Post Surgery Numero Dos update

Post-op recovery from my second surgery has so far gone really smooth. Since I didn't have general anesthesia this time, my energy levels were much higher the following day. This was nice because I felt really good, but kind of a drag because I knew I had to take it easy. I didn't have too much pain last time around and this time I have even less. I think that the axillary incision was more painful than the lumpectomy incision. Both seem to be healing well.

Sunday morning I woke up and same as last weekend the bandages got to come off. Ahhhh, felt so good. Everything looked good too and I was wanting to get out on the bike. So, in order to support the 1 1/2 day old sutures, we put the bandages back on and went out for an easy spin. There was some bandage slippage, but besides that the ride went pretty smooth.

Today, I got out for an easy ride this morning before my afternoon Huntsman appointments. Once again, it felt great to be on the bike. This afternoon I met with a Lymphedema therapist and Nutritionist at Huntsman.

Lymphedema therapist: Basically we reviewed precautions, took baseline measurements, and Shannon and I were shown manual lymph drainage. I also had a compression sleeve ordered for air travel.

Nutritionist: Huntsman offers free Nutritional consultation to all patients. The following is what was recommended:

-Guidelines call for 800-1000 units of Vitamin D/day, however this nutritionist recommended getting closer to 2000 units/day

-Fish oil supplements with both EPA and DHA. Take 1g/day.

-Be sure to get daily recommended amount of Calcium as chemo can cause osteoporosis

-Adopt a primarily plant-based diet. Fish, poultry, meat, or low fat dairy should cover no more than 1/3 of the plate

-No more than 18 oz. of lean red meat/week. Deli meat is not recommended.

-3 1/2 cups of fruits and veggies every day.

I pretty much do all of these things already (with the exception of the supplements) but it is still interesting information and something I plan to follow diligently.

We also discussed me starting to use Chia seed (MILA). My friend Stacy introduced me to this and it sounds ideal for a person fighting cancer. Chia is a food (kind of like flax seed) and it is incredibly nutrient dense. It is supposed to help improve cellular health and that is exactly what I need right now. The nutritionist gave me the green light to start this.

I have also started making green smoothies. I admit, they are kind of disgusting, but they are incredibly nutrient dense so it is worth it. If anyone has a (relatively) yummy green smoothie recipe please send it my way.

On top of this I have been continuing with my visualization. I envision my immune system killing all of the cancer cells in my body. I have even ordered a CD to help guide me in this process, although I find that I am fiercest in fighting the battle when I am on my bike!

Most of all I am hoping for a little luck. Some luck came my way this weekend when the Saffell's brought me a beautiful lucky bamboo. Hopefully this bamboo will work its magic this week.

I am really frightened for what the future holds.

Sugery Numero Dos Report

Today's surgery was pretty uneventful. My surgery time wasn't until 2:00 so I had the morning to blow around the house. I took this time to tie up loose ends and......clean.

Surgery went really smooth today. I was under heavy sedation with propofol. I could hear everything that was going on in the OR, but thankfully I couldn't feel anything. Even with the drugs, my mind was working overdrive. I kept thinking of questions I wanted to ask, but I didn't want to distract anyone. I waited and started talking as they finished suturing me up. Hopefully I didn't say anything too loopy and if I did I'm sure the OR staff got a few good laughs.

Besides that, recovery was short and quick. I was ready to go home right away, but had to wait for my IV to be removed. Shannon immediately rewarded me with some yummy chocolate from Germany. I also get to live with the bandages again this weekend, but they're not as bulky as last time as there was only one incision today.

I should hear if the margins are clean next week. I am very hopeful but really nervous as there are no guarantees.

I am probably a little over one hour post-op and my pain level is 0. I hope it stays this way and I can be on the trainer tomorrow:)

Pathology Report and Update

Since hearing 'You have cancer' in January I have received only positive news regarding my diagnosis. I was even looking ahead to a post-cancer life by the end of this year. On Wednesday that changed.

My nurse at Huntsman called me as soon as my pathology results came in. This I appreciated. I did not appreciate the results. The most immediate concern was that the tumor margins were not clean. The pathologist closely examines all of the tumor margins and if there is a single cancer cell within 2mm of the margin it needs further excision. This means that I will be going back to surgery. Tomorrow. I will not lie. This really sucks. But I knew that there was a 25% chance of not getting clean margins and I am extremely thankful that I am able to have my second excision so quickly. There is no guarantee that we will get clean margins this time, however my surgeon knows which margins to dig at more so I suppose that is something. She also says there is 'no penalty' with survival rates by having to go in and remove more tissue.

My second piece of bad news was that the tumor removed was measured to be 2 cm. This is much bigger than the original 1.2cm tumor but included the other small tumor that was found on Sonocine. This size is relevant because it pushes me over the cusp to Stage 2 cancer and it is pretty much guaranteed that I will need chemo. I meet with the medical oncologist March 10th.

Other not so happy news is that the grade of my tumor changed from 2 to 3. This means that when the entire tumor was examined some nasty, angry, unpredictable cells were found.

And finally, there was focal lymphvascular invasion. This means that there is the potential that the tumor could be spreading, but on a positive note the final lymph node pathology was negative indicating no metastasis.

Based on this information, my tumor is classified as Stage 2, T2,N0,M0. This is still Early Breast cancer, it is just not my 'best case scenario'.

Besides this, my week was going quite well. I really enjoyed the 'care packages' I got. One all the way from Germany! Thanks Heather. I also got a surprise Slyfox Moonwillow care package that included super light mountain bike rotors. I can't wait to weigh my bike now.

I hope the weather is good in St. George next weekend.

Weekend update

Friday after surgery I felt pretty great; I was kinda a spaz. Maybe it was just relief that surgery was finally done? Maybe my IV was spiked? Regardless, by Saturday I crashed, and although I wasn't in too much pain, fatigue had finally set in. After an awkward night of sleep with all the bandages I woke up Saturday morning just in time to go back to sleep until after lunchtime. My goal for Saturday was to rest, rest, and rest some more. My family was visiting in the afternoon and I wanted to be able to spend some quality time with them.

It just so happened that my surgery coincided with my sister's annual family Park City ski trip. Saturday afternoon everyone came down to visit including my adorable niece and nephew who were highly entertaining all night. It was so nice to see family with the highlight being my niece and nephew playing with my puppy. By the end of the night my nephew was saying that he wanted to pee in the grass like the puppy. Sorry sis, good luck with the potty training.

Sunday morning I woke up early to take my bustier (er, bandages) off. Although I realize that the bandage served the important purpose of keeping swelling down, I had been looking forward to getting that uncomfortable thing off all weekend. I was a bit scared to see what was underneath it all but was pleasantly surprised. The incision is large; a couple of inches. But the edges are smooth and there is no swelling that I can see and little bruising. For a cyclist with lots of scars, it was nothing to look at. I would have posted a photo to prove this point but that would probably make this a Rated-R blog:) Then it was back to sleep until 10. I haven't slept this much in......ever. By Sunday afternoon I started to feel more like myself and by the end of the day I was ready for some physical activity.

Today, I awoke at the crack of dawn, 8:30:) I feel pretty good, actually really, really good. There is still some mild discomfort when my arm rubs in the axilla area where the lymph nodes were removed. Push-ups and tricep dips are out of the question. Besides that, pain free! We already took the pup for a hike, played with my new bike, and rode the trainer for an easy spin.

Below is a photo of the new bike. It is a zaboo terra29. It is so beautiful and insanely light too, especially when built up with the Lefty fork. I will write more details when I actually have the opportunity to ride it off-road. We're still planning on heading south in two weeks.

Tomorrow it is back to work and that 6:00 AM alarm is really going to hurt!

Surgery

I have been quietly anxious about surgery most of the week. My stomach has been upset and I have had no appetite. I even thought that perhaps I was getting sick. Turns out it really was just nerves as I feel fine now.

Yesterday I followed my pre-op instructions to call the surgery scheduler between 2-4 PM to find out my time of sugery. I was told to be at the hospital at 6:00 AM and that my surgery would start at 7:30.

6:00 AM in the waiting room

I know that sounds really early, but I was quite happy to be the first surgery of the day.

At 4:00 PM on Thursday I decided to call my nurse. She had called me earlier in the day and I had returned a message but had not heard anything back. Normally, I would have tried calling every 10 minutes, but I am working on not being too annoying of a patient:) (Note: I have questions and call my nurse on an almost daily basis. She is always very patient with me).

When I got hold of her at 4:00 she asked how my marking went. What marking? I guess I was supposed to see the radiologist to get my tumor marked the day before the surgery. Oops, I had no idea. Fortunately I live 10 minutes away from Huntsman and I drove very quickly (to Shannon's dismay) to meet the radiologist. The radiologist then used the ultrasound to identify the tumor(s) and marked my breast with magic marker. I thought it was kind of funny that it was so urgent that I get 'marked' with magic marker. I probably could have done that myself! (I kid).

On to today. We woke up early and I took a final shower before we headed to Hunstman. No breakfast or water for me and my mouth felt like sandpaper by the time we arrived to the hospital.

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:)

Final meditation/visualization before surgery

I also talked at length with my surgeon, Dr. Neumayer. I have not hidden my concern for removing lymph nodes from her. We discussed exactly what was going to happen. First, a sentinel lymph node biopsy would be done. Dr. Neumayer injects a radioactive substance that basically leads her to the sentinel lymph node(s). These are the first nodes that lymph drain to in the axillary area. While she is working on the lumpectomy a pathologist quickly looks at these nodes for any sign of cancer. This quick 'look' is 90% accurate, so the lymph nodes would also be sent off for further testing post-op. If cancer was detected, she was going to have to remove more lymph nodes, however she promised me no more than 6. I was told that when I woke up I would have a drain if my lymph nodes tested positive for cancer. If they were negative, no drain.

The first thing I remember about waking up was speaking with a women. In all honesty, I have no idea who it was (I have a hunch that it was the NP). I immediately asked if I had a drain. The women replied that I must be pretty coherent if I was asking that, and no, I did not have a drain. I was so happy....and groggy. I then proceeded to tell her that I had been dreaming about blogging. I don't remember anything else.

I was then in the PACU recovering. The nurse there was very nice and took my vital signs a million times. I was getting anxious to see Shannon and was finally released to short-stay recovery. That nurse checked my vital signs and then left me alone for a few minutes. When she came back I was scrambling around the room. She asked what I was doing and I told her that I was looking for a phone so I could call my husband. I guess I should have just asked because she immediately got him. She then took my vitals a few more times and then that was it, my discharge instructions were reviewed, I got dressed, and we went home.

Sooooo happy to have water post-op, notice the phone right behind my head. I never found it.

Overall, I have felt really good today. I do tire easily, but I suppose I should not be trying to do house chores quite yetJ. Surgery went as well (or better) than I could have hoped for thus far. I am very grateful for the fantastic staff at Huntsman that took such good care of me today.

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.

Bandaging comes off Sunday

I have not needed to take a single pain pill yet! My surgeon told me I could do physical activity as my body allows. She is confident that I will be able to ride dirt in St. George in two weeks! My new bike is almost built as I write!

It is 9:00 at night and Shannon has spent his entire day taking care of me. He is just getting on the trainer right now. I am so fortunate to have such a dedicated husband who sacrifices so much to take care of me. We are really in this together.

Enough (probably incoherent) babbling for now. Please continue to send positive thoughts my way and for that matter in the direction of all people fighting cancer. All the positive energy is obviously working and I know some people who could really use it.

Good News From Surgery

Jen has been in surgery for about an hour now. She is just about finished. The doctor has already come out and told me that everything went great.

Her lymph node biopsy was negative, meaning that there was no evidence of cancer. In this case, negative is good. The tissue samples still have to go to pathology but they say there is only a 10% chance that pathology will find anything new.

Dr. Neumayer also showed me an ultrasound of the tissue they removed from Jen's breast. You could clearly see both the tumors. That should be all the cancer in her body. It's all gone!

It's weird to think this is such good news and she doesn't even know yet. She is going to be so happy! I can't wait to tell her.

I am sure Jen will post an update when she is awake and alert. I wanted to give everyone the good news.

Jen ready for surgery at 6:30am

Sonocine

Yesterday, Shannon and I drove up to McKay Dee Hospital in Ogden. There is a radiologist there who does a procedure called Sonocine or Automated Whole Breast Ultrasound. I don't know the history of the Sonocine, except for the fact that it is not (yet) routinely used and insurance does not (yet) pay for it. I do know that my surgeon at Huntsman is a big believer in using this procedure to screen for and detect early breast cancer. Especially for women in my situation (positive pathology for mammary carcinoma and negative mammogram and MRI).

I was admittedly a little grumpy during the 45 minute car drive. I think I have had more doctor appointments in the past few weeks than my entire life put together. I am pretty sick of it, and I get even grumpier thinking of all of the appointments I have to look forward to.

Once we arrived at McKay Dee, I checked in for my appointment via telephone. They were sure to get my credit card number before the procedure :) Then I was whisked back to the Sonocine room where I got to wear another flattering top. I don't see why hospitals can't have gowns/robes that are a little less dorky? Anyhow, it made me laugh.

Way too happy while modeling a hot open buttoned hospital shirt

After the procedure I was taken back to Dr. Babcock's (Radiologist) imaging room. It was amazing. The room was full of monitors and she pulled up every image from every procedure that I have undergone up to this point. This includes two mammograms, an ultrasound guided core biopsy, an ultrasound guided axillary biopsy, MRI and now the Sonocine!

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:)

The other interesting piece of information that I gained from this consultation was that Dr. Babcok did not necessarily think my MRI was negative. She pointed out one slice that showed my tumor. She did say that it didn't "light up" as most malignant tumors do, however she could clearly see it. This was incredibly reassuring to me because I no longer need to be hung up on the negative MRI. I can now confidently go into Friday's lumpectomy surgery and have (once again) requested that the sentinel lymph node biopsy be done at this time as well.

What does this mean? Well, I am having surgery this Friday. Hopefully they get clean margins and it will be my only surgery. They will also test my lymph nodes for any spread of cancer. Hopefully this test comes back negative. If the lymph nodes are negative they will do what is called an Oncotype Dx test on the tumor. If this comes back with a low risk of reoccurrence I may not need chemo. I will definitely need radiation. This kind of puts me back to where I was a few weeks ago, however now I have the information to move forward confidently.

My workout goals for the week are a rest day today, weights tomorrow, and one last ride Thursday before surgery. Who says training stops when you have cancer?

And finally, I couldn't resist posting a picture of my puppy. He spends most of his time upside down. Today, while I was at work he also ate the handouts from puppy school. Coincidence...I think not. He's quite smart.

Perfect weekend

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.

Saturday called for a morning weight workout. I've been going to the gym focusing on my upper extremity strength every other day. My goal is to get as strong as possible as quickly as possible. I know that after my lumpectomy on Friday I probably won't be lifting weights for a few months. As it warmed up in the afternoon, Shannon and I headed out for a road ride. I think every single cyclist in Salt Lake City did the same. We probably spent as much time talking to friends on the side of the road as we did pedaling. It was a great day.

Sunday was quite possibly the most beautiful February day ever. We did a group ride with the boys (and Monique) up Emigration to Mountain Dell Golf Course. I cheated and rode my cross bike while everyone else was on their mountain bikes. It was a beautiful day (I can't emphasize this enough), we had great company, and I even felt frisky enough to throw down some hard efforts.

As my weekend riding binge comes to a close, I realize that I rode as much this week as I would have if I were preparing for an epic year of racing. In my mind I suppose I am still training. Just with a different purpose.

Change of Plans

This week has been a bit frustrating. I am still hung up on the results of my MRI. Although I am pleased that no other cancers showed up, I am frustrated that my malignant tumor did not. Although I am not an oncologist, I find this alarming. I have researched this to the best of my ability. My pathology report diagnoses me with Invasive Carcinoma with Mixed Ductal and Lobular Features. From what I have researched, this particular type of breast cancer shows up on MRIs over 95% of the time. I could go on and on citing research articles I have found that support how unusual this is.....but basically, because of this, I feel that we need to investigate further.

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!

Medical Anomaly

Only 5% of all breast cancer diagnoses occur in women under 40 years old. I am 35. According to my research, mammographic sensitivity decreases from 100% in fatty breasts to 45% in extremely dense breasts. My mammogram is negative so I guess I have extremely dense breasts. Ultrasound shows higher sensitivity than mammography with ranges of 86%-94% detection. My Ultrasound is positive for an approximately 10mm mass. MRI shows the highest sensitivity of ~95% detection (Radiology. 2004 Dec;233(3):830-49. Epub 2004 Oct 14.

My MRI results read as follows:

Impression:
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.

More Good News

It was a pretty typical weekend for us. We rode our bikes a couple hours each day, ran errands, worked around the house, visited my Dad, had dinner with my Mom, watched the Super Bowl (I admit I took a short nap during the game), and played touch football. This last one was a bit weird and after about 10 minutes I decided that I much prefer riding my bike!

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.

Genetic Test results are in!!!!!!

Everything is relative. A few weeks ago I was barely familiar with what BRCA1/BRCA2 testing was. Today, I burst into tears when Dr. Regina Rosenthal called me personally at 6:00 on a Friday night to tell me my test was negative. NEGATIVE!!!!!!!! They were tears of joy of course!

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.

Moving forward

In my last post I expressed frustration with the slow process of biopsy, diagnosis, meeting with surgical oncologist, etc, etc. This week that has all changed. My life has turned into a complete whirlwind and you will have to excuse me if I don't make sense or mumble.

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.

Last weekend I escaped to St. George for some on-the-bike therapy

Public Service Announcement #1

I want every single person (men too if you want:) who reads this to do a breast self-exam tonight.

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.