It wasn't just Yumi's health issues that had brought Sayako Ogasawara to the hospital that night. The Director of Lillian Girls' Academy had been at her doctor's offices at Tokyo University Medical Center just the past week for her annual checkup. The various tests this year had included a general physical and cholesterol testing, a pap smear and mammogram, a colonoscopy, and a skin test to look for abnormal spots or moles. She'd learned the hard way with the loss of Sachiko's grandmother that it was foolhardy to forego such simple tests when the end result could very well be the difference between life and death. Between being able to see her daughter get married to the wonderful girl she'd chosen to be her partner or missing that wondrous event. Between holding her first grandchild in her arms or never knowing such singular joy.
Her mother-in-law had died of a breast cancer that had over time metastasized to her lymph nodes and then to her colon and lungs. If she'd had a simple mammogram just three years earlier she could have had a lumpectomy and the woman would most probably have still been with them today. Like most women she'd complained that the tests were "uncomfortable" and that was her rationale for putting them off year after year until it was too late. By the time the cancer had finally been diagnosed it had already progressed to Stage IV and Saiko Ogasawara had fewer than four months to live, most of them in debilitating pain and with severe difficulty breathing.
On the day before Saiko's funeral Sayako had promised not only herself, but Tooru and Sachiko that she would never be so stupid as to forego such simple tests, no matter how uncomfortable or painful they might be, if it meant that she could spend even one more year, one more month, one more day with those she loved.
She'd heard from her doctor's office earlier that the mammogram had discovered a lump in her left breast. It was tiny, only around half a millimeter, and it would have been difficult to find with just normal breast self-examination. A follow-up needle biopsy had confirmed the presence of abnormal cells that called for further action. When they did the biopsy they also removed a few lymph nodes from her left armpit for testing. Luckily those tests had come back negative. Her doctor had assured her that because it had been found so early there was every chance that a simple lumpectomy and hormone or radiation treatments would see her through Sachiko's and Yumi's wedding, through the presentation of her grandchild, and even possibly the birth of Sachiko's and Yumi's grandchildren.
Her visit to Yumi that night was not only to reassure herself of the welfare of her daughter and the girl Sayako had come to love just as much as a child of her own flesh, but also to ready herself for the next morning's surgery. Tooru would be arriving early in the morning just as soon as he picked Miki and Yuichiro up and brought them to the hospital so that they could visit their daughter. Sayako was looking forward to seeing Yumi's mother, her fairy and petite soeur, and to sharing a few moments with the woman she'd come to care so much about after being separated for so long. She would need Miki's strength along with the strength of her family and Yumi who had been through so much more than she herself would have to go through. With their strength and support she knew that she would be able to overcome any obstacles and, like Yumi, she had determined that no cancer, no matter how malignant or pernicious, was going to hold her back or steal even one minute of happiness from her.
Sayako had every intention of helping Yumi and Sachiko plan their wedding no matter how many years it took to come about.
-oo-
When Yumi slowly awoke the next morning her first thought was that she was back at home in the apartment she shared with Sachi. She could feel the weight of her love's arm as it rested lightly across her abdomen along with the weight of Sachiko's head on her shoulder. A strand of raven black hair was tickling her nose and she could feel her lover's warm breath breeze softly across the heated skin of her neck and collarbone. A smile creased her lips before they opened in a contented sigh as she snuggled closer to the woman she loved more than life. A tug at her left arm along with a slight pain as she moved reminded her of just exactly where she was and why.
When she finally opened her eyes it was to find herself in what appeared to be a much larger hospital bed than the one she'd gone to sleep in the night before. An IV line stretched from a bag hung from a pole attached to the bed and ended in a needle stuck into and taped to the inside of her left forearm. From what she could see both the bag of dextrose solution as well as the much smaller bag of antibiotics were empty which probably meant that a nurse would be by soon to switch them out.
The bed she lay in was nearly twice the normal width of a hospital bed which was why Sachi had been able to crawl in to sleep without crowding her. "I guess it pays to be a friend of the Ogasawara's," Yumi giggled softly to herself as she used her right arm to pull her love even closer to her so that their bodies were touching all the way to their toes. Glancing at the clock mounted on the wall she noted that it was just after eight in the morning. Having been through it far too many times before she next looked to the table next to the bed to see a tray with containers of various clear fluids. She groaned at the thought of them having her on a clear liquid diet when what she really wanted was a plate of eggs and bacon. "Maybe a western omelette?" she chuckled softly.
"I'd be happy with a cup of tea and a bit of toast," the girl lying next to her mumbled grouchily. Sachiko had never grown out of not being a morning person. Her low blood pressure in the mornings had never gotten any better which, in Yumi's mind, wasn't all that bad a thing as she turned her head and placed a soft kiss against that smooth brow. "Mmm," the black haired woman smiled softly, "or maybe just a little sweetness," she grinned as she slowly opened her azure eyes to see two beautiful brown eyes looking back at her. "Good morning, love," she purred.
"Good morning, love," Yumi responded in kind before ducking her chin to give Sachi another kiss, this one on her lovely red lips. "Did you sleep well?"
"Mmm," Sachiko smiled again. "I always sleep well when I'm with you," she grinned and hugged her partner tightly. "Speaking of which," she raised her head to glance around at her changed circumstance, "I could have sworn I was sitting in a chair when I fell asleep last night…and you weren't in a bed anywhere near this big."
"I think Sayako-okaasan had something to do with it," Yumi giggled. "We both must have been too exhausted if we didn't wake up when they moved us into this bed."
"Guilty as charged," Sachiko nodded and then had to cover her mouth as she yawned. A cute little squeak escaped her throat as she did so, much to Yumi's delight. It had come as a great and wonderful surprise to learn some of the little quirks her onee-sama had that just made the brown haired girl love her all the more. Those deep blue eyes turned serious as they gazed upon her. "You scared me Yumi. Are you feeling better now?"
"I'm sorry I frightened you, Sachi," Yumi responded softly, dropping her eyes at the thought that she'd once again caused this beautiful, fantastic girl a single iota of pain. She looked up again when she felt a strong but soft hand with long slender fingers cup her cheek and play with her hair.
"It's not your fault, love," Sachiko told her with a gentle smile. "You got sick through no fault of your own. It happens to the best of us. You've had to take care of me in the past as well. It's just…I don't like it when you're sick, Yumi," she whimpered softly. "It reminds me too much of how close I came to losing you." Yumi closed her eyes, unable to put away the guilt even though she knew rationally that neither this infection nor her leukemia were her fault. "You've worked yourself too hard in the past, yes, and become sick as a result, but this wasn't one of those times. This was not your fault," she repeated much more forcefully, hoping to impress upon the girl she loved this essential truth. "I'm just happy that you're feeling better. You are aren't you?" she asked hopefully. Yumi smiled just a bit.
"I am feeling better. I can't even really remember much of that morning except that I remember feeling extremely dizzy and nauseous. Like the room was spinning and my head was full of cotton to the point where I couldn't hear anything. You'd already left for classes and I remember making it to the bathroom as my stomach heaved, but nothing after that."
"Your temperature hit over 40.6C even after they started you on the antibiotics." Sachiko shuddered at the memory of the tiny girl thrashing around on the bed; throwing her covers off and trying to pull off her gown to get just a little cooler even as she shivered. She'd nearly pulled her IV line out despite Sachiko and two orderlies trying to hold her down. The nurses and doctors had eventually packed bags of ice around and on top of her to try to cool her feverish body. "Even your heartbeat started fluctuating wildly; throwing off PVCs. Thank Maria that was only for a short time or it could have seriously damaged your heart."
"I'm sorry, Sachi," Yumi whimpered softly. "I didn't mean to do this to you again."
"I know, sweet. I know," Sachiko smiled and then pulled Yumi to her and hugged her tightly as the smaller girl wept silently on her shoulder. They lay that way until Yumi quieted.
"Sayako-okaasan told me it was a bacterial infection, but she couldn't tell me what caused it," Yumi offered once she'd gotten herself under control.
"They still don't know," the sapphire-eyed girl shook her head slowly. "It usually only attacks when there's a foreign object in the body…like a breathing tube or a catheter, but you didn't have anything like that. They did an MRI of your entire body and found nothing. They even did something to your blood - something about taking some out, separating out the white cells, treating them with some kind of radiation or dye, and then re-injecting them into your body to see where they went to fight off the infection – but still they found nothing. It's a complete mystery." She shook her head again at the frustration of not knowing and then sighed. "At least you're getting better now. That's all that matters to me."
"To me also," Yumi agreed with a warm smile and then grinned. "As I told okaa-san, I still have a wedding to plan, so you're not going to get rid of me any time soon."
"I'll hold you to that promise," Sachiko smiled broadly in return before leaning forward a touch, sealing their promise with a kiss.
A soft knock at the door let them know that it was time for the nurse to change her IV bags. It also ushered in Yumi's parents, Miki and Yuichiro.
-oo-
Sayako lay on the examination table in the radiology department as the nurse, a technician, and the radiologist moved around her speaking softly. Knowing that there was a possibility that they would have to do a number of mammograms in order to specifically identify the location of the lump, she'd requested the radiologist to use a Lidocaine gel to numb the breast first. Once the mammograms had been done and they'd supposedly located the tumor they were targeting the radiologist returned with a needle and syringe.
"Ojou-sama," the man said softly but with a reassuring voice, "I'm going to give you a local anesthetic to reduce any pain from the insertion of the wire. You'll feel a number of pinpricks, I'm probably going to do four to six injections to ensure complete numbness, but it shouldn't feel much worse than a few bee stings." Sayako nodded her head in understanding. Her surgeon had been kind enough to allow her a dose of anti-anxiety medication before they started the procedure since she would be awake for a portion of it. She was now extremely grateful for his foresight.
"What will happen after that?" she asked softly, still a bit nervous even with the medication she'd taken. Her hands were gripping and releasing the fabric of the sheet beneath her.
The radiologist smiled at her. It was a common enough question and he was ready with the answer. "After you're completely numb we'll use a very thin needle, smaller in diameter than what is normally used to draw blood, to target the lump. You might feel some pressure or pulling, but if you feel anything truly uncomfortable please let me know immediately." When she nodded her head again he went on. "We'll be using the mammograms we took earlier to guide us to the exact point. I placed a marker at the site when I did the biopsy, but this method will ensure the greatest precision of finding just the right spot. We'll then insert a tiny wire through the needle and out through its tip such that it lodges against the mass. Once the wire is properly positioned we'll secure it and then remove the needle, leaving the wire in place so that the doctor can use it as a guide to remove the appropriate tissue. After the wire has been inserted I'll take another mammogram to ensure that the wire placement is correct. If it isn't, we'll reposition the wire until it's in the proper place. Luckily I'm pretty good at this," he grinned. "I rarely have to do a repositioning."
"That's good to hear," Sayako chuckled while privately asking Maria-sama to guide him in his endeavors.
"Once the wire is in place the anesthesiologist will give you a mild general anesthetic to let you sleep through the rest of the procedure. I'll inject a dye into the area around the lump which will travel to the sentinel nodes around the mass. That process is relatively painful which is why we use a general anesthetic. The insertion of the wire and dye injection shouldn't take more than an hour or two and most of that will be to allow the dye time to travel to the sentinel node or nodes. Your surgeon will then make a small incision as close to the lump as possible and remove the lump, the sentinel nodes, and a little more tissue surrounding each just to make sure that we've caught it all in one go. That way there's less chance that you'll have to come back for any re-excision surgery."
"Please tell me you're not going to leave that wire in after the surgery," Sayako begged good naturedly. The radiologist laughed and assured her that they wouldn't leave it there.
"During the healing process the body will create scar tissue that will eventually fill up the space from where the mass was removed. You might be able to feel it as a small lump, and it will show up on future mammograms, but there's nothing to be worried about there," he finished his instruction.
"And I'll be able to leave once I'm done in the recovery room?" she asked to be sure. She wanted to get back to Yumi's room as soon as possible.
"Yes," he smiled again. "A lumpectomy with sentinel node removal is usually performed on an outpatient basis and you'll be free to leave as soon as you're feeling better. So, Ojou-sama" he grinned, "are we ready to proceed?"
"I guess we are," the black haired woman replied with a smile of her own along with another entreaty to Maria-sama to watch over her.
-oo-
"Is this really necessary, Miki-okaasan?" Sachiko whined as she was ushered unceremoniously into an examination room just around the same time that Sayako was being put under general anesthetic.
"I promised your mother that you'd have a mammogram done while she's in surgery, Sachi," Miki Fukuzawa told the young woman in no uncertain terms.
"And tell me again why my mother thought it was a wise idea not to tell me about her surgery this morning?" Sachiko huffed in indignation as Miki helped her to get her blouse and bra off and into the gown that the nurse had provided for her.
"You know exactly why Sako-san didn't tell you, Sachi," the dark haired woman admonished her. "She knew you had enough on your mind already with Yumi-chan's illness and didn't need anything more to worry about. I've been assured both by your mother as well as by her doctor that the lumpectomy procedure is relatively simple." She stopped for a moment to collect herself before she continued in a much gentler voice. "Unfortunately it's also just the first step in a long, drawn-out process of hormone and radiation treatments, but she's been told that since the cancer was caught so early there should be every chance for an excellent prognosis and that she will have many more years in which to pester you no end," she giggled.
"And that means I have to have a mammogram why?" Sachiko fumed. She was so upset with her mother and her damned secret that she hadn't given a moment's thought to the fact that her future mother-in-law was helping her get undressed, seeing her bare naked above the waist, and then helping her into the hospital gown.
Miki sighed as she tied up the back of Sachiko's gown. "Sit," she ordered the younger woman. Again without thought, just because of the timber of Miki's voice, Sachiko took a seat in the only chair in the room as Miki hopped up onto the examination table before turning to look at the black haired girl with serious eyes. "Sachi," she said softly as her hands gripped each other. "Although there's no guarantee that you'll get breast cancer, the fact that two members, or even one member of your family, ended up with breast cancer means that the chances you'll get it are immensely increased. In fact, because of the family history, your father even has a greater chance to end up getting cancer. He's in another part of the hospital right now undergoing a prostate exam and a colonoscopy."
"Otou-sama too?" Sachi squeaked in a frightened voice, all anger having fled at Miki-okaasan's words and the thought that both of her parents were at risk.
"Cancer is not a disease where you can afford to bury your head in the sand and pray that it passes you by," Miki told the shaken girl. "It strikes far too many people these days. In 2010 one point six million women heard the words 'you have breast cancer.' What's truly saddening is that many of those that die do so needlessly. If the cancer had been caught earlier over four hundred thousand of those women could have been saved. If they were to have simply followed their doctor's recommendations and had regular mammograms, pap tests, colonoscopies, and skin exams so many, many lives could have been saved," she sighed again. "Sachi…you heard Yumi-chan this morning. If there's even a one percent chance, and that one percent chance can be alleviated through a simple exam or test, it's criminally stupid not to have those tests performed. You might as well be committing suicide. You want to live with my daughter until you're both old and grey don't you?" the brown-eyed woman asked, the desperation in her voice evident.
"Of course!" came the expected reply from her daughter's love.
"Then why wouldn't you want to do everything in your power to ensure that you get those years together?" she asked with tears in her voice, nearly begging Sachiko to see reason.
"When you put it like that, okaa-san," Sachi said softly with a small smile, "what else can do but ask when you're getting yours done."
"You're making your mother, father, Yumi, and Yuichiro and me very, very happy, Sachi," Miki smiled, "and I had mine two months ago along with my pap smear," she chuckled.
-oo-
Sachiko was back in Yumi's room sitting in a lounge chair that someone had found for her and reading another romance novel when Sayako knocked on the doorframe.
"Okaa-san!" Yumi exclaimed at seeing the older woman smiling at her.
"I am so mad at you Okaa-san!" Sachi said angrily but then ran to her mother and took her into her arms.
"Gently, Sachi!" Sayako gasped and her daughter jumped away from her mumbling apology after apology until her mother couldn't help but chuckle. "I'm a bit sore, but the preliminary histology says that they got all of it," she told the girls with a wide smile. "I'll know more when the full lab results are completed, but everything they're seeing right now is that it was still localized to that one spot. No spreading."
"That's wonderful news," Yumi squealed in delight as Sachiko once again, but much more gently, took her mother in her arms as tears of relief and joy fell from her eyes.
"And you, dear?" Sayako asked her daughter as she pushed her away to look into her eyes. The smile on both of the girls' faces told the news, but Sachiko said the words anyway.
"All clear," she hesitated a moment, "for now."
Author's Rant: All right, I know I'm preaching, but I just can't help it. Although the characters in this story are fictional, all of the information I've provided in this chapter is true to the best of my research. In case you hadn't figured it out, this chapter is my offering for Breast Cancer Awareness month. This chapter is dedicated to all those men and women out there that are putting up the good fight every single day to beat their cancer as well as to those working tirelessly to find a cure. For those of you lucky enough to be "all clear" as Sachiko put it, please don't be so stupid as to forego the testing that could literally save your life. First thing Monday morning, call your doctor and schedule a cholesterol screening, a mammogram, a pap smear and pelvic exam, a skin test, or a prostate exam and colonoscopy. Yes, some of the tests may be slightly uncomfortable or even slightly painful, but they could also save your life.
CelticX