Showing posts with label breast cancer. Show all posts
Showing posts with label breast cancer. Show all posts

Monday, August 1, 2022

Cave Drawings

(Published in The Enneagram of Death: Helpful Insights by the 9 Types of People on Grief, Fear, and Dyling, by Elizabeth Wagele.)
Research suggests that trauma survivors can head off long-lasting symptoms by letting friends know what they're going through. Susan Lien Whigham, "The Role of Metaphor in Recovery From Trauma"
I had not thought of my 2010 breast cancer diagnosis and surgery as trauma until I read the transcript of How the Brain Helps Us to Survive Trauma and understood that any life-threatening event can be traumatizing -- war, a terrible car accident, a natural disaster, a heart attack, cancer.

And the measure of how well or quickly we recover, compared to those who might develop post-traumatic stress disorder, is whether or not we can discharge the energy created by the shock. Some of our response to stress is determined by our own emotional resiliency, but much of it depends on whether our caregivers, family, and friends contribute to our feeling helpless or support our gaining a sense of control. We can begin to take charge of our fate when we're able to talk about our feelings, absorb the reality of our circumstances, and move into action.

My strongest urge while convalescing from surgery was simply to be listened to. And yet, I didn't really have the words to express what I was experiencing. Some of my friends interpreted my early quasi-silence as a desire to have my spirit lifted and entertained me with stories. I loved them for this, but I didn't want to hear stories, I wanted to be invited to express what was going on inside of me, needed them to be patient while I searched to find words for what I was experiencing.

So, I was relieved to read how listening for metaphors can help recovery from trauma. I remembered an earlier blog entry where I had tried to express my reaction to others' view of my "bravery": 
It's like driving in a heavy rainstorm late at night. You'd rather be home by a cozy fire, but you're on full alert, every sense attuned to what's happening in your immediate environment. You don't have time to be afraid.  
I didn't feel brave; I felt swept up in a tide of experience. During the two weeks of diagnosis, biopsy, and surgery I was in a kind of trance, floating, as if rocked on the waves of a deep ocean.

Notice the quality of water in these metaphors -- rainstorm, tide, waves, ocean. And notice also how these water metaphors are hard to pin down (another metaphor); how fruitless it would be to try to capture water with a "pin" of any sort. And yet, these watery images helped me embrace a shock too big to encompass with left-brain language.

Breast cancer brought death into my house. Paradoxically, the mastectomy brought a change to my body that meant I could stave off death, probably for many years, so I denied the surgery as trauma. It took almost six months for me to acknowledge that I saw the loss of my breasts as a disfigurement, to notice how I'd been  dressing to hide it from the world, how quickly I covered myself after a shower--when I used to be so happily naked.

I finally let in the loss by following my metaphors, diving in to the ocean, being swept by the tide to a barren shore, finding a flat terrain with strange plants and unknown dangers, dark caves filled with ancient drawings, wondering 
Who are these others who have been here before me? How can I survive this? 

And I knew I had to find my way through this metaphorical territory, go into the dark caves, experience the fear, learn from the ancient drawings, find guidance from others who had been there for a while. The spirits of these women encircled me as I wept for the loss of my breasts, they chanted with me as I celebrated life's changing seasons and embraced more enduring symbols of womanhood. 

 *   *   *

Seven years later, on April 15, 2017 I faced another loss, the death of my mother. Yes, she lived a long and healthy 104 years, and yes, I was exhausted during the final years of caring for her. But each process of grief has its own territory. As the months passed, I looked at the image above of women in community, and wept as they encircled me once more, reminding me of lifelong love from my Mom, who was also my best girlfriend.


Saturday, January 14, 2012

Give Me Liberty, Or Give Me Death!

Chiron taught his students how to become "sacred warriors;" how to follow their quests and then go to death peacefully when the time comes. He taught his students how to access multidimensionality and balance polarization and duality. Today we might call such people shaman, -- those who have learned to walk in other dimensions, work with duality, synthesize male and female, human and animal, mind and body, life and death. M.Z. Hawkins, Chiron and the Tarot 
I had a distressing encounter with the gynecologist I'd been going to for years, when I went in for a pap smear last week. He knew I had extremely low hormone levels from the post-breast cancer medication I was taking, and was thus dry as a prune -- yet jammed the speculum into me, saying "Sorry if this is uncomfortable."

Uncomfortable? It hurt like hell. But not as much as the way he responded to my talking about alternative approaches to lowering estrogen without diminishing brain function. Our brains need some hormones to function properly, and the so-called "brain fog" side effect of my prescribed aromatase inhibitor had become such a problem I was having panic attacks. After a lengthy attempt to get him to hear me, and his saying, "With all due respect..." which you know means no respect at all, I got it. He's been programmed to believe only in magic bullets, and to postpone death as long as possible, no matter what the patient has to go through to stay alive. 

My internist, perhaps not coincidentally a woman, was completely the opposite -- she listened, asked questions, and responded that she, too, would choose quality of life over years lived.

By the way, my risk of recurrence is only one in four without any medication. Also, that statistic only refers to "women my age." It doesn't take level of activity, weight, diet, or other lifestyle factors into account. So I believe I'm more likely than most 73-year-old women to be one of the three in four who don't have a recurrence.

Nonetheless, the oncologist had convinced me that decreasing that risk to one in eight made potential side effects worthwhile, and besides, "not everyone has side effects." So I was a good sport. And I'm not chickenhearted. I handled the headaches and the joint pain. Even when my hips ached so much that every step was an effort, I still got on the treadmill every day. But eventually my thinking became so confused I couldn't get my mind around large concepts or organize my thoughts. Creative writing was out. So was painting. I had no energy for much of anything. The "me" of me was gone. Not acceptable.

After ten months on the aromatase inhibitor, I chose to stop taking it. With the support of my preventive medicine practitioner (also a respected M.D.) I'm keeping track of my estrogen level, experimenting with alternative ways to keep it low but not so low I can't think.

And from now on, I'm partnering only with wounded healers, doctors and other health workers who are in touch with and have learned from their own pain, and who don't let fear of death get in the way of responding to a vibrant woman who would rather die than lose her capacity to think clearly.

(Published in Survivor's Review, Volume No. XIV, 2013.


Monday, January 24, 2011

From the Heart

The word courage comes from the Latin cor or heart.
Because I grew up in a military family, many of my male high school classmates went to West Point, and then to Viet Nam. In 2000, I reconnected with my high school sweetheart and learned he'd been awarded The Bronze Star for "heroic service" in Nam. When I asked him to describe the events leading to the medal, he said "I don't think of myself as a hero. I wasn't feeling courageous. I just did what I had to do."

That's what it was like for me, as I moved from a "suspicious" mammogram to an MRI and biopsy, to bilateral mastectomy all within a two-week period. I just did what I had to do. As have many of you, I always wondered if I would be frightened by life-threatening circumstances. I was not, and so I don't feel "brave" or "amazing" as others have suggested.

Last week I went to my first breast cancer support group meeting, and the other women there said their experience was similar to mine. 

It's like driving in a heavy rainstorm late at night. You'd rather be home by a cozy fire, but you're on full alert, every sense attuned to what's happening in your immediate environment. You don't have time to be afraid. 

Sunday, January 9, 2011

Grist for the Mill

The Sandhill Stage -- a concert series at the Prairie Creek Lodge to benefit the non-profits Conservation Burial, Inc. and Alachua Conservation Trust.
At a Sandhill Stage concert last night, Penny Nichols sang "Grist for the Mill" from The 8 Voyages of Nep, about her own experience with breast cancer.

Penny brought it all back to me -- Linda Ronstadt and the Stone Ponies, Janis Joplin, Mother Earth, Jefferson Airplane. So much pain, so much love, so many blessings, it's all grist for the mill (click here, scroll down and play #4): 

Bring it in, bring it in, 
it's all grist for the mill. 
What comes out is the sweetest flower, 
fills me up in my darkest hour.
Bring it in, bring it in,
it's all grist for the mill.

Sunday, December 26, 2010

Volcanic Moments

A volcano erupts in Iceland. Tens of thousands of flights are canceled and millions of passengers stranded...  Have you experienced any of these typical reactions in the face of an oy vey moment -- lost your sense of humor, became fixated on what wasn't working, gave up completely, felt annoyed and resentful, looked for someone to blame, pretended it wasn't happening?" Larry Dressler, "Volcanic Moments: Four Practices for Facing Surprises with Grace."
Dressler's post miraculously arrived in my in-box on December 24, minutes after my surgeon told me I have cancer in both breasts. Definitely an oy vey moment. My typical defense in the face of unwanted news has been to pretend it wasn't happening. Of course everything bubbles below. Indeed, my personality style has been characterized metaphorically as a "volcano" -- apparently calm, with complex layers beneath the surface. 

I'll be even more particular, and suggest I've been a shield volcano, formed of layers of fluid lava. Unable to pile into steep mounds, these layers create a gentle, sloping cone and spill from several vents. Attempts to shield myself have created a calm exterior but have also led to lifelong digestive problems, joint pain, and occasional bouts of magna-lava anger -- the symptomatic "vents" my body developed to blow off steam when the rumbling could no longer be contained.

Our bodies give us messages and this one is clear: another vent has appeared, cancer erupting in both breasts. So I'm taking Dressler's advice to heart:
  1. Check-in:  Notice without judgment what you're feeling physically and emotionally.
  2. Name It:  What underlying thought, judgment, or belief are you holding too tightly?
  3. Pause:  Instead of acting, take deep, deep, conscious breaths.
  4. Shift:  Ask questions that shift you to a more productive mental, emotional, and physical state: "What beliefs can I let go of right now in order to serve my highest purpose?" "What are the hidden gifts and opportunities in this moment?"
Some of my thoughts and beliefs:
  • "I'm not the cancer type -- my issues have shown up in stomach aches and arthritis." 
  • "Death is unacceptable." 
  • "I must fight this." 
Obviously the first belief has been refuted. The second is simply laughable; we all, eventually, accept death. Third, trying to "fight" the cancer would reinforce the dysfunctional belief that I must shield myself from reality -- instead of fighting I want to embrace and transform this energy for healing. 

On Christmas Eve I extended Dressler's Pause and Breathe stage, spending hours reading about double mastectomy, searching for post-surgery apparel, sending love to my breasts, letting in the messages cancer brings, terror echoing all the way down to my toenails:
CANCER, cancer, cancer, cancer, cancer, cancer.....

...

Wired

Sometimes an abnormal area will be seen on the mammogram that should be tested for cancer, but is not felt as a lump on examination. The mammography department can help your surgeon find the area more easily by using a technique called "wire localization." Harvard Health Publications.
The day after a biopsy of both my breasts I viewed The Buddha documentary, and was struck by this: "All things change. Everything born is subject to decay. Use even this for awakening." 

My wake-up call came suddenly. After a mammogram on December 24 and consulting the next day with my gynecologist, I met with my surgeon last Monday, had an MRI and blood work on Tuesday, and biopsies on Wednesday.

The pre-op procedure was quite an adventure. The radiology team placed localizing wires in each breast, with only a local anesthetic. Some women freak out, the nurses told me. They've seen everything, from a woman who threw up on them to another who bit the nurse's hand. 

I couldn't turn my head to watch, because if I moved the radiologist would have to repeat the procedure. After he finished I looked down and saw a blue push pin in each breast. The nurses then cut two Styrofoam cups to half-size and taped them over the push pins to protect them until surgery. Robo woman!

The woman next to me in the pre-op holding room was questioning her doctor about the size of the scar he'd leave. I gleaned from their conversation (through the curtain between us) that she'd had a lumpectomy before and now had another lesion with lymph node involvement, but had opted for a lumpectomy again instead of mastectomy. 

Her surgeon kept saying "We need to look at the bigger picture. You have breast cancer, and we want to remove it." She appeared to be in her forties, so I understood her fear of losing her breasts, but what level of vanity would lead her to endanger her life? I was clear about my own wishes. I wanted the cancer GONE.

Under general anesthetic for the biopsies, I was woozy afterward, and couldn't help laughing at the dressing that replaced the push pins: white, pointy tents. 

My surgeon called with the results on Friday. Mastectomy on the left. "We can negotiate the right." But why would I want only one breast, and a 72-year-old one at that? Can you picture the reconstruction? "No, no, guys, it's not nearly old enough, far too perky...."  

The Dalai Lama said a miracle is "something you cannot understand, something unexpected." My miracle? Instead of fear, I have felt mostly joy and gratitude for the tangible love from everyone I encounter, including each of the nurses and doctors who took care of me earlier this week. 

A friend wrote to me on Friday: 
"I understand your 'mostly joy' response. I experienced the same with my reality encounter last year at this time. I think it has a lot to do with how we give meaning to the whole of our lives--whatever comes can be greeted with open hands, open mind, open heart, odd calm, certain gratitude, with the occasional terrifying gut check cry."
Christmas Eve: I removed my pointy tents and took a good look at the biopsy stitches. Both breasts would be deeply scarred. Then a deep breath and gut check. Ah, no. They will be gone.