From the "Happiest Place on Earth" to cold, hard reality...

Today is Friday, November 15th.  That means that exactly two weeks ago today, I was diagnosed with breast cancer.  And again, as it was two weeks ago, Monday is another big day for me.  Monday is the day I will have the surgery that I hope and pray rids my body of the cancer that has been growing inside of me for probably close to 4 years.  For my lifelong peace of mind, and in light of my doctors' recommendations, I have elected to have a bilateral mastectomy (that means both boobs--gone!) and reconstruction.  Last week we rejoiced in the news that my PET scan was clear, and I've subsequently learned that my bone scan was clear as well.  Moreover, my breast ultrasound has revealed that the cancer is localized to my right breast and there is no sign of cancer in my left.  My doctors have presented the fact to me that bilateral mastectomy is not my only option; that unilateral mastectomy is an option, and according to my medical oncologist, lumpectomy (followed by radiation and possibly chemotherapy) might also be an option.  However, this road is the road that I have chosen, and I am at peace with my decision.  

I am going in to this surgery with the prayer that it totally eradicates my body of cancer, but know that is not a certainty.  There is the possibility that the cancer has spread to some lymphnodes, there is the possibility that the surgeons may not be able to get clear margins...but I know that none of this means that I am going to die from this cancer.  It only means that my treatment may involve radiation, or it may involve chemotherapy...either way, it will certainly involve the oral hormonal medication: Tamoxifen.  None of these treatment paths will be easy...on me, or on my sweet family who have all vowed to do whatever they can to help me through this (even my almost 4-year old little girl).  But we will do this together because all we all want is "for mommy to get better."  

So, surgery Monday morning at 10 am.  Check in at 8:30 am.  I'll be there or be square.  

On another note, Josh and I decided last Sunday to start this week on a better note than the previous two have started...so where else could we go?  DISNEYLAND!  That's right, we willingly tackled Disneyland (and California Adventure) on a weekend in the middle of the Holiday season celebration.  You know why?  Because we were pretty darn happy about finding out that my cancer hadn't spread throughout my body, and because at that time we weren't really sure how long it would be before I wouldn't be able to make a trip like that again (due to my surgery and recovery).  So, we surprised the girls bright and early in the morning and headed up to the Magic Kingdom.  And it was MAGIC.  Harper got to meet her favorite, "Mee Mouse", we rode all of the girls' favorite rides, we all shared one giant soft serve ice cream cone,...and the best part...we learned that in the 4 months since we were last there, Mia grew the 1/2 an inch she needed to in order to ride on the REAL rides -- Splash Mountain and Space Mountain.  I'm pretty sure that I was about 13 when I first got up the nerve to ride Space Mountain, but our little big girl rode it not once, but twice!  According to her it was "AH-MAZING!!!"  The whole day was pretty ah-mazing, and for the first time since learning of my diagnosis...Josh and I were able to spend a day feeling happy more times than we felt sad or scared.  We spent a day where CANCER didn't permeate every single thought.  Mickey Mouse and his gang can just do that to ya. 

After Disneyland, it was back to reality.  Monday started off like a regular day, which was kind of refreshing.  Josh went off to work, and I took Mia to school.  But by Monday afternoon we were back on our mission to "circle the wagons" and finish the compilation of the team of doctors that are going to help me get rid of this cancer and start living a normal life again.  At 3pm, Josh and I met my reconstructive plastic surgeon, Dr. Glynn Bolitho.  He is a tall, dark and handsome man with the loveliest South African accent.  So lovely in fact, that his accent actually distracted me from all of the yucky things he was actually saying.  "Oh, ok...they cut me open, remove the breast tissue, biopsy the lympnodes, shove the tissue expanders under the muscle...whatever, doc.  Just keep talking."  Then it went on, "So, I come back three weeks later for you to stick a needle into my numb chest and fill up each expander with saline...and we repeat this process 2 or more times over the course of a couple of months...cool...sounds great.  Do you think you could read me a bedtime story when I go to sleep tonight?"  

Josh and I left Dr. Bolitho's office and I called Renee, (my surgical oncologist's scheduler who facilitated all of my appointments with the other doctors).  I wanted to tell her that I liked Dr. Bolitho and didn't feel the need to meet with the other reconstructive surgeon that they were referring me to as an option.  In addition to just liking Dr. Bolitho, (his accent), and his bedside manner, I'd spoken with several people (other moms from Mia's preschool, one of Josh's customers who often works as Bolitho's anesthesiologist, and a radiology nurse who helped me through my MRI) who informed me that I was in the best possible hands with Dr. Bolitho.  So, that was great...one less decision to make.  I have found that a cancer diagnosis makes one quite decisive.  Without having to schedule a different appointment, that should ensure that I get my surgery by the beginning of December.   I was not necessarily prepared for what Renee had to say.  

"Ok then, with Dr. Bolitho on board, the next available surgery date that I have is next Monday, November 18th." 

"Oh, wow...that soon?" I asked.

Things like Thanksgiving and Mia's upcoming 4th birthday party at "Pump it Up" swirled through my brain.

"Do you need more time to think about it?  We can just schedule your follow-up appointment with Dr. Wilde for now if you like.  But I need you to know that Dr. Wilde is already so booked that the next available surgery date after Monday would probably not be until the middle of December"

"Um...can I let you know?  Do you need to know right now?" 

"That's fine, Lindsay.  Take your time."

Before she even said the word, "time."  I'd made my mind up.  What was the first thing I started praying for the moment I was told I had breast cancer?  

I just want it out as soon as possible.  Please Lord, make them get it out as fast as they can.  I can't wait one extra day with this cancer inside of me.

Once again, my prayers were being answered.

"Renee, I'll take Monday.  Sign me up."  


Tuesday was another big day.  First up was meeting with the Radiation Oncologist, Dr. Kenneth Shimizu.  This meeting took place at the Scripps Radiation Center which is an absolutely gorgeous building overlooking the ocean, just a stone's throw from the Scripps Institute of Oceanography.  The appointment was off to a good start when the front desk receptionist let out a huge laugh upon reading the completed forms and paperwork that I had just given her.  Apparently she found my response to the question, "What is your occupation?" quite hilarious.  My answer:

Homemaker/Reformed Attorney.

I actually didn't mean for it to be funny, it was just an honest answer...but I liked the fact that it brought some levity to the situation.  

Dr. Shimizu is also fabulous.  He was calm, methodical, and informative, told us anything and everything we could possibly want to know about radiation.  The best part was that he prefaced everything with the fact that he was optimistic that due to the nature and location of my tumors, it was a distinct possibility that I wouldn't need radiation.  However, there were two scenarios in which it would be required...first, if my surgeon isn't able to get clear margins upon removal of the tumors, and second, if there are more than three lymphnodes found with cancer in them.  But, I loved Dr. Shimizu for saying that he probably wouldn't be seeing me again, but even if he didn't, that I could call him anytime with any question.

Next up, the scary guy that I really didn't want to meet: The Chemo Doctor...otherwise known as the Medical Oncologist.  Since finding out I had cancer, having to go through chemotherapy has probably been my second biggest fear, second only to dying of course.  I watched my Dad go through agonizing rounds of chemo...experiencing debilitating fatigue, round the clock nausea and vomiting, depression, dry mouth, loss of appetite and of course... hair loss.  Though, we always marveled at how long it actually took my Dad to lose his hair.  It was kind of ironic, because he didn't have all that much hair to begin with.  (I'm allowed to say that because I know my Dad took his sense of humor to heaven with him.)

Turns out-- my Chemo Doctor...not so scary.  Dr. Pushpendu Bannerjee is a man with a kind face and a very warm smile.  My sister, Amy, actually worked with him a couple of years ago when she worked on the Medical Oncology floor at Scripps Memorial Hospital in La Jolla.  Dr. Bannerjee went over all of my scans and test results in detail...showing me my PET scan for the first time...slice by slice by slice.  He pointed out how even the cancer that we knew that I had was hard to detect on the PET scan...he pointed out how there was absolutely no sign of cancer anywhere else in my body or my bone.  And then he delivered some news that I didn't expect to be so jarring...

"You know, there is no medical reason that says you need to have a mastectomy."  

What???  Of course I need to have a mastectomy!  I have breast cancer, remember?  Yes, I know, I know, they say that breast cancer used to be a surgical disease and now it doesn't have to be, but I'm 32 years old and I have at least 2 tumors in my breast that have been growing for years!  Angelina Jolie didn't even HAVE breast cancer and she had a mastectomy!  My head began to spin.

My Mom interjected the fear that we all had about cancer recurrence, about how after watching my Dad fight his battle so bravely, I didn't want to take any chances that this cancer could return later, even worse than before.  Dr. Bannerjee understood all of this.  He assured me that my decision to have a bilateral mastectomy was certainly a reasonable one.  He just felt that it was his duty to inform me that it wasn't a medically necessary decision.  He explained that since I would certainly be going on hormonal therapy with Tamoxifen that my risk of getting breast cancer would be reduced by at least 50%, that because of my diagnosis I would continue to be monitored so closely for the rest of my life, that the chances that I would develop any other disease or life-threatening cancer were infinitesimal.   

I left Bannerjee's office feeling quite thrown.  I was encouraged by what he had to say later in the appointment...that he was optomistic that I would not need chemotherapy, that not all patients lose their hair with chemotherapy, and that Tamoxifen would not likely throw me into an early menopausal state.  But my assurance in my almost immediate decision to have a double mastectomy had begun to waver.  Was this the right decision?  Certainly removing only one breast would make for an easier recovery.  Maybe I would be able to lift and carry my girls sooner if I just did the unilateral mastectomy.  I could probably go to Mia's party if I just did one...Maybe I wouldn't be out of commission for so long...

...but then, as I discussed these thoughts out loud in the car on the way home to Josh and my Mom, I saw the looks in their eyes.  They were like two mirrors staring back at me, reminding me of the way I felt when I first learned that I had breast cancer.  Why would I take any chance?  If I can reduce my risk of recurrence by eliminating one of the places that the cancer could return back to...why wouldn't I?  Because I might recover a little sooner?  Because I might be able to reach for the water glass on the higher shelf with my left hand?  Because I want to attend one of my daughter's birthday parties, when she has a lifetime of them ahead of her?  No.  Go with your gut, Lindsay.  It may not be scientific, it may not make sense to everyone, but it makes sense to you.  Do this and live a life without feeling like you're living pressed under the thumb of cancer...breathe easier.  Sleep easier.  Stick around for all of BOTH of your daughter's birthday parties.  

Decision made. I told you, leave it to cancer to make you decisive.

Wednesday was another dose of reality.  First, reality came in the form of being able to finally take Harper back to her "Parent/Toddler Exploration Program" a.k.a. "Mommy and Me" at The Gillispie School (Mia's Preschool).  I'd missed the class two weeks prior because I was busy having a biopsy done of the "probably benign" tumor, and I missed the previous week's class because I was having my MRI.  So, it felt great to be able to take her to the class that she loves and watch her fun personality run wild...through the sandbox, the play kitchen, finger-painting...she does and loves it all!  I also got the chance to connect with some of the other moms and catch them up on what the latest was regarding my diagnosis.  Some of them knew, others didn't.  One of my friends that was aware of what was going on, wanted me to connect with another mom she knew.  This woman was now cancer free after a diagnosis, during pregnancy mind you, of Stage 3D breast cancer that had metastasized to her ovaries and uterus.  Her survival story was one of surgical intervention (bilateral mastectomy), medical intervention (8 months of intense chemotherapy), and alternative medicine (integrative medicine, strict anti-cancer diet regime, and acupuncture).  I told my friend that I would love to connect with this woman-survivor and glean any knowledge and experience from her that I could.  On the spot, my friend sent an email to both of us introducing one another. 

Later that day was my follow-up appointment with Dr. Wilde.  Now that surgery was scheduled, I was sure that it would be a fairly straight forward appointment.  She would go over all of my bloodwork and scans (couldn't be too scary...normal and "no suspicious findings"), and maybe discuss the fact that I didn't need a bilateral mastectomy.  To which I planned to reply, "No thank you...I'll take a double."  Discuss the actual surgery a little more perhaps, and give more detail about recovery.  She would hopefully concur with the optomistic Dr. Shimizu and Dr. Bannerjee and tell me that after my bilateral mastectomy I would most surely be cancer-free.  Easy as that.  I was wrong.

I've learned from watching Grey's Anatomy that part of being a surgeon is being matter of fact.  To cut or not to cut.  Dr. Wilde herself told me that surgeons are neither optimists nor pessimists--they are realists.   And she was.  She brought me down from the cloud that I'd been living on for the previous day and half and told me that she did feel that a BILATERAL mastectomy was in my best interest and gave me my greatest chance of preventing cancer recurrence in my breasts.  She told me that she did not consider lumpectomy an option in my case because of my "multi-focal" disease (that means I have more than one tumor), and did not feel that unilateral mastectomy was a viable option in the absence of results for my genetic testing.  Moreover, even if I did not test positive for the breast cancer gene mutation, whatever chemistry in my body that gave me cancer in my right breast could rear its ugly head again and attack the left as well.  Welp, okey doke.  Bilateral mastectomy.  Glad we are on the same page.  

But, that's not all folks!  She also thought that it was very likely that I might need chemotherapy, even after my mastectomy.  Again, she was talking about multi-focal disease and how the lymphovascular invasion that was present in my pathology meant that there was a possibility that it would be difficult to get clear margins.  This also meant that it was still likely that the cancer has spread to my lymphnodes.  So, nope...don't count on it Lindsay.  Chemo could be in the cards.  

I was now beginning to understand why my blood pressure rose at the mere arrival in Dr. Wilde's office.  This lady is serious about cancer.  She knows her stuff, and she wants to do the best thing to get rid of it.  After my clear bloodwork and scans I may have convinced myself that I had "fake" cancer.  Sure, I had "cancer", but it wasn't the type that spread and caused all sorts of problems.  It was just happily growing in my boob...cut them both off and I'd be done...with a brand new pair to boot!  

The hits just kept on coming.  The informed consent.  More details about my bloodwork.  Yes, it was normal.  But, she had run a panel called a D-Dimer which could indicate if one is at risk for DVT, or deep vein thrombosis, also known as a blood clot.  The normal value is under 450 and mine was 477.  She explained that I already had two risk factors for blood clots: 1) people with cancer are more likely to form clots (I am now a person with cancer), and 2) I was about to undergo a lengthy surgery where I would be lying flat on my back for approximately 5 and a half hours.  If I did have a clot, it could travel to my brain or lungs during surgery and I would die.  These risk factors indicate a risk of fatality.  Um, yeah...you've got my attention lady.  Oh, hello racing heart and stomach rising in my chest.  I thought I was rid of you.   

With that, I was set up for a consultation with a vascular surgeon for Friday.  He would further evaluate my risks for clots and order any tests he felt necessary to perform before my surgery on Monday.   

I left Dr. Wilde's office and cried as we piled into the elevator.  The fear was back.  Now I didn't just have to worry about dying from cancer, but I had to worry about dying just from having the surgery?  I mean, I know that death is always a risk during surgery...but come on, these doctors know what they're doing.  I have a "dream team!"  They wouldn't let me die on their watch.  But now I have 3 different risk factors for a condition that is FATAL?  

Thursday was not a good day.   I spent the day doing mindless things like buying and wrapping Mia's remaining birthday presents, updating my iPhone, cancelling and rescheduling various appointments I would now miss because of my surgery.  I went to the nail salon to have my nails "undone."  No finger nail polish for surgery, and I follow the rules.  Off with the shellac manicure!  I tried to keep my mind occupied and busy with things like writing a pre-surgery grocery list, cleaning the house, doing laundry, beginning to pack for surgery--all the while the choking hands were back on my neck.  I would have to stop in my tracks and hold my heart in from beating out of my chest.  Pause to take deep breaths that didn't seem to help my racing heart, or pulsating pain in my chest.  That feeling of sickening heat rising up in me like the mercury in a thermometer.  By the time dinner time rolled around and Josh and the girls were happily playing "monsters" in the kitchen, I had to confide in him how I was feeling.  He reminded me that I didn't have to white-knuckle this...Dr. Guru had prescribed me some Xanax.  Take one...relax.  You're going to be fine, Lindsay.  You're not going to die.  You don't have a blood clot.  You're going to have this surgery and recover.  Radiation or Chemo, you will get through it.  We will get through it together.  

Josh sweetly took the girls upstairs and did all of their bathtime routine by himself...let's be honest, he is usually the one that does the baths.  It gives me the chance to clean up downstairs after dinner, and usually sit down and catch the latest of whatever horrible reality show that I'm not ashamed to love has aired that day.  I took my Xanax and tried to catch my breath.  Josh texted me a Michael W. Smith video of his performance of "Healing Rain."  Healing rain is falling down, healing rain is falling down...I'm not afraid,  I'm not afraid!  Josh called me up when it was time to tuck the girls in.  Before Mia got into bed, the 4 of us rolled around on the ground and all of them hugged me...first Josh, then Mia, and then Harper jumped on top and sat on my face before laying down and hugging me too.  Yeah, that helped.  Then, Mia wanted to share another video with me.  The song began to play, "Pink fluffly unicorns dancing on rainbows...pink fluffy unicorns dancing on rainbows!"  And that's what the video was...amateurish animation of pink fluffy unicorns dancing on rainbows.  But this silly, mindless video was exactly what I needed to end that day.  I kept singing the song in my head long after the girls had gone to bed...I want to hang on to it and remember to sing it to myself when I walk into surgery.  

PINK FLUFFY UNICORNS, DANCING ON RAINBOWS!  

and also

HEALING RAIN IS FALLING DOWN...HEALING RAIN IS FALLING DOWN...I'M NOT AFRAID!

Nothing scary can happen if those are the thoughts in your mind, right?  Please Lord, let those be the thoughts in my mind.   

**Prayer requests for those that are so inclined:  Please pray that my surgery is successful and that the doctors are able to get all of the cancer out of my body.  Pray that the cancer has not spread to my lymphnodes.  Please pray that the surgery itself is successful, that I don't develop any blood clots, and that the anesthesiologist and other doctors are able to monitor me safely.  Please pray that all goes smoothly with the initial stages of reconstruction.  Pray for me as I come out of anesthesia and make my way into a smooth recovery.  Please, continue to pray for my family as they wait for me during surgery, and throughout this process.  Help them to be strong and give them comfort.  Finally, thank the Lord for the wonderful people He has placed in my life and brought into my life throughout this journey.  I have encountered several angels along the way and I feel so blessed to know and have each and every one of you in my life, supporting me along the way.