Moving forward.

It's now been almost an entire month since my surgery.  Double mastectomy with sentinel lymphnode biopsy and resection.  So much has happened since that day...hospitalization, pain management, recovery and healing, and follow up appointments to schedule and plan for my year of treatment ahead.  But really, that's just the half of it...

My surgery for all intents and purposes, was blessedly a success.  My surgeons were able to remove all of my tumors (2 nodules) in their entirety and got clear margins.  Additionally, they performed a sentinel lymphnode biopsy and ended up removing 21 lymphnodes from my right side.  Unfortunately, 2 of those 21 lymphnodes did have cancer.  Due to the size of my tumors and the amount of lymphnodes involved, I have been classified as having Stage 2B Breast Cancer.  This news, while scary is also encouraging at the same time, as up to Stage 3 is considered "early breast cancer."  Studies show that women diagnosed with my stage of cancer have an 80-90% survival rate after 5 years.  My doctors are still confident that my cancer will be cured, and I will live a long and healthy life.  Praise be to GOD!

More about what my pathology indicates in terms of my future treatment:  We were all hoping and praying for clear margins and no lymphnode involvement.  Our prayers were partially answered.  My margins were clear, but they were small.  My surgeons were able to get 1 millimeter margins.  The goal (in order to avoid radiation), is 2 millimeter margins.  Additionally, when my breast tissue was examined after being excised, there was moderate lymph-vascular invasion.  My doctors explain this to me as being like an ant trail telling them that the cancer has traveled throughout the tissue.  It shows them the way in which my cancer traveled to my lymphnodes...some people have no lymph-vascular invasion, others have severe.  Mine was moderate.  The good news is that all of my breast tissue was removed, so that tissue that was invaded is no longer in my body.  Additionally, while having 2 lymphnodes involved is not what I was praying for, 2 is so much better than three or more.  Also, I feel assured by the fact that my doctors were so aggressive in removing and testing 21 lymphnodes, that I am confident that they got it all.  Another blessing from God is that my right breast showed absolutely no signs of cancer.  At all.  

So, my treatment plan...I will have to have 6-cycles of chemotherapy.  Each cycle is 21 days long.  That's roughly 4.5 months of chemotherapy.  After I finish chemo, I will let my system restore for approximately 3 weeks before I start radiation.  I will do radiation 5 days a week for 6.5 weeks.  3 to 6 months after radiation ends, I can have my final reconstructive surgery, in which my temporary expanders are removed and replaced with final implants. 

Chemotherapy is something that I was and still am, the most terrified about after first hearing the words "breast cancer."  However, my fear is subsiding and I am moving into acceptance about the knowledge that I now have.  I know this...I am 100% going to lose my hair.  There is nothing I can do to stop it...friends and family have suggested supplements, shampoos, and ice caps that their friends have used to keep their hair or help it to grow faster.  Sadly, because of one of the chemo drugs I will be getting is Taxotere, there is no way to avoid hair loss.  It is a definite side effect.  It will happen around the 3rd week after I begin chemo.  It may be a gradual shedding, it may fall out in messy clumps, it may be a combination of the two.  I have already ordered a wig that I hope will help me to feel somewhat normal throughout this scary and traumatic process.  I also have purchased "chemo beanies" that are like easy slip-on head wraps that come in a variety of colors, textures and patterns.  Leave it to women to be industrious while undergoing their own personal tragedy and provide help to others at the same time.  My kids know what to expect, and I hope and pray that this experience won't be too scary for them.  As my daughter Mia said...

"Mommy, Harper didn't have much hair when she was a baby, and I still thought she was cute."  

Granted, I followed this up with a tearful smile asking, "So does that mean you will still think I'm cute when I don't have any hair?"  

She crinkles her nose and tilts her head, "Well, Harper is a BABY.  Babies are always cute." 

I swear, that girl always knows how to make me laugh.

Anyway, in addition to the hair loss issue, there are other things that I know to expect with chemo.  Fatigue is the most commonly experienced side effect.  However, I know the best remedies for fatigue are to maintain a healthy diet and activity level. I am fully committed to that.  Nausea is another side effect I think that everyone associates with chemotherapy.  While I'm sure I will experience some nausea, I already have prescriptions written to combat the symptoms, and will do my part to combat it as well...eating bland foods, taking ginger supplements, etc.  My medical oncologist or another doctor in his office will always be available to me 24/7.  He has told me that if I start to "feel sick," to not to wait to call him...they can always help.  When I asked if "feeling sick" meant throwing up, he placed his hand on my knee and said,

"NO!  You will not throw up.  YOU WILL NOT THROW UP.  If you throw up during chemotherapy, then I have failed as a doctor."  

Well, alrighty then, Dr. Banerjee.  I'm gonna hold you to that.  

I'm sad to have to get radiation as well, but the thought of it doesn't terrify me as much as chemo.  The most common side effects of radiation are also fatigue, and sunburn as well.  Mostly, the bummer about radiation is the inconvenience of it, and the fact that it prolongs the process before I can have my final reconstruction.  But, oh well.  It is what it is and I know I will get through it.  Dr. Shimizu has told me that although the treatments are every weekday, they are quick...from the time I walk in to the time I walk out, the entire appointment should not take more than 20 minutes.  The radiation beam will be on me for only approximately 3 minutes per session.  Not bad when you consider that each chemo treatment is about 4-5 hours long.  Oh, but I'm leaving out the best part!  I will be getting my first tattoos, thanks to radiation.  Apparently, to ensure that the beam is directed at the same exact spot every time, I get to have small dots tattooed on probably 3 places on my chest.  Looks like I'm going to have to breach the contract that my mom made me sign in middle school.  Sorry, Mom...your little girl is getting inked.  All in all, radiation will just have to be something that I integrate into my daily schedule, and thanks to my family, friends, and fellow school mommies, I know we can make it work.  

OK, so I said that the surgery, hospitalization, recovery and treatment plan has just been the half of it...well, here's the other half...

Josh, the girls and I are moving.  Moving this Saturday.  Oh, and by the way, this Saturday means 4 days before Christmas.  Gulp.

 So, for the past 4 weeks, we have been packing our house that we've lived in for 7 years.  Packing while I've been recovering, incisions healing, unable to lift my girls (or anything heavier than a gallon of milk), on pain medication, and unable to drive.  It has been stressful to say the least, but made so much better by the help of dear family and friends.  My mom has been the super packer...committed for the last two weeks to coming over and packing (with a little assistance from me) every single day.  My mother-in-law has also come down several times to pack with her housekeeper and they did a serious number on my kitchen...plates, glassware, appliances...everything.  Both my mother-in-law and father-in-law have taken the girls for days at a time so that Josh, my mom and I could get some real stuff done without neglecting the girls in the process.  Friends from Mia's preschool have been driving her to and from school every day, having her (and sometimes even Harper) over for long playdates...so we can work or catch our breaths as the case may be.  Sweet friends and family have brought meals...basically, everyone is doing anything they can do to help...and it is so very appreciated.

The important thing to note, while you're all thinking, "What are they thinking?  They are crazy!!!  Who in their right mind would move at a time like this?"  Is that we are moving to a house 5 minutes away from us that is literally MY DREAM house.  It has a better layout for our family, will keep us closer together, and will be so much easier to live in.  It has an extra room for guests to stay, which will come in handy when we may need some extra help over the next few months.  Also...it is beautiful, and I know that once we get settled, we will be so very happy there.  The ball was rolling on this new house before we received my diagnosis, and while we slowed it down for a while, once we realized that I was going to live, and live a long life, cancer didn't seem like reason enough to miss out on it.  No time like the present, this small window before chemo starts, to move in and start getting settled.  I'll say it again...we are very blessed and oh so thankful.  


So, when I started this blog, I pictured myself pouring my daily thoughts, fears, and insights into it...daily.  Maybe weekly, if I couldn't get to it every day.  Well, this move and Christmas has shot that to "you know what."  My desire is still there...I want to use this blog to record my experience, but for the past 4 weeks it just has not been possible.  The first week and a half after surgery was rough...there was real pain, and as a result, I took real pain medication.  We are talking strong stuff...I know I spoke to a lot of you, wrote emails, even saw you in person...but so much about that time, I hardly remember.  It's crazy!  I've been totally off pain meds for about 4 days now.  When and if I do take pain medication, it's maybe one pill a day, and what I'm taking is so much less than what I took in the beginning.  The rest of the time has been consumed with the constant doctors visits...along with packing for our move and preparing for Christmas.  It's a great thing that I'm such a good online shopper, because I haven't braved a mall yet this holiday season.  I'm hoping I purchase gifts for everyone on my list, but if I can't...I hope they'll understand.  I promise I'll do better next year.  Josh is more committed to Christmas than I am.  He wants to keep the magic for our girls, who have endured so much change the past month and a half.  When Mia came home from a friend's house after helping to decorate their Christmas tree, and asked to put up our tree, Josh didn't have the heart to tell her that we couldn't have our tree until we moved.  Instead, he schlepped us all out to Target at 7 o'clock at night to let Mia pick out the perfect 4 foot tree and two boxes of ornaments.  He also indulged her in a hot pink sparkly star tree topper.  I actually love our little tree...and the girls do too.  We should be receiving the keys to our new home tomorrow, and Josh already has planned to put up the Christmas lights after he gets off work, and to take over our ACTUAL Christmas tree, so that Christmas is ready for the girls as soon as we move in.  I've tried to tell him that it's not necessary...that they will still have a lovely Christmas, but for him it IS necessary.  And I know it is because he loves them so much, so that makes me happy, and makes me feel very lucky.  

So, that's the plan for now.  1) Move, 2) Christmas, 3) Chemo, 4) Radiation, 5) Reconstructive Surgery.  

I went today for my "chemo teach," where Josh, my mom and I watched a video on what to expect and got to ask my nurse practitioner any questions we had.  After that, I went to have my dressings changed at Dr. McDreamy's, I mean, Dr. Bolitho's office.  The doctor was not at my appointment, but I knew that the nurse would be the one to do the simple dressing change...everything looks like it's healing great.  Well, that is except for one little thing...part of my incision on my left breast is struggling to heal a bit.  Nothing looks infected or anything, but there is one spot that hasn't quite come together like the right side's incision has.  Apparently, it isn't looking how they would want after approximately 4 weeks...soooo, I will have to have another minor surgery TOMORROW.  If I wasn't starting chemo so soon, they may have foregone any surgery, but I have to be 100% healed in order to start chemo.  No open wounds.  So, Dr. Bolitho will stitch up that portion of the incision to ensure that it heals properly before I start chemo.  The surgery I will have tomorrow could be done with local anesthesia, while I'm awake, or it may have to be done under a light general anesthesia.  They have told me to prepare either way...it will be a fast surgery with no pain and no real recovery.  They just don't want to wait for my incision to heal...we just don't have time.  I'll find out tomorrow morning what kind of anesthesia it will be...if you can, please pray for me that the surgery will go well and that it will accomplish the goal: 100% healed in time for chemo.

That's basically it for now.  There is so much to tell about each phase of my recovery thus far...and I've wanted to share it all...but doing so was just too overwhelming for me.  I have regaled many of you with tales of my "barfy" roommate the first night in the hospital, making it through Mia's birthday in a fog of pain meds, seeing my breasts for the first time after surgery...all of it has been another crazy chapter in this roller-coaster of a journey.  But, today, I felt compelled to write, not about where I've been, but where we are now and where we are going.  Today, I feel good...not because of pain meds, but because I'm feeling better.  I am healing (maybe not perfectly), but I am healing...and I know I will heal fully.  For now, I just have to keep moving...moving forward.  

I want to end this post by saying again how much I appreciate everyone's concern for me, my family, my health and how I am doing.  Your prayers, good vibes, and positive thoughts have been felt and warm my heart in my darkest moments.  Flowers, food, and offers to help, are so appreciated and have demonstrated to us just the kind of generous-hearted people we are so blessed to have in our lives.  I covet your continued prayers, and look forward to them continuing to work miracles in our lives.  I believe that the worst of it is behind us...we survived the diagnosis, and the subsequent surgery.  We will make it through the next year...and I pray that come Christmas next year, I will be nearly finished with this marathon.  2016 is going to be MY year.  I know that in 2016 I will be cancer free.  I pray that in 2016 I will be finished with my treatment.  I look forward to 2016, because I know that is the year that my family and I will get our lives back.  And, 2016 is the year that I am committed to paying back all of the love, kindness, and support that so many of you have given to us.  Throughout this process I have asked myself, "Would I think to be that nice...be that thoughtful...be that generous?"  Would I think to do all that everyone has done for us?  Well, I know now what true kindness and compassion is...you have all taught me.  I can't wait to be for someone else, what you ALL have been for me.