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Dealing with the harsh reality of breast cancer

City Sage



'I think it's just a muscle strain," my wife Karen said. "A little too much work with the weights, so there's some swelling and a little discomfort."

The swelling was in her right breast, close to her armpit. I was scared.

"If it's a lump in your breast, you have to check it out," I said. "When was your last mammogram?"

"It's been more than a year," she admitted. "I hadn't thought about it — but OK, I'll make an appointment."

Like many 65-plus, fitness-obsessed oldsters, both of us are in constant denial about old age's ravages and risks. Karen is a front-row Zumba girl, a workout fanatic who bounced back in a couple of weeks from surgery to repair a torn meniscus. I ride my road bike thousands of miles a year, ignoring that a high-speed crash might leave me with far more than road rash.

Yet for all of our fitness-fueled bravado, we understand the future is unknowable. Imagine crows sitting on your shoulders — cancer, heart disease, Alzheimer's, stroke and a host of others. One will get you, so the crows are patient, sure of their quarry.

On New Year's Eve, Karen had a mammogram. It appeared the lump was benign, another tiny spot concerned radiologist Dr. Michael Starkey. A follow-up mammogram four days later led to biopsies on Jan. 12.

We got the results on Jan. 14. The tiny spot was cancer, categorized as an "invasive ductile carcinoma." Dr. Starkey told us that surgery would be necessary, and he gave us contact information for breast-cancer surgical centers at Penrose and Memorial hospitals. We started with Memorial, but they're not in our insurance network so they referred us to Penrose.

Within minutes, Penrose nurse-navigator Ellie Peters contacted Karen.

And so began an impressive 23-day ride through the Colorado Springs health system. Peters would be our guide, answering questions, confirming appointments and explaining the process.

We talked that night. Karen wondered whether "natural" treatments would suffice — herbs, supplements, immune boosters, essential oils and the like.

On Jan. 20, we met with Dr. Nicole Choy, breast surgeon for Penrose-St. Francis Health Services. Warm, articulate and scary smart, Choy is no scalpel-wielding surgical mechanic. She carefully explained Karen's cancer, her treatment options and possible outcomes. Karen trusted her implicitly, as did I. It didn't seem that the totally naturopathic approach was an option.

"When your life is on the line," Karen said, "you go with science."

Appointments were scheduled during the next week with Dr. Aaron Smith, the plastic surgeon who would rebuild Karen's breasts after a lumpectomy, and with oncologist Dr. Maurice Markus. An MRI and yet another mammogram followed on Jan. 29, blood work and an EKG the next day, two more biopsies on Feb. 1 and surgery on Feb. 9.

We showed up at St. Francis at 7:30 a.m. First stop, Penrad Imaging, for another mammogram and careful insertion of thin wires locating the cancers to guide Dr. Choy during surgery. That took longer than expected, so rather than waste minutes waiting for an attendant, Choy pushed Karen's wheelchair through lengthy corridors and multiple doors to the surgical center.

Four hours later, it was over.

The result? So far, all good. No cancer cells in the sentinel lymph node, clean margins and no need for chemo. Radiation should get rid of any remaining cancer cells, and life will go on. Too bad, crow!

Takeaway — this was the American health care system at its best. It was quick, thorough and transparent, an intricately choreographed dance that involved highly competent professionals. For one who has managed to avoid hospitals for more than a half-century, the scale, efficiency and technological sophistication of St. Francis were astonishing.

Years ago, Karen would have spent a night or two at the hospital, but no more — and so much the better. Early discharge reduces hospital bed needs and reduces costs correspondingly. If still run according to traditional models, St. Francis might need 600 beds instead of 195.

We thought of our friends Cindy Fowler and Kristin McCollum, and so many others who have not survived their encounters with the "Emperor of All Maladies."

"All of those walks, those 5Ks, those pink ribbons — and now I'm a breast cancer survivor too," said Karen. "I hope I can say the same thing in five years, 10 years ... we'll see."

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