AQ vs. BC

The days after surgery are a bit of a blur, by the time you get home, get settled into your own bed, and start taking pain medication, you start to feel pretty decent. I decided to wean off the Percocet a couple of days ago and may have experienced some withdrawal symptoms (nausea mostly). Also because you aren’t sleeping as much without the Percocet, you have more time to think and reflect on what happened.

I have never liked change much, but I always forced myself to make changes that I think will bring about positive outcomes (there is nothing worse than stagnation, I have never stood for that). This change to my body is harder than I thought it would be to accept. While, of course having the cancer removed is a major positive outcome, I don’t really feel like I had cancer (that denial thing again?), so what I am left with is a chest that feels foreign and so wrong, and it makes it hard to see the positive outcomes. Honestly, it’s really scary. I know it’s work in progress, but right now I don’t want to look at it. Showering used to be one of my favorite things to do (I know showering before bed and in the morning is excessive, but it is a nice ritual that I enjoyed). Showering now is a little traumatic, I can’t really feel the water hitting my chest and I am really not comfortatable looking at, or touching that area of my body. I still have drains hanging off the edges of my armpits that really disgust me. I went to the Dr. today hoping the drains could be removed, but have to keep them in until Monday, when she will check them again. Fingers crossed Monday will be the day they come out.

I also got a call from my surgeon this week. The full pathology came back and because of the lymph node involvement she suggested the possibility of radiation and chemotherapy. I was pretty bummed out to hear about the radiation. I was scared about the chemo but thought I was probably not going to get away from this thing without getting chemo. I didn’t think radiation was in the mix, and I know radiation delays reconstruction and makes it harder to work with the skin to put the implants in. The extenders that are in place under the skin feel a lot more foreign than the permanent implants, so I was hoping to get those swapped out as soon as possible.

My spirits are pretty low (actually lower yesterday, but a little better today). I knew this wasn’t going to be easy, and as my friend Andrea reminded me last night, none of this is permanent, so just remember that these things will pass. This was about the best advice I could have heard. Thanks AZ.

Well my body, my mind, my journey, it’s a work in progress. Still wishing love, peace, happiness and health to all my friends and family. Thanks to everyone for all the positive notes, cards and gifts.

Well post surgery got a little dicey. The surgery itself went well. I do have a very small trace amount of cancer in one lymph node (not what I wanted to hear but from what I have been told it’s almost like no lymph node involvement because it’s such a trace amount), we will know more about what that means once the full pathology report comes back and I meet with a medical oncologist.

Once the anesthesia wore off and all my visitors were gone, I had what could be described as one of the worst nights of my life. The nurses didn’t follow the Doctors orders to give me 2 percocets every 4 hours, instead giving me morphine in my IV only when I rang the bell telling them my pain was probably a “15” on a scale of 1-10. I later learned that the morphine only lasted for abut 15 minutes, so I basically had a double mastectomy and then spent one night without pain medication. Every time I got up to go to the bathroom It felt like I was being stabbed in the chest with red hot knives and they were being twisted and turned. Luckily my mom spent the night with me, but I basically verbally abused her all night screaming in pain. The good news is that that night is behind me, and the more days that go by the more distant the memory is. Sorry all, the blog can’t be all uplifting. I am really hoping that was the lowest point i will hit.

Right before they wheeled me in for surgery, I was given some magical drugs, and the whole thing didn’t seem so bad! Pictures below…I actually look kind of stoked (ridiculous).

Today is the most exhausted I have felt since I was diagnosed with breast cancer on May 26. I think adrenaline has been keeping me sharp and focused on getting all the tests done and lining everything up for tomorrow’s surgery. Now that it is upon me, and there is nothing left to do but show up tomorrow, I feel mentally and physically drained. Doubts and fears are creeping in about the whole thing and I feel a sadness thinking about this being the last night with my body looking and feeling the way it does now. I know I will have a new normal, but it will take a while to adjust. I am scheduled to arrive at Sibley at 5:30am for prep, with surgery scheduled for 7:30am. I should be coming out of surgery around 12pm and will spend the night at Sibley on Wed. night and come home on Thurs. I am praying that all goes well and that my lymph nodes are clear. This whole thing is surreal.

I had a physical exam today and my pulse clocked in at 112 beats per minute…I am just a tad anxious. I also had some radioactive dye injected into 4 areas of my left breast that will travel to my lymph nodes so that the surgeon can identify them tomorrow. The doctor walked in with a little yellow chest marked radioactive material. I turned away and stared up into a blinding fluorescent light. I felt like breaking down and crying but I held it together. He asked me if I was OK, and I nodded, he smiled, patted my shoulder and said I would be in good hands tomorrow with Dr. Magnant.

When I arrived home there was a beautiful bouquet of flowers on my doorstep from my fellow “spots” at Threespot where I work. The timing of their arrival was perfect and really reminded me again how much love and support I have. As one of my favorite relatives told me from way up in Cape Cod, she would be “in my pocket” tomorrow. I know I have so many friends in my pocket tomorrow giving me strength and keeping me safe. I love you all.

My dad just left and gave me a big hug and I broke down crying for the first time in a while. Dad, I remember happy things like walking hand in hand with you looking for “signs of spring” and building Max’s doghouse. I am looking forward to getting past this and doing more happy things with you. I love you dad. (Of course, this last paragraph is dedicated to my Dad, but there will be plenty more paragraphs dedicated to my “skeleton crew” through this whole process).

Side note: I gave Tiggy a really cold bath with a garden hose on Sunday and now he has what they call “Limber,” “Cold,” or “Dead” tail. Its a little bent at the top, painful and he can’t sit or wag it. It is relatively benign and will clear up in a week or so, but he is on pain medication and an anti-inflammatory. Now we can both look pathetic together while we recuperate. He had to steal my thunder!

Al & Dad Building Max's Doghouse

The mornings are the worst. You are laying there alone with your thoughts. Fear seems to wrap me like a tight blanket. If I go back to sleep, I can relax again as my mind lets go. It is tempting to sleep all day. I know that the dog is waiting for me downstairs. Once I set myself in motion, things get better. I head downstairs, and Tiggy crouches down with his tail wagging. He likes when you sneak up on him, his tail wags furiously. As I approach, he pops up and then performs the perfect “downward dog.”  The mornings are probably the best for him because he knows breakfast is quickly approaching.

I am on Day 3 of an antibiotic to fight a sinus infection. I woke up feeling kind of off and it makes me worry a little bit because I want to be in tip-top shape for surgery on Wed. morning. If I get really sick, it will delay the surgery which I don’t want. I have never had major surgery or been under anesthesia before. I wish I hadn’t watched a Discovery Health episode where a lady was put under and could hear and feel everything but couldn’t move. I mentioned this to my dad and he said I should worry more about an asteroid hitting the earth than that happening to me under anesthesia. This makes me feel better.

My coworker, Tony, stopped by to bring me homemade bread and chili. He pulled up in his little mini Cooper and I just couldn’t help but think, “Wow, he spent part of his weekend cooking and delivering a meal to me”… so incredibly nice. I feel like I should be doing something for him because he is going to be picking up a lot of extra slack while I am out.

OK, I’m off to Annapolis to let the dog swim and give him a bath. My dad cooked some lamb, mashed potatoes and greens.

I know the picture below is random, but this is what I feel like posting.

Jim attempts to clean something from Mr. T's eye. I like this picture becuase you can see Tiggy's personality coming through in it. This was in the Fall, my favorite time of year.

Who would have ever thought I would be going to a plastic surgeon to look at breast implant options?!! Life really is weird and unpredictable. On June 9,  Jim and I met with Dr. Huang in Bethesda to talk about breast reconstruction options.

Dr. Huang took one look at me and agreed with Dr. Magnant that I was too small for the “tummy tuck” option where they use skin from your belly to reconstruct your breasts. I would be a good candidate for saline implants, but would start with extenders at the time of the mastectomy (in case radiation or chemotherapy needs to be done, you don’t want to get your implants until treatment is complete. The extenders will hold the shape of the skin until you are ready for the permanent implant to be put in place.)

Dr. Huang takes us into a room for my photo shoot. I get compliments on my perfectly symmetrical “perky” C-cup boobs. This might sound vain, but what a waste of a good set! It really seems like a shame to remove them in their prime. If they were saggier or more unattractive, maybe the implants would actually seem like a bonus. Oh well, a friend reminded me that they wouldn’t stay this way forever, and now they can remain perky into my post menopausal years (weird).

I dressed, and we went back to Dr. Huang’s office to look at photos. I was surprised to see how good her work looked. Especially the nipple reconstruction. She makes an incision in the skin and almost folds it like origami to make a little nipple. Then a tattoo artist shades it in. It looks real. I can’t help but think this is the first stage of becoming some sort of cyborg.

Dr. Huang has one more suprise for me. “How would you feel about going into surgery soon?” “How soon I asked.” “Wed. morning.” she replied. Holy shit, here we go.

Dr. Zuurbier sure knows how to read those mammogram films. The test results came back just as she thought they would. (Note to all women reading this in the DC area:  I highly recommend Dr. Zuurbier at Sibley; she is the best.)

The results:

• Ductal Carcinoma In Situ (DCIS), or Intraductal Carcinoma, which is breast cancer in the lining of the milk ducts that has not yet invaded nearby tissues in the left breast.
• Invasive Ductal Carcinoma (IDC) in the area where Dr. Zuurbier was looking at the 1.3 centimeter mass in the left breast.
• The tumor is 100% Estrogen Receptor Positive and 60% Progestin Positive. (Um, 14 years on the pill probably didn’t help…So long, birth control.)
• A clear bill of health for the right breast (the MRI saw something suspicious, but it turned out to be nothing).
• No lymph node involvement seen on the mammograms, MRI, sonograms and Pet Scan. Good, please stay that way.
• A clear Pet Scan. (OK, so when they scan your whole body, you are thinking they are going to find something else lingering somewhere…phew.)
• Genetic Testing Results were negative. I don’t carry the BRCA1 or BRCA2 genes.

The treatment plan:

• Double mastectomy with partial reconstruction (saline extenders inserted) done at the time of surgery. (Sorry right breast, I know you are just an innocent bystander, but I am trying to do the breast cancer thing only this one time.)
• Chemo? Radiation? I will know more about this after the full pathology report comes back after surgery.
• Reconstruction. I will be getting silicone implants and nipple reconstruction (yes I said nipple reconstruction, since the cancer is in my milk ducts the poor nipple takes the hit too, and since I like symmetry, adios to the right nipple too.)
• Live life well without cancer.

Finding out you have cancer is the first step. Then there are a lot of steps to see exactly what you are dealing with. This means you have to have tests, lots of them.

Here is what was performed:

• 2 Core Biopsies
• 1 MRI
• 4 Mammograms
• 2 Markers Inserted
• 2 Breast Exams
• 1 Pet Scan (this was my least favorite by far, think getting stuck in small pipe after drinking a gallon of some nauseating liquid and being injected with radioactive dye.)
• Blood work drawn for genetic testing

After finding out I had cancer, I spent several days at home surrounded by close friends and family. I basically cried for 2 days straight. I am not going to go into too much detail about this time, but I will say that I have an amazing family, including two sisters in Andrea and Dart. All the support and love I feel is really the silver lining.

My mom and I were shuffled off to meet the “Nurse Navigator” who would scrape us up off the floor if we collapsed. We holed up in her office crying and wondering what was going to happen next.

Dr. Zuurbier was on a mission to keep things rolling for me. “Anything we can do today, we are going to do!” She went to set up for a sonogram-guided core biopsy of my left breast and then brought me back to the exam room for the procedure. I usually don’t like needles at all (I have been known to pass out cold), but I curled up on my side and went into a zen-like state while Dr. Zurbier injected the area with a numbing agent. Once I was numb, she started to dig into the side of my left breast. I could feel the pulling and tugging, and then Dr. Zuurbier commented “Gosh, I need a hammer and chisel to get through this dense breast tissue!” That was a mental image I could have done without. My mom was in the room this time and rubbed my legs while I stared off into space.  I seemed to be tapping into some inner strength that I didn’t know was there.

Dr. Zuurbier set off to find Dr. Colette Magnant, a top Breast Surgeon and
Director of the Sullivan Center’s Breast Cancer Program to see if she could get me on her schedule. A few minutes later, Dr. Magnant walked in, handed me her card, and said she had set up an apppoiment with me for the following Tuesday.  As luck would have it, we later found out that Dr. Magnant is a good friend of some very old close friends of ours (always nice to have a glowing reccomendation from someone you trust). Things seemed to be falling into place.

By the end of the day, I found out I had breast cancer, had a biopsy, got an appointment with a top surgeon, and was scheduled for an MRI and genetic testing.

We wrapped for the day, and I called my husband, Jim, to give  him the news. He was stunned and grabbed a cab to come meet me at Sibley.

Traffic was too heavy to drive home once Jim arrived, so we headed to dinner at an Indian Restaurant. I felt like I was in a weird dream. Did all that really just happen? Later that night, Jim and I sat in the living room. Jim said, “I don’t feel like you really have this.” I felt the same way. I guess that’s called denial.