After a long weekend, I decided on the oncoblastic reduction, that is, assuming insurance will pay for it. This is where they do a lumpectomy and then try to get the other boob to match. It involves two surgeons in Atlanta, and I let them know I wanted to proceed, but still no surgery date. Next week I start squeaking (as in squeaky wheel): Hi, there! It’s me, and I’m still waiting. Please tell me when I can get this thing out of me.

Out of me has been my new mental mantra. Every headache, gas pain, or tingle convinces me that Unferth (or Parnell, as I also think of him; Lee Smith read at WCU this week, and she always has characters named things like “Parnell’) has metastasized, and of course I don’t know whether it has or hasn’t, but I like to be prepared. Like my friend Laura Wright, I assume all disaster is due to me not anticipating it hard enough or long enough. Therapists have explained that this is superstitious thinking, but the people who think that are the people who haven’t seen a direct correlation between their unpreparedness and doom from above. It’s a burden. For one thing, it’s so incredibly difficult to think of everything that could go wrong. Also, it doesn’t ever cause excellent things to happen, unless by excellent you mean no doom from above…today.

This week I went to get moral support from Carol the Navigator, who seemed to like the idea of the Atlanta procedure (they don’t offer it around here, I’ve confirmed). She got me an appointment with my primary care physician to get “approved” for surgery; that was good, as I don’t have much luck talking to his staff directly. And she canceled my appointment with the local surgeon, so now I’m sort of committed. And a date would be nice.

Also, I went to get genetic counseling and testing. If you have a family history of breast cancer–I do not–they like to see if you carry a gene that predisposes you to cancer. You have probably heard of the best known susceptibility, which is related to the BRCA genes. The BRCA gene test is a blood test that uses DNA analysis to identify harmful changes (mutations) in either one of the two breast cancer susceptibility genes — BRCA1 and BRCA2. But only about 5-10% of cancer is inherited. They also like to test you if you got cancer before you were 50 (no), or if someone in your family got it under 50 (no) or if you had triple negative cancer before age 60 (no–triple negative means, among other things, that your cancer doesn’t respond to hormones), or have male breast cancer (no), or a history with ovarian cancer (not that I know of).

So the chances of my having inherited the BRCA gene mutation are pretty low. But there are other kinds. Plus it turns out 30% of breast cancers are “familial,” which seems to mean that if your family has certain kinds of cancers that are genetically related, your chance of getting those cancers goes up. My family has pancreatic cancer, colon cancer, lung cancer, and melanoma among close relatives (ancestors, siblings, etc.) so the doctors thought it might be worth investigating. The problem with testing, of course, is that you could find out about a predisposition you could do nothing about (for example, taking out your stomach or pancreas in anticipation of cancer doesn’t seem to be an option.) But there’s always the chance that they could find a predisposition you could do something about, which would make it easier to get rid of your ovaries. For some reason, your insurance doesn’t like to routinely pay for the removal of your ovaries, which if you ask me are just sitting around planning mischief. You can read more about these if you’re even slightly interested.

I won’t know the results for some time (more waiting). However, most cancers turn out to be “sporadic,” which means they have to do with environment or lifestyle. I asked my genetic counselor what I could do to keep my genes from mutating. The only thing they seem to be sure about is that whole diet and exercise thing. I mean, they’re really serious about it. And smoking and drinking. But I’ve now spoken to three doctors with three different opinions about the drinking.  One said drinking modestly increased your chance of breast cancer, but the benefit was outweighed by the benefits to your heart. My father’s parents died of heart disease before they were 65. And I do love wine, so I liked this doctor best. Another said drinking more than two drinks per week (two–and by drink they mean very, very little) increases a chance a lot. A third doctor implied it all had to do with not being vegan. Or exercising. Or accumulating belly fat. But nobody can tell you why some people who are thinner get cancer and some people who are fatter do not get it.  They also can’t tell you whether changing any of those things about yourself will help in the slightest. Still, it’s hard not to feel as if I’ve done something to deserve it. It turns out that’s a common feeling among cancer victims.

So this update is mainly about what I don’t know. This morning I saw the chancellor in the gym, and he knew about it. Just about everyone I see seems to have heard. I honestly don’t know how to feel about that.  I know this blog is part of that, though I still don’t know why my posts get fewer likes than Kaleb’s “fart” posting. It’s just like not being picked at recess. One of my favorite poems, by W.H. Auden, talks about the way Dutch masters painted the dark times of our lives: Never in the absolute center of the canvas, but over to the side or falling off the edge, because they knew that people do not stop living their lives just because something happens to you:

They never forgot
That even the dreadful martyrdom must run its course
Anyhow in a corner, some untidy spot
Where the dogs go on with their doggy life and the torturer’s horse
Scratches its innocent behind on a tree.

I can relate to this, because while part of me wants to live life normally, another part wants the entire Internet to stop what it is doing and take notice. I can’t explain it, but there it is. More therapy may be indicated.

Or maybe Auden means to just foreground the day to day, rather than organizing experience around the life altering only. In medieval triptychs, Jesus crucified (and I am not trying to compare myself) is always the center of the triptych. We don’t get too hear about the rest of his life except as it orbits the one grand disaster. So maybe it’s also about changing the narrative. In the title of my blog, maybe the boob could be relegated to subordinate clause. Ot at least a compound: in which Mary’s boob Destroyed Sylva and She ate Cheese Doodles.

Anyway, when I get a date for the surgery, I’ll post. Things have to be planned. The “girls” need to prepare for their transfiguration. My sister wants to buy a ticket. A veritable stable of bras need to be retired.

Someone who just went through this process told me that the best thing about it is the support you find from friends and total strangers. I’m learning that now. Thanks to my friends for keeping me going.