On the drive home from the bar, I began to panic. I called another friend and blurted out the news to her. She immediately pulled up Paget’s Disease on the internet and began to read to me. I recognized some of the same information my dermatologist had shared: it is rare, the treatment is surgery, it can be DCIS (ductal cancer in situ) or there can be an invasive cancer in the breast, it is usually confined to one breast, one surgery involves removing the nipple and aureola, another is a modified radical mastectomy, sentinal nodes are removed to check the lymph nodes, sometimes there is follow up radiation, no mention of chemotherapy. The information from WebMD and the Mayo Clinic was almost identical.

Once I told her I would have to go to the state capital, to the medical center there, she immediately volunteered to accompany me. I accepted, with gratitude; I did not want to face a surgeon alone. I have had a great deal of experience with major medical centers because my son, as a child, was frequently ill. There was never a clear diagnosis as to why and I learned that the physicians who can just say, “I don’t know.” are rare. I also learned that if you questioned doctors and their decisions on how to proceed, you were quickly labeled difficult, in denial, or unrealistic. Most suggestions about alternative medicine or healers were dismissed or ignored. I’m older now, more self confident, and more willing to state my questions and needs and expect to be treated with both courtesy and respect.

When my son was ill, I usually faced it on my own, not asking for help. Now my heart is open and I am willing to ask for help and be grateful for all that is offered. I am well blessed with friends. As soon as I get home I plan to call two friends who are breast cancer survivors and ask to hear their stories and solicit their advice. I know I don’t have to do this alone.

I had planned to meet the same friend who gave me the advice about being open for signs after my dermatology appointment. I was pretty rattled and phoned her and blurted out, “I have breast cancer!” She agreed to meet me immediately and we began a Keystone Cops scene where we tried to find a bar and one another. I needed a drink and some time to process the news. We ended up in parking lots for separate bars across the street from one another. I parked and for some reason she drove me across the street to the other bar. Why we didn’t just go into the bar where we both were I did not know. After a good cry in her van, where she did the very best possible thing, just looked into my eyes and listened with complete acceptance, we went into the bar. As it was after five on a Friday, I had no one to call for medical advice. The bar was full of people celebrating the work week’s end. I had a beer and a bowl of soup and kept trying to get some perspective. I was facing the door to the bar and people who came in were framed in the sunlight. I could not believe my eyes when I realized that the person who had just entered the bar was my OB/GYN. I walked over to her to be sure it really was her, and it WAS. I shared with her my diagnosis and she told me she that in all her years of practice she had never treated a case of Paget’s Disease. But, she knew what it was and the one thing she could share with me was that the prognosis was good.

I think this definitely qualified as a sign. For her to show up at that bar, at that moment, was a gift. Now I knew why we did not go into the bar across the street, I needed to be here.

I have a dear friend who, whenever she is troubled, asks for signs from the universe to let her know things are going as they should. She always promises that she will recognize the signs when she sees them. This seemed like a good time to try that.

After the doctor gave me the news about Paget’s Disease and that the first treatment is surgery, she offered to make an appointment for me with a breast cancer surgeon at the State University Hospital in our state capital. She felt strongly that because of the rarity of this kind of cancer no one in our city could do the surgery and I needed to go to¬† a major medical center. I just nodded my permission and she left. Do you know how, when you have just heard something truly astounding, for a while it is the only thing you can hear? I just kept hearing, over and over, you have breast cancer. Then, through that roar, I realized music was playing in the room. Despite my anxiety, a smile crept over my face. It was Louis Armstrong singing Wonderful World. I had helped found a charter school and that was the theme song for our school. I was immediately soothed and filled with the memory of several hundred children touching their foreheads and then outstretching their arms as they sang “and I think to myself, what a wonderful world” and the peace and hope of those children and those voices and that time centered me. I took a deep breath and dove into the music and the memory, and felt it a sign.

On Friday, January 23rd, on my way to the dermatologist’s office to have a stitch removed from my nipple after a biopsy of some irritated skin, I saw one of those pink ribbon bumper stickers. The print under this one looked a bit different and I could not quite read the words. Avid word lover and reader that I am, I maneuvered my car till I was in position to read the bumper sticker and laughed out loud, “Save the Ta Ta’s!” I thought to myself, there goes a gutsy woman with a great sense of self and a great sense of humor. Little did I realize that my own ta ta’s would soon be some of those needing saving.

I asked the nurse who had just removed the stitch about my biopsy results. She said it was odd that they were not in the folder but she would check on them.

She returned, with the doctor, who pulled up a chair and said “We have to have a little talk.” My heart sank. I wondered what kind of skin problem I had on my nipple and what the treatment might be. I was stunned when she told me that I have breast cancer. It is a very rare type called Paget’s Disease. It accounts for less than five percent of breast cancers. And at that moment I realized that the bumper sticker had been a harbinger, a preparation for what was ahead, a reminder to stay positive, maintain a sense of humor, and that being a gutsy woman is a good, good thing. My journey has begun.