Unintended damage, injuries, or deaths caused by an action, especially unintended civilian casualties caused by a military operation.
Source: The American Heritage® Dictionary of the English Language, Fourth Edition copyright ©2000 by Houghton Mifflin Company. Updated in 2009. Published by Houghton Mifflin Company. All rights reserved.
Unintended damage caused by a war, perhaps a war against breast cancer in your very own body resulting in collateral damage. The impairments are very real and often reside behind the brave, smiling faces you encounter in a survivor. Despite asking a breast cancer warrior if she’s recovered and well after months of toxic treatments and debilitating surgeries, she is still suffering on a regular basis. How, you ask?
Often times you will not hear about the painful and balance compromising neuropathies in her feet. She hides the stumbling gait: the excruciating pain upon waking, trying to walk like a forty year old and not a ninety year old, from everyone except her husband. Yes, you did see her trip up those steps and hear her joke about her awful clumsiness; however, that smile hides the frustration in the numb feet that caught the lip of the granite and nearly caused a full on face plant, or worse, scraped hands that have braced many a fall.
Nor will she elaborate on the difficulties she faces in buttoning her young daughter’s sweater or fumbling and trying to tie the little shoelaces. The often- times illegible handwriting to the poor teachers in a school note, or the misspelled texts stem from stumpy finger tips that aim but do not always hit on target, are a regular routine event these days, one she just shakes off as a new “normal” post treatment.
Words do not come easy, surprisingly, even for the most motor-mouthed of them all. Regular words feel as if they are on the tip of her tongue, but are nowhere to be found in the circuitry of brainwaves. Disappointment and disgust enter as she tries, she blunders, and she finds a somewhat less-fitting replacement word to continue on in dialogue and unbroken conversation; followed with nervous laughter to disguise the aforementioned disappointment. New words are created as the synapses misfire between mouth and brain creating a weird, and often times hilarious, fusion of two similar words that spurt out simultaneously. Memory is far from what it was pre-treatment, while well-intentioned jokes about age from her spouse are smiled at, a sadness sometimes sneaks in as she *still* tries to get accustomed to the new normal, even five years out from completion of treatment.
Nagging joint pain continues to crash the neuropathy party in her body: a residual daily souvenir of the poison cocktails that surged through her blood vessels systemically; the sole mission of chemotherapy to seek and destroy those cancer cells that formed a mini-brigade against your immune system. The trudge against the very cells trying to mutate and possibly kill her, instead leaves her with a significant amount of collateral damage. While the surgeries may have been successful, the skilled surgeons’ knives left scar tissue and disrupted lymphatic flow – highways re-routed and blocked, further adding to swollen arms and hands as lymph fluid has nowhere else to now go. She does not complain about compression sleeves or pumping, after all she is alive and wakes each day grateful for another day of memories, even if they are foggy.
Phantom pains surface every so often, from breast tissue that is no longer there perhaps, causing her to grimace through the smile at the soccer field because she wants to grab her breast in pain, but knows it is inappropriate in a field full of tween boys. Radiated tissue is harder than non-radiated tissue, a reminder she experiences as she shifts from her right side in bed, to her left side instead and back again because it is too uncomfortable to lay upon that previously scorched side.
Chemo weight is nearly impossible to remove, despite 4,552,854 burpees done each week or marathons run. Depression tries to overtake her brain with the weight frustrations, but she smiles again knowing she is alive and the continued efforts to perfect said burpees helps her health in other ways despite the flabalanche that surrounds her middle. Strength may be defined in her life, not only by the size of her deadlift, but instead by knowing she faces the ongoing collateral damage with every ounce of muster she may gather.
Bathing suits are anxiety provoking to most women, but add large surgical scars and uneven, lopsided breasts, and she has to summon the courage to find a flattering suit – one that covers the Frankestein-like marks upon her chest, the radiation tattoos, and helps to adjust the boobs from not being overly stared at for the discrepancy in size. She may want to wear a sign that warns the general public about the scars and misshapen body parts, but she quietly smiles and builds sandcastles anyway.
Despite her unconditionally loving spouse, she may still cover up and hide when he walks unannounced into the bathroom as she exits the shower. She cannot help but wonder what goes through his mind: will he notice the significant different texture in each breast? Will he be turned off by the drastic size difference? Wait, that won’t bother him as much as the anchor-scars that surround each breasts or the rippling or pulling skin from deeply buried scar tissue within? She will then escalate into additional worrisome thoughts: will he be freaked out by the hot flashes and the night sweats? Will he find her early morning hobbling eerily reminiscent of her parents’ old-age disabilities? The collateral damage finds its way into her personal relationships, as if to add insult to injury.
Everyone seems to consider cancer survivors are well after they have beaten their disease, or rather have remained in remission or have no evidence of disease. Many people are unaware of the residual side effects that remain in the weeks, months and years after treatment has long ended. Cancer survivors are told that many of the side-effects will lessen with time or go away all together; but for many, that is not the case and the collateral damage is with them for a lifetime.
Many of us may simply be so thrilled to be alive and to remain free of the disease, we feel this is the “price to pay” for life itself. There are some of us out there that do not cope as well, and wonder if the “price to pay” was worth the daily pain, the new-found disabilities, the slack performance in previously stellar areas of our lives like work and again; the regular amounts of agony left behind when the cancer was obliterated.
The war against cancer, especially breast cancer, leaves significant impairment on the life of the person affected. Many facilities are now only just focusing on survivorship; life after breast cancer and the well-being of the patient once treatment has completed. Recovery needs to be more than follow up appointments every three months to ensure the disease remains at bay. Breast cancer patients need to be sure to continue to advocate for their quality of life post-disease, being educated on residual side-effects that are very real, and knowing what pain is normal and what options for pain management are available.
In the meantime, she may be grinning and bearing it, so give your breast cancer friend a warm and gentle hug to soften the achy joints, offer her compassion as she stumbles in the grass unexpectedly and as she fumbles around for words to add to your conversation. She is learning to live within her post-war environment chock full of collateral damage, despite wearing her best outward smile.
In the meantime, breast cancer survivors are encouraged to participate in the Dr. Susan Love Research Foundations studies – more information may be found here: The Collateral Damage Project