End of Radiation and Next Steps: When Being 'Just Okay' is Okay!

First, THANK YOU to the many, many people who have asked how I am doing! It is so appreciated. I am okay.

This post has been a LONG time coming. It's pretty in-depth. If you'd prefer a one-paragraph summary, here goes:

I was diagnosed with breast cancer August 4, had a lumpectomy September 3, my 21 daily radiation treatments were complete November 4, and I have started tamoxifen and venlafaxine with minimal side effects. My skin barely burned and is completely healed, as are my surgical incisions. Yes, the surgeon took away all the visible cancer and my prognosis is good. Pathology reports of lymph nodes and tumor margins were completely clear. Hopefully, I won't have to deal with any more cancer for the rest of my life. The very positive thing that's come out of the experience is extreme clarity in most of my decisions since I tend to value my life a LOT more these days.

Jon came to see me ring the end-of-radiation bell and we made a day of it. XOXO

That's the gist that most people want to hear and that I truly want to believe! STOP READING if you're short on time. If not, I'd like to clear up some cancer myths a LOT of folks still believe because, thankfully for them, they haven't needed or wanted to learn more about the disease. I'm no expert, but have compiled a lot of good information from multiple books, articles, and discussions with my physicians and other cancer patient friends.CANCER MYTHS THAT BUG ME

MYTH #1: YOU MUST HAVE DONE SOMETHING TO GET CANCER, LIKE SPEND TIME IN TOXIC ENVIRONMENTS OR EAT THE WRONG FOODS.

Nope. Just nope. A couple of people suggested that since some of my WV girlfriends have also been stricken with breast cancer, our common time hanging out in the environment of the WVU Creative Arts Center for many years must be to blame. Something there MUST have caused our cancer. (Asbestos or mold, anyone?) Or, maybe our diet. Lifestyle? That HAS to be it.

Wrong.

Although there are 5 known controllable risk factors for breast cancer (obesity, alcohol consumption, late in life pregnancy, sedentary lifestyle, and multiple years on birth control pills), there are just as many uncontrollable ones, including family history and just plain bad luck.

The tendency when you're blindsided with the diagnosis, as I was August 4, is to blame yourself. But there has been absolutely no scientific evidence that any one behavior (or a combination) causes cancer. Some people's cells just plain decide to betray them, and no one knows why at this time in our history (here's hoping for a CURE in our lifetimes, though).

MYTH #2: THEY GOT IT ALL! YOU'RE CURED!

You're never truly cured of cancer. There is always a chance of recurrence, no matter what surgery or treatment plan you've got in place. Many kinds are treatable, but cancer patients are forever on "cancer surveillance," as my surgeon calls it. My possibility of recurrence, I'm told, is < 2%. That's fantastic and helps ease the mind a bit. But it's not 0. No one's is.

That's a tough pill to swallow - that once diagnosed, you have to think about cancer for the rest of your life. I still think about it a LOT daily, but I'm told this fades over time. I am looking forward to the day when it doesn't cross my mind once.

MYTH #3: HAVING A DOUBLE MASTECTOMY IS BETTER FOR PROGNOSIS THAN JUST A LUMPECTOMY.

Double, or bilateral mastectomy, is when both breasts are removed. A lumpectomy is called a partial mastectomy because just the lesion, its surrounding tissue, and often a few lymph nodes are removed. I had a lumpectomy. The chance of recurrence for lumpectomy + radiation patients is exactly the same as the chance of recurrence for mastectomy patients, even though the latter involves no remaining breast tissue. The reason for this is because there is always the slightest chance that microscopic cancer cells could have broken free even before diagnosis and settled somewhere else in the body, rearing their ugly heads months or years or decades later. The chance of this happening is very rare, but since it's still a chance, it has to be considered in the statistics. Lumpectomy patients almost always undergo radiation therapy as an "insurance policy" of sorts, to help prevent any sneaky cells from popping back up. Furthermore, hormone-positive tumors like mine benefit from a third part of the insurance policy: hormone blockers like tamoxifen, which hopefully starve any pesky microscopic hormone-loving cells. DIE, YOU JERK CELLS.

MYTH #4: ALL WOMEN ARE COMFORTED BY BEING REFERRED TO AS 'WARRIORS' OR 'SURVIVORS.'

This is a tricky one. Here's the deal - people who haven't personally lived this disease have no idea how to talk to the cancer-ridden person about it. They try (I did, too, with my girlfriends before I got it). Their hearts are ALL in the right place. But just as every woman is different, every situation is different. Some folks love all the attention and labels and pink gear. Some want NO part of any of that because it's just another reminder that this thing they didn't want to define them, in fact, has done that very thing. 

Five years ago, I created for one of my friends what I thought was a beautiful ornament with a photo of all of us in our pink during one of the walks for life. I was the super supportive friend with the PERFECT present! Then one day, she very sweetly and diplomatically told me she really didn't want any more things like that, because she didn't want any reminders of the experience.

I am middle-of-the-road with how I feel about all this. I really am. So many people did and said kind and thoughtful things for our family when I was initially facing this, it was extremely moving. I love my pink gear and wear it often. However, I DO feel as if the 'survivor' term is strange because it's meant to imply I've fought something and won, which I haven't. I got a diagnosis and cried/felt nauseous for an entire month, then had a million tests, then surgery, then drove myself to what felt like a trillion radiation treatments, and now I pop a pill each day for 10 years to hopefully keep it away. Nothing about that really says "fight" to me, even though I definitely started honoring that nomenclature and even have it as a label for all these posts. Still, though...

Aren't ALL humans fighting and surviving something (especially in 2020, HOLY MOLY)?

MYTH #5: I DON'T NEED TO WORRY ABOUT A MAMMOGRAM UNTIL I AM 50.

The guidelines for this change ALL THE TIME so it's easy to be confused about the current recommendation. So I suppose this doesn't really qualify as a 'myth' but I definitely have a STRONG opinion about it - GET THE MAMMOGRAM. AT 40! A friend did, and was, unfortunately yet fortunately, diagnosed with her VERY FIRST MAMMOGRAM. Will the mammogram catch everything? NOPE. Lots of times it catches a little and then you find yourself in an MRI where it catches more, and thankfully so. Sometimes it catches nothing (hence the yearly visit to make sure things get caught the next go-around). There is also the self-exam which you should do monthly in the shower. But many of my "cancer club" sisters did not feel anything, and instead were diagnosed as a result of a routine mammogram. I was the same. Just go with your gut here on when to get that mammo, but I tend to lean to as close to 40 as you can, and earlier if ANYTHING seems weird. Above all else, if you have a good feeling about your doctor, LISTEN to him/her. And if something doesn't feel right about your doctor, CHANGE ASAP.

MYTH #6: MY FRIEND IS DONE WITH HER TREATMENT AND WILL BE BACK TO HER OLD SELF.

As I mentioned earlier, you're never really done. It's a life-threatening and thus life-altering thing. However, the "new normal" I've personally found myself in has been a promising one. Decisions about all things are easier. I am taking a genuine interest in caring about my mental and physical health because the universe slapped me up the side of the head and I got the message loud and clear. Life and the small things it offers just plain mean more. 

If you've made it to this point, thank you. Getting it out there really helps me process and heal, and I appreciate you coming along for the ride. So, I am just okay. I'd like to get this experience a little more in the rear view mirror before I feel like I can upgrade to 'good.' 

And you know what?

That is okay!

HALFWAY THERE (and celebrating D)!

Yesterday marked radiation treatment number 11 of 21, so I was officially halfway through this part of the cancer journey - what a GREAT feeling!

I asked the two techs to pose for a commemorative selfie and they were happy to. 

Monday was another great day - D was completely finished with her treatments and got to ring the bell! She had me film it live on facebook and many of her friends tuned in.

Again, there weren't any dry eyes around.

We exchanged some presents neither one knew about and then she walked out of there.

I have missed her the past couple of days and hope we can get together someplace WAY MORE FUN soon.

I'm feeling physically fine. My skin is starting to get a little pink/tender and I'm beginning to feel the fatigue from the build-up of radiation, but I see the oncologist weekly now and he maintains these are both completely normal side effects even though I'm religiously applying all the recommended creams.

Mentally, things are just okay. I felt better for a bit once surgery was done and treatment was in place, but it's now been over 3 months of thinking constantly about cancer and that wears on a person. It's a definite trip on the struggle bus. COVID complications don't help - OMG how I would LOVE to just run away from here on some fabulous vacation, but that's nearly impossible at this point.

And speaking of transportation, the drive is getting very monotonous - I leave at 6:30 every morning to fight fog and crazy drivers. 

But, if there are no traffic tie-ups, I get time to hang by the Marissa Memorial Fountain for a bit to play Harry Potter Wizards Unite before trekking into the radiation wing.

As of the moment I write this, I've got only 9 more sessions to get through. Here's to hanging in there.

First Radiation Treatment!

This morning, I experienced the first dose of daily radiation therapy. Twenty remain [sigh]. Truth be told, it wasn't bad at all. You know what's bad? The insane drivers on I20 and I26, that's what. Holy mackerel. YOU SHOULD HAVE LEFT EARLIER, LOSERS! AND STOP TEXTING WHILE DRIVING!

Anyway, let's talk about yesterday, when I attended my final mapping appointment. I laid on the table with a bolster under my knees and my arms above my head while three sweet techs slid me around on a sheet, drew all over me with a permanent marker, put stickers on me, and made me hold my breath for 30 seconds a few times. Weird. It was a rehearsal of sorts for today, where they wanted everything to be perfectly aligned so they treat the correct area. This makes me happy. 

Today, I scanned my card, walked into the locker room, got changed, and sat down in the radiation waiting area. It was there where I met D! She is halfway through her treatments. We chatted and compared notes while adorning our super sexy radiation smocks, learning that our cancer stories are very similar. 

After a few minutes, in bopped V, whose last day of TWENTY EIGHT treatments was TODAY. She and D had become close. We were instant buddies (in one of the worst clubs). The techs came to get D and me and we asked if we could wait a few minutes more so we could see V ring the bell, signaling the end of her treatment. They happily obliged.

Here are D, me, and V right before the bell ceremony.

Everyone, and I mean EVERYONE, cried when she rang that thing. I know it is not as big a deal as the chemo bell (and shouldn't be, either!) but was so surprisingly emotional. It was very cool for me to be among women in the middle and very ends of their treatments on my first day. 

Soon after V left, it was my turn for treatment. Here are the techs setting up my arm holders.

I like this photo because you can see the beautiful seascape image patients get to admire while lying on the table. I get to look at it for a little bit, but then have to turn my head to the right and up a little to help protect that part of my body from the beams.

Before my session began, my oncologist came in to triple-check that everything was arranged as it should be. During the treatment, I looked at a very small computer screen with bars that aligned when I had taken a deep enough breath, signaling me to hold it. The techs came over the intercom system each time to help coach me along. It was easy and I only had to do it four times. It took 5-10 minutes total. With radiation, you don't feel anything. All that happens is the machine whirls slowly around your head and makes a tiny bit of noise when they are firing the beams. It is very open and is NOTHING like the obnoxiously loud claustrophobia chamber that is an MRI machine.

DONE! 1 down, 20 to go.

Fighting the Mountain Lion

 

A friend shared the following piece of brilliant writing with me. It was posted in the Cancer Survivors Network on the American Cancer Society's website. Unfortunately, I haven't been able to find out who the author is.

I love it very much, as the perfect metaphor for so many of my recent frustrations.

_____________________________________________

In case you've ever wondered...

"What's it like to go through cancer treatment?" It's something like this: one day, you're minding your own business, you open the fridge to get some breakfast, and OH MY GOD THERE'S A MOUNTAIN LION IN YOUR FRIDGE!

Wait, what? How? Why is there a mountain lion in your fridge? NO TIME TO EXPLAIN. RUN! THE MOUNTAIN LION WILL KILL YOU, UNLESS YOU FIND SOMETHING EVEN MORE FEROCIOUS TO KILL IT FIRST!

So, you take off running, and the mountain lion is right behind you. You know the only thing that can kill a mountain lion is a bear, and the only bear is on top of a mountain, so you had better find that bear. You start running up the mountain in hopes of finding the bear. Your friends desperately want to help, but they are powerless against mountain lions, as mountain lions are godless killing machines. But they really want to help, so they're cheering you on and bringing you paper cups of water and orange slices as you run up the mountain and yelling at the mountain lion, "GET LOST, MOUNTAIN LION, NO ONE LIKES YOU." And you really appreciate the support, but the mountain lion is still coming. 

Also, for some reason, there's someone in the crowd who's yelling, "THAT'S NOT REALLY A MOUNTAIN LION. IT'S A PUMA!" and another person yelling, "I READ THAT MOUNTAIN LIONS ARE ALLERGIC TO KALE! HAVE YOU TRIED RUBBING KALE ON IT?"

As you're running up the mountain, you see other people fleeing their own mountain lions. Some of the mountain lions seem comparatively wimpy - they're half grown and only have three legs or whatever - and you think to yourself, "Why couldn't I have gotten one of THOSE mountain lions?" But then you look over at the people who are fleeing mountain lions the size of a monster truck with huge prehistoric saber fangs, and you feel like an ******* for even thinking that. And besides, who in their right mind would want to fight a mountain lion, even a three-legged one?

Finally, the person closest to you, whose job it is to take care of you - maybe a parent or sibling or best friend or, in my case, my husband - comes barging out of the woods and jumps on the mountain lion, whaling on it and screaming, "DAMN IT MOUNTAIN LION, STOP TRYING TO EAT MY WIFE!" and the mountain lion punches your husband right in the face. Now your husband (or whatever) is rolling around on the ground, clutching his nose, and he's bought you some time, but you still need to get to the top of the mountain.

Eventually, you reach the top, finally, and the bear is there. Waiting. For both of you. You rush right up to the bear, and the bear rushes to the mountain lion, but the bear has to go through YOU to get to the mountain lion, and in doing so, the bear TOTALLY KICKS YOUR ***, but not before it also punches your husband in the face. And your husband is now staggering around with a black eye and a bloody nose, and saying "Can I get some help? I've been punched in the face by two apex predators and I think my nose is broken," and all you can say is "I'M KIND OF BUSY... IN CASE YOU HADN'T NOTICED, I'M FIGHTING A MOUNTAIN LION."

Then, IF YOU ARE LUCKY, the bear leaps on the mountain lion and they are locked in an epic battle until, finally, the two of them roll off a cliff edge together, and the mountain lion is dead.

Maybe.

You're not sure - it fell off the cliff, but mountain lions are crafty. It could come back at any moment.

And all your friends come running up to you and say, "That was amazing! You're so brave! We're so proud of you! You didn't die! That must be a huge relief!"

Meanwhile, you blew both your knees, you're having an asthma attack, you twisted your ankle, and also, you have been mauled by a bear. And everyone says, "Boy, you must be excited to walk down that mountain!"

And all you can think as you stagger to your feet is "**** this mountain. I never wanted to climb it in the first place."

Medical Oncology Consult and CT Scan for Radiation Mapping

Today was a long, tiring one full of appointments.

First, I met Dr. Stilwell, my medical oncologist. I. LOVE. HER. She is kind and funny and spunky. She took a lot of time to explain everything I've gone through and what I can expect in the future, and drew graphs and charts to help. I was given LOTS of information, and some of it was new: Apparently, pathology discovered a tiny "satellite lesion" beside the main one. It's all good now since everything was removed, but that spread is enough to wig a person out. Still, I was reminded again that is what radiation treatments and hormone-blocking meds are for. We are going to kick this thing completely.

Dr. Stilwell performed an examination and was pleased with the way I've healed. I had a stitch poking out a little and stabbing me in the armpit and she offered to cut that off for me, which was amazing and that's one less thing to be a martyr about. They took more blood at this appointment because apparently there is so much they can learn from it to help determine the best course of treatment. Science rules. My next appointment with her is going to be in six weeks, after all the radiation treatments are done.

This afternoon, I had my CT scan so they could adjust the board I will lie on and map the exact places they plan to zap. There was nothing scary about this, just strange, as so many parts of this entire process have been. They took an image with normal breathing and then one where I held my breath for about 20 seconds. The doctors will compare those images to see if holding my breath made that much of a difference with heart placement. Yes, this is unsettling, but everybody keeps saying the benefits outweigh the risks, and I agree with them. With radiation, the cancer has a less than 3% chance of recurring. Without it, the percentage could be as high as 40%. So, yeah, go ahead and fire away near my vital organs for a few days.

Here I am, getting ready to go into the machine. We didn't end up choosing this board in the end because they didn't like the angle very much once they got me in there. (BTW, a dear friend's mother made the super cool mask and nearly every health professional I've encountered has been in love with it!)

Here's the board they actually ended up using. It's raised up a little more and is actually more comfortable. I hold my arms above my head and rest them in the purple holders. You can see the red laser line they moved around to get me lined up.

After the CT scan, I was given a tour of the treatment facility and shown how to scan my card when I check in each day (yay - I don't have to stop at the front desk anymore, and instead just march in like I own the place). 

The next step is the final "official" mapping appointment right back here in one week (October 6). They will have my blood tests evaluated by then so they will be able to specifically plan everything about treatment. SO. MANY. DANG. STEPS. The therapist told me that I will very likely start my first treatment the next day, on October 7. I am VERY HAPPY there is FINALLY a date for this! This means I'll be done by my birthday. Yippee!

Radiation Oncology Appointment (and some thoughts on survivorship)

Today, I met Radiation Oncologist Dr. Davis and his nurse Tonya. They are part of the team that gave me this afternoon's crash course in the radiation therapy I will soon have and everything that comes with it. I am not scared or particularly worried about it; I've heard there is often some discomfort and also fatigue, but that seems like it can be handled easily. They also told me I would only be on a 4.5 week plan of 21 daily treatments, which sounded way more promising than 6 weeks' worth of drives to Lexington. One interesting fact I learned about the treatments is that I will have to hold my breath for 30 seconds at a time while they are firing at me because that pushes the heart away from the chest wall and out of the treatment area. I got a whole handout on how to practice this prior to the CT scan. Big, fat, EEK on the necessity of this!

Tonya gave me this binder (I've been given many). It goes into more depth about radiation and cancer in general, and talks a good deal about survivorship, a word I hadn't really heard much until today. I'm not happy that I will now be worried about cancer for the rest of my life, but it's a thing and I suppose it's minor in the grand scheme; I DID get "out of this" for now with relatively easy surgery and treatment options. 

The next step is a morning appointment with my medical oncologist (the one who will oversee my hormone-blocking medication) and a CT scan, both on this Tuesday afternoon. I will have blood drawn and the CT scan won't involve an injection with contrast dye OR me drinking the gross liquid, thank goodness. The scan is just to help the doctors zero in on the exact spot they plan to treat. They will then draw a map on me with a special marker (NOT tattoos, as some of my friends have received during this treatment) and then cover those marks with special stickers that won't come off until I am done with all my treatments. 

The next exciting thing about Tuesday will be knowing the actual schedule for all the treatments. There will be a light at the end of the tunnel then, and I will be able to take steps to go back to teaching (in my new school and new district - finally).

the news you WANT

Kim, my nurse navigator, called this morning with some GREAT news! When it comes to cancer, any news considered to be great is definitely welcome (and often rare), so I started crying when she gave me the oncotype score. It is a 6 out of 100, meaning I do not have to endure chemotherapy (had it been around a 20 or above, chemo would have been seen as a potential benefit and would have been recommended)!

This is a stock photo, but I don't have an actual one of me jumping for joy, so it'll have to do. 

I am so happy that targeted radiation and oral hormonal therapy are the only other parts of treating this jerk cancer (I learn about these next steps this week and next). The low score also means the tumor was not considered to be aggressive and does not have a good chance at all of recurring. I am the happiest and most hopeful I have been since being diagnosed on August 4. Thank you, universe and people who pray.

Who knew getting such a low score on a test could mean such great things?

Post-Op Appointment

Today, Jon and I saw Dr. Craft (for one of the last times) at my check up. That's one of the weird things about this process - you get to know and really like your providers and then BOOM, they are out and new folks are in. I will see him in March, though, for my already-scheduled 6-month post-mammogram check up, so that's good. He calls the mammograms I'll have forever now "surveillance mammograms." 

All news is good, as I posted about on Friday. He confirmed the negative margins and negative lymph nodes and said it was about the best news we could have. The only thing he said he wished looked a little different was the tissue around the site he removed. But then he reminded us that is what radiation therapy is for - to take care of any possible weirdness left over that wasn't able to be detected through other means.

The incisions are healing great. He said 100% of patients develop a seroma where the tumor used to be, and just to call him if I experience any pain from that. He doesn't expect me to. It'll likely be gone in a month or two. 

He said I'll be on radiation treatments and hormonal therapy, and we don't know the time frame of these things yet until we talk to the two oncologists I will now see: Medical and Radiation. The radiation consult has already been scheduled for next week (I continue to love the snappiness of how this hospital system makes things happen)!

Still, the scariest part is behind me (unless I have to go through chemo, but we're not going there). Things are getting better each and every day. 

Some Test Results

I received some good news this morning: initial pathology reports came back to show that the two removed lymph nodes and also tumor margin were completely negative for cancer. This is a very positive outcome and was expected.

There will definitely be daily radiation therapy starting in about 4 weeks, and also years of hormone therapy. I knew this, so this is also okay.

However, the news isn't officially great YET. 20 years ago, my tumor's Stage 1 invasive status would have meant automatic chemotherapy following the radiation treatments. Nowadays, THANK GOD, the tumor is DNA tested (the Oncotype Dx test) for a recurrence score. Like golf, this is one score you want to be LOW. My score on that (which we will learn in about two weeks - you guessed it... MORE WAITING) will be the deciding factor about chemo or not. Here is more information on tumor profiling.

The medical team does NOT expect my score to be high enough to warrant chemo. However, they can't say for sure because, you know, they are scientists, and I am happy that they are. Scientists have saved my life.

Two weeks. Tick tock.

Surgery Day

Yesterday, September 3, I had lumpectomy surgery at Lexington Medical Center in West Columbia, SC. It was a day I was both dreading and dreaming about (dreaming about the getting it overwith part, of course). Everything was scheduled to begin at 10:30, which in reality ended up being closer to 11:30, but who's counting? I'LL tell you who's counting: someone who hasn't had any food or water since midnight, like a Gremlin, that's who.

This is us in the car moments before Jon dropped me off at the imaging center (step one of many for the day). Scared = understatement. I am so thankful he was allowed to be with me because he is my rock and I would have been a basket case otherwise.

In the imaging center, they put fresh-out-of-the-dryer blankets on me (LOVE - this happened throughout the day and I never knew how much I could truly appreciate a warm blanket) and then took photos at a mammography machine where I was seated. The doctor numbed me with my old friend lidocaine and then inserted and attached a wire to the biopsy clip that had been hanging out in my breast since the first biopsy. I was like a strange robot, although I chose not to look over at the weird wire. She then used the ultrasound machine to find the spot and draw a "map" for Dr. Craft with what I think was a permanent marker. Also strange, but hey, ANYTHING THAT HELPS, amiright? They taped a styrofoam coffee cup over the wire to secure it. This was bizarre but they said it works just as well as the $99 cups the medical specialty stores sell, so I went with it. A tech wheeled me over to nuclear medicine next.

Jon had been waiting in the radiology waiting room, and I knew I would soon get to see him for about 15 minutes, so I was super happy and calm to be in this different room. The only lousy part was when a doctor injected blue radioactive dye into my nipple 4 times. Yep. I was pretty glad when that was over. The tech held my hand during this procedure and joked that she wasn't there so much to comfort me as she was to protect the doctor from getting throat punched. I soon understood what she meant, lemme tell ya.

After the dye was injected, I had to do some shoulder exercises and massage it around to make sure it traveled up to the lymph nodes before she took the pictures. She got Jon to come in so he could hang while I did that. He also got to stay for the photos. Weirdest date I hope we'll ever have, that's for sure.

Here we are right before the photos she took of the dyed tissue.

Here I am in the machine where she took two 5-minute photos of the dyed lymph nodes. This was so the doctor would be easily able to locate and remove them for the post-surgery biopsy.

Sadly, Jon and I had to go our separate ways after the photos. He took this of me as I was heading into pre-op and as he traveled to the surgical waiting room.

Pre-op was what you'd expect, I guess. I climbed onto a bed and the nurses put on my compression socks, asked me a bunch of questions, took my vitals, and inserted the IV. I got more lidocaine before the IV insertions, which was comforting. I say insertionS because the first nurse tried on my meatiest vein in my elbow and could not get it to connect. OUCH! Then, a second nurse tried and it took a long time, but this one was in the top of my hand and with more lidocaine (thank you, lidocaine) and she finally got it to take. She legit said a little prayer after she had tried for a while, and then said "Thank you, Jesus" so I knew it was finally working. I was crying at this point, not so much because of the pain, but because I was terrified about what was about to happen. Then she held my hand (she also had tears in her eyes) and prayed with me and convinced me that God had me. Nurses are as wonderful in this way as they are in applying their extensive medical knowledge. She was the exact person I needed at that exact moment.

The anesthesiologist came in next and tried to convince me in his most comforting way that I would indeed NOT die on the table. That felt better to hear and I got a little more calm at that point, after the harrowing IV experience. 

Dr. Craft was next! I loved that he came in to greet me before I was under. He joked about some things and we laughed. He told me this would be a really easy surgery and I may not even need pain medication, although he would prescribe some anyway. Then he fist-bumped me, left and said "See ya in a minute!" I reminded him he'd see me, but I wouldn't see him. I'm sure he knows what kind of crazy he is dealing with when it comes to me, but he laughs a lot and I like a doc with a sense of humor, so it's all good. 

Two anesthesia techs came in next and I asked them if they could run the "cocktail" as they called it before they wheeled me down the hallway and they were happy to oblige. That calmed me down and I was ready for anyone to cut anything off of me at that point. Sign me up! These people know what they are doing. It was a party on a gurney.

There I went, into the room where Dr. Craft would be doing his magic. I talked to the team for a while and they put the gas mask on me. That's about it. I don't even know if they asked me to count backwards from 10 - I was out.

Next thing I knew, I was being wheeled into the recovery room, where there were about 9 other well-spaced patients in various states of consciousness. I was so confused! Wasn't I about to just get surgery? I'm supposed to be in the OPERATING ROOM! So, I asked the nurse a million probably incoherent questions but finally figured out I had indeed HAD the surgery and was awake and alive! WOOT! I took a brave peek into my gown. Yep. The deed was done. She gave me water and the two most delicious graham crackers I have ever eaten in my life, and kept fussing at me to slow down or I'd get sick. But I never did. Never have with anesthesia; I guess I am one of the lucky ones there. Now, my teeth WERE chattering badly, which is a side effect I HAVE always had with anesthesia. She gave me something to help fix that (I think) and I sat there for a bit before being wheeled to the discharge room. I kept trying to convince myself this wasn't a dream.

They got Jon! I could finally see him again! The discharge nurse read all my instructions and he remembered it all. She also sent them on a paper. I remember they were both laughing at me and I wish I could remember what I was saying to them, but maybe it's all for the best that I don't. Anyway, a different nurse helped me plop into a wheelchair and by the time we got to the hospital door, Jon was waiting there in the car. Surgery/pre-op took about 90 minutes, and we had been in the hospital about 7 hours. It was TIME TO LEAVE.

This is us before the ride home, holding the teddy bear that Kim (nurse navigator) had given me when I was prepping for the wire insertion. She suggested I stick him under my armpit for the ride home, but I didn't need to because the seat belt was on the opposite side of my incisions. 

I could barely keep my eyes open once I got home and remember that I was very talkative to Grandma Cathy and Jon and the boys, but I have no clue what I was talking about. A sweet band mom brought the MOST DELICIOUS chicken and noodles. That is a perfect meal for someone who's just had surgery. Everyone else in the family enjoyed it, too. Even Ethan.

Last night before bed, Jon and I were brave enough to take a look at the incisions (one in the armpit and another in the side of the breast). They look fantastic and I am not as worried about being deformed as I was before. Thank you, Dr. Craft and team!

Today, I definitely had a newfound respect for simply waking up. That's going to be a permanent, positive, and necessary change in me, for sure. And the pain isn't bad at all. The armpit incision is annoying enough to need Percocet, but I don't think I'll need any more after this morning's dose.

I'm so very happy to have this behind me. The anxiety I've lived with for over a month is almost all gone, because this scary step is DONE. Of course, the next thing to worry about is the pathology report, but I am going to get those thoughts out of my head as soon as they pop in... no need to think about it until I get the results call (by the end of next week). After that, I have a post-surgery consult with Dr. Craft the morning of September 14.

Thank you, friends, for reading my lengthy journey. And if you're reading because you are going through something similar, I hope my transparency can help relieve you a little, as did so many of the things I read from real women going down this road.

WE HAVE A SURGERY DATE! WOOT! (and a meal train, too - also WOOT!)

It's easier to include what I posted on fb last night after the appointment, so here goes:

Also, the very amazing band boosters have set up a meal train for us. I am overwhelmed with multiple emotions at the number of people who so kindly and generously and selflessly want to help our family get through this crap time. Here is the link, for all you very sweet folks who have asked.

I have this amazing and scary sense of calm right now. I know everything will be okay. It is wonderful to have a PLAN, finally. Bring on Thursday!

Patience

We get these orb weavers, garden weavers, writing spiders, call them what you want, etc every year. This guy has a special place in my heart, though, because he's lived in the bushes by our front patio for a couple of months now. I watch him calmly, beautifully, and patiently craft his web, catch some treasures, and then rebuild almost daily, after the universe temporarily sets him back a little bit.

He is patient.

This is a lesson for me. So many things have been, lately. 

I must be patient.

The treasures will come. I will have to rebuild a few times in between.

But, I shall be patient.

BENIGN!

Good news! 
I spoke to the nurse navigator today and she told me some wonderful news - the second spot is benign! She went into some detail about what it actually WAS, and I tried hard to pay attention, but all that information is lost for the moment as I was freaking out about the amazing news that the doc just now has to focus on one spot, instead of two.

Bad news!
Because the news came in slightly after Jon and I were already on the road for the surgical consult, we cancelled enroute, since we needed this news to progress anyway (it's over a 30 minute drive each time we head from our house to Lexington, SC). So, some kiddo-sitting plans by Grandma and also Jon flipping his schedule around to chauffeur were all for naught. Minor, I suppose, in the grand scheme.

Next!
I have the surgical consult in 3 days, on Monday, which of course is Jon's first day of teaching and Andrew's first day of online learning for the year. Crazy times, but I believe we already know what the plan will be: lumpectomy with probable radiation treatments after healing.

MRI-Guided Biopsy: Not gonna sugarcoat this one

Today I had my MRI-guided biopsy. It was scheduled so the pathologists could diagnose the second spot that's been too small to see with mammography. So, far, it's been the most challenging procedure during this journey (except the WAITING, as I've said many times before..... the waiting trumps everything).

I was face down on the same MRI table like before, and this time, the tech positioned my breast into what was like a tiny milk crate to help the doctor position the needle accurately (a GOOD thing). They slid me in, took photos, slid me out, repositioned, slid me in..... you get it. It was totally the "Hokey Pokey" of procedures. After a few minutes they inserted the contrast agent via IV and then on this slide out, the fun began: numbing with a lidocaine shot, then positioning of the tissue extractor, then more photos, then the extraction itself which, to me HURT but to them was described as some "discomfort." The extractor sounds like a drill (also a bit unnerving) and I am thankful I DID NOT LOOK at the needle itself, because the doctor had to go basically as deep into my breast as anyone could have gone, and also about 6 different times. He kept saying "one more time" like the worst band director ever, and I was pretty happy when he promised this one would TRULY be the last time. Afterward, I bled a LOT. I was bandaged and my chest was wrapped pretty much like a mummy, and then I thankfully ran briskly walked out of that place, for what I hope is the last time ever. I equate this experience to that of a dentist drilling for a cavity, except with your boob, the loud MRI machine, and lots more blood than you think should be leaking out of you. Thankfully, my cancer club sisters had warned me to take some extra strength tylenol a few minutes before going in, which I did, and I know that made it way more tolerable.

My dear school friend took me to the appointment and then my dear sweet husband and family picked me up. I got out of the medieval torture chamber procedure pretty early, so I had some time to kill. I bought this shirt at the gift shop and am in love.

After that, I walked around the beautiful hospital grounds for a while and plopped myself down beside this beautiful fountain, which doubled as a Harry Potter Wizards Unite greenhouse, so I entertained myself there by playing my game until Jon made it.

Tomorrow, we meet with my surgeon to hopefully get the results and all the answers we need to schedule surgery. That date has been LONG AWAITED.

TICK. TOCK. TICK. TOCK.

I will undergo an MRI-assisted biopsy next Thursday. Then, we meet the surgeon on Friday to discuss the results and formulate THE PLAN. I have been waiting so hard for that and I hope it will make everything feel a little bit better. Because, truthfully, things feel pretty bad right now.

This is me after last week's ultrasound where they couldn't find the tiny brat of a lesion.

I am trying very hard to view the waiting as a benefit - my early detection/Stage 1 news has allowed the POSITIVE aspect of TIME between diagnosis and surgery. Doctors have had TIME to order and administer multiple tests (see my cray cray timeline) in order to provide me with the very best care possible.

All the cancer club sisters keep saying this is the toughest part. I've gotta remember that.

My Breast Cancer Timeline

One of my cancer club sisters shared her timeline on her blog. I have loved it, because comparing mine to hers has made the days and days and days of waiting seem less absurd and just kind of the norm.

So, here's mine. I'll [hopefully] keep it updated as this journey progresses.

2020:
July 15 - Routine Mammogram (should have been in March but COVID-19 scared me off)
July 23 - Notification of Abnormal Results
July 29 - Ultrasound
August 3 - Core Biopsy
August 4 - Diagnosis: Invasive Ductal Carcinoma, Stage 1 (isn't "carcinoma" a hideous word???)
August 7 - First Surgical Consult
August 10 - Genetic Testing
August 14 - MRI
August 18 - MRI Results (new tumor located)
August 19 - Fantastic Genetic Results (BRCA negative)
August 20 - Second Ultrasound
August 27 - Second Biopsy (MRI-Assisted)
August 28 - Second Surgical Consult Late but GREAT 2nd Biopsy Results: BENIGN
August 31 - Second Surgical Consult
September 3 - Surgery (partial mastectomy, otherwise known as lumpectomy)
September 14 - Post-Surgery Consult

September 21 - Oncotype Result News (6 out of 100 = NO CHEMO!)

September 24 - Radiation Oncologist Consultation

September 29 - Medical Oncologist Consultation/CT Scan for Radiation Mapping

October 6 - "Official" Mapping Appointment

October 7 - First day of actual radiation therapy

October 8 and 9 - Radiation Treatments #2 and #3

October 12 through 16 - Radiation Treatments #4 through #8

October 19 through 23 - Radiation Treatments #9 through #13

October 26 through 30 - Radiation Treatments #14 through #18

November 2 and 3 - Radiation Treatments #19 and #20

November 4 - FINAL RADIATION TREATMENT!

November 10 - Medical Oncologist Follow-Up

November 16 - First day of Tamoxifen

December 17 - Medical Oncologist Exam

2nd Ultrasound and Conditioning with BEER

Who can ever sanely say they WISHED they'd had the biopsy? Well, that was me today. I went in, almost enthusiastically, even, fully expecting to be stabbed again, which would lead to more ANSWERS.

NOPE.

My second spot is apparently very deep - right behind my breast on the chest wall, and pretty much directly behind the nipple. So, against her best efforts, the doc wasn't able to find it today.  

Next step? An MRI-guided biopsy. This is a disappointing setback and I am unsure of the timing because there are only a few doctors who perform such a procedure. I will hopefully know more about the schedule tomorrow. At this point, I am READY to undergo whatever surgery I need ASAP! I am not even afraid anymore. We are going on a month here - just cut everything out of me, please, and quick.

We stopped for another patio draft beer following today's lousy news. I joked on facebook that this is an attempt to condition myself to actually enjoy the gamut of ridiculous medical procedures. So far, it's not working, so we shall keep trying! GOALS. 

Excellent News!

The genetic counselor called today with the AMAZING news that I am negative for both breast cancer gene mutations (BRCA1 and BRCA2). I started sobbing while talking to her; the release was wonderful.

This news means something else caused my cancer and I wasn't pre-determined to get it, and it's not going to automatically recur. It also means I haven't passed a mutated gene to my boys, so my future grandchildren have a good chance of being well. AND, it means I don't necessarily need a bilateral mastectomy; being positive for either gene would have meant that.

We haven't had a lot of great news with this cancer BULLS$%T lately, so I will happily take this nugget!

GO, GENES! Thanks, Mom and Dad.

MRI. misfeed. meh.

Feeling meh for sure.

Got the MRI results this morning. There is another spot (smaller - 6 mm) in the same breast. Nothing in the other and the lymph nodes appear clear (both good things). My pincushion self will be undergoing another core biopsy this Thursday to see if this is a worrisome place, as well. The MRI shows EVERYTHING, so there are many false positives. I am hanging onto that glimmer of hope. Jon (thank GOD he's allowed to attend), the surgeon, and I meet in a week to discuss all results and plan the type and date of surgery. That's only one more agonizing week of waiting to get to the next step.

I was laminating some music-teaching things this morning. I still need to figure out THAT part of life, and quickly, in my BRAND NEW DISTRICT, starting the year with a LONG-TERM SUB in the middle of COVID CONCERNS due to being IMMUNOCOMPROMISED. Who doesn't love a challenge, right?

But, back to the lamination. I laminated 18 of these boogers perfectly. As symbolism would have it, with this one, THE LAST ONE, I misfed and it's a mess.

Here's hoping the universe was trying to remind me that this health challenge is nothing more than a little misfeed. I am going with that.

Waiting by the phone.......

I had this phone as a teenager. It was awesome. The waiting beside it? Not so much.

Fast-forward a few decades to my trusty iPhone that is ALWAYS WITH ME. WELL, somehow I missed a call from the nurse navigator this afternoon. She was ready to divulge my MRI results. By the time I got her message, she was out of the office. I joked with my cancer club girls that I haven't waited by the phone this much since I was 15 and a cute boy was [hopefully but usually not] calling.

THIS. ALL. SUCKS.

The cancer club girls maintain that the waiting is worse than any surgery or treatment. As someone who is now waiting another 12+ hours until tomorrow morning to learn how much cancer is actually in these breasts of mine, I tend to agree with them.

But still... if you didn't have this phone, aren't you jealous right now? You should be.

MRI and Birthday and Being OUT!

Today was a big one - the MRI. It was also Jon's birthday! So, he drove me there, and then we treated ourselves afterward. More on that...

The MRI: I got changed into scrubs and then they inserted an IV. I laid face down on a table with breast inserts and they played 80s music in my headphones. Halfway through, they injected the contrast dye via IV, and it felt a little cold, but didn't make me nauseous. It was extremely strange and weirdly interesting to feel the dye going through me, but the loud clicking and whirring of the machine was a welcome distraction. The scan itself only took about 20 minutes, and I couldn't wait to get out of there, so I sat up quickly when they rolled me out of the tube. Little did I know, the table had been raised. I almost fell to the floor, and gave the two techs and myself quite a bit of a scare for a second. But, all was well. They removed the IV and I was on my way.

Jon and I decided to decompress by eating out for the second time in 5 months (due to COVID-19 scares). We sat outside at one of our favorite downtown places, Cantina 76. The food and DRAFT BEER (been eons since we had that, too) was perfect.  

So, now, more waiting. All the "cancer club" (worst club to be in - no one wants membership, but once you have it, you need those people more than anything) sisters say the waiting for this result and that result is worse than any surgery or treatment. Gosh, I pray they are right. Next week, we will learn if I am BRCA gene positive, and also if today's MRI showed anything else that is a concern. 

So, tick tock.

Genes

Today, I had my genetic counseling appointment. We discussed my family history and then my blood was drawn. They are looking for the BRCA (breast cancer) gene mutation. If I have it, we might be looking at a recurrence down the road, so we will probably decide to do a bilateral mastectomy. If I am negative (results come in a week), then we might still have just the lumpectomy. My MRI this Friday will also help inform part of the puzzle, as they will be looking for other previously undetectable spots in both breasts.

There is always waiting for one result or another. But, I am thankful the scientists involved have done SO MUCH WORK over the decades to get to this point and get me the best treatment available at this time in life.

Prayers are appreciated for great news from both the genetic test and Friday's MRI.

Joy

Saturday, a family member and his friend invited us to the lake for some tubing. I chose not to get in, due to my biopsy incision still not being fully healed, but I LOVED watching Jon and the boys thoroughly enjoy every moment. We will do more things like this!

Another bit of joy is the MULTIPLE cards, texts, gifts, calls, and prayers I have received already, and we're only in the first moments of the diagnosis. It has all helped tremendously! The humans in our circles from near and far are kind, selfless, magical beings. One of my colleagues who reached out to me used this hashtag for her journey: #loveshowsup. And it's true!

Books

The book on top was given to me by my "nurse navigator," an angel who works for the hospital to keep all the different departments on one page of information disbursement for me. The bottom one was recommended to me by a dear friend who's been down this crappy road. They're both 300 pagers and I've devoured most of them. They are helpful, but there is also a time I need to stop reading, too, when all becomes a little too much.

And speaking of recommendations, one reason I am blogging about this is because of the positive, fearless stories I have read and listened to that have helped me cope so far. Stories from people I physically KNOW. If you get breast cancer, DEPEND ON THOSE WOMEN. They are angels. More about these folks in a later post. In MANY later posts.

I am totally digressing, but more angels are my beautiful husband and children. They are handling this news like champs, ever cheerful and optimistic, trying to keep me from going down the deep, dark rabbit hole. Love to ALL.

Surgeon

This morning, we met with Dr. Craft, my surgeon. Jon and I both really like him! He is smart and kind and funny and explains things well. Pending some more testing (genetics and an MRI), he believes I may be able to "escape" with a lumpectomy and some daily radiation treatments, in addition to probable hormonal therapy for a few years. The good news is that all my hormone receptors are positive, which makes this a lot easier to treat. My tumor is about 1 cm in diameter. Next step: testing.

By the way, due to the COVID-19 pandemic, this is the only appointment Jon will be allowed to attend with me. That adds another whole level of "scary" to this fight, but I can handle it.

Breast Cancer

DIAGNOSIS: Breast Cancer. Invasive Ductal Carcinoma, Stage 1. I am in shock and eager to learn the next steps when we meet with my surgeon.

Biopsy

This morning, I had a core biopsy. It involved a small pinch with lidocaine and then the removal (via large clicking needle that I chose not to look at) of some cells from the spot they don't like. It was basically painless, and the sweet tech held my hand the entire time as the doctor, tech and I discussed dogs and band. Results will be here tomorrow.

BREASTS.

I got your attention!

I've been away from posting for FAR too long, and I regret that this posting is not as jovial as most, but I am ready to be real here.

Breasts.

They are functional. Sexual. Life-saving, even. I nursed both boys well past their first year. GO, BREASTS!

But, breasts can also be total JERKS. This morning, in fact, I learned that my left breast probably contains life-threatening cancer. Biopsy in a few days will confirm but the doc is not optimistic about the spot she saw today during the ultrasound.

And you MUST know we're in a pandemic right now. Whatever. Let me just say BREASTS again.

I am terrified. But AS OF NOW, I do not have cancer. I do not have it until it is confirmed by the biopsy. So I am gonna keep plugging along, writing when I want, and actually, doing ANYTHING I want as much as I can. I do NOT have cancer in my breast. Not now.