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).
Thursday, February 18, 2010
Tuesday, February 9, 2010
...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
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
Sunday, February 7, 2010
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
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
Tuesday, February 2, 2010
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!!)
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!!)
Monday, February 1, 2010
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/
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/
Saturday, January 30, 2010
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!
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!
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