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Women and Their Doctors

Sunday, July 03, 2011


We all hope we’re lucky enough to find competent, compassionate doctors who spend time listening to us, then give us thoughtful answers and possible next steps. Most of my doctors are great patient advocates who write down complicated medical jargon and draw working diagrams of things like my hypothalamus. I’ve also stumbled across a couple of doctors who are bozos, or at the very least, unfeeling.

Take the doctor who, before even introducing himself, slipped my x-ray into the light box and said, “This will probably result in the amputation of your foot.” He refused to hear my suggestion that the marble-sized ball in the arch of my foot might have been caused by new cowboy boots I’d worn for nearly a week. Instead, he interrupted and proceeded to tell me if it were a benign “tumor,” it would have been located on the other side of my arch, but because it wasn’t, it was most certainly malignant. Thirty-five thousand dollars and a new doctor later, a blood clot, probably caused by an ill-fitting cowboy boot, was removed from the arch of my foot. Clearly Dr. Bozo didn’t listen to my “Yes, Doctor, but…,” which reminds me of last week’s post about women and their healthcare.<PREVIEWEND>

“Yes, Doctor, but…,” one of the core insights from the Digitas Health and Yahoo study of 40,000 women in their 40s and 50s, has generated lots of response. In addition to comments on my blog, I’ve received emails and phone calls from women who not only want to play a role in their healthcare, but want to deal with doctors who consult them when making decisions about their care. These responses have made me think about the differences between baby boomers and our mother’s generation and the way we interface with our doctors. If my mother had been told she might have her foot amputated, I’m not sure she would have gotten a second opinion, much less discussed it in-depth with her doctor.

My mother has always wanted to… pardon the pun… put her best foot forward, even with her doctors. While she makes doctors appointments to talk about specific physical problems, I’ve been with her enough to know she doesn’t always tell them the truth. I remember when mother was nearly doubled up in pain from diverticulitis, but when I took her to the doctor, she said something like, “It’s mildly uncomfortable.” When the doctor pressed on her abdomen and asked if that hurt, or if it was tender, she winced, clearly ready to bolt off the examining table but said, “It’s not bad.” A few days later, she complained her doctor wasn’t any good because he didn’t solve her problem. Duh! Garbage in, garbage out! I sometimes wonder if mother thinks good doctors should intuit her problems. Then again, she’s from the generation where “nice girls” don’t talk about sex, or problems “down there,” and where doctors are Gods not to be questioned. Even though most of today’s baby boomers are better informed and more proactive than most of their mothers, we still need to know how to establish good doctor/patient relationships, especially when it comes to certain issues.

As baby boomers age, we may develop embarrassing conditions like lack of bladder control, low libido or painful sex, issues many of us are hesitant to discuss with our doctors. On the flip side, many doctors aren’t initiating these conversations with us. If doctors don’t ask, and patients don’t speak up, then we may be suffering needlessly from manageable conditions. Girlfriends! We are the generation that fought for equality and the destruction of the glass ceiling, the right to say “no” and the right to an abortion. Now is not the time to withdraw into our nearly empty estrogen tanks and silence our voices. Please, speak up, and if your doctor is embarrassed to have these conversations with you, FIND ANOTHER DOCTOR!

In defense of doctors, I think most would prefer to have proactive patients. I also know many doctors silently groan when they see us pull out our 8 ½” x 11” printed pages because our information is often wrong, or has nothing to do with our condition. If you’ve done any symptom searches on the Internet, you already know you can find most any answer you’re looking for. Take diverticulitus for example: You can find information about this condition on websites that range from Johns Hopkins Hospital to a website about air conditioners and furnaces. Really! We need to limit the websites we frequent to credible ones, and steer clear of those that aren’t professional looking or don’t ever link to credible sources.

Taking mother to the doctor is kind of like watching someone who’s being tortured by Guido and Little Louie; someone who's deliberately not relating the right information and yet fears Guido and Little Louie will turn up the torture knob a notch. A couple of weeks ago, I took mother to the geriatrician for swollen, red wrists and hands that seemed to be extremely painful. She moaned all the way there, but when the doctor pressed on mother’s wrists, mother smiled and said, “It doesn't hurt.” When the doctor finally looked at me, I said, “Yes, doctor, but…”

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Women's Health Styles Panel

Sunday, June 26, 2011

Laura Lang, CEO Digitas; Alex von Plato, Exec VP & Chief Creative Officer, Digitas Health; Susan Manber, Sr VP & Exec Planning Dir, Digitas Health; Lesley Jane Seymour, Ed-in-Chief MORE Magazine; Laura Michalchyshyn, Pres & GM Discovery Fit & Health; Brenda Coffee, CEO BreastCancerSisterhood.com; Angela Matusik, Chief Content Exec, iVillage. Photo by Kelly Davidson.

Recently I was honored to be a panelist at a Fortune 100, invitation only event. The NewFront’s “Brands Meet Content” has become the premier event of Internet Week in NYC. At this event, NewFront and Digitas, the world’s largest digital ad agency, brought together Hollywood’s elite, leading content creators, distributors, talent and Fortune 100 marketers to develop the next big innovative ideas in worldwide online content.

Like the cowboys and settlers of the American West, Digitas and NewFront are successfully riding into a new frontier and taking the world's largest brands along with them. With the help of this year’s A-List speakers, this creative, high-tech wagon train is helping brands discover that online content is just as important as distribution, and that content doesn’t necessarily need to be created by the brand. The nuances, new rules, and no rules of this new world are unfolding everyday, but make no mistake. There's a new sheriff in town: Branded, digital content. <PREVIEWEND>

Just a few of the event’s A-List speakers included actor, online content developer and branding wizard, Ashton Kutcher, and his wife, Demi Moore; John Battelle, Founder of WIRED magazine and Federated Media Publishing; Beth Comstock, Chief Marketing Officer & SVP of General Electric; Clive Davis, Chief Creative Officer for SONY Music Entertainment and Richard Stengel, Managing Editor of TIME magazine. I was proud to be in the company of such talented trailblazers.

The NewFront's Women’s Health Styles panel I was on was an outgrowth of a study done by Digitas Health and Yahoo about how women in their 40s and 50s see themselves and how they make decisions about their health. The study wanted to steer clear of the stereotypical image of this age group: women who are somewhere between Super Moms and the Sandwich Generation who care for aging parents. One thing emerged loud and clear from this study. Today’s women are not their mother’s generation.

Women in their 40s and 50s are better educated, have more disposable income, take better care of themselves, look better and make decisions differently than any previous generation in history. We are the generation that grew up believing we could have it all but have since discovered that having it all is a balancing act of compromise, sacrifice and stress. We want to connect with other women who’ve walked in our shoes, women who are genuine and authentic, real women like ourselves.

The Digitas Health/Yahoo study discovered five core insights into this age group:
1.) Women mostly see mid-life as a “wow” followed by a good natured “ugh.” This age group is happier and more positive than women 20 to 30; they have more time for themselves; they’re less concerned with what others think, and their experience has given them wisdom and perspective.

2.) Gathering info about health is as much an emotional experience as a factual one.
Women want information from respected sources, and they want it easy to digest and understand. They also want a trusted source that has their best interest in mind and no hidden agenda.

3.) The Internet helps women “realize to decide.” Over half of the women in the study get their health information and support online, plus giving is as important as getting information. At some point, something happens between a woman’s research and her experiences that gives her an “ah-ha” moment and makes her realize she needs to do something “about it.”

4.) Our response of “Yes Doctor” has become “Yes Doctor, but…” Because so much information is available online, nearly half of the women surveyed believe they have more of a role in diagnosis and treatment. Women want, but don’t often get, a doctor who makes decisions with them, based on who they are and what their situation is.

5.) Five temperaments and approaches to making health decisions.
a. Optimistic & Proactive: She has a positive attitude and does everything she can to stay healthy.
b. Savvy Explorers: Digs and researches online to get a well-rounded understanding.
c. Connected Consensus Seekers: Wants to talk about it with friends and family, especially those who speak from personal experience.
d. Detached & Disinterested: Practically ignores the entire subject of health, including her own.
e. Constrained & Overwhelmed: Has problems coping with chronic conditions and illness and has negative outlook about this stage of life.

As a result of this study, advertisers are learning they need to reach women about their health in new and different ways other than banner ads or a generic Facebook page. Not only do we use technology, we use it for everything from researching our family’s healthcare, to connecting with one another. We look for authenticity and transparency from the brands we use. We want to know more than just the ingredients in our skin cream. We want brands that solicit our opinion and value their relationship with us. Social media allows us to be more than just nameless, faceless statistics. We’re a brand’s focus group; we reward quality brands with loyalty and word-of-mouth advertising, and if they let us down, another brand will take their place.

Thank you Digitas for inviting me to such an awesome event, for appreciating the “sassy strength” of BRENDA’S BLOG and for recognizing the relationships my readers and I have created. We are a team. They mean the world to me, and I hope they mean the world to all the products they honor with their purchases.

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Tissue Expanders for Dummies

Sunday, June 19, 2011

©Brenda Coffee. All rights reserved.

Before my first breast reconstruction surgery, I stuffed socks into my bra so my flat chest matched the size of my other breast. Since I’m not big on carrying a purse, it wasn’t long before I started filling the empty bra cup with practical things like cell phone, money, driver’s license and keys. James compared me to a magician who retrieved rabbits and flowers out of a hat. While I did use rocks and raisins as nipple substitutes, I drew the line at lining my bra with living things.

Today I talked with a woman who’s had phase one of her reconstruction surgery: insertion of a tissue expander. So far, she’s not happy with the results. Compared to her other breast, she says the new one’s too high and too perky, but she knows when all is said and done, the new breast will look more like her natural breast. As we talked I remembered how involved the whole reconstruction process was, so for those of you who don’t understand how it works, here’s “Tissue Expanders and Breast Reconstruction for Dummies.”<PREVIEWEND>

Immediately following a mastectomy, or at some future time after the mastectomy incisions have healed, a tissue expander or temporary implant is surgically inserted under the pectoral muscle. Gradually over a period of weeks or months the surgeon, in the office, numbs your skin and inserts a needle into a port on the expander, then adds small increments of saline solution. This gradual increase in size allows the pectoral muscle to stretch over time until it reaches the desired breast size. Some women complain of tightness while the muscle is being stretched, a few say it’s painful, but for me it was more of an annoyance. You may be thinking, “Women get ‘boob jobs’ all the time, and they don’t need tissue expanders. Why do they need them with breast reconstruction surgery?”

With a regular boob job, or breast augmentation, the implant is placed between the existing breast tissue and the pectoral muscle so the implant is not as noticeable. However, because the breast tissue is removed during a mastectomy, an implant that’s placed on top of the pectoral has no place to hide. It would look like a grapefruit with skin draped over it. Actually, some bad breast augmentations look like that anyway.

Once the expander has been filled to the desired size, it’s then surgically exchanged for either a saline or a Silicone Gel implant. In 1992, the FDA halted the sale of Silicone implants due to safety concerns. In those older implants, the Silicone was in liquid form, which meant if the implant ruptured, the Silicone could potentially travel to other parts of your body, plus it was linked to a variety of autoimmune problems. Today the Silicone is in gel form so if the implant ruptures the Silicone supposedly remains intact. Silicone gel implants result in a more natural looking and feeling breast, as opposed to saline implants, which can often look and feel like a coconut shell. By the way, saline implants are Silicone shells that are filled with saline, which is sterile salt water. Saline implants have a greater likelihood of rippling along the edges where the silicone shell wrinkles and folds and may be noticeable in spots not covered by the pectoral muscle. Regardless of whether you choose saline or Silicone, both implants are subject to rupturing and may need to be replaced in the future. That’s just the nature of the beast. Also, some women are good candidates for a procedure that allows a permanent implant to be inserted immediately after their mastectomy without the need for a tissue expander, so ask your doctor. So that’s the basic one, two, three of tissue expanders. Revisions, nipple reconstruction and tattooing of the areola are optional.

When I tell people I’ve had 10 breast cancer surgeries they find it hard to believe, but after a lumpectomy, mastectomy, tissue expander, permanent implant and nipple reconstruction on just one breast, that’s five surgeries right there. For me, the worst part of any of my surgeries was mentally getting geared up for it. The hardest part of reconstruction is the fear and anxiety of the unknown: How will I react to the anesthesia; what could go wrong; is the surgeon and his team really top notch; will I be in any pain; what will my new breast look like and what if I don’t like it? I sometimes wonder if the reason many women elect not to have reconstruction is because of their fears. Except for the post surgery corset I wore for months and months that made my ribs hurt, the procedure itself wasn’t painful. However, as with any surgical procedure, there are always risks so ask questions and weigh your decisions carefully. You should also know that Silicone and saline implants can interfere with mammography screening and both are subject to breakage during the procedure.

Back to the woman who feared her reconstructed breast might be too high or too perky… After a certain age, can breasts ever be too perky? Oh, and in case you’re wondering, don’t even think about stashing Reese’s Peanut Butter Cups in your bra. Don’t ask… It was chemo brain, I tell you, and that’s my story, and I’m sticking to it.


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Love Loss and What I Wore

Sunday, June 12, 2011

©Brenda Coffee. All rights reserved.

While I was in New York last week, I saw Love, Loss & What I Wore, an off-Broadway play written by the ever-prolific Ephron sisters. Delia and Nora Ephron have an uncanny way of weaving stories that are universal to all women. The play focuses on five women who reminisce about different articles of clothing they’ve owned such as bathrobes, shoes, purses and bras, and the roles each one has played in their lives. One of my favorites vignettes was about bras that had balloon inserts and came with a plastic straw that allowed you to blow them up. When I was 14, I owned something similar only they were called “falsies.”<PREVIEWEND>

The summer of my 14th birthday, bikinis were all the rage. Everyone was talking about Raquel Welch’s animal skin bikini in the movie, One Million Years B.C. A few years earlier, Ursula Andress had emerged from the sea in a James Bond film, wearing a white bikini and a knife. The sizzle over that bathing suit had made her the quintessential Bond girl. When I asked my mother if I could have a bikini she said, “No. It’ll make you look like a prostitute.” She did, however, let me stuff falsies into a blue Jantzen one piece. Go figure!

The first week of summer vacation I wore my new bathing suit to a public pool. I remember the song Itsy Bitsy Teenie Weenie Yellow Polka Dot Bikini was playing through a speaker mounted over the ‘Lifeguard on Duty’ sign. Slowly I slipped into the pool, hoping all the boys, at least the ones over 12, were admiring my shapely new figure. As I settled into the pool, one of my falsies went floating past Greg Duncan, a guy I had a crush on, while my other falsie was being batted about like a volleyball by the older guys in the deep end. Humiliated, I drug myself out of the pool, vowing never to go out in public again.

I’ve more than survived the falsies episode. Now I have little to no modesty when it comes to disrobing or trying on clothes. After 10 breast cancer surgeries and a multitude of sonograms, MRIs and mammograms, plus being the focus of endless probes by doctors and surgeons, I’ve developed an “everyone in town’s already seen them” attitude. Breasts, however, are a big part of who we are. The female quest for beauty and positive self-image dictates what we eat, what we wear and how we feel about ourselves as women. We all know what it’s like to be obsessed with covering up a flaw we think we have, or feeling like we don’t measure up to the models in the magazines. Add the aftereffects of breast cancer to the ongoing conversations in our head, and our self-esteem sometimes gets left on the operating table.

Many of us feel as though our bodies betrayed us, leaving us bald, battle-scarred and shell-shocked. Make no mistake, we’ve been in a war, and what’s worse, the enemy is hiding in our body. No wonder we often emerge from breast cancer with something akin to Post-Traumatic Stress Disorder. Like soldiers who’ve fought in other kinds of wars, we may need counseling, yoga or hypnosis to help us reclaim our self-image and remember the woman we were before we went to war.

As I was leaving the theater in New York, I noticed a young woman in front of me who had a huge Venetian Carnival mask tattooed across her back. You know the kind with the long white nose that looks like an anorexic duckbill? I had to wonder what made her choose that design, and what does it say about her self-image? Did it appeal to her because, on some level, she’s hiding something? I understand why some breast cancer survivors feel the need to hide their figures. I have mismatched mastectomy scars and reconstructed nipples; one has a faded tattoo while the other has no tattoo at all, but I don’t care. I’m still here. We must give ourselves permission to grieve for the things we’ve lost and work at becoming the new person inside us who’s waiting to be freed.

Has your self-image changed with breast cancer or age? Have you stopped wearing clothes you used to wear? Is there something you can do to feel better about your body? Makeovers don’t just pertain to makeup, hair and clothes. Are you ready to makeover the way you think about yourself? While we may not have the same body, hair or skin texture we had before breast cancer, we are alive. Find ways to embrace the new you; cut yourself some slack. We may or may not feel like wearing falsies or teeny bikinis, but then again, who says we can’t?

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Life Outside of Cancer

Sunday, June 05, 2011

Polaroid SX-70. ©Brenda Coffee. All rights reserved.

Last week Marie O’Connor, a sweet friend to all and a breast cancer blogger from Ireland, wanted her readers and fellow bloggers to tell her a little bit about themselves that had nothing to do with breast cancer. Many responded with comments on Marie’s blog while others have written their own blog posts. So far I’ve learned Jan was a patent attorney; Lauren is a pediatric psychologist who’s an expert witness in abuse and neglect cases that come to trial; Philippa advises and manages educational development programs and has lived in Nepal, Mongolia, India, Sri Lanka and Myanmar; Martine was once offered a singing gig in Las Vegas; Jody is an active cancer advocate who pedals 25 miles, several times a week; Beth is an oil painter; Kathi is a home care physical therapist and a closet Adobe software maven; Katie is a writer; Jackie works in media relations and is wild about the Nebraska Cornhuskers; Lani is a college mathematics professor and Anna is a writer and cancer advocate. And me? I’m an entrepreneur who’s done everything from run a greenhouse manufacturing company to doing a hostile takeover of a public company. The one thing, however, that’s always been a constant in my life has been photography.<PREVIEWEND>

I have always been a camera freak: pinhole, Polaroid SX-70, 35mm, panorama, underwater, 8, 16 and 35mm movie cameras and now, digital. The medium has never mattered as long as I could make images and document where I’ve been. Cameras have gotten me backstage passes, 50-yard line access, flights in fighter jets and landings on aircraft carriers. I’ve documented Paul Newman as he raced cars at Watkins Glen, Robert Mondavi’s 90th birthday party, Olympic Track & Field time trials and life on the road with the Harlem Globetrotters. I’ve captured images of buried treasure, bluebonnets in the Texas Hill Country and the heartfelt moments of life and death. The strange thing about being a photographer and a filmmaker is that even though my camera lens brings me up close and personal, it’s sometimes like I’m window peeping. When many of my experiences are over, I don’t feel like I’ve been there. I remember the quarterback dropping back to pass, one shot at a time, increments done with a high speed motor drive, but ask me what happened next, and I may not remember it clearly if I didn’t see it through my camera lens.

Since breast cancer, I’m more interested in where I’m going than where I’ve been. I’m more interested in where you’re going that where you’ve been. Do you have a life outside of having cancer, publishing a magazine or working in the home? What defines you as a person? Do you only see yourself as a doctor, lawyer, Indian chief? Married, single, widowed or divorced? Or do you see yourself as curious, persevering and a loyal friend? We’re not our cancer, our profession or our spouse. We are the sum of the total of our parts. We are the whole person. We are the little girl that got locked out of the house; the skier who likes to stay on the blue runs; the woman who wants to travel down the Amazon. As people, we are flawed, but as children of God, we are perfect in His sight. Are you living a life that will make God proud? Are you living the life you were called to live? Why not?

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Tough Times Make for Tough Women and Dogs

Monday, May 30, 2011

©Brenda Coffee. All rights reserved.

Molly’s been through a lot in her short life. Two months ago she had her tail amputated. Since then, she’s worn a plastic Victorian collar to keep her from chewing the remaining stub until it heals. In many ways, Molly and I are kindred spirits. We were both in search of someone who would love and value us, and we’ve both had big parts of us surgically removed. However the biggest thing we have in common is that both of us were rescued by James, and in turn, James was rescued by us.

When James first found Molly on the road near our house, she was miles from her last foster family. She’s had four foster families and all of them, for one reason or another, didn’t want her. From the moment James got out of his truck and walked toward her, I believe she knew she’d found Prince Charming. Molly fell madly in love with James, and he with her. She was emaciated and had a BB in the floppy part of her ear. I’ve never met a needier soul. Molly’s a great dog, made even better by James’ love and patience. She's part Lab and part Great Dane, and when she stands on her hind legs, she’s almost as tall as I am and that’s a whole lot of dog. She's young and rambunctious, and James worked hard to calm her down, teaching her to heal and to walk on a leash. They liked nothing better than going for walks together on the ranch. She was always at his side, content to bask in the afterglow of a kind word from him or a pat on the head. His death has changed her profoundly.<PREVIEWEND>

Almost immediately she became sullen and depressed, sleeping most of the time, her face and body toward the wall. For months she didn’t want any affection. She just wanted to be left alone. After she stopped dragging her bed in front of his chair, placing her paw on his seat and staring at me, she began chewing on the end of her tail. I was too wrapped up in my own grief to notice the damage she was doing until she began leaving blood trails everywhere she went. I cleansed her tail with hydrogen peroxide, applied Neosporin and tried to keep it wrapped. After two days of repeatedly tearing off her bandage and continuing to chew on her tail, the last four inches were without hair and had become dried and withered like beef jerky. The vet said that portion of her tail was dead, void of all blood supply. If we didn’t amputate it, the rest of her tail and the blood vessels along her spine would continue to die, ultimately causing paralysis and death. If that wasn’t bad enough, a fast-growing mushroom looking thing simultaneously erupted on her left rear foot, and the vet feared it might be cancer.

After the amputation and her foot surgery, we waited almost a week for the pathology report. Thank God, the out of control growth on Molly’s foot was not cancer. I don’t think I could have lost another family member. Since she’s been entombed in this Victorian collar for the last two months, she’s had a hard time navigating. As a result, this plastic contraption has chipped paint off door moldings, and my legs are scraped and bruised. I find myself running out of patience with her sometimes, and yet at the same time, I feel sorry for her.

Recently I found something I wrote back in February: “My heart breaks for this dog. No one wanted her, but James took her in and rescued her, and now that he’s gone, she’s grieving herself to death. Out of my three dogs, Molly is grieving James’ death almost as hard as I am. I know my grief hasn’t helped, nor has shuffling the dogs back and forth to the kennel when we didn’t have heat or water during the coldest days of winter. As I vacillate back and forth from disbelief, to the depths of despair, Molly stands guard over James’ chair. She’s so needy; she can’t bear it when I’m not in view at all times. Now she’s decided to stand guard over my chair, her paw on my lap, occasionally looking back and forth from me to James’ chair. I wish I could make things alright for her.”

Like all of us, Molly just wants someone to love her, and in return, she wants a family she can trust and love in return. I know how she feels. Except for my dogs, my church family and great friends, I no longer have a family I can trust.

Two weeks ago depression plunged me into deep despair. While driving down the freeway, my sobs made it nearly impossible for me to leave my phone number as I tried to make an appointment with a counselor. Looking back, I’m reminded of the depression I felt after learning I had breast cancer. I remember cowering in my car in PetSmart’s parking lot, crying hysterically, unable to pull myself together to go in and buy dog food, or get on the highway and drive home. It had been three months since my diagnosis, and the full impact of what it meant to have breast cancer had finally hit me. Now, the full impact of not having James, or a family, has finally hit me.

As breast cancer survivors, we battle fear, depression and disbelief, struggling with overwhelming concepts like life and death, self-image—who will love us with our scars—and the unsettling possibility of recurrence. It takes a very special person to love someone just as they are. James did that for Molly and me, and now we are doing that for one another.

Molly’s a survivor, conquering everything life has thrown at her. Until now, it never occurred to me that a dog could be a great role model, but Molly’s been one for me. She’s been shot, abandoned multiple times, is still suffering from the amputation and has grieved deeply for the most important person in her life. In true survivor style, she’s emerged on the other side, grateful to discover she’s still valued and loved and like me, is finding her new normal without James.




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Hang On to Your Husbands

Sunday, May 22, 2011


Did you know there are women who will try and steal your husband while you're fighting breast cancer, struggling with surgeries and chemo and trying to maintain some semblance of a normal life? Before a couple of these women lunged for my husband, it never occurred to me I knew anyone like this: women with no moral code, and more importantly, no concept of self-worth. Who does that sort of thing? A woman at my church, that's who.<PREVIEWEND>

One Sunday, because of chemo, I barely had enough energy to blink, much less get dressed and make it to church, I told James to go on without me. Moments after he walked into the church, one of these husband-stealing Jezebels leaned into him, gave him a full contact body hug and proceeded to grind her crotch into his leg. "If I can ever do anything for you," she whispered in his ear. "Call me."

Another time chemo zapped me of energy, I asked James to meet a woman, I thought was my friend, and a workman at our Little House so they could hang light fixtures. This hair-flipping floozy came-on to James bigger than Dallas. When her floor-length trench coat came off, she had on a micro mini skirt, cowboy boots and a thong. Repeatedly she bent over, as though retrieving something from her bag, fanny side toward James. James said each time he moved, so he didn't have such an up close and personal view of her derrière, she moved so that he did. The Little House is only 22 feet by 22 feet, so there wasn’t much room to escape her, plus there was a rain storm going on outside. When he tried to move toward the front porch, she cornered him.

"Has anyone ever told you what pretty eyes you have," she asked.

"Yes," he said. "My wife."

James never liked her because, as he put it, she was always looking to "better deal herself.” When he told me the “pretty eyes” bit, I knew it was true because she says that to most everyone she meets, men and women alike. Later I discovered some of the other women who knew her had a saying: "Don't ever leave your husbands alone with her."

While neither woman's true character surprised me, I was disappointed at their lack of compassion for me and for James. Women who brazenly offer themselves like that show disrespect for husbands as well. We all know husbands can be overwhelmed with their wife's breast cancer, even vulnerable in many respects. The statistics about marriages that breakup after a breast cancer diagnosis are well-known. I know how hard it is to be wife, mother, lover, housekeeper, and hold down a job while going through breast cancer, but hear me when I say this: Talk to your husband about his fears and yours and sex, or lack of sex during breast cancer.

A man’s “little brain” has a tendency to dominate his “big brain,” and while you may not be as interested in sex during treatment as your husband is, his sexual needs do not go away. Even if you’re not lucky enough to be best friends with your husband, this is a time to treat one another like best friends. Try to talk honestly and openly with one another about different ways you can handle sex, and other issues, over the course of your treatment and recovery. Perhaps a counselor can help. If your marriage is a good marriage, this is an opportunity to grow even closer. If your marriage is rocky, perhaps you can find a way to role reverse with one another. Work at becoming best friends, and seeing things from your spouse's point of view. James was a great husband who loved me beyond all reason and placed our marriage first and foremost. We both did. We talked daily about everything, and for the most part, we were usually on the same page.

Women who try and steal another woman’s husband, while his wife is fighting for her life, are contemptible creatures. At least vampires come out at night, but these desperate housewives brazenly do their best work in the daylight with no remorse or misgivings as to the consequences of their actions. They are sad pathetic women in search of an ego fix with no regard for anyone, not even themselves. These women are little more than pit vipers with the word, "Juicy," emblazoned across their butts. Watch out for them, girlfriends. I guarantee you; they’re closer than you think.

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Do You Really Know Your Breasts?

Sunday, May 15, 2011

©Brenda Coffee. All rights reserved.

Years after my diagnosis, a self-breast exam reminder still hung in my shower; the same reminder that prompted me on Christmas Eve morning, 2003, to check my breasts. I knew the moment I felt “it” that something wasn’t right, but six-months and two mammograms later, doctors assured me “it” was okay. It wasn’t. This week, I spoke to a woman whose story is similar to mine. Like me, her breast cancer was found after she insisted the suspicious spot be biopsied, and like me, her cancer was hiding underneath a fibrocystic lump. Lump... Don’t you hate that word? Lumps are never good whether they’re in your breasts, the turkey gravy or they’re the dullard at work who only got the job because he’s the boss’s nephew.

Each week I meet women who had a suspicious spot their doctors opted to watch for a period of time. Not always, but many of those spots turned out to be malignant. If I had a “do over,” I would insist my fibrocystic lump be biopsied—NOW—as in let’s skip the waiting and the second mammogram. Go get your scalpel. I want to know what it is.<PREVIEWEND> Since many insurance companies are trying to keep costs down, and since doctors don’t always receive payments for services and procedures deemed unnecessary, I have to wonder how many breast cancers could have been caught earlier if they’d been biopsied instead of waiting? Even though early diagnosis doesn’t always translate into better survival rates, for those women it helps, it’s EVERYTHING and self-exams often lead to earlier diagnosis.

Think of self-breast exams as mapping your breasts. If you still have periods, choose the same time each month, preferably when your breasts aren’t tender, or if you no longer have a period, pick the same day each month and map your breasts. Most of us think we know our breasts when in reality, we don’t. The easiest way to examine your breasts is in the shower when your hands are soapy. Do you have a spot on one of your breasts that changes every month? Was it there last month? To help you remember where it is, think of that spot as the pointer on a compass or the hands on a clock. Is it north, northeast or maybe it’s at 10 minutes after 2. Do you know how it feels before your period and after your period? Is it sore; has it changed in any way? Get to know every lump and bump on your body, not just your breasts, so you’ll know when something isn’t right, and don’t be one of those people who say, “I don’t want to know.” If you find something you think is not right, call your physician and get it checked. Even if your doctor says it’s okay, listen to your little voice, especially if you regularly examine your breasts.

Even if you’ve been diagnosed with breast cancer and have had a mastectomy and reconstruction, regardless of whether it’s an implant or your own tissue, continue to do monthly self-breast exams just to be on the safe side. Odds are slim that a breast cancer will recur from any remaining breast tissue attached to your skin, but be vigilant. Just like your monthly self-exams before breast cancer, do them at the same time every month.

When I learned I had breast cancer, I wanted both breasts removed so I wouldn’t have to worry about breast cancer returning in the other breast. The surgeon, however, told me he couldn’t remove the other breast because “it's a perfectly viable organ.” Hello! What does that even mean? Capable of living on it’s own? Well so was the wart on the end of Aunt Gertrude’s nose, but she had it removed. I sometimes wonder if male surgeons think removing a healthy breast is tantamount to removing one of their testicles? Fortunately, in the last six years, more women are demanding, and getting, voluntary preventative mastectomies.

Four years after my first mastectomy, I discovered I was BRCA2 positive and had the other breast removed to lower my risk of recurrence. I shouldn’t have needed that surgery if the first surgeon had bowed to my request for a double mastectomy. Thinking back, I should have grabbed his scalpels and like the Karate Kid, assumed the “wax on, wax off” position and said, “No disrespect intended, doc, but these are my breasts and if I want them both removed, that’s what we’re going to do. Got it? Bonzai!”

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How do You Feel About Death

Sunday, May 08, 2011

©Brenda Coffee. All rights reserved.

Death is something we try to outrun our entire lives and yet, ‘what happens when we die’ is the one question to which no one has the exact answer. In her award-winning book, This Republic of Suffering, Death and the American Civil War, Drew Faust, President of Harvard University, writes that people in the 19th Century talked about death more than we do, thereby keeping it in the forefront of their mind. She says we, in the modern age, avoid talking about death at all costs, and because we don’t keep our end time in sight, we don’t live the best lives we could. Since I have encountered the deaths of so many loved ones, I agree with Ms. Faust. <PREVIEWEND>

Last week the online cancer community lost a cherished friend and blogger, Sarah Sadtler Feather, aka “The Carcinista.” Her last post, less than two weeks before she died, informed her friends and readers that because she valued quality of life, she was stopping treatment to spend the time she had left with her family. Sarah’s last post has triggered numerous online and private discussions about death. I sometimes think those of us who’ve received a cancer diagnosis are not as afraid to talk about death as those who are healthy. I also believe healthy people don’t want to hear our thoughts about death, much less know what to say to us when that time comes. Perhaps people don’t want to get too close to death for fear they might “get some of it on them.” When I was in my 20s, I had a friend who was so afraid of death that he drove blocks out of his way to avoid an old cemetery near his apartment. He was the first person I knew who was that phobic about death. Now that I’m older, and death has crossed my path many times, I realize he is not alone.

Several years after I married James, I learned an ex-boyfriend was dying of lung cancer. I'd last seen “the boyfriend from Hell” when the police escorted him from my home after he violated a protection order. As fears for my safety increased, the Sheriff loaned me his shotgun and for several days, posted a bodyguard outside my door. Even though the last time I’d seen my former boyfriend, he was being stuffed into a police car, when I heard about his cancer diagnosis, I asked James if he would mind if I called him. I remember the first thing I said to the ex: "What have you gotten yourself into now?" He laughed and said he didn't know. The next day I went to the hospital where I learned his newly diagnosed lung cancer had already metastasized to his brain. When his doctors forbid him to drive, I took him to some of his chemo treatments, helped him grocery shop, and when he and his family couldn’t bring themselves to ask "How long does he have," I was the one who had that conversation with his doctors, then with him and his family.

The day before he died, his friend called and asked me to come. "You're so good with him," she said. "He's always better after you leave." When I arrived, his eyes were closed and the blankets were pulled up under his chin. His head was covered in a ski cap. I drew up a chair alongside his bed and sat down. For two hours I held his hand and talked to him, reminiscing about trips we'd taken and things we’d done.

"Remember when we drove to Memphis in that wicked rainstorm while we listened to Paul Simon’s Graceland?” His hand lightly stirred in mine. I wondered if it was a coincidence, or if he could hear me, so I kept talking. "Remember the time we windsurfed around the oil tanker, and the wind died when the sun went down? We paddled for hours in the dark. I wasn’t sure we’d ever reach that light on the beach." Again his hand moved, but this time, I was sure he’d heard me.

The night before, his brother and sister had arrived from out of town and some of his friends were there, but none of them were comfortable being in the same room with him. He was home, the place where he'd lived and where he would soon die, but all of them stayed in the living room as though his bedroom were the portal to the dark side. I remember thinking, ‘If I leave, who will stay with him until hospice arrives?’

"Remember the necklace you bought me in the Yucatan? I still wear it.” His eyes briefly fluttered. “Your family’s all here, and they love you. It’s OK if you want to let go.” I knew a minister had been to see him earlier in the week, when he was fully conscious, and had baptized him. “I know there’s a God,” I went on. “Of that, I am certain. It’s OK to let go and be with God." I felt his hand stir in mine for what would be the last time.

A couple of days later, James went with me to the memorial service. That night, as I removed the necklace my former boyfriend had bought me in the Yucatan, the clasp broke and grey stones and tiny gold beads hit the floor, rolling in every direction. As I crawled along the floor to retrieve them, I wondered if it was coincidental, or perhaps he was saying goodbye.

The decision to talk about death is not always ours. Sometimes we must take our cues from the one who is dying. Without rendering his own opinion, Philip, my first husband, told me to choose the treatment for his lung cancer. After that, he clearly didn’t want to talk about the future, his or mine. While I, and everyone around him followed his lead, I don’t think I will do that again, certainly not with someone close to me.

James and I often talked and joked about death. When he’d scrunch up his face at the vegetables I’d put on his plate, I’d say, “You’re going to miss these when I’m gone.” Because of James’ Indian heritage and his West Texas upbringing, his attitude about death was practical and straightforward. “When my time comes,” he’d say, “Just throw me in the canyon and be done with me,” a reference to the days when the Indians broke camp and moved on. It was not uncommon to leave the old and infirm behind so they wouldn’t slow down the rest of the tribe.

Fear dictates our feelings about a lot of things, especially death and dying. I’ve already realized my biggest fears—James is gone and I’ve had cancer—so death holds no fear for me. For those who may be thinking about stopping treatment, it doesn’t mean you’re not a survivor. Like “The Carcinista,” part of surviving is deciding how to live and how to die, what's best for you and your quality of life. For those of you who know someone who’s dying, at least for now, they are still among the living. While you may be uncomfortable about their impending death, please don’t ignore them. Don't be afraid to tell them what they've meant to you, what you will remember about them. It's OK to say "I'm heartbroken," or "I don't know what to say," or "What can I do for you and your family?" And so what if you cry? Big wup! At least they will know you care.

Last week Oprah said something that echoed Drew Faust’s book: "Every death is a wakeup call to live more fully, more completely and more presently." Let us not miss an opportunity to live our lives, and in the process, to lessen our fear of death.

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Lifelines and Relaxation Techniques

Sunday, May 01, 2011

©Brenda Coffee. All rights reserved.

Since James is no longer here to help me, I am solely responsible for taking care of the land and the Little House. While I like to think of myself as a tough woman, able to deal with most anything, I must confess I had to call for help today. This morning I found two dead and bloated squirrels in a water tank we keep for the deer. The thought of those little squirrels, drowning in that tank, unable to climb out because the water level was too low, made me feel responsible and sad, and the thought of plucking them out of the water was more than I could handle. I had to ask for help. A neighbor graciously removed the squirrels from the tank, emptied it and then fashioned a ladder out of fencing material so the next little squirrels that come to drink can find their way out. From time to time, we all need a rope or a ladder that enables us to rise from our condition and gives us the hope of a better tomorrow. Goodness knows I’ve grabbed onto every rope I could find in the last four months.<PREVIEWEND>

My lifelines have come in the guise of prayer, friends, counselor visits, more prayer, Molly, Sam and Goldie, hypnosis, as well as crying until my face is red and swollen and I can’t cry anymore. I think that’s what Oprah calls “the ugly cry” because we wind up with a face that looks like Boris Yeltsin. On two different occasions I've shopped myself silly, only to return everything I purchased, except an outrageously expensive shawl (the shop in Santa Fe only gives store credit), that was hand-woven by blind Tibetan monks and made from 100% nearly extinct Mongolian camel hair. OK… so I exaggerated the blind monks, but what was I thinking? I didn’t even look at the price tag! No amount of new “things" will ever fix what’s ailing me, and I know that. I somehow got caught up in the momentary distraction of retail therapy, but my best therapy has been meeting many of you.

Every week I’m honored to meet new breast cancer survivors. Many I meet online, then subsequently get to know them better through phone calls and emails. Others are friends of friends, who’ve just been diagnosed. I call or email them, hoping I can help in some small way. I’m always amazed at how calm and together most of these women are; how well-informed they are about their cancer and how ready and determined they are to get on with surgery or treatment. Occasionally, however, I speak with women who are thrashing about like I imagine those poor little squirrels in the water tank were, panicking and drowning with fear. For a time, that’s OK because we all do it, but at some point, we must reign ourselves in while we create a different perspective through which to ponder our plight. Unlike the squirrels, most of us have several ladders we can use. In case you don’t recognize a lifeline, here are a couple of simple, yet powerful things you might consider while looking for one.

• Close your eyes, place your tongue behind your teeth and breathe in for a count of four; hold your breath for a count of seven, then slowly exhale for a count of eight. Repeat. If you’ve never done this kind of breathwork before, in the beginning, only repeat the cycle four or five times because it can make you dizzy. This is a powerful way to help us get focused and centered, and if we’re not focused, it’s harder for us to get our emotions under control. If we don’t have our emotions under control, we don’t make good decisions.

Focus on something that has a positive meaning to you. For me, it’s the Twenty-Third Psalm. Every night, after I've gotten into bed and am gearing down to go to sleep, I close my eyes and repeat the Twenty-Third Psalm over and over until I’m not thinking about anything other than “The Lord is my shepherd. I shall not want.” Like breathwork, repeating a "mantra" helps unclutter our thoughts and let's us focus on the needs at hand.

If you’ve never weathered a crisis, you might consider learning to still your mind before you find yourself drowning. Desperate and drowning are generally not conditions under which we make our best decisions. Like learning CPR, we should be skilled at staying calm before the need arises. What if you put a Post It note on your work phone with the numbers “4-7-8” and practice the breathing exercise several times a day, whether you feel stressed or not? The trick is to concentrate on your breaths and your counting, not concentrate on your breaths AND what you need from the grocery store.

By the way, the Mongolian camel hair shawl is still hanging in my closet. The price tag is on it. I'm thinking about auctioning it off. The winner could donate the proceeds to the charity of their choice as well as becoming the owner of an elegant new shawl. Now that would be empowering for all concerned. Anyone feeling generous? If so, hold up your auction paddles high enough for me to see them!

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