Mia Alegría

oh man, an hour of posting to my email list and the socials about not working while recovering from the surgery that's happening tomorrow, and lighting the tree, feeding and playing with Avalanche, while a river rains down on us, and I am entirely wiped out.

I had so much energy an hour ago. I had dinner, I was feeling perky. I dunno what happened, I hit such a wall.

Had to re-stabilize my little light up snowman outside, he falls over in the wind sometimes.

It is unbelievably wet outside. Flooding everywhere that floods. I am glad we have a brand new roof. That I bought. Josh thanked me for this today. "Thanks, Serafaery!" Silly goose.

I've been going to bed at 8pm the last few nights, passing out really is what it feels like, dying to the world for four hours. I think it's more of an escape. A kind of, "I can't take being awake anymore" pattern. I get up at midnight to wriggle out of my clothes, wash my face and brush my teeth, and snuggle back into bed, until my inevitable 4am wake up, that I've been doing since age 20. But it's harder on my body these days, and I actually get up, usually, in perimenopause. I feel the spin of the cortisol racing through my system, the familiar deep dread, and I tell myself it's all chemicals, to not believe anything my mind tells me at 4am, and I scroll myself back to sleep. Until 6:45am. Rinse and repeat.

I think I will bundle up with some Christmas in Paris Stash tea (will I add whipped cream? I do have some) and watch Matrix: Resurrections. In the mood for some sexy people my age to run around in tight black wet clothing.

I can do more cards and decorate the tree and bake cookies when my boob is healing, it'll be okay, I'll just take my time.

I'm excited to have two weeks off, honestly. So excited for the forced downtime and rest. I have not taken a real break in a very long time. Four days here or there, for years, this has been my break pattern. I love my work so much, I am so grateful for my work. But. I need actual rest.

...

one thing i wanted to get out. is that i was pretty spun out with self-hatred last night for buying the junk at target. realizing i need to return it. that it is part of whatever causes my low-grade hoarding.

was watching a hoarding channel last night and thinking about that person's opinion about the condition, and the lower activity in the frontal lobes that causes difficulty with decision-making, and how hard it's been for me to decide whether or not to run screaming from this surgery.

i think having the boys both seem to indicate that they'd rather i not do it made it a lot harder for me. i care so much about their opinions and advice, even if it's unsolicited. i know they have my best interest in mind, and just don't want to see me suffer.

but also i got a really nice reminder somewhere online that said, there will be relapses, try to be patient and focus on gradual, steady, slow progress.

and i do see this. my clutter is less. i am less anxious about it. i have gotten rid of a lot. i caught this bout of collecting and i am fixing it.

i went through all of my mail this morning.

instead of starting a neverending pile.

(i still have a few of those leftover from the apartment that came here, in bins, to go through.)

i am doing a lot better overall. making big decisions, and little ones.

slow, small progress. it's the only way i've ever gotten to a better place with any habit or trait.

i will continue to work on improving things with my husband, even though he is being difficult and my first instinct is to withdraw. i want him to be happier. i will keep trying. i think, every time i try and get rebuffed, at least, he does see that i am making an effort. and that counts for something.

Having a really hard time deciding about surgery Friday.

...

Edited to add: Just doing a little more reading, if I were lower risk in general, less cancer in my family and less dense breast tissue, it would be fine to let this go. Those are the folks who are good candidates for waiting. But my high risk profile means it would be smarter to go ahead, from what I can gather. 5cm is the cutoff for absolutely not waiting, 3cm doesn't provide a lot of comfort, for me. I do have only a single lesion, which is good. I am hoping for just clear margins, no further findings, and being finished with treatment after this.

sigh.

I've decided to go ahead with it for now. If in a couple hours I really feel like this is the wrong choice, I can still reverse course. I can reverse course at any point until I get to the hospital, really.

...

There are so many conflicting factors in my head, and emotional difficulties. It's so so hard to settle my mind one way or the other, I keep flipping back and forth.

I have ADH - Atypical Ductal Hyperplasia. If the vacuum-assisted core needle biopsy had gotten all of the calcifications, they probably would have suggested monitoring, and not surgery. But since there are 3cm left of the "lesion" (clump of cells), they want to take out the rest and its surrounding tissue, not just to prevent it from growing into something cancerous, but also to test the tissue to make totally sure there is nothing else lurking in there, and to make sure it's all removed.

I have a 30% chance of developing breast cancer regardless of whether or not I get this procedure, so I will be closely monitored annually as a "high risk" patient for the rest of my life, regardless of whether or not I have this procedure.

There is a 7% chance this could develop into cancer in 5 years. 13% in ten years. It takes 25 years to reach that 30% risk.

But, I only had a 10% chance of ADH in my biopsy, and here we are.

So, part of me wants to go ahead on Friday, just to have peace of mind and make totally sure everything is out and we know what we're dealing with.

IF that tissue comes back positive for DCIS (basically stage 0 cancer or pre-cancer, depending on who you talk to there are different terms for this), there would be a drug regimen (testing for estrogen receptivity hopefully?) and radiation, and (unlikely) a lumpectomy to remove more tissue if the margins aren't clear (if there's any question as to whether there is more).

BUT. If I wait. There is a chance nothing comes of it. It could be the same in all my scans going forward, and I could avoid surgery altogether.

OR maybe get it in a few years.

OR maybe things change and I have to get it in 3 or 6 months, which would SUCK and ruin my summer.

There is no good time to have surgery.

The idea of saving myself the pain and trouble of surgery is very appealing.

But the fear of letting something unhealthy develop by leaving it be is worrisome.

My friends currently undergoing chemo or having already had it would advise me to do anything to avoid ending up there.

It's hard for me to go against the conventional wisdom of just taking it out to be certain it's nothing.

I have seen statistics that these excisional biopsies come back positive for DCIS more than half the time, but it's a wide range, and I don't know the details or factors.

Both surgeons at both hospitals agree it would be reasonable to wait, because my lesion is 3cm.

1cm would make me feel a lot better.

Over 5 or 6cm, they would not recommend waiting.

I'm in a grey area and it makes it really hard to decide!

There is sort of no right or wrong choice, here. It's an educated guess.

I have to sort of go on instinct?

Initially, I really thought I would cancel it. I wanted to save myself the pain and suffering, especially during such a stressful time.

But just putting off the inevitable sounds horrible. Both surgeons seemed to lean toward that meaning the surgery would happen next year, not never.

If that's the case, I'd rather just do it now, while I'm already prepared, already planned to take the downtime and the time off work, etc.

But part of me loves the idea of working through the holiday and taking all this fear and anxiety away and putting it on older-Sarah's shoulders. Maybe she'll be able to handle it better than me.

But is that being so so mean to my future self?

Or is it being protective and kind, since it's possible surgery is totally unnecessary and neither she nor I would have to go through with it.

It's soooooooooooooooooooooooo haaaaaaaaaaaaaaaaaaaaaaard.

Other confounding factors that shouldn't matter but do: Josh wants me to wait. (He hates how stressed we both are and wants some good time together sooner than later, we've been doing really poorly since the move.)

It's FREE right now. Because of what's going on with insurance. Who knows how much it would cost a year from now. Thousands, potentially.

I feel soooooo poor after buying this stupid house, so stressed about money, so this unfortunately feels like it matters when I know deep down my long term physical health and well-being is more important than a couple thousand dollars.

Honestly the other thing? Sort of selfishly? I want the downtime. I want to just sit and be still and cozy. I want people to back off and let me heal. I want to be forced to be gentle with myself. I want to rest. I want to be left alone. I want to sit and write letters and take long gentle walks through the forest and not work.

I want people to understand that something difficult and painful and serious happened to me.

I also want to work! I want to sparkle the crap out of everyone for Christmas. I want to hike and ski and frolic in the snow.

We have no snow on the mountain yet. Not at any elevation we can reach.

Josh is really hoping I cancel. My customers are hoping I cancel.

I love the idea of the release of not having to do all the prep and deal with dressings and incision scars and icing and painkillers and swelling and not being able to lift.

To just dance and bake and run around whenever the rain allows.

But will I be worried that I made the wrong choice and left cancer to fester?

But if I do it and everything comes back clear, will I be mad I did something terrible to my body that wasn't necessary?

No aerial for two months. :(

Unlikely, but what if I come out of it deformed?

It's soooooooooooooooo haaaaaaaaaaaaaaaaaard.

feeling a lot a lot better, today. so much of depression feels so mysterious to me and totally out of my control. i noticed before i started to feel better subjectively/experientially, that i was starting to be able to take my vitamins and brush my teeth again, this is always a good sign that it's starting to dissipate.

josh so desperately wants to know what causes these corrections, i wish i had an answer for him. i apologized for putting him through that, though he generously observes that it's worse for me than it is for him. it's just so hard not knowing if/when it will stop, when i get like that. for him. for me it feels permanent, my perspective gets so skewed. "this too shall pass" does repeat in my head but along with "and then it will return because this is the truth of who i really am and how i really feel." depression really does feel that way. it feels like the truest thing. even now when i'm not in it, i acknowledge this and don't disagree with this depressed-me assessment.

going to try to go to silks. there's so much i want to do on my days off, my head is swimming. i want to put nails up for stockings and clean the garage cabinet, set up my room more, do more decorating, VACUUM. BAKE.

but first i have orders to get out, and i might want to exchange a sweater as i found a better size in a different store last night, i can do that before silks if i get out the door soon enough. (goodwill thrifted sweaters, two sizes at two different stores of the same gold and beige knit turtleneck.)

need to bring snacks and drinks to silks. need to make a lil grocery list. maybe pick up a stool or two from target on the way home, for the kitchen. off i go. will catch up on journals later.

tyler got me a tree.

my arm where the "vascular team" guy mangled me failing to get a vein for the mri contrast is an eerie shade of green and purple.

i am so relieved that the mri came back clear.

it's nonstop raining but not too cold. we have flooding watches in effect through tomorrow. it's fine, it rains here, we're used to it.