Shyness can stop you from doing all the things in life you'd like to.

I know I have vanished for some time now--over a month! There have been various reasons. Maybe I've been in a little funk. Seattle is so beautiful in the summer but there's this weird pressure that comes with that like: "Make every day count, while there is still sun! Every second you stay inside you are wasting your entire life and squandering nature's beautiful gifts! YOU DON'T DESERVE SEATTLE IN SUMMER!" It's a guilty time for us indoorsy folks. But mostly, I disappeared because I was working on a small writing project (I'll tell you more if anything comes of it) and it was FREAKING ME THE FUCK OUT. 

Growing up, teachers always told me I was a skilled writer. I won embarrassing elementary school contests involving poems about France and humorous dinosaur themed essays (both were destroyed long ago, so don't ask). But, over time, I realized that the bar was pretty low. Sure, maybe I had some nascent talent, but I was no prodigy, just precocious. I started to disregard the encouragement, figuring that my family had to compliment me and that public school teachers were just jazzed that I could compose a semi-coherent sentence. I got a few pieces in school papers and lit mags, I volunteered at this teen publication called New Youth Connections (get it? NYC). But, with puberty came this overwhelming feeling that nothing I had to say really mattered. I was so in awe of classmates who actually wanted to read their work in class. I felt like everything I wrote was unimportant and clunky. I don't even have most of my journals from back then because as soon as I put something down on a page, I wanted to rip it up. 

Someone once told me this story about my mom's short-lived stint as a middle-school violinist. Mom wasn't musical and probably hated playing, but still practiced dutifully on a daily basis. One day, a neighbor heard my mom and made some dumb joke like "What's that, a dying cat?" Mom put down the violin, went upstairs and never played again. I like to think of her never even touching the violin again or burying it in the back yard quietly.

I feel like I have never related to anyone as much as I do to middle-school mom! I too have a visceral fear of embarrassment (it's why I don't dance or do karaoke without 5 gin and tonics)! But it's even more specific than that, I suppose, it's more like a fear of trying to do something you care about and being bad at it. And if you really want to get down to the nitty gritty, it's a fear of having people think you think you are good at something that you are plainly bad at. You know, like on reality show competitions, when a contestant says "I am the best chef here! I'll be the last one standing! Watch out!" and then they present this plate of undercooked chicken or whatever and get sent home immediately.  This is the worst possible fate I can think of. Surely there is some German word for this. 

I had my violin moment at around 18. My mom was a travel writer and had this friend looking for someone to write cheesy little blurbs for this book she was putting together about "romantic getaways" (gross). I was excited to have something to do aside from drink with my friends so I thought I would give it a try. It seemed like pretty easy work: I just combed through the press material she had given me and synopsized. My mom gave me good feedback and initially, so did my "employer." Then, several weeks in, I met her in midtown and she told me that she couldn't use my stuff, that it wasn't professional enough. I have this vivid memory of weeping my way down the 6th Avenue and ducking into a pay phone kiosk and getting the receiver all slippery with my tears and incoherently wailing at my poor mother who was probably pretty used to calls like that by then (I was a temperamental teen). I later heard that the woman had run out of money for her project, so I like to think that she blew me off to save face. But I'll never really know and at that point, the damage had been done. I took a creative writing class here and there, and live journaled like every self respecting gothy twenty-something, but I gave up any notions of doing anything with my writing aside from shoving it way to the back of my desk drawers. 

So putting myself out there for this recent "project" (that sounds really pretentious, but I don't know what else to call it), felt so vulnerable. It seriously took me a month to write one paragraph because I couldn't stop thinking "People might SEE this. Like people I don't know. And they might think things about it. THINGS!" But I guess that's the whole point, right? 




It's all relative...

Grad school was 5 years ago, but my love of reading has been a lingering casualty (reams of peer-reviewed articles will do that to a person). Social work hasn't helped matters. Trade secret: most social workers don't read. We are physically and emotionally exhausted. We want naps, we want reality television, we want numbness. You know what we don't want? To emotionally engage with anyone or anything, even a book. 

Still, the past few weeks I have somehow been clawing my way back into the fold of readers. Sometimes it's just a few pages per day, but there are periods of respectable progress. I am nearing the end of "Where'd You Go, Bernadette," an epistolary novel by Maria Semple.  It focuses on the eponymous Bernadette, a once bright and successful woman whose spirit is crushed and sanity eroded by (wait for it...) SEATTLE! YES SERIOUSLY! IT IS OBVIOUSLY THE STORY OF MY VERY OWN LIFE! The only thing I hate about this book is that I did not think of the idea first because IT WAS OBVIOUSLY THE STORY I WAS BORN TO WRITE. It's been hard to not over identify with Bernadette (except for the part where she is a racist snob. That is pretty unappealing, but probably also an accurate depiction of a rich white lady living on Queen Anne). There are passages where I get a sense of deja vu because they detail my very own complaints, almost down to the letter! Bernadette even complains about Seattleites' habit of always saying "No worries" in response to every interaction, something I thought only bothered me! Sometimes it's so familiar that it's painful. There is one passage in which Bernadette's husband describes her obsessive, long-winded,  and repetitive rants about Seattle's 5 way intersections and poor urban planning. This is practically my daily diatribe. 

Then this past weekend, I had a friend in town from a comparatively rural part of Washington State, which she moved to from NYC about a year back. She's making a go of it, certainly doing a better job than I ever have. But still, it's a pretty drastic transition. We spent a night on the town; cocktails at various Capitol Hill haunts, catching a cab down to Belltown, ending the night eating pizza in the taxi home (have you all been to Rocco's? So delicious! I thought my dreams of decent Seattle slices died with Piercora's but I was mistaken).  Throughout the night, she made several comments about how great it was to be in a city, how much she missed being able to walk to her destination, or even catch a cab, how my tiny studio apartment (which I am always apologizing for) is really cute. And she's right: all of that stuff is great. Unfortunately, it doesn't always feel so great. I can't think of Seattle as "the big city" without a snicker, but I know for a lot of people it is just that. For so many, even the idea of living in Seattle is probably this unimaginable, intimidating dream, a treasured goal, the big time.  It's all relative.

Of course, knowing that doesn't override my emotions. It's like when you're having a bad day and you try to remind yourself that people all over the world are starving and dying, and you are just in a crappy mood because there's a pile of crusty dishes in your sink and there's a run in your stocking, and then you feel even worse because you realize you were trying to use the tragedy of others for your own personal gain. Emotions aren't logical: just because you know something is true doesn't mean it feels that way. But sometimes hearing the perspectives of others can be a useful reminder that everything in your life isn't the complete worst.  

How's that for a cheery mantra? "Everything in my life isn't the complete worst." I find it strangely soothing. 

Getting back to normal...

My post-op appointment was a few days ago and it went smoothly. Dr. Tierney checked my incision site and, aside from some unsightly surgical glue residue (that stuff is tenacious) things are looking good and healing up. From there, we mostly discussed screening recommendations. In about 6 months, after the biopsied area has healed completely, I should schedule an MRI. Then a year from that, a mammogram. And so on. You know, forever. My main problem with MRIs (aside from it being expensive and terrifying, especially given my MRI-specific phobia, stemming from an episode of House wherein a man with an old tattoo's tattoo is ripped from his body because of something about old ink containing trace amounts of metal and MRIs being giant magnets) is that they're super sensitive. Meaning that I could end up with lots of unneeded biopsies, and even more unneeded anxiety. But it does sound like it would be important to at least get one as a baseline, even if I don't keep up with them so regularly. I can also start meeting with the nurse who runs the High Risk Surveillance Program and she can be a point person of sorts.

Beyond that, there's not much to be done. I can schedule with an oncologist to discuss a Tamoxifen regimen. Tamoxifen blocks estrogen and supposedly cuts your cancer risk in half. But it also has potential side effects like blood clots, stroke, uterine cancer (so cancer trade off?) and ominously, "vaginal problems." I get that it's a great, less horrible alternative to chemo for women who have cancer (my mom was on it for a while there). But right now? Not very appealing. If atypia keeps popping up, then a prophylactic bilateral mastectomy is something I might want to consider, but hopefully that won't be the case! 

My surgeon took some time to review a print out from the Breast Cancer Risk Assessment Tool website. She had entered in some of my information and, bleep bloop bleep, the tool generated some magic numbers. My lifetime risk of invasive breast cancer is about 40%, compared with that annoying, omnipresent average woman's of 12.6%. My risk of cancer in the next 5 years is only 1.8% compared with average woman's .3%. So, I suppose that's sort of useful. But with answers come more questions (that may or may not be a direct quote from Fringe. Wow, I watch too much television!). Like, what's lifetime risk? Cancer by 45? By 70? What's invasive? Like Stage III, where I still have a fighting chance? Or Stage IV, like my mom?

I realize those are answers no one can give me. But how can you make such major decisions with such vague information?! I guess you make the best choices you can, the ones you can live with. Maybe that will mean following all of these recommendations to the letter, or maybe I'll end up eschewing all of them in the name of leading a happier, less stressful life. I suppose I will figure it out as I go. Incidentally, I know that everyone has to make these choices to some degree, that everyone is at risk for something, that I am not a special in this regard. But we're all pretty isolated in our own bodies and it's hard not to freak when it seems something might be wonky with yours. 

So yeah, I am healing up well and things are getting back to normal. I am even wearing a normal bra! Hallelujah! That zip up post-surgery number was binding and decidedly unflattering! Contrary to what this blog may indicate, I promise I have not just been sitting around thinking about cancer for months. Going back to work has been a welcome distraction. Also spring is here and I am determined to take advantage of this "nature" I keep hearing about. I have lived in Seattle for almost a decade but have never been to the San Juan Islands (pathetic I know), so this is definitely the year! 

Good news, with a little frustration...

I received an e mail from my surgeon letting me know that the biopsy results are back and they are benign! Obviously, this is great news and a huge relief. But, at the same time, I don't have the sense of closure that I thought I would. I am grateful to be healthy, but also eager to attend my follow up appointment and discuss what I need to be doing from here on out. I know yearly mammograms are in my future for sure, but am less sure about the initial recommendations of annual MRIs. I also wonder if prophylactic bilateral mastectomy (PBM) is still an option I should be considering in the years to come, given my risk factors (which again, include family history and the recent atypical cells). And, most importantly, I want to know when I can stop wearing these incredibly sexy zip up sports bras (the way you can see the outline of the zipper through all of my dresses is especially alluring) and when my biopsy incision will stop looking so Frankenstein. 

I had a frustrating conversation with a friend after I got my results. I told him I still wanted more information about PBM. "Wow," he joked "You really want that mastectomy, huh?" He went on to say that even considering PBM seemed like such an overreaction in light of my good news. I know he was just trying to keep things lighthearted, and I am sure he is genuinely perplexed at why a healthy person would be even vaguely considering a massively invasive surgery. But I find this attitude so condescending, and also so woefully common. Especially, it seems to me, amongst men. Like women considering PBM are just being hysterical, overemotional, illogical. Like women find out they are high risk, run into a surgeon's office, scream "CUT THEM OFF!" and have the procedure later that day, without any research or true consideration of the consequences (and yes, there are many really unpleasant ones). 

I noticed the same attitude surface when Angelina Jolie publicly addressed her own PBM and, more recently, the possibility that she will pursue further surgery to address her heightened risk of ovarian cancer. So many Internet commenters (okay, not exactly known for their sensitivity or powers or perception but still) said things like "It seems really dumb to have surgery when you aren't even sick," or "I bet this was just an excuse to get a boob job," and I saw several go so far as to lament Angelina's decision to "amputate her femininity" and "defile her body" and "God-given parts." I can't help but wonder if people (again, sorry, but usually dudes) would get so worked up if the "god-given parts" were not her breasts and ovaries, or if our society didn't reduce women to sex objects and baby incubators.

Another frustrating, recent read was this piece, which initially purports to be about Samantha Harris (apparently a former host of Dancing with the Stars) and her decision to have a double mastectomy after being diagnosed with breast cancer (which is a different ballgame than a PBM). But then it is really about the author's wife's decision to have a lumpectomy instead of a mastectomy when she was diagnosed with breast cancer and how that was the best choice because she is still alive many years later. But then it is really about how a quoted doctor, Todd Tuttle, thinks women really need to calm down and be sensible before jumping into a mastectomy as treatment for cancer. 

Of course, I think women deserve access to options and accurate facts about the treatments they choose to pursue, be those preventive or life-saving. But I also think that this is a personal choice, and one that the vast majority of women take seriously. I strongly feel that these concerns about women "acting out of fear" would not be so prevalent in a piece about men with, say, prostate cancer, and the treatment decisions they make. I also resent the implication that an emotional choice (lets face it, dealing with cancer will always be emotional to some degree) is by definition an ill-informed choice. I think that assumption alone is dripping in misogyny. 

Okay, enough of that for now! Some of you might be wondering what I plan to do with this blog, since it's inception was so closely linked with health issues that are now somewhat resolved. Well, I plan to continue blog about issues relevant to women who, like me, are at high risk for hereditary breast and ovarian cancer, as well as any related experiences that I might have. It's corny, but I also feel that the past two months of cancer scare helped to highlight some real areas for improvement in my life. So, it is my hope that High Risky Business can be a place to document risks that I am taking (instead of simply risks that I am subject to) and my progress in getting to where I want to be. If that sounds interesting at all, please keep checking back! And thanks so much for your support in recent weeks! 


It's been about 24 hours since my excisional biopsy, and so far things aren't too terrible. Yesterday went surprisingly smoothly. My friend Jill picked me up around 9:30, we checked in at Swedish at 9:45 and things were well underway by around 10:15. After the obligatory urine sample/height/weight check, I was whisked off in a wheelchair (they don't let you walk!) to the True Family Cancer Center where they placed a wire in my breast. Eww, I know, but it's necessary to do this when the area they are later biopsying is really small. Basically, they compress your breast (not as tightly as with a mammogram, but still, not super fun), do some imaging, numb your breast with some lidocaine and insert the wire in order to mark the atypical area, so that the surgeon knows what to remove. The wire actually sticks out of your breast, but they tape it down so you don't have a weird chest antenna.

The placement of the wire was definitely the most emotional part of the day. Up until then, Jill and I had been laughing and joking and it sort of felt like we were just hanging out at a hospital. But when the radiologists began the imaging, it started to set in that this was really happening. I cried a lot (even with the Ativan that my MD had prescribed for this very occasion) and felt the need to explain myself: "My mom had breast cancer and I was in the hospital with her a lot and this brings things up for me." "Was it early stage?" the radiologist asked. I nodded no and she said, kindly "Well, this is totally different. Even if they find cancer, this is going to be a quick fix. You'll worry for years, but you are going to be fine." We continued with the imaging and the nurse patted my arm and reminded me "This is the hardest thing you'll have to do all day. For the rest of it you are going to be asleep!" 

Once the wire was placed, I got wheeled back through the maze of Swedish to the surgery waiting area. More blood pressure checks, more questions about the last time I ate or drank or pooped. I met my anesthesiologist who explained that I wouldn't be under general anesthesia but I would be heavily sedated. He took a look in my mouth "...just in case I need to place a breathing tube. Which is unlikely!" When I asked about risk associated with this procedure he made a confusing analogy to drunk drivers. Jill and I exchanged perplexed glances and he explained that he meant the chance of anything bad happening under sedation was less than us being killed by a drunk driver. So that's good, I guess? I know he meant well, but the things that come out of doctors' mouths are sometimes really hilariously inappropriate. 

My surgeon came by too. I really like her. For one thing, it feels good to be working with a woman. And this has nothing to do with her competency, but she's so glamourous and funny and I am kind of dazzled by her. She asked how I was doing and when I said "Nervous," she said "That's okay, you'll be getting some really drugs soon." She initialed my body (kind of weird, but I guess this is related to safety as it indicates that she has spoken with me and cleared me for surgery) and left to go prepare. 

Entering the OR was frightening because I had never been in one before and they look just like they do on TV, which brings all kinds of catastrophic soap opera scenarios to mind. Very sterile (thankfully!) with a table in the middle and big lights overhead. It was quite cold. I got situated on the table and they started positioning me and covering me with blankets. They even restrained my arms a bit, explaining that sometimes when people are sedated, their arms flop around, which is obviously not a great thing for the surgeon! Then the anesthesiologist put an oxygen mask on me and told me he would be starting the sedation. And also just like on TV, that is the last thing I remember until I woke up about an hour later.  My surgeon told me that they only had to take out a small area and that, aside from the slight scar, I shouldn't notice any cosmetic changes to my breast. They put me in a really glamorous (read: horrendous) post surgical bra and wheeled me out to the recovery room were I was thrilled to accept a pitcher of water and plate of crackers (at that point it was around 3 PM and I hadn't eaten since 9 PM the night before, and hadn't had water since 7 AM that morning). I slathered my mouth with my precious lip gloss (also a pre-surgery no-no), and changed back into my clothes. Jill went to go pick up my Vicodin and we were out of there!

I was surprised at how little pain there was, but now I think that was probably because the local anesthesia was still at work through most of yesterday. Today I definitely woke up with some...sensation. It's no where near excruciating, but it is hard to use my left arm for certain tasks (opening doors, slicing, writing) because that seems to cause little pain flare ups. Still, I can't imagine that I'll need a whole week off of work, as my surgeon had recommended. I am aiming for a Monday return, but I guess we'll see. I've barely used the Vicodin because I HATE that stuff (makes you so groggy!) and have been mostly icing the area instead. I can't shower or take off this bra for another 24 hours so I am also looking really ravishing. I am also getting pretty bored: after over 2 weeks of running around Japan it's hard to just sit still in my studio apartment and watch trashy television. But I guess I should appreciate the rare downtime while I can!