Surgery, you had to be second.

When I was first diagnosed with breast cancer, I wanted to have surgery right away. While I tried to learn about my disease on the phone with a friend of mine who is also a doctor (shout out to my favorite cardiologist), my eyes darted around our Disney hotel room, searching for something I could use to just cut the cancer out of me. When you learn that you have cancer, you just want it out.

I was really hoping I would have one of the breast cancers where you get a mastectomy and/or radiation and you’re done with it. Neither of those things are easy, but I was absolutely terrified of chemotherapy. And rightfully so. It was hell.

Unfortunately, I was diagnosed with triple negative breast cancer. Not just breast cancer, but the worst kind. Triple negative breast cancer is a tricky little bastard that likes to metastasize quickly in bad places like the bones, lungs, or brain. In fact, as my doctor-friend explained, it might have been throwing off micro-metastasces already. They could have been circulating in my blood at that very minute and neither surgery nor radiation would fix that problem. I needed aggressive chemo to hunt down those little cells and kill them before they had a chance to kill me.

With TNBC in the United States, usually surgery is after chemo. Doctors do it this way so they are able to determine whether the cancer responded to chemo. There are no other treatment options for TNBC other than chemo and radiation, so if it doesn’t respond to the first chemo cocktail, they need to move on to something else. After surgery they are able to make this assessment.

Surgery was always the easier part of this for me. I decided the second I heard the word “cancer” that I would have a bilateral mastectomy. To me, the prospect of losing my breasts was a hell of a lot easier than the prospect of losing my hair.

I desperately wish that I could have just had the surgery when I was first diagnosed. I have had surgery before, a nasty abdominal surgery that left me with a giant scar from my sternum to my navel. I would have handled it, flipped my long hair, and moved on.

I am insanely jealous of the women that find out they are at a heightened risk for cancer and are able to have a preventative mastectomy. On social media and in breast cancer groups these women call themselves “previvors.” It’s a whole different issue that comes with a lot of other difficult choices. I appreciate how hard it must be to time the preventative surgeries and the agonizing choices that must go into it all.

I would have done a preventative mastectomy in a hot second.

But preventing cancer was never a luxury I was afforded. I did everything right and got cancer anyway. These groups are hard for me and I had to back out of them because it’s emotionally triggering to watch someone give post-mastectomy work out tips with mascara slathered eyelashes and a giant top-knot. Where is my sister who is bald AF or has a post-cold-capping-decaying-corpse-like-hair situation like mine? Where is my girl that suffers from ongoing joint pain from the red devil? Where is the woman with a bald face who has already had her soul hollowed out, kidnapped, and held hostage by cancer?

To just have had the surgery then, back when I was myself.

Now, after five months of chemo, I feel differently. I don’t look like myself and I sure as hell don’t feel like myself. I feel stripped down. Tired. Angry. Empty.

Cancer already took so much from me and it just seems wildly unfair that I need to go have surgery right now, after everything I have been through. I have a few eyelashes hanging on for dear life, I lost eighty percent of my hair, and soon I’ll lose the ability to ever sleep on my stomach again.

Can I just complain for a second about how awful having no eyelashes actually feels? Aside from the fact that I look wrecked without the help of what feels like aggressive stage makeup, I have realized how practical eyelashes are.

Were.

It’s allergy season, which is extra cool. I can never tell if one of my last three eyelash hairs is irritating my eye, if a coronavirus shaped pollen particle landed in it, or if a bug flew directly into my eyeball.

I should be elated because chemo is over right?

But I can’t shake the funk. Statistically, my overall survival (abbreviated as OS if you read medical journals online like I do) depends a lot on pathology after surgery. It’s going to take a long time to get those results. Okay, maybe not a long time in the era of the never-ending quest for a covid-19 vaccine, but a week to ten days. That amount of time is an eternity when you feel like your existence is riding on it.

Even if I have a pathological complete response (PCR) to chemo, I am not out of the woods. I have encountered numerous women who had PCR and within a year they had mets.

One third of all early stage breast cancers come back as stage four. Stage four breast cancer is called metastatic breast cancer. Metastatic breast cancer is terminal. It kills. (It also happens to get a lot less attention and funding than all the “early detection saves lives” campaigns and some women, young women, are diagnosed right at stage four. But this is a post for another day. I have FEELINGS about this.)

With TNBC, a stage four diagnosis has an average survival of fourteen months. I know I’m not supposed to think about this and I’m sure someone will lob some toxic positivity my way, but facts are facts. I can’t help but wonder which side of this statistic I’ll fall into, and whether having this awful surgery after five months of chemo will make a difference or just end up being more torture that robs me of the enjoyment of precious time.

To add to my stress I have to worry about picking up covid-19 in the hospital. I can’t even just relax for one day and order cafeteria food, I have to be careful not to catch the global pandemic.

It doesn’t help either that the world seems to have gone mad. 2020 is a raging dumpster fire. I always intended this blog to be about everything non-political, but it’s hard to keep it that way today. I have strong feelings about all of it. I’m a lawyer and a recovering political science major.

So, yeah. I have jitters.

The one point I keep returning to is that every person’s cancer experience is different. Statistics are that there is a 3% likelihood of getting breast cancer in pregnancy, but that happened to me. Statistics are that about 1.2% of the population has a peanut allergy, that also happens to be me. Intestinal ileus of the kind I had, too rare to even measure.

However, statistics are that about 25% pregnancies will end in miscarriage, but I had exactly three pregnancies and three healthy babies. Despite all of my weird and bad luck, there have been things that have gone right for me. Hopefully those three kids that I brought seamlessly into this world will have the good fortune of keeping their mother.

I can’t control any of it. All I can do is try to enjoy my last few nights sleeping on my stomach.