Things I've Learned Since Friday ...

1.  Attitude is everything.  The second round of chemo went very smoothly compared to the first and I think it was in part because of how scared I was of the unknown.  I was more relaxed this time and not only did the dreaded blood draw go well, but the actual chemotherapy seemed to go quicker. 

2.  Fried ... well, anything ... isn't a good follow-up to chemotherapy.  Yeah, yeah, I know. Of COURSE it isn't; however, in my defense, the fish and chips at Twisted Rooster are darn tasty.  Or, at least I used to think so.  Oy vey.  I took an anti-nausea pill before we even left the restaurant.  And then again six hours later.

3.  Saturday is my eye of the chemo storm.  I seem to have a lull between the nausea of chemo day and the ache/exhaustion of the third day.  Saturday is a good day for me.  I felt so good this past Saturday that I volunteered one last time at a LaughFest show that night.

4.  Sunday post chemo is my drugged stupor day.  I managed to go out for breakfast and then was done. I mean ... sit down and wake up hours later done.  Go to bed at 6:30 p.m. done.  DONE.  When you hit that point: give in.  Your body needs you to shut the hell up and get unconscious.

5.  Day 17 is THE day.  Dr. V said my hair would fall out two weeks after the first chemotherapy infusion - day 14.  The nurse said it would be more like day 17.  Nurse L has the win.  My hair was fine up until ... well ... today.  This morning, I went to put a bit of product in it, re-smooth it, etc., and ended up with my hair in my hand rather than product in my hair.  A few shakes over the sink told me all I needed to know: Day 17 people. 

I called my hairdresser and she kindly found time for me today.  See, the hair on top of my head was taking the swan dive first and would likely have left me with a bare top and ring of hair.  That might work well for a certain Irishman I know (McMorrow) or some current male coworkers but I decided against the drawn-out end.  And my hairdresser is incredible.  She fit me in, took care of everything, gave me extra scrub to use on my remaining magenta scalp (the mohawk is gone but the pink doesn't want to die), and wouldn't accept more than a hug. 

I got good people. 

And finally ....

6. I have a damn fine looking head.

Talk about liberating.  I thought I'd freak out.  I thought I'd cry. 

I thought I'd begin speaking like Andy Serkis and calling everything my precious.

Ha!  Nope.

I've learned I'm so much stronger than I thought. 

With a sprinkle of crazy for good measure.

When "Robust" is a Good Thing

I've heard the word "robust" used to describe one's figure in a not-so-flattering way even though the simple definition is

:strong and healthy

:strongly formed or built

:successful or impressive and not likely to fail or weaken

But when your surgeon tells you that your margins are "robust" - meaning that the area of surrounding cells taken along with the cancer is clear and of a healthy size - that's a very, very good thing.

I finally received the results of the pathology report completed on my tumor and lymph nodes this morning. 
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Hello! I've been a bit quiet here this week, mostly 'cause of, you know, drugs, and waiting.  And pain if I'm honest. Frankenboob or "fireboob" is being a real bitch while she heals.  Lots of water, pills, and sleeping sprinkled with TV and a Walking Dead trivia game.  Once I was off the narcotics, I did a solo trip on Wednesday.  Getting lightheaded in TJMaxx will quickly belie your self-proclaimed, "I'm FINE."  Lesson learned.  Now I'm back to being bedeviled, bored, and bitchy at home.

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Dr. App quickly told me that it was excellent news.  The report confirms that my lymph nodes were clear - 100% clear - of cancer.  The tumor removed ended up measuring 1.8 cm or 18 mm.  If you recall, the initial ultrasound had this at 11 mm, the MRI had it at 13 mm and a later discussion with Dr. App had it at 15 mm.  Now, I don't know if this change is due to the method of measuring (one being more accurate than another or whatnot) but suffice it to say that I'm glad this monster is out of me before it reached its twenties and started hosting toga parties and generally corrupting the wholesome surrounding cells. 

It had already acquired a mini-me!  They found a small 4 mm second tumor along-side big daddy.  Can you imagine!? How DARE he mess with a child!  [See how the evil tumor suddenly became male and a pedophile?  Nooo, my job doesn't affect me at ALL.]  They also found some DCIS cells hanging around those two.  Think of those as the good kids wanting a taste of the wild side only to find themselves in over their heads and headed to juvy.  Honestly, my boob is quickly becoming an after school special.[ <Don't stop watching that top ten until the end. I needed that laugh.]

In short, my lymph nodes are clear, and they removed everything they need to so that I do not need any further surgery.  Cue the trumpets.  No, I don't get out of chemotherapy (you really WOULD hear me scream at that) or radiation.  I meet with Dr. Vander Woude on Monday to hear more of what will happen when chemo starts late this month or next.

For now, I'm continuing to get caught up on shows I didn't know I needed as I unsuccessfully try to ignore the incision pain.  Ladies, put your bra on and touch the lower left ridge of it.  Now imagine an incision directly underneath of it trying to heal.  And, no, I can't just take it off.  I need to remain wrapped or wearing a sports bra, etc., to keep some pressure on her as she heals or it can result in way too much swelling and even a need for more surgery.  [Honestly, not sure if Dr. App was just trying to scare me with that threat but she's a mighty dynamo and I will not defy her.]

The massive surgical bra monstrosity they sent me home in works a bit better at night with a wrap underneath but even that aggravates the incision.  So ... for now ... before my transformation into Sméagol, just picture me as this little tyrant (with his right hand a bit higher).

A robust little tyrant.  In the successful and not likely to fail way.

A Plan. Of sorts.

I find myself wondering what to share here.  Do I share all?  Do I stay a bit vague on the details and only cover the main events?  Surgery, etc.?  There are benefits to both but, in the end, if someone stumbles upon this blog who is just beginning to fight breast cancer, I guess I'd rather them have my whole experience instead of a diluted version. 

So, here we are then.

After my initial diagnosis of breast cancer last week, I was referred to the Breast Cancer Multispecialty Team (MST) for treatment.  Frankly, I knew going into the appointments that my cancer is aggressive.  The pathology report for my biopsies finally posted early this morning and, so, I read it before going to the MST session.  If you're going through this right now, you'll have to decide for yourself whether or not you want to read reports before meeting with your doctors.  You know better than anyone else whether you'll benefit from it or be harmed. 

Don't listen to anyone else; make your own decision.

For me, if there is a chance it will be bad news, I'd like to read it, digest it, and perhaps get sick from it in private than sitting in front of another human being.  But that's me.

So I knew that my cancer is aggressive.  I joke that since I excel at so many things (Ha!), I should have expected my cancer to excel as well.  Now, I know my joking is a coping mechanism.  And I'll continue to joke for as long as possible.  Forgive me if it offends you.  But I really don't give a damn.

Because my cancer is aggressive, I'm on a priority list for surgery.  So my surgery will likely be within the next 2-3 weeks.  The grading of my cancer is a 3 on a scale of 1 to 3 with 1 being slightly abnormal and 3 being  ... really fucked up.  The pathology also tests whether the cancer is responsive to estrogen or progesterone.  If it is positive for that, then there are medications that have proven effective for helping fight against any reoccurrence.  Mine is negative for both.  Mine is also negative for a protein called HER2.  So my cancer is a triple negative invasive ductal carcinoma. 

Alas - this apparently is quite different than being a triple crown winner.  But, in a way, it is just another tool for the doctors to use to determine the best treatment. 

Which brings me to the plan:

This week, I'll be getting a chest x-ray, which is a fairly standard pre-operative test.  I'll also see my regular primary care doctor for pre-operative approval. 

Next week, I'll be getting at least two more biopsies.  I mentioned my pathology report above.  I also got the results of the lovely hang-loose breast MRI.  Along with measuring my tumor - it is anywhere between 11 and 15 mm depending on the test you read: the MRI has it at 13 mm - the MRI showed a questionable area immediately above my tumor that may be DCIS - ductal carcinoma in situs - basically, cells that would be invasive cancer IF they broke out of the duct.  It is sometimes called Stage 0 cancer.  The MRI also showed two small questionable areas on the bottom outside of both breasts. 

So, next Monday, I will be getting each of those two small areas biopsied.  If they come back negative for cancer - remember that MRIs can show things that look like cancer but are not - then I will be receiving a lumpectomy of my left breast, i.e., the surgeon will remove the tumor and a few lymph nodes (to double check those).  Before that surgery, the doctor wants a biopsy of that area above my tumor in order to determine exactly how much tissue needs to be removed.

If, however, those first two biopsies next week come back positive for cancer, I will be having a double mastectomy, the removal of both of my breasts.  Again, this would be due to the aggressiveness of my cancer so please, if you're just beginning to deal with your own, remember that everyone is different and many things go into the decision of how best to treat breast cancer.  All I can really say about this possibility is this: 

        If I'm to lose the ones I have, I expect the new ones to be SPECTACULAR. 

The actual surgery will likely be sometime during the first two weeks of February.  Up to two weeks of recovery is expected for a lumpectomy - and it would be outpatient surgery.  I'm not sure right now about the mastectomy recovery - I'll cross that bridge if it comes.

Roughly four weeks after the surgery, I'll be starting chemotherapy.  I'll have a port installed so that the drugs can be put directly into a larger artery and I'll receive it every other week.  The good news is that my oncologist strongly urges women getting this chemo to continue to work.  She does not expect me to have nausea or other issues that would impede me from doing so.  The bad news, or at least odd and surreal news, is that I WILL be bald.  Early on in the chemotherapy, my hair will fall out over a day or two - it happens quickly apparently - and I will then struggle not to call myself Gollum. 

Seriously.  Short, bald creature with large eyes.  Just call me Sméagol. 

Yep.

 My chemotherapy will last four to five months. 

And about two weeks after the last dose, I'll likely begin up to six weeks of radiation.  The radiation would take place at daily 15 minute appointments.  It is meant to make sure no stray cells of cancer remain and greatly lessens the chance of reoccurrence.

Regardless of what type of surgery I receive, the end result after chemotherapy and radiation will be this: 

My chance of reoccurrence will be between 4-6%.  When you consider that the chance of any woman in the U.S. developing breast cancer in her life is 12%, those odds sound pretty good. 

So, that's the plan.  I might be forgetting some specifics but, hey, it's been quite a day. 

Do me a favor if you've read this far.  Trust that I am strong.  Trust that I'll be fine.

I really am quite a bitch when I need to be.   

Make me laugh if you can.  It really is the best medicine.  Cause, hey, I'll be a hot mess of bald and boob jokes for most of 2016. 

In short, trust that I've got this.