Scars

Two months after giving birth, I return to the operating table.

The ordeal is smaller this time. It will be outpatient; not even worth mentioning to my friends. Just two small surgeries.

The first surgery will be to replace the temporary implants inserted at the time of mastectomy with more permanent ones. I will be opened up along the existing scars for the implant exchange.

I am tasked with selecting either silicone (more life-like) or saline (zero health risks; zero maintenance until the time of replacement ~ which is roughly every decade with either option.) Not wanting to give any fuel to the arthritis that racks my ribcage, I choose saline. I would prefer a rippling, wrinkly, sloshing water-balloon chest to the pain – or even the possibility of sustaining the pain – of the arthritis. I’ll take weird and ugly over incapacitated any day.

Also while under, I will be having a surgery to remove my ovaries, a laparoscopic bilateral Salpingo-Oophorectomy. Blah, blah, blah-blah. Because I tested positive for a BRCA I gene mutation (what’s up Angelina Jolie), my risk for ovarian cancer is high. Removal of the ovaries greatly reduces this risk and is recommended by age 40.

Silicon or saline? Oophorectomy now or in 10 years? These are weighty and highly nuanced decisions. I will second-guess them for years.

The oophorectomy in particular will have pervasive, unpleasant side effects that make me question this decision many, many times. But these decisions are about survival, or bettering odds for survival.

Health problems birth a need to make difficult, monumental decisions that are often a roll of dice amongst a table of bad options. You can only do the best you can with the information available to you. I’m pretty sure that’s the advice my Dad gave me anyway.

The surgeries put me in bed for a couple of days and I can't lift my tiny baby for the first week. But once again, my mother is here to lend her hands, and I'm bouncing back before the week is up. Onward we move.

To match the scars curving across both sides of my chest and the pair of small ones below, where the JP Drains exited, I now have two bubbly little slits on either side of my belly button, plus another healing slash across the top of my belly button.

Scars; blazing-forever-imperfections across my deeply imperfect body for my imperfect self to lament.

Guest Blog, by Baby L

Today was a big day in our lives: we left the house. That doesn't happen all that often and I think it exhausts my parents when it does. But I'm getting ahead of myself.

The day started like most of my other 15, I was handed off between my daddy and my mommy. I can only assume they take turns because they can only handle so much of my fabulousness before the other one gets jealous and needs a turn. They usually start yawning about when a shift change is in the works.

I haven't figured out why it gets dark for half the day yet, but I just treat it all the same.

Today, when it started getting bright out, or maybe it was a little before, I got the switch from the daddy to the mommy. We were having a nice bottle in bed when the little boy joined us. My, was he interested in giving me "kisses" and "hugs" this morning. I kept getting little slobbery pokes and disturbing squeezes; he took absolutely no notice whatsoever of my disagreeing grunts. I keep giving him my strongest squirms, squeals and dissatisfied faces, but he just kept right on touching me. I can't decide if he's calming and one of my very favorites, or quite a nuisance. For example, this morning, he spread my delicate fingers apart until they would stretch no more. "Mom, look at how I can separate her fingers," he hollers out, as though the achievement is somehow his. I do like the sound of his voice though. It's oddly familiar, like when the mom lays me on her chest and there's the thump-thump rhythm that my body is so in-tune with.

So this morning I got a bath, which I don't mind at all, and then dressed carefully. (I have noticed the mom spends significantly longer getting me dressed than herself. She's really going to have to work on that.)

So, we all get out the door and where is our big outing to? The public library. Wow, so impressed; this family really knows how to live it up. Our mom seriously sat forever, or like an hour, reading books to the boy. I was so bored I had to take a nap. But then I had to remind them I was there and so cried and hollered a little bit. Then the dad came back and they picked up chewable food for themselves or some such thing; I don't know, I took another nap.

That's the beginning of day 16, folks. Life is good so far.

Mother of Two

In the coming days and weeks, I will learn how to be a parent of two.

The first morning I'm home with both children starts bright and early - of course. I've just given my daughter, Baby L, her first bath (after a throw-up incident), fed her tiny tummy an astounding third bottle in four hours, and have her on my shoulder to burp when she lets out a little grunt and a loud gargle of poo fills the back of her diaper. Nearly simultaneously, Little H hollers from the bathroom, "Mommy, I'm done." In other words, Mom, I've just pooped; come wipe my butt. My hands are full and I'm surrounded by multiple needs - and poop. Yes, I am a mother of two now.

I quickly learn to juggle tasks and make quick judgments of priority. I learn to sleep on demand, disregarding noise, light, or any other disturbances, because otherwise there might not be any sleep. I change my clothes, and the bed sheets, only when an inordinate amount of pee or spit-up has soaked into them.

I notice that my first baby, my son, will also need a daunting amount of attention and love as his understanding of his family is changed.

And, I am reminded of my husband's quality of character by how many middle-of-the-night feedings he takes on.

Amidst these suddle lessons, I am completely calm and simply happy. (So happy!) I cuddle that precious, tiny baby and am daily filled with awe of her.

 ~ ❤ ~

Two weeks after Baby L's birth, I start Tamoxifen, an anti-estrogen therapy for hormone receptive breast cancer. I know, that sentence just had a lot of words that don't mean much to the average person. In brief, Tamoxifen works at slowing, stopping, or preventing the growth of a specific type of cancer cells, such as mine.

My start of Tamoxifen was delayed by the pregnancy. So just as soon as the post-partum spotting ceases, I unleash this next phase of treatment on my body and begin the once/day pill regime. 

Side effects include: hot flashes, vaginal dryness, decreased interest in sex, blood clots, overgrowth of uterus lining, ovarian cysts, stroke, endometrial cancer...  But because Tamoxifen has been shown to be effective at lowering the risk of breast cancer recurrence - because it will help me survive - I will take it every day for the next 5 years.  

Gratefully.

Out of the Wilderness

It's a hazy, cool morning, the day after she is born. I stand in front of the shuttered windows of our momentarily quiet recovery room, holding her in my arms and looking out to the view. There's a large medical building across the street from the hospital, not your typical inspiring view, but one that I am appreciating.

The building houses my OB-GYN's office, in particular, the office location I saw her at during the early months of my pregnancy. I showed up there as a cancer patient with a pregnancy that wasn't likely to succeed. And here I stand, as a happy new mother in the maternity ward.  It is so good to be across the street.

And, it's good to be upstairs. That night in the ER, where I was bleeding and fearing the baby's loss, took place a few floors down. That could have so easily gone the other way and I wouldn't be standing here today. I clutch my baby closer. It didn't. She is here.

I settle back into the bed for some more quality time staring at my precious girl. Nurses come and go. Doctors stop by to check on us. A breakfast tray arrives. The business of the hospital carries on around us, but I mostly just see her, taking in her every feature and movement, her smell and the feel of her soft skin.

A woman on the housekeeping staff pushes her cart and mop into the room. She has a long braid down her back and a thick Hispanic accent; she clearly loves to chat and finds me a willing listener. My trash cans get emptied, counters wiped and floors moped and, meanwhile, I learn about her life: how she loves to stay busy to pass the workday, how she has two children at home, and how she recently lost her husband to cancer. 

I relate and tell her briefly how I am familiar with the cancer battle. She is full of empathy and even more advice. She seems to be looking for more things to clean to prolong her visit in my room.

Later, when I'm wheeled out the door to the discharge area, I'll look down the hall and see her and her coworkers having a chat together as they lean on their carts and mops. I'll raise my arm up over a sleeping baby and give a wave goodbye. A small flood of cheers of congratulations and encouragement will follow me down the hallway in a quite perfect send-off from my new friends, the hospital cleaning staff.

Home we go, my daughter and I.

I step outside with her in my arms and I have just stepped out of the wilderness and back onto a path of life that is comprehensible, pleasant, beautiful.

I am beaming with a gratitude that is so deep, it will never leave me.

Birth Story

Three days after my due date, I'm scheduled to arrive at the hospital at 4:45 AM to be induced. With a fortuitous start, two hours prior I awake with contractions. 

The grey light of dawn is speckled with headlights and streetlamps, as we make our way to the hospital. I am staring out the car window, watching everything zoom past. Nervous energy steeled by joy is pulsing through my swollen body. This is it! This is really happening!

They start the IV in my right arm with only a moderate amount of digging, much to my relief.  The Pitocin does it's job and the contractions come on quicker. I hold off on pain relief to see how speedily things will progress.

"Still 4 centimeters dilated," the nurse calls out. My husband Bobby puts down his grading from the corner chair and heads to the cafeteria for breakfast. The room is quiet, save the sound of the baby's heartbeat through the monitor. 

I bury my head in the white pillows and grunt through the pain. With eyes squeezed tightly shut, I see the bank teller across the desk, all those months ago during chemo, when I started having contractions. No, I tell myself, this is the real thing; this is for my baby girl. 

They break my water and the contractions come on more quickly and intensely. I'm ready for an epidural.

And where’s Bobby anyway? Isn’t he supposed to be rubbing my feet, or something like that? That’s what they show the labor experience to be like in those child birthing education videos from the late 80’s: A frizzy-haired, sweater-clad couple eats soup calmly at a restaurant while an outline of early labor flashes across the screen. Next, they’re putting on their coats and walking hand-in-hand into the hospital. He’s rubbing her feet and back through the contractions as we see the middle stages of labor defined. And finally, we see him grasping her hand and talking softly into her ear, one can only assume, with affectionate encouragement.

My loving husband saunters in from having a coffee downstairs. He's probably thinking about getting a nap in before I start to push. I'll manage without the foot rub.

Aww, the welcome relief of numbness creeps down one leg and then the other; the epidural has set in. "9 centimeters and just about time to push" is the next nurse's report. Then my doctor comes into the room and says the baby's heart-rate is low; it's time to get her out. Now.

It's noon and I am pushing. The crushing pain I remember from my son's birth is completely absent, thanks to a speedier process and more effective epidural.

With just a handful of pushes I see her tiny body lifted up above my knees. The umbilical cord had been wrapped around her neck and was beginning to compromise oxygen delivery. But once again, she is saved. And now here she is! I see her!

The tears are streaming down my cheeks in one of the happiest moments I have experienced. She is real and here.

They wipe her off and place her naked onto my chest for skin to skin contact. Between my marred and scarred breasts lays a tiny bundle of perfection. Every other thing in the world drifts away as I feel the weight of that warm, breathing baby pressing onto my broken chest. I stare into her little, dark eyes, that are staring right back at me. I run my hands over the long, dark hair covering her flawlessly round head. I feel the length of her back.

Maybe, in a way, all the tears over the last two years were tears of joy. Because they brought me to her, my daughter.

Stores of Love

We need deep freezers and we need a lot of glass storage containers.

Actually, “a lot” may be an understatement; we need a Smucker’s factory of glass jars. The life of breast milk can be safely extended with the use of glass receptacles and deep freezer storage.

So, in my endeavor to store up donated breast milk for my unborn child, I start collecting glass containers. I buy mason jars by the case and put out a call to everyone I know to start saving their glass jars. My relatives put collection boxes out at their workplaces. Dozens of empty pickle, jelly, spaghetti, and all manner of food product-jars manifest.

I run each one through the dishwasher and then give it a 10-minute bath in boiling water. I stand over the stove, boiling huge steel pots of water and jars. The sound of the glass clanking against the rolling boil is the soundtrack of my pregnancy. Surely the baby, tucked in-utero underneath my tong-clad-hands, grows accustomed to the popping of the hot water and the clanking glass.

I divvy out the collected, sanitized jars and order my deep freezer in anticipation of the incoming stores.

The sales representative, processing my payment for this very special small appliance, makes small talk by asking, "So what are you getting the freezer for?" Funny that you should ask.

I decide that storing other people's breast milk for my unborn child is in fact not a bizarre and creepy answer and tell her my story: I have generous and loving friends who are helping my daughter get a healthy start in a way that I cannot.

My friends take the jars that dozens of people saved for me, I happily stood over a boiling pot sanitizing, and they fill them with their precious time and good intentions for my daughter. (Meanwhile, of course, they fill my heart with gratitude.)

There is a loud shriek on the line followed by some sort of gaspy giggle. The stranger running my credit card screams into the phone, "That is the neatest thing I have EVER heard!" She gushes on, "What amazing friends you have." Yes, I agree.

And now I also have an arsenal of jars distributed amongst every lactating one of them and a deep freezer that, over the next year, will be filled and refilled repeatedly with a cloudy yellowish-white life force. For her, for my daughter.