A Tetrad: To Celebrate the End of My Treatments for Breast Cancer

The following series of poems represents months of work through the most difficult time of my life as of yet. I wish to dedicate these poems to all the wonderful people involved in my care: the surgeons, medical oncologists, radiation oncologists, physician assistants, radiation therapists, nurses, and anyone else who has touched my world these last few months, both in private practice and at Roswell Park Memorial Institute. And to all of the cancer patients, both whom I have met personally and on the online support groups. Your strength never ceases to amaze me. Thank you to all. I couldn't begin to fully express my gratitude.

A TETRAD

It's Not Up to Him

Tell me that I can stay,
A little longer.
A life formed out of bits of thread and spilled blood
Is just a moment, a flash.
My creative clutter the only proof that I breathe.

Flesh plundered, compromised, sight unseen,
By one bad seed waiting,
For that slim circumstance
To strike and grow in a moment,
Interrupting a long-awaited dream.
We never know until we know,
We are not a given, even if we are forgiven.

I’d love to speak to that cell,
Lone invader of my own universe,
Travel the rivers and canyons of this divide,
Confront him and my swept-up fear.
To understand what he’s after,
Stealing my breath in order to live,
And perish with me.

I'd love to debrief that cell,
Make him squirm,
Will he have one noble reason?
Will I even comprehend why,
He means to use my body as his own,
Home Sweet Home,
For a little while?

I’d love to speak to that cell,
To tell him that I will stay,
A little longer.

It’s not up to him.

....................................




Ode to Awareness

Does tomorrow melt in your mouth,
Not in your hands,
Like Desire pulling you along by a taut, silken harness,
Only to nestle and caress you within the jaws of the famished world?

Do you tell your Prince to wake you later,
As you languishly linger within the folds
Of a sleep, unblemished by potion?
But, sooner than later, you will need those eyes open wide,
That breath strong and able,
Expanding and contracting for life.

Do you gaze across an open, fertile landscape,
Only to while away in longing,
For that noble Youth,
When all bitter Beauty has is these petals in her void?
All the while, the leaves rustle amongst us, calling out for Winter,
Awaiting to hear his step on the porch boards.

Do your dreams recall a listless longing,
Lying limp and open on the forest floor,
White flood rising from your cool gown,
A sad stream echoing your delirious sleep?
A cold wind blows, suddenly,
harsh and heavy upon your parched skin.

Shivering with eyes aflutter,
You think,
Perhaps, there is another way,
To conceive of this future,
Without falling through the cracks and chasms,
Of a life lived by another.

As you grasp the reins,
You navigate your way,
Slowly, ever so slowly,
Forward.

........................................


One Good Rain

All we need is one good rain
To wash these sins away.
Too bad it’s not so easy
To become clean again.

In the beginning,
There was sword and shield,
To keep us fully clothed.
Then we had witness protection,
To keep away all our foes.

Now it’s just a crapshoot,
We have nowhere to hide.
For me it’s just a walk on the beach,
But I am not too sure of the tide.

There really is no use,
I can duck in every doorjamb,
But I will always be looking backward,
A weapon filling each hand.

Protect both the chest and head
With armor reinforced.
Not once, but twice,
To withstand the force
An army of 100 men.
The battle cry sounds with a rush,
Of arrows emerging swiftly,
Over the cries of lonely voices
A raging fireball arcs,
And turns this armor to ashen dust,
This hope to smoke.

The fallen counted as we pass
Through these years
To days, not less dangerous.
It is not within the integrity of the body,
But in its own stealthiness.
We can disappear into thin air,
But still find invasion from within.
Crossing the crime of the organized
Will only leave you
With a neck forever cricked
a gaze directed behind those eyes,
A throat not quite nicked.

Night falls over the bustling bar,
A glow arises from the corner.
An enticing circle of fire emerges,
From the dimness
Beyond, the face slowly becoming visible
In the darkness.
A world alive at dusk,
A youth riveting and vibrant,
Confident in her ignorance.

A tinkle of ice as the whiskey
Flows, the smell wafts over me,
Like a banana freshly peeled,
It passes my lips like a fantasy.
That numb little confidence I love
Has entered my skin.
I coast down its river through days
And months
And eventually years
To where I am right now.

Here in this room
Whiskey long forgotten
Yet still a part of me.
Is it really
A mere cellular memory?

That’s it.
The deed is done.
I’ve unsheathed the sword,
Released my own ball of fire,
Submitted my body to flame and forge.
I’ve opened the gate to chaos,
I’ve started this holey war.
I’ve crossed the mafia cell at its own game,
And I will always be looking back.
With a crick in my neck,
A dislocated shoulder,
Waiting for that next attack.

And I owe it all to those whiskey years,
And that marvelous carelessness.
In my innocence of youth,
I had grasped a light,
That has lingered ever since.
And it’s true.
It is still near,
Burning strong and very much
Alive.

..........................................


A Perfect 84

42 years of a life,
Lived well and full,
Is not enough to wrap,
My weary arms around the world.

42 more would do,
Let’s make it symmetrical.
42 more would do very well.
My social calendar,
Is much too full.

84 years you say?
You’d be lucky.
I know.
But, 84 years in the scope of things,
Is just a drop on the great agar plate
Of the world.

84 years is all I ask,
A perfect number seemingly.
Keats got only 25,
And I’m no Keats,
That’s what I see.

We’ll call him Gabe,
My angel
Alarmed me of what’s to come.
He tapped me on the shoulder ,
Changed my curfew to some,
Night I never dreamed of,
Then changed it once again so I’d learn.

Then I knew,
That I was strong enough.
I knew when I saw you in my room,
That night, of all nights,
Mr.Gabriel.
Thank you for coming so soon.

I only wish,
That you were less frightening,
With your perfectly trimmed beard.
And eyes of clay and sinfulness,
Here on hallowed ground, so rare.

We are less earthy than you think,
Bring your white robes, I don’t care.
But I forgive you, Gabriel,
Your message was loud and clear:

These hands have more,
Comfort to give.
This left hand more to write.
This right hand more peace to share,
With those I encounter each night.

This hair much more,
Than vanity,
A frank expression of who I am.
This brain to compute and rationalize,
My relation to earth as it stands.

These eyes,
They are a window,
To a soul,
Not clean, but bright.
These bulky arms,
Which I lament,
Have held my child so tight.

These ears to listen caringly,
To those whom need me most.
This mouth with which to kiss goodnight,
All those whom are not lost.
These teeth to chew
The chocolate, most delicious and so fine.
This nose to smell the springtime air,
As it wispily leaves the vine.


This neck,
To accept,
Kisses and caresses,
All the same.
These shoulders
To shoulder the gardening,
Creating life along the way.

These breasts create a line,
From me to my
Beloved and his stare.
My waist encompassed by those arms
Who really, truly care.
My hips contain my power,
Of life and femininity.
Those thighs that I wish smaller,
Have gotten me from sea to sea.

These old calves are
Not so bad,
But shaving them gets routine.
My feet, oh my woeful feet,
You can kiss them,
But not this week.

My heart,
I save the best for last,
It holds so many dear.
Although I may not express myself,
Hear me loud and clear.

84 years,
Almost a century,
Of life to give and share,
This body with the great wide world,
I’ll do it, if you dare.

Knowing that I love you all,
Sleep silently,
Knowing that I care,
And never for a minute dream
Of when you will not be here.
Leave that worry all to me,
I’ve seen it all before.
To me it’s just a path I’m on,
And I’ve just opened the great big door.


This is my one wish for you,
Life can be so unfair.
For I have people looking out for me,
Some white dove--down here, up there.
Oh No! I’ve lost my shoes again,
Radiation is a bear.

I Keep Chipping Away

I've been working on a series of poems about breast cancer for months now. Writing, rewriting, and finding my muse in many places that I never even thought to look. This particular poem caused me many nights of lost sleep and moments of frustration, and the members of my writing group, who watched me as I brought a new version in each week, can attest to this. I was initially inspired by the Chronicles of Narnia exhibit at the Buffalo Museum of Science. I began reflecting on this idea of children at war and how perhaps we have some kind of innate strength that is present, even since birth. I used the idea of light as a symbol of my own strength, from which I was able to tap into many times over the last 6 months. This poem lay in its beginning stages for at least a couple months until one night, inspiration came to me. The title came to me in a half asleep-half awake state, after throwing off my blankets in the heat. I pictured a computer file labeled with the title One Good Rain, and I began to write and eventually finish this poem in this state of "in-between" consciousness. As I coast through my last few radiation treatments, I am very happy to present to you my latest literary creation and to say that the series is,at long last, complete.

One Good Rain

All we need is one good rain
To wash these sins away.
Too bad it’s not so easy
To become clean again.

In the beginning,
There was sword and shield,
To keep us fully clothed.
Then we had witness protection,
To keep away all our foes.

Now it’s just a crapshoot,
We have nowhere to hide.
For me it’s just a walk on the beach,
But I am not too sure of the tide.

There really is no use,
I can duck in every doorjamb,
But I will always be looking backward,
A weapon filling each hand.

Protect both the chest and head
With armor reinforced.
Not once, but twice,
To withstand the force
An army of 100 men.
The battle cry sounds with a rush,
Of arrows emerging swiftly,
Over the cries of lonely voices
A raging fireball arcs,
And turns this armor to ashen dust,
This hope to smoke.

The fallen counted as we pass
Through these years
To days, not less dangerous.
It is not within the integrity of the body,
But in its own stealthiness.
We can disappear into thin air,
But still find invasion from within.
Crossing the crime of the organized
Will only leave you
With a neck forever cricked
a gaze directed behind those eyes,
A throat not quite nicked.

Night falls over the bustling bar,
A glow arises from the corner.
An enticing circle of fire emerges,
From the dimness
Beyond, the face slowly becoming visible
In the darkness.
A world alive at dusk,
A youth riveting and vibrant,
Confident in her ignorance.

A tinkle of ice as the whiskey
Flows, the smell wafts over me,
Like a banana freshly peeled,
It passes my lips like a fantasy.
That numb little confidence I love
Has entered my skin.
I coast down its river through days
And months
And eventually years
To where I am right now.

Here in this room
Whiskey long forgotten
Yet still a part of me.
Is it really
A mere cellular memory?

That’s it.
The deed is done.
I’ve unsheathed the sword,
Released my own ball of fire,
Submitted my body to flame and forge.
I’ve opened the gate to chaos,
I’ve started this holey war.
I’ve crossed the mafia cell at its own game,
And I will always be looking back.
With a crick in my neck,
A dislocated shoulder,
Waiting for that next attack.

And I owe it all to those whiskey years,
And that marvelous carelessness.
In my innocence of youth,
I had grasped a light,
That has lingered ever since.
And it’s true.
It is still near,
Burning strong and very much
Alive.

A Mother's Day Wish: A Poem by Me

"Poetry is a record of the life around us and in us, and you'll get a better idea from poetry what it was like to be alive in 2011 than you will from the New York Times." ~Garrison Keillor

If this is so, I only hope my own poetry can live up to the task.  This poem was written this week, May 2011:

 

 A Perfect 84

42 years of a life,

Lived well and full,

Is not enough to wrap,

My weary arms around the world.

42 more would do,

Let’s make it symmetrical.

42 more would do very well.

My social calendar,

Is much too full.

84 years you say?

You’d be lucky.

I know.

But, 84 years in the scope of things,

Is just a drop on the great agar plate

Of the world.

84 years is all I ask,

A perfect number seemingly.

Keats got only 25,

And I’m no Keats,

That’s what I see.

We’ll call him Gabe,

My angel

Alarmed me of what’s to come.

He tapped me on the shoulder ,

Changed my curfew to some,

Night I never dreamed of,

Then changed it once again so I’d learn.

Then I knew,

That I was strong enough.

I knew when I saw you in my room,

That night, of all nights,

Mr.Gabriel.

Thank you for coming so soon.

I only wish,

That you were less frightening,

With your perfectly trimmed beard.

And eyes of clay and sinfulness,

Here on hallowed ground, so rare.

We are less earthy than you think,

Bring your white robes, I don’t care.

But I forgive you, Gabriel,

Your message was loud and clear:

These hands have more,

Comfort to give.

This left hand more to write.

This right hand more peace to share,

With those I encounter each night.

This hair much more,

Than vanity,

A frank expression of who I am.

This brain to compute and rationalize,

My relation to earth as it stands.

These eyes,

They are a window,

To a soul,

Not clean, but bright.

These bulky arms,

Which I lament,

Have held my child so tight.

These ears to listen caringly,

To those whom need me most.

This mouth with which to kiss goodnight,

All those whom are not lost.

These teeth to chew

The chocolate, most delicious and so fine.

This nose to smell the springtime air,

As it wispily leaves the vine.

This neck,

To accept,

Kisses and caresses,

All the same.

These shoulders

To shoulder the gardening,

Creating life along the way.

These breasts create a line,

From me to my

Beloved and his stare.

My waist encompassed by those arms

Who really, truly care.

My hips contain my power,

Of life and femininity.

Those thighs that I wish smaller,

Have gotten me from sea to sea.

These old calves are

Not so bad,

But shaving them gets routine.

My feet, oh my woeful feet,

You can kiss them,

But not this week.

My heart,

I save the best for last,

It holds so many dear.

Although I may not express myself,

Hear me loud and clear.

84 years,

Almost a century,

Of life to give and share,

This body with the great wide world,

I’ll do it, if you dare.

Knowing that I love you all,

Sleep silently,

Knowing that I care,

And never for a minute dream

Of when you will not be here.

Leave that worry all to me,

I’ve seen it all before.

To me it’s just a path I’m on,

And I’ve just opened the great big door.

This is my one wish for you,

Life can be so unfair.

For I have people looking out for me,

Some white dove--down here, up there.

Oh No!  I’ve lost my shoes again,

Radiation is a bear.

A Test of Patience: My Very Personal Journey Through Triple Negative Breast Cancer

From everything you have heard about breast cancer, from the risk factors to treatment to prognosis, you are probably not getting the complete picture. There are many different types of breast cancer, and most women are lucky (well, if you could call anyone with cancer lucky) to get the most common form, estrogen positive breast cancer. This most common form coincides with all the typical risk factors, such as early menses, late childbirth, late menopause, hormone replacement, or anything that would increase your lifetime exposure to estrogen. Prognosis is good if caught relatively early (Stage 1 or 2) and there are all sorts of treatments available because it is easy (well, again, easy in the scope of breast cancer treatments) to reduce estrogen in the body.

With triple negative cancer, everything you thought was true now isn’t. This cancer has no hormone receptors, which means that we have no clue how it grows. We have only known about this cancer for a few years, but researchers are working frantically on trying to understand what exactly makes it grow and what risk factors are causing it. There are a few groups who have a tendency to get triple negative breast cancer: African Americans, Hispanics, Ashkenazi Jews, and young pre-menopausal women with positive BRCA mutations. Obesity has found to be something that triggers it, along with a high fat diet. A recent study was just published saying that those who have had no children have the lowest risk of developing triple negative breast cancer, while those who have had more than 3 children are at the highest risk. Pregnancy seems to spark the growth of this type of cancer. African American women have the highest death rates from breast cancer because they are getting more triple negative cancer, and since most African American women are less likely to get their yearly mammograms, their cancer is found too late, usually when a lump is found and at this point, it is much too late. It is a very sad fact for some women that they don’t have access to health care and must be made to suffer for it.

The main difference between triple negative and estrogen positive breast cancer is that triple negative is highly aggressive and is much more likely to metastasize, and it metastasizes fast, usually 1-3 years after diagnosis. Once it does metastasize, the patient is usually given only 9 months to live because it usually goes right to the bones. Estrogen positive breast cancers are less aggressive and take longer to metastasize, therefore most tumors would not need chemotherapy unless very large. Also, there is a drug called tamoxifen to hold it at bay. For triple negative breast cancer, there is no such drug. So, for those with tumors greater than 5 mm., chemotherapy would be considered in that chance that those metastasizing cells would take route somewhere far from the breast. Even so, chemotherapy is more effective in triple negative cancers, but not 100%. There are those who fall through the cracks, trying everything and ending up dying anyhow.

Good news is that there is a tidal wave of research being done right now on different markers, enzymes, and inhibitors that might play a role in its growth. Adding this to the increased emphasis on yearly mammograms and genetic testing, these tumors are found sooner, like in my case. Another good thing is that they are less likely to recur after 5 years, unlike its estrogen positive counterpart. So, once it is killed the first time, you are unlikely to see it ever again.

In my case, my tumor was found accidentally. When I had my yearly mammogram in December, they found some calcifications which are a warning sign of DCIS (Ductal Carcinoma In Situ), a form of breast cancer completely confined by the duct and not able to go anywhere else. I had my first lumpectomy in January to remove the area of DCIS and within this area, they found a 3 mm tumor. This never happens. Triple negative tumors are very rarely found this small because they would not be felt or seen on mammogram. I am so, so lucky and have found that there are not many women like me in the world (I’ve been going onto breast cancer discussion boards to reach out to anyone out there and have only found a handful). Plus, what is even more puzzling is that I am not Black, Hispanic, Jewish, and I did not test positive for genetic testing. The only risk factor I had was obesity. Since cancer is a great motivator, I have lost 30 pounds so far. My doctor wants me to get down to the bottom of my weight range, so I have at least 30 more to go-my own personal form of chemo.  also, my diet should be no more than 20% fat, which is even harder ot accomplish than weight loss.
Well, the day I received my pathology results was the day I got on the worst rollercoaster ride in the world (and I usually love rollercoasters!). I went from having a Stage 0 breast cancer to a Stage 1a triple negative breast cancer. At first, I thought I would need chemo and mastectomy. I ordered up my wigs and hats and got ready. Then I was sent for a second opinion at a large cancer institute and found that chemo isn’t considered until the tumor is 6 mm, and they said I shouldn’t need a mastectomy. I quickly cancelled my surgery date, then had a third opinion to be sure.

So, here I am today. A week after my re-excision (which was completely pain free, by the way) and I am happy to say that my second pathology report says that there were no abnormal cells found! My surgeon explained to me that my body killed all the cancer cells that were left in the process of healing and inflammation from the surgery. So, I get to keep my breast and will be starting 7 weeks and 1 day radiation next week. I am getting off this crazy rollercoaster and am ready to get on with my life. My only hope is that I never have to look breast cancer in the eye again because if I do and it is triple negative breast cancer, it won’t be so easy the second time. That said, I will be welcoming my radiation treatments with open arms. I will rejoice in all of it, the burning, blistering, and fatigue and anything else that comes up, because I will know that those little bastards will burn, and burn, and burn. So, bring it on! I am ready.

By the way, there are all kinds of journeys and most are exciting and new.  This is one journey I did not want to be on.

Sincerely yours,
The Wingchair Traveller

p.s. Just a note to those of you who are visiting my blog for the first time and are on your own journey through breast cancer. Please peruse my recent posts because there may be some things that I have written that will touch and inspire you as you go through all the emotion and turmoil that only cancer can bring us. Also, don't be afraid to comment on any of my posts to share your own stories. I'd love to hear them!