Bye-bye tattoo virgin

So I went to the cancer agency for my CT scan yesterday.

First of all they take you to a room and make you watch an in-house video that explains the whole CT scan procedure and the radiation treatments that I'll start in the near future. It was a cheesy but endearing home-video shot at the BC Cancer Agency, complete with wooden-top 'actors'. The woman who played the cancer patient in the video had a very familiar accent - not only english but a familiar Grimsby/Cleethorpes accent. I swear she could've lived down the road from me. I found it amusingly distracting.

There was a piece at the end of the video listing various cancer support services and a couple of the images were a bit wacky - someone laid in a hospital bed while a volunteer sat by the bedside singing songs to them and playing guitar. Another 'relaxation therapy' session showed people laid out on the room floor while a man stood amid them, tapping and shaking a tambourine. Call me cynical (I won't deny it) but it felt like a comedy skit.

At the end of the video I went back to the waiting room where the CT-Scan-ologist (that's their technical name, right?) came to fetch me and walked me to the room where she and another technician prepped me ready to be fed through the big, white CT-scanner doughnut. With some careful cross-referencing and drawing of dots across my chest, boob and into my armpit, they were ready to do the scan.

They both left the room while the mechanics inside the doughnut began to whirr and rotate, drawing up a 3D image that would be used to map out the exact route for the upcoming radiation treatments. Once again I had that detached sensation of role-playing, being physically in the room but struggling to accept that this is real and this is me, the accidental cancer patient, being zapped and scanned ready to set up a treatment plan I never expected.

After a little more checking, comparing and careful measuring, I was poked twice with a tattoo gun/syringe - one teeny tiny dot mid-chest and another near my armpit. That's it, my proud tattoo virginity out of the window - it bloody hurt though. I have no idea what kind of sado-masochist must enjoy the pain of a whole tattoo, especially those massive murals all over their body. (Or even the woman at my gym who has a 6" Christmas ribbon tattooed on the back of both her left and right thigh. Why oh why???)

So now I'm a marked woman, haha. Radiation in....radiation out. I went for the 'freckle' look - although the tattoo mid-chest (where my cleavage should be, if I had a cleavage) is actually darker and more obvious than the discreet dot just below my armpit. Hopefully make-up will cover it.

Apparently they need a couple of weeks to go through all my scans etc. to map out the radiation sessions so I'll probably get started on the actual treatments early October for 22 treatments, which means it'll be more like early to mid-November before I could start work. Of course there's that minor detail of actually getting a job to go to! I'm still applying for jobs in the meantime anyway but I'm not putting too much pressure on myself at this point.

So me and my two new 'tats' are just waiting to get started on the next phase of all this stuff.

Medication meltdown

So today I met my oncologist (yet another word that I never anticipated using in reference to myself). Dr N. is a pale, slightly built and timid looking man of a seemingly nervous disposition. I couldn't decide whether his previous client had scared the sh*t out of him or was it me he was afraid of? Or maybe everyone has that effect on him. I fought the urge to shout "BOO!" for fear he might literally pee his pants.

He brought with him a female trainee/intern (or whatever it is they call them), who was similarly fragile and had the handshake of limp lettuce. I wondered if they were anticipating I'd burst into floods of tears upon discussing the treatment plan. If that was the case they'd be relieved - or disappointed - since the one thing I haven't done up till now is shed any tears about all this, which is perhaps a little odd, I don't know.

After another round of stripping down and being poked, prodded and even being told by the Doc that I have "what we call lumpy, bumpy breasts" (charmed, I'm sure), we sat down to discuss the treatment plan; 16 radiation treatments to the entire breast plus a further 6 'booster' treatments concentrated on the area where a few cancer cells were left behind (the spot where I'd narrowly escaped a second surgery). I was still doing okay up to that point, despite having previously been led to believe I'd need only 3 weeks of radiation but hey, if they need to do 6 extra treatments to make sure they zap those last remaining cancer cells, then I'm certainly okay with that.

It was the next part of our discussion that was, for me, the kicker.

"Now, you were probably told already that your cancer tested estrogen receptor-positive (ER+)." Which, as he  went on to explain, means the cancer cells bind with estrogen and use it to fuel their growth and it can also enable cancer cells to be carried through the bloodstream to other parts of the body. Yikes, I hadn't even thought about that. And naturally it suddenly flashed through my mind, what if these cancer cells have already gone elsewhere???? And why has nobody explained this whole ER+ thing to me before now?

"The good news is," (Thank goodness - at least there's still some good news) "there are several medications that have proven highly successful in blocking estrogen, the most commonly prescribed being Tamoxifen - which is very effective in preventing the recurrence of this type of breast cancer in pre-menopausal women like yourself. So we'd like to get you started on that two weeks after completing your radiation. This course of treatment is generally prescribed for 5 years."

I know he was offering up a positive solution but I can't deny that my heart sank. I'd read a little bit about Tamoxifen - for which the main 'side effect' (in most cases) is that, as an estrogen blocker, it actually brings on menopause that bit sooner. Brilliant! The very thing I've been dreading - I mean DREADING -  for years but had hoped to keep at bay for at least another 8-12 years. Now I'm inwardly terrified that, joy of joys, I get to start on that miserable road even earlier - turning into a 55 year old when I'm only 44.

Dr N. dutifully detailed many of the potential side-effects of Tamoxifen, including the possibility of endometrial cancer, blood clots, stroke, cataracts etc. but I could only focus on the whole menopause thing because of all the 'delights' it entails: mood swings, weight gain, hot flashes, memory loss, depression, insomnia....to name just a few.

By the time I left the cancer agency, I was consumed with an underlying sense of dread and despair - moreso even than when I received the initial breast cancer diagnosis. While I know I should be (and I am) eternally grateful that such a medication exists, I'm nevertheless terrified of the person I'll become once I start taking it, albeit I would have to enter menopause at some point in the coming years anyway.

I went home, pulled out all the info I could on tamoxifen and menopause and sank a beer while I wallowed in my fears and dread. By the time poor Lorne came home from work I could barely tell him about the appointment before my words washed away amid a flood of tears. I was devastated - mortified that I'm going to change into a sweaty, moody, fat and depressed mess of my present self. "I'm afraid I'll become a different person and that person might well be an absolute nightmare to live with." I blubbed. "I'll become a miserable, irrational, moody, overweight and psychotic monster. It'll be like having PMS 24/7/365 only on a much bigger scale. I don't want to be that person. Added to which  the weight gain will make me feel worse about myself. What a treat! It's bad enough I've dreaded menopause anyway but the thought of having to face it even earlier terrifies me. I feel like I just won't be myself anymore!"

Poor Lorne, I don't think he quite knew what to do/say. I was a stressed, wailing mess.....perhaps an early glimpse of exactly the type of emotional wreck I'll be once I'm on this medication anyway, only minus the sweaty pits. (For now at least.)

On the one hand, I know it seems irrational that I'd be this upset over a medication that, to all intents and purposes, will help prevent the recurrence of this awful disease - and it's nowhere near as drastic as chemo and I get to keep my hair, but I could almost live with the whole breast cancer thing knowing that I'm at least still the same person I was before it. The thought of taking tamoxifen and starting menopause makes me feel that I'll lose that. I won't be myself any more. I won't be the same Katrina - the one Lorne knows and loves. I'll be moody, paranoid and irrational and the prospect of a 15-30lb weight gain really bothers me; a) because I have a wardrobe full of nice clothes that just won't fit anymore and b) because, added to feeling crappy, I'll also feel bad about myself being heavier - God knows I suffered hideously low self-esteem for long enough in throughout my teens and 20's. The last thing I want is to go back to feeling as shitty about myself as I did back then. I was downright miserable, self-conscious and depressed.

I realize I must sound shamefully vain. That my dread of menopause must make me seem so horribly ungrateful for the fact there's even a medication available to me to help protect my health. On the contrary, I'm extremely grateful and I also know just how lucky I am to not need chemo, or worse, and to be living in a country where such treatment is even available to me and it's paid for by the government. Incredibly lucky. How ridiculous then to be crying over potential side-effects that may - or may not - even happen, or at least perhaps not to such a great extent.

The more sensible part of me suspects that maybe my upset and tears are moreso the result of a culmination of events from the past several months rather than actually just centered on the (by all accounts) irrational fear of menopause. I've stoically navigated my emotions through the diagnosis, surgery and upcoming plans for radiation while feeling thus far incredibly 'lucky' that it was found so early, perfectly treatable, and that my outlook really is among the best case scenarios for breast cancer.

So to find myself so ridiculously distraught over the thought of menopause starting a few years early makes me wonder if my upset isn't somewhat misplaced. Having felt that my scenario was, in many ways, a good one (I got the cleanest point of a shitty stick), I'm not sure I've even allowed myself to really address how I feel about all this - it's a bit of a life-changer after all. The fear of menopause and all its glory has perhaps given me the outlet, albeit somewhat misdirected, for spewing an accumulation of feelings/fears/uncertainties that I haven't yet been able to face about all this. In being so grateful that my prognosis is so much more positive compared to many, many others who get a cancer diagnosis, being upset about it just seemed pithy and self-absorbed. I felt like I'd merely dabbled' with breast cancer and - by and large - had a 'lucky escape'. Clearly the british side of me was all set to simply brush it under the carpet, treat it as a minor misdemeanour, say nothing more about it and just be grateful that nothing got too damaged. Yeah - not quite so fast there, Missy!

One surgery down and talk of a second....

(Catch-up of events from July & August)

By the time my July 9th surgery day came around, I’d hardly had time to get over the jetlag of the flight home (which had been an interesting 9 hours next to the most intoxicated person on the plane - not Lorne, I might add ;-) A woman from Glasgow who confessed, in extremely slurred babble, that she was so afraid of flying she’d already got hideously drunk at the airport bar and then proceeded to plough through a further nine bottles of in-flight red wine,, endeavouring to engage me in slurry, non-sensical burble, before finally - and all too briefly - passing out in her drunken stupour.)

It was an early start at BCCA - a 7:30am check-in followed by approximately 6 hours of me sitting around in waiting rooms or being wheelchaired from one department to another - even  through a little-known underground tunnel system that runs between the Jim Pattison Building at Vancouver General Hospital and the BCCA. That was quite unique actually, wheeling through the dusty, underground duct-lined guts of such important buildings. (And eerily reminiscent of a spooky Swedish/Danish co-production "The Kingdom" by Lars von Trier that Lorne and I watched a couple of years ago.)

After an initial chest x-ray, I was piled up with warm blankets and wheeled off for an ultrasound which took forever. The technician was trying to place wire markers in my breast to indicate both areas that were to be removed - which amounted the same area, since they were so close together, and therein lay the problem. He was having great difficulty getting the right spot and, after about 30mins farting around, he brought in a specialist and another technician for advice and then all 3 men were leaning on me, pressing, pulling and pushing against my boob while the main guy pushed and shoved to place the wire. How bloody ridiculous it all seemed as I was unceremoniously man-handled like a cow being branded. Thankfully the numbing agent they used was at least more successful than what I’d been given during the original biopsies but the whole ordeal was somewhat disconcerting all the same.

Next I was wheeled off to have a blue dye injected into my armpit to identify the sentinel lymph node from which they’d be removing a piece (during the surgery) for biopsy to verify whether the cancer had already entered my lymph system. A downright scary thought that I couldn't even let myself think about! I remember Vicky had said the dye injection for her had been incredibly uncomfortable but she must've had a different (less experienced?) person do hers because I hardly felt a thing, thank goodness.

Then it was back through the underground tunnels to BCCA to wait…..and wait…..for the surgery. At that point I suggested Lorne might as well go home until they called for him to pick me up. They were running late and it wasn’t until 3pm that Dr McF came through for a quick pre-surgery chat. "How are you doing? " he asked. "Well I'm a bit bored actually," I replied jokingly. I think I caught him off guard actually. "Well, let's see if we can't remedy that, shall we?" he smiled and a moment later a nurse came through to fetch my bed and wheeled me into the OR - 90 minutes later than scheduled. She apologized for the delay but oddly enough it was her I felt bad for, “I guess that makes it a long day for you,” I said sympathetically. Her response made me laugh out loud, “Yeah but hey, at least I don’t have cancer.” I hadn’t even thought of it that way. At least she was honest and direct - I liked her humour.

I came round at about 4:30pm, feeling woozy and achey, like I'd been punched hard in the chest. I vaguely heard the nurse phone Lorne and he arrived to pick me up a short time later. He gently helped me get dressed, which was a slow process because the smallest movement instantly made me want to throw up. I began crying a little as he slipped on my clothes (I’m really not sure why coming around from an anesthetic seems to make me all weepy). Once home I spent the next few hours in a daze on the living room couch. I really wanted to go to bed but simply couldn’t move without getting an overwhelming wave of nausea right away. And while I wasn't quite as sore from the op as I'd expected, I certainly felt like poop – trapped inside a spinny head, wobbly tummy and cheeks that kept preparing themselves for a good ol’ pukathon.

Around 10pm Lorne went to get the bed ready and, stubborn idiot that I am, I began hobbling toward the stairs, leaning on the couch for support. I didn’t get far before I yelled for him to get me a bowl (to throw up into) and quickly sat back down. He rushed downstairs, amazed that I was even trying to make my way to bed without his help. Thankfully I narrowly avoided hurling and several minutes later we were able to negotiate the stairs – sloooowly – and he helped me undress and slide into bed. He’d carefully laid out a bowl, towel, tissues and a glass of water for me. What a treasure!

On the whole I slept really well and wasn’t in too much pain but I still felt crappy from the anesthetic all the next day (need to keep that in mind for any future surgery, I obviously don’t do well on whatever it is they use to put you under). I took it relatively easy for the next couple of days, although I’m really not very good at sitting around and being ill, allowing myself to do nothing. I was still up and about and went out for walks but paid for it later with a sore reminder of having pushed myself a little too soon.

It's funny, the post-surgery soreness was really my first physical association with all this breast cancer malarky. Well, since I'd first noticed the lump becoming more prominent I guess. The rest had all seemed so surreal up to this point that the incisions, stitches and tenderness in my boob felt like "proof" that the doctors were right and I wasn't just making all this up. How odd that I should feel that way, but I did. For some reason it always surprises me to be taken seriously by doctors - I suspect it stems from my british upbringing, where you have to adamantly argue your case before a doctor will even listen, let alone consider sending you for further tests/treatment. Luckily canadian doctors are less skeptical and I could now see (and feel) the proof right there. The physical awareness allowed me to finally connect mentally with just what's going on.

For the next week or so I had to shower carefully so as not to soak the dressing on my boob and in my armpit, but from what I could see, I was relieved that neither scar was particularly big (between 1.5 and 2 inches) and the one on my boob is so far to the right-hand side, that you don’t really notice it from the front. Plus the surgeon did a great job and seems to have removed relatively little tissue so you can hardly tell. Yay, my bras will still fit! I knew my 36B's were in good hands :-)

By the weekend I was certainly feeling well enough for us still to go camping as planned. It was great to have a change of scenery and get out of the house, albeit I got told off by Lorne again when, tired of feeling so useless and feeble, I decided to lift the cooler full of beer from the van to the picnic table to offer him a beer. He was right, it was insane that I did that and I paid for it over the next few days.

I’m not sure if lifting the cooler had strained my incision/stitches but a few days later I was feeling pretty uncomfortable and noticed a slight infection starting in the stitches in my armpit area. A quick visit to a nearby walk-in clinic confirmed my suspicions and I was put on a 7-day course of Cephalexin antibiotics - all the headachey joy and nausea of a week-long hangover, without any of the drunky fun beforehand. Ugggh! I almost never take antibiotics and I felt dreadful on these but they did their job and staved off any further infection.

On July 23 we went back to see Dr McF for the results from the surgery. We were both very nervous so it was a big relief when he entered the room and started with, "the good news is the lymph node came back clear." Big sigh of relief. And the cancer they removed is indeed very early stage, so the prognosis is good and it's the best case scenario of a shitty situation. "However, " he added, "there were still some small signs of cancer in the margins of the tissue we removed, normally we prefer the margins be clear to make sure we got all the cancer." (This was sounding very similar to what Vicky had gone through with her surgery - only she ended up having two further operations before they got clear margins. Yikes.) "I'm afraid I might have to do a second surgery just to be sure we get everything. To be honest, if it was up to me I wouldn't go in again, I'm sure the radiation will take care of it, but I'm afraid the final decision on that isn't up to me. I'd like to discuss your case at a conference on August 8th and will let you know as soon as I can. I'm hoping we can avoid it but let's see in a couple of weeks."

So then began the wait....August 8th came and went with no news.....so I called his assistant the following week....still no decision, "It was bumped from the last agenda," she said. "It'll be discussed in this week's conference"....and so we waited...and waited. Trying to plan camping and visits to friends in Victoria and anticipating the delay in starting my radiation, around whether or not they'd be operating a second time.

Finally, about a month later and frustrated with still having no decision, we booked an appointment to meet Dr McF face-to-face. He walked into the room and immediately confirmed, "No need for a second surgery." Phew!!! Now why had that taken so long???...apparently because of summer vacations etc. Whatever - I was just glad we can keep moving forward rather than being set back several more weeks by needing more surgery. All good news!

Okay, next up, let's get those radiation treatments lined up and get this thing done with and out of the way. Heaven knows I haven't been able to put my mind to anything these past few months. It's a bugger really, I have all this time off, the weather's been gorgeous and yet I just can't focus on anything because of this hanging over me. I've hardly taken any photos, I still haven't gone through my pics from our UK trip - or even the Cuba trip we did back in January. I haven't worked out much, have applied for just a few jobs, haven't read any books, made any cards or done any other crafts. I haven't done much of anything really, except feel like I'm trapped in a bit of a daze. It's been several months of limbo and having this ominous sense of uncertainty hanging over us. At least now we can continue moving forward as we need to.

The weeks that followed

(Catch-up of events from May 30 to mid-July)

The day I got my diagnosis Vicky insisted on dragging me out for a beer - so I reluctantly joined her kicking & screaming all the way ;-) She came to the pub armed with a book and binder of breast cancer information that she'd been given upon her own diagnosis in 2009. I took my biopsy report with me and we went through it together. In fact, as we went through it, Vicky explained more to me about my results than the doctor had! She's my best friend and ally in everything - and now even with this. It's just a bit ridiculous when you think about it. We're both young, fit and healthy women, who eat well, take care of ourselves and there's been no previous history of breast cancer in our family. Yet there we were, unexpectedly able to start comparing notes on a shared journey neither of us anticipated. It doesn't seem real. We even started laughing about how I've always copied her since we were kids and clearly this was no exception. "Yes, but I went one better," I bragged. "Mine's invasive!" Heck, if we can't laugh about this somehow, especially with each other, then it really has won. But we're made of strong stuff and together we're invincible, so this cancer thing had better start running, now!

In the weeks following (which I'll try to summarize for fear of waffling on forever) I went through a whole range of feelings - mostly wavering between anxiety, bewilderment and trepidation about what comes next. In talking about it with a few close friends it all feels very third-person, like I'm actually talking about someone else and while the words are about me, nothing feels real. I haven't yet really been upset or angry. In fact I haven't shed a tear and quietly wonder if that should be a concern but finding myself suddenly included among the breast cancer statistics being bandied about daily, especially in the media, I know it really isn't a case of 'why me' but rather 'why not me?'

I first met my surgeon on June 12, just 3 days before we left for England. It was very surreal to be going to the BC Cancer Agency (BCCA) and then sitting in the waiting room - along with a woman my age (who wore a wig and was obviously going through chemo) and a couple of others much older than me. I felt like I didn't belong. Like a fraud almost. As if I've stepped into someone else's life and I'm merely acting the part. Just weeks earlier I was working at the Cancer Society, now here I am waiting to see a surgeon about removing my own breast cancer. How things change in a short space of time.

Without any hesitation Lorne came with me to the appointment (and to subsequent ones I might add). His love and support has been incredible and I'm very grateful to have him right there by my side, even asking the questions I forget/hesitate to ask. Conversations neither of us expected we'd be having.

Dr McF is a mild-mannered, softly spoken guy with a sincere empathetic air. Through some rough, hand-drawn scribbles he outlined how my Ductal Carcinoma (invasive) differs from its close relative Ductal Carcinoma In Situ (DCIS) - basically the cancer cells had originated inside the milk duct (and would have been in situ at that point) but they had already started to extend outside of the duct, infiltrating the surrounding tissue in two very small areas, hence becoming invasive.

"Nevertheless," he assured us, "This is still very early stage, the affected area is no more than 6mm. The choice is yours, of course, but I'm confident I can get this just by going in for a lumpectomy."

He broke down the lumpectomy versus mastectomy scenario and I was actually quite surprised to learn both are that very successful in reducing the chances of recurrence - 5% chance of recurrence after a mastectomy versus 8% for a lumpectomy. While mastectomy is certainly an option, I certainly wasn't going to go that route unless I absolutely had to and nothing in our conversation seemed to indicate that would be necessary. (Suddenly I remember a good (male) friend whose attitude - when I first told him Vicky had breast cancer and would be having a lumpectomy - was surprisingly blunt, "She should just get both removed. Why take the risk of it coming back?" Always easy for a guy to say, but would a man opt for chopping off his penis at the first teeny-tiny sign of cancer? I think not!)

And so it was decided, Dr McF would carry out a lumpectomy (confirmed for July 9, just days after we'd get back from our UK trip) and they'd also take a biopsy of the sentinel lymph node at the same time, to verify whether any cancer has already gone into my lymph system - a pretty terrifying thought that I hadn't yet even considered. It would be a day surgery of just a couple of hours and about 4 weeks for full recovery. After that - and depending on the biopsy results of the removed tissue - the most likely follow-up would be for me to have about 3 weeks of daily (Mon-Fri) radiation treatments - basically the same routine Vicky had gone through.

So in the space of a few weeks I'd gone from annual mammogram to ultrasound, to biopsy, to cancer diagnosis and setting up a surgery date. Needless to say, I was still trying to wrap my head around it all but I was nevertheless impressed how quickly these things were moving along and feeling very grateful to be living in a city among some of the world's best cancer researchers and certainly one of the leaders in breast cancer research and treatments. There are times I feel extremely blessed for the life I live and for having the good fortune to live where I do - and this makes it all the more poignant.

In all the attention paid to my right breast, I mentioned to Dr McF that I felt an underlying concern that no-one had yet really checked my left side - except for during the mammogram - and yet I can feel a couple of areas there too that feel similar to what we now know to be cancer in the right breast. As a precaution I was squeezed in for an ultrasound June 14. I was in there for about an hour, the exam was reassuringly thorough but my mind wasn't put at ease any since the Dr who reviewed the results indicated "there are a couple of small areas that we should keep an eye on. Nothing big enough for us to biopsy at this point, but we should probably repeat the ultra-sound in 3 months. I'll forward a report to your doctors."

We left for England the next day and were away until July 4th. We had booked our trip back in March, blissfully unaware of how impeccably well-timed it would turn out to be. The perfect distraction; great to get away, spend time with family, travel round Scotland, drink fabulous single malts and not be sat at home counting the days till surgery. (If this blog wasn’t so ridiculously behind at this point I’d write more about the trip, but that’ll have to be for another day.)

Suffice to say it was therapeutic to be able to detail so openly and honestly about the preceding weeks of tests etc. and the surgery that awaited me within days of getting back to Vancouver. We didn’t dwell on the topic but somehow its presence added a greater depth to our trip, a stronger bond and understanding coupled with that re-awakened awareness of just how much my family means to me, and me to them, and that we just don’t see enough of each other. 

Bit of a conversation stopper

(Catch-up of events from May 30)

Lorne and my sister were the first people I told about my diagnosis. I knew they were both waiting on my results and obviously they were the ones I needed to tell. Telling them, within minutes of leaving the doctor's office, was very surreal - like an out-of-body experience. I was drifting in an other-worldly haze; somewhat detached and mechanical even in making the calls, knowing simply that I should yet not quite grasping the reality of the words as they stumbled from my lips. I couldn't begin to imagine how it must sound to them, listening on the other side - and there was no facial expression for me to gage the impact of what I was even telling them. The words felt so strange, especially using them for the first time in reference to myself. Heck, I don't think I've ever really got used to using them in reference to Vicky even 3 years later.

Looking back I wonder if calling Lorne at work to tell him, albeit on his cell phone, was really the right, or fair, thing to do. (It wasn't until weeks later that I remembered just how distraught Mark was when I'd spoken to him shortly after he'd got the same news from Vicky a couple of years ago. Had I just devastated Lorne the same way?) Was it callous and unthinking of me to tell him the results over the phone and while he was at work? Should I have arranged to meet him in person instead? Coulda, woulda, shoulda, right? At the time I just knew I had to tell him and it couldn't wait until the end of day.

In fact it wasn't until I told a couple of friends later that same day - in person (and over lunch of all things) - that I began to realize the impact that the words "I have breast cancer" would have on halting a conversation. 

Having cleverly kept an open mind about that morning's doctor appointment, even knowing I'd be getting the biopsy results, I saw no reason to change anything about the lunchtime plans I'd made to meet up with my good friends and ex-colleagues, Lynda and Denise. I hadn't seen either of them for a few months so we chatted and laughed for a few minutes, picked an outdoor table to eat at and casually brought out our food. We quickly caught up with each others' latest news and a short while later, during a momentary lull in the conversation, I felt like I was sitting in the middle of a dream where I knew what was about to happen next but couldn't predict the outcome.

"So, I saw my doctor this morning and....it turns out I've got breast cancer." Perhaps not the most subtle delivery but the words fell out and I was shocked at the absolute shock on their faces - their jaws almost literally hit the pavement, especially since I hadn't even mentioned the biopsies or anything previous. Their reaction stirred in me my first direct awareness of the impact that such words have - hanging there as if frozen mid-air. (Crap, crap, crap - what did I go and say that for? Bugger! I've just gone and ruined a perfectly lovely lunch and made this all about me. Way to go, Katrina!) Suddenly feeling acutely aware of what I'd just said, I could hardly even make eye contact. I apologized profusely for just blurting it out like that and, in my usual fashion, tried to fluff over it and immediately sought to uplift or change the conversation as if (hoping?) they'd forget I even said it. Having not yet had chance to let the news sink in myself, I was clearly ill-prepared for the reaction of others and now I just wanted desperately to take it back and simply save it for another day.

They asked how and when all this had happened, how was I feeling about it, how was Lorne doing and what happens next - and I probably answered with the same bewildered, third-person detachment that I'd had earlier with Lorne and Vicky. Besides, I still wasn't quite understanding what any of this meant myself.

Of course the irony of having recently lost my job at the Cancer Society and then getting this diagnosis was not lost on them either. But my trying to lighten the conversation after dropping that little bombshell was terribly awkward and I suspect I failed miserably. I'm not sure how many times I apologized and expressed how terribly guilty I felt for 'spoiling' our lunch date. I think we managed some follow-up small talk, I'm not sure - it's all a little bit vague really.

After we hugged and went our separate ways, I felt strangely off-kilter and disconnected as I wandered downtown, back toward the Canada Line skytrain. Something fundamental had changed that morning and yet everything seemed just the same. Then I was struck with the realization that there are more people with whom I should share this same news - family and close friends - but how? I hadn't anticipated the impact it would have. I was beginning to suspect that this really is big shit - and it's especially big shit to share with those you love. Bugger!

Knowing we'd be going to England within a few weeks, I deliberated over whether to tell my family beforehand or wait until we get there. Should I tell them now or wait until I've at least met with the surgeon, so that I might ideally have more specifics of what's what and a clearer picture of what lies ahead?

Having quickly gained a sense of just what a conversation-stopper it seems to be, I finally opted to tell my family ahead of time, having decided that I didn't want its immediate impact to spoil our relatively short amount of time with everyone.

It was a few days later that I took a deep breath and dialled my mum's number. Just about the first words out of her mouth were, "Hello love, how are you? Keeping happy and healthy I hope?" (How is it mothers always seem to have sixth sense?)

"Well, erm that's actually why I'm calling...." I'm sure she could tell immediately from my tone and I hated to tell her something that I knew would upset her, especially because she'd already had the same news from Vicky not all that long ago and no-one saw that coming either. 

Thankfully I found my words and gave her an overview of the last few weeks of medical appointments, the recent diagnosis and my dilemma as to how/when to tell her - as well as my brothers. In that call she was exactly the mum I needed her to be - upset, naturally, but not distraught, sympathetic but not panicked, concerned and very loving. If hugs could physically pass down an international phone line, then I swear I could feel her arms wrapped tight around me. I hadn't wanted to tell her news that I knew would be hard for her to hear, but was very glad I had. I felt a huge relief, reassurance and now it was out there for processing rather than having it overshadow the start of our trip home in a few weeks, although things like this always heighten the fact we're so bloody far away!

I told Terry & Jane and Graham via a message on Facebook (how very modern) - it seemed easier to break it that way and less like making a round of phone calls as if to say someone had died. As you'd expect, they were shocked but also incredibly supportive. Telling them - and mum - before the trip home was definitely the right decision.

Having got past that initial hurdle, I told just a couple of other close friends and bit-by-bit the words began to sink in just a little, even to my own ears. Lorne also began to tell his family and friends, in his own time and in his own way. He was very private about the calls and part of me wondered how he was really feeling about all this and how was he even explaining it to them, but I respect his privacy and I'm trying to make sure the lines of communication stay wide open between us. He's my love and my support, this thing affects both of us and it's very important to me that neither of us hides from the other just how we are feeling about this which is why, just a couple of weeks later, it was actually a huge relief to me when he declared that my diagnosis scares him shitless. Heck, I know I've lost sleep over it already, trying not to think about it when it sometimes feels like it's all I can think about. How bad is it? Will I need chemo? When will they operate and how might the surgery change the shape of my boob? Bugger - if there's a part my body I've always been perfectly happy with, it's my boobs. Of course I sometimes think they could be perhaps a little more....ample...but, on the whole, I've always been perfectly happy with them.

And how weird that one of my last postings on this blog was actually about my boobage and how unusually and amusingly busty I feel when I wear a push-up bra, which I nickname my prosthetics. Then here I sit, just months later, hoping I don't end up actually needing prosthetics after all this. Ughh, I'll just be glad when I have more info so I know what to expect from here.

My sister & I share everything....even breast cancer.

Hard to believe it's almost a year since I posted anything on this blog. I'm not really sure what happened. I guess part of me felt like I had nothing really to say, no words of wisdom, nothing hilarious to recount, little motivation to write anything out in glorious detail and no big "aha" moment or anything remotely profound to share. If anything, things were just ticking over nicely for a while and so, being the professional procrastinator that I am, update blog simply became one more item gathering dust on my 'To Do' list.

And suddenly it was April. Spring slowly endeavoured to make an appearance, the days started to stretch just a little longer, the Easter Bunny was on his way and I lost my job at the Canadian Cancer Society. Boom!

Coro's Gail Platt (Actress Helen Worth)

Following a couple of awkward conversations with the Human Resources manager (an extremely fake woman who bears an uncanny and rather unfortunate resemblance to Coronation Street's, Gail Platt) and mumblings of 'I just wish we had something else to offer you here', I signed off on a reasonable severance package, cleared my desk and left quietly that same day.

I was hugely disappointed - not least because I was enjoying my work and the feeling of finally contributing to something significantly more worthwhile than lining the bloated pockets of wealthy corporate execs - but I'd be lying if I said my spidey senses hadn't already started to sense that something along the lines of 'restructuring' might be afoot.

While I certainly felt let down, deflated and abandoned, it also meant that I could take the next couple of months off, Lorne & I would still do our 3-week UK trip in June as planned, after which I'd be eligible for EI while looking for work. So all-in-all, the prospect of a 3-month break wasn't actually looking too bad.

Imagine then, the smack of bitter irony when - just as my severance period came to an end - I received a diagnosis of breast cancer! Double-Boom! - if you'll excuse the pun. WTF???

Even as I sit here now, typing this out several months later, I confess I still haven't quite managed to wrap my head around it all.

Let me start by backtracking slightly......albeit I'll endeavour to be concise or I might never finish this post.

May 2012:
Enjoying my time off and still receiving full pay and benefits, I naturally thought it prudent to catch up on any dental visits, eye exams, physio, chiro and any other medical appointments, such as dutifully booking my annual screening mammogram. Oddly enough I had noticed a small, firm lump in the upper corner of my right breast a few months earlier but figured it was likely just a lymph node or perhaps a small cyst. At first I could only really feel it around the 'time of the month' but gradually it seemed to be there all the time (just a teeny-tiny pea-shaped thing) so I planned to mention it during my May 11th mammo anyway. Three days beforehand, during an appointment with my new GP (my first visit with her since my previous Doc had retired), she carried out a routine breast exam and also felt the bump, which I told her had been there at least a couple of months. She checked deeper into my armpit/breast area and thought she could feel another in the same area, perhaps a little smaller. 'Just as a precaution' she referred me for a diagnostic ultrasound to follow the scheduled mammogram.

Despite the fact my sister, Victoria, was diagnosed with breast cancer just a couple of years ago, I can't deny I was nevertheless thinking (hoping?) this was all just very routine and would turn out to be nothing - still believing in my security blanket that breast cancer isn't in our family history. So I was a little surprised when, further to my May 16th ultrasound, it was suggested they follow up with a biopsy 'as an added precaution'.

All this talk of precautions and 'ruling things out' was starting to unnerve me a little and suddenly I wasn't sure what to think. I planned to meet with my sister and get her take on things, especially since she'd already started on this same route late 2009 but, at the same time, I didn't want to be getting unnecessarily alarmed or come across as over-anxious. People regularly go for more tests and biopsies (don't they?) and it was probably just a cyst or fatty tissue or something (wasn't it?). Besides, I also knew Vicky had a lot on her plate and getting together at relatively short notice wasn't easy. Perhaps surprisingly - now that I look back on it - I wanted to talk about it face-to-face not really over the phone, so with not being able to meet up and chat in person, I didn't mention it, still expecting that surely it's all just very routine and probably nothing to worry about anyway, so why not just wait until later, when I actually know for sure? That typically stoic british, stiff upper-lip thing of 'not wanting to make a fuss'. Not always the best approach, I might add.

The morning of May 22 I endured close to 90 minutes of staring at the stark and dirty walls of a treatment room while a female doctor and nurse poked, jabbed, stabbed & punched me with what sounded like a broken, dollarstore cowboy pistol. Despite trying to focus my mind on creating drawings from the dents and scuffs on the bare walls, and no matter how much they injected me with more freezing goop, I could still feel every poke, scrape and jammed-up pistol in all its painful, scary glory - especially when said gun decided it wasn't going to retract! That was at the 60-min mark and I'd already had just about enough. Having tried to remain calm and statue-still thus far, I felt my armour fall apart when the Dr began huffing, puffing and tugging at the gun, now embedded in my breast tissue. "Could you call Dr X in here right away, I can't get this thing out." Sooo NOT what I needed to hear. Suddenly the tears flowed, I began to tremble uncontrollably and just about fainted. A flurry of nurses brought me tissues and a cold, damp facecloth for my forehead, with smelling salts on standby.

Amid this kerfuffle Dr X finally arrived only to exclaim, in a cold, matter-of-fact tone, "Well, there's only one way it can go - it has to come out!" A renewed wave of nausea and light-headedness came over me. "You're just going to have to hold tight and pull it hard." I almost threw up.

I came out of there dazed, bruised. slightly faint and with a small bag of frozen peas stuffed in my bra (yes, they actually gave me a little baggy of frozen peas!) to help minimize swelling. It all felt very weird and I wandered down West Broadway in a somewhat bewildered state, feeling like I deserved a sugary/cakey treat after going through all that, yet still too wobbly to really believe I'd enjoy it.

And so began the wait....of more than a week...during which I did a surprisingly good job of staying neutral, feeling that no amount of worrying would change the outcome one way or the other, so why get myself all worked up by dwelling on the unknown. Of course it still niggled from the back of my mind as I endeavoured to steer myself away from thoughts of how Vicky'd gone through all this too, just over 2 years ago, only it didn't turn out so well.

May 30 - With a greeting of, "Hello there, so did they contact you with a surgery date?" I abruptly discovered my new Doctor/GP is desperately lacking in diplomatic bedside manner!

"Surgery?" (i.e. What the f*ck???)
"Yes, your biopsy results came back positive for breast cancer." Holy cow, she just waded right on in, blurting out facts-in-hand without offering up even the slightest preamble to soften the blow. Nicely done....Not!

"Wow.... erm.... well.... no - I haven't heard anything yet. I didn't know."

She pulled up a chair and quickly skimmed over the 5-page report; a blur of technical jargon, lab-speak and references to 'biomarkers' and 'estrogen receptors'. I scanned the words on the page but nothing seemed to make sense. That is, until she hit the header "Diagnosis" - circled in pen and marked with an asterix.

There it was in capital letters - loud and clear. I felt my insides pull tight as blood retreated from my face. Still the doctor rushed full steam ahead; "Bla, bla.... positive for cancer.... always verified by two doctors.... bla, bla.... so the second signature right here confirms the diagnosis.... How are you doing? You seem to be okay with this." (Did she really just say that? I was more more stunned than 'okay'.)

"Well, I guess I knew coming in here that this could go either way, I suppose I'm just trying to wrap my head around it."

"So the next step is you'll meet with a surgeon, probably sometime in the next few weeks, they'll call you. Okay?"

Apparently my 10 minutes were up.

"Do you have any questions?"
"Erm, I'm not sure. I'm not even sure what to ask."

And that was it. Wham, bang, thank you ma'am. I couldn't decide if she was just blunt, callous, uncomfortable or just eager to get me out of the door. I suspect all of the above.

I wandered out into the waiting area and sat down. I texted my sister - "Ductal carcinoma, same as you :-(" She called me right away, clearly shocked but asking practical questions - based on her own expertise - and being ever the caring big sister.

"Did they say it's In Situ?"
"No, I don't think so, I'm not sure."
"You should ask. You need to know if it's In Situ - DCIS."

I went back to the desk to see if I could ask the doctor just one more question. They were hesitant but the doctor heard me ask and came over with the report in-hand.

"I'm wondering if the results say it's In Situ."
"In Situ? No it's not, your cancer is invasive." She pointed to the capitalized diagnosis we'd glossed over earlier. "See here, it says invasive. You have ductal carcinoma but it's invasive, not in situ. Okay? I'll give you a copy of the report." And off she went, whipped off a photocopy and shuffled me away with it.

And that was it. May 30th, 2012 around 9:45am I found out that, at 44 years old and just like my dear sister before me, I too have breast cancer.

Well this officially sucks!