Finale

Today marks the day one year ago that I discovered the lump. Due to the discrepancy between the Jewish and Gregorian calendars, the Hebrew date of discovery is some two weeks away, marking also Israel’s Independence and 60th birthday.

Regardless of the culture that defines the time period, the completion of the seasons’ cycle behoves me to reflect on the last year and to take stock - what is called in Hebrew, a heshbon nefesh.

For sure, the discovery of a life-threatening disease and its aftermath makes its mark on one’s life on a physical, emotional and mental plane. How could it not? Death had been way down the road and here it was threatening to take up residence right next door. Initially, the changes were primarily physical, while the soul and the psyche struggled with the existential import of what the body was forcing them to endure.

One year later, the physical remnants of that horrendous diagnosis are mellowed but extant. My breast bears the faintest scar, which will no doubt continue to fade over time. It is still swollen from the radiation, though to my eye, grown obtuse from over-familiarity with its contours, the swelling is barely discernable and to the casual eye, is a perfect match of its twin (perhaps it is necessary to point out that I am using a turn of a phrase because no casual eyes have in fact been scanning my breasts). Ironically, the breast, despite being the source of all the trouble, is the least physically affected part of my body. Rather, my left arm, with its lymph node population reduced by 15, is still sensitive in that lying on it or moving it beyond still unascertained boundaries causes pain, or at least, discomfort. Some areas of my upper arm are still numb and it is uncertain whether normal feeling will ever entirely return to it. I continue to heed the warnings of various medical practitioners and in my exercise class, I lift weights only with my right arm and limit my left arm’s participation in various other exercises. In a way, this vigilance seems a little specious as I use no such discrimination when picking up my granddaughters or the groceries, all of which are individually much more than the mere one kilogram of an exercise weight.

I am certain that for most of my adult life I have experienced physical discomfort in various areas of my body which I have ignored, subliminally secure in the knowledge that a twinge is here today and gone tomorrow. However, as I have written earlier in this blog, there is little the body can serve up nowadays that is not processed by a mind still bewildered by the trauma that befell me, as a possible new symptom of the disease that will not go away. Some symptoms are more worrisome than others but their disappearance within a few days reassures me that the body is merely shifting and adapting its aging parts, rather like a house settling in for the night.

To all appearances, the disease has indeed gone away - but there are still those moments when I am conscious of the sword of Damoclese that hovers over me, threatening my sense of well-being and confidence in the future. Part of the reason for this lapse in absolute optimism lies in the years during which the cancer was slowly and insidiously invading my body while I proudly perceived myself as a woman of robust health. Under the circumstances, a cancer diagnosis can be compared to a demonic harlequin gleefully intoning na nanna na na. And now that the disease has been scooped out of me, I choose to continuously question the validity of my perceived health and latch on to each and every bodily quirk as the disaster of the moment rather than enjoy the knowledge that the robust health that I had once believed was mine but was not, is now indeed mine to enjoy.

I once asked Sigal, my surgeon, when I can stop worrying about metastasis and her answer was between five and 10 years, an answer that had value for its truthfulness, but was not one designed to induce equanimity.

Control of my equanimity and restored confidence is totally mine and I spend most days dealing with life with nary a thought of cancer and its attendant unpleasantness. At times, I even find that I have to remind myself in a resolute manner that I’ve had cancer, because it still seems to be so very impossible. Such reminders unfortunately do tend to curtail whatever plans I had been happily in the process of forming until the fear recedes. During the last year, I have heard and read about so many cancer stories, mostly breast, that I realize that not having had to undergo chemotherapy places my experience at a totally different level than those who lost their hair and spent 10 days out of every month vomiting. Sometimes I wonder if my survival would be more assured if I’d suffered more - and then I quickly crush the thought and focus on being grateful that chemo had not been necessary.

I’ve often been asked during this last year how having cancer has changed me as if change were a prerequisite for recovery. In fact, as far as one woman, an astrologist, was concerned, any failure on my part to dig deep, dig true into my psyche would constitute an invitation to the loathsome little green cells to return - although she didn’t say how I was to accomplish this, nor how I would know when I had completed digging. But there has indeed been a change in my weltanschauung and that is simply a relaxing of my erstwhile, fondly held superstitions, nurtured and refined over a lifetime, and used as a source of reassurance. My superstitions had simply let me down. I had gone through all the time-honored rituals and I still had cancer. A thought that began as a whisper and became a clamor finally convinced me that neither numbers nor incantations have the power to change what has already been set in motion. I can now quite happily relinquish these nonsensical props and enjoy the sense of liberation their absence brings. I can also save on my annual astrological forecast bill.

My zeal for healthful cosmetics and toiletries has relaxed somewhat - not because I don’t believe that it is preferable to use products that do not contain known carcinogens but because of the difficulty of finding products that do not contain any toxins at all. It seems that the cosmetics industry cannot fulfill its mission to maintain soft and clean bodies and hair without using at least some toxins but while the ingredients are listed openly, their quantities are not. When I turned to the web to guide me on the relative safety of different products, I was distressed to discover that the shampoo and soap products of Pantene and Dove respectively contain very high levels of harmful toxins.

Nowadays, when I scan the ingredients of a shampoo, I’m looking for sodium lauryth sulphate or sodium lauryl sulphate, which began life as an industrial degreasant and garage floor cleaner.

This substance is found in virtually all personal care products, even those sold in health stores and purport to be superior to common or garden toiletries one buys at the supermarket or pharmacy. In fact, I was disappointed to find that the health store that seemed to answer my need to smear only healthful substances on my body, teeth and hair, stocks pretty much anything in addition to the quasi-healthy stuff, all of which contains some ingredient with a long and chemical sounding name. What is the point of inundating lip salve with plant extract if it also contains petrolatum?

(The jury is out on how dangerous sodium lauryl sulphate is; this site gives a good overview: http://www.health-report.co.uk/sodium_lauryl_sulphate.html).

I’m still eating goat’s and sheep’s dairy products but I believe that it won’t be long before these too will be subjected to hormones and/or antibiotics, as they become more popular (thus rendering the products less healthful, in which case they will become less popular).

Occasionally, I eat cheese derived from a cow, always accompanied with the comment that I do not wish to be a fanatic. Otherwise, my eating habits haven’t changed very much. I ate healthily BC, and although all the mounds of broccoli, almonds and apples I devoured were ineffective in keeping cancer at bay, I don’t see any reason to start wolfing down Big Macs. My major culinary sin, it appears, is enjoying burnt food - aka toast, crispy barbecued chicken - as the heterocyclic amines (HCAs) that are produced are known carcinogens.

But nobody really knows - not the doctors, not the drug companies, not the intrepid medical reporters who go out there and tell you to swallow vitamin E for its antioxidant components and then a year later tell you that vitamin E supplements might in fact kill you. The body is one mighty mystery, the last frontier for human discovery where the firmly held beliefs of yesteryear are the idiotic notions of tomorrow. To all intents, purposes and statistics, I will survive cancer and die in a freak accident 30 years from now. Within the realm of current knowledge, the doctors can be more or less confident that this is where my story ends.

This time last year I celebrated by 60th birthday and I was in the process of completing plans for a year-long celebration when fate intervened and determined that I would spend the past year acknowledging my life in a totally unexpected way. Although I would have preferred it had been different, not all the experiences of the past year were negative. Writing this blog has been an intrinsic part of the cancer experience as by verbalizing all that happened to me brought the fear that at times bordered on hysteria under control. Many a time I was able to distance myself from the unpleasantness of treatment, for example, by formulating the sentences that I would later add to my blog. In fact, it seems that in many cases, breast cancer triggers a woman’s creative juices. I’ve attended a play by a woman who interjected song into her monologue of discovery, treatment and recovery. Another woman detailed her cancer story in comic strip. And there are, of course, numerous poems, books and blogs on and by the subject.

It’s time to wrap this up. I’m focusing on new ways to express myself professionally. I’m looking forward to building the extension we’re adding to our house. I’m eager to welcome more grandchildren into the world. I’m anticipating with enthusiasm spending time with my family and friends. In short, let Gabi be right when she said that the cancer was a detour in my life - because I’m feeling pretty gung ho about life right now and want nothing more than to just get on with it.