It felt great to be out of Gill for a bit, to trade in the dusty country roads and cows for the lush cityscapes of Boston. It's always good to get off the usual paths for a while, and I never really realize how much I tend to travel the same roads and routes over and over again, day in and day out, until, well, suddenly, I'm not on those roads traveling that route, and the road map changes.
It's been hard not knowing how this will go. The uncertainty of it all--the unsettledness--has unsettled me. Once my road map is clear, I know I’ll feel better, but for now, it feels as if I’ve been put on a road, and it's a road I've never been on before, and I don't recognize any of the landmarks. I try going very slowly at first, so much to take in, and it's new! But things start whipping by, time accelerates, as it does, and I find myself speeding, trying not to be out of control, trying to slow down so I can read the damn signs. Yield for homeschooling. Children crossing. But mostly, there are exit signs everywhere, and I’ve no idea which one to take. Turn right for another attempt at a breast-conserving surgery, with the promise of radiation down the road, and the prospect of mastectomy soon after; Turn left for a mastectomy, left again for reconstruction, or stay straight to opt out for now. Different people have lined up along the road to point me in different directions. Go this way! Take a right! Go left! I'm wondering if I can, simply, go back. But I know I can't, and frankly, I'd like to get off this road sooner than later, and return to the more bucolic roads that life has to offer, so it's a road map I must figure out.
My appointment with the breast surgeon at Mass General was slated for Friday, mid-morning, so Jim, the boys and I drove into the city Thursday night, stopping at Pappa Razzi in Concord for a birthday dinner of sorts for Dominick, who turned nine that day, before checking in to our hotel--the Marriott's Residence Inn at Tudor Wharf in Charlestown. Our trusty GPS--lovingly named Harold, despite its girlish voice, and passed down to us by my mother, who got a really nice one (read: all sorts of voices to choose from, though I'm still waiting for the George Clooney model) with her new Civic hybrid--navigated the ever-changing streets like a pro (or a more recent model, in any case), and we arrived at the quiet Charlestown hotel by bedtime.
Right on the water, close to the USS Constitution and Bunker Hill, the Marriott isn't huge, but offers a serene spot with views of the harbor and city lights, a great location, and an array of affordable suites to chose from. Ok, that's my plug. Onward ho.
We actually did like the hotel very much. And when you're zipping around the city, trying to cram in doctor visits and MRIs with family visits and kid-trips to the Museum of Science and Aquarium, and it's cold outside and you're not used to navigating the city streets and throngs of people, it's nice, so nice, to have a warm, peaceful spot to return to. I was grateful that it was quiet--no unruly guests (until the youth hockey players and their families arrived on Saturday morning, and whipped the hotel into a frenzy with their loud, brash antics, but that's another story) or obnoxious city sounds to keep us up. We opted for a suite, and with its spacious two bedrooms and two full baths, small kitchen and living room, we were glad of it. We could spread out, enjoy each other without fighting for footing, and get good sleep. And Jim could make coffee whenever he felt like it! The beds were comfortable--and this is important, because we've all spent nights on lumpy, horrible mattresses that have left our bodies aching and sore for weeks afterwards--and ample. With four of us, and the boys growing tall, we do need our space. And breakfast, a full breakfast, with choices from scrambled eggs to make-your-own-waffles to oatmeal, was included. Self-serve, easy peasy, ready in a jiff. As an added bonus, there was a small indoor pool (and whirlpool), where Dominick could swim and jump like a fish-monkey, across the hall from a mirrored exercise room, with weights and cardio equipment, where Luke could run on the treadmill while watching ESPN (bliss). The very first morning of our visit, we peeked in to see an older couple--probably in their late 70's or early 80's--working out. The woman, grinning in a headband and warm-up clothes, was walking the treadmill, while her guy gutted out the bicycle in his street clothes. Quite adorable.
I awoke Friday morning, eager to open the curtains and take in the view. We were surrounded by boats and water, and the water that morning reflected the rising sun with enough of a sparkle and flash to rouse me from my slumber and make me feel glad for the day, however apprehensive I was feeling. The boats appeared shrunk-wrapped for winter, but some sported doors (and some, wreaths on the doors) that entered into a hoop-house-like enclosure on the deck and cockpit, warmed by the winter sun, where, one would think, you could grow hothouse tomatoes, salad greens, and marijuana plants (medicinal, of course) quite easily. It was fun to imagine what it would be like to live on a boat through a Boston winter, and we spied people stirring from within, and a few small lights on at night.
After breakfast, my father and his fiance', Mimi arrived to take the boys off to the USS Constitution museum while Jim and I met with Dr. Michelle Specht, the breast surgeon at Mass General. There were clues at this point that made for an inauspicious start to the day, and that I couldn't shake. I realized, about an hour before my appointment, that I had forgotten, yes, forgotten, to pick up my mammo films and written reports from Dr. Fox's office the day before, things I was supposed to have brought with me to Dr. Specht's office. I couldn't believe it. What the heck was wrong with me? Where was my head? Was I acting out some deep-seated desire to have the surgery done at home and sabotage, passive-aggressively, my chances of having it done in Boston? Regardless of the deep hidden meanings (DHM, for short) behind my negligence, I felt like a total idiot. I asked Jim to call Dr. Fox's office, and then Dr. Specht's. Reports could be faxed, the pathology slides had already been sent, but there was nothing we could do about the mammo films. "Not a problem," I was told. Oy.
The cab ride over was short, but smokey, despite signs all over the cab that proclaimed it would be a smoke-free ride. Oh well. Breathing all that second hand smoke just made me feel like I was back in Greenfield, alas. We found the Yang Building fairly easily, and maneuvered around the construction to enter through swinging glass doors. There was quite a line of people waiting for the elevators, which all seemed to be full. Next time, I reminded myself, take the stairs. Up at the Avon Breast Center, we checked in, and I headed into the bathroom to de-tea myself, but saw that there was pee all over the seat. Hmmm. By the time I had quickly cleaned it up, gone myself, and washed my hands (washed my hands, done with such intention these days, if I could just get the kids to do it with as much intention), I could hear a woman calling my name, so opened the door and followed her down the hall into a tiny examination room. This was the part I hated most: having to own up to forgetting (forgetting!) my forms (felt like the Clampdown all over again, bad dog, bad dog). Had they received the fax? "No, it's not here." Had we been given the correct fax number? "No, it went to the wrong place." So, Jim--who has an uncanny ability to remain calm and detached when my head is about to spin off my body and my heart jump out of my chest--calmly called Dr. Fox's office to have them re-fax the reports, and a few minutes later, the nurse came in, smiling, to let us know that all had been received. Exhale.
I spent about five minutes filling out a questionnaire to assess my cancer risk; completed on a portable electronic clipboard, it asked me questions about family medical history, whether I smoke (does occasional pub-smoking in college really count? I mean, what if you've never even bought a pack of cigarettes before?), how much I drink (again, just what are we talking about here? drinking beer out of a boot during my rugby days, or the handful of gin and tonics that I enjoy every year?), yadda yadda. You realize quickly just how flawed these risk assessments could be.
Just when I thought it couldn't get any worse, it didn't; in fact, when Dr. Specht showed up, smiling warmly, I felt instantly at ease, and things got much, much better. She was personable, kind, and every bit of the breast cancer pro that has been promised. She was also positive, upbeat, and generous with her time. She spent a good chunk of the hour teaching us about breast cancer--drawing pictures, answering our questions, mapping out the process. She presented everything at a very high level; I was quickly beginning to understand what all the fuss was about. She understood and shared my indecision about whether to have a lumpectomy, or re-incision, or a mastectomy, and ordered up a breast MRI to help make the decision clearer. The MRI, done with contrast dye injected into the blood flow intravenously, would help her determine how much cancerous tissue remained in the left breast, and whether or not any existed in the right breast, by showing increased blood flow to the areas where cancerous cells, which apparently need lots of blood, hang out. Typically, she said she would recommend a mastectomy over a lumpectomy if she had to remove more than a quarter of the overall breast tissue in order to secure clear margins, ie, no cancer left behind (not to be confused with the highly flawed No Child Left Behind act). After my exam, she thought that I could still do a lumpectomy if I wanted to, but wanted me to realize that there was still a good chance that she would not be able to get all the cancer out, and I would still need a mastectomy at some point. The MRI would possibly provide more information to make the best possible decision, but ultimately, she reminded me, the decision was mine. She also recommended that I have either surgery done at Newton-Wellesley Hospital, where she spends Mondays working in the OR, given its proximity to Gill (vs. MGH) and its abundance of private rooms.
Very early into our consultation, I knew that I wanted Dr. Specht to do my surgery. And I had been hoping that this would happen, that my gut would let me know, one way or the other. Dr. Fox is wonderful, and clearly, a gifted surgeon. But Dr. Specht, likewise gifted, is a woman, which under the circumstances, matters to me. She is, like Dr. Fox, immensely likable and well-dispositioned (I'm not even sure that is a word, but you get my drift) to be my doctor, but has more resources and experience at her disposal. And so my decision was made. One down, with more to go. As to which surgery I would chose, I still was not clear, and was hoping the MRI would offer some ideas.
Though I had to return to the hospital in just a couple of hours to have the MRI done, the cab ride back felt far breezier than it had on the way over, and I felt lighter, despite having more information to digest and process. Later, I told myself. There would be time for that later. For the time being, I was enjoying the cab ride, this one truly smoke-free and unfettered. It felt great to be riding a cab amidst a city scape, and not driving past the same farms, ice blossom covered trees, and mud spattered snow banks. Don't get me wrong--Gill is lovely, and the recent snow has draped a crystalline beauty atop its trees and barns that make it a virtual winter wonderland, a postcard--and yet, when it's all you've seen for months and months, it loses a bit of its ethereal quality and starts to fade, tire, even annoy. So--a break to the city, with its own enchanted juxtaposition of the surreal and the real, the futuristic and the archaic, can feel restorative, and edifying.
Little did I know what the breast MRI would have in store for me, nor how completely and utterly exhausted I would feel when I got home on Saturday night. But despite all of that, it was a good trip. We were able to take in the Aquarium on Saturday, where the jelly fishes completely wowed us with their exquisite beauty and colorful dances. When I saw the big tank in the center of the Aquarium, I was reminded of how I used to nurse Luke there when he was a baby. We'd come in to the city to see the harbor seals and other delights and I'd tuck myself in one of the windows and nurse him as the sharks and turtles swam on by. I suppose there's a part of me that is grieving for all that astoundingly wonderful--and I mean that--nursing time with Luke and Dominick, not just because they are growing up so fast, but also because I have to prepare myself for saying goodbye to such a big (though physically and literally quite small) part of myself and my life as a mother. Just how does one say good-bye to a breast? Take lots of pictures? Throw a party? Create a book of nursing memories? A book of nah-nahs. Num-nums. (I love all the different names that babies, and especially toddlers, come up with for their mother's breasts.) Yep, I just might have to do that.
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