A few weeks ago I had a surgical procedure to remove my fallopian tubes and uterus. My variety of breast cancer puts me at a higher risk of developing ovarian cancer and uterine cancer was present in my family. While the downside of removing my ovaries at such a young age is great, there is some research suggesting removing the fallopian tubes may lessen or delay the risk of developing ovarian cancer. The plan was a two stage approach. This first surgery is to be followed by another in three to five years to remove the ovaries. Sounds fun huh. In the meantime, regular blood work and ultrasound exams of my ovaries would hopefully alert me to any problems at an early, read treatable, stage. That was how two Mondays ago I found myself in an OR waiting area once again. This two stage approach is relatively novel and experimental. Rob and I discussed all our options extensively with the gynecologist oncologist and were comfortable with our decisions. What scared me out of my mind that morning was the consent form I was about to sign. Though we had reviewed the consent thoroughly before, it was not actually signed until the morning of surgery. The form began innocently enough with the stated removal of parts. The scary part was the long list of potentials. You see it was entirely plausible that once she opened up my belly she would find something that required further intervention. It was agreed that if she found anything suspicious for cancer she would biopsy and proceed with staging which is a huge operation requiring weeks of recovery. The thought was almost too much for me to bear. I signed the paper, reminded the resident to stay the hell away from my ureters, and went to sleep.
My first thought upon waking was to find out which surgery I had just undergone, the little original one or the big one. Anesthesia is a funny thing in that when you first wake up from it there is no appreciable difference between an hour long case or a ten hour one. I tried desperately to ask the recovery nurse but she must have suspected I was delirious and ignored my probing. I changed my tactic and requested Rob repeatedly. After what felt like hours they finally allowed him back and he was able to share the good news that all looked well.
This was especially welcome news given the last time I found myself in this situation. Shortly after my breast cancer diagnosis I was scheduled for a mastectomy with sentinel node biopsy and possible axillary dissection. The evidence suggests that if the sentinel node or first node that the affected tissue drains to does not have cancer then the rest of the nodes do not either. In my case, the sentinel node had the teeniest tiniest fleck of cancer that the pathologist happened to spot requiring the larger axillary dissection. One of the worst moments of my life was waking from that surgery and having Rob say that they had to do the dissection. I understood all too well the implications and was devastated. In the end, all my axillary nodes were cancer free and the original fleck on my sentinel node was so small that there is some debate over whether to even count it at all. Truly a best case scenario that I could not have envisioned lying in that bed.
Last week I flashed back to that moment and was overcome with gratitude. In fact it was number thirty-four that day. Since I was having surgery that week I thought I would take on a resolution that was easy. I didn’t want to be overwhelmed so I found one that required no physical effort. One of my favorite books has an entire chapter devoted essentially to gratitude. In it, it teaches of a Jewish tradition encouraging adults to say 100 blessings of gratitude a day. We as a family try to say something we are grateful for every evening in November leading up to Thanksgiving but this is a whole new level of commitment. In the book it acknowledges that to fill a quota that large no opportunity must be wasted. As such, it describes the blessings beginning with the act of waking. There is even a prayer for going to the bathroom because “wondrously, the tubes and passages that should be open are open and those that should be closed are closed.” Perhaps it is the general surgeon in me but I remember those words resonated with me the instant I read them and have stayed with me ever since. It is amazing that all the moving parts of the human body work as well as they do as often as they do and it is even more astonishing that we don’t celebrate it. I thought one hundred blessings of gratitude would surely tune me in to the wonder all around me and what better week than one I was dreading and feeling sorry for myself over.
I have always found gratitude to be the special medicine that lifts my spirits. When life is hardest, it is helpful to delineate the good that still exists. As I was thinking of a title for this post it struck me that the blessings of gratitude are like rungs on a ladder that lift me above the everyday worries and hassles and show me the bigger, and usually better picture. There are many large blessings in my life. Not having any evidence of cancer in either myself or my daughter quickly come to mind. Rob continues to build a successful practice, Joe and Jack are growing and happy. We live in an incredible community. Life is most assuredly good. Those phrases of gratitude come quickly and easily. The value of one hundred is that it forces you to look beyond the obvious. You get down to the simplest of pleasures. The delightful warmth of a heating pad, the aroma of coffee, the sounds of children playing outside are all part of my daily fabric that I tend to take for granted. While it may seem strange that not having cancer shares space on the same list with my kids all having the same front cowlick that my father has, that week it made perfect sense. Counting all my blessings large and small, it turns out, was time well spent.