This essay is unique because I acted so quickly after my diagnosis with breast cancer.  And this is the honest story of how it unfolded including the negative emotions.

I wrote this 4 days after my diagnosis (approx. 16 years ago today) and it appeared in the paper the day I came home from the hospital from the mastectomies.  (June 1, 1996)  Things have changed with breast cancer, and other clarifications needed to be made.  These are done in incremental stars *  ** *** **** ***** Refer to the bottom of essay for the explanations.

It took up a full-page in The Town and County Section of The Free Lance Star, and here is the picture with the writing as it appeared.  The writing in the box is under the picture.

Marilyn Holasek Lloyd of Fredericksburg is a former psychiatric nurse and stress consultant.  She teaches literature and college composition at Germanna Community College and is a free-lance writer.  Now at age 50, she has just learned she has breast cancer.  Ironically, she received the diagnosis during Breast Cancer Awareness Month.  (I was wrong about that)

When I first heard the words, “You have breast cancer,” I knew that author Betty Rollin was right when she wrote “First You Cry.”  I went further than that.  I got a little crazy and ranted and raved.  Now, this ranting and raving is really hard on loved ones.  They are trying to be there for me, and here is their spouse and friend in a negative tirade like the operating room never heard.  I’m sure I said many things like the following:

I told you I had cancer;  see, I am going to die—I thought I had more time than this—I thought I’d live to be my father’s age when he died—I’m not going to see my children marry and take care of my grandchildren—All those mammograms killed me—Book me on a ValuJet flight for a tour of the country.*

 A funny thing happened on the way home from the hospital following the bad news, however; I calmed down.  It seemed the love of the Lord’s grace surrounded me, and I experienced a peace that is so unlike the usual way I cope with a crises.  My husband, Stacy couldn’t believe it, because he was expecting more of the same.

I wasn’t even that tired from all the stress and anesthesia of the biopsy.  I couldn’t understand that myself.  I did know, however, a lot of people were praying for me to be calm, because they know how I react to things.

You might be asking yourself right now why a former stress consultant is the ranting and raving type?  The answer is a little  complex.  I guess it comes from that fact that I knew as a young child that loved ones can be gone in a flash–just like my mother was.  Most kids have a mother.  I didn’t.  (She died when I was 8 weeks old) That put a fatalistic perspective on life for me.

My motto grew as I did:  “What I worry about doesn’t usually happen.”  This motto served me well for 50 years until those words came, “You have cancer.”  I inwardly sensed right from the beginning that my motto had to change or I wouldn’t be here to have a motto.

How my motto changed is an important part of what I have to say, but first I want to tell you how I coped on arriving home from the hospital.  First I proceeded to call all my relatives and tell them the diagnosis.  The hard part was telling my children.  They were finishing a semester in college, and my daughter still had an exam to take.  I had to tell them they were on their own getting home for the semester.  Old mom was out of commission for a while.

Then I called friends and told them.  Every friend I told is signing up to have the mammograms they had postponed.  I always had good follow-up with mammograms and checkups, but breast cancer can quickly sneak up on a person, so self-examinations and mammograms are imperative.**  Back to my friends.  You find out who they are very quickly through an ordeal like this.

The next level of people to be informed were the ones that touch my life in such a special way, those involved in my work.  I called Germanna Community College and, thinking my boss might be on vacation, left my diagnosis on her voice mail.  I guess you don’t get one of those messages much in life.   I called the editor I work with at The Free Lance Star and told her.  She has such a calming quality to her voice.  She made me relax, and for just a few minutes, I became my old joking self. . . .It was good for me.

I’m sure MCI was happy with my diagnosis because I called all over the country to friends and family. (How dated this is now with unlimited calling)

Now I was ready for the decision-making part of my ordeal.  My surgeon gives each of his newly diagnosed patients a book called Breast Cancer, the Complete Guide.  I read steadily the 300-page book and finished by the next day.  When I understood the options for my condition, I began discussing them with my husband.  He knows how I think, and we were in perfect agreement.

About this time, however, I had my first setback.  My nursing brain kicked in while I was studying the book, and I sort of lost it a while thinking about those lymph nodes.  Now, everyone takes their lymph nodes for granted, but you don’t when you find out you have breast cancer.

The lymph node dissection and biopsy at the time of the second surgery is the most important prognosticator of longevity.  Size of the original cancer is the first important prognosticator.  Mine, luckily, was small–1.5 centimeters. (Small in breast cancer literature, but huge  when you use a ruler and know you’re measuring cancer.)  The smallness made my cancer a stage one which is good.  However, a stage can sink rapidly when that lymph node biopsy comes through positive. 

Of course, I plugged in my May Family Health computer program and looked at the multimedia graphics.  It also made me a little crazy.

There is a “Catch 22” here concerning the decision-making part of the ordeal.  A patient has to make a decision on what surgery to have without the knowledge of the lymph node predictor.  That is the hard part. ***

Basically I had two options.  One was to have a breast-saver operation known as a lumpectomy along with removal of as many nodes as possible and radiation treatments.

The other option was a modified radical mastectomy where the breast is removed along with the pectorals minor muscle and all of the lymph nodes.  In recent years, the studies have shown equal longevity with either option.  It was all a matter of personal choice.  

Another level of discussion is the decision whether to have breast reconstruction.  Now, sometimes this is even done by a plastic surgeon at the time of the second operation.   Others wait for later.

What would I decide?  After my physician answered my list of questions, it wasn’t hard knowing what I would do, since I know and understand myself so well.  In my case, I knew my breast had to go.  It was trying to kill me.  Anyone that really knows me also knows that I am one of those people who embraces life with gusto, and this decision of what to do next would probably involve overkill just as everything else in my life did.

I decided to have a double mastectomy, although the left side would be a simpler operation.  Most people thought I had lost it at this point.  Most women would decide to conserve their breasts, and I had an off-with-them attitude.

There was no changing my mind.  When I listed all the reasons, my husband was in full agreement with me.  He knew I couldn’t go through any more agonizing mammograms, biopsies, sonograms and other tests every six months. **** They make my immune system take a nose dive like no other stress.  I needed all the strength I had to fight the ultimate enemy.  I just would fight it a different way than most people (although I already had kind and loving input from others who chose this extreme option.)

So, here I sit waiting for the surgery.  I am scared.  I have never had such a big surgery.  My body image has never taken such a hit.  But I feel strength I didn’t know I had.  That strength comes from my faith which has always helped me through my life journey.

I found reading the Bible and listening to ministers comforting.  I also took out of my quote collection two quotes I had hung over my bed 30 years ago in nursing school.

 “I place this day, my life, my loved ones, my work in the Lord’s hands.  There is no harm in the Lord’s hand, only Good.”

The other is:

 “I believe I am always divinely guided.  I will always take the right turn in the road.  God will always make a way where there is no way.”

And so my readers I face the operation knowing already I have a big “thank you” to deliver to the radiologists in my life for giving me a chance to live.*****  I have a competent, caring, compassionate surgeons. (An added bonus here is that one of them and his family are close personal friends.) I have the best family.  The best friends.  And the best life.

And I have a new life motto”

“I want to live, and I will try to live with less worry and more gusto all the time I have left.”

Pray for me, please; I will need it.

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* A plane from that company had just crashed and everyone knew I hated to fly.

** Having mammograms is a complicated issue for those under 50.  I didn’t know that.  Medicine didn’t know that.  (This is another blog)

*** Three months after my surgery sentinel node biopsy came to Fredericksburg.  This would have eliminated the lymph node dissection for me.  It would have been done at the same time of the original excisional biopsy.  That would have preserved my muscle which controls the shoulder and my lymph system.

**** My doctor was watching my other breast every six months.  Not the one with the breast cancer.  I didn’t include that in the original article.

*****As it turned out, the radiologists goofed.  The surgeon did his job right basing  his recommendations on the radiology reports.  In the next essay I will talk about the pathology report, lymph node status, and most importantly how I made the right surgical decisions without the correct input from radiology.

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Writing that essay was the best thing I did for myself.  Literally thousands prayed for me.  And  years later, some women would tell me they were still praying for me.   I THANK ALL THOSE WONDERFUL PEOPLE THAT PRAYED FOR ME BUT ESPECIALLY FOR THOSE THAT DIDN’T KNOW ME AND PRAYED FOR ME  ANYWAY.

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