Chapter Five

You may bleed blue, but I pee blue.

IT WAS NO wonder they instructed me to arrive at the outpatient check-in early. There were five million things to do before they prepped me for surgery, including lots of paperwork. Once that was done, I was sent to have a guide wire inserted into my breast so Dr. O could see the direct route to my tumor. The guide wire insertion wasn’t even the worst part of that lovely episode. It was having a mammogram afterward with the wire in place. Getting squashed like a pancake is uncomfortable enough without having hardware hanging out of your boob. (A week after that I got a letter from the facility telling me to contact my doctor immediately as I had an abnormal mammogram. Oh, really? I wonder why? Duh!)

Ed was allowed to hang out with me once I was dressed in my gown, hair in a skullcap, and leads connecting me to the monitor that showed my heart rate and blood pressure. I’d already talked to the anesthesiologist and answered a lot of questions, mostly about allergies and stuff. Safely tucked onto the gurney that would take me into surgery, I got my own little curtained space to await Dr. O’s appearance. I heard a woman crying in the slot next door, telling her husband, “I don’t want to have a re-excision! I just want to go home!” At the time, I didn’t know what that meant, but I felt awful for her just the same.

When Ed was told to leave, I spoke to the nurse on hand, remarking that having to undergo nonelective surgery had convinced me that I never wanted to have a facelift or tummy tuck or anything else for that matter.

“Why would you put yourself through this if you didn’t have to?” I asked.

“Oh, I want to have my breasts done someday,” she told me. “When you work here, having surgery doesn’t seem like such a big deal.”

It’s all in the perspective, I guess.

I realized when Dr. O arrived because of the sound of her footsteps. She’s a girlie-girl, for sure, always wearing the most fashionable shoes. Once I heard those heels tip-tapping on the floor, I braced myself. She came over to say, “Hi,” and told me about the radioactive dye they were injecting into my body so they could stain the sentinel lymph nodes that were my immune system’s first line of defense. I’m sure I said something stupid, like, “Will it make me glow in the dark?”

But the dye didn’t make me glow. What it did was cause me to pee blue, about the same color blue as one of those toilet bowl cleaners. That season, the St. Louis Blues hockey team had a motto: “We Bleed Blue.” I wished I could have told them that I could top that.

I remember babbling to the surgical team after they’d wheeled me into the operating room. But once the anesthesia was administered, I was out like a light. When I woke up after the surgery, I felt very, very cold. Then I passed out again, only to awaken in recovery. I fought like hell to open my eyes and sit up. I just wanted to go home. It was a while before I could summon a nurse, get some Teddy Grahams and juice, and find my clothes. My chest was so tightly wrapped in a bear-hug bandage that I couldn’t feel much of anything except pressure.

Soon enough, they wheeled me into a little room to wait for Ed and my mom. The way Ed’s face lit up when he saw me was priceless. My mother would later tell me that he might as well have been holding his breath the entire time I was in the operating room; he was so anxious to see that I’d come out of surgery and could still smile and crack jokes.

The ride home was uneventful except for the sight of two dogs humping in someone’s unfenced backyard while we waited at a stoplight. It at least made the three of us laugh, which was something that would become all too important in the weeks and months ahead.

Other than the blue pee and grasping the fact that I needed pain pills to get through the first few days postsurgery—not easy for a girl who doesn’t like taking aspirin—my most vivid memory is of removing the bear-hug bandage. My mother was over at the house at the time, but I went into the bathroom alone to unwrap it. I’m not sure why I wanted to be by myself when I first glimpsed my incisions and bruises, but I did. I was standing in front of the mirror as I slowly began unraveling the bandage, layer after layer, like I was peeling an onion. When I got to the end and finally released my breasts and ribs from its grip, I came very close to passing out. I sank down onto the toilet lid and sat for a few minutes until I could take in a few deep breaths. I’d been breathing so shallowly with it on for the previous twenty-four hours that I was out of practice. I must’ve made some noise, as my mom barged in to see what was going on. She helped me stand and kept an arm around my waist as I looked in the mirror to see my wounds.

My left boob was a virtual rainbow of bruises, the skin all shades of yellow, purple, green, and blue. I had two red incision lines on the left side, one at the site of my lymph node dissection and another longer one at my tumor site. I decided then and there to call that breast Frankenboob. I figured it needed a nickname and that seemed to fit. Despite my attempt at levity, it was a hard thing to digest, no matter that I kept telling myself that I’d kept my breast, that dents and dings and scars made no difference. I was the same person, and staying alive was the name of the game. But it would be a long while before I fully accepted the changes and could gaze at my chest in the mirror without my throat catching.

Something else that came as a surprise: no one had warned me that having sentinel nodes removed from my armpit would cause my arm to feel like it was bound to my side by a string. “They didn’t show you how to do wall-walking with your hand?” a friend of mine who’d gone through a lumpectomy asked, seemingly stunned that this vital piece of information hadn’t been shared. So she described what to do, and I started trying every day to inch my left hand farther and farther up the wall. I was slowly resuming normal activities around the house as well, emptying the dishwasher and tossing clothes in the washing machine. I figured those were very practical exercises to improve my range of motion.

Though I’d made it past the initial surgery, I wasn’t yet in the clear. The two weeks as I waited for my pathology results were the longest of my life. I was hoping for several things: first and foremost, that the surgical path showed pure mucinous carcinoma as the biopsy had. If the mucinous cancer was mixed with any other kind, it would be far trickier to treat. And secondly, I wanted reassurance that Dr. O had gotten all the bad cells out (aka clear margins). I kept thinking of the woman who’d been crying about undergoing a re-excision, and I wondered if that would be me as well. As I’d come to learn, getting re-excised meant going back to the operating room so Dr. O could remove even more tissue to ensure she had not left a single cancer cell behind.

Every night, I prayed for clear margins. I did not want to go back for more surgery. To do so would have felt like taking a step back instead of moving forward.

While I waited, I did the best I could to distract myself. When Ed went to work each morning, my mom came by and would turn on Ellen, knowing that would make me laugh. I had books to write, too, with about one hundred pages of Too Pretty to Die still to finish for Avon and The Debs to start for Delacorte. It was strange, having to remind myself to be funny as I chipped away at a humorous mystery when I was going through a rough patch that was so incredibly serious. But escaping into my fiction was so cathartic. In my books, I could control the characters and what happened to them, strangely reassuring when I felt completely out of control in my real life.

Beyond the writing, I also had Night of the Living Deb releasing in February of 2007, and I had events lined up, starting in a matter of weeks. I didn’t know what I’d be able to do or not do, so I pushed those worries away for a while. My motto fast became “One day at a time,” because that’s about as far ahead as I could look.

When I finally got a call about my pathology results, I knew something wasn’t good. It was Dr. O phoning, not her nurse. I took that to mean, I’ve got bad news, and I was right. One margin wasn’t clear. There were still cancerous cells in my left breast. I had to go back in for more surgery, scheduled for January 10, 2007: yep, the dreaded re-excision.

I told myself, It could be worse. I wasn’t going in for a mastectomy. I was just having more tissue removed. I thought of the women I knew—and so many other women out there—who’d had to undergo much more radical surgery than I. In the grand scheme of things, I was getting off pretty lightly. Throughout my treatment, I kept reminding myself of that fact.

My mom came over the night before my second surgery, and I sat between her and Ed on the bed, each of them holding my hand and being very silly. Despite all the ways I reassured myself, I was still fearful at having to be cut into again when my incisions had had two weeks to start healing. But, somehow, Mom and Ed made me laugh through my tears. They were getting awfully good at breaking up my pity parties.

Damn them.

The morning of my second surgery didn’t start out so well. Someone had told us the wrong time to show up, and the woman at check-in had to rush me along the minute I appeared. Though I guess that was better than having to wait. When I was fast-tracked through prep and on the cart, ready to be wheeled into the operating room, Dr. O stopped by, and I asked her point-blank, “How do you know where the bad cells are when you go back in? How do you find the ones left on just one margin of the tumor site? What if you take out the wrong stuff?”

She gave me an odd look. “Susan, do I ask you how you write your books?”

“Good point,” I said, and then I was off to surgery again.

Luckily, the path results this time showed all margins were clear and there was no sign of any bad cells having traveled to my lymph nodes. I felt almost as though I could breathe again.

The only thing that kept me from resting easily was knowing I had forthcoming appointments with the oncologist and the radiation oncologist. I realized my treatment was hardly over yet. I only hoped it would be of the less-is-more variety. But the way everyone kept reminding me, “We have to do everything we can to make sure this doesn’t come back as you’re only forty-two,” I worried that my treatment might tend toward overkill.

I worried, too, about Ed’s and my relationship. He was my rock and had never let me down, not even for a moment; but I hated that my diagnosis seemed to have taken over everything. I kept saying, “We will get our lives back someday,” and I tried to keep his world from turning as upside-down as mine. I insisted he attend Blues games, play with his recreational league hockey team, and attend his work functions. Even if I couldn’t be by his side, I didn’t want him missing out.

We tried to create quiet times to be together as well, when we didn’t talk about my boob, when we could just feel (even for a few minutes) like a couple in love again. And we joked about saying our vows when we got married. Heck, we were already going through the “for worse” part so we figured we were due for a lot of “for better.”

I’d like to believe I would have made it through my diagnosis without him. But I can’t imagine what it would have been like. Having Ed beside me every step of the way kept me going. I wanted to be well again, not only for myself, but for us. Meeting Ed when I did and falling in love with him was the best thing that ever happened to me. As corny as this may sound, I knew in my heart I was meant to be with him, that we are the truest of soul mates, our age difference be damned.

When I think of all the dominoes that had to fall into place so that I would run into him at that magazine party, I’m amazed that it happened at all. Which reaffirmed my faith in miracles and the idea that we are often guided by something or someone greater than us—God, fate, the universe, Buddha, whatever one chooses to call it—that leads us to exactly where we need to be.

Or, as Ed and I like to joke, our grandmothers got together in Heaven to play some bridge, and one said to the other, “I have this granddaughter who happens to be way too independent for her own good.” Only to have the other respond, “Well, I have a grandson who’s single with a doctorate and a new job. Should we throw them together?”

If anything, Ed’s and my relationship was strengthened because of my cancer. And with more treatment still forthcoming, I needed all the strength I could get.