Reconstruction/Remodel

Do normal bloggers write posts when they get boob jobs? Well, this one is! After the year I've had, let's just keep the full disclosure going, shall we. After my lumpectomy I was scheduled for reconstruction surgery - because, as my doctor described it, nobody want's to look like a sharkbite was taken out of their boob. Right you are, sir. 

October 22nd was my surgery date. I was sort of worried that the surgery team would look at my post lumpectomy boob and say "ah, you look fine - we're cancelling the surgery!", but my doctor reassured me that while my right boob might look ok now, in about 6 months swelling and liquid filling the void would dissipate and I would be left with a big indent, so surgery was still on and I would be happy about it later. Great. 

But that's not even the best news - the best news is that in reconstructing the left breast to match now with the right post lumpectomy breast - I was getting an overall breast reduction at the same time. SO EXCITED - yet scared at the same time. More surgery, more anesthesia, more anxiety....

Fast forward to today. Surgery went beautifully, I'm healing very well, everything looks great despite dressing for Halloween as "FRANKENBOOBIES", I'm all good and walking around with smaller and lighter boobs - so nice. I had my post-op follow up yesterday with Dr. Said. Now I'm on the hurry up and heal process, and doing everything I can to encourage it because I start the last step of my cancer journey (radiation) in a month or so. Because radiation is sort of an ass-kicker for my good cells, I really need to get as healthy as I can before we start. I'll do radiation every week day for 6 1/2 weeks - and then finally we will be done with almost everything. I don't know if I mentioned this in past posts, but people who get a lumpectomy and then don't follow it with radiation have a 30-40% chance of cancer reccurrance in the first three years. Even people with a "complete response" to treatment. People who do get the radiation after lumpectomy have about a 3% reccurrance rate - I like the sound of that much better. So I'll keep you posted on how that goes, should be fairly uneventful, the only bad part is that it keeps us home in Seattle over the Holidays, we won't even be able to be at the farm since I'll need to be close to SCCA the whole time. 

On another note - I'm having anxiety about my hair. I really really want my old hair back, not this super short mostly white salt and pepper version. Despite being super grateful that I'm healthy, I have this lingering hair thing that makes me feel bad. I guess I would feel ok to either have super short hair in my normal color, or my old length with s/p hair, but introducing both at the same time is a little harsh. I feel like it might make me look unusually OLD or bad. I decided that I need to see my hair gal and get her thoughts on what to do. I'm considering coloring it back toward what it was, then over time while it grows I can gradually introduce more and more of the "salty" color. The "not as shocking" approach seems a little easier. Kit has been so nice that I can't get a read on what he really really thinks, and we all know that friends always want to be nice and say "oh, I really like it" but what they really mean is " it's fine for you but I would NEVER do that to my hair!"  I need a neutral opinion - I'm going to see my hair gal on Friday at 4. And, she's going to cut my wig too - just to give me something new for the next month or so before I just give it up and go short. Does any of this make sense? I know, these are the weirdest things to be talking about - but right now it's my life - ugh!

I promise to talk about how excited I am for Thanksgiving and Christmas in my next post. Whopeee.

Oh, ps.... here is a shout out to my reconstruction doctor, Dr. Said at SCCA/UW Medical Center. He's awesome, and don't you think it's kind of amusing that in a year of cancer dealings, the only male doctor I've seen happens to be the one that is building my new boobs. Makes me chuckle. hee hee. But, super pleased with his approach and he's an excellent doctor and has made us feel really comfortable about everything from the first time we met him. He's given me some of the best information about what will happen before/during and after radiation and we feel very lucky to have had him on our team. (By we I mean Kit and me, not my boobs and me!!!)

Dr. Hakim Said

Worst to Best

I got some really good news!

But first I'll tell you about my very nervous completely uncomfortable date for my lumpectomy following the 5 months of chemotherapy I just went through. Let me just say this right away - every single day following the very bad day that I was told I had breast cancer has been a big huge learning experience and has gone really really well. I know that doesn't happen for everyone so I'm super grateful that my experience was what it was rather than what it could have been. Not to say that there weren't days that completely sucked  - but looking back, I'm thankful for a lot lot lot of things. Here are a few:

1. I live in the USA, and more specifically, Seattle, Washington - a place where the medical community is very very progressive.

2. I was treated at Seattle Cancer Care Alliance. That's huge. SCCA is part of a collective that includes Fred Hutchinson Cancer Research Center, Children's Hospital and UW Medical Center (a teaching hospital) - and altogether have first rate cancer care and cancer research.

and 

3. I was assigned (did not choose, but was miraculously assigned) these oncologists who I am so grateful for: 

Dr. Julie Gralow - 


Dr. Kristine Calhoun

As I mentioned in past posts, I was given a diagnosis of HER2 Positive breast cancer - which is sort of scary, but these women had a plan and the appropriate treatment in place and we got down to business and did the work.

One part of my chemotherapy included the drug Perjeta - which if you've watched the news lately - has been extraordinary! While my HER2 cancer hadn't had a chance to get anywhere near terminal, I was given Perjeta along with Herceptin as part of my treatment - and I responded very well.

After my chemo was done, I was scheduled for surgery. From the outset, the surgery was planned to be (hopefully) a lumpectomy but it depended on how well I responded to the treatment. By the time I met with Dr. Calhoun we knew the chemo had gone well, and confirmed that a lumpectomy was the agreed protocol - which gave me a lot of relief because the idea of a mastectomy seems a little bit (or a lot) overwhelming. Surgery was planned for September 25th. 

My history of surgery in life included getting my tonsils out 20 years ago, so based on that - you know - I was afraid  - which seemed pretty normal since in the past 6 months I've been afraid of about everything that's come up for me that has been new. So, on September 25th, no different, afraid but not stopping now.

I had to get a wire localization first - followed by what they call lymph mapping - neither of which anyone should really have done while awake, yet both are done with local numbing - so WIDE AWAKE and not that fun. It's best to just not look at anything they are doing because the first one involves needles and wires, and the second one again with the needles. These little procedures are necessary to make sure the surgeon can find where the "tumor" tissue is or was - so they mark the area with a wire. Then they shoot radioactive isotopes into your breast tissue to drain to the sentinal lymph node - so the surgeon can id which lymph node to take to make sure the cancer really really didnt go to the lymph nodes or beyond. Neither of these procedures hurt, they just freak you out if you think about them too much.

Surgery was right after that. Went perfectly. Lumpectomy done and done. Felt like I was in and out of there super fast, after waiting all morning to get it all going. Not that they weren't doing stuff behind the scenes getting ready, we just had to do a lot of sitting around waiting. In any case, we were relieved that it went so well, then we promptly forgot to stop at the pharmacy on the way out to get the pain meds (we're idiots) - so we had to drive back to the hospital for that. Turned out to be totally unnecessary though - really didn't have any pain at all. Stayed at home healing for a 5 days, then back to normal life stuff and continuing to heal properly. 

Here's where the GOOD NEWS comes in. Results of the surgery (pathology of the tissue) concluded that no cancer had every gotten to the lymph nodes. While they suspected that anyway and the biopsy early on indicated that, it was nice to get final reports that it was true. And......the best part.... the tissue where my lump-mass-tumor was showed no cancer at all. Meaning - I've had a "complete response" to treatment (docs words). So, 6 months ago I had cancer, but I don't have cancer anymore I'm happy to report. As Dr. Calhoun put it, I hit a home run. I'm very very thankful and fortunate that my treatment went so well. With my sort of breast cancer and the size of my tumor, it's not often that they see such results, so hot damn!!!

I still have to do the course of radiation to sweep through that area because it could always be possible that there is as little as one cell they can't detect that could go haywire. I'll do that happily. Everyone says if you've been through chemo - radiation is a breeze. 

My next step is reconstructive surgery on the 22nd of October (next Wednesday), followed by radiation starting around the first of December. That is the last "new" thing I will do. After that I just continue to get an infusion of herceptin every three weeks until end of next May, and then I will be completely finished with this business. Herceptin doesn't have any side effects so it's easy to tolerate. It's also not a "chemotherapy" but a "biologic."

Anyway, it's been a long year but I've had an outcome that has been really good. I have a lot of love in my heart for all the people at Seattle Cancer Care Alliance, and along with the Oncologists above, I love love love these two gals below. Denise Bundow is the Nurse Practitioner that works with Dr. Gralow, and I've seen her all along and she's been so great. 

Denise Bundow

And this gal below, Kay Tilton was the nurse assigned to me on day one. She is a dolly - I love her too. She helped me through all the chemo and gave me all the good warnings about side effects and what was coming next. 

Kay Tilton

The biggest thing is this. I was scared shitless the first time I walked into this building and now I love this place.It's weird to think how many times I drove by this building in all the years I've lived in Seattle and then in one day it turned into my home away from home. And it's good that I like this place, because fortunately for me, I'll be "watched" by these peeps for the next forever.....every 6 months for the next 3 years, and then on after that forever, and that's fine by me.

If you are reading this and you are a woman - please get an annual mammogram. I found my lump myself because of where it was - so it was easy to feel. But a mammogram would have found it too! Get one!! Every year!

Checking in about Check ups

Sorry. Long time no bloggy - lot's to catch up on.

Friday the 28th of March was our big doctor's appointment where I learned everything there is to know about my particular breast cancer. And the first thing I learned is that there are lots and many and more than one kind of breast cancer. Some are estrogen based, some are lobular, some are ductal, you can read all over the internets about all the many many varieties. I only cared to learn about mine. Let me tell, after 2 long weeks of waiting to find out what and how bad my breast cancer was, the 28th could not have come soon enough, and at the same time I would have been ok with that day never coming. Ah, life. 

So, what I learned: My breast cancer is apparently exactly what my Mom's breast cancer was last year. Her2 Positive. That diagnosis 20 years ago would have been quite scary. Today, however, they know just about everything there is to know about it, other than why we get it. It is a ductal invasive type of cancer, and the Her2 positive means it has a protein based receptor that is aggressive - or something like that. Ok, before I go further I need to tell you that I don't officially know what the hell I'm talking about. So if you are they type of person that needs some scientific documentation, then get on line and look it up. I just listened to my doctor and tried to remember a couple of basic details, and I have NO INTENTION of jumping online to read more. I got it OK, and now let's deal with it, and move on. Any additional anecdotes of how mean this cancer is just wont do me a bit of good. I'm going with the basics. The doc says it responds super well to the drug therapy and we can kick it's ass. And that, my friends, is the action we are taking.

This is how it's going down. I start chemo tomorrow. Every other week for 8 weeks I get a combo of Adriamycin and Cytoxan - then when that is done I get Taxol I believe and that goes for something like once a week for 12 weeks. At the same time, every third week, I get Herceptin (for the Her2 protein) along with a new shiny drug called Perjita. After the 12 weeks I get a 4 week rest, then I have surgery. Surgery will either be a lumpectomy or a mastectomy - all depends on how well my tumor responded to treatment along with how the docs and we feel about the options. The lumpectomy can leave me with a 3-4% rate of reocurrance, while the mastectomy is more of a 1-2%  rate. I think we will cross that bridge when we come to it, because as of today I would say both those %'s are low, and a lumpectomy seems so less invasive - but again, I might feel differently in the summer. Decide later. Will also meet with a reconstructive doc to help get all the info. After surgery and the healing if surgery, I will start a program of radiation. That goes 7 weeks, every day M-F but it's a short appointment and doesn't have too lousy of side effects. After that, I will continue Herceptin until next year at this time. I know - it's a long haul. But, the first 12 weeks are the most harsh, and it lightens up after that. Because my mom just went thru this exact protocol, I can tell you that it hopefully wont be so bad. My mother is the original IRON LADY, but still, if I got anything from her (other than the bad gene for Her2 Pos), it is the tough cookie gene. I should be fine. Also, I understand that the drugs they give me to tolerate the chemo are so good now, that most of the time, people wont even know that I'm doing it. 

So, before I start chemo (tomorrow), I had to do a bunch of tests. First thing Monday, I needed a biopsy of my closest lymph node. They wanted to understand if the cancer had gone there. Luckily the biopsy was cancer free - so really good sign. Tuesday, I had a port installed below my collarbone. This is where all the chemo drugs will go in my body. It's pretty alien, but from a tech standpoint, it's a good thing. I don't want my arms all needled up over the year, so a port is a good way to administer drugs on a repeated basis. It is sort of weird and not that comfortable (yet) but I'm guessing I will adjust to it. It has a little spaghetti tube that goes up and into my vein and down toward my heart... apparently works like a champ. Ugh. Then on Wednesday I had to have a heart scan - the chemo drugs can make your heart pump slower, so they like to get a baseline of heart operations before I start. Mine is strong. I'm good. Then finally on Thursday I had a PET scan. That is just a different kind of scan to look at the tumor. I am part of a research study on imaging - so I will get more PET scans along the way. Then, finally on Thursday I met with my main nurse Kay, who gave me all the ins and outs about chemo and how it might make me feel and what kind of awesome things I can expect to happen. Things like nausea, hair loss, mouth sores, dry skin, constipation, acid reflux, early onset menopause, the worry of fever or infection - you know..the good stuff. Jesussssssssss- So, as of today, I'm pretty much ready.

Which brings me back to the subject of hair loss! On Friday I went wig shopping with my friend Mo. She has had a couple of friends that have had to go thru chemo, so she knew the right place to go in Seattle. We had an appointment at the William Collier Salon in Belltown. They are known for treating hair loss patients - whether from chronic conditions or chemo. They know what they are doing and were very nice. It was a big fat reality check though - even if all the medical stuff is scary, it's the vanity stuff that really makes me want to cry about it. The idea of shaving off all my hair because it's going anyway, and getting a wig and the potential of having no eyebrows or eyelashes for a freaking year - ugh, kind of gut wrenching. But, the good side is this.... I can order a wig with real hair and a real looking scalp, and they will match my color and my style of hair, so hopefully the transition will fool people. And, it will be much better to be prepared than to wake up some morning in the next 2 weeks to find all my hair on my pillow and not on my head - I called them yesterday and got that ordered. It's enormously expensive, but when I factor in all the cut and color appointments I will miss in the next year, I'm getting more and more ok with the $2,000 price tag. Seriously, it's good hair. And the time I can save in getting ready in the morning will be really helpful when I have to figure out how to draw on eyebrows. (LORD HELP ME!) 

Ok, so now you are fully up to date on "the cancer" - and I will get on with more interesting posts. 

NOW GO GET A MAMMOGRAM!

Must all Blog Posts be Pleasing?

I read a lot of blogs. In fact, I really love reading blogs about furniture, fashion, DIY, lifestyle, interior design, travel and pretty much everything that is awesome and inspiring about what people are doing with their creative energy. 

I also notice that people are sharing the news of their lives between these posts about lipstick, or lamps or the lastest whatever. Most of the news is about babies. Seems like most bloggers are in the age of "baby on the way!" Fantastic, and so excited for all these people (who I don't know personally) who are having great things happen.

Does anyone post when the NOT GREAT THINGS happen? I can only point to one blog called - An Inch of Gray where I can recall reading  the most heartbreaking post (a couple of years ago). I had just gotten back from an east coast vacation as a storm was blowing up the coastal areas along the Carolina's and up toward Block Island where we were. I came across this blog post through another blog I was following, and here on the pages were the horrifying and super sad story of a blogger who had just lost her 12 year old boy in a drowning in a swollen creek near their house, during that same storm that I flew out of. It was so sad, and it was the first thing I'd ever read on this woman's blog, so probably not the time to get on board. I felt a lot like I was evesdropping on her tragedy, but then I thought she could probably use LOTS of support from all kinds of people right now, including people she didn't even know. I was cheering for her and wishing her well even if she didn't know it, and maybe that was helping her. I hope so.

What I'm getting at is this; I was planning to publish a blog full of ONLY great things, big and small that had to do with creative projects, DIY projects, farming, city life, etc... I didn't have anything planned that was going to make me wonder if it was appropriate for posting..... but then ALL OF A SUDDEN things changed big time for me and if I don't post this, then I'm a big fraud - one of those life-fakers. One of those people that pretend and edit too much on Facebook so that everyone thinks things are great for them all the time and they also only post pictures where they look the best and have no double chin. But for me, people, from here on out, you're getting the good, the bad and the ugly. And in some posts, all of them at once.

Here's the whopper - Last week, when my postings were non-existent, it was because I got some bad news and my hands were too clammy to type. I was diagnosed with breast cancer. Seriously. I know. Shocking. Here's how it went down. I think it was about 7 months ago when I posted that I'd had a funny mammogram and I had to get get another one and an ultrasound. That confirmed I was clean. So off I went, happy to be free and clear. Well, just a few weeks ago, I was in the shower and I found a lump, right breast, off to the right side at around 10 o'clock on the book dial if your nipple were the middle. So, I watched it for a week, and it didn't really go away, so I called my doctor and she made me see the Breast Specialist at the UW Womens Clinic. She confirmed that I had a lump (or mass, as she said) and marched me over to Seattle Cancer Care Alliance - which is where they do all follow up stuff. When I got there I had a mammogram (which hurts by the way when you have a "mass" in there), then an ultrasound - where they almost made me feel better because they thought it was most likely a cyst or a fibroid tumor. But, to be safe they wanted to do a biopsy, because I am 50, and also because my Mom has had breast cancer. So, good to be safe. I had the biopsy - and waited patiently (or not patiently) for the results. That was last week on Monday, and I got called back with the news on Wednesday am. AND NOT THE NEWS I WAS HOPING FOR. 

I can't really explain what it feels like, this limbo I'm in from hearing the news to understanding how bad or not bad it is, and knowing how to fix it. My next appointment is March 28th, and at that time I will meet my "team" which includes a surgeon and some others. I will also have an MRI and that will tell us more about whether the cancer is just in the one spot (which they say is the normal kind in the normal place - and I think I'm supposed to feel better about that - and I sort of do!) Until then, I just wait and I think adjust to the news. 

So, in the next however long, there might be some posts related to the idea that I actually have cancer. Again - so weird. I'm not at all sick, I've never been sick, I eat right, exercise, and take really good care of myself - and suddenly at age 50, never ever having been sick ever, I am a person that has breast cancer. The news alone is enough to make me puke and shit my pants - often. Oh, and I've been crying a little bit. I think that's probably normal.

I am not going to sugar coat it people, but I'm also not planning to post any of those artistic photos of the reality of surgery, etc. Especially because I'm not quite ready for that yet. Baby steps! Anyway, sorry for the downer news, but if my blog is going to be an authentic representation of what's going on around here, I thought you should know, right now things are a little sketchy! I'll keep you posted on future events, but I might leave out the puking and shitting my pants.

Oh, and ps. Cancer can fuck right off. :)

Tomorrow I promise ordinary stuff, like planting vegetables and doing crafts.