The other side

A year ago tonight, I was preparing myself in all sorts of ways for my bilateral mastectomy surgery.  I remember shortly after my diagnosis a friend from church telling me something. Her sister had been diagnosed almost exactly a year earlier than me.  She said that, "things look a lot better a year later." She was so right.

I just went and re-read the posts to remind myself of all of the details. Strange how some things fade from memory.  Or maybe it's just chemo-brain in action?

July 22, 2010

July 17, 2011-Nearly a year later

What struck me from reading my pre-operative posts is how uncertain I was about things. Understandably so.  Everything I did with the feeling that it was a "last" time for doing it. My "last" workout at the gym.  My "last" trip to the beach.  My "last" time cuddiling with Jean-Marc in the morning.  It was a scary time.  I'm a big believer in preparing for the worst, and hoping for the best. I was mentally prepared for weeks of being bedridden and in pain.  I had not even considered chemo and radiation at that point. It was all about the harsh and brutal reality of having body parts removed. Ugh.

I don't do "sick" very well.  And by God's grace, I didn't have to.  In fact, I probably pushed it a bit too much to get back on my feet.  In the early days, I needed help with the drains and such.  It was also difficult to face myself in the mirror for the first time.  I'll confess that sometimes, I still start at my scarred reflection.

For the most part, I can say that those things that I was afraid that I would not be able to do again, I have done. This is not a brag list-it is a praise report and testimony to the faithfulness, mercy and grace of God:

• Cuddling/holding Jean-Marc?  Check! He's quite the love bug, and it's wonderful. 
• Running?  Check!  Ran a 10k in under an hour earlier this month. Less than a year out of surgery, less than 5 months after the end of radiation treatment.  
• Jillian circuits workouts?  Check!  I'm back to my level 3 Jillian circuit workouts.  I've definitely lost some of my upper body strength, particularly on the left shoulder and pectoral area. There is nerve damage there where things were cut. I'm permanently numb on my left tricep and across my chest where the scars are.  BUT-I can do push ups, just not as many.  I keep at it, and am able to do a little more each time.  My body will never be the same, but it is strong nonetheless. 
• The beach? Check!  I just went yesterday with the kids, my sister in law, niece, nephews and mom. I wore a bikini with my foobies in it.  

There have been some unexpected things as well. First on the list would be my lymphedema. Not all breast cancer patients get it. I'm one of the lucky ones.  But I am so thankful that Kaiser was very proactive in educating me on the signs of the disease, and even had me go see a physical therapist before the fact.  That way, when I did get it, I knew right away what to do and was able to learn to control it early. 

My friend was right. Things do look and feel a lot better a year later. Things will never be the same, to be sure. My family and I have been on a journey that has opened our eyes and changed us all, in many ways for the better. It has made us stronger.  Looking back and seeing how God has sustained me has increased my faith tremendously.  I thank you all for your support and prayer over the past year. It has been a blessing.

Moving right along....or not

Day 6 post-op.

I go in to see Dr. K this morning. Hopefully the drains will come out. With Eric's help, I managed to untangle myself from the tubes and bulbs and get into the shower. This time, it wasn't as shocking to see myself in the mirror. I think Eric was more shaken than I was. It is awkward to move-I'm afraid to make sudden movements for fear that I'll pull out a tube. 2 of the 3 drains are well below 50 ccs per 24 hours. The third is just at 50. We'll see what Dr. K does with it. I'm going to take 2 pain pills before I go. Yesterday, I managed to wean myself down to 5 for the whole day. That is pretty good. But I'm not going to take any chances this morning.

You never know what a new day will bring. Yesterday morning I had a huge problem with, well....constipation. I've debated whether or not to blog about it, since it is so personal. And even at that, I'm going to spare some of the more gory details. But I decided that if anyone comes across this blog and is facing surgery, I want them to be very aware of this problem so they can avoid it.

In the hospital, they gave me colace as a stool softener. I didn't blow it off completely, but for the first couple of days just took 1 pill. They said I could take 1-2. I figured that my high fiber diet would take care of any of "those" problems. On day 4 I had my first post-op BM, which was difficult, but I managed to do it. I figured all systems were go. Then yesterday, it just would not move. It was there, but didn't move. When my mom came, I asked her to take me to Discovery Lake so I could walk a bit on flat ground. I figured if my dog needs some walking to poop, maybe I did too? It hurt like crazy just to walk, but I made it.

We got back home and still...nothing. I spent about 2 hours trying. Crying. Begging God to help me. Now, I've had 2 unmedicated childbirths. I've pushed a baby out with her hand by her head. I've pushed out a baby that has a larger head than the baby that was supposedly too big to fit through my pelvis. This was just as bad. Seriously. But worse, because at the end, I didn't have a beautiful baby! But it was also ridiculous. I was wondering what I was going to do if I couldn't get it out. How embarrassing would it be to go to the emergency room for this? I almost passed out a couple of times. Once, I even thought I felt one of my stitches pop. I don't know how mom stood it in the next room. It must have torn her heart out. I was seriously suffering. Words don't really do justice to just how bad this was. Finally it passed. But man, I never want to do that again.

Take if from one who has been there. If you are facing surgery, and they put you on hydrocodone/acetaminophen, MAX OUT the stool softeners.

Things are better in that department today, thank the Lord.

The weather has been unseasonably cool. I for one, am thankful for it. Remember about a week and a half ago when I woke up sweating? I was worrying about the heat and the drains. I did not want to suffer in summer temperatures with drains and post-operative recovery. Well, God took care of the heat for me. I realize now how I wasted that energy worrying about the temperature. That was something that God has control over and made happen in my best interests. If you think about it, everything is like that. God has control over everything, even things we *think* we have control over. We only do because God gives us the strength and power to have some dominion over them. We worry and fret about so much. But in the end, God works all of these little details out in a way that works for us. We just have to trust in Him in all these things. God works everything for the good for those who love Him and are called according to His purposes. (Romans 8:28)

I'll post again later to update on the appointment with Dr. K. My prayer requests are pretty much the same as yesterday. Healing and harmony! Love to you all!

Pillows and Pathology

Day 5 post-op.

Pillows are my new best friends. I have them everywhere: upstairs; downstairs; in the car. The American Cancer Society sent me two small pillows that I tuck under my arms when I'm on the couch downstairs. Kaiser gave me a heart shaped pillow to use under the shoulder strap seat belt in the car. Up in my bedroom, I've got a big incline pillow that I sleep on. Then I've got 2 throw pillows that I tuck under each arm. Then a third pillow in the middle that my hands rest on.

Unexpectedly, my surgeon called yesterday to give me the results of the pathology report. I wasn't expecting to hear anything about the report until my post-op appointment on Wednesday. She said there were "no surprises." We go in tomorrow to see her and will get a copy of it for ourselves and go into it much deeper. But the bottom lines were:

• The right breast was clear of any tumors. That is good-that means my right lymph nodes will all stay in my body. With the left gone, these will be working overtime.
• The tumor on the left breast was 3.5 centimeters. It felt huge. I was afraid it was going to be much bigger.
• She got clear margins. She mentioned something about not needing radiation for this reason. I asked her if that meant I wouldn't need radiation at all, and she deferred to the oncologist, Dr. P.
• 5 of the 15 lymph nodes from the left side were positive for cancer. I already knew there was activity in the lymph nodes since the lump I felt was a lymph node. Because of the delay in surgery, I was afraid that all of the nodes would be positive. Having only 5 is an answer to the prayers that the cancer not spread.
• I asked her what "stage" of cancer I have. She had to scramble a bit and do some cross-referencing on the phone, but she said the factors in the pathology report put it at a 2b. Another answer to prayer. I was afraid it was a 3.

Eric did some research last night and there still is over a 50% chance that there are cancer cells floating around my body somewhere. I think he was kind of hoping that chemotherapy would not be necessary. He kept making comments over the past few days about how flawed the prophylactic use of chemo is when you don't really *know* there is cancer there. I've been resigned to the reality of chemo being in my future. But this 50% statistic is helping him come around to it as well.

With this news, I am feeling pretty good. I was holding out a little bit of dread and fear about the pathology report. To see just how "bad" it was going to be. It was the last unknown, at least for now. It helps to have the enemy unmasked and out in the open.

Dr. K said that if the drains were draining 50 cc or less each per day, she would be able to take them out tomorrow. Yesterday, 2 of the 3 did less than that. The third drain (the second one on the left) did 60 cc. We'll see how they do today. Overnight, they did not drain much. It usually picks up during the daytime. The drains are very uncomfortable. They itch and ache where they are coming out of my side. I'll be a very happy camper when they come out.

So now I am focused on recovering physically from surgery. I want to get back into as good of shape as I can before chemo starts. I know I won't be jumping into my Jillian workouts. But if I can do some cardio on the recumbent bike and keep my lower body strong, I'll be happy. I'll feel strong and ready to take chemo head-on.

My prayer requests today:

• That the drains be able to come out tomorrow. That means 50 cc or less each day. If there is more that they need to do, I want them to stay in. But if it is possible for them to come out tomorrow, it will help me rest better. I'll be able to find my new 'normal.'
• That it not hurt too bad when they take out the drains. I'm a little paranoid about this. I've been warned that it feels creepy. I can deal with a few seconds of creepy. I can deal with pain too. I'd just rather not.
• That I continue to be able to rest. Sleep is physical therapy. I can feel the renewal of energy and tissue when I wake up. Sleep is a godsend right now.
• Overall harmony in the house. It is hard being cooped up during the summer. Like all kids, mine bicker and have typical sibling rivalry. That raises the level of drama for everyone in the house. Eric and his mom get all worked up about it, sometimes seeming to take one side over the other. It just escalates. Eric also gets annoyed at what he sees as the kids' obsession with video games. They don't do it as much as he thinks, really. But he always seems to be coming down hard on them for it. Everyone just needs to chill out and cut each other some slack right now.

I want to thank everyone again for your prayers and support. I've received so many wonderful messages from so many of you. It is so encouraging and uplifting knowing that you all are out there with us in spirit. When this is all over, I want to throw a huge party and invite everyone to come and celebrate in pink and plaid!

Have a blessed day. God is good, all the time!

Surgery, part two

Coming out of general anesthesia is a haze. I can't be chronological about it. Rather, it is a series of impressions, senses and mental images. Confused and scattered. I had the sensation of being jostled around, moved, packed in. My first impression was pain. Thankfully, I was given something for that fairly quickly. The nurse mentioned something about how it hurt when she had it done, except that she had expanders. A breast cancer survivor? The sound of someone throwing up near me in the recovery room. Thirst, but not as bad as after my cesarean. A digital clock on the wall that read military time. It said 18 something. That is the 6 o'clock hour, right? It had been all day. My surgeon's face looming over me telling me it was over, that she had talked to my family. That I wouldn't remember this, but she had to take some extra stitches on one side. What is a few more stitches, I thought. Whatever. The original nurse leaves, a male nurse comes to take her place. I guess it was break time for her. The person next to me is still throwing up. I'm glad I'm not. Can I have some ice, please? The nurse came and fed me a cube and it was delicious. I'm waiting in a hazy doze. The original nurse comes back and makes a call 'upstairs' to see if my room is ready. After a few more minutes, I'm being moved. Can I take my ice cup? I'll even hold it.

As I'm wheeled out, I see Eric and my parents in the hall. I lift my hand up to give them a wave. What do you say? Eric told me right away that I looked good. Gee, thanks. :-) They are told to meet us up on the 5th floor in my room.

The room itself was tiny, and I was sharing it with another patient. The staff got me all situated and my parents and Eric squeezed into the corner. I felt a little bit like a bug under glass. Eric seemed to want to talk, but I just didn't have the capacity to do it. It is hard to know how to act in these situations. It was good to know that they were all there, though. I was thrilled to have a small pitcher of cold water waiting for me, along with 2 juice boxes. I got started on those right away.

Several hospital staff came in and out in those first few minutes to get me settled and introduce me to themselves. They put a sign up over my head warning everyone away from taking blood or blood pressure on my left arm. That is going to be with me for the rest of my life. With no lymph nodes on the left side, I'm at risk for swelling. It's a condition known as lymphedema.

The charge nurse came in and asked me if I wanted anything to eat. Sure. "What do you want?" she asked. How am I supposed to make a decision like that? Is there a menu? Do I have choices? I can barely form words, yet I'm supposed to come up with an idea? She suggested a sandwich, so I agreed. She brought me a turkey sandwich wrapped in plastic. I wasn't up to eating quite

yet, but would try later.

I could tell Eric was a little uncomfortable. I don't blame him. There was nowhere for him to sit, and what do you say, anyway? I told him that it would be okay for him to go home and be with the kids and his mom.

Soon after he left, I got incredibly hot. I asked mom and dad to take the blankets off my legs, but it didn't help. I kept sweating. They got a washcloth wet in the bathroom and put it on my head. It helped a little, but the hot sensation just wouldn't pass. Around this time, a dinner tray was brought and put next to me. It had some turkey with a thick gravy on top. I knew I needed some protein, so I scraped off the gravy and took a bite of the meat. I could barely choke it down. There was a pear on the tray, and that was good. It was cold, and tasted delicious. I tried a second bite of meat and a wave a nausea overtook me. Oh gosh, was I going to throw up now too? (My roomie had been having a bad reaction to her anesthesia). I grabbed a styrofoam cup and held it ready to catch anything. We told the nurses and they gave me some anti-nausea medication. That was better than the barf tray I was expecting. Needless to say, "dinner" was over.

After that, mom and dad did their best to help cool me down. They alternated cool washcloths on my head. They both stood over me fanning me with folded up paper and a notebook. Anything to help me. It started to work. Mom sat by me with the wet cloth and stroked my face and head. That felt so good to be babied like that by my mom. I calmed down, cooled down, and felt like I could sleep.

It was around 8 p.m. and I felt the pain creeping up again. There was a dry-erase board that had my care instructions on it. It said, "Ask for help" and "pain management." So I buzzed the nurse and asked for pain meds. Much like the dinner question, she asked me what I wanted. Well, golly gee. What are my choices? It was basically IV or pill. I wanted something fast acting, so I chose the IV. As she gave it to me, she said the IV meds (morphine) would last 1-2 hours. The meds in pill form would last 3-4 hours. I made a mental note to ask for pills next time. Mom helped me get to the bathroom before they left. It was awkward in the small room, being attached to the IV and an oxygen line. When I got back into bed, the nurse saw I hadn't eaten much. She suggested some sherbert. That sounded good. And it was. Mom would have stayed the night, but I felt like I was okay. I was just going to sleep anyway. As mom and dad left, mom said she would be back down early the next day.

A hospital is a 24/7 kind of place. There really isn't a "night" and "day." So I slept on and off. It was noisy. My roommate had a knee replacement and was on an epidural. Every couple of hours, a crew of people would come in to wake her up and move her position in bed. Which meant I got woken up every couple of hours too. On top of that, a lady would come in to take vital signs every few hours as well. I slept until about 11 and woke up. I thought I would ask for pain meds at midnight, but fell back asleep. There was a shift change right before I fell asleep, and my nurse introduced me to the night nurse. As she left, the first nurse squeezed my hand and told me that she would pray for me. I really appreciated that!

I woke up around 4 a.m. and knew I was going to need to go to the bathroom again soon. But I hadn't had any pain meds since 8 p.m., and that was the morphine that didn't last as long. So I knew it would be very difficult to get up without getting some pain meds in me first. I buzzed the nurse and asked the person who answered. When no one came by 4:30, I was wondering what was going on. The nurse finally came, but she came in to check on my drains. I asked her about the pain meds and she gave them to me right away, but suggested I eat some saltine crackers first.

About 30 minutes later, I asked for help to the bathroom. It was awkward again, but not as hard as it had been the first time. When I got back to bed, I just zoned out for awhile. My roommate made the first contact between us. We never saw each others faces, the curtain was always drawn. She asked me what I was in for. I dropped the cancer bomb yet again. She was very nice and I appreciated her kind words.

They brought a breakfast tray around 7:30 a.m. I was hungry, so anything would have tasted good. It was a pretty high-carb meal of French toast and Cheerios. The only protein was the milk for the cereal. No matter-I gobbled it up. The coffee helped my head too. I am kind of suprised by the lack of healthy food in the hospital, though. I heard the meal service person ask my roommate what she wanted the next day for breakfast. Her choices were: waffles; pancakes; or French toast. What about eggs?? Anyway, I was glad that I wouldn't be in too long for that reason alone.

My surgeon had procedures scheduled that day at Kaiser's Otay Mesa facility, so her assistant came to check on me. He asked me if I was ready to go home. I guess so. He took a peek at my stitches. I looked away. Not ready to go there, yet. He said everything looked really good. The main thing he wanted me to be aware of was that I wasn't to take any "extra" Tylenol, since my pain meds had a big dose of acetaminophen. When I was ready to exercise again, he said a recumbent bike would be the least jarring.

The nurse sent my mom down to the pharmacy to get my pain medication, and she took out my IV. It felt good to be "unhooked." When mom got back, she helped me to get dressed. When I saw myself in the mirror with the post-surgical camisole, with drains and tubes coming out, I asked her to get a picture. I couldn't help but think how "Borg-like" I looked. I told her to get a picture, and here it is. I laughed as I thought of a fitting caption for it, "Resistance is futile!"

I've got three drains, 2 on the left and one on the right. Each is attached to a long tube that is coming out of my side. (Ick) I've got these little velcro pouches that connect onto the camisole to hold the drain itself. They need to be measured and emptied out about 3 times a day. The nurse made sure mom and I were able to do it before we left. With all of the gauze padding, it felt like I was wearing a bulletproof vest or a life preserver.

The nurse wheeled me down and mom picked me up in the front and we left. I have a little heart shaped pillow that I wear underneath the seat belt so it doesn't rub on my chest. Mom was really careful to drive slow. The ride didn't hurt. It was weird to be out of the hospital and see the rest of the world carrying on as if nothing had happened. Yet my life had permanently changed. Now I was on my way home to try and figure out how to live it.

Surgery, part one

"Cancer is like you don't know how to skydive. Then, you are on a plane. All of a sudden, someone straps a parashoot on your waist and they push you out. Then, you have to go through the trial of teaching yourself how." -Isabelle Jamois, age 8

After three agonizing weeks, the day had finally come. Thankfully, (and an answer to prayer), I was able to get sleep the night before. I woke up around 5:40 a.m. and jumped into the shower. My surgeon had given me an antiseptic cleanser called Hibiclens to scrub my upper torso with. When I squirted it out onto the washcloth, I was taken aback by the pinkish red color. Yikes! A nice cool blue would have been better. The red just focused me on what was to come. It was hard to say goodbye to the kids. Isabelle was pretty upset. I found out later that she really was afraid I was going to die that day. As I left, I realized the outfit she had chosen to wear was...pink and plaid! I took her picture as she struck a fighting pose.

My mom and dad met us at the hospital. My check-in time was 9:00 a.m. The four of us went into the pre-op check in waiting room and handed the employee my Kaiser card. He was a funny man, bald and effeminate. I actually remember him from Jean-Marc's surgery there over a year ago. I saw a sign on the wall that said only 1 person could come into pre-op with the patient.

Thus began the debate...who would it be? Dad gracefully bowed out for personal reasons. ;-) That left mom and Eric. Eric said it was up to me. What?! Another decision to make? Before we could talk further, my name was called. I gave my dad a hug, thinking that this was it. The lady nicely corrected us...this was just an admission interview. I went into the room, where I gave her my Advance Health Care Directive. One thing I just love about Kaiser is their electronic records. She faxed the Directive over to medical records, and it will be part of my e-records. I went back out into the waiting room until they called my name.

As it turned out, I was to go back into pre-op by myself. Once I was into a gown and situated, then one person at a time could come and sit with me while I waited for my turn. I was shown into a large room with gurneys lining both sides. There were curtains that could be pulled around each gurney. I remembered the room from Jean-Marc's hernia surgery. In fact, I was in the little cubicle next to where I sat with him. The nurse gave me a heavy paperlike gown to put on, some socks for my feet, and a shower cap for my head. She told me to "take everything off." It was kind of hard to do that, even with the curtains pulled. There were other people in the room that I could see through the cracks. I knew if I could see them, then they could see me. Whatever. They weren't looking anyway. I got "dressed" and got into my gurney.

After several minutes, one of the anesthesiologists came to have a pre-operative discussion with me. She went over my medical history. As I told her, until now, my medical history has been relatively boring. She noted in my medical records my cesarean. She looked at me and said, "Oh yes, you are so little you probably couldn't push a baby out." I nicely told her that I had actually pushed two babies out after my cesarean, thank you very much. She asked if I had any questions. I shared with her one concern that I had and told her about my friend who went through a bilateral mastectomy last year. (Many of you reading this know who I'm talking about.) During her surgery, the anesthesiologist did not notice that the IV that was placed in her ankle had slipped out and infiltrated her foot. She suffered terribly from a swollen foot, needed skin grafts, and went through a lot of needless pain. She made a note of it in my record and promised me that they would be very careful with everything.

Another lady came in to give me my IV. Every new person that would interact with me would ask me what procedure I was having. I kept having to say, "I am having a bilateral mastectomy." Say that 10 times fast. Actually, I was having a modified radical mastectomy on the left and a simple mastectomy on the right. The IV lady was apologetic about the job she was there to do. I knew that it would probably be the worst part of the whole thing for me. I've had IVs in the front of my hand before and they hurt. I was not looking forward to it. I just repeated in my head, "God, please don't let this hurt." She wrapped the rubber tube around my arm and started thumping on my hand to "scare out" a vein. I felt the cold wetness of the antiseptic swab and readied myself for the poke, trying to do some deep breathing to relax. Then I heard her pulling tape. It was done! I hadn't felt a thing. Thank you Jesus for the immediate answer to prayer! The fluids that went into my hand were cold. I wondered if chemo would feel that way later.

Eric came in shortly after that to keep me company. There really isn't much to do but sit there

and wait in pre-op. My surgery was scheduled for 11 a.m. We had about an hour to wait. There is a TV in each little cubicle, but that's about it. One of the nurses asked me if I needed anything to relax. I told her I didn't, really. She looked at me kind of strange and said, "Not even a little bit?" She said she wouldn't give me much, just like having a glass of wine. Hmm. A glass of wine. I told her to go ahead. Eric and I chatted awhile and then he went to get my mom to come and keep me company. My surgeon came in and I asked her if she had her Wheaties that morning. She was in good spirits and seemed very confident. She marked my chest with her initials and noted the side with the cancer. She said it would be about a 3 1/2 -4 hour surgery. She would find my family to fill them in on how it went afterwards, but it would still be a couple hours before I was out of recovery. They had a long day of waiting ahead of them. Then she was gone.

All we had to do was wait. I turned my TV onto Fox News and we just watched. I kept thinking...at any time, someone in scrubs is going to come in and say it's time. Ack! It was interesting eavesdropping on the other people around us too. The guy directly across from me was having some kind of foot surgery and was nasty and combative with everyone. That didn't seem like a good strategy to me. The lady next to me came in self-sedated. By then, the little "glass of wine" that I had been given was worn off. It was okay, I didn't really need anything more. I thought about asking, just for the heck of it. I started to worry about my bladder. I had gone to the restroom right before putting the paper gown on. I was sitting on a chux pad on the bed. They didn't mention whether or not they would be catheterizing me. Was the chux pad because they expected me to wet all over the place? How gross would that be? By then, I kind of had to go again. Just in case. So we buzzed the nurse who came in and "unhooked" me from some of the machines. Mom helped me cover myself and hobble over to the bathroom, hooked to the IV. Better safe than sorry, right?

As it turned out, the particular operating room I was scheduled for was running behind. A little after 11 a.m., Eric came back in to see what was going on. He expected my mom to be out in the waiting room with them again. Soon after that, yet another doctor came in. This was the anesthesiologist that was going to be with me in the operating room. It was good that Eric was there, because he wanted to ask her about the particular drugs that they would be using on me. I didn't particularly care, as long as I was asleep.

As they chatted, a nurse in scrubs with a shower cap came in and introduced herself. She was the surgical nurse who would be taking me to the OR. It was time. The goodbyes with Eric and my mom were fairly quick. Everyone knew what they had to do. They wheeled me out of the big pre-op room and down into a maze of hallways. I heard them say we were headed to OR #3. The room itself did not seem that large. I was introduced to 2 other people with scrubs and masks on. They were going to be helping with the equipment. The pushed my gurney up next to the OR table and leveled them off so I could slide myself onto the operating table. It was narrower than the gurney. They were also debating what size surgical camisole I should get. They decided on medium, I think. (Hey-what about me being small?) They joked about how it wasn't exactly "Victorias Secret" and held it up. I told them they should dye them pink. That would make sense for breast cancer, wouldn't it?

Everyone was very busy. The nurse started putting my arms on what was probably extensions of the table that made my arms extend outward. My surgeon came in and started briefing the team on what was going to be happening. She said they would be starting on the left side. The anesthesiologist asked if she should get started, and Dr. Khoe agreed it was time to put me out. She put a mask over my face and told me to take some deep breaths. As I mentioned in my last post, I remembered God's promise from Psalm 91. I knew He was with me, and was giving His angels charge over me. Then I was out.

He will give His angels charge over you

When I was three years old, I nearly died when I came down with epiglotitis. That is when the epiglottis in your throat swells up and you cannot breathe. My dad was a lieutenant in the Army so my parents took me to the base hospital. They didn't know what was happening, other than their child was gasping for breath and had thick phlegm. The doctor on call was a major, who chalked my condition up to "croup" and described my mom and I as being hysterical. My mom summoned a courage she hadn't known until then to stand up to the man who outranked her husband. To make a long story short, I nearly died. Mom said after that that God had angels watching over me.

I definitely kept them on my toes throughout my life, doing reckless and stupid things as a young "adult." But I never really thought about them too much. I know the bible talks about angels and celestial beings, but I never really considered them too much.

As I shared in my last pre-operative post, the Lord put Psalm 91 on my heart the morning of surgery. It wasn't as if I was paging through my bible looking for something to hold onto. I was brushing my hair and it just came to mind. So I know it was a special word for me.

Isabelle was pretty scared the morning of surgery. (I found out today that she thought I was going to die.) So I read her Psalm 91 and told her to refer to it throughout the day if she felt scared. The part that especially resonated with me were verses 11-12, as well as 14-16:

"For He shall give His angels charge over you,

To keep you in all your ways

In their hands they shall bear you up,

Lest you dash your foot against a stone."

"Because he has set his love upon Me, therefore I

will deliver him; I will set him on hight, because he has known My name.

He shall call upon Me, and I will answer him;

I will be with him in trouble; I will deliver him and honor him.

With long life I will satisfy him, And show

him My salvation."

As I read it to her, I couldn't help by tear up. That isn't uncommon for me when I feel the Holy Spirit speaking to me. Especially when facing something so huge. I explained to her how I knew that this was God speaking directly to me that morning as I went into surgery. That I would be okay. See? It says it right here in His Word.

Several hours later, after I said goodbye to Eric and my mom, I was being wheeled into the operating room. I kept repeating in my head, "He is giving His angels charge over me....He is giving His angels charge over me..." As the anesthesiologist put the mask over my face, I kept repeating this as I drifted off to sleep.

The next thing I recall was a blurry scene with noises and fuzzed images. (I did not have my glasses or contacts in). But overriding all of these senses was the thought, "He gave His angels charge over me. I am okay."

Needless to say, the whole thing blew my mind. It was experiential. It no longer is theological or intellectual. I experienced the care and safekeeping of the Lord, who gave His angels charge over me. I had before, of course. But I wasn't aware of it at the time. This time, God let me know ahead of time so I would not be afraid. And I wasn't! I didn't need any pre-op sedative. The lady in the pre-op bed next to me took it upon herself to take Valium before she came in, and asked for more when she got there. I had something better. I was scared, but I had a peace that passes understanding.

He gave His angels charge over me. I am okay.

I will describe the surgery day in more detail very soon. I even have some pictures to share.

My prayer requests:

• That my body heal from surgery. I am sore around the drain sites. I am taking pretty powerful painkillers, but they have some side effects.
• That scar tissue does not form around the drainage tubes, which would cause pain when they are taken out.
• That I be able to look at myself in the mirror. I have the post-surgical camisole on right now. My surgeon says I can shower. But the thought of taking the camisole off and seeing what is underneath gives me the shivers and makes me want to puke. They gave me extra dressings to put on afterwards, but still. It freaks me out.
• That my family be able to recover and rest.
• That I be able to rest. I can only sleep on my back, and moving at all lying down hurts.

What God put on my heart as I go into surgery

Psalm 91 (New King James Version)

Psalm 91

Safety of Abiding in the Presence of God

¹ He who dwells in the secret place of the Most High
Shall abide under the shadow of the Almighty.
² I will say of the LORD, “He is my refuge and my fortress;
My God, in Him I will trust.”

³ Surely He shall deliver you from the snare of the fowler
And from the perilous pestilence.
⁴ He shall cover you with His feathers,
And under His wings you shall take refuge;
His truth shall be your shield and buckler.
⁵ You shall not be afraid of the terror by night,
Nor of the arrow that flies by day,
⁶ Nor of the pestilence that walks in darkness,
Nor of the destruction that lays waste at noonday.

⁷ A thousand may fall at your side,
And ten thousand at your right hand;
But it shall not come near you.
⁸ Only with your eyes shall you look,
And see the reward of the wicked.

⁹ Because you have made the LORD, who is my refuge,
Even the Most High, your dwelling place,
¹⁰ No evil shall befall you,
Nor shall any plague come near your dwelling;
¹¹ For He shall give His angels charge over you,
To keep you in all your ways.
¹² In their hands they shall bear you up,
Lest you dash your foot against a stone.

(I like that! The image of angels bearing up up in their hands to protect my body. No evil will befall me. Praise God!)

¹³ You shall tread upon the lion and the cobra,
The young lion and the serpent you shall trample underfoot.

¹⁴ “Because he has set his love upon Me, therefore I will deliver him;
I will set him on high, because he has known My name.
¹⁵ He shall call upon Me, and I will answer him;
I will be with him in trouble;
I will deliver him and honor him.
¹⁶ With long life I will satisfy him,
And show him My salvation.”

So I know I will get through this. I will be delivered and saved. Thank you Lord.

Thank you for your prayers. Keep them coming!

A series of "lasts" ... for now

I've read in books where cancer survivors have described their lives in two parts: BC (before cancer) and AC (after cancer). The diagnosis has been hard, for sure. But physically my life has not changed yet. Of course, that will all come to a screeching halt in two days when I go in for surgery.

Over the past few days, I can't help but think of things and activities as I do them as being the "last" time I'll do them normally. With my whole body. Last Friday, we went to the beach. I couldn't help but think that it would be the last time (before surgery) that I would go to the beach. Not that I was ever much of a beach junkie. It is like everything is taking on extra meaning as I do it as I always have done....for the last time. Last Sunday was the last time in church before the big day. Next time I go (which I am hoping I only miss a week), I won't be able to give and receive hugs like I did last Sunday. And boy did I get some really heartwarming hugs!

Today I'll be doing my last Jillian level 3 circuit. I have promised myself that I am going to get back to the place physically when I can do it again. But it is going to be awhile. The physical hit that I'm about to take is on my mind a lot. I've worked really hard over the past year to get to this point. Those level 3 workouts are no joke! It takes me about 70-90 minutes to do them. They involve strength training with hand weights, as well as insane plyometric moves. It is crazy! When my youngest brother, Jared, was here before his current deployment to Iraq, he came over and did them with me for a week. They were a challenge to him, and he maxes out the Army physical fitness test! It has been a source of pride for me that I've been able to get to this point. It's about to go out the window. (But perhaps, that is one of the things I am here to learn. I know God prefers humility over pride. Hmmm...)

I found a book at the library yesterday about exercise and breast cancer. The exercises looked so wimpy to me. They said to be sure to get your doctor's approval before starting anything--even simple arm stretches. The book said it could be about 6 weeks before you start exercising. 6 weeks!!?? I work out 6 days a week, doing dozens of pushups! This is going to be very tough, indeed.

Some "lasts" I was okay with. Like the last time I mopped the floor. :-) Others will be a bummer. Like the last time (for awhile), that I can get Jean-Marc out of bed in the morning. I love that time. He is so excited to see me. He's fresh, happy, and so darn cute. He lets me squeeze his pudgy little toddler body and give him dozens of kisses as I carry him downstairs for breakfast. I'm going to miss that. It will be one thing that keeps me going--the anticipation of that time again. But will it feel different in my altered body? I'll let you know when I find out.

I am looking forward to the surgery, though. At least then I'll know that the tumors are gone. I will have made a devastating first strike at my enemy. But it will be at some price to me as well. It will be the sacrifice of my life "BC." So I guess I am in a bit of mourning for that life. However, I know that God has plans for me. "For I know the thoughts I think toward you. Thoughts of peace and not of evil, but to give you a future and a hope." Jeremiah 29:11. He will turn these ashes into beauty. I just have to remember His promises and look toward the future that He has in store for me, and not look back with sadness. The joy of the Lord will be my strength.

Thank you for your prayers and support. I'm headed down to Spring Valley today to spend the day with my sister and law, niece and nephews. I look forward to holding my newest nephew, Caleb James, for the first time. God is good, all the time.

My prayer requests are the same as before: that the cancer would stop dead in its tracks; that my family and I would not be fearful; and that I would recover quickly without complication. Blessings to you all.

Packing it on?

I've put on 5 pounds since my diagnosis. Ugh.

Fridays have always been my "weigh in" day. I almost didn't even step on the scale today, kind of knowing the direction it was headed. Today was a good 5 pounds more than I was a month ago. Not good. Now it is that time of the month for me, so that may account for a pound or two. But I don't want to re-gain weight because of this disease. I'm going to need to be more disciplined about things.

I'll admit, my "carpe diem" attitude has followed through to the table a little bit. I've been good with the meals, pretty much cooking as I did before, avoiding processed foods and eating organics. Trying to bulk up on veggies and fiber and less on animal proteins. However, being French, Eric considers dessert an essential part of every meal, including lunch. So there are always sweets in the house. I've been following him right along. I've also been allowing myself wine every evening. Might as well enjoy it while I can, I figured. But the scale has busted me!

I'm going to enjoy food & wine through the weekend. Its not like I'm falling down drunk. I'm just having it with dinner and dessert. Come Monday, I'll stop the wine. With surgery on Thursday, I need 48-72 hours without any alcohol. That alone will stop any weight gain. With the painkillers post-op, I probably won't be able to have a drink for a long time. I'll weigh myself again on Thursday morning so I can give the anesthesiologist an accurate number. I'll enjoy food until Wednesday night at midnight, though!

The other component of weight maintenance for me has been working out like a maniac. I've missed a couple workouts over the past few weeks because of appointments. I'll miss a cardio day tomorrow because I'll be at Glen Ivy. When I was in weight loss mode, I would do some "extra credit" cardio a couple times a week just for the calorie burn. I haven't really had the time for that with the kids out of school.

I have 2 more days of Jillian level 3 circuits: Monday and Tuesday. Wednesday is supposed to be my day off, but I'll just make up the cardio on that day. That will be my last day of exercise before surgery. The exercise for me now is less about weight and more about being strong. Especially upper body strength. I'm not going to be able to do upper body exercises as I've been doing now for some time. It'll be goodbye to push ups, military presses and plank exercises. Sigh. I wonder how long it will take me to be able to even lift my arms above my head?

I'm hoping to be able to get up and get moving as soon as I can after surgery, just for recovery purposes. The sooner I'm able to move and get the blood flowing, the faster recovery will be. They will give me some exercises for my arms to do once the drains are out. Right now, I wouldn't even call them "exercises" but I suspect it will take a lot of effort to do these stretches.

I almost didn't write this post. But I want to remember the state I was in every step of the way. In writing it, I guess I have to publicly admit some slipping in the diet department. Oh well.

Getting all the ducks in a row....

Today was a big day.

My first appointment was at 9:30 a.m. We left Isabelle and Jean-Marc at my mom's house in Escondido where they would be spending the next 24 hours. We left early, just because Eric and I are both the type of people who get stressed out if there is the possibility of being late. With the nifty new commuter lanes on the 15 freeway that go all the way up to Escondido, we were really early! It was okay, though. I was able to return my mammogram films that I had checked out for the MRI. I'm such a good girl. The sign on the door said they didn't open until 9 a.m. So I stood outside waiting, even though it looked like the door was unlocked. About 10 minutes until 9, a lady popped out and said I could come in. She commented on how considerate I was not to just barge in. Hey, rules are rules, right?

When I checked in at the general surgery department at the Kaiser Vandever office, I noticed a calendar on the wall. Every time I look at a calendar, the 22nd of July pops out at me. I then looked at today's date...the 12th. I realized for the first time, that the two dates were only 1 row apart. My surgery is next week. That sounds a lot better than 10 days away.

I first met with Judy, the breast care coordinator for Kaiser in San Diego. She introduced me to THE CAMISOLE. After surgery, I'll be in a tighter fitting camisole that velcros up the front. I'll have 3 drains to deal with. (I found this picture from the Be a Survivor website) One on each breast, and one in my left lymph node area. Lovely. About 3 times a day, I'll need to measure the output from my body that collects in the drains and dump the contents. I also need to go to a local store and get a couple of camisoles for the post-operative period. They come with little velcro pockets to hold the drains. I can rip those off and use them with the post-surgical tighter camisole too. Then she started pulling out prosthetic breasts. ("Foobs" as I've seen on some bulletin boards.) After I've healed from surgery, I can be fitted for these. Kaiser will pay for 3 post-mastectomy bras each year (Nordstrom's is on their vendor list!). They will also pay for a pair of foobs every 2 years. We had a nice conversation about what really matters about your prognosis. We won't know how "bad" it really is until about a week after surgery when the pathology report comes back. I am very worried that I might be a stage 3 since I already have lymph node involvement. Judy said that its not so much the "stage" you are put at after pathology. But your personal strength, attitude and situation. In a way, that sounds like a cop out for someone with advanced cancer. Its like....don't worry if you're a stage 3. But maybe that is true. I don't know. I personally am freaked at the concept. But it is a very real possibility for me. I do know these things: I am in the strongest, most fit condition of my life; I'm young for breast cancer; other than cancer, I'm healthy; I've definitely got the will to live; I am STRONG; and there are a lot of people out there praying for me. I know that this whole situation is in God's hands-only He knows the number of my days. I certainly hope that He is using this (and my survival of it), for His glory. But maybe His plan is otherwise. I don't know. But I do trust Him.

Judy also gave me a lanyard with a clip that can hold the drains so I can shower after the surgery. We had a reassuring conversation about my oncologist, Dr. P. I learned that he is the head of research for all of Kaiser in Southern California. He's a very smart guy. I had asked everyone to pray that the oncologist that I happened to be assigned to be "the one." I think the fact that I've heard from multiple sources that he is very cutting edge on the research shows that it is another area where prayer was answered. Praise God!

I also met with my surgeon, Dr. K, for a pre-op appointment. I had definitely decided on the bilateral mastectomy. I still had questions about doing a sentinel node biopsy on the right/healthy side. The MRI and PET scan did not show any cancer on the right side. The chances of any cancer being there are small-nothing has shown up according to the best diagnostic tools. The chances of any cancer having spread from there to a lymph node is even smaller. There aren't any studies to really support a sentinel node biopsy of that side. When we consider that I won't have lymph nodes on the left side, she would prefer to leave the right side alone. As it is, I have a 10-15% chance of lymphedema (arm swelling) on the left side. Based on all of this, I decided to forego the sentinel node biopsy on the right side. If the pathology on the right breast turns out that there is cancer there, I'll have to have surgery to remove the nodes on that side. But at this point, the benefits don't outweigh the risks.

One bright spot. Dr. K did a breast exam on me. I've been having these imaginings of the tumors growing at a frighteningly fast rate. Imagine watching a ranunculus flower bloom with time lapse photography. I had this vision of Dr. K exclaiming, "Oh my! It is much bigger!" But she didn't. That was a relief.

On my way out, I was given a surgical "kit." It is just a folder that has some pre-op instructions, some antesthesia questionnaires and a packed of hibiclens. I'm supposed to wash my chest with that on the day of surgery.

From there, we went over to the laboratory at Zion. I had to get my blood drawn there for the genetic testing. I didn't have an appointment, so I was ready for a wait. They were on number 66 when I got there. I was number 82. It was a bit of a zoo atmosphere. One poor woman was there with two small children who were fussing very loud. I didn't get annoyed at her, although

others did. I pitied her. What an awful place to have to wait with little ones. What was worse was some man sitting right behind me. (The chairs are placed back to back). He was sneezing and snorting over and over. It was so gross--I could just imagine all of the germs he was spreading around me. Yuck. I was able to also do my pre-op bloodwork and pregnancy test. The lab had told me it had to be one week before surgery. Being the "good girl," I was going to wait until Thursday. Dr. K said today would be okay. That was nice, because they were able to draw the blood for both tests out of the same needle poke. Gotta save those veins for chemo.

After the lab, we had about 6 hours to kill before our meeting with the plastic surgeon, Dr. S. We could have come home to North County and then gone back down again. But we decided to make a day of it and do something fun. We headed over to La Jolla and had a nice lunch at George's at the Cove. The food there is delicious and well prepared. And not as expensive as you might think. A glass of wine is as much as a lunch menu item. After lunch, we walked around. I

was a bit drained from the morning, so we found a bench overlooking the Children's Pool and just watched the scenery. I'm not sure how the place got it's name, but it isn't a pool, and children don't go in it. It's a part of the beach where harbor seals have made home. We sat there and watched the seals, the people watching the seals, the sea birds. It was all very relaxing. We even saw a bunch of dolphins swimming northward. While I sat there, I logged onto the Kaiser website to check the results of my lab tests that I had just taken. They usually are pretty quick. Sure enough, the pregnancy test came back....negative. Whew. That was one I was a little worried about. My cycle has been a bit off since my diagnosis. I'm sure its the stress. Last month, I was a week early. Using that date as day 1, I should have started on Saturday. But I hadn't. Getting pregnant right now would be terrible. The cancer would grow because of the estrogen and I couldn't really treat it effectively. So thank you Jesus that I don't have to deal with those difficult decisions.

We also explored a part of La Jolla that was new to us...the caves. We didn't actually go down in them, but we went on the bluffs overlooking them. They do kayak and snorkeling tours of the caves. I'd like to do that someday-it looked like fun. Although the seals nearby were not happy with the visitors. We also found a trail that paralleled the coast. We walked on it as far as we could and then came back.

We still had a bit of time to kill, so we drove to Shelter Island and walked a bit there. By then, all of the outdoor exposure was starting to get to Eric. He has a tendency to get headaches if he's out in the UV too long. He popped some advil, but they didn't really help.

Our last appointment of the day was with the plastic surgeon, Dr. S. We got there a bit early. (Again, usual for us). The receptionist took us to a small room and put a VHS video on about breast reconstruction. I'll have to admit...it made me feel a bit ill to see it. For the more involved procedures where they transfer tissue from one body part to re-create the breast, they just used illustrations, rather than actual pictures. I'm grateful for that, because just the pictures made me want to puke. One in particular, the TRAM flap, they use part of your abdominal muscles. The result is a scar that goes from hipbone to hipbone--even bigger than a cesarean scar. Plus, you lose function in your abdominal muscles. One woman who had the procedure couldn't lift both legs at the same time. I thought of some of the Jillian exercises I do all the time (reverse crunches, lying leg raises). I wouldn't be able to do them anymore. No thank you. Eric also thought that compromising a healthy part of your body for aesthetic purposes didn't make sense. I'm glad he's not that attached to the idea of reconstruction if that is the cost.

We had to wait awhile to be seen by Dr. S. That was not good, because Eric was already not feeling well. We were tired and getting hungry too. He really had to fight the urge to get up and do his huffy French routine at the receptionist. We finally were led to a room and I was told to

put on a gown.

Dr. S came in after awhile and introduced himself. I was referred to him by one of the women in my "Look Good, Feel Better" session. She loved him, and said that Dr. K (the surgeon) worked with him often. I didn't take to him right away, but he seemed competent. He said his preference is to do implants with expanders. It is the least invasive method of reconstruction. Basically, they insert an expander under the chest muscles. Then you go in every couple weeks and they inject saline into them bit by bit so they grow. After a few months of that, you get the permanent implants in, either saline or gel. He prefers the gel, but acknowledges that some women prefer saline. Whatever. I have time to research that.

It was strange having a male doctor examine my naked breasts with my husband sitting right there in the room. I wonder if it was weird for Eric too.

I may not be a candidate for the implants on the left side, however. That is if I end up needing radiation after chemotherapy. Radiated tissue does not expand well. In that case, he would recommend a LAT flap on the left side and the implant on the right. In the LAT flap procedure, they take part of your latissimus dorsi back muscle and create a breast with it. Yikes. I'd have to think long and hard about that one. Again, I would lose some mobility in my back muscle. Dr. S. said it really would be very targeted moves that would be affected. We won't know any of this until after we get the pathology report back and hear from the oncologist, Dr. P. about what his recommended therapy is for me.

All in all, it was a very exhausting day. But it was good to be doing something. It was also nice to realize that surgery is NEXT WEEK. The only things left for me to do is get some chest X-rays and pick up those post-surgical camisoles. And wait, of course.

My prayer requests today are:

• As always, that the cancer has not spread past the lymph nodes. That the nodes are not so extensively involved that it would push me into a stage 3 cancer.
• That I will not need radiation after chemo.
• I could always use more sleep. Today I woke up at 4 a.m. and was in a doze until 6 a.m.

11 days to go...

11 days until my surgery. Not that I'm counting or anything. Yeah, right.

Yesterday was Jean-Marc's 2nd birthday. We had a nice little family get together at our house with my parents. I posted my birthstory and birth slide show on my Facebook page. As I re-watched the video, I couldn't help but notice and think about...you guessed it. My breasts. According to one of the books I have on breast cancer, it takes years for tumors to grow to the point where you can feel it. So I had to have had it while pregnant with Jean-Marc. In fact, it is a good possibility that the hormonal surges associated with the pregnancy and birth may have made it grow. Who knows? It doesn't really matter at this point.

Tomorrow is a big day. I have an appointment with Judy, the nurse coordinator at 9:30 a.m. She is going to talk to me about post-surgical stuff. I'm going to be getting one or two post-surgical camisoles to wear while recovering from surgery. She'll probably also introduce me to the prosthesis as well. At 11:15, I have a pre-op appointment with my surgeon. Then at 6:30 p.m. I have a consultation with a plastic surgeon to see what my options will be in the future for reconstruction, if I choose it. In between, I have to return my original mammogram films to Kaiser and get my blood drawn for the BRCA genetic testing. Eric and I are going to make a day of it. My mom is going to keep the kids all day and overnight. Hopefully we'll find something pleasant to do in the hours in between the appointments. It will be a full day, and keeping busy will kill another day. Soon I'll be down to single digit days.

I've been trying to mentally prepare myself for the immediate post-op. I've been looking at pictures of other women who have been through double mastectomies. At first glance, it is like a punch in the stomach. Especially when I try to envision those scars on me. Two scars on top for my breasts and one below from my cesarean. Battle scars all three, without a doubt. I overcame the cesarean scar. I will overcome these new ones as well. On a bright note, seeing pictures of the same women later in time is encouraging. The scars on the outside fade. It's amazing what plastic surgeons can do to re-create the areola.

It's too bad, but sometimes it takes an intense event to "feel" God. Even though He is always there, when times are good I tend to take Him for granted. Sometimes days would go by when I didn't pick up my bible or pray. I definitely felt His presence during Jean-Marc's birth. During the few weeks since my diagnosis, I've again tangibly felt His presence with me. I'm so grateful that I know Him and can see the times when a comforting word spoken by someone, or a verse recalled isn't coincidence but GOD reaching out to me to get me through this. I want to thank all of you who have been praying for me and supporting me. God is working through you and it is amazing to see the body of Christ coming together in such a beautiful way. It's humbling.

My prayer requests today are:

• That the cancer does not spread further before surgery.
• That I not go crazy waiting for the next 11 days.
• That I can sleep through the night. I actually made it to 6 a.m. yesterday. Today, I was back to 4:30 a.m., but was able to kind of doze until 6. I wouldn't call it sleep though.
• That I be able to be less selfish in this journey. I think I've neglected Eric. He's going through his own set of stuff related to this. I need to be a better wife. Sometimes his crankiness though gets me even more upset. Hey....I'm the one with cancer here! But that is my fleshly, selfish reaction.
• That Olivier has a fun time at boy scout camp. He's leaving this morning until the 17th. I hope he can just let loose and have a great time, not worry about me or be too homesick. A little is okay, though. :-)

Just can't escape it, even in paradise!

I'm back home from Catalina.

It was nice to change the outside scenery for a few days. Taking care of the practical needs of everyone while out of my usual environment helped to distract me from time to time from the "big C" refrain that is on an endless loop in my head. But it definitely pushed its way to the forefront many times. I tried to focus more on making sure everyone had a good time and did thing that they wanted to do. Isabelle had heard about glass bottom boats, so she and I did that on our last day. Olivier was pretty flexible with stuff and seemed to have a good time. Jean-Marc absolutely loved the swimming pool-he definitely is a water baby. The first time I took him in, he was giddy! It was really cute. We got many adorable pictures of him hamming it up for the camera.

But cancer was never far away from me. I don't think Eric noticed it until he downloaded some of his pictures that he had taken the first day. When he saw this one, he realized my mental state. We were on the boat on Tuesday morning, pulling away from Long Beach harbor. The picture does a good job of summing up how I am most of the time. I'm physically present, but not "present." I wish I could be fully engaged mentally in what is going on around me...especially when it is good.

Maybe I'm more sensitive to cancer related things. But I kept hearing snippets of the conversations of passers by that brought me back to it as well. For instance, walking on the pier, a man was on his cell phone and his end of the conversation that I couldn't help but hear went something like, "...they think they got all the cancer out in the surgery...." Every tourist shop I walked by I peered in looking at their collection of hats. I'd like to get a light brown/beige hat to wear once I lose my hair, but not one made of straw. Gosh, even a sand sculpture Isabelle made with her hands looked like breasts to me! Is that nuts or what?

On Wednesday afternoon while I was at the pool with the kids, Kaiser left a message on my cell phone. I called them back to find it was the "surgical outreach" department. Unfortunately, by the time I got the message, they were closed. I called at 9 a.m. on Thursday and left my own message. When they called back, it was just a medical history pre-op interview. Sigh. My medical history up until now is pretty boring. No other medical conditions. No disease. No medical devices. No medication. The only interesting part of the conversation was when she asked if there had been any changes in my weight over the last 6 months. Bingo! I told her I had lost 50 pounds. She asked me if I was going to write a book about how I did it. I told her that Jillian Michaels already had. After I hung up with her, I called the surgical scheduling department to see if my surgery date could be moved up. The answer was NO. That bummed me out for a couple of hours. I felt better after lunch, but my mood seemed to latch onto Eric, who was out of sorts for the rest of the day. I'm not sure why. Perhaps it was realizing how much 2 1/2 days restaurant meals was costing.

I went out for a run early on our last day. The hotel had a "gym," which was a small room with some old equipment. Why run on a broken down treadmill when I could run around the island? I ran up to the Wrigley Memorial, which is on a slight incline. I ran back down. I ran through the small town of Avalon, past the boat terminal on Pebbly Beach road as far as they would allow pedestrians. It took about an hour. It felt great, but my old shoes need replacing, so my knee started hurting. The run was nice, but pointed out this disconnect I have--here I am, able to RUN for an hour. To the people I run by, I don't look sick. But here I am, with cancer cells dividing inside me, trying to kill me. I'm glad I went for my run. I want to feed that "strong" side of me for as long as I can.

I hope I don't sound too morbid or self-pitying. I really did have a good time and I'm glad we went. As my last post showed, God is ministering to me to help me get through this. The trip gave the Eric and the kids a sense of having had a vacation, and I'm 3 days closer to surgery.

My prayer requests:

• I continue to have trouble with sleep. I get to sleep okay, but if I am roused in the night for whatever reason, I have had trouble going back to sleep.
• That this cancer does not get any bigger. My cancer is estrogen driven. This week has been a pre-menstrual week for me. I've been paranoid that my cycle is making these tumors grow like in time-lapse photography. I won't know what "stage" or how big it is until after surgery. Not knowing this is kind of eating at me as well. I really don't want to be at stage 3, but I'm afraid that I may very well be.
• I know the surgery date is in God's hands, like everything else. But each day of waiting is torture. I pray for an earlier date-every day makes a difference. Waiting for certain pain is hard. I'd rather just jump into it and get it over with.

July 22 - Three more weeks??!

I finally have a date for surgery...July 22nd.

I'll have to re-do all of the lab work I did last week because it will be to far from the surgery date. (Blood work & a pregnancy test) I'm glad I didn't make the appointment for the chest X-ray before, I'd probably have to do that again as well. I'll also need to go in and see the surgeon again for a pre-op appointment. That is set for July 8th. Actually, I'm glad to go in and see her again. Especially now that she has the data from the MRI and PET Scan. I'm hoping to be able to make an appointment with the nurse coordinator, Judy, on that same day.

But I am really disappointed to have to wait 3 weeks before surgery. The thought of these cancerous cells dividing and possibly spreading past the lymph nodes is scary. They are supposed to call me if something earlier opens up. My surgeon told me that my case is one with the highest priority. But still. 3 weeks. That is longer than I've known I have breast cancer.

I've got to trust that this will be okay. That waiting 3 more weeks won't mean the spread of this disease any further. I know a lot of prayer went into this surgery date. God is in control.

In the meantime, I've got more stuff to do. Another pre-op visit with the surgeon. A visit with the nurse coordinator down at Zion. I have at least 2 more visits to the lab for blood draws and a chest X-ray. Then there is genetic testing (I'll talk about that in a separate post). Aside from the cancer, I'd like to get my teeth cleaned. The kids and I are due for it. I definitely need to do that before chemo. A massage! A pedicure. I need to buy some button up the front shirts for post-op days. Most of my shirts are pullover. That is going to be really hard to do for awhile.

Eric and I also have decided to do a little mini family vacation next week. If we can get reservations, we are thinking about going to Catalina Island for a few days next week. We want to do something fun as a family before the treatment begins. Our original plans for a trip to Idaho were nixed because of this disease. We'd like to have some happy 2010 summer memories. I don't know how far out of my mind the cancer will be. But the kids will have a good time. Plus...I'll be able to wear my new bathing suits with my "normal" breasts. Kind of weird to think that it'll be one of the last times. I think I have some processing and grieving to do over the loss of my breasts. I know its the right decision. But after nursing 3 kids for over 3 years....They were really good at that. I was a milk machine!

My prayer requests today are:

• If it is at all possible, and in Gods will, that this surgery date will be moved up.
• Sleep. Eric and I both aren't sleeping well this week. I thought after making the decision for the bilateral mastectomy, I would sleep like a baby last night. But I woke up in the night with all kinds of thoughts running through my head. (Well...maybe it was a birthy mojo, because I found out this morning that my sister, Tara, gave birth last night at home to my new niece, Katherine Marie. :-) )
• That regardless of the surgery date, that this cancer does not spread. I feel like every day makes me a ticking time bomb. That some mischievous cells will burst out of my lymph node and into other areas of my body.

As always, thank you all for your prayers and support!

Decision made

I just got off the phone with my surgeon and told her that I wanted a bilateral mastectomy with a sentinel node biopsy on the right side. A sentinel node biopsy will sample a couple lymph nodes on the right side to make sure that there is no cancer there. The chances that there is any cancer there is VERY slim, since they don't "think" there is cancer on the right side. All of the lymph nodes on the left will come out, since we know there is cancer there.

As I mentioned in my earlier post, there were a lot of factors to consider. I also surveyed as many breast cancer patients and survivors as I could. I did not hear of anyone who had a bilateral mastectomy and regretted it. However, I did hear stories of women who had less invasive surgery and later did regret it. Either because they felt "lopsided" or because the cancer came back on the other side. It required them to either live with the issue (at best), or have more surgery to go back and remove the breast.

For me, a big part of the decision is peace of mind. I am a warrior. I am going to stand up and fight this invasion with overwhelming force. I'm taking away its battleground. Taking the rug right out from underneath it. Game over. (I hope). I'm 40 years old. I have a lot of years ahead of me that it could come back in. I don't want to always worry that it would come back. I now have a 95% risk reduction of developing it on the right side. If it comes back, I'll fight it again. But I want to do everything I can today to fight the definitive fight.

It is going to be very strange to lose body parts. I'm not sure how I'm going to feel about losing my breasts. I don't really have a choice for the left side, there are just too many tumors in there. For the reasons mentioned above, I want to deal with both at the same time. Its just going to be very strange to be so flat after 25+ years. And just dealing with the realities of surgery. The incisions, the drains, the pain, the recovery. The down time. That is going to be hard for me to be incapacitated.

They do give you prosthetics that will slip into a camisole. I've seen some survivors refer to them as "foobs." They the shoulders and balance. After you have recovered from surgery, you can get more sophisticated "foobies." Some are even waterproof! Who knew?

I don't know right now if I will choose reconstruction are not. There are lots of options there-some that even give you the added bonus of a tummy tuck. I'm not a candidate for immediate reconstruction. Depending on the size of the tumor, I may need radiation after chemo. I'm glad that isn't a decision that I need to make right now anyway.

The next step is to schedule surgery. I should be able to do that tomorrow. My surgeon told me that my case has the highest priority. The timing is all in God's hands. Of course, now that the decision is made, I want it to happen as soon as possible. Get that cancer the heck out of my body. God will work it out so that all of the balls that are up in the air, (Eric's trip, my menstrual cycle-I don't want to be having my period while recovering from surgery, my soon to be arriving nieces/nephews, kids' birthdays, etc.) will come down in exactly the right place.

Waiting for the phone to ring

I want to have surgery scheduled immediately. If I could go in tomorrow morning, I would. But I have to wait for a call from my surgeon. She needs to make sure what kind of surgery I am electing. When we last spoke the possibility of a lumpectomy was in the air. I suspect she wants me to know for sure that she won't do a lumpectomy without chemo first. That is okay. I've ruled out the lumpectomy anyway.

I had called her office on Friday at 4:30 p.m. Some hopeful part of me was thinking I could get on the surgical calendar on Friday. Why waste a whole weekend-that is 2 more days of cancer growing inside of me. On Friday, I was told she was out of the office. The nurse was very nice-she called me at 5:45 p.m. on Friday night to tell me the doctor wanted to talk to me and she would call me on Monday. On Monday morning, the nice lady (Stephanie) called again to tell me that the doctor was out of the office and I would hear from her on Tuesday. Today is Tuesday. I called the office at 2:30 p.m. and left another message. Hopefully I'll get a call soon.

Our entire summer is up in the air without a surgery date. Eric has plane tickets for France for July 2nd. A business trip he scheduled several weeks ago is in limbo. (Okay, he'll be able to visit his parents at the same time). Both he and the company are very willing to cancel or postpone it. They just need to know. I need to know.

I was praying for guidance and wisdom this morning in my surgical decision. I came across this psalm:

"Give ear to my words, O Lord,

Consider my meditation.

Give heed to the voice of my cry,

My King, and my God,

For to You I will pray.

My voice You shall hear in the morning, O Lord;

In the morning I will direct it to You,

And I will look up." (Psalm 5:1-3)

That was the cry of my heart at 5:55 a.m. this morning. Please hear me God...incline your ear towards me and give me guidance.

The Psalm continues:

"But as for me, I will come into

Your house in the

multitude of Your mercy;

In fear of You I will worship

toward Your holy temple.

Lead me, O Lord, in Your

righteousness because of my enemies; [cancer cells]

Make Your way straight before my face." (vv. 7-8)

My supplication this morning was all about whether to have a single or bilateral mastectomy. I know God speaks to us through His Word. Unfortunately, I don't think there is a verse in there that would say, "daughter....go forth and have a bilateral mastectomy!" But I do want to be in God's will. I want to walk down the path He has laid out before me. I want him to lead me on that straight path.

It goes on:

"Let all those rejoice who put their trust in You;

Let them ever shout for joy,

because You defend them;

Let those also who love Your name

Be joyful in You.

For You, O Lord, will bless the righteous;

With favor You will surround him as with a shield." (vv. 11-12)

I do trust God. There is a joy in knowing that despite the challenges I may be facing right now, God is there to defend me against these sick cells that are dividing. The thought of being surrounded by the Lord is awesome and mighty. I actually had an experience last week when I was in devotional time that I really had the tangible feeling of being surrounded by such love and protection. It was amazing to feel the arms of Abba Father around me, enveloping me. Protecting me. Comforting me. God is so good, even in the midst of this. When I start to freak out, I must remind myself to look to HIM. Not to try to survive this in my own strength.

Regarding the timing of the surgery...the right date will happen. "I know that You can do everything, And No purpose of Yours can be withheld from You." (Job 42:2)

God is good....ALL the time.

Meeting Dr. P

I had my long awaited oncology consultation yesterday.

Eric went with me. Him being in the drug discovery field and knowing many researchers (including cancer specialists) has been a great blessing. He had several pages of notes on research that he had done to get ready for the meeting. I just wanted it to start. As I waited, I played with an app on my iPhone called "Bible Shaker." You choose a category, push a button, and then an appropriate verse pops up. So I chose the topic "Fear" and started pushing the button. There was one really cool one and for the life of me right now I can't find it or remember exactly what it said. But it did say "You will not die." Thank you Lord.

The door opened and Dr. P came in and sat down. He was a quiet man who sat hunched over on the stool and looked at us over the top of his glasses. As we had our conversation, he reminded me of some of the scientists that I've met that have worked with Eric in the past. Quiet, but smart.

Had the results from this week's MRI (an answer to prayer). The MRI showed 3 tumors on the left breast that were fairly close together. That explains the strange feel that it has--it seemed huge. Now I know that it is 3, not one big one. There was a suspicious area at 6 o'clock as well, which may or may not be cancerous. If I was interested in trying to save the breast, it would need to be biopsied. If it was cancerous, a lumpectomy would not be an option. I had already decided that a mastectomy would probably be the way to go, and this sealed it. I don't want to have another biopsy and wait another week for results.

We discussed whether to do chemo first or surgery first. Chemo first would tell us if my cancer was responsive to chemo--apparently not all are. When they do surgery first, they remove the known cancer and then blast you with chemo to kill any cancer cells that may be wandering in the system. They don't know for sure that they are, its kind of a prophylactic measure. If it was responsive to chemo, the tumors should shrink. Frankly, knowing that there was something suspicious in there that we couldn't even feel yet makes me want to just move ahead with surgery STAT.

I brought up the question of a bilateral mastectomy. He did not think it was necessary. There is no evidence of cancer on the right side and I've had the best diagnostic tests done. With my history, I will be monitored very closely for the rest of my life. If cancer does develop, it will be caught early...hopefully stage 0. But still. I want to fight this right now once and for all. Do it right the first time. Knock it out with overwhelming force. He said the chances of it moving to the right after treatment were like 1 in 20. He thoughout t hose were small odds. I don't know. It seems pretty high to me. There is also the question of symmetry. I'll be given a prosthetic breast to wear during treatment and until I do reconstruction. (If I do reconstruction). I wonder if I'll be lopsided if I only have a single? The wig lady earlier this week regretted not having both taken off for that exact reason. Any thoughts you fellow pink ribbon clubbers have out there would be welcome. I was awake for part of the night pondering this question.

There is also going to be the option of participating in a clinical trial. If I choose to participate, I would have to do the chemo down at Zion rather than in San Marcos. They would randomly assign me to one of three groups. Each group gets a different chemo cocktail. I want my experience to help others, but I'm not sure about the trial. I also want to be treated with what is known to work. There's time to decide.

He also did a breast exam. He checked the lymph nodes in my neck. All clear. Whew. He checked the left side and felt the tumors we already knew about.

Througout the exam, Eric was quizzing him on various drugs and trials. As he helped me sit up after the breast exam, they started chatting about Eric's line of work, various uses for drugs on different types of cancer. I'm standing there in a hospital gown, just wanting to get dressed, and these to science guys are yakking! It was funny in a way. They could definitely communicate on a different level that I could.

Is Dr. P "the one?" I suppose so. I'm not really that particular about his personality as long as he is a good doctor and knows what he is doing. On a personal level, he got warmer as we went through the meeting. I get a sense that he really knows his drugs. Eric quizzed him pretty good. He made me feel like I had a good prognosis, even though he won't know the extent of the cancer until after surgery. He referred to women with "much more advanced" breast cancer. Funny how knowing there are others out there worse off than you can be a comfort.

It looks like I'll start chemo in early August. I should have the surgery within 2 weeks. I'll find out more specifically on Monday. That is an area for prayer. I want this cancer cut out as soon as possible. 2 weeks will be an eternity. I also ask for more clarity as I decide between a bilateral or single mastectomy. Thank you all, once again for being prayer warriors on my behalf. It is working!