My Breasts, My Cure -- Chapter Six

Chapter Six

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My First Consultation with Surgeons

         As Dr. Cole suggested, I call Caritas Clinic to make an appointment. A young-sounding clerk named Johnny takes my call. I explain my situation and he interrogates me about my financial situation.

         "How've you been living?"

         "I'm a writer," I say. I think I detected an apology in my tone. How can I tell him without sounding boastful that I used to be very well off; that in addition to my high-end corporate job, I made a lot of money from the stock market. Unfortunately, along with millions of other investors, I was also a victim of the stock market collapse in the late nineties. I lost big time; consequently, I could no longer afford the high cost of health insurance. Since I'd been healthy all of my life, I let my coverage lapse just recently. Who knew I would be going through this now? But Johnny doesn't care to know about these details. He simply is interested in my current financial situation, and how much I can afford to pay now. I think this inquiry is for the possibility that I might get some financial assistance for the surgery and treatment, but I don't know from where.

         "How much do you make from writing?"

         "Just enough to survive."

         The whole discussion embarrasses me. I never thought that I would ever be placed in this defensive situation about money. I had seriously considered going back to work for regular income, and most importantly, for medical insurance coverage. But I have procrastinated so long and now it's too late. Who would insure me now?

         "We have to figure out your share in the cost of treatment based on your assets. So when you come, bring financial statements like bank accounts and retirement accounts."

         "Okay. So when can the doctors see me?"

         "The earliest appointment I can give you is in sixteen days."

         "Sixteen days? Nothing sooner?"

         "It's the best I can do."

         "OK, I'll take that." I give him additional information then we hang up.

         Unsatisfied and concerned, I immediately give Dr. Cole a ring. He takes my call right away. "I cannot see the doctors at Caritas Clinic for another sixteen days," I tell him. "Is that safe?"

         "A couple of weeks would probably not make the cancer worse," he says. "Did you tell them that you have a malignant cancer?"

         "Yes, I did."

         "Maybe you should call them again to be sure that there has not been any misunderstanding."

         I call Johnny again. Dr. Cole was right. Johnny did misunderstand me. "I thought you said something about a lump only, and not a malignant cancer," he says, and reschedules me for the following week-seven days earlier.

         I take care of more business on the phone then I get dressed to drive to Cherry Creek Mall. I am in a spending mood, which is not a smart thing to do considering the expenses that await me for my treatment. The American Cancer Society subsidizes the mammograms and biopsies. Will I have enough in my 401(k) and IRA and other investments to pay for the surgery and other treatments? I need to do some research for any financial assistance that might be available for me, but where should I start? I'll do that tomorrow. Today, I'm going to see Neiman, Sak's and Dillards.

         "So what did the doctors say?" Peter asks when I call him from the mall.

         I take a sip of Starbucks latte. I am now resting from all the hours I spent shopping. "It's cancer . . . malignant cancer," I say calmly, as if reporting the weather forecast for tomorrow.

         He is quiet for a moment. "I'm so sorry."

         "It's all right. I have made an appointment with a surgeon at St. Joseph Hospital. I'll see him in seven days."

         I am being very stoic and courageous. I know I can count on him for strength to make it easier for me to cope with my illness.

         It's my personal tradition whenever I'm in the Cherry Creek area. I shop at the upscale Cherry Creek Mall; first at Neiman Marcus, then Saks 5th, Eddie Bauer, Williams Sonoma and Dillards. Even though I don't care for chocolates, I enjoy shopping at the Godiva store and buying a gift for Peter. He's the avid chocolate lover. By 4:00 in the afternoon, Peter and I meet at the movie theater to watch a film. After the movie he walks me to my car in the parking garage. He is always amused to see my little car full of shopping bags. I hand him a box of Godiva chocolates--his favorite. He thanks me with an appreciative smile.

         After watching a movie, he takes me out to dinner at one of my favorite seafood restaurants overlooking Denver skyline. We do not talk about the cancer so we can enjoy ourselves better, but all the while I wonder what he is thinking about when there is a lull in the conversation. Will his feelings for me change because of my cancer? Will he help take care of me should I get my treatment done in Colorado? Will he consider it a burden if I stayed?

         We go home and he helps me unload my purchases from my car. I am feeling tired so we leave all the bags on the floor downstairs. In bed, with his arm around my shoulders and my face on his chest, we discuss my initial thoughts about my treatment. I mention to him that I might consider getting everything done in California.

         "Pearl," he says lovingly, "You are welcome to stay here for your treatment, and I will be happy to take care of you."

         I feel a lump in my throat. I kiss his hairy chest. "Thank you. But the last thing I want is to be a burden to you."

         "It won't be a burden. I would love to do it for you."

         "You have a job to do at the University. The last thing you need is another person to take care of."

         "But that's what relationships are for, my dear," he insists.

         "I kiss him on the lips. "I love you."

         Sex has always been great between us, and tonight, not even the sudden change in my future health has affected the way we make love.

*

So much to learn. So much to absorb and remember. So many new terms for my vocabulary. It is amazing how little I know about breast cancer before my diagnosis. My first true education takes place at Caritas Clinic St. Joseph Hospital in Colorado where I meet with two surgeons: Dr. Patricia Clark and Dr. Jeffrey Crane, and an intern.

         After reviewing the pathology report one more time, Dr. Patricia Clark, Chief Surgeon, explains: "The type of cancer you have is called an Infiltrating or invasive Ductal Carcinoma."

         Say what? I exclaim in my head. I keep my composure, and pretend that I have done my research and am somewhat familiar with the term. Truthfully, I have done a lot of reading and vaguely remember the term, but since there are so many different kinds of breast cancer, I cannot immediately recall which type this one is. I know that she did not say Ductal Carcinoma In Situ because that's what I thought I might have since Dr. Cole had stated that my cyst was very small-less than a centimeter . . .a pea size. In Situ means that the cancer has not invaded the surrounding tissues and is still intact inside the duct.

         My surgeon-to-be, Dr. Jeffrey Crane (I call him Dr. JC), examines my breasts and locates the lumps per the Pathology report. The really cute, handsome and tall intern who looks so young (Geez, they get younger and younger) also examines my breasts and nods in agreement with Dr. JC.

         "There's some good news, at least," Dr. JC says. "You are Estrogen and Progesterone Receptor positive."

         "I have no idea what you are talking about, doctor," I say with a smile.

         He explains the presence of both estrogen and progesterone receptors, which means that I will respond to therapy or treatment well.

         I should definitely research this further, because the more Dr. JC tries to elucidate the term to me, the more I am confused.

         Dr. JC explains the two options available to me: a lumpectomy with axillary node biopsy (removal of the tumor with safe margin, and some of the lymph nodes to determine if the cancer has spread to the lymphatic system), or a mastectomy (removal of the entire breast). "Think about these options," he says in the end, "and let me know which you would prefer."

         I ponder the two choices for a moment then I turn to the female surgeon. "If you were me, Dr. Clark, which would you choose?"

         Without hesitation, she says: "I would go for the mastectomy. I want to be sure that all the cancer is taken out."

         "Is that what you would recommend as well?" I ask Dr. JC.

         "Yes," he answers.

         It sounds so radical, this removal of the entire breast. I would prefer a lumpectomy and preserve the rest of the breast. It's not vanity that I feel, but why mutilate me so much when my tumor is so tiny?

         "Okay, let's schedule the surgery," Dr. JC says. "How about June 10?"

         I don't know why, but I feel that the meeting is rushed. "June 10 is fine with me."

         The intern tells me that Dr. JC has done more breast surgery than any other surgeon in Colorado. That makes me feel secure knowing that I will be in experienced hands.

         We schedule my pre-op: blood tests, EKG and x-rays, including an MRI and a bone scan.

         The administrator examines my financial statements and frowns. From what I understand, the Government, the hospital, will share the costs of my treatment with me. My share depends on my assets. My 401K and other retirement investment funds are almost entirely exempt from it.

         I leave the clinic with conflicting thoughts. How can they put the burden on me to decide which course of treatment I should take? How do I know which is best for me? Should I seek a second and even third opinion? What is my chance of survival? Should I let my family know what's going on? I know they would want me to go back and get my treatment in Monterey so they can help take care of me. Should I tell my Mom? I don't want to. We can keep it a secret from her. How much of my personal assets will be taken from me? How can I increase my income to assure that I'll have something to live on after my treatment? Will I be able to work while undergoing treatment or will I be so sick that I won't be able to function well?

          Ahh. . . too much to worry about; I'll think about these again tomorrow.

* * *

Next item:"My Breasts, My Cure -- Chapter Seven"