Doctor Conference

This morning, Eric, my dad, and I met with Dr. G (my mom is in Indiana helping my sister move).  I think today's meeting was heavier than last week's.  All three of us walked out like deer in headlights.  But, after a lot of crying and a lot of praying, I think I have a clearer, happier mind and heart. 

At 7:30 this morning, 5 radiology oncologists, 5 breast surgeons (in addition to my own), and 2 medical oncologists met and talked about my case.  They presented it as very factual: "This is a 29 year old woman, and here are her images.  What do we do?"  After that meeting, Dr. G told me they recommend a mastectomy because there was too much cancer in my left breast to really salvage anything for it to look normal.  Here is a very poor picture of the screen she was showing us of my MRI.  The cancer covers the upper half of the breast. 

 

 

So step 1 is surgery.  I have to decide between a single mastectomy on the left side vs. a bilateral mastectomy which means I would do both the cancerous and healthy breast.  If I do the single mastectomy, I just do the left breast, but then I would have to take a pill called tamoxifen for five years.  Tamoxifen blocks the actions of estrogen, and it would be necessary because my cancer is fueled by estrogen.  However, it would put me into menopause, which means no babies for five years. *Cue Malita crying in the doctor's office here.  I would also have to get an MRI and mammogram every year.  The chance of reoccurrence would be 10%. 

 

If I do the bilateral mastectomy, and if the cancer is contained, I won't have to take the tamoxifin and I'll essentially be done.  My chance of reoccurrence with that option is 1%.  If, however, the cancer is invasive, I would still have to take the tamoxifin for five years and then do chemo.  We won't know if it's invasive or not until during surgery when the pathologist can look at the tissue under a microscope.  Dr. G believes it's contained, but we won't know 100% until surgery. 

 

My gut, my head, and my heart are saying to do the bilateral mastectomy, so I'm pretty sure I'll go that route, but I do want to sleep on it for a bit and make sure that I'm still in that camp before reporting any decisions.  Tomorrow morning I'm meeting with the plastic surgeon to talk about reconstructive options. 

 

I did ask her about timeline and she said we can usually do surgery in about 2 weeks.  The surgery itself if I do the bilateral option is 6-8 hours long.  Then my recovery time is 2-4 weeks.  However, the entire process won't be complete for 2-3 months. 

 

The reason it's 2-3 months is because the initial surgery will be done with a temporary implant placed behind my pectoral muscle.  She said that in the past women with implants were identifiable a mile away because the implant is placed in front of the muscle and under the skin and it's' just kind of sitting there.  By placing it behind the pectoral muscle, it will give it a more natural look, and the muscle acts as a scaffold to hold the implant in place.  The temporary implant will then be filled with a saline solution and over those 2-3 months they will gradually increase the amount of saline solution to expand the muscle in preparation for the permanent implant.  She said that once they put the permanent implant in, many women describe the feeling as one equivalent to how you feel after eating a large Thanksgiving meal and then unbuttoning your pants.  You're relaxed and it feels much more comfortable.  Here's a diagram illustrating that process.

  

So that's the science of it all as best I can explain it.  The emotional side of me is just disappointed.  I didn't think I would have to have so much of my breasts removed.  I essentially feel the same way as I did in my last post, but I do feel better.  I think the turning point for me was when I got to work. 

 

Today was a day of prayer and our conference room was transformed with candles and became a soothing atmosphere to just be quiet and pray.  I sat silently praying for myself, but also for our clients who also go through similar situations, and most times have gone through much worse.  I thanked God for giving me such a strong support system, and I asked Him for peace and clarity.  I asked Him to quiet my nerves and to give me confidence.  I also asked Him to continue walking beside our clients and to give them peace, clarity, and confidence as well as they begin new lives here with us. 

 

Tears fell from my face and I heard people come and go.  Then a co-worker/friend of mine sat beside me and asked if she could pray for me.  She began praying and I just broke down and let it all out.  As I sobbed, another co-worker/friend sat on the other side of me.  It was so peaceful to feel their hands upon me, hear them speaking to God, and to feel comfortable enough to let all of my emotions out.  The three of us talked afterwards and I thanked them and told them I feel so lucky to have my faith and my friends and family through all of this. 

 

After that, with every minute that goes by I have become more peaceful and comfortable with the decision I am making.  I remind myself that although I may feel sad or frustrated that I am going to miss out on certain things in the coming months, I could be missing out on far more.  So tonight, I sit here thankful yet again, feeling strength returning, and ready to take on the next steps.



MRI Results

Well, there are two pieces of good news and one bad:

Good News #1: Super surprised but I already got the results back from the blood test regarding the BRCA 1 and BRCA 2 gene mutation and it came back normal!  I was mainly relieved because that means my sister is in the clear, and I was worried about Julia having a 50% chance of getting the gene.  But no worries on that now!

Good News #2: The MRI showed my right breast is clear and normal. 

The Bad News: They found more cancer in the left breast, and so much so that a lumpectomy is now out and I'll have to do a mastectomy.

The cancer team is meeting tomorrow morning at 7:30 to go through everything and verify that, and then I'm meeting with Dr. G (my breast surgeon) at 9:00 to go over it all.  She'll be able to show me the MRI pictures and we'll come up with a more solid treatment plan.  I also already have an appointment for Wednesday morning to meet with Dr. P, the plastic surgeon, to talk about reconstructive options. 

So there's that...

Tonight I've just been crying.  I think I've tried to stay positive for so long that I just needed a crying day.  It's becoming more and more real.  I'm also kind of angry.  Eric suggested I take a bath to relax.  My response was, "No, I don't want to look at them.  I'm mad at them."  But I think I'm entitled to feel a little sad and angry at times.   

I know it's a good thing that I have this option and can get rid of it, but I am comparing a mastectomy to how I felt when I changed my name after getting married.  I felt happy to change my name because I was marrying someone I love and we were officially a family, but I was also sad because I felt like I was losing a part of me.  I was losing a part of my identity. 

Now, I know my boobs do not make me, me.  The feminist in me would go crazy if I said that.  But, I will say that they have been a part of shaping me.  I developed much earlier than most girls in school, and in third grade I was the one wearing a training bra.  From there they became quite large and I was usually complaining about how my D's were causing my back to hurt.  After giving birth to my daughter, I promise you breastfeeding was the worst pain I've ever had to go through in my experience, and I also went through mastitis twice.  Now I'm 29 and have breast cancer and have to bid them adieu.  And really, most of my experiences have been negative, so you would think, "Why doesn't she just say good riddance!?" 

While they have caused me mostly pain and negative feelings, I like how I look.  I know I'm not perfect, but it took me a very long time to get to this point where I feel confident and love myself, every part, inside and out.  To me, it's unnatural to have fake breasts, even if it is for this reason.  God made me who I am, and that's who I'm supposed to be.  I just want to be me, how He made me. 

So tonight, I cry, and I wallow, and I feel sorry for myself.  But tomorrow is a new day, and I will gain a lot more information, and that will empower me and make me feel better. 

MRI Edit

I forgot to mention that the most difficult part of the MRI day was probably the fact that I had to stare at a sign while they put the IV in me that said, "For assistance, dial 7865 for a MRI tech."  Ouch.  Bad grammar always hurts. 

MRI Day

Today was the day of my MRI.  It was the first thing this morning and Eric was kind enough to go with me even though he would just be sitting in the waiting room the whole time.  I felt bad that he was just sitting there, but I was happy to have him there as support. 

We checked in and then a nurse called my name and started us on our maze walk through the hospital.  As we were making our way to our destination, we passed a door marked, "Mother Baby Rooms."  I pointed the door out to Eric.  I thought, "Wow, less than a year and a half ago I was in one of those rooms with J, and now look at where I'm walking."  It was sad, but I guess you just never know where God and life will take you. 

We got to the MRI unit and I was told to undress and take off all my jewelry and put on scrub pants and the gown that opens in the front.  Let me take a moment to talk about these gowns.  I've worn four now in the last month and I'm already tired of them.  Obviously they need to open in the front in order for doctors to have easy access to examine my breasts.  However, the gowns are MASSIVE!  I am always swimming in them and even though it ties on the side, it's still a good foot away from my body if I were to hold it out.  So when I get up I'm grabbing it on the sides with my hand for fear I'm going to flash the entire waiting room.  I hate those gowns. 

H-O-T, HOT!

 



I got called back and the tech put an IV in my arm because we were going to do a contrast to make any abnormalities more visible.  He told me to stay relaxed and have even breathing because if I were to breathe too heavily, my chest would move causing it to ruin the pictures and I would have to reschedule and do it all over again.  Eeesh...noted. 

I thought laying still for 30 minutes would be no big deal.  Plus, I was really tired so I figured I could maybe take a nap!  Wrong.  I had to lay on my stomach with my breasts hanging below me on the table, and my head was cradled in a head rest, similar to a massage table.  They gave me ear plugs because the machine creates a loud banging noise all around you.  They also gave me a squeeze ball to hold in my left hand should I feel there was an emergency and something didn't feel right and I could squeeze that to signal them to stop.  They hooked the IV up for the contrast and wrapped the tubing around my right thumb. 

Then they asked if I was comfortable.  No, not completely, but I thought I could deal with it.  Then they said, "Are you sure?  You can't move at all for 30 minutes, so now's the time to speak up.  Don't worry, you're not being high maintenance if do."  So I conceded and asked them to add another pillow under my feet.  We were up and ready to go.

As the table backed in to the large tunnel, I suddenly remembered I was claustrophobic and quickly shut my eyes as if I were a 3 year old telling myself this wasn't actually happening, and if I just close my eyes then it wasn't actually happening.  Those 30 minutes were tough.  Mainly because a lot of pressure was going to my face and that was hurting, plus I was getting obsessive about my breathing and hoping I was doing it right so I wouldn't ruin the pictures.  I did not want to do this all again.  The only technique that really helped to calm me was to pray.  I prayed a lot.  I couldn't tell you how many Our Fathers and Hail Mary's I did. 

After it was all over, my arms were very much asleep and so was my face.  I didn't know that was possible.  I felt a little weak, but overall it wasn't too bad.  I think the most difficult part was controlling and monitoring my breathing while laying on my stomach.  Out the IV came and I was off on my merry way to see Eric and change back into some clothes that I wasn't swimming in. 

I get the results of the MRI on Monday, so hopefully this weekend is a nice, relaxing one to take away from the stress of waiting.  Onward and forward!

Gratitude

Yesterday I was talking to a co-worker of mine who is moving on to new endeavors, and I told him he could check my blog to keep in touch.  As we were talking about my cancer journey, I said to him, "This is going to sound really strange and ridiculous, but this has actually been a really positive experience."  I still mean that.  Mainly because I see how much love has been shown towards me, and how lifted I feel to God through all your prayers.  It's incredible and I am in total awe. 

Last week when I found out, the second call I made after my mom was to my best friend Amy.  She knew what was going on and gave me her work cell phone number in case I got any news.  When I called her, she was at work, and started crying.  I said, "Amy!  Don't cry!  I'll be fine!"  But of course, I started crying too.  She now lives in North Carolina and I knew it was tough for her to be away at this time, and wouldn't you know it...that night as I was grocery shopping I get a text from her saying she bought a plane ticket to come in for about 24 hours just to hang out.  Who does that?!?!  The best kind of person, that's who.  So I got to take the afternoon off work and we got ice cream, a pedicure, went out to dinner, and hung out on the couch in our pjs watching a movie and stalking our friends on Facebook.  ;)  It was amazing.  It was exactly what I needed. 

 

A number of my co-workers/friends have already been amazing.  One, whom I call my soul mate, is already offering to watch Julia or go to appointments with me.  Another has been sharing so much of her own story because her roommate has been going through the same situation since July and has been informing me of what to expect and tips on how to handle doctor appointments.  I can't say enough how much that has helped.  Today she introduced me to her roommate and the three of us had lunch.  It was great to hear from someone who is recently going through the same journey and is 34, so also younger.  People at work have been amazing and it's so great to have a workplace where you can trust others with information like this and feel like you're not really going to work every day, you're going to your second family. 

 

My neighbors have been great and super supportive, and knowing people who live on your same block that are willing to be there down the road is of great comfort.  And all my friends from years past have also been great.  I have been getting so many messages from folks I haven't talked to in years, and I'm touched to know I still cross their minds from time to time and that love and care is still there.  Tonight I just got done video chatting with two of my friends and former roommates from college and it was so fun to see each other's faces and hear their voices again.  We decided that will become a quarterly event! 

 

And of course, my family.  My parents, sister, husband, aunts, cousins, Godmother, in-laws, everyone.  Everyone has been amazing and I feel like the luckiest person on Earth to have such a strong support system.  This journey will be much easier with so many people along the road from different parts of my life cheering me on. 

 

 





The Day I Met My Cancer Team

WOW.  Knowledge is certainly power.  I can't tell you how much better I feel!!  These last two weeks have been incredibly difficult for me because I've had to wait and sit in the shadows of ignorance.  Today I walk in the light of knowledge and look before the different paths that have been presented to me.  I don't even care that I don't know which path I'm taking yet.  It's just nice to know that I can see what's in front of me now.  

My mom, dad, husband, and I met with my breast surgeon, Dr. G, and I immediately liked her.  She came in and apologized that I was there in the first place, but congratulated me for being an advocate for myself because most young, working mothers may have just ignored it, but now that we caught it early I'm in a place of power and have options.

She spent two hours (wow!) explaining the process and options, the science, and the pictures of my mammogram and ultrasounds.  She said that breast cancer is a lazy cancer and that it's important for us to not rush into anything so that we can get a fuller picture and really explore my options and verify things so that 10, 20, or 30 years from now I'm not regretting the decisions I made. 

In the short term there are two tests that need to be done.  Basically at this point they believe the cancer is non-invasive.  However, I am getting an MRI done on Friday morning because that will be more detailed and accurate, and either show something new or verify what they already know.  Of women who get the MRI, 20% (or 1 in 5) get bumped up to a higher stage based on what they find.  I will get the results of that on Monday.  That will help determine whether or not I will need a lumpectomy or mastectomy.  

The second piece of the puzzle was for me to meet with a genetic counselor.  Because I'm under 35 they always wonder why someone so young could get breast cancer, so they need to test my blood for the BRCA1 and BRCA2 gene mutation.  I had blood drawn in the lab and it gets sent out to a lab in Utah, but I should get the results in the next 1-2 weeks.  

In the meantime, she said it may be good for me to meet with the plastic surgeon just so that we have a game plan in case I need reconstructive surgery.  

I was also very happy to hear that all of the doctors work as a team and meet once a week to talk about their patients and come up with the best plan for them.  I met Jill, who is the nurse navigator and she is essentially the quarterback of the team and coordinates everything.  She was so great and already came in with the MRI scheduled and gave me her card.  She also gave her card to my parents and Eric and told them they could call at any time as well.  So I felt incredibly relieved to know that everything behind the scenes is being taken care of, and that the right hand is talking to the left.  

They also gave me a massive book on breast cancer as a resource along with a folder of information and all of my chart info up until now.  I kind of had fun reading it because I felt like a kid sneaking in to the classroom at lunch and peeking on the teachers desk.  haha.

So all in all, today was a good day!  I gained relief that I love my doctors and clarity in my knowledge and future path.  

All of my new materials!

Road to Diagnosis: The Last Two Weeks

It all started on Friday, March 6.  As I stepped out of the shower, thinking about the day ahead, I noticed a pimple on my left breast.  Being the picker that I am, I went to squeeze it.  As I squeezed that pimple, the pressure caused an expression to emerge from my nipple.  This was quite odd to me since I had stopped breast feeding my daughter back in July.  I dabbed it with a piece of toilet paper and squeezed again to see if more would be expressed.  More did come out, and I noticed it was bloody. 

I am pretty in tune with my body, and I knew that wasn't normal.  I decided to call my OB and was able to get a noon appointment.  At that appointment she said that the discharge wasn't normal, and she examined my breast and said that she didn't feel any lumps, but that I needed to get some imaging done just in case there was something going on she couldn't see. 

I got to the hospital at 2:00 and I was told I would get a mammogram, and if necessary, an ultrasound.  I was by far the youngest woman in the waiting room, and I was swimming in the open front gown they make you wear.  When they called me back, the tech shared her name and there was no small talk as we walked to the machine.  She took her photos and told me to go back to the waiting room. 

She called me back again and she said we would have to do more photos on a 3D mammogram machine. She stepped out of the room for a moment and as she did I leaned back to take a peak at her screen.  I saw that she had zoomed in on an area that was mainly white.  That's when I knew.  I knew something was wrong.  I stood there with my left breast hanging out, facing the mammogram machine with a lead apron wrapped around my waist, knowing this was not the end.  The tech walked back in and became rather friendly than before.  Yep, something's definitely up.  She escorted me back to the waiting room and told me I would be having an ultra sound. 

I laid on a table as the ultrasound tech took pictures.  She was quiet and careful and then left the room.  When she returned, she introduced me to a second ultra sound tech who repeated the motions of the first.  They both left the room and said a radiologist would be in shortly. 

The two ultrasound techs, a nurse, and the radiologist entered the room. We had a detailed conversation about the discharge and he had me express some.  He then said that my mammogram was "complicated."  I have macrocalcifications underneath my breast, which if it were just that would not be a huge issue.  The issue was that I had many microcalcifications in one concentrated area on top of my breast.  For that reason, I would have to have a biopsy.  He also said he wasn't sure if the discharge was related to this or not.  There was an 80% chance the biopsy results would be normal, and 20% chance of it being cancer.

Thursday, March 12 was the day of my biopsy.  The procedure was quite quick.  I had to wear a sports bra and wrap myself with an ace bandage for 3 days afterwards, but the most difficult part was not being able to pick up my daughter (or any heavy lifting for that matter). 

On Monday, March 16 I got the results.  A woman called me while I was at work.  Deep down I knew what the result would be, so when she told me I did have cancer I wasn't surprised.  It was more of a confirmation that was able to put an end to all of my "what if"ing.  All of the information I know at this point can all fit on a post-it note: Breast Cancer, DCIS, Stage 0.  The treatment will probably be a lumpectomy and radiation. 

I spent the week sharing with my friends and family. There were more tears on their end than mine.  After all, I had a week and a half to get used to the idea. 

But, I consider myself lucky.  Lucky that I caught it early, and lucky I have friends and family that would shed tears for my well-being.  

Tomorrow I go to meet with a breast surgeon, to hopefully get more answers.  So...we'll see what luck tomorrow brings.