Two Days Before Surgery

Just when you start feeling better and things are getting back to normal, it's time to gear up for surgery.  I think the hardest part in this whole journey is picking yourself back up again after every knockdown.  This week I did my P90X workouts - only legs and only half the workout.  I couldn't do the 90sec wall squats or complete the single leg wall squats I've lost so much muscle mass.  But I was happy that I got sore after the first workout and it cleared after the second.  Glad to see my body heal and recover.  Going to need that with surgery this week!

My MRI came back good - my 4cm tumor in my breast has shrunk to 1cm and my 3cm tumor in my lymph node has shrunk to almost non-existent.  The mammogram was not helpful (tissue is too dense) and they did not do an ultrasound (the MRI is more precise).  The surgeon will remove the remaining tumor, the dead tumor cells, plus some margin.  They will use something called guide wires plugged into the center of the tumors which they hook in during a mammogram.  Does not sound fun.  This will help the surgeon pinpoint the location and give her the best chance of success removing all the cancerous cells.  Once I'm wired I will undergo the surgery.

I'm having mixed feelings about the surgery.  While I'm happy I will finally have all the bad cells removed, the risk of a follow on surgery to get the margins and the 40% chance I will have to live with lymphadema are hard to swallow.  I've never been one to take meds, even pain killers.  I stopped pain meds 1 day after my appendectomy.  Need everyone's prayers that this surgery will allow full arm movement, no residual lymphadema, and no damage to my nerves or long term numbness in my arm.  I keep remembering what another survivor told me - one day at a time.  For now I am just trying to trust in my doctors, enjoy this beautiful summer weather with my wonderful husband and kids, and crossing a few Boston items off my bucket list.  Mom flew back today too to help out while I'm recovering.  It's go time again!

Quick business trip to Pratt &Whitney sporting my new wig

Dinner at Gibbet Hill Grill with our visiting Texas friends

Love and Support

This week has been incredible.  I've been on this cancer journey for 4 months now and the continued outpouring of love and support is just amazing.  To start the week I received a wonderful gift - a quilt about "What Cancer Cannot Do" with patches of handwritten letters of encouragement from our Texas family.  The next day I received a bouquet of roses from one of Brady's classmates parents who had just learned of the news.  Truly I am blessed!

  Support From Far and Near

This week I also learned of the news that my Aunt Rose has been diagnosed with the same type of breast cancer.  Fortunately they found it on her annual mammogram and were able to diagnose it early.  She will have an MRI this week then meet with her surgeon about removal options all of which will be followed by radiation.  She called me to tell me how much she had learned in the last ~2 weeks going through this process, how she's been thinking of me, and how the chance of recurrence doesn't change much whether you have a lumpectomy or mastectomy.  We may be recovering from surgery the same week!  Our love and prayers to Aunt Rose for strength and healing as she begins this process.  What a heck of a 2016 for her and Skippy (Skippy is currently in a neck brace after a fall at work, multiple lacerations to his head and face, and 3 broken vertebrae). 

Sometimes you just have to put mind over matter.  Today, 6 days after completing my 8th and final chemo treatment, I went for a run.  I won't kid you it was hard.  I have put on ~10 lbs in chemo and lost probably the equivalent if not more in muscle mass.  I ran for 4 minutes, walked for 3 minutes, ran another 2 minutes, and walked another ~10 minutes back to my car.  My legs felt like lead.  My back was stiff.  I'm sure I looked awkward but hey you have to start somewhere.  

Speaking of awkward, since I have to travel for a business meeting with my customer and supplier later this week (first biz trip since starting chemo), I attempted to draw on eyebrows and give my face some resemblance of professional.  Apparently brow pencils are for filling in gaps, not drawing on new eyebrows altogether.  This is going to take some practice.  Here is a time when I would have benefited from a female sibling LOL.

Surgical Consult

Met with the surgeon today to lay out the surgical plan.  We are still planning for a lumpectomy and auxiliary node dissection of the lymph nodes.  She ordered another MRI scan to help her determine the margins around the tumor to remove.  Once that is complete we will set a date for the surgery but right now looking at the third week of August.  Following the MRI I will have another mammogram and ultrasound just ahead of my surgery.  Some good news and bad news, I don't need my ovaries out as my genetic testing was negative (huge relief) however they are planning to take ~15 lymph nodes from under my left arm which is higher than the 3 we were planning and will involve drains for ~1.5 weeks after surgery as well as some PT.  It will take up to ~1 year to determine how this impacts numbness and swelling in my arm, but should have full muscle movement.

Surgery will be at MGH Boston where they will conduct the procedure, and also remove my port, and I will stay overnight for observation.  After that I get to come home and will be out of work for about a week in recovery.  It takes ~10 days for the surgical path report to come back then I will meet with the surgeon again to review the results and remove the drains.  If the margins are clear I won't need additional surgery.

If timing works out I will have my surgery the third week of August, start radiation the third week of September, putting this behind me by Veterans Day in November.  I will likely have to take the Tamoxifen (estrogen suppressant pill) for ~5 years after this ordeal but all this should put me at <5% chance recurrence of the disease.

While the Taxol chemo did take out my eyebrows, some eyelashes, and my nose hair, surprising to find the hair on my head is starting to grow back.  I am now showing peach fuzz.  I'm ready to get back into a workout regiment as well ahead of surgery to give me strength for the upcoming phases of this triathlon.

Last Chemo Treatment

Had my last chemo treatment today, we thought this day would never come!  It was fairly routine.  My labs were good and white blood cell count above normal meaning I would not have to go back tomorrow for the Neulasta shot.  The visit with the oncologist went well too, my echo-cardiogram from last week results were all positive, no visible issues with my heart from treatments.  I meet with the surgeon tomorrow to lay out the surgery plan, and won't meet with my oncologist again until after surgery to review the pathology report.

We made a special gift for the nurses who have been so kind and generous throughout this process.  We made a thank you poster and the boys used finger paint to paint handprints on it - thanks for giving our mom a hand!  We also took them some tasty treats.  The nurses all enjoyed the poster and the treats, and gave mom lots of hugs after finishing my treatment.

I also had a very big surprise at my treatment - a stop in from an old friend from Texas!  Erin Davis was driving from Maryland (Pax River) to Maine to pick up his girls after meeting their new baby cousin.  It's a long drive, but he went out of his way to stop in at MGH West to say hello.  His timing was great, I had ~30min left in chemo so we got to hang out for a bit, catch up, and give him a break from all the driving.  I wouldn't be able to make it through this process without all my supporters!

In the spirit of the 2016 Rio Olympics kicking off this week, this now completes the first leg of my cancer "triathlon".  Finishing chemo I have completed the hardest or "swim" portion of the triathlon, now I move into surgery the "bike" portion, then eventually radiation the "run" portion. Makes it 4 months down, ~3.5 months to go.  Reflecting back on chemo I had no idea what I was in for.  You can read about it, talk to others that have been there, but until you experience it and the side effects on your body you really don't know.  Like raising children, treating cancer takes a village.  I am incredibly thankful for my Mom giving up her summer to spend it here taking care of me and my family, my Dad and Terry for bringing meals or taking kids when we need the help, my brothers for visiting and bringing humor to any situation, and all my geographically dispersed friends and family for all the well wishes and care packages and yummy snacks that keep my house filled with positive energy and help convince me I can beat this - thank you all!  One big step down, two to go!

Radiation Plan Ahead

Today I met with the radiation oncologist at Emerson Hospital in Concord MA to discuss the radiation treatment plan.  Emerson is ~25min from the house and I will no longer have to fight I-95 traffic. While it was good to see their facilities and meet the doctor, it did seem a bit early because we don't have the surgical results yet to put the final radiation treatment plan or schedule in place.  Regardless, assuming I am able to stay on track for a lumpectomy (official name is breast conserving surgery), I would have my simulation mapping and tattooing the area for radiation ~3 weeks after surgery and start radiation ~4 weeks after surgery.  The regiment is 33 treatments (~5000 rads), 28 to administer to the breast / lymph nodes and 5 for a boost to the lymph nodes around my left clavicle (collar bone).  Assuming I have surgery mid to late Aug, I would start radiation mid to late Sept running for 6.5 weeks until early/mid Nov.  Radiation side effects are sunburn, fatigue, and some irritation/pain should the lung/heart/chest muscle get inadvertent radiation or heat from the radiation.  I will have to go to Emerson every weekday for 10-15 min of radiation.  When you receive radiation you lie on your back with your arms overhead and the machine whirls around you per the mapping instructions.  According to the doctor, and from what I've read, the fatigue with radiation builds over time culminating around 3 weeks.  While annoying they say it's not as bad as chemo.  The doctor thought given how well I am feeling on T chemo that I should feel the same in radiation.

Tonight I read the journal of a friend of a relative blogging her breast cancer journey.  The early entries brought back memories - the day I was diagnosed, the biopsy, the first chemo and subsequent side effects.  But her surgical experiences were not without issues and it reminded me that while I am feeling well now not to take anything for granted and be prepared for when things do go wrong.  I will be sure to ask my surgeon a lot of questions so I am prepared for bad or good news.  Am also hoping that the pop up "lump" in my right breast which seems to have disappeared does not pose any new issues that need to be considered for surgery.

The friend also said in her journal, and I have found true in my journey, that cancer does not affect just the one person but all those around her in this process.  I am forever grateful to my family and friends for stepping in to help us get through these difficult times!

The Hot & Cold Of It

One of the new side effects I've experienced with Taxol is hot/cold flashes.  They can occur at anytime and anywhere.  In the middle of the night a hot flash will wake me up and I'm peeling off sheets.  After only a couple minutes I'm freezing and I'm pulling the covers back up.  Sometimes the hot flashes last longer and I'm peeling off layers.  I did not experience this on AC chemo.

Another new side effect I've noticed is I'm losing my eyebrows.  I thought the hair loss was done!  Wonder if they'll ever grow back.  Looks funny too, they're patchy, kinda like a 4 year old tried to draw them on haha.

While these side effects are annoying I'm still feeling much better than on AC chemo.  I meet with the radiation doctors Monday to determine the next phase of the treatment plan.  Can't wait to put this cancer chapter behind me!

1st Trip on Chemo & 2nd Taxol

My second week on Taxol was very uneventful and we were able to take a trip to camp in Maine for July 4th weekend.  The water was warm and the weather was nice so we were able to do a lot outside. Since I was feeling so well we did a short hike on Cascade Falls (3/4 of the loop, ~1 mile).  I was also able to do some swimming which didn't hurt the port side unlike some yoga I tried earlier in the week.  It was great getting to see the grandparents and a couple of the Uncles for the weekend, and getting to forget about having cancer if only for a few days.  Only a few more months until this chapter is behind me!

Had my second Taxol treatment yesterday, 6 down and 2 to go.  All went well and I had a lot of energy afterward, did not need to nap.  This time I did not experience any of the sleep problems or the joint pain the first night like I had the first treatment.  The mouth sores are starting to return so will have to continue to brush my teeth and use the mouth rinse regularly.  Since my white blood cell count was up I did not have to get the Neulasta shot this time, will continue to monitor this over the remaining treatments.  Overall my energy level is better and starting tomorrow I plan to work in 10-30 min of exercise a day.  I need to combat some of the weight gain from the steroids!  Following chemo I will have surgery to remove the tumor cells and the port, then radiation.  I will be meeting with the radiation doctors soon to start laying out that treatment plan.

Erik and I in front of Bald Mtn - 3 Baldys!