Monday, March 7, 2022. The dizziness was far worse today than yesterday. I felt like I was walking crooked. I tried to sit upright and work from my home office, but the room kept tilting sideways. Miah looked into my ears with a flashlight and thought something looked wrong. He didn’t know what he was looking at, but his response freaked me out enough to immediately call Primary-Care-Provider-Doctor A and ask for urgent help. My PCP wasn’t available, but the receptionist booked me to see Physician-Assistant L at 9:50 AM.
I messaged my supervisor and co-workers to let them know I was having a spell of vertigo and would be heading to the doctor shortly. I didn’t know what I was in for and told them I’d try to work later if I could, but my day was uncertain at this point. While I was sending my Team’s message, Miah was across the hall in his office, doing the same thing to notify his colleagues and project team.
45 minutes later, we hopped in the car and headed to the appointment. I felt too dizzy to drive, so that’s why I needed Miah again. I’ll never forget the look of sheer disgust on his face as he drove those 15 minutes to the clinic. I know he wasn’t disgusted with me, but with the sudden unbelievable, unpredictable nature of our lives – abrupt, jarring, sickening.
Physician-Assistant L ironically is the same provider who diagnosed my vertigo as inner-ear crystals in summer 2019. So now I think of her as Vertigo-Lady. She promptly joined Miah and I in the exam room. We talked over my recent cancer diagnosis and worsening dizziness. Miah asked if stress could make vertigo worse, and Physician-Assistant L nodded enthusiastically, “Yes, it absolutely can.”
She performed a neurological exam (everything was normal), followed by a special maneuver to trigger involuntary eye movement, which is a check for inner ear crystals. This maneuver involved having me sit upright on the exam table and be lowered into a horizontal position, while simultaneously tilting my head to the right or left. My eyes didn’t move involuntarily, so there was no certainty of inner-ear crystals. Physician-Assistant L thought it would be best to order a head MRI to rule out metastasis of the cancer. To help with the symptoms, she thought a dose of clonazepam might help to bring my stress down. I still had plenty of tablets at home because I was using them sparingly.
She ordered the MRI to be scheduled “as soon as possible,” and there was an opening the very next day. “I’ll take it,” I said to the scheduler, surprised at how quickly they were able to arrange this imaging. I was now going to visit not one, but two MRI machines this week.
Tuesday, March 8, 2022. Fortunately, I felt well enough to work in the morning and get a few things done. I wanted to keep up and remain accountable. My job is so much more than a means to an income. I love to work. I love being able to work. I love the routine and stability of it. I love the problem-solving and collaboration.
At noon, I shut down my laptop and took another clonazepam to prepare for my next MRI encounter. Miah drove me to the clinic – a different facility this time, known primarily for physical therapy and orthopedic rehabilitation services. The place has a state-of-the-art swimming pool and workout facility, and I even had a fitness membership there about 10 years ago. Arriving didn’t feel scary. This was just a workout center where they happen to have a couple MRI machines.
An acquaintance of mine works the reception desk, and I was hoping she would be there so I could say hello. She was! I marched right up and announced I was there for a head MRI and told her I was dealing with a breast cancer diagnosis. She frowned and shook her head, sorry to hear the news. We kept our visit short. Miah and I took the elevator to the second floor and went to the medical imaging waiting area.
The MRI technician came and got me right away. As she led me through the vestibule, I could hear an MRI machine robotically knock-zinger-beep-clanging away in the room next door. A second technician said hello and introduced herself. These ladies weren’t as young as the sweet girls who did my breast MRI, but they were just as friendly. I needed a contrast IV for one of the images, but the dye was injected manually by the technician this time. The whole procedure was uneventful. The clonazepam guarded me from claustrophobia and anxiety; I just had to withstand the deafening sounds of the massive machine. They gave me ear plugs and headphones, but the monster’s knock-zinger-beep-clanging is a force of decibel that cannot be deterred.
The final scan crooned its magnetic zinger-clang melody, and then the table moved forward and released me from the tunnel. I hopped up so the technician could remove my IV and send me on my way - back to the waiting room, back to Miah, back to home.
That evening, two messages arrived in my secure health system app. First, a response from Primary-Care-Provider-Doctor A. She discovered there are pain doctors who work within the cancer center and are better aware of the intensity of the situation for chronic pain patients like me. She’d reached out for consult and was waiting to hear back. She also sent in a prescription for the correct dose of my preferred pain medicine so I would be all set for pain control after my third biopsy.
The second message subject looked familiar.
Subject: New Test Results
It couldn’t be the head MRI results already, could it? But it was!
Well, that was a relief. I guess I probably did have inner-ear crystals again and that was causing the vertigo. Physician-Assistant L had said sometimes the maneuver test doesn’t trigger involuntary eye movement even though crystals are present. I was also glad to have gotten my head checked regardless. My head hurts all the time from migraines, and it had been longer than I could remember since my last head MRI. I've heard stories of people thinking they have just another migraine, but it’s something more serious. At least now I had some extra reassurance – my head was fine.
Wednesday, March 9, 2022. I started chatting regularly with College-Neighbor-&-Hometown-Classmate E on Facebook Messenger. A couple days earlier, she had posted an image of herself in a hospital gown, and shared about having two body parts removed, soon to be replaced with two new ones. I privately messaged her to inquire. She’d had a double mastectomy and was getting reconstruction. She didn't have an invasive cancer diagnosis, but she had large amounts of atypical ductal hyperplasia. She sent me this infographic to help explain cell changes from normal, to atypical, to cancer.
Due to her other health issues, she couldn’t risk an invasive cancer because her body wouldn’t be able to handle radiation therapy, so she chose the double mastectomy before it could progress any further. I was happy to chat with her and ask questions. Her messages were encouraging, and she was willing to share her experience. She told me what to expect for the MRI biopsy. It was like the mammogram guided one, except with the MRI machine instead. I didn’t love the idea of being all socked in there again, but I had to do what I had to do.
College-Neighbor-&-Hometown-Classmate E provided exactly what I needed to hear, yet another roar of support from the Universe.
8:00 AM. Thursday March 10, 2022. Miah parked the car at the health facility where I’d had biopsy #1, later diagnosed as breast cancer. “I hate this place,” he said, as we walked in. It was a smaller facility and not anywhere near the vicinity of the hospital maze, so I personally preferred this location. But I understood Miah’s point. In his mind, this would always be ground zero.
My appointment was at 8:15 AM, so I checked in and we went to the waiting room. I pulled out a book to read as I waited but a nurse called me back almost immediately. She wasn’t my favorite Nurse L, but rather someone else whom I hadn’t met before. She took me to a small office and explained she was still in training and another nurse was going to be helping her. The second nurse came in and together they pulled up my chart and went through the consent process. I had to use a tablet to review and sign my consent form. I knew how to do it better than the trainee nurse because I had just gone through the same process at the other breast clinic for last week’s biopsy. She was impressed with my knowledge!
The radiologist performing the biopsy came into the room and introduced himself. This man, Radiologist-Doctor W, was much nicer than the doctor for biopsy #1. He was older, seemed humbler, and just more chill, than the other guy. I told him I was still bruised and sore from last week’s biopsy and explained I had pain medicine to take when I got home. For this procedure, I did not take any clonazepam. Similarly, to biopsy #2, I wanted the ability to take pain medicine as soon as I needed it. I knew it was risky to attempt to tolerate the MRI machine stone-cold-sober, but I was willing to grit my teeth and force myself through it somehow. I was also kind of getting used to biopsies at this point. Three biopsies in less than two months had toughened me up.
Trainee-Nurse took me to the MRI suite where I changed, waist up, into a gown. She inserted an IV – contrast dye, automatic plunger system – and walked me to the MRI machine. She wasn’t a trainee in the sense of nursing, but rather a trainee at this medical facility. I climbed a couple stairs to a raised MRI table and prepared to lie on my stomach, feet facing the tunnel. She gave me ear plugs to insert and protect my hearing. There was only one popsicle tray this time, for my right breast. Left side was just a flat surface. This table was more comfortable than my first breast MRI. There was extra padding for my ribcage. Maybe they do that on purpose because they know they are going to hurt you with the biopsy part? Next, Trainee-Nurse socked in my right breast. What I mean by this is, she squashed my breast vertically between two plates. It felt like a mammogram, except while lying on my stomach, very weird. I remember it hurt because I was still bruised from the previous week’s biopsy. But I just kept toughing it out. I said to Trainee-Nurse, “I haven’t taken any medicine to relax me. I want to be proud of myself for doing this completely sober. I think that will feel like a big accomplishment for me.”
She said something encouraging, like I could for sure get through it. After she had thoroughly squashed me in, she handed me a small rubber bulb that I could squeeze to alert them if I needed to stop the scan for any reason (this step occurred for the previous MRIs also, but I forgot to mention it). Then she left the room to begin the pictures. The table moved me feet first into the tube and the familiar knock-zinger-beep-clang song began to play. I think they took 3 or 4 scans, including the automated dye-plunger scan. For this plunger’s release, there was no pain in my arm, thank goodness. It was way better than the medical research center’s plunger. Then the table moved me back out of the tube. We waited. After several minutes, Radiologist-Doctor W entered the suite and checked the pictures to locate the biopsy target. The images were good, and he knew where to map his needle. He came over to me and sat on a stool to my right side. Now I understood why the table was raised – it was for his benefit. He used a sort of graph that was built into the plate squashing my breast. First, he numbed me, then waited for it to take effect, and then inserted a catheter to take the sample. I felt something happening to me, but I didn’t feel any pain or discomfort. I was mostly thinking, “I am doing this! I am not on drugs, and I am doing this!”
Next Radiologist-Doctor W disappeared back into the room with the computer screens and sent me back into the tube to take another picture. He needed to make sure the catheter was placed correctly at the target spot. Knock-Zinger-Beep-Clang played again. The table moved me out of the tube again. Radiologist-Doctor W came back into the room again. This time, he announced, “Ok, I’m going to take the sample now.”
I asked if there would be another champagne bottle cork pop sound and he said, “No, this uses a vacuum suction device.” Ah, so it would be the same sound as the ultrasound biopsy. Sure enough, that’s exactly what I heard as he took the sample. I lay there, cheering myself in my head. He extracted the sample and then placed the marker clip. I felt more pulling and pressure as he finished this part and taped a temporary dressing over the site.
After that, I went back into the machine for a final listen to Knock-Zinger-Beep-Clang. I guess to make sure the song mix was ready for mastering. Just kidding. They had to check the marker clip or something like that. Radiologist-Doctor W returned and said everything looked good, they had taken the sample, and he was all finished. He wished me good luck with everything. I thanked him for taking care of me and told him I hoped the rest of his day was nice for him.
While having me sit upright on the MRI table for a good 5 minutes, Trainee-Nurse held pressure on the biopsy site until the bleeding stopped, and then taped me with Steri-Strips. She removed my IV and helped me down off the table. But I couldn’t get dressed yet because I had to get another mammogram image first, as another check of the marker clip. Trainee-Nurse took me to the mammogram room where I met up with Technician K. Remember Technician K from Post 3 – Diagnostic Mammogram & Breast Ultrasound? Well I remembered her, and she remembered me!
“Guess what? I have 5$cking breast cancer,” I told her.
“Oh no,” she was bummed, but I could tell it wasn't a surprise to her, being that she works at a clinic where they regularly diagnose women with the disease.
“Yeah, and this is my third biopsy. They found more suspicious spots and couldn’t get them with one biopsy method. So I still don't know what my treatment is going to be yet,” I voiced my frustration and she nodded with empathy.
She connected the clear mammogram plate onto the machine, helped me into position, and took the image. Afterwards, she took me to the same room where I had rested after biopsy #1. I plopped into the big recliner chair and waited for my ice pack. Technician K handed me a small ice pack and sat down to chat. I filled her in on my eventful last month and a half.
The pain wasn’t horrible, but it also wasn’t nothing. I hadn’t experienced the best pain control for the first two biopsies, and I wasn’t going to wait around and see if it got any worse. I was taking my pain medicine when I got home no matter what. After about 20 minutes of resting, Technician K said I was ready to get dressed and go home. She gave me the after-care instructions to add to my collection of paperwork at home. I walked to the hallway waiting area near the elevators, where Miah was excited to see me.
“Babe, that was fast! I wasn’t expecting you this soon,” he said. It was still mid-morning.
“Yep, it all went fine,” I told him. We left ground zero and returned home to greet our always-delighted-to-see-us border collies. I took my pain medicine and rested. Childhood-BFF T called to check on me. I had an uneventful afternoon and was surprised by how good I felt. It was nothing like the first two biopsies, probably because I finally had good pain relief this time.
Friday, March 11, 2022. The cancer clinic called to schedule my appointment with the pain doctor. They had an opening in about 2 weeks, on Thursday March 23. I was officially booked to get some help with my concerns and make sure I was properly cared for during my treatment.
Wednesday, March 16, 2022. Nearly a week had passed, and we were still waiting for the biopsy results. At last, the email came.
Subject: New Test Results
It didn’t look good. I’d have to see what Surgical-Oncologist-Doctor L had to say about this. Fortunately, I didn’t have to wait long. She called me that afternoon and waited as I grabbed Miah and put the phone on speaker so we could both listen.
“So, there was some pre-pre-cancer found. It’s abnormal enough that it really should be removed. So now you qualify for either the mastectomy or the lumpectomy followed by radiation. You get to choose which option you want.”
I didn’t know what to say. On the one hand, I was happy that my earlier worries about maybe not qualifying for a one-and-done mastectomy was no longer an issue. Yet, neither option sounded good nor something I wanted to go through.
“You don’t have to decide today,” she said. “The soonest I can do your surgery is on… hang on let me check. I can put a hold on April 13th for you. Just think about it and let me know when you decide.”
Miah asked her to explain again about the risks of the double mastectomy considering my having pectus excavatum. “That condition tends to cause more issues with the reconstruction process,” she explained.
“But Lorie doesn’t want any reconstruction,” Miah told her.
“Yeah, no way would I want to go through more surgeries,” I echoed.
“Then it wouldn’t make any difference. But remember, that condition can look a little disturbing following mastectomy. It’s a permanent, body-altering surgery, so you really need to consider what’s best for you.”
Well, that was a relief. Miah and I were worried about my pectus condition causing difficulties with the mastectomy recovery. Apparently, we hadn’t dug deep enough to understand the nature of the issue. I was still worried about being disturbed by my appearance though. I explained to Surgical-Oncologist-Doctor L that I wasn’t interested in a unilateral mastectomy. If I chose mastectomy, I wanted it performed bilaterally.
I told Surgical-Oncologist-Doctor L I had an appointment with Cancer-Pain-Rehab-Doctor C on March 23rd because I was proactively taking measures to ensure I had good pain control. “That’s a really good idea,” she said. “Normally we don’t send patients to the rehab doctors unless they have problems after their surgery, but in your case, with your chronic conditions, I think it’s really smart. You should ask her what she sees more problems with: bilateral mastectomy without reconstruction, or lumpectomy and radiation.”
We asked a few more questions and ended the call. “Well, now you get what you wanted. You can do whatever surgery you want,” Miah was halfway excited, even though it was a weird thing to get excited about.
“Yeah, but what if I make the wrong decision?”
I thought about a LinkedIn Learning course I had taken the previous year, on problem-solving techniques. The course taught a method using a weighted pros and cons chart with a scoring system. Maybe I could try that for my decision making? I considered my timing. I figured I had at least a week and a half to decide. My appointment with the cancer pain doctor wasn’t until the following Thursday. I needed to consult with her before making any decision.
Over the next couple days, I called all my friends. The Flock had been hovering over me this whole time, but now I finally had a solid lead to discuss with them. Thin-Gorgeous-Extremely-Successful S, Childhood-BFF T, Wise-Woman-YMCA P, Calm-Witty-Experienced-Manager M, Champion-Cleaner A, and all the others, were right there to listen and soundboard, suggest and inquire. I found myself in a place of power.
The power is in the calm. Somehow, I stayed calm because my Flock kept me grounded.
Friday, March 18, 2022. I released my third single, Four of Wands / After the Harvest. As I finalized the sendoff and song release story, I decided to hint at something going on with me. Up until now, I hadn’t posted any mention of distress on my social media. But this song’s message is relevant – it’s about coming through something, getting to the end, and then celebrating your accomplishment. Miah and I couldn’t deny this song had special, new meaning to us, and someday we would hear it differently. I wanted to share my perspective, so I published a somewhat vague message about having some health trouble. The post didn’t get much attention and in some ways that was a relief. I wasn’t ready to shout off the rooftops about my diagnosis anyway, but I was a little bummed I didn’t get much of a response. How could I expect more than a few likes anyway? It was only my second release since launching my marketing plan. I had to be patient. And I also had to be a patient. I couldn’t run full force into launching a huge music campaign right now, but dang it, I was giving it my best shot nevertheless.
Even if nobody read my story, even if no one shared my post, I felt surrounded by a strange comfort. My music showered me in a shimmering cape. I prepared for my walk up to the ring, through the ropes, to ferociously stare into the eyes of Cancer and knock the daylights out of it.
End of 9 - Biopsy #3