Battle Scars!

                                 WARNING:  THERE ARE GRAPHIC POST-OP PHOTOS IN THIS POST.

Just for fun and my fellow Lethal Weapon fans...



My scars aren't as exciting as Riggs' but my new ones sure come with quite a story, huh?

 4 Weeks Post-op:  This is my lymph node biopsy incision just under my left armpit.
It looked "lumpy" up until about a week ago, but now it is very smooth and flat.  I kinda like this one...
it peaks out from my tank top and bra like a badge of honor...my reminder of what God has done!

Just wanted to post an update this week to let y'all know how things went at my one month post-op appointment with my Plastic Surgeon (if you follow my page on Facebook, you already know....@bosomthing) and let you know what I've been up to:

Waiting on Dr. O to come in for
my 1 month follow-up!

It was a great visit and basically, Dr. O said that I am ahead of the curve for one month out!  He was happy with my progress and how all of the incisions look.  He was also quite pleased with the symmetry of my new breasts as the swelling has gone down.  Dr. O feels like there will not be much to do during the Phase 2 Revision surgery since they look so symmetrical now.  He will do some fat grafting, lipo, and scar revision, but we will discuss that in more detail at my next appointment.  He wants to see me in 6 weeks to get started planning and scheduling Phase 2!!

 4 Weeks Post-op:  My incisions are all pretty much healed...one small
spot under my right breast still has a scab.  I am doing twice daily massage
w/cocoa butter lotion and it really helps with the firmness in my breasts that
I feel in the evenings.  Everything is quite symmetrical on top!

Dr. O also released me to  return to week next week!  I'm ready but not ready for that one. Feeling a little nervous about the long hours and being so busy, but I spread my days out a bit so that I'm not working two shifts in a row.  I am excited to get back to see my coworkers and taking care of the babies and families.  6 weeks is a long time to be gone!

 4 Weeks Post-op:  You can tell better at this angle, that there are little
"overhangs" now on both ends of my incision.  Dr. O said this is normal and expected
as the swelling goes down, but he will remove them in Phase 2.

One of the best things....he said as long as I wore a bra, I could lay on my side! It is AWESOME!  Just to get off of my back is fantastic.  I have also been able to lower my incline and can actually lay flat this week.  

Overall, I feel good!  I am experiencing the common "shooting" nerve pains every so often across my chest.  It doesn't seem to have any real rhyme or reason, but I do think it happens more when I am tired and/or have done a lot with my arms.  Other than that and a little abdominal tenderness by bedtime, I have no complaints.  I am trying not to overdo things, but I am pretty much able to do the regular day-to-day stuff without issue. There are still a few top shelves in the house that I can't quite reach yet!  

On Saturday, I walked in my first 5K!  Yes, I walked the full 5 K exactly 1 month and 2 days post-op!  It was exhausting but so worth it.  My son walked with me and it was a really cool experience.  If you have not had the opportunity to participate in a Komen Race for the Cure event, I highly encourage you to do so.  Being surrounded by ~30,000 Fighters/Survivors/Supporters is an amazing thing!  I'm not going to pretend that I wasn't worn out afterward because I was!  Pretty much spent the rest of the day and evening chillin' on the couch, but it was a good kind of tired and I'm so glad I participated!

#pinkchampion   Komen SA Race for the Cure 2017

#pinkchampion   Komen SA Race for the Cure 2017

#pinkchampion   Komen SA Race for the Cure 2017
I walked the wh0le thing!

Since I'm headed back to work in 5 days, my parents gifted me with a cleaning crew to come deep clean the house today!  Waiting on them now and trying to resist the urge to clean house BEFORE they arrive!!  This is a sweet gift and much needed!

Anyway....that's my past week! How about y'all?

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!

T-minus 11 hours.....

The big day is tomorrow...11 hours from now I'll be checking in at 0530.

I think I'm ready...I've made my list and checked it twice..or three or four times. ;)

Still need to finish packing for the hospital but other than that I think I'm basically ready.  Every nook and cranny of the house has been cleaned...I even cleaned inside my oven this weekend.  It just felt like there was a lot to do and not enough time, but now I'm sitting here looking for things to do.

Friday was my last day at work and my amazing  coworkers threw me an awesome party!  Since my birthday is also tomorrow, it was a combination birthday/send off.  We had tons of food and they gave me such sweet, thoughtful gifts.

My coworker made this cute cake!

In our main hallway

Each card inside has a personal note written
on it from my friends!

Yesterday, we had a little family celebration.  And today, my son and I went to church and then out to lunch.  Then, I took my son by the library to pick up a few books for him to read....he will have a lot of downtime too.  After that, it was time to head out to the hospital for my lymph node injection.

I was taken to Nuclear Medicine and had to undress from the waist up.  I wore a gown open to the front and laid down on the imaging table.  The tech marked the left shoulder with a felt marker and the word "yes"!  

The radiologist then came in, did the timeout, prepped the breast and injected the dye just under the skin near the areola.  

This was NOT as bad as I had imagined or read.  It truly was a tiny needle stick.  It DOES sting quite a bit as they push the fluid in, but it is over in about a minute.  The stinging initially felt like a bad bee sting, but then more like an ant bite.  She told me it was very similar to a TB test and she was spot on!





The Nuclear Med Tech moved my table into the machine, took one image , and then I was done.

Image taken right after the injection...the dye will be taken up into my lymphatic system
overnight so that Dr. K will be able to identify the sentinel node in the morning.

Tonight, I have to drink 24 oz of a pre-op drink then nothing after midnight.  Tomorrow morning, I have to drink another 12 oz of the same drink and take a Celebrex pill before I arrive at the hospital.  It'll be a very early morning and a long day.

Mentally, I feel ready...let's just get his done.  Although, the reality of the whole lymph node biopsy is a bit scary.  That is really my biggest concern right now....coming out of this surgery and still having cancer.

I have so many wonderful friends, family, and even strangers who are praying for me right now and it is definitely felt.

"Be joyful in hope, patient in affliction, faithful in prayer."
Romans 12:12

"Do not be anxious about anything, but in every situation,
by prayer and petition, with thanksgiving, present your requests to God."
Philippians 4:6

I researched a lot on what to pack and what I needed to have at home.  I plan to do a post on that subject soon so that I can tell you what worked and what didn't, if I forgot anything, etc.

In the meantime, I'm going to chow down on some dinner before that NPO status kicks in!

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!

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