Readers will learn to:
Praise for Raab's Healing With Words:
"One woman's story, beautifully told and inspiring to those for whom journaling will ease a cancer diagnosis."
--Barbara Delinsky, author UPLIFT: Secrets from the Sisterhood of Breast Cancer Survivors
"Time after time, Diana articulates incisively the thoughts and feelings that convey hoped-for meaning and encouragement. She is a woman who knows what it is to live fully in the face of mortality. She will add value to the life of every person who reads this book. Healing With Words resonates at a spiritual level for me."
--Sena Jeter Naslund, author of Ahab's Wife and Abundance: A Novel of Marie Antoinette
Author's proceeds from the sale of this book donated to benefit the Mayo Clinic Foundation
Learn more at www.DianaRaab.com
Another inspirational book from Loving Healing Press www.LovingHealing.com
HEA039031 Health & Fitness : Diseases - Breast Cancer
SEL501000 Self-Help : Journal Writing
MED058160 Nursing - Oncology & Cancer
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Read an Excerpt
Mammograms and More Mammograms
"Those who don't know how to weep with their whole heart don't know how to laugh either."
— Golda Meir
There is no breast cancer in my family. No cancer of any kind. Except for mine, that is.
Two days after my annual mammogram (I was a month late scheduling the appointment), the nurse phoned to say that the radiologist wanted to take additional views of my right breast. "He just wants to make sure that everything is okay."
This was not the first time I had been called back to the mammography department of my local hospital. A year earlier, I had had a surgical biopsy on the same breast, after a clinician detected a small lump during the manual examination before my mammogram. She had me sit on the edge of the examination table in my hospital gown during that fateful appointment, facing the mirror hanging on the wall. She asked me to raise my arms to see if she could detect any abnormal dimpling on my breasts. Then she asked me to lie down as she did the familiar circular examination that I did faithfully every month, on the first day of my menstrual cycle. I had cystic breasts, but the little cysts moved when I touched them. As a nurse, I knew that if a lump was fixed and did not move, then it was probably malignant and should be looked at right away. I never had any lumps like that.
"I feel a little lump here," she said gently, her hands still on my right breast. "Here, you feel it."
She took my index and middle fingers into her hands. "It's small and moveable, which usually means it's not cancer, but I'm sure they'll want to biopsy it."
Two weeks later I was admitted into the hospital for a biopsy. Thankfully it was benign.
So, when I received this second call from the nurse, part of me was pissed off at having to return for another false alarm. Although the biopsy was negative, the entire surgical ordeal was not something I wanted to endure again.
To be on the safe side, I booked the follow-up mammogram. The weeklong wait for round two was long enough for my imagination to go absolutely haywire. Studies were popping up in newspapers and magazines hypothesizing on what might predispose women to breast cancer. I tried to fit myself into a category, any category, that would indicate that I was at risk, but I could not. I had breast-fed all three of my kids, I exercised four times a week, ate lots of fruits and vegetables, avoided red meat, was not overweight, and drank lots of water. I visited a nutritionist regularly. I ingested a kaleidoscope of herbs and minerals three times daily. I was doing everything right. How could I have breast cancer?
On the morning of my appointment, the alarm rang at six a.m. I slammed the button, showered, and got dressed. My husband volunteered to accompany me to the hospital, but I said I would be okay going by myself. I kissed him goodbye and told him not to worry because it would probably be just another false alarm. What I did not say was that lurking inside of me was a growing sense that things would not be okay this time around.
I drove our twelve-year-old son, Josh, to school, then, hopped on the congested highway, heading to the women's health center. After parking in the hospital's early morning half-empty lot, I went directly to the radiology department, signed the receptionist's clipboard, took a number from the box, and sat in a waiting room crammed with women and old magazines splattered on laminated coffee tables.
Two out of the four magazines displayed headlines pertaining to breast cancer. My friend, Ellen, a radiologist, had (prior to my most recent mammography,) told me that the incidence of breast cancer had risen to epidemic proportions: one woman in eight would be diagnosed with it at some point in their life. This meant that whether at a dinner party or in a shopping center, chances are you would meet someone who already had breast cancer or would succumb to it later in her life. To me, this news was astounding. Another shock: 75 percent of new cases were not genetically related. It was this discussion that my mind kept casting back on. As I flipped through the magazines, pretending to read, my mind churned into a fast-paced movie laden with unanswered questions. Do I have cancer? How will this affect our family?
"Diana Raab," I heard the receptionist call my name.
A Woman's Life
Kicking Wiggling Sucking Pushing Nursing Sleeping Eating Growing Crawling Sitting Walking Counting Reading Writing Biking Dancing Flirting Necking Loving Cramping Rebelling Driving Exercising Studying Working Marrying Nurturing Obsessing Separating Crying Dieting Menopausing Wrinkling Grouching Forgetting Slouching Dying.
Describe your family and note if there is any history of breast cancer in your family tree.
Write about the day you first thought that you had cancer.
"Fear is an emotion indispensable for survival."
— Hannah Arendt
"Just move a tad bit to the left," the soft-spoken technician requested. .
Here I was again, wearing another paper gown (opened to the front) and back in the mammogram room having my boob squashed between two horizontal pieces of glass. I used my arm to hold onto the cold bar beside the machine, arching my back so the technician could get a good view of my (droopy) womanhood.
"Okay, hold your breath one more time," she said.
Then she dashed off to her protective cubicle. Where is my protection? I wondered. Are they really certain all these mammograms aren't destroying my good cells?
"Okay. Have a seat while I check to see if the films are good," she said, darting off to the darkroom.
I sat. I was hoping we were done, that my breasts would not have to endure any more torture. On the small coffee table beside my chair were pamphlets with graphic photos explaining how to give self-breast exams. How many of those had I jammed in my purse during the past twenty years? I wondered how many women actually took them out to read once they arrived home. Studies show that most breast cancers are detected by women themselves. Whatever was going on with me this time was definitely not palpable because my earlier scare made me diligent about performing the exams on the first day of each menstrual cycle.
After about fifteen minutes, the technician returned.
"Everything is fine," she said.
"You mean I am okay?" I said, with a certain degree of elation.
"No Ma'am, I cannot read your mammograms, I'm just saying the pictures came out." She hesitated. "The radiologist would like to talk to you."
"Is everything all right?" I asked.
"That's what he wants to speak with you about. Why don't you go get dressed and I'll meet you outside the changing room and bring you to him."
"Thank you." I quickly ripped off my hospital gown and slipped back into my black Capri pants and pink tank top. I embraced both my breasts and turned sideways in the mirror.
The technician was waiting outside the door.
I nervously followed her into a room lined with mammograms displayed on boards around a wall lit from behind. As I approached, the radiologist swiveled his chair around to glance up at me.
"Are you Diana?"
"Yes," I said with trepidation, walking toward him.
"Let's have a look at this together." He motioned me closer, and I felt my body get cold and my legs go numb. I tried stepping outside myself to become the clinical nurse I had been years earlier. If I didn't succeed, I would surely faint on the tile floor. I stood behind him as he pointed at the pictures of my right breast.
"I can't say for sure, but it seems to me you have something called DCIS, ductal carcinoma in situ."
He could have said anything and I still would have cried. My emotions were piqued. Before my biopsy the previous year, I was called back for repeat mammograms, but the radiologist never requested to meet with me privately. His decisions had been framed alone, behind closed hospital doors.
"This means," continued the radiologist, "there are some cancer cells in your ducts. My best suggestion is that you have a needle biopsy so that we can see the extent of the cancer."
My head felt light. The room began spinning about me. I asked for a chair and was given one by the nurse. The radiologist continued, "The only thing I really want you to know is if there's anything there at all, it's extremely early. You should have a degree of comfort in knowing that. The reason we wanted you to return for more films — and not wear deodorant — is that the first mammogram looked as if there was talcum powder sprinkled on your breast. We wanted to make sure that the spots were not from your deodorant."
I could not remember whether they had reminded me not to wear deodorant the last time.
"Now that you're not wearing any deodorant, we know that what we see are calcifications."
I thanked him. He handed me the mammogram envelope and suggested an appointment with a surgeon as soon as possible. I badly wanted to ask him to look at the films one more time so that he could rescind his diagnosis. Instead, the nurse returned to the room and asked if I was okay.
"Nope, would you be?" I blurted.
Perhaps she was sorry she asked. "Can I get you anything before you leave?" she replied.
"Thank you. I'll be okay." I answered.
I knew that I would not be okay.
I staggered out of the radiology department to the exit leading to my car. I sensed people's eyes upon me, curious about my demeanor. Once outside, I forgot where my car was parked. After walking a few circles, I found it. I opened the door and climbed into the driver's seat. I do not remember removing the keys from the lock or closing the car door. The sun shining in the front window provided no relief for my deep sense of bleakness. I plopped my head on the steering wheel and sobbed relentlessly. My eyes stung from the smudged mascara I had applied that morning. For whom? The doctor? After rubbing my eyes so hard that I could barely see out of them, I rummaged around in the back seat for used water bottles. I poured what little water I found onto a tissue to clean myself up, and phoned my husband at work. I sobbed copiously and my words slurred in his ears.
"I can't understand what you are saying —"
"I'm at the hospital. My mammogram wasn't good."
"What did it show?"
"Something called DCIS. It's an early cancer. Basically, it's a lot of calcifications on the breast. I want to see you," I said between sobs.
"Do you want me to come there?"
"No. I'll drive to your office."
"Are you okay to drive?"
"I'll be fine. See you in ten minutes."
I finished cleaning my make-up in the mirror, and then hit the road.
Simon closed his office door and led me by the hand to the leather sofa I had bought him years earlier for Valentine's Day. He took me into his arms and told me that he would do everything in his power to get me healthy. He squeezed me as tight as he did the day my father died twelve years earlier.
I never wanted to leave his arms.
My mother bestowed me with very few tidbits of useful information, but one was, "You should always have at least one doctor friend." So the following evening, I phoned Ellen, my friend the radiologist, who was also the director of mammography at our local hospital. Ellen and I had an extraordinary friendship that had taken seed several years earlier, during a fifth grade trip to Williamsburg with our daughters. We were blessed that our husbands also got along, so we often went out as a foursome.
"Diana, I'm so sorry you're going through all this. Do you have your films?" she asked with an equal amount of professionalism and empathy.
"Then come on over right away," she said.
Ellen arrived at her front door, still in her business suit. She gave me a hug and invited me in. She took the mammogram envelope from my hand and with urgency in her stride walked to the dining room. One by one, she held each film up to a window lit by an outside garden light. I sensed she had performed this gesture many times before. She motioned for me to move closer.
"Let me show you something, Diana. This is your right breast. These lines are the mammary ducts. I think they're concerned about these white specks. They're calcifications."
"For the most part we all have some, and often that's okay. But, the problem is when they become more abundant. Do you have last year's films for me to compare?"
"I do," I said, removing them from the paper sheath.
"Okay, here we go," she said, holding the old films in her left hand and the new ones in her right as I held my breath, hoping she would say everything looked fine.
"Last year you had a few specks, but it looks as if there are more this year. That's why they're suggesting a needle biopsy."
She put the films down and wrapped her arm around my shoulders. "I want to send you to my friend, Phil, in Dallas; he'll take excellent care of you and will have your results right away." She glanced down at her watch, "It's too late now, but I'll phone him first thing in the morning. Promise. And then I'll call you. When's a good time for you to go to Texas?"
I was happy to have Ellen as a friend and felt fortunate to be able to take this trip. My husband's parents agreed to stay with our kids.
Who is the first person you told about your breast cancer? How did they react?
How are you feeling right now?
The Needle Biopsy
"You can't keep misery from coming, but you don't have to give it a chair to sit on."
The following week Simon and I flew to Dallas. . We checked into the Dallas hospital's hotel room and the following day, my alarm clock shook us from bed at nine o'clock. It was the morning of my biopsy.
The waiting room for the women's health center was decorated with needlepoint chairs and rugs, nestled in a wood-paneled room. The receptionist sitting in this cherry-wood encased receiving area welcomed me, and handed me a clipboard with a stack of blank forms. I sat down beside half a dozen other anxious-looking women and their partners. My eyes shifted side-to-side, wondering what all those women were doing there. Are they in a worse predicament than myself?
Within moments a nurse called out my name. After flipping through my papers and making small talk about the weather, she directed me to the changing room — four barren cubicles containing clothes hooks and a small mirror. Outside these rooms was a cozy sitting area with magazines; the women waiting here were old enough to be my mother. What am I doing here? Aren't I too young to have breast cancer? I felt incredibly out of place.
When I left my cubicle, a middle-aged nurse came to direct me to the biopsy room. I desperately looked for a window into her thoughts. Does she know what is going on inside me? What about my prognosis? Her face offered no answers. Something about her smile did echo concern, but I did not know if her sentiments were directed toward me or toward all the women who stepped through the clinic's doors. Maybe her face mirrors my fear? As we entered the biopsy room palpitations chilled my chest. Tears fell upon my powdered cheek.
"Are you okay?" she inquired, closing the door and putting her arm on my shoulder.
"I'll be okay. I'm just nervous."
"That's normal. You're in good hands. Dr. Phil is the absolute best."
"Yes, I know. I came all the way from Orlando."
She nodded. "I need to take some chest measurements before we begin," she said, glancing at my breasts.
After untying the strings of the hospital gown, I looked down at my breasts too. The stretch marks were impossible to hide, a gentle reminder of having nursed three babies (coupled with sixty pounds of weight gain each time.) My areolas were fairly large and stretched out of shape. In one of the books piled on my bedside table, I had read (ironically, as it turns out) that breast-feeding is the best insurance against breast cancer.
My breasts had served me well. They were a sharp contrast to my 17-yearold daughter's perky ones, but they had nursed three beautiful children and brought me endless erotic pleasure. For me they were the perfect size for my five-foot-four small frame — tottering between and A and B cup-size. It never appealed to me to have them enlarged and I never made a fuss about them. They were there and once a month became a little more tender, but I never worried about that; it was expected, short-term, and part of being a woman. I sometimes wore camisoles instead of bras. Maybe the lack of support contributed to their droopiness ...
"Okay, look straight ahead," the nurse said, while marking up my right breast with a pen.
There was a knock on the door and then it opened slightly. As Dr. Phil squeezed through the crack, I quickly closed my gown. He extended his arm, and a warm smile formed on his lips. He cupped both my hands into his. "What a pleasure it is to meet you," he said. "So you're good friends with Ellen?"
"Yes, and she recommended you very highly."
Excerpted from "Healing With Words"
Copyright © 2010 Diana M. Raab.
Excerpted by permission of Loving Healing Press, Inc..
All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
Excerpts are provided by Dial-A-Book Inc. solely for the personal use of visitors to this web site.
Table of Contents
List of Poems,
Chapter 1 – Mammograms and More Mammograms,
Chapter 2 – The Diagnosis,
Chapter 3 – The Needle Biopsy,
Chapter 4 – The Surgical Biopsy,
Chapter 5 – The Results,
Chapter 6 – The Surgical Decision,
Chapter 7 – The Surgery,
Chapter 8 – Post-Surgical Notes,
Chapter 9 – Recovery and 9/11,
Chapter 10 – Follow-up,
Chapter 11 – More Surgery,
Chapter 12 – Emotional Reflections,
Epilogue – A Tale of Two Cancers,
Appendix A – Writing For Wellness,
Appendix B – Healing Pages,
Appendix C – Glossary,
Appendix D – Cancer Support Organizations,
About the Author,