D-week

Well it's been a very full week or so since I've written. First the medical update: my white blood counts were high enough on Friday so I received my second-to-last chemo treatment. One more to go!! Woohoo! If my counts are high enough that will happen this coming Friday, 8/7. My hemoglobin also has remained high enough that I haven't needed a third transfusion so far, though I am feeling somewhat fatigued and slowed down. 

The week was full on multiple fronts: I had a couple of meetings and deadlines for two different projects I've been working on throughout the treatment (CORE and bringing a generative somatics training to Wisconsin); we had our consult with the plastic surgeon about the possibility of lumpectomy with breast reduction surgery; and I did a ton of emotional work towards making the final decision about the surgery; some friends got married and I was able to attend (and, briefly, dance at) their wedding reception; plus the usual -- exercise, cooking, acupuncture, Chris staying with us for his monthly work visit (including an evening in the ceramics studio together), visiting with friends bringing food, etc. 

I had decided for a variety of reasons that this was the week I wanted to make the decision about the surgery. I wanted to do it after our Monday consult about the oncoplastic reduction, and, inspired by the timing of my sister Rachel's visit so close to the end of chemo, I had planned a small ritual of "letting go" in preparation for the surgery on Saturday (more about that in another post), and felt it would be good to be clear then about what I will be letting go of. Whichever surgery I picked, I knew I would be letting go of my breasts as I have known them. I am also letting go, probably, of my fertility in this process (I was close anyway), and with it (and my breasts), finally completely letting go of the possibility of birthing and breast feeding a baby. 

So this week, between meetings and work and visits, I had a therapy session, two co-counseling sessions, a coaching session, checked with the doctors about their understanding of recurrence likelihoods, had several long talks with Don about our feelings about it, and our fears about how mastectomy might affect our sex life, and did a reading with a Zen tarot card deck and another with the Motherpeace deck.

I spent time processing: the temptations and aversions I feel towards the idea of smaller, uplifted, surgically perfected breasts; my regret at not loving my own breasts more, and offering them gratitude for what they have been in my life; and my regret about not having a child and not getting to experience breast-feeding. I “walked” the two paths using a somatic/intuitive decision-making process, once alone and once supported by my somatics coach on the phone; I continued to process about the dream from last week about the spaciousness after moving with my mom; and pondered the meanings, for me, of the tarot cards that showed up in the Zen tarot reading: “control,” “projection,” “adventure,” “healing,” and “integration.” Where am I trying too hard to control my future? Perhaps I am trying too hard to get this decision “right.” Where do I have projections of the future that are unlikely to be real? Can I be more childlike and trusting and curious in the face of this physical danger? What old and new wounds need to be healed in this process? (The card’s image for “healing” had a person with a large lotus blooming on – I kid you not – their right breast precisely where my largest tumor was!) What if I had more faith in my body’s ability to heal? And, can I more fully integrate the masculine and feminine sides of myself? The images from the Motherpeace reading were also interesting – the image I pulled to represent the lumpectomy/reduction path was the 3 of wands reversed, indicating blockage or opposite of the energies of creative expression, sexual freedom, and mothering; the image I pulled for the mastectomy path was the Magician, leaning almost 90 degrees to the right – active, able, accomplishing a lot, being a pioneer – but perhaps forcing this or striving too hard in that direction.

One of the things that brought the most clarity was the somatics exercise of walking the two paths (for those of you who are familiar with Robert Gass’ decision paths exercise, this is like that only you are actually standing and physically moving along the two imagined paths). While walking down the mastectomy path, I felt grief, but also liberation, and openness in my heart/chest. While walking the lumpectomy/reduction path, I felt my breasts, and my fear of recurrence.

The processing of the dream was also powerful. I took the dream into a session with Judith Heilizer, and she remarked on the spaciousness at the end of it, and said, that is just like you, being generous with your space and time. I immediately thought, mastectomy would leave me more spaciousness, some of it enabling me to be generous with others, while keeping my (altered) breasts would take more time and energy focused on myself and my continued health (with mammograms / MRIs every 6 months and the inevitable painful and temporarily disabling follow-up biopsies, and the tension of waiting for their results).

I also realized in a long session with Anita that I keep feeling like I “should” consider lumpectomy/reduction more, and should want it more. And, that I have a tendency to second-guess my own decisions too much. I also realized in that session how happy I am to be alive, and how much I just want to celebrate life.

So, after giving the alternative, less invasive, easier-to-recover-from lumpectomy with oncoplastic reduction due consideration, I am once again landing on the mastectomy (without reconstruction) side. And, I am practicing the alignment phrase Robert Gass and I came up with earlier this summer:

 “I am removing my breasts, for the sake of my life, and I surrender to the unknowable.”

We have until 8/11 to actually schedule the surgery, and will have an MRI on 8/10 which may indicate whether or not I’ve had a “complete” response to the chemotherapy – if so, that improves my chances of not getting metastatic cancer, and I suppose, could change our thinking again… but probably not, and anyway until then, I’m sticking to the mastectomy story and I’m going to shift my emotional energy from decision-making, to preparing for the surgery. 

I am removing my breasts, for the sake of my life, and I surrender to the unknowable.