Letting It Go

I connected with Antoinette Truglio Martin over a year ago when I sent her a text to learn about her experience with She Writes Press and finding a publicist. She was so helpful. And I have since spotlighted her book: Hug Everyone You Know: A Year of Community, Courage, and Cancer.
I enjoy her Sunday posts: Weekend Coffee Share. I join her at her kitchen table while she shares her feelings and life events of the past week. She seems like a friend whom I have known for years.
Her most recent post spoke of her decision to let her hair go natural. Since I am a strong believer that women of a certain age shouldn’t try to emulate youth but serve as role models showing that aging is not a negative life stage, I am reblogging her post.
I hope you enjoy her post, Letting It Go, as much as I did.

Stories Served Around the Table

Frozen | Let It Go Sing-along | Official Disney UK

Dark and generously thick hair is a dominant family trait for the women on both sides of my DNA tree. But as years tumble forward, our heads fade to gray well before the mindset of middle age. Each generation of women had their method to combat and come to terms with the inevitable. My maternal grandmother enjoyed regular salon visits when she retired. Her hair looked like a blue helmet. The steeliness of her hair color was evident even when she twirled and set pin curls in a net for the night. My mom fought the gray with home dye colors. Her choice was a flat black, very close to her natural color but without the light brown tints. She spent the evening with her head covered in a plastic bag and scrubbing the drips of excess black streams off…

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Firing My Doctor

 

 

 

More Voices: Worry

 Firing My Doctor

Marianna Crane

31 May 2018

 

I didn’t decide to “fire” my doctor on the spot.

During my last appointment with her, I’d filled Dr. Green in on the details of my mastectomy. I happily reported that the surgeon had declared me “cured”–the tumor’s margins were clear and my nodes were negative. Because I had large breasts and wanted to avoid wearing a heavy prosthesis, I’d had a reduction on my healthy breast at the same time. A routine biopsy of that tissue had showed dysplasia–abnormal cells. As a nurse, I’d researched this finding and found scant evidence that it would develop into cancer. My surgeon had concurred.

As I sat on the exam table while Dr. Green stood by the sink drying her hands, I told her I’d decided not to worry about it.

Without making eye contact, Dr. Green said, “I’d worry.”

I froze.

Never one to have a quick comeback, I left the office without a word about her offhand remark. It wasn’t the comment itself that concerned me, but her apparent indifference to my feelings. Plus, what good would worrying do?

Having a potentially life-threatening illness had boosted my resolve to surround myself with people who would cheer me, not depress me. Dr. Green was a competent doctor technically but lacked sensitivity–something that I value in a patient-physician relationship. I decided to look for another primary-care provider.

After calling Dr. Green’s office to cancel my next appointment, I requested that my records be sent to my new doctor. The receptionist asked if I would tell Dr. Green why I was leaving. I agreed, and before I could get nervous Dr. Green was on the line.

I relayed the incident at my last appointment; I said that her “I’d worry” statement had left me shaken and disturbed. Whether I was right or wrong, what I wanted from a provider was someone who cared for my physical and mental needs.

Surprisingly, she thanked me. I hung up the phone feeling rattled that I had voiced such a candid assessment. Gradually, however, jubilation replaced anxiety. I realized that I had control over my life and those whom I allowed into it.

I can only hope that my forthrightness with Dr. Green improved her communication skills.

Marianna Crane
Raleigh, North Carolina

A Story You Won’t Soon Forget

For the past ten years, I wrote my book in isolation. Long hours in front of my computer at my home, or a coffee shop, library and on Amtrak traveling between our home in North Carolina to Washington DC or New York City, and in other spaces I can’t remember. Wherever the location, I rarely chatted with others.

Now I am sharing my thoughts about my book and publishing issues with other authors. A whole new network of fellow writers has opened up to me. I no longer struggle alone but can discuss my experiences with those that have walked along the same path.

I spotlighted Nightingale Tales: Stories from My Life as a Nurse, by Lynn Dow in November. The book described Lynn’s nursing education and early hospital experience that was very much like my own. I spoke with Lynn three weeks ago and more recently with another author, Antoinette Truglio Martin. Both women freely shared their experience in their journey to publication, which publicist they choose, and how they promoted their books. I’m looking forward to contacting more authors as I travel this road.

Getting back to Antoinette Truglio Martin. She wrote Hug Everyone You Know: A Year of Community, Courage, and Cancer. Yes, it’s about cancer but it is not a depressing book. In fact, the Antoinette’s story is a thoroughly enjoyable read about her life as a wife, mother, speech therapist and special education teacher. Cancer is a tangential occurrence in her busy, happy life. She writes:

“. . . The less attention and verbiage I gave this cancer, the less real it was in my day. This cancer is nothing more than a detour—not a chronic condition or terminal illness. Audible words, long dialogues, and ownership would provide it with an embodiment. I tried to keep that to a minimum. The treatment I was willingly putting myself through was aimed to kill any trace of cancer that might have been left behind from surgery (lumpectomy). I believed it was completely gone, and the chemo and radiation therapies served as insurance against a recurrence. This cancer did not deserve an audience and would never be referred to with the personal pronoun ‘my.’”

Antoinette balances her story between her encounters with oncologists, chemo and radiation treatments, and stories of her extended Italian family, living in Long Island near the Great South Bay, and being supported by a group of caring family and friends. Coincidentally, four of her friends were also undergoing treatment for breast cancer.

I happily followed as Antoinette, a self described “overly squeamish, wimpy crybaby” who passed out during a blood draw, as she took charge of her treatments and confronted rude, uncaring and unprofessional medical staff.

One does not have to be faced with a cancer diagnosis to enjoy this book. Hug Everyone You Know opens a window on what it is like to navigate the health care system with a frightening illness. Antoinette educates us with a tender, engaging story that we will not soon forget.

 

 

 

 

Twenty Years After the Cancer Diagnosis.

Next Sunday, November 5th, will be the 20th anniversary of my mastectomy. Afterward, my surgeon draped her arm over my shoulders and said I was “cured” as she escorted me out of her office on Connecticut Avenue in Washington, D.C.

Each November 5th , I would make a big deal of the anniversary date of my surgery, or my second birthday, as I called it. I went someplace special. Like a superstitious baseball player, I ran through the same ritual when I came to bat. I wrote down what I was grateful for in my journal, contacted friends and family, telling them how much I appreciated their concern and attention when I was in the throes of cancer crazy and then scheduled something I would do all alone.

The first year, I took Amtrak from Union Station in Washington, D.C. to New York City and ambled up Fifth Avenue on a glorious fall day. In Central Park, I ate a hot dog with mustard and sauerkraut and listened to a skinny old guy dressed in a bright blue suit with a vest and spats, who sat on a bench across from me, playing a ukulele and singing songs my mother and I had listened to on the small radio on top of the refrigerator when I was a kid and she cooked supper. Wait till the Sun Shines, Nelly. Over There. Don’t Sit Under the Apple Tree with Anyone Else but Me. Filled with nostalgia of my childhood and gratitude for my life, I licked the mustard off my fingers and walked back down Fifth Avenue to Penn Station and back home. I repeated some version of this for the next nine years.

However, when my ten-year anniversary rolled around, I decided I would no longer engage in this superstitious ritual. I no longer needed to hang on to the label of cancer survivor, or replay each detail of the cancer journey as a holy event.

On another glorious fall day, I traveled from my new home in Chapel Hill, North Carolina back to DC for what I called the last celebration. First, I had lunch with Cathy, a nurse who was diagnosed with breast cancer around the same time as I. While I had stage 0—no infiltration, she has stage III. She sat across from me in McCormick & Schmick’s front dinning room, a seafood taco salad front of her. She had lost 30 pounds, intentionally, and looked professional with her soft beige jacket, long green velveteen skirt and government ID hanging around her neck. During radiation treatments she had worn a strawberry blond wig. Rather wild for a woman in a religious order.

“Well, I believe that if I didn’t get breast cancer, I would be still be living in the religious community. It was having cancer that lead me to evaluate where I was and why. It took two years from the first questioning to finally leaving,” Cathy said as she snapped off a piece of the taco shell, and scooped up some beans and fish into her mouth. I wasn’t surprised she left—she always struck me as an independent person—more of a free spirit than a follower who vowed obedience to an organized religion.

“Remember when we talked about whether or not cancer had changed us? You said you were still the same, right?”

“Yeah,” I said, “ I wished I would have become a better person, more caring and polite. But I am the same big mouth from Jersey City. Clumsy and rude.”

Cathy laughed even though she had heard this before.

“Are you happy?” I didn’t know why I asked her—she looked content.

Her eyes widened. “I thought I was going to die.”

Maybe a cancer diagnosis does change you. Not overtly. Some foreign emotion tugs at your gut: an awareness that only rises when it’s important. I didn’t do anything great. I just lived more honestly. Taking responsibility for my own thoughts and actions, I needed less approval from others.

After lunch Cathy went back to work and I headed to the National Cathedral on Wisconsin Avenue.

While my “lesions” were investigated and various treatments were discussed, I frequently made a detour on my way home after work to the Chapel of the Good Shepherd. Small, with seating for seven worshipers, the chapel was tucked away off the courtyard on the crypt level of the cathedral. There I would sit with my fears, always alone. The cool concrete walls, dim lightening, and silence calmed me. I focused on the stature of Christ, a lamb cradled in his arms, his hand burnished smooth by the touch of visitors seeking miracles. I always left infused with strength to face whatever was coming.

This time, when I entered the chapel, I wasn’t alone. To my left, a young woman with long dark hair silently sat with her legs drawn up and her bare feet on the bench, her shoes placed neatly on the floor in front of her. Her dress didn’t classify her as homeless. Her brow was knotted in worry and her cheeks were wet with tears. She didn’t acknowledge me but kept her eyes fixed on the statue of the Good Shepherd. My own mission seemed insignificant in the presence of her agony.

After a few minutes I left. But not before patting the Good Shepherd’s hand. “Thanks for being there when I needed you,” I whispered.

Now approaching my 20th anniversary I know that a “cancer” diagnosis has forced me to appreciate that there are no guarantees in life. I need to take chances. I don’t see any choice but to dive into my dreams.

As I look back on my life that has been rich and challenging, I remember that young woman and wonder what was so awful in her life at that moment. I hope, like me, she went back to the tiny Chapel of the Good Shepherd, her problems resolved. And before she left, she touched the back of Christ’s hand thanking him for being there when she needed comfort and then got on with her life.

The Things I Treasure

Tomorrow we are having the rooms on the second floor of our new townhouse painted. Before we moved furniture to the center of the rooms, I stored in a large cardboard box, out of harms way, the treasures I kept on the shelves of my desk.

Among the various memorabilia I packed away were the usual suspects: I Love My Grandma mug, a picture of my husband and I in Costa Rica taken last February with the waves of the Atlantic Ocean breaking behind us, and various items made by the grandkids: a sea shell necklace, a painted ceramic porpoise, and a handprint of one of the grandsons on a blue clay dish.

There were other items that also occupied a place in my office and heart:

 

Sand Castle
Sand Castle

I have served as preceptor to many nurse practitioners over the years. My first student, Cindy, gave me the sand castle. It reminds me of the talent and dedication of all the students that shadowed me in my practice, and my hope that I had made some small contribution to their professional successes.

 

24-Hour Mug
24-Hour Mug

 

 

(I had written a post about this mug. The wife of one of my patients gave it to me.)

I remember Sadie Rooney handing me a brown paper bag on my visit that autumn day in the early 90s. Her husband, Jim, a self-taught preacher, had died the month before. At first it seemed she wouldn’t have the strength to honor his wish to die at home. But on that day, Sadie was pleased with herself because she had cared for Jim up to the end. So when I reached into the bag and pulled out a mug and read the inscription out loud—24-Hour Woman—I figured Sadie was thanking me for being there for her. I was the 24-Hour Woman: the nurse practitioner orchestrating the journey towards the final curtain for Jim. And buoying up Sadie to face, head on, the whole dying business.

All these years I kept the mug. It came with me when we moved out of state—twice. Sat on my desk at each new job. A reminder of my nursing success. Or so I thought.

I had made notes of my visits to Jim and Sadie. Now as I write their story for my upcoming book, I am re-thinking Sadie. How resilient she turned out to be. She was there for her husband—night and day—quelling her own fears and insecurities. And at our last meeting, she told me of her plans to become a preacher.

Now with the passage of time, I see Sadie as the 24-Hour Woman. Thinking of her gave me the encouragement to take on new challenges as she had done.

 

 

Frank Lloyd Wright Home and Studio mug
Frank Lloyd Wright Home and Studio mug

 

When I lived in Oak Park, Illinois, I volunteered for the Frank Lloyd Wright Foundation along with a social worker friend, Betty. Oak Park has the largest collection of Frank Lloyd Wright designed homes built between 1889 and 1913. While we volunteered, we learned about architecture in general, and Frank Lloyd Wright in particular. Betty and I staffed the gift shop once a month on weekends, enjoying a great diversion from our day jobs: caring for chronically ill elderly.

 

Brass Keys
Brass Keys

When we moved to Maryland from Illinois in 1993, Lois, my best friend, gave me this set of keys. “Keys to the past,” she said, instructing me not to forget the many fun and poignant moments we had shared for the past twenty years. “Keys to the future,” I said looking forward to the excitement of change. It didn’t take long for me to realize I could never replace the treasure of friendship. Brass, the metal of the keys, is strong, pliable, and resistant to deterioration, like a strong friendship, Lois’ and mine, now in its 43rd year.

 

Angel With Broken Wing
Angel With Broken Wing

This gift was from a nursing friend and coworker, Christa. She and I developed breast cancer about the same time almost twenty years ago. She gave it to me when she moved to the west coast some years later. The angel proved to be far too fragile for me, the proverbial bull in the china shop. I display the angel in its imperfect form as a reminder that beauty does not need to be unimpaired.

 

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Pink Ribbon with Medal and Three Pins

 

The pink ribbon with a 1999 medal commemorates my first Komen Run for the Cure in Washington, D.C., the 10th anniversary of the run, with a record breaking 52,000 participants. I walked between Christa and another woman I had met at a support group after my surgery. We were among a sea of women cancer survivors, and one or two men, in pink T-shirts, and supporters, family and friends, in white T-shirts. It was an experience I never want to forget.

The ribbon seemed the perfect medium to attach the three pins used to hold the ends of a broken bone in my shoulder in place (The pins pierced the skin and were screwed into the bone) so it would heal without surgery—a new procedure developed by the orthopedic surgeon I chanced to be referred to in 2001 for treatment. I was in the right place at the right time when I fell.

IMG_2583

A patient and his wife presented this gift to me with wide smiles and much ceremony. He was one of my most frustrating patients, never heeding my sage advice. It reminds me to remain accepting and, at the same time, persistent.

SECOND GUESSING CANCER

stock-photo-doctor-with-mammography-292061516I’ve written in a previous post about my experience of being diagnosed with breast cancer 18 years ago. I’ve always wondered if I should have forgone a mastectomy and adopted a watch and wait stance. However, when my doctors never gave me that option and my family was aghast at my doing anything less than full warfare on the invading cells in my body, I gave in to surgery.

The type of cancer I had, ductal carcinoma in situ or DCIS, is still under investigation. Is it or isn’t it cancer? If it doesn’t leak out of the lining of the milk glands and metastasize, is it truly deadly? The treatments given to women can sometimes cause more problems than living with cells that, in some instances, resolve. So I was happy to see more attention given to finding answers in a new study about DCIS in the JAMA Oncology (online) August 20, 2015.

I had become an advocate of taking “cancer” out of DCIS label. That way women wouldn’t panic and rush to having mastectomies and in some cases prophylactic double mastectomies. Hopefully “watch and wait” would be an added choice rather than have women succumb to unnecessary treatment.

After I read the original article in JAMA—I am not going to tell you I understood all the statistics—I realized that DCIS is what most cancers are: complicated. Some types of DCIS can predict that a lethal breast cancer can occur in the future. I am more sympathetic of the tightrope that physicians and surgeons walk in counseling their patients.

The accompanying editorial by Laura Esserman in the same JAMA issue gives the following suggestions:

  1. Much of DCIS should be considered a “risk factor” for invasive breast cancer and an opportunity for targeted prevention.

  2. Radiation therapy should not be routinely offered after lumpectomy for DCIS lesions that are not high risk because it does not affect mortality.

  3. Low-and intermediate-grade DCIS does not affect mortality.

  4. We should continue to better understand the biological characteristics of the highest-risk DCIS (large, high grade, hormone receptor negative, HER2 positive, especially in very young and African American women) and test targeted approaches to reduce death from breast cancer.

Hopefully these suggestions will become a common practice in health care settings so women like me won’t be regretting a choice they made based on incomplete knowledge and overdiagnosis by the medical professionals.