Monday, February 28, 2011
Friday, February 25, 2011
Thursday, February 24, 2011
Monday, February 21, 2011
Friday, February 18, 2011
I lucked out and got the pre-op 'room with a view' and watched the sunrise over Salt Lake while I was greeted individually by the wonderful and professional team that would be handling me in surgery. The young and friendly anesthesiologist, Sonia, placed my IV and we discussed anesthesia options. Initially we discussed using heavy sedation with a mask which was quite appealing, however once I decided to donate a small amount of bone marrow to cancer research it was decided that general anesthesia with full intubation was warranted. I expressed my concern for becoming nauseous because basically I had been nauseous all week. Sonia told me that they would take precautions against nausea. I am not sure exactly what they did, but I have not had any nausea since I woke up.....and my appetite is back:)
I am stuck in a bulky bandage until Sunday. I see the lymphedema therapist in 10 days and return to see my surgeon in two weeks. I will also be scheduled to meet with the medical oncologist to discuss systemic treatment. This is not a huge hurry as treatment can’t begin until the surgery site heals. In the meantime, test results should be trickling in.
Tuesday, February 15, 2011
There was a lot of radiology going on in that room to say the least. Dr. Babcock was phenomenal. She reviewed the Sonocine results with me and showed me the tumor that she was able to see. This was great news. Finally a screening tool to help detect any future cancers. Unfortunately, she also saw another small tumor that was hiding underneath the one we already knew about. The tumor that we already knew about is about 1.2 cm in size. This second tumor is about half the size and there is no way to feel it. Fortunately, the Sonocine detected it and my lumpectomy margins can be adjusted appropriately. I am now a huge advocate for the Sonocine procedure and encourage insurance companies to pay for them:)
Sunday, February 13, 2011
Our plan for the weekend was to head south to Moab for some singletrack and bike therapy, but on Friday the weekend weather forecast for Salt Lake City was just as warm as Moab. I decided to stay put. Although Moab may have been my last chance to ride singletrack for a while, we had a pretty perfect weekend here in Salt Lake City.
Thursday, February 10, 2011
My surgeon has asked for a 3rd pathology reading on my tumor biopsy. I inquired today about results but have not heard back.
I am scheduled for a a Sonocini (Automated Whole Breast Ultrasound) next Monday at McKay Dee Hospital. This procedure is only done on Mondays and Tuesdays so I had to reschedule my lumpectomy surgery for later in the week. I REALLY need this to show my tumor. We can feel this tiny tumor and see it on ultrasound, but both of these methods are not very practical or reliable for detecting early cancers in the future. I am at an increased risk of developing cancer in the future so I need a good screening tool. Like I said, I REALLY need this Sonocini to work.
Soooooo because of all of this my surgeon (Dr. Neumayer at Huntsman) and I have agreed to postpone the lumpectomy to February 18th. This is only 4 days later and I have been told that I am not putting my health at risk by doing this. We have also decided to do only a lumpectomy on this day. We will wait on pathology results before deciding if a sentinel lymph node biopsy is necessary. It most likely will be necessary, so I already have booked that surgery for March 7th. As you can probably tell from my earlier posts, I am a bit freaked out about messing with my lymph nodes. I want to be absolutely sure we know what we are dealing with before I proceed with the sentinel lymph node biopsy. I am trying to look out for the best interest of my body so that I can live a long, active, and happy life.
Although I feel that I am getting very good care at Huntsman Cancer Institute, I continue to be frustrated by the sloooooow process. I always have a difficult time getting call backs on my biopsy results and scheduling appointments is very difficult.
Besides cancer, I have had a pretty good week. I have been maintaining my cardiovascular fitness by doing 2-3 hour bike rides and have been working hard on increasing upper body strength before my surgery. My puppy, Dizzy, also graduated from puppy school this week. Although he is still a nut, he did the best 'sit' out of all the puppies in class when he got his diploma. Way to go Dizzy!
Tuesday, February 8, 2011
My MRI results read as follows:
Left breast: Negative, no evidence of malignancy
Right breast: Biopsy-proven invasive breast carcinoma not seen on MRI. No abnormal right breast lesions on MRI.
Even with the little titanium piece of shrapnel that is now located in my tumor to help identify it, nothing can be seen on MRI.
My surgeon told me that 10% of cancer are occult to any imaging. I guess I am part of that 10% as well. From where I'm sitting, I feel like a complete medical anomaly.
What does this mean? Well, more tests. We are trying to get an appointment for a Sonocine http://www.sonocine.com/ this week. McKay Dee Hospital has one of these; it is FDA approved however not covered by insurance. From my understanding, this is like a full breast ultrasound. We still want to rule out any additional breast cancers, but it is kind of hard to do when the cancer we already know about doesn't want to show up on anything. I'm also getting orders to see a lymphedema therapist this week and thanks to some great friends I will be getting a final massage this weekend before my Valentine's Day lumpectomy.
I will keep you posted on what we discover.
I also want to thank everyone for continuing to send me positive energy, research articles, inspiring stories, etc, etc. It means so much. I can not believe the amount of women who have/had breast cancer that have opened up to me. Although I am not thrilled about being part of this 'breast cancer club', I am truly humbled by these women's support.
Sunday, February 6, 2011
I also did a lot of research. Some may say that I'm obsessed, but I want to be educated and confident in every decision that we make so I have been tapping into PubMed an online source for medical journal abstracts. I now feel really comfortable with my surgery decision for next Monday.
And finally, more good news. Shannon called me from work this morning. The results from my lymph node biopsy are in. They are NEGATIVE. This is not to say that all of my lymph nodes are negative, but it does mean that the sentinel lymph node dissection will be done as opposed to the axillary lymph node dissection. Sentinel lymph node dissection reduces my chance for lymphedema in the future. Lymphedema is a condition where fluid collects in the arm (or other areas such as the hand, fingers, chest or back) causing it to swell (edema). Not something that a cyclist, or anyone for that matter, wants to deal with. I am still going to take maximum precautions against lymphedema and plan on learning manual lymph drainage techniques this week.
There are three more giant hurdles to get through for this to be 'best case scenario' for me. I need my MRI this afternoon to be negative (with the exception of the tumor that we know is already there). If this is the case we will have a screening tool to help detect future cancers (since mammogram does not work for me) and we can be confident with a lumpectomy. I also hope that it does not show any additional cancers that we have not yet found. Please send positive energy my way at 1:15 for a negative MRI. The rest of the hurdles are dependent on pathology reports from my surgery. I need the sentinel lymph nodes to come back negative and the Oncotype Dx on my tumor that is removed to show a low risk of reoccurrence. I still don't know exactly what this will mean treatment wise, but I know that it is 'best case scenario'.
Overall, I am doing okay. I still feel great physically, but my emotional strength and mood change frequently, although I guess that is not too different from before :)
This I know. I feel strongest, most confident, and almost invincible when I am on my bike. I will fight this. I will race my bike.
Thank you everyone for all of the kind notes, gestures, and positive energy. I am amazed at the outpouring love I am receiving from old friends, new friends, and people that I don't even know. It really does make a difference.
Friday, February 4, 2011
This is huge. People who carry the BRCA1 or BRCA2 gene have a 50-80% chance of developing breast cancer and a 20-60% chance of developing ovarian cancer. They are also more likely to develop other types of cancer. If I were positive the recommendation would most likely be bilateral mastectomy and to have my ovaries removed. This test was especially concerning for me because my Mom is a breast cancer survivor and I am so young at my time of my diagnosis.
Tonight, even though I still have breast cancer I am feeling very fortunate.
Someone must have sacrificed a pig for me.
Wednesday, February 2, 2011
Tuesday afternoon I met with the surgical oncologist at Huntsman Cancer Institute. We waited forever in the waiting room, but it was worth it. I was there for almost 4 hours. First, I was hustled up to Radiology for another ultrasound. This time they looked at my lymph nodes. I then met with the Surgeon, NP, and Nurse and we thoroughly discussed my options. Next was some bloodwork and finally I filled a script for Ambien. Ahhhhh, sleep.
I now have A LOT to think about, but at least I have a plan which is empowering. My next step is to have one of my lymph nodes biopsied. I will do this tomorrow. A lymph node probably should have been biopsied at the same time as my tumor two weeks ago, but because my tumor was not suspicious this was not done. This biopsy will be significant in that if it comes back positive I certainly will need chemotherapy. If it is negative, I may not. Here's hoping for a negative biopsy! I am also meeting with a genetic counselor tomorrow to discuss the implications if my genetic testing for BRCA 1/BRCA 2 gene is positive. Then on Monday I am having an MRI. My hope for this test is that it will show my current tumor and nothing else. We are doing this to try to find a screening tool that works for me since mammogram does not. We are also looking for anything else that looks suspicious. I also want to consult with a lymphedema therapist as to try and prevent any future post-op lymphedema. This two week whirlwind will culminate with surgery on February 14th. Happy Valentine's Day to me and Shannon! The current surgical plan is lumpectomy which is a pretty simple outpatient procedure. The amount of lymph nodes to be removed will be determined by tomorrow's biopsy. After the surgery a pathologist will look at all of the lymph nodes removed for any sign of cancer. If they are all negative, no chemo. Here's to negative lymph nodes again! It is certain that I will need local radiation post-surgery though.
All of this changes if the genetic test for BRCA 1/BRCA 2 gene is positive.
On top of all of this I have gone to work, ridden the trainer, lifted weights, done yoga, and attended puppy school this week. Life certainly doesn't get any slower when you have cancer.
A few things of significance this week.....First, I keep saying I did this and I did that. Really it is WE. Shannon has been there every step of the way. I can't even describe how fortunate I am to have him in my life. I love you Shannon! I have also quickly learned how important it is to have support from friends and family. Thank you everyone for all the love and support. It means so much.
Also, on Monday I had the opportunity to speak with Annabeth Eberle. She is one of the University of Utah Gymnastics team most decorated athletes. She is a phenomenal person as well. She also had breast cancer. I found this out on Facebook of all places and I got in touch with her. She immediately emailed me back and eventually we spoke on the phone. She was incredibly open with me and did not sugar coat anything; just the way I like it. Although I realize that our paths for curing cancer will be very different, she gave me hope. A lot of it. I can not thank her enough.
When I look in the mirror I do not see a person with cancer. I see a strong, athletic woman who takes care of her body. All of the "things" you are supposed to do to prevent cancer, I already do. I often wonder why I am going to put my healthy appearing body through hell. In fact I sometimes wonder if there was just a mix up in pathology. That said, I accept our 'plan' to treat cancer. I am ready to move forward.
Tuesday, February 1, 2011
That is how I found my cancer. My cancer did not show up on mammogram and mammograms are not even recommended for women my age. I found it and I pursued it. I still do not have a clear picture of treatment and prognosis (still waiting on more diagnostics), but I do know that it would have been much, much worse had I not found this now.
This can happen to anyone. To emphasize this point even more.....I have a good friend who told me that she has 3 friends, all under the age of 40, who have been diagnosed with breast cancer in the past two months.
Do your self exam. Now.