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.