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Why Awareness And Mammograms Aren’t Enough

The month of October is upon us. The surge of pink is impending. Admittedly, everything looks cuter with a little pink in it. At least that’s my take on it. But there is nothing remotely cute about Breast Cancer.

Absolutely nothing.

I still embrace pink. I am aware. O God, I am so aware of this illness. Every 14 minutes someone gets diagnosed with this illness. How can anyone not be aware? Awareness is a good thing, raising awareness is a good thing.

I was aware, aware for the last 20 years that this is a fatal illness. When I said goodbye to my aunt, I was aware what breast cancer can do. So aware of the trauma her kids underwent.

I was aware, as I sat with my other aunt during her chemo infusions at the hospital, taking time off from my medical school classes to keep her company.

I was aware that some survive, others don’t.

I examined my self regularly since my 20s. I was very familiar with the texture of my dense breast. Lumpy and nodular especially before my cycle. My first mammogram was at 25 years of age.

I was always familiar with a breast surgeon in my network of doctors. I breastfed two children for over a year each.

I was aware of the risks.

I had 2 mammograms six months apart prior to my cancer, a 7 cm mass that never formed a lump. Just a change in the texture of the breast tissue, that only I could tell felt different.

I was aware of the density issue, I had an ultrasound too, which was normal.

Yes, awareness and mammograms help, but in the end, it was my gut feeling that made me locate the lump in my armpit. A swollen axillary lymph node that is never good news.

So those that read this today, please, examine yourself, know your body and your breasts. Mammograms do save lives but maybe not yours. For me, mammograms were a false sense of security. It was a self-exam that saved my life.

So when you see the pink ribbons all over, ask yourself, when was the last time I properly examined my breasts? When was the last time my doctor taught me how to examine my breasts?

Know your genetic risk, I don’t have the BRCA gene but due to two family members, my risk was higher. Know your family history.

Take care of yourself, eat well and exercise. I did all of that. I still got cancer but it was my fate based on my genetic makeup.

Your outcome can be different, why wouldn’t you give your self that chance?

Before and After

I walk forward
I march ahead
I try hard each day
Then again someone will ask
“Didn’t you have long hair before?”
I did , I did 
A before and an after
There always will be.
I console my self
I seek comfort
Sometimes I lie
And hide from the truth.
Pretend it never happened,
Pretend it was never there,
Then again someone will ask
” didn’t you have long hair before?”
I did , I did
A before and an after
There always will be 
Life expects more
More from us than others
Bravery, courage, right attitude
Every day 
We are different
A tangent that our lives
Have taken
In and out of the flow
Pretending
To be
One of them until
Some one will ask again
“Didn’t you used to have long hair”

“Some Days”


“Some Days”

Yes, I am thankful
Yes, it’s really great
I have made it so far
so far I have been spared
but some days I get flaky
and sad and angry too.
some days I get so flaky
I want my life renewed.

Some days I want hair
thats long and straight
sometimes pretty nails
a carefree attitude
both breasts too,
Some days I get needy
Some days I have wants
Some days I want protection
from fears to be gone
Some days I just get flaky
and sad and angry too

My freedom has left
My mind occupied
My dreams conditional
My life uncertain
But
But I have to pull this burden
a life marked away
a life marked as traitor
day by day
moment by moment
bit by bit

Suppress the fear
Hold on to hope
Distract yourself
It works, sometimes
It works some days
but some days I get flaky
and sad and angry too.
Uzma Yunus

It’s time to go again

Its time go again:
A tribute to my sisters undergoing reconstruction

The OR is ready,
the sheets are clean and crisp,
He is scrubbed and gloved,
Slow music in the back ground,
the masks are on,
The monitors are anxious
the I/V is expectant,
All over ,once again.
It’s time to go.

And you, on the gurney,
ready to count,
till your sleep connects you to them,
quiet hours,
slow breathing,
pain and grogginess,
All over, once again,
It’s time to go.

I am trying,
again and again,
to undo what I didn’t ask for,
All I want,
is to feel whole,
whole again,
like I was,
It’s time to go.
It’s time to try
and to regain
a fraction of what was lost,
I am ready,
I am ready,
I am ready to count,
I am ready to endure the pain,
Ready to be whole again.

Here and Now

I was pretend traveling on FB when a friend of mine asked me “so where are you?” .My reply was “in the moment!!”. That is exactly where life needs to be, in the moment in the present, free of the past and liberated from the future. Just here, just right now. The goal is to appreciate the moment you are currently living in without shadows from the past or apprehensions from the future. When this happens, I breathe easy, I smile more, I laugh a lot.

Cancer leaves a person with fear of the future. I was discussing this with a patient recently who noted that someone he loves may die. My response to him was, that is true for all of us. We all may and will die. It really isn’t new information. If the present is lived well, it helps the future be the future and not become the present.

When I had had the biopsy on a Friday last year, I remember the exact moment when this thought crossed my mind….”If its cancer, what will I change about the rest of my life?”. At that point, content as I was, I said “nothing really’. One year later, I still think, no major changes except for staying grounded in the present.

One of my friends said to me during treatment, “Tragedies need not be rehearsed” that is exactly true. Every thing has a time, I have no desire to live that sooner than I need to. As far as I am concerned, its over, I have my life back and I am in the moment!

Dye another day…..no, not another day

Who would have thought that after a year of grueling cancer treatments, the step that would feel like THE conclusion to the process would be some hair dye in a bottle. Yesterday I said bye to cancer hair. I woke up and decided this is the day to end it.

End what? In my mind, an official end to the cancer tenure in my life. I was finished with treatments but it hadn’t felt like the end until now.

I am amazed at the power this has had. I feel well again, I feel “undiseased”, I feel “normal”. I was unaware of how much I couldn’t stand the gray.May because it whispered “cancer cancer cancer” as I looked in the mirror. May be it reminded my of the time when my life had lost color. May be it was familial.

My grandmother who has passed away now, used to have her hair dyed way into her 90s. It was a routine to go to grandmas every two to three weeks to help dye her hair. As I got older, I became the assistant to my mom in the process. She had long beautiful hair and I enjoyed combing it very much especially as she got older and could no longer sit up, so she would lie there and I would comb her hair spreading it out as I pleased. It was a wonderful connection between 3 women and 3 generations. My mom has always kept her hair short but she also is militant about keeping up with the color. So it was but natural for me to have lots of ambivalence about the gray hair received as a parting gift from the cancer treatment.

It seems that some memories had gotten woven into the silver that I no longer wanted to reflect on, braided in were the glimpses of nausea, fatigue and melancholy and  this silver needed to be tarnished so it was no longer vividly potrayed times that were painful, times that were sad, times that were challenging.

I wanted to join in with the mainstream women. Women that get hair cuts and go to the salon and chit chat with the hair dresser, not the chemo nurse. As the stylist was combing my hair, he asked “Am I hurting you?”, an innocent question but nonetheless a trigger to  flooding thoughts of IVs being put in mixed in with the question “Am I hurting you?”. I smiled at him and said, “Absolutely not! “.

I had never imagined that dying my hair would be such an emotional celebration and would feel like such a triumphant ending, as if I have prevailed over cancer. I will admit that I was a little startled when I looked at myself with the dark brown hair I used to have, I hurriedly  looked away and then I looked again. This time I saw my self, just my self . That is all I wanted to see, no more no less.

 

Going Back

A year has passed since I had a normal mammogram and a normal ultrasound. It was time to go back  last week.

A few weeks ago I had received a generic letter explaining to me the importance of mammography screening and how I needed to make an appointment to get one! Yeah right, the medical betrayal of sorts ,the false security that a normal mammogram have given to my surgeon and I, that test. The test that for lucky ones leads to early diagnosis and treatment, the test that can diagnose stage 0 or 1 cancers.

I thus grudgingly returned to the breast center. What I was unaware of was how much of a disturbing process it was going to be.

 I have treated many patients with Post Traumatic Stress Disorder, very aware of how places, things even scents can trigger memories, memories that the mind tries to suppress but instead they flood with overwhelming intensity. Being a psychiatrist did not render me immune to such processes  my self, whether I understood it theoretically didn’t affect didnt matter.

I was calm until I changed into the gown, put my stuff in the locker. This time as I hung up a bra that was a mastectomy bra with a prosthesis.I slammed the locker shut but it didnt do much to the gates that were starting to open.

Then I sat in the waiting room. As I sat and waited, a wave of emotion started to rise, a scalding mix of anger and melancholia , at odds with each other, the kind of emotions that ball up in your throat to the point that the windpipe can no longer freely move and the air struggles to go in and out.

The kind of emotions that get the whole body riled up in mutiny, with muscles being tense and the stomach in knots. A “why” slowly tried to rise in my mind which my rational brain promptly suppressed.

This last year, nothing in this room has changed, the chairs are in the same spots, the carpet looks the same, the walls and paint, exactly how I remembered and then I thought of this year as I experienced it and nothing seemed the same.

I was suddenly face to face with how life has moved on and is still the same for many and will continue to be.

The technician peeked her head calling my name. This one looked like a sub, for I had not seen her before.Excruciatingly matter of fact  and dry and her demeanor matched the feel of the room just right …cold and distant. And then “squeeze time” arrived.

My only breast, squashed between two plates like a specimen on a slide, literally. My mind flashed a picture of my deceased breast after the biopsy and the mammogram squeeze that led to bleeding from the biopsy site.I saw blood spread underneath the acrylic plate.

I so wanted this to be over. I don’t want any more mammograms please,I wanted to scream, I just wanna go home.

The technician disappeared to review the images with the radiologist as was taking shallow breaths. She reappeared still stoic, we need some additional views.

Now I really wanted to just leave. I wanted to tell her, “Listen I have seen the worst, I have gone through the worst, it wouldn’t  be fair if you saw more”

Some more squeezes later, I was let go. My heart refused to respond to any zen thoughts my mind threw towards it and it remained defiant. I was not ready to hear another sentence starting with “I am so sorry”, I have done that.This cant be happening.

.As I then proceeded to see my breast surgeon my anxiety spiked.He presented with smile and told me that “it was nothing”.

I am not sure if I did feel relieved . Is every thing really normal? That is what he said “last time” but was it… My throat was dry, my mind felt drained.

But what is the other choice? This is my fate as long as I live, monitoring and scanning, missed beats and shaky hands. It comes with the package. Fear is the side served with cancer, and periodically you get seconds even when you are full. I just hope I am done with the main course …for good.