Tuesday, November 17, 2009

All Hands on Breast: My New Cancer Prevention Protocol

C’mon everybody, gather round. Real close – there’s room for everyone. Ok, great, you’re all in nice and tight. Now, I want you to reach out your hands – one, both, I don’t care, just reach out. And now, please place them firmly on my breasts. Yes. Now. Go ahead. Excellent! Thank you! Oh, and if you have a free hand, use that to call all your friends and neighbors, and tell them to come on down. There’s plenty room for everybody, and if I run out of breast, we’ll just start rotating everyone in, or hand out numbers; I’ll stand here all day! Because the more of you there are putting your hands on my breasts, the more chance I have of not dying from a tumor that I didn’t find because the U.S. Preventive Services Task Force now recommends against women being taught how to do regular breast self-exams.

Oh wait. I already know how to do self-exams, so maybe I don’t actually need your help. My doctor taught me. And yes, the first time I put my hands on my breasts to mimic what she’d demonstrated for me, I felt pretty ridiculous (was I doing it right? What the hell is all the stuff in there, anyway?), not to mention a little perverted.

Now, I’m the first to admit that all that breast touching took some getting used to. I did skip a fair number of months. And I confess that sometimes I fibbed to the doctors when they said, “Your mother had breast cancer at 36? Is she still living? You are doing monthly self-exams, aren’t you?”

But here’s the thing: all that breast talk got my attention. I did a lot of self-exams – I paid a lot more attention – than I would have if there hadn’t been a schedule, a concrete action plan. I never really got over feeling pervy about it. But I’m not sure that a generic focus on “breast awareness” - instead of monthly self-exams - can compare to the lyrical hook of “buddy checks.”

So you can just take your hands off my breasts. Go on – off with you. But don’t go too far, because my nieces are going to be needing you. No one’s going to be haranguing them about “buddy checks,” and they won’t be seeing those little hang-tag reminders in the showers at their gym, so I’d really appreciate it if you’d stay tuned to lend a hand.

And according to a CNN.com article I read today, my nieces won’t be the only ones who need your help. Dr. Anne Wallace, professor of surgery and director of the Moores Breast Cancer Program at the University of California-San Diego, says she “has seen patients with large dents in their breasts and tangible masses within. When she asks them whether they had noticed anything there, they say, ‘Oh, gosh. I can't touch my breast. I don't know if it's new.’’

I read this really quickly at first, and interpreted it literally: Can’t touch their breast? Huh? Are their arms too short?

But then it dawned on me that they were saying they are too embarrassed to touch their breasts. Too self-conscious. Too modest. And I thought, well, okay, the idea of monthly self-exams probably is a bit much for them, then, but those prim women are not my nieces. And modesty should not get in the way of education.

My mother was a paragon of modesty - so much so that, on the first day of school, my sisters and I each presented this note to our gym teacher: “Please excuse my daughter from group showers for the remainder of the school year. Thank you very much. Sincerely, Mrs. Bauer.” And even she managed to put her hand on her breast when she felt a strange burning inside. The perv.

The firestorm that was launched this week will no doubt burn for weeks and months to come. And the good people of the U.S. Preventive Services Task Force did not make their recommendations lightly; this is a challenging and multi-faceted quandary. But so far I’m hearing that women shouldn’t be encouraged in self-exams because the protocol is “overcomplicated,” or because many of us have trouble sticking to the monthly “schedule” and then we face huge guilt trips and blame ourselves when we get diagnosed, or because those of us who do self-examine have more biopsies. And that some of us are just too modest to touch our own breasts.

I’m still waiting for someone to tell me that self-exams cause cancer. And maybe then I’ll shut up.

My mom may have been a perv, but I sure did enjoy the last three decades we had together.

(Stay tuned...A Shore Dive Kinda Life will be right back ;-)

Sunday, November 15, 2009

Rehoboth Nor'easter Follow Up

For a follow up (with some good pix) to my blog post about the nor'easter on the Mid-Atlantic coast yesterday, see Rick's post here.

Saturday, November 14, 2009

Rehoboth Nor'easter: The Friday the 13th Storm

This is what keeps me awake at night: Fires and floods.

When a teenage guest in our beach house decided to cozy up on a winter’s day last year, he piled wood into the living room fireplace, just as he’d seen his older cousin do the evening before. He stuffed in some newspaper, lit a match…and didn’t open the flue. He didn’t know what a flue was.

It cost us $500 to repaint the ceiling, and we decided to ignore the rest (except for the dozens of soot-filled cobwebs now clearly visible in every room). And I got to thinking about what would happen to us financially if the house burned down on, say, Memorial Day—the beginning of rental season. Sure, there’s always insurance money to rebuild, but what about the (many) thousands in rent we collect every summer, the money we use to pay the mortgage on— what we hoped would be—our retirement investment? Our dreams for a Shore Dive Kinda Life would go down (or, more precisely, up) in flames.

As I drove to the beach house in Rehoboth yesterday, with a fat nor’easter plopped down just off the mid-Atlantic coast, my anxiety wasn’t stoked by fire, but by flood. Rehoboth Beach and other towns up and down the shore had been beaten about the head and shoulders for three long days and five massive tides, with another tide rising.

On the ride in, I’d passed dozens of low-lying houses up to their ankles in water, and I worried about my own, just three blocks from a very literal “sea-level.” I headed straight to the beachfront, not knowing what to expect. I wanted to see for myself.

Forty-odd years ago, a similar monster—now called the Ash Wednesday Storm—sat on the same coast for three days and nights. The water surge, driven by near-hurricane force winds over a 600 mile span, inexorable and raging, took out the Ocean City, Maryland boardwalk, washed away burial vaults in Chincoteague, Virginia, and joined ocean to bay in Dewey Beach, Delaware—Rehoboth Beach’s next door neighbor—turning the little town into one big swim-up bar, at least until the tides receded.

Thirty years after the Ash Wednesday storm, I saw for myself what a nor’easter could do. Driving back to my rented home—an oceanfront stilt-house in Virginia Beach—after a couple of days away, I noticed a screen door askew here, an errant garbage can there. Then, turning a corner, a hundred yards of beachfront road gone, washed out to sea. I pulled onto my concrete drive – or what was left of it: half had collapsed into the surf and washed away the night before. The outside staircase leading up to the big sundeck now hung, unsupported, six feet above my head.

Inside the swaying house, I stood and looked out at the building waves, not sure what was happening. My phone rang and the rental agency told me to pack up and get out, now. The nor’easter was still out there, the tide was rising fast, and it would be dark soon.

I didn’t need to be told twice; there was so much debris in the road on my way in that I’d run over a nail and my tire was slowly leaking, so I threw ten pairs of socks and my tax return records into a plastic bag and fled. (That was also the moment I learned that I have absolute clown-like reflexes in emergency situations.)

I took a hotel room on the Virginia Beach boardwalk and listened to that storm smack the hell out of us all night long. The next day, twenty-five of my neighbors had lost their homes.

So as I pulled up to the boardwalk yesterday, Friday the 13th, I was concerned. I opened the car door and nearly sacrificed a leg as the wind whipped it back at me. I repositioned the car so the passenger side took the brunt of the gale and stepped out, staggering the few feet to the beach bent over 45 degrees like Geraldo on hurricane duty.

The waves were ferocious, bulky…and close. The dune grass was waging a mighty battle to hold its ground, but the relentless pounding had already taken a toll, carving short cliffs into what had been 100 feet of gently sloping sand. So much water. So much rain.

Nor’easters don’t care about retirement investments, or mortgage payments. And fires burn where and when they want. The moves we get to make in life are like a game of chance: we blow on the dice, toss out the best roll we can, and whoop and holler until our fate is decided. And if we’re lucky, we get to roll again.

Back on Scarborough Avenue, our house is fine. We’re still in the game. And we’re leaving our chips on the table. Rehoboth is pretty beat up, but the dune line held, and Rick and I feel a lucky streak coming on.

Dewey Beach storm photo copyright Journal News

Saturday, November 7, 2009

Getting Off on the Side Road

Last week started with the worst kind of Monday morning. The weekend before had been gray and gloomy, rain for three days straight. But then came Monday, with me back on the clock, yoked to an overflowing desk, and out came the sun, laughing and rolling around in the sky like a puppy that’s slipped out the doggie door.

So I do what any responsible professional who’s supposed to be earning money for a Shore Dive Kinda Life would do: I check my email for work emergencies and, seeing none, head for the mountains. The Blue Ridge is always a magnet on bright fall days, pulling me to get in the car and just drive, searching for side roads.

In my new favorite book, Tales of a Female Nomad, author Rita Golden Gelman’s travels are nothing but side roads. Hers are a little more exotic than Berryville—my lunch stop on Monday (where I found a great smoked ham and lentil soup at Bon Matin CafĂ©). Rita writes about sleeping next to sea lions in the Galapagos Islands, dancing in a protective circle of Zapotec women in Mexico, and meeting orangutans at Camp Leaky in Borneo. The side roads she chose weren’t travelled on a tour bus, and she’s teaching me a lot.

As much as a traveler’s life pulls me, the thought of going through the world as Rita did—diving into the deep end of human relationships instead of my usual splashing around in the shallows—makes me afraid. True, no one’s forcing me out of the tide pool. I think most of us just skim the surface of the countries we visit, and that’s fine—there are plenty of fish to see in the shallows if we just take time to stick our face in the water.

But any diver knows that being on the water can't compare to being in it, and that's what lures me. Part of the siren call of a traveler's life is the sweet shock of stepping off a puddle jumper into a shack of an airport, or realizing you can’t understand the road signs as your taxi whizzes into town. It’s the differentness that both attracts and frightens.

And I’m afraid that—not at all like Rita—I’ll settle for an expat experience that’s divorced from the local reality. Or that I’ll fall into loneliness and gain 30 pounds eating chocolate, like I did in college when I lived in Spain. I’m really afraid that if I do finally screw up my courage to walk down an unmarked street or through a scary door, I’ll end up like my friend Jan: in someone’s living room, admiring their knick knacks as if they’re for sale, nodding in a friendly way to the family who own the house but are too polite to say “Gringa, why are you in my house?” I’m afraid to look like a boob.

So, reading Rita, I’m gaining both courage and tips. In Antigua, Guatemala, hoping to meet some of the local expats, she sat by the door of a little breakfast place where they gathered each morning. She brought no book or magazine or post cards to write – she just sat. And as people came through the door she made eye contact, gave a little smile and a nod. Each (painful) day she became more familiar to them, and by the fourth day she was one of the gang.

If you’ve ever spent time alone in a restaurant—and I have, lots—you know how much courage it takes to just sit, with nothing to hide behind. And that as you sit, you’ll be taunted by your own personal gremlin, whispering in your ear that everyone is talking about you and you probably have dirt or pudding or something on your face.

So Rita’s example is a great tip: Just give it some time, let people get used to you. Be open. And don’t worry about the pudding.

At a Zapotec village in Mexico, Rita walked up and down the hot and dusty village streets each day, smiling at the women as she passed (when they didn’t run away at her approach). After several days of this—women fleeing, children scurrying (and men reacting the opposite)—one woman fell into step beside her, then offered a loan of the traditional skirt, blouse and long waist scarf that would help her blend in and begin to be accepted.

Rita had waited patiently and respectfully for the relationship door to be opened, and maybe it never would have but for one curious lady. But once invited in, Rita made the most of it—standing side by side during meal preparations, shooting marbles with the children. She spent a month in the village, alone but welcome.

As for me, when I’m being honest with myself, I suspect that a Zapotec village is not in my future. Were I to take a deep dive into Rita’s kind of side road travel, it’s not the tourist amenities I’d miss; I wouldn’t care if I never saw another boutique, antique store or cute clothing shop again. And historical markers hold my interest for… zzzz.

But I do love a good bowl of smoked ham and lentil soup. And I'd never say no to a little pudding.

Blue Ridge photograph by Ken Thomas, Wikimedia Commons