Just to shake things up a little, Laura would like to recommend a fantastically creative and funny and true story told entirely in cartoons called Cancer Vixen by the fantastically creative and funny and talented Marisa Acocella Marchetto.

Laura suggests that you either get this for someone you know who has unfortunately had a similar experience, OR that if you have no interest in the topic and are fortunate enough not to know someone unfortunate enough to have had a similar experience you simply go to the Cancer Vixen website (which just happens to have been designed by the amazing web-guy that designed Laura’s site, Jefferson Rabb) for a short animated cartoon teaser for the book AND go to the Cancer Vixen page on Amazon where the author has done a special strip of hilarious cartoons on what it’s like to be an author who (unlike Laura) is addicted to checking her amazon numbers a gazillion times a day:
www.amazon.com/Cancer-Vixen-Marisa-Acocella-Marchetto/dp/0307263576/sr=8-1/qid=1167505981/ref=pd_bbs_sr_1/102-0589160-5206508?ie=UTF8&s=books

Let’s put our focus back on Laura The Reluctant Branter, Laura The Occasional Novelist, Laura The Recoving Self-Publicist. Let’s put our focus back on the true purpose of this site — bragging and ranting and doing anything she can to promote herself and her books.

First order of business is the fantastic website The Posh Mom Life which recently featured Piece of Work as one of their special weekly picks. Laura was surprised and delighted and now shamelessly provides the link to their glowing description of her book right here:

www.poshmom.com/pastpickstravelandcultrepieceofwork.htm

Sarah Dealy (flowers).

Cory (nee Halaby) (food).

Laura is completely panicked that she forgot to thank someone in that long list in her last entry.  She’s going to go over the list with a fine-toothed comb tomorrow and hopes that you’ll forgive her if she has, unwittingly and inadvertently and unintentionally, forgotten to thank you.

Laura is anxious to bring this three-part brant topic to a close, and yet she can’t yet. She absolutely must thank a whole bunch of people whose help completely saved the day:

Her good friend Hilary Monihan for setting up a helping website on lotsahelpinghands.com so that all of Laura’s friends could sign up for times to bring meals and take Benji for playdates. Her wonderful friend and neighbor Tracy Aber co-managed the details of the site, and then all of Laura’s friends and all of Benji’s friends from school and all his teachers from school started helping out in the most amazing ways.

Meals would be left at the door (thank you Elisa D’Andrea and Liz Steinberg and Carole Nathanson and Sheila Doyle and Mike Lorant and Wendy Hurwitz and Pinar Kilicci-Kret and Lisa Goodman and Deb Klein and Micki Avery and Patrice Thornberg and Denise Joseph and Carole Aghassi and Andrea Miller from the Rochester JCC and my book group [Kathleen Olesky, Nancy Leslie, Elizabeth Smith, Liza Schaeffer, Andrea Hauser!);

Benji would be picked up at school and taken for playdates and movies and museum-visits and library-visits (thank you John and Tracy Aber and Hilary Monihan and Paula Fazli and Charlie Mixer and Wendy Hurwitz and Audrey Marks and Kate Haworth and Pinar Kilicci-Kret and Sheila and Mike Doyle/Lorant!) and hosted for four fabulous days in Rhinebeck New York with his cousins and their dogs and their horses (thank you Pat and Colleen Dealy!);

Wonderful gifts of flannel pajamas (thank you Williams School teachers [Brett Aronne and Michelle Gillis and Carolyn Kaufman and Jan Lewis and Julie Gold and Chris Moynihan] and my sister [Linda]!) and unbelievably delicious smoked fish and bagels Fed-Exed from Barney Greengrass in New York (thank you, Goober and family!) and a “bouquet” of fresh fruit (thank you Sally and Len!) and robes and soaps and lotions (thank you Theresa Park and Elise Supovitz!);

Not to mention all the gorgeous glorious flowers (thank you Blog Moms and John and Tracy Aber and Beth Teitell and Warner Books and Marianne Szegedy-Maszak and Paula and Jonathan Fazli and Hilary Macht-Felgran. and Karl and Carole and Hannah and Sophia Aghassi and Jane Dealy!) and books (thank you Marian Brown!) and chocolates (thank you Mary Granfield and Tom Perotta!) and magazines (thank you Barbara Lietzke!) and the back-preserving husband-pillow (thank you Wendy Hurwitz!) and the box of cool toys for Benji (thanks Jenny Loviglio and Nico and Tavi Hartman!) all the emails and cards and good wishes.

In fact, her friends were so unbelievably helpful and caring that she wishes there was a way she could extend this lotsa-helping-hands thing — I mean, what could be better than having great meals brought to your door and your child entertained to the point that he’s having the time of his life?

Having the meals and playdates last another six months, say, till May or June….

Laura knows that she said she was going to finish up the brant she started on December 22 on December 23, and here it is December 29 and she’s only now just getting to it. But Laura suspects it’s less laziness and more ambivalence about her brant-topic that kept her from keeping her word.

(Laura has inserted a pink ribbon — the universal symbol for fighting breast cancer — here in an attempt to lighten and brighten things up! She wishes she could figure out how to put smiley faces — particularly those adorable winking blinking smiley faces — on the pink ribbon but she’s just not that technologically savvy. She did manage to find this pink smiley face-emoticon which she thinks is a pretty good second choice — pink smiley face = symbolic pink color associated with fighting breast cancer–so she happily inserts it here:) <--oops! unintentional smiley!

Despite the fact that Laura is no privacy freak — in fact, she’s often been guilty of the Way Too Much Information thing — she’s still feeling a little funny about writing such a depressing buzz-killer-of-a-brant-entry right in the middle of the holiday season. And yet she just couldn’t figure out how to leave out the event that bracketed the publication of Piece of Work — after all, she found out about her condition a month before the book came out, and she had the surgery about two days after her final book event. And so, in a strange way, it felt like all of her bragging and ranting and self-promotion needed to be tempered by reality: that is, Laura didn’t want her fans (both of them) thinking that she had this amazingly fabulous ‘I write, therefore I’m happy’ kind of life. One of the purposes of her brant — from the very beginning, if you check back to the introductory entry — was to humanize herself for her fans; to show them that she, too, has problems like everyone else. Life isn’t perfect, that’s for sure, but Laura still feels lucky that after a fuckload of major surgery and six whole weeks of shuffling gingerly from her bedroom to the bathroom and back to her bedroom, she has a new set of fake boobs and a flat stomach to show for it.

And so, just to finish the story and move on: Laura had her surgery on Friday, November 17 and it took 12 hours. Yes, that’s right — 12 hours. It was so long that the nurses gave her a pass on getting out of bed the next day and let her “relax” with her patient-controlled morphine drip until Sunday. Which is when she suspended her disbelief and let two nurses talk her into the idea that they were going to pull her out of bed and help her walk to the bathroom four feet away.

The only thing worse than getting out of the hospital bed for the first time was the fact that the minute she’d gotten out of bed the doctors started trying to tell her it was time to go home. They’d tell her on their rounds in the morning; they’d tell her on their rounds in the afternoon; interns, residents, surgeons — doctors she’d never seen before and would never see again — all of them crawling out of the woodwork and stopping in to stare at and cop a feel of her new reconstructed boobs and then tell her that she really should think about going home already.

“So, how are you feeling today?”

“Well, you know, pretty bad.”

“Sure. You were on the table for a long time.”

“Twelve hours, they told me.”

“So, how do you feel now?”

“Now? You mean compared to a minute ago when you asked me? Pretty much the same. Like I got hit by a truck and then the truck sat on me.”

“That’s normal.”

“That’s reassuring.”

“You had pretty major surgery and it takes time to recover. But you really should start thinking about going home already.”

“Already? But it’s only been two days.”

“Right, but tomorrow will be three days. And the sooner you get up and walk around the easier your recovery is going to be.”

But Laura refused to budge. She couldn’t understand how she was supposed to get up and walk around so she could go home when she could barely make it to her handicapped-accessible bathroom! Were they crazy? What was this madness about going home two days after major surgery? Did someone mix up the charts and think she’d come in with a hangnail?

Whatever the reason, this ridiculous farcical dance continued — the doctors telling her to start thinking about going home, and Laura trying to explain that there really was no possible way for her to go home quite yet, which then led to the doctors’ concern that there was some sort of pathalogical reason for her resistance to leaving the hospital. Laura realized that the standoff had devolved to this particular point when a social worker was sent in to ask her why she didn’t want to go home.

“Are you afraid?” the social worker asked. “Do you not feel safe at home?”

Laura was going to say Yes! Yes of course I’m afraid to go home with all these surgical drains and gauze dressings and yes of course I don’t feel safe at home caring for myself three days after surgery since I’m not a fucking registered nurse and neither is my husband! — but before she said anything she realized that the social worker’s question was probing for something else. Was she afraid to go home because she didn’t feel safe because there was domestic abuse? That was the real question. And while Laura doesn’t make light of domestic/spousal abuse at all, for a split second she was tempted to lie and say yes so she could get a few more guilt-free days of hospital time without being shamed every two hours by the doctors on patrol.

And so, on Wednesday, after managing to extract five days of in-patient care, at about 7 p.m. (they will, Laura found out, discharge you at any time of day just to get you the hell out of there), she left the hospital with her husband (who was taking two weeks off to be her full-time caretaker) and went home. After he hoisted her out of the car and practically carried her from the car to the door, she looked up at the flight of stairs that separated her from her bedroom — where she was told she’d be spending the better part of 6-8 weeks — and felt like she was facing Everest. How the fuck was she supposed to get up the stairs and into bed when she had barely made it in from the car without a team of trained medical professionals??

Very slowly, she quickly figured out. Which is how the recovery has gone. Very very slowly. Lots of painkillers for the first two weeks, and lots of sleeping and napping and resting and taking it easy for the next four weeks. And yet now, at the six week point after surgery, Laura suddenly feels she’s made a quantum leap from what she felt like a week ago, and a week before that. (One of the most frustrating parts of the recuperation she felt was the fact that progress wasn’t made day to day, but rather week to week — which meant that everyday she woke up she felt like it was like the movie “Groundhog Day.” She would feel no better until an entire week had passed and even then the difference would hardly seem significant.) For the past few days she’s been walking on her treadmill very very slowly (one mile = 45 minutes) and she even started driving again. Going to CVS and getting to walk through all the aisles touching everything and taking a full hour the way she always does and which drives her husband crazy trying to decide what body lotion and body oil and wrinkle-fixing face cream and toothpaste and hair dye to buy was one of the best moments in recent memory. And she hopes she never forgets just how remarkably joyful the smallest most everyday things in life like going shopping for toiletteries can be.

Well, it’s the end of December — 3 days before Christmas, in fact — and finally Laura has decided to sit up and update her brant. If you’ll notice she said “sit up and update her brant” as opposed to “sit down and update her brant” and there’s a reason for this, which is the same reason she took a 6 or 7 week sabbatical from branting: Laura’s been recovering from some major surgery that she had exactly 5 weeks ago and she’s been laying in bed ever since.

Back in November, when Laura was still branting fairly regularly (although not as regularly as she’d like — she still aspires to everyday-branting) — Laura was wondering what she would do about her brant during her post-op convalescence. Would she alert readers to her involuntary health-related sabbatical? Would she give them all the details about what sort of surgery she was having and why? Would she include them in her recuperation by writing a daily log of her physical healing progress? OR, would she simply disappear until the whole ordeal was over and resume her brant as if nothing had ever happened?

Laura really mulled this one over. While she’s certainly not a privacy freak — How could she be when she has her own website and brant?!?! – Laura still wasn’t sure if she wanted to be one of those people who blogs about every single thing that happens to them, even the incredibly personal ones. And because she was undecided about what to do she just ended up doing nothing: that is, she stopped writing her brant with no explanation as to why she’d stopped and when she might begin again.

If not for one of Laura’s good friends who for some reason is obsessed with her brant and checks it daily on the off-chance it’s been updated, Laura probably wouldn’t be branting right now. But this friend, Wendy, has not let up with her questions as to when Laura was going to start writing again, and because Wendy has been so helpful during Laura’s post-operative convalescent time, Laura felt it was only fair to do her a favor, too: branting as payback.

The other reason Laura decided to brant about her medical experience is because there are certain things she learned during the course of her diagnosis and surgery that she hadn’t known before it and that she figured most women didn’t know either but which she felt they should know. So here she goes.

In late August Laura was diagnosed with breast cancer. She was shocked but not really shocked since she’d always believed, deep down, due to her strong family history, that she would someday get it. In fact, Laura had always been so convinced of the inevitability of it, that she’d started having annual mammograms at 31 and continued to do so right up until she turned 44. But as time went on Laura heard more and more that women were being diagnosed with breast cancer even after they’d been “cleared” with a clean mammogram.

This concerned Laura. Clearly mammograms were not the be-all and end all of diagnostic testing and gave many women a false sense of security. In fact, later she would learn that mammograms are only 69% effective in picking up breast cancer, and believe me, if she’d known this statistic she would have stopped with the mammograms long ago. And due to Laura’s pessimistic nature, she began catastrophizing various horrible scenarios about finding a lump that was so far gone the remainder of her short wonderful life would play like Debra Winger’s in Terms of Endearment. Anyway, at some point last spring, after she’d had her usual annual mammogram, the radiologist reading her film suggested that at some point Laura might want to get a more definitive imaging test — such as an MRI.

Laura thought that was a good idea, but she promptly forgot about it — so busy was she in the early stages of her “Piece of Work” pre-publication self-promotion! — and several months went by before she remembered to ask her primary care physician about it. Oddly enough, her primary care physician, despite knowing her family history of breast cancer tried to talk her out of having the test (it’s expensive for the insurance company), but Laura persisted, remembering all the stories she’d heard about falsely-clean mammograms. Finally the doctor relented and ordered a breast MRI for her and, after scheduling it and rescheduling it twice, Laura finally kept her appointment in mid-August and had the test at the Sagoff Breast Centre in Boston.

Two days later, Laura was called and asked to come by for an ultrasound. Laura didn’t think much of this since when she asked if coming back for a follow-up ultrasound was normal the person on the phone said that lots of people get called back for an ultrasound. So you can imagine her surprise when she showed up for her seemingly “routine” ultrasound and was met by a radiologist pointing at something on her films. Confused, Laura nodded, until she finally understood what the radiologist was saying: she’d seem something in the left breast and though she didn’t think it looked like cancer, she wanted to be certain.

“I’m obsessive,” the radiologist said, a trait Laura figured was a huge asset in her particular line of work.

Before she knew it, right then and there, Laura had a needle biopsy (that was almost completely painless which surprised Laura no end since she thought it was going to be incredibly painful), and the next day, a Friday, she was told that the pathology lab would need the weekend to complete their analysis since the cells were apparently “atypical.” (Not all atypical cells are cancer cells, the radiologist reassured her, but Laura still didn’t like the sound of that).

Finally, that Monday at 5 o’clock, the radiologist called and said that the results were in: Laura had what’s called Ductal Carcinoma in Situ, also known as DCIS, an early type of cancer that starts in the milk ducts. It was Stage 0, she said, which meant that though the cancer was there, it hadn’t gone anywhere.

Yet.

Strangely, though, at some point during her explanation of the diagnosis, the radiologist said to Laura: “Don’t let the word carcinoma fool you. It’s a type of pre-cancer condition routinely treated by lumpectomy and radiation.” Which was a huge relief: pre-cancer isn’t cancer! Laura thought happily, which made calling everyone she knew who was waiting to hear about her test results a whole lot easier.

Unfortunately, though, the pre-cancer/cancer business ended up being a complete misunderstanding, Laura learned when she finally met with the head surgeon at the Sagoff Breast Center at the Faulkner Hospital in Boston.

Dr. Margaret Duggan — a tall, fiercely intelligent, completely approachable, extremely accomplished surgeon who seemed to be around Laura’s age (who is she kidding? Dr. Duggan is probably half Laura’s age!) and who wore scrubs and a white coat and adorably hip but not annoyingly hip black-rimmed squarish glasses, took Laura into her office and spoke to her for over an hour. She gave Laura an incredibly detailed and easy-to-understand mini-course that covered oncology and biology and genetics and surgery and plastic surgery and statistics and probabilities (Dr. Duggan, besides heading up the Sagoff Centre’s Surgery Department, also teaches at Harvard Medical School in her “spare” time) and which included hand-drawn diagrams on a pad of paper which Laura actually understood (if only Dr. Duggan had been her high school biology or chemistry or physics or calculus teacher, Laura is convinced she would have scored higher on the math portion of her SATs and would now, as a grown-up, be able to remember how to say the word “Sudoku,” let alone do Sudoku puzzles and help her son with his first-grade math homework). But despite her wish-fantasy sequence of mathematical and scientific competence, Laura quickly noticed how often Dr. Duggan was using the word “cancer” as opposed to “pre-cancer.”

“So, it’s cancer,” Laura said.

“Well, yes. It’s cancer,” Dr. Duggan said.

“Because, you see, the person who explained it to me said it wasn’t actually cancer, it was pre-cancer.” Laura didn’t want to go into the fact that she’d already told everyone including her husband that it wasn’t actually cancer. And she also didn’t want to appear stupid enough for Dr. Duggan to say: Duh.

“No, it’s definitely cancer.”

Laura nodded, taking a minute to recalibrate her delicately balanced sense of catastrophe-thinking. But as soon as she had done that, another piece of news surprised her: because there were two areas of this DCIS in the left breast, the surgical treatment would be a full mastectomy as opposed to a lumpectomy.

“Wow,” Laura said, nodding like a bobble-head toy.

“The good news is,” Dr. Duggan continued, “is that once you have the surgery you don’t have to have radiation or chemo.”

“Wow,” Laura said again.

“But,” Dr. Duggan continued, “once you have had cancer in one breast, you’re much more likely to get it in the second breast, and so we recommend that you consider having the other breast removed as well as a preventative measure.”

Laura stopped with the nodding. Here she’d come in thinking she had a small pre-cancerous condition and was going to have a lumpectomy — and suddenly she’s definitely having one mastectomy, and possibly two! Her head was spinning. And while Laura was definitely leaning in that bilateral mastectomy direction — better safe than sorry and have both done at once with immediate reconstructive surgery than sit around waiting for it to show up in the second breast — Dr. Duggan suggested she have the genetic blood test for the BRCA 1 and BRCA 2 genes to determine whether or not she had either of them. That way, if she tested positive, she might feel more convinced of her decision.

And so on a beautiful sunny afternoon a week later, Laura drove into Boston (getting lost twice, which doesn’t include getting lost trying to find her way into the parking garage) to the Dana Farber Cancer Institute to meet with a genetic counselor and have her BRCA blood test. The genetic counselor was very nice and extremely smart and to be quite frank most of what she said went right over Laura’s head. But the few things she got was that Ashkenazi Jewish women have a higher rate of breast cancer and that if you tested negatively for the genes it didn’t necessarily mean you weren’t going to get breast cancer, and if you tested positively for the genes it didn’t necessarily mean that you would get cancer, even though your chances were higher with the gene than without it.”But,” the genetic counselor explained, “if you do test positive for the gene then we recommend that you have your ovaries removed also since there’s an increased risk that you will develop ovarian cancer as well.”

Now Laura’s head was really spinning! In for a penny, in for a pound! Suddenly she was getting a double mastectomy and possibly also having her ovaries removed, too! Luckily, though, when the test results came back several weeks later, she found out that she had neither BRCA gene which again was a huge relief. At least she wouldn’t have to worry about being plunged into full-blown menopause at the tender young age of 44.

Laura processed all the news and information as quickly and as best as she could. Soon she was sent by Dr. Duggan to see Dr. Yoon Chun, a highly-regarded plastic surgeon who couldn’t be nicer or more lovely or more intensely intelligent (and who clearly was definitely younger than Laura) and who spent almost two hours with Laura in her office explaining the various reconstruction surgery options available to her. (Dr. Chun also drew pictures, most of which Laura completely understood, and had she not been so absorbed in the decision-making process regarding the creation and construction of her new boobs — saline implants? silicone implants? TRAM flap? DIEP flap? — she probably also would have started thinking about how different her future might have been had Dr. Chun been one of her high school science or math teachers).

And so while she freely admitted to herself and others that having to have such major surgery (the type of reconstructive surgery she was opting for — TRAM flap, short for transverse rectus abdominis myocutaneous flap was essentially a ‘tummy-tuck’ — that’s where the “reconstuctive material” would come from) sucked (recovery time was estimated at 6-8 weeks and Laura figured it might even be more), she couldn’t help but feel incredibly lucky that the news hadn’t been worse. Stage 0 was practically a gift, and the idea that she wouldn’t have to go through the agony of chemo and radiation practically made her giddy with relief. Compared to all the late-night catastropized visions she’d imagined over the years of getting cancer, this was nothing.

Not to mention the fact that she was kind of excited about the ‘Extreme Makeover’ idea of getting a free tummy tuck and having a flat stomach!

All of this, however, was happening barely a month before the publication of Piece of Work, something she’d waited four long years for, and just as Laura was thinking that all her pre-publication self-promotion had been a complete waste of time now that she’d have to cancel her book tour (not that it was that big of a tour or anything), Dr. Duggan assured Laura that the surgery could absolutely wait until her book tour was over. So Laura scheduled the event — which she now referred to almost always as simply “The Tummy Tuck” — for mid-November, after all her bookstore and Jewish Book Fair* appearances that she’d auditioned so strongly for were over (*unfortunately Laura had to cancel three of her five Jewish Book Fair appearances at the last minute since she had to have several mandatory pre-op appointments within a week of her surgery that had already been scheduled and that she couldn’t change).

TO BE CONTINUED tomorrow…