News That Make Me Happy, News That Makes Me Flappy

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I saw two docs this week: Dr. D, my oncologist, and Dr. K, my plastic surgeon.

Oncologist Visit: SCORE!
Plastic Surgeon: Dammit, dammit, dammit.

Dr. D checked a bunch of stuff and the results are pretty good. My white blood cells look normal and my tumor markers are staying down. My estrogen levels have risen about ten points, but he’s comfortable with the level right now (Rising estrogen could be potentially bad since the tumors I had were being fed by estrogen). So I will continue with the current course of hormone- blocking Arimidex. He’s sending me for a baseline bone density test and a chest x-ray, and if those look clear, then I don’t have to go back for 6 months.

The visit with my plastic surgeon went exactly how I didn’t want it to go. >:-/ Before I even changed into the comfy paper shirt, he looked serious. “Why don’t you change so we can talk about your options.” Awesome. Talking about my options could only mean that I was about to get news I didn’t really want. I reluctantly changed and hopped (moped) onto the exam table. He came back in and asked me to stand up. (Oh, I forget to mention, my husband was there too. There is nothing weirder than standing topless in front of another man’s face while your husband looks on!) Dr. K looked at, prodded, and poked at my current upstairs situation. Then he kind of squished my sides, touched my back, and asked to see my belly. He added a little squeeze there and then asked me to sit down. I sat down quickly and sat up very straight (because good posture will help in a situation where you get bad news). He said, “There just isn’t enough skin on your left breast for regular reconstruction. The radiation caused it to shrink too far. But there are some other things we can do.” It was a good thing I was sitting up so tall, because then I had enough room to sink down and feel defeated.

********Can I just be vain for a second? You know what? Cancer sucks and it’s horrible and I hate it. But before cancer I had always privately dreamed of breast augmentation. Then I was diagnosed with cancer and although it has been awful, my secret little victory was a bigger set up top. Finally! Cleavage without wearing a corset! Bathing suit tops that don’t have that waterfall of fluid due to push-up pads! Reconstruction after mastectomy wasn’t going to be perfect and the scars would remain until forever, but at least I would be able to work on that hourglass shape. I have the curvy hips, the small waist, and with proper reconstruction, I would have the busty curves too. Now I know that breast size doesn’t make the woman, and we’re all still the same whether we have breast or not, but I’m serious about my femininity. For me, being feminine starts with your attitude toward yourself and others–and if you look good while doing it, you’ve got the whole package. I need to be thankful for my life, because no matter what I look like, I’m still here to be a wife, mother, and educator. And I am thankful for all of that…I just want to have my cake and womanly curves too.********

Dr. K started to explain the two best option for my troubled breast area. The right side is perfectly fine. I still have a tissue expander in there and I will be able to get normal reconstruction: just an implant and I’m outta there. The left, however, is a shrunken mess and my two options are the dreaded flaps:

Option #1: DIEP—A DIEP flap is a type of breast reconstruction in which blood vessels called deep inferior epigastric perforators (DIEP), and the skin and fat connected to them are removed from the lower abdomen and transferred to the chest to reconstruct a breast after mastectomy without the sacrifice of any of the abdominal muscles (I am calling this one the belly flap).

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Option #2: Latissimus Dorsi Flap—An oval section of skin, fat, and latissimus dorsi muscle is detached and slid around through a tunnel under the skin to the breast area. Blood vessels remain attached whenever possible. The tissue is shaped into a natural-looking breast and sewn into place (this one shall be named the back flap).

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There are pros and cons to these procedures (mostly cons)

Belly Flap pros: tummy tuck (that I don’t really need)
Belly Flap cons: slicing open my abdomen, 4 days in the hospital, giant scar on my abdomen (so no to nude photo shoots), the teeny tiny stretch marks that are left over from pregnancy will be transferred to my breast, requires two surgeons, I don’t really have enough belly fat to make anything worthwhile.

Back Flap pros: smaller scar, shorter hospital stay, your latissimus dorsi muscle isn’t all that important. I told Dr. K that I thought it was an important muscle and he said, “not unless you are an extreme athlete”. (Wow, first I get the news that I can’t have the regular surgery and now I find out I’m not an extreme athlete? Such a cruel, cruel world!)
Back Flap cons: scar across my back (meaning I’ll never go back to wearing those backless gowns I’m so fond of), weird sensations–since the blood vessels stay intact, if someone touches your back, you’ll feel it on your front, weird recovery– how do you sleep with ouchy spots on your back and on your front?

So after discussing all of this, I told Dr. K that I needed time to think about it. He agreed, filled my right tissue expander with more fluid, and I left. (Now I can be described as small, hard grapefruit boob/big, soft, oddly-placed, slightly in the armpit boob.) Luckily, I was able to meet with some fabulous cancer people the next day who had been through the whole process or were about to. Getting first-hand advice was really helpful and I feel much calmer about making a tough decision. Those Pink RibbonCowgirls (a local breast cancer support group) really know how to make everything seem not so scary.

Don’t worry though, I’ll be sure to keep you abreast of what’s flappening. 😉

I Don’t Have a Primary Care Physician

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You know how you go to a new doctor and you have to fill out those forms? Insurance, emergency contact, family history, do you smoke, primary care physician…well every time I get to the primary doctor question, I leave it blank. I don’t have a doctor for regular things like a sinus infections. I only have doctors that take care of specific parts of my body: medical oncologist, breast surgeon, plastic surgeon, radiation oncologist, gynecologist, sleep specialist, gastroenterologist, surfologist (I made that last one up, but in my mind, a surfologist would be the kind of doctor that listens to your stress and then prescribes a visit to a specific beach).

Sleep Specialist: When I was first diagnosed, I began having a terrible time staying asleep. My body had no chance due to tumors and lack of shut-eye. Dr. D prescribed something to help me sleep, but a year later, I found myself still taking it, which didn’t seem quite right. So off I went to Dr. O, the sleep specialist. After meeting with him, he determined that I might have sleep apnea due to my super small palate (great, I have a small palate but big thighs? Not cool), and suggested that I come back for an overnight sleep study. So off I went for an overnight visit to my doctor’s office. The room they put me in looked like a hotel room, and the bed was actually comfy. But then they came in with all these wires and other sciency looking things and started taping them to all parts of my body. They even used special glue to attach things to my newly grown hair.

20130102-090127.jpgAfter having electrodes attached to every part of my body and sleeping fitfully in a strange bed, Dr. O let me in on my test results: There is not a damn thing wrong with me sleepwise. He gave me a specific bedtime though, so I now pack it in every night at 8:40.

Gynecologist: I saw Dr. P in the summer, and he suggested that I come back for a different ultrasound of my left ovary. I got busy and just never made it back in. In November, I started feeling some pretty bad pain right in the the left ovary area, which was clearly cancer. I let the pain last for about 5 weeks, and then I went in to have my ovaries reexamined. After a thorough examination (and me releasing my feet from the stirrups), Dr. P stood up, grabbed my shoulders, looked me in the eye and said, “You don’t have ovarian cancer. Your ovaries are fine. But there might be a problem with your colon.”

Gastroenterologist: I walked in the office of Dr. S, and I was immediately struck by the age difference between me and the other patients. They were more AARP and I was more Run DMC (cause that’s how I roll, yo). They took me back to the inner bowels of the office (pun intended) and I spent an hour talking about (ahem) evacuation, eating, and family history. The Physician Assistant was a truly lovely lady, and she made a concerted effort to hug me and squeeze me while telling me that I would have to undergo both colonoscopy and endoscopy. I suggested that these tests were for older people. She said it was normal for cancer people with my family history to have these tests. (I will detail this process when I have it done–we’ll have to see how it all (pause, wink) comes out.)

I write all of this as I prepare for my three month visit to Dr. K, my plastic surgeon, to see if my skin has healed enough to get regular breast reconstruction or if I have to get the dreaded back flap procedure. I’m also headed to Dr. D, my medical oncologist, for a look at my blood, hormone levels, and tumor markers. As a self-proclaimed Grumpy Cat, I am prepared for the worst. Preparing for the worst is really a good idea though: if you prepare for the worst and get the worst news, at least you were prepared. If you prepare for the worst and get great news, then you get to climb the happy meter for an extended time! But none of my my test results will be sent to my primary care doctor, be cause I don’t have one.

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2012 in review

The WordPress.com stats helper monkeys prepared a 2012 annual report for this blog.

Here’s an excerpt:

4,329 films were submitted to the 2012 Cannes Film Festival. This blog had 13,000 views in 2012. If each view were a film, this blog would power 3 Film Festivals

Click here to see the complete report.

Pinktober: We Might Just Need to Get Over It

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I was diagnosed with breast cancer during the month of October, the month which, as many of you know, has been designated Breast Cancer Awareness month. Every year, the color pink takes over in October, valiantly fighting the oranges and blacks of Halloween. When you know somebody with breast cancer, every time you see the pink, you think of her. When you have just been diagnosed with breast cancer during October, the pinkness engulfs you, acting as an unceasing reminder of a horrible disease. There is almost nowhere to turn for non-pink. Even the NFL gets in on it.

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Right about the time my mother was battling breast cancer, the pink ribbon started to work its way into popular culture. I remember the year my grandma gave my mom a gift she had just purchased from the Avon lady–a pink ribbon pen with a matching pink ribbon pin. When we got home, my mother gave the set to me. She said she didn’t need any cancer reminders. I began to notice the pink ribbon stuff more and more, but I did not indulge in any of it. The pinkness became something for me to battle. I did not want to be reminded of the darkness cancer brought into my mother’s life and I didn’t want any part in what I saw as mindless support.

When I was diagnosed last year, I was very clear about the pink ribbon propaganda: I didn’t want any of it. I read everything I could regarding pink ribbon fever and I felt great unease toward anything emblazoned with the color. I decided that the pink ribbon started out as a noble cause, but then slowly degenerated into just another way to make a buck. I did admit, however, that because of the movement to bring breast cancer into our consciousness, I knew that my symptoms were typical of something gone awry. Without awareness programs, I would have assumed my lump and serious fatigue were just part of aging and bad luck.

I am not the only woman who has seen pink ribbon culture as an adversary. If you delve into the Internet, you can find find plenty of people who think the pink of Pinktober is vile. There are pages and pages of online message boards where women post pictures of what they see as ridiculous advertising gimmicks to “raise awareness for breast cancer” or to “raise funds to help in the fight against breast cancer”. Try heading over to Oriental Trading Company and type in pink ribbon in the search box. You can support breast cancer awareness with pink ribbon rubber duckies, pink ribbon hackey sacks, and pink ribbon cowbells. (All sold by the dozen, of course!) Other sites will sell you pink ribbon toothbrushes, pink ribbon perfume, and pink ribbon car seat covers. Now go to your local supermarket…the possibilities for breast cancer and marketing to meet is endless:

20121002-211347.jpg (Hmmmmmm…pizza? I don’t usually get all science-y, but do some research on the link between breast cancer and obesity. You could do way more to help in the fight against breast cancer than to eat food like this. Go for a walk. Eat something green. Take your vitamins. But triple cheese? No.)

So, what does a somewhat intelligent, slightly sassy, and overly skeptical girl like me do during the Pinktober rush? Well, for several years, she fights an inner battle and makes things difficult. And then, when it comes time for her to teach her daughter a valuable lesson, it is she who learns the most.

I have been trained by the Breast Cancer Resource Center as a speaker in support of their local efforts at supporting women affected by breast cancer. When I found out there was a speaking opportunity at Brighton (cute purses, beautiful jewelry), I jumped at the chance. I invited my daughter Grace to come along. The Brighton store was selling several pink items in support of the BCRC, and I discovered that a portion of the proceeds would go directly to the center. The manager of the store was doing some good math–she was calculating how many bracelets, purses, and make-up bags they would have to sell to be able to support women in need of mammograms. I spoke to several women in the store and found myself drawn to a very pretty silver bracelet with flashy pink bling. A beautiful pink and silver heart hangs from the clasp, along with a dainty pink ribbon.

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“Mom, look at this bracelet!” Grace squealed. “It’s perfect for you! And if you buy it, you’ll get something pretty AND support ladies with cancer!”

Is this kid smart, or what? Acquiring special jewelry while helping a charity that I KNOW is legit? Yes, please.

So I did what was right, and I bought the pink ribbon bracelet. I had to. Really. It’s not every day that I can support my daughter’s belief that I need pretty things.

But after so many years of pink ribbon angst, why did I finally give in? Because I needed to teach Grace a lesson in being mindful. I explained that the original intent of the pink ribbon movement was to bring awareness to breast cancer detection and to support the need for cancer research. I also mentioned that there are really a few reasons for pink ribbon gear:
1. Awareness: you want to share the message of self-examination, yearly mammograms, genetic testing, etc.
2. Honor: you want to honor the memory of someone who has suffered the ickiness of cancer.
3. Money: you want to donate money to research or to programs that assist women who can’t afford treatment. The money part, however, is where things can get tricky. If your intent is to truly give money, I almost think it would be wiser to skip the middle man and donate directly to a legitimate organization. Find out the truth. Do not assume that because there is a pink ribbon accompanied by claims of donation that you are being told the truth.

So it comes to this: if buying one dozen rubber duckies emblazoned with pink ribbons helps you honor your aunt’s memory, then buy them. If putting a pink ribbon sticker on your bumper helps you remember to get regular check-ups, then stick away. If you want to donate money to a breast cancer charity, and you know your money is truly going to the right place, then write that check, kid.

I think that if pink ribbon haters would put their attention to helping friends make informed decisions, a lot could be accomplished. Truly, the heart of pink ribbon propaganda is pure. Some organizations exploit our need to feel like we are doing something, but if you are smart about how you spend your money and if you use the pink ribbon to honor or raise awareness, it’s all good.

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The time has come for getting over Pinktober.

Keep the Calm with the One Lovely Blog Award

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There is an award passed between bloggers, and I think it’s pretty neat. It’s called the One Lovely Blog award, and you get it by being recognized by fellow writers. Continue reading

Competitive? Yes. I Will Beat You to the End of This Title…

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In real life, I’m somewhat competitive. I like winning. I often set a goal and do everything I can to beat it.

The very first day I walked into Kindergarten, I knew I would grow up to be a teacher. When I reached that goal, I found myself seeking more training to become a better teacher. I thought that once I arrived at teaching nirvana that my life would be complete. But then I noticed that I wanted to achieve more in my career, so I went to graduate school and ended up as an assistant principal. I really enjoyed that job. But then, I found myself wanting a little more and now I am serving as a principal. Before cancer, I was dabbling in thoughts about pursuing a doctoral degree so I could pursue my secret dream of working at a university teaching teachers how to be good teachers.

At one point in my adult life, I entered a 5K race as a jumpstart to a weight loss plan. Then I decided I could do more and I started training for a marathon. Then I accidentally ended up pregnant with my third child, which made me see that I only had time for 5K races. When we moved to Texas, my husband started entering races too and we began participating in fun runs and adventure races. Basically, if you could dress up in a costume and get free beer at the end, we were in.

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In 2011, we competed participated in the Warrior Dash–3.1 miles with obstacles. Jeremy had been working really hard at work but had little time to train. When the race began, I found myself pulling away from him. Soon, I couldn’t even see him behind me. For the first time in our short running (jogging) career, I CHICKED him. I crossed the finish line ahead of my husband! I was one second over my goal time, but I beat him! We had never really talked about the fact that he ALWAYS beat me, but when I finally beat him, I was all over it. I pretty much felt like the baddest badass and a true warrior.

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Before I knew about the cancer, my physical fitness was the first thing to go. In June and July 2011, I was doing this Jillian Michaels crazy workout in the morning, followed by a gym visit later in the day. I had sweat on my sweat. But by the end of August, I was lucky if I could walk across the parking lot without resting. I think I fell asleep at my desk at one point. after mastectomy surgery, Jeremy had me up walking all the time. I slowly built up my strength, but then chemotherapy came along. I entered a few races while undergoing treatment, which I think helped me feel normal and alive. By the time I endured radiation, my body was finished. I know for a fact that I fell asleep at my desk. When you are sitting for long periods of time and cancer treatment throws you into CHEMOPAUSE, you gain weight. 15ish pounds to be exact. Not only was my physical fitness level ridiculously low, my clothes weren’t fitting. Not cool. More important, however, is the fact that obesity is a major factor in the world of breast cancer. I don’t know what caused cancer to grow in my chest, but I do know that there are things I can do to make sure it doesn’t come back. One of those things is to maintain a healthy weight.

Jeremy supports me no matter what, and he knows that I like to be fit and strong. For the entire month of August, he got up with me at 5:00 A.M. and walked by my side. I decided to break out the Couch to 5K app so I could add in some running jogging slogging (slow jogging) intervals too. My precious puppy, Maggie Mae, came along as well. At first, I just came away from these events sore and annoyed that I was sweating before the sun came up. But within two weeks, I not only felt stronger but my clothes were fitting better. And the hot flashes? Nearly gone. And those 15 pounds? I lost 7 of the bastards.

One morning last week, Jeremy and I were discussing getting back to normal and entering some of our favorite races. I brought up (of course) the Warrior Dash moment, and started talking trash about this year’s event (which we are entering).

“It must suck,” I said, “to be beaten by a girl. You need to try to redeem yourself, right?”

“Baby,” he said, “I’m not worried about you beating me. Because of cancer, I have a leg up on you. This workout I do with you is just a warm-up for my ten mile run later today.”

I answered this comment with a laugh, but inside I was starting to catch on fire. CHALLENGE ACCEPTED. I seriously doubt I will beat him this year, but I have no doubt that I will beat him again at some point and then I will revel in the glory that will be mine. I will win like a boss. Like a diva. Like a survivor.

Competitive? Just a little.

Searing Heat From the Depths of Hell…or Hot Flashes

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I’m hot. Not hawt…hot…as in temperature and sweat.

Hot flashes are bad. Really, really bad. It is not an understatement to say that I SUFFER from hot flashes. They started right after my second dose of poison chemotherapy, and they haven’t let me forget their existence since then. I told Dr. D about these “oh-God-how-did-I-end-up-on-the-surface-of-the-sun” moments, and he said that due to the chemo, my ovaries were “mad at me” and shutting down. Huh. First, my ovaries should realize that the chemo was necessary just in case a random cancer cell broke free from my breast and made its way down there. Second, my ovaries sound really immature. Couldn’t we just talk about it and find a more peaceful resolution? And third, does Dr. D realize that it’s CRAZY to think that internal organs have emotions?

Some of you will scoff at the idea of suffering from hot flashes–but you need to know that this is way more than just being hot. It starts in my head and sweat beads pop out of every pore on my body. I can be sitting perfectly still and end up drenched in sweat. I was waking up in the middle of the night, completely miserable. And the time I was taking Tamoxifen? Even worse. These moments leave me a little weak and a lot upset. No book, magazine, file folder, or iPad is safe during a hot flash: I can make a fan out of anything. For a while, I was blotting my sweaty face with tissues and napkins, but since I’m me, I realized that sometimes it’s all about the accessories. I ordered these little embroidered handkerchiefs so I could dab my glistening visage with a little class:

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The hot flashes are a sign that my body is going through The Change that is usually reserved for ladies much older than me. But at 36 years old, I’ve been thrown into early menopause (cancer people call it “chemopause”). I tried several remedies: Black Cohosh, increasing Magnesium intake, more soy, less soy, turning the air conditioner down to -5, etc. None of it really worked. Finally, Dr. D prescribed something a little stronger, which did lessen the hot flashes a little bit. But along with hot flashes came other issues caused by The Change, the biggest being gaining weight. Yuck yuck yuck yuck yuck yuck yuck yuck yuck yuck. Yuck.

As usual, I’ve done extensive research on this topic, and last week, I had way less hot flashes than usual. I am almost embarrassed to admit how I made these little devil hot flashes decrease. After trying endless remedies, lamenting with great passion, and going broke from keeping my house freezing, I found a solution. Somehow, some way, all those doctors are onto something. I got in some kind of workout every day last week and I ate an incredible amount of fruits and vegetables. I did not touch any kind of beverage except water and coffee. And lo and behold: less heat. ARGHHH! THE DOCTORS WERE RIGHT THE WHOLE TIME. ONCE AGAIN, THE ANSWER TO LIFE’S PROBLEMS CAN BE SOLVED WITH DIET AND EXERCISE. (Dammit.)

So the only way I can really combat the effects of chemopause (suffering from the effects of having the bowels of Hell living in my skin) is to get all skinny and fit. Great. Now all these other moms are going to be jealous of my shrinking body. I guess that’s something that just can’t be avoided though. It’s a burden I’ll just have to bear. 😉

Did I mention I’m hot?

Freshly Pressed? Nailed It!

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Guess what Guess what Guess what? My post, Do Not Stick a Fork in Your Boob, has been selected to grace the WordPress blog collection called Freshly Pressed. It means that some fab person at WordPress found my post out of 400,000 other posts and said, “Hey, I like that.”

Here’s a screen shot of my achievement:

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Here’s my puppy with a sand ‘stache:

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(Unrelated to the Freshly Pressed thing, but completely and totally cute!)

So I think this may have caught the attention of the WordPress Word Wranglers for one of three reasons:

1. I added some rad original artwork
2. I’m turning into a legit writer
3. I used the word “boob” and thus my post came up in a search for websites of a certain reputation (Wink, wink)
(Wait…did I just imply that the WordPress people are Googling porn? That doesn’t sound right at all)

Whoop! Freshly Pressed!

Do Not Stick a Fork In Your Boob

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Ah, tissue expanders. They mean well, but they sure are a pain in the butt, er, chest.

Here’s the story: tissue expanders, or TEs, are these round bag-like things that are placed in a woman’s chest to make room for eventual breast reconstruction. They can be slowly filled with saline until the desired breast size is reached. In my case, no fluid was added at the time of my mastectomy surgery because there was just no room. The surgeon had to take a lot of skin, so there was barely enough space for the TEs. That was okay though, because the original plan was that I would have surgery, recover, start filling the expanders, and go through reconstruction. Unfortunately, I had high grade, multifocal tumors and a positive margin, so chemotherapy and radiation had to be called in.

I got three fills before I had to stop for radiation. I was going from concave-ish to some sort of shape, so he only used about 50ccs each time. On my third fill, I touched my ballooning breast area and asked Dr. K if there was any chance that they would pop like a water balloon. He quickly said no, but then offered this gem: “I guess they would pop if you stuck a fork in your boob. So don’t do that.” Naturally, I am heeding this advice. (And seriously, if I start stabbing myself with flatware, then I’ve got bigger problems than nicely shaped breasts.)

The deal with radiation is that your skin goes through some changes that aren’t cool for people who are mid-recon like me. So once you have radiation, you have to wait four to six months (and maybe longer) for the skin to return to some sort of natural state. If the skin doesn’t play nice then you have to get surgery that involves a flap of skin from your back. Yuck.

The terrible scarring that took my breath away after surgery is fading. I don’t even notice it anymore. The thing that consumes me right now is odd shape and crazy asymmetry I’ve got going on. My left side, the CANCER side, is still healing from radiation. The skin got really tight and hard, and it looks and feels like I should be really careful when in the vicinity of forks. The right side, though, is really weird. It is hanging about two inches lower than my left and the skin has stretched a little. The tissue expander underneath is so smooshy that I actually have corners sticking out of my skin. It’s completely bizarre. Even though I have some shape due to the fills and don’t really need to wear a bra (no coldness meters), I still wear a bra so I have some consistency shape wise!

Here’s a self portrait I made to illustrate the current state of affairs on my chest:

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In a few months, I’ll go visit Dr. K and see how he thinks everything is going. In the meantime, I’ll continue to rub vitamin E cream into the rock protruding out of my person. I’ll also continue to update my blog in an effort to get these feelings off my chest. (Hah! CHEST! See what I did there?)

CHEMO CURL!!!

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Okay kids, my hair is growing back. Good news!

I was warned about “Chemo Curl,” and the warnings have turned into real life:

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This picture was taken at the Gulf Coast, so the humidity made the curl more prolific. I’m not not really complaining here, but I do think that if I had more gray I would fit in with the Golden Girls.