I'm Rounding Third and Heading Home ...

Long, long ago ... in what seems a lifetime away, I got a bit of bad news and my life began to change.  Over nine months ago, I was reeling from a diagnosis of breast cancer and living the surreal life that comes with it.  And when I found out the date of my surgery, I posted And Here's the Wind-up  because, hey, what better analogy for cancer treatment than baseball, right?


Both seem to take for frick'n ever and include long periods of boredom only slightly mollified by food and drink along with a series of side-shows attempting to entertain you as you wait for each pitch, waiting for something inspiring to occur.  Or, as the player, you try to keep your eye on the ball, some seem to fly high and wide, others nearly take your head off, so you dig yourself in deeper, take a deep breath, and wait, hoping to crack that little m******f***** out of the park.


My personal trip around the bases included a dash towards first with my lumpectomy, then a frantic dash back to first as an infection required a second surgery.  I scrambled next towards second base - mired in chemotherapy - and took some nasty hits that continue to bother me today.  Someone should really knock that second baseman on his ass, maybe fine him for unprofessional conduct.  I limped toward third base - radiation - and started to see the end in sight.  A horde of third-base coaches stood waving me on home.


And here I am, straining to make it to home base, that initial ball o' triple negative breast cancer still (hopefully) flying out into the blue to be hopelessly lost forever.  Pretty sure I broke the bat on that one.  My long, soon-to-be 11 month rounding of those cancer-ball bases will continue this November 11, 2016, when I go into surgery again. 


This is the "matching set" surgery I was so excited about in the wind-up post.  After the lumpectomy and the "revisioning" surgeries last January and February, Frankenboob continues to recover.  Now it is time to re-create some symmetry between the girls. 


No, I won't suddenly be needing to don DD-sized brassieres.  Let's leave Frankenboob alone, shall we?  She's literally just gone through the fires of radiation for goodness' sake.  Her game is over - send her to the showers.  In fact, let's send in another runner for her, okay? 


After some tussles early on in the game that included multiple mammograms, ultra-sounds, and a particularly nasty MRI-guided series of biopsies, Righty has been sitting the bench, resting. 


Now it is up to her to finish this game.  She'll start for home November 11th and she won't emerge unchanged. 


Recovery will take roughly three weeks according to Dr. Livingston (I can't make up ALL these names).  Dr. Andrew Livingston will handle this last surgery for me.  As I reminded him that it only took me two weeks to recover from the creation of Frankenboob (and another 1 1/2 weeks following the "revisioning" surgery), he wisely directed my attention to the months of chemotherapy and radiation in-between and suggested that it just might take a bit more for me to bounce back this time around. 


Right. True.  Players feel a tad different at the end of a game than at the beginning. 


I'm nearly three months out from chemotherapy and one month out from radiation.  Already, I find myself looking back on those months and wondering how on earth I made it through it.  We are SO much stronger than we believe.  I don't believe anyone truly knows their own strength until it is tested.  My hair is back - full and thick ... and gray - and grew as if it had been struggling wildly against a barrier that has suddenly been removed.  The persistent cough that plagued my end of chemo ended in early August. My nails are slowly (agonizingly slowly) healing and growing. 


Treatment has certainly left me weakened, with scars and continued pain, but the important part is that it left.  Treatment is over.  Each day, I look for new ways to hasten recovery.  Currently, that means trying to figure out what I can do for the continuing pain of neuropathy that will not involve medication.  As you can imagine, I'm kind of tired of medications, of putting anything in my body that includes some long list of possible side effects that invariably ends with ... "oh, and death."  The pain and my fatigue should continue to improve over the next weeks and months.


If I were to ask one more thing from all of you who have been so incredibly supportive during this year, it would be for prayers, good thoughts, and hope that by next July (or sooner .... so much sooner), I will be free from the pain of neuropathy.  I am told that if I continue to have pain a year after chemo has ended, it will likely be lasting pain. 


And, yeah, that would suck. 


But first, it will soon be time for a transformation - the creation of Bride of Frankenboob. 


[Yes, I know I'm silly. I prefer that to whiney.] 


I know I've said it before, and I'll continue to say it:  Thank you.  Thank you for your support.  For your prayers.  For your notes of encouragement.  You overwhelmed me with support when I needed it the most. 


If only every person who faced this deadly ... game had such fans.  Such teammates and coaches. 


[See how I steer this back to an American pastime?  My least favorite American pastime.]


I'm going to cross home-plate even if I have to dive for it.  And then I'm going to rest, ice down some joints and muscles, and head to the after-party. 


--------------


Reminder: if you've stumbled across this through a search for breast cancer, chemotherapy, radiation, neuropathy, or any other such word because you're looking for answers, for hope that you can do this or that a loved one can make it through treatment, please feel free to contact me via comments or email.  There is immense hope.  You CAN do this.  Your loved one CAN handle it. 


As a dear friend said long ago: Life is Good. 


If your search was for baseball, well, there is hope for you as well. 


It's called basketball.

Dead Hair Walking ...

Just a Quick Tip: If you know that someone is about to lose their hair to chemotherapy, find another subject for your compliment.  I love the thought but, "Your hair looks so good!!" just reminds me of what I'll be without in the near future. 

Yes, I know it will be temporary.

Yes, I've heard it grows back thicker and curly, and smells of rainbows and sunshine. 

Sure, I'm certain bald will make my "eyes pop."  If I get Dr. App's approval next Tuesday, I'll be sheering my hair Wednesday evening in preparation for chemo later that week.  Bye bye perfect length hair and hello Sméagol.

I don't need other compliments.  Just don't tell my "dead hair walking" how good it looks on its way to the gallows for a respite.

--------------------

Current Schedule:

• Monday - Genetics appointment and BACK TO WORK, y'all! 
• Tuesday - Dr. App appointment and hopefully chemotherapy approval then chemo class
• Wednesday - Hair be gone
• Thursday -  Port placement
• Friday - Official start to chemotherapy 
• Saturday - First shot of Neulasta to help jump start my white blood cells and minimize my immunity issues due to chemotherapy. 

And while searching for a link for Neulasta, I happened upon some suggestions from patients to take Claritin when taking the Neulasta shots.  Neulasta will help increase my white blood cell production but it is known to cause some unpleasant, i.e., just knock me out, pain in my bones.  The suggestion is that taking a Claritin a day around the time of the shots will help this pain.  Hmm ... I'll certainly ask Dr. V about that before chemo begins.  And here I was just passing along a minor tip to all of you and I'm leaving with a new tip for myself.

I Preferred "A Bit"

As I've mentioned, I have "a bit" of cancer.  In the world of cancer, I'm a Stage 1 - a "relatively" small amount, in one location, and immensely treatable (knock on wood with me).  And I went into my 2nd surgery late yesterday afternoon believing I had a bit of an infection.

Hmm.

My dynamo doc explained after my surgery that there was "a lot" of "stuff" in there.  A lot as in more than certainly could be seen in my Frankenboob hole.  And stuff as in ... infection of some unknown bacteria.  But my dynamo doc cleared all of that out of me, washed the area first with saline and then washed it again with an antibiotic wash. 

DIE, GERMS, DIE!!

Now, knowing how tough my little doc is, I envision a lot of tough love going on between she and Frankenboob before she stitched me back up.  And I'm certainly feeling the aftermath today.  Let me set the scene ...

***

My surgery took place at Blodgett Hospital this time rather than the surgical center I was at for my initial lumpectomy on January 29, 2016.  Again, kudos to the Spectrum team of nurses and doctors; everyone was wonderful for my time there. 

I started out in a hospital room where I first had to pee in a cup because I've never had a hysterectomy and, well, am probably carrying the second coming of Christ, don't you know. Yes, they have to give me a pregnancy test.  Yes, even though they just did that on January 29.  Yes, yes, even though it would mean an immaculate conception. 

I again donned the gown with built-in air conditioning/heating and tried to convince the nurses that I did not purposefully match my purple nail polish to the gown.  Or my glasses.  I again had an IV placed in the back of my hand; it's never my favorite but the nurses have been excellent in trying to minimize any discomfort (Ha - PAIN! - it's called sticking a needle into ....good gracious, I'm a wuss) I felt and I appreciate it.  I met my nurse, my anesthesiologist (so wait ... I might remember what?), and, of course, saw Dr. App before being wheeled on my bed into the surgery room.

Each person introduced themselves and explained their part in the process.  My anesthesiologist, who could have been brothers with one of our local Grand Rapids comedians (Stu McCallister), explained that I would not be under general anesthesia this time but would be kept comfortable and sleeping for most of the procedure.  He assured me that if I did remember anything, it would not be something that was painful.  [And he was correct.]

I helped transfer myself from the hospital bed to the surgery table (those things are so narrow) and then separate side holders were placed to support both arms out away from the body, a bit like a cross honestly.  Eventually, my arms were secured and I went to sleep as everyone was busy getting ready. 

I DID wake up while things were still happening but felt no pain.  There was something over my head, which makes sense because they are working in a sterile environment, but at the time, I recall saying something like, "Can you move this from my face?" and "So how's it going?" and trying to - like a drugged idiot - catch the cover with part of my face to move it so I could see.  Because THAT would have turned out well.  I wonder how often a surgical team gets to laugh afterwards about the antics of their patients.  I know I would.

I was awake enough to remember sitting up so that Dr. App could wrap my wound, wrap, wrap, wrap, then wrap some more with an ace bandage, then put another stylish surgical bra on top.  Picture a heavy duty weight lifter.  No, wait, picture this:

THE snowsuit from A Christmas Story

Yep.  My arms aren't touching my sides naturally at the moment.  Which is fine because I'm pretty sure my sides what NOTHING to do with me right now, particularly the left side. The pain will probably be the worst today but should get better by tomorrow.  It did last time anyway.  *fingers crossed* 

I was awake and able to get back onto the hospital bed before being rolled into the recovery area where I'm pretty sure I was a star patient.  I was in very little if any pain, was able to use the restroom on my own, and was fairly quickly wheeled back to a hospital room to finish all the pre-release tests.  I was given a double chocolate muffin, heated up, which was a heavenly beginning to my food for the day at about 6 p.m. after a day of clear liquids only.  I left between 30-45 minutes later.

*****

Dr. App has sent a sample of the "lot of stuff" off to be identified in case a different antibiotic would be more effective.  I'll be interested in hearing what nefarious microorganisms has been colonizing my body and knowing that we are using the most effective means of eradicating them.  Damn immigrants. 

[Can I make that joke in this political climate even when I'm talking about my body?  Before making an assumption as to my views on the subject in our country, don't.  My joke above in no way reflects my thoughts on the subject.  And no, I'm not inclined to share them.  And you'll likely be blocked or unfriended if you push the subject with me.  This has been a public service announcement of the Justa-Blog-System.]

A Slightly Wrong Children's Song

You know that feeling when you can't get a melody out of your head?  One's been twirling around my brain since last night ... when I changed the dressing on my Frankenboob wound.

See if you can hear it, too.

***

There's a hole in my boob, dear doctor, dear doctor,
There's a hole in my boob, dear doctor, a hole!

Then fix it, dear Kimmie, dear Kimmie, dear Kimmie,

Then fix it, dear Kimmie, dear  Kimmie, fix it.

With what shall I fix it, dear doctor, dear doctor,
With what shall I fix it, dear doctor, with what?

With wet/dry dressing, dear Kimmie, dear Kimmie, dear Kimmie,

With wet/dry dressing dear Kimmie, use saline solution.

It's not working, dear doctor, dear doctor, dear doctor,
It's not working dear doctor, dear doctor, now what?

Here's some medicine, dear Kimmie, dear Kimmie, dear Kimmie,

Here's some medicine, dear Kimmie, take one a day, start now!

But this medicine can cause nerve pain and extra heartbeats, dear doctor,
But this medicine can hurt tendons, dear doctor, WTF?!

Come and see me, dear Kimmie, dear Kimmie, dear Kimmie,

Come and see me, dear Kimmie, on Monday afternoon next.

But what in the meantime, dear doctor, dear doctor,
But what in the meantime, dear doctor, there's a hole!

Take your medicine, change your dressings, and don't move, dear Kimmie,

Take your medicine, dear Kimmie, and watch a show on Netflix.

There's a hole in my boob, dear people, dear people,
There's a hole in my boob, dear people, a freakin' HOLE!

Oh, and watch out for mood swings, dear Kimmie, dear Kimmie,

Watch out for paranoia, dear Kimmie, dear Kimmie, watch out.

SERIOUSLY?!

***

This hole is seriously damaging my calm.

Meanwhile, here's a happier version from my childhood.  You know, back when my boobs were tiny and cancer-free:

Oh, Henry.  How you're not smacked over the head is beyond me.  The hole is half-way up the damn bucket, Henry.  It can hold enough to sharpen the stone. 

Logic and children's songs don't always mix. 

Excuse me while I go see if I have any worsening nightmares (another possible side effect).  I'm sure death is listed there as well.  I swear the warnings on medicine are enough to make you fear the medicine more than the disease.

Nope. Not paranoid AT ALL. 

THERE'S A FREAKIN' HOLE.

Relativity

You've most likely heard the phrase, "It's all relative."  I was reminded of the truth of this today along with the sentiment, "Everyone is fighting their own battle." 

I had my 2nd post-op appointment at my surgeon's office and had the hope to have lots of sutures removed and a green light for my chemotherapy to begin next Friday.  I know, it's odd to think of someone wanting that fright-fest to begin, but I have the dates (including the end date) in my head and have been trying to mentally prepare myself for next Friday so ... I'd like to proceed as planned. 

The appointment did not go as planned.

See, this thing called gravity (Ah, Sir Newton), has been pulling Frankenboob down despite my alternating between a mega-supportive sports bra and corset-tight wrap.  The result is that one of the sutures pulled open and ... well .... open wounds are not good things.  I'm now on an antibiotic with instructions to use wet/dry dressings (a square wet with saline solution on the wound with a dry dressing on top), and have a follow-up appointment with Dr. App on Monday afternoon.  It will really be up to her at that appointment as to whether I proceed as planned next Friday.

Meanwhile, my lymph node incision site is doing beautifully and the sutures were removed today.  Odd to think that a location that had much more movement (and next to my armpit) is fine yet the underside of Frankenboob is toxic.

With my perfectly planned next steps and appointments in jeopardy, I picked up the antibiotic prescription and decided to cheer myself up with a protein rich and delicious omelet at Real Food Café (pretty much my second home these days).  I sat down, grumbling internally over the doctor's visit, my toxic tit, and my possible delay in treatment.  I was frustrated and feeling pretty sorry for myself overall.

I glanced next to me and saw two women having lunch.  The younger of the two was talking nonstop and it was easy to tell that this was a young adult daughter talking to her mother.  I also noticed pretty quickly that the mother had some difficulty in speaking and moving.  After making sure that the server understood her mother's order, the daughter continued telling her mother about her plans for the future - school, work, living arrangements, etc.  It did not appear that the mother's condition was recent although I certainly don't know that for sure. 

The two left before I was finished and three men took their place.  One of the men, pulled the table out so that his friend/son/brother could easily sit down.  It was apparent that the man had both difficulty speaking and a physical disability.  Once seated, the table was replaced and the two men joined the third and proceeded to ensure that the server understood all of their lunch orders.

Honestly, I felt ashamed.  I was sitting there feeling sorry for myself because of a completely treatable medical condition when, in the course of 30 minutes or so, here were two individuals who are living with what appear to be lifelong conditions.  Now, please don't misunderstand me.  I have no idea what either of these individuals think or feel about their conditions ... or even if they think of them as conditions.  But it reminded me that everything is relative. 

Having a "bit" of cancer is a pain in my ass - or, rather, a pain in my breast.  But the tumor was relatively small, it was caught relatively early, and my treatment is expected to be relatively manageable with an actual end date.  In the grand scheme of things, in the many ways in which life and health can smack us upside the head, when I could just as easily live in a place where medical treatments are not as advanced, are too expensive, where even clean water is a luxury, my life is still relatively freakin' spectacular. 

Everything is relative. 

I also found myself remembering that everyone is fighting their own battle.  If you saw me today, you would have no idea that I have cancer, or that I'm ill in any way.  You certainly wouldn't know that I have an infected hole in my breast, or would be grabbing yogurt on my way home to re-stock the good bacteria in my body after the antibiotic kills the good, the bad, and the ugly indiscriminately.  I looked around that diner and started wondering what other people were going through.  What hidden battles waited for them at home, or never left them alone.  Medical conditions, mental conditions, the loss of loved ones, financial difficulties, heartbreak ... the potential list is endless. 

It's so easy to be caught up in our own lives that we assume a nice car means the person that just cut us off did so because he's an asshole, not because he's racing to the hospital to be with a loved one.  The woman taking too long to decide what she wants (IT'S MCDONALD'S - DO YOU NOT KNOW THE MENU?!) is simply an idiot, not completely emotionally bent over a breakup or job loss.

One late breakfast humbled me.  I hope I do better in remembering both how blessed I am and that I've no idea what battles are being faced all around me. 

Now, excuse me while I go replace my soaked dressing - WTH! - with a new one.

Stupid toxic tit! 

Still ... relatively ... not that big of a deal.

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. 
----------

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.

-----------
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.

Meanwhile, In The Waiting Room

My surgery went by in the blink of an eye.  For me.  One minute, I was listening to my surgeon explain the plan to her team, the next, I was waking up in recovery and hearing the blessed news that my lymph nodes came back clear (90% sure so far of that).

For my family, however, my surgery took over four hours.  My Dad, stepmom, and two oldest sisters, Linda and Glenda, came to support me, and set up camp near the TV in the waiting room.  Fox News was playing.  And they stayed.  If that doesn't speak volumes of my family's love for me, nothing will.

A few hours into my surgery, Linda walked downstairs to get some food (a salad) and was returning when she noticed people leaving the building and overheard someone saying that it was being EVACUATED. 

She continued back to the waiting room .... and ate her salad.  [Of course, she did.]

Was this a drill?  Must be, right?  Regardless, my family's attitude was - "Sure, ya'll go ahead and leave but my (daughter, sister) is IN SURGERY right now so we're staying, thank you." 

They stayed until someone came and got them.  

I have this vision of my family being bodily dragged out, screaming to stay, struggling against security.  I'm positive that's exactly how it happened.  Yep.  Totally.

So, what happens in this situation?  Lights flashing and people told to leave when actual surgeries are taking place?  What mayhem is occurring when surgeons, elbow deep in blood and flesh, start hearing sirens and the call for evacuation? 

Um, nothing.  Apparently, the surgery calmly continues even if everything around it goes a bit nuts.  My family was told not to worry, that my surgery room had a fire wall or some such protection.  And soon they saw our fine Grand Rapids Fire Department arrive.

Adds a bit of excitement to an otherwise boring wait, don't you think?  When they were allowed back inside, all they know of what happened is that it was safe to be inside again ... except for a particular suite.  It's a bit of a mystery still.

But the real question remains.  WHAT effect would sirens and firetrucks, evacuations and flashing lights, have on my breast?! Because, you know, priorities.

I took a shower tonight and came face to breast with my Frankenboob.  Wow. 

The tumor was removed, breast tissue moved about, and things, um, relocated. Trauma with a capital T. 

She's going to be brilliant.  And no, there will not be a picture.

Alive, Drugged, and WITHOUT Armpit Drain!

Welcome to my hallucination. 

One month ago, I didn't have breast cancer.  Well, I didn't KNOW I have breast cancer.  Ignorance truly is bliss, isn't it?  But ignorance can be deadly as well.  Had I NOT went to my mammogram, had I put it off even several more months, I'd likely be facing a much different future.

My surgery was this morning.  My day began at 5 a.m. when Taylor Swift began yelling at me from my stepmom's phone to "shake it off."  Indeed.  By 6:30, I was entering the Spectrum's Lake Drive Surgical Center, signing in, signing off, and donning another medical wristband.  Soon, I was in Room 23, trading my clothes for a Bair Paws gown, hair cap, and purple Bair Paws socks.  The gown had holes in it and the nurse hooked a hose into one of those holes and gave me a small controller to adjust the temperature OF THE INSIDE OF MY GOWN.  How cool is THAT!?

Hell, even the IV went smoothly this time.

Dr. App [God bless this tiny marvel of a woman] arrived, met some of my family, then kicked them out so she could draw on me.  Literally.  It's an odd feeling to have someone draw on you, saying things like, "And here's where we're going to put your nipple."  [Understatement.]  The anesthesiologist stopped by, other members of the surgical team said hello, and I was soon wheeled into the actual surgery room.  The last thing I remember is Dr. App talking to the team about who I am and what they'd be doing today.  The next thing I remember is coming to with the song, "I Want To Write You A Song," going through my head.

I felt some pain and some nausea.  I immediately directed my attention to my left arm, and realized I did NOT have tubing coming from it as I'd expected.  Then *cue CELEBRATION* the BEST NEWS EVER:

My sentinel lymph nodes showed no sign of cancer and a drain had not been necessary for the four they removed! The surgery was a complete success! 

LITERALLY, the best possible outcome [outside of the Dr. determining that the pathology report was incorrect and there's no cancer ANYWHERE.] 

I didn't stay too long in recovery.  I'm probably too proud of the fact that the unseen patients on either side of me were groaning and moaning and asking for more pain medication while my nurse latched onto a sigh, "You sighed - do you need more medication?"  Once back in my Room 23, they brought me a small banana muffin and water (and medication).  Maybe an hour later, I was headed home.

My surgery went wonderfully.  For me.  *cue CLIFFHANGER*

Did I mention the evacuation and firetruck?   


 

NO WHAMMIES!!!

Nope. None. Nada. 

We've got NO whammies here, ma'am!

               *dances silly jig*

I got the call earlier today.  A nurse from the Betty Ford Breast Cancer Center called to check up on how my night of iced boobs went following the afternoon of 13 biopsies.  The conversation went something like this:

-----

I have some questions to ask before we get to your pathology.  So how did last night go when you got home?

Pathology? You have the pathology?

Oh, yes, but there's a checklist here, we'll get to that.

*Me. Instantly thinking it must be bad news.*

So how did last night go?

Fine. All fine. I haven't taken pain pills since this morning.

Do you have bruising?

Not much.  It's fine.

Fever?

No.

Well, okay, good, just let us know [FOR THE LOVE OF GOD WOMAN TELL ME THE PATHOLOGY] if there are any changes or if you have any questions.

Of course, so you have the pathology?

Yes, let's see ... [YOU'RE KILLING ME, SMALLS!]

Okay, both areas biopsied have the same diagnosis.

*Me. Positive that she just told me that the biopsies have the same diagnosis as my tumor because OF COURSE THAT'S WHAT I'M GOING TO THINK HEARING THOSE WORDS!*

The same?

Yes blah blah blah benign blah blah blah blah

Wait, back up ... benign?!

Yes, no further cancer was shown.

*Silence as a wave of relief is crashing over me*

Kimberly?

*I finally get out*  I'm here.  Just a second.

Why do I always cry at GOOD news?!

Of course, dear.  Now blah blah blah blah blah medical terms blah call us if you have questions.


-------

And then I was back under control. 

None of the 13 biopsies yesterday showed any cancer cells!  Can I get a "Yay!!!!" - because I'm fairly certain all of my neighbors know I was flippin' happy for a while minute there.

So this means my surgery Friday will be a lumpectomy to remove the main tumor and removal of several sentinel lymph nodes to check those for cancer as well.  I will still have chemotherapy and radiation but the cancer has not spread to the rest of my left breast or to my right.  My next big hope is that the lymph nodes continue to be clear.

But for now - NO WHAMMIES! 

And Here's the Wind-up ...

I met with my surgeon today.  Colleen App - she's fabulous. 

I donned a floral cape (SO not a gown) and pretended to be an organic super-hero as she did an in-office ultrasound, comparing my various images with her own taken today, and clarified our plan for surgery.  What, when, where, how, expected outcome for the bosom. 

                        *slightly reddened cheeks*

I'm having surgery next week Friday, January 29th. 

What kind of surgery?  Good question.

That depends on the outcome of my two MRI-guided biopsies on Monday.  Beyond my tumor - located at 11 o'clock in my left breast - my breast MRI identified two other questionable areas, one in the lower outside quadrant of my left breast ... and one in the lower outside quadrant of my right.

You can imagine the concern, right?  One area of one breast vs the whole breast vs oh-crap-it's-in-BOTH-breasts.  The biopsies I'll have on Monday will answer that question.

So, come next Friday, early in the morning, I'll be headed into surgery.

If the biopsies are negative, I'll be getting a lumpectomy of my left breast with the surgical removal of several sentinel lymph nodes (to double check that they are clear for cancer).  It will take about 4 hours.

If the biopsies are positive for cancer, then Friday, I will be having surgery specifically to check my lymph nodes.  Are the sentinel lymph nodes - those nodes to first encounter fucked up breast cancer cells - clear?  If so, yay.  If not, if there is evidence of cancer in my sentinel lymph nodes, then they'll take all of them.  Then, a week or two later, I'll have a mastectomy, single or double depending on what's needed.

Oh, and there's a drain.  DRAIN.  Once they start taking lymph nodes, they'll need to insert a tube into ... well ... my underarm so that fluid that would normally drain out the lymph system can drain out the tube into, I swear to God, a clear grenade that I then empty as needed.  This continues over 5-7 days while, I guess, the area heals from the surgery.  It helps to prevent infection.

                           Yada yada yada.

I heard ... GRENADE filled with fluid from my body that I have to empty. And depending on whether cancer is found in my lymph nodes, I get to have this drain for 5-7 days or more AND learn all about what I would need to do to avoid .... conditions I hope to never need to explain to you without the benefit of wine.

But wait! There's more! Dr. App explained to me what she would do during a lumpectomy to make my left breast whole again.  She explained where the incisions would be made and how, once the tumor is removed, she would lift the breast, make it round and whole, and sit the nipple oh-so-perfectly on top.  A round breast with the nipple perfectly placed.

I'm 45 years old people.  What do you think my first thought was?

[Let me get this straight.  BEST case scenario is my left breast is cleansed of the cancer and basically reconstructed into round perfection then I undergo chemotherapy and radiation and, all that while, I have a perky left breast and my normal 45-year-old droopy ass right?  So, I'm short, bald from chemo, with a perky left breast and droopy right.  Gotcha.  Proceed.]

Would I forever has mismatched tits?

[Because that's the important question when fighting cancer but ... whatever.]

The answer, surprisingly, is no.  No, I will not.  Because the law, believe it or not, guarantees me a matching set.  At some point after all my treatment is done - after the chemo and after the radiation - a plastic surgeon will lift my right breast so that it matches the left!  How AWESOME is that!?

Random, unexpected, and awesome.

So, that's it.  Surgery on Friday  - one way or another.  Hope with me, if you will, that my biopsies are negative.  I'd really love to have my lumpectomy Friday and move on to the next step.

[I'm a bit skittish these days about hoping - it seems whatever I hope ends up a bit skewed.]

________

I had one last happy hour with some coworkers tonight.  Well, last for a few weeks anyway.  Obviously, next week, I'll be hopped up on painkillers post surgery.  The week after, who knows.  It was nice to sit and talk and listen to the odd cases.  To get a "cheers" to the surgery. 

In the midst, my little brother called me - not a usual thing - to apparently tell me about some depositions in a current case.  I took this to be code for ... "I want to call her, I'm not sure what to say about her boobs, so I'll talk work to really say I love her" ... see how I interpret?  It was sweet. 

Honestly, the most frightening part of today was going through the drive thru at Taco Bell tonight - which I do not typically do - and getting to the window with my exact change ready only to have the worker say my food was FREE because of the wait.

        Huh.  Taco Bell.  Free?

               What fucked up hell is THIS?

I'm not ready to die, dammit, it's just fucking breast cancer!!

________

And ... here's the pitch! 

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.