Thursday, May 30, 2013

Quite the productive day

Yesterday was the big day: Surgery (Axillary Lymph Node Dissection).  Surgery wasn't scheduled until 4:00 which meant that I didn't need to be to Huntsman until 2:30.  What to do with the rest of the day?  My plan was to hang out at home and watch movies, but I woke up on the right side of the bed and instead went for an easy bike ride, stocked up on groceries at Costco and Whole Foods, and cleaned the kitchen all while fasting in preparation for surgery.  It was quite the productive day and I was thrilled to squeeze in one last little ride before surgery.

At 2:15, Shannon and I left for Huntsman.  We really do feel fortunate living ten short minutes away from a world class cancer facility.  We arrived, were taken back to our little room, I changed, surgeon and NP checked in, my mom visited, IV placed, and off to surgery.  The procedure itself took a little over an hour.  I was told that 6-7 lymph nodes were removed one of which was the metastatic lymph node that had been marked at my ultrasound guided core biopsy a few weeks ago.  I am so happy and relieved to have that out of my body.  According to my surgeon, the other lymph nodes did not look overly suspicious, however we are waiting on the final pathology which should come back next week.  Apparently, the anesthesiologist has my cocktail dialed.  I was out the door a little over an hour after waking up from general anesthesia and had absolutely no nausea.  Very impressive!  The entire Huntsman team was once again amazing and words can not describe how grateful I am for them taking such good care of me.

Some photos from the day:

 I packed a banana for my post-op recovery food.  It was delicious!
 Apparently during surgery the alarm was continuously going off as my heart rate hovered in the low 30s.  Here it reads 47bpm.  I guess that means that I went into surgery fit and well rested!
 Getting all the monitors removed
I get to wear this lovely bandage for 36 hours.  Yes, those are gauze pads underneath the ace bandage.  You can see the drain coming out of the right side of the ace bandage.  This will be removed once I am producing less than 25cc of fluid over two consecutive days-hopefully early next week!

In the meantime, my activity level has slowed, but it has not come to the screeching halt that I was anticipating.  If it weren't for the drain coming out of my armpit I would be gearing up to spin my bike this weekend.  I'm hoping the drain is ready to come out early next week and in the meantime, I will stick to walking Dizzy.  He's not complaining!

Next week I meet with my medical oncologist where we will come up with a treatment plan.  I am anticipating it to include chemo and changing Tamoxifen to an aromatase inhibitor.  Then on to radiation.  Needing something to look forward to, Shannon and I are in the beginning stages of planning a fall road trip.  Any suggestions?

Friday, May 24, 2013

Round 2: Here we go again

Two weeks ago Shannon and I won 12 Hours of Mesa Verde.

It is with a huge dose of disbelief that I type this, but last week I was diagnosed with a breast cancer recurrence.

How's that for perspective?

Since then my life has been a whirlwind of medical appointments and I have been through the full spectrum of emotions including defeat, fear, anxiety, gratitude, empowerment, and just plain happy to be alive and healthy at this moment.

Although this is technically considered a recurrence, based on the medical information we have so far, it is likely there were some cancer cells established in this lymph node at my original diagnosis in 2011, however it appears as though I fell into the 5-10% of false negatives with sentinel lymph node biopsy.

Here is a timeline for the past week and a half:

Wednesday:  Spoke with NP at Huntsman regarding my concern about an axillary lymph node that I felt was changing (ie more noticable).  I have been able to feel this lymph node for quite some time, however it was not of concern as it was mobile and rubbery.  She set me up to come in the following morning.

Thursday:  Breast exam, ultrasound, followed by core biopsy.  It is never a good sign when after reading an ultrasound the radiologist recommends an immediate core biopsy.

Friday:  Received the news that metastatic breast disease was in fact found in the lymph node.

Saturday/Sunday:  Spent the weekend riding my bike, playing with Dizzy, talking with family, and trying to wrap my head around this very unexpected and scary news.

Monday:  Received my first bit of positive news.  The receptor status of the cancer came back the same as the original cancer.  This gave me hope for two reasons:  1-the cancer had not changed to a less treatable type of breast cancer and 2-The cancer was Estrogen/Progesterone receptor positive which meant that hopefully the Tamoxifen I have been diligently taking for the past two years had helped prevent distant metastases to bones/organs.

Tuesday:  PET scan scheduled.  After fasting all day I was sent home without scan because I exercised prior.  Apparently you can't exercise within 24 hours of PET scans!

Wednesday:  PET scan.  This is a 2.5-3 hour procedure that requires six hours of fasting and no exercise for 24 hours prior.  Upon arriving to Huntsman, I was taken to a small lead lined room and injected with radioactive glucose.  This allows the scanning device to locate metabolic activity indicative of cancer metastasis.  I then spent the next 75 minutes resting in a dimly lit room to reduce brain activity and allow the radioactive glucose to evenly distribute inside the body all while drinking an enormous quantity of Barium Sulfate.  The PET scan itself was less than 30 minutes.  Since there was no music to listen to during the procedure, I focused on spreading positive energy over my body and repeated the mantra "I am strong, I am healthy, I am super duper fast" over and over again.  I am not sure if it was a sugar crash from the radioactive glucose or the stress of the day-likely a combination of both- but after the procedure I was a beast and just wanted to get home to start eating lots of fiber and vegetables to counteract the chemicals I had just put in my body.  It wasn't long before I got the news that the PET scan was negative for distant metastasis.  With the exception of the 1.3 cm lymph node, no other cancer was found in my body.  This was excellent news and such a relief!

Thursday:  Returned to Huntsman for a breast MRI.  This test also came back negative indicating that the cancer did not originate in leftover breast tissue from my 2011 mastectomy.

Today:  One more test.  Brain MRI.

Next week:  Axial Lymph Node Dissection to remove lymph node(s).  

How quickly life can change.  One week racing my bike, the next dealing with cancer.

For the past week or so I have been so consumed with Round 2 that it hasn't really hit me that I won't be racing for the rest of the season.  Instead, I will likely be having surgery, chemo, and radiation.  As my key events come and go, I know there will be sadness.  I have worked incredibly hard training for races this year.  Perhaps I was training for something more?

Although I am taking this one-step-at-a-time, this I know for sure.  Mountain biking will be a huge part of my mental therapy and physical rehab as I undergo Round 2 of treatment for breast cancer.  It just so happens that I have a brand new, super fun, 29er full suspension bike to enjoy.

Additionally, don't count me out for comeback #2!

A few notes:

I have enormous gratitude to a Nurse Practitioner at Huntsman who made me get my butt in there to check out this lymph node.  I easily may have dismissed this if I were told not to worry about it until my next scheduled check-up.  She has gone above and beyond to take exceptionally good care of me.  Thank you Victoria!

I feel incredibly fortunate that it is looking like the cancer is contained to the lymph node.  Although I don't believe that a healthy diet can cure cancer, I do believe that my anti-cancer diet, along with Tamoxifen, has helped protect my body from disease spreading to other organs.  Sometimes the things that we are thankful for are different than we thought.

Additionally, I want to apologize to my many close friends who I have not yet told in person.  Not only does coming out make it real, after a day filled with medical appointments, it is sometimes the last thing Shannon and I want to talk about.  I love you all and appreciate your support and love though Round 2.

In unrelated news, Shannon and I are the proud new owners of a condo in sunny St. George, Utah.  We closed yesterday right after my MRI.  The condo is a stone's throw from mountain bike trails and we are looking forward to some off-road rehab in the desert this winter!  Also, we will be renting our little unit out for short-term rentals.  More info to come!

Tuesday, May 14, 2013

12 Hours of Mesa Verde-2013

Once again Shannon and I loaded the car and traveled out of state for yet another bike race.  This time it was to Cortez, Colorado for 12 Hours of Mesa Verde.  Shannon and I teamed up for our third attempt to win the race and chase after our coveted goal of nine laps.  We finished second in 2009 and 2012, both times barely missing the cutoff time for a ninth lap.  This year not only did we win the co-ed duo category (where Shannon and I team up and alternate laps relay style on the 16-mile course), but we also completed nine laps for a total of 144 miles.

Here's how it went down:  Actually, it almost didn't go down.  As I mentioned in my Whiskey50 post, Shannon had an allergy flare up in Prescott which turned into a full fledged sinus something.  Not only did he barely ride his bike in the week leading up to Mesa Verde, he was still on antibiotics.  I was okay with staying home, but Shannon, being a bit stubborn, insisted we race.  So, after work Thursday, we loaded the TDI with 3 bikes and Dizzy and drove the 3.5 hours to Moab for the night.  The following morning we rolled into Cortez before noon to burn a lap on the racecourse.  I had packed my beloved Pivot Les hardtail race bike as well as my brand spanking new Pivot 429carbon full suspension bike.  I was honestly torn as to which bike I should race.  My hardtail is so fast, but the dualie is sooo fun.  In the end, I decided to race both, but I'll get to that in a minute.  First, with the exception of a little hiccup, Friday's pre-ride was amazing.  Even though I have raced Mesa Verde twice before, I had forgotten just how fun the course is!  We ripped a lap and then I took Dizzy out to burn some puppy energy.  This is when the little hiccup occurred, one minute Dizzy was running behind me, the next he was gone.  I'm sure he just got distracted for a split second, but I was worried.  Some other racers pre-riding stayed on lookout while I rode back to the parking lot where I thought perhaps he got distracted.  Well, he eventually turned up on the trail where I lost him.  Thank you Tara and Chris for helping me find the little bugger.  Good thing he's so darn cute because he was in big trouble!

Naughty hound puppy

Back to the racing.  Saturday morning we woke up at the butt crack of dawn to eat before the 7AM start.  Shannon was to go first which made me especially happy because it was a LeMans start.  A couple hundred bike racers in carbon soled shoes running a 1/4 mile or so to their bikes is a pretty hysterical sight.

The LeMans start

Shannon is not much of a runner and he was about midpack by the time he got to his bike.  He then had a couple of miles of dirt road to pass as many racers as possible before funneling into singletrack for the remaining 13 miles of the lap.  Shannon's first lap put us into 4th place and I was a bit worried that he wasn't feeling well.  As he came through the transition area, I grabbed the baton clothespin and took off not wasting a single second to exchange words. My goal: to make up as much time as possible. My lap went relatively smoothly and I was able to pick off 2 racers putting us into second place.  After my lap, I checked out the real time standings.  We were in 2nd place by about a minute.  Not a large margin to overcome, especially with 9+ hours of racing left, however Shannon's first lap was six minutes slower than the leading team's male rider and I was only five minutes faster than their female.  If those margins stayed consistent we would finish second yet again.  Fortunately, Shannon was feeling fine and he put in a strong second lap putting us just a couple of minutes behind the leading team.  I was able to overcome this deficit my second lap to pull us into the lead.  For the remaining six hours, we both stayed consistent and by the end of the day had about an hour lead on second place.  We finally won 12 Hours of Mesa Verde and perhaps more importantly achieved our 9 lap goal which meant Shannon had to go out for a fifth lap.  Hehe, poor Shannon:)

Now to the bikes:  Pivot Les versus Pivot 429Carbon.  Honestly, it is a toss up.  I rode the Les for my first lap.  It is so light and stiff that it is a huge advantage on the climbs.  I absolutely love racing this bike.  I switched to the 429Carbon dualie for my second lap.   The full suspension was so smooth and effortless through the rock sections plus it was just plain fun to launch over roots and rocks.  In the end, due to the nature of the course, I stuck with the 429.  The fun factor and smooth riding over six hours of racing won out!