Hitting Home: Breast Cancer, Part 2

Sometimes irony can be divine intervention in disguise.  That’s what happened to me on the road to finding a new gynecologist.  My health insurance changed and my current gynecologist fell out of network.  Time to find a new one.

After a search of “in network” options, I met with a well-respected female physician in my community.  During the first visit she quickly signaled she was listening and had done her homework by reviewing my past records before our appointment.  It was a pleasant visit.  I liked her and her staff.  Little did I know at the time that a “perfect storm” was just days away from upending my life.  A few days later, the women’s mammogram center called.  There was a problem with my annual mammogram, and I needed to come back immediately for more testing.  The cancer storm had arrived.

An ultrasound begat a biopsy that begat a wait for a phone call.  During the biopsy, I snuck a look at the ultrasound screen and saw the devil eye to eye.  The spot of asymmetrical breast tissue that for two years was called normal was clearly NOT even to my untrained eye.  What I feared the most was coming true.  All I needed was the call.

The call came on a normal afternoon in my kitchen.  The voice on the line was formal, apologetic, and brief.  It’s cancer.  We’re very sorry. Please schedule a follow up appointment with your doctor.  I uttered a weak thank you and then faded to black with my family free falling close behind.

With cancer on deck, there was time to wait, barely time to cry and to be really, really angry.  My new gynecologist saw me the next day to map out a treatment plan.  But first she needed to say something, not something she normally told her patients.  She was a breast cancer survivor.  She had been in my shoes.  She knew what to do.  She gave me her personal list of cancer physicians, the ones she used or would have used.  My panic lessened.  I had a roadmap and a guide.  The divine was in the house.

With her list, I began interviewing key specialists for my “A” team.  I also put out the word among my breast cancer friends that I was looking for “best in class” providers.    Online I discovered the Revlon/ UCLA Breast Cancer Center offered a multidisciplinary breast cancer consultation.  I called them and they saw me within a week.  It got me an appointment with an entire breast cancer physician team for second opinion evaluation that was held in just one afternoon.   After many rounds of new patient visits, I had lined up a team of doctors and was ready to begin treatment.

Step one: find a surgeon and get the cancer out.  On the first call to her, surprise, she answered the phone herself.  She turned out to be a genuine peach that gave warm hugs and was a master in breast cancer surgery.  But the thought of surgery provoked a million questions and worries.  This is where my Duke health-coaching group stepped in.

Prior to the diagnosis, we had coached one another on personal and professional health goals using our vision and values for the upcoming year.  Their coaching for my breast cancer crystallized the self-advocacy voice that would serve me for professional, complimentary care and self-care.   My coach colleagues helped me prioritize what I had to get done over the next year in order to find the best cure, healing and recovery.  One coach helped with me with visual imaginary for the claustrophobic spaces of MRIs and scans.  The second coach offered new complimentary resources to help me with the painful reactions from the whole breast radiation.

Others joined my support team.  A dear friend from the ranch in Colorado was also traversing her own breast cancer journey and offered to share fears, feelings, and coping notes.  Her candor, humor, and prayers provided inspiration and support that only someone else traveling the same path could offer.

With cancer, nothing’s easy.  There were setbacks along the way.  My new doctor’s review of my records suggested I might have cancer in my uterus too.  As if one cancer wasn’t enough for a person most of my friends and family considered “the healthiest person they knew”, I was now looking at a possible second one.  So three weeks after breast surgery, step two: have a total hysterectomy.  My uterus was abnormal but not cancer.  I had preempted a second diagnosis of cancer.

Step three: after the cutting, begin radiation treatments.  These next steps would take a medical oncologist, the right one.  I went back to the list and set up an appointment.  But I was drowning in a new wave of anxiety that led to panic induced vomiting.  Could I make the appointment without throwing up in the car? I called his office “after hours” to ask for help and within minutes he was on the phone speaking with me.  Anti-vomiting medication was waiting for me at the pharmacy.   This was someone who was available, knowledgeable and cared.  He belonged on my team.

When I first met my medical oncologist face to face, he seemed rather ordinary in an extraordinary office setting providing outpatient cancer care.   I quickly learned he was a gifted physician.   He had a bevy of resources for his patients including a local acupuncturist and a UCLA physician who provided nutrition and supplement recommendations.  When the time was right, he steered me to the community cancer support center, which offered free yoga, qigong, mindfulness sessions, and cancer support groups.  All the while he listened, asked the right questions and guided me through the standard conventional cancer treatment.

Step four: after radiation treatments, begin the targeted hormone therapy.  It triggered joint pain and other side effects.  Finding ways to deal with side effects and reclaim my quality of life became a priority.  My vision and values lead the way.  My strategy was to pace myself through the treatment and get back to places and activities that gave me joy and peace.  After radiation, I went to our second home in Colorado to ride horses, raise wildflowers and hang out with family and friends for a big part of the summer.   My coaching practice moved with me to Colorado.   There I rested and began the final treatment phase.  The sun, summer mountain storms, quaking aspens, good friends, new trails and an unflappable gray mare named Lady set my healing into motion.

Is there any good news about coping with a cancer diagnosis?  Absolutely.  It’s a time when friends, family, community and resources band together on your behalf.   We are clearly in an era of personalized targeted cancer treatment.   We are clearly in an era of better treatment for all kinds and all stages of cancer.  We have better tests that look at the genetics and molecular basis of tumors that give us roadmaps for the optimal treatment options.  As survival improves, cancer grudgingly is moving from a lethal diagnosis to one of a controlled chronic illness.

I opted to share my cancer experience to give hope and courage to others facing a tough diagnosis.  Since my diagnosis, I have met many other cancer survivors on the same path.   Above is a mind map that illustrates the approaches I found useful for navigating cancer along with tools I use as a health coach in putting together a personal health recovery plan for cancer patients.  With my blessings, feel free to use my mind map and pass on to anyone you know who could benefit from it

Next time Food Fights and the Curse of the Sugar Plum Fairy.