The Breath of the Almighty

I have said before that cancer came and went, but the specter of cancer came and stayed. When I had a cancerous tumor in my body, I wasn't even aware of it. It is possible that my cancer developed while I was pregnant with my youngest child. Microscopic mutated cells were rapidly multiplying, clogging the milk ducts of my right breast, and I was blissfully unaware. I knew that when my babe nursed, she would fight and struggle on the right side, but happily nurse on the left. I was aware that my milk production on the right was diminishing, while the left side was keeping up with my little one. I knew that when I tipped my head forward and looked down, my silhouette was becoming increasingly lopsided because of the imbalance in milk production. But with my typical laissez-faire attitude, I never really thought about it. It never once crossed my mind that something could be seriously wrong. 


Yet...


My doctor found the lump. The lump was malignant. The malignancy had metastasized to my lymph nodes. And although those little mutating cells hadn't yet caused me any real harm, the specter of cancer loomed ahead like the Grim Reaper threatening to take me from this world. Thus, my doctor and I did everything possible to stop it, and the real harm started, in the form of life-saving therapy. How ironic that we refer to poison pumping through one's blood as chemotherapy. And burning a person with light at a frequency high enough to knock electrons out of their orbit is radiation therapy. And the drugs I still take everyday to block my estrogen and starve the cancer is referred to as hormone therapy. Come on people, a spa day is therapy - this stuff is just nasty. And I now realize, three years out of the gate, that all those therapies, along with massive doses of antibiotics and eight surgeries in three years will take their toll. I still struggle - not quite where I want to be, not quite on my feet, not quite well. Some days I feel terrible, some days not so terrible. I use natural means to try to conquer the general malaise, hopeful that at some point in the near future I will again be truly well. And so the specter of cancer no longer looms, but instead quietly haunts me with its presence.


And yet, as I ruminate about all these things, I am reminded that those therapies were life-saving, not life-giving. The gift of life comes from somewhere else entirely. The book of Job says, 'The Spirit of God has made me, and the breath of the Almighty gives me life.'  


The breath of the Almighty ... gives life. O God in Heaven, breathe on me.

Fight Like a Girl

This is my final post as a guest blogger at Pine Country Feed. Thank you for going pink in support of breast cancer awareness month!

I don’t know how the phrase ‘You fight like a girl,’ became a classic insult. But after fighting breast cancer it has taken on a whole new meaning. Cancer treatment is like hazing for a sorority no one wants to join. I sometimes refer to others who have had a breast cancer diagnosis as my ‘sisters in the fight.’ But I recognize that I have sisters all around me who are engaged in the fight against this disease, including those who haven’t had that personal diagnosis. There are those that walk, raise money, get the word out, and encourage their friends to consistently do self-exams. And there are those who gather around the weak and wounded, and lift them up.

It was in the month of October – breast cancer awareness month – that I had to go in for a consultation with a radiation oncologist. I had already had a bilateral mastectomy with lymph nodes removed, and I’d gone through six rounds of chemo. I was unprepared for the news that I would have to have radiation. It was like reaching the top of a mountain after a long, hard hike, only to lift my head and realize I wasn’t actually at the summit – I still had miles to go. My appointment was on a Tuesday, a day I normally went to a local moms group I was involved in. My appointment was scheduled for early afternoon, so that morning, I went to my group having told no one about the appointment or how I was feeling. I was so discouraged – I felt heavy, and weary, like I was trying to walk through life with forty-pound weights on my feet.

But something amazing happened that morning. I walked into a room that had gone pink. In solidarity with me, and in support of breast cancer awareness month, everything was decorated in pink. Several of the girls were wearing pink bandanas. One was handed to me as I came in and I tied it around my bald head. A dear friend had done a photo shoot with me a few weeks earlier, celebrating my life, even celebrating my scars which stand as mementos of my survival. She had made a collage of the pictures, and the women had filled it with their signatures and words of encouragement. About fifty women stood around me as I was handed that gift. And later, in a small examining room in the hospital, as the doctor explained how vicious my cancer was, it wasn’t just my husband and me facing the road ahead. I sensed that group of women, standing behind me, cheering me on. This, for me, epitomizes what it means to ‘fight like a girl.’ Throughout my fight, I was surrounded by women who supported, encouraged, connected, babysat, cooked, cleaned, held my hand, cried with me, took me to the hospital for treatment, spent the night at my house, made CD’s of beautiful music, loaned me movies, gave me books, etc, etc.  They chose to become my sisters in the fight. They helped me survive.

So go ahead, tell me I fight like a girl. I couldn’t think of a nicer compliment.

Choose Life

I originally posted this as a guest blogger at Pine Country Feed on October 22, 2010.

I remember, years ago, being invited to a house in the Colorado foothills. As we drove up the driveway, my impressions were all negative. There were spindly little trees, and dirt, and the house itself was nondescript. Entering the home, it had a shabby, run-down feel and everything was brown. I wondered how these people could stand to live here. Then, I was invited out onto the deck. The back deck of the house overhung a small cliff, and from it I could see the entire city of Denver, and miles and miles out onto the eastern plains. The view was extravagant, breath taking, and completely unexpected, and I felt my perspective shift. I now understood exactly why they wanted to live here.

A similar thing can happen when we choose to manage our thoughts and our speech, instead of allowing words to run rampant through our mind, unchecked. Words did not help me survive my cancer, but they dictated how I was to survive – with grace and joy, or with regret and bitterness.

When I received my first dose of chemo, everything went wrong. I spiked a fever, and the chemotherapy decimated my white blood cell count, which meant my immune system was non-functioning. I was hospitalized – the fourth time in two months. This was my second infection, and I was placed on I.V. antibiotics, and put in isolation. The level of physical agony I was experiencing was extreme – more intense than anything I had ever felt. And as I lay there alone in that hospital bed, these words came unbidden into my mind. “This is how it feels to die.”

We have the power to choose life or choose death. That may sound extreme, but every choice we make either leads us toward abundance, and life, or away from it. So, in my total misery, I said, “Today, I choose life.” I drug my thoughts forcibly away from death, and into a place of thanksgiving, thereby changing my whole perspective.

I live in the age of modern medicine, and the antibiotics are doing what my immune system can’t.

Thank you.

If my immune system had crashed while I still had a staph infection, I’d be in I.C.U., clinging to life, instead of here in this bed with the ability to fight. Thank you.

In spite of the brutality of the treatments, they will ultimately save my life. Thank you.

I have a husband who loves me, not in spite of my scars, but because of them. They serve as precious reminders to him of what was almost lost, and he never takes me for granted.

Thank you.  

I have people around me, to love and care for my children when I am unable to be there.

Thank you.

I chose to live that day. I chose to turn from anger, death, misery and suffering, and looked instead at thanksgiving, life, strength and victory. We can all make these choices, every single day. Where are you looking, today? Where are your thoughts taking you? Today – choose life.

I Own my Joy

This post originally appeared as a guest blog at Pine Country Feed on October 15, 2010.

There are many things cancer can do. It is a thief and a destroyer; but I found in my own battle with this beast that there are things that belong to me, and me alone. Cancer has no right to them. For instance, I own my joy – cancer cannot steal it from me. The only way I can lose my joy is if I willingly give it up.  Now, let me be clear.  I’m not talking about happiness here – that feel good feeling we get when circumstances line up in our favor.  Nor am I talking about spiritual joy, a much deeper and abiding thing.  I am talking about daily joy – that knowing that we get that ‘in this moment’, and ‘in this place’, things are right.

Now, this all sounds good and well, but in practice it’s a bit harder.  This is how it would go for me during breast cancer:  Here I am in bed, I’ve had parts of my body amputated, and I’m still full of pain, unable to even lift my baby.  I’ve had three surgeries, two life threatening infections, and now I’m so sick with the effects of chemo that I can’t even get out of bed. And I would say, “God, how exactly am I supposed to have joy here? How?”  I was so beaten and battered, and the road toward self-pity was a far easier one to tread than the road toward victory.  I couldn’t find my joy – it was somehow hidden from me.

And then something would happen – usually something small – and I would recognize that I was ‘in this moment’ and ‘in this place’, a moment and place filled with abundant, undeniable blessing.  I remember my two-year-old girl coming in with a board game. She climbed up on the bed, set up all the pieces, and we proceeded to play – completely disregarding all the rules. The game involved treasure, and my little one found the treasure every single time. Her face would light up with pleasure, and in that sweet face I found my joy.

Then there were times my nine-year-old girl would say, “Mommy, can we do something?” Well, there weren’t many things I could do, so we would perch side by side and watch movies chosen by my child – crazy, kid-friendly movies that would make her laugh out loud. I don’t remember the movies, but I remember seeing the stress slip away from her, and I knew that what I was really doing was giving her the sense that everything was going to be all right. In that simple act of mothering, I found my joy.

I have heard it said that joy is peace dancing, and peace is joy at rest. I found my joy in mothering, and in connecting. My husband would take my hand, saying nothing at all, and I would sense peace dancing about us.  I would mother my children, giving of myself when I felt so empty, and peace would dance.  Where in your life does peace dance? Where do you find your joy?

My Inner Cowgirl

October is a month dedicated to raising awareness about breast cancer.  For the month, Pine Country Feed, a local Colorado store, has gone pink. They have also invited me to guest blog for four Fridays, celebrating the fact that I am a survivor. This is the first of the four posts, and over the next few days I will include the rest. Please visit  Pine Country Feed to read more encouraging posts.

Okay – so, I drive a pickup.  And I can saddle a horse, and ride.  But I’m no cowgirl. I do, however,  know what it means to ‘cowgirl up’ – I learned when I was 38 years old, with two young daughters, and I was told I have breast cancer.  My friends, trying to be encouraging, said interesting things, like this:  “It’s not a death sentence, like it used to be.”  Another said, “I know someone with positive lymph nodes, and she’s just fine.”  But I knew it wasn’t quite like treating strep throat – I was facing serious and hard decisions.  I also knew of women who had lost their battle and died of this disease, in spite of following their doctors’ recommendations.  So what was I to do?  Cut the cancer out, and radiate the breast?  Cut the breast off, and be done with it?  Or, have a bilateral mastectomy, just in case?  Cutting off healthy tissue, ‘just in case’, seemed unbelievably barbaric.  At first, I refused to consider it.

Then one day, my husband came home from work, and told me a man he worked with had asked him to tell me something.  He said, “Tell your wife to do everything she can.  My wife had a single mastectomy, and five years later the cancer came back and took her from me.”  But even hearing this didn’t make the decision for me.  The clincher for me was when my eight-year-old daughter took my hands in hers, looked me in the eye, and said very seriously, “Mommy, please do whatever you can so that we don’t have to go through this again.”  We.  That hit it home for me.  I alone didn’t have cancer.  My whole family had it.  And I wasn’t making decisions for myself only.  I was deciding what lay ahead for everybody who loved me.  So I ‘cowgirled up’ – I had the bilateral mastectomy.

It was only later – after surgery - that we knew I had done the right thing.  Once the doctors could see my cancer ‘up close and personal’, they knew that it was aggressive, behaving in an unpredictable manner, and moving quickly.  In spite of being a very, very small tumor (smaller than a pea), the cancer was already in my lymph nodes.  Surgery wasn’t the end of it, like I thought it would be.  I was facing months more of treatment.  But instead of being terrified, I felt only a sense of resolution.  I was resolved to do whatever it took to fight this beast and survive.  That was the day I discovered I was tougher than I thought.  That was the day I discovered my inner cowgirl.

The Unhealed Part

Well, it's been a while since I've been here.  I have no reason, except that the summer got away from me.  But then, for this month of breast cancer awareness, I've been asked to guest blog at Pine Country Feed - and I knew they were going to link to this blog.  As my niece so eloquently put it, "Maybe this will help you get off your butt and write again."  So here I am.

Today, I will bare my soul in a way I never intended to do when I started this blog.  But several things have conspired to convince me that I should share my whole story, even the most painful parts.  The issue today is rarely talked about because it's intensely personal, and it requires emotional courage.  I'm digging deep today - I've cried all morning just thinking about writing this.  The thought that my father, or my pastor will read this gives me heart palpitations.  Today, I become vulnerable in a way that is extremely uncomfortable.  So, if you have no desire to read today's post, I'll understand.  But, if you have the courage to step into my life, then do, and participate in an experiment in empathy.




I understand that most people have a total disconnect between breast cancer and its effects on intimacy.  I understand this because I myself didn't get it - not until my own personal war with cancer was fought, and I was left to experience first hand the wounds it left.  When I was diagnosed, a very kind friend linked me to an article titled "Intimacy After Breast Cancer."  After thanking her, in my naivete, I rolled my eyes and tossed the article aside.  My husband and I had been married nearly 14 years when I had my cancer surgery.  We had a very natural and easy relationship, and I figured it was no one's business how we dealt with personal issues.  We would work it out.  I didn't want anybody's advice, because I didn't think I needed it.

I am not an emotionally driven person.  Because of this, emotions tend to sneak up on me.  I can go for days, thinking I'm perfectly fine, and then the emotion will overtake me like a storm, and it has to run its course.  When I had my cancer surgery, a bilateral mastectomy, I had immediate reconstruction, so I woke up with a silhouette very similar to the one I'd always had, and heavily bandaged so I couldn't see the wounds.  I was warned to prepare myself before I looked at my scars.  Did I want to be alone, or with someone?  Where did I want to be?  But when I looked, it was no big deal.  I felt ... nothing.

Unfortunately, due to a staph infection, the surgical implants had to be removed, and for the next 14 months, my chest was caved in on each side where my breasts used to be.  I am amazed now to think about how many showers I took, how many times I applied lotion and got dressed, without ever looking at or touching those scars.  I would instinctively turn my back to my husband when I changed my shirt, never once thinking about what I was doing or why.  I was not facing what had happened to me - I was happily existing inside a little bubble of denial.

Then one day, after I had started chemo, after my hair had fallen out, I was in the shower letting the water run over my bald head.  And this thought just came into my head - if an evil person wanted to shame a woman, he would cut off her breasts, shave her head, and toss her out for all to see her ruin.  And with that thought came an overwhelming grief.  It caught me totally off guard, this intense, discomforting emotion as it swept over me.  I ended up in a ball on the floor of the shower, and as the water poured over me, I wept out all this stored-up pain that I wasn't even aware existed.  Then, very slowly, I placed my hands on my chest and felt the contours of my scars.  And then I looked.  One word filled my mind --- ugly.  They were so ugly.  But I was spent by my grief, and I thought it would be alright.  I had poured out all this emotional ugliness, now I could begin to heal.

But those ugly feelings would continue to sneak up on me.  I wore a camisole all the time, except in the shower.  I would take it off, step into the shower, dry off and put a fresh one on.  Without it, I felt too exposed, too vulnerable - insecure and unsafe.  I would wear it to bed.  One night, after the lights were out, my husband reached over and laid his hand on the skin of my stomach, under the camisole.  He very gently slid his hand up, and touched my scar.  It was a sweet and affectionate touch.  Yet my response was visceral.  My eyes filled with tears, my body tensed and I fought the nervous response of my body that wanted to push him away.  I was desperate not to hurt my husband - he loves me and I am absolutely safe with him.  So I willed my body to relax, and I calmed my breathing.  But even that was a betrayal of sorts, because I was presenting something to him that wasn't authentic.  I felt the tiniest wedge slide between us.  I felt I had caused it, and only I knew it was there.  The conflicting emotions inside me were such a tangled mess, I couldn't even put a voice to them.  So I bit my lip, and let the tears fall silently on my pillow, and prayed that God would fix this unnamed thing inside me that had broken.

Post-mastectomy patients form a sorority of sorts.  In this sorority, women share dark and painful secrets that they would never share with others.  Because of this, I know that some women never get over the feelings I've described.  They don't know how to approach it, and this unnamed and un-talked about thing grows between them and their spouse.  It steals their joy.  It throws their relationship out of balance.

Thankfully, I've come to a place of healing and acceptance where I don't feel those things nearly as often.  The first thing I think when someone says "describe yourself" is no longer ... ugly.  But in spite of this, issues relating to intimacy still impact me.  In the last couple of years, I've developed increasingly troublesome symptoms of aching, occasional sharp pain, and general discomfort which most women can probably adequately imagine.  I finally went to the gynecologist about it.  Although she was really wonderful and absolutely professional, and a woman (thank you, Jesus), it was still so humiliating to describe to a total stranger, in minute detail, the most personal details of my life.  And when I was through, she said, "It's your cancer medicine."  I take a cancer drug every day.  I'm 2 1/2 years through a five-year regimen.  I had suspected that the medicine was the cause, but in researching it I had found nothing that was similar to what I was experiencing.  She said the issues I was having were not technically side-effects, and that's why I couldn't find information.  But she was certain that the cancer drug was the cause.

So I asked my oncologist about it, and she confirmed that the problem was my cancer drug.  And there is absolutely nothing we can do about it.  Discontinuing treatment is not an option.  I got the 'talk' - all about my risk level for recurrence, and the fact that I have young children to raise, etc., etc.   So I continue to take the drug, and I continue to struggle.  Sometimes, when my husband takes my hand, instead of love and joy and security, I feel a low-level anxiety.  That thing in our marriage which is supposed to bond us, which is supposed to be an expression of love, has instead become a source of pain.  We love each other, but the natural rhythm of our love has been destroyed.  I am broken - this part of my life is broken, and it has been broken by breast cancer.  How do I fix it?  I can only pray that God will open my eyes to a solution, or simply touch me with His hand.  But for now, this part of me remains unhealed.

Letting Go - June, 2007

That night, after being diagnosed with neutropenic fever, was fitful.  I woke several times, drenched in perspiration but chilled to the bone.  They kept administering the I.V. antibiotics, and I was getting Percocet for pain, which would bring my fever down slightly.  The cough that had started in the E.R. had developed into a full-blown, racking cough.  I had a splitting headache.  And the medicine they were giving me to stimulate my bone marrow to produce white blood cells was causing bone pain.

The nurses had warned me about the bone pain.  I'd said, okay, I've had aching in my bones, I can deal with that.  Oh, my - I had no idea.  When the nurse first came in with Percocet, she asked if my bones hurt. I said I was achy, and she said that it hadn't started yet.  I'd know when I had bone pain, and I wouldn't feel achy.  When it started, it took my breath away.  It was severe, sharp, constant pain in the core of my bones.  It felt like my skeleton was on fire.  I have a memory of sitting on the hospital bed, with my knees drawn up to my chest and my arms wrapped around them.  My dad was there with me, with his large hands shoved into too-small latex gloves, and a paper mask over his face.  I was in such agony, I was rocking, rocking, rocking - like some sort of bizarre self soothing instinct was fueling me.  Every once in a while a little mew of pain would escape my lips.  In some distant part of my mind where I was still calm and focused, I remarked to myself that I sounded like a wounded animal, but I couldn't control it.  I don't remember my father saying anything - he just silently watched me suffer, unable to do anything about it.  The staccato rhythm was beating in my head, 'come on, come on, come on...' as if I could will the hands of the clock to move faster toward that magic time when I was allowed more pain medicine.

This intense pain was on top of the illness that was tearing through my body.  The cough was constant.  I was imagining infectious crud filling my lungs, because I knew my immune system had thrown up its hands in surrender.  It was so hard to cough - it hurt my chest and my throat, and I would hold my head in my hands, trying to keep it from moving because the coughing made it feel like it might split apart.  As I lay there, I thought of my neighbor and dear friend who has cystic fibrosis, and it gave me the courage to say, 'buck up, child - she goes through this all the time.'  At one point my nurse came in and handed me a small cup of liquid.  He said, 'I can't stand hearing you suffer anymore.  Drink this - you'll thank me later.'  As only the desperate will do, I threw it back without a second thought.  It was absolutely foul, nasty tasting stuff.  I curled into a fetal position, as my cough slowly quieted, and sleep overtook me.  I slept for three straight hours, without so much as twitching.  It was a gift - a little bit of peace in the midst of the storm, and I did thank him.

During all of this, I was still swimming in a sea of self-pity.  I just felt sorry for myself - plain and simple.  It seemed so unfair.  This was my fourth hospitalization in two months.  This was the second time in six weeks that I'd been so sick I couldn't lift my head off the pillow.  I thought that this was why people gave up, why they decided to refuse treatment and accept death - because the physical suffering was so unbelievably hard, at some point it wouldn't seem worth it anymore.  I wasn't in that place, but I had a better understanding of people who were, a new compassion born of understanding.

And in all this time in the hospital, I had never been visited by a hospital chaplain, until this day.  I now believe she was sent to me, like a divine appointment, because of what transpired while she was with me.  For one thing, she was a beautiful person.  She had long, straight hair, a pretty face, and a lilting eastern-European accent.  She was soft spoken and gentle, when she introduced herself and asked if I wanted to talk.  God knows me.  If it had been a man asking, I would have said no thank you.  If she had had a gruffer manner, if she had been imposing, I would have said no thank you.  But she was quiet and kind, and when she asked if I wanted to talk, I felt my eyes filling with tears and heard myself saying yes.  I poured out my frustration, and she listened.  She sat by my bed and held my hand, and I felt like a little girl crying to my teacher about how I was being bullied, hoping she could somehow fix it.

When I finished, she asked what my faith tradition was, and I said Christian.  So she asked if she could pray with me, and I, of course, said yes.  I shut my eyes, and waited to hear her ask God to fix everything.  My eyes flew back open when she started her prayer with, 'Holy Spirit, I ask You to help LaRae surrender to You.' I couldn't believe it. It felt like God was telling me, "Child, I just want you to let go."

But letting go is not an easy thing.  It meant letting go of control, and letting go of the need to have a certain outcome.  I had to be content with whatever outcome He chose for me, which meant surrendering my will to His - also no easy thing.  I've heard people refer to Christian faith as a 'crutch', a 'bandaid' that we put on the wounds of life.  They have no idea - obedience to God's word can be amazingly hard.  I'm reminded of the verse which says, "Narrow is the gate and difficult is the way which leads to life, and there are few who find it."  Difficult is the way - I knew what God was asking, and I knew I had to do it.  I was in a tremendous struggle, wrestling with myself.  I wasn't sure how to go about submitting my will to His, so I gripped my hands into fists and took a deep breath.  I then let the breath out, opened my hands, and said, 'I release it.'  And, as is the way of obedience, what in one moment seemed nearly impossible, in the next - after that simple act - became easy.  I felt it go.  I felt myself relax.  I was at peace.  Although I had struggled before, and would struggle again with surrendering my way to His, in that moment - in that room - in that storm, I got it.  I could let go because He was holding me.

Do you trust Me? - June, 2007

When I went for my first dose of chemo in the infusion room, I wasn't exactly sure what to expect.  First, they talked to me.  They were going to start an I.V. for each round of chemo, as long as my veins cooperated.  They could only use my left arm, because after having lymph nodes removed from my right underarm, I can never again have a blood pressure cuff or a needle on my right arm.  They couldn't put in a permanent port, because I'd had a staph infection, and it could seed itself in the port, so the hope was that my veins would cooperate.  They were going to start an I.V., then they would inject a steroid before starting the first of three chemo medications.  They would finish with a bag of saline to clean the vein, because the chemo drugs were so caustic.  The first drug, in fact, which looked just like cherry Kool Aid, came in two large syringes.  The oncology nurse had to inject them into my I.V. little by little, because if we somehow came out of the vein, it would cause necrosis (death of every cell it touched).  The other two chemo drugs would be hung in I.V. bags.  I was warned of nausea, and had three different anti-nausea drugs at home.  I learned my hair would start falling out about fourteen days after chemo.  I could develop sores in my mouth, and Popsicles were recommended.  And then they explained to me about my neutrophil count.

The white blood cells fuel the immune system.  Within the white cells is a specific immune generating cell called the neutrophil.  And chemotherapy kills these cells.  I learned that 7-10 days after each infusion, my white count would dip, called the nadir.  So, seven days after each infusion, I would have my blood drawn to ensure that my white count was within an acceptable range.  The normal neutrophil count in a healthy person is 1500+.  If my neutrophil count dropped below 1000, I would be considered neutropenic. I was given seven shots, to inject over the next seven days at home, to stimulate my bone marrow to produce white cells, in the hopes of preventing neutropenia.   My oncology nurse assured me that she had seen people with a neutrophil count of zero, who didn't even know until their blood was drawn.  She had personally never seen anyone suffer any ill effects from neutropenia, so I shouldn't worry.  Then I was told to stay away from sick people (ha ha - I had two small children) and to notify my doctor immediately if I developed any symptoms of illness.

And so I had chemo.  It went fine, and I really felt nothing, initially.  My husband drove me there, and sat with me during my infusion, then we went to a restaurant for lunch after I finished (starting at 9 A.M. and lasting about five hours).  Then I went home and waited.

Finally, in the early evening it hit ... like a rock.  My stomach started to protest, and I regretted putting food in my mouth.  I took all the anti-nausea medication, which didn't exactly end the nausea, but kept it at bay, making it bearable somehow.  After that first round of chemo, I felt mighty sick, but never actually threw up, so I guess it accomplished its purpose.  I had chemo on Friday, and that evening I crawled into bed and stayed there for three days.  I couldn't read, I couldn't watch T.V., I simply lay on my side, and endured.  It was horrible, and hard to describe.  It wasn't exactly like the flu, or strep, or any other illness, but sort of like all of them at once.  It was as if my body was using every ounce of energy fighting the poison that was coursing through my veins, and there was simply none left to fuel any other activity.  I almost stopped thinking.  I was aware of the sheets, and how they felt against my skin.  I was aware of the breeze blowing through the open windows.  But my mind was like an empty room, with no thoughts at all.  I just lay there, waiting for the assault to end.

And it did.  I woke Monday morning feeling like the worst was over, except for having a sore throat.  I called my doctor's office, to let them know (as I'd been instructed), and tried to keep the sarcasm out of my answer when the nurse asked if I'd been 'exposed' to anything.  I just said, 'uh ... yeah.  I have two kids who are with other kids all the time - I've probably been 'exposed' to everything.'  So they started me on Cipromycin, a broad spectrum antibiotic and told me to watch my temperature.  If it hit 100.8, I was to call back.

Thursday, I started to feel truly ill.  I knew I was entering the nadir, but I didn't really understand what that meant for my body.  Around 7 P.M. Thursday evening, my temp hit 100.8, and I called the on-call nurse.  After consulting with the on-call oncologist, she said I had to come into the E.R.  They put me in the psychiatric room, with a closed door, no phone, no T.V., nothing I could use to attempt suicide.  This was the only room in the E.R. with an actual closing door, and I had to be separated from everyone because of my compromised immune system.  They ran tests and drew blood, and after a while, the doc told me they found no known pathogens, and it was 'extremely unlikely' my blood count would be low enough after one round of chemo to keep me.  I would most likely go home on oral antibiotics, which is where I started.

I, of course, believed him.  I shouldn't have believed him, but I did.  The moment he said 'extremely unlikely' I should have asked him to get my room ready.  And when he came in, a while later, with a sheepish look on his face, I pointed my finger at him and said, 'you SAID extremely unlikely.'  He was sorry, he couldn't believe how low my blood counts were, I was already sick and the diagnosis was neutropenic fever.  Not only did I have to be admitted to the hospital, I was under neutropenic restrictions - I couldn't have any fresh fruit or flowers in my room (because of the bacteria on all living things) and no visitors unless they had on masks, gloves, and gowns.  I didn't even feel that bad - my throat hurt and while at the E.R. a slight cough had started, but it wasn't so bad, so I lobbied him to let me go home.  No go - my neutrophil count was 40, and I had to stay.  (By 5 A.M., it dropped to 30, and I was so sick I felt like I might die, so I have to admit they did the right thing.)

I was checked into the medical floor at 1 A.M. Friday.  The nurse let me 'get settled' (code words for take off your clothes and put on a hideous gown, open to the back, please), and then she came in to review the drugs I was on to make sure her list was accurate.  When she started to read the names, the tears welled up in my eyes, and I totally lost it.  I couldn't hold back the emotion - right then I just felt so amazingly sorry for myself.  I put my hand up, palm facing her, and said, 'give me a minute of self-pity, and then I'll talk to you.'  She sat on the bed, said she understood - I'd been through an awful lot, and she put her arm around me while I cried out tears of frustration.  I shouldn't have had positive lymph nodes in the first place, I shouldn't have had a staph infection, I shouldn't have lost my implants, I shouldn't have been allergic to common antibiotics, and I shouldn't be here!  It was my fourth hospitalization in two months, I'd had three surgeries, and it was my second infection.  I felt abused.

When the nurse finished with me, and I was alone in my dark room (with the door closed because I was in medical isolation), I prayed - well .... some might have called it ranting, but I was directing it toward God, so it was prayer. Did He know what was going on?  Did He even care?  I had hundreds of people praying for me, did He happen to hear them?  I cried and went on until I was spent, then I tried to quiet my spirit.

And I asked God to forgive me because I knew I was behaving like a brat having a tantrum.  And I asked Him what He had for me, because I needed something from Him.  And I heard ... nothing.  Silence.  Please, God - I need something from You.  I don't think my faith is strong enough if You don't reassure me that You're going to fix this.  And I got ... nothing.  So I stilled myself, shut my eyes, pushed away the thoughts that were crowding my mind - and I waited.  I wasn't exactly in the 'right place' spiritually.  I was upset, and felt justified at being so.  But I believed if I was listening, He would speak.  And He did.  In the stillness of that dark room, I felt the quietest whisper in my heart, a gentle stirring in my mind.

Do you trust Me?

My eyes literally flew open and I said, 'what?!?'  (Thankfully, I was alone).  Do I trust You?  This was not at all what I was looking for.  But as this arrow hit the center of my heart, clearly pointing to the crux of the whole matter, I recognized the simple truth of my answer and all its ramifications.

No.  I don't trust You.  If I did, I wouldn't be having a fit because things weren't going as I planned.  If I trusted You, I would believe in your goodness and love, and I wouldn't be questioning Your actions.  I was reminded of Jesus with the woman at the well.  She asked a specific question, and Jesus ignored it, asking one of His own.  And in doing so, He hit the core of her problems, figuratively ripping a scab off a festering wound, so it could heal.  (This story is in John 4).  I, who had spoken through this entire ordeal of my faith, didn't trust my Father.  What a heartbreaking truth.  And I couldn't do it - I couldn't just force myself to start trusting, simply because I knew I was supposed to.

I told the Lord that I'd try.  I asked Him to help me - to show me what I needed to do to trust, because I wanted to but just didn't know how to get there.  And for the time being, I let it go, and mercifully - as I faced one of the worst days (physically speaking) of my entire cancer ordeal, I slept.

Something Called Faith - May, 2007

When I read back through my blog entries, I think, "Oh, my goodness, the poor girl."  For a split instant, it seems like I'm reading about someone else because I feel so distanced from it all.  I wonder how I was possibly strong enough to endure it all, and come out on the other side, intact.  And I am at a loss as to how someone with no faith in anything outside of themselves can possibly survive illness, death, or any other personal disaster, without bitterness taking root and eventually taking over their life.  It is my faith that brought me smoothly through, and not just faith, but an actual relational experience with God, my Father.

There were a few times during my cancer journey where I was very sick - so sick I couldn't get out of bed. During those times, the bubble of my world would slowly begin to constrict, shrinking as I felt worse.  As I lay in my bed, it seemed like my world ended at the walls of my house.  I couldn't concern myself with anything outside of my own family, but I could still feel connected to them as they went about their business in our home.  As my pain or nausea would intensify, my world would shrink to just my bedroom. I would become so focused on dealing with the horrible symptoms, that I no longer heard my children playing in the yard, or the phone ringing.  But if those I loved came into my room, into that bubble, we could still touch and connect.  My oldest daughter could sit on the bed and read with me (she, actually reading; I, holding an open book face down on my stomach as my eyes drifted shut). Or I could play a game in my bed with my little one - completely disregarding the rules because she was two, and I didn't have the energy to explain to her how to play.  Or my husband could lean with me against the pillows, holding my hand, saying nothing.

But then, when I was hospitalized, removed from the familiarities of home, my world would diminish until it ended at my own skin.  I remember lying in a hospital bed, eyes closed, in a fetal position, hearing people talk to me, or talk around me.  But I just lay there, hearing a response in my own head, but unable to make my mouth move to actually reply to them.  And in that moment, I would pull myself into the farthest corner of my mind, willing my bubble to shrink around me, insulating me from the physical agony.  This only happened two or three times - at my worst moments.  And inside that pinpoint of existence, I discovered something quite miraculous.  The God of the universe, Creator God - larger than all physical existence, fit into that tiny space.  I was not all alone - He and I were alone, together.

Recently on facebook, a man commented on a post and said this:  "a 'god' has nothing to do with cancer or any disease.  If 'god' is your strength?  Then so be it.  But for me and many others?  Breast and other cancer is in the hands of early detection... and the Dr's."  The fact that he feels this way is so sad to me.  God has everything to do with cancer and disease ... if ... you put your faith in Him, and ... if ... you have relationship with Him.  He is not the author of disease - please don't get me wrong.  But He is there.  There is no where that God isn't.  I came to the end of myself, my very darkest moment, where my entire bubble was filled with pain, and infection, and cancer, and God was in it, wrapped around it, completely in control of it, having everything to do with it.   His Word says, "Where can I go from Thy Spirit?  Or where can I flee from Thy presence?  If I ascend to heaven, Thou art there; if I make my bed in Sheol (the place of the dead), behold, Thou art there.  If I take the wings of the dawn, if I dwell in the remotest part of the sea, even there Thy hand will lead me, and Thy right hand will lay hold of me."

God is there - in the most awful circumstance, if we will only see Him.  He was there when I came out of surgery, having lost one of my implants to staph infection, and had an allergic reaction in the recovery room to the antibiotic in my I.V.  He was there when I was sent home, and woke up one morning with my neck, chest and shoulders covered in hives - having an allergic reaction to antibiotic number two.  My doctor told me only 2-8% of people who are allergic to one family of antibiotics, will be allergic to another family.  And since I was already allergic to penicillin, I was now allergic to three families of antibiotics, which rarely happens.

God was there when my oncologist tried to explain to me how mind-boggling my pathology report was to all the doctors who'd seen it.  Normally, breast cancer attains some size (roughly two centimeters in diameter) before it 'learns' to spread.  This takes time.  A woman can have a tumor growing for years even, and have lymph nodes that are free of cancer.  In my case, the breast tissue removed during my cancer surgery had no infiltrating cancer cells in it.  All the infiltrating cells, and a microscopically small amount at that, were removed during my breast biopsy four weeks earlier.  My cancer should have been Stage 0; it was detected at the earliest possible moment.  Yet I had an 8 mm tumor deposit in my sentinel lymph node.

In my naivety, I asked if maybe the cancer started in my lymph node, and was just spreading into the breast.  Uhhh... No.  Not possible.  Three different pathologists had reviewed my slides from the O.R. because the results were so baffling.  The Chief of Pathology had reviewed my slides to be sure no mistake was being made.  They were sure of their results, bizarre as they were.  I had no infiltrating cells remaining in the breast (only DCIS cells, which I explain in an earlier post), but I had infiltrating cells in my lymph nodes.  In my 'cancer innocence' I still didn't get what this meant, so my doctor spelled it out for me.  My cancer was moving like a brush fire, and I needed to start chemo without delay.

God was with me there.  Instead of fear, I felt an absolute certainty that He had saved my life.  If I had waited to go to my doctor until I myself had discovered my breast lump, it might have been too late.

He was with me when, a few days later, I noticed a red patch on my right breast and chose to have the second implant removed instead of risking an infection during chemo.  Although it was not infected, the wound cavity was filled with fluid, called a seroma - a breeding ground for infection.  And He was with me when I finally made it to the infusion room, for my first round of chemo.  Even after the amazingly bumpy road I had traveled thus far, I felt only peace and optimism.  The nurse took my blood pressure and started to laugh.  I had the lowest blood pressure she had ever taken in the infusion room in eight years as an oncology nurse (119/72 for anyone interested).  She told me a 'normal' pressure for them was 150/90, because patients facing chemo are scared, which raises the blood pressure.  So I simply told her the truth.  "I'm not afraid.  Should I be?"  No, no, no - it was great that I didn't feel scared.  A good attitude will go a long way towards making you well, she told me.  But it wasn't a good attitude.  It was something called faith.

God's Purpose - Apr, 2007

Well, I finally, somehow, got my sister's attention, and we made it downstairs to the couch.  I called my plastic surgeon's office, and told them what I was feeling.  The nurse asked me if the side that was hurting was red.

Now, I need to explain something.  I had been wearing  a cotton, tank top camisole 24 hours a day for 30 days.  I was sleeping in one, and when I would change it for a clean one, I would pull it over my head and put the new one on without looking down.  With the material against my skin, I felt 'held together', which is hard to explain, but I simply felt better with it on.  So, I hadn't actually looked at my chest for days.

When the nurse asked me how my left side looked, I simply pulled the top of my camisole forward, and looked.  The sides looked the same to me, so I told her I didn't see any red.  She asked if I was swollen, and I said it didn't look like it.  She asked if I had a fever, and I said I didn't.  But, because of my other symptoms, she made an appointment for me to see my regular (primary care) doctor immediately.

My sister took me to the office, and I couldn't even hold myself up, so she got a wheelchair.  It turned out that some mistake had been made, and my appointment wasn't in the book until the next day.  My doctor wasn't even in the building, so they squeezed me in with a physician's assistant who was available.  She ordered an x-ray before I came up to the examining room.  I was wheeled back to radiology, and then asked to take off my shirt and put on a gown (open to the back, please).  Why is this?  I exchanged a cotton shirt, for a cotton gown.  Who knows - but I did what they asked.  In the little changing room, there was a mirror on the wall the size of my refrigerator (at least), and the purpose for this totally escapes me.  Why do I need an enormous mirror in front of which I'm supposed to disrobe?  The question was in my mind, and the answer never materialized; however, I faced this mirror as I took my shirt off.  And I sat transfixed.  The left side of my chest was noticeably bigger than the right, and there was an area as big as my open hand that was a bright, fire-engine red - an angry, burning, ugly thing.  I touched it lightly with my hand, and it was very hot.

When I finally saw the P.A., she looked at my chest and said I clearly had an infection, either staph or strep - it was impossible to tell.  Every centimeter of my body hurt, even my pinkie toes; I was extremely nauseated; I was so dizzy, I couldn't sit up; and I had finally developed a fever.  All this was a concern, because these are symptoms of septicemia (blood poisoning caused by the bacteria) which is no picnic and must be treated.  She took a Sharpie marker, and outlined the red skin with a dotted line.  I asked about the x-ray, and she said because of the proximity of the infection to my heart, they needed to take a look.  Thankfully, my heart was unaffected.  But, the fact that she ordered the x-ray before she saw me made me realize that they assumed I had an infection from the moment I called, whereas I was totally clueless to what was wrong until I stood in front of that mirror and saw the infection's monstrous calling card staring me in the face.  And even then, because the wound itself looked completely normal, even healed, I only knew something was horribly wrong, but not necessarily what.  The word infection never entered my head, until the P.A. said it.

I was sent home with oral antibiotics, and the instruction that if the red traveled outside the dotted line, I was to waste no time getting to the emergency room.  An appointment was made with my surgeon for one o'clock the next afternoon, and I went home.

Even after just one dose of antibiotic, I felt better (like I might live).  I stayed in bed, but the fact that I could feel an improvement gave me hope.  I slept well, and at six the next morning, I got up and went to the bathroom mirror, lifting my shirt.  The red was completely contained inside the black line.  It may have been my imagination, but it seemed slightly paler in color.  It was a Tuesday, and my children, who are homeschooled, had places to go.  My oldest went to her homeschool enrichment group, and my youngest went to MOPS (Mothers of Pre-Schoolers) with a friend of mine.  My husband was at work, and I was feeling okay, so my sister went to get her workout at Curves.  I was alone in the house, and, not feeling like doing much, I sat mindlessly in front of the T.V.

Around 10:30, everything changed.  I took a breath, and had a sharp, stabbing pain on my left side.  It was sudden - the hundred breaths before that moment were pain-free.  Then, in that breath, sharp pain shot across my left side, and again in the next breath, and the next.  With a sinking feeling, I ran to the bathroom and lifted my shirt.  In the mirror, I saw two angry red fingers, wrapping under my arm and toward my back.  About two inches of red was outside the black line.  I immediately called my surgeon's office, and told the nurse who answered what was happening.  And then I innocently said, "I have an appointment at 1 o'clock anyway. Should I just come to that?"

She asked if I had someone to watch my children, which I did.  She asked if I had someone to bring me in.  My parents were five minutes away, so I said yes.  Then she said, "LaRae - I don't want you to panic, but I need you to get here as fast as you possibly can.  Can you be here in under 1/2 hour?"  I said yes, then she told me to bring my toothbrush, because my doctor would probably admit me.

What??  Admit me to the hospital?  This is NOT what I wanted to be happening.  The tension and urgency in her voice hit me like a slap, and although I felt calm and clear headed, I began to shake - violently.  My friend arrived a few moments later, with my littlest and lunch, and I know I gave her a scare.  Here was her very calm, level friend, shaking like I was having a seizure.  I was feeling worse each second, dizziness beginning to creep up on me.  I sat on the bottom step, like a lump of jell-o, until my dad got there to take me to the doctor.  All this while, my little girl was looking at me, wide-eyed, and I kept saying, "Mommy is okay, Mommy is okay."

Well, I was admitted to the hospital, and started on I.V. antibiotics.  My surgeon had to take me back into surgery, to open the wound and flush it with antibiotics.  He told me he was optimistic that he could clean out the wound and around the implant, and I would be able to keep it and be okay.  He also assured me I would feel much better after surgery.  When I woke up, I put my hand to my chest.  Flat.  The implant was gone.  I shut my eyes and said, "No...."  I had that disappointed, I can't believe this is happening, feeling.  The infection, which they determined was staph, was too far gone to save the implant.  Only about 10% of patients develop an infection after surgery, and my doctor hadn't had to remove an implant for over three years.  So I was in a very small group (removing the implant), which was already in a small group (getting the infection), which was already in a small group (having the cancer to begin with).  It seemed I had taken a wrong turn somewhere, and every complication that could arise, did.  But then my doctor talked to me in my room.  He laid his hand on my arm and said how fortunate it was that I hadn't started chemo yet.  This was Wednesday, and I was scheduled for my first infusion on Friday.  He told me that if the infection hadn't surfaced for two more days, I would certainly be in ICU, fighting for my life, because of how profoundly chemo affects the immune system.  He let me know this little, bitty bacteria could have killed me, and it was a very good thing everything happened when it did.

All of this says something about God.  I could have felt like God was letting me down.  I was thankful that I hadn't had chemo yet, but why did I have to get the stupid infection at all?  (I tend to say 'stupid' when my attitude is in the pits, and this all felt very, very stupid.)  We, as people, tend to think that God should do our bidding, answering our prayers exactly the way we want them answered, and if He doesn't - well, then maybe we don't want to believe in Him after all.  But if I learned anything during my walk through cancer, it was this - God is sovereign.  He is not in subjugation to me, and I am not in control.  He is.  Everything that comes to me, comes from Him.  I am NOT saying that God made me sick - absolutely not.  But if I truly believe that He is sovereign, then I must believe that anything that comes to me, comes through Him first, and through the shed blood of Christ, and all Jesus did on that cross - including nailing my infirmities onto it.  And if it comes through Him, then essentially it comes from Him.  This gives me peace, because anything that comes from Him, comes with great purpose.  And, anything that comes from Him, can be trusted.

Apparently, He trusted me enough to let me handle something hard.  And although the path has been difficult to walk, grueling at times, the view from where I stand is good.  From here, I can see, at least partially, His purpose in handing this to me.  I have seen my testimony touch others, and I have witnessed the core of my being become stronger and more compassionate.  He has done as He promises in His Word - He has accomplished a good purpose, even from ugly circumstances. (Romans 8:28)

Death Knocking - Apr, 2007

After my cancer surgery, I slowly adjusted to my new self.  At first, I couldn't lift my arms, and I had to do exercises each day to increase my range of motion.  The right side, because of lymph node removal, felt very tight and sore, but I did my work so that my range of motion would be as large as possible.  My wounds were healing, and my drains were eventually pulled (a yucky experience, but such a relief to have them gone).  I had to wait until everything was completely healed before I could start chemo, but in the meanwhile, I had even had saline added to my tissue expanders which gradually stretch the skin in preparation for permanent implants.

When I went in to have the saline injected, through a port under each arm, my plastic surgeon noticed that I had a very small spot on the wound on the left side that hadn't completely closed.  He looked at it very carefully, determined that it was superficial (meaning the deeper layers of the wound had healed), coated it with antibiotic ointment, and told me to keep it very clean.  Then, because of that slight opening, he only filled each side with 50 cc's of saline, instead of the normal amount of 100 cc's.

I was in a pretty good place at this point.  I hadn't started chemo yet, so I didn't know what was waiting for me (ignorance is bliss, or something like it).  I was fairly happy with my reconstruction so far, feeling fairly normal.  And I felt peace.  I had a few people tell me to be prepared for swinging emotions, that I would feel angry, that I would have moments when I needed to rage, and to cry.  But none of that happened.  After my 'break down' (or whatever it was) when I found out my lymph node biopsy was positive, I hadn't shed a tear.  I felt positive, and strong.  I can't explain that, except to say that I believe God, through the prayers of others and His gift of faith to me, simply wrapped His Holy Spirit around me and bouyed me up.    I had many people comment that I was so calm, was so strong, that they wouldn't deal with this situation as well.  All I know is, I had two children who needed to see that Mommy was okay, and God made me stronger than I was.

A day shy of one month after my surgery, on April 15, a Sunday, my husband took me 'out'.  We went to Target - okay, not a date exactly, but my first real excursion.  I'd been to church that morning, I was feeling good, my energy level was okay.  So, we dropped our kids at my parents house, and went shopping.  We slowly pushed the cart around the store, buying a few things, and then we sat at Starbucks and drank coffee.  Sitting there, a strange feeling came over me.  I said, "something's not right, I feel off."  It was that fast.  I felt fine, then I didn't.  I tried to explain to him what I was feeling.  I was experiencing a very sharp pain on my left side when I inhaled.  I asked if he could think of any metal in my implant that could be poking me.  The answer was no.  He reminded me that the implant was just a silicone balloon, with rounded edges, nothing sharp.  He asked if I felt sick, and I said no.  I just felt wrong - I couldn't even put it into words at the time, but it was as if the world was pulling away from me, and I was shrinking.  My thoughts were becoming indistinct, I couldn't hold onto a thought and focus on it.  It was like a fog was settling around me.

We went back to my parents', and because all my sisters were at the house, they asked us to stay and visit.  I told them I wasn't feeling right, and needed to go home.  Later in the afternoon, my husband went to work (one of his overnight shifts) and my sister from Michigan came home from my folks' to be with me.  We put the little one to bed, and I baked cookies (notice I didn't say made).  I scooped dough from a bucket and put it on a cookie sheet.  Then I did something that I thought for the rest of the night was a critical error.  I pinched off a little piece of dough and put it in my mouth.  This is something I'm sure lots of people do, in spite of the dire warnings about raw eggs, etc.  My sister, my older daughter, and I sat down to watch 'The Miracle Worker', and within half-an-hour, I was feeling queazy.  I was certain it was the raw dough.  And then my energy level crashed.  I didn't even have what I needed to wash the one pan dirtied baking the cookies.  Suddenly, the biggest accomplishment of my life was going to be climbing the stairs and getting into my bed.

My sister encouraged me to call my doctor.  And tell them what?  I'd made myself sick eating raw cookie dough?  I don't think so.  In addition to that, it was Sunday night, and my only recourse would be going to the E.R., which I really didn't want to do.  So I crawled upstairs and went to bed.

The next morning I woke up at 6.  My husband was still at work, so I was alone in my room, with my littlest girl in her crib.  I was so violently nauseated, I was afraid I might vomit on the floor.  "O God, help me make it to the bathroom."  This was my prayer, and in my mind, I was jumping out of bed and racing to the bathroom.  But it didn't happen.  My body didn't move.  I was so ill.  When I realized I could hardly even move, my prayer changed to, "O God, help me get to the phone."  Something was drastically, horribly wrong.  My body hurt, I was sick to my stomach, I had terrible pain on my left side when I breathed, and I couldn't even sit up.  I focused all my energy on putting my hands under my head, and pushing myself up.  After a tremendous effort, I only stayed up about two seconds before I crumpled back to the bed.  I tried calling my sister, but I knew she couldn't hear me.  I tried, and failed, several more times to sit up.  Finally, I let gravity help me, and I rolled off the bed and dropped to the floor.  I began to crawl to the top of the stairs, where it was more likely that my sister, who was sleeping downstairs, could hear me.

Now, I never thought, through any of this, that I would die.  I knew God had me in His hand, I had His promise (see the post Are You There God, it's Me, LaRae), I knew He had a purpose, I believed I still had a calling on my life.  I knew I would survive whatever was happening to me.   But the thought was there -  This is how people feel before they die.  Although I had no intention of answering, this was Death knocking.  And my prayer changed again, to the shortest prayer any of us ever pray - O God, help me, help me, help me......help.

Coming Home - Mar, 2007

Coming home from cancer surgery, I felt two things. The first was an extreme thankfulness for drugs. The other, was a fear that if I moved too quickly, I might yank something loose that was supposed to be sewn together; so, I moved very, very carefully.

Shortly after my cancer treatment was over, my daughter and I (whom I homeschool), studied the Presidents, and we chose one - John Adams - to study in depth. We learned that his daughter, in the early 1800's, had a mastectomy without anaesthesia. She wore her Sunday best, was put in a spare room with her arms and legs tied to the chair she sat in, bit down on a stick (after a dose of laudanum) and had a doctor remove her breast and sew the wound closed with instruments that had not been sterilized. The poor girl survived the surgery, avoided infection, but then died of her cancer because they had waited too long.

As strange as it was to come home with body parts missing, and in spite of the pain I experienced, I really did try to keep my perspective. Would I choose this surgery? No, but at least I had anaesthesia and Percocet to relieve the physical pain of it. Thank God I live in the age of modern medicine, and for narcotic pain meds, which I really view as miracle drugs. And I might not have my breasts, but at least they caught my cancer in time. And I might be facing a brutal plan of treatment, but at least I am alive. These were the things going through my mind. I was alive, and my goal was to stay that way.

I came home from my cancer surgery to two young children, ages eight and two. My two-year-old was still in her crib, and I would not be able to lift her for six to eight weeks. I also had three drains sewn into my wounds, one in my right underarm area where lymph nodes had been removed, and one at each mastectomy site. The drains were tubes coming out of my body, with bulbs on the ends that could be squeezed and then closed, creating a vacuum that gently pulled blood and fluid from the wounds. As these bulbs filled up, they would periodically have to be emptied, and the contents measured, and those measurements recorded, to ensure that I was bleeding an appropriate amount. Although I could empty my drains by myself, it was easier to have someone help me. During this time, my husband was working overnight twice a week, and I couldn't be alone because I wouldn't be able to lift my baby from the crib if she needed me. So my neighbor and dear friend stayed on my couch for five different nights in those first weeks, 'just in case'. I am so thankful for her. And, she is an R.N., so she wasn't grossed out helping me with my drains, which was a bonus. The other nights, my husband was my helper, and in the daytime, my parents. Then, my sister came from Michigan for three weeks, and all the while bouquet after bouquet of flowers came, until my home resembled a florist's. I received cards, and care packages, and meals, some from people I had never even met.

I was surrounded by love, encouragement, caring and sympathy. People's prayers, kind words, and practical support bouyed me up, and helped me walk a very difficult path. Nothing anyone did lessened my physical pain, nor did anything lessen my struggle; but, somehow, the support of friends and strangers lessened my burden. It made my journey bearable. I truly don't know how anyone faces this disease alone, and I thank God that He surrounded me with those all important others who make life what it is - joyful, relational, rich and fulfilling.

Cancer Doesn't Play by Any Rules

March 16, 2007. The day of my cancer surgery. The first step in a grueling journey.

We (my husband and I) had to be at the hospital at some inhumane hour - if I remember right, it was 5:30 A.M.. This was because the doctor was planning a sentinel node biopsy to check my lymph nodes for cancer, and the lead time for this procedure was about two hours.

Lymph nodes form a chain, like little beads on a string. About 90% of the breast's lymph fluid drains to lymph nodes in the underarm area. The first lymph node the fluid reaches is called the sentinel node, and doctors have found that if there is no cancer in that first node, then the lymph nodes will be cancer free. Hence the 'sentinel node biopsy'. About two hours before the surgery I was injected, with three shots around the nipple, with radioactive isotopes. Then we waited for these to drain through the lymphatic system into the underarm area. Before the surgery, I was injected with blue dye, which would color the lymph nodes blue. The doctor found the sentinel lymph node using a Geiger counter (tick, tick, tick) and where the ticking was the loudest, he cut, and looked for the blue node. Really a swift little procedure, if one can get over the fact that the stuff they put in my body had to be carried in a lead box. Hmmm...

I have very clear snapshot memories of that day. After being injected with the isotopes, I went back to pre-op to wait, and since I'd been up since before dawn, I fell asleep. When my surgeon came in to talk with me, and I jerked awake, he said, "Were you sleeping?" I admitted I had dozed off and he said, "People don't sleep in here." Pre-op was a very noisy place, and thinking this is what he meant, I said something about being able to block out the chaos. But I had misunderstood him. He meant that people didn't sleep before cancer surgery because they were afraid. And my clear memory from that moment was that I was totally unafraid. I was resigned to do what must be done, I wanted the cancer out of my body, and I was confident that I was in God's hands. So I slept.

Another snapshot memory: when my anaesthesiologist came in to have me sign the consent form, I noticed that she was about nine months pregnant. Truly - she looked like she was about to give birth. So I casually asked, "When is your baby due?" She laughed, said two weeks, and promised me she wouldn't deliver in the O.R. during my surgery. And my thought as she left was, "Like you can control that..."

My cancer surgery was scheduled to last about four-and-a-half hours. I had chosen to have immediate reconstruction, after a bilateral mastectomy. The sentinel node biopsy would be done, and if the node was positive for cancer, an axillary dissection would be done to remove a pocket of lymph nodes. Then the mammary tissue would be completely removed, along with some skin and both nipples. Then the general surgeon would hand off to the plastic surgeon, who would place tissue expanders under the chest muscle on both sides, partially fill them with saline, and then suture the wounds.

I knew my family would be told during surgery if the lymph node biopsy was positive or negative. If the biopsy was positive, the surgery would be at least an hour longer in order for the doctor to do the axillary dissection. When I woke up in the recovery room, I of course didn't know what had happened. But the biopsy is what I was thinking about when I went to sleep, so the biopsy is what I was thinking about when I woke up. I had every reason to believe the biopsy would be negative. The amount of infiltrating cancer cells in the breast was very small. In fact, the pathology report read that a "trace amount" had been seen. So, I was expecting the biopsy to be negative. My recovery room nurse told my husband that I asked her three times about the biopsy results. The third time I said, "Am I dreaming, or did you tell me my lymph node biopsy was positive?" And she called me honey, and said I wasn't dreaming.

I squeezed my eyes shut and felt tears fall down the side of my face into my ears. I really couldn't believe it - it was the worst news. I thought my surgery would be 'it' and now I knew I was probably facing chemotherapy. When the orderly came to wheel me to my room, I told him my biopsy was positive. And I told my nurses, and my husband, who already knew. When the doctor knew there was cancer in the node, my family was told, and also informed that my surgery would be longer, actually lasting six hours. And then when my parents came in I told them, and other family members, and all the while I was crying, crying, crying. At some point I caught my husband giving me a sidelong glance, full of concern, like I was possibly having a breakdown. "Are you okay?" he asked. No - I am so NOT okay. During the night, I remember a physician's assistant sitting on my bed, holding my hand, as I bawled about my lymph nodes. I simply could not get a grip. I found out, much later, that one of the side effects of anaesthesia, experienced by some people, is a reduced ability to control emotion. In reality, it made me a basket case, for about a day. When I woke up the next morning, I looked at my husband, who had spent the night in my room with me, and said, "I'm okay now."

The day after my surgery, my plastic surgeon came into my room to check on me. He asked how I was and I said I was so, so disappointed. I know he thought I was talking about my reconstruction, because he (rather gruffly) asked what I was disappointed about. And I told him I just couldn't believe my lymph nodes were positive. His face softened and filled with compassion. In that instant, I felt myself become a real person to him, not just a patient, and he became my ally. And he told me, " Cancer doesn't play by any rules. Concentrate on doing what you have to do to get well." I realized that I was playing a game with an opponent who cheats. I would never find a sense of fairness in this experience. And it helped somehow to accept that.

In spite of an extreme level of pain, and muscle cramping across my chest (no fun), I had an overly cheery nurse drawing smiley faces on my board and writing under patient goals 'going home today.' I must say, throughout my cancer ordeal, my nurses were, for the most part, absolutely wonderful. This nurse, however, failed to actually see me. When I told her I didn't think I was ready to go home to my children, she just smiled, assured me I was and that I'd soon be up on my feet and out of there. So I told my plastic surgeon, my newest ally, and the next thing I know, said nurse marches into my room, without looking at me, and erases the smiley faces on my board. Then she changes patient goals from 'going home' to 'pain management', turns on her heel, and marches out. I stayed another night, which made all the difference in the world. I felt like I could present a happy face to my children, which is critical, as any mother knows. Three cheers for Dr. H, the doctor who made me cry (see the post Dignity), and the doctor who helped me stop crying.

Thinking

A couple of things have happened since I last posted that have gotten me thinking. The first is that a girl from my high school graduating class died just under two weeks ago. She died of breast cancer. Since my class had over 600 people, I didn't actually know her. I saw some postings about her death on Facebook, and when I read them, I sat at my computer and cried. I cried for her because I know what she faced as this horrible disease slowly sucked her life away. And I cried for her family who is feeling cheated because someone they love was taken from them too soon. And if I am honest, some of the tears were probably for myself, because this evil has touched me and left its ugly fingerprint on my life.

When I was first diagnosed with breast cancer, my encouraging and loving friends said many things to me, like, "At least they caught it early," and, "Breast cancer is so treatable - it's not a death sentence," and, "Even women with positive lymph nodes end up being completely fine." All of these statements may be true on their face, but I am surrounded by stories, like the story of this girl from my class. Or the story of my Aunt Ruth who died of breast cancer in June, 2009. Or the story of the woman I prayed for at church Sunday whose breast cancer has metastasized to her bones twelve years after her original diagnosis. Breast cancer is a sleeping giant. Unlike other cancers, it can lie dormant for several years and then, suddenly and unexpectedly, rear its ugly head. For anyone who has been personally touched by this villain, life becomes an eternal game of watch and wait. My doctor expects me to do a self-exam of my chest wall and axillary and super clavicle (under the arm and under the collar bone) lymph nodes every WEEK. What exactly I'm supposed to feel, I don't know. It feels lumpy and bumpy to me because my anatomy has been completely altered, and I have scar tissue. When I tell my doctor this, he says what I am looking for are changes. So I find myself thinking - Oh, oh - was this bump here last week, have I felt this before, is this new, has this changed? I've decided the anxiety isn't worth it, so I simply don't do the exam.

The second thing that has happened is that I had my final medical procedure for breast reconstruction. It has been a long road starting with my cancer surgery in March, 2007, and ending Wednesday with surgery number seven. It was surgery per se, but it didn't even involve cutting. I had areolas tattooed onto my body - something I never really envisioned happening, and didn't even know DID happen until it happened to me. As I stand in front of the mirror and look at my 'new parts', I wonder, is this really me? Did this happen to me? I feel far removed from the brutality of what I went through. When I hear someone else's story, for instance, a woman facing a mastectomy, I think, "Oh, the poor girl, how is she going to cope with that? Oh wait, I did that. I'm okay." It's almost as if I forget (almost). Or when I pray with someone who is facing cancer and all that means, and my eyes fill with tears and I choke up, and I think, "Good grief, what is your problem? Oh, right, I've been there, I know what they're facing."

When my husband and I sat in the restaurant after my first plastic surgery appointment, we felt shell shocked. It was hard to grasp that I was going to be dissected and put back together like Frankenstein. I now recognize that the emotion that so overwhelmed me outside my doctor's office, that I wrote about in my last post, was grief. I was grieving the loss of my body, the loss of control, the loss of my life as I knew it. But at that moment, all I knew was that I felt raw, ripped apart, beat up. When I compare that with the distance I now feel, I am thankful that God has created us in such a way that our memories fade, become soft around the edges. We can go to them and pick them up, when we want or need to remember, but for me it's like I'm remembering someone else's life, or some story I read. I no longer feel the horrible, overwhelming emotion. This is good, it's a part of becoming well.

And so I've been thinking. I choose not to be filled with sorrow over all I've lost, or anxiety about what might lie ahead. I try instead to be filled with joy, to obey the command, "Rejoice always!" My mantra is Find Your Joy, and so I find mine, in my family, in my friends, in my faith, in my Lord, in small things, in kisses and "I love you," in togetherness, in laughter, in hope. Where do you find your joy?

Dignity - Mar, 2007

After making the decision to have a bilateral mastectomy, but before my cancer surgery, I had a consult with the plastic surgeon to discuss the possibility of immediate reconstruction. I had done some research, so I basically knew what my options were. They could cut my belly, creating a breast mound with fat and muscle from there. Not appealing, since I would never again be able to do a sit-up. They could cut my back, tunneling latissimus dorsi muscle, skin and fat from my back under the skin of my underarm, creating a pocket in front to fill with an implant. Not appealing, since my back already would ache when I played the piano for too long, or did dishes. The third option was to place tissue expanders under my chest muscle at the time of my cancer surgery. These would be like balloons that would be gradually filled with saline until they were the appropriate size, then a second surgery would be done to replace them with silicone or saline implants. This seemed like the best option to me, because it was the least invasive, it involved the least amount of cutting and pain, and just seemed to be the least horrible alternative, realizing, of course, that none of the alternatives could actually be classified as good.

So I naively went to this appointment, thinking I would tell the doctor what I had decided, he would tell me what to expect, and I would go to breakfast with my husband who had thankfully come to the office with me. I had no premonition that this was going to be one of the worst days of my life, worse even than the day I received my diagnosis, worse than talking to my general surgeon about the cancer surgery itself. I didn't know what to expect, so as the meeting with this doctor began to play out unexpectedly, I struggled to maintain my composure and hide the fact that I was thrown completely off balance. Although I eventually developed a rapport with my first plastic surgeon, and ended up liking him immensely, at this moment, on this day...well, not so much.

First of all, they have me strip and put on a gown - they allow me to keep on my socks. It's very difficult to feel strong and in control when the person you're dealing with is dressed, and you're not, so I'm already feeling vulnerable. The doctor comes in, shakes my hand, and lays me back on the table so he can examine the affected breast. Then I stand on a stool so his face is chest level, he opens my gown, takes out his tape measure and pen, and starts to make and record very precise measurements of everything. He is very matter-of-factly discussing my breast shape, size and position, the amount of belly fat I have (to determine whether I am even a candidate for the belly-cutting surgery), and my options. Add to this the fact that his nurse and my husband are in the room, and for everything the doc says and does, he turns to my husband to make sure he's following, and now it's starting to feel a bit like a science lecture, with me playing the role of specimen. I find I can no longer look at him while he's talking to me, and so I find a spot on the wall where I can focus. My husband asks if the doctor has any pictures of results that we can see, and he hands us a medical textbook to look at, warning us to avoid the pictures of actual surgeries. And there we are, looking at headless pictures of topless women, each with one real breast and one reconstructed breast, trying to decide which we like best. I have an otherworldly feeling, like I'm glimpsing myself doing this in some parallel universe, but it's not happening in my real life.

And then, before the meeting is over, they have me drop my gown and stand completely naked in front of a blue sheet, so the nurse can take photographs. I never did get an adequate explanation of why it had to be this way, why I couldn't put on my jeans, or even my undies, for this part. She assures me the pictures will be from the neck down, will never find their way onto the Internet, and are for their securely kept records. My throat starts to ache with the strain of unshed tears. I find I am violently gritting my teeth, and very deliberately blinking to keep the tears at bay. They let me wrap the gown back around myself as the doctor finishes up what he needs to say, but I no longer comprehend the words. I know if I speak, I will lose it, so I'm mutely nodding when it seems appropriate, but mentally I'm yelling at him, "Go, go, go, go, go..." I desperately want him gone - in that moment I despise him, I despise the room I'm in, and it's taking everything I've got to hold it together. But I am bound and determined - I will not cry in front of this man. He has measured me, marked me, photographed me, and I know if I cry, it will be the thing that finally shatters around me any remaining dignity I have.

Finally, it is over. I'm alone in the room with my husband and I raise my hand, signaling to him, "Don't talk to me - don't touch me." I put on my clothes, controlling the urge to bolt. I try to walk out of the room at a normal pace, when my brain is still screaming, "Go, go, go, go, go..." It's at this point, the moment I start to move, that the turmoil within me reaches a saturation point and I feel the tears prick in my eyes. No amount of blinking can hold them back now, and my husband pulls me toward him, protecting me with his body and arms from all the people who have to step around us, as I let the ugly sobbing run its course. And then I say the only sensible thing I can think of. "Let's go to breakfast." And so we do, gradually steering ourselves back to a sense of normal.

During this time, in an attempt to keep my perspective, I would joke that at least I wasn't losing something vital, like my nose or my right hand. But I was losing something, despite the joking. I will never be thankful for my cancer. I will never count my cancer as a blessing. But I do recognize that this ugly and difficult path, although full of loss, has brought me somewhere, and that somewhere is a good place, a place where I recognize that what I've lost wasn't necessary for me to live a life full of joy and purpose. And that, is a blessing.

We

February, three years ago, I was waiting to have a breast MRI. Although it was an optional test, and would cost us several hundred dollars out of pocket, I chose to have it. (My wonderful husband, in spite of the money, said to do whatever I had to do - one of the many reasons I love him.)

I had cancer in my right breast. Throughout the breast I had DCIS - ductal carcinoma in situ. This cancer is in the milk ducts and is like cancer inside a sealed envelope. As long as the envelope stays sealed, the cancer is actually harmless. The reason DCIS is removed, is because of the potential it has of becoming something worse. In my case, the corner of the envelope had ruptured, and a mass of DCIS cells had formed, creating a lump at the base of the nipple which could be felt. In addition to this, the breast biopsy had shown trace amounts of infiltrating cells, in an amount so small that they couldn't tell anything about it except that it was "there". It seemed that the DCIS was just beginning to mutate into cancer cells that were more dangerous; cells that could spread.

So, the decision was made to have the right breast removed - a unilateral mastectomy. My surgeon talked to me about the option of having a prophylactic mastectomy, which is done to prevent breast cancer from occurring on the unaffected side. The feeling was other worldly, sitting in a clean office, calmly talking with a white-coated gentleman wearing a dress shirt and tie about cutting off parts of my body. And there was no way, absolutely no way I was giving up my left breast if I didn't have to. If the left side remained untouched, then I maintained some modicum of control. I had absolutely no control over what was happening in me, but I did control my choices. They could not do anything to me that I didn't authorize, and somehow, in withholding permission - in saying, "No" - I achieved a sense of power in a situation in which I was otherwise powerless. And I thought that if I had the unilateral, I could just focus on the side that was still me, the side with feeling, the side without scars, and ignore the "missing" side. Was this rational? I don't know, but it was my reality and I became determined to keep the left breast.

This is the reason I was waiting for a breast MRI. I wanted to make sure the left side was unaffected, and for young breast tissue, an MRI is the best scan for seeing even the smallest abnormalities. But I had to wait until the tenth day of my cycle to have the test, and then I waited two weeks for results. The MRI showed "diffuse abnormality" on the right side, but nothing on the left. The left was cancer free. You'd think I would have yelled "woo-hoo", and jumped up and down because I was getting exactly what I wanted.

Except that something happened while I was waiting.

While I was waiting, someone my husband works with told him to tell me to do everything I could and take no chances - because his wife had had a unilateral mastectomy, and five years later the cancer came on the other side, eventually ending her life. While I was waiting, I found out my aunt's breast cancer which she had had years before had become metastatic - stage IV, a death sentence. I didn't know it then, but she would lose her battle in June, 2009. While I was waiting, my doctor ran the numbers and let me know that even if the left side was unaffected, I had a 45% chance of developing cancer on the left in my lifetime. But more persuasive than any of those things, my eight-year-old daughter took my hands, looked me in the eye, and said, "Mommy, do whatever you have to do so that we never have to go through this again." We.

In spite of being caught up in what was happening in my own body, I knew there was a we involved, not just a me. Obviously, I knew what was happening affected my family, my friends. I knew there was a we when people gathered around me at the altar to pray for me, and when I opened my dry eyes, theirs were filled with tears. But the we that was that eight year old, whose eyes were filled with innocence and trust, trumped them all. She changed my mind in an instant. In that moment, I let go my need to control, and chose the path of precaution.

Do I wish it were different? Absolutely. There are times when I look in the mirror at my scarred body, and I wish. But as the saying goes, "If wishes were horses, beggars would ride." Wishing changes nothing. I learned, a short time later, that I had made the right decision. My cancer was aggressive - it had already spread. Doing "everything" was the right thing. So I try, not always successfully, to be grateful for those scars. For they remind me, if I let them, that every single day is a gift. Every single day is one more day of we.

Are You there, God? It's me, LaRae - Feb, 2007

If you had asked me, before I had cancer, how would I feel if I ever received a cancer diagnosis, my answer wouldn't have taken any thought at all. Terrified. This, however, isn't what I felt at all. I was amazed at my own lack of fear. People commented to me at the time, that I was so brave, so courageous. But that wasn't true - I was neither of those things. I simply didn't feel afraid. What I did feel was something like this - I felt utterly alone, cast adrift, heading without a rudder into stormy seas.

It was as if the little boat that was my life, which had always been anchored in a safe port, had had its mooring lines cut, and was drifting away. The shoreline was getting smaller and smaller, and I had no means of getting back. And I found in that moment, that I wondered if God knew what was happening to me, and if He did, did He even care?

I am a woman of faith. I believe, fundamentally, in the core of my being, in a God who loves me, who wants relationship with me, and who has provided a Way for me to have that relationship. But I have to admit, if I am completely honest, that in this moment of crisis, I struggled to believe it. And the reason is this - He was silent. I felt no comforting Presence, no peace in my spirit. And so I sat on the edge of my bed, and cried out to Him - Are you there? - Do You see what's happening? - Do you care what's happening? And then, typical of who I am, once I had quit swimming in my self pity, I approached Him more reasonably.

"Lord, forgive me for my lack of faith. I simply need to hear from You. I need something, anything, even if it's 'Get a grip, already, woman.' I just need to know that You are present in this situation, that You are not standing far off, with Your back turned, refusing to see me." And so I quieted my spirit, and I waited.

And waited.

And waited.

I have never heard God speak in an audible voice. I have never seen a vision. I was not looking for a mystical experience. However, God says, "I love those who love me; and those who diligently seek me will find me." I believe, and have experienced, that when I truly seek Him, with quiet expectation, patiently waiting, He always shows up. Sometimes I suddenly think something I was not thinking before. Sometimes, my heart is stirred within me. This time, like a fully formed thought, it just dropped into my mind. "Psalm 91. Read it."

I got my Bible, looked up the Psalm, and started to read. It was all good stuff, but I wasn't sure what God wanted me to take away from it. Until the end, when the last three verses jumped off the page at me. I knew that I knew that I knew - this is what He had for me, and it was so much better than, "Get a grip, already." I read the verses again, and then I read them aloud, exchanging the masculine pronouns for feminine ones. It went like this:

"Because she has loved Me, therefore I will deliver her; I will set her securely on high, because she has known My name. She will call upon Me, and I will answer her; I will be with her in trouble; I will rescue her, and honor her. With a long life I will satisfy her, and let her behold My salvation."

There is something about speaking these words aloud that imbues them with power. I felt strength enter my heart, like steel. It had no force of its own, but it was solid, unmoving, completely unbending. And I knew that God was not standing far off, with His back turned, refusing to see me. He was standing, face to face.

It is notable that the first get well card I received, which came from my mom's best friend, had Psalm 91:14-16 written in it. And then two days later, I received a stack of note cards from a friend, each with an encouraging word written on it, and the first one - the one on top - contained Psalm 91:14-16. It was as if the Lord were saying, "Do you get it yet?" I got it. I knew what had happened. I sought, and I found Him.