longterm plans

it wasn't that i didn't feel like a cancer patient when i first met with the surgeons back in april. i did.  and certainly when i came out of my 7 hour operation on that saturday evening in may, it was pretty clear things had radically changed for me.  a few weeks ago when my name was added to a prayer list in our church bulletin...that all felt kind of cancer-patient-ish too.  for goodness sake,  i feel like a cancer patient even when i select my lettuce and purchase my milk at the market!  everything has changed in some way.  but it was only last week when i walked into the cancer center for the first time that it truly all took hold.  it felt different.  more real.  more serious.  more hushed.  as if the shades of taupe and grey and cream decor were carefully chosen for those unable to bear bright and vibrant.  carefully selected for those already living in harsh and more in need of calm.  serene.  cool.   as rick and i navigated the quiet hallways of the building, i realized every office and each suite had one thing in common:  cancer treatment.  this was a new building for us and this was a place which was completely dedicated to the long haul.  this was about the ongoing.  this was about treatment.  this was different.


a week ago, when i first visited my oncologist here in this cancer center, we didn't have my test results back yet.  we sat down with dr. ballard and tossed around a lot of hypotheticals.  without that oncotype answer, we just didn't know exactly what i would need.  would it be only medication or would i be scheduling chemotherapy sessions?  we couldn't know for sure.  regardless, it felt different than an operation or a recovery.  it reminded me that cancer was something you managed.  something you lived with.  it was something that could be cut out or even cut off, but that was only part of the process.  it wasn't just about removal, it was about the rest of my life.   and more would be needed.


how do i explain that?  i am not sure.  i am a woman who likes immediate answers and quick results:. paint the room.  clean the fridge.  change the curtains.  tear out the shrubs.  whatever it is, i like to just do it.  get it done.  complete the task and then move on.  one of the frustrating things about cancer has been learning how it is not like that.  even with an aggressive surgery there would be lifetime management.   i was having difficulty thinking past the day's end, let alone a lifetime.  one of my hardest weeks after diagnosis was when i realized i would be in this game for a while.  maybe forever. there were no shortcuts. and so much of it was about choice and choosing and changing.  cut out sugar and fats.  limit red meat and alcohol.  increase exercise and and vegetables and fruits.  choose multi-grains and anti-oxidants.  the lists seemed endless.   i was completely overwhelmed for awhile with the enormity.  all of a sudden i felt like a young woman battling an eating disorder.  i couldn't put a bite of food into my mouth without questioning if i was starving the cancer or feeding the cancer.  talk about an immediate weight loss program!  i moved past that initial shock and have tempered the food thing a bit,  but i am still the woman painstakingly peering at labels in the grocery store.  my kids are doing their best to wait out my health food kick, hoping daily to find that cheetos and poptarts have reappeared in the pantry.  but i buy spinach and blueberries and avocados and organic milk and quietly repeat my mantra:  a lifetime kids.  a lifetime.


today i headed back to the cancer center.  this week we have results.  this week we entered dr. ballard's office with oncotype securely in hand.  i held my number 15.  i held my low risk number tightly and i wasn't letting go easily.   this week my friend, meritt, walked in with me. she and i had been lighthearted and chatty all the way there, but just before seeing dr. ballard i began to panic a little.  what if i was wrong.  what if he knew something else...something new...what if he had changed his mind and decided at 15 he would recommend chemo.  what then?  i had already brought home the cake and lemonade.  we had already celebrated.  i had even posted a picture on facebook - it had 53 comments and 111 "likes" for heaven's sake!  i began to doubt my premature celebration.  i began to doubt my confidence. i began to doubt.


after a few minutes more of quiet panic, in came dr. ballard.  dr. ballard has a wonderful presence.  he is the epitome of a southern gentleman, soft spoken and unhurried.  both times meeting with him i felt more like we were sipping lemonade on a front porch, then discussing cancer in an examining room.  i knew immediately from his smile, he hadn't changed his mind.  he kept repeating over and over again, "you've got a good score, jody...you've got a fine number. a fine number."  he brought out the graph from genomic health and he showed me my percentages and he circled my spot on it all.  all the while he nodded his head approvingly and clucked a bit like a proud mother hen.  he was pleased.  he explained some of the information and even explained some of the risks.  he sadly told us how just a few years ago he was still giving women in my very situation high doses of chemo.  they didn't have the oncotype test back then.  he didn't know better.  he was thrilled that today he could cross chemo off my list.  i was in a low risk of recurrence and i would not benefit even 1% from chemo.  that was it.  he was sure.


after the assurance of good news, we talked about how we would manage my health.  i will be on a daily medication called tamoxifen for the next five years.   every 3 months i will see dr. ballard and have lab work completed and some tests run.  yes, this is treatment, but it is do-able.  i will happily take the medication and visit doctor ballard and drink my green tea and eat my blueberries and exercise regularly.  i am thankful to do so. i am grateful.


just before leaving his office dr. ballard sat back in his chair.  he paused a second, looking me in the eye, and then in his soft, southern way he said , "jody mcnatt, i have a good feeling about you dear.  i think you are going to grow up to be a nice, little old lady. yes, yes, indeed."
i like this part of the longterm plan.  yes, yes i do, indeed.