Calling Kelley Coyne Campoli!

I've been way belated getting back to you, but you're much on my mind. Very early this morning I was awake when I shouldn't have been, paging through some old links that have made me happy in the past, and this one still makes me laugh like a bad bear or a seductive chicken. Like a seductive chicken once made me laugh, I mean. No one has told me (yet) that I laugh like a seductive chicken. But a girl can dream.

For you, my friend, and for anyone else in need of a dose of silliness:

http://ghettohikes.tumblr.com

Ack! Can't seem to make that a link with my mobile app, so I'm adding a bonus to compensate, one amazing result of a "seductive chicken" image search. The NY Times got in trouble with PETA for this one. "Too sexy!" cried the animal lovers, and they were right.

Forza!
Gretchen

If in doubt, don't go out

Apologies first to those I've already ambushed with earlier posts, and fair warning to all of you generous hearts moved to swim out with me into high surf. I love your company, and I want you returning safely to shore. Close your inbox, cancel your RSS feed, do whatever you need to do to keep your head above water and avoid the deadly maw of the Undertoad. SWIM AWAY FROM ME IF YOU THINK I MIGHT TAKE YOU UNDER.

"Now I will you to be a bold swimmer..." Whitman says. Not a foolish one.

Forza!
Gretchen

Here be dragons!

With my new visual deficits, dangers are coming at me from left field.  I make an innocent request  for happy, silly dog pics, and THESE are the near-lethal result. I could have burst a tired vessel in my brain! Proceed at your own risk.

Forza!
Gretchen

The flip side of fear

It's been a long time - I'm weeks overdue on writing the post that was supposed to say, HOORAY! THAT'S IT! ALL DONE!

I've always been a coy mistress of procrastination, so it isn't out of character for me to put off a task I really want to get right, and I had plenty of excuses as always: hormonal hellaciousness when the oophorectomy gave me a hard shove off an estrogen cliff; two incredible weeks with Pete on the big island of Hawaii when my body finally gave my brain a hard talking to and ever so briefly succeeded in shutting it up (I'm spontaneously recovering a mental recording of dear Robin Williams channeling Richard Burton for a Dos Equis ad: "I NEED THIS BEER MORE THAN YOU NEED THIS BEER, AND YET, IF YOU DRINK THIS BEER, IT WILL FUCK YOU UP THE SAME AS IT FUCKS UP ME); the excitement, trepidation, and plain old logistical challenges of returning to training and teaching after nine months of gestating a strange and undeniably damaged but intermittently coherent new self.

But it was superstition mostly. I just didn't feel done. And I was right, damn it. There really are better things than being right.

I am deeply sorry not to be able to deliver this news the old fashioned way, person to person, but at the same time it's a huge relief to be able to deliver it at all when time is very short. It's been a head-spinning couple of days, and I wish I didn't mean that literally. Monday morning, a little less than a week after our return from Hawaii, I had a video conference call with a couple of terrific designers (Forrest and Marla Baer at Cloudyreason) who were resuming collaboration on a revamp of the Bridgetown website that we put on hold last December. They introduced me virtually to their charming frisbee ace of a heeler and helped kick my enthusiasm and confidence into a higher gear - a welcome intervention with classes set to resume this Saturday. But Monday night things took a bad turn when I experienced some sudden and serious visual strangeness.

I initially thought it was a particularly fierce ocular migraine, which I've had in the past and which can sometimes render me temporarily blind, so I didn't get truly frightened until the next morning, when I found that my peripheral vision loss hadn't cleared. And I noticed retrospectively that I'd hit my head on a lot of fast-moving cabinets while in paradise, and tripped many times over our phantom dogs since our return.

Too much preamble, Pete would say.

Tuesday morning we were due at Kaiser West Side for a follow-up with my wonderful OB-GYN, Dr. Mary Knox, an appointment I was looking very hopefully forward to. There's no formula for making patients feel truly cared for, but they might try bottling whatever she's got. I was scared enough by my symptoms to ask Pete if we could head out early and make a detour to the ER first. I was ready to curse myself for a hypochondriac, but I thought I might be having a stroke. An hour later, I understood from the somber faces of everyone testing my vision and reflexes that I wasn't silly to have come in - such a relief to my pride and blow to my hopes! I actually found myself longing to hear that I had a mere bleed in my brain. No such luck. A CT and then an MRI scan of my head revealed a mass about an inch in diameter sitting low in my skull, on the right side near the meeting of the occipital and parietal lobes, presumed to be a metastasis of the original cancer.

My prognosis at that moment appeared very grim indeed, as any metastasis found in the central nervous system almost always presages the discovery of systemic disease. But a wider CAT scan early Wednesday morning (neck to thighs) turned out to be shockingly clean; all indications are that the chemo actually did its job... except in the sanctuary for stray malignancies on the far side of the blood-brain barrier.

The odds that I'll live to eighty (or even fifty) have taken a very big hit, but we have a window of hope. My preternaturally soothing neurosurgeon (see, I just had to get to the point where I could say "my neurosurgeon") discharged me yesterday for a day's reprieve, which we've spent lining up as many legal, financial, and logistical ducks as we've been able (with lots of generous and expert help) to chase into place, leaving all too little time for other vital tasks that don't lend themselves to manic management. (I'm back on steroids and exhausting every doctor, nurse, lawyer, social worker, and notary public who ventures into earshot. Just the one husband, lucky guy.)

In a little more than five hours, we'll head back to the hospital. I'll have an MRI to guide placement of some navigational markers on the back of my skull (there go patches of my newborn, silvered, Buddhist-nun locks, the rest to follow with radiation in another couple of weeks), and Dr. Weinstein will set to his delicate work early in the afternoon. He's confident that he can get the tumor out without damaging much of the surrounding tissue, but the symptoms I'm experiencing now may well become permanent and could worsen or multiply.

These are undeniably problematic, also undeniably fascinating. I finally get to study a brain from the inside, when it is most nakedly exposed through sudden and dramatic alteration. Oliver Sacks are us! (His case study of the colorblind painter concerns a brain lesion close to the area where mine is, where visual signals get interpreted and our view of the world quite artificially constructed and reconstructed ad-hoc.)

In addition to peripheral vision loss (to the left and bottom of my visual field) and some relatively minor sensory deficits (a bit of intermittent numbness in my left limbs and extremities), I have a wildly disorienting symptom that's difficult to describe, which only presented itself yesterday when we returned home: The organization of spaces and objects large and small has been thrown out of whack. I don't have an absolute sense of distortion but rather a feeling of sudden estrangement from settings that have been intimately familiar, irrespective of scale, from the streets where we walk the dogs every day to (this is mightily bizarre) the interiors of our kitchen cabinets. How'd the plates get so big, the gaps between them so yawning? Brain tumors are so very, very interesting. Almost as interesting as they are terrifying.

More preamble. I don't want to sleep, but I should, and I haven't yet said what I most need to say:

I fully intend to survive tomorrow's surgery and emerge with the thread of me maybe a little further frayed but intact. In the highly unlikely event that I do not, it would be a serious bummer for me to have failed to tell all of you who have graced me with your attention and quenched my parched spirits with your interest, affection, and even love how much it pains me to be unable - not finally owing to any lack of time or energy but to a basic, endemic inadequacy - to convey to you my gratitude. But it's big. Really big. And terribly indiscrete.

Thank you.

Hey. I could use a dose of joy and beauty. I need it like I need a hole in my head. How about you? (If you've received this by email, click through to the blog for some sweet and exuberant pics.)

Catch you on the other side. I'll be blushing for my sappy histrionics over here.

Forza!
Gretchen

Getting comfortable with uncertainty

Well, doing our best.

Three weeks ago, I saw my oncologist for what we both hope will be our last consultation for a long while - a full year, if all goes well, though I'm scheduled to meet with someone from the new Survivorship Clinic six months from now. There's evidence that I have some power through my "lifestyle choices" to reduce my risk of recurrence or metastasis, but medically speaking we've done everything we can to eliminate every last rogue cell that might have escaped from my original tumor to sail the salty seas of my body and seek out a new home.

I hadn't known before I read George Johnson's Cancer Chronicles that a cancer's place of origin has a strong bearing on where it might resettle and that this isn't a simple matter of proximity or circulation. As the surgeon Stephen Paget wrote way back in 1889, "When a plant goes to seed, its seeds are carried in all directions. But they can only live and grow if they fall on congenial soil." For reasons biologists still don't fully understand, certain "soils" are more congenial to cancer "seeds," so that a kidney may have as much exposure to malignant cells as the liver, but the liver is much more likely to play host. In a similar vein, muscle sarcomas are quite rare, and still more rare are the carcinomas that successfully metastasize to muscle - the heart resists colonization, while the brain often succumbs.

Beyond this general variation in vulnerability, specific organs and tissues support to greater and lesser degrees the far-flung ambitions of specific cancers. Prostate cancer finds the bones most accommodating, while lung cancer likes the adrenals. If my own cancer reappeared, it would most likely turn up in my lungs, liver, brain, or bones. But we're hoping it won't, and our hope is well-grounded. Having successfully completed the drug regimen Dr. Barnett laid out in February, I've also got the favorable odds she promised me then (though "promise" is a tricky word in this context): seventy of a hundred hypothetical women with my clinical presentation can expect to arrive at the five-year anniversary of their diagnosis without metastasis. The bad news is that, of the remaining thirty, half will likely be dead and the other half soon to follow. These high-grade, triple-negative growths don't mess around. According to Dr. Barnett, the next two years are most critical in revealing whether or not I'm truly cured - if I make it to 2016 without a recurrence, I'll very likely make it to 2019 and beyond.

Of course, I'd really like to avoid developing another cancer, and I remain at moderately heightened risk for melanoma (happy to get an all-clear from a dermatologist two weeks ago) and grave risk for ovarian cancer, but only for another week and a half. A week from Monday, I'll bid my wasted little seed pods an apologetic adieu. If I am in that lucky seventy-percent, and all goes well, August eighteenth could mark the end of this particular medical struggle, though even in the best scenario it would be a tapering sort of an end rather than an abrupt one. I'll still have plenty of physical and psychological de/reconstructing to do. Cancer treatment resembles a labrador puppy only in this: it swings a powerful tail. Best remove delicate objects and feelings to a high shelf or mantel.

The weekend after my appointment with Dr. Barnett, just as Peter and I were beginning to recover our balance, our beloved Barley - who's been with us for all but twelve weeks of her life and all but three months of our nearly thirteen years in Portland - became markedly droopy and unresponsive. I feared that she'd gone suddenly deaf, though in retrospect it seems that she was too much occupied by what was happening inside her to register the sound of her name or other, still less relevant human noises.

We're very fortunate to have two doctors (at one clinic) in whom we gratefully trust: Dr. John Kellogg (or "Old Kellogg," as he prematurely refers to himself) and Dr. Gary Hunt. Over the course of three days, Barley saw them both and allowed herself to be poked and palpated, prodded and scanned. She drooped further but held no grudges. An alarmingly high white blood cell count prompted a series of x-rays, and those x-rays revealed a mass almost as big as a second heart, buried deep in her lungs.

A specialist's opinion was required, the film sent off to a local radiologist. We learned the next morning that the anomaly most probably represented a pulmonary carcinoma, a.k.a. lung cancer. Barley's increasing reluctance to move and her sometimes labored breathing seemed to support this tentative diagnosis, but we couldn't - we can't - be sure. The mass is literally at the heart of her, so cozy with her most vital organs that a biopsy would be traumatic and dangerous even for a young dog, let alone for one two months shy of thirteen. Whether or not it's malignant, it is practically inoperable. A definitive diagnosis might satisfy our curiosity and possibly give us an inkling of what to expect, but it wouldn't lead us to a solution; it wouldn't help us to help her. Neither would it answer the vital questions that remain: how much time is left to us? how much of it joyful?

Old Kellogg's wife, Karen, sent us a lovely email prescribing love and cheeseburgers. Dr. Hunt advised us to have a "contingency plan" for when things went south, and we cancelled a much-anticipated trip to see my sister and her family in Baltimore; we were (and are) determined to see Barley through and to make the most of whatever time we have left with her. We supposed we would count it in days.

HOWEVER, Barley's high WBC count (the inciting incidental) indicated some kind of infectious process. Dr. Hunt guessed that this was likely secondary to the hypothetical carcinoma but put her on antibiotics and asked us to let him or Dr. Kellogg know later in the week whether we saw any significant lifting of spirits. We did! When I spoke with Dr. Kellogg, he emphasized the indeterminacy of the radiologist's report as cause for optimism: a benign mass "could not be ruled out." Additionally, Barley showed none of the anemia or wasting that he would have expected with an advanced cancer. "You'll be bringing her to my funeral," he told me.

That was two weeks ago. Barley swings a little low sometimes, and she's doling out kisses with unusual profligacy, but in the main she's back to her cheerful and sweetly stubborn self, sleek with extra treats and aglow with extra attention. Once she's through her three-week course of antibiotics, we'll sample her blood again and maybe take a hopeful x-ray. Looking to go deeper in hock, mortgage our hearts for a little more time.

Forza!
Gretchen

Creature comfort

Parental advisory: The following contains graphic violence, strong thematic content, and pervasive language.

Many others have observed that one of the great luxuries of physical health is an ability to forget that we are physical. When we are ill, by contrast, our bodies insist moment to moment on their presence, their pains, their petty but consuming needs. These are times when we can safely use that overused phrase "I am literally..."

Five days out of surgery, I am literally deflated. I am literally drained. If Frankenstein had made me, this would be the point in the story where he'd flee in horror back to his rosy-cheeked Swiss family and try to forget that he ever dreamed me to material life. I am a hybrid human-mechanical monster, darkly scored in two great slashes across my collapsed chest. On either side, a small wad of gauze blessedly hides an open wound from which a tube snakes out and leaks fluid - now thick and crimson, now watery and yellow - into a clear silicone receptacle the size and shape of a toy grenade. These drains will be with me at least until Monday. Warm with my own internal heat, they nestle in specially designed pockets in my specially designed "post-surgical camisoles," of which I was prescribed two. The camisoles also have pockets for "softies," tear-shaped pillows that wait on my bedroom dresser (two A/B pillows and two C/D) for the day I am ready to play (as I did when I was ten) with the shape of my body, to make multiple, provisional reconstructions of my femininity. For now, concave is the version of womanly that suits me best.

I cannot run from me. And Peter, bless his stout heart, does not. He and I share a tendency toward squeamishness but have discovered together that this delicacy of feeling is simply not an option at present. There's shit that needs doing, and we're the ones to do it. Three times a day, more often when the flow to my drains is sluggish, we "repair" to the bathroom, where we have all but perfected our little routine of cleaning, stripping, emptying, and measuring: 2cc's from the left, 3 from the right. I tuck the grenades back into their holsters and we wash our hands again. Sometimes I dare a look in the mirror before I zip my camisole closed, sometimes I do not.

Thursday was hard. Dr. Lee had instructed us to remove the "tegoderm" bandages and gauze that covered my long seams. I already suspected from our discussion post-surgery and from what I could see around the gauze that he had not achieved the flat scape I had hoped for. For someone who intends to get implants, a surgeon will leave extra skin if possible, the better to accommodate them, but I've chosen (for reasons I'll save for another post) not to pursue reconstruction, and insofar as I had any aesthetic desires invested in my surgery (very small in proportion to the "I want to live!" desires) they all flew in the direction of Kansas. I had in my mind a tabula rasa, blank canvas, bare ground. But I found that I am moon-cratered. Where mountains stood there are now depressions. My body holds a rumpled memory of abundance.

I couldn't think immediately what they resembled, these transformed features of my new topography. Then it came to me: "I have Eeyore boobs, Pete. Happy birthday."

"Still have your honeypot" was his rejoinder. 

Thus a gal who is literally deflated may feel her spirits lift and expand.

Forza!
Gretchen

p.s. There's a lot that I'm finding unintentionally comical these days. Somehow I don't think Garnet Hill had me in mind when they sent out their new catalog, as apt as their tag may be. The image of exuberant fecundity (a little freezer burnt in transit) also gets spun in an unexpected direction by my present turn of mind:

The good and the bad

Just a few words from your bleary correspondent. As promised, I've been relieved of a significant weight, literal and figurative. My breasts and I are parted. The surgery was lengthy but without complication, and while it will be another week before definitive pathology results come in, the news is tentatively excellent. Two "sentinel" lymph nodes (acting much like Francisco and Bernardo on the ramparts of Elsinore) reported no hostile incursion, and the border of the tumor likewise appeared clear. We're holding off on the champagne for now (not a good mix with Oxycodone), but we have real grounds to hope that the enemy has been successfully expelled.

The bad news actually came Friday, but I could not post it here until I'd had a chance to talk with those whom it affects. I had a call from Cheryl Miranda, the genetics counselor I'd seen, relaying my test results. She told me that I do indeed carry a mutation of the BRCA-1 gene, which we can only assume I inherited from Mom (and she from her mother or father). While the heaviest risks from this mutation fall on women (who face a 60-80% chance of developing breast cancer and a 40-60% chance of developing ovarian cancer over a lifetime), it can also raise a man's risk for prostate cancer, melanoma, and even breast cancer. Thus my bad news is also potentially bad news for everyone in my matriline. The odds that my brother, sister, or uncle carries the mutation are 50-50.

I know it's utterly irrational but also probably inevitable that I feel as if I have personally put them in danger, laid a blood curse on my nearest and dearest. But the curse is really one of knowledge, and therefore mixed. We now have an explanation for our family's lousy "luck," and we can take precautions, some of them radical. I learned when I called Megan that she had been rehearsing her response for weeks, readying herself for an expected blow. Predictably, she worries most for her daughter, Maya; as to her own health she is coolly pragmatic. "Someone asked me the other day what plans I had for the summer, and I said I don't know, maybe getting a double mastectomy." My brave, loving sis has always been ready to follow me anywhere, but I fervently hope she won't follow me here.

Forza!
Gretchen

Chapter 13. In which it is clinically demonstrated that I have a big head.

There comes a point at which accumulated bad luck begins to look like something else altogether. When Mom was diagnosed with melanoma at the beautifully ripe age of thirty-five, the news ripped the floor out from under the reality my family had theretofore inhabited and taught us at a blow how flimsy every personal metaphysics can be.

We didn't dare lay any new boards during the three years of brutal treatment and two years of held breath that Mom needed before her doctors declared her officially in remission, and the structure we built thereafter always had a little of the quality of a dream, or of the impassioned ramblings of a drunk college friend who's just discovered quantum physics: "Dude. Put your hand on this table - or no! better idea - I want you to hit this table as hard as you can. Come on, hit it! Fine, I'll do it. Ahh! Shit, that was too hard. But it feels solid, right? Total illusion, dude. It's mostly space, with maybe a sprinkling of dust. That's it. That's all we are, substancewise. My hand throbbing right now? That's about energy."

Ten years after the melanoma came the inflammatory breast cancer. When I was writing recently about receiving the news of Mom's second diagnosis, I remembered what a friend of mine says about the old expression that some long-neglected activity is "just like riding a bike." She doesn't find this reassuring. "Yeah, I remember riding a bike. It's sweaty and awkward, and it makes your crotch hurt like fuck."

My family has ridden this tandem beast before, and yes, with my own recent diagnosis of a triple-negative carcinoma (more on that designation later), there's a strong feeling for us all of déja fucked. (For maybe the last time ever, I beg pardon for my French.) We're not just indulging a communal sense of self-pity, as it turns out. We may have some scientific justification for our suspicion that we are substantially less favored (genetically speaking) than your average family of bears. Three aggressive cancers diagnosed in two premenopausal women at one degree of separation amount to a strong indication that our shared matter might have come unzipped somewhere. Thus last Monday found me in a basement examining room with a tape measure around my head.

That sounds medieval, or possibly Victorian - back to the days of phrenology! - but the geneticist wanted to see whether I might carry a "PTEN" mutation, one of the few currently known to create a strong vulnerability to untrammeled cell growth, also to big crania. Despite the doctor's discovery that I've got enough brow to make a neanderthal's heart go pitter-pat (58.3 cm!), he doesn't guess this is the problem. The PTEN mutation usually announces its presence in clusters of thyroid cancers and autism. He's more immediately concerned that I may carry the "Angelina Jolie" mutation, a misspelling in the BRCA gene that works (when it works) to correct replication errors in our DNA. The two algorithms currently available to guesstimate risk from patient data (clinical presentation and family history) returned a 10% and a 26% probability that I carry one of the two known forms of the mutation. From our consultation I went directly to see a phlebotomist (can't resist all this juicy language), and two vials of my blood (tucked adorably into a small foam cushion) winged their way that day by express mail to a California lab.

Results are expected just in time for New Year's, and we're waiting to proceed with surgery and the rest until they arrive, because they'll help determine how much of me will remain to me. If the BRCA test is negative, I may lose only the one boob. If it's positive or equivocal, I'll likely undergo a double-mastectomy now and an oophorectomy (removal of my ovaries) later - the risk of a new cancer would otherwise be high.

As you've probably gathered, the two weeks since my diagnosis have not been filled with comforting proviso, qualification, or reprieve. The blows have come in a staggered (and staggering) series:

Tuesday a diagnosis of invasive ductal carcinoma;

Wednesday night the news that the tumor cells display poor differentiation (paradoxically, they are highly diverse) and "brisk mitotic activity" (they are replicating quickly), signaling a high-grade, aggressive growth;

Friday afternoon my new surgical oncologist's judgment that chemo (which I dread far more than surgery) will almost certainly be on my menu of treatment "modalities", also his detection of a suspiciously swollen lymph node near the tumor;

Monday morning the confirmation that the cancer is "triple-negative," meaning that it is not fed by the hormones (estrogen and progesterone) or protein (HER2) that feed most breast cancers and that it is consequently invulnerable to certain of the most effective modern therapies (e.g. Tamoxifen); also Monday a confrontation with the real possibility that I may carry a genetic defect whose detection would have serious potential implications for the future health of my sister, brother, uncle, great-aunt, and all of their offspring;

Thursday the judgment by my new medical oncologist (echoing that of my surgeon) that my tumor may well be larger than suggested by ultrasound and that a PET scan is therefore warranted to check for possible metastasis before we proceed with surgery.

I go in to meet that terrifying prospect this afternoon. Sunday I'll have an MRI of both breasts as a similar precaution.

There is an upside. I am a member of Kaiser Permanente and wildly grateful for this, for reasons I will expand upon in another (effusive) post. But you might have noticed from my litany of bad news how very quickly everyone has mobilized, and how few bureaucratic or scheduling roadblocks I've had to stumble over in pursuit of a more or less definitive diagnosis and a "solid, fluid plan." Beyond this, I am absurdly well-networked, owing to that crappy luck referenced above - Mom's medical oncologist, Dr. Robert Carlson, is now the CEO of the National Comprehensive Cancer Network, and he has most generously offered his informal guidance as well as the names of two Portland oncologists he could recommend highly; one is now on my team and consults with the other. I do not feel that I could be in better or more compassionate hands.

Also, I am learning a lot. My inner biologist manqué has awakened from a long sleep, and my doctors welcome my active participation in the dialogue around my best course of treatment.

And then there is you. If you are reading this, there's a good chance that you're a card-carrying member of my personal League of Extraordinary Gentlepeople. Please forgive me if you have written to me and not yet heard back. You will. But you should know in the meantime that I owe you most of my wherewithal and pretty much all of my courage in these hard days. I'd have a much stronger case against Fortune if she hadn't brought me you.

Forza!
Gretchen

The tonsils of the wolf

A month ago I found a lump in my right breast, maybe an inch large and highly distinct, off on the "distal" side toward my armpit. (These are good occasions for searching out the intersections of science and poetry - "distal" is lovely and deserves a wider acquaintance.) I have been waiting for this almost as for an inevitability. My mom was ten years younger than I am now when she was diagnosed with melanoma. Thanks to a skilled surgeon and a brutal but effective regimen of chemo, she made a near-miraculous escape and thoroughly enjoyed an eleven-year reprieve before one of her breasts swelled suddenly to twice its ordinary size. Days later, she received a diagnosis of inflammatory breast cancer - very rare and very aggressive. She was forty-five then, forty-eight when she died.

Thus, for our family, cancer took on an aspect of the ordinary horrifying, one of life's givens, and that has included for me an assumption that I would one day get my own diagnosis. A rite of passage, though through what and to what none could say. I think my sister, Megan, shares this irrational persuasion (irrational because the cancer that killed Mom has no established genetic basis), but it's strengthened in me by the weird coincidence of a shared birthday. I was born twenty years to the day after Mom, and my superstitious sense of symmetry suggests that I have four years left before my time is up.

I should have expected but did not expect that I would feel so close to Mom when I went in to Kaiser's "imaging" center two weeks ago for a mammogram and sonogram. As it was for Mom, the mammogram was for me all but useless - Megan and I share a matrilineal legacy of low blood pressure and unusually dense breast tissue - but the sonogram confirmed the presence of a tumor. I returned to the center last week for a core needle biopsy and expect results tomorrow that may or may not be conclusive.

The good news is that there's a strong probability - maybe nine to one - that the tumor is benign. The bad news is that it is likely of a type that will require "excision," not just of the tumor itself but also of a wide margin of healthy tissue. "Phyllodes" tumors have a pretty Greek name that refers to a leaf-like pattern of growth at the cellular level. When benign, they may rapidly grow until they distort the breast or even create open lesions on the skin. When malignant, they do not resemble most other forms of breast cancer but are classified as sarcomas, and they may metastasize outside the breast. Both types present a high risk of recurrence if any stray cells are left behind, and definitive distinctions between them are difficult or in some instances impossible to make. (The tumors have three classifications: benign, malignant, and borderline.)

The last and most hopeful possibility is that it's a late-blooming fibroadenoma, which is lacking in both poetry and danger. But that tends to be a young woman's no big problem, and I am no longer a young woman.

So it looks like I may lose at least part of my right boob, and I am having a harder time with that prospect than I could have guessed, given that I've been complaining for thirty years about being overburdened. Yesterday I was flying very low to the ground, not in a grateful or celebratory "Live, dammit!" frame of mind like I've been intent on preserving. A Chargers win could really have come in handy, but nothing doing there.

What could I do but stop running and look my wolf in the teeth? Pen in hand, natch.

Poems in honor of my breasts

I.

I wear a thin woolen sweater in a shade of royal purple
Against my skin
It clings and I revel in the fulsomeness I have from my mother
As she had it from her mother before her.
The question mark drawn from breast to waist
Makes an empty invitation -
Its terminus has been closed for years,
The chamber collapsed, the altar smashed.
Still -
The gesture remains fertile.
Generous,
Covetous eyes
Complete the riddle.

II.

They've never known from perky.
Droopy and friendly as basset puppies,
With plump bodies and soft noses
Warm with fever.
I put them away for polite company -
They're too much!
And too much neglected.
But I loose them for love, for play.

Forza!
Gretchen