But I do need a compression bra.”

One of the women gave me a couple to try on. I tried. It was not going to happen.  I will not go from 48 to 68 overnight. I can’t. 

I returned the items to the woman and thanked her.

If I was going to beat the lymphedema, it would have to be with my current collection of bras, which, as it happens, all have thick bands that kind-of, sort-of compress the area where I have fluid collected.  I also wear the Spanx camisoles if I’m not going out.

Lymphedema status report: After five weeks of working with two lymphedema specialists, and daily lymphedema self-massage, the lymphedema is definitely improving!

Yes, I have had breast surgery and still have cleavage.  Not all women who have or have had breast cancer are so lucky.

Links to information about lymphedema and treatment:

Complete Decongestive Therapy

Canadian Cancer Society

Spanx Camisoles and Tanks (for compression, choose Super-Duper or Ultra Slimming Level)

Best to wear a compression sleeve when exercising to reduce lymphedema risk.   You don’t have to settle for those pasty-looking beige numbers from the medical supply shop.  Check out Lymphedivas for striking, sexy, make-a-statement sleeves.  (If you are in Canada, use the Lymphedivas website to select your sleeves, and order from Winnipeg-based Accucare Canada to avoid duty, shipping and taxes.)

And if you want to have fun in a jacuzzi: Tierra del Sol

The Most Wonderful News Possible

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One very happy family!

One very happy family!

Monday June 23 was the best day ever.

While I continue to document my Acid Trip of Stage III breast cancer and spinal cord resection, I have remarkable news to share.

I picked up my lasted mammogram results through a patient portal on Sunday and confirmed on Monday with my surgeon David McCready.

Comparison is made to prior study of January 27 2014. The patient status post lumpectomy on the left.

BILATERAL MAMMOGRAM
FINDINGS:
The breasts show scattered fibroglandular densities.
There are no dominant nodules or suspicious calcifications seen in either breast.
IMPRESSION: No evidence of malignancy. Routine follow-up as recommended.

Emily, Solomon and I cried tears of joy, over and over. Although the risk of recurrence is high, I’m in the clear for now!

We left the hospital with an indescribable sense of relief.

A Shout-Out to my Sponsors

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It’s fair to say that my father and step-mother saved my life.

My father and my step-mother, Sharon, have been rocks of strength since I was diagnosed. My father and I, and usually Sharon too, have spoken almost every day since my diagnosis.

Sharon is a wealth of good advice.  She told me right away how to manage: meditation, diet and exercise, a recipe I have followed religiously.

My father, it seems, meets a cancer survivor every day.  He is full of stories of remarkable recoveries, and he calls me when either of them find an article or see a broadcast on a promising remedy for breast cancer.

However, I sense my father may be even more affected by my diagnosis than my children.  Like every parent, his worst fear is that something may happen to one of his kids, and cancer happened to me.  A nasty case of it.

Six months into my treatment, my status changed from short-term (full salary) to long-term disability. My income dropped to 65% of my salary. After mortgage and utilities, I had less than $250 per week for food, transportation, clothing, prescriptions, insurance and sundry expenses for myself and my 16-year-old son.

I had lymphedema following breast surgery, and following spinal cord surgery, left-sided weakness and limited neck rotation.  I had exhausted my extended health insurance for lymphatic drainage and physiotherapy.

My son, Solomon, who is naturally but severely underweight, had turned into a human vacuum.  He wanted meat constantly.  My vegetarian, anti-cancer diet was neither sufficient nor appealing to him.

NB: A piece of advice to everyone in their 40’s: buy critical illness insurance immediately.

I had the term of my mortgage extended, which freed up all of $100 a month.  After a full day crunching numbers, I simply couldn’t apply lean theory to my income any further. I lay down on my bed and started crying.

My choices: I could sell the house and move to an apartment, although a two-bedroom apartment in Toronto, above ground, is about $2,500 plus utilities, higher than my mortgage.   I would be living on my equity, but Solomon would have plenty to eat, and I would get the therapy I needed.

The other option was to just put an end to this Acid Trip.

It made perfect sense, at the time: better to control the end of my life, and leave my children with start-up funds, than to let them watch me succumb to cancer.

It wasn’t the first time I considered suicide since my diagnosis.  I was terrified of my future, of being transformed by multiple surgeries and assaulted by toxic substances.

The decision made perfect sense before I spoke with my dad.

I didn’t mention my suicide ideation.

My father could tell I was in a low spot, and he asked what was wrong.  I simply told him that I could no longer afford groceries or the medical treatment I needed for my cervical spine and lymphedema.

My father didn’t hesitate, “What are you worried about money for?  Money shouldn’t be an issue. I’ll take care of you.  I’ve got your back.”

He called later to tell me he was going to send a credit card. “Don’t call and tell me what you’re buying or what things cost.  I don’t have time for that bullshit.”  Just like that.  Problem solved.  Amazing.

I tell people that my father is like Tony Soprano, but Jewish.  And older.  He’s the iconic patriarch of the Abraham Family Circus.

Again I cried, after I got off the phone with him–tears of relief this time.  And maybe I cried on the phone, too.

When the credit card arrived, Solomon and I headed straight to Whole Foods.

We bought a cornucopia of fresh fruit and vegetables, nuts, dairy products and alternatives, juices, meat, meat, and more meat, and a stockpile of healthy snacks for Solomon.  I bought vitamin supplements and cancer-preventing/cancer-fighting powders to add to smoothies.  (I know, it’s probably too late.)  The .cart was filled to the brim!

We bought over $400 worth of food.  Never in my life have I purchased so many groceries.

Solomon was so happy and grateful.

With a tremendous sense of relief, I returned to my physiotherapist and lymphedema specialists.  I also started working with integrative cancer care specialist who looks at all aspects of the patient, including diet and nutrition, mental health and social support. And I joined the gym at the Jewish Community Centre.

Months earlier, before the spinal cord surgery, my family physician had told me that I would need time to recover after my treatment was over.  She said I should take take a vacation, get out of Toronto.

I started planning my Recovery Tour long before my treatment finished. The thought of it kept me going. I got through six weeks of daily radiation without complaint because I knew I was getting the fuck out of town as soon as it was over.

I was planning to withdraw from my retirement savings for the Recovery Tour, but I believe Sharon convinced my dad to cover my expenses.  He left me a voice message. “I’m treating you to an all-expense paid vacation.  Just have a good time,” he said, “and get better.”

After an extended stint of unadulterated rest and relaxation with friends and family, far away from the hospital, I was indeed a happier, stronger person.  I felt as though I finally achieved comfort with uncertainty.

I’m no longer worried about how much time I have left on the planet.  How I choose spend my time is the more important question. Thanks to my diagnosis, and my psychotherapist, I am acutely aware of the preciousness of life.

We are, all of us, here for such a short time.

To Dad and Sharon, thank you. 

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Emotional Side Effects of Cancer 

The Psychosocial Impact of Cancer on Older versus Younger Patients and Their Families

Acid Trip Part 5: What makes cancer seem small?

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Spinal cord compression made cancer seem very small.

Once symptoms of spinal cord compression started, they progressed rapidly.  Each day or two, another part of one of my limbs went numb.  My right foot, my left forearm, my right lower leg.

I could feel pressure in these areas, but I felt as though I had a layer of latex over my skin, as though I was wearing a pair of rubber gloves, or a wet suit.  Climbing a flight of stairs, something I normally do effortlessly, my legs had become heavy. I was breathless.

I emailed my surgeon’s administrative assistant assistant a couple of times, left several messages, but received no response.

My right thigh held out the longest. I remember cycling back home from Kensington Market and thinking to myself, “at least I have sensation in my right thigh.”  But by the time I got home, it too was numb with peripheral neuropathy.

Nevertheless, I continued to exercise five or six days a week. My daughter, Emily, and I were gym buddies.  We did cardiovascular work, then abs, gluts, and arms.  Emily had a habit of increasing the number of reps on a weekly basis.  “If it doesn’t hurt, we’re not working hard enough,” she said. I couldn’t argue.

Occasionally, I jogged.  June 16th was the last run, I realized when I made it home.  My legs were like noodles. Even taking small steps, I could feel a lack of control as each foot landed. I just wasn’t connecting with the ground, and I was afraid of falling.

It was the eve of Critical Link 7, an international conference held every three years. This is the first CL conference in Toronto. Back in 2010, Glendon College was awarded to host the 2013 meeting. The remarkable Dr. Andrew Clifford, CL7 Conference Chair, was preparing to launch the first Masters of Conference Interpreting program in Toronto, and the spanking new Centre of Excellence, an architectural dream of a conference centre, was under construction.

I am on the Board of Directors of Critical Link International, an organization dedicated to the advancement of community interpretation (aka public service interpretation) around the world, promoting and ensuring access to public services for immigrants, refugees and Deaf consumers through professional interpreters.

I was also on the Local Organizing Committee. I had to come out of the C closet to the Board and to the Committee immediately after my diagnosis. My friends and colleagues on the Committee took over my responsibilities, full of compassion and support.

I participated in CL7 as I was able, and when I wasn’t, I slept on couches in the faculty lounge (vacant before and after the lunch hour) or in Andrew’s office.

From left to right: Dr. Andrew Clifford, Bonnie Heath, me (bald), Latha Sukumar, Campbell McDermid, Kiran Malli, Jiri Adler, Angela Sasso, Dr. Marco Fiola, Jane Langes

From left to right: Dr. Andrew Clifford, Bonnie Heath, me (bald), Latha Sukumar, Campbell McDermid, Kiran Malli, Jiri Adler, Angela Sasso, Dr. Marco Fiola, Jane Langes

Only Jane Langes, then Treasurer of the Board, knew about the tumour on my spinal cord.  When the conference was over, I disclosed my tumour and my symptoms to the Canadian members of the Board. They are all dear friends, and I was relieved to tell them.

I was still unable to get an appointment in the Spinal Cord Clinic, in spite of my repeated expressions of concern as I rapidly lost sensation in all of my extremities.

I finally received a phone call from the nurse practitioner, who informed me that unless I was falling or dropping things, I didn’t need to see the surgeon.

“That wasn’t what Dr. Fehlings said,” I told her. “He said I should call as soon as I feel numbness or tingling in my hands or feet.” She told me not to worry.

I wasn’t worried. I was fucking terrified.

Soon after that conversation, I fell. Badly.

I landed on my left knee, right in front of my house. I was alone, bleeding, and it took me a few minutes to get up. I left another message with the administrative assistant.

I kept Debbie Honickman, my family doctor, informed of my changing condition. I had her mobile number and her personal email. She was on holiday when she called me. “If you can’t get an appointment with your neurosurgeon tomorrow morning,” she said, “go to Emergency.” This was a direct order.

On June 24, I presented in the Emergency department at Toronto Western Hospital, over two weeks since the onset of symptoms.  Emily brought me food, clothing and toiletries, and reading material.

I stayed overnight, mostly awake, waiting for an MRI that took place around 4:00 a.m.

Later that morning, I received an electronic birthday present: a slide show of my best friend, Jane, and her daughter, Julia, with an invitation to visit them in Winnipeg, airfare and all.

The sentiment, the generosity and the slide deck moved me to tears. However, from the stretcher in Emergency, with my numb limbs, I truly questioned whether I would be physically able to make it to Manitoba in the near future.

On June 25, my birthday, I got a pass to leave Emergency for an appointment with Eitan Amir, my medical oncologist, whom I admire and adore.  They put me in a cab to Princess Margaret Cancer Centre.

Solomon and Emily met me at Princess Margaret, with a set of clothes and some eye make-up.

I’m sure Shinaz, a wonderful nurse practitioner at the Breast Clinic, could see I was in rough shape. She took me into a consultation room and asked me how I was. I exploded in tears. When I could finally speak, I told her I’d reached a stage I’ve been trying to avoid since I was diagnosed: I look like a cancer patient.

By the time the appointment was over at 2:00 pm, I was wasted. I’d been in hospital 21 hours, and tomorrow was another chemo dance. Grand.

I called the Emergency Department, told them I was too tired to return, and asked for the neurosurgery fellow to call me at home.  I had an appointment booked with the fellow on the following day.  Whatever he had to tell me could wait.

Before the Emergency visit, the plan was to celebrate my birthday with our dear friends, James Summers and Harold Van Johnson, who are like uncles to my children.

All day I was up in the air about whether to cancel dinner.  My daughter convinced me it would feel good to get dressed up to and celebrate in style.  I deserved it, she said, after all I’d been through in the last 24 hours.

I was indeed surprised by a large group of my closest friends, including my staff from the hospital, in the private room upstairs at Bar Italia.  Surprised and beside myself with a buzz of warmth and love, I cried for the second time that day. After the reception, a smaller group dined together downstairs.  The event helped to push the Emergency visit back into the past.

When I met with the neurosurgery fellow in clinic on the following day, he handed me a consent to treatment form, dated the day before.  “We were going to get your consent when you returned to Emergency. You never came back.”

“I called,” I said and explained the circumstances.

He changed the dates on the form and initialed the changes, then passed it to me. I was to have surgery in less than two weeks. The procedure would take 4-5 hours, he said.  My surgeon, Michael Fehlings, and I had already discussed the proposed procedure and risks.

I signed without asking additional questions, but I asked the fellow to modify the document to make it explicit that Michael, and not a trainee, would remove the tumour. We both initialed the change.

Not removing the tumour would eventually result in paralysis from the neck down, and death.  The risks of the procedure, ironically, were exactly the same.

I told my parents. They called my siblings.

Then I called my attorney to update my will.  I gathered all of my financial and life insurance information.  My daughter was added to my safety deposit box account.

I needed my family. I asked my sister-in-law, Patty Abraham, a health professional (and marathon runner/cyclist), if she could come the week before the surgery.  She was able to get a week off from work on short notice. Just knowing that she would be coming lowered my blood pressure. We get on like a house on fire, and she’s a master at both caring for others and logistics. She’s also hilarious.

Coincidentally, both my older brother, Carl, and my father, Carl, had booked a visit to Toronto at the time of surgery, so we were well supported.

News of the spinal cord tumour and the upcoming neurosurgery spread across our community of love, and a flood of calls and emails reassured us that we were not going to experience this alone. Our friends wanted to help in any way they could.  Of course, many offered the gift of food.

My very generous friend, Harriet Eisenkraft, who was also president of our inclusive, egalitarian and beyond-liberal Jewish congregation, Shir Libeynu, volunteered to coordinate food scheduling and delivery.

Patty was remarkable. She took over as a friend/sister/project manager and step-mother.  She counselled all of us, fed us, got the house cleaned up and in order.  I had been trying to get my 16-year-old son to excavate the unused books and tchotchkes from his room for years—with Patty’s support and patience, the job was completed within an hour.  During the week, she prepared meals too large for us on purpose, so that the leftovers would be in the freezer when I returned from the hospital.  I was able to talk to her as I couldn’t talk to my kids or my parents. I don’t know what I would have done without her.

 Part 3 Photo 1 Patty Abraham and me (June 2014)

Surgery Eve

On surgery eve, I had the difficult discussion with my children.  If the surgery was not successful, I did not want heroic measures to be taken. No life support equipment. But my children have known this for years.

Emily said, “We know, Mom.  If you’re not you, you don’t want to live.”

It’s a lot to consider for a 23- and 16-year-old. In fact, I would think it’s terrifying.

On Surgery Eve, with Emily and Solomon

On Surgery Eve, with Emily and Solomon

I spoke with Patty as well, and my brother, Carl, an infectious disease specialist and drummer.  “If I have to be flown to Switzerland, it’s not my kids who are going to bring me. It’s you.”  They understood.

I made several copies of a list of people who needed a call as soon as I was out of surgery.  Emily and Patty promised they would take care of it.

Without anyone uttering it, I’m sure we were all thinking the same thing.