This Princess Has A Pea
Posts tagged Surgeon
Breast Cancer -versary #2
Feb 10th
Just the Facts: It’s now my 2nd Cancer-versary. I was diagnosed with breast cancer on February 12, 2010. And it has been an entire year since my last post on this blog. An update is due! Rest assured, the news is all good: I am fine! In fact, I think I’m healthier than I’ve ever been!
Details: Thankfully, the last year has been pretty quiet in terms of cancer treatment. It wasn’t without some ups and downs, though and they primarily revolved around my taking the prescription drug, Tamoxifen. The doctors recommended that I stay on Tamoxifen for its estrogen-limiting effect for a full 5 years following my breast cancer surgery. The clock started in June of 2010. Side effects were manageable at first, limited to some fatigue and hot flashes, but as the year went on, things got a lot worse. The fatigue became severe, and I also experienced mental fog and assorted “female” problems. But probably the most difficult side effect for me was significant hair loss. I was losing a lot of hair in the shower everyday and it seemed to be worsening with time.
My hair after about 11 months on Tamoxifen
I was more than a little troubled by this and so was my oncologist. When I saw her in July, she suggested I take a break from Tamoxifen to see if my side effects went away. From the beginning, taking Tamoxifen was like having an insurance policy. We were certain that my cancer was all gone after the surgery, but the drug was to ensure that any remaining cancer cells would not be able to grow. It wasn’t until a few months later, when I had been off the drug for a while, that I could see how much my quality of life was truly suffering while I was on Tamoxifen. By the next time I saw the doctor, the hair loss had slowed down and according to my hair stylist, I even had new “baby” hairs coming in all over my head. I had also begun to feel much better in general.
My hair today, after being off Tamoxifen for 8 months. Can you tell a difference? It's not completely back to normal yet but it's getting there! The baby hairs are the ones standing up! ha ha
My oncologist suggested that I stay off the Tamoxifen a few more months and consider re-starting it in early 2012. I had made it a year on the drug, just 20% of the recommended amount of time. But even so, she estimated my chances of recurrence to be very very low, all things considered. After being off the drug for about 8 months now, I can’t imagine going back on it, and I don’t plan to. The bottom line is: I am very confident that I am cancer free and will stay that way. I know it is a risk, but I believe in the path I’m taking. My next visit to the oncologist is later this month, and I expect a good report. After this visit I will see my breast cancer surgeon for a follow up in May or June, and then I will switch to a biannual rather than quarterly check-up schedule. That’s a milestone! It must mean that the docs are pretty sure I’m ok, too!
April 6, 2012 is the anniversary of my cancer surgery. (I’m so weird about anniversaries and dates. They are all emblazoned into my memory. And each one carries its own set of emotions and issues.) On one hand it seems like forever-ago that I had the mastectomy surgery. On the other hand, I’m still trying to get used to the sensation of the implants on my chest, and the lack of sensation in many other parts of my torso. But April 6 is an anniversary I celebrate! I think of it as the day I beat cancer!
The cancer may be gone, but like a ghost, it continues its haunting.
There is not a day that I don’t think about the possibility of a recurrence. The choices I make everyday with the way I eat, exercise, sleep, think, pray, etc are all framed within the context of being a cancer survivor. The haunting is fading with time, but on some level, breast cancer will remain a battle for me to fight from now on. Good thing I’m StrongerSarah! 
picture credit: the Girlfriend Book
What’s coming up? Routine check-ups with my oncologist, breast surgeon and plastic surgeon. According to my plastic surgeon, a new variety of silicone gel breast implants, called the “gummy bear” implants, may receive FDA approval sometime soon. He believes that this style would work much better for me. (I still have some problems with my implants.) Apparently the FDA has been “almost ready” to approve them for years now, despite Europe and pretty much everywhere else having approved them years ago. Should this happen, I may consider getting the new implants before the time when my current ones would normally need to be replaced (10 years or so). My plastic surgeon advised me not to “hold my breath” on the FDA approval. In the meantime, I’m very happy to be done with surgeries.
Prayer Requests: Besides a prayer of thanksgiving for my good health, my prayer is the following: that women would take their risk of breast cancer seriously, be proactive about their breast health and their health in general, and have their screenings done on time. Sometimes it’s easy to think of cancer/diseases as things that just happen to others. But breast cancer strikes 1 in 8 women. Some say that statistic is an underestimate!
As for me, I’m doing really well. And I expect to continue for another 50 years or so, at least! Thanks so much for your prayers and support through all of this.
Cancer-versary
Feb 12th
Just the Facts: A year ago today I was diagnosed with Invasive Mammary Carcinoma — a “pea” was found. Ironically, I had one of the last visits I’ll need with my plastic surgeon this week. In the course of a year, I’ve discovered I had breast cancer, had a bilateral mastectomy and had two follow-up surgeries to reconstruct my breasts. This journey really has no end, but, thankfully, I am through the rough part. My health is now excellent and on top of that, I’m pretty much looking myself. This year hasn’t been easy but it’s over, and I’m ready to focus on other things!
Details: On February 12, 2010, I answered my cell phone to hear a radiologist’s voice. I knew that since the doctor was calling (not a nurse), this was bad news. He proceeded to tell me that the biopsy I had two days prior had revealed Invasive Mammary Carcinoma. Life changed instantly as I realized what might happen as well as what would have to happen.
Later I would learn that I had not one, but two tumors. They both turned out to be sort of small, each slightly larger than a pea. My choices for treatment were really not too difficult to make. In order to be most aggressive in this fight, I needed to have both breasts removed. Thankfully, I found a wonderful breast surgeon and an equally incredible plastic surgeon. I had a bilateral mastectomy with immediate reconstruction on April 6, 2010. That was the day I conquered the cancer!
Following the surgery, we learned that my lymph nodes were cancer-free and that the margins from surgery were clear. My cancer had apparently been confined to the breast tissue, which was now gone. Later a special diagnostic test was performed on the tumors and it revealed that the cancer would not respond particularly well to chemotherapy, but would be responsive to hormone therapy. We rejoiced at that news! No chemo, although five years on the drug, Tamoxifen, was essential.
Through the summer I went through the strange process of tissue expansion in anticipation of a second surgery to place silicone breast implants. I am thankful such procedures exist, but it was both exciting and highly annoying. On August 31, 2010, the tissue expanders that had been placed at the time of the mastectomy were replaced with silicone implants.
Life with implants is somewhat strange too, but so much better than expanders. At first, I was very pleased with the outcome of the exchange surgery. Then, something went wrong. The internal sutures on the left side did not hold as my plastic surgeon had planned, and the left implant shifted. It was not good. So on December 27, 2010, I had that fixed.
I am technically still recovering from that surgery. It has been about 6 and 1/2 weeks. My plastic surgeon says that 8 weeks is the absolute longest it should take for the implants and sutures to be “set”. I am taking every precaution to make sure that things don’t shift again. For this period, being “careful” has meant among other things: no kettlebell training nor any form of weight training, no heavy exercise, no lifting anything heavier than a milk jug, and sleeping in a recliner with pillows propped all around me for support to avoid any shifting. Yes, I have been sleeping a recliner for almost 7 weeks. (And will continue for another week.) This is that important!
I see my oncologist every three months. I will be doing that for another 2 years, then less often. I go back to my breast surgeon for one more follow-up with him in a few months. And I still have a few things for the plastic surgeon to finish up, though overall we are generally pleased with the outcome of this last surgery. As far as we know (and we certainly HOPE) there should be no more breast reconstruction surgery. Just a few finishing touches. 
Those will be completed later in 2011, probably.
Sometimes I still can’t believe all this has happened. Aside from some symptoms from the Tamoxifen, I feel great. It’s weird to think that I am a breast cancer survivor. But I am! And as predicted, I am certainly STRONGER now!
What’s coming up: Some more healing, physically and mentally. More doctor visits. More plastic surgery. But the worst is definitely over.
Prayer Requests: A year later, I am cancer-free and strong. Please thank God with me!! The blessings I have received through this trial far outweigh the difficulties I have had to endure. It’s okay to pray that the cancer stays away, too.
This blog: Given that this journey is winding down in a big way, the blog is too. I can’t tell you how much the support from friends here has meant to me. But it is time to move on. I’ll only update this blog a couple more times, probably. It will have to be something huge to do so, and I’m hoping that there really isn’t anything else huge that happens. However, I’m leaving the blog here, in case there is someone who might want to learn about my journey. Unfortunately, breast cancer is running rampant, and we will all know someone who will be diagnosed with it at some time. I don’t know if reading about my journey would help someone else facing a similar path, but it will be here, just in case.
Thank you for reading and commenting over the last year. I pray that everyone who has reached out to me in any way would receive tenfold blessings in return.
Wishing good health and happiness to all!
((Hugs)),
Stronger Sarah
Research, Options, and Back to my Kettlebells
May 1st
Just the Facts: This week I saw my plastic surgeon for more “expansion” and may now be done with that. We’ve been thinking through all that was said at the oncology appointment and doing lots of our own research as we wait for the results from the Oncotype Dx test. In the meantime, I have set the wheels in motion to see a second oncologist. Happily, I have been given the OK to proceed with my kettlebell workouts.
Details: Every week seems to have at least one fairly major thing going on and this week is no different. This week we have been doing lots of research on tamoxifen and chemotherapy, recurrence rates and natural therapies. We wait to hear results on the Oncotype Dx test, which will have a big impact on whether or not I take chemotherapy. We have discussed our options with each other, with friends who have gone through the same or similar things, and have read lots about our choices. There really is no “good” option. We continue to work through it all and try to figure out what is right for me.
As usual, I visited my most-excellent plastic surgeon this week to have more saline added to my tissue expanders. This may be the last “expansion” for me since we seem to have achieved a look that fairly closely resembles the former me. Of course, we have the option of looking different, which is what we are considering now. What a crazyweird decision THIS is to make! In contrast to the drug/therapy decision, this one is definitely more fun, though still nearly as confusing. Once we have reached a point we are happy with, the clock starts for a 3-month wait. I will then be able to have the quite-uncomfortable and very fake-feeling expanders exchanged for real implants in outpatient surgery.
This week I also started the process of getting in to see another oncologist. We really like our first oncologist and may choose to stay with her, but wanted a second opinion. Once the second doctor has reviewed my pathology reports, we will be contacted with an appointment date. I expect that to be in about 2-3 weeks.
My plastic surgeon has given the OK for medium-weight kettlebell workouts. (Next week I can move up to my “normal” routine.) I’m so happy to be building my strength back!
What’s Coming Up? On Tuesday I will see my surgeon for the last visit with him for a long time. His portion of this is basically complete and I know he’ll be happy to see how well I am doing. On Friday I will have a CT of the Chest/Abdomen/Pelvis and a Bone Scan. The oncologist ordered these imaging tests as a baseline. I am not looking forward to them due to having to drink large amounts of contrast fluid. It will go fine — it’s just one more thing, and a minor one, at that. The Oncotype Dx results are expect the following week, and we’ll have our appointment with the oncologist on May 11 to discuss those results. Also that week, I will return to the plastic surgeon for another regular visit.
Prayer Requests: Please pray for discernment for us in our decision making. Also, I am still having trouble sleeping well. This will pass with time, but please pray for that remaining discomfort to pass quickly.
Doctors and Drains
Apr 14th
Just the Facts: It has been a busy couple of days. I had my post-surgery follow up appointment with my surgeon yesterday (Tuesday), which went very well. Then I went to my plastic surgeon to have my four surgical drains removed. Today I went back to be checked because it seemed like I was retaining too much fluid, but all is well.
Details: I am 8 days post-mastectomy and reconstruction surgery as of today. Yesterday I saw my surgeon for a follow-up visit. He was very pleased with how I am doing and we mainly ended up discussing the pathology report and our next steps. He referred me to an oncologist and had an appointment set with her for April 23. We will meet and discuss the pathology report in greater detail, then she will most likely order an Oncotype DX report for me, which will boil down all my decisions about chemotherapy and hormone therapy into hard numbers. The surgeon reiterated that most likely, chemotherapy won’t be recommended since my lymph nodes were clear. Hormone therapy (tamoxifen) will VERY likely be recommended.
Here are some “highlights” from the path report for those who have an interest in such things:
- There were two tumors (This princess actually had two peas.) One was 1.5cm and the other was 1.2cm. They were both invasive carcinoma. There were also a few occurrences of In Situ Carcinoma (not invasive) that accounted for the other worrisome spots on the MRI.
- The margins were clear with a range of 2-5mm, which is excellent.
- Three lymph nodes were removed and all were cancer free.
- The left breast was completely benign.
- Both tumors are highly estrogen sensitive and at least partially progesterone sensitive, which makes the cancer highly treatable with hormone therapy.
- The tumors were HER/2 negative, another reason chemotherapy is likely not needed in my case. HER/2 positive cancers are always treated with chemo.
- The tumors were a low grade, meaning very slow growing.
After discussing the report with my surgeon, he asked that I make another follow up appointment with him for three weeks from now. After that he won’t need to see me for a year.
The plastic surgeon’s office is where we’ll be spending lots of time in the coming weeks, and that’s where Tracy took me right after we left the surgeon’s office. They ask you to monitor and measure the amount of drainage that you have each day that you have the drains and come into the office when the output is at or below a certain level. By Tuesday I had been at the magical level for 48 hours and called to see about getting the drains taken out. (Managing life with them is no treat!)
The nurse called early Tuesday morning and said I could just come in whenever it was convenient. So we headed there about 11:00am. Sparing the ugly details, I will just say that having those drains removed was gross and awful in many ways. Afterward, I was relieved but also felt very disoriented and off-balance. For the last week I had grown used to them, my 4 new appendages. Further, they had been there since the loss of another major part of me. Somehow the mix of adding and subtracting plastics and parts left me quite out of sorts. After some lunch I felt better.
However, by late afternoon, I noticed that I was beginning to look quite fluffy and puffy, especially in the post-surgical area. The fluid that would have found it’s way out via a drain was beginning to pool in the area and I started to get nervous. My doctor had mentioned that the success of the reconstruction was dependent on keeping the fluid retention under control, in order to avoid infection and general failure of the effort. I knew some fluid retention had to be expected, but it seemed too much, too fast. I called the plastic surgeon’s office and the nurse asked me to come in today (Wednesday) because she wanted a doctor (mine wasn’t in the office) to check it out.
Through the evening it seemed to get worse, then better, and back and forth. I really did not sleep well, partially trying to monitor the puffiness as I slept, as if there were anything I could do about it. I somewhat expected the doctor to tell me that I would need to go back to the OR and have the drains put back in.
However, the opposite turned out to be the case. The doctor I saw said that the retention was really very little, in the spectrum of things. He said that it would 1)begin to be reabsorbed by my body or 2)be removed by needle if it persisted or 3)be pushed out as we proceed with the tissue expansion process. I already had an appointment to see my plastic surgeon tomorrow (Thursday) so he will check the situation again then and decide what, if anything, else needs to be done. Whew!
Me: I feel good. The ordeal with the drains has left me, well, drained. (I couldn’t resist.) But generally I feel strong, energetic and healthy. The after effects of 6 hours of anesthesia are not unnoticed, though, as I do get sleepy and groggy when I really don’t think I should. I have been told that those effects could take 6+ weeks to wear off. I plan to ask my plastic surgeon for details tomorrow about EXACTLY what types of exercise I can safely do right now, because I want to move again, in that way, and I know it will help clear my groggy head!
What’s Coming Up? Plastic Surgeon tomorrow and every Thursday for a while, Oncologist on 4/23.
Other: Our family has been so hugely blessed by all the support and good wishes and prayers from friends. Thank you. Thank you. Thank you. I am not able to answer most blog comments but I do read them all again and again. Thank you so much.
Plastic Surgeon Happiness
Apr 2nd
Just the Facts: I saw my plastic surgeon yesterday for a pre-op visit. I am so psyched to be working with this doctor. It went very well.
Details: Tracy and I spent a good amount of time talking over the reconstruction surgery with my plastic surgeon yesterday. I am so comfortable with this doctor. He clearly understands my personality: my need to move and get back into action as soon as possible. Although he is firm in his requirements (ie no shower as long as I have surgical drains, to prevent infection), he has demonstrated that he will do whatever is necessary to help me get through the tough parts of this as quickly as possible. And above all, I am confident in his ability and desire to do a good job for me. Since I’ll be seeing this doctor once per week for at least the next couple of months, it’s good that we have found a good match.
We asked to see a sample tissue expander (what I’ll get next week) and a sample implant (what I’ll get later) to examine and we were able to “play” with them a bit. Those implants are tough! My fears of bursting one while doing a kettlebell clean were put to rest when I saw the damage the doctor tried (unsuccessfully) to inflict on the implant. The expander was a rougher, more rigid version of an implant. He showed us how the port works on that. It’s really kind of cool! It helped for me to be able to visualize what’s to come. That was the missing piece in my mind-preparation process.
Friends have been beyond amazing to me lately. I can’t even begin to list the ways that people have blessed me with their love and support. I do not feel worthy of all of this, but I am humbled and honored. In the future, my approach to caring for others facing tough stuff will change. In other words, I’m going to be more like the people who have stepped forward for me. In the mean time, I thank God for the blessings I have received, and I pray that each of you will be blessed enormously in return for the kindness you have shown.
What’s Coming Up? No more appointments until the Big One. Surgery is scheduled for 10:30am EDT on Tuesday, April 6. My plastic surgeon indicates that it will probably be late starting — to plan on 11:30 or so as the start time. The mastectomy portion of surgery should last about 2 hours. The plastic surgery will be about 3 1/2 hours. UGH!
Me: Trying to tie up loose ends but starting to care less about that. Enjoying time with my family. Looking forward to Easter!
Great Meeting with Plastic Surgeon
Mar 18th
Just the Facts: Today’s meeting with the plastic surgeon went really well. We had a lengthy conversation with him and looked at photos of his work. We were impressed. We see no need for another plastic surgery opinion.
Details: Tracy and I met with the plastic surgeon who both breast surgeons recommended. We were kind of prepared to have to put up with some “quirks” in this doctor but were pleasantly surprised. We asked numerous questions and he answered all of them to our satisfaction.
There are, of course, no guarantees regarding exactly the way this process will go because the extent of my cancer is not yet fully determined. But we expect to be able to begin reconstruction at surgery. The plan is to place tissue expanders which will pave the way for implants. The expanders will be inserted right after the mastectomy surgery. If all goes well, the expansion process will take several months, probably 3-6 in all. Then there will be surgery to exchange the expanders with implants. The final steps to reconstruction should be completed within about a year. My goal is to look about the same as I do now, but I have to believe that I will really look much better since age and gravity will no longer be an issue! Is it wrong to be excited? 
Prayer Requests: Today is praise! I am grateful for the surgical team that I am working with. I have so much confidence in them. Outside of not having to deal with this at all, knowing that intelligent, experienced people are helping me is the best thing I could hope for. Please praise and thank God for bringing me to this point.
Other: I received another huge blessing today from my good friend, Fred. He wrote a post about me on his blog. Fred is a talented writer and a wonderful person. I am so grateful that he is helping me get my story out. Please check out his post and make yourself at home at his blog, too. You’ll soon discover what a gem Fred is!
Pre-Surgery Meeting with Surgeon
Mar 16th
Just the Facts: Tracy and I met with my surgeon again today. He answered a long list of questions and gave us more insight into how the surgery and recovery will go. We now have a good comfort level with this aspect of my treatment.
Details: Today’s meeting was scheduled for two reasons. First, I had a number of questions that I wanted to ask the surgeon including what to expect, what if’s, and when-can-I’s. Second, the surgeon wanted to meet with us again to make sure we were all on the same page about the procedure he will perform. The meeting went well. We did not feel rushed and the doctor was wonderful about answering our questions.
He reviewed his impressions after looking at my MRI results and confirmed to me AGAIN (I can’t hear it enough) that my lymph nodes looked normal on the MRI. Of course, there is no guarantee until the lymph node biopsy, but all signs indicate that the cancer has not spread. He does not anticipate a need for chemo or radiation.
At the end, I signed a consent for surgery. We’re set to go. We feel confident with the doctor and the procedure. It won’t be easy and the aftermath will be rough but we know what to expect and we’ll get through it fine.
What’s Coming Up: Our first meeting with the plastic surgeon on Thursday. I will have a long list of questions for him, too. I’m told he will be the one to say how soon I can shower and eventually exercise after the surgery, so I’ll be most interested in his comments. Though I’m really kind of dreading yet ANOTHER exam, I know that this one is the most important with regard to my future “look”.
Me: After today: thankful for my great surgeon and ready to move forward. Not in a panicky way, but in a confident way. Still nesting when possible, but busy with regular life stuff and doctor appointments. I think I’m feeling the best that I have felt since before I found out about the cancer. Thank you for your continued good wishes and prayers. They have definitely made it possible for me to get to this more “comfortable” spot.
Just an Update
Mar 15th
Just the Facts: Nesting continues. Two doctor visits planned this week: my surgeon and plastic surgeon.
Details: This will be an exciting week. They all are lately! Tomorrow Tracy and I meet with my surgeon again. I have quite a list of questions that I have accumulated. Poor guy! Thursday we meet with the plastic surgeon for the first time. I’m looking forward to meeting him and hope he is going to work out right for us.
Lately I’m doing a lot of nesting. The pantry is straight and the refrigerator is clean. My closet has been overhauled. I note that Tracy has begun cleaning out the garage as well. That’s mostly because we need to fit a lot of my studio items in there for storage. The guest bedroom is next on my list, and if the nesting urge continues, I’ll tackle the kids’ rooms. That would be big.
Prayer Requests: Please pray for my sweet Olivia today. She is feeling uncertain and needs peace and comfort. It’s just not enough for me to tell her that I’m OK. (I get that!) Mitchell seems to be doing well, but pray that his confidence and secure feelings continue.
Other: I’m on a mission to find some kind of pink ribbon thing to put in my yard or mailbox or something. I need everyone around me to know I’m fighting this fight. Is this in the name of cancer awareness? Well, kind of, but in all honesty, I have to say that’s not the main reason. I think I just want everyone to know! Maybe it’s so they’ll understand if I turn up one day wearing a scarf on my head, or if I’m seen plodding to my mailbox looking like I’ve been beat up. If you see me out there, waive or give me the thumbs up. I’ll know that you know the deal, and I’ll be thankful.
Surgery Scheduled
Mar 10th
Just the Facts: My surgery will be on April 6 at Carolinas Medical Center. It is scheduled for 10:30am and I have to be there by 8:30am. I am so excited to have it scheduled!
Details: I’m kind of shocked that this actually happened today. I was expecting to have to wait until at least next week to get this done, but apparently my surgeon and his team got this pushed through. We meet with my surgeon again next Tuesday and the plastic surgeon on Thursday.
I spoke with my surgeon on the phone today. He is proving himself to be even more amazing than I expected, as he has now called me twice to touch base and make sure I didn’t have any questions or issues. I did ask him today whether or not I should speak with a radiology doctor and/or oncologist now. His answer was no, on both counts. He feels that radiology will probably not be needed at all and that oncology would have nothing to offer until the tumors can be studied after surgery. He did suggest a couple of names of oncologists who I can consider for later.
Late this afternoon I received a call from the hospital to set up my pre-admission appointment. That will be on March 29.
Prayer Request: Please pray that my lymph nodes prove to be clear and that the cancer has not spread. We do not believe that it has, but I continue to have that concern come to mind. Pray for my children, Olivia and Mitchell – that they would have peace about the surgery. Please give thanks and praise for my strong marriage and wonderful husband, Tracy. Our 20th anniversary is March 31.
Thank you SO much for your comments, thoughts, support and prayers. It makes a HUGE difference!!