Best of Blog: The Michelangelo of Mammaries

August 16, 2013 //

This post is from 7/31/12, the day of my first visit to see Dr. Welk. It was surreal. I have re-posted this previously. It is a favorite of mine. Personally, it took me awhile to feel comfortable in a plastic surgery office. I have such strong associations between plastic surgery and poor body image. But I now feel at home there and Breann and Judy who work reception are always so friendly to me when I come in. They are now requesting that I visit them from time to time as it is clear that I have very few remaining appointments with Dr. Welk. (Knock on wood.)

This afternoon I met with Drew Welk, M.D. a plastic surgeon at the Polyclinic. We had a good meeting and it was interesting to shift from a physician who focuses on disease treatment to one who focuses on aesthetics. I found out that my incision is not in the best place to which I replied, “Yeah, my cancer insists on being all kinds of inconvenient.” To his credit, he laughed at my ribbing. I did learn that I have very favorable “breast geometry” with only a little post-partum loss of muscle tone. Yay, my breasts got complimented! They’ve been a little starved for positive comments lately, especially the right one, which is currently looks like a more than a little like a dented tin can these days.

Dr. Welk is talking to Dr. Beatty tomorrow to share his input regarding the best way to make incisions for the mastectomy so that he has something reasonable to work with later after the fat has been removed from my skin, the latter of which I get to keep. He took pictures in the clinic photography booth, which was set up like the DMV, except for the fact that I was partially disrobed and he had his choice of three different expensive looking cameras. (Or maybe the other cameras belonged to other surgeons. That makes more sense.) He took the last picture after he’d drawn a little incision map with a Sharpie.

It wasn’t as bad as I thought it would be and I liked him. Plus it was a surgery day for him so between his energetic demeanor and the fact that he was wearing scrubs, he looked like a surgeon action figure. (Not to be confused with 1973’s surgeon Barbie and yes, she was real; click the link. Also, not to be confused with an action figure for the character, Surgeon from Hellraiser 2. Mom don’t go to that link: That surgeon doll is heinous.)

Okay, so Michelangelo is probably not the best sculptor to reference in this post. He was criticized for the way he sculpted breasts, basically that it looked like he’d thrown a couple of softballs on top of a suspiciously manly shaped torso. A better sculptor might be the 20th century artist, Lachaise. That man knew how to sculpt realistic breasts on refreshingly substantial looking women. Hmm. “The Lachaise of La Twins”? I’ll stick with Michelangelo for the alliteration. My cousin, Beth favors Bernini breasts herself. Bernini’s sculptures are absolutely breath taking but the first thing that comes to my mind is “the Rape of Persephone”–not the image I want in my head when thinking about my breast reconstruction. Beth conceded that Bernini tended to show women on the run. But I present exhibits A, B, and C for your consideration:

One of Lachaise’s fabulous, “Standing Woman” I think this is a clear winner. Unlike “Dawn”, Lachaise’s sculptures of women actual look like a woman modeled for them. Also, Lachaise’s women look like they could fend off a Greek god or random creep in the bushes, unlike Bernini’s stunningly beautiful but nearly defenseless damsels.

Bernini’s Apollo and Daphne. This is Beth’s submission. In this case, Daphne is so desperate to get out of Apollo’s stalkeresque clutches that she turns herself into a tree!

Michelangelo. This is a sculpture I’ve seen in person. It’s from the Tomb of the Medici’s in Florence. This figure is supposed to be “Dawn” Looks like a man named “Don” with softball boobs, am I right?

Tags Best of Blog, Body image, Breast Cancer, breast reconstruction, Humor, Mastectomy

Categories Best of Blog, Facts, Feelings

My Eyes Are up Here: The Best of the Breast!!!!

August 15, 2013 //

I am taking time off from writing new posts until August 26th. Now don’t fret. At this point of my life, I have an average of two life-changing epiphanies a week! So you know I will be back, with even more musings, angst, and merriment than ever before.

Speaking of silliness, I have set up my blogging schedule to deliver at least one of my favorite humorous blogs, each day. So, if you haven’t been reading long, it will be new material to you. And if you have been reading for a long time, perhaps it will be like seeing an old friend. Or if you read it but forgot it, it will be like one of those awkward encounters when you meet someone you assume is a stranger but with whom you actually went to high school. And that person recounts all of your teenaged shenanigans with, “Remember the time we…?”

I will warn you that at least a couple of the posts are ones that have already been re-posted as part of my “Best of Blog” category. Yes, I will be posting them for a third time. Although I love all of my children, there are a couple that did not get the love and attention they deserved the first or second time around. So like Mama Rose, I am pushing them back into the spot light regardless of what they want or what you want. AND YOU WILL LAUGH AND LAUGH AND LAUGH THIS TIME!!!!!!!!!!!

Tags Breast Cancer, Humor

Categories Best of Blog, Silly

Encounters

August 14, 2013 //

As you know, I walk between 3-4 miles every day. This week, I’ve had a couple of interesting encounters. The first was an encounter with a black hen that had gotten out of her yard. There are actually a number of chickens and a few roosters that live in the neighborhood. Actually, there are fowl living all over my city thanks to the Seattle City Chickens program. I enjoy the chickens, though not as much so as my husband who will change our walking route so that he can encounter the most chickens. He likes animals, in general, but also used to raise chickens when he lived in Oakland, CA. And yes, I mean Oakland, CA. He and his brother were riding the BART train into Berkeley and they saw a pet store. They loved pet stores so they eagerly walked into the doors of a REPTILE PET STORE. They immediately saw a group of baby chicks. “Why are you selling chicks in a reptile store?” The reply? “Those are boa food!”

So they emptied out all of the money from their pockets (allowance ear marked to buy comic books) and bought as many chicks as they could. Then they brought them home. “You can’t have chickens in Oakland” their mom reasonably said. Then they started crying, “But they’re going to feed them to snakes!!!!!!”

So the boys got themselves some chickens. The population quickly dwindled to one rooster, Cruiser. (There were a number of coyotes in the area.) Cruiser was quite territorial and used to sit on the roof behind the chimney, waiting for the postal carrier. When the postal carrier arrived, Cruiser would swoop down for an attack. The postal carrier promptly started delivering their mail to the neighbor’s house.

Okay, now for the second encounter. Perhaps I should give it a title.

Encounter #2: Elizabeth is not the only spy in the neighborhood!

I was out on my walk today and an older man driving a truck, stopped and rolled his window down. I thought he was going to ask me for directions. Instead he said, “You must walk about 3 miles a day.” (“Hmm,” I thought, “how does he know that.”) I replied, “Yes, how do you know that?” He said, “I live at the intersection of x and y streets. I see you by my house.” (“Hmm,” I thought, “we are not three miles from the intersection of x and y streets. You look harmless older man but I will be on the look out for black trucks in the future.”)

At this point, probably harmless but possibly creepy stalker-y man says, “Are you walking for exercise?” I reply, “Yes, I am.” He says, “That’ll make you live longer.”

I said, “Yep, hope so.”

So thank you, probably harmless older gentleman for reminding me of the reason I have walked 735 miles in the last eight months.

Tags Breast Cancer, chickens, coping with breast cancer, exercise, neighborhoods, Seattle, Seattle City Chickens

Categories Feelings

Fight the Occupation

August 13, 2013 //

Separation anxiety is common for children. And some of them have it really bad. They follow a parent from room to room. They won’t sleep on their own out of fear that robbers, bogie men, or bad guys from t.v. will get them. They have nightmares with separation themes like being kidnapped, one of their parents dying.

Separation anxiety is treatable but it is intense because the way to break it’s spell is to prove it wrong. Children (and their parents) need time away from one another. They need separations. They need practice being alone and finding out that the world did not end and that everyone is okay. It takes a lot of practice to do this and you start with really tiny separations and work your way up. I typically have kids rate the stressfulness of different separation scenarios (ex. being alone for 10 seconds versus a minute versus ten minutes) on a 1 to 10 scale (10 being most stressful.) I tell them that with relaxation methods and the right incentives they should be able to face a situation as high as a 6.

A 6 can seem like a lot. So with little kids, I might have them give mom and/or dad a hug to “fill up the love tank.” Then it is his/her job to use whatever coping strategies they have to keep it full and stave off the anxiety that typically makes them run back to Mom or Dad, thereby reinforcing the spell of irrational anxiety.

I have been applying this concept to myself, not so much that of a “love tank” but to no longer think of myself as some limitless supply of energy, emotions, and thoughts. I need to do things that fill me up. It is part of my mindfulness practice and my commitment to better self care.

There are plenty of things I can do that fill my time. I don’t have the bandwidth I used to have. Maybe it will come back and maybe it won’t. Although I am getting stronger, there’s still a discrepancy between the amount of mental stamina I need to function the way I used to and the amount I actually have. I have not yet been able to return to my normal reading habits. I used to read a book everyday. I’ve done this since I was a young girl. Every once in awhile, I would have a couple of week period or even a month when I was not reading a novel or a work of non fiction. I have read very little besides blogs for the past couple of months. It is too hard to concentrate after I’ve completed everything else on my to do list.

After my brief barrel of monkeys experience with hyperactive Facebooking, I find myself striving for balance, once again. You know what one of the harder things about balance is for me? It’s not black and white. It’s about having some but not too much of one thing so I can have some, but not too much of another thing, and so on and and so on. It is simpler sometimes just to go without. I spent about 4 years of my 20’s never eating sweets. I just thought it was easier that way. It helped me keep down my weight. But I missed out on some good grub. Four years is a long time. I still don’t eat a lot of sweets but I eat some and have learned to be more moderate about it. And a little chocolate is good for the soul, people.

A problem with excessive use of electronic media is that it doesn’t fill people up. We can’t be healthy with chocolate all of the time, even if it is that tantalizingly delicious Dagoba chocolate. Excessive screen time just occupies minds. I see this with kids with ADHD all of the time. Contrary to appearances, they are actually typically under-stimulated. All of the daydreaming, screen use, jumping around, etc serve to increase alertness by increasing dopamine activity. And screen time is the easiest way to keep their minds busy and occupied. And they will play them forever if allowed to do so. And when the plug is pulled, there’s often acute distress. “World, stimulate me! I am depleted! This is too hard! I can’t entertain myself! Give me back my screen!”

There are so many aspects of blogging, social media, and just the Internet in general that are extremely valuable to me. But others, not so much. And too much makes me unable to deal with the quiet of my mind. “Entertain me, world!” But the quiet of my mind is important. Silence is important. It is important for me to be alone with my thoughts and to not fear where they will take me in this very uncertain time in my life. I can’t occupy my mind to fend off the what if’s and the what could be. I know that the more I avoid these silences, the harder they will be for me and the more I will try to avoid them. Avoidance of being alone, just alone with my thoughts, even the scary ones feeds a spell. It feeds the spell of separation anxiety, not just the fear of being separated from my family by death but the fear of being bored. That’s sounds ridiculous, right? But I ask you to look at a bus stop full of people tomorrow morning. You will see that all of them are looking at their Smartphones!

I don’t want an occupied mind. I want an active and creative mind that also knows how to tolerate the slow parts of life, the parts we need for restoration and peace. I am not leaving the land of screens. I am just trying to be more careful about how and why I use them. So I am now asking myself, “Does this fill me up or does it just occupy my mind?”

Tags balance, excessive computer use, mindfulness, social media

Categories Feelings, Mindfulness

Sex and the Single Girl-Part 2

August 12, 2013 //

As I wrote last February, breast cancer is not “big sexy time.”

I know that the negative impact of cancer treatment on sexuality and response is kind of a taboo topic. And I figure that improvements in this arena over time are even a more taboo topic.

Ladies don’t like to kiss and tell. But it sure would be nice to know that after all of the body rearrangement, surgeries, and chemical warfare, that there’s something to which those of us with partners or those of us who are between partners, might possibly look forward.

So hypothetically speaking, I think that things in that, ahem, arena could improve over time.

That is all.

Tags Breast Cancer, sexuality

Categories Feelings

Protected: Mothers and Daughters

August 11, 2013 //

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Tags coping with breast cancer, grief, Mothers and Daughters, Parenting

Categories Feelings

Return of the mojo

August 9, 2013 //

After two days of steady and grief-y tears, I am starting to feel better and perhaps a bit of my mojo has returned. Unfortunately, this return was marked by another, my first hot flash since my Lupron injection last week.

Perhaps the current stage of grieving fever has broken. Alternatively, I guess a little mojo plus a fine film of sweat does sound a little like a tropical vacation.

Thanks for worrying about me, people. I am hopeful that I will get a break from the necessary but sucky Sadland, in which I have resided for the past couple of days.

Categories Feelings

Protected: Mess

August 9, 2013 //

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Tags Breast Cancer, coping with breast cancer, Family, Friends, grief, social support

Categories Feelings, Parenting

No words

August 8, 2013 //

Every August, for the past several years, I get an unexpected wave of sadness. Then I remember that my friend, Gina died in the month of August. I can’t even remember how long ago; it must have been at least 15 years. Gina was just a beautiful person and friend. I met her in graduate school. I was in the clinical psychology program and she was in the counseling psychology program, which was housed in Education rather than in Arts & Sciences. We met through our mutual friends, Annette and Ellen, who are also now counseling psychologists. Gina had just returned from her clinical internship to finish her dissertation, her remaining Ph.D. requirement. She was also recently divorced.

Gina was so fun and such a kind-hearted person. After she graduated, she ended up taking a job at Duke University in onco-psychology. Yes, she worked with cancer patients. Gina used to talk about how happy John and I were together. “Elizabeth laughs when John tells stories you know that she’s heard a hundred times.” She and Annette were quite taken with John and referred to him as being the “most marriageable man” that they knew. Not that they thought he was available; they just thought he was well suited to marriage and were looking for someone like him. (And believe me, this is not the first time my girlfriends have talked about my husband this way to the point when my friend, Cheryl would even say, “I’ve got to get myself a computer nerd.” It was just fine.)

I suspect even more than being re-married, Gina wanted to be a mother. She eventually did marry her husband, Bob. We flew back to North Carolina for the wedding reception and John was the official photographer at the small family-only service at Coker Arboretum on the UNC campus. He took some really beautiful shots.

Gina did have a baby, a beautiful boy. We were so happy for her. A few months later, Annette called and I answered. “Gina died.” She’d had an brain aneurism and died while her husband was driving her to the hospital. There’s a boy in North Carolina who only knows the mother who waited for and wanted him so much through a video that Annette made. When she found out that Bob and Gina didn’t have a camcorder, she borrowed one and took footage.

I was wondering today why I was feeling her death again like the day Annette called. I looked down at my calendar. In fact I feel sadder than I have felt in many years. Today is August 8th. Today is the anniversary of my mastectomy. Today is a reminder of what I have lost and the greatest losses were not of my breast or my femininity, or my sense of self.

The loss I feel today is the loss of the ability to take for granted that I will be able to be alive for as long as my daughter needs me.

I have learned to be happy, to be appreciative, to have abundant and overwhelming joy in my life. But some days are just sad and that’s as it should be. In our sympathy card, I wrote to Bob, “So many words describe what Gina meant to us. No words describe our grief in losing her.”

Tomorrow is a new day. But today is the one I have right now.

There are no words.

Tags Breast Cancer, grief, Parenting

Categories Feelings, Parenting

Living life without letting your ass hang out while wearing a hospital gown every 3 seconds

August 7, 2013 //

Being a breast cancer patient has tested both my physical and emotional privacy. Although I have no alternative frame of reference, being a psychologist with breast cancer has added another precarious layer of tricky boundary issues.

The physical exposure is obvious but I don’t think most people, unless they have been pregnant or have had a serious medical issue, can fully appreciate it. You’re asked to be naked all of the time or in the case of a breast cancer patient, half-naked all of the time. You get handled, prodded, squished, injected with radiation, pierced with needles and wires, sliced open, and flooded with chemical warfare. I’ve met so many O.R. nurses while climbing onto an operating table in a flimsy gown, only seeing the hazy outline of their faces because I am so near sighted without my glasses. During four surgeries, while unconscious, adhesive electrodes were placed on the front and back of my torso. A part of every first shower following surgery was finding one or two that were left behind. In addition to the bandages, drains, and incisions, this was another reminder of the way my body was cut, pasted, and manipulated while I was unconscious.

Emotionally, I have been vulnerable and scared in front of so many strangers, wonderful strangers, the healthcare providers from whom I have received my assessment and treatment. Many of them are strangers no more but there are a number of folks whom I’ve met only once. Walking in with my husband to the Swedish Cancer Institute for the first time, just my being there broadcasted the very private information that I had cancer. Before I even handed over my insurance card or gave the patient coordinator my name, she knew that I have cancer because I was at the Women’s Cancer Clinic. Everyone in the waiting room knew, too, if they happen to notice me. The second scariest thing about my life (told you, parenting is scarier), a very private matter was revealed to so many whether I wanted it to be or not.

As you know, I am child/adolescent psychologist with a private practice. At the time of my diagnosis I was booked out for three months. I didn’t know my treatment plan except that I would have at least one surgery and probably take tamoxifen. I didn’t know whether I would have radiation treatment or chemotherapy. I knew very little about the logistics of my life and how they would impact my practice.

I don’t know about you, but if I wait three months for a doctor’s appointment, I don’t really like it to be cancelled at the last minute. And I particularly wouldn’t want to reschedule for another couple of months only for it to be cancelled again. I figured that the families of my patients would feel the same and if I appeared to flake out on them, not only would the needed services be delayed, but my reputation could be harmed. I am a small business owner. A bad reputation threatens my livelihood.

After talking with my colleagues in my psychologist consulting group, I decided that I needed to tell the parents of my patients something. (As an aside, this group, along with my own psychologist, helped me continually assess whether my illness or the stress surrounding it were significantly impacting my competence, in which case I would have to transfer all or a portion of my caseload, as is required by law.) I initially decided to tell the parents that I had “a serious but treatable medical issue.” I tried this a couple of times and the acute anxiety in the faces of the parents was rather distressing to me. So I ended up telling parents that I had breast cancer, a very good prognosis, and as much detail about how it would impact my schedule as I knew. That actually worked a lot better. Fearing that some parents would under-report issues to avoid burdening me, I also told them that they had to tell me if they were not able to get from me what they needed so that I could refer them elsewhere. Since I do a lot of assessment, it meant telling people I’d not even met about my health. I wanted to them a chance to schedule with someone else if they didn’t want to take the chance that I would be unavailable. Fortunately, out of about 18 assessments, I only needed to refer one family. I was able to carry off all of the others, many of them during the month between my diagnosis and my first surgery. As a frame of reference, for the type of assessments I do, completing two per week is considered a lot and I was writing about three reports per week during that month. (I’m getting a little off topic but I am kind of amazed that I was able to pull that off.)

And sometimes the physical lack of privacy crossed into my experience with parents of patients. Guess what? Some of the parents of my patients work in hospitals, my hospital. And one of them works in one of the pre-op areas where I hung out in a flimsy hospital gown, sometimes with my ass hanging out and other times mercifully clothed in a pair of hospital pj bottoms. And that person was really nice about it, allowed me as much dignity as possible, gave me a hug before each surgery, and gave me extra pillows.

So how did I deal with having my ass hanging out, literally and figuratively? As for the physical privacy, although I am somewhat modest, I knew I had no choice and got over it. When nurses, physicians, or technicians apologized to me about the discomfort of procedures, I just said, “I know you are trying to help me. Just do what you need to do.”

In my practice, I learned to deal with inquiries about my health with appreciation and a short and positively worded reply. The only time I initiated the subject was when I had an upcoming surgery that would impact scheduling or require a long absence. When parents emailed me during my medical leaves inquiring about my health, I gave them a short and positively worded reply sometimes followed by the statement, “Now I am going to take a nap” just in case there was any question that I was not available for clinical consultation.

Although I believe that I have navigated all of this quite well, the lack of privacy has gotten me too used to not having it. I also share much of my inner life on this blog and for the most part, I navigate the privacy boundary in a way that may not be comfortable for everyone but that is comfortable for me as well as for my husband. And I have reaped so many benefits from my blog. I have met incredible people and become part of a powerfully supportive community. And I wouldn’t have them if I hadn’t written about my experience, sometimes in intimate detail. But sometimes I wonder if I disclose too much on my blog. Other times I know I disclose too much about my thoughts and feelings to friends and acquaintances. For example, I believe I have told a substantial portion of my life story to the new psychologist that joined our office a few weeks ago. She still likes me and is pretty chatty herself. But still, this is not the way I want to conduct my life, spilling my guts, every 10 minutes.

In another one of my “duh moments” I realize that I can’t keep acting as if everyone is entitled to and interested in hearing my life story, just because an incredibly scary part of my life, my breast cancer, is out in the open. The parents of my patients needed information and reassurance. I’ve told my healthcare providers, “Do what you need to do.” And that course of action worked for the most part. But I am at a different stage in this process, one that allows for more privacy than I am currently allowing myself to have.

How do I keep my boundaries in check? What is my touchstone? Although my life is more settled it is still very intense. The positives and the negatives stand out in sharp relief. What keeps me grounded while I experience a technicolor world with the bluest sky, the strongest joy, the most heartfelt gratitude, love that is surrounded by birds and flowers, and the scary cliffs of opportunity or ruin?

Your own touchstone may be different. I think mine is a question, which must first be answered before any additional questions are posed or actions are taken.

“Elizabeth, what do YOU need?”

Tags boundaries with patients, Breast Cancer, coping with breast cancer, privacy

Categories Feelings, Mindfulness