Wednesday, October 16, 2013

RECEIVED THE "ALL CLEAR" FROM MY DOCTOR!


Lymph Node biopsy:  Benign

Surrounding Tissue (margins):  Benign

Happy Girl!  Had some celebratory champagne!

Sunday, October 6, 2013

WELCOME, FALL! What I Did on My Summer Vacation.

Welcome, Fall!!!  The Santa Anas have been around for a few days; the proof is on the Kleenex tissue in the morning.  TMI.  Dry nose, dry legs, dry mouth, dry eyes.  This will pass, though, and we will be greeted with brisk, chilly mornings and bright, clear days - watching colorful leaves skip across the sidewalk and enjoying the smell of cozy fires burning in fireplaces in the neighborhood.  It is my goal to turn my house into a Halloween house of horrors by end of weekend.  I so love the arrival of Fall .

It was an interesting summer, to say the least.  Lots of fun activities and events in the beautiful outdoors!  Concerts in the park - Ladera Ranch, Dana Point, Aliso Viejo.. Days at the beach - Crystal Cove State Park and "refreshments" at The Beachcomber Cafe.. Camping with the family at Doheny Beach.. many trips to the OCFair and summer concerts - The GoGo's, Roger Daltrey, Weezer..

August is a blur.  I decided to get caught up on all of my health screening appointments including my first Colonoscopy.  OB/GYN exam, PAP, Blood Tests, Mammogram, Dermotologist checkup, the lovely pre-exam Prep followed by Colonoscopy - check, check, check, and check, all clear.  Oops.  Called back for follow-up Mammo and ultrasound.  This happened with my first Mammo (horrified now to say that I'd had only one at age 40 and I am now 52) and the ultrasound showed only fluid filled cysts and all clear!  Surely this is the same, right?  Um, we need to do a biopsy on this.  Fuck.  The ultrasound tech and the radiologist have zero Poker Face skills.  I could see it on their faces that it wasn't good - but I was still trying to keep the upper hand on vulnerability and keep a positive attitude until all the facts were known.  OK, back in a few days to do the biopsy.






A lot of nervous waiting involved in this process but the biopsy was a piece of cake, no real discomfort or after effects.  Now an excrutiating two days waiting to receive the pathology report.  They won't tell you over the phone; it all has to be way more dramatic than that.  So, I was a zombie for those days.  No one knows anything about this yet, aside from two girlfriends at work.  My appointment is first thing in the morning, 7:45.  I make the drive from home to the imaging center, stomach and heart and a number of other organs in my throat.  Rather dizzy with anxiety, I make the walk from the parking lot to the imaging center; trying to manage my anxiety with various affirmations, meditative practices - trying to stay centered and composed and "behind" the fear.  I manage to get my name out correctly to the receptionist and I let her know I am here for biopsy results.  


It's all a little fuzzy, but here's how I remember it going down:   The "nurse navigator/counselor" comes out and takes me to a counseling room and leaves to get the radiologist.  Yes, Ms. No Poker Face returns with a sheet of paper which is my pathology report.  I don't even remember her saying hello, good morning, who are you? ... nothing.  The nurse navigator and radiologist sit down on the sofa across from where I am sitting and the radiologist just hands me the report and points to the highlighted area and, I am sure, she must have said it's ductal carcinoma, although I do not really remember.  Moderately Infiltrating Ductal Carcinoma associated with Ductal Carcinoma In Situ.  OK.  Wow.  She must have said it's a low to intermediate grade (non-aggressive) tumor approximately 5mm so pretty tiny.  I never felt it, doctor didn't feel it.  Behind dense tissue.  With the new technology, they can now find a 2mm tumor.  Can't really tell you what was said as my memory is fogged with massive doses of adrenaline.  Radiologist leaves and nurse navigator takes me back to her office to discuss the diagnosis. 


I am very composed.  Started asking questions about the size, stage, type of cancer (still don't like even saying that word).  She gives me the first glimmer of hope in saying that it's low grade, ductal cancer, moderately infiltrating beyond the duct.  She says it could very possibly be treated with lumpectomy and radiation.  I hate the thought of radiation.    I remain composed and focused on getting a handle on what I have just been told.  Suddenly, I think - "How am I going to tell my family this?  How am I going to tell my son?"  Breakdown begins.  Nurse navigator starts handing me tissues as I try to mop up the tears right from the eyelid before they even start streaming down my meticulously, mineral powder make-up and blush adorned face.  I am not walking out of here looking like a blubbering, spineless, hysterical, weak person.  I am actually concerned about upsetting the women out there in the waiting room who will have to watch me walk through to exit.  At this highly emotional, scary, dramatic, life changing moment - I am worried about upsetting the women in the waiting room.  

Nurse navigator breaks out a huge notebook and a thick portfolio of information.  She starts going through section by section, page by page, all of the info on treatments, pre-op procedures, sentinel lymph node biopsy, radiation, breast preservation, wire localization - there's a little journal to use, contact sheet for nurse navigators, support group info....  dizzy, dizzy, dizzy.  Do we need to talk about all of this TODAY?  Way too freaking much information, missy.  Then she tells me the binder is for me to take home.  What?  There's also the thick pamphlet from the American Cancer Society.  I don't fucking want that!  Get me out of here.  These people are way too dramatic for me.  In hindsight, they really made a scary, stressful situation even worse with their drama. 

Sunglasses on.  Binder and portfolio in hand, I begin the walk of shame.  Why it felt like a walk of shame?  I guess because you just cannot feel more freaking vulnerable than walking out of the breast imaging center counseling office with arms full of cancer publications wearing sunglasses.  Nurse navigator asks me if I "have anyone at home?"  Um, no.  I live alone.  "But you have friends and family who support you?"  Yes, of course.  .. and I have my dogs.  Geez.  I am not weak and I am not dying!  I make the walk through the waiting room, make the walk out of the building and into the parking structure.  Make the walk to my car.  Toss the binder and portfolio into the back seat - the binder pops open and falls apart. 

Sitting in my car, really falling apart now.  I call a good friend.  She is experienced in this as she works with stage 4 people in really bad shape and brings them back to health with naturopathic treatments and good nutrition.  She is not only a close, treasured friend, but the one I need to tell NOW.   I somehow caught her at a good time to talk.  I manage to get the words out.  She is in shock herself  - "I didn't expect to have to counsel YOU."  Me either, Honey.  Me either.  I read the pathology report to her and she is amazing and comforting and consoling.  She understands the diagnosis to be very treatable and considers me a very lucky girl.  "This is low grade and non-aggressive, the Her2 report (likelihood of spreading and recurrence) is Negative.  Angiolymphatic involvement (involvement in blood vessels and lymphatic system) is Negative.  This just needs to be plucked out!"  I will be forever grateful for her for her wisdom, love, and support at this very frightening moment.

Not sure if I can go into work just yet.  So, I drove home.  Texted my coworkers and let them know I am not sure if I will be in.  Feel free to break the news to the boss(es) for me.  Trying to regain composure.  Doing make up repairs.  I managed to get a grip and went into work around Noon.  Hugged my co workers who I had told.  Not anywhere near ready to talk with the boss(es) just yet.  Glad that I don't have to. 

So, here begins my medical odyssey.  The days and weeks to come prove to be a bit of a scary roller coaster.  I made the calls to family and friends... and made it through the call to my son.  People will tend to follow your lead so I did my best to present the "best possible situation" with the "sunniest of dispositions" - the news will be received with the least amount of fear, worry, and drama as possible, which is what I wanted.  I began to review the lists of breast surgeons provided by the imaging center and also ask for recommendations from my friend who is connected in this area.  I made appointments with two surgeons.  They both presented the same treatment plan with the same very positive attitude for an easy fix.  I opted for the doctor (female breast cancer survivor) who was very close to my home.  She gave me the info about surgery, the Sentinel Lymph Node Biopsy done during surgery, and advised me about a new "research protocol" in radiation treatment called Intra-Operative Radiation Therapy.  This procedure has been used in Europe for over 10 years and has FDA approval for clinical trials and now research here in the U.S.  It has been in research protocol here for between 6-8 years or so.  This is a one-time radiation treatment done following the lumpectomy. 

The Radiation Oncologist inserts a catheter into the lumpectomy bed and the equipment inflates a balloon into the area.  This provides data that is used to program the equipment and calculate the area to be radiated.  The radiation being the most intimidating and scary part of the whole process - this made so much sense to me!  So, I signed up and will be part of the study program for 5 years.  I schedule a consultation with the Radiation Oncologist for the IORT treatment and she is a brilliant and lovely young Indian woman. I get a good vibe from her and she answers all of my questions and eases my concerns about the procedure.

The doctor also advises me that oncological reconstruction may be advised.  After the lumpectomy and radiation, the tissue will shrink and harden and there will most likely be "dimpling" and possibly " turning" of the affected breast.  So, I have a consultation with the plastic surgeon as well and opt for the reconstruction - which includes lift and reduction to achieve symmetry.  

I had a family camping trip planned for the last week in September and I asked the doctor if it is possible to get everything scheduled and have surgery done before my trip?  She said that it might be better to just go and enjoy the camping trip and have surgery the following Monday morning.  So, that's what I did.  With all of the details ironed out, all of the information I need in hand, a better understanding of my treatment plan and all good reports, I am able to relax and move forward in September.  My doctor had also taken blood for the genetic testing  - which came back Negative!  I really feel like the luckiest girl in the world. 

In times of change, discovery, and challenge, I always try to look deeper into the situation to see what lesson lies within.   While I went through many moods and experienced full spectrum emotions, I think the most significant take away for me would be to be open and accepting (open to receive) the love and support offered by loved ones.  I am the one to deal with challenges of any sort - on my own, feeling strong and self-sufficient - often more comfortable offering support to others than asking for it myself.  This has a lot to do with letting go of the need to be in control, learning to trust, learning to receive love.

Rewind to day of diagnosis:  While speaking with my friend about the pathology report, she is a bit shocked that she is the only one who knows about my situation.  I really wanted to wait until I knew what I was dealing with before standing on the rooftops and announcing to my loved ones what was going on - but I get how she would think I should have reached out to SOMEONE.  I took this as a cue to make an appointment with a therapist she had recommended to me months ago.  I was thinking about seeing him about relationship issues I have experienced and, being recently single again, I wanted to be well-equipped to manifest the best possible new relationship in the future.  So, I started that new path as well. 

Three days after the diagnosis, I have a 'first meet date" with an interesting man who came up on my "your matches" list on match.com.  I had actually cancelled my subscription being very weary of the parade of fools I had been meeting.  But, low and behold, under the wire, this one looked different, somehow, so I opted to talk to him on the phone and then meet.  It turned into a six hour date.  Three hours talking at the bar - then moving to a table for dinner for another three hours.  It has been a very welcome distraction getting to know him and after five lovely dates, he seems like a wonderful, intelligent, thoughtful, spiritual, sweet, romantic man who shares many of the same passions in life as I do.  More to follow on this :)

Surgery was six days ago.  Everything went as planned.  I basically had a partial mastectomy; the surgeon removed the tumor and surrounding tissue, the radiation oncologist did the IORT treatment, the plastic surgeon then came in and removed part or most of the radiated area, did some redistributing of tissue to fill in the space, then lifted and reduced other side as well to make the girls match.  I had drain tubes on each side with a bulb on the end to measure and dispose of fluids.  It was an all day ordeal. 

My sister and her boyfriend came to stay the night before surgery as we needed to be there at 8AM.  My  sweet sister was with me the whole day - while her boyfriend stayed home with all of our doggies.  First procedure was nuclear medicine - injection of radioactive tracers and digital imaging to map the lymph nodes.  Next, wire localization procedure.  A mammogram is done and wires inserted to point the surgeon to the exact tumor site and the titanium "marker" which was inserted during biopsy.  Next, surgery center for pre-op questions, forms, I/V, etc.  Plastic surgeon arrives first to mark me up like a tailor doing alterations.  The breast surgeon arrives and we are almost ready.  She tells me that she is only going to remove the "first in line" Sentinel node and send out with tissue for pathology.  This means she is confident enough in an "all clear" report to forego the "freeze section biopsy" during surgery. 

After the RN blows out two veins trying to insert the I/V, she called in another nurse and she got it done in one try.  They have me on a bag of fluids, antibiotic, and just before rolling in to surgery, they give me Benadryl and a sedative.  I feel the cold Benadryl going through my veins and it felt like it went straight to my adrenals in the middle of my stomach.  I told them "I am going to be out before you even give me the anesthesia" and I was.  Last memory is saying bye to my sister as she goes off to waiting area and I'm being wheeled in to surgery. 

Five hours later, I am groggy as hell and trying to wake up.  It takes me about an hour and 1/2 to fully wake and be able to talk.  My sister tells me that I was swearing about the awful taste of chemicals in my mouth and complete dry, cotton mouth.  She is feeding me water through a straw and saltines so that they are sure I am not nauseous before leaving.  They help me to the restroom; I can hardly stand or walk straight.  They put me in a wheelchair and off we go.  I think I was pretty chatty and slurry on the ride home.  We stopped to get food for them (I will have chicken noodle soup before taking my pain meds).  My sister sees a car swerving into other lanes ahead of us.  A drunk driver.  I see him go way into the lane on the right and tell her, "Call 911!  Pull next to him!  Roll down my window!"  We pull next to him and I say, "Are you alright?  You were swerving."   He is clearly intoxicated and gets very rude and irate with me.  He says, "Are YOU alright?  Why don't you go fuck yourself?"  "I am just trying to help you, man."  He says more rude things and we give his license plate to 911 operator as he turns into a neighborhood.  I guess that drug cocktail made me all ballsy.

My sister and her boyfriend stayed to keep me supervised until Tuesday afternoon when I was getting around better and managing my meds.  Today is day 6.  I had my follow-up with the plastic surgeon and he said that I looked fantastic for three days post-op.  He took off those awful drains that had been like my little twin babies for three days.  They were clipped to my surgical "sports" bra to keep them elevated and the pressure off the stitch keeping it in place and, during showers, I had to tie them to a string and put around my neck.  Cute, huh?  I told him that I am avoiding the mirror when getting into the shower - it's all a bit shocking with the ink markings, blood, stitching, all covered with surgical glue.  Just in time for Halloween, it's FrankenBoob! 

Finished with antibiotics, switched to Tylenol and planning to get back to work tomorrow, at least half day.  It's been quite a week.  My boobs seem so small to me, and I am not used to actually seeing my nipples down there.  The doctor assures me that I am still about a D cup and that, once the swelling goes down in a couple weeks, they will "relax" and not look so smashed back into my chest.  : )



I've recently recommitted to writing; something I loved when I was young and hope to reignite my creative self.

This is my first blog.  This is my first blog entry.  I had ice cream for lunch today and, for a snack, a big marshmallow.  I hope to get the creative flow going here and hope that you will enjoy the trip with me.  Thank you for joining me!