Essay: A ripple in the still waters of life
By Heather Gentzel
In the fall of 2005, when I was 20 years old, I found a lump in my breast and the lessons I learned from it changed my life. I didn’t think much of it when I first discovered the lump; I ignored it as some kind of normal fibrosis that would eventually work itself out, like everyone told me they had done.
A few months later, I was changing in front of my vanity mirror when out of the corner of my eye I caught a glimpse of what looked like a deformity on my left breast. My breath immediately halted as I remembered the nodule I had found the semester before.
Is that the same lump? Did it really grow that fast? Did this happen overnight? Questions swarmed through my head as I performed a self breast exam and realized that the ripple I had seen at the top of my breast was only a fraction of what was underneath. Running my hands in small clockwise circles, I noticed that what I thought was a normal nodule felt like the underneath of an iceberg. Lumpy and hardened, it covered almost the entire top side of my breast. Lifting my arm up, you could see it ripple and change shapes as I extended and rotated my left shoulder and arm.
I sat at my vanity for what seemed like an eternity and spent the rest of the evening on WebMD looking up information on lumps, breast cancer, malignant tumors, biopsies and a plethora of possible diagnoses before I got the courage to call my OB-GYN and scheduled the soonest appointment they had available… in two weeks.
“It’s probably nothing,” my mother said. She nervously tried reassuring me that this happens all the time. “Women get lumps, baby. It doesn’t mean there is anything to worry about but I will make sure to go to your appointment with you.”
Despite her tone I could see she was nervous. After all, breast cancer runs high in our family. My maternal grandmother had a double mastectomy in 1986, the year after I was born. I had always known this growing up (my grandmother wore her battle scars proudly) and was prepared for the possibility of high risk in my own future. I knew that when I reached the appropriate age I would maintain yearly mammograms and had routinely performed self breast exams since my mother and aunts showed all of us girls as pre-teens. It had never occurred to me that it may be something I would have to worry about before the age of 30.
The weeks went by slowly. But that was nothing compared to the eternally long wait in the doctor’s office. I kept telling myself that everything was going to be fine and I really believed it, even after he recommended a mammogram “to be on the safe side.”
Not being well-endowed in that particular area, the first thought when I arrived in the X-ray room was “you’ve got to be kidding me.” There was no way they were going to be able to get enough of my breast to place in this thing! Low and behold, despite my apprehension, they managed to get me in position. A few uncomfortable squirms later and the brief expectation that they might just rip my breast off right there in the room, the radiology session then ended and I was sent on my way to wait for the results.
“We’ll call you,” the nurse reassured me as she grabbed the chart for the next patient.
Right, I thought to myself, because I’m not a nervous wreck already without the anxiety behind a life changing medical phone call…
Nonetheless, I put on my sweetest smile and walked away. A thousand thoughts swarmed through my head as I imagined every worst case scenario imaginable, ultimately deciding that there was no way anything could actually be wrong. I kept reminding myself that I was a few weeks shy of 21 and that it’s normal for women to have lumpy breasts. I waited constantly over the next 72 hours for even the smallest ripple in the still waters of my life, for some kind of movement or pulse to the never ending vagueness that followed as I waited for the results of my radiology appointment. In the span of a few weeks I had imagined every possible outcome, from worst case scenarios, to fairy tale infused happy endings.
A few days later I received a call from my doctor asking me to come in for a follow up as soon as possible. I immediately got the image of a high school graduate receiving their college acceptance response letter. Was this my thin envelope? Why couldn’t they just tell me that nothing was wrong so I could move on?
This time, when I told my mom what the doctor said over the phone and about my impending follow up, we sat together in deafening silence. Without hearing her speak, I knew by the way she kept herself overly busy (re-cleaning the counter over and over), that she was as nervous as I was.
When the Tuesday appointment finally came around, we hardly sat in the waiting room for five minutes before the physician brought me into his office. He gently explained to me that the mass was abnormal and they feared it may be cancerous. I sat there pale faced as he continued to relay advanced medical terminology that quickly went over my head. He proceeded to tell me that they did not want to wait to schedule a biopsy. Because of the size, density and impression of the mass, they preferred to remove it immediately.
The words repeated themselves in my head like a worn out children’s carousel. Words that were dull in color, lacking emotion and eerily lethargic. All of a sudden I felt light headed, claustrophobic… unfinished. I had to get out of there.
Walking out of the room and into the lobby, I could hear my mom receiving a recommendation for a surgeon who could squeeze me in today for a consultation. I remember thinking to myself, this was actually happening. I am going to have surgery. They are going to cut into my breast and I may, or may not, have cancer.
The next 24 hours were a blur as I spoke to a surgeon, scheduled a date and waited for Friday — my 21st birthday. Reaching out to my boyfriend of three years for emotional support, I told him of my surgery and what the doctor had said. Before I could even say how appreciative I was that he was there with me he broke off our relationship.
This was too much for him.
It caused him too much stress.
He just couldn’t be there for me.
I guess it’s true what they say, when it rains it really does pour.
On the evening before the surgery instead of celebrating my 21st birthday at midnight, taking shots and getting free drinks like other young adults who celebrated this milestone, I was eating an early dinner of bland foods and making sure not to drink anything past midnight. Midnight rolled in and I sat there watching reruns of 90’s sitcoms, wishing myself happy birthday.
Early the next morning, my mother and I headed to the ambulatory surgical center and I was prepped for surgery. I remember the anesthesiologist bringing me my “cocktail” as they love to call it, and asking me to count down from 10. I was so nervous, I remember getting down to three before finally closing my eyes.
The next thing I remember is being woken up by a nurse in a large white room with a dozen other sleeping patients coming out of surgery. I felt alone and confused and kept asking for my mom. The nurse stroked my forehead and told me to relax while she went to find her. While waiting for my mother and slowly coming out of my anesthesia haze the surgeon came to check on me and rubbed my toes to offer comfort as the tears flowed freely from my face. Through tears and confusion I insisted he bring me my lump. I wanted to see the thing he took out of me, the thing that rippled underneath my skin like an alien being. He stared at me with a cocked eyebrow then chuckled and agreed, insisting he would be back any moment.
My mother’s familiar frame, clinging on to her purse and hurriedly looking past the beds for her daughter, rushed to me. She pulled a seat next to me and stroked my forehead and hair as she has done since I was a child. He soft touch allowed me to feel comforted and quickly eased my emotions and jittery post-surgery nerves.
Soon after her arrival, the surgeon came back with an opaque Dixie cup containing what looked like a yellow piece of fat. It was HUGE. The center of the mass was 3×4 centimeters with several thick fibrosis strands snaking out of the mass like Medusa’s head.
“Awesome” was the last thing I remember hearing myself say before laying my head down and succumbing to the anesthesia. The next day fell into a painful vicodin haze.
My follow up appointment was a week following my surgery date. The days between the lumpectomy and finding out the biopsy/lab results were full of painful arm lifting, bruising and bloody bandages. The surgical incision spanned three inches of my right breast and I quickly developed a keloid scar. One evening, I woke up in the middle of the night to thick, black blood oozing from my wound and I am so thankful I had my mother there to change my gauze and reassure me that draining was normal post surgery.
The follow up confirmed the best and worst case scenarios. My OB-GYN explained to me that I carry the gene for breast cancer and the lump they took out was precancerous. Without skipping a beat he continued on in great detail, explaining to me that because of this pre-existing gene, an imbalance (increase) in estrogen, and years of oral and injected birth control, I had developed a large and fast growing lump.
I couldn’t believe it. I was so fortunate to find out that the lump wasn’t malignant but was now directly faced with the realization that had I ignored it and if they hadn’t removed it, it would have progressed.
When I thought he had finished all he had to say and began to thank him for his time, he asked me to stay seated for some additional findings from my lab results. Continuing on without any hesitation, he explained to me that the test results also indicated that based on my abnormally high estrogen levels, hormone imbalance and irregular menstrual cycles, I may struggle with fertility in the future and should prepare myself for the possibility that I either may not be able to bare children, or will face fertility complications in my future.
“Wait, WHAT?”, I spoke the sentence out loud as one fast moving, jumbled word. Glancing at my mother and then back at the doctor, he recommended that I seek a second opinion and fertility tests when I was closer to that point in my life.
This was not at all what I was expecting. The memory of five week long periods and years of irregular cycles came crashing into me as his words sank in. And here I was worried about not being able to drink on my 21st birthday. Finally absorbing the information, and having gained the confidence to ask questions that received answers, I stuffed my purse with more literature pamphlets then I could carry and walked out of the office to let Pandora’s box of reality sink in.
That day changed my life.
Not only did it humble me, it showed me that these moments we look forward to — these milestones we think we are owed — are not guaranteed. I’ve had several lumps and tests following that surgery and all have turned up negative.
The fertility issues did not pose an immediate threat at 21 but as I approach 30 and struggle with carrying a child, the reality that it’s difficult for me to bear children went from being a distant problem to everyday thoughts and experiences. I routinely check my breasts whether I am at home reading a book, washing in the shower, or changing my clothes. I never miss an opportunity to observe the unavoidable and at this point it has become second nature.
These experiences have taught me not to take anything for granted, including what I am capable of emotionally and my full potential as a woman. It has taught me to live and think outside my comfort zone and not let an event or person alter my strength.
My story is not everyone else’s, but I hope that women who have second thoughts about what is going on in their body read this and think twice about ignoring their gut instinct and draw strength from the lessons I have learned.