Two Year DIAGNOSIVERSARY!!

Two years ago yesterday, I received that life-altering phone call.….you know those calls, the one you are either excited to get or dreading....the one that means you got your dream job or the one that says you have a potentially terminal illness.  In that moment, that 30 seconds, your whole life changes.  

If you've read my post about that day, you know that I got my breast cancer diagnosis while I was at work and honestly, I'm glad it went down that way. I stayed too busy to ruminate on it as much and it gave me time to process without getting too emotional.  

For some of us, the diagnosiversary is a tough day. It can bring up a lot of negative emotions and fears and remind us that it isn't truly over.  I know some women who really struggle on these days.  For me, yesterday was more of a celebration in my mind!  I never once thought about shedding a tear or being sad (the fear of recurrence is always present but no more yesterday than any other day).  Yesterday's anniversary was just another reminder of how good our God is and how He orchestrates the perfect timing of even the scary stuff in our lives.  


Breast Cancer is awful...not going to lie.  But, the diagnosis is NOT the end.  The battle begins when you get that call.  It might be a tough one and you might fall behind along the way.  It can be fought though and even won.  Your life is NOT OVER with the diagnosis. You are just taking a new path.  And, you may find like I did, that the path is a little rough and patchy at times but there are also new joys and discoveries along the way that you never imagined!

I am ever reminded of the amazing people I have met and befriended on this breast cancer journey.  People I NEVER would have met if I hadn't been diagnosed.  It's also a reminder of what a difference early detection can make and how important it is to be screened on time.  I learned so many things about myself and God has stretched me into a ministry I never dreamed I'd be a part of.  

God has a plan.  Even when we cannot see or understand it, He has a plan!  Trust Him and don't let fear reign. Be open to what He might be doing even in what seems an impossible situation. 

As always, I am happy to answer questions or to chat any time, please leave a comment or message me on my Facebook page @bosomthing

Amazing Grace

This past month FB has popped up with lots of memories from last year....like today being the anniversary of my Pre-op Appointment for my Bilateral Mastectomy!

What a crazy and surreal time that was but also amazing!  I know, I know....how does someone refer to a breast cancer diagnosis and subsequent life-altering surgery as "amazing"?

Well, I'll tell you.....

#1: God is good...ALL the time. (Say it with me) And, ALL the time, God is GOOD!
Even in the worst moments, He is in control.  When we don't understand, He does. Once you relinquish control and let HIM guide, great things can happen.  God put me in all the right places at the right time.

Some of you know this, but I was not even supposed to be in San Antonio at the time of my diagnosis. If things had gone according to plan, I would have gotten married the Summer before and moved out of town.  Obviously, having my heart broken and a relationship ending was NOT something I saw as a blessing at the time!  But, in hindsight, God knew where I needed to be, who I needed to be with, and what catalyst it would take to get me there.  That relationship ending gave me the push I needed to leave my job and get back to work in the NICU that I love.  If I had not changed jobs when I did, I would have had an entirely different course of care, physicians, etc. Because of my job, I was in position to work with one of the top surgical oncologists and a renowned plastic surgery group who performed a "gold standard" type of reconstruction!  I was also surrounded by a team of people I love and who love me and supported me throughout the whole journey.  God knew....even when I didn't....amazing!

#2:  You never know how you will be used.
As a nurse, its my job to help people. I think that most nurses feel some inner calling to do just that...just part of our nature.  As a NICU nurse, I never in a million years thought I'd have anything to do with oncology...breast cancer in particular.  Because of my diagnosis, I have met so many people...other women touched by breast cancer, family members and friends.  I have friends now that I would never have met. By sharing my story openly, other women have been helped.  I've volunteered as a patient advocate with two groups and am always willing to lend an ear to another fighter/survivor.  Who would have thought I'd be

walking in breast cancer 5Ks, attending breast cancer awareness events, and blogging my personal life for the world?  My son grew a lot throughout this past year and has participated in events with me too. I believe he will have a better compassion and understanding for others in his life now. Even though this isn't the path I would have chosen, I am happy and blessed that God has allowed me to be used through it.  It is amazing is it to be able to help others!

#3: Grace is typically defined as "the free and unmerited favor of God".  My

breast cancer was caught early (Stage 0) and was contained (DCIS, non-invasive). I got my biopsy within days of the ultrasound that found it. My surgery (within 2 months later) was successful. No other locations were found and my lymph nodes were clear. Yes, I had a bilateral mastectomy, but I woke up CANCER-FREE....no chemo, no radiation.  My recovery was certainly not a breeze, but it was relatively complication free. My revision surgery gave me exactly what I needed and again was complication free.  My overall results (all completed within 1 calendar year) are wonderful. I was significantly blessed!  I know this even more than ever before in my life. I am grateful for things..little things...more than before. I  found out that I am as strong as I hoped I'd be in the face of a scary thing and happier than I imagined I would be again.  And, I surely feel HIS amazing grace in my life.

Here's hoping you feel HIS Amazing Grace in your life this week!

Origami Cranes, Pink Ladies, and Diagnosiversaries

Two days ago was my first diagnosiversary...one year since I received the biopsy results that said "you have breast cancer".  (Here's the post I wrote about that life-altering phone call.)  Some days, it all feels like a long time ago and other days, it feels like it just happened.  I crammed a lot of stuff into 2017!!

Yesterday, I was asked to come back into my PS office to re-take my "after" photos. They have a new backdrop wall and wanted some extra shots to use on their website.  Yep....that's me..."before & after" model.  Granny asked if I was posing for Playboy next?!?!  Ha!  

Last night, I went back to my PS main office for a Pink Ladies event.  There was quite a turnout for this one and it was good to get out and meet some new pink sisters.  I sat next to a woman who is coming up on 5 years cancer-free and three others who are less than 6 months into their journeys....we all have stories to share.
  
The guest speakers last night were from the local group Overcomers: Daughters of the King of Kings.  It is a neat organization that focuses on breast cancer SURVIVORS.  This is a much needed ministry and I was excited to hear about it.  Overcomers realized (like many of us) that the journey is NOT over after surgery and reconstruction and treatment is done.  While I am very blessed to be cancer-free, my life is not the same as it once was and how I feel, think, act is forever changed.    
All of the small group leaders are fellow breast cancer survivors. They host a 9-week workshop every Fall and Spring that I am really hoping to take part in soon.  (Go to their website to register for the one starting 02/21/18 if you are interested and available.)

Great tips no matter where or who you are!

After we heard from the Overcomers group, a sweet Pink Sister shared with us her participation in an organization called Cranes for Cancer.  According to Japanese legend, anyone who receives 1,000 origami cranes will have good luck. If you read the story on the website, you'll see why they have chosen to mail a box of 1,000 origami cranes to people battling cancer.  There are also photos of some lovely art installations done with these cranes.

After giving us a little history, she taught us all how to make the cranes last night...it was challenging. I cannot imaging making 1,000 of them myself....it's harder than it looks to make just 1!  But, it was fun to learn and to laugh with those around me as we attempted the folds.

My first attempt at an origami crane!

If any of you are local and are interested, PRMA Pink Ladies have events every 2-3 months. Each one is different and they always have one of the nurses available for any one who has reconstruction questions while they are there. Check out the PRMA Facebook page (@PRMAplasticsurgery) for more details.

So, while this week of anniversaries has brought up a lot of emotions, most of all it has reminded me of what a blessed story I now have to share and how much God has taught me throughout this tough year.

Have a terrific weekend!

Friendly Reminder!

Happy Sunday!

Breast Reconstruction Graduation

A week ago today, I "graduated" from my breast reconstruction journey!  It's still hard to believe that this year of surgeries and appointments and procedures and all of the stress, pain, discomfort, and sleepless nights from those is over.  I still have my surveillance visits with my oncologist's office for a total of 5 years, but as far as reconstructive surgery...I'm done!

The appointment was quick and went well. Basically, Crystal just looked at how my tattoos had healed and asked me if I had any remaining issues that needed to be addressed. She said that everything looked great and since I'm happy with my results...that's it!  We took my final photos and that was that.  As soon as she sends me the copies, I'll post my "before and afters" for you.

Honestly, this year does not seem real sometimes. Sometimes I wake up in the morning and in that quiet moment, I think it might have all been a dream. To have been diagnosed and done all in one calendar year is truly a blessing and I am so grateful.  This year has been a learning experience. Not just medical information but a lot of learning about myself...who I am, what I can do, and how amazing my support system is.  This journey would not have been as smooth without all of my friends and family.

While last week's appointment marks the end of my reconstruction (and surgeries), it is not the end of my breast cancer journey by any means.  My incisions have healed well and my scars will eventually fade some, but I'll always carry them with me.  And, that's okay, because they mean I fought a battle and came out on the other side.

This diagnosis and subsequent journey also allowed me to meet some great women...fellow fighters and survivors.  I am honored to get to share my story here and on social media and to chat with others every day.  

So, what's next you ask?

I don't have another oncology appointment until March.  Between now and then, it's just life in my new normal.  Massaging my scars in the hopes of getting them to fade well and I need to focus on getting the extra weight I gained this year off.

And, counting my many blessings!  Watching one of my all-time favorite Christmas movies, White Christmas, as I type this post and I love this line from one of the many songs:  "If you're worried and you can't sleep, just count your blessings instead of sheep and you'll fall asleep counting your blessings!"

My last time wearing the PRMA pink gown!

I plan to continue to post along the way and keep y'all updated on healing, tips and advice, etc. 

Tip Time:
With that in mind, many of you have asked about bras and know if you've read my previous posts on the topic that bra shopping post-reconstruction can be quite challenging. Well, I found this bra from Warner's that is just about perfect!  It has extra wide sides which provide great support but don't rub on my drain scars like most bras do.  I wear it to work all day (12+ active hours) and have no issues.  It is available in both wire-free and underwire.  And, it is affordable so you could use it between surgeries (before your final size) and not spend a fortune on bras you can't wear later.  Walmart carries them for just under $18 here in San Antonio.  I've included a photo of the tag so that you can shop online if needed:

Hope all of you have a wonderful Christmas!

MY TIMELINE:

12/22/16  Routine Screening Mammogram

01/18/17  Repeat Imaging and US of left breast; LUMP found.

01/20/17  Core Needle Biopsy

01/24/17  Biopsy results positive...Stage 0 DCIS, left breast

01/25/17  Meeting with Breast Center Navigator and Genetic Testing

01/30/17  Consultation with Surgical Oncologist, Dr. K

02/08/17  Consultation with Plastic Surgeon

02/21/17  Pre-op Visit with Dr. O's nurse

02/27/17 Pre-op Labs and Testing

03/05/17 Lymph Node Injection

03/06/17 SURGERY DAY!

03/10/17 Home!

03/16/17 10 day Post-op Visit with Plastic Surgery nurse
03/20/17  2 week Post-op Appointment with Surgical Oncologist, Dr. K

04/07/17  1 month Post-Op w/Plastic Surgeon, Dr. O

04/16/17 Returning to work!
05/19/17  Appointment with Dr. O to schedule Phase 2 Surgery!

07/13/17 Pre-op Visit with Dr. O's nurse; Pre-op Labs/EKG

07/25/17 Phase 2 Surgery!!

08/08/17  2 week Post-op Visit with Plastic Surgery Nurse
09/25/17 6 month Follow-Up with Surgical Oncologist Office
11/07/17 Micropigmentation (tattoo) Day!!
12/08/17 FINAL Plastic Surgery nurse visit!  Breast Reconstruction graduation day!!

Can you spare a nipple? My Surgical Oncology Consultation

It's Monday, Jan. 30th, and I have known for under a week that I have Stage 0 DCIS (confirmed by biopsy).  Today, I met my wonderful Surgical Oncologist, Dr. K. for the first time.  He was just as great as I had been told.  Here's how it went....

After a ton of paperwork....get used to that....I met with the nurse practitioner.  After reviewing my history, she did a quick physical exam before Dr. K came into the room. Typically, Dr. K would have gone over my diagnosis and treatment options in detail...he is often the first person most cancer patients talk to after their diagnosis; however, I had the benefit of having met with the Breast Center Navigator the week before.  This made my visit a little easier and we could pretty much go straight into my surgical options.  He confirmed that no chemotherapy would be called for with Stage 0 DCIS, but that radiation would be required if I chose the lumpectomy route.

Here were my options again (in case you missed my last post):

Option 1: Lumpectomy followed by 5 days/week x 6 weeks of radiation and 5 yrs of hormone suppression medication (leading to menopause symptoms).

Option 2: Left (unilateral) mastectomy and reconstruction followed by 5 yrs of hormone suppression....no radiation.

Option 3: Double mastectomy and reconstruction ....no radiation, no meds

My thoughts:

Option 1:  With a lumpectomy, there is always the possibility that a cancer cell will be left behind.  This is why radiation is necessary.  The thought of having the cancer come back in the same breast or in my other one is scary.  I also did not want to go through the radiation (and all of its side effects) required with a lumpectomy.  The hormone suppression therapy would come with all of the fun of menopause symptoms too.  

Option 2: Once again, the hormone suppression therapy is required in order to protect the right breast that is left behind.  And, again, there is the possibility of breast cancer recurrence in my unaffected breast.  

Option 3: No radiation...no hormone therapy...no more mammograms....no more breast tissue.  While the initial recovery is longer and it is definitely more intense, the outcome would give me the least amount of recurrence risk.

For me, I felt that even the smallest percentage of risk for recurrence was too much for me. 

This included the less than 4% risk included with saving my nipples.  In order to do a "nipple-sparing" procedure, a small amount of breast tissue is left behind....meaning that there is a little something left for those pesky cancer cells to come back to.  Again, not worth it to me and after seeing the amazing work that can be done with plastics and tattooing, I am not at all concerned with losing the nipples too.  

After Dr. K reviewed the statistics for each of the 3 options and then he said to me:  "I will advocate for you whichever option you choose. I will be on your side."  Those are powerful words to hear from anyone, but especially helpful from the physician who is going to be trying to save your life.

After having spent the last week doing my own research, Dr. K was able to confirm what I knew and give me additional info specific to my case.  In the end, I felt very comfortable with my decision and signed consent for a Bilateral (a.k.a. Double) Skin-Sparing Mastectomy with Sentinel Lymph Node Biopsy and possible Lymph Node Dissection.

Image from https://www.cancer.gov/about-cancer/diagnosis-staging/staging/sentinel-node-biopsy-fact-sheet

Because if the breast cancer was going to spread, it would spread via the lymph nodes, a sentinel lymph node biopsy will be performed at the start of my surgery.  The evening before surgery, I will go to the Radiology department of the hospital to have a radioactive tracer dye injected into my lymph nodes.  On the morning of surgery, Dr. K will use this to determine which lymph node is the FIRST one from the cancerous lesion...the sentinel lymph node.  He will remove this node and send it for an immediate biopsy.  If it is clear, he will proceed with the mastectomy as planned.  If it is positive, he will have to remove more lymph nodes for a dissection and further biopsies.  Obviously, this will change my prognosis significantly, as well as my treatment plan.  

There are lots of things to consider as you are making the choice for yourself. Take the time to review all of the info and to research each one.  

The only negative about the appointment was finding out that Dr. K was not going to be available on the date the Breast Center Navigator and I had discussed, so my surgery would likely be later.  Not like this was devastating news or anything, but any extension on the process seemed like forever.

My next appointment was going to be with the Plastic Surgeon, Dr. O, in 9 days.  Assuming things went well with him, the two offices would compare calendars and get me scheduled for surgery.

Still felt surreal leaving that office and the next 9 days went slowly.

MY TIMELINE:

12/22/16  Routine Screening Mammogram

01/18/17  Repeat Imaging and US of left breast; LUMP found.
01/20/17  Core Needle Biopsy
01/24/17  Biopsy results positive...Stage 0 DCIS, left breast
01/25/17  Meeting with Breast Center Navigator and Genetic Testing
01/30/17  Consultation with Surgical Oncologist, Dr. K

Treatment Options & Genetic Testing

So, here we are on 01/25/17....I was diagnosed yesterday with Stage 0 DCIS in my left breast.  Today I am heading to the Breast Center to meet with the Patient Navigator and the Genetics Nurse for Genetic Testing........

In the Breast Center:

A mastectomy pillow (goes under your arm) given
to me at the Breast Center.

I arrived at the Breast Center and was greeted by the Breast Center Patient Navigator, "A". She was very sweet and very knowledgeable.  Please be sure to check with your facility to see if they offer this assistance.  It is very helpful, especially in the beginning to have someone who knows the ropes to guide you through all of the information, appointments, and help you choose the best physicians for your treatment.

"A" started by going over my biopsy results in detail and discussing what it meant.  I had researched some online the night before based on our previous telephone conversation, so by the end of our talk, I felt like I had a thorough understanding.  We discussed my treatment options next.

For me, Stage 0 DCIS, does not require chemotherapy.  No chemo...this was good news.
It does require surgical intervention though because left untreated, DCIS becomes invasive and can spread.  "A" assured me that all 3 of my surgical options were good and produced positive outcomes for patients.  

Here's how my options were laid out:

Option 1: Lumpectomy followed by 5 days/week x 6 weeks of radiation and 5 yrs of hormone suppression medication (leading to menopause symptoms).

Option 2: Left (unilateral) mastectomy and reconstruction followed by 5 yrs of hormone suppression....no radiation.

Option 3: Double mastectomy and reconstruction ....no radiation, no meds

Additionally, if the latter two, there is implant vs natural tissue reconstruction.

All of these would be discussed in further detail with the Surgical Oncologist. My Surgical Oncologist would be the one to provide the statistics on the options, but "A" said that none of them would be "wrong".  This is most definitely a personal choice.  

We also discussed the physicians in the area and the ones that the Breast Center recommends.  I had already been told by several friends and coworkers that Dr. K was the absolute best for Surgical Oncology. "A" confirmed this and started working on setting me up with an appointment the following Monday.  "A" told me that I would hear from her or Dr. K's office to confirm my appointment.  She also recommended a Plastic Surgeon (from the group I had already heard about from friends) who works closely with Dr. K and is excellent with the natural tissue reconstruction option.  She would work on getting me an appointment with his office, as well.  She was anticipating that I could have surgery in just under a month...around Feb. 23rd.

I was then introduced to the Genetics Nurse, "E".  "E" explained the testing process and had several charts to show me how it worked and what the results would entail.  Most people have heard of BRCA 1 & 2 testing (thanks to Angelina Jolie), but my test would cover 28 genes.  The genes being tested would cover not only my genetic predisposition for breast cancer, but for 8 different cancers.  This was the one I took:

It was a simple saliva test...basically spitting into a test tube....a lot of spitting!  
We discussed what the findings would mean for my family....like the fact that regardless of the results, my niece should start getting routine mammograms at age 30 (instead of 40) just because she now has an Aunt with breast cancer.  Results would be available in 7-10 days.

I left the office with a ton of information swirling around in my head!  So many numbers and details.  This is one of those times, you want to have something to write things down on (or another person to take notes/listen).

It's all a bit overwhelming, but I felt good after my appointment.  Again, for me, this all signified a working, active, plan...things were moving in a positive direction.  I spent the rest of the day and evening updating family and friends and reading about the surgical options online.

I encourage you to be proactive if you have received a breast cancer diagnosis. 
Arm yourself with information and don't hesitate to advocate for yourself.  
Ask lots of questions!  
Write everything down and start a folder or file to keep all of the paperwork you will gather along the way...there is a bunch!  

Please feel free to comment or to ask questions if there is something you'd like to know more about.  I'm happy to share anything that might help you in your journey.

MY TIMELINE:

12/22/16  Routine Screening Mammogram

01/18/17  Repeat Imaging and US of left breast; LUMP found.
01/20/17  Core Needle Biopsy
01/24/17  Biopsy results postive...Stage 0 DCIS, left breast
01/25/17  Meeting with Breast Center Navigator and Genetic Testing