The Diagnosis

Finding strength in bad news, one step at a time.

I sat by my community pool, reveling in the sunshine. My kids splashed in the water overlooking the canyon on a hot summer day. I remember watching yellow butterflies and thinking how I wanted to be exactly where I was.

My radiologist called. "Unfortunately, there were breast cancer cells in the biopsy."

But my doctors had said there was nothing to worry about: the OBGYN who did my breast exam, the young primary care doctor, even the radiologist. The lymph node in my armpit had been mobile and small. Nothing had come up in the mammogram or ultrasound. Even the first biopsy had come back inconclusive but nothing to worry about. I had gotten a second one against everyone's advice, instead of leaving it during COVID in the summer.

I'm 33. I eat well and exercise. I meditate for goodness' sake. Sure, maybe I drink a few glasses of wine every few days and have a sweet tooth, but who doesn’t? I did everything I was supposed to do to live until eighty at the very least! But my boobs are trying to kill me.

This was NOT in the plan. Sure, cancers are in my family, but not until later. Then I remembered. My grandmother had breast cancer at 50, my aunt at 40, and my great great-grandma passed away from breast cancer at 40. I had inherited it along with my dimples and tilted eyes, my addictions to coffee and shopping, and my curly brown hair.

I cried. I texted my friend who survived breast cancer. She told me to get a calendar and hold on for the ride. I called my husband and told him. I have breast cancer.  I couldn’t say the word cancer after that initial phonecall. The would wouldn’t come, stuck on my tongue like a swearword.

I was so scattered that first week and yet so focused. A strange adrenaline coursed through me like the kind I felt when I found out I was pregnant. I scheduled my consult. I scheduled my Tests with a capital “T:” Breast MRI in a thin long tube of a machine with tribal beats sounding through my ear plugs. Breast Biopsy in the MRI machine: I popped in and out like a toaster strudel and the radiologist with a knife poked in and out like he was checking whether his muffins were done. Then came the Covid Test, tearing up as they swiped one then two nostrils. Thank goodness this didn't happen when they were sticking that crazy long stick into the back of your brain. Full Body Bone Scan, CT Scan an Echocardigram to see if I'm healthy enough for chemo.

I was in a hurry. I wanted this over and my impatience made me go as fast as I could. I was diagnosed August 6. I scheduled chemotherapy for August 28.

Fertility:

Then came the worst appointment. My visit with a fertility specialist. Dr. Hu was nice and calm, the opposite of how I felt. She showed me an ultrasound of my eleven viable little future babies that I had ovulated that month. She even used the words: "We can save them." Ouch.

I have some trauma around fertility like anyone else. My path to becoming a mother was not smooth sailing, but I had two healthy happy children. Was I selfish to want the possibility of more? One in five women never had a period again after chemo.

I didn't even know if I wanted those future babies. All I knew was time was ticking inside my body and I needed to get that cancer evicted from my personal space. I wanted that chemo to eat it away like Pacman. Dr. Hu said saving those eggs would delay chemotherapy by a few weeks. That felt like too many weeks with Covid circling ever closer. I wanted to start. Impatience is one of my many character defects. I chose to let those eggs go. Only time will tell if I come to regret my decision. I reasoned there are other ways, surrogacy and donors and adoption. Still it was shock piled upon shock.

Mental Health:

I found out we had a social worker on staff named Laurie. I called her right away. She was a tall fifty-something with bold red hair, freckles, and intelligent blue eyes. She sat with me in front of the UCSD Koman cancer center near a garden. We watched a giant monarch butterfly bob lazily past. She told me to feel every feeling, anger sadness and anxiety.

"Feel it now, in the moment and don't try to shove it away," she said. Her advice was to process it now when I feel it, so I can leave it behind later.

She helped me learn how to talk to my kids, 5 and 3. "I have a booboo inside and the doctors will give me medicine to make it better." If I'm crying: "Mommy's sad right now and it will pass." My instinct had been to hide it all the pain, from my kids and my grandmothers, but she said it's important to do this as a family and go through it together. She told me I'm not allowed to entertain relatives. People should be ready to work and help. It’s about me now. Don't try to take care of other people's feelings.

More Testing

The test results were a bombardment of indeterminate news. I had 6 lymph nodes measuring 2-3 cm behind my pectoral and under my armpit. A small cyst in the liver, measuring not even a mm that could be anything but terrified me that it had spread. I had a small 1mm breast mass which needed a biopsy. Still, I worried. About everything.

I was left feeling confused and relieved. The cancer hadn't spread anywhere else apart from that liver question, but we'd see after chemo if it was anything to worry about. I still had a mountain to climb.

CT Scan.

The First Appointment.

Bring a notebook.

My first appointment was with a breast surgeon. She felt me up and told me it's likely she'll find a mass in my breast during the MRI but possibly not. I had her feel an area in my breast that felt thick to me. She said she couldn't feel anything. She was wrong. Later, I found out that was where the 1mm bump was.

It's really important to form an impression of each doctor you'll meet and I met a lot. I left the surgeon feeling confused and unsure. I didn't like the surgeon. I felt like she was tired or disconnected. I called to switch. I found out she was about to go on maternity leave and my instincts were correct. She had sorta checked out.

For my first oncology appointment, I was ready. I had a notebook. I was progesterone and estrogen + and her2-. I had no idea what that meant. I had a less aggressive cancer but it could possibly come back over time. It’s hormonal, I understood. I had my husband on Facetime along with my parents and sister. Since it was a pandemic, I had to do everything alone, but I wasn't really alone. I brought God with me to every appointment.

The oncologist said I was stage 2 or 3 and not to worry about the liver because it didn't look like cancer. We wouldn't know for sure until after chemotherapy but he was pretty positive. He reassured me gently. He explained that staging is something surgeons use to determine what to take out and oncology has made so many leaps that it's hard for staging to keep up. I think he was trying to cheer me up. It worked marginally. I was still a stress ball of adrenaline.

Find Your Happy Place.

The C word. I couldn't even use it at first. The first time I told someone I have cancer, it jolted me so hard, I had to breathe deeply through my panic. Now I can type it, write it, sing it. I have cancer. It doesn't have the power it once had. That's because I found my happy place and a support group of other young women who had the shock of breast cancer at a young age.

My happy place is the beach. I go there once a week, to an isolated space and sit in the sand. My children come or sometimes I go alone.

Someone once told me how sad it would be if a wave didn't know it was part of the ocean. If, like us, it rose, crested and fell and worried and worried about the end of the wave. We know it flows back into the ocean again as a part of something bigger. I meditate on that, take deep breaths. No one knows anything about when they will go, but it's not my time yet.

I know this will pass but I still have to live through it. As the weeks faded behind that diagnoses, and my shock faded along with it, I felt anger, sadness, hope, love, all emotions that pulled me in different directions but let me know I was alive.