It has been a while since I posted, and the past week and a half have been pretty unusual. Three of my sisters were able to fly down to be with me during surgery and the worst days of post-op, and apparently they made a great impression on the doctors and staff. When Dr. Ma, the plastic surgeon, stopped to visit me in the hospital the morning after surgery, she said we all looked exactly alike. It’s funny, because we look quite different from each other, but perhaps the critical mass of Adamsness (pale skin, dark eyes, twisted grimaces, gummy smiles) blinds the uninitiated to our individual singularities.

Surgery day began when we wandered into the wrong admitting office with a newly-hired employee who gamely forged ahead to fill out the papers. Like me, she clearly had difficulty reading the NC State Employee health documents and quoted me a price somewhere between $2500 and 90,000. As I indicated in a previous entry, I have given up trying to decipher anything from my health plan and so opted to pass that problem off to the future or to my heirs (I had to give them a copy of my living will and health care proxy). She escorted us to a very tasteful, comfortable waiting room that had overstuffed chairs and screens you could use to check what stage of surgery your loved one is if you knew the secret code. After I got hooked up to an IV and was draped awkwardly in the obligatory surgical handkerchief, my sisters came in to wait, and we entertained the entire staff for a couple more hours until surgery. I know their favorite part was listening to the famous sayings of men translated into female office-speak (“I have not yet begun to fight” becomes “I’m not going to fight you, Dave. Maybe it’s just me—what does the room think?”)

Apparently my sisters passed this time fruitfully, eating Mexican food and having wonderful chats with my usually recalcitrant surgeons—I may never learn everything they talked about. Of course, I remember nothing until I awoke in recovery with some kind of medieval corset, a strange black box wired to my left bosom with saran-wrap and purple sandpaper that occasionally emitted sounds somewhere between a fart and a trill, and a bizarre top-pointing ponytail like something a Dr. Seuss creature might wear. (One wonders how doctors resist the temptation—if they do–to dress their anesthetized patients in Yoda costumes or pose them with life-size models of celebrities. I seem to remember remarking that the trip to surgery was a macabre odyssey out of Jacob’s Ladder while my keepers laughed demonically. ) At any rate, I woke up extremely thirsty and, apparently, somewhat allergic to or at least intolerant of the opiates. Although I enjoy telling how much radioactive green dye came out of me when I could finally pee again, and how very relieved I felt when the rest of my purgative powers were eventually restored, I will spare you any more details.

The results of my pathology, which came in several days later, were mixed. When you get a lumpectomy, they now remove only your sentinel (nearest) nodes and send them off to lab (a mastectomy takes longer, so they’re usually able to test nodes and, if they see cancer, to remove the secondary or axillary nodes). The surgeon got good margins around my tumor, which had grown to about 2.8 cm. I had two sentinel lymph nodes, one of which was clear, while the other had a 9mm mass in it, with part of that mass having moved beyond the node into the lymph channel (in cancer parlance, this is called extranodal extension or extracapsillary extension.) This is a complication that meant my surgeon, a careful and somewhat taciturn sort, wanted to check with the tumor board (today!) and get back to me. She didn’t tell me exactly what it means, and she still hasn’t.

I spent the first weekend in utter despair because I googled it (when you do, you come up with studies mostly written in a strange mathematical shorthand littered with phrases like “recurrence” and “poor prognosis.”) I gather that it probably means more involved axillary nodes, chemotherapy, definitely radiation, and possibly another surgery, but my emails to my surgeon produced only cryptic one-line responses like “yes” and “maybe” and “that’s not a very good study.” Since then my worthy sister Polly has talked to a doctor who was very reassuring (these factors, after all, must be weighed with all the other data, some of which are good.) And I’ve heard from other people who have survived such things. So I’m waiting. And I advise you, if you yourself decide to get cancer, to not only find good surgeons, as I have, but to also make sure they are not too stingy with explanations and the occasional encouraging platitude. Sometimes you really need these things, especially if you are going to spend the next two weeks confined to a dark house by yourself.

While the prospect of chemo is daunting, the new breasts have been an endless source of fascination. My friend Trish pointed out that even reduced they are fairly large (Dr. Ma described them as B-C, and I thought I wore a C-D before) but they seem quite a bit smaller than before (I also weigh about six pounds less post-surgery, which if you think about it is like unloading most of a gallon-container of milk). They’re hard as rocks and very pointy, but part of that is the swelling, which may someday go down. They were also lifted (if you google this, it appears that they cut a large key-hole shape, remove breast tissue from the middle and bottom parts of the hole, and then move your nipple to the top of the hole.) My procedure must have been more difficult because the left breast had a large hunk removed from the left posterior wall, and I’m quite impressed that everything got put back together with no major tears or gaps. I assume part of the credit goes to the Black Box of Flatulance. The whole effect is slimming, but just a bit Frankensteiny at present, what with the visible nipple seams and the sepia-toned bruising. I’m still wearing the corset, mainly to keep things from moving around too much, though I’ve jettisoned the black trilling box and most of the saran wrap.

Still, I’m not allowed to lift even small things or walk my dogs for four weeks in case the breasts fall off or the scars erupt in a shower of goo. Embarrassing as it is to ask for help with a gallon of milk or a car door now, I honestly don’t know how I’m going to handle the dogs for the next six months or so with debilitating nausea and hair loss thrown in. So if you’re local, and you’re at all inclined to help, please let me know if you want to join Kaleb’s Goon squad on Facebook. It makes it easier for me to ask for help instead of serially dialing and begging everyone one by one, and it might take some of the burden off Kaleb, who has heroically come to help me shop, carry off trash, and scoop cat boxes every day since I got home. You may all wish at this point that I’d married or raised children who were obligated to help at such times, but if you know how poorly I’ve trained my dogs, you’ll probably conclude that helping me now is the lesser burden to the world.

In the meantime, I’m doing nothing but walking and watching a ridiculous amount of television. The best part is almost unlimited dog cuddling, plus this awesome wedge pillow and support structure that lets me sleep sitting up. And I get to eat ice cream on every trip to Atlanta (it’s like a new tradition). Pam Duncan took me to Atlanta Friday for my first saran wrap-removal–and ice cream. My sisters and I drove up from Atlanta and stopped at a flea market where we ate ice cream and boiled peanuts at a picnic table. (They don’t know much about the south but have come to associate it with the boiled peanuts.) Even when we don’t get along, I love getting to spend this unprecedented time with them, eating, doing nothing, even just sitting and not talking while the black box chirps and farts softly in the background. It’s more like being at home than almost any moment I can remember as an adult. I don’t know why it takes something like my treacherous boob to get us all together, but I wish very hard that it can happen again.

Thanks to everyone who has helped and offered to help and asked how I’m doing. It’s still very hard to get used to asking for things, and I still haven’t sat down to write back to you all, but it means everything.