Wednesday, December 19, 2012

things are about to get real

School is finally over for the semester!  I finished my finals today, and now I can just relax.  Except not really.  I still have to finish Christmas shopping, I have two doctors appointments this week, and I have to mentally and emotionally prepare myself for my mastectomy.

I watched a web-series on YouTube about a girl named Claudia.  I came across it a long time ago when I was looking for videos about mastectomies, so I could get an idea of what the recovery process would be like.  She is a girl about my age with a genetic mutation called BRCA 1, which gave her an ~85% risk of developing breast cancer.  In order to defy those odds, she underwent a preventative bilateral mastectomy and documented her journey.  In one of her videos, she met up with the founder of the Keep-A-Breast foundation and had her torso made into a cast.  This way, she will always remember her natural form.

I loved this idea!  Of course there are pictures, but the idea of having a tangible representation of my body forever before I permanently change the way my chest looks was so comforting to me.  I looked up the Keep-A-Breast foundation and saw that I could apply for their Treasured Chest program.  I wasn't sure how that would work, since they are based in LA.  I didn't think I would have time to go all the way there to have a breast cast made before my surgery, but I submitted an application to see what would happen.  I got an email shortly after telling me that I would be receiving my DIY casting kit very soon.  That made so much more sense, and they were right, only a couple of days later I got a package in the mail.  It looked just like a Treasure Chest, and inside were all kinds of goodies, including plaster strips and an instructional DVD on how to make a breast cast.  It looks like a fun and slightly messy project, hopefully my mom and I can figure it out.  Then once I make it, I can decorate it.  Or maybe I can have someone decorate it for me - I'm still trying to decide.  I'm also still trying to decide how I want to decorate it, what kind of tone I want it to convey, etc.  I'm really looking forward to making my cast and seeing how it turns out.

I cannot believe my mastectomy is in 9 days (I guess 8 now, since it's after midnight).  The closer it gets, the more real it gets.  The more real it gets, the harder it is to stay complacent about it.  Some people have had the pleasure of witnessing me burst into tears for seemingly no reason.  I'm really scared.  Of what exactly, I'm not sure.  I know everything will be fine, but I don't know that there won't be any complications.  I don't know for sure how it will turn out.  I don't know how painful the recovery is going to be, or the expansion process, or the removal of the surgical drains.  Or maybe I'm more scared of what I do know - that I won't have any sensation in my right breast.  That it won't really be a breast anymore.  That I won't have a nipple there.  One thing that is really helping me with all of this is that I'll still have the left side.  And, I will still be me at the end of this long journey.  If anything, I'll be even stronger and more self-aware because of it.  My physical appearance will change slightly, hopefully for the better, but it won't change who I am.  So really, I don't have all that much to be afraid of, especially because of the amazing support system I have.  I appreciate you all so so so much.  And I appreciate being able to vent my feelings on here.  It's nice just to have people to listen to me, and it's nice to have the whole internet listen to me, lol.  I do not know what I would do without you guys, the people who have been there for me in more ways than I could list.  The people who have given me courage and positive thoughts.  The people who have listened to my fears and let me feel the way that I feel.  Thank you all.

I have an appointment tomorrow for another ultrasound.  I asked my breast surgeon about getting one to make sure that there isn't anything to worry about in my left breast before they do the mastectomy.  I also want to get an ultrasound of my abdominal area, since Fibromatosis usually shows up there, and the only reason I knew to get my breast checked out was because of the physical change that I saw.  I didn't see or feel a "lump," so how would I know that there's not anything in my stomach or my other breast?  I'm sure there's not, but I'm relieved that it's going to be verified.

On Thursday, I have another appointment - my pre-op appointment.  Then a week later I'll be going in for my surgery.  I can't believe it's almost here.  Lisa, my neighbor, gave me a CD to listen to that she listened to before, during, and after her surgery.  I've listened to the first few tracks a few times - the last couple are for after the surgery.  I'm going to ask if I can listen to it during my surgery, which I'm sure I'll be able to, since Lisa and I have the same surgeons.  It's very calming to listen to, the first few times I listened to it I fell asleep before I could finish it.  They recommend not listening to it while driving, and I can understand why.  Listening to it has been helping me prepare myself, especially when I'm feeling extra anxious.

Okay, that's all for now.  I need to go to sleep, heading to Kaiser in the morning.  Nighty night.

*Edit:  12/20 - Of course, they found something in my left breast at my ultrasound appointment yesterday.  It's probably something called Fibroadenoma according to the radiologist, which is no big deal.  I had it biopsied today just to make sure that it's nothing, and I should find out the results of that tomorrow or Monday.
I hope it's tomorrow, I HATE the waiting process.

Friday, November 30, 2012

Silicone vs. Saline and other thoughts

Hey everyone!  I thought I'd give another update for those who are interested. 

If you don't already know/haven't seen my previous posts, I have Fibromatosis.  It is, as I'm calling it for now, a very rare form of breast cancer with some benign qualities and some malignant qualities.  I had a lumpectomy to remove the tumor, but the margins weren't clear, so I'm going back in for a mastectomy on December 27.

I met with my Plastic Surgeon again today, and we had a longer (hour long) consultation discussing options, looking at pictures, etc.  He also pulled out a loose stitch from my lumpectomy -- OUCH!  But besides that one thing, the appointment went very well.  I'm still not really sure exactly what I'm going to do, but I still have a lot of time to figure that out.  Even after my mastectomy and tissue expander placement on the 27th, I'll have about 3-4 months or so before my exchange surgery.  So questions like silicone vs. saline and how big of an implant I'm gonna get have time to be answered.  I'm also not sure if I want to try to do nipple reconstruction or not, but that has time to be decided as well.

I am so lucky to have the people in my life that I do.  Shout-out to my Mommy, Lisa, Nicole, and Justin, who have all been soooo supportive and helpful through this whole thing.  All of my friends and family have been great.  My mom has been with me to every appointment since the very beginning and took care of me when I was recovering from my first surgery.  Lisa has been my mentor, she went through the same process as me with the same surgeons and everything.  She has accompanied me to both of my consults with the Plastic Surgeon, and she has been a great resource for me.  Not only that, but she's very caring and it's really nice to have someone to talk to who knows exactly what I'm going through.  Nicole is great, I can call her any time I need to vent or just be sad and she's always there for me.  She even wants to go with me when I get my tattoo on my breast - and she wants to get one too.  That's why she's my boo for life.  And Justin - I am so blessed to have him in my life.  He has been so great to me, he's going to be with me for my surgery and the first part of my recovery.  He's been there for me since the beginning, sticking by me and supporting me.  The timing for meeting him is kinda bad, since he met me right when this was all starting and now he has to deal with it too, but also SO good for me, since I have him to support me and comfort me. 

I am also privileged to be so well cared for by my doctors and nurses.  I feel like they all really care about me, they have all been very compassionate, helpful, and supportive.  I really like all of them.  I loved the nurse I had before my lumpectomy, she liked me so much that she found me when I was in recovery even though I had a different nurse - just to check up on me.  I'm thinking about requesting her to be my nurse for my mastectomy too, if that's possible. 

Finally, I have to thank the wonderful ladies of Breastcancer.org - they have all been amazing.  They are all so strong and brave, and having them to talk to has been immensely beneficial for me. 

Having all of these people around me has really made this whole process a lot easier.

To be honest, I am starting to get scared.  Mostly what I'm scared of is the impending freak-out that is bound to happen.  I have had a few freak-outs, but for the most part I have been handling myself pretty well through all of this.  I just know that at some point, as my surgery gets closer, it's all really going to hit me what is going to happen.  I'm going to lose my breast and my nipple.  And I AM going to freak out about it.  I mean like REALLY freak out, not just cry a little and then be done with it.  I am afraid of what that's going to look like and I am afraid for whoever has to witness it.  Hopefully it won't be too bad.

Alright, that's all for now.  Thank you to everyone who has been a part of my journey, I appreciate you all. <3 br="br">

Saturday, November 10, 2012

Update on my journey with fibromatosis

Yes, it is Fibromatosis as the biopsies suspected.  And yes, it is a journey.  I had my lumpectomy surgery on October 29, and I thought that was going to be the end of it.  Unfortunately, it's not.

Considering this isn't technically a form of cancer depending on who you talk to, it certainly acts like a cancer.  My pathology report and surgeon told me that I don't have clear margins, which I'm pretty sure she knew when she was doing the lumpectomy.  It had already grown way too big.  She took out three different pieces of tissue, one measuring 9 x 2 x 2 cm.  And the margins still weren't clear.  It's still in me and needs to come out.

My whole breast needs to come out.  I found out a few days ago that I'll need to have a mastectomy.  I already suspected that when my surgeon told me that I would need to have more surgery, because she mentioned having me talk to a plastic surgeon.  So when I heard that word in the doctor's office, it didn't shock me as much as it did my mom.  I guess this is one of the times that my "jump to conclusions and expect the worst" nature was actually helpful.  The only thing I didn't expect was that my nipple won't be spared.  (I figure since you all already know I'll be losing my breast, might as well say the whole truth.)  That part was really sad to me at first, but I'm feeling a little better about it and about this whole thing.  I am so incredibly blessed to have people in my life who have been supportive and understanding.  I am very lucky to have a wonderful community of online breast cancer survivors to talk to about all this and get advice from.  And, as unfortunate of a coincidence as this is, one of my neighbors who I have known my whole life (I was good friends with one of her sons when we were younger, and my brother with his brother) recently had a mastectomy by my same breast surgeon and reconstruction by my plastic surgeon.  She has been a great resource to me and I'm sure she will continue to be, helping me along this journey with advice and encouragement and complete understanding.  I also really like my breast surgeon and my plastic surgeon.  Both are very kind and caring people, and I am hopeful that at the end of all this I will feel almost whole even though I'll only have one real breast.

Since I won't have a nipple, I've been weighing my options - try to have it reconstructed out of skin/tissue, have it tattooed on, or go without one.  I hadn't even considered the idea of having an artistic tattoo done to cover the scar until my neighbor told me that that's what she was thinking of doing.  I LOVE that idea!  I keep looking at pictures online of tattoos covering mastectomy/reconstruction scars, and I really like some of them.  I know that whole part of this journey isn't until months down the road (at least), but you know me, I love to plan ahead.  I've already been thinking of what I'd want my tattoo to look like.  I'm not sure if that's what I'll end up doing, but I like the idea for now.

My mastectomy is scheduled for December 27.  Just in time for new years!  Haha.  So much for my new years plans.  At least I'll be able to celebrate Christmas like a normal person - I'll just have to celebrate new years a little early this year.  While I'm still under from the mastectomy, my plastic surgeon is going to come in and place the tissue expander in with a small amount of fluid.  So I won't be completely flat when I wake up, just mostly flat.  After that I'll have to stay a night in the hospital; unless I feel like a "rock star," then my plastic surgeon said I can go home that day.  But I'm thinking I'll have to stay overnight and I'll be able to go home the next day.  The recovery time for this surgery will be longer than my lumpectomy, it will take about a month before I can go back to mostly normal activity.  The first two weeks I won't be able to do much of anything.  I'm glad the new Kindle HD that I want will be out by then, since I'll have a LOT of downtime.

Then, gradually over the next 3 or 4 months, I'll have my expander filled with saline.  They have to do this over time because there won't be much tissue to work with after the mastectomy.  Once that process is done, I'll have my exchange surgery and the expander will be replaced with a "permanent" implant.  It's not really permanent since I'll have to have it replaced every ten years or so.  Then once I'm all recovered and healed from that, I can figure out what I'm gonna do about nipple reconstruction or tattooing or whatever.

All this fun stuff going on has been really bad timing with my just getting hired back at the racquet club a couple weeks ago.  It's just been too stressful with all the appointments I've been going to, researching, talking to genetics counselors (since fibromatosis can be linked to Gardner's syndrome, I might have to have some tests done to make sure I don't have that), and planning surgeries.  I gave my two-weeks notice.  It feels weird since I just started there, but I really need this time to focus on me, my family, and my school.  [Side note: I've been taking classes at CRC because I've decided to pursue my old dream of nursing.  Especially since my experience with so many nurses from this whole ordeal, it's just made me want to do that even more.  I love the idea of being able to help people the way they have helped me.  I know that's a bit of a step from my Aquatic Biology degree, but it's not too far from it with all the biology classes I took in college.]  And once my classes are over in December, it will be nice not to have to worry about work at all while I'm preparing for and recovering from surgeries.  My boss was very kind and sympathetic.  She told me they were going to miss me there and that once this is all over, they'll be right there waiting for me to come back.  It is comforting to know that I'll still have a job there if I want it after I'm healed.  I am glad that we ended on good terms and that this might not be the end, depending on what's going on in my life in 6 months.

I'll try to keep this updated throughout this process.  I know this is a really rare and unique situation for me to be in, but breast cancer isn't as rare and it can happen to anyone.  I will stress again to everyone: pay attention to your bodies!  And check your breasts monthly!  Even if you're young like me, it is important to be aware of any changes in your body.

Saturday, October 6, 2012

Breast Cancer Awareness

I haven't updated in almost a year!  Time has been going so quickly, plus no one reads this so.. yeah.

Anyway, a lot has happened in the last year.  I have had a few health scares, along with a recent startling diagnosis. I am someone who is more susceptible to skin cancer than most, with my fair skin and abundance of moles, so I am always paying attention to any changes in my body.  I advise everyone else to do the same, as the human body is amazing and changes can often be ways for it to tell us that something is wrong.

This past January (I think) I had a mole removed and the pathology report came back as moderate-severe atypia.  I had to go in for a re-excision to make sure it wasn't malignant and that all the margins were clear.  The re-excision was done this past February, and I was fortunate in that everything was fine.  Whatever it was, I caught it early, and got rid of it before it could become worse.

Now, fast forward to September.  I know I am susceptible to melanoma, and one of these days I was actually kind of expecting to be diagnosed with it.  However, I hadn't even considered the possibility of me getting breast cancer.  (At least, not for several more years, since it is so rare in women my age).  About a month ago, I noticed a change with my breast.  I don't want to go into too much detail, but when it hadn't gone back to normal after a few days, I did some research.  I realized that most of the causes for this particular change were connected with aging or with infections or diseases which I was pretty sure I didn't have.  The other possible cause?  Breast Cancer.  I know this is unlikely at my age, but it was seeming like the most likely thing out of the other possibilities I came across.

I made an appointment with my GP, and she was quick to refer me to a Breast Specialist.  The BS referred me for an ultrasound, which found an "area of concern."  They didn't know what it was, so I had three biopsies and a mammogram.  The ultrasound, biopsies, and mammogram all happened this past Monday, and I got a call from the Radiologist on Wednesday that my biopsies needed further testing and that I would have to wait 3-4 more days for the results.

That was unsettling.

I went the next couple days worrying, sure I had to have breast cancer.  Then on Friday morning (yesterday) I got a call from the BS.  She told me that they still didn't have the final pathology, but that she had spoken to the original Pathologists and they told her that it definitely wasn't breast cancer.  Instead, she said it might be something benign called Papillomatosis that they might have to remove.  She told me I could breathe a sigh of relief, but for some reason (my own intuition I guess), I didn't feel the relief like everyone else did.  Something didn't feel right.  My mom was next to me when I got the call, and she hugged me with happiness.  She informed my extended family, I called my brother and told those who I had informed of my scare the good news.  I hadn't told very many people, since I didn't want to bring unnecessary stress into people's lives if it really was nothing.  My dad was relieved, my friends were relieved, everyone was relieved except me.

So then, later that day, around 4pm, I got another call from the Radiologist.  I was babysitting the kids at the time, but Caden was playing his video games and Taylor was upstairs, so I answered.  He asked me if I had time to go over the final pathology with him, and I said yes.  His tone sounded weird, not excited like it should have been if he were calling to tell me I didn't have cancer.  He told me I had something called Fibromatosis - Bland Spindle Cell Proliferation.  "It's not malignant, but it is a form of cancer and will need to be removed."  "How is it not malignant if it's cancer?"  "It doesn't metastasize and you won't require chemo or anything like that."  I guess it is considered a cancer because it is locally invasive, and it has a high frequency of recurrence.  He told me he would refer me to a surgeon who would contact me next week.  And he said it was REALLY rare, like less than 1% of all breast tumors.  I later looked it up and saw it accounts for about 0.2% of all breast tumors.

What are the odds?  Well, obviously 0.2%.  Or even less, since the odds of me even getting a cancerous breast tumor are low at this age.  Crazy.

I consider myself lucky, though.  Even though this is an annoying pain in the butt, it could have been a lot worse.  And I was expecting it to be worse.

It's frustrating, though.  I haven't been sleeping well for about a week now.  I don't think the bad dreams will stop until after I get this thing out of me.  I'm hoping that happens soon.

What I've learned from all this: pay attention to your body and trust your intuition.  Even if it looks like a subtle change, if you feel like it should be checked out, get it checked out.