These are the three words I started saying to myself about seven years ago. At the time, I had started Weight Watchers and found this trio helpful in motivating myself, dealing with set-backs, and staying the course. I ended up losing 43 pounds, then gaining 10, then gaining 10, then losing 20… I have also used them to deal with other life challenges. To me it conveys a learning process–knowing when to stop and wait, when to keep trying, all the while working toward a peaceful place of balance.

I think a lot about balance. My balance right now is tenuous. The three P’s are being put back into place in a major way. Dr. Beatty called last night to give me a brief overview of the final pathology report. He had given me preliminary results on Monday, which were confirmed. The tissue removed in my last surgery contains stage 0 cancer and one area of invasive cancer. The areas are not contiguous, which suggests that I have multiple cancers in my breast. Dr. Beatty prepared me for this on Monday and I made an appointment for a plastic surgeon for next week for an initial consultation. Dr. Beatty is recommending a mastectomy and I am scheduled to have it on August 8th. I don’t know the full pathology report and I have many questions to ask him. Although I’m not happy about the news, one bit of relief is that their finding another invasive tumor makes it easier for me to decide to proceed with surgery. As you may recall, the results of the 1st pathology were somewhat inconclusive. The pathologists described a 2.5 cm area of breast tissue as, “atypical ductal hyperplasia bordering on ductal carcinoma in situ.” ADH is not cancer but DCIS is cancer, albeit a non-invasive cancer. Basically, they weren’t sure but came down on the side of treating the area as DCIS.

As a diagnostician myself, I understand this. Sometimes my diagnoses are not slam dunks and there may be some discrepancy or lack of clarity. Sometimes I recommend further evaluation, or monitoring and later reassessment, the latter because time can often provide additional diagnostic clarity. But other times, I am unwilling to risk a child not having access to a potentially highly effective treatment. In those cases, I use my clinical judgment. The risks are greater for these pathologists so I imagine that they often take a “better safe than sorry stance.” I was fine going with “ADH bordering on DCIS” for a second lumpectomy but was unsettled with the prospect of a repeat this time and giving up my entire breast based on those kinds of results. But this second pathology report is clearer and I feel that my decision-making is more soundly grounded in “what is” rather than “what if”.

My next big results are the oncotype testing results. I really hope they come back as low risk for recurrence so I don’t need to have chemotherapy. The prospect of losing some of my very best physical features is discouraging not to mention just feeling dead dog sick. I remember how much I enjoyed the nausea, vomiting, and crushing fatigue of pregnancy. I enjoyed it so much that I’ve formed an informal network of friends who like me, love children, especially our own but did not enjoy pregnancy at all. I won’t name any names because it can be stigmatizing to admit that pregnancy wasn’t the powerful earth mother experience that others talk about. I did have a good childbirth experience, although I did ask for medication early and often, which is also a controversial thing to do. Although I have seen some women friends proudly post on Facebook things like, “little Johnny was born weighing 7 pounds following an unmedicated birth”, I haven’t seen anything like, “little Zoey was born weighing 8 pounds after blasted out with a cascade of petocin followed by my OB using a plastic stick to manually break the ambiotic sac, followed by the administration of some opiate that did nothing for pain, followed by a botched administration of an epidural (if the anesthesiologist misses the epidural space, the drugs don’t work), followed in an hour by an effective epidural, which left me in such relief that as I saw the I.V. bag empty down to just what was left in the tube leading to my arm, prompted me to ask twice, “Are you sure there’s enough in there?” and to reassure hospital staff that I would be good for the money if my insurance wouldn’t cover another bag of magical drugs.

Okay, triple P’s. I’m hoping, waiting, and breathing.