31 August 2011

Nuts and Bolts Today

Today we got a few things out of the way and moved forward. I met with a second reconstruction surgeon and we will use her. I feel she is every bit as competent as Two-Drain, but her office is more convenient, she is more personable and she listened to what I had to say. She prefers to do boob surgeries on a Monday since she has the whole week to watch how the healing is going, but with Dr. Boob about to drop a kid, they've got to do it on a Friday to make it work on both schedules... and Dr. Boob has to bump someone too. I'm waiting to hear back from the scheduler for a final confirmation.

This afternoon I had a boob MRI. Nobody mentioned the I.V., and while the gal doing me may have been a great radiology technician, she was a lousy phlebotomist. And I had to put stickers on my nipples which pulled like hell when I took them off. All in all, it was on the unpleasant side of neutral, but I got through it because I do not have claustrophobia issues. Still, I was wishing I'd had a clonopin before I went. I will have results on Friday when I see Dr. Boob for a pre-surgery follow-up.

I asked the gal if she knew what she was looking for based on the order. She said she had no idea. I asked if it was routine to have an MRI after a cancer diagnosis and before a mastectomy and she said no. Evidently they only do the MRI when the mammogram is crap. I am a little anxious about the results. Because nothing shows up on the mammogram, and the ultra sound can't get all the way down to the chest wall, I'm worried that there may be other lesions that we haven't found yet. Puppies and rainbows, puppies and rainbows, puppies and rainbows. This is really one of the last times we can get bad news. The MRI will also show some of the lymph nodes and it will be good to get a better picture of those as well. Based on the ultra sound, Dr. Boob said they look good, (not cancerous,) but again, we won't know until I'm on the table and the nodes are in the lab.

30 August 2011

The Cancer Card

Life deals out a hand and one has to play with the cards one is given. I used to play no matter what I was dealt. As I matured, I was better able to discern when it was wise to play and when it made sense not to. As the man says, "You've got to know when to hold 'em and when to fold 'em." And as with most card games, it is a combination of luck and skill that determines if one is a winner or a loser.

No one expects to get cancer, no one asks for it. Some people rail against it, "Why me?" Some folks blame God, or their parents (who smoked,) or a corporation for carcinogens in our environment. But the truth is, it is like lightening - it strikes where it strikes according to chance circumstances governed by laws of nature. Billions of cells divide billions of times, nothing is perfect and sometimes they go haywire. <--- not meant as medical advice. :-)


Very few things in our culture trump cancer. It is a 'get out of jail free' card, (sometimes literally.) It is an excuse to hang one's hat on for rudeness or lethargy or anger or self-absorption. It can put you at the front of the line for boarding planes, picking parent teacher conference times, or seeing a busy plastic surgeon. And it can be a very bad thing. Or it can be a very good thing. I was neither expecting nor wanting this card, but I'll be damned if I ain't going to use it.

So I have - to get my contractor to call me back to wrap up projects, to not have to be homeroom mom, to get my windows bumped up on the manufacturer's job list, to garner empathy for my kids from teachers at school while we are going through the stress at home, and to rally a support system. All of those external things are direct manifestations of the circumstance. I need to get the contractors out of the house so I can rest after surgery, the kids need slack because of the stress, and bring on the meal train 'cuz mama ain't cookin'.

So I'm going to play this hand and this card for all that it's worth. It's a shitty hand, but I know I have the skill to make me a winner. The cancer card has allowed me to shrug off the mantle of trivial responsibility I've had as a stay at home mom and to concentrate on something I've ignored for years.... me. I am very self-absorbed right now. I spend my days on fitness, organization, writing, healthcare and naps. I'm still doing laundry and planning/cooking meals, making lunches and getting the kids off to and home from school, but with much less stress than I've experienced in the past. I now see it in its proper role - trivial. More important is spending time with the kids and Dan and taking care of myself.

29 August 2011

My Abbreviated Summer

Fall has come early for me this year. My summer was effectively over, when two weeks ago I was diagnosed. The lazy, hazy crazy days of summer were gone in an instant. I needed the kids to go back to school STAT! I needed to think about all those things that get done in the fall in order to get ready for winter - changing out screens for storm windows, wrapping up house projects, getting the pool painted and winterized, cleaning up the garden, (especially the container farm we have going on the front patio.) Starting up scouts and piano, and soccer, and Chinese lessons. Filling out the forms for school and Sunday School. Paying fees, buying clothes for the kids, planning/making Halloween costumes, thinking about holiday gifts. That's the the level of detail I deal with all the time.

That's the stuff I'm gonna have to let slide.

We probably won't have Halloween decorations up. I'll have to order Halloween costumes on-line, we'll shut down the pool early and my sorry garden will have to be ripped out, the boxes emptied of soil and put in the shed.

I've been walking... a LOT. I find it clears my head, makes me feel good and I know it will help with my recovery to get some exercise in now. I am noticing signs of fall so early this year, like starting mid-August there were brown leaves littering the lawns. Not a huge amount, but here and there, and dead twigs strewn about. And this week there are even more. The squirrels are cheeky as ever, but with more urgency. I'm feeling like winter is already knocking on the door.

I usually really enjoy fall and look forward to winter after a long hot summer. But this year I'm not looking forward to it at all. I don't want summer to be over, despite needing to have the girls back in a routine that allows me to focus on me and get to doctor appointments. I'm worried that fall will also be abbreviated. I feel rushed and anxious about the season to come and I'm not ready for my winter.

28 August 2011

It's Cancer Limerick Sunday!

At first I was really scared
But now there's good news to share
With two drainage tubes
I'll get rid of my boobs
And I don't really care about hair
======
I'm getting so much satisfaction out of this blog. So far the ideas are coming fast and furious and I have so much to say. I keep starting pages to post later and then having difficulty choosing which to post on any given day since I love what I'm writing. Evidently, cancer cures writers block.

For many years now, the people who are closest to me have told me that I should write. And I have, here and there:

I write the most awesome letters to companies that have pissed me off or exceeded my expectations and I usually get resolution on issues or cool free stuff.

I've written blogs about the kids or the house from which I've had good positive feedback.

I write lovely letters and emails to people.

However I've not really felt that I've had a voice. But now I have found a voice with this diagnosis and it just won't shut up. I found my voice to say no to things that are not important to me. I am also able to say no to things that are important but that I know won't suffer without my input or supervision. I found my voice to advocate for myself. I found my voice to ask for help. I found my voice to tell others how I feel.

Some people tell me that this will be my book. Others feel this will be one small chapter in my book. I'm not looking that far ahead, I'm too busy working towards a happy ending.

27 August 2011

It ain't just a river in Egypt....

I don't feel like I have cancer. I don't feel sick, I'm not scared, and I'm certainly not feeling sorry for myself. I'm reading others' cancer blogs and feeling bad for them... because THEY have CANCER. I was scared before Dr. Boob told me the size of the tumor and gave me her estimate of the stage. But since then, I have refused to think of this as life threatening. I'm strong, stubborn and irritated, and I hope to stay that way. Right from the start I decided to be very aggressive with this. Much to my relief, Dr. Boob suggested a mastectomy instead of a lumpectomy and much to hers, I replied with, "Let's make it a double!" I'm not looking forward to chemo, but if it improves my chance of no recurrence, I'll gladly do it. This attitude has misled some people to feel I may be in denial. It has led most of the cancer survivors I've met so far to tell me I have exactly the right stuff to kick cancer in the taco.

The kids seem to be following my lead on this. I'm pretty upbeat and while I am pushing them to become more independent and telling them that I feel pretty good right now but I will be feeling sicker later, they are handling this pretty well.

But Dan can't. He is really genuinely scared and while this has come at a pretty good time for me, (kids are getting to be more independent, both of them are in all day school, I've been working towards finally getting in shape this summer so I'm ironically healthier than I've been in years,) it's come at a bad time for him, (changes at work, a couple of years of less-than-ideal health for him, a pet side-project stalling.)

That being said, he told me a couple of weeks ago that while he would never wish for something like this to happen, he looks at it as a challenge to excel under pressure and rise to the occasion. I would expect nothing less of him, as he has always picked me up and supported me when I've fallen. He knows what to say to me when I'm freaking out, he inspires me to be the best that I can be and helps enable that inclination. He's got my back.

Mr. Science has also allowed me to lead as we move through the decision making process, only chiming in when he feels I might be getting too emotional with my assessments, which is probably a good thing. We are for the most part on the same page when it comes to the treatment plan. He was hesitant to seek a second opinion from a different plastic surgeon because he feels as though we have no time. Since my MRI got pushed back a week, I feel like we do have time. We have all the time in the world, because I'm not going anywhere.

About a week ago he asked me what I want to live for. I wasn't ready for the question. I am now. For us.

26 August 2011

Sharin' and Carin'

The two Breast Care Coordinators at Kettering Health Network (my hospital) are named Sharon and Karen. How fricken' perfect is that? I was a little put off by the idea of the breast cancer class, because I'm pretty good at doing my own research, but I'm also a follower of directions in that if someone says "Take this class" (like the breast surgeon said,) I'm going to do it. I was just hoping it wasn't going to be all pink and huggy.

So on Thursday I dutifully attended my "Navigating The Breast Cancer Journey Class" I was the only patient there. There were two breast cancer survivors present for moral support, as well as Sharon, but they figured out pretty quickly that I had my shit together. We basically skipped over the portions of the power point dealing with advocating for yourself and setting up a support network. (More on that later.)

We also skipped over the portions where I get a biopsy and get diagnosed and look at the treatment options, pick a surgeon, learn about mastectomy and research reconstruction. Cause I've already done all that. So we sailed through most of the course but she ended up giving me almost more than I could carry out of there. The coordinator did her best to provide me with stuff that wasn't pink. Pillows and literature and scrapbooks, Oh My! I was staggering under the weight of it all. Luckily it's not all for me. I'm going to spread the love with some assigned reading for Dan and the kids. There's something for everyone!


And speaking of everyone, we continue to receive well-wishes and offers of help. And I now have my very own volunteer coordinator to match my needs with the many offers we've received. She's going to work something out with a google calendar or a link to my blog or something to make it easy for me to indicate if/when I need help with the kids, errands, meals etc. That should be up and running in a few days.

Dan has indicated that in my desire to post every day, the quality of my writing is suffering. I had to remind him that I'm not really doing this for my audience. I'm writing for me because it helps me sort out my thoughts on this. It helps me to follow each train to where it leads without losing sight of it. It creates a historical record of how I'm feeling, when and how I made decisions in my treatment, documents what is happening to me physically and emotionally and, oh yeah, it also helps others to keep abreast (pun intended,) of my situation in a way that is convenient to both the reader and me. I write when I feel like it, you read when you feel like it. Frankly, it's working for me.

25 August 2011

So how are we doing?

Here's a little up-date on how we all are doing, because it's like the whole family has cancer, not just me.

N - (7 year old) Acting out a bit, but honestly I can't tell if it's because she's anxious about starting second grade or if it's because I'm sick. (Although I suspect it's the former since I'm not really sick yet.) She did, however, ask me the other day if I thought she or her sister were going to get cancer - in an either/or scenario, as though one of them HAD to have it. Because I am now BRCA negative, I was happy to tell her that there are things we can do to lower the risk and because that risk is no higher for them than if I didn't have cancer, it's probable that neither of them will have it!

M - (9 year old) She is a little more thoughtful and appears to be internalizing what is going on. She has of late begun to come up to me and give me hugs, something her Drama 'Tween persona would not have allowed three weeks ago. She knows this is what killed my mom and had genuine fear about what will happen to me. She can tell when they are driving me crazy with their constant bickering and will back down to keep the peace, although she still ignores most of what I say as pertains to chores.


Dan - (Husband) A little history here. The last time someone he loved had cancer they died of it swiftly and turned his world upside down. That is his experience. Add to this a personality that is loathe to NOT be in control and you can see how this is turning into a difficult situation for him.

Dan and I handle things quite differently. Our strengths and weaknesses are generally very complimentary. But when he is stressed, he becomes somewhat emotionally needy, and when I am stressed, I detach. At first glance, it sounds like this incompatibility is going to kill us. But really, how would it look if we both became emotionally needy or if we both detached? I'm quite confident that with him consciously seeking emotional closeness from me along with other sources and with me stepping up and reaching out to him, we'll get through this ok. I told him I wouldn't be able to meet him in the middle but we are taking steps to get both of us what we need.

We are both concerned about the kids, but feel that by downplaying this and carrying on business as usual, they will sail through unscathed.

Support is pouring in from all sides. We are thankful.

Yesterday I got my hair cut. Based on the feedback I've received, some people get it, some people think they get it, and some people don't get it at all. I cut my hair for many reasons:
I feel different, so I want to look different.
I wanted to control something - it looks like I will have chemo and this haircut is a strong signal of what is to come, but on MY terms.
It's simply practical - I won't be able to effectively brush or dry long hair for 4 weeks after surgery, and I'm not going to want to deal with it.
This is merely phase one - I've always had a secret desire to shave my head.

24 August 2011

All is right with the world!* (*within reason.)

I had my regular appointment scheduled with my primary physician this morning. It was time for my yearly PAP. Go figure. I told her she'd better not find anything. (And she skipped the breast exam.)

She asked how I was doing and I told her about my meeting with Two-Drain and she immediately validated me by saying that OF COURSE I should go for a second opinion. We talked about the surgeon, and also about my choice of Oncologist. Apparently I've fingered a VERY popular oncologist and so she gave me the name of another one she likes, just in case my first choice is booked. (like in Vegas, when you can't get into the hotel you want, right?)

Now BEFORE I saw my doc, I called Dr. Boob, my breast surgeon, and told them that my meeting with Two-Drain did not go well. At least from my point of view, and as far as I figure it, my opinion still matters at this point. I'm waiting to hear back from their office for a second referral, hopefully for a female doc. You know, one who maybe has boobs and can relate to me a little better. That was good news, but this is even better... when I called the nurse told me she was about to call me because the BRCA results are in and I AM NEGATIVE!!!!! This is not only good news for me, but also for my sisters, my nieces my nephews and my kids! So we can now roll on, full steam ahead without worrying about getting a gynecological oncologist involved.

It's already Wednesday and Dr. Boob wanted me to have an MRI and I haven't heard back from them yet. When I called yesterday, they indicated that they did not receive pre-authorization from Tricare yet. I've been kind of holding off scheduling stuff this week because I need to get the MRI scheduled. Well, holding off on stuff other than the plastic surgeon, my primary care doc, a haircut, my how-to-have-cancer class and I'm looking to go to the gym and get a massage on Friday. But you know, other stuff is just going to have to wait!

I've had long hair for a while. My profile picture here was taken about 4 or 5 years ago and captures how I feel right now, but my 7 year old can't remember a time when Mom didn't have long hair. I got my hair cut very short for no other reason than I don't want to have to deal with it when I start to feel sick. I'm also anticipating chemo. This was my way of starting to prepare for the inevitable. It's a very palpable change that I am in control of when I am facing so many others that will be out of my control. My daughter had a hissy fit and told me it made me look stupid. Never fear, I'm not taking fashion advice from a kid who still matches clothes based on "They are both blu-ish."

23 August 2011

A small introduction.

When Dan and I met with Dr. Boob, we had our usual vaudeville act going. (He's the straight man.) As the doc was describing the mastectomy procedure, she drew what the incision would look like (direction and size on the boob she had drawn on the page,) and arrows for taking out the breast tissue and then a line for where the scar would be and she drew two drains. Drains are the tubes they put in after major surgery to ensure that fluid doesn't accumulate at the surgery site. (Enough about that, I'm sure I'll have MUCH more to say about it after my surgery.)
She explained that Dr. S_____ likes to put in two drains, to which Dan replied, "Well, that's why they call him Two-Drain S_____."

Ever since then, we've referred to my reconstrution surgeon as "Two-Drain."

I'm furiously reading about breast reconstruction methods. I do have a couple of good books coming, but I've been reading blogs and websites and I've come to two conclusions. First, there is no good information on-line, since most information sites about specific methods that I've come across are either sponsored by some drug company promoting their method/product. Or it's a plastic surgeons' website that is promoting the method they've decided to specialize in. And second, it wouldn't really matter since every case is different and so what worked for someone else in my exact situation, (double mast, dcis/invasive, etc.) may still be the wrong decision for me.


Sunday's conversation with Kim, my sister:
K: Whatcha doing?
Me: Reading about breast reconstruction. My new hobby.
K: Your new hobby is breast reconstruction?
Me: Nope, my new hobby is reading about it.
(Ba-dum-bump!)

=====

So today I met with Two-Drain. I have VERY mixed feelings about him. He did a very quick analysis of my situation and came to pretty set conclusions, without consulting with me at all. He sounds like he really knows what he's doing, but I found him to be extremely patronizing.


He is recommending expanders and implants, (of his choosing.) When I asked what size, he assured me they could be as large as I wanted. When I mentioned I'd like to be significantly smaller than I am now he discouraged it, telling me that I would not be happy being smaller because it wouldn't look right. You know, I have a pretty small frame when I'm not 30 pounds overweight and I'm thinking 4 - 6 months of chemo is probably going to slim me down a little. I've always had big boobs, along with the leers, backaches and painful bouncing exercise creates. When I am slim, I am a 32 d or dd. How can that be 'right' for my frame? Unless, of course, one values big boobs.

But where I am now in my life is not there. Getting another pair to match the ones I have seems both vain, and oddly enough inauthentic. I went into this consultation not sure if I even wanted reconstruction beyond a wound closure with healthy functioning chest muscles. He didn't even let me entertain that idea, dismissing me with a "I've never done that before, why would you do that, you don't want to do that."
I'm feeling a little put off.


So in addition to him being the expert of what I need physically, Two-Drain also seems to think he knows what I need emotionally.

Dan, on the other hand, had a great rapport with the guy and was happy with what he had to say. Do you see where this is going?


I came out of today's appointment feeling manipulated and for the first time in a week, as though I was no longer in charge of what's going on with my body. I think I need a second opinion.

22 August 2011

What's in a name?

One of the secrets of life is to make stepping stones out of stumbling blocks. ~Jack Penn

This quote could have been the inspiration for my blog name... but it isn't. A friend sent me this quote when she saw the name of my blog. Doesn't it fit beautifully with what I'm doing here?


I chose the name Stepping Stones because that is what it feels like to me. As cliched as it sounds, it does feel like a journey, as though I'm on the shore of a lake and I see a stepping stone. I step onto it, and while I know there are other stones in front of me, I'm not sure which path will take me to the other side of this wide black lake. I can see the other shore, but I can't get there from here until the next step presents itself and becomes visible. So for once I am NOT charging ahead. Instead I'm doing research on the many different choices I have in front of me and I'm pretty patiently waiting for test results, doctor appointments and other answers to my questions whether by email to friends who have been on this journey or through blogs and other literature. I'm currently waiting to hear back from the 'Breast Care Coordinator' at Kettering, to see when is their next available 'Navigating the Breast Cancer Journey' class. (I bet you $10 and a healthy boob there will be pink involved.)

Whether it's test results or doctor appointments for advice/options, I am at the mercy of time, which is not a good feeling since I'm in a rather time-sensitive situation. OK, this graphic is kind of dramatic, and I must say, with the breathing room Dr. Boob gave us last week, I do not feel I am hurting my chances of recovery by waiting for a few more weeks to have surgery. If I had local access to a comprehensive cancer center, (Markey Center at UK, James Center at the OSU,) I would probably already be prepped, waiting to roll on in to the OR. But I feel my decision to deal with this aggressively, along with my willingness and acceptance of drastic measures will be protection enough against recurrence.

21 August 2011

It is Cancer Limerick Sunday!

I'm thinking of future and past
Assembling my team and my cast
Looking for answers
About my damn cancers
But no information comes fast.

======
Hey friends and family, have I told you lately how much I love you? I have to give a shout out to my support community.


As soon as I got my positive biopsy results, I immediately posted to facebook, asking local peeps for cancer doc recommendations, and also emailed the Moms of Oakwood requesting recommendations from them as well. Several of our Moms members have had cancer in the years since the club was formed. We are active in fundraising for cancer research through Relay for Life and Carewalk and whenever anyone in town has a challenge like this, the Moms Club organizes volunteers for meals, childcare etc.

Recommendations and offers of help began pouring in almost immediately. In fact from my Facebook posts, Blog, Mom's Club email and folks I saw/told at the Harman open house, I'd say that pretty well everyone knows and I have been overwhelmed at the generous offers of assistance.

I have prayers and good healing thoughts coming from all over the country and beyond but where the rubber meets the road is who is going to walk the girls home after school and get them started on homework on Tuesday when I meet with the plastic surgeon? (By the way, I'm meeting with the plastic surgeon on Tuesday.)

Numerous friends have offered to watch the girls for me when I have appointments or just need some time for me. (Like when I'm shopping for nipples online? How do I explain that to a 7 year old?!?) My sisters and sister-in-law have offered to come help out when I have surgery. Food has already arrived!

Dan and I are humbled by your heartfelt wishes and pledges of support and I feel very, very grateful. Thank you!

(I was looking for a nice thank you image and I found this. OK, this picture embodies about everything I hate in the cancer world. It is so bad I had to use it. First of all, it's PINK. From the cliched rose to the jewel drops that look like boobs, it's simply hideous. And if you are the designer, I'm sorry if I hurt your feelings, but please, try a little originality next time.)

20 August 2011

The good things about my nodule. (How to be positive about Cancer.)

When Dan and I were sitting in the breast surgeons office waiting for her to come in, we talked a little. I lamented that I hadn't seen the doctor sooner. The change in boob left had been apparent for a pretty long time. Maybe a year? Maybe more? But I had mammograms and they came back normal and so I didn't worry about it. He said that he had noticed it within the last 6 months and scolded himself for not pushing me to go to the doctor about it. We were pretty bummed about the prospect that it had been growing for some time.

When Dr. Boob came in, we told her the whole sad story, plus guilt. I mentioned that I should have pushed my doctor to prescribe an ultrasound, instead of just a mammogram and she put our minds at ease that there was no doctor in the world who would have done that without more cause than just, "Nice rack." The mammogram is the first line of defense and unless there is some other kind of symptom, I wouldn't have been able to get an ultrasound.On my mammogram from last week with the titanium marker, the mass is still virtually invisible. It's only slightly better on the ultrasound. If I hadn't been able to pinpoint the problem for them, they likely would not have found it.

The geographical location of the mass is another positive thing. What tipped me off was that my nipple looked funny. It had retracted on one side, which made it all askew. (See Marty Feldman reference.) If I didn't have that adhesion action going so close to the surface I NEVER would have found it. Also, just in case I had any vanity driven illusions about a lumpectomy, the fact that the culprit is so close to the nipple indicates that the bulls eye has to go. And heck, if that's the case, you may as well take it all and I won't have to worry so much about a recurrence. (You know, the thing that killed my mom.) And I am leaning towards a bi-lateral, so whatever I decide to do, (reconstruction or no,) I will have a matched set.

My cancer is estrogen and progesterone receptor positive. That means it responds well to hormone therapy, which is the least toxic to other parts of me. We are still waiting on the HER2/neu status from the biopsy. If it's positive, we have another tool to fight it, (although it also means it's aggressive, so we'll be having to manage a greater recurrence risk.)

My nodule is small, 1.5 x 1 cm. Which based on my anecdotal history (maybe a year since I noticed something??) means it's slow growing. And that means it may not have had the chance to be mature or aggressive enough to metastasize.

And lastly, Thursday evening I attended the open house for Harman Elementary. For the first time in forever I was able to walk from sign-up sheet to sign-up sheet with no guilt what-so-ever. I've cleared my schedule and calendar and I feel great about it. No one is going to call me to volunteer for ANYTHING this year. I am giddy with freedom.

19 August 2011

Many of you have asked, "How are you feeling?"

While Dan remains cautiously optimistic, I am feeling VERY positive about this. I think that's the way the roles are going to have to be. Dan needs to reserve a little emotional energy in case we get bad news, because really, he's the one who will have to ultimately deal with the fall-out. I, on the other hand, must think of only puppies and rainbows and will fart butterflies.

Until I hear some horrible news, I'm going to assume all will be well.

Ok, but how am I feeling?

Ever since I got the call last Monday. I can feel that thing in there. It doesn't exactly ache, or tingle, or itch, but I would describe it as more of an uncomfortable awareness. Just sitting here, my right boob feels normal, regular, typical in that I can't really feel it at all. But the left one is screaming "HELLO!! CANCER HERE CALLING YOUR NAME!!!!!" I'm starting to hate that boob.

Which opens a whole other can of worms. I've never really thought of my relationship with 'the girls'. Sure, they've been hanging with me for a long time, but we never really talk, you know?

I've always had an impressive rack. For a while, when I was young and foolish, they defined me. But now that they've done their job, (had some fun, fed some babies,) I feel like they really aren't that important. So I'm really up in the air about whether or not to have reconstructive surgery after we part ways. I'd like to take up running again, sans the heavy duty cannon holder or be able to wear something backless or some of those cute halters.

Is this merely a cosmetic issue, or are there other factors I need to consider? Will I feel unbalanced once the weight is off my chest? Will I feel less feminine? Will people react differently to me? How does society see a boob-less woman? Will it be just as frustrating to find clothes that fit non-existent boobs as it is to find clothes that fit big boobs? Will I finally be able to buy a surplice top or dress?

Don't ask me why... they just never fit me right.

I guess it's time for me to start talking to survivors and reading other's blogs. Feel free to message me if you have some experience with this. I need all the help I can get.

18 August 2011

Today I met with my breast surgeon for the first time. Dan came with me. You know when you go to a doctor for the first time and you have to fill out forms full of really inane questions?

What problem are we seeing you for?
I have breast cancer.
Where is this problem?
Um, in my breast.

Who writes these things?

(Dammit Jim! I'm a doctor, not a form writer!)

So I filled out 5 or 6 pages and then the very good nurse came to get us and did some preliminary stuff, (temp, weight, bp, etc.) and gave me a pink folder full of pink brochures full of information I'm sure I can find from gender neutral colored sources online. The room was pink. I think they are taking it a little too far - like when Miriam, at 20 months, refused to wear anything that wasn't purple. But I digress.

In waddles Dr. Boob, who is VERY pregnant. How can she lean into the table with that basketball in the way? I mean, my boobs are big but they can't compete with a 6 or 7 pound baby. Still, I was willing to listen to what she had to say.

So she shows me my last two mammograms, on which the lump is still barely visible, even with the titanium marker in it. She goes over the pathology report and starts making notes and drawing pictures on a piece of paper. The path report findings show the mass is both estrogen and progesterone receptor positive. That means we will have good results with hormone therapy. We should know in the next few days about the Her-2 status, another way to manage through hormone treatment.

My mass (it's not a tooomah,) is 1.5 cm by 1 cm. It's smaller than I thought, but then again, when I was feeling it, I was also feeling the inflamed tissue surrounding it. She did an exam and reassured us that as far as she could tell, my lymph nodes looked clear and along with the pathology report she felt that we were in an early stage. It was better news than we had expected.

We talked a little bit about risk factors and we told her we definitely wanted the genetic testing done. The BRCA gene is a marker for high risk. With my mom having died of breast cancer, and having several other cases in the previous generations on both sides, along with being of Eastern European (Ashkenazic) Jewish descent, and now with a positive biopsy under the age of 50, I have a likelyhood of having BRCA1 or BRCA2. Having this gene puts me at a 85%(?) risk of developing cancer and greatly increases the risk of recurrence. They did a saliva sample in the office today and it will take 7 - 14 days for results.

The geographical location of the mass simplifies our choices. Dr. Boob recommended a unilateral simple mastectomy with reconstruction. We also discussed a bilateral. I'll be having an MRI for right and left and into the armpits to see the nodes. That will be scheduled next week.

I haven't done any research into reconstruction, and that really wasn't her thang, so any questions I have about that I will direct at gals who have had it done, as well as the plastic surgeon she's setting me up with. I'm really on the fence about it. After years of D cup backaches and never finding a button up blouse that fits, the idea of nothing is pretty intriguing. And a solid B sounds good too.

16 August 2011

Mid-morning, I get another call from Dr. T's office. It's her nurse and she tells me again what Dr. T called about the night before. But this time she gives me the breast surgeon's number and tells me to call them so I do.

Have you ever had to tell a receptionist in a calm voice that you were just diagnosed with cancer and so you need a consultation with the surgeon? It's not as easy as it sounds. Like, without bursting into tears, that is. But I assume they deal with that kind of thing a lot. I let them know my doctor wanted me to see the surgeon THIS WEEK. Like that really matters. They are a cancer practice so every case is an emergency and everybody needs to see the surgeon this week. I get an appointment a day and a half out. Is this a good thing or a bad thing? What's wrong with this surgeon that she's not booked?

I'm not really that worried about it, it's just an initial consult and if I'm not happy I can find a different surgeon. Who am I kidding? I just want this thing out of my boob. If she brought out and ice pack and a ginsu knife tomorrow I'd tell her to go for it.
I need to make sure my mammograms and ultrasounds, as well at the pathology report make it to the surgeon's office for my appointment so I have to call the Breast Evaluation Center to make sure that gets done. Why does it take 5 phone calls? Because medical records suck. No offense to the hardworking file clerks out there, but HIPAA guidelines have seriously complicated their jobs to the point of near stagnation.

Word to my file clerk homies out there.

I tap into my support network, arrange a play date for the kids and shoot my husband an invite via google calendar. I got this.

15 August 2011

Monday I'm walking on eggshells. I'm tied to my phone, waiting for a phone call. I can't concentrate on anything and I'm eating for two - me and my potential cancer. I get the call from Dr. T at a little after 4:00 pm.
She tells me that the biopsy is positive and my heart starts beating really fast and hard. It's so loud in my ears I can't hear her anymore. My mind races forward and I have to force myself to return to the conversation.
I grab a pencil and paper and have to ask her again for the findings. I know Dan is going to want to research this so the Greek-ier the terms, the better. Dr. T is a little confused by the report. There are two findings: Intraductal Carcinoma, in situ AND invasive. She asks if they biopsied more than one mass. Only one was done, but evidently it's a busy little buggar. I ask, "What's the next step?"

She tells me I need a surgeon. I ask for her recommendation and she is hesitant to give me one, suggesting I should ask around to find one I would be happy with. Hmmm, I'm thinking. How do I find a good surgeon? I don't know where to begin. Should I ask them to hold out their hands so I can see if they shake? I tell her that I've been satisfied with her past recommendations so I need a name from her. She refers me to a surgeon at Wright State Physicians. It's a teaching hospital, breast cancer is one of their specialties, yada, yada, yada.
She tells me she'll send my report over to the surgeon in the morning and I should get a call from them tomorrow. And If I don't get a prompt appointment, I need to call her office back because she wants me to see the surgeon this week.
I start sending out emails, phone calls and posts to gather my support system. And I google my cancer type.

11 August 2011

I show up bright and early for my biopsy. I get lost again. For those of you who know me, you understand what this means. I NEVER get lost. I'm beginning to think I'm in denial. I finally end up asking someone in the hospital where the heck the office is. I sign in and wait. My appointment was at 7:30. The office opens at 8:00, yet somehow they manage to be over an hour behind. I finally get into the ultrasound room at a quarter to nine. Thank goodness for Text Twist.

The technician is very good, explaining everything and walking me through what is happening/will be happening/will be happening after. In fact, when I think about it everyone I've dealt with so far has been patient, compassionate, professional and skilled.
She starts by doing a whole new ultra sound on the left boob again, focusing on the mass behind my nipple, and then working out from there. And yes, all the same questions, answers. I ask about the multiple storm centers. She tells me they are other masses but they don't look suspicious so they are just going after the one that is irregular. She gets me set up, and gets the doc who is doing the biopsy. The doc comes in and further explains everything again. They double check my name, birth date, which boob they are cutting etc. Everything's a go and they start.

I'm propped on my right side with my left arm over my head, at this angle I can totally see the screen as she's putting the anesthetic needle in, and then the shunts they use to guide the biopsy needle. The doc is having trouble pushing through the mass - it's very fibrous, and I'm imagining this type of thing, (see pic) and she manages to do 7 passes. When they are done, they insert a small titanium clip into the mass so they know where it is for future reference. She sends me over for another mammogram so they can verify the clip placement.

Ironically it shows up as a pink ribbon shape.

The technician is kind enough to show me the samples, which look like half inch long white worms floating in the sterile solution. She also shows me how the biopsy needle works and by the way, those are some freaking huge needles. I'm glad she didn't show me before the procedure. I get dressed, go over post care with the technician and she tells me I should have findings in 3 - 5 business days.
I stuff an ice pack in my bra and immediately drive to a jewelry store to buy myself a pair of new earrings. Nice, no?