1. How Did You Decide To Write When Mommy Had A Mastectomy?
2. Weren't There Already Children's Books About Breast Cancer?
3. How Much Of The Children's Book Story Reflects Your Personal Experience With Your Family?
4. Were Your Kids Involved In Ideas For The Book? Once You Had The Initial Concept Did The Book Come Together Easily? Was It A Different Experience To Write A Children's Book Then Your Previous Publications?
5. What Else Is Different About Your Book?
6. How Would You Describe Your Book In Terms Of Being A Resource?
7. Tell Me About The Illustrations. Aren't They Hand Painted?
About the Author's Unusual Form of Breast Cancer
1. How Did You Find Your Breast Cancer?
2. What Are Microcalcifications?
3. How Do You Proceed When You Have Breast Cancer Based On Microcalcifications Instead Of A Tumor?
4. What Did Your Tests Reveal?
5. Describe Your Emotional Reaction To Learning Of Your Breast Cancer.
6. Is Microcalcified Based Breast Cancer Treated Differently From Tumor Based Breast Cancer?
7. So How Did You Decide To Have A Double Mastectomy And How Difficult Was That Decision?
8. Did They Check To See If The Breast Cancer Has Spread?
9. Did Your Cancer Go Into The Lymphatic System?
About Reconstruction
1. How Did You Make The Choice About Breast Reconstruction?
2. How Do You Approach The Idea Of Breast Reconstruction?
3. Did You Have Unique Options Because Your Reconstruction Was Related To Breast Cancer?
4. What Did You Decide About Reconstruction?
5. How Hard Was It To Lose Your Breasts And Create New Ones?
6. So How Did You Shape Your Dream Breasts?
7. So How Does A Mother Just Stop Everything To Have Breast Cancer And Recover?
How Did You Decide To Write When Mommy Had A Mastectomy?
Well I have always been a writer. When I was healing during my breast cancer a friend of mine called me in the morning to tell me that she had dream that previous night. She dreamt I had written a book that had helped a lot of people and made me famous. So I thought about it and later that day I remembered asking my breast surgeon if he knew of a children's book to discuss my operation with my children. He didn't and wished he did. He wanted to give them out to his patients. So that's when I knew there needed to be book and that I, unwittingly, was prepared to write it.
Weren't There Already Children's Books About Breast Cancer?
There were several children's books about mommies who had tumor-based breast cancer. These books addressed the lumpectomy, chemotherapy and radiation procedures and all the nausea and hair loss that goes with it. But there wasn't a book about the mastectomy operation or the reconstruction aspect. A lot of women, even with tumor base cancer, opt for a single or double mastectomy and reconstruction. There really needed to be a resource available for all these woman.
How Much Of The Children's Book Story Reflects Your Personal Experience With Your Family?
The book certainly comes from personal experience. It only reflects part of that experience, though, because it was through my daughter's eyes. I have a son too. At the time he was in second grade and my daughter was in kindergarten. We also had our special hug. Also the book doesn't reflect what a big help my husband was throughout the breast cancer and the contributions of our community. So it is a reflection of my personal experience with my family and still doesn't cover it all.
The book really just took off. Once I had the idea I just sat down and wrote the text, illustrating with a marker as I went along. My children, who were 7 and 9 at the time definitely put in their 2 cents worth. My husband too. I have been a writer of many venues and even written other children's books so I knew about the process of letting a book evolve. Everyone gave really insightful comments and it was fun. I also showed it to Dr. Wendy Harpham an author of several bestselling books on cancer. Her edits were excellent.
What Else Is Different About Your Book?
All the other books featured a son as the main character. Breast cancer, although men can and do get it, is primarily a female disease. So the main character is a little girl who needs to know if she can catch it or will catch it and how will mommy look afterwards. This book and the gorgeous illustrations really bring out the beauty of the mother and daughter bond.
How Would You Describe Your Book In Terms Of Being A Resource?
The book introduces, with soft illustrations and gentle words, a child to breast cancer, defines the mastectomy operation, states reconstruction options and prepares both parent and child for mommy's hospital stay and recovery. It validates both mother and child feelings and provides concrete ways for them to help each other. Even those children whose parent's medical illness is not breast cancer can feel comforted by the clarity of feelings and concrete ways to help. This book is a much needed resource for parents, medical professionals, teachers, and public and school librarians. We really appreciate the way INAMED Corporation has been so helpful in supporting the books publication and making it available to so many in the medical community.
Tell Me About The Illustrations. Aren't They Hand Painted?
Ralph Butler painted each of the illustrations and covers and survived the 4 hurricanes in Florida too. It was a remarkable effort to get it done. By the way, Ralph Butler is known in other quarters—he was the artist commissioned by the Governor to design the back of the Florida quarter!
How Did You Find Your Breast Cancer?
I had a pain in my breast but I felt no lump. I went to the doctor anyway and I'm glad I did. There was never a tumor. I had a lesser known form of breast cancer called microcalcifications.
They are small cancerous particles that can only be seen on x-ray. That's why mammograms especially base line mammograms are so important. Since I had taken the time to get my baseline mammogram at 35, there was a comparative measure. So when my radiologists compared the two x-rays on showed the darkness of healthy breasts. My second mammogram showed my left breast with scattered white particles dotting the darkness and my right breast looked like it was smeared white.
How Do You Proceed When You Have Breast Cancer Based On Microcalcifications Instead Of A Tumor?
In both cases a doctor will perform a biopsy to test the toxicity of the findings. With a tumor a doctor has the option of performing a needle biopsy or removing the lump and the surrounding tissues (lumpectomy). With micro-calcifications, because they are scattered all over the breast, a doctor targets a sample area to cut out for a biopsy.
My sample biopsy revealed Ductal Carcinoma In Situ (DCIS), a precancerous formation. Using the standard Van Nuys breast cancer index, my right breast ranked a 9 out of 10; my left was a 4.
Describe Your Emotional Reaction To Learning Of Your Breast Cancer.
My emotional reaction was initially shock and my second reaction was trusting god. I knew that breast cancer was treatable and that it had only been a year since my last mammogram. Still until I had my mastectomies and checked my lymph node to see if the cancer had spread I did contemplate the harsh reality of death. I have known death since I was a child. My mother died when I was 9 and my father died when I was 27. Neither from cancer. So the thought of leaving my children without a mother was very frightening. I think that is why the book does show that breast cancer, if caught early enough, is treatable and that everything can, and often does, return to normal.
Is Microcalcified Based Breast Cancer Treated Differently From Tumor Based Breast Cancer?
Very much. If you have a tumor, the key thing is that when it is removed, all the cancer is gone, and that area is now surrounded by clean tissue. So the first option is to have a lumpectomy and the second is to have full mastectomy to remove all the tissue and nipple. Because microcalcifications are scattered throughout the breast it is difficult to get clear margins and know for sure if it has all been removed. Thus a lumpectomy is not a good option and a full mastectomy is performed.
So How Did You Decide To Have A Double Mastectomy And How Difficult Was That Decision?
After the biopsy and the concern over clear margins with any kind of lumpectomy approach, it was certain that I needed a mastectomy on my right breast immediately. My left could wait. But did I want to wait? Did I want to go around wondering if the left breast would become cancerous? And then what? Another trauma for the whole family to endure? I didn't want that so I decided on a bilateral mastectomy. I think this decision was a good one both aesthetically, medically and emotionally because my doctors did the operations one right after the other and I didn't have to worry about more operations or the cancer growing and so I could really focus on resting and recuperating. Doing them both allowed our family to put it behind us.
Did They Check To See If The Breast Cancer Has Spread?
In both cancers, as part of a biopsy operation, a gateway lymph node is always removed and tested to see if the cancer has spread into the lymphatic system.
Did Your Cancer Go Into The Lymphatic System?
No. I was really lucky to catch it early. Because of our early detection and treatment there had been no spread to the lymph nodes and thus I did not need chemotherapy or radiation. This is in part why I ended up writing the book When Mommy Had A Mastectomy?
How Did You Make The Choice About Breast Reconstruction?
My husband and I did speak of reconstruction. He was in favor of it. I wasn’t so sure and wanted to keep the focus on getting that cancer out. I felt it was a decision that could wait. Then right before my mastectomy my plastic surgeon asked me if I had considered breast reconstruction. He noted that many women remove the breast with the general surgeon and have a plastic surgeon come in afterwards to rebuild. The idea sooner rather than later made sense to my husband and I and so we postponed the surgery so I could do some research.
How Do You Approach The Idea Of Breast Reconstruction?
When it comes to reconstruction, the issues are not medical but rather aesthetic and emotional and personal. How do I want my breasts to look? To feel? Do I want something to be flat, insert padding into my breast, to wear padded bras, or to have breasts surgically recreated? If I do want breast to be part of my body, who is going to shape them and what will I fill them with? And, since I must lose my nipples, shall I tattoo them or recreate them?
Did You Have Unique Options Because Your Reconstruction Was Related To Breast Cancer?
In terms of surgical options, yes. In Texas, silicone is an option for breast cancer related reconstruction. So I had a choice, "silicone or saline." I knew that the safety of silicone had been debated over the years but my plastic surgeon recommended INAMED implants without hesitation and my friends with implant experience all said the silicone, if you can get it, is much more comfortable.
What Did You Decide About Reconstruction?
I decided ultimately that I wanted permanent reconstruction—if I could lose my keys, I could also lose my padding or padded bras—and that I wanted to feel as comfortable and natural as possible and if silicone could do that for me then that what I wanted. I would take do an even 2 breast trade-in.
How Hard Was It To Lose Your Breasts And Create New Ones?
Losing my breasts was not easy. I will always treasure my original breasts and the intimacies shared with my husband and nursing my babies. For those memories I will be eternally grateful.
But as long as I was making decisions about new breasts I might as well seize the opportunity to create the breasts of my dreams. Don't hundreds of thousands of woman have or contemplate plastic surgery for the perfect breasts?
So How Did You Shape Your Dream Breasts?
Initially I evaluated my original breasts for their strengths and weaknesses. Frankly as much as I loved their sizeable shape, even with an exercise bra, they hurt when I jogged. Smaller breasts would be better for my workouts. As for my beloved nipples, well, tattooed nipples would allow me to go braless. The freedom to go braless and jogging without bopping breasts sounded pretty good, considering. Now I think of them my consolation prize.
So How Does A Mother Just Stop Everything To Have Breast Cancer And Recover?
I am still in awe. How was I going to just sit still and heal while the rest of the world kept going? What would I have done without my friend who made the master post-operative family schedule that I could follow? Or the parents of my children's classmates who pitched in to hire a family cook to help with our meals?
My cup truly overflowed with good doctors, family, and friends who gave in so many beautiful and memorable ways before, during and after the surgeries. Almost every day the doorbell would bring cheer from family and friends throughout the nation with baskets of food, bottles of wine, and bouquets of beautiful aromatic flowers.
I can still remember once lying on the sofa bed in pain trying to figure out dinner when the doorbell rang. It was my neighbor with a complete homemade turkey dinner that I could, and did, put directly on the table to eat. I felt really nurtured and loved throughout the whole process. It was very healing in more ways than one.