Paula was very gentle, very kind and sounding "sorry".  She just comes right out with it.  "Sweety, I'm sorry...it is cancer."  I'm pretty much dumb-struck.  She goes on to say that the tumor is small, 2cm or less, and it was caught early.  She expresses that she's glad I'm surrounded by my family and tells me I have an appointment on the 13th to meet with the surgeon to discuss options.  I have Infiltrating Ductal Carcinoma.  Ugly words!!

I'm crying and trying to breathe, but it feels like all the air in the house had been sucked out and I'm stuck in a vacuum.  I start apologizing through my tears to the kids.  I feel so guilty for "doing this to them".  That was my first and dominant thought.  I was going to put my children through pain after they'd already experienced so much loss, heartache and pain in their lives.  At the edge of my mind, I hear and feel their love and support and sense they're already building up their courage in order to comfort me.  Right in the middle of this, Jason gets home.  I turn to greet him and when I open my mouth, nothing comes out but a wail.  He folds me into his big, strong arms and lets me sob.  I try to apologize to him and he says "It's ok...I lost it a few times after my diagnosis.  You're going to be okay.  I beat Hodgkins...you can beat this."  Never once did I have the thought "I'm going to die."

I'm supposed to fix dinner but I'm needing to escape.  I ask George to take over at the stove and I head home...to my nest.  I don't cry on the way home.  I just focus on getting there.  As soon as I've changed into my jammies, I jump on the computer and start researching.  Infiltrating ductal carcinoma; Staging; Grading; surgery options; chemo therapy; radiation.  I subjected myself to ALL of it and I went into hurry-and-absorb mode.  Then, I searched for support groups.  I knew as soon as the site loaded that I'd found the right place.  I posted my situation, hoping for just one response.  I got it.  And so much more. 

11/13/02 - My first meeting with the surgeon.  Mary (from the office) graciously offered to go with me.  As advised, she'll take notes because I'll probably forget bits of information. 
We're shown into your basic sterile exam room.  I'm handed a paper gown and gently told to undress from the waist up.  My heart is just pounding and I feel like I can't get enough air.  I really hate wearing this "gown".  It's UGLY; I feel exposed and vulnerable; I feel like a "patient".
The doc comes in.  He's pleasant looking.  He extends his hand and looks me right in the eye.  He just passed his first test.  He examines me first.  His touch is gentle, yet firm.  He's very thorough.  He gauges the tumor is about 2cm or less (confirming Paula's estimate).  He notices the huge bruise and comments that it's from pooling blood following the biopsy and it will take a while to fade.  It doesn't hurt so I don't remark.
While he's business-like, he's not cold.  He's passed his second test.  I'd made up my mind that if he was cold or didn't look at me like a PERSON, I was not going to accept him into my life.

My Options:

Modified Radical Mastectomy (very UGLY words!).  No chemo, no radiation.  Don't pass go, don't collect $200.  Jump to Tamoxifen for five years.

Lumpectomy with axillary node dissection.  Depending on the node and tumor biopsy, chemo, rads, Tamoxifen for five years.

Lumpectomy with Sentinal Node/s dissection.  Then we talk about the results.

He states over and over...it's my choice, my decision.  I asked for his recommendation.  He recommends the 3rd option.  I agree and we set a surgery date for November 20th.  I don't know if I'm taking the "chicken" path or not.  I'm trying to listen to my instincts but I can't get past the roar of my terror.  He reminds me I can change my mind at any time, even up to the hour before surgery.  I can back out or I can change the procedure.  He also advises me he's on-call for jury duty that week.  Swell, just what I need.  But, I don't want to wait if there's a chance I can know more sooner.  I need to know MORE as soon as possible.

I begin to agonize over my choice.  I can't sleep; I can't eat; I can feel I'm starting to lose weight (I was 90 pounds) I can't focus; I can't shake this terror.  I go back to the support forum - I need comfort.  I need to feel safe.  It's  there waiting for me.  I already know that I can't face this gobblin called breast cancer without being connected to others in the same boat.  I cling to that like my life depends on it.  I have a sense that my sanity depends on it.  I know they "understand" fully and completely.  They're there for me.

My boss listens intently and patiently while I bring him up to speed.  He offers encouragement and humor which I very much appreciate.  I've asked to not be treated as a "sick person" and that requested is being honored.  I'm learning how to ask for exactly what I need without hesitation and that feels good.

11/14/02 - My first meeting with the breast care coordinator, Beth.  She's lovely, warm and kind.  I tell her of my choice, so she explains each and every step for the day of surgery and encourages me to ask questions.

About 3 hours before surgery I'll be sent to nuclear medicine to receive an injection of a radio-active substance called Technetium 99 (teck-nee-shum) which will exactly locate the Sentinal Node/s.  This will be injected into my aureola.  Oh, gawwwd!!!  She tells me it will burn slightly, but the injection will last less than 2 minutes.  I get sick to my stomach just hearing this.

She then tells me that once I'm under anesthesia blue dye will be injected which will "light up" the Sentinal Node/s.  The surgeon will use a small hand-held device that acts as a geiger-counter.  This device will precisely locate the node so the surgeon can make just a small incision right above it.

The tumor in my breast and about 1/4 inch of tissue around it will be removed.  This incision can be about 3 inches.  Everything will be sent to pathology for testing and evaluation.  It is hoped the surgeon can achieve clear margins on this first pass.  If he's successful, it's one hurdle jumped and one step closer to wellness.  Funny, aside from feeling all muddle-brained and panicky, I don't feel UNwell.

I can't really think of any major questions because I'm feeling completely brain-dead.  We will meet again on the 19th.

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