October, Part Two
As promised, here are the rough sections I’ve been working on for the Library Confidential memoir, which I’m sharing with you in honor of Breast Cancer Awareness month.
I’ve always told my memoir clients: rough drafting is not perfection. It’s a placeholder. I expect that all of what I’m sharing with you will be edited extensively for the book.
Library Confidential is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber.
I know some of this is touchy subject matter, and I’ve debated how much to share, but I offer it in service. Maybe it will resonate with someone, somewhere.
If you have any comments or want to reach out, please do. I’m happy to answer questions, as well. Comment here or email me at annamarieobrien@gmail.com
See you in November.
Love,
AMO
–
In February 2016 our new Christmas puppy jumped onto me from the back of the sofa while I was laying there prone and sick with the flu. I had a strong immune system, and I hadn’t had the flu since I was a teenager. Unfortunately, it got us all and the whole family was leveled for ten days.
The puppy, with her adorable puppy energy, landed straight on my left breast on the tenderest flesh just under the nipple, right over my heart. The pain sat me straight up, eyes watering, grasping my poor tit and yelping to Jesus.
Fully grown now, she’s only seventeen pounds. As a five-month old puppy, she was just a tiny thing, a few pounds really. But the force of the impact left a blue bruise on my boob, and the spot remained tender, as well as a little swollen and painful around my periods.
Incidentally, it was the same area that was painful from a clogged duct when I was nursing my last baby but that was six years prior.
The spot persisted over the summer, but by then the kids were out of school. I took a wait-and-see mindset, hoping it would resolve. I went ahead and had a great summer break.
By the end of July, it was time to get it looked at. It was still painful and there was definitely a thickness to it, maybe a lump. It felt like a knotty rope kind of. It wasn’t smooth or defined, but it was there.
And look, I’m a minimalist when it comes to doctors and procedures and medications, so I made an appointment for an ultrasound. I just wanted a look-see, thinking it was probably just a cyst or a hematoma. I wasn’t ready for another mammogram. My last one had been 5 years prior and they are not fun.
The spot was black on the ultrasound - I could see it. Almost like negative space. The doctor, a breast specialist in Scottsdale, looked immediately concerned as she pressed the wand around with the jelly on my sore boob.
She suggested a biopsy, right then and there.
In retrospect, I should have waited - but I was already in the office, my kids were already with my mom, so I called and told her I’d be a little while longer, and then I called my husband.
Ironically, the biopsy device was manufactured by my husband’s employer.
I had a disgustingly long needle jammed into my breast. The doctor misfired the device and had to jam it in again, no doubt irritating the spot - and I left there with a huge bandage on my breast, dripping blood, slightly horrified at what I had just been subjected to on that sunny Thursday afternoon as I drove myself home.
The next day, the doctor sounded grim. It was a two centimeter tumor. It was hormone negative, HER2 positive. Which meant it was highly aggressive. It was also just millimeters away from growing into my chest wall.
“However, it is a highly treatable form of cancer that responds well to chemotherapy.” She said.
I hung up the phone and started crying.
My husband's response to the news - in addition to the shock and sorrow of the whole thing - was to immediately buy expensive floor seats for the Guns N’ Roses show out at the football stadium. The show was ten days after the diagnosis, and I attended with a bandage on my breast. I knew it would be a while before I could go to a concert again. It was our last hurrah before the shitstorm.
Here in Phoenix we have a number of excellent options for cancer treatment - MD Anderson was on my side of town, so I had my medical records sent there. Then, they did a mammogram on my recently biopsied breast, which was pure agony, and then they biopsied the lymph node under my left arm. I also had to do genetic testing, to see if I had the BRCA genes - which, thankfully, I do not.
The tumor had grown to seven centimeters - almost triple in size since the biopsy just a few weeks prior. I was stunned. How did a bruise from a dog jump turn into FUCKING CANCER? Doctors said there was no correlation, but I’m still skeptical. I found a study that showed breast trauma could lead to a tumor, but it didn’t matter.
I was presented with many shitty options moving forward.
I could have a mastectomy. Or a double mastectomy. I could do reconstruction if I wanted, or I could go flat.
However, any and all of these options would still involve chemotherapy, radiation, and surgery.
The thought of chemotherapy? Definitely a worst fear for a girl who leans granola-crunchy. Believe me, I researched alternative therapies. Herbs, keto, and detox sounded fine to me.
But I had small kids, and I couldn’t take the chance. They needed their mommy.
The doctor was very encouraging when I told her I’d like to try and keep my breasts.
Her only concern was that my boobs were on the smaller side and this tumor was pretty huge, so it depended on how much tissue they could conserve. We’d need to do chemo first to see how the tumor responded.
I’ve always liked my boobs. The Creator blessed me with a decent pair. They were never cumbersome or annoying. I nursed two babies, and in a good bra they are still pretty great. I didn’t think they were trying to kill me and I wanted to keep them if I could.
“As long as the cancer doesn’t involve the lymph nodes, and assuming we can shrink the tumor, we should be able to perform breast-conserving surgery”, the doctor said.
I was so relieved to hear it. It was the best of the shitty options I could hope for.
“Will I be able to work?” I asked the Doctor. She knew I was a public librarian.
Work at the Library had been so stressful for many years, and the last year had been brutal, with the death of my dear friend and coworker, John, who had died of sudden-onset leukemia almost a year to the day I was diagnosed.
“If you had to, I guess. You’ll do better if you tap into your benefits and take medical leave. The chemo has a lot of unpleasant side effects, unfortunately. You won’t be able to work with the public, because you won’t have an immune system. You’ll want to be at home.” She explained.
We were going over the treatments, the side effects, and the timeline - first, a surgically installed port in my chest to handle the chemo chemicals, and then at least a year, probably 18 months until the entire process was done. We were realizing the impact this was going to have on the family, the job, the finances - everything.
I looked at my husband and told him - “I’ll be able to finally finish my book.”
During the first few rounds of chemo, I could feel the spot in my breast actually tingling, almost like an internal itch. I imagined it shrinking, the medicine eating the tumor, like an army of PacMans, munching away.
The chemo was awful. Awful in a way that I can hardly describe without getting graphic. But it was exquisitely painful. My tummy, my skin, losing my hair in handfuls and going completely bald. My fingernails and toenails were lifting off their beds.
I went into menopause for 18 months. “Chemopause” they call it. I think my vagina literally dried shut. Every part of my body dried up, my joints ached, my teeth were loose, and I lost 30 pounds because my taste buds were burned off and all my pipes felt broken.
I was on a cocktail of four chemo chemicals: something awful, something awful, something that made my hair fall out, and Herceptin, which is an immuno-therapy specifically for HER2 type breast cancer.
Unfortunately I was very allergic to Herceptin. On my chemo days every three weeks, after blood tests to make sure I was strong enough to do it - they’d do the chemo cocktail first, and then switch it over to Herceptin last.
After the first two rounds of going into anaphylactic shock, they gave me benadryl and steroids before every Herceptin infusion. After my scheduled chemo rounds were concluded, I’d have to continue doing those Herceptin infusions every three weeks for almost a year.
I won’t lie: I always looked forward to the benadryl.
I’m not even a drinker, but the benadryl dose directly to the port line is like sweet drunken heaven. Ten seconds and I’d be slurring my words and saying funny shit to my husband, twenty seconds before I’d konk out in the chemo chair for a good nap while the Herceptin and the other medicines did their work while likewise wrecking my body.
Every day, I’d get in the shower, and I’d talk to my tumor.
I’d tell it THANK YOU, I’ve gotten the message. I understand why you’re here, but you’re not needed any longer. You can go away knowing that I have been changed. Thank you for being here, but you can leave. Your work here is done.
After the third chemo and during my daily inspection in the shower, I was convinced that 1. The tumor was gone, and 2. Going through three more rounds of chemo was going to kill me. The third one was especially rough.
I called the doctor and asked for another scan.They normally only do scans at the beginning and at the end of treatment, and I was scheduled for six rounds of chemo. I told her all my reasons - mostly that there was nothing there anymore - like, the spot was gone, I couldn't feel any evidence of a tumor any more.
To my surprise, she agreed. I think she was curious, too. This thing had been so large.
We did the scan a week later.
I’d already had my labs done that morning, and the ugly port in my chest was primed for the contrast fluid that a very nice tech would pump into me; but for about 20 minutes, I was waiting as one does to go back to where the big scan machines were.
I was bald by this point, wearing a black skullcap everywhere I went to cover the baby-duck fuzz of what was left of my hair. I was skinny, constantly nauseated but hungry, with chemo sores on my skin. I was a wreck in so many ways.
But I had on full makeup, because I’d be goddamned if I couldn’t at least try and feel like myself during this mindfuck of an experience. Black eyeliner helped keep me SANE, I’m telling you.
The waiting area was small, maybe six seats, with gray cubicle walls and fluorescent lights. I was in my comfy, loose yoga pants and I had a hospital gown draped around me.
An older man waiting there with me kept smiling at me. I wondered what kind of cancer he had. I smiled back. Everyone here at the cancer center has always been so kind.
The very nice tech eventually came to get me. As we said hello and she scanned my ID bracelet, she looked dismayed as she stepped in front of me and discreetly adjusted my hospital gown.
“Oh Sweetie, let’s get you fixed up here…”
Only then did I realize that my left breast - the sick one, the bedraggled and abused one, the one where the tumor was, or wasn’t, as I was here to find out - had been pretty much hanging out of my gown the whole time I’d been sitting there with that old man, nipple and all. The whole thing, there for all the world to see.
I started laughing out loud as I walked with the tech down the hall to the freezing cold scan room. A feeling of silliness, giddiness, and pure happiness enveloped me. Joy, almost.
Maybe it was just the look on that man’s face, or the absurdity of my predicament but I laid down on the table shivering and giggling until I had to get serious and listen to the machine give me directions. They brought me a warm blanket until the scan started. I was still smiling like a fool as I went into the tube.
My poor left tittie - she still had some good mojo. She wasn’t dead yet. She’d been right out there in the wind, enjoying the fresh air and making people smile, even on her worst of days.
After the scan, I waited an hour and then went to see my oncologist for the results.
And just like I had thought, the scan showed that after three rounds of chemo - THE TUMOR WAS INDEED GONE. The doctor was pretty surprised. I was ecstatic.
“I knew it! Oh my gosh! Thank you!”
There was nothing on the scan. No tumor, no scar tissue. Only the little metal marker clip that had been left after the first biopsy. And so far there was nothing in my lymph nodes.
I agreed to go through one more round of chemo, just to be sure, but my doctor concluded that the maximum benefit had already been achieved. No need for rounds 5 and 6.
I still had to get through breast surgery to clear the margins, 9 more months of Herceptin, 36 rounds of radiation, and then, eventually, surgery to remove the port.
But this was a very good start.
Library Confidential is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber.