“Thank you so much for organizing this, Adriana. I am so lucky to have such great friends!” I gave her and everyone else on our team a big hug. I was ready to go to bed—not for long, though. It was Sunday, and I wanted to hang out with the kids.
“Are you okay?” Mom asked on the following Tuesday morning. She’d walked into the kitchen as I was taking a pill.
“It’s only a Tylenol. In case I feel pressure from the expansion.” I was going for my second fill and planned to ask Doctor 9 to put in 100 cubic centimeters. I didn’t have a clue how I’d feel after that.
“I’ve gotten Rudy dressed.” My mom had bundled him up because even though it was May, it was an incredibly windy day and unusually cold.
“Great!” I said, but wondered if going alone would be easier. Mom would have to take care of Rudy anyway while Greg was working, since there weren’t any day-care spots. “Are you sure you’re okay coming, Mom? You have to do so much: get Rudy dressed, in and out of his car seat and stroller, and chase him around while I get filled up.”
“I’m fine, Alana. Don’t worry about me. You know I don’t want you going to appointments alone.”
I did like having someone with me, especially my mother, and I had to admit that I didn’t know if I’d be able to drive home by myself, so along she came.
The drive was terrible. To say it was windy was an understatement. We’d just made it over the major skyway in our area when we heard on the radio it was being closed because of the gusts. I struggled to keep the car straight as the wind battered us from all sides. “Did you see that?” I said. “The windshield wiper got ripped off!” Next to go was a piece of rubber that sealed the front window. Something flew past, and I screamed, “What was that?”
“A ceiling tile, I think.”
“They must be building houses nearby.” A few pylons were strewn across the road near a section of construction. I navigated past them, then glanced anxiously at Rudy in the rearview mirror. We passed three transport trucks that had tipped over onto their sides on the opposite side of the highway.
“Are you sure we should keep going?” Mom asked as a roof shingle whipped past.
“We’re almost there. If we turn back now, we’ll have much farther to go.” Somehow we made it to the appointment on time. “I guess our ‘after-fill’ shopping trip is out of the question,” I said as we got out of the car.
Once inside, we had to wait quite a while. To distract Rudy, we chased him around in the hallway, then sat down to catch our breath.
“I’ve figured out how this setup works,” I told Mom.
“What do you mean?” She looked confused.
“Since Doctor 9 sees so many patients, he has two operating rooms. See where the people have been going in and out?” Mom nodded. “While he’s working on one, the nurses prep the next in the second room. Efficient.”
We were called in. When Doctor 9 came in, he had a resident with him, whom he introduced, then he examined me. “How did the last fill go?”
“Great. In fact, so good with 60 cubic centimeters, I wanted to ask: Can I get more this time? I was thinking 120.”
“That should be doable.”
Doctor 9 took a syringe, prepped it, and began to push it into one breast, while the resident did the same with my other breast. They were tag-teaming me! I couldn’t help but think, Is this to save time? Is it so the resident can follow along? I wasn’t sure, but to be honest, I was fine with it because it took less time. It wasn’t something I minded so much, but it certainly wasn’t something I wanted to prolong. I sat up after the resident had put on the bandages. “My mind is saying, ‘That should hurt like hell,’ but my body isn’t feeling a thing. Is that normal?”
“That’s likely due to the lack of nerve connections from your previous surgeries,” Doctor 9 said. “They do have the potential to repair themselves, but if they will remains to be seen.”
Within fifteen minutes, I was done. I got dressed while Mom checked Rudy—luckily he’d fallen asleep in his stroller—and we were on our way down to the parking lot.
“How do you feel?” Mom asked.
“As the saline was injected, I felt a bit of pressure—mainly on the inside of my chest, as if the expanders were pressing in—but it didn’t cause as much discomfort as I’d thought it would.” I watched as she tucked Rudy into his car seat. “But it’s weird walking into a room with your breasts one size, then walking out with them almost twice as big as they were before.”
We set off. Thankfully the wind had died down.
“The beauty of reconstruction surgery done this way is that I can live with the results for two weeks, then decide if this size is just right or if I want to get bigger. I’m scheduled for two more fills, but I might not go for the last one—I don’t want to get too big and live with backache for the rest of my life—but a perky C cup seems to be a nice way to finish off the journey.”
“So this could be the last time you need to do this?”
“No. Even if I’m happy like this, I need one more fill—another 100 cubic centimeters in each breast in a few weeks.”
“Why?”
“The skin needs to stretch a little more for the surgery. They need extra room to play with, so to speak. After that, we’d leave things for six more weeks so the skin can stretch for the final exchange surgery.”
That night, Melanie came over to bring me some banana bread and rice pudding, which I loved. “How did it go today?”
“The drive was insane. We got home and found our barbecue had fallen over, and the kids’ play set was blown clear across the pool! At least I didn’t have to worry about my hair getting messed up by the wind!” I felt good enough now that I could joke about something like that. It was such a change from earlier days.
“It’s really growing in, isn’t it?”
“I even go out in public without my hat now.”
“How does that feel?”
“Okay. I get looks from people I don’t know, but I don’t care. This is the longest my hair has been in a long time, so I want to show it off.”
“Good for you!”
“I even wake up with bedhead sometimes, which is exciting. And I think I need to get my eyebrows sugared. I feel like an ape compared to a month ago!” And it was true. Maybe someone I didn’t know wouldn’t have noticed, and maybe I’d lived with my hair not growing for so long that it stood out to me, but it suddenly seemed as though my hair was coming back quicker than I thought it would. I went to visit Lepa every few weeks so she could shape it, and she wouldn’t allow me to pay, just as she’d said at the haircutting party. My eyebrows and eyelashes were almost completely back to normal as well, and it had been only three months since I finished chemo. I had to start shaving my legs again, too. Never my favorite thing, but at this point I smiled every time I needed to do it. It was nice to have those leg hairs back.
Chapter 34
ON TRIAL
The plans for our new house were coming along. I’d been researching different builders and had convinced Greg (and myself) that I could contract all of the trades out myself. It was a tough sell, but I knew it would be the most cost-effective route to go. He said yes on one condition: He didn’t want anything to do with the process. So my days became consumed with architect appointments, phone calls trying to track down people to do the foundation, framing, drywall, insulation and roof, and everything in between. Not only that, of course, I had a few other things to think about as well.
“Are you going to sign up for the metformin trial?” Greg asked. With everything that had been going on, I hadn’t committed to it, and he knew I had a year from my initial diagnosis to sign up for it and begin taking the drug.
“I think so.” Helen, the clinical trial nurse, had said there would be few side effects, and I’d done more research and discovered that metformin had been around for years. “It’s worth a try.” But it was already May. I only had two months left to make the deadline. “I’ve filled out all of the pap
erwork, and I’m scheduled to have preliminary tests—X-rays and blood work. They need nine vials, apparently. They’re going to drain me!”
“Why so many?”
“I don’t know exactly, but I do know one of them is a pregnancy test. But that won’t be a problem—after not having my period for four months while doing chemo, it’s still quite irregular.” I’d also experienced hot flashes and other menopausal symptoms, like night sweats and interrupted sleep, and that hadn’t completely stopped yet, either. “With all of that, I’m pretty sure I’m not fertile, or pregnant.”
“There’s only one way to get pregnant,” my mom said when I told her about the test.
I said, “I know, Mom,” and rolled my eyes at her. What I didn’t say was that during my brief experience with menopause, many things happened to my body that made intimacy the furthest thing from my mind. The random sweats made me feel gross, the hormone changes dried up certain places that never used to be dry, and I felt physically unattractive with my buzz cut and my wonky breasts. How on earth did women endure years of menopause? I knew one thing, though: the menopausal symptoms coupled with the trauma of my post-surgery body made it virtually impossible for a pregnancy to even come close to happening. I just didn’t want to get into all of that with my mom.
I needed to go to JCC to have my blood taken for the trial, as well as get the necessary X-rays. I dropped the kids off at day care and picked up my mom, and we headed off to the hospital. I probably could have taken my kids with me to this appointment, but honestly how much fun would it be for them to sit in the car for an hour on the way there, wait in the waiting room while I had X-rays and blood work for who knows how long, and then sit in the car again for an hour on the way back. The day care was a godsend. I loved it and so did the kids.
When we arrived at JCC, the first stop was the lab. As promised, they drew nine vials of blood. I had been doing this so often that the needles didn’t bother me one bit anymore—I was so used to being poked and prodded.
At the X-ray clinic, I was checked in and given a gown by the technician. “Remove your bra and shirt, please, then put this on. I’ll be back in a minute,” she said. When I was finished changing, she returned and led me into a room. “Stand here,” she said, and positioned me properly before she moved behind a window nearby. “Take a deep breath and hold it,” she said. I could hear the machine click once, then stop. The technician came out from behind the glass. “Do you have anything inside you?”
For a second, I wondered what she meant. “Oh, yes, expanders, for breast reconstruction.”
“I wondered what those were.”
I almost started laughing, she looked so confused. “Can I see what they look like?”
“Sure.” She waved me behind the window and pointed at a computer monitor. “That’s you.”
“They look so funny!” On the screen was what appeared to be a normal-looking chest X-ray, except for two circles side by side that looked like bullet holes. “No wonder you looked so perplexed when you asked!”
After the X-ray was done, Mom and I headed up to the clinical trials office.
“I wonder if I’m going to get metformin or a placebo.”
“I hope it’s the metformin.”
When Helen arrived, she invited us to sit down, then said, “We have a problem.”
“What?” I swallowed hard. “It hasn’t even been six months since I finished chemo . . .” The only thing I could think would be a problem was that they found some kind of sign indicating a recurrence of cancer in my blood work.
“No, no, there’s nothing wrong,” Helen said. “But your HCG levels, the hormone that indicates pregnancy, are elevated.”
“What?”
She studied her papers. “Your HCG level is at two, and we need it to be at one in order to continue with the study. We need to be certain you’re not pregnant.”
“I’m positive I’m not.”
“I’m afraid we can’t go by that. The only way we can be sure is for you to take another pregnancy test in a few days. If you are pregnant, that number would double every twenty-four to seventy-two hours. If you’re not, then it will remain the same or go back down to one.”
“Has this happened before?” Mom asked.
“I’m afraid not.”
Of course, I thought. It had to happen to me.
I laughed a little, as I glanced at my mother, but I didn’t think it was funny at all. I wanted to be part of the trial. I wanted that drug. I tried to think of something else.
“I can’t believe it’s time for a checkup already.” I still had to meet with Doctor 7, my oncologist, before we could go home.
“The time has gone so quickly,” my mother said.
“It has! But look, here’s a marker.” I ran a hand through my hair. It wasn’t particularly even all over, despite Lepa’s efforts, but if I pulled on it, I could stretch it to about an inch. It was coming in a bit coarser than before, with a slight wave to it, and in certain lights it looked almost salt and pepper as opposed to my old blond color.
“It’s looking so cute.”
“It is, isn’t it?”
By the time we got to Doctor 7’s office, the talk had distracted me somewhat, but I was wondering how the hell I could be pregnant.
Doctor 7 examined me. “You have a little redness underneath your left breast. If it gets very red, let me know. That could be a sign of cellulitis, a common skin infection caused by bacteria. But otherwise everything seems fine. Before you go, though, I want to run through the major symptoms of a recurrence you need to be aware of.”
“Just a minute,” I said and got out my notebook.
“Ready? Sudden persistent headache, unusual lumps, a strange cough that doesn’t go away, trouble breathing, pain in your bones that’s persistent and unexplainable.”
“I know I’ve been told, but I have to ask again, what are the odds of a recurrence?”
“You have about a 40 percent chance of recurrence.”
My face fell.
“Your chances of recurrence were 60 percent before chemotherapy,” she said gently, “and chemotherapy reduces the risk by about a third.”
I left the office feeling rather subdued. “I’m more determined than ever to get into the metformin trial,” I said to my mother. “I can’t stop thinking about that number—forty. It’s so high.”
“You’re doing everything you possibly can to keep cancer at bay, Alana. If you look at it differently, you have a 60 percent chance of it not coming back.” I wanted to do everything possible to change those percentages, but it frustrated me that some things I couldn’t change. I could participate in the trial, I could eat healthy, I could be on alert for the signs of recurrence, but I just couldn’t change those numbers. I felt helpless.
First, though, I would have to find out if I was pregnant. Four days later I went to the lab closest to my home to have a pregnancy test done. It took twenty-four hours for the results to come back. Helen called when they did. My HCG level was less than five, but that’s as precise as they got. The level could have been one, two, three or four for that matter, but their machine wasn’t high tech enough to get numbers smaller than five, so the results weren’t accurate enough.
“It would be best if you get a blood test at JCC,” Helen said. She suggested I wait another two weeks and get it on the same day that I had my fill appointment. By then we would know for sure by the numbers whether or not I was indeed pregnant.
The two weeks went by, and Greg and Mom joked about the situation quite a bit, but we were the only people in on the joke. We decided that it probably wouldn’t be wise to tell everyone about this little glitch in the plan. I honestly didn’t believe I was, but . . . that was something I didn’t want to think about. I loved being a mom. I loved my kids to pieces. I lived for them, and I had never imagined the happiness that they would bring me. Every once in a while, Charley would ask if she could have a sister. (It was kind of funny that she never asked if she could h
ave another brother, but I guess that’s probably how older sisters feel about younger brothers.)
My answer was always the same: “Mommy has so much love for both you and Rudy that I don’t want to share it. I don’t want to share my love with anyone else. It’s all for the both of you.” The real fact of the matter was that they both made me happy, and I didn’t feel the need to add more to the mix. We were good.
Being diagnosed with cancer and going through all the chemotherapy I went through took a toll on my body, not to mention my reproductive organs. I’d gone through early menopause, after all. What effect had all of that had on my eggs? I was approaching thirty-five, too. I knew that there were more health risks involved for both the baby and me. Not to mention, I’d had cancer while I was breastfeeding. Did the pregnancy cause or encourage the cancer to grow? The doctors didn’t say it had, but they also never said that it hadn’t. Oh, and let’s not forget, I didn’t have any breasts left. I wouldn’t be able to breastfeed.
My body simply wasn’t in tiptop shape. I’d been lucky to have survived this time around, but I didn’t want to do anything that would put my future health or a baby’s health at risk. And if I was pregnant, I definitely wouldn’t be able to be on the metformin trial. There would be no more babies in my future, I had decided, and I was fine with that. I had two beautiful healthy kids, and I was on my way to being healthy as well. I felt no need to mess with that.
I talked to Greg. “Greg, you know if the test was positive, we’d have a big decision to make.”
“I know. Ultimately, that’s something we would have to think about. But for right now the test isn’t positive,” he said, trying to reassure me.
“I know, but it’s not negative.”
“Try not to think about it until you go for your next test. I’m sure it’s just a glitch.”
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