CELIA'S DIARY (based on a true experience)
Celia Engstrom is a small town lawyer and compulsive volunteer who resides with her husband Peter in the wilds of the BC Central Interior. The town's resident physicians have recently fled the community for more restful practices under sunnier skies. Temporary doctors known as locums now administer to the needs of the infirm and the unhealthy. This situation hasn't bothered Celia one bit. She eats her apple a day and takes her vitamins routinely--in alphabetical order. Once in a while she'll visit the medical clinic for a fast check-up. Celia is now sixty years of age and her husband is seven years her junior. Peter has become an author of wildlife books since retiring from his job at the mine. Celia also plans to retire soon. She wants to dedicate her golden years to volunteering. She's already on the Village Council, the Library Board and the Museum Society. Each evening before going to bed she writes in her diary. As she explains to Maria her office manager, it keeps her brain organized. Maria usually snorts and mutters something derogatory about the quality and even the existence of Celia's brain. The two women are the best of friends.
April 28 1999: Peter's been nagging me so I took time off from work for a quick checkup. The doctor (one of our temporary locums) agreed that the breast lump is most likely a cyst. I told her my husband insisted I have it inspected. She replied, "He's a good man!" Appointment at Prince George Regional Hospital (PGRH) is on May 13th.
May 13th: To Prince George today to have my breast poked, pried and squeezed. Its contours were scanned and then scrutinized while being displayed on an ultrasound screen. After that it was a series of mammograms on the torture machine that must have been invented by a disgruntled husband! Apparently I have lots of cysts, some quite small and the large one that they are not quite sure about. I'll make an appointment with a doctor (another locum) and he or she will let me know the results.
May 17th: Cousin Fanny in Vancouver also has breast concerns. She will have breast reduction surgery sometime in July. Tonight I recalled where and when I rammed my boob--it was at a client's home about 2 months ago. The old gentleman resided in a barely habitable suite in his son's basement. The entrance to this haven was dark and cluttered with guy stuff such as transmissions and gas engines. There was a sling of lumber hanging down from the ceiling and
I'd smacked right into it. Hurt like the devil at the time but I didn't notice any bruises or contusions later.
May 19th: Peter accompanied me to Prince George for a consultation with Dr. Woods, who impressed us as being a kind and knowledgeable physician. Guess I'll need to undergo a 15 minute surgical procedure to remove the lump because he doesn't want to take any chances. Says it is a 90% chance it's not cancer - probably a "fatty necrosis" (something like that) caused by the injury.
June 3rd: This morning I phoned Dr. Wood's office because it's been more than two weeks since I saw him. Now he is the one who is ill! Off work on a prolonged medical leave. So I'm back to square one. Saw Dr. Hall, my new fulltime doctor, and he's checking out the availability of another Prince George surgeon--a Dr. Ainsworth.
June 8th: Guess Dr. Ainsworth will be the one to eradicate the lump. Maria informs me he's very good at gallbladders. If he can remove those successfully, a lumpectomy should be a piece of cake!
June 11th: I didn't realize it before but Dr. Ainsworth and Dr. Woods share the same reception area and office space in the building. The gals in both offices are shocked and dismayed by Dr. Wood's sudden illness. So am I. Learning that my young, good-looking doctor is sicker than I am is a real kick in the butt! Dr. Ainsworth is a nice fellow though, who appears to know his anatomy. I don't think he'll remove my gallbladder by mistake.
June 19th: Had the lump removed yesterday and the doctor removed two for the price of one. There had been two cancellations and I expected to get in on the later one. Instead, I was rushed through on the earlier major cancellation. Upon examining the boob Dr. Ainsworth mentioned there were now two lumps. The other, I believe, was one of the resident cysts which had grown. He said he'd like to remove them both and enquired politely, "May I?" (I think I said yes.) The anaethesiolgist was upset with the O.R. nurses who stated he'd given them a look "like a wet weekend." They argued with him while he put the needle in my hand. He growled back but I noticed a friendly glimmer in the back of his really nice brown eyes as he bantered with them. Peter picked me up at 3:30 instead of the 5 p.m. they'd originally thought it would be. It hurt last night but after I put on a bra and took some Advil it quit and I slept quite well.
June 25: Tomorrow is my 61st birthday. My boob itches and appears healed. On Monday I'll get one of the nurses at the clinic to remove the blue sutures.
June 29: Last evening at 5p.m. Dr. Ainsworth phoned and gave me the shock of my life. The tumour he'd removed was malignant and I'll need more surgery. I'm to see him tomorrow at noon. Last night my mind was in a state of paralysis with tiny jabs of fear poking at me off and on. Today I'm okay. I worked and had a hug or two with Mrs. Clausen my client who's had a double mastectomy. She's proud of her new plastic bustline and wears sweaters all the time.
June 30: To Prince George today to see Dr. Ainsworth who was anxious to inspect the incision and make sure all that was okay. It was ironic because as I told him, he was just going to open things up again anyway. (Dr. Ainsworth didn't laugh. I guess my remark didn't tickle his funnybone.) He said Dr. Woods had suspected the lump was malignant when he examined me. I have two options, neither one of them any fun: a partial mastectomy with lymph gland removal followed by radiation treatments; or else a total mastectomy with the obligatory lymph gland removal. I think I'll go for the complete mastectomy. I hate the thought of radiation therapy unless absolutely necessary. My breast seems to hurt more now that I know the truth. Peter says he would gladly change places with me--in a heartbeat. That makes me want to cry!
July 2 : Last night I had a serious chat with Maria who vowed her attitude toward me will not change. She said people had avoided her father while he was going through his terrible cancer ordeal. That was a while ago, she admitted, and people are now more open about the disease. I assured her that I was okay with my situation. I was having the mastectomy simply as a precautionary measure. The cancer as such--I stated emphatically-- had already been removed.
July 3: Reality has set in. I am realizing that just because the lump is gone doesn't mean there's no more cancer. Last night in bed I apologized to my breast. I allowed myself to love and honor it for it's role in perhaps saving the rest of my body. I did the same thing tonight and it helps. The effect is similar to that of a prayer.
July 4: I'm closing the office and will fly to Vancouver on Saturday for a short holiday. Be home on Wednesday the 14th. Dr. Ainsworth said the surgery wouldn't be until after the middle of the month, so that gives me plenty of time.
July 5: This morning I talked to Dr. A on the phone. He agreed that the total "M" was the best way to go. The tumour was 3 centimeters in size, so there's a chance there could be more. The only problem is the surgery might be scheduled before when I come home on the 14th. If that should happen Dr. Ainsworth urged strongly that I change my holiday plans. The hospital will phone me in a couple of days.
July 6: The hospital called and my surgery is on the 15th. But I will need to be at Pre-admissions at PGRH by 2 p.m. on the previous day. My flight up from Vancouver is at 7p.m. so will have to secure a seat on an earlier flight.
July 7: Saw Mrs. Arnold on the street. It's hard to feel sorry for myself around her, what with all the health problems in her family. Her philosophy is: "We have good days and we have bad days." A friend had the same surgery years ago, she told me. The woman developed lymphedema and her arm is still hugely swollen. Last night Maria mentioned someone who had the surgery and is on chemotherapy because they found more cancer in the lymph glands. That's the route it takes apparently when it spreads elsewhere in the body.
July 8: I'm having some dandy hot flashes since I threw out my hormone replacement pills. Worse than the original menopause! The doctors say they are not a factor when it comes to the cancer but I'm taking no chances. I took the estrogen to protect myself from the heart attacks that are so prevalent in my mother's family. But if the alternative is breast cancer I'd rather take my chances with clogged arteries!
July 14 This morning Cousin Fanny and Cousin Arly drove me to the Vancouver Airport where we said our good-byes over Starbucks coffee and breakfast. Fanny presented me with a lovely ceramic angel that she'd just received as a birthday gift. (I will return it as soon as I am well!) Arly insisted on paying for my breakfast because, as she put it, she had no "angel" for me. My plane landed in Prince George with plenty of time left over for Peter and me to enjoy a leisurely lunch before the pre-admissions' session at the hospital.
Later (the same day): We're in our motel room relaxing after a huge supper which included a milkshake for me. I have until midnight to fill up. After that only sips of water before morning. I've had a bath and shaved the axillia area (armpit) as advised per instructions from Pre-admissions. (As I applied the razor a slightly revised version of Deana Carter's song, "Did I Shave My Legs For This?" came to mind...)
July 15: I'm in Room 262 at PGRH. Peter just brought up some reading material. When he left I experienced a few sharp twinges of fear. I reached for the "Cup of Chicken Soup" book that cousin Arly had given me and selected a story at random. Strangely the tale had to do with courage and breast cancer. One of those synchronicity things, but it helped.
July 17: I'm home sweet home again and it's two days after surgery. The one hour operation was supposed to begin at 1:15 in the afternoon. But it wasn't until 3:15 before I was even moved out of Pre-opt. Once out in the hallway I was inexplicably left there in my bed for what seemed like hours. Peter was at the hospital all afternoon--pacing backwards and forwards--to and from Room 262. No one seemed to know where I was. But he was with me in the Recovery Room by the time I regained consciousness. Later the nurses giggled when I told them my husband must really love me. He had seen me with only one boob. Scarier still, he finally got to see me with no teeth. My upper denture is what holds my face together so that must have been an awful sight!
July 18: I get fatigued easily but right now have very little pain. I've managed to catch up on a few phone calls. This afternoon had a nice chat with stepdaughter Lynne who phoned from Saskatchewan. Lynne said she was grateful that I had been there for her (on the phone) when her mother was dying of a virulent form of liver cancer. I asked her if she'd ever learned about the cause of her mother's cancer. "The doctor thought it probably metastasized from an undetected breast tumour," she replied softly. Cousin Fanny was okay last night after her surgery. I told her it was ironic that we both hurt in the same places! More so for her, since both were operated on.
July 19: My home support worker arrived this morning. I had a shallow bath and she washed my hair. I asked her to please scrub the right armpit which I couldn't do--before we were both asphyxiated! Later I bathed the half of my left armpit that was unwounded. There is just a faint red line visible from where the lymph nodes were taken. I am feeling a bit shaky today but Gravol works wonders for that.
July 20: Tomorrow we're off to Prince George for Doctor Ainsworth to give me the verdict about my lymph nodes. If there has been no spreading of the cancer cells we'll be celebrating!
July 21: Dr. Ainsworth seemed ready to leap into his vacation which starts Friday. He was already wearing his shorts and was extremely cheerful. But he did not have the stats on my lymph nodes. He removed the drain that was protruding lumpily from under my blouse and held in place with a safety pin. ( I had finally learned to empty and clean it without feeling faint.) Dr. A warned there would probably be some pain as he pulled at the tubing but I didn't feel a thing. He gazed approvingly at his handiwork which stretched halfway across my chest like a heavy duty zipper. The staples could come out on Friday, he stated happily. The information about the lymph nodes should be available by then too.
July 22: My entire upper body seems to have been affected by the surgery. Even minor muscle use is a challenge. Tonight I had to ask Peter to pry the wad of packing out from my new bottle of extra-strength Tylenol. I've been joshing him about how he likely saved my life by nagging me into having the lump inspected in the first place. According to an old Chinese proverb he is now forever obliged to look after me!
July 23: I just phoned my way across Canada leaving messages (mostly) after learning the state of the lymph glands that Dr. A removed. This morning the clinic did not have the information and Dr. Ainsworth's answering machine proclaimed that he had already left on his holidays. I was somewhat teary-eyed and despondent. The receptionist made a few more calls to Prince George and eventually contacted someone with access to the information. Dr. Hall telephoned me with the news: all nine lymph nodes were negative! Peter and I did a little jump for joy (carefully-- I hurt.)
July 27: Got my staples removed today so hopefully I'll sleep better than I did last night. The nurse had no problem taking them out and I didn't feel a thing. She was also able to erase the ugly tape marks from where my bandages had been. I explained to her that the skin on that side of my chest is absolutely numb--feels like cardboard. It freaks me out to touch it, let alone scrub it. And there's this piece of folded skin at the end of the incision that throbs whenever I move. That really freaks me out!
July 30: Yikes, it feels as if the left portion of my chest is made of cardboard over top of a burning searing layer of hot lava! I simply must remember to take it easy. Earlier today I attempted to remove some laundry from the washing machine. I soon realized that pulling with my right hand places a strain on my left side too.
Aug. 1: I've decided not to drive anymore. Yesterday I drove to the office and back remembering to use my good right arm as the main strength on the steering wheel. For almost thirty years my left hand steered while my right was reserved for a cigarette. After I quit smoking the habit continued. But all that jostling over bumps and around corners must have shaken things up because, pain-wise, I am back to square one.
Aug. 2: The house is quiet except for the whirl of fans and the air conditioner. It is another sweltering hot day. I donned shorts and summer top this morning and am wondering how I can de-emphasize my right boob?
Aug. 6: My chest is painful all over again. Had to take painkillers twice during the night. Yesterday I convinced Peter that I was healthy enough to accompany him on a duck-watching expedition to Hallett Lake. It was a long and bumpy ride and our windshield was dinged twice by passing logging trucks but it was worth it. The weather was wonderful. Peter drove very slowly over the rough sections while I clutched a soft cushion against my chest. While he was communing with the waterfowl I strolled languidly into the nearby woods. I meandered through a grove of beautiful young pine trees, caressing their warm needles and cuddling up to their soft branches. It was so nice to be out there in the bush with the trees!
Aug. 13 Felt extremely well this morning. Drove to the office where Maria was busy haranguing the nice young lawyer from Prince George who's been filling in. By afternoon the hot lava pains were back. Felt better later after doing my post-mastectomy routines. According to the
physiotherapist the exercises prevent lymphedema. And I don't need a swollen arm like Popeye! I already resemble Olive Oyl his flatchested girlfriend--on the one side anyway.
Aug. 18: This morning the lady from the Canadian Cancer Society arrived with some brochures and an artificial boob for me. We chatted for over an hour. I told her I am keeping my fingers crossed that I won't need chemotherapy. Dr. Hall says I will probably be placed on an estrogen fighting drug called Tamoxifen if the tissues from my breast are found to be estrogen-positive. But if it turns out they are estrogen-negative, Dr. Ainsworth will likely prescribe chemo.
Aug. 24: The mastectomy bras I ordered from the Sears catalogue arrived today. They have pockets for a prosthesis sewn into both cups. Think I'll delay removing those on the right side--just in case. When the cancer lady was here she showed me a bra and prosthesis that she had purchased from a medical supply store for about three hundred dollars. My Sears model is a bargain at only thirty-six (plus the price of the plastic foam falsie.) I may end up having reconstructive surgery, anyway. I'll have it done for my sake, not Peter's. (He says he would love me even if I had no boobs at all!)
Aug. 31: Dr. Ainsworth was pleased with the way my incision is healing. In fact he was pleased all around with my progress. "When I saw the size of that lump I didn't think everything would turn out this well," he admitted. The examination of breast tissue had indicated my cancer was estrogen-positive, he said. Up until five years ago, Dr. A. continued, women in my situation would automatically be placed on Tamoxifen and that would be the end of it. But now some medical experts were advocating chemo as well. I expressed my dismay at the suggestion. I needed to be as fit and energetic as possible, I told him, because of some upcoming commitments. He asked me how old I was. When I told him 61 he reckoned I was past the age of menopause and assured me there should be no problem with just taking the Tamoxifen.
Sept. 2: I finally got up the nerve to shave under my left arm, using one of those new safety razors with the disposable cartridges. The cancer book advises using an electric razor to avoid nicks and scratches. But as I explained to Maria when we shopped for one in Prince George I simply will not put out that kind of money (the cheapest one was 79 dollars) for just one armpit! As we were hovering over one display counter she pointed out a package that was much cheaper than the others. "Why don't you just let it grow long and use one of those?" she queried deadpan. The box contained a set of barbering clippers.
Oct. 23: My long awaited speech at the Chamber of Commerce luncheon was a resounding success. Fellow councilor Elaine assured me I was adequately intimidating in my fitted style top and long black skirt. The hardest part of dressing up I am finding is getting my boobs aligned. No matter how I tighten the bra straps the real one has a tendency to sag, while the false one sits up perkily. This morning I had to safety pin it back down to where it belonged.
Nov. 5: Despite a weak and aching left shoulder which Dr. Ainsworth says was caused by muscle damage during surgery I survived my trip to the Coast on behalf of the Museum Society. Before leaving home I borrowed another wheeled suitcase which enabled me to tow my presentation scrapbooks and financial folders through two airport terminals. My own suitcase which contained clothing I pushed ahead of me. Cousin Fanny with her newly diminished bosom drove me to her home in Coquitlam. Yesterday afternoon as we were about to depart for my Vancouver hotel room the windshield wipers on Fanny's car stopped dead. And a car with no windshield wipers in the Lower Mainland rain is about as good as no car at all! This morning during a temporary dry spell she was able to transport me to the Coquitlam stop of the West Coast Express commuter train. The plan was for me to catch a cab from the train's terminus in Vancouver and be whisked
off to my early-morning appointment. After that I would carry on to my hotel room. The cab drivers of course would assist with the suitcases. But what we didn't consider was that unlike the Skytrain which also stops at Waterfront Station, the West Coast Express ends up below street level. When the train came to a stop I found myself disembarking onto a metal platform, dragging my suitcases behind me with my good right arm. The only exit in sight from the shadowy warehouse setting was an escalator that appeared to be churning its human cargo up through the roof. A sea of men and women wearing business suits and carrying briefcases surged around me while I paused in confusion alongside the tracks. When the mobile staircase had finally emptied I lifted one suitcase up and onto the lower step and, in a state of despair, watched it topple over and fall off . Then seemingly from out of nowhere, a smartly clad elderly lady with a Scottish accent picked up the bag and indicated that I should follow her with the other one. Blindly I trudged behind my guide, up the six to eight escalators connected by hallways that zoomed off in as many directions. There was no way I could have journeyed on my own up to street level, and to the particular exit where the taxicabs were lined up across the street. Perhaps she was my guardian angel?
Nov. 10 : I'm all alone this week. Peter is away on a book tour. Just listened to the tail end of a play on CBC Radio which was about breast cancer and having a biopsy. Felt a bit down as I undressed for bed. I peered at the wrinkled, lumpy landscape where my left breast used to be and attempted to comfort my inner child by quietly crooning , "Poor, poor Celia... Poor, poor Celia...." The chant did help to quell my depressed spirits. The skin below my incision has been dry with a bit of a rash lately. That particular patch was formerly underneath the breast. It is used to being in the shadow of the mountain for all those years. No wonder it is drying out!
Nov. 15: Four months since my surgery and I have decided not to worry about what the future has in store for me. It is highly unlikely that cancer will strike my remaining breast. Tomorrow I will get the scissors out and snip off the superfluous pockets that are sewn into the right hand side of my mastectomy bras. I'll also bundle up Cousin Fanny's angel and send it back to her. I don't need it anymore.
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