This is the 15th entry in a multi-part series. Read the rest here.
Before reconstruction, I have appointments with my breast surgeon (the one who performed the mastectomy), my oncologist, my integrative doctor, and my plastic surgeon, plus a phone consult with a nurse practitioner.
The breast surgeon is pleased and admires the plastic surgeon’s work. I think about how different she is now, how much friendlier she's gotten over the course of this. I see my oncologist right after and she comments that my armpit is still a little red from radiation, but she is otherwise also very pleased. We have a more in-depth version of the "what next" conversation we had on the phone a few weeks ago and she offers to see me every four months instead of every six for the first two years. Since my last treatment was in July, I’m almost four months clear. Still a ways to go to that much coveted five-year cancer-free mark. I’m not that worried.
She wants me to get bloodwork done before surgery. I’ll need to fast for 12 hours beforehand, which is not that big of a deal but she goes out of her way to talk me through it.
The nurse practitioner calls and asks me a slew questions. Do I smoke or drink? How much do I exercise? "Do you live alone?" No. "What floor are you on?" Third. "Do you have an elevator?" Haha. I ask if it’s outpatient or not and she doesn’t know. What about those wipes I had to use the night before last time or the Gatorade I had to drink in the morning? She has no clue.
Surgery is just over a week away and I have no information.
A few days before I see my plastic surgeon, Paula and I drive north of the city to see my integrative doctor. It’s been awhile and we’re both curious and, in a weird way, a little excited. He always lays down some obvious but deep truth like, "you need to learn to let people help you." I usually don’t like being told what to do, but I look forward to hearing what he has to say. I’ve sent him all of my scans and records for the past year, along with an inventory of my remaining supplements and a few other things.
We came for a directive, but right away it’s clear we’re not going to get one. Haha. Always keeping me on my toes.
My new protocol will depend on if we want to act as if I am disease-free or if we want to continue as if I am still in treatment and we are targeting any microscopic disease that might be left. “What do you think?” I ask. “You’re at least as good of a judge as I am,” he says, but he’s clearly displeased when I say I’m ready to be done with treatment.
I feel great. And I really do. “Yeah, well, you were probably feeling great the day you got diagnosed.” Ouch. And true.
Why isn’t he happier? Everyone else is. I am an A+ cancer patient, other than my occasional bad attitude and my very public diary.
Part of me gets why he’s being antagonistic. To make me take ownership of my decision—and it is my decision. Or to mitigate any regret I might feel if the cancer were to come back. Or to keep me from being complacent about my health. It’s some combination of these, or maybe even he doesn’t know.
He mentions some immunotherapy options in Israel and other far-off places. “What do you think that would cost?” Thirty thousand, maybe more. Plus expenses and time off work, I think.
In addition to my medical records, I had to send him my goals for the next year. I live for this shit. Done. But he pushes back on some of them and has other things I think I should be doing instead. “Are you meditating?” Sometimes. My morning routine depends on the season or my mood or whatever, and I feel fine about it. He recommends doing an immersive retreat, ten days or so, over a daily meditation practice. From a Chinese medicine perspective, I already do a lot. A more balanced approach would mean less daily doing and more just being.
He says it might be nice for me to walk El Camino. “I’d love to go to Spain,” I say.
“France is nicer.”
“How about a yoga retreat?” I don’t like hanging out with people who do yoga. I’m sulking now. “Well, it would be really good for you to have a social aspect to your exercise.” Why?
Paula doesn’t chime in as much as usual. He takes some notes and says he’ll send me an email in the next few days. I pay my $400 and we leave a little quieter than usual. As soon as we’re out of earshot I say, “That was pretty antagonistic, right?”
“Oh yeah, definitely,” Paula says.
When he emails me a day or two later with my new supplement protocol and other recommendations, the tone is a lot friendlier. It includes everything from a tea I should drink daily to this episode of Chef’s Table to lymphedema self-massage videos to recommending that I order a yoni egg. He’s gone full-on Goop on me. But sure, why not?
As usual, my plastic surgeon is the friendliest of the lot. For some reason I was expecting something more high-tech and in-depth, like 3D images and getting to feel different implant options. But this is Kaiser, not some Beverly Hills private practice or a reality TV show. My main choice here is silicone or saline. He tells me the pros and cons of both and I say whatever he thinks is best is fine with me. I trust him. I ask about the size and he says he’ll order several different ones and see what looks best in the surgery room. Okay. The expectation is that it will be a little smaller than my tissue expander. I leave feeling a little more at ease, but there’s still something I’m missing. I don’t know what it is.
After surgery, I’ll be off for the rest of the year. So the week before, I keep myself busy wrapping up my work and organizing my apartment. It’s cathartic to let go of so much. I’m not nearly as sad as I was before the mastectomy, but I’m also not quite sure what to do with myself. Like, what am I supposed to do—spend quality time with my breast?
Maybe I should have. But how can you really know how it’s going to feel to lose something until it’s actually gone?
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