#1: From the top! 2…3...4…

May 2017

(a break in the routine)

I‘m usually first to wake up and shower. Brian gets out of bed when Quinn wakes up and yells “Da-DAAA!” He changes her and tries to keep her occupied long enough to let me finish getting ready. At some point she’ll search for me. “Mommy?” When she finds me in the bedroom she sing-songs her request. “Nilka*! Mommy nilka-nilka!” (*”Milk” became “Nilk” became “Nilka-Nilka”). I scoop her and Bosqo up onto our bed. And the three of us snuggle while Q nurses. Then we play Kabushi*with the pillows, Q’s baby version of peekaboo/hide and seek. (*”Peekaboo” became “Kakaboo” became “Kaboo” became “Kabushi.”) This has more or less been the routine for months.

But one morning while I wait in bed for Q to toddle in, I find a hard lump in my left breast about the size of a small blackberry. But maybe it’s a clogged milk duct. That happens sometimes. I nurse her and it doesn’t go down. That night I nurse her again and still it doesn’t go down. I tell Brian and decide to wait a menstrual cycle to see if the ebb and flow of hormones have any effect on it. 80% of the time when women get a lump checked, it’s nothing to worry about. Less than 5% of breast cancer cases are women under 40.

June 2017

(now what?)

Yeah… this thing isn’t going away. One morning I wake up with a stiff shoulder. I think it’s because I fell asleep on it weird. But the stiffness doesn’t go away after a few days. The stiff shoulder is on the same side as the lump. This, I don’t tell Brian.

June 20, 2017

(it’s probably nothing)

There are like 9 doctors and a bunch of nurse pracitioners at my obgyn. The earliest appointment is with a nurse practitioner I’ve never met: Feiyan Su. She’s perfectly nice and professional, but in a week’s time, she will make it onto my permanent shit list. By her recommendation I make an appointment to get an ultrasound/mammogram.

June 22, 2017

(but it might be something)

The man at the front desk of the NYU Cancer Center is so gentle and kind in the way that he directs me to the 3rd floor. I think they must be trained to assume everyone has cancer and is to be handled like an egg.

Unfortunately, the ultrasound finds my weird little boob lump to be anything but egg-like — it’s hard, solid and asymmetrical. It doesn’t hurt when prodded. These are all bad signs. They tell me they’ll use the ultrasound to then look under my arm as lymph nodes are sometimes associated with tumors. CRAP. The sore arm. And sure enough, there it is on the monitor, my fate in the shape of a tiny black circle on a screen: a swollen lymph node. They order biopsies on both ASAP. They tell me to go get food and come back.

(uh… armpit cancer?)

My parents’ dry cleaners is nearby. I decide to stop by so I can say hi and charge my phone. I pick up a phone charger at a Verizon store on the way. The cashier makes a genuine comment about how beautiful the weather is today. I muster enough energy to politely agree.

My mom is surprised to see me and asks what brought me here. “I had a doctor’s appointment in the area.” “Oh my god, is everything ok???” … Now, the PLAN was to be composed and not alarm her until we had results. But what ACTUALLY happens is that after flexing my courage like a muscle all day, standing in front of my concerned mom, the tears start flowing. My dad comes over and asks why I’m crying. But honestly, even if I just learned I had to amputate my leg, he’d still ask me what the heck I was crying for. He says I’m upset for no reason and that years ago they pulled a golf ball sized fat deposit from his side, pff, this is nothing. I tell him about the lymph node in my armpit which could indicate something serious. And his response is -no lie- “What! Come on, who’s ever heard of getting cancer in the armpit??” I don’t get freaked out or stressed very often. Especially by health stuff. (just ask poor Brian who’s always nagged me about seeing doctors and taking medicine, to which I’ve always responded something like, “meh, sickness is all in your head, I’m fine.”) So regardless of how my dad laughs off my imagined Armpit Cancer, my mom recognizes my fear and anxiety and walks me out the door to tell me, “Everything’s going to be okay. It’s probably nothing. But even if it IS something. It’s still going to be okay.” It’s worth noting that my family is NOT emotionally expressive. I’ve never been told “I’m proud of you” or “I’m sad with you” or “I believe in you.” For a long time “I love you” was something only said on birthdays and holidays. So this message of support is a big deal.

(the biopsy)

They do a core needle biopsy on the lump. First, they numb the area, make an incision, stick what looks like a giant meat thermometer into me, then clip a few samples off the mass which sounds like a giant staple gun going off inside my body. This sample will go off to get biopsied. Then on the lymph node, they do a fine needle aspiration, the instrument for this isn’t nearly as dramatic as StapleGunTurkeyBaster. They say they’ll need to take 3 samples from the lymph node. A pathologist stands by to look at the cells in real time as they are removed from my armpit. But after the 2nd sample, the pathologist says “yeah, i’m good.” What? Why good? What did you already see in 2 samples that you don’t need a third? This is also bad.

I get dressed and meet the doctor in an office. The lymph node turned up atypical cells. But hey, breastfeeding does some weird stuff to the boobs, she says. Still, the doctor uses phrases like “I know this is a lot to take in.” “Do you need someone to be with you when you get your results?” “I know this is a shock.” She asks me if I have any questions. I say, “I have a LOT. But you won’t be able to answer them until we have a definitive answer from today’s biopsy.” “No.” “But given that I have a lymph node at the same time as a solid mass in my breast, the likelihood it’s cancer is very high.” “Yes.”

On my way out, I hurry past the friendly front desk guy but this time I am unable to hide my tears. I think to myself, he probably sees this a lot.

I walk back towards work because it’s better than going home to see Quinn right now. I wouldn’t be able to handle it. At the office I go straight to check in on my editor Rob since I’ve been gone all day for what I thought would be a quick appointment. He asks me how I’m doing and again, I just start full on sobbing. My EP enters at that same moment. Dam’s broken, and I ugly sob to them both. I tell him I’d rather watch footage than go home.

The weekend of June 23rd, 2017

(bathroom floor)

They told me that the results of the two biopsies would go back to my obgyn office, so I should expect a call from them with the results.

Brian says we don’t know anything yet and negative thinking won’t help anything. But I know that lump + lymph node = cancer. And I saw the way the doctors spoke not just to me, but to each other. Quinn makes me afraid to hope because there’s too much at stake.

This waiting period is the most emotionally difficult time Brian and I ever have as a couple. I cry a LOT. I cry nursing Q wondering if these would be the last times I’d ever feel this close to her. I cry during good times wondering how many of these are left? How present would I be in the following months? What would life without me mean for her?

That Saturday morning, we go to the Sunnyside farmer’s market. We make chit-chat with vendors, we run into our dog walker and meet his girlfriend, comment on their fun t-shirts. We play normal as best as we can. Then back home, I give Bosqo a bath. Q crowds our tiny bathroom wanting to help — we show her how to use the hair dryer on the old man, how to brush him… and as with any practical lesson involving a toddler (and a live animal), it’s equal parts cute and chaotic, where all the parts of your mommy brain and body are working at once to keep everyone happy and safe — and it all just hits me at once. I motion for Brian to take Q and Bosqo out of the bathroom for me. And I just sit there next to the bathtub, too heavy with sadness and anxiety to stand up. In this moment what terrifies me most is that I’m not strong enough to be Quinn’s mom through this. I don’t have enough stuff to pick myself up even in the presence of my beautiful, brilliant little girl. When Brian and Q come to check on me I sob to him, “I’m not strong enough for this. I can’t do this with grace and humor. I’m not going to be one of those “inspirational cancer” stories. I’m going to be bitter… and angry… and sad because FUCK this shit.”

This is one of my lowest moments. Well, that. And also crying over all the ways I’d leave Q signs from the other side. That’s right, I cried imagining myself as a Ghost Mom. But listen, not like the creepy kind of Ghost Mom who shuffles around the attic wailing “my baby! where’s my baaaaybeee?” I mean like … BW and Q get into a car and Justin Bieber’s Sorry comes on (her favorite)… or like, why is this butterfly following Q around the playground… or like Q says “Mommy came and played with me last night!” and like, BW sees that our Cookie Monster puppet is not where he left it last…. also it’s mysteriously covered in Terra chip crumbs. I hate to admit but I’m tearing up now as I type this.

Anyway, that’s how much I love my little girl. When faced with death, I fantasize about how I’d haunt her to tell her how much I loved her even in the after life.

The week of June 26, 2017

(A diagnosis, then the actual shittier diagnosis)

Monday morning, I awake thinking this will be my last “normal” morning. That day at work, my body tenses at each and every notification on my phone. But the day goes on and ends with no call from my ObGyn office. I think, if it was an emergency they would’ve called me. Why would they keep me waiting if they know there’s an actionable diagnosis? The next morning same thing, THIS is my last normal morning before I get the call that will change my life forever. Again, no call. I reach out to them to let them know I’m waiting on a biopsy result. “When we have the results in, a nurse will call you. Would you like me to transfer you to the nurse station?” “… will they say the same thing you just told me?” “Yes.” “Then no.”

Brian and I go through a weird cycle where we’re sad, but then as more time passes without news, the more we feel normal again as if none of this happened, and then the hoping scares us and then we go to the dark place again.

Wednesday I call again, “this is ridiculous, this is well past when I was told the results would be returned and I’m VERY anxious to get them.” “Of course, we’ve just been doing a little phone tag with the doctor, but as soon as we can speak to them, we’ll give you a call.” UGH. If it was a clear biopsy, the message would be “the biopsy came back negative! byeee!” This is bad. At this point I only have all the fears and no answers. I’ve had 5 straight days living with electric eels doing the running man challenge in my chest all damn day.

Late Wednesday, NP Feiyan Su (remember her?) calls to tell me the bad news. She asks me what I know already. I say that they found a lump and atypical cells in a lymph node on the same side. She says the biopsy turned up DCIS, a form of cancer that occurs in the milk duct. But this type of cancer is very much contained and has an extremely high success rate. She gives me some recommendations for breast surgeons to start reaching out to. OK, great, I have my answer. I knew there was something wrong and I was right, but as odd as it sounds, DCIS is the best cancer I could’ve hoped to have had. It doesn’t spread, it stays put, some women go years with DCIS in their breast without ever knowing it. My shoulders relax and I feel a hundred pounds lighter. I call my mom who sobs with relief at this news. “This is what so-and-so’s mom had this year and it was NOT BAD! She didn’t need surgery or chemo and she’s fine! Oh thank god, thank god!” She says she’s been praying every morning at church. She says that however much I was hurting and worrying, was double for her because, “When a baby is sick the mother suffers twice as much with worry. In my mind’s eye I’ve been picturing you as you were at Quinn’s age now. That’s how I’ll always see you. Now that you’re a mom, you understand that, right? Just like you’ll always see Quinn as your baby, that’s how I see you. You see that now right?” We exchanged tearful I love you’s. I feel so blessed.

The next day I call my friend Tessa who kicked breast cancer’s ass in her 20’s and still continues to kick its ass everyday. “Nope,” she jokes, “we don’t want you in our club, you can’t come in, bye.” I walk her through the diagnosis and she tells me that if it is DCIS, that’s great, but what about the lymph node, did they say anything about that? She tells me I should check with my doctor’s office. I leave a message and don’t get a call back until that late afternoon from Susan, my assigned point person at Downtown Women for all the paperwork and appointments to come. “We got your message about the lymph node and we now have the full paper report in the office. They did turn up malignancy in the lymph node and the core biopsy turned up DCIS and Invasive Ductal Carcinoma.” Wait… wait… what? What does that all mean? “In my experience ‘invasive’ means it’s spreading and you’re looking at surgery and chemo.” As she keeps talking, I feel like I’m underwater. I tell her, wait, stop… this feels like I’m getting diagnosed all over again. This is not what I was told by Nurse Su. “Well, I’m sure it was a shock to you, I understand if you didn’t retain everything she said. I know this is a lot to take in...” UM. I would have DEFINITELY remembered the words “invasive” “carcinoma” and fucking “MALIGNANT.” I tell her I’m very upset at how this was handled. She says she’s sorry, but at least now I know and we can only move forward from here. And that’s how NP Feiyan Su ended up on my shit list in black permanent marker.

(it’s always quinn)

Knowing I have cancer is a lot less weighty than fearing I have cancer. But because of the long July 4th holiday it takes an extra week to get an appointment in with a breast surgeon. So until I can fully understand what I have, how bad it is and what actions we need to take next… I have a lot of time to think.

My first and biggest concern, the thing that constantly runs through my mind and turns my gut is my baby — how will this life change effect her and my ability to mother her? I think about post-surgery and not being able to take care of myself let alone her. I think about the burden I’ll put on Brian to take care of her when I feel too sick from chemo. If I’m on post cancer treatments that I can’t get pregnant on for years, will I ever be able to have another baby and give Quinn a sibling? How much time will these appointments and treatments take from this precious time while she’s still so little? What kind of person will I be when I come out the other side? Jaded and tired? Will I be constantly scared of recurrence? Of having her grow up without her mommy?

This is what makes me the ANGRIEST and MOST bitter. Take my body, but don’t fuck with the way I want to be a mom. It is the MOST important thing to me.

At 21 months, I am still nursing Quinn as part of our routine and for comfort. And as silly as it sounds, the idea of cutting Q off from the boob causes me the most anxiety, more than surgery or more than anything. It’s our special bonding time every day. When I can snuggle my little baby close while she’s still a baby. I know we’d have to end this one day, but I wanted us to make that call. I hate this cancer. I hate it deeply.

July 11–19th, 2017

(more doctors than a golf clubhouse)

This week is a dense blur of hospital waiting rooms, examination rooms, needles in my arm, lying inside tubes, medical jargon delivered in apologetic tones and so many ups and down.

Here’s my basic pathology.

I am a clinical stage 2b (The actual stage can’t be determined until after surgery. But I fear it’s actually higher.) I have IDC/DCIS with lymph node involvement. My tumor is approximately 2.1cm. I am ER+/PR+/HER2-/BRCA- That means my cancer cells respond to estrogen and progesterone (which also means i have a weapon in my cancer arsenal) and I did not test positive for HER2 — a protein connected to very aggressive cancers. The growth rate is 25% which isn’t slow but not super aggressive. My genetic tested came back negative for the BRCA 1 and BRCA 2 genes — which everyone keeps referring to as the thing Angelina Jolie has. I guess Angelina has the BRCA gene and she had to get a double mastectomy which was such big news that even my mom knew about it.

Speed Dating: Doctor Edition

(Monday June 10, 2017: Axelrod)

Dr. Axelrod back at NYU Cancer Center is a certified bad ass in the world of breast cancer surgery. She is a straight shooter, but caring and present. This lady calls the shots. She also co-wrote a book about boob cancer… with Rosie O’Donnell… called Bosom Buddies which, you know, is 1 more book co-written by a celebrity than I can boast. The walls of her small office are covered with accolades, NY Mag Best Doctors of the Year covers and boob-themed gag gifts, presumably from colleagues and grateful patients. She thinks she can perform a lumpectomy. But to get a better look, she orders me a PET/MRI and pulls strings to get me in the next morning.

Fun Fact: Brian’s phone autocorrects Axelrod to AXE LORD!

(Tuesday June 11, 2017: Look out, Radioactive woMan!)

I get injected with a slightly radioactive something (the first of COUNTLESS needles in my arms) and spend 45 minutes on my tummy with my little byoobs dangling from cutouts in the examination table, 45 minutes on my back inside a tube. It’s SUPER loud in there. They tell me I can listen to music or a podcast. Somehow both start playing at the same time over my headphones. (My Favorite Murder + Coldplay Pandora station = not recommended.) I am part of a research study and am given $50 for my trouble. This cancer is already paying off.

I go straight to see NYU’s Dr. Julia Smith who Axelrod also called to get me an appointment super quickly. (I think they also prioritize young cases like mine.) She will be responsible for reviewing my genetics screening — not only for the BRCA gene, but for any other anomalies that might make me prone to cancer in other places. She is smart and very kind. I mention that I’ll need these results to go to Sloan Kettering as well where I’m getting a 2nd opinion. She used to work there and says that while I’d get excellent care at both hospitals, she left MSK for a reason and that’s because it’s a bit of a factory where a patient can feel a bit lost.

Fun Fact: While I waited for my CD images at Radiology, my slightly radioactive ass had to be quarantined because there were children in the waiting room.

(Wednesday July, 12 2017: 2nd Opinions, Sloan Kettering)

The previous week, I had put in a request to NYU to send my biopsy/ultrasound stuff to Memorial Sloan Kettering in time for my 2nd opinion appointment. But the day before my appointments, I get a call saying my materials never arrived. So the morning of, I spend 2 hours at NYU hunting down my medical records. This is where the cranky starts.

We get to MSK around 11am. The staff is lovely and professional. But it takes us 6 1/2 hours to see two doctors. The first doctor is an Italian breast surgeon with a beautiful accent. When he gently and purposely examines my “braysts,” Brian is on the other side of the room sitting very upright and looking straight ahead into a wall in an attempt to be as respectful and as much of a non-entity as possible. The absurdity is slightly David Lynch-y in tone and I have to suck in my lips to keep from giggling. It doesn’t work because I let out a guffaw. The surgeon apologizes because he thinks he hit a ticklish spot, but really I just have the emotional intelligence of a middle schooler. He orders ANOTHER MRI, this time one that will take a closer look at the braaystseh. I’m frustrated that I have more tests instead of answers.

At around 5pm (3 hours after our scheduled appointment), we finally see the oncologist, a beautiful ex-dance instructor from France (I learn this when I tell her I work in reality TV and she tells me her favorite reality show is Dance Moms). French Onc is tired and distracted, gives us a rushed appointment which we didn’t fully understand the point of. Right before she leaves, she half mentions that I need to get blood drawn. Okay, bye, thanks I guess? We wait in the exam room and no one comes. We leave to ask the nurse station if we were supposed to stay in the room in order to get my blood drawn or what, but I’m then told that I have to wait for a nurse? To give me a class about chemo or something? It’s about 5:30pm and I haven’t eaten all day. WHAT class, WHERE? Also WHY am I getting blood work done? At this point a punchy and hungry Kathy may or may not have been shushed by her husband to which punchy-hungry Kathy responded by getting louder. I told my friends the story through Snapchat and ended up embarrassing Brian a second time…

Also, I didn’t realize the irony of wearing a shirt with the symbol for Cancer to my Sloan Kettering appointment until Brian pointed it out.

An older, brusque nurse with a heavy indistinguishable accent introduces herself and is gathering piles of pamphlets and guidelines from a closet. She says she needs to go over all of them with me. I say NOPE, I’ll read them at home. Can I go now? As I’m trying to leave she blurts, “OHBYTHEWAY, ARE YOU INTERESTED IN COLD CAPS?” Oh my god just let me go. But she keeps trying to give me info on these things — they’re worn on your head during chemo to reduce hair loss. They’re expensive, uncomfortable and not even that effective from what I’ve heard. So finally as a way to shut it down I say, “I don’t think I’ll be able to afford them because I don’t think my insurance covers it.” At this moment Rushed French Oncologist happens to pass by and interjects with, “We wouldn’t know about your coverage, that’s a question for your insurance company, you should contact them since all insurance is different and that’s not information that we would…” ALRIGHT, already, Dr. Unhelpful, I GET it! (By the way the no-nonsense nurse comes back with the out of pocket cost. “$500”. That’s PER chemo treatment. Which I will have 8–12 of. So yeah, no THANKS no-nonsense nurse.)

I hurry to the blood drawing lab to just get this shit done with. Brian and I had taken the full day off for doctors so we thought we’d get home earlier than usual to hang out with Quinn together, but instead we’ve put in a full work day’s worth of just waiting the fuck around. In the waiting room there’s one other woman who’s maybe in her early 70's. A nurse comes out and calls for Kathleen. The old white lady and I both perk up and answer “yes?” Oh, hahaha, we’re both Kathleens. Adorable. “What’s the last name?” we ask. It’s Farelli. Old white lady gets up and collects her purse. As she follows the nurse back, Punchy Kathy puts her elbows on her knees, squints her eyes and wags a menacing finger at her while growling, “Youuuu win this time, Kathleen.” The last thing I ate was a Paris Baguette pastry at 9am and maybe some waiting room graham crackers. So that’s my excuse for threatening a senior.

Fun Fact: NYU’s cancer crackers of choice are Keeblers graham crackers. MSK’s are Nabisco graham crackers. What does it all mean?!

(Saturday July 15, 2017: Dedicated Boob MRI)

dance with a hot dog as if no one is watching

(Tuesday July 18th, 2017: The Worst, The Worst, The Worst)

The results from the dedicated MRI Sacchini at MSK requested aren’t at NYU yet. But Axelrod bristles at the fact that Sacchini even requested one and doesn’t seem terribly interested in seeing it anyway. (This annoys me a little. But I’ve learned that surgeons are human. Their brilliance, decisiveness and confidence can also be accompanied by egotism and arrogance. They do not like to be questioned.) But, sure, she’ll look at it when the report comes in even though she doesn’t think the test was necessary. On my regular full body MRI, they found a blip on my lungs and kidney that she wants me to get a CT scan for. Gugh.

Dr. Meyers is night and day from Rushed MSK oncologist. She is warm and kind and knows my case well, she asks my daughter’s name. If you want to picture her, imagine Andrea Martin playing a beautiful holistic healer —who early 2000’s Jennifer Aniston gets story-pivoting wisdom from near the end of the movies — but you know, in a funny way. Mother Onc unfortunately delivers the toughest blow of this whole ordeal...

After surgery, chemo and radiation, because my cancer is so estrogen positive Dr. Meyers wants me on a 10 year Tamoxifen program with no break. Tamoxifen is effective on cancers on mine, but you are not allowed to get pregnant on it. The next time I could get pregnant would be at 47. Which they don’t recommend. On top of this, the chemo treatment I’m looking at is a notorious ovary killer. I might go into menopause during chemo and never get my period back.

All this to say, I can’t have another baby.

Brian and I were going to start trying for a second this year. After this summer, actually. Quinn was conceived so easily that we thought best to hold off until we felt totally ready. We wanted to give my dad a grandson, but would’ve been delighted to have another sweet girl like Q. We had worries — can we afford this, can we handle two… but I wanted it so badly. And not-rich people do this all the time right? My brother and I were so close growing up and we still are. I wanted to give Q that. I wanted to be pregnant again… raise another little baby… watch Q be a big sister. I wanted that. All of that. I still want that goddammit.

I try to hold it together through the rest of the consultation but when Meyers steps out I just let it out. I don’t just cry — I sob from my chest, I mourn.

When Meyers comes back she literally gives me a box of tissues to take with me. She says, “Let it all out now because you don’t want it to come out later. This is a lot and we don’t always have to be brave.”

My parting gift for being such a cry baby

(Wednesday July 19, 2017: Bye-Bye Lefty)

Back at MSK, Sacchini reports that that 2nd dedicated MRI he ordered shows the cancer spreading out towards the nipple. By the time they get rid of it all, there wouldn’t be much left since I’m on the smaller side. Given this new information, Sacchini recommends a mastectomy. He says MSK boasts the highest number of nipple sparing mastectomies every year, but in my case he can’t advocate for one because the cancer is too close to the anterior of the breast. But don’t worry, he says, because nipple reconstruction is an option. I keep picturing the image of that rat with the human ear grafted onto its back.

I tell Sacchini that this is the 2nd bit of new bad news I’ve had this week because NYU told me I can’t have any more children. He looks surprised and confused. How could they make this call before surgery tells us the full pathology? Then he gave a slightly passive aggressive jab at NYU saying that maybe it’s because they haven’t seen as many cases. That MSK treats 4000 breast cancer patients a year and NYU only does 300. Then he freely gave me the MRI report without my having to ask, told me I could request the CD images of the MRI downstairs and pretty much gives me a dismissive, “Well. If you want us to do your surgery, you know where to find us. Bye.”

I leave feeling shitty and lost. Like my health is tied up in hospital politics and egos.

Fun Fact: Sacchini says that my tumor has been growing for 8 months. That means my cancer can be pretty much traced back to when Donald Trump was elected president of the United States. I mean…

(Friday July 21, 2017)

CT Scan: I’m back at NYU Langone’s main hospital for the first time since having Quinn. I have with me a baking dish of bacon & bourbon rice krispie treats for an Elvis-themed pot luck I’m attending after work. (I call it, “A Little Less Smoky Bacon, A Little More Rice Kris-Please”) In the waiting area I see a sign that says that there’s no eating in respect for patients who may be fasting before their tests. I’m super self-conscious of the smell of butter and bacon emanating from my lap. Oh, and there’s also a lot of Orthodox Jews here. Double bad on the bacon.

(spoiler alert: CT Scan comes back clear — hooray! No lung cancer, for me, not today!)

Fertility Consultation:

This was OVERWHELMING. It turns out that harvesting eggs is only slightly less complicated than say, making a croque-en-bouche in the shape of a ferris wheel. (note: 100% of my croque-en-bouche knowledge comes from competition shows… so I don’t know that this is an accurate comparison)

There is a complicated schedule of blood work and daily injections of one of several different drugs, each of which you acquire from one of several different sources which you self-administer using one of two different types of syringes. And with my cycle starting any day now I need to make a decision about whether or not we can afford this, whether or not this is worth it, whether or not I have the wherewithal to deal with this right now and recall this mini AP Bio lesson I just received from nurse Christine. On top of all this, they tell me I should not be breastfeeding as the hormones nursing releases work against the ones I’ll be injecting myself with. For whatever reason this is what breaks the dam. If Q is my last and only baby, I want these last few weeks to enjoy her baby time, and now this whole experience is taking that from me as well. Dr. Goldman takes me into an empty examination room to listen to me and shed tears with me (she has a 21 month old herself). She tells me whatever decision I make is the right one. (sidenote: Dr. Goldman is used to helping UWS ladies who can financially afford to put their family planning on hold for funsies. But helping women like me hold onto their reproductive rights through shit circumstances like cancer is why she went into medicine. It’s her passion, and I see that in how she handles me.) Then I find out that I am actually covered for medical based fertility under my plan — a rarity! — this makes the decision for us. We have to take this gift even if we never use it.

Axelrod calls me. She looked at Sacchini’s dedicated MRI. She acknowledges that it shows more cancer, but she still thinks the images overestimate the affected area. She talks around the pros and cons of a mastectomy, leaving the onus on me to decide whether to try for a lumpectomy she had originally planned for or go with the safer, but more drastic mastectomy given the new information from the MRI. She thinks she can try to save the nipple. It’ll have to be biopsied, it won’t look the same, and if they find something, I’ll have to go BACK into surgery to remove it. I think she’s dancing around changing her initial diagnosis to Sacchini’s diagnosis based on the MRI he ordered. I tell her I’m more comfortable with a mastectomy at this point. She then tells me I need to start drying out the boob like, last week in order for the surgery to be easier.

I guess I have been putting off wearning for long enough.

I take the weekend to enjoy her. We take photos of our last nursing session, Sunday night. The next day I put gauze and medical tape over my nipples. This is an idea I got after my initial biopsy when Quinn avoided my left boob because the bandaid on it seemed to weird her out. Monday morning comes around… “Nilka! Mommy nilka!” I say, “No, Mommy nilka broken.” and show her the gauze on my boobs. There were a couple meltdowns. But by the 2nd night when I tell her “Mommy nilka broken” she asks, “See?” I show her, and with her curiosity satisfied she moves on. “Book?” Sure, baby, which one do you want to read? By Thursday she stops asking. This was 100% harder for me than it is for her. I always knew this would be the case, but it didn’t make it any easier.

(Tuesday July 25, 2017: Plastic Surgeon)

Dr. Choi walks me through the process of reconstructive surgery. We go over Sacchini’s dedicated MRI report. She doesn’t beat around the bush. They spare the nipple when the cancer is at least 2cm away from the it. The dedicated MRI puts the spreading cancer 2.1cm away from the nipple. She thinks a mastectomy with NON-nipple sparing is the smartest way to go. I agree. Done. What nipple.

During my surgery, I will have a tissue expander…placed? installed? that’s not the word… nestled?… under my skin which they will slowly inflate over the course of a few months in order to stretch my skin. After chemo I will go in to have it replaced with an implant. I will have a smaller implant placed in my right breast to match the left. (hey, why not, it’s covered.) I should still be able to nurse on my right side if, please god-please, I have another baby. After radiation, we can talk nipple reconstructions and tattoos.

THE DECISION

Ego or no, I know Dr. Axelrod is a world-class breast surgeon. And from my plastic surgeon to the fertility doctor to my Andrea Martin oncologist — the personalized care I’ve experienced at NYU makes me feel like I will be listened to and cared for as not just a statistic but as a scared, young mom going through something she never imagined she’d have to. (and it’s worth noting that Axelrod gave me her cel phone. I mean, what surgeon does that?)

THE PLAN

On August 10: I will be getting a non-nipple sparing unilateral mastectomy and lymphadenectomy on the left side. At the end of August I will begin fertility treatments and if all goes well, have embryos frozen. (I was initially freaked out by this, but what gets frozen is just a fertilized egg with like, 10 cells instead of the 1. They are heartier than just freezing eggs and also, it’s the only way it’s covered on my insurance.) Then in late September I will start Taxol chemo treatments, then Adriamycin which will take me through at least February. After reconstructive surgery I will start 6 weeks of daily radiation. Then 10 years (but hopefully less) of the notorious Tamoxifen.

OTHER IMPORTANT DATES…

Sept 13th: We’ve had Hamilton tickets for this day since Election Day 2016. And we’re GOING godammit!!

Oct 5th: Quinn turns 2. I want the theme to be unicorns. But I have a feeling she’ll like Elmo much better.

Nov 3rd: Brian and I will have been married for 5 years. And in sickness and in health, I am so lucky to have a husband who is unflinchingly there for me, supporting me and loving me in every way possible. Quinn and I love you so much and don’t know what we’d do without you. To even better times yet to come, Husband.

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