From a Beginning Breast Cancer Survivor

Beverly Dubrin, bdubrin@ca.astound.net
Last Modified: April 28, 2003

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Introduction
The Biopsy
Decisions and Doctors
Surgery
Recovery
The Hair
What's Next
Coping


I was diagnosed with breast cancer in September 1997, just ten days before my husband and I were scheduled to leave for a two-week vacation in France. The month before, I had gone for my annual mammogram and was called back the next day for more detailed pictures because something was "questionable." The radiologist told me there were three micro-calcifications that should be biopsied. She advised me to get a surgeon and take care of it. I was stunned, first because I had always had normal mammograms and second because this radiologist was talking to me as if I had a surgeon at my beck and call! As the kids say, "Hellooooo!"

As luck would have it, I have a terrific primary care doctor who calmed me down, told me not to worry about anything until I was sure I had something to worry about, and got me in touch with an excellent surgeon. When the surgeon could not see me for over a month, my primary care doctor got on the phone to her office and got me in a few weeks sooner. Throughout this "odyssey," as I sometimes call it, she has made sure that I have seen the right doctors and has taken time out of her busy schedule to regularly call to check on me. I feel blessed to have her taking care of me and I say, if you do not think your doctor has a sincere interest in your well-being, find another one and do it as soon as you can, preferably while you are healthy.

THE BIOPSY

The biopsy surgery went fine; I came home after it and indulged in a hearty dinner of barbecue from one of my favorite restaurants. The surgeon said she would call the next day to let me know about the pathology. Much as I tried to keep myself busy with my work, I was on pins and needles. Her phone call did not come until 6 p.m. while I was hurrying through dinner before heading for my weekly French class. She told me one of the calcifications was malignant and that she would like me to come to her office with my husband to discuss surgery options. Time stood still.

Of course, I knew that there was the probability that I had breast cancer, but until I heard her words, it did not sink in. Thinking, I had everything in control, I got into my car and headed off to class. Imagining that I was driving carefully, despite my racing mind, I stopped at a traffic light at a busy intersection and then when I saw cars driving all around me, realized that I had stopped in the middle of that intersection. I was not in control!

DECISIONS AND DOCTORS

I guess I should say a bit about myself. I am the healthiest person I know. I am 56 years old. I have my own business...writing about travel, dining, and shopping in Northern California both for my own private newsletter and for other publications. I plan events and give guided tours for visitors to the San Francisco Bay Area. And, in odd moments, I train people to use their Macintosh computers (my prior career was in data processing, working for large corporations). I exercise regularly, swimming three or four times a week with a Masters Swim Team, playing tennis, and riding a mountain bike. I eat well (Could I have eaten too much broccoli?) and am not overweight. I have a wonderful husband, delightful miniature poodle, and many very special friends. My life is good, happy, busy, and, above all, healthy. Up to this point, my most major health problem has been severe osteoarthritis in one knee...I tried to learn to ski once and the injuries sustained from a fall brought this on.

In the ten days that followed, I saw more doctors and made more important decisions than I ever have in all my life. My primary care doctor sprung into action once again and made sure that both a medical oncologist and a plastic surgeon adjusted their schedules to make time to see me before I left for vacation.

As for the vacation...I was willing to cancel it, but as I went through the rounds of doctors, they all agreed that my going away was not going to endanger or worsen my condition. First I saw the surgeon who, in explaining the invasive component of the calcification, made it clear that a mastectomy was the best surgery option. As for reconstruction, I had already decided that, given my active lifestyle, immediate reconstruction was what I wanted. The next stop was to the plastic surgeon who explained the different types of reconstruction. The TRAM Flap was what I chose...abdominal tissue and attached muscle are tunneled up to reconstruct a new breast. This is the only procedure that generally does not require any kind of implant. Also, it is the most complicated surgical procedure, taking 6 to 7 hours. The "bonus" of the TRAM Flap, is that you get a tummy tuck in the process, and even I had a little tummy that could be made a bit flatter!

The final doctor I saw was the medical oncologist who explained the whys and wherefores of chemotherapy. It was in this doctor?s office that I relaxed just a bit after he said, "You must feel wonderful since you?ve had the biopsy. Right now you have less cancer in your body than you?ve had in years." Those words continue to cheer me when I feel a bit down...breast cancer does not pop up overnight; it takes years before even something as small as mine is detectable.

By the time I went on vacation, my surgery was scheduled, my first chemotherapy was scheduled, and I had given the first of two units of blood for my surgery.

Taking a two-week vacation in the midst of all this was the best thing that I could have done. I felt as if I had been on a treadmill and this gave me and my husband a chance to get off and catch our breath. We had a wonderful time and came back clearheaded and ready to tackle what was ahead.

SURGERY

My surgery was in early November, It went well and, according to the anesthesiologist, I woke up smiling. I don?t even remember talking to him, but I do remember talking with my husband in my room, debating over whether I wanted to try the morphine pump even though I was not in pain, and chatting with a friend who decided to pop in on her way home from work.

I spent four nights in the hospital, progressing well, to the delight of my doctors and nurses. The little peek I got at my reconstructed breast gave me another boost; it looked great; it looked like the old me.

RECOVERY

Recovery progressed well. From the day I got home I started taking walks. First it was just around the block, then it was around our neighborhood, and soon I was heading out to nearby trails. Having a well-conditioned body was paying off.

Two weeks after surgery, I started chemotherapy...four treatments of Adriamycin and Cytoxan, spaced 21 days apart. I am writing this on the eve of my last treatment. Again, what my medical oncologist said was what has happened. He advised me to think of myself as a healthy person who would feel awful for two days every three weeks. That pretty much has been what has happened. I do live in fear of infection with my compromised immune system and must wash my hands a hundred times a day. When I hear someone cough or sneeze while I am in line at the post office or grocery store, I cringe. Before I go to someone?s house or have guests at my home or office, I ask if they have colds.

Five weeks after surgery, I got the OK from the plastic surgeon to go back to my old activities. So far, I am back to swimming, doing three workouts a week. This is the rainy season in California and I have only taken one short bike ride and, as a weekend tennis player, have not had a clear weekend to see how I will do with a racquet in my hand.

THE HAIR

Right on target, two weeks after my first chemo treatment, my hair started falling out. Friends who had gone through hair loss advised me to cut it off as soon as it started to fall out. I could not do it!!!

For a week, I washed my hair in the sink with the drain closed and then fished out handfuls of hair. After a week, scalp started to show and I put on the wig that I had picked out before I started the chemo. Some wisps of hair have remained and I cherish them. Every day I look to see if new hair is coming growing back. So far, nothing is happening, except that some eyelashes and parts of my brows have also fallen out. I keep wondering if the new hair will be blond and curly as the old was...only time will tell.

With the hair loss, I learned something about myself. I found out how much of my self-image is tied up in that hair. I feel like a different me, no matter how nice my wig, or how "cute" my scarves and hats.

WHAT?S NEXT

Once I finish with and recover from chemo, I start radiation treatments...28 treatments, every weekday for about 5 1/2 weeks. I?ve met with my radiation oncologist and next week will have my simulation done. Radiation should start in a few weeks.

After that . . . close follow-up with my doctors and keeping my fingers crossed about the future.

COPING

I cope by talking about my problems, or by writing about them. I have told everyone I know that I have breast cancer. I?ve proudly showed my reconstruction to anyone who even remotely expresses an interest in seeing it. At the pool, my swimming colleagues marvel at my appearance, check out the shape of my head, and come up with new scarf-tying tips. My swim coach keeps an eye on me, making sure I don?t overdo.

I?m happy to tell my story and hope that I can be inspiration to those who may have to go through a similar experience. A lot of my strength has come from family and friends who are out there cheering me on. In many cases, I am the first person they know who has openly discussed the whole process.

I have gained insights into the people in my life, too. While many have kept in touch, including a special group of men friends who take me out to lunch to celebrate each milestone of my treatment, some have stayed away as if I have the plague. My reaction to this is more amazement than anything else. Cancer is not contagious and the last thing in the world that I want to do is to hide away from the rest of the world.

Hopefully, the remainder of my treatment will progress smoothly and in a few months medical appointments will not hold such a predominant spot in my daily routine. But, I know my life has changed and I am going forward to lead a life that I value more dearly than anything else.