Eenie, meenie, miney moe. Pathology report, here we go. Anatomy of a decision.

Eeinie, meenie, miney moe. Pathology report, here we go. Surviving breast cancer.   “Without adjuvant treatment local regional progression, distant spread and death are risks.” What would you do? My breast surgeon was expecting to find a 3.5 cm tumor – but found a 4.8 cm tumor instead. Pathology later uncovered an additional 2 cm tumor – hidden in the dense breast tissue that she removed. No indication in any of the many imaging tests prepared us for either surprise. Sentinel lymph node report, clear of cancer. Nine additional lymph nodes clear of cancer. Blood also clear of cancer. My surgeon said I’d made the right call to go for the complete mastectomy with no nipple sparing as the tumor was irregular in shape and attached to my nipple. (Imaging tests had indicated that I was a candidate for a lumpectomy with radiation. Hmmm.) Good news so far, right? Always nice when I make a good decision and God knows this was not an easy one. (See Kiss My Breast Good-bye.) It appears, however, that my life and death, decision-making muscle is being put to the test once again. Seems I have no clean margins. Or, in doctor-speak, margins of the tissue removed from my breast test positive for cancer. So, though the cancer party-crasher stayed local and never left the house, it played to the edges of the walls that contained it. Doctors don’t like dirty walls. I get that. My breast surgeon gets it, too. That I am disappointed because, all along, I have been weighing in on quality of life issues and risks that can present down the road as a result of invasive cancer treatments. And that I have been nutritionally proactive with alternative approaches since diagnosis. (A decision that, I believe, kept the cancer contained in the breast – through months of delaying insurance coverage complications, I might add.) But her job is done. She took all that she could take – short of muscle. Now I must consider what the radiation and chemo oncologists bring to the table.
Full breast radiation (hello, it’s gone) with 20 weeks of chemotherapy and 10 years of hormone treatments.
Still leaving me with a 10% chance that the cancer will return within 10 years and not guaranteeing complications will not be present in other parts of my body as a result of the triple-treatment hit. I am really wrestling with this decision, guys. Focusing on the fact that the tumors and all my breast tissue are gone, this feels like they are engaging the canons where a few well-placed snipers might do. But there don’t seem to be any snipers available. I know of women who are going through this cancer treatment regimen right now who still have their breasts with sizable tumors. (My prayers go out to those of you who have already made these tough decisions. You have my respect for the courage you express, everyday, to show up for yourself and your loved ones in the ways you have decided are best.) Survive as Yourself from Bernadette's Musings from the Messy Room on Breast Cancer Remember when I told you that if I blog about ReaLLy meSSy STuFF it will be for us to build muscle? Well, roll up your sleeves because I’m not playing alone. This is where my decision-making drama with cancer becomes your decision-making drama with [fill in the blank.] You make decisions every day. Now, what if every decision you made mattered – even ones that are not in a life or death category? Like the preference ones that say, “I want this. I like that.” Or the reaction, “Stayed up too late. Hit snooze. Reschedule that appointment.” ones. Even avoidance, “Let someone else make that decision.” ones. And lets not forget those coin-flipping, daisy-petal-picking decisions. Most decisions move you easily along while on cruise or autopilot. Others put you on notice, requiring stand-up attention. Sometimes, you know why you made a particular decision. Sometimes, you are clueless as to the criteria that motivated you. (Was alcohol involved?) But here is the one, most consistent thing about any decision you will ever make – and why you want to pay attention. You will live with the consequences. Life is an assumption we make while dying. Death is an assumption we make while living. Your decision.
When your decisions no longer matter, you stop living.
Make a decision to pause for a moment and take that last sentence in. Eeinie, meenie, miney moe. Pathology report, here we go. Decisions on breast cancer. I am making a decision to get comfortable with the question mark that now resides where my breast was. It offers a gift that reminds me of the preciousness of each day – found in every decision I make. How will I use my time today? How will I love today? Who will I laugh and cry with, today? And, as a nutritionally proactive woman who intends to beat this thing as naturally as she can, what will I eat and not eat that will strengthen me, today, while I wait two weeks for the results of another test that I asked the oncologist for? Why? Because, no matter who rolls the dice, I will be the one living with the consequences of my next decision. Not my doctors. I’m not an expert. I’m just a messy muse blathering on in a messy room – with dirty margins. Thank God, I don’t need to be an authority to make decisions matter. I just need to be the author of my own life. I have no more time to entertain ghostwriter decisions made on my behalf – unless they come through Grace and The Divine. I have a proposition for you. Walk alongside me for the next few days and take note of your decisions – like they matter. Consider three decisions – big or small – that you will make matter this week. And you are welcome to share them in the comments below! Here are some decisions that mattered to me this week.
  • Helped a friend organize her studio so she can move into the next level of her business. I played prima donna while “helplessly” sitting, pointing and suggesting. She did the heavy lifting that doctor's orders wont let me do. (5 lb. limit.) Amazingly, I found I can be a prima donna and maintain a friendship.
  • Gave myself a two-hour break from this dang compression bra that I am supposed to wear 24/7 for 6 weeks. I promise you, I did not do jumping jacks. And my poor right breast was very grateful.
  • Standing by my June decision to not feed the cancer by staying off dairy, meat, and refined sugar. I feel so much better and, surprisingly, not deprived at all. I made another decision that I did not have to be 100% perfect about this. For me, the need to hit the mark perfectly originates from fear – thus feeding it. Besides, 95% lets you have dark chocolate and eat out with friends.
  • Asked for the ONcoType DX testing, even after the oncologist said it wouldn’t mean anything because my margins were dirty. He finally understood that it was an important part of my decision-making process.
  • Met with a Doctor who specializes in oncological physical therapy to help with the aftermath of chemo (should I go that route). Right now we are focused on reclaiming range of motion in my mastectomy arm – and NOT getting lymphedema.
Now it’s your turn. As always, I am grateful for your visits and appreciate your comments. Remember, sharing is caring. If you found something here that inspired, you may know someone else who will feel the same. XO Bernadette