What if…

What if you were told you had one year to live? Don’t worry–I haven’t been given a life/death sentence. But, I have been thinking about this a lot. Maybe the high profile suicides of Kate Spade and Anthony Bourdain and the outpouring of grief people were sharing on social media made me think about choosing mortality. Maybe the book I’m reading by Nina Riggs, The Bright Hour: A Memoir of Living and Dying, made me think about mortality choosing us.

The Bright Hour is Riggs’ memoir about dealing with and dying from triple negative breast cancer. Her cancer was particularly aggressive and continued growing while she was in chemo and radiation. She and her husband were teaching their younger son how to ride a bike and she tripped and broke her back. The cancer had devoured her L2 vertebra. As a writer, I’d love to have been able to talk craft with her and discuss her process. As a cancer survivor/thriver, I’m just pissed. Pissed that this disease can be so unpredictable and take so many people before they have had a chance to live a long life.

At one point in her memoir, her husband tells her that he can’t wait for things to get back to normal. She responds, “Thinking that way kind of invalidates my whole life right now. I have to love these days in the same way I love any other. There might not be a ‘normal’ from here on out.” He thinks she is in denial about her cancer. She replies, “These days are days. We choose how we hold them.” I’m only about 100 pages into the book, but have been stewing, mulling, chewing over her finely crafted prose. It’s a good thing I have plenty of opportunity for quiet in my life.

Here is what I’ve been thinking about and trying not to think about: what if I had one year to live? For shits and grins, let’s assume that money is no object. what if 6.15

Would I keep working? No.

Would I try to run another marathon? No.

Would I enjoy running, yoga, swimming, and biking, etc. for the pure pleasure of  moving my body in the world? Yes.

Would I eat well and avoid alcohol? Yes and within reason.

Would I take medication to prolong my life? There’s a toughie. I don’t know. I don’t want to choose mortality. Abstaining from medication that might buy me more time seems like slow-motion suicide. I suppose the side effects of the medication would dictate whether or not I would be willing to take it.

Would I travel? Hell, yes. Would I tell anyone where I was going? As tempting as it might be to just disappear like Brad Pitt in Legends of the Fall, I’d want to see friends and family I haven’t been able to see for a while. I’d like to go to Australia with Jake and see it through his eyes. I’d like to go to Germany with Ute and experience her homeland through her eyes. I’d like to bicycle through Europe with friends.

Would I turn back time and say yes to opportunities I passed by? Perhaps, but only if I could still be Jake’s mom.

Would I do impetuous dangerous activities? Probably not.

Would I write? Duh. Of course.

Would I try to finish some projects like all the quilts I have purchased fabric for? Within reason.

Would I work in my garden? Yes. It is my oasis.

Would I move? Hmmmm. I’m not sure. I don’t want to live here forever, but if I only had one year to live and didn’t have to work, I’d probably fulfill my lifelong dream of living in France or somewhere else.

Would I write letters to everyone who means the world to me? Yes.

Would I get married if the opportunity presented itself? Yes, as long as I wouldn’t be saddling my partner with massive medical debt. I can imagine that personal ad, “Single woman with one year to live seeks life partner for short term assignment.”

What if we each lived as if today were our last day on earth? The idea exhausts me. The notion of trying to cram a regret-free life into each twenty-four period is untenable for me. However, like Nina Riggs said, I can choose how I hold each day.

For now, I’ll choose honesty, simple pleasures, nice chocolate, true friends and family, my crazy groundhog-eating dog, staying physical, and a nice glass of red wine now and then. I’d like to take a long road trip with Jake and see the federal parks. A long highway, hot wind on our faces, a cool soundtrack and companionable silence with hawks swooping overhead.

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HYPERTEXT REVIEW – FLASH FICTION – Hypertext Magazine

A little shameless self promotion. Check out Hypertext Magazine for some amazing fiction, essays, and more–including my flash fiction!

https://www.hypertextmag.com/hypertext-review-flash-fiction/

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In Stride

I spent the day at Froedtert for my semi-annual check-up and also got to hang with my friend, Margie, for her penultimate (gawd, I love that word) chemo appointment. We have the same oncologist. Margie asked me to come into her exam room with her, so Dr. Cheng looked totally confused when he saw me sitting there.

It felt like an out-of-body experience to be a witness to my friend’s appointments as well as have mine in the same day. Mondays in chemo-land are always behind schedule. One great thing about Dr. Cheng is that he will take whatever time he needs to take with his patients. The bad thing is that it sets up a domino effect. He was late to see Margie and he was late to see me, which meant that I had to miss hanging with Margie during most of her chemo. At least she was able to nap and I was able to read more of O Magazine than I needed to. I now know what kind of clothes I should be buying this year and that Reese Witherspoon has her own lifestyle brand that Oprah was willing to plug most likely because of their shared experience in A Wrinkle in Time. What is it with celebrities and their lifestyle brands? Is it similar to their need to have a Cause du Jour?

Other than the fact that I don’t feel like a female anymore, I have no issues. Sure, I worry about all of the women I know who have had cancer concurrently with me are dying, have died, or have had a recurrence and are dealing with metastatic cancer. That sounds like I’m taking it lightly. I’m not. It weighs on me each and every day. Why them? Why me? Why any of us? See, this is one of those reasons I do not believe in higher powers. If there was such a thing/being as God/Allah/Buddha/Whatevs – then cancer would be reserved for child molesters, serial killers, school shooters, etc. Normal people like me and my friends would not get cancer.

I told Dr. Cheng that I am bone dry everywhere (I gestured to my vagina, my eyes, my nose, all over), have no desire, and don’t feel like a woman anymore. He nodded and said that he has heard that before. He said he can refer me to a specialist in the Wish Clinic. Of course, my sarcastic mind went straight to the “I Wish I Was a Woman Clinic” – who names these things? Someone with good intentions, no doubt. I can’t take an estrogen cream, so I have no idea what the doctor will suggest. Maybe the doctor is like a fairy godmother and will grant me three wishes. One of which – no cancer – is impossible.

We had our ongoing discussion about whether or not I would continue taking Exemestane (aromatase inhibitor) beyond the five years (1.5 more to go). There isn’t much statistical benefit to continuing beyond five years. Single digit. Not big enough in my book. Sometimes, I think what the oncologists are selling is fear. I told him we could keep having the discussion, but that I’m not convinced that anything beyond five years is going to make that much of a difference.

The only blip was the results of my bone density test from October. My spine shows bone loss – osteopenia. Ha! I almost typed – did type – osteopenis. Bone boner. Osteoporosis is -2.5. My spine is at -2.

abstract shapes, bone structure

Bone. Looks like abstract art – especially a Shannon Goff sculpture.

I attribute that to two things. I’ve been taking half the dose of calcium because I can’t be bothered to take pills twice per day and I virtually quit running after the Chicago Marathon in 2016. I burned out. I told Dr. Cheng we could wait until my next bone density test to see if my bone loss has reversed.

I’ll be running a marathon in September in honor of my friend, Lori, who just died. Fucking ovarian cancer. The silent killer. Maybe re-introducing weight-bearing exercise will help. That and upping my cottage cheese and salmon intake and taking a calcium pill mid-day — all of those things should help. If I lived someplace sunnier and got more Vitamin D, then that also would help. Does anyone want to marry me and move to Spain, the South of France, Mexico, or Australia?

One of the ongoing conundrums of cancer treatment is that you get to choose your poison. In my case, it is the aromatase inhibitor which leads to bone loss, dementia, and heart disease — oh joy! But doesn’t lead to uterine or endometrial cancer or pulmonary embolisms — oh double joy! So, I will suck it up and run, run, run. Run for me. Run for Lori. Run for Pam. Run for Patty. Run for Waid. Run for everyone affected by cancer who cannot run. bone running xray

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Four years. Three years. Some fears.

I have a list of dates clipped to the red file cabinet next to my computer desk. The first line is 12.20.13 – Diagnosis. Each year, I approach this anniversary with a vague unease. It follows hot on the heals of the anniversary of the last day of active treatment – camus solsticeDecember 11. That is the day that really matters. Each year around the sun without any recurrence is a blessing, a gift.

But, I’ve been in a funk and have had a hard time looking on the bright side of survivorship. Yes, I’m glad to be alive; however, the life I’m currently living is a far cry from the life I had imagined I’d be living in my mid-fifties. I have always been healthy and get impatient with illness. If I get a cold or the flu, I just want to be left alone so I can lie in bed and float in and out of sleep, resurfacing when I feel close to well. But, I suppose more than anything, I don’t like being weak anymore than I like crying in front of people. It’s just me. My perception of illness and weakness. I know there are plenty of strong-willed people with chronic diseases or disabilities. And now, I am one of them.

Prior to being diagnosed with cancer, if I had a swollen gland (lymph node) in my neck, I didn’t think my cancer had recurred and metastasized to my brain. Prior to being diagnosed with cancer, if I had a sore back from doing 80 massages a week (hyperbole), I didn’t think my cancer had recurred and metastasized to my bones. Prior to being diagnosed with cancer, if I had a sore throat and cough that lingered for a few weeks, I didn’t think my cancer had recurred and metastasized to my lungs. Prior to being diagnosed with cancer, if I had any new and different physical issue, I didn’t think about it much at all. It would pass. I was healthy. I was whole.

Now I am healthy with an asterisk. Healthy*. * = hopefully. I am no longer whole. I lost a breast, two Fallopian tubes, two ovaries, some self-esteem, and a great deal of gentleness. I find myself hardening, becoming brittle, dried out, a husk of my former fun and sensual self.

I intentionally did not date much when Jake was little and when we moved to Wisconsin, dating became a non-issue for the most part. It seemed like the people who got divorced up here, just hooked up with other divorced people they already knew. It reminded me of watching the kids at Jake’s high school cycle through a very small pool of “eligible” kids which meant that the same few boys dated the same few girls. This probably happens in a lot of schools; it was just more obvious with his class since there were only 125 students in his graduating class. So, Jake and I have had about the same amount of success dating in Wisconsin. I had imagined that I would be free to date when Jake went to college. What really happened is that I was free to have a mastectomy and radiation. There were plenty of people who saw my naked breast(s), but none of them with any intent other than to poke, prod, shift, remove, or zap.

The other day on Facebook, I bemoaned the lack of market for one-breasted women. A couple of girlfriends pushed back and called me out on my comments. I said I had to re-frame my inner dialogue. They agreed. I do. I need a mental rubber band that I can snap whenever my mind goes doom-and-gloom. In addition to not liking illness, I’m also not a big fan of self-pity and I’ve probably been indulging in it. Part of the problem – and a great problem to have – is that I’m writing a memoir about my cancer. So, I need to finish it pronto so that I can stop reliving the cancer stuff over and over every day. I’d like to close the chapter on that part of my life. I want to get to the part of my life that includes travel, a beau, writing full time.

I want to get to December 20th and not think about the anniversary of my diagnosis. I want to think that it is the eve of the Winter Solstice and that the darkest day of the year will soon pass and each day will be a little lighter and brighter.

Winter-Solstice-and-Yule-A-shift-from-darkness-to-light.jpg.optimalMy goals for this year are to actually take time to live, not just exist. If the ice caves develop, I’m heading north to see them. I’ll run a race or two, maybe someplace new. Jake will graduate in May. If he wants to take a trip with me, great. If not, I’m throwing a dart at a map and checking out a new destination. I’d like to work on being more kind – to myself and everyone else. My primary goal is to finish my cancer memoir and go about the business of getting it published. I’ll keep visualizing book signings to crowded rooms – with any luck I won’t drop the F bomb – too often. I see stacks of my memoir on the table and I’m signing the books and people (probably mainly women) will be telling me how much they laughed and cried. I’m going to focus on the good in my life and not be brought down by my own inner paranoia or the more generalized unease I feel when I think about current affairs.

So, this year, and every year forward, the winter solstice brings me the promise of a renewed life and the ability to set new goals and re-frame my thoughts so that they are more aligned with me and my purpose. It allows me to reflect on the blessings in my life – my family and friends who are patient and supportive of me, my dogs (currently one – but there will be more), my readers and publishers, and my medical team who have helped me achieve each anniversary.

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Defining a life

Death has been on my mind a lot lately. Omnipresent. Oppressive. Not my own, necessarily, but that thought is always there now, too–just outside my visual field, like something I see frittering around in my peripheral vision.

My dog, Sophie, is almost fourteen – or in human years – 98. About as old as my great-grandmother when she died and not nearly as wise. (In Greek, Sophie means wise – that is what I wanted – a wise dog.) I didn’t intend to get Sophie, but I think I was probably the only person on earth who could have put up with her idiosyncrasies. Maybe she would have had less if I could have afforded to have trained her – or if I had actually read all of the books that people recommended.

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Sophie sleeping. Let sleeping dogs sleep. Always.

The day after Christmas in 2003, my brother called from Texas and left a message on my voicemail at work. He and his daughter, Hayley, were out exchanging gifts and running errands. I was at the office, working through my post-Turkey and stuffing stupor. I listened to his message. “Hey, Kathy, I found a puppy for you. AKC lab. $200!” I called him back and he explained that he was driving past the Home Depot parking lot and there was a truck with a sign, “AKC Labs – $200.” He stopped to look at them and called me right away. I said I wasn’t interested in a puppy. I would be moving to Wisconsin in six weeks and didn’t need a puppy. I wanted to get settled and adopt an older dog. If nothing else, Pat is persistent, which is a good thing. He is a salesman. He cajoled. He begged. He told me how cute they were. They!? I only wanted one dog and not a puppy. Finally, beaten down and needing to focus on some complex real estate transactions, I said, “Fine. Why don’t your run your errands and then drive by and if they are still there, I’ll take one. Female.”

When I got home, my mom said, “Call your brother about the puppies.”

“Puppies? I only said one.”

“Puppies. Julie is hopping mad.”

My sister-in-law may be small, but you do not want Julie’s fury unleashed in your direction. She can be like one of those tiny dust squalls that spirals out of control into a full-blown haboob. I called and Julie answered. No idle pleasantries. “Pat, your sister is on the phone!”

“Hey sis! I got your puppy and I’m trying to talk Julie into the other one.”

“Other one?”

“Yeah. I thought Daisy needed a friend.” Their yellow lab Daisy would have been about nine or so then.

In the background, I could hear the clickety clack of Julie’s heels on their kitchen floor as she paced back and forth getting dinner ready. “Daisy does not need a friend and your sister needs a dog like she needs a hole in the head.” Julie did have a point.

“I have a call into the breeder, but he isn’t returning my phone calls.”

“Why would he? He has $400 cash and two less dogs.”

A reasonable person would have wondered why pure lab puppies were going for $200 each. Especially female. In 1992, I had bought my first dog – a black lab, Molly Bloom, for $300 from a backyard breeder. She was a great dog. Empathetic. Loyal. Quiet. Great with babies. The best footrest ever. So, a $200 dog should have been a red flag. The breeder had told Pat that he bred ’em fast and small. Sophie was both. She weighs less than sixty pounds and in her youth she could bolt out of the house so fast I swear I heard air swoosh. When I took her to the beach, she tore down the Lake Michigan’s shoreline as if she she were hellbent on getting to Mexico in a half hour or less. Evidently, Pat and I weren’t reasonable. We had spent our childhoods in apartments and had always wanted dogs.

My mom thinks Sophie is part coyote. When she was young and would sit barking at me nonstop, I thought she looked like she was part pit bull. She has pink rims around her eyes and a pink nose, which the breeder said meant liver-colored, but I took to meant one-screw loose. It’s actually not liver-colored, but rather a Dudley lab and means she has less melanin. No biggie, just not a show dog. I’m not sure if it’s linked or not, but she gets skin tags wherever she has rubbed herself raw from seasonal allergies or Rowdy or Suki have bitten her (but those are different stories and I won’t go into them now).

I found a home for Sophie’s litter-mate and my brother Terry and his family drove down to Texas to celebrate New Years Eve and bring the puppies up.

I was not prepared for the full onslaught of Sophie. Where Molly had been mellow and content to sit by my feet, Sophie’s nervous energy got on my nerves–and everyone else’s. She has paced from the time she came home–only pausing to sleep. Shortly after I moved to Wisconsin with Jake (my son) and Sophie, she dismembered his favorite stuffed animal. While I was cooking dinner, I heard Jake shriek. I ran to the bottom of the stairs and looked up. He was bawling and holding Arthur. Stuffing oozed from Arthur’s belly and legs and tufts of it littered the hallway outside Jake’s bedroom. Jake yelled, “I hate this fucking dog! The next time Uncle Pat calls and says he has a god-damn dog, hang up on him!” Yes, my seven-year-old son had a potty mouth. No surprise. We scooped up all of the stuffing and after dinner, I patched Arthur. I think his pants are totally reconstructed.

In an effort to get myself in shape and burn some of Sophie’s energy, we ran a few miles most mornings for years. About a year ago, a little stiffness in her hips has turned into major arthritis. She is deaf. She is blind. She shits in the house on an almost daily – sometimes twice daily – basis. She has pissed on rugs, chairs, my bed.

The bed. In 2006, we inherited a three-legged Australian shepherd named Wishbone. He, like Molly, was a good dog. Sophie knocked him to the ground his first day home with us and humped his head. This continued for nearly six years until he died. He would look up from between her frantically thrusting legs and seem to ask, “Why me?” When Wishbone first came to live with us they played so much during the day, that Sophie slept like the dead and wet my bed almost nightly. A waterproof mattress cover and some DES for her helped. There is nothing quite like putting your feet in a wet spot to jolt you out of a sound sleep.  When Wishbone died, Jake and I went more than a year as a one-dog household. It was quieter. We (I) had less poop to pick up outside. Less dog hair all over the house. Then, in early 2013, I made the mistake of checking out the humane society webpages. One thing led to another and we ended up with Rowdy. (He is another story and I won’t get into that now, either.)

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Sophie hugging my reflection

I’ve been wondering about Sophie dying for a few months now. I wish she would do it like Molly and Wishbone. Well, Molly for sure. Not Wishbone. He had a massive seizure and emptied his bowels and bladder on one of my favorite throw rugs. Molly died in her sleep in my bed one morning while I was still nursing Jake. She had been sick for over a year. The best diagnosis her vet could come up with was auto-immune arthritis. But, I think it was probably anaplasmosis – a tick-borne disease. They weren’t testing for that back in 1996; Rowdy has a mild case of it and the full blown symptoms are the same as Molly’s.

Jake had never heard me cry up to that point (10 months old). Actually, cry is an understatement. Sob. I sobbed. As in burst into tears. Gut wrenching sobs. I buried my head in Molly’s neck and just sobbed. Jake burst into a belly laugh. I suppose from a ten-month-old’s point of view, a grown woman making bizarre sounds is pretty funny.

If my Google searches are monitored, which (according to Edward Snowden) they most likely are, then this is some of what will surface: when to put down a dog; heavy panting in dogs; beau bergdhal; is donald trump insane; breast reconstruction; definition of kill; and a helluva lot more.

Because I like old-fashioned dictionaries more, I will quote the dictionary I somehow got from my uncle Mike. It is a faded red, like an old brick. Webster’s New World Dictionary of the American Language College Edition is debossed on the cover. I love this dictionary. I have crammed quotes in the pages, carefully handwritten on yellow legal paper when I had good penmanship; long lists of words that I discovered in books and didn’t know; my astrological chart; a childhood picture of an old boyfriend who has since died.

kill (kil) v.t. 1. to cause the death of; put to death; slay. 2. a) to destroy the vital or active qualities of. …. 8.[Colloq.], to overcome, as with laughter or embarrassment. (think Sandlot “You’re killing me Smalls.”)  .. v.i. 1. to destroy life.

Soon, I will be killing my dog. Not myself. But, I will be paying my vet to help me kill Sophie. I hate euphemisms. I will not be putting Sophie down. She will not be crossing the Rainbow Bridge. I do not believe in unicorns; in their mythical world, they probably cross rainbow bridges. I will be killing Sophie with  my vet’s assistance. I met with her today on an unrelated matter (another long story I will not get into now). I told her I feel guilty for thinking about it since Sophie still eats and seems to enjoy her walks even though her gait resembles a drunken bow-legged sailor. The vet said not to feel guilty. She sees too many people who wait too long. She said they are the people who should feel guilty and I would be doing the ultimate kindness.

I wonder about this with people, but that is definitely another long post that I will not get into now.

What I want to leave you with is this: even though Sophie is and always been flawed, erratic, needy, anxious, hell on my furniture and flooring, a hellion, hates cats with a passion, tolerates Rowdy…she loves me and I love her. She may not be perfect, but neither am I.

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Dork

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Last Ditch Effort

I met with my oncologist today, his nurse, and LPN to receive my semi-annual dose of post-chemo hugs and good news about my bloodwork and bone density results. I had to put my bone density test on hold for a week or so in order to help my mom with some of her medical issues. (It’s a bitch getting old.) Since I haven’t been running as much I hope I haven’t lost too much bone mass. The drug I’m taking for five years is an aromatase inhibitor and negatively impacts bone density. The ironic part of a tumor that is fueled by estrogen is that when you cut off the supply of estrogen in your body, the things that suffer are your bones, brain, and heart. So, if this drug does a number on me, I will have fractures, dementia, and heart disease. Oh joy. Forget herpes, cancer is the gift that keeps on giving.

When I was talking with the nurse practitioner, I told her that fears of recurrence mess with me, especially now that three of my breast cancer friends who were all diagnosed around the same time have had recurrences. She said what I already tell myself almost daily–each cancer and each individual are different. That still doesn’t make it any easier. I did ask her about brain metastases since my tumor was Her2-positive and brain mets are more common with Her2+ and triple negative breast cancers. She said they normally occur within 2-3 years. I haven’t had wicked headaches or other symptoms, so I’m not too worried, but I like to be mentally prepared for worse case scenarios.

As she was looking at my blood levels on the computer monitor, she asked if I had any other concerns. I reminded her that I will be getting a tattoo in two days and she asked where it would be. I cupped the vacant real estate above my chest/breast and said, “Here, a crab.”

“Why a crab?”

“For cancer. Cancer the crab.”

She asked if the scar would be tattooed. I nodded my head. This leads me to think that they haven’t seen much in the way of breast tattoos. Maybe fake nipples to go along with the fake breasts, but not the beautiful tattoos that I’ve seen on the internet. I know they’re not for everyone. But, that’s okay. I’m not everyone. I’m me – the new me with one breast and one scar. Actually, thanks to cancer, nine scars. There would be more from the biopsies and lumpectomies, but those were cut out along with my breast tissue.

She asked me to put on a gown while she went to get my oncologist. When they came back in, he quickly examined me and then asked about the tattoo. He did his last ditch effort

ditch

Random ditch

 

and asked me about reconstruction and said there are new methods. I repeated what I’ve told almost every doctor and nurse I’ve talked with throughout my treatment–I’m the only one paying my bills. I’m single. If I have surgery, there is no money coming in. If I have multiple surgeries (which is always the case in reconstruction) there will be multiple times with no money coming in. If it comes down to a breast or a mortgage payment, I will always choose to pay my mortgage. I have a physically demanding job and cannot afford to lose the use of my pectorals. He repeated that there are new methods and said they have a new plastic surgeon. I said, “If I get reconstruction, then my crab tattoo will be really big.”

I understand. At least I think I do. I think my medical team wants me to be able to live a normal life. But, what they probably don’t understand, even though they see an inordinate amount of women and a few men with breast cancer, is that life will never be normal again.

I think about dying daily, sometimes hundreds of times a day. Not taking my own life. That doesn’t interest me. That’s for other people with bigger issues, although suicide is 20% higher with breast cancer patients than with the normal population. (Lung cancer is the winner with suicide and cancer patients.) But, all in all, I do think about death more often than I did pre-diagnosis. Mainly because I rarely thought about death. When my grandfather died when I was thirteen, I made out a will and stuffed a gladiola blossom from one of his casket sprays into a baggie and then tucked it into my dictionary. The pink flower turned green and hairy. I had to throw it away. I made out a real will after my son was born. I need to do a new one, now that I don’t have to worry about who will raise him.

But death and dying. The real kind of dying. The kind I don’t want to think about. The active kind of dying. Like most people, I would like to die peacefully, quietly, in the very distant future, in my sleep, in my own bed, not on a toilet or out running errands. I don’t want a recurrence and months or years of treatments and watching the worry and pain on my family and friends’ faces as they watch me erode and corrode and slip away. That is not the death and dying I want.

So, for now and the foreseeable future, I will continue to live and work on living more fully. This will mean saying yes to some things that I have put off and no to things that I truly don’t need or have time for in my life. So, if I say yes to something you ask me to do, I truly want to do it. And, conversely, please know that if I say no, it’s not personal.

And, because, there is so much to pray for right now, please join me in praying for peace and healing for everyone. Right now, Puerto Rico needs our prayers, financial assistance, and help reconstructing. Forget breasts. They don’t need reconstruction. Maybe every woman who is thinking of reconstruction right now could just ask her insurance company to donate the thousands of dollars that would otherwise go to recreating breasts to reconstructing Puerto Rico.

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Breast Cancer Prevention

Let’s talk about this. There is no way to prevent breast cancer. None whatsoever. Not now. Maybe in the future. But not now. The only exception is if a person has a BRCA 1 or 2 mutation s/he can have a double mastectomy (a barrel of fun) and a salpingo-oophorectomy (tubes and ovaries removed). This minimizes the risk of breast and/or ovarian cancer in this small population. Somewhere between 5-10% of breast cancers are due to BRCA mutations. That’s about 12,000-24,000 newly diagnosed cases each year. People used to say the only way to prevent breast cancer was by being a man. Not true. 10% of breast cancers are in men.

Every now and then, well meaning friends will post something in my Facebook messenger account asking me to put a heart on my timeline in honor of Breast Cancer Prevention Week. The first couple of times I received the request I ignored it. There is no such thing as Breast Cancer Prevention Week. Or at least, I have not been able to find any information about this. The next wave of requests hit me when I was feeling snarkier. I probably pissed off some coworkers when I went on a rant about why I would not put a heart on my timeline.

That was a few months ago. I recently saw another wave of red hearts peppering timelines and wondered what hidden cause was making the rounds. Then I received another request to put the red heart on my timeline and share the message about Breast Cancer Prevention Week. I told my friend it doesn’t exist. I decided I had to post something about it.

So, here is what I do know about preventing breast cancer, per the Mayo Clinic website:

1. Don’t smoke.
2. Don’t be fat.
3. Exercise.
4. Limit alcohol consumption.
5. Breastfeed.
6. Limit hormone replacement therapy.
7. Minimize exposure to radiation and environmental pollution.

Considering I did 1-6 and can only hope that my environment was as safe as possible — and I still had breast cancer — my takeaway is that the list is flawed. While I was being treated someone told me that cancer is a matter of bad genes, bad environment, or bad luck. For me, it was bad luck.

Maybe I was a bit more peeved this most recent time I received the request because I had just found out that one of my breast cancer buddies received bad news. Her cancer came back as a free floating belly mass. WTF?! I hadn’t considered that possibility. I have only been thinking about the liver, lungs, bones, and brain as possible metastasis sites. They are the most common, but they don’t have exclusive rights, apparently.

You might be wondering what in sam hell you can do.

You can do breast self-exams (BSE) monthly, preferably at the same time each month. Gentlemen, this includes you, too.

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If you have any doubt you are doing it correctly, ask your doctor or check out some videos on the internet. It’s a good thing to know your breasts when they are healthy so you have a point of comparison. It’s also nice to know what you’re missing when they are chopped off. Your breast tissue covers more area than you would think. Here is a good visual. Don’t forget to check all the way into your armpit. That is where cancer likes to hang out on its way to other organs. Since my mastectomy, my breast exam instuctions are to palpate to the bottom of my ribcage. Go for it. What do you have to lose other than a minute?

You can get genetic testing if you are high risk. This is currently covered under the ACA; don’t count on it if Trump gets his way with insurance. Preventive medicine for millions of people will no longer be availale and there will be a spike in breast cancer (all cancer) deaths because some people (everyone else besides the 1%) will not be diagnosed when they are Stage I or II and their cancers will be more advanced, hence more lethal.

You can get mammograms. Sure, I know they are about as much fun as slamming your finger in a car door, but they do help detect tumors.

You can be proactive. If you think something is amiss, push for testing. Push for answers. I did. It saved my life. For now.

And, for the love of god, don’t do your BSE with a bra on or have talons like this model.

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WTF! Take off your bra.

You can exercise, eat well, keep your weight under control, don’t smoke, limit alcohol. There is a wealth of information about healthy diets. I’m not a dietician. I know what works for me. Find what works for you.

And, if you do get cancer, it’s not the end of the world or your life. It’s just the end of life as you knew it.

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