Sunday, April 22, 2012

Who Needs Hair Anyway?

Well yesterday was the second day I had been dreading for the past 8 weeks (the first was starting treatment).

Yesterday I regained what little control I have in this whole situation.

Yesterday I lost my hair.

Had I waited to lose my hair naturally I would have been waiting for another 9 days. It would have started to fall out in large clumps. I would wake up with piles of hair lying on the pillow.

I decided to say a big "screw you" to chemo and shave my head before that could happen.

I have had this planned for a while so I asked my best friend to come into town and go wig shopping with me. I tried on so many that they started to blend together by the end. I did decide to get two (both similar styles and colors). I will be wearing a wig until my hair grows back long enough to create some sort of pixie cut (like Michelle Williams) so having two will be nice. I was able to bring one home but had to have the other one ordered in a darker color.

I was initially planning to have my head shaved in a salon, but as the time got closer I decided that I really wanted to do it at home. I knew that I would most likely cry, and I felt more comfortable crying in front of Derek and friends. We turned it into a small party; we had four friends here and through the wonders of technology our good friends in South Carolina were able to join us as well.

Even though it was upsetting and I cried throughout most of it...I wouldn't change a thing about how it happened. I was surrounded by people that I love and was glad to be able to share such a big part of my journey with them. They also helped keep my spirits up afterward as well!

The party didn't stop with my shaved head, since Derek decided to have his shaved as well! Once he was done my friend Adam joined us too. Pictures are at the bottom!

As an update from my last post, I am very happy to say that I have been feeling great for the past several days! All of my digestive issues have resolved, my weight is back to pre-treatment range, and I really don't have any fatigue. I was able to walk 2 miles this morning and another 2 this afternoon. My thrush has mostly resolved. I still have mouth sores so eating gets uncomfortable, but still very manageable. I had another blood count on Friday and while all of the counts are lower, they are all still within normal limits with the exception of my platelets. Tomorrow is supposed to be the day my counts are the lowest, so I am really hoping that I will continue to feel good for the next week and a half.

"You've only got three choices in life: give up, give in, or give it all you've got." - Unknown

Help me reach my goal for the Susan G. Komen Twin Cities 3-Day

Thursday, April 19, 2012

A new day, a new side effect

Well I definitely dodged a bullet with the nausea and vomiting, but I seem to have developed almost every other side effect since my last post!

On Monday afternoon I went back to the clinic for my Neulasta injection. This is a very expensive medication (thank you insurance company for covering it at 100%) that will help keep my white blood cell count up. Not everyone needs to get this after each chemo cycle, but since I am continuing to work through treatment (and since I work in healthcare) my oncologist wants me to get it each time. The medication works by stimulating the bone marrow to produce more white cells, so one of the main side effects is bone and joint pain. It started for me right away on Monday night, but Tuesday morning it felt like I was hit by a truck. I was incredibly achy and fatigued (which I thought was chemo fatigue starting but it was just another side effect of the injection). Work on Tuesday morning was quite tough, but by the afternoon things started to get better. We have already adjusted my schedule slightly for the day after each injection for the remainder of my treatments.

*Warning...the following might be TMI for some people, but I promised I was going to be honest*

One side effect I was expecting was constipation related to all of the anti-nausea medications I was taking last weekend. I have actually developed the very opposite and have had diarrhea since Monday. I knew this was a potential side effect as well, but had no idea that the Taxotere would literally destroy my GI system. I had a very scary episode yesterday morning when my stool was black and tarry (a sign of bleeding higher up in the gastrointestinal tract). Since I was at work when it happened I did a hemoccult test on myself (a test that checks for blood in the stool) and it came back positive. I called my oncologist and they told me to start taking Immodium and have my blood count drawn at my clinic and faxed to them. Luckily I only had two episodes and it seems to have resolved now (the bleeding, not the diarrhea). Overall my blood counts are not too bad, but my platelets have already dropped to below normal limits.

Along with the diarrhea I have developed terrible stomach cramps. These seem to be the worst in the late afternoon and early evening, and also sometimes in the middle of the night. Today I developed thrush (a fungal infection in the mouth) and also some mouth sores. All of this combined with the fact that no food sounds appetizing has created a 3 1/2 pound weight loss since Monday (I have lost a total of 12 pounds since my diagnosis). I have really been trying hard to follow a very healthy, low fat diet since my diagnosis but right now that has all gone out the window. Eating is very difficult but I am forcing myself to do it, and trying to eat foods that are higher in calories and protein. I have started to "drink" more of my meals by making a smoothie with frozen bananas, greek yogurt, peanut butter, almond milk and ground flaxseed.

These past few days have been very difficult both physically and emotionally. I am trying to take advantage of any moments when I actually feel "good". I have a follow-up appointment and labs again tomorrow afternoon which I am looking forward to. The fatigue from the Neulasta has worn off and the true chemo fatigue hasn't hit me yet, but I have a feeling it will start soon. The only other side effects I have developed are dry skin (especially my hands) and acne, but that one is actually related to my IUD.

This weekend promises to be emotional again, as I am planning to pick out a wig and shave my head (pictures to come next week). I have certainly had my share of pity parties in the past few days, but I am trying to just take things minute by minute and hour by hour. I just have to keep hoping that along with the healthy cells dying there are cancer cells dying as well.

"The human spirit is stronger than anything that can happen to it." - C. C. Scott

Help me reach my goal for the Susan G. Komen Twin Cities 3-Day

Sunday, April 15, 2012

So far so good?

Chemo treatment #1: Check!

Friday morning was emotionally very difficult for me, but I was fortunate to be busy at work so my mind was mostly occupied. Derek brought me to the appointment and waited with me in the waiting room. Dr. Hartung's nurse called me back to check my vitals, and I thought I was going to lose it. Even once my doctor came in, I was still fighting back the tears. She went over all of my nausea medications with me and reviewed the side effects of the chemo treatment again. She really is wonderful and made me feel more at ease before treatment started. She walked me back to the chemo room and then it was go time.

I had a fabulous nurse for my first session. She made a me a little nervous about the port, however. Apparently it works the best if you put a big white blob of numbing cream over the port and secure it with a piece of Glad Press N Seal for an hour. Sometimes when you just rub it in your skin (like I did) it doesn't have the same effect. When she poked through the skin it really just felt like a shot or any other blood draw, so I think I will skip the Press N Seal  for now (not sure how I would explain that one to my last few patients of the day).

Once I was hooked up and running they started all of my anti-nausea medications (Dexamethasone, Aloxi and Emend). These took 30 minutes and during this time they had me watch an educational video about what side effects to expect from treatment and how best to manage them. Once those were in it was time for the Taxotere (1 hour), then the Carboplatin (1 hour), then the Herceptin (90 minutes). The initial Herceptin takes the longest, but from now on it only takes 30 minutes. My nurse learned early on what Derek has known for years...I have a bladder the size of a pea! I am making sure to drink almost 3 liters of water daily, so adding IV infusions to that means that I averaged a bathroom trip at least once an hour.

During the infusions I honestly felt fine both physically and emotionally. It feels good to have this process started, knowing that I can now be counting down to the final treatment. Derek sat with me for the last 20 minutes of the infusion (and handled it like a trooper!). I felt completely fine when we left, so we stopped to pick up some prescriptions, grabbed some Chinese takeout for dinner and even did some grocery shopping. 

About 4 hours after leaving I started to feel a little queasy. I'm not even so sure that I would go as far to call it nausea, but my stomach felt a little unsettled. I was tired anyway so I took Ativan (a medication to help me sleep and help with nausea) and went to bed. I slept straight through until 4am (I can't remember the last time that happened) but did wake up feeling a little unsettled again. An empty stomach can make nausea worse, so I took some Compazine (another prescription for nausea) and had some breakfast. 

Honestly...that is how this entire weekend has gone. No vomiting. No hovering near the toilet. Just me diligently taking my medications and snacking on something every few hours. I was going into this weekend expecting the worst so that I would be happy with anything better than that, but I never in my wildest dreams imagined that I would feel so...normal! I have had a few episodes of uncomfortable stomach cramping, but so far that's it! I have been taking advantage of this weekend and using my time to get some things done around the house and I ran some errands yesterday. I am a little nervous about the fatigue that it supposed to come later in the week, but I am hoping this weekend is a sign of things to come. I go back tomorrow for an injection of Neulasta (to help boost up my white blood cell count) and again on Friday afternoon for labs and to meet with their NP. This visit will mainly be to let them know how I did these weekend and see if they need to make any adjustments to my nausea medications (nope, keep them coming please)!

Thank you so much to everyone for your words of encouragement for the past several days. I really can't tell you enough how much they all mean to me. I'll post another update later in the week!

Aimee :)

Help me reach my goal for the Susan G. Komen Twin Cities 3-Day

Thursday, April 12, 2012

Pre-chemo Ramblings

Less than 24 hours until chemo round 1.

First I'll recap what's happened since my last post. Last Friday I had another fill with my plastic surgeon. I had some soreness over the weekend but it wasn't as bad as I was anticipating. Derek and I went home for the first time since my surgery, and probably the last time for a while (we plan to be home-bound for most of the summer). It was really great to see our families again and spend some time with everyone before chemo starts.

I had my IUD inserted on Monday afternoon. I will be the first to admit that I am a baby. I have little tolerance for pain. Let's just say I was glad it only took a few minutes.

My echocardiogram was Tuesday morning. This was probably the easiest procedure I've had since the beginning because all I had to do was lay there. I haven't actually heard about my results yet, but I imagine they would have let me know if my heart wasn't working well enough to start treatment tomorrow.

I wanted to show you all a picture of my port. This is how I will receive all of the infusions I need in the next year and will save my right arm from being ravaged every three weeks. I have a numbing cream to apply an hour before each treatment so that the needlestick won't hurt as much (this is standard...not just me being a baby). This was placed during surgery and I don't feel it at all. Most of the time I forget it's even there.

Derek is dropping me off and picking me up from treatment tomorrow, but this is something that I feel I need to do by myself, at least for the first time. I have magazines to catch up on and over a dozen books on my Nook to get through, so I certainly won't be bored. I also created a chemo playlist to listen to. No sad songs allowed, only songs that make me feel empowered and/or feel like dancing!

This week has by far been the hardest and most emotional since the initial diagnosis. I seem to cry at anything and everything. I feel nervous. I feel anxious. I feel mad. I feel sad. I feel terrified. I feel betrayed by my body. At the same time I feel lucky. Lucky that I found the tumor early. Lucky that I am stage 1. Lucky that with the help of modern medicine I have a better prognosis than I would have even 10 years ago. Lucky that I am alive.

Today I started taking the steroids that I have to take the day before, day of and day after each treatment to help with nausea and also to prevent fluid from building up in my lungs. Taking those made it officially real for me, and made the rest of the day particularly hard. After work I just couldn't seem to pull myself together, so I decided to go for a long walk. Once I started out I decided I really felt like a run, so that's exactly what I did. It was slower than I would like since these tissue expanders are like two hard rocks on my chest and didn't take well to a faster pace. I didn't care though. I was running. I was listening to my favorite running songs. It was EXACTLY what I needed tonight. Now I don't feel so sad. I don't feel so scared. I feel empowered. I feel strong.

Chemo may knock me down for a while, but I won't let it knock me out.
Help me reach my goal for the Susan G. Komen Twin Cities 3-Day

Wednesday, April 4, 2012

The Countdown Begins...

I will apologize in advance if this post gets long, but I have a LOT to update everyone on!

Today Derek and I met with my oncologist. I have once again lucked out in the doctor lottery because she is fabulous! She spent over an hour with us going over EVERYTHING, and she was very patient with all of my questions. I'll just start from the beginning of my notes.

I am now incredibly glad that I decided to have a bilateral mastectomy instead of a lumpectomy (which would have required chemo and radiation) or just a single mastectomy. She told me that the younger you are when you are diagnosed the higher the risk of a cancer developing in the opposite breast. This is also true of estrogen receptor negative tumors (which mine is). My general risk of recurrence if I were to only have the surgery is 30-35% (since I am stage 1 it is probably more like 25-30%). Adding the chemotherapy is going to decrease that risk to about 15% (again, since I am stage 1 it is more like 10-12%). As much as I hate the thought of chemo, I like those odds.

My initial BRCA 1 and 2 genetic tests were negative so I thought I was in the clear, but apparently not. Without going into all of the genetics, the standard BRCA testing only tests for a mutation using one method, and this method will detect 90% of the mutations. There is a separate method of testing that will pick up the other 10%, but it is not routinely done unless requested, and it is usually not covered by insurance. The out of pocket cost for this test is usually around $700. There is also a 1-2% chance that the cancer could have been caused by something called Li-Fraumeni syndrome, which I have never heard of prior to today. That test usually is covered by insurance, so I will be meeting with a genetic counselor to discuss all of this further and will have that test first. If that test is negative we will have to fork over the money for the other test. It is important to know if I have the BRCA mutation in particular, because it will also increase my risk of developing ovarian cancer (Li-Fraumeni syndrome does not). If I am in fact positive for the mutation then I would need to consider having a prophylactic oophorectomy (removal of my ovaries) before the age of 40. 

Now onto the important topic, the actual chemo treatments...

I have two options for treatment. Option #1 involves using two medications every other week for 4 cycles, then 2 different medications every week for 12 cycles. The first two medications would cause moderate to high levels of nausea and vomiting, but after that it shouldn't be much of an issue. This combination of drugs carries a slight risk of heart damage and development of a secondary leukemia.

Option #2 involves using a set of three medications (different from those in option #1) every 3 weeks. The nausea is usually a little less than option #1, but would last the entire time. Total treatment would be a few weeks less, and the risk of developing heart damage and leukemia are still present, but slightly lower.

I will lose my hair with either option.

Being able to work through my treatments is very important to me, so I struggled a bit with this decision. She told me that recurrence rates are very similar so we don't need to take those into account. She also said that if it was her she would choose option #2, but she wouldn't work during treatment. She also has three young children at home which she said would factor into her decision heavily. One of the medications I would need in option #1 is called Adriamycin, and it's nickname is the "red devil". I have read terrible things about this drug and really wanted to avoid it if I could.

I have decided on option #2, which is known as TCH  (Taxotere, Carboplatin and Herceptin). The Herceptin is the medication I will continue every three weeks for a year (instead of every week thank goodness). That medication is not really considered chemotherapy, but more of a biologic therapy. It won't really be contributing much to the side effects.

And now onto the side effects. The main ones she listed were mild to moderate nausea, constipation, diarrhea, hair loss, black nails, and of course the heart damage and leukemia. The other side effects that I could potentially develop (based on the prescribing information) include changes in taste, fatigue, muscle/bone/joint pain, increased eye tearing, mouth sores, changes in vision, weight loss, decreased appetite, stomach pain, and numbness/tingling in my fingers. Doesn't that all sound lovely? I have also read that many people actually gain weight during chemo. Another common side effects is something called "chemo brain" which has me worried. It means that my short term memory will be fried. I am already forgetting things and making multiple lists a day because of the stress, so I am terrified of that getting worse.

The good news is that they do the chemotherapy right at the office instead of the infusion center at the hospital. She gave me a tour before taking me to the lab to have my baseline blood counts and chemistry panel drawn. From now on I will fortunately be able to have them drawn at my clinic and faxed to her. I have to have a baseline echocardiogram (an ultrasound of my heart) on Tuesday morning and will need that repeated every three months during treatment.

I had a feeling this was coming, but she told me that I have to stop my birth control pill. Even though my tumor was negative for both estrogen and progesterone receptors (the two hormones used in most birth control pills), she still doesn't want me on pills. She would like me to use an IUD (intrauterine device) instead. Luckily this is my area of expertise. Whereas most women would be needing to make a consult appointment with someone like me and then coming back for another appointment to have the IUD inserted, I can have it done at any time in my clinic. While I am very comfortable inserting IUD's, I am not so thrilled about being on the other end of the procedure. I just keep telling myself to stop being such a baby...I mean I did just recover from a mastectomy! Alas, with the help of some good medications, I'll be having it inserted on Monday.

My first chemo session is now scheduled, and will be next Friday, April 13 (yes I know). Unfortunately my second treatment will be on my 29th birthday. I won't lie...that one has me depressed. I just keep telling myself that I have to sacrifice one birthday in order to have a lot more.

This has definitely been a whirlwind of a day, and I have a feeling that will continue for the next week and a half. At this point I really just want to say "bring it" and get this s**t over with!

I'll leave you with another one of my favorite quotes right now...

"You never know how strong you are until being strong is the only choice you have" -Unknown
Help me reach my goal for the Susan G. Komen Twin Cities 3-Day

Monday, April 2, 2012

My First {Official} Post

Hello everyone!

Welcome to my new blog. I have transferred all of my Caring Bridge posts to this site so that they will be easily accessible as well.

I have two main goals for this site. We have friends and family all over the US (and some in Europe too!) so this is the easiest way to keep everyone updated on my progress all at once. My other hope in starting this site is that eventually it will be found by other breast cancer patients. I cannot even begin to tell you how much I have been helped by reading other breast cancer and chemotherapy blogs, so I hope that this is my little way of paying it forward. I can read research articles and talk to health care professionals all day long, but when it comes to knowing what to expect after surgery and during chemotherapy there is nothing like hearing it straight from someone who has been there.

I will be straightforward with you...I plan to be very open and honest here. Everyone keeps telling me how strong I have been, and I am really trying my best to stay upbeat and positive.

I start chemo soon, and I make no promises that I can continue that.

I want to make this a very real account of what I am going through, and I have no illusions that it will be easy, or pretty. Most of you will never see it, but every once in a while I do cry. And get angry. And wonder "why me". I have a feeling those moments will become more and more frequent once treatment starts and I'm feeling miserable. That being said, those moments will be just as much a part of this journey as the happy and positive ones, so be prepared for everything.

Along with posting about my treatments I also plan to throw in some posts about the new lifestyle I am choosing to live (low-fat diet, alcohol free, more organic foods and natural products). When I post about these topics please do not feel that I am preaching to you (and someone PLEASE tell me if I come across that way). My only goal for these posts will be to give you insight into why I am choosing this lifestyle, not to convert anyone else.

Now for an actual update...

Remember that last update I posted where I said I was feeling great after my first fill of the tissue expanders? Well I wasn't feeling so great the next morning. I felt like I regressed by about a week in terms of my pain and discomfort. That also happened to be my first morning back at work which made things a little more interesting. I was able to tolerate the pain with Naproxen during work but took a Vicodin and a nap as soon as I was done. Fortunately the pain only persisted for the day and by Friday I was feeling back to normal. I was definitely ready for naps after both mornings of work, but am happy to say I haven't needed one since then. Today at work I felt much more like myself and was able to move around much easier than last week. I am still not doing any bigger procedures for the rest of the week but everything else is very doable for me.

I am back to exercising very regularly and am up to almost an hour each night (please don't freak out's not nearly at the level I was before surgery)! My biggest problem right now is honestly sleep. Last week I couldn't seem to fall asleep, but lately my body has just decided to nap for a few hours and then spend the rest of the night awake or sleeping very lightly. So far this has just been more frustrating than anything else, as I haven't really noticed any fatigue during the day. I do take various different medications for sleep occasionally, but I really don't want to become dependent on them (which I know I will).

I have an appointment with my oncologist on Wednesday, and I will be THAT patient that pulls out a page long list of questions. My biggest concerns right now are how many cycles I will need and how to best manage the side effects so that I can work as much as possible (not just for monetary reasons...I actually love my job).

Friday afternoon will be my next fill of the tissue expanders. This time I will be a little more prepared and pre-medicated for the pain I'm sure I will have on Saturday.

I want to leave you with a quote that I found while reading another breast cancer blog. It is so simple, yet it hit me incredibly hard. I say it my head over and over each day and it is now my new mantra for this journey.

"Live the life you're fighting for" - Leslie Moore

Sunday, April 1, 2012

Two Weeks Out and Feeling Great

March 28, 2012:

It has now officially been two weeks since my surgery, and I really am feeling great. I have been continuing to get better and better every day, and have even started getting in some regular exercise again. I am nowhere near my level of activity prior to surgery, but  I have been walking (outside and on the treadmill), and getting in some time on the elliptical as well. The most exercise I can do is usually 20 minutes at a time, but I'm hoping to increase that to 30 minutes by the end of next week.

I had a lot of visitors last weekend and I loved seeing everyone! By Sunday night I was completely exhausted, but it was all worth it.

Monday afternoon I had a post-op appointment with my breast surgeon, and she was very pleased with how I have been healing. I don't have to see her again until the end of September (unless any issues arise).

Today has probably been the best day so far, mainly because I just got home from an appointment with my plastic surgeon and I no longer have my drains! I was worried that it would be painful to have them removed, but really it was more awkward than anything else. I feel a little soreness on the left side but that's about it. I am thrilled to not have to carry them around in a pouch anymore!

Today was also my first "fill" with my plastic surgeon. At the time of surgery he placed 170cc's in each tissue expander. During the fills he uses a device to find the port in each expander, then places a small needle through the port. The needle is attached to a small catheter, which in turn is attached to a syringe. He put an additional 50cc's of saline in each side, bringing my total to 220. I will go back again every week and he will continue to fill until I am happy with the size of the expansion. I had heard that this process was very uncomfortable because of the stretching of the skin, but it really wasn't. It was definitely a very strange sensation, and my chest feels a little tighter now, but I have no pain!

Tomorrow will be my first day back at work and I am really looking forward to it. I will work half days until next Wednesday, and then I will finish next week by working 3/4 days (until 3pm), then the following week I will jump back into my regular schedule. I think I will definitely be ready for naps in the afternoon, but I am glad to have the opportunity to gradually ease back into the swing of things.

Post Op Day 8

March 22, 2012:

Well it has officially been over a week since my surgery now. It really feels like it was all just yesterday, but I am happy to be putting it even further behind me.

The past two days have been my best so far. I am taking naproxen just occasionally for pain during the day (I only took it twice today), but I still take my stronger pain medicine at night (mostly to help me sleep better). For the past two nights I have been able to sleep in bed again, and I have actually been sleeping well! I really feel that getting a good night's sleep has made a big difference in how I have been feeling lately. I am moving around the house without any problems and have been doing more for myself. It took me some time, but I was able to completely empty the dishwasher and put everything away this morning!

I had my first post-op appointment yesterday and my doctor feels I am healing nicely. I was really hoping to have my drains removed, but he said it is still too early. I have another appointment next Wednesday and they should come out then (they better, since I start back at work the next day)! I won't lie, I was pretty bummed out after the appointment, but Derek knew that taking me out for ice cream would make me feel better :)

Today I had a meeting with the two women who handle marketing for our clinic. In the next few weeks I will likely be discontinuing the caringbridge site and creating a blog instead. Most of you know that I had my own baking blog for about a year and a half, but I decided to stop that this past December. I am looking at starting this new blog  as an entirely new experience and feel that instead of causing me stress, it will most likely help me de-stress. Once everything is up and running I will post the address so you can all continue to follow my progress.

After that meeting I stopped in to the clinic and was able to see some of my co-workers, and had lunch with two of them. It really felt great to get out of the house and start to feel "normal" again. We have friends staying with us this weekend and will be seeing a lot of different people which I am really looking forward to as well.There is a group of us going to see The Hunger Games this weekend, which I have been looking forward to for months.

I hope you all have a fantastic weekend!

Post Op Day 5

March 19, 2012:

I apologize for not doing an update yesterday. It's hard to believe that it has been 5 days since my surgery already! I imagined this time going by very slowly, but actually it all seems like a blur.

Overall I continue to improve each day. I am trying to spend more and more time out of the recliner and up moving around. Since the weather has been fabulous I try to go for 2 short walks outside each day. I was originally taking my pain medication every 4 hours but I can usually get by with every 6 now, and I hope to continue to slowly wean down from that. Getting up in the morning is always the hardest as I am very stiff and sore. I have a particular area on my right side that can be quite painful and sometimes makes it difficult to talk or catch my breath.

Having my parents here over the weekend was a great help! We decided to send the dogs home with them for the week. They still get a little jumpy sometimes. Derek will be working from home while I recover, but we figured it might be too much for him to try to work, take care of me and both dogs! He has been absolutely fantastic and supportive throughout this entire process. He has even been emptying my drains twice a day (a shock for anyone who knows him)!

Speaking of my drains, I don't think I have mentioned them yet. I have one on each side, sewn into my upper lateral chest area. We empty them twice a day and measure the amount from each side. I have been around 15 cc/day, and if that continues over the next few days then I should be able to have them removed at my first post-op appointment on Wednesday.

I have my oncology appointment scheduled for Wednesday April 4th. This will be the major appointment to fully discuss my risk of recurrence and treatment with chemotherapy and Herceptin. I will most likely have to undergo a few more tests after that appointment but I should be starting chemo by the end of the following week.

Thank you all again for your love and support...I have a LOT of thank you cards to start working on!

Post Op Day 3

March 17, 2012:

From Derek:

Aimee asked me to do an update. Right now she is resting peacefully in the reclining chair (best seat for her currently). She made it home yesterday afternoon and things have been going wonderfully. She is definitely still sore, but glad to be home. We have her setup in our living room with a table next to her for everything she needs to be close by. We decided to send the puppies home with my mom yesterday because we were afraid they would jump up on her. 
Aimee's parents came back up this morning and brought the puppies back home. We introduced them slowly to Aimee and they have been doing great. A couple of times they have crawled up on her pillow in her lap and just laid there. They likely sense that she is not feeling the best and have been pretty good thus far. 
When we got home yesterday we were greeted by more flowers and cards waiting at our door for Aimee. We also got a nice surprise from my office as they sent quite the meal over for us to enjoy. Thank you to everyone for the support and gifts.
Overall, things are going quite well. It will be a slow but sure process to get her back to feeling 100%. We will continue to send out updates on how she is feeling and how recovery is going. Until then...

Post Op Day 2

March 16, 2012:

Good morning everyone! I am definitely I much better spirits today! I was able to get a decent amount of sleep last night which has made a big difference. I also haven't had any more nausea so I was able to eat dinner last night and breakfast this morning. I am still sore and moving pretty slowly, but I did walk around the halls for a while last night.
My breast surgeon called me this morning to let me know she will come to see me around 1130 and that I can go home sometime this afternoon. She also let me know that the final pathology came back and the nodes were still clear (sometimes they can appear fine initially but with special staining cancer cells can be found)!

Derek's mom will be leaving after I get settled at home, and my parents will be coming back up tomorrow morning and staying the rest of the weekend. I am very excited to be going home, but also a little worried about how much I'm going to be restricted. Anyone who knows me knows that I don't do well doing nothing, or having to rely so much on other people...but I KNOW that I'm going to have to get used to it.

Several people have expressed interest in visiting, and I would absolutely love that! I just ask that you call Derek's phone first or text me. So far I am fine texting but holding the phone to talk gets very uncomfortable.
Thank you again for your love and support and I hope you all have a wonderful day!

Post Op Day 1

March 15, 2012:

From Derek:

We came to see Aimee right away at 8 am this morning. She was more alert than last night. She has been battling some nausea issues, but the nurses are working to get that under control for her. She hasn't been able to eat anything but she hopes to soon. At this point she is definitely going to be here through tomorrow it looks like.

From Aimee:

Hello everyone! I'm typing this from my phone so I'm going to try to keep this short, but I just wanted to let you all know that I am doing well. I really didn't get much sleep last night and was very sick this morning, but we have played around with my meds and I'm feeling much better now! I am definitely very sore, but the pain is manageable. My bladder catheter came out earlier today and now I have to pee every 10 minutes which is starting to get annoying. I was able to eat a little for lunch (and keep it down). Getting in and out of bed is starting to get easier, and I have a great nurse today which has been nice. Derek and his mom have been taking very good care of me and I am very thankful for that.

Thank you all so much for your love and support! I read and appreciate every single message as they truly help lift my spirits!

Surgery Updates

March 14, 2012:

From Derek:
I wanted to provide a brief update on Aimee's surgery progress. We made it to the hospital this morning at 930 AM. Aimee had her pre-op work done and then we had to wait for a couple of hours until her surgery was set to begin. She left for surgery at 1:30 PM and the first surgeon said she would stop out and give us an update after she completed her part. 
The first surgeon just stopped out at 3:30 PM and told us some GREAT news! She said that Aimee's surgery went great. She also told us that she examined Aimee's lymph nodes and there is no spread to them (the BEST news we could get at this point). She said the next surgeon will likely be out in a few hours with the final surgery update. Then she will need to recover for an hour or so before we get to see her.
Thank you everyone for your support and prayers. 
More updates to come!

Surgery  Update #2:
We just had Aimee's 2nd (and final) surgeon stop in. He said things went extremely well and he was able to complete his final part of the surgery. He said she will be extremely sore (due to it being on both sides), but other than that he expects that she should be able to come home in a day or two. Knowing how motivated Aimee is, she will likely want to try and come home tomorrow (likely late afternoon or evening). The Surgeon said it is 50/50 chance, otherwise she will likely come home Friday sometime. 
We will be able to see her in about an hour the Dr. said. I will post one final update once that happens. 
Once again, thank you all for the support and prayers. 
Surgery Update #3:
We were able to go see Aimee in her room. She was awake, but definitely a bit groggy. She had gotten a call already from her first surgeon to let her know how well the first part of the surgery had gone. She was ready for some ice chips (since she hasn't been able to eat or drink anything since early this morning). Myself and family members visited briefly before she was ready to try and go to sleep for the night. She was happy to have the surgery over with and ready to start her initial recovery. 

Ready For The Big Day

March 13, 2012:

I started out the day with another visit with my plastic surgeon, Dr. Thao. He did all of his markings for surgery tomorrow (meaning he basically drew all over my chest with a sharpie). I wish I would have known that he was going to draw a line down the middle of my chest starting at the top of my sternum. The shirt I wore today didn't cover the top of the line and I felt like patients were staring at it all day. It was unbelievably hot in the office today so unfortunately my sweat smeared some of the sharpie onto the inside of my shirt, but I've learned not to be so bothered by the little things :)

The other news of the day is that my genetic test results came back and are negative (meaning the cancer is not caused by an inherited genetic mutation). I have mixed feelings about this...part of me was hoping for it to be positive so that I could have a definite cause for the cancer. The other part of me is relieved that no one else in my family will have to worry about having inherited the gene.

My fabulous co-workers are responsible for the highlight of my day...

I have had my eye on a particular Coach purse for a while now, but decided not to spend the money on it in light of everything else going on. This afternoon the entire office ambushed me at my desk and surprised me with the purse! I was so shocked and grateful that even now, thinking about it with a smile on my face, I have a hard time putting my feelings into words. Simply put, I work with an amazing group of people!

All of your phone calls, comments, emails, texts and messages have truly humbled and amazed me. I am sorry if I have not responded to each one individually, but please know that they do not go unnoticed. I feel good going into tomorrow knowing that so many people are thinking about me. I love you all!

Two Days and Counting

March 12, 2012:

I have to start by saying that I have the greatest breast surgeon that anyone could ever hope for! She actually called me over the weekend to let me know she had been thinking more about my surgery and wanted to talk to me about the option of a nipple sparing mastectomy (NSM). Initially she wasn't sure I was a candidate, but after thinking about it more and talking to my plastic surgeon they both agree that I am. She wanted to talk to me in person about it but because of my pre-op appointment I didn't have time to get to her office in St. Paul and then back to Woodbury in time. She was operating in Maplewood so she offered to stop by MY office after she was done and we basically had my "appointment" there!

The NSM would involve a different incision and removal of most of the tissue below the nipple, but not the nipple itself. The tissue would be sent to the lab during surgery and if there were any cancerous or atypical cells present then I would no longer be a candidate and the nipple and areola would have to be removed. If the final pathology report (that comes back 3 days after surgery) showed any abnormal cells then I could end up having the nipple removed anyway, just several days after the initial surgery. There is also a small risk of necrosis, meaning that the nipple tissue would start to die after surgery and require removal.

Dr. Schmidt gave me some articles to review and told me to think about it. Initially I was excited about the idea, but after reading the articles I am concerned about a slightly higher risk of recurrence reported in the literature (about 3%). At this point the main benefit would be cosmetic, and my highest levels of anxiety stem from the fear of recurrence, so I have decided not to have that procedure. I will just be sticking with the typical mastectomy with some options for nipple reconstruction at a later date.

My pre-op appointment went fine. It was with a family practice nurse practitioner, whose office is just down the hall from my plastic surgeon. My vital signs all looked great, my hemoglobin level is excellent, and I'm not pregnant! She cleared me for surgery without any problems, so almost everything is in place now.

I have one more appointment with the plastic surgeon tomorrow morning. He will be doing all of the markings he will need for surgery. I should be getting a phone call from the hospital tomorrow letting me know what time I need to be there. My parents, younger brother and his fiance, mother-in-law and sister-in-law will all be there the day of surgery so I hope they have a big waiting room! Dr. Schmidt anticipates me going home on Friday, which is what I am hoping for as well. Derek will be posting an update Wednesday once I am out of surgery, but I will try my best to be updating myself on Thursday!

The First of Many Appointments

March 8, 2012:

Yesterday was the big day that we had been waiting for. I had my first appointment with my plastic surgeon, Dr. Thao. He was very understanding and sympathetic since his sister had breast cancer at a young age as well.
It started out with him taking pictures (a tad bit awkward!) and doing a lot of measurements of both breasts. Then we talked more in detail about the surgery.
The first 1 1/2 - 2 hours of surgery time will be with my breast surgeon, Dr. Schmidt. She will perform a sentinel node biopsy first to see if there has been any spread into the lymph nodes. If there has been then she will need to remove several more nodes. Once she has finished her part of the surgery then Dr. Thao will come in to begin the reconstruction process. His portion of the surgery will take approximately 3 hours.
I will not actually be coming out of surgery with breast implants. I will have what are called tissue expanders placed on each side. The tissue expanders will be filled with approximately 100cc of saline initially. I will then go back every 1-2 weeks after surgery to have more saline inserted (about 50cc at a time). I have heard that this process can be very uncomfortable, but this will allow for the stretching and expansion of my skin. Once I am comfortable with the size of the tissues expanders I will have to leave them in place for a few more months and let the skin "settle" in that position. After I finish chemo I will then go back in for another surgery to have the actual silicone implants placed.
Dr. Thao's surgery schedule is booked out for the next 6 weeks, but fortunately he was very willing to rearrange some things, so I am on the schedule for Wednesday March 14 at 2pm. They expect me to stay in the hospital for 2-3 days.
Mentally, I am very glad to have the surgery scheduled so soon, as I want nothing more than to get rid of the cancerous tumor inside me. With that being said, having the surgery scheduled now makes everything more "real" (although this entire experience still seems very surreal to me). Stress has been starting to take its toll on my body, as I am noticing more fatigue, decreased appetite and problems sleeping. My anxiety levels have been on the rise but I have only needed to take medication twice. For the most part I just keep focusing on each next step I need to take and organizing my life to make things easier after surgery.
I really do appreciate all of your thoughts and comments. It means the world to me knowing that there are so many people out there who care. I am trying to be very open and honest about the entire process. If you have any medical questions or want to know more about any of my procedures please feel free to ask. Luckily I am in the position to comprehend all of this information a little better than most!

And so it begins...

March 3, 2012:

As a women's health nurse practitioner, I do breast exams every day. I considered myself just like the average women by only doing my own breast exams every so often. In early February 2012 I found a lump in my left breast. I had my period at the time and we were leaving for vacation in Hawaii two days later, so I decided not to worry about it until we got back. With the stress and business of assimilating back to normal life, I honestly forgot about it for a week and a half. While doing another exam I realized that it hadn't changed. I really thought it was just an area of particularly dense breast tissue, but felt I should probably have it looked at, just in case.

I had an ultrasound and mammogram performed on February 24. The radiologist informed me that there was a mass and that it was very concerning, so I would need to schedule a biopsy. After he left I asked the ultrasound technician to review my scan with me and tell me exactly what was concerning. "Irregular borders, calcifications, and more tall than wide". Those were the words running through my head for the rest of the weekend. It only took me a few Google searches to realize that I, most likely, had breast cancer.

I am very lucky to work where I work, and with who I work with. On Monday morning, February 27, I was able to see a breast surgeon right away. She got me set up for a biopsy right away the next morning. On Tuesday February 28th, just a few hours after the biopsy, the doctor confirmed that it was in fact cancer.

My finally pathology came back just the next day: Grade 3 invasive ductal carcinoma. My particular cancer is negative for both estrogen and progesterone receptors (meaning that these hormones are not feeding the cancer), but positive for the HER2/neu receptor. This means that I do have an increased risk of recurrence, especially in the first 5 years, and that this particular cancer is more aggressive than others.

I have decided to undergo a bilateral mastectomy with reconstruction. I will need at least 4-6 cycles of chemotherapy at 3 week intervals, plus a weekly infusion of a medication called Herceptin for one year.

Derek or I will try to update this website frequently to keep all of our friends and family informed of my progress.