Relief

Okay, I'm done. What next? Anticipation riddles me as I digest the magnitude of what I have just accomplished.

7+ weeks, 38 treatments, relentless fatigue, and a sunburn later, I'm done. It doesn't seem like much, not yesterday or 7 weeks ago. But today, after finishing my last radiation treatment, I sat in my car and cried for longer than I have since I was diagnosed.

Not because I was sad. At all! It's the weirdest emotion I may have ever experienced. Relief? Might be the best way to explain it. I imagine it was what it must feel like to get rescued after being stranded at sea or finish the longest race of your life. It's the kind of thing you don't realize what you did until after you're done. And when you do, you are overcome with such emotion and pride and awareness that you have to allow yourself 5 minutes to sit in your car and cry while you absorb the reality of what has just happened.

My dear and loving husband met me at the oncology office to commemorate my last radiation treatment and learn what my medical oncologist has in store for my follow up treatment. I'm blessed to have my partner literally hold my hand through this entire journey like I'm a four year old crossing a busy and dangerous street for the first time.

During this process I have fed off of the encouragement from my cheerleaders on the sidelines constantly reminding me that I am strong enough to make it through this. I think many of you were scared for me, but I never saw it. I don't even know the words to thank you for being so brave and inspiring.

I fill my script of tamoxifen tomorrow. All my worries about side effects of this drug or its interference with our big baby-making plans seem distant compared to its benefits. I'm going to give this drug an honest chance because in the end, to quote my surgeon, "this drug is going to save me".

Today, life is good.

Home stretch

Ok, all you runners out there can relate to this. You know those days when you set out to do a long, hard run but you're just not "feeling it"? Maybe you're especially tired after a long work week plus you stayed out too late last night not to mention it's 101 degrees outside and 90% humidity. Okay, so you are about 75% done with your run and you come across the shortcut back home. If you're an overachiever like me, you're not going to take the shortcut. But... you know that split second where you actually really consider taking the shortcut, where home and a cold shower and tall glass of water could come a mile or so sooner, and even though you really aren't going to quit early, you relish in the thought of it?

That's just about how I'm feeling right now.

Of course, in this case, quitting really, truly is not an option for me. But, I have to admit to having this tiny little fantasy where my oncologist calls me up tomorrow morning and says, "you know, if you really wanted to quit and not finish these last 2 treatments you totally have that option". I know, I know, it's only 2 more treatments. After 34 of them, what's the big deal? Well, if you have been following my blog at all, you have probably learned that patience is not my virtue. I'm seriously ready to get on with things already.

I think half of the problem with two more treatments is that one of them happens to fall on Monday. I'd love to start a new fresh week and go a full 5 days without a 5pm radiation date. But, to borrow a phrase from one of my favorite former managers, "it is what it is". So true!!

So, I guess I better suck it up and get ready for the last mile. It will be Tuesday before I know it and I can't wait for the tall cold margarita waiting for me at the end of my radiation run.

Radiation Vacation

Well, a vacation of sorts. As part of my radiation treatments, I have been prescribed a "boost"... meaning 8-10 of my radiation treatments will be focused in on one tiny little area instead of the entire breast. This is because while my margins surrounding the tumor were all clear of cancer cells, there was one margin that was a little too close for comfort for my oncologist.

Usually the boost treatments are the last ones you get, but I heard that sometimes they can be inserted into the middle of the regular treatments to give sunburned skin a break. Today during my weekly visit with my radiation oncologist, he took one look at my pink skin and said, "yeah, we'll be starting the boost tomorrow".

So this is good news! My irritated skin could use a break and so could I. Because my body won't be working to repair as much, I should regain some of my energy back as well.

This vacation may not involve a beach or fruity cocktails, but right now it's the next best thing!

"Somebody's got a case of the Mondays"

But not because of TPS reports or working on Saturday. See, Mondays are a bit of a rollercoaster these days. After having Saturdays and Sundays off from my treatment, I always start feeling like myself again come Monday morning. Oh, but Monday afternoon. What a buzz kill! Five pm is just a reminder about all the other 5 pm's I have left.

Since I can't just decide not to go in or take my frustration out on a fax machine while listening to gangster rap (fun as it sounds), I guess I better harness some of that new-found patience I've been working on. At least today is one more day down, and come 5 pm Friday I'll be one whole week down. It will all be over before I know it.

I wonder how it will feel when I'm done. I'm going to have to come up with something really good to do with my 5 o'clocks. Happy hour, anyone?

Long time, no post

Okay, I have a lot of catching up to do.

First, sorry to anyone who has been checking my blog fruitlessly for updates. I have to be honest and say... I've been avoiding you. Not you personally, of course. I've been avoiding this blog, or maybe I've been avoiding cancer. Ultimately this is proving to be very difficult, especially with the 5:00 pm daily reminder at each of my radiation treatments. Obviously I am not doing a very good job of avoiding cancer, because that is probably why I couldn't sleep tonight and why I am up at 5am writing a long overdue blog update.

Here's the cancer cliff notes: I started radiation treatments on March 24th and have been prescribed 33-36 treatments once a day, 5 days a week. Works out to be about 7 weeks. This includes a "boost" at the end, or a set of treatments that are focused in just where the tumor was. Otherwise, the treatments cover a wider area from the middle of my chest over to my armpit and up to my clavicle. I got a cold my first week of treatment and never really stopped feeling tired after it was gone, and this week I started noticing a sunburn and some mild irritation. I am frustrated with not being able to do as much as I want to without getting tired, but really it could be so much worse.

Everyone wants to know what the treatments are like. Truth be known, they are sort of relaxing in a weird way. Once you get used to all the beeping and buzzing, it's actually kind of nice to lay down and do nothing for 2 minutes at the end of your work day. They made a mold of me using some high-tech bean bag (I keep wondering if there is a rep that sells those things, what a cool job to have) and they line me up using some stickers and three tiny tattooed black dots on my belly. And I said I'd never get another tattoo again! You have to lay really still, which was hard at first but I have a few relaxation tricks I've used (thanks for the thermometer tip, Cindy!) and the machine just rotates around and does it's thing. The whole deal is said and done in less than 2 minutes and I don't feel a thing.

Today I will mark my halfway point through the treatments. I am thankful for feeling as well as I do and for all of the supportive words and hugs that I have gotten from you all. I will be done with these treatments before I know it and ready to get back to running and sweaty yoga. Oh, and I am officially back on the blog wagon... stay tuned for more posts!

xoxo...

I'm so over it.

Turns out, I'm not nearly as patient as I thought I was. Why can't I be all better already???

Man, this weekend was great. Shaun came up, and on Saturday I even felt good enough for him to take me out to lunch and a little shopping. To quote my friend Cecelia, I felt "on top of the world"!

Guess those steroids they gave me before the surgery were making me feel pretty good, because once they wore off, I realized I really didn't magically bounce back that quickly. Don't worry, I'm still doing really well! Saw my surgeon for a follow up today and she was super pleased with how I'm healing. The thing is, well, I'm just tired. I haven't been able to go back to work or yoga or running this week like I really thought I would. Okay, it's only Tuesday. I had surgery on Friday. But what Dan says about me is true: I don't do sick very well.

I may not be patient, but I am decisive. I'm not going to sit around and worry about what I can't do. Instead, this next week (or so) is all about the positives. Today we had our follow up with the surgeon, and guess what? The tumor they took out was actually a little smaller than they thought it was... only .7 cm. The margins are all clear, meaning it hasn't spread to the surrounding tissue. And the nodes they biopsied are officially cancer-free. As I type this, I have a huge smile across my face because I realize how very, very fortunate I am! Thanks to everyone for your prayers... I believe they are really working.

Mmm, time for some of my husband's home cooking and my favorite new addiction, the Olympics!

Surgery update

Jessica is awake and coherent. There were no signs of spread in the connected lymph nodes, so they only ended up removing about 2 lymph nodes. The margins around the tumor were clear. Everything looks as good as possible at this point :)

We won't have the full pathology report on the tumor until Tuesday or Wednesday. 

Hi everyone. This is Jessica's husband, Dan.

I wanted to let you know that Jessica's surgery has been moved up to 8:00 AM tomorrow (Friday, 2/19/10). As Jessica, metioned before, she and the surgeon have opted for a lumpectomy vesus a mastectomy. The lumpectomy is relatively straightforward outpatient procedure and the impact in terms of hospital stay and recovery period is far less severe when compared to the mastectomy plus reconstruction that we had previously been looking at.

They are estimating that the operation itself will take roughly 90 minutes. The procedure will require general anesthesia, with Jessica being cleared to go home fairly quickly once she has woken up and is is feeling back to sorts... possibly as early as lunchtime should everything go well.

I will be posting updates on Jessica's behalf to this blog during her surgery and recovery tomorrow. I will try to get updates posted here as quickly as possible as information comes in (after I relay it to direct family first, of course).

...and that's my final answer

It seems like things are finally winding down a bit in terms of doctors visits thanks to being able to cram most of them in yesterday afternoon, and so I can finally post the most definite plans we will have until after the surgery.

The surgery has actually been moved to Friday, February 19th at 10:15am. It's an outpatient surgery and shouldn't last more than an hour and a half. I was able to see a radiation oncologist yesterday, who said I was a good candidate for radiation. Provided I won't need chemo, which would usually start after the surgery, I can start the radiation 2 weeks after the surgery and it will be every day, Monday-Friday for about 6 weeks or so. I'll have a weird sunburn in the shape of a square in a really uncomfortable place for a few weeks before it turns to tan. Already shopping for cute bathing suits to cover the bizarre tan line I'll have this summer!

Some other great news from my medical oncologist... she totally agreed with my decision to go with lumpectomy (not surprising) and said that she would be "really surprised" if I need chemo!

Many of you know that Dan and I had planned on starting a family this year before I got diagnosed. One of the most heartbreaking things I have struggled with during this process is whether or not we will be able to have children. Because chemo can cause infertility and early menopause in some women, not having chemo would be a great thing for us! Another concern of ours is the drug tamoxifen I will have to be on for 5 years after the surgery during which I absolutely cannot get pregnant. My oncologist said that the 5 years is "negotiable" and although not ideal, I might be able to break after about 2-3 years to have children and then go back on it. We are still weighing our risks and benefits in that regard (because my tumor responds to estrogen, being pregnant regardless is going to slightly increase my risk of a recurrence but less so if it is after the 5 years). Dan and I are not ruling out the very expensive option of preserving embryos after the surgery, before radiation and tamoxifen, just in case.

Well, that's the latest and greatest! Now, for what I'm really excited about... a shorter recovery from my surgery means I *should* still be able to go to South by Southwest this year!! My friends Nicole, Laura, Ajit, and Shaun will be coming and I am really looking forward to relaxing and catching some great live music with them. Check out the lineup announced so far:

http://sxsw.com/music

Overthinking? Who, me?

If there's one thing yoga has taught me, it's the value of not thinking at all. I definitely put that to the test during my 5-day hiatus from decision making. I have returned from my vision quest of sorts, and somehow made decisions without really thinking about it.

So I did end up seeking a second opinion on my surgery. Right before I went in to the appointment, though, my first surgeon called me. She told me that she thought I would be a good candidate for a lumpectomy, and that because my test results indicate this is a relatively non-aggressive tumor I was only looking at a recurrence rate of 5% vs 1-2% for a mastectomy. The second surgeon told me about the same thing. The risk is that when they go in to take the lump out, there's always a chance they could find more (apparently mammograms and MRIs are only so sensitive). Of course, there's always the good chance that the one tiny lump could be it.

The question became: am I feeling lucky? Answer: I'm all in.

On Friday I called my surgeon and changed the crazy scary surgery on the 18th to just a lumpectomy. What does all this mean? Less surgery, faster recovery! It's a trade off, though... if they find more it would mean a bilateral mastectomy for sure. Regardless, I'm taking my chances that this lump will be it. Even if it isn't, at least I will be sure that mastectomy is the right thing to do should that time come.

I have acquired more specialists in the last 2 weeks than I have in my whole life. This coming week I visit with a medical oncologist, who will work with me on my treatment post-surgery and advise me on my ability to be pregnant one day. I also see a radiation oncologist, who will determine if I am a candidate for the radiation that has to accompany the lumpectomy. I also get a PET scan, a much more sensitive test that might show any spreading that the MRI and mammograms did not detect. If all goes well, I am a go for lumpectomy on the 18th.

Thanks to everyone for the prayers, support, love, and encouragement. I'm pretty confident that all this mojo is going to produce nothing but positive results!

Now, for my moment of zen:
"Yoga teaches us to cure what need not be endured and endure what cannot be cured." ~B.K.S. Iyengar

It's complicated...

Remember that wedding in Mexico I planned for a full year before waking up one morning and realizing that I didn't want to get married in Mexico and I wanted to do it right here in Austin, Texas in the place nearest and dearest to my and my husband's hearts? And then I called the UT Alumni Center and got my date reserved and then let everyone else know and the whole thing turned out to be perfect? Yeah, it's kinda like that.

This morning, I woke up and drove to San Antonio with the intention of firming things up with my plastic surgeon for my surgery on the 18th. Instead, he dropped the bomb on me that he wasn't so sure that the tissue reconstruction I wanted would work for me afterall, and maybe I should start considering other options. And then my breast surgeon called with some great news but told me maybe I should re-consider having a bilateral mastectomy. Oh, and by the way, whatever my surgery is, it's still scheduled for the 18th and can I decide what I want to do as soon as possible?

I met some amazing, inspiring, courageous women tonight in a breast cancer support group. I cried about how pressured I felt to come up with an answer so soon. I begged them to tell me how I will know my decision is the right one. "Believe me, you'll know", they said. I left feeling inspired by them but lost and doutful about myself.

On the drive home: epiphany. Oh, it's like Mexico.

So, I know what to do now. I need to take a break from making any decisions for a couple of days. I have more research I need to do. I am not going to worry about offending my doctors if I seek a second opinion. And one morning, I'll wake up, schedule the right thing, and then I'll let everyone else know about it.

Kind of like my hair... scheduled this last week and didn't tell a soul I was going to chop it off. It felt empowering to make a decision about something that affected me and nobody else. So, my happy thought of the day... a great haircut & amazing color (thanks, 'gelica!!)

Surgery is scheduled for 2/18

Well, I got the call this morning that my surgery has been scheduled for February 18. The surgery is going to involve a unilateral mastectomy (meaning only one breast) in addition to GAP flap reconstruction. It's going to be pretty long, probably about 10 hours, because the surgery involves taking tissue from my butt (TMI, sorry) and transfering it to my breast and all the little blood vessels have to be reconnected via microsurgery. Isn't it amazing what doctors can do these days?!?

My surgeon's group is amongst the few in the nation that have perfected this technique and they happen to be in San Antonio so the whole surgery will take place at Methodist hospital there. Because they are taking the tissue from the butt, and I am quite literally getting it from both sides, they can only do one breast at a time. This means that I will have the surgery on the cancer breast, recover, go through chemo if I have to, and then have the surgery on the other side. Not exactly thrilled about a surgery/chemo "sandwich" but for some reason this still just "feels like" the right choice.

I could have opted for implants instead, and then I would be able to have both breasts done at the same time. Both tissue reconstruction and implant reconstruction have their positives and negatives, but Dan and I both feel that the tissue reconstruction has more positives for me. Yeah, it means more in terms of surgery and recovery this year, but implants only have about a 10-year life span and those of you who know my paranoid, worry-wart nature know that I would be constantly worried about a leak. Plus, I'd love to just get surgery out of the way and not have to worry about it down the road.

We will keep you all updated as we learn more!

Now for something a little less cancer-y...

I've decided I don't want breast cancer to consume my life, and therefore this blog is not going to be all cancer, all the time. I'm going to include other stuff: things that make me smile, things to be thankful for, etc. Today's random happy thought? My husband's cooking. 'Nuff said. Go check out his blog and see all the fabulous food I get to eat all the time:

http://www.dangourmet.blogspot.com/

Let's take it from the top...

Isn't it weird how your whole life can change in one small moment? I think back to my moments: barely missing that huge tree in my first car accident, my first kiss with my (future) husband, the day I walked across the stage at the UT Erwin Center, my first kiss with my official husband at our wedding. Most recently: Monday, January 25, 2010 at 10:48am. The moment I heard my radiologist utter the words "I'm afraid I have some bad news". The moment I learned I have breast cancer.

This blog is my way of keeping all of my family and friends updated on the rapidly evolving information we are receiving regarding my cancer and treatment. During my recovery, it's going to be an outlet for emotions and boredom. And in the process, I hope there are other young women who might read this and find knowledge and reassurance in me sharing my story. To those of you future survivors, I share with you my favorite words said to me by a very good friend: "YOU WILL BEAT THIS". For you current survivors, thank you for sharing your own stories as they have gotten me through this last week.

Ok, now for the facts. There's a lot of technical terms and jargon in here, so here's a link to a great guide on the Susan B Komen website for anyone who is interested in learning more:

http://ww5.komen.org/breastcancer/aboutbreastcancer.html

Everyone wants to know how I found out I had a lump. Believe it or not, I found it myself. I haven't done a breast self-exam in well over a year. With the recent controversy surrounding the guidelines regarding mammograms last year, I told myself I was going to start doing self-exams more regularly. Laying in bed watching TV during my surprise birthday vacation with my husband, something reminded me of that commitment. I did one right then and there, and found a tiny lump. I convinced myself it was probably nothing. Regardless, when I went to visit my ob-gyn the following month to discuss our goal of starting a family soon, I asked her to check it out. Thank God I did, and thank God she took such as small lump so seriously. One needle biopsy and two mammograms later, I got the call.

Here's what we know so far:

We are still waiting for results back from various tests, but at this point we know that it is definitely an 8mm low-grade invasive tumor and it appears likely that it is a Stage I. Based on the MRI it APPEARS that the cancer has not yet entered into the lymph nodes and there are no signs of distant metastasis. This can only be confirmed using a node test after the surgery. The tumor is small and we are very fortunate to have detected it as early as we did. Assuming it really is at Stage I, the survival odds are incredibly high (roughly 99%). We are still waiting for genetic test results to determine whether the cancer is a result of a BRCA1 or BRCA2 gene mutation (which would indicate a high likelihood of recurrence). That test will determine not only my course of action regarding surgery, but also our course of action regarding having children one day.

When a tumor is biopsied, it is sent off to test for certain markers. These will basically determine what type of treatment a woman will respond to following surgery. The three main markers are estrogen, progesterone, and her2/neu. Without getting into too much detail (again see the above link if you want to know more about what each of these mean), the ideal outcome of these markers would be to be estrogen and progesterone positive and her2/neu negative. That would mean that I could respond to hormone therapy to suppress the growth of this and any future tumors and I may not need chemo. On Wednesday I got some great news that I am estrogen/progesterone "strongly positive". I am waiting to find out the results of the her2/neu marker: positive meaning definitely chemo, negative meaning maybe none. After the surgery, the tumor will be sent off for another test called Oncotype DX. If my score is low, then no chemo for now. If it's high, then chemo for sure.

Oh, surgeries. Because I am 32, there is a good chance this is going to come back, genetic or not. Like many other young women, I am likely going to opt to have a double mastectomy to lower my chance of a recurrence. Thanks to advancements in technology, I have a lot of options for breast reconstruction out there. I am inspired and assured by speaking with so many women over the last week who are happy with whatever reconstruction choice they made. My options are either implants or reconstruction using my own tissue (google GAP flap breast reconstruction). At the moment, I'm leaning toward reconstruction using my own tissue. Those of you who know my indecisive nature know that this could change at any moment!

Ok, I know it was a long post. But it was a long week. This is all we know for now, and I will keep you all in the loop as we learn more. I want to thank you all for your supportive words, loving thoughts, and heartfelt prayers... because of you, I am able to feel strong and positive every day!