Closing Up Shop

The Noble Breast is moving to a new home! 

I've created NavaBrahe.com, which is the new home of this blog, and some other projects I've been working on. 

Thank you for all your support on this site. I look forward to your continued support in my new home. 

xoxoxo

Nava

Look At Me, I'm Sandra Lee

**The Noble Breast Is Moving! Shortly after this post, I will commence posting on NavaBrahe.com, which is now not only my name, but my domain! I'll post again when I am ready to re-direct from this blog, over to the new site.**

Now, on to the business at hand: 

I have a beef with Sandra Lee. For about a week now, I've been reading snippets about how she's been battling a post-operative infection following her mastectomy. I can empathize with her plight, even though I managed to remain infection-free before, during and after my surgery. What I'm not happy about is that details about her situation are sparse, other than the typical celeb stuff, like being walked into surgery by Governor Andrew Cuomo, her boyfriend, and wanting fresh flowers and glasses of wine during recuperation. I want to know the who, what, where, when, and why - because when you declare yourself an advocate for women with breast cancer, you give up the luxury of privacy. 

What I've learned over the past year (tomorrow is the one year anniversary of my first chemotherapy treatment), is that cancer is chock-full of details. Breast cancer especially. There are many variables, so if you're going to share your experience, you'd better do your best to not leave anything out. 

I'm guessing that in Ms. Lee's case, her infection was likely caused by preparations for reconstruction; or not. There's no way to be certain because she's not telling us. Women who choose to undergo reconstruction after mastectomy need to know that the process does not always go smoothly. Many times, infections crop up, things go awry, and most importantly, there are circumstances patients must be made aware of, because in some cases, reconstruction could prove difficult, or, as in my case, inadvisable. As I've said repeatedly, every woman's case is different. And if you're going to share, you owe it to your followers to over-share. Less is not more in this case - more is necessarily more. 

I could be overstepping here, because I am not a celebrity. I'm not suggesting Ms. Lee provide every gory detail, but the reason behind her infection would certainly provide an education to women who are going through similar experiences. This isn't a naked-while-pregnant selfie, a la Kim Kardashian; this is valuable information we don't often get from our doctors, nor do we go looking for it ourselves. 

Lest I sound like a broken record, it's better to know, than not. And that should be a part of the role of advocate Ms. Lee and other celebrities have chosen to undertake. 

Nava 

I'm Wondering...

Summer is always the sluggish time of year when it comes to work. It doesn't matter what you do for a living - working during the summer is a drag. Commuting in hot weather via public transit saps your will to live (thankfully, I don't have to endure that anymore), but so does that niggling feeling in the back of your mind that you're not working because the evil forces are conspiring against you. 

As you all know, I am a freelance writer. It was quite difficult to resign myself to not working while I was going through chemo, but that's over and done with. Now that I'm feeling better and my brain is functioning at or near where it was prior to the infusions of poison, I'm still not working anywhere near as much as I'd like. Is this the universe conspiring against me? Am I unlucky? Is there a pile of shit out there with my name on it that I haven't stepped in yet? 

At the end of May I got some work from the local office of a marketing content company. The pay was good and the work wasn't particularly taxing. The problem, however, was actually getting paid in a timely fashion. I've been lucky for the most part in my career as a freelancer, because I've only gotten ripped off twice by questionable clients. This time, I was sitting around like a schmuck waiting weeks for payment. Since finances have been tight, I was quite vocal to my contacts at this company about needing payment for my services sooner, rather than later. My assertive attitude paid off, literally, because I received payment for the work I did in June much quicker than I did for the previous project in May. 

Here's where the evil forces come into play: I haven't done any work for this company at all this month. I sent an e-mail to my contacts telling them I was ready for a new project, and never heard back. Did I screw myself by being too aggressive? Or, is it possible that these people read this blog and decided they did not want to work with someone who had cancer? 

My e-mail signature contains a link to this blog. Every time I apply for work via e-mail, I use this blog to showcase my writing skills. I'm starting to think that prospective employers might be somewhat hesitant to hire someone who is recovering from breast cancer. I've e-mailed at least a dozen queries over the past four weeks, and haven't had so much as an automatic reply from any of them. Do I offend? Has my mojo as a wordsmith deserted me? Or, am I damaged goods? 

I've asked a lot of questions in this entry, none of which are easy to answer. When you go through a tough time in life, you want to believe there are good things waiting for you on the other side of those difficulties. Some people struggle constantly to keep cancer at bay for as long as they can. I like to think I am on a path where that won't be the case. 

As far as my career as a freelance writer is concerned, I want to pick up where I left off, but I also want to believe that there are better, brighter opportunities ahead of me. Freelancing is an unreliable, stressful way to earn a living. You're always hustling; if you don't work, you don't make money. It's exhausting. But, in all that stress and exhaustion lurks an elusive notion that at some point, there will be a reward that will make it all worthwhile. 

I'm wondering: where is my pile of shit, and when do I get to step in it?

Nava

The Argument For Remaining Flat

A couple of months ago, I joined the Facebook group of the organization Flat & Fabulous. The members of this group have been diagnosed with breast cancer, had mastectomies (single and double), and elected to forgo reconstruction. Another fun fact about having breast cancer is that it isn't always easy to put your breasts back if that is what you want. Many women aren't aware of this, and it makes for some interesting debates in the breast cancer community. 

Not every woman who is diagnosed with breast cancer has to have chemotherapy and radiation. These women, along with women who elect to undergo preventative mastectomies, can usually have successful reconstruction soon after the initial surgery. Women like myself, who had to have chemo and get roasted, are the ones who have the toughest time with reconstruction. Chemo isn't really a factor, but once you've been roasted, your skin becomes compromised, which makes inserting things like tissue expanders and breast implants very difficult. Reconstruction for women like me involves fat transfer from other areas of the body, and skin grafting to make up for the damage we're left with. These procedures, according to the plastic surgeon I met with last year after my mastectomy, are possible, but can be complicated. 

Since joining the F&F Facebook group, I've interacted with many brave and strong women who are committed to not undergoing reconstruction; some for the reasons I've mentioned, and others because they are perfectly content to not have breasts. Still more have been through reconstruction that has gone awry. There are stories of infections and other medical mishaps, asymmetry, and overall dissatisfaction with the end result that lead many to have their implants removed. Others will occasionally wear prostheses, affectionately known as "foobs" (fake boobs), because they cannot, or will not, go through the additional hell reconstruction can turn into. 

The other day, I was finally able to order a compression sleeve to treat my lymphedema. The store I went to also had a full line of mastectomy products, including bras and prostheses. I decided to try on a bra with a pair of "foobs" to get an idea of how they looked and felt. I have to say, I had more fun playing with the squishy silicone foobs than I did wearing them. It felt weird to have on a bra with protrusions in the pockets, rather than ones attached to my own body. It felt odd to be wearing a bra again (I didn't miss it). The foobs looked okay, but I wasn't ready to order a pair. I have plans for my body that might include foobs at some point in the future, but for now, I choose to remain boob-less, and foob-less. 

My choices vis-a-vis breasts might not be what another woman would choose, but that doesn't bother me. I'm glad to know there are other women out there who, for many reasons, choose to remain flat. These women are inspiring, because many of them can ignore society's obsession with the female form, and do what is best for them. I count myself among their ranks because I don't need to have breasts to feel like a woman. I don't catch glimpses of my flat chest in the mirror and wish they were still there. I'd rather be healthy and live another 50 years than worry about everyone else thinks of my flatness. It's a waste of time. 

Maybe one day I'll change my mind and go for a pair of D-cup prostheses, or maybe some new surgical technique will be invented to make reconstruction easier for women like me. Until then, I am content to remain flat, fabulous, and healthy. 

Nava 

Here We Go Again

"Sweet Jesus in a Jeep" is a popular expression of frustration I see time and time again on social media. I refrain from using it, since I am Jewish, but I've been known to verbally exclaim "Jesus Christ!" on a regular basis to express frustration about many things. At present, I am in a position where I am completely flummoxed, and there isn't an adequate expression to describe my frustration with the raging mammography debate. 

This week, another study surfaced debunking mammography, and both Reuters and NPR reported it, re-igniting the debate about how more mammograms lead to the "overdiagnosis" of breast cancer, and do not increase the survival rate from the disease beyond the ten years following diagnosis. I have one thing to say about that: So fucking what? 

I think by now we understand that mammography is a flawed detection method, and that the research community needs to come up with a better way to screen women for breast cancer. Researchers in North America and around the world are currently working on treatments that will manage certain cancers, and there is real hope that these treatments will benefit many people. In the meantime, another segment of the research community is intent on berating women for their reliance upon mammography, and the epidemic of breast cancer it causes. 

We have two extremes: women, like myself, who had mammograms and were found to have early-stage breast cancer, and younger women, some of whom found lumps through self-examination, and are diagnosed with aggressive forms of late-stage breast cancer. In the middle are the millions of women who go for regular mammograms to either assuage their fears, or because they have family histories of breast cancer. All of us, I think, are confused and angry at the message these studies are sending: We are damned if we do, and damned if we don't go for mammograms, yet there isn't even a whiff of a suggestion about any viable alternatives we can explore to protect our health. Genetic testing is one alternative, but there is plenty of discourse out there finding fault with that, too. So, what are we supposed to do? 

Here's my suggestion: stop pursuing these ridiculous studies that don't do anything except alarm the public, and cause divisive arguments about who is and isn't benefiting from mammography. We are courting another controversy where one doesn't need to exist. Mammography is becoming one more reason for women to feel bad about themselves. Instead of shaming us, why not come up with better ways to help us? 

I am getting very angry at the judgement women dealing with breast cancer encounter at every turn. We are chided for going for mammograms; we are vilified for having bilateral mastectomies in an effort to protect ourselves. We are "overdiagnosed". I want to put my fist through a wall every time I see that word.

Someone please give me a cogent, reasonable answer to this question: WHAT ARE WE SUPPOSED TO DO? 

Nava

A Perpetual Snit

When I think about temper tantrums, the first person who comes to mind is John McEnroe. The man had the most legendary temper in tennis, and since Wimbledon gets underway tomorrow, it seems fitting to use his image. 

I've been looking at my Facebook posts for the past week or so, and I noticed I've become a bit of the curmudgeon I said I didn't want to be. I haven't engaged in any hurricane-force McEnroe-esqe rants - although I am always poised to use his signature line, "You cannot be serious!", whenever the opportunity presents itself. No, I've been snide and snippy; I'm in some sort of perpetual snit, and I seem to have dug in my heels quite firmly. 

First off, it's coming up on that day - yes, the one year anniversary of the boob-lopping. As you can probably imagine, all manner of cancer-related thoughts are going through my head, and I can't seem to stop them. When I close my eyes and try to sleep, I see the word "RECURRENCE" in big red letters. When I finally do fall asleep, I have strange dreams about people I haven't seen in decades, and we somehow wind up in the most bizarre places. There's a reason for this, I'm guessing: Effexor and I are not getting along very well, and I think the strange dreams are a side effect. As I've mentioned, Tamoxifen does not play well with SSRI antidepressants, and Effexor is the ONE drug that will let Tamoxifen do its job. I'm really in a pickle with this one. I don't want to attempt to wean myself off anything right now - my body has been through enough lately - and my options are severely limited. Well, truthfully, there aren't any. 

Next, I am still in the midst of an imbroglio with my insurance carrier over the compression sleeve. I do have coverage - about one-tenth of what the device costs. That's a no-go for me at the moment, since my income is nowhere near what it was before my diagnosis. My faithful patient advocate is still waging war on my behalf, but these supplies should be available to every woman without the hassle. Once you mess with the lymph nodes, swelling is inevitable; managing it can be akin to shoveling shit against the tide. We all know how much fun that is. 

I got sick again last week; another bout with a flu-like bug, similar to what struck right after I finished radiation. Ironically, I had another cardiac ultrasound scheduled that I had to cancel. I have to have one every three months as part of the study. They could slather me in bacon grease, but I'm not coming into contact with any sonic probes unless I feel up to it. After last time, this is non-negotiable. 

Mostly, I think I'm experiencing something similar to postpartum depression. I don't want to say I have post-traumatic stress disorder, because I think the acronym for that has been co-opted too often, and sadly, the condition is losing credibility. Don't get me wrong, I know PTSD is a real battle for so many, but I feel the term should not be used to describe the fallout from every tough life event we experience. Maybe "post-cancer depression" would work? Like the baby-blues, it inexplicably creeps up on you just when you're starting to feel good again, and bounces you into one emotional tizzy after another - sort of like what our friend Mr. McEnroe used to do with tennis balls. Is this real? Is this documented? Have there been papers published about it in peer-reviewed medical journals? Yes to the first question; as for the others, I'll get back to you. 

My breast cancer sister and fellow writer friend told me she went through something similar one year after her diagnosis. She said she felt like she had to soldier on through her diagnosis, treatment, and reconstruction. After everything was completed, she crashed. It feels like the same thing is happening to me. I've been through the four stages of cancer: diagnosis, surgery, chemotherapy, and radiation. I didn't quite believe in the "aftermath" portion of the experience, but here I am, smack in the middle of it. And, quite honestly, it sucks. 

I said I wasn't going to mourn the loss of my breasts. What I am mourning are the intangible losses you can only relate to if you've had cancer. Your life has been bisected into two parts: "before cancer", and "after cancer". You have no choice but to accept that. And like the four stages of grief, acceptance is always the toughest hurdle. 

Nava

Holding Pattern

One topic I've refrained from discussing on this blog is the health insurance issue. The reason is, up until a couple of months ago, I was one of those rare individuals who wasn't constantly battling with my provider. Unfortunately, all that changed in April, and now I find myself in a holding pattern while a very patient patient advocate wages war on my behalf. Is that too confusing? Maybe I should have referred to the advocate as "diligent". Well, since I am metaphorically hamstrung at the moment, I will indulge in the pun. 

One very disturbing fact about life in the good old U.S. of A. is that being diagnosed with cancer can lead you to confront very dire financial straits. Having watched every episode of "Breaking Bad", I remain convinced that series creator Vince Gilligan was chastising the insurance industry, in addition to giving us way too much information about how to manufacture metric tons of methamphetamine. Maybe if I had watched the series before my diagnosis, I'd feel differently, but I binge-watched it on Netflix while I was going through chemo.

Walter White was essentially a good guy, but when he received a lung cancer diagnosis, and found out that his shitty-public-high-school-teacher-insurance-coverage wasn't going to pay for his treatment, he morphed into Heisenberg, and became a monster. It's an extreme scenario, but one that many of us are familiar with on a not-so-melodramatic level. 

There is a push-pull between patient and provider; a sort of tango you must dance in order to get through your medical ordeals. This dance requires many steps, and can get quite stressful. The vast majority of us learn early on that once you are confronted with cancer, you might have a positive prognosis, but when it comes to your health insurance, you have no choice but to get used to living in the "Land of No".  

I was very fortunate to have gotten though my diagnosis, surgery, and treatment without any issues, but I had to switch insurance providers back in March in order to remain under the care of my family doctor and medical oncologist. That switch has caused me more stress over the past two-and-a-half months than dealing with cancer has caused over the past year. My new provider has said "no" to all my lymphedema treatments, including visits to the physical therapist I was seeing, and, at this moment, will not pay for a compression sleeve for my ever-expanding left arm. The patient advocate was able to get me 12 physical therapy visits to last the rest of the year, and is currently awaiting word about the compression sleeve. Moreover, I want to try out a pair of breast prostheses, because, well, I'm curious. Those aren't covered, either. 

 I must disclose that I am an advocate of the Affordable Care Act, more commonly known as "Obamacare", and my insurance coverage was made possible by it. I am a freelance writer, which means I work for myself - I do not have an employer that provides insurance coverage for me. I am so happy this is the case, because we all know people who slog away at dead-end jobs just for the benefits. We shouldn't have to do that, but in the U.S., "single payer healthcare", "socialized medicine" and "Canada-style healthcare" are phrases that scare the hell out of certain people. They shouldn't, but if you suffer from chronic ignorance and/or make your living as a paid political operative, you're going to disagree. Unfortunately, ignorance can be tough to treat, and lobbying is legal, for the most part. 

As I sit here waiting to get an e-mail or phone call from my diligent patient advocate, I wonder what it would be like to live in world where patient advocacy is an unnecessary occupation, like lactation consultants, or Feng Shui experts. 

Wouldn't it be great if we could get what we needed from our health care providers without having to resort to filing bankruptcy, or write television shows about destitute science teachers who have to resort to a life of crime to survive? 

We always say we have insurance "just in case". When just-in-case turns into life-or-death, the fight for survival shouldn't include worrying about what your provider will and will not pay for. I'd sleep a hell of a lot better at night knowing I don't have to fight for fake boobs and a contraption that will keep my arm from exploding. Since I'm currently not sleeping very well, I take comfort in the fact that if I want sleeping pills, my insurance will pay for them. 

Nava

Woman Dysphoria

I have no problem admitting that I'm more than a little obsessed with the Bruce/Caitlyn Jenner story. For me, it goes way beyond living with gender dysphoria for one's entire life; I find myself thinking, why would a man want to become a woman? I realize that is a very simplistic question, and the answer is far from black-and-white. The reason I'm asking is because women generally rank higher on the level-of-bullshit scale than most men do. Life can be so much harder for women because we love to make it harder for ourselves. Yes, you heard me - some of us revel in the misery and drama instead of rising above it. Go ahead, grab the eggs, tomatoes, and heads of lettuce and prepare to start flinging them in my general direction.

About a month ago, I heard the term "genderqueer" for the first time. The link I've provided to the explanation of that term is comprehensive, and also a little confusing. I'm getting quite an education about this, and I had no idea how complicated it can be.

When I was a kid, girls were either "girly" or "tomboys". I fell into the tomboy category, and I managed to stay there as an adult. Sure, I have a girly side, but it's not as prominent as it is for other women. I like to think I have a decent combination of masculine and feminine qualities, but I have no desire whatsoever to be identified as male. I am a woman inside and out, even though my body is lacking a couple of its identifying characteristics. I find this entire topic fascinating as it pertains to transgender issues, but also as it pertains to womens bodies and minds, especially the bodies and minds of women who have been diagnosed with breast cancer.

Let's face it, ladies: some of us can be quite a handful. You know what I'm talking about. I'm not gender-bashing here - think of the movie "Mean Girls". There's a lot of girl-on-girl crime going on in the world, and we all need to learn to be a little nicer to each other. The LGBT community has its struggles, and it turns out, so does the breast cancer community. I've witnessed a lot of curmudgeonly behavior out there from women who seem to get off on the misery.

Yes, breast cancer is a life-threatening disease, and its methods of diagnosis and treatment are far from perfect. The disease itself exacts a toll that stays with you for a very long time, and could possibly kill you. These facts are no excuse for us to be flaming bitches towards each other. We all have our unique experiences, in addition to having a common ground we need to share. We are aware of the tornado of controversy swirling around us, and we need to stop adding to it. I'm not saying we need to hold hands in a circle and sing "Kumbaya", but we do need to take down the level of girl-on-girl crime. Curtail the mastectomy-and-mammogram bashing, please. Respect the decisions of your fellow woman and support her. It's simple, and it shows compassion and empathy - something women like to think we're better at than men.

I am in no way saying that gender identity issues and breast cancer are the same. There are many similarities, but they are two totally different animals. What should be stock-in-trade across the board, however, is caring, compassion, and understanding. Many women need to "man up" and stop trying to focus all the attention on themselves. Seriously, ladies, there are people out there who have it a hell of a lot worse than you do. Please remember that. Thank you.

Nava

Donate Some Thought

Scamming has gotten to the point where we can joke about it. The majority of us know those poorly written e-mails from Nigerian royalty promising multimillion dollar awards are scams. The problem is, we now have scams coming at us from every direction, and it's getting much harder to spot them. To further exacerbate our confusion, legitimate, licensed charities are in on it. They couldn't possibly be scamming us, could they? 

Last week, my fellow breast cancer sister got a call from a prominent breast cancer charity, the Breast Cancer Charities of America, looking for a donation. This call came on the heels of the Federal Trade Commission (FTC) blowing the doors off a $187 million dollar scam perpetrated by a group of cancer charities. 

My friend is no pushover. She questioned the caller about how much of her donation would actually go towards helping women with breast cancer. When the caller responded that about 15 cents of every dollar goes to women in need, my friend declined to donate. When you read about administrators of charities spending millions on cars, houses, vacations, and other expenditures that only benefit them, you have to think twice before you loosen those purse strings. Only 15 cents out of every dollar? That's thievery, not charity. 

The problem is, this type of thievery is easy to get away with. You can set up a legitimate looking Web site, write fake testimonials from individuals who claim the organization has helped them, and recruit famous people as mouthpieces for hire. In the end, a trickle goes to the actual cause. And it's all legal if you have the proper paperwork in place. No one will be the wiser, until someone comes looking. And we all know, it takes very little effort to unravel a good scam. 

The next time you get a solicitation phone call*, or spot what looks to be a legitimate charitable organization online, please do your homework before whipping out your credit card. A reputable charity will have no problem disclosing where every penny of your donations go, and it is up to you to decide whether or not that particular charity is worthy of receiving your hard-earned scratch. Keep in mind that there are many low-profile organizations in your area doing great work to help people. Very often, it's best to donate to one of those, than it is to send money to the high-profile behemoths that are most likely in bed with a harem of corporate partners that are spending your donations on slick marketing campaigns to sell products. 

*If you don't want to be pestered by phone at all, add your number(s) to the National Do Not Call Registry. 

Nava

That Fateful Mammogram

May 24, 2014 was the day I had my first-ever mammogram at age 47. I was flip about it. I told my Facebook friends I was going to do battle with the "hamburger press" for the first time, and afterwards, I said it really wasn't a big deal. I went for coffee with a new friend. I got a frantic phone call from my doctor at eight o'clock that night advising me to go for more screening. Here we are.

Now that a complete turn of the calendar has passed, I find I'm less inclined to look back upon those first few weeks of dealing with the specter of breast cancer. The number of times I said, "I just know it's cancer", either out loud or to myself, is not something I ever want to re-live. The terror I felt when I met with the radiologist after the second mammogram and ultrasound, and saw in her eyes that she knew, without having to perform a biopsy, that the news wouldn't be good, is a look I never again want to see.You get where I'm going. 

These days, I like to focus on everything I've learned over the past year. I'll never consider myself an expert on breast cancer, but my knowledge level has increased exponentially. I'm grateful for that; it's almost as if I took another graduate-level university course in what could potentially kill me.

Instead of writing a 25-page paper, I had to endure surgery and treatment, and everything else that goes along with those processes. The blog entries have helped me deal with the side effects, but I'd have much rather written a doctoral thesis about something pertaining to Shakespeare, Milton, Donne, or maybe Dante, just for shits and giggles. Twisting just my brain into knots would have been more enjoyable than what cancer treatment did to the rest of me.

My goal is, was, and always will be to have other women benefit from my experiences. Many of us are blindsided by our diagnoses, and feel very alone in facing them. I've been very lucky to have one person who is, was, and always will be my staunchest supporter. I count on many more people for electronic support, and a small group in the medical community who continue to treat me with the respect and dignity we are all entitled to. If you do have to go through something like breast cancer, having these elements in place makes it easier. And that's saying a lot.

I wasn't convinced that marking the year was a good idea. Then I thought, why not? I won't be mourning the passing of my breasts, even though they were taken from me on July 3, 2014, which makes the occasion kind of hard to forget here in America.

I won't be setting off fireworks to commemorate anything, but I will forever remind anyone who reads my words to never turn a nose up at learning something new. Education is life - literally. It might not make you an Internet celebrity, or earn you six-figure bank, but it is important. No one will be clicking "Like" or giving you the thumbs up when you're dead.

Nava

Tamoxifen, Sandra Lee, Mammography, and DCIS

Who likes buffets? If you do that's totally fine. I won't begrudge you, but I will share my thoughts:

I think buffets are evil. I think they are a bastion for those among us who have annoying food proclivities that border on being textbook eating disorders. They are all about quantity as opposed to quality. They illustrate the inherent gluttony of North Americans who think that multiple trips to the food troughs qualify as exercise. Number of times I've been to Las Vegas: three; number of buffets I ate at: zero. They remind me of my insane Canadian family.

I have no idea why I have a hair across my ass about buffets. Maybe I'm trying to channel my annoyance at being bombarded with myriad opinions about breast cancer, and the underlying acrimony towards women who are stricken with it. Really, this isn't very different from the incoherent right wing abortion/contraception/rape debates. Some segments of society want to lay the blame at our feet for our diagnoses, while simultaneously expressing frustration at not having better ways to diagnose and treat us.

Since I last blogged, I've read even more conflicting opinions about mammography, mastectomies, and ductal carcinoma in situ (DCIS). Yesterday, Sandra Lee, the Food Network personality and partner of New York governor Andrew Cuomo, announced she has breast cancer. She was diagnosed with DCIS and is undergoing a double mastectomy to avoid further treatment. Of course, the details of her diagnosis were not shared, leaving people like me wondering if there is more to it than just DCIS, which I like to describe as cancer warming up in the bullpen.

Ms. Lee's announcement included a pledge to advocate for screening as a way to save lives, which falls in line with populist opinion, but rankles the researchers and militant feminists who swear we do ourselves more harm than good. I think by now you all know how I feel about that, but my voice is barely a whisper in the shout box. We need to open a high-profile dialogue about risk, as opposed to detection, and no one seems to be listening. You can find the risk dialogue if you search for it, but unfortunately, it's easier to just argue the status quo than it is to start a new conversation.

I'm a little over a week into my Tamoxifen/Effexor regimen, and so far I've felt a few more intense hot flashes, and have had some minor digestive issues. To put it plainly, I can no longer drink hot coffee (the ice maker in my fridge is working overtime), and I've got my bottle of Imodium on standby. I'm hoping all this is just temporary, although I do very much enjoy iced coffee when the weather is warm.

Tomorrow, I am going for a skin test in preparation for receiving my first "vaccine" injection. I will be getting jabbed next week, during my third Herceptin infusion.

Nava

Natal Indulgence

Today is my 48th birthday, and I declare that I am entitled to rant a bit (not that I've ever refrained from ranting before) about what I've gone through during the past year and what it has taught me. 

As you might expect, my first birthday post-breast cancer diagnosis is a bit different from all the others. I'm not really thinking about my mortality; what I am thinking about is how my view of the world has changed over the past 12 months. So, buckle up and read on: 

The Worst Brings Out the Best: When you're confronted with a cancer diagnosis, you find out just how much you're willing to put up with. Trivial things that might have once caused your skin to crawl, and the hairs on the back of your neck to stand on end no longer elicit that type of reaction. Moreover, and this is something most of us already know, you find out who your true friends are. The ones who stick with you through cancer, are the ones who will be there with you through anything. The ones who scurry off like frightened rabbits should be consigned to the holes they crawl into and remain there for eternity.

You Must Find a New "Normal": First of all, there's no such thing as "normal". What you have to make peace with is the fact that your life as you know it has changed forever. It may sound strange, but since I had that experience once before, I was better prepared for it to happen again. Honestly, the second time around was easier to deal with. Don't get me wrong, hearing I had cancer was still greatly distressing, but I was lucky to have a better support system this time, than I did the first time my life was blown apart. 

It is Much Uglier Than You Can Imagine: Every woman's experience with breast cancer is different. Unfortunately, most of what we know about the experience comes from sources that gloss over a great deal of what it's really like. Celebrity tell-alls about cancer never used to bother me. Now, I roll my eyes at them. You'll never really understand until you go through it. And the irony is, we don't want to hear about it from the woman next-door; we have collectively become such colossal star-fuckers, that the little people don't seem to matter. 

We Must Destroy the Double Standard: One of the most shocking revelations I've had is discovering the double standard that exists when it comes to breasts. Women who elect to undergo plastic surgery to enhance their bust lines are applauded by everyone for doing something that will make them feel better about themselves. Women who undergo double mastectomies in an effort to give themselves peace of mind about recurrence are vilified, and thought of as unfeminine heathens who willingly mutilate their bodies. This has to change. Regardless of gender, we are all so much more than the sum of our body parts. 

Shut Up About Mammograms: Today, yet another article about mammograms found its way into my social media world. For decades now, we've had the prevention message jammed down our throats and most of us realize it is outmoded. We don't want to be clubbed over the head and dragged off to the breast press because someone wearing a pink ribbon is haranguing us. We understand there is conflicting information about when to get screened, how often, and all the false positives/negatives that occur. Instead of flogging us with countless contradictory studies and opinions, we need to find more effective ways to treat cancer, instead of thinking we can prevent it. At this stage of the game, there is no such thing. 

Stop Telling Us To Live With It: There are countless articles written about breast cancer being "over-diagnosed". Many medical professionals opine that there are certain types of breast cancer we can live with. I don't agree with that horse shit. My cancer spread to my lymph nodes and I never had any symptoms. We shouldn't have to live with cancer if it can be dealt with. People living with metastatic disease don't have a choice. 

We Must Take Responsibility For Ourselves: The easiest thing to do when it comes to dealing with health issues is to stick your head in the sand and hope for the best. I'm guilty of doing that, and so are you. If we take the time to learn about our family history and what we need to be conscious of, we're halfway home. Making informed decisions about how to stay as healthy as possible requires a bit of soul-searching, not a trip to the supermarket for a wheelbarrow of kale. Yes, eating healthfully is part of it, but knowing where you come from and what you might be at risk for is a significant part of the process. When we determine our risk factors, we can make more informed choices. Only we can do that for ourselves. I can't make you do it; I can only share my experiences, which will hopefully get you thinking about your own. 

Nava

My Eggo Is Not Preggo

I had my second Herceptin treatment the other day, and I'm due to get my first "vaccine" injection in three weeks. So far, so good with Herceptin; no vile side effects with the exception of a slightly crusty nose, which isn't anywhere near as bad as it was when I was getting Taxol. I hope it eventually goes away because someone, somewhere is going to catch me picking my nose. 

As promised, here is a link to some information about the study I'm participating in. There is a great deal of excitement about immunotherapy studies lately, because they seem to hold a lot of promise for controlling different types of cancer, including breast cancer. Herceptin is a pioneering treatment in this category, along with Gardasil. Many of us are more familiar with Gardasil because of the controversy surrounding it; some people ignorantly believe that vaccinating young girls with Gardasil to prevent cervical cancer gives them the green light to be sexually promiscuous, but that couldn't be further from the truth. I don't want to go off on a rant about all the misinformation flying around about vaccinations in general; I will end by saying both treatments are groundbreaking, and Herceptin in particular, is helping many women in the battle against recurrence. 

Last, but certainly not least, if you are reading this, please devote about 40 minutes to watching Killing Cancer. This documentary is a real eye-opener about the work being done to bring immunotherapy treatments to people who would otherwise be doomed without them. 

Finally, the title and image I've chosen have to do with the fact that I have to take a pregnancy test before every Herceptin infusion. Peeing in a cup is no big deal, but I chuckle at the irony that there's no way I could possibly be pregnant at this stage of the game. Alas, I must do it because protocol demands it; but I will giggle, smirk, and joke each and every time, because I just gotta be me. 

And now, the moment you've all been waiting for: Nava Does Menopause. 

As I said, all the pregnancy testing in my future is the epitome of irony since I have settled on an estrogen-suppression regimen. If you recall, my medical oncologist and I were discussing using Lupron and anastrozole, an aromatase inhibitor, to kill whatever estrogen is left in my body. I also toyed with the idea of having my ovaries removed, but I've abandoned that for the time being. I gave myself a much-needed break after the horrific conclusion of roasting, and during that time, I did some research on Lupron and decided it wasn't for me. Instead, I am starting Tamoxifen, and will take it for the next six-to-nine months. It's been eight months since my last period, so technically, I am still pre-menopausal. You have to be period-less for at least a year before you are classified as menopausal. Moreover, aromatase inhibitors are given only to women who have crossed over, which is why I am starting out with Tamoxifen. In addition to Tamoxifen, I will be taking the antidepressant Effexor, instead of my trusty Celexa. It turns out Celexa can render Tamoxifen less effective, so I had to switch. Here's hoping I can literally remain chill, and not be overcome by heat prostration - sorry, hot flashes. 

Stay tuned for updates. 

Nava

Preventable My Ass

I've been battling a cold for the past week, and I swear, it has legs. I guess I was due for one this severe, because I haven't had a cold since I left the Great White North two-and-a-half years ago. I think that's a personal record. I never got sick while I was on chemo, despite my non-existent immune system, so I think my body is treating me to a long overdue comeuppance.

Besides being stuffy and achy, I'm pissed off yet again by some things I found in my Facebook feed. An article that appeared in the Washington Post the other day set off the mammogram alarms, with it's "gloom and doom" title masking the real intent of the story, which is to bitch and moan about the over-diagnosis of breast cancer.

“Right now, we have women getting bilateral mastectomies for ductal carcinoma in situ, which is not a cancer,” Otis Brawley, chief medical officer of the American Cancer Society, said. “It’s the world turned upside down.” Otis - my man! Thank you for telling me I lopped off my tits for nothing. If someone diagnosed you with testicular carcinoma in situ (I don't know if that exists, but I'm making a point), would you put your balls at risk and let it go untreated? My guess is "no".

The Post article was shared by my favorite militant-feminist breast cancer organization, Breast Cancer Action, and the comments that followed truly blew my mind. There are women out there who actually think cancer is preventable; that diet and exercise will spare you from the blight, and keep you healthy until you gently pass on into the night. You know what? In some places, that might be true.

North America is known for it's pesticide-bombed, sugar-laden, genetically modified, processed "Frankenfood", along with myriad chemicals polluting our groundwater, soil, and atmosphere. We refuse to embrace solar energy, we still mine and burn coal, and now we're "fracking" the hell out of the planet to get our hands on natural gas deposits and bitumen. All this is likely responsible for the increase in breast and other cancers, but eating metric tons of kale and cauliflower isn't going to put the brakes on those cancer cells. The truth is, we don't know what will. Science is getting closer to finding out, but right now, we do what we have to do if those nasty cells manifest themselves in our bodies.

Maybe one day, I will buy myself a romantic villa in Tuscany, or a fabulous chateau in Provence (when I finally get published). I'll grow my own pesticide-free fruits and vegetables, slaughter my own hormone- and antibiotic-free animals, and drink enough wine to keep me in a glorious stupor for the rest of my days. My cancer might come back, despite any effort made to escape the filthy, disease-ridden, industrialized world.

Cancer is like a nuke; it will find you wherever you attempt to hide. Preventable my ass; let's stop kidding ourselves, shall we?

Why I Like Not Having Breasts

I thought I'd do something a little different today. I'm sharing an essay I wrote a couple of months ago, and have been attempting to flog for publication. So far, no bites. I hope you enjoy it.

Why I Like Not Having Breasts

In June, 2014, I was diagnosed with early-stage cancer in my left breast. The news came about ten days after my very first mammogram. I had spent most of my adult life half-heartedly performing self-examinations, and never felt anything resembling a lump, so my diagnosis came as quite a shock.

It turned out my cancer was the kind that was not in lump form. It was in my milk ducts, and is known as invasive ductal carcinoma, and ductal carcinoma in situ. I was lucky enough to have both. There were about four centimeters of fully-developed cancer cells in total, and more warming up in the bullpen. To make things even more interesting, the doctors suspected that my lymph nodes also contained some malignant cells, and a biopsy proved they were right.

Lumpectomies are not an option with the type of cancer I had. When the surgeon told me it would be best to have a mastectomy, I looked at him, and without hesitation said, “Fine; take them both.” He sensed my certainty and replied, “Alright, we’ll do a double.”

I realize that most women are not particularly eager to part with their breasts. Boobs, titties, girls, knockers, fun bags, headlights – whatever you care to refer to them as – are the embodiment of womanhood. Without them, some of us tend to lose our identity. I never felt that way. At 47, I never had children, and, quite honestly, I never thought my breasts were particularly attractive. I am of Eastern European Jewish descent on both sides of my family, and I’d inherited a pair of low-hangers from my mother and grandmother. My nipples pointed towards the ground ever since I was a teenager.

Since I was a bit unlucky in the genetics department, my breasts proved challenging when it came to buying bras. I wasn’t burdened with a pair of mammoth, back-breaking breasts (I was a D cup), but as I got older, finding bras that fit me well became harder to procure. I was once molested by a saleswoman in a lingerie shop – the kind where they measure you and attempt to “fit” you into the best bra for your size and breast shape. The woman became extremely frustrated because my nipples refused to hold their place in the center of the cups. I kept trying to explain I’d been dealing with that problem most of my life, but she couldn’t find a shred of empathy for my plight. I was 34 years-old when that happened, and from that day forward, I had a sneaking suspicion that maybe I wasn’t meant to go through life with such troublesome appendages attached to my body.

Don’t get me wrong; I wasn’t wishing for cancer. I was thinking maybe I’d go for a breast lift, or a breast reduction when I was older. I knew several women who were diagnosed with breast cancer, and watched a cousin to whom I was very close, suffer with metastatic disease. She’d had a lumpectomy and chemotherapy in the early 90s, and the cancer came back in her other breast. Then, it spread to her spine, and eventually to the rest of her body. When she died in 2005, I vowed that if it ever happened to me, I would “lop off my tits” without hesitation. And that’s exactly what I did.

The breast cancer lottery awarded me with the full enchilada. Because cancer was found in my lymph nodes, I had to undergo chemotherapy, and as I write this, I am preparing to embark on six weeks of radiation. In addition to that, having 26 lymph nodes removed (five of them cancerous) left me with nerve damage and lymphedema in my left arm.

Despite all that, I am not sorry I got rid of my breasts. There will be no more mortification in the lingerie department, and gravity no longer has dominion over my nipples. Yes, my cancer might come back, but I’ll sleep better at night knowing I did everything I could to hopefully prevent that from happening.

Science and unchecked vanity might say that I mutilated my body, but I disagree. I made an informed, educated decision to do what I thought was best for me. And I’ll never get poked by an underwire bra ever again.  

Meltdown

 
Life has been very interesting since I last posted, mainly because I had a complete meltdown following the conclusion of roasting. I didn't realize that, like the roast you let rest on the counter after removing it from the oven and tenting it with foil, you keep cooking after you're cooked. Yes, as bad as I felt the last time I blogged, I started to feel even worse a couple of days later.

I went back to see my medical oncologist the Friday after I had the CT scan, and that disastrous cardiac ultrasound. Thankfully, my scan was clear and my heart is fine. The rest of me, however, was a huge mess. I was in horrific pain, and I believe I had a slight cold/flu, because I had a runny, stuffy nose and a fever. He took a look at my left chest/underarm area and promptly wrote me prescriptions for a strong antibiotic and painkillers. I was also supposed to receive my first jabbing with Lupron, but on top of everything else, I could not handle being thrown into menopause. I went home and spent the remainder of the weekend on a merry-go-round of chills, sweats, and nausea. It felt like someone sneaked more chemo into my lemonade. I was begging for mercy, and a few times, the phrase "kill me now" crossed my lips. The high point was when I barfed up a roast beef sandwich, mere moments after consuming it. There are no adjectives to describe the frustration you feel when you're hungry, and your body rejects what it craves.

Happily, I am feeling better, but there is still residual discomfort from roasting. To say that I was rendered well done, and extra-crispy, is an understatement. Again, I know it is impossible to predict how one will react to cancer treatments, but like the overachiever I tend to be, I went above and beyond expectation. Sure, I heard all the waiting room-gossip about the horrors of radiation, and my hubris got the better of me. "I'm no wimp", I kept telling myself. "I am strong like bull!" The truth is, no one here gets out alive.

When I was in high school, all the big Doors fans read that Jim Morrison biography (it was first published in 1980). You were beyond cool if you were seen carrying a copy of it with your school books. Not being the biggest Doors fan, I passed. I still haven't read it. I have no intention of ever reading it. It's a snappy title, however, and a solid aphorism when used to give perspective to what it's like to go through cancer treatment. You have to literally kill off parts of yourself - physical and emotional - to get through it.

My grace, humor, dignity, and general "fuck you" attitude towards cancer seem to have collectively left the building. I've reached the point where giving a shit is too bothersome. This is an inevitable phase of the experience, and I'm not quite ready to claw my way out. I've postponed menopause, at least until the end of the month. I am, however, going ahead with the immunotherapy study, and am scheduled to receive my first Herceptin infusion this Thursday. Despite my current attitude, I feel I still owe a debt to all the people who have helped me, and to all the people who might have to get on the same merry-go-round. Now is not the time to be selfish or self-destructive. I can say it, but part of me doesn't mean it. Sometimes, it's easier to just be weak.

Nava

Some News and a Bitchfest

I promised I would reveal what the next leg of my journey is going to be. I thought I would be doing it with a bit more levity, but right now, misery trumps everything.

I'm going to be taking part in an immunotherapy clinical trial starting in April. My medical oncologist apparently had me in mind early on, because my cancer fell within the parameters necessary for participation in this particular study. In a few weeks, I will begin receiving the drug, Herceptin, every three weeks for a year, along with a "vaccine" that is supposed to prevent the recurrence of breast cancer. The reason why I put quotes around the word "vaccine" is because it is a single-blind study, and I won't know if I am getting the actual vaccine, or a placebo.

I promise to have more information about the study when I'm not feeling quite so bitchy. I'll just say that I am very happy to take part in it. Maybe in some small measure, I will one day be responsible for saving a life. If I can prevent anyone from going through the hell that is chemotherapy and radiation, it will all be worth it.

Now, on to the bitchfest.

I'm miserable because my epidermal decline brought on during the last week of roasting still has me cursing like a longshoreman. There's no way to describe it other than to say, this shit fucking hurts. And it itches. And I subjected myself to a pre-study CT scan and cardiac ultrasound yesterday, which was a huge mistake. Drinking about 900 mL of berry-flavored barium suspension was rough, but it turned out to be nothing compared to the unrelenting pressure of an ultrasound probe pressing into my chest.

The ultrasound technician kept remarking that he was having a tough time getting the images, and I was lying there exasperated. When I asked why he was having so much difficulty, he said he couldn't explain it. Mind you, I had one of these back in August, about a week before I started chemo. The technician who performed that one uttered nary a complaint. Yesterday, I was in no mood. I almost went all Brooklyn on the poor guy because, "If you stuck that thing up my ass, would you have a better vantage point?" was on the tip of my tongue. Naturally, the words never crossed my lips, but I was ever so tempted.

So, here I am, 24-hours later, still sore, burning, achy, and cranky. To top it all off, I have a slight cold, which is adding to my misery. And, I got word this morning from a reliable source that Joan Lunden is writing a book about her breast cancer experience. Of course she is. I mean, why wouldn't she? She's Joan Lunden for fuck's sake. Who am I? Oh, just some random schmuck toiling in obscurity in my minuscule little corner of the Internet. 

I know; I know; I shouldn't say things like that. But come on... I have things to say that are just as relevant. And I really can write. There's no ghostwriter all up in here taking dictation from me; there is no interlocutor between brain and fingers. I think I stole a variation of that last line from a "Sopranos" episode.

I don't want to turn into one of those bitter writers who does nothing but lament about never getting published. I used to have a friend/colleague who would post all his rejection e-mails on Facebook. Not only did I unfriend him, I blocked him because I just couldn't take reading them anymore. Maybe karma is smacking me for that, but I don't care. I am trying to keep the faith that this will all work out. It has to. I will not take "no" for an answer. 

Nava

Roasting Completed

I'm posting a few days late again. This time, I've been busy tending to my roasting injuries. It is absolutely shocking how quickly your skin goes from "pinked" to the worst sunburn you've ever had in your life. 

My epidermal decline went into overdrive last Monday, when the skin in my underarm area started peeling, unbeknownst to me, because I couldn't feel it, and because I was in a pretty dense fog less than 24 hours after having to part with my cat. From there, it just kept getting worse. At present, I am beet red across the entire left side of my chest, and the redness has crept about halfway up my neck. I don't even want to discuss what's going on under my arm. All I will say is that I am so thankful I don't have any sensation in most of that area. If I did, I'd probably need to be in a medically-induced coma, or attached to a morphine drip. 

Please keep in mind that like everything else having to do with cancer, the radiation experience is different for everyone. Maybe I got a little full of myself with all the "schmearing", thinking that I would get away completely unscathed. I don't know how much worse it would have been if I hadn't been diligent with the skin care. Regardless, it's over. And once the sunburn has healed, I don't want to think about it anymore. 

Nava

Lily

When you're diagnosed with cancer, the days, weeks, and months following that news are filled with loss. You lose a body part or two, you lose your hair, you sometimes lose your dignity, and often times, you even have to sacrifice your livelihood because the treatment leaves you incapable of earning a living. In most cases, you can recover those losses; I can even replace my breasts if I want to, but I've yet to make that decision.

The other day, I suffered an irretrievable loss. My cat, Lily (pictured above), passed away on Sunday, and I am heartbroken. Lily had been with me through many ups-and-downs in my life, and she was only eight days short of her 18th birthday when I had to let her go. In many ways, it is harder to make peace with losing a pet because you count on them for support you sometimes cannot get from humans. Anyone who tells you that humans are capable of the kind of unconditional love animals are, is full of shit; an animal loves in a way humans can't, and that's just the way it is.

Lily came into my life from somewhere in the Pocono region of Pennsylvania. A former colleague of mine was in possession of a female cat that was regularly birthing litters of kittens. In March, 1997, he asked me if I'd be interested in adopting one from her latest batch, and I said yes. I asked him to choose one of the females, and bring her to me when she was about three months old. At the time he asked me, I had just gone to contract on a house. Anyone who has ever transacted real estate in New York state knows you can feel your hair growing during the time it takes to seal the deal. Finally, early that June, "Twitcher" came to live with me. The name was bestowed upon her by my co-worker's children, because she twitched a lot after she was born. My ex-husband re-named her Lily. She joined Clarkie, the male cat I adopted from the county animal shelter in October, 1994.

Lily and Clarkie were my first pets. I wasn't allowed to have pets as a child for two reasons: the first was because a bird my brother had before I was born, died while it was left to fend for itself when he and my parents were visiting the family in Toronto. Second, my mother had no affection whatsoever for animals. They loved her, but for some reason, she was unable to return their affection. My father was ambivalent, and fond of quoting a Yiddish expression which meant (loosely translated) that cats plugged up your head. So, I was 27 and living on my own when I finally adopted my first pet.

Regaling you with stories about both Lily and Clarkie would require me to write pages, so I will condense by saying that both cats brought so much joy to my life. I can't imagine going through life without caring for an animal. It became a passion of mine and I don't intend to give it up. Many people feel that way about children, but for me, that wasn't an option. I've never been sorry I haven't had kids, even though I do like them. Pets, however, are more my speed. Say and think what you will, but I'm being completely honest. I'd rather clean a litter box than change a diaper; and yes, I've done both.

Clarkie lead a life of leisure with me in two apartments and my house, before he passed away in April, 2007. He was diagnosed with a cancerous tumor in his mouth that winter, and I tried like hell to save him. I never knew exactly how old he was, but I was told he was approximately one year-old when I adopted him, which meant he was 14 or 15 years-old when I lost him. At that point, I had lost both my parents, and a few other people I was close to. Somehow, losing my first pet was a blow that hurt worse than all those human deaths combined. Clarkie was there for me when my dad passed away in 1996; he slept on my head and kneaded his paws, claws intact, on my face. He nursed me through bronchitis, colds, and kidney stones, and waited patiently in the window for me to return whenever I was out. He once pulled a chicken carcass out of the garbage and picked it completely clean on the kitchen floor. I never figured out how he got at it without upending the garbage pail, which was under the sink, inside a cabinet.

Lily, on the other hand, kept me company in a few dark, unhappy places. She endured 24 hours on the road during an aborted trip to Toronto, when exceedingly officious Canadian border wingnuts would not let me bring furniture into Canada, because I wasn't yet officially a resident of Ontario. That bureaucratic horror cost me one sleepless night in a grungy motel room, and thousands of dollars in legal fees. She accompanied me on a move to the Washington D.C. area, and was happy in her home there, because she had about 1,000 square feet of carpeting to sink her claws into. From there, we successfully made it, furniture in tow, to Toronto, where we lived with a psychotic relative for a little over a year. Lily knew who she was dealing with: one night, said psycho was rewarded with a gash on the nose for encroaching too far into Lily's personal space. A few weeks later, she sent me to the emergency room for penicillin and a tetanus shot after a swipe of her paw scratched my eyeball. Not long after, the psycho threatened to dump her in an animal shelter. We moved out into our own apartment.

Lily's last two-and-a-half years were spent in the company of Mr. Stinkman, a portly, fluffy feline who wanted so badly to be her friend. She tolerated Mr. Stinkman, but they never really became friends. This made me sad because I wanted her to love him the way she loved Clarkie. She had grown old and tired at that point, and I think all the drama of the previous few years had taken its toll on her.

In hindsight, I think Lily started to really decline after I was diagnosed with breast cancer. She lost a bit of weight before we left Toronto, but she was still spry, hungry, and somewhat kittenish when we got here. It was last summer, as I recuperated from surgery, and before I started chemotherapy, when I noticed things were changing. Maybe she hung on long enough to make sure I would be okay. The irony of her dying eight days before such a milestone birthday, and five days before I finish radiation is not lost on me. She'd had enough.

When I took her to the vet to be euthanized, she died in the examination room, before the doctor could administer the injection. It was peaceful, and I don't think she was in any pain. That's the best we can hope for, when our beloved furry friends decide it's time to go. I'm heartbroken, and I'm trying like hell to get through this last week of treatment. Of all that I've lost over these months of being a cancer patient, I feel this one most acutely, and it will stay with me longer than anything else.

Nava