Holding on to Normal

by Alana Somerville

  Oddly, I didn’t feel scared, just nervous about the anesthetic. I’d heard horror stories about people not waking up because of it, and I was afraid I might be one of those people. But again, what choice did I have in the matter?

  The next appointment was for a breast MRI. This time a technician prepped a syringe and injected a radioactive dye into a vein in my right hand. I watched as the syringe was emptied into me so the dye could begin to mix with my blood. The dye was clear. In fact, it looked like saline, but it was far from it. This stuff would course through my veins and help the technicians find any more cancer in my body. I thought that I would feel it in some way—I mean, after all, it was radioactive. But I felt nothing. My understanding was that if the tumor was a cyst, blood wouldn’t flow into it, but if it was cancer, blood would flow into it to feed it. After the dye had been given a chance to make its way through my system, I was asked to take off all my clothing above the waist and drape myself in a hospital gown with the ties at the front. By then, my breasts had already been seen by so many people that the gown seemed pointless. I lay facedown on the MRI table, with my breasts suspended in two slots. We were a team of three: me, a technician in the room with me who assisted with directions and suggestions and who consulted with a second technician in an adjoining room, who apparently was looking at computer images of my breasts to make sure everything was in clear view. It took me a couple of minutes to adjust myself so they could get the best picture possible.

  The technicians were great, and as they worked, I tried to make small talk. Maybe that was a stall tactic on my part—if I kept them talking about other things, they wouldn’t be able to tell me bad news. Or maybe it was exactly the opposite: If I talked with them enough and managed to get them to feel sympathetic towards me, they would tell me everything they knew. They told me that when they first got the machines at the hospital, they practiced on each other to achieve the best comfort level for patients, since the position was painful for many. They even told me how they’d performed a breast MRI on another colleague and found a four-centimeter lump in her breast that previously had gone undetected. That amazed me. I was naive enough to think that if you worked in the medical profession, you would somehow know more about the human body and would be able to find abnormalities like that in your own body way before they got to that stage.

  I found myself quite comfortable lying in the MRI machine. My head was resting on its side, and I felt as though I was ready to take a nap. I didn’t experience any of the claustrophobia some people talk about. I could easily have fallen asleep if it hadn’t been for the loud clicking sound the machine made. I even felt brave enough to venture the question. “Do you see anything unusual?”

  No response.

  I held my breath.

  “I can’t see anything.”

  I exhaled. Of course, even as I did so, I knew that didn’t mean there wasn’t anything there.

  Chapter 7

  WILL I WAKE UP AGAIN?

  The day of the surgery, I woke up at five A.M. It was pitch black out, dead quiet, and I was wired. I had to be at the hospital at 7:15 A.M., even though the operation wasn’t until ten. My mother had slept over the night before. She’d volunteered to come over again to watch the kids while I had surgery. I thought about her while I rolled out of bed. How would I feel if one of my children was going to be operated on? I couldn’t imagine she’d had an easy night—not that she’d ever say anything.

  Everyone was asleep, so I quietly moved about getting ready. Our kids were usually light sleepers—mornings at our house were hectic so it was sometimes difficult to keep them from waking up. About a half hour before we had to leave, I crept back into the bedroom to wake Greg up, and by the time I got back to the kitchen, Mom was there. I did a few more things while she hung out with me and then with Greg when he came out to grab breakfast, and thankfully the kids slept through it all.

  Greg drove to the hospital. We didn’t talk much. My mind was left to drift in every direction possible. Would I wake up from the anesthetic? Would they find more cancer when they went in there? Would it hurt afterwards? For how long? The questions kept coming, and I knew that depending on the outcome of this surgery, my life could go in two different directions once again.

  We pulled into the parking lot, and the hospital was already buzzing, despite the early hour. In the admitting department I filled out what seemed like a huge stack of paperwork (I felt as though I was signing my life away). Next we headed up to the nuclear medicine department to meet my surgeon. When we got there, I stopped in front of the doors. The nuclear symbols on them loomed large: corrosive, explosive, flammable. Nothing could have felt less inviting, but through the doors I went, despite all my inhibitions.

  Inside, I found myself in a large open room filled with big machines, where a nurse asked me to disrobe and lie on a metal table in the center of the room. I felt as though I was about to take part in a strange experiment, which in a sense I was. My surgeon, Doctor 6, came in and I felt a bit better. Something about her calm and confident demeanor relaxed me, as much as I could relax given the situation. Angel, I kept thinking. She’s my angel. She’s got this.

  “How are you doing?” she asked.

  “Okay.” What else could I say? But I appreciated her asking.

  She nodded and turned around. When she turned back, she held a long, slender syringe filled with a blue liquid. My blood pressure ratcheted up. “I’m going to inject radioactive dye into your nipple area,” she explained, and her eyes drifted away from mine to focus on my chest. I steeled myself for the inevitable pain. I was surprised, though. It didn’t hurt as much as I thought it would. Maybe all of those months of breastfeeding Rudy had made my nipples super tough.

  “The dye will make its way into your lymph nodes,” she said. “The whole point of this is to identify where your sentinel lymph nodes, the nodes that cancer is most likely to spread to first, are. During surgery, I’ll identify those sentinel nodes and take out three or four of them to check if they’re cancerous. Those first few nodes are like a first line of defense. The cancer has to get through those before it can travel farther.”

  I watched the level in the syringe drop as she talked. I thought about the blue dye silently creeping into my sentinel nodes. I imagined those nodes as border security and U.S. customs agents. How many were on the front line of defense? If the cancer was able to get past them, where would it go after that? What corner of my body would it sneak into?

  “If those nodes are cancerous, I’ll remove the remaining nodes. All of them. If cancer hasn’t spread to the sentinel nodes, it’s unlikely it will have gone any farther, so your lymph nodes will stay intact.”

  She pushed the dye into me. After that, I had to wait another two hours. I walked every hallway of that hospital several times. I was so nervous. I tried to memorize my surroundings in an odd sort of memory game, but that didn’t help. Neither did reading magazines in the lobby. While I paced, Greg ate. It was probably his way of dealing with the anxiety. He kept checking in, asking if I wanted anything or if he could help, but there was nothing he could do. I don’t know if I expected him to follow the same protocol I had to—not eating before surgery—but watching him eat was driving me crazy. I was starving and couldn’t sit still.

  I called my mother to update her. “Hi, Mom.” I tried to picture myself as a brave warrior.

  “Hi. What’s happening?” She sounded almost as nervous as I was.

  I told her about the dye, and that the surgery was about forty-five minutes away. “Can I talk to the kids?” I asked. I was trying to keep my voice steady, but it had fallen off to a shaky whisper.

  I heard her calling, “Charley, Mommy is on the phone.” Then Charley’s little voice sounded in my ear.

  “Hi, Mommy.”

  “Hi, Charley. Are you having a good morning? Are you having fun with Babcia?” Babcia is Polish for grandmother.

  “Mommy, I love you,” Charley said, and then she was gone. I was
glad she was happy, but I admit I wanted her to miss me. My little girl was okay without me. She didn’t need me. I looked at all the sick people around me. Was I going to be like them? Was that already me? Did I suddenly have a time stamp on my life? Would I make it out of this alive? Would Charley and Rudy have to live their lives without their mom? What was happening seemed surreal, a bizarre dream. It hadn’t turned into a nightmare yet, because I didn’t feel sick, but it certainly wasn’t a good dream. I hung up the phone and started pacing again.

  At nine A.M., I was called in to get ready for surgery.

  “Here we go,” I said to Greg as I headed over to the nurse who called my name.

  “Relax, you will be fine. You’re in good hands,” he reminded me.

  And off I went with the nurse to a preop area. Greg would be able to come in after I was prepped. I thought everything would be sterile and cold, but it was good to discover that wasn’t the case. I was given a snug blue gown to change into, and there were nice warm little bootees for my feet. Then I got to hang out in a comfortable leather lounge chair while a nurse started my IV. She said I had little veins and it might take a couple of tries, but I didn’t even feel a pinch and the line was in, taped and ready to go. I also received an injection of heparin in my thigh to prevent blood clots—apparently a standard pre-surgery procedure.

  “I think they mentioned that to me in the preop appointment, but there was so much information that day, it all became somewhat of a blur,” I said to the nurse in a rush. I think I was babbling.

  She smiled. “It’s a lot to take in.”

  That needle didn’t hurt, either, other than a tiny pinch. When she was done, she covered me with a warm blanket and let Greg come and sit with me.

  “Are you ready for this?” he asked.

  “Ready as I’ll ever be,” I said, trying to play it cool, even though I was terrified I wouldn’t wake up after surgery. “Will you keep my mom posted?”

  “Yes, I’ll tell her everything that happens.” I felt scared. I didn’t know what else to say. Obviously Greg didn’t, either.

  Right before surgery, Doctor 6 showed up. She asked me which breast she was going to operate on. She knew it was the left breast, I knew it was the left breast, but it was protocol to ask. After we both verified verbally that it was actually the left breast, she wrote her initial on it with a felt-tipped pen. (Artwork on my body! That was a first.) The marker on my skin tickled. You’d think I would have started laughing, but as Doctor 6 leaned over me, I noticed that her surgical cap was pale pink and that it was covered in a pale pink ribbon design. I choked up. Everything became real. This wasn’t a dream. It wasn’t just any surgery I was going in for. This was about breast cancer. I had to take a minute before I gave Greg a kiss and could say good-bye to him.

  I’d expected to be wheeled to the operating room and lifted up onto the table—that was the way I’d seen it done in the movies. Instead, I set off with the nurse on what seemed like the longest walk of my life. And when we arrived in the operating room, I was simply asked to get up onto the table. By then I was shaking uncontrollably. I kept looking around the room, and the more I looked, the more nervous I became. Everything was so unwelcoming and high tech: giant fluorescent lights hanging from the ceiling, metal trays with masses of surgical tools, whiteboards with code words I couldn’t decipher. There were no warm and fuzzy decorations. There were no cute drawings by previous patients the way there were elsewhere. There were no chatty discussions.

  There were so many people—three nurses, an anesthesiologist, and the surgeon and her resident. To my mind, if the situation involved so many people, it must be way more serious than I’d been thinking. I mean, I knew it was serious, but this amount of attention was freaking me out. Everyone swarmed about, busily prepping for surgery, while I lay on the table shaking, those giant lights blinding me. I felt like a specimen, pinned, silent and scared. One of the nurses put a warm blanket over me, which helped.

  Eventually Doctor 6 came over to me to explain how the radioactive injection they’d given me earlier would work. She pointed at an instrument, saying, “That’s my Star Wars machine,” and waved a wand over my breast and armpit area. The wand made noises that did sound like something from the Star Wars movies. “I’ll use this to pinpoint exactly where your sentinel lymph nodes are,” she said. “That’s how I’ll know which ones to take out.” She sounded so confident. This would be easy. She knew what she was doing.

  The anesthesiologist put a mask over my face, asked me to breathe deeply, Doctor 6 said, “Here comes the good stuff,” and that is the last thing I remember.

  Chapter 8

  MISSING PIECES

  I woke up in the recovery room two hours later. Greg’s face was the first I saw. I recall him saying I was awake, and I kept hearing muffled voices, so I’m sure he was chatting with the nurses, but I was so out of it I had no idea what was being said and just wanted to fall back asleep again. I felt lethargic and very confused. Apparently Doctor 6 came to speak with me after the surgery, but I have no recollection of that at all. It was the strangest feeling, not knowing exactly what had happened during two hours of my life, although it definitely ranks up there as one of the best sleeps I’ve ever had. Luckily, Greg was able to tell me what she said.

  The lump was removed, and it measured 2.9 centimeters. I later found out that 3 centimeters would have possibly meant a different stage in my cancer diagnosis, so that 1 millimeter was very important. Doctor 6 also removed four lymph nodes. Of those, only one seemed a little larger than normal—that was the one that had shown up on my MRI. I’d brought that MRI scan to JCC. When I’d first seen her, Doctor 6 had told me that a patient’s scans are only as good as the person who reads them. So I’d begun getting every single scan burned onto individual disks, which I carried around with me. It seemed logical that since the doctors and nurses at JCC work with cancer all the time, they look at any images in addition to the original radiologists. As it turned out, the two radiologists who looked at my MRI came up with two slightly different results. Both agreed, though, that one of the sentinel nodes was enlarged, but they differed on whether this meant cancer for sure.

  Greg reported that Doctor 6 removed the enlarged node and three other nodes, and sent them all for a frozen section while I was on the operating table, which meant those nodes were flash frozen, then cut open to see if there was any cancer inside. Even though I was sort of out of it, I remembered that I had signed a waiver before surgery saying that if more cancer was found, an axillary dissection to remove all of my lymph nodes could be done. “Thankfully,” Greg assured me, “no visible cancer was found.”

  The main recovery room was quite hectic, so after about half an hour, I was moved to a quieter room with fewer nurses and machines. “Once you’re able to get up and use the washroom on your own and we check your incision and change the dressing one last time to make sure everything is good, we can release you,” a nurse told us. Before they let me go, though, a nurse showed me how to change the dressing myself. I found I couldn’t look at the incision. I wasn’t ready to see what they had done to me.

  About two hours after I came out of surgery, the nurse officially released me and we got ready to leave the hospital. I was tired, but felt surprisingly good. My chest was sore, but didn’t hurt as much as I’d expected. Before we left the room there was something I needed to do. How much of me was missing? I wondered. I finally reached up to feel it. I was bandaged so well there was no movement at all in my breast area, which I realized helped tremendously, but I couldn’t tell how big a piece was gone.

  Greg wheeled me out. When we got to the doorway of the hospital, I said, “Stop here. I can walk the rest of the way.” I sounded so determined that he didn’t try to change my mind. I walked the entire way to the car, not because I wanted to be a hero, but because I felt fine. On the way home, we picked up the Tylenol 3 with codeine that had been prescribed for pain, just in case.

  I was so relieved when we
finally got home. Mom smiled from ear to ear when she saw me and insisted I rest on the couch. The kids were watching TV, so I gently snuggled up next to them and tried to relax while Greg went outside to do some yard work. I lounged around for the rest of the day, but by the time Mom was making dinner, I was up for playing with the kids.

  “You’re sure you’re okay?” Mom asked.

  “I’m fine,” I assured her, and physically speaking I was. I didn’t need the prescription we’d gotten—Extra Strength Tylenol ended up being enough to alleviate any discomfort I had. I even slept well that night. I was fine on another level, too. I was so glad that a big step of the journey was over and done with. I was alive. And although I had much more of a battle ahead of me, I felt motivated; I felt like I had my boxing gloves on, ready for the next stage in this war.

  All the week after the surgery, my mom stayed with Greg and me, helping out as much as she could. One of my friends, Adriana, brought delicious homemade Italian meals over, and had ever since I was first diagnosed. I tried to do as much as I used to, but found I couldn’t. Rudy was eight months old and a hefty twenty-five pounds. I wasn’t able to lift him into his crib, get him into his high chair, put him on the changing table to change his diaper, or even give him a bottle. It ripped my heart out. In what seemed like an instant, I wasn’t able to hold my baby or care for him the way I used to.

  I changed Rudy, but on the carpet in his room. I fed him his bottles, but he crawled up onto a pillow on my lap as I sat on the carpet leaning against the couch. And his new bed became a mattress on the floor. My eight-month-old son was sleeping on a mattress on the floor!