Ya know, I really thought I would have that little lumpectomy in April and that by now I would be cheerfully stopping for radiation and doughnuts in the mornings on my way to work and then maybe skip chemo and get promoted to Happily Ever After.

Then I failed Lumpectomy 101. The best laid plans and all that.

After all my research I decided on Bilateral Mastectomy two for two, plus axillary lymph node dissection, with immediate reconstruction, and a really good chance of chemo. There were other options, and not everyone might have made the choice I'm making, but I think it's the best one for me.

The oncologist said that the BracAnalysis was negative. Yay. And the PET scan shows no indication of distant metastasis. And the oncotype testing of my tumor suggests a moderately low recurrence of cancer. So all of that is excellent news.

Oh Happy Day, finally got a surgery date at CCH for June 30! This gives me the entire month of June to kayak, maybe go to a wine tasting, hang out with friends, earn a little money, get my speedwalk on in the mornings. Not too much to blog on I think between now and then, we shall see.

Bonus trivia question: Why do plastic surgeons seem to use the word "bigger" as if it were a synonym for "better"?

All I can post this week is about what didn't happen.

I called my insurance company last week to ask for an out-of-network waiver so I can have Dr. Bashore do my reconstructive surgery. Spoke to one of an army of customer service personnel, otherwise known as satan's minions. Their job description: listen patiently, respond compassionately, enter data into a computer, promise follow up within 48 hours, and accomplish nothing.

The oncologist called me on Monday night, nothing important he said, but I missed the call and called back Tuesday to ask him to call me again. Still haven't heard from him.

Called insurance company twice on Tuesday this week and spoke with two different minions who said they lacked one crucial piece of information: do I already have the date for surgery scheduled? Well, no, kind of waiting to find out about that out-of network-waiver so I know if I can use Dr. Bashore. They promised to send my request back Upstairs and guess what, respond within 48 hours.

Called again on Wed, the next minion told me that for some reason my request had not been sent to the mysterious Upstairs and by the way, they need to know if I have a surgery date scheduled.

Called twice on Thursday, they needed to know if I have a surgery date scheduled. I finally said Let me get this straight. I'm supposed to schedule a very costly surgery without knowing if my insurance is going to pay for any of it, and then if my insurance isn't going to pay for it I'm supposed to cancel the surgery and start all over again, wasting more time? Apparently so. Which is

a. just stupid
b. why didn't the very first minion tell me that ten days earlier?

I also asked another minion to fax me an authorization to permit a third party to speak to them on my behalf, and she told me that she would be happy to do that, but that it would take three to five days for them to process that request and fax it.

Friday I called Dr. Bashore's office and spoke with Mary the Insurance Goddess. Then I went out kayaking. While I was still on the water Mary called me to tell me what part of claims my insurance company will and will not pay, and called me again to give me an estimate of what my out of pocket expenses will be. I can't tell you how refreshing it was to speak to an actual human being and get real information in response. I almost fell in the water I was so shocked and delighted.

Then I called Dr. K's office so that they can coordinate with Dr. B's office and CCH and Git 'er Done. I think I'll find out about the big date Monday.

Hence today's photo. I think we've all seen the card. Thanks Joel, it really reflects sometimes how I feel on the inside.

Got back from a marvelous little getaway where we just ate and drank and napped and looked at the ocean. There is no real news on the FC (freaking cancer) front. I am going in circles with the insurance company to get an out-of-network waiver so I can have the plastic surgeon who works out of CCH instead of the other, perfectly acceptable plastic surgeon who works out of Worstoff hospital. Once the insurance company gives me a yea or nay I can call Dr. Korey and his office will coordinate with the operating room and the plastic surgeon and I will have the big DATE.

In the meantime it seems like every day I have to call the insurance company or three or more doctors offices to elicit or provide some kind of information, and there is the endless re-routing of calls, the bottomless pit of voicemail, and the waiting for and missing returned calls. Except with Dr. Korey's office which is wonderful.

Also, I did get my PET scan results and although I haven't yet had the official explanation from the oncologist (that appt is Monday next week), from what the nurse told me there is nothing unexpectedly bad in it. Yay!

And on a humorous note, when we were sitting in the airport to leave town last week this larger-than-life woman came huffing up with two giant shoulder bags. Glamorous gal with big jewelry and bright clothes and big makeup, and the first thing out of her mouth as she sat down next to us was that she'd had a mastectomy 16 years ago and it was harder to carry stuff now. So I told her my situation and Lord, was she enthusiastic. She stripped off her jacket to show me where they took her body fat from her back to reconstruct her, and then she's patting the bare part of her humongous breast and saying to me "just feel this, just put your hand right here" and I'm saying "Girlfriend, I am not putting my hand on your boob in the middle of the Orlando airport".

One out of eight women, my friends.

Taking some time out to enjoy life.

Picture worth a thousand words.

Back to reality 5/17.

Just tying up a few loose ends after spending last week with multiple medical experts, reading lots of journal articles, and talking to some very upbeat breast cancer survivors. I now know more than I ever wanted to about the topic. Before we left for MD Anderson I told Bjorn that I wanted to come away from that facility feeling like THIS is The Place I Want To Be Treated, above all others. It was obviously a terrific facility, but I didn't get that feeling. So I'm hoping to finalize some things this week and plan for surgery here in podunk Brevard county early in June.

Saturday Bjorn took me out on Kathy and Randy's tandem kayak. I thought I was all tough and brought my own paddle as well. Shocked to find that after 20 strokes my arm felt like lead. Okay, just going to have to build up to my usual two mile meandering. Even so, just being on the water has such a magical effect.

If I might cease and desist for a moment from this endless self absorption:

Props to my primo caregiver Bjorn. I'm getting so much support from so many people, and many of you have been kind enough to ask how Bjorn is doing. Especially in the context that my dx occurred roughly two weeks after his mom died quite unexpectedly.

I'm here to tell ya, he's been amazing. We are both staggering through some previously uncharted terrain here, propping eachother up, and I'd have to say he's doing most of the propping. It has been helpful to have him at some of the recent MD appts for moral support as well as for taking notes while I get examined. He has made gourmet meals to tempt me when I have no appetite, distracted me, encouraged me, reassured me, loved me, cajoled me, entertained me, calmed me, and demonstrated in so many ways that he is in this for the long haul.

And he manages to look really fine while he is doing all of this.

Ok, enough ceasing and desisting. Lets get back to sending the rest of that positive and healing energy in MY direction.

A woman can never be too rich or too thin?

Well Wallis Simpson was wrong on one account. According to Dr. Diaz, the plastic surgeon I saw Friday, I am not a candidate for using my body fat for reconstructing any of my parts. It was almost humorous. He's saying "push your stomach out" and I'm saying "I AM pushing it out." Also Dr. Diaz does not have a good poker face at all. Since I am a psychologist, many of my friends and associates have a very good poker face. Dr. Diaz, as I was asking him about treatment options he did not consider to be in my best interest, was making faces like I was subjecting him to a series of really noxious smells, to the point where I actually said to him "look at what you are doing with your face!" Very expressive.

Monday I saw Dr. Levine, which was not very productive. I waited an hour to get in to see him, and then he didn't have the results of the BRACanalysis because his office failed to send in my family history of cancer so it didn't get approved by insurance, and the tumor analysis wasn't back yet, and I was kind of feeling like What Am I Doing Here? This is two hours out of my life that I will never get back. The positive point is that he did order a PET/CT scan, and his staff called me today and I am having it tomorrow AM. It should light up any metastases, although I really doubt I have any. And the BRACanalysis lady called me today to say that now that Dr. Levine's office sent my family history, my test is approved and covered 100 percent by my insurance. Results in about two weeks.

This AM I saw Dr. Korey. Got to love Dr. Korey. He is straightforward, plain-spoken, makes me feel like a human being, went over all my options with me (again), all the pros and cons, answered every question I could think of even if the answer was not pleasant. Dr. K doubts that the axillary lymph node dissection will yield any further evidence of metastasis. Me too. But we gotta do it. Dr. K said that if the river is really flat this weekend then maybe I can do a little paddling, and that I can go in the pool when I have my mini-getaway later in the month (no diving).

In the meantime, I'm working to maintain a healthy balance of life and healing and work. I walked Friday and Saturday and Sunday and I can't tell you how great it felt to get my whole body in motion. I did lots of resting over the weekend. We spent Saturday evening with some cherished friends and there was lots of interesting conversation and laughter. I'm healing great and that spastic hand is getting better by degrees.

I appreciate each and every one of you who are checking in with me by card or email or phone or smoke signal. I am touched to hear from people I don't really know who are taking the time to send me a kind word or a kind thought.