Ummm, my eyes are up here!

I had just been telling Dave how much I liked the woman surgeon we met with because I felt that she understood me better.  Dave said, "Well, a woman might be able to empathsize with  you better, but a guy knows what a good set of t*ts look like".  Thus began our first consult with a plastic surgeon - Dr. Andrew Smith at RGH.

I'm looking at two options for reconstruction.  The first option is that they place an expander behind my chest muscle during my mastectomy (or mastectomies).  Then, for approximately 2 months, I go in every other week and they put a needle into it to fill it slowly with saline.  Once it gets to the desired amount, I would go back in for surgery to replace it with implants.  The other option is to get a tram flap.  This is where they cut a giant section out below your belly button and use it to construct a breast.  You get a little tummy tuck as a bonus.  Nipples could be tattooed on later as they have their own artist on deck - and we got to see the pictures.

The plastic surgeon, Dave, and my naked self had all these discussions.  They were all talking about my breasts as if I wasn't there....it was just them and my boobs.  I actually didn't know where to put my own eyes, so I joined in and looked down at my breasts too.  Then the surgeon looked at my lower abdomen to assess if I'd be a candidate for the tram flap procedure.  Turns out, and I don't know if this is a compliment or not, I don't have "a lot to work with".  So, I could have either  2 B-sized breasts  or 1 D-sized breast.  And he says the tummy tuck wouldn't even make much of a difference on me.  I was like, "Dude, it's Halloween and I plan on eating all my kids' candy once they fall asleep, so give me a chance to grow a saggy tummy that you can work with."  That wouldn't even be a challenge.

Finally....results of MRI and a consult with a surgeon

Finally the results of the MRI - a few highlights:

• Right breast is fine
• Left breast has two other suspicious areas
• Didn't say anything about lymph nodes
• Didn't say anything about what stage

The funny thing is that I got all the information over the phone from my gyn doctor's office.  I was frantically taking notes because Dave was on a work call and I didn't want to forget to tell him anything.  I wrote "4th area, superior to cancerous area, near aereola, might have spread".  He read the notes and frantically started packing us up to get ready to see our first surgeon consult.  (Back to this story in a minute....)

I loved the breast surgeon at Rochester General:  Dr. Medeiros.  Sorry, I butchered that name on my last update.  She is the director of breast surgery and Dave got us in there for an immediate appointment through a work contact. She did a visual and breast exam first - to get a good idea of the kind of surgery we were looking at.  As she was doing this, Dave was asking a million questions....namely, if the cancer had spread to other areas of my body.  At this point she said she had no reason to believe that it did.  She left the room for me to get dressed and Dave let out the BIGGEST SIGH OF RELIEF.  I was like ????????  He said that when he read my notes from the morning, it said the MRI showed that the cancer had spread into my AORTA.   Now go back up and reread the underlined part.  He read "aereola" as "aorta" and thought the cancer had spread to my heart.  He was quite worked up over this.  We've been laughing over this ever since.

Back to the surgeon's recommendations:  I am looking at a rough-looking lumpectomy or a mastectomy with breast reconstruction.   I'm having genetic testing to see if I have a predisposition to breast cancer.  If I do, I will have a bi-lateral mastectomy.  She would not be able to tell if my lymph nodes are affected until she removes them during surgery and has them tested.  If they are positive for cancer, I would be looking at chemotherapy.  If not, I may get away without chemo.  I may be a candidate for Tamoxifen for 5+ years instead. Radiation is to be determined.  Stage of cancer is to be determined after surgery - most likely I am stage 2b.  I have an 85% chance of living for 5 more years.  Sweet, right? :).....nothing like an honest discussion about your life span.  Breast reconstruction would involve a spacer placed behind my chest muscle that is slowly expanded over 2-3 months until it is the right size for an implant. First surgery could be in about 3-4 weeks, with an overnight hospital stay and out of work for 6 weeks.  Then the second (breast reconstruction) surgery would be a few months later and I would be out of work for about 2 weeks. 

Dave and I went to lunch and shared a carafe of wine.....and had philosophical discussions.  Fun times. I've been in denial, but this is becoming a little more real to me.

On the horizon:  I meet with a plastic surgeon on Monday.  I get 2 more second opinions on Tuesday (Dr. Caldwell and Dr. Hetland).  Then a week from that I head to Cleveland Clinic to consult with a surgeon, oncologist, radiologist, and plastic surgeon.  I'm exhausted from today's information - not sure I can do this several more times.

But, looking on the bright side, I don't have cancer of the aorta! :)

And in the meantime, Dave is enjoying looking at pictures of breast reconstruction.  Sigh. :) :)

No results

Been waiting allllllllllllll day for my MRI results.  Elizabeth Wende Breast Clinic said that they would send them to my doctor by today.  Many people have shared experiences of EWBC sending them the SAME day to their doctor.  Something is going on between Borg & Ide and EWBC.
EWBC didn't get the mammogram images from B&I in order to write up my MRI report.  B&I had put them on CDs for me and I hand delivered them to EWBC.  Since B&I apparently hates me, I'm assuming I delivered blank CDs.  Pretty pissed does not begin to explain how I'm feeling right now.....

We had an appointment with my gyn and got a lot of questions answered.  We requested a BRCA2 (genetic) test which required me to fill a test tube with spit.  Lovely.  Results in 4 weeks.  We were also easily able to get all the biopsy pathology reports that B&I and ACM refused to give me.  Unbelievable.

So no MRI results and we see our first surgeon at 10:30am tomorrow morning. Dr. Maduros at Rochester General.  She has requested the MRI results for our appointment too.  We'll see....

MRI

The MRI was not bad.  The doctor had offered me a xanax and I accepted.  Wow, I can see how people could get addicted to those.  It slowed all the anxiety in my heart and breathing down.  So nice.  I was only in the machine for 20 minutes and the contrast dye didn't hurt.  Elizabeth Wende Breast Clinic is seriously the best.  They gave me a CD with the images, without me even asking.

Borg & Ide Imaging, on the other hand, I have been ready to throttle!  They have shortened my life span by three years with stress alone.   I have been trying to get a copy of my biopsy pathology report from them and it's a no-go.  They tell me to call the lab, ACM, for a copy.  ACM says they cannot give it to me, only Borg & Ide.  B & I tell me that only ACM can give it to me.  They have changed their story every time I have called - BOTH places - and I'm not kidding.....I have called at least 4 times to each place.  By the last 2 calls, I had lost my cool and was yelling.  I just don't get it.  When Dave is talking to potential surgeons, they ask him questions that only the pathology report can give.  It's really been unbelievable.

Anyway, results from MRI should come from my gyn tomorrow.  Also, going to ask about getting genetic testing.

In the meantime, I am trying to explain to Will and James, in 4 year old language, what is happening to me.  I have showed them my bruises and bandages from the biopsies.

Me:  Remember when the doctor had to check my breast with the needle?
Will/James:  (wide eyed, open mouthed, horrified looks). yes...
Me:  The doctor found a little disease in there and they are going to have to do a little surgery to take the diseased part out.
Will/James:  (slight hesitation). Can we get the nerf guns out?

:D

Pink is not my color.....

.....but my left breast does not agree.  It went rogue.....developed two lumps.  I found them in mid-October.  I spent three days trying to determine if I was really feeling lumps.  Then I went to Dr. Google and "we" both agreed it was just fibroids....dense breast tissue......hormones.  Dave was like, "Nah, call your real doctor just for fun."  I did.  They had me come in that day.  Yes, two lumps - $15 co-pay please and thanks.  Onto a diagnostic mammogram at Borg & Ide the next week.  3-D mammogram, ultra-sound and a recommendation to have a biopsy.  Dave sat FOREVER in the main waiting room and I was in the inner waiting room.  We were texting each other, trying to make sense of things.  Trying to figure out what questions to ask.  He asked if he should come back to my waiting room.  Um, not unless you want to sit with a bunch of women not wearing shirts.  I begged them to get me in  for the biopsy ASAP.  How about in 30 minutes?  Eeeek - okay.  I had zero time to google what I was in for.  It wasn't a fine needle aspiration.  It was a core biopsy guided with ultrasound in a room that was about 45 degrees. They prepped me for surgery that I was to be awake for.  One shot of lidocaine.  Then a scalpel cut.  Then 4 of the biggest needles I have ever laid eyes on.  The doctor had to push her weight on them to get them in.  The best way to explain it is if you have ever tried to put a large needle through leather.  It took a lot of time and effort for each needle and then it would SNAP a chunk of me - the biopsy.  Thought I was done, but no.  That was all for the first tumor.  Lidocaine and 5 biopsy needles for the second tumor.  Then, two more insertions of titanium clips for each tumor - markers.  Then the long wait for results that would take 2 days.   Except, this was over a weekend, so it was really 4 days.

I told Dave that bad things come in threes.  I found two lumps - bad thing #1, I hit a deer and dented the front of my van the morning after the biopsy - bad thing #2.  I knew a cancer diagnosis would be bad thing #3.  But, that Sunday the Buffalo Bills LOST!  Dave was like "That's the bad thing #3, you're going to get good news tomorrow!!"  Except, I still had the worst nervous stomach ache....

I tried not to google too much....but.....

I had to wait until the end of the 4th day, Monday, and I still hadn't heard.  When my anxiety levels reached maximum capacity, I called.  The receptionist nonchalantly told me "Oh, yes, you had a mammogram and then a cyst drained.  You're all set.  Just call your primary doctor".  Um, no my friend, these were not cysts.  These were tumors and your office said they would call to tell me if they were cancerous or not.  "Oh, um, we'll have someone call you back."  Back to waiting. Then, finally the phone call.  I bribed my kids with chocolate to be quiet so I could hear.   1 benign, 1 cancerous.  Grade 2 out of 3.  Not encapsulated.  And then a lot of talk of what to do next.  I blanked out a bit.  I've been doing that a lot since this diagnosis.

Thank God for Dave. He has been making it his business to learn everything.  He has scheduled consultations with four Rochester surgeons.   We will go to those together in early November.

Tomorrow, we drop the kids off at daycare at 6:30am to get to my next step - an MRI.  This will determine what stage I'm at and if it has spread to my lymph nodes. I'm still in denial.  I hope reality doesn't hit me too hard tomorrow.