2016 Takes Shape

Here we are another year older. And another year wiser. Or not. But I like to think so.

My New Year’s resolution is to try to give less of a shit, generally, which is bound to fail. But I’m really going to give it the college try. Well, selectively. How about this: I will give less of a shit about shit that I deem is less worthy than other shit.

This has been a strange six months for me. I alluded to some of it in Reentry: Part One (no that is NOT a porn) which, sadly, is the last post I wrote and is dated October of last year. I could now go on and on about how I never write anymore, enumerate the various mundane pressures in my life that I feel have kept me from being able to write and have left me feeling inadequate and be all apologetic but as part of my New Year’s resolution, I have decided not to give a shit, right? Besides, I am now writing and that’s what matters.

I remind you that this started as a blog about, among other things, dealing with breast cancer. Incidentally it turned into a blog about whatever, generally, was on my mind and I felt like writing about at the time. It has evolved into a series of posts that are maybe more about the latter and less about dealing with cancer. However, once in a while I feel it is necessary to stir that shit up again. Just in case you thought (hoped?) I had forgotten all about it.

January, they say, is characteristically a difficult month to endure. The pine-scented jingle jangle of the holidays is over, evidenced by discarded carcasses with browning needles here and there. The days are colder and shorter and the bills are higher. It is a time to reflect on what we accomplished and failed to accomplish and we are all suddenly supposed to be better, eat healthier, drink less, exercise more, be more like Tom and Gisele.

For me, it has the added fun-filled benefit of being the anniversary of my cancer diagnosis. January 3, I believe, is the day I received a call (and an e-mail, actually) that “yes there is a cancer… but totally ‘routine’ and ‘treatable.'”

There is “a” cancer. Is this supposed to be better than telling someone, “you have cancer?” It sounds like some politician’s passive announcement after having just ordered fighter jets to drop bombs on the enemy. “[Insert middle eastern location] has been bombed in an airstrike. Civilian casualties were sustained.”

This year marked the fourth anniversary of my diagnosis. You might be thinking: “well, that’s cause for celebration! Another year and you will reach that magical five-year mark.” First of all, I think the five year mark is properly acknowledged on the anniversary of the termination of treatment. And let’s face that it is somewhat arbitrary. Second, forgive me if I am not all excited about the reminder that at age 39, I discovered one night in the shower a lump in my breast, underwent a number of stress-inducing and physically uncomfortable tests, and found out that in fact, yes, against all odds I had a life-threatening illness that would affect the quality of my life for the next who-knows-how-long. Do I sound bitter? Sorry. I’m not. Just keeping it real. It was a sucky, terrifying experience.

One of the hardest things about it, which I endured in waves rather than as a constant, was the feeling that I was damaged goods. The feeling when standing on the street and observing passersby that I was being left behind while everyone went on with their marvelous daily lives, clinking glasses, traveling to exotic locales, being carefree, running up hills in Primrose Hill Park. Of course a lot of that is bullshit since everyone has something they have to deal with — some a lot more serious and unpleasant than my lot. If life were as pretty as everyone pretends it is on Facebook and Instagram the world would be a different place. But if all it takes is a few minutes of looking at social media (come on you know you felt like pretty girl’s fat ugly friend after you looked at your skinny rich friend’s latest [photoshopped?] vacation pics) to make you feel bad about yourself, is it any wonder that, standing outside, pale and bald (albeit clad in a headscarf and slathered with makeup to disguise such things), I felt a little bit like a loser?

There was something about being in that group that made me feel decidedly uncool, like a misfit, a reject, someone with an issue “normal” people politely inquire about but don’t really understand. What’s more, they generally don’t want to be bothered with it because it is uncomfortable, undesirable, “unfun” and just “un.”

As I said, I didn’t always feel that way. And I don’t feel that way any longer. Maybe other people in that situation never felt that way at all. I think it is my nature to want to be included, to join in the party. So that likely predisposed me to experiencing what I did. That and being teased a lot as a kid in grammar school. Fuck you, all of you zeroes who gave me a hard time back in the day. I forgive you. And in any event I don’t give a shit — my NYR, remember?

But anyhow, I will continue with the point of this whole thing, which is really about feeling better about myself.

As my plastic surgeon friend Beth told me years ago on the eve of my treatment, once you are done with all the draconian life-saving nonsense, you are left with your cosmetic appearance. And thanks to the radiation that I was never supposed to need on my right side following my bilateral mastectomy/reconstruction and chemo, my right boob (remember Marjorie?) ended up healing a little less than ideally. I must interject that implants and radiation do NOT mix well and there is about a 50% failure rate (meaning complete failure) so all in all my result was pretty damn good. I don’t want nobody misunderstanding and failing to be impressed by my rockstar surgeon in London. Because he is a badass, though understated because he is so polite and English and wears nice grey flannel suits and shit.

Anyhow, my right “boob” a/k/a Marjorie kind of looked like Rocky Balboa after a few too many rounds, the main offender being a scar that was tethered and caused a significant dent in the middle. For years now I have been covering that bitch up with good, lightly padded Chantelle bras and those stupid lulu lemon oval pads that come in their wouldn’t-fit-anyone-with-normal-tits-that-I could-never-wear-before-anyway exercise tops. Think ultra-thin chicken fillet sitting on top of that dent to smooth it out.

Without the chick fillet, the dent was clearly visible, particularly from a three-quarter angle. Not ideal.

After I moved back to the US I decided to pursue a more permanent remedy and went to see a couple of plastic surgeons. They decided that what I needed was a scar revision, in which they would open the original incision, remove scar tissue, release any tethering to the muscle beneath and sew Marjorie back up with thicker, better skin a couple milimeters on either side of the original scar.

So that is how I decided to start 2016. And on January 5, I went for it.

This morning I just had my follow-up post-op appointment. Marjorie is looking pretty good. Much better, in fact. She is not allowed to carry more than 5 lbs for another two weeks, and she can’t spin or do boot camp class with the other suburban mommies. But if all goes to plan and Marjorie behaves, it will be so worth it.

I told a couple of ladies at my younger daughter’s new school about the procedure and one said, aptly, “that’s good — it won’t be a constant reminder of what happened.” I thought about it and said, “well, I don’t really give a shit about that — there will always be a reminder… I just want to be hot.”

If all goes well, terrific. If it doesn’t, well, then, I will dust off the chicken fillets and try not to give too much of a shit about that either.

Whatever happens, 2016 is taking shape, people. Happy New Year.

Photo on 13-01-2016 at 13.30 #2

It Does Matter

It’s so easy to hear about someone else’s problem and to make an immediate pronouncement about it. How they should feel, what will happen, what matters and what doesn’t (or at least what should matter and what shouldn’t) in the grand scheme of life. The thing is, sometimes you have to bite your tongue.

Let’s face reality. People do not generally like to hear about other people’s problems because most of the time they don’t really give a shit and other people’s problems are boring, annoying, uncomfortable or some combination thereof. I think that we often lob back a not-so-well-thought-out response because we feel that we have to respond to achieve some sort of closure or resolution. Or just to fill the awkward space after someone pulls back the curtain.

But there is something to be said for the American Indian approach to conversation. A long reflective pause can come in handy. It allows one to collect one’s thoughts and assess the new information. Listening is almost always a good thing. Responding without thinking is often not.

What exactly, you might ask, am I getting at? Well, I’ve been noodling about conversations I’ve had and people’s reactions to things I have shared with them. Most of the time I am blissfully upbeat and am able to cope cheerfully and with a good deal of humour. But I, like everyone else on the planet, have my moments of negativity and frustration. And I often feel that whenever I gripe about something I get that rapid-fire response. Shut-down before the conversation really even starts. Sort of like “well you’ve had your cancer and beaten it so really you should not complain about something as trivial as the way you look.”

No one likes a complainer. But people do need to be allowed to express negative feelings sometimes and just because you are on the receiving end of such does not mean you are responsible for “fixing it.” Nor is it your job to dismiss a person’s complaint with a one-liner, although I am 100% certain that I have been guilty of both trying to fix things and dismissing negative observations with an immediate response on numerous occasions. So this is directed at me just as much as anyone else. I should practice what I preach, after all.

I’m looking back, trying to reconstruct (no pun intended) the past eighteen months of my life. How I was then, how I am now. And how my thoughts and feelings have evolved with the passage of time.

I’ve boiled the whole breast cancer ordeal down to two phases. Phase One: kill the enemy. Take no prisoners. This was the honey badger phase. If you don’t know what I am talking about read some of my early blog entries and you will find that the honey badger became my mascot early on in the process, primarily because it’s one naaaaaasty lean, mean killing machine (and secondarily because Randall’s ridiculously effeminate narration on YouTube makes me giggle my ass off).

The goal of Phase One was to eradicate the disease. It felt urgent and critical and it was not difficult for me to be single-minded about the process. The mission was to do whatever necessary to maximise my chances of beating this fucker. So basically I got down to bidness PDQ and that was that.

Throughout treatment I remained hyper-focused on my mission and had only one speed: full steam ahead. I did what I did because I had to do it so I didn’t waste a lot of time being sad about the process. I just pushed through it and tried to amuse myself and others by, among other things, wearing absurd outfits to chemo and walking around London in a pink wig, because I had no choice and I knew it would be over eventually.

At the same time, however, I did spend time considering Phase Two. Phase Two would involve my eventual cosmetic appearance. As my plastic surgeon friend pointed out, once the cancer is a distant memory what you are left with is your reconstruction. It might not seem that important in Phase One but it could later so it needs to be considered carefully from the beginning.

As one relative aptly put it while we were awaiting a diagnosis, “well it’s really going to suck if you have to cut off your boobs, because you have nice boobs.” Yes, I thought. It will suck. And in fact it did and does suck.

Knowing that I had to do it didn’t make it suck less; it merely made wallowing over the suckiness somewhat futile. But still, sometimes I allow myself to wallow just a little bit. Mostly by myself in the privacy of my own home, like while I am curled up on the couch at 11:00pm having just finished another episode of Mad Men courtesy of Apple TV. What? Oh I am only on Season 2 and yes I know I am about the only American left who hasn’t watched every season. Sue me.

Sometimes I do feel that it would be awfully nice to have real breasts again. Something soft that bounces when I run and something with nerves that might notice if I inadvertently walked into a wall. Sometimes I do feel that I am missing something. Something feminine. Something womanly.

In her Op-Ed in the New York Times, Angelina Jolie wrote about her decision to have a prophylactic double mastectomy to reduce her risk of developing breast cancer for which she is a BRCA gene carrier. Ms. Jolie lost her mother to ovarian cancer and very recently, her aunt to  breast cancer.

Ms. Jolie’s doctors estimated that she had an 87% chance of developing breast cancer and a 50% chance of getting ovarian cancer. So she decided to be proactive. She underwent radical surgery so that she would significantly reduce her risk of enduring a Phase One. She went right to Phase Two. It was her choice and in my opinion it was a good choice, a choice I would have made under similar circumstances.

As it turns out, I did not have the “luxury” of foresight with my disease (btw I am not a BRCA gene carrier). So for me Phase Two was not something that I chose but rather something that I had to do. It had no choice but to remove my right breast, although I could have kept the left breast. My thinking was logical. I sort of felt like I might as well just be rid of both if I had to lose the one. That way at least I would be symmetrical, make the plastic surgeon’s job easier and not have to get screening on the left side all the time wondering if disease would develop in that breast.

The decision to remove one or both breasts preventively is controversial. Some believe that doing so is a “psychological” choice rather than a medical one. Meaning that what could arguably be adequately monitored with screening tests and physical exams needn’t be surgically removed simply out of “fear.” That sounds pretty judgmental, don’t you think? Reading such things caused me to revisit my decision. And I can safely say that if faced with the dilemma today I would do the exact same thing I decided to do eighteen months ago.

For me, the decision to remove both breasts was practical. It turns out that my breast surgeon agreed. After telling him that my inclination was to do a “double” I asked him what he would advise his sister to do under the circumstances and he didn’t even hesitate. After all, I was relatively young, at 39. I have a lot of life to live yet. I, like Ms. Jolie, have small children.

Unfortunately for me, unlike Ms. Jolie, I lacked information that would have enabled me to take action before Phase One became necessary. Therefore, Phase One interfered somewhat with Phase Two because I had to (rather unexpectedly) undergo radiation which can cause a host of problems, including affecting the blood supply to the treated area, increasing the risk of infection and of developing a hard scar capsule around the implant. Furthermore, I was not able to keep my right nipple because one of the tumours was too close to the nipple. Again I decided to just take them both off, because they can do pretty groovy nipple reconstructions by cutting a bit of skin from the top of the breast, shaping and suturing it and then eventually adding a tattoo.

Nipple-sparing mastectomies are possible but the nipples do not behave the same way as before and they may lack sensation. And of course there is always that small risk that cancer will develop in the nipple.

So, here we are five months following my implant exchange surgery. My new boobs have softened and settled. But there are a few issues. The incision on the right side (the side that was radiated) is a bit hard and therefore slightly distorts the shape of the implant from a certain angle. Also, the skin over parts of the implant is so thin that I can sometimes feel rippling (sort of like wrinkles) of the implant beneath the surface.

Despite these issues, the overall result is good. Especially considering that I had radiation. Both implants remain soft and in a bra or bathing suit things generally look pretty okay.

But still, sometimes I do feel odd. I look at my reflection and I am confused by the change. The girl with long hair and big boobs has been replaced by a slimmer, smaller- and higher(!)-chested version with short curly hair.

Thanks to an infection in March, which gave me and my plastic surgeon a scare, I have not had my nipple reconstruction yet, so I sort of feel like Barbie (well, maybe a brunette Skipper Barbie because I am nowhere near voluptuous enough to be real Barbie). And I am bothered by the “seam” that the scar on the right has created. We might be able to improve the distortion with some fat grafting (during which some fat would be sucked out of my stomach — bonus — and injected in the small space between skin and silicone implant).

I know that I cannot expect perfection and I do not, particularly with an implant-based reconstruction following radiation, which is known to be problematic. I know that beating the cancer was more important than my cosmetic appearance and I accept that.

Overall I feel pretty good, but I do believe I will feel better once I have my little tweaks. The scars will continue to fade and once I have nipples, provided that goes well, my new twins will more closely approximate the real thing.

But, on occasion I do get pissed off. So let me be pissed off. You do not have to remind me that what’s important is that I don’t have cancer anymore. I know that. And please do not tell me that my cosmetic appearance doesn’t matter. In a world obsessed, and I mean obsessed with breasts and the female form? Please.

It does matter. It matters to me.


Well, here I am one week before the last “major” step in my fun-filled journey. That’s right, people. It’s D-day. Time to get my new tits.

I guess C-day would be a more apt description of the event since Ds are not in the cards. Actually I have no idea what cup size they will be because we are sooooo scientific and just above all that pettiness — we go by cc’s, not cup sizes. Where was it that I read or heard or saw in some 80s movie that more than a handful is wasteful, anyway (cough… bullshit)?

So I’ll be all cliché and ask you to please send me positive vibes next Tuesday at 9:00am Greenwich Mean Time (and those of you who started to cry after you read that I will, alas, not be restored to my former bodacious glory can pray for a miracle after you stop blubbering. Just stop it. You know who you are).

Seriously though. It has been nearly a year since I went to the very same hospital where I’ll be going next Tuesday, let a man draw all over my boobies with a Sharpie, waved good-bye to my husband and was wheeled into the OR (or the theatre as they call it here — sounds so dramatic doesn’t it?) for the removal of my breasts. You know, it’s a funny thing. I was not nervous. Not at all. I slept like a baby the night before my double mastectomy. Because I wanted that cancer out of my body and frankly felt as though the day couldn’t come soon enough.

I’ve had a year to think about that now. I’ve been through a lot and have gained some perspective. For one year I have had expanders for boobs. Expanders are like implants but they are not meant to be permanent. They are place-holders, pocket-preparers, envelope-makers. Each expander has a metal port into which a hypodermic needle can be inserted (once it has pierced the skin covering the expander — you cannot see the ports) either to inject or remove saline, thus changing the size of the “boob.” And I’ve tried just about every look under the sun. From “pumped up” to pretty darn flat and everywhere in between. This is for a number of reasons, having to do with slowly inflating to create a good pocket and allow the tissue to stretch and recover around the expander, and having to remove some liquid temporarily to get a good angle during radiation treatments.

The other day I had a strange experience. I attended an exercise boot camp with a couple friends. There I was, struggling on a treadmill at an uncomfortable incline, jogging at an impossible pace (interval training is a bitch, particularly uphill), for me, not having been much of a runner for the past ten years. There was a big ole mirror about two feet from me and I didn’t recognise myself. I looked so slight and sort of weird. And then I realised it was because those jugs of mine weren’t there any more. And what was there wasn’t moving at all (I mean AT ALL). That plus the short hair made me feel kind of boyish. And it dawned on me that my boobs were really part of my identity.

It was just weird. I thought, “gee, my shoulders don’t look as broad as I thought they were.” And “gee, I’m awfully scrawny and lanky…” And I guess it’s because my boobs were sort of my thing, not that they were all-defining or anything but let’s just say they were one of my things. And now they’re not. It’s kind of an odd experience, really.

There are other physical changes too, which no doubt contribute to the sense of otherness. I work out more than I did before this happened. And I am a little older now. So yeah, maybe I am a little more sinewy and lanky. I guess it’s the new me. I’ll tell you something, though. The new me is definitely ready for some new tits. I hope that they move, even a little. These expanders have been better than nothing, for sure, but I’m so over them.

Want to get technical? Here’s the plan: my surgeon is going to go through the same incisions that were made during the first surgery. I’d say my healed incisions are about 3 1/2 inches across the very centre of each breast. He will remove the expanders and pop in — now here’s where it gets creative — my cohesive gel silicone implants. These implants are silicone, yes, but they are “gummy bear” implants, so-named for their cohesive rather than liquid silicone structure. They are still in clinical trial in the US even though they have been around for some twenty years (I don’t know why — ask the FDA). They are particularly appealing for breast reconstruction because they are anatomically shaped (think more tear drop less m&m but they won’t melt in your mouth or your hands) which is supposed to impart a more lifelike look to my breasts. And if I got stabbed in the boob they purportedly wouldn’t leak ooey gooey silicone all inside my insides. Rather, they would stay together, just like a harpooned gummy bear (thus the nickname).

Here’s the bad news: implant reconstruction is tricky in people who have undergone radiation. Radiotherapy damages the blood supply to the tissue that has been subjected to radiation and it also increases the likelihood of capsular contracture — or hard scar tissue — forming around the implant. It also increases the likelihood of other complications none of which I am going to discuss or am particularly concerned about. There’s always something, for Christ’s sake. The gist is that after radiation things can get kind of fucked up and sclerotic and sometimes skin and tissue don’t behave properly. Ah well.

I’m hoping that this doesn’t screw up my results too badly on the side that got zapped. Six months following radiation, that side is already firmer than the non-radiated side, which is nice and soft and ready to behave. The surgeon will try to release some of the scar tissue on that right side in the hope that the new implant will settle and form a better more natural shape. Not so firm and not so high.

I figure if it really gets bad I can just use that boob as a drinks table. Screw it. At least I won’t be setting off any more metal detectors in the airports of the world. Because I really wanted to learn how to say “I’m not packing, I just have breast implants with metal ports” in Thai.

Anyhow that’s about it for tonight’s instalment. Feel free to ask me any questions about any of this. Really you can. I like to be technical. And you might be curious. Or not. Whatever.

One-Trick Pony

So it’s sort of my anniversary. Or should I say cancerversary? Wait… I think I just threw up in my mouth a little in the face of such a cheesy, fabricated word. Anyhow, it has been a year since my diagnosis. To be completely accurate it has been a year, two weeks and one day. The date I got the call (“yes it does show a cancer … but you’ll have perky tits forever”) really isn’t what I think of as the anniversary, however, considering I was at least 66 2/3 % convinced that the results of the biopsy would not be good a week before the call came in.

I was not being pessimistic, people. I was being realistic. I had looked the radiologist in the eye, said “I am a big girl; what do you think” and she had levelled with me. She was “reasonably concerned” there was cancer present. So although lots of well-wishers told me not to worry and that everything would turn out fine I kind of knew that wasn’t how things were likely to go down. That was when I started dealing.

Which probably explains, at least in part, why this past December was such a tough month for me, as I mentioned in a previous post.

So how is this relevant now that December has come and — blissfully — gone? Well it got me thinking. That’s sort of a lie, actually. Because I am always thinking. In fact I wish I could turn off my brain sometimes. But it got me thinking, specifically, about what the hardest things have been about this experience to date. And I came up with something sort of interesting and to some people, maybe unexpected.

When I think back over the last fourteen months, from finding a lump in the shower, to the investigations, to confirmation that something sinister had taken up residence in my body, to surgery, chemo, radiation and all the delightful direct effects and side effects of such, to recovering after it all, the answer is as clear as a bell.

The hardest things have been (1) the waiting period between finding out that I might have cancer and formulating a plan of action (surgery + ?) after I found out I definitely had cancer, with a little bonus period after my surgery during which I had to wait yet again for more detailed pathology results leading to a further plan of action (chemo + radiation) and (2) most of the month of December, about a year from the beginning of all this crap. So there’s a pattern here, see it? It’s before and after. Those have been the hardest times. By far the most stressful. Not during. Hmm.

People who have been through this or something like it and those who have cared for them or who otherwise know warned me that the initial waiting period would be the worst. And that I might feel “down” after it was all over. The waiting was awful. It was terrifying and just plain old difficult to bear. I concur. But I did not feel down right after the treatment was over. Maybe a little adrift at times, but not really down. Until December when I got hit with a bad cold and a nasty clenching crimp in my back. That reminded me of being weak. Of having limitations. And things sort of deteriorated from there. Part of it was an obvious thing. I did not feel good physically, so it follows that I didn’t feel so hot mentally. The cold persisted and turned into a sinus infection and the back persisted such that I was uncomfortable for a good part of the day, every day. That doesn’t make for a great mood. I was downright cranky.

I know now that everyone and his dog seems to have had a nasty cold over December — some even got two colds. I am not special in that regard. It just especially affected me because it made me think about feeling unwell and the last time I had felt unwell was while I was undergoing chemotherapy. It was a lack of patience on my part. An “I’m well now and it’s over and there is no time or space for being sick because I refuse to be limited.” And the back thing was similar. It screwed up my workouts, deprived me of endorphins, made me lose a little muscle. Made me see a dip. I don’t like dips. I’m into crescendos.

I feel much better now. Much. It’s a new year and I have a feeling that despite the conventional wisdom, thirteen is going to be my lucky number. Or at least better than twelve, which, as a friend put it who also had a hell of a 2012, can totally kiss my ass.

In retrospect, although undergoing treatment was not pleasant, it really wasn’t that hard, relatively speaking. My mission was clear; beautiful in its simplicity. It was sort like I became this one-trick pony and the pony’s focus was this: kill it. I was an assassin. Single-minded, willing to do whatever it took to carry out the hit. The wire had already hit my numbered Swiss account and I would go and go until the hit was carried out.

What else made it bearable? It was temporary. I’ll shave my head today, but my hair will grow back tomorrow. I’ll feel shitty and have metal mouth and queasiness today but I will have my appetite back tomorrow. You get the gist. It was something to slog through, not a permanent state of affairs to which I had to adjust. And I started to write and then I learned a hell of a lot about myself.

I was also incredibly fortunate to handle the meds pretty well. Although I rested in bed on the afternoon following treatment and went to bed early every night, I wasn’t in bed all day and I still exercised and generally enjoyed a good appetite. None of my side effects landed me in the hospital, even though some were infuriating (such as the swollen thumb episode).

What’s my point? I don’t really have one. I’m just musing. People say I have been strong. That I sailed through treatment. I don’t really know if that is true. Maybe it was just easy for me to have a singular focus and to get through something I needed to get through. Put all life’s little stresses on hold. Sleep well at night because I knew what mattered and what didn’t. Wasn’t going to get worked up about the little bullshit over which I had spent plenty of time obsessing in the past. Big deal.

We’ll see how the next couple of months pan out. I have a date on the calendar for the acquisition of my new tits. That’s pretty exciting. Sort of. If you told me I would move to London and a year and a half later be going in for a set of silicone tits — ahem — after having had my original tits removed — I would not have believed you. I still find it hard to believe except that anything has to be better and more comfortable than these saline expanders with metal ports that feel about as hard as boulders sewn under my skin. I’m ready to move on. Ready to take the next step. We’ll hope for the best. See where it takes me. Plan on bikini shopping in the near future.

And then the world is gonna be my oyster again, bitch.


A Further Look at Airport Screening Issues

Howdy. You may have read my posts about encountering airport security at Heathrow. If not click on Things I Am Prepared to Say to Airport Security (before) and End of Shit (after).

Well, it turns out that a host of ladies sporting bionic buzzies have had troubles with so-called insensitive TSA employees. My friend Dee just sent me a link to an article about the very topic. Check out http://globaltravelerusa.com/web/view/tsa-apologizes-to-breast-cancer-patient-for-embarrassing-screening-at-jfk#.UCTliYaeypY.email. The gist of it is that last fall, a lady who had recently undergone bilateral mastectomies with reconstruction and had those expanders with the metal ports in them set off the screening gizmo at JFK airport and was not exactly treated with kid gloves.

Now look, I am the first to speak out in favour of heightened airport security in this crazy world we live in. Anyone could produce a document from a “doctor” indicating that they have some prosthesis that might set off the screening thingie.

Nonetheless, I agree that a modicum of civility is warranted. Even if the TSA folks are not satisfied by a card or a doctor’s letter proclaiming the presence of a prosthetic medical device (and I ain’t saying they should be), should not the bearer of such be offered a private screening if so desired? You can cop a feel or have a look, but only in the champagne room, please.

Luckily for me, I am not easily embarrassed and did not mind being patted down in public at Heathrow airport. I don’t think I would like having to go into a private room and take off my top, but if asked I would do so. Safety first, after all. I really don’t give a shit.

But not every person embraces the honey badger way. I read about one poor lady who had to remove her bra for the authorities and about another whose prosthesis was manipulated from side to side by a TSA employee. Not really a turn on.

At the end of the day, most people don’t know a damn thing about breast cancer or prosthetic devices. The TSA is not going to concern itself with whether you have had a hard time being treated for x, y or z over the past months and whether their exam of you gives rise to emotional trauma. They just want to process you and make sure you aren’t going to blow up at 35,000 feet. And after the shoe bomber and other pathetic sacks of excrement like him, you can hardly blame them.

I have to fly three times in the next ten days so I’ll have plenty of opportunities to get mistreated and will let you know how it all goes. If I get invited into the champagne room I can tell you right now that I plan to charge for it.


Why I’m Lucky

Yeah, I know. This is a loaded title. There are just too many ways and too many things I can think of. But I am going to start with a couple of ideas and maybe soon there will need to be a part deux, trois and even quatre.

I am tolerating the Taxol pretty well. For you newcomers or those who just, ahem, haven’t been keeping up to speed (tsssk tsssk), that is the chemo drug that I am currently on. Sure, I have a couple of irritating little side effects, but nothing the honey badger can’t handle. One of them is zits (or as the English like to say, “spots” which is what I thought one found on a dalmatian). Yes. I broke out. Ridiculous. Hair loss, then a break out. My young and gorgeous gal pal and fellow survivor pointed out to me at lunch the other day that it’s like going through puberty in reverse. Throw in that I had to give up my boobs and that something else (if you catch my drift) hasn’t shown up in a while and she’s really got a point.

So I decided I didn’t need to be dealing with that bullshit (the pimples, people) and went straight to the dermatologist (okay full disclosure I also had some irritating little rashies developing on my hands and head… so it was a multi-purpose visit) who promptly put me on something to curtail that unwanted effect. It’s working. Part of feeling good is looking good, right? Balk if you will, but to me this is important. To the dermatologist too. Which is why I love her.

When you think about it, it is not at all surprising that one might erupt on the outside given what’s going on on the inside of one’s bod at the moment, no? No.

So what else? Bone pain. Not bad, just a little. Not enough for me to run out and buy the cane (read Countdown if this isn’t ringing a bell) but enough to remind me I have bones and they hurt. Just the legs so far. I don’t even need Tylenol (sorry Brits — Paracetamol). Just a little homeopathic stuff and I can deal. In fact I’ll pop one right now… excuse me. There.

And for some reason it hurts under my finger nails, especially my right thumb. I took off my fingernail polish yesterday to investigate and lo and behold there was some brown discolouration under there. I had read that this could happen. In fact your entire nail can fall off. (Ew!)

Oh — sorry. I am rambling and you are confused. This is where the “why I am lucky” part comes in, in case you were wondering what the hell the title was about since all I have done thus far is bitch about insignificant side effects. I’m getting there…

Today I visited the nail salon to get a polish change on my fingernails and a pedicure. I wanted to see if there was more brown discolouration under my toenails and get new polish on all the nails to strengthen and protect them. I do a lot with my hands (cook, mow the lawn (really), give my kids a bath, you name it), so it is pretty annoying to feel weakness and vulnerability in that area.

So I was chatting to the aesthetician about all of this when I noticed a woman watching me and slowly approaching. Call her Greta. I would say she was about sixty-five. Short white hair, blue eyes, one eye completely dilated. Attractive.

Turns out she was a fellow breast cancer survivor and had heard me talking about it.

She was about six months out from treatment, having gone through a mastectomy, chemotherapy and radiotherapy. But unlike me, she did not have an easy breezy time of it. She ended up in the hospital for three weeks during chemo because her white blood cell count didn’t rise as it should have despite her having had immune booster shots (as I do) after every treatment. Her right eye was dilated because she had developed a serious infection in that eye and they were now watching it closely — the outcome unclear. She had a prosthetic breast and hadn’t had a reconstruction because her body couldn’t tolerate it after chemo. She had had a hell of a time. But there she was, out and about, standing before me. Dealing. And she was lovely.

She was also both empathetic and encouraging, without any preachiness or gloom, unlike previous “mentors” I may have unwittingly had (see Assaulted at the Global Festival: Things Not to Say to a Cancer Patient for that story). She didn’t tell me how I was going to feel or prescribe anything except courage, basically. I really liked her. I hope I see here there again.

She made me feel like I am having a cake walk. Just an inconvenience. Just a few months out of my year so that I can kill this piece of crap and get on with my life, thank you very much.

I’m not Job, sitting on that dung heap. No sir. I’ve had way too easy a time of it.

I’m lucky.

Breast Cancer for Dummies Part Deux

Because I started my blog in the midst of chemotherapy, rather than at the beginning of my story, I have jumped around quite a lot. This has turned out fine, because — at least in my experience — life is rarely linear. However, I do feel that it is time to continue with the story of how I ended up here, five out of eight chemos in, fighting breast cancer. This leads me to the second instalment of Breast Cancer for Dummies.

As I mentioned in my first post on this topic, “Breast Cancer for Dummies Part I,” I am not a doctor, nor do I have any expertise on this subject other than what I have learned along the way in dealing with my own disease. Nevertheless, I believe that you will find the following useful if you ever wanted to know more about breast cancer without reading a text-book, or if you are just curious to know how I got to this point. If this grabs you then you should start with Part I above if you haven’t already read it, or maybe give it a skim to refresh your recollection if you have read it. Conversely, if you find this all too technical and “involved,” fear not. More silly posts about this, that and the other thing are forthcoming. And I won’t be offended if you skip this one.

Moving right along…

Where did I leave off? Ah, yes. I took you through finding my lump, having imaging, getting biopsies and initial diagnosis. So here we are in the first week of January 2012 and we have, in the right breast, multifocal, ER+, PR+, HER2-, Grade II Ductal Carcinoma in Situ (DCIS) and Invasive Ductal Carcinoma (IDC) with no apparent lymphovascular invasion. The biopsies reveal at least two tumours, oriented radially, each appearing to measure under a centimetre.

Oh, and I won’t make you take a multiple choice quiz this time because I know you were upset about that in Part I and it made you have flashbacks from the SAT or whatever torturous British or [insert appropriate nationality] exams you had to take. I don’t want you breaking out into a cold sweat and shorting out your computer, tablet or smart phone. Isn’t that nice of me?

Anyhoo, when we left off I had just been diagnosed with breast cancer. What then? The first order of business with cancer like mine was to see a breast surgeon. When I was told this it sort of took me aback. What about an oncologist? What about “the whole picture?” Well, how it works is, they like to get the tumour(s) out of you first and then they figure out the whole picture. So breast surgeon it is. He looks at the pathology from your biopsies and your imagining and recommends what kind of surgery you need. This becomes step one in the big “killing it” game plan.

I found that putting in place the game plan was a big deal. Once I began to do so, I started feeling a hell of a lot more in control, because I knew what step one was. This was instrumental in moving beyond the initial shock of “how can I have cancer?!” and “why me?!” and all of that unproductive Nancy Kerrigan-esque jazz. No one likes a whiner.

Now, if you read my first post, “Halfway Through Chemo… How Did I Get Here?” you may recall that having spoken to Beth, my plastics/breast reconstruction surgeon buddy, I had already begun to wrap my head around removing the entire breast (maybe both) even before I had my diagnosis. Beth had seen and heard about a number of women who had opted for lumpectomies and then ended up with a recurrence in the same breast and thus a mastectomy anyhow. She had also seen women who had opted for a single mastectomy who ended up back under the knife for mastectomy number two after a recurrence in the “healthy” breast.

That being said, the most common surgery for breast cancer remains lumpectomy. With lumpectomy, the tumour is removed and then generally the patient is given radiotherapy to reduce the risk of a local recurrence in case any cancer cells remain at or near the site. Sometimes more surgery is required after the pathologist examines the removed “lump,” which you can think of as a cube of tissue, each side of which is rubbed with ink to determine whether there are “clean” or “dirty” margins. This is not an exact science, but the gist is that the surgeon wants to get a clear margin around the tumour so that dirty a/k/a cancer cells are not left in the patient.

So there I was, back in London, armed with my initial pathology. And I needed a breast surgeon.

One of the greatest sources of stress we faced was figuring out whether we were going to be comfortable doing my surgery and any additional (if any) treatment in London, having lived here for exactly five months, or whether we felt we needed to haul ass back to the US. So after we made some enquiries about the best and the brightest — hee hee! I almost wrote “the breast and the bightest,” — I started calling around. I went totally honey badger on the situation. (By the way if you still do not know what the honey badger is, I am going to get a little annoyed at you. So please watch Randall’s YouTube video linked above and get caught up.) I managed to secure two appointments with London-based breast surgeons on very short notice. A good sign.

Days later I saw the first guy. He was both a breast and reconstruction surgeon. He recommended based on my pathology and imaging that I have a mastectomy in the right breast and monitor the left breast. He ordered an MRI to try to get a better sense of the locations and sizes of my tumours.

Three days later, I saw the second surgeon. He also did both breast surgery and reconstruction and concurred that I needed a mastectomy. That the cancer was multifocal warranted removing all the breast tissue. I was comfortable with this and frankly relieved that both surgeons recommended the course of action I had already envisioned based on my conversations with Beth. I thought about the healthy left breast. I had been told that in the UK, many surgeons are loath to do a risk-reducing mastectomy when the unaffected breast can be “monitored” going forward, as surgeon no. 1 recommended.

I have to say, I didn’t like the idea of that. I did not ever want to deal with this again. Plus, I figured at the end of the day if I was going to lose one boob I might as well just do them both. One boob, two boobs, whatever. Just kill it.

I pushed the second surgeon on it. “If I were your sister, would you advise me to remove the other breast?” His head nodded an emphatic “yes” before “breast” even left my lips. His eyes never left mine as he said the word. Okay, this was my guy. He was honest and straightforward and aggressive. That was what I needed, wanted. So I decided I would have them both done. By him. Step one of the game plan firmly in place. Check one box. Kill it.

I know. This post is kind of heavy, not as much fun as the beer fermenting in the bathroom or wearing leopard print to chemo. But you have to take the bitter with the sweet, my friend. It is part and parcel of the whole picture and I want you to understand where I am and where I was.

And did I mention there is a silver lining? When you do a bilateral mastectomy, you do tend to have an easier time getting a more symmetrical cosmetic result. So that was a plus in my mind right there. No cancer and matching boobs. Good show!

Step two was a visit to a reconstruction surgeon. Now, as I mentioned, some breast surgeons (these are the folks who do lumpectomies and mastectomies — their job is to remove the cancer) do their own reconstructions and are “oncoplastic” (onco being cancer and plastic, well, duh…).  But there are some pretty tricky reconstruction procedures to choose from these days, and many breast surgeons do not dabble in some of the more involved techniques.

I was told I could have an immediate reconstruction following skin-sparing bilateral mastectomies, which means that they were going to give me new (temporary) boobs right away after removing all of my breast tissue, but keeping as much of my own skin as possible. That way you look down and see your own skin. It’s just what’s inside that’s all new.

This is quite a departure from a radical mastectomy, which for years was all that was available to women, leaving them with a scar from armpit to midline. Of course, some patients today still require a radical mastectomy, depending on the extent of their cancer. Yet for many of these women, a delayed reconstruction remains a possibility. I was simply fortunate enough to be a candidate for instant gratification. An immediate boob swap, as it were.

But what kind of boob swap?

I went to see the breast recon guru so that I could consider all the possibilities. This guy is known not only for his excellent breast reconstructions but for his fabulous boob jobs to the stars. Aim high, I always say. I liked him immediately. He was gentle and kind and sympathetic, and I felt comfortable in his hands (literally — I mean all modesty goes out the window with this, people). I stripped and he felt me up. And then he pinched my tummy and my bottom and the inside of my thigh. Why? He was weighing his options. There are some pretty amazing microvascular surgeries they can do now where they take a bit of tissue from your abdomen, inner thigh or rear-end and make a boob out of it. Really. The benefit of these surgeries, although they do involve a site scar and require a long recovery period, is that the reconstructed boob can last indefinitely if all goes well. This is because it is made of your own tissue and fat, so it looks and acts more like a natural boob, which is — as we all know — mostly fat.

He didn’t pinch me for long, however, before it became clear that these fancy procedures were not an option for me. Not enough extra tissue, he said. I hadn’t eaten enough fries (chips if you are a limey). In a way I was relieved. It was sort of nice to be told that I was too thin for that option (aw shucks). Also, then I didn’t have to decide whether I wanted to deal with a seven-hour surgery that would require months of recovery while trying to take care of a five-year-old and a seven-year-old.

Now don’t get me wrong, the autologous tissue flap, as these things are called, is an excellent and desirable option. If done well and pulled off without complications it yields a more natural breast and can last forever. But it is a big deal. And there just wasn’t enough fat on me to do it so that was that.

Implants it is, he said. Okay. Do it up.

Have you ever seen a silicone implant? Most of them are shaped like M&Ms. They are symmetrical. But being in Europe has its advantages. Here, they have been using “shaped” implants for well over ten years, implants that are still in clinical trial in the United States. These are also known as gummy-bear or 410 implants and are made from cohesive silicone that is less liquid-y than the traditional silicone implant (thus the comparison to a gummy bear, though I wouldn’t want to eat one). These implants are interesting for breast reconstructions because they are shaped more like a natural breast, with a slope and a projection. That is, they are flatter at the top and rounder and fuller at the bottom. More boob-like.

Well, thanks to a friend of mine whose two buddies recently had breast cancer in the US and whose surgeon happened to be participating in the clinical trial, I knew about the gummy-bear implants. I asked the recon guru. Yes, he said. He liked them and would use them on me. But first I would get saline expanders (basically temporary implants that are inflated with salt water) in order to make a nice pocket for the permanent silicone implants. Getting them primed for boob swap number two later on down the line. Patience is a virtue…

By the way did you hear about that son of a bitch in France who sold all those implants made out of industrial grade silicone? I cannot even tell you what I want to do to him but I think you can imagine. It involves a honey badger.

Okay then, step two in place: reconstruction. I had started to assemble my dream team. And they would work together, the breast surgeon doing the mastectomy on one side with the reconstruction surgeon following on his heels, and then onto the other side.

But we need to back up. There was another order of business to address. This was the sentinel node biopsy. Before beginning the mastectomies, the breast surgeon would remove one or more lymph nodes from under my right arm to find out if they contained any cancer cells. The sentinel nodes are like the guardsmen lymph nodes — the first line of defence. A technician locates them by injecting you with a radio isotope near the tumour and then tracking to which lymph nodes that isotope drains. X marks the spot and the breast surgeon removes this node(s) at the beginning of surgery so that it can be tested for cancer cells, often while the patient is on the table. If cancer cells are found, the surgeon will perform an axillary lymph node dissection (ALND), which is when they remove a number of other (or all) the lymph nodes.

The long and short of it is that you don’t want to find cancer cells in your lymph nodes, because it means that the cancer has started to spread. You can still kill it of course, but it isn’t what you want. If they find cancer in your sentinel nodes, they remove more nodes to see how many of them contain cancer cells. And all of this factors into your treatment plan. Whether you will need chemotherapy to seek and destroy any cancer cells floating around in other parts of your body/bloodstream and/or radiation to kill any cancer cells that are hanging out at or near the site from which the tumour was removed.

The night before the surgery I slept well. Really, I did. I was calm and ready to get on with it. D-Day was February 7 and I had waited about a month after diagnosis for my surgery. Although this sounds scary, I was assured by doctors on two continents that unless you have a very aggressive form of cancer, waiting a month or even two should not make a difference because breast cancer is slow-growing.

Still, the waiting was not easy. Indeed, it was the hardest part. This is because you cannot progress with the next step of your game plan until after the tumours are removed during surgery and then analysed by the pathologists. So you wait, and noodle and try not to be too mental. I dealt with it by going to the gym a lot, which you know if you read “Work It Out.”

The morning of the surgery, my husband took me to the hospital, to be joined later by my mother who had stayed at home to see the girls off to school. Once I was in my room, each surgeon came to see me, separately. Each explained what he was going to do and the recon guru marked up my boobs with a permanent marker and took pictures. Again — all modesty out the window. I smiled for the camera. A little while after that, I waved to Bill and they wheeled me out of the room. The anaesthesiologist had me out in about 20 seconds.

I woke up to my name being called. “Emily… Emily.” I blinked, had no idea where I was. I snapped back into focus. “The node, was it negative?” I asked. The nurse didn’t know. “The node…” I said. The anaesthesiologist rounded the corner and confirmed: the node had been negative. I exhaled. So they hadn’t removed any other nodes. All had gone according to plan.

Shortly thereafter, they wheeled me back into my room. I started ordering my poor husband around immediately, telling him to send an email to everyone that all had gone well and I was fine. I had killed it.

But alas. I still had to wait for my final pathology report. And that is why cancer is such a BITCH. Because just when you think you have won one battle, it sucker punches you right in the face.

I went into the hospital on a Tuesday. On Saturday morning, (still in the hospital) the breast surgeon came to see me. I was happy to see him. We chatted briefly before he got that serious look that doctors get and told me he had some pathology results. Bill was still at home with the girls.

“Were there any surprises?” I asked. “Yes,” he said. I got my notebook. Sat down.

They say that when you get difficult news, you should always have someone with you because you only absorb about 20% of what you are told. I’d like to give myself credit for about 80%, but it is harder when you aren’t prepared.

The breast surgeon said that there were three things we had not expected:

(1) The tumours were larger than the imaging had indicated, because one area of what appeared to be discrete little spots were actually interconnected and therefore counted as one tumour. That one measured 30 mm or 3 cm. The other one was about 14 mm. Shit.

(2) Although the sentinel nodes were clear, two other tiny nodes that happened to come out as part of the mastectomy revealed “micrometastases,” which are bits of tumour that are 0.2 mm to 2 mm in size. These nodes needed to be further analysed to determine whether the cancer cells were in fact that tiny, and therefore less significant, or whether they were bigger and posed more of a threat. If “macrometastases” were found, they might eventually have to go in and do that axillary dissection.

In any event, (1) + (2) = chemotherapy for me. This was not easy news to digest. But I kept writing, determined to take intelligible notes so that I could make sense of it all later.

And he wasn’t finished.

(3) Even though I had had all of my breast tissue removed (the whole point of the mastectomy), the margins of the tissue removed in the right breast were not great. Tumour was “present” at the margins, meaning in my case that it had abutted the natural barriers of my chest wall, posteriorly, and my skin, anteriorly. Therefore, he thought, I needed radiation, something we had been about 85% sure I wasn’t going to face.

That Saturday was rough. And it marked the beginning of yet another waiting period.

But the next bit of news we got was good. A week later, we saw the oncologist and he confirmed that the nodes had only micrometastases. Micro mets used to be undetectable but modern technology has allowed us to find these tiny cells. Some doctors treat the presence of micro mets no differently than finding nothing in the nodes (i.e., they treat such a patient as “node negative”). My doctors, although very encouraged by this news, did feel that the presence of the micro mets plus the size of the tumours warranted a more aggressive stance on both chemotherapy and radiation, tipping the scales in favour of both. Part of this had to do with my age. They tend to be more aggressive with breast cancer when you are young.

When I asked the breast surgeon why there might have been tiny deposits of cancer in these random nodes that “happened” to come out with the mastectomy but not in my sentinel nodes, he indicated that when one has cancer there are probably micro mets present somewhere. It happens. And this does not mean that they will ever grow into tumours. Or that you have a bigger metastasis elsewhere. But it still blows your mind.

And that is how I ended up where I am today, five treatments in. Counting down to June 7, five short weeks from now. My last chemo.

Two weeks after that I will begin radiation, five days a week for five weeks (my, that’s a lot of fives). Whew.

If you got through all of that I commend you. It sure as hell pooped me out.

Work It Out

I realised yesterday that I hadn’t been to the gym in a week. Lame. Could this be because I have been sitting on my bum writing blog posts every day for the last seven days? Yup.

Now don’t get me wrong. I am loving writing. I am loving having the blog. It is so energising, liberating, cathartic, cleansing, fun and different. And I plan to do it obsessively for the foreseeable future. But all this blogging is going to make for a flat ass and that simply won’t do. I need a nice juicy little behind to match my newbs (well, as much as I can have one without plastic surgery at age almost 40). Who says a cancer patient can’t have it goin’ on?

When we first moved to London in late July of 2011 I avoided working out for a few months. I had the usual excuses. “We just moved here.” “I have so much to do.” “I walk a lot so it doesn’t matter.” “I’m not sure where to join.” Blah blah blah. But all that was load of BS. Finally I investigated local gyms in October.

I did a blitz of the workout places in the hood.

The first place was the most convenient and by far the weirdest. It was a small neighbourhood gym about a six minute walk in amongst the lovely houses of Belsize Park, which is the only reason I can think of to justify the exorbitant membership fee. (No offence if you own this gym or you have worked out there since you were 12 — different strokes for different folks, people.) I walked in. The reception had a low ceiling and the first thing I saw was a cafe. Assaulted by the aroma of coffee and pastry. I don’t need to be smelling that shit when I am in workout mode.

I was taken on a tour. I cannot even describe the different rooms I went into, all on different levels and connected by various narrow stairways and hallways and doors and really just a labyrinth of British bizarreness. No way in hell I would have remembered what was where. And the cardio room, which I sort of remember, was totally 1980s and not my vibe. Even if I had been a good sport about the confusing interior I would certainly have fallen down the stairs at some point and injured myself. And the low ceilings and labyrinth thing and 80s mirrors made me feel like Alice in Wonderland on a bad acid trip. Not for me.

Then I tried the gym in the O2 centre, which had recently been purchased by Virgin. It was large and more Americanised than the little gym. It seemed to have a lot of decent equipment and a variety of classes. But I didn’t get a friendly vibe about the place — it was rather vanilla and commercial. The decisive factor really was that it was too far for me to walk to and I knew I would never haul my ass there, thus resulting in a colossal waste of funds and influx of self-inflicted guilt. Nope.

The third and final gym I checked out was a smallish place across from the Royal Free Hospital, which is an NHS hospital. This gym is housed in an old armoury and the downstairs used to be a shooting gallery. Are you thinking what I’m thinking? That’s right; I’m liking it already. And at this point I don’t even know I have cancer. The place has very high ceilings because the building is shaped like a barn. It is not shiny and new but it is clean, has a lot of good equipment and the staff is friendly. (In American staff is singular, people. I like to mix things up to keep you on your toes.)

And there is zero glitz factor. I will not be running into scathes of perfectly coiffed blonde mommies who have come to “glow” after the morning drop off. Thank God. Au contraire, there is a real diversity of people in this gym — different races and from very young to quite elderly and all sorts of physical types, folks with disabilities — you name it.

The manager explains that they are about to get a new German cardio/weight training circuit that will be centre stage. Each member who subscribes to this program will get a personalised chip card, which after an initial set-up, when stuck into each machine, will cause it to adjust automatically to your body. A cylinder of bubbling water in the middle of the circuit tells you when to change machines. Did I mention it also has pretty coloured lights that tint the water while you watch? Oooh ahhh. You are supposed to get a complete workout in only 35 minutes, the time it takes to complete two rounds on the circuit.

Well, folks, after hearing about this I’m sold. The Germans are efficient and know how to make shit and the circuit seems like the ticket for me. Oh, and I can walk to this gym in under ten minutes or take the bus and be there in five if I’m lazy or it’s hailing.

I start working out. The circuit is good. Within a couple weeks, I begin to see results. A couple weeks after that, I find my lump. I keep working out, taking a break only for Christmas holidays (you know what I did over vacay if you read my first post, Halfway Through Chemo… How Did I Get Here?). The day after my diagnosis, my husband plays hooky and we both go to the gym. I am a little fragile, but with him by my side and my body wrapped around those machines I hang tough.

Throughout the month of January, I kill it. Go to the gym and do that circuit regularly, and also throw in some yoga at an airy venue in Primrose Hill. I start to get sort of ripped. I feel strong and fit and powerful. Gearing up for war.

I decide to tell the gym staff about my diagnosis and impending surgery. (The poor manager is so shocked when I tell him he is speechless for about a minute.) The people I tell are super supportive and assure me that they will help me through it, making whatever adjustments are necessary to my training throughout the process.

My last workout is February 5, two days before surgery. It is a Sunday and I walk to the gym from Hampstead Heath where I have left the girls and Bill and two other families sledding and throwing snowballs. (What? That’s totally normal for London.) On the way I spot cute pyjamas and a bathrobe in a store window. I buy them so I can be fashionable while strutting up and down the hospital hallways. Then I go for that last workout. I kill it. I’m good. I’m in a good place.

No question that I recovered from surgery more quickly because of that German circuit. And even though I couldn’t pick up my kids much less carry a grocery bag for weeks after the surgery, I gradually recovered. Now I don’t even remember what I felt like two months ago. Because I am back there, killing it, bald as a cue ball and with my machines set to about half of what I was doing pre surgery.

But it don’t matter. I will keep going back. Through the chemo, through it all. Whenever I can. Because no fucking cancer is going to keep me from getting a little more bootylicious.

Are you still sitting there? Reading this?

Get off your ass and get to the gym. What’s your excuse?


Boob Retrospective

The other night my husband turned to me and asked me if I ever miss my old boobs. My initial thought was to turn the question back on him and ask whether he missed my old boobs. But after a pause, I responded: “no, they were bad.” And I meant it.

I mean, I liked my boobs a lot before I found out one of them had cancer in it. Even though after two children they were not at their prime. (But they were still pretty good). After that I just sort of developed a surgeon’s mentality about them. Cut the bad shit out. Kill it. Please.

Hmmm. Let me reflect on my boobs. We had a long history. Well, sort of. It took them an awful long while to make an appearance. I went through puberty at 14 and didn’t have much to show in the way of boobs until then. By then I was a tall skinny kid without any curves and had suffered lots of jokes about anatomy throughout grammar school. “Hey, Emily, I’ve got a joke that’s so funny it’ll make your tits fall off. Oh, I see you’ve already heard it.” Hardee harrrrr harrrr. This really happened. I am not making it up.

I did not care for changing in the locker room for gym class. Most of the other girls had purchased bras (or desperately needed to) and had some hips going on (I didn’t — still don’t but that’s another story). I got impatient and finally went to a department store and bought a bra anyway. I found the thing about ten years later in the attic in a box of old clothes. It was white shiny polyester and about the size of a double eye patch. I remember when I bought it I showed it to my friend Beth and she remarked that it was baggy. This was true. Ouch.

In ninth grade they finally showed up. Overnight the commentary from the opposite sex went from banal remarks about their absence to “hey looking perky today.” In spite of myself I smiled shyly and blushed. Let’s face it; I was proud finally to have them and not going to pretend I was offended that someone noticed.

They were good. Smallish and neither too close together nor too far apart. A nice projection. And yes, perky.

Highschool was good. They were about a B-cup. They had some fans.

College, also good. I filled out a little more and was a solid C.

After college I worked as a legal assistant at a large New York law firm. I was known as bright and for my “posture.” I was able to wear dresses and tops without a bra and still look good. Not at the law firm! Geez!

They were good in law school. Of course I was still in my twenties… I bought a tight dress at Betsey Johnson in Manhattan after first year. A gal from Jersey trying on clothes too said “you have great boobs. Are they real?”

After law school I clerked for a judge in New Orleans. Her fast talking, animated and hilarious courtroom deputy at the time referred to my boobs in his Louisiana drawl as “the rack” and asked frequently after them as a surrogate for asking how I was. “Hey, Em. How’s the rack?” They were a nice D by then.

There was also the “decoy eye” incident, whereupon a man with strabismus entered the chambers and asked to speak to me about something procedural. I came out and talked to him for about ten minutes (during which it became clear that no one could help him because he was dumb as a post). After he had left, the judge’s assistant said that she had had to leave the room while we were speaking because she was so uncomfortable. I said “oh, yeah. I know what you mean. He was so dumb and I couldn’t help him understand…” She replied that no, in fact, she had been uncomfortable because he had been staring at my breasts the entire time we were speaking. “What?” I replied. “Are you sure? He was looking me in the eye the whole time.” Without missing a beat, the courtroom deputy chimed in “that was just the decoy eye.”

I wore a strapless dress to my wedding. It was fabulous. I purchased the white strapless bustier bra at a posh shop on the Upper East Side in Manhattan, had it altered to fit the rack just so and then sewed into my dress so there would be no wardrobe malfunction. And this was before that Janet Jackson incident.

During pregnancy, my boobs started creeping into scary letters of the alphabet, and when years later I unearthed the underwire bras I wore in the eighth and ninth months I was amazed at their size. They resembled two fabric salad bowls connected by a strip of material rather than the double eye patch I started with.

After the birth of our first child, I remarked that each boob was larger than the child’s head. Granted, she did have a small head. But still. I snapped a pic of myself holding my child with much of my boob strategically covered by one hand and sent it to a pregnant friend. She pinged back “I am SHOCKED. SHOCKED by the size of your boob.”

When I went to a postnatal yoga class about two weeks after giving birth, my adorable and tiny yoga instructor took one look at me and said “I see that your milk has come in.” Read: stay back or you might take me out with one of them things.

After giving birth to Isabel, a maternity nurse remarked that she thought “I was going to have quite a supply.” Indeed she was right. I nursed each of my babies for about a year and appeared to have enough leftover to feed several other children.

And after Charlotte was weened they were a little deflated but really still nice boobs. I was still able to wear some dresses and tops sans bra and look good.

So now I ask myself again: do I miss my old boobs?

I guess what I would say is that I think of them fondly. We had a good run.

Now when I watch television or a movie and there is nudity I don’t see breasts the same way I did before. I am more attuned to the shape, the projection, the way the breasts move or don’t move when the actress moves her body. When I take the tube (this is the London underground train for those who aren’t familiar) and a young lady with attractive boobs gets on I admire them more than I might have before. I try not to look for too long.

I miss softness and movement and that natural slope.

What I have now are my temporary boobs. Because I had immediate reconstruction after my bilateral mastectomies in early February, I have “place holders.” They are filled with saline and are making a nice pocket for my permanent silicone implants, which I will get, if all goes well, later this year. They look pretty good. Even in a bra you can’t tell. But they are hard and they do not move. I mean at all. I could jump off the top of a truck and the things wouldn’t budge.

But I do get to do something special. Every once in a while, I go into see my reconstruction surgeon and he expands them suckers with another 50 ccs of saline each. This takes a very little time. And I leave his office with bigger boobs. Instaboob. Bigger tits in 60 seconds. Think of the fortune that could be made if this service were available for normal women.

I am fembot hear me roar.

I get to try before I buy. The newbs will have more projection and softness and movement than my tempies even if they won’t be the real real thing. And they will never sag. I will be the hottest mama in the nursing home. Still killing it in a low-cut dress with no bra. Hooah.