So I have Cancer. Now What?

I received my diagnosis of Triple Positive Invasive Ductal Carcinoma on a Friday the 13th in September 2019. I hate horror flicks. This just gave me even more of a reason. I mean seriously? Friday the 13th? Nice touch. I went to the Oncologist (Cancer Doc) and Breast Surgeon appointments my Nurse Navigator had made for me. I got the warm fuzzy feels I was hoping for from the Oncologist when we met September 17th. She was a little quirky and had a youthful disposition. In the patient exam room was a huge whiteboard on one wall and she began scribbling all over it laying out my options in her opinion. At this point I had only had a mammogram, ultrasound and biopsy of my tumor. It was being classified as Grade 2 out of 3. I was told they no longer like to "stage" them this early on which is the label people are most familiar with. This was my first appointment and I was in plan mode. I hung on her every word as I diligent wrote what she said down in my notebook. Yes, I bought a cancer notebook. Those that know me could probably bet I bought it within 24 hours of getting the call. Those people would be correct. I took this diagnosis on as a job. I spend my weeks checking off completed tasks and moving forward. I cried my few mins in the car after being told and now it was time to get to work. I have always been very good at compartmentalizing my life. I would even say I may have achieved expert level with this assignment. Not to brag or anything. Totally not kidding. As I left my appointment with her, I felt I had a good plan in place. I had decided to go with surgery then chemo. From the moment I found the lump, I knew I wanted to have a double mastectomy. For one, I hated my boobs and two, why not?! I was young and literally in the best shape of my life. If I was going to recover best from a major surgery, now was the time. Oh and three, I HATE throwing up. I know everyone feels that way to a point, but I literally almost die inside when it happens. I can't even think about it. It just gets me. So that naturally was the first thing I thought of when the nurse told me I would have to have chemo. Not losing my boobs, not losing my hair, both of which were very important to me. I just didn't want to throw up. That was literally my only request outside of not dying. Which I have actually never feared. I truly believe I will be just fine and this is just some crap chapter in my life to teach me something or another. So, I would not see my Oncologist for vomiting, I mean chemo again till after I had healed from surgery. 

It was suggested that I meet with a genetic counselor as to help me better understand the gravity of the situation when it came to what I might expect for my future. This was a fairly simple process and I actually learned a lot. I went in and sat down with a geneticist’s student. She was very sweet and understanding of my situation. She completed a "tree" of sorts to try and trace my family history of illnesses that I knew of. She then made the decision for me to complete an Invitae gene marker kit and sent me to the lab. I had about 7 tubes of blood drawn and began the waiting process. I was emailed the results and she scheduled a phone consult to discuss them further. I was negative for all markers. None. Zero. They tested me for the 9 gene variants that specifically pertain to breast cancer and I was negative. The tested me further for the 47 gene variants that are common for hereditary cancer and I was negative. While I thought this would be a relief, it wasn't. No weight was lifted off my chest. No decisions I had made up until this point had been changed by these results. Now I was wondering where in the hell the cancer came from. Had I been wrong for putting my cell phone in my bra for all these years? I stored my Chapstick and wireless earbud there also. What about those? Was it all the years of drinking water out of plastic water bottles after they rolled around in my trunk for months and countless heated meals in microwaveable plastic Tupperware? Who knew? Now I felt like I had been attacked and would never know who did it. I almost felt worse.

Since I knew I wanted to have a double mastectomy, my nurse navigator also made me an appointment with a local plastic surgeon on in late September. I had met him before seeing as we both had worked in joining operating rooms at one of the local outpatient facilities. He was nice and had a pretty good reputation. My biggest issue with his protocol was that he preferred to place implants above the muscle and I was insistent that I wanted mine under. This was the end of our very short lived patient/provider relationship. 

During the first week of October 2019 I made it to my appointment with the surgeon. She was a woman and had great credentials. She was well known and highly referred out. I showed up with a few in tow. Apparently me having such a structured plan after only one appointment led my family to believe I was in great denial or hiding something. So I ended up with my best guy friend, my ex sister-in-law/bff and ex-husband. Most who are in the medical industry know that surgeons are typically not known for having bubbly personalities. She was exactly what I envisioned and less than thrilled with the room of visitors and even less interested in answering their questions. After talking for about thirty minutes or so, she broke it to me. She said I most definitely needed chemo before surgery and that was her recommendation. What?! This was my choice. I found the lump early so I get to make the decisions. Or so I thought. Apparently not. She started by whipping out the port which I would have to get surgically placed and discussing chemo procedures for accessing, flushing and cleaning my port site. I was not prepared. I am very strong minded and don't take well to someone telling me how to manage my own treatment. They get to dictate enough. Give me something here. I left that appointment upset obviously. I had just been handed the puke bucket in my eyes. I know it's such a little thing to get upset about, but it's just me. So they scheduled my port placement surgery and I went home.  

When they say things happen for a reason and people come into your life at the right time, I do believe it. I had just so happened to meet a neighbor of one of my friends over the summer who was a few weeks away from celebrating her 1 year being cancer free. She had all sorts of insight for me. After spending multiple nights and endless hours talking, I decided I wanted to get an appointment with her providers for a second opinion. She got me in touch with her nurse navigator and we were off running.

I was referred to a new surgeon and we met October 8th. He was more of the fatherly type. He was very nice but the kind that would still whoop you if needed. He was firm and gentle at the same time. The only thing we had serious differences on from day one was my zero willingness to budge on the type of surgery I wanted to remove my tumor. I walked into his office wanting a double mastectomy and that was what I was going to get. I figured I was too young to deal with the worrying and stress over keeping the boobs I never really even like anyways. The risks were so much higher for recurrence by leaving tissue there. It was a no brainer to me. Plus, who wants to do radiation? I almost glow in the sun so a daily sunburn for 6 weeks straight to my titties is not exactly high on my list of to-do's. While discussing my tumor size, he was shocked I had not had any tests such a CAT/PET scan or a MRI done yet. He ordered a MRI for the earliest available. I was quickly scheduled for October 23rd. That would put me well over a month since my diagnosis. Time was of the essence here obviously, but we all wanted to make sure we were making the right decisions.

While waiting for the MRI, I met with a new Oncologist October 9th. She was a renowned doctor who was a little older than myself but had also been diagnosed and treated for the same type of breast cancer as I had been diagnosed with. I felt like I had been matched with her for multiple reasons right off the bat. She said we would wait for the MRI results and decide from there where we would start as far as treatment goes. She laid out very blunt just how serious my diagnosis was. This was the first time I was told my a provider that my cancer was mean. Like really mean. Aggressive and unforgiving. Relentless and held nothing back. She said I was ahead of the game having found it so early on. She kept saying to me that this was an amazing gift. I should always remind myself of it when I had doubts. I still tell myself this often as the need happens more and more the closer I get to finishing treatment. More on that later though.  

I also made an appointment with my Gynecologist to get an IUD placed. I needed to be on some sort of hormone free birth control due to my age as I was told. I guess being a single Mom with breast cancer is a turn on these days. I have been on some form of birth control since I was a teen due to painful and heavy periods. I have met multiple people who claim this might be something I want to look into when I am researching where my cancer came from. 

So I spent the next couple of weeks juggling working, being a mom and selling my house. As if I didn't have enough going on, I had to manage the inspections and negotiations. I had received an offer prior to my diagnosis and when I tried to back out due to my situation, I was told by the buyers I would be sued. That only touches on the pleasantries they brought to the table. 
I showed up at the hospital downtown at 11pm for my MRI alone. Everyone that knew about my diagnosis had something going on or were watching my little for me. I figured this was the easy part anyways. I was so tired and had apparently talked myself into such a relaxed sense that I fell asleep in the MRI tube. Face down and ta-ta's a hangin'! What a weird but oddly satisfying position. Maybe they could be on to something.  

The results came back pretty quickly and I received a call. Chemo...now. My tumor had more than doubled in size and was now over the maximum size for surgery first. Insurance now dictated that I must complete the chemotherapy protocol for Her2Neu Triple Positive breast cancer. So less than a week after my MRI, I spent my first half of Halloween 2019 laying in an OR getting my port placed in my right bicep. I had some pretty gnarly bruising on my arm that was the best costume accessory. The procedure was easy. I chatted with my Mom and did some work while waiting to be wheeled back. I laid on the bed with a sheet over my head and watched the clock on the wall as they threaded the line through my vein and to my heart. I now have this shiny purple heart port as my access for treatment. I must say that after having it for a year now, I hardly notice it anymore. Now seeing as I have pretty thin arms, it sticks out and always looks bruised due to the color and shadows it makes. The only time I remember it's there is when I try and hold something under my right arm or reach for something and brush up against it. Just hurts like a sharp pain then a bruise. I am told I can have it removed once I am 12 months cancer free. I will be more than happy to schedule that procedure.

This is an exact example of the port placed in my right bicep area. 

Oct. 31, 2019 Just getting home from surgery

    

Oct. 31, 2019  Late afternoon. Measuring post-op bruising with outline dots

Nov. 1, 2019 Healing

Next time I can detail treatment and starting chemo. I am going to try and upload some photos too. Thank you for being interested in my journey!