Back to the Surgeon

After several days of stalking his office trying to get an appointment finally got in to see Dr R. Does every doctor have two offices? Does that give them more golf course options? The good thing is this office is actually closer to work than his Stone Oak location. Mom had an appointment of her own today so it's just me and Dad this time. Dad is my official note taker for these appointments.

So there are three options on the table:
1. Lumpectomy with lymph node extraction. Chance of local recurrence and probably a very odd looking breast. Radiation is also a probability with this option.
2. Single mastectomy with immediate reconstruction. The odds of the two breasts matching is somewhat low. Also burn the bridge for using the stomach mound for breast tissue should I get cancer in the right breast. That is a one shot deal. Will always have to worry about and closely watch the right breast.
3. Double mastectomy with either implants or the flap surgery (natural tissue) for reconstruction. This option lowers chance of recurrence dramatically as the only breast tissue left is basically the skin. No need to have MRI and ultrasound followups every six months. Also breasts will match. Hey I'm 40and single, it matters.

No matter which option the nipple is gone. Bye-bye. Hasta la vista, baby. Had a nice 40 years together but probably won't make it to 41. I really don't ever want to deal with this again. I used to wonder at women who get perfectly good breasts removed because of the chance of cancer, not any more. Take them, get them both out of here. Now just to decide if I want the expanders or the free tummy tuck.The recovery time for having fat moved from one area to the other is longer, and it's more involved than I thought, as it includes blood vessels to keep the tissue alive. Having expanders with either saline or silicone is the other option, perky breasts for life, but it is not as natural looking as unlike with getting them for enhancement purposes, there is now no breast tissue to hide them behind. They can look a bit, well, bumpy and need additional cosmetic surgery to even out the edges. Insurance companies will cover either as the natural breasts are more expensive on the outset, but do not require long term care (or replacement). 

I decide to go all natural even though it's a 6 hour surgery with a 5-6 day hospital stay. I'm wondering if I'll be in the hospital for my birthday. Oh yeah! Maybe I'll get a candle in my Jell-o. I really don't want to deal with any of this later on though. Besides I'm more of a natural type gal, and oh ya, there's the free tummy tuck. Finally I get something out of this. Next week I get to see plastics. Never thought I'd say that, but my surgeon says these guys at PRMA are experts at reconstruction, that is what they do, it's not a side job for them after nose jobs and butt lifts. Also have an appointment with a gastroenterologist next week as my genetic tests showed a mutation in the gene for colon cancer. I'm so looking forward to having that checked out. I can't wait for 2013 to be over.

Hey Look It's Another Follow-Up Visit

Had a follow-up with Dr B today to go over all the test results. Work has been absolutely crazy (and not in a good way) with the new leadership and I got out a little late to go pick up Mom and get to Stone Oak. Had never been to this office before so actually passed right by it and was about ten minutes late. Of course Dr B is never on time so we still sat around for nearly two hours and then had a ten minute visit. I'm still gaining weight even though I ate nothing but soup for about a week. Not sure how that works. I still blame the steroids but I'm sure the lack of exercise doesn't help. I think I need to go shopping for a fashionable tent to wear. 

Test results were on the positive side. There is no sign that it has spread or any sign that there is any cancer in the lymph nodes. There is no way to tell for sure until they remove some lymph nodes during surgery. The mass has gone from 2.9x2.2x3.0 to 1.3x1.5x1.4 which means it responded to the chemo, but it is impossible to tell what is cancer and what is scar tissue. That will have to wait until surgery. Ah surgery, something to look forward to, ha. I've known it's coming since the start, but that doesn't mean I am looking forward to it. Dr B not willing to take radiation off the table at this point. Will meet with the surgeon next. We will see what our options are. I have an idea of what I want to do in my head, but will wait to see what Dr R has to say.

Follow-up Number Two

Had a MUGA (Multi Gated Acquisition Scan) and a PET scan today. Fist time for both of these. The MUGA was to check my heart, to see if there was any damage done by the chemo drugs. Don't know if there is damage but boy do I get tired just walking up a flight of stairs. I seriously feel damaged. I can't believe how little things make me winded. It'll be a while before Mika and I get back to a couple miles a day let along working out. The body is so stiff that the most basic of Yoga moves is difficult, but I can still touch my toes. At least I'll have plenty of padding to use if I go with the tummy-tuck and reconstruction.

Mom and I spent most of the afternoon at the START Center between the MUGA and PET. The MUGA was first, and the nurse was awesome, being a survivor herself. There really is a feeling of sisterhood between total strangers. We are survivors and while no two journeys are the same there is a now a tie that binds you together. The MUGA is definitely different than an EKG. You lie on your back and basically have a scanner just inches away from your chest and then lie there for about 15 minutes while it takes an image of your heart. It then rotates slightly and takes another image of your heart. Unlike the EKG you can't watch while it works. I had started to doze off when the PA system paged someone, surprised my reaction did not ruin the test.

Went back to the waiting room after the MUGA to wait for the PET. They make up the radio-active tracer specifically for you so you can't go early. The technician pushes the tracer in a vein and then you have to sit in a room for 45-60 minutes and wait for it to work its way through your system. Like so many I have met along this journey the technician was personable and professional, talking me through the whole procedure. Some day someone is going to have to explain to me just how this PET thing works. There are two separate domes and you move in and out of them several times. For some reason the set up reminded me of something you would see out of Star Wars, some hut on Tatooine. The worst part was that there was a gap between the two domes and you ended up staring directly into the ceiling light as you passed from one to the other. Ack! Have yet to figure out why I can nod off during these tests but not sleep at night.

Was exhausted by the time we got home. Didn't help that I had to be fasting for the tests. Not even coffee. Mom walked Mika that night as I was totally useless.

First Follow-up

Had my first post-chemo test today. Had a oh so fun MRI, once we finally got there. Got a little anxious when we got stuck in a major traffic accident on the way. Poor Mom having to put up with me. Good thing I have Google Maps on my phone so I could find an alternate route. We were about 10 minutes late, but I had called and they said no problem. 

The MRI was about as much fun as last time, face down, breasts hanging down, sternum resting on cold bar, arms stretched out front; but this time my technician was a woman so she was able to help position me so it actually wasn't as bad (or the mind forgets pain). Not as much pressure on the sternum. Of course the muscles ached before so it was uncomfortable. Deep yoga breathes. Glad Mom was there to drive home as I felt still by the time it was done. Next is the MUGA and PET, then next week we'll get the test results. No anxiety there.

The Elephant in the Room

So the mastectomy. It's a reality that's been hanging out there for a while but I've been kind of ignoring it will trying to get through the chemo. This weekend in the paper there was a letter in one of the advice columns from a woman who wrote about how her husband hasn't sexually touched her since her mastectomy 10 years ago. That really wasn't had wanted to read, but it is the reality I'm expecting. The last three years my social life has been on hold while working and going to school. There would always be time to date, to enjoy myself even if I never found "the one," even though I'm uh-hum middle-aged. Once you've  had breast cancer, once you've had a mastectomy, how do you date? How do you start a relationship with that reality? What's the protocol for that? Second date "oh by the way this one is fake, the real one tried to kill me." Or is that not til the third date? 

I know that technically the fact that I've had cancer doesn't make it more likely that I will have cancer in the future. There's never any guarantees in life for any of us. But still as much as I pretend nothing will change, it makes a difference in the way I view myself. As much as I pretend it's not a big deal, they are taking a part of my body and that changes things. It's not just fat and tissue although they are welcome to the fat, it is part of what makes us women, it's part of our body image and I can pretend .... well I can't even pretend it doesn't matter, it matters. And if it matters to me how can it not matter to someone else?

Great Expectations

That's the thing about expectations they're expected but not always met. Worked from home Tuesday, then went in on Wednesday. Not sure that was a good idea. The big news of course was that our furlough days have been cut down to six, which means only one more week. Was completely spent by the time I go home. Mom was very concerned as I was barely able to eat anything before heading to bed. Didn't even attempt to work from home on Thursday. Thursday was awful, but made it through work on Friday-barely. 

Throat is as bad as I can remember it being, kept me up part of the night between the pain and the expectorating (learned that word from Beauty & the Beast). Had expected  to feel better today, at least have some energy and be able to eat. Instead I'm barely able to get out of bed and consume some warm water with honey. I really should be working on my dissertation but can't even be bothered to turn the computer on until nearly 4 PM. Oh, congrats to the cohort members who graduated yesterday, you really deserve it. Hoping that will be me this fall. But right now I'm struggling physically and mentally.

Friends and family have been an awesome source of support, even dropping off dinner for Mom and Dad. It looked and smelled awesome, but throat just not up for it. I haven't even touched the chocolate shake Dad got me. So looking forward to eating like a normal human being one day. Knowing this is the last treatment helps but, I guess not unexpectedly, it's been the hardest. Knowing what is still to come also weighs  heavily on my mind. First thing first, take care of self so I can function again. One last furlough day (yeah down from 22 to 11 to 6) to take advantage of to heal, then rounds of tests, and then to worry about saying goodbye to an old friend. 

The 8th Round Blues

Seems like I say this every time, but each round seems harder. I wonder if I'm just getting so tired of this I can't deal with it or if the effects are truly getting worse. Round two surveys are coming in for the dissertation and I just can't seem to find the energy to start working on them. I know I need to, if I don't get this dissertation done now I'll probably never graduate. I just can't start over, that is too much to think about. There is too much time, energy and money put in to give up now. But there's just so much to do both for the dissertation and just to get better that it seems overwhelming some times. 

And then there's everything going on at work. New leadership, new roles, new expectations, and I just need to learn to let go of that. But I feel like there are people counting on me. Maybe it's just ego, the world will not stop spinning if I cant get everything done. Maybe it's time to just worry about me but I have a hard time doing that. Today I'm at my parents house trying to pull my act together. Love their whirlpool tub but it only helps so much for so long. Monday is a furlough day so while there is no pay and that really hurts on top of it all, it does give me an extra day to recuperate. I really need to get motivated, I need to find some energy, I need to find some focus, but really I just want to go back to bed. I think it's time to revisit that whirlpool tub.