Kari turns 21!!!

Top Photo:  Me, Miranda, Josh, Kari,
Bottom left: Me and Kari, Bottom right: Me, Beth, Holly, Kari

My baby girl turned 21 today!  How did that happen???

My sister, Beth, and I met up with her, Miranda, and Holly down at Jackson's Pit where both Uncle Ben, and Big Brother Joshua work.   We had a couple of drinks with her before leaving her behind to enjoy the rest of her birthday with her friends.  

Of course, I had to give her the lecture about being responsible and not drinking and driving, and she took it well.  I tried not to be annoying about it.  

I am glad I was able to spend some time with her tonight.  💗💗💗💗

New development

Dr. Edwards, the surgeon who did my lumpectomy and who would be doing my mastectomy, called me today.  He wanted to discuss the nipple sparing procedure Dr. Taylor and I discussed.

He doesn't think I am a good candidate for the procedure.

For one, he said he has only been present for a nipple sparing mastectomy ONCE and that was during his residency years before.  Also, because of the location of my tumor, and the fact that my cancer was microfocal, he said I would increase my risk of a recurrence of the cancer.  Plus there are always the other risks, like poor blood supply to the nipples, which would then lead to nipple necrosis, yadda yadda. 

Ultimately, he said if I wanted to do a nipple sparing mastectomy, he would refer me to the Mayo Clinic.  He would not participate, unless I chose a regular mastectomy with reconstruction.  

To be honest, I had thought about asking for a referral there anyway.  Now that I am having chemo first, I have time to explore other reconstruction options.  There is plenty of time, so I said sure thing.  His office will send the referral and get back with me when they have an appointment date for me.

I think this will be a good move.  

Everything is just great.

I have decided to do a double mastectomy with reconstruction.  Because I wanted reconstruction, I needed to meet with Dr. Taylor, who is the plastic surgeon here who does immediate breast reconstruction after mastectomies.  Daniele was able to get me scheduled with him on Thursday, along with another appointment with Dr. Seimers so we could discuss what I could expect with the chemotherapy I'd be getting after the surgery.

The appointment with Dr. Taylor went well.  He actually presented me with a different sort of reconstruction, that they have not yet done at the hospital, so I would be the guinea pig.  What they currently do at my facility is at the time of the mastectomy, expanders are placed under the pectoral muscle to stretch out the tissue to make room for implants to be placed later on down the road.  What Dr. Taylor proposed was instead of placing expanders right away, I would go back to him two weeks after my mastectomy and he would then place the implants at that time, on top of the pectoral muscle instead of below it.  He explained that it would also make for a more natural looking breast, and there is a lower chance of capsular contracture.  This would be a skin and nipple sparing procedure.  It all sounded good, so I said lets do it. 

Dr. Taylor said he would touch base with Dr. Edwards, and we could likely get me scheduled in the next couple of weeks.  He would talk to him about doing the new procedure and we'd get the ball rolling.  I left the appointment feeling pretty positive and upbeat.  Even though I would be having major surgery and then several weeks of chemotherapy, it felt good to have a plan again.  

Since I didn't meet with Dr. Siemers for another hour or so, I popped in and visited my good friend, Martin.  Talked with him a bit about what was going down.  Got a couple of great hugs from him, and reassured him that I was doing fine and I had confidence that everything was going to turn out just fine.  

Isn't that how it always goes when you talk to people about serious life events?  Of course they are concerned about you, and want to help out somehow, but they don't know what to really do or even say to you.  So, you have to put on the impression that you've got it all under control.  It's fine.  Swell.  Just peachy!  But the truth is you don't know really what you are going to do or what to say either.  So conversation becomes an awkward dance where both parties are trying their best to not step on each others toes.

Anyway, after visiting with Martin I made my way to Dr Siemers office.  We talked about my conversation with Dr. Taylor and he asked what the timeline was, as far as when I would have having the surgery.  Daniele told him probably middle to end of November for the Stage One (mastectomy) and then two weeks after that for Stage Two (implant placement).  He started doing some calculating and said "Well, I hate to put a wrench in your plans, but that's just not going to work out."  Basically, because it would be anywhere from 2-3 weeks before I could get Stage One done, 2 weeks later for Stage Two, and then around 6 weeks to heal, I'd be pushing chemo back until the beginning of the year.  Because my cancer is Grade III (most aggressive) he didn't want me to wait that long for fear it might end up spreading beyond my lymph nodes.  

So, the plans I had tentatively set only an hour before, were tossed out the window and I was being shuffled back to schedule my mediport placement, as well as my first chemo treatment.

Before I left, Daniele told me how she was very impressed with my optimism and felt that I was one of those people who knew how to make the best of a tough situation, which is not incorrect.  

"You are going to come out of this whole situation with a better idea of how strong you are, and how capable you are, I can see you doing something great with this experience."

Of course, I want to believe this, but that's a lot of pressure right now.  My head is still kind of spinning from all the changes that have occurred over a relatively short period of time, and I just need time to process it all.  

I got home and tried to not think about all the information I had to process, but that proved to me difficult that I anticipated.  It seemed like every time I tried to do something other than think about my day, my mind would start racing, my breathing rate would increase, could feel my heart rate increasing.  I kept telling myself to calm down and relax, but I started breathing faster and feeling terribly off.  Thankfully, I had had the mind enough, the week prior, to see my family doctor about a prescription for Xanax, so I grabbed one of those and threw it back and then laid on the sofa to wait until the medication kicked in.

I have never felt anything like that before, and can only describe as what I would assume to be a panic attack, brought on by all the all the information from my visits, as well as everything else that had come down with it.  I had to give up my seat in the nursing program.  Because of all the class time I had missed so far, and the upcoming classes I would be missing, I would have to look into getting Incompletes for the semester.  It was all just too much.

The meds did kick in and I was able to calm down and feel better for the rest of the evening.  

So the plan at this time is to get my mediport placed on November 30th, and I will be starting Chemotherapy on December 4th.  It's going to be a wild ride, but maybe Daniele is right.  Maybe I will be able to make something great out of this.  Maybe I will learn just how strong I really am.  

There is always a silver lining.  Sometimes it's hard to see, but it's always there.

You can't schedule cancer.

The results of the lumpectomy I had on October 30^th came back with news I was not expecting.  

• Positive margins still on the breast tissue they removed from around the tumor 
• The tumor they removed was 5x larger than what showed up on imaging
• Tumors were found in both the sentinel nodes they took out for testing
• I went from a Grade II to a Grade III in the aggressiveness of the cancer.  Grade III is the most aggressive.

I received this news just two days after receiving my acceptance letter from the Bay College Nursing Department.  I was set to begin my clinicals in January and continue moving forward towards my degree.

My reaction, when Dr. Edwards gave me the news, was “Oh wow.  That’s unexpected.” Followed by an uncontrollable welling of tears and a wave of heat and electricity that ran through my body from the top of my head to my toes.

Inside my head I was screaming “Fuck! Fuck! Fuck! FUCK! FUCK! FUCK!” at the Universe.  “Can't I get a break??  Just once???”

When I was first diagnosed and met with Dr. Edwards, the general surgeon, it was assumed everything had been caught early enough that a lumpectomy would easily get the cancer out, and I’d just have some radiation to follow up and all would be done by the end of the year.   That's how I wanted it to happen, because at that point I was expecting that I would be accepted to the nursing program and I didn't want anything to interfere. 

At least, that’s how it was supposed to happen.

However, life rarely goes as planned, and when you throw something like cancer in the mix, it makes it even more unpredictable. 

All the plans had changed from what they were the week prior.  

Instead of the radiation I was expecting after the lumpectomy, chemotherapy was definitely on the table now.  I had to decide if I wanted to let Dr. Edwards go back in for a re-excision of my breast to see if he could get the rest of cancer, or to opt for a mastectomy.  If I went with a mastectomy I needed to decide if I wanted to just take the left breast, or if I wanted to a double mastectomy, and if I would want breast reconstruction.

I left the appointment, made it to my car, and broke down in tears in the parking lot.  All the stress and tension that had built up from the day I had been first diagnosed, a month and a half prior, finally surfaced and I sat there and I sobbed uncontrollably.  I had been holding so much of my fears and worries inside me, in order to not be a burden to others, but the news I had just received was too much to hold in.  I cried for a good 15 minutes, not caring if anyone saw me.  I just needed to get it all out.

After my tears ran dry, I gathered myself together and called Gerry.  He asked if I was okay.  I said I wasn't.  He told me to go home and take it easy.  I told him that's what I was planning on doing.  I called my chemistry instructor to let him know I wasn't coming to class that day.  I went home and sat on my sofa with my laptop and began to feverishly research the pros and cons of re-excision vs. mastectomy.  I researched breast construction.  I researched chemo for breast cancer.  

Gerry called and told me he was coming home early and did I want to go for lunch.  I said yes.  I needed to get my mind off of the news and focus on more pleasant things.  We went to Elizabeth's Chop House, had a couple of martini's with our lunch and then came home.  

Ironically, later that evening I cracked open a beer, and sat down to finish watching the NBC nightly new with Lester Holt, and he begins reporting on the connection between breast cancer and women who are moderate drinkers.  

I dumped my beer out.

Well Fuck.

 You know that feeling when you go see your surgeon for your follow-up exam for the lumpectomy he did to remove the breast cancer you were diagnosed with, and he tells you that the margins on the tissue removed indicated that he didn't quite get it all?  And then he tells you that the two sentinel nodes that were removed, and tested, both came back positive for cancer?  So now you have to decide if you want him to remove more tissue to see if he can get the rest of the cancer, or if he should just do a full on mastectomy.

So.  That was my Tuesday morning.

There is no feeling quite like that rush through your body that you get when you receive bad news like that.  I really thought that everything was going to come back with clean margins and a negative pathology.  Instead, Dr. Edwards told me that the tumor was much larger than what showed up on the imaging.  Originally it was between 7-8mm, but the tumor they removed was 38mm.  Also, on this pathology report, the Nottingham grade came back as a stage 3, which means it's an aggressive cancer.  He said there was a 25% chance that it has spread to other lymph nodes, and then there is the increased chance that it has gone beyond the nodes.

I will have to have chemotherapy.  Maybe some radiation still...I can't quite remember.  And because of all this new information, as well as not wanting to deal with the possibility that MAYBE it could come back again someday, I have decided to do a double mastectomy with reconstruction.  My surgery could be as soon as next Friday, the 17th of November.  

Last week, the plan was lumpectomy and radiation, then start nursing school in the winter.  Now it's surgery, recovery, chemotherapy for 4 months, possible radiation, and no nursing school. 

Life is so very very unpredictable.

Being Strong When I Don't Have Any Strength Left

I can't sleep tonight. My whole body is sore, I did something to my neck over the weekend so not matter how I lay my head, I am uncomfortable. And then there is the fact that my left breast (Cancer Breast) has been aching the last couple of days, and yesterday in the shower I was kind of poking around and I swear that the tumor has grown...significantly. THe docs told me there would be some scar tissue left behind after the biopsy, and I could feel that the first couple of weeks after. It was just a small lump, though. Now it is so much bigger, and even seems to be making my left breast swell some. I was laying on my back tonight and was comparing the shape of both my breasts as I laid there. Usually, they flatten out and fall to the side a bit -- all perkiness gone. Well, tonight the right side followed suit, but the left side was just a little fuller than it should be. Like, it wasn't flat-as-a-pancake; it was more like the top of a cupcake that's fallen a little after being taken out of the oven. Know what I mean??

So, now I can add ten-thousand more worrisome thoughts to the already one-hundred million worrisome thoughts taking up brain space. I shouldn't worry about it until I can talk to the doctors office tomorrow. My lumpectomy is on Monday, but if the cancer has grown/spread, then maybe a lumpectomy isn't the best way to go. In which case, my decision would be either a bi-lateral or double mastectomy. This is why I can't NOT worry about it, because that changes SO MANY things...the type of surgery, time spent in the hospital, recovery time, etc. It was so easy when I first met with Dr. Edwards...it all fit easily into a neat little, planned package that I could present to anyone who asked and say "YEs! It's all going to be just fine! See? I have it all planned out!!"

I hope I am just stressing out over nothing. It's just hard to poke around on my breast and actually FEEL something there that a month ago I didn't even know existed. It's and odd feeling...mentally and emotionally. I guess, I am not really sure what to feel about it -- other than worry. I've got that down pat.

Tonight, Gerry asked if I was worried. DUH! However, my answer was not the rehearsed, neatly scripted response I give to everyone else. It was YES, and I was able to share all the reasons I was. And it felt good. I haven't really talked with him a whole lot about it because I "don't want to burden" him. *sigh* Everything I have experienced in my life is somehow directly tied to my not wanting to burden someone. I freaking have CANCER! Only a year and a half after my daughter being diagnosed with cancer?? And I don't want to BURDEN anyone? But that's my M.O. I have to handle it all by myself, because....??? I don't know. Because I always have?

My step-sister sent me a card to say she's been thinking of me and to tell me how she admires how STRONG I am. My first thought was "Well, if Strong means putting on a good face for everyone else while completely losing it on the inside, then HELL YEAH I'm Strong."

I don't want to be strong anymore. At least, not right now. It's exhausting me.

Whew! That Was A Close One!

 HUGE SIGH OF RELIEF!!!!!

So I met with the surgeon and oncologist today. THe news is good. The best I could ask for!!

I will be having a lumpectomy on October 30th to remove the mass, some surrounding tissue, and 1-2 sentinel lymph nodes (for further testing). Outpatient procedure. Only a couple days to recover. No need for a mastectomy!!! Fortunately the tumor is small enough that, even though it has infiltrated into the breast tissue, it hasn't spread much beyond that area. After I heal up from the surgery, I will be getting 3-4 weeks of radiation and then I will also be on a medication for the next 5 years that will help reduce the chances of the cancer making a comeback.

So yeah....I can't even tell you how GOOD this all feels. Because I am so dramatic, I was preparing myself for the worst. I was sure Dr. Edwards was going to tell me that I had to have a mastectomy and I just wasn't sure how I was going to deal with that. But I don't have to, so *whew*.

I am feeling very happy right now.