Happy Anniversaries and Nerve-wracking Moments

Since September we have been celebrating various cancer-related anniversaries: The day the bleeding started! D-day (diagnosis day)! The anniversary of surgery #1! Typically these anniversaries involve eating lots of good food and drinking some yummy craft beer or fancy bottle of wine and just thinking about how much has happended in the just-over-a-year since it all began. Given that everything turned out so well, these are very happy anniversaries.

Recently, however, we got a reminder of all the worries and anxiety we were dealing with last fall and winter. Just a couple weeks ago I went for a regular MRI (I will be having these either once or twice a year, I can't remember) and received a call from my doctor that there was something visible in the MRI that warranted a follow-up ultrasound. They felt it was very benign looking and nothing to worry about, but that I should still do the follow-up scan to better characterize this mysterious little "nodule." Depending on what they found they might have to recommend a core biopsy - - the same procedure that had me bleeding all over the floor and fainting last year!

I was totally fine leading up to the appointment and then the night before I became so nervous that I started getting really cranky and irritable. The next day I was sick to my stomach and couldn't eat lunch. At the ultrasound, the tech spent an awful lot of time go over one particular spot. It reminded me of the ultrasound I had last year, when the tech kept focusing on the same one spot and looking all concerned. Last year, the tech was concerned because she saw something she didn't like. This year, as it turned out, the tech was all concerned-looking because she couldn't find anything where the MRI had shown the suspicious finding. She called in the doctor, who redid the entire ultrasound and confirmed that the "nodule" was nowhere to be found. In the end, she decided she will compare last year's MRI to this year's before making a final assessment, but said she is not worried at all about what she had originally seen - it could have just been the curve of a blood vessel.

I was instantly reassured and completely trust this doctor's instincts; however, for nearly 24hrs leading up to that moment, I found myself once again thinking about surgeries, treatments, radiation, chemo, drugs, implants, wigs, hair scarves, drains, pain, taking time off, etc, etc. How happy I am that I was able to walk out of that doctor's office and leave all those thoughts behind me.... I suppose this calls for another celebration!

This holiday season I am definitely grateful for my health and the health of my family.

The SCAR Project & Making Strides Against Breast Cancer

I don't remember when I first heard about The SCAR Project. It was probably through the YSC. Yesterday, D and I got to visit the last day of the 2nd annual gallery exhibit of The SCAR Project, a collection of images of young women facing breast cancer, beautifully photographed by David Jay.


The SCAR Project website explains:
The mission is three-fold: raise public consciousness of early-onset breast cancer, raise funds for breast cancer research/outreach programs and help young survivors see their scars, faces, figures and experiences through a new, honest and ultimately empowering lens.


For me, this project is so special because when I was doing my research for my own cancer surgeries and decision-making, the one thing I could not find enough of was good examples, and images, of other young women who had been through a similar experience. 
I hope to soon get involved with this project. Please check it out here:


The SCAR Project website


The SCAR Project Facebook Page


Also, last month I participated in the American Cancer Society's Making Strides Against Breast Cancer walk in Central Park, as part of the New York-Presbyterian hospital team. I raised nearly 2X my $250 goal and it was a nice way to celebrate finally circling back around to a year since this all began! Click here for my donation page and for more information please go to the American Cancer Society's Making Strides Against Breast Cancer website.

Can't a girl catch a break?!

Last night I had emergency surgery to remove an ovarian cyst I didn't know I had. What's worse is I am smack in the middle of my orientation for a new internship program I have started.

Saturday night D and I were celebrating his grandfather's birthday with his whole family. I was having weird discomfort all night but I thought it was a GI issue - - maybe I ate too much or had gas or something. Trying to go to the bathroom didn't help though.

I made it through all of Sunday (yesterday) feeling perfectly fine as usual. Then, around 10 or 10:30 PM I started developing a bit of an abdominal pain that started spreading and becoming more and more painful and violent. Before I knew it I was crying in excrutiating pain (and I actually have a really high pain tolerance!). I was pretty sure it must have something to do with my new IUD. If not, then it had to be GI-related or maybe a UTI.

We called my OB/GYN since the IUD was my first thought. She was concerned I could be pregnant despite the IUD, or have ruptured a cyst. She advised us to go to the hospital she is affiliated with so that she could come take care of me if my condition warranted a visit from her.

While trying to put on some clothes to wear to the hospital, I ended up sprawled on my bedroom floor in pain. Something was definitely wrong.

At the hospital, once we finally were given a bed in the ER, my doctor's team, a resident and a PA, came to see me. After a pregnancy test turned out negative, they explained they were concerned I had a cyst and did an ultrasound to look for one. Sure enough, I had a moderate to large cyst (5 x 7 cm) on one of my ovaries. They explained how a cyst can cut off the blood flow to an ovary so you have to remove a big threatening cyst like that or you can lose your ovary. They were pretty sure I was going to have to go immediately into emergency surgery, but were waiting for my doctor for the final word.

When my doctor came she basically confirmed everything they said except that she didn't think the blood flow to the ovary was being cut off. That said, it was a large cyst and I was in a lot of pain, so there was no room to send me home "under observation" - - I was definitely going into surgery ASAP. I would not be going back home without having surgery first.

By the time I was being wheeled into surgery it was probably around 4AM this (Monday) morning. As they pushed me to the OR in a wheelchair, all I could think was "I can't believe I'm about to have another surgery!" It just didn't seem real. It didn't seem possible!

Before the surgery my doctor had explained that depending what kinds of incisions she had to make and what she found once inside, I could be in the hospital anywhere from just that day, to three days, to up to a week. Fortunately, I ended up with the most ideal situation: she was able to do the surgery laparoscopically, with just a slit above either hipbone, and the ovary was not cut off from its blood source and did not have to be removed. I could leave the same day. (Since coming home I found out from D that the cyst actually ruptured sometime between the ultrasound and the surgery.)

I spent the whole morning recovering in the PACU. I was allowed to eat but my mouth was so dry and no amount of ice chips, water, tea, cranberry juice or losenges was helping. So I felt like I was choking on the eggs that my brother-in-law brought back for me. When D brought sugary croissants it was exactly what I needed to get the salivary juices flowing! I also finally managed to pee too. I had a lot of discomfort but as soon as my CBC results came back normal, I could go home!

I was given some basic discharge instructions and a presription for percocet, which I had already had at home from my last surgery. At home I took some drugs and then we snacked and napped. As soon as the 6 hours of drug effectiveness was up, I felt a sharp pain shoot through my abdomen. I took more drugs and we ate dinner. Now, I am still walking funny and sitting up straight is a challenge, but the drugs help enough that I am going to try to make it back to school tomorrow. Wish me luck!

What a night.

The Pink Daisy Project

I just read about this great resource in this article on CNN.com

Check out their website here: The Pink Daisy Project

Breast Cancer in the News - - Here's What I'm Reading

When a Breast Cancer Surgeon's Mother Undergoes a Double Mastectomy
Washingtonian - July 5, 2011

Brooklyn Cancer Survivor Receives Donations Of Breast Milk For Her Baby
CBS New York - July 28, 2011

Breast Cancer: Tamoxifen Saves Lives but Some Women Go Without It - ABC News
July 29, 2011

            

'nuff said

Found this picture on another blog and thought it was perfect for mine: Live the Charmed Life

Clean Boob of Health

If you hadn't guessed by my month-long departure from this blog, we finally went on that long-awaited, much-deserved vacation I had been looking forward to. We went to Brussels, with day trips to Bruges, Leuven & Amsterdam, for about 9 days in May and had a wonderful time. Usually when we go on vacation I can immediately forget about everything I'm leaving behind and just bask in the relaxation and fun and culture of the trip. This time, it took me until at least half-way through the trip to finally start to relax and shed all the stress I had brought with me. Leading up to the trip I had been trying to finish up all my coursework, from my two incomplete classes at school. I had assignments and exams to makeup and was such a stressed-out mess that my face broke out in stress-induced dermatitis (according to my new dermatologist). We've been back from Brussels just over two weeks now and I'm finally beginning to feel like a normal person again. And it's summer, my favorite time of year, so I'm the happiest girl in America right now!


Today was my first post-mastectomy, post-implants mammogram of my right breast. I was really nervous about squishing my implant in that crazy machine. I had to sign a paper stating that I understand that while it is extremely uncommon, there is a possibility of implant rupture and further, that the benefit of the screening outweighs the risk of an implant rupture. It was explained to me that normally only two images are taken of each breast (only one breast in my case), but that with implants four images are taken: two of the whole breast (front & side) and two of just as much breast tissue as they can image while pushing the implant as far into the back of your chest as possible (front & side). I have had a mammogram before so I wasn't surprised by the yanking and pulling, followed by incredible pressure; but when the technician had to push the implant out of the way in order to take a picture of just breast tissue alone, that was definitely a bit uncomfortable. In the end all that matters is that when the doctor called me to her office to review the results of the exam, she gave me a clean boob of health! Woohoo!


My technician was a young girl who's friend was just diagnosed with breast cancer. The friend, who is only 37, has two young children. I told her to please tell her friend about Young Survival Coalition, so I think it's fitting that I give another "shout out" here to the YSC. Young Survival Coalition's website and support group meetings were very helpful to me before each of my surgeries. Check out their website here.

S-T-R-E-S-S

The word "stress" does not even begin to describe what I've been experiencing the past few weeks. Between still reeling from our cancer experience, running around like crazy in order to take make-up classes at school during lunch breaks and early evenings from work, and deadlines for a final paper and final exam approaching, plus the non-stop stampeding of the toddler upstairs, I've been ready to blow my top any second.


Over the past two or three weeks I developed some scaly dry red patches under my nose and on my chin. I went to a dermatologist who decided it looked like a type of dermatitis triggered by...you guessed it, stress! She said "Have you been under a lot of stress recently?" My first reaction was just to laugh. Sometimes when there's nothing else left, that is all you can do. This morning, D went to a cardiologist for a chest pain he'd been having. After thoroughly checking his heart and lungs it turns out it's probably just...yep, stress.


The good news is that after busting my butt for the past few weeks, I've crossed most of my responsibilities off my list and this weekend all I need to do is make two tiny adjustments to my final paper and continue studying for my exam next Wednesday. I'm so prepared that I don't have to cram all weekend either. Our yoga teacher is out tomorrow but I think we're gonna hit up our back-up yoga spot. The best news of all? Our vacation is getting closer and closer.

Bottom's up?...Hold that thought!

Recently I decided to limit my alcohol consumption to no more than 3 drinks per week (giving up alcohol for Lent helped me "reset" my wine-drinking habits). I decided to make this change because I know that alcohol consumption is associated with an increased risk for breast cancer. I want to do everything I can to prevent a recurrence or new cancer. When I explain this to people they are always surprised. They had no idea that consuming alcohol could increase your risk for breast cancer and that the risk increases with increased consumption of alcohol.

The American Cancer Society says:

The use of alcohol is clearly linked to an increased risk of developing breast cancer. The risk increases with the amount of alcohol consumed. Compared with non-drinkers, women who consume 1 alcoholic drink a day have a very small increase in risk. Those who have 2 to 5 drinks daily have about 1½ times the risk of women who drink no alcohol. Excessive alcohol use is also known to increase the risk of developing cancers of the mouth, throat, esophagus, and liver. The American Cancer Society recommends that women limit their consumption of alcohol to no more than one drink a day.

While the American Cancer Society refers to a "one drink a day" recommended limit on alcohol consumption, a pamphlet I have at home, from breastcancer.org, entitled "Your Guide to Reducing Your Risk of Breast Cancer" recommends limiting your alcohol intake to "fewer than 5 drinks a week."

If you want to know what you can do to reduce your breast cancer risk, limiting your alcohol is one place you can start.

For more information on reducing your risk for breast cancer, visit the American Cancer Society website or breastcancer.org.

Time to hit the books...and get some "Crazy Sexy" inspiration!

Two weeks ago I did my best to sneek into a classroom and be the best "guest" I could be, sitting out of the way and being as quiet as possible.

This week, however, was my first week really back in the swing of things, as I returned to both of the classes that I had taken incompletes in last fall. I spent Monday running back and forth between work and school in order to fit 2 classes into my day. Once again, I sat in a corner and didn't participate. I felt like I was crashing a party. This wasn't really my class, so I should remain as invisible as possible. Then I realized, "I'm doing it again. I need to stop apologizing for my cancer!" I have just as much right as anyone to raise my hand and speak up, plus it will probably help my grades. So, with the 3-1/2 weeks I have left of this make-up semester, I plan to fully participate as much as possible.

On another note, I got a great reminder today about a cancer survivor who's story and website I absolutely love. Kris Carr was diagnosed with a rare and incurable cancer in her early 30s. Her reaction was to set off on a hunt for alternative therapies, filming the whole thing along the way. I saw Kris Carr's documentary, Crazy Sexy Cancer, when it premiered on TLC in 2007, and immediately fell in love. I remember thinking Ms. Carr was so likable and truly admirable. But I completely forgot about this wonderful resource as I was going through my own journey, until a friend reminded me about her today. Just this morning I was thinking I wanted to get a new book for our upcoming vacation. I think I'll get Kris Carr's Crazy Sexy Cancer Survivor. Cancer or no, I strongly recommend you check out Kris' websites (also listed under "Breast Cancer Resources" in the right frame):

Crazy Sexy Cancer

Crazy Sexy Life

A New Start, Courtesy of Lent

Lent began just over a month ago on Ash Wednesday, March 9. Catholics traditionally give up something during the observance of Lent, from Ash Wednesday until Easter. I love Lent because I view it as a fun and exciting opportunity to challenge myself and start fresh with a change of pace. I love that Lent comes at the start of Spring. It's the perfect time to make a new beginning by changing bad habits. This year, Lent came at a time when I was also thinking about how to take even better care of my health, to do everything in my power to protect my body from a cancer recurrence or a new cancer. From the time I found out I had cancer, I had slacked off on my healthy eating behaviors and I had developed some bad habits I wanted to correct. I know that alcohol consumption increases breast cancer risk and that this risk increases with increased consumption of alcohol. I love wine and was in the habit of drinking a glass or two with dinner every week, a few nights per week. I also had some food consumption habits that I wanted to break. This year for Lent, I really went for it, giving up all of the following:

• Meat, 100% (For the past year we've been vegetarian with a once-a-month meat benefit but during Lent meat is completely off limits for both me and my husband. We still eat eggs, dairy, fish & seafood.)
• Wine (& all other alcohol)
• The decadent milk hot chocolate from my absolute favorite spot (I'm not giving it away that easy!)
• Butter (I had been using the best real butter option, Land O' Lakes Light Butter w/ Canola Oil, but have switched to I Can't Believe It's Not Butter Light)
• My favorite Organic Valley 1% Organic Chocolate Milk (I have limited these to one per day. It was not a regular occurrence for me to drink more than one per day but it certainly happened every now and then. I am limiting these because they are 1%, not skim, and the chocolate flavor means added sugars.)

For more information on risk factors for breast cancer, please see this page from the American Cancer Society website.

Young Survival Coalition

When I first got my diagnosis I, of course, scoured the internet for anything I could find on breast cancer, especially resources for young women with breast cancer. I came across the website for the Young Survival Coalition, which has its headquarters in Manhattan and affiliates throughout the United States.


The YSC is a support and resource group for women who were first diagnosed with breast cancer before the age of 40. YSC has monthly support group meetings where women can discuss whatever is on their mind at the moment. I went to two support group meetings - - one before each of my two surgeries. I met such wonderful women there who helped me prepare for and get through my surgeries, emotionally and practically.


This week, in New York, March 30 at 630PM, YSC is hosting an informative event called Exploring Complementary and Integrative Medicine.


To learn more about the Young Survival Coalition, click here.

Big Plans for the Weekend

So maybe this doesn't really sound like a big plan, but it is, I assure you. Today marks four weeks since my second surgery (Friday, February 18 - Friday, March 18 to be exact). This means that starting tomorrow I can work out again! And THAT means that tomorrow morning, D and I are getting up bright and early to head to our regular yoga class. I'm very excited to get back out there. I'll probably be signing up for some dance and Zumba events soon and can't wait to get back to my kickboxing class at the gym!

Back to Life, Back to Reality

Monday was my first day back at work in over two weeks. Readjusting to a work schedule was rough but overall, it went well. Tuesday, D and I went to a second follow-up with my breast surgeon. She said everything looked good and I don't have to see her for another six months. I will have annual mammograms and MRIs but they will not be at the same time. They will be spaced apart. My next mammogram will be in June and my MRI will be in October/November. Or maybe it's the other way around. I can't remember right now. Yesterday I met with one of my teachers from one of the two classes that I had to take incompletes in. She is teaching the same course at the same day and time and they are almost at the same point in the semester where I left off. She suggested I start sitting in on these classes so that I can make up my coursework on the same schedule as the current students and get to hear the actual lectures. I think it's a great idea, so in April I plan to start sitting in on these courses. Tomorrow I meet with my other teacher and my hope is that I can do the same thing with her class. Besides making up my coursework the two other things I'm really looking forward to are being able to workout again and taking a well-deserved vacation. Mom & I took a four-week set of dance classes awhile back. It was a lot of fun and I think I will check out their upcoming schedule to see what I can fit in with my new school schedule. Then, D and I are hoping to be able to get away in the coming months. Our last really big trip was Iceland. After that we did Portland, Oregon. I initially wanted to go someplace warm where we could do lots of outdoor activities like hiking, horseback riding, kayaking, etc., so we were looking at going somewhere in Central America like Belize, Costa Rica, Nicaragua or Guatemala. Turns out Guatemala is in their rainy season at the time we want to go, while Nicaragua is way too dusty & hot. Costa Rica seems too touristy and too much ON the beaten path. Belize seemed like it was the destination of choice but we just can't seem to figure out a trip plan that we are happy with. So now we're just being really open-minded, searching for deals on flights and packages to almost anywhere. At this point I'm starting to think I'd prefer a relaxing vacation in a European city, getting breakfast in a cafe every morning, taking the metro everywhere and just roaming around a cloudy, cool European city checking out museums and whatnot. As of tomorrow I have one more week before I can start working out again. I can't wait.

Before I go, here's an article I found yesterday, from the Today show website, about pregnant women with cancer, seeing their pregnancies through (click the hyperlink):

Pregnant with cancer, women struggle to heal for two

Outlook Good

Reading over my last few posts I realized that I was really upset two posts ago ("Spoke too soon?") and improving in the previous post ("32C") but that I hadn't yet written to tell you how I'm feeling now, five days after that last doctor's appointment. Gradually over the last five days I've started to feel really happy with the results of my implant surgery. The steri-strips (a white tape the doc puts over the incision) are completely gone now and I can clearly see what I'm dealing with. It's not bad. It's actually pretty good. Firstly, the mastectomy scar still looks surprisingly really good even after being re-opened. Secondly, the differences in the two breasts really aren't as dramatic as I made them out to be. Basically, I think what happened is that when I came home from surgery and took my first look at the results, I jumped the gun in getting so excited about how perfect they looked. In the back of my mind I knew there was a good deal of swelling contributing to the two breasts looking so similar, but I wanted to be positive and happy and excited. As the swelling went down though, reality set in. They are never going to look like a proper pair. (But hey, my original boobs were actually pretty dissimilar to begin with!) Now I'm feeling really happy with them and am back to my old feelings of "I don't think I want a lift" and "I definitely don't want to mess around with nipple reconstruction." However, I know that they may continue to change a bit as they settle and so, again, I am keeping an open mind and just seeing how I feel, and how they look, over the course of the next few months.


Everything else is great. I'm missing the gym, of course. I still have 2-1/2 weeks of no gym and it's driving me insane! I've started reviewing the work I had left off with when I left school towards the end of the semester. I have until sometime in May to complete those two courses. And I'm getting ready to return to work next week. Next week I also have a dietetic internship interview, so wish me luck!

32C

Friday, D and I went to my first follow-up appointment since my implant surgery. I had been feeling pretty down all week because I was a little disappointed with the results of my surgery and felt like I was probably going to be needing a third surgery. By the time the day of the appointment came around I was starting to feel better and since seeing the doctor I feel fine now. Basically, the plastic surgeon explained that he didn't do the lift as planned because once he put the small implant in my right breast it was actually lifted up a lot, and very much in line with the left breast, and doing a lift would not have been much more of an improvement. Knowing that, he decided to not cut up and scar up my right breast anymore. He also pointed out that the two implants may settle slightly so if we do a lift at all we would probably get a better result from doing it after first waiting a bit. I'll be following up with him regularly but in about 3 months we'll see how the two breasts are sitting and will decide whether a lift will be beneficial, at that time. He also still wants me to consider getting the nipple reconstruction. He pointed out that even though it doesn't bother me to have a scar in the place of a nipple on my left breast, doing the nipple reconstruction may make the two breasts look similar enough to distract from the differences that I currently see and had been bothering me. That's fine with me. I'm willing to remain open-minded and wait the three months to see how I feel.

The same day I went to Victoria's Secret to treat myself to a fancy new bra. I have one more week before I am allowed to wear normal underwire bras again. A sales girl measured me and told me I am now a 32C. I was really surprised to hear that because I feel like I still have pretty small boobs and look just like myself, but I guess it's all about the fullness up top, which I definitely have more of now. She asked me what I was looking for and I explained that after two surgeries for breast cancer I just wanted to treat myself to something nice but no longer need all the padding most of their bras come filled with. She told me she too was a cancer survivor, a different kind, and led me to some really nice padding-free bras. I found this absolutely gorgeous,classy, lacy number and of course...they didn't have my size. Later the same day I tried the huge Victoria's Secret at 34th street but again, no luck. While I was there I told a second sales girl my story and she told me four different people in her family had had breast cancer and one wasn't doing so well. We're everywhere.

With two surgeries now behind me and D starting a new job Monday, we decided to head to the North Fork yesterday for a much deserved break. We had been there over Columbus Day weekend and had absolutely loved it. We'd been dying to go back. We spent the day tasting good wines and eating great food (and stocking up on our favorite Pinot Noir Mustard). Back at the B&B we layed in bed watching TV on the laptop. It was such a perfect relaxing day.

Tomorrow it's my mission to find that damn bra in my size! (It's on backorder online.)

Spoke too soon?

Today is Monday, three days post implant surgery. A lot of the swelling has gone down and I've removed the top part of the dressing (as instructed by my doctor). When I first came home from the surgery my new boobs looked pretty similar: high, round & similarly shaped. Today, the right one looks more like it used to: it's sitting a bit lower on my chest than the left boob and it is sort of swaying out to the right side of my chest. My doctor tried to get away without doing the lift because he knew I was really unhappy about it and about having another scar; however, if this is any indication of what the final result is going to be, this just won't do. The two boobs still look really different as of right now. The goal is to get them looking as similar as possible. I'm worried that I'm going to have to get the lift anyway and that this is going to mean a third surgery. Looking at the steri-strips currently covering my stitches I'm also beginning to realize that just because my mastectomy scar didn't bother me the first time around, doesn't mean it's still not going to bother me now. What if it just looks worse now that it's been cut open a second time? So then, if I have an ugly lift scar and an ugly mastectomy scar, do I consider the fake nipple & areola tattoo? A fake nipple & areola would cover up most of the mastectomy scar. But I'm sure they come with their own issues too. I've heard of fake nipples dropping so much that they are hardly there anymore and of areola tattoos fading. All of this is just driving home the point that there is no good way out of this and that these boobs may be a work in progress for a long time. I'm in such a bad mood right now that some Chardonnay may be in order! (Don't worry I haven't taken any pain killers today.) Tomorrow, D and I are going to go try to find me a new bra. I'm still walking around in my zip-up sports bra even though the doctor said I could wear a regular bra as long as it doesn't have underwire, so maybe that will make me feel better.

P.Y.T. (Perky Young Thing)

So, yesterday went far better than we had expected. D’s brother drove us to the hospital and we got to the registration desk at 6 o’ clock on the dot. I was sent with other patients to get changed and checked-in. My doctor came by and went over the plans with me and then marked me all up. I was so nervous that when a nurse came by to go over my medical history, I just started crying. She gave me a big hug and made me feel a lot better. Once she was done, D, his brother & my mom were all allowed back to see me. The OR nurse came by, as did the anesthesiologist, to ask more questions. Before we knew it we were walking me into surgery. I said my goodbyes and the nurse walked me the rest of the way to the OR. On the way we met up with my anesthesiologist, who was joking around with another guy who seemed to look like the friend-of-a-friend anesthesiologist who took my case last time. I couldn't tell for sure though and I didn't ask.


In the OR room I was freezing cold, which made it hard to find a vein for the IV. They used a combination of blankets, some kind of thermal plastic film and a heater blowing warm air on me, which only made me feel a little more comfortable but at least helped the doctor find my vein and get me set up with my anesthetics and anti-nausea drugs. My plastic surgeon made me feel really comfortable and safe. Before I knew what had happened I was coming to. I couldn't see anything but I could clearly hear my anesthesiologist saying "Diane, it's time to wake up for school!" (which is exactly what he warned me he would say). At this point, I think they were wheeling me to recovery. Or maybe he said that while they were taking out my ET tube and then wheeled me over. I was so foggy and just starting to wake up at that time that I really can't be sure.


As I started to regain consciousness in the recovery room, I remember feeling like I couldn't breathe all that well through my nasal tube, plus the smell of the plastic & oxygen were sickening, so I took big gulps of air through my mouth. The more oxygen I got in me the more I seemed to wake up. My vision was blurry but I made eye contact with a nurse so they could see I was already waking up. D, his brother & my mom all came by almost immediately. They were told to just say "hi" real quick because I needed my sleep, and I agreed. I felt so groggy still. They gave me some good news: my doctor didn't have to do the lift (mastopexy) on the right side (the part I was nervous about). He only put in the implant and that was enough to gain the symmetry we were looking for. Everyone went back to wait for me in the waiting room and I started getting better and better pretty quickly. Soon I was sitting up in bed, then they gave me cranberry juice and saltines, and finally I was moved over into a chair. Before I knew it I could shake my head "no" without feeling tipsy and they were bringing me my clothes and kicking me out. Around the time that they were feeding me snacks and getting me ready to move to the chair, I saw a man who I swore this time was the anesthiologist-friend from my last surgery. I confirmed his name with my nurse and she called him over. We had a nice talk and I got to thank him for taking my case last time. I told him my husband and I owed him big time. I got a wheelchair escort out to the waiting room where my mom said no one had warned them I was coming out, so she had to call the boys, who had gone for a walk, to go pick up the car from the parking lot.


After waiting awhile for the car we were finally on our way. Mom went back to work and the boys drove me home. Back at home D got us some mid-east and Egyptian food for lunch and I took my drugs. Later, in the bathroom, I took off my surgical bra (a weird white velcro-closure sports bra that they send you home in) for my first look at the results. The first thing I was happy to see was that I was not going to have an ugly scar on my right breast too. Since he only did the implant, and no lift, my doctor made a small cut along the lower curve of my areola, so the scar will blend right into that area. I now have two round perky boobs. The right one is huge compared to the left but I think it's due to swelling. As my doctor had warned us, the left breast has already been traumatized so I wasn't going to feel any pain there. For the right boob, however, this is all new stuff, so it's all painful and tender and swollen. Hopefully once the swelling goes down they'll look pretty much the same size. While perky and round, the boobs seem to be pretty close to my old size. They kind of look like how my old boobs used to look like in a push-up bra, the only difference is now they are permanently pushed up...and who can really complain about that? Last night I was able to sleep comfortably on my left side for the first time in a long time (Of course, now it hurts to lay on the right side. Beggars can't be choosy, I guess.).


Today, D went to our regular yoga class (I can't workout for a month) while I slept in a little bit before cleaning up the apartment and having a small snack so I could take my drugs (antibiotics and percocet). D came back and made us breakfast. Since the doctor told D yesterday that there was no reason for me to spend the whole two weeks on the couch, we decided to go out. We picked up our dry cleaning and headed to Barnes & Noble to research travel destinations for our next big trip. We had a sushi lunch at our favorite spot and now we're back home just relaxing, especially since I took my drugs at the start of lunch and by the end of lunch they had me feeling all tired and woozy. Tomorrow I get to shower and Monday I get to pull off the top layer of my dressing. I'll keep you all posted. Thanks for all the well wishes and for checking in on me!

A Farewell to Boobs (as I know them anyway)

Tomorrow is my reconstruction surgery. As I write this I'm sitting in a cafe awaiting a plate of brioche french toast & strawberries. (It's about 130PM - - I specifically searched in advance for a place, close to my hair salon, that sells french toast all day.) I'm trying to fill myself up because last time I did a poor job of eating enough before the midnight deadline. I feel like a Gremlin with this "nothing after midnight" rule. Not being able to eat the morning of my mastectomy made me super cranky. And then I didn't eat for nearly 36 hours because I was "NPO" (non per os aka nothing by mouth) until the morning AFTER my surgery! Even then it was just a collection of disgusting orange flavored "clears" like jello and italian ice. My surgery is at 730AM and I have to be there at 6AM, which means we have to leave by 5AM and up even earlier. Yeesh! Yesterday I decided that if I needed to be ready for surgery and in bed so early in the evening then I wanted the whole day off from work today. I scrambled to get all my work done for the week. This morning I slept late before coming into the city for my hair blow-out (so I don't have to worry about lifting my arms to style my hair while I'm recovering). I visited D at his job before running an errand for him and now I'm sitting here just trying to relax and get into some sort of calm, positive mindset before heading into surgery.

Meanwhile, since my last post I have had my IUD (intrauterine device) implanted. Yowza! I was expecting a pinch during the procedure and maybe some cramping for a few hours after. My doctor told us it would be a "walk in the park" compared to what I've been through recently. I have no idea what she was talking about. It was BAD. As the doctor warned that "now you'll feel some pressure and like a bad cramp," an intense pain spread through my abdomen and before I knew it I was climbing up the wall. I think I squeezed all the blood right out of D's hand. The doctor asked me if I could please try to relax my butt cheeks. Fortunately, the whole procedure lasted just a couple minutes. Unfortunately, the rest of the night was even worse than the procedure itself. In the doc's office they gave me four Advil and I took them all. Almost immediately, severe cramping set in. The train ride home was excrutiating. Thank goodness D was with me. At home I was uncomfortable all night. I could hardly enjoy my dinner. By bedtime the pain was so bad I couldn't get comfortable at all and was really anxious. I had to be up early the next morning for some pre-surgical testing and a final appointment with the plastic surgeon. I couldn't get to sleep. As much as I hate the drug, I ended up taking a Valium in order to get to sleep. Somehow, the Valium neither knocked me out nor made the pain go away but it did make this feeling of calm come over me that allowed me to get to sleep. It was like the first drug the anesthesiologist gave me before my mastectomy. His words were "first I'm going to give you something that's going to make life a little easier," and boy did it! The Valium did the same thing the night of the terrible IUD cramps. Today is two weeks since getting the IUD implanted and believe it or not the bad cramps only started to subside in the past 24-36 hours. They didn't stick around all day every day. They would come and go and get worse at night. But they were definitely there. I called the doctor Monday and she said it is actually normal and my body is getting used to having some foreign object lodged in my uterus. I guess that makes sense.

The next day at our appointment with the plastic surgeon I asked so many questions that I think I drove the doctor crazy. I also think I insulted him on some personal level when I said I wasn't interested in getting a fake nipple, which he highly recommends. In order to end the conversation I told him I was willing to be open-minded and allow myself to change my mind later if my feelings changed. (I don't see myself changing my mind later.) Regardless, in the end I felt I aired out all my concerns and now I feel like I can go into surgery completely confident that he will do what he deems best but also keep my concerns in mind at the same time. Wish me luck!

Loose ends

I just got a very nice reminder that people are actually still checking in on this every now and then. It prompted me to go back and look at what I've posted so far and I realize I left a few loose ends on my last few posts so I'd like to tie those up now.

D and I ended up sticking with the original medical oncologist. We never even saw the second opinion oncologist. We decided within a couple days of seeing the original oncologist that we would just stick with her. I didn't have my Tamoxifen in hand right away because I was ordering it through Medco by Mail, for a discount. I started taking the Tamoxifen the Sunday before last, so about a week and a half ago. I had been feeling really apprehensive about it and thought maybe we should have a ceremonial "first Tamoxifen" moment. The night I took it for the first time I realized I just wanted to get it over with and if I waited for the new week to start I would certainly postpone it until the following weekend. I called D over and decided to just do it. I kind of sat there holding the tiny white pill and just staring at it for awhile. I couldn't bring myself to swallow it. It reminded me of how my brother & I both had issues swallowing pills as children (one of us still does...I won't name names but let's just say I routinely pop Singulairs, Advils & birth control pills with no problem!). I maybe got a little emotional, maybe. But then I tossed the pill into my mouth and it was done: I had officially started my 5 years on Tamoxifen.

More importantly, by episode 7 of season 1 I was sooo over Thirtysomething. What is wrong with those people? Why are they always whining and complaining?! And maybe the topics they discuss were relevant in the 90s but they definitely feel dated in 2011.

Anyway, after my surgery I had stopped reading cancer books (and switched to killing my brain cells with endless Netflix), but this past week I felt a need to return to them. Why I Wore Lipstick to My Mastectomy by Geralyn Lucas is a really great read (even if you are not dealing with your own or someone else's cancer) and really helped me prepare for my first surgery. Now that I have my second surgery coming up (Friday, February 18), I have all new concerns and thought I'd re-read the book from a new perspective. It was just as enjoyable and as helpful as the first time. I also looked up Geralyn on YouTube and she is so freaking adorable. Now I've moved on to Cancer: 50 Essential Things To Do by Greg Anderson. It's a guide for getting from diagnosis, through treatment, through recovery and through life, in a very holistic, body-mind-spirit sort of way. This one has been a little less helpful but really only because I already did or am doing most of what is advised, mostly as a result of trying to live my life this way even before my diagnosis. Even so, I have written down two things I will start to incorporate.

On a related note, I've been working on balancing showing honor & respect for what I've just gone through and what I need (some time off from school, extra rest) with really viewing everything that has happened as mostly a positive experience, and myself as really lucky. Knowing how good I have been feeling through most of this, and how lucky I was to have stopped this thing in its tracks at stage "0," I started the year sort of too gung-ho and feeling like I needed to just jump right back into everything. Work, school, catching up with friends, etc. I am realizing that sometimes I need to take a step back and give myself a break (like I did by taking the leave of absence from school or by cancelling a night out with a friend because I was just too tired and cranky).

Tomorrow after work, D & I are seeing my GYN to get my IUD implanted. I'm kind of nervous about it because I've always heard that it pinches a bit when they implant it and you could possibly be in some discomfort the rest of the night. Also, I've always had crazy reactions to different contraceptives, with only the pill that I've taken for years causing no problems, so I'm nervous that I'll end up with negative side effects from this thing. I guess time will tell.

Friday I have my pre-op testing followed by what I expect to be my last follow-up with my plastic surgeon before the implant surgery. I've got a lot of questions for the doctor. I need to be 100% confident about the next surgery before I leave his office Friday. Right now I still have some issues with the lift and areola reduction on the right breast. So, even though I know it is probably the best thing to do and that I probably will stick with it, I won't be putting my final stamp of approval on it until I've tackled every one of my concerns with him.

So, the other day I ran into a friend at work who is a lady I used to talk to quite often and who always asks when my husband and I will be having kids. She asked me this question again, of course, and I ended up telling her about the mastectomy and the Tamoxifen and the not being able to have kids for awhile. Turns out she had a lumpectomy and radiation and Tamoxifen 9 years ago. She's been fine ever since. Never had side effects from the Tamoxifen. Even the radiation wasn't that bad except that it sometimes made her feel really hot and one time she felt so hot, walking back to work after an appointment, that she thought she might faint. I never knew all this and was so glad she shared. She said the same about me. So who doesn't have a breast cancer story? Every time I talk to someone I find out either they had some kind of cancer, if not breast, or a family member of theirs did. I remember sitting in my first nutrition class ever, back in undergrad, and the teacher saying that something like 1 in 4 people will get cancer in their lifetime (this was...1999/2000-ish) and that if we each considered ourself and 3 friends of ours, at least one of us in each of those groups of four friends, would end up with cancer one day.

Hmm, probably shouldn't leave you on such a grim note. I do want to mention, actually, that I will probably try to start working on turning some things that I wrote during diagnosis, doctor appointments, surgery & recovery, into new posts to share. I realize that there are certain things people always want to know that I really haven't talked about here. What did I do when my GYN told me over the phone that it was cancer (but hadn't yet told me how positive the situation was)? Did I stay at work? Did I run home? Did I cry? What was the hospital like? What was recovery like? I touched on some of this stuff in my "Notes to My Family" emails/posts, but I think there is more I can share. Before that, however, you can probably expect an update from me on how the IUD and the pre-op and the follow-up went.

Wish me luck!

Something's Got To Give

Recently I started to get stressed out thinking about all the things I've got on my plate:

Working full-time; school part-time; 2 incomplete courses to make up; new courses starting January 24; dietetic internship application due February 15; surgery February 18; Tamoxifen & IUD to adjust to...aaahhh!

Just over a week ago I came to terms with the fact that I knew I just could not handle it all. It would be too much for anyone, let alone someone being treated for, recovering from and coming to terms with their cancer. I was at home drinking wine (no surprise), watching an episode of Thirtysomething on Netflix (hey, that was an award-winning, critically-acclaimed show that I was too young to appreciate or even have permission to watch at the time it was on the air!) and generally puttering around trying to figure out what to do. Almost as soon as D walked through the door I blurted out something like "I just cannot do it all! It's impossible! Something's got to give!" (Maybe all that Thirtysomething & wine made me a little more dramatic than I needed to be?) After staring at me with total calm and lack of any reaction, he casually suggested "Well, maybe you just don't take classes this semester," pointing out that the Master's level courses I was about to take were not necessary in order to continue moving toward my internship and RD exam. (Why does he always have to make everything look so easy and obvious?) He was right. If I couldn't do it all, I needed to make a move and taking a semester off was probably the best course of action.

So that was toward the end of last week; however, it wasn't until the weekend that I felt absolutely certain that I needed to do this. Monday was a holiday so first thing Tuesday morning I set to making about a million phone calls to find out exactly what I needed to do and make sure I wasn't going to be penalized in any way. Was a medical leave of absence the right choice or were there other options? Could a leave be processed in time for me to drop courses by Monday the 24th (the last day to drop and get all your tuition & fees back)? Would I still have access to my online account (the portal that gives you access to your school e-mail, all the information you need for your courses and all the library materials available electronically)? What would happen to my loans? What would happen to my scholarship? What did I need to fill out or provide in order to process the leave of absence? Believe it or don't believe it, getting the answers to all these questions and getting a doctor's note from my doctor took much of the last four days (including today). Just now, in the process of writing this, I received confirmation that my doctor's note was received, my leave will be processed and my classes will be dropped for me. Phew.

So, what's next? Well, did you SEE that To Do list above? I've got about 3 weeks to get my dietetic internship application completed and submitted, so I'll be working on that. Also, 3 days after that is due I have my next surgery, so I'll be spending the next few weeks preparing for that, both mentally and with pre-op and follow-up doctor's appointments.

Meanwhile, I don't know if you even want to watch this, but this is the story, aired on the Today show (gotta love Meredith, Matt, Ann & Al), of a little 3-year-old girl who was diagnosed with a very rare juvenile form of breast cancer. Thankfully, she is now cancer-free and her prognosis is good. Insane.

Breast Reconstruction is NOT Breast Augmentation

Let's get something straight. Having breast reconstruction surgery is not the same as getting a boob job. "Who would think that?!" you might ask, appalled. But plenty of seemingly well-meaning people have said some pretty crazy things to me about my soon to be new boobs. I think people want to say something positive and so the first thing they think is "well, you get a free boob job in the process!" or "well, you'll have perky boobs for the rest of your life!;" however, for many of us going through reconstruction, it certainly doesn't feel that way. Don't get me wrong, I've read some comments from people who were never happy with their breasts or their body and are actually happier with their new boobs or with the tummy tuck they got through TRAM flap surgery (transverse rectus abdominus myocutaneous; a procedure in which the new breast is made from abdominal tissue). On the other hand, several women I've spoken with, who have already had reconstruction, are very unhappy to have had to go through this process and are very unhappy with the boobs they now have.

Let's think about this. A breast augmentation, or "boob job," involves adding an implant to an existing breast, without altering the function of the breast and while minimizing scarring as much as possible. You can take out your implants later, if you change your mind, and still have your breasts there. As long as your breasts were functioning before, and as long and you suffered no complications from the surgery, you can still breastfeed. You still have sensation. You still have an areola and a nipple.

Mastectomy plus breast reconstruction involves removing the breast tissue, plus skin and the areola/nipple area (in some cases the skin, nipple and/or areola are able to be spared). Your milk ducts and lobules are gone. Your nipple and areola are gone. The skin loses sensation and becomes numb to the touch, so you can't feel anything over most of the breast area. Typically, and in my case, a tissue expander is placed and the remaining skin is stretched to make room for an implant. The implant will create the shape of a breast, AKA a "breast mound," so that you can wear normal clothes & bathing suits without worry, but is not actually a breast. You can't breastfeed from the affected side anymore. If you lose or gain weight, the "breast mound" will not grow or shrink with you (same during pregnancy). I like to think of it as a permanent/semi-permanent (sometimes implants need to be removed or replaced) subcutaneous prosthesis. It sits there, under your mastectomy-scarred stretched skin, taking the shape of a boob so that no one will notice as long as you're dressed. If you want, you can have your plastic surgeon fashion a new nipple out of the skin on the "mound" and you can have an areola tattooed around it (and the "nipple" colored in). You can also opt to have both the areola and nipple tattooed on. Apparently there are some great tattoo artists out there who can make some realistic-looking 3D nipples and areolas. Unfortunately, you never really get your nipple and areola back.

In my case, since I only had a mastectomy on one side, there is also the issue of altering the right breast to match the implanted boob on the left. This is the point where you should be thinking "Hang on, after all that you now have to cut into, and mess around with, your only remaining, healthy, intact breast as well?! That's crazy!" Yes, yes it is. An implant is round (unless you're talking the new-fangled teardrop shaped implants, which surgeons apparently are still figuring out exactly how to work with). This means that implanting the left side alone would leave me with one very round perky boob sitting high up on my chest and one normal, sloping breast sitting significantly lower. In order to make the two sides match I will need to have a slight breast lift (mastopexy) and a very small implant on the right side (to match the "curvature in the upper pole" that an implant gives, as my surgeon likes to say). Did I mention that since a breast lift involves removal of breast skin that I will also need my areola slightly reduced in size or else it will look tremendous sitting in the middle of my newly lifted breast? Did I remind you that this procedure leaves me with a bonus scar? You might be thinking "If it's so bad and if you're so unhappy about it, why do it?" Because it is the lesser of two evils. I am a very active person. I want to continue to be able to throw on my workout clothes, a bikini, a dress or a snug-fitting top and not worry about how my lopsided boobs look in them. I want to avoid having to wear a prosthesis. I want to be able to continue living my life as I always have.

That's what this is about. It's not about getting a boob job as a sweet concession prize for breast cancer. It's about preferring to just keep your own breasts, as they were given to you, but since that is not an option, doing whatever you can to continue to look as close to your old self as possible and to continue to live daily life as you had before.

There, I got that off my chest......literally!

Zumba & Tamoxifen

Tuesday was my first real day back in the gym. (During my third and fourth week of recovery I went to the gym a few times but walking incredibly slowly on a treadmill, doing everything I can to NOT pump my arms or bounce, doesn’t really count.) I went to my favorite class: Zumba! I didn’t know what to expect. Might I injure myself? Would I have the endurance to make it through the whole class? There was a teacher I’d never had before and the class was packed. I stood off to the side and tried to pace myself. The teacher came over to me and had me move into an unclaimed hole in the group so I could actually see her and the mirror. I was trying not to go crazy (remember: I LOVE ZUMBA!) but when the teacher clapped her hands and yelled at the class “let’s go!” I flung my arms up into the air and instantly gasped and pulled my left arm back down. I had felt a little tug. It was a sign that I really did need to be careful. Damn. So, imagine my horror when the teacher then gestured for me to come stand next to her. I can’t control myself when I’m front-center! I need to go all out! I did my best to find some safe ground between totally going out all and reverting back to my previous treadmill pace. I stayed up there through the end of the class. At the end, the teacher asked me if I was an instructor. I told her I had been certified but was not yet teaching because I have been sick for awhile. I didn’t feel like getting into it with her. I was glad though that she pulled me up there. Oh yea…I’ve still got it!

Yesterday was our first appointment with the medical oncologist that my breast surgeon had recommended. We have an appointment with a second oncologist scheduled for next week because everyone has been telling me that your relationship with your oncologist is such a long-standing, intimate relationship that you should really love the doctor you choose to go with. So, I figured I’d end up meeting with at least a few. The oncologist was super energetic, which caught me off-guard. On the other hand, she said exactly what I was expecting to hear, gave thorough and reasonable answers to all my questions, was personable and demonstrated that she can be flexible and take a patient’s wants and needs into concern (she said if we were just dying to have a child before 5 years are up we could talk about putting the Tamoxifen on hold and then finishing the 5 years after). At the end of the appointment she gave me a quick check-up and my first prescription for Tamoxifen. Outside, D and I discussed what we thought about her. We didn't have any strong feelings either way. Plus, I would only need to see her once every 6 months for a quick check-up and a new script. I haven’t yet cancelled the appointment for next week, but we’ll see what happens. I might just decide to stick with this lady.

Christmas & Kelly Choi

Christmas and New Year's were great, even if I they did sneak up on me. Since this whole crazy thing started back at the end of September, I completely missed the whole transition into the holiday season. Usually we cook a bunch of stuff for our Thanksgiving dinners with our families. This year we cut back a lot on what we were able to contribute. Then, there wasn't much opportunity to go Christmas shopping so I just made sure that my nieces and nephew and brother had gifts and my sister took care of everyone else for me. On Christmas morning D & I had our traditional Christmas breakfast of German apple pancakes and champagne. I think it was the first thing I cooked post-surgery (we were 3 weeks post-surgery by this time). We didn't have gifts for each other. It was enough that we managed to get our Christmas tree up! That night we realized that we hadn't even taken pictures (usually we take pictures together while opening presents), so we snapped one shot right before bed. The day before New Year's Eve I was getting my final fill at the doctor's office so once again I was not at all thinking about the holiday. Also, since it was still kind of messy out from the winter storm, we didn't have definite plans and weren't sure we wanted to leave the neighborhood. We ended up at the neighborhood restaurant where D's friends celebrate every year. We had a fabulous dinner and ended up staying to watch the coverage of the ball drop with everyone. It turned out to be a nice evening. Two days later, we visited some friends who just had their first baby. An adorable tiny little girl who they brought home on Christmas Eve, just in time for Christmas & New Year's! Though scaled-back a lot, we ended up having a pretty nice and stress-free holiday season and got to spend lots of time with family and friends.

Yesterday was my first day back at work. I hadn't been happy about it but it really wasn't bad at all. I went to lunch with my three girlfriends from work. We went to our favorite little Japanese place. While we were sitting there we noticed that a girl and a couple camera guys had come in and were setting up lights and a demo in a corner of the restaurant. It was Kelly Choi! Kelly Choi is apparently the host of Top Chef Masters but I know her from the food show I used to watch after work on NY1. I was super excited, as was one of my friends, but our other two friends just thought we were nuts. Excited friend waved over our server and asked him to see if Kelly wouldn't mind taking a picture with us. She was happy to oblige so we went over and Not-So-Excited friends came and posed with us so as not to appear so obviously unimpressed! (Kelly was insanely tall & thin and made us all look ridiculously short & pudgy, so I was asked to please cut out everyone from the pic, should I decide to post it.) Today, it's Day 2 back at work and my first day back at the gym. Zumba!

Notes to My Family: January 4, 2011

Hi Family,

I will try to keep this latest one short.

A couple things:

This past Thursday (the day before New Year's Eve), D, mom & I went for my third & final fill. It went fine as usual.

While we were there we determined that my next surgery will be February 18th. Everything is fine. This has been planned all along. It is the second part of the reconstruction process. The date is locked in but we have no time or even hospital confirmed yet. This is because the surgery may take place at Manhattan Eye, Ear & Throat Institute, which is a part of Lenox Hill. The surgery is day surgery/outpatient & Manhattan EET provides ambulatory surgery facilities. This surgery is much less intense recovery-wise. I'm out the same day & I only need to take one week off of work to just rest. The following week I still need to take it easy & maybe not workout and stuff but I can go back to work. There should be less pain & fewer drugs and no drains!

Yesterday was my first day back at work. I was not thrilled about it but it ended up being a pretty good day. I went out to lunch with my girlfriends at work and while we were there, Kelly Choi of NY1 came in with her camera people. I'm assuming it was for one of her NY1 food shows but I don't even know if she is still filming those since becoming host of Top Chef Masters.

This week and next we have appointments with medical oncologists. We'll see how those go. Hopefully good. I don't want to have to meet 20 people before finding an oncologist I like and while I don't really want to start the Tamoxifen, I also don't want to put it off forever.

I have started putting together the blog. Right now it is really just a place for me to collect my notes to you, some great resources that might come in handy for someone else and just little anecdotes I want to share along the way. I don't know what kind of access or restrictions I'm putting on it so let me know if you have trouble getting in.

Hope everyone had a Merry Christmas and Happy New Year!

Love, Diane :)