t - seven days

One week from this very moment I will be either on, or on my way to, an operating table where I will spend between five and twelve hours depending on whether I have a simple mastectomy or a mastectomy and reconstruction. I should be home between Thursday and Saturday.

This afternoon we head to Ann Arbor to begin the lymph node extraction process which starts with two shots of nuclear medicine being administered today followed by quick outpatient surgery tomorrow morning. I should be home by tomorrow afternoon. The nuclear medicine is used to track the lymph nodes, the node or nodes containing the most medicine will be removed and analyzed tomorrow.

I feel like this surgery is a sort of proving ground; how tough am I? I know I don't need to be tough or prove anything to anyone, that the grounds and the proof are only for me. Still, I feel compelled to be the strongest post-mastectomy patient the world has ever seen. Mastectomy. Mastectomy. The word feels foreign. The whole process feels surreal. I'm pretty sure this is not my life.

When I was 9 we went to Disney World. Nearly all of the other kids I knew had already gone and having a couple of Disney fans for aunts, I had long been fed the movies and books; this vacation was an exciting prospect. I also grew up quite poor and the idea of going to Disney World had been far outside the parameters of my single mother's tiny budget for my entire life, so Orlando and it's cartoon wonders were comfortably seated in someone else's reality. I remember packing up the car and leaving impossibly early - still dark, cold, dewy. My mom asked if I was excited and I nodded sleepily, but the truth was that there wasn't an ounce of excitement in me because it never felt real. I could not begin to imagine our arrival in Florida - a place that seemed so exotic in my untraveled Midwestern mind - and since I couldn't imagine it, I couldn't muster the appropriate feelings. At some point between Ohio to Florida, I woke from my backseat slumber, sat bolt upright and shouted, WE ARE GOING TO DISNEY WORLD! I got it. We were far enough from home for it to sink in, on our way, destination ahead, no going back, and suddenly I could picture it. The butterflies and giddiness took hold and I am sure I spent the rest of the trip bouncing unsecured around the backseat of the car. We stopped and filled bottles with ocean water, passed groves of grapefruit and oranges, read highway signs for places with names I'd read and heard on the news but never been so close to - exciting names like Tallahassee and Miami. And eventually we arrived in Orlando.

Now, I don't think I'll have the same emotional reaction to finally recognizing that the surgery is happening as I did to finally realizing that Disney World was within reach of my eager little hands. But I do think that the recognition will take as long to set in. I can't clearly picture the hospital, me in a gown with an iv stand, nurses shuffling quickly around, Jason and my mom hovering near me. I can't picture the aftermath because I do not yet know what it will be and perhaps it is this - the up in the air nature of the planning, waiting, and adjusting period, that keeps me from being able to see it - but until I can, it just doesn't feel real. I keep wanting to remind everyone that I do not feel sick. That's the strangest thing about cancer - it isn't the disease that makes you feel sick early on, it is the treatment that does you in.

But for now I will take the next week one day at a time, hoping all the way for lymph nodes free of cancer.