It was in Las Vegas when I had the first hint that my life was about to change. Mr. Amazon and I were on a much needed adult vacation in the home of bright lights and silicone, when as I was going to bed after a long day of blackjack, I haphazardly did a quickie breast self exam and thought I found a lump. ( hint #1. Don't beat yourself up about the self exams you didn't do, just concentrate on the one you are going to do today) It was weird because could feel it only when I was sitting up and my arm was over my head. (hint #2 Do all the positions listed in a self exam instructions. What shows up one way may not be obvious in others) I kind of brushed it off because I, for one thing, had moved a pile of rocks the day before and must have just pulled a muscle; furthermore, I was much too young to have breast cancer. Statistically I knew that my risk for breast cancer was very, very low. (hint #3 Statistics are a wonderful thing when you are looking at large populations of people but are of limited value when looking at an individual) Gee, I wasn't technically old enough to have my first mammogram, according to most insurance companies, for at least 3 more years; although I did have a negative mammogram 2 years previous. So I thought I was ok and I put the lump out of my head and continued on my merry vacation.

A week or so later I did another self exam and this time my hand went right to the lump. Hmmm. Better get this checked out. I made an appointment with my MD who fit me in her schedule that very day. (hint #4 I was very lucky to have a proactive physician. Be prepared to be a strong advocate for getting seen and treated in a timely manner) If I had to wait a week to see her, I probably would have put it off for even longer. She felt the lump and reminded me of even more statistics; 11 out of 12 lumps in women my age turn out to be nothing serious and early detection is the key to positive outcomes. (refer back to hint # 3) Even though chances are that this was nothing to worry about, it was necessary to do all the steps until we know exactly what we were dealing with.

I had a mammogram. The first films they took showed nothing, the second, more intensive one, showed only a tiny bit of a shadow in the inner most edge of the picture. (hint # 5 doing a mammogram or a Self Breast Exam doesn't negate the need for the other. My tumor would have been missed by a conventional mammogram for many years. On the other hand, many tumors are found with mammography before they can be felt.) Then I had an ultrasound, followed by a visit to a surgeon who did a needle biopsy. This all occurred during the space of one week while I was juggling car pool, PTA president duties, preschool mommy helper and baking cookies for the upcoming bake sale. No time to worry. (hint #6 Don't worry until you have to, meanwhile do the right steps in order and keep life as normal as possible as you wait)

The next Monday, I got a call from the surgeon that had done my biopsy. He told me that the pathology report said "suspicious of a malignancy". I replied to him loudly, "What the hell does that mean?" (hint # 7 Ask lots of questions until you understand clearly) He said it meant that there were some abnormal cells but he needed to get a larger sample to know for sure what was going on. Could I come in tomorrow and have an "open biopsy." (Read, “out patient surgery where they slice a large chunk of the lump out to do an immediate examination”.) "No, sorry. I am scheduled to be mommy helper on a field trip. Sorry, no can do," I told him in no uncertain terms.

The surgeon was very persuasive and since I am always the one to try to keep every one happy, I went on that field trip, and went into surgery right afterwards; racing from the museum to the hospital in record time.

The surgery removed a golf ball sized chunk of tissue from the upper surface of my right breast. While I was still in the operating room, the pathology report confirmed it was a large, nasty, fast growing cancer. One tumor was the size and shape of a large peanut, and there was another one that was the size of a kumquat. (Why is it that they always describe tumors as the size of food?) My surgeon came to me in the recovery room with a high stack of books, pamphlets and brochures, and placed them in my lap. He said yes, I did have breast cancer. Now I needed to educate myself because WE have some decisions to make. Not you have to figure this out on your own. Not I am going to tell you what you have to do. He set up a collaborative effort that permeated my entire journey. (hint # 8 Use professionals to get information, suggestions, advice but you have to be comfortable with all the choices you make regarding treatment. They are your boobs and your wishes need to be given respect!)

After discussions with my medical support team, second opinions, lots of research, heartfelt discussions with my family, and prayerful consideration of my needs and wants for outcomes from my treatment, we decided the best course of treatment for me was a modified radical mastectomy. (Read “amputation of my right breast and removal of lymph nodes from my armpit”) (hint # 9 Everyone's medical case, mental case and family situation is unique. Just because your friend had good or bad luck with one way of treating her cancer does not mean it will work for your Aunt Suzy) It turns out that I probably made the best choice because in the tissue they removed during the mastectomy, they found yet another small tumor that had been left behind from the biopsy.

In order to get back to my mothering duties ASAP I opted not to have reconstructive surgery. I did undergo 6 months of chemotherapy and then 6 weeks of daily radiation. (hint # 10 Although of limited value to assess an individual's chances of having cancer, statistics are very important when choosing possible treatment options)

Breast Cancer Journey
When I was diagnosed with breast cancer and going through all the testing and treatments and therapies, people would say to me, "Gee, you must feel like you are on a roller coaster ride." and I would think, "No, that isn't quite right." You willingly get on a roller coaster ride and there are ups and downs on your journey and you are a strapped in, non participating rider. I knew I needed to be an active participant in my treatment and recovery. Very little of the amusement park analogy fit with what I felt like I was going through. Obviously I needed a better analogy to describe what this breast cancer journey was like. So I came up with my "canoe trip down the river of life" story.

I see the river as being the path that God has provided for my life. He provided the river, a canoe with paddle, and support staff. Up to this point my river had been relatively calm with only a few meanders and minor rough waters - nothing I couldn't handle with minimal support. Then in October of 1997, as I found the lump in my breast, I heard the roar of approaching white water. Sure enough, as I rounded the bend I saw huge drop offs and large boulders in the middle of the now raging torrent when the diagnosis of malignancy was presented. Each boulder represented a decision to be made; choosing an oncologist, type of surgery I should have, holistic vs. western medical treatment, type of chemotherapy, etc,... you get the picture. As I approached each boulder (decision) I could go around it to its left or right or I could choose not to decide and just allow the river to take me. If I let the river choose my course, it may take my canoe safely around the rock or it could just as easily crash me into its face and certain death.

On the shore of my river was my extensive support system. Doctors, nurses, physical therapists, spiritual advisors, et al were there to teach me how to read the river and how to direct the canoe. They could give me the information, recite the statistics and show me possible paths, but it was ultimately up to me to make the decisions and forge the route best for me. Friends and family were also there to shout encouragement and say prayers for my safe passage. Their support and importance cannot be overstated!

After miles of working with and against the river (2 surgeries and 6 months of chemotherapy, experiencing just about every negative side effect possible - my oncologist joking that she wanted me to have the "full cancer experience"), I finally got to a place where I did not feel I needed to be quite so vigilant. During my 6 weeks of radiation, the boulders were submerged but the river still ran swiftly. I yearned for the time when my river smoothed out and I was able to hang my feet over the side of the canoe and savor the trip. I believe I am there now.

Life after Cancer
Loosing a breast in your 30's, or at any age, is a traumatic thing. Our society puts a HUGE emphasis on breasts and cleavage. Making the decision to live the rest of my life with only one was very difficult. Body image is an important part of what people believe themselves to be. I am blessed that my husband has been very supportive and has ensured me by words and actions that he loves ME; not that hunk of excess and mutating flesh that had been my breast.

I went through great pains to get my body back in shape after the assault by first the cancer then the surgery and treatments. Physical therapy and then regular exercise were vital to getting my body back. I am proud to say that I am healthier and more fit now than I have ever been in my life. (hint # 11, A cancer diagnosis is no longer an excuse to sit back in your recliner for the rest of your life. Exercise and staying active is vital to recovery.) That knowledge has erased any body image problems I might have had with my one boob. Granted I will never wear a bikini again nor an evening gown split to my navel, but I doubt I would be dressing like that even with intact cleavage.

Sex after Cancer
The physical and hormonal changes in my body from the chemotherapy and radiation made sex next to impossible, yet we made due. Actually what I needed more than anything was cuddling and moral support. Mr. Amazon was wonderful in providing me with those.

After all my treatments were done and my hair grew back, I thought we would get back to the same old sex life as before. I waited,... and waited,... and waited. It seemed I flat out didn't care if I ever had sex again. Mr. Amazon didn't thrill me. I loved him dearly, but I just didn't want sex. Porn didn't turn me on. Kisses were flat.

I had lost the 1st step of the sexual response- desire. Some people believe that desire is completely a head thing. I am here to tell you that there is a major physiological component that was damaged with my treatment. A counselor suggested that I replace the desire part of the sexual response with commitment. I may not feel like or even want sex but I was supposed to "go along with it" because I am committed to my husband and our marriage. On the surface that sounds crass and condescending to my feelings but I wanted so much to "want to" again that I tried it. I wouldn't say no when he asked because I was committed to our marriage. I even tried instigating sex a few times in the "commitment" effort, again not because I wanted sex, but because I wanted to show him that I loved him. It wasn't long (a few months perhaps) that I was looking forward to our "commitment" sessions. Then without even becoming aware, desire came back- and it came back stronger than ever!

Funny thing about this. In my research to find "desire" again I have turned into a much more highly charged sexual being. My one breast got bigger (I hear that is not uncommon) and has gotten far more sensitive then it ever was when I had two. I am much more aware of what I like in bed and Mr. Amazon and I communicate more and are more creative and loving then ever before. Is it because I passed that 40 year old sexual peak thing? Or is it because we faced my mortality? Or is it because I beat cancer? Who knows? I do know that cancer does not mean the end of your sexual life. It can be the beginning of a much more fulfilling one.

This month I celebrate my 5 year anniversary from my diagnosis. I now strive to stretch my limits and body in ways I never would have before my cancer experience. I love my family more and have new appreciation for my friends. I can now say, "I have been blessed by breast cancer."