October 29, 2010

Guest Column: Friends and family are the right 'medication' for breast cancer


I don’t define myself as a breast cancer survivor, and it isn’t something I usually talk about because I am not unusual.

In 1997, a few months after my bout with breast cancer, I attended the Manteo Rotary Club’s Christmas party where I learned that several friends there also were dealing with it. I did a discreet head count that evening and found that we fit the national statistics of that period - one in four of the women had breast cancer sometime during that year.

Since then, I have known many women on the Outer Banks who have had the disease and most are now healthy and productive.

Each has a different story to tell, and we all hope that our experiences can inspire women to get that recommended annual gynecological exam and regular mammograms.

Fortunately, we now have excellent specialists and facilities for diagnosis, counseling and treatment right here on the Outer Banks, so distance isn’t an excuse.

For me, things happened very quickly. One day I was in Norfolk for my annual gynecological check up and mammogram. The next day, I was told that my gynecologist had scheduled an appointment for me with a surgeon the following day. And the day after that, I had a surgical biopsy.

Not understanding the medical language, I didn’t realize what it meant when the nurses in the recovery area were talking among themselves about a lot of calcification in my left breast.

When the doctor received the pathology reports, he called me in to explain that I had DCIS, Ductal Carcinoma in situ. Not a terrible diagnosis. In fact, some view it as a pre-cancerous condition.

I didn't then and don't now take DCIS lightly. The prefix “pre” may impart a false hope and a lack of urgency. It is not to be treated casually for no one knows when one cell will escape and completely alter the condition.

I didn't feel that I could wait to see what may or may not happen. I wanted the rogue cells in my body gone. So did my husband Ernie. So did my surgeon.

The malignant cells (the calcifications the nurses noted) were spread throughout the milk ducts in my left breast. They could not be individually excised. They needed to be rooted out before they could make their way beyond the ducts and into normal breast tissue and,
perhaps, further.

There were no options. The breast had to be removed.

My surgeon suggested that Ernie and I meet with a reconstructive surgeon, and we agreed. His office made a call and we went directly to see a reconstructive surgeon to talk about replacing the breast.

His plan was to perform a pedicle TRAM flap or Transverse Rectus Abdominus Muscle flap. During the procedure, he would move tissue from my lower abdominal area and tunnel it up beneath the skin to my chest where it would be used to form a “breast.”

It was a fairly new technique and both surgeons were excited by it.

His suggestion was to work with my surgeon and take over from him once the breast was removed rather than wait and have a second surgery later.

He offered other options, but this seemed the most sensible. I wouldn’t have two surgeries and there would be no foreign material in my body.

Sensible? I don’t know if I was really capable of making a sensible decision then, but I did know that I wanted to get the mastectomy done as soon as possible and didn't want to insert anything artificial in my body.

Ernie and I made a decision immediately and wanted to get on with it. But coordinating scheduling of two busy surgeons is not easy, especially when they expected to be in surgery for seven to nine hours.

That meant weeks of waiting and researching and, finally, wavering — of suddenly tearing up with no warning and no prompting. The earlier  serenity I felt was fading as time passed.

I finally told my surgeon that I was prepared to go through with the mastectomy and forego the reconstruction for the sake of ridding my body of cancer. I also began to question the value of the TRAM flap. When I asked him if he really believed in the TRAM flap and, if so, would he recommend it to his wife and daughter, he said categorically yes. I was back on track.

Soon after that, his office called to say they had made the hospital arrangements.

My friends at Browning Artworks, where I worked during the summers, threw a farewell party for my breast, and we had a really ridiculously good time with boob jokes in abundance. There was even a specially-themed cake!

My parents drove from Florida, accompanied by my sister, Kate. The plan was for Mom, a career emergency room nurse, and Dad to remain in Norfolk throughout my hospital stay and in Hatteras the first week I was home so she could be my nurse when I most needed special care.

My sister, Jill, would come from Jacksonville for the second week and then Kate would return for the third week when I should require less acute care and become more mobile.
Ernie then could return to our business without worrying about my care and get some much needed TLC of his own from our family.

The surgery was successful. There was no need for either chemo or radiation treatments. Other than healing from the surgery, I was done.

The healing from the reconstruction, however, required several days in the hospital. I was covered from neck to feet with something akin to heavy duty bubble wrap that had heat pumped into it to keep the temperature at 94 degrees.

The muscle, skin, fat, and blood vessels that had been cut, moved and reconnected had to stay warm or face death. Fortunately, I was medicated for pain so didn’t suffer much from the heat either.

My family did, though, because the room was very hot. Mom worried because I never really could tolerate heat and she focused on that rather than on what had just been done.

When we came home, my Hatteras Island friends, Linda and Lou
Browning, Beth Midgett, Edie Coulter and Lori Wales (the Artworks
crew), had come in and left flowers and a lovely dinner that Ernie and my parents had only to reheat and enjoy at the already-set table.

Recovery went well and by the time Kate left after week three, I was mostly taking care of myself.

Thirteen years later, annual check ups, diagnostic mammograms and chest x-rays continue to show full recovery and for that I am most grateful.

I do, however, continue to be confused by the insurance reimbursements: partial for necessary removal of a cancerous breast but complete for the optional construction of a new one. Not complaining, mind you, just puzzled. Think about that.

Unfortunately, last year, I “returned the favor” as my sister Jill and I took care of Kate when she had invasive breast cancer, invasive ductal carcinoma, in fact.

Her treatment plan was more aggressive than mine and Kate, too, is doing very well now.

We have no known history of any cancer in our family, so I started an unfortunate trend.

That kind of innovation is not admirable.

(Lynne Foster lives in Hatteras village.  The wife of a fisherman, she is involved in many community activities, including organizing the annual Day at the Docks.)

About the Get Pinked! Campaign

How can you Get Pinked? Raise $1,000 and partner with The Outer Banks Hospital's Get Pinked! Campaign to fight breast cancer in Dare County. The goal is to give every woman and man in Dare County the very best chance to survive the disease of breast cancer. For more information call the hospital's Development Office at 252-449-9183.

The Outer Banks Hospital Development Council is a subsidiary of University Health Systems Foundation in Greenville. The mission of the council is to develop relationships and secure financial resources to support the health and wellness services of The Outer Banks Hospital. Council members have raised funds to underwrite the costs of projects from the opening a Cancer Resource Center located in the Medical Office Building adjacent to the hospital and purchasing technology and equipment for the identification and treatment of cancer and other diseases. 

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