Gotta keep on keepin' on.......

Cancer again...that's 3 times in 2 years. This time it’s not breast cancer, but a new one called squamous cell carcinoma. New cancer, same old fighting spirit! My blog is still named for one of many songs that kept me going the first time around. Driving home from an upsetting appointment, I turned on the radio just as this line from Steve Miller Band's Jet Airliner was playing: "I've got to keep on keepin' on" I did just that. And I'll do it again.

Sunday, September 30, 2007

Buy 3 get 1 free

Did I mention my bonus surgery? In addition to the bilateral mastectomy on Tuesday, I also had an oopharectomy. That's doctor-speak for "removing ovaries".

Guess I was the 1 millionth mastectomy served, so they threw in the "ooph" for me.

Actually, I have my surgeon to thank for this bonus surgery. On Monday (the day before surgery), he learned from my oncologist that I had wanted to get this done and said "why not do it all at once?" He didn't want me to be under anesthesia twice, and he knew I'd have a recovery period after the mastectomies which would delay getting the ooph.

He also knew I felt a certain urgency to get this done. Estrogen is very bad for many breast cancers, mine included, because it encourages it to multiply. So naturally, I want as little estrogen in my system as possible. Removing my ovaries surgically would eliminate the estrogen permanently and put me into menopause. Being menopausal opens up a whole new world of drugs that are tons better at preventing recurrence than what I was on. Between that, and considering how quickly my cancer came back, I wanted the estrogen to stop N-O-W.

I really wanted to do the ooph procedure this summer, but my oncologist suggested I try shutting them down chemically instead. So I let them inject some Lupron in my right buttock. I was to have these injections every 3 months.

The Lupron has some wacky side effects, and there is question as to its effectiveness toward the end of the 3 months. And, of course, we're not really sure it did its duty, and it shares the blame with the Tamoxifen in failing to prevent a recurrence.

So thanks to my surgeon, I was able to have the surgery I wanted to do in the first place.

The ooph was a laparoscopic procedure, requiring 4 little incisions just below my bellybutton. My gynecologist did the procedure after my surgeon did his thing. That was another surprise: my gynecologist originally was unavailable, since it was scheduled last-minute (as in the day before) and he couldn't free up his schedule. One of his partners was going to do the procedure. We had met her before, 6 years ago when she was the on-call doctor when Leah was born. But Leah arrived quickly, 20 minutes after I got to the hospital, and the on-call doctor never made it in time, so the nurses and a doctor who happened to be in the hospital delivered Leah, and we met the on-call as she breezed in during baby Leah's weigh-in. She was very nice, I remember. Just not very punctual.

After I woke up from Tuesday's surgeries, and they wheeled me to my room, John told me I had had a special guest surgeon. My regular gynecologist had done the procedure! I was so excited to hear that. He is a great doctor. Not that I didn't like the other one, and I was asleep the whole time anyway so it's not as if we had this sparkling conversation, but I felt good knowing that a doctor who's known me through 3 of our 4 babies did the surgery. A real bonus for me!

Friday, September 28, 2007

ready to heal one more time

Surgery went well. I did fine. I didn’t wake up from the anesthesia screaming hysterically, so that to me was a success. I wasn't too nervous going in, probably because they kept me so busy in the pre-op many conversations around me, so many questions to answer over and over. They (the nurses, anesthesiologist, surgeon, surgeon's assistant, maybe even the janitor) all wanted to know my birthday, what surgeries I've had, and what I was having done that day.

And once again, like with my lumpectomy in February, they asked me to initial the side the surgeon would be removing. "Both sides," I said, "Do I still need to initial them?" The nurse thought it wouldn't be necessary. But she let me anyway. So I signed my initials and a little smiley face on each breast. Why not start the surgeon's day with a smile!

When I woke up I must have been on quite a roll. I had all the nurses laughing. I don't remember what I was saying but they were enjoying it. I do remember laughing myself, saying, "You know, it's not nice to laugh at someone when they're coming out of anesthesia!" One of the nurses, named Deena, wheeled me up to my room. She hung out with me a little longer, I guess because I was so entertaining.

I was surprisingly mobile after surgery. And the pain wasn't that bad. Of course, they kept giving me morphine which was pretty nice. They kept me on liquids the first 2 days, then I finally had a normal breakfast and lunch Thursday before checking out. My surgeon wanted me to stay that extra day (normally mastectomies go home after 1 day) because he knew I had 4 children and he thought I could use the rest. He is so great.

So I'm resting and healing at home, finally. I've received lots of encouraging cards, some beautiful flowers, and yummy meals from friends and neighbors. My parents are running the show at home so John can tend to me. I don't need much, just a place to sleep and someone to help me walk off the gas from the anesthesia!

I'll write more later, I promise.

Monday, September 24, 2007

Some pre-surgery thoughts.....

I have been puttering around the house tonight. Packed my bag, straightened my bedroom (in case anyone wants to dust and vacuum while I'm out), snacked all evening since I can't eat or drink after midnight and I know I'll be hungry.

Looked at my breasts in the mirror for a few minutes, since that seemed like the proper thing to do the night before a mastectomy, but 1) was not impressed and 2) didn't feel an overly sentimental need to say good-bye.

I had waffled briefly today, wondering again if I was doing the right thing by opting for a bilateral mastectomy. But based on my ho-hum reaction when I looked in the mirror tonight, I'm guessing I'll be fine with it. As long as I don't wake up from the anesthesia screaming that someone stole my breasts.

Having a mastectomy, double or not, doesn't guarantee that I'll never have cancer again. It could go to the chest wall if it's really that stubborn. But removing most of the breast tissue significantly reduces the places for the cancer to grow, and I am comfortable with that. Studies have shown that women who do a lumpectomy followed by radiation have the same prognosis as women who opt for the mastectomy. Well, I already DID the lumpectomy and radiation, and I had just a 15% chance of recurrence after that.....and here I am with cancer again! My chance of getting cancer in my now-healthy breast is maybe slightly higher than the average woman. But I wasn't a high risk for the 1st cancer to begin with!

So this time, I'm going to be as aggressive as my cancer seems to be. I'd much rather regret being aggressive than regret playing it safe.

Friday, September 21, 2007

Bye-bye Boobies (or Ta Ta to my Ta Ta's?)

Well, the days have gone by so quickly since my 2nd diagnosis in August. I've practically lived at the hospital, with all these scans and tests and doctor visits. I haven't had time to visit my friend Susanne's new baby, who judging from the emailed pics is absolutely beautiful. I haven't had time to get the dining room cleared out so I have some scrapbooking space for my recovery. I haven't had time to organize the art closet to make it easier for everyone (my parents and the kids) to keep the girls busy with activities.

And, most upsetting, I haven't had time to organize a good-bye party for my breasts. I even thought of some great party themes: Ta-Ta to Kate's Ta-Ta's, Bon Voyage Boobies, Bye-Bye Boobies, Harrivaderci Hooters (OK, that's stretching it a bit).

Oh, did I say good-bye breastS? Yes, that was "breasts" plural. I decided to take them both, even though only 1 of them has cancer at the moment. Many reasons for this: symmetry for reconstruction, peace of mind knowing that there's less place for cancer to go. Who's to say it won't travel to the other one someday? I don't want to live in fear. And honestly, after nursing my 4 babies until their 1st birthdays....well, except for Jesse as I started chemo when he was 5 months poor little 34-barely-B-cup breasts are just not what they used to be! Without the magic of Victoria's Secret, I'm practically concave in profile anyway. So I'm not too upset over it. Well, other than being upset about having cancer again and all, and wondering how many weeks after surgery until I can lift and carry and hold and snuggle my kids.....

On the bright side, since I have an actual deadline of Sept 25th (my surgery), I have been able to put some pressure on my husband to do a little bit of landscaping for me. "Oh honey, it would be so nice to have the yard looking so spiff while I recover...."

So, I have found time for gardening, and plan to spend this last pre-surgery weekend with my family, my breasts, and a whole bunch of flowers, bulbs, and hosta....

Thursday, September 20, 2007

My cancer has behavioral problems

Good news: nothing in my bones! That was a big relief. No cancer in the major organs either. According to the MRI and PET scan, we're looking at a few tiny spots in the left breast, same one as before. They may or may not have been there in February. They've been able to grow despite the Tamoxifen I've been taking to prevent recurrence and despite the Lupron injections I've gotten to shut down my ovaries (and eliminate estrogen since that can help cancer grow)

On the bright side, says my oncologist, we are learning more about my cancer's behavior. As though it is a person, perhaps a mischievous toddler? Well, I am thinking this cancer needs a bit of a timeout, don't you?....and maybe a swift kick in the you-know-what!

Anyway, my surgery is set for Tuesday the 25th, 8am. I'm looking forward to finishing off this behaviorially-challenged cancer!

Friday, September 14, 2007

What I learned from my new plastic surgeon

My new plastic surgeon is full of interesting information:
Apparently if you're slender, you can't make a fake breast out of your stomach, back, or butt. And you can't use donor tissue either (I've had several offers, thank you anyway). And bulking up between now and surgery will not help me create more usable tissue.

That's what I learned today at my consult with the plastic surgeon.

The original plan was to do the mastectomy and reconstruction together. The surgeon would do his thing, step aside, and let the plastic surgeon do his thing.

But, I learned today, when you're only 5 months out from completing radiation, you're not a good candidate for reconstruction. I need to be 8 months out, which is December/January-ish.

And since I'm officially too thin to offer part of my stomach, back or butt to build my new breast, my only option is implants. But at least I have an option!

So I'm now waiting on my surgeon to set a date for the mastectomy. Shouldn't be that complicated, only having to get 1 doctor in the operating room, right?

Stay tuned!

And please, I don't mean to be selfish because I know there are others out there in need, but if you can send your prayers/positive vibes/happy thoughts/whathaveyou my way, I would truly appreciate it. I am going crazy waiting on results of my bone scan, MRI, and PET scan. John is of the "no news is good news" mentality, and I am trying really hard to be that way too.

Monday, September 10, 2007

Not what I wanted to hear, but I'm OK with it so far

This is a long post. I have a lot to say. You've been warned!

Looks like I got ahead of myself on this cancer anniversary thing! It's baa-aack..... It is the same kind I had before, invasive lobular cancer with some ductal carcinoma in situ mixed in. Fortunately, this time it is much much smaller. It is teeny-tiny, hardly even registers on the measuring scale. And it doesn't appear to have spread, which means...I chemo.

My surgeon discovered it under my lumpectomy scar when he examined me after my mammogram. August 22nd was my first mammogram since surgery. They make you wait 6 months before they'll do one.

I was nervous going in to the mammogram, worried that they'd find something but also worried that it would really hurt. I never minded mammograms before, but the left one's been through so much with surgery and radiation....I was certain it would explode!

It wasn't painful, and no that was a relief. Then my doctor reviewed the mammogram pictures with me, and showed me how everything (yes, both left and right) looked clear.

YAY! More relief! I was ecstatic, just about in tears, to hear that! I hopped up on the examination table so he could check his work....the lumpectomy scars, the lymph node removal scars, range of motion, etc.... He felt around and was troubled by a strange lump on my lumpectomy scar. He decided to do an ultrasound to rule out any problems. He kept saying, "It's probably nothing, just fat necrosis which is common....."

He did a biopsy that same day, and said he'd get back to me once he heard from the pathologist. That was a Wednesday. I wasn't concerned, since he was pretty reassuring about it being nothing. Last year at this time, when he did the biopsy that revealed my cancer, he was not quite as encouraging. So I was feeling pretty good about it all.

But the following Monday, when I answered the phone and heard my doctor's voice and not his nurse's.....I knew the news wasn't good.

I was prepared for it, I suppose. I haven't really left "cancer mode" anyway, still haven't felt truly cancer-free even though my oncologist declared me so in June. "After my mammogram, I'll feel better," I told everyone. Silly me!

SO.....John and I met with the surgeon that same Monday at 12:30. He answered my initial questions over the phone that morning, but he (and we) really wanted to meet face-to-face so we could discuss options. I'm still impressed that we even made it to the appointment as we had little warning: the dr called around 10:30 to tell me it was cancer, then said he had an opening at 12:30 to discuss it! Luckily, John was able to leave the office immediately, and after striking out with all the babysitters I knew, I called my friend and neighbor Kim who agreed to watch the girls. That was at about 11:15. I grabbed a quick shower, packed lunches and activity bags for the kids, and waited for John to get home. (We brought Jesse along to the appointment. I didn't feel right leaving him at Kim’s. She could certainly handle him, but she has a beautiful house and our busy boy is awfully destructive!)

Back to the meeting with the doctor......we learned that it is the same kind of cancer, it is less than 4 millimeters in size (the first one was 2.5 centimeters), and my surgical option at this time is a mastectomy. Based on where the cancer is, my previous cancer, and that the left breast has already endured radiation (can only do it once per side), this is my only option. But that's OK, I don't mind.

Yes, that's right! I said I Don't Mind Having To Have A Mastectomy. I'm almost relieved, to tell you the truth, because the last few months I've been letting myself get all worked up.....wondering how I was going to live with these frequent breast exams and mammograms and MRIs, and the constant worrying in between checkups that the cancer is back or whether something I'm eating, drinking, breathing, doing or not doing will cause a recurrence.

And don't get me started on the drugs I'm taking to prevent recurrence (you can see how well THAT'S been working!)

So it is a bit of a relief. I had been saying to people (well, just to John and my sister, I think) that if I had to do it over again I would definitely opt for the mastectomy. Mostly because I am a worrier, and the worrying really stinks. (Of course, I’d never tell my surgeon that, after he did such a tremendous job saving my breast with the lumpectomy. Wouldn’t want to hurt his feelings after the creative stitching he did, and the breast is so perky, even though it does point a bit east….)

I am very fortunate (not to mention impressed) that my surgeon actually found this lump, after my OB had examined me in April and my oncologist in June. Both found nothing. But I guess a surgeon would know better what to look for in a scar, since this is his line of work anyway.

So while it's not good news, it could be tons worse. This tumor is not in the same league as my first cancer, a good thing! And the resulting surgery may help alleviate some of my fears of recurrence. (Just keep your fingers crossed about the chemo. I would rather not have to do that again.)

Coming up: I'm waiting for a surgery date, and waiting on results from the MRI, bone scan, and PET scan I had (to determine if the cancer has gone anywhere else, something I'd like to know before surgery), plus an appointment with a plastic surgeon.