Time will go on...

6 months ago I found a lump. 60 days ago I underwent my 2nd lumpectomy. 6 years from now now will have survived the the most prominent time for recurrence. Time will go on, many events will occur and many things will change but one thing is certain for me, I will never again be the same.

I hate to admit what an impact this b/c has had on me, physically of course but mentally and emotionally as well. At times I couldn't tell you which is the heaviest. I guess it all depends on the situation or even the moment.

My menopause is in full swing and every day that I think I have felt the full affects of the lack of estrogen in my body it shows me otherwise. I don't know how long I will be suffering from these hot flashes but I can tell you that Thursday night I had "hot flashes" every 30 minutes for approximately 2-5 minutes beginning at 3:15 in the morning. Just as one would pass and I would finally feel like I was drifting off to sleep again, another would come on. This continued for houre until I finally got out of bed for work. My inability to have estrogen won't ever end but I guess, and hope and pray that at some time the menopausal symptoms will fade.

I haven't slept well since my initial surgery in December for a multitude of reasons. I am still not able to comfortably lay on my stomach and because of the lymph node biopsy, I am not able to extend my left arm above my head for more than a few minutes or lay on my left side for long. Sleeping has become a chore for me. I hate to be a complainer but I am exhausted!

Every pain I feel within the "ta" causes me to question if it is from the healing, or if it is from the cancer. I have occosaional pain on theother "ta" as well, which is not new and although the dr's haven't been able to explain it they tell me that it isn't a sign of b/c. My questions come with no answers, which lead to more concerns. Either way, I'm done with being in pain and limitations. It's been far too long now, and this is only Part I of the process.

The combination of 3 surgeries, not sleeping well and the lack of hormones is taking a toll on me. I look in the mirror lately and see a reflection I feel like I shouldn't be seeing for several years to come. I feel old and tired and worn out. I hate that I feel this discouraged sometimes and I still have such a long road ahead of me - radiation, possibly chemo, 5-10 years of daily medication, menopause, risk for osteoporosis, 6 month exams, & the possibility of recurrence. I hate that cancer will forever remain a significant part of my life.

I know that in time I will be fine, but I also know that I will never again be the same.

Stop complaining!

Have you ever noticed how it sometimes seems that if you aren’t complaining about something people think everything is OK? It doesn’t matter whether it's your health, your mental outlook, your love life, your friendships - or even your workload.

Is it that people are generally such positive thinkers that we assume everything is OK or could it be that in essence we are that small-minded & perhaps self-absorbed?

If you were to climb a mountain and weren’t out of breath when you reached the summit, would that mean it wasn’t challenging? Visually it may appear that way to those observing you but that may not have been the case at all. It could very well have been for a myriad of reasons such as your training, or the pace you kept. It may have even been because you took a break a few minutes prior to reaching the summit to gain your composure.

If your desk isn’t messy, full of papers and you’re not complaining to the boss or coworkers, does that mean that you don't have enough work to do? Of course not.

Not complaining is simply that – NOT complaining. It’s unfortunate that some people seem to believe that the amount of complaining they do equals the amount of merit their situation warrants.

You never know what mountains people are climbing. Remember how things appear to be may not necessarily be what they are.

Choices & Alternatives

The more alternatives, the more difficult the choices.

I was talking with 2 coworkers today and one asked the other, "Don't you think she is so brave? I just wouldn't know what I would do." My response was, "What other choice is there?" What's the alternative? It isn't as if you can simply admit defeat. At least I can't. My b/c diagnosis is not the worst thing that could happen to me, or to anyone for that matter. Yes, it's a bad thing and yes it is scary but at least I have choices and opportunities. Some women with this disease, and so many people with other illnesses have no choice. I am not terminal, or paralyzed or even handicapped for that matter.

I had just said to the other co-worker that this b/c has left me having to make some difficult choices and I really didn't like that part of my treatment and I thought I, as a patient, should not be put in that position. You go to a doctor because they are the expert, and you expect them to determine your treatment plan. You expect them to advise you, guide you, even take the control out of your own hands. You expect them to be the one to make the tough calls, such as, "Would you prefer a lumpectomy + 6 weeks of radiation, or a mastectomy and no radiation?"

Really? Seriously...which would I PREFER? Well, as a matter of fact, since you are asking me, I quite honestly prefer NEITHER of those choices. Just the same as when facing the decision of which dessert to choose I preferably choose not to make a choice at all and have everything on the dessert menu! With regards to my treatment, I would prefer neither but what's the alternative? Like choosing all the deserts, not choosing between the two surgeries simply would not have been conducive to good health and long living.

The moral of this blog is be thankful when you have the opportunity to make a choice. Consider the alternative; you could have nothing. Up until I starting blogging this evening (on a somewhat unrealated topic) I hadn't realized just how fortunate I was to have been given a choice to make. As you know, I chose the lumpectomy + radiation.

I read this quote once and tucked it way, instantly feeling the depth in the simplicity of it:

Life is the sum of all your choices.  ~Albert Camus
~ Choose wisely (my 2 cents!)

Hello...It's Me

I've had the past 2 weeks off re-cooperating from my third (successful and FINAL!) lumpectomy and although I've had more time on my hands than I have known what to do with at times or even enjoy to some extent, I just simply have not felt like writing. I had no idea SO many people were reading my blog. I am flattered, grateful and even surprised to have heard that so many of you noticed that I haven't been posting.

Just before my last surgery I was scurrying to get some things done at the office and before I realized it I had broken down in tears of shear frustration from trying to get so many things done and feeling like time was almost my enemy. I know that time is not my enemy, it will be a part of my healing process but I also realized that having cancer is a full time job (and not one that I applied for!) Between making appointments and arrangements it just seems like it is never ending. Hmm...I guess in a way it actually is! Although I couldn't get away from the cancer, getting away from the computer gave me a bit of a rest. As you know, when I write, I REALLY write a lot! :0)

I go back to work tomorrow and I am truly looking forward to it. I work with a lot of wonderful people who all genuinely care about my health and happiness. I am very blessed to work with them as well as be in the military, so my health care is not an issue. It is actually part of my job to be healthy. I have heard and read so many tragic stories of women who don't have insurance or a support system and can't afford medicine or even gas money for the many appointments. I said in the beginning that if you have to have cancer, this is the way to have it (type, stage, etc.) Well, I am once again very fortunate.

Thanks for reading and for being there for me in so many ways. I can not imagine what this would have been like for me so far had I not had the love, support and prayers of so many people.

Just so you know, you can always post a comment to the blog. :0)

Ta-Ta For Now (TTFN)

One Hot Woman!

WOW! I'm sure when Will dreamed of sharing his life with a hot woman that this isn't quite what he had in mind but he's got me - hot flashes and all!!

Because my particular b/c is hormone receptor positive part of my adjuvant (ongoing) treatment is to basically deplete my body of all estrogen so with that said, I have been deprived of my hormones and am in full menopause. :( How does that country song go? "I'm much too young to feel this #%&! old?" I'll be honest, I can't imagine going through this for years to come but it isn't really much of an option, considering the consequences. I know it's basically simple compared to the other treatments that still lay ahead of me and so little compared to what so many other women have undergone but OMG!!! The so called hot flashes aren't really flashes at all, as a matter of fact the only remote thing they have in common with a flash of any type is how fast and how unpredictably they come on.

I have a new found respect for those women out there who have gone through menopause, a bit of advice to those facing it to invest in a "chillow-pillow", and such awe for Will, who is ever so patient and tolerant of me and my mood swings! :0)

Will - I am one hot woman and I am all yours! Is there any doubt who the lucky one is in this relationship?! :0)

Ta-Ta For Now!

Oncotype DX Test

Genomic tests, such as the Oncotype DX look at groups of genes and how active they are. Genetic tests, such as BRCA 1 and BRCA 2 look at an individual’s inherited traits or genes.

All breast cancer tumors are unique. Key differences between individual tumors influence the likelihood of the cancer recurring. These differences are associated in part with the level of expression of a certain group of cancer-related genes. This genomic test (Oncotype DX) looks at a group of 21 genes and their activity in breast tumor tissue and uses a mathematical equation to translate it into a numerical value, which indicates the likelihood that a woman’s cancer will return or recur (distant recurrence).

The Recurrence Score™ result gives information about how likely the woman is to benefit from chemotherapy in addition to hormonal therapy and adds information beyond traditional factors such as tumor size, tumor grade, and the woman’s age by looking at the biological makeup of her tumor. The Oncotype DX test does not provide information about an individual’s inherited genetic makeup but provides information about the genetic activity of the tumor and is designed for patients with node-negative, estrogen-receptor-positive, early-stage (I or II) breast cancer, which is the type I have. Research has shown that the Oncotype DX Recurrence Score is effective in predicting the likelihood of disease recurrence within ten years and the magnitude of chemotherapy that goes beyond traditional measures.

The Oncotype DX test is currently being conducted on tissue taken from my initial lumpectomy in December. Results take approximately 2 weeks. Once results are received I will meet with my Oncologist and we will devise the next battle plan. Until then, it's more of trying to be patient and live each day to the fullest. The silver lining in this is I think the waiting will give me an opportunity to mentally and emotionally prepare (at least as much as possible) for the possibility of having to endure chemo and the side effects that are associated with it. Up until now I had been told that only radiation would be needed. You do what you have to (as if your life depended on it - sort of like with the MRI!) Maybe I'll even try on a couple of wigs or two while I wait - I have always wanted to have long, curly, blonde hair. Hmm....now if I can also be at least 5'4"! ;0)

TTFN!

Understanding Breast Cancer Recurrence

Despite the best efforts of your health care team to surgically remove all traces of your breast cancer tumor, the reality is that breast cancer can still recur. Early stage breast cancer can return months to years after the original diagnosis and treatment. The cancer can come back as a local recurrence (in the treated breast) or as a distant recurrence elsewhere in the body, such as the bones, lungs, liver, or other organs.

Many laboratory tests are performed on samples of the breast tumor taken during surgery to help doctors design a treatment plan based on the specific characteristics of the tumor. However, even with these tests, it can be difficult for doctors to precisely determine the aggressiveness of the tumor.

Simply put, recurrence is the return of the same type of cancer after initial treatment. Therapy for early-stage breast cancer aims to reduce the chance that cancer will recur. It is valuable to know the chance that your particular cancer will return, because that can help you and your doctor determine whether additional treatment beyond surgery is appropriate (i.e., chemotherapy in addition to radiation & long term hormonal treatment).

There are two main types of recurrence:
Local recurrence is the return of cancer to the area where a woman originally had cancer and subsequent surgery. Signs of local recurrence of breast cancer usually become apparent during mammograms, physical examinations by a health professional or self-examinations.

Local recurrence is often treated similarly to the way the original cancer was treated: with surgery, followed by radiation therapy (if it was not done initially), chemotherapy and/or hormonal therapy.

In distant recurrence, the cancer metastasizes, or spreads to parts of the body other than the original location (breast or lymph nodes located near the breast). Symptoms such as bone pain, weight loss, and shortness of breath may be signs of distant recurrence. If cancer does metastasize, it commonly spreads to the lungs, bones, liver or brain.

The Side Affects of B/C

Today was the most difficult day I have had to face throughout my b/c journey. Probably one of the most difficult days in all my life. It was my first visit to the Medical Oncology department.

I have remained positive and strong throughout this process and I think in a sense I have also remained in a bit of denial. I hear the words of my diagnosis as they are spoken by each doctor and then as the minutes, hours days, even weeks pass I absorb it as I can, sometimes little by little and with even more time I digest it, educate myself about it and then am able to accept it & regurgitate it. But sometimes I wonder if I've really truly accepted it yet. It still sounds surreal to hear myself say I have breast cancer. Even more so when I say or hear that I have cancer. Sometimes I find myself believing that when the word breast is put before the word cancer it doesn't sound quite as terrifying or quite as threatening. But my first visit to the oncologist suddenly made me very aware that I do in fact have cancer - breast cancer.

Know that I have and still remain positive about my health, my attitude and my life but while sharing this part of my life with you I think it is only honest and right for me to not only share the facts, statistics or clinical description but also the array of emotions that I have and will experience. You may find it sad and even tearful, but, after all, it is cancer and it is quite powerful and scary.

When Will & I headed out to Walter Reed the day didn't seem much different than most. I noticed (as I'm sure Will did too) how irritable I grew as the minutes grew closer to leaving for my appointment. I try to schedule them as early as possible because although Walter Reed is only about 20 miles away, due to DC traffic the commute ranges anywhere from an hour to an hour and a half - on a bad day, even longer. I realized that my irritability before and primarily during the commute had become an obvious pattern and that although I was truly concerned about being late and missing the appointment, I was simply worried. I'm glad I realized this because Will deserved an explanation and an apology, although he is too good of a man to ever require or expect either.

Once I gave myself an attitude adjustment we tried to make the most out of our time together in the car while singing and realizing every note of the way that we are surely no one else's American Idol.

When we entered the hospital and the ward our spirits were still high, and probably appeared oblivious to an outsider that we were going for any type of cancer treatment. It's funny - I have made it a point every time I go to the doctor to take a few extra minutes to invest in my hair, clothes and makeup. I tell myself that although I have cancer on the inside, I don't have to look like I am sick. Maybe that sounds shallow or vain, but it's true and those few extra minutes make me feel better. While I was checking in Will & I both saw her - the cancer patient - behind us, waiting to check in also. We saw her at different moments and didn't say anything to each other as she stood there wearing the scarf that hid her baldness.

My heart skipped a beat, then thumped and suddenly ached. We went into the waiting room and when I was called back for my vitals the other patient was called back also. She obviously had much more experience with the process and knew the staff by name. Although I didn't yet know what my treatments would be, I realized that I too would soon become a "regular" there and that I would know the process far too well, probably learning more about the staff than just their names, maybe even the names of their children. The nurse asked her who her helper was for the day, it was her mother. They both looked really tired. As she weighed in, she joked about the fluctuations in her weight then went to have blood drawn. I'm not sure what I felt at that moment, knowing my time for this process and the resulting side effects could be just weeks away.

While we were in the waiting room (waiting and waiting and waiting) I wished I had brought a distraction, preferably an iPod, and realized that my "inexperience" showed but that I wouldn't make that same mistake twice. My reality shifted when I left the waiting room to walk to the restroom. I don't know just how far away the restroom was but as I noticed the treatment rooms along the left side of the hallway the restroom just seemed to get farther and farther away. I saw the lady we had seen earlier sitting in a chair, half covered with a blanket and no longer wearing her scarf as she received her chemo treatment. My eyes filled and my head began to spin slightly. I made it to the restroom and began to weep. I just cried and cried. I tried to tell myself to be strong, to be positive, but I hurt. I simply ached inside. I looked at myself in the mirror - my red puffy eyes and I couldn't help but look at my full head of hair. I stuffed tissues in my pocket, knowing although I seemed to temporarily regain my composure, I would still have to walk by those rooms again. I told myself I WOULD NOT look. I was only in there for a few minutes but when I walked out, obviously teary eyed, and the woman I had seen twice before had finished her chemo and was walking out. Her eyes met mine and I felt as if she intentionally made eye contact with me as she offered me a smile. In that smile she showed strength, weakness, hope, fear, and compassion. She looked at me as though she had already met me. Although one of us had hair, and the other none, it was certain that we shared something much bigger in common.

I felt bad for Will, as I feel bad now while writing this, because not only do I want to be strong, I want to always APPEAR to be strong. I know that isn't possible or even healthy. It has always been difficult for me to show fear and weakness and I have always been such a "do-er" and caregiver. Cancer has a way of doing many things, including inducing humility.

Genetic Testing; BRCA 1 & 2

Each year, more than 192,000 American women learn they have breast cancer. Approximately 5 to 10 percent of these women have a hereditary form of the disease. Alterations or mutations in certain genes make some women more susceptible to developing breast and other types of cancer.

We are each born with two copies of about 100,000 different genes.  One copy comes from your mother and one from your father.  The BRCA gene (short for breast cancer) normally plays a role in preventing breast and ovarian cancer; however, if you are born with BRCA1 or BRCA2 mutation inherited from either your mother or your father, you are more susceptible to these two cancers. 

I had blood drawn to determine if I have the gene mutation which would make me more susceptible to breast cancer again in the same ta (one ta of my "ta-ta's) or a newly developed cancer in the other ta, or elsewhere in my body. My appointment with the Geneticist is April 18th. The BRCA 1 & 2 analysis will provide some additional information and help guide my treatment by indicating whether more aggressive actions are necessary now to improve my quality of life for the rest of my life. 

Margaritaville

"Who says you can’t keep enjoying life in the midst of difficult challenges? Regardless of the catastrophe, when life hands you the proverbial lemon don’t settle for lemonade. Grab yourself some tequila, salt and a blender – then savor your lemon margarita with a smile on your face." ~Author unkown

My mom & dad did a great job of taking care of me while I recouped from my 3rd surgery. They also (especially my dad!) did an absolutely outstanding job of transforming the basement into our own Margaritaville! Will & my dad also redid the bathroom, including re-tiling the floor and replacing the sink.

All I did was sit around and drink margaritas! Well, not really, but I did I did drink some tropical punch flavored kool-aid! ;0)

I've heard of b/c causing "construction and reconstruction" but somehow I don't think this is the typical response. Here's to "changes in latitudes ad changes in attitudes"! Cheers!

TTFN! ;0)

3rd Times the Charm!!!

My third (and final!!!) surgery was a success! No need to go into the clinical specifics, since I've already "journaled" down this road a time or two before but my surgeon confirmed that this time (finally!!!) the margins were clean, meaning no traces of cancer at the outer edges!!!!!!!!!!!!!!!!!!!!!!

My next step from here is to oncology where we will discuss radiation treatments. The "team" initially told me the radiation would start 4 - 6 weeks post surgery. My guesstimate makes that mid to late April. 6 weeks, 5 days a week.

I'm healing well. Actually I've gotten a little too good at this - I'm already far too much of an expert on lumpectomies!

More when I know more!

TTFN! :0) :0) :0)