The Longest Post Ever...

And all of a sudden, my doctors don't need me anymore.

Move along...

Nothing to see here....

Except for the plastic surgeon... and even he has a PA now that can handle my more minor issues of keeping my implant INSIDE "wound healing complications."

I saw them last week, where the consensus is "If I don't call you, all is good."

He said, "Well you're 4 months out, are you running?"  I said, "A little bit." I said I was lifting a little but not chest and I definitely have weakness.  ie: "push up" = "face plant"

He says, "Great well we can move on to the next step!" and he left and left it to the PA to tell me the "next step."
So now can come the symmetry part of the reconstruction. A little lift and a small reduction of B+. She said he could also do a small amount of liposuction--

and use that fat  to inject around B- in areas where there are volume hollows.  There is a bit of a hole right over the upper aspect of B-.

I asked when the time frame was for all this to be safe to start doing, and she said anytime!

And while this sounds all fine and good, I already knew what my answer would be.

"You know what.... I just need a break."

I feel like I've been in a constant state of healing, restriction, and caution for at least 7 months, if not more prior to the July exchange surgery.  So undoubtedly there would be more when we start messing with B+ as well.  I need a break from doctors, from pokes, and prods, and lifts...  
I need people all up and out of my business.  

(Not all people, just the people REALLY. up. in. my. business.)

Maybe I need a break from the focus being on me.

I saw a patient last week and she mentioned she had missed a week of physical therapy due to having a biopsy.  I asked her where and she told me it was a breast biopsy.  And she kept saying how painful it was and I said, "I know, I know".  And I asked "And.....?"  She said it was negative.  "That's great", I said.  But I could see something was still off with her.  Like she hadn't breathed in 10 days.  She started to cry and pour out how scared she had been, even upon hearing good results.  Her aunt has it, as well as a friend of hers.  But she hadn't told anyone she was having the procedure.  She didn't want to worry her daughter, who's in her first semester away at college, or her family, because her aunt was in treatment with chemo and had been ill for a few years, and why should I tell you how lucky I am while you were not?  I knew all those feelings she was feeling.  And if this was the first place she could acknowledge them and let them out, then this was where it was going to be.

****

Fast forward a few months!!  I left off up there around January and with not much going on I've been putting my efforts back into being normal!!  A little running but damn am I all over the place with that.  I've got a 10K in two months (2 weeks) and I really maybe oughtta start training for that eventually.  Maybe I'm hoping for the 2 year old marathon carry-over effect.  Not likely.  The gym has been going much better.  My pull-up progress is now at level 0.2, which is, try to hang on the bar and lift your feet off the ground, getting that full dead-hang stretch through the shoulder and chest. Daaayyuummmm, not comfortable... but improving.

Sometime in May I used a gift certificate that was oh, 18 months old, for a manicure at a local spa.  My manicurist was young and had that super short cropped cute pixie cut.  She was in the middle of filing my nails when she excused herself.  She came back and said she was having a hot flash, which I found odd but said "No problem..."  She then confided that she had just finished chemotherapy for breast cancer, and at that point, well I was just like "Hey, now we got something to talk about!"  Because seriously I hate trying to make small talk, when you're forced to make small talk because you're sitting face to face a foot across from another person, and you can't run away,  because they're gripping your wrist, filing your nails. (See why that gift certificate was old?)
  
I had my "every 6 monthly" mammo/ultrasound in June.  And you get to know-- 

A. when they want more pics, and 

B. when they linger over an area for a while with the ultrasound that they're looking at something suspect.  And

C. when the radiologist walks in and rolls the stool up to sit down right in front of you then you know something's REALLY suspect.  So I was like "Lay it on me."

He says there's two tiny new specks on B+ that are new since 6 months ago.  He THINKS they're benign, and PROBABLY nothing, and he's DEBATING about suggesting a biopsy, but IF they're any different in 6 months THEN YOU DEFINITELY  NEED ONE.

I was filled with warm and fuzzy comfort.

He finished with the "The numbers are on your side that it's nothing."
And I thought, "Really dude?  The numbers were on my side to begin with and we know how that turned out."

So, the next day, my last patient is a woman going through her second round of breast cancer; her first rounds now of radiation.  She was explaining that she felt fatigued since starting and wasn't sure if that was to be expected.  At that point I decided to tell her that I had been through it and did feel some fatigue during my treatment.  So we got to talking off topic about that and I confided my decision that had to be made about whether to get the biopsy or wait the six months.
    
She looked me in the eyes, and with a "Don't fucking wait!" I knew that I would not be fucking waiting.

The next morning I saw my oncologist who also believed the specks were nothing to be concerned about and she had talked with the other radiologist for a second opinion and SHE thought there was nothing to be concerned about.  And I said, "I want the biopsy.  Six months is Christmas... that'll suck..... But I can't do it for 2 weeks, because I'm going to Disney.... so I don't want to think about it while I'm down there.... that'll suck too."
  
I let her know that basically every time there's even a new speck on my mammos I'll be doing a biopsy--  so just get ready to sign off on 'em.

So we Disney-ed and that was a great time and I managed to not really think about the fact that B+ was trying to act up. My biopsy came and it was actually more comfortable than the first one thankfully.

So... we've been through this before yes?  Yes.  Results in three days.
Day 3, no call, no report on my patient portal.  (Refresh, refresh, refresh.)

Wait, an early call is bad, and late call is good, no call is...... what does THAT mean!

Day 4, Friday.  No report.  I call the office.  Lady answers.  I said, "Hi, I'd like to know if my biopsy results are in?"  Gave her my name.  Hear papers ruffling, typing..... 

"Yes they're in."

I wait.....

"Do you have an appointment coming up?"

"Uh, yeah, next Wednesday."

"Ok, we'll see you then, bye."

Ok, that is NOT how that played out in my head.

Acceptable options included, "Can I have the doctor call you?"  "Would you like someone to call you with the results?"  I would even take "We don't give results over the phone but I will have someone call you as it's been 4 days."

Long story short - by Day 9 by results were on the portal and it's negative.  So B+ better behave because these things get friggen pricey.  

By Day 10 I saw the oncologist who said that- yeah I know it's benign....

She apologized for the miscommunication about my results as well so all in all I am happy... for the next 6 months.

This summarizes the last 9 months.  I don't plan on keeping up little posts with all with the mundane ins and outs of my life but it's so sweet when I get little messages from my friends now and again, asking how I'm doing.  It means so so much.  So this is how I've been doing.  Pretty damn good.
xo

Goals. Met. Missed. Made.

December 9th brought a day of tests.  One mammo, one ultrasound, one MRI.  These actually should be mammo and US, and six months later the MRI, and alternate like that.  However, I had some suspect cysts on B+ 6 months ago, so this was a follow up on that.

The fantastic thing about an online patient portal  is having all your reports and info available for those of us with OCD who like refreshing the page until the report is available far earlier than one will get a phone call from the doctor (in most cases).

Refresh

Refresh

Refresh

Benign.  B- and B+ aced their tests.

And so far B- is continuing to show improvement in the "Keep your shit together... literally" category.  

I followed up with the oncologist a few days later.  Knowing my films were clean, I was curious as to what she'd have to say.

She didn't have much at all to say actually.  She was funny though, saying, "My mind is only drawn to the abnormal".  Essentially meaning, "I have no use for you anymore".  I plan to have no use for her anymore either. 

I did ask her what my "numbers" were.  This doctor is very knowledgeable is the stats and risks.  She came back stating that some new information she had learned at a recent conference gives me a blanket risk of 6-10% by 10 years on the left, and 3-6% by 10 years on the right.  (It's essentially 0.3 to 0.6% per year for the next 10 years.  Is my math right?)  Had I not done radiation, it would be higher.  IF I had been BRCA+ it would be nearly 50%.

I started off 2015 with balls to the wall intentions of hitting a few goals.  They're still written on my Resolution board that everyone writes on at our New Year's Eve Party.  Let's see how I fared, shall we?

Spartan Trifecta - So. Close.  Like by DAYS close.  This was pretty disappointing.  You can read about the Beast, Super, and the Sprint Not Meant to Be.  Do I plan on trying for the Trifecta again?  I don't really know yet.  The Beast was... brutal.  The Super was a little better I suppose since I knew my limits from what I experienced at the Beast.  Suffice it to say there was crying after the Beast, and no crying after the Super. If the Beast isn't in Jersey again?  Maybe.  (Update!  I see now there is a Spartan Delta??  Oh wait... I gotta do an Ultra Beast?  This would probably result in ultra crying. Yeah, this probably won't be happening.  Curse you and your fancy shiny medals!)

Triathlon - A bet made to me by an old friend.  I'd do tri, and she'd do her first half.  I think I swam.... once in 2015, so we'll assume this didn't happen.  I actually still would like to try one one day.  They have mini-indoor ones that I think I could use to get my feet (actually) wet.  This is still a possibility.

50% of 2015 miles run in 2015.  Unless I can bang out 916 miles by Thursday, this doesn't look good. There are some runs I didn't log I know... not 916 miles worth.  I've already been asked to renew this goal... this one I will give my best shot.  (oh wait, it's now 50% of 2016 miles?! That's just ludicrous.)      

Half Marathon - This was the one I deferred from the year earlier.  And the one that suffered from the (near literal) fall-out of B-'s failure.  BUT, I walk/ran the 5K, and it felt good to be in that scene again.  I kind of like the half-marathon distance.  I'd love to do at least one this year.  I'd love to do the Wineglass Half (obvs) if I get my crap together to sign up.  I want to do some 5K's and I've never officially done a 10K so maybe we'll cross that off the list this year too.  

87% Plant Based Eating - This is a topic that brings up a lot of discussion.  I follow a lot of different blogs and FB pages on eating.  First and foremost because I like all.the.food.  I have friends who eat Paleo, Keto, and Spaghetti-o.  My 10 year old claims he is Flexitarian and generally chooses very little meat and all the veggies and sides.  My 7 year old likes a meatball sub, add pepperoni... that's it.  He's quite the carnivore.

During my downtime this year I watched an interesting movie called "Forks Over Knives."  All I'll say is that is opens your eyes to how food affects you, and how it can hurt or help you.  It wasn't new information to me per se, but I think I just saw things from a different perspective now.

As a bit of an experiment, Chris and I have gone meat free.  Chris is like 100% on it.  No meat, no fish, almost no eggs.  Chris has had his own health concerns this year, (because if you're gonna burn up that health insurance, light that shit up BIG!) so the information here appealed to him as well.

I on the other hand, do not envision a world without sushi.  We've been doing this since August I think.  Do I steal a pepperoni off the kids pizza?  Yes.  Did I eat a little turkey at Christmas?  Yes.  But not at Thanksgiving.  (I lie, I ate turkey skin, because turkey skin.)  So truly I am pretty majority plant based.

I must say, I feel really really good since eating this way.  I dropped a few pounds, my hair seriously grew a ton, and I feel much less lethargic into the afternoon.  That's what I can report so far!  Chris also feels really good and has no plan to flex.

I'm not going to argue one way or another about what WOE is right or wrong.  Keto people see great results, and vegan or plant based athletes have amazing results.  Studies show support for both.  What caught my eye were the studies on how plant vs. meat may have effects on cancer.  At the same time, cancer absolutely affects those who have gone years and years never eating meat.  Your genes are your genes, can't change 'em.  If eating this way simply gets me eating more veggies, increases my home cooking, and makes me feel good - then I'm for it.

Yoga Certification - Hey!  This one actually happened!! I am now a Level I Certified Yoga Instructor.  I'm going to spend more time developing some nice beginner classes and hopefully teach.  I also want to use my TRX cert as well.  

I told myself I wasn't going back to the gym till January 1st.  But I've been back a month or so.  I am doing no chest work.  Very light back, shoulders, arms, and legs.  I tried the other day to do a modified push up.  I can lower down about 1/3rd of the way and then I just keep falling (carefully).  There is no pec strength up in here.  There is definitely no UP to my PUSH.  I remember when I had a goal of one pull up.  I think goal number 1 this year is one push up.  Takin it back to basics.  

Ok, what are your goals for twentysixteen???  Mine is one push up.  Give me something more than that.

The Issue With the Tissue

So, as usual, I have no news for you..... unless it's juicy.....

Grab a drink.  It's a long one.....

I left off here in June.  My exchange surgery was scheduled.  I also went to a Breast Cancer Yoga Certification course in Long Island... (or is it ON Long Island?).  So let me tell you about that first!

Not Long Island, but I was here and it was awesome

Breast Cancer Yoga
Generally speaking, it is not handstands and pretzels and contortions.  It's a restorative practice, focusing on gentle stretching and relaxation with full use of props such as blocks or bolsters so as to let your body deeply relax and focus on the breath.  It's tremendously beneficial mentally as well, allowing much of the stress and anxiety that often surrounds us during treatments to be relieved.

I have a lot to learn about yoga, which is kind of overwhelming for me.  I took this class with 4 other great women who have been practicing and teaching for many years and I felt a little out of place.  However, they were welcoming and warm and I learned a lot from them.

The Spartan Super!
I completed the Spartan Super!  This was a roughly 8 mile event on a Massachusetts farm.  Read: FLAT. So happy.  The morning weather was a pouring rain though, which pretty much left the entire 8 miles a path of thick, knee deep mud, and rivers so dirty you couldn't see your footing.  Plus a mix of natural "farm product" running off from the cows nearby.  So.  Even though it was flat, we had to take it so slowly to not break our necks or ankles negotiating the land!

Me and THE OCR Princess, making the photos worth the effort

This left the Spartan Sprint - the shortest distance - that would complete my Trifecta.  This was coming in August.

Surgery. Part I
My exchange surgery was July 10th and was pretty uneventful.  The ps swapped out the expander for what was to be the permanent silicone implant.  He was pleased with the outcome.  I had essentially no pain after! This is an outpatient surgery; got it done in the morning, and went home and had lunch!  Feeling good!! Ready to move on!!

The ps advised me to not move my arm above my shoulder for a period of time.  And I listened.  When he told me I could start increasing activity as long as I felt ok, I did.  Treadmill, range of motion, VERY light weights.  Like, not struggling at all.  Basically something to hold on to while my main intention was range of motion.  I felt well, no pains, no problems.  Returned for a follow up, and all was looking well.

Houston.  We Have a Problem.
This brings us to August 21st.  Our anniversary.  Long story short - because it is short (but a little gruesome if you want to skip it)..... somehow.... I accidentally rolled over in bed towards face down, shifted myself along the bed with my arm to re-position myself and then felt a weird sense.  Like my skin was pinched but not painful- right over B-.  I felt over it- and felt a gap.  In the dark I pretty much leapt to the bathroom in two steps, took one quick look at my hand, saw blood, and said to Chris, 'we have to go, we have to go'.  I grabbed a nearby bath towel to hold over it, and we left for the ER. Thank God the kids were sleeping over at my parents.

I walked into the ER, and the nurse asked, "What seems to be the problem?"  And, as you do with BC and you generally end up showing your boobs to everyone freely, I lifted my shirt and she said, "OK then, right over here."

In shifting myself a couple inches across my bed I essentially dragged my full incision apart.  

B-'s new grade- F... -

The attending doctor called my ps, who was out of town of course.  Because if you're a doctor when does the shit hit the fan with your patients- Friday nights, Christmas Eve, the day you leave for vacation.  He advised her to close it with stitches and be at his office Tuesday.

Aww, my first stitches!!  I beat my two boys to them.  Since I'm still numb over a majority of the area I didn't really feel the numbing shot, or the stitches being done.  Very Patrick Swayze Roadhouse of me. (Please don't remake that with Rousey... just, no.)

She stitched me up with 10 stitches, spaced across the wound, though the medial side was still a little open.  It looked as sad and as temporary as it was meant to be.  An attempt to just hold everything inside till I could see my ps.  I proceeded the next day to go to a friends' birthday party and feel like Debbie Downer with news of the prior evening's events.  I kept checking (probably not discreetly) to see that I wasn't unraveling.

The next few days were not fun.  But I had no pain.  None.  I thought that was so strange.

So Tuesday comes and I go to the ps.  All the feelings of the prior four days- fear, anxiety, failure (like my body failed me; or I failed my body), shame (like I did something to cause this) came to the breaking point. Up to this point I hadn't really cried, not even in the ER.

The ps walked in and says, "What the hell happened?" and I said, "I broke it." and just started to cry.

He assured me that I didn't cause this and that while it was "unusual" (Read: I don't think this has ever happened before.) to have this happen 6 weeks out from the surgery, that working with radiated tissue is hard, it's unpredictable.  Radiation essentially mutates the normal healing process of tissue.  Scars normally form in a cross linked pattern, but in tissue that's been radiated, the pattern can be only unilateral.  This leads to a loss of tensile strength.  I had been noticing since the surgery, once the Dermabond glue was gone, that the medial side of the scar was butted together, but the skin didn't seem as well bonded and looking like a scar was forming as it did on the lateral side.  There's no way to know how it was healing under the surface either, well, until it blew out.

He noted the good news, it wasn't "as bad" as he was anticipating, and there was no skin loss.  However, this would require another surgery.  The integrity of the reconstruction was now lost, and he would have to revise the scar.  This time he would use a graft to bolster under the scar.  "I want staples." I said.  Well... before that I said, "Just take the whole thing out."  I was just done.

He came back with the paperwork to schedule the surgery and went over the procedure and standard risks involved: infection, seroma, wound healing problems (and we sort of laughed at that one) death etc..  I signed away and was ready to go a week later.

To Trifecta, or Not to Trifecta
But in a few days, the day before the surgery to be exact, was the Spartan Sprint.  This was the final literal piece of my pie medal.  The three pieces fit together to make one big medal.  I at first was all, "Eff this!!  I'm going, and I'll skip all the obstacles, and I'll squat instead of burpee, and I'll bandage it real good, and tape plastic wrap around that so nothing gets in!"

But the day before the run, common sense powered through.  I had heard the course was more like 5 miles than 3.  And I just didn't have the energy to try to go.  I also figured my doctor may not be thrilled that less than 24 hours before surgery I was knee-deep in stagnant, muddy, farm fecal, probably necrotizing fasciitis-y mud.  So I sent Chris without me, and ate my $45.  

This was honestly the lowest I had felt in the whole near-year since my diagnosis.  I was just lost.  To come back up from activity from last year, to returning to it after the July surgery, only to lose it again.  And I was just so angry - the "cancer" part was taken care of a year ago.... all this shit is the "reconstruction".  I questioned that I should've just stopped at the mastectomy.  I also had already downgraded my upcoming half-marathon to a 5K, and now that was in jeopardy of not happening.  When these activities have become an outlet for your stress and anxiety or depression and they just make you feel good and strong and then you can't??  It's shitty.  

 Oh and then!  A few nights before I was half listening to ABC World News.  All the bad news was front and center, but my ear caught this, "After the break, why a study says that aggressive treatments for a type of breast cancer may not be necessary."

You don't say.  Oh the irony.....

AND what's worse!  They didn't even go into it!  They gave about 7 seconds to it and just said that treatments such as mastectomies or radiation may not be necessary.

Yeah, you said that.  

So I had to Google this up.  THIS is a bit of a summary of the study.  And even taking away the news drama spin, it's still a little confusing to interpret the information.  “The study showed that even though a lumpectomy can reduce the risk of a recurrence developing in the same breast, it does not change the risk of dying from the disease,” said Dr. Kramer. “This suggests that what you do locally to treat DCIS may not affect the risk of dying, which is the most important outcome.” Huh?  "In another finding, 517 women diagnosed with DCIS died of breast cancer without ever developing an invasive cancer in the same or other breast prior to death.  Some cases of DCIS may have an 'inherent potential' to spread to other parts of the body."  What?!  I do know this is true of many cancers, but still... in what you read on DCIS, you'll find "Stage 0", "Pre-Cancer", arguments whether its even cancer at all (which kind of pisses me off) and all these seemingly "good" sounding terms.... oh but wait, it can pop up somewhere else and take you out.  Awesome.  

I had to read this a few times and this is MY general understanding.  Treatments today, and the intention of the doctors and patient, are to aim to reduce recurrence and ultimately death, but studies show in the end it seems to lower only the risk of recurrence and not death.  Treatment doesn't seem to lower the risk of both. AND because the risk of dying from this type is so low, that there is a question to perform an aggressive treatment in the first place.  The study states it provides a case for not rushing a woman from diagnosis to surgery in a short amount of time.  These changes have been implemented for men with prostate cancer; while once treated with quick surgery, now are managed with follow-up and regular screening.  

While this IS an option in DCIS, treatment plans are determined on many things, including age and family history, among others.  

Medicine isn't perfect, it's not textbook.  The studies are done on a population of people, and those results are extrapolated to give statistics- risks and percentages.  They are not set in stone.  They are used to determine the best possible course of care.    

So in my case, and in the cases of women who are diagnosed everyday and are thrown into the confusing swarm of information and numbers and percentages, you do what you do with the information you are given.  And why wouldn't you want to do everything you could to drop that risk factor, that percentage down as low as possible! 

Surgery Part 2 ( Actually 3 )
I showed up at 5:45 a.m. and got all situated.  After FOUR failed attempts to start my IV, of which each time resulted in crazy ass swelling around where they tried to start, they called in the big guns.  This older woman who looked like she was on the 14th of her 12 hour shift.  She flicked her finger 231 times against the little vein between my 1st and 2nd knuckle.  So while the other area were bruising after the needle, we were gonna tenderize this spot first, THEN jam a needle in it.  This is for my own good, this is for my own good.

Sleepy meds, nighty night, and I was out.  Woke up later WAY more sore than the July surgery.  Long story short, he secured the shit out of it.  One running zipper stitch PLUS thick crusty superglue over it.  PLUS 8 little stitches around that.  Those are the ones that secured the graft under the incision.  He also swapped out my implant for one slightly smaller because he tried to replace the one I had, but since he had to cut away the last scar, I had less tissue to close, and he felt it would be too much tension.  So I already have gotten a reduction.  Whomp whomp.

B-'s new grade- F-........ A---

Reading operative reports is fun too.  I found out the reason I was so friggen sore on the outer edge of B- over to my ribs and up under my collarbone was because he had to scrape the tissue apart due to contraction of the capsule to increase the pocket for the implant.  Sort of like when you separate the skin of your turkey from the meat to jam a stick of butter in there?  That's what he did, without butter.  Holy cow, so sore.  

Surftown Half Marathon/5k Run/Walk/Maybe I'll try a little run 
I made up my mind to show up to this.  I would walk the three miles, and take my medal.  The damn environment and crowds suck you in though.  I wanted to run.  I walked across the starting line and thought, "Damn, this is depressing." And then I walked by the first photographer and thought "Oh hell no, we can't have this."  So by the second photographer, I broke into a little trot that may or may not come across like a run, enough for the camera, then I walked again.  

Once I got to the 2 mile marker, that was it... one to go.  I broke into a jog, holding my left arm against me (amazing form there).  I definitely felt it but not awful.  With probably a half mile to go, I slowly let the left arm down and gently let the arm go with my movement.  I ran that mile and finished. I took my medal, walked over to the side, and again, probably not discreetly, checked down my bra to make sure I was intact.  All was good.

 When you sort of run and walk for 40 minutes

you risk severe dehydration and therefore

two beers are necessary.

I had a follow up yesterday and he didn't take the stitches out yet because there's still a lot of glue over it.  I said I don't mind at all.  And he said again, "It's really unusual that this happened 6 weeks after that first surgery."  Read: I've never seen this happen, you probably effed it up somehow, but I don't want you to feel bad or cry, so we call this "unusual".  I'm technically only 2 weeks and 2 days out from surgery.  I ran a mile.  I need to get to 6 weeks.  Actually I won't be fine until December 17th, a year from when I finished radiation.  Because the opinion is out there that the tissue isn't "normal" again till a year after radiation.  (PS doesn't agree, and many studies I read on post-radiation reconstruction also disagree)  But I'll tell you what.  I don't trust it.  I'm afraid to move, I won't lift.  I quit the damn gym so I wouldn't have anywhere to go and be tempted to try to do something that might eff this up.  I am scared.  Honest to God over the past 2 weeks when I sneeze I feel it there and I'm convinced I am going to sneeze my boob apart.

Today is September 19th.  My mastectomy was 1 year ago today.  And as much as I thought and hoped, the ride isn't over yet.  I just went to my first pity party, it sucked, and I'm going to ghost outta there, kinda like I do at other parties!  Give it the Irish Good-bye.

I'm sorry this is long.  You're probably drunk.  You're welcome.          

 

Is. It. Dead.

I had two follow ups last Wednesday.  One with the oncologist and one with the ps.  I didn't expect she had anything much to tell me.  I had done the treatments, I knew things were looking better.  

The nurse took my vitals and weight (let's not go there mmkay?) and then was talking to herself about whether I needed blood work.  Hell if I know!  I just show up when I'm supposed to!

She came in and pretty much asked me 328 questions about how I was, and I reported everything was seeming pretty well!  She kind of acted surprised.  She seemed REALLY surprised that I had lowered my dose of Lexapro to the minimum.  I wasn't taking it for anything to do with this, I had started it for bad PMS.  

And then you get cancer.  

And then PMS seems stupid.  

But then you can't just stop Lexapro cold turkey - as I read "it's like throwing your brain off a cliff".  So I'm weaning off.  

She checked everything out and then was looking to coordinate my next steps, mammos and MRI's.  I should get a mammo in 6 months, and an MRI in December - once the exchange and reconstruction is done.  Then probably alternate every 6 months after that.

This was all yada yada yada in my head.  I got right to what was on MY mind:

"Based on your experience with a case like mine, and now having done radiation, what do you think is (waving over B-) in there?"

"Is it dead?"

She says, "I would say yes."

I didn't burst into tears or throw my hands up in relief.  I just nodded and said ok.  

Why doesn't this make me feel better?!?

I know why really, I'm just a black and white person when it comes to this.  You have it or you don't.  I logically know about the percentages and I know my treatment reduced everything to the lowest possible point, but still, I have the feeling that I am still only cautiously optimistic until the MRI in December.  I'm not going to be a crazy head-case until then and lose sleep and worry.  I just want something on paper to confirm.  I want someone looking IN there and confirming that it is indeed, dead.  

After this appointment I went straight to the ps.  He said I was healing well.  He also said I've rotated my expander.  Oops.  My guess is maybe since its gotten more comfortable to sleep on my left that I'm kind of mashing it around a little?  To me this thing doesn't move at all, but somehow I smooshed it over or around or west or whatever.  He said "Don't worry, I'll fix it."  Awesome.  

He said he has no way to tell what damage if any has been done to the pocket by the radiation.  The area will continue to heal for 6 months so from now on there can be continued contraction, scarring and skin issues.  He said that while at times they just go back near the main incision to do the swap, that if he foresees any problem, he'll instead make a new incision underneath the breast and swap it from there.  Yeah baby, more scars.

I asked him how long the recovery usually is. "Cause I got things to do!" is how I phrased it.  I have a Spartan Super run June 20th, and the Surftown Half Marathon in early September.  So I'm open for a little boob job anywhere in the middle there.  

Oh yes Cancer, you work around MY schedule now.....

He states usually two weeks.  So July may be good!  Nice birthday gift to myself huh??  

He said he doesn't really need to see me again till we're ready to nail down a date.  Until then I have one more follow up with the radiation oncologist, and maybe the surgeon?  Have to check my book.  But its damn nice to see the calendar filling in with events and possible runs and all this other good stuff besides doctor's appointments.  

I'm picking up my running again.  I have made a couple crazy-ass deals with friends over all this.  One being the triathlon.  What's nice is that there are some indoor kinds that I think are manageable for me as a total beginner.  I have nowhere to swim!!  I have a $99 bike from Target.  Seriously not competitive here.  But actually I'm finding some workable options! 

The other one I got roped into thanks to a little wine and crazy New Years resolutions (actually it's just because I blindly say yes to everything) is to run 2015 miles in 2015.  And this can be split among people, and I'm doing it with a grand total of ONE other people.  So if Fair Oaks math serves me right I have... 1007...  and a half..... miles to bang out this year.  

I really need like.... 2015 other people to share the load with right now.  Anyone?  Bueller?

I tried to run 1000 in 2013.  I got to 666 or 669.  That's kinda close.  



  

   

Weight Off My Shoulders, and Up in the Air

I.  Am.  Done. 

33 radiation treatments done over 6 weeks.  It seemed like it was going to be a long time, and then - it was over.

B- looks rough but actually fared better than the doctors and nurses expected.  The skin is red, peeling, dry, like a good sunburn.  The scar area is contracted.  And even though I'm done the effects continue to work for about two weeks, so it may continue to cook on the inside.  I said to Chris that I seriously feel like B- is warmer to the touch that B+.  I suppose that makes sense.  It's just strange.

I had my last day of radiation all planned out.  It was supposed to be Wednesday the 17th.  Be done by 8:30 am, grab a coffee, and head to the spa to use a gift certificate that I've been holding on to since May.  It was for Mother's Day/post-Marathon treat.  Of course with a marathon if you get through it with all your toenails intact you're lucky.  I did not, definitely bruised, sore, and I lost 1.5 of them.  So pedi had to wait.  

This last day was gonna be IT!  But Monday evening they call me to tell me the machine had broke, and a new part was being installed the next day, so no patients could be treated.  That bumped my last day to Thursday, and I would get to treat myself on my last day to.... work.  Whomp whomp.

I had one last check-in with my doctor.  I could only ask her, "what happens now?"  She said they continue to monitor, both with scans and with palpation.  And that just seemed, after all this, so... simple?  And my inner voice kept shouting at her, "NO ONE FELT ANYTHING IN THE FIRST PLACE!!"  In my head, by the time someone (someone, lol, anyone, random stranger) is feeling something on me, it's gone too far.  And this tucks back into the little box in my head labelled "scary stuff". 

We shall see.

But after that last day, I felt a sense of relief and freedom that I hadn't felt in a long time.  Everyday from July 18th to December 18 was CANCER.  And somehow that day, leaving the hospital I felt DONE!  I have a bunch of appointments in January.  And I know obviously it's not over.  In a minimum of 6 months I start a process of reconstruction.  Can't be setting of metal alarms forever!  But that's gonna have to fit around some planned activities.  (more on that later!)

I've gotten back into the gym.  It's been interesting to analyze myself and where I've gotten weak.  Seems to be my shoulder and chest is getting stronger, by oddly enough my right shoulder and core are not feeling 100%.  Can't hold planks like I used to, and my right shoulder fatigues quicker now.  Just things to work on.  

In the gym last week, I was doing shoulder press.  Chris was spotting me since my left shoulder is still a little wonky.  Did 25's no problem. Did 30's not bad.  Tried 35's.  These used to be no problem.  But I could feel the left getting goofy and I relied on the support of the seat back.  

An older man came up to Chris as he was re-racking my weights (that's what the trainers should do lol)  He told him I should lower my weights and bring my seat angle back, he said I have a weak back.  Chris said thanks, and the guy walked on.  Chris told me what he had said.  

"Weak back!  No shit Sherlock, I have half a chest too!  
Whadya recommend for that!"  
(Again my shouty inner voice.)

I picked up the 40's .  (Because I'm spiteful.)

I put them back down.  (Because he messed with my head.  And they were heavy.)

Not happening today.  Probably next week.  

I thank you all so. much. for reading the post on Baby Gavin last time.  The prayers and any donations you sent are an amazing blessing for him and his family.  I know he got to spend Christmas at home.  And back on with the fight they go.  

I Might Have Left Out This Info - More TMI

Day 11 of radiation tomorrow!  A third of the way there.  B- is doing ok; getting a rosy tone, no middle of the night glowing as of yet. 

 It occurred to me that over these last posts I left out a rather important piece of information.  How I figured out something might be wrong in the first place.  

I mentioned that when 4 doctors went to second base on B- while in the midst of my testing, none of them felt a lump.  And all women are told to do self-checks to feel for lumps.  

So this goes back to May.  The day before I ran the Buffalo Marathon.  We were staying with my cousins.  I decided to hop in the shower.  I took off my bra and noticed a small stain like dried blood inside the cup.  So I'm looking at myself and I don't see anything, no cuts, scratches, I certainly don't shave there...

So I squeezed gently at the nipple, and out comes a pink/orange blood-tinged ooze.  And naturally, I'm like,

"Oh that ain't right."

I'm not nursing anyone here.  Nothing should be coming out of here anymore!  This doesn't occur on the right side.  

So after the shower, I sit downstairs and do what anyone would do-

Google the shit out of it.  

 The differentials are from the mild... to the cancer..... Dr. Google thinks everything is cancer.  

Exactly what I want to read before I need to go RUN A GODDAMN MARATHON.  I need all my mental focus to just not shit myself by mile 19..... or 2.  

Regardless, I put it in the back of my mind through the marathon.  And running a marathon makes you forget a whole bunch of stuff.  Like your name.  I finished with a smile and a release of tears.  It's so emotional!  I was so proud of what I had just done.  Chris had finished a while before me and was there to greet me and all I said was, "I want to go home."  Skip the post-run beer, I sure as hell wasn't getting any time awards, I just wanted to go home.  It was ah-mazing.  

I had postponed my physical from February to early June because of training.  It's interesting to think now the pieces that fell into place and the timing to how I discovered this.  I wouldn't have noticed anything in February, and would have had nothing to say to the doctor out of the ordinary.  I can't even recall on breast exams at the doctor or gyno if they squeeze your nips to check... 

So with the physical in June I mentioned the discharge (another one of those 'ew' words).  It was consistent.  Don't think I wasn't now regularly squeezing that thing to see if it was still happening or I had imagined it.  She cultured it and it was negative for whatever it could be positive for I don't even know.  My gyno thought it was likely a  90% chance of being a papilloma - a benign growth affecting the duct, easily handled with a small surgery.  But that kicked off the blood work (negative) and mammogram with ultrasound.  Small calcifications, enlarged ducts, but nothing that screamed "TUMOR" till the biopsy.  And it was not the 90%.  

So lesson is - breast self-exams AND squeeze your nips!  My surgeon mentioned that even if you aren't nursing, yellow or whitish discharge can be physiologic.  But blood is well, blood.  And not every blood (or serosanginous - word of the day) is cancer.  But definitely worth the follow-up.  

But this raised my question to the doctors about the future.  Especially after the mastectomy and the fact that margins were positive so there is SOME very small chance of local recurrence - though lowered with radiation.

"How do I know anything is there when I had no lump and now I'm nip-less, i.e. nothing to squeeze and see??"  

Basically it comes down to mammos on B+, and MRI's on B-.  Skin changes can occur so still self-checks are a good idea, but basically the MRI and I will become pals.  I'll take that day to be nervous as shit that "this is the time something shows", but otherwise keep filling my brain with the good stuff: runs to do, yoga moves to not break my neck with, coffee, wine, books, friends and family, wine....  

But this is kinda true too, 

 

 It's all gonna be ok.  
 

 







 

1 Down, 32 to Go

Before I begin, I've decided that from now on, my breast formerly known as left will now be referred to as B- and my right will be B+.  Writing breast over and over, it's becoming one of those words like "panties" and "moist", just ew.

Today I started radiation.

I have 33 scheduled treatments.  

I'm not sure where I last left off.  The doctors brought my case before the tumor board and determined that a few things worked against my favor- my age and my type is ER-negative (meaning hormonal medications used to stop growth of tumors are useless for me).  So my doctor feels in her gut that radiation is the best way to keep my percentages and chances as low as possible.  

Last week was the simulation.  They measure, mark, and tattoo you.  Oh yeah, tattoo.  Measurements are to the millimeter and cross-checked.  They adjust the x and y of the table in subtle jerks.  Check again.  

I lay on my back with arms overhead, holding on to bars.  And these people are all up in my business with little rulers and sharpie markers.  

I am slid into the machine and it whirs - kind of like an MRI, this gets the lay of my land, so to speak, so they know at what precise angles to direct the radiation.  

When they have it right, the tech comes in to tattoo me.  It's 4 pinpoints no bigger than a .  One outside B+, one on my sternum, two outside B-.  I asked him for a butterfly or anchor or something cool, but he said his artistic talents are limited to .'s

Yesterday was a dry run.  I am laid on the table again.  The ceiling overhead is painted like a night sky, with white dots for stars.  I'll see this ceiling 5 days a week till mid-December.  More checking, now with laser-level lights from the ceiling x-ing across my chest.  All I can think of is 

They tug the sheet under me here and there to line me up, and take and few pictures from the left, swing the machine over to my right, and shoot again.  The oncologist approves the line-up, and these will be my settings.

Today was number 1.
Same room, same techs.  I say "I feel like I was just here yesterday!"  Then realizing, hey dumbass, I'll be here tomorrow, and the next four or five weeks.  I am not so clever after all.

I am lined up and adjusted more efficiently now.  The rad. onc. places three little patches around B- that will measure the dose I receive.  The machine starts 90 degrees to my left side.  (No more laser lights though!  I was kind of disappointed.)  The room is dim, but when they hit the button to zap me, the room lights flash on.  The machine orbits around slowly to a 45 degree angle to my right.  

As it passes over me I catch my reflection in the glass pane of the machine.  It caught me off guard a bit.  Like seeing myself how all these doctors and nurses are seeing me.  Seeing myself from outside myself.  It's a vulnerable position.  Arms braced over my head, B- hanging out in the breeze with sharpie-x's around the scars.  I'll catch that reflection for 33 days.  Or I could start counting the stars on the ceiling. 

I think this gives me more anxiety because with the mastectomy, it was instantaneous.  I like things to be taken care of NOW.  This is a long, intimate treatment road, and besides any rash or skin reaction, I can't SEE that it's working on the DCIS.  Takes a little more mental fortitude to keep the positive up for nearly 33 days straight...   

Lights out, lights on, treatment done!  Literally 5-7 minutes outside of getting gown on, setting up, almost 20 minutes in to out.

I don't feel anything with the treatment itself, but have been counselled on the skin reaction that may start within the next 1-2 weeks.  Mild reactions such as a tanning or pink tone to the skin, or more severe reactions such as a blistering rash.  Awesome!  There are creams or medications to help.  They suggest I go bra-less whenever I can.  No problems there!!

I grabbed coffee from the cafe counter outside the radiation suite.  I should make friends with the cashier, as I no doubt will be getting 33 cups of coffee from her in the next few weeks.  It's just too easy.  That's how they make you feel better.  All the coffee.  If they only had a bar..... 

I met two older women in the waiting room.  One on her 20th and last day, one mid-way through.  Both had undergone chemo, too.  So far I only have seen older (than me) patients here.  I am definitely the young newbie.  But these women were funny, saying there probably wasn't anyone in the hospital who HADN'T seen her boobs by now. They say these people become like family, because your treatment time is pretty much locked, you'll see the same nurses and patients.  

So I'll see you in 32 days!!!