An Invitation to "Warrior Up"

October 6, 2019

I walked out of yoga on Wednesday night; warm, soaked, and yoga stoned. It was about 7:15 and I noticed a missed call from my surgeon's office. His message sounded rather formal. He asked me to call him on his cell. I wasn't loving the sound of that. I took myself out for a vanilla yogurt with rainbow sprinkles for dinner hoping it might sweeten the mood and buy me a few minutes to collect myself. I called Alan, "Should I be scared to call him back?" I left him a message. I said," I don't know if you call all of your patients with "that voice" or if it's bad, but please call me back. The phone rang as I was pulling into my driveway. "He started talking...Microcystic adnexal carcinoma", but the only word I heard was carcinoma. I asked if he could repeat himself. Maybe I misunderstood or heard him wrong? I've had annual skin checks head to toe, yearly physicals, dermatology appointments and no one has ever voiced the slightest concern about this cyst under my lip. It looked like your average sebaceous cyst. In the last year it's grown and I notice it in pictures. When I put it out to a jury, my family was undecided."If you take it off, you might have a worse scar or if it really bothers you, go and have it removed." The doctor in the house didn't push either way. He wanted it to be my decision. I kept putting it off because I "knew" it was just cosmetic and I was really afraid it might create a defect in my lip. Two weeks ago, I mustered the courage to face this little pebble under my skin, which is how I've always described it. I went in for a consult. The doctor finished a procedure early and offered to remove it during my appointment. I went to an excellent plastic surgeon in our community, who happens to be our friend for years. As a matter of practice, he sent it out for pathology. I was grateful he did such a beautiful job and happy it was finally over. Turns out, this was just the beginning. This is an unusual cancer of the sweat glands; the word "rare" comes up often when researching.The first time it was mentioned in medical research was in 1982; new kid on the block. 30% of the time it's misdiagnosed so I'm lucky they found it immediately. The average age of diagnosis is 56, yup. And it's on the left side of the face, yup yup. I am not afraid to be treated but I am afraid to look scary, if that makes sense. It's not vanity really. I just would have preferred to have cancer in my underarm or on the bottom of my foot but nobody asked my opinion. It’s my face, just below my lip or on it and looking “damaged” is a very real fear that I have to manage daily. I walked in to the house and Alan said, "I called you three times. What's up?" He sounded worried, and I shared my news. He was absolutely stunned. We just stared at each other with our mouths hanging open, completely dumbfounded. I walked over to him and he held me in his arms, and that is when I started to cry. Dylan happened to call just minutes later. I choked down sobs to tell him. He was classic Dylan, level headed and thoughtful. My son is my voice of reason and always knows what to say to make me okay. Eliza was heading to University of Florida for Homecoming Weekend the next day. I asked him not to say anything as he was driving her to the airport, of course. My gift to her would be a reprieve from my news and a weekend she would always remember with her girlfriends. The cancer would keep until she returned to San Francisco. I shared my news with a handful of people who would need to know or I needed to know, made some schedule changes and walked around in a fog. Alan and I barely slept that first night. At 4 a.m. i looked over and he was wide awake staring at the ceiling. I reached over for his hand and he was held me around. We just laid in the dark listening to the loudest silence I've ever heard. My mind kept awfullizing the outcome, seeing pictures of myself distorted, thinking about what people would say when they saw me if it looked bad. Clearly my mind was offering nothing productive. Fear haunted my every thought. I gave myself the night to let my mind go crazy with the news. What I realized is that when I focus on the ugliness, I feel terrible. My mind could not be in charge. This would be a heart and soul expedition. The next morning, I went to yoga, not 12 hours after I received the news. I just laid on my mat the entire time. The day was a blur but I started to rally in the afternoon. I decided there were silver linings, so I started looking for them in everything I did. Alan and I went out for a beautiful dinner. He cried, I cried and I was starting to find a stride. These 4 days have been mostly living in the moment and making lemonade. I had only one episode of being so overwhelmed I had to crawl into bed and pull the covers over my eyes. The red tape of healthcare could make you sick if you weren't already. My sister spent the entire next day making appointments with the best surgeons in Miami. This is a very unusual diagnosis so it's not something that every surgeon is equipped to handle. A non stop flurry of texts ensued between Alan and Margaret. They coordinated appointments between her colleagues at Baptist and Alan's connections at UM. One of our close friends from medical school is the Chairman of the Department of Dermatology at Jackson, which is the #1 dermatology program in the country. This is when you are glad you married a doctor. Doctors take care of each other and their families #perk. I've googled,"How to tell people you have cancer" and nothing landed for me. I played with the idea that I would keep this private, but I have students who would notice my absence and friends who would sense my distance. There's no reason to conceal my current (and not permanent)reality, so why would I go through this on my own. Monday I will be seeing 2 of the finest surgeons in Miami. My sister will be attending as my advocate. She will ask all the right questions and get all the necessary answers. Tuesday and Thursday are filled with more of the same; bloodwork, MRIs, reading slides, sending test results, etc. There will be decisions to make. Which procedure has the least risk with the biggest reward? Do we need to be less aggressive, more aggressive? Who makes me feel good? It is my intention to have a working treatment plan by the end of the week. That doesn't mean I will, but I hope to have a sense of what's happening; when, where and with who. This time last year was the toughest few months of my life. I am certain that if I hadn't taken that journey I would not be able to navigate this unexpected excursion with my feet so firmly planted on the ground. I isolated myself and felt alone then. This is a different kind of challenge and I intend to soak up every bit of human kindness and connection that is offered. It took vitamins, medicine, and so much more to heal me last year, but the only one who could synthesize it all and make change happen was me. It will take tests, surgery and reconstruction this time and again, I will be the one to hold steady and breathe through it. My intention is to handle this efficiently and immediately and I’m offering it up. I want to continue doing the things that make me feel like me; practicing yoga, teaching yoga, and making my difference. The universe has sent me an invitation to "warrior up" and I have accepted. I will walk my walk with grace and courage surrounded by an army of soldiers who have agreed to stand by my side. "I am fierce, I am strong, I can weather's life unexpected storms." Let it rain.