Well, Rats

OK, that doesn’t express how I’m really feeling. Breast biopsies are back, and I have low-grade ductal carcinoma in situ (DCIS) of the right breast. (Warning, true emotions coming up – FUCK, FUCK, FUCK) Sure, if one has to have breast cancer this is the type to have – assuming the needle biopsy is correct – confined to the lining of the ducts, survival rate beyond 15 years is 85-95% depending on which studies you read. Newest research gives results for lumpectomy (excision of surrounding tissue, even without a lump) compared to lumpectomy with radiation and lumpectomy+radiation+tamoxifen. (Tamoxifen has its own serious side effect profile.) There is added benefit for all 3 treatments but not sure if it’s enough to go through radiation and risk and side effects of tamoxifen. Then there is always the option to cut ’em off…

Decisions, decisions. Seeing breast surgeon May 2.

I was expecting this result but some how still stunned.

Good news is that being post-menopausal, my breast cancer doesn’t confer extra risk to my sisters.

Get your mammograms on schedule.

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Stress & (Not) Eating & Ramblings

The days between finding out the results of my mammograms (bilateral BI-RADS category 4 microcalcifications = suspicious for malignancy) and the biopsies done yesterday, I behaved very unlike me. I did not eat to soothe my anxiety. In fact, I had almost no anxiety until the day before when I started feeling what I can only described as “scared”. When pressed by my spouse to talk about it, the feeling came from being out of control of a medical situation, having my body touched, being exposed. All normal things that most people in a patient role experience, but some of us have more issues than others about our bodies. I am one of them.

For years I spent my life with my head cut off from the rest of me – literally. Probably explains why it was so easy to gain 100 pounds during my medical residency as I lost what little contact with my physical self that I had from vigorous sports. To keep the numbness going, I started binge eating after 36 hours of work (ah, the good ol’ days). Then bingeing became a way of dealing with stress in general.

One way I tried to control my life was through knowledge, understanding, problem solving. Free kindergarten did not exist when and where we lived when I was 5, so my Dad started teaching me to read and do math at a very young age. I quickly learned that the world seemed much easier to control if I could wrap my little brain around facts and put them together. Makes for a school-smart kid. Doesn’t necessarily help make one a complete person. He also taught me to play football, baseball/softball and from there I took off on every sport I could participate in. Great stress reduction to move one’s body. My family was extraordinarily loving. Still I split my head from my body.

Fast forward to last week when faced, literally, with my mammograms while talking with the radiologist. All the things that I know, that I researched and taught others to do when faced with medical decisions flew out the window. I didn’t ask enough questions. I stammered around trying to act like a doctor and a patient, trying to keep the detachment in my brain from the obvious physical abnormalities staring at me from the radiology view boxes. After calling Sue and realizing how totally numb that I felt, I went to Starbucks with iPad in hand to research the radiographic findings and get a little soothed from some mocha and caffeine (my one sugar treat). I couldn’t do it. I wrote the last blog post instead. I talked to my Mom (um, she’s dead, so it was a one-sided conversation). Then I steeled myself for the binge urge – it never came. Emotions never came until Sunday night when that feeling of being out of control hit hard.

Segue to yesterday at the radiologists’ office – an amazingly woman-centered environment. With Sue in tow, we arrived early. Suddenly Sue (who had her own breast cancer scare 4 years ago) tells me that the doc doing my biopsies went to the same medical school that we did! Why should that be so comforting? She might still be a jerk – many physicians are. She was wonderful – answered what questions I had and more that I hadn’t thought of; thoroughly explained the procedure; and then spent the entire time (it took 2.5 hours because, well both sides and it takes time to position, repeat pictures, etc.) talking with me as a human and a colleague. We yapped about medicine, Tucson, Texas, public health. I stayed in my head entirely. This time being able to disconnect from the neck down was very adaptive. Only today when I took off my sports bra did I realize how much time my breasts had spent under compression. How stiff one can get from lying like a pretzel wrapped around a machine for a couple of hours. How much pain you can ignore until the stress is gone. Ow, my neck hurts. My shoulders hurt. My boobs – fine as long they stay supported. My emotional state is good also. I don’t feel numb but am eager/anxious to find out the results by Thursday and move on from there.

For anyone who has to have a breast biopsy in the future let me reassure you that the procedure (stereotactic vacuum assisted core biopsy) is relatively painless compared to the old days of sticking a 14-gauge needle in and poking around.

This post has been more stream-of-consciousness than usual. Good for me, not so good for the reader. If you made it to the bottom of the post, I promise not to do this again – until the next time that I do. 🙂

Be Careful What You Wish For

Two days ago after my mammogram, I was lamenting the saggy state of my still rather large breasts and contemplating whether to get them lopped off -OK, OK, surgically reduced and lifted – at the end of my weight loss.

Today I am numb as the results of the mammography reveal very suspicious micocalcifications in both breasts. How suspicious one might ask? The scoring system known as BI-RADS has both areas at 4 on a scale of 0 to 6 where: 0- incomplete, 1- negative, 2-benign findings, 3-probably benign, 4-suspicious abnormality, 5-highly suspicious of malignancy, 6-known biopsy with proven malignancy. To put this in to a better perspective, a BI-RADS of 5 means the chance a woman with that score actually has some type of breast cancer is about 95%. (For those interested, this likelihood is called the positive predictive value or PPV.) The PPV for a score of 4 is only 20-40%, but that is a heck of a lot higher risk than I had 2 days ago. Disturbingly I find there are sub categories, 4a 4b 4c with much greater risk in 4c, as high 79%. My radiologist didn’t breakdown the subcategory – just as well. It is what is.

I am scheduled for bilateral breast biopsies Monday. My wonderful PT and massage for an ailing neck are out the window for the following week then we will deal with the results.

I draw strength from all the physical trials my Mother went through the last 10 years of her life, smiling the entire time. How bad can this be? Cheers!

To Reduce or Not?

Not what you’re thinking. I have reduced: my calorie count and sugar/starch/grain consumption; body weight by 115 pounds; and body fat by an estimated 45%. Now with 50 pounds left, there is one (actually 2) things on mind, rather on my chest.

During a mammogram yesterday, as my boobs in all their pendulous glory lay squished one at a time under the compressor paddle getting irradiated, once again I pondered breast lift & reduction surgery. Why? I don’t consider myself a vain person. (Who does?) Facial plastic surgery and body sculpting are not on the list. But honestly, my chest looks like I’ve had 12 kids. The best under-wire bra money can buy only puts my boobs so close to anatomically correct position. My neck is killing me – so much I was concerned that a 16-year old cervical spine fusion had finally failed. The MRI thankfully only showed arthritis, and my physical terrorist is having a difficult time getting the right side of my neck muscles to unspasm. (“Ah-ha, a paper trail!” said the mammogram technician. “Maybe you can qualify medically for a breast reduction.”) Who wants surgery? Sure boobs above my waist (slight exaggeration) would be delightful. Being able to walk/jog without the slapping of breast tissue on chest, no longer being embarrassed, no more neck pain – all very tempting.

Fifty pounds to think about it. I don’t like surgeons. Hey, I’m a doctor, why should I?

old woman in bikini bottom only

Spring In The Desert

Last week it was 95°. On Saturday it was 55° and rainy in Tucson with about 9 inches of snow up in the Catalina Mountains behind our house.

Catalina mountains

Catalina Mountain Snow in April

We decided to drive up the Catalina Highway – about 30 miles from our house at 2600 feet to the top of Mount Lemmon (well, close to the top), which peaks out at 9,157 feet. Supposedly the brief trek is the equivalent of traveling from Mexico to Canada ecologically and climate-wise. In the one hour it took to drive, the temperature dropped from 60° to 31° when we reached the little town of Summerhaven near the ski “resort”. Yes, there is skiing in Southern Arizona, but not this year. Usually there are about 180 inches of snowfall. This year I’m not certain there have been any days open for skiing, it has been so dry.

Tree blooming in the snow

Unidentified tree blooms in Summerhaven

 

icy tree bud

Icy tree bud

I made Sue stop and take a picture of me standing in the snow while her parents tried to get over their car sickness (evil snicker).

Snow bunny

Once back in the desert I shot a few blooms around the neighborhood while walking the pets.

Ocotillo with mesquite tree and saguaro cactus

Mexican bird of paradise bloom

Mexican Bird of Paradise

 

 

 

 

 

Generic cactus blooming

Cactus under palo verde tree

 

 

 

 

 

Finally, say goodbye to my in-laws! They left today with Sue escorting them home. Thank goodness since they had major travel delays in Chicago. I’m afraid they would have bounced back without her in tow!  (I’ve already reclaimed my space, emptied their crap out of the house, the pantry, and the fridge. Ah, peace…)

Adios ’til next year.

 

Sue & parents

I Scream

This is unofficial rant day for da blog. So I’ll make these kinda brief and to the point:

Another plateau. After 565 days, one would think I would be used to these. My devout adherence to <1200 calories/day plus no sugar/starch/grains is my own body’s proof that calories in/calories out math does not apply to weight as measured on a scale.

My in-laws continue to bring ice cream into the house. Finally told clinically crazy mother-in-law (MIL) that putting ice cream in our freezer is like giving whiskey to an alcoholic. Blank stare.

They removed “my” chair from the living area to put a chair MIL bought for herself. Now I’m beginning to feel more than a little displaced but have found a source of firewood for our cool desert evenings…invasive inlawsIt’s too darn hot! I either have to walk at 6 am or at dusk now, which is when rattlesnakes are most active on the trails. Lovely. Maybe spring will return for a few more days before I have to walk elsewhere.

Why can’t all clothes be sized the same? I leapt for joy when apparently dropping 2 sizes only to find that in another store I was a size larger. So, add sizing to the scale as a bad measure of fat loss. The tape measure is best if you can’t measure your actual fat stores.

A grocery store clerk turned down my ID when paying with a credit card because I looked nothing like the picture. Oh wait, that’s maybe a good thing, except now I probably need to go get a new driver’s license.

Finally – In an attempt to cut spending, Congress wants to repeal Medicare (for those currently born after 1955) and replace it with private health insurance. Yes, those of you who have paid in will lose out. The most efficient health insurance program for our nation’s elderly will be handed over to the most inefficient industry on earth. How about going after some revenue from the big corporations that pay ZERO taxes? (Apologies, this comes from my concern over health care for seniors and the poor. I don’t give a rip which political party is proposing such idiocy.)

Now off for a brisk walk along a local park route.

Have a great weekend! (I wish cause they will be gone after next weekend.)