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January 12, 2014

The Journey Continues

There is something uniquely cathartic about the Oregon coast. I feel a sense of peace, calm, safety, clarity, and clearing; I feel at home. It is never too frigid to remove my shoes and peel off my socks to press my feet into the ocean sand. I found myself coastal bound on Monday January 6, 2014 – instinctually drawn to my private refuge to ponder.

It was a typical annual appointment with my oncology nurse practitioner– we laughed at times, were mildly serious with a twist of levity as we discussed my anemic state – my practitioner noting: “I have to tell you Christina, I have never quite seen an iron panel quite like yours … it’s so low!” My response was something along the lines of, I am here to provide a service and challenge your knowledge. After reviewing blood work, we were fix’n to wrap things up. She asked if I wanted to have a breast exam – I was agreeable, as long as I did not have to put on the awful gown. I prefer just too … well, you know … whip ‘em out. I thought she could take a look at the end of my lumpectomy scar. I pointed to the inner end of my scar, where I felt something liken to a small round nut. There is quite a bit of scar tissue that can be felt under the skins surface, but this area felt more structured, rounded, and separate from the scar tissue. We decided it would be best to have it checked out by way of imaging.

I was agreeable to undergoing a bilateral breast ultrasound, in Oregon, only if the radiologist would be present to discuss what she was seeing during the test. I traditionally travel to the TOPS breast clinic in Texas to have testing – TOPS has the radiologist participating in the ultrasounds and discussing the findings in ‘real time’, I like this. My nurse practitioner stated she would look into my request and follow-up with me. The following day, Friday, I received a message from the oncologist that my request was granted, it was a matter of matching schedules, and we would connect Monday or Tuesday. I was in a good space. No worries. However, Friday early evening, I received a voicemail from the oncology scheduling office informing me that they had scheduled an appointment for me to be seen first thing Monday morning. I gasped. Normally, I would be ecstatic that I would not have to wait for an appointment. As my heart sank into my stomach, I said out-loud, “they think something is wrong”. Let me back-up really quick here. When I went to my annual appointment, it was going to be routine. My tumor markers looked good – all in normal range and I was more interested in discussing my freakishly low iron levels. I was going to decline a breast exam but thought I could have her look the area at the end of the scar. I was not concerned when leaving her office after all my tumor markers look good. I was not concerned until I received the telephone message noting my ultrasound appointment. I could sense the practitioner’s urgency. Now I was concerned.Monday morning I find myself listening to the radiologist tell me that the mass was cancerous and that there was lymph node involvement. Her recommendation was to immediately have a biopsy so a course of treatment could be charted. There I was, on the exam table, in the darkened room, thinking:

Did she really just say that?
No way.
I don’t believe it!
Take it back!
You have no idea what you are doing!
Biopsy, um … NO!
Course of treatment – um… do you know who I am?

I was not emotional. I was however, shocked, numb, disconnected. Surely, this is some kind of mistake. What is now being called “The Mass” is cancerous; this was completely incongruent with my tumor marker tests. It does not make sense, no sense at all. I called my husband – when I told him their findings I could hear him gasp and quietly remark “oh my god”.I needed to be alone to process what I just learned. I apologized to my husband, I think in a text. I told him I was sorry – I know he did not sign up for this. His response – actually, I DID sign up for “this”, for better or worse. Why the hell was I apologizing? What exactly was it that I was apologizing for, it was not as though I went to the store and said, “Yep, I will take a nugget of cancer with side of lymph node involvement … have a nice day.”

As I drove to the coast, my mind was all over the place and I could not make sense of what was happening. I was numb and still in shock – still disbelieving that the cancer was back. I slowly walked along the shoreline, wiggling my toes in the cold dampened sand. After walking awhile, I scouted out a place to sit-down so I could write. 

As I approach the sandy beach, I peel off my socks and shoes. I plant my feet in the sand– feet and sand become one; I feel grounded. Drawn to the sea, I approach and instinctually turn left and stroll. Not inclined to rush, hurry; to get wherever it is I think I may be going. I walk. I gaze at the footprints left in the sand – a memory etched and left behind. I am reminded of early morning beach walks, just grandpa and me. My two footprints beside each one of his. We held hands you know. I would fill his pockets with treasures left by the sea. I always turn left; does this have meaning? Perhaps. I am in a daze. I sit upon the cold sand, bare feet buried in the sand. The sound of the sea is loud and echoes along the vast shoreline. Watching each wave’s distinct formation building only to crash to the ground.
Today I was told the cancer has returned by way of a tumor and it seems as though the precocious cancer has most likely went on holiday and traveled into my lymph nodes. I was calm and questioning. I don’t believe what the doctors were saying for many reasons. I walk in the sand breathing in the fresh sea air. I find solitude. I feel grounded. I feel peace. I feel my grandpa with me – he is smiling as he looks into my eyes. His eyes tell me I am true perfection – flaws and all.

I don’t believe the doctors, I just don’t. An image on a screen only details a guess, a suspicion. I say I don’t believe them, yet as I drove over the mountain, I was making mental notes of things I needed to say to people, the legacy I hope would be celebrated, ways I could let those I care deeply for can know I will forever be with them – even when I leave this lifetime. I could link these co-occurring thought patterns to my ADD combined with my love for organization. On the other hand, does it hold another meaning? I am not sure. I am okay with not knowing. I don’t have to know everything.

I believe that what we need will be provided, at just the right moments; we must simply be open to receiving. I was going to spend all day Saturday reading in preparation for the first day of the spring semester, which will begin Monday. Instead, I found myself enjoying some television followed by several hours of making earrings. Recently my close friend Leslie shared her jewelry making knowledge. I have to say that handcrafting earrings into interesting arrangements is calming, therapeutic, and rewarding. Before I knew it, the day had slipped away. I decided that a Calgon take me away moment, was exactly what I needed. As I relaxed, I began to read The Gifts of Imperfection: Let Go of Who You Think You’re Supposed to Be and Embrace Who You Are (Brown, 2010). There it was; just what I needed. The words resonated deep within me. As I read, I reflected back on why I had apologized to my husband after learning the cancer has returned. I believe I felt shame that the cancer was back, fear of what was to come, and judgment of those around me. If the cancer is back – I have not only let myself down; I have failed everyone. My friends and family believed that if anyone could conquer this diagnosis, it was me. The naysayers would think and remark, “I told you so, this is what happens when you choose your so called alternative treatment – serves you right.” Those choosing alternative treatments would now have doubts. I turn back on myself and start making a list of things I could have or should have been doing better, more complete. There you have it – I was feeling shame and fear. This is a piece of literature to be celebrated and a must read. 

As Brene Brown writes:
Here’s the bottom line: If we want to live and love with our whole hearts, and if we want to engage with the world from a place of worthiness, we have to talk about the things that get in the way – especially shame, fear, and vulnerability. (Brown, 2010)

I am working on talking about the things that are getting in my way. My shame, fear, and vulnerability. I am going to show true courage, I am going to talk about some of my fears.

I am afraid.
I fear cancer is going to end my life.
I fear my time is short.
I fear I will lose my mind.
I fear looking into the eyes of those I love and feeling their pain and hopelessness.
I fear being in pain.
I fear not knowing.
I fear being alone.

I am a strong, hopeful, and realistic. I am week, fearful, impractical. I am beautiful because of my imperfections – perfectly imperfect. For now, I carry on. School begins tomorrow and I am looking forward to an exciting second semester. My first semester was incredible; I enjoyed nearly every moment! It was challenging academically, personally, and emotionally. Pleased that I made it through 13 credit hours (4 classes) earning a 4.0 GPA. Bigger than my GPA was my emotional and personal growth – this program has a way of nudging you to go deeper in your own journey. I will travel to Texas this month to obtain a second opinion on the mass in my breast. I will not be making any panicked decisions while in Texas including biopsies and/or surgery. I will however, be gathering information from all my practitioners. Upon my return, I will chart my course of action.

Today, I am hopeful~