Inspiration born of adversity
By MELANIE AVE
© St. Petersburg Times, published May 11, 2001
NORTHDALE -- Brenda Rutledge was taking a shower on a February morning when she felt it.
There it was, between the nipple of her left breast and her underarm. As the water fell around her, she ran her fingers across it again. A slight bulge, just below the skin.
She called Jim, her husband of 15 years. "Feel," she told him when he came running into the bathroom. "Tell me if you feel anything."
Could it be?
Cancer happened to other people, to other families, to other wives. Not to his Brenda, the picture of life, always on the go, always laughing. At 51 she was a striking woman with blond hair, hazel eyes and a petite but curvaceous figure.
She worked for Dolphin Capital in Northdale, checking its software for problems. She loved her job. She loved her family madly, especially her eight grandchildren. She was too busy, too healthy, too alive for this.
The future stretched before them like an artist's canvas, waiting to be filled with vibrant experiences of middle age. Jim had been retired two years and they were going to sail, travel and visit friends and family in Las Vegas and Alabama.
This lump inside his wife's chest was probably nothing, Jim thought. He told himself, This is probably not it.
Brenda called her family doctor and asked to be seen immediately. "I found a lump," she told the nurse nervously. "It's rather large."
A few telephone calls later, the words became common on her tongue.
I found a lump. I found a lump. I found a lump.
'Somebody's got to have cancer'
Fifteen months have passed. Brenda Rutledge, mother, grandmother, computer whiz, the woman always ready with a joke, has survived the most critical time of her life: the year after a diagnosis and surgery for breast cancer, when statistics showed her cancer had the highest chance of returning.
After a radical mastectomy and months of chemotherapy, Brenda prays her cancer is gone.
Hers is a life of constant uncertainty. April 4, 2001, the anniversary of her mastectomy was a milestone.
Friends and family say Brenda has been an inspiration as she fought to retain her optimistic outlook -- and her life. She never asked, Why me?, but instead, Why not me?
"Hey, I figured somebody's got to have cancer," Brenda said, smiling.
Two days after a family doctor referred Brenda for testing of the lump, Brenda and Jim stared at the results of an ultrasound, all shades of white, black and gray. The technician had told them that a light-colored ultrasound usually meant a fluid-filled benign cyst. A dark color usually indicated a mass, benign or malignant.
The image they saw on the ultrasound was dark.
As the doctor studied the image and observed its star-like shape, he uttered the word they had dreaded. Cancer.
"I'd be very surprised," Brenda remembers the doctor saying, "if it's not cancer."
The couple grasped one another and cried. Until then, all Jim knew of cancer was that it kills. Sometimes slowly. Sometimes not.
Later that day, Brenda went to work to discover a letter from her boss, offering a free trip to Hawaii for working late one night. The lows and highs of the day crashed.
Twenty-four hours after a biopsy, or tissue sample, the phone rang at Brenda and Jim's peach-colored dream house in St. Petersburg.
The pathology report was back, the doctor told them. Brenda had "invasive ductile carcinoma." The lump was 2.8 centimeters large, living and growing inside the upper left quadrant of Brenda's left breast. It had probably been there for years.
The rest of the doctor's words were lost.
It was like: You have cancer. Blah, blah, blah, blah.
Brenda's entire left breast would be removed. They wouldn't know if the growth had spread until then.
Brenda couldn't bear to have only one breast, even briefly, so she chose to have reconstructive surgery at the same time as the mastectomy.
It was easy to find an experienced plastic surgeon for the reconstruction. But finding a surgeon to remove her breast at the same time was difficult.
One doctor did not answer a host of Brenda's questions. Another insisted she not have reconstructive surgery so soon. All the while time was ticking. The cancer was growing and all Brenda could think was, Get this thing out of me!
More than a month after Brenda had found the lump, she found a surgeon -- Dr. Leslie Pearlstein, a grandfatherly, soft-spoken physician in St. Petersburg, who hugged her the first time they met.
"Very caring person," Brenda wrote in her journal. "This is the one! Found my surgeon!"
'We think we got it all'
It took seven hours to remove her lump, which had grown to 3.2 centimeters, and to rebuild a breast from her stomach tissue.
Doctors told her nervous family waiting outside, "We think we got it all," Jim remembers. "They tell you, "We feel good about it.' " But the doctors can't guarantee they removed every cell, leading Jim to wonder: "Did they or didn't they?"
Brenda gradually improved. The removal of 12 inches of stitches in her stomach felt like someone ripping the skin from her body. Still, she learned to sit up and use the bathroom by herself.
She received eight treatments of chemotherapy, every 21 days. The chemo would kill the fast-growing cells in the body, including hair and mouth cells.
Brenda referred to it as poison.
Her first treatment was scheduled for May 1. She was ready. Having chemotherapy meant she was fighting.
The office was a curiously calm and serene place, with an ocean-like decor of sea life wallpaper border and an aquarium in the middle of the room. Brenda and Jim picked a chair in the corner of the room, by the windows.
A nurse hooked an IV bag filled with saline and anti-nausea medicine and fed it to Brenda's port, a tiny plastic object placed under the skin.
Another nurse asked if Brenda wanted to go to a women's cancer support group meeting.
Karen Garrett, who was newly diagnosed with cancer, remembers seeing Brenda walk into the meeting. Preparing for her first chemotherapy treatment two days later, Karen had been devastated by her cancer diagnosis.
Then she saw Brenda walk in, her IV pole in tow.
"I thought that was so cool," Karen said. "She was so happy."
The women asked about her mastectomy and reconstructive surgery. What was it like? they wanted to know.
Instead of describing it, Brenda raised her shirt and showed them the long scar on her lower abdomen. She raised her shirt even higher.
"This is my new breast," Brenda said. It looked like a normal breast, except for the jagged, circular scar where her nipple used to be. "This is my tummy," she said, half laughing, pointing to the area of skin filling in the circular area of her left breast.
"And this," Brenda said, directing their attention to her stomach, "this is my new belly button."
The women were awe-struck. After all Brenda had been through, she was showing off her reconstructed breast like a teenager with a shiny, new car.
The women in the support group became fast friends. Three, including Brenda, scheduled their chemotherapy together. They would meet in a corner and chat away the hours as the chemicals warred with their cancer cells.
Brenda recovered at home for two months after her surgery. But for chemotherapy, she never missed a full ill day of work. She timed the treatments so that if she got sick, it would be on the weekends.
Ten days after her first treatment, Karen called in tears. Her hair had started to fall out in clumps, all over her pillows and in her shower drain, she told Brenda. Was it happening to her?
No, but her roots hurt, Brenda admitted.
After she got off the phone, she decided to do a little test. She reached up and tugged on her hair and ended up with a chunk of blond hair in her hand.
She called her daughter and told her to come over and shave her head "like they do in the Army."
If her hair was going to come out, she wanted it out all at once.
Every day when she looked at herself in the mirror -- with no hair, eyelashes or eyebrows and a puffy face -- she thought, This is not really me. I don't look like this.
It was the temporary Brenda. She couldn't wait for the real one to return.
In November, Brenda went to see her oncologist, Dr. Richard Knipe, for the first time since her chemotherapy had ended a few weeks before.
She was upbeat and smiling. She wore an angel pin on her right shoulder, just covering her port.
Her almost-bald head was wrapped in a silky brown scarf that lay elegantly across her left shoulder, topped by a straw hat.
She told the doctor she'd been fighting a cold. "If you could give me a cure for that, maybe?" she said with a laugh.
Knipe told Brenda that for the next two years she would see him every three months. She would have to do monthly self breast exams on her remaining right breast, and she would need a mammogram once a year.
He gave her a hug. "You've done extremely well," he told her. "You've got to try and get yourself back on track to where you were before."
It was almost a let-down.
"It's like, I have nothing to hang onto there," Brenda thought later. "Oh, you're done with me? I sure hope it's worked."
She had an 88 percent chance of living five years.
She told friends, "I feel two different ways. They've done whatever they can do for me. It's either going to come back or it's not."
In December Brenda became deeply depressed. She could not stop crying, convinced her cancer had returned. Nightmares would scare her awake.
She had accidentally let a prescription lapse. Weeks later she laughed off the whole period with her friends from the support group after they went to dinner at the Ovo Cafe in St. Petersburg to celebrate. "I really weirded out," Brenda said.
They understood, especially her close friend, Mariagnes Gallerie, an outgoing and stylish St. Petersburg hairdresser who had just completed chemotherapy and radiation for breast cancer.
The two women ordered margaritas.
"Here's to it being over with," Brenda said, raising her glass.
"I hear you," Mariagnes said, leaning over to hug Brenda.
The two women erupted into laughs and almost fell on the floor.
Days before Christmas, Brenda's worries began anew. She had nagging aches in her hips and lower back, just like those described by a friend whose breast cancer had spread to her bones.
A doctor's visit and subsequent bone scan assured her the pains were arthritic not cancer.
"I guess I'm just getting old," she said.
Finally, the year anniversary of Brenda's mastectomy arrived. It was the date Brenda considered her anniversary of being cancer free: April 4, 2001. And, if for only a few days, she wanted to place the uncertainty behind her.
She was finally getting that free trip to Hawaii.
She would go there with Jim and her best friends from Las Vegas.
"This is my big reward," she said, days before leaving. "You know how kids don't mind going to the doctor when they get a lollipop afterward.
"This is my big, huge lollipop. This is my reward for making it."
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