Monday, November 22, 2010

The Century Club

This is my hundredth blog post, which, of course is a big deal. And I want to write a REALLY IMPORTANT POST fully reflecting and honoring the momentous occasion. But, as usual, I’ll probably wing it, see what my fingers poop out and move on.

How about this for a theme of my hundredth blog post: time. It seems fitting. My life over the last nineteen months is meted out on this blog, and the posts mark the passing of time, the reaching of decisions, the moving past and through difficult choices, the celebration of new beginnings.

Next month will be the one-year anniversary of my surgery. It’s been a little more than eleven months since I underwent a prophylactic bilateral mastectomy, and I have now lived with these new breasts on my chest longer than I lived with the knowledge of my BRCA status and my natural boobs. In other words: I had surgery a little more than eight months after I learned my status; I’ve had these new hooters for 28% longer. So, should I have waited? Should I have let more time pass?

It’s a question I ask myself when I meet women who are BRCA positive and have known their status for years but say things like “I’m only now beginning to understand what it means and make decisions.” I guess my problem was, from the very beginning, I understood too much what my status meant, felt too deeply the need to take immediate action, and made a decision about what do with the results before I even learned them. I hear a lot of women say, “I got my results and just put it out of my head.” And I can’t relate at all. Once I got my results, that knowledge completely consumed all my brain space. And the only way to get my head back was to sacrifice my tits.

Would I have gotten that brain space back if I had waited a little longer, let the information settle in, got more comfortable with my genes? I can’t say with certainty, but I doubt it. It’s not like this knowledge – this knowledge that I need to make some decision at some point, hopefully before my body made the decision for me – isn’t something you can get over; you might be able to set it aside for a moment (or much longer, if you are some one much more capable of denial than I am) but the fact remains: you must do something (whether surveillance or surgery). Surveillance, from my perspective, would only compound the impact of that knowledge; mammograms and MRIs only serve to remind you of your risk.

The truth is, I knew from the first that I wanted to have surgery. I was never thrilled with any of the options presented to me, but surgery made the most sense for me. And once I really confronted that choice – began seeing doctors, meeting other women who'd gone before me – it wasn’t a question of if but when. So why wait? In the weeks leading up to my surgery, when, at weaker moments I considered calling the whole thing off because I was just SO fucking scared, I reminded myself that I'd be doing this at some point. Why not now?

That now is now nearly year ago, and while I’m never glad I had to have surgery (“had to have” is a loaded phrase, but suffice it to say it wasn’t my tits that were the problem there: my brain was. I’ve mentioned hundreds of times,but it’s not equipped to deal with uncertainty and anxiety) I’m glad I got it out of the way. A lot has changed in those eleven months. Not only do I have new hooters, I have a new job, a change I was only able to make after I realized that I’m stronger than I ever thought I could be. My job resulted directly from the empowerment I felt about conquering the hardest fucking thing and coming out alive and happier on the other side.

So what would I look like, and what would my life look like, today if I had waited? I don't know for sure. But I'm glad I didn't. There is never a good time for something like this, never a perfect moment to make a life-altering decision. But I'm glad I made it last year. I've had nearly a whole year to see things from the other side, and I like the view from her much better.

Friday, November 12, 2010

Real Housewives of BRCA

I have dirty secret: I love bad TV. (I also, for the record, love really good, really cerebral TV: I think shows like Mad Men and The Wire, both of which I count among my all time favorites, are so good they are like reading complex novels -- and just as challenging.) But in my quest to straddle the gap between high-brow (my work, my fancy degrees, my bookshelf, my magazine subscriptions) and the low-brow (basically any reality show where I have as much in common with the characters as I do with meerkats; ie: I frequently doubt we're members of the same species), I have become addicted, yes, to the Real Housewives cohort on Bravo. (Hubby’s a convert, too: we look forward to evenings with our “girls” and some Thai takeout.)

I like to say watch these shows anthropologically, mentally noting the strange plumage and rituals of an exotic tribe. But it's more than that. It's hard to put my finger on exactly what compels me about this show: part of it's the conspicuous consumption, part of it's the voyeurism. But, I think, on a certain level, I’m attracted to it because it deals in, likely inadvertently, aspiration, reinvention, and fakery -- in other words, all of the complex human traits that might be found in characters in a great novel. The difference is, the Housewives are blissfully un-self-aware. And that's where the comedy comes in. When Teresa, of New Jersey, was revealed to be nearly 11 million dollars in debt (how does that even happen?), her entire persona was shown to be a facade, her gaudy, architecturally-incongruous mansion a Potemkin village. She's fooling no one but herself. More comedy gold: last night, on the Beverly Hills edition, Camille Grammer, now ex-wife of Dr. Fraiser Crane, said she would feel cramped in a 3500-square-foot, three-bedroom apartment in Manhattan. Because, you know, New York is known for its spacious -- and affordable -- real estate. Really, I'd like to have it so rough. Who are these people?

I have nothing in common with any of these women, with their fake breasts and fish lips. I think the show is supposed to make you feel bad: look at all the stuff they have that you don't. But I don't feel that way. It reminds me how happy I am to be in a marriage where, above all else, we value communication and equity. Sure, who wouldn’t want a closet full of Louboutins? But I don’t want them at the expense of my independence. The Housewives, then, both fascinate and repel me, often in equal measure. They are windows into a world very different than my own.

So imagine my surprise when, out of nowhere, we cut to Camille, she of beautiful body and sad eyes, getting a manicure and talking with her mother about the results of her recent BRCA 1 & 2 screening. What? BRCA on Bravo? Camille, she reveals, is BRCA positive, a carrier of the same mutation as her mother, who is currently batting breast cancer. Wait, that’s huge. BRCA just got more air time and was put in front of more people than were likely reached during the Hereditary Breast and Ovarian Cancer Awareness and Previvor campaigns this fall. And then, typically, Camille, California-ly, says, “it’s all about positive energy.” Well, actually Camille, it’s not. But she said she’s being monitored and had recently undergone a battery of tests, so it seems even if her head is distorted by new age thinking, her doctors have her following a strict surveillance regimen.

All of which, of course made me think – does Camille know what she’s up against? Did she receive good genetic counseling? Is she aware she, at her age, should probably consider an oopherectomy? In other words, I wanted to help this woman -- this woman who until moments before was a caricature, and exaggeration, a strange being from the planet Restylan -- because we had something very important in common. I hope she’s getting the care she needs. This is a woman who is very well attended to in every other aspect of her life -– serviced by nannies and assistants and personal trainers and creepy family friends who make passes at her in hot tubs in Hawaii – and I just want her to be as vigilant about her breast and ovarian health as she is about maintaining her twenty-six homes.

And I hope people who heard her talk about BRCA last night, and who wonder about what that means and whether they should be screened for it, find the answers they need, too.

See, bad TV can sometimes be (and do) good.

(Apropos of nothing boob related, Richard Lawson has the best recaps on the internet of the Hausfraus over at Gawker. Read and weep -- with tears of laughter.)

Thursday, November 4, 2010

A letter addressed to my (dearly departed) breasts

Many years ago, when my grandmother passed away, my distraught grandfather lamented that one of the hardest things was continuing to receive mail -- mostly junk -- addressed to his dear Alice. "She's gone. Don't they know that?" he wailed.

I never knew what he meant, though I could imagine his anguish, until today. Because today I got a letter addressed to my dead breasts.

It was an invitation to participate in a study "to understand the impact of having breast imagining procedures done." It goes on to say "Not only are we looking closely at the results of your tests (mammograms and MRIs) but how these tests make you feel." Well, folks, I guess you missed the memo, but I no longer have breasts or any need to image them. But how does that make me feel? A little weird, if you want to be perfectly honest.

I had to laugh, if not wince a little, too, when I read the letter. I forget ALL THE TIME that I don't have breasts anymore. That's because my fake ones are so good they even fake me out. And it's also because, unlike before, when I had my might-kill-me-at-any-time natural but rogue boobs, I don't obsess over them. So it's jarring at times to be going about your day, going through mail, and be -- BAM! -- reminded that a) you don't have tits anymore, and b) not everyone knows.

The letter came from a hospital where I had my one and only MRI and with which I consulted when I considered surgeons to perform my prophylactic mastectomy and reconstruction. But I ultimately chose another hospital and another set of doctors, so quite literally, according to their files, I'm just a high risk woman, waiting to make a decision. That's why they sent a letter to my boobs.

Little did they know...