The Last Day

Today is a weird sort of day. I joked all weekend that we were into bonus material; anything I accomplished was extra. I've accomplished a lot in the past few weeks, but there is still so much more to do that I know I won't be able to do for a long time. I can't decide if I want to run around like a chicken with my breast cut off today or just... chill. And enjoy what I've come to think of as The Last Day.

The last full day of my old normal.

My last day with my two God-given breasts. It's a weird feeling. I feel... I don't know. In a way, I'm so sick of all of this, I have no energy left to feel. I just do. But the anticipation of how I am going to feel after I wake up tomorrow with a hard lump where my breast used to be and a drain with bloody discharge leaking out of it is what has me the most worked up. I've had a long time to contemplate this - two months - so you'd think I'd be over it by now, but I'm not.

Because the reality is that you just don't know how you are going to feel until you are actually there. Maybe I'll feel fine afterward. Maybe I'll be one of those people who bounces back right away and is driving within a few days, returning to work, and moving on with life. Maybe I'll feel so fine I'll cancel the reconstruction. Maybe I'll be able to let my family go on the trip they were planning for this weekend. Or maybe I won't. Maybe it will be even worse than I'm expecting. Maybe I'll sink into a deep depression and want to kill myself. Maybe I will feel anger and self-loathing every single day for the rest of my life.

So many women declare with such bravado that they would definitely have no problem having their boobs cut off and living the rest of their lives happily free from wearing a bra. They say this because they think it will make me feel better, but it doesn't, because I know that it's not true. I also know they aren't lying; I just know that they don't know what they would actually choose if it were really them. And in the end, very few women choose a bilateral mastectomy with no reconstruction. Even nipple reconstruction, which seems like a lot of trouble for such a trivial body part, and one that I despise no less, isn't completely off my table right now, in the event that I end up losing my nipple. I never would have guessed even six weeks ago that I'd desperately want to save my nipple.

People react to their cancer diagnoses so differently. For me, it took a long time for the reality to sink in. My parents and my husband took my initial diagnosis much harder than I did, mostly because I was too stupid to understand how truly life-changing this would be. Even when there was a very real possibility that the cancer had spread into my rib, I wasn't that worked up. I was just thinking there must be a quick fix for this. Ribectomy, anyone? (Who needs their rib, anyway?) I didn't know that this would technically put me into Stage IV, terminal. Others seem to react with more hysteria initially; the visceral OMG GET IT OUT OF ME! GET IT OUT OF ME! reaction that leads people to get bilateral mastectomies for 0.5 cm, stage 0, grade 1, ductal carcinoma in situ within a few weeks of their diagnosis. It is the treatments that give these people comfort, whereas for me, it's the treatments that I loathe. I don't know if I will ever feel that elation over 'having the cancer gone' that some describe after a mastectomy. Then again, maybe I will. I don't know.

Some people have told me it's too bad I've gone through all of this, only to have it end this way. I could have had this done in May, and I would be all recovered now, happily getting monthly shots to put me into menopause, taking an aromatase inhibitor, and in the middle of a lecture this very moment, instead of at home. But the truth is I wasn't ready back in early May. Even after lumpectomy #1, I wasn't ready. Even after lumpectomy #2, I wasn't ready; I honestly would have considered a third re-excision if every single one of my doctors hadn't counseled me otherwise. I actually feel pretty strongly that I have cancer in my right breast, too, I just know it. I probably ought to proceed with a bilateral mastectomy, but I'm not ready for that. It's easier for me to wrap my mind around having to go through all of this again sometime in the near future than it is for me to wrap my mind around a bilateral mastectomy, and since none of my doctors counseled me to have the double, I continue to proceed one conservative step at a time. All of this is part of my 'new normal' of living with cancer.

I started praying for my surgeons ever since I had a date for my mastectomy, and I feel that God must be mocking me in some way by doing this to me. Nonetheless, I will keep at it.

Blessings

• I'm grateful to be back in the hands of Dr. L, and thankful for who she is. After she was so helpful to me last Tuesday, I sent her a thank-you e-mail, and concluded with: Please take care of yourself this week. (No darts please!! :)). She replied: You are so sweet, I'm so glad we could help out. (...) I absolutely plan to stay away from darts, especially now! Gives me the willies just thinking about it!! See you next week! Jane
• I continue to be thankful for the love and support from my family, friends, and colleagues.  
• I'm thankful for a new Chair who has worked tirelessly to make my work situation as minimally stressful as possible, complete with the e-mail he sent me last Thursday: I met with [The Dean], [his administrative assistant] and [the head or HR] today about your leave. The bottom line is you are totally covered and will receive full pay for the semester. Even if you don't do another minute of work for ABC College this semester, you’ll still have at least 5 days of sick leave left. You might even have 10 if you continue to accrue sick leave days over the semester – [head of HR] is checking into the official policies on this. If you want to come back before the end of the semester and work on "other duties", you can stop drawing as much from sick leave. Everyone is very happy to be flexible with how we structure your leave, so don't worry about it. We'll sort it out when you feel ready to come back. For as much as I complain about work, this is a true blessing.

Hopes

• I pray for Dr. L, for her safety, health, and clear mind tomorrow. I ask the same for Dr. G, the plastic surgeon who will be assisting her. 
• I pray the surgery goes as she planned, that she will be able to do a nipple-sparing mastectomy.
• I pray for clear margins, that after all of this I won't have to do radiation or chemotherapy.
• I pray that I will make it through with no complications, and that the pain will not be too horrendous. And if it is, I pray for the strength to get through it.

I realize a lot of people have life-changing things happen to them without the luxury of contemplating them. Sometimes people are thrust into things full force, waking up the next day with a 'new normal' that is so devastating it boggles the mind. But people are shockingly resilient. We often admire the strength of others, not believing that we have it in ourselves to behave the same way, but I believe we do. At least, I pray that we do, that I do. While I'm thankful for the time I've had to come to terms with everything that is happening, I need to stop circling and start moving forward again. I pray this surgery happens tomorrow. I pray that all of my mourning is done, and that I will wake up feeling happy.